title: Comparison of Capillary and Venous Plasma Drug Concentrations After Repeated Administration of Risperidone, Paliperidone, Quetiapine, Olanzapine, or Aripiprazole.
abstract: Quantification of blood levels of antipsychotic drugs may be useful for managing medication therapy. This open-label, parallel-group study was performed to compare finger-stick-based capillary with corresponding venous plasma concentrations for risperidone, paliperidone, quetiapine, olanzapine, and aripiprazole and their major metabolites after repeated dosing in patients with schizophrenia or related illnesses. Finger-stick-based capillary and venous blood samples were collected at various times within a dosing interval. All drug concentration measurements in the derived plasma samples were performed with validated liquid chromatography-tandem mass spectrometry methods. Finger-stick-based capillary and venous plasma drug concentrations after repeated dosing were generally similar. Olanzapine capillary plasma concentrations, however, were on average approximately 20% higher than venous concentrations, with a trend for a relatively greater difference occurring shortly after dosing. In addition, smaller capillary-venous differences were observed for extended-release and long-acting intramuscular formulations and for aripiprazole, a drug with a long half-life, compared with drugs administered as an immediate-release formulation (risperidone, olanzapine). After repeated dosing, plasma derived from finger-stick-based blood was observed to be predictive of the venous concentrations. Capillary sampling may be an appropriate alternative to venous sampling to readily evaluate systemic drug concentrations.
authors.affiliation: Janssen Research & Development, Division of Janssen Pharmaceutica NV, Beerse, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Remmerie
authors.affiliation: Janssen Research & Development, Division of Janssen Pharmaceutica NV, Beerse, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Meulder
authors.affiliation: Janssen Research & Development, LLC, Raritan, NJ, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Ariyawansa
authors.affiliation: Janssen Research & Development, LLC, Raritan, NJ, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Savitz
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000097:blood*; D000068180:Aripiprazole / Q000493:pharmacokinetics; D001569:Benzodiazepines / Q000493:pharmacokinetics; D001800:Blood Specimen Collection / Q000379:methods; D002196:Capillaries / Q000378:metabolism*; D005260:Female; D005385:Fingers; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D000068882:Paliperidone Palmitate / Q000493:pharmacokinetics; D000069348:Quetiapine Fumarate / Q000493:pharmacokinetics; D018967:Risperidone / Q000493:pharmacokinetics; D012559:Schizophrenia / Q000188:drug therapy / Q000378:metabolism; D014680:Veins / Q000378:metabolism*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D000068180:Aripiprazole; D018967:Risperidone; D000077152:Olanzapine; D000068882:Paliperidone Palmitate
keywords: antipsychotic drug monitoring; antipsychotics; aripiprazole; capillary concentrations; olanzapine; paliperidone; quetiapine; risperidone; venous concentrations