©© 2008 American College of Clinical Pharmacology, Inc.
The Journal of Clinical Pharmacology
, 10.1177/0091270008315314
Disposition and Antimuscarinic Effects of the Urinary Bladder Spasmolytics Propiverine: Influence of Dosage Forms and Circadian-Time Rhythms
Karen May 1,
Kristin Westphal 2,
Thomas Giessmann 1,
Danilo Wegner 1,
Ulrike Adam 3,
Markus M. Lerch 4,
Reinhard Oertel 5,
Rolf W. Warzok 6,
Werner Weitschies 3,
Manfred Braeter 7,
and
Werner Siegmund 1*
1 Department of Clinical Pharmacology, University of Greifswald
2 Department of Anesthesiology and Intensive Care, University of Greifswald
3 Department of Biopharmacy and Pharmaceutical Technology, University of Greifswald
4 Department of Internal Medicine A, University of Greifswald
5 Department of Clinical Pharmacology, University of Technology, Dresden
6 Department of Pathology, University of Greifswald
7 Apogepha Arzneimittel GmbH, Dresden
* To whom correspondence should be addressed. E-mail: siegmuw{at}uni-greifswald.de.
 |
Abstract |
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Propiverine extended release is expected to be better tolerated compared to immediate release tablets because of slower drug release and reduced formation of active metabolites in the colon. CYP3A4 and ABCC2, the major variables in pharmacokinetics of propiverine, are less expressed in the colon. Therefore, disposition and pharmacodynamics of propiverine were measured in a double-blind, double-dummy, crossover study with administration of 15 mg immediate release 3 times daily for 7 days compared to 45 mg extended release once daily for 7 days in 24 healthy subjects. Twelve subjects also received 15 mg propiverine intravenously. Serum and urine propiverine levels were measured repeatedly following oral administration on day 7 for up to 72 hours and correlated to duodenal expression of CYP3A4, ABCB1, and ABCC2. Propiverine immediate release 3 times daily was not different to extended release once daily in areas under the serum concentration-time curve (0-24 hours) and peak-trough fluctuation. The areas under the serum concentration-time curve of propiverine immediate release was circadian-time–dependent, with the lowest values during the night. Disposition of intravenous propiverine and propiverine immediate release administered in the night was influenced by intestinal expression of ABCC2. We concluded that oral absorption of propiverine is site-dependent and influenced by dosage form and circadian-time–dependent elimination processes.
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