Single- vs Multiple-Dose Pharmacokinetics of Clozapine in Psychiatric Patients

Miles G. Choc, Francis Hsuan, Gilbert Honigfeld, William T. Robinson, Larry Ereshefsky, Miles L. Crismon, Stephen R. Saklad, Jack Hirschowitz, Richard Wagner

    Research output: Contribution to journalArticlepeer-review

    72 Scopus citations

    Abstract

    Clozapine plasma levels were monitored in 16 patients during a series of three consecutive treatments (single dose–multiple dose–single dose). Each patient received a single 75-mg dose (3 × 25 mg) with clozapine tablets, and serial plasma samples were collected over 48 hr after the dose. At 48 hr, a multiple-dose regimen was started, consisting of an initial dose escalation period followed by dosing at a constant regimen for at least 6 days. After the last dose, serial plasma samples were again obtained over 72 hr. Drug was then withheld for at least 7 days, a final single 75-mg dose was given, and plasma sampling was repeated. A subset of the patient population (N = 7) was used to test for a food effect during the single-dose treatments. The pharmacokinetic parameters between the initial and the final single dose periods were not significantly different. Similarly, there were no differences within patients when given the dose after fasting (fed 1 hr after dose) or with a meal. In contrast, the terminal elimination rate differed between the single-dose and the multiple-dose treatments (t(Formula presented.)m3 = 7.9 hr single dose and 14.2 hr multiple dose) (P < 0.05) and the dose-normalized area under the plasma concentration/time curves increased 27% with multiple dosing. Since a previous study in patients (Choc et al., Pharm. Res. 4:402–405, 1987) showed dose proportionality of clozapine plasma concentrations during multiple-dose regimens, the present results cannot be described by Michaelis–Menten kinetics.

    Original languageEnglish (US)
    Pages (from-to)347-351
    Number of pages5
    JournalPharmaceutical Research: An Official Journal of the American Association of Pharmaceutical Scientists
    Volume7
    Issue number4
    DOIs
    StatePublished - Apr 1990

    Keywords

    • clozapine
    • pharmacokinetics
    • single- vs multiple-dose regimen

    ASJC Scopus subject areas

    • Biotechnology
    • Molecular Medicine
    • Pharmacology
    • Pharmaceutical Science
    • Organic Chemistry
    • Pharmacology (medical)

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