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Ketek

Clinical Pharmacology
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CLINICAL PHARMACOLOGY

Pharmacokinetics

Absorption: Following oral administration, telithromycin reached maximal concentration at about 1 hour (0.5 - 4 hours).

It has an absolute bioavailability of 57% in both young and elderly subjects.

The rate and extent of absorption are unaffected by food intake, thus KETEK tablets can be given without regard to food.

In healthy adult subjects, peak plasma telithromycin concentrations of approximately 2µg/mL are attained at a median of 1 hour after an 800-mg oral dose.

Steady-state plasma concentrations are reached within 2 to 3 days of once daily dosing with telithromycin 800 mg.

Following oral dosing, the mean terminal elimination half-life of telithromycin is 10 hours.

The pharmacokinetics of telithromycin after administration of single and multiple (7 days) once daily 800-mg doses to healthy adult subjects are shown in Table 1.

Table 1

  Mean (SD)
Parameter Single dose (n=18) Multiple dose (n=18)
Cmax (µg/mL) 1.9 (0.80) 2.27 (0.71)
Tmax (h)* 1.0 (0.5-4.0) 1.0 (0.5-3.0)
AUC(0-24) (µg•h/mL) 8.25 (2.6) 12.5 (5.4)
Terminal t½ (h) 7.16 (1.3) 9.81 (1.9)
C24h (mg/mL) 0.03 (0.013) 0.07 (0.051)
* Median (min-max) values
SD=Standard deviation
Cmax=Maximum plasma concentration
Tmax=Time to Cmax
AUC=Area under concentration vs. time curve
t½=Terminal plasma half-life
C24h =Plasma concentration at 24 hours post-dose

In a patient population, mean peak and trough plasma concentrations were 2.9µg/mL (±1.55), (n=219) and 0.2 µg/mL (±0.22), (n=204), respectively, after 3 to 5 days of KETEK 800 mg once daily.

Distribution: Total in vitro protein binding is approximately 60% to 70% and is primarily due to human serum albumin.

Protein binding is not modified in elderly subjects and in patients with hepatic impairment.

The volume of distribution of telithromycin after intravenous infusion is 2.9 L/kg.

Telithromycin concentrations in bronchial mucosa, epithelial lining fluid, and alveolar macrophages after 800 mg once daily dosing for 5 days in patients are displayed in Table 2.

Table 2

  Hours
post-dose
Mean concentration (µg/mL) Tissue/
Plasma
Ratio
Tissue or
fluid
Plasma
Bronchial mucosa 2 3.88* 1.86 2.11
12 1.41* 0.23 6.33
24 0.78* 0.08 12.11
Epithelial lining fluid 2 14.89 1.86 8.57
12 3.27 0.23 13.8
24 0.84 0.08 14.41
Alveolar macrophages 2 65 1.07 55
8 100 0.605 180
24 41 0.073 540
*Units in mg/kg
Brand Name: Ketek
Generic Name: Telithromycin

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