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Ketek
CLINICAL PHARMACOLOGY
Ketek
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 | ||||
Generic Name: Telithromycin
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