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Population pharmacokinetics of levamisole in children with steroid‐sensitive nephrotic syndrome
Author(s) -
KreeftmeijerVegter A. R.,
Dorlo T. P. C.,
Gruppen M. P.,
Boer A.,
Vries P. J.
Publication year - 2015
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12607
Subject(s) - levamisole , pharmacokinetics , volume of distribution , population , medicine , nephrotic syndrome , endocrinology , gastroenterology , environmental health
Aim The aim was to investigate the population pharmacokinetics of levamisole in children with steroid‐sensitive nephrotic syndrome. Methods Non‐linear mixed effects modelling was performed on samples collected during a randomized controlled trial. Samples were collected from children who were receiving 2.5 mg kg –1 levamisole (or placebo) orally once every other day. One hundred and thirty‐six plasma samples were collected from 38 children from India and Europe and included in the analysis. A one compartment model described the data well. Results The apparent clearance rate (CL/ F ) and distribution volume ( V / F ) were 44 l h –1 70 kg –1 and 236 l 70 kg –1 , respectively; estimated interindividual variability was 32–42%. In addition to allometric scaling of CL/ F and V / F to body weight, we identified a significant proportional effect of age on CL/ F (–10.1% per year). The pharmacokinetics parameters were not affected by gender, tablet strength or study centre. The median (interquartile range) maximum plasma concentration of levamisole was 438.3 (316.5–621.8) ng ml –1 , and the median area under the concentration–time curve was 2847 (2267–3761) ng ml –1 h. Median t max and t ½ values were 1.65 (1.32–2.0) h and 2.60 (2.06–3.65) h, respectively. Conclusions Here, we present the first pharmacokinetic data regarding levamisole in children with steroid‐sensitive nephrotic syndrome. The pharmacokinetic profile of levamisole in children was similar to findings reported in adults, although the elimination rate was slightly higher in children.