S-Carboxymethyl-l-cysteine : a multiple dosing study using pharmacokinetic modelling

S-Carboxymethyl-l-cysteine is a mucolytic agent used as adjunctive therapy in the treatment of respiratory disorders. Various mechanisms of action have been proposed but few studies have attempted to link the required in vitro concentrations with those achieved actually in vivo during clinical therapy.The data from several published studies has been re-analysed by WinNonlin using non-compartmental analysis modelling, Phoenix modelling and Classic PK compartmental modelling for both single (500-1500 mg) and multiple oral administration of the drug.Multiple dose modelling indicated maximum peak concentrations (Cmax) ranging from 1.29 to 11.22 μg/ml and those at steady state (Css(av)) from 1.30 to 8.40 μg/ml. For the standard therapeutic regimen of 3 × 750 mg (2250 mg/day) these values were 1.29-5.22 μg/ml (Cmax) and 1.30-3.50 μg/ml (Css(av)). No accumulation was observed.Hence, only the pharmacodynamic studies reporting significant effects below c.10 μg/ml were likely to occur in vivo and these were mainly gene-related mechanisms. The majority of events, although demonstrable in vitro, required levels much greater than possible to achieve in the clinical situation.Such unappreciated disregard for in vitro-in vivo 'concentration matching' may lead to erroneous conclusions regarding mechanisms of action for many drugs as well as for S-carboxymethyl-l-cysteine.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:51

Enthalten in:

Xenobiotica; the fate of foreign compounds in biological systems - 51(2021), 8 vom: 19. Aug., Seite 865-870

Sprache:

Englisch

Beteiligte Personen:

Steventon, Glyn B [VerfasserIn]
Mitchell, Stephen C [VerfasserIn]

Links:

Volltext

Themen:

Cysteine
Expectorants
Journal Article
K848JZ4886
Pharmacodynamics
Pharmacokinetics
Pharmacometric modelling
S-Carboxymethyl-l-cysteine

Anmerkungen:

Date Completed 23.07.2021

Date Revised 23.07.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/00498254.2021.1928330

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM325260419