The effect of sevelamer carbonate and lanthanum carbonate on the pharmacokinetics of oral calcitriol
| Autor: | Antoine Robinson, Michael Smyth, Lynne Poole, Heather Van Heusen, Patrick Martin, David M. Pierce, Stuart Hossack |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male calcitriol medicine.medical_specialty Calcitriol Cmax Administration Oral chemistry.chemical_element Sevelamer sevelamer carbonate Young Adult chemistry.chemical_compound Lanthanum Oral administration Internal medicine Polyamines polycyclic compounds medicine Humans Tissue Distribution Chelating Agents lanthanum carbonate Transplantation Cross-Over Studies business.industry Area under the curve Middle Aged Lanthanum carbonate Endocrinology chemistry Nephrology Kidney Failure Chronic Carbonate Female Original Article lipids (amino acids peptides and proteins) bioavailability business chronic kidney disease medicine.drug |
| Zdroj: | Nephrology Dialysis Transplantation |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfq598 |
| Popis: | Background. Lanthanum carbonate and sevelamer carbonate are non-calcium-based phosphate binders used to manage hyperphosphataemia in patients with chronic kidney disease (CKD). Patients with CKD may require intravenous or oral active vitamin D. We investigated the effects of lanthanum carbonate and sevelamer carbonate on the bioavailability of oral calcitriol. Methods. This was a three-period, crossover study in healthy volunteers. Forty-one individuals were randomized to one of six possible sequences, each consisting of three treatment periods separated by washouts. The treatments were calcitriol (1 μg at lunch), calcitriol with lanthanum carbonate (3000 mg/day) and calcitriol with sevelamer carbonate (7200 mg/day). Serum calcitriol levels were assessed at baseline and throughout the study. Results. Co-administration of lanthanum carbonate with calcitriol had no significant effect on area under the curve over 48 h (AUC0–48) for serum exogenous calcitriol [least-squares (LS) mean, calcitriol with lanthanum carbonate vs calcitriol alone: 429 pg h/mL vs 318 pg h/mL, respectively; P = 0.171]. Similarly, there was no significant effect on maximum concentration (Cmax). In contrast, co-administration with sevelamer was associated with a significant reduction in bioavailability parameters for calcitriol (calcitriol with sevelamer carbonate vs calcitriol alone, LS mean AUC0–48: 137 pg h/mL vs 318 pg h/mL, respectively; P = 0.024; LS mean Cmax: 40.1 pg/mL vs 49.7 pg/mL, respectively; P < 0.001). Conclusions. Sevelamer carbonate significantly reduces serum concentrations of exogenous calcitriol when administered concomitantly with oral calcitriol, whereas lanthanum carbonate has no significant effect. This should be considered when treating CKD patients who require phosphate binders and oral vitamin D. |
| Databáze: | OpenAIRE |
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