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iamlisheng

木虫 (小有名气)

[求助] 药代动力学(医药专业)

12.3 Pharmacokinetics
Absorption
After single dose administration of REXULTI tablets, the peak plasma brexpiprazole
concentrations occurred within 4 hours after administration; and the absolute oral
bioavailability was 95%. Brexpiprazole steady-state concentrations were attained within
10-12 days of dosing.
REXULTI can be administered with or without food. Administration of a 4 mg REXULTI tablet
with a standard high fat meal did not significantly affect the Cmax or AUC of brexpiprazole.
After single and multiple once daily dose administration, brexpiprazole exposure (Cmax and
AUC) increased in proportion to the dose administered. In vitro studies of brexpiprazole did
not indicate that brexpiprazole is a substrate of efflux transporters such as MDRI (P-gp)
and BCRP.
Distribution
The volume of distribution of brexpiprazole following intravenous administration is high
(1.56±0.42 L/kg), indicating extravascular distribution. Brexpiprazole is highly protein
bound in plasma (greater than 99%) to serum albumin and a1-acid glycoprotein, and its
protein binding is not affected by renal or hepatic impairment. Based on results of in vitro
studies, brexpiprazole protein binding is not affected by warfarin, diazepam, or digitoxin.
Elimination
Metabolism
Based on in vitro metabolism studies of brexpiprazole using recombinant human
cytochrome P450 (CYP1A1, 1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, and 3A4),
the metabolism of brexpiprazole was shown to be mainly mediated by CYP3A4 and
CYP2D6.
In vivo brexpirazole is metabolized primarily by CYP3A4 and CYP2D6 enzymes. After
single- and multiple-dose administrations, brexpiprazole and its major metabolite,
DM-3411, were the predominant drug moieties in the systemic circulation. At
steady-state, DM-3411 represented 23% to 48% of brexpiprazole exposure (AUC)
in plasma. DM-3411 is considered not to contribute to the therapeutic effects of
brexpiprazole.
Based on in vitro data, brexpiprazole showed little to no inhibition of CYP450
isozymes.
Excretion
Following a single oral dose of [14C]-labeled brexpiprazole, approximately 25%
and 46% of the administered radioactivity was recovered in the urine and feces,
respectively. Less than 1% of unchanged brexpiprazole was excreted in the urine
and approximately 14% of the oral dose was recovered unchanged in the feces.
Apparent oral clearance of a brexpiprazole oral tablet after once daily administration
is 19.8 (±11.4) mL/h/kg. After multiple once daily administration of REXULTI, the
terminal elimination half-lives of brexpiprazole and its major metabolite, DM-3411,
were 91 hours and 86 hours, respectively.
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