caa a22 4500 47705613X CHVBK 20180405111347.0 cr unu---uuuuu 170330e19961201xx s 000 0 eng 10.1007/s002280050203 doi (NATIONALLICENCE)springer-10.1007/s002280050203 Pharmacokinetics of meloxicam in patients with end-stage renal failure on haemodialysis: a comparison with healthy volunteers [Elektronische Daten] [D. Türck, A. Schwarz, D. Höffler, H. H. Narjes, G. Nehmiz, G. Heinzel] Objective: The pharmacokinetics of meloxicam have been studied following administration of a single 15-mg capsule to 12 patients with end-stage renal failure. Pharmacokinetic parameters were determined after haemodialysis. The pharmacokinetic profile obtained in these patients is compared to data obtained from age- and gender-matched healthy volunteers. Results: Total plasma meloxicam concentrations were lower in patients with end-stage renal failure (AUC0-∞12.6 μg ⋅ h ⋅ ml−1) in comparison with healthy volunteers (AUC0-∞39.3 μg ⋅ h ⋅ ml−1). This was reflected by an increase in total clearance (+211%). However, there was an enhanced free meloxicam fraction (unbound drug) in the end-stage renal failure patients (0.9% vs. 0.3% in healthy volunteers). This was observed in association with raised free Cmax (5.0 vs. 2.6 ng/ml) but similar free AUC0-∞(0.13 vs. 0.11 μg ⋅ h ⋅ ml−1) in both groups. Therefore, the raised free fraction is compensated for by the increased total clearance such that no accumulation of meloxicam occurs. Meloxicam plasma concentrations were similar before and after haemo- dialysis. Conclusion: Meloxicam has displayed a pharmacokinetic profile in end-stage renal failure which is similar to that observed for other highly protein bound non-steroidal anti-inflammatory drugs (NSAIDs). However, in view of the higher free Cmax value, and despite no evidence of accumulation, it may be prudent to treat this group of patients with a 7.5-mg dose of meloxicam. This is the lower dose normally recommended for adults. Meloxicam is not dialysable. Springer-Verlag Berlin Heidelberg, 1996 Key words End-stage renal failure nationallicence Meloxicam nationallicence haemo- dialysis nationallicence pharmacokinetic nationallicence Türck D. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut Schwarz A. Städtische Klinken, Darmstadt III, Germany, DE aut Höffler D. Städtische Klinken, Darmstadt III, Germany, DE aut Narjes H. H. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut Nehmiz G. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut Heinzel G. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut https://doi.org/10.1007/s002280050203 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050203 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Türck D. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut NATIONALLICENCE 700 1- Schwarz A. Städtische Klinken, Darmstadt III, Germany, DE aut NATIONALLICENCE 700 1- Höffler D. Städtische Klinken, Darmstadt III, Germany, DE aut NATIONALLICENCE 700 1- Narjes H. H. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut NATIONALLICENCE 700 1- Nehmiz G. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut NATIONALLICENCE 700 1- Heinzel G. Dr Karl Thomae GmbH, Birkendorfer Str. 65, D-88397 Biberach, Germany, DE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer