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Supplementary Material 0114-5916/09/0007-0001/$49.95/0 REVIEW ARTICLE © 2009 Adis Data Information BV Drug Safety 2009; 32 (7): Supplementary Material 0114-5916/09/0007-0001/$49.95/0 REVIEW ARTICLE © 2009 Adis Data Information BV. All rights reserved. Pharmacokinetic Changes of Psychotropic Drugs in Patients with Liver Disease Implications for Dose Adaptation Chantal Schlatter,† Sabin S. Egger,† Lydia Tchambaz† and Stephan Krähenbühl Division of Clinical Pharmacology & Toxicology, University Hospital, Basel, Switzerland † These authors contributed equally to this work. Supplementary Material This supplementary material contains the table referred to in the full version of this article, which can be found at http://drugsafety.adisonline.com. Note the reference citations and reference list are independent from the published article and reference numbering will differ. 1 Table I. Kinetic data including metabolic pathway, hepatic and dose-dependent adverse effects and dose adjustment recommendations for the use of psychotropic drugs in patients with liver disease b Drug Drug Metabolism Q0 t1/2 [h] PB Vd F [%] Clsys E Hepatic Dose-dependent Studies performed and dosage recom- cat.a [%] [L/kg] [L/h] adverse adverse reactions mendations effects Psychostimulants Am- Lo Deethylation 0.95 2 95 restlessness, dizzi- Studies: No clinical studies available in pa- fepramone of the amine ness, tremor, insom- tients with liver disease. Product information: function, nia, anxiety, delirium, Contraindicated in patients with liver failure. reduction of hallucinations, de- Personal recommendation: Should be the ketone pression, changes in avoided in patients with liver disease. function, libido, pallor or flush- and hy- ing, palpitation, ar- droxylation rhythmia, anginal pain, of the ben- hypertension, circula- zene ring[1-3] tory collapse, exces- sive sweating, dry mouth, anorexia[1] Methyl- Hi Deesterifi- 0.95 2 20 2 30 40 0.7 Case re- nervousness, insom- Studies: No clinical studies available in pa- phenidate cation by ports: nia, headache, dizzi- tients with liver disease. Product information: non micro- hepatocel- ness, dyskinesia, tics, No recommendations provided. Personal somal es- lular in- seizure, abdominal recommendation: According to pharmacoki- terase to jury,[4] liver pain, nausea, ano- netic data, start with a third of normal dose. ritalinic acid, failure after rexia, tachycardia, Adjust maintenance dose according to dose- minor: oxi- high palpitation, increased dependent adverse reactions. dation, hy- doses.[5] blood pressure, ar- droxyla- rhythmia, visual dis- tion.[2] turbances[1, 2, 6] Pharma- cokinetic data are presented as mean values for both enanti- omers of 2 b Drug Drug Metabolism Q0 t1/2 [h] PB Vd F [%] Clsys E Hepatic Dose-dependent Studies performed and dosage recom- cat.a [%] [L/kg] [L/h] adverse adverse reactions mendations effects methyl- phenidate. Modafinil[7] Lo Hydrolytic 0.95 10.5 62 0.9 40-65 3.4 0.06 Sporadic: headache, anxiety Studies: In an open-label study, 21 patients deamida- elevated nervousness, insom- with primary biliary cirrhosis received modaf- tion, S- liver en- nia, dizziness, nau- inil at an initial dose of 100mg/d for treatment oxidation, zymes, sea, diarrhoea, ano- of daytime somnolence and fatigue.[9] Dos- aromatic cholestatic rexia, dry mouth, con- age was up-titrated according to tolerability ring hy- liver injury[1, stipation, changes in and response. Significant reduction in day- droxylation, 3] blood pressure, extra- time somnolence and fatigue were observed. glucuronida- systoles, palpitations, Seven patients discontinued treatment due tion.[3] tachycardia, arrhyth- to significant headache. No major increase in mias[1, 8] blood pressure was observed. Product in- formation: Caution in patients with severe liver disease. T1/2 is doubled in patients with liver cirrhosis. 50% dose reduction in pa- tients with severe liver disease to 100- 200mg/d. Personal recommendation: Ac- cording to pharmacokinetic data, open-label study and product information, start with 100mg daily and adjust dosage according to dose-dependent adverse reactions. Phenter- Nk Mainly renal 0.3 20 3.5 restlessness, dizzi- Studies: No clinical studies available in pa- mine elimination, ness, tremor, insom- tients with liver insufficiency. Product infor- 5% metabo- nia, anxiety, hallucina- mation: Contraindicated in patients with liver lized by N- tions, changes in li- insufficiency. Personal recommendation: oxidation, bido, palpitation, ar- According to pharmacokinetic data showing entero- rhythmia, anginal pain, primarily renal elimination, dosage should be hepatic hypertension, circula- adjusted according to renal function. circulation[1] tory collapse, exces- sive sweating, dry mouth, gastrointestinal symptoms[1] 3 b Drug Drug Metabolism Q0 t1/2 [h] PB Vd F [%] Clsys E Hepatic Dose-dependent Studies performed and dosage recom- cat.a [%] [L/kg] [L/h] adverse adverse reactions mendations effects Phenylpro- Lo Renal elimi- 0.15 4 4 99 restlessness, dizzi- Studies: No clinical studies available in pa- panolamine nation[1] ness, tremor, insom- tients with liver disease. Product information: nia, anxiety, aggres- Contraindicated in patients with liver failure. siveness, irritability, Personal recommendation: According to changes in libido, pharmacokinetic data, showing primarily palpitation, tachycar- renal elimination, dosage should be adjusted dia, anginal pain, hy- according to renal function. pertension, excessive sweating, dry mouth, anorexia, gastrointes- tinal symptoms[1] Sibutramine Hi Demethyla- 1 1.1 97 1750 >0.9 frequency tachycardia, palpita- Studies: No clinical studies available in pa- tion (CYP unknown: tions, hypertension, tients with liver disease. Product information: 3A4) to abnormal constipation, anorexia, Combined AUC of the two active metabolites active liver func- nausea, dry mouth, increased by 24% in patients with moderate mono- tion tests insomnia, headache, liver insufficiency compared with healthy desmethyl- (ALT, AST, dizziness[1, 3, 10] subjects. No dosage adjustment necessary and di- AP);[3] case in patients with mild to moderate liver im- desmethyl- report: cho- pairment. Contraindicated in patients with sibutramine, lestatic severe liver dysfunction. Personal recom- followed by hepatitis.[11] mendation: According to pharmacokinetic hydroxyla- data, start with the lowest possible dose tion and available (10mg/d). Adjust maintenance conjuga- dose according to dose-dependent adverse tion,[1, 8] reactions. entero- hepatic circula- tion.[10] Antiepileptics 4 b Drug Drug Metabolism Q0 t1/2 [h] PB Vd F [%] Clsys E Hepatic Dose-dependent Studies performed and dosage recom- cat.a [%] [L/kg] [L/h] adverse adverse reactions mendations effects Barbexa- Lo Hydroxyla- 0.75 80 50 0.7 90 0.3 <0.01 Induction of Irritability, agitation, Studies: Mean t1/2 of phenobarbital was sig- clone tion to hy- acute in- drowsiness, optical nificantly prolonged by 51% in cirrhotics droxyphe- termittent hallucinations, ataxia, compared with healthy individuals (130 vs 86 [1] [13] nobarbital porphyria. nystagmus, dizziness, hours). T1/2 of phenobarbital was not sig- (inactive).[12] vomiting, weight loss, nificantly different between patients with Note: Bar- gingival hyperplasia, acute viral hepatitis and healthy individuals bexaclon is respiratory depres- (104 vs 86 hours).[13] Monitoring of serum a salt com- sion, hypotension, levels recommended in patients with liver posed of shock, rhabdomyoly- disease and prolonged therapy.[13] Product phenobarbi- sis[1] information: Contraindicated in patients with tal and L- severe liver disease. Adjust dosage in pa- propylhexe- tients with liver disease (no specification) drine. The and monitor serum levels. Personal recom- listed kinetic mendation: According to pharmacokinetic data refer to data, start with dose in the lower range of phenobarbi- normal. Adjust maintenance dose according tal. to the measured therapeutic concentration (therapeutic range: 10-40 mg/L). Car- Lo Epoxidation 1 15 75 1.4 >70 4.5 0.08 Frequent: dizziness, drowsiness, Studies: No clinical studies available in pa- bamazepine to active hepatocel- unsteadiness, head- tients with liver disease. Product information: epoxide lular injury ache, ataxia, diplopia, Caution in patients with liver disease. Moni- metabolite (increase of nausea, vomiting, tor liver function and stop carbamazepine in by CYP transami- asthenia, tremor, dy- case of worsening liver function. Personal 3A4, glu- nases). skinesia, oedemas, recommendation: According to pharmacoki- curonida- Rare: cho- weight gain, SIADH, netic data, start with initial dose in the lower tion, further lestatic liver tachycardia, hypoten- range of normal and adjust maintenance metabolism injury. Very sion, arrhythmia, res- dose according to plasma concentrations of of active rare: granu- piratory depression[1, 2, carbamazepine (therapeutic range: 4-11 metabolite lomas, liver 8] mg/L). by epoxide failure.[1, 4] hydrolase.[2] Induction of acute in- termittent porphyria.[1] 5 b Drug Drug Metabolism Q0 t1/2 [h] PB Vd F [%] Clsys E Hepatic Dose-dependent Studies performed and dosage recom- cat.a [%] [L/kg] [L/h] adverse adverse reactions mendations effects Clonaze- Lo CYP 3A4,[14] 1 30 85 3 98 6.5 0.12 Rare: hepa- drowsiness, dizziness, Studies: PB reduced in cirrhotic patients.[15] pam nitro-group tocellular muscular weakness, Patients with liver cirrhosis may be sensitive reduction, injury.[4] ataxia, dysarthria, to sedative effects of benzodiazepines.[16] N- constipation, coordina- Product information: Clonazepam should not acetyla- tion disturbances, be used in
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