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, 71 (2), 199-206

Effects of Imatinib Mesylate on the Pharmacokinetics of Paracetamol (Acetaminophen) in Korean Patients With Chronic Myelogenous Leukaemia

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Effects of Imatinib Mesylate on the Pharmacokinetics of Paracetamol (Acetaminophen) in Korean Patients With Chronic Myelogenous Leukaemia

Dong-Wook Kim et al. Br J Clin Pharmacol.

Abstract

Aims: The major objective of the present study was to investigate the effect of imatinib on the pharmacokinetics of paracetamol in patients with chronic myelogenous leukaemia (CML).

Methods: Patients (n = 12) received a single oral dose of acetaminophen 1000 mg on day 1 (control). On days 2-8, imatinib 400 mg was administered daily. On day 8 (treatment), another 1000 mg dose of paracetamol was administered 1 h after the morning dose of imatinib 400 mg. Blood and urine samples were collected for bioanalytical analyses.

Results: The area under the plasma concentration-time curve (AUC) for paracetamol, paracetamol glucuronide and paracetamol sulphate under control conditions was similar to that after treatment with imatinib; the 90% confidence interval of the log AUC ratio was within 0.8 to 1.25. Urinary excretion of paracetamol, paracetamol glucuronide and paracetamol sulphate was also unaffected by imatinib. The pharmacokinetics of paracetamol and imatinib in Korean patients with CML were similar to previous pharmacokinetic results in white patients with CML. Co-administration of a single dose of paracetamol and multiple doses of imatinib was well tolerated and safety profiles were similar to those of either drug alone.

Conclusions: The pharmacokinetics of paracetamol and its major metabolites in the presence of imatinib were similar to those of the control conditions and the combination was well tolerated. These findings suggest that imatinib can be safely administered with paracetamol without dose adjustment of either drug.

Figures

Figure 1
Figure 1
Metabolism of paracetamol glucuronidation by UDP-glucuronosyltransferase (UGT) and sulphation by sulphotransferase (SULT) are major metabolic pathways, and oxidation by cytochrome P450-2E1 (CYP2E1) is a minor metabolic pathway
Figure 2
Figure 2
Mean plasma paracetamol concentration–time profiles on day 1 (control; -SD) and day 8 (after treatment with imatinib; +SD) in patients with CML (n= 12). Control (formula image); Treatment (formula image)
Figure 3
Figure 3
Mean paracetamol glucuronide (PG) and paracetamol sulphate (PS) plasma concentration–time profiles on day 1 (control; -SD) and day 8 (treatment with imatinib; +SD) in patients with CML (n= 12). PG-Control (formula image); PG-Treatment (formula image); PS-Control (formula image); PS-Treatment (formula image)
Figure 4
Figure 4
Mean (+SD) plasma concentration–time profiles of imatinib and its metabolite (CGP74588) on day 8 in patients with CML (n= 12). Imatinib (formula image); CGP74588 (formula image)

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