The Pharmacokinetics of Subcutaneous Methylnaltrexone Bromide in Rhesus Macaques (Macaca mulatta)

J Am Assoc Lab Anim Sci. 2023 May 1;62(3):260-266. doi: 10.30802/AALAS-JAALAS-22-000111. Epub 2023 Apr 20.

Abstract

Opioids are an integral component of pain management for nonhuman primates. These potent analgesics also adverse gastrointestinal (GI) effects that include constipation, bloating, and delayed gastric emptying. Methylnaltrexone bromide (MNTX) is a selective, peripherally acting μ- and κ-opioid receptor antagonist that can be used to mitigate the GI effects associated with opioid administration. Unlike naltrexone, a similar drug in this class, MNTX possesses an N-methyl-quaternary amine group that prevents it from crossing the blood brain barrier. This blockage allows inhibition of peripheral GI opioid receptors without affecting opioid-mediated analgesia in the central nervous system. We conducted a pharmacokinetic analysis of MNTX in serum and CSF of 6 healthy juvenile male rhesus macaques after subcutaneous administration of a 0.15-mg/kg dose. We hypothesized that the macaques would demonstrate a Tmax of 0.5 h, similar to that of humans, and that no MNTX would be detected in the CSF. This treatment resulted in a peak serum concentration of 114 ± 44 ng/mL at 0.25 ± 0.00 h; peak CSF at concentrations were 0.34 ± 0.07 ng/mL at the Tmax. These data show that subcutaneous administration of MNTX to rhesus macaques may block peripheral adverse effects of opioids without interfering with their central analgesic effects.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics, Opioid / pharmacology
  • Animals
  • Humans
  • Macaca mulatta
  • Male
  • Naltrexone* / pharmacology
  • Naltrexone* / therapeutic use
  • Narcotic Antagonists* / pharmacology
  • Narcotic Antagonists* / therapeutic use
  • Quaternary Ammonium Compounds / pharmacology
  • Quaternary Ammonium Compounds / therapeutic use

Substances

  • methylnaltrexone
  • Naltrexone
  • Narcotic Antagonists
  • Analgesics, Opioid
  • Quaternary Ammonium Compounds