Correlation of quinidine absorption with disintegration and dissolution rates

Novel approach to the analysis of in vitro-in vivo relationships

The objective of this study was to quantify the dependence of degree of in vitro-in vivo correlation on the relative rates of dissolution and intestinal permeation and on the fraction of dose absorbed. The following equation was derived assuming first-order dissolution and permeation after oral drug administration: Fa = fa-1(1 - alpha(alpha - 1)-1 (1 - Fd) + (alpha - 1)-1(1 - Fd)alpha), where Fa is the fraction of the total amount of drug absorbed at time t, fa the fraction of the dose absorbed at t = infinitive, alpha is the ratio of the first-order permeation rate constant to the first-order dissolution rate constant, and Fd is the fraction of dose dissolved in vitro at time t. This equation was examined in order to pursue a theoretical treatment of in vitro-in vivo correlation. The degree of in vitro-in vivo correlation between Fa and Fd was measured by r2. alpha was varied between 1000 and 0.001. fa was varied between 0.1 and 1.0. Points employed in the linear regression were geometrically balanced about the derived equation. r2 values decreased as alpha decreased for all values of fa. r2 values were virtually independent of fa for all values of alpha, except for 0.01 < alpha < 1.0. The slope of the regression was modulated by both alpha and fa; larger alpha and smaller fa each increased slope. Application of the equation to a piroxicam data set demonstrated the equation's utility relative to the USP Level A correlation approach. It is concluded that the degree of in vitro-in vivo correlation depends on the relative rates of dissolution and intestinal permeation and on the fraction of dose absorbed and that the derived model merits further study.

Comparative bioavailability characteristics of commercial quinidine polygalacturonate and sulfate tablets

This study compared the relative bioavailability characteristics of quinidine polygalacturonate (QP) and quinidine sulfate (QS) after oral administration of commercial tablets and a liquid form prepared from crushed tablets in 13 healthy adult male volunteers. Each subject received the following four single-dose treatments in a randomized, crossover manner with a one-week washout period between treatments: 400 mg QS liquid, two 200-mg QS tablets, 550 mg QP liquid, and two 275-mg QP tablets. All four treatments were equivalent in terms of the dose of quinidine base. Multiple serum samples and two 24-hour urine specimens were collected over 24 and 48 hours, respectively, and assayed for quinidine with a specific HPLC assay method. For the absorption and disposition parameters measured (maximum serum concentration, time to reach maximum concentration, area under the concentration-time curve [0-48 hours], absorption and elimination rate constants, absorption and elimination half-lives, apparent total body clearance, apparent volume of distribution, and dose fraction excreted in the urine) no significant differences were observed for any of the parameters among the four treatments (p greater than 0.05). The results of the present investigation demonstrated that QP and QS produced identical serum quinidine concentration-time curves when given in the form of a tablet or liquid. The clinical implications of these observations with respect to the dosing of QP are discussed.

Bioavailability of 11 quinidine formulations adn pharmacokinetic variation in humans

The bioavailabilities of eight quinidine sulfate, two gluconate, and one polygalacturonate formulations were compared, with one of the sulfate formulations as a reference (R) in a panel of 24 volunteers, according to a design comprising duplicate 6 x 6 Latin squares in two subject groups. Only one gluconate formulation (H) gave a significantly lower (p less than 0.05) area under the curve from 0 to 30 hr (AUC30), 90% or R, which was not as significant as AUC infinity (94% of R). Formulation H also gave a significantly lower peak concentration (Cmax) and a longer time to peak concentration (tmax) and generally exhibited some characteristics of sustained-release product. In addition, one product (F) gave a significantly higher Cmax while another formulation (D) gave a longer tmax. The wide range of dissolution times obtained with these products with three test conditions was not reflected in the AUC, Cmax, or tmax values obtained, except the Formulation H was consistently the slowest to dissolve. The terminal rate constants, expressed as t 1/2, of the 24 subjects gave an overall mean of 7.49 +/- 0.77 hr and ranged from 6.24 +/- 0.28 to 0.49 +/- 0.90 hr in individuals. The estimated total body clearance, with the assumption that the oral bioavailability was 70%, gave an overall mean of 4.22 +/- 1.05 and ranged from 2.49 +/- 0.28 to 6.42 +/- 0.70 mg/min/kg in individuals, demonstrating the wide range of quinidine disposition even in healthy subjects; this finding is in agreement with recently published results.

Clinical pharmacokinetics of quinidine

The elimination of quinidine is accomplished by a combination of renal excretion of the intact drug (15 to 40% of total clearance) and hepatic biotransformation to a variety of metabolites (60 to 85% of total clearance). Many of the metabolites appear to be pharmacologically active. Typical ranges for kinetic properites of quinidine in healthy persons are: apparent volume of distribution 2.0 to 3.5 litres/kg; elimination half-life 5 to 12 hours; clearance, 2.5 to 5.0 ml/min/kg. Quinidine clearance is reduced in the elderly, in patients with cirrhosis, and in those with congestive heart failure. Oral quinidine is available either as relatively rapidly absorbed conventional tablets (usually quinidine sulphate) or as a variety of slowly absorbed sustained release preparations. Absolute systemic availability generally is 70% or greater. Quinidine is 70 to 95% bound to plasma protein, primarily to albumin but also to a number of other plasma constituents. Binding is reduced in patients with cirrhosis, partly because of hypoalbuminaemia, but is not influenced by renal insufficiency. Clinical interpretation of total serum or plasma quinidine concentrations must be altered in patients with reduced or increased binding, since it is the unbound fraction which is pharmacologically active.