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Journal of pharmaceutical sciences2015; 104(9); 3229-3235; doi: 10.1002/jps.24505

Few Drugs Display Flip-Flop Pharmacokinetics and These Are Primarily Associated with Classes 3 and 4 of the BDDCS.

Abstract: This study was conducted to determine the number of drugs exhibiting flip-flop pharmacokinetics following oral (p.o.) dosing from immediate-release dosage forms and if they exhibit a common characteristic that may be predicted based on BDDCS classification. The literature was searched for drugs displaying flip-flop kinetics (i.e., absorption half-life larger than elimination half-life) in mammals in PubMed, via internet search engines and reviewing drug pharmacokinetic data. Twenty two drugs were identified as displaying flip-flop kinetics in humans (13 drugs), rat (nine drugs), monkey (three drugs), horse (two drugs), and/or rabbit (two drugs). Nineteen of the 22 drugs exhibiting flip-flop kinetics were BDDCS Classes 3 and 4. One of the three exceptions, meclofenamic acid (Class 2), was identified in the horse; however, it would not exhibit flip-flop kinetics in humans where the p.o. dosing terminal half-life is 1.4 h. The second, carvedilol, can be explained based on solubility issues, but the third sapropterin dihydrochloride (nominally Class 1) requires further consideration. The few drugs displaying p.o. flip-flop kinetics in humans are predominantly BDDCS Classes 3 and 4. New molecular entities predicted to be BDDCS Classes 3 and 4 could be liable to exhibit flip-flop kinetics when the elimination half life is short and should be suspected to be substrates for intestinal transporters.
Publication Date: 2015-05-25 PubMed ID: 26010239PubMed Central: PMC4536115DOI: 10.1002/jps.24505Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research examined the occurrence of flip-flop pharmacokinetics in different types of drugs, and observed that this is largely associated with drugs belonging to the BDDCS Classes 3 and 4.

Study Purpose and Methods

  • The purpose of the study was to identify how many drugs show flip-flop pharmacokinetics following oral administration from immediate-release dosage forms, and to determine if there are any common characteristics that can be predicted based on their BDDCS classification.
  • The researchers carried out a comprehensive literature review searching for drugs showing flip-flop kinetics (where the absorption half-life is longer than the elimination half-life) in mammals. This was done by browsing through published articles in PubMed, utilizing internet search engines, and examining pharmacokinetic data of different drugs.

Findings

  • Twenty-two drugs were found to exhibit flip-flop pharmacokinetics in different types of mammals: 13 drugs in humans, 9 in rats, 3 in monkeys, 2 in horses, and 2 in rabbits.
  • The vast majority (19) out of these 22 drugs belong to the BDDCS Classes 3 and 4.
  • Regarding the remaining three drugs, one (meclofenamic acid, Class 2) was identified in horses, but it does not show flip-flop kinetics in humans; carvedilol’s behavior could be explained by solubility issues; and the behaviour of sapropterin dihydrochloride (Class 1) needs further study.

Implications

  • The research concludes that the small number of drugs displaying oral flip-flop pharmacokinetics in humans predominantly belong to the BDDCS Classes 3 and 4.
  • This suggests that new molecular entities predicted to fall under BDDCS Classes 3 and 4 could be prone to showing flip-flop kinetics, especially when the elimination half-life is short. Thus, they should be suspected to be substrates for intestinal transporters.

Cite This Article

APA
Garrison KL, Sahin S, Benet LZ. (2015). Few Drugs Display Flip-Flop Pharmacokinetics and These Are Primarily Associated with Classes 3 and 4 of the BDDCS. J Pharm Sci, 104(9), 3229-3235. https://doi.org/10.1002/jps.24505

Publication

ISSN: 1520-6017
NlmUniqueID: 2985195R
Country: United States
Language: English
Volume: 104
Issue: 9
Pages: 3229-3235

Researcher Affiliations

Garrison, Kimberly L
  • Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.
Sahin, Selma
  • Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.
  • Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.
Benet, Leslie Z
  • Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.

MeSH Terms

  • Administration, Oral
  • Animals
  • Biopharmaceutics / classification
  • Half-Life
  • Haplorhini
  • Horses
  • Humans
  • Intestinal Mucosa / metabolism
  • Kinetics
  • Membrane Transport Proteins / metabolism
  • Pharmaceutical Preparations / classification
  • Pharmaceutical Preparations / metabolism
  • Pharmacokinetics
  • Rabbits
  • Rats

Grant Funding

  • R21 GM075900 / NIGMS NIH HHS
  • GM61390 / NIGMS NIH HHS
  • U01 GM061390 / NIGMS NIH HHS
  • U19 GM061390 / NIGMS NIH HHS
  • GM75900 / NIGMS NIH HHS

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