Population pharmacokinetics of levamisole in children with steroid‐sensitive nephrotic syndrome

E-ISSN： 1365-2125|80|2|242-252

ISSN： 0306-5251

Source： BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (ELECTRONIC), Vol.80, Iss.2, 2015-08, pp. : 242-252

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Abstract

AimThe aim was to investigate the population pharmacokinetics of levamisole in children with steroid‐sensitive nephrotic syndrome.MethodsNon‐linear mixed effects modelling was performed on samples collected during a randomized controlled trial. Samples were collected from children who were receiving 2.5 mg kg–1 levamisole (or placebo) orally once every other day. One hundred and thirty‐six plasma samples were collected from 38 children from India and Europe and included in the analysis. A one compartment model described the data well.ResultsThe apparent clearance rate (CL/F) and distribution volume (V/F) were 44 l h–1 70 kg–1 and 236 l 70 kg–1, respectively; estimated interindividual variability was 32–42%. In addition to allometric scaling of CL/F and V/F to body weight, we identified a significant proportional effect of age on CL/F (–10.1% per year). The pharmacokinetics parameters were not affected by gender, tablet strength or study centre. The median (interquartile range) maximum plasma concentration of levamisole was 438.3 (316.5–621.8) ng ml–1, and the median area under the concentration–time curve was 2847 (2267–3761) ng ml–1 h. Median tmax and t½ values were 1.65 (1.32–2.0) h and 2.60 (2.06–3.65) h, respectively.ConclusionsHere, we present the first pharmacokinetic data regarding levamisole in children with steroid‐sensitive nephrotic syndrome. The pharmacokinetic profile of levamisole in children was similar to findings reported in adults, although the elimination rate was slightly higher in children.