Pharmacokinetics and dosage recommendations for an oseltamivir oral suspension for the treatment of influenza in children

被引:57
作者
Osage C. [1 ]
Barrett J. [1 ]
Hill G. [1 ]
Mann J. [1 ]
Dorr A. [1 ]
Dutkowski R. [1 ]
Ward P. [1 ]
机构
[1] Hoffmann-La Roche Inc., Dept of Clinical Pharmacology, Nutley, NJ 07110
来源
Paediatric Drugs | 2001年 / 3卷 / 3期
关键词
Influenza; Oseltamivir; Zanamivir; Rimantadine; Oseltamivir Carboxylate;
D O I
10.2165/00128072-200103030-00005
中图分类号
学科分类号
摘要
Objective: Oseltamivir “Ro 64-0796” is an ester prodrug of the active metabolite Ro 64-0802 “oseltamivir carboxylate”, a potent and selective inhibitor of the neuraminidase enzyme of influenza virus. In this study we report the pharmacokinetics of oseltamivir in healthy children volunteers “study 1” and in children with influenza “study 2”. Study Participants and Methods: In study 1, an open-label, single dose study, serial plasma samples were obtained from a total of 18 healthy children “5 to 18 years” who were grouped by age “n = 6 per group” and received single oral doses of oseltamivir 2 mg/kg. In study 2, a randomised, placebo controlled phase III study in paediatric children “1 to 12 years” presenting with influenza symptoms, 199 pharmacokinetic sparse samples were obtained from 87 patients, and serial samples were obtained from 5 patients. Pooled data were compared with those from adult studies. Results: Children “1 to 12 years” eliminated the active metabolite faster than both adolescents “13 to 18 years” and adults, resulting in lower exposure to the active drug. In these children, oseltamivir 2 mg/kg twice daily resulted in drug exposures within the range associated with tolerability and efficacy in adults administered approximately 1 mg/kg twice daily. Unit doses of oseltamivir 30, 45 and 60mg oral suspension are recommended twice daily in children weighing ≤15kg “or ≤33lb, aged 1 to 3 years”, > 15 to 23kg “or >33 to 51 lb, aged 4 to 7 years” and >23 to 40kg “or >51 to 881b, aged 8 to 12 years”, respectively. A 75mg capsule may be a viable dosage formulation in children “e.g. over 8 years of age” who are able to swallow solid dosage forms. Conclusions: Young children cleared the active metabolite oseltamivir carboxylate at a faster rate than older children and adults. Convenient administration recommendations for the oseltamivir oral suspension in children are possible to maintain drug exposure within the target window.
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页码:229 / 236
页数:7
相关论文
共 18 条
[1]  
Glezen W.P., Influenza and hospitalizations in children, N Engl J Med, 342, pp. 1752-1753, (2000)
[2]  
Simonsen L., Fukuda K., The impact of influenza on hospitalization, J Infect Dis, 181, pp. 831-837, (2000)
[3]  
Couch R.B., Prevention and treatment of influenza, N Engl J Med, 343, pp. 1778-1787, (2000)
[4]  
Massarella J.W., He G.Z., Dorr A., Et al., The pharmacokinetics and tolerability of the oral neuraminidase inhibitor oseltamivir “Ro 64-0796/GS4104” in healthy adult and elderly volunteers, J Clin Pharmacol, 40, pp. 836-843, (2000)
[5]  
He G., Massarella J., Ward P., Clinical pharmacokinetics of the prodrug oseltamivir and its active metabolite Ro 64-0802, Clin Pharmacokinet, 37, pp. 471-484, (1999)
[6]  
Treanor J.J., Hayden F.G., Vrooman P.S., Et al., Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: A randomized, controlled trial, JAMA, 283, pp. 1016-1024, (2000)
[7]  
Nicholson K.G., Aoki F.Y., Osterhaus A.D.M.E., Et al., Efficacy and safety of oseltamivir in treatment of acute influenza: A randomised controlled trial, Lancet, 355, pp. 1845-1850, (2000)
[8]  
Hayden F., Atmar R.L., Margo S., Et al., Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza, N Engl J Med, 341, pp. 1336-1343, (1999)
[9]  
(1999)
[10]  
Wiltshire H., Wiltshire B., Citron A., Et al., Development of a high-performance liquid chromatographic mass spectrometric assay for the specific and sensitive quantification of Ro 64-0802, an anti-influenza drug, and its pro-drug, oseltamivir, in human and animal plasma and urine, J Chromatography B Biomed Sci Appl, 745, pp. 373-388, (2000)