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Single and Multiple Dose Pharmacokinetics of Acetaminophen (Paracetamol) in Polymedicated Very Old Patients with Rheumatic Pain BERNARD BANNWARTH, FABIENNE PEHOURCQ, FABRICE LAGRANGE, MYRIAM MATOGA, SYLVAIN MAURY, MURIEL PALISSON, and MANUELA LE BARS
ABSTRACT.
Methods. Twelve inpatients (11 women), aged 89 ± 4 years, weight 59 ± 10 kg, receiving 3 to 8 concomitant medications, entered the study. Their creatinine clearance according to the Cockroft-Gault formula was 42 ± 12 ml/min. The pharmacokinetics of 1 g acetaminophen was evaluated after the first dose (D1) and after the last dose (D7) during a 3 times daily regimen of 1 g for 5 consecutive days. Results. The plasma pharmacokinetic profile of acetaminophen did not change significantly at D7 compared to D1. No significant within-patient differences were observed, especially with respect to plasma elimination half-life (2.74 ± 0.48 and 2.77 ± 0.32 hours, respectively), area under the concentration-time curve (82.5 ± 21.1 and 90.1 ± 15.2 µg*h/ml, respectively), and apparent oral clearance (3.68 ± 0.85 and 3.28 ± 0.52 ml/min/kg, respectively). Conclusion. No drug accumulation occurred during multiple dosing with acetaminophen in these very old subjects. On the basis of pharmacokinetic data alone, a dose regimen of acetaminophen 1 g tid seems to be appropriate in such patients. (J Rheumatol 2001;28:182-4) Key Indexing Terms:
ACETAMINOPHEN
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