Skip to main content
Current Therapeutic Research, Clinical and Experimental logoLink to Current Therapeutic Research, Clinical and Experimental
. 2006 May;67(3):193–203. doi: 10.1016/j.curtheres.2006.06.005

Pharmacokinetics of experimental pentavalent antimony after intramuscular administration in adult volunteers*

Laura Vásquez 1,2,**, José V Scorza Dagert 2, José V Scorza 2, Nelson Vicuña-Fernández 1, Yaneira Petit de Peña 3, Sabrina López 3, Herminia Bendezú 2, Elina Rojas 2, Libia Vásquez 1, Belén Pérez 2
PMCID: PMC3965980  PMID: 24678095

Abstract

Background:

Pentavalent antimony (SbV) has demonstrated therapeuticeffectiveness against clinical manifestations of leishmaniasis, an infection caused by Leishmania, a genus of flagellate protozoa comprising parasites of worldwide distribution. Approximately 1.8 million new cases are reported annually.

Objective:

The aim of this study was to assess the pharmacokinetics of the investigational generic SbV, Ulamina (pentachloride of antimony + N-methylglucamine), in healthy adult volunteers.

Methods:

In this study, SbV was administered IM as a single 5-mg/kg dose.Blood samples were collected at 0.25, 0.75, 1, 2, 4, 8, 12, and 24 hours after administration; urine samples were collected at 6-hour intervals during the 24-hour postadministration period. Determination of trivalent antimony, SbV, and total antimony concentrations in blood and urine samples was carried out using atomic absorption spectrometry. Clinical history was reviewed and the subjects were monitored before and after administration of SbV using physical examination, weight, and hepatic- and renal-function studies. The pharmacokinetic parameters calculated were Cmax, Tmax, absorption constant (Ka), elimination constant (Kel), AUC2–24h, AUC0-∞, elimination phase (t½β), volume of distribution (Vd), and urinary excretion rate.

Results:

Five subjects (3 men, 2 women; mean age, 28 years [range, 18–34 years]) were included in the study. One hour after drug administration the following values were obtained: Cmax, 1.1 μg/mL; Tmax, 1.3 hours; Ka, 1.87 hours; Kel, 0.043 hours; AUC0–24h, 12.26 μg/mL · h; AUC0-∞, 19.84 μg/mL · h; t½β, 17.45 hours; Vd, 6.6 L/kg; and urinary excretion rate, 2.8 μg/h; these were mean values for the entire study group. The single dose was well tolerated by all subjects.

Conclusions:

The investigational generic SbV, Ulamina, was associated with linearelimination after IM administration of a single 5-mg/kg dose. A 2-compartment pharmacokinetic model was observed in these volunteers; the mean t½β, was 17.45 hours and the mean Vd was 6.6 L/kg.

Key words: pharmacokinetic, antimony, Ulamina, humans, antileishmania drugs

Full Text

The Full Text of this article is available as a PDF (584.4 KB).

Footnotes

*

Some results contained in this manuscript were presented at the First International Congress ofTherapeutics 2005 & XVII Congress of the Latin American Association of Pharmacology, October 28, 2005. Caracas City, Venezuela.

References

  • 1.Palacios R, Osorio L.E., Grajalew L.F., Ochoa M.T. Treatment failure in children in a randomized clinical trial with 10 and 20 days of meglumine antimonate for cutaneous leishmaniasis due toLeishmania viannia species. Am J Trop Med Hyg. 2001;64:187–193. doi: 10.4269/ajtmh.2001.64.187. [DOI] [PubMed] [Google Scholar]
  • 2.Berman J. Current treatment approaches to leishmaniasis. Curr Opin Infect Dis. 2003;16:397–401. doi: 10.1097/00001432-200310000-00005. [DOI] [PubMed] [Google Scholar]
  • 3.Croft S.L., Coombs G.H. Leishmaniasis—current chemotherapy and recent advances in the search for novel drugs. Trends Parasitol. 2003;19:502–508. doi: 10.1016/j.pt.2003.09.008. [DOI] [PubMed] [Google Scholar]
  • 4.Alrajhi A.A., Ibrahim E.A., De Vol E.B. Fluconazole for the treatment of cutaneous leishmaniasis caused by Leishmania major. N Engl J Med. 2002;346:891–895. doi: 10.1056/NEJMoa011882. [DOI] [PubMed] [Google Scholar]
  • 5.Tracy J.W., Webster L.T. Drugs used in the chemotherapy of protozoal infections. In: Hardman J.G., Limbird L.E., Molinoff P.B., editors. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 10th ed. McGraw-Hill; New York, NY: 2001. pp. 1097–1120. [Google Scholar]
  • 6.Romero G.A., Guerra M.V., Paes M.G., Macedo V.O. Comparison of cutaneous leishmaniasis due to Leishmania (viannia) braziliensis and L. (v.) guyanensis in Brazil: Therapeutic response to meglumine antimoniate. Am J Trop Med Hyg. 2001;65:456–465. doi: 10.4269/ajtmh.2001.65.456. [DOI] [PubMed] [Google Scholar]
  • 7.Romero G.A., Flores M.R., Noronha E.F., Macedo V.O. High frequency of skin reactions in patients with leishmaniasis treated with meglumine antimoniate contaminated with heavy metals: A comparative approach using historical controls. Mem Inst Oswaldo Cruz. 2003;98:145–149. doi: 10.1590/s0074-02762003000100019. [DOI] [PubMed] [Google Scholar]
  • 8.Chulay J.D., Fleckenstein L., Smith D.H. Pharmacokinetics of antimony during treatment of visceral leishmaniasis with sodium stibogluconate and meglumine antimoniate. Trans R Soc Trop Med Hyg. 1988;82:69–72. [PubMed] [Google Scholar]
  • 9.Roberts W.L., Berman J.D., Rainey P.M. In vitro antileishmanial properties of tri- and pentavalent antimonial preparations. Antimicrob Agents Chemother. 1995;39:1234–1239. doi: 10.1128/aac.39.6.1234. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.GlaxoSmithKline . Patient information leaflet: Pentostam injection. 2006. http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=4423 Available at. Accessed June 8. [Google Scholar]
  • 11.Medical information: Glucantime, injectable solution: Envase 5 amp 1.5g/5mL. E.F.222.Guia Spilva de las Especialidades Farmaceuticas. XXIX Edición. Caracas, Venezuela: Aventis Pharma; 2005.
  • 12.Veeken H., Ritmeijer K., Seaman J., Davidson R. A randomized comparison of branded sodium stibogluconate and generic sodium stibogluconate for the treatment of visceral leishmaniasis under field conditions in Sudan. Trop Med Int Health. 2000;5:312–317. doi: 10.1046/j.1365-3156.2000.00555.x. [DOI] [PubMed] [Google Scholar]
  • 13.Sundar S., Sinha P.R., Agrawal N.K. A cluster of cases of severe cardiotoxicity among kala-azar patients treated with a high-osmolarity lot of sodium antimony gluconate. Am J Trop Med Hyg. 1998;59:139–143. doi: 10.4269/ajtmh.1998.59.139. [DOI] [PubMed] [Google Scholar]
  • 14.Rijal S, Chappuis F., Singh R. Sodium stibogluconate cardiotoxicity and safety of generics. Trans R Soc Trop Med Hyg. 2003;97:597–598. doi: 10.1016/s0035-9203(03)80043-3. [DOI] [PubMed] [Google Scholar]
  • 15.Vásquez L., Scorza J.V., Vicuña-Fernández N. Comparación de tolerabilidad y fisico-quimica entre lotes de antimonial comercial y no comercializado (Glucantime® Vs. Ulamina) en eltratamiento de la leishmaniasis cutánea. MedULA. 2005;11:1–4. [Google Scholar]
  • 16.Petit de Peña Y., Vielma O., Burguera J.L. On-line determination of antimony (III) and antimony (V) in liver tissue and whole blood by flow injection-hydride generation—atomic absorptionspectrometry. Talanta. 2001;55:743–754. [PubMed] [Google Scholar]
  • 17.Petit de Peña Y., Vicuna-Fernández N., López S. Antimony speciation in human blood samples from patients treated with Ulamina; a novel experimental drug for leishmaniasis. Metal Ions Biol Med. 2004;8:560–563. [Google Scholar]
  • 18.Farrier D. Summit Research Services; Montrose, CO: 2003. PK Solutions 2.0. Noncompartmental pharmacokinetics data analysis. [Google Scholar]
  • 19.Wagner J.G. Technomic Publishing Company; Lancaster, Penn: 1993. Pharmacokinetics for the Pharmaceutical Scientist. [Google Scholar]
  • 20.Villodre A., Plá J. Curvas de excreción urinari. In: Doménech J., Martinez J., Plá J., editors. Biofarmacia y Farmacocinética. Vol I: Farmaocinética. Editorial Sintesis Madrid; 2001. pp. 251–276. [Google Scholar]
  • 21.Frezard F., Demicheli C., Ferreira C.S., Costa M.A. Glutathione-induced conversion of pentavalent antimony to trivalent antimony in maglumine antimoniate. Antimicrob Agents Chemother. 2001;45:913–916. doi: 10.1128/AAC.45.3.913-916.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.McKinney J.D. Metabolism and disposition of inorganic arsenic in laboratory animals and humans. Environ Geochem Health. 1992;14:43–48. doi: 10.1007/BF01783627. [DOI] [PubMed] [Google Scholar]
  • 23.Rees P.H., Keating M.I., Kager P.A., Hockmeyer W.T. Renal clearance of pentavalent antimony (sodium stibogluconate). Lancet. 1980;2:226–229. doi: 10.1016/s0140-6736(80)90120-8. [DOI] [PubMed] [Google Scholar]
  • 24.Belloli C., Ceci L., Carli S. Disposition of antimony and aminosidine in dogs after administration separately and together: Implications for therapy of leishmaniasis. Res Vet Sci. 1995;58:123–127. doi: 10.1016/0034-5288(95)90064-0. [DOI] [PubMed] [Google Scholar]

Articles from Current Therapeutic Research, Clinical and Experimental are provided here courtesy of Elsevier

RESOURCES