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. 2018 Nov 20;10(11):483. doi: 10.3390/toxins10110483

Table 4.

The major pharmacokinetic variability factors, and their use for dose adjustment of the clinically approved toxin-derived peptide drugs.

Drug Variability Factor Dose Adjustment
Captopril dimerization and interaction with endogenous thiol-containing compounds in the plasma -
active tubular secretion in the kidneys dose reduction in renal insufficiency
Cyclosporine body weight therapeutic monitoring of trough blood concentrations
dosage adjustment taking into account the variability factors
co-administration of inhibitors of CYP3A
hematocrit
and additional factors
Eptifibatide renal elimination of the drug maintain the IV bolus component and reduce the IV infusion component of the dosage regimen in patients with renal insufficiency
Lepirudin renal elimination of the drug dose selection based on patients’ weight
dose reduction in renal insufficiency
monitoring of anticoagulant effects (aPTT test)
gender, age, and disease state affect the drug distribution and elimination
Bivalirudin renal elimination of the drug dose selection based on patients’ weight
dose reduction in renal insufficiency
monitoring of anticoagulant effects (aPTT test)
Ziconotide not reported -
Exenatide body weight -
renal elimination of the drug dose reduction in renal insufficiency
Lixisenatide body weight -
renal elimination of the drug no dose reduction, but close monitoring of drug safety, in mild or moderate renal impairment; use of the drug in patients with end stage renal disease is not recommended
Linaclotide not reported -
Plecanatide not reported -