Pharmacokinetics of grepafloxacin

Abstract

Grepafloxacin is a fluoroquinolone antibiotic which is rapidly absorbed in healthy volunteers following oral dosing. It reaches peak plasma levels around 2 h after administration, then declines bi-exponentially, with an extended half-life of around 12 h. Grepafloxacin is eliminated primarily through metabolism and is excreted mainly in the faeces. Renal clearance accounts for only 10-15% of the administered dose. Grepafloxacin plasma concentrations increase disproportionately with increasing doses, but this is unlikely to be of clinical significance over the range of therapeutic doses. The rate and extent of absorption are not affected by food or elevated intragastric pH. The pharmacokinetics of grepafloxacin are affected by gender, with these differences relating to variations in body weight. No effect of age on the pharmacokinetics of grepafloxacin was found. Renal impairment does not affect grepafloxacin pharmacokinetics, whereas peak plasma concentrations, areas under plasma concentration-time curves and renal excretion are increased in patients with hepatic impairment. Grepafloxacin can be co-administered with warfarin and theophylline, though reduction of the theophylline dose is necessary. Following oral administration, higher grepafloxacin concentrations are achieved in lung and genital tissues than in serum, indicating its potential in the treatment of respiratory and sexually transmitted diseases. In addition, it exceeds therapeutically effective levels in bile and gall-bladder tissues, and accumulates in polymorphonuclear leucocytes such that it may be useful against intracellular pathogens.