Disposition of intravenous radioactive acyclovir

• DOI: 10.1038/clpt.1981.218
• Publication Date: 2010-08-30T12:09:47Z
• Authors: Paulo de Miranda; Steven S Good; Oscar L Laskin; Harvey C Krasny; James D Connor; Paul S Lietman
• Keywords: Guanine; Metabolic Clearance Rate; Radioimmunoassay; Acyclovir; Blood Proteins; Antiviral Agents; 3. Good health; Kinetics; 03 medical and health sciences; 0302 clinical medicine; Humans; Infusions, Parenteral; Carbon Radioisotopes; Chromatography, High Pressure Liquid; Protein Binding

The kinetic and metabolic disposition of (8-14C)acyclovir (ACV) was investigated in five subjects with advanced malignancy. The drug was administered by 1-hr intravenous infusion at doses of 0.5 and 2.5 mg/kg. Plasma and blood radioactivity-time, and plasma concentration-time data were defined by a two-compartment open kinetic model. There was nearly equivalent distribution of radioactivity in blood and plasma. The overall mean plasma half-life and total body clearance +/- SD of ACV were 2.1 +/- 0.5 hr and 297 +/- 53 ml/min/1.73 m2. Binding of ACV to plasma proteins was 15.4 +/- 4.4%. Most of the radioactive dose excreted was recovered in the urine (71% to 99%) with less than 2% excretion in the feces and only trace amounts in the expired Co2. Analyses by reverse-phase high-performance liquid chromatography indicated that 9-(carboxymethoxymethyl)guanine was the only significant urinary metabolite of ACV, accounting for 8.5% to 14.1% of the dose. A minor metabolite (less than 0.2% of dose) had the retention time of 8-hydroxy-9-[(2-hydroxyethoxy)methyl]guanine. Unchanged urinary ACV ranged from 62% to 91% of the dose. There was no indication of ACV cleavage to guanine. Renal clearance of ACV was approximately three times the corresponding creatinine clearances.