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Table 2 Plasma pharmacokinetic parameters

From: Methadone adverse reaction presenting with large increase in plasma methadone binding: a case series

Parameter

N

ADR

 

Dose A

Dose B

Ratio (B/A)

Dose C

Dose D

Ratio (D/C)

Letrozole Cbaseline (ng/mL)

0

106.9

 

0

76.1

 

Methadone

      

AUC0-24 h (ng/hour/mL)

288.5

272.2

0.94

291.2

1857

6.4

AUCinf (ng/hour/mL)

879.8

833.1

0.95

946.0

5674a

6.0

Distribution T1/2 (hour)

8.3

7.0

0.84

6.7

15.5

2.3

Elimination T1/2 (hour)

48.5

50.4

1.0

52.4

52.4a

1.0

Clearance (L/hour)

6.8

7.2

1.1

6.3

1.1a

0.17

Vd (extrap) (L)

516.6

557.4

1.1

502.9

119.2b

0.24

Vd (area) (L)

476.9

524.3

1.1

469.0

80.0a

0.17

EDDP

      

AUC0-24 h (ng/hour/mL)

29.2

26.9

0.92

28.2

217.6

7.7

Observed Cmax (ng/mL)

1.6

1.3

0.81

1.6

10.5

6.6

AUCmethadone/AUCEDDP (0-12 h)

12.3

13.6

1.1

12.6

11.6

0.92

AUCmethadone/AUCEDDP (0-24 h)

9.9

10.1

1.0

10.3

8.5

0.83

EMDP

      

AUC0-24 h (ng/hour/mL)

2.7

2.0

0.74

1.5

10.4

6.9

Observed Cmax (ng/mL)

0.18

0.14

0.78

0.075

0.55

7.3

  1. aEstimated using clearance and half-life calculated from the terminal elimination phase.
  2. bEstimated using an extrapolation method based on the terminal elimination phase.
  3. AUC = area under the plasma concentration time curve; AUC0-12 h = AUC from time 0 to 12 hours; AUC0-24 h = AUC from time 0 to 24 hours; AUCinf = AUC from time 0 to infinity; ADR = our patient who experienced methadone overexposure; C = concentration; EDDP = 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (primary metabolite of methadone); EMDP = 2-ethyl-5-methyl-3,3-diphenyl-1-pyrroline (secondary metabolite of methadone); N = our unaffected patient; T1/2 = half-life; Vd = volume of distribution.