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Table 4 Pharmacokinetic indices for plasma drug binding at eight and 12 hours after methadone dosing

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

Parameter

N

ADR

 

Dose A

 

Dose B

Dose C

 

Dose D

Methadone

      

Cfree, 8 h (ng/mL)

1.40

 

1.43

1.36

 

3.18

Cbound, 8 h (ng/mL)

8.45

 

8.22

8.72

 

78.0

Cfree, 12 h (ng/mL)

1.18

 

1.10

1.38

 

2.61

Cbound, 12 h (ng/mL)

6.86

 

6.74

7.40

 

58.8

Mean f u

0.14

 

0.14

0.15

 

0.04

f u ratio (A/B or C/D)

 

1.0

  

3.7

 

Vd (extrap) ratio

 

0.93

  

4.2

 

Vd (area) ratio

 

0.91

  

5.9

 

EDDP

      

Cfree, 8 h (ng/mL)

0.38

 

0.39

0.35

 

0.75

Cbound, 8 h (ng/mL)

0.72

 

0.75

0.61

 

6.56

Cfree, 12 h (ng/mL)

0.36

 

0.36

0.38

 

0.77

Cbound, 12 h (ng/mL)

0.71

 

0.66

0.69

 

7.37

Mean f u

0.34

 

0.35

0.36

 

0.10

f u ratio (A/B or C/D)

 

1.0

  

3.6

 
  1. ADR = our patient who experienced methadone overexposure; C = concentration; EDDP = 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (primary metabolite of methadone); f u = fraction unbound; N = our unaffected patient.