Nabumetone (BRL 14777) presystemic elimination and disposition in patients with liver impairments

The effect of presystemic elimination of nabumetone disposition was evaluated in 6 cirrhotic patients after oral administration of a single dose of 1000 mg of the drug. The data revealed the major role of hepatic metabolism in the removal of the drug from the body. The relatively high values of hepatic plasma excretion ratio (= 0.60 +/- 0.04) and of the total intrinsic clearance (= 90.74 +/- 15.87 l/h) places nabumetone between drugs with intermediate properties; clearance being partly dependent on plasma (blood) flow rate and on the hepatic metabolism whose systemic availability was 32% of the dose. Very good coincidence was obtained when ranging patients according to morphological evaluation of liver impairments was compared to the values of nabumetone disposition parameters. There was a statistically significant positive correlation (r = 0.831, p less than 0.05) between the fraction of the dose reaching the systemic circulation, f, and the gamma-GT "normalization index" (i.e., ratio between the observed decrease of serum gamma-glutamyl transpeptidase activity and the pretreatment difference from the upper normal value). A definite interpretation of the data cannot be provided until more knowledge about the effect of 6-mO-2-naphthylacetic acid on nabumetone metabolism is available.