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Transfer from immediate-release disopyramide to controlled-release disopyramide.

D M DiPersio, M S Chow

|February 1, 1987

Summary

Patients can switch from immediate-release (IR) disopyramide to controlled-release (CR) disopyramide. A 12-hour CR dosing regimen can be initiated 6 hours after the final IR dose for patients with normal organ function.

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Area of Science:

Pharmacokinetics and Drug Metabolism
Clinical Pharmacy Practice
Cardiovascular Drug Therapy

Background:

Disopyramide is prescribed in immediate-release (IR) and controlled-release (CR) formulations.
Transferring patients between these formulations requires careful consideration of pharmacokinetic parameters to maintain therapeutic efficacy and safety.

Purpose of the Study:

To simulate serum disopyramide concentrations during the transition from IR to CR formulations.
To establish a safe and effective dosing strategy for switching disopyramide preparations.

Main Methods:

Pharmacokinetic parameters from IR disopyramide were utilized.
Serum concentrations from an initial dose of CR disopyramide phosphate were measured.
Simulations were performed to predict concentration profiles during formulation transfer.

Main Results:

The simulation demonstrated that a typical patient can transition from q 6 h IR disopyramide to an equivalent daily dose of CR disopyramide.
The CR disopyramide can be administered q 12 h.
Initiation of CR disopyramide should occur 6 hours after the final IR dose.

Conclusions:

A q 12 h CR disopyramide regimen is a viable alternative for patients previously on q 6 h IR disopyramide.
This transition strategy is suitable for patients with normal cardiac, renal, and hepatic function.
The recommended timing ensures a smooth pharmacokinetic transition, minimizing potential concentration fluctuations.

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