A dose-ranging pharmacokinetics study of sodium diethyldithiocarbamate in normal healthy volunteers

Sodium diethyldithiocarbamate (DDTC) is an investigational modulator of the toxicity produced by cisplatin. The pharmacokinetics of DDTC were evaluated after administration of 200 mg/m2/hr (n = 8) and 400 mg/m2/hr (n = 7) DDTC as 4-hour intravenous infusions to normal male healthy volunteers. Diethyldithiocarbamate concentration at steady-state (Cpss) increased disproportionally from 27.0 +/- 7.6 microM for the low dose to 74.8 +/- 19.3 microM for the high dose, whereas total body clearance decreased from 23.83 +/- 8.23 mL/min/kg for the low dose to 15.48 +/- 2.72 mL/min/kg for the high dose (P < 0.05). However, the volume of distribution in the terminal phase remained unchanged. Diethyldithiocarbamate terminal elimination half-life (t1/2 beta) increased from 3.74 +/- 1.10 minutes for the low dose to 6.08 +/- 1.07 minutes for the high dose (P < 0.005). The data were then fitted using a one-compartment open model with zero-order infusion and Michaelis-Menten elimination kinetics. The Km for DDTC was estimated to be 124.3 +/- 19.9 microM, whereas the Vm was estimated to be 3.67 +/- 1.15 mumol/min/kg. However, DDTC t1/2 beta was independent of DDTC concentrations, suggesting that the nonlinearity in DDTC kinetics does not exactly follow Michaelis-Menten elimination kinetics. Thus, DDTC pharmacokinetics are dose dependent and may not be concentration dependent. Clinically, DDTC Cpss will increase nonlinearly with an increase in dose.