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Stereoselective disposition of ibuprofen enantiomers in infants

E Rey1, A Pariente-Khayat, L Gouyet

  • 1Département de Pharmacologie Périnatale et Pédiatrique, Hôpital Saint-Vincent de Paul, Paris, France.

Insights

Infant pharmacokinetics of ibuprofen show similar half-lives for both enantiomers. However, lower plasma concentrations of the active S(+)-ibuprofen suggest higher infant dosages may be needed.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Drug Metabolism

Background:

  • Ibuprofen is a common nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation.
  • Understanding the pharmacokinetic differences between ibuprofen enantiomers is crucial for optimizing pediatric dosing.
  • Infant drug metabolism can differ significantly from adults, necessitating specific pharmacokinetic studies.

Purpose of the Study:

  • To investigate the pharmacokinetic profiles of S(+) and R(-) ibuprofen enantiomers in infants.
  • To compare the enantiomer-specific pharmacokinetics of ibuprofen in an infant population.
  • To determine if current ibuprofen dosing regimens are adequate for infants based on enantiomer-specific concentrations.

Main Methods:

  • Oral administration of a single racemic ibuprofen dose (7.6 mg/kg) to 11 infants.
  • Measurement of plasma concentrations of S(+) and R(-) ibuprofen enantiomers over time.
  • Calculation of pharmacokinetic parameters including half-life and area under the concentration-time curve (AUC).

Main Results:

  • Mean half-life for S(+)-ibuprofen was 1.6 ± 0.5 hours; for R(-)-ibuprofen, it was 1.5 ± 0.5 hours.
  • Mean AUC for S(+)-ibuprofen was 31.5 ± 14.3 mg·h/L; for R(-)-ibuprofen, it was 36.6 ± 13.8 mg·h/L.
  • Plasma concentrations of the active S(+)-enantiomer were lower in infants compared to adult data.

Conclusions:

  • The pharmacokinetics of ibuprofen enantiomers in infants show comparable elimination rates.
  • Lower plasma levels of S(+)-ibuprofen in infants suggest potential underdosing compared to adults.
  • Further studies are warranted to establish optimal ibuprofen dosage regimens for pediatric populations.

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