Effects of surfactants on amiodarone intestinal absorption. I. Sodium laurylsulfate

Amiodarone is a widely used antiarrhythmic agent with high variability in therapeutic effects, which appears to be related, at least in part, to its pharmacokinetics, and in particular, gastrointestinal absorption. The drug exhibits physico-chemical properties highly suitable for diffusion across lipophilic absorbing membranes but its low aqueous solubility can act as the rate limiting step for absorption, making it erratic and variable. In studying the intestinal absorption mechanism of amiodarone, a series of experiments using a rat gut in situ preparation was performed in the presence of a synthetic anionic surfactant, as a drug solubilizer, i.e., sodium laurylsulfate, at variable supramicellar concentrations (from 2.6 to 104 mM). Absorption rate constants of amiodarone decreased as surfactant concentration increased, the absorption being unusually fast at lower surfactant concentrations. Equations were developed to evaluate the relationship between absorption rate constant and surfactant concentration in the intestinal luminal fluid.