Pharmacokinetic behaviour of sublingually administered 8-methoxypsoralen for PUVA therapy. 2001

S E Shephard, and P Langguth, and R G Panizzon
Department of Dermatology, University Hospital of Zürich, Switzerland. shephard@derm.unizh.ch

BACKGROUND Conventional oral PUVA therapy is hampered by large inter- and intraindividual variations in the bioavailability of 8-methoxypsoralen (8-MOP), caused by its low solubility in the gastrointestinal juices and large interindividual differences in hepatic metabolism rate (hepatic first pass). OBJECTIVE New galenic formulations of 8-MOP based on solid dispersions, suspensions, and saturated solutions containing penetration enhancers were developed for sublingual administration, a drug delivery route which avoids the hepatic first pass metabolism. METHODS Solubility properties of 8-MOP were tested in 22 potential penetration enhancers and solubilizers. Following preliminary in vivo tests of 13 sublingual 8-MOP formulations, five were administered to groups of volunteers at a nominal dose of 0.6 mg/kg body weight: two solid dispersions based on PEG 1540 (with and without Xylitol); a solution in Labrasol (glyceryl and PEG-8 caprylate/caprate), PEG 400, Transcutol (ethoxydiglycol) (1:1:1); a micronized suspension in sorbitol, water, ethanol, propylene glycol (ca. 3:1:1:5 w/v); and Oxsoralen capsules. Pharmacokinetic behaviour of 8-MOP was examined in serum; samples were analysed by HPLC. Photosensitivity was measured in seven subjects. RESULTS The peak of maximum 8-MOP concentration in blood was sharp, rapid and reproducible: tmax of 8-MOP in blood averaged 23+/-3 min, independent of the particular formulation. Cmax was higher when 8-MOP was presented in dissolved form (solution and capsule formulations, 85+/-29 and 85+/-35 ng/ml, respectively) and lowest with the suspension (42+/-15 ng/ml). Photosensitivity peaked reproducibly at 45 min. post dosing. CONCLUSIONS Sublingual PUVA therapy is suitable for patients with skin types I and II, in particular patients who are less suitable candidates for standard PUVA therapy (due to hepatic, renal, or cardiac insufficiency) or who have experienced side effects with standard PUVA.

UI MeSH Term Description Entries
D008297 Male Males
D008730 Methoxsalen A naturally occurring furocoumarin compound found in several species of plants, including Psoralea corylifolia. It is a photoactive substance that forms DNA ADDUCTS in the presence of ultraviolet A irradiation. 8-Methoxypsoralen,Ammoidin,Xanthotoxin,8-MOP,Deltasoralen,Dermox,Geroxalen,Meladinina,Meladinine,Meloxine,Methoxa-Dome,Méladinine,Oxsoralen,Oxsoralen-Ultra,Puvalen,Ultramop,8 MOP,8 Methoxypsoralen,8MOP,Methoxa Dome,Oxsoralen Ultra
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011565 Psoriasis A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. Palmoplantaris Pustulosis,Pustular Psoriasis of Palms and Soles,Pustulosis Palmaris et Plantaris,Pustulosis of Palms and Soles,Psoriases
D011701 PUVA Therapy Photochemotherapy using PSORALENS as the photosensitizing agent and ultraviolet light type A (UVA). Psoralen Ultraviolet A Therapy,Therapy, PUVA,PUVA Therapies,Therapies, PUVA
D005079 Excipients Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form. These include binders, matrix, base or diluent in pills, tablets, creams, salves, etc. Excipient,Stabilizing Agent,Stabilizing Agents,Suspending Agent,Suspending Agents,Agent, Stabilizing,Agent, Suspending,Agents, Stabilizing,Agents, Suspending
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000286 Administration, Sublingual Administration of a soluble dosage form by placement under the tongue. Drug Administration, Sublingual,Sublingual Drug Administration,Sublingual Administration,Administration, Sublingual Drug,Administrations, Sublingual,Administrations, Sublingual Drug,Drug Administrations, Sublingual,Sublingual Administrations,Sublingual Drug Administrations
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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