Pharmacokinetics and bioavailability of cimetidine in humans. 1980

P V Pedersen, and R Miller

Cimetidine given orally without food after an overnight fast produces a blood concentration curve with a pronounced second peak that does not appear after parenteral administration or when the drug is taken with food. The following interpretation of this kinetic phenomenon is proposed: 1. The drug cumulates in a tissue or organ that is well perfused in the first-pass transfer. 2. The hepatic parenchymal tissue and the bile phase are the most likely storage areas. 3. The high capacity of the cumulation may be due to the formation of conjugates or other modifications of the drug with a pronounced affinity for the hepatic-biliary system. 4. The rate of cumulation is much higher in the first-pass transfer than from the systemic circulation, possibly due to the difference in the drug concentrations and the conjugation rate. 5. The cumulation appears to occur by a competitive process. 6. Absorbed elements of food seem to compete in this process. 7. The second peak apparently is the result of a rapid release of drug and bioreversible drug compounds from the hepatic-biliary system with subsequent reabsorption. 8. This release may occur spontaneously but appears to be triggered by food intake. A pharmacokinetic model constructed according to this interpretation showed good agreement with data from oral, intravenous, and intramuscular administration. The special problems associated with the evaluation of bioavailability in the presence of reabsorption are discussed.

UI MeSH Term Description Entries
D007408 Intestinal Absorption Uptake of substances through the lining of the INTESTINES. Absorption, Intestinal
D007700 Kinetics The rate dynamics in chemical or physical systems.
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008433 Mathematics The deductive study of shape, quantity, and dependence. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Mathematic
D002927 Cimetidine A histamine congener, it competitively inhibits HISTAMINE binding to HISTAMINE H2 RECEPTORS. Cimetidine has a range of pharmacological actions. It inhibits GASTRIC ACID secretion, as well as PEPSIN and GASTRIN output. Altramet,Biomet,Biomet400,Cimetidine HCl,Cimetidine Hydrochloride,Eureceptor,Histodil,N-Cyano-N'-methyl-N''-(2-(((5-methyl-1H-imidazol-4-yl)methyl)thio)ethyl)guanidine,SK&F-92334,SKF-92334,Tagamet,HCl, Cimetidine,Hydrochloride, Cimetidine,SK&F 92334,SK&F92334,SKF 92334,SKF92334
D006146 Guanidines A family of iminourea derivatives. The parent compound has been isolated from mushrooms, corn germ, rice hulls, mussels, earthworms, and turnip juice. Derivatives may have antiviral and antifungal properties.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations
D001646 Bile An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum. Biliary Sludge,Sludge, Biliary
D001682 Biological Availability The extent to which the active ingredient of a drug dosage form becomes available at the site of drug action or in a biological medium believed to reflect accessibility to a site of action. Availability Equivalency,Bioavailability,Physiologic Availability,Availability, Biologic,Availability, Biological,Availability, Physiologic,Biologic Availability,Availabilities, Biologic,Availabilities, Biological,Availabilities, Physiologic,Availability Equivalencies,Bioavailabilities,Biologic Availabilities,Biological Availabilities,Equivalencies, Availability,Equivalency, Availability,Physiologic Availabilities

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