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Enantioselective distribution of albendazole metabolites in cerebrospinal fluid of patients with neurocysticercosis.

AbstractAIMS:
Albendazole (ABZ) is effective in the treatment of neurocysticercosis. ABZ undergoes extensive metabolism to (+) and (-)-albendazole sulphoxide (ASOX), which are further metabolized to albendazole sulphone (ASON). We have investigated the distribution of (+)-ASOX (-)-ASOX, and ASON in cerebrospinal fluid (CSF) of patients with neurocysticercosis.
METHODS:
Twelve patients with a diagnosis of active brain parenchymal neurocysticercosis treated with albendazole for 8 days (15 mg kg(-1) day(-1)) were investigated. On day 8, serial blood samples were collected during the dose interval (0-12 h) and one CSF sample was taken from each patient by lumbar puncture at different time points up to 12 h after the last albendazole dose. Albendazole metabolites were determined in CSF and plasma samples by h.p.l.c. using a Chiralpak AD column and fluorescence detection. Population curves for CSF albendazole metabolite concentration vs time were constructed.
RESULTS:
The mean plasma/CSF ratios were 2.6 (95% CI: 1.9, 3.3) for (+)-ASOX and 2.7 (95% CI: 1.8, 3.7) for (-)-ASOX, with the two-tailed P value of 0.9873 being non-significant. These data indicate that the transport of ASOX through the blood-brain barrier is not enantioselective, but rather depends on passive diffusion. The present results suggest the accumulation of the (+)-ASOX metabolite in the CSF of patients with neurocysticercosis. The CSF AUC(+)/AUC(-) ratio was 3.4 for patients receiving albendazole every 12 h. The elimination half-life of both ASOX enantiomers in CSF was 2.5 h. ASOX was the predominant metabolite in the CSF compared with ASON; the CSF AUC(ASOX)/AUC(ASON) ratio was approximately 20 and the elimination half-life of ASON in CSF was 2.6 h.
CONCLUSIONS:
We have demonstrated accumulation of the (+)-ASOX metabolite in CSF, which was about three times greater than the (-) antipode. ASOX concentrations were approximately 20 times higher than those observed for the ASON metabolite.
AuthorsO M Takayanagui, P S Bonato, S A C Dreossi, V L Lanchote
JournalBritish journal of clinical pharmacology (Br J Clin Pharmacol) Vol. 54 Issue 2 Pg. 125-30 (Aug 2002) ISSN: 0306-5251 [Print] England
PMID12207631 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anthelmintics
  • albendazole sulfone
  • Albendazole
  • albendazole sulfoxide
Topics
  • Adult
  • Albendazole (analogs & derivatives, cerebrospinal fluid, metabolism, pharmacokinetics, therapeutic use)
  • Anthelmintics (cerebrospinal fluid, pharmacokinetics, therapeutic use)
  • Brain Diseases (cerebrospinal fluid, drug therapy, metabolism)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurocysticercosis (cerebrospinal fluid, drug therapy, metabolism)
  • Stereoisomerism

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