Key result
Ticlopidine administration resulted in significantly higher AUC values in elderly subjects compared to young subjects after a single 250 mg dose (2.04 vs 1.11 micrograms ml-1 h; P=0.002).
Why the study?
Does age affect the pharmacokinetics of single and multiple doses of ticlopidine?
Does age affect the pharmacokinetics of single and multiple doses of ticlopidine?
Ticlopidine exposure is significantly higher in elderly compared to young subjects after multiple dosing, suggesting age-related differences in its pharmacokinetics.
May warrant PK caution with ticlopidine in elderly; leaves open effects on multiple dosing and clinical outcomes.
The pharmacokinetics of orally administered ticlopidine hydrochloride, a novel inhibitor of platelet aggregation, were determined both after a single dose and after 21 days of twice daily dosing in 12 young (mean 28.6 years) and 13 elderly (mean 69.5 years) subjects. Concentrations of unchanged ticlopidine in plasma were measured by g.l.c. After a single 250 mg dose of ticlopidine, the mean area under the curve, AUC (0-12 h) was 1.11 micrograms ml-1 h in young subjects and 2.04 micrograms ml-1 h in old subjects (P = 0.002). Mean values of t1/2,z in young and elderly subjects were 7.9 h and 12.6 h, respectively (P = 0.01). Steady state plasma drug concentrations were attained after 14 days of dosing with ticlopidine. After the final dose on day 21, AUC values in elderly subjects were 2-3 times those in young subjects (P less than 0.001). The plasma t1/2,z averaged 4.0 days for young subjects and 3.8 days for elderly subjects (P = 0.7). The longer t1/2,z and higher AUC values after multiple dosing probably reflect an increase in bioavailability of ticlopidine after repeated dosing, saturation of metabolism or insufficient analytical sensitivity to characterize the terminal elimination phase after single dose.
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Shah et al. (1991) studied this question. Ticlopidine hydrochloride vs. Young subjects was evaluated on AUC (0-12 h) after a single 250 mg dose (p=0.002). Ticlopidine administration resulted in significantly higher AUC values in elderly subjects compared to young subjects after a single 250 mg dose (2.04 vs 1.11 micrograms ml-1 h; P=0.002).
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