| Title |
A dosing algorithm for metformin based on the relationships between exposure and renal clearance of metformin in patients with varying degrees of kidney function
|
|---|---|
| Published in |
European Journal of Clinical Pharmacology, April 2017
|
| DOI | 10.1007/s00228-017-2251-1 |
| Pubmed ID | |
| Authors |
Janna K. Duong, M. Y. A. M. Kroonen, S. S. Kumar, H. L. Heerspink, C. M. Kirkpatrick, G. G. Graham, K. M. Williams, R. O. Day |
| Abstract |
The aims of this study were to investigate the relationship between metformin exposure, renal clearance (CLR), and apparent non-renal clearance of metformin (CLNR/F) in patients with varying degrees of kidney function and to develop dosing recommendations. Plasma and urine samples were collected from three studies consisting of patients with varying degrees of kidney function (creatinine clearance, CLCR; range, 14-112 mL/min). A population pharmacokinetic model was built (NONMEM) in which the oral availability (F) was fixed to 0.55 with an estimated inter-individual variability (IIV). Simulations were performed to estimate AUC0-τ, CLR, and CLNR/F. The data (66 patients, 327 observations) were best described by a two-compartment model, and CLCR was a covariate for CLR. Mean CLR was 17 L/h (CV 22%) and mean CLNR/F was 1.6 L/h (69%).The median recovery of metformin in urine was 49% (range 19-75%) over a dosage interval. When CLR increased due to improved renal function, AUC0-τ decreased proportionally, while CLNR/F did not change with kidney function. Target doses (mg/day) of metformin can be reached using CLCR/3 × 100 to obtain median AUC0-12 of 18-26 mg/L/h for metformin IR and AUC0-24 of 38-51 mg/L/h for metformin XR, with Cmax < 5 mg/L. The proposed dosing algorithm can be used to dose metformin in patients with various degrees of kidney function to maintain consistent drug exposure. However, there is still marked IIV and therapeutic drug monitoring of metformin plasma concentrations is recommended. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Australia | 3 | 43% |
| Spain | 1 | 14% |
| Unknown | 3 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 71% |
| Practitioners (doctors, other healthcare professionals) | 1 | 14% |
| Scientists | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 39 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 9 | 23% |
| Student > Ph. D. Student | 8 | 21% |
| Researcher | 4 | 10% |
| Student > Doctoral Student | 3 | 8% |
| Other | 3 | 8% |
| Other | 5 | 13% |
| Unknown | 7 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 33% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 15% |
| Biochemistry, Genetics and Molecular Biology | 2 | 5% |
| Nursing and Health Professions | 2 | 5% |
| Computer Science | 2 | 5% |
| Other | 7 | 18% |
| Unknown | 7 | 18% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 May 2017.
All research outputs
#6,200,950
of 22,968,808 outputs
Outputs from European Journal of Clinical Pharmacology
#699
of 2,567 outputs
Outputs of similar age
#98,400
of 310,521 outputs
Outputs of similar age from European Journal of Clinical Pharmacology
#6
of 22 outputs
Altmetric has tracked 22,968,808 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 2,567 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 310,521 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 22 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.