The Effect of Decontamination Procedures on the Pharmacokinetics of Venlafaxine in Overdose

V KUMAR, S OSCARSSON, L FRIBERG, Geoffrey Isbister, L HACKETT, S DUFFULL

    Research output: Contribution to journalArticle

    Abstract

    The aim of this work was to investigate the pharmacokinetics (PK) of venlafaxine in overdose and the effects of single-dose activated charcoal (SDAC) and whole-bowel irrigation (WBI), alone or in combination, as methods of decontamination. The data included 339 concentration-time points from 76 venlafaxine overdose events (median dose 2,625 (150-13,500 mg)); 69 were slow-release doses. SDAC, WBI, a combination of both, or no decontamination were administered to patients as decided by the treating clinician. The data were modeled using WinBUGS (Windows Bayesian Inference Using Gibbs Sampling). A one-compartment model with first-order input and elimination provided an adequate description of the data. SDAC increased clearance (CL) of venlafaxine by 35%, and SDAC and WBI combined reduced the fraction absorbed by 29%. However, the latter produced a greater reduction in maximum plasma concentration (C max) for a similar drop in area under the plasma concentration-time curve (AUC). Both SDAC alone, and a combination of SDAC and WBI, decreased the AUC after venlafaxine overdose, but the combination may be more beneficial because it reduces peak concentrations to a greater extent. � 2009 American Society for Clinical Pharmacology and Therapeutics.
    Original languageEnglish
    Pages (from-to)403-410
    Number of pages8
    JournalClinical Pharmacology and Therapeutics
    Volume86
    Issue number4
    Publication statusPublished - 2009

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