Pharmacokinetics of Isepamicin Sulfate in patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis

The pharmacokinetics of Isepamicin Sulfate (ISP), which is excreted mainly by the kidney, were investigated in patients undergoing HD and CAPD. Intravenous administration of ISP at a dose of 200mg was carried out in 7 patients on HD and 5 patients on CAPD. Serum concentrations of ISP were measured by fluorescence polarization immunoassay (FPLA). The two compartment model was used for pharmacokinetic analysis. Hemodialysis patients had an elimination half life (T1/2β) of 53.48±14.2 hours when they were not on HD and 2.48±0.61 hours during HD. CAPD patients had an elimination half of 40.67±7.58 hours. The whole blood clearances of ISP by HD and CAPD were 95.4±30.6ml/min and 2.56±0.97ml/min, respectively. In conclusion, ISP excretion was remarkably prolonged in patients with chronic renal failure. This drug can be effectively removed by HD, however, necessitating supplementation after each dialysis session. Removal during CAPD was negligible. Drug monitoring is recommended for safe and effective treatment in chronic renal failure patients on all dialysis modalities.