Anthracycline Pharmacokinetics: Limited sampling model for plasma level monitoring with special reference to epirubicin (Farmorubicin)

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Abstract
A new prinicple for plasma level monitoring of the anthracy-clines doxorubicin and epirubicin is presented. The area under the plasma concentration time curve (AUC) is linearly correlated with the maximum plasma concentration of the drugs at the end of 2 and 4 hours' constant rate infusions. From this relationship it is possible to obtain accurate estimates of the AUC values of the drugs in the individual patients from plasma samples, withdrawn during the last 15 minutes prior to the completion of the infusions. The limited sampling model for drug monitoring of doxorubicin and epirubicin described here is robust and simple to use. It does not require a strict time control for the withdrawing of samples. Measured maximum plasma concentrations of epirubicin during 2 hours' constant rate infusions of 70mgm−2 to patients with lymphoma (median age: 46.5 years) were within the range 171–404ngml−1 (median value: 265ngml−1).