Clozapine In Human Plasma Research Articles

Comparative Bioavailability of Two Oral Formulations of Clozapine in Steady State Administered in Schizophrenic Volunteers Under Individualized Dose Regime

In the present study, a novel, fast, sensitive and robust method to quantify clozapine in human plasma using quetiapine as the internal standard (IS) is described. The analyte and the IS were extracted from plasma using a single protein precipitation extraction technique with methanol and analyzed by high performance liquid chromatography coupled to the electrospray ionization tandem mass spectrometric (HPLC-ESI-MS/MS). The method was linear over the range 20 to 1500 ng.mL-1. The intra-assay precisions ranged from 3.8 to 5.9%, while inter-assay precisions ranged from 4.2 to 6.0%. The intra-assay accuracies ranged from 99.3 to 107.5%, while the inter-assay accuracies ranged from 98.9 to 101.7%. This method agrees with the requirements proposed by the US Food and Drug Administration of high sensitivity, specificity and high sample throughput and was used to evaluate the pharmacokinetic profiles and bioequivalence of the two clozapine formulations in twenty six schizophrenic patients affected by refractory schizophrenia under steady-state conditions. During the hospitalization period the patients received the 100 mg clozapine formulation tablets corresponding to the same dose they were using 14 days before hospitalization. The clozapine pharmacokinetic did not differ significantly after administration of both test and the reference formulations. The Tmax and T1/2 for the test formulation were 2.26 and 10.92 h, respectively. In addition, the Tmax and T1/2 for the reference formulation were 2.44 and 11.08 h, respectively. The 90% confidence interval of the mean ratio of lnAUC0-t was within 0.80-1.25 range which indicates that the test formulation was bioequivalent to the reference formulation when orally administered to schizophrenic patients regarding both the rate and extent of absorption.

LC-MS-MS Determination and Pharmacokinetic Study of Clozapine in Human Plasma

A sensitive and selective liquid chromatographic method coupled with tandem mass spectrometry was established and validated for the determination and pharmacokinetic study of clozapine in human plasma. Ethyl acetate extraction was used for plasma sample preparation with mirtazapine as internal standard. Chromatographic separation was achieved on a Hanbon Kromasil C18 (250 mm × 4.6 mm, 5 μm) column by isocratic elution with a mixture of 70 volumes of methanol and 30 volumes of water containing 0.2% ammonium acetate and 0.1% formic acid as mobile phase delivered at 1.0 mL min−1. The MS-MS detection was carried out on a tandem mass spectrometer using positive electrospray ionization and multiple reaction monitoring with argon for collision-induced dissociation. The ion transitions were monitored as follows: m/z 327 to m/z 270 for clozapine and m/z 266 to m/z 195 for the internal standard (mirtazapine), respectively. Calibration curves were generated over the concentration range from 0.10 to 200 ng mL−1 with the lower limit of quantification of 0.10 ng mL−1, and two segments of linear calibration curves were established by regressing in the way of least-square in the range from 0.10 to 5.0 and 5.0 to 200 ng mL−1, respectively. The intra- and inter-day precision and accuracy were determined at three different concentration levels, 0.20, 10.0 and 100 ng mL−1, and were all better than 15% (n = 5). This specific and sensitive liquid chromatography coupled with tandem mass spectrometry has been successfully applied to a pharmacokinetic study of clozapine after a single oral dose of 25 mg in healthy Chinese volunteers.

Determination of clozapine and its N-desmethyl metabolite by high-performance liquid chromatography with ultraviolet detection

A rapid high-performance liquid chromatographic method has been developed for the simultaneous determination of the atypical antipsychotic drug clozapine and its principal metabolite, N-desmethyl clozapine in human plasma. After liquid–liquid extraction the compounds were separated in a reversed-phase column and measured by ultraviolet absorption at 230 nm. For both compounds inter-day variations were <3.8%, and, based on a plasma sample volume of 2 ml, the limits of quantification were 25 ng/ml. Analytical interference from coadministered psychoactive drugs and their metabolites was also studied, and no interference was found from the most commonly used antidepressants and antipsychotic drugs. The assay is sufficiently sensitive and easy to use for the analysis of plasma samples in human clinical trials and therapeutic drug monitoring.

Solid-phase microextraction for the assay of clozapine in human plasma

Solid-phase microextraction (SPME) was investigated as sample preparation for the assay of the neuroleptic drug clozapine in human plasma. A mixture of human plasma, water, loxapine as internal standard and aqueous NaOH was extracted with a 100 μm-polydimethylsiloxane-(PDMS)-fiber for 30 min. The analyte and internal standard were well separated in the gas chromatogram. The calibration was linear and passed the origin. Accuracy and precision as well as the influence of changes of the matrix were investigated. No interfering drug was found. It is concluded that the method can be used in the therapeutic drug monitoring of clozapine.

Fishing for a drug: solid-phase microextraction for the assay of clozapine in human plasma

Solid-phase microextraction (SPME) was investigated as a sample preparation method for assaying the neuroleptic drug clozapine in human plasma. A mixture of human plasma, water, loxapine (as internal standard) and aqueous NaOH was extracted with a 100-μm polydimethylsiloxane (PDMS) fiber (Supelco). Desorption of the fiber was performed in the injection port of a gas chromatograph at 260°C (HP 5890; 30 m×0.53 mm I.D., 1 μm film capillary; nitrogen–phosphorous selective detection). Fibers were used repeatedly in up to about 75 analyses. The recovery was found to be 3% for clozapine from plasma after 30 min of extraction. However, in spite of the low recovery, the analyte was well separated and the calibration was linear between 100 and 1000 ng/ml. The within-day and between-day precision was consistently about 8 to 15% at concentrations of 200 ng/ml to 1000 ng/ml. No interfering drug was found. The limit of detection was 30 ng/ml. The sample volume was 250 μl. The influence of the concentration of proteins, triglycerides and salt, i.e., changes in the matrix on the peak areas and peak-area ratios was studied. The method is not impaired by physiological changes in the composition of the matrix. Good agreement was found with a liquid–liquid extraction–gas–liquid chromatography (LLE–GLC) standard method and an on-line column-switching high-performance liquid chromatography (HPLC) method for patients’ samples and spiked samples, respectively. It is concluded that the method can be used in the therapeutic drug monitoring of clozapine because the therapeutic window of clozapine is from 350 to 600 ng/ml.

Determination of clozapine in human plasma by solid-phase extraction and liquid chromatography with amperometric detection

A sensitive and selective high-performance liquid chromatographic method has been developed for monitoring clozapine levels in human plasma. Chromatography was performed on a reversed-phase column (C8, 150 mm×4.6 mm i.d., 5 μm) with acetonitrile-aqueous sodium acetate solution, 88∶12 (v/v), as mobile phase; the flow rate was 1 mL min−1. Clozapine oxidation at +800 mV was detected amperometrically. Response was linearly dependent on concentration over the range 50–1500 ng mL−1 clozapine in plasma. Sample preparation by solid-phase extraction before HPLC analysis gave high extraction yield (94%). The accuracy and precision of the method were both very good (recovery: 97%;RSD<3.3%).

Automated on-line dialysis, trace enrichment and high-performance liquid chromatography. Inhibition of interaction with the dialysis membrane and disruption of protein binding in the determination of clozapine in human plasma.

Problems related to interaction of drugs with the dialysis membrane and to protein binding must be overcome in order to develop automated methods for drug analysis based on on-line dialysis, trace enrichment and HPLC. In order to study these problems, clozapine and its active metabolite N-desmethylclozapine were chosen as model compounds because they were found to interact with the dialysis membrane, and clozapine is highly protein bound. Addition of a cationic surfactant, dodecylethyldimethyl ammonium bromide, to the donor solution and to the plasma samples was found to inhibit interaction of the drugs with surfaces. The protein binding in plasma was disrupted prior to dialysis by lowering the pH with hydrochloric acid and the plasma proteins were solubilised with glycerol. The results obtained were used to develop a fully automated method for the determination of clozapine and N-desmethylclozapine in human plasma. More than 100 samples could be analysed within 24 h. The limit of detection in human plasma was 0.050 mumol/l for clozapine and 0.055 mumol/l for N-desmethylclozapine. Linearity was found for drug concentrations between 0.25-3 mumol/l. The relative standard deviations were between 1.2-6.7% and the method was applicable for therapeutic drug monitoring.

A rapid gas chromatographic method quantitating clozapine in human plasma or serum for the purpose of therapeutic monitoring.

A gas chromatographic method using nitrogen-phosphorus detection was developed to quantitate clozapine in plasma or serum. Methyl clonazepam was used as an internal standard. Sample preparation included a single-step extraction with ethyl acetate, which was injected directly onto a wide-bore capillary column. Within-run and total precision, measured as percent coefficient of variation, were determined at low, therapeutic, and high clozapine plasma concentrations. The within-run precision for the low, therapeutic, and high clozapine plasma samples was 5.2, 2.7, and 2.4%, respectively. The total precision for the low, therapeutic, and high clozapine plasma samples was 10.0, 2.6, and 2.0%, respectively. Analytical accuracy was evaluated by comparing quantitative results with those obtained from a reference laboratory. Those samples containing therapeutic or high concentrations agreed within 3%; the sample containing a subtherapeutic concentration differed by 11.9%. The limit of quantitation was determined to be 35 ng/mL, and the upper limit of linearity was 3000 ng/mL. No significant interferences were detected after testing more than two dozen drugs and metabolites.

Rapid and sensitive determination of clozapine in human plasma using high-performance liquid chromatography and amperometric detection

The present study allows the quantitative determination of clozapine, after a single extraction step in low volumes of blood with a sensitivity comparable with radioimmunoassay and gas chromatography