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Pharmacokinetics and QT interval pharmacodynamics of oral haloperidol in poor and extensive metabolizers of CYP2D6

The Pharmacogenomics Journal volume 3, pages 105–113 (2003)Cite this article

ABSTRACT

We studied the pharmacokinetics and QT interval pharmacodynamics of a single 10 mg dose of oral haloperidol in a randomized, double-blind, placebo-controlled, crossover trial of healthy poor (PMs) and extensive (EMs) metabolizers of CYP2D6. There was a statistically significant greater mean QTc on haloperidol (421.6±20.1 ms) than on placebo (408.4±18.5 ms, P=0.0053) occurring 10 h post haloperidol/placebo administration. Men and women had similar ranges of QTc changes from placebo. Despite a statistically significant greater mean elimination half-life (19.1±3.6 vs 12.9±4.0 h, P=0.04) and lower mean apparent oral clearance (12.8±4.1 vs 27.0±11.3 ml/min/kg, P=0.02) of haloperidol in CYP2D6 PMs than in EMs, this exposure change did not translate into marked QTc changes from baseline that could be considered clinically important. Although the magnitude of the mean QTc prolongation on haloperidol relative to placebo is relatively small, it may assume significance in the presence of other risk factors for QT prolongation.

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Acknowledgements

Supported in parts by Grants T32-9M 08386, a Pharmacogenetics Research Network Grant (U01-GM61373) and RO1-GM56898-01 from the National Institutes of General Medical Sciences, Bethesda, MD and by the Georgetown University GCRC. Data from this study are deposited in the Pharmacogenetics Knowledge Base (Pharmgkb.org) supported by U01-GM61374.

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Authors and Affiliations

  1. Divisions of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA

    M Desai, L Li, J C Gorski, M Arefayene, Y Liu, Z Desta & D A Flockhart

  2. Georgetown University Medical Center, Washington, DC, USA

    M Desai, J E Tanus-Santos, M Arefayene, Z Desta & D A Flockhart

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  1. M Desai
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  2. J E Tanus-Santos
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  3. L Li
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  7. Z Desta
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  8. D A Flockhart
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Correspondence to D A Flockhart.

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Desai, M., Tanus-Santos, J., Li, L. et al. Pharmacokinetics and QT interval pharmacodynamics of oral haloperidol in poor and extensive metabolizers of CYP2D6. Pharmacogenomics J 3, 105–113 (2003). https://doi.org/10.1038/sj.tpj.6500160

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