Pharmacokinetics and tissue distribution of itraconazole after oral and intravenous administration to horses

Abstract

Objective - To determine the pharmacokinetics of itraconazole after IV or oral administration of a solution or capsules to horses and to examine disposition of itraconazole in the interstitial fluid (ISF), aqueous humor, and polymorphonuclear leukocytes after oral administration of the solution. Animals - 6 healthy horses. Procedure - Horses were administered itraconazole solution (5 mg/kg) by nasogastric tube, and samples of plasma, ISF, aqueous humor, and leukocytes were obtained. Horses were then administered itraconazole capsules (5 mg/kg), and plasma was obtained. Three horses were administered itraconazole (1.5 mg/kg, IV), and plasma samples were obtained. All samples were analyzed by use of high-performance liquid chromatography. Plasma protein binding was determined. Data were analyzed by compartmental and noncompartmental pharmacokinetic methods. Results - Itraconazole reached higher mean ± SD plasma concentrations after administration of the solution (0.41 ± 0.13 μg/mL) versus the capsules (0.15 ± 0.12 μg/mL). Bioavailability after administration of capsules relative to solution was 33.83 ± 33.08%. Similar to other species, itraconazole has a high volume of distribution (6.3 ± 0.94 L/kg) and a long half-life (11.3 ± 2.84 hours). Itraconazole was not detected in the ISF, aqueous humor, or leukocytes. Plasma protein binding was 98.81 ± 0.17%. Conclusions and clinical relevance - Itraconazole administered orally as a solution had higher, more consistent absorption than orally administered capsules and attained plasma concentrations that are inhibitory against fungi that infect horses. Administration of itraconazole solution (5 mg/kg, PO, q 24 h) is suggested for use in clinical trials to test the efficacy of itraconazole in horses.