Effect of concomitant administration of clodronate and estramustine phosphate on their bioavailability in patients with metastasized prostate cancer

Pharmacol Toxicol. 1996 Sep;79(3):157-60. doi: 10.1111/j.1600-0773.1996.tb00260.x.

Abstract

Estramustine phosphate is generally used as a second-line treatment in patients with advanced prostate cancer. The bone metastases due to the cancer are often treated simultaneously with clodronate in order to relieve the bone pain. Therefore, the interaction of clodronate (800 mg orally four times daily) and estramustine phosphate (280 mg orally twice daily) on their bioavailability was studied in twelve patients with prostate carcinoma and bone metastases. The drugs were first given separately, each to six patients, for five days, and then concomitantly for the same period. The bioavailabilities of the drugs were calculated on the last day of each treatment period. When clodronate was given alone, its concentrations in serum and AUC for one dose interval (6 hr) did not differ from those obtained with the drug given concomitantly with estramustine phosphate, nor did the combination of estramustine phosphate change the excretion of clodronate in urine. The serum concentrations of estramustine phosphate were elevated by about 80% when the drug was given together with clodronate. The AUC for one dose interval (12 hr) was also significantly higher for estramustine phosphate with clodronate than without clodronate. The urinary excretion of estrone, a major metabolite of estramustine phosphate, was also significantly higher after the admission with clodronate. The results suggest that clodronate increases the oral bioavailability of estramustine phosphate.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Non-Narcotic / pharmacokinetics
  • Analgesics, Non-Narcotic / therapeutic use*
  • Analysis of Variance
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Hormonal / pharmacokinetics
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Biological Availability
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / secondary
  • Carcinoma / drug therapy
  • Clodronic Acid / administration & dosage
  • Clodronic Acid / pharmacokinetics
  • Clodronic Acid / therapeutic use*
  • Clodronic Acid / urine
  • Drug Synergism
  • Drug Therapy, Combination
  • Estramustine / administration & dosage
  • Estramustine / pharmacokinetics
  • Estramustine / therapeutic use*
  • Estramustine / urine
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Male
  • Middle Aged
  • Pain / drug therapy
  • Prostatic Neoplasms / drug therapy*

Substances

  • Analgesics, Non-Narcotic
  • Antineoplastic Agents, Hormonal
  • Clodronic Acid
  • Estramustine