1 The pharmacokinetics, protein binding, bioavailability and metabolism of (+)-R-and (-)-S-nitrendipine were studied in six healthy subjects following random oral administration of 20 mg (+)-R-, 20 mg (-)-S-and 20 mg R,S-nitrendipine (pseudoracemic mixture of 10 mg [13C4)-(+)-R-and 10 mg (-)-S-enantiomer). 2 After administration of the enantiomers pronounced differences in AUC (R: 29.9 + 20.1; S: 123.8 ± 63.7 ng ml-' h; P < 0.05), bioavailability (R: 10.7 ± 7.4%; S: 44.6 + 23.1%; P < 0.05) and Cmax (R: 14.4 ± 7.7; S: 72.5 ± 40.5 ng ml-1; P < 0.05) were observed between R-and S-nitrendipine. When racemic nitrendipine was given bioavailability and dose normalized AUC and Cmax values of the S-enantiomer were not different from the values after S-nitrendipine-administration. In constrast, bioavailability (R: 10.7% R,S: 22.1%) and dose normalized AUC (R: 15.0; R,S: 29.5 ng ml-1 h and Cmax (R: 7.2; R,S: 16.8 ng ml-') of R-nitrendipine were doubled following R,S-as compared with R-nitrendipine administration. t½/2 (R: 9.8; S: 9.1 h) and tmax were not different between the enantiomers nor were the values different after administration of the enantiomers or racemate. The fraction unbound in serum of R-nitrendipine was 0.0098 ± 0.0032 (s.d.) and that of S-nitrendipine was 0.0083 + 0.0015 (s.d.). 3 The AUC values of the major pyridine metabolite Ml were similar after administration of R-and S-nitrendipine (S: 114.7 ± 48.5; R: 71.7 ± 29.9 ng ml-' h). After racemic nitrendipine dose normalized AUC values were not different from those observed after administration of the enantiomers. 4 The cumulative urinary excretion of the four major pyridine metabolites M2a, M2b, M3a and M3b was significantly higher after S-nitrendipine. The % of dose which was recovered in urine within 48 h was 63.2 ± 6.6% (administration of racemate)/69.0 ± 5.9% (administration of S-enantiomer) for the S-enantiomer and 42.0 ± 5.1% (R,Snitrendipine)/43.8 ± 7.6% (R-enantiomer) for the R-enantiomer, respectively. Formation of metabolite M2a, which is generated by cleavage of the ethyl ester bond and oxidation of the 1,4-dihydropyridine ring to pyridine, exhibited stereoselectivity. On average 43.9 ± 3.9% of dose was formed from S-nitrendipine as compared with 24.7 ± 2.2% from R-nitrendipine following administration of the racemate. 5 Substantial differences in the metabolism, bioavailability and disposition of R-and Snitrendipine were observed. The first-pass metabolism of nitrendipine is stereoselective affecting mainly the less potent R-enantiomer. The bioavailability of R-nitrendipine doubled after administration of the racemate as compared with R-nitrendipine suggesting a metabolic enantiomer-enantiomer interaction with the S-enantiomer acting as an inhibitor of R-nitrendipine metabolism. With regard to the metabolic pathways responsible for stereoselective first-pass metabolism, it is unlikely that oxidation of nitrendipine to the pyridine metabolite Ml is involved since no substantial differences in the AUC of this metabolite were observed after admi...