Pharmacokinetic drug interactions with oral haloperidol in adults: dose correction factors from a combined weighted analysis

McGrane, Ian R.; Spina, Edoardo; Hiemke, Christoph; Leon, José de

doi:10.1080/17425255.2022.2057297

Cited by 6 publications

(4 citation statements)

References 113 publications

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“…Thus, the history of clozapine may not be relevant for new drugs, but it may be relevant for other psychiatric drugs approved before comprehensive pharmacokinetic studies were required. In that sense, he proposes that for personalized dosing, prescribers need to consider DDIs and smoking for haloperidol (McGrane et al, 2022) and CYP2D6 PM genotyping, DDIs, and renal impairment for risperidone dosing (de Leon, 2022).…”

Section: Discussionmentioning

confidence: 99%

The history of clozapine in clinical practice: From its introduction to a guideline proposing personalized titrations

Leon

2022

J Psychopharmacol

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Section: Discussionmentioning

confidence: 99%

The history of clozapine in clinical practice: From its introduction to a guideline proposing personalized titrations

Leon

2022

J Psychopharmacol

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“…60 Thus, clozapine has never been well studied. This is not unique for clozapine; other antipsychotics, including haloperidol 61 or risperidone, 62 approved before 1996, have the same problem. Once a drug becomes generic there is no incentive for the pharmaceutical company to economically support the huge effort needed to complete comprehensive studies and update the package insert.…”

Section: Clozapine and Development Of Pharmacokinetic Sciencementioning

confidence: 99%

“…Unfortunately, biological diversity has not received enough attention in psychopharmacology practice, in general, and in patients of East Asian ancestry, specifically. Supplementary Table 14 (in the online-only Data Supplement) uses as examples four other psychiatric drugs (diazepam, 52,[180][181][182][183][184] carbamazepine, [185][186][187] olanzapine, 21,25,131,157,188 and haloperidol 24,61,64,[189][190][191] ) in which paying attention to East Asian ancestry may be important. The literature provides reasonable information concerning lower diazepam dosing in East Asians and for genotyping human leukocyte antigen-B*15:02 before starting carbamazepine in East Asian countries, except Japan.…”

Section: Further Reflections On Ethnopsychopharmacology Relevant For ...mentioning

confidence: 99%

“…In 2012, in an in vitro study, Kato et al 190 reported that haloperidol glucuronidation is explained by several UGTs, but UGT2B7 is the most important. • In a recent review of haloperidol pharmacokinetics, 61 the author commented that some patients of African-American ancestry may have longer elimination half-lives possibly due to differences in UGTs, but there was little understanding of the functional effects and racial variations of the UGT2B7 allele. Unfortunately, he was not aware of differences for East Asians.…”

Section: Supplementary Table 1 the Need For An Open-minded Readermentioning

confidence: 99%

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Reflections on the Lack of Consideration of Ethnic Ancestry to Stratify Clozapine Dosing

León

2023

Psychiatry Investig

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This review article argues against trusting standard clozapine references, including the US package insert, because they do not include advances in the sciences of pharmacokinetics and pharmacovigilance and ignore the effects of ethnic ancestry on therapeutic dosing. The minimum therapeutic dose leading to the minimum therapeutic concentration of 350 ng/mL in serum/plasma can be used to compare individuals/groups with treatment-resistant schizophrenia. The US clozapine package insert recommends targeting doses of 300-450 mg/day and, subsequently, increments of up to 100 mg with a maximum dose of 900 mg/day. Ethnic ancestry is defined by DNA ancestry group. Asians (people with ancestry ranging from Pakistan to Japan) and Indigenous Americans are similar in clozapine dosing; their average clozapine minimum therapeutic dose ranged from 166 mg/day (female non-smokers) to 270 mg/day (male smokers). For those with European ancestry, average clozapine minimum therapeutic doses ranged from 236 mg/day (female non-smokers) to 368 mg/day (male smokers). Based on limited studies, Black (African sub-Saharan ancestry) patients may be treated with typical US doses (300-600 mg/day), assuming no poor metabolism (PM) status. Ancestry's impact on clozapine lethality in four countries is discussed (two countries with highly homogenous populations, Denmark and Japan, and two countries with increasingly heterogenous populations due to immigration, Australia and the UK). An international guideline with 104 authors from 50 countries/regions was recently published, providing 6 personalized clozapine titration schedules for adult inpatients (3 ancestry groups and PM/non-PM schedules) and recommending c-reactive protein monitoring at baseline and weekly for 4 weeks.

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Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: A systematic review & combined analysis

Schmidt

Deligiannidis

Kittel‐Schneider

et al. 2023

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Pharmacokinetic drug interactions with oral haloperidol in adults: dose correction factors from a combined weighted analysis

Cited by 6 publications

References 113 publications

The history of clozapine in clinical practice: From its introduction to a guideline proposing personalized titrations

The history of clozapine in clinical practice: From its introduction to a guideline proposing personalized titrations

Reflections on the Lack of Consideration of Ethnic Ancestry to Stratify Clozapine Dosing

Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: A systematic review & combined analysis

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