Abstract | OBJECTIVE: AIM: DESIGN: Pharmacokinetics of immediate and modified release hydrocortisone, each administered at a dose of 40-20-0 mg, in nine patients with ACC and adjuvant mitotane treatment. For comparison, ten patients with secondary adrenal insufficiency (SAI) on three different hydrocortisone regimens and ten healthy males were included. METHODS: RESULTS: Calculated free serum cortisol levels after 40 mg immediate release hydrocortisone in ACC patients (46 ± 14 nmol/l) were similar to those after 10 mg immediate release hydrocortisone intake in men with SAI (64 ± 16 nmol/l) or to the physiological morning free cortisol levels in healthy subjects (31 ± 5 nmol/l). Compared to immediate release hydrocortisone, free cortisol levels after 40 mg modified release hydrocortisone in ACC patients were significantly lower (12 ± 3 nmol/l; P = 0·03) resulting in a generally lower AUC (98 ± 21 vs 149 ± 37 nmol h/l; P = 0·02). CONCLUSIONS: 40-20-0 mg immediate release, but not modified release hydrocortisone, resulted in sufficient glucocorticoid coverage in patients with ACC receiving mitotane treatment. The use of equivalent doses of modified release hydrocortisone preparation should be avoided in patients on mitotane treatment.
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Authors | Marianne Weigel, Stefanie Hahner, Mark Sherlock, Amar Agha, Lucy Ann Behan, Paul M Stewart, Wiebke Arlt, Daniela Beier, Kathrin Frey, Kathrin Zopf, Marcus Quinkler |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 86
Issue 4
Pg. 499-505
(Apr 2017)
ISSN: 1365-2265 [Electronic] England |
PMID | 28063163
(Publication Type: Journal Article)
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Copyright | © 2017 John Wiley & Sons Ltd. |
Chemical References |
- Mitotane
- Adrenocorticotropic Hormone
- Hydrocortisone
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Topics |
- Adrenal Cortex Neoplasms
(drug therapy)
- Adrenal Insufficiency
(drug therapy)
- Adrenocorticotropic Hormone
(blood)
- Adult
- Aged
- Case-Control Studies
- Female
- Humans
- Hydrocortisone
(administration & dosage, blood, pharmacokinetics)
- Male
- Middle Aged
- Mitotane
(therapeutic use)
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