Pharmacokinetic Evaluation of Drug Interactions with Anti-Human Immunotrophic Virus (HIV) Drugs. III. 2′,3′-Dideoxycytidine (ddC) and Zidovudine in Monkeys

A pharmacokinetic evaluation of a potential drug interaction between zidovudine (AZT) and dideoxycytidine (ddC) was conducted in monkeys. Each of six animals received 20 mg/kg of AZT intragastrically in the absence and presence of an intravenous steady-state dosage regimen of ddC. The regimen was designed to produce steady-state ddC plasma concentration of 1.77 µg/ml for 30 min. Plasma and urine samples were analyzed for AZT, its major glucuronide metabolite, GAZT, and ddC by HPLC techniques. Pharmacokinetic parameters for AZT and GAZT were calculated by non-compartmental methods. The mean apparent clearance of AZT was 1.40 and 1.78 L/hr/kg in the absence and presence of ddC, respectively. The mean AUC for GAZT was 36.39 µg-hr/ml in the absence of ddC and 28.81 µg-hr/ml in the presence of ddC. No statistical differences were found in these and other pharmacokinetic parameters in the absence and presence of ddC. The absence of an effect on AZT's pharmacokinetics by ddC is attributed to the primary metabolic and renal elimination pathways for AZT and ddC, respectively. The results of this study provide a rational basis to design combined AZT-ddC treatment regimens in AIDS patients.