Cited by 107Pharmacogenetics and Drug MetabolismAnesthesia and Sedative AgentsPharmaceutical studies and practices

Gender differences in pharmacokinetics and pharmacodynamics of zolpidem following sublingual administration

Greenblatt, David J., Harmatz, Jerold S., Singh, Nikhilesh N., Steinberg, Frank, Roth, Thomas, Moline, Margaret L., Harris, Stephen C., Kapil, Ram P.·2014·The Journal of Clinical Pharmacology

Abstract

The effect of dose and gender on the pharmacokinetics (PK) and pharmacodynamics (PD) of zolpidem after administration of a buffered zolpidem sublingual tablet (ZST; Intermezzo®, Purdue Pharma L.P., Stamford, CT, USA) was evaluated in healthy non‐elderly male and female volunteers. Subjects received a single morning dose of ZST (1.0, 1.75, and 3.5 mg) or placebo in a four‐way crossover study. In male and female subjects zolpidem PK were linear, with area under the curve (AUC) proportional to dose, and apparent oral clearance and elimination half‐life independent of dose. However, AUC averaged 40% to 50% higher in females than in males receiving the same dose. The gender effect was incompletely explained by body weight. In females, ZST produced PD changes consistent with benzodiazepine agonist effects, particularly at the 3.5‐mg dose. For several PD variables, PD effects were significantly related to plasma zolpidem concentrations when data were aggregated across subjects. However, there was variability in response among individuals. In males, PD effects of zolpidem seldom differed from placebo regardless of plasma concentration. The findings confirm that zolpidem clearance is lower in females than in males. PD effects of zolpidem from ZST are greater in female subjects, due to a combination of higher plasma concentrations and greater intrinsic sensitivity.

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  • In a placebo-controlled 4-way crossover study, evaluation of the pharmacodynamic effect area under the curve indicated a significant influence of sex, independent of dose, on the DSST such that effects on women were greater than those on men.

    “In this placebo-controlled, 4-way crossover study, evaluation of the pharmacodynamic effect area under the curve indicated a significant influence of sex, independent of dose, on the DSST such that effects on women were seen to be greater than those on men.36”

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Authors
Greenblatt, D. J., Harmatz, J. S., Singh, N. N., Steinberg, F., Roth, T., Moline, M. L., Harris, S. C., & Kapil, R. P.
Affiliations
  • Tufts University (US)
  • Transcept Pharmaceuticals, Inc. Point Richmond CA USA
  • Henry Ford Hospital (US)
  • Purdue Pharma (United States) (US)
Venue
The Journal of Clinical Pharmacology
Publisher
Wiley
Published
2013-11-27
Volume
54
Issue
3
Pages
282-290
ISSN
  • 0021-9754 (ISSN-L)
  • 0091-2700
  • 1552-4604
OpenAlex
W1557131785
Cited by
107
References
38
Citations by year
2026: 5 · 2025: 6 · 2024: 9 · 2023: 11 · 2022: 7 · 2021: 11 · 2020: 7 · 2019: 10 · 2018: 8 · 2017: 5 · 2016: 18 · 2015: 7 · 2014: 3
FWCI
10.17
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Pharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Purdue Pharma
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
Keywords
zolpidem, sublingual administration, gender differences, pharmacokinetics, pharmacodynamics, drug clearance, dose proportionality, sex differences in drug response, individual variability in response, hypnotics
MeSH terms
Zolpidem, Administration, Sublingual, Adult, Double-Blind Method, Female, Humans, Hypnotics and Sedatives, Male, Middle Aged, Pyridines, Sex Characteristics, Cross-Over Studies, Young Adult

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