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The biliary excretion of acebutolol in man

Practolol is excreted in human bile (Kaye & Kumana, 1974) and acebutolol [( ~)-1-(2-acetyl-4-n-butyramidophenoxy)-2-hydroxy-3-isopropylaminopropane], has a similar chemical structure, pKa and lipid solubility. Its biliary excretion in two male patients A,B (41, 59 years; 76.4, 65.1 kg) with indwelling T-tubes following bile duct exploration was examined with the patients’ consent. Serum bilirubin was 1.71, 1.80 mg d1-I; serum aspartate aminotransferase was 62, 63 Babson units; serum akaline phosphatase was 47, 213 I.U. litre-I. Clinical examination and electrocardiography had excluded cardiovascular and respiratory disease. Renal disease was excluded on the basis of normal serum creatinine values for both patients. About 45 min after a light breakfast each subject’s T-tube was gently flushed out with warm sterile isotonic saline under aseptic conditions to establish a free flow of bile. Control samples of plasma, bile and urine were taken 1 h after breakfast. Each patient then swallowed 3 x 100 mg capsules acebutolol hydrochloride (Sectral). Venous blood samples were taken for plasma drug analysis at 1, 2, 3, 4, 6 and 8 h after dosing. Bile and urine were collected 2 hourly up to 8 h and from 8 to 24 h after dosing. Samples were analysed for acebutolol content by the method of Cuthbert & Collins (1975) as modified by Kaye, Kumana & others (1976). These methods measure acebutolol plus its N-acetyl metabolite (f)-l-(2-acetyl-4-acetamidophenoxy)-2-hydroxy-3isopropylaminopropane (M&B 16,942). Bile samples were also examined by thin-layer chromatography using glass plates pre-coated with silica gel DF-B (0.5 mm thick) containing ultraviolet indicator (Camag), and with chloroform-methanol-glacial acetic acid (7:3 :1 by volume) as solvent. Bile samples were hydrolysed (5N HC1) and re-assayed for acebutolol to determine whether there was evidence for glucuronide or sulphate conjugates of the drug present in bile. The plasma concentration of acebutolol in the two patients are shown in Table 1. Reduced absorption of the drug may have occurred in A. Urinary recovery of acebutolol for the two patients is shown in Table 1. Over a 24 h period 13.4 and 39.1 % of the dose were recovered from the urine of A and B respectively. This last figure is similar to that found in healthy volunteers (Kaye & others, 1976). Recovery of acebutolol in the bile of the two patients is shown in Table 1. By 24 h 2-7 and 8.5 % of the dose had appeared in the bile of A and B respectively. After acid hydrolysis of the bile samples from both patients the concentration of acebutolol as measured remained virtually unchanged.