Insights into the Pharmacokinetic Properties of Antitubercular Drugs

Abstract

Introduction: The furiously advancing cases of multidrug-resistant tuberculosis (TB) along with the recent emergence of total drug resistant TB and TB-AIDS comorbidity prompt an increasingly solemn threat to global public health. The knowledge of pharmacokinetic properties helps in selecting an appropriate anti-TB dosage regimen for getting optimal results in patients. Areas Covered: This article provides a brief compilation of the information available regarding published pharmacokinetic data for anti-TB drugs and may act as a single window for investigators/medical practitioners in this field. The information regarding absorption, tissue distribution, elimination and pharmacokinetic interactions of the first- and second-line anti-TB drugs and candidate drugs under clinical trials is discussed. Expert opinion: Inapt pharmacokinetic properties (such as poor absorption, too short biological half-life, extensive first-pass metabolism, drug-food and drug-drug related interactions) are not pleasing for anti-TB drugs and significantly contribute to treatment failure and further resistance. The long duration, monotonous and multidrug treatment plan leads to poor patient compliance and consequently new caveats of anti-TB drug resistance are spreading into every corner of the world. Few new agents, which are in development phase, are considering the aspect of shortening duration of the treatment regimen and provide a boost in therapy that is sorely needed.