Muriel Noetzli1, Eva Choong, Nicolas Ansermot, Chin B Eap. 1. Unit of Biochemistry and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, CHUV, University of Lausanne, Hospital of Cery, Prilly, Switzerland .
Abstract
BACKGROUND: A simple liquid chromatography mass spectrometry method was developed and validated for the simultaneous determination of antidementia drugs, including donepezil, galantamine, rivastigmine and its major metabolite, NAP 226-90, and memantine. METHODS: A solid phase extraction procedure with a mixed-mode sorbent was used to isolate the drugs from 0.5 mL human plasma. Reverse phase chromatographic separation of the compounds was obtained with a gradient elution of an ammonium acetate buffer at pH 9.3 and acetonitrile and the analytes were detected by mass spectrometry in the single ion monitoring mode. RESULTS: The method was validated according to the recommendations of the Food and Drug Administration, including assessment of trueness (-8.0% to +10.7%), imprecision (repeatability: 1.1-4.9%, intermediate imprecision: 2.1-8.5%), selectivity and matrix effects variability (less than 6%) as well as short- and long-term stability in plasma. The calibration ranges were from 1 ng/mL to 300 ng/mL (rivastigmine and memantine) and 2 ng/mL to 300 ng/mL (donepezil, galantamine, and NAP 226-90). CONCLUSIONS: The method was successfully applied to patients' samples and might contribute to evaluate whether a therapeutic drug monitoring-guided dose adjustment of antidementia drugs could contribute to minimize the risk of adverse reactions and to increase the probability of efficient therapeutic response.
BACKGROUND: A simple liquid chromatography mass spectrometry method was developed and validated for the simultaneous determination of antidementia drugs, including donepezil, galantamine, rivastigmine and its major metabolite, NAP 226-90, and memantine. METHODS: A solid phase extraction procedure with a mixed-mode sorbent was used to isolate the drugs from 0.5 mL human plasma. Reverse phase chromatographic separation of the compounds was obtained with a gradient elution of an ammonium acetate buffer at pH 9.3 and acetonitrile and the analytes were detected by mass spectrometry in the single ion monitoring mode. RESULTS: The method was validated according to the recommendations of the Food and Drug Administration, including assessment of trueness (-8.0% to +10.7%), imprecision (repeatability: 1.1-4.9%, intermediate imprecision: 2.1-8.5%), selectivity and matrix effects variability (less than 6%) as well as short- and long-term stability in plasma. The calibration ranges were from 1 ng/mL to 300 ng/mL (rivastigmine and memantine) and 2 ng/mL to 300 ng/mL (donepezil, galantamine, and NAP 226-90). CONCLUSIONS: The method was successfully applied to patients' samples and might contribute to evaluate whether a therapeutic drug monitoring-guided dose adjustment of antidementia drugs could contribute to minimize the risk of adverse reactions and to increase the probability of efficient therapeutic response.