Lisdexamfetamine Pharmacokinetic Comparison Between Patients Who Underwent Roux-en-Y Gastric Bypass and Nonsurgical Controls

Kristine J. Steffen, Afroz Shareef Mohammad, James L. Roerig, James E. Mitchell, Carrie Nelson, Molly Orcutt, Wenqiu Zhang, Ann L. Erickson, William F. Elmquist

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction/Purpose: The objective of this research was to characterize the impact of Roux-en-Y gastric bypass (RYGB) on the pharmacokinetic properties of the pro-drug lisdexamfetamine and its active metabolite, d-amphetamine. Materials and Methods: A case-control design was used where patients who had undergone RYGB 9–24 months prior were matched on sex, age, and body mass index (BMI) to nonsurgical controls who had no history of weight loss surgery. Each participant received a single 50 mg dose of lisdexamfetamine, and plasma samples were collected over a 24-h period following dosing. Noncompartmental analyses were used to compare pharmacokinetic measures between groups. Results: There were no significant differences between the RYGB (n = 10) and NSC groups (n = 10) on sex (70% female), age (40.9 ± 9.6 vs. 41.3 ± 8.9 years), BMI (30.3 ± 5.2 vs. 31 ± 5.9 kg/m2), or ethnicity (100% vs. 80% White). The pharmacokinetic parameters between the RYGB and NCS groups were found to be equivalent for lisdexamfetamine and d-amphetamine, including maximum plasma concentration (Cmax), time to maximum plasma concentration (Tmax), and area under the plasma concentration–time curve (AUC(0–∞)). Conclusion: These data suggest that there is no need to routinely adjust lisdexamfetamine dosing following RYGB. However, given the potential for inter-individual differences, patients who undergo RYGB should be clinically monitored and individualized dosing strategies should be considered for concerns surrounding efficacy or toxicity.

Original languageEnglish (US)
Pages (from-to)4289-4294
Number of pages6
JournalObesity Surgery
Volume31
Issue number10
DOIs
StatePublished - Oct 2021

Bibliographical note

Funding Information:
Dr. Steffen has received a research grant for this work from Shire Pharmaceuticals (IIR-USA-001057), which was awarded to North Dakota State University. Other authors declare that they have no conflict of interest.

Funding Information:
This study was funded by Shire Pharmaceuticals Grant number IIR-USA-001057.

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Bariatric surgery
  • Lisdexamfetamine
  • Pharmacokinetic
  • RYGB
  • Roux-en-Y gastric bypass

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