Effect of deuteration on the single dose pharmacokinetic properties and postoperative analgesic activity of methadone

Although methadone is effective in the management of acute pain, the complexity of its absorptiondistribution-metabolism-excretion profile limits its use as an opioid of choice for perioperative analgesia. Because deuteration is known to improve the pharmacokinetic, pharmacodynamic and toxicological properties of some drugs, here we characterized the single dose pharmacokinetic properties and post-operative analgesic efficacy of d9-methadone. The pharmacokinetic profiles of d9-methadone and methadone administered intravenously to CD-1 male mice revealed that deuteration leads to a 5.7- and 4.4-fold increase in the area under the timeconcentration curve and maximum concentration in plasma, respectively, as well as reduction in clearance (0.9 +/- 0.3 L/h/kg vs 4.7 +/- 0.8 L/h/kg). The lower brain-to-plasma ratio of d9-methadone compared to that of methadone (0.35 +/- 0.12 vs 2.05 +/- 0.62) suggested that deuteration decreases the transfer of the drug across the blood-brain barrier. The estimated LD50 value for a single intravenous dose of d9-methadone was 2.1-fold higher than that for methadone. Moreover, d9-methadone outperformed methadone in the efficacy against postoperative pain by primarily activating peripheral opioid receptors. Collectively, these data suggest that the replacement of three hydrogen atoms in three methyl groups of methadone altered its pharmacokinetic properties, improved safety, and enhanced its analgesic efficacy.(c) 2022 The Japanese Society for the Study of Xenobiotics. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study characterized the pharmacokinetic properties and post-operative analgesic efficacy of d9-methadone, a deuterated form of methadone. Deuteration improved the drug's absorption and distribution, reduced clearance, and decreased its ability to cross the blood-brain barrier. D9-methadone exhibited better safety and enhanced analgesic efficacy, primarily through activation of peripheral opioid receptors.