Roxithromycin Pharmacokinetics in Hospitalized Geriatric Patients: Oral Administration of Whole Versus Crushed Tablets

Malka Britzi, Matitiahu Berkovitch, Stefan Soback, Arthur Leibovitz, Rafael Segal, Marina Smagarinsky, Emily Lubart*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Drug administration as tablets to debilitated elderly patients in crushed form can modify the pharmacokinetic characteristics of the active components. Only scarce information is available on the pharmacokinetics when administered in such form. The aim of this study was to evaluate the pharmacokinetics of roxithromycin administered in crushed form and to compare it with the pharmacokinetics of a group of geriatric patients receiving it in the conventional tablet form. Methods: Twenty patients from the acute ward of the Shmuel Harofeh Geriatric Medical Center in stable, clinical, and hemodynamic condition were studied. Patients in group 1 (n 10) received medications orally in tablet form. Group 2 (n 10) included age- and disease-matched patients from the same department, who received oral roxithromycin in crushed tablet form. The mean daily dose was the same in both groups: 300 mg (150 mg twice daily). The patients received the drug for 3 days before the initiation of the study. Blood samples for determination of the roxithromycin concentration were taken at the baseline, 1 hour before the drug administration, and at 1, 3, 4, 6, 8, and 10 hours after drug administration. Roxithromycin concentration was measured by a liquid chromatography-tandem mass spectrometry method. Results: Pharmacokinetic parameters of roxithromycin were significantly different between the 2 groups: the C min and C max were significantly higher, the t max significantly longer, AUC 0-10 larger, and CL/F smaller in group 2. Conclusions: Roxithromycin pharmacokinetic parameters were significantly different between the 2 patient groups resulting in higher drug serum concentrations in the crushed tablets group. The impact of the increased drug exposure is unclear.

Original languageEnglish
Pages (from-to)512-515
Number of pages4
JournalTherapeutic Drug Monitoring
Issue number4
StatePublished - 25 Aug 2015


  • crushed form
  • geriatric patients
  • pharmacokinetics
  • roxithromycin


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