Following a single oral 200 mg dose of cannabidiol (CBD), renal impairment status was found to have no effect on CBD or its biotransformation products. |
No statistically significant differences were observed in maximum measured plasma concentration (Cmax), area under the plasma concentration–time curve (AUC) from time zero to last measurable concentration (AUCt), AUC from time zero to infinity (AUC∞), or time to Cmax (tmax) values between subjects with renal impairment and subjects with normal renal function. |
A single dose of 200 mg CBD was well tolerated across all subject groups, and no safety concerns were observed. |
1 Introduction
2 Methods
2.1 Trial Design
2.2 Inclusion and Exclusion Criteria
2.2.1 Trial Population
- Group 1: mild renal impairment (CLcr 50–80 mL/min).
- Group 2: moderate renal impairment (CLcr 30 to < 50 mL/min).
- Group 3: severe renal impairment (CLcr < 30 mL/min).1
- Group 4: normal renal function (CLcr > 80 mL/min).
2.3 Trial Assessments
2.3.1 Pharmacokinetic Assessments
- Pre-dose, then at 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 12, 24, 36, and 48 h post-dose.
2.3.2 Chromatographic Conditions and Specifications
2.3.3 Safety Assessments
2.4 Statistical Analysis
3 Results
3.1 Subject Demographics
Characteristics | Mild RI (n = 8) | Moderate RI (n = 8) | Severe RI (n = 8) | Normal RF (n = 8) |
---|---|---|---|---|
Sex [n (%)] | ||||
Male | 5 (62.5) | 5 (62.5) | 3 (37.5) | 3 (37.5) |
Female | 3 (37.5) | 3 (37.5) | 5 (62.5) | 5 (62.5) |
Race [n (%)] | ||||
White | 8 (100) | 8 (100) | 8 (100) | 8 (100) |
Age (years) [mean (SD)] | 61.9 (10.9) | 58.8 (12.4) | 64.6 (10.6) | 60.4 (11.5) |
BMI (kg/m2) [mean (SD)] | 27.6 (3.3) | 28.5 (2.9) | 29.9 (3.5) | 29.6 (3.6) |
CLcr (mL/min) [mean (SD)] | 66.9 (8.3) | 40.0 (6.1) | 21.7 (6.0) | 111.7 (31.8) |
3.2 Concomitant Medication
3.3 Pharmacokinetics
Comparison | Cmax [geometric LS mean ratio (90% CI)] | AUC∞ [geometric LS mean ratio (90% CI)] | AUCt [geometric LS mean ratio (90% CI)] | CL/F [geometric LS mean ratio (90% CI)] | tmax [difference (90% CI)]a (h) |
---|---|---|---|---|---|
CBD | |||||
Mild/normal | 1.31 (0.73–2.35) | 1.20 (0.59–2.45) | 1.44 (0.83–2.51) | 0.83 (0.41–1.69) | 0.25 (0.00–1.00) |
Moderate/normal | 1.12 (0.62–2.02) | 1.05 (0.56–1.96) | 1.14 (0.66–1.98) | 0.96 (0.51–1.79) | 0.00 (− 0.50 to 0.00) |
Severe/normal | 1.02 (0.57–1.83) | 1.20 (0.64–2.25) | 1.15 (0.66–1.99) | 0.83 (0.44–1.56) | 0.00 (0.00–0.50) |
6-OH-CBD | |||||
Mild/normal | 0.94 (0.66–1.35) | 1.58 (0.98–2.55) | 1.38 (0.83–2.31) | 0.25 (− 0.75 to 1.50) | |
Moderate/normal | 1.14 (0.80–1.63) | 2.01 (1.25–3.25) | 1.49 (0.90–2.49) | − 0.50 (− 0.50 to 0.00) | |
Severe/normal | 1.01 (0.71–1.43) | 1.65 (1.07–2.54) | 1.74 (1.04–2.90) | 0.38 (− 0.50 to 1.00) | |
7-OH-CBD | |||||
Mild/normal | 0.85 (0.54–1.36) | 1.14 (0.81–1.59) | 1.08 (0.77–1.53) | 0.25 (− 0.50 to 1.50) | |
Moderate/normal | 1.35 (0.85–2.15) | 1.37 (0.98–1.91) | 1.32 (0.94–1.86) | 0.00 (− 0.50 to 0.50) | |
Severe/normal | 1.10 (0.69–1.75) | 1.56 (1.12–2.19) | 1.42 (1.01–2.00) | 0.00 (− 0.50 to 0.50) | |
7-COOH-CBD | |||||
Mild/normal | 0.88 (0.50–1.54) | 1.04 (0.69–1.55) | 0.00 (− 0.50 to 1.00) | ||
Moderate/normal | 0.89 (0.50–1.56) | 1.07 (0.72–1.60) | 0.00 (− 0.50 to 0.50) | ||
Severe/normal | 0.68 (0.39–1.19) | 0.95 (0.63–1.41) | 1.00 (0.00–1.50) |
Renal function group | Cmax (ng/mL)a | tmax (h)b | t½ (h)c,d | AUCt (ng·h/mL)a | AUC∞ (ng·h/mL)a,d | %AUCextraa,e | CL/F (L/h)c | Vz/F (L)c |
---|---|---|---|---|---|---|---|---|
(n = 8) | (n = 8) | (n = 8) | (n = 8) | (n = 8) | (n = 8) | (n = 8) | (n = 8) | |
CBD | ||||||||
Mild RI | 200 (42.7) | 2.5 (1.5–5.0) | 15.5f (64.5) | 671 (40.9) | 600g (50.0) | 7.50g (73.0) | 365g (52.3) | 6661g (55.5) |
Moderate RI | 172 (85.3) | 2.0 (2.0–3.0) | 14.6f (46.6) | 530 (74.4) | 522f (63.6) | 7.99f (55.5) | 434f (50.4) | 7778f (58.0) |
Severe RI | 155 (40.6) | 2.5 (1.5–7.0) | 13.1f (41.5) | 532 (32.7) | 601f (35.9) | 8.63f (31.3) | 351f (37.3) | 6016f (39.9) |
Normal RF | 153 (74.7) | 2.5 (2.0–3.0) | 11.2 (47.2) | 464 (77.6) | 499 (76.6) | 6.81 (27.4) | 510 (87.6) | 5800 (29.2) |
6-OH-CBD | ||||||||
Mild RI | 4.12f (59.0) | 2.5f (0.8–5.0) | 19.3h (6.6) | 30.5f (63.1) | 61.2h (3.3) | 16.3h (25.4) | ||
Moderate RI | 5.17f (32.1) | 2.0f (1.5–2.5) | 22.0h (38.1) | 35.5f (78.5) | 74.9h (2.1) | 19.5h (47.5) | ||
Severe RI | 3.98f (31.8) | 2.5f (1.0–6.0) | 20.2g (30.8) | 39.2f (48.8) | 55.9g (52.6) | 21.1g (35.8) | ||
Normal RF | 3.86i (18.2) | 2.5i (2.0–3.0) | 15.0h (45.4) | 22.6i (51.7) | 34.3h (54.8) | 17.2h (14.9) | ||
7-OH-CBD | ||||||||
Mild RI | 44.6 (77.0) | 2.8 (1.0–5.0) | 19.8 (15.9) | 327.3 (60.2) | 381.7 (59.6) | 13.8 (25.0) | ||
Moderate RI | 70.5 (30.0) | 2.3 (2.0–3.0) | 18.1 (26.3) | 400.0 (23.7) | 457.6 (25.0) | 11.4 (50.0) | ||
Severe RI | 61.9j (37.6) | 3.0j (2.0–6.0) | 19.1j (13.7) | 448.1j (15.5) | 520.8j (17.0) | 13.8j (13.7) | ||
Normal RF | 52.3 (34.8) | 2.5 (2.0–4.0) | 16.6 (30.6) | 302.3 (22.6) | 335.1 (20.7) | 8.4 (56.0) | ||
7-COOH-CBD | ||||||||
Mild RI | 648.3i (109.5) | 4.0i (2.5–6.0) | NC | 15,676.7i (69.2) | NC | NC | ||
Moderate RI | 578.4g (32.9) | 2.5g (2.5–4.0) | NC | 14,629.0g (29.2) | NC | NC | ||
Severe RI | 571.9 (51.2) | 4.0 (2.5–9.0) | NC | 15,420.1 (37.5) | NC | NC | ||
Normal RF | 842.5g (49.8) | 3.0 (2.5–5.0) | NC | 16,301.6 (33.1) | NC | NC |