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Abstract
The analysis of perhexiline in plasma offers an important contribution to the management of patients prescribed such therapy for refractory angina pectoris. Perhexiline has properties and complexities of non-linear kinetics and is subject to genetically predetermined metabolic variants in hydroxylation. The present communication describes a refinement of a previous high performance liquid chromatographic fluorescence method and the application of this method in the therapeutic monitoring of 100 patients at steady-state. The method described is sensitive, accurate and precise, with intra-assay CV's of 2. 1%, 1.4% and 3.7% at concentrations of 150, 750 and 1500 μg/L, and between-assav CV's of 5.7%, 4.7% and 5.8% at 50, 1000 and 3000 μg/L, respectively. The review of patient specimens received in our therapeutic drug monitoring laboratory, suggested that approximately 6% appear to belong to the “poor-hydroxvlation” metabolic sub-population, with a further 16% attaining steady-state plasma perhexiline concentrations above the “therapeutic range” of 150 to 600 μg/L following standard dosage schedules of 100 to 200 mg/day.