Interpretation
The standard half-life of perhexiline is 15 hours, with time to steady-state of 3 days.
Perhexiline and its metabolites are cleared from the body via hepatic metabolism and are excreted in the bile and urine. Perhexiline is subject to saturable (non-linear) metabolism (i.e. small changes in dosage can produce disproportionate changes in plasma concentration). Perhexiline metabolism is also influenced by genetic polymorphisms: 5 – 10% of Caucasian patients are poor metabolisers and will achieve high plasma perhexiline concentrations with standard doses.
Because of perhexiline’s slow and variable clearance, inter-subject variability in metabolism and the potential for serious toxicity, regular monitoring of plasma levels of perhexiline is essential.
Reference Intervals
Plasma perhexiline concentrations should be maintained between 0.15 – 0.60 mg/L.
Test Method
LCMS following solvent extraction
