Assay and disposition of carvedilol enantiomers in humans and monkeys: evidence of stereoselective presystemic metabolism

Carvedilol is a new beta-blocking agent with vasodilating activities, which is a racemic mixture of R(+)- and S(-)-enantiomers. Since the two enantiomers differ in pharmacological properties, it is necessary to individually measure their plasma concentrations in order to evaluate the pharmacological effects of racemic carvedilol after oral administration. In this study, a sensitive, stereospecific high-performance liquid chromatographic assay was used to determine the plasma concentration of each enantiomer. The assay involves the diastereomeric derivatization of racemic carvedilol with 2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosyl isothiocyanate as a chiral reagent. After oral administration of racemic carvedilol to humans, the mean Cmax and AUC infinity values for R(+)-enantiomer were 2.6 and 2.8 times greater, respectively, than those for the more active S(-)-enantiomer. Similarly, in monkeys, the respective R:S enantiomer ratios for Cmax and AUC infinity were 1.5 and 1.2. The difference in AUCoral between these enantiomers is ascribed to the greater intrinsic clearance of S(-)-enantiomer than that of the R(+)-enantiomer in the liver, and to a lower plasma protein binding of the S(-)-enantiomer.