All,


I've recently been working up a Phase 2 PK data set: oral administration, QD 
dosing and PK samples on weeks 3, 5 and 7 of the study.  Per protocol, the 
morning dose is withheld and the patient comes to the clinic for a blood 
sample.  To me, this seems like a straightforward application of SS and II, 
something like:

ID    DATE      TIME CMT DV   EVID AMT SS II MDV

11101 3/30/2010 7:45 1   .    1    200 1  24 1
11101 3/31/2010 9:33 2   25.6 0    .   .  .  0

However, Guide V, section 8.2.8 indicates predictions can't be made beyond the 
dosing time + II:

"Ordinarily, steady-state levels can only be predicted between t1 , the time on 
the steady-state dose record, and t2 , the sum of t1 and the interdose 
interval. If it is not only necessary to compute a steady-state prediction 
between t1 and t2 , but also after t2 , then there must also occur one or more 
non-steady-state dose records at t2 , t2+II , etc. with doses just like the 
steady-state dose. "



Here, the PK sample is taken after dosing + II.  NONMEM 7.1.2 appears to give 
me a prediction, but I'm suspicious of the results.  I thought about adding a 
very, very small transient dose at the II, but the language in 8.2.8 seems to 
indicate the dose needs be "just like the steady-state dose", so that might not 
work.

 *   Have others encountered this issue, and if so, what did you do to work 
around the limitation?
 *   Can other shed some light on what predictions can't be made beyond II, 
since transient equations can be mixed with SS equations?

Warm Regards,

Mike Dodds

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