Pharmacokinetics of Josamycin in patients with liver cirrhosis and Gilbert's syndrome after repeated doses.

The pharmacokinetics of Josamycin was studied in 31 subjects (10 normals, 9 Gilbert's syndrome and 12 compensated liver cirrhosis) after the administration of Josamycin (1 g orally) and in 13 subjects (4 normals, 4 Gilbert's syndrome and 5 compensated liver cirrhosis) after 3-day Josamycin treatment (1 g orally every 12 hours). Josamycin pharmacokinetics was impaired in liver cirrhosis and, to a lesser extent, in Gilbert's syndrome. Moreover, in the three groups of individuals studied the drug accumulated after multiple dosing. These results suggest that a dosage adjustment of Josamycin is recommended when dealing with these patients.