The human urinary metabolites of diltiazem were analyzed by thin-layer chroma tography (TLC) and gas chromatography-mass spectrometry. Diltiazem was metabolized by deacetylation, N-demethylation, O-demethylation and conjugation. Metabolite M
A, N-monodemethyl-diltiazem, was identified as a new major metabolite in human urine, and four metabolites were identified as deacetyl-diltiazem (M
1), deacetyl-N-monodemethyl-diltiazem (M
2), deacetyl-O-demethyl-diltiazem (M
4), deacetyl-N, O-demethyl-diltiazem (M
6) which were known as rat urinary metabolites. Metabolite M
2, M
4 and M
6 were converted in part to glucuronides and/or sulfates. Unchanged diltiazem and metabolite M
A were determined in human plasma and urine by TLC-densitometry. Diltiazem and metabolite M
A excreted in 24-h urine were 44.4 and 48.5% of the total unconjugated form, rcspectively. The mean plasma level of metabolite M
A was approximately one-third of diltiazem level. On the basis of these findings, a probable metabolic pathway of diltiazem in man is presented.
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