Area under the curve or AUC is a pharmacokinetic statistic used to describe the total exposure to a drug. More specifically, it is the time-averaged concentration of drug circulating in the body fluid analyzed (normally plasma, blood or serum). Standard calculation of AUC involves using non-compartmental techniques to calculate the AUC from time 0 to the last measurable concentration. This is called AUC0-t and represents the observed exposure to a drug. But what happens after the last measurable concentration? How much drug is “left” in the body? And what happens to it?
The total AUC or AUC0-∞ is the area under the curve from time 0 extrapolated to infinite time. This parameter is calculated using the following equation:
I described previously how to calculate AUC0-t. Thus we only have to calculate AUCt-∞ to complete the equation listed above. The extrapolation of AUC to infinity requires several assumptions. The first assumption is that after the last measurable concentration, drug declines in mono-exponential fashion. The second assumption is that the elimination rate constant of that mono-exponential decline is accurately estimated by the terminal elimination rate constant observed with the measurable data. The final assumption is that no other processes besides elimination are involved. In general, these assumptions are valid. At low concentrations, drug usually declines in mono-exponential fashion. And the terminal elimination rate constant does not change over time or with different concentrations of circulating drug. And finally, other processes such as absorption and distribution do not play a significant role in the terminal phase of the pharmacokinetic profile.
Extrapolated AUC
If those assumptions are valid, we can then treat the extrapolated portion of the AUC similar to an IV bolus dose. If an IV bolus dose is administered, and the drug follows mono-exponential decline, the AUC can be calculated as the following:
Using this same equation, we can substitute the numbers we have and get the following:
This extrapolated AUC is then added to the observed AUC to give a value for total AUC. Another useful metric is to calculate the fraction of the total AUC that is due to the extrapolated AUC. This can be calculated using the following equation:
If the % extrapolated is greater than 20%, than the total AUC may be unreliable. The unreliability of the data is not due to a calculation error. Instead it indicates that more sampling is needed for an accurate estimate of the elimination rate constant and the observed area under the curve.
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