Chris,

If the elimination is first-order for both drugs then its probably computationally quicker to use ADVAN5 (or ADVAN7). This lets you specify separate compartments to account for the input, distribution and elimination of each drug.

The input dose is defined by the usual data items (AMT, RATE, II, ADDL, SS) with CMT linking the input to the compartment you define with ADVAN5 (or ADVAN7).

In my opinion a user defined DVID is more flexible and a clearer way of linking the DV with the model prediction. I use clearer to mean for a human reading the code to understand what is intended. CMT can work sometimes but won't work for things like effect predictions that are not amounts in a compartment.

I am nor sure what Bill means with EVID=2 and EVID=3. EVID=2 does not reset any compartment but it can be used to turn a compartment on or off. It is commonly used to define a record used for prediction in $TABLE at a time when there is no dose or observation event. EVID=3 resets all compartments. All EVIDs are subject specific.

Best wishes,

Nick


This is from the NONMEM online help. There are some minor additional features 
with NONMEM 7 which you can find for yourself.

 0    Observation  event.  The DV data item is an observation.  The CMT
      data item specifies which compartment is being  observed.   Dose-
      related data items (AMT, RATE, II, ADDL, SS) must be zero.

 1    Dose  event.   The  CMT  data item specifies which compartment is
      being dosed.  The DV data item is ignored.  One or more  of  AMT,
      RATE,  II,  ADDL,  SS  data  items must be non-zero to define the
      dose.

 2    Other-type event.  The DV data  item  is  ignored.   Dose-related
      data  items  must  be zero.  Examples of other-type events are: A
      compartment is turned on or off (CMT specifies which  compartment
      is  to be turned on or off); a prediction is obtained at a speci-
      fied time so that it may be displayed in a table  or  scatterplot
      (PCMT  specifies  the  compartment  from  which the prediction is
      obtained); some event occurs at a different time than any  obser- |
      vation or dose event, e.g. a covariate such as weight changes, an |
      intervention such as hemodialysis is started or stopped.

 3    Reset event.  The kinetic  system  is  re-initialized.   Time  is
      reset  to  the time of the event record, the amounts in each com-
      partment are reset to zero, the on/off status of each compartment
      is  reset  to  its  initial status.  The DV data item is ignored.
      Dose-related data items must be zero.

 4    Reset-and-dose event.  The system is first reset, and then a dose
      is given.  The DV data item is ignored.


On 03-Sep-16 07:01, William Denney wrote:
Hi Chris,

I think that the most straight-forward way to handle this is to have two sets of compartments and write the $DES block manually (or writing the algebraic equations if it's a one- or two-compartment model).

It wouldn't be straight-forward to model if the subjects receive the drugs at the same time. If the drugs are received at separate times (like different periods of a study or even different studies), then the DVID flag idea would work, too.

There are only five EVID values as far as I know, and there's not a subtle way to use them for two doses, I don't think:

• 0= observation
• 1= dose
• 2= other (I usually use it to reset the compartment)
• 3= reset the subject
• 4= reset and dose at the same time

Thanks,

Bill

On Sep 2, 2016, at 1:22 PM, Penland, Chris <chris.penl...@astrazeneca.com <mailto:chris.penl...@astrazeneca.com>> wrote:

Greetings NMusers,

Does nonmem have the capacity, unbeknownst to me, for modeling two simultaneous drugs?

I would like some suggestions about how to define the dataset and model for a subcutaneous drug and oral drug being administered on different schedules. I would use DVID = 1 and 2 for the two plasma pk observations. I figure this soft of thing had to be dealt with in the past when trying to model dynamic DDIs (vs, just taking one of the drugs as a covariate on the other’s parameters).

One approach is to specify the compartments for each to be dosed into then have those feed the central, but I’m curious to see if there is something more subtle in the nonmem syntax. Is there something about EVID, that I don’t know that would help (beyond EVID=1 for dosing)

What if you had two oral drugs? Would you treat the two dosing compartments as separate and possibly link them together at the parameter/covariance level?

Thanks,

Chris

Chris Penland, PhD

ECD / Quantitative Clinical Pharmacology

Waltham, MA USA

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