Absorption Oral bioavailability: following oral administration,<unk>  pivoxil is absorbed from the gastrointestinal tract and hydrolyzed to<unk>  by esterases. Maximal plasma concentrations of<unk>  under fasting conditions average 1.8 ± 0.6 µg/mL following 200 mg dose and occur 1.5 to 3 hours following dosing.<unk>  does not accumulate in plasma following twice daily administration to subjects with normal renal function. Under fasting conditions, the estimated absolute bioavailability of<unk>  pivoxil is approximately 14%. Distribution Binding of<unk>  to plasma proteins averages 88%, and the mean volume of distribution of<unk>  at steady state is 9.3L.<unk>  has been shown to penetrate into bronchial mucosa, epithelial lining fluid, skin blister fluid and tonsillar tissue and clinically relevant concentrations against common pathogens are achieved in these tissues for at least 4 hours. Metabolism and Excretion<unk>  is predominantly eliminated by the kidneys as unchanged drug and has a renal clearance of 4.1–5.6 L/h after multiple doses; its elimination half-life is 1.5 hours.
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