A ABSORPTION
D DISTRIBUTION
M METABOLISM
E EXCRETION

ADME & Pharmacokinetics

Understanding how drugs move through your body—and why testing in human-relevant systems is essential for predicting real-world drug behavior

What is ADME?

The four processes that determine a drug's journey through your body

Absorption

How the drug enters your bloodstream. For oral drugs, this happens primarily in the small intestine. The drug must cross cell membranes and survive first-pass metabolism.

1 Solubility in gut fluids
2 Permeability across intestinal wall
3 Gut pH and transit time
4 P-glycoprotein efflux pumps

Distribution

How the drug spreads throughout your body. Factors like blood flow, tissue binding, and the blood-brain barrier determine where the drug can reach and accumulate.

1 Plasma protein binding (albumin)
2 Tissue perfusion rates
3 Volume of distribution (Vd)
4 Membrane permeability

Metabolism

How your body chemically transforms the drug. The liver's CYP450 enzymes are the primary players, converting drugs into metabolites—sometimes active, sometimes toxic.

1 CYP450 enzyme activity
2 Phase I (oxidation) reactions
3 Phase II (conjugation) reactions
4 Genetic polymorphisms

Excretion

How your body eliminates the drug. The kidneys filter drugs from blood into urine, while the liver excretes some drugs via bile into feces. This determines how long the drug stays active.

1 Renal clearance rate
2 Biliary excretion
3 Half-life (t½)
4 Enterohepatic recirculation

The CYP450 Family

These liver enzymes metabolize ~75% of all drugs—and vary dramatically between species

CYP3A4
50%
of all drugs metabolized
Statins, HIV drugs, immunosuppressants
CYP2D6
25%
of all drugs metabolized
Antidepressants, opioids, beta-blockers
CYP2C9
15%
of all drugs metabolized
Warfarin, NSAIDs, oral hypoglycemics
CYP2C19
10%
of all drugs metabolized
PPIs, clopidogrel, antidepressants
CYP1A2
5%
of all drugs metabolized
Caffeine, theophylline, some antipsychotics
CYP2E1
3%
of all drugs metabolized
Acetaminophen, alcohol, anesthetics

Why Animal ADME Data Fails

Species-specific differences make animal pharmacokinetics unreliable predictors of human response

Human ADME

  • CYP2D6 metabolizes 25% of drugs—single gene form
  • CYP3A4 is the dominant drug-metabolizing enzyme
  • Specific UGT enzymes for glucuronidation
  • P-gp transporter with human-specific substrates
  • Albumin binding with human-specific affinity
  • Renal clearance based on human GFR (~120 mL/min)
  • Bile acid composition affects enterohepatic cycling

Animal ADME

  • CYP2D6 doesn't exist in mice—rats have 6 forms
  • Different CYP3A isoforms with altered specificity
  • Different Phase II enzyme expression patterns
  • Transporter substrates vary by species
  • Plasma protein binding differs significantly
  • Allometric scaling often fails for clearance
  • Different bile composition affects absorption

Understanding Bioavailability

The fraction of drug that reaches systemic circulation unchanged

100% Dose
Oral Dose
70% Absorbed
Gut Absorption
40% Survives
First-Pass Liver
28% Final F
Bioavailability

Example: A drug with 70% gut absorption and 40% survival through first-pass metabolism has 28% oral bioavailability (F = 0.70 × 0.40 = 0.28)

How NAMs Improve ADME Predictions

Human-relevant models provide accurate pharmacokinetic data

Gut-on-Chip

Human intestinal cells with villi structures predict oral absorption, P-gp efflux, and drug-food interactions accurately.

Liver-on-Chip

Primary human hepatocytes with correct CYP450 expression predict metabolism, clearance, and drug-drug interactions.

Kidney-on-Chip

Proximal tubule cells under flow predict renal clearance, transporter-mediated secretion, and nephrotoxicity.

BBB-on-Chip

Blood-brain barrier models predict CNS drug penetration—critical for neurological drugs and avoiding neurotoxicity.

Multi-Organ Systems

Connected organ chips model complete ADME—absorption in gut, metabolism in liver, excretion via kidney—in one system.

PBPK Modeling

AI-powered physiologically-based pharmacokinetic models integrate human data to predict concentration-time profiles.

Key Pharmacokinetic Terms

Essential vocabulary for understanding ADME

Bioavailability (F)

Fraction of administered dose that reaches systemic circulation. IV drugs have F=1 (100%); oral drugs typically F=0.1-0.9.

Half-life (t½)

Time for plasma drug concentration to decrease by 50%. Determines dosing frequency—drugs with short t½ need more frequent dosing.

Clearance (CL)

Volume of plasma cleared of drug per unit time (mL/min). Total clearance = hepatic + renal + other elimination routes.

Volume of Distribution (Vd)

Theoretical volume needed to contain total drug at plasma concentration. High Vd means extensive tissue distribution.

First-Pass Metabolism

Drug metabolism in gut wall and liver before reaching systemic circulation. Can dramatically reduce oral bioavailability.

AUC (Area Under Curve)

Total drug exposure over time, calculated from concentration-time curve. Key metric for bioequivalence studies.

Cmax

Maximum plasma concentration achieved after dosing. Important for efficacy (must reach therapeutic level) and safety (must not exceed toxic level).

Tmax

Time to reach maximum concentration. Reflects absorption rate—faster absorption = earlier Tmax.