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IN the ADME literature sometimes the E is Excretion and sometimes Elimination

Rang[1] has Elimination:

" the irreversible loss of drug from the body. It occurs by two processes: metabolism and excretion"

Excretion:

elimination from the body of chemically unchanged drug or its metabolites

Graham[2] has ADME as

The four main topics to consider in pharmacokinetics are absorption, distribution, metabolism and excretion (often abbreviated to ADME)

And also considers excretion a form of elimination, but for bile duct excretion where the drug is diverted from the blood into the bile duct, the drug can be re-absorbed again, so is this elimination?

(or is this all pointless semantic fuckery?)

there is a note on p202 of "Admet for Medicinal Chemists: A Practical Guide" indicating that it is sometimes mistakenly presented as "Elimination"

"The study of how a drug is absorbed, distributed, metabolized and excreted (known as ADME in the Pharmaceutical industry) is called pharmacokinetics"

Patrick, G. L. (2009) ‘Pharmacokinetics and related topics’, An Introduction to Medicinal Chemistry (4th edn), Oxford, Oxford University Press, pp. 11


In the preface for "ADMET for medicinal chemists" they have "The acronym "ADMET" referes "absorption, distribution, metabolism, excretion and toxicity"

ADME-Tox (Absorption, Distribution, Metabolism, Elimination, and Toxicity)

Tsaioun, Katya and Kates, Steven A (2011) ADMET for medicinal chemists : a practical guide, Hoboken, N.J., John Wiley & Sons.

The BMA medical dictionary has Excretion:

removal of waste from the body

Authors referring to the E in ADME as Elimination are;

Thomas_1.pdf "The pharmacokinetic phase of drug action includes the Absorption, Distribution, Metabolism and Elimination (ADME) of the the Drug"


Jeffrey says

""here the drug may undergo metabolism and/or elimination in the bile prior to reaching the systemic (general) circulation" pg 119

Absorption:

all processes from the site of administration to the site of measurement

Distribution:

the reversible transfer of drug between the site of measurement and other sites within the body

Metabolism:

the irreversible loss of drug from the body by biochemical conversion

Elimination:

the irreversible loss of drug from the site of measurement within the body

Excretion:

the irreversible loss of drug from the body

Disposition:

elimination+distribution


  1. Humphrey P. Rang, Maureen M. Dale, James M. Ritter, R. J. Flower and Graeme Henderson (2012) Rang and Dale’s pharmacology (heart), 7th ed. Edinburgh, Elsevier.
  2. Patrick, G. L. (2009) ‘Pharmacokinetics and related topics’, /An Introduction //to// Medicinal Chemistry/ (4th edn), Oxford, Oxford University Press, pp. 11
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