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Batchelor H, Kaukonen AM, Klein S, Davit B, Ju R, Ternik R, Heimbach T, Lin W, Wang J, Storey D. Food effects in paediatric medicines development for products Co-administered with food. Int J Pharm 2017; 536:530-535. [PMID: 28495584 DOI: 10.1016/j.ijpharm.2017.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 01/11/2023]
Abstract
A small amount of food is commonly used to aid administration of medicines to children to improve palatability and/or swallowability. However the impact of this co-administered food on the absorption and subsequent pharmacokinetic profile of the drug is unknown. Existing information on food effects is limited to standard protocols used to evaluate the impact of a high fat meal in an adult population using the adult medication. In the absence of a substantial body of data, there are no specific guidelines available during development of paediatric products relating to low volumes of potentially low calorie food. This paper brings together expertise to consider how the impact of co-administered food can be risk assessed during the development of a paediatric medicine. Two case studies were used to facilitate discussions and seek out commonalities in risk assessing paediatric products; these case studies used model drugs that differed in their solubility, a poorly soluble drug that demonstrated a positive food effect in adults and a highly soluble drug where a negative food effect was observed. For poorly soluble drugs risk assessments are centred upon understanding the impact of food on the in vivo solubility of the drug which requires knowledge of the composition of the food and the volumes present within the paediatric gastrointestinal tract. Further work is required to develop age appropriate in vitro and in silico models that are representative of paediatric populations. For soluble drugs it is more important to understand the mechanisms that may lead to a food effect, this may include interactions with transporters or the impact of the food composition on gastro-intestinal transit or even altered gastric motility. In silico models have the most promise for highly soluble drug products although it is essential that these models reflect the relevant mechanisms involved in potential food effects. The development of appropriate in vitro and in silico tools is limited by the lack of available clinical data that is critical to validate any tool. Further work is required to identify globally acceptable and available vehicles that should be the first option for co-administration with medicines to enable rapid and relevant risk assessment.
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Affiliation(s)
- Hannah Batchelor
- School of Pharmacy, Institute of Clinical Sciences,Robert Aitken Building, University of Birmingham, Edgbaston, B15 2TT, UK; European Paediatric Formulation Initiative, Biopharmaceutics Workstream (3).
| | - Ann Marie Kaukonen
- School of Pharmacy, Institute of Clinical Sciences,Robert Aitken Building, University of Birmingham, Edgbaston, B15 2TT, UK; Finnish Medicines Agency, Helsinki, Finland; Formulation and Industrial Pharmacy Unit, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Finland
| | - Sandra Klein
- Department of Pharmacy, University of Greifswald, Germany; Pharmaceutical Sciences, MSD, Hoddesdon, UK
| | | | - Rob Ju
- Drug Product Development, Abbvie, North Chicago, IL, USA
| | - Robert Ternik
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis IN 46285, USA
| | - Tycho Heimbach
- PK Sciences, Novartis Institutes for Biomedical Research,One Health Plaza, East Hanover, NJ, USA
| | - Wen Lin
- PK Sciences, Novartis Institutes for Biomedical Research,One Health Plaza, East Hanover, NJ, USA
| | - Jian Wang
- Office of Drug Evaluation IV, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - David Storey
- Pharmaceutical Sciences, MSD, Hoddesdon, UK; European Paediatric Formulation Initiative, Biopharmaceutics Workstream (3)
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Hara A, Endo S, Matsunaga T, El-Kabbani O, Miura T, Nishinaka T, Terada T. Human carbonyl reductase 1 participating in intestinal first-pass drug metabolism is inhibited by fatty acids and acyl-CoAs. Biochem Pharmacol 2017; 138:185-192. [PMID: 28450226 DOI: 10.1016/j.bcp.2017.04.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
Abstract
Human carbonyl reductase 1 (CBR1), a member of the short-chain dehydrogenase/reductase (SDR) superfamily, reduces a variety of carbonyl compounds including endogenous isatin, prostaglandin E2 and 4-oxo-2-nonenal. It is also a major non-cytochrome P450 enzyme in the phase I metabolism of carbonyl-containing drugs, and is highly expressed in the intestine. In this study, we found that long-chain fatty acids and their CoA ester derivatives inhibit CBR1. Among saturated fatty acids, myristic, palmitic and stearic acids were inhibitory, and stearic acid was the most potent (IC50 9µM). Unsaturated fatty acids (oleic, elaidic, γ-linolenic and docosahexaenoic acids) and acyl-CoAs (palmitoyl-, stearoyl- and oleoyl-CoAs) were more potent inhibitors (IC50 1.0-2.5µM), and showed high inhibitory selectivity to CBR1 over its isozyme CBR3 and other SDR superfamily enzymes (DCXR and DHRS4) with CBR activity. The inhibition by these fatty acids and acyl-CoAs was competitive with respect to the substrate, showing the Ki values of 0.49-1.2µM. Site-directed mutagenesis of the substrate-binding residues of CBR1 suggested that the interactions between the fatty acyl chain and the enzyme's Met141 and Trp229 are important for the inhibitory selectivity. We also examined CBR1 inhibition by oleic acid in cellular levels: The fatty acid effectively inhibited CBR1-mediated 4-oxo-2-nonenal metabolism in colon cancer DLD1 cells and increased sensitivity to doxorubicin in the drug-resistant gastric cancer MKN45 cells that highly express CBR1. The results suggest a possible new food-drug interaction through inhibition of CBR1-mediated intestinal first-pass drug metabolism by dietary fatty acids.
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Affiliation(s)
- Akira Hara
- Faculty of Engineering, Gifu University, Gifu 501-1193, Japan
| | - Satoshi Endo
- Gifu Pharmaceutical University, Gifu 501-1196, Japan.
| | | | - Ossama El-Kabbani
- Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Takeshi Miura
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Hyogo 663-8179, Japan; Faculty of Pharmacy, Osaka Ohtani University, Osaka 584-8540, Japan
| | - Toru Nishinaka
- Faculty of Pharmacy, Osaka Ohtani University, Osaka 584-8540, Japan
| | - Tomoyuki Terada
- Faculty of Pharmacy, Osaka Ohtani University, Osaka 584-8540, Japan
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53
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Abuhelwa AY, Williams DB, Upton RN, Foster DJ. Food, gastrointestinal pH, and models of oral drug absorption. Eur J Pharm Biopharm 2017; 112:234-248. [DOI: 10.1016/j.ejpb.2016.11.034] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/14/2022]
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Maher HM, Alzoman NZ, Shehata SM, Abahussain AO. UPLC-ESI-MS/MS study of the effect of green tea extract on the oral bioavailability of erlotinib and lapatinib in rats: Potential risk of pharmacokinetic interaction. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1049-1050:30-40. [PMID: 28260629 DOI: 10.1016/j.jchromb.2017.02.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/24/2017] [Accepted: 02/26/2017] [Indexed: 02/06/2023]
Abstract
Green tea (GT) is one of the most consumed beverages worldwide. Tyrosine kinase inhibitors (TKIs) belong to the oral targeted therapy that gained much interest in oncology practice, among which are erlotinib (ERL) and lapatinib (LAP). Since green tea polyphenols (GTP) are known to be inhibitors of receptor tyrosine kinases, GTE could likely potentiate the anticancer effect of TKIs, but with a possibility of pharmacokinetic (PK) interaction with co-administered TKIs. In this study, the effect of GTE on the PK of ERL/LAP in rats was studied. UPLC-ESI-MS/MS method has been developed and validated for the quantification of ERL and LAP in rat plasma, using gefitinib (GEF) as the internal standard. Plasma samples were treated extensively by protein precipitation (PPT) followed by solid phase extraction (SPE) using octadecyl C 18/14% cartridges. Chromatographic analysis was carried out on Acquity UPLC BEH™ C18 column with a mobile phase consisting of water: acetonitrile (20: 80, v/v), each with 0.15% formic acid. Quantification was performed in the positive electrospray ionization (ESI+) mode with multiple reaction monitoring (MRM) of the transitions m/z 394.29→278.19 (ERL), m/z 581.07→365.13 (LAP), and m/z 447.08→128.21 (GEF). The method was fully validated as per the FDA guidelines showing linearity over the range of 0.4-1000 (ERL) and 0.6-1000 (LAP) ng/mL with very low lower limit of quantification (LLOQ) of 0.4 and 0.6ng/mL for ERL and LAP, respectively. The applicability of the method was extended to perform a comparative study of the PK of ERL/LAP following short-term and long-term administration of GTE, compared with their single oral administration. The results revealed that a significant reduction in the oral bioavailability was recorded with both ERL and LAP following the ingestion of GTE particularly for short-term administration. A reduction in Cmax (AUC) by 67.60% (69.50%) and 70.20% (73.96%), was recorded with short-term administration of GTE, compared with only 16.03% (21.09%) and 13.53% (22.12%) reduction for ERL and LAP, respectively, with long-term administration. Thus patients taking TKIs should preferably avoid drinking GT or ingesting GTE capsules during the period of treatment with TKIs.
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Affiliation(s)
- Hadir M Maher
- College of Pharmacy, Department of Pharmaceutical Chemistry, King Saud University, Riyadh 11495, P.O. Box 22452, Saudi Arabia; Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry, University of Alexandria, El-Messalah, Alexandria 21521, Egypt.
| | - Nourah Z Alzoman
- College of Pharmacy, Department of Pharmaceutical Chemistry, King Saud University, Riyadh 11495, P.O. Box 22452, Saudi Arabia
| | - Shereen M Shehata
- College of Pharmacy, Department of Pharmaceutical Chemistry, King Saud University, Riyadh 11495, P.O. Box 22452, Saudi Arabia
| | - Ashwag O Abahussain
- College of Pharmacy, Department of Pharmaceutical Chemistry, King Saud University, Riyadh 11495, P.O. Box 22452, Saudi Arabia
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Johnson EJ, Won CS, Köck K, Paine MF. Prioritizing pharmacokinetic drug interaction precipitants in natural products: application to OATP inhibitors in grapefruit juice. Biopharm Drug Dispos 2017; 38:251-259. [PMID: 28032362 DOI: 10.1002/bdd.2061] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/14/2016] [Accepted: 12/20/2016] [Indexed: 12/16/2022]
Abstract
Natural products, including botanical dietary supplements and exotic drinks, represent an ever-increasing share of the health-care market. The parallel ever-increasing popularity of self-medicating with natural products increases the likelihood of co-consumption with conventional drugs, raising concerns for unwanted natural product-drug interactions. Assessing the drug interaction liability of natural products is challenging due to the complex and variable chemical composition inherent to these products, necessitating a streamlined preclinical testing approach to prioritize precipitant individual constituents for further investigation. Such an approach was evaluated in the current work to prioritize constituents in the model natural product, grapefruit juice, as inhibitors of intestinal organic anion-transporting peptide (OATP)-mediated uptake. Using OATP2B1-expressing MDCKII cells (Madin-Darby canine kidney type II) and the probe substrate estrone 3-sulfate, IC50s were determined for constituents representative of the flavanone (naringin, naringenin, hesperidin), furanocoumarin (bergamottin, 6',7'-dihydroxybergamottin) and polymethoxyflavone (nobiletin and tangeretin) classes contained in grapefruit juice. Nobiletin was the most potent (IC50 , 3.7 μm); 6',7'-dihydroxybergamottin, naringin, naringenin and tangeretin were moderately potent (IC50 , 20-50 μm); and bergamottin and hesperidin were the least potent (IC50 , >300 μm) OATP2B1 inhibitors. Intestinal absorption simulations based on physiochemical properties were used to determine the ratios of unbound concentration to IC50 for each constituent within enterocytes and to prioritize in order of pre-defined cut-off values. This streamlined approach could be applied to other natural products that contain multiple precipitants of natural product-drug interactions. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Emily J Johnson
- College of Pharmacy, Washington State University, Spokane, WA, USA
| | - Christina S Won
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936, USA
| | - Kathleen Köck
- Quintiles IMS, Inc., Clinical Pharmacology, 6700 W 115th Street, Overland Park, KS 66211, USA
| | - Mary F Paine
- College of Pharmacy, Washington State University, Spokane, WA, USA
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56
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Intraduodenal infusion of cyanidin-3-glucoside transiently promotes triglyceride excretion into bile in rats. Nutr Res 2017; 38:34-42. [DOI: 10.1016/j.nutres.2017.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 12/12/2016] [Accepted: 01/13/2017] [Indexed: 12/21/2022]
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Abstract
Natural foods and vegetal supplements have recently become increasingly popular for their roles in medicine and as staple foods. This has, however, led to the increased risk of interaction between prescribed drugs and the bioactive ingredients contained in these foods. These interactions range from pharmacokinetic interactions (absorption, distribution, metabolism, and excretion influencing blood levels of drugs) to pharmacodynamic interactions (drug effects). In a quantitative respect, these interactions occur mainly during metabolism. In addition to the systemic metabolism that occurs mainly in the liver, recent studies have focused on the metabolism in the gastrointestinal tract endothelium before absorption. Inhibition of metabolism causes an increase in the blood levels of drugs and could have adverse reactions. The food-drug interactions causing increased blood levels of drugs may have beneficial or detrimental therapeutic effects depending on the intensity and predictability of these interactions. It is therefore important to understand the potential interactions between foods and drugs should and the specific outcomes of such interactions.
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Affiliation(s)
- Jong Hwan Choi
- Department of Biochemistry, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chang Mann Ko
- Department of Pharmacology, Yonsei University Wonju College of Medicine, Wonju, Korea
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58
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Mouly S, Lloret-Linares C, Sellier PO, Sene D, Bergmann JF. Is the clinical relevance of drug-food and drug-herb interactions limited to grapefruit juice and Saint-John's Wort? Pharmacol Res 2016; 118:82-92. [PMID: 27693910 DOI: 10.1016/j.phrs.2016.09.038] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 01/15/2023]
Abstract
An interaction of drug with food, herbs, and dietary supplements is usually the consequence of a physical, chemical or physiologic relationship between a drug and a product consumed as food, nutritional supplement or over-the-counter medicinal plant. The current educational review aims at reminding to the prescribing physicians that the most clinically relevant drug-food interactions may not be strictly limited to those with grapefruit juice and with the Saint John's Wort herbal extract and may be responsible for changes in drug plasma concentrations, which in turn decrease efficacy or led to sometimes life-threatening toxicity. Common situations handled in clinical practice such as aging, concomitant medications, transplant recipients, patients with cancer, malnutrition, HIV infection and those receiving enteral or parenteral feeding may be at increased risk of drug-food or drug-herb interactions. Medications with narrow therapeutic index or potential life-threatening toxicity, e.g., the non-steroidal anti-inflammatory drugs, opioid analgesics, cardiovascular medications, warfarin, anticancer drugs and immunosuppressants may be at risk of significant drug-food interactions to occur. Despite the fact that considerable effort has been achieved to increase patient' and doctor's information and ability to anticipate their occurrence and consequences in clinical practice, a thorough and detailed health history and dietary recall are essential for identifying potential problems in order to optimize patient prescriptions and drug dosing on an individual basis as well as to increase the treatment risk/benefit ratio.
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Affiliation(s)
- Stéphane Mouly
- UMR-S1144, Faculté de Médecine Paris-Diderot, 10 avenue de Verdun 75010 Paris, France; Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France.
| | - Célia Lloret-Linares
- UMR-S1144, Faculté de Médecine Paris-Diderot, 10 avenue de Verdun 75010 Paris, France; Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France
| | - Pierre-Olivier Sellier
- Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France
| | - Damien Sene
- Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France
| | - J-F Bergmann
- UMR-S1144, Faculté de Médecine Paris-Diderot, 10 avenue de Verdun 75010 Paris, France; Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France
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Abdlekawy KS, Donia AM, Elbarbry F. Effects of Grapefruit and Pomegranate Juices on the Pharmacokinetic Properties of Dapoxetine and Midazolam in Healthy Subjects. Eur J Drug Metab Pharmacokinet 2016; 42:397-405. [DOI: 10.1007/s13318-016-0352-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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60
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Roe AL, Paine MF, Gurley BJ, Brouwer KR, Jordan S, Griffiths JC. Assessing Natural Product-Drug Interactions: An End-to-End Safety Framework. Regul Toxicol Pharmacol 2016; 76:1-6. [PMID: 26776752 DOI: 10.1016/j.yrtph.2016.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/07/2016] [Indexed: 11/28/2022]
Abstract
The use of natural products (NPs), including herbal medicines and other dietary supplements, by North Americans continues to increase across all age groups. This population has access to conventional medications, with significant polypharmacy observed in older adults. Thus, the safety of the interactions between multi-ingredient NPs and drugs is a topic of paramount importance. Considerations such as history of safe use, literature data from animal toxicity and human clinical studies, and NP constituent characterization would provide guidance on whether to assess NP-drug interactions experimentally. The literature is replete with reports of various NP extracts and constituents as potent inhibitors of drug metabolizing enzymes, and transporters. However, without standard methods for NP characterization or in vitro testing, extrapolating these reports to clinically-relevant NP-drug interactions is difficult. This lack of a clear definition of risk precludes clinicians and consumers from making informed decisions about the safety of taking NPs with conventional medications. A framework is needed that describes an integrated robust approach for assessing NP-drug interactions; and, translation of the data into formulation alterations, dose adjustment, labelling, and/or post-marketing surveillance strategies. A session was held at the 41st Annual Summer Meeting of the Toxicology Forum in Colorado Springs, CO, to highlight the challenges and critical components that should be included in a framework approach.
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Affiliation(s)
- Amy L Roe
- Product Safety & Regulatory Affairs, The Procter & Gamble Company, Cincinnati, OH 45040, United States.
| | - Mary F Paine
- Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA 99210, United States.
| | - Bill J Gurley
- College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
| | | | - Scott Jordan
- Marketed Biologicals, Biotechnology and Natural Health Products Bureau, Marketed Health Products Directorate, Health Canada, Ottawa, Ontario, Canada.
| | - James C Griffiths
- Council for Responsible Nutrition, Washington, DC 20036, United States.
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61
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Ghanemi A. For dentists and doctors: The neglected concepts about the factors influencing the effects of drugs. Saudi Dent J 2016; 28:1-2. [PMID: 26792962 PMCID: PMC4688445 DOI: 10.1016/j.sdentj.2015.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Abdelaziz Ghanemi
- Address: Kunming Institute of Zoology, Chinese Academy of Sciences, No. 32 Jiaochang Donglu, Kunming 650223, Yunnan Province, China
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62
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Gufford BT, Barr JT, González-Pérez V, Layton ME, White JR, Oberlies NH, Paine MF. Quantitative prediction and clinical evaluation of an unexplored herb-drug interaction mechanism in healthy volunteers. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2015; 4:701-10. [PMID: 26904384 PMCID: PMC4759704 DOI: 10.1002/psp4.12047] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/21/2015] [Indexed: 12/11/2022]
Abstract
Quantitative prediction of herb–drug interaction risk remains challenging. A quantitative framework to assess a potential interaction was used to evaluate a mechanism not previously tested in humans. The semipurified milk thistle product, silibinin, was selected as an exemplar herbal product inhibitor of raloxifene intestinal glucuronidation. Physiologically based pharmacokinetic (PBPK) model simulations of the silibinin–raloxifene interaction predicted up to 30% increases in raloxifene area under the curve (AUC0‐inf) and maximal concentration (Cmax). Model‐informed clinical evaluation of the silibinin–raloxifene interaction indicated minimal clinical interaction liability, with observed geometric mean raloxifene AUC0‐inf and Cmax ratios lying within the predefined no effect range (0.75–1.33). Further refinement of PBPK modeling and simulation approaches will enhance confidence in predictions and facilitate generalizability to additional herb–drug combinations. This quantitative framework can be used to develop guidances to evaluate potential herb–drug interactions prospectively, providing evidenced‐based information about the risk or safety of these interactions.
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Affiliation(s)
- B T Gufford
- College of Pharmacy Washington State University Spokane, Washington USA
| | - J T Barr
- College of Pharmacy Washington State University Spokane, Washington USA
| | - V González-Pérez
- College of Pharmacy Washington State University Spokane, Washington USA
| | - M E Layton
- College of Medical Sciences Washington State University Spokane, Washington USA
| | - J R White
- College of Pharmacy Washington State University Spokane, Washington USA
| | - N H Oberlies
- Department of Chemistry and Biochemistry University of North Carolina at Greensboro Greensboro North Carolina USA
| | - M F Paine
- College of Pharmacy Washington State University Spokane, Washington USA
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63
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Gufford BT, Graf TN, Paguigan ND, Oberlies NH, Paine MF. Chemoenzymatic Synthesis, Characterization, and Scale-Up of Milk Thistle Flavonolignan Glucuronides. Drug Metab Dispos 2015; 43:1734-43. [PMID: 26316643 PMCID: PMC4613946 DOI: 10.1124/dmd.115.066076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/26/2015] [Indexed: 11/22/2022] Open
Abstract
Plant-based therapeutics, including herbal products, continue to represent a growing facet of the contemporary health care market. Mechanistic descriptions of the pharmacokinetics and pharmacodynamics of constituents composing these products remain nascent, particularly for metabolites produced following herbal product ingestion. Generation and characterization of authentic metabolite standards are essential to improve the quantitative mechanistic understanding of herbal product disposition in both in vitro and in vivo systems. Using the model herbal product, milk thistle, the objective of this work was to biosynthesize multimilligram quantities of glucuronides of select constituents (flavonolignans) to fill multiple knowledge gaps in the understanding of herbal product disposition and action. A partnership between clinical pharmacology and natural products chemistry expertise was leveraged to optimize reaction conditions for efficient glucuronide formation and evaluate alternate enzyme and reagent sources to improve cost effectiveness. Optimized reaction conditions used at least one-fourth the amount of microsomal protein (from bovine liver) and cofactor (UDP glucuronic acid) compared with typical conditions using human-derived subcellular fractions, providing substantial cost savings. Glucuronidation was flavonolignan-dependent. Silybin A, silybin B, isosilybin A, and isosilybin B generated five, four, four, and three monoglucuronides, respectively. Large-scale synthesis (40 mg of starting material) generated three glucuronides of silybin A: silybin A-7-O-β-D-glucuronide (15.7 mg), silybin A-5-O-β-D-glucuronide (1.6 mg), and silybin A-4´´-O-β-D-glucuronide (11.1 mg). This optimized, cost-efficient method lays the foundation for a systematic approach to synthesize and characterize herbal product constituent glucuronides, enabling an improved understanding of mechanisms underlying herbal product disposition and action.
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Affiliation(s)
- Brandon T Gufford
- Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (B.T.G., M.F.P.); and Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.D.P., N.H.O.)
| | - Tyler N Graf
- Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (B.T.G., M.F.P.); and Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.D.P., N.H.O.)
| | - Noemi D Paguigan
- Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (B.T.G., M.F.P.); and Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.D.P., N.H.O.)
| | - Nicholas H Oberlies
- Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (B.T.G., M.F.P.); and Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.D.P., N.H.O.)
| | - Mary F Paine
- Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (B.T.G., M.F.P.); and Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.D.P., N.H.O.)
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64
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Content evaluation of 4 furanocoumarin monomers in various citrus germplasms. Food Chem 2015; 187:75-81. [DOI: 10.1016/j.foodchem.2015.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/01/2015] [Accepted: 04/03/2015] [Indexed: 11/22/2022]
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65
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Gufford BT, Chen G, Vergara AG, Lazarus P, Oberlies NH, Paine MF. Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction. Drug Metab Dispos 2015; 43:1353-9. [PMID: 26070840 PMCID: PMC4538855 DOI: 10.1124/dmd.115.065086] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/12/2015] [Indexed: 12/26/2022] Open
Abstract
Women at high risk of developing breast cancer are prescribed selective estrogen response modulators, including raloxifene, as chemoprevention. Patients often seek complementary and alternative treatment modalities, including herbal products, to supplement prescribed medications. Milk thistle preparations, including silibinin and silymarin, are top-selling herbal products that may be consumed by women taking raloxifene, which undergoes extensive first-pass glucuronidation in the intestine. Key constituents in milk thistle, flavonolignans, were previously shown to be potent inhibitors of intestinal UDP-glucuronosyl transferases (UGTs), with IC50s ≤ 10 μM. Taken together, milk thistle preparations may perpetrate unwanted interactions with raloxifene. The objective of this work was to evaluate the inhibitory effects of individual milk thistle constituents on the intestinal glucuronidation of raloxifene using human intestinal microsomes and human embryonic kidney cell lysates overexpressing UGT1A1, UGT1A8, and UGT1A10, isoforms highly expressed in the intestine that are critical to raloxifene clearance. The flavonolignans silybin A and silybin B were potent inhibitors of both raloxifene 4'- and 6-glucuronidation in all enzyme systems. The Kis (human intestinal microsomes, 27-66 µM; UGT1A1, 3.2-8.3 µM; UGT1A8, 19-73 µM; and UGT1A10, 65-120 µM) encompassed reported intestinal tissue concentrations (20-310 µM), prompting prediction of clinical interaction risk using a mechanistic static model. Silibinin and silymarin were predicted to increase raloxifene systemic exposure by 4- to 5-fold, indicating high interaction risk that merits further evaluation. This systematic investigation of the potential interaction between a widely used herbal product and chemopreventive agent underscores the importance of understanding natural product-drug interactions in the context of cancer prevention.
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Affiliation(s)
- Brandon T Gufford
- Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., A.G.V., P.L.), College of Pharmacy, Washington State University, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina, Greensboro, North Carolina (N.H.O.)
| | - Gang Chen
- Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., A.G.V., P.L.), College of Pharmacy, Washington State University, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina, Greensboro, North Carolina (N.H.O.)
| | - Ana G Vergara
- Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., A.G.V., P.L.), College of Pharmacy, Washington State University, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina, Greensboro, North Carolina (N.H.O.)
| | - Philip Lazarus
- Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., A.G.V., P.L.), College of Pharmacy, Washington State University, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina, Greensboro, North Carolina (N.H.O.)
| | - Nicholas H Oberlies
- Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., A.G.V., P.L.), College of Pharmacy, Washington State University, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina, Greensboro, North Carolina (N.H.O.)
| | - Mary F Paine
- Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., A.G.V., P.L.), College of Pharmacy, Washington State University, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina, Greensboro, North Carolina (N.H.O.)
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Mouly S, Morgand M, Lopes A, Lloret-Linares C, Bergmann JF. Interactions médicaments–aliments en médecine interne : quels messages pour le clinicien ? Rev Med Interne 2015; 36:530-9. [DOI: 10.1016/j.revmed.2014.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 12/22/2014] [Indexed: 01/31/2023]
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Foo WYB, Tay HY, Chan ECY, Lau AJ. Meclizine, a pregnane X receptor agonist, is a direct inhibitor and mechanism-based inactivator of human cytochrome P450 3A. Biochem Pharmacol 2015; 97:320-30. [PMID: 26239802 DOI: 10.1016/j.bcp.2015.07.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 07/29/2015] [Indexed: 12/15/2022]
Abstract
Meclizine is an agonist of human pregnane X receptor (PXR). It increases CYP3A4 mRNA expression, but decreases CYP3A-catalyzed testosterone 6β-hydroxylation in primary cultures of human hepatocytes, as assessed at 24h after the last dose of meclizine. Therefore, the hypothesis to be tested is that meclizine inactivates human CYP3A enzymes. Our findings indicated that meclizine directly inhibited testosterone 6β-hydroxylation catalyzed by human liver microsomes, recombinant CYP3A4, and recombinant CYP3A5. The inhibition of human liver microsomal testosterone 6β-hydroxylation by meclizine occurred by a mixed mode and with an apparent Ki of 31±6μM. Preincubation of meclizine with human liver microsomes and NADPH resulted in a time- and concentration-dependent decrease in testosterone 6β-hydroxylation. The extent of inactivation required the presence of NADPH, was unaffected by nucleophilic trapping agents or reactive oxygen species scavengers, attenuated by a CYP3A substrate, and not reversed by dialysis. Meclizine selectively inactivated CYP3A4, but not CYP3A5. In contrast to meclizine, which has a di-substituted piperazine ring, norchlorcyclizine, which is a N-debenzylated meclizine metabolite with a mono-substituted piperazine ring, did not inactivate but directly inhibited hepatic microsomal CYP3A activity. In conclusion, meclizine inhibited human CYP3A enzymes by both direct inhibition and mechanism-based inactivation. In contrast, norchlorcyclizine is a direct inhibitor but not a mechanism-based inactivator. Furthermore, a PXR agonist may also be an inhibitor of a PXR-regulated enzyme, thereby giving rise to opposing effects on the functional activity of the enzyme and indicating the importance of measuring the catalytic activity of nuclear receptor-regulated enzymes.
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Affiliation(s)
- Winnie Yin Bing Foo
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
| | - Hwee Ying Tay
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
| | - Eric Chun Yong Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
| | - Aik Jiang Lau
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Influence of Food on Paediatric Gastrointestinal Drug Absorption Following Oral Administration: A Review. CHILDREN-BASEL 2015; 2:244-71. [PMID: 27417362 PMCID: PMC4928757 DOI: 10.3390/children2020244] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/15/2015] [Accepted: 05/18/2015] [Indexed: 12/26/2022]
Abstract
The objective of this paper was to review existing information regarding food effects on drug absorption within paediatric populations. Mechanisms that underpin food-drug interactions were examined to consider potential differences between adult and paediatric populations, to provide insights into how this may alter the pharmacokinetic profile in a child. Relevant literature was searched to retrieve information on food-drug interaction studies undertaken on: (i) paediatric oral drug formulations; and (ii) within paediatric populations. The applicability of existing methodology to predict food effects in adult populations was evaluated with respect to paediatric populations where clinical data was available. Several differences in physiology, anatomy and the composition of food consumed within a paediatric population are likely to lead to food-drug interactions that cannot be predicted based on adult studies. Existing methods to predict food effects cannot be directly extrapolated to allow predictions within paediatric populations. Development of systematic methods and guidelines is needed to address the general lack of information on examining food-drug interactions within paediatric populations.
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Finotti E, Gezzi R, Nobili F, Garaguso I, Friedman M. Effect of apple, baobab, red-chicory, and pear extracts on cellular energy expenditure and morphology of a Caco-2 cells using transepithelial electrical resistance (TEER) and scanning electron microscopy (SEM). RSC Adv 2015. [DOI: 10.1039/c4ra15129a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The present study investigated the effects of four food extracts on the Caco-2 intestinal cell line using a new transepithelial electrical resistance method (TEER) concurrent with electron microscopy (SEM).
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Affiliation(s)
- Enrico Finotti
- CRA-NUT National Council for Agricultural Research
- Research Center for Food and Nutrition
- 00178 – Rome
- Italy
| | - Riccardo Gezzi
- Department of Orthodontics
- Georg-August-University
- Göttingen
- Germany
| | - Fabio Nobili
- CRA-NUT National Council for Agricultural Research
- Research Center for Food and Nutrition
- 00178 – Rome
- Italy
| | - Ivana Garaguso
- CRA-NUT National Council for Agricultural Research
- Research Center for Food and Nutrition
- 00178 – Rome
- Italy
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Christiansen ML, Müllertz A, Garmer M, Kristensen J, Jacobsen J, Abrahamsson B, Holm R. Evaluation of the Use of Göttingen Minipigs to Predict Food Effects on the Oral Absorption of Drugs in Humans. J Pharm Sci 2015; 104:135-43. [DOI: 10.1002/jps.24270] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 10/28/2014] [Accepted: 10/29/2014] [Indexed: 01/08/2023]
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Marlicz W, Loniewski I, Grimes DS, Quigley EM. Nonsteroidal anti-inflammatory drugs, proton pump inhibitors, and gastrointestinal injury: contrasting interactions in the stomach and small intestine. Mayo Clin Proc 2014; 89:1699-709. [PMID: 25440891 DOI: 10.1016/j.mayocp.2014.07.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/20/2014] [Accepted: 07/28/2014] [Indexed: 02/06/2023]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) are among the most frequently prescribed groups of drugs worldwide. The use of NSAIDs is associated with a high number of significant adverse effects. Recently, the safety of PPIs has also been challenged. Capsule endoscopy studies reveal that even low-dose NSAIDs are responsible for gut mucosal injury and numerous clinical adverse effects, for example, bleeding and anemia, that might be difficult to diagnose. The frequent use of PPIs can exacerbate NSAID-induced small intestinal injury by altering intestinal microbiota. Thus, the use of PPI is considered to be an independent risk factor associated with NSAID-associated enteropathy. In this review, we discuss this important clinical problem and review relevant aspects of epidemiology, pathophysiology, and management. We also present the hypothesis that even minor and subclinical injury to the intestinal mucosa can result in significant, though delayed, metabolic consequences, which may seriously affect the health of an individual. PubMed was searched using the following key words (each key word alone and in combination): gut microbiota, microbiome, non-steroidal anti inflammatory drugs, proton pump inhibitors, enteropathy, probiotic, antibiotic, mucosal injury, enteroscopy, and capsule endoscopy. Google engine search was also carried out to identify additional relevant articles. Both original and review articles published in English were reviewed.
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Affiliation(s)
- Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland.
| | - Igor Loniewski
- International Pharmaceutical Consulting, Szczecin, Poland
| | | | - Eamonn M Quigley
- Division of Gastroenterology and Hepatology, Houston Methodist Hospital, and Weill Cornell Medical College, Houston, TX
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72
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Ainslie GR, Wolf KK, Li Y, Connolly EA, Scarlett YV, Hull JH, Paine MF. Assessment of a candidate marker constituent predictive of a dietary substance-drug interaction: case study with grapefruit juice and CYP3A4 drug substrates. J Pharmacol Exp Ther 2014; 351:576-84. [PMID: 25253884 DOI: 10.1124/jpet.114.216838] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Dietary substances, including herbal products and citrus juices, can perpetrate interactions with conventional medications. Regulatory guidances for dietary substance-drug interaction assessment are lacking. This deficiency is due in part to challenges unique to dietary substances, a lack of requisite human-derived data, and limited jurisdiction. An in vitro-in vivo extrapolation (IVIVE) approach to help address some of these hurdles was evaluated using the exemplar dietary substance grapefruit juice (GFJ), the candidate marker constituent 6',7'-dihydroxybergamottin (DHB), and the purported victim drug loperamide. First, the GFJ-loperamide interaction was assessed in 16 healthy volunteers. Loperamide (16 mg) was administered with 240 ml of water or GFJ; plasma was collected from 0 to 72 hours. Relative to water, GFJ increased the geometric mean loperamide area under the plasma concentration-time curve (AUC) significantly (1.7-fold). Second, the mechanism-based inhibition kinetics for DHB were recovered using human intestinal microsomes and the index CYP3A4 reaction, loperamide N-desmethylation (KI [concentration needed to achieve one-half kinact], 5.0 ± 0.9 µM; kinact [maximum inactivation rate constant], 0.38 ± 0.02 minute(-1)). These parameters were incorporated into a mechanistic static model, which predicted a 1.6-fold increase in loperamide AUC. Third, the successful IVIVE prompted further application to 15 previously reported GFJ-drug interaction studies selected according to predefined criteria. Twelve of the interactions were predicted to within the 25% predefined criterion. Results suggest that DHB could be used to predict the CYP3A4-mediated effect of GFJ. This time- and cost-effective IVIVE approach could be applied to other dietary substance-drug interactions to help prioritize new and existing drugs for more advanced (dynamic) modeling and simulation and clinical assessment.
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Affiliation(s)
- Garrett R Ainslie
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
| | - Kristina K Wolf
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
| | - Yingxin Li
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
| | - Elizabeth A Connolly
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
| | - Yolanda V Scarlett
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
| | - J Heyward Hull
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
| | - Mary F Paine
- Curriculum in Toxicology (G.R.A., M.F.P.) and Division of Gastroenterology and Hepatology (Y.V.S.), School of Medicine, and UNC Eshelman School of Pharmacy (K.K.W., Y.L., E.A.C., J.H.H.), The University of North Carolina, Chapel Hill, North Carolina; and Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, Washington (G.R.A., M.F.P.)
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Gufford BT, Chen G, Lazarus P, Graf TN, Oberlies NH, Paine MF. Identification of diet-derived constituents as potent inhibitors of intestinal glucuronidation. Drug Metab Dispos 2014; 42:1675-83. [PMID: 25008344 DOI: 10.1124/dmd.114.059451] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Drug-metabolizing enzymes within enterocytes constitute a key barrier to xenobiotic entry into the systemic circulation. Furanocoumarins in grapefruit juice are cornerstone examples of diet-derived xenobiotics that perpetrate interactions with drugs via mechanism-based inhibition of intestinal CYP3A4. Relative to intestinal CYP3A4-mediated inhibition, alternate mechanisms underlying dietary substance-drug interactions remain understudied. A working systematic framework was applied to a panel of structurally diverse diet-derived constituents/extracts (n = 15) as inhibitors of intestinal UDP-glucuronosyl transferases (UGTs) to identify and characterize additional perpetrators of dietary substance-drug interactions. Using a screening assay involving the nonspecific UGT probe substrate 4-methylumbelliferone, human intestinal microsomes, and human embryonic kidney cell lysates overexpressing gut-relevant UGT1A isoforms, 14 diet-derived constituents/extracts inhibited UGT activity by >50% in at least one enzyme source, prompting IC(50) determination. The IC(50) values of 13 constituents/extracts (≤10 μM with at least one enzyme source) were well below intestinal tissue concentrations or concentrations in relevant juices, suggesting that these diet-derived substances can inhibit intestinal UGTs at clinically achievable concentrations. Evaluation of the effect of inhibitor depletion on IC(50) determination demonstrated substantial impact (up to 2.8-fold shift) using silybin A and silybin B, two key flavonolignans from milk thistle (Silybum marianum) as exemplar inhibitors, highlighting an important consideration for interpretation of UGT inhibition in vitro. Results from this work will help refine a working systematic framework to identify dietary substance-drug interactions that warrant advanced modeling and simulation to inform clinical assessment.
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Affiliation(s)
- Brandon T Gufford
- Section of Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., P.L.), Washington State University College of Pharmacy, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.H.O.)
| | - Gang Chen
- Section of Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., P.L.), Washington State University College of Pharmacy, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.H.O.)
| | - Philip Lazarus
- Section of Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., P.L.), Washington State University College of Pharmacy, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.H.O.)
| | - Tyler N Graf
- Section of Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., P.L.), Washington State University College of Pharmacy, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.H.O.)
| | - Nicholas H Oberlies
- Section of Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., P.L.), Washington State University College of Pharmacy, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.H.O.)
| | - Mary F Paine
- Section of Experimental and Systems Pharmacology (B.T.G., M.F.P.) and Department of Pharmaceutical Sciences (G.C., P.L.), Washington State University College of Pharmacy, Spokane, Washington; and Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina (T.N.G., N.H.O.)
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74
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Peluso I, Palmery M. Is a flavonoid-rich diet with steamer cooking safe during calcineurin inhibitors therapy? J Clin Pharm Ther 2014; 39:471-4. [PMID: 24938126 DOI: 10.1111/jcpt.12186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 05/19/2014] [Indexed: 12/14/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Dietary therapy is recommended for decreasing the symptoms of the metabolic syndrome and the risk of type 2 diabetes and cardiovascular diseases in subjects on calcineurin inhibitors. However, food-drug interactions may occur particularly with patients on such immunosuppressive therapy. This article comments on the benefit/risk assessment of a flavonoid-rich diet and steam-cooking of such food during calcineurin inhibitors therapy. COMMENT Patients are commonly advised against consuming citrus fruits and juices, grape juice and green tea. High vegetable intake may however increase the risk of food-diet interactions by inhibiting drug metabolic enzymes and transporters. Vegetable glucosinolates are potential interactants and may lead to adverse effects of drugs with narrow therapeutic indices and in the presence of genetic polymorphism. Examples of food components with potential drug interactants include all members of the Brassicaceae family. WHAT IS NEW AND CONCLUSION The potential additive and synergistic effects of flavonoids with other molecules in interfering with drug bioavailability need to be taken into account. The risk is highest with drugs with a narrow therapeutic index and in subjects with genetic polymorphisms of proteins involved in the disposition of those drugs.
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Affiliation(s)
- I Peluso
- Department of Physiology and Pharmacology "V. Erspamer", "Sapienza" University of Rome, Rome, Italy
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75
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Labeled content of two furanocoumarins in dietary supplements correlates with neither actual content nor CYP3A inhibitory activity. J Pharm Biomed Anal 2014; 98:260-5. [PMID: 24951959 DOI: 10.1016/j.jpba.2014.05.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/22/2014] [Accepted: 05/24/2014] [Indexed: 01/08/2023]
Abstract
Dietary supplements are a multi-billion dollar business, with yearly profit increases. Allegedly safe, these supplements are marketed to a variety of niches, encompassing claims from immune support to weight loss. Six sports nutrition supplements were acquired that were labeled to contain the furanocoumarin(s) bergamottin and/or 6',7'-dihydroxybergamottin (DHB), both of which are potent irreversible inhibitors of the prominent drug metabolizing enzyme cytochrome P450 3A (CYP3A). Both furanocoumarins are typically present in grapefruit juice, which has been shown to inhibit intestinal CYP3A, perpetrating an increase in the systemic exposure of certain concomitant 'victim' drugs. The acquired supplements were analyzed using ultra-performance liquid chromatography coupled to both a photodiode array (PDA) detector and a triple quadrupole mass spectrometer (MS). Contrary to the product labeling, four of the supplements contained no detectable quantities of either furanocoumarin (LOD 0.060μg/capsule), while two of the supplements contained minimal amounts (one contained 12.13 (±0.23) μg bergamottin and 65.51 (±0.64) μg DHB per capsule; the other contained 2.705 (±0.069) μg bergamottin per capsule and no detectable quantities of DHB). A CYP3A inhibition bioassay was used to assess whether the actual content of the furanocoumarins correlated with CYP3A inhibitory activity. Despite the low amounts of bergamottin and DHB, CYP3A inhibition by the supplements was greater than could be accounted for by the two furanocoumarins. The additional activity suggests the presence of other potent or highly abundant CYP3A inhibitors.
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Sjögren E, Abrahamsson B, Augustijns P, Becker D, Bolger MB, Brewster M, Brouwers J, Flanagan T, Harwood M, Heinen C, Holm R, Juretschke HP, Kubbinga M, Lindahl A, Lukacova V, Münster U, Neuhoff S, Nguyen MA, Peer AV, Reppas C, Hodjegan AR, Tannergren C, Weitschies W, Wilson C, Zane P, Lennernäs H, Langguth P. In vivo methods for drug absorption – Comparative physiologies, model selection, correlations with in vitro methods (IVIVC), and applications for formulation/API/excipient characterization including food effects. Eur J Pharm Sci 2014; 57:99-151. [DOI: 10.1016/j.ejps.2014.02.010] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 01/11/2023]
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Brantley SJ, Argikar AA, Lin YS, Nagar S, Paine MF. Herb-drug interactions: challenges and opportunities for improved predictions. Drug Metab Dispos 2014; 42:301-17. [PMID: 24335390 PMCID: PMC3935140 DOI: 10.1124/dmd.113.055236] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 12/11/2013] [Indexed: 01/23/2023] Open
Abstract
Supported by a usage history that predates written records and the perception that "natural" ensures safety, herbal products have increasingly been incorporated into Western health care. Consumers often self-administer these products concomitantly with conventional medications without informing their health care provider(s). Such herb-drug combinations can produce untoward effects when the herbal product perturbs the activity of drug metabolizing enzymes and/or transporters. Despite increasing recognition of these types of herb-drug interactions, a standard system for interaction prediction and evaluation is nonexistent. Consequently, the mechanisms underlying herb-drug interactions remain an understudied area of pharmacotherapy. Evaluation of herbal product interaction liability is challenging due to variability in herbal product composition, uncertainty of the causative constituents, and often scant knowledge of causative constituent pharmacokinetics. These limitations are confounded further by the varying perspectives concerning herbal product regulation. Systematic evaluation of herbal product drug interaction liability, as is routine for new drugs under development, necessitates identifying individual constituents from herbal products and characterizing the interaction potential of such constituents. Integration of this information into in silico models that estimate the pharmacokinetics of individual constituents should facilitate prospective identification of herb-drug interactions. These concepts are highlighted with the exemplar herbal products milk thistle and resveratrol. Implementation of this methodology should help provide definitive information to both consumers and clinicians about the risk of adding herbal products to conventional pharmacotherapeutic regimens.
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Affiliation(s)
- Scott J Brantley
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina (S.J.B.); Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, Pennsylvania (A.A.A., S.N.); Department of Pharmaceutics, University of Washington, Seattle, Washington (Y.S.L.); and College of Pharmacy, Washington State University, Spokane, Washington (M.F.P.)
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Wang M, Lu J, Li J, Qi H, Wang Y, Zhang H. Steviol glucuronidation and its potential interaction with UDP-glucuronosyltransferase 2B7 substrates. Food Chem Toxicol 2014; 64:135-43. [DOI: 10.1016/j.fct.2013.11.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 11/05/2013] [Accepted: 11/22/2013] [Indexed: 02/08/2023]
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79
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Jang YJ, Jeong TC, Noh K, Baek IW, Kwon KI, Kim E, Yoon YR, Kang W. Prandial effect on the systemic exposure of amisulpride. Arch Pharm Res 2014; 37:1325-8. [PMID: 24469600 DOI: 10.1007/s12272-014-0331-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
Abstract
A substituted benzamide, amisulpride is an atypical antipsychotic and a specific antagonist for dopamine D2 and D3 receptors. The prandial effect on amisulpride absorption remains unclear, therefore, this study was designed to investigate the effect of food on the systemic exposure to amisulpride in healthy volunteers. The study was a randomized, two-way crossed trial in which a single oral dose of amisulpride was administered on two occasions, with 7-days washout period between each drug administration. The volunteers were randomly divided into two groups and received amisulpride (50 mg) with Korean traditional food or under fasting state. Blood was serially taken, and the plasma amisulpride concentrations were measured by LC/MS/MS. At fasting state, amisulpride reached the first peak (37.1 ± 13.3 ng/ml) at ~2.3 h, and decreased down to 19.4 ± 4.3 ng/ml until 3.5 h, and then again went up to the second peak (25.3 ± 5.8 ng/ml) at 5 h followed by a slow decay with 10.6 h of half-life. In contrast, no double peaks were shown when the drug was given with meal. The maximum concentration of amisulpride (56.0 ± 12.7 ng/ml) was increased by a 1.5-fold compared with that under fasting (p > 0.05), and the time to peak shortened a little (1.7 ± 0.6 h).
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Affiliation(s)
- Yoo-Jung Jang
- College of Pharmacy, Yeungnam University, Kyoungbuk, 712-749, South Korea
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80
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Nikolac N, Supak-Smolcić V, Simundić AM, Celap I. Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling. Biochem Med (Zagreb) 2013; 23:242-54. [PMID: 24266294 PMCID: PMC3900082 DOI: 10.11613/bm.2013.031] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60-80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations. The Croatian Society for Medical Biochemistry and Laboratory Medicine, Working Group for the Preanalytical Phase issued this recommendation. This document is based on the CLSI guideline H3-A6, with significant differences and additional information.
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Affiliation(s)
- Nora Nikolac
- Croatian Society of Medical Biochemistry and Laboratory Medicine, Committee for the Scientific Professional Development, Working Group for Pre-analytics, Zagreb, Croatia.
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81
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Effects of artificial sweeteners on the AhR- and GR-dependent CYP1A1 expression in primary human hepatocytes and human cancer cells. Toxicol In Vitro 2013; 27:2283-8. [DOI: 10.1016/j.tiv.2013.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 07/03/2013] [Accepted: 10/02/2013] [Indexed: 11/18/2022]
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82
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Vandermolen KM, Cech NB, Paine MF, Oberlies NH. Rapid Quantitation of Furanocoumarins and Flavonoids in Grapefruit Juice using Ultra-Performance Liquid Chromatography. PHYTOCHEMICAL ANALYSIS : PCA 2013; 24:654-60. [PMID: 23780830 PMCID: PMC3855432 DOI: 10.1002/pca.2449] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/27/2013] [Accepted: 04/24/2013] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Grapefruit juice can increase or decrease the systemic exposure of myriad oral medications, leading to untoward effects or reduced efficacy. Furanocoumarins in grapefruit juice have been established as inhibitors of cytochrome P450 3A (CYP3A)-mediated metabolism and P-glycoprotein (P-gp)-mediated efflux, while flavonoids have been implicated as inhibitors of organic anion transporting polypeptide (OATP)-mediated absorptive uptake in the intestine. The potential for drug interactions with a food product necessitates an understanding of the expected concentrations of a suite of structurally diverse and potentially bioactive compounds. OBJECTIVE Develop methods for the rapid quantitation of two furanocoumarins (bergamottin and 6',7'-dihydroxybergamottin) and four flavonoids (naringin, naringenin, narirutin and hesperidin) in five grapefruit juice products using ultra-performance liquid chromatography (UPLC). METHODS Grapefruit juice products were extracted with ethyl acetate; the concentrated extract was analysed by UPLC using acetonitrile:water gradients and a C18 -column. Analytes were detected using a photodiode array detector, set at 250 nm (furanocoumarins) and 310 nm (flavonoids). Intraday and interday precision and accuracy and limits of detection and quantitation were determined. RESULTS Rapid (< 5.0 min) UPLC methods were developed to measure the aforementioned furanocoumarins and flavonoids. R(2) values for the calibration curves of all analytes were >0.999. Considerable between-juice variation in the concentrations of these compounds was observed, and the quantities measured were in agreement with the concentrations published in HPLC studies. CONCLUSION These analytical methods provide an expedient means to quantitate key furanocoumarins and flavonoids in grapefruit juice and other foods used in dietary substance-drug interaction studies.
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Affiliation(s)
- Karen M Vandermolen
- Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Patricia A. Sullivan Science Building, PO Box 26170, Greensboro, NC, 27402, USA
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Maurer JM, Schellekens RCA, van Rieke HM, Stellaard F, Wutzke KD, Buurman DJ, Dijkstra G, Woerdenbag HJ, Frijlink HW, Kosterink JGW. ColoPulse tablets perform comparably in healthy volunteers and Crohn's patients and show no influence of food and time of food intake on bioavailability. J Control Release 2013; 172:618-24. [PMID: 24096020 DOI: 10.1016/j.jconrel.2013.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 09/23/2013] [Indexed: 11/18/2022]
Abstract
ColoPulse tablets are an innovative development in the field of oral drug delivery and are characterized by a colon-specific release. Until now ColoPulse dosage forms (only capsules) have been studied in healthy volunteers having a standardized breakfast three hours after administration but not in specific patient groups and not with a shorter interval between administration and breakfast. Information on bioavailability and release characteristics of ColoPulse tablets in Crohn's patients and the influence of food and time of food intake is a prerequisite to properly design future clinical studies with active substances in these patients. In the current cross-over study bioavailability and drug release characteristics of ColoPulse tablets were compared in healthy volunteers and in Crohn's patients in remission. Furthermore the influence of food and time of food intake on the in vivo drug release behavior of ColoPulse tablets was investigated. In this study the dual label isotope strategy was used which means that a ColoPulse tablet containing (13)C-urea and an uncoated, immediate release tablet containing (15)N2-urea were taken simultaneously. Breath and urine samples were collected during the test day for isotope analysis. The appearance of the stable isotopes in breath and/or urine provides information on the site of release from the dosage form, release characteristics and bioavailability. Both tablets were administered on two different days in a cross-over design: the first day with a breakfast (non-standardized) one hour after administration and the second day with a standardized breakfast three hours after administration of the tablets. There was no difference in instructions for administration between both days. Results of 16 healthy volunteers and 14 Crohn's patients were evaluated. At least 86% (51 out of 59) of all ColoPulse tablets administered in this study released their contents at the desired intestinal region. There was no significant difference in bioavailability between healthy volunteers and Crohn's patients on both days (day 1 75.8% vs 90.2%, p=0.070 and day 2 83.4% vs 91.4%, p=0.265). There was also no significant influence of food and time of food intake on bioavailability in healthy volunteers (75.8% and 83.4%, p=0.077) and in Crohn's patients (90.2% and 91.4%, p=0.618) when day 1 and day 2 were compared. Release characteristics did not significantly differ between healthy volunteers and Crohn's patients. However, food and time of food intake had some, clinically non-relevant, influence on the release characteristics within both groups which is in line with the fact that food affects gastro-intestinal transit times. This study shows that ColoPulse tablets enable the site-specific delivery of drugs or other compounds (e.g. diagnostics) deep in the ileo-colonic region of the intestine of Crohn's patients in a comparable amount and rate as in healthy volunteers. Food and time of food intake had no relevant influence on bioavailability. In conclusion ColoPulse delivery systems are promising and deserve further research for local therapy with immunosuppressive drugs in Crohn's patients in the near future.
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Affiliation(s)
- J M Maurer
- Department of Hospital and Clinical Pharmacy, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
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Brantley SJ, Graf TN, Oberlies NH, Paine MF. A systematic approach to evaluate herb-drug interaction mechanisms: investigation of milk thistle extracts and eight isolated constituents as CYP3A inhibitors. Drug Metab Dispos 2013; 41:1662-70. [PMID: 23801821 PMCID: PMC3876807 DOI: 10.1124/dmd.113.052563] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 06/25/2013] [Indexed: 10/26/2022] Open
Abstract
Despite increasing recognition of potential untoward interactions between herbal products and conventional medications, a standard system for prospective assessment of these interactions remains elusive. This information gap was addressed by evaluating the drug interaction liability of the model herbal product milk thistle (Silybum marianum) with the CYP3A probe substrate midazolam. The inhibitory effects of commercially available milk thistle extracts and isolated constituents on midazolam 1'-hydroxylation were screened using human liver and intestinal microsomes. Relative to vehicle, the extract silymarin and constituents silybin A, isosilybin A, isosilybin B, and silychristin at 100 μM demonstrated >50% inhibition of CYP3A activity with at least one microsomal preparation, prompting IC50 determination. The IC50s for isosilybin B and silychristin were ∼60 and 90 μM, respectively, whereas those for the remaining constituents were >100 μM. Extracts and constituents that contained the 1,4-dioxane moiety demonstrated a >1.5-fold shift in IC50 when tested as potential mechanism-based inhibitors. The semipurified extract, silibinin, and the two associated constituents (silybin A and silybin B) demonstrated mechanism-based inhibition of recombinant CYP3A4 (KI, ∼100 μM; kinact, ∼0.20 min(-1)) but not microsomal CYP3A activity. The maximum predicted increases in midazolam area under the curve using the static mechanistic equation and recombinant CYP3A4 data were 1.75-fold, which may necessitate clinical assessment. Evaluation of the interaction liability of single herbal product constituents, in addition to commercially available extracts, will enable elucidation of mechanisms underlying potential clinically significant herb-drug interactions. Application of this framework to other herbal products would permit predictions of herb-drug interactions and assist in prioritizing clinical evaluation.
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Affiliation(s)
- Scott J Brantley
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Leleux J, Williams RO. Recent advancements in mechanical reduction methods: particulate systems. Drug Dev Ind Pharm 2013; 40:289-300. [PMID: 23988193 DOI: 10.3109/03639045.2013.828217] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The screening of new active pharmaceutical ingredients (APIs) has become more streamlined and as a result the number of new drugs in the pipeline is steadily increasing. However, a major limiting factor of new API approval and market introduction is the low solubility associated with a large percentage of these new drugs. While many modification strategies have been studied to improve solubility such as salt formation and addition of cosolvents, most provide only marginal success and have severe disadvantages. One of the most successful methods to date is the mechanical reduction of drug particle size, inherently increasing the surface area of the particles and, as described by the Noyes-Whitney equation, the dissolution rate. Drug micronization has been the gold standard to achieve these improvements; however, the extremely low solubility of some new chemical entities is not significantly affected by size reduction in this range. A reduction in size to the nanometric scale is necessary. Bottom-up and top-down techniques are utilized to produce drug crystals in this size range; however, as discussed in this review, top-down approaches have provided greater enhancements in drug usability on the industrial scale. The six FDA approved products that all exploit top-down approaches confirm this. In this review, the advantages and disadvantages of both approaches will be discussed in addition to specific top-down techniques and the improvements they contribute to the pharmaceutical field.
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Affiliation(s)
- Jardin Leleux
- Deparment of Biomedical Engineering, The University of Texas at Austin , TX , USA and
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86
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Drug interactions result from a number of underlying pharmacokinetic and pharmacodynamic mechanisms. DRUGS & THERAPY PERSPECTIVES 2013. [DOI: 10.1007/s40267-013-0047-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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87
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Exploring food effects on indinavir absorption with human intestinal fluids in the mouse intestine. Eur J Pharm Sci 2013; 49:27-32. [DOI: 10.1016/j.ejps.2013.01.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 12/20/2012] [Accepted: 01/14/2013] [Indexed: 10/27/2022]
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88
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