1
|
Cho CK, Kang P, Jang CG, Lee SY, Lee YJ, Bae JW, Choi CI. PBPK modeling to predict the pharmacokinetics of venlafaxine and its active metabolite in different CYP2D6 genotypes and drug-drug interactions with clarithromycin and paroxetine. Arch Pharm Res 2024; 47:481-504. [PMID: 38664354 DOI: 10.1007/s12272-024-01495-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/11/2024] [Indexed: 06/20/2024]
Abstract
Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), is indicated for the treatment of major depressive disorder, social anxiety disorder, generalized anxiety disorder, and panic disorder. Venlafaxine is metabolized to the active metabolite desvenlafaxine mainly by CYP2D6. Genetic polymorphism of CYP2D6 and coadministration with other medications can significantly affect the pharmacokinetics and/or pharmacodynamics of venlafaxine and its active metabolite. This study aimed to establish the PBPK models of venlafaxine and its active metabolite related to CYP2D6 genetic polymorphism and to predict drug-drug interactions (DDIs) with clarithromycin and paroxetine in different CYP2D6 genotypes. Clinical pharmacogenomic data for venlafaxine and desvenlafaxine were collected to build the PBPK model. Physicochemical and absorption, distribution, metabolism, and excretion (ADME) characteristics of respective compounds were obtained from previously reported data, predicted by the PK-Sim® software, or optimized to capture the plasma concentration-time profiles. Model evaluation was performed by comparing the predicted pharmacokinetic parameters and plasma concentration-time profiles to the observed data. Predicted plasma concentration-time profiles of venlafaxine and its active metabolite were visually similar to the observed profiles and all predicted AUC and Cmax values for respective compounds were included in the twofold error range of observed values in non-genotyped populations and different CYP2D6 genotypes. When clarithromycin or clarithromycin plus paroxetine was concomitantly administered, predicted plasma concentration-time profiles of venlafaxine properly captured the observed profiles in two different CYP2D6 genotypes and all predicted DDI ratios for AUC and Cmax were included within the acceptance range. Consequently, the present model successfully captured the pharmacokinetic alterations of venlafaxine and its active metabolite according to CYP2D6 genetic polymorphism as well as the DDIs between venlafaxine and two CYP inhibitors. The present model can be used to predict the pharmacokinetics of venlafaxine and its active metabolite considering different races, ages, coadministered drugs, and CYP2D6 activity of individuals and it can contribute to individualized pharmacotherapy of venlafaxine.
Collapse
Affiliation(s)
- Chang-Keun Cho
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Pureum Kang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Choon-Gon Jang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Seok-Yong Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
| | - Yun Jeong Lee
- College of Pharmacy, Dankook University, Cheonan, 31116, Republic of Korea
| | - Jung-Woo Bae
- College of Pharmacy, Keimyung University, Daegu, 42601, Republic of Korea
| | - Chang-Ik Choi
- College of Pharmacy, Dongguk University-Seoul, Goyang, 10326, Republic of Korea.
| |
Collapse
|
2
|
Vashistha VK, Sethi S, Tyagi I, Das DK. Chirality of antidepressive drugs: an overview of stereoselectivity. ASIAN BIOMED 2022; 16:55-69. [PMID: 37551287 PMCID: PMC10321182 DOI: 10.2478/abm-2022-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Stereochemistry plays an important role in drug design because the enantiomers of a drug frequently vary in their biological action and pharmacokinetic profiles. Racemates of a drug with either an inactive or an unsafe enantiomer can lead to detrimental effects. The manufacturing industry may still produce racemates, but such decisions must pass through rigorous analyses of the pharmacological and pharmacokinetic characteristics of the particular enantiomer related to the racemates. The pharmacokinetics of antidepressants or antidepressive agents is stereoselective and predominantly favors one enantiomer. The use of pure enantiomers offers (i) better specificity than the racemates in terms of certain pharmacological actions, (ii) enhanced clinical indications, and (iii) optimized pharmacokinetics. Therefore, controlling the stereoselectivity in the pharmacokinetics of antidepressive drugs is of critical importance in dealing with depression and psychiatric conditions. The objective of this review is to highlight the importance of the stereochemistry of antidepressants in the context of the design and development of new chirally pure pharmaceuticals, the potential complications caused by using racemates, and the benefits of using pure enantiomers.
Collapse
Affiliation(s)
| | - Sonika Sethi
- Department of Chemistry, GD Goenka University, Gurgaon, Haryana122103, India
| | - Inderjeet Tyagi
- Centre for DNA Taxonomy, Molecular Systematics Division, Zoological Survey of India, Ministry of Environment, Forest and Climate Change, Government of India, Kolkata700053, India
| | - Dipak Kumar Das
- Department of Chemistry, GLA University, Mathura, Uttar Pradesh281406, India
| |
Collapse
|
3
|
Tozatto E, Benzi JRDL, Rocha A, Coelho EB, Lanchote VL. Nifedipine Does Not Alter the Pharmacokinetics of Venlafaxine Enantiomers in Healthy Subjects Phenotyped for CYP2D6, CYP2C19, and CYP3A. J Clin Pharmacol 2020; 61:319-327. [PMID: 32974907 DOI: 10.1002/jcph.1745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/24/2020] [Indexed: 01/16/2023]
Abstract
Venlafaxine (VEN) is a P-glycoprotein (P-gp) substrate, and nifedipine has been described by in vitro and experimental studies as a P-gp inhibitor. The present study aimed to investigate whether nifedipine alters the kinetic disposition of VEN enantiomers and their metabolites in healthy subjects. A crossover study was conducted in 10 healthy subjects phenotyped as extensive metabolizers for cytochrome P450 (CYP) 2D6, CYP2C19, and CYP3A. In phase 1, the subjects received a single oral dose of 150 mg racemic VEN, and in phase 2, a single oral dose of 40 mg nifedipine was administered with the VEN treatment. Plasma concentrations of VEN enantiomers and their metabolites O-desmethylvenlafaxine and N, O- didesmethylvenlafaxine (ODV and DDV, respectively) were evaluated by liquid chromatography with tandem mass spectrometry up to 72 hours after drug administration. Phase 2 was compared with phase 1 using the 90% confidence interval (CI) of the ratio of geometric means for Cmax and area under the curve (AUC). AUC enantiomeric ratios S-(+)/R-(-) were evaluated within each and between phases using the Wilcoxon test (P ≤ .05). The kinetic disposition of VEN was enantioselective (phase 1) with VEN S-(+)/R-(-) AUC ratio median of 2.83 (AUC0-∞ , 526 vs 195 ng·h/mL). However, AUC median did not differ between enantiomers for the metabolites ODV (1971 vs 2226 ng·h/mL) and DDV (199 vs 151 ng·h/mL). The 90%CI of the ratio of geometric means showed that the phases are bioequivalent. A single oral dose of 40 mg nifedipine did not alter VEN enantiomer pharmacokinetics in healthy subjects.
Collapse
Affiliation(s)
- Eduardo Tozatto
- Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Jhohann Richard de Lima Benzi
- Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Adriana Rocha
- Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Vera Lucia Lanchote
- Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| |
Collapse
|
4
|
Chen F, Bai Q, Wang Q, Chen S, Ma X, Cai C, Wang D, Waqas A, Gong P. Stereoselective Pharmacokinetics and Chiral Inversions of Some Chiral Hydroxy Group Drugs. Curr Pharm Biotechnol 2020; 21:1632-1644. [PMID: 32718284 DOI: 10.2174/1389201021666200727144053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/15/2020] [Accepted: 07/07/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chiral safety, especially chiral drug inversion in vivo, is the top priority of current scientific research. Medicine researchers and pharmacists often ignore that one enantiomer will be converted or partially converted to another enantiomer when it is ingested in vivo. So that, in the context that more than 50% of the listed drugs are chiral drugs, it is necessary and important to pay attention to the inversion of chiral drugs. METHODS The metabolic and stereoselective pharmacokinetic characteristics of seven chiral drugs with one chiral center in the hydroxy group were reviewed in vivo and in vitro including the possible chiral inversion of each drug enantiomer. These seven drugs include (S)-Mandelic acid, RS-8359, Tramadol, Venlafaxine, Carvedilol, Fluoxetine and Metoprolol. RESULTS The differences in stereoselective pharmacokinetics could be found for all the seven chiral drugs, since R and S isomers often exhibit different PK and PD properties. However, not every drug has shown the properties of one direction or two direction chiral inversion. For chiral hydroxyl group drugs, the redox enzyme system may be one of the key factors for chiral inversion in vivo. CONCLUSION In vitro and in vivo chiral inversion is a very complex problem and may occur during every process of ADME. Nowadays, research on chiral metabolism in the liver has the most attention, while neglecting the chiral transformation of other processes. Our review may provide the basis for the drug R&D and the safety of drugs in clinical therapy.
Collapse
Affiliation(s)
- Fuxin Chen
- Department of Chemistry and Chemical Engineering, Xi'an University of Science & Technology, Xi'an 710054, China
| | - Qiaoxiu Bai
- Department of Chemistry and Chemical Engineering, Xi'an University of Science & Technology, Xi'an 710054, China
| | - Qingfeng Wang
- Department of Chemistry and Chemical Engineering, Xi'an University of Science & Technology, Xi'an 710054, China
| | - Suying Chen
- Department of Chemistry and Chemical Engineering, Xi'an University of Science & Technology, Xi'an 710054, China
| | - Xiaoxian Ma
- Department of Chemistry and Chemical Engineering, Xi'an University of Science & Technology, Xi'an 710054, China
| | - Changlong Cai
- Research Center of Ion Beam Biotechnology and Biodiversity, Xi'an Technological University, Xi'an 710021, China
| | - Danni Wang
- School of Food and Biological Engineering, Shaanxi University of Science & Technology, Xi'an 710021, China
| | - Ahsan Waqas
- Department of Chemistry and Chemical Engineering, Xi'an University of Science & Technology, Xi'an 710054, China
| | - Pin Gong
- School of Food and Biological Engineering, Shaanxi University of Science & Technology, Xi'an 710021, China
| |
Collapse
|
5
|
Hancu G, Budău M, Muntean DL, Gagyi L, Rusu A. Capillary electrophoresis in the enantioseparation of modern antidepressants: An overview. Biomed Chromatogr 2018; 32:e4335. [DOI: 10.1002/bmc.4335] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/26/2018] [Accepted: 07/04/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Gabriel Hancu
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy; University of Medicine and Pharmacy of Tîrgu Mureș; Romania
| | - Monica Budău
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy; University of Medicine and Pharmacy of Tîrgu Mureș; Romania
| | - Daniela Lucia Muntean
- Department of Analytical Chemistry and Drug Analysis, Faculty of Pharmacy; University of Medicine and Pharmacy of Tîrgu Mureș; Romania
| | | | - Aura Rusu
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy; University of Medicine and Pharmacy of Tîrgu Mureș; Romania
| |
Collapse
|
6
|
Frankle WG, Robertson B, Maier G, Paris J, Asmonga D, May M, Himes ML, Mason NS, Mathis CA, Narendran R. An open-label positron emission tomography study to evaluate serotonin transporter occupancy following escalating dosing regimens of (R
)-(-)-O
-desmethylvenlafaxine and racemic O
-desmethylvenlafaxine. Synapse 2017; 72. [DOI: 10.1002/syn.22021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/09/2022]
Affiliation(s)
- W. Gordon Frankle
- Department of Psychiatry; NYU Langone Medical Center; New York New York
| | | | - Gary Maier
- MaierMetrics and Associates, LLC; Boston Massachusetts
| | - Jennifer Paris
- Department of Psychiatry; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Deanna Asmonga
- Department of Psychiatry; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Maureen May
- Department of Psychiatry; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Michael L. Himes
- Department of Psychiatry; University of Pittsburgh; Pittsburgh Pennsylvania
| | - N. Scott Mason
- Department of Radiology; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Chester A. Mathis
- Department of Radiology; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Rajesh Narendran
- Department of Psychiatry; University of Pittsburgh; Pittsburgh Pennsylvania
- Department of Radiology; University of Pittsburgh; Pittsburgh Pennsylvania
| |
Collapse
|
7
|
Godoy ALPC, Rocha A, da Silva Souza C, Lanchote VL. Pharmacokinetics of venlafaxine enantiomers and their metabolites in psoriasis patients. J Clin Pharmacol 2015; 56:567-75. [DOI: 10.1002/jcph.630] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/27/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Ana Leonor Pardo Campos Godoy
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas; Faculdade de Ciências Farmacêuticas de Ribeirão Preto; Universidade de São Paulo; Ribeirão Preto São Paulo Brazil
| | - Adriana Rocha
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas; Faculdade de Ciências Farmacêuticas de Ribeirão Preto; Universidade de São Paulo; Ribeirão Preto São Paulo Brazil
| | - Cacilda da Silva Souza
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto; Universidade de São Paulo; Ribeirão Preto São Paulo Brazil
| | - Vera Lucia Lanchote
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas; Faculdade de Ciências Farmacêuticas de Ribeirão Preto; Universidade de São Paulo; Ribeirão Preto São Paulo Brazil
| |
Collapse
|
8
|
Magalhães P, Alves G, Llerena A, Falcão A. Venlafaxine pharmacokinetics focused on drug metabolism and potential biomarkers. ACTA ACUST UNITED AC 2015; 29:129-41. [PMID: 24607919 DOI: 10.1515/dmdi-2013-0053] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/23/2014] [Indexed: 01/16/2023]
Abstract
Venlafaxine (VEN) is one of the safest and most effective drugs used in the treatment of selective serotonin reuptake inhibitors-resistant depression, and thereby it is nowadays one of the most commonly prescribed antidepressants. Nevertheless, patients treated with antidepressant drugs including VEN have exhibited large inter-individual variability in drug outcomes, possibly due to the influence of genetic and nongenetic factors on the drug pharmacokinetics and/or pharmacodynamics. Among them, an increased interest has emerged over the last few years on the genetic and/or phenotypic profile for drug-metabolizing cytochrome P450 isoenzymes and drug transporters such as potential predictive pharmacokinetic-based biomarkers of the variability found in drug biodisposition and antidepressant response. The integration of some of these key therapeutic biomarkers with classic therapeutic drug monitoring constitutes a promising way to individualization of VEN's pharmacotherapy, offering to clinicians the ability to better predict and manage pharmacological treatments to maximize the drug effectiveness. Thus, this review provides an extensive discussion of the pharmacokinetics of VEN focusing in particular on metabolism issues, without forgetting the clinically relevant sources of pharmacokinetics variability (mainly the genetic sources) and aiming on the identification of phenotypic and/or genetic biomarkers for therapy optimization.
Collapse
|
9
|
Modified Regulatory Pathways to Approve Generic Drugs in the US and a Systematic Review of Their Outcomes. Drugs 2015; 75:633-50. [DOI: 10.1007/s40265-015-0382-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Garcia Arieta A. Reasons to use stereoselective assay methods. Chirality 2012; 24:499. [DOI: 10.1002/chir.22022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 02/03/2012] [Indexed: 11/09/2022]
|