3
|
Kamble SH, Obeng S, León F, Restrepo LF, King TI, Berthold EC, Kanumuri SRR, Gamez-Jimenez LR, Pallares VLC, Patel A, Ho NP, Hampson A, McCurdy CR, McMahon LR, Wilkerson JL, Sharma A, Hiranita T. Pharmacokinetic and Pharmacodynamic Consequences of Cytochrome P450 3A Inhibition on Mitragynine Metabolism in Rats. J Pharmacol Exp Ther 2023; 385:180-192. [PMID: 37019472 PMCID: PMC10201580 DOI: 10.1124/jpet.122.001525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/11/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
Mitragynine, an opioidergic alkaloid present in Mitragyna speciosa (kratom), is metabolized by cytochrome P450 3A (CYP3A) to 7-hydroxymitragynine, a more potent opioid receptor agonist. The extent to which conversion to 7-hydroxymitragynine mediates the in vivo effects of mitragynine is unclear. The current study examined how CYP3A inhibition (ketoconazole) modifies the pharmacokinetics of mitragynine in rat liver microsomes in vitro. The study further examined how ketoconazole modifies the discriminative stimulus and antinociceptive effects of mitragynine in rats. Ketoconazole [30 mg/kg, oral gavage (o.g.)] increased systemic exposure to mitragynine (13.3 mg/kg, o.g.) by 120% and 7-hydroxymitragynine exposure by 130%. The unexpected increase in exposure to 7-hydroxymitragynine suggested that ketoconazole inhibits metabolism of both mitragynine and 7-hydroxymitragynine, a finding confirmed in rat liver microsomes. In rats discriminating 3.2 mg/kg morphine from vehicle under a fixed-ratio schedule of food delivery, ketoconazole pretreatment increased the potency of both mitragynine (4.7-fold) and 7-hydroxymitragynine (9.7-fold). Ketoconazole did not affect morphine's potency. Ketoconazole increased the antinociceptive potency of 7-hydroxymitragynine by 4.1-fold. Mitragynine (up to 56 mg/kg, i.p.) lacked antinociceptive effects both in the presence and absence of ketoconazole. These results suggest that both mitragynine and 7-hydroxymitragynine are cleared via CYP3A and that 7-hydroxymitragynine is formed as a metabolite of mitragynine by other routes. These results have implications for kratom use in combination with numerous medications and citrus juices that inhibit CYP3A. SIGNIFICANCE STATEMENT: Mitragynine is an abundant kratom alkaloid that exhibits low efficacy at the μ-opioid receptor (MOR). Its metabolite, 7-hydroxymitragynine, is also an MOR agonist but with higher affinity and efficacy than mitragynine. Our results in rats demonstrate that cytochrome P450 3A (CYP3A) inhibition can increase the systematic exposure of both mitragynine and 7-hydroxymitragynine and their potency to produce MOR-mediated behavioral effects. These data highlight potential interactions between kratom and CYP3A inhibitors, which include numerous medications and citrus juices.
Collapse
Affiliation(s)
- Shyam H Kamble
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Samuel Obeng
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Francisco León
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Luis F Restrepo
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Tamara I King
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Erin C Berthold
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Siva Rama Raju Kanumuri
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Lea R Gamez-Jimenez
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Victoria L C Pallares
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Avi Patel
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Nicholas P Ho
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Aidan Hampson
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Christopher R McCurdy
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Lance R McMahon
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Jenny L Wilkerson
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Abhisheak Sharma
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| | - Takato Hiranita
- Departments of Pharmaceutics (S.H.K., T.I.K., E.C.B., S.R.R.K., C.R.M., A.S.), Translational Drug Development Core (S.H.K., S.R.R.K., C.R.M., A.S.), Medicinal Chemistry (S.O., F.L., C.R.M.), and Pharmacodynamics (S.O., L.F.R., L.R.G.-J., V.L.C.P., A.P., N.P.H., L.R.M., J.L.W., T.H.), College of Pharmacy, University of Florida, Gainesville, Florida; Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, Alabama (S.O.); Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (F.L.); Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (A.H.); and Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas (L.R.M., J.L.W., T.H.)
| |
Collapse
|