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Jeon SY, Jeon JH, Park JH, Lee J, Pang M, Choi MK, Song IS. Simultaneous Analysis of a Combination of Anti-Hypertensive Drugs, Fimasartan, Amlodipine, and Hydrochlorothiazide, in Rats Using LC-MS/MS and Subsequent Application to Pharmacokinetic Drug Interaction with Red Ginseng Extract. TOXICS 2022; 10:576. [PMID: 36287856 PMCID: PMC9610909 DOI: 10.3390/toxics10100576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Fimasartan, amlodipine, and hydrochlorothiazide are commonly used in combination therapies as antihypertensive drugs. This study aimed to develop and validate an analytical method for fimasartan, its active and major metabolite fimasartan-amide, amlodipine, and hydrochlorothiazide in rat plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The standard calibration curves for fimasartan (1−500 ng/mL), its active and major metabolite fimasartan-amide (0.3−100 ng/mL), amlodipine (0.5−200 ng/mL), and hydrochlorothiazide (5−5000 ng/mL) were linear with R2 > 0.9964, and the inter- and intra-day accuracy and precision and stability were within the acceptable criteria. Using this validated analytical method, the pharmacokinetic interaction of these triple combination drugs between single administration and concomitant administration of the triple combination was investigated; the results did not reveal a significant difference in any of the pharmacokinetic parameters. Based on these results, we investigated the effects of red ginseng extract (RGE) on the pharmacokinetics of fimasartan, fimasartan-amide, amlodipine, and hydrochlorothiazide after oral administration of the combination in rats. No significant difference was observed in the pharmacokinetic parameters of fimasartan, fimasartan-amide, amlodipine, and hydrochlorothiazide, except for the Tmax values of amlodipine. The delayed Tmax value of amlodipine was attributed to its decreased intestinal permeability after repeated RGE treatments. In conclusion, using a combination of antihypertensive drugs and simultaneous analytical methods, we established efficient drug interaction and toxicokinetic studies using a small number of animals.
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Affiliation(s)
- So-Yeon Jeon
- College of Pharmacy, Dankook University, Cheon-an 31116, Korea
| | - Ji-Hyeon Jeon
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, Vessel-Organ Interaction Research Center (VOICE), Research Institute of Pharmaceutical Sciences, College of Pharmacy, Kyungpook National University, Daegu 41566, Korea
| | - Jin-Hyang Park
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, Vessel-Organ Interaction Research Center (VOICE), Research Institute of Pharmaceutical Sciences, College of Pharmacy, Kyungpook National University, Daegu 41566, Korea
| | - Jihoon Lee
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, Vessel-Organ Interaction Research Center (VOICE), Research Institute of Pharmaceutical Sciences, College of Pharmacy, Kyungpook National University, Daegu 41566, Korea
| | - Minyeong Pang
- College of Pharmacy, Dankook University, Cheon-an 31116, Korea
| | - Min-Koo Choi
- College of Pharmacy, Dankook University, Cheon-an 31116, Korea
| | - Im-Sook Song
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, Vessel-Organ Interaction Research Center (VOICE), Research Institute of Pharmaceutical Sciences, College of Pharmacy, Kyungpook National University, Daegu 41566, Korea
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Kang WY, Lee HW, Gwon MR, Cho S, Shim WS, Lee KT, Yang DH, Seong SJ, Yoon YR. A Pharmacokinetic Drug Interaction Between Fimasartan and Linagliptin in Healthy Volunteers. Drug Des Devel Ther 2021; 14:2101-2111. [PMID: 32546973 PMCID: PMC7266304 DOI: 10.2147/dddt.s248205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objective Fimasartan, an angiotensin II type 1 receptor blocker, and linagliptin, a dipeptidyl-peptidase-4 inhibitor, are frequently coadministered to treat patients with hypertension and diabetes, respectively. This study sought to evaluate the pharmacokinetic interactions between fimasartan and linagliptin after co-administration in healthy Korean subjects. Methods The overall study was divided into two separate parts, with each part designed as an open-label, multiple-dose, two-period, and single-sequence study. In Part A, to investigate the effect of linagliptin on fimasartan, 25 subjects received 120 mg fimasartan alone once daily for seven days during Period I, and 120 mg fimasartan with 20 mg linagliptin for seven days during Period II. In Part B, to examine the effect of fimasartan on linagliptin, 12 subjects received only linagliptin once daily for seven days during Period I, followed by concomitant administration of fimasartan for seven days during Period II, at the same doses used in Part A. Serial blood samples were collected at scheduled intervals for up to 24 h after the last dose to determine the steady-state pharmacokinetics of both drugs. Results Thirty-six subjects completed the study. The geometric mean ratio and 90% confidence intervals for maximum plasma concentration at steady state (Cmax,ss) and area under the concentration–time curve at steady state (AUCτ,ss) of fimasartan with or without linagliptin were 1.2633 (0.9175–1.7396) and 1.1740 (1.0499–1.3126), respectively. The corresponding values for Cmax,ss and AUCτ,ss of linagliptin with or without fimasartan were 0.9804 (0.8480–1.1336) and 0.9950 (0.9322–1.0619), respectively. A total of eight adverse events (AEs) were reported and the incidence of AEs did not increase significantly with co-administration of the drugs. Conclusion Our results suggest that there are no clinically significant pharmacokinetic interactions between fimasartan and linagliptin when co-administered. Treatments were well tolerated during the study, with no serious adverse effects. Clinical Trial Registry http://clinicaltrials.gov, NCT03250052.
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Affiliation(s)
- Woo Youl Kang
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hae Won Lee
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Mi-Ri Gwon
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Seungil Cho
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Wang-Seob Shim
- Kyung Hee Drug Analysis Center, Kyung Hee University, Seoul, Republic of Korea
| | - Kyung-Tae Lee
- Kyung Hee Drug Analysis Center, Kyung Hee University, Seoul, Republic of Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Sook Jin Seong
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Young-Ran Yoon
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
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Abstract
Hypertension is a major public health problem of modern era. Fimasartan is a new Angiotensin Receptor Blocker approved for treatment of hypertension. It is more potent and longer acting angiotensin receptor blocker with effects lasting over 24 hours. Many clinical studies have affirmed its role in pharmacotherapy of hypertension. Further, it is renoprotective and has proven beneficial in diabetes also. This article briefly discusses the pharmacology and clinical evidence with fimasartan with a short summary of previous angiotensin receptor blockers.
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Affiliation(s)
- Akshyaya Pradhan
- Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vikas Gupta
- Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rishi Sethi
- Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh, India
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Cho EJ, Sung KC, Kang SM, Shin MS, Joo SJ, Park JB. Fimasartan reduces clinic and home pulse pressure in elderly hypertensive patients: A K-MetS study. PLoS One 2019; 14:e0214293. [PMID: 30964905 PMCID: PMC6456168 DOI: 10.1371/journal.pone.0214293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/06/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Angiotensin II receptor blockers (ARBs) are recommended for treating patients with hypertension. However, comparative safety and efficacy of ARB use in elderly patients have not been well established. This study was designed to determine the efficacy of fimasartan, an ARB, in hypertensive elderly patients by measuring clinic and home blood pressures (BPs) and evaluating safety compared to nonelderly patients. METHOD In the K-MetS study, a nationwide prospective observational study of hypertensive patients on fimasartan, elderly patients (60 years and older) who were treated for 1 year with fimasartan were recruited. BP was evaluated in clinic and at home. RESULTS Of the 6 399 enrolled patients, 2 363 were elderly (46.9% males, mean age 67.3 ± 5.7 years). Fimasartan reduced systolic and diastolic BP (SBP and DBP) in clinic from 144.1 ± 17.3 to 127.7 ± 12.9 mmHg and from 85.1 ± 10.4 to 76.8 ± 8.4 mmHg, respectively, (all p<0.0001) in 1 year. Similar results were found in home BPs. These BP changes were consistent with those in nonelderly patients. However, pulse pressure, a better predictor of cardiovascular events in the elderly, decreased more in elderly than in nonelderly patients by -8.2 ± 0.3 in elderly and -7.0 ± 0.2 mmHg (p<0.0001), respectively, after adjustment for confounding factors. Adverse events were reported in 1.6% of elderly hypertensives, independent of dose, which was consistent with results in nonelderly patients. CONCLUSIONS Fimasartan resulted in better pulse pressure reduction with similar BP reduction efficacy and safety in hypertensive elderly patients compared with nonelderly patients.
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Affiliation(s)
- Eun Joo Cho
- Division of Cardiology, St. Paul’s Hospital, Catholic University of Korea, Seoul, Korea
| | - Ki Chul Sung
- Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Korea
| | - Seok Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Korea
| | - Mi-Seung Shin
- Division of Cardiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Seung Jae Joo
- Division of Cardiology, Jeju National University Hospital, Jeju, Korea
| | - Jeong Bae Park
- JB lab and clinic, Seoul, Korea
- Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim TH, Paik SH, Chi YH, Bulitta JB, Lee DY, Lim JY, Chung SE, Song CH, Jeong HM, Shin S, Shin BS. Regional Absorption of Fimasartan in the Gastrointestinal Tract by an Improved in situ Absorption Method in Rats. Pharmaceutics 2018; 10:pharmaceutics10040174. [PMID: 30282950 PMCID: PMC6320822 DOI: 10.3390/pharmaceutics10040174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 12/26/2022] Open
Abstract
The aim of the present study was to assess the regional absorption of fimasartan by an improved in situ absorption method in comparison with the conventional in situ single-pass perfusion method in rats. After each gastrointestinal segment of interest was identified, fimasartan was injected into the starting point of each segment and the unabsorbed fimasartan was discharged from the end point of the segment. Blood samples were collected from the jugular vein to evaluate the systemic absorption of the drug. The relative fraction absorbed (Fabs,relative) values in the specific gastrointestinal region calculated based on the area under the curve (AUC) values obtained after the injection of fimasartan into the gastrointestinal segment were 8.2% ± 3.2%, 23.0% ± 12.1%, 49.7% ± 11.5%, and 19.1% ± 11.9% for the stomach, duodenum, small intestine, and large intestine, respectively, which were comparable with those determined by the conventional in situ single-pass perfusion. By applying the fraction of the dose available at each gastrointestinal segment following the oral administration, the actual fraction absorbed (F′abs) values at each gastrointestinal segment were estimated at 10.9% for the stomach, 27.1% for the duodenum, 40.7% for the small intestine, and 5.4% for the large intestine, which added up to the gastrointestinal bioavailability (FX·FG) of 84.1%. The present method holds great promise to assess the regional absorption of a drug and aid to design new drug formulations.
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Affiliation(s)
- Tae Hwan Kim
- College of Pharmacy, Catholic University of Daegu, Gyeongsan, Gyeongbuk 38430 Korea.
| | - Soo Heui Paik
- College of Pharmacy, Sunchon National University, Sunchon, Jeonnam 57992, Korea.
| | - Yong Ha Chi
- Central Research Institute, Boryung Pharm. Co., Ltd., Seoul 03127, Korea.
| | - Jürgen B Bulitta
- College of Pharmacy, University of Florida, Orlando, FL 32827, USA.
| | - Da Young Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Korea.
| | - Jun Young Lim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Korea.
| | - Seung Eun Chung
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Korea.
| | - Chang Ho Song
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Korea.
| | - Hyeon Myeong Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Korea.
| | - Soyoung Shin
- College of Pharmacy, Wonkwang University, Iksan, Jeonbuk 54538, Korea.
| | - Beom Soo Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Korea.
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Choung W, Jung HJ, Nam EH, Yang D, Yoo B, Choi H, Lee BR, Park M, Jang SM, Lim JS, Kim KH, Chin J, Jung K, Lee G, Kim SH. Discovery of the bifunctional modulator of angiotensin II type 1 receptor (AT1R) and PPARγ derived from the AT1R antagonist, Fimasartan. Bioorg Med Chem Lett 2018; 28:3155-3160. [DOI: 10.1016/j.bmcl.2018.08.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/21/2018] [Accepted: 08/27/2018] [Indexed: 11/24/2022]
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Angeli F, Verdecchia P, Trapasso M, Pane M, Signorotti S, Reboldi G. PK/PD evaluation of fimasartan for the treatment of hypertension Current evidences and future perspectives. Expert Opin Drug Metab Toxicol 2018; 14:533-541. [PMID: 29676941 DOI: 10.1080/17425255.2018.1468435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Fimasartan is the ninth and latest Angiotensin Receptor Blockers for the treatment of hypertension. Fimasartan is a derivative of losartan in which the imidazole ring has been replaced. It provides a selective type 1 angiotensin II receptor antagonist effect with noncompetitive, in surmountable binding. Fimasartan is rapidly absorbed following oral administration with an oral bioavailability of 18.6 ± 7.2%. Fimasartan is relatively stable in terms of metabolism and more than 90% of circulating fimasartan moieties in the plasma are in the parent form; fecal elimination and biliary excretion are the predominant elimination pathways of fimasartan. Areas covered: We reviewed data from clinical trials that investigated safety and efficacy of fimasartan in hypertension. Expert opinion: Fimasartan proved good efficacy in blood pressure reduction. In large clinical studies,fimasartan showed an excellent safety profile and when combined with hydrochlorothiazide oram lodipine, it showed a better effect on controlling blood pressure than monotherapy. Fimasartan 60-120 mg once daily has also shown an antihypertensive effect over 24-h. Moreover, preclinical studies demonstrated organ-protecting effects of fimasartan. These results make fimasartan an attractive candidate for the treatment of hypertension. However, it remains to test the benefit of using fimasartan on clinical outcomes.
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Affiliation(s)
- Fabio Angeli
- a Department of Cardiology and Cardiovascular Pathophysiology , Hospital and University of Perugia , Perugia , Italy
| | - Paolo Verdecchia
- b Department of Internal Medicine , Hospital of Assisi , Assisi , Italy
| | - Monica Trapasso
- c Department of Medicine , University of Perugia , Perugia , Italy
| | - Marina Pane
- c Department of Medicine , University of Perugia , Perugia , Italy
| | - Sara Signorotti
- c Department of Medicine , University of Perugia , Perugia , Italy
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Choi YJ, Lee JY, Ryu CS, Chi YH, Paik SH, Kim SK. Role of cytochrome P450 enzymes in fimasartan metabolism in vitro. Food Chem Toxicol 2018; 115:375-384. [PMID: 29596975 DOI: 10.1016/j.fct.2018.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/14/2018] [Accepted: 03/24/2018] [Indexed: 02/05/2023]
Abstract
Fimasartan (FMS), an angiotensin II receptor antagonist, is metabolized to FMS S-oxide, FMS N-glucuronide, oxidative desulfurized FMS (BR-A-557), and hydroxy-n-butyl FMSs. The purpose of this study was to characterize enzymes involved in NADPH-dependent FMS metabolism using recombinant enzymes such as cytochrome P450 (CYP) and flavin-containing monooxygenase (FMO), as well as selective chemical inhibitors. The results showed that CYP, but not FMO, plays a major role in FMS metabolism. CYP2C9, CYP3A4, and CYP3A5 were involved in the formation of FMS S-oxide, which was further metabolized to BR-A-557 by CYP3A4/5. CYP2C9 played an exclusive role in n-butyl hydroxylation. The specificity constant (kcat/Km) values for S-oxidation by CYP2C9, CYP3A4, and CYP3A5 were 0.21, 0.34, and 0.19 μM-1∙min-1, respectively. The kcat/Km values of hydroxylation at the 1-, 2-/3-, and 4-n-butyl group in CYP2C9 were 0.0076, 0.041, and 0.035 μM-1∙min-1, respectively. The kcat and Km values provide information for the prediction of FMS metabolism in vivo. In addition, simultaneous determination of the FMS metabolites may be used to evaluate CYP2C9 and CYP3A4/5 activity.
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Affiliation(s)
- Young Jae Choi
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Ji-Yoon Lee
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Chang Seon Ryu
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Yong Ha Chi
- Central Research Institute, Boryung Pharm. co., Ltd. Ansan, Gyeonggi 425-839, Republic of Korea
| | - Soo Heui Paik
- College of Pharmacy, Sunchon National University, Suncheon-si, Republic of Korea
| | - Sang Kyum Kim
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea.
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Bulitta JB, Paik SH, Chi YH, Kim TH, Shin S, Landersdorfer CB, Jiao Y, Yadav R, Shin BS. Characterizing the time-course of antihypertensive activity and optimal dose range of fimasartan via mechanism-based population modeling. Eur J Pharm Sci 2017; 107:32-44. [PMID: 28599987 DOI: 10.1016/j.ejps.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 06/01/2017] [Accepted: 06/05/2017] [Indexed: 11/26/2022]
Abstract
Fimasartan is a novel angiotensin II receptor blocker. Our aims were to characterize the time-course of the antihypertensive activity of fimasartan via a new population pharmacokinetic/pharmacodynamic model and to define its optimal dose range. We simultaneously modelled all fimasartan plasma concentrations and 24-h ambulatory blood pressure monitoring (ABPM) data from 39 patients with essential hypertension and 56 healthy volunteers. Patients received placebo, 20, 60, or 180mg fimasartan every 24h for 28days and healthy volunteers received placebo or 20 to 480mg as a single oral dose or as seven doses every 24h. External validation was performed using data on 560 patients from four phase II or III studies. One turnover model each was used to describe diastolic and systolic blood pressure. The input rates into these compartments followed a circadian rhythm and were inhibited by fimasartan. The average predicted (observed) diastolic blood pressure over 24-h in patients decreased by 10.1±7.5 (12.6±9.2; mean±SD)mmHg for 20mg, 14.2±7.0 (15.1±9.3) mmHg for 60mg, and 15.9±6.8 (11.5±9.9)mmHg for 180mg daily relative to placebo. The model explained the saturation of antihypertensive activity by counter-regulation at high fimasartan concentrations. Drug effect was maximal at approximately 23ng/mL fimasartan for diastolic and 12ng/mL for systolic blood pressure. The proposed mechanism-based population model characterized the circadian rhythm of ABPM data and the antihypertensive effect of fimasartan. After internal and external model validation, 30 to 60mg oral fimasartan given once daily was predicted as optimal dose range.
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Affiliation(s)
- Jürgen B Bulitta
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA.
| | - Soo Heui Paik
- College of Pharmacy, Sunchon National University, Suncheon, Jeollanam-do, Republic of Korea
| | - Yong Ha Chi
- Central Research Institute, Boryung Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Tae Hwan Kim
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA; School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Republic of Korea
| | - Soyoung Shin
- Department of Pharmacy, College of Pharmacy, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - Cornelia B Landersdorfer
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville campus), Parkville, Victoria, Australia
| | - Yuanyuan Jiao
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Rajbharan Yadav
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville campus), Parkville, Victoria, Australia
| | - Beom Soo Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Republic of Korea.
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Kim COK, Jeon S, Han S, Hong T, Park MS, Yoon YR, Yim DS. Decreased potency of fimasartan in liver cirrhosis was quantified using mixed-effects analysis. Transl Clin Pharmacol 2017; 25:43-51. [PMID: 32095458 PMCID: PMC7033533 DOI: 10.12793/tcp.2017.25.1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 11/30/2022] Open
Abstract
Fimasartan is a nonpeptide angiotensin II receptor blocker. In a previous study that compared the pharmacokinetics (PK) of fimasartan between patients with hepatic impairment (cirrhosis) and healthy subjects, the exposure to fimasartan was found to be higher in patients, but the decrease of blood pressure (BP) was not clinically significant in those with moderate hepatic impairment. The aims of this study were to develop a population PK-pharmacodynamic (PD) model of fimasartan and to evaluate the effect of hepatic function on BP reduction by fimasartan using previously published data. A 2-compartment linear model with mixed zero-order absorption followed by first-order absorption with a lag time adequately described fimasartan PK, and the effect of fimasartan on BP changes was well explained by the inhibitory sigmoid function in the turnover PK-PD model overlaid with a model of circadian rhythm (NONMEM version 7.2). According to our PD model, the lower BP responses in hepatic impairment were the result of the increased fimasartan EC50 in patients, rather than from a saturation of effect. This is congruent with the reported pathophysiological change of increased plasma ACE and renin activity in hepatic cirrhosis.
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Affiliation(s)
- Choon OK Kim
- Department of Clinical Pharmacology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | | | - Seunghoon Han
- Department of Clinical Pharmacology and Therapeutics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Taegon Hong
- Department of Clinical Pharmacology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Min Soo Park
- Department of Clinical Pharmacology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Young-Ran Yoon
- Clinical Trial Center, Kyungpook National University Hospital, Daegu 41944, Korea
| | - Dong-Seok Yim
- Department of Clinical Pharmacology and Therapeutics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Kim TH, Kim MG, Shin S, Chi YH, Paik SH, Lee JH, Yoo SD, Youn YS, Bulitta JB, Joo SH, Jeong SW, Weon KY, Shin BS. Placental transfer and mammary excretion of a novel angiotensin receptor blocker fimasartan in rats. BMC Pharmacol Toxicol 2016; 17:35. [PMID: 27459959 PMCID: PMC4962410 DOI: 10.1186/s40360-016-0080-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 07/19/2016] [Indexed: 12/02/2022] Open
Abstract
Background Fimasartan (FMS) is a potent angiotensin receptor blocker for the treatment of mild to moderate hypertension. This study aimed to evaluate the transfer of FMS to fetus and breast milk in rats. Methods In order to study the transfer to the fetus and nursing pup, pregnant and nursing maternal rats were administered with FMS by a constant intravenous infusion to reach target plasma concentrations of 200 ng/mL and 100 ng/mL. The concentrations of FMS in plasma, placenta, amniotic fluid, fetus, and milk were determined by a validated LC-MS/MS assay. Results Upon constant intravenous infusion, the plasma FMS concentration reached the target steady state concentrations (Css = 200 ng/mL and 100 ng/mL) in 24 h. The tissue-to-plasma partition coefficients (Kp) for placenta, amniotic fluid, and milk were obtained based on the observed FMS concentrations in the tissues and Css. The Kp values for all tissues were not different between high (Css = 200 ng/mL) and low (Css = 100 ng/mL) dose groups. While the mean Kp of the placenta was 44.6–59.0 %, the mean Kp was 1.3–1.7 % for the amniotic fluid and 14.9–17.0 % for fetus. The mean Kp of milk was 10.4–15.2 %. Conclusions Placental transfer and milk excretion of FMS was relatively lower compared to other angiotensin receptor blockers.
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Affiliation(s)
- Tae Hwan Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Min Gi Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Soyoung Shin
- College of Pharmacy, Wonkwang University, Iksan, Jeonbuk, South Korea
| | - Yong-Ha Chi
- Boryung Pharm. Co., Ltd., Seoul, South Korea
| | - Soo-Heui Paik
- College of Pharmacy, Sunchon National University, Sunchon, Jeonnam, South Korea
| | - Joo-Han Lee
- Boryung Pharm. Co., Ltd., Seoul, South Korea
| | - Sun Dong Yoo
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Yu Seok Youn
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | | | - Sang Hoon Joo
- College of Pharmacy, Catholic University of Daegu, 13-13 Hayang-ro, Hayang-eup Gyeongsan-si, Gyeongbuk, 712-702, South Korea
| | - Seok Won Jeong
- College of Pharmacy, Catholic University of Daegu, 13-13 Hayang-ro, Hayang-eup Gyeongsan-si, Gyeongbuk, 712-702, South Korea
| | - Kwon-Yeon Weon
- College of Pharmacy, Catholic University of Daegu, 13-13 Hayang-ro, Hayang-eup Gyeongsan-si, Gyeongbuk, 712-702, South Korea
| | - Beom Soo Shin
- College of Pharmacy, Catholic University of Daegu, 13-13 Hayang-ro, Hayang-eup Gyeongsan-si, Gyeongbuk, 712-702, South Korea.
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12
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Abstract
Fimasartan is the ninth, and most recent, angiotensin II receptor antagonist approved as an antihypertensive agent. Fimasartan, a pyrimidin-4(3H)-one derivative of losartan with the imidazole ring replaced, which enables higher potency and longer duration than losartan. Fecal elimination and biliary excretion are the predominant elimination pathways of fimasartan and the urinary excretion was found to be less than 3 % 24 h after administration. Fimasartan is primarily catabolized by cytochrome P450 isoform 3A and no significant drug interaction was observed when used in combination with hydrochlorothiazide, amlodipine, warfarin, or digoxin. Fimasartan at a dosage range of 60-120 mg once daily showed an antihypertensive effect over 24 h. In a large, population-based observational study, fimasartan showed an excellent safety profile. Anti-inflammatory and organ-protecting effects of fimasartan have been shown in various preclinical studies, including aortic balloon injury, myocardial infarct ischemia/reperfusion, doxorubicin cardiotoxicity, and ischemic stroke models.
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Affiliation(s)
- Hae-Young Lee
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Byung-Hee Oh
- Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Chongno-gu, Seoul, 03080, Korea.
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13
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Characterization of In Vivo Metabolites of a Potential Anti-obesity Compound, the 3-Methyl-1H-Purine-2,6-Dione Derivative C-11, Employing Ultra-High Performance Liquid Chromatography Coupled with Quadrupole Time-of-Flight Mass Spectrometry. Chromatographia 2016. [DOI: 10.1007/s10337-016-3097-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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14
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Malik MY, Jaiswal S, Sharma A, Shukla M, Lal J. Role of enterohepatic recirculation in drug disposition: cooperation and complications. Drug Metab Rev 2016; 48:281-327. [PMID: 26987379 DOI: 10.3109/03602532.2016.1157600] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Enterohepatic recirculation (EHC) concerns many physiological processes and notably affects pharmacokinetic parameters such as plasma half-life and AUC as well as estimates of bioavailability of drugs. Also, EHC plays a detrimental role as the compounds/drugs are allowed to recycle. An in-depth comprehension of this phenomenon and its consequences on the pharmacological effects of affected drugs is important and decisive in the design and development of new candidate drugs. EHC of a compound/drug occurs by biliary excretion and intestinal reabsorption, sometimes with hepatic conjugation and intestinal deconjugation. EHC leads to prolonged elimination half-life of the drugs, altered pharmacokinetics and pharmacodynamics. Study of the EHC of any drug is complicated due to unavailability of the apposite model, sophisticated procedures and ethical concerns. Different in vitro and in vivo methods for studies in experimental animals and humans have been devised, each having its own merits and demerits. Involvement of the different transporters in biliary excretion, intra- and inter-species, pathological and biochemical variabilities obscure the study of the phenomenon. Modeling of drugs undergoing EHC has always been intricate and exigent models have been exploited to interpret the pharmacokinetic profiles of drugs witnessing multiple peaks due to EHC. Here, we critically appraise the mechanisms of bile formation, factors affecting biliary drug elimination, methods to estimate biliary excretion of drugs, EHC, multiple peak phenomenon and its modeling.
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Affiliation(s)
- Mohd Yaseen Malik
- a Department of Pharmaceutics , National Institute of Pharmaceutical Education and Research (NIPER) , Raebareli , India ;,b Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - Swati Jaiswal
- b Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India ;,c Academy of Scientific and Innovative Research , New Delhi , India
| | - Abhisheak Sharma
- b Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India ;,c Academy of Scientific and Innovative Research , New Delhi , India ;,d Department of Pharmaceutics and Drug Delivery, School of Pharmacy , The University of Mississippi , Oxford , USA
| | - Mahendra Shukla
- b Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India ;,c Academy of Scientific and Innovative Research , New Delhi , India
| | - Jawahar Lal
- b Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India ;,c Academy of Scientific and Innovative Research , New Delhi , India
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15
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Ghim JL, Paik SH, Hasanuzzaman M, Chi YH, Choi HK, Kim DH, Shin JG. Absolute bioavailability and pharmacokinetics of the angiotensin II receptor antagonist fimasartan in healthy subjects. J Clin Pharmacol 2015; 56:576-80. [PMID: 26272450 DOI: 10.1002/jcph.618] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/10/2015] [Indexed: 11/07/2022]
Abstract
The present study was conducted to determine the absolute bioavailability of fimasartan (FMS; Kanarb(®) ) after the single oral administration of a 60-mg tablet or a single 30-mg intravenous (IV) infusion. This investigation was a randomized, single-dose, open-labeled, two-way crossover study of 16 healthy Korean male subjects. The subjects were divided into two groups (n = 8) and each received either the oral or IV formulation followed by one-week washout period. The Cmax (ng/ml) and AUC∞ (h · ng/ml) following oral and IV administration were 62.4 ± 48.6 and 291.1 ± 121.7; and 683.3 ± 104.3 and 782.3 ± 112.7 (mean ± SD), respectively. The Tmax (h) were 3.0 h (range: 0.5-5.0 h) and 1.0 h (range: 0.8-1.0 h) in the test and reference groups, respectively. The terminal elimination half-lives (t1/2 , h) were similar (5.8 and 5.5 h, respectively) indicating that the route of administration did not influence the absorption or elimination of FMS. The systemic clearance (CL, L/h) and the volume of distribution at steady-state (Vdss , L) were 331.3 ± 444.5 L/h and 403.3 ± 710.4 L following oral administration and 39.1 ± 5.3 L/h and 42.4 ± 25.5 L following IV administration. The absolute bioavailability of the FMS tablet was 18.6%.
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Affiliation(s)
- Jong-Lyul Ghim
- Department of Clinical Pharmacology, Inje University, Busan Paik Hospital, Busan, Korea
| | - Soo Heui Paik
- Central Research Institute, Boryung Pharmaceutical Co, Ltd, Seoul, Korea
| | - M Hasanuzzaman
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Korea
| | - Yong Ha Chi
- Central Research Institute, Boryung Pharmaceutical Co, Ltd, Seoul, Korea
| | - Hyang-Ki Choi
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Korea
| | - Dong-Hyun Kim
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Korea
| | - Jae-Gook Shin
- Department of Clinical Pharmacology, Inje University, Busan Paik Hospital, Busan, Korea.,Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Korea
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Lee JY, Choi YJ, Oh SJ, Chi YH, Paik SH, Lee KH, Jung JK, Ryu CS, Kim KB, Kim DH, Yoon YR, Kim SK. Characterization of fimasartan metabolites in human liver microsomes and human plasma. Xenobiotica 2015; 46:40-51. [PMID: 26068523 DOI: 10.3109/00498254.2015.1047429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
1. The metabolites of fimasartan (FMS), a new angiotensin II receptor antagonist, were characterized in human liver microsomes (HLM) and human subjects. 2. We developed a method for a simultaneous quantitative and qualitative analysis using predictive multiple reaction monitoring information-dependent acquisition-enhanced product ion scanning. To characterize metabolic reactions, FMS metabolites were analyzed using quadrupole-time of flight mass spectrometer in full-scan mode. 3. The structures of metabolites were confirmed by comparison of chromatographic retention times and mass spectra with those of authentic metabolite standards. 4. In the cofactor-dependent microsomal metabolism study, the half-lives of FMS were 56.7, 247.9 and 53.3 min in the presence of NADPH, UDPGA and NADPH + UDPGA, respectively. 5. The main metabolic routes in HLM were S-oxidation, oxidative desulfuration, n-butyl hydroxylation and N-glucuronidation. 6. In humans orally administered with 120 mg FMS daily for 7 days, the prominent metabolites were FMS S-oxide and FMS N-glucuronide in the 0-8-h pooled plasma sample of each subject. 7. This study characterizes, for the first time, the metabolites of FMS in humans to provide information for its safe use in clinical medicine.
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Affiliation(s)
- Ji-Yoon Lee
- a College of Pharmacy, Chungnam National University , Daejeon , Republic of Korea
| | - Young Jae Choi
- a College of Pharmacy, Chungnam National University , Daejeon , Republic of Korea
| | - Soo Jin Oh
- b Bio-Evaluation Center, KRIBB , Ochang , Chungbuk , Republic of Korea
| | - Yong Ha Chi
- c Central Research Institute, Boryung Pharm. Co., Ltd. , Ansan , Gyeonggi , Republic of Korea
| | - Soo Heui Paik
- c Central Research Institute, Boryung Pharm. Co., Ltd. , Ansan , Gyeonggi , Republic of Korea
| | - Ki Ho Lee
- d College of Pharmacy, Korea University , Jochiwon-eup , Sejong , Republic of Korea
| | - Jae-Kyung Jung
- e College of Pharmacy and Medicinal Research Center (MRC), Chungbuk National University , Seowon-gu, Cheungju , Chungbuk , Republic of Korea
| | - Chang Seon Ryu
- a College of Pharmacy, Chungnam National University , Daejeon , Republic of Korea
| | - Kwon-Bok Kim
- f AB SCIEX, Yangjae 2-Dong Seocho-Gu , Seoul , Republic of Korea
| | - Dong-Hyun Kim
- g Department of Pharmacology and PharmacoGenomics Research Center , Inje University College of Medicine , Busan , Republic of Korea , and
| | - Young-Ran Yoon
- h Department of Biomedical Science and Clinical Trial Center, BK21 PLUS , KNU Bio-Medical Convergence Program for Creative Talent, Kyungpook National University Graduates School and Hospital , Daegu , Republic of Korea
| | - Sang Kyum Kim
- a College of Pharmacy, Chungnam National University , Daejeon , Republic of Korea
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17
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Kim TH, Shin S, Landersdorfer CB, Chi YH, Paik SH, Myung J, Yadav R, Horkovics-Kovats S, Bulitta JB, Shin BS. Population Pharmacokinetic Modeling of the Enterohepatic Recirculation of Fimasartan in Rats, Dogs, and Humans. AAPS JOURNAL 2015; 17:1210-23. [PMID: 25990964 DOI: 10.1208/s12248-015-9764-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/30/2015] [Indexed: 11/30/2022]
Abstract
Enterohepatic recirculation (EHC) can greatly enhance plasma drug exposures and therapeutic effects. This study aimed to develop a population pharmacokinetic model that can simultaneously characterize the extent and time-course of EHC in three species using fimasartan, a novel angiotensin II receptor blocker, as a model drug. All fimasartan plasma concentration profiles in 32 rats (intravenous doses, 0.3-3 mg/kg; oral doses, 1-10 mg/kg), 34 dogs (intravenous doses, 0.3-1 mg/kg; oral doses, 1-10 mg/kg), and 42 healthy volunteers (single or multiple oral doses, 20-480 mg) were determined via liquid chromatography-tandem mass spectrometry (LC-MS/MS) and simultaneously modeled in S-ADAPT. The proposed model quantitatively characterized EHC in three species after oral and intravenous dosing. The median (range) fraction of drug undergoing recirculation was 76.3% (64.9-88.7%) in rats, 33.3% (24.0-45.9%) in dogs, and 65.6% (56.5-72.0%) in humans. In the presence compared with the absence of EHC, the area under the curve in plasma was predicted to be 4.22-fold (2.85-8.85) as high in rats, 1.50-fold (1.32-1.85) in dogs, and 2.91-fold (2.30-3.57) in humans. The modeled oral bioavailability in rats (median (range), 38.7% (20.0-59.8%)) and dogs (median, 7.13% to 15.4%, depending on the formulation) matched the non-compartmental estimates well. In humans, the predicted oral bioavailability was 25.1% (15.1-43.9%) under fasting and 18.2% (12.2-31.0%) under fed conditions. The allometrically scaled area under the curve predicted from rats was 420 ng·h/mL for 60 mg fimasartan compared with 424 ± 63 ng·h/mL observed in humans. The developed population pharmacokinetic model can be utilized to characterize the impact of EHC on plasma drug exposure in animals and humans.
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Affiliation(s)
- Tae Hwan Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Korea
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Lu YY, Wang X, Wang XW, Liu JY, Li P, Ren H, Lou YQ, Lu C, Zhang GL. Development and validation of a high performance liquid chromatography method for determination of 6-benzyl-1-benzyloxymethyl-5-iodouracil (W-1), a novel non-nucleoside reverse transcriptase inhibitor and its application to a pharmacokinetic study in rats. Biomed Chromatogr 2015; 29:1548-52. [DOI: 10.1002/bmc.3457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 01/21/2015] [Accepted: 02/15/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Ying-Yuan Lu
- Department of Pharmacology, Basic Medical School; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Xin Wang
- Department of Pharmacology, Basic Medical School; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Xiao-Wei Wang
- Department of Chemical Biology, School of Pharmaceutical Sciences; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Jun-Yi Liu
- Department of Chemical Biology, School of Pharmaceutical Sciences; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Pu Li
- Department of Pharmacology, Basic Medical School; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Hong Ren
- Department of Pharmacology, Basic Medical School; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Ya-Qing Lou
- Department of Pharmacology, Basic Medical School; Beijing (Peking) University; Beijing 100191 People's Republic of China
| | - Chuang Lu
- Millennium Pharmaceuticals-Takeda; Cambridge Massachusetts USA
| | - Guo-Liang Zhang
- Department of Pharmacology, Basic Medical School; Beijing (Peking) University; Beijing 100191 People's Republic of China
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Jeong ES, Kim YW, Kim HJ, Shin HJ, Shin JG, Kim KH, Chi YH, Paik SH, Kim DH. Glucuronidation of fimasartan, a new angiotensin receptor antagonist, is mainly mediated by UGT1A3. Xenobiotica 2014; 45:10-8. [DOI: 10.3109/00498254.2014.942810] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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