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Effects of the CYP2D6*10 allele on the pharmacokinetics of atomoxetine and its metabolites

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Abstract

To investigate the effect of the variant CYP2D6*10 allele on the pharmacokinetics of atomoxetine and its metabolites, 4-hydroxyatomoxetine (4-HAT) and N-desmethylatomoxetine (NAT), in healthy subjects, a single oral dose of atomoxetine was administered to 62 subjects with a CYP2D6*wt/*wt (*wt = *1 or *2, n = 22), CYP2D6*wt/*10 (n = 22) or CYP2D6*10/*10 (n = 18) genotype. Plasma samples were then collected for 24 h after atomoxetine administration. The concentrations of atomoxetine and its metabolites were assayed using LC–MS/MS. For atomoxetine, the Cmax, AUC0–∞, t1/2 and CL/F showed genotype-dependent differences. The CYP2D6*10/*10 and CYP2D6*wt/*10 groups showed 1.74- and 1.15-fold higher Cmax, 3.40- and 1.33-fold higher AUC0–∞, and 69.7 and 24.6 % lower CL/F, compared to those of the CYP2D6*wt/*wt group, respectively. The Cmax and t1/2 for 4-HAT were lower and longer in the CYP2D6*10/*10 group than those in the CYP2D6*wt/*wt group, but the AUC0–∞ was not different between these groups. The Cmax, AUC0–∞ and t1/2 for NAT were profoundly greater in the CYP2D6*10/*10 group than they were in the CYP2D6*wt/*wt group. The concentration of active moieties of atomoxetine (atomoxetine + 4-HAT) in the CYP2D6*10/*10 group was 3.32-fold higher than that in the CYP2D6*wt/*wt group. The mean exposure to active moieties of atomoxetine was markedly higher in subjects with the CYP2D6*10/*10 genotype compared to that in those with the CYP2D6*wt/*wt genotype. The higher systemic exposure of the active atomoxetine moieties in CYP2D6*10/*10 individuals may increase the risk of concentration-related adverse events of atomoxetine, although this has not yet been clinically confirmed.

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    Authors and Affiliations

    1. School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea

      Ji-Yeong Byeon, Young-Hoon Kim, Yun-Jeong Lee, In Su Kim, Choon-Gon Jang & Seok-Yong Lee

    2. National Institute of Food and Drug Safety Evaluation, MFDS, Cheongwon-Gun, 363–951, Republic of Korea

      Han-Sung Na, Se-Hyung Kim & Myeon-Woo Chung

    3. Department of Dental Hygiene, Hanseo University, Seosan, 356-706, Republic of Korea

      Jong-Hwa Jang

    4. College of Pharmacy, Dankook University, Cheonan, 330-714, Republic of Korea

      Yun-Jeong Lee

    5. College of Pharmacy, Keimyung University, Daegu, 704-701, Republic of Korea

      Jung-Woo Bae

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    1. Ji-Yeong Byeon
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    Ji-Yeong Byeon, Young-Hoon Kim, Han-Sung Na and Jong-Hwa Jang have contributed equally to this study.

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    Byeon, JY., Kim, YH., Na, HS. et al. Effects of the CYP2D6*10 allele on the pharmacokinetics of atomoxetine and its metabolites. Arch. Pharm. Res. 38, 2083–2091 (2015). https://doi.org/10.1007/s12272-015-0646-z

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    • DOI: https://doi.org/10.1007/s12272-015-0646-z

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