Skip to main content

Advertisement

Log in

Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers

  • Pharmacokinetics and Disposition
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

We examined the effect of a single apple juice intake on the pharmacokinetics of fexofenadine enantiomers in healthy Japanese subjects.

Methods

In a randomized two phase, open-label crossover study, 14 subjects received 60 mg of racemic fexofenadine simultaneously with water or apple juice. For the uptake studies, oocytes expressing organic anion-transporting polypeptide 2B1 (OATP2B1) were incubated with 100 μM (R)- and (S)-fexofenadine in the presence or absence of 10 % apple juice.

Results

One-time ingestion of apple juice significantly decreased the area under the plasma concentration–time curve (AUC0–24) for (R)- and (S)-fexofenadine by 49 and 59 %, respectively, and prolonged the time to reach the maximum plasma concentration (t max) of both enantiomers (P < 0.001). Although apple juice greatly reduced the amount of (R)- and (S)-fexofenadine excretion into urine (Ae0–24) by 54 and 58 %, respectively, the renal clearances of both enantiomers were unchanged between the control and apple juice phases. For in vitro uptake studies, the uptake of both fexofenadine enantiomers into OATP2B1 complementary RNA (cRNA)-injected oocytes was significantly higher than that into water-injected oocytes, and this effect was greater for (R)-fexofenadine. In addition, apple juice significantly decreased the uptake of both enantiomers into OATP2B1 cRNA-injected oocytes.

Conclusions

These results suggest that OATP2B1 plays an important role in the stereoselective pharmacokinetics of fexofenadine and that one-time apple juice ingestion probably inhibits intestinal OATP2B1-mediated transport of both enantiomers. In addition, this study demonstrates that the OATP2B1 inhibition effect does not require repeated ingestion or a large volume of apple juice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Giacomini KM, Huang SM, Tweedie DJ et al (2010) Membrane transporters in drug development. Nat Rev Drug Discov 9:215–236

    Article  CAS  PubMed  Google Scholar 

  2. Kalliokoski A, Niemi M (2009) Impact of OATP transporters on pharmacokinetics. Br J Pharmacol 158:693–705

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Xiong H, Carr RA, Locke CS, Katz DA, Achari R, Doan TT, Wang P, Jankowski JR, Sleep DJ (2007) Dual effects of rifampin on the pharmacokinetics of atrasentan. J Clin Pharmacol 47:423–429

    Article  CAS  PubMed  Google Scholar 

  4. van Giersbergen PL, Treiber A, Schneiter R, Dietrich H, Dingemanse J (2007) Inhibitory and inductive effects of rifampin on the pharmacokinetics of bosentan in healthy subjects. Clin Pharmacol Ther 81:414–419

    Article  PubMed  Google Scholar 

  5. Zheng HX, Huang Y, Frassetto LA, Benet LZ (2009) Elucidating rifampin’s inducing and inhibiting effects on glyburide pharmacokinetics and blood glucose in healthy volunteers: unmasking the differential effects of enzyme induction and transporter inhibition for a drug and its primary metabolite. Clin Pharmacol Ther 85:78–85

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Bidstrup TB, Stilling N, Damkier P, Scharling B, Thomsen MS, Brosen K (2004) Rifampicin seems to act as both an inducer and an inhibitor of the metabolism of repaglinide. Eur J Clin Pharmacol 60:109–114

    Article  CAS  PubMed  Google Scholar 

  7. Shitara Y (2011) Clinical importance of OATP1B1 and OATP1B3 in drug-drug interactions. Drug Metab Pharmacokinet 26:220–227

    Article  CAS  PubMed  Google Scholar 

  8. Kusuhara H, Miura M, Yasui-Furukori N, Yoshida K, Akamine Y, Yokochi M, Fukizawa S, Ikejiri K, Kanamitsu K, Uno T, Sugiyama Y (2013) Effect of coadministration of single and multiple doses of rifampicin on the pharmacokinetics of fexofenadine enantiomers in healthy subjects. Drug Metab Dispos 41:206–213

    Article  CAS  PubMed  Google Scholar 

  9. Bailey DG (2010) Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 70:645–655

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Tapaninen T, Neuvonen PJ, Niemi M (2011) Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 71:718–726

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Neuhofel AL, Wilton JH, Victory JM, Hejmanowsk LG, Amsden GW (2002) Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol 42:461–466

    Article  CAS  PubMed  Google Scholar 

  12. Lilja JJ, Backman JT, Laitila J, Luurila H, Neuvonen PJ (2003) Itraconazole increases but grapefruit juice greatly decreases plasma concentrations of celiprolol. Clin Pharmacol Ther 73:192–198

    Article  CAS  PubMed  Google Scholar 

  13. Lilja JJ, Juntti-Patinen L, Neuvonen PJ (2004) Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 75:184–190

    Article  CAS  PubMed  Google Scholar 

  14. Lilja JJ, Raaska K, Neuvonen PJ (2005) Effects of orange juice on the pharmacokinetics of atenolol. Eur J Clin Pharmacol 61:337–340

    Article  CAS  PubMed  Google Scholar 

  15. Schwarz UI, Seemann D, Oertel R, Miehlke S, Kuhlisch E, Fromm MF, Kim RB, Bailey DG, Kirch W (2005) Grapefruit juice ingestion significantly reduces talinolol bioavailability. Clin Pharmacol Ther 77:291–301

    Article  CAS  PubMed  Google Scholar 

  16. Dresser GK, Bailey DG, Leake BF, Schwarz UI, Dawson PA, Freeman DJ, Kim RB (2002) Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther 71:11–20

    Article  CAS  PubMed  Google Scholar 

  17. Satoh H, Yamashita F, Tsujimoto M, Murakami H, Koyabu N, Ohtani H, Sawada Y (2005) Citrus juices inhibit the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 33:518–523

    Article  CAS  PubMed  Google Scholar 

  18. Rodriguez-Fragoso L, Martinez-Arismendi JL, Orozco-Bustos D, Reyes-Esparza J, Torres E, Burchiel SW (2011) Potential risks resulting from fruit/vegetable-drug interactions: effects on drug-metabolizing enzymes and drug transporters. J Food Sci 76:R112–R124

    Article  CAS  PubMed  Google Scholar 

  19. Bailey DG, Dresser GK, Leake BF, Kim RB (2007) Naringin is a major and selective clinicalinhibitor of organic anion-transporting polypeptide 1A2 (OATP1A2) in grapefruitjuice. Clin Pharmacol Ther 81:495–502

    Article  CAS  PubMed  Google Scholar 

  20. Imanaga J, Kotegawa T, Imai H, Tsutsumi K, Yoshizato T, Ohyama T, Shirasaka Y, Tamai I, Tateishi T, Ohashi K (2011) The effects of the SLCO2B1 c.1457C > T polymorphism and apple juice on the pharmacokinetics of fexofenadine and midazolam in humans. Pharmacogenet Genomics 21:84–93

    Article  CAS  PubMed  Google Scholar 

  21. Shirasaka Y, Shichiri M, Mori T, Nakanishi T, Tamai I (2013) Major active components in grapefruit, orange, and apple juices responsible for OATP2B1-mediated drug interactions. J Pharm Sci 102:280–288

    Article  CAS  PubMed  Google Scholar 

  22. Shirasaka Y, Shichiri M, Murata Y, Mori T, Nakanishi T, Tamai I (2013) Long-lasting inhibitory effect of apple and orange juices, but not grapefruit juice, on OATP2B1-mediated drug absorption. Drug Metab Dispos 41:615–621

    Article  CAS  PubMed  Google Scholar 

  23. Robbins DK, Castles MA, Pack DJ, Bhargava VO, Weir SJ (1998) Dose proportionality and comparison of single and multiple dose pharmacokinetics of fexofenadine (MDL 16455) and its enantiomers in healthy male volunteers. Biopharm Drug Dispos 19:455–463

    Article  CAS  PubMed  Google Scholar 

  24. Tateishi T, Miura M, Suzuki T, Uno T (2008) The different effects of itraconazole on the pharmacokinetics of fexofenadine enantiomers. Br J Clin Pharmacol 65:693–700

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Sakugawa T, Miura M, Hokama N, Suzuki T, Tateishi T, Uno T (2009) Enantioselective disposition of fexofenadine with the P-glycoprotein inhibitor verapamil. Br J Clin Pharmacol 67:535–540

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Akamine Y, Miura M, Yasui-Furukori N, Kojima M, Uno T (2012) Carbamazepine differentially affects the pharmacokinetics of fexofenadine enantiomers. Br J Clin Pharmacol 73:478–481

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Cvetkovic M, Leake B, Fromm MF, Wilkinson GR, Kim RB (1999) OATP and P-glycoprotein transporters mediate the cellular uptake and excretion of fexofenadine. Drug Metab Dispos 27:866–871

    CAS  PubMed  Google Scholar 

  28. Matsushima S, Maeda K, Inoue K, Ohta KY, Yuasa H, Kondo T, Nakayama H, Horita S, Kusuhara H, Sugiyama Y (2009) The inhibition of human multidrug and toxin extrusion 1 is involved in the drug-drug interaction caused by cimetidine. Drug Metab Dispos 37:555–559

    Article  CAS  PubMed  Google Scholar 

  29. Akamine Y, Miura M, Sunagawa S, Kagaya H, Yasui-Furukori N, Uno T (2010) Influence of drug-transporter polymorphisms on the pharmacokinetics of fexofenadine enantiomers. Xenobiotica 40:782–789

    Article  CAS  PubMed  Google Scholar 

  30. Miura M, Uno T, Tateishi T, Suzuki T (2007) Determination of fexofenadine enantiomers in human plasma with high-performance liquid chromatography. J Pharm Biomed Anal 43:741–745

    Article  CAS  PubMed  Google Scholar 

  31. Shirasaka Y, Li Y, Shibue Y, Kuraoka E, Spahn-Langguth H, Kato Y, Langguth P, Tamai I (2009) Concentration-dependent effect of naringin on intestinal absorption of beta(1)-adrenoceptor antagonist talinolol mediated by p-glycoprotein and organic anion transporting polypeptide (OATP). Pharm Res 26:560–567

    Article  CAS  PubMed  Google Scholar 

  32. Center for Drug Evaluation and Research (2003) Guidance for industry: bioavailability and bioequivalence studies for orally administered drug products: general considerations. U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Rockville, MD

  33. Product information (2003) Allegra®; Sanofi-Aventis K.K., Tokyo, Japan

  34. Glaeser H, Bailey DG, Dresser GK, Gregor JC, Schwarz UI, McGrath JS, Jolicoeur E, Lee W, Leake BF, Tirona RG, Kim RB (2007) Intestinal drug transporter expression and the impact of grapefruit juice in humans. Clin Pharmacol Ther 81:362–370

    Article  CAS  PubMed  Google Scholar 

  35. Rebello S, Zhao S, Hariry S, Dahlke M, Alexander N, Vapurcuyan A, Hanna I, Jarugula V (2012) Intestinal OATP1A2 inhibition as a potential mechanism for the effect of grapefruit juice on aliskiren pharmacokinetics in healthy subjects. Eur J Clin Pharmacol 68:697–708

    Article  CAS  PubMed  Google Scholar 

  36. Pauli-Magnus C, von Richter O, Burk O, Ziegler A, Mettang T, Eichelbaum M, Fromm MF (2000) Characterization of the major metabolites of verapamil as substrates and inhibitors of P-glycoprotein. J Pharmacol Exp Ther 293:376–382

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflicts of interest in relation to this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Masatomo Miura.

Additional information

Tsukasa Uno is a former member of the University of the Ryukyus.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Akamine, Y., Miura, M., Komori, H. et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol 70, 1087–1095 (2014). https://doi.org/10.1007/s00228-014-1705-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-014-1705-y

Keywords

Navigation