The AAPS Journal

, Volume 16, Issue 2, pp 206–213

Genetic Polymorphisms of Metabolic Enzymes and the Pharmacokinetics of Indapamide in Taiwanese Subjects


  • Teng-Hsu Wang
    • School of PharmacyNational Defense Medical Center
  • Cheng-Huei Hsiong
    • School of PharmacyNational Defense Medical Center
  • Hsin-Tien Ho
    • Graduate Institute of Life Sciences, National Defense Medical Center
  • Tung-Yuan Shih
    • School of PharmacyNational Defense Medical Center
  • San-Jan Yen
    • School of PharmacyNational Defense Medical Center
  • Hui-Hung Wang
    • Institute of Biomedical SciencesAcademia Sinica
  • Jer-Yuarn Wu
    • Institute of Biomedical SciencesAcademia Sinica
    • Department of Medical ResearchChina Medical College Hospital
  • Benjamin Pei-Chung Kuo
    • Mithra Bioindustry Co., LTD
  • Yuan-Tsong Chen
    • Institute of Biomedical SciencesAcademia Sinica
    • Department of PediatricsDuke University Medical Center
  • Shung-Tai Ho
    • Department of AnesthesiologyTaipei Veterans General Hospital
    • School of PharmacyNational Defense Medical Center
Research Article

DOI: 10.1208/s12248-013-9535-x

Cite this article as:
Wang, T., Hsiong, C., Ho, H. et al. AAPS J (2014) 16: 206. doi:10.1208/s12248-013-9535-x


To understand the genetic makeup and impact on pharmacokinetics (PK) in the Taiwanese population, we analyzed the pharmacogenetic (PG) profile and demonstrated its effects on enzyme metabolism using indapamide as an example. A multiplex mass spectrometry method was used to examine the single nucleotide polymorphism (SNP) profile of eight major phases I and II metabolic enzymes in 1,038 Taiwanese subjects. A PG/PK study was conducted in 24 healthy subjects to investigate the possible effects of 28 SNPs on drug biotransformation. Among the genetic profile analyzed, eight SNPs from CYP2A6, CYP2C19, CYP2D6, CYP2E1, CYP3A5, and UGT2B7 showed higher variant frequencies than those previously reported in Caucasians or Africans. For instance, we observed 14.7% frequency of the SNP rs5031016 (I471T) from CYP2A6 in Taiwanese, whereas 0% variation was reported in Caucasians and Africans. The PG/PK study of indapamide demonstrated that the polymorphic SNPs CYP2C9 rs4918758 and CYP2C19 rs4244285 appeared to confer lowered enzyme activity, as indicated by increased Cmax (25% ∼ 64%), increased area under the plasma level-time curves (30∼76%), increased area under the time infinity (43% ∼ 80%), and lower apparent clearance values than PK for wild-type indapamide. Our results reinforce the biochemical support of CYP2C19 in indapamide metabolism and identify a possible new participating enzyme CYP2C9. The PG/PK approach contributed toward understanding the genetic makeup of different ethnic groups and associations of enzymes in drug metabolism. It could be used to identify two genetic markers that enable to differentiate subjects with varied PK outcomes of indapamide.


indapamidemetabolic enzymespharmacogeneticspharmacokineticsSNPs

Copyright information

© American Association of Pharmaceutical Scientists 2013