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Effects of verapamil on etoposide pharmacokinetics after intravenous and oral administration in rats

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Summary

Etoposide is mainly metabolized by cytochrome P450 (CYP) 3A and is a substrate for P-glycoprotein (P-gp). This study examined the effects of verapamil, a CYP3A and P-gp inhibitor, on the pharmacokinetics of etoposide in rats. A single dose of etoposide was administered via oral (p.o.; 10 mg/kg) or intravenous (i.v.; 3.3 mg/kg) routes to rats alone (control animals) or together in combination with verapamil (2 or 6 mg/kg; experimental animals). The presence of verapamil significantly increased the area under the plasma concentration-time curve (AUC); (P<0.05; 39.2–47.6%) and significantly reduced (P<0.01; 27.8–31.2%) the total body clearance (CLt) of p.o. administered etoposide. The absolute bioavailability (F) of etoposide increased by 1.38- to 1.47-fold. The presence of verapamil significantly increased (P<0.01; 38.3–38.9%) the AUC and significantly reduced (P<0.01; approximately 27%) the total body clearance (CLt) of i.v. administered etoposide. This increased bioavailability suggests that verapamil inhibits metabolic activity and elimination etoposide. The increased bioavailability of etoposide in the presence of verapamil should be taken into consideration for dosage regimens due to a potential drug interaction (DI).

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References

  1. Higgins C.F. (1992): ABC transporters: from microorganisms to man. Annu. Rev. Cell Biol., 8, 67–113.

    Article  CAS  PubMed  Google Scholar 

  2. Borst P., Evers R., Kool M., Wijnholds J. (2000): A family of drug transporters: the multidrug resistance-associated proteins. J. Natl. Cancer Inst., 92, 1295–1302.

    Article  CAS  PubMed  Google Scholar 

  3. Chan L.M., Lowes S., Hirst B.H. (2004): The ABCs of drug transport in intestine and liver: efflux proteins limiting drug absorption and bioavailability. Eur. J. Pharm. Sci., 21, 25–51.

    Article  CAS  PubMed  Google Scholar 

  4. Sutherland L., Ebner T., Burchell B. (1993): The expression of UDP-glucuronosyltransferases of the UGT1 family in human liver and kidney and in response to drugs. Biochem. Pharmacol., 45, 295–301.

    Article  CAS  PubMed  Google Scholar 

  5. Turgeon D., Carrier J.S., Levesque E., Hum D.W., Belanger A. (2001): Relative enzymatic activity, protein stability, and tissue distribution of human steroid-metabolizing UGT2B subfamily members. Endocrinology, 142, 778–787.

    Article  CAS  PubMed  Google Scholar 

  6. Clark P.I., Slevin M.L. (1987): The clinical pharmacology of etoposide and teniposide. Clin. Pharmacokinet., 12, 223–252.

    Article  CAS  PubMed  Google Scholar 

  7. Relling M.V., Nemec J., Schuetz E.G., Schuetz J.D., Gonzalez F. J., Korzekwa K.R. (1994): O-demethylation of epipodo-phyl-lotoxins is catalyzed by human cytochrome P450 3A4. Mol. Pharmacol., 45, 352–358.

    CAS  PubMed  Google Scholar 

  8. van Maanen J.M., de Vries J., Pappie D., van den Akker E., Lafleur V.M., Retel J., van der Greef J., Pinedo H.M. (1987): Cytochrome P-450-mediatedO-demethylation: a route in the metabolic activation of etoposide (VP-16-213). Cancer Res., 47, 4658–4662.

    PubMed  Google Scholar 

  9. Kawashiro T., Yamashita K., Zhao X.J., Koyama E., Tani M., Chiba K., Ishizaki T. (1998): A study on the metabolism of etoposide and possible interactions with antitumor or sup-porting agents by human liver microsomes. J. Pharmacol. Exp. Ther., 286, 1294–1300.

    CAS  PubMed  Google Scholar 

  10. Leu B.L., Huang J.D. (1995): Inhibition of intestinal P-glyco-protein and effects on etoposide absorption. Cancer Chemother. Pharmacol., 35: 432–436.

    Article  CAS  PubMed  Google Scholar 

  11. Kan W.M., Liu Y.T., Hsiao C.L., Shieh C.Y., Kuo J.H., Huang J.D., Su S.F. (2001): Effect of hydroxyzine on the transport of etoposide in rat small intestine. Anticancer Drugs, 12, 267–273.

    Article  CAS  PubMed  Google Scholar 

  12. Gottesman M.M., Mickisch G.H., Pastan I. (1994): In vivo models of P-glycoprotein-mediated multidrug resistance. Cancer Treat. Res., 73, 107–128.

    CAS  PubMed  Google Scholar 

  13. Lin J.H., Yamazaki M. (2003): Role of P-glycoprotein in pharmacokinetics: clinical implications. Clin. Pharmacol., 42, 59–98.

    Article  CAS  Google Scholar 

  14. Bjornsson T.D., Callaghan J.T., Einolf H.J., Fischer V., Gan L., Grimm S., Kao J., King S.P., Miwa G., Ni L., Kumar G., McLeod J., Obach S.R., Roberts S., Roe A., Shah A., Snikeris F., Sullivan J.T., Tweekie D., Vega J.M., Walsh J., Wrighton S.A. (2003): The conduct of in vitro and in vivo drug-drug interaction studies: a PhRMA perspective. J. Clin. Pharmacol., 43, 443–469.

    CAS  PubMed  Google Scholar 

  15. Li X., Yun J.K., Choi J.S. (2007): Effects of morin on the pharmacokinetics of etoposide in rats. Biopharm. Drug Dispos., 28, 151–156.

    Article  PubMed  Google Scholar 

  16. Kovarik J.M., Beyer D., Bizot M.N., Jiang Q., Allison M.J., Schmouder R.L. (2005): Pharmacokinetic interaction between verapamil and everolimus in healthy subjects. Br. J. Clin. Pharmacol., 60, 434–437.

    Article  CAS  PubMed  Google Scholar 

  17. Carcel-Trullols J., Torres-Molina F., Araico A., Saadeddin A., Peris J.E. (2004): Effect of cyclosporine A on the tissue distribution and pharmacokinetics of etoposide. Cancer Chemother. Pharmacol., 54, 153–160.

    Article  CAS  PubMed  Google Scholar 

  18. Spahn-Langguth H., Baktir G., Radschuweit A., Okyar A., Terhaag B., Ader P., Hanafy A., Langguth P. (1998): P-glyco-protein transporters and the gastrointestinal tract: evaluation of the potential in vivo relevance of in vitro data employing talinolol as model compound. Int. J. Clin. Pharmacol. Then, 36, 16–24.

    CAS  Google Scholar 

  19. Hollt V., Kouba M., Dietel M., Vogt G. (1992): Stereoisomers of calcium antagonists which differ markedly in their potencies as calcium blockers are equally effective in modulating drug transport by P-glycoprotein. Biochem. Pharmacol., 43, 2601–2608.

    Article  CAS  PubMed  Google Scholar 

  20. Vogelgesang B., Echizen H., Schmidt E., Eichelbaum M. (1984): Stereoselective first-pass metabolism of highly cleared drugs studies of the bioavailability of L- and D-verapamil examined with a stable isotope technique. Br. J. Clin. Pharmacol., 18, 733–740.

    CAS  PubMed  Google Scholar 

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Piao, YJ., Li, X. & Choi, JS. Effects of verapamil on etoposide pharmacokinetics after intravenous and oral administration in rats. Eur. J. Drug Metabol. Pharmacokinet. 33, 159–164 (2008). https://doi.org/10.1007/BF03191113

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