To evaluate association of the dose-dependent effect of rifampicin, an OATP1B inhibitor, on the plasma concentration–time profiles among OATP1B substrates drugs and endogenous substrates.
Eight healthy volunteers received atorvastatin (1 mg), pitavastatin (0.2 mg), rosuvastatin (0.5 mg), and fluvastatin (2 mg) alone or with rifampicin (300 or 600 mg) in a crossover fashion. The plasma concentrations of these OATP1B probe drugs, total and direct bilirubin, glycochenodeoxycholate-3-sulfate (GCDCA-S), and coproporphyrin I, were determined.
The most striking effect of 600 mg rifampicin was on atorvastatin (6.0-times increase) and GCDCA-S (10-times increase). The AUC0–24h of atorvastatin was reasonably correlated with that of pitavastatin (r2 = 0.73) and with the AUC0–4h of fluvastatin (r2 = 0.62) and sufficiently with the AUC0–24h of rosuvastatin (r2 = 0.32). The AUC0–24h of GCDCA-S was reasonably correlated with those of direct bilirubin (r2 = 0.74) and coproporphyrin I (r2 = 0.80), and sufficiently with that of total bilirubin (r2 = 0.30). The AUC0–24h of GCDCA-S, direct bilirubin, and coproporphyrin I were reasonably correlated with that of atorvastatin (r2 = 0.54–0.70).
These results suggest that direct bilirubin, GCDCA-S, and coproporphyrin I are promising surrogate probes for the quantitative assessment of potential OATP1B-mediated DDI.
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Area under the plasma concentration–time curve
Breast cancer resistance protein
High performance liquid chromatography
Liquid chromatography–tandem mass spectrometry
Multiple reaction monitoring
Sodium-taurocholate cotransporting polypeptide
Organic anion transporter
Organic anion-transporting polypeptide 1B1
Organic anion-transporting polypeptide 1B3
Organic anion-transporting polypeptide 2B1
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Acknowledgments and Disclosures
The authors thank Miwa Yoshida (P-One Clinic) for her technical support in conducting the clinical research, and Drs. Ragu Ramanathan, Amanda King-Ahmad, and David Rodrigues (Pfizer, Groton, CT) for their kind support in introducing their analytical method for coproporphyrins I and III to this study. This study was financially supported by a Grant-in-Aid for Scientific Research (S) [Grant 24,229,002], and Grant-in-Aid for Scientific Research (B) [17H04100] from Japan Society for the Promotion of Science, and a Grant-in-Aid from the Japan Research Foundation for Clinical Pharmacology.
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Takehara, I., Yoshikado, T., Ishigame, K. et al. Comparative Study of the Dose-Dependence of OATP1B Inhibition by Rifampicin Using Probe Drugs and Endogenous Substrates in Healthy Volunteers. Pharm Res 35, 138 (2018). https://doi.org/10.1007/s11095-018-2416-3
- drug–drug interaction
- endogenous substrates
- hepatobiliary transport
- organic anion transporter
- surrogate probe