Skip to main content
Log in

The Pharmacokinetic and Pharmacodynamic Interactions between the 5-Lipoxygenase Inhibitor Zileuton and the Cyclo-Oxygenase Inhibitor Naproxen in Human Volunteers

  • Published:
Clinical Pharmacokinetics Aims and scope Submit manuscript

Summary

The potential pharmacokinetic and pharmacodynamic interactions between zileuton, a 5-lipoxygenase inhibitor, and naproxen, a nonsteroidal anti-inflammatory drug that acts as a cyclo-oxygenase inhibitor, have been investigated in 24 healthy volunteers. Coadministration of these 2 drugs had no effect upon the plasma concentration-time curves of either zileuton (800mg) or naproxen (500mg) when compared with each drug administered alone. Both naproxen plasma concentrations during the elimination phase and area under the plasma concentration-time curve values were statistically significantly raised upon coadministration with zileuton, when compared with naproxen alone. However, these differences in these 2 values were sufficiently small to be of no clinical significance.

There was no evidence that the combination of zileuton and naproxen had an effect on leukotriene B4 levels that was different from the inhibitory effect of zileuton alone, or had an effect on serum thromboxane B2 levels that was different from the effect of naproxen alone. Moreover, inhibition of the 5-lipoxygenase pathway by zileuton did not appear to aggravate the gastrointestinal adverse events commonly associated with naproxen administration. It is concluded that zileuton and naproxen may be coadministered with minimal risk of a clinically significant interaction.

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.

Similar content being viewed by others

References

  1. Brain SD, Williams TJ. Leukotrienes and inflammation. Pharmacol Ther 1990; 46: 57–66

    Article  PubMed  CAS  Google Scholar 

  2. Rouzer CA, Samuelsson B. On the nature of the 5-lipoxygenase reaction in human leukocytes: enzyme purification and requirement for multiple stimulatory factors. Proc Nat1 Acad Sci USA 1985; 82: 6040–4

    Article  CAS  Google Scholar 

  3. Carter GW, Young PR, Albert DH, et al. 5-lipoxygenase inhibitory activity of zileuton. J Pharmacol Exp Ther 1991; 256: 929–37

    PubMed  CAS  Google Scholar 

  4. Abraham WM, Ahmed A, Cortes A, et al. The 5-lipoxygenase inhibitor zileuton blocks antigen-induced late airway responses, inflammation and airway hyperresponsiveness in allergic sheep. Eur J Pharmacol 1992; 217 (2–3): 119–26

    Article  PubMed  CAS  Google Scholar 

  5. Collawn C, Rubin P, Perez N, et al. Phase II study of the safety and efficacy of a 5-lipoxygenase inhibitor in patients with ulcerative colitis. Am J Gastroenterol 1992; 87: 342–6

    PubMed  CAS  Google Scholar 

  6. Hui KP, Taylor IK, Taylor GW, et al. Effect of a 5-lipoxygenase inhibitor on leukotriene generation and airway responses after allergen challenge in asthmatic patients. Thorax 1991; 46(3): 184–9

    Article  PubMed  CAS  Google Scholar 

  7. Israel E, Dermarkarian R, Rosenberg M, et al. The effects of a 5-lipoxygenase inhibitor on asthma induced by cold, dry air. N Engl J Med 1990; 323: 1740–4

    Article  PubMed  CAS  Google Scholar 

  8. Israel E, Rubin P, Kemp JP, et al. The effect of inhibition of 5-lipoxygenase by zileuton in mild-to-moderate asthma. Ann Intern Med 1993; 119: 1059–66

    PubMed  CAS  Google Scholar 

  9. Laursen L-S, Naesdal J, Bukhare K, et al. Selective 5-lipoxygenase inhibition in ulcerative colitis. Lancet 1990; 335: 683–5

    Article  PubMed  CAS  Google Scholar 

  10. Day RO. Mode of action of non-steroidal anti-inflammatory drugs. Med J Aust 1988; 148: 195–9

    PubMed  CAS  Google Scholar 

  11. Day RO, Graham GG, Williams KM, et al. Clinical pharmacology of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1987; 33: 383–433

    Article  PubMed  CAS  Google Scholar 

  12. Granneman GR, Braeckman RA, Erdman KA. Determination of a new 5-lipoxygenase inhibitor, zileuton, and its inactive N-dehydroxylated metabolite in plasma by high performance liquid chromatography. Clin Pharmacokinet 1995; 29 Suppl. 2: 1–8

    Article  PubMed  CAS  Google Scholar 

  13. Pradelles P, Grassi J, Maclouf J. Enzyme immunoassays of eicosanoids using acetylcholinesterase. In: Colowick SP, Caplan NO, editors. Methods of enzymology. New York: Academic Press 1990; 187:87

    Google Scholar 

  14. Graham GG. Pharmacokinetics and metabolism of non-steroidal anti-inflammatory drugs. Med J Aust 1987; 147: 597–602

    PubMed  CAS  Google Scholar 

  15. Runkel R, Mroszczak E, Chaplin M, et al. Naproxen-probenecid interaction. Clin Pharmacol Ther 1982; 31: 705–12

    Article  Google Scholar 

  16. Lin JH, Cocchetto DM, Duggan DE. Protein binding as a primary determinant of the clinical pharmacokinetic properties of non-steroidal anti-inflammatory drugs. Clin Pharmacokinet 1987; 12: 402–32

    Article  PubMed  CAS  Google Scholar 

  17. Machinist JM, Kukulka MJ, Bopp BA. In vitro plasma protein binding of zileuton and its N-dehydroxylated metabolite. Clin Pharmacokinet 1995; 29 Suppl. 2: 34–41

    Article  PubMed  CAS  Google Scholar 

  18. Awni WM, Braeckman RA, Granneman R, et al. Pharmacokinetic and pharmacodynamic properties of zileuton after oral administration of single and multiple dose regimens of zileuton 600mg in healthy volunteers. Clin Pharmacokinet 1995; 29 Suppl. 2: 22–33

    Article  PubMed  CAS  Google Scholar 

  19. Peskar BM, Kleine A, Pyras FP, et al. Gastrointestinal toxicity. Role of prostaglandins and leukotrienes. Med Toxicol 1986; 1 Suppl. 1: 39–43

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Awni, W.M., Braeckman, R.A., Cavanaugh, J.H. et al. The Pharmacokinetic and Pharmacodynamic Interactions between the 5-Lipoxygenase Inhibitor Zileuton and the Cyclo-Oxygenase Inhibitor Naproxen in Human Volunteers. Clin-Pharmacokinet 29 (Suppl 2), 112–124 (1995). https://doi.org/10.2165/00003088-199500292-00016

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003088-199500292-00016

Keywords

Navigation