INFLUENCE OF ERYTHROMYCIN ON THE PHARMACOKINETICS OF XIMELAGATRAN MAY INVOLVE INHIBITION OF P-GLYCOPROTEIN-MEDIATED EXCRETION
A pharmacokinetic interaction between erythromycin and ximelagatran, an oral direct thrombin inhibitor, was demonstrated in this study in healthy volunteers. To investigate possible interaction mechanisms, the effects of erythromycin on active transport mediated by P-glycoprotein (P-gp) in vitro in...
Saved in:
Published in | Drug metabolism and disposition Vol. 34; no. 5; pp. 775 - 782 |
---|---|
Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Bethesda, MD
American Society for Pharmacology and Experimental Therapeutics
01.05.2006
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | A pharmacokinetic interaction between erythromycin and ximelagatran, an oral direct thrombin inhibitor, was demonstrated in
this study in healthy volunteers. To investigate possible interaction mechanisms, the effects of erythromycin on active transport
mediated by P-glycoprotein (P-gp) in vitro in Caco-2 and P-gp-over-expressing Madin-Darby canine kidney-human multidrug resistance-1
cell preparations and on biliary excretion of melagatran in rats were studied. In healthy volunteers (seven males and nine
females; mean age 24 years) receiving a single dose of ximelagatran 36 mg on day 1, erythromycin 500 mg t.i.d. on days 2 to
5, and a single dose of ximelagatran 36 mg plus erythromycin 500 mg on day 6, the least-squares mean estimates (90% confidence
intervals) for the ratio of ximelagatran with erythromycin to ximelagatran given alone were 1.82 (1.64â2.01) for the area
under the concentration-time curve and 1.74 (1.52â2.00) for the maximum plasma concentration of melagatran, the active form
of ximelagatran. Neither the slope nor the intercept of the melagatran plasma concentration-effect relationship for activated
partial thromboplastin time statistically significantly differed as a function of whether or not erythromycin was administered
with ximelagatran. Ximelagatran was well tolerated regardless of whether it was administered with erythromycin. Erythromycin
inhibited P-gp-mediated transport of both ximelagatran and melagatran in vitro and decreased the biliary excretion of melagatran
in the rat. These results indicate that the mechanism of the pharmacokinetic interaction between oral ximelagatran and erythromycin
may involve inhibition of transport proteins, possibly P-gp, resulting in decreased melagatran biliary excretion and increased
bioavailability of melagatran. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0090-9556 1521-009X |
DOI: | 10.1124/dmd.105.008607 |