Identification of the human liver enzymes involved in the metabolism of the antimigraine agent almotriptan.

Article Details

Citation

Salva M, Jansat JM, Martinez-Tobed A, Palacios JM

Identification of the human liver enzymes involved in the metabolism of the antimigraine agent almotriptan.

Drug Metab Dispos. 2003 Apr;31(4):404-11.

PubMed ID
12642466 [ View in PubMed
]
Abstract

Almotriptan is a novel highly selective 5-hydroxytryptamine(1B/1D) agonist developed for the acute oral treatment of migraine. The in vitro metabolism of almotriptan has been investigated using human liver subcellular fractions and cDNA-expressed human enzymes, to study the metabolic pathways and identify the enzymes responsible for the formation of the major metabolites. Specific enzymes were identified by correlation analysis, chemical inhibition studies, and incubation with various cDNA expressed human enzymes. Human liver microsomes and S9 fraction metabolize almotriptan by 2-hydroxylation of the pyrrolidine group to form a carbinolamine metabolite intermediate, a reaction catalyzed by CYP3A4 and CYP2D6. This metabolite is further oxidized by aldehyde dehydrogenase to the open ring gamma-aminobutyric acid metabolite. Almotriptan is also metabolized at the dimethylaminoethyl group by N-demethylation, a reaction that is carried out by five different cytochrome P450s, flavin monooxygenase-3 mediated N-oxidation, and MAO-A catalyzed oxidative deamination to form the indole acetic acid and the indole ethyl alcohol derivatives of almotriptan. The use of human liver mitochondria confirmed the contribution of MAO-A to the metabolism of almotriptan. Both, the gamma-aminobutyric acid and the indole acetic acid metabolites have been found to be the major in vivo metabolites of almotriptan in humans. In addition, different clinical trials conducted to study the effects of CYP3A4, CYP2D6, and MAO-A on the pharmacokinetics of almotriptan confirmed the involvement of these enzymes in the metabolic clearance of this drug and that no dose changes are required in the presence of inhibitors of these enzymes.

DrugBank Data that Cites this Article

Drug Enzymes
DrugEnzymeKindOrganismPharmacological ActionActions
AlmotriptanAmine oxidase [flavin-containing] AProteinHumans
Unknown
Substrate
Details
AlmotriptanCytochrome P450 2C19ProteinHumans
Unknown
Substrate
Details
AlmotriptanCytochrome P450 2C8ProteinHumans
Unknown
Substrate
Details
AlmotriptanCytochrome P450 2D6ProteinHumans
Unknown
Substrate
Details
AlmotriptanCytochrome P450 2E1ProteinHumans
Unknown
Substrate
Details
AlmotriptanCytochrome P450 3A4ProteinHumans
Unknown
Substrate
Details
AlmotriptanDimethylaniline monooxygenase [N-oxide-forming] 3ProteinHumans
Unknown
Substrate
Details