Eletriptan metabolism by human hepatic CYP450 enzymes and transport by human P-glycoprotein.

Article Details

Citation

Evans DC, O'Connor D, Lake BG, Evers R, Allen C, Hargreaves R

Eletriptan metabolism by human hepatic CYP450 enzymes and transport by human P-glycoprotein.

Drug Metab Dispos. 2003 Jul;31(7):861-9.

PubMed ID
12814962 [ View in PubMed
]
Abstract

"Reaction phenotyping" studies were performed with eletriptan (ETT) to determine its propensity to interact with coadministered medications. Its ability to serve as a substrate for human P-glycoprotein (P-gp) was also investigated since a central mechanism of action has been proposed for this "triptan" class of drug. In studies with a characterized bank of human liver microsome preparations, a good correlation (r2 = 0.932) was obtained between formation of N-desmethyl eletriptan (DETT) and CYP3A4-catalyzed testosterone 6 beta-hydroxylation. DETT was selected to be monitored in our studies since it represents a significant ETT metabolite in humans, circulating at concentrations 10 to 20% of those observed for parent drug. ETT was metabolized to DETT by recombinant CYP2D6 (rCYP2D6) and rCYP3A4, and to a lesser extent by rCYP2C9 and rCYP2C19. The metabolism of ETT to DETT in human liver microsomes was markedly inhibited by troleandomycin, erythromycin, miconazole, and an inhibitory antibody to CYP3A4, but not by inhibitors of other major P450 enzymes. ETT had little inhibitory effect on any of the P450 enzymes investigated. ETT was determined to be a good substrate for human P-gp in vitro. In bidirectional transport studies across LLC-MDR1 and LLC-Mdr1a cell monolayers, ETT had a BA/AB transport ratio in the range 9 to 11. This finding had significance in vivo since brain exposure to ETT was reduced 40-fold in Mdr1a+/+ relative to Mdr1a-/- mice. ETT metabolism to DETT is therefore catalyzed primarily by CYP3A4, and plasma concentrations are expected to be increased when coadministered with inhibitors of CYP3A4 and P-gp activity.

DrugBank Data that Cites this Article

Drug Enzymes
DrugEnzymeKindOrganismPharmacological ActionActions
EletriptanCytochrome P450 2D6ProteinHumans
Unknown
Substrate
Details
EletriptanCytochrome P450 3A4ProteinHumans
Unknown
Substrate
Details
Drug Transporters
DrugTransporterKindOrganismPharmacological ActionActions
EletriptanP-glycoprotein 1ProteinHumans
Unknown
Substrate
Details
Drug Interactions
DrugsInteraction
Eletriptan
Nelfinavir
The metabolism of Eletriptan can be decreased when combined with Nelfinavir.
Eletriptan
Ritonavir
The metabolism of Eletriptan can be decreased when combined with Ritonavir.
Eletriptan
Ketoconazole
The metabolism of Eletriptan can be decreased when combined with Ketoconazole.
Eletriptan
Nefazodone
The metabolism of Eletriptan can be decreased when combined with Nefazodone.
Eletriptan
Itraconazole
The metabolism of Eletriptan can be decreased when combined with Itraconazole.