Cholesterol alters the binding of Ca2+ channel blockers to the membrane lipid bilayer.

X-ray diffraction and equilibrium binding techniques were used to study the effect of cholesterol on membrane binding of the charged 1,4-dihydropyridine (DHP) Ca2+ channel antagonist amlodipine and uncharged isradipine, nimodipine, and nitrendipine. Increases in membrane cholesterol content resulted in a marked decrease in DHP binding to cardiac phospholipid membranes, as expressed by the equilibrium partition coefficient (Kp[mem]). Between a 0:1 and 0.3:1 cholesterol to phospholipid mole ratio, the Kp(mem) values for isradipine, nimodipine, and nitrendipine decreased by greater than 50%, whereas that for amlodipine decreased by only 10%. Electron density profiles calculated from the X-ray diffraction data showed that the time-averaged locations for the DHPs and cholesterol in the membrane overlap, leading to the conclusion that the addition of cholesterol alters the lipid bilayer hydrocarbon core structure in a manner that makes drug partitioning into the membrane less energetically favorable. These data support the idea that drug interactions with the anisotropic membrane environment are complex and may be greatly influenced by cholesterol composition. This effect of cholesterol was also observed for phenylalkylamine (verapamil) and benzothiazepine (diltiazem) Ca2+ channel blockers. The DHP amlodipine had the highest membrane partition coefficient (Kp[mem] greater than 10(4) and the slowest rate of dissociation and was affected least by membrane cholesterol content. The combination of electrostatic and hydrophobic bonding between amlodipine and membrane phospholipid may explain the high affinity of this drug for the membrane bilayer with normal and elevated cholesterol. The results of this study show that cholesterol content differentially affects the membrane-binding properties of the charged DHP amlodipine, compared with other Ca2+ channel blockers. These data help explain the biological distribution of these drugs and the distinct pharmacokinetics of amlodipine versus other Ca2+ channel blockers.