Choi Young H, Lee Myung G
College of Pharmacy, Dongguk University-Seoul, Seoul, South Korea.
Xenobiotica. 2012 May;42(5):483-95. doi: 10.3109/00498254.2011.633177. Epub 2012 Mar 14.
It has been reported that hypertension exponentially increases in the patients with type 2 diabetes mellitus. Thus, this study was performed to investigate the pharmacokinetic and pharmacodynamic interactions between nifedipine and metformin, since both drugs were commonly metabolized via hepatic CYP2C and 3A subfamilies in rats. Nifedipine (3 mg/kg) and metformin (100 mg/kg) were simultaneously administered intravenously or orally to rats. Concentrations (I) of each drug in the liver and intestine, maximum velocity (V(max)), Michaelis-Menten constant (K(m)), and intrinsic clearance (CL(int)) for the disappearance of each drug, apparent inhibition constant (K(i)) and [I]/K(i) ratios of each drug in liver and intestine were determined. Also the metabolism of each drug in rat and human CYPs and blood pressure were also measured. After the simultaneous single intravenous administration of both drugs together, the AUCs of each drug were significantly greater than that in each drug alone due to the competitive inhibition for the metabolism of nifedipine by metformin via hepatic CYP3A1/2 and of metformin by nifedipine via hepatic CYP2C6 and 3A1/2. After the simultaneous single oral administration of both drugs, the significantly greater AUCs of each drug than that in each drug alone could have mainly been due to the competitive inhibition for the metabolism of nifedipine and metformin by each other via intestinal CYP3A1/2 in addition to competitive inhibition for the hepatic metabolism of each drug as same as the intravenous study.
据报道,2型糖尿病患者的高血压呈指数级增长。因此,本研究旨在探讨硝苯地平和二甲双胍之间的药代动力学和药效学相互作用,因为这两种药物在大鼠体内通常通过肝脏CYP2C和3A亚家族代谢。将硝苯地平(3mg/kg)和二甲双胍(100mg/kg)同时静脉注射或口服给予大鼠。测定肝脏和肠道中每种药物的浓度(I)、每种药物消除的最大速度(V(max))、米氏常数(K(m))和内在清除率(CL(int))、每种药物在肝脏和肠道中的表观抑制常数(K(i))和[I]/K(i)比值。同时还测定了每种药物在大鼠和人细胞色素P450中的代谢情况以及血压。两种药物同时单次静脉注射后,由于二甲双胍通过肝脏CYP3A1/2对硝苯地平代谢的竞争性抑制以及硝苯地平通过肝脏CYP2C6和3A1/2对二甲双胍代谢的竞争性抑制,每种药物的AUC均显著高于单独使用每种药物时的AUC。两种药物同时单次口服给药后,每种药物的AUC显著高于单独使用每种药物时的AUC,这主要可能是由于除了与静脉注射研究一样对每种药物肝脏代谢的竞争性抑制外,还存在硝苯地平和二甲双胍通过肠道CYP3A1/2相互对代谢的竞争性抑制。