The Roskamp Institute Inc, Sarasota, Florida 34243.
J Pharm Sci. 2013 Oct;102(10):3838-43. doi: 10.1002/jps.23680. Epub 2013 Jul 29.
Venlafaxine, and to a lesser extent desvenlafaxine, has previously been shown to induce the expression of the drug efflux transporters P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) in whole cells and alter the cellular permeability of a known drug efflux probe (rhodamine 123). To validate these in vitro findings, wild-type mice were treated for 4 days with 10 mg/kg venlafaxine or desvenlafaxine, and drug efflux transporter expression was examined in the brain, liver, and intestine. P-gp and BCRP expression was significantly upregulated in the intestine, following a treatment with venlafaxine (2.6- and 6.7-fold, respectively) or desvenlafaxine (2.3- and 4.8-fold, respectively). In addition, venlafaxine increased the BCRP expression in the brain (40%) and liver (60%), whereas desvenlafaxine had no effect on drug efflux transporter levels in these tissues. Using the same treatment paradigm, we observed a minimal impact of either drug on the brain disposition of the known drug efflux probe, topotecan. However, in the periphery, venlafaxine treatment significantly reduced the topotecan oral bioavailability by nearly 40%, whereas the impact of desvenlafaxine on topotecan plasma levels was more modest (23%). These studies demonstrate an effect of venlafaxine on the drug efflux transport activity and the potential for clinical drug-drug interactions.
文拉法辛,在较小程度上还有去甲文拉法辛,先前已被证明能够在全细胞中诱导药物外排转运蛋白 P 糖蛋白(P-gp)和乳腺癌耐药蛋白(BCRP)的表达,并改变已知药物外排探针(罗丹明 123)的细胞通透性。为了验证这些体外发现,用 10mg/kg 的文拉法辛或去甲文拉法辛对野生型小鼠进行 4 天处理,并在大脑、肝脏和肠道中检查药物外排转运蛋白的表达。文拉法辛(分别上调 2.6 倍和 6.7 倍)或去甲文拉法辛(分别上调 2.3 倍和 4.8 倍)处理后,肠道中 P-gp 和 BCRP 的表达显著上调。此外,文拉法辛增加了大脑(40%)和肝脏(60%)中 BCRP 的表达,而去甲文拉法辛对这些组织中的药物外排转运蛋白水平没有影响。使用相同的处理模式,我们观察到两种药物对已知药物外排探针拓扑替康在大脑中的分布影响极小。然而,在外周,文拉法辛处理显著降低了拓扑替康的口服生物利用度近 40%,而去甲文拉法辛对拓扑替康血浆水平的影响则更为温和(23%)。这些研究表明文拉法辛对药物外排转运活性有影响,并可能存在临床药物相互作用。