Kim Tae Hwan, Thapa Subindra Kazi, Lee Da Young, Chung Seung Eun, Lim Jun Young, Jeong Hyeon Myeong, Song Chang Ho, Choi Youn-Woong, Cho Sang-Min, Nam Kyu-Yeol, Kang Won-Ho, Shin Soyoung, Shin Beom Soo
College of Pharmacy, Catholic University of Daegu, Gyeongsan, Gyeongbuk 38430, Korea.
College of Pharmacy, Wonkwang University, Iksan, Jeonbuk 54538, Korea.
Pharmaceutics. 2018 Sep 6;10(3):152. doi: 10.3390/pharmaceutics10030152.
This study examined the effects of esomeprazole on aceclofenac pharmacokinetics and gastrointestinal complications in rats. Aceclofenac alone, or in combination with esomeprazole, was orally administered to male Sprague-Dawley rats. Plasma concentrations of aceclofenac, its major metabolite diclofenac, and esomeprazole were simultaneously determined by a novel liquid chromatography-tandem mass spectrometry method. Gastrointestinal damage was determined by measuring ulcer area and ulcer lesion index of the stomach. Oral administration of aceclofenac induced significant gastric ulceration, which was inhibited by esomeprazole administration. Following concurrent administration of aceclofenac and esomeprazole, overall pharmacokinetic profiles of aceclofenac and metabolic conversion to diclofenac were unaffected by esomeprazole. Aceclofenac metabolism and pharmacokinetics were not subject to significant food effects, whereas bioavailability of esomeprazole decreased in fed compared to fasting conditions. In contrast, the pharmacokinetics of aceclofenac and esomeprazole were significantly altered by different dosing vehicles. These results suggest that co-administration of esomeprazole with aceclofenac may reduce aceclofenac-induced gastrointestinal complications without significant pharmacokinetic interactions. The optimal combination and clinical significance of the benefits of the combination of aceclofenac and esomeprazole need to be further evaluated.
本研究考察了埃索美拉唑对大鼠醋氯芬酸药代动力学及胃肠道并发症的影响。将醋氯芬酸单独或与埃索美拉唑联合,口服给予雄性斯普拉格 - 道利大鼠。采用一种新型液相色谱 - 串联质谱法同时测定醋氯芬酸、其主要代谢产物双氯芬酸及埃索美拉唑的血浆浓度。通过测量胃的溃疡面积和溃疡病变指数来确定胃肠道损伤情况。口服醋氯芬酸会引起显著的胃溃疡,而给予埃索美拉唑可抑制这种溃疡。醋氯芬酸与埃索美拉唑同时给药后,醋氯芬酸的整体药代动力学特征以及向双氯芬酸的代谢转化不受埃索美拉唑影响。醋氯芬酸的代谢和药代动力学不受食物的显著影响,而与禁食状态相比,进食状态下埃索美拉唑的生物利用度降低。相反,不同的给药载体显著改变了醋氯芬酸和埃索美拉唑的药代动力学。这些结果表明,埃索美拉唑与醋氯芬酸联合给药可减少醋氯芬酸引起的胃肠道并发症,且无显著的药代动力学相互作用。醋氯芬酸与埃索美拉唑联合使用的最佳组合及其益处的临床意义有待进一步评估。