De Mey C, Meineke I, Steinijans V W, Huber R, Hartmann M, Bliesath H, Wurst W
Center for Cardiovascular Pharmacology, Mainz, Germany.
Int J Clin Pharmacol Ther. 1996 May;34(1 Suppl):S58-66.
Substituted benzimidazole inhibitors of the gastric H+/K(+)-ATPase may interact with the cytochrome P450 enzyme system and alter the pharmacokinetics of coadministered drugs, as known for omeprazole. The primary aim of the present studies was to determine whether pantoprazole, a new, selective proton pump inhibitor, modifies the plasma concentrations of orally-administered antipyrine, a commonly used marker for mixed hepatic oxidase enzyme activity. In the acute study, 12 healthy male volunteers were given a) a single 30 mg i.v. doses of pantoprazole, b) a single 5 mg/kg oral dose of antipyrine, or c) coadministered pantoprazole and antipyrine according to a randomized three-period change-over design. In the chronic study, another 12 volunteers received 40 mg once-daily oral doses of pantoprazole on day 3 and on days 5-12, and a single oral 5 mg/kg dose of antipyrine on days 1, 12 and 14. Antipyrine plasma concentrations were measured without pantoprazole (day 1), on the last day of chronic dosing with pantoprazole (day 12) and 48 hours after the last dose of pantoprazole (day 14) to differentiate between inhibition and induction, respectively. Both drugs were well tolerated and no adverse events or clinically relevant alterations in vital signs or laboratory parameters were observed during treatment. The point estimates of the respective AUC-and Cmax-ratios for antipyrine with and without pantoprazole were 0.99 and 0.98 in the acute study, and 1.01 and 0.93 on day 12, and 1.04 and 0.99 on day 14 of the chronic study. The corresponding 90%-confidence intervals were all within the equivalence range of 0.8-1.25 so that lack of interaction either by inhibition or induction can be concluded.
胃H⁺/K⁺-ATP酶的取代苯并咪唑抑制剂可能与细胞色素P450酶系统相互作用,并改变同时服用药物的药代动力学,奥美拉唑就是如此。本研究的主要目的是确定一种新型选择性质子泵抑制剂泮托拉唑是否会改变口服安替比林的血浆浓度,安替比林是混合肝氧化酶活性常用的标志物。在急性研究中,12名健康男性志愿者按照随机三周期交叉设计接受了以下处理:a)单次静脉注射30mg泮托拉唑;b)单次口服5mg/kg安替比林;c)同时给予泮托拉唑和安替比林。在慢性研究中,另外12名志愿者在第3天以及第5至12天每天口服40mg泮托拉唑,并在第1天、第12天和第14天单次口服5mg/kg安替比林。分别在未服用泮托拉唑时(第1天)、泮托拉唑慢性给药的最后一天(第12天)以及最后一剂泮托拉唑给药后48小时(第14天)测量安替比林血浆浓度,以区分抑制和诱导作用。两种药物耐受性良好,治疗期间未观察到不良事件或生命体征及实验室参数的临床相关改变。在急性研究中,服用和未服用泮托拉唑时安替比林各自的AUC和Cmax比值的点估计值分别为0.99和0.98;在慢性研究的第12天分别为1.01和0.93,第14天分别为1.04和0.99。相应的90%置信区间均在0.8至1.25的等效范围内,因此可以得出不存在抑制或诱导相互作用的结论。