The effects of buprenorphine, a powerful mixed agonist/antagonist analgesic, on several cytochrome P450 (CYP) isoform specific reactions in human liver microsomes were investigated to predict drug interaction of buprenorphine in vivo from in vitro data. The following eight CYP-catalytic reactions were used in this study: CYP1A1/2-mediated 7-ethoxyresorufin O-deethylation, CYP2A6-mediated coumarin 7-hydroxylation, CYP2B6-mediated 7-benzyloxyresorufin O-debenzylation, CYP2C8/9-mediated tolbutamide methylhydroxylation, CYP2C19-mediated S-mephenytoin 4-hydroxylation, CYP2D6-mediated bufuralol 1′-hydroxylation, CYP2E1-mediated chlorzoxazone 6-hydroxylation, and CYP3A4-mediated testosterone 6β-hydroxylation. Buprenorphine strongly inhibited the CYP3A4- and CYP2D6-catalyzed reactions with Ki values of 14.7 μM and 21.4 μM, respectively. The analgesic also weakly inhibited specific reactions catalyzed by CYP1A1/2 (Ki=132 μM), CYP2B6 (Ki=133 μM), CYP2C19 (Ki=146 μM), CYP2C8/9 (IC50>300 μM), and CYP2E1 (IC50>300 μM), but not CYP2A6 mediated pathway. In consideration of the Ki values obtained in this study and the therapeutic concentration of buprenorphine in human plasma, buprenorphine would not be predicted to cause clinically significant interactions with other CYP-metabolized drugs.
本研究调查了强效混合激动剂/拮抗剂
镇痛药丁丙诺啡在人肝微粒体中对几种细胞色素P450(CYP)同工酶特异性反应的影响,旨在从体外数据预测丁丙诺啡在体内的药物相互作用。本研究使用了以下八种CYP催化反应:CYP1A1/2介导的7-乙氧基
罗丹明O-脱乙基化、CYP2A6介导的
香豆素7-羟化、CYP2B6介导的7-苄氧基
罗丹明O-脱苄基化、CYP2C8/9介导的
甲苯磺丁
脲甲基羟化、CYP2C19介导的S-
美芬妥英4-羟化、CYP2D6介导的
布非洛尔1′-羟化、CYP2E1介导的
氯唑沙宗6-羟化和CYP3A4介导的
睾酮6β-羟化。丁丙诺啡对CYP3A4和CYP2D6催化反应显示出强烈抑制作用,Ki值分别为14.7 μM和21.4 μM。该
镇痛药还对CYP1A1/2(Ki=132 μM)、CYP2B6(Ki=133 μM)、CYP2C19(Ki=146 μM)、CYP2C8/9(IC50>300 μM)和CYP2E1(IC50>300 μM)介导的特异性反应表现出弱抑制作用,但不包括CYP2A6介导的通路。综合本研究获得的Ki值和丁丙诺啡在人血浆中的治疗浓度,预计丁丙诺啡不会引起与其他CYP代谢药物临床意义上的显著相互作用。