代谢
纳美芬在肝脏中被广泛代谢,主要通过由UGT2B7和UGT1A3以及UGT1A8介导的葡萄糖醛酸苷结合反应,主要代谢物是药理学上不活跃的纳美芬3-O-葡萄糖醛酸苷。纳美芬还会代谢成微量的N-脱烷基代谢物,这种代谢物的药理活性很小。纳美芬可以通过CYP3A4/5介导的脱烷基反应形成纳洛美芬。纳洛美芬可以进一步转化为纳洛美芬3-O-葡萄糖醛酸苷和纳洛美芬3-硫酸盐,这些通常是不活跃的代谢物。纳美芬也可以通过CYP3A4/5介导的硫酸化反应形成纳美芬3-O-硫酸盐,这种代谢物保留了一些药理活性。然而,纳美芬3-O-硫酸盐在血液中的浓度不到纳美芬的10%;因此,它不太可能是纳美芬药理活性的主要贡献者。一些受试者的血浆浓度-时间曲线表明,纳美芬可能经历肠肝循环。
Nalmefene is extensively metabolized by the liver, primarily by glucuronide conjugation mainly mediated by UGT2B7 and UGT1A3 and UGT1A8 to a lesser extent. The major metabolite is pharmacologically inactive nalmefene 3-O-glucuronide. Nalmefene is also metabolized to trace amounts of an N-dealkylated metabolite, which has minimal pharmacological activity. Nalmefene can undergo dealkylation mediated by CYP3A4/5 to form nornalmefene. Nornalmefene can be further converted to nornalmefene 3-O-glucuronide and nornalmefene 3-sulfate, which are generally inactive metabolites. Nalmefene can also undergo CYP3A4/5-mediated sulfation to form nalmefene 3-O-sulfate, which retains some pharmacological activity. However, nalmefene 3-O-sulfate is present in the circulation in less than 10% of that of nalmefene; thus, it is unlikely to be a major contributor to the pharmacological activity of nalmefene. The plasma concentration-time profile in some subjects suggests that nalmefene undergoes enterohepatic recycling.
来源:DrugBank