代谢
长春瑞滨在人肝脏中经历大量消除。在人类血液、血浆和尿液中已经鉴定出长春瑞滨的两个代谢物;长春瑞滨N-氧化物和去乙酰长春瑞滨。已经证明去乙酰长春瑞滨是长春瑞滨在人体中的主要代谢物,并且已经显示出去乙酰长春瑞滨具有与长春瑞滨相似的抗肿瘤活性。长春瑞滨还被代谢为另外两个次要代谢物,20'-羟基长春瑞滨和长春瑞滨6'-氧化物。长春瑞滨的治疗剂量(30 mg/m2)在血液或尿液中产生的这两种代谢物的量非常小,甚至无法量化。长春瑞滨的代谢由肝细胞色素P450同工酶CYP3A亚家族介导。由于肝脏是药物代谢的主要途径,因此肝功能损害的患者可能会在标准剂量下表现出增加的毒性,然而,目前还没有这方面的数据。同样,细胞色素P450酶对长春瑞滨代谢的贡献在接受其他通过此途径代谢的药物的患者中具有潜在的启示。
Vinorelbine undergoes substantial hepatic elimination in humans. Two metabolites of vinorelbine have been identified in human blood, plasma, and urine; vinorelbine N-oxide and deacetylvinorelbine. Deacetylvinorelbine has been demonstrated to be the primary metabolite of vinorelbine in humans, and has been shown to possess antitumor activity similar to vinorelbine,. Vinorelbine is metabolized into two other minor metabolites, 20'-hydroxyvinorelbine and vinorelbine 6'-oxide. Therapeutic doses of vinorelbine (30 mg/m2) yield very small, if any, quantifiable levels of either metabolite in blood or urine. The metabolism of vinorelbine is mediated by hepatic cytochrome P450 isoenzymes in the CYP3A subfamily,. As the liver provides the main route for metabolism of the drug, patients with hepatic impairment may demonstrate increased toxicity with standard dosing, however, there are no available data on this. Likewise, the contribution of cytochrome P450 enzyme action to vinorelbine metabolism has potential implications in patients receiving other drugs metabolized by this route.
来源:DrugBank