代谢
阿立哌唑月桂酯通过酯酶水解形成N-羟甲基-阿立哌唑。N-羟甲基-阿立哌唑经历快速的非酶促自发裂解,或经水介导的水解,转化为阿立哌唑,这主要贡献了阿立哌唑月桂酯的药理作用。阿立哌唑进一步通过肝脏的CYP3A4和CYP2D6代谢,形成去氢阿立哌唑,保留了一些药理活性。去氢阿立哌唑对D2受体的亲和力与阿立哌唑相似,并代表血浆中阿立哌唑暴露的30-40% [FDA标签]。细胞色素P450 2D6存在遗传多态性,这导致CYP2D6代谢型之间药代动力学的差异,并相应调整剂量 [A34289]。
Aripiprazole lauroxil is hydrolyzed to form N-hydroxymethyl-aripiprazole via esterases. N-hydroxymethyl-aripiprazole undergoes a rapid, nonenzymatic spontaneous cleavage, or water-mediated hydrolysis, to form aripiprazole, which mainly contributes to the pharmacological actions of aripiprazole lauroxil. Aripiprazole is further metabolized by hepatic CYP3A4 and CYP2D6 to form dehydro-aripiprazole, which retains some pharmacological activity. Dehydro-aripiprazole displays affinities for D2 receptors similar to aripiprazole and represents 30-40% of the aripiprazole exposure in plasma [FDA Label]. Cytochrome P450 2D6 is subject to genetic polymorphism, which results in pharmacokinetic differences among CYP2D6 metabolizer phenotypes and dosage adjustments accordingly [A34289].
来源:DrugBank