Fluconazole but not the CYP3A4 inhibitor, itraconazole, increases zafirlukast plasma concentrations

European Journal of Clinical Pharmacology

Volumn 68, Issue 5, 2012, Pages 681-688

  Karonen, Tiina ^a   Laitila, Jouko ^a   Niemi, Mikko ^a   Neuvonen, Pertti J ^a   Backman, Janne T ^a  

^a UNIVERSITY OF HELSINKI   (Finland)

Author keywords

CYP2C9; CYP3A4; Drug interaction; Fluconazole; Itraconazole; Zafirlukast

Indexed keywords

CYTOCHROME P450 2C9; CYTOCHROME P450 3A4; FLUCONAZOLE; GENOMIC DNA; HYDROXYITRACONAZOLE; ITRACONAZOLE; PLACEBO; ZAFIRLUKAST;

ADULT; AREA UNDER THE CURVE; ARTICLE; CONTROLLED STUDY; CROSSOVER PROCEDURE; DRUG BLOOD LEVEL; DRUG ELIMINATION; DRUG HALF LIFE; DRUG METABOLISM; DRUG POTENTIATION; ENZYME ACTIVITY; ENZYME SPECIFICITY; EVENING DOSAGE; FEMALE; HUMAN; HUMAN EXPERIMENT; MALE; MORNING DOSAGE; NORMAL HUMAN; PLASMA CONCENTRATION-TIME CURVE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SINGLE DRUG DOSE; TIME TO MAXIMUM PLASMA CONCENTRATION;

ADULT; ANTI-ASTHMATIC AGENTS; ANTIFUNGAL AGENTS; ARYL HYDROCARBON HYDROXYLASES; BIOTRANSFORMATION; CROSS-OVER STUDIES; CYTOCHROME P-450 CYP3A; DRUG INTERACTIONS; ENZYME INHIBITORS; FEMALE; FLUCONAZOLE; GENETIC ASSOCIATION STUDIES; HALF-LIFE; HUMANS; ITRACONAZOLE; LEUKOTRIENE ANTAGONISTS; MALE; POLYMORPHISM, GENETIC; TOSYL COMPOUNDS; YOUNG ADULT;

EID: 84864280946     PISSN: 00316970     EISSN: 14321041     Source Type: Journal    
DOI: 10.1007/s00228-011-1158-5     Document Type: Article

References (42)

1. Calhoun WJ (1998) Summary of clinical trials with zafirlukast. Am J Respir Crit Care Med 157(6 Pt 1):S238-S246 (Pubitemid 28304150)
2. Kelloway JS (1997) Zafirlukast: the first leukotriene-receptor antagonist approved for the treatment of asthma. Ann Pharmacother 31(9):1012-1021 (Pubitemid 27390959)
3. Lipworth BJ (1999) Leukotriene-receptor antagonists. Lancet 353 (9146):57-62. doi:10.1016/S0140-6736(98)09019-9 (Pubitemid 29037713)
4. Accolate Clinical Pharmacology and Biopharmaceutics Review(s). http://www.accessdata.fda.gov/drugsatfda-docs/nda/99/20-547-S007-ACCOLATE- BIOPHARMR.PDF. Accessed June 2010
5. Accolate Pharmacology Review(s) hwafgddn-SAPPAJ Accessed June 2010
6. Dekhuijzen PN, Koopmans PP (2002) Pharmacokinetic profile of zafirlukast. Clin Pharmacokinet 41(2):105-114 (Pubitemid 34264037)
7. Savidge RD, Bui KH, Birmingham BK, Morse JL, Spreen RC (1998) Metabolism and excretion of zafirlukast in dogs, rats, and mice. Drug Metab Dispos 26(11):1069-1076 (Pubitemid 28516581)
8. Accolate label, AstraZeneca LP, 2009. <≤http://www.accessdata.fda. gov/drugsatfda-docs/label/2009/020547s027lbl.pdf≥> Accessed May 2010
9. Kassahun K, Skordos K, McIntosh I, Slaughter D, Doss GA, Baillie TA, Yost GS (2005) Zafirlukast metabolism by cytochrome P450 3A4 produces an electrophilic alpha, beta-unsaturated iminium species that results in the selective mechanism-based inactivation of the enzyme. Chem Res Toxicol 18(9):1427-1437. doi:10.1021/tx050092b (Pubitemid 41361716)
10. Karonen T, Filppula A, Laitila J, Niemi M, Neuvonen PJ, Backman JT (2010) Gemfibrozil markedly increases the plasma concentrations of montelukast: a previously unrecognized role for CYP2C8 in the metabolism of montelukast. Clin Pharmacol Ther 88(2):223-230. doi:10.1038/clpt.2010.73
11. Karonen T, Neuvonen PJ, Backman JT The CYP2C8 inhibitor gemfibrozil does not affect the pharmacokinetics of zafirlukast. Eur J Clin Pharmacol 67 (2): 151-155. doi:10.1007/s00228-010-0908-0
12. Shader RI, Granda BW, von Moltke LL, Giancarlo GM, Greenblatt DJ (1999) Inhibition of human cytochrome P450 isoforms in vitro by zafirlukast. Biopharm Drug Dispos 20(8):385-388. doi:10.1002/1099-081X(199911)20:8<385 (Pubitemid 30449777)
13. Walsky RL, Gaman EA, Obach RS (2005) Examination of 209 drugs for inhibition of cytochrome P450 2 C8. J Clin Pharmacol 45(1):68-78. doi:10.1177/0091270004270642
14. Jaakkola T, Laitila J, Neuvonen PJ, Backman JT (2006) Pioglitazone is metabolised by CYP2C8 and CYP3A4 in vitro: potential for interactions with CYP2C8 inhibitors. Basic Clin Pharmacol Toxicol 99(1):44-51. doi:10.1111/j.1742-7843.2006. pto-437.x (Pubitemid 44034394)
15. Jaakkola T, Backman JT, Neuvonen M, Niemi M, Neuvonen PJ (2006) Montelukast and zafirlukast do not affect the pharmacokinetics of the CYP2C8 substrate pioglitazone. Eur J Clin Pharmacol 62(7):503-509. doi:10.1007/s00228- 006-0136-9
16. Garey KW, Peloquin CA, Godo PG, Nafziger AN, Amsden GW (1999) Lack of effect of zafirlukast on the pharmacokinetics of azithromycin, clarithromycin, and 14-hydroxyclarithromycin in healthy volunteers. Antimicrob Agents Chemother 43(5):1152-1155 (Pubitemid 29214739)
17. Olkkola KT, Backman JT, Neuvonen PJ (1994) Midazolam should be avoided in patients receiving the systemic anti-mycotics ketoconazole or itraconazole. Clin Pharmacol Ther 55(5):481-485 (Pubitemid 24192233)
18. Jalava KM, Olkkola KT, Neuvonen PJ (1997) Itraconazole greatly increases plasma concentrations and effects of felodipine. Clin Pharmacol Ther 61(4):410-415. doi:10.1016/S0009-9236(97) 90191-0 (Pubitemid 27195943)
19. Backman JT, Kivistö KT, Olkkola KT, Neuvonen PJ (1998) The area under the plasma concentration-time curve for oral midazolam is 400-fold larger during treatment with itraconazole than with rifampicin. Eur J Clin Pharmacol 54(1):53-58 (Pubitemid 28189400)
20. Olkkola KT, Ahonen J, Neuvonen PJ (1996) The effects of the systemic antimycotics, itraconazole and fluconazole, on the pharmacokinetics and pharmacodynamics of intravenous and oral midazolam. Anesth Analg 82(3):511-516 (Pubitemid 26072953)
21. Kaukonen KM, Olkkola KT, Neuvonen PJ (1998) Fluconazole but not itraconazole decreases the metabolism of losartan to E-3174. Eur J Clin Pharmacol 53(6):445-449 (Pubitemid 28154745)
22. Bharathi DV, Naidu A, Jagadeesh B, Laxmi KN, Laxmi PR, Reddy PR, Mullangi R (2008) Development and validation of a sensitive LC-MS/MS method with electrospray ionization for quantitation of zafirlukast, a selective leukotriene antagonist in human plasma: application to a clinical pharmacokinetic study. Biomed Chromatogr 22(6):645-653. doi:10.1002/bmc.983 (Pubitemid 351959415)
23. Gubbins PO, Gurley BJ, Bowman J (1998) Rapid and sensitive high performance liquid chromatographic method for the determination of itraconazole and its hydroxy-metabolite in human serum. J Pharm Biomed Anal 16(6):1005-1012 (Pubitemid 28139037)
24. Inagaki K, Takagi J, Lor E, Okamoto MP, Gill MA (1992) Determination of fluconazole in human serum by solid-phase extraction and reversed-phase high-performance liquid chromatography. Ther Drug Monit 14(4):306-311
25. Accolate label, AstraZeneca Pharmaceuticals LP <≤http://www. accessdata.fda.gov/drugsatfda-docs/label/2011/020547s031lbl.pdf≥> Accessed Aug 2011
26. Adkins JC, Brogden RN (1998) Zafirlukast. A review of its pharmacology and therapeutic potential in the management of asthma. Drugs 55(1):121-144 (Pubitemid 28035128)
27. Neuvonen PJ, Jalava KM (1996) Itraconazole drastically increases plasma concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 60(1):54-61. doi:10.1016/S0009-9236(96) 90167-8 (Pubitemid 26279221)
28. Kivistö KT, Lamberg TS, Kantola T, Neuvonen PJ (1997) Plasma buspirone concentrations are greatly increased by erythromycin and itraconazole. Clin Pharmacol Ther 62(3):348-354. doi:10.1016/S0009-9236(97)90038-2 (Pubitemid 27417801)
29. Huang SM, Temple R, Throckmorton DC, Lesko LJ (2007) Drug interaction studies: study design, data analysis, and implications for dosing and labeling. Clin Pharmacol Ther 81(2):298-304. doi:10.1038/sj.clpt.6100054 (Pubitemid 46174829)
30. Huang SM, Strong JM, Zhang L, Reynolds KS, Nallani S, Temple R, Abraham S, Habet SA, Baweja RK, Burckart GJ, Chung S, Colangelo P, Frucht D, Green MD, Hepp P, Karnaukhova E, Ko HS, Lee JI, Marroum PJ, Norden JM, Qiu W, Rahman A, Sobel S, Stifano T, Thummel K, Wei XX, Yasuda S, Zheng JH, Zhao H, Lesko LJ (2008) New era in drug interaction evaluation: US Food and Drug Administration update on CYP enzymes, transporters, and the guidance process. J Clin Pharmacol 48(6):662-670. doi:10.1177/0091270007312153 (Pubitemid 351713150)
31. US Food and Drug Administration. Draft Guidance for Industry. Drug Interaction Studies - Study Design, Data Analysis, and Implications for Dosing and Labeling Accessed April 8, 2011
32. European Medicines Agency. Guideline on the investigation of drug interactions (draft, 2010). ≤http://www.ema.europa.eu/docs/en-GB/document- library/Scientific-guideline/2010/05/WC500090112.pdf≥ Accessed April 8, 2011
33. Kunze KL, Wienkers LC, Thummel KE, Trager WF (1996) Warfarin-fluconazole. I. Inhibition of the human cytochrome P450-dependent metabolism of warfarin by fluconazole: in vitro studies. Drug Metab Dispos 24(4):414-421
34. Varhe A, Olkkola KT, Neuvonen PJ (1996) Effect of fluconazole dose on the extent of fluconazole-triazolam interaction. Br J Clin Pharmacol 42(4):465-470 (Pubitemid 26340147)
35. Black DJ, Kunze KL, Wienkers LC, Gidal BE, Seaton TL, McDonnell ND, Evans JS, Bauwens JE, Trager WF (1996) Warfarin-fluconazole. II. A metabolically based drug interaction: in vivo studies. Drug Metab Dispos 24(4):422-428
36. Niwa T, Shiraga T, Takagi A (2005) Effect of antifungal drugs on cytochrome P450 (CYP) 2 C9, CYP2C19, and CYP3A4 activities in human liver microsomes. Biol Pharm Bull 28(9):1805-1808 (Pubitemid 41324160)
37. Saari TI, Laine K, Bertilsson L, Neuvonen PJ, Olkkola KT (2007) Voriconazole and fluconazole increase the exposure to oral diazepam. Eur J Clin Pharmacol 63(10):941-949. doi:10.1007/s00228-007-0350-0 (Pubitemid 47387914)
38. Kang BC, Yang CQ, Cho HK, Suh OK, Shin WG (2002) Influence of fluconazole on the pharmacokinetics of omeprazole in healthy volunteers. Biopharm Drug Dispos 23(2):77-81. doi:10.1002/bdd.291 (Pubitemid 34521110)
39. Desta Z, Zhao X, Shin JG, Flockhart DA (2002) Clinical significance of the cytochrome P450 2 C19 genetic polymorphism. Clin Pharmacokinet 41(12):913-958 (Pubitemid 35168437)
40. Sim SC, Risinger C, Dahl ML, Aklillu E, Christensen M, Bertilsson L, Ingelman-Sundberg M (2006) A common novel CYP2C19 gene variant causes ultrarapid drug metabolism relevant for the drug response to proton pump inhibitors and antidepressants. Clin Pharmacol Ther 79(1):103-113. doi:10.1016/j.clpt.2005.10. 002 (Pubitemid 43069582)
41. *17 allele; a pharmacokinetic study in healthy volunteers. Br J Clin Pharmacol 65 (5):767-774. doi:10.1111/j.1365-2125.2008. 03104.x (Pubitemid 351535091)
42. *17 allele in healthy subjects. Eur J Clin Pharmacol 64(12):1175-1179. doi:10.1007/s00228-008- 0529-z