Intestinal Drug Interactions Mediated by OATPs: A Systematic Review of Preclinical and Clinical Findings - PubMed (original) (raw)
Review
. 2017 Sep;106(9):2312-2325.
doi: 10.1016/j.xphs.2017.04.004. Epub 2017 Apr 13.
Affiliations
- PMID: 28414144
- DOI: 10.1016/j.xphs.2017.04.004
Review
Intestinal Drug Interactions Mediated by OATPs: A Systematic Review of Preclinical and Clinical Findings
Jingjing Yu et al. J Pharm Sci. 2017 Sep.
Abstract
In recent years, an increasing number of clinical drug-drug interactions (DDIs) have been attributed to inhibition of intestinal organic anion-transporting polypeptides (OATPs); however, only a few of these DDI results were reflected in drug labels. This review aims to provide a thorough analysis of intestinal OATP-mediated pharmacokinetic-based DDIs, using both in vitro and clinical investigations, highlighting the main mechanistic findings and discussing their clinical relevance. On the basis of pharmacogenetic and clinical DDI results, a total of 12 drugs were identified as possible clinical substrates of OATP2B1 and OATP1A2. Among them, 3 drugs, namely atenolol, celiprolol, and fexofenadine, have emerged as the most sensitive substrates to evaluate clinical OATP-mediated intestinal DDIs when interactions with P-glycoprotein by the test compound can be ruled out. With regard to perpetrators, 8 dietary or natural products and 1 investigational drug, ronacaleret (now terminated), showed clinical intestinal inhibition attributable to OATPs, producing ≥20% decreases in area under the plasma concentration-time curve of the co-administered drug. Common juices, such as apple juice, grapefruit juice, and orange juice, are considered potent inhibitors of intestinal OATP2B1 and OATP1A2 (decreasing exposure of the co-administered substrate by ∼85%) and may be adequate prototype inhibitors to investigate intestinal DDIs mediated by OATPs.
Keywords: drug interaction; inhibition; intestinal absorption; organic anion-transporting polypeptide transporters; polymorphism; transporter.
Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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