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Vol. 297, Issue 3, 1036-1043, June 2001
Graduate School of Pharmaceutical Sciences, University of Tokyo,
Tokyo, Japan
This study was designed to establish a strategy to predict drug
interactions involving biliary excretion. The interaction between
methotrexate and probenecid was examined as an interaction model since
this interaction has already been clinically reported. Coadministration of probenecid reduced the biliary clearance of methotrexate in a dose-dependent manner in rats. This inhibition by
probenecid was confirmed in vivo both in the uptake and excretion processes of methotrexate across sinusoidal and canalicular membranes, respectively. That is, both hepatic uptake clearance, assessed in
integration plot analysis, and steady-state biliary clearance defined
with respect to hepatic unbound methotrexate, were reduced in the
presence of probenecid. Probenecid inhibited the active transport of
methotrexate both in isolated hepatocytes and canalicular membrane
vesicles, confirming the interaction at those two membranes. The degree
of inhibition of the uptake and excretion processes found in vivo was
comparable with the predicted values using the inhibition constant
assessed in isolated hepatocytes and canalicular membranes,
respectively. This suggests that the interaction at each membrane
transport process can be quantitatively estimated from in vitro data.
We have also proposed the method to predict the degree of inhibition of
the net excretion from circulating plasma into the bile, the predicted
values being also comparable with the inhibition actually found in
vivo. The present analysis demonstrates a strategic rationale for
predicting drug interactions involving biliary excretion using in vitro
systems to avoid any false negative predictions.
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