The effect of hormone replacement therapy on CYP3A activity.
BACKGROUND
The effect of menopause and hormone replacement therapy on hepatic and intestinal wall CYP3A activity is poorly defined. This study was therefore designed to determine the effect of menopause and estrogen replacement therapy on hepatic and intestinal CYP3A activity with a specific CYP3A substrate, midazolam.


METHODS
Twelve young women (27 +/- 5 years), 10 elderly women receiving estrogen replacement therapy (71 +/- 6 years), and 14 elderly women not receiving estrogen replacement therapy (71 +/- 5 years) received simultaneous intravenous (0.05 mg/kg over 30 minutes) and oral (3 to 4 mg of a stable isotope, 15N3-midazolam) doses of midazolam. Serum and urine samples were assayed for midazolam, 15N3-midazolam, and metabolites by use of gas chromatography-mass spectrometry.


RESULTS
No significant (P > .05) differences were observed in systemic clearance and oral clearance between the three groups. Likewise, no differences were observed in oral, hepatic, or intestinal availability. A significant correlation was observed between oral and intestinal availability and not hepatic availability.


CONCLUSIONS
Neither menopause nor menopause with estrogen replacement therapy altered intestinal or hepatic CYP3A activity relative to that in a control group of young women.
Gorski
J C
JC
Division of Clinical Pharmacology, Indiana University School of Medicine, Wishard Memorial Hospital, Indianapolis 46202-2879, USA.
Wang
Z
Z
Haehner-Daniels
B D
BD
Wrighton
S A
SA
Hall
S D
SD
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000493:pharmacokinetics; D019540:Area Under Curve; D001189:Aryl Hydrocarbon Hydroxylases; D001682:Biological Availability; D051544:Cytochrome P-450 CYP3A; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism*; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006207:Half-Life; D006801:Humans; D006993:Hypnotics and Sedatives / Q000493:pharmacokinetics; D007262:Infusions, Intravenous; D008874:Midazolam / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D010089:Oxidoreductases, N-Demethylating / Q000378:metabolism*; D011374:Progesterone / Q000008:administration & dosage / Q000494:pharmacology*
D014151:Anti-Anxiety Agents; D004967:Estrogens; D006993:Hypnotics and Sedatives; D011374:Progesterone; D003577:Cytochrome P-450 Enzyme System; D001189:Aryl Hydrocarbon Hydroxylases; D051544:Cytochrome P-450 CYP3A; D010089:Oxidoreductases, N-Demethylating; D008874:Midazolam