Interaction of novel platelet-increasing agent eltrombopag with rosuvastatin via breast cancer resistance protein in humans.
Eltrombopag (ELT), an orally available thrombopoietin receptor agonist, is a substrate of organic anion transporting polypeptide 1B1 (OATP1B1), and coadministration of ELT increases the plasma concentration of rosuvastatin in humans. Since the pharmacokinetic mechanism(s) of the interaction is unknown, the present study aimed to clarify the drug interaction potential of ELT at transporters. The OATP1B1-mediated uptake of ELT was inhibited by several therapeutic agents used to treat lifestyle diseases. Among them, rosuvastatin was a potent inhibitor with an IC(50) of 0.05 µM, which corresponds to one-seventh of the calculated maximum unbound rosuvastatin concentration at the inlet to the liver. Nevertheless, a simulation study using a physiologically based pharmacokinetic model predicted that the effect of rosuvastatin on the pharmacokinetic profile of ELT in vivo would be minimal. On the other hand, ELT potently inhibited uptake of rosuvastatin by OATP1B1 and human hepatocytes, with an IC(50) of 0.1 µM. However, the results of the simulation study indicated that inhibition of OATP1B1 by ELT can only partially explain the clinically observed interaction with rosuvastatin. ELT also inhibited transcellular transport of rosuvastatin in MDCKII cells stably expressing breast cancer resistance protein (BCRP), and was found to be a substrate of BCRP. The interaction of ELT with rosuvastatin can be almost quantitatively explained on the assumption that intestinal secretion of rosuvastatin is essentially completely inhibited by ELT. These results suggest that BCRP in small intestine may be the major target for interaction between ELT and rosuvastatin in humans.
Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan (K.T., T.S., K.M., R.S., T.S., Y.M., N.N., Y.K.); and Pharmaceutical Research Department, Biological Research Laboratories, Nissan Chemical Industries, Ltd., Saitama, Japan (K.T., M.H., N.I.).
Kazuya
K
Takeuchi
Tomoko
T
Sugiura
Kazuki
K
Matsubara
Ren
R
Sato
Takuya
T
Shimizu
Yusuke
Y
Masuo
Masato
M
Horikawa
Noritaka
N
Nakamichi
Norihisa
N
Ishiwata
Yukio
Y
Kato
D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters / Q000037:antagonists & inhibitors* / Q000235:genetics; D000328:Adult; D000818:Animals; D001565:Benzoates / Q000493:pharmacokinetics* / Q000494:pharmacology; D001692:Biological Transport; D001792:Blood Platelets / Q000166:cytology / Q000187:drug effects*; D003198:Computer Simulation; D004285:Dogs; D004347:Drug Interactions; D005464:Fluorobenzenes / Q000097:blood / Q000493:pharmacokinetics*; D057809:HEK293 Cells; D022781:Hepatocytes / Q000378:metabolism; D006801:Humans; D006834:Hydrazines / Q000493:pharmacokinetics* / Q000494:pharmacology; D007421:Intestine, Small / Q000378:metabolism*; D018374:LLC-PK1 Cells; D027381:Liver-Specific Organic Anion Transporter 1; D061985:Madin Darby Canine Kidney Cells; D008297:Male; D051379:Mice; D008954:Models, Biological; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors* / Q000235:genetics; D027361:Organic Anion Transporters / Q000037:antagonists & inhibitors* / Q000235:genetics; D011720:Pyrazoles / Q000493:pharmacokinetics* / Q000494:pharmacology; D011743:Pyrimidines / Q000097:blood / Q000493:pharmacokinetics*; D053628:Receptors, Thrombopoietin / Q000819:agonists; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000097:blood / Q000493:pharmacokinetics*; D013552:Swine
C116614:ABCG2 protein, human; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters; D001565:Benzoates; D005464:Fluorobenzenes; D006834:Hydrazines; D027381:Liver-Specific Organic Anion Transporter 1; D009363:Neoplasm Proteins; D027361:Organic Anion Transporters; D011720:Pyrazoles; D011743:Pyrimidines; D053628:Receptors, Thrombopoietin; C503999:SLCO1B1 protein, human; D013449:Sulfonamides; C082218:MPL protein, human; D000068718:Rosuvastatin Calcium; C520809:eltrombopag