title: Interaction Between Domperidone and Ketoconazole: Toward Prediction of Consequent QTc Prolongation Using Purely In Vitro Information.
abstract: We aimed to investigate the application of combined mechanistic pharmacokinetic (PK) and pharmacodynamic (PD) modeling and simulation in predicting the domperidone (DOM) triggered pseudo-electrocardiogram modification in the presence of a CYP3A inhibitor, ketoconazole (KETO), using in vitro-in vivo extrapolation. In vitro metabolic and inhibitory data were incorporated into physiologically based pharmacokinetic (PBPK) models within Simcyp to simulate time course of plasma DOM and KETO concentrations when administered alone or in combination with KETO (DOM+KETO). Simulated DOM concentrations in plasma were used to predict changes in gender-specific QTcF (Fridericia correction) intervals within the Cardiac Safety Simulator platform taking into consideration DOM, KETO, and DOM+KETO triggered inhibition of multiple ionic currents in population. Combination of in vitro-in vivo extrapolation, PBPK, and systems pharmacology of electric currents in the heart was able to predict the direction and magnitude of PK and PD changes under coadministration of the two drugs although some disparities were detected.
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK.
authors.forename: H
authors.initials: H
authors.lastname: Mishra
authors.affiliation: 1] Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK [2] Unit of Pharmacoepidemiology and Pharmacoeconomics, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Polak
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK.
authors.forename: M
authors.initials: M
authors.lastname: Jamei
authors.affiliation: 1] Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK [2] Manchester Pharmacy School, University of Manchester, Manchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Rostami-Hodjegan