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Influence of CYP2D6 and CYP2C19 genetic polymorphism on the pharmacokinetics of tolperisone in healthy volunteers

  • Pharmacogenetics
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Abstract

Purpose

This is the first study that connects pharmacokinetics of tolperisone with genetic polymorphism of the enzymes involved in its metabolism in human. We aimed to identify the influence of polymorphism of two main enzymes (CYP2D6 and CYP2C19) on pharmacokinetic profile of parent drug.

Methods

In a single-dose study, 28 healthy Caucasian male volunteers received an oral dose of 150 mg of tolperisone. The subjects were genotyped with respect to CYP2D6 and CYP2C19 enzymes. Plasma was sampled for up to 12 h post dose, followed by quantification of tolperisone by a fully validated HPLC-tandem mass spectrometry (MS/MS) method. The pharmacokinetic parameters were estimated using a non-compartmental method and compared statistically at level p < 0.05 across the genotyped groups.

Results

High variability (exceeded 100 %) of main bioavailability parameters (AUCt, AUCinf, Cmax) was observed in the whole group of subjects. An essential difference in the pharmacokinetics of tolperisone of quick metabolizers whose genotype expressed wild homozygote CYP2D6 *1/*1 with respect to heterozygous *1/*4 and *1/*5 subjects was demonstrated. The mean AUCinf was 2.1- and 3.4-fold higher in *1/*4 and *1/*5, respectively, than in *1/*1 subjects. In case of Cmax, the differences were greater and reached maximally 3.8 times (mean values 54.00, 98.85, and 205.20 ng/mL for CYP2D6 *1/*1, *1/*4, and *1/*5, respectively). Values of the parameters for the one subject that expressed *4/*4 genotype were even 8.5 times higher than in subjects with extensive or intermediate phenotype. Although CYP2C19 *1/*2 subjects had higher AUCt, AUCinf, and Cmax values than *1/*1, no statistically significant differences were observed. Oral clearance (CL/F) significantly decreased by 65.7 % in heterozygous *1/*2 relative to homozygous *1/*1 extensive metabolizers.

Conclusion

In this study, we first demonstrated the effect of CYP2D6 polymorphism on pharmacokinetics of tolperisone in Caucasian subjects. The contribution of CYP2C19 enzyme seems to be less important.

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References

  1. Nagata K, Yamazoe Y (2002) Genetic polymorphism on human cytochrome P450 involved in drug metabolism. Drug Metabol Pharmacokinet 17(3):167–189

    Article  CAS  Google Scholar 

  2. Zanger UM, Schwab M (2013) Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther 138:103–141. doi:10.1016/j.pharmthera.2012.12.007

    Article  CAS  PubMed  Google Scholar 

  3. Callegari E, Kalgutkar AS, Leung L, Obach RS, Plowchalk DR, Tse S (2013) Drug metabolites as cytochrome p450 inhibitors: a retrospective analysis and proposed algorithm for evaluation of the pharmacokinetic interaction potential of metabolites in drug discovery and development. Drug Metab Dispos 41:2047–2055. doi:10.1124/dmd.113.052241

    Article  CAS  PubMed  Google Scholar 

  4. Daly AK (2012) Genetic polymorphisms affecting drug metabolism: recent advances and clinical aspects. Adv Pharmacol 63:137–167. doi:10.1016/B978-0-12-398339-8.00004-5

    Article  CAS  PubMed  Google Scholar 

  5. Howland RH (2012) Where are we today with personalized medicine? J Psychosoc Nurs Ment Health Serv 50(11):11–13. doi:10.3928/02793695-20121005-01

    Article  Google Scholar 

  6. Dalmadi B, Leibinger J, Szeberenyi S, Borbas T, Farkas S, Szombathelyi Z, Tihanyi K (2003) Identification of metabolic pathways involved in the biotransformation of tolperisone by human microsomal enzymes. Drug Metab Dispos 31(5):631–636

    Article  CAS  PubMed  Google Scholar 

  7. Balint J, Hell Z, Markovits I, Parkanyi L, Fogassy E (2000) Synthesis and resolution of a tolperisone metabolite. Tetrahedron-Asymmetry 11:1323–1329

    Article  CAS  Google Scholar 

  8. Balint J, Markovits I, Egri G, Tuza Z, Parkanyi L, Fogassy E (2001) Synthesis, resolution and absolute configuration of a tolperisone metabolite. Tetrahedron-Asymmetry 12:719–724

    Article  CAS  Google Scholar 

  9. Balint J, Egri G, Markovits I, Czugler M, Marthi K, Demeter A, Temesvari-Takacs K, Fogassy E (2002) Synthesis of some tolperisone metabolites in racemic and optically active form. Tetrahedron-Asymmetry 12:3417–3422

    Article  CAS  Google Scholar 

  10. Daly AK (2003) Pharmacogenetics of the major polymorphic metabolizing enzymes. Fundam Clin Pharmacol 17:27–41

    Article  CAS  PubMed  Google Scholar 

  11. Desta Z, Zhao X, Shin J-G, Flockhart DA (2002) Clinical significance of the cytochrome P450 2C19 genetic polymorphism. Clin Pharmacokinet 41(12):913–958

    Article  CAS  PubMed  Google Scholar 

  12. Strom CM, Goos D, Crossley B, Zhang K, Buller-Burkle A, Jarvis M, Quan F, Peng M, Sun W (2012) Testing for variants in CYP2C19: population frequencies and testing experience in a clinical laboratory. Genet Med 14(1):95–100. doi:10.1038/gim.0b013e3182329870

    Article  CAS  PubMed  Google Scholar 

  13. Cohen J (1988) Statistical power analysis for the behavioral sciences, LEA Publishers

  14. Bae JW, Park YS, Sohn UD, Myung CS, Ryu BK, Jang CG, Lee SY (2006) HPLC determination of tolperisone in human plasma. Arch Pharm Res 29(4):339–342

    Article  CAS  PubMed  Google Scholar 

  15. Bae JW, Kim MJ, Park YS, Myung CS, Jang CG, Lee SY (2007) Considerable interindividual variation in the pharmacokinetics of tolperisone HCl. Int J Clin Pharmacol Ther 45(2):110–113

    Article  CAS  PubMed  Google Scholar 

  16. Choi CI, Park JI, Lee HI, Lee YJ, Jang CG, Bae JW, Lee SY (2012) Determination of tolperisone in human plasma by liquid chromatography/tandem mass spectrometry for clinical application. J Chromatogr B Analyt Technol Biomed Life Sci 12(911):59–63. doi:10.1016/j.jchromb.2012.10.027

    Article  Google Scholar 

  17. Ruan CJ, Liu DY, Jiang J, Hu P (2012) Effect of the CYP2C19 genotype on the pharmacokinetics of icotinib in healthy male volunteers. Eur J Clin Pharmacol 68(12):1677–1680. doi:10.1007/s00228-012-1288-4

    Article  CAS  PubMed  Google Scholar 

  18. Gawrońska-Szklarz B, Adamiak-Giera U, Wyska E, Kurzawski M, Gornik W, Kaldonska M, Drozdzik M (2012) CYP2C19 polymorphism affects single-dose pharmacokinetics of oral pantoprazole in healthy volunteers. Eur J Clin Pharmacol 68(9):1267–1274. doi:10.1007/s00228-012-1252-3

    Article  PubMed Central  PubMed  Google Scholar 

  19. Bohanec Grabar P, Grabnar I, Rozman B, Logar D, Tomsic M, Suput D, Trdan T, Peterlin Masic L, Mrhar A, Dolzan V (2009) Investigation of the influence of CYP1A2 and CYP2C19 genetic polymorphism on 2-cyano-3-hydroxy-N-[4-(trifluoromethyl)phenyl]-2-butenamide (A77 1726) pharmacokinetics in leflunomide-treated patients with rheumatoid arthritis. Drug Metab Dispos 37(10):2061–2068. doi:10.1124/dmd.109.027482

    Article  PubMed  Google Scholar 

  20. Mamiya K, Hadama A, Yukawa E, Ieiri I, Otsubo K, Ninomiya H, Tashiro N, Higuchi S (2000) CYP2C19 polymorphism effect on phenobarbitone. Pharmacokinetics in Japanese patients with epilepsy: analysis by population pharmacokinetics. Eur J Clin Pharmacol 55(11–12):821–825

    Article  CAS  PubMed  Google Scholar 

  21. Quasthoff S, Mockel C, Zieglgansberger W, Schreibmayer W (2008) Tolperisone—a typical representative of a class of centrally acting muscle relaxants with less sedative side effects. CNS Neurosci Ther 14:107–119. doi:10.1111/j.1527-3458.2008.00044.x

    Article  CAS  PubMed  Google Scholar 

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Correspondence to M. Pawlowska.

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Pawlowska, M., Bogiel, M., Duda, J. et al. Influence of CYP2D6 and CYP2C19 genetic polymorphism on the pharmacokinetics of tolperisone in healthy volunteers. Eur J Clin Pharmacol 71, 699–705 (2015). https://doi.org/10.1007/s00228-015-1856-5

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  • DOI: https://doi.org/10.1007/s00228-015-1856-5

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