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Vol. 300, Issue 3, 1063-1069, March 2002
Department of Pharmacy, Kyoto University Hospital, Faculty of
Medicine, Kyoto University, Kyoto, Japan
The purpose of this study was to clarify the contribution of
P-glycoprotein to the bioavailability and intestinal secretion of
grepafloxacin and levofloxacin in vivo. Plasma concentrations of
grepafloxacin and levofloxacin after intravenous and intraintestinal administration were increased by cyclosporin A, a P-glycoprotein inhibitor, in rats. The total body clearance and volume of distribution at steady state of grepafloxacin were significantly decreased to 60 and
63% of the corresponding control values by cyclosporin A. The apparent
oral clearance of grepafloxacin was decreased to 33% of the control,
and the bioavailability of grepafloxacin was increased to 95% by
cyclosporin A from 53% in the controls. Intestinal clearance of
grepafloxacin and levofloxacin were decreased to one-half and one-third
of the control, respectively, and biliary clearance of grepafloxacin
was also decreased to one-third with cyclosporin A in rats. Intestinal
secretion of grepafloxacin in mdr1a/1b (
/
) mice,
which lack mdr1-type P-glycoproteins, was significantly
decreased compared with wild-type mice, although the biliary secretion
was similar. Intestinal secretion of grepafloxacin in wild-type mice
treated with cyclosporin A was comparable to those in
mdr1a/1b (
/
) mice with or without cyclosporin A,
indicating that cyclosporin A completely inhibited
P-glycoprotein-mediated intestinal transport of grepafloxacin. In
conclusion, our results indicated that P-glycoprotein mediated the
intestinal secretion of grepafloxacin and limited the bioavailability
of this drug in vivo.
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