Inhibition of Biliary Excretion of Methotrexate by Probenecid in Rats: Quantitative Prediction of Interaction from in Vitro Data

  1. Kaoru Ueda,
  2. Yukio Kato,
  3. Kanji Komatsu and
  4. Yuichi Sugiyama
  1. Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan

    Abstract

    This study was designed to establish a strategy to predict drug interactions involving biliary excretion. The interaction between methotrexate and probenecid was examined as an interaction model since this interaction has already been clinically reported. Coadministration of probenecid reduced the biliary clearance of methotrexate in a dose-dependent manner in rats. This inhibition by probenecid was confirmed in vivo both in the uptake and excretion processes of methotrexate across sinusoidal and canalicular membranes, respectively. That is, both hepatic uptake clearance, assessed in integration plot analysis, and steady-state biliary clearance defined with respect to hepatic unbound methotrexate, were reduced in the presence of probenecid. Probenecid inhibited the active transport of methotrexate both in isolated hepatocytes and canalicular membrane vesicles, confirming the interaction at those two membranes. The degree of inhibition of the uptake and excretion processes found in vivo was comparable with the predicted values using the inhibition constant assessed in isolated hepatocytes and canalicular membranes, respectively. This suggests that the interaction at each membrane transport process can be quantitatively estimated from in vitro data. We have also proposed the method to predict the degree of inhibition of the net excretion from circulating plasma into the bile, the predicted values being also comparable with the inhibition actually found in vivo. The present analysis demonstrates a strategic rationale for predicting drug interactions involving biliary excretion using in vitro systems to avoid any false negative predictions.

    Footnotes

    • Send reprint requests to: Professor Yuichi Sugiyama, Ph.D., Graduate School of Pharmaceutical Sciences, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033. E-mail:BXG05433{at}nifty.ne.jp

    • This study was supported in part by a grant-in-aid for Scientific Research provided by the Ministry of Education, Science and Culture of Japan.

    • Abbreviations:
      CMV
      canalicular membrane vesicle
      HPLC
      high-performance liquid chromatography
      fp
      free fraction in plasma
      fh
      free fraction in liver
      CLtotal
      total body clearance
      CLbile,p
      biliary clearance with respect to circulating plasma
      CLbile,h
      biliary clearance with respect to the liver concentration
      Cpss
      steady-state plasma concentration
      Chss
      steady-state liver concentration
      Vbile
      biliary excretion rate
      CLint,bile
      intrinsic clearance for net biliary excretion
      P1
      intrinsic clearance for hepatic uptake
      P2
      intrinsic clearance for the sinusoidal efflux
      P3
      intrinsic clearance for biliary excretion across canalicular membrane
      Qp
      hepatic plasma flow rate
      Xliver
      the amount of drug in the liver
      AUC
      area under the curve
      Iu,plasma
      unbound inhibitor concentration in plasma
      Iu,liver
      unbound inhibitor concentration in liver
      Rb
      blood-to-plasma concentration ratio
      cMOAT/MRP2
      canalicular multispecific organic anion transporter/multiresistance protein 2
      • Received November 21, 2000.
      • Accepted February 7, 2001.
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