Influence of grapefruit juice on itraconazole plasma levels in mice and guinea pigs.

Levels of itraconazole and its metabolite hydroxy-itraconazole were measured by HPLC in plasma samples from guinea pigs and DBA/2 and BALB/c mice after oral or intraperitoneal treatment with itraconazole/cyclodextrin solution at 5 and 20 mg/kg daily for 7 days. The animals were randomly assigned to receive grapefruit juice or drinking water in their fluid bottles, since components of grapefruit juice have been found to alter the pharmacokinetic behaviour of pharmaceuticals that interact with cytochrome P450 enzymes. The results demonstrated clear differences in itraconazole pharmacokinetics between the three animal types studied. The total levels of antifungally active azole were highest in DBA/2 mice and lowest in guinea pigs, regardless of the route of administration. Guinea pigs that drank grapefruit juice had higher plasma levels of azoles after oral administration of the drug, but the juice did not influence levels of itraconazole or its metabolite in guinea pigs treated intraperitoneally, or in either mouse strain treated orally or intraperitoneally. This result indicates that grapefruit juice effects on the pharmacokinetics of itraconazole are species dependent and confined to the gastrointestinal tract, influencing drug absorption. Differences in itraconazole pharmacokinetics between mouse strains need to be considered in the design of experiments involving itraconazole treatment of mice experimentally infected with fungi.