Literature DB >> 21953914

CYP3A4-mediated lopinavir bioactivation and its inhibition by ritonavir.

Feng Li1, Jie Lu, Xiaochao Ma.   

Abstract

The combination of lopinavir (LPV) and ritonavir (RTV) is one of the preferred regimens for the treatment of HIV infection with confirmed efficacy and relatively low toxicity. LPV alone suffers the poor bioavailability due to its rapid and extensive metabolism. RTV boosts the plasma concentration of LPV by suppressing its metabolism and thus increasing LPV efficacy. In the current study, we found that RTV also inhibits LPV bioactivation. LPV bioactivation was investigated in human liver microsomes and cDNA-expressed human cytochromes P450. Twelve GSH-trapped reactive metabolites of LPV were identified by using a metabolomic approach. Semicarbazide-trapped reactive metabolites of LPV were also detected. RTV effectively suppressed all pathways of LPV bioactivation via CYP3A4 inhibition. Our data together with previous reports suggest that LPV plus RTV is an ideal combination because RTV not only boosts LPV plasma concentration, but it decreases LPV bioactivation.

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Year:  2011        PMID: 21953914      PMCID: PMC3250054          DOI: 10.1124/dmd.111.041400

Source DB:  PubMed          Journal:  Drug Metab Dispos        ISSN: 0090-9556            Impact factor:   3.922


  31 in total

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