Effect of phenobarbital treatment on metabolism of vitamin D by rat liver.

Phenobarbital has been postulated to impair hepatic conversion of vitamin D to 25-hydroxyvitamin D [25(OH)D] either by accelerating the conversion of vitamin D to biologically inactive products or by directly inhibiting 25(OH)D production. The effect of a dose of phenobarbital documented to decrease circulating 25(OH)D levels on hepatic vitamin D metabolism has been investigated in rachitic rats with a recycling in vitro hepatic perfusion system. Phenobarbital (75 mg/kg/day) administered intraperitoneally to D-replete rats increased circulating 25(OH)D blood levels after 4 wk of therapy but was attended by decreased levels after 6 and 8 wk. Rachitic rats were then injected daily with phenobarbital for either 4 or 8 wk and the livers removed and perfused at a rate of 15 ml/min for 3 h. The concentrations of [3H]25(OH)D in the hepatic perfusate at 3 h was decreased after both 4 and 8 wk of phenobarbital. Although total [3H]-25(OH)D production (hepatic plus perfusate) was unaffected by phenobarbital, the efficiency of hepatic production was decreased after 8 wk of treatment and the release of [3H]-25(OH)D from the liver into the perfusate was inhibited after both 4 and 8 wk. The data indicate that chronic phenobarbital therapy decreases both the release of [3H]25(OH)D from the liver into the perfusate and the efficiency of hepatic [3H]-25(OH)D production. Phenobarbital-induced inhibition of 25(OH)D release from the liver may be another mechanism for the low 25(OH)D levels noted in humans after long-term phenobarbital therapy.