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1.
Pharm Res ; 38(11): 1821-1838, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34853982

RESUMO

AIMS: Gastric ulcer is a continuous worldwide threat that inquires protective agents. Olmesartan (OLM) has potent anti-oxidant and anti-inflammatory characters, yet having limited bioavailability. We targeted the gastro-protective potential and probable mechanism of OLM and its niosomal form against indomethacin (IND) induced-gastric ulcer in rats. MAIN METHODS: we prepared OLM niosomes (OLM-NIO) with different surfactant: cholesterol molar ratios. We evaluated particle size, zeta-potential, polydispersity, and entrapment efficiency. In-vitro release study, Fourier transform infrared spectroscopy, differential scanning calorimetry, and transmission electron microscopy were performed for selected niosomes. In-vivo, we used oral Omeprazole (30 mg/kg), OLM or OLM-NIO (10 mg/kg) for 3 days before IND (25 mg/kg) ingestion. We assessed gastric lesions, oxidative and inflammatory markers. KEY FINDINGS: OLM-NIO prepared with span 60:cholesterol ratio (1:1) showed high entrapment efficiency 93 ± 2%, small particle size 159.3 ± 6.8 nm, low polydispersity 0.229 ± 0.009, and high zeta-potential -35.3 ± 1.2 mV, with sustained release mechanism by release data. In-vivo macroscopical and histological results showed gastro-protective effects of OLM pretreatment, which improved oxidative stress parameters and enhanced the gastric mucosal cyclooxygenase-1 (COX-1) and prostaglandin E2 (PGE2) contents. OLM pretreatment suppressed interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) contents and translocation of p38 mitogen-activated protein kinase (p38-MAPK). Besides, OLM substantially promoted the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) protective pathway. OLM-NIO furtherly improved all previous outcomes. SIGNIFICANCE: We explored OLM anti-ulcerative effects, implicating oxidative stress and inflammation improvement, mediated by the Nrf2/HO-1 signaling pathway and p38-MAPK translocation. Meanwhile, the more bioavailable OLM-NIO achieved better gastro-protective effects compared to conventional OLM form.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Imidazóis/administração & dosagem , Indometacina/efeitos adversos , Úlcera Gástrica/tratamento farmacológico , Tetrazóis/administração & dosagem , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Animais , Disponibilidade Biológica , Modelos Animais de Doenças , Liberação Controlada de Fármacos , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/patologia , Heme Oxigenase (Desciclizante)/metabolismo , Humanos , Imidazóis/farmacocinética , Lipossomos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Masculino , Fator 2 Relacionado a NF-E2/metabolismo , Ratos , Úlcera Gástrica/induzido quimicamente , Úlcera Gástrica/patologia , Tetrazóis/farmacocinética
2.
Arch Pharm Res ; 44(12): 1109-1119, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34817825

RESUMO

Candesartan cilexetil is an angiotensin II receptor blocker and it is widely used to treat hypertension and heart failure. This drug is a prodrug that rapidly converts to candesartan after oral administration. Candesartan is metabolized by cytochrome P450 2C9 (CYP2C9) enzyme or uridine diphosphate glucurinosyltransferase 1A3, or excreted in an unchanged form through urine, biliary tract and feces. We investigated the effect of genetic polymorphism of CYP2C9 enzyme on drug pharmacokinetics using physiologically based pharmacokinetic (PBPK) modeling. In addition, by introducing the age and ethnicity into the model, we developed a model that can propose an appropriate dosage regimen taking into account the individual characteristics of each patient. To evaluate the suitability of the model, the results of a clinical trial on twenty-two healthy Korean subjects and their CYP2C9 genetic polymorphism data was applied. In this study, PK-Sim® was used to develop the PBPK model of candesartan.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Benzimidazóis/farmacocinética , Compostos de Bifenilo/farmacocinética , Citocromo P-450 CYP2C9/genética , Modelos Biológicos , Tetrazóis/farmacocinética , Adulto , Fatores Etários , Povo Asiático/genética , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Polimorfismo Genético , Adulto Jovem
3.
Pharm Biol ; 59(1): 1619-1622, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34818122

RESUMO

CONTEXT: Succinic acid and irbesartan are commonly used drugs in cardiovascular disease treatment. The interaction might occur during their co-administration, which was still unclear. OBJECTIVE: To reveal the effect of succinic acid on the metabolism of irbesartan and its potential mechanism. MATERIALS AND METHODS: The Sprague-Dawley rats (n = 6) were treated with a single dose of 30 mg/kg irbesartan (control) or the co-administration with the pre-treatment of 200 mg/kg succinic acid for 7 d. The effect of succinic acid on the metabolic stability and the activity of CYP2C9 was evaluated in rat liver microsomes. RESULTS: Succinic acid increased the AUC (5328.71 ± 959.31 µg/L × h vs. 3340.23 ± 737.75 µg/L × h) and prolonged the half-life of irbesartan (from 12.79 ± 0.73 h to 20.59 ± 6.35 h). The Tmax (2.83 ± 0.75 h vs. 3.83 ± 1.10 h) and clearance rate (3.46 ± 1.13 L/h/kg vs. 6.91 ± 1.65 L/h/kg) of irbesartan was reduced by succinic acid. Consistently, succinic acid improved the metabolic stability (half-life from 23.32 ± 3.46 to 27.35 ± 2.15 min, intrinsic clearance rate from 59.43 ± 6.12 to 50.68 ± 5.64 µL/min/mg protein). Succinic acid was also found to inhibit the activity of CYP2C9 with the IC50 value of 13.87 µM. DISCUSSION AND CONCLUSIONS: Succinic acid increased the system exposure of irbesartan via inhibiting CYP2C9. The experiment design of this study also provides a reference for the further validation of this interaction in humans.


Assuntos
Inibidores do Citocromo P-450 CYP2C9/farmacologia , Irbesartana/farmacocinética , Microssomos Hepáticos/metabolismo , Ácido Succínico/farmacologia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Animais , Área Sob a Curva , Sistema Enzimático do Citocromo P-450/efeitos dos fármacos , Sistema Enzimático do Citocromo P-450/metabolismo , Interações Medicamentosas , Meia-Vida , Concentração Inibidora 50 , Masculino , Ratos , Ratos Sprague-Dawley
4.
Clin Pharmacol Drug Dev ; 10(11): 1290-1296, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33647189

RESUMO

To evaluate the pharmacokinetic interactions among rosuvastatin, ezetimibe, and telmisartan, a randomized, open-label, 3-period, 6-sequence crossover study was conducted in healthy subjects. Subjects received one of the following treatments once daily for 7 days in each period with a 1-week washout: a fixed-dose combination of ezetimibe/rosuvastatin 10/20 mg, telmisartan 80 mg, combination therapy of ezetimibe/rosuvastatin 10/20 mg, or telmisartan 80 mg. Blood samples were collected up to 24 hours postdose at steady state. Geometric mean ratios (GMRs) and their 90% confidence intervals (CIs) of the combination therapy to monotherapy for the maximum plasma concentration (Cmax,ss ), and the area under the time-concentration curve within a dosing interval at steady state (AUCtau,ss ) were estimated. Among the 36 randomized subjects, 31 subjects completed the study. The GMRs and 90%CIs of Cmax,ss and AUCtau,ss of total ezetimibe were not significantly altered. The Cmax,ss of free ezetimibe was increased (GMR, 1.85; 90%CI, 1.56-2.19) but not for the AUCtau,ss (GMR, 1.16; 90%CI, 1.06-1.26). Similarly, the Cmax,ss of rosuvastatin was increased (GMR, 2.13; 90%CI, 1.88-2.43) without a change in the AUCtau,ss (GMR, 1.09; 90%CI, 1.03-1.15). The Cmax,ss (GMR, 1.16; 90%CI, 1.01-1.32) and AUCtau,ss (GMR, 1.26; 90%CI, 1.17-1.37) of telmisartan were slightly increased. Considering the therapeutic range of the components, the interaction would have limited clinical impact.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Anticolesterolemiantes/farmacocinética , Interações Medicamentosas , Ezetimiba/farmacocinética , Rosuvastatina Cálcica/farmacocinética , Telmisartan/farmacocinética , Adulto , Estudos Cross-Over , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
5.
Methods Mol Biol ; 2207: 109-125, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33113131

RESUMO

Hypertension treatment is a current therapeutic priority as there is a constantly increasing part of the population that suffers from this risk factor, which may lead to cardiovascular and encephalic episodes and eventually to death. A number of marketed medicines consist of active ingredients that may be relatively potent; however, there is plenty of room to enhance their pharmacological profile and therapeutic index by improving specific physicochemical properties. In this work, we focus on a class of blood pressure regulators, called sartans, and we present the computational scheme for the pharmacological improvement of irbesartan (IRB) as a representative example. IRB has been shown to exert increased pharmacological action compared with other sartans, but it appears to be highly lipophilic and violates Lipinski rule (MLogP >4.15). To circumvent this drawback, proper hydrophilic molecules, such as cyclodextrins, can be used as drug carriers. This chapter describes the combinatory use of computational methods, namely molecular docking, quantum mechanics, molecular dynamics, and free energy calculations, to study the interactions and the energetic contributions that govern the IRB:cyclodextrin association. We provide a detailed computational protocol, which aims to assist the improvement of the pharmacological properties of sartans. This protocol can also be applied to any other drug molecule with diminished hydrophilic character.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II , Portadores de Fármacos , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , beta-Ciclodextrinas , Bloqueadores do Receptor Tipo 1 de Angiotensina II/química , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Portadores de Fármacos/química , Portadores de Fármacos/farmacocinética , Interações Hidrofóbicas e Hidrofílicas , beta-Ciclodextrinas/química , beta-Ciclodextrinas/farmacocinética
6.
Clin Transl Sci ; 14(1): 194-203, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32702160

RESUMO

Heart failure (HF) causes pathological changes in multiple organs, thus affecting the pharmacokinetics (PK) of drugs. The aim of this study was to investigate the PK of candesartan in patients with HF while examining significant covariates and their related impact on estimated clearance using a population PK (Pop-PK) modeling approach. Data from a prospective, multicenter study were used. Modeling and simulations were conducted using Nonlinear Mixed-Effects Modeling (NONMEM) and R software. A total of 281 white patients were included to develop the Pop-PK model. The final model developed for apparent oral clearance (CL/F) included weight, estimated glomerular filtration rate (eGFR), and diabetes, which partly explained its interindividual variability. The mean CL/F value estimated was 7.6 L/h (1.7-22.6 L/h). Simulations revealed that an important decrease in CL/F (> 25%) is obtained with the combination of the factors retained in the final model. Considering these factors, a more individualized approach of candesartan dosing should be investigated in patients with HF.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Benzimidazóis/farmacocinética , Compostos de Bifenilo/farmacocinética , Insuficiência Cardíaca/tratamento farmacológico , Modelos Biológicos , Tetrazóis/farmacocinética , Administração Oral , Idoso , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Benzimidazóis/administração & dosagem , Variação Biológica da População , Compostos de Bifenilo/administração & dosagem , Canadá , Doença Crônica/tratamento farmacológico , Feminino , Insuficiência Cardíaca/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tetrazóis/administração & dosagem
7.
BMJ Open ; 10(12): e040768, 2020 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-33293316

RESUMO

INTRODUCTION: The COVID-19 epidemic grows and there are clinical trials of antivirals. There is an opportunity to complement these trials with investigation of angiotensin II type 1 receptor blockers (ARBs) because an ARB (losartan) was effective in murine influenza pneumonia. METHODS AND ANALYSIS: Our innovative design includes: ARBs; alignment with the WHO Ordinal Scale (primary endpoint) to align with other COVID-19 trials; joint longitudinal analysis; and predictive biomarkers (angiotensins I, 1-7, II and ACE1 and ACE2). Our hypothesis is: ARBs decrease the need for hospitalisation, severity (need for ventilation, vasopressors, extracorporeal membrane oxygenation or renal replacement therapy) or mortality of hospitalised COVID-19 infected adults. Our two-pronged multicentre pragmatic observational cohort study examines safety and effectiveness of ARBs in (1) hospitalised adult patients with COVID-19 and (2) out-patients already on or not on ARBs. The primary outcome will be evaluated by ordinal logistic regression and main secondary outcomes by both joint longitudinal modelling analyses. We will compare rates of hospitalisation of ARB-exposed versus not ARB-exposed patients. We will also determine whether continuing ARBs or not decreases the primary outcome. Based on published COVID-19 cohorts, assuming 15% of patients are ARB-exposed, a total sample size of 497 patients can detect a proportional OR of 0.5 (alpha=0.05, 80% power) comparing WHO scale of ARB-exposed versus non-ARB-exposed patients. ETHICS AND DISSEMINATION: This study has core institution approval (UBC Providence Healthcare Research Ethics Board) and site institution approvals (Health Research Ethics Board, University of Alberta; Comite d'etique de la recerche, CHU Sainte Justine (for McGill University and University of Sherbrook); Conjoint Health Research Ethics Board, University of Calgary; Queen's University Health Sciences & Affiliated Hospitals Research Ethics Board; Research Ethics Board, Sunnybrook Health Sciences Centre; Veritas Independent Research Board (for Humber River Hospital); Mount Sinai Hospital Research Ethics Board; Unity Health Toronto Research Ethics Board, St. Michael's Hospital). Results will be disseminated by peer-review publication and social media releases. TRIAL REGISTRATION NUMBER: NCT04510623.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Tratamento Farmacológico da COVID-19 , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Humanos , Modelos Logísticos , Estudos Multicêntricos como Assunto , Pandemias , Ensaios Clínicos Pragmáticos como Assunto , Estudos Prospectivos , SARS-CoV-2 , Resultado do Tratamento
8.
Arch Pharm Res ; 43(11): 1187-1196, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33249530

RESUMO

Losartan has been shown to be a substrate of the drug-efflux transporter MDR1, encoded by the ABCB1 gene. ABCB1 c.2677G>T and c.3435C>T variants are known to be associated with reduced expression and function of P-glycoprotein (P-gp). We investigated the effects of ABCB1 diplotype on the pharmacokinetics of losartan. Thirty-eight healthy Korean volunteers with different ABCB1 diplotypes [c.2677G> T and c.3435C>T; carriers of GG/CC (n = 13), GT/CT (n = 12) and TT/TT (n = 13) diplotype] were recruited and administered a single 50 mg oral dose of losartan potassium. Losartan and its active metabolite E-3174 samples in plasma and urine were collected up to 10 and 8 h after drug administration, respectively, and the concentrations of both samples were determined by HPLC method. Significant differences were observed in Cmax of losartan and losartan plus E-3174 (Lo + E) among the three diplotype groups (both P < 0.01). However, the power of the performed test is less than the desired power (0.800). The tmax of losartan and E-3174 in three diplotype groups were also significantly different (both P < 0.01). The AUC values of Lo + E were significantly different among the three diplotype groups until 6 h after losartan administration (P < 0.01). On the contrary, AUC at the periods of 8-10 h and 10 h-infinity of Lo + E were significantly lower in the TT/TT group than in the GG/CC group. Urinary excretion of losartan until 4 h after losartan administration in the TT/TT group was higher than that of the GG/CC group. These results suggest that c.2677G>T/c.3435C>T diplotypes of ABCB1 may significantly increase the early-phase absorption of losartan, but not the total absorption.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Absorção Gastrointestinal , Losartan/farmacocinética , Variantes Farmacogenômicos , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Subfamília B de Transportador de Cassetes de Ligação de ATP/metabolismo , Administração Oral , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Cromatografia Líquida de Alta Pressão , Genótipo , Humanos , Losartan/administração & dosagem , Farmacogenética , República da Coreia , Adulto Jovem
9.
Drug Des Devel Ther ; 14: 4221-4230, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116410

RESUMO

PURPOSE: To compare the bioequivalence of two formulations of valsartan (80 mg capsules) under fasting and fed conditions in healthy Chinese volunteers using a full-replicate study design. METHODS: A total of 78 Subjects were randomly assigned to fasting cohort (n = 48) or fed cohort (n = 30). Each cohort includes 4 single-dose observation periods and 3-day washout periods. Blood samples were collected at designed time point. Plasma concentration of valsartan was analyzed by a validated LC-MS/MS method. Noncompartmental analysis method was employed to determine the pharmacokinetic parameters. Based on the within-subject standard deviation (SWR) of the reference formulation, either reference-scaled average bioequivalence (RSABE) or average bioequivalence (ABE) method was used to evaluate the bioequivalence of the two formulations. RESULTS: Under fasting conditions, the RSABE method was used to evaluate the bioequivalence of Cmax (SWR>0.294), while ABE method was used to evaluate the bioequivalence of AUC0-t and AUC0-∞. The geometric mean ratio (GMR) of the test/reference for Cmax was 99.52%, and the 95% upper confidence bound was <0. For AUC0-t and AUC0-∞ comparisons, GMRs were 102.07% and 101.92%, and the 90% CIs of the test/reference were 96.28%-108.21%, 96.28%-107.88%, respectively. Under fed conditions, the SWR value of Cmax, AUC0-t and AUC0-∞ all exceeded the cutoff value of 0.294 and therefore, the RSABE method was used. The GMRs for Cmax, AUC0-t and AUC0-∞ were 98.78%, 103.33% and 103.08%, respectively, while the 95% upper confidence bound values were all <0. These results all met the bioequivalence criteria for highly variable drugs. All adverse events were mild and transient. CONCLUSION: In this study, the generic formulation of valsartan 80 mg capsule was considered to be bioequivalent to the reference product under both fasting and fed conditions, and satisfied the requirements for marketing in China. NMPA REGISTRATION NO: CTR20181422.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Valsartana/farmacocinética , Adolescente , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Área Sob a Curva , Povo Asiático , Cápsulas , Estudos de Coortes , Estudos Cross-Over , Composição de Medicamentos , Ingestão de Alimentos , Jejum , Feminino , Voluntários Saudáveis , Humanos , Masculino , Equivalência Terapêutica , Valsartana/efeitos adversos , Adulto Jovem
10.
Clin Pharmacol Ther ; 108(4): 885-895, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32498119

RESUMO

To investigate how variability in multiple pharmacokinetic genes associates with telmisartan exposure, we determined telmisartan single-dose (40 mg) pharmacokinetics and sequenced 379 genes in 188 healthy volunteers. Intronic UGT1A variants showed the strongest associations with the area under the plasma concentration-time curve from zero hours to infinity (AUC0-∞ ) and peak plasma concentration (Cmax ) of telmisartan. These variants were strongly linked with the increased function UGT1A3*2 allele, suggesting that it is the causative allele underlying these associations. In addition, telmisartan plasma concentrations were lower in men than in women. The UGT1A3*2 was associated with a 64% and 63% reduced AUC0-∞ of telmisartan in UGT1A3*2 heterozygous and homozygous men, respectively (P = 1.21 × 10-16 and 5.21 × 10-8 ). In women, UGT1A3*2 heterozygosity and homozygosity were associated with 57% (P = 1.54 × 10-11 ) and 72% (P = 3.31 × 10-15 ) reduced AUC0-∞ , respectively. Furthermore, a candidate gene analysis suggested an association of UGT1A3*3 and the SLCO1B3 c.767G>C missense variant with telmisartan pharmacokinetics. A genotype score, which reflects the effects of sex and genetic variants on telmisartan AUC0-∞ , associated with the effect of telmisartan on diastolic blood pressure. These data indicate that sex and UGT1A3 are major determinants and suggest a role for OATP1B3 in telmisartan pharmacokinetics.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Pressão Sanguínea/efeitos dos fármacos , Glucuronosiltransferase/genética , Variantes Farmacogenômicos , Polimorfismo de Nucleotídeo Único , Telmisartan/farmacocinética , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Bloqueadores do Receptor Tipo 1 de Angiotensina II/sangue , Feminino , Glucuronosiltransferase/metabolismo , Voluntários Saudáveis , Humanos , Masculino , Mutação de Sentido Incorreto , Farmacogenética , Fatores Sexuais , Membro 1B3 da Família de Transportadores de Ânion Orgânico Carreador de Soluto/genética , Membro 1B3 da Família de Transportadores de Ânion Orgânico Carreador de Soluto/metabolismo , Telmisartan/administração & dosagem , Telmisartan/sangue , Adulto Jovem
11.
Food Chem Toxicol ; 142: 111441, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32450287

RESUMO

The central renin angiotensin system (RAS) is implicated in Alzheimer's disease (AD). Here, induction of experimental AD simulation was performed by D-galactose (D-Gal) injection to ovariectomized (OVX) rats fed on high fat high fructose diet (HFFD). Telmisartan administration to OVX/HFFD/D-Gal rats lowered the expression of hippocampal angiotensin 1 and 2 receptors and glucose transporter 2 in addition to lowering of the peripheral and central glucose levels. Furthermore, it improved cognitive impairment and suppressed hippocampal amyloidogenic markers including amyloid-beta level, phosphorylated tau protein and beta site amyloid precursor protein cleaving enzyme 1 expression, while elevated levels of insulin degrading enzyme and recovered permeability of blood brain barrier (BBB). In addition, it inhibited hippocampal oxido-nitrosative stress as well as neuroinflammatory and apoptotic biomarkers. Telmisartan improved memory and cognitive impairment as shown in the behavioral Morris water maze, Y-maze, novel object recognition and open field tests in addition to amelioration of depressive like behavior as shown in forced swimming test. Histopathological examination of brain and immune expression of glial fibrillary acidic protein were also improved together with astrogliosis improvement. In conclusion, telmisartan improved memory and cognitive impairment, recovered amyloidogenesis-hyperglycemic axis, astrogliosis, integrity of BBB, memory deficit and oxidonitrosative stress induced in OVX/HFFD/D-Gal rats.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Angiotensinas/fisiologia , Hiperglicemia/complicações , Ovariectomia , Receptores de Estrogênio/fisiologia , Telmisartan/uso terapêutico , Doença de Alzheimer/complicações , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Animais , Barreira Hematoencefálica , Feminino , Modelos Animais , Ratos , Ratos Wistar , Telmisartan/farmacocinética
12.
Hypertension ; 75(6): 1584-1592, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32336236

RESUMO

Blood pressure-lowering drugs have different blood pressure-lowering profiles. We studied if differences in blood pressure mean and variability can explain the differences in risks of cardiovascular events and death among 15 245 high-risk hypertensive patients randomized to valsartan or amlodipine and followed for 4.2 years in the VALUE trial (Valsartan Antihypertensive Long-Term Use Evaluation). We selected patients with ≥3 visits and performed Cox regression analyses, defining mean blood pressure as a time-dependent covariate and visit-to-visit and within-visit blood pressure variability as the SD. Of 14 996 eligible patients, participants in the valsartan group had higher systolic mean blood pressure by 2.2 mm Hg, higher visit-to-visit systolic variability by 1.4 mm Hg, and higher within-visit systolic variability by 0.2 mm Hg (P values <0.0001). The higher risks of myocardial infarction and stroke in the valsartan group was attenuated after adjustment for mean and variability of systolic blood pressure, from HR 1.19 (95% CI, 1.02-1.39) to 1.11 (0.96-1.30) and from HR 1.13 (0.96-1.33) to 1.00 (0.85-1.18), respectively. The lower risk of congestive heart failure in the valsartan group was accentuated after adjustment, from HR 0.86 (0.74-1.00) to 0.76 (0.65-0.89). A smaller effect was seen on risk of death, from 1.01 (0.92-1.12) to 0.94 (0.85-1.04). In conclusion, the higher risks of myocardial infarction and stroke in patients randomized to valsartan versus amlodipine were related to the drugs' different blood pressure modulating profiles. The risk of congestive heart failure with valsartan was lower, independent of the less favorable blood pressure modulating profile.


Assuntos
Anlodipino , Pressão Sanguínea/efeitos dos fármacos , Insuficiência Cardíaca , Hipotensão/tratamento farmacológico , Infarto do Miocárdio , Acidente Vascular Cerebral , Valsartana , Anlodipino/administração & dosagem , Anlodipino/farmacocinética , Análise de Variância , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Determinação da Pressão Arterial/métodos , Determinação da Pressão Arterial/estatística & dados numéricos , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/farmacocinética , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Humanos , Hipotensão/metabolismo , Hipotensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Avaliação de Processos e Resultados em Cuidados de Saúde , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Tempo , Valsartana/administração & dosagem , Valsartana/farmacocinética
13.
Basic Clin Pharmacol Toxicol ; 126(3): 193-202, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31514255

RESUMO

Losartan presents multiple peaks in the concentration-time profile. This characteristic can be attributed to gastric emptying, which is known to significantly affect the disposition of highly soluble and permeable compounds. The aim of this study was to develop a population pharmacokinetic model for losartan and its active metabolite (EXP-3174) in order to describe the effect of gastric emptying on their disposition. Population pharmacokinetic analysis was performed using concentration-time data derived from a crossover bioequivalence study in 31 volunteers after a single oral dose of 100 mg losartan potassium in the fasted state. Delay differential equations (DDEs) were explored for the description of losartan absorption and EXP-3174 formation, since when solved they result in oscillatory behaviour. A two-compartment model preceded by a pre-absorption compartment (referring to small intestine) adequately described the observed concentration-time profiles of losartan. In the final model, a sinusoidal equation was used for the description of gastric emptying in view of its simplicity, leading to enhanced stability of the model and its capacity to describe periodicity. In case of EXP-3174, a one-compartment model, with a delayed first-order formation rate from losartan's central compartment, best described its disposition. Using the model developed, it was shown through simulations that changes in gastric emptying parameters lead to changes in the C-t profiles of both compounds. In particular, plasma oscillations can be enhanced or completely suppressed, simply by changing parameters affecting gastric emptying.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Esvaziamento Gástrico/fisiologia , Losartan/farmacocinética , Modelos Biológicos , Administração Oral , Adolescente , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Estudos Cross-Over , Feminino , Humanos , Losartan/administração & dosagem , Masculino , Equivalência Terapêutica , Adulto Jovem
14.
Eur J Pharm Sci ; 139: 105048, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31446077

RESUMO

Co amorphous systems are supersaturated drug delivery systems which offer a basic platform for delivery of multicomponent adducts (combination of more than one active pharmaceutical ingredient (API)) and/or as a fixed dose combination therapy, in addition to their potential to improve the apparent solubility, dissolution rate and ultimately bioavailability of poorly water soluble APIs. In the present work, a new drug-drug co amorphous system namely valsartan-nifedipine was prepared by quench cooling technique. Prepared co amorphous system was characterized for its solid state behavior with the help of Fourier Transform Infrared spectroscopy (FTIR), Differential Scanning Calorimetry (DSC) and Powder X Ray Diffractometry (PXRD). The optimized co amorphous system was stable for 1 month when exposed to accelerated stability condition (40 ±â€¯2 °C and 75 ±â€¯5% RH). The improved stability of amorphous nifedipine in co amorphous system was attributed to improved miscibility and intra and intermolecular non-covalent interactions mainly due to presence of hydrogen bonding between valsartan and nifedipine which was studied by FTIR analysis. Co amorphous systems were evaluated by mainly in vitro dissolution and in vivo benefit. In vitro dissolution study showed nearly 5.66 folds and 1.61 folds improvement which was translated to 3.63 and 2.19 times enhancement in vivo Cmax for nifedipine and valsartan respectively.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II , Bloqueadores dos Canais de Cálcio , Nifedipino , Valsartana , Bloqueadores do Receptor Tipo 1 de Angiotensina II/química , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Animais , Bloqueadores dos Canais de Cálcio/química , Bloqueadores dos Canais de Cálcio/farmacocinética , Combinação de Medicamentos , Composição de Medicamentos , Liberação Controlada de Fármacos , Feminino , Nifedipino/química , Nifedipino/farmacocinética , Ratos Sprague-Dawley , Valsartana/química , Valsartana/farmacocinética
15.
Eur J Drug Metab Pharmacokinet ; 44(6): 797-806, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31254178

RESUMO

BACKGROUND AND OBJECTIVE: Telmisartan is an angiotensin receptor blocker used for the treatment of hypertension. The effects of gender and uridine diphosphate-glycosytransferase 1A1 (UGT1A1) genetic polymorphisms (rs4124874, rs4148323, and rs6742078) on telmisartan plasma concentration and blood pressure in Chinese patients with hypertension have been reported previously. In this study, we aimed to develop a population pharmacokinetic (PopPK) model to quantify the effects of gender and UGT1A1 polymorphisms on the pharmacokinetics of telmisartan. METHODS: Population pharmacokinetic analyses were performed using data collected prospectively from 58 Chinese patients with mild to moderate essential hypertension (aged 45-72 years; 36 men, 22 women) receiving 80 mg/day telmisartan orally for 4 weeks. Blood samples were collected in heparinized tubes at 0, 0.5, 1, and 6 h on day 28 after telmisartan administration. The plasma concentrations and UGT1A1 genetic variants were determined by high-performance liquid chromatography-mass spectrometry and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, respectively. RESULTS: A two-compartment pharmacokinetic structural model with first-order elimination and absorption best described the pharmacokinetic characteristics of telmisartan. Gender and triglyceride influenced the apparent oral clearance (CL) of telmisartan. UGT1A1 (rs4124874) affected the bioavailability (F1) of telmisartan. Lower CL and bioavailability resulted in higher plasma concentrations being observed in female subjects with UGT1A1 CC or CA genotype and high triglyceride. CONCLUSION: A PopPK model of telmisartan was established to confirm that UGT1A1 genotype, gender and triglyceride can affect the pharmacokinetics of telmisartan in Chinese patients with hypertension. Our findings can provide relevant pharmacokinetic parameters for further study of telmisartan.


Assuntos
Anti-Hipertensivos/farmacocinética , Glucuronosiltransferase/genética , Hipertensão/tratamento farmacológico , Telmisartan/farmacocinética , Adulto , Idoso , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Povo Asiático/genética , Pressão Sanguínea/efeitos dos fármacos , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
16.
Pak J Pharm Sci ; 32(2 (Supplementary)): 853-858, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31103982

RESUMO

A sensitive, reproducible and modest analytical procedure was developed and validated for evaluation of irbesartan in human plasma. LLE (Liquid-Liquid extraction) of the drug was carried out with acetonitrile (1:1 v/v). Chromatographic separation of irbesartan was conducted by the help of 4.0mm × 25cm column having L1 packing from plasma and mobile phase utilizing HPLC. The mobile phase comprise of phosphate buffer and acetonitrile in a ratio of 67:33 v/v. The flow rate was set at 1ml/minute and the detector at a wavelength of 220 nm. The resolution of irbesartan was well performed from plasma components. This method was validated and demonstrated linearity with a concentration range of 0.1to 6µg/ml of irbesartan in plasma. Intra-day, inter-day accuracy was found 89.33% to 96.37% while intra-day, inter-day precision was found within the limit of 0.02 and 2.15 respectively. The mean recovery of irbesartan was 97.28%. The efficacy of extraction was proved by above-mentioned results. In plasma, the 0.05 and 0.1µg/ml dilutions were exhibited as the LOD and LOQ of irbesartan. Stability studies disclosed that irbesartan showed stability at -20°C storage.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/sangue , Cromatografia Líquida de Alta Pressão/métodos , Irbesartana/sangue , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Calibragem , Cromatografia de Fase Reversa/métodos , Estabilidade de Medicamentos , Humanos , Irbesartana/farmacocinética , Limite de Detecção , Sensibilidade e Especificidade
17.
Drug Dev Ind Pharm ; 45(6): 981-994, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30865478

RESUMO

A nanoparticulate system; cubosomes has been suggested to support the controlled release of Telmisartan (TEL), a poorly water-soluble medication. Four distinctive formulae were selected according to the results of three estimated responses. The liquid cubosomes were successfully adsorbed onto Aerosil 380 to form granules. The formulae were evaluated for their flow properties. The best granules were compressed into tablets suitable for oral administration. The tablets were evaluated for its performance. The in vivo study of the best selected cubosomal tablets was checked after oral administration in the blood of albino rabbits utilizing an HPLC method. Results revealed that the highest EE was shown in formulae C5 (59.68 ± 1.3). All the prepared formulae had particle size less than 500 nm with PDI < 0.5 and the highest zeta potential results were observed in C5, C7, C9, C11 and C12 (>30 mv). A7 and A9 prepared using Aerosil 380 showed a perfect flowability. After 1 h of dissolution testing, the commercial product showed a 66% drug release while the release of all cubosomal formulae didn't exceed 35% during the first hour reaching a 85% of the drug released at the end of 24 h. A7 was selected for the in vivo study; Tmax of TEL absorption is increased for cubosomal formula by three folds indicating sustained release pattern. The relative bioavailability is also increased by 2.6 fold. The investigation proposed the rationality of cubosome to figure an effective controlled release tablets to improve its bioavailability and expand its activity.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Portadores de Fármacos/química , Liberação Controlada de Fármacos , Telmisartan/farmacocinética , Administração Oral , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Animais , Disponibilidade Biológica , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/farmacocinética , Composição de Medicamentos/métodos , Masculino , Tamanho da Partícula , Coelhos , Solubilidade , Comprimidos , Telmisartan/administração & dosagem
18.
J Pharm Sci ; 108(8): 2774-2780, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30922857

RESUMO

This study aimed to kinetically analyze the nonlinear absorption and systemic exposure of telmisartan (TEL) after oral administration to rats by using a stable isotope-IV method. Rats were orally administered different dose of TEL, followed by the intravenous injection of 0.005 mg/kg of deuterium-labeled TEL (TEL-d3). Assuming that TEL-d3 shows same pharmacokinetic properties with TEL, systemic clearance (CLtot), oral bioavailability (Foral), and intestinal and hepatic availability (Fa*Fg, Fh) of TEL were calculated in each individual rat. AUCpo of TEL increased disproportionately with dose and showed a sigmoid-type relation, indicating the involvement of multi-nonlinear processes in oral absorption of TEL. Fa*Fg of TEL increased with dose at the low-dose range while decreased at the high-dose range. In contrast, Fh increased and CLtot decreased significantly in the middle range (2 to 6 mg/kg). As main factors of nonlinearity, saturations of solubility, efflux transport in the intestine, and the hepatic uptake of TEL were indicated. In conclusion, this study demonstrated a high possibility of a stable isotope-IV method to characterize complicated pharmacokinetic properties of oral drugs in animals, which can help to consider the future risks in their clinical use.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Telmisartan/farmacocinética , Administração Oral , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Animais , Disponibilidade Biológica , Deutério/administração & dosagem , Deutério/farmacocinética , Absorção Intestinal , Cinética , Fígado/metabolismo , Masculino , Dinâmica não Linear , Ratos , Ratos Sprague-Dawley , Telmisartan/administração & dosagem
19.
Eur J Pharm Sci ; 132: 72-85, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-30797937

RESUMO

Eprosartan mesylate is an angiotensin receptor blocker which suffers from extremely poor bioavailability owing to its poor solubility and poor permeability. The rationale of the present work was to design the drug delivery system capable of overcoming these constraints. Nanoformulation of eprosartan mesylate was developed using ultrasonic wave-assisted liquid-antisolvent technique. Nanoformulation was further freeze dried with the addition of 1% of mannitol resulting in formation of re-dispersible EPM nanopowder. To prove our proof of principle, the re-dispersed nanopowder with z-average particle size 165.2 ±â€¯1.8 nm was evaluated enormously for in-vitro dissolution behaviour and permeability assay through Caco-2 cell model. In-vitro dissolution study was performed at pH 1.2, pH 4.5 and pH 6.8. Result demonstrates enhanced dissolution from EPM nanopowder with negligible pH dependence. Transport studies accomplished using validated Caco-2 based cell model showed 11-fold enhanced apparent permeability of redispersed nanopowder when compared to pure EPM and corresponding physical mixture (p < 0.0001). In-vivo study reveals, exceptionally strong variations in plasma concentration of EPM through nanopowder (62 mg/kg) formulation when compared with physical mixture and pure EPM (62 mg/kg) group. Moreover, study manifests that 5-fold lower dose (12.4 mg/kg) of developed formulation yields higher exposure (4600 ±â€¯36 ng·mL-1·h) than pure EPM (2349 ±â€¯34 ng·mL-1·h) and corresponding physical mixture (2456 ±â€¯49 ng·mL-1·h) at therapeutic dose (62 mg/kg). Further, L-NAME induced hypertensive model was undertaken to investigate effect of reduced dose of EPM nanopowder on systolic blood pressure, biochemical analysis and histopathology of heart. Results revealed pronounced antihypertensive potential of re-dispersed EPM nanopowder at 5-fold lower dose (12.4 mg/kg). In conclusion, our study indicates that nanopowder delivery might be the promising approach for providing enhanced oral bioavailability at lower dose.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Pressão Sanguínea/efeitos dos fármacos , Portadores de Fármacos/química , Imidazóis/farmacocinética , Nanopartículas/química , Tiofenos/farmacocinética , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Animais , Células CACO-2 , Composição de Medicamentos , Humanos , Imidazóis/administração & dosagem , Imidazóis/farmacologia , Masculino , Permeabilidade , Pós , Ratos Wistar , Solubilidade , Tiofenos/administração & dosagem , Tiofenos/farmacologia
20.
ChemMedChem ; 13(23): 2546-2557, 2018 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-30430750

RESUMO

The renin angiotensin aldosterone system (RAAS) is a hormonal cascade involved in the regulation of blood pressure and electrolyte balance, and represents a common target for the treatment of various diseases including hypertension, heart failure, and diabetes. Herein we present a novel 18 F-labeled derivative of the drug irbesartan, one of the most prescribed angiotensin II type 1 receptor (AT1 R) antagonists, for in vivo positron emission tomography (PET). This allows the in vivo measurement of AT1 R expression, and thus the evaluation of functional changes in its expression under pathophysiological conditions. We followed various synthetic approaches optimized for the introduction of fluorine into different positions of the aliphatic side chain of irbesartan. Radioligand binding studies revealed that fluorine atoms at specified positions (α-position (IC50 =6.6 nm) and δ-position (IC50 =8.5 nm) of the aliphatic side chain) do not alter the binding properties of irbesartan (IC50 =1.6 nm). After successful radiolabeling with fluorine-18 in a radiochemical yield of 11 %, we observed high renal uptake in healthy rats and pigs, which could be decreased by pretreatment with the parent compound irbesartan.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/química , Radioisótopos de Flúor/química , Irbesartana/análogos & derivados , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos/química , Receptores de Angiotensina/análise , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacocinética , Animais , Feminino , Radioisótopos de Flúor/farmacocinética , Irbesartana/farmacocinética , Rim/química , Rim/diagnóstico por imagem , Rim/metabolismo , Compostos Radiofarmacêuticos/farmacocinética , Suínos
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