Interaction of common azole antifungals with P glycoprotein.
Article Details
- CitationCopy to clipboard
Wang EJ, Lew K, Casciano CN, Clement RP, Johnson WW
Interaction of common azole antifungals with P glycoprotein.
Antimicrob Agents Chemother. 2002 Jan;46(1):160-5.
- PubMed ID
- 11751127 [ View in PubMed]
- Abstract
Both eucaryotic and procaryotic cells are resistant to a large number of antibiotics because of the activities of export transporters. The most studied transporter in the mammalian ATP-binding cassette transporter superfamily, P glycoprotein (P-gp), ejects many structurally unrelated amphiphilic and lipophilic xenobiotics. Observed clinical interactions and some in vitro studies suggest that azole antifungals may interact with P-gp. Such an interaction could both affect the disposition and exposure to azole antifungal therapeutics and partially explain the clinical drug interactions observed with some antifungals. Using a whole-cell assay in which the retention of a marker substrate is evaluated and quantified, we studied the abilities of the most widely prescribed orally administered azole antifungals to inhibit the function of this transporter. In a cell line presenting an overexpressed amount of the human P-gp transporter, itraconazole and ketoconazole inhibited P-gp function with 50% inhibitory concentrations (IC(50)s) of approximately 2 and approximately 6 microM, respectively. Cyclosporin A was inhibitory with an IC(50) of 1.4 microM in this system. Uniquely, fluconazole had no effect in this assay, a result consistent with known clinical interactions. The effects of these azole antifungals on ATP consumption by P-gp (representing transport activity) were also assessed, and the K(m) values were congruent with the IC(50)s. Therefore, exposure of tissue to the azole antifungals may be modulated by human P-gp, and the clinical interactions of azole antifungals with other drugs may be due, in part, to inhibition of P-gp transport.
DrugBank Data that Cites this Article
- Drug Transporters
Drug Transporter Kind Organism Pharmacological Action Actions Itraconazole P-glycoprotein 1 Protein Humans UnknownInhibitorDetails Ketoconazole P-glycoprotein 1 Protein Humans UnknownInhibitorDetails - Binding Properties
Drug Target Property Measurement pH Temperature (°C) Itraconazole P-glycoprotein 1 IC 50 (nM) 1700 N/A N/A Details Ketoconazole P-glycoprotein 1 IC 50 (nM) 5600 N/A N/A Details - Drug Interactions
Drugs Interaction Integrate drug-drug
interactions in your softwareDigoxinKetoconazole The serum concentration of Digoxin can be increased when it is combined with Ketoconazole.