Biomedical Engineering Reference
In-Depth Information
TABLE 24.1. (
Continued
)
Inhibitor/
Measured
Putative
Drug
Inducer
Effect/Toxicity
Mechanism
Refs.
Loperamide
Quinidine
Increased CNS
adverse effects
Inhibition of MDR1
181
Digoxin
Rifampin
Decreased plasma
levels and AUC
Induction of MDR1,
CYP3A
118
Talinolol
Rifampin
Decreased AUC
Induction of MDR1
119
Tacrolimus
Rifampin
Decreased
apparent oral
bioavailability,
decreased total
clearance
Induction of MDR1,
CYP3A
282
Fexofenadine
Rifampin
Decreased AUC,
peak plasma
concentrations,
increased oral
clearance
Induction of MDR1,
CYP3A
120
Cyclosporin A
Rifampin
Decreased oral
bioavailability
Induction of MDR1,
CYP3A
121
Digoxin
St John's Worth
Decreased AUC
and peak
plasma
concentrations
Induction of MDR1
125,283
Cyclosporin A
St John's Worth
Decreased
plasma levels
Induction of MDR1
123
Indinavir
St John's Worth
Decreased
plasma levels
Induction of MDR1,
CYP3A
124
Tacrolimus
St John's Worth
Decreased
plasma levels
Induction of MDR1,
CYP3A
131
Topotecan
Elacridar
(GF120918)
Increased
apparent oral
availability
Inhibition of BCRP,
MDR1
164
Methotrexate
Omeprazole/
Pantoprazole
Increased AUC,
decreased
clearance
Inhibition of BCRP,
MDR1
45,111
a
The supposed molecular mechanism of this drug-drug interaction came from preclinical findings; in a
clinical study, coadministration of talinolol and verapamil resulted in a decrease in talinolol oral AUC (area
under the plasma concentration-time curve) compared with placebo
112
(see the text).
erythromycin, as in vitro experiments reported that all these drugs could reduce the
renal secretion of digoxin by inhibiting Pgp activity in the renal tubule.
88
,
89
Recently, Phillips et al. reported a case of a clinical drug-drug interaction between
the HIV protease inhibitor ritonavir and digoxin in a 61-year-old woman undergoing
antiretroviral triple therapy combined with digoxin, in whom digoxin toxicity devel-
oped 3 days after coadministration of ritonavir.
90
Although it has been demonstrated
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