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  • 1
    ISSN: 1432-2072
    Keywords: Key words Bromperidol ; Reduced bromperidol ; Steady-state plasma concentration ; Itraconazole ; Cytochrome P450 3A4
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Rationale: A previously reported pharmacokinetic interaction between bromperidol and carbamazepine, an inducer of cytochrome P450 (CYP) 3A4, suggests possible involvement of CYP3A4 in the metabolism of bromperidol. Objective: We investigated pharmacokinetic interaction between bromperidol and itraconazole, a potent inhibitor of CYP3A4, to clarify the involvement of CYP3A4 in the metabolism of bromperidol and its reduced metabolite. Methods: Itraconazole 200 mg/day for 7 days was coadministered to eight schizophrenic patients treated with a fixed dose of bromperidol 12 or 24 mg/day for at least 2 weeks. Blood samples were taken before and 1 week after itraconazole coadministration and 1 week after its discontinuation, together with clinical assessments using the Brief Psychiatric Rating Scale (BPRS) and the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale. Results: Plasma concentrations of bromperidol during itraconazole coadministration (16.7±4.9 ng/ml) were significantly higher (P〈0.01) than before itraconazole coadministration (8.9±4.4 ng/ml) and 1 week after its discontinuation (9.9±4.3 ng/ml). Plasma concentrations of reduced bromperidol during itraconazole coadministration (3.6±2.9 ng/ml) were significantly higher (P〈0.01) than before itraconazole coadministration (1.8±1.3 ng/ml). No changes were observed in BPRS and UKU scores throughout the study. Conclusions: The pharmacokinetic interaction between bromperidol and itraconazole is probably due to the inhibitory effect of itraconazole on the metabolism of bromperidol. This study provides in vivo evidence of involvement of CYP3A4 in the metabolism of bromperidol and reduced bromperidol.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2072
    Keywords: Key words Bromperidol ; Reduced bromperidol ; Plasma concentration ; Metabolism ; CYP2D6 genotype ; Flunitrazepam
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The effects of various factors, including the cytochrome P450 (CYP) 2D6 genotype and the coadministration of flunitrazepam, on the steady-state plasma concentrations (Css) of bromperidol and its reduced metabolite were studied in 62 schizophrenic inpatients receiving bromperidol 12 mg/day. By use of allele-specific PCR analysis, the wild type allele (CYP2D6 * 1A) and four mutated alleles causing either absent (CYP2D6 * 3, CYP2D6 * 4 and CYP2D6 * 5) or decreased (CYP2D6 * 10) CYP2D6 activity were identified. The means (ranges) of the Css of bromperidol and reduced bromperidol corrected to the median body weight were 7.2 (1.3–17.4) and 2.2 (0.4–8.9) ng/ml, respectively. Neither the Css of bromperidol nor that of reduced bromperidol significantly differed among the patients with no (n = 28), one (n = 30) and two mutated alleles (n = 4). The patients coadministered with flunitrazepam (n = 52) had significantly (P 〈 0.05) higher Css of bromperidol, but not reduced bromperidol, than those not (n = 10). Age, sex and smoking had no significant effects on the Css of these compounds. The present study thus suggests that the polymorphic CYP2D6 is not involved in the metabolism of bromperidol and reduced bromperidol to a major extent. The coadministration of flunitrazepam inhibits the metabolism of bromperidol, but age, sex and smoking do not affect it.
    Type of Medium: Electronic Resource
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