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中国临床药理学与治疗学 ›› 2009, Vol. 14 ›› Issue (3): 313-318.

• 临床药理学 • 上一篇    下一篇

五酯胶囊对健康受试者咪哒唑仑及其代谢物1′-羟基咪哒唑仑药动学的影响

吴笑春, 辛华雯, 李罄, 余爱荣, 熊磊   

  1. 广州军区武汉总医院临床药理科, 武汉430070, 湖北
  • 收稿日期:2008-09-01 修回日期:2008-09-01 发布日期:2020-10-27
  • 基金资助:
    湖北省卫生厅科研基金资助(JX3B38)

Effects of wuzhi-capsule on the pharmacokinetics of midazolam and its metabolite 1′-hydroxy midazolam in healthy volunteers

WU Xiao-chun, XIN Hua-wen, LI Qing, YU Ai-rong, XIONG Lei   

  1. Department of Clinical Pharmacology, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, Hubei,China
  • Received:2008-09-01 Revised:2008-09-01 Published:2020-10-27

摘要: 目的 研究健康受试者合用中药制剂五酯胶囊(Wuzhi-capsule, WZ) 前后CYP3A4 探针药咪哒唑仑(Midazolam,MDZ) 及其代谢物1′-羟基咪哒唑仑(1′-hydroxymidazolam, 1′-OH-MDZ) 的动力学过程, 以证实WZ 是否影响MDZ 的代谢过程, 从而间接证明WZ 对CYP3A4 的影响。 方法 研究分两期, 12 名健康男性志愿者在第一周期单剂量口服MDZ 15 mg 后, 开始连续服用WZ 3 粒, bid ×7 d, 在第二周期依然单剂口服MDZ 15 mg, 同时服用WZ 3 粒。每期口服MDZ 后即按设计的时间采血, 用LC MS MS 法测定血浆MDZ 及1′-OH-MDZ浓度, 并分别计算药动学参数。 结果 合用WZ 前后MDZ 的主要药动学参数:AUC0-24分别为(578 ±227) 和(1186 ±320) μg·L-1 · h ;t1 2 分别为(3.4 ±1.0) 、(3.6 ±1.1) h ;CL(s) 分别为(31 ±17) 、(14±6) L h ;tmax 分别为(0.8 ±0.5) 、(1.6 ±1.2) h ;Cmax分别为(171 ±70) 、(282 ±152) μg L;V F(C)分别为(149 ±98) 、(67 ±24) L。合用WZ 前后1′-OH-MDZ 的主要药动学参数:AUC0-24 分别为(141±699) 、(129 ±49) μg·L-1· h ;t1 2 分别为(5.6 ±3.3) 、(5.0 ±2.1) h ;CL(s) 分别为(130 ±68) 、(134±72) L h ;tmax 分别为(0.8 ±0.3) 、(1.6 ±1.2) h ;Cmax 分别为(48 ±23) 、(36 ±28) μg L;V F(C) 分别为(918 ±499) 、(935 ±544) L。 结论 与使用WZ前相比, 使用WZ 后MDZ 的AUC0-24和Cmax 分别增加119.4 %、85.6 %, CL(s) 降低52.1 %, tmax 延迟1倍。WZ 能显著增加MDZ 的血浓度和生物利用度。推测WZ 可能是一种CYP3A4 抑制剂或含有具有CYP3A4 抑制作用的成分。

关键词: 五酯胶囊, 咪哒唑仑, 1′-羟基咪哒唑仑, 药动学, 健康受试者

Abstract: AIM: To assess the effect of wuzhicapsule (WZ) on the pharmacokinetics of midazolam, a probe drug of CYP3A4, and its metabolite 1′-hydroxymidazolam in healthy volunteers so as to study the effects of wuzhi-capsule on CYP3A4. METHODS: The study was divided into two stages.On the first stage, 12 healthy male volunteers were orally treated with 15 mg midazolam and then with 3 capsules twice daily for 7 days.On the second stage, the volunteers took another 15 mg midazolam followed by 3 capsules of wuzhi-capsule.Blood samples were taken after midazolam was given on each stage.The midazolam and 1′-hydroxy midazolam concentrations in plasma were determined by LC MS MS, and the pharmacokinetic parameters were calculated. RESULTS: The pharmacokinetic parameters of midazolam before and after coadministration with wuzhi-capsule were as follows: AUC0-24 were (578 ±227), (1186 ±320) μg·L-1 ·h, t1 2 were (3.4 ±1.0), (3.6 ±1.1) h, CL (s) were(31 ±17), (14 ±6) L h, tmax were (0.8 ± 0.5), (1.6 ±1.2) h, Cmax were(171 ±70), (282 ± 152) μg L,V F(C) were (149 ±98), (67 ±24) L. The pharmacokinetic parameters of 1′-hydroxy midazolam before and after coadministration with wuzhi-capsule were as follows:AUC0-24 were (141 ±699), (129 ±49) μg·L-1·h, t1 2 were (5.6 ±3.3), (5.0 ±2.1) h, CL(s) were (130 ±68), (134 ±72) L h, tmax were (0.8 ±0.3), (1.6 ±1.2) h, Cmax were (48 ±23), (36 ±28) μg L, V F(C) were (918 ±499), (935 ± 544) L. CONCLUSION: AUC0-24 and Cmax were increased by 119.4 % and 85.6 % after midazolam administration, respectively.The CL(s) is decreased by 52.1 %.The tmax is one time longer.Wuzhi-capsule can markedly increase the blood concentration and bioavailability of midazolam.Wuzhi-capsule or some of its ingredints may be an inhibitor of CYP3A4.

Key words: wuzhi-capsule, midazolam, 1′-hydroxy midazolam, pharmacokinetics, healthy volunteers, LC MS MS, CYP3A4

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