Effect of grapefruit juice on the pharmacokinetics of tolvaptan, a non-peptide arginine vasopressin antagonist, in healthy subjects.

Purpose: Tolvaptan is a selective vasopressin V2 receptor antagonist that can be given orally once daily for treatment of clinically significant hypervolemic and euvolemic hyponatremia (US and Europe) or extracellular volume expansion despite taking other diuretics (Japan). In vitro studies indicate...

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Publicado en:European Journal of Clinical Pharmacology Vol. 68; no. 2; pp. 207 - 212
Autores principales: Shoaf, Susan, Mallikaarjun, Suresh, Bricmont, Patricia
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Springer Nature Feb2012
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2012
      vid: 68
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-011-1106-4
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        atl: Effect of grapefruit juice on the pharmacokinetics of tolvaptan, a non-peptide arginine vasopressin antagonist, in healthy subjects.
      aug:
        au:
          Shoaf, Susan
          Mallikaarjun, Suresh
          Bricmont, Patricia
        affil: Clinical Pharmacology, Otsuka Pharmaceutical Development & Commercialization, Inc., 2440 Research Boulevard Rockville 20850 USA
      sug:
        subj:
          Heterocyclic Compounds Pharmacokinetics
          Grapefruit Pharmacokinetics
          Fruit Juices
          Vasopressins Antagonists and Inhibitors
          Hyponatremia Drug Therapy
          Drug-Food Interactions
          Random Assignment
          Crossover Design
          Heterocyclic Compounds Administration and Dosage
          Heterocyclic Compounds Blood
          Biological Availability
          Human
          Male
          Female
          Adult
          Chromatography, High Pressure Liquid
          Mass Spectrometry
          Data Analysis Software
          Descriptive Statistics
          Analysis of Variance
          Confidence Intervals
          Heterocyclic Compounds Adverse Effects
          Heterocyclic Compounds Urine
          Funding Source
          Randomized Controlled Trials
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: Tolvaptan is a selective vasopressin V2 receptor antagonist that can be given orally once daily for treatment of clinically significant hypervolemic and euvolemic hyponatremia (US and Europe) or extracellular volume expansion despite taking other diuretics (Japan). In vitro studies indicated that tolvaptan was a CYP3A4 substrate. Methods: A single-center, randomized, crossover trial of 60-mg tolvaptan with 240 mL of water or with 240 mL of reconstituted grapefruit juice (washout period of 72 h between doses) was conducted in 20 healthy subjects. Blood samples for tolvaptan plasma concentrations were obtained for 48 h postdose. Results: All subjects completed the trial. Following co-administration with grapefruit juice, tolvaptan concentrations were elevated compared with tolvaptan alone for only 16 h postdose; consequently, the mean elimination half-life of tolvaptan was unchanged, 5.7 vs 5.1 h respectively. The mean maximal plasma concentration (C) and the area under the curve (AUC) of tolvaptan were increased 1.86- and 1.56-fold respectively when co-administered with grapefruit juice. Conclusions: It appears that grapefruit juice increases the bioavailability of tolvaptan, but does not affect its systemic elimination. The adverse event profile was consistent with the aquaretic effect of tolvaptan as urinary frequency, thirst, and dry mouth were the most frequently reported events.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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