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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2009-1-30
pubmed:abstractText
The sphingosine-1-phosphate receptor modulator fingolimod is predominantly hydroxylated by cytochrome CYP4F2. In vitro experiments showed that ketoconazole significantly inhibited the oxidative metabolism of fingolimod by human liver microsomes and by recombinant CYP4F2. The authors used ketoconazole as a putative CYP4F2 inhibitor to quantify its influence on fingolimod pharmacokinetics in healthy subjects. In a 2-period, single-sequence, crossover study, 22 healthy subjects received a single 5-mg dose of fingolimod in period 1. In period 2, subjects received ketoconazole 200 mg twice daily for 9 days and a single 5-mg dose of fingolimod coadministered on the 4th day of ketoconazole treatment. Ketoconazole did not affect fingolimod t(max) or half-life, but there was a weak average increase in C(max) of 1.22-fold (90% confidence interval, 1.15-1.30). The AUC over the 5 days of ketoconazole coadministration increased 1.40-fold (1.31-1.50), and the full AUC to infinity increased 1.71-fold (1.53-1.91). The AUC of the active metabolite fingolimod-phosphate was increased to a similar extent by 1.67-fold (1.50-1.85). Ketoconazole predose plasma levels were not altered by fingolimod. The magnitude of this interaction suggests that a proactive dose reduction of fingolimod is not necessary when adding ketoconazole to a fingolimod regimen. The clinician, however, should be aware of this interaction and bear in mind the possibility of a fingolimod dose reduction based on clinical monitoring.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0091-2700
pubmed:author
pubmed:issnType
Print
pubmed:volume
49
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
212-8
pubmed:meshHeading
pubmed-meshheading:19118083-Adult, pubmed-meshheading:19118083-Antifungal Agents, pubmed-meshheading:19118083-Area Under Curve, pubmed-meshheading:19118083-Cross-Over Studies, pubmed-meshheading:19118083-Cytochrome P-450 Enzyme System, pubmed-meshheading:19118083-Dose-Response Relationship, Drug, pubmed-meshheading:19118083-Drug Interactions, pubmed-meshheading:19118083-Drug Monitoring, pubmed-meshheading:19118083-Enzyme Inhibitors, pubmed-meshheading:19118083-Female, pubmed-meshheading:19118083-Half-Life, pubmed-meshheading:19118083-Humans, pubmed-meshheading:19118083-Immunosuppressive Agents, pubmed-meshheading:19118083-Ketoconazole, pubmed-meshheading:19118083-Male, pubmed-meshheading:19118083-Middle Aged, pubmed-meshheading:19118083-Propylene Glycols, pubmed-meshheading:19118083-Sphingosine, pubmed-meshheading:19118083-Young Adult
pubmed:year
2009
pubmed:articleTitle
Ketoconazole increases fingolimod blood levels in a drug interaction via CYP4F2 inhibition.
pubmed:affiliation
Novartis Pharma, Building WSJ 210.427, 4002 Basel, Switzerland.
pubmed:publicationType
Journal Article, Controlled Clinical Trial, Research Support, Non-U.S. Gov't