1. Inhibition of drug-metabolizing enzymes by Qingfei Paidu decoction: Implication of herb-drug interactions in COVID-19 pharmacotherapy.
- Author
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Zhang, Feng, Huang, Jian, Liu, Wei, Wang, Chao-Ran, Liu, Yan-Fang, Tu, Dong-Zhu, Liang, Xin-Miao, Yang, Ling, Zhang, Wei-Dong, Chen, Hong-Zhuan, and Ge, Guang-Bo
- Subjects
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DRUG-herb interactions , *COVID-19 , *COVID-19 treatment , *MICROSOMES , *VIRUS diseases , *DRUG therapy , *ANGIOTENSIN I , *NALTREXONE - Abstract
Corona Virus Disease 2019 (COVID-19) has spread all over the world and brings significantly negative effects on human health. To fight against COVID-19 in a more efficient way, drug-drug or drug-herb combinations are frequently used in clinical settings. The concomitant use of multiple medications may trigger clinically relevant drug/herb-drug interactions. This study aims to assay the inhibitory potentials of Qingfei Paidu decoction (QPD, a Chinese medicine compound formula recommended for combating COVID-19 in China) against human drug-metabolizing enzymes and to assess the pharmacokinetic interactions in vivo. The results demonstrated that QPD dose-dependently inhibited CYPs1A, 2A6, 2C8, 2C9, 2C19, 2D6 and 2E1 but inhibited CYP3A in a time- and NADPH-dependent manner. In vivo test showed that QPD prolonged the half-life of lopinavir (a CYP3A substrate-drug) by 1.40-fold and increased the AUC of lopinavir by 2.04-fold, when QPD (6 g/kg) was co-administrated with lopinavir (160 mg/kg) to rats. Further investigation revealed that Fructus Aurantii Immaturus (Zhishi) in QPD caused significant loss of CYP3A activity in NADPH-generating system. Collectively, our findings revealed that QPD potently inactivated CYP3A and significantly modulated the pharmacokinetics of CYP3A substrate-drugs, which would be very helpful for the patients and clinicians to avoid potential drug-interaction risks in COVID-19 treatment. Image 1 • Qingfei Paidu decoction (QPD) dose-dependently inhibits CYPs1A, 2A6, 2C8, 2C9, 2C19, 2D6 and 2E1 in a reversible manner. • QPD inhibits CYP3A in a time- and NADPH-dependent manner in liver microsomes from both humans and rats. • QPD significantly increases the plasma exposure and half-life of lopinavir in rats. • Fructus Aurantii Immaturus (Zhishi) in QPD plays a crucial role in CYP3A inactivation. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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