Effect of apatinib on the pharmacokinetics of tramadol and O-desmethyltramadol in rats.

Since the combination of anticancer drugs and opioids is very common, apatinib and tramadol are likely to be used in combination clinically. This study evaluated the effects of apatinib on the pharmacokinetics of tramadol and its main metabolite O-desmethyltramadol in Sprague-Dawley (SD) rats and the inhibitory effects of apatinib on tramadol in rat liver microsomes (RLMs), human liver microsomes (HLMs) and recombinant human CYP2D6.1. The samples were determined by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The in vivo results showed that compared with the control group, apatinib increased the AUC _(0-t) , AUC _(0-∞) and C _max values of tramadol and O-desmethyltramadol, and decreased the values of V _Z /F and CLz/F. In addition, the MRT _(0-t) , MRT _(0-∞) values of O-desmethyltramadol were increased. In vitro , apatinib inhibited the metabolism of tramadol by a mixed way with IC ₅₀ of 1.927 µM in RLMs, 2.039 µM in HLMs and 15.32 µM in CYP2D6.1. In summary, according to our findings, apatinib has a strong in vitro inhibitory effect on tramadol, and apatinib can increase the analgesic effect of tramadol and O-desmethyltramadol in rats.
Competing Interests: The authors declare that they have no competing interests.
(© 2023 Bao et al.)