Dose-dependent intestinal and hepatic first-pass metabolism of midazolam, a cytochrome P450 3A substrate with differently modulated enzyme activity in rats
F. Higashikawa et al., Dose-dependent intestinal and hepatic first-pass metabolism of midazolam, a cytochrome P450 3A substrate with differently modulated enzyme activity in rats, J PHARM PHA, 51(1), 1999, pp. 67-72
The dose-dependent first-pass metabolism of midazolam, a cytochrome P450 (C
YP) 3A substrate, was separately estimated in the intestine and liver after
administration into a jejunal loop of rats with differently modulated enzy
me activity. Modulation of CYP3A enzyme activity of Sprague-Dawley rats was
performed by pretreating the rats with inducers such as dexamethasone or b
y co-administering ketoconazole tan inhibitor) with midazolam.
Bioavailabilities of midazolam administered into the jejunal loop at a dose
of 10 mu mol were 12% in untreated (control) rats, and 2% in dexamethasone
-pretreated rats. Coadministered ketoconazole (2 mu mol) significantly incr
eased the bioavailability to 53% and 7%, respectively, in these rats. The i
ntestinal first-pass metabolism of midazolam administered into the jejunal
loop at a dose of 50 nmol in untreated and dexamethasone-pretreated rats, e
stimated by the mesenteric blood-collecting method in-situ, was 25% and 49%
of absorbed amount, respectively. The intestinal first-pass metabolism of
midazolam was reduced when ketoconazole (0.5 mu mol) was co-administered or
when the dose of midazolam was increased to 0.5 mu mmol in these rats. Ass
uming that the contribution of intestinal first-pass metabolism could be ne
gligible when midazolam was administered at a much higher dose of 10 mu mol
, the estimated hepatic first-pass metabolism of midazolam at a dose of 10
mu mol in untreated rats, dexamethasone-pretreated rats, untreated rats giv
en ketoconazole, and dexamethasone-pretreated rats given ketoconazole was,
respectively, 86, 97, 46, and 92% of the amounts absorbed.
In conclusion, the dose-dependent intestinal first-pass metabolism and the
hepatic first-pass metabolism of midazolam in rats with differently modulat
ed CYP3A activities was quantitatively estimated by in-vivo and in-situ abs
orption studies.