Potential P-glycoprotein-mediated drug-drug interactions of antimalarial agents in Caco-2 cells

Am J Trop Med Hyg. 2012 Jul;87(1):64-9. doi: 10.4269/ajtmh.2012.11-0817.

Abstract

Antimalarials are widely used in African and Southeast Asian countries, where they are combined with other drugs for the treatment of concurrent ailments. The potential for P-glycoprotein (P-gp)-mediated drug-drug interactions (DDIs) between antimalarials and P-gp substrates was examined using a Caco-2 cell-based model. Selected antimalarials were initially screened for their interaction with P-gp based on the inhibition of rhodamine-123 (Rho-123) transport in Caco-2 cells. Verapamil (100 μM) and quinidine (1 μM) were used as positive inhibition controls. Lumefantrine, amodiaquin, and artesunate all showed blockade of Rho-123 transport. Subsequently, the inhibitory effect of these antimalarials on the bi-directional passage of digoxin (DIG) was examined. All of the drugs decreased basal-to-apical (B-A) P-gp-mediated DIG transport at concentrations of 100 μM and 1 mM. These concentrations may reflect therapeutic doses for amodiaquin and artesunate. Therefore, clinically relevant DDIs may occur between certain antimalarials and P-gp substrates in general.

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / physiology*
  • Antimalarials / pharmacology*
  • Caco-2 Cells
  • Drug Interactions
  • Humans
  • Rhodamine 123 / metabolism

Substances

  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Antimalarials
  • Rhodamine 123