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Eur. J. Clin. Pharmacol. · Mar 2009
The CYP2C19 ultra-rapid metabolizer genotype influences the pharmacokinetics of voriconazole in healthy male volunteers.
- Guo Wang, He-Ping Lei, Zhi Li, Zhi-Rong Tan, Dong Guo, Lan Fan, Yao Chen, Dong-Li Hu, Dan Wang, and Hong-Hao Zhou.
- Pharmacogenetics Research Institute, Institute of Clinical Pharmacology, Central South University, Changsha, Hunan 410078, China.
- Eur. J. Clin. Pharmacol. 2009 Mar 1; 65 (3): 281-5.
AimTo study the pharmacokinetic characteristics of voriconazole in healthy Chinese male volunteers in relation to cytochrome P450 (CYP) 2C19 genotype status, including ultra-rapid metabolizers (URMs), homozygous extensive metabolizers (EMs), and poor metabolizers (PMs).MethodTwenty healthy Chinese male volunteers were recruited for the study. Of these, four were CYP2C19 heterozygous URMs (*1/*17), eight were CYP2C19 homozygous EMs (*1/*1), and eight were CYP2C19 PMs (*2/*2). After a single oral dose of 200 mg voriconazole, plasma concentrations of voriconazole were determined for a 24-h period by liquid chromatography-mass spectrometry/mass spectrometry.ResultIn Chinese male subjects, the allele frequencies of the CYP2C19*17 and CYP2C19*2 alleles were 0.64 and 35.6%, respectively, and both alleles were in Hardy-Weinberg equilibrium. The area under the concentration-time curve (AUC) from predose to 24 h (AUC(0-24)) and from predose to infinity (AUC(0-infinity)), and apparent oral clearance (CL/F) of voriconazole were statistically different among all three genotypic groups (P < 0.001, respectively). The maximum plasma concentration (C(max)) value of URMs also showed statistically significant differences from those of EMs and PMs (P = 0.036 and P = 0.035, respectively). The elimination half-life (t(1/2)) in URMs was 87% (P = 0.58) of that in EMs and 51% (P= 0.002) of that in PMs.ConclusionOur data indicate that the presence of the CYP2C19*17 allele results in ultra-rapid metabolism of voriconazole after a single oral dose.
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