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Antimicrobial Agents and Chemotherapy, June 1998, p. 1463-1469, Vol. 42, No. 6
Departement de Pharmacotoxicologie,
Hôpital Avicenne, Bobigny 93009 cedex, France
Received 21 April 1997/Returned for modification 17 October
1997/Accepted 20 February 1998
Oligopeptidic drugs such as
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Analysis of the Pharmacokinetic Interaction between Cephalexin
and Quinapril by a Nonlinear Mixed-Effect Model
-lactams and angiotensin-converting
enzyme inhibitors share the same carriers in humans and animals, which
results in possible pharmacokinetic interactions. To model such
interactions, the effects of quinapril on cephalexin
pharmacokinetics were investigated in rats. Blood cephalexin
concentrations were measured by liquid chromatography, and the data
were analyzed by a noncompartmental method and by fitting a
bicompartmental model by a nonlinear mixed-effect modeling approach.
Five groups of eight rats were examined. In the first three groups,
cephalexin elimination kinetics after intra-arterial
administration alone or in combination with quinapril given by the
parenteral or the oral route were studied, and the occurrence of a
pharmacokinetic interaction was not revealed. The absence of an effect
of quinapril on cephalexin elimination after parenteral administration
might be explained either by the higher affinity of cephalexin for the renal anionic transport system than that of quinapril or by the much
higher concentrations of cephalexin than those of quinapril. In the
last two groups, cephalexin was administered by the oral route alone or
in combination with quinapril. The mean area under the
concentration-time curve (AUC) for cephalexin was increased by ca. 30%
by coadministration of quinapril (40.1 versus 31.4 mg · h/liter;
P = 0.04). The mean elimination clearance of
cephalexin was significantly decreased by quinapril, from 0.81 to 0.64 liter/h/kg of body weight (P < 0.05), probably by
competitive inhibition of cephalexin secretion at the tubular level.
The mean absorption rate constant of cephalexin was significantly
lowered by quinapril (from 0.249 to 0.177 h
1;
P < 0.01), without modification of the extent of
absorption (89%). This pharmacokinetic interaction could be explained
by competitive inhibition of cephalexin active transport by quinapril at the intestinal level.
*
Corresponding author. Mailing address: Departement de
Pharmacotoxicologie, Hôpital Avicenne, 125 route de Stalingrad,
Bobigny 93009 cedex, France. Phone: 33 01 48 95 56 61. Fax: 33 01 48 95 56 59. E-mail: michel.tod{at}avc.ap-hop-paris.fr.
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