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The Journal of Clinical Pharmacology
Article . 2016 . Peer-reviewed
License: Wiley Online Library User Agreement
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Evaluation and Quantitative Prediction of Renal Transporter‐Mediated Drug‐Drug Interactions

Authors: Bo, Feng; Manthena V, Varma;

Evaluation and Quantitative Prediction of Renal Transporter‐Mediated Drug‐Drug Interactions

Abstract

AbstractWith numerous drugs cleared renally, inhibition of uptake transporters localized on the basolateral membrane of renal proximal tubule cells, eg, organic anion transporters (OATs) and organic cation transporters (OCTs), may lead to clinically meaningful drug‐drug interactions (DDIs). Additionally, clinical evidence for the possible involvement of efflux transporters, such as P‐glycoprotein (P‐gp) and multidrug and toxin extrusion protein 1/2‐K (MATE1/2‐K), in the renal DDIs is emerging. Herein, we review recent progress regarding mechanistic understanding of transporter‐mediated renal DDIs as well as the quantitative predictability of renal DDIs using static and physiologically based pharmacokinetic (PBPK) models. Generally, clinical DDI data suggest that the magnitude of plasma exposure changes attributable to renal DDIs is less than 2‐fold, unlike the DDIs associated with inhibition of cytochrome P‐450s and/or hepatic uptake transporters. It is concluded that although there is a need for risk assessment early in drug development, current available data imply that safety concerns related to the renal DDIs are generally low. Nevertheless, consideration must be given to the therapeutic index of the victim drug and potential risk in a specific patient population (eg, renal impairment). Finally, in vitro transporter data and clinical pharmacokinetic parameters obtained from the first‐in‐human studies have proven useful in support of quantitative prediction of DDIs associated with inhibition of renal secretory transporters, OATs or OCTs.

Related Organizations
Keywords

Organic Cation Transport Proteins, Pharmaceutical Preparations, Metabolic Clearance Rate, Drug Evaluation, Preclinical, Animals, Humans, Organic Anion Transporters, Drug Interactions, Kidney, Forecasting

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
41
Top 10%
Top 10%
Top 10%
bronze