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The Clinical Significance of Drug Transporters in Drug Disposition and Drug Interactions

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Abstract

The field of drug transporters has exploded over the past 30 years. It is now known that transporters are located in virtually every organ and tissue in the body and are involved in every aspect of drug absorption, distribution, excretion, and even influence drug metabolism by regulating access to drug metabolizing enzymes. Because of their ubiquity and function, drug transporters profoundly influence drug pharmacokinetics and pharmacodynamics. Moreover, factors which influence drug transporter function, such as genetic polymorphisms or transporter based drug interactions, can have a major impact on drug efficacy and safety. This chapter summarizes the role of transporters in drug disposition, gives examples of their clinical relevance, and describes the emerging role of drug transporters in drug discovery and development.

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References

  • Abel S, Nichols DJ, Brearley CJ and Eve MD (2000) Effect of cimetidine and ranitidine on pharmacokinetics and pharmacodynamics of a single dose of dofetilide. Br J Clin Pharmacol 49:64–71.

    PubMed  CAS  Google Scholar 

  • Allen JD, Brinkhuis RF, Wijnholds J and Schinkel AH (1999) The mouse Bcrp1/Mxr/Abcp gene: amplification and overexpression in cell lines selected for resistance to topotecan, mitoxantrone, or doxorubicin. Cancer Res 59:4237–4241.

    PubMed  CAS  Google Scholar 

  • Amidon GL, Lennernas H, Shah VP and Crison JR (1995) A theoretical basis for a biopharmaceutic drug classification: the correlation of in vitro drug product dissolution and in vivo bioavailability. Pharm Res 12:413–420.

    PubMed  CAS  Google Scholar 

  • Asberg A, Hartmann A, Fjeldsa E, Bergan S and Holdaas H (2001) Bilateral pharmacokinetic interaction between cyclosporine A and atorvastatin in renal transplant recipients. Am J Transplant 1:382–386.

    PubMed  CAS  Google Scholar 

  • Ayrton A and Morgan P (2008) Role of transport proteins in drug discovery and development: a pharmaceutical perspective. Xenobiotica 38:676–708.

    PubMed  CAS  Google Scholar 

  • Bachmakov I, Glaeser H, Fromm MF and Konig J (2008) Interaction of oral antidiabetic drugs with hepatic uptake transporters: focus on organic anion transporting polypeptides and organic cation transporter 1. Diabetes 57:1463–1469.

    PubMed  CAS  Google Scholar 

  • Backman JT, Kyrklund C, Neuvonen M and Neuvonen PJ (2002) Gemfibrozil greatly increases plasma concentrations of cerivastatin. Clin Pharmacol Ther 72:685–691.

    PubMed  CAS  Google Scholar 

  • Banfield C, Gupta S, Marino M, Lim J and Affrime M (2002) Grapefruit juice reduces the oral bioavailability of fexofenadine but not desloratadine. Clin Pharmacokinet 41:311–318.

    PubMed  CAS  Google Scholar 

  • Benet LZ and Cummins CL (2001) The drug efflux-metabolism alliance: biochemical aspects. Adv Drug Deliv Rev 50 Suppl 1:S3–11.

    PubMed  CAS  Google Scholar 

  • Breedveld P, Zelcer N, Pluim D, Sonmezer O, Tibben MM, Beijnen JH, Schinkel AH, van Tellingen O, Borst P and Schellens JH (2004) Mechanism of the pharmacokinetic interaction between methotrexate and benzimidazoles: potential role for breast cancer resistance protein in clinical drug-drug interactions. Cancer Res 64:5804–5811.

    PubMed  CAS  Google Scholar 

  • Cascorbi I (2006) Role of pharmacogenetics of ATP-binding cassette transporters in the pharmacokinetics of drugs. Pharmacol Ther 112:457–473.

    PubMed  CAS  Google Scholar 

  • Chandra P and Brouwer KL (2004) The complexities of hepatic drug transport: current knowledge and emerging concepts. Pharm Res 21:719–735.

    PubMed  CAS  Google Scholar 

  • Chinn LW and Kroetz DL (2007) ABCB1 pharmacogenetics: progress, pitfalls, and promise. Clin Pharmacol Ther 81:265–269.

    PubMed  CAS  Google Scholar 

  • Choudhuri S and Klaassen CD (2006) Structure, function, expression, genomic organization, and single nucleotide polymorphisms of human ABCB1 (MDR1), ABCC (MRP), and ABCG2 (BCRP) efflux transporters. Int J Toxicol 25:231–259.

    PubMed  CAS  Google Scholar 

  • Ciarimboli G (2008) Organic cation transporters. Xenobiotica 38:936–971.

    PubMed  CAS  Google Scholar 

  • Cvetkovic M, Leake B, Fromm MF, Wilkinson GR and Kim RB (1999) OATP and P-glycoprotein transporters mediate the cellular uptake and excretion of fexofenadine. Drug Metab Dispos 27:866–871.

    PubMed  CAS  Google Scholar 

  • de Boer AG, van der Sandt IC and Gaillard PJ (2003) The role of drug transporters at the blood-brain barrier. Annu Rev Pharmacol Toxicol 43:629–656.

    PubMed  Google Scholar 

  • de Miranda P, Good SS, Yarchoan R, Thomas RV, Blum MR, Myers CE and Broder S (1989) Alteration of zidovudine pharmacokinetics by probenecid in patients with AIDS or AIDS-related complex. Clin Pharmacol Ther 46:494–500.

    PubMed  Google Scholar 

  • Degorter MK and Kim RB (2009) Hepatic drug transporters, old and new: pharmacogenomics, drug response, and clinical relevance. Hepatology 50:1014–1016.

    PubMed  CAS  Google Scholar 

  • Ding R, Tayrouz Y, Riedel KD, Burhenne J, Weiss J, Mikus G and Haefeli WE (2004) Substantial pharmacokinetic interaction between digoxin and ritonavir in healthy volunteers. Clin Pharmacol Ther 76:73–84.

    PubMed  CAS  Google Scholar 

  • Dobson PD and Kell DB (2008) Carrier-mediated cellular uptake of pharmaceutical drugs: an exception or the rule? Nat Rev Drug Discov 7:205–220.

    PubMed  CAS  Google Scholar 

  • Drescher S, Schaeffeler E, Hitzl M, Hofmann U, Schwab M, Brinkmann U, Eichelbaum M and Fromm MF (2002) MDR1 gene polymorphisms and disposition of the P-glycoprotein substrate fexofenadine. Br J Clin Pharmacol 53:526–534.

    PubMed  CAS  Google Scholar 

  • Drewe J, Gutmann H, Fricker G, Torok M, Beglinger C and Huwyler J (1999) HIV protease inhibitor ritonavir: a more potent inhibitor of P-glycoprotein than the cyclosporine analog SDZ PSC 833. Biochem Pharmacol 57:1147–1152.

    PubMed  CAS  Google Scholar 

  • Ekins S, Ecker GF, Chiba P and Swaan PW (2007) Future directions for drug transporter modelling. Xenobiotica 37:1152–1170.

    PubMed  CAS  Google Scholar 

  • Endres CJ, Hsiao P, Chung FS and Unadkat JD (2006) The role of transporters in drug interactions. Eur J Pharm Sci 27:501–517.

    PubMed  CAS  Google Scholar 

  • FDA (2006) Draft guidance for industry: drug interaction studies – study design, data analysis, and implications for dosing and labeling http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm072101.pdf.

  • Feng B, Obach RS, Burstein AH, Clark DJ, de Morais SM and Faessel HM (2008) Effect of human renal cationic transporter inhibition on the pharmacokinetics of varenicline, a new therapy for smoking cessation: an in vitro-in vivo study. Clin Pharmacol Ther 83:567–576.

    PubMed  CAS  Google Scholar 

  • Fenner KS, Troutman MD, Kempshall S, Cook JA, Ware JA, Smith DA and Lee CA (2009) Drug-drug interactions mediated through P-glycoprotein: clinical relevance and in vitro-in vivo correlation using digoxin as a probe drug. Clin Pharmacol Ther 85:173–181.

    PubMed  CAS  Google Scholar 

  • Fletcher CV, Henry WK, Noormohamed SE, Rhame FS and Balfour HH, Jr. (1995) The effect of cimetidine and ranitidine administration with zidovudine. Pharmacotherapy 15:701–708.

    PubMed  CAS  Google Scholar 

  • Frenia ML and Long KS (1992) Methotrexate and nonsteroidal antiinflammatory drug interactions. Ann Pharmacother 26:234–237.

    PubMed  CAS  Google Scholar 

  • Fuhr U, Jetter A and Kirchheiner J (2007) Appropriate phenotyping procedures for drug metabolizing enzymes and transporters in humans and their simultaneous use in the “cocktail” approach. Clin Pharmacol Ther 81:270–283.

    PubMed  CAS  Google Scholar 

  • Geick A, Eichelbaum M and Burk O (2001) Nuclear receptor response elements mediate induction of intestinal MDR1 by rifampin. J Biol Chem 276:14581–14587.

    PubMed  CAS  Google Scholar 

  • Ghibellini G, Leslie EM and Brouwer KL (2006a) Methods to evaluate biliary excretion of drugs in humans: an updated review. Mol Pharm 3:198–211.

    PubMed  CAS  Google Scholar 

  • Ghibellini G, Vasist LS, Hill TE, Heizer WD, Kowalsky RJ and Brouwer KL (2006b) Determination of the biliary excretion of piperacillin in humans using a novel method. Br J Clin Pharmacol 62:304–308.

    PubMed  CAS  Google Scholar 

  • Giacomini KM, Sugiyama Y (2006) in “Goodman & Gilman’s The Pharmacological Basis of Therapeutics” (Brunton LL, Lazo JS, & Parker RL, eds) 41–70. McGraw-Hill, New York.

    Google Scholar 

  • Giacomini KM, Huang SM, Tweedie DJ, Benet LZ, Brouwer KL, Chu X, Dahlin A, Evers R, Fischer V, Hillgren KM, Hoffmaster KA, Ishikawa T, Keppler D, Kim RB, Lee CA, Niemi M, Polli JW, Sugiyama Y, Swaan PW, Ware JA, Wright SH, Yee SW, Zamek-Gliszczynski MJ and Zhang L (2010) Membrane transporters in drug development. Nat Rev Drug Discov 9:215–236.

    PubMed  CAS  Google Scholar 

  • Gorboulev V, Ulzheimer JC, Akhoundova A, Ulzheimer-Teuber I, Karbach U, Quester S, Baumann C, Lang F, Busch AE and Koepsell H (1997) Cloning and characterization of two human polyspecific organic cation transporters. DNA Cell Biol 16:871–881.

    PubMed  CAS  Google Scholar 

  • Greiner B, Eichelbaum M, Fritz P, Kreichgauer HP, von Richter O, Zundler J and Kroemer HK (1999) The role of intestinal P-glycoprotein in the interaction of digoxin and rifampin. J Clin Invest 104:147–153.

    PubMed  CAS  Google Scholar 

  • Griffith RS, Black HR, Brier GL and Wolny JD (1977) Effect of probenecid on the blood levels and urinary excretion of cefamandole. Antimicrob Agents Chemother 11:809–812.

    PubMed  CAS  Google Scholar 

  • Hagenbuch B and Gui C (2008) Xenobiotic transporters of the human organic anion transporting polypeptides (OATP) family. Xenobiotica 38:778–801.

    PubMed  CAS  Google Scholar 

  • Han JY, Lim HS, Shin ES, Yoo YK, Park YH, Lee JE, Kim HT and Lee JS (2008) Influence of the organic anion-transporting polypeptide 1B1 (OATP1B1) polymorphisms on irinotecan-pharmacokinetics and clinical outcome of patients with advanced non-small cell lung cancer. Lung Cancer 59:69-75.

    PubMed  Google Scholar 

  • Hedman A, Angelin B, Arvidsson A, Beck O, Dahlqvist R, Nilsson B, Olsson M and Schenck-Gustafsson K (1991) Digoxin-verapamil interaction: reduction of biliary but not renal digoxin clearance in humans. Clin Pharmacol Ther 49:256–262.

    PubMed  CAS  Google Scholar 

  • Hedman A, Angelin B, Arvidsson A, Dahlqvist R and Nilsson B (1990) Interactions in the renal and biliary elimination of digoxin: stereoselective difference between quinine and quinidine. Clin Pharmacol Ther 47:20–26.

    PubMed  CAS  Google Scholar 

  • Hedman M, Neuvonen PJ, Neuvonen M, Holmberg C and Antikainen M (2004) Pharmacokinetics and pharmacodynamics of pravastatin in pediatric and adolescent cardiac transplant recipients on a regimen of triple immunosuppression. Clin Pharmacol Ther 75:101–109.

    PubMed  CAS  Google Scholar 

  • Hirano M, Maeda K, Shitara Y and Sugiyama Y (2006) Drug-drug interaction between pitavastatin and various drugs via OATP1B1. Drug Metab Dispos 34:1229–1236.

    PubMed  CAS  Google Scholar 

  • Ho RH and Kim RB (2005) Transporters and drug therapy: implications for drug disposition and disease. Clin Pharmacol Ther 78:260–277.

    PubMed  CAS  Google Scholar 

  • Hosoyamada M, Sekine T, Kanai Y and Endou H (1999) Molecular cloning and functional expression of a multispecific organic anion transporter from human kidney. Am J Physiol 276:F122–128.

    PubMed  CAS  Google Scholar 

  • Huang SM and Woodcock J (2010) Transporters in drug development: advancing on the Critical Path. Nat Rev Drug Discov 9(3):175–176.

    PubMed  CAS  Google Scholar 

  • Igel S, Drescher S, Murdter T, Hofmann U, Heinkele G, Tegude H, Glaeser H, Brenner SS, Somogyi AA, Omari T, Schafer C, Eichelbaum M and Fromm MF (2007) Increased absorption of digoxin from the human jejunum due to inhibition of intestinal transporter-mediated efflux. Clin Pharmacokinet 46:777–785.

    PubMed  CAS  Google Scholar 

  • Inotsume N, Nishimura M, Nakano M, Fujiyama S and Sato T (1990) The inhibitory effect of probenecid on renal excretion of famotidine in young, healthy volunteers. J Clin Pharmacol 30:50–56.

    PubMed  CAS  Google Scholar 

  • Ishikawa T, Sakurai A, Kanamori Y, Nagakura M, Hirano H, Takarada Y, Yamada K, Fukushima K and Kitajima M (2005) High-speed screening of human ATP-binding cassette transporter function and genetic polymorphisms: new strategies in pharmacogenomics. Methods Enzymol 400:485–510.

    PubMed  CAS  Google Scholar 

  • Jalava KM, Partanen J and Neuvonen PJ (1997) Itraconazole decreases renal clearance of digoxin. Ther Drug Monit 19:609–613.

    PubMed  CAS  Google Scholar 

  • Jonker JW and Schinkel AH (2004) Pharmacological and physiological functions of the polyspecific organic cation transporters: OCT1, 2, and 3 (SLC22A1-3). J Pharmacol Exp Ther 308:2–9.

    PubMed  CAS  Google Scholar 

  • Juliano RL and Ling V (1976) A surface glycoprotein modulating drug permeability in Chinese hamster ovary cell mutants. Biochim Biophys Acta 455:152–162.

    PubMed  CAS  Google Scholar 

  • Kalliokoski A and Niemi M (2009) Impact of OATP transporters on pharmacokinetics. Br J Pharmacol 158:693–705.

    PubMed  CAS  Google Scholar 

  • Karjalainen MJ, Neuvonen PJ and Backman JT (2006) Rofecoxib is a potent, metabolism-dependent inhibitor of CYP1A2: implications for in vitro prediction of drug interactions. Drug Metab Dispos 34:2091–2096.

    PubMed  CAS  Google Scholar 

  • Kim RB, Leake BF, Choo EF, Dresser GK, Kubba SV, Schwarz UI, Taylor A, Xie HG, McKinsey J, Zhou S, Lan LB, Schuetz JD, Schuetz EG and Wilkinson GR (2001) Identification of functionally variant MDR1 alleles among European Americans and African Americans. Clin Pharmacol Ther 70:189–199.

    PubMed  CAS  Google Scholar 

  • Kimura N, Okuda M and Inui K (2005) Metformin transport by renal basolateral organic cation transporter hOCT2. Pharm Res 22:255–259.

    PubMed  CAS  Google Scholar 

  • Kindla J, Fromm MF and Konig J (2009) In vitro evidence for the role of OATP and OCT uptake transporters in drug-drug interactions. Expert Opin Drug Metab Toxicol 5:489–500.

    PubMed  CAS  Google Scholar 

  • Klaassen CD and Lu H (2008) Xenobiotic transporters: ascribing function from gene knockout and mutation studies. Toxicol Sci 101:186–196.

    PubMed  CAS  Google Scholar 

  • Koepsell H, Lips K and Volk C (2007) Polyspecific organic cation transporters: structure, function, physiological roles, and biopharmaceutical implications. Pharm Res 24:1227–1251.

    PubMed  CAS  Google Scholar 

  • Kohl C (2009) Transporters – the view from industry. Chem Biodivers 6:1988–1999.

    PubMed  CAS  Google Scholar 

  • Koshiba S, An R, Saito H, Wakabayashi K, Tamura A and Ishikawa T (2008) Human ABC transporters ABCG2 (BCRP) and ABCG4. Xenobiotica 38:863–888.

    PubMed  CAS  Google Scholar 

  • Kruijtzer CM, Beijnen JH, Rosing H, ten Bokkel Huinink WW, Schot M, Jewell RC, Paul EM and Schellens JH (2002) Increased oral bioavailability of topotecan in combination with the breast cancer resistance protein and P-glycoprotein inhibitor GF120918. J Clin Oncol 20:2943–2950.

    PubMed  CAS  Google Scholar 

  • Kunta JR and Sinko PJ (2004) Intestinal drug transporters: in vivo function and clinical importance. Curr Drug Metab 5:109–124.

    PubMed  CAS  Google Scholar 

  • Lau YY, Huang Y, Frassetto L and Benet LZ (2007) Effect of OATP1B transporter inhibition on the pharmacokinetics of atorvastatin in healthy volunteers. Clin Pharmacol Ther 81:194–204.

    PubMed  CAS  Google Scholar 

  • Launay O, Sadorge C, Jolly N, Poirier B, Bechet S, van der Vliet D, Seffer V, Fenner N, Dowling K, Giemza R, Johnson J, Ndiaye A, Vray M, Sansonetti P, Morand P, Poyart C, Lewis D and Gougeon ML (2009) Safety and immunogenicity of SC599, an oral live attenuated Shigella dysenteriae type-1 vaccine in healthy volunteers: results of a Phase 2, randomized, double-blind placebo-controlled trial. Vaccine 27:1184–1191.

    PubMed  CAS  Google Scholar 

  • Leslie EM, Deeley RG and Cole SP (2005) Multidrug resistance proteins: role of P-glycoprotein, MRP1, MRP2, and BCRP (ABCG2) in tissue defense. Toxicol Appl Pharmacol 204:216–237.

    PubMed  CAS  Google Scholar 

  • Li M, Anderson GD and Wang J (2006) Drug-drug interactions involving membrane transporters in the human kidney. Expert Opin Drug Metab Toxicol 2:505–532.

    PubMed  CAS  Google Scholar 

  • Lin JH (2003) Drug-drug interaction mediated by inhibition and induction of P-glycoprotein. Adv Drug Deliv Rev 55:53–81.

    PubMed  CAS  Google Scholar 

  • Link E, Parish S, Armitage J, Bowman L, Heath S, Matsuda F, Gut I, Lathrop M and Collins R (2008) SLCO1B1 variants and statin-induced myopathy – a genomewide study. N Engl J Med 359:789–799.

    PubMed  CAS  Google Scholar 

  • Maeda K and Sugiyama Y (2008) Impact of genetic polymorphisms of transporters on the pharmacokinetic, pharmacodynamic and toxicological properties of anionic drugs. Drug Metab Pharmacokinet 23:223–235.

    PubMed  CAS  Google Scholar 

  • Mahar Doan KM, Humphreys JE, Webster LO, Wring SA, Shampine LJ, Serabjit-Singh CJ, Adkison KK and Polli JW (2002) Passive permeability and P-glycoprotein-mediated efflux differentiate central nervous system (CNS) and non-CNS marketed drugs. J Pharmacol Exp Ther 303:1029–1037.

    PubMed  Google Scholar 

  • Mao Q and Unadkat JD (2005) Role of the breast cancer resistance protein (ABCG2) in drug transport. AAPS J 7:E118–133.

    PubMed  CAS  Google Scholar 

  • Marchetti S, Mazzanti R, Beijnen JH and Schellens JH (2007) Concise review: Clinical relevance of drug drug and herb drug interactions mediated by the ABC transporter ABCB1 (MDR1, P-glycoprotein). Oncologist 12:927–941.

    PubMed  Google Scholar 

  • Matsushima S, Maeda K, Kondo C, Hirano M, Sasaki M, Suzuki H and Sugiyama Y (2005) Identification of the hepatic efflux transporters of organic anions using double-transfected Madin-Darby canine kidney II cells expressing human organic anion-transporting polypeptide 1B1 (OATP1B1)/multidrug resistance-associated protein 2, OATP1B1/multidrug resistance 1, and OATP1B1/breast cancer resistance protein. J Pharmacol Exp Ther 314:1059–1067.

    PubMed  CAS  Google Scholar 

  • Morimoto K, Oishi T, Ueda S, Ueda M, Hosokawa M and Chiba K (2004) A novel variant allele of OATP-C (SLCO1B1) found in a Japanese patient with pravastatin-induced myopathy. Drug Metab Pharmacokinet 19:453–455.

    PubMed  CAS  Google Scholar 

  • Motohashi H, Uwai Y, Hiramoto K, Okuda M and Inui K (2004) Different transport properties between famotidine and cimetidine by human renal organic ion transporters (SLC22A). Eur J Pharmacol 503:25–30.

    PubMed  CAS  Google Scholar 

  • Muck W, Mai I, Fritsche L, Ochmann K, Rohde G, Unger S, Johne A, Bauer S, Budde K, Roots I, Neumayer HH and Kuhlmann J (1999) Increase in cerivastatin systemic exposure after single and multiple dosing in cyclosporine-treated kidney transplant recipients. Clin Pharmacol Ther 65:251–261.

    PubMed  CAS  Google Scholar 

  • Neuvonen PJ, Niemi M and Backman JT (2006) Drug interactions with lipid-lowering drugs: mechanisms and clinical relevance. Clin Pharmacol Ther 80:565–581.

    PubMed  CAS  Google Scholar 

  • Niemi M, Backman JT, Fromm MF, Neuvonen PJ and Kivisto KT (2003) Pharmacokinetic interactions with rifampicin: clinical relevance. Clin Pharmacokinet 42:819–850.

    PubMed  CAS  Google Scholar 

  • Niemi M, Backman JT, Neuvonen M and Neuvonen PJ (2003) Effects of gemfibrozil, itraconazole, and their combination on the pharmacokinetics and pharmacodynamics of repaglinide: potentially hazardous interaction between gemfibrozil and repaglinide. Diabetologia 46:347–351.

    PubMed  CAS  Google Scholar 

  • Nigam SK, Bush KT and Bhatnagar V (2007) Drug and toxicant handling by the OAT organic anion transporters in the kidney and other tissues. Nat Clin Pract Nephrol 3:443–448.

    PubMed  CAS  Google Scholar 

  • Nozaki Y, Kusuhara H, Kondo T, Iwaki M, Shiroyanagi Y, Nakayama H, Horita S, Nakazawa H, Okano T and Sugiyama Y (2007) Species difference in the inhibitory effect of nonsteroidal anti-inflammatory drugs on the uptake of methotrexate by human kidney slices. J Pharmacol Exp Ther 322:1162–1170.

    PubMed  CAS  Google Scholar 

  • Olbricht C, Wanner C, Eisenhauer T, Kliem V, Doll R, Boddaert M, O’Grady P, Krekler M, Mangold B and Christians U (1997) Accumulation of lovastatin, but not pravastatin, in the blood of cyclosporine-treated kidney graft patients after multiple doses. Clin Pharmacol Ther 62:311–321.

    PubMed  CAS  Google Scholar 

  • Pang KS and Gillette JR (1978) Kinetics of metabolite formation and elimination in the perfused rat liver preparation: differences between the elimination of preformed acetaminophen and acetaminophen formed from phenacetin. J Pharmacol Exp Ther 207:178–194.

    PubMed  CAS  Google Scholar 

  • Pedersen KE, Christiansen BD, Klitgaard NA and Nielsen-Kudsk F (1983) Effect of quinidine on digoxin bioavailability. Eur J Clin Pharmacol 24:41–47.

    PubMed  CAS  Google Scholar 

  • Poirier A, Funk C, Lave T and Noe J (2007) New strategies to address drug-drug interactions involving OATPs. Curr Opin Drug Discov Devel 10:74–83.

    PubMed  CAS  Google Scholar 

  • Regazzi MB, Iacona I, Campana C, Raddato V, Lesi C, Perani G, Gavazzi A and Vigano M (1993) Altered disposition of pravastatin following concomitant drug therapy with cyclosporin A in transplant recipients. Transplant Proc 25:2732–2734.

    PubMed  CAS  Google Scholar 

  • Rengelshausen J, Goggelmann C, Burhenne J, Riedel KD, Ludwig J, Weiss J, Mikus G, Walter-Sack I and Haefeli WE (2003) Contribution of increased oral bioavailability and reduced nonglomerular renal clearance of digoxin to the digoxin-clarithromycin interaction. Br J Clin Pharmacol 56:32–38.

    PubMed  CAS  Google Scholar 

  • Sadeque AJ, Wandel C, He H, Shah S and Wood AJ (2000) Increased drug delivery to the brain by P-glycoprotein inhibition. Clin Pharmacol Ther 68:231–237.

    PubMed  CAS  Google Scholar 

  • Sasongko L, Link JM, Muzi M, Mankoff DA, Yang X, Collier AC, Shoner SC and Unadkat JD (2005) Imaging P-glycoprotein transport activity at the human blood-brain barrier with positron emission tomography. Clin Pharmacol Ther 77:503–514.

    PubMed  CAS  Google Scholar 

  • Scheffer GL, Pijnenborg AC, Smit EF, Muller M, Postma DS, Timens W, van der Valk P, de Vries EG and Scheper RJ (2002) Multidrug resistance related molecules in human and murine lung. J Clin Pathol 55:332–339.

    PubMed  CAS  Google Scholar 

  • Scherrmann JM (2009) Transporters in absorption, distribution, and elimination. Chem Biodivers 6:1933–1942.

    PubMed  CAS  Google Scholar 

  • Schinkel AH and Jonker JW (2003) Mammalian drug efflux transporters of the ATP binding cassette (ABC) family: an overview. Adv Drug Deliv Rev 55:3–29.

    PubMed  CAS  Google Scholar 

  • Schinkel AH, Smit JJ, van Tellingen O, Beijnen JH, Wagenaar E, van Deemter L, Mol CA, van der Valk MA, Robanus-Maandag EC, te Riele HP and et al. (1994) Disruption of the mouse mdr1a P-glycoprotein gene leads to a deficiency in the blood-brain barrier and to increased sensitivity to drugs. Cell 77:491–502.

    PubMed  CAS  Google Scholar 

  • Schneck DW, Birmingham BK, Zalikowski JA, Mitchell PD, Wang Y, Martin PD, Lasseter KC, Brown CD, Windass AS and Raza A (2004) The effect of gemfibrozil on the pharmacokinetics of rosuvastatin. Clin Pharmacol Ther 75:455–463.

    PubMed  CAS  Google Scholar 

  • Shitara Y, Horie T and Sugiyama Y (2006) Transporters as a determinant of drug clearance and tissue distribution. Eur J Pharm Sci 27:425–446.

    PubMed  CAS  Google Scholar 

  • Shitara Y, Itoh T, Sato H, Li AP and Sugiyama Y (2003) Inhibition of transporter-mediated hepatic uptake as a mechanism for drug-drug interaction between cerivastatin and cyclosporin A. J Pharmacol Exp Ther 304:610–616.

    PubMed  CAS  Google Scholar 

  • Shitara Y, Sato H and Sugiyama Y (2005) Evaluation of drug-drug interaction in the hepatobiliary and renal transport of drugs. Annu Rev Pharmacol Toxicol 45:689–723.

    PubMed  CAS  Google Scholar 

  • Shu Y, Brown C, Castro RA, Shi RJ, Lin ET, Owen RP, Sheardown SA, Yue L, Burchard EG, Brett CM and Giacomini KM (2008) Effect of genetic variation in the organic cation transporter 1, OCT1, on metformin pharmacokinetics. Clin Pharmacol Ther 83:273–280.

    PubMed  CAS  Google Scholar 

  • Shu Y, Sheardown SA, Brown C, Owen RP, Zhang S, Castro RA, Ianculescu AG, Yue L, Lo JC, Burchard EG, Brett CM and Giacomini KM (2007) Effect of genetic variation in the organic cation transporter 1 (OCT1) on metformin action. J Clin Invest 117:1422–1431.

    PubMed  CAS  Google Scholar 

  • Shugarts S and Benet LZ (2009) The role of transporters in the pharmacokinetics of orally administered drugs. Pharm Res 26:2039–2054.

    PubMed  CAS  Google Scholar 

  • Simonson SG, Raza A, Martin PD, Mitchell PD, Jarcho JA, Brown CD, Windass AS and Schneck DW (2004) Rosuvastatin pharmacokinetics in heart transplant recipients administered an antirejection regimen including cyclosporine. Clin Pharmacol Ther 76:167–177.

    PubMed  CAS  Google Scholar 

  • Somogyi A, McLean A and Heinzow B (1983) Cimetidine-procainamide pharmacokinetic interaction in man: evidence of competition for tubular secretion of basic drugs. Eur J Clin Pharmacol 25:339-345.

    PubMed  CAS  Google Scholar 

  • Somogyi A, Stockley C, Keal J, Rolan P and Bochner F (1987) Reduction of metformin renal tubular secretion by cimetidine in man. Br J Clin Pharmacol 23:545–551.

    PubMed  CAS  Google Scholar 

  • Song IS, Shin HJ, Shim EJ, Jung IS, Kim WY, Shon JH and Shin JG (2008) Genetic variants of the organic cation transporter 2 influence the disposition of metformin. Clin Pharmacol Ther 84:559–562.

    PubMed  CAS  Google Scholar 

  • Sun H, Dai H, Shaik N and Elmquist WF (2003) Drug efflux transporters in the CNS. Adv Drug Deliv Rev 55:83–105.

    PubMed  CAS  Google Scholar 

  • Takeda M, Babu E, Narikawa S and Endou H (2002a) Interaction of human organic anion transporters with various cephalosporin antibiotics. Eur J Pharmacol 438:137–142.

    PubMed  CAS  Google Scholar 

  • Takeda M, Khamdang S, Narikawa S, Kimura H, Hosoyamada M, Cha SH, Sekine T and Endou H (2002b) Characterization of methotrexate transport and its drug interactions with human organic anion transporters. J Pharmacol Exp Ther 302:666–671.

    PubMed  CAS  Google Scholar 

  • Takeda M, Khamdang S, Narikawa S, Kimura H, Kobayashi Y, Yamamoto T, Cha SH, Sekine T and Endou H (2002c) Human organic anion transporters and human organic cation transporters mediate renal antiviral transport. J Pharmacol Exp Ther 300:918–924.

    PubMed  CAS  Google Scholar 

  • Thompson TN (2005) Drug metabolism in-vitro and in-vivo results: how do these data support drug discovery? in “Using Mass Spectrometry for Drug Metabolism” (Walter Korfmacher, ed) CRC Press, Boca Raton, FL.

    Google Scholar 

  • Thyss A, Milano G, Kubar J, Namer M and Schneider M (1986) Clinical and pharmacokinetic evidence of a life-threatening interaction between methotrexate and ketoprofen. Lancet 1:256–258.

    PubMed  CAS  Google Scholar 

  • Troger U, Stotzel B, Martens-Lobenhoffer J, Gollnick H and Meyer FP (2002) Drug points: Severe myalgia from an interaction between treatments with pantoprazole and methotrexate. BMJ 324:1497.

    PubMed  CAS  Google Scholar 

  • Tsuji A (2002) Transporter-mediated drug interactions. Drug Metab Pharmacokinet 17:253–274.

    PubMed  CAS  Google Scholar 

  • Tsuji A and Tamai I (1996) Carrier-mediated intestinal transport of drugs. Pharm Res 13:963–977.

    PubMed  CAS  Google Scholar 

  • Unadkat JD, Dahlin A and Vijay S (2004) Placental drug transporters. Curr Drug Metab 5:125–131.

    PubMed  CAS  Google Scholar 

  • Uwai Y, Saito H and Inui K (2000) Interaction between methotrexate and nonsteroidal anti-inflammatory drugs in organic anion transporter. Eur J Pharmacol 409:31–36.

    PubMed  CAS  Google Scholar 

  • van de Steeg E, van der Kruijssen CM, Wagenaar E, Burggraaff JE, Mesman E, Kenworthy KE and Schinkel AH (2009) Methotrexate pharmacokinetics in transgenic mice with liver-specific expression of human organic anion-transporting polypeptide 1B1 (SLCO1B1). Drug Metab Dispos 37:277–281.

    PubMed  Google Scholar 

  • VanWert AL, Gionfriddo MR and Sweet DH (2010) Organic anion transporters: discovery, pharmacology, regulation and roles in pathophysiology. Biopharm Drug Dispos 31:1–71.

    PubMed  CAS  Google Scholar 

  • Waller ES, Sharanevych MA and Yakatan GJ (1982) The effect of probenecid on nafcillin disposition. J Clin Pharmacol 22:482–489.

    PubMed  CAS  Google Scholar 

  • Wandel C, Kim RB, Kajiji S, Guengerich P, Wilkinson GR and Wood AJ (1999) P-glycoprotein and cytochrome P-450 3A inhibition: dissociation of inhibitory potencies. Cancer Res 59:3944–3948.

    PubMed  CAS  Google Scholar 

  • Wang EJ, Casciano CN, Clement RP and Johnson WW (2001) Active transport of fluorescent P-glycoprotein substrates: evaluation as markers and interaction with inhibitors. Biochem Biophys Res Commun 289:580–585.

    PubMed  CAS  Google Scholar 

  • Wang JS, Neuvonen M, Wen X, Backman JT and Neuvonen PJ (2002) Gemfibrozil inhibits CYP2C8-mediated cerivastatin metabolism in human liver microsomes. Drug Metab Dispos 30:1352–1356

    PubMed  Google Scholar 

  • Watanabe T, Kusuhara H, Maeda K, Shitara Y and Sugiyama Y (2009) Physiologically based pharmacokinetic modeling to predict transporter-mediated clearance and distribution of pravastatin in humans. J Pharmacol Exp Ther 328:652–662.

    PubMed  CAS  Google Scholar 

  • Welling PG, Dean S, Selen A, Kendall MJ and Wise R (1979) Probenecid: an unexplained effect on cephalosporin pharmacology. Br J Clin Pharmacol 8:491–495.

    PubMed  CAS  Google Scholar 

  • Wright SH (2005) Role of organic cation transporters in the renal handling of therapeutic agents and xenobiotics. Toxicol Appl Pharmacol 204:309–319.

    PubMed  CAS  Google Scholar 

  • Wu CY and Benet LZ (2005) Predicting drug disposition via application of BCS: transport/absorption/elimination interplay and development of a biopharmaceutics drug disposition classification system. Pharm Res 22:11–23.

    PubMed  CAS  Google Scholar 

  • Yamada A, Maeda K, Kamiyama E, Sugiyama D, Kondo T, Shiroyanagi Y, Nakazawa H, Okano T, Adachi M, Schuetz JD, Adachi Y, Hu Z, Kusuhara H and Sugiyama Y (2007) Multiple human isoforms of drug transporters contribute to the hepatic and renal transport of olmesartan, a selective antagonist of the angiotensin II AT1-receptor. Drug Metab Dispos 35:2166–2176.

    PubMed  CAS  Google Scholar 

  • Yamashiro W, Maeda K, Hirouchi M, Adachi Y, Hu Z and Sugiyama Y (2006) Involvement of transporters in the hepatic uptake and biliary excretion of valsartan, a selective antagonist of the angiotensin II AT1-receptor, in humans. Drug Metab Dispos 34:1247–1254.

    PubMed  CAS  Google Scholar 

  • Yamazaki M, Suzuki H and Sugiyama Y (1996) Recent advances in carrier-mediated hepatic uptake and biliary excretion of xenobiotics. Pharm Res 13:497–513.

    PubMed  CAS  Google Scholar 

  • Yasui-Furukori N, Uno T, Sugawara K and Tateishi T (2005) Different effects of three transporting inhibitors, verapamil, cimetidine, and probenecid, on fexofenadine pharmacokinetics. Clin Pharmacol Ther 77:17–23.

    PubMed  CAS  Google Scholar 

  • Yi SY, Hong KS, Lim HS, Chung JY, Oh DS, Kim JR, Jung HR, Cho JY, Yu KS, Jang IJ and Shin SG (2004) A variant 2677A allele of the MDR1 gene affects fexofenadine disposition. Clin Pharmacol Ther 76:418–427.

    PubMed  CAS  Google Scholar 

  • Zair ZM, Eloranta JJ, Stieger B and Kullak-Ublick GA (2008) Pharmacogenetics of OATP (SLC21/SLCO), OAT and OCT (SLC22) and PEPT (SLC15) transporters in the intestine, liver and kidney. Pharmacogenomics 9:597–624.

    PubMed  CAS  Google Scholar 

  • Zhang L, Reynolds KS, Zhao P and Huang SM (2010) Drug interactions evaluation: an integrated part of risk assessment of therapeutics. Toxicol Appl Pharmacol 243:134–145.

    PubMed  CAS  Google Scholar 

  • Zhang L, Zhang Y, Strong JM, Reynolds KS and Huang S-M (2008) A regulatory viewpoint on transporter-based drug interactions. Xenobiotica 38:709–724.

    PubMed  CAS  Google Scholar 

  • Zhang Y and Benet LZ (2001) The gut as a barrier to drug absorption: combined role of cytochrome P450 3A and P-glycoprotein. Clin Pharmacokinet 40:159–168.

    PubMed  CAS  Google Scholar 

  • Zhou S-F (2008) Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition. Xenobiotica 38:802–832.

    PubMed  CAS  Google Scholar 

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Thompson, T.N. (2011). The Clinical Significance of Drug Transporters in Drug Disposition and Drug Interactions. In: Bonate, P., Howard, D. (eds) Pharmacokinetics in Drug Development. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-7937-7_13

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