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Vol. 30, Issue 6, 643-647, June 2002
Division of Clinical Chemistry, Karolinska Institute, Huddinge
University Hospital, Stockholm (S.E.H.A., M.D.), and Preclinical
Development (M.H.) and Research DMPK (S.S.), AstraZeneca R&D,
Södertälje, Sweden
Although lidocaine has been used clinically for more than
half a century, the metabolism has still not been fully elucidated. In
the present study we have addressed the involvement of hydroxylations, deethylations, and ester hydrolysis in the metabolism of lidocaine to
2,6-xylidine. Using microsomes isolated from male rat liver, we found
that lidocaine is mainly metabolized by deethylation to
N-(N-ethylglycyl)-2,6-xylidine, and
N-(N-ethylglycyl)-2,6-xylidine is mainly
metabolized to N-glycyl-2,6-xylidine, also by
deethylation. However, 2,6-xylidine can be formed both from lidocaine
and N-(N-ethylglycyl)-2,6-xylidine, but
not from N-glycyl-2,6-xylidine, in an NADPH-independent
reaction, suggesting that the amido bond in these compounds can be
directly hydrolyzed by esterases. To test this hypothesis, we incubated lidocaine,
N-(N-ethylglycyl)-2,6-xylidine, and
N-glycyl-2,6-xylidine with purified liver
carboxylesterases. Rat liver microsomal carboxylesterase ES-10,
but not carboxylesterase ES-4, hydrolyzed lidocaine and N-(N-ethylglycyl)-2,6-xylidine to
2,6-xylidine, identifying this esterase as a candidate enzyme in the
metabolism of lidocaine.
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