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Received for publication January 23, 2007.
Revised May 29, 2007.
Accepted for publication May 30, 2007.
Pyrazinamide (PZA) is widely used in combination with other drugs in chemotherapy for tuberculosis (TB). However, the dose-related liver injury is the main adverse effect of PZA and its metabolite (pyrazinoic acid; PA). Silibinin is the main flavonoid extracted from milk thistle (Silybum marianum), and it displays hepatoprotective properties. This study investigates the pharmacokinetics of PZA and PA, and their interaction with silibinin in rats. The parallel study design was divided into six groups: PZA alone, PZA + long-term silibinin exposure, PZA + concomitant short-term silibinin exposure, PA alone, PA + long-term silibinin exposure, and PA + concomitant short-term silibinin exposure groups. The results indicate that the distribution ratio of PZA from bile-to-blood (AUCbile/AUCblood) in the PZA + long-term silibinin exposure and PZA + concomitant short-term silibinin exposure groups was also not significantly different when compared with the PZA alone group. However, the bile-to-blood distribution ratio of PA was significantly decreased from the PA + long-term silibinin exposure and the PA + concomitant short-term silibinin exposure groups. Upon PZA administration, the blood but not bile levels of PA were markedly increased in the PZA + long-term silibinin exposure and PZA + concomitant short-term silibinin exposure groups but the bile-to-blood ratio of PA was decreased. These results suggest that the excretion pathway of PA might be blocked by silibinin through xanthine oxidase and hepatobiliary excretion.
Key words:
analytical chemistry, biliary excretion, drug disposition, drug interactions, drug-drug interactions, excretion, hepatobiliary disposition, hepatobiliary transport, HPLC, pharmacokinetics
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