Influence of concomitant quinidine administration on dextromethorphan disposition in rats

J Vet Pharmacol Ther. 2004 Apr;27(2):111-4. doi: 10.1111/j.1365-2885.2004.00559.x.

Abstract

High doses of dextromethorphan (DM) have been clinically investigated for the treatment of multiple neuronal disorders including neuropathic pain. Several authors have suggested the concomitant administration of DM and a CYP2D6 reversible inhibitor in order to enhance the exposure of DM and limit the exposure to total dextrorphan (DX). The present study proposes to determine whether or not a single dose of quinidine is sufficient to enhance the plasma concentrations of DM in rats and keep those of DX at a minimal level. Oral doses of DM (50 mg/kg) were administered with increasing dose levels of quinidine (0, 2, 20, and 50 mg/kg) to male Sprague-Dawley rats and blood samples were collected over 24 h. Plasma concentrations of DM and total DX were determined using ESI-LC/MS/MS. Quinidine coadministration resulted in a more than twofold increase in the area under the curve of DM with an ED(50) of approximately 2 mg/kg whereas those of total DX were only increased by 21%. These results support the working hypothesis that a single dose of quinidine may enhance the plasma concentrations of DM relative to those of total DX and may therefore improve the treatment of neuropathic pain.

MeSH terms

  • Animals
  • Antitussive Agents / metabolism
  • Antitussive Agents / pharmacokinetics*
  • Area Under Curve
  • Dextromethorphan / metabolism
  • Dextromethorphan / pharmacokinetics*
  • Dose-Response Relationship, Drug
  • Drug Interactions
  • Enzyme Inhibitors / pharmacology*
  • Male
  • Metabolic Clearance Rate
  • Quinidine / pharmacology*
  • Rats
  • Rats, Sprague-Dawley

Substances

  • Antitussive Agents
  • Enzyme Inhibitors
  • Dextromethorphan
  • Quinidine