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Stolte, Maximilian ; Ali, Weaam ; Jänis, Janne ; Gessner, Andre ; El-Najjar, Nahed

Paclitaxel, Imatinib and 5-Fluorouracil Increase the Unbound Fraction of Flucloxacillin In Vitro

Stolte, Maximilian, Ali, Weaam, Jänis, Janne , Gessner, Andre and El-Najjar, Nahed (2020) Paclitaxel, Imatinib and 5-Fluorouracil Increase the Unbound Fraction of Flucloxacillin In Vitro. Antibiotics 9 (6), p. 309.

Date of publication of this fulltext: 16 Jun 2020 15:17
Article
DOI to cite this document: 10.5283/epub.43351


Abstract

Flucloxacillin (FLU), an isoxazolyl penicillin, is widely used for the treatment of different bacterial infections in intensive care units (ICU). Being highly bound to plasma proteins, FLU is prone to drug-drug interactions (DDI) when administered concurrently with other drugs. As FLU is binding to both Sudlow's site I and site II of human serum albumin (HSA), competitive and allosteric ...

Flucloxacillin (FLU), an isoxazolyl penicillin, is widely used for the treatment of different bacterial infections in intensive care units (ICU). Being highly bound to plasma proteins, FLU is prone to drug-drug interactions (DDI) when administered concurrently with other drugs. As FLU is binding to both Sudlow's site I and site II of human serum albumin (HSA), competitive and allosteric interactions with other drugs, highly bound to the same sites, seem conceivable. Knowledge about interaction(s) of FLU with the widely used anticancer agents paclitaxel (PAC), imatinib (IMA), and 5-fluorouracil (5-FU is scarce. The effects of the selected anticancer agents on the unbound fraction of FLU were evaluated in pooled plasma as well as in HSA and alpha-1-acid glycoprotein (AGP) samples, the second major drug carrier in plasma. FLU levels in spiked samples were analyzed by LC-MS/MS after ultrafiltration. Significant increase in FLU unbound fraction was observed when in combination with PAC and IMA and to a lesser extent with 5-FU. Furthermore, significant binding of FLU to AGP was observed. Collectively, this is the first study showing the binding of FLU to AGP as well as demonstrating a significant DDI between PAC/IMA/5-FU and FLU.



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Details

Item typeArticle
Journal or Publication TitleAntibiotics
Publisher:MDPI
Place of Publication:BASEL
Volume:9
Number of Issue or Book Chapter:6
Page Range:p. 309
Date8 June 2020
InstitutionsMedicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Identification Number
ValueType
10.3390/antibiotics9060309DOI
KeywordsDRUG-DRUG INTERACTIONS; HUMAN SERUM-ALBUMIN; CRITICALLY-ILL PATIENTS; PROTEIN-BINDING; CANCER-PATIENTS; ALPHA-1-ACID GLYCOPROTEIN; CLINICAL-PHARMACOLOGY; ALLOSTERIC MODULATION; ANTICANCER DRUGS; PHARMACOKINETICS; albumin; alpha-1-acid glycoprotein; drug-drug interactions; anti-infective agents; ultrafiltration; cancer
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-433514
Item ID43351

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