ABSTRACT:This report describes a newly identified potential of grapefruit juice (GFJ) in mediating pharmacokinetic drug interactions due to its capability to inhibit esterase. The study demonstrates that GFJ inhibits purified porcine esterase activity toward p-nitrophenyl acetate and the prodrugs lovastatin and enalapril. In rat and human hepatic or gut S9 fractions and rat gut lumen, GFJ inhibited the hydrolysis of enalapril and lovastatin, which are known to be metabolized principally by esterases, lovastatin being metabolized also by CYP3A. In Caco-2 cells, with minimal CYP3A activity, permeability of these prodrugs was increased in the presence of GFJ. In rats, oral coadministration of GFJ or an esterase inhibitor, bis-(p-nitrophenylphosphate), with the prodrugs led to respective increases in plasma area under the curve by 70% or 57% for enalaprilat and 279% or 141% for lovastatin acid. In addition, portal vein-cannulated rats pretreated with GFJ at ؊15 and ؊2 h before lovastatin administration (10 mg/kg p.o.) as a solution, 1) in water and 2) in GFJ, showed, respectively, a 49% increase (CYP3A-inhibited) and a 116% increase (both CYP3A and gut esteraseinhibited) in the portal plasma exposure to the active acid, compared with a non-GFJ pretreatment group. Overall, along with the CYP3A inactivation by GFJ, the decreased esterase activity also played a significant role in increasing the metabolic stability and permeability of esters leading to enhancement of exposure to the active drugs in rats. These new esterase inhibition findings indicate that the potential of drug interaction between ester prodrugs and GFJ should also be considered in the clinic.Since the first report of the grapefruit juice (GFJ) effect on the oral bioavailability of felodipine (Bailey et al., 1989(Bailey et al., , 1991, the effect of grapefruit juice ingestion on oral pharmacokinetics has been reported for approximately 40 drugs (Saito et al., 2005), generally related to CYP3A inhibition. These drugs differ in their chemical and pharmacological properties but are, in common, extensively metabolized by CYP3A. The mechanism of action thus was postulated to be competitive and mechanism-based inhibition of CYP3A4/5 (hereafter referred to as CYP3A) in the small intestine by GFJ (Schmiedlin-Ren et al., 1997;He et al., 1998). Although some recent reports point to the inhibitory effects of grapefruit juice on the function of P-glycoprotein (Zhou et al., 2004) and OATP (Dresser et al., 2002), the contribution to the bioavailability of drugs that are substrates of P-glycoprotein and OATP has not been well established. It is interesting to note that the magnitude of GFJ effect varied greatly, and we noted that the magnitude of GFJ effect was not proportional to the extent of CYP3A-mediated intestinal metabolism. As an example, cyclosporine, which is extensively metabolized in human intestine by CYP3A, led to only a weak interaction with GFJ (Ducharme et al., 1995), the interaction unlikely to be of clinical significance. However, lovastatin, which...