Background:
Chiral safety, especially chiral drug inversion in vivo, is the top priority of current scientific research. Medicine researchers and pharmacists often ignore that one enantiomer will be converted or partially converted to
another enantiomer when it is ingested in vivo. So that, in the context that more than 50% of the listed drugs are chiral drugs,
it is necessary and important to pay attention to the inversion of chiral drugs.
Methods:
The metabolic and stereoselective pharmacokinetic characteristics of seven chiral drugs with one chiral center in
hydroxy group were reviewed by in vivo and in vitro include the possible chiral inversion of each drug enantiomer. These
seven drugs include (S)-Mandelic acid, RS-8359, Tramadol, Venlafaxine, Carvedilol, Fluoxetine and Metoprolol.
Results:
The differences in stereoselective pharmacokinetic could be found for all the seven chiral drugs, since R and S
isomers often exhibit different PK and PD properties. However, not every drug has shown the properties of one direction or
two direction chiral inversion. For chiral hydroxyl group drugs, the redox enzyme system may be one of the key factors for
chiral inversion in vivo.
Conclusion:
In vitro and in vivo chiral inversion is a very complex problem and may occur during every process of ADME.
Nowadays, research on chiral metabolism in the liver has the most attention, while neglecting the chiral transformation of
other processes. Our review may provide basis for the drug R&D and the safety of drugs in clinical therapy.