Sulpiride, a dopamine D 2 receptor antagonist, is widely used for the treatment of schizophrenia, depression, and gastric and duodenal ulcers because it has a much lower incidence of extrapyramidal side effects than any other antagonist of this type.1,2) Optimization of treatment with sulpiride requires knowledge of its bioavailability, pharmacokinetics, and pharmacodynamics in humans. Mizuno et al. showed that the main site of sulpiride absorption is the intestine.3)The bioavailability of sulpiride shows species differences: it is low in some species, a mean of 27% in humans and 15-20% in rat, whereas it is relatively high (44-85%) in dogs.
4)The low bioavailability in humans is probably due to poor absorption.3) Baluom et al. 5) reported that the intestinal absorption of sulpiride was increased when it was concomitantly administered with the substrates of P-glycoprotein, verapamil, and quinidine in rats. They speculated that the poor oral bioavailability of sulpiride was caused by brush border P-glycoprotein efflux.In previous studies, we investigated the transcellular transport of sulpiride using the human intestinal cell line Caco-2. 6,7) Our results indicated that the apical-to-basolateral transport of sulpiride was significantly inhibited by the substrates or inhibitors of peptide transporter PEPT1, and organic cation transporters OCTN1 and/or OCTN2. On the other hand, the basolateral-to-apical transport was significantly inhibited by the substrates or inhibitors of P-glycoprotein on the apical membrane, and basolateral peptide transporter and organic cation transporter OCT1 on the basolateral membrane. From these findings, we speculated that a decrease in the absorption of sulpiride may occur in combination therapy involving the substrates or inhibitors of PEPT1, OCTN1, and OCTN2; conversely, the concomitant administration of the substrates or inhibitors of P-glycoprotein and OCT1 may increase the absorption of sulpiride.To determine the appropriate clinical administration of sulpiride, we consider it essential to investigate its interactions with drug transporters. Drug transporters corresponding to human drug transporters such as P-glycoprotein, organic cation and anion transporters, and peptide transporters are expressed in the rat intestine. The aim of this study was to investigate whether the concomitant administration of sulpiride and the substrates or inhibitors of PEPT1, OCTN1, OCTN2, OCT1, and P-glycoprotein affects the intestinal absorption and the pharmacokinetic behavior of sulpiride after oral administration in rats.
MATERIALS AND METHODS
MaterialsSulpiride and cephalexin hydrate were purchased from ICN Biomedicals, Inc. (Costa Mesa, CA, U.S.A.). L-Carnitine was purchased from Sigma (St. Louis, MO, U.S.A.). Captopril, carboxymethyl cellulose sodium salt (CMC-Na), choline chloride, cyclosporin A, quinidine, verapamil hydrochloride, and nicotinic acid were purchased from Wako Pure Chemical Industries (Osaka, Japan). Guanidine was purchased from Kanto Chemical (Tokyo, Japan). All chemicals us...