Skip to main content
Top
Published in: Advances in Therapy 8/2019

01-08-2019 | Premature Ejaculation | Original Research

Impacts of Cytochrome P450 2D6*10 Allele and a High-Fat Meal on the Pharmacokinetics of Dapoxetine in Healthy Chinese Men: A Single-Dose, Two-Treatment Study

Authors: Shiwei Tang, Ping Zhao, Liang Zheng, Chengming Wen, Ling Wang, Xuehua Jiang

Published in: Advances in Therapy | Issue 8/2019

Login to get access

Abstract

Introduction

Factors that impact the pharmacokinetics of dapoxetine, a 5-HT selective reuptake inhibitor used for the treatment of premature ejaculation, have not been clearly identified. This study aimed to evaluate the effects of consumption of a high-fat meal and cytochrome P450 (CYP) 2D6 polymorphisms on the pharmacokinetics of dapoxetine in healthy Chinese men.

Methods

Twenty-two healthy volunteers were enrolled and classified based on their CYP2D6 genotype. A single-dose, two-treatment (fasted and fed), two-period, one-sequence pharmacokinetic study was conducted. Plasma concentrations of the drug were determined using LC-MS. Pharmacokinetic parameters were calculated by a noncompartmental analysis.

Results

The consumption of food significantly prolonged the time required for dapoxetine to reach its peak concentration and area under the concentration-time curve (AUC0–48) (p < 0.01). Compared with that in *1/*10 and *2/*10 genotypes, the dapoxetine plasma exposure in *10/*10 individuals was notably increased. The AUC0–48 value for *10/*10 was significantly higher than that for *1/*10 and *2/*10 (p < 0.05).

Conclusion

The obtained results demonstrated that a high-fat meal and the CYP2D6 *10/*10 genotype influence the pharmacokinetic properties of dapoxetine and may thus have potential clinical implications. Future studies focusing on safe dapoxetine dosing based on CYP2D6 genotyping are needed.

Funding

This study was partially sponsored by Xiamen Fuman Pharmaceutical Co., Ltd. The article processing charges were funded by The People’s Hospital of Dujiangyan City.
Appendix
Available only for authorised users
Literature
2.
go back to reference Russo A, Capogrosso P, Ventimiglia E, La Croce G, Boeri L, Montorsi F, et al. Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review. Int J Clin Pract. 2016;70(9):723–33.CrossRefPubMed Russo A, Capogrosso P, Ventimiglia E, La Croce G, Boeri L, Montorsi F, et al. Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review. Int J Clin Pract. 2016;70(9):723–33.CrossRefPubMed
3.
go back to reference Andersson KE, Mulhall JP, Wyllie MG. Pharmacokinetic and pharmacodynamic features of dapoxetine, a novel drug for ‘on-demand’ treatment of premature ejaculation. BJU Int. 2006;97(2):311–5.CrossRefPubMed Andersson KE, Mulhall JP, Wyllie MG. Pharmacokinetic and pharmacodynamic features of dapoxetine, a novel drug for ‘on-demand’ treatment of premature ejaculation. BJU Int. 2006;97(2):311–5.CrossRefPubMed
4.
go back to reference Modi NB, Dresser MJ, Simon M, Lin D, Desai D, Gupta S. Single- and multiple-dose pharmacokinetics of dapoxetine hydrochloride, a novel agent for the treatment of premature ejaculation. J Clin Pharmacol. 2006;46(3):301–9.CrossRefPubMed Modi NB, Dresser MJ, Simon M, Lin D, Desai D, Gupta S. Single- and multiple-dose pharmacokinetics of dapoxetine hydrochloride, a novel agent for the treatment of premature ejaculation. J Clin Pharmacol. 2006;46(3):301–9.CrossRefPubMed
5.
go back to reference Modi NB, Nath R, Staehr P, Gupta SK, Aquilina JW, Rivas D. Pharmacokinetic, pharmacodynamic, and electrocardiographic effects of dapoxetine and moxifloxacin compared with placebo in healthy adult male subjects. J Clin Pharmacol. 2009;49(6):634–42.CrossRefPubMed Modi NB, Nath R, Staehr P, Gupta SK, Aquilina JW, Rivas D. Pharmacokinetic, pharmacodynamic, and electrocardiographic effects of dapoxetine and moxifloxacin compared with placebo in healthy adult male subjects. J Clin Pharmacol. 2009;49(6):634–42.CrossRefPubMed
6.
go back to reference Thyssen A, Sharma O, Tianmei S, Aquilina JW, Vandebosch A, Wang SS, et al. Pharmacokinetics of dapoxetine hydrochloride in healthy Chinese, Japanese, and Caucasian men. J Clin Pharmacol. 2010;50(12):1450–60.CrossRefPubMed Thyssen A, Sharma O, Tianmei S, Aquilina JW, Vandebosch A, Wang SS, et al. Pharmacokinetics of dapoxetine hydrochloride in healthy Chinese, Japanese, and Caucasian men. J Clin Pharmacol. 2010;50(12):1450–60.CrossRefPubMed
8.
go back to reference Dresser MJ, Kang D, Staehr P, Gidwani S, Guo C, Mulhall JP, et al. Pharmacokinetics of dapoxetine, a new treatment for premature ejaculation: impact of age and effects of a high-fat meal. J Clin Pharmacol. 2006;46(9):1023–9.CrossRefPubMed Dresser MJ, Kang D, Staehr P, Gidwani S, Guo C, Mulhall JP, et al. Pharmacokinetics of dapoxetine, a new treatment for premature ejaculation: impact of age and effects of a high-fat meal. J Clin Pharmacol. 2006;46(9):1023–9.CrossRefPubMed
9.
go back to reference Zhang WM, Qiang W, Ying-Fei W, Ming S, Wang R. Development and validation of a sensitive UPLC-MS/MS method for the simultaneous determination of dapoxetine and its two metabolites in human plasma. J Pharm Biomed Anal. 2016;119:45–9.CrossRefPubMed Zhang WM, Qiang W, Ying-Fei W, Ming S, Wang R. Development and validation of a sensitive UPLC-MS/MS method for the simultaneous determination of dapoxetine and its two metabolites in human plasma. J Pharm Biomed Anal. 2016;119:45–9.CrossRefPubMed
10.
go back to reference Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther. 2013;138(1):103–41.CrossRefPubMed Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther. 2013;138(1):103–41.CrossRefPubMed
11.
go back to reference Bahar MA, Setiawan D, Hak E, Wilffert B. Pharmacogenetics of drug-drug interaction and drug-drug-gene interaction: a systematic review on CYP2C9, CYP2C19 and CYP2D6. Pharmacogenomics. 2017;18(7):701–39.CrossRefPubMed Bahar MA, Setiawan D, Hak E, Wilffert B. Pharmacogenetics of drug-drug interaction and drug-drug-gene interaction: a systematic review on CYP2C9, CYP2C19 and CYP2D6. Pharmacogenomics. 2017;18(7):701–39.CrossRefPubMed
12.
go back to reference Teh LK, Bertilsson L. Pharmacogenomics of CYP2D6: molecular genetics, interethnic differences and clinical importance. Drug Metab Pharmacokinet. 2012;27(1):55–67.CrossRefPubMed Teh LK, Bertilsson L. Pharmacogenomics of CYP2D6: molecular genetics, interethnic differences and clinical importance. Drug Metab Pharmacokinet. 2012;27(1):55–67.CrossRefPubMed
13.
go back to reference Gaedigk A, Sangkuhl K, Whirl-Carrillo M, Klein T, Leeder JS. Prediction of CYP2D6 phenotype from genotype across world populations. Genet Med. 2017;19(1):69–76.CrossRefPubMed Gaedigk A, Sangkuhl K, Whirl-Carrillo M, Klein T, Leeder JS. Prediction of CYP2D6 phenotype from genotype across world populations. Genet Med. 2017;19(1):69–76.CrossRefPubMed
14.
go back to reference Hicks JK, Sangkuhl K, Swen JJ, Ellingrod VL, Muller DJ, Shimoda K, et al. Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clin Pharmacol Ther. 2017;102(1):37–44.CrossRefPubMed Hicks JK, Sangkuhl K, Swen JJ, Ellingrod VL, Muller DJ, Shimoda K, et al. Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clin Pharmacol Ther. 2017;102(1):37–44.CrossRefPubMed
15.
go back to reference Kirchheiner J. CYP2D6 phenotype prediction from genotype: which system is the best? Clin Pharmacol Ther. 2008;83(2):225–7.CrossRefPubMed Kirchheiner J. CYP2D6 phenotype prediction from genotype: which system is the best? Clin Pharmacol Ther. 2008;83(2):225–7.CrossRefPubMed
16.
go back to reference Wu X, Yuan L, Zuo J, Lv J, Guo T. The impact of CYP2D6 polymorphisms on the pharmacokinetics of codeine and its metabolites in Mongolian Chinese subjects. Eur J Clin Pharmacol. 2014;70(1):57–63.CrossRefPubMed Wu X, Yuan L, Zuo J, Lv J, Guo T. The impact of CYP2D6 polymorphisms on the pharmacokinetics of codeine and its metabolites in Mongolian Chinese subjects. Eur J Clin Pharmacol. 2014;70(1):57–63.CrossRefPubMed
17.
go back to reference Jin SK, Chung HJ, Chung MW, Kim JI, Kang JH, Woo SW, et al. Influence of CYP2D6*10 on the pharmacokinetics of metoprolol in healthy Korean volunteers. J Clin Pharm Ther. 2008;33(5):567–73.CrossRefPubMed Jin SK, Chung HJ, Chung MW, Kim JI, Kang JH, Woo SW, et al. Influence of CYP2D6*10 on the pharmacokinetics of metoprolol in healthy Korean volunteers. J Clin Pharm Ther. 2008;33(5):567–73.CrossRefPubMed
18.
go back to reference Byeon JY, Kim YH, Na HS, Jang JH, Kim SH, Lee YJ, et al. Effects of the CYP2D6*10 allele on the pharmacokinetics of atomoxetine and its metabolites. Arch Pharm Res. 2015;38(11):2083–91.CrossRefPubMed Byeon JY, Kim YH, Na HS, Jang JH, Kim SH, Lee YJ, et al. Effects of the CYP2D6*10 allele on the pharmacokinetics of atomoxetine and its metabolites. Arch Pharm Res. 2015;38(11):2083–91.CrossRefPubMed
19.
go back to reference Gasso P, Rodriguez N, Mas S, Pagerols M, Blazquez A, Plana MT, et al. Effect of CYP2D6, CYP2C9 and ABCB1 genotypes on fluoxetine plasma concentrations and clinical improvement in children and adolescent patients. Pharmacogenomics J. 2014;14(5):457–62.CrossRefPubMed Gasso P, Rodriguez N, Mas S, Pagerols M, Blazquez A, Plana MT, et al. Effect of CYP2D6, CYP2C9 and ABCB1 genotypes on fluoxetine plasma concentrations and clinical improvement in children and adolescent patients. Pharmacogenomics J. 2014;14(5):457–62.CrossRefPubMed
20.
go back to reference Yin SJ, Ni YB, Wang SM, Wang X, Lou YQ, Zhang GL. Differences in genotype and allele frequency distributions of polymorphic drug metabolizing enzymes CYP2C19 and CYP2D6 in mainland Chinese Mongolian, Hui and Han populations. J Clin Pharm Ther. 2012;37(3):364–9.CrossRefPubMed Yin SJ, Ni YB, Wang SM, Wang X, Lou YQ, Zhang GL. Differences in genotype and allele frequency distributions of polymorphic drug metabolizing enzymes CYP2C19 and CYP2D6 in mainland Chinese Mongolian, Hui and Han populations. J Clin Pharm Ther. 2012;37(3):364–9.CrossRefPubMed
21.
go back to reference Varela N, Quinones LA, Stojanova J, Garay J, Caceres D, Cespedes S, et al. Characterization of the CYP2D6 drug metabolizing phenotypes of the Chilean mestizo population through polymorphism analyses. Pharmacol Res. 2016;110:276.CrossRefPubMed Varela N, Quinones LA, Stojanova J, Garay J, Caceres D, Cespedes S, et al. Characterization of the CYP2D6 drug metabolizing phenotypes of the Chilean mestizo population through polymorphism analyses. Pharmacol Res. 2016;110:276.CrossRefPubMed
22.
go back to reference Harrison-Woolrych M. Patient reporting encouraged during monitoring of dapoxetine in New Zealand. Drug Saf. 2011;34(11):1115–6.CrossRefPubMed Harrison-Woolrych M. Patient reporting encouraged during monitoring of dapoxetine in New Zealand. Drug Saf. 2011;34(11):1115–6.CrossRefPubMed
23.
go back to reference Li J, Yuan H, Bai Y, Pu C, Tang Y, Dong Q, et al. Dapoxetine for premature ejaculation: an updated meta-analysis of randomized controlled trials. Clin Ther. 2014;36(12):2003–14.CrossRefPubMed Li J, Yuan H, Bai Y, Pu C, Tang Y, Dong Q, et al. Dapoxetine for premature ejaculation: an updated meta-analysis of randomized controlled trials. Clin Ther. 2014;36(12):2003–14.CrossRefPubMed
24.
go back to reference Yue FG, Dong L, Hu TT, Qu XY. Efficacy of Dapoxetine for the treatment of premature ejaculation: a meta-analysis of randomized clinical trials on intravaginal ejaculatory latency time, patient-reported outcomes, and adverse events. Urology. 2015;85(4):856–61.CrossRefPubMed Yue FG, Dong L, Hu TT, Qu XY. Efficacy of Dapoxetine for the treatment of premature ejaculation: a meta-analysis of randomized clinical trials on intravaginal ejaculatory latency time, patient-reported outcomes, and adverse events. Urology. 2015;85(4):856–61.CrossRefPubMed
25.
go back to reference Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJ, Shabsigh R, et al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials. Lancet. 2006;368(9539):929–37.CrossRefPubMed Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJ, Shabsigh R, et al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials. Lancet. 2006;368(9539):929–37.CrossRefPubMed
26.
go back to reference Kowey PR, Mudumbi RV, Aquilina JW, DiBattiste PM. Cardiovascular safety profile of dapoxetine during the premarketing evaluation. Drugs R D. 2011;11(1):1–11.CrossRefPubMed Kowey PR, Mudumbi RV, Aquilina JW, DiBattiste PM. Cardiovascular safety profile of dapoxetine during the premarketing evaluation. Drugs R D. 2011;11(1):1–11.CrossRefPubMed
27.
go back to reference Tistaert C, Heimbach T, Xia B, Parrott N, Samant TS, Kesisoglou F. Food effect projections via physiologically based pharmacokinetic modeling: predictive case studies. J Pharm Sci. 2019;108(1):592–602.CrossRefPubMed Tistaert C, Heimbach T, Xia B, Parrott N, Samant TS, Kesisoglou F. Food effect projections via physiologically based pharmacokinetic modeling: predictive case studies. J Pharm Sci. 2019;108(1):592–602.CrossRefPubMed
28.
go back to reference de Jong J, Sukbuntherng J, Skee D, Murphy J, O’Brien S, Byrd JC, et al. The effect of food on the pharmacokinetics of oral ibrutinib in healthy participants and patients with chronic lymphocytic leukemia. Cancer Chemother Pharmacol. 2015;75(5):907–16.CrossRefPubMedPubMedCentral de Jong J, Sukbuntherng J, Skee D, Murphy J, O’Brien S, Byrd JC, et al. The effect of food on the pharmacokinetics of oral ibrutinib in healthy participants and patients with chronic lymphocytic leukemia. Cancer Chemother Pharmacol. 2015;75(5):907–16.CrossRefPubMedPubMedCentral
29.
go back to reference Fouad SA, Shamma RN, Basalious EB, El-Nabarawi MA, Tayel SA. Novel instantly-soluble transmucosal matrix (ISTM) using dual mechanism solubilizer for sublingual and nasal delivery of dapoxetine hydrochloride: in-vitro/in vivo evaluation. Int J Pharmaceut. 2016;505(1–2):212–22.CrossRef Fouad SA, Shamma RN, Basalious EB, El-Nabarawi MA, Tayel SA. Novel instantly-soluble transmucosal matrix (ISTM) using dual mechanism solubilizer for sublingual and nasal delivery of dapoxetine hydrochloride: in-vitro/in vivo evaluation. Int J Pharmaceut. 2016;505(1–2):212–22.CrossRef
30.
go back to reference Tornio A, Backman JT. Cytochrome P450 in pharmacogenetics: an update. Adv Pharmacol. 2018;83:3–32.CrossRefPubMed Tornio A, Backman JT. Cytochrome P450 in pharmacogenetics: an update. Adv Pharmacol. 2018;83:3–32.CrossRefPubMed
31.
go back to reference Dong AN, Tan BH, Pan Y, Ong CE. Cytochrome P450 genotype-guided drug therapies: an update on current states. Clin Exp Pharmacol Physiol. 2018;45(10):991–1001.CrossRefPubMed Dong AN, Tan BH, Pan Y, Ong CE. Cytochrome P450 genotype-guided drug therapies: an update on current states. Clin Exp Pharmacol Physiol. 2018;45(10):991–1001.CrossRefPubMed
Metadata
Title
Impacts of Cytochrome P450 2D6*10 Allele and a High-Fat Meal on the Pharmacokinetics of Dapoxetine in Healthy Chinese Men: A Single-Dose, Two-Treatment Study
Authors
Shiwei Tang
Ping Zhao
Liang Zheng
Chengming Wen
Ling Wang
Xuehua Jiang
Publication date
01-08-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 8/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-019-00982-x

Other articles of this Issue 8/2019

Advances in Therapy 8/2019 Go to the issue