Table 3.
Drug | Half Maximum Inhibition Concentration (IC50, μM) | Dose (mg/mmol) | Molecular Weight (g/mol) | Peak Plasma Concentration (Cmax, μM) | Maximal Hepatic Inlet Concentration ([I]inlet,max, μM) | Predicted R Value |
---|---|---|---|---|---|---|
Simvastatin Acid | 4.3 | 80/0.183 | 436.6 | 0.058 (40) | 12.274 | 3.85 |
Omeprazole | 84.3 | 80/0.232 | 345.42 | 4.146 (42) | 19.586 | 1.23 |
Alprazolam | 99.5 | 3/0.01 | 308.76 | 0.333 (43) | 0.981 | 1.01 |
Desloratadine | 140.5 | 5/0.16 | 310.8 | 0.015 (44) | 1.088 | 1.01 |
Dose is the highest proposed clinical dose; Cmax is the peak plasma concentration at the highest proposed clinical dose; [I]inlet,max was estimated as Cmax + (ka x Dose x FaFg/Qh) (13), where Qh is the hepatic blood flow (1500 mL/min), ka is the absorption rate constant, and FaFg is the fraction of oral dose that reaches the liver. Because the values of ka and FaFg were not available, for conservative predictions, they were assumed equal to the theoretical maxima of 0.1 min−1 and 1 (13), respectively. R values were estimated as 1 + [I]inlet,max/Ki. Because the concentration of E217βDG (1 μM) was well below its Km (45, 46), the Kis were approximated by the IC50s based on Ki = IC50/(1 + [S]/Km) (47). For simvastatin acid, the Cmax and dose were assumed equal to those of simvastatin. For desloratadine, R values were estimated with the Cmax following the highest clinical dose of desloratadine since it is higher than the Cmax following that of loratadine (48, 49).