The objective of the present work was to investigate the potential for pharmacokinetic drug-drug interactions between glimepiride (GMP) and piperazine dithioctate (PDT) in rats to support the development of an orally combined product of the two drugs. An LC-MS/MS bioanalytical method was developed for simultaneous quantification of GMP and thioctic acid (TA) in rat plasma. The accuracy, precision, linearity, selectivity, and recovery were all within an acceptable range. The oral plasma exposure of the GMP solution was more than 14-times greater than that of the GMP suspension at a dose of 0.5 mg/kg, suggesting a dissolutionlimited absorption of the GMP suspension. Oral co-administration of PDT (72 mg/kg) with GMP suspension (0.5 mg/kg) reduced the plasma GMP exposure by approximately 80% without a significant change in t 1/2 and t max . Oral co-administration of PDT with GMP solution had no significant effect on the plasma pharmacokinetics of GMP. PDT lowered the pH (from ca. 7 to 5.6) and the dissolved GMP concentration in the GMP suspension. It was also shown that GMP was more soluble at pH 7 than at 5.7 in an aqueous solution, and the oral plasma exposure of a GMP suspension at pH 7.0 was substantially higher than that of a suspension at pH 5.7. These results suggest that the pH-dependent solubility of GMP was likely responsible for PDT's effect on the oral absorption of GMP. In conclusion, the current work suggests a possibility of drug-drug interaction between GMP and PDT upon oral co-administration.Key words glimepiride; piperazine dithioctate; pharmacokinetics; thioctic acid; drug-drug interaction Glimepiride (GMP) (Fig. 1) is a medium-to long-acting oral sulfonylurea widely prescribed to treat type 2 diabetes.
1)GMP lowers blood glucose by stimulating the release of insulin and by enhancing the activity of intracellular insulin receptors.2,3) GMP is rapidly and completely absorbed following oral administration, with a bioavailability close to 100% and a t max of 2-3 h in humans. 4) GMP is eliminated mainly by metabolism by CYP2C9, and the mean plasma elimination half-life (t 1/2 ) is 5-8 h in humans.
5)Thioctic acid (TA) (Fig. 1) is an antioxidant present in prokaryotic and eukaryotic cells. It has been administered for the treatment of various oxidative stress-related diseases, including alcoholic liver disease, diabetes, glaucoma, and neurodegenerative disorders.6,7) TA can also decrease neuropathy symptoms, therefore, it has been approved as a prescription drug for the treatment of diabetic polyneuropathy, and has been frequently co-prescribed with GMP. [8][9][10][11] TA also is widely available as a nutritional supplement in the United States. TA was shown to be absorbed rapidly with a t max of 0.8 h following a single oral dose of 200 mg in humans, and its mean oral bioavailability is 29.1%, with a mean t 1/2 of 0.5 h.
12)Piperadine dithioctate (PDT) (Fig. 1) is a piperazine salt of TA with physicochemical properties more suitable for formulations than TA itself. The melting points of PDT and TA are...