2006
DOI: 10.1124/jpet.106.110379
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Interaction of Nonsteroidal Anti-Inflammatory Drugs with Multidrug Resistance Protein (MRP) 2/ABCC2- and MRP4/ABCC4-Mediated Methotrexate Transport

Abstract: Methotrexate (MTX) has been used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of inflammatory diseases as well as malignancies. Especially at high MTX dosages, severe adverse effects with this combination may occur, usually resulting from an impaired renal elimination. It has been shown that the mechanism of this interaction cannot be fully attributed to inhibition of basolateral MTX uptake in renal proximal tubules. Here, we studied the effect of various NSAIDs on MTX tra… Show more

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Cited by 204 publications
(159 citation statements)
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“…Little is known about the effect of P-glycoprotein or MRP1 modulators on MRP2 and/or MRP4, and further, few (if any) inhibitors specific for the latter transporters have been identified. However, MRP2 and MRP4 transport can be modulated by an array of organic anions, some of which are therapeutically useful agents (Bakos et al, 2000;de Wolf et al, 2007;El-Sheikh et al, 2007). Given the contributions of MRP2 and MRP4 to the pharmacokinetic profiles of numerous therapeutic agents (and hence their efficacy and/or safety) (Russel et al, 2008;Lagas et al, 2009), such information is clinically relevant.…”
Section: Introductionmentioning
confidence: 99%
“…Little is known about the effect of P-glycoprotein or MRP1 modulators on MRP2 and/or MRP4, and further, few (if any) inhibitors specific for the latter transporters have been identified. However, MRP2 and MRP4 transport can be modulated by an array of organic anions, some of which are therapeutically useful agents (Bakos et al, 2000;de Wolf et al, 2007;El-Sheikh et al, 2007). Given the contributions of MRP2 and MRP4 to the pharmacokinetic profiles of numerous therapeutic agents (and hence their efficacy and/or safety) (Russel et al, 2008;Lagas et al, 2009), such information is clinically relevant.…”
Section: Introductionmentioning
confidence: 99%
“…Several experimental models have been developed to investigate the hepatobiliary transporters, their distributions, and functions. These experimental models include liver canalicular membrane vesicles (El-Sheikh et al, 2007), isolated and cultured hepatocytes (Li et al, 1999), isolated perfused liver (Zamek-Gliszczynski et al, 2006), and transporter-deficient animal models (Kuroda et al, 2004). However, these models have limited utility in providing information on biliary excretion, as they are not optimal to obtain quantitative information (membrane vesicles and cultured hepatocytes) or require complicated and labor intensive experiments.…”
Section: Introductionmentioning
confidence: 99%
“…29,30) Also, NSAIDs such as salicylate, piroxicam, ibuprofen, naproxen, sulindac, tolmetin, etodolac, dicrofenac, indomethacin, ketoprofen, phenylbutazone and celecoxib inhibit MRP1, MRP2 and/or MRP4. 30,31) MRP2 and MRP3 share 48% homology at the amino acid level, 32) and have several common inhibitors. 33) Thus, it is not unexpected that uricosuric drugs and NSAIDs also inhibit Mrp3 (Figs.…”
Section: Discussionmentioning
confidence: 99%