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Inhibition Constants, Inhibitor Concentrations and the Prediction of Inhibitory Drug Drug Interactions: Pitfalls, Progress and Promise

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Strategies and standards for predicting the likelihood of pharmacokinetically significant inhibitory drug-drug interactions for drug development purposes which rely primarily on projected in vivo concentrations of cytochrome P450 (CYP) or transporter inhibitors, [I], and in vitro estimates of their inhibitory constants, Ki, were specified in several commentaries based upon a conference held by the European Federation of Pharmaceutical Sciences (EUFEPS) several years ago. Since then the application of those strategies and standards has met with varying degrees of success. Many of the vexing issues that were identified in the EUFEPS Conference Report remain, while other issues are systematically being resolved. This article briefly reviews the underlying strategy in the prediction of the significance of inhibitory DDIs using [I]/Ki ratios; some of the difficulties or pitfalls associated with the predictive application of [I]/Ki ratios; and some of the recent refinements of the general strategy.

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Keywords: Drug-drug interactions (DDIs); Ki; inhibition; inhibition constant; transporters

Document Type: Research Article

Affiliations: Professor of Pharmacology, The University of Toledo College of Pharmacy, 2801 W. Bancroft St., Toledo, Ohio 43606, USA.

Publication date: January 1, 2006

More about this publication?
  • Current Drug Metabolism aims to cover all the latest and outstanding developments in drug metabolism and disposition. The journal serves as an international forum for the publication of timely reviews in drug metabolism. Current Drug Metabolism is an essential journal for academic, clinical, government and pharmaceutical scientists who wish to be kept informed and up-to-date with the latest and most important developments. The journal covers the following areas:

    In vitro systems including CYP-450; enzyme induction and inhibition; drug-drug interactions and enzyme kinetics; pharmacokinetics, toxicokinetics, species scaling and extrapolations; P-glycoprotein and transport carriers; target organ toxicity and interindividual variability; drug metabolism and disposition studies; extrahepatic metabolism; phase I and phase II metabolism; recent developments for the identification of drug metabolites and adducts.
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