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  • The concomitant use of lapa...
    Karbownik, Agnieszka; Szałek, Edyta; Sobańska, Katarzyna; Grabowski, Tomasz; Klupczynska, Agnieszka; Plewa, Szymon; Wolc, Anna; Magiera, Magdalena; Porażka, Joanna; Kokot, Zenon J.; Grześkowiak, Edmund

    Investigational new drugs, 10/2018, Volume: 36, Issue: 5
    Journal Article

    Summary Lapatinib is a tyrosine kinase inhibitor used for the treatment of breast cancer. Paracetamol is an analgesic commonly applied to patients with mild or moderate pain and fever. Cancer patients are polymedicated, which involves high risk of drug interactions during therapy. The aim of the study was to assess the interaction between lapatinib and paracetamol in rats. The rats were divided into three groups of eight animals in each. One group received lapatinib + paracetamol (I L + PA ), another group received lapatinib (II L ), whereas the last group received paracetamol (III PA ). A single dose of lapatinib (100 mg/kg b.w.) and paracetamol (100 mg/kg b.w.) was administered orally. Plasma concentrations of lapatinib, paracetamol and its metabolites – glucuronide and sulphate, were measured with the validated HPLC-MS/MS method and HPLC-UV method, respectively. The pharmacokinetic parameters of both drugs were calculated using non-compartmental methods. The co-administration of lapatinib and paracetamol increased the area under the plasma concentration-time curve (AUC) and the maximum concentration (C max ) of lapatinib by 239.6% ( p  = 0.0030) and 184% ( p  = 0.0011), respectively. Lapatinib decreased the paracetamol AUC 0-∞ by 48.8% and C max by 55.7%. In the I L + PA group the C max of paracetamol glucuronide was reduced, whereas the C max of paracetamol sulphate was higher than in the III PA group. Paracetamol significantly affected the enhanced plasma exposure of lapatinib. Additionally, lapatinib reduced the concentrations of paracetamol. The co-administration of lapatinib decreased the paracetamol glucuronidation but increased the sulphation. The findings of this study may be of clinical relevance to patients requiring analgesic therapy.