The Effect of Ethinyloestradiol and Levonorgestrel on the CYP2C19-mediated Metabolism of Omeprazole in Healthy Female Subjects
Overview
Authors
Affiliations
Aims: To study the effect of an oral contraceptive (OC) formulation containing ethinyloestradiol and levonorgestrel (LNG) (combination OC) or LNG alone on the CYP2C19-mediated hydroxylation of omeprazole in healthy females.
Methods: This was an open crossover study with three phases. In phase one, 10 healthy females received a single 40-mg dose of omeprazole. Thereafter the subjects received in a random order either 40 micro g ethinyloestradiol and 75 micro g LNG or 60 micro g LNG alone once daily for 10 days. On day 10, 1 h after the last OC dose, subjects received a single 40-mg oral dose of omeprazole. The plasma concentrations of omeprazole, 5'-hydroxyomeprazole and omeprazole sulphone were determined for up to 8 h.
Results: The use of combination OC increased the area under the curve (AUC) of omeprazole by 38% [95% confidence interval (CI) - 3.8, 80; P = 0.040] and caused a 48% increase (95% CI 28, 68) in the AUC ratio of omeprazole/5-hydroxyomeprazole. LNG alone did not effect the 5'-hydroxylation of omeprazole. Neither of the OC preparations seemed to have an inhibitory effect on the formation of omeprazole sulphone by CYP3A4.
Conclusions: Oral contraceptives containing ethinyloestradiol but not those containing only LNG decrease CYP2C19 activity.
Zhang Y, Liu M, Zhu Z, Chen H BMC Public Health. 2024; 24(1):1215.
PMID: 38698372 PMC: 11067170. DOI: 10.1186/s12889-024-18710-8.
Sandvik P, Lydersen S, Hegstad S, Spigset O Pharmacol Res Perspect. 2020; 8(3):e00615.
PMID: 32529756 PMC: 7290083. DOI: 10.1002/prp2.615.
Sex Differences in Human and Animal Toxicology.
Gochfeld M Toxicol Pathol. 2016; 45(1):172-189.
PMID: 27895264 PMC: 5371029. DOI: 10.1177/0192623316677327.
Pharmacokinetic drug interaction profiles of proton pump inhibitors: an update.
Wedemeyer R, Blume H Drug Saf. 2014; 37(4):201-11.
PMID: 24550106 PMC: 3975086. DOI: 10.1007/s40264-014-0144-0.
Deligiannidis K, Byatt N, Freeman M J Clin Psychopharmacol. 2014; 34(2):244-55.
PMID: 24525634 PMC: 4105343. DOI: 10.1097/JCP.0000000000000087.