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The Effect of Ethinyloestradiol and Levonorgestrel on the CYP2C19-mediated Metabolism of Omeprazole in Healthy Female Subjects

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Specialty Pharmacology
Date 2003 Aug 5
PMID 12895199
Citations 17
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Abstract

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.

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References
1.
Abernethy D, Todd E . Impairment of caffeine clearance by chronic use of low-dose oestrogen-containing oral contraceptives. Eur J Clin Pharmacol. 1985; 28(4):425-8. DOI: 10.1007/BF00544361. View

2.
Stoehr G, Kroboth P, Juhl R, Wender D, Phillips J, Smith R . Effect of oral contraceptives on triazolam, temazepam, alprazolam, and lorazepam kinetics. Clin Pharmacol Ther. 1984; 36(5):683-90. DOI: 10.1038/clpt.1984.240. View

3.
Jurima M, Inaba T, KALOW W . Mephenytoin hydroxylase activity in human liver: inhibition by steroids. Drug Metab Dispos. 1985; 13(6):746-9. View

4.
Kim M, Bertino Jr J, Gaedigk A, Zhang Y, Sellers E, Nafziger A . Effect of sex and menstrual cycle phase on cytochrome P450 2C19 activity with omeprazole used as a biomarker. Clin Pharmacol Ther. 2002; 72(2):192-9. DOI: 10.1067/mcp.2002.126174. View

5.
Belle D, Callaghan J, Gorski J, Maya J, Mousa O, Wrighton S . The effects of an oral contraceptive containing ethinyloestradiol and norgestrel on CYP3A activity. Br J Clin Pharmacol. 2002; 53(1):67-74. PMC: 1874548. DOI: 10.1046/j.0306-5251.2001.01521.x. View