Protein Information

ID 140
Name CYP3A4
Synonyms CP33; CYP3; HLP; CYP3A; CP34; CYP 3A4; CYP 3; CYP3A3…

Compound Information

ID 1774
Name warfarin
CAS

Reference

PubMed Abstract RScore(About this table)
20220045 Kirby LC, Johnson BM, Adams LM, Eberwein DJ, Zhang K, Murray SC, Lates CD, Blum RA, Morris SR: Effect of Casopitant, a Novel NK-1 Receptor Antagonist, on the Pharmacokinetics and Pharmacodynamics of Steady-State Warfarin. J Clin Pharmacol. 2010 Mar 10.
Casopitant, a novel NK-1 receptor antagonist under investigation for the prevention of postoperative and chemotherapy-induced nausea and vomiting, is a weak to moderate inhibitor of CYP3A and a moderate inducer of CYP2C9 in vitro. Furthermore, both CYP enzymes are involved in the metabolism of R- and S-warfarin, respectively. This clinical study was conducted to explore the potential drug-drug interaction between casopitant and warfarin. In total, 97 healthy participants were enrolled and 54 completed the study. Participants received individualized daily dosing of warfarin to an international normalized ratio (INR) of 1.3 to 2.3 over a 14-day period (period 1). Immediately following period 1, participants entered period 2 and were randomized to receive either regimen A (oral casopitant [150 mg day 1, 50 mg days 2 and 3] and warfarin [days 1-10]) or regimen B (oral casopitant 60 mg and warfarin [days 1-14]). INR assessments were performed daily. The steady-state Cmax and AUC of R- and S-warfarin were not altered by regimen A, but R-warfarin AUC was increased 1.31-fold (90% confidence interval [CI]: 1.22, 1.41), and S-warfarin AUC was increased 1.27-fold (90% CI: 1.18, 1.38) on day 14 in regimen B. Steady-state INR values were not affected by either casopitant regimen.
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