Effects of myricetin,an antioxidant,on the pharmacokinetics of losartan and its active metabolite,EXP‐3174, in rats: possible role of cytochrome P450 3A4, cytochrome P450 2C9 and P‐glycoprotein inhibition by myricetin

Objectives The effects of myricetin, a natural flavonoid, on the pharmacokinetics of losartan and its active metabolite, EXP‐3174, were investigated in rats. Losartan and myricetin interact with cytochrome P450 (CYP) enzymes and P‐glycoprotein, and the increase in the use of health supplements may result in myricetin being taken concomitantly with losartan as a combination therapy to treat or prevent cardiovascular diseases. Methods The pharmacokinetic parameters of losartan and EXP‐3174 were determined after oral administration of losartan (9 mg/kg) to rats in the presence or absence of myricetin (0.4, 2 and 8 mg/kg). The effects of myricetin on P‐glycoprotein as well as CYP3A4 and CYP2C9 activity were also evaluated. Key findings Myricetin inhibited CYP3A4 and CYP2C9 enzyme activity with a 50% inhibition concentration of 7.8 and 13.5 µm , respectively. In addition, myricetin significantly enhanced the cellular accumulation of rhodamine 123 in MCF‐7/ADR cells overexpressing P‐glycoprotein in a concentration‐dependent manner. The pharmacokinetic parameters of losartan were significantly altered by myricetin compared with the control. The presence of myricetin (2 or 8 mg/kg) increased the area under the plasma concentration–time curve of losartan by 31.4–61.1% and peak plasma concentration of losartan by 31.8–50.2%. Consequently, the absolute bioavailability of losartan in the presence of myricetin increased significantly (P < 0.05, 2 mg/kg; P < 0.01, 8 mg/kg) compared with the control. There was no significant change in the time to reach the peak plasma concentration, apparent volume of distribution at steady state or terminal half‐life of losartan in the presence of myricetin. Furthermore, concurrent use of myricetin (8 mg/kg) significantly decreased the metabolite–parent area under the plasma concentration–time curve ratio by 20%, implying that myricetin may inhibit the CYP‐mediated metabolism of losartan to its active metabolite, EXP‐3174. Conclusions The enhanced bioavailability of losartan may be mainly due to inhibition of the CYP3A4‐ and CYP2C9‐mediated metabolism of losartan in the small intestine or in the liver, and the P‐glycoprotein efflux pump in the small intestine by myricetin.