Kratom (Mitragyna speciosa)
Refined Prediction of Pharmacokinetic Kratom-Drug Interactions: Time-Dependent Inhibition Considerations
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- All kratom extracts inhibited CYP2C9, CYP2D6 and CYP3A (hepatic and intestinal) activities by similar extents, indicating minimal product to product variability with respect to CYP inhibition. Mitragynine inhibited CYP2C9, CYP2D6, and CYP3A activity by greater than 50%, warranting further investigation as a reversible or a time dependent inhibitor of the CYP activities.
- The 7-fold shift observed with mitragynine against intestinal and hepatic CYP3A activity suggests mitragynine is a time dependent inhibitor. IC50values were within the concentration range reported in post-mortem human plasma and tissues. Although no leftward shift was observed for CYP2D6, the IC50was also within the concentration range reported in post-mortem human plasma and tissues.
- Mitragynine was shown to be a strong competitive inhibitor of CYP2D6 activity. The robust Ki(~1 µM) will be applied to mechanistic and PBPK models to predict drug interaction potential.
- Mitragynine is a time dependent inhibitor of both intestinal and hepatic CYP3A activity. The efficiency of inactivation (kinact/KI) was similar to that of the clinically relevant time dependent inhibitor verapamil. The kinetic parameters, KIand kinactwill be applied to mechanistic and PBPK models to predict drug interaction potential.
1 . Screening of kratom extracts as inhibitors of CYP2D6 activity in HLM (id=NPDI-o6FZsw)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP2D6 4173631
Cell fraction Pooled human liver microsomes -7999662
Three methanolic Kratom extracts were tested, K-50, K-51 and K-52.
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
400 µL
10 min
NADPH
Available
Available
4 µM
2, 10, and 20 µg/ml
2 . Screening of mitragynine as inhibitors of CYP2D6 activity in HLM (id=NPDI-sfeVpQ)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP2D6 4173631
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
400 µL
10 min
NADPH
Available
Available
4 µM
1, 10, and 100 µM
3 . Inhibition kinetics of CYP2D6 activity by mitragynine in HLM (id=NPDI-ksOM2w)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
N/A
- CYP2D6 4173631
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 MG/ML
Commercially available
1010191
200 µL
10 min
NADPH
Available
Available
0.12 - 10 µM
4 . IC50 shift determination for mitragynine towards CYP2D6 activity in HLM with NADPH (id=NPDI-XFPmtA)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP2D6 4173631
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1010191
NADPH
Available
Available
4 µM
250 µL
30 min
NADPH with precipitant
200 µL
10 min
No dilution
0.015 - 100 µM
5 . IC50 shift determination for mitragynine towards CYP2D6 activity in HLM without NADPH (id=NPDI--jKvig)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP2D6 4173631
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1010191
200 µL
10 min
NADPH
Available
Available
4 µM
250 µL
30 min
NADPH with no precipitant
200 µL
10 min
No dilution
0.015 - 100 µM
6 . Screening of kratom extracts as inhibitors of CYP2C9 activity in HLM (id=NPDI-71pBaQ)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP2C9 4309227
Cell fraction Pooled human liver microsomes -7999662
Three methanolic Kratom extracts were tested, K-50, K-51 and K-52.
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
400 µL
10 min
NADPH
Available
Available
4 µM
2, 10, and 20 µg/ml
7 . Screening of mitragynine as inhibitors of CYP2C9 activity in HLM (id=NPDI-bOmVTQ)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP2C9 4309227
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
400 µL
10 min
NADPH
Available
Available
4 µM
1, 10, and 100 µM
8 . IC50 shift determination for mitragynine towards CYP2C9 activity in HLM with NADPH (id=NPDI-Xrn4xQ)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP2C9 4309227
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1010191
NADPH
Available
Available
4 µM
250 µL
30 min
NADPH with precipitant
200 µL
10 min
No dilution
0.015 - 100 µM
9 . IC50 shift determination for mitragynine towards CYP2C9 activity in HLM without NADPH (id=NPDI-xK3lmw)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP2C9 4309227
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1010191
NADPH
Available
Available
4 µM
250 µL
30 min
NADPH with no precipitant
200 µL
10 min
No dilution
0.015 - 100 µM
10 . Screening of kratom extracts as inhibitors of CYP3A activity in HLM (id=NPDI-7-Gg-g)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP3A
Cell fraction Pooled human liver microsomes -7999662
Three methanolic Kratom extracts were tested, K-50, K-51 and K-52.
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
400 µL
2 min
NADPH
Available
Available
2 µM
2, 10, and 20 µg/ml
11 . Screening of mitragynine as inhibitors of CYP3A activity in HLM (id=NPDI-ov597g)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP3A
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
400 µL
2 min
NADPH
Available
Available
2 µM
1, 10, and 100 µM
12 . Screening of kratom extracts as inhibitors CYP3A activity in HIM (id=NPDI-QbMPuw)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP3A
Cell fraction Pooled human intestinal microsomes -7999663
Three methanolic Kratom extracts were tested, K-50, K-51 and K-52.
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1610314
400 µL
10 min
NADPH
Available
Available
2 µM
2, 10, 20 µg/mL
13 . Screening of mitragynine as inhibitors CYP3A activity in HIM (id=NPDI-vr5BAA)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
50% inhibition at the highest tested concentration
- CYP3A
Cell fraction Pooled human intestinal microsomes -7999663
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1610314
400 µL
10 min
NADPH
Available
Available
2 µM
1, 10, and 100 µM
14 . Inhibition kinetics of CYP3A activity by mitragynine in HLM (id=NPDI-515DHw)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
N/A
- CYP3A
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1010191
NADPH
Available
Available
20 µM
1100 µL
0, 2, 5, 10, and 20 min
NADPH with precipitant
200 µL
5 min
No dilution
0.56 - 30 µM
15 . Inhibition kinetics of CYP3A activity by mitragynine in HIM (id=NPDI-Tr3Eyg)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
N/A
- CYP3A
Cell fraction Pooled human intestinal microsomes -7999663
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
NA
0.05 mg/mL
Commercially available
1610314
NADPH
Available
Available
20 µM
1100 µL
0, 2, 5, 10, and 20 min
NADPH with precipitant
200 µL
5 min
No dilution
0.56 - 30 µM
16 . IC50 shift determination for mitragynine towards CYP3A activity in HLM with NADPH (id=NPDI-4_UdSg)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP3A
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1010191
NADPH
Available
Available
2 µM
250 µL
30 min
NADPH with precipitant
200 µL
2 min
No dilution
0.015 - 100 µM
17 . IC50 shift determination for mitragynine towards CYP3A activity in HLM without NADPH (id=NPDI-EjMg0g)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP3A
Cell fraction Pooled human liver microsomes -7999662
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1010191
NADPH
Available
Available
2 µM
250 µL
30 min
NADPH with no precipitant
200 µL
2 min
No dilution
0.015 - 100 µM
18 . IC50 shift determination for mitragynine towards CYP3A activity in HIM with NADPH (id=NPDI-A66pwQ)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP3A
Cell fraction Pooled human intestinal microsomes -7999663
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1610314
NADPH
Available
Available
2 µM
250 µL
30 min
NADPH with precipitant
200 µL
10 min
No dilution
0.015 - 100 µM
19 . IC50 shift determination for mitragynine towards CYP3A activity in HIM without NADPH (id=NPDI-o8WmjA)
In Vitro Enzyme Inhibition Experiment
Inhibition was detected. Cutoff used —
IC50<10 µM for reversible inhibition and IC50shift ≥1.5 fold for time dependent inhibition
- CYP3A
Cell fraction Pooled human intestinal microsomes -7999663
Results
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
---|
Experimental Conditions
A cocktail of probe substrates for CYP2C9 (diclofenac), CYP2D6 (dextromethorphan), and CYP3A (midazolam) was used for the IC50shift determination.
Methanol (0.8 % v/v) served as solvent control. Tienilic acid (0.4 and 0.8 µM), paroxetine (0.25 and 0.5 µM), and 6',7'-dihydroxybergamottin (1 and 2 µM) served as positive control inhibitors of CYP2C9, CYP2D6, and CYP3A activities, respectively.
NA
0.05 mg/mL
Commercially available
1610314
NADPH
Available
Available
4 µM
250 µL
30 min
NADPH with no precipitant
200 µL
10 min
No dilution
0.015 - 100 µM