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Vol. 27, Issue 11, 1319-1333, November 1999
Drug Metabolism and Pharmacokinetics Section (A.E.M.,
H.C., L.S.G., D.D.C.) and Department of Chemical and Physical Sciences
(G.A.N., J.A.M., S.P.S.), DuPont Pharmaceuticals Company, Stine-Haskell
Research Center, Newark, Delaware
Efavirenz (Sustiva, Fig. 1) is a
potent and specific inhibitor of HIV-1 reverse transcriptase approved
for the treatment of HIV infection. To examine the potential
differences in the metabolism among species, liquid chromatography/mass
spectrometry profiles of efavirenz metabolites in urine of rats,
guinea pigs, hamsters, cynomolgus monkeys, and humans were obtained and
compared. The metabolites of efavirenz were isolated, and structures
were determined unequivocally by mass spectral and NMR analyses.
Efavirenz was metabolized extensively by all the species as evidenced
by the excretion of none or trace quantities of parent compound in
urine. Significant species differences in the metabolism of efavirenz were observed. The major metabolite excreted in the urine of all species was the O-glucuronide conjugate (M1) of the
8-hydroxylated metabolite. Efavirenz was also metabolized by direct
conjugation with glucuronic acid, forming the
N-glucuronide (M2) in all five species. The sulfate
conjugate of 8-OH efavirenz (M3) was found in the urine of rats and
cynomolgus monkeys but not in humans. In addition to the aromatic
ring-hydroxylated products, metabolites with a hydroxylated
cyclopropane ring (at C14) were also isolated. GSH-related products of
efavirenz were identified in rats and guinea pigs. The cysteinylglycine
adduct (M10), formed from the GSH adduct (M9), was found in significant
quantities in only rat and guinea pig urine and was not detected in
other species. In vitro metabolism studies were conducted to show that
the GSH adduct was produced from the cyclopropanol intermediate (M11)
in the presence of only rat liver and kidney subcellular fractions and was not formed by similar preparations from humans or cynomolgus monkeys. These studies indicated the existence of a specific
glutathione-S-transferase in rats capable of
metabolizing the cyclopropanol metabolite (M11) to the GSH adduct, M9.
The biotransformation pathways of efavirenz in different species were
proposed based on some of the in vitro results.
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Fig. 1.
Structure of efavirenz.
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