Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats

Ying Li,1,2,* Wenyu Du,1– 3,* Chunhui Shan,4 Zefang Yu,1 Jing An,1,2 Zhanjun Dong1,2 1Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 2Hebei Key Laboratory of Clinical Pharmacy, Shijiazhuang, Hebei, People’s Republic of China;...

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Main Authors: Li Y, Du W, Shan C, Yu Z, An J, Dong Z
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:Drug Design, Development and Therapy
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Online Access:https://www.dovepress.com/decoding-drug-interactions-character-and-degree-of-pharmacokinetic-int-peer-reviewed-fulltext-article-DDDT
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author Li Y
Du W
Shan C
Yu Z
An J
Dong Z
author_facet Li Y
Du W
Shan C
Yu Z
An J
Dong Z
author_sort Li Y
collection DOAJ
description Ying Li,1,2,* Wenyu Du,1– 3,* Chunhui Shan,4 Zefang Yu,1 Jing An,1,2 Zhanjun Dong1,2 1Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 2Hebei Key Laboratory of Clinical Pharmacy, Shijiazhuang, Hebei, People’s Republic of China; 3Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 4Department of Medical Imaging, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhanjun Dong, Email dzjhbgh@126.comBackground: Sorafenib and lenvatinib play a significant role as small molecule targeted drugs in the treatment of advanced hepatocellular carcinoma. However, both drugs are most commonly associated with hypertension as a side effect, frequently needing antihypertensive treatment. Telmisartan, an antagonist of angiotensin II receptor, can attenuate sorafenib- or donafenib-induced hypertension. In clinical settings, sorafenib or donafenib is often prescribed alongside telmisartan, but the pharmacokinetic interactions between donafenib and telmisartan, as well as sorafenib and telmisartan, are not well understood. Therefore, this study aimed to evaluate these pharmacokinetic interactions in male Sprague-Dawley (SD) rats.Methods: The animals were divided into seven groups (n = 6) and treated with sorafenib, donafenib, or telmisartan as monotherapy (groups I–III), multi-dose sorafenib or donafenib with single dose telmisartan (groups IV and V), or multi-dose telmisartan with single dose sorafenib or donafenib (groups VI and VII). The levels of drugs in rat plasma were quantified using ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS).Results: Multiple doses of donafenib resulted in a 0.97-fold (P=0.010) increase in the area under the plasma concentration–time curve (AUC) of telmisartan and a 57.3% (P=0.038) and 45.6% (P=0.032) decrease in the apparent clearance (CLz/F) and the apparent volume of distribution (Vz/F) of telmisartan, respectively. Telmisartan resulted in a decrease in donafenib exposure; however, this effect was not statistically significant. The pharmacokinetic characteristics of sorafenib were significantly altered when it was co-administered with telmisartan. In particular, the AUC value and the maximum plasma concentration (Cmax) increased by 77.7% (P< 0.001) and 60.9% (P< 0.001), respectively, whereas Vz/F (50.4%, P=0.008) and CLz/F (46.0%, P=0.006) were significantly decreased. However, sorafenib did not affect the pharmacokinetic characteristics of telmisartan.Conclusion: The results demonstrated potential interactions between telmisartan and sorafenib or donafenib, which may guide dosage adjustment and prevent toxic effects in individual patients.Keywords: hepatocellular carcinoma, hypertension, donafenib, telmisartan, sorafenib, pharmacokinetics, drug–drug interactions
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spelling doaj-art-75b17d3058b24542811a1571a2fdea912025-08-20T03:50:44ZengDove Medical PressDrug Design, Development and Therapy1177-88812025-07-01Volume 19Issue 160476060104825Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in RatsLi YDu WShan CYu Z0An JDong Z1Department of Pharmacydepartment of pharmacyYing Li,1,2,* Wenyu Du,1– 3,* Chunhui Shan,4 Zefang Yu,1 Jing An,1,2 Zhanjun Dong1,2 1Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 2Hebei Key Laboratory of Clinical Pharmacy, Shijiazhuang, Hebei, People’s Republic of China; 3Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 4Department of Medical Imaging, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhanjun Dong, Email dzjhbgh@126.comBackground: Sorafenib and lenvatinib play a significant role as small molecule targeted drugs in the treatment of advanced hepatocellular carcinoma. However, both drugs are most commonly associated with hypertension as a side effect, frequently needing antihypertensive treatment. Telmisartan, an antagonist of angiotensin II receptor, can attenuate sorafenib- or donafenib-induced hypertension. In clinical settings, sorafenib or donafenib is often prescribed alongside telmisartan, but the pharmacokinetic interactions between donafenib and telmisartan, as well as sorafenib and telmisartan, are not well understood. Therefore, this study aimed to evaluate these pharmacokinetic interactions in male Sprague-Dawley (SD) rats.Methods: The animals were divided into seven groups (n = 6) and treated with sorafenib, donafenib, or telmisartan as monotherapy (groups I–III), multi-dose sorafenib or donafenib with single dose telmisartan (groups IV and V), or multi-dose telmisartan with single dose sorafenib or donafenib (groups VI and VII). The levels of drugs in rat plasma were quantified using ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS).Results: Multiple doses of donafenib resulted in a 0.97-fold (P=0.010) increase in the area under the plasma concentration–time curve (AUC) of telmisartan and a 57.3% (P=0.038) and 45.6% (P=0.032) decrease in the apparent clearance (CLz/F) and the apparent volume of distribution (Vz/F) of telmisartan, respectively. Telmisartan resulted in a decrease in donafenib exposure; however, this effect was not statistically significant. The pharmacokinetic characteristics of sorafenib were significantly altered when it was co-administered with telmisartan. In particular, the AUC value and the maximum plasma concentration (Cmax) increased by 77.7% (P< 0.001) and 60.9% (P< 0.001), respectively, whereas Vz/F (50.4%, P=0.008) and CLz/F (46.0%, P=0.006) were significantly decreased. However, sorafenib did not affect the pharmacokinetic characteristics of telmisartan.Conclusion: The results demonstrated potential interactions between telmisartan and sorafenib or donafenib, which may guide dosage adjustment and prevent toxic effects in individual patients.Keywords: hepatocellular carcinoma, hypertension, donafenib, telmisartan, sorafenib, pharmacokinetics, drug–drug interactionshttps://www.dovepress.com/decoding-drug-interactions-character-and-degree-of-pharmacokinetic-int-peer-reviewed-fulltext-article-DDDThepatocellular carcinomahypertensiondonafenibtelmisartansorafenibpharmacokinetics
spellingShingle Li Y
Du W
Shan C
Yu Z
An J
Dong Z
Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats
Drug Design, Development and Therapy
hepatocellular carcinoma
hypertension
donafenib
telmisartan
sorafenib
pharmacokinetics
title Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats
title_full Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats
title_fullStr Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats
title_full_unstemmed Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats
title_short Decoding Drug Interactions: Character and Degree of Pharmacokinetic Interactions Between Telmisartan and Sorafenib or Donafenib in Rats
title_sort decoding drug interactions character and degree of pharmacokinetic interactions between telmisartan and sorafenib or donafenib in rats
topic hepatocellular carcinoma
hypertension
donafenib
telmisartan
sorafenib
pharmacokinetics
url https://www.dovepress.com/decoding-drug-interactions-character-and-degree-of-pharmacokinetic-int-peer-reviewed-fulltext-article-DDDT
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