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Elacridar is an inhibitor of breast cancer resistance protein (BCRP) and P-glycoprotein (P-GP) that has been used to improve the brain distribution of drugs. Recent studies have revealed that elacridar could probably be the substrate of these multidrug transporters (MDTs) [2].

Recent studies had shown that elacridar and taxanes co-administrated orally could increase plasma concentrations of docetaxel (four-fold) and paclitaxel (10.7-fold) in mice. Co-administration of elacridar with taxanes and ritonavir could lead to a further increase in plasma concentrations of docetaxel (37.4-fold) and paclitaxel (31.9-fold). Besides, co-administration of elacridar with taxanes and ritonavir could potently increase taxanes concentration in the brain, but not increase the brain penetration of the taxanes [1].

Elacridar co-administrated orally with crizotinib has shown to increase the crizotinib concentrations in plasma and brain as well as increase the brain-to-plasma ratios of crizotinib, indicating that co-administration of crizotinib with elacridar could increase oral availability of crizotinib and delivery of crizotinib to the brain [2].

Apart from these, the uptake of elacridar at nanomolar doses in mouse brain was proved to be limited by Pgp- and Bcrp1-induced efflux at the blood - brain barrier. In vitro, Elacridar was indicated a low intracellular accumulation at nanomolar concentrations and a high intracellular accumulation at micromolar concentrations in Pgp- and Bcrp1-overexpressing cell lines [3].

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