Impact of Gut Microbiota on the Pharmacokinetics of Orally Administered Drugs

Abstract

The gut microbiota, a complex and dynamic ecosystem in the human gastrointestinal tract, plays a pivotal role in modulating the pharmacokinetics of orally administered drugs. These microorganisms can directly metabolize drugs, alter their chemical structure, and modulate host drug-metabolizing enzymes and transporters. Such interactions can significantly affect drug absorption, bioavailability, distribution, and elimination, leading to variability in therapeutic outcomes and adverse drug reactions. Recent advances in microbiome research have unveiled the profound influence of microbial composition and activity on drug efficacy and toxicity. This article reviews the mechanisms by which gut microbiota impact drug pharmacokinetics, discusses notable examples of microbiota–drug interactions, and explores these findings' clinical and therapeutic implications. Understanding these interactions is crucial for the development of personalized medicine strategies and the optimization of drug therapy in diverse patient populations.