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This probe drug cocktail is a specific combination of five drugs—caffeine, tolbutamide, dextromethorphan, midazolam, and digoxin—used as a diagnostic tool in clinical pharmacology to evaluate the activity of key metabolic enzymes and transporters. In the Phase Ib/IIa clinical trial led by Michael Hoelscher for the treatment of pulmonary tuberculosis, this cocktail is employed to assess potential drug-drug interactions (DDI) between the investigational drug BTZ-043 and Cytochrome P450 enzymes (CYP1A2, CYP2C9, CYP2D6, CYP3A4) and the P-glycoprotein (P-gp) transporter. By measuring the plasma concentrations of these probe substrates and their metabolites, researchers can determine if BTZ-043 inhibits or induces these pathways, which is critical for establishing the safety and dosing profile of the new anti-tuberculosis agent.
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