Intestinal permeability is only one part of systemic drug exposure.
What the paper found
An in-situ frog intestinal-perfusion experiment used midazolam and losartan as probe substrates. Midazolam permeability did not change significantly with the tested inhibitors, and the authors compared model estimates with values from other experimental systems.
What the evidence cannot establish
A perfused frog intestine does not reproduce human oral dosing, first-pass metabolism or distribution. A model correlation does not validate every interacting medicine or formulation.
Implications for forensic review
Identify what was measured: transfer across tissue rather than a human plasma concentration-time curve. The study can inform experimental method development. It cannot establish that an inhibitor has no clinical midazolam interaction or predict a person’s absorbed dose from an amount reportedly swallowed.
Source and related reading
Source: PMC4500896, supplied full-text paper. Findings are paraphrased; case-review implications are an interpretation.
Related: Unchanged Midazolam Exposure Does Not Establish Absence of Every Lemborexant Interaction.
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