Epstein S, Cryer B, Ragi S, Zanchetta J R, Walliser J, Chow J, Johnson M A, Leyes A E
Mount Sinai School of Medicine, New York, NY, USA.
Curr Med Res Opin. 2003;19(8):781-9. doi: 10.1185/030079903125002577.
Poor quality has been reported for some generics and other copies of original products. We performed a pilot study to compare the disintegration/dissolution profiles of FOSAMAX (alendronate) 70 mg tablets with those of copies of FOSAMAX that were manufactured outside the United States.
We used the standard United States Pharmacopeia (USP) disintegration method to evaluate FOSAMAX 70 mg tablets and 13 copies. At least 12 (n = 12) dosage units were tested for each product (except Fosmin, n = 10). The dissolution profiles of FOSAMAX and one representative copy were also compared.
Nine copies (Osteomax, Defixal, Fosmin, Endronax, Osteomix, Genalmen, Fixopan, Osteoplus, and Fosval) disintegrated two- to ten-fold faster than FOSAMAX. Three other copies (Neobon, Regenesis, and Ostenan) disintegrated at least five-fold slower than FOSAMAX. Neobon is a softgel capsule, so special consideration was given to this different dosage form. One copy (Arendal) did not fall into either category but exhibited potentially large inter- and intra-lot variability. Dissolution of alendronate from Regenesis lagged behind that from FOSAMAX.
Slower disintegration may reduce efficacy because bisphosphonates must be taken in the fasting state and contact with food or even certain beverages severely reduces bioavailability. Faster disintegration (or the use of gel-caps or other alterations to the drug formulation) could increase the risk of esophagitis, an adverse event associated with prolonged contact of the esophagus with bisphosphonates. These disintegration and dissolution results suggest that important differences may exist between FOSAMAX and its copies with regard to bioavailability, pharmacokinetics, and clinical efficacy and safety profiles. Additional testing is warranted to evaluate the pharmacokinetics and clinical safety of these copies.
据报道,一些仿制药及原研产品的其他复制品质量较差。我们开展了一项初步研究,以比较福善美(阿仑膦酸钠)70毫克片剂与在美国境外生产的福善美复制品的崩解/溶出曲线。
我们采用美国药典(USP)标准崩解方法评估福善美70毫克片剂及13种复制品。每种产品至少测试12个(n = 12)剂量单位(福斯明除外,n = 10)。还比较了福善美及其一种代表性复制品的溶出曲线。
9种复制品(骨力素、迪菲克、福斯明、恩多纳克斯、骨力美、吉那美、菲克帕、骨力加、福斯瓦尔)的崩解速度比福善美快2至10倍。另外3种复制品(新骨宝、重生、奥斯坦)的崩解速度比福善美至少慢5倍。新骨宝是软胶囊,因此对这种不同剂型给予了特别考虑。一种复制品(阿仑德)不属于上述任何一类,但批次间和批次内变异可能较大。重生中阿仑膦酸钠的溶出落后于福善美。
崩解较慢可能会降低疗效,因为双膦酸盐必须在空腹状态下服用,与食物甚至某些饮料接触会严重降低生物利用度。崩解较快(或使用软胶囊或对药物制剂进行其他改变)可能会增加食管炎的风险,食管炎是一种与食管长时间接触双膦酸盐相关的不良事件。这些崩解和溶出结果表明,福善美及其复制品在生物利用度、药代动力学以及临床疗效和安全性方面可能存在重要差异。有必要进行额外测试以评估这些复制品的药代动力学和临床安全性。