Modi Nishit B, Nath Rajneesh, Staehr Peter, Gupta Suneel K, Aquilina Joseph W, Rivas David
Johnson & Johnson Pharmaceutical Research & Development, 700 US Route 202, Raritan, NJ 08869, USA.
J Clin Pharmacol. 2009 Jun;49(6):634-42. doi: 10.1177/0091270009333486. Epub 2009 Apr 23.
Selective serotonin reuptake inhibitors (SSRIs) may be associated with electrocardiographic effects. The electrocardiographic pharmacodynamics of dapoxetine, a short-acting SSRI being developed for the treatment of premature ejaculation, are compared with those of placebo and moxifloxacin (positive control) in 2 single-center, randomized, crossover studies in healthy men. In study 1, subjects receive 2 doses of dapoxetine 120 mg, given 3 hours apart; a single dose of moxifloxacin 400 mg; and 2 doses of placebo, given 3 hours apart. In study 2, subjects receive single doses of dapoxetine 60 mg, dapoxetine 120 mg, moxifloxacin 400 mg, and placebo. Moxifloxacin significantly increases QT and corrects QT intervals (QTc) compared with placebo in both studies (eg, Bazett-corrected QTc of 11.90 milliseconds [95% confidence interval, 2.68 to 21.11] and 5.06 [95% confidence interval, -2.26 to 12.38]). Dapoxetine 60, 120, and 240 mg do not prolong the QT/QTc interval and have no clinically significant electrocardiographic effects. Dapoxetine and moxifloxacin pharmacokinetics are similar to previous reports. Adverse events are generally mild in severity; nausea is the most common. The results demonstrate that dapoxetine does not have electrocardiographic effects at doses of 60, 120, and 240 mg.
选择性5-羟色胺再摄取抑制剂(SSRIs)可能与心电图效应有关。在两项针对健康男性的单中心、随机、交叉研究中,将正在研发用于治疗早泄的短效SSRIs达泊西汀的心电图药效学与安慰剂和莫西沙星(阳性对照)进行了比较。在研究1中,受试者接受两剂120毫克达泊西汀,间隔3小时给药;一剂400毫克莫西沙星;以及两剂安慰剂,间隔3小时给药。在研究2中,受试者接受单剂量60毫克达泊西汀、120毫克达泊西汀、400毫克莫西沙星和安慰剂。在两项研究中,与安慰剂相比,莫西沙星均显著增加QT和校正QT间期(QTc)(例如,Bazett校正QTc分别为11.90毫秒[95%置信区间,2.68至21.11]和5.06[95%置信区间,-2.26至12.38])。60毫克、120毫克和240毫克达泊西汀不会延长QT/QTc间期,且无临床显著的心电图效应。达泊西汀和莫西沙星的药代动力学与既往报道相似。不良事件一般严重程度较轻;恶心最为常见。结果表明,60毫克、120毫克和240毫克剂量的达泊西汀无心电图效应。