Department of Pharmaceutics, Sinhgad College of Pharmacy, Pune, Maharashtra, India.
Pharm Dev Technol. 2011 Apr;16(2):127-36. doi: 10.3109/10837450903511186. Epub 2010 Jan 27.
The front line antitubercular drugs rifampicin (RMP) and isoniazid (INH), when co-administered, face the problem of reduced bioavailability of RMP. Stabilization of RMP in the presence of INH under acidic environment may improve the bioavailability of RMP. In vitro degradation studies showed around 15-25% degradation of RMP under the aforesaid conditions if the ratio of RMP: INH is above 1:0.5.This degradation is reduced to less than 10% when the ratio of RMP: INH is below 1:0.25. Based on these findings, an innovative drug delivery system was designed with the immediate release of RMP and tailored prolonged release of INH. The bilayer tablets prepared with this concept were subjected to relative bioavailability studies in healthy human volunteers in an open label, balanced, randomized, single-dose, cross-over study under fasted state. A validated LC-MS/MS bioanalytical method was employed for estimation of RMP and INH in plasma. Bioavailability studies revealed that C(max) and AUC for RMP increased by 18 and 20%, respectively, confirming the above innovative concept. Even in the case of INH, AUC increased significantly by around 30% and thus time above minimum inhibitory concentration (MIC) would also increase, which may result in further improved clinical outcome.
利福平(RMP)和异烟肼(INH)是一线抗结核药物,当两者同时使用时,RMP 的生物利用度会降低。在酸性环境下,RMP 与 INH 共存时可以稳定 RMP,从而提高 RMP 的生物利用度。体外降解研究表明,如果 RMP:INH 的比例高于 1:0.5,则在上述条件下 RMP 的降解率约为 15-25%。当 RMP:INH 的比例低于 1:0.25 时,降解率降低至低于 10%。基于这些发现,设计了一种创新的药物传递系统,该系统具有 RMP 的即刻释放和 INH 的定制延长释放。采用该概念制备的双层片剂在禁食状态下进行了健康人体志愿者的开放性、平衡、随机、单剂量、交叉研究的相对生物利用度研究。采用经过验证的 LC-MS/MS 生物分析方法测定血浆中的 RMP 和 INH。生物利用度研究表明,RMP 的 Cmax 和 AUC 分别增加了 18%和 20%,证实了上述创新概念。即使在 INH 的情况下,AUC 也显著增加了约 30%,因此最小抑菌浓度(MIC)以上的时间也会增加,这可能会进一步改善临床结果。