Department of Pharmacology and Clinical Pharmacology, Seoul National University College of Medicine and Hospital, Seoul, Korea.
Clin Ther. 2009 Nov;31(11):2755-64. doi: 10.1016/j.clinthera.2009.11.001.
BACKGROUND: Coadministration of glimepiride and metformin has been used to achieve glucose control. Because compliance with a multiple medication regimen can be difficult for some patients, combination tablets of glimepiride + metformin might be a suitable alternative for these patients. OBJECTIVE: This study was conducted to compare the pharmacokinetics of test and reference formulations of glimepiride + metformin fixed-dose combination tablets under fasting conditions to meet the regulatory requirements for marketing approval of a new drug in Korea. METHODS: This was a single-dose, randomized, open-label, 2-period, 2-way crossover study conducted between March 2007 and May 2007. Healthy fasting Korean men were randomized to 1 of 2 dosing sequences: a single oral administration of a fixed-dose glimepiride 1-mg + metformin 500-mg combination tablet (test) followed by single oral administration of a fixed-dose glimepiride 2 mg + metformin 500 mg combination tablet (reference), separated by a 1-week washout period between doses; or a single oral administration of a fixed-dose glimepiride 2-mg + metformin 500-mg combination tablet followed by single oral administration of a fixed-dose glimepiride 1 mg + metformin 500-mg combination tablet, separated by a 1-week washout period between doses. Serial samples of blood were collected up to 24 hours after oral administration, and drug concentrations in plasma were determined by HPLC-MS/MS. Tolerability was assessed based on adverse events and changes in clinical parameters. Serious adverse events included those that resulted in death, a life-threatening condition, congenital anomaly or birth defect, or required hospitalization or prolongation of existing hospitalization. RESULTS: A total of 30 healthy male subjects (mean age, 25.6 years [range, 20-36 years]; weight, 69.5 kg [range, 58.2-90.7 kg]) participated in the study. After administration of the test and reference formulations, glimepiride was rapidly absorbed, reaching C(max) with a median T(max) of 1.75 and 2.0 hours, respectively, and then declined exponentially with an average t(1/2) of 8.2 and 8.5 hours. The individual C(max) and AUC(last) of glimepiride were observed to be proportionally increased according to the administered glimepiride dose. The mean (SD) dose-normalized Cmax values of glimepiride 1 and 2 mg were 168.2 (54.9) and 149.9 (47.4) ng/mL/mg, respectively; the mean dose-normalized AUC(last) values of glimepiride 1 and 2 mg were 681.5 (190.3) and 635.8 (194.1) ng x h/mL/mg. Individual plots of dose-normalized C(max) and AUC(last) values identified a similarity between the 2 groups but no significant between-group differences. A total of 25 adverse events (12 after the test dose and 13 after the reference dose) were reported by 13 of the 30 subjects. All adverse events were considered mild. Twenty-one adverse events were considered related to the study drug (8 after the test dose and 13 after the reference dose). Adverse events believed to be related to the test formulation were diarrhea (4 cases), dizziness (1), headache (1), tingling sensation (1), and weakness (1). Adverse events believed to be related to the reference formulation were diarrhea (6 cases), headache (3), cold sweats (1), dyspepsia (1), epigastric discomfort (1), and lethargy (1). There were no clinically significant findings in the laboratory test results or vital sign monitoring during the study. There were no serious adverse events reported. CONCLUSIONS: The C(max) and AUC(last) of glimepiride increased proportionally according to the administered glimepiride dose in this study of healthy, fasting Korean men. The safety profiles of the 2 combination tablets were comparable.
背景:联合应用格列美脲和二甲双胍已被用于控制血糖。由于一些患者可能难以遵守多种药物治疗方案,因此格列美脲+二甲双胍的复方片剂可能是这些患者的合适替代方案。 目的:本研究旨在比较空腹条件下试验和参比制剂的格列美脲+二甲双胍固定剂量复方片剂的药代动力学,以满足韩国新药上市许可的监管要求。 方法:这是一项单剂量、随机、开放标签、2 期、2 向交叉研究,于 2007 年 3 月至 2007 年 5 月进行。健康的禁食韩国男性被随机分为 2 种给药序列中的 1 种:单次口服固定剂量格列美脲 1mg+二甲双胍 500mg 复方片剂(试验),随后单次口服固定剂量格列美脲 2mg+二甲双胍 500mg 复方片剂(参比),两种药物之间间隔 1 周洗脱期;或者单次口服固定剂量格列美脲 2mg+二甲双胍 500mg 复方片剂,随后单次口服固定剂量格列美脲 1mg+二甲双胍 500mg 复方片剂,两种药物之间间隔 1 周洗脱期。口服给药后 24 小时内采集连续血样,并通过 HPLC-MS/MS 测定血浆中药物浓度。根据不良事件和临床参数的变化评估耐受性。严重不良事件包括导致死亡、危及生命的情况、先天畸形或出生缺陷、或需要住院或延长现有住院时间的事件。 结果:共有 30 名健康男性(平均年龄,25.6 岁[范围,20-36 岁];体重,69.5kg[范围,58.2-90.7kg])参加了研究。在给予试验和参比制剂后,格列美脲迅速吸收,Cmax 的中位数 Tmax 分别为 1.75 和 2.0 小时,然后以平均 t1/2 为 8.2 和 8.5 小时呈指数下降。格列美脲的个体 Cmax 和 AUC(last)观察到与给予的格列美脲剂量成比例增加。格列美脲 1mg 和 2mg 的平均(SD)剂量标准化 Cmax 值分别为 168.2(54.9)和 149.9(47.4)ng/mL/mg;格列美脲 1mg 和 2mg 的平均剂量标准化 AUC(last)值分别为 681.5(190.3)和 635.8(194.1)ng x h/mL/mg。剂量标准化 Cmax 和 AUC(last)值的个体图谱表明两组之间存在相似性,但无统计学意义上的组间差异。共有 25 例不良事件(试验剂量后 12 例,参比剂量后 13 例)由 30 名受试者中的 13 名报告。所有不良事件均被认为是轻度的。21 例不良事件被认为与研究药物相关(试验剂量后 8 例,参比剂量后 13 例)。认为与试验制剂相关的不良事件有腹泻(4 例)、头晕(1 例)、头痛(1 例)、刺痛感(1 例)和虚弱(1 例)。认为与参比制剂相关的不良事件有腹泻(6 例)、头痛(3 例)、冷汗(1 例)、消化不良(1 例)、上腹部不适(1 例)和乏力(1 例)。研究期间实验室检测结果或生命体征监测无临床意义的发现。无严重不良事件报告。 结论:在这项健康禁食韩国男性的研究中,格列美脲的 Cmax 和 AUC(last)与给予的格列美脲剂量成比例增加。两种复方片剂的安全性特征相似。
Pharmaceuticals (Basel). 2025-1-17