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富马酸替诺福韦二吡呋酯前药在健康志愿者中的药代动力学及食物相互作用。

Pharmacokinetics and food interaction of a novel prodrug of tenofovir, tenofovir dipivoxil fumarate, in healthy volunteers.

机构信息

Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

出版信息

J Clin Pharm Ther. 2013 Apr;38(2):136-40. doi: 10.1111/jcpt.12023. Epub 2012 Dec 28.

Abstract

WHAT IS KNOWN AND OBJECTIVE

Tenofovir dipivoxil fumarate is a novel ester prodrug of tenofovir, a specific anti-hepatitis B virus (HBV) drug candidate. The pharmacokinetic properties and the effects of food intake on tenofovir dipivoxil have not yet been reported in healthy adults. The aim of this study was to evaluate the pharmacokinetic properties and food interaction of tenofovir dipivoxil in healthy Chinese volunteers.

METHODS

Pharmacokinetic studies included an ascending single dose of 150, 300, 600 mg and multiple doses of 300 mg. Food interaction was evaluated following a single oral dose of tenofovir dipivoxil fumarate 300 mg administered with a high-fat and high-energy standard breakfast or after a 12-h fast. Pharmacokinetic parameters of tenofovir given in each treatment period were calculated using non-compartmental analysis.

RESULTS

After a single dose of 150, 300 and 600 mg, the main pharmacokinetic parameters for tenofovir were as follows: Cmax 209·6, 456·7, 989·8 ng/mL; AUClast 1744·9, 2663·5, 6010·2 ng h/mL, respectively. After multiple doses of 300 mg, the main pharmacokinetic parameters for tenofovir were Cmax 523·4 ng/mL, AUClast 4152·4 ng h/mL. After a single dose of 300 mg with a high-fat and high-energy standard breakfast, the main pharmacokinetic parameters for tenofovir were Cmax 448·5 ng/mL, AUClast 3286·8 ng h/mL. The plasma Cmax and AUC of tenofovir showed significance difference between a single dose of 300 mg and the accordingly multiple doses (P < 0·05). A standard high-fat meal enhanced mean AUClast values of tenofovir (relative AUClast  = 125·8%; 90% CI 114·5, 136·2); however, food did not show any significant on Cmax (relative Cmax  = 103·4%; 90% CI 94·6, 112·6).

WHAT IS NEW AND CONCLUSIONS

Oral tenofovir dipivoxil fumarate produced predictable and dose-proportional plasma tenofovir pharmacokinetics. The accumulation ratio was 1·51, suggesting tenofovir dipivoxil fumarate displayed accumulation after repeated administration. The bioavailability of tenofovir dipivoxil fumarate was increased by approximately 25% as measured by AUClast after a single dose when taken with food, compared with fasting.

摘要

已知和目的

富马酸替诺福韦二吡呋酯是替诺福韦的新型酯前药,是一种特定的抗乙型肝炎病毒(HBV)候选药物。替诺福韦二吡呋酯的药代动力学特性以及食物摄入对其的影响尚未在健康成年人中报道。本研究的目的是评估替诺福韦二吡呋酯在健康中国志愿者中的药代动力学特性和食物相互作用。

方法

药代动力学研究包括单次递增剂量 150、300、600mg 和多次剂量 300mg。在给予 300mg 替诺福韦二吡呋酯后,通过给予高脂肪和高能量标准早餐或禁食 12 小时来评估食物相互作用。使用非房室分析计算替诺福韦在每个治疗期的药代动力学参数。

结果

单次给予 150、300 和 600mg 后,替诺福韦的主要药代动力学参数如下:Cmax 209.6、456.7、989.8ng/mL;AUClast 1744.9、2663.5、6010.2ng·h/mL,分别。多次给予 300mg 后,替诺福韦的主要药代动力学参数为 Cmax 523.4ng/mL,AUClast 4152.4ng·h/mL。单次给予 300mg 并给予高脂肪和高能量标准早餐后,替诺福韦的主要药代动力学参数为 Cmax 448.5ng/mL,AUClast 3286.8ng·h/mL。替诺福韦的血浆 Cmax 和 AUC 在单次 300mg 剂量和相应的多次剂量之间存在显著差异(P<0.05)。标准高脂肪餐增加了替诺福韦的平均 AUClast 值(相对 AUClast=125.8%;90%CI 114.5,136.2);然而,食物对 Cmax 没有产生任何显著影响(相对 Cmax=103.4%;90%CI 94.6,112.6)。

新发现和结论

口服替诺福韦二吡呋酯产生了可预测且与剂量成比例的替诺福韦血浆药代动力学。蓄积比为 1.51,表明替诺福韦二吡呋酯在重复给药后表现出蓄积。与禁食相比,当单剂量给药时,替诺福韦二吡呋酯的生物利用度增加了约 25%,以 AUClast 测量。

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