Murphy Joseph, Wang Shean-Sheng, Stieltjes Hans, Wajs Ewa, Devineni Damayanthi
Int J Clin Pharmacol Ther. 2015 Mar;53(3):256-64. doi: 10.5414/CP202233.
To assess the effect of food on the pharmacokinetics (PK) of canagliflozin and metformin following administration of a canagliflozin/metformin (150/1,000 mg) immediate-release (IR) fixed-dose combination (FDC) tablet.
A randomized, open-label, singlecenter, single-dose, 2-period, 2-sequence crossover study was conducted in healthy participants. Participants were randomized to 2 sequences of fasted and fed (or vice versa) administration of one 150/1,000 mg canagliflozin/metformin IR FDC, with 10-14 day washout between treatments PK parameters (AUC, Cmax, tmax, t1/2) were assessed for canagliflozin and metformin. Safety was evaluated.
When comparing the IR FDC tablet administered with and without food, PK parameters of canagliflozin were bioequivalent as the 90% confidence intervals (CIs) for log-transformed AUClast, AUCâ, and Cmax were within the bioequivalence limits of 80-125%. For metformin, overall exposure was similar under fed and fasted conditions as geometric mean ratios for AUC and associated 90% CI were contained within the bioequivalence limits, but geometric mean Cmax decreased by 16% in the fed compared to fasted state. Both treatments were well tolerated with similar adverse events and most common were gastrointestinal events, generally attributed to metformin.
Food did not affect canagliflozin bioavailability parameters (Cmax and AUCs) or AUCs of metformin. The Cmax of metformin was decreased by 16%, which is not considered clinically meaningful. The canagliflozin/metformin FDC tablet is recommended to be taken with meals to reduce the symptoms of gastrointestinal intolerability associated with metformin.
评估食物对服用卡格列净/二甲双胍(150/1000毫克)速释(IR)固定剂量复方(FDC)片剂后卡格列净和二甲双胍药代动力学(PK)的影响。
在健康受试者中进行了一项随机、开放标签、单中心、单剂量、两阶段、两序列交叉研究。受试者被随机分为2个序列,分别在空腹和进食状态下(或反之)服用一片150/1000毫克卡格列净/二甲双胍IR FDC,治疗之间有10 - 14天的洗脱期。评估了卡格列净和二甲双胍的PK参数(AUC、Cmax、tmax、t1/2)。对安全性进行了评估。
比较在有食物和无食物情况下服用的IR FDC片剂时,卡格列净的PK参数具有生物等效性,因为对数转换后的AUClast、AUC∞和Cmax的90%置信区间(CIs)在生物等效性限度80 - 125%之内。对于二甲双胍,进食和空腹条件下的总体暴露相似,因为AUC的几何平均比值及相关的90% CI包含在生物等效性限度内,但与空腹状态相比,进食时几何平均Cmax降低了16%。两种治疗的耐受性均良好,不良事件相似,最常见的是胃肠道事件,一般归因于二甲双胍。
食物不影响卡格列净的生物利用度参数(Cmax和AUCs)或二甲双胍的AUCs。二甲双胍的Cmax降低了16%,这在临床上不被认为有意义。建议卡格列净/二甲双胍FDC片剂与餐同服,以减轻与二甲双胍相关的胃肠道不耐受症状。