Lee Soyoung, Nam Kyu-Yeol, Oh Jaeseong, Lee SeungHwan, Cho Sang-Min, Choi Youn-Woong, Cho Joo-Youn, Lee Beom-Jin, Hong Jang Hee
Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea.
College of Pharmacy, Ajou University, Suwon, Republic of Korea.
Drug Des Devel Ther. 2018 May 23;12:1413-1420. doi: 10.2147/DDDT.S146958. eCollection 2018.
Levodropropizine is a non-opioid antitussive agent that inhibits cough reflex by reducing the release of sensory peptide in the peripheral region. To improve patients' compliance, a controlled-release (CR) tablet is under development. The aim of this study was to compare the pharmacokinetic (PK) profiles of the CR and immediate-release (IR) tablets of levodropropizine. In addition, the effect of food on the PK properties of levodropropizine CR tablet in healthy subjects was evaluated.
A randomized, open-label, multiple-dose, three-treatment, three-period, six-sequence, crossover study was conducted on 47 healthy subjects. All subjects were randomly assigned to one of the six sequences, which involve combinations of the following three treatments: levodropropizine IR 60 mg three times in the fasted state (R), levodropropizine CR 90 mg two times in the fasted state (T), and levodropropizine CR 90 mg two times in the fed state (TF). Serial blood samples were collected up to 24 h after the first dose. Tolerability was assessed based on the vital signs, adverse events (AEs), and clinical laboratory tests.
Levodropropizine CR showed lower maximum drug concentration () and similar total exposure compared to levodropropizine IR. The geometric mean ratios (GMRs) (90% confidence intervals [CIs]) of T to R for the and area under the concentration-time curve from the 0 to 24 h time points (AUC) were 0.80 (0.75-0.85) and 0.89 (0.86-0.93), respectively. In the fed group, levodropropizine CR showed exposure similar to that in the fasted group. The GMRs (90% CIs) of TF to T for the and AUC were 0.90 (0.85-0.97) and 1.10 (1.05-1.14), respectively. No serious AEs occurred with both levodropropizine CR and IR tablets.
Total systemic exposure for levodropropizine was similar in subjects receiving the CR and IR formulations in terms of the AUC. Although food delayed the absorption of levodropropizine CR, systemic exposure was not affected.
左羟丙哌嗪是一种非阿片类镇咳药,通过减少外周区域感觉肽的释放来抑制咳嗽反射。为提高患者的依从性,正在研发一种控释(CR)片剂。本研究的目的是比较左羟丙哌嗪CR片和速释(IR)片的药代动力学(PK)特征。此外,评估了食物对健康受试者中左羟丙哌嗪CR片PK特性的影响。
对47名健康受试者进行了一项随机、开放标签、多剂量、三治疗、三周期、六序列的交叉研究。所有受试者被随机分配到六个序列之一,这六个序列涉及以下三种治疗的组合:空腹状态下左羟丙哌嗪IR 60 mg,每日三次(R);空腹状态下左羟丙哌嗪CR 90 mg,每日两次(T);进食状态下左羟丙哌嗪CR 90 mg,每日两次(TF)。在首剂给药后长达24小时内采集系列血样。根据生命体征、不良事件(AE)和临床实验室检查评估耐受性。
与左羟丙哌嗪IR相比,左羟丙哌嗪CR的最大药物浓度()较低,但总暴露量相似。T与R在和0至24小时时间点的浓度-时间曲线下面积(AUC)的几何平均比值(GMRs)(90%置信区间[CIs])分别为0.80(0.75 - 0.85)和0.89(0.86 - 0.93)。在进食组中,左羟丙哌嗪CR的暴露量与空腹组相似。TF与T在和AUC的GMRs(90% CIs)分别为0.90(0.85 - 0.97)和1.10(1.05 - 1.14)。左羟丙哌嗪CR片和IR片均未发生严重AE。
就AUC而言,接受CR和IR制剂的受试者中左羟丙哌嗪的全身总暴露量相似。尽管食物延迟了左羟丙哌嗪CR的吸收,但全身暴露量未受影响。