Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea.
Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Drug Des Devel Ther. 2020 Feb 19;14:661-668. doi: 10.2147/DDDT.S233014. eCollection 2020.
A fixed-dose combination (FDC) tablet formulation of amlodipine/losartan/rosuvastatin 5/100/20 mg was developed to improve medication compliance in patients with both hypertension and dyslipidemia. The comparative pharmacokinetic study was performed to compare the profile of an FDC tablet formulation of amlodipine/losartan/rosuvastatin with that of concomitant administration of a currently marketed FDC tablet of amlodipine/losartan with a rosuvastatin tablet.
A randomized, open-label, single oral dose, two-way crossover study was conducted in 60 healthy subjects. Subjects were orally administered the FDC tablet of amlodipine/losartan/rosuvastatin and a loose combination (LC) of two tablets comprising an FDC of amlodipine/losartan and rosuvastatin. Blood samples were collected for up to 144 h post dose for pharmacokinetic evaluations. Plasma concentrations of amlodipine, losartan, EXP3174 (an active metabolite of losartan), and rosuvastatin were measured by using liquid chromatography-tandem mass spectrometry. The geometric mean ratio (GMR) and its 90% confidence interval (90% CI) in the FDC treatment to LC treatment for the area under the concentration-time curve from zero to the last quantifiable time point (AUC) and the maximum plasma concentration (C) were calculated. Safety was monitored throughout the study.
The GMR (90% CI) values of AUC and C were 0.9946 (0.9663-1.0238) and 0.9690 (0.9379-1.0011) for amlodipine, 0.9855 (0.9422-1.0308) and 0.9178 (0.8349-1.0089) for losartan, 0.9814 (0.9501-1.0136) and 0.9756 (0.9313-1.0219) for EXP3174, and 0.9448 (0.8995-0.9923) and 0.9609 (0.8799-1.0494) for rosuvastatin, respectively. No clinically significant changes were observed in any of the safety parameters, including clinical laboratory tests, vital signs, electrocardiograms, and physical examinations, between the FDC treatment and the LC treatment.
We confirmed the pharmacokinetic equivalence of the FDC and LC treatments. This triple combination FDC formulation could be a clinically useful replacement for LC therapy.
开发了一种氨氯地平/缬沙坦/瑞舒伐他汀 5/100/20mg 的固定剂量复方片剂,以提高同时患有高血压和血脂异常的患者的用药依从性。进行了比较药代动力学研究,以比较氨氯地平/缬沙坦/瑞舒伐他汀固定剂量复方片剂与目前市售的氨氯地平/缬沙坦固定剂量复方片剂与瑞舒伐他汀片剂联合给药的制剂特征。
在 60 名健康受试者中进行了一项随机、开放标签、单口服剂量、双交叉研究。受试者口服给予氨氯地平/缬沙坦/瑞舒伐他汀固定剂量复方片剂和包含氨氯地平/缬沙坦固定剂量复方和瑞舒伐他汀片剂的两种片剂的松散组合(LC)。给药后最多采集 144 小时的血样进行药代动力学评估。采用液相色谱-串联质谱法测定氨氯地平、缬沙坦、EXP3174(缬沙坦的活性代谢物)和瑞舒伐他汀的血浆浓度。计算 FDC 治疗与 LC 治疗的 AUC 和 C 的几何均数比值(GMR)及其 90%置信区间(90%CI)。整个研究期间监测安全性。
AUC 和 C 的 GMR(90%CI)值分别为氨氯地平 0.9946(0.9663-1.0238)和 0.9690(0.9379-1.0011),缬沙坦 0.9855(0.9422-1.0308)和 0.9178(0.8349-1.0089),EXP3174 0.9814(0.9501-1.0136)和 0.9756(0.9313-1.0219),瑞舒伐他汀 0.9448(0.8995-0.9923)和 0.9609(0.8799-1.0494)。在 FDC 治疗与 LC 治疗之间,任何安全性参数(包括临床实验室检查、生命体征、心电图和体格检查)均未观察到临床意义上的变化。
我们证实了 FDC 和 LC 治疗的药代动力学等效性。这种三联复方 FDC 制剂可能是 LC 治疗的一种临床有用的替代品。