DPPⅣ抑制剂对2型糖尿病的Ⅰ期临床研究

目的：评价某二肽基肽酶Ⅳ（ dipeptidyl peptldase Ⅳ,DPPⅣ）抑制剂连续多次口服给药的安全性,同时进行药代／药效动力学研究。方法用随机、安慰剂平行对照、双盲、多剂量递增给药的多中心临床试验方法,将36名2型糖尿病受试者随机纳入DPPⅣ抑制剂50 mg组、100 mg组、200 mg组;每组12例受试者中,10例接受DPPⅣ抑制剂,2例接受安慰剂。试验疗程为7 d,以葡萄糖、胰岛素、C肽在空腹、餐后3 h、口服葡萄糖耐量试验（ oral glucose tolerance test ,OGTT）的相应指标即0－3h的曲线下面积（AUC0－3h）为药效指标,评价此DPPⅣ抑制剂及其代谢产物浓度与胰高血糖素样肽1（glucagon-like peptide 1,GLP-1）的关系,分析其耐受性和安全性。结果揭盲后对3个剂量组和安慰剂组共4组进行分析。安慰剂组与各剂量DPPⅣ抑制剂组均无严重不良事件和重要医学事件发生。给药7d后50 mg组空腹血糖以及100 mg组的空腹血糖、餐后3 h血糖以及OGTT后AUC0－3h均有显著降低（ P＜0．05）。50 mg组的OGTT后胰岛素AUC0－3h升高、100 mg组的餐后3 h胰岛素水平升高以及50 mg组餐后3 h的C肽升高、200 mg组的OGTT后C肽AUC0－3h均显著升高（P＜0．05）。当药物剂量在50、100、200 mg范围递增时,药物浓度先不变后增高,而餐后GLP-1水平先显著增高后不变。结论此DPPⅣ抑制剂在2型糖尿病受试者中有较好的安全性和耐受性,推荐100 mg为Ⅱ期临床试验剂量。     

甲磺酸仑伐替尼胶囊在中国健康受试者中的生物等效性研究

摘 要 目的：研究国产甲磺酸仑伐替尼胶囊在中国健康受试者中的药代动力学特征,评价国产受试制剂（T）与原研参比制剂（R,商品名：乐卫玛■）的生物等效性。方法：采用空腹/餐后、随机、开放、两周期、两序列、双交叉试验设计。空腹试验和餐后试验分别入组28例健康受试者,男女兼有。入组的受试者随机分配至T-R或R-T给药序列组,每周期单次空腹或餐后口服甲磺酸仑伐替尼胶囊受试制剂或参比制剂4 mg/粒。采用高效液相色谱-串联质谱法（HPLC-MS/MS）测定0 ~ 120 h不同采集点的血浆中仑伐替尼浓度。采用Phoenix WinNonlin 8.2软件计算药代动力学参数（Cmax、tmax、AUC0 - t、AUC0 - ∞、t1/2）,并对主要参数进行生物等效性评价。结果：健康受试者空腹单次口服给药后,受试制剂及参比制剂的Cmax、AUC0 - t、AUC0 - ∞的算数平均值分别为70.55和69.89 ng·mL-1、801.3和792.6 h·ng·mL-1、823.6和814.6 h·ng·mL-1,几何均值比值及90%CI分别为103.17%（96.52% ~ 110.28%）、101.15%（98.09% ~ 104.30%）和101.10%（98.12% ~ 104.18%）;健康受试者餐后单次口服给药后,受试制剂及参比制剂的Cmax、AUC0 - t、AUC0 - ∞算数平均值分别为44.82和49.21 ng·mL-1、738.1和747.5 h·ng·mL-1、765.1和777.1 h·ng·mL-1,几何均值比值及90%CI分别为90.41%（83.92% ~ 97.42%）、98.81%（96.16% ~ 101.53%）和98.50%（95.94% ~ 101.13%）。不良事件程度轻度,未出现严重不良事件和非预期不良反应。结论：国产甲磺酸仑伐替尼胶囊与参比制剂甲磺酸仑伐替尼胶囊（乐卫玛■）于空腹或餐后状态下给药后,在中国健康受试者体内两制剂生物等效。     

高脂餐对健康受试者单次口服盐酸二甲双胍缓释片药物动力学影响

摘要：目的:研究高脂餐对盐酸二甲双胍缓释片药物动力学影响。方法:采用随机、开放、单周期单次给药、平行设计,72例健康受试者平均分配至仿制药（广东赛康制药厂有限公司生产）组和原研药（英国Merck Serono Limited生产）组,仿制药组和原研药组再随机分为空腹亚组和餐后亚组,每个亚组18例。分别在空腹及高脂餐后单次给予盐酸二甲双胍缓释片（500mg/片）,计算其药物动力学参数,采用Phoenix Win Nonlin 7.0和SAS 9.4软件进行统计分析,比较餐后和空腹条件下生物等效性。结果:仿制药组在餐后和空腹条件下曲线下面积(AUC0→t和AUC0→∝)、最大血药浓度(Cmax)几何均值之比（餐后/空腹）以及上述指标的90%置信区间（CI）分别为116.57%（112.43%,154.54%）,116.37%（112.28%,153.75%）和85.32%（74.49%,97.72%）;原研药组上述药物动力学参数及其90%CI分别为122.37%（105.71%,141.65%）,121.42%（105.13%,140.23%）和85.83%（73.61%,100.08%）。而全部完成试验的受试者（总研究组）上述参数及其90%CI分别为127.10%（114.25%,141.39%）,126.40%（113.78%,140.42%）和85.68%（77.44%,94.79%）。各组主要药物动力学参数餐后/空腹比值的90%CI均不在生物等效区间内（80.00%～125.00%）。与同组空腹亚组相比,仿制药组、原研药组和总研究组餐后的药物暴露量(AUC0→t和AUC0→∞)明显增加（P<0.05或P<0.01）,总研究组餐后的Cmax明显降低（P<0.05）。结论:盐酸二甲双胍缓释片（500 mg/片）在空腹和餐后条件下服用不等效,高脂餐提高了药物吸收程度、延缓药物吸收速度、减少血药浓度波动程度。本研究从药物动力学方面为盐酸二甲双胍缓释片临床用药提供科学依据。     

反义寡核苷酸药物癌泰得及其代谢产物的猕猴体内药代动力学研究

研究反义寡核苷酸药物癌泰得(cantide)及其代谢产物在猕猴体内的药代动力学特征。通过采用两步固相萃取法结合无胶筛分毛细管电泳技术测定猕猴血浆中的癌泰得及其代谢产物的血药浓度,并计算药代动力学参数。研究比较了猕猴单次静脉滴注不同剂量(8,16,24 mg.kg-1)癌泰得后血浆中原形药物及其代谢产物M1和M2的药代动力学行为。猕猴经静脉滴注给药后,癌泰得在血浆中消除迅速,末端t1/2为57.91～77.97 min,其Cmax、AUC0-inf和AUC0-t与给药剂量的线性相关系数(r)分别为0.991 8、0.956 8和0.977 3。代谢产物紧随原形药物之后达到峰浓度,且峰浓度均明显低于原形药物。原形药物及其代谢产物M1和M2的CLs分别为1.60～2.19、5.92～8.58和6.07～8.78 mL.min-1.kg-1。结果表明癌泰得原形及其代谢产物的Cmax、AUC0-inf和AUC0-t均随给药剂量增加而增加。代谢产物的清除率大于原形药物,且代谢产物在高剂量组表现为MRT明显延长,末端消除相半衰期亦增大。     

丙酸倍氯米松福莫特罗吸入气雾剂在中国健康受试者的药代动力学研究北大核心CSCD

目的评价中国健康受试者单剂吸入不同剂量丙酸倍氯米松福莫特罗吸入气雾剂(超细丙酸倍氯米松/福莫特罗100μg/6μg固定剂量复方)后的药代动力学特征和安全性。方法按开放、随机、单剂给药、3个剂量组平行设计。在36名中国健康受试者中进行,分别单剂吸入200μg/12μg,400μg/24μg和800μg/48μg丙酸倍氯米松福莫特罗吸入气雾剂后,采集每例受试者24 h内的血样,用于评价丙酸倍氯米松及其代谢产物倍氯米松-17-单丙酸盐(B17MP)和福莫特罗的药代动力学,同时观察试验期间的安全性事件。结果 36名受试者全部完成研究,单剂吸入200μg/12μg、400μg/24μg或800μg/48μg丙酸倍氯米松福莫特罗吸入气雾剂后,B17MP药代动力学参数如下:t1/2分别为2.76,3.03和3.49 h,tmax分别为0.50,0.38和0.38 h,Cmax分别为263,708和975pg·mL^(-1),AUC0-t分别为786,2179和2968 pg·mL^(-1)·h;福莫特罗药代动力学参数如下:t1/2分别为2.13,5.31和4.88 h,tmax分别为0.08,0.08和0.17 h,Cmax分别为9.8,24.0和37.6 pg·mL^(-1),AUC0-t分别为16.3,55.9和83.5pg·mL^(-1)·h。丙酸倍氯米松福莫特罗吸入气雾剂被很好地耐受。结论中国健康受试者丙酸倍氯米松福莫特罗吸入气雾剂单剂吸入200μg/12μg,400μg/24μg和800μg/48μg后吸收迅速,丙酸倍氯米松迅速代谢成为B17MP,其消除半衰期约为3 h,福莫特罗在低剂量组消除半衰期约为2 h,在另2个剂量组半衰期约为5 h。两者的全身暴露量均没有明显偏离剂量正比关系,受试者个体间变异较大。     

酰托普利在健康男、女受试者体内的药代动力学研究

目的：研究新型血管紧张素转换酶抑制剂酰托普利在健康男、女受试者体内的药代动力学和安全性。方法：10名健康男、女受试者（男、女各半）连续口服酰托普利30mg（bid,7d）,另有10名健康男、女受试者（男、女各半）分别在空腹和进食标准餐后单剂量口服酰托普利60mg,按规定时间点取血并测定血浆药物浓度,采用WinNonlin软件计算药代动力学参数。结果：受试者首次和末次口服30mg酰托普利后的平均Cmax分别为（279±100）、（299±101）μg/L,tmax分别为（1.2±0.5）、（1.2±0.3）h,t1/2分别为（1.3±0.9）、（1.3±0.5）h,AUC0-t分别为（421±107）、（461±152）μg·L^-1·h,在二者之间无统计学差异。比较受试者单剂量空腹和餐后口服酰托普利60mg,tmax明显延后,Cmax有所降低,其他参数AUC、t1/2等在两种给药方式间无差异。各试验组中男、女受试者的药动学参数均无统计学差异。结论：本研究未观察到酰托普利有药物蓄积现象,进食影响该药的吸收速率,不影响其吸收程度,其体内过程不受性别差异的影响。     

孟鲁司特钠咀嚼片在中国健康受试者中的生物等效性研究北大核心CSCD

目的评价2种孟鲁司特钠咀嚼片在中国健康受试者中的生物等效性。方法采用单中心、随机、开放、单剂量、双周期、双交叉试验设计,空腹和餐后条件下各入组24例健康受试者,随机交叉单次口服孟鲁司特钠咀嚼片受试制剂和参比制剂5 mg,用LC-MS/MS法测定血浆中孟鲁司特的浓度,用WinNonlin 7.0软件计算药代动力学参数,用SAS 9.4软件评价生物等效性。结果受试者口服孟鲁司特钠咀嚼片受试制剂与参比制剂5 mg后,主要药代动力学参数如下:空腹组Cmax分别为(311.91±56.82)和(297.92±69.30)ng·mL^(-1),AUC0-t分别为(1968.30±442.29)和(1940.38±458.19)ng·h·mL^(-1),AUC0-∞分别为(2047.60±480.74)和(2013.03±483.28)ng·h·mL^(-1);餐后组Cmax分别为(292.93±64.70)和(284.10±61.79)ng·mL^(-1),AUC0-t分别为(1851.69±374.26)和(1833.54±454.75)ng·h·mL^(-1),AUC0-∞分别为(1917.17±398.69)和(1897.29±489.54)ng·h·mL^(-1)。2种制剂的Cmax、AUC0-t和AUC0-∞经对数转换后90%置信区间空腹状态下分别为98.76%~113.22%,97.87%~105.98%和97.95%~106.22%;餐后状态下分别为96.78%~109.84%,96.84%~106.59%和96.75%~106.96%。结论无论是空腹还是餐后单次口服2种孟鲁司特钠咀嚼片在中国健康受试者体内均具有生物等效性。     

单次注射比阿培南在健康人体的药代动力学

目的研究注射用比阿培南(碳青霉烯类抗生素)在健康人群单次给药药代动力学。方法用分层随机、三交叉、拉丁方设计、空腹给药的试验方法,12名健康受试者单次静脉滴注比阿培南150,300,600 mg,HPLC法测定给药后血、尿药物浓度,DAS软件计算药代动力学参数。结果受试者静滴比阿培南150,300,600 mg后药代动力学参数如下,Cmax分别是(8.49±1.03),(16.31±1.83),(34.51±3.74)mg.L-1;Tmax均为(1.00±0.00)h;t1/2β分别为(1.08±0.80),(0.89±0.14),(0.93±0.08)h;AUC0-t分别(13.49±2.29),(28.91±4.92),(60.85±8.72)mg.L-1.h;CL分别是(11.09±1.58),(10.54±1.85),(9.98±1.39)L.h-1.kg-1。12 h尿排出率分别为61.9%,62.1%,62.8%。结论注射用比阿培南药代动力学符合二室开放模型,药代动力学参数与剂量呈线性相关,受试者耐受性良好。     

单次口服莫达芬尼片在中国健康志愿者的药代动力学

目的研究单次口服莫达芬尼片的药代动力学。方法选择9名健康成年男性受试者分别单次口服100,200,300mg 3个剂量的莫达芬尼片后,用HPLC法测定血中原形药莫达芬尼及代谢产物莫达芬尼酸浓度,用3P97软件进行数据处理,计算药代动力学参数。结果原形药莫达芬尼的药-时曲线符合二房室模型,其主要药代动力学参数的Cmax、AUC0-∞、AUC0-t随剂量加大而增加;t1/2b、tmax、b、CL与给药剂量无关。莫达芬尼片原形药经肾排泄较少,48h经肾累积排泄率分别为(4.44±4.28)%,(3.35±2.20)%和(2.86±1.39)%。主要代谢产物莫达芬尼酸药-时曲线符合二房室模型,48h莫达芬尼酸经肾累积排泄率分别为(33.51±18.90)%,(32.36±19.92)%和(22.88±6.89)%。结论莫达芬尼在100～300mg内,呈线性动力学特征而无饱和性,其消除过程是经肝脏代谢,代谢产物为莫达芬尼酸,代谢产物主要经肾排泄。     

盐酸西替利嗪片人体生物等效性试验

目的 评价健康受试者空腹和餐后条件下单剂量服用盐酸西替利嗪片受试制剂和参比制剂是否具有生物等效性。方法 采用随机、开放、单剂量、自身交叉设计,液质联用（LC-MS/MS）法测定健康受试者空腹或餐后给药后血浆中西替利嗪的药物浓度,使用Phoenix Winnonlin 8.0软件计算药动学参数,使用SAS 9.4软件进行生物等效性评价。结果 空腹BE试验：24名健康受试者分别单次空腹服用受试制剂和参比制剂10 mg后,Cmax、AUC0-t、AUC0-∞几何均数的比值分别为100.18%、96.37%、96.00%,其90%置信区间分别为95.72% ~ 14.84%、92.37% ~ 100.55%、91.77% ~ 100.42%,均落在等效区间80.00% ~ 125.00%之间;餐后BE试验：22名健康受试者分别单次餐后服用受试制剂和参比制剂10 mg后,Cmax、AUC0-t、AUC0-∞几何均数的比值分别为103.98%、102.19%、101.58%,其90%置信区间分别为98.31% ~ 109.97%、98.33% ~ 106.20%、98.07% ~ 105.20%,均落在等效区间80.00% ~ 125.00%之间。结论 两种制剂对于空腹和餐后条件下的健康成年受试者具有生物等效性。     

Effect of food on the relative bioavailability of two oral formulations of posaconazole in healthy adults

AIMS: This randomized, crossover, single-dose study evaluated the relative oral bioavailability of posaconazole suspension and coprecipitate tablet formulations. Additionally, the study determined whether systemic exposure to posaconazole was affected by prandial status or by the fat content of a meal. METHODS: This was a randomized, open-label, four-way crossover, single-dose study in 20 healthy men. Posaconazole pharmacokinetics were evaluated over 72 h following a single oral dose of posaconazole suspension (200 mg/5 ml) administered with a high-fat meal, a nonfat breakfast, or after a 10 h fast, or posaconazole tablets (2 x 100 mg) administered with a high-fat meal. RESULTS: The posaconazole suspension showed a significant increase in bioavailability compared with the tablet (increase in AUC(0,72 h) = 137% (90% confidence interval (CI) 119%, 156% and Cmax = 123% (90% CI 104%, 146%). The mean increases in AUC(0,72 h) and Cmax values were about 400% when administered with a high-fat meal compared with administration of the suspension in the fasting state (AUC(0,72 h) 90% CI 343%, 448%; Cmax 90% CI 352%, 493%). Administration of the suspension with a nonfat meal enhanced exposure, resulting in an increase in AUC(0,72 h) of 264% (90% CI 231%, 302%) and in Cmax of 296% (90% CI 250%, 350%) relative to the fasted state. CONCLUSIONS: The suspension formulation of posaconazole was associated with enhanced systemic exposure and increased relative bioavailability compared with the tablet. Food substantially enhanced the rate and extent of posaconazole absorption in healthy subjects.     

Effect of food on the pharmacokinetics of sunitinib malate (SU11248), a multi-targeted receptor tyrosine kinase inhibitor: results from a phase I study in healthy subjects

The effect of food on the oral bioavailability of sunitinib malate (SU11248, an oral, multi-targeted tyrosine kinase inhibitor with anti-angiogenic and anti-tumor activities) was assessed in a randomized open-label, two-way crossover study. A 50-mg dose of SU11248 was administered to 16 healthy subjects after a 10-h fast in one period and after a high-fat, high-calorie meal in the other period. The 90% confidence intervals (CIs) for maximum plasma concentration (Cmax) and area under the concentration-time curve (AUC) were within the 80-125% bioequivalence range, indicating the absence of a food effect. SU11248 exposure increased slightly in the fed compared with the fasted state (ratios of fed/fasted geometric least square means: Cmax 104%, AUC0-last and AUC0-infinity both 112%). There was a delay in the formation/absorption of the active metabolite SU12662 in the fed state (mean Cmax decreased 23%), but exposure remained unaffected (90% CIs for AUC0-last and AUC0-infinity were within 80-125%). These results indicate that SU11248 can be administered with or without food.     

Effect of food on everolimus absorption: quantification in healthy subjects and a confirmatory screening in patients with renal transplants

STUDY OBJECTIVE: To quantify the influence of a high-fat meal on the oral bioavailability of the immunosuppressant everolimus in a single-dose study in healthy subjects and to confirm the results in a small food-effect screening assessment in patients with renal transplants who were receiving multiple-dose everolimus. DESIGN: Randomized, open-label, crossover, single-dose study and confirmatory screening. SETTING: Phase 1 unit for the single-dose study and two German hospitals for the patient screening. SUBJECTS: Twenty-four healthy male volunteers; six clinically stable patients with renal transplants who were originally part of a phase I dose-escalation study. INTERVENTION: The 24 healthy men received everolimus 2 mg orally under fasting conditions and after a high-fat meal. The six patients received everolimus 2.5 mg/day orally, in addition to cyclosporine and prednisone. On two occasions, a pharmacokinetic profile was obtained over the dosing interval after drug administration under fasting conditions and after a high-fat meal in a randomized sequence. MEASUREMENTS AND MAIN RESULTS: In the single-dose study in healthy subjects, a high-fat meal delayed everolimus time to maximum concentration (Tmax) by a median 1.25 hours, reduced peak blood concentration (Cmax) by 60%, and reduced area under the concentration-time curve (AUC) by 16%. In the multiple-dose screening in patients with renal transplants, a high-fat meal delayed Tmax by a median 1.75 hours and reduced Cmax by 53% and AUC by 21%. Everolimus trough levels showed no food effect, whereas the peak-trough fluctuation was dampened by 52%. CONCLUSIONS: A high-fat meal modestly reduced everolimus AUC. To minimize longitudinal variability in exposure, everolimus should be administered consistently either with food or without food.     

Effect of a high-fat meal on the bioavailability of a polymer-coated erythromycin particle tablet formulation

The effect of food on the relative bioavailability of an erythromycin particles-in-tablet formulation was studied in 27 healthy volunteers, using a four-way, crossover study design with the following treatments: one or two erythromycin capsules USP (Eryc, Parke-Davis), or one polymer-coated erythromycin particles-in-tablet (PCE, Abbott) administered fasting or with a high-fat meal. Under fasting conditions the erythromycin particles-in-tablet and erythromycin capsule formulations are bioequivalent based on similar tmax and dose-normalized Cmax and AUC values. The rate and extent of absorption from the particles-in-tablet formulation, however, are dramatically reduced following administration with a meal. Mean Cmax and AUC values decreased by 73% and 72%, respectively, and seven subjects had no detectable erythromycin plasma concentrations for 16 hours following administration of the particles-in-tablet formulation with the high-fat meal. Greater than 40% of the subjects had nonfasting Cmax and AUC values that were less than 10% of those values following administration of the dose fasting. Cmax and AUC values in nonfasting subjects were within 75% to 125% of fasting values in only two and one of 27 subjects, respectively. The erythromycin particles-in-tablet formulation therefore should not be administered with meals.     

Effect of food on the bioavailability of adinazolam from a sustained release formulation: effect of meal timing and lack of dose dumping

Food effects on adinazolam absorption from sustained release (SR) adinazolam mesylate tablets were assessed in 28 healthy male volunteers. Subjects received 15 mg SR tablets, 15 mg immediate release tablets, 15 mg oral solution, administered after an overnight fast, and 15 mg SR tablets after a high fat breakfast. Treatments were administered in a crossover design. Plasma adinazolam and N-desmethyladinazolam (NDMAD) concentrations were determined by HPLC. Adinazolam and NDMAD AUC values were unaffected by food. Cmax for SR tablets was increased 33 per cent and 18 per cent for adinazolam and NDMAD, respectively, when administered postprandially. Tmax occurred later in the fed state; no dose dumping was observed. Meal timing effects on adinazolam absorption from SR tablets were assessed in 24 healthy subjects, who received 30 mg SR tablets 1 h before, 0.5 h after, 2 h after a high fat meal, and in the fasted state. Postprandial administration had no effect on AUC, but resulted later and higher adinazolam and NDMAD Cmax. Differences in these values were less than 11 per cent. Administration of SR tablets before meals yielded Cmax and Tmax values which were similar to the fasted state. Results suggest that meal timing does not substantially affect adinazolam absorption from the SR tablet.     

Food intake increases the relative oral bioavailability of vanoxerine.

Each of 12 healthy male subjects received single oral doses of 100 mg vanoxerine (GBR 12909), a dopamine reuptake inhibitor with potential antidepressant activity, on three different occasions (fasting, after a low-fat meal and after a high-fat meal) according to a randomized, cross-over design. The mean tmax value increased from 0.82 h after fasting to 1.44 h after a low-fat meal and to 2.46 h after a high-fat meal. Only modest food effects were seen on mean Cmax values (55 nM, 52 nM and 84 nM, after fasting, after the low-fat meal and after the high-fat meal, respectively) but values of AUC up to the last measurable concentration (AUC(0,t)) increased by 76% (from 110 to 194 nM h) after the low-fat meal and by 255% (from 110 to 391 nM h) after the high-fat meal compared with fasting. All of these effects were statistically significant except for the differences in tmax and Cmax between fasting and the low-fat meal. The mechanism of these changes is unclear, but it seems likely that food may lower the first-pass metabolism of vanoxerine, as has been shown for other lipophilic basic drugs.     

Effect of food on the oral bioavailability of didanosine from encapsulated enteric-coated beads

The objective of this study was to assess the effect of food and timing of meals on the bioavailability of didanosine from encapsulated enteric-coated beads. Four different independent, open-label, single-dose, randomized, crossover studies were conducted in healthy subjects (n = 20-30). Didanosine (400 mg) was given concomitantly with a high-fat meal, light meal, yogurt, and applesauce. In addition, didanosine was given 1, 1.5, 2, and 3 hours before and 2 hours after a light meal. Statistical comparison with fasting conditions was made using the equivalence approach for Cmax (70%-143%) and AUC (80%-125%). The high-fat meal, light meal, yogurt, and applesauce decreased the Cmax by 46%, 22%, 30%, and 24%, respectively, and lowered the AUC by 19%, 27%, 20%, and 18%, respectively; statistical analyses indicated an indeterminate food effect, except for the Cmax for the high-fat meal. For 1 hour before meal, Cmax and AUC were lower by 15% and 24% and, for 2 hours after meal, were lower by 15% and 10%, respectively. There was an indeterminate food effect for 1 hour before the meal treatment; in addition, 2 hours after the meal, treatment approached statistical equivalence, missing narrowly on the lower bounds. For 1.5, 2, and 3 hours before meal treatments, Cmax values were unchanged, but AUC was lower by 10%, 4%, and 0%, respectively; lack of food effect was observed for all three treatments. Across studies, median time to Cmix ranged from 1.67 to 2.67 hours but was delayed by 2.5 to 3 hours with high-fat and light meals compared to fasting conditions. The half-life of didanosine was 1.5 to 2 hours. It was concluded that the bioavailability of didanosine from encapsulated enteric-coated beads was reduced by approximately 20% to 25% with food, which can be circumvented by taking didanosine on an empty stomach. The clinical significance of such moderate reductions in didanosine exposure with food, especially as part of a highly active antiretroviral therapy, is not clear.     

基于超高效液相色谱-串联质谱快速检测索非布韦及其代谢物在大鼠体内的生物等效性分析

目的：建立超高效液相色谱-串联质谱（UPLC-MS/MS）快速并同时测定大鼠血浆中抗丙肝药索非布韦及其代谢物GS-331007的含量,探讨索非布韦代谢产物作为标记物测定药时曲线的可能性,研究不同厂家抗丙肝药索非布韦在大鼠体内的生物等效性。方法：通过液质联用检测原研药A和仿制药B以36 mg·kg^-1灌胃大鼠各时间点索非布韦和GS-331007的血药浓度。用DAS 2.1.1和SPSS 17.0软件计算药动学参数并比较原研药A和仿制药B的一致性。结果：原研药A和仿制药B中索非布韦药动学参数C_max分别为（1 376.08±174.95）ng·mL^-1和（1 297.58±164.93）ng·mL^-1,t_max分别为（0.75±0.08）h和（0.72±0.16）h,t_1/2分别为（1.57±0.20）h和（1.73±0.45）h,AUC_（0→t）分别为（2 691.67±280.85）ng·mL^-1·h和（2 851.20±199.54）ng·mL^-1·h,AUC_{（0→∞）}分别为（2 748.51±258.91）ng·mL^-1·h和（3 007.75±364.02）ng·mL^-1·h,原研药A和仿制药B代谢物GS-331007 C_max分别为（1 302.52±163.73）ng·mL^-1和（1 430.88±107.52）ng·mL^-1,t_max分别为（3.97±0.74）h和（3.95±1.38）h,t_1/2分别为（5.56±2.55）h和（5.44±1.38）h,AUC_（0→t）分别为（9 723.24±1170.38）ng·mL^-1·h和（9 032.31±1 037.76）ng·mL^-1·h,AUC_{（0→∞）}分别为（9 893.26±1 251.89）和（9 316.90±1 293.44）ng·mL^-1·h。结论：本实验建立的UPLC-MS/MS方法可在3.5 min内准确测定大鼠血浆中索非布韦及其代谢物GS-331007含量。根据索非布韦和其代谢物GS-331007药时曲线得出原研药A和仿制药B的药动学参数一致性较好（P>0.05）。本工作发现用代谢物GS-331007作为索非布韦生物等效性研究的可能性。     

The effect of food on the absorption of oral ziprasidone

Oral ziprasidone bioavailability is increased when taken with food. Here we describe two pharmacokinetic studies to quantify the impact of food on ziprasidone absorption in healthy volunteers. The first, an open-label, six-way crossover study, investigated ziprasidone absorption in eight healthy men. Subjects received oral ziprasidone (20, 40, and 80 mg) after an 8-hour fast or immediately following a US Food and Drug Administration standard meal (50% fat). In this study, area under the serum concentration- time curve (AUC) was greater in fed than in fasting states at each dose (20 mg, +48%; 40 mg, +87%; 80 mg, +101%). Under fasting conditions, increases in AUC and maximum drug concentration (Cmax) were less than dose-proportional; under fed conditions, they were dose-proportional. The second, an open-label, randomized, three-way crossover study, explored the impact of dietary fat on ziprasidone absorption in 14 healthy subjects. Subjects received ziprasidone (40 mg) under three conditions: fasting, with a high-fat meal (60% fat), and with a moderate-fat (30% fat) meal. AUC and Cmax under fed conditions increased by 104% and 84% (60%-fat meal) and 79% and 98% (30%-fat meal) , respectively, relative to the fasting state. There was no clear difference in ziprasidone bioavailability between the fed groups, suggesting that meal fat content is not a major determinant of bioavailability. Less pharmacokinetic variability was observed in the fed state, suggesting more consistent absorption of ziprasidone. These results demonstrate that administration of ziprasidone with food is crucial to ensure optimal, reliable dose-dependent bioavailability and thus predictable symptom control and tolerability.