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Pharmacokinetic Drug Interaction Between Ezetimibe and Tacrolimus After Single Dose Administration in Healthy Subjects

Primary Purpose

Pharmacokinetics, Drug Interactions, Hypercholesterolemia

Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
1 tablet Ezetrol(R) (ezetimibe), MSD Sharp & Dohme GmbH, Germany
1 capsule Prograf(R) (tacrolimus), Astellas Pharma GmbH, Germany
1 tablet Ezetrol(R) + 1 capsules Prograf(R)
Sponsored by
University Medicine Greifswald
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Pharmacokinetics focused on measuring pharmacokinetics, drug interactions, ezetimibe, tacrolimus, human experimentation

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • age: 18 - 45 years
  • sex: male and female
  • ethnic origin: Caucasian
  • body weight: 19 kg/m² to 27 kg/m²
  • good health as evidenced by the results of the clinical examination, ECG, and the laboratory check-up, which are judged by the clinical investigator not to differ in a clinical relevant way from the normal state
  • written informed consent

Exclusion Criteria:

  • known allergy to macrolide antibiotics
  • existing cardiac or hematological diseases and/or pathological findings which might interfere with safety, pharmacodynamic effect and/or pharmacokinetics of ezetimibe and sirolimus
  • existing hepatic and renal diseases and/or pathological findings which might interfere with safety, pharmacodynamic effect and/or pharmacokinetics of ezetimibe and sirolimus
  • existing gastrointestinal diseases and/or pathological findings which might interfere with safety, pharmacodynamic effect and/or pharmacokinetics of ezetimibe and sirolimus
  • acute or chronic diseases which could affect drug absorption or metabolism
  • history of any serious psychological disorder
  • drug or alcohol dependence
  • positive drug or alcohol screening
  • smokers of 10 or more cigarettes per day
  • positive screening results for HIV, HBV and HCV
  • volunteers who are on a diet which could affect the pharmacokinetics of the drug
  • heavy tea or coffee drinkers (more than 1L per day)
  • lactation and pregnancy test positive or not performed
  • volunteers suspected or known not to follow instructions
  • volunteers who are unable to understand the written and verbal instructions, in particular regarding the risks and inconveniences they will be exposed to as a result of their participation in the study
  • volunteers liable to orthostatic dysregulation, fainting, or blackouts
  • blood donation or other blood loss of more than 400 ml within the last 12 weeks prior to the start of the study
  • participation in a clinical trial during the last 3 months prior to the start of the study
  • less than 14 days after last acute disease
  • any systemically available medication within 4 weeks prior to the intended first administration unless, because of the terminal elimination half-life, complete elimination from the body can be assumed for the drug and/or its primary metabolites (except oral contraceptives)
  • repeated use of drugs during the last 4 weeks prior to the intended first administration, which can influence hepatic biotransformation (e.g. barbiturates, cimetidine, phenytoin, rifampicin)
  • repeated use of drugs during the last 2 weeks prior to the intended first administration which affect absorption (e.g. laxatives, metoclopramide, loperamide, antacids, H2-receptor antagonists)
  • intake of grapefruit containing food or beverages within 7 days prior to administration
  • known allergic reactions to the active ingredients used or to constituents of the pharmaceutical preparation
  • subjects with severe allergies or multiple drug allergies

Sites / Locations

  • Department of Clinical Pharmacology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

C

A

B

Arm Description

administration of 1 tablet Ezetrol(R) (10 mg ezetimibe) and 1 capsule Prograf(R) (5 mg tacrolimus)

administration of 1 tablet Ezetrol(R) (10 mg ezetimibe)

administration of 1 capsule Prograf(R) (5 mg tacrolimus)

Outcomes

Primary Outcome Measures

Primary characteristics: for ezetimibe: AUC0-∞, Cmax; for tacrolimus: AUC0-∞, Cmax

Secondary Outcome Measures

Second. characteristics: for ezetimibe: CLR, Ae (urine), Ae (feces); for ezetimibe glucuronide: AUC0-∞, Cmax, Ae (urine), Ae (feces); for ezetimibe, ezetimibe glucuronide and tacrolimus: AUC0-t, t½, tmax

Full Information

First Posted
February 12, 2008
Last Updated
February 12, 2008
Sponsor
University Medicine Greifswald
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1. Study Identification

Unique Protocol Identification Number
NCT00621699
Brief Title
Pharmacokinetic Drug Interaction Between Ezetimibe and Tacrolimus After Single Dose Administration in Healthy Subjects
Official Title
Pharmacokinetic Drug Interaction Between Ezetimibe and Tacrolimus After Single Dose Administration in Healthy Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
February 2008
Overall Recruitment Status
Completed
Study Start Date
September 2007 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
November 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
University Medicine Greifswald

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to confirm a significant influence of ezetimibe and tacrolimus on each others pharmacokinetics
Detailed Description
Hypercholesterolemia is a frequent finding in organ transplant recipients receiving immunosuppressive drugs such as tacrolimus. To prevent increased cardiovascular morbidity and mortality in these patients, co-medication with lipid-lowering statins is recommended. However, treatment with statins is limited in many patients by insufficient cholesterol-lowering efficacy, drug interactions and serious adverse drug reactions (e.g. rhabdomyolysis). These patients may benefit from comedication with the cholesterol absorption inhibitor ezetimibe. Since tacrolimus and ezetimibe were shown to be substrates of the efflux transporter ABCB1 (P-glycoprotein), drug interactions between both compounds may occur. Therefore, this clinical study in healthy subjects was initiated to evaluate the clinical relevance of drug/drug interactions between tacrolimus and ezetimibe according to the accepted bioequivalence approach.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pharmacokinetics, Drug Interactions, Hypercholesterolemia, Immunosuppression
Keywords
pharmacokinetics, drug interactions, ezetimibe, tacrolimus, human experimentation

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
C
Arm Type
Experimental
Arm Description
administration of 1 tablet Ezetrol(R) (10 mg ezetimibe) and 1 capsule Prograf(R) (5 mg tacrolimus)
Arm Title
A
Arm Type
Active Comparator
Arm Description
administration of 1 tablet Ezetrol(R) (10 mg ezetimibe)
Arm Title
B
Arm Type
Active Comparator
Arm Description
administration of 1 capsule Prograf(R) (5 mg tacrolimus)
Intervention Type
Drug
Intervention Name(s)
1 tablet Ezetrol(R) (ezetimibe), MSD Sharp & Dohme GmbH, Germany
Other Intervention Name(s)
Ezetrol
Intervention Description
administration of 1 tablet Ezetrol(R) (10 mg ezetimibe), 0-144 h blood sampling, 0-5 d urine sampling (24 h intervals) and 0-10 d feces sampling
Intervention Type
Drug
Intervention Name(s)
1 capsule Prograf(R) (tacrolimus), Astellas Pharma GmbH, Germany
Other Intervention Name(s)
Prograf
Intervention Description
administration of 1 capsule Prograf(R) (5 mg tacrolimus), 0-144 h blood sampling
Intervention Type
Drug
Intervention Name(s)
1 tablet Ezetrol(R) + 1 capsules Prograf(R)
Other Intervention Name(s)
Ezetrol+Prograf
Intervention Description
administration of 1 tablet Ezetrol(R) (10 mg ezetimibe) and 1 capsule Prograf(R) (5 mg Tacrolimus), 0-144 h blood sampling, 0-5 d urine sampling (24 h intervals) and 0-10 d feces sampling
Primary Outcome Measure Information:
Title
Primary characteristics: for ezetimibe: AUC0-∞, Cmax; for tacrolimus: AUC0-∞, Cmax
Time Frame
September 2007 to November 2007
Secondary Outcome Measure Information:
Title
Second. characteristics: for ezetimibe: CLR, Ae (urine), Ae (feces); for ezetimibe glucuronide: AUC0-∞, Cmax, Ae (urine), Ae (feces); for ezetimibe, ezetimibe glucuronide and tacrolimus: AUC0-t, t½, tmax
Time Frame
September 2007 to November 2007

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: age: 18 - 45 years sex: male and female ethnic origin: Caucasian body weight: 19 kg/m² to 27 kg/m² good health as evidenced by the results of the clinical examination, ECG, and the laboratory check-up, which are judged by the clinical investigator not to differ in a clinical relevant way from the normal state written informed consent Exclusion Criteria: known allergy to macrolide antibiotics existing cardiac or hematological diseases and/or pathological findings which might interfere with safety, pharmacodynamic effect and/or pharmacokinetics of ezetimibe and sirolimus existing hepatic and renal diseases and/or pathological findings which might interfere with safety, pharmacodynamic effect and/or pharmacokinetics of ezetimibe and sirolimus existing gastrointestinal diseases and/or pathological findings which might interfere with safety, pharmacodynamic effect and/or pharmacokinetics of ezetimibe and sirolimus acute or chronic diseases which could affect drug absorption or metabolism history of any serious psychological disorder drug or alcohol dependence positive drug or alcohol screening smokers of 10 or more cigarettes per day positive screening results for HIV, HBV and HCV volunteers who are on a diet which could affect the pharmacokinetics of the drug heavy tea or coffee drinkers (more than 1L per day) lactation and pregnancy test positive or not performed volunteers suspected or known not to follow instructions volunteers who are unable to understand the written and verbal instructions, in particular regarding the risks and inconveniences they will be exposed to as a result of their participation in the study volunteers liable to orthostatic dysregulation, fainting, or blackouts blood donation or other blood loss of more than 400 ml within the last 12 weeks prior to the start of the study participation in a clinical trial during the last 3 months prior to the start of the study less than 14 days after last acute disease any systemically available medication within 4 weeks prior to the intended first administration unless, because of the terminal elimination half-life, complete elimination from the body can be assumed for the drug and/or its primary metabolites (except oral contraceptives) repeated use of drugs during the last 4 weeks prior to the intended first administration, which can influence hepatic biotransformation (e.g. barbiturates, cimetidine, phenytoin, rifampicin) repeated use of drugs during the last 2 weeks prior to the intended first administration which affect absorption (e.g. laxatives, metoclopramide, loperamide, antacids, H2-receptor antagonists) intake of grapefruit containing food or beverages within 7 days prior to administration known allergic reactions to the active ingredients used or to constituents of the pharmaceutical preparation subjects with severe allergies or multiple drug allergies
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Werner Siegmund, Prof
Organizational Affiliation
Department of Clinical Pharmacology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Clinical Pharmacology
City
Greifswald
ZIP/Postal Code
17487
Country
Germany

12. IPD Sharing Statement

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Pharmacokinetic Drug Interaction Between Ezetimibe and Tacrolimus After Single Dose Administration in Healthy Subjects

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