Safety and Pharmacokinetic (PK) Study of Intravenous (IV) Acetaminophen Administration in Pediatric Inpatients
Primary Purpose
Pain, Fever
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
IV Acetaminophen
IV Acetaminophen
Sponsored by
About this trial
This is an interventional treatment trial for Pain
Eligibility Criteria
To be eligible for entry into the Study, Subjects must meet or Subjects' Parent or Guardian must meet, agree with or confirm all of the following criteria:
- Provide written Informed Consent/Assent prior to participation in the Study
Age strata:
- Full-term Neonates (≤ 28 days old and minimum post conception age of 37 weeks at birth)
Infants [29 days to <2 years (yrs) old]
- 29 days to <6 months
- 6 to <12 months
- 12 to <24 months)
- Children (2 yrs to <12 yrs old)
- Adolescents (12 yrs to ≤16 yrs old)
- Inpatient status: are currently inpatients or have an admission scheduled and will soon become an inpatient (e.g., elective surgery)
- Diagnosis: requires or will require analgesic treatment for acute pain or antipyretic treatment for fever
- IV access: have a need for IV access for the duration of the Study either due to a nothing by mouth (NPO) status or due to the Investigator's assessment that oral treatment is not optimal (for example, severe nausea or vomiting)
- The Subject's Parent/Guardian must have the ability to read and understand the Study procedures and have the ability to communicate meaningfully with the Study Investigator and staff
- Be free of other physical, mental, or medical conditions which, in the opinion of the Investigator after completing the screening assessment, make Study participation inadvisable
- If a female of child bearing potential, have a negative pregnancy test
Exclusion Criteria (Screening)
A Subject is NOT eligible for entry if ANY of the following criteria are met:
- Is not able to comply with the plasma sampling requirements of the Study
- Has known or suspected hypersensitivity to acetaminophen or the inactive excipients of IV Acetaminophen.
- Has been taking any acetaminophen-containing product in the 12 hours prior or any of the following in the 48 hours prior to randomization in the Study: probenecid, disulfiram, isoniazide, St. John's wort, skullcap, chaparral, comfrey, germander, jin bu huan, kava, pennyroyal, and valerian
- Has any significant medical condition that in the opinion of the Investigator contraindicates participation in the Study
- Has impaired liver function, with evidence of clinically significant liver disease, or other condition that may suggest the potential for an increased susceptibility to hepatic toxicity with IV APAP exposure. For this criterion, a total bilirubin greater than 1.5 times upper limit of normal (ULN) for age or an Alanine aminotransferase (ALT) serum glutamic pyruvic transaminase (SGPT) or Aspartate transaminase (AST) serum glutamic oxaloacetic transaminase (SGOT) greater than 2.5 times ULN for age will be deemed as evidence of clinically significant (Common Terminology Criteria for Adverse Events [CTCAE] Grade 2) liver dysfunction or disease.
- Has significantly impaired renal function or known significant renal disease, as evidenced by an estimated glomerular filtration rate (using the Schwartz formula) calculated to be less than 1/3rd of normal for the applicable age strata
- Has participated in another interventional clinical Study (investigational or marketed product) within 30 days of the planned Study randomization date
Sites / Locations
- Lucile Packard Children's Hospital
- CS Mott Childrens Hospital
- Duke University Health Systems
- Children's Hospital Of Philadelphia
- Children's Hospital Of Pittsburgh
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Intravenous (IV) Acetaminophen 15 milligrams/kilogram (mg/kg)
Intravenous (IV) Acetaminophen 12.5 (mg/kg)
Arm Description
Intravenous Acetaminophen administered 15 milligrams/kilogram (mg/kg) every 8 hours (q8h) or every 6 hours (q6h) based age of subject
Intravenous Acetaminophen administered 12.5 milligrams/kilogram (mg/kg) every 6 hours (q6h) or every 4 hours (q4h)
Outcomes
Primary Outcome Measures
Single-dose Maximum Plasma Concentration (Cmax) , Micrograms Per Milliliter (µg/mL) Pharmacokinetics of IV Acetaminophen
Cmax: Maximum Plasma Concentration
Single-dose Time to Reach Maximum Plasma Concentration [Tmax(h)] Pharmacokinetics of IV Acetaminophen
Tmax: Time to reach maximum plasma concentration (Cmax)
Multiple-dose Area Und the Curve (AUC) From Time 0 (Predose) to the Time of the Dosing Interval at Steady-state (0-t (µg*h/ml) Pharmacokinetics of IV Acetaminophen
AUC 0-t (µg*h/ml): Area under the plasma concentration versus time curve from time 0 (predose) to the time of the dosing interval at steady-state.
Multiple-dose Terminal Elimination Half-life [t1/2(h)] Pharmacokinetics of IV Acetaminophen
t1/2: Terminal elimination half-life
Secondary Outcome Measures
Number of Subjects Reporting at Least One Treatment-Emergent Adverse Event (TEAE)
A TEAE is defined as an adverse event that starts on or after the start of study medication
Subjects Who Experience at Least One Serious Treatment-Emergent Adverse Event (TEAE)
A Serious Treatment Emergent Adverse Event is defined as any untoward medical occurrence at any dose of IV acetaminophen that; Results in Death, Is life-threatening, Requires inpatient hospitalization or causes prolongation of existing hospitalization, Results in persistent or significant disability/incapacity, Is a congenital anomaly/birth defect, Is an important medical event
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00493246
Brief Title
Safety and Pharmacokinetic (PK) Study of Intravenous (IV) Acetaminophen Administration in Pediatric Inpatients
Official Title
A Prospective, Multi-Center, Randomized, Open-Label, Single and Repeated Dose, 48 Hour Study, of Intravenous Acetaminophen in Pediatric Inpatients to Determine Pharmacokinetics (PK) and Safety in Acute Pain and Fever
Study Type
Interventional
2. Study Status
Record Verification Date
September 2016
Overall Recruitment Status
Completed
Study Start Date
June 2007 (undefined)
Primary Completion Date
November 2008 (Actual)
Study Completion Date
November 2008 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mallinckrodt
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
We are doing this study to find out what happens to acetaminophen in the body after it is given to children through the vein. Children's bodies may handle drugs differently than adults. Understanding how long the drug stays in the body and how the drug is changed or metabolized by the body (called pharmacokinetics) is an important step in learning what the best dose of acetaminophen for children should be. We are also interested in learning about the safety of this medication when given to children.
Detailed Description
A Prospective, Multi-Center, Randomized, Open-Label, Single and Repeated Dose, 48 Hour Study, of Intravenous Acetaminophen in Pediatric Inpatients to Determine Pharmacokinetics (PK) and Safety in Acute Pain and Fever
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Fever
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
75 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Intravenous (IV) Acetaminophen 15 milligrams/kilogram (mg/kg)
Arm Type
Experimental
Arm Description
Intravenous Acetaminophen administered 15 milligrams/kilogram (mg/kg) every 8 hours (q8h) or every 6 hours (q6h) based age of subject
Arm Title
Intravenous (IV) Acetaminophen 12.5 (mg/kg)
Arm Type
Experimental
Arm Description
Intravenous Acetaminophen administered 12.5 milligrams/kilogram (mg/kg) every 6 hours (q6h) or every 4 hours (q4h)
Intervention Type
Drug
Intervention Name(s)
IV Acetaminophen
Other Intervention Name(s)
APAP, IV APAP
Intervention Description
This study will investigate two doses (12.5 milligrams/kilogram (mg/kg) and 15 milligrams/kilogram) based on weight administered every four hours (q4h), every six hours (q6h), or every eight hours (q8h) (depending on age)
Neonates: 12.5 mg/kg q6h IV acetaminophen Neonates: 15 mg/kg q8h IV acetaminophen Infants: 12.5 mg/kg q4h IV acetaminophen Infants: 15 mg/kg q6h IV acetaminophen Children: 12.5 mg/kg q4h IV acetaminophen Children: 15 mg/kg q6h IV acetaminophen Adolescents: 12.5 mg/kg q4h IV acetaminophen Adolescents: 15 mg/kg q6h IV acetaminophen
Intervention Type
Drug
Intervention Name(s)
IV Acetaminophen
Other Intervention Name(s)
APAP, IV APAP
Intervention Description
This study will investigate two doses (12.5 milligrams/kilogram (mg/kg) and 15 milligrams/kilogram) based on weight administered every four hours (q4h), every six hours (q6h), or every eight hours (q8h) (depending on age)
Neonates: 12.5 mg/kg q6h IV acetaminophen Neonates: 15 mg/kg q8h IV acetaminophen Infants: 12.5 mg/kg q4h IV acetaminophen Infants: 15 mg/kg q6h IV acetaminophen Children: 12.5 mg/kg q4h IV acetaminophen Children: 15 mg/kg q6h IV acetaminophen Adolescents: 12.5 mg/kg q4h IV acetaminophen Adolescents: 15 mg/kg q6h IV acetaminophen
Primary Outcome Measure Information:
Title
Single-dose Maximum Plasma Concentration (Cmax) , Micrograms Per Milliliter (µg/mL) Pharmacokinetics of IV Acetaminophen
Description
Cmax: Maximum Plasma Concentration
Time Frame
Time Zero (just prior to first dose) to 24 hours post first dose
Title
Single-dose Time to Reach Maximum Plasma Concentration [Tmax(h)] Pharmacokinetics of IV Acetaminophen
Description
Tmax: Time to reach maximum plasma concentration (Cmax)
Time Frame
Time Zero (just prior to first dose) to 24 hours post first dose
Title
Multiple-dose Area Und the Curve (AUC) From Time 0 (Predose) to the Time of the Dosing Interval at Steady-state (0-t (µg*h/ml) Pharmacokinetics of IV Acetaminophen
Description
AUC 0-t (µg*h/ml): Area under the plasma concentration versus time curve from time 0 (predose) to the time of the dosing interval at steady-state.
Time Frame
Time Zero (just prior to first dose) to 48 hours post first dose
Title
Multiple-dose Terminal Elimination Half-life [t1/2(h)] Pharmacokinetics of IV Acetaminophen
Description
t1/2: Terminal elimination half-life
Time Frame
48hrs
Secondary Outcome Measure Information:
Title
Number of Subjects Reporting at Least One Treatment-Emergent Adverse Event (TEAE)
Description
A TEAE is defined as an adverse event that starts on or after the start of study medication
Time Frame
First dose of study medication to 30 days after the last dose of study medication
Title
Subjects Who Experience at Least One Serious Treatment-Emergent Adverse Event (TEAE)
Description
A Serious Treatment Emergent Adverse Event is defined as any untoward medical occurrence at any dose of IV acetaminophen that; Results in Death, Is life-threatening, Requires inpatient hospitalization or causes prolongation of existing hospitalization, Results in persistent or significant disability/incapacity, Is a congenital anomaly/birth defect, Is an important medical event
Time Frame
First dose to 30 days following last dose of study medication
10. Eligibility
Sex
All
Minimum Age & Unit of Time
29 Days
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
To be eligible for entry into the Study, Subjects must meet or Subjects' Parent or Guardian must meet, agree with or confirm all of the following criteria:
Provide written Informed Consent/Assent prior to participation in the Study
Age strata:
Full-term Neonates (≤ 28 days old and minimum post conception age of 37 weeks at birth)
Infants [29 days to <2 years (yrs) old]
29 days to <6 months
6 to <12 months
12 to <24 months)
Children (2 yrs to <12 yrs old)
Adolescents (12 yrs to ≤16 yrs old)
Inpatient status: are currently inpatients or have an admission scheduled and will soon become an inpatient (e.g., elective surgery)
Diagnosis: requires or will require analgesic treatment for acute pain or antipyretic treatment for fever
IV access: have a need for IV access for the duration of the Study either due to a nothing by mouth (NPO) status or due to the Investigator's assessment that oral treatment is not optimal (for example, severe nausea or vomiting)
The Subject's Parent/Guardian must have the ability to read and understand the Study procedures and have the ability to communicate meaningfully with the Study Investigator and staff
Be free of other physical, mental, or medical conditions which, in the opinion of the Investigator after completing the screening assessment, make Study participation inadvisable
If a female of child bearing potential, have a negative pregnancy test
Exclusion Criteria (Screening)
A Subject is NOT eligible for entry if ANY of the following criteria are met:
Is not able to comply with the plasma sampling requirements of the Study
Has known or suspected hypersensitivity to acetaminophen or the inactive excipients of IV Acetaminophen.
Has been taking any acetaminophen-containing product in the 12 hours prior or any of the following in the 48 hours prior to randomization in the Study: probenecid, disulfiram, isoniazide, St. John's wort, skullcap, chaparral, comfrey, germander, jin bu huan, kava, pennyroyal, and valerian
Has any significant medical condition that in the opinion of the Investigator contraindicates participation in the Study
Has impaired liver function, with evidence of clinically significant liver disease, or other condition that may suggest the potential for an increased susceptibility to hepatic toxicity with IV APAP exposure. For this criterion, a total bilirubin greater than 1.5 times upper limit of normal (ULN) for age or an Alanine aminotransferase (ALT) serum glutamic pyruvic transaminase (SGPT) or Aspartate transaminase (AST) serum glutamic oxaloacetic transaminase (SGOT) greater than 2.5 times ULN for age will be deemed as evidence of clinically significant (Common Terminology Criteria for Adverse Events [CTCAE] Grade 2) liver dysfunction or disease.
Has significantly impaired renal function or known significant renal disease, as evidenced by an estimated glomerular filtration rate (using the Schwartz formula) calculated to be less than 1/3rd of normal for the applicable age strata
Has participated in another interventional clinical Study (investigational or marketed product) within 30 days of the planned Study randomization date
Facility Information:
Facility Name
Lucile Packard Children's Hospital
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
CS Mott Childrens Hospital
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Duke University Health Systems
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Children's Hospital Of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Children's Hospital Of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Safety and Pharmacokinetic (PK) Study of Intravenous (IV) Acetaminophen Administration in Pediatric Inpatients
We'll reach out to this number within 24 hrs