Open-label, single-center, phase I trial to investigate the mass balance and absolute bioavailability of the highly selective oral MET inhibitor tepotinib in healthy volunteers.

Tepotinib (MSC2156119J) is an oral, potent, highly selective MET inhibitor. This open-label, phase I study in healthy volunteers (EudraCT 2013-003226-86) investigated its mass balance (part A) and absolute bioavailability (part B). In part A, six participants received tepotinib orally (498 mg spiked with 2.67 MBq [14C]-tepotinib). Blood, plasma, urine, and feces were collected up to day 25 or until excretion of radioactivity was <1% of the administered dose. In part B, six participants received 500 mg tepotinib orally as a film-coated tablet, followed by an intravenous [14C]-tepotinib tracer dose (53-54 kBq) 4 h later. Blood samples were collected until day 14. In part A, a median of 92.5% (range, 87.1-96.9%) of the [14C]-tepotinib dose was recovered in excreta. Radioactivity was mainly excreted via feces (median, 78.7%; range, 69.4-82.5%). Urinary excretion was a minor route of elimination (median, 14.4% [8.8-17.7%]). Parent compound was the main constituent in excreta (45% [feces] and 7% [urine] of the radioactive dose). M506 was the only major metabolite. In part B, absolute bioavailability was 72% (range, 62-81%) after oral administration of 500 mg tablets (the dose and formulation used in phase II trials). In conclusion, tepotinib and its metabolites are mainly excreted via feces; parent drug is the major eliminated constituent. Oral bioavailability of tepotinib is high, supporting the use of the current tablet formulation in clinical trials. Tepotinib was well tolerated in this study with healthy volunteers.

Metabolite characterization of ambrisentan, in in vitro and in vivo matrices by UHPLC/QTOF/MS/MS: Detection of glutathione conjugate of epoxide metabolite evidenced by in vitro GSH trapping assay.

The focus of the present study is on in vitro and in vivo metabolite identification of ambrisentan (AMBR) a selective endothelin type - A (ETA) receptor antagonist using quadruple time-of-flight mass spectrometry (QTOF/MS). in vitro metabolism study was conducted by incubating AMBR in rat liver microsomes (RLM), rat and human liver S9 fractions. In vivo study was carried out through the collection of urine, faeces and plasma samples at various time points after oral administration of AMBR in suspension form at a dose of 25 mg/kg to six male Sprague - Dawley (SD) rats. The samples were prepared using an optimized sample preparation techniques involving protein precipitation (PP), freeze liquid extraction (FLE) and solid phase extraction (SPE). The extracted samples were further concentrated and analyzed by developing a sensitive and specific liquid chromatography-mass spectrometry (LC-MS) method. A total of seventeen metabolites were identified in in vivo samples which includes hydroxyl, demethylated, demethoxylated, hydrolytic, decarboxylated, epoxide and glucuronide metabolites. Most of the metabolites were observed in faeces and urine matrices and few were observed in the plasma matrix. Only ten metabolites were identified in in vitro study which was commonly observed in in vivo study. The detailed structural elucidation of all the metabolites was done using UHPLC/QTOF/MS/MS in combination with accurate mass measurements. The toxicity profile of AMBR and its metabolites were predicted using TOPKAT software. In addition, a mass spectrometric method was developed for the detection and characterization of GSH-trapped reactive epoxide metabolitein human liver S9 fraction supplemented with glutathione (GSH) as trapping agent.

Pharmacokinetics and excretion balance of OR-1896, a pharmacologically active metabolite of levosimendan, in healthy men.

OBJECTIVE: To investigate the pharmacokinetics and excretion balance of [(14)C]-OR-1896, a pharmacologically active metabolite of levosimendan, in six healthy male subjects. In addition, pharmacokinetic parameters of total radiocarbon and the deacetylated congener, OR-1855, were determined. METHODS: OR-1896 was administered as a single intravenous infusion of 200 microg of [(14)C]-OR-1896 (specific activity 8.6 MBq/mg) over 10 min. The pharmacokinetic parameters were calculated by three-compartmental methods. RESULTS: During the 14-day collection of urine and faeces, excretion (+/-S.D.) averaged 94.2+/-1.4% of the [(14)C]-OR-1896 dose. Mean recovery of radiocarbon in urine was 86.8+/-1.9% and in faeces 7.4+/-1.5%. Mean terminal elimination half-life of OR-1896 (t(1/2)) was 70.0+/-44.9 h. Maximum concentrations of OR-1855 were approximately 30% to that of OR-1896. Total clearance and the volume of distribution of OR-1896 were 2.0+/-0.4 l/h and 175.6+/-74.5l, respectively. Renal clearances of OR-1896 and OR-1855 were 0.9+/-0.4 l/h and (5.4+/-2.3)x10(-4) l/h, respectively. CONCLUSIONS: This study provides data to demonstrate that nearly one half of OR-1896 is eliminated unchanged into urine and that the active metabolites metabolite of levosimendan remain in the body longer than levosimendan. The remaining half of OR-1896 dose is eliminated through other metabolic routes, partially through interconversion back to OR-1855 with further metabolism of OR-1855. Given the fact that the pharmacological activity and potency of OR-1896 is similar to levosimendan, these results emphasize the clinical significance of OR-1896 and its contribution to the long-lasting effects of levosimendan.

Pharmacokinetics, pharmacodynamics and safety of CEP-26401, a high-affinity histamine-3 receptor antagonist, following single and multiple dosing in healthy subjects.

CEP-26401 is a novel orally active, brain-penetrant, high-affinity histamine H3 receptor (H3R) antagonist, with potential therapeutic utility in cognition enhancement. Two randomized, double-blind, placebo-controlled dose escalation studies with single (0.02 to 5 mg) or multiple administration (0.02 to 0.5 mg once daily) of CEP-26401 were conducted in healthy subjects. Plasma and urine samples were collected to investigate CEP-26401 pharmacokinetics. Pharmacodynamic endpoints included a subset of tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and nocturnal polysomnography. Population pharmacokinetic-pharmacodynamic modeling was conducted on one CANTAB and one polysomnography parameter of interest. CEP-26401 was slowly absorbed (median tmax range 3-6 hours) and the mean terminal elimination half-life ranged from 24-60 hours. Steady-state plasma concentrations were achieved within six days of dosing. CEP-26401 exhibits dose- and time-independent pharmacokinetics, and renal excretion is a major elimination pathway. CEP-26401 had a dose-dependent negative effect on sleep, with some positive effects on certain CANTAB cognitive parameters seen at lower concentrations. The derived three compartment population pharmacokinetic model, with first-order absorption and elimination, accurately described the available pharmacokinetic data. CEP-26401 was generally well tolerated up to 0.5 mg/day with most common treatment related adverse events being headache and insomnia. Further clinical studies are required to establish the potential of low-dose CEP-26401 in cognition enhancement.

Pharmacokinetics of single and consecutive doses of cilazapril and its depressor effects in patients with essential hypertension.

The pharmacokinetic properties and antihypertensive effects of cilazapril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, were investigated in five patients with mild to moderate essential hypertension (mean age 57 years, mean serum creatinine 1.2 mg/dL, mean glomerular filtration rate 69 mL/min/1.73m2, mean blood pressure 158/94 mm Hg). All patients were hospitalized and placed on a constant sodium diet (7 g of NaCl/day) throughout the study. After an overnight fast, a 1.25-mg dose of cilazapril was given orally once a day for 5 or 8 days. On the first and last days of treatment, blood samples were taken and blood pressure was measured. All patients tolerated cilazapril with no untoward effects. Cilazapril induced a significant decrease in both systolic and diastolic blood pressure, and its antihypertensive effect was still present 24 hours after administration. Serum ACE activity was markedly suppressed for at least 24 hours. The peak plasma concentrations (Cmax) of cilazapril and its diacid were 117 and 24.6 ng/mL on the first treatment day, and 144 and 31.1 ng/mL on the last day. The area under the plasma concentration time curve (AUC) of cilazapril and its diacid were 408 and 227 ng.h/mL on the first day, and 501 and 305 ng.h/mL on the last day. In looking at the data gathered on the first and last treatment days, no significant differences were noted in Cmax and AUC values. These results suggest that cilazapril has a long-lasting effect and is a useful antihypertensive agent in controlling blood pressure in patients with mild to moderate essential hypertension.

Time-dependent elimination of cinoxacin in rats.

The effect of the variation of urinary pH on the pharmacokinetics of the acidic antibacterial agent, cinoxacin (pKa 4.60), was examined. Urinary pH of 24-h fasted rats remained at about pH 6 during the daytime, while that of nonfasted rats was high (about pH 7.5) in the morning and gradually decreased to a pH similar to that of the fasted rat in the afternoon. The free fraction of cinoxacin in fasted rat sera in the morning was similar to that in nonfasted rats despite the longer half-life of cinoxacin in fasted rats. In the afternoon the free fraction was slightly different despite similar cinoxacin elimination in fasted and nonfasted rats. These findings seemed to exclude the contribution of protein binding from the causes of increased cinoxacin elimination in nonfasted rats in the morning. Elimination rate constants of cinoxacin obtained with a one-compartment open model correlated well with urinary pH 30 min after injection, suggesting that the urinary pH plays a more important role in cinoxacin elimination. When cinoxacin was orally administered to fasted rats at 11:00, the area under the plasma concentration-time curve was threefold larger than in nonfasted rats. As found with the intravenous administration, this difference may be explained by the prolonged half-life caused by decreased urinary pH after fasting. This study revealed the time-dependent elimination of cinoxacin in nonfasted rats, which is related to physiological change of urinary pH caused by food intake.

Pharmacokinetics and bioavailability of bemoradan, a long-acting inodilator in healthy males.

Bemoradan is a potent, long-acting orally active inodilator. The pharmacokinetics and bioavailability of bemoradan were studied in twelve normal males following oral administration of single, ascending doses of the bemoradan HCL salt in capsules. Plasma and urine levels of bemoradan were determined by HPLC (detection limits: approximately 0.5 ng/ml for plasma and 5 ng/ml for urine). Bemoradan was rapidly absorbed from the capsule formulation at all doses (Cmax occurred at 2.1-2.4 hours). Bemoradan was slowly eliminated from the body (harmonic mean t1/2 16-23 hours). There was a dose-proportional increase in the AUC (0-48) values of bemoradan in humans following the administration of 0.5, 1, 1.5 and 2 mg of bemoradan. The AUC (0-48) values increased to 2.3, 3.4 and 4.0 times when the dose was increased to 2, 3 and 4 times. Urinary excretion of unchanged bemoradan accounted for approximately 5-12% of the dose. Results from this study and previous studies in rats and dogs indicate that bemoradan is well and rapidly absorbed after oral dosing, has linear pharmacokinetics and long elimination half-lives across species.

[Biotransformation of pyridazines. 1. Pyridazine and 3-methylpyridazine]. / Biotransformation von Pyridazinen. Teil 1: Pyridazin und 3-Methylpyridazin.

Pyridazin (1) and 3-methylpyridazine (6) undergo oxidative biotransformation in an unexpected high degree. Beside the unchanged compounds, after administration of 1 two isomeric monohydroxylated products (2, 3), 4,5-dihydrodihydroxypyridazine (4) and 4,5-dihydroxypyridazine (5) and after administration of 6 one ringhydroxylated 6-derivative (7), 3-hydroxymethylpyridazine (8), one ringhydroxylated 3-hydroxymethylpyridazine derivative (9) and 4,5-dihydroxy-3-methylpyridazine (10) were suggested as urinary metabolites in rats. 2 and 7 are the main metabolites of 1 and 6, respectively.

Metabolites of 3-hydrazino-6-[bis-(2-hydroxyethyl)amino]pyridazine dihydrochloride in rat urine.

In 24 hr urine of rats orally given 150 mg/kg of 3-hydrazino-6-[bis-(2-hydroxyethyl)amino]pyridazine dihydrochloride (DL 150), no unchanged compound was detected. Three metabolites, less polar than DL 150, were isolated, their structures assigned by UV, MS, IR and 1H NMR spectroscopies, and confirmed by synthesis. They are: 3-[bis-(2-hydroxyethyl)amino]-6-isopropoxypyridazine (1); 3-[bis-(2-hydroxyethyl)amino]pyridazine (2); 3-methyl-6-[bis-(2-hydroxyethyl)amino]-s-triazolo[4,3-b]pyridazine (3). The metabolism of DL 150 in the rat follows some of the metabolic pathways reported for hydralazine.

Human pharmacokinetics of cadralazine: a new vasodilator.

The pharmacokinetic profiles in plasma and the renal elimination of 2-(3-[6-(2-hydroxypropyl)ethylamino]pyridazinyl)ethylcarbazate+ ++ were investigated in six healthy volunteers following single oral doses of 5, 10 and 20 mg of cadralazine. The study was run in a randomized change-over design experiment. Concentrations of cadralazine in plasma and urine were determined by a high-performance liquid chromatography method. Maximum plasma levels (Cmax) were reached between 0.25 and 1.0 h (tmax) after administration and ranged from 69.8 to 210.0 ng/g after the 5 mg dose, 148.9 to 333.3 ng/g after the 10 mg dose and 292.9 to 474.5 ng/g after the 20 mg dose. The corresponding area under the plasma concentration-time curve (AUC24hO) are 330, 621 and 1168 (ng/g). h. Mean renal elimination of the unchanged-drug ranged from 69 to 73% of the dose. Mean Cmax, AUC24hO and mean total renal elimination were linearly dose-related. An elimination half-life from plasma of about 2.5 h was observed for cadralazine. Estimations for the mean renal and total clearance range from 185 to 216 ml/min and 251 to 295 ml/min, respectively.

Effects of furosemide and the combination of furosemide and the labeled dosage of pimobendan on the circulating renin-angiotensin-aldosterone system in clinically normal dogs.

OBJECTIVE: To evaluate the effect of administration of the labeled dosage of pimobendan to dogs with furosemide-induced activation of the renin-angiotensin-aldosterone system (RAAS). ANIMALS: 12 healthy hound-type dogs. PROCEDURES: Dogs were allocated into 2 groups (6 dogs/group). One group received furosemide (2 mg/kg, PO, q 12 h) for 10 days (days 1 to 10). The second group received a combination of furosemide (2 mg/kg, PO, q 12 h) and pimobendan (0.25 mg/kg, PO, q 12 h) for 10 days (days 1 to 10). To determine the effect of the medications on the RAAS, 2 urine samples/d were obtained for determination of the urinary aldosterone-to-creatinine ratio (A:C) on days 0 (baseline), 5, and 10. RESULTS: Mean ± SD urinary A:C increased significantly after administration of furosemide (baseline, 0.37 ± 0.14 µg/g; day 5, 0.89 ± 0.23 µg/g) or the combination of furosemide and pimobendan (baseline, 0.36 ± 0.22 µg/g; day 5, 0.88 ± 0.55 µg/g). Mean urinary A:C on day 10 was 0.95 ± 0.63 µg/g for furosemide alone and 0.85 ± 0.21 µg/g for the combination of furosemide and pimobendan. CONCLUSIONS AND CLINICAL RELEVANCE: Furosemide-induced RAAS activation appeared to plateau by day 5. Administration of pimobendan at a standard dosage did not enhance or suppress furosemide-induced RAAS activation. These results in clinically normal dogs suggested that furosemide, administered with or without pimobendan, should be accompanied by RAAS-suppressive treatment.

Metabolism of OR-1896, a metabolite of levosimendan, in rats and humans.

OR-1896 is a pharmacologically active, long-lived metabolite of levosimendan. In the current study, the metabolism of (14)C-labelled OR-1896 was investigated in six healthy men after intravenous infusion over 10 min and in male rats after an intravenous bolus dose. In human plasma, the only (14)C-compounds detected were (14)C-OR-1896 and its deacetylated form, (14)C-OR-1855, in varying proportions in different subjects. In rat plasma >93% of radioactivity was associated with OR-1896. Radioactivity was mainly excreted to urine in both rats (about 69% of the dose) and humans (about 87% of the dose). OR-1896 was a major urinary compound in both humans and rats. Another major human metabolite was hypothesized as N-conjugated OR-1855. Other human and rat urinary biotransformation products were characterized as N-hydroxylated OR-1896 and N-hydroxylated OR-1855, as well as glucuronide or sulphate conjugates of N-hydroxyl OR-1896. The main difference between rat and human metabolism was a lower amount of OR-1855-related metabolites in the rats. In human faecal homogenates, only OR-1896 and OR-1855 were detected, whereas rat faecal metabolite profile was similar to that in urine.

Determination of cadralazine in human plasma and urine by high-performance liquid chromatography.

A high-performance liquid chromatographic method is described for the determination of cadralazine in human plasma and urine. To 1 g of plasma (pH 7) or urine (adjusted to pH 11), internal standard was added and the samples were extracted with chloroform-ethanol (95:5, v/v). The substances were then back-extracted into acid (pH 2) and 100 microliter of the aqueous phase were injected. Chromatography was performed on a 10-micron LiChrosorb RP-8 column with acetonitrile-phosphate buffer pH 6 (15:85, v/v) as eluent at a flow-rate of 2.7 ml/min. The substances were detected by UV spectrophotometry at 254 nm. Concentrations down to 0.141 nmol/g in plasma or 10.59 nmol/g in urine could be measured with very good precision. This method was applied to samples from two healthy volunteers given a single oral dose of 10 mg or 20 mg of cadralazine .

Circulating and brain metabolites of minaprine in the baboon.

A mixture of 15N-labelled, 14C-labelled and unlabelled minaprine was administered orally to three baboons, and metabolites in blood, urine and brain investigated. Biological samples were extracted with dichloromethane and the radioactive components extracted were analysed by t.l.c. and autoradiography. Compounds identified by comparing their physiochemical properties with those of synthetic standards and by g.l.c.-mass spectrometry were minaprine, 3-[2-(3-oxo)morpholino-ethylamino]-4-methyl-6-phenylpyridazine, 3-amino-4-methyl-6-phenylpyridazine, 3-[2-(aminoethyl)ethylamino]-4-methyl-6-phenylpyridazine, p-hydroxyminaprine and minaprine N-oxide. In addition to the urinary metabolites, two circulating metabolites were detected: metabolite A, 3-[2-(3-oxo)morpholino-ethylamino]-4-methyl-6-phenylpyridazine, and metabolite B (unidentified). All circulating metabolites appeared very early in blood, confirming the rapid and extensive metabolism of the drug. Metabolites A, B and 3 (p-hydroxyminaprine) were the major metabolites present in plasma. The parent drug was not the major circulating form, and was present in a higher concentration in erythrocytes than in plasma. Erythrocytes might act as a reservoir of the drug and could explain the relatively slow blood clearance of minaprine despite its rapid metabolism. The qualitative metabolic profile in brain tissue was similar to that in blood.

Identification in man of urinary metabolites of a new bronchodilator, MDL 257, using triple stage quadrupole mass spectrometry-mass spectrometry.

The structure elucidation of drug metabolites directly from urine by tandem mass spectrometry (MS/MS) for a new bronchodilator is described. When urine samples from human subjects dosed with 400 mg of MDL 257 were examined by MS/MS, three major urinary metabolites previously characterized in animal studies were confirmed and two previously unsuspected metabolites were identified. Using the operational modes of a triple stage quadrupole mass spectrometer, it is possible both to detect and to identify possible metabolites. Since the pure drug and its metabolites often contain common structural daughter ions, the parent spectra of these common daughter ions should contain some or all of the molecular ions of possible metabolites. Daughter spectra of these suspected molecular ions were obtained and the resulting daughter spectra were interpreted for structural information of suspected metabolites. This study confirms the utility of MS/MS to do rapid metabolic profiling and identification directly from complex samples such as urine, with minimal time for sample preparation and analysis. This technique can provide unique and complimentary data when combined with the more classical approaches such as HPLC profiling, isolation, and off-line spectroscopy.

Determination of hydralazine metabolites: 4-hydrazino-phthalazin-1-one and n-acetylhydrazinophthalazin-1-one by gas chromatography and s-triazolo[3,4-alpha]phthalazine and phthalazinone by high-performance liquid chromatography.

Methods are described for the determination of 2-N-acetylhydrazinophthalazin-1-one, 4-hydrazinophthalazin-1-one, phthalazinone and s-triazolo[3,4-alpha]phthalazine in human urine. 4-Hydrazinophthalazin-1-one and 4-N-acetylhydrazinophthalazin-1-one (following acid hydrolysis) are reacted with acetylacetone to give a distinctive pyrazole derivative which can be determined by gas chromatography using a nitrogen-specific detector. Phthalazinone and s-triazolo[3,4-alpha]phthalazine are measured underivatised by high-performance liquid chromatography.

Isolation and structure determination of a further metabolite of diftalone.

A further metabolite of diftalone, a new antiinflammatory drug, has been identified as 7,14-dihydroxyphthalazino [2,3-b] phthalazine-5,12(7H,14H)-dione, on the basis of physico-chemical properties. The free metabolite was isolated from guinea-pig urine, where it is present as such and as the beta-glucuronide. This structure confirms the selective susceptibility of the methylene group of diftalone towards biological hydroxylation.