Methylphenidate Multiphasic Release Tablet: Bioequivalence Assessment between Two Formulations Administered under Fasting and Fed Conditions.

Methylphenidate hydrochloride is used to treat children, adolescents, and adults with attention deficit/hyperactivity disorder (ADHD). Multiphasic release formulation has been used to control drug levels, mainly during children's school period. This study aimed to evaluate the bioequivalence between two methylphenidate hydrochloride extended-release tablets to meet regulatory requirements for registration in Brazil. Two independent studies (under fasting and fed conditions) designed as open-label, randomized, single-dose, two-period, two-way crossover trials were conducted in healthy subjects of both genders. Subjects were enrolled and randomly received a single dose of the test formulation methylphenidate hydrochloride 54 mg extended-release tablet (Consiv®, Adium S.A., São Paulo, Brazil) or the reference formulation (Concerta®, Janssen-Cilag Farmacêutica Ltd., São Paulo, Brazil), in each period, with a 7-day washout interval. Serial blood samples were collected up to 24 h post dose and methylphenidate plasma concentrations were obtained using a validated LC-MS/MS method. A total of 96 healthy subjects were enrolled in the fasting study, of which 80 completed the study. For the fed study, 52 healthy subjects were enrolled, and 46 subjects completed it. In both studies, 90% confidence intervals for Cmax, AUC0-t, AUC0-inf, and partial AUCs were within the acceptable limits of 80.00 to 125.00%. Thus, according to regulatory requirements, the test formulation (Consiv®) was considered to be bioequivalent to the reference formulation (Concerta®) in both conditions (fasting and fed) and, therefore, it can be considered interchangeable in clinical practice. Both formulations were safe and well tolerated in single-dose administration.

Avaliação da bioequivalência entre duas formulações de rivaroxabana ­ 20 mg comprimido revestido ­ administradas em jejum e pós-prandial em voluntários sadios / Evaluation of bioequivalence between two rivaroxaban formulations ­ coated tablet 20 mg ­ administered under fasting and fed conditions in healthy volunteers

Objetivo: O objetivo deste trabalho foi avaliar a bioequivalência entre duas formulações de rivaroxabana 20 mg comprimido revestido, sendo a formulação teste produzida por Sanofi Medley, Brasil e a formulação referência (Xarelto®) comercializada por Bayer S/A. Métodos: Os estudos foram conduzidos em voluntários sadios de ambos os sexos e as formulações foram administradas em dose única, sob o estado de jejum e pós-prandial. Cada estudo foi conduzido de maneira independente, sendo ambos do tipo aberto, randomizado e com intervalo (washout) de sete dias entre os períodos. O estudo em jejum foi realizado em quatro períodos, com 48 voluntários, enquanto o pós-prandial foi realizado em dois períodos, com 36 voluntários. Resultados: Na administração em jejum, a razão entre a média geométrica da formulação teste e referência (T/R) de Cmáx foi de 100,77%, com intervalo de confiança de 90% (IC 90%) de 94,24% a 107,76%. Para ASC0-t, a razão T/R foi de 100,65%, com IC 90% de 96,13% a 105,39%. Na administração pós-prandial, a razão T/R de Cmáx foi de 110,63%, com IC 90% de 102,39% a 119,54%. Para ASC0-t, a razão T/R foi de 104,65%, com IC 90% de 98,44% a 109,12%. Conclusões: As formulações teste e referência foram consideradas estatisticamente bioequivalentes em ambas as condições de administração, de acordo com os critérios exigidos pela Agência Nacional de Vigilância Sanitária (Anvisa). A formulação teste foi registrada na Anvisa e disponibilizada para comercialização, contribuindo, assim, para a ampliação da disponibilidade do tratamento para doenças tromboembólicas e para a redução de custos ao paciente e ao Sistema Único de Saúde.

Objective: The objective of the present study was to evaluate the bioequivalence between two formulations of rivaroxaban 20 mg coated tablet, the test formulation being manufactured by Sanofi Medley, Brazil and the reference formulation (Xarelto® ) commercialized by Bayer S/A. Methods: The studies were conducted in healthy volunteers of both sexes and the formulations were administered in a single dose, under fasting and fed conditions. Each study was conducted independently, both being open-label, randomized and with a seven-day interval (washout) between periods. The fasting study was carried out in four periods, with 48 volunteers, while the fed study was carried out in two periods, with 36 volunteers. Results: In the fasting administration, the ratio between.

Tromboembolismo pulmonar séptico secundário à síndrome de Lemierre / Septic pulmonary thromboembolism due to Lemierre syndrome

Descrita pela primeira vez em 1900 por Coumont e Cade, a tromboflebite séptica da veia jugular interna (síndrome de Lemierre) é uma condição rara. Acomete indivíduos jovens e possui elevada morbimortalidade. Relatamos o caso de uma paciente atendida inicialmente como portadora de amigdalite bacteriana e que retornou com piora do quadro, associado à trombose da veia jugular interna, evoluindo, na internação, com embolia séptica pulmonar. Além de relatar o caso, fazemos breve revisão da literatura e chamamos a atenção sobre este importante assunto.(AU)

First described in 1900 by Coumont and Cade, septic thrombophlebitis of the internal jugular vein (Lemierre's syndrome) is relatively rare. It affects young patients and has high morbidity and mortality. We describe the case of a woman first diagnosed with a bacterial tonsillitis, who returned to the hospital with worsening of the condition, associated with internal jugular vein thrombophlebitis, that developed to pulmonary embolism during her hospitalization. We reported the case, and made a brief review of the literature, highlighting the details of this important condition.(AU)

Development and validation of an LC-ESI-MS/MS method for the simultaneous quantification of naproxen and sumatriptan in human plasma: application to a pharmacokinetic study.

A sensitive and fast liquid chromatography-electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) method was developed and validated for the simultaneous quantification of naproxen and sumatriptan in human plasma. A simple liquid-liquid extraction procedure, with a mixture of ethyl acetate, methyl tert-butyl ether, and dichloromethane (4:3:3, v/v), was used for the cleanup of plasma. Naratriptan and aceclofenac were employed as internal standards. The analyses were carried out using an ACE C18 column (50 × 4.6 mm i.d.; particle size 5 µm) and a mobile phase consisting of 2 mM aqueous ammonium acetate with 0.025 % formic acid and methanol (38:62, v/v). A triple-quadrupole mass spectrometer equipped with an electrospray source in the positive mode was set up in the selective reaction monitoring mode to detect the ion transitions m/z 231.67 → m/z 185.07, m/z 296.70 → m/z 157.30, m/z 354.80 → m/z 215.00, and m/z 336.80 → m/z 97.94 for naproxen, sumatriptan, aceclofenac, and naratriptan, respectively. The method was validated and proved to be linear, accurate, precise, and selective over the ranges of 2.5-130 µg mL(-1) for naproxen and 1-50 ng mL(-1) for sumatriptan. The validated method was successfully applied to a pharmacokinetic study with simultaneous administration of naproxen sodium and sumatriptan succinate tablet formulations in healthy volunteers.

Comparative study between two recombinant human NPH insulin formulations for the treatment of type 2 diabetes mellitus.

OBJECTIVE: To compare the effects of the neutral protamine Hagedorn (NPH) recombinant human insulin formulations Gansulin and Humulin N® on the glycemic control of patients with type 2 diabetes mellitus (T2DM). SUBJECTS AND METHODS: Prospective, double-blind, randomized, parallel, single-center study of 37 individuals with T2DM treated with NPH insulin formulations. The Tukey-Kramer test for multiple comparisons, the Wilcoxon paired comparison test and the Chi-Square test were used for the statistical analyses. The significance level was set at 5% (p < 0.05). RESULTS: The NPH insulin formulations Humulin and Gansulin similarly reduced the HbA1c levels observed at the end of the study compared with the values obtained at the beginning of the study. In the Humulin group, the initial HbA1c value of 7.91% was reduced to 6.56% (p < 0.001), whereas in the Gansulin group, the reduction was from 8.18% to 6.65% (p < 0.001). At the end of the study, there was no significant difference between the levels of glycated hemoglobin (p = 0.2410), fasting plasma glucose (FG; p = 0.9257) and bedtime plasma glucose (BG; p = 0.3906) between the two insulin formulations. There was no nt difference in the number of hypoglycemic events between the two insulin formulations, and no severe hyp episodes were recorded. CONCLUSION: This study demonstrated similar glycemic control by NPH insulin Gansulin compared with human insulin Humulin N® in patients with T2DM.

Comparative study between two recombinant human NPH insulin formulations for the treatment of type 2 diabetes mellitus

ABSTRACT Objective To compare the effects of the neutral protamine Hagedorn (NPH) recombinant human insulin formulations Gansulin and Humulin N® on the glycemic control of patients with type 2 diabetes mellitus (T2DM). Subjects and methods Prospective, double-blind, randomized, parallel, single-center study of 37 individuals with T2DM treated with NPH insulin formulations. The Tukey-Kramer test for multiple comparisons, the Wilcoxon paired comparison test and the Chi-Square test were used for the statistical analyses. The significance level was set at 5% (p < 0.05). Results The NPH insulin formulations Humulin and Gansulin similarly reduced the HbA1c levels observed at the end of the study compared with the values obtained at the beginning of the study. In the Humulin group, the initial HbA1c value of 7.91% was reduced to 6.56% (p < 0.001), whereas in the Gansulin group, the reduction was from 8.18% to 6.65% (p < 0.001). At the end of the study, there was no significant difference between the levels of glycated hemoglobin (p = 0.2410), fasting plasma glucose (FG; p = 0.9257) and bedtime plasma glucose (BG; p = 0.3906) between the two insulin formulations. There was no nt difference in the number of hypoglycemic events between the two insulin formulations, and no severe hyp episodes were recorded. Conclusion This study demonstrated similar glycemic control by NPH insulin Gansulin compared with human insulin Humulin N® in patients with T2DM.

Estudo de bioequivalência entre duas formulações de pregabalina 150 mg cápsulas em voluntários sadios / Bioequivalence study between two formulations of pregabalin 150 mg capsules in healthy volunteers

A biodisponibilidade de pregabalina em duas formulações diferentes de cápsulas gelatinosas duras de 150 mg foi comparada por meio de um estudo de bioequivalência de dose única, randomizado, aberto, cruzado em dois períodos e com 36 voluntários brasileiros, sadios, do sexo masculino. Amostras de sangue foram coletadas durante um período de 48 horas e o plasma obtido foi mantido congelado até o momento de análise. As concentrações plasmáticas de pregabalina foram determinadas utilizando um método de HPLC-MS/MS validado. A separação cromatográfica foi obtida com fase móvel composta por tampão acetato de amônio 2 mM com 0,025% de ácido fórmico e metanol (3:7 v/v), com fluxo de 1,5 mL/min. A coluna cromatográfica empregada foi ACE 5 C18 (100 x 4,6mm) e o tempo total de corrida foi 2,5 minutos. A detecção por espectrometria de massas foi realizada utilizando-se ionização por electrospray no modo positivo. Os intervalos com 90% de confiança para concentração plasmática máxima (Cmax) e área sob a curva (ASC0-t) foram determinados utilizando os dados após transformação logarítmica. As formulações teste e referência foram consideradas bioequivalentes, uma vez que os intervalos com 90% de confiança para a média geométrica da razão teste/referência ficaram compreendidos na faixa de 80% a 125%, conforme preconizado pelo Food and Drug Administration (FDA) e a Agência Nacional de Vigilância Sanitária (ANVISA). O intervalo com 90% de confiança para as razões das médias geométricas para Cmax foi 99,90% (92,85%-107,49%) e para ASC0-t foi 102,61% (100,69-104,56%). Desta forma, as cápsulas de pregabalina 150 mg testadas (Zodiac Produtos Farmacêuticos S.A.) foram bioequivalentes às cápsulas de Lyrica® 150 mg (Laboratórios Pfizer), de acordo com taxa e extenção de absorção...

Estudo de bioequivalência entre duas formulações de ciprofibrato 100 mg comprimidos em voluntários sadios após administração de dose única / Bioequivalence study between two formulations of ciprofibrate 100 mg tablets in healthy volunteers after single dose administration

A comparação da biodisponibilidade de duas formulações de ciprofibrato 100 mg comprimidos (ciprofibrato 100 mg - Aché Laboratórios Farmacêuticos S/A, formulação teste, e Oroxadin® 100 mg - Sanofi-Aventis Farmacêutica Ltda., formulação referência) foi realizada por meio de um estudo de bioequivalência em 52 voluntários sadios. O estudo foi realizado através de um delineamento aberto, randomizado, em dose única, cruzado em dois períodos e com tempo de washout de nove semanas. As amostras de plasma foram obtidas durante um intervalo de tempo de 72 horas. As concentrações plasmáticas de ciprofibrato foram determinadas por cromatografia líquida de alta eficiência com detecção por espectrometria de massas (CLAE-MS/MS), com ionização por electrospray em modo positivo. Os parâmetros farmacocinéticos área sob a curva (ASC0-72), concentração plasmática máxima (Cmax) e tempo máximo (Tmax) foram obtidos a partir da curva de concentração plasmática do ciprofibrato versus tempo. As razões das médias geométricas com intervalo de confiança 90% após transformação logarítmica foram 89,43% (85,09% - 93,99%) para Cmax e 97,23% (94,73% - 99,79%) para ASC0-72. As formulações teste e referência são consideradas bioequivalentes se os intervalos com 90% de confiança para a média geométrica da razão teste/referência ficarem compreendidos na faixa de 80% a 125%. Dessa forma os comprimidos de ciprofibrato 100 mg testados (Aché Laboratórios Farmacêuticos S/A) foram bioequivalentes aos comprimidos de Oroxadin® 100 mg, de acordo com taxa e extenção de absorção.

4th Global CRO Council for Bioanalysis: coadministered drugs stability, EMA/US FDA guidelines, 483s and carryover.

The Global CRO Council for Bioanalysis (GCC) was formed in September 2010. Since then, the representatives of the member companies come together periodically to openly discuss bioanalysis and the regulatory challenges unique to the outsourcing industry. The 4th GCC Closed Forum brought together experts from bioanalytical CROs to share and discuss recent issues in regulated bioanalysis, such as the impact of coadministered drugs on stability, some differences between European Medicines Agency and US FDA bioanalytical guidance documents and lessons learned following recent Untitled Letters. Recent 483s and agency findings, as well as issues on method carryover, were also part of the topics discussed.

US FDA/EMA harmonization of their bioanalytical guidance/guideline and activities of the Global Bioanalytical Consortium.

The 2011 annual conference of the American Association of Pharmaceutical Scientists, held in Washington DC, USA, hosted a roundtable entitled: 'Update of the US FDA/European Medicines Agency (EMA) harmonization of their bioanalytical guidance - Global Bioanalytical Consortium activity and impact on small and large molecules.' The roundtable was initiated with a presentation from CT Viswanathan on the history of the revision of the FDA guideline on bioanalytical method validation. It was followed by a presentation by Jan Welink who presented an update on the final European Medicines Agency guideline on bioanalytical method validation with relevance to ongoing harmonization efforts. The final presentation was by Fabio Garofolo on the progress of the Global Bioanalytical Consortium harmonization teams for small and large molecules. Brian Booth and Sam Haidar of the FDA updated the audience on the status of the revision of the FDA bioanalytical guidance. The roundtable was moderated by Stephen Lowes.

Comparação da bioequivalência entre duas formulações de dicloridrato de betaistina 24 mg comprimidos em voluntários sadios após a administração de dose única / Comparison of the bioequivalence between two formulations of betahistine hydrochloride 24 mg tablets in healthy volunteers after a single dose dministration

A biodisponibilidade de uma dose única de dicloridrato de betaistina em comprimidos de 24 mg produzidos por Aché Laboratórios Farmacêuticos S.A. foi comparada com o medicamento referência (à época do estudo) dicloridrato de betaistina 24 mg (Labirin®, Apsen Farmacêutica S.A.). Um estudo de dose única, randomizado, aberto, cruzado em dois períodos foi realizado em 34 voluntários brasileiros, sadios, de ambos os gêneros. Dezenove coletas de sangue foram realizadas durante 24 horas. As amostras foram mantidas congeladas até o momento de análise. As concentrações plasmáticas de ácido 2-piridilacético, um metabólito da betaistina, foram determinadas utilizando um método de CLAE-EM/EM validado. Os intervalos com 90% de confiança para concentração plasmática máxima (Cmáx) e área sob a curva (ASC0-t) foram determinados utilizando os dados após transformação logarítmica. As formulações teste e referência foram consideradas bioequivalentes se os intervalos com 90% de confiança para a média geométrica da razão teste/referência ficassem compreendidos na faixa de 80% a 125%. Os intervalos com 90% de confiança para as razões das médias geométricas para Cmáx foi 105,18% (97,31%-113,70%) e para ASC0-t foi 99,33% (95,55%-103,26%). Em conclusão, os comprimidos de dicloridrato de betaistina 24 mg testados (Aché Laboratórios Farmacêuticos S.A.) foram bioequivalentes aos comprimidos de Labirin® 24 mg, de acordo com taxa e extensão de absorção.

A rapid and sensitive HPLC-APCI-MS/MS method determination of fluticasone in human plasma: application for a bioequivalency study in nasal spray formulations.

A sensitive method for the determination of fluticasone in plasma was developed using high performance liquid chromatography with tandem mass spectrometric detection, whereas beclomethasone was used as internal standard. The analytes were extracted with a simple liquid-liquid extraction from the plasma samples and separated on an ACE C(18) 50 × 4.6 mm i.d.; 5 µm particle size column with a mobile phase consisting of acetonitrile - 0.01% formic acid (48:52, v/v) at a flow rate of 1 ml/min. Detection was achieved by an Applied Biosystems API 5000 mass spectrometer (LC-MS/MS) set at unit resolution in the multiple reaction monitoring mode. Atmospheric pressure chemical ionization (APCI) was used for ion production. The mean recovery for fluticasone propionate was 85%, with a lower limit of quantification set at 2 pg/mL. The validated analytical method was applied to a bioequivalence study of fluticasone propionate administered by nasal spray formulations in human volunteers.

Simultaneous quantitation of levodopa and 3-O-methyldopa in human plasma by HPLC-ESI-MS/MS: application for a pharmacokinetic study with a levodopa/benserazide formulation.

A sensitive and simple method was developed for the quantitation of levodopa and its metabolite 3-O-methyldopa, in human plasma, after oral administration of tablet formulations containing levodopa (200 mg) and benserazide (50 mg). The analytes were extracted by a protein precipitation procedure, using carbidopa as an internal standard. A mobile phase consisting of 0.2% formic acid and acetonitrile (94:6, v/v) was used and chromatographic separation was achieved using ACE C(18) column (50 mm×4.6 mm i.d.; 5 µm particle size). Selected reaction monitoring was performed using the fragmentation transitions m/z 198→m/z 107, m/z 212→m/z 166 and m/z 227→m/z 181 for levodopa, 3-O-methyldopa and carbidopa, respectively. Calibration curves were constructed over the range 50.0-6000.0 ng/mL for levodopa and 25.0-4000.0 ng/mL for 3-O-methyldopa. The method shown to be specific, precise, accurate and provided recovery rates higher than 85% for all analytes. No matrix effect was detected in the samples. The validated method was applied in a pharmacokinetic study with a levodopa/benserazide tablet formulation in healthy volunteers.

Liquid chromatography-tandem mass spectrometry for the simultaneous quantitation of artemether and lumefantrine in human plasma: application for a pharmacokinetic study.

A liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) method for the simultaneous quantitation of artemether and lumefantrine in human plasma was developed and validated. Artesunate was used as an internal standard (IS). The analytes were extracted by a protein precipitation procedure and separated on a reversed-phase Zorbax SB-Ciano column with a mobile phase composed of methanol and 10mM aqueous ammonium acetate containing 0.2% (v/v) acetic acid and 0.1% (v/v) formic acid. Multiple reaction monitoring was performed using the transitions m/z 316 → m/z 267, m/z 530 → m/z 348 and m/z 402 → m/z 267 to quantify artemether, lumefantrine and artesunate, respectively. Calibration curves were constructed over the range of 10-1000 ng/mL for artemether and 10-18,000 ng/mL for lumefantrine. The lower limit of quantitation was 10 ng/mL for both drugs. The mean R.S.D. values for the intra-run precision were 2.6% and 3.0% and for the inter-run precision were 3.6% and 4.6% for artemether and lumefantrine, respectively. The mean accuracy values were 102.0% and 101.2% for artemether and lumefantrine, respectively. No matrix effect was detected in the samples. The validated method was successfully applied to determine the plasma concentrations of artemether and lumefantrine in healthy volunteers, in a one-dose pharmacokinetic study, over the course of 11 days.