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This is a Phase I, open-label, 3-period crossover trial to investigate the pharmacokinetic interaction (process by which a drug is absorbed, distributed, metabolised and eliminated by the body) between TMC125 and fluconazole, and between TMC125 and voriconazole.
In this Phase I, open-label, 3-period crossover trial the potential pharmacokinetic interaction between TMC125 and fluconazole and between TMC125 and voriconazole will be investigated. Fluconazole and voriconazole are triazole antifungal agents.
Fluconazole and voriconazole are inhibitors of CYP isoenzymes 2C19, 2C9 and CYP3A4. Fluconazole is metabolized by the liver to a small extent. Approximately 80% of the administered fluconazole dose appears in the urine in unchanged form. Voriconazole is metabolized by CYP2C19, 2C9 and 3A4. TMC125 is also metabolized by CYP3A, 2C9 and 2C19. Because of the effect of fluconazole and voriconazole on the metabolic pathways relevant for TMC125 metabolism, concomitant administration of TMC125 and fluconazole or voriconazole might increase TMC125 pharmacokinetics. Because of the effect of TMC125 on the metabolic pathways relevant for voriconazole metabolism, concomitant administration of TMC125 and voriconazole might also modify voriconazole pharmacokinetics. Since the elimination of fluconazole is mainly via the kidneys, an effect of TMC125 on fluconazole pharmacokinetics is not expected. The current trial aims to assess the 2-way pharmacokinetic interaction between TMC125 and fluconazole, and between TMC125 and voriconazole, to provide dosing recommendations for combined use in the treatment of HIV infected patients.In this trial the pharmacokinetic interaction between TMC125 and fluconazole, and between TMC125 and voriconazole, all at steady-state will be investigated in 18 healthy subjects. During the first two sessions, each subject will receive 2 treatments (Treatments A and B) in a randomized way. In Treatment A, 200 mg TMC125 twice a day. will be administered from Day 1 to Day 7 with an additional morning dose on Day 8. In Treatment B, 200 mg fluconazole once a day in the morning will be administered from Day 1 to Day 16, co-administered with 200 mg TMC125 twice a day from Day 9 to Day 16.
These sessions are followed by a third session, Treatment C, in which 400 mg voriconazole twice a day will be administered on Day 1 and 200 mg voriconazole twice a day will be administered from Day 2 to Day 15, with an additional morning dose on Day 16. From Day 9 to Day 15, 200 mg TMC125 twice a day will be co-administered, with an additional morning dose on Day 16. All TMC125 and fluconazole intakes will be under fed conditions, within 10 minutes after a meal. Voriconazole will be administered 1.5 hour before a meal. Between subsequent treatment sessions, there will be a washout period of at least 2 weeks. Full pharmacokinetic profiles will be determined for one dosing interval (12 hours) for TMC125 on Day 8 of Treatment A and on Day 16 of Treatments B and C. For fluconazole, full pharmacokinetic profiles will be determined for one dosing interval (24 hours) on Days 8 and 16 of Treatment B. For voriconazole, full pharmacokinetic profiles will be determined for one dosing interval (12 hours) on Days 8 and 16 of Treatment C. Safety and tolerability will be monitored continuously throughout the trial. Treatment A: 200 mg TMC125 twice daily, orally from Day 1 to 7 and a morning dose on Day 8. Treatment B: 200 mg fluconazole once daily, orally from Day 1 to 16, co-administered with 200 mg TMC125 twice daily from Day 9 to 16. Treatment C: 400 mg voriconazole twice daily, orally on Day 1 and 200 mg voriconazole twice daily will be administered from Day 2 to 15, with a morning dose on Day 16. From Day 9 to 15, 200 mg TMC125 twice daily will be co-administered, with a morning dose on Day 16.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TMC125 | Drug |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetics of TMC125, voriconazole and fluconazole |
| Measure | Description | Time Frame |
|---|---|---|
| short-term safety and tolerability of the coadministration of voriconazole or fluconazole and TMC125 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tibotec Pharmaceuticals Clinical Trial | Tibotec Pharmaceutical Limited | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23400742 | Derived | Kakuda TN, Van Solingen-Ristea R, Aharchi F, Smedt GD, Witek J, Nijs S, Vyncke V, Hoetelmans RM. Pharmacokinetics and short-term safety of etravirine in combination with fluconazole or voriconazole in HIV-negative volunteers. J Clin Pharmacol. 2013 Jan;53(1):41-50. doi: 10.1177/0091270011433329. Epub 2013 Jan 24. |
| Label | URL |
|---|---|
| Clinical Study Report Synopsis of TMC125-TiDP2-C187: A Phase I, open-label trial to investigate the pharmacokinetic interaction between TMC125 and two antifungal agents (fluconazole and voriconazole), all at steady-state in healthy volunteers. | View source |
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| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| D009181 | Mycoses |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| D001423 | Bacterial Infections and Mycoses |
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| ID | Term |
|---|---|
| C451734 | etravirine |
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