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The objective was to establish the pharmacokinetic (PK) profile at steady state of two different nevirapine (NVP) extended release (XR) formulations at 300 mg or 400 mg daily (QD) under fasted and fed conditions in comparison with the commercially available NVP immediate release (IR) tablet at 200 mg BID (400 mg/day).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NVP XR 400 mg (KCR 25%) fasted | Experimental |
| |
| NVP XR 400 mg (KCR 25%) fed | Experimental |
| |
| NVP XR 400 mg (KCR 20%) fasted | Experimental |
| |
| NVP XR 400 mg (KCR 20%) fed | Experimental |
| |
| NVP XR 300 mg (KCR 25%) fasted | Experimental |
| |
| NVP XR 300 mg (KCR 25%) fed | Experimental |
| |
| NVP XR 300 mg (KCR 20%) fasted | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NVP XR 400 mg (KCR 25%) | Drug |
| ||
| NVP XR 400 mg (KCR 20%) |
| Measure | Description | Time Frame |
|---|---|---|
| AUCτ,ss (area under the concentration-time curve of the analyte in plasma at steady state over the time dosing interval τ) | up to day 22 | |
| Cmin,ss (minimum measured concentration of the analyte in plasma at steady state over the time dosing interval τ) | up to day 22 | |
| Cmax,ss (maximum measured concentration of the analyte in plasma at steady state over the time dosing interval τ) | up to day 22 |
| Measure | Description | Time Frame |
|---|---|---|
| Cmax,ss / Cmin,ss ratio | up to day 22 | |
| %PTF (percentage peak-trough fluctuation) | up to day 22 | |
| tmax,ss (time from dosing to the maximum concentration of the analyte in plasma at steady state over the time dosing interval τ) |
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Inclusion Criteria:
HIV-1 infected males or females ≥ 18 and ≤ 60 years of age
Body mass index 18.5 to 29.9 kg/m2, inclusive
Signed and dated written informed consent prior to admission to the study in accordance with Good Clinical Practice and local legislation
Treated with a stable Viramune® BID based regimen since at least 12 weeks prior to study entry. If however, the subject's current Viramune® treatment consists of two 200mg tablets once daily (prescribed off label), the subject is allowed to participate if he/she agrees to switch to Viramune® 200mg twice daily, 14 days before the start of Nevirapine Extended Release.
An HIV-1 viral load of ≤ 50 c/mL at screening
Acceptable screening laboratory values that indicate adequate baseline organ function with the following exceptions:
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST)
≤2.5 times the upper limit of normal (ULN) (DAIDS Grade 1) or
Gamma-glutamyl transferase (GGT) <2.5 times ULN (DAIDS Grade 1)
Willingness to abstain from alcoholic beverages for 24 hours prior to intensive pharmakokinetic sampling days
Willingness to abstain from ingesting substances which may alter drug plasma levels by interaction with the cytochrome P450 system during the study
Willingness to abstain from grapefruit and grapefruit juice, Seville oranges and juice, and St John's wort or milk thistle starting 14 days prior to administration of study medication until the end of the study, and
Karnofsky performance score ≥70
Exclusion Criteria:
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| NVP XR 300 mg (KCR 20%) fed | Experimental |
|
| NVP IR 200 mg (Viramune®) | Active Comparator |
|
| Drug |
|
| NVP XR 300 mg (KCR 25%) | Drug |
|
| NVP XR 300 mg (KCR 20%) | Drug |
|
| high-fat breakfast | Other |
|
| NVP IR 200 mg (Viramune®) | Drug |
|
| up to day 22 |
| CL/F,ss (apparent clearance of the analyte in the plasma after extravascular administration at steady state) | up to day 22 |
| Cavg (average measured concentration of the analyte in plasma at steady state) | up to day 22 |
| Number of patients with adverse events (AEs) | up to day 57 |
| Number of patients with clinically relevant changes in clinical laboratory tests | Baseline, up to day 37 |
| Number of patients with abnormal detectable viral load | Baseline, up to day 37 |
| Number of patients with clinically relevant changes in vital signs (blood pressure, pulse rate) | Baseline, up to day 37 |
| Number of patients with clinically relevant changes in 12-lead electrocardiogram (ECG) | Baseline, day 23 |
| Number of patients with clinically relevant changes in physical examination | Baseline, up to day 37 |
| Assessment of tolerability by the investigator on a 4-point scale | up to day 37 |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| ID | Term |
|---|---|
| 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 |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D019829 | Nevirapine |
| ID | Term |
|---|---|
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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