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To investigate and compare the possible response of Panadol® and SafeTynadol® formulations in healthy volunteers.
Acetaminophen (AAP) is the most popular used analgesic/ antipyretic drug with serious hepatotoxic adverse effects; suicidal or unintentional overdose of AAP-induced hepatotoxicity. Cytochrome P450 2E1 (CYP2E1) is thought contribute to the responsible reactive metabolite N-acetyl-p-benzoquinone (NAPQI) of AAP overdose-induced hepatotoxicity. Pharmaceutical excipients are inactive ingredients that are added to a pharmaceutical compound. The objective of this study was to investigate the possible response of Panadol® (AAP alone) and SafeTynadol® (AAP with various selected excipients combination) formulations, while observing the AAP toxic metabolites (AAP-Cys) circumstances change in healthy volunteers. According to the current safety data, could be potentially develop hepatotoxicity-free AAP new formulation drug.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Reference drug (1000mg) | Placebo Comparator | Eligible subjects were randomly assigned to either of the two treatment sequence.The evaluable subjects were those who had completed both period I and II. The study was completed when there were at least 12 evaluable subjects. Panadol® oral dosage form (500 mg*2 tablets = 1000 mg) was orally administered with 240 ml of water once daily in the morning in each of the single-dose study period. |
|
| Test drug (1000mg) | Experimental | Eligible subjects were randomly assigned to either of the two treatment sequence.The evaluable subjects were those who had completed both period I and II. The study was completed when there were at least 12 evaluable subjects. SafeTynadol® oral dosage form (500 mg*2 tablets = 1000 mg) was orally administered with 240 ml of water once daily in the morning in each of the single-dose study period. |
|
| Reference drug (4000mg) | Placebo Comparator | Eligible subjects were randomly assigned to either of the two treatment sequence.The evaluable subjects were those who had completed both period III and IV. The study was completed when there were at least 12 evaluable subjects. Panadol® oral dosage form (500 mg*8 tablets = 4000 mg) was orally administered with 240 ml of water once daily in the morning in each of the single-dose study period. |
|
| Test drug (4000mg) | Experimental | Eligible subjects were randomly assigned to either of the two treatment sequence.The evaluable subjects were those who had completed both period III and IV. The study was completed when there were at least 12 evaluable subjects. SafeTynadol® oral dosage form (500 mg*8 tablets = 4000 mg) was orally administered with 240 ml of water once daily in the morning in each of the single-dose study |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Panadol® | Drug | Acetaminophen 500mg Tablet |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage change from baseline of ALT peak level within study periods | ALT peak level in blood after administration | Blood samples were collected on days 2-7 (before dosing) |
| Measure | Description | Time Frame |
|---|---|---|
| - Incidence of peak ALT elevations > 1X ULN within study periods; | The blood concentration of ALT. | Day 1-7 |
| - Incidence of peak ALT elevations > 2X ULN within study periods; | The blood concentration of ALT. |
| Measure | Description | Time Frame |
|---|---|---|
| - Incidence of adverse events | Safety | Day 1-12 |
| - Clinical laboratory test | Concentrations of acetaminophen in plasma | Day 1-12 |
Inclusion Criteria:
Normal healthy adult subjects between 20-50 years of age.
Body weight within 80-120% of ideal body weight. Male: Ideal body weight = (height - 80) * 0.7 Female: Ideal body weight = (height - 70) * 0.6
Acceptable medical history and physical examination including:
Acceptable clinical laboratory determinations without significant deviation from normal values within two months prior to Period I (or Period III or Period V) dosing, which includes AST (SGOT), ALT (SGPT), r-GT, alkaline phosphatase, total bilirubin, albumin, glucose, BUN, uric acid, creatinine, total cholesterol, triglyceride (TG) and oral galactose single point (OGSP).
Acceptable hematology within two months prior to the study, which includes hemoglobin, hematocrit, red blood cells, MCV, MCH, MCHC, white blood cells, differential white blood cells and platelets.
Acceptable urinalysis within two months prior to the study, which includes pH, blood, glucose and protein.
Signed the written informed consent to participate in this study.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| TeYu Mr Lin, Dr. | Principal Investigator | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tri-Service General Hospital | Taipei | Neihu District | 114202 | Taiwan |
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| ID | Term |
|---|---|
| D017114 | Liver Failure, Acute |
| ID | Term |
|---|---|
| D017093 | Liver Failure |
| D048550 | Hepatic Insufficiency |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D000082 | Acetaminophen |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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Single Blindie
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|
| Reference drug 2 tablets Q6H (28,000mg) | Placebo Comparator | Eligible subjects were randomly assigned to either of the two treatment stage.Each treatment will be completed when there are at least 7 evaluable subjects. The evaluable subjects are randomized into period V. Panadol® oral dosage form (500mg*2 tablets =1000mg) will be orally administered with 240 ml of water every 6 hours daily in each of the multiple-dose study period (Q6H, total 28 dosages, 56 tablets). |
|
| Test drug 2 tablets Q6H (28,000mg) | Experimental | Eligible subjects were randomly assigned to either of the two treatment stage.Each treatment will be completed when there are at least 7 evaluable subjects. The evaluable subjects are randomized into period V. SafeTynadol® oral dosage form (500mg*2 tablets =1000mg) will be orally administered with 240 ml of water every 6 hours daily in each of the multiple-dose study period (Q6H, total 28 dosages, 56 tablets). |
|
| SafeTynadol® | Drug | Acetaminophen 500mg Tablet |
|
|
| Day 1-7 |
| - Incidence of peak ALT elevations > 3X ULN within study periods; | The blood concentration of ALT. | Day 1-7 |
| - Incidence of peak ALT elevations > 5X ULN within study periods; | The blood concentration of ALT. | Day 1-7 |
| - Incidence of peak ALT elevations > 8X ULN within study periods; | The blood concentration of ALT. | Day 1-7 |
| - Incidence of total bilirubin ≥ 2.5mg/dL within study periods; | The blood concentration of total bilirubin. | Day 1-7 |
| - Hepatic failure rate (hepatic encephalopathy, ascites, total bilirubin ≥ 2.5mg/dL or liver transplantation) within study periods; | The blood concentration of hepatic encephalopathy, ascites, total bilirubin. | Day 1-7 |
| - The time-interval weighted area under the curve (AUC) of free plasma acetaminophen-cysteine (AAP-Cys) and AAP-Cys adducts within study periods. | The blood concentration of free plasma acetaminophen-cysteine (AAP-Cys) and AAP-Cys adducts | Day 1-7 |
| - The time-interval weighted area under the curve (AUC) of ALT level within study periods | The blood concentration of ALT. | Day 1-7 |
| - Clinical laboratory test | Concentrations of acetaminophen metabolites (AAP-Glc) in plasma | Day 1-12 |
| - Clinical laboratory test | Concentrations of acetaminophen metabolites (AAP-Sul) in plasma | Day 1-12 |
| - Clinical laboratory test | Concentrations of acetaminophen metabolites (GS-AAP) in plasma | Day 1-12 |
| - Clinical laboratory test | Concentrations of acetaminophen metabolites (AAP-Cys) in plasma | Day 1-12 |
| - Clinical laboratory test | Concentrations of acetaminophen metabolites (AAP-NAC) in plasma | Day 1-12 |
| - Vital sign | Heart rate (bpm) | Day 1-12 |
| - Vital sign | Blood pressure (mmHg) | Day 1-12 |
| - Vital sign | Temperature (℃) | Day 1-12 |
| Aniline Compounds |
| D000588 | Amines |