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Monocentric study of no pharmacokinetic interaction between chlorthalidone and losartan, with an open, randomized, single-dose design with four periods, four sequences and crossover in healthy volunteers, under fasting conditions, administered in fixed combination (Test product of Laboratorios Silanes, SA de CV) against the individual components administered jointly and separately (Higroton® 50, a product of Sandoz, SA de CV and Cozaar® , a product of Schering-Plow, SA de CV)
The study was designed to recruit 36 healthy subjects, which were randomized for this study contemplating losses. All the volunteers whose data allowed at least one comparison to be made were included in the corresponding statistical analysis. The objective was to statistically compare the bioavailability of chlorthalidone (at normalized dose) and losartan potassium, in a non-interaction pharmacokinetic study after single-dose oral administration of a product with the fixed combination of active ingredients with respect to the individual components administered together and separately in healthy fasting volunteers. As a secondary objective, the tolerability of the presentations was evaluated based on the registry of adverse events at the end of the four study periods.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A1: Individual formulation of chlorthalidone | Active Comparator | (Higroton 50, product of Sandoz, S.A. de C.V.) |
|
| A2:Individual formulation Losartan | Active Comparator | (COZAAR, product of Schering Plough, S.A. de C.V., S.A. de C.V.) |
|
| A3: Co-administration of individual formulations | Active Comparator | Co-administration of individual formulations of chlorthalidone and losartan potassium |
|
| B: Fixed combination of chlorthalidone and losartan potassium | Experimental | B: Fixed combination of chlorthalidone and losartan potassium (product of Laboratorios Silanes S.A. de C.V.) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chlorthalidone (HIGROTON® 50) | Drug | Tablets with 50mg of Chlorthalidone, product de Sandoz, S.A. de C.V. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum observed concentration following the treatment (Cmax) | Evaluate the fixed dose pharmacokinetics profile of Dexketoprofen-Vitamin B, employing the maximum observed concentration following the treatment (Cmax). | Baseline, 0.333, 0.750, 1.000, 1.250, 1.750, 2.000, 3.000, 4.500, 5.000, 5.500, 6.000, 6.500, 7.000, 8.000, 10.000, 12.000, 18.000, 24.000, 48.000, 72.000, 96.000, 120.000 y 144.000 hours. |
| The area under the curve from time zero to the last measurable concentration (AUC 0-t) | Evaluate the fixed dose pharmacokinetics profile of Dexketoprofen-Vitamin B, employing the area under the curve from time zero to the last measurable concentration (AUC 0-t)using the linear trapezoidal method. | Baseline, 0.333, 0.750, 1.000, 1.250, 1.750, 2.000, 3.000, 4.500, 5.000, 5.500, 6.000, 6.500, 7.000, 8.000, 10.000, 12.000, 18.000, 24.000, 48.000, 72.000, 96.000, 120.000 y 144.000 hours. |
| The area under the curve from time zero to infinity calculated (AUC 0-inf) | Evaluate the fixed dose pharmacokinetics profile of Dexketoprofen-Vitamin B, employing the area under the curve from time zero to infinity calculated (AUC 0-inf). | Baseline, 0.333, 0.750, 1.000, 1.250, 1.750, 2.000, 3.000, 4.500, 5.000, 5.500, 6.000, 6.500, 7.000, 8.000, 10.000, 12.000, 18.000, 24.000, 48.000, 72.000, 96.000, 120.000 y 144.000 hours. |
| Time of the maximum measured concentration (Tmax) | Evaluate the fixed dose pharmacokinetics profile of Dexketoprofen-Vitamin B, employing time of the maximum measured concentration (Tmax). | Baseline, 0.333, 0.750, 1.000, 1.250, 1.750, 2.000, 3.000, 4.500, 5.000, 5.500, 6.000, 6.500, 7.000, 8.000, 10.000, 12.000, 18.000, 24.000, 48.000, 72.000, 96.000, 120.000 y 144.000 hours. |
| Elimination rate (Ke) | Evaluate the fixed dose pharmacokinetics profile of Dexketoprofen-Vitamin B, employing the elimination rate (Ke), calculated by log-linear regression of the final phase of elimination. |
| Measure | Description | Time Frame |
|---|---|---|
| Registry of adverse events of the presentations [Tolerability] | Determined the tolerability of the presentations based on the registry of adverse events at the end of the four study periods. | 67 days |
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Inclusion Criteria:
The participation of the subjects was voluntarily in accordance with the guidelines proposed in the General Health Law and their consent will be obtained according to the aforementioned law. Likewise, the standards set by the Declaration of Helsinki, the Brazilian Review and Good Clinical Practices will be maintained.
Only healthy male volunteers between 18 and 55 years of age were included. - The body mass index of the subjects should be between 18.0-27.0 kg / m2 according to Quetelet.
The volunteers must be healthy, a criterion determined by the results of a complete medical history carried out by the doctors of the Clinical Research site and the laboratory and clinical test (12-lead electrocardiogram) carried out by a certified Clinical Laboratory and / or staff of the Center.
The limits of variation allowed within normality in the screening visit was: blood pressure (sitting) from 90 to 129 mm Hg systolic and 60 to 79 mm Hg diastolic, heart rate between 50 and 100 beats per minute and respiratory rate between 14 and 20 breaths per minute according to current SOP with code CLI-DES-008 "Measurement of Vital Signs". Vital signs will be taken after 5 minutes of resting in a sitting position.
Subjects willing to practice abstinence as a lifestyle or use of two family planning methods (including barrier methods, non-hormonal intrauterine device or bilateral tubal obstruction, and hysterectomy) during the course of the clinical study and up to 30 days after the last dose.
The laboratory and test examinations that will be carried out for the inclusion of the subjects during the selection visit to the study will be:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Araceli G Medina Nolasco, M.D | Investigación Farmacológica y Biofarmacéutica, S.A.P.I. de C.V. | Principal Investigator |
| Liz J Medina Reyes, M.D | Investigación Farmacológica y Biofarmacéutica, S.A.P.I. de C.V. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Laboratorio Silanes, S.A. de C.V. | Mexico City | 11000 | Mexico |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17220048 | Background | Bienert A, Brzeziniski R, Szalek E, Dubai V, Grzeskowiak E, Dyderski S, Drobnik L, Wolc A, Olejniczak-Rabinek M. Bioequivalence study of two losartan formulations administered orally in healthy male volunteers. Arzneimittelforschung. 2006;56(11):723-8. doi: 10.1055/s-0031-1296781. | |
| 26009652 | Background | Das AK, Dhanure S, Savalia AK, Nayak SK, Tripathy SK. Human bioequivalence evaluation of two losartan potassium tablets under fasting conditions. Indian J Pharm Sci. 2015 Mar-Apr;77(2):190-5. doi: 10.4103/0250-474x.156583. |
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| Losartan (COZZAR®) | Drug | Losartan potassium 100 mg tablet, a product of Schering-Plough, S.A. C.V. |
|
|
| A1+ A2 Co-administration of Chlorthalidone and Losartan | Drug | 50mg chlorthalidone + 100 mg losartan potassium |
|
|
| Chlorthalidone + Losartan Fixed-Dose combination | Drug | Tablets with fixed combination of Chlorthalidone 25 mg and Losartan Potassium |
|
|
| Baseline, 0.333, 0.750, 1.000, 1.250, 1.750, 2.000, 3.000, 4.500, 5.000, 5.500, 6.000, 6.500, 7.000, 8.000, 10.000, 12.000, 18.000, 24.000, 48.000, 72.000, 96.000, 120.000 y 144.000 hours. |
| 9839298 | Background | del Castillo D, Campistol JM, Guirado L, Capdevilla L, Martinez JG, Pereira P, Bravo J, Perez R. Efficacy and safety of losartan in the treatment of hypertension in renal transplant recipients. Kidney Int Suppl. 1998 Dec;68:S135-9. doi: 10.1046/j.1523-1755.1998.06827.x. |
| 27514506 | Background | Dudkowski C, Karim A, Munsaka M. Effects of Food Intake on the Pharmacokinetics of Azilsartan Medoxomil and Chlorthalidone Alone and in Fixed-Dose Combination in Healthy Adults. Clin Pharmacol Drug Dev. 2016 Sep;5(5):393-8. doi: 10.1002/cpdd.249. Epub 2016 Mar 4. |
| 10455478 | Background | Mann R, Mackay F, Pearce G, Freemantle S, Wilton L. Losartan: a study of pharmacovigilance data on 14,522 patients. J Hum Hypertens. 1999 Aug;13(8):551-7. doi: 10.1038/sj.jhh.1000880. |
| 8842055 | Background | Pentikis HS, Henderson JD, Tran NL, Ludden TM. Bioequivalence: individual and population compartmental modeling compared to the noncompartmental approach. Pharm Res. 1996 Jul;13(7):1116-21. doi: 10.1023/a:1016083429903. |
| 17710740 | Background | Potvin D, DiLiberti CE, Hauck WW, Parr AF, Schuirmann DJ, Smith RA. Sequential design approaches for bioequivalence studies with crossover designs. Pharm Stat. 2008 Oct-Dec;7(4):245-62. doi: 10.1002/pst.294. |
| 26096961 | Background | Shah JV, Patel DP, Shah PA, Sanyal M, Shrivastav PS. Simultaneous quantification of atenolol and chlorthalidone in human plasma by ultra-performance liquid chromatography-tandem mass spectrometry. Biomed Chromatogr. 2016 Feb;30(2):208-16. doi: 10.1002/bmc.3537. Epub 2015 Jul 7. |
| 12859158 | Background | Zandbergen AA, Baggen MG, Lamberts SW, Bootsma AH, de Zeeuw D, Ouwendijk RJ. Effect of losartan on microalbuminuria in normotensive patients with type 2 diabetes mellitus. A randomized clinical trial. Ann Intern Med. 2003 Jul 15;139(2):90-6. doi: 10.7326/0003-4819-139-2-200307150-00008. |
| ID | Term |
|---|---|
| D002752 | Chlorthalidone |
| D002744 | Chlorpheniramine |
| D019808 | Losartan |
| ID | Term |
|---|---|
| D000096926 | Benzenesulfonamides |
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D001577 | Benzophenones |
| D010797 | Phthalimides |
| D007094 | Imides |
| D007659 | Ketones |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D054833 | Isoindoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D010632 | Pheniramine |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D001713 | Biphenyl Compounds |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D013777 | Tetrazoles |
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