Pharmacokinetics and bioequivalence of two formulations of rebamipide 100-mg tablets: a randomized, single-dose, two-period, two-sequence crossover study in healthy Korean male volunteers. 2009

Hea-Young Cho, and Hwa Yoon, and Geun-Kyeong Park, and Yong-Bok Lee
Clinical Trials Management Division, Korea Food and Drug Administration, Seoul, Korea.

BACKGROUND Rebamipide is a quinolinone-derived gastroprotective agent approved in Korea for the treatment of gastric ulcers, acute gastritis, and exacerbated chronic gastritis. OBJECTIVE The aims of this study were to evaluate the pharmacokinetics and bioequivalence of a reference (branded) and test (generic) formulation of rebamipide 100-mg tablets in healthy Korean male volunteers for the purposes of generic substitution and to evaluate the relationship between genetic polymorphisms in the ABCB1 gene (exons 21 and 26) and rebamipide pharmacokinetics. METHODS This study had a 2-period crossover design, with a 7-day washout between formulations. Healthy Korean male volunteers were randomly assigned to receive a single 100-mg dose of the test or reference formulation, administered with 240 mL of water after a 12-hour overnight fast. Serum concentrations of rebamipide up to 12 hours after administration were determined using a validated HPLC method with fluorescence detection. Vital signs (temperature, blood pressure, and heart rate) were measured before and after dosing in both periods. Adverse events were monitored by clinic staff on the days of study drug administration and were recorded for up to 1 week after the last dose of study medication. Pharmacokinetic parameters were determined using a noncompartmental method. The formulations were considered bioequivalent if the log-transformed ratios of AUC(0-t), AUC(0-infinity)), and C(max) were within the predetermined bioequivalence range (80%-125%) established by the US Food and Drug Administration and Korean legislation. The in vitro dissolution profiles of the 2 formulations were examined, and the influence on rebamipide pharmacokinetics of genetic polymorphisms in the ABCB1 gene (P-glycoprotein) was investigated. RESULTS Thirty healthy Korean male volunteers (mean [SD] age, 22.97 [1.67] years [range, 20-27 years]; height, 174.56 [6.27] cm [range, 159.1-184.8 cm]; and weight, 69.44 [8.32] kg [range, 54.7-90.2 kg]) were enrolled in and completed the study. No adverse events were reported. The 2 formulations had comparable in vitro dissolution profiles. The mean AUC(0-t) for the test and reference formulations was 831.09 (329.52) and 903.46 (419.17) ng/mL/h, respectively; the AUC(0-infinity) was 851.68 (332.62) and 923.58 (423.21) ng/mL/h; the C(max) was 218.12 (93.90) and 220.57 (107.48) ng/mL; the T(max) was 2.05 (1.15) and 2.10 (0.76) hours; and the t((1/2)) was 1.96 (0.52) and 1.93 (0.49) hours. No significant sequence, subject, formulation, or period effects were detected for any pharmacokinetic parameter. The point estimates for AUC(0-t), AUC(0-infinity), and C(max) were 0.95 (90% CI, 0.84-1.06), 0.95 (90% CI, 0.84-1.06), and 1.01 (90% CI, 0.89-1.15), respectively, satisfying the criterion for bioequivalence. There was no statistically significant difference in T(max). No significant differences in rebamipide AUC(0-t), AUC(0-infinity), or C(max) were found among the ABCB1 2677 GG, GT, or TT groups, or among the ABCB1 3435 CC, CT, or TT groups. There was no evidence that genetic polymorphisms in the ABCB1 gene influenced the pharmacokinetics of rebamipide. CONCLUSIONS The results of this study in healthy Korean male volunteers suggest that the 2 rebamipide 100-mg tablet formulations administered in the fasted state met the regulatory criterion for bioequivalence. There was no evidence that rebamipide pharmacokinetic parameters were influenced by genetic polymorphisms in the ABCB1 gene (exons 21 and 26). ClinicalTrials.gov identifier: .

UI MeSH Term Description Entries
D008297 Male Males
D011110 Polymorphism, Genetic The regular and simultaneous occurrence in a single interbreeding population of two or more discontinuous genotypes. The concept includes differences in genotypes ranging in size from a single nucleotide site (POLYMORPHISM, SINGLE NUCLEOTIDE) to large nucleotide sequences visible at a chromosomal level. Gene Polymorphism,Genetic Polymorphism,Polymorphism (Genetics),Genetic Polymorphisms,Gene Polymorphisms,Polymorphism, Gene,Polymorphisms (Genetics),Polymorphisms, Gene,Polymorphisms, Genetic
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D002626 Chemistry, Pharmaceutical Chemistry dealing with the composition and preparation of agents having PHARMACOLOGIC ACTIONS or diagnostic use. Medicinal Chemistry,Chemistry, Pharmaceutic,Pharmaceutic Chemistry,Pharmaceutical Chemistry,Chemistry, Medicinal
D002851 Chromatography, High Pressure Liquid Liquid chromatographic techniques which feature high inlet pressures, high sensitivity, and high speed. Chromatography, High Performance Liquid,Chromatography, High Speed Liquid,Chromatography, Liquid, High Pressure,HPLC,High Performance Liquid Chromatography,High-Performance Liquid Chromatography,UPLC,Ultra Performance Liquid Chromatography,Chromatography, High-Performance Liquid,High-Performance Liquid Chromatographies,Liquid Chromatography, High-Performance
D005838 Genotype The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS. Genogroup,Genogroups,Genotypes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000409 Alanine A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases IMMUNITY, and provides energy for muscle tissue, BRAIN, and the CENTRAL NERVOUS SYSTEM. Abufène,Alanine, L-Isomer,L-Alanine,Alanine, L Isomer,L Alanine,L-Isomer Alanine
D000897 Anti-Ulcer Agents Various agents with different action mechanisms used to treat or ameliorate PEPTIC ULCER or irritation of the gastrointestinal tract. This has included ANTIBIOTICS to treat HELICOBACTER INFECTIONS; HISTAMINE H2 ANTAGONISTS to reduce GASTRIC ACID secretion; and ANTACIDS for symptomatic relief. Anti-Ulcer Drugs,Agents, Anti-Ulcer,Anti Ulcer Agents,Anti Ulcer Drugs,Drugs, Anti-Ulcer

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