Pharmacokinetics of lamivudine, zidovudine, and nevirapine administered as a fixed-dose combination formulation versus coadministration of the individual products

J Clin Pharmacol. 2007 Nov;47(11):1381-9. doi: 10.1177/0091270007307572.

Abstract

The pharmacokinetics of 150 mg lamivudine, 300 mg zidovudine, and 200 mg nevirapine were assessed following single oral administration of a fixed-dose combination tablet and coadministration of the separate innovator products in healthy male subjects (n = 64) under fasting conditions in an open-label, randomized, 2-way crossover study. Multiple blood samples were collected up to 72 hours and plasma concentrations of antiretrovirals were assayed using liquid chromatography/tandem mass spectrometry methods. Pharmacokinetic parameters were calculated using noncompartmental methods, and bioequivalence was assessed using an analysis of variance model. The ratio of the least squares mean (fixed-dose combination to individual products) and 90% confidence intervals of AUC(0-t), AUC(0-infinity), and C(max) for lamivudine, zidovudine, and nevirapine were all within 80.0% to 125.0%, suggesting a similar rate and extent of antiretroviral exposure in the bloodstream. Mean oral clearance (CL/F) values of lamivudine, zidovudine, and nevirapine for the fixed-dose combination were 23.7, 127, and 1.65 L/h, respectively. The fixed-dose combination and individual products were equally safe and well tolerated, with only a few subjects experiencing drug-related adverse events. The current fixed-dose combination of lamivudine, zidovudine, and nevirapine is expected to provide a similar efficacy/safety profile as coadministration of the individual products, a better adherence to treatment, and considerable cost savings in the treatment of HIV.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Drug Combinations
  • Drug Therapy, Combination
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / economics
  • Humans
  • Lamivudine / adverse effects
  • Lamivudine / economics
  • Lamivudine / pharmacokinetics*
  • Male
  • Middle Aged
  • Nevirapine / adverse effects
  • Nevirapine / economics
  • Nevirapine / pharmacokinetics*
  • Reverse Transcriptase Inhibitors / adverse effects
  • Reverse Transcriptase Inhibitors / economics
  • Reverse Transcriptase Inhibitors / pharmacokinetics*
  • Zidovudine / adverse effects
  • Zidovudine / economics
  • Zidovudine / pharmacokinetics*

Substances

  • Drug Combinations
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • Zidovudine
  • Nevirapine