joyjac
★    

Philippines,
2012-05-15 11:22
(5139 d 20:34 ago)

Posting: # 8570
Views: 13,658
 

 Omeprazole [Design Issues]

Dear colleagues,

While literature indicates that omeprazole is a highly variable drug, can anyone help me know the range of CVs (minimum, maximum) for Cmax, AUC0-t and AUC0-inf, particularly, for the comparator/innovator drug, Losec?

Supposing omeprazole is combined with an anti-inflammatory drug i.e. naproxen, will the variablity of omeprazole be reduced? What would be the best design for such fixed dose combination?

Thank you for the kind help.
drgunasakaran1
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2012-05-15 11:50
(5139 d 20:06 ago)

@ joyjac
Posting: # 8571
Views: 12,331
 

 Omeprazole


Dr Gunasakaran Sambandan MD
Disclaimer: The replies/posts are my personal opinions, and they do not represent my company's views on the same. LinkedIn
Helmut
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Vienna, Austria,
2012-05-15 21:00
(5139 d 10:56 ago)

@ drgunasakaran1
Posting: # 8572
Views: 12,099
 

 Omeprazole

Dear Dr. Gunarsakaran,

THX for digging out these PARs. Always interesting reading matter. ;-)

Public Assessment Report 1 Omeprazol “Copyfarm” Omeprazole


“The primary pharmacokinetic variables evaluated for single dose studies were AUC0-t and Cmax and for steady state, AUCτ and Cmax. Bioequivalence was determined based on limits of 80-125% for AUC and 70-143% for Cmax.
Based on the pharmacokinetic parameters of omeprazole, it can be concluded that Omeprazol “Copyfarm” and Losec/Antra tablets from AstraZeneca are bioequivalent with respect to rate and extent of absorption, and fulfil the bioequivalence requirements outlined in the relevant CHMP Note for Guidance.”
(my emphasis)

The 2001 NfG stated:

In certain cases a wider interval may be acceptable. The interval must be prospectively defined e.g. 0.75-1.33 and justified addressing in particular any safety or efficacy concerns for patients switched between formulations.

(my emphasis again)
The 2006 Q&A document stated:

The possibility offered here by the guideline to widen the acceptance range of 0.80 – 1.25 for the ratio of Cmax (not for AUC) should be considered exceptional and limited to a small widening (0.75 − 1.33).

… applicable only if CVWR >30% was demonstrated in a replicate design study.

The upper CLs of Cmax were 137% (10mg, fasting, MD), 142% (20mg, fed, SD), 135% (20mg, fasting, MD). It’s good to see that – even in Denmark – assessors didn’t take guidelines literally.* BTW, in the only replicate design study (20mg, fasting, SD) CVintra of Cmax was 45%.


  • At least not in April 2009. ;-)

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pash413
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India,
2012-12-06 19:09
(4934 d 11:47 ago)

@ Helmut
Posting: # 9685
Views: 11,324
 

 Omeprazole

Dear all

One small confusion how to control last point Cmax in Fed BE study of prazole DR tablets. In some subjects Cmax is observed in last time points. Shall we exclude data of such subjects from final BE calculation?
Helmut
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Vienna, Austria,
2012-12-07 16:29
(4933 d 14:27 ago)

@ pash413
Posting: # 9689
Views: 11,368
 

 Cmax at tlast

Dear Pash!

❝ One small confusion how to control last point Cmax in Fed BE study of prazole DR tablets. In some subjects Cmax is observed in last time points.


What was your sampling schedule? Did these subjects show low concentrations as well? Did you observe this effect both after test and reference or only after the reference? See this nasty example.

❝ Shall we exclude data of such subjects from final BE calculation?


What do you mean by “shall we”? What does your protocol state? To which regulatory agency will you submit the study?

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wienui
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Germany/Oman,
2016-04-07 13:00
(3716 d 18:56 ago)

@ Helmut
Posting: # 16169
Views: 8,971
 

 Omeprazole, widen of Cmax in a normal crossover design?

❝ ❝ “The primary pharmacokinetic variables evaluated for single dose studies were AUC0-t and Cmax and for steady state, AUCτ and Cmax. Bioequivalence was determined based on limits of 80-125% for AUC and 70-143% for Cmax.”


Dear All,

Could we widen the Cmax rang to 70-143% of HVD (Omeprazole) in a normal (not a replicate) 2x2 crossover BE study.

Thanks,

Cheers,
Osama
Helmut
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Vienna, Austria,
2016-04-07 14:57
(3716 d 16:59 ago)

@ wienui
Posting: # 16170
Views: 8,937
 

 Omeprazole reference = HVDP

Hi wienui,

❝ Could we widen the Cmax rang to 70-143% of HVD (Omeprazole) in a normal (not a replicate) 2x2 crossover BE study.


Regulatory perspective: According to all current guidelines I am aware of, no.
Scientific perspective: Why not? ;-) Omeprazole formulations are already OTC in many countries. Hence, the efficacy/safety profile is established. Many other products were approved with an AR of 70–143% in 2×2 studies in the EU (was recommended as the standard [sic] for Cmax in the 9th draft of the NfG1 following suggestions of Blume et al.2). Following the concept of reference-scaling one has to demonstrate that the reference in the particular study shows a CV of >30%. Given the data in the public domain I would say we can be pretty sure that the reference is a HVDP indeed. Just my two cents.


    References
  1. Commission of the European Communities, CPMP Working Party on the Efficacy of Medicinal Products. Investigation of Bioavailability and Bioequivalence. Note for Guidance III/54/89-EN, 9th Draft. Brussels: 1991.
  2. Blume H, Kübel-Thiel K, Reutter B, Siewert M, Stenzhorn G. [Nifedipin: Monographie zur Prüfung der Bioverfügbarkeit/Bioäquivalenz von schnell-freisetzenden Zubereitungen]. Pharm Ztg. 1988;133:389–93. German.

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