评估磷酸依米他韦胶囊分别与索磷布韦片、奥美拉唑镁肠溶片、瑞舒伐他汀钙片药物-药物相互作用

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目的:评价磷酸依米他韦胶囊分别与索磷布韦片、奥美拉唑镁肠溶片、瑞舒伐他汀钙片在健康受试者中的药物-药物相互作用及联合用药的耐受性。方法:试验1(磷酸依米他韦胶囊与索磷布韦片)采用随机、开放、连续给药设计,纳入28例受试者随机分为2组。试验2(磷酸依米他韦胶囊与奥美拉唑镁肠溶片)采用非随机、开放设计,纳入42例受试者分为3组。试验3(磷酸依米他韦胶囊与瑞舒伐他汀钙片)采用开放设计,纳入14例受试者。采用验证过的液相色谱串联质谱分析方法(LC-MS/MS)检测依米他韦、索磷布韦及其主要代谢产物GS-331007、奥美拉唑、瑞舒伐他汀的血药浓度,采用Phoenix WinNonlin软件计算药代动力学参数。结果:(1)试验1中,单药和联合给药后,索磷布韦Cn max和AUCn 0-tau几何平均值比值(GMR)的90% n CI为152.0%(118.0%~197.0%)和230.0%(184.0%~287.0%),与索磷布韦单药比较,分别增加了52.0%和130.0%;GS-331007 Cn max GMR的90% n CI为74.0%(67.5%~81.2%),与索磷布韦单药比较,降低了26.0%。(2)试验2中,同时给药、间隔4 h给药、间隔12 h给药,依米他韦单药和联合给药后Cn max GMR的90% n CI分别为68.9%(44.5%~106.7%)、64.0%(43.8%~93.6%)和56.4%(38.9%~81.9%);AUCn 0-t GMR的90% n CI分别为68.6%(46.5%~101.2%)、68.3%(47.6%~98.0%)和60.5%(41.8%~87.5%),与依米他韦单药比较,Cn max和AUCn 0-t分别降低31.1%和31.4%、36.0%和31.7%、43.6%和39.5%。(3)试验3中,单药和联合给药后,瑞舒伐他汀Cn max和AUCn 0-72 GMR的90% n CI分别为172.4%(153.6%~193.5%)和158.0%(144.3%~172.9%),与瑞舒伐他汀单药比较,分别升高了72.4%和58.0%。试验期间均未发生严重不良事件和导致退出试验的不良事件。n 结论:磷酸依米他韦胶囊与索磷布韦片、奥美拉唑镁肠溶片、瑞舒伐他汀钙片均存在药物相互作用。“,”Objective:To evaluate the drug-drug interactions and the tolerability of combined medication between yimitasvir phosphate capsules with sofosbuvir tablets, omeprazole magnesium enteric-coated tablets, and rosuvastatin calcium tablets in healthy volunteers.Methods:A randomized, open, and continuous administration design was used in trial 1 (yimitasvir phosphate capsules with sofosbuvir tablets). 28 subjects were randomly divided into two groups. A non-randomized, open design was used in trial 2 (yimitasvir phosphate capsules with omeprazole magnesium enteric-coated tablets), and included 42 subjects divided into three groups. The open design method was used in trial 3 (yimitasvir phosphate capsules with rosuvastatin calcium tablets), and included 14 subjects. The plasma concentrations of yimitasvir phosphate, sofosbuvir and their main metabolites GS-331007, omeprazole and rosuvastatin were validated by a liquid chromatography/tandem mass spectrometry (LC-MS/MS). The pharmacokinetic parameters were calculated by Phoenix winNonlin software.Results:(1) in trial 1, after single and co-administration, the 90% n CI of sofosbuvir Cn max and AUCn 0-tau geometric mean ratio (GMR) were 152.0% (118.0% ~ 197.0%) and 230.0% (184.0% ~ 287.0%), with an increase of 52.0% and 130.0% compared to single dose of sofosbuvir, respectively. The 90% n CI of GS-331007 Cn max GMR was 74.0% (67.5% ~ 81.2%) and reduced by 26% compared to single dose of sofosbuvir. (2) in trial 2, the 90% n CI of Cn max GMR after yimitasvir single or co-administration at the same time, with a 4-hours interval, or with a 12- hours interval were 68.9% (44.5% ~ 106.7%) , 64.0% (43.8% ~ 93.6%) and 56.4%(38.9% ~ 81.9%), and the 90% n CI of AUCn 0-t GMR were 68.6% (46.5% ~ 101.2%), 68.3% (47.6% ~ 98.0%) and 60.5% (41.8% ~ 87.5%), respectively. Compared with single dose of yimitasvir, the Cn max and AUCn 0-t were decreased by 31.1% and 31.4%, 36.0% and 31.7%, 43.6% and 39.5%, respectively. (3) In trial 3, after single and co-administration, the 90% n CI of rosuvastatin Cn max and AUCn 0-72 GMR were 172.4% (153.6% ~ 193.5%) and 158.0% (144.3% ~ 172.9%), respectively, with an increase of 74.9% and 60.5% compared to single dose of rosuvastatin. There were no serious adverse events and adverse events leading to withdrawal from the trial.n Conclusion:Yimitasvir phosphate capsules have drug-drug interactions with sofosbuvir tablets, omeprazole magnesium enteric-coated tablets, and rosuvastatin calcium tablets.
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