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Effect of eliglustat on the pharmacokinetics of digoxin, metoprolol, and oral contraceptives and absorption of eliglustat when coadministered with acid-reducing agents.
Molecular Genetics and Metabolism ( IF 3.8 ) Pub Date : 2020-01-07 , DOI: 10.1016/j.ymgme.2020.01.001
Nathan Thibault 1 , Jennifer Ibrahim 1 , M Judith Peterschmitt 1 , Ana Cristina Puga 1 , Leorah Ross 1 , Lucie Vu 1 , Yong Xue 1 , Sandrine Turpault 1
Affiliation  

Eliglustat is an oral substrate reduction therapy indicated for patients with Gaucher disease type 1. Based on in vitro data, clinical trials were conducted to assess the potential for drug-drug interactions between eliglustat and digoxin (P-glycoprotein substrate), metoprolol (sensitive CYP2D6 substrate), a combined oral contraceptive (CYP3A substrate), and acid-reducing agents. Healthy subjects were enrolled in four Phase 1 clinical studies to evaluate the effect of eliglustat on the pharmacokinetics, safety, and tolerability of digoxin (N = 28), metoprolol (N = 14), and a combined oral contraceptive (N = 30) and the effect of acid-reducing agents on eliglustat pharmacokinetics, safety, and tolerability (N = 24). Coadministration resulted in increased exposure to digoxin (1.49-fold) and metoprolol (2-fold) with eliglustat, negligible effects on oral contraceptive pharmacokinetics with eliglustat, and a negligible effect of acid-reducing agents on eliglustat pharmacokinetics. Across all studies, eliglustat was well-tolerated. One serious adverse event (spontaneous abortion) and one discontinuation due to an adverse event (urinary tract infection) were reported, both during the acid-reducing agents study. When eliglustat is coadministered with medications that are P-glycoprotein or CYP2D6 substrates, lower doses of these concomitant medications may be required. Eliglustat may be coadministered with oral contraceptives and acid-reducing agents without dose modifications for either drug.

中文翻译:

当与降酸剂共同使用时,依格司他对地高辛,美托洛尔和口服避孕药的药代动力学和依格司他吸收的影响。

Eliglustat是一种针对Gaucher疾病1型患者的口服底物减少治疗药物。根据体外数据,进行了临床试验,以评估Eliglustat和地高辛(P-糖蛋白底物),美托洛尔(CYP2D6敏感性)之间药物相互作用的潜力底物),联合口服避孕药(CYP3A底物)和减酸剂。健康受试者参加了四项1期临床研究,以评估依格鲁司通对地高辛(N = 28),美托洛尔(N = 14)和联合口服避孕药(N = 30)的药代动力学,安全性和耐受性的影响。酸减少剂对Eliglustat药代动力学,安全性和耐受性的影响(N = 24)。与eliglustat共同给药导致地高辛(1.49倍)和美托洛尔(2倍)的暴露增加,eliglustat对口服避孕药代动力学的影响可忽略不计,而减酸剂对eliglustat药代动力学的影响可忽略不计。在所有研究中,依格司他的耐受性良好。在减酸剂研究期间,报告了一项严重的不良事件(自然流产)和一项因不良事件引起的中止(尿路感染)。当eliglustat与P-糖蛋白或CYP2D6底物的药物合用时,可能需要降低这些伴随药物的剂量。Eliglustat可以与口服避孕药和降酸药共同使用,而无需调整任何一种药物的剂量。在减酸剂研究期间,报告了一项严重的不良事件(自然流产)和一项因不良事件引起的中止(尿路感染)。当eliglustat与P-糖蛋白或CYP2D6底物的药物合用时,可能需要降低这些伴随药物的剂量。Eliglustat可以与口服避孕药和降酸药共同使用,而无需调整任何一种药物的剂量。在减酸剂研究期间,报告了一项严重的不良事件(自然流产)和一项因不良事件引起的中止(尿路感染)。当eliglustat与P-糖蛋白或CYP2D6底物的药物合用时,可能需要降低这些伴随药物的剂量。Eliglustat可以与口服避孕药和降酸药共同使用,而无需调整任何一种药物的剂量。
更新日期:2020-01-07
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