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编号:10239928
氨氯地平在中国受试者体内的药物动力学及制剂的生物等效性
http://www.100md.com 《沈阳药科大学学报》 2000年第5期
     作者:栾燕 张逸凡 陈笑艳 徐海燕 钟大放

    单位:栾燕(沈阳市卫生防疫站,沈阳 110013)张逸凡 陈笑艳 徐海燕 钟大放(沈阳药科大学药物代谢与药物动力学实验室,沈阳 110015)

    关键词:氨氯地平;药物动力学;制剂生物等效性;液相色谱-质谱-质谱联用法

    沈阳药科大学学报000506 摘 要 采用液相色谱-质谱-质谱联用法测定了18名健康男性受试者口服苯磺酸氨氯地平片和络活喜后不同时刻血浆中氨氯地平的浓度,并求出主要药物动力学参数. 受试者口服含氨氯地平10 mg的受试制剂和参比制剂后,血浆中氨氯地平的Tmax分别为(5.6±1.8)h和(4.7±1.2) h,Cmax分别为(7.36±2.04)ng/mL和(6.72±1.41)ng/mL,t1/2分别为(38.7±14.2)h和(37.4±8.5)h.用梯形法计算,AUC0-t分别为(272.5±71.0)ng.h/mL和(263.4±73.2)ng.h/mL.苯磺酸氨氯地平片的相对生物利用度平均为(104.9±17.3)%.统计分析表明两种制剂生物等效.
, 百拇医药
    分类号 R963

    Studies on Pharmacokinetics of Amlodipine in Chinese Volunteers and Bioequivalence of Its Two Formulations

    Luan Yan, Zhang Yifan, Chen Xiaoyan, Xu Haiyan, Zhong Dafang

    (Laboratory of Drug Metabolism and Pharmacokinetics, Shenyang Pharmaceutical University,Shenyang 110015)

    Abstract The plasma concentrations of amlodipine were determined by a validated LC/MS/MS method after administration of a 10 mg single dose of amlodipine besylate tablet(test formulation) and Norvasc (reference formulation)to each of the 18 healthy male Chinese volunteers in an open randomized cross-over trial. The major pharmacokinetic parameters of the amlodipine test formulation and reference formulation were then calculated by non-compartmental analysis. The results showed that Tmax were(5.6±1.8)h and(4.7±1.2)h;Cmax were(7.36±2.04)ng/mL and(6.72±1.41)ng/mL;t1/2 were(38.7±14.2)h and(37.4±8.5)h;AUC0-t were(272.5±71.0)ng.h/mL and(263.4±73.2)ng.h/mL, respectively. In conclusion, the relative bioavailability of the test formulation was(104.9±17.3)%. The results of the statistical analyses showed that the two formulations were bioequivalent.
, 百拇医药
    Key words amlodipine;pharmacokinetics;bioequivalence;LC/MS/MS

    氨氯地平是一种新型钙离子拮抗剂,能阻滞心肌和血管平滑肌细胞钙离子内流,具有舒张血管平滑肌,扩张外周小动脉,降低外周阻力及扩张冠状动脉的作用.临床上主要用于高血压和心绞痛的治疗〔1〕.与同类型的其他药物相比,该药具有服药剂量低,生物利用度高,药效维持时间长等特点〔2,3〕,有很好的应用前景.但该药在中国受试者体内的药物动力学行为尚未见报道.作者采用液相色谱-质谱-质谱联用法(LC/MS/MS)测定了健康受试者口服单剂量苯磺酸氨氯地平两种片剂后不同时刻的血浆药物浓度,旨在研究其药物动力学特点及评价制剂的生物等效性.

    1 材料与方法

    1.1 药品与试剂

, 百拇医药     受试制剂苯磺酸氨氯地平片由浙江宁波制药厂试制,批号991012,每片含氨氯地平5.0 mg;参比制剂络活喜由大连辉瑞制药有限公司生产,批号95805011,每片含氨氯地平5.0 mg;氨氯地平对照品(含量99.5%)由天津药物研究院提供;4′-羟基普罗帕酮(内标物,含量99.3%)采用微生物转化法自制;乙腈为色谱纯,购自山东禹王试剂厂;乙醚、二氯甲烷、甲酸和氢氧化钠均为分析纯;空白人血浆由沈阳中心血站提供.

    1.2 研究对象与给药方法

    选择健康男性志愿受试者18名,年龄为20~25岁,体重为55~75 kg,签署知情同意书,于试验前在医院接受全面的体格检查,对肝、肾功能进行化验测定,并进行心电图检查,结果均属正常.受试者无即往病史和药物过敏史,试验前14 d内未用任何药物.于试验前一日晚8:00开始禁食,试验当日晨7:00空腹按规定的剂量和方法服药,服药后2 h和5 h进食统一的标准餐.服药后受试者在室内休息,同时进行血压监测.采血期间禁烟酒和含咖啡因类饮料,避免剧烈运动.由两名医药专业人员严格掌握采血时间,两名护士负责采血.
, http://www.100md.com
    1.3 给药方案

    本试验采用双周期交叉试验设计.试验当日受试者按试验安排服用受试制剂2片(相当于氨氯地平10 mg)或参比制剂2片(相当于氨氯地平10 mg).两种制剂均用200 mL温开水送下.每次试验间隔14 d.

    1.4 样品采集与处理

    于口服各药前和服药后2.0、4.0、6.0、8.0、10.0、14.0、24.0、36.0、48.0、72.0、96.0 h,由肘正中静脉取血5 mL并立即移入经肝素处理的离心试管中,静置5 min后,离心15 min(3 000 r/min),分离血浆,于-20℃冰箱中保存待测.采血过程中应注意避光.

    1.5 血浆样品的分析方法

    由于氨氯地平血浆浓度仅为纳克级水平,故本试验在参考文献〔4〕的基础上建立了测定血浆中氨氯地平浓度的液相色谱-质谱-质谱联用法.见另文报道〔5〕.
, 百拇医药
    按生物样品分析的有关国际规范的要求对本法的精密度、准确度、提取回收率及样品稳定性进行了考察,均符合有关规范的要求.

    1.6 数据处理

    从实测数据直接获得最大血药浓度Cmax及相应达峰时间Tmax的值. 以半对数作图法,由消除相的末4个浓度点求算消除速率常数ke,并以公式0.693/ke计算末端消除半衰期t1/2.采用梯形法计算血药浓度-时间曲线下的面积AUC0-t值,并以末端点的血药浓度除以ke,计算外推至无穷大的AUCt-∞值.

    2 结果

    2.1 血药浓度

    18名健康受试者口服含氨氯地平10 mg的受试制剂和参比制剂后,血浆中氨氯地平在4~6 h血药浓度达到峰值,其结果分别为(7.36±2.04)ng/mL和(6.72±1.41)ng/mL,不同时间血药浓度见表1,平均血药浓度曲线见图1.
, 百拇医药
    2.2 药物动力学参数

    将表1中的数据输入计算机,按“数据处理”项下的方法,计算主要动力学参数,结果见表2.

    Tab.1 The plasma concentrations of the reference formulation and the test formulation/ng.mL-1 t/h

    Volunteer

    1

    2

    3

    4

    5
, 百拇医药
    6

    7

    8

    9

    10

    11

    12

    13

    14

    15

    16

    17

    18

    Reference formulation
, 百拇医药
    0.0

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.
, http://www.100md.com
    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    2.0

    3.99

    4.84

    6.17

    4.65

    3.91

    5.33
, http://www.100md.com
    2.93

    5.84

    5.38

    5.25

    4.00

    3.62

    6.98

    4.53

    3.29

    2.31

    6.20

    3.73

    4.0
, 百拇医药
    8.52

    6.63

    8.21

    6.33

    5.56

    7.32

    4.54

    4.79

    5.78

    5.53

    4.80

    4.91

    9.44
, http://www.100md.com
    5.10

    6.79

    8.85

    6.44

    6.16

    6.0

    7.90

    5.71

    8.19

    6.05

    5.74

    8.03

    5.41
, http://www.100md.com
    4.40

    4.70

    4.72

    5.49

    4.56

    9.61

    4.39

    6.20

    8.33

    6.77

    7.35

    8.0

    7.60
, http://www.100md.com
    5.40

    6.09

    5.55

    6.16

    7.22

    4.82

    4.36

    3.75

    4.46

    5.17

    3.97

    9.46

    4.18
, http://www.100md.com
    5.00

    7.76

    6.23

    6.25

    10.0

    5.62

    4.95

    6.72

    5.24

    4.69

    7.75

    4.51

    3.86
, 百拇医药
    3.56

    3.76

    4.40

    3.35

    6.54

    5.24

    4.94

    7.09

    6.36

    5.42

    14.0

    5.79

    4.55
, http://www.100md.com
    6.24

    4.85

    3.71

    6.48

    3.95

    3.29

    2.64

    3.22

    3.81

    3.04

    6.59

    3.98

    4.22
, 百拇医药
    5.93

    5.08

    4.18

    24.0

    3.82

    3.51

    5.39

    4.46

    3.12

    5.22

    2.80

    2.02

    2.62
, http://www.100md.com
    3.24

    3.24

    2.13

    4.73

    3.02

    3.68

    5.57

    4.35

    3.35

    36.0

    3.00

    2.36

    3.83
, 百拇医药
    3.68

    2.39

    4.70

    2.43

    1.98

    2.12

    2.60

    2.60

    1.94

    4.21

    2.65

    3.40

    4.34
, http://www.100md.com
    3.66

    3.59

    48.0

    1.75

    1.86

    2.26

    2.58

    2.39

    3.30

    2.08

    1.85

    1.16

    1.56
, 百拇医药
    2.45

    1.19

    4.04

    1.54

    2.13

    4.10

    3.11

    3.28

    72.0

    1.40

    1.21

    1.87

    1.73
, 百拇医药
    1.49

    2.56

    0.94

    1.43

    0.84

    0.94

    1.39

    0.64

    2.08

    1.08

    1.85

    2.78

    1.78
, 百拇医药
    2.10

    96.0

    0.91

    0.75

    0.9

    1.32

    0.97

    1.47

    0.49

    0.91

    0.44

    0.60

    1.04
, http://www.100md.com
    n.d.

    1.67

    0.65

    1.29

    1.92

    1.23

    1.31

    Test formulation

    0.0

    n.d.

    n.d.

    n.d.

    n.d.
, http://www.100md.com
    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.

    n.d.
, 百拇医药
    n.d.

    2.0

    2.83

    4.63

    7.21

    6.36

    5.84

    8.65

    3.21

    4.00

    5.54

    4.29

    3.99
, http://www.100md.com
    4.14

    5.09

    2.28

    4.60

    4.26

    6.83

    3.23

    4.0

    10.34

    5.61

    9.28

    6.97

    7.26
, http://www.100md.com
    10.6

    4.74

    4.47

    5.31

    5.04

    5.50

    4.88

    5.80

    2.94

    6.56

    8.44

    7.73

    6.52
, 百拇医药
    6.0

    8.97

    6.22

    9.38

    7.01

    7.33

    9.77

    4.56

    6.99

    4.39

    5.58

    5.41

    4.62
, http://www.100md.com
    8.84

    3.73

    8.89

    8.58

    7.65

    9.07

    8.0

    7.07

    6.35

    8.31

    6.75

    8.20

    6.72
, 百拇医药
    4.39

    5.69

    4.28

    5.54

    5.28

    4.61

    7.87

    3.89

    5.93

    9.00

    7.14

    5.78

    10.0
, 百拇医药
    7.76

    5.55

    7.57

    6.86

    7.84

    6.63

    4.12

    2.29

    4.78

    5.00

    4.37

    3.92

    6.80
, 百拇医药
    3.33

    5.41

    7.05

    6.28

    5.57

    14.0

    5.89

    4.82

    6.61

    5.55

    6.17

    5.80

    3.05
, 百拇医药
    4.59

    3.66

    4.54

    3.19

    3.40

    6.08

    3.20

    4.67

    6.01

    5.16

    4.47

    24.0

    3.88
, 百拇医药
    4.73

    6.42

    3.91

    5.55

    4.59

    2.96

    3.39

    2.96

    3.49

    3.04

    3.21

    4.30

    2.47
, 百拇医药
    3.52

    4.96

    4.10

    4.00

    36.0

    3.23

    3.69

    4.78

    3.22

    4.03

    4.39

    1.59

    1.88
, 百拇医药
    2.17

    3.07

    2.53

    2.88

    4.20

    1.69

    2.50

    3.79

    3.60

    3.65

    48.0

    2.13

    2.80
, 百拇医药
    3.05

    2.38

    2.31

    3.66

    1.07

    1.07

    1.34

    2.14

    2.20

    1.72

    2.78

    1.60

    2.21
, 百拇医药
    3.44

    2.86

    3.28

    72.0

    1.59

    1.94

    1.71

    1.89

    1.74

    1.95

    0.61

    0.91

    1.01
, 百拇医药
    1.09

    1.31

    0.66

    1.49

    1.24

    1.77

    2.63

    1.78

    2.11

    96.0

    1.10

    0.93

    1.38
, http://www.100md.com
    1.04

    1.13

    1.46

    0.41

    0.18

    0.17

    0.99

    0.88

    n.d.

    1.21

    0.72

    1.85

    1.28
, 百拇医药
    1.26

    1.37

    n.d.—Concentration below the limit of determination2.3 相对生物利用度

    用梯形法计算口服受试制剂和参比制剂的AUC0-t,并按公式F=AUC(受试制剂)/AUC(参比制剂)计算苯磺酸氨氯地平片的相对生物利用度,平均为(104.9±17.3)%.

    Fig.1 Mean plasma concentration of amlodipine versus time after an oral dose of 10 mg test formulation and reference formulation
, 百拇医药
    Tab.2 The main pharmacokinetic parameters of amlodipine test formulation(TF)and reference formulatiom(RF)after an oral dose of 10 mg amlodipine in 18 healthy volunteers(±s) Parameters

    TF

    RF

    ke/h-1

    0.019±0.006

    0.020±0.005

, 百拇医药     t1/2/h

    38.7±14.2

    37.4±8.5

    Tmax/h

    5.6±1.8

    4.7±1.2

    Cmax/ng.mL-1

    7.36±2.04

    6.72±1.41

    AUC0-t/ng.mL-1.h-1
, 百拇医药
    272.5±71.0

    263.4±73.2

    AUC0-∞/ng.mL-1.h-1

    332.7±96.5

    321.6±101.9

    F/%

    104.9±17.3

    2.4 生物等效性

    将主要药物动力学参数经对数转换后进行方差分析, 结果显示,两种制剂中氨氯地平的AUC0-t、Cmax和Tmax均无显著性差异,进一步采用双单侧检验和(1-2α)置信区间法分析,AUC0-t和Cmax均拒绝不等效假设(P<0.05),受试制剂AUC0-t的90%置信区间为参比制剂相应参数的96.5%~110.9%,Cmax的90%置信区间为参比制剂相应参数的102.4%~117.5%,表明两种制剂具有生物等效性.结果见表3、4.Tab.3 ANOVA of the main pharmacokinetic parameters Parameters
, http://www.100md.com
    F

    Between-

    formulations

    Between-

    periods

    Between-

    individuals

    InAUC0-t

    0.80

    0.10

    10.16

    InCmax
, http://www.100md.com
    3.42

    0.060

    8.34

    Tmax

    2.53

    0.00

    0.66

    F0.05(1,16)=4.49;F0.05(17,16)=2.32;P<0.053 讨论

    文献报道采用HPLC-电化学检测法〔6〕、GC-ECD法〔7,8〕等,测定了白人健康受试者单剂量口服氨氯地平的血浆浓度.在与本实验相同剂量下,其典型的药物动力学参数〔8〕Cmax为(5.9±1.2)ng/mL,Tmax为(7.6±1.8) h,AUC0-∞为(238±53)ng.h/mL,t1/2为(35.7±6.1)h.作者实验测得的中国受试者结果与之相比,Cmax和AUC0-∞偏高,而t1/2无显著性差异.这些数据和特点可供调整临床用药剂量时参考.本实验中两种制剂的药物动力学实验结果经统计分析证明无显著性差异,具有生物等效性.
, 百拇医药
    Tab.4 Results of two one-sided t-test and two-sided 90% confidence limits test Parameters

    t1

    t2

    90%Confidence

    interval/%

    AUC0-t

    6.53

    4.74

    96.5~110.9
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    Cmax

    10.92

    7.60

    102.4~117.5

    t1-0.05(16)=1.75;P<0.05

    国家自然科学基金资助项目,No.39625025,39930180

    参考文献

    1,Meredith PA, Elliott HL. Clinical pharmacokinetics of amlodipine. Clin Pharmacokinet, 1992,22:22~31
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    2,Beresford AP, McGibney D, Humphrey MJ, et al.Metabolism and kinetics of amlodipine in man. Xenobiotica, 1988,18:245~254

    3,Williams DM, Cubeddu LX. Amlodipine pharmacokinetics in healthy volunteers. J Clin Pharmacol, 1988,28:990~994

    4,Yasuda T, Tanaka M, Iba K, et al. Quantitative determination of amlodipine in serum by liquid chromatography with atmospheric pressure chemical ionization tandem mass spectrometry. J Mass Spectrom, 1996,31:879~884
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    5,陈笑艳,栾燕,钟大放,等.液相色谱-质谱-质谱联用法测定人血浆中氨氯地平,药学学报(待发表)

    6,Shimooka K, Sawada Y, Tatematsu H, et al. Analysis of amlodipine in serum by a sensitive high-performance liquid chromatographic method with amperometric detection. J Pharm Biomed Anal, 1989,7:1267~1272

    7,Beresford AP, Macrae PV, Stopher DA, et al. Analysis of amlodipine in human plasma by gas chromatography. J Chromatogr, 1987,420:178~183

    8,Faulkner JK, McGibney D, Chasseaud LF, et al. The pharmacokinetics of amlodipine in healthy volunteers after single intravenous and oral doses and after 14 repeated oral doses given once daily. Br J Clin Pharmac, 1986,22:21~25

    收稿日期:2000-04-05, http://www.100md.com