Pharmacokinetics of multiple doses of co-crystal of tramadol-celecoxib: findings from a four-way randomized open-label phase I clinical trial

Br J Clin Pharmacol. 2018 Jan;84(1):64-78. doi: 10.1111/bcp.13428. Epub 2017 Oct 12.

Abstract

Aim: We compared the pharmacokinetic (PK) profiles of co-crystal of tramadol-celecoxib (CTC) vs. each reference product (alone and in open combination) after single (first dose) and multiple dosing.

Methods: Healthy adults aged 18-50 years received, under fasted conditions, 15 twice-daily doses of the following treatments (separated by ≥14-day washout): 200 mg immediate-release (IR) CTC (equivalent to 88 mg tramadol and 112 mg celecoxib; treatment 1); 100 mg IR tramadol (treatment 2), 100 mg celecoxib (treatment 3); and 100 mg IR tramadol and 100 mg celecoxib (treatment 4). The treatment sequence was assigned by computer-generated randomization. PK parameters were calculated using non-compartmental analysis. Parameters for CTC were adjusted according to reference product dose.

Results: A total of 30 subjects (20 males, mean age 35 years) were included. Multiple-dose tramadol PK parameters for treatments 1, 2 and 4, respectively, were 551, 632 and 661 ng ml-1 [mean maximum plasma concentration (Cmax )]; 4796, 4990 and 5284 ng h ml-1 (area under the plasma concentration-time curve over the dosing interval at steady state); and 3.0, 2.0 and 2.0 h (median time to Cmax at steady state). For treatments 1, 3 and 4, multiple-dose celecoxib PK parameters were 445, 536 and 396 ng ml-1 ; 2803, 3366 and 2897 ng h ml-1 ; and 2.0, 2.0 and 3.0 h. Single-dose findings were consistent with multiple-dose data. Types of adverse events were consistent with known reference product safety profiles.

Conclusion: After single (first dose) and multiple dosing, PK parameters for each active pharmaceutical ingredient in CTC were modified by co-crystallization compared with reference products alone or in open combination.

Keywords: celecoxib; co-crystal; pain; pharmacokinetics; tramadol.

Publication types

  • Clinical Trial, Phase I
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics, Opioid / chemistry
  • Analgesics, Opioid / pharmacokinetics*
  • Analgesics, Opioid / therapeutic use
  • Area Under Curve
  • Celecoxib / chemistry
  • Celecoxib / pharmacokinetics*
  • Celecoxib / therapeutic use
  • Cross-Over Studies
  • Crystallization / methods
  • Cyclooxygenase 2 Inhibitors / chemistry
  • Cyclooxygenase 2 Inhibitors / pharmacokinetics*
  • Cyclooxygenase 2 Inhibitors / therapeutic use
  • Drug Administration Schedule
  • Drug Combinations
  • Drug Compounding / methods*
  • Fasting
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Pain / drug therapy
  • Tramadol / chemistry
  • Tramadol / pharmacokinetics*
  • Tramadol / therapeutic use

Substances

  • Analgesics, Opioid
  • Cyclooxygenase 2 Inhibitors
  • Drug Combinations
  • Tramadol
  • Celecoxib