A Physiologically Based Pharmacokinetic Modeling Approach to Predict Drug-Drug Interactions of Buprenorphine After Subcutaneous Administration of CAM2038 With Perpetrators of CYP3A4

J Pharm Sci. 2018 Mar;107(3):942-948. doi: 10.1016/j.xphs.2017.10.035. Epub 2017 Nov 2.

Abstract

CAM2038, FluidCrystal injection depot, is an extended release formulation of buprenorphine given subcutaneously every 1 week (Q1W) or every 4 weeks (Q4W). The purpose of this research was to predict the magnitude of drug-drug interaction (DDI) after coadministration of a strong CYP3A4 inducer or inhibitor using physiologically based pharmacokinetic (PBPK) modeling. A PBPK model was developed for CAM2038 based on the previously published buprenorphine PBPK model after intravenous and sublingual administration and the PK profiles after subcutaneous administration of CAM2038 from 2 phase I clinical trials. The strong CYP3A4 inhibitor ketoconazole was predicted to increase the buprenorphine exposure by 35% for the Q1W formulation and 34% for Q4W formulation, respectively. Also, the strong CYP3A4 inducer rifampin was predicted to decrease the buprenorphine exposure by 26% for both the Q1W and Q4W formulations. The results provided insight into the potential DDI effect for CAM2038 and suggested a lack of clinically meaningful DDI when CAM2038 is coadministered with CYP3A4 inhibitor or inducer. Therefore, no dose adjustment is required when CAM2038 is coadministered with CYP3A4 perpetrators.

Keywords: buprenorphine; drug-drug interaction; ketoconazole; physiologically based pharmacokinetics; rifampin.

MeSH terms

  • Administration, Cutaneous
  • Administration, Sublingual
  • Buprenorphine / pharmacokinetics*
  • Chemistry, Pharmaceutical / methods
  • Clinical Trials, Phase I as Topic
  • Cytochrome P-450 CYP3A / metabolism*
  • Cytochrome P-450 CYP3A Inducers / administration & dosage*
  • Cytochrome P-450 CYP3A Inhibitors / administration & dosage*
  • Drug Interactions / physiology*
  • Humans
  • Ketoconazole / administration & dosage
  • Rifampin / administration & dosage

Substances

  • Cytochrome P-450 CYP3A Inducers
  • Cytochrome P-450 CYP3A Inhibitors
  • Buprenorphine
  • Cytochrome P-450 CYP3A
  • Ketoconazole
  • Rifampin

Associated data

  • ISRCTN/ISRCTN41550730
  • ISRCTN/ISRCTN24987553