Bioequivalence and Food Effect Assessment of 2 Fixed-Dose Combination Formulations of Dolutegravir and Lamivudine

Clin Pharmacol Drug Dev. 2020 Feb;9(2):189-202. doi: 10.1002/cpdd.740. Epub 2019 Nov 14.

Abstract

This single-dose study evaluated the bioequivalence, food effect, and safety of 2 experimental, 2-drug, fixed-dose formulations of 50 mg dolutegravir and 300 mg lamivudine (formulation AH and formulation AK) as compared with coadministration of single-entity tablets of 50 mg dolutegravir and 300 mg lamivudine (reference). In fasted subjects, formulation AH lamivudine exposure was similar to the reference; however, dolutegravir exposure was consistently higher in formulation AH, with area under the concentration-time curve (AUC) and maximum concentration (Cmax ) approximately 27% to 28% greater than reference. Formulation AK met bioequivalence standards to the reference for dolutegravir (AUC0-∞ and Cmax ) and lamivudine (AUC0-∞ and AUC0-t ) exposure; however, dolutegravir AUC0-t and lamivudine Cmax were approximately 16% and 32% higher than the reference, respectively. A high-fat meal increased dolutegravir AUC and Cmax by up to 33% and 21%, respectively, and decreased lamivudine Cmax by approximately 30%. Both test and reference formulations were well tolerated. The results support further development of formulation AK as a novel, 2-drug, fixed-dose combination tablet treatment for patients with HIV.

Keywords: HIV; bioequivalence; dolutegravir; lamivudine.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Area Under Curve
  • Body Mass Index
  • Drug Therapy, Combination
  • Fasting / metabolism*
  • Female
  • Food / adverse effects*
  • HIV Infections / drug therapy*
  • HIV Infections / metabolism
  • HIV Integrase Inhibitors / administration & dosage
  • HIV Integrase Inhibitors / adverse effects
  • HIV Integrase Inhibitors / pharmacokinetics
  • HIV-1 / drug effects
  • HIV-1 / isolation & purification
  • Heterocyclic Compounds, 3-Ring / administration & dosage
  • Heterocyclic Compounds, 3-Ring / adverse effects
  • Heterocyclic Compounds, 3-Ring / pharmacokinetics*
  • Humans
  • Lamivudine / administration & dosage
  • Lamivudine / adverse effects
  • Lamivudine / pharmacokinetics*
  • Male
  • Middle Aged
  • Oxazines / administration & dosage
  • Oxazines / adverse effects
  • Oxazines / pharmacokinetics*
  • Piperazines / administration & dosage
  • Piperazines / adverse effects
  • Piperazines / pharmacokinetics*
  • Pyridones / administration & dosage
  • Pyridones / adverse effects
  • Pyridones / pharmacokinetics*
  • Reverse Transcriptase Inhibitors / administration & dosage
  • Reverse Transcriptase Inhibitors / adverse effects
  • Reverse Transcriptase Inhibitors / pharmacokinetics
  • Safety
  • Therapeutic Equivalency

Substances

  • HIV Integrase Inhibitors
  • Heterocyclic Compounds, 3-Ring
  • Oxazines
  • Piperazines
  • Pyridones
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • dolutegravir