Effects of Food Intake on the Pharmacokinetics of Azilsartan Medoxomil and Chlorthalidone Alone and in Fixed-Dose Combination in Healthy Adults

Clin Pharmacol Drug Dev. 2016 Sep;5(5):393-8. doi: 10.1002/cpdd.249. Epub 2016 Mar 4.

Abstract

Azilsartan medoxomil is a long-acting angiotensin II receptor blocker used to treat hypertension as monotherapy or in fixed-dose combination (FDC) with chlorthalidone. This study assessed the effects of food intake on the plasma pharmacokinetics of the active moiety, azilsartan, and of chlorthalidone when administered as separate tablets or in FDC. Cohort 1 (n = 24) received azilsartan medoxomil (80 mg) and chlorthalidone (25 mg) once in a fasted condition and once 30 minutes after the initiation of a high-fat meal (fed). Cohort 2 (n = 24) received the same drugs as an FDC tablet in the fasted and fed conditions. In cohort 1, the fed-fasted ratios for AUC0-inf and Cmax were 108.3 (101.6-115.5) and 103.7 (94.3-114.1), respectively, for azilsartan and 112.3 (106.5-118.4) and 100.3 (90.6-111.1), respectively, for chlorthalidone. In cohort 2, the corresponding ratios were 78.6 (67.6-91.4) and 78.6 (64.4-96.0) for azilsartan and 101.0 (96.5-86.7) and 75.9 (66.5-86.7) for chlorthalidone. The combination therapies were well tolerated, and food intake had no consistent effect on adverse events. Food intake had a somewhat greater effect on plasma pharmacokinetics after administration of the FDC tablet than after administration of separate tablets, but the effects of food on the plasma pharmacokinetics of the FDC were not expected to be clinically meaningful.

Keywords: AUC; Cmax; angiotensin II receptor blocker; half-life; hypertension.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Angiotensin II Type 1 Receptor Blockers / administration & dosage
  • Angiotensin II Type 1 Receptor Blockers / adverse effects
  • Angiotensin II Type 1 Receptor Blockers / pharmacokinetics
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacokinetics
  • Benzimidazoles / administration & dosage*
  • Benzimidazoles / adverse effects
  • Benzimidazoles / pharmacokinetics
  • Chlorthalidone / administration & dosage*
  • Chlorthalidone / adverse effects
  • Chlorthalidone / pharmacokinetics
  • Cohort Studies
  • Dietary Fats / administration & dosage
  • Drug Combinations
  • Fasting
  • Female
  • Food-Drug Interactions*
  • Humans
  • Male
  • Oxadiazoles / administration & dosage*
  • Oxadiazoles / adverse effects
  • Oxadiazoles / pharmacokinetics
  • Tablets
  • Young Adult

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Antihypertensive Agents
  • Benzimidazoles
  • Dietary Fats
  • Drug Combinations
  • Oxadiazoles
  • Tablets
  • azilsartan medoxomil
  • Chlorthalidone