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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/29887
Title: A chewable pediatric fixed-dose combination tablet of stavudine, lamivudine, and nevirapine: Pharmacokinetics and safety compared with the individual liquid formulations in human immunodeficiency virus-infected children in Thailand
Authors: Nirun Vanprapar
Tim R. Cressey
Kulkanya Chokephaibulkit
Petronella Muresan
Nottasorn Plipat
Virat Sirisanthana
Wasana Prasitsuebsai
Suchat Hongsiriwan
Tawee Chotpitayasunondh
Achara Eksaengsri
Maripat Toye
Mary Elizabeth Smith
Kenneth McIntosh
Edmund Capparelli
Ram Yogev
Mahidol University
Chiang Mai University
Harvard School of Public Health
University of Michigan School of Public Health
Chonburi Regional Hospital
Queen Sirikit National Institute of Child Health
Thailand Government Pharmaceutical Organization
Baystate Medical Center
National Institute of Allergy and Infectious Diseases
Children's Hospital Boston
University of California, San Diego
Ann & Robert H. Lurie Children's Hospital of Chicago
Keywords: Medicine
Issue Date: 1-Jan-2010
Citation: Pediatric Infectious Disease Journal. Vol.29, No.10 (2010), 940-944
Abstract: Background: Pediatric fixed-dose combinations (FDCs) are needed to facilitate antiretroviral therapy in children. We evaluated the relative bioavailability, safety, and therapeutic adequacy of a novel chewable pediatric FDC tablet of stavudine (7 mg), lamivudine (30 mg), and nevirapine (50 mg), referred to as GPO-VIR S7, and compared it with the individual original brand-name liquid formulations in human immunodeficiency virus-infected Thai children. Methods: The International Maternal Pediatric Adolescent AIDS Clinical Trials group (IMPAACT) P1056 study was a phase I/II, 2-arm, randomized, open-label, multidose pharmacokinetic cross-over study. Children ≥6 to ≤30 kg receiving nevirapine-based HAART for at least 4 weeks were randomized to receive GPO-VIR S7 chewable tablets or the equivalent liquid formulations. Children were stratified by weight and dosing was weight-based. Intensive 12-hour blood sampling was performed on day 28, and subjects then crossed-over to the alternate formulation at equal doses with identical 12-hour sampling on day 56. Pharmacokinetic indices were determined by noncompartmental analysis. Results: Thirty-four children completed the study. While taking Government Pharmaceutical Organization (GPO)-VIR S7 the geometric mean (90% CI) area under the curve was 1.54 μg•hr/mL (1.42-1.67) for stavudine, 6.39 (5.82-7.00) for lamivudine, and 74.06 (65.62-83.60) for nevirapine. Nevirapine drug exposure for GPO-VIR S7 was therapeutically adequate. Geometric mean area under the curve ratios (90% CI) of GPO-VIR S7/liquid formulation for stavudine, lamivudine, and nevirapine were 0.97 (0.92-1.02), 1.41 (1.30-1.53), and 1.08 (1.04-1.13), respectively. No serious drug-related toxicity was reported. Conclusions: The chewable FDC was safe and provided therapeutically adequate plasma drug exposures in human immunodeficiency virus-infected children. Substituting the FDC for liquid formulations can simplify antiretroviral therapy. © 2010 by Lippincott Williams & Wilkins.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=77957278518&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/29887
ISSN: 15320987
08913668
Appears in Collections:Scopus 2006-2010

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