Healthy
Conditions
Brief summary
Open-label, two-way crossover design with a quinidine sulfate run-in period followed by a randomised sequence of dabigatran etexilate plus quinidine sulfate or dabigatran etexilate alone to evaluate the safety of co-administration of dabigatran etexilate and quinidine. and the pharmacokinetic interaction between quinidine and dabigatran etexilate.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Healthy male and female subjects * Age ≥18 and Age ≤55 years * Body Mass Index (BMI) ≥18.5 and BMI \<30 kg/m2 * Signed and dated written informed consent prior to admission to the study in accordance with GCP and the local legislation.
Exclusion criteria
* Any finding of the medical examination (including Blood Pressure (BP), Pulse Rate (PR) and Electrocardiogram (ECG)) deviating from normal and of clinical relevance * Any evidence of a clinically relevant concomitant disease * Gastrointestinal, hepatic, renal, respiratory, cardiovascular, metabolic, immunological or hormonal disorders * Surgery of the gastrointestinal tract (except appendectomy) * Diseases of the central nervous system (such as epilepsy) or psychiatric disorders or neurological disorders * History of relevant orthostatic hypotension, fainting spells or blackouts * Chronic or relevant acute infections * History of relevant allergy/hypersensitivity (including allergy to drug or its excipients) * Intake of drugs with a long half-life (\>24 hours) within at least one month or less than 10 half-lives of the respective drug prior to administration or during the trial * Use of drugs which might reasonably influence the results of the trial or that prolong the QT/QTc interval based on the knowledge at the time of protocol preparation within 10 days prior to administration or during the trial * Participation in another trial with an investigational drug within thirty days prior to administration or during the trial * Inability to refrain from smoking on trial days Smoker (\>10 cigarettes or \>3 cigars or \>3 pipes/day) * Alcohol abuse (more than 60 g/day) * Drug abuse * Blood donation (more than 100 mL within four weeks prior to administration or during the trial) * Excessive physical activities (within one week prior to administration or during the trial) * Any laboratory value outside the reference range that is of clinical relevance * Inability to comply with dietary regimen of trial site * A marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval \>450 ms) * A history of additional risk factors for Torsades de Pointes (e.g., heart failure, hypokalemia, family history of Long QT Syndrome) * Taking drugs which are known P-gp and/or CYP3A4 inhibitors or inducers (verapamil, phenothiazine antipsychotics, macrolide antibiotics (clarithromycin, erythromycin), antifungal drugs, antiviral drugs (protease inhibitors like nelfinavir) or St. John´s Wort) within the last 4 weeks before screening * Taking drugs which are known CYP2D6 substrates (antidepressants, antiarrhythmics, beta blockers) within the last 2 weeks before screening * For female subjects: * Pregnancy or planning to become pregnant within 2 months of study completion * Positive pregnancy test * No adequate contraception e.g., sterilisation, IUD (intrauterine device), have not been using a barrier method of contraception for at least 3 months prior to participation in the study * Are not willing or are unable to use a reliable method of barrier contraception (such as diaphragm with spermicidal cream/jelly or condoms with spermicidal foam), during and up to 2 months after completion/termination of the trial * Chronic use of oral contraception or hormone replacement containing ethinyl estradiol as the only method of contraception * Partner is unwilling to use condoms * Currently lactating
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Differences between treatments in systolic blood pressure profiles (using area under the BP-time curve) | -0:15 before, and every 15 minutes for 2 hours post-dose, 3, 4 and 12 hours post dose |
| Incidence of symptomatic hypotension | -0:15 before, and every 15 minutes for 2 hours post-dose, 3, 4 and 12 hours post dose |
Secondary
| Measure | Time frame |
|---|---|
| Occurrence of Adverse Events | up to day 26 |
| Abnormal findings in physical examination | up to day 26 |
| Changes from baseline in Vital Signs (Blood Pressure (BP), Heart Rate (HR)) | up to day 26 |
| Changes from baseline in 12-lead ECG (electrocardiogram) | up to day 26 |
| Changes from baseline in QT prolongation | up to day 26 |
| Changes in clinical laboratory tests | up to day 26 |
| Number of patients with adverse events leading to treatment discontinuation | up to day 26 |
| AUC (area under the concentration-time curve of the analyte in plasma) | up to 48 hours after the last dose |
| Cmax (maximum measured concentration of the analyte in plasma) | up to 48 hours after the last dose |
| tmax (time from dosing to the maximum concentration of the analyte in plasma) | up to 48 hours after the last dose |
| Area under the effect curve (AUEC) for activated partial thromboplastin time (aPTT), thrombin time (TT) and ecarin clotting time (ECT) | up to 48 hours after last dose |
| t½ (terminal half-life of the analyte in plasma) | up to 48 hours after the last dose |
| Cpre (pre-dose concentration of the analyte in plasma immediately before administration of the following dose) | up to 48 hours after the last dose |
| MRTpo,ss (mean residence time of the analyte in the body at steady state after po administration) | up to 48 hours after last dose |
| Vz/F,ss (apparent volume of distribution during the terminal phase λz at steady state following an extravascular dose) | up to 48 hours after last dose |
| CL/F,ss (apparent clearance of the analyte in the plasma at steady state after extravascular administration) | up to 48 hours after last dose |
| Cavg (average concentration of the analyte in plasma under steady-state conditions) | up to 48 hours after last dose |
| Cmin,ss (minimum measured concentration of the analyte in plasma at steady state) | up to 48 hours after last dose |
| PTF (peak trough fluctuation) | up to 48 hours after last administration |
| RAUCt1-t2, MET, 5 (ratio of AUCt1-t2 of 3-OH-quinidine/quinidine) | up to 48 hours after last dose |
| λz (terminal rate constant in plasma) | up to 48 hours after the last dose |
| Maximum effect ratio (ERmax) for activated partial thromboplastin time (aPTT), thrombin time (TT) and ecarin clotting time (ECT) | up to 48 hours after last dose |