Effect of esomeprazole, a proton pump inhibitor on the pharmacokinetics of sonidegib in healthy volunteers

Br J Clin Pharmacol. 2016 Oct;82(4):1022-9. doi: 10.1111/bcp.13038. Epub 2016 Jul 13.

Abstract

Aims: This study aimed to evaluate the impact of esomeprazole on the pharmacokinetics of sonidegib.

Methods: This Phase I study evaluated the impact of the proton pump inhibitor (PPI) esomeprazole on the oral absorption and pharmacokinetics (PKs) of a single dose of sonidegib under fasted conditions. A total of 42 healthy subjects were enrolled to receive either sonidegib alone (200 mg single dose) or sonidegib in combination with esomeprazole (40 mg pre-treatment 5 days and combination were given on day 6). Primary PK parameters assessed in the study were area under the concentration-time curve (AUC) from 0-14 days and 0-7 days and maximum observed plasma concentration (Cmax ).

Results: The plasma exposure (AUC0-14d, AUC0-7d and Cmax ) of a single 200 mg oral dose of sonidegib was decreased by 32-38% when sonidegib was co-administered with esomeprazole compared with sonidegib alone, with no apparent change in elimination slope and tmax . Baseline gastric pH was similar between the two arms.

Conclusions: These results suggest a modest reduction in the extent of sonidegib absorption by esomeprazole. There was no obvious metabolic drug-drug interaction between the two agents. Both sonidegib and esomeprazole were well tolerated in the study population.

Keywords: Hh pathway, esomeprazole; basal cell carcinoma; drug-drug interaction; pH-dependent solubility; sonidegib.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Biphenyl Compounds / adverse effects
  • Biphenyl Compounds / blood
  • Biphenyl Compounds / pharmacokinetics*
  • Drug Interactions
  • Esomeprazole / adverse effects
  • Esomeprazole / pharmacology*
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / adverse effects
  • Proton Pump Inhibitors / pharmacology*
  • Pyridines / adverse effects
  • Pyridines / blood
  • Pyridines / pharmacokinetics*
  • Young Adult

Substances

  • Biphenyl Compounds
  • Proton Pump Inhibitors
  • Pyridines
  • sonidegib
  • Esomeprazole