Investigation of PK-PD drug-drug interaction between acenocoumarol and amoxicillin plus clavulanic acid. - Archive ouverte HAL Access content directly
Journal Articles Fundamental & Clinical Pharmacology Year : 2009

Investigation of PK-PD drug-drug interaction between acenocoumarol and amoxicillin plus clavulanic acid.

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X. Delavenne
  • Function : Author
S. Demasles
  • Function : Author
N. Mallouk
  • Function : Author
Michel Tod
Pascal Girard
  • Function : Author
  • PersonId : 829460

Abstract

A pharmacokinetic-pharmacodynamic (PK-PD) drug-drug interaction between acenocoumarol and amoxicillin + clavulanic acid antibiotic was assessed in eight healthy volunteers, using a population PK-PD) model. Each subject received at day 1 a single dose of 8 mg of acenocoumarol. Then 1 g of amoxicillin + 250 mg of clavulanic acid was given from days 3 to 9. On day 8, each subject received a single dose of 8 mg of acenocoumarol concomitantly with the antibiotic combination. Eleven blood samples were taken during 48 h following each acenocoumarol administration. Acenocoumarol plasma concentrations and prothrombin time were measured at each sampling time. We first identified the structural PK model by pooling data from this trial with individual data from other acenocoumarol PK trials. An indirect response model was used to fit PD data. Models were built using a non-linear mixed effect modelling approach with nonmem software. Covariates were tested on PK and PD parameters, including antibiotic treatment. Acenocoumarol PK data were fitted by a two-compartment, first-order input model with log normal inter-individual variability. Weight and antibiotic treatment were found to improve significantly the fit of PK data with a 15% decrease in acenocoumarol clearance with concomitant antibiotics (P < 0.05). An indirect response model was successfully applied to the PK-PD data of acenocoumarol. No covariate, including antibiotic treatment effect, significantly affected PT. Drug-drug interaction was demonstrated at the PK level, without any PD corollary.

Dates and versions

ujm-00439720 , version 1 (08-12-2009)

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Cite

X. Delavenne, S. Laporte, S. Demasles, N. Mallouk, Thomas Basset, et al.. Investigation of PK-PD drug-drug interaction between acenocoumarol and amoxicillin plus clavulanic acid.. Fundamental & Clinical Pharmacology, 2009, 23 (1), pp.127-35. ⟨10.1111/j.1472-8206.2008.00642.x⟩. ⟨ujm-00439720⟩
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