title: Existing and new criteria for bioequivalence evaluation of new controlled release (CR) products of carbamazepine.
abstract: While the three classical pharmacokinetic (PK) parameters, AUC, Cmax and tmax are adequate to assess bioequivalence of immediate release (IR) formulations, they are not designed to fully characterize the pharmacokinetic (PK) performance of controlled release (CR) formulations and provide only limited insight into the function of carbamazepine (CBZ) CR products. Thus, for reliable assessment of bioequivalence in CR formulations, there is a role for the use of additional criteria (parameters). The following are the proposed new parameters: MRT (mean residence time), Cmax/AUC, plateau time or POT (the time span associated with the concentrations within 25% of Cmax), tapical (the arithmetic mean of the times associated with POT) and Capical (the arithmetic mean of the concentrations within 25% of Cmax). The above proposed parameters, were utilized in a recent PK study of new CR products of CBZ (600 mg) designed for once daily dosing. The comparative PK analysis was conducted in a three-way crossover single dose studies of three CBZ CR formulations (Teril 600 CR tablet, CBZ 600 granulate and Timonil 600 Retard tablet). Teril 600 CR was found to be bioequivalent to Timonil 600 Retard while CBZ 600 granulate was not. This conclusion was reached utilizing both the classical and the proposed new parameters. The new parameters showed that CBZ 600 granulate has similar rate of absorption as the two 600 mg CR tablets, but its extent of absorption was lower. The new parameters examined in this paper are more attractive than the single point parameters, Cmax and tmax, for assessment of rate of absorption and the flatness of the plasma concentration versus time curve. Their potential benefit and practical utility was confirmed in this study, which demonstrated bioequivalence between a new CR and an innovator CBZ (600 mg) tablet. Absorption rate assessment is important in light of concentration-related side effects associated with CBZ therapy and the impact of fluctuations and the flatness of the CBZ plasma concentration curve on the drug efficacy and tolerability.
authors.affiliation: Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel. bialer@md2.huji.ac.il
authors.forename: M
authors.initials: M
authors.lastname: Bialer
authors.forename: L
authors.initials: L
authors.lastname: Arcavi
authors.forename: S
authors.initials: S
authors.lastname: Sussan
authors.forename: A
authors.initials: A
authors.lastname: Volosov
authors.forename: A
authors.initials: A
authors.lastname: Yacobi
authors.forename: D
authors.initials: D
authors.lastname: Moros
authors.forename: B
authors.initials: B
authors.lastname: Levitt
authors.forename: A
authors.initials: A
authors.lastname: Laor
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000493:pharmacokinetics*; D002220:Carbamazepine / Q000493:pharmacokinetics*; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D005069:Evaluation Studies as Topic; D006801:Humans; D008297:Male; D012016:Reference Values; D013810:Therapeutic Equivalency
chemical_list: D000927:Anticonvulsants; D003692:Delayed-Action Preparations; D002220:Carbamazepine