Arzneimittelforschung 2012; 62(01): 35-39
DOI: 10.1055/s-0031-1295426
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Bioequivalence of Two Misoprostol Tablets in Healthy Chinese Female Volunteers: A Single-Dose, Two-Period, Double Crossover Study

J. Huang
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
2   Medical Faculty of Shandong University, Jinan, P. R. China
,
R. Chen
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
2   Medical Faculty of Shandong University, Jinan, P. R. China
,
R. Li
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
,
C.-M. Wei
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
,
G.-Y. Yuan
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
,
X.-Y. Liu
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
,
B.-J. Wang
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
,
R.-C. Guo
1   Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, P. R. China
› Author Affiliations
Further Information

Publication History

received 20 September 2011

accepted 28 October 2011

Publication Date:
10 January 2012 (online)

Abstract

Objective:

To assess the bioequivalence of a new generic formulation of misoprostol (CAS 59122-46-2) 0.2 mg tablets (test) and the available branded tablet (reference) for the requirement of state regulatory criteria and the marketing of the test product in China.

Methods:

A randomized-sequence, 2-period crossover study was conducted in 20 healthy Chinese female volunteers in the fasted state. Blood samples were collected at baseline and 0.083, 0.17, 0.25, 0.33, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4 and 6 h after a single oral dose of 0.6 mg misoprostol test or reference, followed by a 7-day washout period. Misoprostol acid, the active metabolite of misoprostol, was determined by an HPLC-MS/MS method. Drug And Statistics 2.0 was used to calculate the pharmacokinetics parameters and assess bioequivalence of the 2 formulations. It was considered bioequivalent if the 90% CIs of the mean ratios (test: reference) for Tmax, Cmax and AUC0–t were all within the range from 80% to 125%. Adverse events were monitored throughout the study based on clinical parameters and patient reports.

Results:

The main pharmacokinetics parameters for the test and reference were as follows: t1/2 was (0.680±0.371) h and (0.650±0.264) h; Tmax was (0.415±0.087) h and (0.399±0.097) h; Cmax was (1.941±0.417) ng/mL and (2.047±0.397) ng/mL; AUC0–t was (1.535±0.419) ng·h/mL and (1.652±0.400)ng·h/mL, and the AUC0–∞ was (1.576±0.465) ng·h/mL and (1.686±0.396) ng·h/mL. The mean ratios (test: reference) for Cmax, AUC0–t, and AUC0–∞ were 95.3%±13.2%, 92.65%±17.31%, and 93.61%±18.97%, respectively. No significant (p>0.05) differences in pharmacokinetic parameters were found between preparations, treatments and periods.

Conclusions:

This single-dose study in healthy Chinese fasted volunteers was shown that the misoprostol test and reference met the requirement of US and China regulatory criterion, and the test and reference were bioequivalent.

 
  • References

  • 1 Fernandez MM, Coeytaux F, Rodolfo Gomez P et al. Assessing the global availability of misoprostol. Gynecol Obstet 2009; 105: 180-186
  • 2 Akin A, Dabash MR, Dilbaz B et al. Increasing women’s choices in medical abortion: a study of misoprostol 400 µg swallowed immediately or held sublingually following 200 mg mifepristone. Eur J Contracept Reprod Health Care 2009; June; 14 (03) 169-175
  • 3 Choksuchat C. Clinical Use of Misoprostol in Nonpregnant Women: Review Article. J Minim Invasive Gynecol 2010; July; 17 (04) 449-455
  • 4 Schreiber CA, Creinin MD, Reeves MF et al. Mifepristone and misoprostol for the treatment of early pregnancy failure:a pilot clinical trial. Contraception 2006; December; 74 (06) 458-462
  • 5 Jinglian H, Yuzhen W, Aiying L. The pharmacological effects and clinical applications of misoprostol. Occup Health 2002; 18: 125-126
  • 6 Moraes BM, do Amaral BC, Morimoto MS et al. Anti- inflammatory and analgesic actions of etoricoxib (an NSAID) combined with misoprostol. Inflammopharmacology 2007; 15: 175-178
  • 7 Schoenhard G, Oppermann J, Kohn FE. Metabolism and Pharmacokinetic Studies of Misoprostol. Dig Dis Sciences 1985; 30: 126-128
  • 8 Eric AS, Robert DC, Stephen LF. Comparison of misoprostol plasma concentrations following buccal and sublingual administration. Contraception 2005; 71: 22-25
  • 9 Diop A, Raghavan S, Rakotovao JP et al. Two routes of administration for misoprostol in the treatment of incomplete abortion: a randomized clinical trial. Contraception 2009; June; 79 (06) 456-462
  • 10 Danielsson KG, Marions L, Rodriguez A et al. Comparison between oral and vaginal administration of misoprostol on uterine contractility. Obstet Gynecol 1999; February; 93 (02) 275-280
  • 11 Chong YS, Chua S, Shen L et al. Does the route of administration of misoprostol make a difference? The uterotonic effect and side effects of misoprostol given by different routes after vaginal delivery. Obstet Gynecol Reprod Biol 2004; 113: 191-198
  • 12 Karageyim Karsidag AY, Buyukbayrak EE, Kars B et al. Vaginal versus sublingual misoprostol for second-trimester pregnancy termination and effect on Doppler measurements. Gynecol Obstet 2009; 106: 250-253
  • 13 Feitosa FEL, Sampaio ZS, Alencar Jr CA et al. Sublingual vs. vaginal misoprostol for induction of labor. Gynecol Obstet 2006; 94: 91-95
  • 14 Karime A. Antiulcer prostaglandin misoprostol: Single and multiple dose pharmacokinetic profile. Prostaglandins 1987; 33 (Supplement 1) 40-50
  • 15 Zieman M, Fong SK, Benowitz NL et al. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol 1997; July; 90 (01) 88-92
  • 16 Tang OS, Gemzell-Danielsson K, Ho PC. Misoprostol: Pharmacokinetic profiles, effects on the uterus and side-effects. Int J Gynecol Obstet 2007; 99: 160-167
  • 17 Abdel-Aleem H, Villar J, Gülmezoglu AM et al. The pharmacokinetics of the prostaglandin E1 analogue misoprostol in plasma and colostrum after postpartum oral administration. Eur J Obstet Gynecol Reprod Biol 2003; 108: 25-28
  • 18 Aronsson A, Fiala C, Granath F et al Pharmacokinetic profiles up to 12 h after administration of vaginal, sublingual and slow-release oral misoprostol. Free communication (oral) presentations/International Journal of Gynecology & Obstetrics 2007; 22: 1912-1918
  • 19 Andolina KL, Tolosa JE, Monzo JM et al. Randomized controlled trials of postpartum misoprostol pharmacokinetics using a novel packaging method. Obstet Gynecol 2002; 99: 52-53
  • 20 Zou Y, Chen XY, Song B et al. Determination of misoprostol acid in human plasma by liquid chromatography coupled to tandem mass spectrometry. J Chromatogr B 2007; 852: 122-127