Bioavailability and Safety of the Factor Xa Inhibitor Edoxaban and the Effects of Quinidine in Healthy Subjects
- 9 September 2013
- journal article
- Published by Wiley in Clinical Pharmacology in Drug Development
- Vol. 2 (4), 358-366
- https://doi.org/10.1002/cpdd.53
Abstract
Background Edoxaban is an oral, once‐daily, direct factor Xa inhibitor under investigation for stroke prevention in patients with atrial fibrillation and for treatment and secondary prevention of venous thromboembolism. This study evaluated edoxaban absolute bioavailability and effects of the P‐glycoprotein inhibitor quinidine on edoxaban pharmacokinetics after intravenous edoxaban administration. Methods Healthy volunteers received three treatments in a randomized sequence: single oral 60‐mg edoxaban dose, single intravenous 30‐mg edoxaban dose, and concomitant single intravenous 30‐mg edoxaban dose with quinidine 300 mg every 8 hours for 4 days. The primary objective was to determine absolute bioavailability of edoxaban. Secondary objectives included pharmacokinetics and pharmacodynamics of edoxaban after oral or intravenous administration, quinidine effect on intravenous edoxaban pharmacokinetics, and safety. Results Thirty‐six subjects were randomized; five discontinued (three for adverse events [AEs]). Edoxaban oral absolute bioavailability was 61.8%. With concomitant quinidine, total edoxaban exposure increased ∼35% and total clearance decreased ∼25%. Coagulation parameters increased after edoxaban administration in most subjects, but returned to baseline within 24 hours postdose. No deaths, serious AEs, or bleeding‐related AEs occurred. Conclusions Absolute bioavailability of edoxaban in healthy volunteers was established (61.8%). Edoxaban, administered orally or intravenously, appeared to be safe and well tolerated.Keywords
Funding Information
- Daiichi Sankyo Pharma Development, Edison, NJ
This publication has 13 references indexed in Scilit:
- A randomized trial of the safety, pharmacokinetics and pharmacodynamics of edoxaban, an oral factor Xa inhibitor, following a switch from warfarinBritish Journal of Clinical Pharmacology, 2013
- Pharmacokinetics of the Direct Factor Xa Inhibitor Edoxaban and Digoxin Administered Alone and in CombinationJournal of Cardiovascular Pharmacology, 2012
- Pharmacokinetics, Biotransformation, and Mass Balance of Edoxaban, a Selective, Direct Factor Xa Inhibitor, in HumansDrug Metabolism and Disposition, 2012
- Edoxaban administration following enoxaparin: A pharmacodynamic, pharmacokinetic, and tolerability assessment in human subjectsThrombosis and Haemostasis, 2012
- Modelling and simulation of edoxaban exposure and response relationships in patients with atrial fibrillationThrombosis and Haemostasis, 2012
- Characterisation of exposure versus response of edoxaban in patients undergoing total hip replacement surgeryThrombosis and Haemostasis, 2012
- EdoxabanDrugs, 2011
- DRUG-DRUG INTERACTION STUDIES OF CARDIOVASCULAR DRUGS (AMIODARONE, DIGOXIN, QUINIDINE, ATORVASTATIN AND VERAPAMIL) INVOLVING P-GLYCOPROTEIN (P-GP), AN EFFLUX TRANSPORTER, ON THE PHARMACOKINETICS (PK) AND PHARMACODYNAMICS (PD) OF EDOXABAN, AN ORAL FACTOR XA INHIBITORJournal of the American College of Cardiology, 2011
- Evaluation of the novel factor Xa inhibitor edoxaban compared with warfarin in patients with atrial fibrillation: Design and rationale for the Effective aNticoaGulation with factor xA next GEneration in Atrial Fibrillation–Thrombolysis In Myocardial Infarction study 48 (ENGAGE AF–TIMI 48)American Heart Journal, 2010
- New AnticoagulantsCirculation, 2010