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Current Therapeutic Research, Clinical and Experimental logoLink to Current Therapeutic Research, Clinical and Experimental
. 2008 Dec;69(6):504–513. doi: 10.1016/S0011-393X(09)00002-2

Bioequivalence evaluation of two capsule formulations of amoxicillin in healthy adult male bangladeshi volunteers: A single-dose, randomized, open-label, two-period crossover study

Ashik Ullah 1, Mohammad Abul Kalam Azad 2, Rebeka Sultana 1, Maruf Mohammad Akbor 1, Ahasanul Hasan 1, Mahbub Latif 3, Abul Hasnat 1,*
PMCID: PMC3969944  PMID: 24692824

Abstract

Background: Amoxicillin, a semisynthetic penicillin antibiotic, is widely prescribed in Bangladesh due to its extended spectrum and its rapid and extensive oral absorption with good tolerability. Although a number of generic oral formulations of amoxicillin are available in Bangladesh, a study of the bioequivalence and pharmacokinetic properties of these formulations has not yet been conducted in a Bangladeshi population.

Objective: The aim of this study was to assess the pharmacokinetic properties and bioequivalence of 2 formulations of amoxicillin 500-mg capsules (test, SK-mox®; reference, Amoxil-Bencard®) using serum data.

Methods: This single-dose, randomized, open-label, 2-period crossover study was conducted in healthy male subjects in compliance with the Declaration of Helsinki and International Conference on Harmonisation guidelines. Subjects were assigned to receive the test or the reference drug as a single-dose, 500-mg capsule under fasting conditions after a 1-week washout period. After oral administration, blood samples were collected and analyzed for amoxicillin concentration using a validated high-performance liquid chromatography method. The pharmacokinetic parameters were determined using a noncompartmental method. The formulations were considered bioequivalent if the natural log-transformed ratios of pharmacokinetic parameters were within the predetermined equivalence range of 80% to 125%, according to the US Food and Drug Administration (FDA) requirement.

Results: Twenty-four healthy adult male Bangladeshi volunteers (mean [SD] age, 26.92 [3.37] years; age range, 23–34 years; mean [SD] body mass index, 23.O9 [1.58] kg/m2) participated in the study. Using serum data, the values obtained for the test and reference formulations, respectively, were as follows: Cmax, 9.85 (2.73) and 10.63 (2.12) μg/mL; Tmax, 1.29 (0.58) and 1.33 (0.49) hours; and AUC0–12, 27.09 (7.62) and 28.56 (6.30) μg/mL · h−1. No period, sequence, or formulation effects were observed; however, significant variation was found among subjects with regard to AUC0–12 (P < 0.001), AUC0−∞ (P = 0.002), area under the moment curve (AUMC) from 0 to 12 hours (P < 0.001), and AUMC0−∞ (P = 0.017). All CIs for the parameters measured were within the FDA-accepted limits of 80% to 125%.

Conclusion: The present study suggests that the test 500-mg amoxicillin capsule was bioequivalent to the reference 500-mg capsule according to the FDA regulatory definition, in this population of healthy adult male Bangladeshi volunteers.

Key words: amoxicillin, pharmacokinetic, bioequivalence, analysis of variance, confidence interval, Bangladeshi population

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References

  • 1.Dhaon NA. Amoxicillin tablets for oral suspension in the treatment of acute otitis media: A new formulation with improved convenience. Adv Ther. 2004;21:87–95. doi: 10.1007/BF02850336. [DOI] [PubMed] [Google Scholar]
  • 2.Spangler SK, Lin G, Jacobs MR, Appelbaum PC. Postantibiotic effect of sanfetrinem compared with those of six other agents against 12 penicillin-susceptible and -resistant pneumococci. Antimicrob Agents Chemother. 1997;41:2173–2176. doi: 10.1128/aac.41.10.2173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Thorburn CE, Knott SJ, Edwards DI. In vitro activities of oral beta-lactams at concentrations achieved in humans against penicillin-susceptible and -resistant pneumococci and potential to select resistance. Antimicrob Agents Chemother. 1998;42:1973–1979. doi: 10.1128/aac.42.8.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Neu HC, Winshell EB. Pharmacological studies of 6 (D(−)-amino-p-hydroxyphenylacetamido) penicillanic acid in humans. Antimicrob Agents Chemother (Bethesda). 1970;10:423–426. [PubMed] [Google Scholar]
  • 5.Brusch JL, Bergeron MG, Barza M, Weinstein L. An in vitro and pharmacological comparison of amoxicillin and ampicillin. Am J Med Sci. 1974;267:41–48. doi: 10.1097/00000441-197401000-00006. [DOI] [PubMed] [Google Scholar]
  • 6.Paintaud G, Alván G, Dahl ML. Nonlinearity of amoxicillin absorption kinetics in human. Eur J Clin Pharmacol. 1992;43:283–288. doi: 10.1007/BF02333024. [DOI] [PubMed] [Google Scholar]
  • 7.Adam D, de Visser I, Koeppe P. Pharmacokinetics of amoxicillin and clavulanic acid administered alone and in combination. Antimicrob Agents Chemother. 1982;22:353–357. doi: 10.1128/aac.22.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Philipson A, Sabath LD, Rosner B. Sequence effect on ampicillin blood levels noted in an amoxicillin, ampicillin, and epicillin triple crossover study. Antimicrob Agents Chemother. 1975;8:311–320. doi: 10.1128/aac.8.3.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Bodey GP, Nance J. Amoxicillin: In vitro and pharmacological studies. Antimicrob Agents Chemother. 1972;1:358–362. doi: 10.1128/aac.1.4.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Eshelman FN, Spyker DA. Pharmacokinetics of amoxicillin and ampicillin: Crossover study of the effect of food. Antimicrob Agents Chemother. 1978;14:539–543. doi: 10.1128/aac.14.4.539. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Suarez-Kurtz G, Ribeiro FM, Vicente FL, Struchiner CJ. Development and validation of limited-sampling strategies for predicting amoxicillin pharmacokinetic and pharmacodynamic parameters. Antimicrob Agents Chemother. 2001;45:3029–3036. doi: 10.1128/AAC.45.11.3029-3036.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Pires de Abreu LR, Ortiz RM. HPLC determination of amoxicillin comparative bioavailability in healthy volunteers after a single dose administration. J Pharm Pharm Sci. 2003;6:223–230. [PubMed] [Google Scholar]
  • 13.Verbist L. Triple crossover study on absorption and excretion of ampicillin, pivampicillin, and amoxycillin. Antimicrob Agents Chemother. 1974;6:588–593. doi: 10.1128/aac.6.5.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.European Agency for the Evaluation of Medicinal Products, International Conference on Harmonisation—World Health Organization . Guideline for Good Clinical Practice [EMEA Web site]. ICH topic E6. WHO; Geneva, Switzerland: 2002. http://www.emea.europa.eu Accessed January 10, 2008. [Google Scholar]
  • 15.World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [WMA Web site] October 7, 2000 doi: 10.1310/GTFR-2DRX-M6YE-ELXR. http://www.wma.net/e/policy/b3.htm Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, and amended by the 52nd WMA General Assembly, Edinburgh, Scotland. Accessed January 10, 2008. [DOI] [PubMed] [Google Scholar]
  • 16.Chow SC, Wang H. On sample size calculation in bioequivalence trials. J Pharmacokinet Pharmacodyn. 2001;28:155–169. doi: 10.1023/a:1011503032353. [published correction appears in J Pharmacokinet Pharmacodyn. 2002;29:101] [DOI] [PubMed] [Google Scholar]
  • 17.Azad MAK, Ullah A, Latif AHMM, Hasnat A. Bioequivalence and pharmacokinetic study of two oral formulations of ciprofloxacin tablets in healthy male volunteers. J Applied Res. 2007;7:150–157. [Google Scholar]
  • 18.Jones B, Kenward GM. Design and Analysis of Cross-Over Trials. 2nd ed. Chapman & Hall; New York, NY: 2003. pp. 1–14. [Google Scholar]
  • 19.US Food and Drug Administration In vivo bioequivalence guidances. Pharmacopeial Forum. 1993;19:6501–6508. [Google Scholar]

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