Key result
Edoxaban oral absolute bioavailability was 61.8% in healthy volunteers, and concomitant quinidine increased total edoxaban exposure by ~35%.
Why the study?
What is the absolute bioavailability of edoxaban and the effect of the P-glycoprotein inhibitor quinidine on its pharmacokinetics in healthy subjects?
RCT (n=36)
randomized sequence
What is the absolute bioavailability of edoxaban and the effect of the P-glycoprotein inhibitor quinidine on its pharmacokinetics in healthy subjects?
Edoxaban has an absolute oral bioavailability of 61.8% in healthy subjects, and its exposure is moderately increased by the P-glycoprotein inhibitor quinidine.
Answers are grounded in this paper and cite their sources.
Increased edoxaban exposure with quinidine warrants P-gp interaction caution; extends bioavailability data for NOAC dosing in atrial fibrillation.
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.
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Matsushima et al. (2013) conducted an RCT in Healthy volunteers (n=36). Edoxaban vs. Different administration routes and concomitant quinidine was evaluated on Absolute bioavailability of edoxaban. Edoxaban oral absolute bioavailability was 61.8% in healthy volunteers, and concomitant quinidine increased total edoxaban exposure by ~35%.
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