Key result
Co-administration of nebivolol and furosemide causes no pharmacokinetic interaction between either drug.
Why the study?
Potential pharmacokinetic interaction between nebivolol and furosemide in subjects genotyped for CYP2D6 status was studied to assess drug interaction risk.
Does co-administration of nebivolol and furosemide alter the pharmacokinetic profile of either drug in healthy subjects?
Does co-administration of nebivolol and furosemide alter the pharmacokinetic profile of either drug in healthy subjects?
Co-administration of nebivolol and furosemide does not result in clinically significant pharmacokinetic interactions, regardless of CYP2D6 metabolizer status.
No dose adjustment needed for coadministration; leaves open confirmation in larger patient cohorts.
Background Potential interaction between nebivolol, a unique antihypertensive which couples vascular endothelial nitric oxide releasing capabilities with cardioselective β1-blockade, and furosemide, was studied by comparison of pharmacokinetic (PK) parameter estimates in subjects genotyped for CYP2D6 status. Methods Subjects[12 extensive (EM), 3 poor (PM) metabolizers] received 40 mg oral furosemide on Day 1. On Days 2–10, oral nebivolol (10 mg) was administered QD. On Day 11, nebivolol and furosemide were given QD. PK estimates for nebivolol and furosemide were assessed. Results Co-administration of furosemide with nebivolol produced no statistically significant changes in PK estimates for d,l-nebivolol or its enantiomers in EM and PM subjects. The 90% confidence intervals for Cmax, CSS and AUCτ in EM and PM subjects were within 80% - 125%. For furosemide, ANOVA testing of Cmax, AUCt, AUC∞, and Cl/F revealed no interaction with nebivolol. The 90% confidence intervals for furosemide Cmax, AUCt and AUC∞ were slightly different between treatments, but all passed through 100% and least squares mean ratios ranged from 0.93 to 0.95. Conclusions Regardless of CYP2D6 metabolizing status, there were no drug interactions observed that would affect the PK profile of either nebivolol or furosemide upon co-administration. Clinical Pharmacology & Therapeutics (2005) 77, P79–P79; doi: 10.1016/j.clpt.2004.12.192
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Morton et al. (2005) studied Healthy (n=15). Nebivolol and furosemide co-administration vs. Furosemide alone and nebivolol alone was evaluated on Pharmacokinetic parameter estimates (Cmax, CSS, AUC) for nebivolol and furosemide. Co-administration of nebivolol and furosemide produced no significant changes in the pharmacokinetic profiles of either drug, with least squares mean ratios for furosemide ranging from 0.93 to 0.95.
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