Effect of Celecoxib and Etoricoxib on the Pharmacokinetics and Pharmacodynamics of Oral Tramadol - Full Text View

Purpose

Tramadol is an opioid analgesic, which is widely used in the treatment of acute and neuropathic pain. After oral administration, tramadol is rapidly and almost completely absorbed. Tramadol is extensively metabolised by O- and N-demethylation, which are catalysed by the liver CYP-450 enzymes. O-desmethyltramadol is an active metabolite and its formation is catalysed by CYP2D6. This study is aimed to investigate the possible interaction of oral tramadol with selecoxib and etoricoxib. Selecoxib is known to inhibit CYP2D6. Twelve healthy male or female adult non-smoking volunteers aged 18-40 years with body weights within ±15% of the ideal weight for height are taken into the study. Primary endpoints of the study are plasma concentrations of tramadol and its metabolites.

Condition	Intervention	Phase
Healthy	Drug: Placebo Drug: Selecoxib Drug: Etoricoxib	Phase 1

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Pharmacokinetics/Dynamics Study Intervention Model: Crossover Assignment Masking: Single Blind (Subject) Primary Purpose: Basic Science

Further study details as provided by Turku University Hospital:

Primary Outcome Measures:

Concentration of tramadol and its metabolites in plasma [ Time Frame: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 24, 48 hours after administration of tramadol ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Serotonin concentrations [ Time Frame: 0, 4 and 8 hours after tramadol administration ] [ Designated as safety issue: No ]
Serotonin concentrations will be analyzed with chromatographical methods from the blood samples drawn 0, 4 and 8 hours after tramadol administration
Pharmacodynamic effects [ Time Frame: 1, 2, 3, 4, 5, 6, 8, 10, 12 hours after administration of tramadol ] [ Designated as safety issue: No ]
The psychomotor effects of tramadol will be assessed with the measurement of pupil size with Cogan's pupillometer, Maddox wing test and digit symbol substitution test
Analgesia [ Time Frame: 1, 2, 3, 4, 5, 6, 8, 10, 12 hours after the administration of tramadol ] [ Designated as safety issue: No ]
The analgesic effect of tramadol will be evaluated using the cold pressor test. Briefly, the subject's hand is immersed into ice-cold water of + 4° C up to the wrist. The subject is told to keep his or her hand in the water and to report when the cold sensation becomes painful. Cold pain threshold is defined as the latency from the immersion of the hand to the subject's first report of pain. Cold pain intensity is assessed at 30 s intervals following immersion of the hand in cold water for up to 60s . A verbal numerical rating scale of 0-100 will be used.

Estimated Enrollment:	12
Study Start Date:	January 2011
Study Completion Date:	July 2011
Primary Completion Date:	July 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Placebo Comparator: Placebo	Drug: Placebo The subjects will be given orally placebo twice a day for 7 days prior to the study.
Active Comparator: Selecoxib	Drug: Selecoxib The subjects will be given orally selecoxib 200mg twice a day for 7 days prior to the study.
Active Comparator: Etoricoxib	Drug: Etoricoxib The subjects will be given orally etoricoxib 120mg once a day for 7 days prior to the study.

Eligibility

Ages Eligible for Study:	18 Years to 40 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

Healthy volunteers
Age 18-40
Body weight within ±15% of the ideal weight for height

Exclusion Criteria:

A previous history of intolerance to the study drugs or to related compounds and additives
Concomitant drug therapy of any kind for at least 14 days prior to the study
Existing or recent significant disease
History of hematological, endocrine, metabolic or gastrointestinal disease, including gut motility disorders
History of asthma or any kind of drug allergy
Previous or present alcoholism, drug abuse, psychological or other emotional problems that are likely to invalidate informed consent, or limit the ability of the subject to comply with the protocol requirements
A positive test result for urine toxicology
A "yes" answer to any one of the Abuse Questions
Pregnancy or nursing
Donation of blood for 4 weeks prior and during the study
Special diet or life style conditions which would compromise the conditions of the study or interpretation of the results
Participation in any other studies involving investigational or marketed drug products concomitantly or within one month prior to the entry into this study
Smoking for one month before the start of the study and during the whole study period
Any history of coagulation abnormality, also in first degree relatives

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01304069

Locations

Finland
Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University and Turku University Hospital
Turku, Finland

Sponsors and Collaborators

Turku University Hospital

More Information

No publications provided

Responsible Party:	Klaus T Olkkola, MD, Prof, Turku University Hospital
ClinicalTrials.gov Identifier:	NCT01304069 History of Changes
Other Study ID Numbers:	119/180/2010, 2010-023373-19
Study First Received:	February 24, 2011
Last Updated:	July 8, 2011
Health Authority:	Finland: Finnish Medicines Agency

Keywords provided by Turku University Hospital:

Pharmacokinetics
Pharmacodynamics

Additional relevant MeSH terms:

Etoricoxib
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic

Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Therapeutic Uses
Central Nervous System Agents
Antirheumatic Agents

ClinicalTrials.gov processed this record on May 23, 2013