Cebranopadol is a novel first-in-class analgesic acting as a nociceptin/orphanin FQ peptide and opioid peptide receptor agonist with central analgesic activity. It is currently in clinical development for the treatment of chronic pain conditions. This trial focuses on the clinical pharmacokinetic (PK) properties of cebranopadol after oral single- and multiple-dose administration.
The basic PK properties of cebranopadol were assessed by means of noncompartmental methods in six phase I clinical trials in healthy subjects and patients. A population PK analysis included two further phase I and six phase II clinical trials.
After oral administration of the immediate-release (IR) formulation, cebranopadol is characterized by a late time to reach maximum plasma concentration [Cmax] (4–6 h), a long half-value duration [HVD] (14–15 h), and a terminal phase half-life in the range of 62–96 h. After multiple once-daily dosing in patients, an operational half-life (the dosing interval resulting in an accumulation factor [AF] of 2) of 24 h was found to be the relevant factor to describe the multiple-dose PKs of cebranopadol. The time to reach steady state was approximately 2 weeks, the AF was approximately 2, and peak-trough fluctuation (PTF) was low (70–80%). Dose proportionality at steady state was shown for a broad dose range of cebranopadol 200–1600 µg. A two-compartment disposition model with two lagged transition compartments and a first-order elimination process best describes cebranopadol data in healthy subjects and patients after single- and multiple-dose administration.
Cebranopadol formulated as an IR product can be used as a once-daily formulation; it reaches Cmax after only 4–6 h, and has a long HVD and a low PTF. Therefore, from a PK perspective, cebranopadol is an attractive treatment option for patients with chronic pain.
Zöllner C, Stein C. Opioids. Handbook Exp Pharmacol. 2007;177:31–63. CrossRef
Fussen R, Nemeth R, Ossig J, Boinpally R. Single-dose pharmacokinetics and relative bioavailability of the novel strong analgesic cebranopadol [abstract no. WIP-0199]. 7th World Congress, World Institute of Pain; 7–10 May 2014: Maastricht.
Darwish M, Bond M, Tracewell W, Robertson P Jr, Yang R. Pharmacokinetics of hydrocodone extended-release tablets formulated with different levels of coating to achieve abuse deterrence compared with a hydrocodone immediate-release/acetaminophen tablet in healthy subjects. Clin Drug Investig. 2015;35(1):13–22. CrossRefPubMed
Royal M. A head-to-head, single-dose trial of KADIAN ® vs AVINZA ® 30 mg in healthy, opioid-naïve subjects in the fed state: comparison of pharmacokinetics [abstract no. 732]. J Pain. 2005;6:S41. CrossRef
- Clinical Pharmacokinetic Characteristics of Cebranopadol, a Novel First-in-Class Analgesic
- Springer International Publishing