Asunaprevir + Omeprazole = Precautionary

Effect on Concentration

Asunaprevir
Unknown
Applies within class?
No
Omeprazole
Decrease
Applies within class?
No

Pharmacologic Effects

Asunaprevir
Effect
N/A
Applies within class?
No
Omeprazole
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 22-Nov-2022

Summary

***It should be noted that the effect of omperazole on asunaprevir PK was not reported in this study, therefore caution is advised.

Sources

Asunapevir vs many drugs ^

Study Design

Two single sequence studies were conducted to assessthe effectof multiple-dose BMS-650032 (asunaprevir) on the pharmacokinetics (PK) ofa cocktail of cytochrome P (CYP) -450 probes and a P-glycoprotein (P-gp) probe. The study subjects includedhealthy men and women ages 18 to 49 years with a BMI of 18 to 32kg/m2.In studyAI447020 on Days 1 and 11, 19 subjects receivedsingle oral doses of substrates of CYP1A2 (Caffeine 200mg), CYP2D6 (Dextromethorphan30mg), CYP3A4 (Midazolam 5mg), CYP2C9 (Losartan25mg), and CYP2C19 (Omeprazole 40mg) concurrently. On days 2-11, 200mg BID of asunaprevir was given. Blood sampleswere collected for PK analysis through 24h post-dose on Days 1 and 11 for the probe substrates. The geometric mean ratios (GMR) and 90% confidence intervals (90%CI) were calculated to show the magnitude of change during co-administration.

Study Results

Drug NameCmaxGMR (90% CI)AUC GMR (90% CI)Omeprazole0.957 (0.790, 1.160)0.804 (0.691, 0.936)Co-administration of asunaprevir and omeprazole showed a small change in the Cmaxand AUC of omeprazole. Asunaprevir decreased the Cmaxand AUC of omeprazole by 4% and 20%, respectively. Based on the results of this study, it would appear that there are no clinically signficiant changes in the Cmaxor AUC of omeprazole when co-administered with asunaprevir.

Study Conclusions

References

T Eley, D Gardiner, A Persson, et al. Evaluation of drug interaction potential of the hcv protease inhibitor bms-650032 at 200mg twice daily (bid) in metabolic cocktail and p-glycoprotein (p-gp) probe studies in healthy volunteers. 62nd Annual Meeting Of The American Association For The Study Of Liver Diseases. San Francisco, CA. ; 2011.