No Effect of the Novel Antidiabetic Agent Nateglinide on the Pharmacokinetics and Anticoagulant Properties of Warfarin in Healthy Volunteers

• Published in: Journal of clinical pharmacology Vol. 42; no. 12; pp. 1358 - 1365
• Main Authors: Anderson, Denise M., Shelley, Sarah, Crick, Nina, Buraglio, Mauro
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-2002; SAGE Publications; Sage Science; Wiley Subscription Services, Inc
• Subjects: Analysis of Variance; Anticoagulants - pharmacokinetics; Anticoagulants - pharmacology; Area Under Curve; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Cross-Over Studies; Cyclohexanes - blood; Cyclohexanes - pharmacokinetics; Cyclohexanes - pharmacology; Drug Administration Schedule; Drug Interactions; General and cellular metabolism. Vitamins; Humans; Hypoglycemic Agents - blood; Hypoglycemic Agents - pharmacokinetics; Hypoglycemic Agents - pharmacology; Male; Medical sciences; Nateglinide; Pharmacology. Drug treatments; Phenylalanine - analogs & derivatives; Phenylalanine - blood; Phenylalanine - pharmacokinetics; Phenylalanine - pharmacology; Prothrombin Time; Time Factors; Warfarin - pharmacokinetics; Warfarin - pharmacology; Human; Pharmacokinetic pharmacodynamic relationship; Drug combination; Warfarin; Healthy subject; Coumarine derivatives; Oral administration; Controlled therapeutic trial; Anticoagulant; Antivitamin K; Hypoglycemic agent; Drug interaction; Pharmacokinetics; Nateglinide
• ISSN: 0091-2700; 1552-4604
• DOI: 10.1177/0091270002238772

The novel hypoglycemic agent nateglinide is pharmacologically distinct from oral hypoglycemic agents such as sulfonylureas and repaglinide. The present study investigated the effects in healthy volunteers of multiple doses of nateglinide on the pharmacokinetics and pharmacodynamics of warfarin. The study comprised a randomized two‐group, two‐way crossover, open‐label design in 12 healthy male subjects. One group of 6 subjects initially received a single oral dose of warfarin 30 mg and then, after a 7‐ to 14‐day washout, received both warfarin and nateglinide (120 mg nateglinide, 10 min before meals for 4 days and a single dose of 30 mg warfarin on the second day). The alternate group of 6 subjects received treatments in the opposite order. Pharmacokinetic profiles were derived from plasma warfarin and nateglinide concentrations. Prothrombin measurements were evaluated in both periods as a measure of warfarin activity. When administered alone or in combination, there were no statistically significant differences in mean warfarin (R‐ and S‐enantiomers) or nateglinide pharmacokinetic parameters. The concurrent administration of nateglinide and warfarin did not affect the maximal change in prothrombin time that follows warfarin administration. In this study, there was no evidence of an effect of coadministration of nateglinide on the pharmacodynamic action of warfarin or any pharmacokinetic interaction between warfarin and nateglinide.