Cefixime Trihydrate

This article discusses a clinical trial conducted to evaluate the bioequivalence of a generic Cefixime Trihydrate dry syrup compared to its brand-name counterpart, Suprax®. The study aimed to determine if the generic version, manufactured by PT. Bernofarm in Indonesia, performs similarly to the reference product made by Odan Laboratories Ltd. in Canada. Understanding bioequivalence is crucial for ensuring that generic medications are as safe and effective as their brand-name counterparts.

Table of Contents

What is Cefixime Trihydrate?

Cefixime Trihydrate is an antibiotic medication used to treat various bacterial infections. It belongs to a class of drugs called cephalosporins, which are similar to penicillin antibiotics. Cefixime Trihydrate is available in different forms, including a dry syrup formulation that is reconstituted (mixed with water) before use[1].

In the medical community, this medication is also known by its brand name Suprax®, which is manufactured by Odan Laboratories Ltd., Canada, and is a registered trademark of Astellas Pharma Inc., Japan[1].

How is Cefixime Trihydrate Administered?

Cefixime Trihydrate is typically administered as an oral suspension. The dry syrup needs to be reconstituted with water before use. Here’s how it’s prepared:

  • For the test drug (Cefixime Trihydrate 100 mg/5 mL dry syrup): The medication is dissolved in 20 mL of water, split into 2 portions. The drug is then shaken well for at least 30 seconds after each addition of water[1].
  • For the reference drug (Suprax® 100 mg/5 mL dry syrup): The medication is dissolved in 33 mL of water, also split into 2 portions. Similarly, it is shaken well for at least 30 seconds after each addition of water[1].

In the study, participants received a single dose of 5 mL of the reconstituted syrup (either the test drug or Suprax®) with 240 mL of water[1].

Bioequivalence Study

A bioequivalence study was conducted to investigate whether the 100 mg/5 mL cefixime trihydrate dry syrup manufactured by PT. Bernofarm, Indonesia was bioequivalent to its reference product, 100 mg/5 mL Suprax® dry syrup[1].

Bioequivalence is a term used to describe when two medications are pharmaceutically equivalent and their effects can be expected to be essentially the same. This is important for ensuring that generic versions of medications work just as well as brand-name versions.

The study aimed to determine if the two products were bioequivalent by comparing their pharmacokinetic parameters. Pharmacokinetics refers to how the body processes a drug, including how it’s absorbed, distributed, metabolized, and excreted[1].

Pharmacokinetics of Cefixime Trihydrate

The study focused on two main pharmacokinetic parameters:

  1. Maximum plasma concentration (Cmax): This is the highest concentration of the drug in the blood after administration[1].
  2. Area Under Curve from 0 to 32 hours (AUCt): This measure represents the total exposure to the drug over time[1].

Blood samples were collected at various time points (pre-dose at 0 hours and post-dose at 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 8, 10, 12, 16, 24, and 32 hours) to analyze these parameters[1].

Study Design and Methodology

The bioequivalence study was designed as follows:

  • Study type: Randomized, single-blind, two-period, single dose, cross-over design[1].
  • Participants: 22 healthy volunteers[1].
  • Condition: Fasting (participants were not allowed to eat before taking the medication)[1].
  • Analysis method: Blood samples were analyzed using High-Performance Liquid Chromatography (HPLC), a technique used to separate, identify, and quantify components in a mixture[1].

The study aimed to determine if the two products were bioequivalent by calculating the geometric mean ratio and 90% confidence intervals. The two products are considered bioequivalent when the 90% confidence intervals of the cefixime trihydrate geometric mean ratio between the test and reference product fall within the range of 80.00-125.00% for AUCt and Cmax[1].

This type of study is crucial for ensuring that generic versions of medications are as safe and effective as their brand-name counterparts, providing patients with more affordable treatment options without compromising on quality or efficacy.

Aspect Details
Study Type Bioequivalence study
Drug Tested Cefixime Trihydrate 100 mg/5 mL dry syrup
Comparator Suprax® 100 mg/5 mL dry syrup
Study Design Randomized, single-blind, two-period, single dose, cross-over
Number of Participants 22 healthy volunteers
Dosage Single 5 mL dose with 240 mL water
Primary Outcomes Geometric Mean Ratio, 90% confidence intervals
Secondary Outcomes Maximum plasma concentration (Cmax), Area Under Curve (AUCt)
Analysis Method HPLC (High-Performance Liquid Chromatography)
Bioequivalence Criteria 90% CI within 80.00-125.00% for AUCt and Cmax

Ongoing Clinical Trials on Cefixime Trihydrate

  • Study on Antibiotic Treatments for Kidney Infection in Children: Comparing Cefixime, Ceftriaxone, and Amikacin for Ages 1 Month to 3 Years

    Not yet recruiting

    3 1 1 1
    Investigated diseases:
    France
  • A Study Comparing How the Body Absorbs Cefixime in Healthy Volunteers

    Not recruiting

    1 1 1 1
    Romania

Glossary

  • Bioequivalence: A state where two drugs with the same active ingredient have equal effects in terms of how they work in the body, ensuring that a generic version is as safe and effective as its brand-name counterpart.
  • Cefixime Trihydrate: An antibiotic medication used to treat various bacterial infections. In this study, it was formulated as a dry syrup to be mixed with water before use.
  • Dry Syrup: A powdered form of medication that needs to be mixed with water before taking. It's often used for medications that are unstable in liquid form for long periods.
  • Pharmacokinetics: The study of how a drug moves through the body, including how it's absorbed, distributed, metabolized, and eliminated.
  • Cmax: Maximum plasma concentration, which is the highest level of a drug in the blood after it's been taken. It helps measure how well a drug is absorbed.
  • AUCt: Area Under the Curve, a measure of the total amount of drug in the bloodstream over time. It helps determine how much of the drug the body is exposed to.
  • Geometric Mean Ratio: A statistical measure used to compare the bioavailability of two drug formulations, helping to determine if they are bioequivalent.
  • Confidence Interval: A range of values that likely contains the true value of an unknown population parameter. In this study, 90% confidence intervals were used to assess bioequivalence.
  • Cross-over Design: A type of clinical trial where participants receive different treatments in a specific order, allowing each person to serve as their own control.
  • HPLC: High-Performance Liquid Chromatography, a technique used to separate, identify, and measure components in a mixture. In this study, it was used to analyze blood samples for Cefixime Trihydrate levels.

References

  1. https://clinicaltrials.gov/study/NCT04982861