Page last updated: 2024-11-06

quinidine gluconate

Description Research Excerpts Clinical Trials Roles Classes Pathways Study Profile Bioassays Related Drugs Related Conditions Protein Interactions Research Growth Market Indicators

Description

Quinidine gluconate is a salt of quinidine, an antiarrhythmic drug used to treat certain types of irregular heartbeats. It is synthesized by reacting quinidine with gluconic acid. Quinidine gluconate works by blocking sodium channels and potassium channels in the heart, which helps to regulate the heart's rhythm. It can cause side effects such as nausea, vomiting, diarrhea, and dizziness. Quinidine gluconate is studied because of its potential to treat atrial fibrillation, a type of irregular heartbeat. It is also used to treat other heart rhythm disorders.'

quinidine gluconate: RN given refers to (9S)-isomer & ratio of [1:1] [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID94328
CHEMBL ID1200437
CHEBI ID27502
SCHEMBL ID41479
SCHEMBL ID15541190
MeSH IDM0066906

Synonyms (76)

Synonym
KBIO1_000228
DIVK1C_000228
SPECTRUM5_001080
IDI1_000228
SPECTRUM_000910
quinalan
duraquin
cinchonan-9-ol, 6'-methoxy-, (9s)-, mono-d-gluconate (salt)
einecs 230-333-9
quinidine, d-gluconate (salt)
quinidine mono-d-gluconate (salt)
quinatime
quinidine gluconate
CHEBI:27502 ,
(9s)-6'-methoxycinchonan-9-ol--d-gluconic acid (1:1)
quinidine d-gluconate
quinidine gluconate (usp)
KBIOGR_001393
KBIO3_001806
KBIO2_003958
KBIO2_006526
KBIOSS_001390
KBIO2_001390
NINDS_000228
SPECTRUM2_000408
SPBIO_000336
SPECTRUM3_000893
SPECTRUM4_000987
SPECTRUM1500523
HMS2092E19
gluconic acid quinidine salt
dura-tab
quinidine monogluconate, d-
quinidine mono-d-gluconate
gluquinate
CHEMBL1200437
nsc-757297
HMS500L10
HMS1920N18
pharmakon1600-01500523
nsc757297
einecs 229-517-1
6587-33-3
d-gluconic acid, compound with (9s)-6'-methoxycinchonan-9-ol
CCG-38674
r6875n380f ,
quinidine gluconate [usp]
unii-r6875n380f
nsc 757297
cinchonan-9-ol, 6'-methoxy-, (9s)-, mono-d-gluconate
quinidine gluconate [orange book]
quinidine gluconate [usp monograph]
quinidine gluconate [mi]
quinidine gluconate [vandf]
quinidine gluconate [usp-rs]
quinidine gluconate [who-dd]
quinidine gluconate [mart.]
SCHEMBL41479
SCHEMBL15541190
W-110193
quinidine gluconate, united states pharmacopeia (usp) reference standard
SR-05000001710-2
sr-05000001710
SR-05000001710-1
quinidine gluconate salt, analytical standard
Q27094388
(s)-[(2r,4s,5r)-5-ethenyl-1-azabicyclo[2.2.2]octan-2-yl]-(6-methoxyquinolin-4-yl)methanol;(2r,3s,4r,5r)-2,3,4,5,6-pentahydroxyhexanoic acid
EX-6000
DTXSID801027497
HY-B1751F
CS-0030857
9s-6'-methoxy-cinchonan-9-ol, mono-d-gluconate(salt)
quinidine gluonate
quinidine gluconate (usp-rs)
quinidine gluconate (mart.)
quinidine gluconate (usp monograph)

Research Excerpts

Pharmacokinetics

ExcerptReferenceRelevance
" The elimination half-life was 12."( Intravenous quinidine for the treatment of severe falciparum malaria. Clinical and pharmacokinetic studies.
Karbwang, J; Looareesuwan, S; Phillips, RE; Warrell, DA; White, NJ, 1985
)
0.27
" Further application of the BSP for pharmacodynamic monitoring will require electrode refinements and an increased understanding of its mechanism of action."( The pharmacodynamic response of the basal skin potential to quinidine gluconate.
Ando, HY; Escobar, A; Schnaare, RL; Sugita, ET, 1986
)
0.51

Bioavailability

Steady-state bioavailability of sustained-release quinidine gluconate tablets manufactured by two companies was compared in a crossover study.

ExcerptReferenceRelevance
"The effect of aluminum hydroxide gel on quinidine gluconate bioavailability was studied in eight nonsmoking healthy male volunteers."( Effect of aluminum hydroxide gel on quinidine gluconate absorption.
Fraker, TD; Mauro, LS; Mauro, VF; Somani, P; Temesy-Armos, PN, 1990
)
0.82
" Under the conditions of the study, both the rate and extent of quinidine bioavailability was significantly affected by food."( Effect of dietary fat content on the bioavailability of a sustained release quinidine gluconate tablet.
Brown, WJ; Gallo, JM; Hemingway, SM; Honigberg, IL; Kotzan, JA; Martinez, MN; Pelsor, FR; Shah, VP; Skelly, JP; Zaman, R,
)
0.36
"Simulated data using a linear one- and two-compartment body model with different absorption characteristics were used to evaluate the ability of single dose bioavailability data to predict the relationships that exist at steady state."( Prediction of steady-state bioequivalence relationships using single dose data I-linear kinetics.
Jackson, AJ,
)
0.13
"Steady-state bioavailability of sustained-release quinidine gluconate tablets manufactured by two companies was compared in a crossover study."( Bioavailability of two manufacturers' sustained-release quinidine gluconate tablets at steady state.
Taggart, WV; Zinny, MA, 1984
)
0.77
"Steady-state bioavailability of a sustained-release quinidine gluconate formulation was compared with that of a sustained-release quinidine sulfate preparation in a crossover study."( Steady-state bioavailability of two sustained-release quinidine preparations: quinidine gluconate versus quinidine sulfate.
Holyoak, W; Taggart, WV, 1983
)
0.74
"A recently marketed prolonged-release quinidine gluconate tablet was compared with the innovator's tablet in a single-dose bioavailability study with 12 healthy male subjects."( Serious bioavailability problems with a generic prolonged-release quinidine gluconate product.
Jacob, J; Lieberman, P; Meyer, MC; Straughn, AB,
)
0.64
" oral bioavailability of quinidine was, unexpectedly, greater than 100% (147 +/- 44%)."( Loss of quinidine gluconate injection in a polyvinyl chloride infusion system.
Darbar, D; Dell'Orto, S; Roden, DM; Wilkinson, GR, 1996
)
0.73

Dosage Studied

Two different chronic dosing regimens of quinidine gluconate were administered to each of four healthy volunteers in a pilot study. In a cross-over study, 2 commercial dosage forms of the same drug were given to 18 healthy subjects who fasted for 10 hours.

ExcerptRelevanceReference
" As a consequence of Tmax and Cmax decreasing and increasing from single to multiple dosing regimens, the confidence intervals for these parameters reflected these changes."( Prediction of steady-state bioequivalence relationships using single dose data I-linear kinetics.
Jackson, AJ,
)
0.13
" Patient population estimates were then derived to predict the quinidine dosage necessary to achieve given plasma concentrations."( Quinidine dosage in children using population estimates.
Burckart, GJ; Marin-Garcia, J, 1986
)
0.27
" The proposed procedure was applied to currently marketed samples of quinidine salts and their dosage forms."( Analysis of Cinchona alkaloids by high-performance liquid chromatography. Application to the analysis of quinidine gluconate and quinidine sulfate and their dosage forms.
Smith, E, 1984
)
0.48
" Medication dosages, dosing intervals, and time elapsed from last dosage until blood sampling were determined."( Long-term antiarrhythmic therapy. Problem of low drug levels and patient noncompliance.
Fuster, V; Goldman, ME; Kupersmith, J; Schweitzer, P; Squire, A; Stern, EH, 1984
)
0.27
" The tablets manufactured by Berlex provided statistically significantly higher plasma levels during the second half of the dosing interval (six to 12 hours postdose)."( Bioavailability of two manufacturers' sustained-release quinidine gluconate tablets at steady state.
Taggart, WV; Zinny, MA, 1984
)
0.51
" In a cross-over study, 2 commercial dosage forms of quinidine gluconate, fast- and slow-release, were administered to 18 healthy subjects who had fasted for 10 hours in 3 treatments which were administered during the fasting period (T1), and before (T2) of after (T3) a standard breakfast."( Urinary excretion kinetics of intact quinidine and 3-OH-quinidine after oral administration of a single oral dose of quinidine gluconate in the fasting and non-fasting state.
Gagnon, MA; Sirois, G; St-Onge, JM,
)
0.59
"Two different chronic dosing regimens of quinidine gluconate were administered to each of four healthy volunteers in a pilot study to evaluate quinidine for nonlinear pharmacokinetics."( Assessment of quinidine gluconate for nonlinear kinetics following chronic dosing.
Pershing, LK; Russo, J; Russo, ME; Smith, RA,
)
0.76
"Blood quinidine levels obtained by single and multiple dosage schedules of all available quinidine preparations were ascertained."( THE RELATIONSHIP OF DOSAGE SCHEDULE TO THE BLOOD LEVEL OF QUINIDINE, USING ALL AVAILABLE QUINIDINE PREPARATIONS.
CHAKRABARTI, SG; GOLDBERG, WM, 1964
)
0.24
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Drug Classes (1)

ClassDescription
D-gluconate adduct
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Bioassays (4)

Assay IDTitleYearJournalArticle
AID977599Inhibition of sodium fluorescein uptake in OATP1B1-transfected CHO cells at an equimolar substrate-inhibitor concentration of 10 uM2013Molecular pharmacology, Jun, Volume: 83, Issue:6
Structure-based identification of OATP1B1/3 inhibitors.
AID977602Inhibition of sodium fluorescein uptake in OATP1B3-transfected CHO cells at an equimolar substrate-inhibitor concentration of 10 uM2013Molecular pharmacology, Jun, Volume: 83, Issue:6
Structure-based identification of OATP1B1/3 inhibitors.
AID540299A screen for compounds that inhibit the MenB enzyme of Mycobacterium tuberculosis2010Bioorganic & medicinal chemistry letters, Nov-01, Volume: 20, Issue:21
Synthesis and SAR studies of 1,4-benzoxazine MenB inhibitors: novel antibacterial agents against Mycobacterium tuberculosis.
AID588519A screen for compounds that inhibit viral RNA polymerase binding and polymerization activities2011Antiviral research, Sep, Volume: 91, Issue:3
High-throughput screening identification of poliovirus RNA-dependent RNA polymerase inhibitors.
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (58)

TimeframeStudies, This Drug (%)All Drugs %
pre-199029 (50.00)18.7374
1990's15 (25.86)18.2507
2000's6 (10.34)29.6817
2010's8 (13.79)24.3611
2020's0 (0.00)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 37.40

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index37.40 (24.57)
Research Supply Index4.30 (2.92)
Research Growth Index4.36 (4.65)
Search Engine Demand Index52.41 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (37.40)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials8 (12.31%)5.53%
Reviews2 (3.08%)6.00%
Case Studies20 (30.77%)4.05%
Observational0 (0.00%)0.25%
Other35 (53.85%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (7)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Impact of Nuedexta on Bulbar Physiology and Function in ALS [NCT03883581]Phase 1/Phase 228 participants (Actual)Interventional2019-07-25Completed
A Two-part Study to Determine the Relative Bioavailability of Dabigatran Etexilate 150 mg Bid (Capsules) With and Without 600 mg Quinidine Sulfate Tablets (Part 1) and to Measure the Effect of Quinidine as a Probe Inhibitor of P-glycoprotein on the Absorp [NCT02171546]Phase 142 participants (Actual)Interventional2007-11-30Terminated
A Double-Blind, Randomized, Placebo-Controlled, Multicenter Study to Assess the Safety and Efficacy and to Determine the Pharmacokinetics of Two Doses of AVP-923 (Dextromethorphan/Quinidine) in the Treatment of Pseudobulbar Affect (PBA) in Patients With A [NCT00573443]Phase 3326 participants (Actual)Interventional2007-12-31Completed
A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled Study to Assess the Efficacy, Safety, and Tolerability of AVP-786 (Deuterium Modified Dextromethorphan Hydrobromide/Quinidine Sulfate) as an Adjunctive Therapy in Patients With Major Dep [NCT02153502]Phase 2206 participants (Actual)Interventional2014-07-31Completed
A Randomized, 2-Part, Crossover, Single Center Study to Evaluate Effect of Quinidine on the Pharmacokinetics of NKTR-118 and the Concomitant Effect of Quinidine and NKTR-118 on Morphine-induced Miosis [NCT01533155]Phase 1214 participants (Actual)Interventional2012-03-31Completed
A Study to Investigate the Effect of CYP2C19 Phenotype on the Pharmacokinetics of LY2216684 in Healthy Subjects [NCT01460381]Phase 118 participants (Actual)Interventional2011-10-31Completed
A Double-Blind, Randomized, Placebo-Controlled Single-Dose, Five Period Crossover Study of the Electrocardiographic Effects of Ranolazine, Dofetilide, Verapamil, and Quinidine in Healthy Subjects [NCT01873950]Phase 122 participants (Actual)Interventional2013-05-31Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT00573443 (7) [back to overview]Mean Change From Baseline at Day 84 in Beck Depression Inventory (BDI-II) Total Score
NCT00573443 (7) [back to overview]Mean Change From Baseline to Day 84 in Pain Rating Scale (PRS) of MS Subjects
NCT00573443 (7) [back to overview]PBA Episode Rate Ratio (Post/Pre), Regression Adjusted
NCT00573443 (7) [back to overview]Mean Change From Baseline at Day 84 in SF-36 (Short-Form) Health Survey Medical Outcome Score by Category
NCT00573443 (7) [back to overview]Mean Change From Baseline in CNS-LS Total Score by Visit
NCT00573443 (7) [back to overview]Mean Change From Baseline to Day 84 in Neuropsychiatric Inventory (NPI-Q) Frequency and Severity Score (EE Population)
NCT00573443 (7) [back to overview]Mean Change From Baseline to Day 84 in Neuropsychiatric Inventory (NPI-Q) Frequency and Severity Score (ITT Population)
NCT01460381 (6) [back to overview]Pharmacokinetics: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity [(AUC(0-∞)] of LY2216684 + Quinidine in Cytochrome P450 (CYP)2C19 Poor Metabolizers (PM)
NCT01460381 (6) [back to overview]Pharmacokinetics: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity [AUC(0-∞)] of LY2216684 in Cytochrome P450 (CYP)2C19 Extensive Metabolizers (EM) Versus Poor Metabolizers (PM)
NCT01460381 (6) [back to overview]Pharmacokinetics: Maximum Observed Plasma Concentration (Cmax) of LY2216684 + Quinidine in CYP2C19 Poor Metabolizers
NCT01460381 (6) [back to overview]Pharmacokinetics: Maximum Observed Plasma Concentration (Cmax) of LY2216684 in Cytochrome P450 (CYP)2C19 Extensive Metabolizers (EM) Versus Poor Metabolizers (PM)
NCT01460381 (6) [back to overview]Pharmacokinetics: Time to Maximum Observed Plasma Concentration (Tmax) of LY2216684 + Quinidine in CYP2C19 Poor Metabolizers
NCT01460381 (6) [back to overview]Pharmacokinetics: Time to Maximum Observed Plasma Concentration (Tmax) of LY2216684 in Cytochrome P450 (CYP)2C19 Extensive Metabolizers (EM) Versus Poor Metabolizers (PM)
NCT01873950 (10) [back to overview]Change in Relationship (Ratio) Between Heart Rate and QT
NCT01873950 (10) [back to overview]Change in Spatial QRS-T Angle Using Exposure/Response (Dofetilide and Verapamil Arms)
NCT01873950 (10) [back to overview]Change in Spatial QRS-T Angle Using Exposure/Response (Ranolazine and Quinidine Arms)
NCT01873950 (10) [back to overview]Change in Ventricular Gradient Using Exposure/Response (Dofetilide and Verapamil Arms)
NCT01873950 (10) [back to overview]Change in Ventricular Gradient Using Exposure/Response (Ranolazine and Quinidine Arms)
NCT01873950 (10) [back to overview]Placebo, and Baseline-adjusted Changes in Spatial QRS-T Angle
NCT01873950 (10) [back to overview]Placebo, and Baseline-adjusted Changes in Ventricular Gradient
NCT01873950 (10) [back to overview]Change in PR, QRS, J-Tpeak, Tpeak-Tend and QTc Using Exposure/Response (Dofetilide and Verapamil Arms)
NCT01873950 (10) [back to overview]Change in PR, QRS, J-Tpeak, Tpeak-Tend and QTc Using Exposure/Response (Ranolazine and Quinidine Arms)
NCT01873950 (10) [back to overview]Placebo, and Baseline-adjusted Changes in PR, QRS, J-Tpeak, Tpeak-Tend and QTc
NCT03883581 (5) [back to overview]Bamboo Passage Reading Duration (in Seconds)
NCT03883581 (5) [back to overview]Change in ALSFRS-R Bulbar Subscale Score
NCT03883581 (5) [back to overview]Change in Dynamic Imaging Grade of Swallowing Toxicity
NCT03883581 (5) [back to overview]Change in Patient-reported Outcome: Center for Neurologic Study-Bulbar Function Scale (CNS-BFS)
NCT03883581 (5) [back to overview]Change in Speech Intelligibility

Mean Change From Baseline at Day 84 in Beck Depression Inventory (BDI-II) Total Score

The BDI-II is a 21-item self report instrument intended to assess the existence and severity of symptoms of depression, summed to give a single score. The BDI-II uses a 4-point for each item ranging from 0 to 3. A total score of 0-13 is considered minimal range, 14 to 19 is mild, 20 to 28 is moderate, and 29 to 63 is severe. (NCT00573443)
Timeframe: Baseline and Day 84

InterventionScores on a Scale (Mean)
AVP-923-30-1.59
AVP-923-20-1.03
Placebo-0.02

[back to top]

Mean Change From Baseline to Day 84 in Pain Rating Scale (PRS) of MS Subjects

Subjects with MS were instructed to also record daily the pain they experienced using the PRS. After evaluating the subject's ability to comply with these requirements, the investigator determined if a caregiver should complete the study diary and assessments. Subjects rated their pain over the past 12 hours on a scale of 0 to 10 (0=none, 10=worst pain ever experienced). (NCT00573443)
Timeframe: Baseline, Day 15, Day 29, Day 57, Day 84

InterventionScores on a Scale (Mean)
AVP-923-30-1.0
AVP-923-20-0.7
Placebo-0.4

[back to top]

PBA Episode Rate Ratio (Post/Pre), Regression Adjusted

Episodes were counted each day and recorded in a daily diary. The outcome measure is the ratio of the episode rate over the 84-day treatment period to the rate during the baseline period, adjusted for study site, and underlying disease using longitudinal negative binomial regression. (NCT00573443)
Timeframe: Baseline to Day 84

InterventionUnit-free (ratio of episodes/week) (Least Squares Mean)
AVP-923-300.247
AVP-923-200.237
Placebo0.465

[back to top]

Mean Change From Baseline at Day 84 in SF-36 (Short-Form) Health Survey Medical Outcome Score by Category

The SF-36 is designed to examine a person's perceived health status. The SF-36 includes one multi-item scale measuring eight health concepts: vitality, physical functioning, bodily pain, general health perceptions, physical role-, emotional role-, social role functioning, and mental health. Answers to each question are scored and summed to produce raw scale scores for each health concept which are then transformed to a 0 - 100 scale, a high score defining a more favorable health state. An aggregate summary measure is calculated by averaging the scores from the eight health concepts. (NCT00573443)
Timeframe: Baseline and Day 84

,,
InterventionScores on a Scale (Mean)
Physical Functioning ScaleRole Physical ScaleBodily Pain ScaleGeneral Health ScaleVitality ScaleSocial Functioning ScaleRole Emotional ScaleMental Health Scale
AVP-923-20-5.30-4.265.84-2.95-5.301.42-1.813.09
AVP-923-30-0.903.474.09-1.47-0.909.3411.555.53
Placebo-4.05-1.75-1.13-1.28-4.05-3.092.36-0.28

[back to top]

Mean Change From Baseline in CNS-LS Total Score by Visit

Center for Neurologic Studies-Lability Scale (CNS-LS) is an instrument for the measurement of PBA that has been validated for the use in patients with ALS and MS. It is a 7-item self-report questionnaire that measures the frequency and severity of PBA episodes, including assessments of labile laughter and labile tearfulness,and provides a score for total PBA (total score can range from 7-35). The following 5-point scoring was used: 1=Applies never, 2=Applies rarely, 3=Applies occasionally, 4=Applies frequently, 5=Applies most of the time. A score of 13 or higher may suggest PBA, and the higher the score the more severe the episodes. (NCT00573443)
Timeframe: Baseline, Day 15, Day 29, Day 57, Day 84

,,
InterventionScores on a Scale (Mean)
Day 15 (Visit2)Day 29 (Visit 3)Day 57 (Visit 4)Day 84 (Visit 5)
AVP-923-20-6.27-7.62-8.89-8.24
AVP-923-30-6.77-8.03-8.59-8.17
Placebo-4.58-5.70-5.66-5.72

[back to top]

Mean Change From Baseline to Day 84 in Neuropsychiatric Inventory (NPI-Q) Frequency and Severity Score (EE Population)

The NPI is a retrospective (to 1 month) caregiver-informant interview assessing frequency and severity of 12 neuropsychiatric symptom domains. The NPI score is based on the sum of the severity ratings (0=absent, 1=mild, 3=severe). The 12 symptom domains include delusions, hallucinations, agitation/aggression, dysphoria/depression, anxiety, euphoria/elation, apathy/indifference, disinhibition, irritability/lability, aberrant motor behaviors, nighttime behavioral disturbances, and appetite/eating abnormalities. The NPI severity score is based on severity ratings (0=absent, 1=mild to 3=severe). (NCT00573443)
Timeframe: Baseline to Day 84

,,
InterventionScores on a Scale (Mean)
Frequency ScoreSeverity Score
AVP-923-20-3.09-1.81
AVP-923-30-1.68-0.80
Placebo-1.25-0.91

[back to top]

Mean Change From Baseline to Day 84 in Neuropsychiatric Inventory (NPI-Q) Frequency and Severity Score (ITT Population)

The NPI is a retrospective (to 1 month) caregiver-informant interview assessing frequency and severity of 12 neuropsychiatric symptom domains. The NPI score is based on the sum of the severity ratings (0=absent, 1=mild, 3=severe). The 12 symptom domains include delusions, hallucinations, agitation/aggression, dysphoria/depression, anxiety, euphoria/elation, apathy/indifference, disinhibition, irritability/lability, aberrant motor behaviors, nighttime behavioral disturbances, and appetite/eating abnormalities. The NPI severity score is based on severity ratings (0=absent, 1=mild to 3=severe). (NCT00573443)
Timeframe: Baseline to Day 84

,,
InterventionScores on a Scale (Mean)
Frequency ScoreSeverity Score
AVP-923-20-2.56-1.59
AVP-923-30-1.62-0.74
Placebo-1.33-0.98

[back to top]

Pharmacokinetics: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity [(AUC(0-∞)] of LY2216684 + Quinidine in Cytochrome P450 (CYP)2C19 Poor Metabolizers (PM)

Blood samples were collected prior to and up to 120 hours following coadministration of LY2216684 and quinidine on Day 11 (Period 2) for the measurement of LY2216684 plasma concentrations. (NCT01460381)
Timeframe: Predose up to 120 hours post administration of quinidine

Interventionnanograms*hours per milliliter (ng*h/mL) (Geometric Mean)
LY2216684 + Quinidine (CYP2C19 Poor Metabolizers)1530

[back to top]

Pharmacokinetics: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity [AUC(0-∞)] of LY2216684 in Cytochrome P450 (CYP)2C19 Extensive Metabolizers (EM) Versus Poor Metabolizers (PM)

Blood samples were collected prior to and up to 120 hours following dosing of LY2216684 on Day 1 (Period 1) for the measurement of LY2216684 plasma concentrations. (NCT01460381)
Timeframe: Predose up to 120 hours post administration of LY2216684

Interventionnanograms*hours per milliliter (ng*h/mL) (Geometric Mean)
LY2216684 (CYP2C19 Poor Metabolizers)749
LY2216684 (CYP2C19 Extensive Metabolizers)698

[back to top]

Pharmacokinetics: Maximum Observed Plasma Concentration (Cmax) of LY2216684 + Quinidine in CYP2C19 Poor Metabolizers

Blood samples were collected prior to and up to 120 hours following coadministration of LY2216684 and quinidine on Day 11 (Period 2) for the measurement of LY2216684 plasma concentrations. (NCT01460381)
Timeframe: Predose up to 120 hours post administration of quinidine

Interventionnanograms per milliliter (ng/mL) (Geometric Mean)
LY2216684 + Quinidine (CYP2C19 Poor Metabolizers)66.9

[back to top]

Pharmacokinetics: Maximum Observed Plasma Concentration (Cmax) of LY2216684 in Cytochrome P450 (CYP)2C19 Extensive Metabolizers (EM) Versus Poor Metabolizers (PM)

Blood samples were collected prior to and up to 120 hours following dosing of LY2216684 on Day 1 (Period 1) for the measurement of LY2216684 plasma concentrations. (NCT01460381)
Timeframe: Predose up to 120 hours post administration of LY2216684

Interventionnanograms per milliliter (ng/mL) (Geometric Mean)
LY2216684 (CYP2C19 Poor Metabolizers)54.7
LY2216684 (CYP2C19 Extensive Metabolizers)54.8

[back to top]

Pharmacokinetics: Time to Maximum Observed Plasma Concentration (Tmax) of LY2216684 + Quinidine in CYP2C19 Poor Metabolizers

Blood samples were collected prior to and up to 120 hours following coadministration of LY2216684 and quinidine on Day 11 (Period 2) for the measurement of LY2216684 plasma concentrations. (NCT01460381)
Timeframe: Predose up to 120 hours post administration of quinidine

Interventionhours (Median)
LY2216684 + Quinidine (CYP2C19 Poor Metabolizers)3.00

[back to top]

Pharmacokinetics: Time to Maximum Observed Plasma Concentration (Tmax) of LY2216684 in Cytochrome P450 (CYP)2C19 Extensive Metabolizers (EM) Versus Poor Metabolizers (PM)

Blood samples were collected prior to and up to 120 hours following dosing of LY2216684 on Day 1 (Period 1) for the measurement of LY2216684 plasma concentrations. (NCT01460381)
Timeframe: Predose up to 120 hours post administration of LY2216684

Interventionhours (Median)
LY2216684 (CYP2C19 Poor Metabolizers)2.00
LY2216684 (CYP2C19 Extensive Metabolizers)2.00

[back to top]

Change in Relationship (Ratio) Between Heart Rate and QT

Different post-dose time-points employ different techniques for altering heart rate (leg raises and postural maneuvers). Using the measurements from all the time-points of postural maneuvers, the QT/RR relationship was modeled as a linear relationship between the square root of RR in seconds and QT in seconds and computed on a by subject, treatment and time-point basis. The change in the QT and heart rate relationship was assessed as the difference (mean and 95% CI) between the slopes from the models for each drug vs. placebo. (NCT01873950)
Timeframe: 24 hours

Interventionratio (Mean)
Ranolazine 1500mg0.01
Dofetilide 500mcg0.06
Verapamil HCl 120 mg0.02
Quinidine Sulfate 400mg0.11

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Change in Spatial QRS-T Angle Using Exposure/Response (Dofetilide and Verapamil Arms)

"The exposure response analysis will be performed for each treatment and will use a linear or nonlinear model (as determined by visual inspection) to quantify the relationship between exposure and Baseline and placebo adjusted change from Baseline for each ECG parameter (same as for primary analysis).~The magnitude of change (mean and 95% CI) in spatial QRS-T angle for the observed mean Cmax for each drug may be calculated." (NCT01873950)
Timeframe: 24 hours

Interventiondegrees per ng/ml (Mean)
Dofetilide 500mcg-3.9
Verapamil HCl 120 mg0.4

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Change in Spatial QRS-T Angle Using Exposure/Response (Ranolazine and Quinidine Arms)

"The exposure response analysis will be performed for each treatment and will use a linear or nonlinear model (as determined by visual inspection) to quantify the relationship between exposure and Baseline and placebo adjusted change from Baseline for each ECG parameter (same as for primary analysis).~The magnitude of change (mean and 95% CI) in spatial QRS-T angle for the observed mean Cmax for each drug may be calculated." (NCT01873950)
Timeframe: 24 hours

Interventiondegrees per mcg/ml (Mean)
Ranolazine 1500mg-1.0
Quinidine Sulfate 400mg2.7

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Change in Ventricular Gradient Using Exposure/Response (Dofetilide and Verapamil Arms)

"The exposure response analysis will be performed for each treatment and will use a linear or nonlinear model (as determined by visual inspection) to quantify the relationship between exposure and Baseline and placebo adjusted change from Baseline for each ECG parameter (same as for primary analysis).~The magnitude of change (mean and 95% CI) in ventricular gradient for the observed mean Cmax for each drug may be calculated." (NCT01873950)
Timeframe: 24 hours

InterventionmV.ns per ng/ml (Mean)
Dofetilide 500mcg4.0
Verapamil HCl 120 mg1.2

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Change in Ventricular Gradient Using Exposure/Response (Ranolazine and Quinidine Arms)

"The exposure response analysis will be performed for each treatment and will use a linear or nonlinear model (as determined by visual inspection) to quantify the relationship between exposure and Baseline and placebo adjusted change from Baseline for each ECG parameter (same as for primary analysis).~The magnitude of change (mean and 95% CI) in ventricular gradient for the observed mean Cmax for each drug may be calculated." (NCT01873950)
Timeframe: 24 hours

InterventionmV.ns per mcg/ml (Mean)
Ranolazine 1500mg-0.7
Quinidine Sulfate 400mg1.6

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Placebo, and Baseline-adjusted Changes in Spatial QRS-T Angle

Compute maximum mean placebo, and baseline-adjusted change for: spatial QRS-T angle (degrees) (NCT01873950)
Timeframe: 24 hours

Interventiondegrees (Least Squares Mean)
Ranolazine 1500mg-2.2
Dofetilide 500mcg-4.9
Verapamil HCl 120 mg-2.4
Quinidine Sulfate 400mg3.9

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Placebo, and Baseline-adjusted Changes in Ventricular Gradient

Compute maximum mean placebo, and baseline-adjusted change for: ventricular gradient (mV*ms). (NCT01873950)
Timeframe: 24 hours

InterventionmV*ms (Least Squares Mean)
Ranolazine 1500mg2.5
Dofetilide 500mcg4.8
Verapamil HCl 120 mg4.2
Quinidine Sulfate 400mg6.0

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Change in PR, QRS, J-Tpeak, Tpeak-Tend and QTc Using Exposure/Response (Dofetilide and Verapamil Arms)

"The exposure response analysis will be performed for each treatment and will use a linear or nonlinear model (as determined by visual inspection) to quantify the relationship between exposure and Baseline and placebo adjusted change from Baseline for each ECG parameter (same as for primary analysis).~The magnitude of change (mean and 95% CI) in QTc for the observed mean Cmax for each drug may be calculated." (NCT01873950)
Timeframe: 24 hours

,
Interventionms per ng/ml (Mean)
Change in PRChange in QTcChange in QRSChange in J-TpeakcChange in Tpeak-Tend
Dofetilide 500mcg-0.573.60.239.134.4
Verapamil HCl 120 mg28.73.90.3-0.73.6

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Change in PR, QRS, J-Tpeak, Tpeak-Tend and QTc Using Exposure/Response (Ranolazine and Quinidine Arms)

"The exposure response analysis will be performed for each treatment and will use a linear or nonlinear model (as determined by visual inspection) to quantify the relationship between exposure and Baseline and placebo adjusted change from Baseline for each ECG parameter (same as for primary analysis).~The magnitude of change (mean and 95% CI) in QTc for the observed mean Cmax for each drug may be calculated." (NCT01873950)
Timeframe: 24 hours

,
Interventionms per mcg/ml (Mean)
Change in PRChange in QTcChange in QRSChange in J-TpeakcChange in Tpeak-Tend
Quinidine Sulfate 400mg3.078.90.426.151.2
Ranolazine 1500mg4.212.00.80.710.0

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Placebo, and Baseline-adjusted Changes in PR, QRS, J-Tpeak, Tpeak-Tend and QTc

Compute maximum mean placebo, and baseline-adjusted change for: PR (ms), QRS (ms), J-Tpeak (ms), Tpeak-Tend (ms) and QTc (ms) (NCT01873950)
Timeframe: 24 hours

,,,
Interventionms (Least Squares Mean)
Change in PR intervalChange in QRS durationChange in J-TpeakcChange in Tpeak-TendChange in QTc
Dofetilide 500mcg2.31.139.540.079.3
Quinidine Sulfate 400mg5.12.129.149.878.1
Ranolazine 1500mg6.52.73.38.812.6
Verapamil HCl 120 mg32.12.6-2.44.85.2

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Bamboo Passage Reading Duration (in Seconds)

The Bamboo Passage is a 60-word reading passage that is commonly used to measure speech duration. (NCT03883581)
Timeframe: Baseline; Day 30

InterventionSeconds (Mean)
Pre NuedextaPost Nuedexta
ALS Individuals With Bulbar Dysfunction66.1965.33

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Change in ALSFRS-R Bulbar Subscale Score

The ALS Functional Rating Scale-Revised Bulbar subscore is an outcome comprised of questions 1-3 on the validated ALSFRS-R scale. These items rate speech, swallowing and salivation functions on a scale from 0-total loss of function to 4- no symptoms for a total score of 0 to 12. (NCT03883581)
Timeframe: Baseline; Day 30

Interventionscore on a scale (Mean)
Pre NuedextaPost Nuedextaa
ALS Individuals With Bulbar Dysfunction7.478.39

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Change in Dynamic Imaging Grade of Swallowing Toxicity

The validated Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) will be performed on all collected videofluoroscopic swallowing studies to assess global swallowing function. The DIGEST total score is determined using the composite of individual airway safety and bolus efficiency subscores (range: 0-4). The DIGEST total is rated on a 5-point ordinal score ranging from 0 (no dysphagia) to 4 (life-threatening dysphagia). (NCT03883581)
Timeframe: Baseline; Day 30

InterventionParticipants (Count of Participants)
Pre Nuedexta DIGEST 0 (Normal)Post Nuedexta DIGEST 0 (Normal)
ALS Individuals With Bulbar Dysfunction37

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Change in Patient-reported Outcome: Center for Neurologic Study-Bulbar Function Scale (CNS-BFS)

The CNS-BFS is a validated patient-reported scale that assess self-reported impairments in the domains of speech, salivation and swallowing. Each domain contains 7 questions with ratings ranging from 1-5 with 5 considered the worst. For the speech domain, individuals who are unable to speak are assigned a value of 6 for each item (speech domain ranges from 1-6). Total scores ranging from 21 (no impairment) - 112 (severe impairment in all domains). (NCT03883581)
Timeframe: Baseline; Day 30

InterventionScore (Mean)
Pre NuedextaPost Nuedexta
ALS Individuals With Bulbar Dysfunction56.8754.13

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Change in Speech Intelligibility

The Sentence Intelligibility Test (SIT) will be performed to assess the change in speaking intelligibility over the 30 day period. The primary outcome of the SIT will be the percentage of sentence intelligibility (%) during oral reading. (NCT03883581)
Timeframe: Baseline; Day 30

InterventionPercent Intelligibility (Mean)
Pre NuedextaPost Nuedexta
ALS Individuals With Bulbar Dysfunction71.5273.06

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