Skip to main content
Top
Published in: Cancer Chemotherapy and Pharmacology 1/2014

01-01-2014 | Short Communication

Calcium carbonate does not affect imatinib pharmacokinetics in healthy volunteers

Authors: Hussein Tawbi, Susan M. Christner, Yan Lin, Matthew Johnson, Emily T. Mowrey, Craig Cherrin, Edward Chu, James J. Lee, Shannon Puhalla, Ronald Stoller, Leonard R. Appleman, Brian M. Miller, Jan H. Beumer

Published in: Cancer Chemotherapy and Pharmacology | Issue 1/2014

Login to get access

Abstract

Purpose

Imatinib mesylate (Gleevec®/Glivec®) has revolutionized the treatment of chronic myeloid leukemias and gastrointestinal stromal tumors, and there is evidence for an exposure response relationship. Calcium carbonate is increasingly used as a calcium supplement and in the setting of gastric upset associated with imatinib therapy. Calcium carbonate could conceivably elevate gastric pH and complex imatinib, thereby influencing imatinib absorption and exposure. We aimed to evaluate whether use of calcium carbonate has a significant effect on imatinib pharmacokinetics.

Methods

Eleven healthy subjects were enrolled in a 2-period, open-label, single-institution, randomized crossover, fixed-schedule study. In one period, each subject received 400 mg of imatinib p.o. In the other period, 4,000 mg calcium carbonate (Tums Ultra®) was administered p.o. 15 min before 400 mg of imatinib. Plasma concentrations of imatinib and its active N-desmethyl metabolite CGP74588 were assayed by LC–MS; data were analyzed non-compartmentally and compared after log transformation.

Results

Calcium carbonate administration did not significantly affect the imatinib area under the plasma concentration versus time curve (AUC) (41.2 μg/mL h alone vs. 40.8 μg/mL h with calcium carbonate, P = 0.99), maximum plasma concentration (C max) (2.35 μg/mL alone vs. 2.39 μg/mL with calcium carbonate, P = 0.89).

Conclusions

Our results indicate that the use of calcium carbonate does not significantly affect imatinib pharmacokinetics.
Literature
1.
go back to reference Bristol-Myers Squibb Company (2007) Prescribing information Sprycel(R) (dasatinib) Bristol-Myers Squibb Company (2007) Prescribing information Sprycel(R) (dasatinib)
2.
go back to reference de Campos DR, Vieira NR, Bernasconi G, Barros FA, Meurer EC, Marchioretto MA, Coelho EC, Calafatti SA, Sommer C, Couto JM, Buranello S, Silva AR, Amarante AR, Abib E, Junior JP (2007) Bioequivalence of two enteric coated formulations of pantoprazole in healthy volunteers under fasting and fed conditions. Arzneimittelforschung 57:309–314PubMed de Campos DR, Vieira NR, Bernasconi G, Barros FA, Meurer EC, Marchioretto MA, Coelho EC, Calafatti SA, Sommer C, Couto JM, Buranello S, Silva AR, Amarante AR, Abib E, Junior JP (2007) Bioequivalence of two enteric coated formulations of pantoprazole in healthy volunteers under fasting and fed conditions. Arzneimittelforschung 57:309–314PubMed
3.
go back to reference Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, Heinrich MC, Tuveson DA, Singer S, Janicek M, Fletcher JA, Silverman SG, Silberman SL, Capdeville R, Kiese B, Peng B, Dimitrijevic S, Druker BJ, Corless C, Fletcher CDM, Joensuu H (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347:472–480PubMedCrossRef Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, Heinrich MC, Tuveson DA, Singer S, Janicek M, Fletcher JA, Silverman SG, Silberman SL, Capdeville R, Kiese B, Peng B, Dimitrijevic S, Druker BJ, Corless C, Fletcher CDM, Joensuu H (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347:472–480PubMedCrossRef
4.
go back to reference Demetri GD, Wang Y, Wehrle E, Racine A, Nikolova Z, Blanke CD, Joensuu H, von Mehren M (2009) Imatinib plasma levels are correlated with clinical benefit in patients with unresectable/metastatic gastrointestinal stromal tumors. J Clin Oncol 27:3141–3147PubMedCrossRef Demetri GD, Wang Y, Wehrle E, Racine A, Nikolova Z, Blanke CD, Joensuu H, von Mehren M (2009) Imatinib plasma levels are correlated with clinical benefit in patients with unresectable/metastatic gastrointestinal stromal tumors. J Clin Oncol 27:3141–3147PubMedCrossRef
5.
go back to reference Druker BJ, Sawyers CL, Kantarjian H, Resta DJ, Reese SF, Ford JM, Capdeville R, Talpaz M (2001) Activity of a specific inhibitor of the BCR-ABL tyrosine kinase in the blast crisis of chronic myeloid leukemia and acute lymphoblastic leukemia with the Philadelphia chromosome. N Engl J Med 344:1038–1042PubMedCrossRef Druker BJ, Sawyers CL, Kantarjian H, Resta DJ, Reese SF, Ford JM, Capdeville R, Talpaz M (2001) Activity of a specific inhibitor of the BCR-ABL tyrosine kinase in the blast crisis of chronic myeloid leukemia and acute lymphoblastic leukemia with the Philadelphia chromosome. N Engl J Med 344:1038–1042PubMedCrossRef
6.
go back to reference Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, Lydon NB, Kantarjian H, Capdeville R, Ohno-Jones S, Sawyers CL (2001) Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 344:1031–1037PubMedCrossRef Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, Lydon NB, Kantarjian H, Capdeville R, Ohno-Jones S, Sawyers CL (2001) Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 344:1031–1037PubMedCrossRef
7.
go back to reference Parise RA, Ramanathan RK, Hayes MJ, Egorin MJ (2003) Liquid chromatographic-mass spectrometric assay for quantitation of imatinib and its main metabolite (CGP 74588) in plasma. J Chromatogr B Anal Technol Biomed Life Sci 791:39–44CrossRef Parise RA, Ramanathan RK, Hayes MJ, Egorin MJ (2003) Liquid chromatographic-mass spectrometric assay for quantitation of imatinib and its main metabolite (CGP 74588) in plasma. J Chromatogr B Anal Technol Biomed Life Sci 791:39–44CrossRef
8.
go back to reference Picard S, Titier K, Etienne G, Teilhet E, Ducint D, Bernard MA, Lassalle R, Marit G, Reiffers J, Begaud B, Moore N, Molimard M, Mahon FX (2007) Trough imatinib plasma levels are associated with both cytogenetic and molecular responses to standard-dose imatinib in chronic myeloid leukemia. Blood 109:3496–3499PubMedCrossRef Picard S, Titier K, Etienne G, Teilhet E, Ducint D, Bernard MA, Lassalle R, Marit G, Reiffers J, Begaud B, Moore N, Molimard M, Mahon FX (2007) Trough imatinib plasma levels are associated with both cytogenetic and molecular responses to standard-dose imatinib in chronic myeloid leukemia. Blood 109:3496–3499PubMedCrossRef
9.
go back to reference Radimer K, Bindewald B, Hughes J, Ervin B, Swanson C, Picciano MF (2004) Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999–2000. Am J Epidemiol 160:339–349PubMedCrossRef Radimer K, Bindewald B, Hughes J, Ervin B, Swanson C, Picciano MF (2004) Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999–2000. Am J Epidemiol 160:339–349PubMedCrossRef
10.
go back to reference Sparano BA, Egorin MJ, Parise RA, Walters J, Komazec KA, Redner RL, Beumer JH (2009) Effect of antacid on imatinib absorption. Cancer Chemother Pharmacol 63:525–528PubMedCentralPubMedCrossRef Sparano BA, Egorin MJ, Parise RA, Walters J, Komazec KA, Redner RL, Beumer JH (2009) Effect of antacid on imatinib absorption. Cancer Chemother Pharmacol 63:525–528PubMedCentralPubMedCrossRef
11.
go back to reference Straub DA (2007) Calcium supplementation in clinical practice: a review of forms, doses, and indications. Nutr Clin Pract 22:286–296PubMedCrossRef Straub DA (2007) Calcium supplementation in clinical practice: a review of forms, doses, and indications. Nutr Clin Pract 22:286–296PubMedCrossRef
12.
go back to reference Yin OQ, Gallagher N, Fischer D, Demirhan E, Zhou W, Golor G, Schran H (2010) Effect of the proton pump inhibitor esomeprazole on the oral absorption and pharmacokinetics of nilotinib. J Clin Pharmacol 50:960–967PubMedCrossRef Yin OQ, Gallagher N, Fischer D, Demirhan E, Zhou W, Golor G, Schran H (2010) Effect of the proton pump inhibitor esomeprazole on the oral absorption and pharmacokinetics of nilotinib. J Clin Pharmacol 50:960–967PubMedCrossRef
Metadata
Title
Calcium carbonate does not affect imatinib pharmacokinetics in healthy volunteers
Authors
Hussein Tawbi
Susan M. Christner
Yan Lin
Matthew Johnson
Emily T. Mowrey
Craig Cherrin
Edward Chu
James J. Lee
Shannon Puhalla
Ronald Stoller
Leonard R. Appleman
Brian M. Miller
Jan H. Beumer
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 1/2014
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-013-2337-0

Other articles of this Issue 1/2014

Cancer Chemotherapy and Pharmacology 1/2014 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine