The targeted oral, once-daily phosphodiesterase 4 inhibitor roflumilast and the leukotriene receptor antagonist montelukast do not exhibit significant pharmacokinetic interactions

J Clin Pharmacol. 2009 Apr;49(4):389-97. doi: 10.1177/0091270008330980.

Abstract

This nonrandomized, fixed-sequence, 3-period study investigated potential pharmacokinetic interactions between the leukotriene receptor antagonist montelukast, approved for the treatment of asthma, and roflumilast, an oral, once-daily phosphodiesterase 4 inhibitor in clinical development for asthma and chronic obstructive pulmonary disease. Pharmacokinetic interactions are of interest because both drugs may be coadministered and share a common metabolic pathway via cytochrome P450 3A. Single-dose montelukast (10 mg, po) was administered alone in period 1, followed by repeated once-daily roflumilast alone (500 microg, po) for 12 days (period 2). In period 3, 500 microg qd roflumilast was coadministered with 10 mg qd montelukast for 8 days. Different pharmacokinetic parameters were evaluated for montelukast alone, for steady-state roflumilast and its pharmacologically active metabolite roflumilast N-oxide alone, for single-dose montelukast when coadministered with steady-state roflumilast, and for steady-state roflumilast and its N-oxide metabolite when coadministered with steady-state montelukast. The AUC and Cmax of montelukast were modestly increased by 9% and 8%, respectively, when single-dose montelukast was coadministered with steady-state roflumilast. The pharmacokinetics of roflumilast and roflumilast N-oxide in steady state remained unchanged when repeat-dose montelukast was coadministered at steady-state. Concomitant administration of both drugs was well tolerated. These findings suggest that no dose adjustment is warranted for either drug when roflumilast and montelukast are coadministered.

Publication types

  • Clinical Trial

MeSH terms

  • Acetates / administration & dosage
  • Acetates / adverse effects
  • Acetates / pharmacokinetics*
  • Administration, Oral
  • Adolescent
  • Adult
  • Aminopyridines / administration & dosage
  • Aminopyridines / adverse effects
  • Aminopyridines / blood
  • Aminopyridines / metabolism
  • Aminopyridines / pharmacokinetics*
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / pharmacokinetics*
  • Benzamides / administration & dosage
  • Benzamides / adverse effects
  • Benzamides / blood
  • Benzamides / metabolism
  • Benzamides / pharmacokinetics*
  • Cyclopropanes / administration & dosage
  • Cyclopropanes / adverse effects
  • Cyclopropanes / blood
  • Cyclopropanes / metabolism
  • Cyclopropanes / pharmacokinetics
  • Drug Interactions
  • Drug Therapy, Combination
  • Humans
  • Leukotriene Antagonists / administration & dosage
  • Leukotriene Antagonists / adverse effects
  • Leukotriene Antagonists / pharmacokinetics*
  • Male
  • Middle Aged
  • Phosphodiesterase Inhibitors / administration & dosage
  • Phosphodiesterase Inhibitors / adverse effects
  • Phosphodiesterase Inhibitors / pharmacokinetics*
  • Quinolines / administration & dosage
  • Quinolines / adverse effects
  • Quinolines / pharmacokinetics*
  • Sulfides

Substances

  • Acetates
  • Aminopyridines
  • Anti-Asthmatic Agents
  • Benzamides
  • Cyclopropanes
  • Leukotriene Antagonists
  • Phosphodiesterase Inhibitors
  • Quinolines
  • Sulfides
  • Roflumilast
  • roflumilast N-oxide
  • montelukast