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Effect of Food on the Pharmacokinetics of Rifalazil, a Novel Antibacterial, in Healthy Male Volunteers

From ActivBiotics, Inc (Dr Chen, Dr Cabana, Dr Kivel, Dr Michaelis), Lexington, Massachusetts. Current affiliations: Millennium Pharmaceuticals, Cambridge, Massachusetts (Dr Chen); NDS International, Inc, Kennett Square, Pennsylvania (Dr Cabana); and RFS Pharma, LLC, Tucker, Georgia (Dr Kivel).

Rifalazil is a new antibiotic structurally related to rifampin but devoid of the metabolic liabilities typically associated with the rifamycin class of antibiotics. A randomized, 3-way crossover study in healthy male volunteers (n = 12) investigated the safety and pharmacokinetics of a single 25-mg oral rifalazil dose administered under a standard breakfast containing fat as 30% of calories, a high-fat breakfast containing fat as 60% of calories, and an overnight fast of 10 hours with a 21- to 28-day washout between doses. Systemic exposure to rifalazil based on C_max, AUC_0-Tlast, and AUC_0- was increased progressively as the fat content of the test breakfast was increased from 30% to 60% compared with fasting. The confidence intervals for both fat-containing breakfasts are outside the limits of 80% to 125% allowed for food effect bioequivalence based on C_max, AUC_0-Tlast, and AUC_0-. This food effect may be a result of increased fractional absorption with increasing dietary fat content. Another striking finding was the large reduction of the pharmacokinetic intersubject variability after rifalazil administration with food. Rifalazil was safe and well tolerated under fed and fasted conditions.

Key Words: Rifalazil • pharmacokinetics • food effect • variability • RNA polymerase inhibitor

Address for correspondence: Yingxue Chen, PhD, Millennium Pharmaceuticals, Inc, 35 Landsdowne Street, Cambridge, MA 02139; e-mail: Ying.Chen{at}MPI.com.

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				K. W Garey, M. Salazar, D. Shah, R. Rodrigue, and H. L DuPont Rifamycin Antibiotics for Treatment of Clostridium difficile-Associated Diarrhea Ann. Pharmacother., June 1, 2008; 42(6): 827 - 835. [Abstract] [Full Text] [PDF]