Study to Evaluate Drug-drug Interactions of Guaifenesin and Hydrocodone Bitartrate

• Humibid® (Drug), also known as Guaifenesin: Humibid® 1200 mg (single extended release) tablet
• Hydrocodone Bitartrate (Drug): Hydrocodone Bitartrate (3.33 mg q4h X 3)
• Humibid® and Hydrocodone Bitartrate tablet (Drug): Humibid® 1200 mg (single extended release) tablet and Hydrocodone bitartrate (3.33 mg q4h X 3)

Primary outcomes

• Maximum Observed Plasma Concentration (Cmax) of Guaifenesin [0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 8.5, 9, 9.5, 10, 11, 13, 16, 20, 24, and 26 hours Post dose]: Pharmacokinetic Parameter Cmax (Maximum measured plasma concentration)
• Area Under Plasma Concentration-time Curve From Time 0 to the Last Measurable Concentration (AUC(0-t)) of Guaifenesin [0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 8.5, 9, 9.5, 10, 11, 13, 16, 20, 24, and 26 hours Post dose]: Pharmacokinetic Parameter AUC(0-t) The area under the plasma concentration versus time curve from time 0 to time of the last measurable concentration.
• Area Under Plasma Concentration-time Curve From Time 0 to Infinity (AUC(0-inf)) of Guaifenesin [0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 8.5, 9, 9.5, 10, 11, 13, 16, 20, 24, and 26 hours Post dose]: The area under the plasma concentration versus time curve from time 0 to infinity, calculated as AUC(0-t) + Ct/ Kel, where Ct is the last measurable concentration.
• Apparent Terminal Elimination Rate Constant (Kel) of Guaifenesin [0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 8.5, 9, 9.5, 10, 11, 13, 16, 20, 24, and 26 hours Post dose]: Apparent first-order terminal elimination rate constant calculated from a semi-log plot of the plasma concentration versus time curve. The parameter was calculated by linear least-squares regression analysis using the maximum number of points in the terminal log-linear phase.
• Time to Maximum Observed Concentration (Tmax) of Guaifenesin [0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 8.5, 9, 9.5, 10, 11, 13, 16, 20, 24, and 26 hours Post dose]: Pharmacokinetic Parameter (Tmax) Time of the maximum measured plasma concentration.
• Apparent Terminal Elimination Half-life (T1/2) of Guaifenesin [0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 8.5, 9, 9.5, 10, 11, 13, 16, 20, 24, and 26 hours Post dose]: Apparent first-order terminal elimination half-life was calculated as 0.693/Kel.

Secondary outcomes

• Number of Adverse Events(AEs) Experienced by Participants [Upto Day 17]: Intensity was determined by the Investigator. For symptomatic AEs the following definitions were applied. Mild = AE did not limit usual activities; subject may have experienced slight discomfort. Moderate = AE resulted in some limitation of usual activities; subject may have experienced significant discomfort. Severe = AE resulted in an inability to carry out usual activities; subject may have experienced intolerable discomfort/ pain. Relationship to Investigational Medicinal Products (IMP) Unlikely = Slight, but remote, chance that AE was caused by IMP. Possible = Reasonable suspicion that the AE was caused by IMP. Probable = Most likely that AE was caused by IMP.

Sex: All, ages: 19 Years to 55 Years, accepts healthy volunteers

Inclusion Criteria:

1. Males and/or females between the ages of 19 and 55 years, inclusive.
2. Females of childbearing potential were using one of the following acceptable birth control methods:

   * Intrauterine device (IUD) in place for at least 3 months prior to study;
   * Barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening through 30 days beyond study completion;
   * Stable hormonal contraceptive for at least 3 months prior to study through 30 days beyond completion of study;

   Abstinence was not an acceptable form of contraception.

   Females of non-childbearing potential were surgically sterile (bilateral tubal ligation with surgery at least 6 months prior to study, hysterectomy, or bilateral oophorectomy at least 3 months prior to study) or postmenopausal <2 years. An FSH >40 mIU/mL was obtained and in the record.
3. Good general health was determined by medical history, physical examination, electrocardiogram (ECG), and clinical laboratory measures.
4. Within 15% of Ideal Body Weight as defined by the 1983 Metropolitan Life chart.
5. Non-tobacco users, who had not used nicotine or nicotine-containing products for at least 1 year.
6. Able to read, understand, and sign the informed consent after the nature of the study had been explained.
7. Negative finding on tests for Hepatitis B and C antigen as well as HIV and pregnancy test (if female).
8. Negative urine screen for drugs of abuse and alcohol at screening and the first check in.
9. Non-alcohol or drug abuser - for alcohol, defined as history of less then 4 drinks daily.

Exclusion Criteria:

1. Clinically significant abnormalities detected by medical history, physical, ECG, or clinical laboratory findings (as determined by the Principal Investigator). Any disease or condition which impacted absorption, distribution, metabolism, or elimination of the study drugs.
2. Females who were pregnant or nursing.
3. History of hypersensitivity reaction to the study drugs or related compounds, such as other opioids.
4. Receipt of an investigational drug within 1 month prior to study enrollment.
5. Donation of blood or significant loss of blood within 56 days or plasma within 14 days prior study enrollment.
6. Known or suspected use of illicit drugs (including codeine or hydrocodone, etc.).
7. The use of any medication on a chronic basis with the exception of oral contraceptives for women of childbearing potential. An appropriate drug-free period for prescription or over-the-counter (OTC) drugs provided to washout any especially long half-life drugs.
8. Consumption of alcohol within 48 hours prior to each dosing period.
9. Consumption of grapefruit 14 days prior to dosing and throughout the study.
10. Hemoglobin value < 12 g/dL. If a subject's hemoglobin dropped below 11.0 g/dL the subject was dropped from the study at the Principal Investigator's discretion.

Participant flow

Outcome results

• Maximum Observed Plasma Concentration (Cmax) of Guaifenesin (Primary), Mean, ng/mL: Treatment A (Reference) - Plasma Guaifenesin 1770 +/- 628; Treatment C (Test) - Plasma Guaifenesin 1810 +/- 784; Treatments B (Reference) - Plasma Hydrocodone Bitartrate 11.3 +/- 2.14; Treatment C (Test) - Plasma Hydrocodone Bitartrate 11.3 +/- 1.78
• Area Under Plasma Concentration-time Curve From Time 0 to the Last Measurable Concentration (AUC(0-t)) of Guaifenesin (Primary), Mean, ng*hr/mL: Treatment A (Reference) - Plasma Guaifenesin 8286.2 +/- 2440.0; Treatment C (Test) - Plasma Guaifenesin 8186.7 +/- 2801.0; Treatments B (Reference) - Plasma Hydrocodone Bitartrate 133.36 +/- 29.407; Treatment C (Test) - Plasma Hydrocodone Bitartrate 132.99 +/- 23.053
• Area Under Plasma Concentration-time Curve From Time 0 to Infinity (AUC(0-inf)) of Guaifenesin (Primary), Mean, ng*hr/mL: Treatment A (Reference) - Plasma Guaifenesin 8501.5 +/- 2784.5; Treatment C (Test) - Plasma Guaifenesin 8347.8 +/- 2762.4; Treatments B (Reference) - Plasma Hydrocodone Bitartrate 140.44 +/- 32.792; Treatment C (Test) - Plasma Hydrocodone Bitartrate 139.70 +/- 26.044
• Apparent Terminal Elimination Rate Constant (Kel) of Guaifenesin (Primary), Mean, 1/hr: Treatment A (Reference) - Plasma Guaifenesin 0.205 +/- 0.104; Treatment C (Test) - Plasma Guaifenesin 0.207 +/- 0.199; Treatments B (Reference) - Plasma Hydrocodone Bitartrate 0.151 +/- 0.0251; Treatment C (Test) - Plasma Hydrocodone Bitartrate 0.155 +/- 0.0233
• Time to Maximum Observed Concentration (Tmax) of Guaifenesin (Primary), Mean, hr: Treatment A (Reference) - Plasma Guaifenesin 1.08 +/- 0.551; Treatment C (Test) - Plasma Guaifenesin 1.04 +/- 0.415; Treatments B (Reference) - Plasma Hydrocodone Bitartrate 9.59 +/- 2.16; Treatment C (Test) - Plasma Hydrocodone Bitartrate 9.33 +/- 2.09
• Apparent Terminal Elimination Half-life (T1/2) of Guaifenesin (Primary), Mean, hr: Treatment A (Reference) - Plasma Guaifenesin 4.82 +/- 3.30; Treatment C (Test) - Plasma Guaifenesin 5.34 +/- 3.13; Treatments B (Reference) - Plasma Hydrocodone Bitartrate 4.71 +/- 0.833; Treatment C (Test) - Plasma Hydrocodone Bitartrate 4.60 +/- 0.831
• Number of Adverse Events(AEs) Experienced by Participants (Secondary), Number, Events: Treatment A 7; Treatment B 12; Treatment C 25

Adverse events

Time frame: Up to Day 17

Other adverse events by term