to metabolites, rather than parent drug. It should be noted that the PAWC is a value that is calculated based on relative potency determined in an animal model of antidepressant activity, and does not represent pharmacologic activity in humans.
4.2.3
What are the characteristics of the exposure-response relationships
(dose-response, concentration-response) for efficacy and safety?
·
Based on PK parameters, what is the degree of linearity or nonlinearity
in the dose-concentration relationship for WELLBUTRIN XL?
According to the WELLBUTRIN SR label, bupropion and its metabolites display linear kinetics with chronic administration of 300 to 450 mg/day. This relationship was studied in the present application.
·
Do PK Parameters change with time following chronic dosing?
The
pharmacokinetic parameters have not been directly compared following acute and
chronic dosing of WELLBUTRIN XL in the same study. The following data summarizes comparable
pharmacokinetic data from studies submitted to the present NDA (21-515) for WELLBUTRIN
XL after single or multiple doses of 300 mg WELLBUTRIN XL.
Mean (% CV) Single Dose PK
Parameters (Study AK1BIOVAIL2571) |
tmax(h)a AUC0-∞ (ng*h/ml) Bupropion 5.00
(4.00 – 8.00) 1728.3
(28) Bupropion 16.00
(5.5.0 – 24.00) 1613.6 (39) Erythyroamino Alcohol Bupropion Threoamino 8.0 (5.00 – 16.00) 9091.3
(43) Alcohol Hydroxybupropion 12.00 (6.00 – 24.00) 23498.8 (41) PAWC 5.50
(4.50 – 24.00) 70.4 (34) |
|
Mean
(%CV) Multiple Dose PK Parameters (Study
AK1BIOVAIL2543) tmax(h)a AUC0-24 (ng*h/ml) Bupropion 5.00 (3.00 – 7.00) 1612.0 (30) Bupropion 8.00
(5.00 – 14.00) 2145.7
(29) Erythyroamino Alcohol Bupropion Threoamino 8.00 (5.00 – 14.00) 10987.9
(29) Alcohol Hydroxybupropion 7.00
(4.00 – 14.00) 20824.8
(36) PAWC 6.00 (4.00 – 14.00) 66.5 (27) |
amedium
(range)
·
How long is the time to onset and offset of the pharmacological response
or clinical endpoint?
According to the label for WELLBUTRIN SR, 4 weeks
may be required before the full antidepressant effect is evident. Efficacy of WELLBUTRIN SR was demonstrated
for as long as
11
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