Bioequivalence of a new oral levosulpiride formulation compared with a standard one in healthy volunteers

Simona De Gregori, Laura Cipollina, Annalisa De Silvestri, Marianna Ventura, Roberta Michelini, Monica Morosini, Michela Montagna, Carmine Tinelli, Mario Regazzi, Mariadelfina Molinaro, Roberto Imberti

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Background: A monocentric, single-dose, open-label, 2-way, crossover randomized study was conducted by the San Matteo Phase I Clinical Trial Unit and Experimental Therapy (Pavia, Italy) to assess the bioequivalence and the systemic tolerability of a new oral formulation of levosulpiride (tablet 25 mg: test) versus a commercially available formulation on the Italian market (tablet 25 mg: reference). Methods: Thirty-five healthy adult volunteers, men (n = 19) and women (n = 16), aged between 18 and 55 years were screened and 32 of them were enrolled in the study. After having signed the written informed consent, each subject received a single oral dose of Test or Reference product with 250 mL of natural mineral water, in fasting conditions, interspersed with a 6-day washout period Blood samples were collected up to 36 hours after drug administration: the drug plasma levels were determined by high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry. The pharmacokinetic parameters included peak plasma concentration (Cmax), time corresponding to Cmax (tmax), area under the plasma concentration-time curve from zero to infinity (AUC0-N) or to the last sampling time assessment (AUC0-36), the elimination rate constant (ke), and the terminal half-life (t1/2). Safety was measured by pre- and post-treatment specific biochemical investigations, physical examination, electrocardiogram, occurrence of adverse events, and any information on patients' withdrawal. Results: The geometric mean ratio Test/Reference (90% confidence interval) for levosulpiride was 103.0% (95.8-110.8) for AUC0-36, 103.6% (95.9-111.9) for AUC0-N, and 104.3% (94.9-114.6) for Cmax. ke and t1/2 were 0.07 (SD: 0.02) and 9 hours (8-12) for both the formulations. Clearance (L/h) was 29.6 (613.5) and 30.7 (614.2) for the test and the reference product, respectively. Conclusions: Because the acceptance criteria required by the drug regulatory agency (European Medicines Agency, EMA) for bioequivalence prescribe limits of 80%-120% for untransformed data and 80%-125% for "ln" transformed data, we can confirm that the 2 formulations are bioequivalent, in terms of the rate and extent of absorption.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalTherapeutic Drug Monitoring
Issue number2
Publication statusPublished - Jan 1 2017
Externally publishedYes



  • Bioequivalence
  • Levosulpiride oral formulation
  • Tandem mass spectrometry

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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