The purpose of this study is to assess the relative abuse potential of the hydrocodone bitartrate extended-release tablet compared to immediate-release hydrocodone bitartrate.
Hydrocodone bitartrate is a semisynthetic opioid analgesic and antitussive. Hydrocodone is widely used for various indications similar to those of codeine, primarily for relief of moderate to moderately severe pain. For the treatment of pain in the United States, hydrocodone is currently available only as an immediate-release (IR) product in combination with other medications such as acetaminophen or ibuprofen. The extended-release (ER) formulation tested in this study is designed to be resistant to dose dumping with alcohol or rapid release of hydrocodone after tampering. The study will consist of 3 phases: A, B,and C. Phase A is the screening phase where subject eligibility will be confirmed (Visit 1). Subjects who are eligible will enter Phase B, a double-blind, 2-period crossover design (Visit 2) followed by Phase C, a double-blind 4-period crossover design (Visits 3 through 6). Phase B is the randomized, double-blind, placebo-controlled, 2-treatment, 2- period crossover portion of the study which is designed to ensure that the subject can tolerate a 45-mg dose of hydrocodone and that the subject can discriminate between the effect of hydrocodone and the effect of placebo. Subjects will arrive at the study center on the day prior to the first study drug administration and remain at the study center for a minimum of 24 hours after the second study drug administration in phase B. After a review of the inclusion/exclusion criteria and check-in procedures (including a Naloxone Challenge),eligible subjects will be randomly assigned to one of 2 treatment sequences. For subjects who qualify to continue into phase C, there will be a minimum 7-day washout period between the second dose in phase B and the first dose in phase C. Phase C is the randomized, double-blind, triple-dummy, placebo-controlled, 4-period crossover portion of the study. Subjects will arrive at the study center the day prior to each study drug administration in phase C and remain at the study center through 72 hours after study drug administration in each period. Eligible subjects will be randomly assigned to 1 of 4 treatment groups. Each dose in phase C will be separated by a minimum 14 day washout period. All subjects (including those who withdraw from the study) will be asked to return to the study center for a follow-up visit approximately 48 to 72 hours after discharge from the study center following their final dose of study drug.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
100
Phase B: Eligible subjects will be randomized to treatment sequence XY or YX whereby treatment X is 60 mL of a noncarbonated flavored beverage and treatment Y is hydrocodone bitartrate powder at a dose strength of 45-mg reconstituted in 60 mL of a noncarbonated flavored beverage. Phase C: Eligible subjects will be randomly assigned to 1 of 4 treatment arms: Treatment A: intact placebo tablet, 60 mL noncarbonated flavored beverage, 1 crushed 45-mg hydrocodone bitartrate extended-release tablet. Treatment B: intact placebo tablet, hydrocodone bitartrate powder at a dose strength of 45-mg in 60 mL of a noncarbonated flavored beverage and 1 crushed placebo tablet. Treatment C: intact 45-mg hydrocodone bitartrate extended-release tablet, 60 mL noncarbonated flavored beverage, and 1 crushed placebo tablet Treatment D: intact placebo tablet, 60 mL noncarbonated flavored beverage, and 1 crushed placebo tablet.
Placebo will consist of 60 mL of a non-carbonated beverage without the addition of active treatment
Cephalon Investigational Site 001
Salt Lake City, Utah, United States
Cephalon Investigational Site 100
Toronto, Ontario, Canada
Drug Liking and Effects Questionnaire (DLEQ)
The DLEQ measures positive, negative, and any drug effects using bipolar and unipolar VAS. Bipolar VAS range from a strong negative response (score of 0) to a strong positive response (score of 100) with a neutral midpoint (score of 50). Unipolar VAS range from a response of 'none' (score of 0) to 'extremely' (score of 100). Questions include assessments of liking, drowsiness, good effects, bad effects, nausea,and any effects. The primary outcome is question 1 which states: "My liking for this drug is:"
Time frame: Phase B: prior to and at designated times up to 24 hours after study drug administration. Phase C:prior to and at set times up to 72 hours after study drug administration
Overall drug liking visual analog scale (VAS) score
Overall drug liking scale measures the extent the subject "likes" the drug as measured on a 100 mm visual analog scale anchored at one end by the phrase "strong disliking" and on the other end by "strong liking", and in the middle (50 mm) "neither like nor dislike". The question posed to the subject is: "overall, my liking for this drug is:".
Time frame: 24 hours after the start of each study drug administration in phase B and C
Pharmacokinetic maximum observed (Cmax) plasma concentrations
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Take drug again Visual Analog Scale
Take drug again visual analog scale measures the extent the subject is willing to take the drug again as measured on a 100 mm visual analog scale anchored at one end by the phrase "Definitely would not" and on the other end by "definitely would". The question posed to the subject is: "If given the opportunity, I would want to take this drug again:".
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 24 hours after the start of each study drug administration in phase B and C
Price Value Assessment Questionnaire
Price Value Assessment Questionnaire measures the subjective assessment of perceived value of a drug. The question posed to the subject is: "What is the most that you would be willing to pay for the same dose of the drug that you have just taken, if it was offered to you on the street?" The subject chooses from a list of dollar amounts. The greater the dollar amount the more the subject values the drug.
Time frame: 24 hours after the start of each study drug administration in phase B and C
Addiction Research Center Inventory (ARCI): Morphine Benzedrine Group (MBG) Subscale
The Addiction Research Center Inventory (ARCI) is a questionnaire consisting of several distinct subscales that assesses mood states typically associated with certain classes of drugs through the use of true or false questions. The Morphine Benzedrine Group (MBG) subscale assesses euphoria with 16 true or false questions. Each true item is given a score of 3 and each false item is scored 0. Higher scores are associated with greater euphoria. Minimum score is 0, highest score is 48.
Time frame: Phase B: prior to and at designated times up to 24 hours after study drug administration. Phase C:prior to and at set times up to 72 hours after study drug administration
Addiction Research Center Inventory (ARCI): Lysergic Acid Diethylamide (LSD) Subscale
The Addiction Research Center Inventory (ARCI) is a questionnaire consisting of several distinct subscales that assesses mood states typically associated with certain classes of drugs through the use of true or false questions. The Lysergic Acid Diethylamide (LSD) subscale assesses dysphoria with 14 true or false questions. Each true item is given a score of 3 and each false item is scored 0. Higher scores are associated with greater dysphoria. Minimum score is 0, highest score is 42.
Time frame: Phase B: prior to and at designated times up to 24 hours after study drug administration. Phase C:prior to and at set times up to 72 hours after study drug administration
Addiction Research Center Inventory (ARCI): Pentobarbital Chlorpromazine Alcohol Group (PCAG) Subscale
The Addiction Research Center Inventory (ARCI) is a questionnaire consisting of several distinct subscales that assesses mood states typically associated with certain classes of drugs through the use of true or false questions. The Pentobarbital Chlorpromazine Alcohol Group (PCAG) Subscale assesses sedation with 15 true or false questions. Each true item is given a score of 3 and each false item is scored 0. Higher scores are associated with greater dysphoria. Minimum score is 0, highest score is 45.
Time frame: Phase B: prior to and at designated times up to 24 hours after study drug administration. Phase C:prior to and at set times up to 72 hours after study drug administration
Pupillometry
Pupillometry measures change in pupil size (miosis - shrinkage of pupil) as an indicator of opioid pharmacological properties. The same eye for each subject will be used for all measurements during the study.
Time frame: Phase B: prior to and at designated times up to 24 hours after study drug administration. Phase C:prior to and at set times up to 72 hours after study drug administration
Time to maximum observed drug concentration (tmax)
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Area under the plasma concentration by time curve (AUC) from time 0 to maximum drug concentration time - Immediate release product
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Area under the plasma concentration by time curve (AUC) from time 0 to maximum drug concentration time - Extended release product intact
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Area under the plasma concentration by time curve (AUC) from time 0 to maximum drug concentration time - Extended release product crushed
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Area under the plasma concentration by time curve (AUC) from time 0 to last measureable drug concentration
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Area under the plasma concentration by time curve (AUC) from time 0 to infinity
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration
Apparent plasma terminal elimination rate constant and associated elimination half-life
To characterize the pharmacokinetics of the hydrocodone bitartrate extended-release tablet (crushed and intact) and immediate-release hydrocodone bitartrate by assessing plasma concentration data over 72 hours following study drug administration
Time frame: Approximately 30 minutes before study drug administration up to 72 hours post study drug administration