This is a Phase 1, open-label, three-period crossover study evaluating the pharmacokinetics and safety of single-dose Wafermine™ (ketamine sublingual wafer) at dose levels of 25 mg, 50 mg, and 75 mg in healthy adult participants under fasting conditions. Participants will receive all three dose levels in a fixed ascending sequence during a single inpatient admission, with washout periods between doses. Pharmacokinetic sampling will be conducted over 36 hours following each dose.
This study is designed to characterize the pharmacokinetic profile of ketamine and its metabolite norketamine following sublingual administration of Wafermine™. Each participant will receive three single-dose treatments (25 mg, 50 mg, and 75 mg) administered in a fixed ascending sequence across three treatment periods. All treatment periods will occur during a single inpatient stay. Participants will undergo a minimum 10-hour fast prior to dosing. Each dosing period will be separated by a washout period of at least 48 hours. Serial blood samples will be collected up to 36 hours post-dose in each period. Safety and tolerability will be assessed through monitoring of adverse events, vital signs, electrocardiograms, clinical laboratory tests, and local tolerability assessments.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
14
Single-dose sublingual administration of Wafermine™ at dose levels of 25 mg, 50 mg, and 75 mg under fasting conditions.
Q-Pharm Pty Ltd.
Brisbane, Queensland, Australia
Peak Plasma Concentration (Cmax) of Ketamine and Norketamine
Maximum observed plasma concentration (Cmax) of ketamine and norketamine following administration of study treatment. Plasma concentrations will be derived using non-compartmental analysis (NCA).
Time frame: From pre-dose through the last measurable concentration, with plasma samples collected up to 36 hours post-dose.
Terminal Elimination Half-Life (t½) of Ketamine and Norketamine
Terminal elimination half-life (t½) of ketamine and norketamine calculated from the terminal phase of the plasma concentration-time curve using non-compartmental analysis.
Time frame: From pre-dose through the last measurable concentration, with plasma samples collected up to 36 hours post-dose.
Time to Peak Plasma Concentration (Tmax) of Ketamine and Norketamine
Time to maximum observed plasma concentration (Tmax) of ketamine and norketamine following administration of study treatment.
Time frame: Pre-dose to 36 hours post-dose
Area Under the Plasma Concentration-Time Curve (AUC) of Ketamine and Norketamine
Area under the plasma concentration-time curve from time zero to the last measurable concentration (AUC₀-t) and extrapolated to infinity (AUC∞) for ketamine and norketamine, calculated using non-compartmental analysis.
Time frame: From pre-dose through the last measurable concentration, with plasma samples collected up to 36 hours post-dose.
Incidence and Severity of Treatment-Emergent Adverse Events (TEAEs)
Assessment of the incidence, nature, and severity of treatment-emergent adverse events (TEAEs) following administration of study treatment. Adverse events will be coded using the Medical Dictionary for Regulatory Activities (MedDRA) and graded according to Common Terminology Criteria for Adverse Events (CTCAE), where applicable
Janakan Krishnarajah, MD
CONTACT
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Time frame: From first dose through end of study/follow-up (~10 days)
Vital Signs: Change From Baseline in Systolic Blood Pressure
Change from baseline in systolic blood pressure will be assessed at scheduled vital sign assessment timepoints. Systolic blood pressure will be measured in the supine position after at least 3 minutes of rest using standard clinical equipment. Results will be summarized using descriptive statistics. Unit of Measure: millimeters of mercury (mmHg)
Time frame: From first dose through End of study/ follow-up, approximately 10 days
Vital Signs: Change From Baseline in Diastolic Blood Pressure
Change from baseline in diastolic blood pressure will be assessed at scheduled vital sign assessment timepoints. Diastolic blood pressure will be measured in the supine position after at least 3 minutes of rest using standard clinical equipment. Results will be summarized using descriptive statistics. Unit of Measure: millimeters of mercury (mmHg)
Time frame: From first dose through end of study/ follow-up, approximately 10 days
Vital Signs: Change from Baseline in Heart Rate
Change from baseline in heart rate will be assessed at scheduled vital sign assessment timepoints. Heart rate will be measured in the supine position after at least 3 minutes of rest using standard clinical equipment. Results will be summarized using descriptive statistics. Unit of Measure: Beats per minute
Time frame: From first dose through End of study/ follow-up, approximately 10 days
Vital Signs: Change From Baseline in Respiratory Rate
Change from baseline in respiratory rate will be assessed at scheduled vital sign assessment timepoints. Respiratory rate will be measured using standard clinical procedures. Results will be summarized using descriptive statistics. Unit of Measure: Breaths per minute
Time frame: From first dose through end of study/follow-up, approximately 10 days
Vital Signs: Change From Baseline in Tympanic Temperature
Change from baseline in tympanic temperature will be assessed at scheduled vital sign assessment timepoints. Tympanic temperature will be measured using standard clinical equipment. Results will be summarized using descriptive statistics. Unit of Measure: Degrees Celsius (°C)
Time frame: From first dose through end of study/follow-up, approximately 10 days
Vital Signs: Change From Baseline in Oxygen Saturation
Change from baseline in oxygen saturation will be assessed at scheduled vital sign assessment timepoints. Oxygen saturation will be measured by pulse oximetry. Oxygen saturation may be monitored continuously for 2 hours post-dose, with values recorded at scheduled timepoints. Results will be summarized using descriptive statistics. Unit of Measure: percentage of peripheral oxygen saturation (SpO2, %)
Time frame: From first dose through end of study/follow-up, approximately 10 days
Number of Participants with Clinically Significant Vital Sign Abnormalities
Clinically significant abnormalities in vital signs, including systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, tympanic temperature, and oxygen saturation, will be assessed based on investigator judgment. Clinically significant abnormalities may be recorded as adverse events, as applicable. Unit of Measure: Participants
Time frame: From first dose through end of study/follow-up, approximately 10 days
12-lead Electrocardiogram Readings: Change from Baseline in PR Interval
PR interval values and changes from baseline will be summarized descriptively by visit for all post-baseline visits through the End of Study/Follow-up visit. Unit of Measure: milliseconds
Time frame: Baseline through end of study/follow-up (assessed up to 6 weeks)
12-lead Electrocardiogram Readings: Change from Baseline in QRS Duration
QRS Duration values and changes from baseline will be summarized descriptively by visit for all post-baseline visits through the End of Study/Follow-up visit. Unit of Measure: milliseconds
Time frame: Baseline through end of study/follow-up (assessed up to 6 weeks)
12-lead Electrocardiogram Readings: Change from Baseline in QT Interval
QT Interval values and changes from baseline will be summarized descriptively by visit for all post-baseline visits through the End of Study/Follow-up visit. Unit of Measure: milliseconds
Time frame: Baseline through end of study/follow-up (assessed up to 6 weeks)
12-lead Electrocardiogram Readings: Change From Baseline in QTcF Interval
QTcF values will be summarized descriptively by visit through the End of Study/Follow-up visit. QTcF categories will be summarized as counts and percentages. Unit of Measure: milliseconds
Time frame: Baseline through end of study/follow-up (assessed up to 6 weeks)
12-lead Electrocardiogram Readings: Change From Baseline in ECG Heart Rate
Heart Rate values and changes from baseline will be summarized descriptively by visit for all post-baseline visits through the End of Study/Follow-up visit. Unit of Measure: beats per minute
Time frame: Baseline through end of study/follow-up (assessed up to 6 weeks)
Number of Participants with Clinically Significant Electrocardiogram Abnormalities
Clinically significant electrocardiogram abnormalities will be assessed based on investigator or clinical interpretation of 12-lead electrocardiogram results. ECG Clinical interpretation may be categorized as normal, abnormal not clinically significant, and abnormal clinically significant. Unit of Measure: Participants
Time frame: From baseline through end of study (assessed up to 6 weeks)
Number of Participants with Clinically Significant Clinical Laboratory Abnormalities
Clinically significant clinical laboratory abnormalities will be assessed based on test results, as determined by the investigator. Laboratory abnormalities may be summarized overall and by laboratory category and/or parameter, as applicable. Unit of Measure: Participants
Time frame: From baseline through end of study (assessed up to 6 weeks)
Number of Participants with Local Tolerability Findings at the Sublingual Administration Site
Local tolerability findings at the sublingual administration site will be assessed following study drug administration. Assessments may include participant-reported oral symptoms, such as sublingual irritation, burning sensation, or bitter taste, and investigator-assessed sublingual findings, such as inflammation and/or abnormalities in mucosal integrity. Findings may be summarized by severity category and assessment type, as applicable. Unit of Measure: Participants
Time frame: From first dose on Day 1 through the Follow-up Visit on Day 10