Clobazam Oral Film Provides a Highly Consistent and Easy-to-Give Dose

Monday, December 03, 2018

A new oral-film formulation of clobazam (Sympazan; Aquestive, Warren, NJ) was recently approved by the Food and Drug Administration (FDA) for adjunctive treatment of people with seizures associated with Lennox-Gastaut syndrome (LGS). At the American Epilepsy Society Annual Meeting in New Orleans, LA, data on pharmacokinetics of clobazam and its active metabolite N-desmethylclobazam that led to that approval were presented. 

For a drug formulation to be considered of average bioequivalence to a previously approved drug by the FDA, there must be a 90% CI that pharmacokinetic measures fall within 80% to 125% of the same measures for the dose originally approved. As shown in the Table, the oral formulation meets a more rigorous standard with all measures falling between 90 and 110%. This strongly supports for physicians, patients, and caregivers that they can feel confident that the oral film formulation is providing a dose that is consistent with other formulations they may have already used. In addition, the oral film may be easier and more consistent for caregivers to administer as it requires rapid placement on the tongue with no crushing tablets, swallowing pills with water, or leaving residue of the medication in a cup.

In this study, 51 healthy adults received 10 mg or 20 mg of clobazam as a tablet or an oral film on an open-label basis. Participants were randomly assigned to groups that received the 4 different doses and formulations in 4 different sequences for 4 different time periods after an overnight fast of at least 10 hours. Subjects also fasted for 4 hours after receiving the medication. Levels of clobazam and N-desmethylclobazam were measured before dosing and at regular intervals for 21 days after dosing and there was a 28-day washout period between doses. No significant differences in adverse effects between formulations was observed. 

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