A Study to Evaluate the Effect of T89(Dantonic®)on Steady-State Pharmacodynamics of Warfarin

Due to a large proportion of patients that could benefit from Dantonic treatment is likely to take warfarin concomitantly. And there is no systematic experience of warfarin drug-drug interaction between Dantonic and warfarin on humans. It is highly relevant to investigate the potential interaction of theses two drugs.

Primary endpoint:

•The change in INR with T89 (Day 25) compared with that without T89 (Day 18)

Secondary endpoints:

• The change in PK variables for R-warfarin and S-warfarin on Day 17 compared with those on Day 24
• Safety assessments across all time points

Inclusion criteria

• Nonsmoking male or female with 18-50 years of age and a body mass index (BMI) from 19.0 to 30.0 kg/m2;
• Healthy adult with no active medical problems or significant chronic diseases as determined by the study doctor based on medical history, physical examination and laboratory evaluations;
• Taking no medications 2 weeks before Day 0 and during the study, including drugs of abuse, prescription and non prescription medications (including natural health products, Vitamins, and herbals) and did not receive vaccinations;
• Agree to avoid eating Seville oranges, grapefruits (including grapefruit juice), broccoli, brussels sprouts, charcoal-grilled meats, alcoholic beverages, and caffeine- and theobromine-containing beverages and foods from the time of screening visit and the duration of the study;
• Agree to maintain adequate birth control, independent from hormonal contraceptive use, from the time of the screening visit and during the study, at the discretion of the investigator;
• Agree to abstain from alcoholic beverages, caffeinated beverages and orange juice from 6pm the night before a study day until completion of that study day;
• A negative fecal occult blood test (FOBT) ;
• Agree to avoid participation in contact sports and/or other activities with significant risk of trauma injury for 7 days after each study day;
• Subject understands and is willing, able and likely to comply with all study procedures and restrictions;
• Subject is able to give voluntary oral and written informed consent, at the discretion of the investigator.

Exclusion criteria

• Subjects with an elevated INR (INR> 1.2) at screening visit;
• No gastrointestinal bleeding history within 12 months prior to screening visit;
• No history of endoscopically proven peptic ulcer disease;
• Known hypersensitivity to warfarin;
• Prosthetic heart valves, mitral stenosis, or other conditions such as recent (<3 months) pulmonary embolism requiring anticoagulant therapy;
• History or presence of renal and hepatic insufficiency;
• History of hyperthyroidism;
• History of any bleeding disorder or hypercoagulation state;
• Surgical or medical condition liable to interfere with the absorption, metabolism or excretion of warfarin;
• Regular intake of other medication affecting the process of coagulation or platelet aggregation (during the 2 weeks prior to screening and/or during the run-in and treatment periods);
• Significant change in diet likely to interfere with the effects of warfarin in the 2 weeks prior to screening and/or during the run-in and treatment periods, at the discretion of the investigator;
• History of conditions associated with hemorrhagic risk, surgery or head injury within 6 months prior to screening visit;
• Hematological abnormalities (thrombocytopenia, clinically significant low granulocyte count, anemia, hypofibrinogenaemia, hemophilia, purpura, hemopathy with prolongation of bleeding time);
• Blood loss/donation >400 mL within 12 weeks prior to the screening visit and/or during the run-in and treatment periods;
• Known to have serum hepatitis or who are carrier of the hepatitis B surface antigen (HBsAg), or hepatitis C antibody, or have a positive result to the test for HIV antigens and/or antibodies;
• Pregnancy or lactation;
• Participation in any other clinical trial or receipt of an investigational drug within 60 days prior to the time of the screening visit, or previous participation in this study;
• Those subjects unable, in the opinion of the investigator, to comply fully with the trial requirements;
• Subjects with a recent history (within 24 months prior to the screening visit) of alcoholism or known drug dependence, at the discretion of the investigator;
• Subjects with positive urine cotinine, urine drug screen and/or alcohol breath test;
• In the opinion of the investigator, patients with medical history or other factors which may interfere with enrollment or the study.