Bioavailability of dronedarone tablets administered with or without food in healthy participants

Study objective: There is inadequate awareness of the effect of food on the bioavailability of dronedarone. We report results from two phase 1 studies assessing the effect of food on dronedarone's bioavailability. Design, setting and participants: Study 1; single-center, open-label, randomized study in healthy adults (males and females). Study 2; single-center, open-label, randomized study in healthy males. Interventions: Study 1; a single 400-mg oral dose of dronedarone (marketed formulation) in fed (high-fat [47.4 g] meal) and fasted states. Study 2; a single 800-mg oral dose of dronedarone (two 400-mg tablets) after fat-rich (37.3 g) and low-fat (5.3 g) meals, and after fasting. Main outcome measures: Pharmacokinetic parameters including maximum plasma concentration (C_max) and area under the curve from time 0 to last measurable time (AUC_last) were assessed for dronedarone and its active N-debutyl metabolite. Results: Twenty-six participants were included in Study 1 and nine in Study 2. In Study 1, administration of 400 mg dronedarone with a high-fat meal vs. fasted state resulted in 2.8-fold and 2.0-fold increases in C_max and AUC_last, respectively. In Study 2, administration of 800 mg dronedarone with a fat-rich or low-fat meal vs. fasted state resulted in 4.6-fold and 3.2-fold increases in C_max, respectively, and 3.1-fold and 2.3-fold increases, respectively, in AUC_last. Results for the N-debutyl metabolite were similar to dronedarone. No adverse events were considered related to dronedarone. Conclusion: With food, the bioavailability of dronedarone is markedly increased. In clinical practice, dronedarone should be administered with a complete meal to maximize drug absorption.