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InteractionEarly Phase 1NCT05365451

Pharmacokinetic Drug-Drug Interaction Study to Identify Biomarkers of Kidney Transporters

A Early Phase 1 study testing MetFORMIN Oral Solution, Cimetidine 400 MG and Furosemide Oral Liquid Product in people with Interaction and Endogenous Biomarkers, run by Washington State University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study is to confirm the feasibility of using a panel of endogenous substrates/metabolites as a robust biomarker of OCTs and OATs by conducting a controlled, comprehensive clinical drug-drug interaction study in healthy adult volunteers. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Interaction, Endogenous Biomarkers
What is being tested?
MetFORMIN Oral Solution, Cimetidine 400 MG and Furosemide Oral Liquid Product
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
1 siteUnited States
Study dates
11 Apr 2022to 22 Jul 2023
Phase
Early Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Are from 18-65 years old and healthy
  • Are not taking any medications (prescription and non-prescription) or dietary/herbal supplements that can interfere with your ability to eliminate the study drugs from your body
  • Are willing to stop taking dietary/herbal supplements and citrus juices for several weeks
  • Are willing to stop consuming caffeinated beverages or other caffeine-containing products the evening before and the morning of the first day of each study arm
  • Are willing to stop drinking alcoholic beverages for at least 1 day prior to any study day and during the study day
  • Are willing to use an acceptable method of birth control that does not include oral contraceptive pills or patches (such as abstinence, copper IUD, condom) throughout your participation in the study and for at least 3 weeks after you last take the study drugs
  • Have the time to participate

Who cannot join

  • Are under 18 or over 65 years old
  • Smoke/vape/chew tobacco products
  • Use cannabis products, including marijuana, hemp, and other THC- and CBDcontaining products• Are taking medications or dietary/herbal supplements that can interfere with your ability to eliminate the study drugs from your body
  • Have a chronic illness such as (but not limited to) kidney disease, liver disease, diabetes mellitus, high blood pressure, coronary artery disease, chronic obstructive pulmonary disease, cancer, or HIV/AIDS
  • Have a hematologic (blood) disorder
  • Have a history of drug or alcohol addiction or major psychiatric illness
  • Have a history of allergy to metformin, cimetidine, furosemide, or probenecid
  • Are pregnant, nursing, or plan to become pregnant within 3 weeks after participation

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Washington State University College of Pharmacy and Pharmaceutical Sciences

    Spokane, Washington, 99202

Other trials in United States

About this study

The objective of this study is to confirm the feasibility of using a panel of endogenous substrates/metabolites as a robust biomarker of OCTs and OATs by conducting a controlled, comprehensive clinical drug-drug interaction study in healthy adult volunteers. Metformin and furosemide will be used as probe drugs for OCTs and OATs, respectively; cimetidine and probenecid will be used as corresponding inhibitors. Results from this study will validate this novel approach, which will be extended to children by collaborators at Children's Mercy Hospital in Kansas City, MO.

Read the detailed description

The kidneys are major organs responsible for the excretion of both endogenous and exogenous compounds, the latter including drugs and other xenobiotics. Excretion occurs via passive or active processes, the latter involving transporters such as organic cation transporters (OCTs) and organic anion transporters (OATs). Inhibition of these transporters, coupled with the large interindividual variability in transporter expression, can lead to toxic accumulation of compounds/xenobiotics cleared primarily by this route. During drug discovery and development, if in vitro evidence suggests renal transporters mediate excretion of a new chemical entity, the Food and Drug Administration recommends conducting a controlled clinical study to evaluate potential risks. These time-consuming and expensive clinical studies routinely involve adult participants and known substrates of renal transporters. However, such studies are not always feasible in children due to the enhanced potential for toxicities. This limitation led to the hypothesis that endogenous substrates could be used as surrogates, or biomarkers, of individual renal transporter function.

Endogenous OCT substrates, such as 1-methyladenosine (m1A) and 1-methylnicotinamide (MNA), as well as OATs, such as homovanillic acid (HVA) and pyridoxic acid (PDA), are promising biomarkers of renal transporters in adults. However, using one or few such endogenous substrates can be misleading due to factors other than variability in specific renal transporter function. We propose to address this knowledge gap by using a panel of endogenous substrates/metabolites that recently has been identified as a robust biomarker of rodent Octs and Oats. Validation of these substrates/metabolites as biomarkers of OCTs and OATs in humans, both adults and children, will aid in the development of physiologically-based pharmacokinetic models that can be used to predict renal transporter-mediated xenobiotic excretion, drug-drug interactions, and toxicity in children.

Being tested
MetFORMIN Oral Solution, Cimetidine 400 MG, Furosemide Oral Liquid Product, Probenecid 500 MG
Keywords
Kidney Transporter, Pharmacokinetics

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MetFORMIN Oral SolutionDrug

    Also called Riomet

    liquid

  • Cimetidine 400 MGDrug

    Also called Tagamet

    tablet

  • Furosemide Oral Liquid ProductDrug

    Also called Lasix

    oral solution

  • Probenecid 500 MGDrug

    Also called Probalan

    tablet

Study groups in NCT05365451
Study groupRoleWhat they receive
Arm 1A: metformin alone (baseline)ExperimentalArm 1A will consist of administration of a single dose of metformin (50 mg) by mouth as a liquid to 16 subjects (8 males, 8 females). Plasma and urine will be collected from 0-24 hours. Participants may or may not elect to participate in Arms 2A and 2B. A washout of at least 7 days will occur between Arm 1A and Arm 1B.
Receives: Drug: MetFORMIN Oral Solution
Arm 1B: metformin + cimetidineExperimentalArm 1B will consist of administration of a single oral dose of cimetidine (400 mg) with water by mouth. One hour later, metformin (50 mg) will be administered by mouth as a liquid. Plasma and urine will be collected from 0-24 hours. Participants may or may not elect to participate in Arms 2A and 2B. A washout of at least 7 days will occur between Arm 1B and Arm 2A.
Receives: Drug: MetFORMIN Oral Solution; Drug: Cimetidine 400 MG
Arm 2A: furosemide alone (baseline)ExperimentalArm 2A will consist of administration of a single dose of furosemide (5 mg) by mouth as a liquid. Plasma and urine will be collected from 0-24 hours. A washout of at least 7 days will occur between Arm 2A and Arm 2B.
Receives: Drug: Furosemide Oral Liquid Product
Arm 2B: furosemide + probenecidExperimentalArm 2B will consist of administration of a single oral dose of probenecid (1,000 mg) with water by mouth. One hour later, furosemide (5 mg) will be administered by mouth as a liquid. Plasma and urine will be collected from 0-24 hours. Participants may or may not elect to participate in Arms 1A and 1B. A washout of at least 7 days will occur between Arm 2B and Arm 1A.
Receives: Drug: Furosemide Oral Liquid Product; Drug: Probenecid 500 MG

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Metformin Area Under the Concentration vs. Time Curve (AUC)

    baseline metformin area under the concentration vs. time curve (AUC)

    Measured: 0-24 hours

  2. Metformin AUC in Presence of Cimetidine

    Metformin area under the concentration vs. time curve (AUC) in presence of cimetidine

    Measured: 0-24 hours

  3. Metformin Maximum Concentration (Cmax)

    baseline metformin maximum concentration (Cmax)

    Measured: 0-24 hours

  4. Metformin Cmax in Presence of Cimetidine

    metformin Cmax in the presence of cimetidine

    Measured: 0-24 hours

  5. Metformin Renal Clearance (CLr)

    baseline metformin renal clearance (CLr)

    Measured: 0-24 hours

  6. Metformin CLr in Presence of Cimetidine

    metformin CLr in the presence of cimetidine

    Measured: 0-24 hours

  7. Furosemide Area Under the Concentration vs. Time Curve (AUC)

    baseline furosemide area under the concentration vs. time curve (AUC)

    Measured: 0-24 hours

  8. Furosemide AUC in Presence of Probenecid

    furosemide AUC in the presence of probenecid

    Measured: 0-24 hours

  9. Furosemide Renal Clearance (CLr)

    baseline furosemide renal clearance (CLr)

    Measured: 0-24 hours

  10. Furosemide CLr in Presence of Probenecid

    furosemide CLr in the presence of probenecid

    Measured: 0-24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 May 2022
  2. Study start11 Apr 2022
  3. Primary completion22 Jul 2023
  4. Study completion22 Jul 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Early Phase 1
Primary purpose
Basic science
Allocation
Non-randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05365451
Sponsor's protocol ID
19163
Other IDs
R01HD081299
Status last verified
Aug 2025
First submitted
4 May 2022
Last updated
8 Aug 2025
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Morrissey KM, Stocker SL, Wittwer MB, Xu L, Giacomini KM. Renal transporters in drug development. Annu Rev Pharmacol Toxicol. 2013;53:503-29. doi: 10.1146/annurev-pharmtox-011112-140317. Epub 2012 Nov 8.

    PubMed 23140242
  • US Food and Drug Administration. Clinical Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/clinical-drug-interaction-studies-cytochrome-p450-enzyme-and-transporter-mediated-drug-interactions.

  • Shen H, Holenarsipur VK, Mariappan TT, Drexler DM, Cantone JL, Rajanna P, Singh Gautam S, Zhang Y, Gan J, Shipkova PA, Marathe P, Humphreys WG. Evidence for the Validity of Pyridoxic Acid (PDA) as a Plasma-Based Endogenous Probe for OAT1 and OAT3 Function in Healthy Subjects. J Pharmacol Exp Ther. 2019 Jan;368(1):136-145. doi: 10.1124/jpet.118.252643. Epub 2018 Oct 25.

    PubMed 30361237
  • Miyake T, Mizuno T, Takehara I, Mochizuki T, Kimura M, Matsuki S, Irie S, Watanabe N, Kato Y, Ieiri I, Maeda K, Ando O, Kusuhara H. Elucidation of N 1-methyladenosine as a Potential Surrogate Biomarker for Drug Interaction Studies Involving Renal Organic Cation Transporters. Drug Metab Dispos. 2019 Nov;47(11):1270-1280. doi: 10.1124/dmd.119.087262. Epub 2019 Sep 11.

    PubMed 31511257
  • Naji-Talakar S, Sharma S, Martin LA, Barnhart D, Prasad B. Potential implications of DMET ontogeny on the disposition of commonly prescribed drugs in neonatal and pediatric intensive care units. Expert Opin Drug Metab Toxicol. 2021 Mar;17(3):273-289. doi: 10.1080/17425255.2021.1858051. Epub 2021 Jan 20.

    PubMed 33256492
  • Feng B, Varma MV. Evaluation and Quantitative Prediction of Renal Transporter-Mediated Drug-Drug Interactions. J Clin Pharmacol. 2016 Jul;56 Suppl 7:S110-21. doi: 10.1002/jcph.702.

    PubMed 27385169
  • Thakur A, Singh DK, Hart KD, Kis E, Gaborik Z, Denton TT, Clarke JD, Paine MF, Prasad B. From Discovery to Translation: Endogenous Substrates of OAT1 and OAT3 as Clinical Biomarkers for Renal Secretory Function. Clin Pharmacol Ther. 2025 Sep;118(3):693-704. doi: 10.1002/cpt.3719. Epub 2025 May 22.

    PubMed 40401788

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing MetFORMIN Oral Solution, Cimetidine 400 MG and Furosemide Oral Liquid Product in people with Interaction and Endogenous Biomarkers, run by Washington State University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Aug 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Metformin Area Under the Concentration vs. Time Curve (AUC) (time frame: 0-24 hours). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05365451, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Aug 2025.

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