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Bioequivalence Evaluation of Immediate-Release Empagliflozin/Metformin Fixed-Dose Combination Tablets Under Fed Conditions in Healthy Mexican Subjects and Exploratory Analysis of Metformin Dose Proportionality

Guido Ávila EG, Martínez Muñoz A, de la Cruz Cruz P, Hernández Piña OE, Pérez-Urizar JT, Escobedo-Moratilla A

Pharmaceuticals (Basel, Switzerland), 2026

42 participants

Abstract

Background/Objectives: Fixed-dose combinations (FDCs) improve therapeutic adherence in type 2 diabetes. These studies aimed to evaluate the pharmacokinetics and establish the bioequivalence of four immediate-release empagliflozin/metformin FDC formulations under fed conditions in healthy Mexican subjects. Methods: A total of 42 healthy volunteers per study (168 total) were enrolled in four randomized, open-label, two-way crossover, single-dose studies with a 14-day washout period. Formulations were administered orally under standardized fed conditions. Plasma concentrations of both drugs were quantified using a validated liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method. Results: Across all dose strengths, the 90% confidence intervals (CIs) for the geometric mean ratios of peak plasma concentration (Cmax) and area under the concentration-time curve (AUC0-t) for both empagliflozin and metformin were entirely within the 80.00-125.00% bioequivalence acceptance range. The specific 90% CIs for Cmax and AUC0-t were: Study A (5/850 mg): empagliflozin (90.18-103.16%; 94.37-101.81%), metformin (98.43-107.69%; 97.18-106.62%); Study B (12.5/500 mg): empagliflozin (91.94-102.77%; 93.38-98.51%), metformin (92.58-101.73%; 94.85-103.91%); Study C (12.5/850 mg): empagliflozin (95.47-107.74%; 95.34-101.25%), metformin (94.19-103.59%; 94.06-103.21%); and Study D (12.5/1000 mg): empagliflozin (94.53-107.10%; 98.13-105.66%), metformin (98.89-107.51%; 99.25-109.92%).…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 42 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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