Ames negative; chromosome aberrations positive in vitro; negative in vivo rat bone marrow micronucleus
“Sulopenem etzadroxil was negative for mutations in an in vitro Ames assay with and without metabolic activation but positive for chromosome aberrations with and without metabolic activation in vitro in peripheral human lymphocytes and Chinese hamster ovary cells. In vivo, sulopenem etzadroxil was negative for genetic toxicity in a bone marrow micronucleus assay in rats.”
No effect on rat fertility; no malformations in rat and rabbit EFD; cleft palate in mice at ~46x clinical exposure
“Sulopenem etzadroxil did not inhibit fertility in male and female rats and was not associated with fetal malformations in embryo-fetal studies in rats and rabbits. However, in mice, a higher litter and fetal incidence of cleft palate in fetuses occurred at a sulopenem etzadroxil dose associated with sulopenem exposures approximately 46-times the mean clinical exposure”
Clinical Cmax ~6- and 40-fold below the hERG IC50s of sulopenem etzadroxil and sulopenem; minimal QT concern
“However, concern for inhibition of hERG potassium channels and possible QT prolongation in the clinic is minimal because the 2.64 µg/ml plasma Cmax for sulopenem associated with administration of a single bilayer tablet containing 500 mg sulopenem etzadroxil in fed patients is approximately 6-fold and 40-fold lower than the hERG IC50 values for sulopenem etzadroxil and sulopenem, respectively.”
Not genotoxic overall: Ames negative; in vitro chromosome aberration positive without (not with) metabolic activation; rat micronucleus and comet negative