Subjects must meet all of the following inclusion criteria to be eligible for enrollment
in the study:
1. For Part 1 and Part 3 specific: Healthy female subjects of non childbearing potential
and male subjects who, at the time of screening, are between the ages of 18 and 55
years, inclusive (Healthy is defined as no clinically relevant abnormalities
identified by a detailed medical history, full physical examination, including blood
pressure and pulse rate measurement, 12 lead ECG and clinical laboratory tests).
2. For Part 2 specific: Female subjects of non childbearing potential and male subjects
who, at the time of screening, are between the age of 65 and 85 years, inclusive.
Subjects must be in good health as determined by the Investigator based on a detailed
medical history, full physical examination (including blood pressure and pulse rate
measurement), 12 lead ECG and clinical laboratory tests. Subjects with mild, chronic,
stable disease eg, controlled hypertension, non insulin dependent diabetes,
osteoarthritis may be enrolled if deemed medically prudent by the investigator.
Subjects taking daily prescription or non prescription medications for management of
acceptable chronic medical conditions must be on a stable dose of these, as defined
by non change in dose for the 3 months prior to the first dose of study medication
and no planned changes during the conduct of the study.
3. Female subjects of non childbearing potential must meet at least one of the following
- Achieved postmenopausal status, defined as follows: cessation of regular menses
for at least 12 consecutive months with no alternative pathological or
physiological cause; status may be confirmed by having a serum follicle
stimulating hormone (FSH) level confirming the post menopausal state;
- Have undergone a documented hysterectomy and/or bilateral oophorectomy;
- Have medically confirmed ovarian failure. All other female subjects (including
females with tubal ligations will be considered to be of childbearing potential.
4. Body Mass Index (BMI) of 17.5 to 30.5 kg/m2; and a total body weight > 50 kg (110
5. For Part 2 specific: the creatinine clearance greater than 60 mL/min using the
Cockcroft Gault method.
6. Evidence of a personally signed and dated informed consent document indicating that
the subject has been informed of all pertinent aspects of the study.
7. Subjects who are willing and able to comply with scheduled visits, treatment plan,
laboratory tests, and other study procedures.
1. For Part 1 and Part 3 specific: Evidence or history of clinically significant
hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular,
hepatic, psychiatric, neurologic, or allergic disease (including drug allergies, but
excluding untreated, asymptomatic, seasonal allergies at time of dosing) at the
discretion of the investigator.
2. For Part 2 specific: Recent (eg, last 6 months) evidence or history of unstable
disease or moderate to severe conditions which would, in the Investigator's opinion,
interfere with the study evaluations or impact on the safety of participating
subjects including but not limited to anemia, liver disease, stroke.
3. Any condition possibly affecting drug absorption (eg, gastrectomy).
4. A positive urine drug screen.
5. History of regular alcohol consumption exceeding 14 drinks/week for females or 21
drinks/week for males (1 drink = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of
beer or 1.5 ounces (45 mL) of hard liquor) within 6 months of Screening.
6. Treatment with an investigational drug within 30 days (or as determined by the local
requirement) or 5 half lives preceding the first dose of study medication, whichever
7. Screening supine blood pressure ?140 mm Hg (systolic) or ? 90 mm Hg (diastolic),
following at least 5 minutes of supine rest. If blood pressure (BP) is ? 140 mm Hg
(systolic) or 90 mm Hg (diastolic), the BP should be repeated two more times,
following 2 minutes rest and the average of the three BP values should be used to
determine the subject's eligibility.
8. Screening supine12 lead ECG demonstrating QTcf >450 or a QRS interval >120 msec. If
QTcf exceeds 450 msec, or QRS exceeds 120 msec, the ECG should be repeated two more
times and the average of the three QTc or QRS values should be used to determine the
9. Subjects with ANY of the following abnormalities in clinical laboratory tests at
screening, as assessed by the study specific laboratory and confirmed by a single
repeat, if deemed necessary:
- Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transminase (SGOT)
or alanine aminotransferase (ALT)/serum glutamic pyruvic transminase (SGPT) 1.5x
upper limit of normal (ULN);
- Total bilirubin 1.5 x ULN; subjects with a history of Gilbert's syndrome may
have a direct bilirubin measured and would be eligible for this study provided
the direct bilirubin is ULN.
10. Male subjects with partners currently pregnant; male subjects able to father children
who are unwilling or unable to use a highly effective method of contraception as
outlined in this protocol for the duration of the study and for at least 28 days
after the last dose of investigational product or longer based upon the compound's
half life characteristics.
11. For Part 1 and Part 3 specific: Use of prescription or nonprescription drugs and
dietary supplements within 7 days or 5 half lives (whichever is longer) prior to the
first dose of study medication. As an exception, acetaminophen/paracetamol may be
used at doses of ? 1 g/day. Limited use of non prescription medications that are not
believed to affect subject safety or the overall results of the study may be
permitted on a case by case basis following approval by the sponsor.
12. For Part 2 specific: Systemic therapy with any of the following cytochrome P450 (CYP)
3A4 strong and moderate inhibitors/inducers within 7 days or 5 half lives (whichever
was longer) prior to the first dose of study medication, or during the study:
phenobarbital, carbamazepine, phenytoin, rifampin, rifabutin, St. John's Wort,
bosentan, modafinil, nafcillin, aprepitant, ciprofloxacin, boceprevir,
clarithromycin, conivaptan, grapefruit juice, itraconazole, ketoconazole, mibefradil,
nefazodone, posaconazole, telaprevir, telithromycin, voriconazole, aprepitant,
diltiazem, erythromycin, fluconazole, verapamil and human immunodeficiency virus
(HIV) protease inhibitors (eg, indinavir, ritonavir, nelfinavir, atazanavir,
amprenavir, fosamprenavir, etc).
13. For Part 2 specific: sensitive CYP3A substrates or CYP3A substrates with narrow
therapeutic index within 7 days or 5 half lives (whichever was longer) prior to the
first dose of study medication, or during the study. However, this exclusion may be
removed if the Part 1 results suggest low risk.
14. Herbal supplements and hormone replacement therapy must be discontinued 28 days prior
to the first dose of study medication.
15. Blood donation (excluding plasma donations) of approximately 1 pint (500 mL) or more
within 56 days prior to dosing.
16. History of sensitivity to heparin or heparin induced thrombocytopenia.
17. Unwilling or unable to comply with the Lifestyle Guidelines described in this
18. Subjects who are investigational site staff members directly involved in the conduct
of the study and their family members, site staff members otherwise supervised by the
Investigator, or subjects who are Pfizer employees directly involved in the conduct
of the study.
19. Other severe acute or chronic medical or psychiatric condition or laboratory
abnormality that may increase the risk associated with study participation or
investigational product administration or may interfere with the interpretation of
study results and, in the judgment of the investigator, would make the subject
inappropriate for entry into this study.
20. For Cohorts 3 5 in Part 1 specific: Subjects with a history of significant active
bleeding, coagulation disorder or clinically significant finding on PT/PTT/INR at
21. For Cohorts 3 5 in Part 1 specific: Subjects with lower spinal malformations (on
physical examination or lumber X ray), local spinal/skin infection, or other
abnormalities that would exclude puncture (LP).
22. For Cohorts 3 5 in Part 1 specific: Subjects with allergy to lidocaine or its
23. Use of tobacco or nicotine containing products in excess of the equivalent of 5
cigarettes per day.
24. Subjects who answer "Yes" to the Columbia Suicide Severity Rating Scale (C SSRS)
questions 4 or 5. In addition, subjects deemed by the investigator to be at
significant risk of suicidal or violent behavior should be excluded.
25. Subjects who have attempted suicide in the past.
26. Subjects who have unexplained history of sudden death in their family.