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EP1817021A1 - Nsaid-zusammensetzungen mit klinischer qualität - Google Patents

Nsaid-zusammensetzungen mit klinischer qualität

Info

Publication number
EP1817021A1
EP1817021A1 EP05850126A EP05850126A EP1817021A1 EP 1817021 A1 EP1817021 A1 EP 1817021A1 EP 05850126 A EP05850126 A EP 05850126A EP 05850126 A EP05850126 A EP 05850126A EP 1817021 A1 EP1817021 A1 EP 1817021A1
Authority
EP
European Patent Office
Prior art keywords
ibuprofen
pharmaceutical composition
formulation
tablet
agent
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP05850126A
Other languages
English (en)
French (fr)
Inventor
Fahkreddin Jamali
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Equitech Corp
Original Assignee
Equitech Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Equitech Corp filed Critical Equitech Corp
Publication of EP1817021A1 publication Critical patent/EP1817021A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/192—Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2009—Inorganic compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2013—Organic compounds, e.g. phospholipids, fats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2022—Organic macromolecular compounds
    • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
    • A61K9/2054—Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2022—Organic macromolecular compounds
    • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
    • A61K9/2059—Starch, including chemically or physically modified derivatives; Amylose; Amylopectin; Dextrin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • the present invention is directed to solid NSAID formulations having increased absorption in rate suppressed vagal systems.
  • One of the primary NSAIDs, (V)-2-(4-!sobuty!phenyl) propionic acid, ibuprofen is a potent and well tolerated anti-inflammatory, analgesic, and anti-pyretic compound.
  • NSAIDs non-steroidal anti-inflammatory drugs
  • ibuprofen ibuprofen, meloxicam, and ketoprofen
  • Any delay in absorption or reduction in the circulating drug concentration may result in treatment failure or in reduced activity of the analgesic.
  • ibuprofen is almost completely absorbed from the gastrointestinal tract. It is, therefore, expected that, typically, peak serum concentrations and maximal analgesic effect normally occur within 1 to 2 hours of administration.
  • vagus nerve nerv ⁇ s vagus
  • the observed reduced absorption is believed to be caused by suppression of the vagal nervous system.
  • the vagus nerve nerv ⁇ s vagus, is the 10 th cranial nerve; suppressing the activity of the vagus nerve causes reduced gastric juice secretion and motility, both of which are associated with decreased absorption of NSAIDs.
  • Sufficient fluid and a rather quick exit from stomach is needed for efficient absorption.
  • an active agent does not dissolve readily or cannot penetrate the epithelial membrane (e.g., if it is highly ionized and polar), residence time at the absorption site may be insufficient. In such cases, bioavailability tends to be highly variable as well as low.
  • the physicochemica! properties of a drug govern its absorptive potential, but the properties of the dosage form (which partly depend on its design and manufacture) can also largely determine drug bioavailability. Differences in bioavailability among formulations of a given drug can have clinical significance. Thus, the concept of equivalence among drug products is important in making clinical decisions.
  • 4,834,966 dissolve the ibuprofen formulation prior to administering the composition.
  • Other prior art formulations e.g., PCT/EP97/00841 , incorporate an alkali metal bicarbonate into the ibuprofen formulation to enhance the compressibility of the solid dosage form.
  • These formulations include ibuprofen as the active agent, the bicarbonate as a compressibility enhancer, a compressible filler, and a disintegrant (preferably croscarmellose sodium or sodium starch glycollate).
  • Alkali metal carbonates and bicarbonates are soluble materials which have previously been proposed for use in effervescent tablets, for example to react with the acid component in an effervescent couple (see for example WO 94/10994) or to prevent initiation of the effervescent reaction e.g. during storage.
  • Effervescent tablets disintegrate by means of the reaction between acid and base particularly in the presence of water leading to the production of carbon dioxide.
  • the system of disintegration of non-effervescent dosage forms according to the present invention, which are arranged to be swallowed and for which an effervescent reaction is not desired, is different to that of effervescent formulations.
  • the soluble acidic component is not intended to react with the alkali metal carbonate or bicarbonate to produce an effervescent reaction prior to administering the tablet. That is, the solid dosage form of the present invention does not need to be dissolved in water prior to taking the tablet.
  • US Patent 5,681 ,583 describes a multilayer tablet in which one layer is designed to accelerate release of active ingredients.
  • the patent discloses compounds that "can produce effervescence and disintegration". As stated in claim 1 , however, the same layer contains several other excipients that are included to facilitate dissolution and disintegration independent of the effervescent. In contrast, the present invention relies on the acid-base reaction to enhance disintegration and dissolution.
  • the '583 patent also teaches the need, in the first layer, for coating reagents. The present deals with an uncoated compressed tablet. Indeed, the coating action will be detrimental to a rapid disintegration and dissolution in the stomach of a patient under pain due to low agitation, emptying and fluid. Acute pain suppresses gastric emptying, agitation and juice.
  • lbuprofen is a relatively weak acid (pka 4.4) and has poor solubility in water: less than 1 part of drug will dissolve in 10,000 parts of water. However, it is fairly soluble in simple organic solvents, lbuprofen solubility is particularly low in acidic environment where it will have a relatively long residence time when the patient is in pain. This slows down absorption.
  • liquid formulations or faster dissolving ibuprofen salts demonstrate faster absorption and higher peak serum concentrations when given to healthy subjects.
  • NSAIDs are weak organic acids and are not ionized in the acidic environment of the stomach. Therefore, NSAIDs are able to diffuse freely into the mucosal cells. Once inside the mucosal cell, the more neutral intracellular pH causes
  • NSAIDs to ionize, resulting in a diminished ability to passively diffuse back through the mucosal cells.
  • Mucosa! cell ion trapping causes NSAIDs to accumulate, resulting in elevated intracellular concentrations and direct cellular injury.
  • the cell membranes on the stomach wall contain lipids, they offer little resistance to the lipid-soluble NSAlD.
  • the NSAID acts against the cell membrane, increasing its permeability. This results in cell swelling and death.
  • the local acid effect of NSAIDs has been reduced by enteric-coating the drug, delaying dissolution until later in the digestive process.
  • enteric-coating does little more than improve the symptoms of upset stomach.
  • ibuprofen In healthy subjects, ibuprofen is well absorbed and extensively bound to plasma proteins in vivo. It is prescribed for rheumatic arthritis and other musculoskeletal disorders, as well as acute gout. The dosage of the drug is typically from 600 to 1200 mg daily in divided doses, with 2,400. mg per day being the maximum. [0021] Ibuprofen is also indicated for use in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, seronegative arthropathies, periarticular disorders and soft tissue injuries.
  • Ibuprofen may also be used in the treatment of postoperative pain, postpartum pain, dental pain, dysmenorrhoea, headache, musculoskeletal pain or the pain or discomfort associated with the following: respiratory infections, colds or influenza, gout or morning stiffness.
  • a critical factor relating to the use of ibuprofen to treat the above disorders concerns, as noted above, improving the onset of action of ibuprofen, particularly in the treatment of pain. This issue partially concerns improving the amount and speed of achieving a certain blood. serum level of ibuprofen. It is believed that ideally a rapid disintegration of a formulation, beginning in the mouth, but primarily in the stomach in which 100% of the formulation is disintegrated results in the release the drug into the body more quickly, thereby leading to a more rapid onset of therapeutic action, as compared with a standard dosage form or with dosage forms calibrated against healthy individuals. Accordingly, it is desired to produce a solid dosage form for oral administration adapted to disintegrate quickly in the gastro-intestinal tract. It is also preferred that the dosage form is manufactured by compression on standard tabletting machines.
  • the composition contains an NSAID, preferably ibuprofen (hereinafter referred to as IB); a disintegration and dissolution agent, such as a bicarbonate, preferably sodium bicarbonate; tartaric acid as an additional excipient; and neusilin as a matrix.
  • IB ibuprofen
  • the composition may optionally also include starch.
  • the bicarbonate is a disintegrator or disintegrating agent that increases the solubility of the NSAID.
  • One of the important effects of sodium bicarbonate ingestion is that the acid-base reaction takes place in the stomach. This results is production of carbon dioxide in a bubbling fashion. This motion results in rapid disintegration of the formulation and the rapid drug dissolution in aqueous environments.
  • the acid-base reaction results in the break down of the formulation integrity and exposes the contained maize to water. This results a bursting effect that further accelerates disintegration and dissolution of the drug therein.
  • the bicarbonate increases solubility by promoting the formation of sodium ibuprofen, a salt that is readily converted to ibuprofen; ibuprofen precipitates under gastric conditions, so the anti-precipitation agent prevents precipitation by increasing the solubility of the ibuprofen in the gastric environment. This is achieved by addition of solubilizing agents such as Neusilin.
  • compositions and methods of the present invention achieve chemically what happens biologically when NSAIDS are administered and absorbed in healthy subjects.
  • the stomach has a certain amount of movement or motility, as well as gastric juice that contribute to a tablet disintegrating into particles, and then dissolving into molecules.
  • compositions and methods of the present invention provide a formulation whereby the solid dosage form provides it own movement through the acid- base reaction and is disintegrated in the stomach at a faster rate, it subsequently presents itself in the stomach as a soluble salt of ibuprofen leading in part to quicker absorption, thereby, faster onset of action.
  • ⁇ mg « [0030]
  • a vagally suppressed human i.e., a human in pain
  • both the motility and gastric juice extraction are reduced.
  • stomach emptying and gastrointestinal transit time are delayed. These conditions result in delayed absorption.
  • the present invention accelerates the time line of disintegration into particle form by chemically mimicking the agitation provided by the motility function, by initiating the disintegration from tablet form into particles as soon as the tablet is exposed to a very limited amount of fluid.
  • the incorporated bicarbonate starts reacting with acids. The result is breaking down of the larger solid particles, enhancing solubility, and providing a greater amount of active agent earlier in the process, thereby accelerating the absorption rate, and thereby providing more relief, faster.
  • compositions and methods of the present invention achieve this result by surrounding, capturing, or formulating active agent particles, such as ibuprofen, in a matrix or the like of a metasiiicate, such as Neusilin.
  • the composition may further include a disintegrating agent that, upon exposure to an aqueous environment, promotes the break-up of the tablet into smaller particles of active agent, thereby increasing the availability of the active agent for absorption.
  • the solid dosage forms according to the invention are adapted for direct administration to a patient to obtain the desired therapeutic effect. They are not intended to be dissolved or dispersed in water prior to administration.
  • the compressed dosage forms according to the present invention need no further processing, e.g. coating, after compression of a composition comprising a mixture of the ingredients to produce a solid dosage form.
  • Figure 5 shows the mean incremental area under the curve (AUC) for R- ibuprofen in plasma concentrations following administration of either a formula of the present invention or Motrin.
  • Figure 6 shows the mean incremental area under the curve (AUC) for total ibuprofen in plasma concentrations following administration of either a formula of the present invention or Motrin.
  • Figure 7 shows the mean cumulative (incremental) AUC of ibuprofen (o-1 h) following administration of the formula (open bars) or Motrin (closed bars) to patients after dental surgery.
  • Figure 8. shows the mean cumulative (incremental) AUC of ibuprofen (0-6 h) following administration of the formula (open bars) or Motrin (closed bars) to patients after dental surgery.
  • Figure 9 shows the man pain intensity score (PIS) over time using a categorical pain intensity scale for patients after dental surgery following administering either the formula or Motrin. There was no statistically significant differences between the two products due to the small number of subjects tested. However, there was consistent trend for greater PlS for Motrin IB.
  • Figure 10 shows the mean pain intensity difference (PID) between the two products over time using a visual analogue scale (VAS) after dental surgery following administering either ZAG-1701 or Motrin.
  • PID mean pain intensity difference
  • VAS visual analogue scale
  • Figure 11 shows the percent of patients who recorded meaningful relief following a dose of either Motrin or ZAG-1701.
  • Figure 12 shows the comparative dissolution profiles among lbuprofen alone; ibuprofen and sodium bicarbonate; and ibuprofen, sodium bicarbonate, and Gelucire®.
  • the present invention is a method of treating pain and/or inflammation comprising administering a solid dosage formulation comprising an active agent in a matrix, and a first and second disintegrant; wherein said active agent is an NSAID; wherein said matrix is a metasilicate, wherein the first disintegrant comprises sodium bicarbonate; and wherein said second disintegrant comprises tartaric acid.
  • the present invention is also a method of treating pain and or inflammation by administering a solid dosage formulation having a fast onset of action, wherein the solid dosage formulation comprises a formulation of the present invention.
  • the present invention is also a method of increasing the onset of action of a solid formulation, e.g., a tablet, comprising blending tartaric acid and a diluent to form a first blend; adding at least one diluent and a binder to said first blend to form a second blend; blending an active agent and a metasilicate matrix to form a third blend; adding sodium bicarbonate to said third blend to form a fourth blend; and compressing said fourth blend into a tablet.
  • a solid formulation e.g., a tablet
  • the present invention is a composition containing an NSAlD as an active agent, said composition having increased absorption and onset of action in vagally suppressed systems.
  • the composition comprises an NSAID and a disintegration and dissolution agent, such as a bicarbonate, in a matrix or carrier, such as a metasilicate.
  • the preferred NSAID is ibuprofen.
  • the composition may further include an anti- precipitation agent e.g. Gelucire®.
  • the composition may further include tartaric acid as an additional disintegrating agent.
  • a porous carrier include, for instance, aluminum magnesium metasilicate (available from Fuji Chemical Industry Co., Ltd.; Trade-name: NEUSILIN).
  • the present invention is also a composition comprising ibuprofen on a matrix comprising a metasilicate, and a disintegration and dissolution agent, such as a bicarbonate.
  • the invention also includes a method of treating inflammation or alleviating pain comprising administering a composition as described in this paragraph.
  • the present invention is also a composition comprising ibuprofen and a matrix comprising a metasilicate, a disintegration and dissolution agent, such as a bicarbonate.
  • Such a composition is characterized by having earlier onset of action and increased absorption of the active agent, as compared to other compositions when the comparison assesses the absorption of the active agent under pain conditions.
  • the invention also includes a method of treating inflammation or alleviating pain comprising administering a composition as described in this paragraph.
  • the present invention is also any of the above compositions, further comprising one or more lubricating agents, one or ore binders, one or more additional disintegrating agents, one or more flow aids, one or more preservatives, and/or one or more colorants and/or flavorants.
  • the present invention is also a method for increasing the absorption of an
  • NSAID-containing composition said method comprising providing a composition, such as one of the compositions described above, whose ingredients are specifically formulated to increase absorption under pain conditions, i.e., in a vagally suppressed system.
  • the present invention is also a method of treating acute pain in humans comprising administering a composition according to the present invention.
  • the present invention provides a method of treating inflammation, pain and pyrexia by administration of a pharmaceutical composition comprising racemic ibuprofen, together with a pharmaceutically acceptable carrier to a mammal, e.g. a human, in need thereof.
  • a pharmaceutical composition comprising racemic ibuprofen, together with a pharmaceutically acceptable carrier to a mammal, e.g. a human, in need thereof.
  • the ibuprofen is present in one or more of its well known forms, namely, ibuprofen, its S(+) and R(-) enantiomers, including different enantiomeric ratios thereof, salts, hydrates, and other derivatives.
  • the preferred form is a dihydrate.
  • the most preferred form is the acid form.
  • the ibuprofen may be also present in the form of any salt or other derivative of ibuprofen or its enantiomers. If necessary, the ibuprofen may comprise one or more ibuprofen active ingredients such as racemic ibuprofen and S(+)-ibuprofen in combination. However, we prefer that the ibuprofen comprises a single ibuprofen active ingredient.
  • the ibuprofen active agent may also be present in different degrees of hydration. The present invention applies to both anhydrous and hydrated forms, for example the monohydrate or the dihydrate. The most stable anhydrous or hydrated form will generally be used.
  • the ibuprofen is in the form of a salt of racemic or S(+)-ibuprofen.
  • Representative examples include alkali metal salts, for example the sodium or potassium salts of ibuprofen; alkaline earth metal salts, e.g. the calcium or magnesium salts of ibuprofen; metal salts, e.g. the aluminum salt of ibuprofen; amino acid salts for example the lysine or arginine salts of ibuprofen: or amine salts, e.g. the meglumine salt of ibuprofen.
  • the ibuprofen is a single salt selected from alkali metal salts, amino acid salts and amine salts.
  • soluble ibuprofen salts also have the advantage that, as they are more soluble in an aqueous medium, on release from the formulation they have improved absorption, thus leading to an improved onset of action compared to the substantially insoluble forms of ibuprofen.
  • the sodium salt of ibuprofen is particularly preferred, especially the sodium salt of racemic ibuprofen. It has been found that the dihydrate of the sodium salt of racemic ibuprofen is a particularly stable hydrated form, accordingly we prefer to use the sodium salt dihydrate in a compressed dosage form according to the present invention.
  • compositions and methods of the present invention are particularly suited to forming non-aqueous granulations and to solid dosage formulations, preferably dosage formulations that are non-effervescent prior to administration or prior to in vivo delivery.
  • one or more of the disintegrants burst the tablet or caplet apart in the stomach, thereby presenting a greater amount of active agent.
  • the present invention further relates to tablets and granules, formulated in accordance with the present invention, that are fast dissolving and fast acting.
  • the granulation and tabletting composition also includes normal excipients useful for the preparation of tablets.
  • the present invention is also a composition and method of treatment comprising an NSAID as an active agent, blended with a metasilicate matrix and a bicarbonate as a disintegrating agent.
  • the composition may further comprise one or more of the following: one or more disintegrating agents, preferably sodium bicarbonate and/or tartaric acid; one or more diluents or fillers; one or more binders or adhesives; one or more additional disintegrating agents; one or more lubricating agents; one or more preservatives, preferably propyl gallate; and one or more miscellaneous adjuncts, such as colorants and/or flavorants, any of said adjuncts being well known to those skilled in the art.
  • one or more disintegrating agents preferably sodium bicarbonate and/or tartaric acid
  • one or more diluents or fillers one or more binders or adhesives
  • additional disintegrating agents one or more lubricating agents
  • preservatives preferably propyl gallate
  • miscellaneous adjuncts such as color
  • any number of pharmaceutically active agents may be employed in the formulations of the present invention. These active agents may exist as either solids or liquids at standard temperature and pressure. Exemplary pharmaceutically active agents suitable for use herein include, but are not limited to, the non-steroidal anti ⁇ inflammatory agents such as piroxicam, indomethacin, fenoprofen, meloxicam, and ibuprofen. In a preferred embodiment of the invention, the composition and method includes ibuprofen as the active agent.
  • compositions of the invention may include about 15 to about 99% by weight of an active agent, such as ibuprofen, preferably up to about 80% by weight, more preferably from about 15% to about 70% by weight; about 10% to about 60% by weight of a first disintegrant, such as a bicarbonate, preferably between about 12% and 30%, and more preferably between about 12% and 20%.
  • an active agent such as ibuprofen
  • a first disintegrant such as a bicarbonate
  • compositions of the present invention may include up to about 30% by weight of a second disintegrant, such as tartaric acid, preferably up to about 15%, more preferably between about 1% and about 10%.
  • a second disintegrant such as tartaric acid
  • compositions of the present invention may include up to about 30% by weight of a matrix, such as a metasilicate, preferably up to about 2%, more preferably between about 1% and about 15%.
  • a matrix such as a metasilicate
  • compositions of the present invention may include up to about 80% by weight of one or more diluents, such as microcrystalline cellulose and sodium starch glycolate, preferably up to about 40%, more preferably between about 5% and about 20%.
  • diluents such as microcrystalline cellulose and sodium starch glycolate
  • compositions of the invention are generally prepared in unit dosage form.
  • the unit dosage of ibuprofen is in the range of 5-1200 mg in a pre-calculated amount to provide doses which are equivalent by weight to doses of for example 100 mg, 200 mg, 400 mg or 800 mg of ibuprofen.
  • the amount of an NSAlD substance in a quick release, sustained release, or modified release composition according to the invention may be selected so that is corresponds to about 1 mg, 2 mg, 3 mg, 4 mg, 5 mg, 8 mg, 10 mg, 12 mg, 16 mg, 20 mg, 24 mg, 25 mg, 30 mg, 32 mg, 50 mg, 60 mg,
  • NSAlD substance 100 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600 mg, 700 mg, 800 mg, 900 mg, 1 g, 1.1 g, 1.2 g, 1.3 g or 1.6 g of NSAlD substance which are dosages generally known in the art.
  • the preferred dosage form according to the invention is in the form of a capsule, tablet, sachet etc.
  • the size of the dosage form may be adapted to the amount of the active drug substance contained in the composition.
  • the bicarbonate is preferably an alkali metal carbonate, more preferably any bicarbonate salt that is pharmaceutically acceptable, preferably sodium or potassium bicarbonate.
  • the alkali metal carbonates may be supplied anhydrous or in varying degrees of hydration, e.g., the monohydrate and decahydrate. Any of these forms may be used.
  • compositions of the present invention may be administered orally, rectally, or topically, preferably orally or topically.
  • the preferred mode of administration is orally, i.e. as a solid tablet easily dissolved in the gastric environment.
  • the therapeutic compositions of the present invention may take the form of any of the known pharmaceutical compositions for oral, rectal, or topical administration.
  • compositions for oral administration are preferred compositions of the invention and there are known pharmaceutical forms for such administration, for example tablets, caplets, and capsules.
  • the identity of the components and amounts thereof refer to the weight and identity of the starting materials used in preparing the composition. It is possible that during preparation of the composition and/or tablets, some interaction or reaction may occur between two or more components. To the extent that such interaction or reaction occurs the present invention is intended to cover such occurrences.
  • Normal excipients useful in the preparation of the tablets include, but are not limited to: lubricants such as magnesium stearate, sodium stearyl fumarate and sodium benzoate; anti-adherents such as talc and polyethylenglycol; glidants such as colloidal silica; diluents such as dicalcium phosphate, cellulose (for example microcrystalline cellulose) and its derivatives, carbohydrates and polyalcohols such as saccharose, xylitol and lactose; disintegrants such as crosslinked vinylic polymers (such as crosslinked PVP), derivatives of starch and of cellulose such as sodium carboxymethyl-starch and sodium croscarmelose; wetting agents such as TWEEN 80 (Trademark registered by ICI of Americas for polysorbate) and sodium lauryl sulphate.
  • lubricants such as magnesium stearate, sodium stearyl fumarate and sodium benzoate
  • anti-adherents such as
  • excipients and their amounts can be readily determined by those of ordinary skill in the art according to the methods normally used in pharmaceutical technology. However, in the present invention, it is important to avoid excipients that would cause a significant decrease in tablet dissolution rate. [0064] Further, excipients should allow a good workability of the tablet. In preparing the tablet of the present invention, simple mixing may be sufficient. One skilled in the art will readily recognize that a number of mixing and tabletting protocols may be used. For example, it may be desirable to prepare an IB granulate, to mix it with the bicarbonate and the excipients, and then to compress.
  • An exemplary method of preparing a composition of the present invention comprises dissolving ibuprofen in an alkaline solution; mix with neusilin; change the pH (e.g., by adding glacier acid) so that the ibuprofen re-crystallizes; and remove the solution.
  • the ibuprofen is thereby loaded on the neusilin matrix. It should then be dried, e.g., overnight.
  • Other processes that lead to a workable tablet are shown in the Examples.
  • the diluent includes lactose, calcium phosphate, dextrin, microcrystalline cellulose, sucrose, starch, calcium sulphate, sodium bicarbonate, or mixtures thereof.
  • the lubricating agent includes magnesium stearate, stearic acid, calcium stearate, sodium bicarbonate, or mixtures thereof. More preferably the lubricating agent is magnesium stearate or stearic acid.
  • the disintegrating agent includes microcrystalline cellulose, maize starch, sodium starch glycolate, low substituted hydroxypropyl cellulose, alginic acid or croscarmelose sodium, sodium bicarbonate, or mixtures thereof.
  • the binder includes polyvinyl pyrrolidone, gelatin, Gelucire®, hydroxypropylmethyl cellulose, starch, or mixtures thereof.
  • Suitable flow aids include, but are not limited to talc and colloidal silicon dioxide.
  • compositions of the present invention may additionally comprise a taste masking component for example a sweetener, a flavoring agent, arginine, sodium carbonate or sodium bicarbonate.
  • a taste masking component for example a sweetener, a flavoring agent, arginine, sodium carbonate or sodium bicarbonate.
  • Solid non-effervescent compositions are preferred compositions of the present invention.
  • the preferred compositions are preferably formed into a tablet.
  • disintigarion occurs in stomach through the acid/base reaction.
  • the NSAID such as ibuprofen
  • the NSAID may, if desired, be associated with other compatible pharmacologically active ingredients and/or enhancing agents.
  • ibuprofen may be combined with any ingredient commonly used in a cough or cold remedy, for example, an antihistamine, caffeine or another xanthine derivative, a cough suppressant, a decongestant, an expectorant, a muscle relaxant, or combinations thereof.
  • exemplary compatible pharmacologically active ingredients include, but are not limited to codeine, oxycodone, hydrocodone, and/or hydromorphone.
  • Suitable antihistamines which are preferably non-sedating include acrivastine, astemizole, azatadine, azelast/ne, bromodiphenhyrdramine,. brompheniramine, carbinoxamine, cetirizine, chlorpheniramine, cyproheptadine, dexbrompheniramine, dexchlorpheniramine, diphenhydramine, ebastine, ketotifen, lodoxamide, loratidine, levocubastine, mequitazine, oxatomide, phenindamine, phenyltoloxamine, pyrilamine, setastine, tazifyiline, warmthlastine, terfenadine, tripelennamine or triprolidine.
  • Suitable cough suppressants include caramiphen, codeine or dextromethorphan.
  • Suitable decongestants include pseudoephedrine, phenylpropanolamine and phenylephrine.
  • Suitable expectorants include guaifensin, potassium citrate, potassium guaiacolsulphonate, potassium sulphate and terpin hydrate.
  • the disintegration time of the tablet formed in accordance with the present invention is less than 30 minutes as measured by the method described in the European Pharmacopoeia 1986, Ref V .5.1.1 (updated 1995) (A. Disintegration Test for Tablets and Capsules). Preferred disintegration times are less than 6 minutes (e.g. 1-10 minutes), more preferably less than 5 minutes (e.g. 1-5 minutes) and most preferably 3 minutes or less (e.g. 1-3 minutes). Consequently the release is faster with respect to the commercially available ibuprofen based analgesic tablets (see the examples below).
  • the tablet size is between 100-700 mg preferably between 400-600 mg (in the Examples, the typical size of a tablet of the present invention is 570 mg) for a tablet containing 200 mg racemic IB. Considering the need for acid/base reaction, this size tablet is favorable due to the ease of swallowing.
  • a diluent or filler is used in its conventional pharmacological definition, and refers to an ingredient that adds necessary bulk to a formulation to prepare tablets of a desired size.
  • a binder or adhesive is used in its conventional pharmacological definition, and refers to an ingredient that promotes the adhesion of the particles of the formulation.
  • a disintegrator or disintegrating agent is used in its conventional pharmacological definition, and refers to an ingredient that promotes the post-administration break-up of the tablets into smaller particles for more ready drug availability.
  • a lubricant or lubricating agent is used in its conventional pharmacological definition, and refers to an ingredient that enhances the flow of the tabletting material into the tablet dies, and prevents the tabletting material from sticking to punches and dies.
  • enhanced absorption or similar terms and phrases relating to the relative speed, rate, and/or quantity of the bioavailability of the active agent is measured in reference to the standard in the industry, Motrin.
  • the compositions of the present invention provide, to a patient in pain, a greater concentration of active agent faster, as compared to the bioavailability curve for Motrin. For example, see Figures 1- 3.
  • enhanced absorption may be determined or quantified by using the area under the curve (AUC).
  • AUC area under the curve
  • the extent and rate of absorption, as represented by the AUC, for the formulations of the present invention delivers a greater amount of active agent in a shorter time frame as compared to Motrin.
  • it is important to determine enhanced absorption of a particular composition as it applies to a patient in pain, or data obtained from a patient or subject in pain.
  • the dosage forms of the present invention are administered orally, thus the therapeutic dosage forms are presented in solid dosage form, preferably as a tablet.
  • the dosage forms may be coated with a sugar or film coating, which dissolves substantially immediately the dosage form comes into contact with an aqueous medium.
  • the composition may also be compressed onto a solid core of another material to form a solid formulation with a quick release outer coating.
  • the compressed composition may be present in one or more layers of a multi-layer solid dosage form.
  • the remaining layers or core may comprise standard excipients to provide conventional, fast or slow release and are well within the knowledge of a person skilled in the art (e.g., see Remington's Pharmaceutical Sciences, 17th Edition, Ed Gennaro et al; or Ansel's "Introduction to Pharmaceutical Dosage Forms", 2 nd edition, Henry Kimpton Publishers).
  • a tablet or caplet of the present invention functions as follows: after swallowing a caplet with a glass of water, the sodium bicarbonate reacts with tartaric acid and ibuprofen in the stomach. This appears to provide stomach agitation or movement that breaks the caplet into finer pieces and solubilizes the ingredients. A weak resultant solution of sodium ibuprofen may be formed, which may eventually react with stomach acid resulting in its conversion to crystallized ibuprofen. To prevent crystallization and precipitation, Neusilin acts as a solubilizer due to its lingering alkaline nature.
  • the purpose of this experiment is to produce tablets that disintegrate in 15-30 min with no external agitation.
  • Example 15 Formulation having improved dissolution rate and absorption of ibuprofen.
  • the solid dispersion and physical mixture of ibuprofen was tested for dissolution rate and improved rate of bioavailability.
  • the influence of the carrier and two other excipients (sodium bicarbonate and tartaric acid) in solid dispersion and the physical mixture as they affect drug dissolution behavior were also studied.
  • Gelucire® 44/14, sodium bicarbonate, tartaric acid, and ibuprofen were made into a physical mixture and solid dispersion.
  • the solid dispersion was prepared by the fusion method at 60 0 C, then cooled, then ground into granules of suitable size, then compressed as a tablet.
  • solid dispersion and physical mixture formulations were compared with a marketed product in healthy and treated rats (an animal model for pain; see PCT/IB02/01139, incorporated herein by reference) in terms of rapid absorption and early exposure of the ibuprofen to the systemic circulation.
  • Example 16 Formulation with tartaric acid.
  • a composition was formed using ibuprofen (1 mole), sodium bicarbonate (1.8 mole), tartaric acid (0.2 mole), and Gelucire® 44/14 (5% of total mass).
  • Gelucire® was weighed and dissolved in a small amount of isopropyl alcohol. The remaining ingredients were mixed together, then mixed with the Gelucire® solution to produce a fluffy paste. Using a sieve (mesh 20), granules with the size of 841 mm were produced. The granules were dried overnight at room temperature, then used to produce tablets using a single punch compressing machine with 500 kg (punch id no. 3/16N) of compressing pressure. It is preferred that the compression force should be minimal.
  • the formulation in this example may also include starch, and a portion of the sodium bicarbonate may optionally be used as a lubricant.
  • the Gelucire® dissolved in the isopropyl alcohol may be sprayed over the remaining mixture of ingredients.
  • the objective of this trial was to compare the rate of absorption on ibuprofen administered as ZAG 1701 (the present invention) with a commercially available product (Motrin IB). This study was conducted in patients after dental surgery, a FDA accepted test of analgesia.
  • Pharmacokinetic parameters were calculated using the actual, rather than the scheduled, times of sample collection. Graphical presentations of individual subject results also used the actual times of sample collection. Graphical presentations of mean results used the scheduled times. Pharmacokinetic analyses were conducted on the concentrations of R-ibuprofen, S-ibuprofen and total ibuprofen (sum of R-ibuprofen and S- ibuprofen). See Figure 3.
  • Peak concentration (Cmax) was the observed maximum value during the collection period of 0 (baseline) to 6 hours.
  • the time to peak concentration (Tmax) was the time at which Cmax was observed (or first observed, if the peak value occurred at more than one time).
  • the apparent first-order elimination rate constant (Ke) was estimated as the negative value of the slope of the regression line for the terminal log-linear concentration-time values. A minimum of three terminal values was required to obtain an estimate.
  • the values included in the regression analyses were determined by examination of the individual subject plots of natural logarithm of concentration against time. Whenever the terminal concentration-time values were not log-linear or the estimated rate would have been physiologically implausible (Ke ⁇ 0.01), no elimination rate was estimated. Elimination half-life (TY ⁇ ) was estimated as Iog e (2)/Ke.
  • Areas under the curve were calculated from time 0 to the scheduled time of each sample collection through the 6-hour collection sample. Area under the curve was calculated by the linear trapezoidal method. Area to infinite time (AUCinf) was calculated by extrapolating AUC 0-6, by the addition of the quantity: Ce / Ke, where Ce is the concentration at the 6-hour collection time. Area to infinity could only be calculated when an elimination rate constant had been estimated.
  • the intra-subject coefficient of variation was estimated from the mean square error term (MSE) of the In-transformed (log e ) results as:
  • Table 2 summarizes the statistical analyses comparing 200 mg ZAG- 1701 caplets to 200 mg Motrin IB ® caplets with regard to incremental areas under the curve and time to peak. Incremental areas from time 0 to the time of the early sample collections are known to reflect the rate of drug absorption. Time of peak concentration is a direct function of this rate. ZAG-1701 caplets had statistically significantly (p ⁇ 0.05) greater mean (up to 2.8 fold) incremental areas under the curve than Motrin IB ® through the first hour post-dose. This was true for R- ibuprofen, S-ibuprofen and Total ibuprofen. The mean time of peak for [ZAG-1701] was less than 60% that of Motrin IB ® . These results indicate that the rate of ibuprofen absorption for [ZAG-1701] is faster than that for Motrin IB ® .
  • Figures 1 and 2 show that during the first hour post-dose, when analgesics are most needed, the formula provides a significantly greater concentration of the drug into the blood stream thereby to the site of action.
  • S-ibuprofen is the pharmacologically active enanitomer of racemic ibuprofen.
  • R-ibuprofen converts S-ibuprofen once in the body.
  • Figure 4-6 show that the extent of absorption is significantly greater following administration of the formula as compared with Motrin IB during the first hour post-dose when the analgesic effect is most needed.
  • Figure 7 shows that there are significant differences between the two products were noticed during the first 60 minutes following a complaint of pain.
  • the rate of ibuprofen absorption from ZAG-1701 is significantly faster than that for Motrin IB ® .
  • the incremental extent of absorption of ibuprofen was up to 2.8 fold greater from ZAG-1701 as compared with Motrin.
  • ZAG-1701 and Motrin IB ® have comparable total ibuprofen absorption.
  • Example 20 Analytical Methods for Drug Product Two analytical testing procedures, Dissolution Assay of lbuprofen Release in ZAG-1701 Tablets, and ADetermination of lbuprofen and Impurities in lbuprofen Drug Product by HPLC® are summarized below.
  • 1% chioroacetate buffer solution (pH 3.0): Dissolve 10.0 g chioroacetic acid in 1000 ml of dionized water. Adjust the pH to 3.0 with ammonium hydroxide solution.
  • Mobile phase Combine 400 mL of 1 % chioroactetate buffer (pH and 600 mL of acetonitrile and mix well. Filter the solution through 0.45 ⁇ m Nylon membrane filter and degas before use, Diluent (0.2% chioroacetate buffer, pH Acetonitrile, 40/60 v/v): Dissolve 20.0 g of chioracetic acid in 1000 mL of deionized water. Adjust the pH to 3.0 with ammonium hydroxide solution. Mix 400 ml of 02% chioroactate buffer with 600 mL of CAN.
  • Standard Solution Preparation lbuprofen working Standard (4 mg/mL): Accurately weigh approximately 100 mg of lbuprofen reference standard, and transfer into a 25 mL volumetric flask. Dissolve in approximately 15 mL of the diluent with shaking, dilute to volume with diluent and mix well.
  • Resolution Solution Preparation lsobutylacetophenone stock solution (0.20 mg/mL): Weigh approximately 20 mg of 4- lsobutylacetophenone reference standard, and transfer into a 100 mL volumetric flask. Dissolve in approximately 80 mL of acetonitrile with shaking, dilute to volume with acetonitrile and mix well
  • Resolution standard solution Weigh approximately 100 mg of ibuprofen reference standard into a 25 mL volumetric flask. Pipette 1 ,0 mL of 4- lsobutylacetophenone stock standard solution into the 25 mL volumetric flask. Add approximately 15 mL of the diluent into the flask and shake until the standard is completely dissolved. Dilute to volume with the djluent and mix.
  • Potency and Related Substances Accurately weigh 10 intact tablets and record the tablets weight. Transfer the 10 tablets into a 500 mL volumetric flask. Add approximately 350 mL of the diluent into the flask and shake mechanically for 30 minutes. Sonicate the mixture for 30 minutes with occasional shaking. Allow to cool to room temperature. Dilute to volume with the diluent and mix well. Centrifuge a portion of the resulting solution at about 3500 rpm for 10 minutes.
  • Blend Uniformity Accurately weigh and record the weight of the container with in process blend. This is gross weight. Depending on the weight of contents, transfer the entire contents into an appropriate volumetric flask. Add appropriate diluent in each volume flask, and shake mechanically for 30 minutes. Sonicate the mixture for 30 minutes with occasional shaking. Allow cooling to room temperature. Dilute to volume with the diluent and mix well. Centrifuge a portion of the resulting solution at about 3500 rpm for 10 minutes.
  • Dissolution medium 1 % SDS in deionized water

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