CA2682872A1 - Rapid dissolution of combination products - Google Patents
Rapid dissolution of combination products Download PDFInfo
- Publication number
- CA2682872A1 CA2682872A1 CA002682872A CA2682872A CA2682872A1 CA 2682872 A1 CA2682872 A1 CA 2682872A1 CA 002682872 A CA002682872 A CA 002682872A CA 2682872 A CA2682872 A CA 2682872A CA 2682872 A1 CA2682872 A1 CA 2682872A1
- Authority
- CA
- Canada
- Prior art keywords
- dosage form
- oral dosage
- triptan
- nsaid
- bicarbonate
- 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.)
- Abandoned
Links
- 238000004090 dissolution Methods 0.000 title claims description 37
- 239000000041 non-steroidal anti-inflammatory agent Substances 0.000 claims abstract description 72
- 229940021182 non-steroidal anti-inflammatory drug Drugs 0.000 claims abstract description 72
- 239000006186 oral dosage form Substances 0.000 claims abstract description 59
- 238000000034 method Methods 0.000 claims abstract description 22
- ZISSAWUMDACLOM-UHFFFAOYSA-N triptane Chemical compound CC(C)C(C)(C)C ZISSAWUMDACLOM-UHFFFAOYSA-N 0.000 claims description 142
- 239000000203 mixture Substances 0.000 claims description 89
- KQKPFRSPSRPDEB-UHFFFAOYSA-N sumatriptan Chemical compound CNS(=O)(=O)CC1=CC=C2NC=C(CCN(C)C)C2=C1 KQKPFRSPSRPDEB-UHFFFAOYSA-N 0.000 claims description 70
- 229960003708 sumatriptan Drugs 0.000 claims description 49
- CMWTZPSULFXXJA-UHFFFAOYSA-N Naproxen Natural products C1=C(C(C)C(O)=O)C=CC2=CC(OC)=CC=C21 CMWTZPSULFXXJA-UHFFFAOYSA-N 0.000 claims description 47
- 229960002009 naproxen Drugs 0.000 claims description 47
- CMWTZPSULFXXJA-VIFPVBQESA-N naproxen Chemical compound C1=C([C@H](C)C(O)=O)C=CC2=CC(OC)=CC=C21 CMWTZPSULFXXJA-VIFPVBQESA-N 0.000 claims description 46
- 239000008187 granular material Substances 0.000 claims description 35
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 claims description 29
- 239000002245 particle Substances 0.000 claims description 26
- BVKZGUZCCUSVTD-UHFFFAOYSA-M Bicarbonate Chemical compound OC([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-M 0.000 claims description 22
- WHNWPMSKXPGLAX-UHFFFAOYSA-N N-Vinyl-2-pyrrolidone Chemical group C=CN1CCCC1=O WHNWPMSKXPGLAX-UHFFFAOYSA-N 0.000 claims description 18
- 239000000654 additive Substances 0.000 claims description 18
- 229960000913 crospovidone Drugs 0.000 claims description 18
- 229920000523 polyvinylpolypyrrolidone Polymers 0.000 claims description 18
- 239000000546 pharmaceutical excipient Substances 0.000 claims description 17
- 235000013809 polyvinylpolypyrrolidone Nutrition 0.000 claims description 16
- 229910000030 sodium bicarbonate Inorganic materials 0.000 claims description 16
- BVKZGUZCCUSVTD-UHFFFAOYSA-L Carbonate Chemical compound [O-]C([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-L 0.000 claims description 14
- 229920002785 Croscarmellose sodium Polymers 0.000 claims description 14
- 239000002253 acid Substances 0.000 claims description 13
- 235000017557 sodium bicarbonate Nutrition 0.000 claims description 13
- 230000000996 additive effect Effects 0.000 claims description 12
- DPXJVFZANSGRMM-UHFFFAOYSA-N acetic acid;2,3,4,5,6-pentahydroxyhexanal;sodium Chemical group [Na].CC(O)=O.OCC(O)C(O)C(O)C(O)C=O DPXJVFZANSGRMM-UHFFFAOYSA-N 0.000 claims description 10
- 229960001681 croscarmellose sodium Drugs 0.000 claims description 10
- 235000010947 crosslinked sodium carboxy methyl cellulose Nutrition 0.000 claims description 10
- 239000002552 dosage form Substances 0.000 claims description 10
- KRKNYBCHXYNGOX-UHFFFAOYSA-N citric acid Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O KRKNYBCHXYNGOX-UHFFFAOYSA-N 0.000 claims description 9
- WPYMKLBDIGXBTP-UHFFFAOYSA-N benzoic acid Chemical compound OC(=O)C1=CC=CC=C1 WPYMKLBDIGXBTP-UHFFFAOYSA-N 0.000 claims description 8
- 239000011975 tartaric acid Substances 0.000 claims description 8
- NOOLISFMXDJSKH-UTLUCORTSA-N (+)-Neomenthol Chemical compound CC(C)[C@@H]1CC[C@@H](C)C[C@@H]1O NOOLISFMXDJSKH-UTLUCORTSA-N 0.000 claims description 7
- NOOLISFMXDJSKH-UHFFFAOYSA-N DL-menthol Natural products CC(C)C1CCC(C)CC1O NOOLISFMXDJSKH-UHFFFAOYSA-N 0.000 claims description 7
- 239000002671 adjuvant Substances 0.000 claims description 7
- 229940041616 menthol Drugs 0.000 claims description 7
- 206010027599 migraine Diseases 0.000 claims description 7
- CIWBSHSKHKDKBQ-JLAZNSOCSA-N Ascorbic acid Chemical compound OC[C@H](O)[C@H]1OC(=O)C(O)=C1O CIWBSHSKHKDKBQ-JLAZNSOCSA-N 0.000 claims description 6
- FEWJPZIEWOKRBE-UHFFFAOYSA-N Tartaric acid Natural products [H+].[H+].[O-]C(=O)C(O)C(O)C([O-])=O FEWJPZIEWOKRBE-UHFFFAOYSA-N 0.000 claims description 6
- 235000002906 tartaric acid Nutrition 0.000 claims description 6
- DSSYKIVIOFKYAU-XCBNKYQSSA-N (R)-camphor Chemical group C1C[C@@]2(C)C(=O)C[C@@H]1C2(C)C DSSYKIVIOFKYAU-XCBNKYQSSA-N 0.000 claims description 5
- 241000723346 Cinnamomum camphora Species 0.000 claims description 5
- FEWJPZIEWOKRBE-JCYAYHJZSA-N Dextrotartaric acid Chemical compound OC(=O)[C@H](O)[C@@H](O)C(O)=O FEWJPZIEWOKRBE-JCYAYHJZSA-N 0.000 claims description 5
- 229930008380 camphor Natural products 0.000 claims description 5
- 229960000846 camphor Drugs 0.000 claims description 5
- -1 tetramethylene tetramine Chemical compound 0.000 claims description 5
- ATRRKUHOCOJYRX-UHFFFAOYSA-N Ammonium bicarbonate Chemical group [NH4+].OC([O-])=O ATRRKUHOCOJYRX-UHFFFAOYSA-N 0.000 claims description 4
- 229910000013 Ammonium bicarbonate Inorganic materials 0.000 claims description 4
- 239000005711 Benzoic acid Substances 0.000 claims description 4
- VZCYOOQTPOCHFL-OWOJBTEDSA-N Fumaric acid Chemical compound OC(=O)\C=C\C(O)=O VZCYOOQTPOCHFL-OWOJBTEDSA-N 0.000 claims description 4
- UFWIBTONFRDIAS-UHFFFAOYSA-N Naphthalene Chemical compound C1=CC=CC2=CC=CC=C21 UFWIBTONFRDIAS-UHFFFAOYSA-N 0.000 claims description 4
- 235000012538 ammonium bicarbonate Nutrition 0.000 claims description 4
- 239000001099 ammonium carbonate Substances 0.000 claims description 4
- 235000010233 benzoic acid Nutrition 0.000 claims description 4
- XBDQKXXYIPTUBI-UHFFFAOYSA-N dimethylselenoniopropionate Natural products CCC(O)=O XBDQKXXYIPTUBI-UHFFFAOYSA-N 0.000 claims description 4
- CGIGDMFJXJATDK-UHFFFAOYSA-N indomethacin Chemical compound CC1=C(CC(O)=O)C2=CC(OC)=CC=C2N1C(=O)C1=CC=C(Cl)C=C1 CGIGDMFJXJATDK-UHFFFAOYSA-N 0.000 claims description 4
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 claims description 4
- 229960000371 rofecoxib Drugs 0.000 claims description 4
- RZJQGNCSTQAWON-UHFFFAOYSA-N rofecoxib Chemical compound C1=CC(S(=O)(=O)C)=CC=C1C1=C(C=2C=CC=CC=2)C(=O)OC1 RZJQGNCSTQAWON-UHFFFAOYSA-N 0.000 claims description 4
- XSQUKJJJFZCRTK-UHFFFAOYSA-N Urea Chemical compound NC(N)=O XSQUKJJJFZCRTK-UHFFFAOYSA-N 0.000 claims description 3
- 235000010323 ascorbic acid Nutrition 0.000 claims description 3
- 239000011668 ascorbic acid Substances 0.000 claims description 3
- 229960005070 ascorbic acid Drugs 0.000 claims description 3
- 235000015165 citric acid Nutrition 0.000 claims description 3
- 229940079832 sodium starch glycolate Drugs 0.000 claims description 3
- 239000008109 sodium starch glycolate Substances 0.000 claims description 3
- 229920003109 sodium starch glycolate Polymers 0.000 claims description 3
- BJEPYKJPYRNKOW-REOHCLBHSA-N (S)-malic acid Chemical compound OC(=O)[C@@H](O)CC(O)=O BJEPYKJPYRNKOW-REOHCLBHSA-N 0.000 claims description 2
- WKEMJKQOLOHJLZ-UHFFFAOYSA-N Almogran Chemical compound C1=C2C(CCN(C)C)=CNC2=CC=C1CS(=O)(=O)N1CCCC1 WKEMJKQOLOHJLZ-UHFFFAOYSA-N 0.000 claims description 2
- JOYRKODLDBILNP-UHFFFAOYSA-N Ethyl urethane Chemical compound CCOC(N)=O JOYRKODLDBILNP-UHFFFAOYSA-N 0.000 claims description 2
- ZRVUJXDFFKFLMG-UHFFFAOYSA-N Meloxicam Chemical compound OC=1C2=CC=CC=C2S(=O)(=O)N(C)C=1C(=O)NC1=NC=C(C)S1 ZRVUJXDFFKFLMG-UHFFFAOYSA-N 0.000 claims description 2
- BLXXJMDCKKHMKV-UHFFFAOYSA-N Nabumetone Chemical compound C1=C(CCC(C)=O)C=CC2=CC(OC)=CC=C21 BLXXJMDCKKHMKV-UHFFFAOYSA-N 0.000 claims description 2
- KDYFGRWQOYBRFD-UHFFFAOYSA-N Succinic acid Natural products OC(=O)CCC(O)=O KDYFGRWQOYBRFD-UHFFFAOYSA-N 0.000 claims description 2
- 229960002133 almotriptan Drugs 0.000 claims description 2
- BJEPYKJPYRNKOW-UHFFFAOYSA-N alpha-hydroxysuccinic acid Natural products OC(=O)C(O)CC(O)=O BJEPYKJPYRNKOW-UHFFFAOYSA-N 0.000 claims description 2
- KDYFGRWQOYBRFD-NUQCWPJISA-N butanedioic acid Chemical compound O[14C](=O)CC[14C](O)=O KDYFGRWQOYBRFD-NUQCWPJISA-N 0.000 claims description 2
- 239000004202 carbamide Substances 0.000 claims description 2
- RZEKVGVHFLEQIL-UHFFFAOYSA-N celecoxib Chemical compound C1=CC(C)=CC=C1C1=CC(C(F)(F)F)=NN1C1=CC=C(S(N)(=O)=O)C=C1 RZEKVGVHFLEQIL-UHFFFAOYSA-N 0.000 claims description 2
- 229960000590 celecoxib Drugs 0.000 claims description 2
- 239000011248 coating agent Substances 0.000 claims description 2
- 238000000576 coating method Methods 0.000 claims description 2
- 229960002472 eletriptan Drugs 0.000 claims description 2
- OTLDLQZJRFYOJR-LJQANCHMSA-N eletriptan Chemical compound CN1CCC[C@@H]1CC1=CN=C2[C]1C=C(CCS(=O)(=O)C=1C=CC=CC=1)C=C2 OTLDLQZJRFYOJR-LJQANCHMSA-N 0.000 claims description 2
- BEFDCLMNVWHSGT-UHFFFAOYSA-N ethenylcyclopentane Chemical compound C=CC1CCCC1 BEFDCLMNVWHSGT-UHFFFAOYSA-N 0.000 claims description 2
- 229960005293 etodolac Drugs 0.000 claims description 2
- XFBVBWWRPKNWHW-UHFFFAOYSA-N etodolac Chemical compound C1COC(CC)(CC(O)=O)C2=N[C]3C(CC)=CC=CC3=C21 XFBVBWWRPKNWHW-UHFFFAOYSA-N 0.000 claims description 2
- MNJVRJDLRVPLFE-UHFFFAOYSA-N etoricoxib Chemical compound C1=NC(C)=CC=C1C1=NC=C(Cl)C=C1C1=CC=C(S(C)(=O)=O)C=C1 MNJVRJDLRVPLFE-UHFFFAOYSA-N 0.000 claims description 2
- 229960004945 etoricoxib Drugs 0.000 claims description 2
- 229960002390 flurbiprofen Drugs 0.000 claims description 2
- SYTBZMRGLBWNTM-UHFFFAOYSA-N flurbiprofen Chemical compound FC1=CC(C(C(O)=O)C)=CC=C1C1=CC=CC=C1 SYTBZMRGLBWNTM-UHFFFAOYSA-N 0.000 claims description 2
- 229960002284 frovatriptan Drugs 0.000 claims description 2
- SIBNYOSJIXCDRI-SECBINFHSA-N frovatriptan Chemical compound C1=C(C(N)=O)[CH]C2=C(C[C@H](NC)CC3)C3=NC2=C1 SIBNYOSJIXCDRI-SECBINFHSA-N 0.000 claims description 2
- 239000001530 fumaric acid Substances 0.000 claims description 2
- 235000011087 fumaric acid Nutrition 0.000 claims description 2
- 229960000905 indomethacin Drugs 0.000 claims description 2
- DKYWVDODHFEZIM-UHFFFAOYSA-N ketoprofen Chemical compound OC(=O)C(C)C1=CC=CC(C(=O)C=2C=CC=CC=2)=C1 DKYWVDODHFEZIM-UHFFFAOYSA-N 0.000 claims description 2
- 229960000991 ketoprofen Drugs 0.000 claims description 2
- 229960004752 ketorolac Drugs 0.000 claims description 2
- OZWKMVRBQXNZKK-UHFFFAOYSA-N ketorolac Chemical compound OC(=O)C1CCN2C1=CC=C2C(=O)C1=CC=CC=C1 OZWKMVRBQXNZKK-UHFFFAOYSA-N 0.000 claims description 2
- 239000004310 lactic acid Substances 0.000 claims description 2
- 235000014655 lactic acid Nutrition 0.000 claims description 2
- 229960002202 lornoxicam Drugs 0.000 claims description 2
- OXROWJKCGCOJDO-JLHYYAGUSA-N lornoxicam Chemical compound O=C1C=2SC(Cl)=CC=2S(=O)(=O)N(C)\C1=C(\O)NC1=CC=CC=N1 OXROWJKCGCOJDO-JLHYYAGUSA-N 0.000 claims description 2
- 239000001630 malic acid Substances 0.000 claims description 2
- 235000011090 malic acid Nutrition 0.000 claims description 2
- HYYBABOKPJLUIN-UHFFFAOYSA-N mefenamic acid Chemical compound CC1=CC=CC(NC=2C(=CC=CC=2)C(O)=O)=C1C HYYBABOKPJLUIN-UHFFFAOYSA-N 0.000 claims description 2
- 229960001929 meloxicam Drugs 0.000 claims description 2
- 229960004270 nabumetone Drugs 0.000 claims description 2
- 229960005254 naratriptan Drugs 0.000 claims description 2
- UNHGSHHVDNGCFN-UHFFFAOYSA-N naratriptan Chemical compound C=12[CH]C(CCS(=O)(=O)NC)=CC=C2N=CC=1C1CCN(C)CC1 UNHGSHHVDNGCFN-UHFFFAOYSA-N 0.000 claims description 2
- 229960002739 oxaprozin Drugs 0.000 claims description 2
- OFPXSFXSNFPTHF-UHFFFAOYSA-N oxaprozin Chemical compound O1C(CCC(=O)O)=NC(C=2C=CC=CC=2)=C1C1=CC=CC=C1 OFPXSFXSNFPTHF-UHFFFAOYSA-N 0.000 claims description 2
- 229960002702 piroxicam Drugs 0.000 claims description 2
- QYSPLQLAKJAUJT-UHFFFAOYSA-N piroxicam Chemical compound OC=1C2=CC=CC=C2S(=O)(=O)N(C)C=1C(=O)NC1=CC=CC=N1 QYSPLQLAKJAUJT-UHFFFAOYSA-N 0.000 claims description 2
- 239000011736 potassium bicarbonate Substances 0.000 claims description 2
- 229910000028 potassium bicarbonate Inorganic materials 0.000 claims description 2
- 235000015497 potassium bicarbonate Nutrition 0.000 claims description 2
- TYJJADVDDVDEDZ-UHFFFAOYSA-M potassium hydrogencarbonate Chemical compound [K+].OC([O-])=O TYJJADVDDVDEDZ-UHFFFAOYSA-M 0.000 claims description 2
- 235000019260 propionic acid Nutrition 0.000 claims description 2
- IUVKMZGDUIUOCP-BTNSXGMBSA-N quinbolone Chemical compound O([C@H]1CC[C@H]2[C@H]3[C@@H]([C@]4(C=CC(=O)C=C4CC3)C)CC[C@@]21C)C1=CCCC1 IUVKMZGDUIUOCP-BTNSXGMBSA-N 0.000 claims description 2
- 229960000425 rizatriptan Drugs 0.000 claims description 2
- TXHZXHICDBAVJW-UHFFFAOYSA-N rizatriptan Chemical compound C=1[C]2C(CCN(C)C)=CN=C2C=CC=1CN1C=NC=N1 TXHZXHICDBAVJW-UHFFFAOYSA-N 0.000 claims description 2
- 239000004334 sorbic acid Substances 0.000 claims description 2
- 235000010199 sorbic acid Nutrition 0.000 claims description 2
- 229940075582 sorbic acid Drugs 0.000 claims description 2
- VZCYOOQTPOCHFL-UHFFFAOYSA-N trans-butenedioic acid Natural products OC(=O)C=CC(O)=O VZCYOOQTPOCHFL-UHFFFAOYSA-N 0.000 claims description 2
- LNPDTQAFDNKSHK-UHFFFAOYSA-N valdecoxib Chemical compound CC=1ON=C(C=2C=CC=CC=2)C=1C1=CC=C(S(N)(=O)=O)C=C1 LNPDTQAFDNKSHK-UHFFFAOYSA-N 0.000 claims description 2
- 229960002004 valdecoxib Drugs 0.000 claims description 2
- MWOOGOJBHIARFG-UHFFFAOYSA-N vanillin Chemical compound COC1=CC(C=O)=CC=C1O MWOOGOJBHIARFG-UHFFFAOYSA-N 0.000 claims description 2
- FGQOOHJZONJGDT-UHFFFAOYSA-N vanillin Natural products COC1=CC(O)=CC(C=O)=C1 FGQOOHJZONJGDT-UHFFFAOYSA-N 0.000 claims description 2
- 235000012141 vanillin Nutrition 0.000 claims description 2
- 229960001360 zolmitriptan Drugs 0.000 claims description 2
- UTAZCRNOSWWEFR-ZDUSSCGKSA-N zolmitriptan Chemical compound C=1[C]2C(CCN(C)C)=CN=C2C=CC=1C[C@H]1COC(=O)N1 UTAZCRNOSWWEFR-ZDUSSCGKSA-N 0.000 claims description 2
- 238000002360 preparation method Methods 0.000 abstract description 5
- 238000011282 treatment Methods 0.000 abstract description 5
- 230000008569 process Effects 0.000 abstract description 3
- 239000003826 tablet Substances 0.000 description 57
- HQKMJHAJHXVSDF-UHFFFAOYSA-L magnesium stearate Chemical compound [Mg+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O HQKMJHAJHXVSDF-UHFFFAOYSA-L 0.000 description 26
- 239000010410 layer Substances 0.000 description 19
- 238000005469 granulation Methods 0.000 description 18
- 230000003179 granulation Effects 0.000 description 18
- 239000004615 ingredient Substances 0.000 description 17
- 229960003940 naproxen sodium Drugs 0.000 description 17
- CDBRNDSHEYLDJV-FVGYRXGTSA-M naproxen sodium Chemical compound [Na+].C1=C([C@H](C)C([O-])=O)C=CC2=CC(OC)=CC=C21 CDBRNDSHEYLDJV-FVGYRXGTSA-M 0.000 description 17
- 229960000658 sumatriptan succinate Drugs 0.000 description 17
- 235000019359 magnesium stearate Nutrition 0.000 description 13
- HEMHJVSKTPXQMS-UHFFFAOYSA-M Sodium hydroxide Chemical compound [OH-].[Na+] HEMHJVSKTPXQMS-UHFFFAOYSA-M 0.000 description 12
- 239000003814 drug Substances 0.000 description 10
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 9
- 208000019695 Migraine disease Diseases 0.000 description 8
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 8
- GUBGYTABKSRVRQ-DCSYEGIMSA-N Beta-Lactose Chemical compound OC[C@H]1O[C@@H](O[C@H]2[C@H](O)[C@@H](O)[C@H](O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@H]1O GUBGYTABKSRVRQ-DCSYEGIMSA-N 0.000 description 7
- 229920000168 Microcrystalline cellulose Polymers 0.000 description 7
- 230000002378 acidificating effect Effects 0.000 description 7
- 238000009472 formulation Methods 0.000 description 7
- 239000000463 material Substances 0.000 description 7
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- 229940016286 microcrystalline cellulose Drugs 0.000 description 7
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- 229910002016 Aerosil® 200 Inorganic materials 0.000 description 5
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- 230000000052 comparative effect Effects 0.000 description 5
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- 238000000859 sublimation Methods 0.000 description 5
- 230000008022 sublimation Effects 0.000 description 5
- 229940124597 therapeutic agent Drugs 0.000 description 5
- VJHCJDRQFCCTHL-UHFFFAOYSA-N acetic acid 2,3,4,5,6-pentahydroxyhexanal Chemical compound CC(O)=O.OCC(O)C(O)C(O)C(O)C=O VJHCJDRQFCCTHL-UHFFFAOYSA-N 0.000 description 4
- 239000002585 base Substances 0.000 description 4
- 229940075614 colloidal silicon dioxide Drugs 0.000 description 4
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- 239000001767 crosslinked sodium carboxy methyl cellulose Substances 0.000 description 4
- 150000003839 salts Chemical class 0.000 description 4
- 239000012453 solvate Substances 0.000 description 4
- 239000000126 substance Substances 0.000 description 4
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 3
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical group C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 3
- DBMJMQXJHONAFJ-UHFFFAOYSA-M Sodium laurylsulphate Chemical compound [Na+].CCCCCCCCCCCCOS([O-])(=O)=O DBMJMQXJHONAFJ-UHFFFAOYSA-M 0.000 description 3
- 238000002474 experimental method Methods 0.000 description 3
- 239000008194 pharmaceutical composition Substances 0.000 description 3
- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 3
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- QZAYGJVTTNCVMB-UHFFFAOYSA-N serotonin Chemical compound C1=C(O)C=C2C(CCN)=CNC2=C1 QZAYGJVTTNCVMB-UHFFFAOYSA-N 0.000 description 3
- 235000019333 sodium laurylsulphate Nutrition 0.000 description 3
- 210000002784 stomach Anatomy 0.000 description 3
- WSVLPVUVIUVCRA-KPKNDVKVSA-N Alpha-lactose monohydrate Chemical compound O.O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@H]1O[C@@H]1[C@@H](CO)O[C@H](O)[C@H](O)[C@H]1O WSVLPVUVIUVCRA-KPKNDVKVSA-N 0.000 description 2
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 2
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 2
- KFZMGEQAYNKOFK-UHFFFAOYSA-N Isopropanol Chemical compound CC(C)O KFZMGEQAYNKOFK-UHFFFAOYSA-N 0.000 description 2
- 241000124008 Mammalia Species 0.000 description 2
- 229930195725 Mannitol Natural products 0.000 description 2
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 2
- 239000011149 active material Substances 0.000 description 2
- 238000005056 compaction Methods 0.000 description 2
- 238000001035 drying Methods 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 239000007789 gas Substances 0.000 description 2
- 229910052736 halogen Inorganic materials 0.000 description 2
- 150000002367 halogens Chemical class 0.000 description 2
- 239000008240 homogeneous mixture Substances 0.000 description 2
- 229960001021 lactose monohydrate Drugs 0.000 description 2
- 239000000594 mannitol Substances 0.000 description 2
- 235000010355 mannitol Nutrition 0.000 description 2
- 229910000403 monosodium phosphate Inorganic materials 0.000 description 2
- 235000019799 monosodium phosphate Nutrition 0.000 description 2
- 229940069328 povidone Drugs 0.000 description 2
- 229910052710 silicon Inorganic materials 0.000 description 2
- 239000010703 silicon Substances 0.000 description 2
- AJPJDKMHJJGVTQ-UHFFFAOYSA-M sodium dihydrogen phosphate Chemical compound [Na+].OP(O)([O-])=O AJPJDKMHJJGVTQ-UHFFFAOYSA-M 0.000 description 2
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- 229910002012 Aerosil® Inorganic materials 0.000 description 1
- GUBGYTABKSRVRQ-XLOQQCSPSA-N Alpha-Lactose Chemical compound O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@H]1O[C@@H]1[C@@H](CO)O[C@H](O)[C@H](O)[C@H]1O GUBGYTABKSRVRQ-XLOQQCSPSA-N 0.000 description 1
- 206010003791 Aura Diseases 0.000 description 1
- GUBGYTABKSRVRQ-QKKXKWKRSA-N Lactose Natural products OC[C@H]1O[C@@H](O[C@H]2[C@H](O)[C@@H](O)C(O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@H]1O GUBGYTABKSRVRQ-QKKXKWKRSA-N 0.000 description 1
- 229910019142 PO4 Inorganic materials 0.000 description 1
- 102000004005 Prostaglandin-endoperoxide synthases Human genes 0.000 description 1
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- 150000007513 acids Chemical class 0.000 description 1
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- 239000012736 aqueous medium Substances 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
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- 230000015572 biosynthetic process Effects 0.000 description 1
- 239000000872 buffer Substances 0.000 description 1
- 239000008366 buffered solution Substances 0.000 description 1
- 239000001569 carbon dioxide Substances 0.000 description 1
- 229910002092 carbon dioxide Inorganic materials 0.000 description 1
- 125000005587 carbonate group Chemical group 0.000 description 1
- 125000003178 carboxy group Chemical group [H]OC(*)=O 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 239000011247 coating layer Substances 0.000 description 1
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- 239000007884 disintegrant Substances 0.000 description 1
- KWDPCPJWIQRCHI-UHFFFAOYSA-L disodium 2,3-dihydroxybutanedioic acid hydrogen carbonate Chemical compound C([O-])(O)=O.[Na+].C(C(O)C(O)C(=O)O)(=O)O.[Na+].C([O-])(O)=O KWDPCPJWIQRCHI-UHFFFAOYSA-L 0.000 description 1
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- 235000011008 sodium phosphates Nutrition 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 239000007962 solid dispersion Substances 0.000 description 1
- KDYFGRWQOYBRFD-UHFFFAOYSA-L succinate(2-) Chemical compound [O-]C(=O)CCC([O-])=O KDYFGRWQOYBRFD-UHFFFAOYSA-L 0.000 description 1
- PORMUFZNYQJOEI-UHFFFAOYSA-N sumatriptan succinate Chemical compound OC(=O)CCC(O)=O.CNS(=O)(=O)CC1=CC=C2NC=C(CCN(C)C)C2=C1 PORMUFZNYQJOEI-UHFFFAOYSA-N 0.000 description 1
- 229960002871 tenoxicam Drugs 0.000 description 1
- WZWYJBNHTWCXIM-UHFFFAOYSA-N tenoxicam Chemical compound O=C1C=2SC=CC=2S(=O)(=O)N(C)C1=C(O)NC1=CC=CC=N1 WZWYJBNHTWCXIM-UHFFFAOYSA-N 0.000 description 1
- 238000005979 thermal decomposition reaction Methods 0.000 description 1
- RYFMWSXOAZQYPI-UHFFFAOYSA-K trisodium phosphate Chemical compound [Na+].[Na+].[Na+].[O-]P([O-])([O-])=O RYFMWSXOAZQYPI-UHFFFAOYSA-K 0.000 description 1
- 238000001291 vacuum drying Methods 0.000 description 1
Classifications
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/20—Pills, tablets, discs, rods
- A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
- A61K9/2077—Tablets comprising drug-containing microparticles in a substantial amount of supporting matrix; Multiparticulate tablets
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- 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
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
- A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
- A61K31/404—Indoles, e.g. pindolol
-
- 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
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
- A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
- A61K31/404—Indoles, e.g. pindolol
- A61K31/4045—Indole-alkylamines; Amides thereof, e.g. serotonin, melatonin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- 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
- A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
- A61K9/2086—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
- A61K9/209—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat containing drug in at least two layers or in the core and in at least one outer layer
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
- A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
- A61K9/5084—Mixtures of one or more drugs in different galenical forms, at least one of which being granules, microcapsules or (coated) microparticles according to A61K9/16 or A61K9/50, e.g. for obtaining a specific release pattern or for combining different drugs
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- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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- A61P25/06—Antimigraine agents
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0002—Galenical forms characterised by the drug release technique; Application systems commanded by energy
- A61K9/0007—Effervescent
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Abstract
Provided are rapidly dissolving pharmaceutical oral dosage forms of triptans and NSAIDs, processes for the preparation thereof, and methods of treatment therewith.
Description
RAPID DISSOLUTION OF COMBINATION PRODUCTS
Cross-Reference to Related Applications [0001] This application claims the benefit of U.S. Provisional Application Serial Nos.
60/922,031, filed Apri14, 2007; 60/932,613, filed May 31, 2007; and 61/070,563, filed March 21, 2008, the contents of which are hereby incorporated by reference.
Field of the Invention [0002] The invention encompasses a method for the production of rapid dissolution tablets comprising at least two active pharmaceutical ingredients.
Background of the Invention [0003] Migraine is the most common cause of vascular headache, and afflicts approximately 15% of women and 6% of men. Typically, migraine is treated with a single drug or a combination of drugs known to be effective in treating migraine.
Most drugs effective in the treatment of migraines are members of one of three major pharmacologic classes: anti-inflammatory agents, 5-HT, antagonists, and dopamine antagonists. See HARRISON'S PRINCIPLES OF INTERNAL MEDICINE 73-76 (15th ed. 2001).
Cross-Reference to Related Applications [0001] This application claims the benefit of U.S. Provisional Application Serial Nos.
60/922,031, filed Apri14, 2007; 60/932,613, filed May 31, 2007; and 61/070,563, filed March 21, 2008, the contents of which are hereby incorporated by reference.
Field of the Invention [0002] The invention encompasses a method for the production of rapid dissolution tablets comprising at least two active pharmaceutical ingredients.
Background of the Invention [0003] Migraine is the most common cause of vascular headache, and afflicts approximately 15% of women and 6% of men. Typically, migraine is treated with a single drug or a combination of drugs known to be effective in treating migraine.
Most drugs effective in the treatment of migraines are members of one of three major pharmacologic classes: anti-inflammatory agents, 5-HT, antagonists, and dopamine antagonists. See HARRISON'S PRINCIPLES OF INTERNAL MEDICINE 73-76 (15th ed. 2001).
[0004] Sumatriptan succinate has the chemical name 3-[2-(dimethylamino)ethyl]-N-methyl-indole-5-methanesulfonamide succinate and the following chemical structure:
OOH N -COOH
H
N
OO
N
H
OOH N -COOH
H
N
OO
N
H
[0005] Naproxen sodium has the chemical name (S)-6-methoxy-a-methyl-2-naphthaleneacetic acid, sodium salt, and the following chemical structure:
O'Na+
O
SUBSTITUTE SHEET (RULE 26) [0006] Sumatriptan succinate is a selective 5-hydroxytriptamine, receptor subtype agonist currently marketed under the trade name IMITREX for the acute treatment of migraine attacks with or without aura in adults. Naproxen sodium is a non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties. The mechanism of action of the naproxen anion, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition. Both actives have been combined in a single tablet, which is expected to be marketed under the trade name TREXIMA .
Current treatments for migraines include a range of over-the-counter analgesics and triptans. Recent reports have indicated that combination therapies of triptans and NSAIDs greatly improve the relief of migraines in patients. See, e.g., U.S. Patent Nos. 5,872,145;
6,060,499; 6,586,458.
O'Na+
O
SUBSTITUTE SHEET (RULE 26) [0006] Sumatriptan succinate is a selective 5-hydroxytriptamine, receptor subtype agonist currently marketed under the trade name IMITREX for the acute treatment of migraine attacks with or without aura in adults. Naproxen sodium is a non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties. The mechanism of action of the naproxen anion, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition. Both actives have been combined in a single tablet, which is expected to be marketed under the trade name TREXIMA .
Current treatments for migraines include a range of over-the-counter analgesics and triptans. Recent reports have indicated that combination therapies of triptans and NSAIDs greatly improve the relief of migraines in patients. See, e.g., U.S. Patent Nos. 5,872,145;
6,060,499; 6,586,458.
[0007] U.S. Publication No. 2004/0180089 ("the '089 publication") refers to a dosage form containing a triptan and an NSAID as therapeutic agents, where the triptan and the NSAID are segregated into separate layers, in a side-by-side arrangement, such that the dissolution of each therapeutic agent occurs independently of the other. The `089 publication, p. 1, 6-7. The '089 publication suggests that in the stomach, the NSAID
naproxen may form a gel-like matrix, which retards the dissolution of the triptan unless the two therapeutic agents are maintained in distinct side-by-side layers. Id. The '089 publication addresses this dissolution problem by separating the triptan and the NSAID into separate distinct layers, such that each layer contains at least 90% of either the triptan or the NSAID, as opposed to a single layer tablet matrix containing both agents or one layer forming a core surrounded by the other layer. The '089 publication, p. 1, 10. The '089 publication discloses that such an arrangement provides for the independent dissolution of each therapeutic agent, such that the dissolution rates approximate the rates if the drugs were given separately.
Id.
naproxen may form a gel-like matrix, which retards the dissolution of the triptan unless the two therapeutic agents are maintained in distinct side-by-side layers. Id. The '089 publication addresses this dissolution problem by separating the triptan and the NSAID into separate distinct layers, such that each layer contains at least 90% of either the triptan or the NSAID, as opposed to a single layer tablet matrix containing both agents or one layer forming a core surrounded by the other layer. The '089 publication, p. 1, 10. The '089 publication discloses that such an arrangement provides for the independent dissolution of each therapeutic agent, such that the dissolution rates approximate the rates if the drugs were given separately.
Id.
[0008] However, this technique of preparing bilayer tablets requires specialized tabletting equipment, such as a rotary bilayer tablet press. Furthermore, the process itself is cumbersome and requires several stages. For example, the NSAID layer is loaded first, compacted using a minimal compaction force, and the triptan layer is added next, and the tablet compacted using a final compaction force such that a tablet with the desired mechanical properties is achieved. See, e.g., the '089 publication, p. 3, 33.
[0009] U.S. Publication No. 2007/0184109 ("the '109 publication") also refers to pharmaceutical compositions comprising a 5HTi receptor agonist (such as sumatriptan succinate) or a pharmaceutically acceptable derivative thereof in combination with an NSAID
(such as naproxen sodium) or pharmaceutically acceptable derivative thereof.
The '109 publication compares the dissolution of sumatriptan succinate in two compositions of sumatriptan succinate and naproxen sodium, the first having the sumatriptan succinate and the naproxen sodium in the same zone and the second having the sumatriptan succinate and the naproxen sodium in separate layers of a bilayer tablet. '109 publication, pp. 9-10, tables 3 and 4. The '109 publication states that the dissolution of the first composition was "slower than expected," and that the slow dissolution "led to the conclusion that the naproxen sodium was disabling the dissolution of the sumatriptan granules when blended together." See id. at p. 9, 97. As to the second composition, the '109 publication states that "[c]ombining the two formulations as separate layers in a bilayer tablet allowed for the rapid release of sumatriptan succinate from the tablet, without as much interference from naproxen sodium."
See id. at p. 10, 100.
(such as naproxen sodium) or pharmaceutically acceptable derivative thereof.
The '109 publication compares the dissolution of sumatriptan succinate in two compositions of sumatriptan succinate and naproxen sodium, the first having the sumatriptan succinate and the naproxen sodium in the same zone and the second having the sumatriptan succinate and the naproxen sodium in separate layers of a bilayer tablet. '109 publication, pp. 9-10, tables 3 and 4. The '109 publication states that the dissolution of the first composition was "slower than expected," and that the slow dissolution "led to the conclusion that the naproxen sodium was disabling the dissolution of the sumatriptan granules when blended together." See id. at p. 9, 97. As to the second composition, the '109 publication states that "[c]ombining the two formulations as separate layers in a bilayer tablet allowed for the rapid release of sumatriptan succinate from the tablet, without as much interference from naproxen sodium."
See id. at p. 10, 100.
[0010] Therefore, there is a need for an efficient simple process which does not require specialized equipment, while maintaining the dissolution properties of each of the therapeutic agents.
Summary of the Invention [0011] In one embodiment, the invention encompasses an oral dosage form comprising a therapeutically effective amount of a triptan and a therapeutically effective amount of an NSAID, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, and not less than about 60% of the triptan dissolves in 30 minutes in 200 ml of 0.O1N HCl solution in a USP Type II
Dissolution Apparatus at a rotation speed of 40 rpm and a temperature of 37 C. Preferably, not less than about 70% of the triptan dissolves in 30 minutes, and more preferably not less than about 80% of the triptan dissolves in 30 minutes.
Summary of the Invention [0011] In one embodiment, the invention encompasses an oral dosage form comprising a therapeutically effective amount of a triptan and a therapeutically effective amount of an NSAID, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, and not less than about 60% of the triptan dissolves in 30 minutes in 200 ml of 0.O1N HCl solution in a USP Type II
Dissolution Apparatus at a rotation speed of 40 rpm and a temperature of 37 C. Preferably, not less than about 70% of the triptan dissolves in 30 minutes, and more preferably not less than about 80% of the triptan dissolves in 30 minutes.
[0012] In one preferred embodiment, the oral dosage form further comprises at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, with the proviso that the superdisintegrant is not croscarmellose sodium.
[0013] In another preferred embodiment, the oral dosage form is in the form of a porous tablet. Preferably, the porosity of the tablet is at least about 10%.
[0014] In yet another embodiment, the invention encompasses an oral dosage form comprising: (a) a therapeutically effective amount of a triptan, (b) a therapeutically effective amount of an NSAID, and (c) at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, the additive is present in an amount of more than 10% by weight of the oral dosage form, and the superdisintegrant is not croscarmellose sodium.
[0015] In another embodiment, the invention encompasses an oral dosage form comprising: (a) a therapeutically effective amount of a triptan, (b) a therapeutically effective amount of an NSAID, and (c) at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, the ratio of the amount of NSAID to the total amount of additives is less than about 5, and the superdisintegrant is not croscarmellose sodium.
[0016] In another embodiment, the invention encompasses a method for preparing the above-described oral dosage forms comprising separately granulating each of the triptan and the NSAID, combining the separate granulates with at least one extragranular pharmaceutically acceptable excipient to form a mixture, and compacting the mixture into the oral dosage form.
[0017] In another embodiment, the invention encompasses a method for preparing the above-described oral dosage forms comprising granulating one of the triptan or the NSAID
with at least one pharmaceutically acceptable excipient to form a granulate, adding to the granulate a dry blend comprising at least the other of the triptan or the NSAID and at least one pharmaceutically acceptable excipient to form a mixture, and compacting the mixture into the oral dosage form.
with at least one pharmaceutically acceptable excipient to form a granulate, adding to the granulate a dry blend comprising at least the other of the triptan or the NSAID and at least one pharmaceutically acceptable excipient to form a mixture, and compacting the mixture into the oral dosage form.
[0018] In another embodiment, the invention encompasses a method for preparing the above-described oral dosage forms comprising coating an inert core with a layer comprising a triptan and an NSAID.
[0019] In another embodiment, the invention encompasses a method of treating acute migraines comprising administering a therapeutically effective amount of at least one of the above-described dosage forms to a patient in need thereof. Preferably, the triptan is sumatnptan and the NSAID is naproxen.
Brief Description of the Drawings [0020] Figure 1 illustrates exemplary tablet forms of triptan and NSAID. In Figure 1, "A" comprises the triptan and, optionally, at least one pharmaceutically acceptable excipient;
"B" comprises the NSAID and, optionally, at least one phannaceutically acceptable excipient; and "C" comprises an additional active material and/or at least one pharmaceutically acceptable excipient.
Brief Description of the Drawings [0020] Figure 1 illustrates exemplary tablet forms of triptan and NSAID. In Figure 1, "A" comprises the triptan and, optionally, at least one pharmaceutically acceptable excipient;
"B" comprises the NSAID and, optionally, at least one phannaceutically acceptable excipient; and "C" comprises an additional active material and/or at least one pharmaceutically acceptable excipient.
[0021] Figure 2 illustrates comparative dissolution of 2 separate tablets of sumatriptan and naproxen (Compositions 10 and 11), homogeneous compositions of sumatriptan and naproxen with sodium bicarbonate and the superdisintegrant crospovidone (Compositions 6 and 8), and a bi-layer tablet of sumatriptan and naproxen (Composition 13).
Detailed Description of the Invention [0022] The invention addresses the above-described shortcomings of the prior art by providing rapidly dissolving tablets comprising a triptan and an NSAID, wherein the triptan and the NSAID are present in a single zone and each of the triptan and the NSAID maintains its individual dissolution characteristics irrespective of the presence of the other.
Detailed Description of the Invention [0022] The invention addresses the above-described shortcomings of the prior art by providing rapidly dissolving tablets comprising a triptan and an NSAID, wherein the triptan and the NSAID are present in a single zone and each of the triptan and the NSAID maintains its individual dissolution characteristics irrespective of the presence of the other.
[0023] When naproxen or a similar NSAID and a triptan are in a non-segregated tablet, it has been reported that the NSAID, which is usually present in a high dose compared with the triptan, tends to form a gel-like matrix in the presence of an aqueous medium. The gel-like matrix erodes slowly and is likely to entrap the triptan, thereby delaying its release.
It has now been surprisingly found, however, that when rapidly dissolving tablets are used, the formation of the gel is prevented, allowing for the rapid dissolution of the triptan.
It has now been surprisingly found, however, that when rapidly dissolving tablets are used, the formation of the gel is prevented, allowing for the rapid dissolution of the triptan.
[0024] As used herein, unless otherwise defined, the term "triptan" means a triptan or a pharmaceutically acceptable salt or solvate thereof.
[0025] As used herein, unless otherwise defined, the term "NSAID" means an NSAID or a pharmaceutically acceptable salt or solvate thereof.
[0026] As used herein, unless otherwise defined, the term "sumatriptan" means sumatriptan free base or a pharmaceutically acceptable salt or solvate thereof. A preferred form of sumatriptan is sumatnptan succinate.
[0027] As used herein, unless otherwise defined, the term "naproxen" means naproxen free acid or a pharmaceutically acceptable salt or solvate thereof. A
preferred form of naproxen is naproxen sodium.
preferred form of naproxen is naproxen sodium.
[0028] As used herein, unless otherwise defined, the term "therapeutically effective dosage" means a dosage sufficient to treat migraines. The person of ordinary skill in the art would be able to determine a therapeutically effective dosage based upon the description herein coupled with the general knowledge in the art. For a particular patient, a therapeutically effective dosage may depend on variables such as age, gender, weight, and extent of condition.
[0029] As used herein, unless otherwise defined, the term "zone" means a region in a dosage form that has a distinct composition. Preferably, the region has a substantially homogeneous composition, i.e., the region contains a substantially homogeneous mixture of particles of triptan and particles of NSAID. In one preferred embodiment, the region contains a substantially homogeneous mixture of granulates of triptan, granulates of NSAID, and extragranular excipients. For example, a zone may be a core, a coating layer, or other type of layer in the oral dosage form, examples of which are depicted in Figure 1.
[0030] The invention encompasses oral dosage fornms and compositions comprising a triptan and an NSAID. Suitable triptans include, but are not limited to, sumatriptan, eletriptan, rizatriptan, frovatriptan, almotriptan, zolmitriptan, and naratriptan. Preferably, the triptan is sumatriptan. Suitable NSAIDs include, but are not limited to, flurbiprofen, ketoprofen, naproxen, oxaprozin, etodolac, indomethacin, ketorolac, nabumetone, mefanamic acid, piroxicam, lornoxicam, meloxicam, rofecoxib, celecoxib, etoricoxib, and valdecoxib.
Preferably, the NSAID is naproxen or rofecoxib. More preferably, the NSAID is naproxen.
Preferably, the NSAID is naproxen or rofecoxib. More preferably, the NSAID is naproxen.
[0031] Typically, the oral dosage forms of the invention are in the form of rapidly dissolving tablets in which the triptan and the NSAID are combined in a single zone, while each of the triptan and the NSAID maintains its individual dissolution characteristics irrespective of the presence of the other.
[0032] Typically, a rapid dissolution will be understood to mean that not less than about 60% of the triptan in the oral dosage form dissolves in acidic media in 30 minutes.
Preferably not less than about 70% of the triptan dissolves in acidic media in 30 minutes, and more preferably not less than about 80% of the triptan dissolves in acidic media in 30 minutes. As used herein, unless otherwise defined, the term "acidic media"
means 200 ml of 0.01N HCl solution in a USP Type II Dissolution Apparatus at a rotation speed of 40 rpm.
Preferably not less than about 70% of the triptan dissolves in acidic media in 30 minutes, and more preferably not less than about 80% of the triptan dissolves in acidic media in 30 minutes. As used herein, unless otherwise defined, the term "acidic media"
means 200 ml of 0.01N HCl solution in a USP Type II Dissolution Apparatus at a rotation speed of 40 rpm.
[0033] In one embodiment of the invention, the rapid dissolution of the oral dosage form is achieved through the use of an effervescent couple. The effervescent couple comprises a basic ingredient and an acidic ingredient, the basic ingredient liberating carbon dioxide when it and the acidic ingredient are contacted with water. The effervescent couple can be formed, for example, by including both the base component and the acid component as extra-granular excipients in the oral dosage form. In another example, the effervescent couple can be formed by including only the base component as an extra-granular excipient in the oral dosage form, and using stomach acid as the acid component, i.e., the base component reacts with stomach acid to form the effervescent couple once the oral dosage form is administered to a patient.
[0034] Typically, the base component is a carbonate or a bicarbonate. Suitable bicarbonates include, but are not limited to, ammonium bicarbonate, and alkali metal bicarbonates such as potassium bicarbonate and sodium bicarbonate. Preferably, the bicarbonate is sodium bicarbonate. Typically, the bicarbonate is present in an amount of more than 10% to about 20% by weight of the zone in which both particles of triptan and particles of NSAID are present. Preferably, the bicarbonate is present in an amount of about 11% to about 17% by weight of the zone in which both particles of triptan and particles of NSAID
are present.
are present.
[0035] The acid component, when included in the oral dosage form, may be any pharmaceutically acceptable acid. Suitable acids include, but are not limited to, ascorbic acid, citric acid, tartaric acid, succinic acid, fumaric acid, malic acid, lactic acid, propionic acid, sorbic acid, and benzoic acid. Preferably, the acid is ascorbic acid, citric acid or tartaric acid. Typically, the acid component is present in an amount so as to produce an approximately a 1:1 molar ratio between the basic groups on the base component and the acidic groups on the acid component.
[0036] In another embodiment of the invention, the rapid dissolution of the oral dosage form may be achieved by using a large amount of superdisintegrant as an extragranular excipient, with the proviso that the superdisintegrant is not croscarmellose sodium. Suitable superdisintegrants include, but are not limited to, crospovidone and sodium starch glycolate. Preferably, the superdisintegrant is crospovidone.
Typically, the crospovidone is present in an amount of about 7% to about 20% by weight of the zone in which both particles of triptan and particles of NSAID are present, and preferably more than 10% to about 17% by weight of the zone in which both particles of triptan and particles of NSAID are present. The skilled artisan would appreciate that the appropriate amount of superdisintegrant varies with the type of superdisintegrant used, as well as the properties of the active materials and other excipients used, and can determine the appropriate amount of superdisintegrant based upon these factors.
Typically, the crospovidone is present in an amount of about 7% to about 20% by weight of the zone in which both particles of triptan and particles of NSAID are present, and preferably more than 10% to about 17% by weight of the zone in which both particles of triptan and particles of NSAID are present. The skilled artisan would appreciate that the appropriate amount of superdisintegrant varies with the type of superdisintegrant used, as well as the properties of the active materials and other excipients used, and can determine the appropriate amount of superdisintegrant based upon these factors.
[0037] Optionally, the rapid dissolution of the oral dosage form may be achieved by using a mixture of additives as extra-granular excipients, i.e., a mixture of carbonate, bicarbonate, and/or superdisintegrant. Typically, the additives are present in a total amount of more than 10% by weight of the zone in which both particles of triptan and particles of NSAID are present. Preferably, the additives are present in a total amount of more than 10%
to about 60% by weight, more preferably more than 10% to about 50% by weight, and most preferably more than 10% to about 40% by weight of the zone in which both particles of triptan and particles of NSAID are present.
to about 60% by weight, more preferably more than 10% to about 50% by weight, and most preferably more than 10% to about 40% by weight of the zone in which both particles of triptan and particles of NSAID are present.
[0038] Typically, the ratio of the amount of NSAID to the total amount of additives is less than about 5. Preferably, the ratio of the amount of NSAID to the total amount of additives is about 1 to about 4.5, more preferably about 2 to about 4.5, and most preferably about 2.5 to about 4.5.
[0039] In another embodiment of the invention, the rapid dissolution of the oral dosage form may be achieved by producing a highly porous tablet. An increased dissolution rate can be obtained by increasing the porosity (void spaces) of the tablet.
Void spaces in the tablet matrix facilitate the permeation of water to rapidly erode the entire tablet. This may be achieved by adding a volatilizable adjuvant to the composition, which is subsequently removed by sublimation or thermal decomposition. See, e.g., U.S. Patent Nos.
3,885,026, 5,529,789, 5,853,758; Aly, A.M., Semreen M., and Qato, M.K., "Superdisintegrants for solid dispersion to produce rapidly disintegrating tenoxicam tablets via camphor sublimation,"
Pharmaceutical Technology, January 2005, pp. 68-78; Koizumi K. et al., "New method of preparing high-porosity rapidly saliva soluble compressed tablets using mannitol with camphor, a subliming material," Int. J. Pharm. 152 (1997) pp. 127-13 1; Gohel, M. et al., "Formulation design and optimization of mouth dissolve tablets of nimesulfide using vacuum drying technique," AAAPS PharmSciTech 2004, 5(3) Article 36, all of which are hereby incorporated by reference. The degree of porosity may be expressed as the percent of weight lost from the dosage form following removal of the volatilizable adjuvant.
Void spaces in the tablet matrix facilitate the permeation of water to rapidly erode the entire tablet. This may be achieved by adding a volatilizable adjuvant to the composition, which is subsequently removed by sublimation or thermal decomposition. See, e.g., U.S. Patent Nos.
3,885,026, 5,529,789, 5,853,758; Aly, A.M., Semreen M., and Qato, M.K., "Superdisintegrants for solid dispersion to produce rapidly disintegrating tenoxicam tablets via camphor sublimation,"
Pharmaceutical Technology, January 2005, pp. 68-78; Koizumi K. et al., "New method of preparing high-porosity rapidly saliva soluble compressed tablets using mannitol with camphor, a subliming material," Int. J. Pharm. 152 (1997) pp. 127-13 1; Gohel, M. et al., "Formulation design and optimization of mouth dissolve tablets of nimesulfide using vacuum drying technique," AAAPS PharmSciTech 2004, 5(3) Article 36, all of which are hereby incorporated by reference. The degree of porosity may be expressed as the percent of weight lost from the dosage form following removal of the volatilizable adjuvant.
[0040] Preferably, the porosity of the tablet is at least about 10%, i.e., upon removal of the volatilizable adjuvant, 10% of the tablet weight is lost. The weight loss (and thus the porosity of the tablet) can be measured, for example, by techniques disclosed in the articles mentioned in the immediately preceding paragraph. The desired weight loss may be achieved by incorporating into the extra granular excipients a solid adjuvant which is volatilizable at either elevated temperatures, or reduced pressures, or a combination of both.
Suitable volatilizable adjuvants include materials that undergo sublimation and materials that thermally decompose to gases. Materials that undergo sublimation include, but are not limited to, camphor, menthol, benzoic acid, urethane, urea, vanillin, tetramethylene tetramine, and naphthalene. Preferably, the material that undergoes sublimation is camphor or menthol.
Materials that thermally decompose to gases include, for example, ammonium bicarbonate.
Suitable volatilizable adjuvants include materials that undergo sublimation and materials that thermally decompose to gases. Materials that undergo sublimation include, but are not limited to, camphor, menthol, benzoic acid, urethane, urea, vanillin, tetramethylene tetramine, and naphthalene. Preferably, the material that undergoes sublimation is camphor or menthol.
Materials that thermally decompose to gases include, for example, ammonium bicarbonate.
[0041] In another embodiment of the invention, the rate of rapid dissolution may be adjusted by controlling the hardness of the tablet. Preferably, the hardness of the tablet is about 10 to about 30 SCU, and more preferably about 12 to about 25 SCU.
Hardeness is typically measured by the method disclosed in REMINGTON - THE SCIENCE AND
PRACTICE OF
PHARMACY, 882-883 (20th ed. 2000), hereby incorporated by reference.
Hardeness is typically measured by the method disclosed in REMINGTON - THE SCIENCE AND
PRACTICE OF
PHARMACY, 882-883 (20th ed. 2000), hereby incorporated by reference.
[0042] The compositions described herein may be prepared in accordance with methods that are standard in the art. Preferably, the triptan and NSAID are granulated separately using any acceptable granulation method, using, for example, a high-shear granulator. Any acceptable granulation solvent may be employed, such as, but not limited to, water, ethanol, isopropanol, or any combination thereof. More preferably, the granulation solvent is water.
[0043] Optionally, the NSAID granulate may be mixed with colloidal silicon dioxide before adding the triptan granulate and the remaining inactive ingredients.
[0044] Apart from the active ingredients, any acceptable pharmaceutical excipient may be used. For example, the composition may comprise binders (such as polyvinylpyrrolidone), disintegrants (such as crospovidone, microcrystalline cellulose, and sodium starch glycolate), lubricants (such as magnesium stearate and hydrogenated vegetable oil), and fillers (such as lactose and mannitol). The tablets may optionally be coated.
[0045] The invention further encompasses a method of treatment comprising administering the pharmaceutical fonmulation to a mammal. Preferably, the mammal is a human. Preferably, the pharmaceutical formulation comprises sumatriptan succinate and naproxen sodium in the form of a rapidly dissolving tablet in which the sumatriptan succinate and the naproxen sodium are combined in a single zone and is administered to treat acute migraines, which is expected to be the approved use for TREXIMA .
[0046] The amount of active compounds administered and the dosing regimen used will depend on the particular drug selected, the age and general condition of the subject being treated, the severity of the subject's condition, and the judgment of the prescribing physician.
[0047] Having described the invention with reference to certain preferred embodiments, other embodiments will become apparent to one skilled in the art from consideration of the specification. The invention is further defined by reference to the following examples. It will be apparent to those skilled in the art that many modifications, both to materials and methods, may be practiced without departing from the scope of the invention.
Examples [0048] In the following examples several fixed-dose combinations of sumatriptan succinate and naproxen sodium have been prepared.
Example 1: Granulation of Sumatriptan succinate [0049] The composition for sumatriptan succinate granulation is provided in Table 1.
Table 1. Composition of sumatriptan succinate granulation.
Ingredient Wei ng t% Amount Total (w/w) m tablet weight Sumatriptan succinate 56.1 119.00 29.75 Lactose monohydrate 24.1 51.00 12.75 Microcrystalline cellulose 19.8 42.00 10.5 Water -- QS
Total 100.0 212.00 53.0 [0050] Sumatriptan succinate, lactose monohydrate and microcrystalline cellulose were mixed for 2 minutes in a high shear granulator at a mixer speed of 460 rpm. Water was added until a suitable granulation was achieved at a mixer speed of 920 rpm and a chopper speed of 2220 rpm. The resulting wet granulate was transferred to a fluid bed drier (Glatt-2), with an inlet temperature of 60 C and an outlet temperature of 35 C, and dried. Loss on drying (LOD) was determined using a Mettler-Toledo HR73 Halogen Moisture Analyzer, and was found to be 0.69%. The dried granulate was then milled using an 18 mesh screen.
Example 2: Granulation of Naproxen sodium 500 m~
Examples [0048] In the following examples several fixed-dose combinations of sumatriptan succinate and naproxen sodium have been prepared.
Example 1: Granulation of Sumatriptan succinate [0049] The composition for sumatriptan succinate granulation is provided in Table 1.
Table 1. Composition of sumatriptan succinate granulation.
Ingredient Wei ng t% Amount Total (w/w) m tablet weight Sumatriptan succinate 56.1 119.00 29.75 Lactose monohydrate 24.1 51.00 12.75 Microcrystalline cellulose 19.8 42.00 10.5 Water -- QS
Total 100.0 212.00 53.0 [0050] Sumatriptan succinate, lactose monohydrate and microcrystalline cellulose were mixed for 2 minutes in a high shear granulator at a mixer speed of 460 rpm. Water was added until a suitable granulation was achieved at a mixer speed of 920 rpm and a chopper speed of 2220 rpm. The resulting wet granulate was transferred to a fluid bed drier (Glatt-2), with an inlet temperature of 60 C and an outlet temperature of 35 C, and dried. Loss on drying (LOD) was determined using a Mettler-Toledo HR73 Halogen Moisture Analyzer, and was found to be 0.69%. The dried granulate was then milled using an 18 mesh screen.
Example 2: Granulation of Naproxen sodium 500 m~
[0051] The composition for naproxen sodium granulation is provided in Table 2.
Table 2. Composition of naproxen sodium granulation.
Ingredient Wei ng t% Amount Total (w/w) m tablet weight Naproxen sodium 87.0 500.00 125.0 Microcrystalline cellulose 8.7 50.00 12.5 Povidone 4.3 25 6.25 Water -- QS
Total 100.0 575.00 [0052] Naproxen sodium, microcrystalline cellulose and povidone were mixed for minutes in a high shear granulator at a mixer speed of 460 rpm. Water was added until a seiitable granulation was achieved at a mixer speed of 920 rpm and a chopper speed of 2220 rpm. The resulting wet granulate was transferred to a fluid bed drier (Glatt-2), with an inlet temperature of 60 C and an outlet temperature of 35 C, and dried. Loss on drying (LOD) was determined using a Mettler-Toledo HR73 Halogen Moisture Analyzer, and was found to be 2.84%. The dried granulate was then milled using an 18 mesh screen.
Example 3: Preparation of compositions containing granulates of naproxen and sumatriptan [0053] The granulates from Examples 1-2 were combined in pharmaceutical compositions according to Tables 3a, 3b, 3c, and 3d. About 15-20 tablets were prepared from each batch.
Table 3a. Comparative formulations of naproxen and sumatriptan without sodium bicarbonate or the superdisintegrant crospovidone.
Ingredient Composition 1 Composition 2 Composition 12 Part I Naproxen granulate 68.05% 64.25% 57.10%
Part II Sumatriptan 25.08% 23.695 21.05%
granulate Part III Microcrystalline 2.37% 2.23% 1.99%
cellulose Lactose anhydrous 2.37% 2.23% 1.99%
Croscarmellose 1.18% 5.59% 13.90%
sodium Tartaric acid - -Sodium bicarbonate - - -Crospovidone - - -Colloidal silicon - - 1.98%
dioxide [AEROSIL 200]
Menthol - -Part IV Magnesium stearate 0.95% 2.01% 1.99%
Total 100.00% 100.00% 100.00%
T,able 3b. Formulations of naproxen and sumatriptan with sodium bicarbonate or the effervescent couple sodium bicarbonate and tartaric acid.
Ingredient Composition 3 Composition 4 Part I Naproxen granulate 52.80% 57.21%
Part II Sumatriptan granulate 19.47% 21.09%
Part III Microcrystalline cellulose 3.67% 3.98%
Lactose anhydrous 3.67% 3.98%
Croscarmellose sodium - -Tartaric acid 8.82% -Sodium bicarbonate 9.92% 11.94%
Crospovidone - -Colloidal silicon dioxide - -[AEROSIL 200]
Menthol - -Part IV Magnesium stearate 1.65% 1.79%
Total 100.00% 100.00%
Table 3c. Formulations of naproxen and sumatriptan with the superdisintegrant crospovidone.
Ingredient Composition 5 Composition 7 Part I Naproxen granulate 63.54% 57.10%
Part II Sumatriptan granulate 23.43% 21.05%
Part III Microcrystalline cellulose 2.21 % 1.99%
Lactose anhydrous 2.21 % 1.99%
Croscarmellose sodium - -Tartaric acid - -Sodium bicarbonate - -Crospovidone 2.21% 13.90%
Colloidal silicon dioxide - 1.99%
[AEROSIL 200]
Menthol 4.42% -Part IV Magnesium stearate 2.03% 1.99%
Total 100.00% 100.00%
Table 2. Composition of naproxen sodium granulation.
Ingredient Wei ng t% Amount Total (w/w) m tablet weight Naproxen sodium 87.0 500.00 125.0 Microcrystalline cellulose 8.7 50.00 12.5 Povidone 4.3 25 6.25 Water -- QS
Total 100.0 575.00 [0052] Naproxen sodium, microcrystalline cellulose and povidone were mixed for minutes in a high shear granulator at a mixer speed of 460 rpm. Water was added until a seiitable granulation was achieved at a mixer speed of 920 rpm and a chopper speed of 2220 rpm. The resulting wet granulate was transferred to a fluid bed drier (Glatt-2), with an inlet temperature of 60 C and an outlet temperature of 35 C, and dried. Loss on drying (LOD) was determined using a Mettler-Toledo HR73 Halogen Moisture Analyzer, and was found to be 2.84%. The dried granulate was then milled using an 18 mesh screen.
Example 3: Preparation of compositions containing granulates of naproxen and sumatriptan [0053] The granulates from Examples 1-2 were combined in pharmaceutical compositions according to Tables 3a, 3b, 3c, and 3d. About 15-20 tablets were prepared from each batch.
Table 3a. Comparative formulations of naproxen and sumatriptan without sodium bicarbonate or the superdisintegrant crospovidone.
Ingredient Composition 1 Composition 2 Composition 12 Part I Naproxen granulate 68.05% 64.25% 57.10%
Part II Sumatriptan 25.08% 23.695 21.05%
granulate Part III Microcrystalline 2.37% 2.23% 1.99%
cellulose Lactose anhydrous 2.37% 2.23% 1.99%
Croscarmellose 1.18% 5.59% 13.90%
sodium Tartaric acid - -Sodium bicarbonate - - -Crospovidone - - -Colloidal silicon - - 1.98%
dioxide [AEROSIL 200]
Menthol - -Part IV Magnesium stearate 0.95% 2.01% 1.99%
Total 100.00% 100.00% 100.00%
T,able 3b. Formulations of naproxen and sumatriptan with sodium bicarbonate or the effervescent couple sodium bicarbonate and tartaric acid.
Ingredient Composition 3 Composition 4 Part I Naproxen granulate 52.80% 57.21%
Part II Sumatriptan granulate 19.47% 21.09%
Part III Microcrystalline cellulose 3.67% 3.98%
Lactose anhydrous 3.67% 3.98%
Croscarmellose sodium - -Tartaric acid 8.82% -Sodium bicarbonate 9.92% 11.94%
Crospovidone - -Colloidal silicon dioxide - -[AEROSIL 200]
Menthol - -Part IV Magnesium stearate 1.65% 1.79%
Total 100.00% 100.00%
Table 3c. Formulations of naproxen and sumatriptan with the superdisintegrant crospovidone.
Ingredient Composition 5 Composition 7 Part I Naproxen granulate 63.54% 57.10%
Part II Sumatriptan granulate 23.43% 21.05%
Part III Microcrystalline cellulose 2.21 % 1.99%
Lactose anhydrous 2.21 % 1.99%
Croscarmellose sodium - -Tartaric acid - -Sodium bicarbonate - -Crospovidone 2.21% 13.90%
Colloidal silicon dioxide - 1.99%
[AEROSIL 200]
Menthol 4.42% -Part IV Magnesium stearate 2.03% 1.99%
Total 100.00% 100.00%
[0054] The porosity of composition 5 was measured to be about 4.4%.
Table 3d. Formulations of naproxen and sumatriptan with both sodium bicarbonate and the superdisintegrant crospovidone.
Ingredient Composition 6 Composition 8 Composition 9*
Part I Naproxen granulate 58.26% 57.10% 57.10%
Part II Sumatriptan 21.48% 21.05% 21.05%
granulate Part III Microcrystalline 2.03% 1.99% 1.99%
cellulose Lactose anhydrous 2.03% 1.99% 1.99%
Croscarmellose - - -sodium Tartaric acid - - -Sodium bicarbonate 12.16% 11.92% 11.92%
Crospovidone 2.03% 1.98% 1.98%
Colloidal silicon - 1.98% 1.98%
dioxide [AEROSIL 200]
Menthol - - -Part IV Magnesium stearate 1.99% 1.99%
Total 100.00% 100.00% 100.00%
* In this composition the colloidal silicon dioxide used was AEROSIL R 972.
All other compositions in Tables 3a to 3d contained AEROSIL 200.
Table 3d. Formulations of naproxen and sumatriptan with both sodium bicarbonate and the superdisintegrant crospovidone.
Ingredient Composition 6 Composition 8 Composition 9*
Part I Naproxen granulate 58.26% 57.10% 57.10%
Part II Sumatriptan 21.48% 21.05% 21.05%
granulate Part III Microcrystalline 2.03% 1.99% 1.99%
cellulose Lactose anhydrous 2.03% 1.99% 1.99%
Croscarmellose - - -sodium Tartaric acid - - -Sodium bicarbonate 12.16% 11.92% 11.92%
Crospovidone 2.03% 1.98% 1.98%
Colloidal silicon - 1.98% 1.98%
dioxide [AEROSIL 200]
Menthol - - -Part IV Magnesium stearate 1.99% 1.99%
Total 100.00% 100.00% 100.00%
* In this composition the colloidal silicon dioxide used was AEROSIL R 972.
All other compositions in Tables 3a to 3d contained AEROSIL 200.
[0055] Part III ingredients were combined and mixed. Naproxen granulate was added and mixed for 5 minutes. Sumatriptan granulate was added and mixed for 5 minutes.
Magnesium stearate was added and mixed for 2 minutes. Compositions were tabletted using a Kilian SP300 tabletting machine, with a mean hardness of about 20-24 SCU (high hardness, HH). Compositions 8 and 9 were tabletted to a mean hardness of about 13-15 SCU
(low hardness, LH).
Magnesium stearate was added and mixed for 2 minutes. Compositions were tabletted using a Kilian SP300 tabletting machine, with a mean hardness of about 20-24 SCU (high hardness, HH). Compositions 8 and 9 were tabletted to a mean hardness of about 13-15 SCU
(low hardness, LH).
[0056] Tablets from composition 5 were then placed in a vacuum oven heated to about 35 C for about 5 hours.
Example 4: Preparation of a comparative composition containing sumatriptan [0057] The granulation of Example 1 was used in a composition according to Table 4.
About 15 tablets were prepared.
Table 4. Composition containing sumatriptan succinate Ingredient Composition 10 Part I Sumatriptan 80.00%
granulate Part II Microcrystalline 7.55%
cellulose Lactose anhydrous 7.55%
Croscarmellose 3.77%
sodium Part III Magnesium stearate 1.13%
Total 100.00%
Example 4: Preparation of a comparative composition containing sumatriptan [0057] The granulation of Example 1 was used in a composition according to Table 4.
About 15 tablets were prepared.
Table 4. Composition containing sumatriptan succinate Ingredient Composition 10 Part I Sumatriptan 80.00%
granulate Part II Microcrystalline 7.55%
cellulose Lactose anhydrous 7.55%
Croscarmellose 3.77%
sodium Part III Magnesium stearate 1.13%
Total 100.00%
[0058] Ingredients of Part II were combined and mixed for 5 minutes. The resulting sumatriptan granulation was then added and blended for 5 minutes. Magnesium stearate was finally added to the sumatriptan granulation, and blended for 2 minutes.
Tablets were prepared using a Kilian SP300 tabletting machine, to a mean hardness of about 20 SCU.
Example 5: Preparation of a comparative composition containing naproxen [0059] The granulation of Example 2 was used in a composition according to Table 5.
About 15 tablets were prepared.
Table 5. Composition containing naproxen Ingredient Composition 11 Part I Naproxen granulate 91.13%
Part II Microcrystalline 3.17%
cellulose Lactose anhydrous 3.17%
Croscarmellose 1.58%
sodium Part III Magnesium stearate 0.95%
Total 100.00%
Tablets were prepared using a Kilian SP300 tabletting machine, to a mean hardness of about 20 SCU.
Example 5: Preparation of a comparative composition containing naproxen [0059] The granulation of Example 2 was used in a composition according to Table 5.
About 15 tablets were prepared.
Table 5. Composition containing naproxen Ingredient Composition 11 Part I Naproxen granulate 91.13%
Part II Microcrystalline 3.17%
cellulose Lactose anhydrous 3.17%
Croscarmellose 1.58%
sodium Part III Magnesium stearate 0.95%
Total 100.00%
[0060] Ingredients of Part II were combined and mixed for 5 minutes. Naproxen granulation was then added and blended for 5 minutes. Magnesium stearate was finally added to the naproxen granulation, and blended for 2 minutes. Tablets were prepared using a Killian SP300 tabletting machine, to a mean hardness of about 20 scu.
Example 6: Preparation of a bi-layer tablet containing sumatriptan and naproxen [0061] The granulations from examples 1-2 were used in a composition according to Table 6. About 6 tablets were prepared.
Table 6. Bi-layer tablet containing sumatriptari and naproxen Ingredient Composition 13 Part I Naproxen granulate 67.97%
Part II Sumatriptan granulate 25.06%
Part III Microcrystalline 2.36%
cellulose Lactose anhydrous 2.36%
Croscarmellose 1.18%
sodium Part IIV Magnesium stearate 1.07%
Total 100.00%
Example 6: Preparation of a bi-layer tablet containing sumatriptan and naproxen [0061] The granulations from examples 1-2 were used in a composition according to Table 6. About 6 tablets were prepared.
Table 6. Bi-layer tablet containing sumatriptari and naproxen Ingredient Composition 13 Part I Naproxen granulate 67.97%
Part II Sumatriptan granulate 25.06%
Part III Microcrystalline 2.36%
cellulose Lactose anhydrous 2.36%
Croscarmellose 1.18%
sodium Part IIV Magnesium stearate 1.07%
Total 100.00%
[0062] Ingredients of Part III were combined and mixed. 2/3 of the total weight were mixed for 5 minutes with granulate of Part I, 6 mg of magnesium stearate were added, and the combined mixture mixed for 2 minutes. The resulting first admixture was poured into the matrix of a manual press, and lightly pressed. The remainder of the Part III
mix were mixed for 5 minutes with the granulate of Part II, and then 3 mg of magnesium stearate were added, and the admixture was mixed for 2 minutes. The resulting second admixture was poured on top of the first admixture inside the matrix. The total composition was pressed using a manual press. The hardness of the resulting tablets was not determined.
Example 7: Dissolution of tablets [0063] Dissolution of the sumatriptan in tablets prepared in Example 3 was studied using a USP Apparatus 2(paddles), rotation speed of 40 rpm, at a temperature of 37 C. See U.S. PHARMACOPEIA, 2413-2414 (28th ed. 2005), hereby incorporated by reference. The medium used was 0.O1N HCl or a buffered solution at pH 6 with 0.15% sodium dodecyl sulfate. In some cases, 0.O1N HCl was used for 30 minutes, neutralized with a sodium phosphate and sodium hydroxide solution, buffered to pH 6 and 0.15% sodium dodecyl sulfate added. The dissolution profile of the sumatriptan in these compositions was compared with the dissolution of sumatriptan in a tablet of sumatriptan prepared according to Example 4 in the presence of a separate tablet of naproxen prepared according to Example 5, as well as the dissolution of sumatriptan in a bilayer tablet of sumatriptan and naproxen prepared according to Example 6. The results are summarized in Table 7 below.
Table 7. Dissolution of sumatriptan following exposure to 0.O1N HCl for 30 minutes Formulation Hardness %
(total % carbonate, bicarbonate (SCU) Dissolved and superdisintegrant) Sumatriptan and naproxen Composition 1 22-25 10**
without a carbonate, bicarbonate or the Composition 2 22-25 24 superdisintegrant crospovidone Composition 12 15-17 16 Sumatriptan and naproxen Composition 3 (9.92%) 22-25 48 with sodium bicarbonate or the effervescent couple Composition 4 (11.94%) 22-25 77 sodium bicarbonate and tartaric acid Sumatriptan and naproxen Composition 5(2.21%) 22-25 13 with the superdisintegrant crospovidone Composition 7(13.90%) 13-17 75 Sumatriptan and naproxen Composition 6 (14.19%) 13-17 85**
with sodium bicarbonate and the superdisintegrant Composition 8 LH (13.90%) 13-17 95*
erospovidone Composition 8 HH (13.90%) 22-25 89**
Composition 9 LH (13.90%) 13-15 102 Composition 9 HH (13.90%) 22-25 88 Sumatriptan and naproxen Composition 10 (in the -- 89*
in separate tablets presence of composition 11) Bi-layer tablet of Composition 13 -- 68 sumatriptan and naproxen * average of 3 experiments; ** average of 2 experiments; LH = low hardness; HH
= high hardness [0064] As illustrated in Table 7 above, compositions having less than 10% of carbonate, bicarbonate, or superdisintegrant release about 25% or less of the sumatriptan following exposure to 0.01N HCl for 30 minutes. Compositions having more than 10% of carbonate, bicarbonate, or superdisintegrant, however, release about 50% to 100% of the sumatriptan following exposure to 0.01N HCl for 30 minutes. The dissolution profile of sumatriptan in the compositions having more than 10% of carbonate, bicarbonate, or superdisintegrant is comparable to the dissolution profile of sumatriptan when it is administered separately from naproxen, either in a separate tablet or in a bi-layer tablet wherein the naproxen and the sumatriptan are in separate layers.
Example 8: Dissolution of Tablets [0065] Comparative dissolution of 2 separate tablets of sumatriptan and naproxen (Compositions 10 and 11), homogeneous compositions of sumatriptan and naproxen with sodium bicarbonate and the superdisintegrant crospovidone (Compositions 6 and 8), and a bi-layer tablet of sumatriptan and naproxen (Composition 13) was carried out using a USP
Apparatus II (paddles), rotation speed 40 r.p.m, at a temperature of 37 C.
Tablets were initially placed in 200 mL 0.01N HCl solution for 30 minutes. The solution was then neutralized using 10 mL of phosphate neutralizing buffer (60 g/L sodium dihydrogen phosphate, titrated to pH 6 with sodium hydroxide, and sodium hydroxide added until a pH of is reached). This was followed by addition of 700 mL phosphate buffer (6 g/L
sodium dihydrogen phosphate, pH adjusted to 6 with sodium hydroxide, and 0.15% (w/v) sodium lauryl sulfate added). Samples were drawn 15, 30, 45, 60, 90, and 120 minutes after the experiment was started. Results are shown in Figure 2.
mix were mixed for 5 minutes with the granulate of Part II, and then 3 mg of magnesium stearate were added, and the admixture was mixed for 2 minutes. The resulting second admixture was poured on top of the first admixture inside the matrix. The total composition was pressed using a manual press. The hardness of the resulting tablets was not determined.
Example 7: Dissolution of tablets [0063] Dissolution of the sumatriptan in tablets prepared in Example 3 was studied using a USP Apparatus 2(paddles), rotation speed of 40 rpm, at a temperature of 37 C. See U.S. PHARMACOPEIA, 2413-2414 (28th ed. 2005), hereby incorporated by reference. The medium used was 0.O1N HCl or a buffered solution at pH 6 with 0.15% sodium dodecyl sulfate. In some cases, 0.O1N HCl was used for 30 minutes, neutralized with a sodium phosphate and sodium hydroxide solution, buffered to pH 6 and 0.15% sodium dodecyl sulfate added. The dissolution profile of the sumatriptan in these compositions was compared with the dissolution of sumatriptan in a tablet of sumatriptan prepared according to Example 4 in the presence of a separate tablet of naproxen prepared according to Example 5, as well as the dissolution of sumatriptan in a bilayer tablet of sumatriptan and naproxen prepared according to Example 6. The results are summarized in Table 7 below.
Table 7. Dissolution of sumatriptan following exposure to 0.O1N HCl for 30 minutes Formulation Hardness %
(total % carbonate, bicarbonate (SCU) Dissolved and superdisintegrant) Sumatriptan and naproxen Composition 1 22-25 10**
without a carbonate, bicarbonate or the Composition 2 22-25 24 superdisintegrant crospovidone Composition 12 15-17 16 Sumatriptan and naproxen Composition 3 (9.92%) 22-25 48 with sodium bicarbonate or the effervescent couple Composition 4 (11.94%) 22-25 77 sodium bicarbonate and tartaric acid Sumatriptan and naproxen Composition 5(2.21%) 22-25 13 with the superdisintegrant crospovidone Composition 7(13.90%) 13-17 75 Sumatriptan and naproxen Composition 6 (14.19%) 13-17 85**
with sodium bicarbonate and the superdisintegrant Composition 8 LH (13.90%) 13-17 95*
erospovidone Composition 8 HH (13.90%) 22-25 89**
Composition 9 LH (13.90%) 13-15 102 Composition 9 HH (13.90%) 22-25 88 Sumatriptan and naproxen Composition 10 (in the -- 89*
in separate tablets presence of composition 11) Bi-layer tablet of Composition 13 -- 68 sumatriptan and naproxen * average of 3 experiments; ** average of 2 experiments; LH = low hardness; HH
= high hardness [0064] As illustrated in Table 7 above, compositions having less than 10% of carbonate, bicarbonate, or superdisintegrant release about 25% or less of the sumatriptan following exposure to 0.01N HCl for 30 minutes. Compositions having more than 10% of carbonate, bicarbonate, or superdisintegrant, however, release about 50% to 100% of the sumatriptan following exposure to 0.01N HCl for 30 minutes. The dissolution profile of sumatriptan in the compositions having more than 10% of carbonate, bicarbonate, or superdisintegrant is comparable to the dissolution profile of sumatriptan when it is administered separately from naproxen, either in a separate tablet or in a bi-layer tablet wherein the naproxen and the sumatriptan are in separate layers.
Example 8: Dissolution of Tablets [0065] Comparative dissolution of 2 separate tablets of sumatriptan and naproxen (Compositions 10 and 11), homogeneous compositions of sumatriptan and naproxen with sodium bicarbonate and the superdisintegrant crospovidone (Compositions 6 and 8), and a bi-layer tablet of sumatriptan and naproxen (Composition 13) was carried out using a USP
Apparatus II (paddles), rotation speed 40 r.p.m, at a temperature of 37 C.
Tablets were initially placed in 200 mL 0.01N HCl solution for 30 minutes. The solution was then neutralized using 10 mL of phosphate neutralizing buffer (60 g/L sodium dihydrogen phosphate, titrated to pH 6 with sodium hydroxide, and sodium hydroxide added until a pH of is reached). This was followed by addition of 700 mL phosphate buffer (6 g/L
sodium dihydrogen phosphate, pH adjusted to 6 with sodium hydroxide, and 0.15% (w/v) sodium lauryl sulfate added). Samples were drawn 15, 30, 45, 60, 90, and 120 minutes after the experiment was started. Results are shown in Figure 2.
Claims (34)
1. An oral dosage form comprising a therapeutically effective amount of a triptan and a therapeutically effective amount of an NSAID, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, and not less than about 60% of the triptan dissolves in 30 minutes in 200 ml of 0.01N HCl solution in a USP
Type II Dissolution Apparatus at a rotation speed of 40 rpm and a temperature of 37°C.
Type II Dissolution Apparatus at a rotation speed of 40 rpm and a temperature of 37°C.
2. The oral dosage form of claim 1, wherein the triptan is sumatriptan, eletriptan, rizatriptan, frovatriptan, almotriptan, zolmitriptan, or naratriptan.
3. The oral dosage form of claim 1, wherein the triptan is sumatriptan.
4. The oral dosage form of any one of claims 1 to 3, wherein the NSAID is flurbiprofen, ketoprofen, naproxen, oxaprozin, etodolac, indomethacin, ketorolac, nabumetone, mefanamic acid, piroxicam, lornoxicam, meloxicam, rofecoxib, celecoxib, etoricoxib, or valdecoxib.
5. The oral dosage form of any one of claims 1 to 3, wherein the NSAID is naproxen or rofecoxib.
6. The oral dosage form of claim 1, wherein the triptan is sumatriptan and the NSAID is naproxen.
7. The oral dosage form of any one of claims 1 to 6, wherein not less than about 70% of the triptan dissolves in 30 minutes.
8. The oral dosage form of any one of claims 1 to 6, wherein not less than about 80% of the triptan dissolves in 30 minutes.
9. The oral dosage form of any one of claims 1 to 8, further comprising at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, with the proviso that the superdisintegrant is not croscarmellose sodium.
10. The oral dosage form of claim 9, wherein the bicarbonate is ammonium bicarbonate, potassium bicarbonate, or sodium bicarbonate.
11. The oral dosage form of claim 9 or 10, wherein the bicarbonate is sodium bicarbonate.
12. The oral dosage form of any one of claims 9 to 11, wherein the bicarbonate or carbonate is present in an amount of more than 10% to about 20% by weight of the zone in which particles of the triptan and the NSAID are admixed.
13. The oral dosage form of any one of claims 9 to 12, wherein the bicarbonate or carbonate is present in an amount of about 11% to about 17% by weight of the zone in which particles of the triptan and the NSAID are admixed.
14. The oral dosage form of any one of claims 9 to 13, wherein the additive is a bicarbonate.
15. The oral dosage form of claim 14, further comprising a pharmaceutically acceptable acid.
16. The oral dosage form of claim 15, wherein the pharmaceutically acceptable acid is ascorbic acid, citric acid, tartaric acid, succinic acid, fumaric acid, malic acid, lactic acid, propionic acid, sorbic acid, or benzoic acid.
17. The oral dosage form of any one of claims 9 to 16, wherein the superdisintegrant is crospovidone or sodium starch glycolate.
18. The oral dosage form of any one of claims 9 to 17, wherein the superdisintegrant is present in an amount of about 7% to about 20% by weight of the zone in which particles of the triptan and the NSAID are admixed.
19. The oral dosage form of any one of claims 9 to 18, wherein the superdisintegrant is present in an amount of more than 10% to about 17% by weight of the zone in which particles of the triptan and the NSAID are admixed.
20. The oral dosage form of any one of claims 9 to 19, wherein the additive is present in an amount of more than 10% by weight of the zone in which particles of the triptan and the NSAID are admixed.
21. The oral dosage form of any one of claims 9 to 20, wherein the triptan is in granulate form and the additive is extra-granular.
22. The oral dosage form of claim 21, wherein the NSAID is in granulate form.
23. The oral dosage form of any one of claims 1 to 22 in the form of a porous tablet.
24. The oral dosage form of claim 23, wherein the porosity of the tablet is at least about 10%.
25. The oral dosage form of claim 23, further comprising a volatilizable adjuvant.
26. The oral dosage form of claim 25, wherein the volatilizable adjuvant is camphor, menthol, benzoic acid, urethane, urea, vanillin, tetramethylene tetramine, naphthalene, or ammonium bicarbonate.
27. An oral dosage form comprising:
(a) a therapeutically effective amount of a triptan, (b) a therapeutically effective amount of an NSAID, and (c) at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, the additive is present in an amount of more than 10% by weight of the zone in which particles of the triptan and the NSAID are admixed, and the superdisintegrant is not croscarmellose sodium.
(a) a therapeutically effective amount of a triptan, (b) a therapeutically effective amount of an NSAID, and (c) at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, the additive is present in an amount of more than 10% by weight of the zone in which particles of the triptan and the NSAID are admixed, and the superdisintegrant is not croscarmellose sodium.
28. The oral dosage form of claim 27, wherein the superdisintegrant is crospovidone.
29. An oral dosage form comprising:
(a) a therapeutically effective amount of a triptan, (b) a therapeutically effective amount of an NSAID, and (c) at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, the ratio of the amount of NSAID to the amount of additive is less than about 5, and the superdisintegrant is not croscarmellose sodium.
(a) a therapeutically effective amount of a triptan, (b) a therapeutically effective amount of an NSAID, and (c) at least one additive selected from the group consisting of (i) a carbonate, (ii) a bicarbonate, and (iii) a superdisintegrant, wherein the dosage form includes at least one zone in which particles of the triptan and the NSAID are admixed, the ratio of the amount of NSAID to the amount of additive is less than about 5, and the superdisintegrant is not croscarmellose sodium.
30. The oral dosage form of claim 29, wherein the superdisintegrant is crospovidone.
31. A method for preparing the oral dosage form of any one of claims 1 to 30 comprising separately granulating each of the triptan and the NSAID, combining the separate granulates with at least one extragranular pharmaceutically acceptable excipient to form a mixture, and compacting the mixture into the oral dosage form.
32. A method for preparing the oral dosage form of any one of claims 1 to 30 comprising granulating one of the triptan or the NSAID with at least one pharmaceutically acceptable excipient to form a granulate, adding to the granulate a dry blend comprising at least the other of the triptan or the NSAID and at least one pharmaceutically acceptable excipient to form a mixture, and compacting the mixture into the oral dosage form.
33. A method for preparing the oral dosage form of any one of claims 1 to 30 comprising coating an inert core with a layer comprising a triptan and an NSAID.
34. A method of treating acute migraines comprising administering a therapeutically effective amount of the oral dosage form of any one of claims 1 to 30 to a patient in need thereof.
Applications Claiming Priority (7)
Application Number | Priority Date | Filing Date | Title |
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US92203107P | 2007-04-04 | 2007-04-04 | |
US60/922,031 | 2007-04-04 | ||
US93261307P | 2007-05-31 | 2007-05-31 | |
US60/932,613 | 2007-05-31 | ||
US7056308P | 2008-03-21 | 2008-03-21 | |
US61/070,563 | 2008-03-21 | ||
PCT/US2008/004429 WO2008124081A2 (en) | 2007-04-04 | 2008-04-03 | Rapid dissolution of combination products |
Publications (1)
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CA2682872A1 true CA2682872A1 (en) | 2008-10-16 |
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ID=39530000
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CA002682872A Abandoned CA2682872A1 (en) | 2007-04-04 | 2008-04-03 | Rapid dissolution of combination products |
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EP (1) | EP2029117A2 (en) |
CA (1) | CA2682872A1 (en) |
WO (1) | WO2008124081A2 (en) |
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AU2006317530B2 (en) | 2005-11-28 | 2011-09-01 | Imaginot Pty Ltd | Oral therapeutic compound delivery system |
EP3090743A1 (en) | 2008-01-09 | 2016-11-09 | Charleston Laboratories, Inc. | Pharmaceutical compositions for treating headache and eliminating nausea |
WO2009152551A1 (en) * | 2008-06-20 | 2009-12-23 | Alphapharm Pty Ltd | Pharmaceutical formulation |
EP2387993B1 (en) * | 2010-05-21 | 2012-11-07 | Sanovel Ilaç Sanayi Ve Ticaret Anonim Sirketi | Orally disintegrating tablets of zolmitriptan and process for preparing the same |
CN102552423B (en) * | 2012-02-20 | 2013-07-24 | 崔新明 | Medicinal composition for treating migraine |
DE202015006313U1 (en) * | 2014-09-09 | 2016-02-02 | Charleston Laboratories, Inc. | Pharmaceutical compositions |
WO2017152130A1 (en) | 2016-03-04 | 2017-09-08 | Charleston Laboratories, Inc. | Pharmaceutical compositions |
TR201720429A2 (en) * | 2017-12-15 | 2019-07-22 | Sanovel Ilac Sanayi Ve Ticaret Anonim Sirketi | PHARMACEUTICAL COMPOSITIONS OF FLURBIPROFEN AND 5-HT1–#&RECEPTOR AGONISTS |
TR201921902A1 (en) * | 2019-12-27 | 2021-07-26 | Sanovel Ilac Sanayi Ve Ticaret Anonim Sirketi | Orally disintegrating tablets containing flurbiprofen and eletriptan |
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WO2004110492A2 (en) * | 2003-06-06 | 2004-12-23 | Glaxo Group Limited | Composition comprising triptans and nsaids |
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2008
- 2008-04-03 CA CA002682872A patent/CA2682872A1/en not_active Abandoned
- 2008-04-03 WO PCT/US2008/004429 patent/WO2008124081A2/en active Application Filing
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WO2008124081A2 (en) | 2008-10-16 |
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