CN1203852C - 维得克西组合物 - Google Patents
维得克西组合物 Download PDFInfo
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- CN1203852C CN1203852C CNB008059063A CN00805906A CN1203852C CN 1203852 C CN1203852 C CN 1203852C CN B008059063 A CNB008059063 A CN B008059063A CN 00805906 A CN00805906 A CN 00805906A CN 1203852 C CN1203852 C CN 1203852C
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Classifications
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Abstract
本发明提供一种药物组合物,它包含大约1mg至大约100mg的维得克西微粒和一种或多种可药用赋形剂。该组合物用于治疗或预防环加氧酶-2介导的疾病和病症。
Description
发明领域
本发明涉及可通过口服释放的包含维得克西(Valdecoxib)活性组分的药物组合物,制备该组合物的方法,通过给予接受治疗者所述组合物来治疗环加氧酶-2介导的疾病的方法,和所述组合物在生产药物中的应用。
发明背景
Talley等人在美国专利5,633,272中公开了化合物4-(5-甲基-3-苯基-4-异噁唑基)苯磺酰胺,本文也称作维得克西,以及制备该化合物和相关化合物的方法。维得克西具有下列结构:
在上述美国专利5,633,272中公开了所记载的化合物包括维得克西作为有效的抗炎、镇痛和解热药,它对环加氧酶-2(COX-2)的抑制作用大大超过对环加氧酶-1(COX-1)的抑制作用,因此具有高度选择性。上述美国专利5,633,272中也包含关于给予所述化合物的制剂,包括可口服释放的剂型如片剂和胶囊剂的一般性参考。
欧洲专利0 863 134中公开了可口服释放的组合物,它包含选择性环加氧酶-2抑制剂,特别是2-(3,5-二氟苯基)-3-(4-甲基-磺酰基)苯基)-2-环戊烯-1-酮,结合以赋形剂组分包括微晶纤维素、乳糖一水合物、羟丙基纤维素、交联羧甲基纤维素钠和硬脂酸镁。
国际专利WO 00/32189中公开了可口服释放的组合物,它包含选择性环加氧酶-2抑制剂,特别是塞利克西(celecoxib),结合以选自适宜的稀释剂、崩解剂、粘合剂、润湿剂、润滑剂等的赋形剂组分。
维得克西具有相当低的水溶性,并由于该原因,建议通过非肠道途径给予可溶性更好的前药帕立克西(parecoxib),它裂解后形成维得克西。例如参见Dionne(1999),“COX-2抑制剂-IBC Conference,12-13 April 1999,Coronado,CA,U.S.A.”,Idrugs,2(7),664-666。
然而,显示良好生物利用度和即刻释放特性的维得克西的可口服释放剂型是有益的。
如下文所述,在一系列环加氧酶-2介导的疾病和病症中指示或潜在地指示给予维得克西。因此,提供具有针对所述适应征特定生物利用度特性的可口服释放制剂是非常有益的。提供显示符合快速起效药动学的即刻释放口服制剂是特别有益的。
在治疗环加氧酶-2介导的疾病和病症中,所述制剂代表重要的进展。
发明概述
现提供一种药物组合物,其中每单位剂量包含大约1mg至大约100mg维得克西微粒和一种或多种可药用赋形剂。
在一个实施方案中,当对禁食接受治疗者口服给药时,单次剂量提供的维得克西血清浓度时间过程具有至少一种下列特性:
(a)给药后达到治疗阈浓度的时间不超过大约0.5小时;
(b)给药后达到最大浓度的时间(Tmax)不超过大约3小时;和
(c)最大浓度(Cmax)不低于大约100ng/ml。
“治疗阈浓度”是指对于给予维得克西的特定适应征来说达到治疗效应的血清中维得克西的最小浓度。典型地,该阈浓度至少大约为20ng/ml,例如为大约25-大约75ng/ml。
该组合物可以是离散的固体制剂形式如片剂、硬或软胶囊剂、锭剂、小药囊或软锭剂,一个或一小部分构成单次剂量;或者,该组合物可以是大体上均匀的可流动的制剂形式,如微粒或颗粒固体或液体悬浮液,其中单次剂量可通过目测方法量取。
在目前优选的实施方案中,组合物以片剂形式存在,其中赋形剂包括水溶性稀释剂、崩解剂、粘合剂和润滑剂。最优选地,粘合剂包含预凝胶化淀粉。
本发明还提供了治疗适于用环加氧酶-2抑制剂治疗的患者的内科疾病的方法,该方法包括口服给予本发明组合物,每天1-大约4次。
本发明的其它特性中一部分是显而易见的并且下文将指出另一部分。
附图的简要说明
图1是说明本发明维得克西片剂典型制备方法的流程图。
图2是说明本发明维得克西片剂另一制备方法的流程图。
图3是显示人口服给予本发明维得克西片剂后血浆维得克西浓度的曲线图。
发明详述
本发明组合物每单位剂量包含大约1mg至大约100mg维得克西微粒。该组合物是即刻释放剂型,当口服给予患有所治疗疾病的受治疗者,特别是人时,能够迅速减轻环加氧酶-2介导的疾病。
据信,如果不受任何理论的限制,本发明组合物所获得的优良的临床作用是由维得克西改善的生物利用度产生的,特别是当口服给予该组合物时,由维得克西在胃肠道出人意外地有效吸收产生的。该有效吸收可由本领域技术人员通过监测所治疗对象在给药后的一段时间内血清维得克西浓度证实。要求在尽可能短的时间内达到相当有效环加氧酶-2抑制作用的维得克西血清浓度阈值。
如上所述,在一个实施方案中,当口服给予禁食接受治疗者时,单次剂量提供的维得克西血清浓度时间过程具有至少一种下列特性:
(a)给药后达到治疗阈浓度(典型地至少为大约20ng/ml)的时间不超过大约0.5小时;
(b)给药后达到最大浓度的时间(Tmax)不超过大约3小时;和
(c)最大浓度(Cmax)不低于大约100ng/ml。
应该理解,在提供满足上述任一标准(a)-(c)的血清浓度有效的剂量单位中维得克西的量将依赖于所治疗对象的体重。例如,如果接受治疗的对象是小孩或小动物(例如狗),那么在所指出的大约为1mg至大约100mg范围内相对低的维得克西量就可能提供满足标准(a)-(c)中至少一项的血清浓度。如果接受治疗的对象是成人或大动物(例如马),那么所指出的血清浓度可能需要相对大剂量的维得克西。对于成人来说,为提供所指示的血浆浓度,每单位剂量本发明组合物中适宜的维得克西的量典型地为大约5mg至大约40mg。
在优选的具体实施方案中,当口服给予禁食成人患者20mg剂量时,组合物的生物利用度是,
(a)在给药后不超过大约0.5小时达到维得克西血浆浓度20ng/ml,更优选50ng/ml;
(b)给药后Tmax不超过大约3小时;和
(c)Cmax不低于大约100ng/ml。
本发明组合物包含微粒形式的维得克西。例如通过碾磨或研磨、或者通过从溶液中沉淀产生的初级维得克西微粒可聚集形成第二级聚合体颗粒。除非另外说明,本文所使用的术语“粒度”是指初级微粒最长维度的大小。相信,粒度是影响维得克西临床效力的重要参数。因此,在一个实施方案中,组合物具有一个维得克西粒度分布使得D90粒度小于大约75μm。“D90粒度”在本文定义为90%(重量比)的颗粒最长维度小于所述颗粒大小的粒度。
另外或可选择地,本发明组合物中维得克西颗粒的重均粒度优选地为大约1μm至大约10μm,最优选为大约5μm至大约7μm。
在另一实施方案中,本发明组合物中维得克西颗粒的重均粒度为大约10nm至大约1000nm(1μm),例如,为大约100nm至大约400nm,或者为大约500nm至大约800nm。
本发明组合物包含维得克西与一种或多种选自稀释剂、崩解剂、粘合剂、润湿剂和润滑剂的赋形剂。在一个优选的实施方案中,至少一种赋形剂是水溶性稀释剂或润湿剂。相信,所述水溶性稀释剂或润湿剂有助于维得克西在胃肠道的分散和溶解。优选地至少水溶性稀释剂是存在的。在另一优选的实施方案中,至少一种赋形剂是崩解剂。在另一优选的实施方案中,至少一种赋形剂是粘合剂;如上所述,特别优选预凝胶化淀粉作为粘合剂。在另一优选的实施方案中,至少一种赋形剂是润滑剂。特别优选地,除维得克西外,所述组合物包含水溶性稀释剂、崩解剂、粘合剂和润滑剂中的每一个。
本发明组合物可以是大体上均匀的可流动的制剂形式,如微粒或颗粒固体或液体,或者可以是离散的制剂形式如胶囊剂或片剂。
当组合物是大体上均匀的可流动的制剂形式时,单次剂量可使用适宜的容量测定装置如匙或杯通过目测方法量取。适宜的可流动制剂形式包括但不限制于粉剂和颗粒剂。或者,所述可流动的制剂形式可以是悬浮液,它包含以固体微粒相分散在液相优选水相中的维得克西。在制备所述悬浮液时,使用润湿剂如土温80等似乎是有益的。悬浮液可通过将碾磨过的维得克西分散在液相中制备;或者维得克西可从溶剂如醇、优选乙醇的溶液中沉淀。优选地,水相包含可口的载体如水、糖浆或果汁,例如苹果汁。
本发明组合物用于治疗和预防各种由COX-2介导的疾病,包括但不限制于以炎症、疼痛和/或发烧为特征的疾病。该组合物特别适于用作抗炎剂,如用于治疗关节炎,其好处是,与缺少COX-2对COX-1的选择性的常规非甾体抗炎药(NSAID)的组合物相比,它具有明显小的毒副作用。尤其,与常规NSAID的组合物比,本发明组合物引起胃肠道毒性和胃肠道刺激性包括上胃肠道溃疡和出血的可能性降低,引起肾脏副作用如肾功能降低导致液体潴留和加重高血压的可能性降低,对出血时间包括抑制血小板功能的作用降低和引起阿司匹林敏感性哮喘患者哮喘发作的能力降低。因此,对于禁用常规NSAID的病人来说,本发明组合物特别适于用作所述NSAID的替代品,其中所述病人包括,例如患有消化性溃疡、胃炎、局限性肠炎、溃疡性结肠炎、憩室炎或近期有胃肠伤害病史的病人;患有胃肠道出血、血凝固疾病包括贫血如低凝血酶原血、血友病或其它出血问题的病人;患有肾病的病人;或者手术前或服用抗凝剂的病人。
所述组合物用于治疗各种关节炎性疾病,包括但不限于类风湿性关节炎、脊椎关节病、痛风性关节炎、骨关节炎、系统性红斑狼疮和幼年型关节炎。
所述组合物适用于治疗哮喘、支气管炎、痛经、早产、腱炎、滑囊炎、变应性神经炎、巨细胞病毒感染、细胞程序死亡包括HIV-引起的细胞程序死亡、腰痛、肝病包括肝炎、与皮肤相关的疾病包括牛皮癣、湿疹、痤疮、烧伤、皮炎和紫外线伤害包括晒伤以及术后发炎包括眼手术如白内障手术或屈光手术的术后发炎。
所述组合物适用于治疗胃肠疾病如炎性肠疾病、节段性回肠炎、胃炎、过敏性肠综合征和溃疡性结肠炎。
所述组合物适用于治疗疾病引起的炎症,所述疾病如偏头痛、结节性多动脉炎、甲状腺炎、再生障碍性贫血、何杰金氏病、硬化病(sclerodoma)、风湿热、I型糖尿病、神经肌肉的接合处疾病包括重症肌无力、白化病包括多发性硬化、类肉瘤病、肾病综合征、贝切特氏综合征、多肌炎、齿龈炎、肾炎、过敏症、损伤后引起的肿胀包括脑水肿、心肌局部缺血等。
所述组合物适用于治疗眼病,如视网膜炎、结膜炎、视网膜病、葡萄膜炎、眼恐光症和急性眼组织损伤。
所述组合物适用于治疗肺炎,如与病毒感染相关的肺炎和膀胱纤维化以及骨吸收,如与骨质疏松相关的骨吸收。
所述组合物适用于治疗某些中枢神经系统疾病,如皮质性痴呆包括早老性痴呆、神经变性,以及由中风、局部缺血和外伤引起的中枢神经系统伤害。本文中所使用的术语“治疗”包括部分或全部抑制痴呆,包括阿耳茨海默氏病、血管性痴呆、多梗塞性痴呆、早老性痴呆、酒毒性痴呆和老年性痴呆。
所述组合物适用于治疗变应性鼻炎、呼吸窘迫综合征、内毒性休克综合征和肝病。
所述组合物适用于治疗疼痛,包括但不限制于术后痛、牙痛、肌肉痛和癌症引起的疼痛。例如,所述组合物适用于缓解各种疾病引起的疼痛、发烧和炎症,所述疾病包括风湿热、流感和其它病毒性感染包括普通的感冒、下背(low back)和颈痛、痛经、头痛、牙痛、挫伤和扭伤、肌炎、神经痛、滑膜炎、关节炎包括类风湿性关节炎、关节变性疾病(骨关节炎)、痛风和关节强硬性脊椎炎、滑囊炎、烧伤以及外科和牙科手术后引起的外伤。
所述组合物适用于治疗和预防与炎症相关的心血管疾病,包括血管疾病、冠状动脉疾病、动脉瘤、血管排斥、动脉硬化、动脉粥样硬化包括心脏移植性动脉粥样硬化、心肌梗塞、栓塞、中风、血栓形成包括静脉血栓形成、绞痛包括不稳定型绞痛、冠状动脉斑炎症、细菌引起的炎症包括衣原体引起的炎症、病毒引起的炎症和与外科手术相关的炎症,所述外科手术如血管移植包括冠状动脉搭桥手术、血管再形成手术包括血管成形术、放置支架、动脉内膜切除术或其它涉及动脉、静脉或毛细血管的介入治疗。
所述组合物适用于治疗接受治疗者与血管生成相关的疾病,例如用于抑制肿瘤血管生成。所述组合物适用于治疗瘤形成包括转移;眼科疾病如角膜移植物排斥、眼新血管形成、视网膜新血管形成包括损伤或感染后新血管形成、糖尿病性视网膜病、黄斑变性、晶状体后纤维组织形成和新血管性青光眼;溃疡性疾病如胃溃疡;病理性但非恶性的疾病,如血管瘤包括婴儿血管瘤、鼻咽血管纤维瘤和无血管的骨坏死;以及女性生殖系统疾病如子宫内膜异位。
所述组合物适用于预防和治疗良性瘤和转移瘤并且瘤包括癌,如结肠直肠癌、脑癌、骨癌、上皮细胞衍生的瘤(上皮癌)如基底细胞癌、腺癌、胃肠癌如唇癌、口腔癌、食管癌、小肠癌、胃癌、结肠癌、肝癌、膀胱癌、胰腺癌、卵巢癌、子宫颈癌、肺癌、乳腺癌、皮肤癌如鳞状上皮细胞癌和基底细胞癌、前列腺癌、肾细胞癌和其它已知的影响全身上皮细胞的癌。特别适用于本发明组合物治疗的瘤形成是胃肠癌、Barrett食管癌、肝癌、膀胱癌、胰腺癌、卵巢癌、前列腺癌、子宫颈癌、肺癌、乳腺癌和皮肤癌。所述组合物也可以用于治疗放射性治疗引起的纤维变性。所述组合物也可以用于治疗患有腺瘤性息肉的接受治疗者,包括那些患有家族腺瘤性息肉(FAP)的接受治疗者。此外,所述组合物可用于防止处于FAP危险中的病人息肉形成。
所述组合物通过抑制有收缩性的前列腺素类激素的合成抑制前列腺素类激素诱导的平滑肌收缩并因此可用于治疗痛经、早产、哮喘和与嗜酸性细胞相关的疾病。它们也可以用于减少骨丢失,特别是绝经后妇女的骨丢失(即治疗骨质疏松症)和治疗青光眼。
本发明组合物优选的用途是类风湿性关节炎和骨关节炎的治疗,疼痛的一般处理(特别是口腔手术后疼痛,一般手术后疼痛,整形手术后疼痛和急性突发骨关节炎),早老性痴呆的治疗和结肠癌的化学预防。
除了用于人的治疗外,本发明组合物用于伴生动物、外来动物、农场动物等的兽医治疗,特别是哺乳动物的兽医治疗。尤其,本发明组合物用于治疗马、狗和猫COX-2介导的疾病。
本发明还涉及适于用COX-2抑制剂治疗的疾病的治疗方法,该方法包括口服给予需要治疗的对象本发明组合物。用于预防、缓解或改善疾病的剂量方案优选每日一次或每日两次治疗,但可根据各种因素调整。这些因素包括治疗对象的类型、年龄、重量、性别、饮食和内科疾病以及疾病的性质和严重性。因此,实际上所使用的剂量方案可广泛地改变并因此可衍生自上述优选的剂量方案。
最初的治疗可由上述剂量方案开始。如果需要,治疗通常持续几个星期至几个月或几年直至疾病或病症已经被控制或消除。用本发明组合物治疗的对象可通过本领域公知的方法进行常规监测以便确定治疗的功效。连续分析所监测到的数据可用于在治疗过程中调整治疗方案,使得可以在任何时间点给予最佳有效剂量,并且可以测定治疗的持续时间。这样,可在治疗过程中合理地调整治疗方案和给药时间表,使得可以给予最低并且能够显示令人满意功效剂量的组合物,并且使得只要成功地治疗疾病需要,那么就可以连续给药。
本发明组合物可以与阿片样物质和其它镇痛剂联合使用,其中所述镇痛剂包括麻醉性镇痛剂、Mu受体拮抗剂、Kappa受体拮抗剂、非麻醉性(即非成瘾性的)镇痛剂、单胺摄取抑制剂、腺苷调节剂、大麻酯衍生物、P物质拮抗剂、神经激肽-1受体拮抗剂和钠通道阻滞剂等。优选的联合治疗包括使用本发明组合物和一种或多种化合物,所述化合物选自醋氯芬酸、阿西美辛、e-乙酰氨基己酸、对乙酰氨基酚、醋氨沙洛、乙酰苯胺、乙酰水杨酸(阿司匹林)、S-腺嘌呤核苷基甲硫氨酸、阿氯芬酸、阿芬他尼、烯丙罗定、阿明洛芬、阿洛普令、阿法罗定、双(乙酰水杨酸)铝、氨芬酸、氨氯苯嗪、3-氨基-4-羟基丁酸、2-氨基-4-甲基吡啶、氨丙吡酮、氨基比林、阿米西群、水杨酸铵、安吡昔康、呱氨托美丁、阿尼利定、安替比林、水杨酸安替比林、安曲非宁、阿扎丙宗、苄达酸、贝诺酯、苯噁洛芬、苄哌立隆、苄达明、苄基吗啡、柏莫洛芬、苯腈米特、α-红没药醇、溴芬酸、对溴乙酰苯胺、5-溴水杨酸乙酸酯、溴水杨醇、布西汀、步氯酸、布可隆、丁苯羟酸、布马地宗、丁丙诺啡、布他西丁、异丁苯丁酸、布托啡诺、乙酰水杨酸钙、卡马西平、卡比芬、卡洛芬、卡沙兰、三氯叔丁醇、氯西诺嗪、胆碱水杨酸盐、辛可芬、桂美辛、西拉马朵、环氯茚酸、氯美辛、氯尼他秦、氯尼辛、氯吡酸、丁子香、可待因、可待因甲基溴化物、磷酸可待因、硫酸可待因、克罗丙胺、克罗乙胺、地索吗啡、右苯恶啶、右吗拉胺、地佐辛、地恩丙胺、双氯芬酸钠、二苯米唑、联苯吡胺、二氟尼柳、双氢可待因、双氢可待因酮烯醇乙酸酯、双氢吗啡、乙酰水杨酸二羟铝、地美沙朵、地美康醇、二甲噻丁、吗苯丁酯、地匹哌酮、diprocetyl、安乃近、地他唑、屈恶昔康、依莫法宗、苯乙氨茴酸、依匹唑、依他佐辛、依特柳酯、乙水杨胺、依索庚嗪、依托沙秦、乙甲噻丁、乙基吗啡、依托度酸、依托芬那酯、依托尼秦、丁香酚、联苯乙酸、芬布芬、芬克洛酸、芬度柳、非诺洛芬、芬太尼、芬替酸、非普地醇、非普拉宗、夫洛非宁、氟芬那酸、氟诺洛芬、氟苯乙砜、氟吡氨酯、氟丙喹宗、氟比洛芬、磷柳酸、龙胆酸、格拉非宁、葡美辛、水杨酸甘油酯、愈创兰油烃、氢可酮、氢吗啡酮、羟哌替啶、异丁芬酸、布洛芬、异丁萘生、水杨酸咪唑、吲哚美辛、吲哚洛芬、三苯唑酸、isoladol、异美沙酮、异尼辛、依索克酸、依索昔康、凯托米酮、酮洛芬、酮咯酸、对乳酰乙氧基苯胺、lefetamine、左啡诺、洛芬太尼、氯那唑酸、芬诺昔康、氯索洛芬、乙酰水杨酸赖氨酸盐、乙酰水杨酸镁、甲氯芬那酸、甲芬那酸、哌替啶、美普他酚、氨基水杨酸、美他佐辛、盐酸美沙酮、左美丙嗪、甲嗪酸、甲氧夫啉、美托酮、莫非布宗、莫苯唑酸、吗拉宗、吗啡、盐酸吗啡、硫酸吗啡、水杨酸吗啡、麦罗啡、萘丁美酮、纳布啡、1-萘基水杨酸酯、萘普生、那碎因、萘福泮、尼可吗啡、尼芬那宗、尼氟灭酸、尼美舒利、5’-硝基-2’-丙氧基乙酰苯胺、去甲左啡诺、去甲美沙酮、去甲吗啡、诺匹哌酮、奥沙拉秦、阿片、奥沙西罗、奥沙美辛、噁丙嗪、羟考酮、羟吗啡酮、羟布宗、阿片全碱、瑞尼托林、帕沙米特、喷他佐辛、哌立索唑、非那西丁、苯吗庚酮、非那佐辛、盐酸非那吡啶、非诺可、苯哌利定、非诺吡酮、乙酰水杨酸苯酯、保泰松、水杨酸苯酯、非尼拉朵、吡酮洛芬、匹米诺定、哌布宗、哌立酮、吡咯芬(piprofen)、吡拉唑酸、哌腈米特、吡罗昔康、普拉洛芬、丙谷美辛、普罗庚嗪、γ-二甲哌替啶、丙帕他莫、丙吡兰、右丙氧芬、异丙安替比林、普罗喹宗、丙替嗪酸、雷米那酮、雷米芬太尼、利马唑甲硫酸盐、醋水杨胺、水杨苷、水杨酰胺、水杨酰胺o-乙酸、水杨基硫酸、对水杨酯、沙维林、西美曲特、水杨酸钠、舒芬太尼、柳氮磺胺吡啶、舒林酸、超氧化物歧化酶、舒洛芬、琥布宗、他尼氟酯、替尼达普、替诺昔康、特罗芬那酯、粉防己碱、噻唑丁炎酮、噻洛芬酸、噻拉米特、替利定、替诺立定、托芬那酸、托美丁、曲马多、tropesin、维米醇、联苯丁酸、希莫洛芬、扎托洛芬和佐美酸(见TheMerck Index,第12版,Therapeutic Category and BiologicalActivity Index,ed.S.Budavari(1996),pp.Ther-2至Ther-12(镇痛(牙用),镇痛(麻醉性),镇痛(非麻醉性),抗炎(非甾类)。
特别优选的联合治疗包括联合使用本发明组合物与阿片样化合物,尤其,所述阿片样化合物是可待因、哌替啶、吗啡或其衍生物。
本发明维得克西组合物也可以与第二种COX-2抑制剂,例如赛利克西、罗非克西(rofecoxib)等一起联合给药。
与维得克西一起联合给药的化合物可以与维得克西分别配制或者在本发明组合物中与维得克西一起配制。如果维得克西与第二种药物,例如阿片样药物一起配制,那么,第二种药物可配制成即刻释放、快速起效、持续释放或双重释放形式。
本发明组合物通常适用于以大约1mg至大约100mg的每日剂量给予维得克西。典型地,每剂量单位的本发明组合物包含每日剂量的大约1/10至全部量的维得克西。优选的每日剂量大约为2mg至大约60mg,更优选大约5mg至大约40mg,例如大约5mg、大约10mg、大约20mg或大约40mg。如果所述剂量单位是适用于口服给药的分散的制剂形式,如胶囊剂或片剂,那么所述各制剂形式包含大约1mg至大约100mg,优选大约5mg至大约60mg,更优选大约10mg至大约50mg,例如大约10mg、大约20mg或大约40mg的维得克西。
本发明组合物中所使用的维得克西可按照任何本身已知的方法,包括在上述美国专利5,633,272中所阐述的方法制备。
除维得克西外,本发明组合物包含一种或多种适用于口服给药的赋形剂。从与组合物中其它组分相容的意义上来说,所述赋形剂必须是可药用的并且必须是对接受者无害的。所使用的赋形剂可以是固体或液体,或者二者兼有。
本发明组合物每单位剂量包含所需量的维得克西并且可以是下列形式,例如片剂、丸剂、硬或软胶囊剂、锭剂、扁囊剂、可分散的粉剂、颗粒剂、悬浮剂或适用于口服给药的任何其它形式。片剂、丸剂等可以制成包衣或不包衣。
例如,适用于口腔或舌下给药的本发明组合物包括在调味基质如蔗糖和阿拉伯胶或西黄蓍胶中包含维得克西的锭剂,和在惰性基质如明胶和甘油或蔗糖和阿拉伯胶中包含维得克西的软锭剂。
液体剂量形式包括维得克西在液态稀释剂、典型地在含水稀释剂中的悬浮液。所述悬浮液可包含其它赋形剂,例如润湿剂、乳化剂和悬浮剂、稳定剂、增稠剂和甜味剂、矫味剂和芳香剂。
本发明组合物可按照任何适宜的药剂学方法制备,所述方法包括将维得克西与赋形剂合并的步骤。通常,可通过将维得克西均匀并且充分地与液体或细分散的固体稀释剂混合,然后如果需要,将所得到的混合物装胶囊或成形制备所述组合物。例如,可通过将所述混合物的粉末或颗粒可有可无地与一种或多种其它赋形剂一起压缩或铸模制备片剂。可通过将自由流动的组合物,例如可有可无地与一种或多种稀释剂、崩解剂、粘合剂和润滑剂混合的包含维得克西的粉末或颗粒在适宜的压片机上压缩制备压缩片。可通过将用液体稀释剂湿润的维得克西粉末可有可无地与一种或多种赋形剂铸模在适宜的成型机中制备模制片。
通过赋形剂的选择和组合,可提供在功效、生物利用度、清除时间、稳定性、维得克西与赋形剂的相容性、安全性、溶解曲线、崩解曲线和/或其它药动学、化学和/或物理性质方面性能改善的组合物。优选地,赋形剂包含一种或多种水溶性或水可分散性物质并且具有润湿性以便抵消维得克西的低水溶性和疏水性。如果将组合物配制成片剂,与所选择的赋形剂混合后提供的片剂显示,除了其它性质之外,还改善了溶解性和崩解性、硬度、抗碎强度和/或易碎性。
本发明组合可有可无地包含一种或多种可药用稀释剂作为赋形剂。适宜的稀释剂的实例包括单独或联合使用的乳糖,包括无水乳糖和乳糖一水合物;淀粉,包括可直接压片的淀粉和水解淀粉(例如CelutabTM和EmdexTM);甘露糖醇;山梨糖醇;木糖醇;右旋糖(例如CereloseTM2000)和右旋糖一水合物;磷酸氢钙二水合物;蔗糖为基础的稀释剂;糖膏剂的糖;硫酸氢钙一水合物;硫酸钙二水合物;颗粒状乳酸钙三水合物;dextrates;肌醇;水解的谷类固体;直链淀粉;纤维素包括微晶纤维素、食用级来源的α-和无定形纤维素(例如RexcelTM)和粉末状纤维素;碳酸钙;甘氨酸;膨润土;聚乙烯吡咯烷酮等。如果存在,所述稀释剂占组合物总重量的大约5%至大约99%,优选大约10%至大约85%,并且更优选大约20%至大约80%。优选地,所选择的稀释剂显示适宜的流动性和可压性(如果要求制备片剂)。
单独或联合使用的乳糖和微晶纤维素是优选的稀释剂。两种稀释剂与维得克西是化学相容的。使用颗粒外微晶纤维素(即在干燥步骤后,将微晶纤维素加到湿法制粒的组合物中)可用于改善硬度(对于片剂来说)和/或崩解时间。乳糖特别是乳糖一水合物是特别优选的。典型地,使用乳糖提供的组合物具有适宜的维得克西释放速度、稳定性、压片前流动性和/或消耗相当低稀释剂的干燥性。它提供有助于制粒紧密的高密度底物(如果使用湿法制粒)并因此改善混合物的流动性。
本发明组合物可有可无地包含一种或多种可药用崩解剂作为赋形剂,特别是在片剂情况下。适宜的崩解剂包括单独或联合使用的淀粉,包括甘醇酸淀粉钠(例如Pen West的ExplotabTM)和预凝胶化的玉米淀粉(例如NationalTM1551,NationalTM1550和ColocornTM1500);粘土(例如VeegumTM HV);纤维素如纯纤维素、微晶纤维素、甲基纤维素、羧甲基纤维素和羧甲基纤维素钠、交联羧甲基纤维素钠(例如FMC的Ac-Di-SolTM);藻酸盐;交联聚维酮和树胶如琼脂、瓜尔胶、槐树豆胶、卡拉牙胶、果胶和西黄蓍胶。
崩解剂可在制备本发明组合物的任何适宜的步骤中加入,特别是在制粒前或在压片前润滑步骤中加入。如果存在,所述崩解剂占组合物总重量的大约0.2%至大约30%,优选大约0.2%至大约10%,并且更优选大约0.2%至大约5%。
交联羧甲基纤维素钠是用于片剂或胶囊剂崩解的优选的崩解剂,并且如果存在,优选地占组合物总重量的大约0.2%至大约10%,更优选大约0.2%至大约7%,并且进一步更优选大约0.2%至大约5%。交联羧甲基纤维素钠使得本发明粒状组合物具有优良的粒内崩解性能。
本发明组合物可有可无地包含一种或多种可药用粘合剂或粘着剂作为赋形剂,特别是在片剂情况下。优选地,所述粘合剂和粘着剂提供给压片粉足够的内聚力以便于正常的加工操作如整粒、润滑、压片和包装,而且还使得片剂在摄入后崩解,组合物一经消化即被吸收。适宜的粘合剂和粘着剂包括单独或联合使用的阿拉伯胶;西黄蓍胶;蔗糖;明胶;葡萄糖;淀粉如包括但不限制于预凝胶化淀粉(例如NationalTM1511和NationalTM1500);纤维素如包括但不限制于甲基纤维素和羧甲基纤维素钠(例如TyloseTM);藻酸和藻酸盐;硅酸铝镁;聚乙二醇(PEG);瓜尔胶;多糖酸;膨润土;聚乙烯吡咯烷酮(聚维酮或PVP),例如聚维酮K-15、K-30和K-29/32;聚甲基丙烯酸酯;羟丙基甲基纤维素(HPMC);羟丙基纤维素(例如KlucelTM);和乙基纤维素(例如EthocelTM)。如果存在,所述粘合剂和/或粘着剂占组合物总重量的大约0.5%至大约25%,优选大约0.75%至大约15%,并且更优选大约1%至大约10%。
预凝胶化淀粉是优选的粘合剂,它提供给用于制备维得克西制剂颗粒的维得克西与其它赋形剂的粉末混合物粘着性。如果存在,优选地,预凝胶化淀粉占组合物总重量的大约0.5%至大约20%,更优选大约5%至大约15%,并且促进混合物中微粒的粘着以便在湿法制粒中形成颗粒。
本发明组合物可有可无地包含一种或多种可药用润湿剂作为赋形剂。优选地,选择所述润湿剂以便使维得克西与水充分接触,据信,这是改善组合物生物利用度的条件。
可用作本发明组合物润湿剂的表面活性剂的非限定实例包括季铵化合物例如苯扎氯铵、苯索氯铵和氯化十六烷基吡啶鎓,硫代丁二酸二辛基钠,聚氧乙烯烷基苯基醚例如壬苯醇醚9、壬苯醇醚10和辛苯昔醇9,泊咯沙姆(聚氧乙烯和聚氧丙烯嵌段共聚物),聚氧乙烯脂肪酸甘油酯和油类例如聚氧乙烯(8)辛酸/癸酸单-和二-甘油酯(例如Gattefossé的LabrasolTM),聚氧乙烯(35)蓖麻油和聚氧乙烯(40)氢化蓖麻油;聚氧乙烯烷基醚例如聚氧乙烯(20)鲸蜡硬脂基(cetostearyl)醚,聚氧乙烯脂肪酸醚例如聚氧乙烯(40)硬脂酸酯,聚氧乙烯脱水山梨糖醇酯例如聚山梨酯20及聚山梨酯80(例如ICI的TweenTM80),丙二醇脂肪酸酯例如丙二醇月桂酸酯(例如Gattefossé的LauroglycolTM),十二烷基硫酸钠,脂肪酸及其盐例如油酸、油酸钠和油酸合三乙醇胺,甘油脂肪酸酯例如甘油单硬脂酸酯,山梨糖醇酯例如脱水山梨糖醇单月桂酸酯、脱水山梨糖醇单油酸酯、脱水山梨糖醇单棕榈酸酯和脱水山梨糖醇单硬脂酸酯,泰洛沙泊及其混合物。如果存在,所述润湿剂占组合物总重量的大约0.25%至大约15%,优选大约0.4%至大约10%,并且更优选大约0.5%至大约5%。
优选的润湿剂是阴离子表面活性剂。十二烷基硫酸钠是特别优选的润湿剂。如果存在,十二烷基硫酸钠占组合物总重量的大约0.25%至大约7%,更优选大约0.4%至大约4%,并且进一步更优选大约0.5%至大约2%。
本发明组合物可有可无地包含一种或多种可药用润滑剂(包括抗粘着剂和/或助流剂)作为赋形剂。适宜的润滑剂包括单独或联合使用的甘油behapate(例如CompritolTM 888);硬脂酸及其盐,例如硬脂酸镁、硬脂酸钙和硬脂酸钠;氢化植物油(例如SterotexTM);胶态二氧化硅;滑石粉;蜡;硼酸;苯甲酸钠;醋酸钠;富马酸钠;氯化钠;DL-亮氨酸;聚乙二醇类(例如CarbowaxTM4000和CarbowaxTM6000);油酸钠;十二烷基硫酸钠;和十二烷基硫酸镁。如果存在,所述润滑剂占组合物总重量的大约0.1%至大约10%,优选大约0.2%至大约8%,并且更优选大约0.25%至大约5%。
硬脂酸镁是优选的润滑剂,例如在片剂压片过程中用于减少设备与粒状混合物之间的摩擦。
适宜的抗粘着剂包括滑石粉,玉米淀粉,DL-亮氨酸,十二烷基硫酸钠,和金属硬脂酸盐。滑石粉是优选的抗粘着剂或助流剂,例如用于防止制剂粘着在设备表面,也用于防止混合物静止不动。如果存在,滑石粉占组合物总重量的大约0.1%至大约10%,更优选大约0.25%至大约5%,并且进一步更优选大约0.5%至大约2%。
其它赋形剂如着色剂、矫味剂和甜味剂是制药领域公知的并且可在本发明组合物中使用。例如,片剂可以用肠溶衣包衣或不包衣。例如,本发明组合物可进一步包含缓冲剂。
当药物配制成本发明口服释放的组合物时,维得克西的粒度减小会导致生物利用度改善。因此,优选地,维得克西的D90粒度小于大约75μm,更优选小于大约40μm,最优选小于大约25μm。另外或可选择地,优选地,维得克西的重均粒度范围为大约1至大约10μm,更优选为大约5至大约7μm。任何适宜地磨细、磨碎或微粒化方法都可用于减小粒度。
本发明胶囊和片剂组合物是即刻释放组合物,当用标准溶出分析法体外测定时,在大约45分钟内释放至少大约50%,更优选至少大约60%并且最优选至少大约75%的维得克西。
特别优选的本发明胶囊和片剂组合物在大约15分钟内体外释放至少大约50%维得克西,和/或在大约30分钟内至少释放大约60%维得克西。
例如,尽管本发明组合物可通过直接装胶囊或直接压片方法制备,但优选在装胶囊或压片前湿法制粒。除其它作用外,湿法制粒使得磨细的组合物密度增加,结果使得装胶囊或压片的组合物流动性、可压性改善并且计量和重量分散更容易。制粒产生的次级粒度(即细粒大小)不是关键的,重要的仅在于优选平均粒度使之便于操作和加工,并在制备片剂时,允许形成容易压片的可制成可药用片剂的混合物。
当灌注或流出时所需要的颗粒堆密度通常为大约0.3至大约1.0g/ml,例如为大约0.6至大约0.9g/ml。
为了通过加压制备片剂,可将制备均匀批量片剂所需足够量的粒状混合物在常规生产规模的压片机上,在正常压力(例如,典型的压片冲模使用大约1至大约50kN的压力)下压片。所得到的片剂硬度应该便于加工、生产、贮存并且可用于摄取(ingestion);然而,为了避免过度易碎性,所要求的最小硬度为大约4kP,优选为大约5kP,并且更优选为大约6kP,并且为了避免接下来当与胃液接触时片剂难以形成水合物,所要求的最大硬度为大约18kP,优选为大约15kP,并且更优选为大约12kP。当硬度在适宜的范围内时,按照标准测试方法测试,典型地,片剂的易碎性低于大约1.0%,优选低于大约0.8%并且更优选低于大约0.5%。
优选地,选择适合在本发明即刻释放胶囊和片剂组合物中使用的赋形剂,特别是崩解剂,提供按照标准体外测试方法测试时崩解时间小于大约30分钟,优选小于大约25分钟,更优选小于大约20分钟,并且进一步更优选小于大约15分钟。
本发明进一步提供制备包含维得克西颗粒的组合物的方法。在特定实施方案中,本发明提供制备以片剂形式存在的所述组合物的方法。尽管干法制粒或直接压片方法可使用,但包含湿法制粒步骤的方法是目前优选的。在两个说明性实施方案中,分别在低或高切变下进行湿法制粒。
图1通过图解方式概述了低切变方法。在该说明性方法中,将微粒化维得克西在行星式混合器中与一种或多种固体微粒稀释剂,例如乳糖一水合物(初级稀释剂)和微晶纤维素(次级稀释剂)和粘合剂,优选预凝胶化淀粉混合形成预混合物。然后以促进颗粒形成的量加入水,同时继续混合。将颗粒例如在烘箱中干燥,然后在具有适宜筛孔的comil中整粒以便提供相当均匀的颗粒。将这些颗粒与崩解剂例如交联羧甲基纤维素钠混合,最后与润滑剂例如硬脂酸镁混合来制备压片用混合物。在该说明性方法中可注意到,微晶纤维素加到颗粒内,而羧甲基纤维素钠加到颗粒外。最后,例如将压片用混合物在旋转压片机上压片得到片剂。该片剂可以是不包衣的或者可以使用本领域已知的适宜的包衣方法包衣。
图2通过图解方式概述了高切变方法。在该说明性方法中,将微粒化维得克西在高切变混合器中与初级稀释剂例如乳糖一水合物、第一部分次级稀释剂例如微晶纤维素、粘合剂优选预凝胶化淀粉和第一部分崩解剂例如交联羧甲基纤维素钠混合形成预混合物。然后以促进颗粒形成的量加入水,同时继续高切变混合。颗粒可有可无地进行湿法过筛,然后优选在流化床干燥器中干燥,然后,例如可在Fi tz磨中进行干法整粒。所得到的颗粒与第二部分次级稀释剂和第二部分崩解剂混合,最后与润滑剂例如硬脂酸镁混合来制备压片用混合物。在该说明性方法中可注意到,微晶纤维素和羧甲基纤维素钠都分别加到颗粒内和颗粒外。最后,例如将压片用混合物压片并且如低切变方法中所述可以是不包衣的或包衣的。
本发明也提供利用本发明组合物在制备治疗和/或预防COX-2介导的疾病的药物中的用途。
实施例
下列实施例用于说明而不是限制本发明各个方面。除非另外说明,在这些实施例中列举的所有百分数都是以基于组合物总重量的重量比表示的。
实施例1:通过低切变湿法制粒制备的维得克西10mg片剂制备含有表1所示组分的片剂。
表1
组分 | 功能 | 量(mg) |
微粒化维得克西 | 活性组分 | 10 |
乳糖一水合物NF,#310 | 初级稀释剂 | 105 |
微晶纤维素NF(AvicelTM PH-101) | 次级稀释剂 | 60 |
预凝胶化淀粉NF(National Starch 1500) | 粘合剂 | 20 |
交联羧甲基纤维素钠NF(Ac-Di-SolTM) | 崩解剂 | 4 |
硬脂酸镁 | 润滑剂 | 1 |
总片重 | 200 |
首先将批量生产的适宜量的微粒化维得克西与等量乳糖一水合物混合,通过20目筛过筛,并加到Hobart行星式混合器中。将余量的乳糖一水合物和微晶纤维素加到该混合器中,然后在缓慢的叶轮转速下混合大约10分钟。通过在12-15分钟内手工加入净化水,将所得到的预混合物在行星式混合器中制粒,同时继续在慢至中等叶轮转速下混合。所得到的湿颗粒在60±5℃的入口空气温度的Gruenberg烘箱的托盘上干燥至2.0±1.0%含湿量,通过干燥失重进行测定。所得到的干颗粒利用Quadro comil、在中速下通过14号筛整粒,然后与交联羧甲基纤维素钠一起放到Patterson Kelley V-掺合器中。该V-掺合器工作大约5分钟使得羧甲基纤维素钠与颗粒充分混合;然后加入硬脂酸镁并进一步混合大约3分钟,由此制备润滑的混合物。将该混合物在Manesty DB16旋转压片机上,用7.5mm标准凹面的机床压片,得到片重为200±10mg,硬度为10±4kP的片剂。
实施例2:通过高切变湿法制粒制备的维得克西10mg片剂制备含有表2所示组分的片剂。
表2
组分 | 功能 | 量(mg) |
微粒化维得克西 | 活性组分 | 10 |
乳糖一水合物NF,#310 | 初级稀释剂 | 103 |
微晶纤维素NF(AvicelTMPH-101)颗粒内颗粒外 | 次级稀释剂 | 603030 |
预凝胶化淀粉NF(National Starch 1500) | 粘合剂 | 20 |
交联羧甲基纤维素钠NF(Ac-Di-SolTM)颗粒内颗粒外 | 崩解剂 | 633 |
硬脂酸镁 | 润滑剂 | 1 |
总片重 | 200 |
将微粒化维得克西、乳糖一水合物、颗粒内微晶纤维素、预凝胶化淀粉和颗粒内羧甲基纤维素钠在Baker Perkins高切变混合器中以高叶轮/切刀速度下混合大约3分钟形成预混合物。将净化水通过Watson Marlow蠕动泵用大约3分钟的时间加到该预混合物中并继续再混合45秒。所得到的湿粒在60±5℃入口空气温度的Aeromatic流化床中干燥至2.0±1.0%含湿量,通过干燥失重进行测定,得到干颗粒。干颗粒利用具有向前推动刀片的Fitz磨,在1800rpm下通过20目筛整粒,然后放到Patterson Kelley V-掺合器中。这时,将颗粒与颗粒外微晶纤维素和颗粒外羧甲基纤维素钠一起混合大约5分钟,再与硬脂酸镁混合3分钟,得到润滑的混合物。将该混合物在Korsch PH-230旋转压片机上,用7.5mm标准凹面的机床压片,得到片重为200±10mg的片剂。制备硬度为6、8、10和12kP的片剂。
实施例3:包衣的维得克西5、10、20和40m8片剂
利用实施例2的方法,制备含有表3所示组分的片剂。通过使用15%包衣材料的水悬浮液,将片剂用未包衣片重3%量的OpadryYellow YS-1-12525A和Opadry White YS-1-18027A进行膜包衣。
表3
组分 | 量/片(mg) | |||
微粒化维得克西 | 5 | 10 | 20 | 40 |
乳糖一水合物NF | 108 | 103 | 206 | 186 |
微晶纤维素NF | 60 | 60 | 120 | 120 |
预胶凝化淀粉NF | 20 | 20 | 40 | 40 |
交联羧甲基纤维素钠NF | 6 | 6 | 12 | 12 |
硬脂酸镁NF | 1 | 1 | 2 | 2 |
总重量(包衣除外) | 200 | 200 | 400 | 400 |
Opadry Yellow YS-1-12525A | 6 | 12 | ||
Opadry White YS-1-18027A | 6 | 12 |
实施例3片剂的性质示于表4。
通过下列方法评估崩解剂。将6个相同的片剂分别放到崩解篮中底部具有金属丝筛网的6个管中.在崩解试验过程中,将水浴温度预先加热到37℃±2℃并保持在该温度下。将1000ml的烧杯放到水浴中。烧杯中加入足够量的水以确保在试验过程中,所述管的金属丝筛网保持在水面下至少2.5cm处。将崩解篮放入水中并重复地升降直至试验结束,同时保持管子的金属丝筛网在水面下至少2.5cm处。各片剂的崩解时间是从崩解篮放入水中开始测定的到最后一部分片剂通过管子底部筛网的时间。
表4
5mg | 10mg | 20mg | 40mg | |
形状 | 椭圆形 | 小胶囊 | 小胶囊 | 七边形 |
厚度(mm) | 3.6±0.2 | 3.6±0.2 | 4.8±0.4 | 4.2±0.3 |
硬度(kP) | 9±3 | 9±3 | 13±5 | 13±5 |
易碎性(%) | <0.8 | <0.8 | <0.8 | <0.8 |
体外崩解 | 12分钟 | 12分钟 | 12分钟 | 12分钟 |
实施例4:维得克西片剂在人体内的药动学性质
为了测定实施例2中维得克西组合物的药动学性质,用24名健康成人进行研究。以20mg(2片)的剂量给予维得克西。给药前和口服给药后0.5、1、1.5、2、2.5、3、4、6、8、12、16和24小时采集静脉血。通过在3000G离心,将血浆从血液中分离出来并将样品在-20℃下贮存直至分析使用。用HPLC分析法测定血浆中维得克西的浓度。结果示于图3中。
计算的Cmax为303±93ng/ml。计算的Tmax为2.97±0.73h。
Claims (11)
1、药物组合物,其每剂量包含5mg至40mg的D90粒度小于75μm的维得克西微粒和一种或多种药用赋形剂,其中当口服给予禁食接受治疗者时,单次剂量提供的维得克西血清浓度的时间过程为给药后达到治疗20ng/ml阈浓度的时间不超过0.5小时。
2、权利要求1的组合物,其中所述维得克西血清浓度的时间过程为:给药后达到最大浓度的时间不超过3小时;和
最大浓度Cmax不低于100ng/ml。
3、权利要求1或2的组合物,它是一种片剂,其中赋形剂包括占组合物重量5%至99%的一种或多种稀释剂,0.2%至30%的一种或多种崩解剂,0.5%至25%的一种或多种粘合剂,和0.1%至10%的一种或多种润滑剂。
4、权利要求3的组合物,其中粘合剂是预凝胶化淀粉。
5、权利要求1或2的组合物,它是一种片剂,其中赋形剂包括乳糖一水合物、微晶纤维素、交联羧甲基纤维素钠、预凝胶化淀粉和硬脂酸镁。
6、权利要求1的组合物,它进一步包含一种或多种阿片样物质或镇痛剂。
7、权利要求1、2或6的组合物,其中维得克西微粒的重均粒度为10nm至1000nm。
8、权利要求1、2或6的组合物,其中维得克西微粒的重均粒度为1μm至10μm。
9、权利要求1-8的任一组合物在生产用于治疗或预防需接受治疗的患者环加氧酶-2介导的疾病的药物中的用途。
10、权利要求1-8的任一组合物在制备用于经一天口服给药1-4次来治疗患者的环加氧酶-2介导的疾病的药物中的用途。
11、权利要求10的用途,其中口服给药是一天一次或两次。
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