EP2804585A1 - Dry powder formulations comprising tiotropium, formoterol and budesonide - Google Patents

Dry powder formulations comprising tiotropium, formoterol and budesonide

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Publication number
EP2804585A1
EP2804585A1 EP13720142.2A EP13720142A EP2804585A1 EP 2804585 A1 EP2804585 A1 EP 2804585A1 EP 13720142 A EP13720142 A EP 13720142A EP 2804585 A1 EP2804585 A1 EP 2804585A1
Authority
EP
European Patent Office
Prior art keywords
range
pharmaceutical formulation
formulation according
excipient
particle size
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP13720142.2A
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German (de)
French (fr)
Inventor
Mahmut Bilgic
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Individual
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Individual
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Publication date
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Publication of EP2804585A1 publication Critical patent/EP2804585A1/en
Withdrawn legal-status Critical Current

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Classifications

    • 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
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/007—Pulmonary tract; Aromatherapy
    • A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
    • A61K9/0075—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy for inhalation via a dry powder inhaler [DPI], e.g. comprising micronized drug mixed with lactose carrier particles
    • 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
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
    • 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
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/439—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom the ring forming part of a bridged ring system, e.g. quinuclidine
    • 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
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/58—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin

Definitions

  • the present invention relates to pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof in order to be used in symptomatic and/or prophylactic treatment of respiratory tract diseases, particularly asthma and COPD.
  • P2-adrenergic agonists used in the treatment of respiratory tract diseases such as asthma and COPD activate P2-adrenergic receptors and affect the muscles around the airways; alleviate or remove bronchospasm.
  • Salbutamol, levosalbutamol, procaterol, fenoterol, terbutaline, pirbuterol, metaproterenol ve bitolterol mesylate can be listed among short-acting ⁇ 2 agonists.
  • Long- acting ⁇ 2 agonists can be used more frequently in the treatment of patients suffering symptoms of asthma at nights and exercise-induced asthma.
  • Formoterol, salmeterol, bambuterol and clenbuterol are examples of long-acting ⁇ 2 agonists.
  • Corticostereoids which is another group of active agents used in the treatment of asthma and COPD, are synthetic and potent anti-inflammatory drugs similar to natural corticosteroid hormones secreted by adrenal glands. It is known that corticosteroids are quite effective drugs in asthma treatment. Budesonide, beclomethasone, flunisolide and fluticasone are among molecules belonging to this group.
  • Anticholinergics affect the muscles on bronchi including large airways. Like agonists, these drugs divide into two as short-acting and long-acting too. Short-acting anticholinergics are generally used to alleviate symptoms while long-acting anticholinergics are used to prevent inhalation problems. Ipratropium bromide and oxitropium bromide can be listed among short-acting anticholinergics. Tiotropium is a long-acting anticholinergic agent. Tiotropium starts to act in 20 minutes following its intake and its effects can be observed in 24 hours thus it suffices to take tiotropium once a day.
  • combination drugs in the treatment of respiratory tract diseases such as asthma and COPD is quite effective, particularly in reducing the number of asthma attacks. Since activity of the active agents used in combination drugs can be enabled in smaller doses compared to their use alone, severity of potential side effects and/or their possibility of occurrence can decrease.
  • the dry powder formulation comprising active agent combination has good flow characteristics is an important criterion in terms of inhalation of said formulation effectively and therefore in terms of providing an effective treatment.
  • a dry powder formulation which does not have good flow characteristics is obtained, it is seen that the formulation has low homogeneity and consequently dosing accuracy cannot be ensured during filling the dry powder formulation prepared into reservoirs of multi dose inhalators comprising more than one dose or into blister cavities of a blister package, each of them comprising one dose, or into capsules comprising one dose.
  • the fact that the dry powder formulation does not have good flow characteristics affects emptying capacity and emptying attribute negatively during inhalation of the formulation from capsule, blister or reservoir.
  • the active agents cannot reach to the lungs in sufficient amounts.
  • the active agents are diluted by various non-functional excipients.
  • the physical characteristics of these excipients, used in quite high amounts as compared to the active agent amount in the formulations, such as average particle size have an important role in providing good flow in the dry powder formulation. Since the active agents used are delivered to the lungs in sufficient amounts and in a controlled manner in the dry powder formulation having good flow characteristics, desired therapeutic effect is obtained.
  • the inventors have developed dry powder formulations which comprise tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof and have high homogeneity and good flow characteristics wherein dosing accuracy is ensured and sufficient amount of active agent can be delivered to the lungs.
  • the present invention relates to pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof.
  • dry powder formulations which comprise tiotropium, formoterol and budesonide having a ratio in the range of 0,5: 0.05:3 to 1 :3:45, preferably in the range of 1 :0.1 :2 to 1 :2:40 to each other by weight and also at least one pharmaceutically acceptable fine grained and coarse grained excipient having an average particle size ratio to each other in the range of 1 :30 to 1 :2, preferably in the range of 1 :20 to 1 : 5, more preferably in the range of 1 :15 to 1 : 10 have good flow characteristics and high homogeneous dispersion, therefore dose accuracy is obtained in the formulations and sufficient amount of active agent can be delivered to the lungs.
  • the fine grained excipient used in the text refers to an excipient having an average particle size less than 10 ⁇ , preferably in the range of 0.1 to 9.9 ⁇ , more preferably in the range of 2 to 8 ⁇ , for instance in the range of 0.3, 0.5, 0.7, 0.9, 1.1, 1.3, 1.5, 1.7, 1.9, 2.3, 2.5, 3.0, 3.5, 4.0, 4.5 to 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5 ⁇ ;
  • the coarse grained excipient used in the text refers to an excipient having an average particle size in the range of 10 to 90 ⁇ , preferably in the range of 12 to 85 ⁇ , more preferably in the range of 15 to 80 ⁇ , for instance in the range of 15, 20, 25, 30, 35, 40, 45 to 50, 55, 60, 65, 70, 75, 80, 85 ⁇ .
  • the subject of the present invention is the pharmaceutical formulation in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0,5: 0.05:3 to 1 :3:45, preferably in the range of 1 :0.1 :2 to 1 :2:40 by weight,
  • the excipient comprised in said formulation is composed of at least one pharmaceutically acceptable excipient mixture comprising fine grained excipient and coarse grained excipient and
  • tiotropium and/or pharmaceutically acceptable derivatives thereof which is one of the active agents comprised in the dry powder drug formulation comprising the active agent combination refers to tiotropium's free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or combinations thereof.
  • formoterol and/or pharmaceutically acceptable derivatives thereof which is one of the active agents comprised in the dry powder drug formulation comprising the active agent combination refers to formoterol's free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or a combination thereof.
  • formoterol fumarate is used.
  • budesonide and/or pharmaceutically acceptable derivatives thereof which is one of the active agents comprised in the dry powder drug formulation comprising the active agent combination refers to budesonide' s free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or combinations thereof.
  • the inhalation formulation comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof can be delivered to the patient in dry powder form.
  • Said dry powder formulations further comprise at least one physiologically and pharmaceutically acceptable excipient along with the active agent.
  • This excipient is composed of fine grained excipient, coarse grained excipient or a combination thereof, preferably a combination of fine grained excipient and coarse grained excipient.
  • This excipient can be selected from monosaccharides (glucose etc.), disaccharides (lactose, saccharose, maltose or pharmaceutically acceptable hydrates, anhydrates or a combination thereof etc.), oligosaccharides and polysaccharides (dextrant etc.), polyalcohols (sorbitol, mannitol, xylitol etc.), salts (sodium chloride, calcium carbonate etc.) or a combination thereof. Same or different substances are used as fine grained excipient and coarse grained excipient, though preferably the same substance is used. Fine grained and coarse grained excipients are preferably lactose, more preferably lactose anhydrate.
  • the amount of the pharmaceutically acceptable excipient is preferably in the range of 1-50 mg, preferably in the range of 2-40 mg, more preferably in the range of 3-30 mg.
  • the average particle size of the active agent used is quite important in order that the formulation to be obtained has good flow characteristics and therefore an effective inhalation is performed.
  • the subject of the present invention is pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that
  • the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0,5 : 0.05 :3 to 1 :3 :45, preferably in the range of 1 :0.1 :2 to 1 :2:40 by weight
  • - the average particle size ratio of fine grained excipient: coarse grained excipient is in the range of 1 :30 to 1 :2, preferably in the range of 1:20 to 1:5, more preferably in the range of 1:15 to 1:10 and
  • the average particle size of the active agents used is in the range of 1 ⁇ to 10 ⁇ , preferably in the range of 1.5 ⁇ to 7.5 ⁇ , more preferably in the range of 1.5 ⁇ to 5 ⁇ .
  • the amounts of said fine grained and coarse grained excipients constituting the excipient combination having two different average particle sizes as fine grained and coarse grained comprised in the dry powder formulation of the present invention is an important criterion in obtaining the characteristics that can provide an effective treatment.
  • the inventors have seen that characteristics such as proper flow, particularly homogenous particle dispersion and dose uniformity of the formulation are ensured and therefore the sufficient amount of the active agent reaches to the lungs more easily in the case that the ratio of fine grained excipient to coarse grained excipient constituting the excipient combination is in the range of 1 :1 to 1 :25 by weight, preferably in the range of 1:1 to 1:10 by weight, more preferably in the range of 1:1.5 to 1:5 by weight.
  • the subject of the present invention is the pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0,5: 0.05:3 to 1 :3:45, preferably in the range of 1 :0.1 :2 to 1 :2:40 by weight, the average particle size ratio of fine grained excipient: coarse grained excipient is in the range of 1 :30 to 1 :2, preferably in the range of 1 :20 to 1 :5, more preferably in the range of 1 :15 to 1 :10 and
  • the ratio of fine grained excipient to coarse grained excipient is in the range of 1 :1 to 1 :25 by weight, preferably in the range of 1 : 1 to 1 : 10 by weight, more preferably in the range of 1 : 1.5 to 1 :5 by weight.
  • the process for preparation of the pharmaceutical formulations of the present invention in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is composed of the following steps: I. micronizing tiotropium, formoterol and budesonide so as to bring them to the desired particle size,
  • the present invention relates to inhalation of the dry powder formulations comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof by using inhalation devices comprising capsule, blister or reservoir.
  • the inventors have found that the inhalation is performed most productively when capsule volume comprising the drug in dry powder form of the present invention comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 0.1 to 0.5 ml, preferably in the range of 0.15-0.45 ml, more preferably in the range of 0.2-0.4 ml.
  • the present invention is characterized in that volume of the capsule used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 0.1 to 0.5 ml, preferably in the range of 0.15-0.45 ml, more preferably in the range of 0.2-0.4 ml.
  • the inventors have seen that the active agent combination comprised in the capsule is protected from external factors as well as the possibility of moistening that can arise from the nature of the capsule itself is removed in the case that moisture ratio of the package in capsule form having high protection property against moisture and other negative external factors is in the range of 5-20%, preferably in the range of 7-15%.
  • moisture ratio of the package in capsule form having high protection property against moisture and other negative external factors is in the range of 5-20%, preferably in the range of 7-15%.
  • the present invention is characterized in that moisture ratio of the package in capsule form used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 5-20%, preferably in the range of 7- 15%.
  • the capsule preferred to be used in the scope of the present invention can be made of a substance selected from a group comprising gelatine, chitosan, starch and/or starch derivatives, cellulose and/or cellulose derivatives or synthetic polymers, and it is composed of telescoping body and cap parts.
  • capsule material can be selected from a group comprising hydroxypropyl cellulose, hydroxypropylmethyl cellulose, methyl cellulose, hydroxymethyl cellulose, hydroxyethyl cellulose if the capsule to be used is made of cellulose and its derivatives.
  • capsule material can be selected from a group comprising polyethylene, polyester, polyethyleneterephthalate, polycarbonate or polypropylene if the capsule to be used is made of synthetic polymer.
  • various molecular weighted polyethylene glycol, sorbitol, glycerol, propylene glycol, polyethylene oxide-propylene oxide block copolymers and/or other polyalcohols and polyethers can be added as adjuvant if the capsule material to be used is made of gelatine.
  • the inventors have found that in the case that fullness ratio of the capsule cavity used is in the range of 0.05 to 25%, preferably in the range of 0.1 to 20%, more preferably in the range of 0.5-15%, an effective inhalation of the drug is ensured in the case that said dry powder formulation is inhaled from capsule.
  • the present invention is characterized in that fullness ratio of capsule cavity is in the range of 0.05 to 25%, preferably in the range of 0.1 to 20%, more preferably in the range of 0.5 to 15%.
  • the dry powder formulation of the present invention is inhaled from blister, which is one of the inhalation methods
  • the inventors have found that an effective inhalation is performed in the case that cavity volume of the blister comprising the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 18-30 mm , preferably in the range of 20 - 25 mm , more, preferably in the range of 21 -24 mm .
  • the present invention is characterized in that cavity volume of the blister used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is 18-30 mm , preferably in the range of 20 to 25 mm , more preferably in the range of 21-24 mm in the case that said dry powder formulation is inhaled from blister.
  • fullness ratio of the blister cavity used should be in the range of 15-95%, preferably in the range of 20-85% and more preferably in the range of 50-80% in order to inhale the formulation of the present invention from blister without any problem and in order to perform an effective inhalation.
  • the present invention is characterized in that fullness ratio of the blister used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 15-95%, preferably in the range of 20-85% and more preferably in the range of 50-80%.
  • the base and the lid sheets constituting the peelable blister strip pack wherein the blisters comprising the dry powder formulation of the present invention are collocated, are sealed tightly by any suitable method in order to provide impermeability.
  • the base and lid sheets constituting the peelable blister strip package comprising the dry powder formulation of the present invention are composed of many layers. Polymeric layers, aluminium foil and preferably Aclar® fluoropolymer film are among the layers constituting the base and the lid sheets.
  • Desiccant agents added to the layers constituting blister strip package comprising dry powder formulation of the present invention are selected from silica gel, zeolite, alumina, bauxite, anhydrous calcium sulphate, activated carbon, hydrophilic chyles.
  • polymeric layers in the base and lid sheets of peelable blister strip package comprising said dry powder formulation are made of the same or different polymers. Thickness of these polymeric layers varies depending on the type and characteristics of the polymeric material used. Therefore, thickness of the polymeric layer varies in the range of 15-55 ⁇ , preferably in the range of 20-30 ⁇ according to the type of the polymeric material used.
  • the layer covering the inner surface of the cavity is a polymeric layer because of the fact that when the layer in contact with the dry powder formulation in the blister cavity is aluminium foil, some part of dry powder formulation adheres to the inner surface of the blister cavity due to porous structure of the aluminium foil and electrostatic forces and this causes uncontrolled dose inhalation.
  • Polymers constituting the polymeric layer can preferably be selected from thermoplastic polymers such as polyethylene, polypropylene, polystyrene, polyolefin, polyamide, polyvinyl chloride, polyurethane or synthetic polymers.
  • the drug composition in dry powder form described in the present invention comprising tiotropium, foraioterol and budesonide and/or pharmaceutically acceptable derivatives thereof can be used in the treatment of many respiratory diseases particularly asthma, Chronic Obstructive Pulmonary Disease (COPD) and allergic rhinitis.
  • COPD Chronic Obstructive Pulmonary Disease
  • the drug composition of the present invention is used in the treatment of respiratory tract diseases comprising, but not limited to, allergic or non allergic asthma in every stage, acute lung injury (ALI), acute respiratory distress syndrome (ARDS), exacerbation of airways hyperactivity, chronic obstructive pulmonary disease including bronchiectasis, emphysema and chronic bronchitis; airways or lung diseases (COPD, COAD or COLD) pneumoconiosis, aluminosis, anthracosis, asbestosis, chalicosis, ptilosis, siderosis, silicosis, tabacosis and byssinosis.
  • This treatment may be prophylactic or symptomatic.
  • the composition of the present invention is particularly used in symptomatic treatment of asthma, allergic rhinitis and COPD.
  • Dry powder formulation suitable for a gelatin capsule used in capsule inhaler comprises 1 part of tiotropium, 0.2 part of foraioterol fumarate, 20 parts of budesonide; and 275 parts of fine grained lactose and 9.5 parts of coarse grained lactose as carrier, all of which are micronized in an air jet mill.
  • fine grained lactose and coarse grained lactose are stirred in a mixer after sieved separately.
  • Tiotropium, foraioterol and budesonide are added to this mixture one by one, sieved again and mixed.
  • the powder mixture obtained at the end of the process is filled into capsules.
  • composition of the present invention can be explained with, but not limited to, these examples.

Abstract

The present invention relates to pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide in order to be used in respiratory tract diseases.

Description

DRY POWDER FORMULATIONS COMPRISING TIOTROPIUM, FORMOTEROL
AND BUDESONIDE
The present invention relates to pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof in order to be used in symptomatic and/or prophylactic treatment of respiratory tract diseases, particularly asthma and COPD.
In case of respiratory tract diseases such as asthma or chronic obstructive pulmonary disease (COPD); stimulants such as allergen, infection, good and bad smell, smoke cause constricted muscles covering the airways, in other words bronchoconstriction, excessive secretion in glands and consequently contraction in the airways. In this case, the patient cannot exhale the inhaled air or he/she cannot inhale.
P2-adrenergic agonists used in the treatment of respiratory tract diseases such as asthma and COPD activate P2-adrenergic receptors and affect the muscles around the airways; alleviate or remove bronchospasm. p2-adrenergic agonists -which are bronchodilators- divide into two groups as short-acting and long-acting. Since short-acting β2 agonists have short onset of time, they are given as relaxant. However, they should be administered frequently as their effect last short. Salbutamol, levosalbutamol, procaterol, fenoterol, terbutaline, pirbuterol, metaproterenol ve bitolterol mesylate can be listed among short-acting β2 agonists. Long- acting β2 agonists can be used more frequently in the treatment of patients suffering symptoms of asthma at nights and exercise-induced asthma. Formoterol, salmeterol, bambuterol and clenbuterol are examples of long-acting β2 agonists.
Corticostereoids, which is another group of active agents used in the treatment of asthma and COPD, are synthetic and potent anti-inflammatory drugs similar to natural corticosteroid hormones secreted by adrenal glands. It is known that corticosteroids are quite effective drugs in asthma treatment. Budesonide, beclomethasone, flunisolide and fluticasone are among molecules belonging to this group.
Another group of active agents used in the treatment of respiratory tract diseases is anticholinergics. Anticholinergics affect the muscles on bronchi including large airways. Like agonists, these drugs divide into two as short-acting and long-acting too. Short-acting anticholinergics are generally used to alleviate symptoms while long-acting anticholinergics are used to prevent inhalation problems. Ipratropium bromide and oxitropium bromide can be listed among short-acting anticholinergics. Tiotropium is a long-acting anticholinergic agent. Tiotropium starts to act in 20 minutes following its intake and its effects can be observed in 24 hours thus it suffices to take tiotropium once a day.
Use of combination drugs in the treatment of respiratory tract diseases such as asthma and COPD is quite effective, particularly in reducing the number of asthma attacks. Since activity of the active agents used in combination drugs can be enabled in smaller doses compared to their use alone, severity of potential side effects and/or their possibility of occurrence can decrease.
The fact that the dry powder formulation comprising active agent combination has good flow characteristics is an important criterion in terms of inhalation of said formulation effectively and therefore in terms of providing an effective treatment. In the case that a dry powder formulation which does not have good flow characteristics is obtained, it is seen that the formulation has low homogeneity and consequently dosing accuracy cannot be ensured during filling the dry powder formulation prepared into reservoirs of multi dose inhalators comprising more than one dose or into blister cavities of a blister package, each of them comprising one dose, or into capsules comprising one dose. Furthermore, the fact that the dry powder formulation does not have good flow characteristics affects emptying capacity and emptying attribute negatively during inhalation of the formulation from capsule, blister or reservoir. As a result, due to the reasons listed above, the active agents cannot reach to the lungs in sufficient amounts. In order to ease the delivery of the active agents having therapeutic effect in quite small doses by the inhalation route, the active agents are diluted by various non-functional excipients. The physical characteristics of these excipients, used in quite high amounts as compared to the active agent amount in the formulations, such as average particle size have an important role in providing good flow in the dry powder formulation. Since the active agents used are delivered to the lungs in sufficient amounts and in a controlled manner in the dry powder formulation having good flow characteristics, desired therapeutic effect is obtained.
The inventors have developed dry powder formulations which comprise tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof and have high homogeneity and good flow characteristics wherein dosing accuracy is ensured and sufficient amount of active agent can be delivered to the lungs. Description of the Invention
The present invention relates to pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof.
Surprisingly, the inventors have seen that dry powder formulations which comprise tiotropium, formoterol and budesonide having a ratio in the range of 0,5: 0.05:3 to 1 :3:45, preferably in the range of 1 :0.1 :2 to 1 :2:40 to each other by weight and also at least one pharmaceutically acceptable fine grained and coarse grained excipient having an average particle size ratio to each other in the range of 1 :30 to 1 :2, preferably in the range of 1 :20 to 1 : 5, more preferably in the range of 1 :15 to 1 : 10 have good flow characteristics and high homogeneous dispersion, therefore dose accuracy is obtained in the formulations and sufficient amount of active agent can be delivered to the lungs.
The fine grained excipient used in the text refers to an excipient having an average particle size less than 10 μηι, preferably in the range of 0.1 to 9.9 μιη, more preferably in the range of 2 to 8 μιτι, for instance in the range of 0.3, 0.5, 0.7, 0.9, 1.1, 1.3, 1.5, 1.7, 1.9, 2.3, 2.5, 3.0, 3.5, 4.0, 4.5 to 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5 μιη; the coarse grained excipient used in the text refers to an excipient having an average particle size in the range of 10 to 90 μηι, preferably in the range of 12 to 85 μιη, more preferably in the range of 15 to 80 μπι, for instance in the range of 15, 20, 25, 30, 35, 40, 45 to 50, 55, 60, 65, 70, 75, 80, 85 μιη.
According to this, the subject of the present invention is the pharmaceutical formulation in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0,5: 0.05:3 to 1 :3:45, preferably in the range of 1 :0.1 :2 to 1 :2:40 by weight,
- the excipient comprised in said formulation is composed of at least one pharmaceutically acceptable excipient mixture comprising fine grained excipient and coarse grained excipient and
- the average particle size ratio of the fine grained excipient to the coarse grained excipient is in the range of 1 :30 to 1 :2, preferably in the range of 1 :20 to 1 :5, more preferably in the range of 1 : 15 to 1 : 10. According to the present invention, tiotropium and/or pharmaceutically acceptable derivatives thereof which is one of the active agents comprised in the dry powder drug formulation comprising the active agent combination refers to tiotropium's free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or combinations thereof. According to the present invention, formoterol and/or pharmaceutically acceptable derivatives thereof which is one of the active agents comprised in the dry powder drug formulation comprising the active agent combination refers to formoterol's free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or a combination thereof. Preferably, formoterol fumarate is used.
According to the present invention, budesonide and/or pharmaceutically acceptable derivatives thereof which is one of the active agents comprised in the dry powder drug formulation comprising the active agent combination refers to budesonide' s free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or combinations thereof.
According to the present invention, the inhalation formulation comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof can be delivered to the patient in dry powder form. Said dry powder formulations further comprise at least one physiologically and pharmaceutically acceptable excipient along with the active agent. This excipient is composed of fine grained excipient, coarse grained excipient or a combination thereof, preferably a combination of fine grained excipient and coarse grained excipient. This excipient can be selected from monosaccharides (glucose etc.), disaccharides (lactose, saccharose, maltose or pharmaceutically acceptable hydrates, anhydrates or a combination thereof etc.), oligosaccharides and polysaccharides (dextrant etc.), polyalcohols (sorbitol, mannitol, xylitol etc.), salts (sodium chloride, calcium carbonate etc.) or a combination thereof. Same or different substances are used as fine grained excipient and coarse grained excipient, though preferably the same substance is used. Fine grained and coarse grained excipients are preferably lactose, more preferably lactose anhydrate. According to the present invention, the amount of the pharmaceutically acceptable excipient is preferably in the range of 1-50 mg, preferably in the range of 2-40 mg, more preferably in the range of 3-30 mg. On the other hand, along with the particle size of the excipient comprised in the dry powder formulations of the present invention, the average particle size of the active agent used is quite important in order that the formulation to be obtained has good flow characteristics and therefore an effective inhalation is performed. The inventors have seen that use of active agents having an average particle size in the range of 1 μηι to 10 μηι, preferably in the range of 1.5 μπι to 7.5 μιη, more preferably in the range of 1.5 μπι to 5 μηι has a significant contribution to the formulation obtained for having proper flow characteristics and for having dose uniformity and to delivery of the active agent to the lungs in sufficient amount. According to this, the subject of the present invention is pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that
- the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0,5 : 0.05 :3 to 1 :3 :45, preferably in the range of 1 :0.1 :2 to 1 :2:40 by weight, - the average particle size ratio of fine grained excipient: coarse grained excipient is in the range of 1 :30 to 1 :2, preferably in the range of 1:20 to 1:5, more preferably in the range of 1:15 to 1:10 and
- the average particle size of the active agents used is in the range of 1 μιη to 10 μηι, preferably in the range of 1.5 μπι to 7.5 μπι, more preferably in the range of 1.5 μιη to 5 μηι.
The amounts of said fine grained and coarse grained excipients constituting the excipient combination having two different average particle sizes as fine grained and coarse grained comprised in the dry powder formulation of the present invention is an important criterion in obtaining the characteristics that can provide an effective treatment. The inventors have seen that characteristics such as proper flow, particularly homogenous particle dispersion and dose uniformity of the formulation are ensured and therefore the sufficient amount of the active agent reaches to the lungs more easily in the case that the ratio of fine grained excipient to coarse grained excipient constituting the excipient combination is in the range of 1 :1 to 1 :25 by weight, preferably in the range of 1:1 to 1:10 by weight, more preferably in the range of 1:1.5 to 1:5 by weight. In another aspect, the subject of the present invention is the pharmaceutical formulations in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0,5: 0.05:3 to 1 :3:45, preferably in the range of 1 :0.1 :2 to 1 :2:40 by weight, the average particle size ratio of fine grained excipient: coarse grained excipient is in the range of 1 :30 to 1 :2, preferably in the range of 1 :20 to 1 :5, more preferably in the range of 1 :15 to 1 :10 and
the ratio of fine grained excipient to coarse grained excipient is in the range of 1 :1 to 1 :25 by weight, preferably in the range of 1 : 1 to 1 : 10 by weight, more preferably in the range of 1 : 1.5 to 1 :5 by weight.
The process for preparation of the pharmaceutical formulations of the present invention in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is composed of the following steps: I. micronizing tiotropium, formoterol and budesonide so as to bring them to the desired particle size,
II. micronizing the excipient so as to bring it to the desired particle size,
III. mixing the active agents micronized in the Ist step firstly with the fine grained excipient and then the coarse grained excipient in a mixer or firstly with the coarse grained excipient and then the fine grained excipient in a mixer and
IV. consequently, filling the mixture obtained in dry powder form into appropriate capsules, blisters or reservoirs and making it ready for use.
In another aspect, the present invention relates to inhalation of the dry powder formulations comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof by using inhalation devices comprising capsule, blister or reservoir.
In the case that the dry powder formulation of the present invention is inhaled from capsule, which is one of the inhalation methods, the inventors have found that the inhalation is performed most productively when capsule volume comprising the drug in dry powder form of the present invention comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 0.1 to 0.5 ml, preferably in the range of 0.15-0.45 ml, more preferably in the range of 0.2-0.4 ml.
According to this, in the case that the dry powder formulation of the present invention is inhaled from capsule, the present invention is characterized in that volume of the capsule used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 0.1 to 0.5 ml, preferably in the range of 0.15-0.45 ml, more preferably in the range of 0.2-0.4 ml.
In another aspect, the inventors have seen that the active agent combination comprised in the capsule is protected from external factors as well as the possibility of moistening that can arise from the nature of the capsule itself is removed in the case that moisture ratio of the package in capsule form having high protection property against moisture and other negative external factors is in the range of 5-20%, preferably in the range of 7-15%. Thus, effective delivery of the formulation in dry powder form of the present invention to the lungs of the patient is enabled by preventing agglomeration. According to this, in the case that the dry powder formulation of the present invention is inhaled from capsule, the present invention is characterized in that moisture ratio of the package in capsule form used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 5-20%, preferably in the range of 7- 15%. In another aspect, in the case that the dry powder formulation of the present invention is inhaled from capsule, the capsule preferred to be used in the scope of the present invention can be made of a substance selected from a group comprising gelatine, chitosan, starch and/or starch derivatives, cellulose and/or cellulose derivatives or synthetic polymers, and it is composed of telescoping body and cap parts. According to this, in the case that the dry powder formulation of the present invention is inhaled from capsule, capsule material can be selected from a group comprising hydroxypropyl cellulose, hydroxypropylmethyl cellulose, methyl cellulose, hydroxymethyl cellulose, hydroxyethyl cellulose if the capsule to be used is made of cellulose and its derivatives. In the case that the dry powder formulation of the present invention is inhaled from capsule, capsule material can be selected from a group comprising polyethylene, polyester, polyethyleneterephthalate, polycarbonate or polypropylene if the capsule to be used is made of synthetic polymer.
In the case that the dry powder formulation of the present invention is inhaled from capsule, various molecular weighted polyethylene glycol, sorbitol, glycerol, propylene glycol, polyethylene oxide-propylene oxide block copolymers and/or other polyalcohols and polyethers can be added as adjuvant if the capsule material to be used is made of gelatine.
In another aspect, the inventors have found that in the case that fullness ratio of the capsule cavity used is in the range of 0.05 to 25%, preferably in the range of 0.1 to 20%, more preferably in the range of 0.5-15%, an effective inhalation of the drug is ensured in the case that said dry powder formulation is inhaled from capsule.
According to this, in the case that said dry powder formulation is inhaled from capsule, the present invention is characterized in that fullness ratio of capsule cavity is in the range of 0.05 to 25%, preferably in the range of 0.1 to 20%, more preferably in the range of 0.5 to 15%.
In the case that the dry powder formulation of the present invention is inhaled from blister, which is one of the inhalation methods, the inventors have found that an effective inhalation is performed in the case that cavity volume of the blister comprising the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 18-30 mm , preferably in the range of 20 - 25 mm , more, preferably in the range of 21 -24 mm . According to this, the present invention is characterized in that cavity volume of the blister used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is 18-30 mm , preferably in the range of 20 to 25 mm , more preferably in the range of 21-24 mm in the case that said dry powder formulation is inhaled from blister. The inventors have found that fullness ratio of the blister cavity used should be in the range of 15-95%, preferably in the range of 20-85% and more preferably in the range of 50-80% in order to inhale the formulation of the present invention from blister without any problem and in order to perform an effective inhalation. In the case that said dry powder formulation is inhaled from blister, the present invention is characterized in that fullness ratio of the blister used for storage and delivery of the drug in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof is in the range of 15-95%, preferably in the range of 20-85% and more preferably in the range of 50-80%.
In the case that the dry powder formulation of the present invention is inhaled from blister, the base and the lid sheets constituting the peelable blister strip pack, wherein the blisters comprising the dry powder formulation of the present invention are collocated, are sealed tightly by any suitable method in order to provide impermeability. The base and lid sheets constituting the peelable blister strip package comprising the dry powder formulation of the present invention are composed of many layers. Polymeric layers, aluminium foil and preferably Aclar® fluoropolymer film are among the layers constituting the base and the lid sheets.
The inventors have seen that, in the case that the formulation of the present invention is inhaled from blister, adding desiccant to the polymeric layers in order to reduce moisture and gas permeability of base and lid sheets constituting the blister package is effective in protecting stability of said dry powder formulation. Desiccant agents added to the layers constituting blister strip package comprising dry powder formulation of the present invention are selected from silica gel, zeolite, alumina, bauxite, anhydrous calcium sulphate, activated carbon, hydrophilic chyles.
In the case that dry powder formulation of the present invention is inhaled from blister, polymeric layers in the base and lid sheets of peelable blister strip package comprising said dry powder formulation are made of the same or different polymers. Thickness of these polymeric layers varies depending on the type and characteristics of the polymeric material used. Therefore, thickness of the polymeric layer varies in the range of 15-55 μιη, preferably in the range of 20-30 μιη according to the type of the polymeric material used.
The layer covering the inner surface of the cavity is a polymeric layer because of the fact that when the layer in contact with the dry powder formulation in the blister cavity is aluminium foil, some part of dry powder formulation adheres to the inner surface of the blister cavity due to porous structure of the aluminium foil and electrostatic forces and this causes uncontrolled dose inhalation. Polymers constituting the polymeric layer can preferably be selected from thermoplastic polymers such as polyethylene, polypropylene, polystyrene, polyolefin, polyamide, polyvinyl chloride, polyurethane or synthetic polymers. The drug composition in dry powder form described in the present invention comprising tiotropium, foraioterol and budesonide and/or pharmaceutically acceptable derivatives thereof can be used in the treatment of many respiratory diseases particularly asthma, Chronic Obstructive Pulmonary Disease (COPD) and allergic rhinitis. Accordingly, the drug composition of the present invention is used in the treatment of respiratory tract diseases comprising, but not limited to, allergic or non allergic asthma in every stage, acute lung injury (ALI), acute respiratory distress syndrome (ARDS), exacerbation of airways hyperactivity, chronic obstructive pulmonary disease including bronchiectasis, emphysema and chronic bronchitis; airways or lung diseases (COPD, COAD or COLD) pneumoconiosis, aluminosis, anthracosis, asbestosis, chalicosis, ptilosis, siderosis, silicosis, tabacosis and byssinosis. This treatment may be prophylactic or symptomatic. In addition, the composition of the present invention is particularly used in symptomatic treatment of asthma, allergic rhinitis and COPD.
EXAMPLE 1 :
Dry powder formulation suitable for a gelatin capsule used in capsule inhaler comprises 1 part of tiotropium, 0.2 part of foraioterol fumarate, 20 parts of budesonide; and 275 parts of fine grained lactose and 9.5 parts of coarse grained lactose as carrier, all of which are micronized in an air jet mill.
In obtainment of the formulation that shall be used in said invention, fine grained lactose and coarse grained lactose are stirred in a mixer after sieved separately. Tiotropium, foraioterol and budesonide are added to this mixture one by one, sieved again and mixed. The powder mixture obtained at the end of the process is filled into capsules.
The pharmaceutical composition of the present invention can be explained with, but not limited to, these examples.
The example can be repeated by replacing the amounts used in example 1 with the amounts given in the table below. Amount of
Amount of Amount of Amount of Amount of fine grained
EXAMPLE tiotropium formoterol budesonide coarse grained lactose
(parts) (parts) (parts) lactose (parts)
(parts)
2 2 0,2 40 19 550
3 2 0,3 36 19 550
4 2 0,36 36 18 560
5 2 0,4 40 18 560
6 2 0,5 44 20 550
7 3 0,48 63 28,5 822
8 3 0,45 57 27 825
9 3 0,6 51 27 819
10 3 0,45 60 28,5 819
11 3 1,5 60 27 831
12 4 1,6 76 38 1 100
13 4 2,4 72 36 1 100
14 4 2 84 34 11 12
15 4 2,8 80 36 11 10

Claims

1. A pharmaceutical formulation in dry powder form comprising tiotropium, formoterol and budesonide and/or pharmaceutically acceptable derivatives thereof, characterized in that the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 0.5: 0.05: 3 to 1:3:45,
the excipient comprised in said formulation is composed of an excipient combination comprising a fine grained excipient having an average particle size less than 10 μηι and a coarse grained excipient having an average particle size in the range of 10 μιη to 90 μηι and
- the average particle size ratio of the fine grained excipient: the coarse grained excipient is in the range of 1 :30 to 1 :2.
2. The pharmaceutical formulation according to claim 1, characterized in that the ratio of tiotropium, formoterol and budesonide to each other respectively is in the range of 1 :0.1 :2 to 1 :2:40.
3. The pharmaceutical formulation according to claims 1-2, characterized in that the average particle size ratio of fine grained excipient: coarse grained excipient is in the range of 1 :20 to 1 :5.
4. The pharmaceutical formulation according to claims 1-3, characterized in that the average particle size ratio of fine grained excipient: coarse grained excipient is in the range of 1:15 to 1:10.
5. The pharmaceutical formulation according to claims 1-4, characterized in that the average particle size of the fine grained excipient is in the range of 0.1 to 9.9 μηι.
6. The pharmaceutical formulation according to claims 1-5, characterized in that the average particle size of the fine grained excipient is in the range of 2 to 8 μιη.
7. The pharmaceutical formulation according to claims 1-6, characterized in that the average particle size of the fine grained excipient is in the range of 0.3, 0.5, 0.7, 0.9, 1.1, 1.3, 1.5, 1.7, 1.9, 2.3, 2.5, 3.0, 3.5, 4.0, 4.5 to 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5 μιη.
8. The pharmaceutical formulation according to claims 1-7, characterized in that the average particle size of the coarse grained excipient is in the range of 12 to 85 μιη.
9. The pharmaceutical formulation according to claims 1-8, characterized in that the average particle size of the coarse grained excipient is in the range of 15 to 80 μηι.
10. The pharmaceutical formulation according to claims 1-9, characterized in that the average particle size of the coarse grained excipient is in the range of 20, 25, 30, 35, 40, 45 to 50, 55, 60, 65, 70, 75, 80, 85 μιη.
11. The pharmaceutical formulation according claims 1-10, wherein tiotropium and/or pharmaceutically acceptable derivatives thereof comprise tiotropium' s free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or a combination thereof.
12. The pharmaceutical formulation according claims 1-11, wherein formoterol and/or pharmaceutically acceptable derivatives thereof comprise formoterol's free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or a combination thereof.
13. The pharmaceutical formulation according claim 12, wherein formoterol is used in formoterol fumarate form.
14. The pharmaceutical formulation according claims 1-13, wherein budesonide and/or pharmaceutically acceptable derivatives thereof comprise budesonide's free base, pharmaceutically acceptable solvates, hydrates, enantiomers or diastereomers, racemates, organic salts, inorganic salts, esters, polymorphs, crystalline forms and amorphous forms and/or a combination thereof.
15. The pharmaceutical formulation according to claims 1-14, wherein the fine grained and the coarse grained excipients are selected from monosaccharides (glucose), disaccharides (lactose, saccharose, maltose or pharmaceutically acceptable hydrates, solvates, anhydrous forms or a combination thereof), oligosaccharides and polysaccharides (dextrant), polyalcohols (sorbitol, mannitol, xylitol), salts (sodium chloride, calcium carbonate) or a combination thereof.
16. The pharmaceutical formulation according to claims 1-15, wherein the fine grained and the coarse grained excipients are selected from the same or different substances.
17. The pharmaceutical formulation according to claims 1-16, wherein lactose or a pharmaceutically acceptable hydrate, anhydrate or a combination thereof is used as fine grained excipient and coarse grained excipient.
18. The pharmaceutical formulation according to claims 15-17, wherein lactose anhydrate is used as fine grained excipient and coarse grained excipient.
19. The pharmaceutical formulation according to claims 1-18, wherein the total amount of the pharmaceutically acceptable excipient is in the range of 1-50 mg.
20. The pharmaceutical formulation according to claim 19, wherein the total amount of the pharmaceutically acceptable excipient is in the range of 2-40 mg.
21. The pharmaceutical formulation according to claim 20, wherein the total amount of the pharmaceutically acceptable excipient is in the range of 3-30 mg.
22. The pharmaceutical formulation according to claims 1-21, wherein the average particle size of the active agents comprised in said formulation is in the range of 1 μπι to 10 μπι.
23. The pharmaceutical formulation according to claim 22, wherein the average particle size of the active agents comprised in said formulation is in the range of 1.5 μπι to 7.5 μη .
24. The pharmaceutical formulation according to claim 23, wherein the average particle size of the active agents comprised in said formulation is particularly in the range of 1.5 μιη to 5 μπι.
25. The pharmaceutical formulation according to claims 1-24, wherein the ratio of fine grained excipient to coarse grained excipient is in the range of 1 : 1 to 1 :25 by weight.
26. The pharmaceutical formulation according to claim 25, wherein the ratio of fine grained excipient to coarse grained excipient is in the range of 1 : 1 to 1 : 10 by weight.
27. The pharmaceutical formulation according to claim 26, wherein the ratio of fine grained excipient to coarse grained excipient is in the range of 1 : 1.5 to 1 :5 by weight.
28. A process in order to prepare the pharmaceutical formulation according to claims 1-27, characterized in that said process is composed of the steps of:
I. micronizing tiotropium, formoterol and budesonide so as to bring them to the desired particle size,
II. micronizing the excipients together or separately in order to bring them to the desired particle size,
III. mixing the active agents micronized in step I firstly with the fine grained excipient and then with the coarse grained excipient in a mixer or firstly with the coarse grained excipient and then with the fine grained excipient in a mixer and
IV. consequently, filling the mixture obtained in dry powder form into suitable capsules, blisters or reservoirs and making it ready for use.
EP13720142.2A 2012-01-16 2013-01-16 Dry powder formulations comprising tiotropium, formoterol and budesonide Withdrawn EP2804585A1 (en)

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WO2016055546A1 (en) * 2014-10-08 2016-04-14 Zambon S.P.A. Pharmaceutical composition containing budesonide and formoterol.
EA035740B1 (en) * 2014-10-08 2020-08-03 Ератеч С.Р.Л. Composition comprising at least one dry powder obtained by spray drying to increase the stability of the formulation
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WO2011093812A2 (en) * 2010-01-28 2011-08-04 Mahmut Bilgic Pharmaceutical formulation comprising tiotropium and budesonide in dry powder form
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