KR100890537B1 - Methods and devices for providing prolonged drug therapy - Google Patents

Abstract

Methods and apparatus are provided for maintaining a desired therapeutic drug effect over an extended treatment period. In particular, oral formulations are provided that release the drug in the gastrointestinal tract at an elevated release rate over a long period of time. The formulation may further comprise immediate release of the drug.

Prolonged drug therapy, oral formulation, capsule, longitudinally compressed tablet core

Description

METHODS AND DEVICES FOR PROVIDING PROLONGED DRUG THERAPY}

1 is a cross-sectional view of a double-cushioned osmotic dosage form according to the present invention.

2 is a cross-sectional view of a triple layer osmotic dosage form, further comprising an immediate release drug barrier and an aesthetic barrier, in accordance with the present invention.

3 is a graph illustrating the amount of drug released over time from a preferred embodiment of the present invention as described in Example 6. FIG.

4 is a graph showing plasma drug concentrations over time, obtained after administration of methylphenidate, according to experimental form (open diamond) and standard form (closed ring) as described in Example 7.

The present invention relates to methods and apparatus for maintaining the desired therapeutic drug effect over an extended treatment period. In particular, the present invention relates to methods and apparatus for providing drug release in the gastrointestinal tract at an elevated release rate over an extended time period. In this manner, drugs are released at increasing rates during some drug administration periods sufficient to maintain the desired therapeutic drug effect over an extended treatment period.

2. Description of the related art, including information disclosed under 37 CFR 1.97 and 1.98

To produce its pharmacological effect, the drug must be made available at appropriate concentrations at the site of action in vivo. This utilization is influenced by many factors including the amount of drug administered, the extent and rate of absorption from the site of administration, the distribution within the tissue, binding or localization, its bioconversion and excretion. One commonly used indicator of drug utilization is the concentration of drug obtained in the blood or plasma of the patient, or other suitable biofluid or tissue, following administration of the drug. Conveniently, this concentration may be referred to hereinafter as "plasma drug concentration", which is intended to include the drug concentration measured in any suitable biological fluid or tissue. Plasma drug concentration measurements provide very useful information including, for example, comparative information regarding different drug formulations and / or different drug administration routes. In addition, for many drugs, various drug effects, including both desired pharmacological effects, i.e. therapeutic drug effects, and unwanted pharmacological effects, i.e. side effects, are associated with a particular plasma drug concentration or a range of plasma drug concentrations.

In orally administered drug formulations, absorption occurs in the gastrointestinal ("gi") tract, and local microenvironments such as surface area, blood flow and membrane properties (significantly change in different parts of the gastrointestinal tract), the physicochemical of the drug itself It is influenced by many factors including properties, drug concentrations, the presence and activity of drug-specific transport mechanisms, and the like. One important factor in the rate of absorption of drugs administered as oral formulations is the rate at which the drug is released from the formulation. In oral formulations the rate of drug release is usually measured as the rate of in vitro dissolution, ie the amount of drug released from the formulation per unit time.

Conventional oral dosage forms can generally be described as "immediate-release" because mainly full doses of drug are released from the dosage form within a very short time, ie, minutes, after administration. As the bolus of this released drug is absorbed, the plasma drug concentration typically rises rapidly to a maximum or peak concentration and then drops as the drug is distributed, bound or localized, bioconverted and / or excreted in the tissue. . This reduction time varies for different drugs and depends on many factors, but will be characteristic for the particular drug. Typically, for some time when plasma drug concentration rises, peaks, and falls, the drug provides its therapeutic effect, ie, the plasma drug concentration achieves or exceeds the effective concentration. Also, at some point during this time, the therapeutic effect disappears, ie, the plasma drug concentration drops to a level below the effective concentration. In addition, unwanted side effects can often occur when some time near the time at which the peak concentration is obtained, ie when the plasma drug concentration is within the highest range.

In this regard, it is believed that a sustained drug effect is seen during the time the plasma drug concentration is within the effective plasma drug concentration range. However, since plasma drug concentration decreases over time, immediate drug formulations should be administered multiple times at appropriate intervals to ensure that plasma drug concentration remains within, or rises back to, an effective concentration range. At the same time, however, there is a need to avoid or reduce plasma drug concentrations to rise to a higher range where side effects occur and / or stay too long in that range. Therefore, for many drugs, immediate release formulations should be administered multiple times, separated at appropriate intervals, to maintain satisfactory normalization of the desired and undesired pharmacological effects over an extended treatment period.

One focus of efforts to improve drug treatment has been to provide non-rapid oral drug formulations that primarily affect the absorption of the drug by altering the release rate of the drug from the formulation. Examples of such non-rapid transport systems include delayed-release and sustained-release systems. Sustained-release formulations generally release the drug for extended periods of time as compared to immediate release formulations. There are many approaches for achieving sustained release of the drug from oral formulations known in the art. Such different approaches are described, for example, in Remington's Pharmaceutical Sciences, 1990, rev. 1682-1685, elution systems such as ion exchange resin systems, osmotic systems, compound diffusion / elution systems and matrix elution systems, and encapsulated elution systems (including, for example, “tiny time pills”). And diffusion systems such as storage devices and matrix devices.

It is particularly desirable to provide sustained-release oral formulations that provide drug release at substantially constant release rates over long periods of time. In this way, for many drugs, plasma drug concentration rises initially for a short time as drug release begins, and then remains substantially constant over time as drug release continues at a constant rate. For many drugs, this substantially constant plasma drug concentration is associated with a substantially constant drug effect over the course of the device charge. In addition, since the initial relatively high peak plasma drug concentration is suppressed, the problem of side effects can be reduced. Thus, the benefits of constant-release formulations include a reduction in the number of doses of the drug that need to be administered over time and a better balance of the desired pharmacological and unwanted pharmacological effects of the drug. What is provided is mentioned.

Osmotic formulations have been remarkably successful, particularly in providing constant-release of the drug over long periods of time. Osmotic formulations, generally using osmotic pressure, allow compartments that are free to diffuse, but, if present, to compartments formed, at least in part, by semipermeable walls that do not allow free diffusion of the osmotic agent (s) or drug. To generate thrust to absorb the fluid. Substantially constant drug release by designing a system with a suitable release means for the drug formulation to provide a relatively constant osmotic pressure and to release the drug formulation at a rate corresponding to the rate of fluid fluid absorbed as a result of the relatively constant osmotic pressure. Speed can be obtained. A significant advantage for osmotic systems is that the rate is osmotically determined over a long time, even though this process is independent of pH and thus the formulations face different microenvironments that have meaningfully different pH values across the gastrointestinal tract. It will last.

Surprisingly, simple but very effective osmotic devices are known in the art which comprise a drug in a mixture with excipients in the compartment, optionally comprising osmoactively active ingredient (s), although for many drugs Although effective, the release rate in such devices often decreases over time, and complete transport of the drug load may not occur. More sophisticated forms of the osmotic device include two component layers in the compartment formed by the semipermeable wall. One component layer comprises the drug in a mixture with excipients, optionally comprising an osmotic active ingredient (s), to form a transportable drug formulation in the compartment, and the second component layer typically contains an osmotic active ingredient ( ), But not drugs. The osmotic active ingredient (s) in the second ingredient layer usually comprises an osmopolymer (s) having a relatively large molecular weight, which is absorbed by the fluid and no release of these ingredients occurs via the drug formulation ejection means. In this case, "swelling" is indicated. The second component, as the osmotic fluid is absorbed, causes the osmopolymer (s) to swell and to push against the transportable drug formulation of the first compartment, thereby releasing the drug formulation at a substantially constant rate. The layer is called a "push" layer. The above-mentioned devices are described, for example, in USP 4,327,725, owned by Alza Corporation; No. 4,612,008; No. 4,783,337; And 5,082,668, each of which is incorporated herein by reference in its entirety.

While constant-release formulations have proven effective for many different drug treatments, there are clinical situations that are not completely satisfactory. In some patients treated with a constant-release dosage form for some conditions or diseases, despite the maintenance of substantially constant drug release, which is expected to provide a lasting effect, the therapeutic effect of the drug is at the end of the desired treatment period. A decrease was observed in the previous period. Thus, if a sustained-release formulation that releases a drug at a substantially constant rate over a long period of time is not satisfactory, there remains a need to provide a method and apparatus for maintaining the desired therapeutic drug effect over a desired extended treatment period.

One aspect of the present invention is to provide improved drug treatment for clinical situations where the therapeutic effect of the administered drug treatment is unexpectedly reduced before the end of the desired treatment period. Surprisingly, in a sample clinical situation, it has been found that when a drug is administered at an elevated release rate over a long period of time, rather than being substantially constant, it provides a therapeutic effect in which the drug effect does not decrease before the end of the extended treatment period. It was.

With the discovery that administering drugs at substantially elevated release rates provides improved drug treatment, there is an increased need for sustained-release oral formulations adapted to provide such release rates over an appropriate period of time. Accordingly, another aspect of the present invention relates to oral sustained-release formulations that provide synergistic drug release rates over long periods of time, methods of making such formulations, and methods of using such formulations to maintain therapeutic effects for the desired extended treatment period. It includes providing.

Surprisingly, it has been found that oral osmotic formulations can be obtained that exhibit elevated drug release rates for extended periods of time. In particular, the present invention relates to osmotic formulations having a bilayer or triple layer adapted to provide an elevated drug release rate over a long period of time. In addition, to provide early rapid expression of drug action, the present invention additionally relates to formulations comprising a dose of immediate release drug.

The bilayer oral osmotic dosage forms of the present invention, when hydrated, comprise a first component layer comprising an excipient and a selected drug to form a transportable drug composition, and a fluid-expandable osmopolymer and excipient contained within the compartment formed by the semipermeable membrane. And a second push layer having a discharge means for drug release from the compartment. Both layers are compressed into a bilayer tablet core before an appropriate hole for drug release is formed through which the semipermeable membrane is applied. Importantly, the bilayer tablet cores disclosed herein provide for a longitudinally compressed tablet ("LCT") core having two component layers compressed together to have a "capsular" form with a different layer at each narrow end. , Is formed.

The combination of properties, including osmoticity of the component layers, fluid effluent of the semipermeable membrane and the form of the tablet core, ensures that the drug is released at an elevated rate over a long period of time. In a preferred embodiment, sufficient activity of the push layer is obtained by the use of relatively high concentrations (at least about 35%) of an osmotic effective solute, or an osmagent such as sodium chloride. In addition, sorbitol is preferably included in the first component layer.

The triple layer oral osmotic dosage forms of the present invention comprise a novel triple layer tablet core having an appropriate release means for release of the drug formulation through the semipermeable membrane, surrounded by the semipermeable membrane. The novel triple layer tablet core has a first drug-containing layer, a second drug-containing layer and a third push layer. In the process, through the combination of formulation components, the drug is released from the first drug-containing layer continuously and then from the second drug-containing layer. Drug concentration gradients have been found to facilitate the achievement of elevated drug release rates over long periods of time. Thus, other excipients in the drug-containing layer change more flexibly and are adjusted for other purposes such as ease of manufacture and pharmaceutical refinement. In this way, formulations that exhibit reliable drug release with a desired sustained and rising rate over a long period of time can be reliably and effectively produced.

Preference is given to using LCT core forms which enhance the hydration of the triple layer core, as described above. In addition, the effluent-enhancer is preferably included in the semipermeable membrane composition. In a presently preferred embodiment, the desired rise over a long period of time with a combination of properties including the LCT triple layer core form, an appropriate drug concentration gradient between the first and second component layers, the osmoticity of the component layers, and the fluid outflow of the semipermeable membrane. Get drug release of rate.

There are a number of clinical situations and drug treatments that can be enhanced with the use of formulations that provide sustained and rising release rates over long periods of time. Sample formulations disclosed herein include CNS-acting drugs and cardiovascular-acting drugs. Those skilled in the art will appreciate that the present invention is applicable to many other forms of drugs and drug therapies. Examples of suitable forms of drugs include anti-infective drugs, analgesics, anesthetics, anti-arthritis drugs, anti-asthmatic drugs, anticonvulsants, antidepressants, antidiabetic drugs, anti-diarrheal drugs, antihistamines, anti-inflammatory drugs, anti-migraine drugs, anti-tumor drugs, anti Parkinson's, antipruritic, antipsychotics, antipyretics, anticonvulsants, anticholinergic drugs, sympathomimetic drugs, calcium channel blockers, beta blockers, antiarrhythmic drugs, antihypertensives, ACE inhibitors, diuretics, vasodilators, nasal decongestants, hormones, Hypnotics, immunosuppressive agents, parasympathetic stimulants, prostaglandins, proteins, peptides, sedatives and neurostabilizers.

Sample clinical situations described herein include treatment of ADHD with methylphenidate therapy. Accordingly, the present invention also relates to the preparation of oral methylphenidate sustained release formulations which provide sustained and rising rates of drug release over a long period of time.

It has also been found that oral methylphenidate sustained release formulations that provide elevated release rates of drug over an extended period of time can be used to provide an effective once daily regimen for ADHD. Thus, the present invention also improves for ADHD by eliminating the need for multiple daily doses of methylphenidate and providing a therapeutic effect throughout the day, comparable to the therapeutic effect provided by multiple doses of immediate release methylphenidate. Drug therapy.

In addition to the features and advantages described above, others will become more apparent from the following detailed description of the invention and the appended claims.

Although the present invention is described by sample formulations containing particular sample drugs, methods of making such drug formulations, and methods of using methylphenidate-containing formulations to provide the desired therapeutic outcome, the present invention is directed to sample embodiments. It is not limited. The present invention, as broadly disclosed herein, will be apparent to those skilled in the art, with increasing drug release rates over time, methods of making such formulations, and any suitable drug, and therapeutic effects for the desired extended treatment period with respect to drug therapy. Oral sustained-release formulations that provide a method of using such formulations to maintain a.

Many effective drug treatments use immediate oral dosage forms that are administered at intervals to provide and maintain the desired therapeutic effect over an extended treatment period. In addition, sustained-release formulations for many drugs are known, in particular constant-release oral formulations. There are many examples of effective drug therapies that provide the desired therapeutic effect over an extended treatment period, using a constant-release oral formulation. In many cases, such drug treatments offer advantages over drug treatments with immediate oral dosage forms that are administered at intervals. However, there are clinical situations where the constant-release formulation unexpectedly exhibits a decrease in therapeutic effect at the time before the end of the desired extended treatment period.

One example of a clinical situation in which drug treatment using sustained-release oral dosage forms that provide a substantially constant rate of drug release over a long period of time is not wholly satisfactory is attention deficit disorder (ADD) and attention deficit hyperactivity disorder. Central nervous system (CNS) stimulating drugs are used to treat various conditions and disorders, including (ADHD). Such disorders are usually diagnosed in children but may occur in adults. Treatment of these and other psychological conditions with CNS stimulating drugs has a long history. About 25 years ago, methylphenidate replaced amphetamine as the primary stimulant prescribed for treating ADHD in children.

Methylphenidate therapy in children with ADHD has been extensively studied and the efficacy and safety of this treatment are well documented. Methylphenidate therapy has been shown to be very effective in reducing symptoms of hyperactivity, attention deficit and impulsiveness in children with ADHD. The purpose of drug therapy is to control behavioral symptoms during the day at which the patient is in a school or elsewhere involved in the activity, where symptom control is beneficial to the ability to learn and / or participate in the activity. However, because of concerns about side effects, drug therapy is usually discontinued for at least part of the evening and at night, for most patients. Depending on the particular situation of the patient, drug therapy may or may not be stopped over the weekend.

Treatment usually involves immediate release methylphenidate administered two or three times daily. For various reasons, patients often have difficulty following the dosing schedule. Because of the potential for misuse, methylphenidate is a regulated substance and drug access is a particular problem. Such dosage forms are usually administered for at least once a day during school hours, and generally children are not allowed to self-medicate medication at school. For this reason, school officials are usually responsible for administering drugs to children during the school day, but this approach raises the issue of potential injury to children by medical privacy and peers. In addition, compliance issues are further complicated when the transport, storage and supply of drugs must normally be documented and / or monitored and the schedules of the different classes involved, ie children, educators and school officials, must be combined and controlled. The unfortunate consequence is that medications can be delayed or missed, and these together result in a reduction in the effectiveness of the treatment.

For all of the above reasons, sustained-release oral formulations of methylphenidate would be a welcome improvement, providing a substantially constant drug release over a long period of time, thereby eliminating the need for administration during the course of the course. In fact, such sustained-release formulations of methylphenidate have been on the market for many years. However, clinical experience with such formulations has been disappointing in that the behavioral symptoms of patients taking controlled-release formulations are less controlled after that day compared to children taking multiple immediate release formulations. In addition, the slower onset of action of the controlled-release formulation compared to immediate release formulations is unsatisfactory for many patients.

Surprisingly, it has been found that administering methylphenidate at a substantially rising, release rate over a long period of time, rather than being substantially constant, provides therapeutic efficacy similar to that obtained with multiple doses of immediate release methylphenidate formulations. A detailed description of this finding is disclosed in USP No. 910,593, filed Jul. 31, 1997, filed on July 31, 1997, which application is partly continuous. In brief review, in one clinical study, a comparison of the behavior, attention and cognitive efficacy of methylphenidate and placebo administered according to three different release rate modalities: immediate release, constant-release and synergistic-release. Immediate release methylphenidate was administered twice at intervals. The constant-release modality was administered as the initial loading dose, with the total amount remaining being administered in equally small doses at close intervals over the time of the second immediate dose. The rise-release form was administered as an initial loading dose, with the total amount remaining extending over a small interval of closely spaced rise over the time of the second immediate dose.

In this study, it was observed that the constant-release modality had reduced clinical efficacy compared to the immediate release modality during the evaluation period after the second immediate release dose. In contrast, the up-release modalities demonstrated clinical efficacy comparable to immediate modalities during the evaluation period. As such, the rise-release modality deviates from the decrease in treatment efficacy seen in the constant-release modality in later periods of extended treatment.

It is noted that the development of acute resistance to methylphenidate has been proposed as an explanation for the unsatisfactory reduction of the therapeutic effect observed in some cases, without certainty in the mechanism (s) of action of the present invention. Support for this hypothesis indicates that a decrease in the effect of methylphenidate is seen over an extended treatment period, not only when a constant-release form is used, but also when immediate methylphenidate formulations are administered at very close intervals. Proven in a second clinical study. However, elevation-release therapies have been shown to maintain therapeutic effectiveness throughout the extended treatment period.

While discovering that drug effects over an extended treatment period may be enhanced in some situations where drugs are administered at elevated release rates over an extended period of time, the need for sustained release oral formulations applied to provide such release rates increases. In one aspect of the invention, it has surprisingly been found that bilayer oral osmotic dosage forms can be adapted to this need. In another aspect, it has been surprisingly found that sustained-release oral osmotic formulations with novel triple layer cores can also be prepared that also achieve sustained release of the drug formulation at elevated rates for extended periods of time.

As is known in the prior art, osmotic formulations comprising a compressed tablet core are sufficiently hydrated and begin to release the drug, requiring a short time after administration. For some drug treatments, some delay in initial drug release is unsatisfactory. This problem is overcome by adding an initial dose of drug supplied to the immediate protective membrane applied to the surface of the semipermeable membrane. In a preferred embodiment of the invention, as described herein, for example, an immediate release drug protective film is applied on the surface of a bilayer or trilayer osmotic dosage form.

For this description, the following definitions apply:

For the sake of clarity and simplicity herein, an appointment is used to denote drug administration time in 0 hours (t = 0 hours), in appropriate time units, post-administration time such as t = 30 minutes or t = 2 hours, and the like. .

As used herein, the term "drug" usually refers to a pharmacologically active substance which, when transported to a living organism, produces a desired, usually beneficial effect. Drug compositions are commonly used clinically in the form of their pharmaceutically acceptable salts. In addition, some drug compositions exhibit chirality and therefore have at least one optical isomer. Since different optical isomers may exhibit different pharmacological effects, it may be advantageous to use substantially pure forms of the optical isomers of the drug, or pharmaceutically acceptable salts thereof. Thus, the term "drug" includes a pharmaceutically acceptable salt thereof and names a clinically useful form of a drug composition comprising a substantially pure isomer of the drug composition and a pharmaceutically acceptable salt thereof. . Although a limited number of drugs are shown in the sample embodiments, the present invention is not limited to the sample embodiments, but is fully applicable to other suitable drugs, which can be understood by those skilled in the art.

The amount of drug included in the formulation of the present invention varies depending on the particular drug, the indication of treatment and the desired duration of administration, such as every 12 hours, every 24 hours, and the like. Depending on the dose of drug to be administered, one or more formulations may be administered.

The drug “release rate” refers to the amount of drug released from the formulation per unit time, such as milligrams (mg / hour) of drug released per hour. Drug release rates are calculated under in vitro formulation dissolution test conditions known in the art. As used herein, the rate of drug release obtained at a particular time “after administration” refers to the rate of in vitro drug release obtained at a particular time after the implementation of the appropriate dissolution test. The dissolution test used in the examples described herein was carried out in a metal coil sample holder, immersed in about 50 ml of acidic water (pH = 3) equilibrated in a 37 ° C. constant temperature water bath and attached to a USP type VII bath indexer. In the loaded formulation. A few drops of release rate solution were injected into the chromatography system to quantify the amount of drug released during the test interval.

A commonly used reference means for evaluating drug release from an oral dosage form is the time at which 90% of the drug in the dosage form is released. This means is named "T ₉₀ " for the formulation.

An “immediate” dose of a drug refers to a dose that is released completely within a time of substantially less than about 1 hour, preferably less than about 30 minutes. As used herein, an immediate release dose of a drug, applied as a coating to the surface of a formulation, is prepared in a suitable pharmaceutically acceptable carrier to form a coating solution that will rapidly elute upon administration, thereby providing immediate administration of the drug. Name the administration of the drug. As is known in the art, such immediate drug barriers may comprise the same or different drug (s) included in the base formulation.

"Periodic release rate" refers to the amount of drug released from the formulation during a particular periodic interval, measured at the end of a particular periodic interval, i.e., at each periodic interval at which the measurement was made, and the amount of drug released during the periodic interval The periodic release rate is shown. For example, the amount of drug released, measured at t = 1 hour, represents the periodic release rate from the formulation for the first hour after administration, and the amount of drug released, measured at t = 2 hours, during the second hour after administration Periodic release rate and the like.

"Raising release rate" refers to an increased rate of periodic release compared to the immediately preceding periodic release rate if the periodic intervals are equal. For example, the amount of drug released from the formulation is measured every hourly interval, and during the fifth hour after administration (measured at t = 5 hours), the amount of drug released is administered during the fourth hour following administration (t = 4 hours). As greater than the amount of drug released, an elevated release rate occurred from the fourth time to the fifth time.

The measured first periodic release rate, such as the non-zero periodic release rate at t = 1 hour, is greater than the release rate during the preceding period, such as the time before the formulation is administered, so that the first periodic release The rate will always be considered to encompass the generation of an elevated release rate.

The elevated release rate described herein names the release rate from the formulation that is applied to provide sustained release of the drug and does not include release of the drug from any immediate release drug coating that may be applied to the formulation. In formulation embodiments that include an immediate release dose of the drug applied as a coating over the base formulation, the drug release measured at t = 1 hour usually results in both drug released from the immediate release drug coating and any drug released from the base formulation. However, the amount of drug released from the drug shield is not taken into account to determine whether the rate of drug release at t = 2 hours is greater than drug release at t = 1 hour.

As used herein with respect to the time at which an elevated release rate is provided, the term “an extended time period”, starting at t = 0 hours, is above the midpoint, preferably intermediate, of the relevant T ₉₀ of the formulation. Means time that lasts above the point. Since the formulations of the present invention are intended to provide sustained release of the drug, a suitable T ₉₀ for the present invention is at least about 6 hours, and consequently, "long time" is at least 3 hours while an elevated release rate is provided.

According to the above-mentioned definition, the term "raising release rate over a long period of time" means the rising release rate of a drug obtained from the time of administration of the formulation above, preferably above, the midpoint of the relevant T ₉₀ for the formulation. To illustrate this, consider the situation in which the formulation has a T ₉₀ of about eight hours. In this situation, the "raising release rate over a long time" is obtained when the release rate at each time until t = 4 hours is larger than the release rate of the immediately preceding time. Preferably, the release rate continues to rise for a time exceeding t = 4 hours.

Bilayer oral osmotic formulations and methods of making and using such formulations are described, for example, in US Pat. No. 4,327,725, owned by Alza Corporation; 4,612,008; 4,783,337; And 5,082,668, as known and claimed in the art, each of which is incorporated herein by reference in its entirety. Prior art bilayer osmotic dosage forms achieve sustained release of the drug formulation, followed by a relatively simple initial rate of release followed by a substantially constant release rate over the major portion of the T ₉₀ period. Achieving an elevated release rate over a prolonged period of time over T _{90 of} 50% is not found within the prior art. The formulations of the present invention are useful for providing continuous effective drug treatment over an extended treatment period without showing a decrease in effectiveness during the second half of the extended treatment period.

The bilayer oral osmotic dosage forms of the present invention comprise a first component layer comprising an excipient for forming a drug of choice and a transportable drug composition when hydrated, and a second push layer comprising a fluid-expandable osmopolymer and an excipient. These two layers are applied to a bilayer tablet core before a semipermeable membrane is applied through which a suitable hole for drug release is formed. The combination of properties, including osmoticity of the component layers, fluid effluent of the semipermeable membrane and the form of tablet cores, ensures that the drug is released at an elevated rate over a long period of time.

Importantly, the bilayer tablet core of the present invention is formed in a rounded cross shape with each component layer having a length and an ambient width substantially between the top and bottom. The two layers are compressed together longitudinally so that the resulting bilayer tablet core has the same combined width as the component layer and the combined length of the component layers. The overall form may be described as "capsular", where the bilayer tablet core has an ambient width less than the length, has a round "narrow" top and a round "narrow" bottom, and each narrow end comprises a different component tablet layer. have.

For this description, the tablet cores described above are referred to as longitudinally compressed tablet ("LCT") cores. This LCT type ensures that when the push layer expands longitudinally in the compartment formed by the semipermeable membrane, the surface area of the push layer in contact with the semipermeable membrane is increased more than when other forms are used.

In a preferred embodiment, sufficient activity of the push layer is obtained by using a relatively high concentration (at least about 35%) of an osmotic effective solute, or an osmotic agent such as sodium chloride. Thus, the size of the push layer is relatively large and may be slightly larger than the first component layer containing the drug and excipient. In addition, in certain embodiments, it has been found that sorbitol is a useful excipient in the first component layer. Surprisingly, the combination of the above-described properties, including the use of sorbitol as an excipient in LCT core form, a relatively high percentage of osmotic agent, and in some sample embodiments, provides a desired elevated release rate over time from a bilayer oral osmotic dosage form. Was found to provide. Sample embodiments of such bilayer osmotic dosage forms are described in Examples 1-3 below.

Embodiments of the bilayer oral formulation 15 are shown in the cross-sectional view of FIG. 1. The ingredients are not drawn to scale. The bilayer LCT core comprises a first component layer 21 comprising a drug and an optional excipient, and a second push layer 29 comprising one or more osmotic agents together with one or more fluid-expandable osmopolymers, optionally with optional excipients. Suitable excipients are known in the art and include diluents, carriers, binders, fillers and processing aids. The semipermeable membrane 57 surrounds the bilayer tablet core to form a compartment, and an appropriately sized hole 55 is formed through the semipermeable membrane into the first component layer 21 to allow the drug formulation to be released from within the compartment. As will be explained, the aperture 55 is preferably formed at the narrow end of the formulation comprising the first partition layer. In the process, through the combination of the bilayer osmotic dosage form components, the drug is released from the first drug-containing layer at an elevated release rate for a long time. Although not shown in FIG. 1, immediate administration of the drug can be provided by applying a drug-containing protective film to the bilayer formulation disclosed herein, if desired.

In addition to the bilayer osmotic formulations described above, surprisingly, oral formulations exhibiting elevated drug release rates for extended periods of time have also been obtained with a novel trilayer tablet core surrounded by a semipermeable membrane, with an appropriate means of release to release the drug formulation through the semipermeable membrane. It was found that it could be lost. The novel triple layer tablet core has a first drug-containing layer, a second drug-containing layer and a third push layer. During the process, the drug is released from the first drug-containing layer in a continuous and controlled manner, and then from the second drug-containing layer, such that through a combination of formulation components, an elevated release rate is obtained over a long period of time.

The drug concentration gradient between the first and second drug-containing layers of the triple layer core facilitates the achievement of elevated drug release rates for a long time from the triple layer osmotic dosage form. Thus, other excipients of the drug-containing layer can be changed and adjusted more flexibly for other purposes, such as ease of manufacture and pharmaceutical refinement. For example, triple layer osmotic dosage forms preferably avoid the use of sorbitol as excipient. This sorbitol draws moisture during storage that can cause difficulties in handling and manufacturing, as well as long term stability issues and is very hygroscopic, thus providing manufacturing efficiency and product shelf life advantages. In addition, sufficient activity of the push layer can be obtained with the use of relatively lower concentrations (less than about 25%) of osmotically effective solutes such that the size of the push layer can be smaller than the size of the two drug-containing layers. Can be. Preferably, the push layer is smaller than the combined size of the first and second drug-containing layers. The advantage for smaller size push layers is that if desired, the overall size of the formulation does not become large enough to cause manufacturing difficulties and / or to be unpleasant to the patient, and higher doses of the drug can be applied.

In the presently preferred embodiment, the hydration rate of the triple layer osmotic dosage form is enhanced with the inclusion of an effluent-enhancer in the semipermeable membrane. It is also desirable to use longitudinally compressed tablet (“LCT”) core forms, as described above, for triple layer osmotic formulations to enhance hydration. In a presently preferred embodiment, the desired rise over time with a combination of properties including the LCT triple layer core type, an appropriate drug concentration gradient between the first and second component layers, the osmoticity of the component layers and the fluid effluent of the semipermeable membrane. Get drug release of rate. Advantageously, this preferred embodiment represents a continuous and reliable process and can be efficiently manufactured on a large scale basis.

A preferred embodiment of a triple layer oral osmotic dosage form comprising an immediate release dose of a drug applied as the protective film and the aesthetic protective film 14 is shown in the cross-sectional view of FIG. 2. The triple layer LCT core comprises a first component layer 20 comprising a selection drug in pharmaceutically acceptable form with a selection excipient; Second component layer 18 comprising a higher concentration of drug with the optional excipient; And a third push layer 28 comprising one or more osmopolymers, optionally comprising one or more osmotic agents with optional excipients. Semipermeable membrane 56 surrounds the triple layer tablet core to form a compartment, and an appropriately sized hole 54 is formed through the semipermeable membrane into the first component layer, allowing the drug formulation to be released from within the compartment. As will be explained, the hole 54 is preferably formed within the narrow end of the formulation comprising the first component layer. In the process, through the combination of triple layer osmotic dosage form components, the drug is released from the first drug-containing layer at a sustained and controlled manner, at an elevated release rate for a long time, and then from the second drug-containing layer.

As shown in FIG. 2, a preferred embodiment further comprises an immediate release dose of the drug contained in the protective layer 60 applied on the surface of the triple layer osmotic dosage form. The drug is mixed with a suitable excipient such as hydroxypropylmethylcellulose to prepare a solution for coating on the surface of the semipermeable membrane of the triple layer osmotic formulation, which will rapidly elute and release the drug after administration.

As shown in FIG. 2, it is also desirable to provide any aesthetic protective film 62 applied over the surface of the drug-containing protective film 60. As is known in the art, these aesthetic protective coatings offer the advantages including taste-masking, improved appearance and swallowing, and further ease of "lubrication" for processing steps such as printing, packaging, and the like. Sample embodiments of triple layer osmotic dosage forms, which exhibit substantially elevated release rates over long periods of time, are described in Examples 4-6 and Examples 8 and 9 below.

The sustained maintenance of the therapeutic effect over an extended treatment period by the administration of an oral osmotic dosage form, which exhibits an elevated release rate over a prolonged period of the invention, has been demonstrated. An example is given in Example 7 below. In particular, such osmotic formulations containing methylphenidate can be used to provide an effective once daily regimen for ADHD. This finding eliminates the need for multiple daily doses of methylphenidate and provides an all-day therapeutic benefit that is comparable to the therapeutic efficacy provided by multiple doses of immediate methylphenidate, thereby providing significant improvements in drug therapy for ADHD. Indicates.

The following examples are illustrative of the invention and, as such examples, should not be construed as limiting the scope of the invention in any way, other equivalents thereof being modified in the art in view of this description and the appended claims. It will be clear.

EXAMPLE

Example  One

Bilayer oral osmotic dosage forms are prepared according to conventional methods of preparation known in the art and are described in detail in US application No. 967,606, filed Nov. 10, 1997, filed in part. It is a continuous application. Briefly, a first component layer containing methylphenidate hydrochloride and a selective excipient, and a second push layer containing a suitable osmopolymer, 40% by weight osmotic agent and optional excipient, were prepared separately by granulation. Next, the first component layer and the second push layer granulation formulation were vertically compressed together to form a bilayer LCT core. The selected semipermeable membrane was then coated around the bilayer LCT core and a 30 mil hole suitable for drug release was formed there through, into the first component layer.

Each formulation prepared included the following:

First component layer

14.08 mg Methylphenidate hydrochloride

90.26 mg poly (ethylene) oxide (200,000 number average molecular weight)

5.5 mg poly (vinylpyrrolidone) (40,000 number average molecular weight)

0.11 mg magnesium stearate

0.555 mg Butylated Hydroxy Toluene

Second push layer

71.032 mg poly (ethylene) oxide (7,000,000 number average molecular weight)

52.8 mg sodium chloride

6.6 mg poly (vinylpyrrolidone) (40,000 number average molecular weight)

1.32 mg red iron oxide

0.132 mg magnesium stearate

0.555 mg Butylated Hydroxy Toluene

Semi-permeable membrane

15.3 mg cellulose acetate (39.8% acetyl content)

1.7 mg poly (ethylene glycol) (3350 number average molecular weight)

The periodic release rate from the formulation was measured every hour for 10 hours using an in vitro dissolution test. A residual amount of drug of 0.72 mg remained in the formulation. The results are shown in Table 1 with an indication of whether or not an elevated release rate occurs.

Time (hours) Amount of drug released (mg) Rising release rate One 0.22 YES 2 1.45 YES 3 1.72 YES 4 1.84 YES 5 2.05 YES 6 2.21 YES 7 2.13 NO 8 1.26 NO 9 0.39 NO 10 0.09 NO

As shown in Table 1, the drug was released from the formulation for an extended period of time over a long time, ie more than 90% of the drug was released until t = 8 hours, t = 6 hours, which was a long time past the midpoint of T ₉₀ . Up release rate occurred until.

Example 2

Bilayer oral osmotic dosage forms are prepared according to conventional manufacturing methods known in the art and are described in detail in US application No. 967,606, filed Nov. 10, 1997, filed in part, the application of which day is part of It is a continuous application. Briefly, a first component layer containing methylphenidate hydrochloride, sorbitol, and an optional excipient, and a second push layer containing an appropriate osmopolymer, 40% by weight osmotic agent and an optional excipient were prepared separately by granulation. Next, the first component layer and the second push layer granulation formulation were vertically compressed together to form a bilayer LCT core. The selected semipermeable membrane was then coated around the bilayer LCT core and a 30 mil hole suitable for drug release was formed there.

Each formulation prepared included the following:

First component layer (110 mg)

12.8% Methylphenidate Hydrochloride

54.75% poly (ethylene) oxide (200,000 number average molecular weight)

25.4% Sorbitol

5% hydroxypropylmethylcellulose (11,200 number average molecular weight)

2% Magnesium Stearate

0.05% Butylated Hydroxy Toluene

Second push layer (132 mg)

53.85% poly (ethylene) oxide (7,000,000 number average molecular weight)

40% Sodium Chloride

5% hydroxypropylmethylcellulose (11,200 number average molecular weight)

1% red iron oxide

0.1% Magnesium Stearate

0.05% Butylated Hydroxy Toluene

Semipermeable membrane (42 mg)

47.5% cellulose acetate (39.8% acetyl content)

47.5% cellulose acetate (32% acetyl content)

5% Poly (ethylene Glycol) (3350 Number Average Molecular Weight)

Periodic release rates from the formulations were measured every hour for 24 hours using an in vitro dissolution test. No residual amount of drug remained in the formulation. The results are shown in Table 2 with indications of rising release rate occurrences.

Time (hours) Amount of drug released (mg) Rising release rate One 0.13 YES 2 1.16 YES 3 1.53 YES 4 1.61 YES 5 1.75 YES 6 1.79 YES 7 2.13 YES 8 2.18 YES 9 1.07 NO 10 0.43 NO 11 0.17 NO 12 0.13 NO

As shown in Table 2, more than 90% of the drug was released until t = 9 hours, and an elevated release rate occurred until t = 8 hours, long time past the midpoint of T ₉₀ .

Example 3

Bilayer oral osmotic dosage forms, which add an immediate release dose of the drug to be applied as a protective film on the semipermeable membrane, are prepared according to the usual preparation methods known in the art and are filed in US Application No. 967,606, the present application of that day is a partial consecutive application. Briefly, a first component layer containing methylphenidate hydrochloride, sorbitol and an optional excipient, and a second push layer containing an appropriate osmopolymer, 39.8% by weight osmotic agent and an optional excipient, were prepared separately by granulation. Next, the first component layer and the second push layer granulation formulation were vertically compressed together to form a bilayer LCT core. The selected semipermeable membrane was then coated around the bilayer LCT core and a 30 mil hole suitable for drug release was formed there. Drug-containing protective membrane mixtures were prepared and coated onto the semipermeable membrane of the osmotic formulation. Optionally, a taste-masking protective film was also applied.

Each osmotic bilayer formulation prepared included the following:

First component layer

14 mg Methylphenidate

61 mg poly (ethylene) oxide (200,000 number average molecular weight)

27.5 mg sorbitol

5.5 mg polyvinylpyrrolidone

2.2 mg magnesium stearate

* 0.055 mg butylated hydroxy toluene

Second push layer

72 mg poly (ethylene) oxide (7,000,000 number average molecular weight)

53 mg sodium chloride

6.6 mg polyvinylpyrrolidone

1.3 mg red iron oxide

0.132 mg magnesium stearate

0.066 mg butylated hydroxy toluene

Semi-permeable membrane

20 mg cellulose acetate (39.8% acetyl content)

20 mg cellulose acetate (32% acetyl content)

2 mg poly (ethylene glycol) (4000 number average molecular weight)

A rapid-release drug-containing protective film comprising 60% hydroxypropylmethylcellulose and 40% methylphenidate hydrochloride was prepared, and 10 mg of the final solution (ie containing 4 mg of methylphenidate salt) was coated on the semipermeable membrane of the osmotic formulation. It was.

Periodic release rates from the drug barrier and osmotic dosage forms were measured at 30 minutes, 1 hour and then every hour for the next 9 hours. 4 mg of methylphenidate contained in the drug shield was released within the first 30 minutes, and the periodic release rate of 0.41 mg shown at t = 1 hour included the drug released from the bilayer osmotic dosage form during the second 30 minutes interval. No residual amount of drug remained in the formulation. The results of each hour are shown in Table 3 with an indication of the occurrence of the rising release rate.

Time (hours) Amount of drug released (mg) Rising release rate One 0.41 YES 2 1.05 YES 3 1.49 YES 4 1.57 YES 5 1.71 YES 6 1.75 YES 7 2.09 YES 8 2.14 YES 9 1.32 NO 10 0.48 NO

As shown in Table 3, with the exception of the immediate drug barrier, more than 90% of the drug was released until t = 9 hours, and an upward release rate occurred until t = 8 hours, long time past the midpoint of T ₉₀ . It was.

Example 4

Triple layer oral osmotic dosage forms are prepared according to conventional methods of preparation known in the art and are described in detail in US application no. 937,336, filed Aug. 19, 1997, filed concurrently. Partial continuous application. Briefly, a first component layer containing pseudoephedrine hydrochloride and a selection excipient, a second component layer containing higher concentration of pseudoephedrine hydrochloride and a selection excipient, and a third push layer containing an appropriate osmopolymer, osmotic agent and optional excipient It was prepared separately by the granulation method. Next, the first component layer, the second component layer, and the third push layer granulation formulation were vertically compressed together to form a triple layer LCT core. Then, the selected semipermeable membrane was coated around the triple layer LCT core, and a 30 mil hole suitable for drug release was formed there.

Each formulation prepared included the following:

First component layer

4.4 mg hydroephedrine

15.3 mg poly (ethylene) oxide (300,000 number average molecular weight)

1.1 mg hydroxypropylmethylcellulose (9,200 number average molecular weight)

1.1 mg polyoxyethylene 40 stearate

0.11 mg magnesium stearate

Second component layer

13.5 mg hydroephedrine

2.59 mg poly (ethylene) oxide (300,000 number average molecular weight)

0.9 mg hydroxypropylmethylcellulose (9,200 number average molecular weight)

0.9 mg polyoxyethylene 40 stearate

0.018 mg red iron oxide

0.09 mg magnesium stearate

3rd push layer

22.2 mg poly (ethylene) oxide (7,000,000 number average molecular weight)

12 mg sodium chloride

2 mg hydroxypropylmethylcellulose (9,200 number average molecular weight)

2 mg polyoxyethylene 40 stearate

1.2 mg crosslinked acrylic acid polymer

0.4 mg red iron oxide

0.2 mg magnesium stearate

Semi-permeable membrane

11.4 mg cellulose acetate (39.8% acetyl content)

0.6 mg polyethylene glycol (3350 number average molecular weight)

The periodic release rate from the osmotic dosage form was measured every hour for 7 hours and the results are shown in Table 4 with an indication of the occurrence of the elevated release rate.

Time (hours) Amount of drug released (mg) Rising release rate One 0.13 YES 2 0.65 YES 3 2.2 YES 4 2.78 YES 5 3.24 YES 6 3.14 YES 7 3.43 YES

As shown in Table 4, about 87% of the drug was released during the first 7 hours, and an elevated release rate was obtained throughout this period.

Example 5

Has a greater drug concentration gradient in the second component layer than the first component layer, the viscosity of the first component layer is less than the viscosity of the second component layer, and the viscosity of the second component layer is lower than the viscosity of the third push layer Triple layer oral osmotic dosage forms with viscosity are disclosed in detail in US application no. 937,336, filed Aug. 19, 1997, prepared according to conventional manufacturing methods known in the art, and on that day This application of is a partial continuous application.

Each formulation prepared included the following:

First component layer (350 mg)

* 8.6% Nicardidipine

54.8% Sorbitol

36.8% poly (ethylene) oxide (200,000 number average molecular weight)

Second component layer (120 mg)

45% nicardipine

50% poly (ethylene) oxide (300,000 number average molecular weight)

5% hydroxypropylmethylcellulose (9,200 number average molecular weight)

Third push layer (350 mg)

68.75% poly (ethylene) oxide (7,000,000 number average molecular weight)

20% Sodium Chloride

5% `hydroxypropylmethylcellulose (9,200 number average molecular weight)

5% crosslinked acrylic acid polymer

1% red iron oxide

0.25% Magnesium Stearate

Semipermeable membrane (43.5 mg)

95% cellulose acetate (39.8% acetyl content)

5% `polyethylene glycol (3350 number average molecular weight)

The formulation had a 25 mil vent hole formed through the semipermeable membrane to allow the drug formulation to be released from within the compartment. An elevated release rate was obtained with the formulation of Example 5 for a long time of about 16 hours.

Example 6

The trilayer osmotic dosage form of the present invention in a preferred embodiment, which further comprises an immediate release dose of a drug applied as a protective film, shown in FIG. 2, was prepared according to a conventional osmotic tablet preparation method.

The first component layer comprised (weight%): methylphenidate hydrochloride 9.40%, polyethylene oxide 83.71% (Union Carbide, Danox, Connecticut trade name Polyox N-80), polyvinylpyrrolidone 5% (BAS Corp., Mt. Olive, Kolidon 29-32, New Jersey); Succinic acid 1.34%; Stearic acid 0.5%; Butylated hydroxy toluene 0.05%.

The second component layer included (weight%): methylphenidate hydrochloride 13.65%, polyethylene oxide 78.80% (Union Carbide, Danbury, Connecticut trade name Polyox N-80), polyvinylpyrrolidone 5% (BAS Corp., Mt. Olive, Kolidon 29-32, New Jersey); Succinic acid 1.95%; Stearic acid 0.5%; 0.05% butylated hydroxy toluene; And 0.05% yellow iron oxide as colorant.

The third push layer comprised (weight%): 73.7% high molecular weight polyethylene oxide (Union Carbide, Danox, trade name Polyox 303 from Connecticut), 20% sodium chloride; Polyvinylpyrrolidone 5% (BAS Corp., Mt. Olive, trade name Kolidon 29-32 from NJ); 0.25% stearic acid; 0.05% butylated hydroxy toluene; And green iron oxide 1% as colorant.

Each of the first component layer, the second component layer, and the third push layer were separately prepared as a granulated composition in a fluidized bed granulator. The granulated composition was then continuously compressed longitudinally on a rotary tablet press to produce a triple layer LCT core. For each formulation, 40 mg of the first component layer granules and 75 mg of the second component layer granules were first sequentially filled and compacted to 100 Newtons into the die. Thereafter, 90 mg of the third push layer granules were added to the die, and final compression was performed at 1500 Newtons.

The composition of the semipermeable membrane was 83 weight percent of cellulose acetate (CA 398-10 having a acetyl content of 39.8%, product of Eastman Chemical, Kingsport, Tennessee) and 17 weight copolymer of ethylene oxide and propylene oxide, added as effluent-enhancer. % (Trade name Poloxamer 188 from BASF Corp., Mt. Olive, NJ). The two components were eluted in a combination of 99.5% acetone and 0.5% water to form a 5% solid solution. Then, in a pan coater, the solution was sprayed onto the triple layer LCT core at a thickness of 25.7 mg and a thickness of 4-5 mils.

A semipermeable membrane was applied to form a compartment comprising the triple layer LCT core, followed by a 0.76 mm (40 mil) hole through the semipermeable membrane at the narrow end of the compartment proximal to the first component layer, yielding 14 mg of methylphenidate each. Including a preferred triple layer osmotic dosage form. Each formulation was approximately 5.3 mm in diameter, approximately 12 mm long.

Drug shields to provide immediate initial doses of the drug include about 30 weight percent methylphenidate hydrochloride, about 70 weight percent hydroxypropylmethylcellulose (trade name Methocel E3 from Dow Chemical Co., Midland, Miami), and trace amounts of phosphoric acid ( Ie, 20 ml of phosphoric acid added to 87 kg of the drug in solution. By eluting and mixing the components in water, an aqueous coating solution was prepared to form a solution with a 10% solid composition. Thereafter, in a pan coater, the solution was sprayed onto the semipermeable membrane of the trilayer osmotic formulation at a weight of about 14.0 mg comprising about 4 mg of immediate release methylphenidate.

A final aesthetic protective composition comprising a bottom layer of Opadry II (trade name Colorcon, West Point, Pennsylvania), weighing 16.9 mg and a top layer of transparent Opadry with trace amounts of Carnauba wax, a lubricant, was prepared and applied as follows. : First, Opadry II (10%) is suspended in water (90%) and sprayed onto the drug-coated formulation; Next, clear Opadry (5%) is suspended in water (95%) and sprayed onto the drug- and Opadry II-coated formulations; Finally, the formulation was rolled in the coater with carnauba wax for 10 minutes to ensure that about 100 ppm of wax was uniformly distributed over the transparent Opadry protective film.

Many pharmaceutical formulations utilize the drug in salt form, such as the hydrochloride salt of methylphenidate as used herein. However, salt forms of such drugs prepared in aqueous solutions are susceptible to degradation and often have stability and shelf life issues. It has been found that the addition of a suitable pH-adjusting agent to the aqueous solution reduces unwanted degradation and improves the stability of the product. In particular, in a preferred embodiment of the triple layer osmotic dosage form comprising methylphenidate hydrochloride, the degradation of the drug component can be minimized by the addition of suitable antidegradants, succinic acid to the first and second component layers, and phosphoric acid to the drug protective film. It was found that it can. Other suitable antidegradants, which are eluted in an aqueous medium, are pharmaceutically acceptable, i.e. non-toxic, suitable for oral administration to humans, exhibit sufficient pH-adjusting ability, i.e. up to 4, preferably up to 3 compound having a pH. Additional examples include potassium phosphate, sodium phosphate, fumaric acid, citric acid, tartaric acid, malic acid, hydrochloric acid, aspartic acid, glutamic acid, oxalic acid, lactic acid, malonic acid, glyceric acid and ascorbic acid.

The periodic release rates for the 24 sample formulations prepared as described were measured every hour for 12 hours and are shown in graphical form in FIG. 3. The average amount released at each time is shown in Table 5 with an indication of the occurrence of the rising release rate. The total 4 mg immediate release dose was released substantially in the first hour, which amounts to an ascending release rate occurring at t = 2 hours, ie the mean amount at t = 2 hours represents the immediate dose compared to the average amount at t = 1 hour. Note that it is ignored for measurements that are less than 4 mg.

Time (hours) Amount of drug released (mg) Rising release rate One 4.098 YES 2 1.138 YES 3 1.650 YES 4 1.193 YES 5 2.043 YES 6 2.099 YES 7 1.966 NO 8 1.763 NO 9 0.428 NO 10 0.174 NO 11 0.084 NO 12 0.061 NO

As shown in Table 5, with the exception of the immediate drug barrier, more than 90% of the drug was released until t = 8 hours, with an elevated release rate up to t = 6 hours, long time past the midpoint of T ₉₀ . It was.

Example 7

15 mg 으로 표준화시켰다.The therapeutic effect of a single dose of a triple layer osmotic formulation containing 14 mg of methylphenidate and further comprising an immediate release drug protective film containing 4 mg of methylphenidate was studied and compared with multiple doses of immediate methylphenidate. Safety and therapeutic efficacy parameters were assessed for 12 hours in the same subjects treated with the following modalities on different days: Trial osmotic dosage form once at t = 0 hours, and immediate methylphenidate (Ritalin (trade name) )) A standard form of three doses at t = 0 hours, t = 4 hours and t = 8 hours. Since the subject is a conventional methylphenidate user, the dose of methylphenidate administered during each modality was slightly modified to bring as close as possible to the “daily dose” that each subject normally administered. For comparison, the actual dose is Ritalin administered in a triple layer osmotic 18 mg single dose and three 5 mg doses.

Normalized to 15 mg.

Plasma drug concentrations were measured in all subjects simultaneously during the study period for each modality. The time selected is immediately before, and after 1.5 and 2.5 hours of administration of the first two doses of immediate methylphenidate (ie, t = 0 hours, t = 1.5 hours, t = 2.5 hours, t = 4 hours, t = 5.5 Time, t = 6.5 hours), and the time before, immediately before, and after 1.5 hours and 3.5 hours (ie, t = 8 hours, t = 9.5 hours and t = 11.5 hours) at the third dose.

In FIG. 4, plasma drug concentrations obtained from a group of study participants (n = 16) treated in experimental form (indicated by open diamond) and in standard form (indicated by closed ring) are shown in graphical form. The comparison of FIGS. 3 and 4 shows the correlation between in vitro release rate up to t = 8 hours and plasma drug concentration in vivo up to approximately t = 9.5 hours.

As shown in FIG. 4, after administration of each immediate dose, the plasma drug concentration rises relatively rapidly and then generally drops to a characteristic rate until the next dose is administered. In addition, the plasma drug concentration after administration of the triple layer osmotic dosage form is initially due to the release of the drug from the immediate release protective film, indicating an initial relatively rapid rise. Subsequently, however, the plasma drug concentration does not drop and continues to rise substantially up to 9.5 hours (except for a slight "fall" between t = 5.5 hours and t = 6.5 hours). In particular, note the differences between the time period between about 1 hour before and about 1.5 hours after administration of the second and third immediate doses. In the standard mode, during this period, the plasma drug concentration drops to a trough concentration and then rises back to the peak concentration. In the experimental mode, during this same time, the plasma drug concentration rises substantially smoothly and shows no peaks and troughs.

Therapeutic parameters, including safety, and behavior, attention and cognitive function, were assessed every hour during the first 3 hours and the last 3 hours of the study period, with 2 hour intervals between. The clinical effects of the experimental modalities were nearly comparable with the clinical effects of the standard modalities throughout the 24-hour study period. An effective once daily regimen for ADHD offers significant benefits and many benefits in drug therapy by eliminating the need for multiple doses of methylphenidate while providing sustained therapeutic efficacy throughout the day.

Example 8

Triple according to the preparation method of Example 6, except that a total of 28 mg of methylphenidate, ie, 28 mg of methylphenidate contained in the first and second component layers and 8 mg of methylphenidate in the drug protection film Layered oral osmotic formulations were prepared. All remaining components were also doubled, so that the weight percentage was the same as in Example 6. The third push layer was also doubled. The semipermeable membrane had the same composition as in Example 6 except that it was applied at a weight of about 34 mg.

This formulation shows the release of 36 mg of methylphenidate with about 8 mg of immediate release over a long period of time and the remaining 28 mg released at an elevated release rate.

Example 9

A triple layer oral osmotic formulation was prepared according to the preparation method of Example 6, except that a total of 42 mg of methylphenidate contained in the first and second component layers and 12 mg of methylphenidate in the drug protection film were prepared. . The first component layer included (wt%): methylphenidate hydrochloride 11.5%, polyethylene oxide 81.6% (Union Carbide, Danbury, Connecticut trade name Polyox N-80), polyvinylpyrrolidone 5% (BAS Corp., Mt. Olive, Kolidon 29-32, New Jersey); Succinic acid 1.3%; Stearic acid 0.5%; 0.05% butylated hydroxy toluene; And 0.05% yellow iron oxide as colorant. The second component layer comprised (weight%): methylphenidate hydrochloride 19.8%, polyethylene oxide 72.7% (Union Carbide, Danbury, Connecticut trade name Polyox N-80), polyvinylpyrrolidone 5% (BAS Corp., Mt. Olive, Kolidon 29-32, New Jersey); Succinic acid 1.95%; Stearic acid 0.5%; Butylated hydroxy toluene 0.05%. The semi-permeable membrane had the same composition as in Example 6 except that the third push layer was doubled from Example 6 and applied at a weight of about 34 mg.

This formulation shows the release of 54 mg of methylphenidate with about 12 mg of immediate release over a long period of time and the remaining 42 mg released at an elevated release rate.

As applied to this embodiment, the features and advantages of the invention have been described and indicated, but those skilled in the art can make various modifications, changes, additions, and deletions without departing from the spirit of the invention in the description herein.

The present invention relates to methods and apparatus for maintaining the desired therapeutic drug effect over an extended treatment period. In particular, the present invention relates to methods and apparatus for providing drug release in the gastrointestinal tract at an elevated release rate over an extended time period. In this manner, the drug is released at increasing rates during some drug administration periods sufficient to maintain the desired therapeutic drug effect over an extended period of treatment.

Claims (37)

CNS-acting drugs selected from the group consisting of amphetamines and metamphetamines, and pharmaceutically acceptable carriers, the rate of periodic release immediately prior to the time period that lasts above the midpoint of the time at which 90% of the drugs in the formulation are released A formulation which releases a CNS-acting drug at an increased periodic release rate compared to the formulation, wherein the drug is continuously released from the first layer and then released from the second layer, the formulation comprising the following (a) to (c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. Pharmaceutically acceptable polymers comprising a dose of a drug selected from the group consisting of amphetamine and metamphetamine at low to high dose concentrations in the polymer, when the formulation is operated, sustained-release of the drug at low to high dose concentrations. A longitudinally compressed capsule osmotic tablet formulation is provided, comprising (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. A plurality of compositions comprising a pharmaceutically acceptable carrier, a dose of a drug selected from the group consisting of amphetamine and metamphetamine in increasing doses in the composition, and when the dosage form is activated, the dosage form contains 90 Vertically compressed capsule-type osmotic tablets that provide sustained-release of the drug in increasing dose over a period of time that continues above the midpoint of the time at which% is released, comprising (a) to (c) Formulation: (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. delete The formulation of claim 3, wherein the pharmaceutically acceptable carrier is a polymer. A composition comprising different pharmaceutically acceptable polymers, a plurality of layers comprising a dose increasing the dose of a drug selected from the group consisting of amphetamine, methamphetamine and pharmaceutically acceptable salts thereof in the composition, When operated, longitudinally compressed capsule-type osmotic tablet formulations that provide sustained-release of the drug in increasing doses, comprising the following (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. A pharmaceutically acceptable carrier composition, and a dose of 1 mg to 500 mg of a drug selected from the group consisting of amphetamine, metamphetamine and pharmaceutically acceptable salts thereof in the formulation, When operated, provides sustained-release of a drug selected from the group consisting of increasing doses of amphetamine and metamphetamine, A longitudinally compressed capsule osmotic tablet formulation for delivery of the drug, comprising the following (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. A pharmaceutically acceptable carrier and a plurality of layers comprising a rising dose of 1 mg to 500 mg of a drug selected from the group consisting of amphetamine and metamphetamine in the layer, and sustained-release and elevation when the formulation is operated A vertically compressed capsule tablet formulation for providing oral delivery of the drug in a sustained-release and synergistic dose, comprising the following (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. A dosage of 1 mg to 500 mg of a drug selected from the group consisting of a plurality of layers comprising a pharmaceutically acceptable carrier, amphetamine, metamphetamine and pharmaceutically acceptable salts thereof, wherein the formulation is operated If provided, a sustained-release and escalating dose of the drug, the vertically compressed capsule osmotic for oral delivery of the drug in a sustained-release and synergistic dose, comprising (a) to (c) Sex Tablet Formulations: (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. delete Between 100 ng and 500 mg of a drug selected from the group consisting of amphetamine, metamphetamine and pharmaceutically acceptable salts thereof, mixed with a pharmaceutically acceptable carrier, to achieve an elevated plasma concentration profile after administration to the patient A longitudinally compressed capsule osmotic tablet formulation comprising (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. CNS-acting, including dextroseamphetamine as a drug and a pharmaceutically acceptable carrier, and at an increased periodic release rate compared to the immediately preceding periodic release rate for a time that persists above the midpoint of the time at which 90% of the drug in the formulation is released. A vertically compressed capsule osmotic tablet formulation comprising (a) to (c) which releases a drug and is subsequently released from the first layer and then released from the second layer: (a) A capsule, longitudinally compressed, comprising three layers, wherein a portion of the drug is contained within the first layer, the remaining portion of the drug is contained within the second layer, and the third layer comprises an osmotic polymer. Tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the external fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. 100 ng to 500 mg of methylphenidate in admixture with a pharmaceutically acceptable carrier and containing methyl in a sustained and increasing dose over time that lasts above the midpoint of the time at which 90% of the drug in the formulation is released. A vertically compressed capsule osmotic tablet formulation that releases phendate and comprises the following (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. Methylphenidate and pharmaceutically acceptable salts thereof, mixed with a pharmaceutically acceptable carrier, delivered at a controlled and increasing dose over a period of time that extends beyond the midpoint of the time at which 90% of the drug in the formulation is released. A vertically compressed capsule osmotic tablet formulation comprising 100 ng to 500 mg of a drug selected from the group consisting of: (a) to (c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. A pharmaceutically acceptable polymer, comprising a methylphenidate dose at a low to high dose concentration in the polymer, and when the formulation is operated, provides sustained-release of low to high dose concentrations of methylphenidate, comprising (a) Longitudinally compressed capsule osmotic tablet formulations comprising: (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. 16. The formulation of claim 15 wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextromeamphetamine, phenylisopropylamine and femoline. A plurality of compositions comprising a pharmaceutically acceptable carrier, a dose of methylphenidate in increasing doses in said composition, wherein when the formulation is operated, at least the midpoint of the time at which 90% of the drug in the formulation is released. Vertically compressed capsule osmotic tablet formulations that provide sustained release of methylphenidate at increasing dose over a duration of time, comprising the following (a) to (c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. delete 18. The formulation of claim 17, wherein the pharmaceutically acceptable carrier is a polymer. 18. The formulation of claim 17 wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextromeamphetamine, phenylisopropylamine and femoline. A composition comprising different pharmaceutically acceptable polymers, a plurality of layers comprising a dose increasing the dose of a drug selected from the group consisting of methylphenidate and pharmaceutically acceptable salts thereof in the composition, wherein the formulation operates Wherein the vertically compressed capsular osmotic tablet formulations provide sustained-release of increasing doses of methylphenidate, comprising the following (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. 22. The formulation of claim 21 wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextroseamphetamine, phenylisopropylamine and femoline. A pharmaceutically acceptable carrier composition, and a dose of 1 mg to 500 mg of a drug selected from the group consisting of methylphenidate and pharmaceutically acceptable salts thereof in the formulation, wherein the dosage form, when A vertically compressed capsule osmotic tablet formulation comprising (a) to (c) for delivery of methylphenidate, providing sustained release of methylphenidate: (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. 24. The formulation of claim 23 wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextroseamphetamine, phenylisopropylamine and femoline. A plurality of layers comprising a pharmaceutically acceptable carrier, comprising a rising dose of 1 mg to 500 mg of methylphenidate in said layer, for oral delivery of methylphenidate at sustained-release and elevated doses, A longitudinally compressed capsule tablet formulation comprising (a)-(c), wherein the formulation provides sustained-release and rising doses of methylphenidate when the formulation is operated: (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. 26. The formulation of claim 25 wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextroseamphetamine, phenylisopropylamine and femoline. A sustained-release and elevation comprising a plurality of layers comprising a pharmaceutically acceptable carrier, a dose of 1 mg to 500 mg of a drug selected from the group consisting of methylphenidate and pharmaceutically acceptable salts thereof A longitudinally compressed capsule osmotic tablet formulation comprising (a) to (c) for oral delivery of methylphenidate at a dose, wherein the sustained-release and rising dose of methylpheny when the formulation is operated Formulations that provide dates: (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. The formulation of claim 27, wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextroseamphetamine, phenylisopropylamine and femoline. delete delete Between 100 ng and 500 mg of a drug selected from the group consisting of methylphenidate and pharmaceutically acceptable salts thereof, mixed with a pharmaceutically acceptable carrier, to achieve an elevated plasma concentration profile after administration to a patient, A longitudinally compressed capsule osmotic tablet formulation comprising (a)-(c): (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer to allow drug to be released from within the compartment into the external fluid environment. 32. The formulation of claim 31 wherein the methylphenidate in the formulation is replaced with a drug selected from the group consisting of dextroseamphetamine, phenylisopropylamine and femoline. Pharmaceutical in a vertically compressed tablet containing 100 ng to 500 mg of methylphenidate and a pharmaceutically acceptable carrier for treating attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) in a patient As a composition, The composition is (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer, the drug being released from within the compartment into the external fluid environment, A pharmaceutical composition, wherein administering the composition to said patient achieves a substantially elevated methylphenidate plasma drug concentration over a period of 5.5 hours after said administration. The pharmaceutical composition of claim 33, wherein the substantially elevated methylphenidate plasma drug concentration is achieved over a period of 5.5 to 8 hours after said administration. The pharmaceutical composition of claim 33, wherein the substantially elevated methylphenidate plasma drug concentration is achieved over a period of 5.5 to 9.5 hours after said administration. A pharmaceutical composition in a vertically compressed tablet containing 100 ng to 500 mg of methylphenidate and a pharmaceutically acceptable carrier for treating attention deficit disorder or attention deficit hyperactivity disorder in a patient, The composition is (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer, the drug being released from within the compartment into the external fluid environment, A pharmaceutical composition wherein administering the composition to said patient achieves a substantially elevated methylphenidate plasma drug concentration over a period of 8 hours after said administration. A pharmaceutical composition in a vertically compressed tablet containing 100 ng to 500 mg of methylphenidate and a pharmaceutically acceptable carrier for treating attention deficit disorder or attention deficit hyperactivity disorder in a patient, The composition is (a) part of the drug is contained within the first layer, the remainder of the drug is contained within the second layer, and the third layer comprises three layers, comprising a suitable osmotic polymer. Compressed tablet cores; (b) a semipermeable membrane surrounding the encapsulated tablet core to form a compartment having an osmotic gradient to move the fluid from the external fluid environment in contact with the semipermeable membrane; And (c) a hole formed through the semipermeable membrane into a capsule tablet core in a position proximate to the first layer, the drug being released from within the compartment into the external fluid environment, A pharmaceutical composition, wherein administering the composition to the patient achieves a substantially elevated methylphenidate plasma drug concentration over a period of 9.5 hours after said administration.

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