MX2008016115A - Compositions comprising nanoparticulate meloxicam and controlled release hydrocodone. - Google Patents

Compositions comprising nanoparticulate meloxicam and controlled release hydrocodone.

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Publication number
MX2008016115A
MX2008016115A MX2008016115A MX2008016115A MX2008016115A MX 2008016115 A MX2008016115 A MX 2008016115A MX 2008016115 A MX2008016115 A MX 2008016115A MX 2008016115 A MX2008016115 A MX 2008016115A MX 2008016115 A MX2008016115 A MX 2008016115A
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Mexico
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hydrocodone
composition
release
meloxicam
chloride
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MX2008016115A
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Spanish (es)
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John Devane
Paul Stark
Scott Jenkins
Gary Liversidge
Niall Fanning
Gurvinder Singh-Rekhi
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Elan Pharma Int Ltd
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Publication of MX2008016115A publication Critical patent/MX2008016115A/en

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    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/485Morphinan derivatives, e.g. morphine, codeine
    • AHUMAN NECESSITIES
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    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/14Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/141Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers
    • A61K9/145Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers with organic compounds
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    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/50Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/5073Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals having two or more different coatings optionally including drug-containing subcoatings
    • A61K9/5078Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals having two or more different coatings optionally including drug-containing subcoatings with drug-free core
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/50Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/5084Mixtures of one or more drugs in different galenical forms, at least one of which being granules, microcapsules or (coated) microparticles according to A61K9/16 or A61K9/50, e.g. for obtaining a specific release pattern or for combining different drugs
    • AHUMAN NECESSITIES
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    • A61K9/00Medicinal preparations characterised by special physical form
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    • A61K9/50Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/51Nanocapsules; Nanoparticles
    • A61K9/5107Excipients; Inactive ingredients
    • A61K9/513Organic macromolecular compounds; Dendrimers
    • A61K9/5138Organic macromolecular compounds; Dendrimers obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone, poly(meth)acrylates
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    • A61K9/50Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
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    • A61K9/5107Excipients; Inactive ingredients
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    • A61K9/5161Polysaccharides, e.g. alginate, chitosan, cellulose derivatives; Cyclodextrin
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    • A61P25/04Centrally acting analgesics, e.g. opioids
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    • A61P29/02Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID] without antiinflammatory effect
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    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/50Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/5005Wall or coating material
    • A61K9/5021Organic macromolecular compounds
    • A61K9/5026Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone, poly(meth)acrylates
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B82NANOTECHNOLOGY
    • B82YSPECIFIC USES OR APPLICATIONS OF NANOSTRUCTURES; MEASUREMENT OR ANALYSIS OF NANOSTRUCTURES; MANUFACTURE OR TREATMENT OF NANOSTRUCTURES
    • B82Y5/00Nanobiotechnology or nanomedicine, e.g. protein engineering or drug delivery

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Abstract

The invention relates to a compositions comprising a nanoparticulate meloxicam composition in combination with a multiparticulate modified release hydrocodone composition that, upon administration to a patient, delivers a hydrocodone in a bimodal or multimodal manner. The multiparticulate modified release composition comprises a first component and at least one subsequent component; the first component comprising a first population of hydrocodone - comprising particles and the at least one subsequent component comprising a second population of hydrocodone-comprising particles, wherein the combination of the components exhibit a bimodal or multimodal release profile. The invention also relates to a solid oral dosage form comprising such a combination composition.

Description

COMPOSITIONS COMPRISING MELOXICAM NANOPARTICULATE AND HYDROCODONE CONTROLLED RELEASE FIELD OF THE INVENTION The present invention relates to compositions comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising hydrocodone or a salt or derivative thereof. In particular, the present invention relates to compositions comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition which in operation supplies hydrocodone or a salt or derivative thereof, in a bimodal fashion or multimodal. The present invention further relates to solid oral dosage forms comprising these multiparticulate controlled release compositions as well as methods for delivering these compositions to a patient in need thereof.
BACKGROUND OF THE INVENTION Background that relates to controlled release oral compositions The effectiveness of pharmaceutical compounds for the prevention and treatment of disease states depends on a variety of factors including the speed and duration of the delivery of compound from the dosage form to the patient. The combination of the rate and duration of delivery exhibited by a dosage form administered in a patient can be described as its release profile in vivo and, depending on the pharmaceutical composition administered, will be associated with a concentration and duration of the pharmaceutical compound in the plasma blood, called plasma profile. Since pharmaceutical compounds vary in their pharmacokinetic properties such as bioavailability, and absorption and elimination rates, the release profile and the resulting plasma profile become important elements to consider in the design of effective drug therapies. The release profiles of the dosage forms can exhibit different release rates and durations and can be continuous or pulsatile. Continuous release profiles include release profiles in which one or more pharmaceutical compounds are continuously released, at a constant or variable rate, and the pulsatile release profiles include release profiles in which at least two discrete amounts are released from one or more pharmaceutical compounds at different speeds and / or through different time frames. For any particular pharmaceutical compound or combination of these compounds, the release profile for a given dosage form results in an associated plasma profile in a patient. Similar to the variables applicable to the release profile, the associated plasma profile in a patient can exhibit constant or variable concentration levels in blood plasma of the pharmaceutical compounds in the dosage form through the duration of action and can be continuous or pulsatile . Continuous plasma profiles include plasma profiles of all speeds and duration that exhibit a single maximum plasma concentration. Pulsatile plasma profiles include plasma profiles in which at least two higher levels of blood plasma concentration of the pharmaceutical compound are separated by a lower concentration level in blood plasma. The pulsatile plasmatic profiles that exhibit two peaks can be described as "bimodal". When two or more components of a dosage form have different release profiles, the release profile of the dosage form as a whole is a combination of the release profiles individual The release profile of a two-component dosage form in which each component has a different release profile can be described as "bimodal". For dosage forms of more than two components, in which each component has a different release profile, the release profile resulting from the dosage form can be described as "multimodal". Depending, at least in part, on the pharmacokinetics of the pharmaceutical compounds that are used, as well as the specific release profiles of the components of the dosage form, a bimodal or multimodal release profile may result in a plasma profile either continuous or pulsatile in a patient. Conventional frequent dosing regimens in which an immediate release dosage form (IR) is administered at periodic intervals typically results in a pulsatile plasma profile. In these cases, a peak in the concentration of the drug in plasma is observed after each dose of JR with channels (regions of low concentration of drugs) that develop between points of time of consecutive administration. These dosing regimens (and their resulting pulsatile plasma profiles) can have particular pharmacological and therapeutic effects associated with them. they are beneficial for certain drug therapies. For example, it has been thought that the washout period provided by the decrease in the plasma concentration of the active ingredient between the peaks will be a factor that contributes to the reduction or prevention of patient tolerance to various types of drugs. Many controlled release drug formulations are directed to the production of a zero order release of the drug compound. Indeed, often a specific goal of these formulations is to minimize peak-to-channel variation in the plasma concentration levels associated with conventional frequent dosing regimens. However, for certain drugs, some of the intrinsic therapeutic and pharmacological effects in a pulsatile system may be lost or decreased as a result of constant or near-constant plasma concentration levels attained by the zero-order delivery drug delivery systems. In this way, modified release compositions or formulations that substantially mimic the release of frequent JR dosage regimens, while reducing the need for frequent dosing, if appropriate. Similarly, compositions or formulations of modified libration that are combine the benefits of at least two different release profiles to achieve a resulting plasma profile that exhibits pharmacokinetic values within therapeutically effective parameters. Shah et al., J Cont. I laughed (1989) 9: 169-175 are intended to disclose that certain types of hydroxypropylmethylcellulose ethers compressed into a solid dosage form with a therapeutic agent can produce a bimodal release profile. However, it is noted that while polymers from one supplier provided a bimodal profile, the same polymers with almost identical product specifications obtained from a different source provided non-bimodal release profiles. Giunchedi et al., Int. J. Pharm (1991) 77: 177-181 disclose the use of a multiple-unit formulation of hydrophilic matrix for the pulsed release of ketoprofen. Giunchedi et al., Show that ketoprofen is rapidly eliminated from the blood after dosing (half-life in plasma 1-3 hours) and consecutive pulses of the drug may be more beneficial than constant release for some treatments. The exposed multiple-unit formulation comprises four identical hydrophilic matrix tablets placed in a gelatin capsule. Although in vivo studies show two peaks in the plasma profile, the washout period is not well defined and the variation between peak and channel plasma levels is small. Conté et al., Drug Dev. Md. Pharm, (1989) 15: 2583-2596 and EP 0 274 734 (Pharmidea Srl) show the use of a three-layer tablet for the delivery of ibuprofen in consecutive pulses. The three-layer tablet is made from a first layer containing the active ingredient, a barrier layer (the second layer) of semi-permeable material that is interposed between the first layer and a third layer containing a further amount of the active ingredient. The barrier layer and the third layer are housed in a waterproof envelope. The first layer dissolves in contact with a solvent fluid while the third layer is only available after dissolution or rupture of the barrier layer. In this tablet, the first portion of the active ingredient must be released instantaneously. This process also requires the production of a semipermeable layer between the first and third layers in order to control the relative rates of delivery of the two portions of the active ingredient. Additionally, rupture of the semipermeable layer leads to uncontrolled discharge of the second portion of the active ingredient which may not be convenient.
U.S. Patent No. 5,158,777 (ER Squibb &Sons Inc.) discloses a formulation comprising captopril within a center with stable pH enteric coated or combined delayed release or with additional captopril which is available for immediate release after the administration. To form the center with stable pH, chelating agents such as disodium edetate or surfactants such as polysorbate 80 alone or in combination with a buffering agent are used. The composition has an amount of captopril available for immediate libration after oral administration and an additional amount of captopril with stabilized pH available for release into the colon. U.S. Patent Nos. 4,728,512, 4,794,001 and 4,904,476 (American Home Products Corp.) relate to preparations that provide three different releases. The preparation contains three groups of spheroids containing an active medicinal substance: the first group of spheroids is uncoated and disintegrates rapidly upon ingestion to release an initial dose of medicinal substance; the second group of spheroids is coated with a pH sensitive coating to provide a second dose; and the third group of spheroids is coated with an independent coating of pH to provide the third dose. The preparation is designed to provide a repeated release of medicinal substances that are metabolized extensively pre-systemically or have relatively short elimination half-lives. U.S. Patent No. 5,837,284 (Menta et al.) Discloses a dosage form of methylphenidate having immediate release and delayed release particles. The delayed release is provided by the use of pH-independent polymers of ammonium methacrylate combined with certain fillers.
B. Background that is related to hydrocodone A typical example of a drug that can produce tolerance in patients is hydrocodone. Hydrocodone or dihydrocodeinone (marketed as Vicodin®, Anexsia®, Dicodid®, Hycodan®, Hycomine®, Lorcet®, Lortab®, Norco®, Hydroco®, Tussionex®, and Vicoprofen®), also known as 4, 5a tartrate -epoxy-3-methoxy-17-methylmorphinan-6-one (1: 1) hydrated (2: 5), is an opioid derived from opiates codeine or thebaine that occur in nature. The compound has the following structure: Hydrocodone has the chemical formula Ci8H2iN03, a molecular weight of 299.368, and a half-life of 4-8 hours. Hydrocodone is an orally active and antitussive narcotic analgesic. In recent years, the salts and production of this drug have increased significantly, since they are used for libration and illicit use. Hydrocodone is commonly available in the form of a tablet, capsule and syrup. Like a narcotic, hydrocodone relieves pain by binding with opioid receptors in the brain and spinal cord, it can be ingested with or without food. When ingested with alcohol, it can intensify drowsiness. It can interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. Common side effects include fading, dizziness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, mood swings, mental confusion, anxiety, lethargy, difficulty urinary, spasm of the ureter, irregular or depressed breathing and rash. Hydrocodone can be habit forming, and can lead to physical and psychological addiction. In the United States, pure hydrocodone and forms containing more than 15 mg per dosage unit are considered Catalog II drugs. Those that contain less than or equal to 15 mg per dosage unit in combination with acetaminophen or another uncontrolled drug are called hydrocodone compounds and are considered drugs from Catalog III. Hydrocodone can be found in combination with other drugs such as acetaminophen (acetaminophen), aspirin, ibuprofen and homatropine methyl bromide. The presence of acetaminophen in products containing hydrocodone discourages many users of drugs from ingesting excessive amounts. However, some users will have the opportunity to extract a portion of the acetaminophen using hot / cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from consuming excessive amounts of acetaminophen for a long period of time, ingesting 10,000 to 15,000 milligrams of acetaminophen in a 24-hour period typically resulting in severe hepatoxicity, and doses in the variation of 15,000-20,000 milligrams at day have been reported as fatal. This is a factor that leads many addicts to use only single entity opioids such as Oxicontin. The daily intake of hydrocodone should not exceed 40 milligrams in patients who can not tolerate opiates. However, it is clearly stated in the 2006 PDR (Physicians Desk Reference) that Norco 10, which contains 10 milligrams of hydrocodone and 325 milligrams of Apap, can be ingested at a dosage of up to twelve tablets per day (120 milligrams of hydrocodone). High amounts of hydrocodone are only intended for opioid-tolerant patients, and the assessment of these levels should be monitored very carefully. This restriction is limited only by the fact that twelve tablets, each containing 325 milligrams of Apap, places the patient just below the FDA maximum in 24 hours of 4,000 mg of Apap. Some specially prepared products are routinely administered for chronic pain patients at dosages of up to 180 mg hydrocodone per day. Tolerance to this drug can increase very quickly if it is abused. Because of this, addicts often over-dosed from ingesting handfuls of pills, in pursuit of the elevation they experience very early in their use of hydrocodone. Symptoms of an overdose with hydrocodone include respiratory depression, extreme drowsiness, coma, stupor, cold and / or sticky skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and / or death.
C. Background that are related to Meloxicam Meloxicam, also known as 4-hydroxy-2-methyl-N- (5-methyl-2-thiazolyl) -2-Hl, 2-benzothiazine-3-carboxamide 1,1-dioxide , is a member of the enolic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). Meloxicam is derived from oxicam with the following chemical structure: Meloxicam has an empirical formula of Ci4H13N304S2 and a molecular weight of 351.41. See, The Physicians' Desk Reference, 56th Ed., Pp. 1054 (2002); and The Merck Index, Ed., pp. 1040-1041 (Merck &Co. 2001). Meloxicam is practically insoluble in water with a higher solubility observed in sg acids and bases. It is very lightly soluble in methanol. The Physicians' Desk Reference, 56th Ed., Pp. 1054. The 1,1-dioxides of 4-hydroxy-2H-1, 2-benzothiazine-3-carboxamide and salts thereof, as well as the methods for preparing these compounds, the pharmaceutical compositions containing them as active ingredients, and methods for using them as antiphlogistics are set forth in U.S. Patent No. 4,233,299. See also German Patent No. 2,756,113. The pharmacology of meloxicam in horses is set forth in Lees et al., Brit. Vet. J., 147: 97 (1991); Veterinary tests in dogs are analyzed in Henderson et al., Prakt. Tierarzt., 75: 179 (1994); the physiochemical properties of meloxicam are discussed in Tsai et al., Helv. Chim. Acta, 76: 842 (1993); the pharmacology, mechanism of action, and clinical efficacy are discussed in Brit. J. Rheumatol., 35 (Suppl 1): 1-77 (1996); and clinical tests of gasntestinal tolerability in arthritis are discussed in Hawkey et al., Brit. I Rheumatol. , 37: 937 (1998), and Dequeker et al., Brit. J. Rheumatol., 37: 946 (1998). Meloxicam exhibits anti-inflammatory, analgesic, and antifebrile activities. Like other NSAIDs, the primary mechanism of action of meloxicam is via the inhibition of the enzyme cyclo-oxygenase (COX) system, which results in a decreased synthesis of prostaglandin. See, The Physicians' Desk Reference, 56th Ed., Pp. 1054 (2002). The COX enzyme system consists of at least two COX isoforms. COX-1 is constitutively expressed in the gasntestinal tract and kidneys and is involved in the production of prostaglandins required for production of gastric mucosa and adequate renal blood flow. See, Vane et al., Proc. Nati Acad. Sci. USA, 91: 2046-2050 (1994); Oulette et al., Proc. Nati Acad. Sci. 98: 14583-14588 (2001); and Seibert et al., Proc. Nati Acad. Sci. 91: 12013-12017 (1994). On the other hand, COX-2 is not present in healthy tissue and its expression is induced in certain inflammatory states. Id. The pathological production of prostaglandins by COX-2 is implicated in several human disease states, including rheumatoid arthritis, osteoarthritis, pyrexia, asthma, bone resorption, cardiovascular diseases, nephrotoxicity, atherosclerosis, and hypotension. Id. High levels of prostaglandins intensify or prolong pro-inflammatory signals that cause pain, stiffness, and inflammation associated with these conditions. See, Smith et al., Proc. Nati Acad. Sci.r 95: 13313-13318 (1998). Meloxicam is superior to traditional non-selective NSAIDs because its selectivity inhibits COX-2, causing minor gastrointestinal problems such as hemorrhage, heartburn, reflux, diarrhea, nausea, and abdominal pain. eloxicam preferably inhibits COX-2 with a COX-2 / COX-1 inhibition ratio of 0.09. It is convenient to selectively inhibit COX-2 and the pathological production of prostaglandins for which this enzyme is responsible due to the therapeutic analgesic / anti-inflammatory properties of the NSAIDs that occur due to the inhibition of COX-2 inducible at the site of inflammation. In contrast, the majority of adverse drug reactions to NSAIDs, including gastrointestinal ulcers and renal impairment, result from the inhibition of the constitutive COX-1 enzymes. This is due as a result of this inhibition of COX-1, the prostaglandins necessary for the production of gastric mucosa and renal blood circulation are not produced. See, Vane et al., Proc. Nati Acad. Sci. USA, 91: 2046 (1994); Oulette et al., Proc. Nati Acad. Sci. 98: 14583 (2001); and Seibert et al., Proc. Nati Acad. Sci., 91: 12013 (1994). Compounds that selectively inhibit prostaglandin biosynthesis by inhibiting the activity of the inducible enzyme, COX-2, exert anti-inflammatory effects without the adverse side effects associated with the inhibition of COX-1. Some of the commercial names under which meloxicam is marketed include MOBIC®, MOBEC®, MOBICOX®, MOVALIS®, and OVATEC®. eloxicam has been shown to be useful in the symptomatic treatment of osteoarthritis with pain (osteoarthritis, degenerative joint disease), symptomatic treatment of rheumatoid arthritis, symptomatic treatment of ankylosing spondylitis, and symptomatic treatment of signs and symptoms of osteoarthritis, including pain, stiffness, and inflammation. The form of meloxicam currently marketed in the United States is MOBIC® (Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT), provided in 7.5 and 15 mg tablets. The bioavailability of a single 30 mg oral dose is 89% compared to an intravenous bolus injection of 30 mg. The pharmacokinetics of a single intravenous dosage of meloxicam is proportional to the dose in the variation of 5 to 60 mg. See, The Physicians' Desk Reference, 56th Ed., Pp. 1054 (2002). After administration of multiple oral doses of meloxicam, the pharmacokinetics is proportional to the dose in the variation of 7.5 to 15 mg. The speed or degree of absorption is not affected by the administration of multiple doses. Under steady state conditions of fasting, the average Cmax is reached from four to five hours, with a second meloxicam concentration peak occurring at approximately twelve to fourteen hours after the dosage, suggesting a gastrointestinal recirculation. Under steady state feeding conditions in healthy male adults, the 7.5 mg tablets have an average Cmax of 1.05 μq / ton, a Tmax of 4.9 hours, and a Ti 2 of 20.1 hours. Under steady state feeding conditions in elderly men and women, the 15 mg tablets have a Cmax of 2.3 and 3.2 g / ml respectively, a Tmax of 5 and 6 hours, respectively, and a ti / 2 of 21 and 24 hours, respectively. See, The Physicians' Desk Reference, 56th Ed., Pp. 1054 (2002). Although meloxicam has been tested and approved by the FDA only to relieve the signs and symptoms of osteoarthritis, it may be useful to relieve the signs and symptoms of rheumatoid arthritis, decrease back pain, and acute pain, for example, the treatment of post-surgical pain, the treatment of pain resulting from injuries on the battlefield, and migraine pain. Meloxicam can be especially effective for the treatment of all types of pain associated with inflammation. NSAIDs, similar to meloxicam, are useful in pain management because NSAIDs provide an analgesic effect without the sedation and addictive properties of narcotic analgesics. In addition, the prolonged ti / 2 of meloxicam makes it useful for lasting relief that does not is provided by narcotic analgesics. However, due to their typically long onset of action, conventional NSAIDs, which include conventional meloxicam, are often unsuitable for acute pain management. Because meloxicam is practically insoluble in water, obtaining sufficient bioavailability of this drug is problematic. The prior art methods for increasing the bioavailability of meloxicam include increasing its solubility by forming a cyclodextrin complex of the drug (see U.S. Patent No. 6,284,269) or by forming a meloxicam salt with an inorganic or organic base ( publication of United States patent application No. 2002/0035107 Al). U.S. Patent Application Publication No. 20020035264, for "Ophthalmic Formulation of a Selective Cyclooxygenase-2 Inhibitory Drug," discloses pharmaceutical compositions suitable for topical administration to an eye containing a selective COX-2 inhibitory drug, or nanoparticles of a drug of low solubility in water, at an effective concentration for the treatment and / or prophylaxis of an eye disorder, and one or more ophthalmically acceptable excipients that reduce the elimination rate of the eye such that the composition has a effective residence time of approximately 2 to 24 hours. Examples of these ophthalmically acceptable excipients provided in the published application include degraded carboxyl-containing polymers that form an in situ gellable aqueous solution, suspension or solution / suspension. These excipients, which are described in U.S. Patent No. 5,192,535, can be inconvenient. In addition, this disclosure, which is limited to ocular formulations, does not address a need for rapid-onset oral meloxicam formulations for the treatment of migraine. U.S. Patent Application Publication No. 20020077328, for "Selective Cyclooxygenase-2 Inhibitors and Vasomodulator Compounds for Generalized Pain and Headache Pain," refers to a therapeutic combination useful in the treatment, abatement, prevention, or delay of pain comprising a high energy form of a selective cyclooxygenase-2 inhibitor, a vasomodulator, and a pharmaceutically acceptable excipient, carrier, or diluent. The cyclooxygenase-2 inhibitor and the vasomodulator are each present in an effective amount to contribute to the treatment, prevention, reduction or delay of pain. Vasomodulators exposed include vasoconstrictors, vasodilators, bronchodilation agents, and agents for bronchoconstriction, such as, antagonists with renin-angiotensin system, nitrovasodilators, direct vasodilators, calcium channel blocking drugs, phosphodiesterase inhibitors, sympathomimetics, sympatholytics, and inhibitors of synthase and nitric oxide. These additional pharmaceutical agents can be inconvenient, since they can cause unwanted side effects.
D. Background that relates to compositions with a nanoparticulate active agent Nanoparticulate active agent compositions, first described in U.S. Patent No. 5,145,684 ("the patent? 684"), are particles that consist of a therapeutic agent or for poorly soluble diagnostics having a non-crosslinked surface stabilizer absorbed or associated with the surface thereof. Methods for preparing the compositions with a nanoparticulate active agent are described, for example, in U.S. Patent Nos. 5,518,187 and 5,862,999, both for "Method of Grinding Pharmaceutical Substances"; U.S. Patent No. 5,718,388, for "Continuous Method of Grinding Pharmaceutical Substances"; and the patent of the States No. 5,510,118 for "Process of Preparing Therapeutic Compositions Containing Nanoparticles". Compositions with a nanoparticulate active agent are also described, for example, in U.S. Pat. Nos. 5, 298, 262 to "Use of Ionic Cloud Point Modifiers to Prevent Particle Aggregation During Sterilization"; 5,302,401 for "Method to Reduce Particle Size Growth During Lyophilization"; 5,318,767 for "X-Ray Contrast Compositions Useful in Medical Imaging"; 5,326,552 for "Novel Formulation for Nanoparticulate X-Ray Blood Pool Contrast Agents Using High Molecular Weight Non-ionic Surfactants"; 5,328,404 for "Method of X-Ray Imaging Using lodinated Aromatic Propanedioates"; 5,336,507 for "Use of Charged Phospholipids to Reduce Nanoparticle Aggregation"; 5,340,564 for "Formulations Comprising Olin 10-G to Prevent Particle Aggregation and Increase Stability"; 5,346,702 for "Use of Non-Ionic Cloud Point Modifiers to Minimize Nanoparticulate Aggregation During Sterilization"; 5,349,957 for "Preparation and Magnetic Properties of Very Small Magnetic-Dextran Particles"; 5,352,459 for "Use of Purified Surface Modifiers to Prevent Particle Aggregation During Sterilization"; 5,399,363 and 5,494,683, both for "Surface Modified Anticancer Nanoparticles"; 5,401,492 for "Water Insoluble Non-Magnetic Manganese Particles as Magnetic Resonance Enhancement Agents "; 5,429,824 for" Use of Tyloxapol as a Nanoparticulate Stabilizer "; 5,447,710 for" Method for Making Nanoparticulate X-Ray Blood Pool Contrast Agents Using High Molecular Weight Non-ionic Surfactants; "5,451,393 for" X-Ray Contrast Compositions Useful in Medical Imaging; "5,466,440 for" Formulations of Oral Gastrointestinal Diagnostic X-Ray Contrast Agents in Combination With Pharmaceutically Acceptable Clays; "5,470,583 for" Method of Preparing Nanoparticle Compositions Containing Charged Phospholipids to Reduce Aggregation; "5,472,683 for" Nanoparticulate Diagnostic Mixed Carbamic anhydrides as X-Ray Contrast Agents for Blood Pool and Lymphatic System Imaging; "5,500,204 for" Nanoparticulate Diagnostic Dimers as X-Ray Contrast Agents for Blood Pool and Lymphatic System Imaging; "5,518,738 for" Nanoparticulate - NSAID Formulations; "5,521,218 for" Nanoparticulate lododipamide Derivatives for Use as X-Ray Contrast Agents "; 5,525,328 for" Nanoparticulate Di agnostic Diatrizoxy Ester X-Ray Contrast Agents for Blood Pool and Lymphatic System Imaging "; 5,543,133 for "Process of Preparing X-Ray Contrast Compositions Containing Nanoparticles"; 5,552,160 for "Surface Modified NSAID Nanoparticles"; 5,560,931 for "Formulations of Compounds as Nanoparticulate Dispersions in Digestible Oils or Fatty Acids"; 5,565,188 for "Polyalkylene Block Copolymers as Surface Modifiers for Nanoparticles"; 5,569,448 for "Sulfated Non-ionic Block Copolymer Surfactant as Stabilizer Coatings for Nanoparticle Compositions"; 5,571,536 for "Formulations of Compounds as Nanoparticulate Dispersions in Digestible Oils or Fatty Acids"; 5,573,749 for "Nanoparticulate Diagnostic Mixed Carboxylic Anydrides" as X-Ray Contrast Agents for Blood Pool and Lymphatic System Imaging; "5,573,750 for" Diagnostic Imaging X-Ray Contrast Agents; "5,573,783 for" redispersible Nanoparticulate Film Matrices With Protective Overcoats; "5,580,579 for "Site-specific Adhesion Within the GI Tract Using Nanoparticles Stabilized by High Molecular Weight, Linear Poly (Ethylene Oxide) Polymers"; 5,585.108 for "Formulations of Oral Gastrointestinal Therapeutic Agents in Combination with Pharmaceutically Acceptable Clays"; 5,587,143 for "Butylene Oxide-Ethylene oxide Block Copolymers Surfactants as Stabilizer Coatings for Nanoparticulate Compositions; "5,591,456 for" Milled Naproxen With Hydroxypropyl Cellulose as Dispersion Stabilizer; "5,593,657 for" Novel Barium Salt Formulations Stabilized by Non-ionic and Anionic Stabilizers; "5,622,938 for" Sugar Based Surfactant for Nanocrystals "; 5,628,981 for" Improved Formulations of Oral Ga strointestinal Diagnostic X-Ray Contrast Agents and Oral Gastrointestinal Therapeutic Agents "; 5,643,552 for" Nanoparticulate Diagnostic Mixed Carbonic Anhydrides as X-Ray Contrast Agents for Blood Pool and Lymphatic System Imaging "; 5,718,388 for" Continuous Method of Grinding Pharmaceutical Substances; "5,718,919 for" Nanoparticles Containing the R (-) Enantiomer of Ibuprofen "; 5,747.001 for" Aerosols Containing Beclomethasone Nanoparticle Dispersions "; 5,834,025 for" Reduction of Intravenously Administered Nanoparticulate Formulation Induced Adverse Physiological Reactions; "6,045,829" Nanocrystalline Formulations of Human Immunodeficiency Virus (HIV) Protease Inhibitors Using Cellulosic Surface Stabilizers "; 6,068,858 for" Methods of Making Nanocrystalline Formulations of Human Immunodeficiency Virus (HIV) Protease Inhibitors Using Cellulosic Surface Stabilizers; "6,153,225 for" Injectable Formulations of Nanoparticulate Naproxen; "6,165,506 for" New Solid Dose Form of Nanoparticulate Naproxen; "6,221,400 for" Methods of Treating Mammals Using Nanocrystalline Formulations of Human Immunodeficiency Virus ( HIV) Protease Inhibitors; "6,264,922 for" Nebulized Aerosols Containing Nanoparticle Dispersions; "6,267,989 for" Methods for Preventing Crystal Growth and Particle Aggregation in Nanoparticle Compositions; "6,270,806 for" Use of PEG-Derivatized Lipids as Surface Stabilizers for nanop articulate Compositions "; 6,316,029 for "Rapidly Disintegrating Solid Oral Dosage Form, "6,375,986 for" Solid Dose Nanoparticulate Compositions Comprising a Synergistic Combination of a Polymeric Surface Stabilizer and Dioctyl Sodium Sulfosuccinate "; 6,428,814 for" Bioadhesive Nanoparticulate Compositions Having Cationic Surface Stabilizers; "6,431,478 for" Small Scale Mill; "6,432,381 for "Methods for Targeting Drug Delivery to the Upper and Lower Gastrointestinal Tract", 6,592,903 for "Nanoparticulate Dispersions Comprising a Synergistic Combination of a Polymeric Surface Stabilizer and Dioctyl Sodium Sulfosuccinate", 6,582,285 for "Apparatus for sanitary wet milling"; 6,656,504 for "Nanoparticulate Compositions Comprising Amorphous Cyclosporine"; 6,742,734 for "System and Method for Milling Materials"; 6,745,962 for "Small Scale Mill and Method Thereof"; 6,811,767 for "Liquid droplet aerosols of nanoparticulate drugs;" 6,908,626 for "Compositions having a combination of immediate read and controlled read racteristics "; 6,969,529 for "Nanoparticulate compositions comprising copolymers of vinyl pyrrolidone and vinyl acetate as surface stabilizers"; and 6,976,647 for "System and Method for Milling Materials", all are specifically incorporated as references. In addition, U.S. Patent Publication No. 20020012675 Al, for "Controlled Relase Nanoparticulate Compositions"; patent publication of United States No. 20050276974 for "Nanoparticulate Fibrate Formulations"; U.S. Patent Publication No. 20050238725 for "Nanoparticulate compositions having a peptide as a surface stabilizer"; U.S. Patent Publication No. 20050233001 for "Nanoparticulate megestrol formulations"; U.S. Patent Publication No. 20050147664 for "Compositions comprising antibodies and methods of using the same for targeting nanoparticulate active agent delivery"; U.S. Patent Publication No. 20050063913 for "Novel metaxalone compositions"; U.S. Patent Publication No. 20050042177 for "Novel compositions of sildenafil free base"; U.S. Patent Publication No. 20050031691 for "Gel stabilized nanoparticulate active agent compositions"; U.S. Patent Publication No. 20050019412 for "Novel glipizide compositions"; U.S. Patent Publication No. 20050004049 for "Novel griseofulvin compositions"; U.S. Patent Publication No. 20040258758 for "Nanoparticulate topiramate formulations"; U.S. Patent Publication No. 20040258757 for "Liquid dosage compositions of stable nanoparticulate active agents"; U.S. Patent Publication No. 20040229038 for "Nanoparticulate meloxicam formulations "; U.S. Patent Publication No. 20040208833 for" Novel Fluticasone Formulations; "U.S. Patent Publication No. 20040195413 for" Compositions and method for milling materials; "U.S. Patent Publication No. 20040156895 for "Solid dosage forms comprising pullulan"; U.S. Patent Publication No. U.S. Patent Publication No. U.S. Patent Publication No. 20040156872 for "Novel nimesulide compositions"; United States No. 20040141925 for "Novel triamcinolone compositions", U.S. Patent Publication No. 20040115134 for "Novel nifedipine compositions", U.S. Patent Publication No. 20040105889 for "Low viscosity liquid dosage forms"; U.S. Patent No. 20040105778 for "Gamma irradiation of solid nanop link active agents"; U.S. Patent No. 20040101566 for "Novel benzoyl peroxide compositions"; U.S. Patent Publication No. 20040057905 for "Nanoparticulate beclomethasone dipropionate compositions"; U.S. Patent Publication No. 20040033267 for "Nanoparticulate compositions of angiogenesis inhibitors"; publication ofU.S. Patent No. 20040033202 for "Nanoparticulate sterol formulations and novel sterol combinations"; U.S. Patent Publication No. 20040018242 for "Nanoparticulate nystatin formulations"; U.S. Patent Publication No. 20040015134 for "Drug delivery systems and methods"; U.S. Patent Publication No. 20030232796 for "Nanoparticulate polycosanol formulations &novel polycosanol combinations"; U.S. Patent Publication No. 20030215502 for "Fast dissolving dosage forms having reduced friability"; U.S. Patent Publication No. 20030185869 for "Nanoparticulate compositions having lysozyme as a surface stabilizer"; U.S. Patent Publication No. 20030181411 for "Nanoparticulate Compositions of Mytogenactivated Protein (MAP) Kinase Inhibitors"; U.S. Patent Publication No. 20030137067 for "Compositions having a combination of immediate release and controlled reléase characteristics"; U.S. Patent Publication No. 20030108616 for "Nanoparticulate Compositions Comprising Copolymers of Vinyl Pyrrolidone and Vinyl Acétate as Surface Stabilizers"; U.S. Patent Publication No. 20030095928 for "Nanoparticulate insulin"; United States Patent Publication No. 20030087308 for "Method for high throughput screening using a small scale mili or microfluidics"; U.S. Patent Publication No. 20030023203 for "Drug delivery systems & methods"; U.S. Patent Publication No. 20020179758 for "System and method for milling materials" and U.S. Patent Publication No. 20010053664 for "Apparatus for sanitary wet milling", describe compositions with a nanoparticulate active agent and are specifically incorporated As a reference, in particular, U.S. Patent Publication No. 20040229038 for "Nanoparticulate meloxicam formulations" discloses nanoparticulate meloxicam formulations and is incorporated by reference, compositions of small amorphous particles are described, for example, in U.S. Patent No. 4,783,484"Particulate Composition and Use Thereof as Antimicrobial Agent"; 4,826,689 for "Method for Making Uniformly Sized Particles from Water-Insoluble Organic Compounds;" 4,997,454 for "Method for Making Uniformly-Sized Particles From Insoluble Compounds"; 5,741,522 for "Ultrasmall, Non-aggregated Porous Particles of Uniform Size for Entrapping Gas Bubbles Within and Methods "; and 5,776,496, for "Ultrasmall Porous Particles for Enhancing Ultrasound Back Scatter". All patents mentioned above are incorporated herein by reference. The problem with conventional hydrocodone formulations is that they can be habit forming. There is a technical need for controlled release formulations that can alleviate these side effects. In addition, there is a need in the art for novel controlled-release hydrocodone combination compositions that provide alternatives to existing combination compositions. The present invention satisfies these needs.
SUMMARY OF THE INVENTION An object of the present invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone which, at the time of administration to a patient, exhibit a bimodal or multimodal release profile. Another object of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative. thereof, in combination with a controlled-release hydrocodone composition in the which a first portion of the composition, i.e., a hydrocodone or a salt or derivative thereof, released immediately upon administration and a second portion of the hydrocodone or a salt or derivative thereof, is released rapidly after an initial delay period in a bimodal fashion. Another object of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone, which, upon administration to a a patient, exhibit a bimodal or multimodal release profile that results in a plasma profile within pharmacokinetically effective pharmacokinetic parameters. A further object of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone which, at the time of administration to a patient, exhibit a pulsatile release profile, and / or a pulsatile plasma profile.
Still another object of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone which, at the time of administration to a patient, (1) produces a plasma profile substantially similar to that of the plasma profile produced by the administration of two or more dosage forms JR sequentially administered, and / or (2) substantially mimics the pharmacological and therapeutic effects produced by the administration of two or more dosage forms JR administered sequentially. Conventional frequent dosing regimens in which an immediate release (IR) dosage form is administered at periodic intervals typically results in a pulsatile plasma profile. In this case, a peak is observed in the concentration of the drug in plasma after the administration of each dosage JR with channels, (regions of low concentration of drugs) that develop between points of time of consecutive administration. These dosing regimens (and their resulting pulsatile plasma profiles) have particular pharmacological and therapeutic effects associated with the same. For example, the washout period provided by the decrease in plasma concentration of the active between the peaks has been penalized as being a contributing factor in the reduction or prevention of patient tolerance to various types of drugs. The present invention further relates to a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a controlled release composition comprising hydrocodone or a salt or derivative thereof, which in operation produces a plasma profile of hydrocodone that eliminates the "peaks" and "channels" produced by the administration of two or more dosage forms JR administered sequentially if this profile is beneficial. This type of profile can be obtained using a controlled release mechanism that allows a "zero order" supply. Thus, a further objective of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a controlled release hydrocodone composition that in operation supplies hydrocodone or a salt or derivative thereof , in a pulsatile way or a zero order form. Modified multiparticulate controlled release compositions similar to those disclosed herein are set forth and claimed in U.S. Patent Nos. 6,228,398 and 6,730,325 to Devane et al., both are incorporated by reference herein. The entirety of the prior art relevant in this field is also found in the present. Another object of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a controlled release composition which substantially reduces or eliminates the development of patient tolerance to hydrocodone or a salt or derivative of the same. Another object of the invention is to prepare the dosage in the form of erodible formulations, formulations with controlled diffusion, or controlled osmotic formulations. Another object of the invention is to provide a controlled release composition capable of releasing a hydrocodone or a nanoparticulate meloxicam in a bimodal or multimodal manner in which a first portion of the active is released either immediately or after a delay time to provide a pulse of the drug release and one or more additional portions of the hydrocodone or a nanoparticulate meloxicam is released, after a respective delay time, to provide additional pulses of drug release for a period of up to twenty-four hours. A still further objective of the invention is to provide a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone in which the amount of one or more of the active ingredients in the first population of particles is a minor portion of the amount of one or more of the active ingredients in the composition, and the amount of one or more of the active ingredients in one or more of the population Additional particles is a major portion of the amount of one or more of the active ingredients in the composition. Still a further objective of the invention is to provide a solid dosage form comprising the composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with the multiparticulate modified release composition of the present invention. A preferred dosage form of the invention is a solid oral dosage form, although any pharmaceutically acceptable dosage form can be used. Another aspect of the invention is directed to pharmaceutical compositions comprising a composition according to the invention and a pharmaceutically acceptable carrier, as well as any one or more of several desired excipients. One embodiment of the invention encompasses a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone, wherein the pharmacokinetic profile of the nanoparticulate meloxicam , or a salt or derivative thereof, is not affected by the diet or fasting state of a subject ingesting the meloxicam composition. In yet another embodiment, the invention encompasses a composition comprising nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a multiparticulate modified release composition comprising at least two populations of particles comprising hydrocodone, wherein the administration of meloxicam nanoparticulate to a subject in a fasting state is bioequivalent to the administration of nanoparticulate meloxicam to a subject in a fed state. In all the above embodiments, the nanoparticulate meloxicam particles have an effective average particle size less than about 2000 nm, and preferably also comprise at least one surface stabilizer adsorbed thereon or associated with the surface of the meloxicam particles. This invention also discloses a method for making the nanoparticulate meloxicam compositions. The method comprises contacting the meloxicam particles with at least one surface stabilizer for a time and under conditions to reduce the effective average particle size of the meloxicam particles to less than about 2000 nm. The present invention is also directed to methods of treatment including, but not limited to, pain management, which comprises administering a dosage form comprising a therapeutically effective amount of the composition of the invention to provide a bimodal or multimodality of the hydrocodone included in it. Other objects of the invention include the provision of a once-daily dosage form of a hydrocodone and a nanoparticulate meloxicam which, in operation, produce a plasma profile substantially similar to the plasma profile produced by the administration of two dosage forms of hydrocodone of immediate release provided sequentially and a method for the prevention and treatment of conditions of pain based on the administration of this dosage form. The above objects are obtained by a composition comprising a nanoparticulate meloxicam, or a salt or derivative thereof, in combination with a controlled release composition having a first component comprising a first population of hydrocodone particles, and a second component or formulation comprising a second population of hydrocodone particles. The hydrocodone-comprising particles of the second component further comprise a modified release constituent comprising a release coating or the release of matrix material, or both. After oral delivery, the composition in operation supplies a hydrocodone in a pulsatile or zero order form. In one embodiment of the invention, the compositions of the invention deliver a hydrocodone in a pulsatile or zero order form for a period of up to twenty-four hours. The present invention utilizes the delivery of controlled release of hydrocodone or a salt or derivative thereof, from a solid oral dosage formulation to allow dosage to be less frequent than before, and preferably once daily administration , increasing the convenience and adaptability of patient. The mechanism of controlled release preferably could use, but is not limited to, erodible formulations, controlled diffusion formulations and controlled osmotic formulations. A portion of the total dosage can be released immediately to allow a rapid onof the effect. The invention could be useful to improve the adaptability, and therefore, the therapeutic effect for all treatments that require a hydrocodone, including, but not limited to, the treatment of pain conditions. Preferred controlled release formulations are erosible formulations, controlled diffusion formulations and controlled osmotic formulations. According to the invention, a portion of the total dose can be released immediately to allow the rapid onof the effect, with the remaining portion of the total dose released over a prolonged period of time. The invention could be useful to improve the adaptability and therefore the therapeutic effect for all treatments that require a hydrocodone. Both the above general description and the following brief description of the figures and the detailed description are illustrative and explanatory and are intended to provide a further explanation of the invention as it is claimed. Other objects, advantages, and novel features will be readily apparent to those skilled in the art from the following detailed description of the invention.
BRIEF DESCRIPTION OF THE FIGURES Figure 1 shows simulations of a single dosage of 10 mg of hydrocodone formulations in which 20% of the hydrocodone is contained in the IR component. Figure 2 shows simulations of a single dosage of 10 mg of hydrocodone formulations in which 20% of the hydrocodone is contained in the JR component. Figure 3 shows stable-state simulations of 10 mg of hydrocodone formulations in which 20% of the hydrocodone is contained in the JR component. Figure 4 shows steady-state simulations of 10 mg of hydrocodone formulations in which 20% of the hydrocodone is contained in the JR component. Figure 5 shows simulations of a single dose of 10 mg of hydrocodone formulations in which 50% of the hydrocodone is contained in the JR component.
Figure 6 shows simulations of a single dose of 10 mg of hydrocodone formulations in which 50% of the hydrocodone is contained in the JR component. Figure 7 shows stable-state simulations of 10 mg of formulations of hydrocodone in which 50% of the hydrocodone is contained in the JR component. Figure 8 shows steady-state simulations of 10 mg of hydrocodone formulations in which 50% of the hydrocodone is contained in the IR component. Figure 9 shows simulations of a single dose of 20-160 mg / day of hydrocodone formulations (Option 1) in which 20% of the hydrocodone is contained in the IR component. Figure 10 shows steady state simulations of 20-160 mg / day of hydrocodone formulations (Option 1) in which 20% of the hydrocodone is contained in the JR component. Figure 11 shows single dose simulations of 20-80 mg BID of hydrocodone formulations (Option 3) in which 20% of the hydrocodone is contained in the IR component. Figure 12 shows stable-state simulations of 20-80 mg BID of hydrocodone formulations (Option 3) in which 20% of the hydrocodone is contained in the JR component. Figure 13 shows simulations of a single dose of 20-160 mg / day of hydrocodone formulations (Option 1) in which 50% of the hydrocodone is contained in the JR component. Figure 14 shows steady-state simulations of 20-160 mg / day of hydrocodone formulations (Option 1) in which 50% of the hydrocodone is contained in the JR component. Figure 15 shows simulations of a single dose of 20-160 mg / day of hydrocodone formulations (Option 3) in which 50% of the hydrocodone is contained in the JR component. Figure 16 shows steady-state simulations of 20-160 mg / day of hydrocodone formulations (Option 3) in which 50% of the hydrocodone is contained in the JR component.
DETAILED DESCRIPTION OF THE INVENTION The compositions of the invention comprise (a) a composition comprising a nanoparticulate meloxicam, or a salt or derivative thereof, and at least one surface stabilizer; and (b) an oral controlled release composition of a hydrocodone or a salt or derivative thereof.
The purpose of the nanoparticulate meloxicam release composition in combination with controlled release hydrocodone is at least two times: (1) to provide enhanced analgesia via drug synergy; and (2) limit the intake of hydrocodone by causing unpleasant and often unsafe side effects at doses greater than those prescribed. The present invention provides a method for treating a patient in need of pain relief by using a composition according to the invention. The method comprises administering a therapeutically effective amount of a dosage form, such as a solid oral dosage form, comprising a nanoparticulate meloxicam composition in combination with a controlled release hydrocodone composition, to provide a pulsed or bimodal delivery or zero order of hydrocodone. The advantages of the present invention include reducing the dosage frequency required by multiple conventional IR dosing regimens while still maintaining the benefits derived from a pulsatile plasma profile or eliminating or minimizing the "maximum" to "minimum" ratio. This reduced dosing frequency is advantageous in terms of patient adaptability to have a formulation that can be administered at a reduced frequency. The reduction in dosing frequency made possible by using the present invention could contribute to reducing health care costs by reducing the amount of time spent by healthcare workers on drug administration. In one embodiment of the invention, the nanoparticulate meloxicam composition, in accordance with standard pharmacokinetic practice, has a bioavailability that is approximately 100% higher, approximately 90% higher, approximately 80% higher, approximately 70% higher. , approximately 60% higher, approximately 50% higher, approximately 40% higher, approximately 30% higher, approximately 20%: higher, or approximately 10% greater than a conventional non-nanoparticulated meloxicam dosage form. The compositions of the invention can be administered to a subject via any conventional means, including, but not limited to: oral, rectal, ocular, parenteral (eg, intravenous, intramuscular, or subcutaneous), intracisternally, pulmonary, intravaginal, intraperitoneally, locally (eg, example, powders, ointments or drops), or as a buccal or nasal spray. In the sense in which it is used in the present, the term "subject" is used to mean an animal, preferably a mammal, including a human or non-human being. The terms patient and subject can be used interchangeably. Compositions suitable for parenteral injection may comprise dispersion solutions, sterile physiologically acceptable aqueous or non-aqueous suspensions or emulsions, and powders for reconstitution in sterile injectable solutions or dispersions. Examples of suitable carriers, diluents, solvents, or aqueous and non-aqueous vehicles include water, ethanol, polyols (propylene glycol, polyethylene glycol, glycerol, and the like), suitable mixtures thereof, vegetable oils (such as olive oil) and injectable organic esters such as ethyl oleate. Proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants. The compositions may also contain adjuvants such as preservatives, humectants, emulsifiers, and dispersants. The prevention of the growth of microorganisms can be ensured by various antibacterial and antifungal agents, such as parabens, chlorobutanol, phenol, sorbic acid, and so on. similar. It may also be convenient to include isotonic agents, such as sugars, sodium chloride and the like. Prolonged absorption of the injectable pharmaceutical form can be caused by the use of agents that retard absorption, such as aluminum monostearate and gelatin. Solid dosage forms for oral administration including, but not limited to: capsules, tablets, pills, powders, and granules. In these dosage forms, the active agents are combined with at least one of the following: (a) one or more inert excipients (or carriers), such as sodium citrate or calcium phosphate; (b) filling materials or extenders, such as starches, lactose, sucrose, glucose, mannitol, and silicic acid; (c) binders, such as carboxymethyl cellulose, alignates, gelatin, polyvinyl pyrrolidone, sucrose, and acacia; (d) humectants, such as glycerol; (e) disintegrating agents, such as agar-agar, calcium carbonate, potato starch or tapioca starch, alginic acid, certain complex silicates, and sodium carbonate; (f) solution retarders, such as paraffin; (g) absorption accelerators, such as quaternary ammonium compounds; (h) wetting agents, such as cetyl alcohol and glycerol monostearate; (i) adsorbents, such as kaolin and bentonite; and (j) lubricants, such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulphate, or mixtures thereof. For capsules, tablets, and pills, the dosage forms may also comprise buffering agents. Liquid dosage forms for oral administration include; pharmaceutically acceptable emulsions, solutions, suspensions, syrups, and elixirs. In addition to hydrocodone and meloxicam, liquid dosage forms may comprise inert diluents commonly used in the art, such as water or other solvents, solubilizing agents, and emulsifiers. Illustrative emulsifiers are ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils, such as cottonseed oil, peanut oil, oil of corn germ, olive oil, castor oil, and sesame oil, glycerol, tetrahydrofurfuryl alcohol, polyethylene glycol, sorbitan esters and fatty acid, or mixtures of these substances, and the like. Together with these inert diluents, the composition may also include adjuvants, such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, and flavoring agents. "Therapeutically effective amount", in the sense in which it is used herein, with respect to a dosage with meloxicam and hydrocodone should be understood as that dosage which provides the specific pharmacological response for which a hydrocodone or a meloxicam is administered in a significant number of subjects who need this treatment. It is emphasized that the "therapeutically effective amount" administered to a particular subject in a particular case will not always be effective in the treatment of the conditions described herein, even if it is judged that this dosage is a "therapeutically effective amount". by those skilled in the art. It should also be understood that the dosages of meloxicam and hydrocodone, in particular cases, are measured as oral dosages, or with reference to drug levels as measured in the blood. One of ordinary skill will appreciate that effective amounts of a meloxicam and a hydrocodone can be determined empirically and can be used in pure form or, where these forms exist, in an ester salt, or pharmaceutically acceptable prodrug form. The actual dosage level of a meloxicam and a hydrocodone in the compositions of the invention can be varying to obtain an amount of a meloxicam and a hydrocodone that is effective to obtain a desired therapeutic response for a particular composition and method of administration. The selected dosage level will therefore depend on the desired therapeutic effect, the route of administration, the potency of meloxicam administered, the desired duration of treatment, and other factors. The unit dosage compositions may contain these amounts or their multiples thereof as may be used to constitute the daily dosage. It should be understood, however, that the specific dosage level for any particular patient will depend on a variety of factors: the type and degree of cellular or physiological response that will be achieved; the activity of the specific agent or composition employed; the specific agents or composition employed; age, body weight, general health, sex, and diet of the patient; the time of administration, route of administration, and rate of excretion of the agent; the duration of the treatment; drugs used in combination or coincident with the specific agent; and similar factors well known in the medical arts.
I. Controlled release hydrocodone Component of the compositions of the invention A. Definitions As used herein, the term "enhancer" refers to a compound that is capable of enhancing the absorption and / or bioavailability of an active ingredient by stimulating net transport through the gastrointestinal tract (GIT) in an animal, such as a human being. The enhancers include, but are not limited to, medium chain fatty acids and salts, esters, ethers and derivatives thereof, including glycerides and triglycerides; nonionic surfactants such as those that can be prepared by reacting ethylene oxide with a fatty acid, a fatty alcohol, an alkylphenol or a fatty acid ester with sorbitan or glycerol; cytochrome P450 inhibitors, P-glycoprotein inhibitors and the like; and mixtures thereof. The term "particulate in the sense in which it is used herein refers to a state of matter characterized by the presence of particles, dragees, beads or discrete granules regardless of their size, shape or morphology." The term "multiparticulate" ", in the sense in which it is used in the present, means a plurality of particles, dragees, beads, granules discrete or aggregated or mixed thereof, regardless of their size, shape or morphology. The term "modified release", in the sense in which it is used herein with respect to the coating or coating material or used in any other context, means the release that is not an immediate release and is taken to encompass controlled release. , sustained release and delayed release. The term "time delay", in the sense in which it is used herein, refers to the length of time between the administration of the composition and the release of the hydrocodone from a particular component. The term "delay time", in the sense in which it is used herein, refers to the time between the supply of the hydrocodone from one component and the subsequent delivery of hydrocodone from another component. The term "erosonable", in the sense in which it is used herein, refers to formulations that can be corroded, reduced or impaired by the action of substances within the body. The term "controlled diffusion", in the sense in which it is used herein, refers to formulations that may be disseminated as a result of its spontaneous movement, for example, from a region of greater at a lower concentration. The term "controlled osmotic", in the sense in which it is used herein, refers to formulations that may diffuse as a result of its movement through a semipermeable membrane in a solution of higher concentration which tends to equalize the concentrations of the formulation on both sides of the membrane.
B. Illustrative Modalities The composition according to the invention comprises at least two populations of hydrocodone or a salt or derivative thereof, comprising particles having different dissolution profiles in vitro. The modified multiparticular release composition and the dosage forms made therefrom comprise at least two components comprising hydrocodone. In one embodiment, the release of the hydrocodone or a salt or derivative thereof, from the second and subsequent components, if any, is modified such that there is a time delay between the release of the hydrocodone or a salt or derived from it, from the first component and each subsequent component. The number of pulses in the release profile that arises from this composition in operation will depend on the number of components comprising hydrocodone in the composition. For example, a composition comprising two components comprising hydrocodone will produce two pulses in the release profile, and a composition comprising three components comprising hydrocodone will produce three pulses in the release profile. In another embodiment, the release of the active ingredients from the subsequent components is modified in such a way that the release of hydrocodone from the first component and each subsequent component starts substantially at the time of administration although through different periods of time and / or different speeds. For example, a controlled release composition may have a first component comprising a first population of hydrocodone or a salt or derivative thereof, and a second component comprising a second population of hydrocodone or a salt or derivative thereof. The hydrocodone-comprising particles of the second component are coated with a modified release coating. Alternatively or additionally, the second population of particles comprising hydrocodone further comprises a modified release matrix material. After oral delivery, the composition in operation supplies the hydrocodone or a salt or derivative thereof, in a pulsatile or zero order form.
In one embodiment of the invention, the controlled release composition comprising hydrocodone or a salt or derivative thereof, in operation supplies the hydrocodone in a bimodal or pulsatile or zero order form. This composition in operation produces a plasma profile that substantially mimics that obtained in the sequential administration of two doses of hydrocodone JR. The present invention is further related to a controlled release composition comprising a hydrocodone or a salt or derivative thereof, which in operation produces a plasma profile that eliminates or minimizes the "maximum" and "minimum" produced by the administration of two or more JR dosage forms administered sequentially if that profile is beneficial. This type of profile can be obtained using a controlled release mechanism that allows a "zero order" supply. Any suitable dosage form can be used for the compositions of the invention. In one embodiment, the invention provides solid forms for oral dosage comprising a composition according to the invention. The characteristics of the release time for the supply of the hydrocodone or a salt or derivative thereof, of each of the components can be varied to the modify the composition of each component, including the modification of any of the excipients or coatings that may be present. In particular, the release of the hydrocodone or a salt or derivative thereof can be controlled by changing the composition and / or amount of the modified release coating on the particles, if this coating is present. If more than one modified release component is present, the modified release coating for each of these components may be the same or different. In a similar wayWhen the modified release is facilitated by the inclusion of a modified release matrix material, the release of the hydrocodone or a salt or derivative thereof can be controlled by the choice and amount of a modified release matrix material used. . The modified release coating may be present, in each component, in any amount that is sufficient to provide the desired delay time for each particular component. The modified release coating may be present, in each component, in any amount that is sufficient to provide the desired time delay between the components. The delay of time or delay time for the release of hydrocodone or a salt or derivative of the same, each component can also be varied by modifying the composition of each of the components, including the modification of any excipients and coatings that may be present. For example, the first component can be an immediate release component wherein the hydrocodone or a salt or derivative thereof, is released immediately at the time of administration. Alternatively, the first component, for example, may be a delayed time immediate libration component in which the hydrocodone or a salt or derivative thereof, is released substantially in its entirety immediately after a time delay. The second component, for example, may be a delayed-release immediate release component as just described or, alternatively, a delayed-release or extended release sustained release component in which the hydrocodone or a salt or derivative thereof, it is released in a controlled manner over a prolonged period of time. It should be understood that suitable hydrocodones also include all pharmaceutically acceptable salts, acids, esters, complexes or other derivatives of hydrocodone, and may be present in either the form of an enantiomer or as a racemic or otherwise mixture thereof. enantiomers The hydrocodone in each component can be the same or different. In one embodiment, the first component comprises a first hydrocodone or a salt or derivative thereof, and the second component comprises a second hydrocodone or a salt or derivative thereof. In another embodiment, two or more hydrocodones can be incorporated into one or more components. In addition, a hydrocodone present in a component of the composition can be accompanied, for example, by an enhancing compound or a sensitizing compound in another component of the composition, to modify the bioavailability or therapeutic effect of hydrocodone. The amount of the hydrocodone comprised in the composition and in the dosage forms made therefrom can be assigned equally or unequally through the different populations of particles comprising the components of the composition and comprised in the dosage forms made from the same In one embodiment, the hydrocodone or a salt or derivative thereof, comprised in the particles of the first component comprises a small portion of the total amount of the hydrocodone or a salt or derivative thereof, in the composition or dosage forms, and the amount of the hydrocodone or a salt or derivative thereof, in the other components comprises a major portion of the total amount of hydrocodone or a salt or derivative thereof, in the composition or dosage form. In an embodiment comprising two components, approximately 20% of the total amount of the hydrocodone or a salt or derivative thereof, is comprised in the particles of the first component, and approximately 80% of the total amount of the hydrocodone or a salt or derivative thereof is comprised in the particles of the second component. The hydrocodone or a salt or derivative thereof, preferably is present in the composition and in the dosage forms made therefrom in an amount between about 0.1 to 1000 mg, between about 1 to 160 mg, or between about 5 to about 80 mg. Depending on at least part of the particular hydrocodone, or a salt or thereof, which is included in the composition and dosage forms, the hydrocodone or a salt or derivative thereof, is present in an amount between about 5 to about 80 mg, between about 5 to 60 mg, between about 5 to 40 mg, between about 5 to 20 mg, between about 5 to 10 mg, between about 10 to 80 mg, between about 10 to 60 mg, between about 10 to 40 mg, between about 10 to 20 mg, between about 20 to 80 mg, between about 20 to 60 mg, between about 20 to 40 mg, between about 40 to 80 mg, between about 40 to 60 mg, or between about 60 to 80 mg. When the active ingredient is hydrocodone, it is preferably present in the composition and in dosage forms made therefrom in an amount between about 5 to 160 mg; more preferably the active ingredient is present in the first component in an amount between about 10 to 80 mg. The profile for the release of the hydrocodone or a salt or derivative thereof, of each component of the composition can be varied by modifying the composition of each component, including the modification of any of the excipients or coatings that may be present. In particular, the release of the hydrocodone or a salt or derivative thereof can be controlled by the choice and amount of the modified release coating applied to the particles where this coating is present. If more than one modified release component is present, the modified release coating for each of these components may be the same or different. Similarly, when the modified release is carried out by means of a modified release matrix material, the release of the hydrocodone or a salt or derivative thereof can be controlled by the choice and amount of the Modified release matrix material used. For example, the modified release coating applied to the second population of a hydrocodone or a salt or derivative thereof, causes a time lag between the release of the active from the first population of particles comprising active hydrocodone and the release of the active from the second population of particles comprising hydrocodone. Similarly, the presence of a modified release matrix material in the second population of particles comprising hydrocodone causes a time delay between the release of hydrocodone from the first population of particles comprising hydrocodone and the release of hydrocodone or a salt or derivative thereof, from the second population of particles comprising hydrocodone. The duration of the delay time may be varied by altering the composition and / or amount of the modified release coating and / or altering the composition and / or amount of the modified release matrix material used. In this way, the duration of the delay time can be designed to mimic a desired plasma profile. In one embodiment, the first component can be an immediate release component wherein the hydrocodone or a salt or derivative thereof, comprised it is released practically immediately at the time of administration. In another embodiment, the first component can be a delayed release component in which the hydrocodone or a salt or derivative thereof, is released substantially immediately after a time delay. In any of these embodiments, the second component can be a modified release component in which the hydrocodone or a salt or derivative thereof is released for a period of time or practically immediately after a time delay. In another embodiment, the controlled release composition comprises an immediate release component and at least one modified release component, the immediate release component comprising a first population of particles comprising hydrocodone and the modified release components comprising the second and of particles comprising hydrocodone. The second and subsequent modified release components may comprise a controlled release coating. Additionally or alternatively, the second and subsequent controlled release components may comprise a modified release matrix material. In operation, the administration of this modified release composition multiparticulate having, for example, a unique modified release component results in pulsatile plasma concentration levels characteristic of hydrocodone in which the immediate release component of the composition causes a first peak in the plasma profile and the release component modified causes a second peak in the plasma profile. The embodiments of the invention comprising more than one modified release component cause additional peaks in the plasma profile. As will be appreciated by those skilled in the art, the exact nature of the plasma profile will be influenced by the combination of all the factors described above. In this way, by varying the composition of each component thereof, including the amount and nature of the hydrocodone or a salt or derivative thereof, and the modified release coating or modified matrix material, where appropriate, may result in many plasma profiles of the same at the time of administration to a patient. Depending on the release profile of each component, the resulting plasma profile can be bimodal or multimodal, and can be defined by separate and clearly defined peaks associated with each component (for example, when the delay time between the components immediate release and delayed release is long) or super-tax peaks associated with each component (for example, when the delay time is short). For example, administration of a multiparticulate modified release composition having an immediate release component and a unique modified release component can result in a plasma profile in which the immediate release component of the composition causes a first peak in the plasma profile and the modified release component cause a second peak in the plasma profile. The embodiments of the invention comprising more than one modified release component can cause original peaks in the plasma profile. Alternatively, administration of a multiparticulate modified release composition having an immediate release component and one or more modified release components may result in a bimodal or multimodal release profile although a plasma profile having a single peak or minor peaks. than the number of components contained in the composition. The plasma profile produced from the administration of a single unit dosage of the present invention is advantageous when it is convenient to provide two or more portions of hydrocodone or a salt or derived from it, without the need for the administration of two or dosage units. Additionally, in the case of some disorders it is particularly useful to have this bimodal plasma profile. In embodiments that include drug compounds used for pain management, such as for example hydrocodone, the compositions and dosage forms of the present invention can provide continuous analgesia for up to 24 hours by providing maximum to minimal fluctuations in plasma levels and reducing or eliminate the side effects associated with these drug compounds. Any coating material that modifies the release of the hydrocodone or a salt or derivative thereof, in the desired form can be used in the practice of the present invention. In particular, suitable coating materials for use in the practice of the invention include, but are not limited to, polymer-coated materials, such as cellulose acetate phthalate, cellulose acetate trimaleate, hydroxypropylmethylcellulose phthalate, polyvinylacetate phthalate, methacrylate copolymers, and ammonium, such as those sold under the Trade Mark Eudragit® RS and RL, polyacrylic acid, and polyacrylate and methacrylate copolymers such as those sold under the trademark Eudragit® S and L, polyvinylacetaldiethyl amino acetate, hydroxypropylmethylcellulose acetate succinate, shellac; hydrogels and gel-forming materials, such as carboxyvinyl polymers, sodium alginate, sodium carmellose, calcium carmellose, sodium carboxymethyl starch, polyvinyl alcohol, hydroxyethylcellulose, methylcellulose, gelatin, starch, and cellulose-based degraded polymers in the the degree of degradation is low to facilitate water adsorption and expansion of the polymer matrix, hydroxypropylcellulose, hydroxypropylmethylcellulose, polyvinylpyrrolidone, crosslinked starch, microcrystalline cellulose, chitin, amino acrylate methacrylate copolymer (Eudragit® RS-PM, Rohm &Haas) , pullulan, collagen, casein, agar, gum arabic, sodium carboxymethylcellulose, poly (hydrophilic hydrophilic polymers) poly (hydroxyalkylmethacrylate) (weight m. ~ 5k-5,000k), polyvinylpyrrolidone (weight m. ~ 10k-360k), anionic hydrogels and cationic, polyvinyl alcohols having low residual acetate content, an inflatable mixture of agar and carbo ximethylcellulose, copolymers of maleic anhydride and styrene, ethylene, propylene or isobutylene, pectin (weight m. ~ 30k-300k), polysaccharides such as agar, acacia, karaya, tragacanth, algin and guar, polyacrylamides, Polyox® polyethylene oxides (weight m. ~ 100k-5, OOOk), AquaKeep® acrylate polymers, polyglycan diesters, cross-linked polyvinyl alcohol, and poly N-vinyl-2-pyrrolidone, sodium starch glycolate (e.g., Explotab®; Edward Mandell C. Ltd.); hydrophilic polymers such as polysaccharides, methylcellulose, sodium or calcium carboxymethylcellulose, hydroxypropylmethylcellulose, hydroxypropylcellulose, hydroxyethylcellulose, nitrocellulose, carboxymethylcellulose, cellulose ethers, polyethylene oxides (for example, Polyox®, Union Carbide), methylethylcellulose, ethylhydroxyethylcellulose, cellulose acetate, cellulose butyrate, cellulose propionate, gelatin, collagen, starch, maltodextrin, pullulan, polyvinylpyrrolidone, polyvinyl alcohol, polyvinyl acetate, fatty acid esters and glycerol, polyacrylamide, polyacrylic acid, methacrylic acid or methacrylic acid copolymers (e.g. Eudragit®, Rohm &Haas), other acrylic acid derivatives, sorbitan esters, natural gums, lecithins, pectin, alginates, ammonium alginate, sodium, calcium, potassium alginates, propylene glycol alginate, agar, and gums such as arabic, karaya, locust, tragacanth, carrageenans, guar, xant anus, scleroglucans and mixtures and combinations thereof. To the coating can be added excipients such as plasticizers, lubricants, solvents and the like. Suitable plasticizers include acetylated monoglycerides; butylphtalylbutyl glycolate; dibutyl tartrate; diethyl phthalate; dimethyl phthalate; ethylphthalethyl glycolate; glycerin; propylene glycol; triacetin; citrate; tripropycin; diacetin; dibutyl phthalate; acetyl monoglyceride; polyethylene glycols; Castor oil; triethyl citrate; polyhydric alcohols, glycerol, acetate esters, gilcerol triacetate, acetyltriethyl citrate, dibenzyl phthalate, dihexyl phthalate, butyloctyl phthalate, diisononyl phthalate, butyloctyl phthalate, dioctyl azelate, epoxidized phthalate, triisoctyl trimellitate, phthalate diethylhexyl, di-n-octyl phthalate, di-i-octyl phthalate, di-i-decyl phthalate, di-n-undecyl phthalate, di-n-tridecyl phthalate, tri-2-ethylhexyl trimethylate, di-2-ethylhexyl adipate, di-2-ethylhexyl sebacate, di-2-ethylhexyl azelate, dibutyl sebacate. When the modified release component comprises a modified release matrix material, any suitable modified release matrix material or a suitable combination of modified release matrix materials can be used. These materials are known to those skilled in the art. The term "modified release matrix material" in the sense in which it is used herein, includes hydrophilic polymers, hydrophobic polymers and mixtures thereof which are capable of modifying the release of a hydrocodone or a salt or derivative thereof, dispersed therein in vitro or in vivo. Modified release matrix materials suitable for the practice of the present invention include, but are not limited to, microcrystalline cellulose, sodium carboxymethylcellulose, hydroxyalkylcellulose such as hydroxypropylmethylcellulose and hydroxypropylcellulose, polyethylene oxide, alkylcelluloses such as methylcellulose and ethylcellulose, polyethylene glycol, polyvinylpyrrolidone, cellulose, cellulose acetate butyrate, cellulose acetate phthalate, acetate cellulose trimethylate, polyvinyl acetate phthalate, polyalkyl methacrylates, polyvinyl acetate and mixtures thereof. A modified multiparticulate release composition according to the present invention can be incorporated in any suitable dosage form that facilitates the release of the hydrocodone or a salt or derivative thereof, in a bimodal or multimodal manner. Typically, the dosage form may be a combination of different populations of a hydrocodone or a salt or derivative thereof, comprising particles constituting immediate release and modified release components, the combination being It will fill in suitable capsules, such as hard or soft gelatin capsules. Alternatively, the different individual populations of a hydrocodone or a salt or derivative thereof, comprising particles can be compressed (optionally with additional excipients) into mini-tablets which can then be filled into capsules in suitable proportions. Another suitable dosage form is that of a tablet with multiple layers. In these dosage forms, the first component of the multiparticulate modified release composition can be compressed into a layer with the second component that will subsequently be added as a second layer of the multilayer tablet. Populations of hydrocodone or a salt or derivative thereof, comprising particles comprising the composition of the invention can also be included in fast dissolving dosage forms such as an effervescent dosage form or a fast melt dosage form. In one embodiment, the composition of the invention and the dosage forms made therefrom release hydrocodone or a salt or derivative thereof, such that virtually all of the hydrocodone or a salt or derivative thereof, comprised in the first component is released before release of a hydrocodone or a salt or derivative of it, of the second component. For example, when the first component comprises an IR component, the release of the hydrocodone or a salt or derivative thereof, of the second component can be retarded until virtually all of the hydrocodone or a salt or derivative thereof has been released. , in the JR component. The release of the hydrocodone or a salt or derivative thereof from the second component can be delayed as detailed above by the use of a modified release coating and / or a modified release matrix material. Because the plasma profile produced by the controlled release hydrocodone composition at the time of administration may be substantially similar to the plasma profile produced by the administration of two or more hydrocodone dosage forms of JR provided below, the release composition The present invention is particularly useful for the administration of a hydrocodone or a salt or derivative thereof, for which tolerance of the patient may be problematic. This controlled release composition is therefore advantageous to reduce or minimize the development of patient tolerance to the hydrocodone or a salt or derivative thereof, in the composition.
When it is desirable to minimize the tolerance of the patient by providing a dosing regimen that facilitates the flushing of a first dosage of hydrocodone or a salt or derivative thereof, of a patient's system, the release of hydrocodone or a salt or derivative thereof, the second component is retarded until virtually all of the hydrocodone or a salt or derivative thereof, comprised in the first component, has been released and further retarded until at least a portion of the hydrocodone or a salt or derivative thereof, is released from the first component that has been cleared from the patient's system. In one embodiment, the release of the hydrocodone or a salt or derivative thereof, of the second component of the composition is retarded, virtually, if not completely, for a period of at least about two hours after the administration of the drug. composition. In another embodiment, the composition of the invention and the dosage forms made therefrom release hydrocodone or a salt or derivative thereof, such that hydrocodone or a salt or derivative thereof, comprised in the first component is released during the release of the hydrocodone or a salt or derivative thereof, of the second component. In one modality, the release of the hydrocodone or a salt or derivative thereof, the second component of the composition occurs during and beyond the release of the hydrocodone or a salt or derivative thereof, of the first component.
C. Other Types of Controlled-Release Hydrocodone Assays As described herein, the invention includes various types of controlled release systems by which hydrocodone or a salt or derivative thereof, can be delivered in a pulsatile or of zero order. These systems include, but are not limited to: films with the hydrocodone or a salt or derivative thereof, in a polymeric matrix (monolithic devices); hydrocodone or a salt or derivative thereof, contained by the polymer (deposition devices); polymeric or microencapsulated colloidal particles (microparticles, microspheres or nanoparticles) in the form of deposit or matrix deposits; hydrocodone or a salt or derivative thereof, contained by a polymer containing a hydrophilic and / or leachable additive for example, a second polymer, surfactant or plasticizer, etc., to provide a porous device, or a device in which the hydrocodone or a salt or derivative thereof, the release can be "controlled" osmotically (the both deposit and matrix devices); enteric coatings (ionize and dissolve at a suitable pH); Polymers (soluble) with "pendant" hydrocodone attached (covalently); or a salt or derivative thereof, molecules; Devices where the release rate is controlled dynamically: for example, the osmotic pump. The delivery mechanism of the invention will control the rates of drug release. While some mechanisms will release hydrocodone or a salt or derivative thereof, at a constant rate (zero order), others will vary as a function of time depending on factors such as changing the concentration gradients or the leaching additive that leads to Porosity, etc. The polymers used in the sustained release coatings are necessarily biocompatible, and ideally biodegradable. Examples of both polymers that occur in nature such as Aquacoat® (FMC Corporation, Food &Pharmaceutical Products Division, Philadelphia, USA) (ethylcellulose converted to spheres mechanically to sub-micron dimension with aqueous base, pseudo-latex dispersions ), and synthetic polymers such as the Eudragit® range (Róhni Pharma, Weiterstadt.) variation of poly (acrylate, methacrylate) copolymers are also known in the art. 1. Deposit Devices A typical method for controlled release is to encapsulate or contain the hydrocodone or a salt or derivative thereof, totally (eg, as a core), within a film or polymeric coating (i.e., microcapsules or cores). coated with atomization / spin). The various factors that can affect the diffusion process can be easily applied to the deposition devices (for example, the effects of the additives, the polymer functionality. {And, therefore, the pH of the diluted solution.}. , porosity, film melting conditions, etc.) and, therefore, the choice of polymer should be an important consideration in the development of deposit devices. The modeling of the release characteristics of the deposit devices (and monolithic devices) in which the transport of the hydrocodone or a salt or derivative thereof, is carried out by means of a mechanism of diffusion of solutions that therefore implies typically a solution to a second law of Ficks (conditions in an unstable state, concentration-dependent flow) for the relevant boundary conditions. When the device contains dissolved hydrocodone, or a salt or derivative thereof, the release rate decreases exponentially with time as the concentration (activity) of the agent (ie, the driving force for release) within the device decreases (ie, first order release). However, if the hydrocodone or a salt or derivative thereof is in a saturated suspension, then the driving force for release remains constant (zero order) until the device is no longer saturated. Alternatively the kinetics of the rate of release may be a controlled desorption, and a function of the square root of time. The transport properties of the coated tablets can be improved compared to the free polymer films, due to the enclosed nature of the tablet core (permeant) which can allow the constitution internal accumulation of an osmotic pressure which will then act to force the permeating off the tablet. The effect of deionized water or salt-containing tablets coated on the silicone elastomer containing poly (ethylene glycol) (PEG) has been investigated, and also the effects of water on the free films. The release of salt from the tablets was found to be a mixture of diffusion through pores filled with water, formed by the hydration of the coating, and osmotic pumping. The KC1 transport through films containing only 10% PEG was negligible, despite the extensive swelling observed in similar free films, indicating that porosity was necessary for the release of KC1 which was then presented by "diffusion". pore". The disc-shaped, coated salt tablets were found to swell in deionized water and change their shape to a spheroidal wafer as a result of the accumulation of internal hydrostatic pressure: the change in shape provides a means to measure the " force "generated. As might be expected, the osmotic force decreased with increasing levels of PEG content. The lower levels of PEG allowed the water to impregnate through the hydrated polymer; while the resulting porosity of the coating that dissolves at higher levels of PEG content (20 to 40%) allowed the pressure to be mitigated by the flow of KC1. Methods and equations have been developed, which by monitoring (independently) the release of two different salts (eg, KC1 and NaCl) allowed the calculation of the relative magnitudes that both the osmotic pumping and the trans-pore diffusion contributed to the release of salt from the tablet. At low PEG levels, the osmotic flow was increased to a greater degree than it was due to trans-pore diffusion due to the generation of only a number of low density pores: at a 20% load, both mechanisms contributed approximately equal to the release. The accumulation of hydrostatic pressure, however, decreased the osmotic influx, and the osmotic pumping. At higher PEG loads, the hydrated film was more porous and less resistant to salt spillage. Therefore, although osmotic pumping increased (compared to the lower load), trans-pore diffusion was the dominant release mechanism. An osmotic release mechanism for microcapsules containing a water-soluble core has also been reported. 2. Monolithic devices (matrix devices) Monolithic devices (matrix) are possibly the most common devices for controlling the release of drugs. This is possible because they are relatively easy to manufacture, compared to the reservoir devices, and there is no danger of an accidental high dosage that could result from the rupture of the membrane of a reservoir device. In this device the hydrocodone or a salt or derivative thereof, is present as a dispersion within the polymer matrix, and is typically formed by compressing a polymer / drug mixture or by dissolving or melting. The properties of the dosage release of the monolithic devices may depend on the solubility of the hydrocodone or, a salt or derivative thereof, in the polymeric matrix or, in the case of porous matrices, the solubility in the solution lowered within the pore network of the particles, and also the tortuosity of the network (to a greater degree than the permeability of the film), depending on whether the hydrocodone or a salt or derivative thereof, is dispersed in the polymer or dissolved in the the polymer. For low drug loads, (0 to 5% P / V) hydrocodone or a salt or derivative thereof, will be released by a solution diffusion mechanism (in the absence of pore). At higher loads (5 to 10% W / V), the release mechanism will be complicated by the presence of cavs formed near the surface of the device as hydrocodone, or a salt or derivative thereof, is lost: these cavs they are filled with fluid from the environment that increases the rate of drug release. It is common to add a plasticizer (eg, a poly (ethylene glycol)), or surfactant, or an adjuvant (ie, an ingredient that increases efficiency), to the matrix devices (and deposit devices) as a means to enhance permeability (although, on the other hand, the plasticizer can be fuge, and simply serve to assist in the formation of film and, therefore, decrease permeability - a property normally more convenient in coatings for polymeric paint). It was observed that the leaching of PEG acted to increase the permeability of the films of (ethylcellulose) linearly as a function of PEG loading by increasing porosity, however, the films retained their barrier properties, without allowing the transport of electrolytes. It was deduced that the intensification of its permeability was as a result of the effective decrease in thickness caused by PEG leaching. This was evident from the graphs of cumulative permeant flow per unit area as a function of time and reciprocal thickness of the film at a PEG loading of 50% P / V: graphs showing a linear relationship between the permeation rate and reciprocal film thickness, as expected for the transport mechanism type solution diffusion (Fickian) in a homogeneous membrane. The extrapolation of the linear regions of the graph to the time axis provided pose intercepts in the time axis: the magnitude of them decreased towards zero with the decrease of the thickness of the film. These time of Delay changes were attributed to the presence of two diffusional flows during the early stages of the experiment (the "drug" flow and also the PEG flow), and also to the more usual delay time during which the concentration of permeant in the film It is accumulating. Caffeine, when used as a permeant, showed negative delay times. No explanation is forthcoming, although it was observed that caffeine exhibited a lower division coefficient in the system, and that this was also a characteristic of the aniline permeation through polyethylene films that showed a negative time delay Similary . The effects of aggregate surfactants on matrix (hydrophobic) devices have been investigated. It was thought that the surfactant may increase the hydrocodone or a salt or derivative thereof, the rate of release by three possible mechanisms: (i) increased solubilization, (ii) improved "wettability" to the dissolution medium, and (iii) ) pore formation as a result of the leaching of surfactants. For the system studied (Eudragit® RL 100 and RS 100 plastified by sorbitol, Flurbiprofen as the drug, and a variation of surfactants) it was concluded that an improved tablet wetting led only to an improvement partial release of the drug (implying that the release was by diffusion, instead of dissolution, controlled), although the effect was greater for Eudragit® RS than for Eudragit® RL, while the greater influence on the release was for those surfactants which were more soluble due to the formation of the "disruptions" in the matrix that allows the dissolution medium to access within the matrix. This has an obvious relevance for a study of latex films that could be suitable for pharmaceutical coatings, due to the ease with which a polymeric latex can be prepared with a surfactant as opposed to free surfactant. Differences were found between the two polymers - with only the Eudragit® RS showing interactions between the anionic / cationic surfactant and the drug. This was attributed to the different levels of quaternary ammonium ions on the polymer. There are also composite devices that consist of a polymer / drug matrix coated in a polymer that does not contain drug. This device was constructed from aqueous Eudragit® latices, and was found to provide a zero-order release by diffusion of the drug from the core through the liner. Similarly, a core has been produced polymer that contains the drug, although coated with a liner that was eroded by the gastric fluid. The rate of drug release was found to be relatively linear (a function of the diffusion process that limits velocity through the liner) and inversely proportional to the thickness of the liner, while core release was only found to decrease with time. 3. Microspheres Methods have been described for the preparation of hollow microspheres ("microballoons") with the drug dispersed in the lining of the sphere, and also quite porous matrix microspheres ("microsponges"). The microsponges were prepared by dissolving the drug and the polymer in ethanol. With the addition to the water, the ethanol diffused in the emulsion droplets leaves a fairly porous particle. Hollow microspheres were formed by preparing an ethanol / dichloromethane solution containing the drug and the polymer. When emptying in water, this formed an emulsion that contained dispersed polymer / drug / solvent particles, by a coacervation-like process, from which ethanol (a good solvent for the polymer) spread rapidly precipitating the polymer on the surface of the droplet to provide a hard liner particle that encloses the drug, dissolved in dichloromethane. In this point, a gaseous phase of dichloromethane was generated within the particle which, through diffusion through the liner, was observed to bubble to the surface of the aqueous phase. The hollow sphere, under reduced pressure, was then filled with water, which could be removed for a period of drying. (No drug was found in the water.) A suggested use of the microspheres was as devices for delivery of floating drugs for use in the stomach. 4. Hanging Devices A means has been developed to link a variation of drugs such as analgesics and antidepressants, etc., by means of an ester linkage to latex particles with poly (acrylate) ester prepared by aqueous emulsion polymerization. These latices have passed through an ion exchange resin in such a way that the polymeric end groups converted to their strong acid form could "self-catalyze" the release of the drug by hydrolysis of the ester bond. The drugs have been linked to polymers, and also the monomers have been synthesized with a pendant drug attached. The research group has also prepared their own dosage forms in which the drug binds to a biocompatible polymer via a labile chemical bond eg polyanhydrides prepared from a substituted anhydride (prepared by itself by reacting an acid chloride with the drug: methacryloyl chloride and the sodium salt of methoxybenzoic acid) were used to form a matrix with a second polymer (Eudragit® RL) that released the drug on hydrolysis in the gastric fluid. The use of polymeric Schiff bases suitable for use as carriers of pharmaceutical amines has also been described. 5. Enteric Films Enteric coatings consist of pH-sensitive polymers. Typically the polymers are carboxylated and interact (swell) very little with water at low pH, while at high pH the polymers ionize causing swelling, or dissolution of the polymer. Therefore, the coatings can be designed to keep the acidic environment of the stomach intact (protecting either the drug from its environment or the stomach of the drug), although to dissolve in the more alkaline environment of the intestine. 6. Osmotically controlled devices The osmotic pump is similar to a reservoir device although it contains an osmotic agent (eg, the active agent in salt form) that acts to inhibit water from the surrounding medium via a semipermeable membrane. This device has been described, called the "elemental osmotic pump". Pressure is generated within the device which forces the active agent out of the device via an orifice (of a size designed to minimize the diffusion of solutes, while preventing the accumulation of a major hydrostatic pressure that has the effect of lowering the pressure osmotic and change the dimensions { volume.}. of the device). While the internal volume of the device remains constant, and there is an excess of solid (saturated solution) in the device, then the rate of release remains constant providing a volume equal to the volume of solvent absorption. 7. Electrically stimulated release devices Monolithic devices have been prepared using polyelectrolyte gels that swell when, for example, an external electrical stimulus was applied, causing a change in pH. The release could be modulated, by current, providing a pulsatile release profile. 8. Hydrogels Hydrogels find a use in several biomedical applications, in addition to their use in drug matrices (for example, soft contact lenses, and various "soft" implants, etc.).
II. Nanoparticulate meloxicam component of the compositions of the invention The compositions of the invention comprise a nanoparticulate meloxicam composition. The nanoparticulate meloxicam composition comprises meloxicam particles having an effective average particle size less than about 2000 nm and preferably at least one surface stabilizer adsorbed on or associated with the surface of the drug. The advantages of the nanoparticulate meloxicam compositions of the invention compared to conventional, non-nanoparticulated or solubilized meloxicam dosage forms include, but are not limited to: (1) smaller tablet or size of the solid dosage form; (2) lower doses of the drug required to obtain the same pharmacological effect; (3) increased bioavailability; (4) practically similar pharmacokinetic profiles of the meloxicam compositions when administered in the diet against the fasting state; (5) bioequivalence of meloxicam compositions when administered in the diet against the fasting state; (6) an increased rate of dissolution of the meloxicam compositions; and (7) the meloxicam compositions can be used together with other active agents useful in the prevention and treatment of non-effective conditions. The present invention also includes nanoparticulate meloxicam compositions together with one or more non-toxic physiologically acceptable carriers or adjuvants, collectively referred to as carriers. The compositions may be formulated for parenteral injection (eg, intravenous, intramuscular, or subcutaneous), oral administration in solid, liquid, or aerosol form, vaginal, nasal, rectal, ocular or local administration (powders, ointments, or drops), buccal, intracisternal, intraperitoneal, or topical, and the like. A preferred dosage form of the invention is a solid dosage form, although any pharmaceutically acceptable dosage form can be used. The solid forms of Illustrative dosages include, but are not limited to: tablets, capsules, sacks, pills, powders, pills, or granules, and the solid dosage form can be, for example, a fast-melt dosage form, a controlled-release dosage form, a lyophilized dosage form, a delayed release dosage form, a sustained release dosage form, a pulsatile delivery dosage form, an immediate release and mixed controlled release form, or a combination thereof. A solid dose tablet formulation is preferred. The present invention is described herein using various definitions, as set forth below and throughout the application. The term "effective average particle sizes", in the sense in which it is used herein, means that at least about 50% of the nanoparticulate meloxicam particles have sizes less than about 2000 nm, by weight or by other suitable measurement technique (eg, such as by volume, number, etc.), when measured, for example, by flow fractionation sedimentation, photonic correlation spectroscopy, light scattering, disk centrifugation, and other known techniques by those skilled in the art. In the sense in which it is used herein, "approximately" will be understood by those of ordinary skill in the art and will vary to some degree depending on the context in which it is used. If there are uses of the term that are not clear to persons with normal experience in the technique provided in the context in which it is used, "approximately" will mean up to plus or minus 10% of the particular term. In the sense in which it is used herein with reference to stable meloxicam particles, "stable" means that the particles do not flocculate or agglomerate appreciably due to attractive interparticle forces or otherwise increase in particle size. "Stable" connotes, but is not limited to one or more of the following parameters: (1) the particles do not flocculate or agglomerate appreciably due to attractive interparticle forces or otherwise significantly increase in particle size over time; (2) the physical structure of the particles is not altered over time, such as by the conversion of an amorphous phase to a crystalline phase; (3) the particles are chemically stable; and / or (4) where the meloxicam or a salt or derivative thereof has not been subjected to a heating step at or above the melting point of the meloxicam particles in the preparation of the nanoparticles of the present invention. The term "conventional" or "non-nanoparticulate active agent" is to be understood as an active agent that solubilizes or has an effective average particle size greater than about 2000 nm. Nanoparticulate active agents, as defined herein, have effective average particle sizes less than about 2000 nm. The phrase "drugs poorly soluble in water", of the phrase in the sense in which it is used herein, refers to drugs having a water solubility of less than about 30 mg / ml, less than about 20 mg / ml. , less than about 10 mg / ml, or less than about 1 mg / ml. As used herein, the phrase "therapeutically effective amount" is to be understood as the dosage of the drug that provides the specific pharmacological response for which the drug is administered to a significant number of subjects in need of this treatment. It is emphasized that a therapeutically effective amount of a drug that is administered to a particular subject in a particular case will not always be effective in the treatment of the condition / diseases described herein, although it is judged that this dosage will be a therapeutically effective amount by those skilled in the art.
A. Preferred Characteristics of the Nanoparticulate Meloxicam Coaporations of the Invention 1. Enhanced Bioavailability The nanoparticulate meloxicam formulations of the invention exhibit increased bioavailability, and require lower dosages compared to conventional non-nanoparticulated meloxicam formulations. 2. Improved pharmacokinetic profiles The invention also provides nanoparticulate meloxicam, or a salt or derivative thereof, compositions having a desirable pharmacokinetic profile when administered to mammalian subjects. The desirable pharmacokinetic profile of compositions comprising meloxicam include, but are not limited to: (1) a Cmax for meloxicam, when analyzed in the plasma of a mammalian subject after administration which is preferably greater than Cmax for a non-nanoparticulate formulation of the same meloxicam, administered to the same dosage; and / or (2) an AUC for meloxicam, when analyzed in the plasma of a mammalian subject after administration, which is preferably greater than AUC for a non-nanoparticulate formulation of the same meloxicam, administered at the same dosage; and / or (3) a Tmax for meloxicam, when analyzed in the plasma of a mammalian subject after administration, which is preferably less than Tmax for a non-nanoparticulate formulation of the same meloxicam, administered at the same dosage. The desirable pharmacokinetic profile, in the sense in which it is used herein, is the pharmacokinetic profile measured after the initial dose of meloxicam or a salt or derivative thereof. In one embodiment, a composition comprising a nanoparticulate meloxicam exhibits in a comparative pharmacokinetic test with a non-nanoparticulate formulation of the same meloxicam, administered at the same dosage, a Tmax not greater than about 90%, not greater than about 80%, not greater than about 70%, no greater than about 60%, no greater than about 50%, no greater than about 40%, no greater than about 30%, no greater than about 25%, no greater to approximately 20%, no greater than approximately 15%, no greater than approximately 10% or no greater than approximately 5% of the Tmax exhibited by the non-nanoparticulate meloxicam formulation. In another embodiment, the composition comprising a nanoparticulate meloxicam exhibits in comparison with the pharmacokinetic test with a non-nanoparticulate formulation of the same meloxicam, administered at the same dosage, a Cmax that is at least about 50%, at least about 100% , at least about 200%, at least about 300%, at least about 400%, at least about 500%, at least about 600%, at least about 700%, at least about 800%, at least about 900%, at least about 1000%, at least about 1100%, at least about 1200%, at least about 1300%, at least about 1400%, at least about 1500%, at less about 1600%, at least about 1700%, at least about 1800%, or at least about 1900% greater than the Cmax exhibited by the meloxicam formulation is not nanoparticulate. In still another embodiment, the composition comprising a nanoparticulate meloxicam exhibits a comparative pharmacokinetic test with a non-nanoparticulate formulation of the same meloxicam, administered to the same dosage, an AUC that is at least about 25%, at least about 50%, at least about 75%, at least about 100%, at least about 125%, at least about 150%, at least about 175%, at least about 200%, at least about 225%, at least about 250%, at least about 275%, at least about 300%, at least about 350%, at least about 400%, at least about 450%, at least about 500%, at least about 550%, at least about 600%, at least about 650%, at least about 700%, at less about 750%, at least about 800%, at least about 850%, at least about 900%, at least about 950%, at least about 1000%, at least about 1050%, at least about 1100%, at least about 1150%, or at least about 1200% greater than the AUC exhibited by the non-nanoparticulate meloxicam formulation. In one embodiment of the invention, the Tmax of meloxicam, when analyzed in the plasma of the mammalian subject, is less than about 6 to 8 hours. In other embodiments of the invention, the Tmax of meloxicam is less than about 6 hours, less than about 5 hours, less than about 4 hours, less than about 3 hours, less than about 2 hours, less than about 1 hour, or less than about 30 minutes after administration. The desirable pharmacokinetic profile, in the sense in which it is used herein, is the pharmacokinetic profile measured after the initial dose of meloxicam or a salt or derivative thereof. The compositions can be formulated in any way as described herein and as is known to those skilled in the art. 3. The pharmacokinetic profiles of the meloxicam compositions of the invention are not affected by the feeding or fasting state of the subject ingesting the compositions. The invention encompasses meloxicam compositions, wherein the pharmacokinetic profile of meloxicam is not substantially affected by the condition of food or fasting of a subject that ingests the composition. This means that there is no substantial difference in the amount of drug absorbed or the rate of absorption of the drug when the compositions of the drug are administered. nanoparticulate meloxicam in the fed state versus the fasted state. The benefits of a dosage form, which practically eliminates the effect of the food, includes an increase in the convenience of the subject, thus increasing the subject's adaptability, as the subject does not need to ensure that they are ingesting a dose with either without food This is significant, since with a poor adaptability of the subject an increase in the medical condition for which the drug is being prescribed can be observed. 4. Bioequivalence of meloxicam compositions of the invention when administered in the nourishing versus fasting state The invention also encompasses a nanoparticulate meloxicam composition in which the administration of the composition to a subject in a fasting state is bioequivalent to the administration of the composition to a subject in a feeding state. The difference in the absorption (AUC) or Cmax of the nanoparticulate meloxicam compositions of the invention, when administered in the fed versus the fasted state, is preferably less than about 60%, less than about 55%, less than about 50%, less than about 45%, less than about 40%, less than about 35%, less than about 30%, less than about 25%, less than about 20%, less than about 15% %, less than about 10%, less than about 5%, or less than about 3%. In one embodiment of the invention, the invention encompasses compositions comprising a nanoparticulate meloxicam, wherein the administration of the composition to a subject in a fasting state is bioequivalent to the administration of the composition to a subject in a feeding state, in particular as defined by Cmax and the AUC guidelines provided by the Food and Drug Administration of the United States and the Corresponding European Regulatory Agency (EMEA). In accordance with US FDA guidelines, two products or methods are bioequivalent if the 90% Confidence Intervals (CI) for AUC and Cmax are between 0.80 to 1.25 (Tmax measurements are not relevant for bioequivalence for regulatory purposes). To show a bioequivalence between two compounds or administration conditions according to the European EMEA guidelines, the IQ of 90% for AUC should be between 0.80 to 1.25 and IQ of 90% for the Cmax should be between 0.70 to 1.43. 5. Dissolution profiles of the meloxicam compositions of the invention The nanoparticulate meloxicam compositions of the invention are proposed to have unexpectedly dramatic dissolution profiles. Rapid dissolution of an active agent administered is preferred, a faster dissolution in general leads to a faster onset of action and greater bioavailability. To improve the dissolution profile and bioavailability of meloxicam, it may be useful to increase the dissolution of the drug in such a way that a level close to 100% could be obtained. The meloxicam compositions of the invention preferably have a dissolution profile in which at least about 5% of the composition dissolves within about 5 minutes. In other embodiments of the invention, at least about 30% or at least about 40% of the meloxicam composition dissolves in about 5 minutes. In still other embodiments of the invention, preferably at least about 10 minutes, at least about 40%, at least about 50%, at least about 60%, at least about 70%, or at least about 80 is dissolved in about 10 minutes. % of the meloxicam composition. Finally, in another embodiment of the invention, preferably at least about 20 minutes is dissolved in at least about 70%, at least about 80%, at least about 90%, or at least about 100% of the composition of meloxicam. The solution of preference is measured in a medium that is discriminant. This means of dissolution will produce two very different dissolution curves for two products that have very different dissolution profiles in the gastric juices; that is, the dissolution medium is predictive of the in vivo dissolution of a composition. An illustrative dissolution medium is an aqueous medium containing sodium lauryl sulfate with surfactant at 0.025 M. The determination of the dissolved amount can be carried out by spectrophotometry. The rotary knife method (European Pharmacopoeia) can be used to measure the dissolution. 6. Redispersibility profiles of the meloxicam compositions of the invention A further feature of the meloxicam compositions of the invention is that the compositions are redispersed in such a way that the effective average particle size of the redispersed particles of Meloxicam is less than about 2 microns. This is significant, since at the time of administration the meloxicam compositions of the invention will not be redispersed to a substantially nanoparticulate particle size, then the dosage form may lose the benefits obtained by the meloxicam formulation in a particle size. nanoparticulate. This is because the nanoparticulate active agent compositions benefit from the small particle size of the active agent; if the active agent is not redispersed in the small particle sizes with the administration, then "groups" or agglomerated particles of the active agent are formed, due to the extremely high surface free energy of the nanoparticulate system and the thermodynamic driving force to reach a total reduction in free energy. With the formation of these agglomerated particles, the bioavailability of the dosage form can fall well below that observed with the liquid dispersion form of the nanoparticulate active agent. In addition, the nanoparticulate meloxicam or a salt or derivative thereof, the compositions of the invention exhibit a dramatic redispersion of the nanoparticulate meloxicam particles with administration to a mammal, such as a human or animal, as demonstrated by reconstitution / redispersion in a bio-relevant aqueous medium such that the effective average particle size of the redispersed meloxicam particles is less than about 2 microns. This bio-relevant aqueous medium can be any aqueous medium exhibiting the desired ionic strength of pH, which form the basis of the bio-relevance of the medium. The desired pH and ionic strength are those that are representative of the physiological conditions found in the human body. This bio-relevant aqueous medium, for example, can be aqueous electrolytic solutions or aqueous solutions of any salt, acid, or bases, or a combination thereof, that exhibit pH and ionic strength. A bio-relevant pH is well known in the art. For example, in the stomach, the pH varies slightly from less than 2 (although typically greater than 1) to 4 or 5. In the small intestine, the pH can vary from 4 to 6, and in the colon it can vary from 6 to 8. Bio-relevant ionic strength is also well known in the art. Gastric fluid in the fasting state has an ionic strength of approximately 0.1 M whereas intestinal fluid in the fasted state has an ionic strength between approximately 0.14. See, for example, Lindahi et al., "Characterization of Fluids from the Stomach and Proximal Jejunum in Men and omen," Pharm.
Res., 14 (4): 497-502 (1997). It is believed that the pH and ionic strength of the test solution is more decisive than the specific chemical content. Accordingly, suitable pH and ionic strength values can be obtained through many combinations of strong acids, strong bases, salts, single or multiple conjugated acid-base pairs (ie, weak acids and the corresponding salts of that acid) , monoprotic and polyprotic electrolytes, etc. Representative electrolyte solutions can be, but are not limited to, HC1 solutions, ranging in concentration from about 0.001 to 0.1 M, and NaCl solutions, ranging in concentration from about 0.001 to 0.1 M, and mixtures thereof. For example, electrolytic solutions can be, but are not limited to, between about 0.1 M HCl or less, between about 0.01 M HCl or less, between about 0.001 M H or less, between about 0.1 M NaCl or less, between about NaCl 0.01 M or less, between about 0.001 NaCl or less, and mixtures thereof. Of these electrolyte solutions, 0.01 M HCl and / or 0.1 M NaCl, are the most representative of the fasting human physiological conditions, due to the pH conditions and ionic resistance of the proximal gastrointestinal tract.
The electrolytic concentrations of 0.001 M HCl, 0.01 M HCl, and 0.1 M HCl correspond to pH 3, pH 2, and pH 1, respectively. In this way, a 0.01 M HCl solution simulates the typical acid conditions found in the stomach. A 0.1 M NaCl solution provides a reasonable approximation of the ionic resistance conditions found throughout the body, including gastrointestinal fluids, although concentrations greater than 0.1 M can be used to simulate the feeding conditions within the human GI tract. Solutions of salts, acids, illustrative bases or combinations thereof, which exhibit the desired pH and ionic strength, include, but are not limited to, phosphoric acid / phosphate + sodium salts, calcium and potassium chloride salts, acetic acid / salts of acetate + sodium chloride, potassium and calcium salts, carbonic acid / bicarbonate salts + chloride and sodium salts, potassium and calcium, and citric acid / citrate salts + chloride, sodium, potassium and calcium salts. In other embodiments of the invention, the redispersed meloxicam particles of the invention (redispersed in an aqueous, bio-relevant medium, or any other suitable medium) have an effective average particle size less than about 1900 nm, less than about 1800 nm , less than about 1700 nm, less than about 1600 nm, less than about 1500 nm, less than about 1400 nm, less than about 1300 nm, less than about 1200 nm, less than about 1100 nm, less than about 1000 nm, less than about 900 nm, less than about about 800 nm, less than about 700 nm, less than about 600 nm, less than about 500 nm, less than about 400 nm, less than about 300 nm, less than about 250 nm, less than about 200 nm, less than about 150 nm, less than about 100 nm, less than about 75 nm, or less than about 50 nm, as measured by light scattering methods, microscopy, or other suitable methods.
B. Nanoparticulate Meloxicam Compositions The invention provides compositions comprising meloxicam particles and at least one surface stabilizer. Surface stabilizers are preferably absorbed on the surface of the meloxicam particles or are associated therewith. Especially useful surface stabilizers herein are preferably physically adhered to, or associated with, the surface of the nanoparticulate meloxicam particles, although they do not react chemically with the meloxicam particles or by themselves. The individually adsorbed molecules of the surface stabilizer are essentially free of intermolecular crosslinkers. The invention also includes meloxicam compositions together with one or more carriers, non-toxic physiologically acceptable vehicles or adjuvants, collectively referred to as carriers. The compositions can be formulated for parenteral injection (eg, intravenous, intramuscular, or subcutaneous), oral administration in solid, liquid, or aerosol form, vaginal, nasal, rectal, ocular, local (powders, ointments or drops), oral administration , intracisternal, intraperitoneal, or topical, and the like. 1. Meloxicam particles The compositions of the invention comprise meloxicam particles or a salt or derivative thereof. The particles may be in a crystalline phase, a semi-crystalline phase, an amorphous phase, a semi-amorphous phase, or a combination thereof. 2. Surface Stabilizer The combinations of plus one surface stabilizer can be used in the invention. The Useful surface stabilizers that can be employed in the invention include, but are not limited to: known organic and inorganic pharmaceutical excipients. These excipients include various polymers, low molecular weight oligomer, natural products, and surfactants. Illustrative surface stabilizers include surfactants or nonionic, ionic, anionic, cationic, zwitterionic compounds. Representative examples of surface stabilizers include hydroxypropylmethylcellulose (now known as hypromellose), hydroxypropylcellulose, polyvinylpyrrolidone, sodium lauryl sulfate, dioctyl sulfosuccinate, gelatin, casein, lecithin. (phosphatides), dextran, acacia gum, cholesterol, tragacanth, stearic acid, benzalkonium chloride, calcium stearate, glycerol monostearate, cetostearyl alcohol, cetomacrogol emulsifying wax, sorbitan esters, polyoxyethylene alkyl ethers (eg, macrogol ethers) such as cetomacrogol 1000), polyoxyethylene castor oil derivatives, polyoxyethylene sorbitan fatty acid esters (for example, commercially available Tweens® such as, for example, Tween 20® and T een 80® (ICI Specialty Chemicals)); polyethylene glycols (for example, Carbowaxs 3550® and 934® (Union Carbide)), polyoxyethylene stearates, dioxide colloidal silicon, phosphates, calcium carboxymethylcellulose, sodium carboxymethylcellulose, methylcellulose, hydroxyethylcellulose, hypromellose phthalate, non-crystalline cellulose, magnesium aluminum silicate, triethanolamine, polyvinyl alcohol (PVA), 4- (1,1,3,3-) polymer tetramethylbutyl) -phenol with ethylene oxide and formaldehyde (also known as tyloxapol, superione, and triton), poloxamers (for example, Pluronics F68® and F108®, which are block copolymers of ethylene oxide and propylene oxide); poloxamine (e.g., Tetronic 908®, also known as Poloxamine 908®, which is a tetrafunctional block copolymer derived from the sequential addition of propylene oxide and ethylene oxide to ethylenediamine (BASF Yandotte Corporation, Parsippany, NJ.)); Tetronic 1508® (T-1508) (BASF Wyandotte Corporation), Tritons X-200®, which is a sulfonate of alkylaryl polyether (Rohm and Haas); Crodestas F-110®, which is a mixture of sucrose stearate and sucrose distearate (Croda Inc.); p ~ isononilfenoxipoli- (glycidol), also known as Olin-IOG® or Surfactant 10-G® (Olin Chemicals, Stamford, CT); Crodestas SL-40® (Croda, Inc.); and SA90HCO, which is Ci8H37CH2 (CO (CH3) H2 (CHOH) 4 (CH2OH) 2 (Eastman Kodak Co.); decanoyl-N-methylglucamide; n-decyl-pD-glucopyranoside; n-decyl-p-maltopyranoside; -dodecyl- -D-glucopyranoside; n-dodecyl- -D-maltoside; heptanoyl-N-methylglucamido; n- heptyl-p-D-glucopyranoside; n-heptyl-p-D-thioglucoside; n-hexyl-p-D-glucopyranoside; nonanoyl-N-methylglucamido; n - ???? - ß-D-glucopyranoside; octanoyl-N-methylglucamido; n-octyl-p-D-glucopyranoside; octyl-D-thioglucopyranoside; PEG-phospholipid, PEG-cholesterol, PEG-cholesterol derivatives, PEG-vitamin A, PEG-vitamin E, lysozyme, random copolymers of vinylpyrrolidone and vinyl acetate, and the like. Examples of useful cationic surface stabilizers include, but are not limited to: polymers, biopolymers, polysaccharides, cellulosics, alginates, phospholipids, and non-polymeric compounds, such as zwitterionic stabilizers, poly-n-methylpyridinium, antriulpyridinium chloride, cationic phospholipids, chitosan , polylysine, polyvinylimidazole, polybrene, polymethylmethacrylate trimethylammonium bromide (PM TMABr), hexyldecyltrimethylammonium bromide (1-IDMAB), and polyvinylpyrrolidone-2-dimethylaminoethyl methacrylate dimethyl sulfate. Other useful cationic stabilizers include, but are not limited to: cationic lipids, sulfonium, phosphonium, and quaternary ammonium compounds, such as stearyltrimethylammonium chloride, benzyl-di (2-chloroethyl) ethylammonium bromide, cocotrimethylammonium chloride or bromide, chloride or bromide. cocomethyldihydroxyethylammonium chloride decyltriethylammonium, decyl dimethylhydroxyethylammonium chloride or bromide, C12-i5dimethylhydroxyethylammonium chloride or bromide, cocodimethylhydroxyethylammonium chloride or bromide, myristyltrimethylammonium methylsulfate, lauryldimethylbenzylammonium chloride or bromide, lauryl dimethyl (ethenoxy) ammonium chloride or bromide, N-alkyl chloride ) dimethylbenzylammonium chloride, N-alkyl (C14-18) dimethyl-benzylammonium chloride, N-tetradecylmethylbenzylammonium chloride monohydrate, dimethyldidecylammonium chloride, N-alkyl and (C12-14) dimethyl-i-naphthylmethylammonium chloride, trimethylammonium halide, salts of alkyl trimethylammonium and dialkyl dimethylammonium salts, lauryltrimethylammonium chloride, alkylamidoalkyldialkylammonium ethoxylated salt and / or an ethoxylated trialkylammonium salt, dialkylbenzenedialkylammonium chloride, N-didecyldimethylammonium chloride, N-tetradecyldimethylbenzylammonium chloride monohydrate, N-alkyl chloride (C12-14) dimethyl-l-naphthylmethylammonium and dodecyl dimethyl chloride lbenzylammonium, dialkylbenzealkylammonium chloride, lauryltrimethylammonium chloride, alkylbenzylmethylammonium chloride, alkylbenzyldimethylammonium bromide, C12, C15 bromides, Ci7trimethylammonium, dodecylbenzyltriethylammonium chloride, poly-diallyldimethylammonium chloride (DADMAC), chlorides dimethylammonium, alkyldimethylammonium halides, tricetlmethylammonium chloride, decyltrimethylammonium bromide, dodecyltriethylammonium bromide, tetradecyltrimethylammonium bromide, methyltrioctylammonium chloride (ALIQUAT 336MR), POLYQUAT 10MR, tetrabutylammonium bromide, benzyltrimethylammonium bromide, choline esters (such as choline esters of fatty acids), benzalkonium chloride, stearalkonium chloride compounds (such as, stearyltrimonium chloride and distearyldimonium chloride), cetylpyridinium bromide or chloride, quaternized polyoxyethylalkylamino halide salts, MIRAPOLMR and ALKAQUAYMR (Alkaril Chemical Company), salts of alkylpyridinium; amines, such as alkylamines, dialkylamines, alkanolamines, polyethylenepolyamines, N, N-dialkylaminoalkyl acrylates, and vinylpyridine, amine salts, such as lauryl amine acetate, stearylamine acetate, alkylpyridinium salt, and alkylimidazolium salt, and amine oxides; imidazole salts; protonated quaternary acrylamides / methylated quaternary polymers, such as poly [diallyldimethylammonium chloride] and poly- [N-methylvinylpyridinium chloride]; and cationic guar. These illustrative cationic surface stabilizers and other useful cationic surface stabilizers are described in J. Cross and E. Singer, Cationic Surfactants: Analytical and Biological Evaluation (Marcel Dekker, 1994); P. and D. Rubingh (Editor), Cationic Surfactants: Physical Chemistry (arcel Dekker, 1991); and J. Richmond, Cationic Surfactants: Organic Chemistry, (Marcel Dekker, 1990). The non-polymeric surface stabilizers are any non-polymeric compound, such as benzalkonium chloride, a carbonate compound, a phosphonium compound, an oxonium compound, a halonium compound, a cationic organometallic compound, a quaternary phosphorus compound, a compound of pyridinium, an anilinium compound, an ammonium compound, a hydroxylammonium compound, a primary ammonium compound, a secondary ammonium compound, a tertiary ammonium compound, and quaternary ammonium compounds of the formula NR1R2R3RI. For compounds of the formula R1R2R3R4 (+ > (i) none R1-R are CH3; (ii) one of R1-R4 is CH3; (iii) three of R1-R4 are CR3; (iv) all of R1-R4 are CH3; (v) two of R1-R4 are CH3, one of R1-R4 is C6H5CH2, and one of 1-R4 is an alkyl chain of seven carbon atoms or less; (vi) two of R1-R4 are CH3, one of R1-R4 is C6H5CH2, and one of R1-R4 is an alkyl chain of nineteen carbon atoms or more; (vii) two of R1-R4 are CH3 and one of R1-R4 is of the group C6H5 (CH2) ~, where n > l; (viii) two of R1-R4 are CH3, one of R1-R4 is C6H5CH2, and one of R1-R4 comprises at least one heteroatom; (ix) two of R1-R4 are CH3, one of R1-R4 is C6H5CH2, and one of R1-R4 comprises at least one halogen; (x) two of R1-R4 are CH3, one of R1-R4 is C6H5CH2, and one of R1-R4 comprises at least one cyclic fragment;(xi) two of R1-R4 are CH3 and one of R1-R4 is a phenyl ring; or (xii) two of R1-R4 are CH3 and two of R1-R4 are purely aliphatic fragments. These compounds include, but are not limited to: behenalconium chloride, benzothonium chloride, cetylpyridinium chloride, behentrimonium chloride, lauralconium chloride, cetalconium chloride, cetrimonium bromide, cetrimonium chloride, cetylamine hydrofluoride, chlorallylmetenamine chloride (Quatemium-15 ), distearyldimonium chloride (Quatemium-5), dodecyldimethylethylbenzylammonium chloride (Quaternium-1), Quatemium-22, Quatemium-26, Quatemium-18 hectorite, dimethylaminoethylchloride hydrochloride, cysteine hydrochloride, diethanolammonium (10) oleyl ether phosphate, ether phosphate of diethanolammonium POE (3) oleyl, tallowalkyl chloride, dimethyldioctadecylammoniumbentonite, stearalkonium chloride, domifenium bromide, denatonium benzoate, miristalconium chloride, lauryrimonium chloride, ethylenediamine dihydrochloride, guanidine hydrochloride, pyridoxine HC1, iofethamine hydrochloride, meglumine hydrochloride, methylbenzethonium chloride, myrtrimonium bromide, chloride of oleyltrimonium, polyquatermium-1, procaine hydrochloride, cocobetaine, stearalkonium bentonite, stearalkonium hectonite, stearyltrihydroxyethylpropylenediamine dihydrofluoride, sebotrichonium chloride, and hexadecyltrimethylammonium bromide. Surface stabilizers are commercially available and / or can be prepared by techniques known in the art. Most of these surface stabilizers are known pharmaceutical excipients and are described in detail in the Handbook of Pharmaceutical Excipient, published jointly by the American Pharmaceutical Association and The Pharmaceutical Society of Great Britain (The Pharmaceutical Press, 2000), specifically incorporated by reference. 3. Other pharmaceutical excipients The pharmaceutical compositions according to the invention may also comprise one or more binding agents, fillers, lubricating agents, suspending agents, sweeteners, flavoring agents, preservatives, buffers, wetting agents, disintegrants, effervescent agents, and other excipients. These excipients are known in the art. Examples of fillers are lactose monohydrate, anhydrous lactose, and various starches; examples of binding agents are various celluloses and cross-linked polyvinylpyrrolidone, microcrystalline cellulose, such as Avicel® PH101 and Avicel® PH102, microcrystalline cellulose, and silicon microcrystalline cellulose (ProSolv SMCCMR). Suitable lubricants, including agents that act on the flowability of the powder to be compressed, are colloidal silicon dioxide, such as Aerosil® 200, talc, stearic acid, magnesium stearate, calcium stearate, and silica gel. Examples of sweeteners are any natural or artificial sweeteners, such as sucrose, xylitol, sodium saccharin, cyclamate, aspartame, and acsulfame. Examples of flavoring agents are agnasweet® (trademark of MAFCO), chewing gum flavor and fruit flavors, and the like. Examples of preservatives are potassium sorbate, methylparaben, propylparaben, benzoic acid and its salts, other esters of parahydroxybenzoic acid, such as butylparaben, alcohols such as ethyl or benzyl alcohol, phenolic compounds such as phenol, or quaternary ammonium compounds such as benzalkonium chloride. Suitable diluents include pharmaceutically acceptable inert fillers, such as microcrystalline cellulose, lactose, calcium dibasic phosphate, saccharides, and / or mixtures of any of the foregoing. Examples of diluents include microcrystalline cellulose, such as Avicel® PH101 and Avicel® PH102; lactose such as lactose monohydrate, anhydrous lactose, and Pharmatose® DCL21; calcium dibasic phosphate such as Emcompress®; mannitol; starch; sorbitol; saccharose; and glucose. Suitable disintegrants include lightly cross-linked polyvinylpyrrolidone, corn starch, potato starch, corn starch, and modified starches, croscarmellose sodium, cross-povidone, sodium-starch glycolate, and mixtures thereof. Examples of effervescent agents are effervescent couples such as organic acid and a carbonate or bicarbonate. Suitable organic acids include, for example, citric, tartaric, malic, fumaric, adipic, succinic, and alginic acid and anhydrides and acid salts. Suitable carbonates and bicarbonates include, example, sodium carbonate, sodium bicarbonate, potassium carbonate, potassium bicarbonate, magnesium carbonate, sodium carbonate-glycine, L-lysine carbonate, and arginine carbonate. Alternatively, only the sodium bicarbonate component of the effervescent couple can be present. 4. Particle size of nanoparticulate meloxicam The compositions of the invention comprise meloxicam particles having an effective average particle size of less than about 2000 nm (ie, 2 microns), less than about 1900 nm, less than about 1800 nm, less than about 1700 nm, less than about 1600 nm, less than about 1500 nm, less than about 1400 nm, less than about 1300 nm, less than about 1200 nm, less than about 1100 nm, less than about 1000 nm, less than about 900 nm, less than about 800 nm, less than about 700 nm, less than about 600 nm, less than about 500 nm of meloxicam, smaller than between about 400 nm, less than about 300 nm, less than about 250 nm, less than about 200 nm, less than about 150 nm, less than about 100 nm, less than about 75 nm, or less than about 50 nm, as measured by measured light scattering methods, microscopy, or other suitable methods. By "an effective average particle size less than about 2000 nm" it is to be understood that at least 50% of the meloxicam particles have a particle size smaller than the effective average, weight or by another suitable measurement technique (e.g. , volume, number, etc.), that is, less than approximately 2000 nm, 1900 nm, 1800 nm, etc., when measured by the techniques observed above. In other embodiments of the invention, at least about 60%, at least about 70%, at least about 80%, at least about 90%, at least about 95%, or at least about 99% the meloxicam particles have a particle size smaller than the effective average, that is, less than about 2000 nm, 1900 nm, 1800 nm, 1700 nm, etc. In the present invention, the D50 value of a nanoparticulate meloxicam composition is the particle size below which 50% of the meloxicam particles fall, by weight. Similarly, D90 is the particle size below which 90% of the meloxicam particles fall, by weight. 5. Concentration of meloxicam and surface stabilizers The relative amounts of meloxicam and one or more surface stabilizers can vary widely. The optimum amount of the individual components may depend, for example, on the particular meloxicam selec the lipophilic hydrophilic balance (HLB), the melting point, and the surface tension of the aqueous solutions of the stabilizer, etc. The meloxicam concentration can vary between about 99.5% up to 0.001%, between about 95% up to 0.1%, or between about 90% up to 0.5%, by weight, based on the combined total dry weight of meloxicam and at least a surface stabilizer, not including other excipients. The concentration of at least one surface stabilizer can vary from about 0.5% to 99.999%, from about 5.0% to 99.9%, or from about 10% to 99.5%, by weight, based on the combined total dry weight of meloxicam and at least one surface stabilizer, not including other excipients.
C. Methods for Producing Nanoparticulate Meloxicam Compositions Nanoparticulate meloxicam compositions can be produced using, for example, grinding, homogenization, precipitation, freezing, or tempered emulsion techniques. Illustrative methods for making nanoparticulate compositions are described in the '684 patent. Methods for making nanoparticulate compositions are also described in U.S. Patent No. 5,518,187 to "Method of Grinding Pharmaceutical Substances"; U.S. Patent No. 5,718,388 for "Continuous Method of Grinding Pharmaceutical Substances"; U.S. Patent No. 5,862,999 to "Method of Grinding Pharmaceutical Substances"; U.S. Patent No. 5,665,331 for "CoMicroprecipitation of Nanoparticulate Pharmaceutical Agents' with Crystal Gro th Modifiers "; U.S. Patent No. 5,662,883 for" Co-Microrecipitation of Nanoparticulate Pharmaceutical Agents with Crystal Growth Modifiers; "U.S. Patent No. 5,560,932 for" Microprecipitation of Nanoparticulate Pharmaceutical Agents "; United States No. 5,543,133 for "Process of Preparing X-Ray Contrast Compositions Containing Nanoparticles"; United States Patent No. 5,534,270 for "Method of Preparing Stable Drug Nanoparticles "; U.S. Patent No. 5,510,118 for" Process of Preparing Therapeutic Compositions Containing Nanoparticles "; and U.S. Patent No. 5,470,583 for" Method of Preparing Nanoparticle Compositions Containing Charged Phospholipids to Reduce Aggregation "; they are specifically incorporated by reference The resulting nanoparticulate meloxicam compositions or dispersions can be used in solid or liquid dosage formulations, such as liquid dispersions, gels, aerosols, ointments, creams, controlled release formulations, fast melt formulations, formulations freeze-dried tablets, capsules, delayed-release formulations, sustained-release formulations, pulsatile-release formulations, mixed release and controlled-release formulations, etc. 1. Trituration to obtain dispersions of nanoparticulate meloxicam The trituration of a meloxicam to obtain a nanoparticulate dispersion comprises dispersing the meloxicam particles in a liquid dispersion medium in which the meloxicam is sparingly soluble, followed by the application of mechanical means in the presence of medium. crushing to reduce the particle size of meloxicam to the desired effective average particle size. The dispersion medium can be, for example, water, safflower oil, ethanol, t-butanol, glycerin, polyethylene glycol (PEG), hexane, or glycol. A preferred dispersion medium is water. The meloxicam particles can be reduced in size in the presence of at least one surface stabilizer. Alternatively, the meloxicam particles may be contacted with one or more surface stabilizers after friction. Other compounds, such as a diluent, can be added to the meloxicam / surface stabilizer composition during the size reduction process. The dispersions can be manufactured continuously or in a batch mode. 2. Precipitation to obtain nanoparticulate meloxicam compositions Another method for forming the desired nanoparticulate meloxicam composition is by microprecipitation. This is a method for preparing stable dispersions of poorly soluble active agents in the presence of one or more surface stabilizers and one or more surface active agents for the enhancement of free colloidal stability. any trace toxic solvents or solubilized heavy metal impurities. This method comprises, for example: (1) dissolving the meloxicam in a suitable solvent; (2) adding the step step formulation (1) to a solution comprising at least one surface stabilizer; and (3) precipitating the formulation of step (2) using a product without suitable solvent. The method can be followed by the removal of any salt formed, if present, by dialysis or diafiltration and the concentration of the dispersion by conventional means. 3. Homogenization to obtain nanoparticulate meloxicam compositions Illustrative homogenization methods for preparing the nanoparticulate compositions of the active agent are described in U.S. Patent No. 5,510,118, for "Process of Preparing Therapeutic Compositions Containing Nanoparticles". This method comprises dispersing the particles of a meloxicam in a liquid dispersion medium, followed by subjecting the dispersion to homogenization to reduce the particle size of a meloxicam to the desired effective average particle size. Meloxicam particles can be reduced in size in the presence of at least one stabilizer superficial. Alternatively, the meloxicam particles can be contacted with one or more surface stabilizers either before or after the friction. Other compounds, such as a diluent, can be added to the meloxicam / surface stabilizer composition, either before, during, or after the size reduction process. Dispersions can be produced continuously or in a batch mode. 4. Cryogenic methodologies for obtaining nanoparticulate meloxicam compositions Another method for forming the desired nanoparticulate meloxicam composition is by liquid aerosol freezing (SFL). This technology comprises an organic or organocose solution of meloxicam with stabilizers, which is injected into a cryogenic liquid, such as liquid nitrogen. The droplets of the meloxicam solution are frozen at a sufficient rate to minimize crystallization and particle size, thus formulating nano-structured meloxicam particles. Depending on the choice of solvent system and processing conditions, nanoparticulate meloxicam particles - may have variable particle morphology. In the isolation step, nitrogen and solvent are removed under conditions that prevent the agglomeration or maturation of meloxicam particles. As a complementary technology to the SFL, ultra-fast freezing (URF) can also be used to create equivalent nanostructured meloxicam particles that greatly intensify the surface area. URF comprises an organic or organocumous solution of meloxicam that is stabilized on a cryogenic substrate. 5. Emulsion methodologies for obtaining nanoparticulate meloxicam compositions Another method for forming the desired nanoparticulate meloxicam composition is by template emulsion. Template emulsion creates nanostructured meloxicam particles with controlled particle size distribution and rapid dissolution performance. The method comprises an oil / water emulsion which is prepared, then swollen with a non-aqueous solution comprising the meloxicam and the stabilizers. The particle size distribution of the meloxicam particles is a direct result of the size of the droplets in emulsion before loading with the meloxicam a property that can be controlled and optimized in this process. In addition, through the selected use of solvents and stabilizers, reaches the stability of the emulsion without or with Ostwald suppressed maturation. Subsequently, the solvent and water are removed, and the stabilized nanostructured meloxicam particles are recovered. Various morphologies of meloxicam particles can be achieved by proper control of processing conditions. In the following examples, all percentages are presented by weight unless stated otherwise. The term "purified water", in the sense in which it is used throughout the examples, refers to water that has been purified by passing it through a water filtration system. It should be understood that the examples are for illustrative purposes only, and should not be construed as limiting the spirit and scope of the invention, as defined by the scope of the claims below. All references identified herein, including a United States patent, are expressly incorporated herein by reference.
EXAMPLE 1 The purpose of this example is to describe the preparation of a multiparticulate modified release composition comprising an hxdrocodone which can be used in the combination compositions of the invention Hydrocodone release compositions modified multiparticulate according to this invention that has an immediate release component and a modified release component that have a Modified release coating are prepared from according to the formulations shown in tables 1 and 2.
TABLE 1 Hydrocodone solutions with immediate release component Ingredient Quantity, 0% (w / w) (i) (ü) (iü) (iv) (v) (vi) Hydrocodone bitartrate 6. 0 6.0 6.0 6.0 6. 0 6.0 HPMC 2910 1. 0 2.0 2.0 - 1.5 Polyethylene glycol 6000 - - 0.5 - Povidone K3 - - - 5. 0 - Fumaric acid 6.0 - - - Citric acid - 6.0 - - Dilicon dioxide 1. 5 1.0 1.0 - 2.0 Talcum 1. 5 - - - - Purified water 90 .0 85.0 85.0 93.5 89 .0 90.? TABLE 2 Hydrocodone solutions with modified release component Ingredient Quantity, 0% (w / w) (i) (ü) (iü) (iv) (v) (vi) Eudragit RS 100 4.1 4.9 5.5 4.4 - 5.5 7. 5 Eudragit RL 100 - 0.5 - 1.1 - - Eudragit L 100 1.4 - - - - - Ethocel - - - - 3.0 - Triethyl citrate 1.5 1.6 - 1.1 - - 1. 5 Dibutyl sebacate - - - - 0.6 1.0 Silicon dioxide 1.0 1.0 1.0 - 2.0 1.0 Talc 2.5 2.5 1.0 2.8 - 1.0 2. 5 Acetone 34.0 34.0 15.0 35.6 - 14.0 33 .5 Isopropyl alcohol 50.0 50. 72.5 50. 94.4 72.5 50 .0 Purified water 5.5 5.5 5.0 5.0 - 5.0 5. 0 In these illustrative hydrocodone formulations, the sugar spheres (30/35 mesh) were provided as inert cores that act as a carrier for the active ingredient and other excipients present in the formulation. The selected quality and sizes reflect the requirements to produce multiparticulates with an average diameter in the size variation of 0.5-0.6 mm to facilitate the subsequent coating and encapsulation process. It was used hydroxypropylmethylcellulose (2910) (Methocal E6 Premium LV) to prepare the immediate release coating solution that was coated onto the sugar spheres to produce the JR beads and acts as a binding agent. Silicon dioxide (Syloid 244FP) is an anti-adherent that was used in the preparation of the IR coating solution (Table 1) and the modified release coating suspension (Table 2). Type B of the methacrylate-ammonium copolymer (Eudragit RS 100) is a polymer for speed control that imparts controlled release properties to the formulation and exhibits pH independent release properties. Talc (Altaic 200) was used as an anti-adherent in the modified release coating process to make the modified release beads. Acetone and isopropyl alcohol are the two solvents in which the polymer is dissolved for speed control to produce the coating suspension that is applied to the IR beads to form the modified release beads. The resulting coating suspension is applied to the IR beads to form the modified release beads. The modified release beads are dried in an oven for 10-20 hours at 40-500C / 30-60% RH to remove residual solvents and obtain a moisture content of approximately 3-6%. Suitable processing procedures are further detailed in U.S. Patent No. 6,066,339 which is incorporated herein by reference in its entirety. Table 3 shows the dissolution profiles for two multiparticulate modified release formulations prepared according to tables 1 and 2. These results indicate that approximately 20% of the hydrocodone was released in the first hour and approximately 80% of the hydrocodone was released for a period of approximately 11 hours.
TABLE 3 Dissolution data for the compositions containing an IR component and a modified release component Formulation Time (hour) Fumaric acid Non-smoking acid 0 0 0 1 22 26 2 33 31 4 54 54 6 68 64 8 77 73 In vivo study A randomized, single-dose, placebo-controlled, parallel-group comparator study was conducted to evaluate the safety, efficacy, and PK of hydrocodone formulations in subjects immediately after a bunioectomy study. The study treatments were 10, 20, 30, 40 mg of hydrocodone bitartarate, matching active comparator (10 mg hydrocodone / APAP) or matching placebo. During the 24-hour confinement periods, blood was collected at baseline and up to 17 additional time points, from 115 subjects (approximately 17 to 21 subjects per group), to determine plasma concentrations of hydrocodone. The following PK parameters were calculated and presented in Tables 4-6.
Table 4 Parameter Statistics HC ER 10 mg HC ER 20 mg HC ER 30 mg HC ER 40 mg HC / APAP Placebo N = 21 N = 19 N = 19 N = 17 N = 18 N = 21 21?, ?? (ng / mL) n 19 19 17 18 21 Average 8.9 17.9 31.7 37.5 19.5 0.1 Dev. Stand. 2.11 5.85 8.50 8.82 8.69 0.17 5 Medium 9.1 16.3 30.1 34.1 20.2 0.0 Tnex min. 5/15 10/27 16/46 28/62 9/45 0/1 QBX (hr) n 21 19 19 17 18 3 Average 6.3 6.0 63 61 27 82 Dev. Stand. 1.46 1.80 1.88 1.62 1.65 13.70 Medium 6.1 5.2 6.1 6.0 2.1 0.6 Tmax min. 4/9 4/12 4/10 4/10 1/7 0/24 10 Kel (1 / hr) n 21 19 19 17 18 NC (a) Medium 0.090 0.095 0086 0079 0138 NC Dev. Stand. 0.0276 0.0289 0.0229 0.021 0.0297 NC Medium 0.092 0.089 0.083 0.079 0.147 NC Tmax min. 002/013 005/016 005/013 0.05 / 0 .13 0.06 / 0.18 NC NC = not calculated fifteen Table 5 Parameter Statistics HC ER 10 mg HC ER 20 mg HC ER 30 mg HC ER 40 mg HG / APAP Placebo N = 21 N = 19 N = 19 N = 17 N = 18 N = 21 T 1/2 (hr) n 21 19 19 17 18 21 Average 9.5 7.9 8.6 9.4 5.3 NC Dev. Stand. 8.25 2.44 2.32 2.40 1.64 NC Medium 7.6 7.8 8.4 8.8 4.7 NC Min / Max 5/45 4/15 5/13 5/14 4/11 NC AUCfina! (ng hr / mL) n 21 19 19 17 18 21 Medium 109.0 212.9 392.5 464.6 131.2 0.1 Dev. Stand. 27.25 73.19 117.74 124.01 36.80 0.19 Medium 104.2 196.2 367.0 471.0 129.9 0.0 Min / Max 73/179 130/377 177/671 321/712 80/182 0/1 AUCinf (ng * hr / mL) n 21 19 19 17 18 NC Mean 136.9 255.6 480.7 596.2 137.6 NC Dev. Stand. 39.48 85.66 138.70 172.73 39.99 NC Medium 128.1 252.7 459.5 578.0 135.4 NC Min / Max 80/217 151/468 226/756 375/992 83/189 CN Table 6 Proportion HC ER 10 mg HC ER 20 mg HC ER 30 mg HC ER 40 mg HC / APAP Place Statistics using AUC final N = 21 N = 19 N = 19 N = 17 N = 18 N = N 21 19 19 17 18 3 Average 0.000 0.001 0.002 0.003 0. 001 0. 000 Hydromorphone / Hydrocodone Dev. Stand. 0.0009 0.0038 0.0027 0.0050 0.0012 0.0000 5 Medium 0.000 0.000 0.001 0.002 0. 000 0. 000 Tnax min. 0.00 / 0 .00 0.00 / 0.02 0.00 / 0 .01 0.00 / 0 .02 0. 00 / 0.00 0. 00/0. N 21 19 19 17 18 3 0.362 0. 448 0. 000 Hydromorphone / Medium 0.366 0.360 0.327 Hydrocodone Dev. Stand. 0.1189 0.1215 0.1243 0.1310 0.2144 0.0000 Median 0.368 0.324 0.297 0.334 0. 400 0. 000 Tmax min. 0.11 / 0.61 0.17 / 0.58 0.20 / 0.76 0.23 / 0.74 0.22 / 0.84 0. 00/00 10 Hydrocodone simulations The studies of hydrocodone formulations of the present invention were conducted to simulate the profiles associated with the administration of hydrocodone twice daily for both single dose and steady state. The white doses were 10, 20, 40 and 80 mg, and the minimum concentration carried out was 5-10 ng / ml. The study formulations were two-component dosage forms comprising an immediate release component and a modified release component in which hydrocodone was equally (50/50) or unequally (20/80) assigned through the two components . Non-compartmental parameters were used to find the estimates of the unit input response and a one-compartment model was assumed for all simulations. The non-compartmental parameters after oral dosing of 10 mg of hydrocodone administered to five male adults are reported as shown in the following table 7.
Table 7 Non-compartmental parameters It was estimated that K10 and V / f will be 0.18 and 334.29L respectively. For the kOl absorption rate constant, various profiles were simulated using various kOl estimates. The estimates of the secondary parameters were compared to identify a suitable ka as set forth in the following table 8.
Table 8 Comparison of the absorption speed constant (ka) ka = l AUC 166.19 ka = l K01-HL 0.69 ka = l K10-HL 3.85 ka = l CL / F 60.17 ka = l Tmax 2.09 ka = l Cmax 20.53 ka = 2 AUC 166.19 ka = 2 K01-HL 0.35 ka = 2 K10-HL 3.85 ka = 2 CL / F 60.17 ka = 2 Tmax 1.32 ka = 2 Cma 23.57 ka = 6 AUC 166.19 ka = 6 K01-HL 0.12 ka = 6 KIO-HL 3.85 ka = 6 CL / F 60.17 ka = 6 Tmax 0.60 ka = 6 Cma 26.84 ka = 2 seems to be the best estimate of the rate of absorption of the hydrocodone of instantaneous release determined that the maximum concentration observed and the time for the maximum concentration were comparable to the data previously established. To conduct these simulations, options were identified. Options 1 and 2 assumed a first order release and option 3 a zero order release. The graphs of the plasma concentrations of these simulations are shown in the Figures 1 to 16.
EXAMPLE 2 The purpose of this example was to prepare nanoparticulate meloxicam dispersions stabilized with various surface stabilizers. Aqueous dispersions of 5% by weight of meloxicam (Unichem Laboratories, Ltd.) and 1% by weight of stabilizer (see table 9 below) were loaded into a NanoMill® crushing (Elan Drug Delivery, Inc., King of Prussia, PA; see for example U.S. Patent No. 6,431,478 for "Small Scale Mili") equipped with a batch chamber of 10 cc. The following parameters of the NanoMill® crushing system were used for all formulations: grinding speed = 5500 rpm; Total crushing time = 1 hour; type of media for polymeric grinding = PolyMillTM200 (The Dow Chemical Co.); and a load of sufficient means to process. The particle size analysis of the resulting crushed dispersions was performed using a Horiba LA-9 particle size analyzer 10 (Horiba, Instruments, Irvine, CA). The results are shown below in Table 9. In the following table, the value for D50 is the particle size below which 50% of the particles of the active agent falls. Similarly, D90 is the particle size below which 90% of the particles of the active agent fall.
TABLE 9 5 10 All formulations were extracted at an initial time except for lecithin and lysozyme, where the initial particle size was measured at 24 hours. fifteen The results demonstrate that meloxicam can be formulated in stable nanoparticulate compositions with each of the surface stabilizers shown in Table 9, since all formulations have a D50 particle size less than about 2000 nm. The nanoparticulate meloxicam compositions shown in Table 9 had average particle sizes ranging from 95 to 227 nm, with sizes D50 and D90 ranging from 89 nm to 227 nm and 117 nm to 322 nm, respectively. It will be apparent to those skilled in the art that various modifications and variations may be made in the methods and compositions of the present invention without departing from the spirit or scope of the invention. In this way, it is intended that the present invention cover the modifications and variations of the invention provided and that come within the scope of the appended claims and their equivalents.

Claims (1)

  1. NOVELTY OF THE INVENTION Having described the present invention, it is considered as a novelty and, therefore, the content of the following CLAIMS is claimed as property: 1. A composition characterized in that it comprises: (a) a multiparticulate modified release composition that comprises hydrocodone or a pharmaceutically acceptable salt thereof, an enantiomer thereof, derivative thereof, or a mixture thereof, and comprising: (i) a first component comprising a first population of particles comprising hydrocodone; and (ii) at least one subsequent component, each subsequent component comprising a subsequent population of particles comprising hydrocodone, wherein at least one subsequent population of particles comprising hydrocodone further comprises a modified release coating, a release matrix material modified, or a combination of a modified release coating and a modified release matrix material, such that the composition after oral delivery to a subject provides at least one hydrocodone, or a salt or derivative thereof, in a bimodal or multimodal fashion; and (b) a nanoparticulate meloxicam composition comprising: (i) meloxicam particles or a salt or derivative thereof having an effective average particle size less than about 2000 nm; and (ii) at least one surface stabilizer. 2. The composition according to claim 1, characterized in that the multiparticulate modified release composition comprises a first component and a subsequent component. 3. The composition according to claim 2, characterized in that the first component is an immediate release component and the subsequent component is a modified release component. 4. The composition according to claim 3, characterized in that the modified release component comprises particles having a modified release coating. 5. The composition according to claim 3, characterized in that the modified release component comprises a modified release matrix material. 6. Composition in accordance with claim 1, characterized in that the multiparticulate modified release composition, the first population of particles comprising hydrocodone and at least one subsequent population of particles comprising hydrocodone comprises the same hydrocodone. The composition according to claim 1, characterized in that the multiparticulate modified release composition, the first population of particles comprising hydrocodone and at least one subsequent population of particles comprising hydrocodone comprise different hydrocodones. The composition according to claim 1, characterized in that the multiparticulate modified release composition, the first population of particles comprising hydrocodone comprises two or more hydrocodones. The composition according to claim 1, characterized in that the multiparticulate modified release composition, at least one subsequent population of particles comprising hydrocodone contains two or more hydrocodones. The composition according to claim 1, characterized in that the modified multiparticulate release composition, the hydrocodone comprises practically an optically pure enantiomer or a mixture, racemic or otherwise, of enantiomers. 11. The composition according to claim 1, characterized in that the multiparticulate modified release composition, at least one of the components further comprises an enhancer. The composition according to claim 1, characterized in that for the multiparticulate modified release composition, the amount of hydrocodone comprised in the first and subsequent component is the same. 13. The composition according to claim 1, characterized in that the modified multiparticulate release composition, the amount of hydrocodone comprised in the first component is a minor portion of the hydrocodone comprised in the composition and the amount of hydrocodone comprised in the subsequent components is a major portion of the hydrocodone comprised in the composition. The composition according to claim 13, characterized in that the multiparticulate modified release composition, the first population of particles comprising hydrocodone comprises between about 10% and about 40% of a hydrocodone comprised in the composition and the subsequent populations of the particles that comprise Hydrocodone comprises between about 60% and about 90% of the hydrocodone comprised in the composition. 15. The composition according to claim 13, characterized in that the multiparticulate modified release composition, the first population of hydrocodone comprising the particles comprises approximately 20% of the hydrocodone comprised in the composition and the subsequent populations of hydrocodone comprising the particles comprise approximately 80% of the hydrocodone comprised in the composition. 16. The composition according to claim 1, characterized in that the multiparticulate modified release composition, the first and subsequent populations of particles comprising hydrocodone have different release profiles. The composition according to claim 1, characterized in that the multiparticulate modified release composition, the first component is an immediate release component and at least one subsequent component is a modified release component. 18. The composition according to claim 17, characterized in that: (a) at the time of administration to a patient, it rapidly releases hydrocodone from the first population of particles comprising hydrocodone and releases at least about 80% of the hydrocodone from at least one subsequent population of hydrocodone-comprising particles within approximately 12 hours; or (b) at the time of administration to a patient, rapidly releases the hydrocodone from the first population of particles comprising hydrocodone and releases at least about 80% of the hydrocodone from at least one subsequent population of particles comprising hydrocodone in approximately 24 hours. 19. The composition according to claim 1, characterized in that the multiparticulate modified release composition, the release profile of the hydrocodone at the time of administration to a patient mimics the release profile of the same hydrocodone administered in the form of two or more dosages of immediate release forms of hydrocodone. The composition according to claim 1, characterized in that the multiparticulate modified release composition, the release profile of the hydrocodone at the time of administration to a patient mimics the release profile of the same hydrocodone administered in the form of two or more dosages of the hydrocodone in which a dosage has an immediate release profile and at least one dosage has a modified release profile. 21. A solid oral dosage form characterized in that they comprise the composition according to claim 1. 22. The dosage form according to claim 21, characterized in that the multiparticulate modified release composition comprises a combination of the first and the subsequent particles comprising hydrocodone filled in hard gelatine or soft gelatine capsules. 23. The dosage form according to claim 21, characterized in that the multiparticulate modified release composition comprises first and subsequent components that are separately and independently compressed into mini-tablets and filled into hard or soft gelatin capsules. 24. The dosage form according to claim 21, characterized in that the multiparticulate modified release composition, the first component is compressed in the first layer of a multilayer tablet and at least one subsequent component is Compresses on a back layer of the multilayer tablet. 25. The dosage form according to claim 21, characterized in that the multiparticulate modified release composition, the first and subsequent components are incorporated in a fast dissolving dosage form. 26. The dosage form according to claim 25, characterized in that the fast dissolving dosage form is a fast melting tablet dosage form. 27. The dosage form according to claim 21, characterized in that the hydrocodone is present at about 0.1 mg to about 1 g, or between about 10 mg to 80 mg. 28. The dosage form according to claim 21, characterized in that it comprises: (a) about 10 mg of hydrocodone and having a mean hydrocodone C max of between about 8.9 ng / mL + 20%; (b) about 10 mg of hydrocodone and having a Cmax of hydrocodone from about 5 to about 15 ng / mL; (c) approximately 20 mg of hydrocodone and that has an average hydrocodone Cmax between approximately 17.9 ng / mL + 20%; (d) about 20 mg of hydrocodone and having a Cmax of hydrocodone between about 10 to about 27 ng / mL; (e) about 30 mg of hydrocodone and having a Cmax of hydrocodone averages between about 31.7 ng / mL + 20%; (f) about 30 mg of hydrocodone and having a Cmax of hydrocodone between about 16 to about 46 ng / mL; (g) approximately 40 mg of hydrocodone and having a Cmax of hydrocodone averages between about 37.5 ng / mL + 20%; (h) about 40 mg of hydrocodone and having a Cmax of hydrocodone between about 28 to about 62 ng / mL; (i) about 10 mg to about 40 mg of hydrocodone and having a mean hydrocodone Tmax of about 6 hours ± 20%; (j) about 10 mg to about 40 mg of hydrocodone and having a Tmax of hydrocodone between about 4 to about 12 hours; (k) approximately 10 mg of hydrocodone and having an average hydrocodone AUCfini of about 109 ng * hr / mL + 20%; (1) about 10 mg of hydrocodone and having an AUCfini of hydrocodone between about 73 to about 179 ng * hr / mL; (m) about 20 mg of hydrocodone and having an average hydrocodone AUCfini of approximately 212.9 ng * hr / mL + 20%; (n) about 20 mg of hydrocodone and having an AUCfini of hydrocodone between about 130 to about 377 ng * hr / mL; (o) approximately 30 mg of hydrocodone and having an average hydrocodone AUCfini of approximately 392.5 ng * hr / mL + 20%; (p) about 30 mg of hydrocodone and having an AUCfini of hydrocodone between about 177 to about 671 ng * hr / mL; (q) approximately 40 mg of hydrocodone and having an average UCfinai of approximately 464.6 ng * hr / mL + 20%; (r) about 40 mg of hydrocodone and having an AUCfini of hydrocodone between about 321 to about 712 ng * / mL. 29. The composition according to claim 1, characterized in that the nanoparticulate meloxicam particle is selected from the group that it consists of a crystalline phase, an amorphous phase, a semi-crystalline phase, a semi-amorphous phase, and mixtures thereof. The composition according to claim 1, characterized in that the effective average particle sizes of the meloxicam particles are selected from the group consisting of less than about 1900 nm, less than about 1800 nm, less than about 1700 nm, less of about 1600 nm, less than about 1500 nm, less than about 1400 nm, less than about 1300 nm, less than about 1200 nm, less than about 1100 nm, less than about 1000 nm, less than about 900 nm, less than about 800 nm, less than about 700 nm, less than about 600 nm, less than about 500 nm, less than about 400 nm, less than about 300 nm, less than about 250 nm, less than about 200 nm, less than about 100 nm , less than about 75 nm, and less than about 50 nm. 31. The composition according to claim 1, characterized in that the composition is formulated: (a) for administration selected from the group consisting of parenteral injection, oral administration solid, liquid, or aerosol form, vaginal, nasal, rectal, otic, ocular, local, buccal, intracisternal, intraperitoneal, and topical administration; (b) in a dosage form selected from the group consisting of liquid dispersions, gels, sacs, solutions, aerosols, ointments, tablets, capsules, creams, and mixtures thereof; (c) in a dosage form selected from the group consisting of controlled release formulations, fast melt formulations, lyophilized formulations, delayed release formulations, sustained release formulations, pulse release formulations, and immediate release and release formulations controlled mixed; or (d) any combination thereof. 32. The composition according to claim 1, characterized in that: (a) meloxicam is present in an amount ranging from about 99.5% up to 0.001%, between about 95% up to 0.1%, or between about 90% up to 0.5% in weight, based on the combined total dry weight of meloxicam and at least one surface stabilizer, not including other excipients; (b) at least one surface stabilizer is present in an amount between about 0.5% up to 99. 999% by weight, between about 5.0% to 99.9% by weight, or between about 10% to 99.5% by weight, based on the combined total dry weight of meloxicam and at least one surface stabilizer, not including other excipients; or (c) a combination thereof. The composition according to claim 1, characterized in that the surface stabilizer is selected from the group consisting of a nonionic surface stabilizer, an anionic surface stabilizer, a cationic surface stabilizer, a zwitterionic surface stabilizer, and a surface stabilizer. ionic. 34. The composition according to claim 1, characterized in that the surface stabilizer is selected from the group consisting of cetylpyridinium chloride, gelatin, casein, phosphatides, dextran, glycerol, acacia gum, cholesterol, tragacanth, stearic acid, benzalkonium chloride, calcium stearate, glycerol monostearate, cetostearyl alcohol, cetomacrogol emulsifying wax, sorbitan esters, polyoxyethylene alkyl ethers, polyoxyethylene castor oil derivatives, polyoxyethylene sorbitan fatty acid esters; polyethylene glycols, dodecyltrimethylammonium bromide, polyoxyethylene stearates, colloidal silicon dioxide, phosphates, sodium dodecylsulfate, calcium carboxymethylcellulose, hydroxypropylcelluloses, hypromellose, sodium carboxymethylcellulose, methylcellulose, hydroxyethylcellulose, hypromellose phthalate, noncrystalline cellulose, magnesium aluminum silicate, triethanolamine, polyvinyl alcohol, polyvinylpyrrolidone, polymer 4- (1,1, 3,3-tetramethylbutyl) -phenol with ethylene oxide and formaldehyde, poloxamers, poloxamines, a charged phospholipid, dioctylsulfosuccinate, dialkylesters of sodium sulfosuccinic acid, sodium lauryl sulfate, alkylaryl sulfonate, mixtures of sucrose stearate and sucrose distearate, p-isononylphenoxypoly- (glycidol), decanoyl-N-methylglucamide, n-decyl-pD-glucopyranoside, n-decyl-p-maltopyranoside, n-dodecyl-D-glucopyranoside, n-dodecyl maltoside pD- , heptanoyl-N-methylglucamido, n-heptyl-pD-glucopyranoside, n-heptyl-pD-thioglucoside, n-hexyl- -D-glucopyranoside, nonanoyl-N-methylglucamido, n - ???? - ß-Dg lucopiranosido, octanoyl-N-metilglucamido, n-octyl-pD-glucopyranoside, octyl-pD-thioglucopyranoside, lysozyme, PEG-phospholipid, PEG-cholesterol derivatives, PEG-cholesterol, PEG-vitamin A, PEG-vitamin E, lysozyme, random copolymers of vinyl acetate and vinylpyrrolidone, a cationic polymer, a bipolymer cationic, a cationic polysaccharide, a cationic cellulose, a cationic alginate, a cationic nano-polymeric compound, cationic phospholipids, cationic lipids, trimethylammonium bromide, polymethylmethacrylate, sulfonium compounds, polyvinylpyrrolidone-2-dimethylaminoethyl methacrylate, hexadecyltrimethylammonium bromide, phosphonium compounds , quaternary ammonium compounds, benzyl-di (2-chloroethyl) ethylammonium bromide, cocotrimethylammonium chloride, cocotrimethylammonium bromide, cocomethyldihydroxyethylammonium chloride, cocomethyldihydroxyethylammonium bromide, decyltriethylammonium chloride, decyldimethylhydroxyethylammonium chloride, decyldimethylhydroxyethylammonium bromide, Ci2- chloride i5dimetilhidroxietilamonio bromide C12-i5dimetilhidroxietilamonio of cocodimetilhidroxietilamonio chloride, bromide cocodimetilhidroxietilamonio methylsulfate myristyl, lauryldimethylbenzylammonium chloride, bromide laurildimetilbencila monio, lauryldimethyl (ethenoxy) 4 ammonium chloride, lauryldimethyl (ethenoxy) 4 ammonium bromide, N-alkyl (C12-is) dimethylbenzylammonium chloride, N-alkyl (C-e) dimethyl chloride benzylammonium, N-tetradecilmetilbencilamonio monohydrate, dimethyldidecylammonium chloride, N-alkyl coluro and (C12-14) dimethyl-l-naftilmetilamonio, trimethylammonium halide, alkyltrimethylammonium salts, dialkyl dimethylammonium salts chloride, lauryltrimethylammonium chloride, ethoxylated alkylamidoalkyldialkylammonium salt, an ethoxylated trialkylammonium salt, dialkylbenzenedialkylammonium chloride, N-didecyldimethylammonium chloride, N-tetradecyldimethylbenzylammonium chloride monohydrate, N-alkyl (C12-14) dimethyl-l-naphthylmethylammonium chloride, chloride of dodecyldimethylbenzylammonium, dialkylbenzealkylammonium chloride, lauryltrimethylammonium chloride, alkylbenzylmethylammonium chloride, alkylbenzyldimethylammonium bromide, Ci.sub.2.trimethylammonium bromides, Cistrimethylammonium bromides, C.sub.7.trimethylammonium bromides, dodecylbenzyltriethylammonium chloride, poly-diallyldimethylammonium chloride (DADMAC), dimethylammonium chlorides, alkyldimethylammonium, tricetylmethylammonium chloride, decyltrimethylammonium bromide, dodecyltriethylammonium bromide, tetradecyltrimethylammonium bromide, methyltrioctylammonium chloride, POLYQUAT 10MR, tetrabutylammonium bromide, benzyltrimethylammonium bromide, coli esters na, chloride benzalkonium, stearalkonium chloride compounds, cetylpyridinium bromide, cetylpyridinium chloride, quaternized polyoxyethylalkylamino halide salts, MIRAPOL ™, ALKAQUAY ™, alkylpyridinium salts; amines, amine salts, amine oxides; imidazole salts; protonated quaternary acrylamides; methylated quaternary polymers, and cationic guar. 35. The composition according to claim 1, characterized in that the composition does not produce significantly different meloxicam absorption levels when administered under feeding conditions compared to fasting conditions. 36. The composition according to claim 1, characterized in that the administration of the composition to a subject in a fasting state is bioequivalent to the administration of the composition to a subject in a feeding state. 37. The composition according to claim 36, characterized in that "bioequivalence" is established by: (a) a 90% confidence interval between 0.80 and 1.25 for Cmax and AUC; or (b) a 90% confidence interval between 0.80 and 1.25 for AUC and a 90% confidence interval of between 0.70 to 1.43 for Cmax. 38. The composition according to claim 1, characterized in that: (a) the T ax of meloxicam or a salt or derivative thereof, when analyzed in the plasma of a mammalian subject after administration, is less than for a non-nanoparticulate composition of the same meloxicam, administered at the same dosage; (b) the Cmax of meloxicam or a salt or derivative thereof, when analyzed in the plasma of a mammalian subject after administration, is greater than the Cmax of a non-nanoparticulate composition of the same meloxicam, administered at the same dosage; (c) the AUC of meloxicam or a salt or derivative thereof, when analyzed in the plasma of a mammalian subject after administration, is greater than the AUC for a non-nanoparticulate composition of the same meloxicam, administered at the same dosage; or (d) any combination thereof. 39. A method for treating pain characterized in that they comprise administering a therapeutically effective amount of a composition according to claim 1.
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