Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
  • A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/2004—Excipients; Inactive ingredients
  • A61K9/2022—Organic macromolecular compounds
  • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
  • A61K9/2054—Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/28—Dragees; Coated pills or tablets, e.g. with film or compression coating
  • A61K9/2806—Coating materials
  • A61K9/2833—Organic macromolecular compounds
  • A61K9/286—Polysaccharides, e.g. gums; Cyclodextrin
  • A61K9/2866—Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
  • A61P25/16—Anti-Parkinson drugs
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/18—Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• This invention relates to sustained release formulations of dopaminergic compounds, including S-2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one (aplindore) and pharmaceutically acceptable salts thereof.
• the potent and selective D2/D3 partial agonist aplindore (S-2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one) has been identified as a treatment for schizophrenic patients.
• aplindore results in high initial drug concentrations.
• Such an “immediate release” pattern can pose difficulties, which include failure to maintain optimal exposure levels over time, and unpleasant side effects from having too large initial dose.
• This invention is directed to these, as well as other, important ends.
• the present invention provides controlled release dosage formulations comprising a compound of Formula I: wherein:
• the compound is 2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one, or a pharmaceutically acceptable salt thereof.
• the compound is S-2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one (aplindore), or a pharmaceutically acceptable salt thereof:
• the compound is aplindore fumarate.
• the controlled release dosage formulation is an oral dosage formulation.
• the formulation comprises one or more microparticles, which can be, for example, pellets, beads, tablets, spheroids or combinations of two or more thereof.
• the compound is released from said dosage form at a rate effective to increase the time it takes to reach maximum therapeutic concentration (i.e., T max ) as compared to the T max of an instant release formulation, for example, so that the T max of the controlled release dosage formulation is at least about 1.5 times, 2 times, 2.5 times, 3 times, 4 times, 5 times or 5.5 times the T max of an instant release formulation.
• T max maximum therapeutic concentration
• the compound is released from said dosage form at a rate effective to decrease the maximum therapeutic concentration of said compound (i.e., C max ) compared to the C max of an instant release formulation, for example, so that the C max of the controlled release dosage formulation is less than about 0.75 times, 0.60 times, 0.50 times, or 0.40 times the C max of an instant release formulation.
• C max the maximum therapeutic concentration of said compound
• the compound is released from the dosage form at a rate effective to increase the pharmaceutically effective concentration of the compound in a mammal over a time period (i.e., area under the plasma (serum or blood) concentration versus time curve, AUC, such as AUC 0-12 ) relative to an instant release formulation, for example, so that the AUC 0-12 of the controlled release dosage formulation is at least about 1.05 times, 1.1 times 1.2 times, 1.3 times, or 1.4 times the AUC 0-12 of the instant release formulation.
• a time period i.e., area under the plasma (serum or blood) concentration versus time curve, AUC, such as AUC 0-12
• AUC area under the plasma (serum or blood) concentration versus time curve
• the compound is released from a 0.1 mg dosage form at a rate effective to provide an area under the plasma (serum or blood) concentration versus time curve (AUC) from zero to twelve (12) hours (AUC 0-12 ) from about 260 pg*h/mL to about 2400 pg*h/mL; while for other such embodiments the AUC 0-12 is from about 290 pg*h/mL to about 1300 pg*h/mL.
• AUC can be measured as described in Principles of Drug Action: The Basis of Pharmacology, 3 rd ed., W. B. Pratt & P. Taylor, eds., (Churchill Livingstone: New York), 1990.
• 5 mg of the compound provides an AUC ss (area under the curve at steady state, from 0 to 12 hours) from about 36000 pg*h/mL to about 109000 pg*h/mL; while others provide an AUC ss from about 36000 pg*h/mL to about 75000 pg*h/mL.
• 30 mg of the compound provides an AUC 0-12 from about 121000 pg*h/mL to about 890000 pg*h/mL, while other such embodiments provide an AUC 0-12 from about 170000 pg*h/mL to about 760000 pg*h/mL.
• the compound is released from 0.1 mg dosage form at a rate effective to provide a maximum plasma (serum or blood) concentration (C max ) from about 40 pg/mL to about 190 pg/mL; and in other such embodiments from about 40 pg/mL to about 180 pg/mL.
• Maximum plasma concentration is measured as described in Principles of Drug Action: The Basis of Pharmacology, 3 rd ed., W. B. Pratt & P. Taylor, eds., (Churchill Livingstone: New York), 1990; Human Pharmacology: Molecular to Clinical, K. Kist, ed. (Mosby-Year Books: Philadelphia), 1991.
• 5 mg of the compound provides a C max from about 4000 pg/mL to about 14000 pg/mL, while in other such embodiments, the C max is from about 6000 pg/mL to about 12000 pg/mL. In some embodiments, 30 mg of the compound provides a C max from about 18000 pg/mL to about 110000 pg/mL; in other such embodiments, the C max is from about 20000 pg/mL to about 92000 pg/mL.
• dosages are gradually increased (i.e., titrated) over time (e.g., days or weeks) to the desired dosage to avoid or lessen the severity of possible side effects such as nausea or other indications of patient intolerability.
• time e.g., days or weeks
• some embodiments of the present invention provide for the administration of increasing dosages incrementally where the starting dose ranges from about 0.05 mg to about 0.4 mg per day.
• the dosages are increased incrementally over a period of time to an ending dose, which it or a dose of a greater amount is administered on a daily basis thereafter, and which may range for example, from about 2 mg to about 75 mg per day.
• the dose titration period to reach the ending dose is at least about 3 days, at least about 5 days, at least about 12 days, or at least about 15 days.
• a set of controlled release dosage forms which comprise a plurality of individual controlled release dosage forms, where two or more of the individual dosage forms comprise different amounts of the compound.
• the individual dosage form may be a single unit dosage (e.g., one tablet or capsule), or may include multiple unit dosages (e.g., 2 or more tablets or capsules).
• the set of controlled release dosage formulations has 2 or more individual controlled release dosage forms containing a starting dose and an ending dose (where the ending dose or a dose of a greater amount is administered on a daily basis thereafter and the ending dose is greater than the starting dose).
• the set may contain two or more different individual controlled release dosage forms ranging from about 0.05 mg to about 30 mg of compound.
• the set of controlled release dosage formulations have at least two or more of the individual controlled release dosage forms selected from 0.05 mg, 0.1 mg, 0.2 mg, 0.25 mg, 0.3 mg, 0.4 mg, 0.5 mg, 0.6 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 8 mg, 10 mg, 11 mg, 12 mg, 13 mg, 14 mg, 15 mg, 16 mg, 17 mg, 20 mg, 23 mg, 24 mg, 25 mg, 26 mg or 30 mg of the compound.
• the set of controlled release dosage formulations has at least two of the individual controlled release dosage forms containing a different amount of the compound with the amount of the compound in each of the different dosage forms differing by at lease ten percent, and more preferably at least 20 percent.
• each of the individual dosage forms provides an AUC 0-12 ranging from about 260 pg*h/mL to about 890000 pg*h/mL.
• the oral controlled release dosage formulations include at least some of microparticles, which include an inert core; a layer of the active compound disposed on the inert core; and a coating comprising at least one release rate controlling polymer disposed on the layer of the compound. In some embodiments, all of the microparticles include the inert core, the layer of compound, and the coating.
• the oral controlled release dosage formulations include at least some of microparticles, which include an inert core; a coating layer disposed on the inert core, the coating layer including the compound and at least one release rate controlling polymer. In some embodiments, all of the microparticles include the inert core and the coating layer.
• the oral controlled release dosage formulations include at least some of microparticles, which include a core that includes the active compound; and a coating layer disposed on the core, the coating layer including at least one release rate controlling polymer. In some embodiments, all of the microparticles include the core that includes the compound, and the coating layer.
• the oral controlled release dosage formulations include at least some of microparticles, which include a core, the core including the compound and at least one release rate controlling polymer; and a coating layer disposed on the core, the coating layer optionally including at least one release rate controlling polymer. In some embodiments, all of the microparticles include the core that includes the compound and the coating layer.
• the percentage by weight of the active compound in the formulation is from about 1% to about 25%, preferably from about 2% to about 15%, preferably from about 5% to about 10%.
• the formulation includes capsules containing the microparticles.
• the microparticles are compressed into a tablet or a pellet.
• the oral controlled release dosage formulations include one or more pellets.
• the pellets further include a coating that further includes at least one release rate controlling polymer.
• the pellets are contained within a capsule.
• the formulation further includes one or more ingredients selected from fillers, disintegrants, excipients, and combinations of two or more thereof.
• the pellets and ingredients are compressed into tablets.
• the percentage by weight of the active compound in the formulation is from about 1% to about 25%, preferably from about 2% to about 15%, preferably from about 5% to about 10%.
• the formulation comprises a wax matrix, preferably wherein the formulation is a tablet.
• the wax is present in a total amount by weight of from about 10% to about 60%, preferably from about 20% to about 40%, preferably.
• the wax includes carnauba wax, cetostearyl alcohol, fatty acids, or a mixture or two or more thereof.
• the wax-containing formulation further includes at least one release rate-controlling polymer.
• the oral controlled release dosage formulation is a tablet further including a coating that includes a water soluble polymer, and/or at least one release-rate controlling polymer.
• the oral controlled release dosage formulations of the invention include a polyethylene oxide matrix, preferably wherein the formulation is a tablet.
• the tablet includes a polyethylene oxide matrix.
• the polyethylene oxide is present in a total amount by weight of from about 5% to about 40%, preferably from about 10% to about 20%, of the formulation.
• the oral controlled release dosage formulation is a tablet that includes at least one release rate controlling polymer.
• the dosage form is a co-compressed tablet.
• the co-compressed tablet includes a core and an outer compressed coat; wherein the core includes active compound and at least one release rate controlling polymer.
• the co-compressed tablet includes a core and an outer compressed coat; wherein the compressed coat includes active compound and at least one release rate controlling polymer.
• the co-compressed tablet includes a core and an outer compressed coat; wherein each of the core and the compressed coat includes active compound and at least one independently selected release rate controlling polymer.
• the core and the outer compressed coat each contain at least one high viscosity matrix forming hydroxypropyl methyl cellulose, and at least one low viscosity matrix forming hydroxypropyl methyl cellulose.
• the low viscosity matrix forming polymer comprises a hydroxypropyl methylcellulose selected from Methocel K100LV, Methocel E50LV, Methocel E5, Methocel E15LV or a combination of two or more thereof; and the high viscosity matrix forming polymer includes a hydroxypropyl methylcellulose selected from Methocel K4M, Methocel K15M, Methocel K100M, Methocel E4M and combinations of two or more thereof.
• the low viscosity matrix forming polymer includes Methocel K100LV
• the high viscosity matrix forming polymer includes Methocel K4M.
• the formulation includes at least one matrix forming polymer, which preferably is selected from waxes, gums, hydroxypropyl methylcelluloses, hydroxyethyl celluloses, hydroxypropyl celluloses, carbapols, polymethacrylates, polyethylene oxides, and combinations of two or more thereof.
• the active compound is present in an amount of from about 0.02% to about 16% by weight, preferably from about 0.02% to about 4% by weight of the formulation.
• the formulations include one high viscosity hydroxypropyl methyl cellulose and one low viscosity hydroxypropyl methyl cellulose.
• the high viscosity matrix forming polymer includes a hydroxypropyl methylcellulose selected from Methocel K4M, Methocel K15M, Methocel K100M, Methocel E4M and combinations of two or more thereof.
• the hydroxypropyl methylcellulose is present in an amount by weight of from about 15% to about 80%, preferably about 25% to about 50%, and is preferably Methocel K4M.
• the low viscosity hydroxypropyl methyl cellulose includes Methocel K100LV, Methocel E50LV, Methocel E5, Methocel E15LV or a combination of two or more thereof, preferably in an amount by weight of from about 15% to about 80%, preferably from about 20% to about 50%, and is preferably Methocel K100LV.
• the oral controlled release dosage formulations of the invention can include a water soluble excipient, preferably in an amount by weight of up to about 50%, preferably from about 2% to about 25%.
• the excipient is a sugar.
• the oral controlled release dosage formulations of the invention can include a water dispersing excipient, which is preferably microcrystalline cellulose, colloidal silicone dioxide, silicified microcrystalline cellulose, starch, a super disintegrant, or a combination of two or more thereof.
• a water dispersing excipient is present in an amount by weight of from about 2% to about 50%, preferably from about 5% to about 25%.
• the oral controlled release dosage formulations of the invention include one or more of antioxidants, stabilizers, chelating agents, acidic pH modifiers, basic pH modifiers, or combinations of two or more thereof.
• the oral controlled release dosage formulations of the invention include one or more of a binder, a flow aid, lubricant, or a solubility modifier, which can be a surfactant, an acidic compound or a basic compound.
• the oral controlled release dosage formulations of the invention include a coating that includes a water soluble polymer and a coloring agent, and/or a pH dependent release rate controlling polymer, a pH independent release rate controlling polymer, or a combination thereof.
• the dosage form includes one or more release rate controlling polymers, which can be, for example, one or more of polymethacrylates, methacrylic acid-methacrylic acid ester copolymers, cellulose acetate phthalate, ethyl cellulose, polyvinyl acetate-phthalate, hydroxypropylmethylcellulose phthalate, or combinations of two or more thereof.
• the release rate controlling polymer can be one or more of polymethacrylates, methacrylic acid-methacrylic acid ester copolymers, ethyl cellulose, or combinations of two or more thereof.
• the release rate controlling polymer is selected from high viscosity matrix forming hydroxypropyl methyl celluloses and low viscosity matrix forming hydroxypropyl methyl celluloses.
• the high viscosity matrix forming polymer comprises a hydroxypropyl methylcellulose selected from Methocel K4M, Methocel K15M, Methocel K100M, Methocel E4M and combinations of two or more thereof.
• the low viscosity matrix forming polymer comprises a hydroxypropyl methylcellulose selected from Methocel K100LV, Methocel E50LV, Methocel E5, Methocel E15LV or a combination of two or more thereof.
• the release rate controlling polymer comprises of one or more of Eudragit RS, Eudragit RL, Surelease, or combinations of two or more thereof.
• the oral controlled release dosage formulations of the invention include one or more solubility modifiers, for example surfactants, acidic compounds, basic compounds, and combinations thereof.
• the oral controlled release dosage formulations of the invention include one or more of antioxidants, pH modifiers, metal chelators, or combinations of one or more thereof.
• the oral controlled release dosage formulations of the invention can include one or more of fillers, disentegrants, binders, or combinations of one or more thereof.
• the oral controlled release dosage formulations of the invention include one or more fillers, binders, disintegrants, lubricants, stabilizers, pH modifiers, antioxidants or combinations of two or more thereof.
• the oral controlled release dosage formulations of the invention include a pharmaceutically effective amount of an active compound; a high viscosity hydroxypropyl methyl cellulose in an amount of from about 20% to about 60% by weight; and a low viscosity hydroxypropyl methyl cellulose in an amount of from about 20% to about 60% by weight.
• the oral controlled release dosage formulations of the invention include a pharmaceutically effective amount of an active compound, a water soluble compensating excipient in an amount of from about 0.5% to about 5% by weight; a water dispersible excipient in an amount of from about 5% to about 30% by weight; a high viscosity hydroxypropyl methyl cellulose in an amount of from about 20% to about 60% by weight; a low viscosity hydroxypropyl methyl cellulose in an amount of from about 20% to about 60% by weight; and, optionally, a lubricant in an amount of from about 0.1% to about 1% by weight.
• the oral controlled release dosage formulations of the invention include a pharmaceutically effective amount of an active compound; a water dispersible excipient in an amount of from about 10% to about 30% by weight; a high viscosity hydroxypropyl methyl cellulose in an amount of from about 20% to about 40% by weight; a low viscosity hydroxypropyl methyl cellulose in an amount of from about 20% to about 40% by weight; and, optionally, a lubricant in an amount of from about 0.1% to about 1% by weight.
• the present invention provides methods of treating a disorder of the dopaminergic system that include administering to a patient in need of such treatment a controlled release dosage formulation according to the invention.
• the present invention provides methods for the treatment of schizophrenia, schizoaffective disorder, Parkinson's disease, Tourette's syndrome, psychosis in Lewis Body disease, psychosis in Alzheimer's disease, hyperprolactinemia, drug addiction or acute mania in bipolar disorder, comprising administering to a patient in need of such treatment a controlled release dosage formulation according to the invention.
• the present invention provides methods for the treatment of symptoms of Parkinson's disease, comprising administering to a patient in need of such treatment a controlled release dosage formulation according to the invention.
• the present invention also provides processes for preparing the formulations provided herein, and products of those processes.
• the present invention provides controlled release dosage formulations that include as an active ingredient a compound of Formula I: wherein the constituent variables are as described supra.
• active compound is intended to refer to compounds of Formula I, and particularly 2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one, S-2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one (aplindore), and their pharmaceutically acceptable salts, preferably but not limited to their fumarate salts, and prodrugs of the foregoing.
• the dosage formulations described herein facilitate the controlled release of active compounds in a mammal through many routes, including oral administration.
• the formulations include the compound S-2-[(Benzylamino)-methyl]-2,3,8,9-tetrahydro-7H-1,4-dioxino[2,3-e]indol-8-one, referred to as aplindore, preferably the fumarate salt thereof.
• Aplindore may form pharmaceutically acceptable salts with various acids including inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, perchloric acid, nitric acid, iodic acid, and the like as well as organic acids such as oxalic acid, fumaric acid, succinic acid, acetic acid, benzoic acid, glycolic acid, malic acid, citric acid, methane sulfonic acid, benzene sulfonic acid, salicyclic acid, para-toluene sulfonic acid, adipic acid, and the like. Formulations including all such salts are within the scope of the present invention.
• inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, perchloric acid, nitric acid, iodic acid, and the like
• organic acids such as oxalic acid, fumaric acid, succinic acid, acetic acid, benzoic acid, glycolic acid, mal
• prodrug has its accustomed meaning of a covalently modified derivative of a compound or a pharmaceutically acceptable salt thereof, wherein such modification results in a derivative that is metabolically labile and after administration to a mammal, and results in liberation of the parent compound in the gut, plasma or tissue.
• Such derivatives may be prepared by esterification, acylation or otherwise modifying the compound in such a way as to incorporate a physiologically labile group.
• Aplindore contains one chiral center and is used predominately as the S-isomer. However, activity also resides in the R-isomer.
• the formulations of the present invention include both isomers, and are not limited to a single enantiomer or particular enantiomeric mixture.
• instant release refers to formulations that provide a rapid and non-gradual release of active compound from the formulation; i.e., formulations that contain active compound and a rapidly dissolving carrier that does not retard the release of the active compound from the formulation.
• Such instant release formulation are either devoid of release rate controlling polymers or other species that retard the release of the active compound from the formulation, or contain such polymers or species in amounts that are sufficiently small such that the release of the active compound from the formulation is not retarded relative to an otherwise identical formulation lacking such polymers or species.
• an “instant release” formulation is active compound blended in the microcrystalline cellulose Avicel, which results in greater than 75% dissolution of aplindore or a pharmaceutically acceptable salt thereof in less than 0.25 hours in a 0.1 N HCl solution as described infra.
• slow release slow release
• medium release slow release
• fast release controlled release formulations as described herein, above, that release active compound at a rate that is slow, medium or fast rate relative to each other.
• controlled release As used herein, the terms “controlled release”, “controlled release formulation”, “controlled release dosage formulation” and the like refer to formulations that contain materials that retard the release of active compound from the formulation relative to an “instant release” formulation as described above, e.g., relative to an otherwise identical formulation lacking the release rate controlling polymer or other release-retarding materials.
• controlled release can apply to any number of extended release forms and will be considered substantially synonymous with delayed release, time release, prolonged release, time programmed release, time released, time coated release, sustained release, slow acting, long acting, delayed acting, spaced release, time spaced release, extended acting, extended action, and the like.
• controlled release formulations can result in a release of active compound from the dosage form at a rate effective to increase the time it takes to reach maximum therapeutic concentration (i.e., T max ) as compared to the T max of an instant release formulation, for example, so that the T max of the controlled release dosage formulation is at least about 1.5 times, 2 times, 2.5 times, 3 times, 4 times, 5 times or 5.5 times the T max of an instant release formulation.
• Controlled release formulations can also result in release of active compound from the dosage form at a rate to decrease the maximum therapeutic concentration of said compound (i.e., C max ) compared to the C max of an instant release formulation, for example, so that the C max of the controlled release dosage formulation is less than about 0.75 times, 0.60 times, 0.50 times, or 0.40 times the C max of an instant release formulation.
• C max the maximum therapeutic concentration of said compound
• Controlled release formulations can also result in release of the active compound from the dosage form at a rate effective to increase the pharmaceutically effective concentration of the compound in a mammal over a time period (i.e., area under the plasma (serum or blood) concentration versus time curve, AUC, such as AUC 0-12 ) relative to an instant release formulation, for example, so that the AUC 0-12 of the controlled release dosage formulation is at least about 1.05 times, 1.1 times 1.2 times, 1.3 times, or 1.4 times the AUC 0-12 of the instant release formulation.
• AUC area under the plasma (serum or blood) concentration versus time curve
• release rate controlling polymer is intended to denote any polymer material suitable for pharmaceutical dosage forms that retard the release of drug substances from such dosage forms. Examples of suitable release rate controlling polymers can be found in Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990), incorporated by reference herein in its entirety for all purposes.
• Some preferred release rate controlling polymers suitable for use in the present invention include, without limitation, one or more of polymethacrylates, methacrylic acid-methacrylic acid ester copolymers, cellulose acetate phthalate, ethyl cellulose, polyvinyl acetate-phthalate, hydroxypropylmethylcellulose phthalate, high viscosity matrix forming hydroxypropyl methyl celluloses such as Methocel K4M, Methocel K15M, Methocel K100M, Methocel E4M, and low viscosity matrix forming hydroxypropyl methyl celluloses such as Methocel K100LV, Methocel E50LV, Methocel E5, Methocel E15LV or a combination of two or more thereof.
• Further preferred release rate controlling polymers include one or more of Eudragit RS, Eudragit RL, Surelease, or combinations of two or more thereof.
• the different release rate controlling polymers confer different release rate properties to the formulation.
• a wide variety of release profiles of active compound can be achieved.
• Those skilled in the art are credited with the ability to select appropriate polymers in appropriate amounts to achieve desired release rates of active compound.
• Controlled release solid formulations of aplindore, or pharmaceutically acceptable salts of aplindore can include any of the many dosage forms known in the art, including tablets, for example co-compressed tablets and matrix tablets, encapsulated dosage forms such as capsules or pellets containing microparticles in the form of pellets, beads, tablets, spheroids or combinations of two or more thereof, powders and the like.
• the controlled release formulation can contain microparticles that contain active compound, and at least one release rate controlling polymer in a location suitable to retard release of the active compound.
• microparticles can be in the form of, for example, pellets, beads or spheroids.
• the microparticles include a core and at least one coating layer. Either of the core and the coating layer can either be inert (i.e., contain no active compound) or can contain active compound, provided that at least one of the core or one coating layer contain active compound.
• the microparticles are contained within a capsule, or compressed into a tablet.
• microparticlate dosage formulations of the invention can contain active compound in any convenient percentage by weight.
• the formulation contains active compound in percentage by weight of from about 1% to about 25%, preferably from about 2% to about 15%, preferably from about 5% to about 10%.
• the formulations of the invention can contain any of a variety of additional materials that confer beneficial properties to the formulation.
• additional materials include, for example, solubility modifiers such as surfactants, acidic compounds and basic compounds, antioxidants, acidic and basic pH modifiers, chelating agents, fillers, disentegrants, binders, lubricants, stabilizers, excipients including water soluble excipients such as sugars and water dispersing excipients such as microcrystalline cellulose, colloidal silicone dioxide, silicified microcrystalline cellulose and starch.
• Nonlimiting examples of water soluble or water dispersing excipients include lactose, mannitol, sucrose, and the like.
• the water soluble excipients may be present in a range depending upon the particular therapeutic objective required. In general, the range of water soluble excipients is from 0 to 50%, or 2 to 25%.
• Examples of water dispersible excipients include microcrystalline cellulose, colloidal silicone dioxide, silicified microcrystalline cellulose (Prosolve), starches, superdisintegrants such as croscarmelose sodium and the like.
• the range of water dispersible excipients is typically from about 5% to about 50%, preferably from about 10% to about 30% by weight.
• Non-limiting examples of stabilizers include antioxidants such as BHA, BHT, ascorbic acids, tocopherols, and the like.
• suitable metal chelators include EDTA, citric acid and the like.
• Nonlimiting examples of pH modifiers that are either acidic or basic compounds such as citric acid, sodium citrate, fumaric acid, sodium fumarate and the like.
• Nonlimiting examples of binders include starches, PVP, HPMC, HPC and the like.
• Nonlimiting examples flow aids include magnesium stearate and the like.
• Nonlimiting examples of solubility modifiers include surfactants like SLS or Tween 80, and the like.
• the formulations of the invention are in the form of coated pellets or spheres.
• One nonlimiting example of such formulations is spheres containing a core of active compound in an inert matrix, coated with a release rate controlling polymer as disclosed herein.
• a suitable release rate controlling polymers are pH dependent or independent polymers, such as polymethacrylates Eudragit L/S, Eudragit RS/RL, cellulose acetate phthalate, ethyl cellulose and the like.
• Further examples include one or more of high viscosity matrix forming hydroxypropyl methyl cellulose, and low viscosity matrix forming hydroxypropyl methyl celluloses as described herein.
• the formulations of the invention are in the form of pellets.
• examples of such formulations include those containing pellets that contain a layer of active compound on top of an inert core, for example a sugar sphere, and a surface coating containing one or more release rate controlling polymers.
• the formulations of the invention are in the form of tablets.
• the percentage by weight of active compound in the formulation is from about 1% to about 25%, preferably from about 2% to about 15%, preferably from about 5% to about 10%.
• Nonlimiting examples of such tablets are co-compressed tablets (i.e., a “tablet-in-tablet), and matrix tablets.
• the co-compressed tablet includes a core and an outer compressed coat.
• Either or both of the core and the outer compressed coat can contain active compound and/or one or more release rate controlling polymers.
• the dosage form is a co-compressed tablet wherein both the core and the outer compressed coat contain active compound, and at least one, preferably two, release rate controlling polymers, one of which is preferably a high viscosity matrix forming hydroxypropyl methyl cellulose, and the other of which is preferably a low viscosity matrix forming hydroxypropyl methyl celluloses.
• Preferred high viscosity matrix forming polymers include a hydroxypropyl methylcellulose selected from Methocel K4M, Methocel K15M, Methocel K100M, Methocel E4M and combinations of two or more thereof, preferably Methocel K4M.
• Preferred low viscosity matrix forming polymers include hydroxypropyl methylcelluloses selected from Methocel K100LV, Methocel E50LV, Methocel E5, Methocel E15LV or a combination of two or more thereof, preferably Methocel K100LV.
• the tablet is a matrix tablet.
• the matrix forming composition may contain waxes, gums, polyethylene oxides, carbapols, hydroxypropyl methylcelluloses, hydroxyethyl celluloses, polymethacrylates or other release rate controlling polymers as described herein.
• such matrix tablets are prepared by blending the active compound and the matrix forming polymer together, and compressing the blend.
• the tablet is a matrix tablet that includes a wax matrix.
• a wax matrix such as carnauba wax, cetostearyl alcohol or fatty acids, or combinations thereof, and adding active compound along with a filler such as microcrystalline cellulose as well as other excipients, fillers, lubricants and the like, and allowing the mixture to cool.
• the formulations prepared maybe optionally coated with or contain one or more water soluble or release rate controlling control release polymers.
• the wax is present in the formulation in a total amount by weight of from about 10% to about 60%, preferably from about 20% to about 40%, preferably from about 10% to about 60%.
• suitable waxes are amenable to the present invention. Nonlimiting examples of such waxes include carnauba wax, cetostearyl alcohol, fatty acids, or a mixture or two or more thereof.
• the matrix tablet also can contain one or more release rate-controlling polymers as described herein.
• a further nonlimiting example of such a matrix tablet is a tablet that includes a polyethylene oxide matrix, for example and not limitation, polyethylene oxide resins such as SENTRY POLYOX (Union Carbide Corp.) or equivalents.
• Suitable POLYOX's include POLYOX WSR N-10, N-60 K, WSR-1105N, WSR 303.
• the POLYOX used may have a molecular weight in the range of 100,000 to 7,000,000 or 900,000 to 5,000,000.
• the polyethylene oxide is present in the formulation in a total amount by weight of from about 5% to about 40%, preferably from about 10% to about 20% of the formulation.
• the matrix tablet also can contain one or more release rate-controlling polymers as described herein.
• a further nonlimiting example of such a matrix tablet is a tablet that includes one or more release rate controlling polymers as described herein as the matrix forming polymer.
• such tablets include one or more high viscosity matrix forming hydroxypropyl methyl celluloses, and/or one or more low viscosity matrix forming hydroxypropyl methyl celluloses as described herein as the matrix forming polymer.
• High viscosity polymers may also be used such as Methocel K15M, Methocel K100M, or Methocel E4M and the like.
• a low viscosity hydroxypropyl methylcellulose is used such as MethocelE50LV, Methocel E5, or MethocelE15LV or combinations thereof and the like.
• both a high viscosity and a low viscosity hydroxypropyl methylcellulose are used in the matrix together wherein the low viscosity hydroxypropyl methylcelluloses is present in a range of from about 15% to 80%, preferably from about 25% to about 50%, and the high viscosity hydroxypropyl methylcellulose is present in an amount by weight of from about 20% to about 50%.
• active compound may be contained within any layer of a dosage form of the invention, and controlled release of the active compound can be achieved by the use of a release rate controlling polymer either contained within the layer containing the active compound, or in any layer encompassing the layer containing the active compound, for example an enteric coating.
• a release rate controlling polymer either contained within the layer containing the active compound, or in any layer encompassing the layer containing the active compound, for example an enteric coating.
• Such an enteric coating may also be applied to pellets, beads or spheroids containing active compound, or the active compound can be contained within the enteric coating itself.
• the controlled release dosage formulation is a matrix tablet formulation where the active compound is present in an amount by weight of from about 0.02% to about 16%, preferably from about 0.02% to about 4%.
• the tablets of the formulations of the invention can be coated with water soluble polymer coloring agents, or coated with pH dependent or pH independent polymers to further control the rate of release of active compound.
• the tablets of this invention are coated with a subcoat, an enteric coating or an overcoating, or any combination thereof.
• formulations contemplated by the present invention are not limited to the examples presented herein. Rather, the examples indicate that a vast number of formulations fulfill the general goal of the invention and one of ordinary skill in the art will recognize that varying the formulations beyond those of the examples is contemplated where the formulation so varied still accomplishes the general goal of the invention by providing a controlled release of active compound.
• the active compound is aplindore.
• Aplindore and pharmaceutically acceptable salts thereof are particularly well-suited to treating various disorders of the central nervous system and more particularly to those central nervous disorders relating to the dopaminergic system.
• aplindore or any drug
• the drug must be dosed in a manner sufficient to achieve the particular blood plasma level over a period of time deemed sufficient to meet the clinical objective sought.
• dosing of subject patients with aplindore resulted in side effects including nausea and vomiting which has been correlated with the time period where aplindore reached its maximal plasma levels.
• controlled release dosage forms that ameliorate the deleterious side effects of instant release aplindore administration, including oral and non-oral controlled release dosage formulations.
• the present invention includes each of the numerous technologies that exist for controlled release non-oral dosage formulations including pumps, implants, patches, depot injection, injection with controlled release carrier, and the like. Delivery of active compound in accordance with the present invention can be via mucosal, vaginal, rectal, ocular, transdermal, intrauterine, routes and the like.
• the present invention provides a method of administering aplindore that includes administering to a mammal in need thereof a starting controlled release dosage formulation comprising aplindore; and thereafter administering to the mammal at least one other controlled release dosage formulation comprising aplindore, wherein the starting controlled release dosage formulation contains a lesser amount of aplinodre relative to the other controlled release dosage formulation.
• the starting controlled release dosage formulation comprises from about 0.05 mg to about 0.4 mg of aplindore.
• any of the numerous technologies that exist for attaining sustained release oral formulations including those described above, as well as micro and macroencapsulation, fibers, matrices both polymeric (high viscosity and low viscosity) and non-polymeric, foams, liposomes, micelles, gels, physically dispersed drug in polymeric, porous, slightly porous or non-porous matrices, adsorption onto ion exchange resins, mixing with or adsorption onto chemically or biologically degradable matrices and the like.
• the active compound can be formulated in such a way that the drug achieves a single maximal concentration or may be formulated so that the drug is pulsed in two or more peaks.
• Liquid dosage forms include syrups, suspensions, emulsions, elixirs and the like.
• the liquid carrier can include an organic or aqueous base and maybe further modified with suitable pharmaceutical additives such as solubilizers, emulsifiers, buffers, preservatives, sweeteners, flavoring agents, suspending agents, thickening agents, colorsviscosity regulators, stabilizers or osmoregulators, or combinations thereof.
• suitable pharmaceutical additives such as solubilizers, emulsifiers, buffers, preservatives, sweeteners, flavoring agents, suspending agents, thickening agents, colorsviscosity regulators, stabilizers or osmoregulators, or combinations thereof.
• the aqueous carrier may also contain polymeric substances or oils.
• the following examples illustrate some controlled release dosage formulations that achieve the invention objective by decreasing the rate of dissolution, increasing the time to maximum concentration, or reducing the maximum concentration value for a given quantity of aplindore, or a combination of these three.
• the following non-limiting examples of oral delivery vehicles formulated for controlled delivery are listed below. The examples are illustrated for non-limiting dose ranges of 0.05 to 10 mg and a wide range of controlled release oral formulations in order to demonstrate a number of release profiles that were further tested in monkeys and humans and reported on herein below.
• the three formulation approaches illustrated below are 1) coated pellets; 2) co-compressed tablets (tablet-in-tablet); and 3) matrix tablets.
• a low required dose of aplindore or its pharmaceutically acceptable salts allows for layering of the drug onto the surface of an inert sugar sphere, followed by a release-controlling polymer coat.
• the drug may also be incorporated into the sphere by an extrusion/spheronization process which is not illustrated in the present examples.
• co-compressed tablet was investigated for the purpose of having a zero-order or nearly zero-order release profile and different release profiles obtained by varying the amounts of drug and polymer (HPMC) in the core tablet and in the outer compressed coat, as well as the total tablet weight. Tablets can be made individually via various presses or equipment well known to those of skill in the art.
• the co-compressed tablets of the present invention were made individually on the Carver press using standard round tooling.
• Matrix tablet examples were prepared utilizing hydroxypropyl methylcelluslose (HPMC), waxes, polyethylene oxides (PEO), alone or in combinations.
• HPMC hydroxypropyl methylcelluslose
• PEO polyethylene oxides
• the spheres prepared by extrusion/spheronization were coated with Eudragit RS/RL and Surelease to control the release of aplindore.
• the formulation and the dissolution profiles are shown in Table 2.
• the Surerelease coated spheres of composition 3 were tested in monkeys to assess the in vivo release and the corresponding monkey plasma levels are shown in Table 3. TABLE 2 Formulation and dissolution of sustained release coated spheres prepared by extrusion/spheronization.
• Composition 3 4 % W/W % W/W Spheroids core Aplindore fumarate 10.0 5.0 Avicel 90.0 95.0 SR Coating Surerelease 7.5 0 80:20Eudragit RS/Eudragit RL 0 15 Dissolution (Hrs) % Dissolved % Dissolved 0.1 N HCl 0.25 1.3 na 0.5 11.3 na 1 28.49 na 2 45.78 na pH 6.8 phosphate buffer 1 19.53 3.78 2 38.88 24.30 4 53.3 na 6 na 77.10 8 62.11 97.7 12 65.38 99.38
• Aplindore fumarate sustained-release pellets were also prepared by layering the active drug on sugar spheres.
• the formulation and the dissolution data are given in Table 3.
• Composition 5 was tested for in vivo release in monkeys. The data is included in Table 4.
• TABLE 3 Formulation and dissolution of sustained release coated aplindore layered sugar spheres.
• composition 5 % W/W Spheroids core Sugar spheres 25/30 mesh 100 Drug coating (5% as free base) aplindore fumarate 44.4 HPMC 6 cps 55.6 Controlled release Coating Eudragit RS100 45.5 Triethylcitrate 9.1 Talc 45.5 Dissolution Time(Hr) % Dissolved 0.1 N HCl 0.25 0.9 0.5 3.77 1 13.71 2 31.1 pH 6.8 phosphate 1 8.15 2 21.27 4 38.37 8 63.89 12 79.02
• Table 6 lists formulations of matrix tablets containing Carnauba wax and cetostearyl alcohol as matrix forming polymers, with microcrystalline cellulose.
• the wax was melted and aplindore alone or its blend with microcrystalline cellulose was added with stirring. The mixture was allowed to cool to room temperature and milled. The resulting granulation was blended with the lubricant magnesium stearate and compressed into tablets. The tablets exhibit sustained release profile.
• Wax matrix formulations and dissolution Composition 9 11 % W/W % W/W Aplindore fumarate 4.0 4.0 Avicel PH101 63.0 55.5 Carnauba wax 32.0 — Cetostearyl alcohol — 40 Magnesium stearate 1.0 0.5 Dissolution (Paddle 50 rpm, phosphate buffer pH 6.8). % Dissolved % Dissolved 0.25 6.56 7.46 0.5 10.23 10.33 1 21.13 15.87 2 53.8 27.43 4 72.36 45.26 6 77.02 56.81 8 79.01 64.64 12 81.50 76.19
• Table 6 outlines formulations and dissolution profiles of matrix tablets prepared using PEO polymers. The tablets show sustained release profiles.
• hydroxypropyl methylcellulose used in accordance with examples of the invention are hydroxypropylmethylcellulose sold under the trademark METHOCEL (Dow Chemical Co.) or equivalents.
• Suitable METHOCELS include the K grades such as METHOCEL K15M Premium CR, METHOCEL K100M Premium CR, METHOCEL K100 Premium LV and METHOCEL K4M Premium.
• Other suitable METHOCELS include the E, F and J grades.
• Table 7 lists examples of matrix tablets utilizing hydroxypropyl methylcellulose (HPMC) of low viscosity Methocel KLV100 (hydroxypropyl content less than 9%) and high viscosity Methocel K4M. Aplindore fumarate and the polymers were mixed, lubricated with magnesium stearate and compressed into tablets. These tablets show sustained release dissolution in 0.1 N HCl and pH 6.5 buffer.
• HPMC hydroxypropyl methylcellulose
• the aplindore 10 mg fast-release, 10 mg medium-release and 10 mg slow-release HPMC matrix core tablets were tested in monkeys along with an immediate-release capsule formulation.
• the formulations and dissolution data are listed in Table 7. Tablets were compressed using ⁇ fraction (11/32) ⁇ inch standard concave round tooling.
• the dissolution was determined as directed in the USP, using Apparatus 2 (paddles), at 50 rpm using 0.1N HCl for the first 2 hours and 0.05 M phosphate buffer, pH 6.8 at 37 ⁇ 0.5° C. Volume of dissolution medium was 900 mL.
• the pharmacokinetic parameters are presented in Table 8. These aplindore medium-release and slow-release formulations have achieved the requirement according to their in vivo performance in the monkey study.
• the bioavailabilities of the three HPMC matrix tablet formulations were 85.5, 95.0 and 116.4% respectively, for slow-release, medium-release and fast-release formulations relative to the immediate-release capsule formulation.
• the aplindore fumarate 5.0 mg, 2.0 mg, 0.5 mg and 0.05 mg medium-release and slow-release HPMC matrix tablets were all made on the Colton Press.
• the formulations were finalized based on dissolution results at 150 rpm and are listed in Tables 9 and 10.
• the dissolution data of aplindore fumarate 5.0 mg, 2.0 mg, 0.5 mg and 0.05 mg medium-release & 5.0 mg, 2.0 mg, 0.5 mg and 0.05 mg slow-release HPMC matrix tablets are also listed in Table 9 and 10.
• TABLE 9 Composition and Dissolution of Aplindore Fumarate 5.0 mg, 2.0 mg, 0.5 mg and 0.05 mg Medium-Release HPMC Matrix Tablets in pH 6.8 Buffer with USP II Method with Paddle Speed at 150 rpm Compositions Composition Composition Composition Composition Composition Composition Composition Composition Composition Composition Composition #17 #18 #19 #20 5.0 mg 2.0 mg 0.5 mg 0.05 mg Medium Release Medium Release Medium Release Medium Release aplindore free base* (added 2.00% 0.80% 0.20% 0.02% as fumarate salt) Lactose Fast Flo 22.00% 23.20% 23.80% 23.98% Avicel PH 301 20.00% 20.00% 20.00% 20.00% Methocel K4M, Prem
• aplindore core tablets Further formulations for aplindore core tablets are shown in the table below.
• TABLE 11 Aplindore Fumarate Medium-Release Formulations (core tablets) aplindore aplindore aplindore Compositions aplindore aplindore 2.0 mg 0.5 mg 0.05 mg quantity 10.0 mg 5.0 mg Medium Medium Medium type Medium Release Medium Release Release Release Release APLINDORE 4.00% 2.00% 0.80% 0.20% 0.02% free base* (added as fumarate salt) Lactose Fast 20.00% 22.00% 23.20% 23.80% 23.98% Flo Avicel PH 301 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% Methocel K4M, 29.00% 29.00% 29.00% 29.00% Prem CR Methocel 26.60% 26.60% 26.60% 26.60% K100LV Prem CR LH Mg stearate 0.40% 0.40% 0.40% 0.40% 0.40%
• the process is a dry blending and direct compression.
• a dry granulation process consisting of slugging and mill or roller compaction and milling can be used, or, preferably, a dry granulation to improves flow properties of the blend.
• a wet granulation process can also be used. However, this is not generally preferred because of possible sensitivity of active compound to moisture, and the possible degradation to form an insoluble hydrate.
• the tablets can be coated or uncoated.
• a human clinical study was conducted as a multiple dose study of two controlled release formulations of aplindore fumarate, a slow-release (SR) formulation and a medium-release (MR) formulation.
• Thirty-two (32) subjects were enrolled and 31 completed the study.
• Subjects were randomly assigned to receive one of the two formulations or placebo.
• Subjects were titrated from 0.05-mg to 5.0-mg on days 1 to 12.
• On days 12 to 16 subjects fasted before receiving the test article (5.0-mg doses twice per day (BID)).
• BID twice per day
• a full 24-hour pharmacokinetic profile was taken after AM dose under fasting conditions.
• subjects received a medium fat meal 30 minutes before test article administration (5.0-mg doses BID), and on day 21 a full 24-hour pharmacokinetic profile was taken.
• Table 13 summarizes the pharmacokinetic profile of aplindore fumarate SR 5.0-mg BID and aplindore fumarate MR 5.0-mg BID under fed and fasted conditions and the results from the same dose of APLINDORE IR (5.0-mg) in patients in a separate study. TABLE 13 Pharmacokinetic Parameters for Aplindore Fumarate Sustained Release Matrix Tablets in Human.
• aplindore was absorbed more slowly with mean t max ranging from 1.8 to 3.5 hours, compared to 0.7 hours for aplindore instant release (IR).
• MR and SR Under fasted conditions, MR and SR have similar concentrations and pharmacokinetic parameters with SR providing slightly higher concentrations.
• the mean C max for SR was 9229 pg/mL compared to 8065 pg/mL for MR.
• the AUC ss for SR is approximately 25% higher than the AUC ss for MR.
• Both of the controlled release formulations provide different pharmacokinetic profiles than aplindore fumarate IR 5.0-mg.
• C max of SR and MR is approximately one-third the C max of IR, and the t max has been prolonged by 1 to 2 hours.
• the total exposure (AUC ss ) is higher for the two sustained-release formulations ( ⁇ 66,000 pg*h/mL in SR, ⁇ 55,000 pg*h/mL in MR, vs. ⁇ 49,500 pg*h/mL in IR) and the variability in aplindore AUC ss is lower for the MR and SR formulations than the IR formulation.

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