Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
  • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
  • A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
  • A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants

Definitions

• the present invention relates to a stable liquid formulation comprising an acid labile substituted benzimidazole compound such as a proton pump inhibitor, i.e. a H , K -
• the liquid product can be stored refrigerated or stored at room temperature for several months without significant degradation.
• the invention provides a stable liquid formulation of the H , K -ATPase inhibitor in a water free or almost water free solvent.
• Such a stable liquid formulation is i.a. suitable as a ready-to-use solution for parenteral administration or as a concentrate for ex tempore preparation of a solution for parenteral administration.
• the present invention also refers to the manufacture of such stable liquid i.a. parenteral formulations, and their use in medicine.
• the susceptibility for chemical degradation of the proton pump inhibitors poses special problems in the pharmaceutical formulation of solutions for parenteral administration.
• the degradation of the proton pump inhibitors in liquid solutions is pH-dependent; the rate of reaction is very high at low pH values.
• the proton pump inhibitors have a low solubility in water and a higher solubility in less polar solvents.
• alkaline salts of the proton pump inhibitors generally have a higher solubility in water and a lower solubility in less polar solvents.
• compositions of proton pump inhibitors for parenteral administration are formulated as dry preparations for ex tempore reconstitution in a sterile solvent.
• the dry preparations are obtained by lyophilisation of sterile filtered solutions.
• the chemical instability of the proton pump inhibitors precludes heat sterilisation of these compounds.
• the stability of the formulations must be maintained and the formulations should have suitable storage stability. Further suitable requirements are easy handling and inexpensive manufacturing.
• Proton pump inhibitors are for instance compounds known under the generic names omeprazole, lansoprazole, pantoprazole, rabeprazole, leminoprazole and esomeprazole.
• Omeprazole and therapeutically acceptable salts thereof are described in EP-A1-0005129.
• EP-A1-124495 describes certain salts of omeprazole and EP-A1-174726, EP-A1-166287 and GB 2163747 are directed to lansoprazole, pantoprazole and rabeprazole respectively.
• WO 94/27988 is directed to salts of the single enantiomers of omeprazole.
• Proton pump inhibitors are susceptible to degradation/transformation in acidic and neutral media. Due to the stability problems, intravenous formulations of the H , K -ATPase inhibitors are usually made in the form of a dry powder that is to be dissolved in a liquid just before use.
• WO 94/02141 describes an injection of an antiulcerative benzimidazole compound, such as omeprazole.
• the injection comprises a lyophilised product, which is dissolved in physiological saline just before use.
• the lyophilised product is prepared from a strong alkaline solution of sodium salt of omeprazole, sodium hydroxide and water, whereafter the solution is lyophilised.
• EP 356 143-A1 describes an i jectable solution comprising a substituted benzimidazole and at least one of ethanol, propylene glycol and polyethylene glycol.
• the active compound is either used as such, or preferably as a lyophilised material of an alkaline aqueous solution of the compound, dissolved in the ethanol, propylene or polyethylene glycol. If a lyophilised material is used an acidic substance is also added to the solvent.
• Table 2 (EP 356143-A1, page 5) comprising polyethylene glycol have a water content of about 50%.
• EP 124 495 describes for instance, see example 13, injectable solutions which are obtained by dissolving omeprazole sodium salt in sterilised water, followed by filtration and lyophilisation to give a lyophilised material. The prepared material is then dissolved in a sterile-filtered mixed solution of polyethylene glycol 400 for injection, sodium dihydrogenphosphate and sterilised water.
• the previously described parenteral dosage forms recommend a freeze dried product, which makes the manufacture of intravenous products expensive.
• the present invention provides a stable liquid formulation which can be used as a ready-to-use solution for parenteral administration or a concentrate for ex tempore preparation of a solution for parenteral administration without using lyophilisation processes/steps in the manufacturing.
• the present invention provides a stable liquid formulation of an acidic susceptible H K - ATPase inhibitor, such as a proton pump inhibitor.
• the stable liquid formulation can be used as a ready-to-use solution for parenteral administration or as a concentrate for ex tempore preparation of a solution for parenteral administration.
• the liquid product can be stored refrigerated or stored at room temperature for several months without significant degradation.
• a water free or almost water- free, polyethylene glycol solution of a sodium or potassium salt of a H ,K -ATPase inhibitor of Formula I below or a sodium or potassium salt of a single enantiomer of one of the compounds is provided.
• the sodium or potassium salt of the H , K -ATPase inhibitor may be formed in situ in the polyethylene glycol solution by adding a sodium hydroxide or potassium hydroxide and the active compound, i.e the H , K -ATPase inhibitor
• Water that has been added with the sodium or potassium salt of the active compound or that has been formed by the in situ formation of the sodium or potassium salt of the active compound can be evaporated by purging the polyethylene glycol solution with nitrogen It is by such a procedure possible to remove practically all the water or to obtain a water content of a pre-set value.
• the stable liquid formulation may also be filled into capsules which then are enteric coated, and used for oral administration.
• the stable liquid formulation may be filled into a one or two compartment syringe to provide a ready-to-use product or ex tempore preparation product that will be easy to use for parenteral administration.
• N in the benzimidazole moiety means that one of the ring carbon atoms substituted by R 6 -
• R 9 optionally may be exchanged for a nitrogen atom without any substituents
• R] R 2 and R 3 are the same or different and selected from hydrogen, alkyl, alkoxy optionally substituted by fluorine, alkylthio, alkoxyalkoxy, dialkylamino, piperidino, morpholino, halogen, phenyl and phenylalkoxy;
• R 4 and R 5 are the same or different and selected from hydrogen, alkyl and aralkyl
• R 6 ' is hydrogen, halogen, trifluoromethyl, alkyl and alkoxy;
• R 6 -R 9 are the same or different and selected from hydrogen, alkyl, alkoxy, halogen, halo-
• alkoxy, alkylcarbonyl, alkoxycarbonyl, oxazolyl, trifluoroalkyl, or adjacent groups Rg-R 9 form ring structures which may be further substituted;
• R 10 is hydrogen or forms an alkylene chain together with R 3 and
• Ri i and R 12 are the same or different and selected from hydrogen, halogen or alkyl.
• the compounds may also be used in the form of a sodium or potassium salt of a single enantiomer.
• Especially preferred compounds for the present invention are a sodium salt of omeprazole or a sodium salt of (SJ-omeprazole.
• the stable liquid formulation is prepared by dissolving a sodium or potassium salt of a compound with Formula I in polyethylene glycol.
• Suitable polyethylene glycols are for instance, polyethylene glycol 200, 300 or 400.
• the most preferred polyethylene glycol is PEG 400.
• the prepared formulation according to present invention is water free or almost water free.
• the formulation should comprise less than 6 % by weight of water, preferably less than 3 %, and more preferably less than 2 % by weight of water.
• Water that has been added with the sodium or potassium salt of the active compound or that has been formed by the in situ formation of the sodium or potassium salt of the active compound can be evaporated by purging the polyethylene glycol solution with nitrogen. It is by such a procedure possible to remove practically all the water or to obtain a water content of a pre-set value.
• the compound of Formula I can be used as such added and dissolved together with at least an equivalent amount of sodium or potassium hydroxide in polyethylene glycol. The sodium salt or potassium salt of the active compound will then be formed in situ.
• the formulation contains the active compound in the form of a sodium or potassium salt in order to obtain a stable product.
• the water solubility of proton pump inhibitor compounds is low and they are generally more soluble in less polar solvents.
• the solubility of proton pump inhibitors in polyethylene glycol is as expected in general higher than the corresponding water solubility. It has now been discovered that a sodium or potassium salt of the active H ,K -
• ATPase inhibitor surprisingly has a higher solubility in polyethylene glycol than the active compound itself. It is therefore possible to achieve a high concentration of the compound in the polyethylene glycol solution with a sodium or potassium salt of the active compound. A high concentration is of vital importance particularly for parenteral products since the volume to be administered is generally small.
• the injection volume for an intravenous bolus injection should preferably not exceed 10 ml and for a subcutaneous injection the volume should preferably not exceed 1 ml.
• Water that has been added with the sodium or potassium salt of the active compound or that has been formed by the in situ formation of the sodium or potassium salt of the active compound can be evaporated by purging the polyethylene glycol solution with nitrogen. It is by such a procedure possible to remove practically all the water or to obtain a water content of a pre-set value.
• the stable liquid formulation of the invention can be filtrated sterile by conventional methods and it is therefore relatively easy to produce a sterile parenteral product aseptically.
• the stable liquid formulation may be filled into a one or two compartment syringe to provide a ready-to-use product or ex tempore preparation product that will be easy to use for parenteral administration.
• the stable liquid formulation may be mixed with for instance water for injection or saline solution for injection when it is used as a concentrate for ex tempore preparation for parenteral administration.
• the solvent may also comprise a pharmaceutically acceptable excipient that will control the pH of the final solution to a desired value. If the stable liquid formulation is to be filled into one of the chambers of a two compartments syringe, the other chamber in the syringe will then be filled with a suitable solvent as described above. This syringe will then become an easy to use ex tempore preparation product in contrast to earlier proposed arrangements.
• a product according to prior art a two compartments syringe, would contain the lyophilised H ,K -ATPase in one compartment and a sterile water solution in the other compartment.
• Such a structural arrangement would lead to a very expensive method of manufacture compared to the invention provided in this patent application.
• the stable liquid formulation according to the present invention may comprise suitable pharmaceutically acceptable excipients that can be dissolved in the water free or almost water free polyethylene glycol formulation without interferring with the properties and uses of the claimed formulation, such as stability and solubility.
• the pharmaceutical substances used in the claimed formulations are useful for inhibiting gastric acid secretion in mammals including man by controlling gastric acid secretion at the final step of the acid secretory pathway and thus reduce basal and stimulated gastric acid secretion irrespective of stimulus.
• they may be used for prevention and treatment of gastric-acid related diseases in mammals and man, including e g reflux oesophagitis, gastritis, duodenitis, gastric ulcer, duodenal ulcer and Zolhnger- El son syndrom
• they may be used for treatment of other gastrointestinal disorders where gastric acid inhibitory effect is desirable e.g.
• NSAID non- steroidal anti-inflammatory drugs
• GORD symptomatic gastro-oesophageal reflux disease
• They may also be used for patients in intensive care situations, in patients with acute upper gastrointestinal bleeding, pre-and postoperatively to prevent aspiration of gast ⁇ c acid and to prevent and treat stress ulceration. Further, they may be useful in the treatment of pso ⁇ asis as well as in the treatment of Hehcobacter infections and diseases related to these.
• a unit dose of the proton pump inhibitor for instance 1 - 100 mg is preferably administered once or twice a day.
• the doses may be given with a higher dosmg frequency depending on the severeness of the disease and the patient's conditions, also up to 500 mg may be adminstered per day in severere cases.
• Suitable doses for injection and infusion comprise for instance 5, 10, 15, 20, 30 and 40 mg of the pharmaceutical active compound.
• the formulations may also be used in combination with other drug treatments, such as one or more antibacterial compounds, a moti ty stimulating drug, an antacid and/or a H 2 - blocker, such as for instance ranitidine.
• other drug treatments such as one or more antibacterial compounds, a moti ty stimulating drug, an antacid and/or a H 2 - blocker, such as for instance ranitidine.
• omeprazole Stable liquid formulation of omeprazole.
• Liquid formulations of omeprazole or sodium omeprazole in water or polyethylene glycol 400 were prepared and analysed after different storage times at room temperature (25 °C).
• Formulations A-D were prepared by dissolving omeprazole sodium monohydrate in polyethylene glycol 400 and then purging the solutions with nitrogen in order to remove any water that had been added with the active compound. To solution D was then also added 2 % water.
• Formulation E was prepared by dissolving omeprazole (non salt form) in polyethylene glycol and then purging the solution with nitrogen in order to remove any water that had been added with the active compound.
• Formulation F was prepared by dissolving omeprazole sodium monohydrate in water.
• omeprazole the non-ionised species
• solubility of omeprazole has been determined to approximately 0.1 g/1 in water and approximately 100 g/1 in dichloromethane at room temperature (22 °C).
• Omeprazole sodium on the other hand is freely soluble in water and only slightly soluble in dichloromethane and this, again, is due to the large differences in polarity of the different solvents. Omeprazole sodium is ionised and is therefore much more soluble in water compared with omeprazole and the opposite is applicable in the less polar solvent dichloromethane.
• omeprazole the non-ionised species
• solubility is much better in polyethylene glycol, a less polar solvent, than in water.
• Omeprazole sodium is freely soluble in polyethylene glycol 400, which is unexpected and contradictory to what was expected. This means that the solubility in polyethylene glycol is much higher for omeprazole sodium than for omeprazole.
• the high solubility of omeprazole sodium in polyethylene glycol is very favourable regarding the formulation aspects of a parenteral pharmaceutical product.

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• 1999
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• 2000
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• 2002
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