WO2008000194A1 - Extended release solid pharmaceutical composition containing carbidopa and levodopa - Google Patents
Extended release solid pharmaceutical composition containing carbidopa and levodopa Download PDFInfo
- Publication number
- WO2008000194A1 WO2008000194A1 PCT/CR2006/000006 CR2006000006W WO2008000194A1 WO 2008000194 A1 WO2008000194 A1 WO 2008000194A1 CR 2006000006 W CR2006000006 W CR 2006000006W WO 2008000194 A1 WO2008000194 A1 WO 2008000194A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- tablet
- release
- levodopa
- extended release
- carbidopa
- Prior art date
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- 238000013265 extended release Methods 0.000 title claims abstract description 125
- 239000008194 pharmaceutical composition Substances 0.000 title claims description 39
- IVTMXOXVAHXCHI-YXLMWLKOSA-N (2s)-2-amino-3-(3,4-dihydroxyphenyl)propanoic acid;(2s)-3-(3,4-dihydroxyphenyl)-2-hydrazinyl-2-methylpropanoic acid Chemical compound OC(=O)[C@@H](N)CC1=CC=C(O)C(O)=C1.NN[C@@](C(O)=O)(C)CC1=CC=C(O)C(O)=C1 IVTMXOXVAHXCHI-YXLMWLKOSA-N 0.000 title claims description 29
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- RBTVSNLYYIMMKS-UHFFFAOYSA-N tert-butyl 3-aminoazetidine-1-carboxylate;hydrochloride Chemical compound Cl.CC(C)(C)OC(=O)N1CC(N)C1 RBTVSNLYYIMMKS-UHFFFAOYSA-N 0.000 description 1
- UWHCKJMYHZGTIT-UHFFFAOYSA-N tetraethylene glycol Chemical class OCCOCCOCCOCCO UWHCKJMYHZGTIT-UHFFFAOYSA-N 0.000 description 1
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- VMYFZRTXGLUXMZ-UHFFFAOYSA-N triethyl citrate Natural products CCOC(=O)C(O)(C(=O)OCC)C(=O)OCC VMYFZRTXGLUXMZ-UHFFFAOYSA-N 0.000 description 1
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- BSVBQGMMJUBVOD-UHFFFAOYSA-N trisodium borate Chemical compound [Na+].[Na+].[Na+].[O-]B([O-])[O-] BSVBQGMMJUBVOD-UHFFFAOYSA-N 0.000 description 1
- HRXKRNGNAMMEHJ-UHFFFAOYSA-K trisodium citrate Chemical compound [Na+].[Na+].[Na+].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O HRXKRNGNAMMEHJ-UHFFFAOYSA-K 0.000 description 1
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- UHVMMEOXYDMDKI-JKYCWFKZSA-L zinc;1-(5-cyanopyridin-2-yl)-3-[(1s,2s)-2-(6-fluoro-2-hydroxy-3-propanoylphenyl)cyclopropyl]urea;diacetate Chemical compound [Zn+2].CC([O-])=O.CC([O-])=O.CCC(=O)C1=CC=C(F)C([C@H]2[C@H](C2)NC(=O)NC=2N=CC(=CC=2)C#N)=C1O UHVMMEOXYDMDKI-JKYCWFKZSA-L 0.000 description 1
- OENHQHLEOONYIE-JLTXGRSLSA-N β-Carotene Chemical compound CC=1CCCC(C)(C)C=1\C=C\C(\C)=C\C=C\C(\C)=C\C=C\C=C(/C)\C=C\C=C(/C)\C=C\C1=C(C)CCCC1(C)C OENHQHLEOONYIE-JLTXGRSLSA-N 0.000 description 1
Classifications
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- 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
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- 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
- A61K9/2009—Inorganic compounds
-
- 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
- A61K31/13—Amines
- A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
- A61K31/137—Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
-
- 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
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
- A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
- A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- 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
- A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
- A61K9/2086—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
- A61K9/209—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat containing drug in at least two layers or in the core and in at least one outer layer
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- 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
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- 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
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- 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
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- 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
Definitions
- the present invention concerns a solid oral dosage form that provides an extended release of levodopa and carbidopa.
- the invention concerns a pharmaceutical composition providing an extended release of levodopa and carbidopa, over an about 1 to 4 hour period following exposure to an aqueous environment.
- the invention also provides dosage forms that present a dual release of levodopa and/or carbidopa.
- the dosage form provides an extended release of levodopa and optionally carbidopa, and an immediate or rapid release of carbidopa.
- the dosage form provides a delayed and extended release of levodopa and optionally carbidopa, and an immediate or rapid release of carbidopa.
- Solid dosage forms containing a combination of levodopa (LD) and carbidopa (CD) are well known. Such dosage forms are used to treat Parkinson's disease and other movement disorders.
- the combination of LD and CD remains the most effective anti- Parkinson drug.
- Levodopa the levorotatory isomer of dihydroxy-phenylalanine, is the natural metabolic precursor of dopamine (DA), which is responsible for the therapeutic effectiveness in the central nervous system (CNS).
- DA dopamine
- CNS central nervous system
- DA central nervous system
- LD can reach the CNS.
- LD is rapidly absorbed by the saturable amino-acid active transport system located in proximal one third of the small intestine (duodenum and jejunum). Peak concentrations are between 30-120 minutes, depending mainly on the gastric emptying time and the length of time the drug is exposed to the degradative enzymes of the gastric and intestinal mucosa.
- Osmotica Costa Rica S.A. et al. Docket No. PHUS-1 65
- AADC L-aminoacid decarboxylase
- Carbidopa/levodopa generic rapid release tablets are also available from SANDOZ and TEVA. None of those tablets are controlled release tablets.
- the "wearing-off ' and "on-off ' phenomena have emerged as major problems in the LD-CD long-term treatment of Parkinson's disease.
- the wearing off effect Within two to five years of initiating combination therapy certain limitations become apparent as the disease progresses, the benefit from each dose becomes shorter ("the wearing off effect") and some patients alternate unpredictably between mobility and immobility (“the on-off effect”), which may occur many times a day.
- “On” periods are usually associated with high or rising plasma LD concentrations and often include abnormal involuntary movements, i.e., dyskinesias.
- Off 1 periods have been correlated with low or falling plasma LD levels and bradykinetic episodes.
- controlled release oral dosage combinations include SINEMETTM CR (or NACOMTM), which is an extended release oral tablet containing CD (25-50 mg) and LD (100-200 mg). It releases drug over a period of about 3-6 hours (Physicians' Desk Reference 57th Ed. 2003 pg. 1111, the disclosure of which is hereby incorporated by reference), which period exhibits inter-patient variability.
- the tablet comprises hydroxypropylcellulose, polyvinylacetate- crotonic acid copolymer, magnesium stearate, and red ferric oxide.
- the SINEMET CR tablet is a polymeric-based drug delivery system that controls the release of carbidopa and levodopa as it slowly erodes.
- the 25-100 (CD-LD) tablet and the 50-200 (CD-LD) tablet each contains the drugs present in 1-4 weight ratio.
- SINEMET CR is about 4-8 hours during the waking day; however, it can be administered more frequently and in higher doses if needed. SINEMET CR can be administered in combination with SINEMET immediate release. However, patients taking SINEMET CR can develop increased dyskinesia as compared to SINEMET immediate release. Dempski et al. ⁇ Neurology (1989); 39(Suppl. 2):20-4) disclose the results of a study on the pharmaceutical design and development of the SINEMET CR erosion-controlled or diffusion-controlled release formulation. Data from clinical trials cited in the U.S. Pat. No. 4,900,755 indicate that effective antiparkinson effects were achieved with fewer daily doses of the controlled release form as compared with the conventional combination. Related U.S.
- Patent No. 4,832,957 discloses a matrix tablet comprising "a polymer vehicle comprising 5-25 mg of water-soluble hydroxypropyl cellulose polymer, and 2-50 mg of a less water-soluble polyvinyl acetate-crotonic acid copolymer.”
- Related U.S. Patent No. 4,983,400 discloses a controlled release solid oral dosage formulation for the controlled release of CD and LD consisting essentially of a uniform dispersion of 5-300 mg of CD, 20-1200 mg of LD in a polymer vehicle of 2 to 120 mg of polymethyl methacrylate. This formulation contains poly(methyl methacrylate) as a release rate-controlling polymer.
- CD 25-50 mg
- LD 100-200 mg
- MYLAN KV PHARM
- IMPAX LABS IMPAX LABS
- TORPHARM TORPHARM
- Canadian pharmaceutical company sells a controlled-release formulation of levodopa and carbidopa (APO-LEVOCARB CR tablets) that contains a polymer-based drug delivery system that controls the release of LD and CD as it slowly erodes.
- APO-LEVOCARB CR tablets a controlled-release formulation of levodopa and carbidopa
- PCT International Publication WO 94/06416 discloses a tablet consisting of a first layer containing one or more drugs with immediate or controlled release formulation comprising polymeric substances which swell or solubilize when contacted with aqueous liquids, wherein the polymeric substances are selected from the group consisting of cross- linked polyvinylpyrrolidone, low and medium molecular weight hydroxypropyl cellulose and hydroxypropyl methylcellulose, cross-linked sodium carboxymethylcellulose, carboxymethyl starch, potassium methacrylate-divinylbenzene copolymer, polyvinyl alcohols, starches, microcrystalline cellulose and ⁇ -cyclodextrin; a second layer containing one or more drugs, either equal to or different from those of the first layer, with slow release formulation, comprising polymeric substances which swell or erode or are gellable when contacted with aqueous liquids, wherein the polymeric substances are selected from the group consisting of hydroxypropyl methylcellulose having a mole
- hydroxypropyl cellulose having molecular weight from 2,000 to 2,000,000, carboxyvinyl polymers, polyvinyl alcohols, glucans, scleroglucans, mannans, xanthans, alginic acid, carboxymethylcellulose, poly(methyl vinyl ethers/maleic anhydride), ethylcellulose and methylcellulose; and a third layer, which is a low- permeability barrier coating said second layer.
- the inventors disclose that the availability of pharmaceutical compositions capable of liberating different drugs at successive times would be useful in the case that the drugs benserazide or CD should be administered with or before L-dopa administration; thus the peripheral conversion of L-dopa into dopamine would be drastically reduced and higher amounts of L-dopa would reach the systemic circulation and the brain, where conversion into dopamine produces the desired therapeutic effect. Thus, much lower L-dopa doses can have a high therapeutic effect and, at the same time, produce lesser side effects.
- PCT International Publication WO 99/17745 discloses a controlled-release monolithic system for oral administration.
- the system comprises a disintegrating layer, an erodible layer and a swelling layer, of which two are external and one is intermediate, each layer containing one or more drugs.
- the system comprises a swelling layer comprising levodopa methylester, CD, Eudralack red, hydroxypropyl Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- methylcellulose (Methocel Kl 5M), hydroxypropyl methylcellulose phthalate (HPMCP 50), triacetin, talc and magnesium stearate; an erodible layer comprising levodopa methyl hydrochloride, CD, potassium metabisulfrte, blue lake, glyceryl palmitostearate, lactose, polyvinylpyrrolidone (Plasdonet K29-32), talc and magnesium stearate; and a disintegrating layer, comprising levodopa methyl hydrochloride, CD, Eudralack yellow, polyvinylpyrrolidone (Plasdonet K29-32), microcrystalline cellulose (Avicel PHl 02), croscarmellose sodium (Ac-Di-SoI), talc and magnesium stearate.
- Bettini et al. disclose the three-layered matrix tablet comprising a water swellable layer, a water erodible layer, and a water disintegratable layer for levodopa methyl ester and CD.
- This tablet contains a release rate-controlling polymer.
- the three layers are assembled in the monolithic matrix in different relative positions. In one configuration, the tablet can be useful for the reduction of the morning on-off fluctuation, because it provides an early LD plasma peak. In another configuration the tablet may be useful for the afternoon administration, because it avoids end-of-dose deterioration by providing prolonged release of the drugs.
- European Patent No. 0253490 discloses a formulation of LD and CD uniformly dispersed in a polymeric matrix consisting of a mixture of two polymers, one of which is water-soluble, such as hydroxypropyl methylcellulose, and the other of which is weakly water soluble polymer, such as polyvinyl acetate/crotonic acid copolymer. This tablet contains a release rate-controlling polymer.
- U.S. Patent No. 4,361,545 discloses a solid, orally administrable pharmaceutical tablet composition for the slow, zero order release of drugs having a water solubility of about 1/5-1/500 (w/w).
- the formulations are based upon control of active ingredient release from the surface of the tablet via a controlled surface erosion mechanism.
- This tablet requires a surface controlling compound which has a water solubility of about 1/1- 1/40 (w/w); an erosion controlling compound which has a water solubility of about 1/1- 1/10 (w/w); a surface activator which is a disintegrating agent for pharmaceutical compositions at which amount the compound is ineffective as a disintegrating agent, a surfactant which is pharmaceutically acceptable in oral compositions, a binder and a die wall lubricant.
- This tablet contains a disintegrant and a surfactant.
- U.S. Patent No. 5,192,550 discloses an osmotic device for administering a drug, for example LD and/or CD, for treating central nervous system disorders.
- a drug for example LD and/or CD
- the device Applicant Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- a first composition comprising a pharmaceutical drug carrier and 100 nanograms to 700 milligrams of drug granules.
- U.S. Patent No. 5,266,332 discloses a method for treating Parkinson's disease wherein the method comprises admitting into the patient an osmotic device comprising a drug composition in the compartment comprising 10 ng to 1200 mg of an anti-Parkinson drug and a hydrophilic polymer.
- U.S. Patents No. 5,532,274 and No. 5,624,960 disclose a formulation having controlled liberation of LD and CD during a short release phase comprising a polymer mixture consisting of polyvinyl alcohols.
- U.S. Patent No. 5,840,756 discloses a pharmaceutical composition that comprises levodopa ethyl ester, hydroxypropyl methylcellulose, hydroxypropylcellulose and a carboxyvinyl polymer, and provides an early burst of LD followed by the maintenance of a sustained level of LD.
- the composition contains a release rate controlling polymer and may optionally further contain CD.
- 6,117,453 discloses a solid pharmaceutical composition
- a solid pharmaceutical composition comprising an active ingredient, such as LD or CD, which is not in an amorphous form, polyethylene oxide, and the balance consisting of conventional additives, excluding basic components.
- This composition contains a release rate controlling polymer
- U.S. Patent No. 6,217,905 discloses a dosage form for administering an anti- Parkinson drug to a patient, wherein the dosage form comprises: "(a) a composition comprising 0.10 mg to 750 mg of an anti-Parkinson drug and a pharmaceutically acceptable carrier for the anti-Parkinson drug selected from the group consisting of hydroxypropylcellulose, hydroxypropyl methylcellulose and polyvinylpyrrolidone, which composition in the presence of fluid that contacts the dosage form provides a dispensable anti-Parkinson therapeutic formulation; and wherein the dosage form: (b) provides the anti-Parkinson drug substantially-free of adverse effects for administration in a rate- controlled metered dose per unit time over 24 hours.
- a composition comprising 0.10 mg to 750 mg of an anti-Parkinson drug and a pharmaceutically acceptable carrier for the anti-Parkinson drug selected from the group consisting of hydroxypropylcellulose, hydroxypropyl methylcellulose and polyvinylpyrrolidone, which composition in the presence
- the anti- Parkinson drug is a combination of LD and CD.
- U.S. Patent No. 6,238,699 and its related U.S. Patent No. 6,756,056 disclose a pharmaceutical tablet comprising a sustained release core layer of CD (25-75 mg), LD (100-400 mg), cellulose ether (80 mg), and microcrystalline cellulose, wherein the sustained release layer is overcoated with an immediate release layer comprising CD (10- Applicant: Osmotica Costa Spain, S.A. et al. Docket No. PHUS-165
- a bilayer tablet consisting of one layer of sustained release carbidopa-levodopa adjacent to a layer of immediate release carbidopa- levodopa is also disclosed. This tablet contains a release rate-controlling polymer.
- 6,372,254 discloses a press-coated tablet suitable for oral administration, comprising an immediate-release compartment comprising a compressed blend of an active agent, such as LD, and one or more polymers, and an extended-release compartment, formed by press-coating to substantially envelop the immediate-release compartment, and comprising a compressed blend of the active agent, a hydrophilic polymer and hydrophobic material, wherein the tablet exhibits a first order release of the active agent interrupted by a pulsed delivery of the active agent.
- This tablet contains a release rate-controlling polymer.
- U.S. Patent No. 6,531,153 discloses a pharmaceutical composition comprising a therapeutically effective amount of LD and of CD, dispersed in a hydrophilic matrix, and an organic acid.
- the hydrophilic matrix generally comprises a gelling substance such as hydroxypropyl methylcelMose.
- Other gelling components may be used, such as polyvinylpyrrolidone, poly(vinyl alcohol), hydroxypropylcellulose, hydroxymethylcellulose or gelatin, alone or as a mixture.
- This pharmaceutical composition contains a release rate-controlling polymer.
- 20040009219 disclose a controlled release pharmaceutical device that comprises pharmaceutically active substances, such as LD or CD, microbial polysaccharide, and uncrosslinked linear polymer, such as cellulose ether.
- pharmaceutically active substances such as LD or CD
- microbial polysaccharide such as microbial polysaccharide
- uncrosslinked linear polymer such as cellulose ether.
- the device provides sustained or pulsatile delivery of pharmaceutically active substances for a predetermined period of time.
- the duration, uniformity and continuity of release of the pharmaceutically active agent(s) can be suitably controlled by varying the relative amount of the xanthan gum and HPMC.
- This formulation contains a release rate-controlling polymer.
- PCT International Publication No. WO 98/47491 discloses a matrix tablet for the sustained release of drug, for example LD and CD. This tablet, however, requires two release rate controlling polymers having opposing wettability characteristics. Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- U.S. Patent Application Publication No. 20030224045 discloses a pharmaceutical dosage form having an immediate release component and a controlled release component comprising: a) an immediate release component comprising a ratio of CD to LD of from about 1:2 to about 1:50 such that the in vitro dissolution rate of the immediate release component according to measurements under the USP paddle method of 50 rpm in 900 ml aqueous buffer at pH 4 at 37 C is from about 10% to about 90% LD released after 30 minutes and from about 50% to about 99% after 1 hour; b) a controlled release component comprising a ratio of CD to LD of from about 1:2 to about 1:50 such that the in vitro dissolution rate of the controlled release component according to measurements under the USP paddle method of 50 rpm in 900 ml aqueous buffer at pH 4 at 37 C is from about 10% to about 40% LD released after 1 hour; from about 25% to about 60% released after 2 hours; from about 40% to about 75% after 4 hours and from about 55% to about 90% after about 6 hours, the in vitr
- U.S. Patent Application Publication No. 20030228360 discloses a pharmaceutical dosage form having an immediate release component and a controlled release component comprising: a) an immediate release component comprising a ratio of CD to LD of from about 1:1 to about 1:50 such that the in vitro dissolution rate of the immediate release component according to measurements under the USP paddle method of 50 rpm in 900 ml aqueous buffer at pH 4 at 37 C is from about 10% to about 99% LD released after 15 minutes and from about 60% to about 99% after 1 hour; b) a controlled release component comprising a ratio of CD to LD of from about 1:1 to about 1:50 such that the in vitro dissolution rate of the controlled release component according to measurements under the
- USP paddle method of 50 rpm in 900 ml aqueous buffer at pH 4 at 37 C is from about 10% to about 60% LD released after 1 hour; from about 20% to about 80% released after 2 hours; and from about 30% to about 99% after about 6 hours, the in vitro release rate chosen such that the initial peak plasma level of LD obtained in vivo occurs between 0.1 and 6 hours after administration of the dosage form to a patient.
- This pharmaceutical dosage form does not comprise a controlled release component comprising LD and optionally CD, and an immediate or rapid release component comprising only CD.
- This Applicant Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- pharmaceutical dosage form does not comprise a gastro-resistant controlled release component.
- U.S. Patent Application Publication No. 20040013727 discloses a pharmaceutical hydrophilic gel forming matrix formulation comprising one or more active substances, such as active substances for the treatment of Parkinson's disease, and having a prolonged release of said one or more active substances upon exposure to gastrointestinal fluids, characterized in that said release is substantially ion-strength independent.
- This formulation contains a release rate-controlling polymer.
- U.S. Patent Application Publication No. 20040028735 discloses a pharmaceutical formulation for oral administration of a pharmaceutically active compound (such as compounds selected from anti-parkinsonian agents) which includes a tablet core containing an uncoated granulation of a therapeutically effective amount of at least one pharmaceutically active ingredient, an optional surface active agent, an optional pharmaceutically acceptable alkaline agent and a combination of at least one water soluble binder and at least one water insoluble binder, whereby controlled release is achieved by way of the water soluble and water insoluble binders.
- a pharmaceutically active compound such as compounds selected from anti-parkinsonian agents
- the binders can be any pharmaceutically acceptable combination of non-toxic water soluble and water insoluble binders such as the following water-soluble polymers, e.g., polyvinyl alcohol, polyvinylpyrrolidone, methylcellulose, hydroxypropyl cellulose, hydroxymethyl cellulose, and the following water-insoluble polymers, e.g., a polymethacrylic acid copolymer such as Eudragit NE30D. This formulation contains release rate-controlling polymeric binders.
- water-soluble polymers e.g., polyvinyl alcohol, polyvinylpyrrolidone, methylcellulose, hydroxypropyl cellulose, hydroxymethyl cellulose
- water-insoluble polymers e.g., a polymethacrylic acid copolymer such as Eudragit NE30D.
- This formulation contains release rate-controlling polymeric binders.
- U.S. Patent Application Publication No. 20040166159 discloses a pharmaceutical dosage form comprising an immediate release and a controlled release component, wherein said immediate release component and said controlled release component each comprises an AAAD inhibitor, such as CD, and LD in a ratio of from about 1:1 to about 1:50; wherein said immediate release component exhibits an in vitro dissolution profile comprising at least about 10% LD release after 15 minutes and at least about 60% LD release after 1 hour; and wherein said controlled release component exhibits an in vitro dissolution profile comprising from about 10% to about 60% LD release after 1 hour, from about 20% to about 80% LD release after 2 hours, and at least about 30% LD release after 6 hours.
- said immediate release component exhibits an in vitro dissolution profile comprising at least about 10% LD release after 15 minutes and at least about 60% LD release after 1 hour
- said controlled release component exhibits an in vitro dissolution profile comprising from about 10% to about 60% LD release after 1 hour, from about 20% to about 80% LD release after 2 hours, and at least about
- the dosage form can optionally contain a cathecol-O-methyltransferase (COMT) inhibitor.
- This pharmaceutical dosage form does not comprise a controlled release Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- an immediate or rapid release component comprising only CD.
- WO 01/66081 (requires sucrose fatty acid esters as release rate-controlling material); Korean Patent Application No. KR 2003/056474; and European Patent Applications No. EP 324,947 (requires pelletized formulation), and No. EP 253490 (matrix controlled release tablet requiring a two-polymer polymeric matrix).
- the prior art controlled release tablets which include matrix tablets, layered tablets, coated tablets, and osmotic devices, invariably comprise a release rate-controlling polymer or polymeric coat in order to provide a controlled release of CD and LD.
- prior art tablets provide a rapid release of CD and LD.
- a controlled release tablet that provides a controlled release of CD and LD in the absence of a release rate-controlling polymer or coating. Such a tablet would be simpler to manufacture than existing tablets and also would not have the potential for degradation of the CD and LD by the release rate-controlling polymer or coatings or conditions used to include them in the formulation. It would be another improvement in the art to provide oral dosage forms that provide a reduced dosing frequency compared to the oral LD-CD ER dosage forms currently available, and/or a faster relief for patients in the morning off-state.
- the present invention seeks to overcome the disadvantages of related dosage forms known in the art.
- the invention provides an extended release solid pharmaceutical composition comprising LD and CD, which are released slowly and substantially continuously over a 1 to 4-hour period when the tablet is placed in an aqueous medium.
- Applicant Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- the extended release composition comprises LD, CD, an organic acid and a carbohydrate or sodium chloride; 2) the extended release composition is included in a tablet; 3) the CD is further included in the tablet in a rapid or immediate release form; 4) the LD is also included in the tablet in a rapid or immediate release form; 5) the LD is included in the tablet in a delayed-extended release form; 6) the tablet further comprises a delayed release coating surrounding the extended release composition or a delayed release material in the controlled release composition such that the extended release of LD and/or CD is delayed by a lag time; 7) the tablet excludes significant amounts of a release rate modifying polymer; 8) the controlled release composition excludes significant amounts of a disintegrant; 9) the controlled release composition excludes significant amounts of a surfactant; and/or 10) the tablet further comprises a finish or polish coat to improve its aesthetic appearance.
- a LD extended release dosage form comprising: a LD, and optionally CD, extended release composition; and a CD immediate or rapid release composition, such that the LD is released slowly and substantially continuously over a 1 to 4-hour period after exposure of the tablet to an aqueous environment, and the CD is released within about 60 min from the immediate or rapid release composition.
- a LD delayed and extended dosage form comprising: an extended release composition comprising LD, and optionally CD, surrounded by an enteric coating, and a combination LD-CD immediate or rapid release composition surrounding the enteric coating, such that release of the LD, and optionally the CD, from the extended release composition is delayed and then released slowly and substantially continuously over a 1 to 4-hour period after exposure of the tablet to an aqueous environment, and the combination LD-CD composition is released within about 60 min after initiation of its release.
- Yet another aspect of the invention provides a method of treating a disease, disorder or syndrome that is responsive to combination LD and CD therapy, the method comprising the step of orally administering less unit doses as compared to the oral LD-CD
- ER dosage forms currently available for example SINEMET CR.
- This reduction in unit dose requirement i.e. a reduction in the total number of unit doses per day required to achieve a particular clinical endpoint, is achieved because the formulation of the invention Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- the formulation of the invention provides an increase in LD bioavailability of about 10% to 90% as compared to that observed for SINEMET CR and/or because the formulation of the invention provides an increase of the mean residence time of LD in the systemic circulation (blood plasma) up to about 30% over that provided by SINEMET CR when administered at the same dosage level and, consequently, provides sustained therapeutic plasma levels above the minimum therapeutic threshold up to about 5 to 12 hours after dosing.
- Yet another aspect of the invention provides a method of treating a disease, disorder or syndrome that is responsive to combination LD and CD therapy, the method comprising the step of orally administering to a subject a LD-CD dosage form that releases in the stomach of the subject the first 15 to 40% of the LD dose during the first hour after administration, thereby producing higher plasma levels of LD above the minimum therapeutic threshold as compared to that observed for SINEMET CR when administered in the same dosage amount.
- Yet another aspect of the invention provides an oral dosage form that provides a reduction of the required dose of CD, as compared to administration of SINEMET CR in order to achieve about the same therapeutic benefit, by releasing the CD in regions of the gastrointestinal tract having a pH less than or equal to about 5, whereby overall GI absorption of the CD is improved by minimizing its in situ degradation in the GI tract, in other words, by making the CD immediately available for absorption so any exposure to solution (gastric media) above pH 5 is minimized.
- FIG. 1 depicts the in vitro release profiles of LD and CD from the exemplary tablets of Examples 1 and 2.
- FIG. 2 depicts the in vitro release profiles of LD and CD from the exemplary tablets of Example 8. Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- FIG. 3 depicts the in vitro release profiles of LD and CD from the exemplary tablets of Example 11.
- FIG. 4 depicts the in vitro release profiles of LD and CD from the exemplary tablets of Example 12.
- FIG. 5 depicts the LD mean plasma concentration vs. time curves from the exemplary tablets of Example 11 and Sinemet CR administered according to Example 13.
- FIG. 6 depicts the CD mean plasma concentration vs. time curves from the exemplary tablets of Example 11 and Sinemet CR administered according to Example 13.
- the present invention provides a tablet for the oral administration of LD and CD to a patient suffering from a movement related disease, disorder or syndrome.
- An orally administrable solid pharmaceutical composition comprising LD in controlled release form and CD in controlled and/or rapid release form is provided.
- the pharmaceutical composition optionally includes LD in immediate or rapid release form.
- pharmaceutically acceptable is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
- a “therapeutically effective amount” is the amount or quantity of drug, which is sufficient to elicit the required or desired therapeutic response, or in other words, the amount that is sufficient to elicit an appreciable biological response when administered to a patient.
- immediate release a release of an active agent to an environment over a period of seconds to no more than about 30 minutes once release has begun and release begins within a second to no more than about 15 minutes after exposure to an aqueous environment.
- An immediate release composition releases drug in the buccal cavity, esophagus and/or stomach.
- RR rapid release
- a rapid release composition releases drug in the stomach, jejunum or duodenum after oral administration, provided the composition does not include a delayed release material or delayed release coating. In such a case, the rapid release composition would release drug in the upper, middle and/or lower intestine or colon.
- extended release is meant a controlled release of an active agent from a dosage form to an environment over (throughout or during) an extended period of time, e.g. greater than or equal to one hour.
- extended release profile assumes the definition as widely recognized in the art of pharmaceutical sciences. An extended release dosage form will release drug at substantially constant rate over an extended period of time or a substantially constant amount of drug will be released incrementally over an extended period of time.
- extended release includes the terms “controlled release”, “prolonged release”, “sustained release”, or “slow release”, as these terms are used in the pharmaceutical sciences.
- controlled release is meant a release of an active agent to an environment over a period of about eight hours up to about 12 hours, 16 hours, 18 hours, 20 hours, a day, or more than a day.
- a controlled release can begin within a few minutes after exposure to an aqueous environment or after expiration of a delay period (lag time) after exposure to an aqueous environment.
- sustained release is meant a controlled release of an active agent to maintain a constant drug level in the blood or target tissue of a subject to which the pharmaceutical composition is administered.
- a "dosage form” is a solid dosage form containing the pharmaceutical composition of the invention and being suitable for oral administration to a patient (subject).
- a “zero-order” release profile characterizes the release profile of a dosage form that releases a constant amount of drug per unit time.
- a “pseudo-zero order” release profile is one that approximates a zero-order release profile.
- a “first order” release profile characterizes the release profile of a dosage form that releases a constant percentage of an initial drug charge per unit time.
- a “pseudo-first order” release profile is one that approximates a first order release profile. Applicant: Osmotica Costa Spain, SA et al. Docket No. PHUS-1 65
- a delayed but controlled or extended release dosage form is one that provides a delayed release of a drug followed by a controlled or extended release of the drug.
- delayed release is meant any formulation technique wherein release of the active substance from the dosage form is modified to occur at a later time than that from a conventional immediate release product.
- the beginning of the controlled release of drug is delayed by an initial period of time. The period of delay is generally about 5 minutes to 10 hours, or 30 minutes to 5 hours, or 1 hour to 3 hours.
- release rate-controlling coating refers to a coating surrounding a tablet that controls the rate of release of drug from an associated composition such that the drug is released substantially continuously over an extended period of time.
- a delayed release coating is not a release-rate controlling coating, since a delayed release coating does not control the rate of drug release.
- a delayed release coating merely delays the initial release of drug from an associated composition.
- the present pharmaceutical composition can include a delayed release coating that delays the initial release of CD and/or LD from a controlled release composition or a rapid release composition.
- Thejiresent pharmaceutical composition can also include a delayed release material in a controlled release composition or a rapid release composition such that the delayed release material delays the initial release of CD and/or LD from the controlled release composition or the rapid release composition.
- AUC refers to the area under the plasma concentration-time curve, as calculated by the trapezoidal rule over the complete dosing interval.
- Cmax refers to the highest plasma concentration of the drug attained within the dosing interval.
- Tmax refers to the time period which elapses after administration of the dosage form at which the plasma concentration of the drug attains the highest plasma concentration of drug attained within the dosing interval.
- Suitable types of excipients include adsorbents, antioxidants, acidifying agent, alkalizing agent, buffering agents, colorants, flavorants, sweetening agents, tablet antiadherents, tablet binders, tablet diluents, tablet direct compression Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- excipients tablet disintegrants, tablet glidants, tablet lubricants, tablet opaquants and/or tablet polishing agents. Similar excipients used in capsule formulations can also be include in the present pharmaceutical composition.
- alkalizing agent is intended to mean a compound used to provide alkaline medium for product stability.
- Such compounds include, by way of example and without limitation, ammonia solution, ammonium carbonate, diethanolamine, monoethanolamine, potassium hydroxide, sodium borate, sodium carbonate, sodium bicarbonate, sodium hydroxide, triethanolamine, diethanolamine, organic amine base, alkaline amino acids and trolamine and others known to those of ordinary skill in the art.
- acidifying agent is intended to mean a compound used to provide an acidic medium for product stability.
- Such compounds include, by way of example and without limitation, acetic acid, acidic amino acids, citric acid, fumaric acid and other alpha hydroxy acids, hydrochloric acid, ascorbic acid, phosphoric acid, sulfuric acid, tartaric acid and nitric acid and others known to those of ordinary skill in the art.
- adsorbent is intended to mean an agent capable of holding other molecules onto its surface by physical or chemical (chemisorption) means.
- Such compounds include, by way of example and without limitation, powdered and activated charcoal and other materials known to one of ordinary skill in the art.
- antioxidant is intended to mean an agent that inhibits oxidation and thus is used to prevent the deterioration of preparations by the oxidative process.
- Such compounds include, by way of example and without limitation, ascorbic acid, ascorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, hypophophorous acid, monothioglycerol, propyl gallate, sodium ascorbate, sodium bisulfite, sodium formaldehyde sulfoxylate and sodium metabisulfite and other materials known to one of ordinary skill in the art.
- buffering agent is intended to mean a compound used to resist change in pH upon dilution or addition of acid or alkali.
- Such compounds include, by way of example and without limitation, potassium metaphosphate, potassium phosphate, monobasic sodium acetate and sodium citrate anhydrous and dihydrate and other materials known to one of ordinary skill in the art.
- sweetening agent is intended to mean a compound used to impart sweetness to a preparation.
- Such compounds include, by way of example and Applicant: Osmotica Costa Spain, S.A. et al. Docket No. PHUS-1 65
- antiadherent is intended to mean an agent that prevents the sticking of tablet formulation ingredients to punches and dies in a tableting machine during production.
- Such compounds include, by way of example and without limitation, magnesium stearate, talc, calcium stearate, glyceryl behenate, polyethylene glycol (PEG), hydrogenated vegetable oil, mineral oil, stearic acid and other materials known to one of ordinary skill in the art.
- binder is intended to mean a substance used to cause adhesion of powder particles in granulations.
- Such compounds include, by way of example and without limitation, acacia, poly(vinylpyrrolidone), compressible sugar (e.g., NuTab), ethylcellulose, gelatin, liquid glucose, povidone, pregelatinized starch, tragacanth, starch, cellulose materials such as methyl cellulose and sodium carboxy methyl cellulose, alginic acids and salts thereof, polyethylene glycol, guar gum, polysaccharide, bentonites, sugars, invert sugars, poloxamers (PLURONICTM F68, PLURONICTM F 127), collagen, albumin, cellulosics in nonaqueous solvents, combinations thereof and the like.
- acacia poly(vinylpyrrolidone), compressible sugar (e.g., NuTab), ethylcellulose, gelatin, liquid glucose, povidone, prege
- binders include, for example, polypropylene glycol, polyoxyethylene-polypropylene copolymer, polyethylene ester, polyethylene sorbitan ester, polyethylene oxide, combinations thereof and other materials known to one of ordinary skill in the art.
- the term "diluent” or “filler” is intended to mean inert substances used as fillers to create the desired bulk, flow properties, and compression characteristics in the preparation of tablets and capsules.
- Such compounds include, by way of example and without limitation, dibasic calcium phosphate, kaolin, lactose, sucrose, mannitol, microcrystalline cellulose, powdered cellulose, precipitated calcium carbonate, sorbitol, and starch and other materials known to one of ordinary skill in the art.
- direct compression excipient is intended to mean a compound used in direct compression tablet formulations.
- Such compounds include, by way of example and without limitation, dibasic calcium phosphate (e.g., Ditab) and other materials known to one of ordinary skill in the art.
- the term “glidant” is intended to mean an agent used in tablet and capsule formulations to promote flowability of the granulation.
- Such compounds include, by way of example and without limitation, colloidal silica, cornstarch, talc, calcium Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHL ) S-1 65
- silicate magnesium silicate, colloidal silicon, silicon hydrogel and other materials known to one of ordinary skill in the art.
- lubricant is intended to mean a substance used in the instant formulations to reduce friction during compression or other processing.
- Such compounds include, by way of example and without limitation, calcium stearate, magnesium stearate, mineral oil, stearic acid, and zinc stearate and other materials known to one of ordinary skill in the art.
- the term "opaquant” is intended to mean a compound used to render a capsule or a tablet coating opaque. May be used alone or in combination with a colorant.
- Such compounds include, by way of example and without limitation, titanium dioxide, talc and other materials known to one of ordinary skill in the art.
- polishing agent is intended to mean a compound used to impart an attractive sheen to coated tablets.
- Such compounds include, by way of example and without limitation, carnauba wax, white wax and other materials known to one of ordinary skill in the art.
- disintegrant is intended to mean a compound used in solid dosage forms to promote the disruption of the solid mass into smaller particles that are more readily dispersed or dissolved.
- exemplary disintegrants include, by way of example and without limitation, starches such as corn starch, potato starch, pre-gelatinized and modified starches thereof, sweeteners, clays, such as bentonite, microcrystalline cellulose (e.g., Avicel), carboxymethylcellulose calcium, cellulose polyacrilin potassium
- colorant is intended to mean a compound used to impart color to solid (e.g., tablets) pharmaceutical preparations. Such compounds include, by way of example and without limitation, FD&C Red No. 3, FD&C Red No. 20, FD&C
- flavorant is intended to mean a compound used to impart a pleasant flavor and often odor to a pharmaceutical preparation.
- exemplary flavoring agents or flavorants include synthetic flavor oils and flavoring aromatics and/or natural oils, extracts from plants, leaves, flowers, fruits and so forth and combinations thereof. These may also include cinnamon oil, oil of wintergreen, peppermint oils, clove oil, bay oil, anise oil, eucalyptus, thyme oil, cedar leave oil, oil of nutmeg, oil of sage, oil of bitter almonds and cassia oil.
- flavor examples include vanilla, citrus oil, including lemon, orange, grape, lime and grapefruit, and fruit essences, including apple, pear, peach, strawberry, raspberry, cherry, plum, pineapple, apricot and so forth.
- Flavors that have been found to be particularly useful include commercially available orange, grape, cherry and bubble gum flavors and mixtures thereof. The amount of flavoring may depend on a number of factors, including the organoleptic effect desired. Flavors will be present in any amount as desired by those of ordinary skill in the art. Particular flavors are the grape and cherry flavors and citrus flavors such as orange.
- the present pharmaceutical composition can also employ one or more commonly known surface active agents or cosolvents that improve wetting or disintegration of the tablet core or layers.
- Plasticizers can also be included in the pharmaceutical composition to modify the properties and characteristics of the polymers used in the coats or core of the composition.
- the term "plasticizer” includes all compounds capable of plasticizing or softening a polymer or binder used in invention.
- the plasticizer should be able to lower the melting temperature or glass transition temperature (softening point temperature) of the polymer or binder.
- Plasticizers such as low molecular weight PEG, generally broaden the average molecular weight of a polymer in which they are included thereby lowering its glass transition temperature or softening point. Plasticizers also generally reduce the viscosity of a polymer. It is possible the plasticizer will impart some particularly advantageous physical properties to the tablet of the invention.
- Plasticizers useful in the invention can include, by way of example and without limitation, low molecular weight polymers, oligomers, copolymers, oils, small organic molecules, low molecular weight polyols having aliphatic hydroxyls, ester-type plasticizers, glycol ethers, poly(propylene glycol), multi-block polymers, single block polymers, low molecular weight poly(ethylene glycol), citrate ester-type plasticizers, triacetin, propylene glycol and glycerin.
- plasticizers can also include ethylene Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- glycol 1,2-butylene glycol, 2,3-butylene glycol, styrene glycol, diethylene glycol, Methylene glycol, tetraethylene glycol and other poly(ethylene glycol) compounds, monopropylene glycol monoisopropyl ether, propylene glycol monoethyl ether, ethylene glycol monoethyl ether, diethylene glycol monoethyl ether, sorbitol lactate, ethyl lactate, butyl lactate, ethyl glycolate, dibutylsebacate, acetyltributylcitrate, triethyl citrate, acetyl triethyl citrate, tributyl citrate and allyl glycolate.
- plasticizers are commercially available from sources such as Aldrich or Sigma Chemical Co. It is also contemplated and within the scope of the invention, that a combination of plasticizers may be used in the present formulation.
- the PEG based plasticizers are available commercially or can be made by a variety of methods, such as disclosed in Poly(ethylene glycol) Chemistry: Biotechnical and Biomedical Applications (J.M. Harris, Ed.; Plenum Press, NY) the disclosure of which is hereby incorporated by reference.
- compositions of the invention can also include oils, for example, fixed oils, such as peanut oil, sesame oil, cottonseed oil, corn oil and olive oil; fatty acids, such as oleic acid, stearic acid and isotearic acid; and fatty acid esters, such as ethyl oleate, isopropyl myristate, fatty acid glycerides and acetylated fatty acid glycerides.
- fixed oils such as peanut oil, sesame oil, cottonseed oil, corn oil and olive oil
- fatty acids such as oleic acid, stearic acid and isotearic acid
- fatty acid esters such as ethyl oleate, isopropyl myristate, fatty acid glycerides and acetylated fatty acid glycerides.
- Alcohols such as ethanol, isopropanol, hexadecyl alcohol, glycerol and propylene glycol; with glycerol ketals, such as 2,2-dimethyl-l,3-dioxolane-4-methanol; with ethers, such as poly(ethyleneglycol) 450, with petroleum hydrocarbons, such as mineral oil and petrolatum; with water, or with mixtures thereof; with or without the addition of a pharmaceutically suitable surfactant, suspending agent or emulsifying agent.
- Soaps and synthetic detergents may be employed as surfactants and as vehicles for detergent compositions. Suitable soaps include fatty acid alkali metal, ammonium, and triethanolamine salts.
- Suitable detergents include cationic detergents, for example, dimethyl dialkyl ammonium halides, alkyl pyridinium halides, and alkylamine acetates; anionic detergents, for example, alkyl, aryl and olefin sulfonates, alkyl, olefin, ether and monoglyceride sulfates, and sulfosuccinates; nonionic detergents, for example, fatty amine oxides, fatty acid alkanolamides, and poly(oxyethylene)-block-poly(oxypropylene) copolymers; and amphoteric detergents, for example, alkyl ⁇ -aminopropionates and 2- alkylimidazoline quaternary ammonium salts; and mixtures thereof.
- cationic detergents for example, dimethyl dialkyl ammonium halides, alkyl pyridinium halides, and alkylamine acetates
- the dosage form of the invention can assume any shape or form known in the art of pharmaceutical sciences.
- the device of the invention can be a capsule, caplet, pill, sphere, tablet, oblong tablet, bar, plate, paraboloid of revolution, ellipsoid of revolution or the like.
- the dosage form can also include surface markings, cuttings, grooves, letters and/or numerals for the purposes of decoration, identification and/or other purposes.
- the dosage form can include a finish coat as is commonly done in the art to provide the desired shine, color, taste or other aesthetic characteristics.
- Materials suitable for preparing the finish coat are well known in the art and found in the disclosures of many of the references cited and incorporated by reference herein.
- the immediate release or rapid release composition includes a water soluble and/or erodible, inert and non-toxic material that is at least partially, and optionally substantially completely, soluble or erodible in an environment of use. Exemplary materials are disclosed in U.S. Patents No. 4,576,604 to Guittard et al. and No. 4,673,405 to Guittard et al., and No. 6,004,582 to Faour et al. and the text Pharmaceutical Dosage Forms: Tablets Volume I, 2nd Edition. (A. Lieberman. ed. 1989, Marcel Dekker, Inc.), the relevant disclosures of which are hereby incorporated by reference.
- Materials which are suitable for use in the immediate release or rapid release composition include, by way of example and without limitation, water soluble polysaccharide gums such as carrageenan, fucoidan, gum ghatti, tragacanth, arabinogalactan, pectin, and xanthan; water-soluble salts of polysaccharide gums such as sodium alginate, sodium tragacanthin, and sodium gum ghattate; water-soluble hydroxyalkylcellulose wherein the alkyl member is straight or branched of 1 to 7 carbons such as hydroxymethylcellulose, hydroxyethylcellulose, and hydroxypropylcellulose; Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- cellulose-based lamina formers such as methyl cellulose and its hydroxyalkyl methylcellulose cellulose derivatives such as a member selected from the group consisting of hydroxyethyl methylcellulose, hydroxypropyl methylcellulose, and hydroxybutyl methylcellulose; croscarmellose sodium; other cellulose polymers such as sodium carboxymethylcellulose; and other materials known to those of ordinary skill in the art.
- Other materials include poly(vinylpyrrolidone), polyvinylalcohol, polyethylene oxide, a blend of gelatin and polyvinyl-pyrrolidone, gelatin, glucose, saccharides, povidone, copovidone, poly(vinylpyrrolidone)-poly(vinyl acetate) copolymer.
- the artisan of ordinary skill will recognize that the above-noted materials include film-forming polymers that are not release rate controlling materials even though they may include the same chemical functionality thereof. This is because film-forming polymers that do not control release rate generally have lower molecular weight than otherwise similar film-forming polymers having higher molecular weight.
- a delayed release material (coating) used in the pharmaceutical composition will possess limited solubility or erodibility or be insoluble or non-erodible in a first external fluid, while being soluble and/or erodible in a second external fluid.
- the delayed release material may be insoluble in the fluid of a first environment of use, such as gastric juices, acidic fluids, or polar liquids, and soluble or erodible in the fluid of a second environment of use, such as intestinal juices, substantially pH neutral or basic fluids, or apolar liquids.
- a first environment of use such as gastric juices, acidic fluids, or polar liquids
- soluble or erodible in the fluid of a second environment of use such as intestinal juices, substantially pH neutral or basic fluids, or apolar liquids.
- a wide variety of other polymeric materials are known to possess these various solubility properties and can be used.
- Such other polymeric materials include, by way of example and without limitation, cellulose acetate phthalate (CAP), cellulose acetate trimelletate (CAT), poly(vinyl acetate)phthalate (PVAP), hydroxypropyl methylcellulose phthalate (HP), poly(methacrylate ethylacrylate) (1:1) copolymer (MA- EA), poly(methacrylate methylmethacrylate) (1:1) copolymer (MA-MMA), poly(methacrylate methylmethacrylate) (1:2) copolymer, EUDRAGITTM L-30-D (MA- EA, 1:1), EUDRAGITTM L-100-55 (MA-EA, 1:1), hydroxypropyl methylcellulose acetate succinate (HPMCAS), COATEPJCTM (PVAP), AQUATERICTM (CAP), AQOATTM (HPMCAS) and combinations thereof.
- CAP cellulose acetate phthalate
- CAT cellulose acetate trimelletate
- PVAP poly
- An optional polymeric material for the delayed release material/coating is a poly(vinylpyrrolidone)-vinyl acetate copolymer, such as the material supplied by BASF under its KOLLIDON VA64 trademark. This can be mixed with other excipients such as Applicant: Osmotica Costa Spain, S.A. et al. Docket No. PHUS-165
- the materials can be prepared in solutions having different concentrations of polymer according to the desired solution viscosity. For example, a 10% w/v aqueous solution of KOLLIDONTM K 30 has a viscosity of about 5.5-8.5 cps at 20° C, and a 2% w/v aqueous solution of METHOCELTM E-15 has a viscosity of about 13-18 cps at 20° C.
- the delayed release composition can also comprise other materials suitable which are substantially resistant to gastric juices and which will promote enteric release. These materials do not dissolve, disintegrate, or change their structure in the stomach and during the period of time that the dosage form resides in the stomach.
- Representative materials that keep their integrity in the stomach can comprise a member selected from the group consisting of (a) keratin, keratin sandarac-tolu, salol (phenyl salicylate), salol beta- naphthylbenzoate and acetotannin, salol with balsam of Peru, salol with tolu, salol with gum mastic, salol and stearic acid, and salol and shellac; (b) a member selected from the group consisting of formalized protein, formalized gelatin, and formalized cross-linked gelatin and exchange resins; (c) a member selected from the group consisting of myristic acid-hydrogenated castor oil-cholesterol, stearic acid-m
- cellulose acetyl phthalate comprising a member selected from the group consisting of cellulose acetyl phthalate, cellulose diacetyl phthalate, cellulose triacetyl phthalate, cellulose acetate phthalate, hydroxypropyl methylcellulose phthalate, sodium cellulose acetate phthalate, cellulose ester phthalate, cellulose ether phthalate, methylcellulose phthalate, cellulose ester-ether phthalate, hydroxypropyl cellulose phthalate, alkali salts of cellulose acetate phthalate, alkaline earth salts of cellulose acetate phthalate, calcium salt of cellulose acetate phthalate, ammonium salt of hydroxypropyl methylcellulose phthalate, cellulose acetate hexahydrophthalate, hydroxypropyl methylcellulose hexahydrophthalate, polyvinyl acetate phthalate (such as SURETERICTM of Colorcon), diethyl phthalate, dibuty
- Solutes can be added to the tablet. These solutes can aid in either the suspension or dissolution of drug.
- exemplary solutes include organic and inorganic compounds such as salts, acids, bases, chelating agents, sodium chloride, lithium chloride, magnesium chloride, magnesium sulfate, lithium sulfate, potassium chloride, sodium sulfite, calcium bicarbonate, sodium sulfate, calcium sulfate, calcium lactate, d-mannitol, urea, tartaric acid, raffinose, sucrose, alpha-d-lactose monohydrate, glucose, combinations thereof and other similar or equivalent materials which are widely known in the art.
- Carbidopa (CDP; L- ⁇ -hydrazino- ⁇ -methyl- ⁇ -(3,4-dihydroxybenzene) propanoic acid monohydrate) is commercially available in pharmaceutical grade bulk quantities from sources such as Teva Pharmaceutical Industries LTD (Netanya, Israel), and Divis Laboratories LTD (Andhra Pradesh, India).
- CD is intended to mean the crystalline or amorphous form of the anhydrous or hydrate form of the drug.
- Levodopa L- ⁇ -amino- ⁇ -methyl- ⁇ -(3,4-dihydroxybenzene) propanoic acid
- LD is commercially available in pharmaceutical grade bulk quantities from sources such as Divis Laboratories LTD (Andhra Pradesh, India) and Egis Pharmaceuticals LTD (Budapest, Hungary).
- the term LD is intended to mean the crystalline or amorphous form of the anhydrous or hydrate form of the drug.
- FIG. 1 depicts the release profiles for formulations prepared as disclosed in Examples 1 and 2 respectively, as compared to SINEMET CR.
- the in vitro testing was performed with USP Type II dissolution apparatus (paddles), in 900 ml of HCl 0.1N with a fixed agitation rate of 50 revolutions per minute, maintained at a temperature of 37 ⁇ 0.5° C. The samples were tested by high pressure liquid chromatography.
- the CD release Applicant Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- the values can vary depending upon the conditions employed. Moreover, the values may have an absolute standard deviation (STD) of ⁇ 10%, ⁇ 5% or +3% at each given time point.
- STD absolute standard deviation
- the dissolution profile for the drugs will vary according to the specific formulations used to create the dosage form.
- the dosage forms of Ex. 1 and Ex. 2 comprise: a single ER composition comprising a combination of LD and CD, wherein the composition excludes a release rate-controlling polymer, and a disintegrant. These dosage forms do not comprise a release rate-controlling coating, nor an IR or RR coating.
- the dosage form of Ex. 3 comprises: an ER composition comprising LD, (which excludes a release rate-controlling polymer and a disintegrant), an enteric coating surrounding the ER composition, which coating delays the release of the active agents from the ER composition; and an IR or RR coating comprising a combination of LD and CD.
- the dosage form of Ex. 4 comprises: an ER composition comprising a combination of LD and CD (which exclude a release rate-controlling polymer and a disintegrant), and an IR or RR coating surrounding the ER composition, the coating comprising CD.
- the dosage form of Ex. 5 comprises: an ER composition comprising LD, (which composition excludes a release rate-controlling polymer and a disintegrant), and an IR or RR coating comprising CD, wherein the coating surrounds the ER composition.
- the dosage form of Ex. 6 comprises in stacked arrangement: an ER layer comprising a combination of LD and CD, wherein the ER layer includes a release rate-controlling polymer; and an IR or RR layer comprising CD.
- Ex. 7 comprises in stacked arrangement: an ER layer comprising a combination of LD and CD, (which ER layer excludes a release rate- controlling polymer and a disintegrant) and an IR or RR layer comprising CD.
- the dosage form of Ex. 8 comprises: an ER layer comprising LD, (which layer includes a release rate- controlling polymer), and an IR or RR layer comprising a combination of LD and CD.
- Ex. 9 comprises: an ER core composition comprising LD, (which core includes a release rate-controlling polymer), an enteric coating surrounding the core, (wherein the coating delays release of active agent from the core), and an IR or RR coating comprising a combination of LD and CD, wherein the IR or RR coating surrounds the ER coating.
- the dosage form of Ex. 10 comprises an ER core composition comprising: a combination of LD and CD, (wherein the core excludes a release rate-controlling polymer and a disintegrant), an enteric coating that surrounds the core and delays the release of active agent from the core; and an IR or RR coating comprising a combination of LD and
- the dosage form of Ex. 11 comprises in stacked arrangement, an ER layer comprising LD and a release rate- controlling polymer; and an IR or RR layer comprising CD.
- an ER layer comprising a combination of LD and CD, (wherein the ER layer excludes a release rate-controlling polymer and a disintegrant), and an IR or RR layer comprising a combination of LD and CD.
- the oral dosage forms of the present invention would provide a reduced dosing frequency as compared to the oral LD-CD ER dosage forms that are currently commercially available, e.g. SINEMET CR, by providing first the release of CD to produce an early AADC inhibition at the gastro-intestinal level prior to the absorption of the LD. Consequently, the LD released later than the CD would reach absorption sites and systemic circulation once the AADC is fully inhibited. This synchronization of the action time of CD would provide an improvement of about 10% to 90% in early absorption LD bioavailability compared to that observed for SINEMET CR.
- Examples 4, 5, 6, 7, and 11 which comprise an ER formulation of LD and optionally in combination with CD, and an IR or RR formulation comprising only CD. While not wishing to be bound by any particular theory, it is believed that the oral dosage forms of the present invention would also provide a faster relief in patients of the morning off-state caused by the reduction in plasma LD concentration that occurs while a patient is sleeping. Parkinson's patients usually awaken in the morning in the off state and must wait for a morning dose of LD to take effect before they can function comfortably.
- the synchronized dosage forms disclosed in Examples 4, 5, 6, 7, and 11, help minimize the symptom since they rapidly make available the first 15 to 40% of the LD dose dissolved during the first hour in the stomach for the absorption, producing high plasma levels of LD above the therapeutic threshold, before any oral LD-CD ER dosage forms currently available.
- Other dosage forms designed to achieve this goal are disclosed in Examples 3, 8, 9, 10, and 12, each dosage form of which comprises an ER core formulation of LD and optionally in combination with CD, an optional enteric coating which delays the release of the active agents from the core, and an IR or RR coating formulation comprising a combination of LD and CD and surrounding the core.
- the oral dosage forms of the present invention would also provide a reduced dosing frequency as compared to the oral LD-CD ER dosage forms currently available by incrementing the mean residence time of LD in the systemic circulation up to about 30% and, consequently, providing sustained plasma levels above the therapeutic threshold up to about 5 to 12
- the dosage forms designed to achieve this goal comprise at least about 40% of the total LD and CD doses in a combined delayed and extended release formulation, which would start the release of the active agents at pH 5.0 or higher, and complete it in 1.0 to 2.5 hours within the absorption window, and the rest of the LD and CD doses in an immediate or rapid release formulation.
- These dosage forms will provide a first plasma concentration peak (pulse) and, before plasma concentrations fall below the therapeutic threshold, a second plasma concentration peak (pulse), which would extend the overall time period during which therapeutic levels of the LD are present in the plasma, especially as compared to the SINEMET CR dosage form.
- the second plasma concentration peak would result in an increased AADC inhibition due to the previously absorbed CD; therefore, it would provide an increase of at least 20% in bioavailability compared to the available extended release products, especially SINEMET CR.
- Dosage forms designed to achieve this goal are disclosed in Examples 3, 9, and 10, each dosage form of which comprises an ER core formulation of LD, an enteric coating surrounding the core, which coating delays the release of the active agents from the core, and an IR or
- RR coating formulation surrounding the enteric coating and comprising a combination of LD and CD.
- the food may produce an additional delay of the second peak due to the increase in gastric-emptying time, thereby providing an additional extension of the overall time period that the CD is present in the plasma at a therapeutic level.
- the oral dosage forms of the present invention may also provide a reduction of the daily total oral dose of CD required to achieve a particular clinical endpoint, as compared to the administration of SINEMET CR, by releasing the CD in the regions of the gastrointestinal tract having a pH less than or equal to about 5, thereby providing improved absorption of CD by reduction of its degradation in vivo.
- Dosage forms designed to achieve this goal are disclosed in Examples 3, 5, 8, 9, and 11, each dosage form of which comprises and ER formulation of only LD, optionally a delayed coating, and an IR or RR coating formulation comprising a combination of CD and optionally LD.
- the range of weight ratio of CD to LD in a tablet can vary from 1:1 to 1:50.
- the ratio can be varied depending upon the disorder being treated and the amount of drug per unit dose.
- the weight ratio of CD to LD is about 1 to 4. Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- Example 11 A pharmacokinetic study carried out as described in Example 13 showed that the dosage form of Example 11 (Test, T) of the present invention compared to SINEMET CR (Reference, R), provides a bioequivalent AUC, a higher Cmax (T:R, p ⁇ 0.05) and a shorter Tmax (T:R, p ⁇ 0.05) for LD.
- the parameter values are disclosed in the following table.
- T Trips, T of the present invention compared to SINEMET CR (Reference, R), provides bioequivalent AUC and Cmax, and a shorter Tmax (T:R, p ⁇ 0.05) for carbidopa.
- the parameter values are disclosed in the following table.
- the bilayer tablet of the invention containing an extended release of LD and an immediate or rapid release of CD as compared to the oral LD-CD ER dosage forms that are currently commercially available, e.g. SINEMET CR, provides enhanced absorption of levodopa, shown by an increase on the Cmax between 23.66% and 63.46%, and a faster onset of action, shown by the plasma levels of levodopa and carbidopa provided at earlier time points, in other words, shown by the shorter Tmax.
- the LD and CD mean plasma concentration vs. time curves from the exemplary tablets of Example 11 and Sinemet CR administered according to Example 13 are disclosed in FIGs. 5 and 6 respectively.
- bilayer tablets Qf the invention containing an extended release of LD and an immediate or rapid release of CD as compared to the oral LD-CD IR dosage forms that are currently commercially available, e.g. SINEMET, is that it provides a reliable and rapid plasma level of LD and a longer duration of action than existing immediate release dosage forms which may offer a rapid plasma level of LD but a short duration of action.
- the pharmaceutical composition of the invention is used to treat involuntary movement in any disease, syndrome or other disorder known to be treatable with the combination of CD and LD.
- diseases, syndromes and disorders include Parkinson's disease, Parkinson's disease-like disorders that occur due to injury to or illness in the nervous system, postencephalitic parkinsonism, symptomatic parkinsonism due to carbon monoxide intoxication and/or manganese intoxication, tremors in complex regional pain syndrome, childhood amblyopia, frontal lobe dysfunction in traumatic brain injury, movement disorder following midbrain haemorrhage, locked-in syndrome, adult age phenylketonuria with extrapyramidal syndrome, progressive supranuclear palsy, restless leg syndrome, dopamine deficiency syndrome, axial muscle rigidity associated with etretinate therapy, tardive dystonia (dyskinesia), L-dopa induced dyskinesia, hereditary extrapyramidal system disease, akinetic-rigid
- the invention also discloses dosage forms containing amantadine (AMN), LD and optionally CD.
- AMN amantadine
- Example 14 discloses an exemplary delayed and extended release tablet that provides a delayed and extended release of LD and CD from an enteric coated extended release core of LD and CD and an immediate release external coating comprising AMN, LD and CD.
- Example 15 discloses an exemplary bilayered tablet that provides an extended release of LD and CD, and an immediate or rapid release of AMN and CD.
- Amantadine can be administered to late-stage Parkinsonian patients as adjunct (add-on or combination) therapy to levodopa for treating dyskinesias.
- PCT International Publication No. WO04/087116 to Vergez et al. discloses a phase II, controlled study in a double-blind setting carried out to evaluate the impact of the combination of amantadine and citalopram in the UPDRS score of patients suffering from motor fluctuations. The study showed clear evidences that amantadine on top of levodopa treatment produced a significant improvement in all of the motor fluctuation-related scores (UPDRS and AIMS) in fluctuating patients.
- UPDRS and AIMS motor fluctuation-related scores
- the invention also provides a method of treating Parkinson's disease by orally administering a dosage form comprising AMN, CD and LD such that the combined release profile of amantadine, LD and CD will an improved clinical benefit to a subject to which the dosage form is administered, as compared to administration of a dosage form, such as SINENET CR that Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- AMN excludes AMN, wherein the improved clinical benefit can be improved bioavailability and/or less side effects (nausea, vomiting, and/or appetite loss).
- Levodopa, CD and the carbohydrate were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the organic acid previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of a granulating solution containing an antiadherent and purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40- 6O 0 C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, the lubricant, previously sieved through a 30-mesh screen, was added and mixed for about 5 minutes. This final blend was tabletted to provide the tablets.
- LD and CD were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the organic acid and the sodium chloride previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of a granulating solution containing an antiadherent and purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40- 6O 0 C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, the lubricant, previously sieved through a 30-mesh screen, was added and mixed for about 5 minutes. This final blend was tabletted to provide the tablets.
- the following procedure is used to prepare an exemplary compressed extended release tablet that provides a delayed and controlled release of LD, in the presence of a delayed release coating, and an immediate release of LD and CD in an external coating.
- ER is taken to mean extended release.
- RR is taken to mean rapid release.
- IR is taken to mean immediate release.
- DR is taken to mean delayed release.
- the core containing carbohydrate is manufactured as disclosed in Example 1, but in the absence of CD.
- the core containing sodium chloride is manufactured as disclosed in Example 2, but in the absence of CD.
- an enteric coating composition is prepared as follows: triacetin is blended in purified water. Hydroxypropyl methylcellulose phthalate is added and mixed thoroughly to form a polymer suspension. This suspension is sprayed onto the cores in a perforated pan coater to obtain coated cores.
- An external coating composition is prepared as follows: a film former polymer, a plasticizer, a filler and a disintegrant are blended in purified water. The pH of this blend is adjusted to between 6-8 with sodium phosphate dibasic. Then the LD and the CD are added to the blend, and mixed thoroughly to form a polymer mixture. This mixture is sprayed onto the coated cores in a perforated pan coater to obtain the final tablets.
- Example 4 The following procedure is used to prepare an exemplary extended release tablet that provides a controlled release of LD and CD, in the absence of a release rate- controlling polymer and a release rate-controlling coating, and an immediate release of CD.
- the core containing carbohydrate is manufactured as disclosed in Example 1.
- the core containing sodium chloride is manufactured as disclosed in Example 2.
- An external coating composition is prepared as follows: a firm former polymer, a plasticizer, a filler and a disintegrant are blended in purified water. The pH of this blend is adjusted to between 6-8 with sodium phosphate dibasic. Then the CD is added to the blend, and mixed thoroughly to form a polymer mixture. This mixture is sprayed onto the coated cores in a perforated pan coater to obtain the final tablets.
- the following procedure is used to prepare an exemplary extended release tablet that provides a controlled release of LD, in the absence of a release rate-controlling polymer and a release rate-controlling coating, and an immediate release of CD.
- the core containing LD and carbohydrate is manufactured as disclosed in Example 1.
- the core containing LD and sodium chloride is manufacture as disclosed in Example 2.
- the external coating mixture is manufactured as disclosed in Example 4. This mixture is sprayed onto the coated cores in a perforated pan coater to obtain the final tablets.
- the extended release layer composition is prepared as follows: the LD, CD and the CR polymer are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the filler and colorants previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend. Then, the granulation process is initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules. The wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, the glidant and the lubricant, previously sieved through a 30-mesh screen, is added and mixed for about 5 minutes, to obtain the granules to manufacture the extended release layer.
- Applicant Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- the immediate or rapid release composition is prepared as follows: the CD, filler, binder and half of the amount of the disintegrant are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process is initiated by the gradual addition of water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60 0 C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction.
- the glidant, lubricant, and the other half of the amount of the disintegrant, previously sieved through a 30-mesh screen are added and mixed for about 5 minutes.
- the extended release layer composition and the immediate or rapid release layer composition are compressed as follows: (120-260) mg of the extended release composition is added to the die and tamped, then it is overlaid with (60-260) mg of the immediate or rapid release composition and the two compositions are pressed to obtain the bilayer tablets.
- the following procedure is used to prepare an exemplary bilayer tablet that provides an extended release of LD and CD, in the absence of a release rate-controlling polymer, and an immediate or rapid release of CD.
- the extended release layer composition is prepared as follows.
- the LD and CD are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the tartaric acid and the sodium chloride previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process is initiated by the gradual addition of a granulating solution containing polyethylene glycol 4000 and purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60 0 C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, the magnesium stearate, previously sieved through a 30-mesh screen, is added and mixed for about 5 minutes.
- the immediate or rapid release composition is prepared as follows: the CD, microcrystalline cellulose, povidone and a half croscarmellose sodium are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process is initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, colloidal silicon dioxide, the other half of the croscarmellose sodium and magnesium stearate, previously sieved through a 30-mesh screen, are added and mixed for about 5 minutes.
- the extended release layer composition and the immediate or rapid release composition are compressed as follows: (120-380) mg of the extended release composition is added to the die and tamped, then it is overlaid with (60-260) mg of the immediate or rapid release composition and the two compositions are pressed to obtain the bilayer tablets.
- Example 8 The following procedure was used to prepare a bilayer tablet that provides an extended release of LD and an immediate or rapid release of LD and CD. Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- the extended release layer composition was prepared as follows: the LD and hydroxyethylcellulose were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with microcrystalline cellulose and colorants previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, colloidal silicon dioxide and magnesium stearate, previously sieved through a 30-mesh screen, were added and mixed for about 5 minutes.
- the immediate or rapid release composition is prepared as follows: the LD, CD, microcrystalline cellulose, povidone and half of the croscarmellose sodium were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend. The granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules. The wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction. Next, the dry granules were milled using a rotary mill with a 1575 ⁇ m Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- the extended release layer composition and the immediate or rapid release composition were compressed as follows: (115-385) mg of the extended release composition was added to the die and tamped, then it was overlaid with (165-245) mg of the immediate or rapid release composition and the two compositions were pressed to obtain the bilayer tablets.
- the following procedure is used to prepare an exemplary dry coated gastro- resistant tablet that provides a delayed and extended release of levodopa and an immediate or rapid release of levodopa and carbidopa.
- the extended release layer composition is prepared as follows: the levodopa and hydroxyethylcellulose are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with microcrystalline cellulose and colorants previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, colloidal silicon dioxide and magnesium stearate, previously sieved through a 30- mesh screen, were added and mixed for about 5 minutes. This final blend was tabletted to provide the tablet cores.
- the enteric coating composition is prepared as follows: Polyvinyl acetate phthalate (Sureteric TM of Colorcon) is blended in purified water to form a polymer suspension. Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- This suspension is sprayed onto the cores in a perforated pan coater to obtain gastro- resistant coated cores.
- the immediate or rapid release composition is prepared as follows: the levodopa, carbidopa, microcrystalline cellulose, povidone and half of the croscarmellose sodium are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process is initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40- 6O 0 C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, colloidal silicon dioxide, magnesium stearate, and the other half of the croscarmellose sodium, previously sieved through a 30-mesh screen, are added and mixed for about 5 minutes and then press coated onto the gastro-resistant coated cores to obtain dry coated gastro-resistant tablets.
- the following procedure is used to prepare an exemplary dry coated gastro- resistant tablet that provides a delayed and extended release of levodopa and an immediate or rapid release of levodopa and carbidopa.
- the levodopa is first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the tartaric acid and the sodium chloride previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process is initiated by the gradual addition of a granulating solution containing polyethylene glycol 4000 and purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, the magnesium stearate, previously sieved through a 30-mesh screen, is added and mixed for about 5 minutes. This final blend is tabletted to provide the extended release cores.
- an enteric coating composition is prepared as follows: triacetin is blended in purified water and the hydroxypropyl methylcellulose phthalate is added and mixed thoroughly to form a polymer suspension. This suspension is sprayed onto the cores in a perforated pan coater to obtain gastro-resistant coated cores.
- the immediate or rapid release composition is prepared as disclosed in Example 9, and then press coated onto the gastro resistance coated cores to obtain dry coated gastro- resistant tablets.
- the extended release layer composition was prepared as follows: the LD and hydroxyethylcellulose were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with microcrystalline cellulose and colorants previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, colloidal silicon dioxide and magnesium stearate, previously sieved through a 30-mesh screen, was added and mixed for about 5 minutes.
- the immediate or rapid release composition was prepared as follows: the CD, microcrystalline cellulose, povidone and half of the croscarmellose sodium were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend. The granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules. The wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction. Next, the dry granules were milled using a rotary mill with a 1575 ⁇ m Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-165
- the extended release layer composition and the immediate or rapid release composition were compressed as follows: (216-490) mg of the extended release composition was added to the die and tamped, then it was overlaid with (157-540) mg of the immediate or rapid release composition and the two compositions were pressed to obtain the bilayer tablets.
- the extended release layer composition was prepared as follows: the LD and CD were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the organic acid and the sodium chloride previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of a granulating solution containing polyethylene glycol 4000 and purified water to the powder blend, with Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction.
- the magnesium stearate previously sieved through a 30-mesh screen, was added and mixed for about 5 minutes.
- the immediate or rapid release composition is prepare as follows: the LD and CD, microcrystalline cellulose, povidone and half of the croscarmellose sodium were first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules were milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, colloidal silicon dioxide, magnesium stearate, and the other half of the croscarmellose sodium, previously sieved through a 30-mesh screen, were added and mixed for about 5 minutes.
- the extended release layer composition and the immediate or rapid release composition were compressed as follows: (70-410) mg of the extended release composition was added to the die and tamped, then it was overlaid with (70-210) mg of the immediate or rapid release composition and the two compositions were pressed to obtain the bilayer tablets.
- Treatment A is the dosage form of Example 9 of the present invention.
- Treatment B is the dosage form of Example 11 of the present invention.
- Treatments C and D contained reference treatments.
- Treatment C is a single extended release tablet of STNEMET CR containing 50 mg of CD and 200 mg of LD (Rl).
- treatment D is a combination of one SINEMET (IR) tablet of 25 mg of CD and 100 mg ofLD plus one SINEMET CR tablet of 25 mg of CD and 100 mg of LD (R2).
- Example 14 The following procedure is used to prepare an exemplary delayed and extended release tablet that provides a delayed and extended release of LD from an enteric coated extended release core of LD and an immediate release external coating comprising AMN, LD and CD.
- the extended release layer composition is prepared as follows: the levodopa and a CR polymer are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the filler and colorants previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process was initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation was dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- glidant and the lubricant previously sieved through a 30-mesh screen, were added and mixed for about 5 minutes. This final blend was tabletted to provide the tablet cores.
- the enteric coating composition is prepared as follows: a plastizicer is blended in purified water. The enteric film polymer is added and mixed thoroughly to form a polymer suspension. This suspension is sprayed onto the cores in a perforated pan coater to obtain gastro-resistant coated cores.
- the immediate or rapid release composition is prepared as follows: amantadine, LD, CD, a filler, a binder and a disintegrant are placed in a high shear mixer and mix for 5 minutes.
- the granulation process is initiated by the gradual addition of purified water to the high shear mixer with continuous blending to produce a wet blend.
- the wet blend is granulated and dried at 40-50 0 C for 20 minutes in a fluid bed to remove the water. Then, the dry granules are screened through a 20 USP mesh screen for size reduction.
- the screened granules are mixed with a glidant and a lubricant, which have been previously passed through a 60 mesh screen, in a V-Blender during 5 minutes.
- the granulate is applied over the cores through compression to obtain AMN-LD-CD coated gastro resistant cores.
- the tablets have an outer diameter of about 12 mm.
- a finish coat comprising Opadry and a colorant hi purified water is applied onto the AMN-LD-CD coated gastro resistant cores to obtain the final tablets.
- the following procedure is used to prepare an exemplary bilayer tablet that provides an extended release of LD and CD, and an immediate or rapid release of AMN and CD.
- the extended release layer composition is prepared as follows: the LD, CD and the CR polymer are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed with the filler and colorants previously milled using a hammer mill with a 0020 screen, in a mixer granulator for up to 10 minutes to form a homogenous powder blend. Then, the granulation process is initiated by the gradual addition of purified water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules. The wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction. Then, the glidant and the lubricant, previously sieved through a 30-mesh screen, is added and mixed for about 5 minutes, to obtain the granules to manufacture the extended release layer.
- the immediate or rapid release composition is prepared as follows: the AMN, CD, filler, binder and half of the amount of the disintegrant are first individually screened in a rotary mill with a 991 ⁇ m screen, and then mixed in a mixer granulator for up to 10 minutes to form a homogenous powder blend.
- the granulation process is initiated by the gradual addition of water to the powder blend, with continuous mixing, to change the consistency of the dry powder ingredients to granules.
- the wet granulation is dried in a static bed at 50-70° C or in a fluid bed at 40-60°C for humidity reduction.
- the dry granules are milled using a rotary mill with a 1575 ⁇ m screen at less than 1200 rpm for size reduction.
- the glidant, lubricant, and the other half of the amount of the disintegrant, previously sieved through a 30-mesh screen are added and mixed for about 5 minutes.
- the extended release layer composition and the immediate or rapid release layer composition are compressed as follows: (132-493) mg of the extended release composition is added to the die and tamped, then it is overlaid with (128-678) mg of the Applicant: Osmotica Costa Rica, S.A. et al. Docket No. PHUS-1 65
- immediate or rapid release composition and the two compositions are pressed to obtain the bilayer tablets.
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Abstract
Description
Claims
Priority Applications (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2006345054A AU2006345054A1 (en) | 2005-08-05 | 2006-08-04 | Extended release solid pharmaceutical composition containing carbidopa and levodopa |
JP2008524349A JP2009502987A (en) | 2005-08-05 | 2006-08-04 | Extended release solid pharmaceutical composition containing carbidopa and levodopa |
BRPI0614091-2A BRPI0614091A2 (en) | 2005-08-05 | 2006-08-04 | solid extended release pharmaceutical composition containing carbidopa and levodopa |
CA002614389A CA2614389A1 (en) | 2005-08-05 | 2006-08-04 | Extended release solid pharmaceutical composition containing carbidopa and levodopa |
EP06828467A EP1909768A1 (en) | 2005-08-05 | 2006-08-04 | Extended release solid pharmaceutical composition containing carbidopa and levodopa |
MX2008001711A MX2008001711A (en) | 2005-08-05 | 2006-08-04 | Extended release solid pharmaceutical composition containing carbidopa and levodopa. |
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US70583905P | 2005-08-05 | 2005-08-05 | |
US60/705,839 | 2005-08-05 |
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WO2008000194A1 true WO2008000194A1 (en) | 2008-01-03 |
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PCT/CR2006/000006 WO2008000194A1 (en) | 2005-08-05 | 2006-08-04 | Extended release solid pharmaceutical composition containing carbidopa and levodopa |
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US (1) | US20070275060A1 (en) |
EP (1) | EP1909768A1 (en) |
JP (1) | JP2009502987A (en) |
KR (1) | KR20080033354A (en) |
CN (1) | CN101516351A (en) |
AR (1) | AR055106A1 (en) |
AU (1) | AU2006345054A1 (en) |
BR (1) | BRPI0614091A2 (en) |
CA (1) | CA2614389A1 (en) |
MX (1) | MX2008001711A (en) |
WO (1) | WO2008000194A1 (en) |
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BR112015010601B1 (en) | 2012-11-09 | 2022-07-19 | Civitas Therapeutics, Inc. | PHARMACEUTICAL COMPOSITION AND USE OF THE COMPOSITION |
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US10994013B2 (en) | 2013-04-24 | 2021-05-04 | Temple University—Of the Commonwealth System of Higher Education | Solid dosage form containing arabinogalactan |
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US9808478B2 (en) * | 2015-04-17 | 2017-11-07 | Steven Loyd | Control release of fat soluble antioxidants from an oral formulation and method |
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US11986449B2 (en) | 2020-12-22 | 2024-05-21 | Amneal Pharmaceuticals Llc | Levodopa dosing regimen |
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Cited By (3)
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EP2419508A4 (en) * | 2009-04-17 | 2012-11-14 | Somalabs Inc | Method for the induction of a reward response by modulation of dopaminergic systems in the central nervous system |
CN102924652A (en) * | 2012-11-26 | 2013-02-13 | 无锡朗力药物技术有限公司 | Method for refining polyacrylic resin IV |
EP3773532A4 (en) * | 2018-03-29 | 2022-11-02 | Avion Pharmaceuticals, LLC | Levodopa fractionated dose composition and use |
Also Published As
Publication number | Publication date |
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JP2009502987A (en) | 2009-01-29 |
MX2008001711A (en) | 2008-04-07 |
CA2614389A1 (en) | 2008-01-03 |
US20070275060A1 (en) | 2007-11-29 |
AU2006345054A1 (en) | 2008-01-03 |
AR055106A1 (en) | 2007-08-08 |
BRPI0614091A2 (en) | 2011-03-09 |
EP1909768A1 (en) | 2008-04-16 |
KR20080033354A (en) | 2008-04-16 |
CN101516351A (en) | 2009-08-26 |
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