WO2010006929A1 - Pharmaceutical compositions comprising levetiracetam - Google Patents

Pharmaceutical compositions comprising levetiracetam Download PDF

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Publication number
WO2010006929A1
WO2010006929A1 PCT/EP2009/058316 EP2009058316W WO2010006929A1 WO 2010006929 A1 WO2010006929 A1 WO 2010006929A1 EP 2009058316 W EP2009058316 W EP 2009058316W WO 2010006929 A1 WO2010006929 A1 WO 2010006929A1
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WO
WIPO (PCT)
Prior art keywords
pharmaceutical composition
composition according
per weight
levetiracetam
respect
Prior art date
Application number
PCT/EP2009/058316
Other languages
French (fr)
Inventor
Domenico Fanara
Johan Schild
Original Assignee
Ucb Pharma, S.A.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Application filed by Ucb Pharma, S.A. filed Critical Ucb Pharma, S.A.
Priority to JP2010549160A priority Critical patent/JP4903900B2/en
Publication of WO2010006929A1 publication Critical patent/WO2010006929A1/en

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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
    • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
    • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/4015—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil having oxo groups directly attached to the heterocyclic ring, e.g. piracetam, ethosuximide
    • A—HUMAN NECESSITIES
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    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
    • A61K9/0056—Mouth soluble or dispersible forms; Suckable, eatable, chewable coherent forms; Forms rapidly disintegrating in the mouth; Lozenges; Lollipops; Bite capsules; Baked products; Baits or other oral forms for animals
    • A—HUMAN NECESSITIES
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    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
    • A61K9/1605—Excipients; Inactive ingredients
    • A61K9/1617—Organic compounds, e.g. phospholipids, fats
    • A61K9/1623—Sugars or sugar alcohols, e.g. lactose; Derivatives thereof; Homeopathic globules
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    • A—HUMAN NECESSITIES
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    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
    • A61K9/1605—Excipients; Inactive ingredients
    • A61K9/1629—Organic macromolecular compounds
    • A61K9/1635—Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone, poly(meth)acrylates

Definitions

  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam, brivaracetam or seletracetam as active ingredient.
  • Levetiracetam or (S)-(-)-alpha-ethyl-2-oxo-1 -pyrrolidine acetamide, a laevorotatory compound is disclosed as a protective agent for the treatment and the prevention of hypoxic and ischemic type aggressions of the central nervous system in the European patent No. EP 0 162 036 B and has the following formula:
  • This compound is also effective in the treatment of epilepsy, a therapeutic indication for which it has been demonstrated that its dextrorotatory enantiomer (R)-(+) alpha-ethyl-2-oxo-1 -pyrrolidine acetamide completely lacks activity (AJ. Gower et al., Eur. J. Pharmacol., 222, 1992, 193-203).
  • International patent application having publication number WO 01/62726 discloses 2-oxo-1 -pyrrolidine derivatives and methods for their preparation. It particularly discloses compound (2S)-2-[(4R)-2-oxo-4-propyl-pyrrolidin-1 -yl] butanamide known under the international non propriety name of brivaracetam.
  • Brivaracetam International patent application having publication number WO 2005/121082 describes a process of preparation of 2-oxo-1 -pyrrolidine derivatives and particularly discloses a process of preparation of (2S)-2-[(4S)-4-(2,2-difluorovinyl)-2-oxo-pyrrolidin- 1 -yl]butanamide known under the international non propriety name of seletracetam.
  • Brivaracetam is effective in the treatment of epilepsy.
  • a phase Il clinical trial evaluated the efficacy and safety of brivaracetam (5, 20 and 50 mg per day) in the adjunctive treatment of adult patients (16-65 years) with refractory partial onset seizures, with or without secondary generalization.
  • Brivaracetam is also effective in the treatment of patients (>18 years) with post-herpetic neuralgia.
  • Seletracetam is effective in the treatment of epilepsy.
  • Two phase Na dose exploration studies were conducted with seletracetam in epilepsy evaluating the efficacy and safety of seletracetam in the adjunctive treatment of partial onset seizures in highly refractory adult patients currently receiving up to three concomitant anti- epileptic drugs.
  • compositions which can be administered orally are to have a composition free from the taste of the active ingredient, when dispersed in water or swallowed directly.
  • the present invention relates to orally administrable granules comprising an active ingredient, and particularly to an orally, pleasant tasting particulate form of levetiracetam, brivaractam or seletracetam, that when dispersed into water is substantially free of the taste of the active ingredient.
  • a dry syrup preparation means "preparations which are dissolved or suspended before use” according to general rules for preparations in the Japanese pharmacopoeia. This is the preparation especially for patients like children who dislike a medicine or elderly persons having difficulty swallowing, and even the children and/or the elderly persons can easily take it. Many adults and many children have difficulty swallowing the pills or tablets, or can not swallow them, and thereby do not benefit from levetiracetam, brivaracetam or seletracetam. Furthermore, the preparation is handy, and can be divided and dosed very easily.
  • the present invention relates to an orally administrable pharmaceutical composition in the form of a dry syrup comprising, as active ingredient, levetiracetam, brivaracetam or seletracetam and, as excipient, at least 10 to 90 % per weight of granulated powder diluent, selected among mannitol, sorbitol or xylitol, having an average particle size of from 75 to 520 ⁇ m, with respect to the total weight of the composition.
  • the present invention relates to an orally administrable pharmaceutical composition in the form of a dry syrup comprising, as active ingredient, levetiracetam and, as excipient, at least 10 to 90 % per weight of granulated powder mannitol, as diluent, having an average particle size of from 75 to 520 ⁇ m, with respect to the total weight of the composition.
  • the present invention relates to an orally administrable pharmaceutical composition in the form of a dry syrup for treating a disease selected from the group consisting of elipepsy, Parkinson's disease, dyskenia other neurological disorders, comprising, as active ingredient, levetiracetam, brivaracetam or seletracetam and, as excipient, at least 10 to 90 % per weight of granulated powder diluent, selected among mannitol, sorbitol or xylitol, having an average particle size of from 75 to 520 ⁇ m, with respect to the total weight of the composition.
  • active ingredient as used herein is defined as a substance which has a therapeutic effect.
  • the amount of the active ingredient present in the pharmaceutical composition of the invention may vary depending on the mammal to which the compositions are administered and the disease to be treated. All the percentages are given per weight of the total weight of the core of the tablet, except when it is written otherwise.
  • dry syrup as used herein is defined as a formulation having a granule form.
  • the pharmaceutical composition of the invention can be dispersed into water before administration; preferably a clear solution is then obtained.
  • the pharmaceutical composition of the invention could be swallowed directly too, i.e. without use of water.
  • the pharmaceutical composition of the invention can be packaged in any type of adequate packaging, such as bottle, sachet or capsule.
  • the composition is prepackaged in unit dose form so that each packaged unit contains a single dose of active ingredient.
  • the unit dose can be poured directly onto the tongue or into water or food.
  • the pharmaceutical composition according to the present invention comprises 20 to 80% per weight of diluent with respect to the total weight of the composition.
  • the pharmaceutical composition according to the present invention comprises 25 to 75 % per weight of diluent.
  • the pharmaceutical composition according to the present invention comprises 30 to 70 % per weight of diluent, more preferably 35 to 65 % per weight of diluent, most preferably 40 to 60 % per weight of diluent with respect to the total weight of the composition.
  • the pharmaceutical composition according to the present invention comprises diluent having an average particle size of from 75 to 450 ⁇ m.
  • the pharmaceutical composition according to the present invention comprises diluent having an average particle size of from 100 to 300 ⁇ m; more preferably having an average particle size of from 120 to 250 ⁇ m; most preferably having an average particle size of from 150 to 200 ⁇ m.
  • additional excipients may be added to the pharmaceutical composition.
  • the pharmaceutical composition of the present invention comprises at least an additional excipient.
  • the additional excipients are soluble in water at room temperature. Consequently, the pharmaceutical composition of the invention may also comprise, as excipient, a binder.
  • binder as used herein is defined as an agent able to bind particles which cannot be bound only by a compression force.
  • the binder may be present in the form of a single compound or in the form of a mixture of compounds.
  • binders are starches, sodium croscarmellose, also referred to as cross-linked sodium carboxymethylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, hydroxymethylcellulose, polyvnylalcohol, alginate, and polyvinylpyrrolidone.
  • Preferred binders according to the present invention are polyvinylpyrrolidone, sodium starch glycolate and sodium croscarmellose. More preferred binder is polyvinylpyrrolidone.
  • the pharmaceutical composition according to the present invention comprises 0.5 to 5.0 % per weight of binder with respect to the total weight of the composition.
  • the pharmaceutical composition comprises 1 .0 to 4.0 % per weight of binder with respect to the total weight of the composition.
  • the pharmaceutical composition according to the invention comprises 1 .5 to 2.5 % per weight of binder with respect to the total weight of the composition.
  • the pharmaceutical composition of the invention may also comprise, as excipient, a sweetener agent.
  • a sweetener agent which can be used according to the present invention are aspartam, acesulfame of potassium, cyclamates (artificial sweeteners), and saccharin.
  • the composition comprises an artificial sweetener agent. More preferred sweetener agent is aspartam.
  • the pharmaceutical composition according to the present invention may comprise 1 .0 to 30 % per weight of sweetener agent with respect to the total weight of the composition.
  • the pharmaceutical composition comprises 2.0 to 15 % per weight of sweetener agent.
  • the pharmaceutical composition according to the invention comprises 1 .0 to 7.5 % per weight of sweetener agent with respect to the total weight of the composition.
  • the pharmaceutical composition of the invention may also comprise a flavouring agent, as excipient.
  • flavouring agents are cherry flavor, grapefruit flavor, tetrarome orange and oleum aurantii.
  • a liquid flavouring agent is used.
  • Preferred flavouring agent is tetrarome orange.
  • the pharmaceutical composition according to the present invention comprises 0.01 to 2.00 % per weight of flavouring agent.
  • the pharmaceutical composition according to the present invention comprises 0.02 to 1 .50 % per weight of flavouring agent, more preferably 0.04 to 1 .00 % per weight of flavouring agent, most preferably 0.08 % to 1 .2 % per weight of flavouring agent.
  • the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and
  • sweetener agent 1 .0 to 30 % per weight of sweetener agent
  • flavouring agent 0.01 to 2.00 % per weight of flavouring agent, with respect to the total weight of the composition.
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and 40 to 60 % per weight of diluent,
  • sweetener agent 1 .0 to 7.5 % per weight of sweetener agent
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising levetiracetam as active ingredient and
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising 30.0 to 85.0 % per weight of levetiracetam, brivaracetam or seletracetam with respect to the total weight of the composition.
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising 35.0 to 83.0 % per weight of levetiracetam with respect to the total weight of the composition.
  • the present invention relates to a pharmaceutical composition comprising 36.0 to 80.0 % per weight of levetiracetam with respect to the total weight of the composition.
  • the present invention relates to a pharmaceutical composition comprising 38.0 to 78.0 % per weight of levetiracetam with respect to the total weight of the composition.
  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising 45.0 to 75.0 % per weight of levetiracetam, with respect to the total weight of the composition.
  • the sum of sweetener agent, flavouring agent, and binder present in the pharmaceutical composition comprising levetiracetam as active ingredient is less than or equal to 90.0 % per weight, preferably less than or equal to 80.0 % per weight, more preferably less than or equal to 30.0 % per weight with respect to the total weight of the composition.
  • the pharmaceutical composition according to the present invention is preferably in the form of granules into sachet, and granules into bottles.
  • the composition may also be compressed into chewable tablets.
  • the pharmaceutical composition according to the present invention may comprise a taste-masking agent.
  • the pharmaceutical composition of the invention can be manufactured by any process according to conventional methods known to the man skilled in the art. Examples of processes are direct compression, dry granulation, wet granulation, melt granulation. Preferably, the pharmaceutical composition is manufactured by wet granulation.
  • the active ingredient, mannitol and binder are granulated by wet granulation process. Then the flavouring agent is added on the dried granulates. Then the sweetener agent is added. A final mixing is performed.
  • a dry syrup composition comprising 500 mg of Levetiracetam, 451 mg of granulated powder mannitol having an average particle size of 180 ⁇ m (Pearlitol® SD200), 19 mg of polyvinylpolyrrolidone (Povidone K 30), 30 mg of aspartam and 1 mg of Tetrarome Orange.
  • a dry syrup comprising 500 mg of Levetiracetam, 451 mg of granulated powder mannitol having an average particle size of 180 ⁇ m (Pearlitol® SD200), 19 mg of polyvinylpyrrolidone (Povidone K 30), 30 mg of aspartam and 1 mg of oleum aurantii.
  • the present invention relates to a pharmaceutical composition comprising levetiracetam useful for the treatment or prevention of a disease.
  • disease we understand a disease selected from the group consisiting of epileptogenesis, seizure disorders, convulsions, Parkinson's disease, dyskinesia induced by dopamine replacement therapy, tardive dyskinesia induced by administration of neuroleptic drugs, Huntington Chorea, and other neurological disorders including bipolar disorders, mania, depression, anxiety, attention deficit hyperactivity disorder (ADHD), migraine, trigeminal and other neuralgia, chronic pain, neuropathic pain, cerebral ischemia, cardiac arrhythmia, myotonia, cocaine abuse, stroke, myoclonus, tremor, essential tremor, simple or complex tics, Tourette syndrome, restless leg syndrome and other movement disorders, neonatal cerebral haemorrhage, amyotrophic lateral sclerosis, spasticity and degenerative diseases, bronchial asthma, asthmatic status and allergic bronchitis, asthmatic syndrome, bronchial hyperreactivity and bronchospastic syndromes as well as allergic and vas
  • curative is meant efficacy in treating a current symptomatic episode of a disorder or condition.
  • prophylactic is meant prevention of the occurrence or recurrence of a disorder or condition.
  • the present invention concerns also a method for treatment of a human patient by using the pharmaceutical composition.
  • the present invention concerns also the pharmaceutical composition for use as a medicament for curing the said disease.
  • the present invention concerns also the use of the pharmaceutical composition for the manufacture of a medicament for a therapeutic application in the said disease.
  • said disease is selected from the group consisting essentially of epilepsy, Parkinson's disease, dyskinesia, migraine, tremor, essential tremor, bipolar disorders, chronic pain, neuropathic pain, or bronchial, asthmatic or allergic conditions. More preferably said disease is epilepsy.
  • the present invention concerns also a method for manufacturing a medicament intended for therapeutic application in the said disease, characterized in that the pharmaceutical composition according to the present invention is used.
  • the present invention is also directed to methods of treating humans to alleviate disease by the administration of the pharmaceutical composition.
  • the pharmaceutical composition of the invention is in a form of homogeneous, free flowing, attrition resistant, uniform sized granules.
  • One advantage of the invention is the characteristic that the flavouring agent is well dispersed at the surface of the granules.
  • the pharmaceutical composition is a taste masked formulation.
  • the composition is subtantially free from a solubilized levetiracetam taste and has a pleasant, non-medicinal taste.
  • Another advantage of the invention is that a small amount of binder to allow an easier flowability of the granule and in the same time good and quick dissolution into water.
  • composition of the invention could be dispersed into food or aqueous liquid and swallowed without bitter taste.
  • Another advantage of the invention is that the pharmaceutical composition, once placed onto the tongue disperses almost immediately, without having a gritty or other noticeable residue.
  • the pharmaceutical composition of the invention does not need to comprise a lubricant, magnesium stearate, stearic acid, polyethylene glycol, sucrose, sugar, as excipients. No external coating is needed. So, it is easy to manufacture. No dispersant is needed.
  • the dry syrup A is prepared by wet granulation process according to the invention with the following composition (Table 1 ). Table 1 . Composition of dry syrup A
  • Mannitol (Pearlitol S D 200) is a granulated powder mannitol having an average particle size of about 180 ⁇ m,
  • Povidone K30 is a polyvinylpyrrolidone used as a binder, however it also acts as a de-bittering agent and secondary can assist in building viscosity.
  • the binder, povidone is dissolved into the granulation liquid (water), which is added to the mix mannitol and active ingredient.
  • the wet granulates are dryed. At the end of the drying, when the temperature decreased at room temperature, the liquid flavouring agent, tetrarome orange, mix with alcohol is spayed homogeneously on all granulates surface. The granulates are sieved before addition of sweetener agent, aspartam. The final blend is mixed.
  • a granulometry test is performed. The results are as follows: ⁇ 10% of the fractions of granulate below 75 ⁇ m >90% of the fractions of granulate above 75 ⁇ m and below 500 ⁇ m 0% of the fractions of granulate above 500 ⁇ m.
  • the granulometric results are ideal for a formulation as the one described here.
  • a dosage in active ingredient is performed, the assay results are in percentage above 95%. The results obtained are within the common specifications of 95.0% to 105.5%.
  • composition is free-flowing and is substantialy free from the taste of solubilized levetiracetam when placed on the human tongue in dry form or when dispersed in water and taken within about five minutes of said dispersal.
  • the dry syrup B is prepared by wet granulation process according to the invention with the following composition (table 2) Table 2. Composition of dry syrup B
  • the composition exhibits a satisfactory taste.
  • Example 3 (comparative example) The dry syrup C is prepared by wet granulation process with the following composition (table 3) Table 3. Composition of dry syrup C
  • composition has a bitter taste and therefore does not allowed a good compliance of drug intake by patient
  • the dry syrup D is prepared by wet granulation process with the following composition (table 4)
  • the granulate obtained after wet granulation is not free flowing, and with non homogeneous size.
  • the dry syrup E is prepared by wet granulation process with the following composition
  • Levetiracetam is well absorbed and generally completely bio-available in all species studied (mouse, rat, rabbit and dog) following a single 54 mg/kg dose. Levetiracetam displays linear kinetics in these species with plasma levels and exposure being generally proportional to dose, although in the dog, both plasma levels and exposure were hypo-proportional at higher doses in some studies due to emesis. For a given dose of levetiracetam, exposure was similar in the rat and dog but slightly lower in the mouse. In mice and rats, food appeared to decrease absorption as plasma levels and exposure were lower when given by dietary administration compared to gavage. After repeated administration at doses used in toxicology studies, plasma levels remained stable in mice and tended to increase in rats. In mice, rats and dogs there were some signs of enzyme induction at higher doses. However, this did not result in an appreciably lower exposure to levetiracetam following repeated administration.
  • Levetiracetam is homogenously distributed in tissues following administration to mice, rats, rabbits and dogs, the main exceptions being the kidney (higher concentrations) and adipose tissue (markedly lower concentrations). The rate of exchange between plasma and the central nervous system was slower than for most other tissues.
  • Levetiracetam crosses the placental barrier but does not accumulate in the amniotic fluid.
  • levetiracetam has a volume of distribution between 0.5 and 0.7 L/kg corresponding to the volume of intra- and extra-cellular water. Levetiracetam does not bind to plasma proteins and is equally distributed between blood and plasma. In all species, levetiracetam and its metabolites are excreted predominantly in the urine with no other significant routes of excretion. There was no retention or accumulation of levetiracetam in the body with less than 1 % of the radioactivity remaining in the carcass following administration of [ 1 4 C]-levetiracetam to mice and rats.
  • Example 7 All experiments were performed in accordance with the Guidelines of the local Ethical Committee for Animal Experimentation.
  • Epileptiform responses in hippocampal slices Levetiracetam reduces epileptiform responses induced in rat hippocampal slices by high-K+/low-Ca2+ concentrations in the perfusion fluid and induced by bicuculline.
  • the effect of brivaracetam on epileptiform responses induced by high-K+/low-Ca2+ concentrations or by bicuculline was examined in transverse hippocampal slices prepared from Sprague-Dawley rats according to previously reported standard procedures.
  • the epileptiform responses were induced by passing from a normal perfusion of artificial cerebrospinal fluid (ACSF) (K+ 3 mM; Ca2+ 2.4 mM) to either high-K+/low-Ca2+ fluid (HKLCF) (K+ 7.5 mM; Ca2+ 0.5 mM) or to 5 M bicuculline methiodide (BMI)-containing ACSF.
  • Extracellular field potentials (FPs) were recorded in the CA3 area of the slices with 2 M NaCI-filled glass microelectrodes.
  • the evoked FPs were recorded at 10-min intervals in response to fimbrial stimulation with constant current rectangular pulses that elicit a single population spike (PS) of 50-75% of the maximal amplitude when the slice is in ACSF.
  • PS population spike
  • 2 min of spontaneous activity were also recorded, in the middle of each 10-min interval between the recordings of evoked responses.
  • Either brivaracetam or levetiracetam was added to the bathing fluid of the slices 20 min before shifting from ACSF to either HKLCF or 5 M BMI-containing ACSF, and was kept in the perfusion fluid throughout the experiment.
  • mice were pretreated with either saline, brivaracetam (i.p., 30 min) or levetiracetam (i.p., 60 min), and the proportion of mice protected against clonic convulsions was used as the end point to assess anticonvulsant activity.
  • mice Chemically induced seizures in mice:Pentylenetetrazol, 83 mg kg- 1 s. ⁇ , was used to evaluate the anticonvulsant properties of brivaracetam. The dose was selected based on dose-effect curves in saline-treated animals as the convulsive dose inducing clonic convulsions of all four extremities in 97% of the animals. Immediately after administration of the chemoconvulsant, the mice were placed individually in small plastic cages (25 13 8 cm) and observed for the presence of clonic convulsions in all four extremities, for 60 min. The occurrence of tonic convulsions (hindlimb extension) and mortality was also recorded during this interval. The proportion of mice protected against clonic convulsions was calculated and used as the end point for anticonvulsant activity.
  • constant-current single stimuli-evoked bursts of repetitive PSs that is, PS2, PS3 and so on
  • PS2, PS3 and so on increased markedly in number in the first 30 min of HKLCF perfusion from the single PS1 to an average of 7.62.3 PS per evoked burst, and continued to increase slightly up to the end of the records, reaching an average of 8.81 .6 PS per evoked burst after 80-min perfusion of HKLCF.
  • Both brivaracetam and levetiracetam reduced these epileptiform responses.
  • Audiogenic seizure-susceptible mice were protected against the expression of clonic convulsions by brivaracetam and levetiracetam; ED50 values are shown in Table 2.
  • Brivaracetam, administered i.p. 30 min before seizure induction in mice also protected against clonic convulsions induced by pentylenetetrazol and against tonic hindlimb extension induced by a maximal electroshock in mice, although with higher ED50 values.
  • Brivaracetam significantly suppressed spontaneous SWDs in GAERS rats from a dose of 2.1 mg kg- 1 with complete inhibition appearing at the highest dose tested (67.9 mg kg- 1 ).
  • Levetiracetam on the other hand, induced significant suppression of SWDs from a dose of 5.4 mg kg- 1 .
  • Example 8 Levetiracetam dry syrup 50 % (500 mg sachet, 1000 mg sachet and 500 mg/g bottle)
  • composition of the granules is as follows (table 6) Table 6
  • the particle distribution is as follows: not more than 10 % ⁇ 75 ⁇ m; 5% > 500 ⁇ m; 0 % > 850 ⁇ m.
  • the composition exhibits a satisfactory taste.
  • the composition exhibits a satisfactory taste.

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Abstract

The present invention relates to a pharmaceutical composition comprising levetiracetam, brivaracetam or seletracetam, as active ingredient. The invention relates specifically to a dry syrup formulation.

Description

PHARMACEUTICAL COMPOSITIONS COMPRISING LEVETIRACETAM
The present invention relates to a pharmaceutical composition comprising levetiracetam, brivaracetam or seletracetam as active ingredient.
Levetiracetam or (S)-(-)-alpha-ethyl-2-oxo-1 -pyrrolidine acetamide, a laevorotatory compound, is disclosed as a protective agent for the treatment and the prevention of hypoxic and ischemic type aggressions of the central nervous system in the European patent No. EP 0 162 036 B and has the following formula:
N'
NH.
O Levetiracetam
This compound is also effective in the treatment of epilepsy, a therapeutic indication for which it has been demonstrated that its dextrorotatory enantiomer (R)-(+) alpha-ethyl-2-oxo-1 -pyrrolidine acetamide completely lacks activity (AJ. Gower et al., Eur. J. Pharmacol., 222, 1992, 193-203). International patent application having publication number WO 01/62726 discloses 2-oxo-1 -pyrrolidine derivatives and methods for their preparation. It particularly discloses compound (2S)-2-[(4R)-2-oxo-4-propyl-pyrrolidin-1 -yl] butanamide known under the international non propriety name of brivaracetam.
Figure imgf000002_0001
Brivaracetam International patent application having publication number WO 2005/121082 describes a process of preparation of 2-oxo-1 -pyrrolidine derivatives and particularly discloses a process of preparation of (2S)-2-[(4S)-4-(2,2-difluorovinyl)-2-oxo-pyrrolidin- 1 -yl]butanamide known under the international non propriety name of seletracetam.
Figure imgf000003_0001
Seletracetam
2-0X0-1 -pyrrolidine derivatives are therefore particularly useful in the pharmaceutical industry.
Brivaracetam is effective in the treatment of epilepsy. A phase Il clinical trial evaluated the efficacy and safety of brivaracetam (5, 20 and 50 mg per day) in the adjunctive treatment of adult patients (16-65 years) with refractory partial onset seizures, with or without secondary generalization. Brivaracetam is also effective in the treatment of patients (>18 years) with post-herpetic neuralgia.
Seletracetam is effective in the treatment of epilepsy. Two phase Na dose exploration studies were conducted with seletracetam in epilepsy evaluating the efficacy and safety of seletracetam in the adjunctive treatment of partial onset seizures in highly refractory adult patients currently receiving up to three concomitant anti- epileptic drugs.
One of the objectives currently sought in the development of pharmaceutical compositions which can be administered orally is to have a composition free from the taste of the active ingredient, when dispersed in water or swallowed directly.
The present invention relates to orally administrable granules comprising an active ingredient, and particularly to an orally, pleasant tasting particulate form of levetiracetam, brivaractam or seletracetam, that when dispersed into water is substantially free of the taste of the active ingredient.
There are various types of pharmaceutical preparations such as tablet, powder, granule, capsules etc. Among them, a dry syrup preparation means "preparations which are dissolved or suspended before use" according to general rules for preparations in the Japanese pharmacopoeia. This is the preparation especially for patients like children who dislike a medicine or elderly persons having difficulty swallowing, and even the children and/or the elderly persons can easily take it. Many adults and many children have difficulty swallowing the pills or tablets, or can not swallow them, and thereby do not benefit from levetiracetam, brivaracetam or seletracetam. Furthermore, the preparation is handy, and can be divided and dosed very easily. According to one aspect, the present invention relates to an orally administrable pharmaceutical composition in the form of a dry syrup comprising, as active ingredient, levetiracetam, brivaracetam or seletracetam and, as excipient, at least 10 to 90 % per weight of granulated powder diluent, selected among mannitol, sorbitol or xylitol, having an average particle size of from 75 to 520 μm, with respect to the total weight of the composition.
According to another aspect, the present invention relates to an orally administrable pharmaceutical composition in the form of a dry syrup comprising, as active ingredient, levetiracetam and, as excipient, at least 10 to 90 % per weight of granulated powder mannitol, as diluent, having an average particle size of from 75 to 520 μm, with respect to the total weight of the composition.
According to another embodiment, the present invention relates to an orally administrable pharmaceutical composition in the form of a dry syrup for treating a disease selected from the group consisting of elipepsy, Parkinson's disease, dyskenia other neurological disorders, comprising, as active ingredient, levetiracetam, brivaracetam or seletracetam and, as excipient, at least 10 to 90 % per weight of granulated powder diluent, selected among mannitol, sorbitol or xylitol, having an average particle size of from 75 to 520 μm, with respect to the total weight of the composition. The term "active ingredient" as used herein is defined as a substance which has a therapeutic effect.
The amount of the active ingredient present in the pharmaceutical composition of the invention may vary depending on the mammal to which the compositions are administered and the disease to be treated. All the percentages are given per weight of the total weight of the core of the tablet, except when it is written otherwise.
The term "dry syrup" as used herein is defined as a formulation having a granule form. The pharmaceutical composition of the invention can be dispersed into water before administration; preferably a clear solution is then obtained. The pharmaceutical composition of the invention could be swallowed directly too, i.e. without use of water.
The pharmaceutical composition of the invention can be packaged in any type of adequate packaging, such as bottle, sachet or capsule. Preferably, the composition is prepackaged in unit dose form so that each packaged unit contains a single dose of active ingredient. The unit dose can be poured directly onto the tongue or into water or food.
Examples of diluent are mannitol, sorbitol and xylitol. More preferred diluent is mannitol. Usually, the pharmaceutical composition according to the present invention comprises 20 to 80% per weight of diluent with respect to the total weight of the composition.
Particularly, the pharmaceutical composition according to the present invention comprises 25 to 75 % per weight of diluent.
Preferably, the pharmaceutical composition according to the present invention comprises 30 to 70 % per weight of diluent, more preferably 35 to 65 % per weight of diluent, most preferably 40 to 60 % per weight of diluent with respect to the total weight of the composition. Usually, the pharmaceutical composition according to the present invention comprises diluent having an average particle size of from 75 to 450 μm.
Preferably, the pharmaceutical composition according to the present invention comprises diluent having an average particle size of from 100 to 300 μm; more preferably having an average particle size of from 120 to 250 μm; most preferably having an average particle size of from 150 to 200 μm.
Moreover, further to the granulated diluent, additional excipients may be added to the pharmaceutical composition. Usually, the pharmaceutical composition of the present invention comprises at least an additional excipient. Preferably, the additional excipients are soluble in water at room temperature. Consequently, the pharmaceutical composition of the invention may also comprise, as excipient, a binder.
The term "binder" as used herein is defined as an agent able to bind particles which cannot be bound only by a compression force. The binder may be present in the form of a single compound or in the form of a mixture of compounds. Examples of binders are starches, sodium croscarmellose, also referred to as cross-linked sodium carboxymethylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, hydroxymethylcellulose, polyvnylalcohol, alginate, and polyvinylpyrrolidone. Preferred binders according to the present invention are polyvinylpyrrolidone, sodium starch glycolate and sodium croscarmellose. More preferred binder is polyvinylpyrrolidone.
The pharmaceutical composition according to the present invention comprises 0.5 to 5.0 % per weight of binder with respect to the total weight of the composition. Preferably, the pharmaceutical composition comprises 1 .0 to 4.0 % per weight of binder with respect to the total weight of the composition. More preferably, the pharmaceutical composition according to the invention comprises 1 .5 to 2.5 % per weight of binder with respect to the total weight of the composition.
The pharmaceutical composition of the invention may also comprise, as excipient, a sweetener agent. Examples of sweetener agent which can be used according to the present invention are aspartam, acesulfame of potassium, cyclamates (artificial sweeteners), and saccharin. Preferably, the composition comprises an artificial sweetener agent. More preferred sweetener agent is aspartam.
The pharmaceutical composition according to the present invention may comprise 1 .0 to 30 % per weight of sweetener agent with respect to the total weight of the composition. Preferably, the pharmaceutical composition comprises 2.0 to 15 % per weight of sweetener agent. More preferably, the pharmaceutical composition according to the invention comprises 1 .0 to 7.5 % per weight of sweetener agent with respect to the total weight of the composition. The pharmaceutical composition of the invention may also comprise a flavouring agent, as excipient.
Examples of flavouring agents are cherry flavor, grapefruit flavor, tetrarome orange and oleum aurantii. Preferably, a liquid flavouring agent is used. Preferred flavouring agent is tetrarome orange. Usually, the pharmaceutical composition according to the present invention comprises 0.01 to 2.00 % per weight of flavouring agent. Preferably, the pharmaceutical composition according to the present invention comprises 0.02 to 1 .50 % per weight of flavouring agent, more preferably 0.04 to 1 .00 % per weight of flavouring agent, most preferably 0.08 % to 1 .2 % per weight of flavouring agent. Usually, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
10 to 90 % per weight of diluent,
0.5 to 5.0 % per weight of binder,
1 .0 to 30 % per weight of sweetener agent, and 0.01 to 2.00 % per weight of flavouring agent, with respect to the total weight of the composition.
Particularly, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
20 to 80 % per weight of diluent, 0.5 to 5.0 % per weight of binder,
1 .0 to 30 % per weight of sweetener agent, and
0.01 to 2.00 % per weight of flavouring agent, with respect to the total weight of the composition.
Preferably, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
30 to 70 % per weight of diluent,
1 .0 to 4.0 % per weight of binder,
2.0 to 15 % per weight of sweetener agent, and 0.02 to 1 .50 % per weight of flavouring agent, with respect to the total weight of the composition.
More preferably, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and 40 to 60 % per weight of diluent,
1 .5 to 2.5 % per weight of binder,
1 .0 to 7.5 % per weight of sweetener agent, and
0.08 to 1 .2 % per weight of flavouring agent, with respect to the total weight of the composition. Usually, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
10 to 90 % per weight of mannitol,
0.5 to 5.0 % per weight of polyvinylpyrrolidone,
1 .0 to 30 % per weight of aspartam, and 0.01 to 2.00 % per weight of tetrarome orange, with respect to the total weight of the composition.
Particularly, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
20 to 80 % per weight of mannitol, 0.5 to 5.0 % per weight of polyvinylpyrrolidone,
1 .0 to 30 % per weight of aspartam, and
0.01 to 2.00 % per weight of tetrarome orange, with respect to the total weight of the composition.
Preferably, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
30 to 70 % per weight of mannitol,
1 .0 to 4.0 % per weight of polyvinylpyrrolidone,
2.0 to 15 % per weight of aspartam, and
0.02 to 1 .50 % per weight of tetrarome orange, with respect to the total weight of the composition.
More preferably, the present invention relates to a pharmaceutical composition comprising levetiracetam as active ingredient and
40 to 60 % per weight of mannitol,
1 .5 to 2.5 % per weight of polyvinylpyrrolidone, 1 .0 to 7.5 % per weight of aspartam, and
0.08 to 1 .2 % per weight of tetrarome orange, with respect to the total weight of the composition. In a further particular embodiment, the present invention relates to a pharmaceutical composition comprising 30.0 to 85.0 % per weight of levetiracetam, brivaracetam or seletracetam with respect to the total weight of the composition.
Usually, in this further particular embodiment, the present invention relates to a pharmaceutical composition comprising 35.0 to 83.0 % per weight of levetiracetam with respect to the total weight of the composition.
Particularly, in this further particular embodiment, the present invention relates to a pharmaceutical composition comprising 36.0 to 80.0 % per weight of levetiracetam with respect to the total weight of the composition. Preferably, in this further particular embodiment, the present invention relates to a pharmaceutical composition comprising 38.0 to 78.0 % per weight of levetiracetam with respect to the total weight of the composition.
More preferably, in this further particular embodiment, the present invention relates to a pharmaceutical composition comprising 45.0 to 75.0 % per weight of levetiracetam, with respect to the total weight of the composition.
In one embodiment of the present invention, the sum of sweetener agent, flavouring agent, and binder present in the pharmaceutical composition comprising levetiracetam as active ingredient is less than or equal to 90.0 % per weight, preferably less than or equal to 80.0 % per weight, more preferably less than or equal to 30.0 % per weight with respect to the total weight of the composition.
The pharmaceutical composition according to the present invention is preferably in the form of granules into sachet, and granules into bottles. The composition may also be compressed into chewable tablets.
Optionally, the pharmaceutical composition according to the present invention may comprise a taste-masking agent.
The pharmaceutical composition of the invention can be manufactured by any process according to conventional methods known to the man skilled in the art. Examples of processes are direct compression, dry granulation, wet granulation, melt granulation. Preferably, the pharmaceutical composition is manufactured by wet granulation.
The active ingredient, mannitol and binder are granulated by wet granulation process. Then the flavouring agent is added on the dried granulates. Then the sweetener agent is added. A final mixing is performed.
Specific formulations are as follows: • A dry syrup composition comprising 500 mg of Levetiracetam, 451 mg of granulated powder mannitol having an average particle size of 180 μm (Pearlitol® SD200), 19 mg of polyvinylpolyrrolidone (Povidone K 30), 30 mg of aspartam and 1 mg of Tetrarome Orange. • A dry syrup comprising 500 mg of Levetiracetam, 451 mg of granulated powder mannitol having an average particle size of 180 μm (Pearlitol® SD200), 19 mg of polyvinylpyrrolidone (Povidone K 30), 30 mg of aspartam and 1 mg of oleum aurantii. In another aspect the present invention relates to a pharmaceutical composition comprising levetiracetam useful for the treatment or prevention of a disease.
By the term "disease", we understand a disease selected from the group consisiting of epileptogenesis, seizure disorders, convulsions, Parkinson's disease, dyskinesia induced by dopamine replacement therapy, tardive dyskinesia induced by administration of neuroleptic drugs, Huntington Chorea, and other neurological disorders including bipolar disorders, mania, depression, anxiety, attention deficit hyperactivity disorder (ADHD), migraine, trigeminal and other neuralgia, chronic pain, neuropathic pain, cerebral ischemia, cardiac arrhythmia, myotonia, cocaine abuse, stroke, myoclonus, tremor, essential tremor, simple or complex tics, Tourette syndrome, restless leg syndrome and other movement disorders, neonatal cerebral haemorrhage, amyotrophic lateral sclerosis, spasticity and degenerative diseases, bronchial asthma, asthmatic status and allergic bronchitis, asthmatic syndrome, bronchial hyperreactivity and bronchospastic syndromes as well as allergic and vasomotor rhinitis and rhinoconjunctivitis. The term "treatment" as used herein, includes curative treatment and prophylactic treatment.
By "curative" is meant efficacy in treating a current symptomatic episode of a disorder or condition.
By "prophylactic" is meant prevention of the occurrence or recurrence of a disorder or condition.
The present invention concerns also a method for treatment of a human patient by using the pharmaceutical composition.
The present invention concerns also the pharmaceutical composition for use as a medicament for curing the said disease. The present invention concerns also the use of the pharmaceutical composition for the manufacture of a medicament for a therapeutic application in the said disease.
Preferably said disease is selected from the group consisting essentially of epilepsy, Parkinson's disease, dyskinesia, migraine, tremor, essential tremor, bipolar disorders, chronic pain, neuropathic pain, or bronchial, asthmatic or allergic conditions. More preferably said disease is epilepsy.
The present invention concerns also a method for manufacturing a medicament intended for therapeutic application in the said disease, characterized in that the pharmaceutical composition according to the present invention is used. The present invention is also directed to methods of treating humans to alleviate disease by the administration of the pharmaceutical composition.
The pharmaceutical composition of the invention is in a form of homogeneous, free flowing, attrition resistant, uniform sized granules. One advantage of the invention is the characteristic that the flavouring agent is well dispersed at the surface of the granules.
Another advantage of the invention is that the pharmaceutical composition is a taste masked formulation. The composition is subtantially free from a solubilized levetiracetam taste and has a pleasant, non-medicinal taste. Another advantage of the invention is that a small amount of binder to allow an easier flowability of the granule and in the same time good and quick dissolution into water.
The composition of the invention could be dispersed into food or aqueous liquid and swallowed without bitter taste. Another advantage of the invention is that the pharmaceutical composition, once placed onto the tongue disperses almost immediately, without having a gritty or other noticeable residue.
Moreover, the pharmaceutical composition of the invention does not need to comprise a lubricant, magnesium stearate, stearic acid, polyethylene glycol, sucrose, sugar, as excipients. No external coating is needed. So, it is easy to manufacture. No dispersant is needed.
The following examples are provided for illustrative purposes only and are not intended, nor should they be construed, as limiting the invention in any manner. Those skilled in the art will appreciate that routine variations and modifications of the following examples can be made without exceeding the spirit or scope of the invention.
Examples Example 1 .
The dry syrup A is prepared by wet granulation process according to the invention with the following composition (Table 1 ). Table 1 . Composition of dry syrup A
Figure imgf000010_0001
Mannitol (Pearlitol S D 200) is a granulated powder mannitol having an average particle size of about 180 μm,
Povidone K30 is a polyvinylpyrrolidone used as a binder, however it also acts as a de-bittering agent and secondary can assist in building viscosity. The binder, povidone, is dissolved into the granulation liquid (water), which is added to the mix mannitol and active ingredient.
The wet granulates are dryed. At the end of the drying, when the temperature decreased at room temperature, the liquid flavouring agent, tetrarome orange, mix with alcohol is spayed homogeneously on all granulates surface. The granulates are sieved before addition of sweetener agent, aspartam. The final blend is mixed.
A granulometry test is performed. The results are as follows: <10% of the fractions of granulate below 75 μm >90% of the fractions of granulate above 75 μm and below 500 μm 0% of the fractions of granulate above 500 μm. The granulometric results are ideal for a formulation as the one described here.
A dosage in active ingredient is performed, the assay results are in percentage above 95%. The results obtained are within the common specifications of 95.0% to 105.5%.
The composition is free-flowing and is substantialy free from the taste of solubilized levetiracetam when placed on the human tongue in dry form or when dispersed in water and taken within about five minutes of said dispersal.
Example 2.
The dry syrup B is prepared by wet granulation process according to the invention with the following composition (table 2) Table 2. Composition of dry syrup B
Figure imgf000011_0001
The composition exhibits a satisfactory taste.
Example 3 (comparative example) The dry syrup C is prepared by wet granulation process with the following composition (table 3) Table 3. Composition of dry syrup C
Figure imgf000012_0001
The composition has a bitter taste and therefore does not allowed a good compliance of drug intake by patient
Example 4 (comparative example)
The dry syrup D is prepared by wet granulation process with the following composition (table 4)
Table 4. Composition of dry syrup D
Figure imgf000012_0002
The granulate obtained after wet granulation is not free flowing, and with non homogeneous size.
Example 5 (comparative example)
The dry syrup E is prepared by wet granulation process with the following composition
(table 5).
Table 5. Composition of dry syrup E
Figure imgf000012_0003
The granulates obtained after wet granulation are not free flowing, and with non homogeneous size. Example 6: Pharmacological data
Levetiracetam is well absorbed and generally completely bio-available in all species studied (mouse, rat, rabbit and dog) following a single 54 mg/kg dose. Levetiracetam displays linear kinetics in these species with plasma levels and exposure being generally proportional to dose, although in the dog, both plasma levels and exposure were hypo-proportional at higher doses in some studies due to emesis. For a given dose of levetiracetam, exposure was similar in the rat and dog but slightly lower in the mouse. In mice and rats, food appeared to decrease absorption as plasma levels and exposure were lower when given by dietary administration compared to gavage. After repeated administration at doses used in toxicology studies, plasma levels remained stable in mice and tended to increase in rats. In mice, rats and dogs there were some signs of enzyme induction at higher doses. However, this did not result in an appreciably lower exposure to levetiracetam following repeated administration.
Levetiracetam is homogenously distributed in tissues following administration to mice, rats, rabbits and dogs, the main exceptions being the kidney (higher concentrations) and adipose tissue (markedly lower concentrations). The rate of exchange between plasma and the central nervous system was slower than for most other tissues.
Levetiracetam crosses the placental barrier but does not accumulate in the amniotic fluid.
Consistent with the findings from the tissue distribution studies, levetiracetam has a volume of distribution between 0.5 and 0.7 L/kg corresponding to the volume of intra- and extra-cellular water. Levetiracetam does not bind to plasma proteins and is equally distributed between blood and plasma. In all species, levetiracetam and its metabolites are excreted predominantly in the urine with no other significant routes of excretion. There was no retention or accumulation of levetiracetam in the body with less than 1 % of the radioactivity remaining in the carcass following administration of [1 4C]-levetiracetam to mice and rats.
Example 7: All experiments were performed in accordance with the Guidelines of the local Ethical Committee for Animal Experimentation.
Epileptiform responses in hippocampal slices: Levetiracetam reduces epileptiform responses induced in rat hippocampal slices by high-K+/low-Ca2+ concentrations in the perfusion fluid and induced by bicuculline. The effect of brivaracetam on epileptiform responses induced by high-K+/low-Ca2+ concentrations or by bicuculline was examined in transverse hippocampal slices prepared from Sprague-Dawley rats according to previously reported standard procedures. The epileptiform responses were induced by passing from a normal perfusion of artificial cerebrospinal fluid (ACSF) (K+ 3 mM; Ca2+ 2.4 mM) to either high-K+/low-Ca2+ fluid (HKLCF) (K+ 7.5 mM; Ca2+ 0.5 mM) or to 5 M bicuculline methiodide (BMI)-containing ACSF. Extracellular field potentials (FPs) were recorded in the CA3 area of the slices with 2 M NaCI-filled glass microelectrodes. The evoked FPs were recorded at 10-min intervals in response to fimbrial stimulation with constant current rectangular pulses that elicit a single population spike (PS) of 50-75% of the maximal amplitude when the slice is in ACSF. In the HKLCF model, 2 min of spontaneous activity were also recorded, in the middle of each 10-min interval between the recordings of evoked responses.
Either brivaracetam or levetiracetam was added to the bathing fluid of the slices 20 min before shifting from ACSF to either HKLCF or 5 M BMI-containing ACSF, and was kept in the perfusion fluid throughout the experiment. Audiogenic seizures in mice: Genetically sound-sensitive male mice (16-28 g; n=10 per group), responding with wild running, clonic and tonic convulsions to an acoustic stimulation, were used. Audiogenic seizures were induced by an acoustic stimulus (90 dB, 10-20 kHz) applied for 30 s. The mice were pretreated with either saline, brivaracetam (i.p., 30 min) or levetiracetam (i.p., 60 min), and the proportion of mice protected against clonic convulsions was used as the end point to assess anticonvulsant activity.
Chemically induced seizures in mice:Pentylenetetrazol, 83 mg kg- 1 s.α, was used to evaluate the anticonvulsant properties of brivaracetam. The dose was selected based on dose-effect curves in saline-treated animals as the convulsive dose inducing clonic convulsions of all four extremities in 97% of the animals. Immediately after administration of the chemoconvulsant, the mice were placed individually in small plastic cages (25 13 8 cm) and observed for the presence of clonic convulsions in all four extremities, for 60 min. The occurrence of tonic convulsions (hindlimb extension) and mortality was also recorded during this interval. The proportion of mice protected against clonic convulsions was calculated and used as the end point for anticonvulsant activity.
Results
Epileptiform responses in hippocampal slices: Changing the perfusion of rat hippocampal slices from the normal ACSF to HKLCF produced increasingly epileptiform FPs in the CA3 area in response to constant-current fimbrial stimulation. In control slices exposed to HKLCF alone, the PS1 amplitude progressively increased, reaching plateau values within 20 min (4.250.77 mV), nearly twofold higher than those recorded under ACSF perfusion (2.180.15 mV; means. d. for n=10 slices). Also, constant-current single stimuli-evoked bursts of repetitive PSs (that is, PS2, PS3 and so on) increased markedly in number in the first 30 min of HKLCF perfusion from the single PS1 to an average of 7.62.3 PS per evoked burst, and continued to increase slightly up to the end of the records, reaching an average of 8.81 .6 PS per evoked burst after 80-min perfusion of HKLCF. Both brivaracetam and levetiracetam reduced these epileptiform responses. Upon 15-min perfusion of HKLCF, spontaneous field bursts occurred in 4 out of the 10 control slices exposed to HKLCF alone, whereas from 25 min in HKLCF to the end of the records, all control slices presented regular field bursting. Brivaracetam (3.2 M), but not levetiracetam (32 M), reduced the rate of this spontaneous bursting.
In vivo studies: In fully amygdala-kindled rats, brivaracetam induced a significant suppression in motor-seizure severity from a dose of 21 .2 mg kg- 1 , whereas levetiracetam induced a similar effect from a dose of 170 mg kg- 1 . Brivaracetam also significantly reduced the after-discharge duration at the highest dose tested (212.3 mg kg- 1 ), whereas levetiracetam was inactive on this parameter up to 1700 mg kg- 1 .
Audiogenic seizure-susceptible mice were protected against the expression of clonic convulsions by brivaracetam and levetiracetam; ED50 values are shown in Table 2. Brivaracetam, administered i.p. 30 min before seizure induction in mice, also protected against clonic convulsions induced by pentylenetetrazol and against tonic hindlimb extension induced by a maximal electroshock in mice, although with higher ED50 values.
Brivaracetam significantly suppressed spontaneous SWDs in GAERS rats from a dose of 2.1 mg kg- 1 with complete inhibition appearing at the highest dose tested (67.9 mg kg- 1 ). Levetiracetam, on the other hand, induced significant suppression of SWDs from a dose of 5.4 mg kg- 1 .
Pretreatment with brivaracetam during corneal kindling of mice resulted in a significant reduction in the incidence of generalized motor seizures, and a similar incidence reduction was observed with levetiracetam at higher doses. Continued corneal stimulations following termination of treatment showed a persistent reduction in the incidence of generalized motor seizures in the group previously treated with the highest dose of brivaracetam.
Example 8: Levetiracetam dry syrup 50 % (500 mg sachet, 1000 mg sachet and 500 mg/g bottle)
The composition of the granules is as follows (table 6) Table 6
Figure imgf000016_0001
solvent not present in the finished product.
The particle distribution is as follows: not more than 10 % < 75 μm; 5% > 500 μm; 0 % > 850 μm.
The composition exhibits a satisfactory taste. The composition exhibits a satisfactory taste.

Claims

Claims
1 . An orally administrable pharmaceutical composition in the form of a dry syrup comprising, as active ingredient, levetiracetam, brivaracetam or seletracetam and, as excipient, at least 10 to 90 % per weight of granulated powder diluent, selected among mannitol, sorbitol or xylitol, having an average particle size of from 75 to 520 μm, with respect to the total weight of the composition.
2. The pharmaceutical composition according to claim 1 , wherein the active ingredient is levetiracetam.
3. An orally administrable pharmaceutical composition in the form of a dry syrup for treating a disease selected from the group consisting of elipepsy, Parkinson's disease, dyskenia other neurological disorders, comprising, as active ingredient, levetiracetam, brivaracetam or seletracetam and, as excipient, at least 10 to 90 % per weight of granulated powder diluent, selected among mannitol, sorbitol or xylitol, having an average particle size of from 75 to 520 μm, with respect to the total weight of the composition.
4. The pharmaceutical composition according to claim 1 , 2 or 3, wherein the diluent is mannitol.
5. The pharmaceutical composition according to claim 1 , 2, 3 or 4, wherein it comprises 20 to 80% per weight of diluent with respect to the total weight of the composition.
6. The pharmaceutical composition according to claim 5, wherein it comprises 40 to 60 % per weight of diluent with respect to the total weight of the composition.
7. The pharmaceutical composition according to any one of the preceding claims, wherein it comprises a diluent having an average particle size of from 75 to 450 μm.
8. The pharmaceutical composition according to claim 7, wherein it comprises a diluent having an average particle size of from 150 to 200 μm.
9. The pharmaceutical composition according to any one of the preceding claims, wherein it comprises at least an additional excipient soluble in water at room temperature.
10. The pharmaceutical composition according to any one of the preceding claims, wherein it comprises a binder.
1 1 . The pharmaceutical composition according to claim 10, wherein the binder is polyvinylpyrrolidone.
12. The pharmaceutical composition according to claim 10 or 1 1 , wherein it comprises 0.5 to 5.0 % per weight of binder with respect to the total weight of the composition.
13. The pharmaceutical composition according to claim 12, wherein it comprises 1 .5 to 2.5 % per weight of binder with respect to the total weight of the composition.
14. The pharmaceutical composition according to any one of the preceding claims, wherein it comprises a sweetener agent.
15. The pharmaceutical composition according to claim 14, wherein ithe sweetener agent is aspartam.
16. The pharmaceutical composition according to claim 14 or 15, wherein it comprises 1 .0 to 30 % per weight of sweetener agent with respect to the total weight of the composition.
17. The pharmaceutical composition according to any one of the preceding claims, wherein it comprises a flavouring agent.
18. The pharmaceutical composition according to claim 17, wherein the flavouring agent is tetrarome orange.
19. The pharmaceutical composition according to claim 17 or 18, wherein it comprises 0.01 to 2.00 % per weight of flavouring agent.
20. The pharmaceutical composition according to any one of the preceding claims, wherein it comprises levetiracetam, as active ingredient, and 40 to 60 % per weight of mannitol, 1 .5 to 2.5 % per weight of polyvinylpyrrolidone, 1 .0 to 7.5 % per weight of aspartam, and 0.08 to 1 .2 % per weight of tetrarome orange, with respect to the total weight of the composition.
21 . The pharmaceutical composition according to any one of the preceding claims, wherein it comprises 500 mg of Levetiracetam, 451 mg of granulated powder mannitol having an average particle size of 180 μm (Pearlitol® SD200), 19 mg of polyvinylpolyrrolidone (Povidone K 30), 30 mg of aspartam and 1 mg of Tetrarome Orange.
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