WO2011152810A1 - Formulations comprising calcium, vitamin d and vitamin k for osteoporosis - Google Patents

Formulations comprising calcium, vitamin d and vitamin k for osteoporosis Download PDF

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Publication number
WO2011152810A1
WO2011152810A1 PCT/TR2011/000151 TR2011000151W WO2011152810A1 WO 2011152810 A1 WO2011152810 A1 WO 2011152810A1 TR 2011000151 W TR2011000151 W TR 2011000151W WO 2011152810 A1 WO2011152810 A1 WO 2011152810A1
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Prior art keywords
effervescent
formulation
formulation according
vitamin
formulation comprises
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PCT/TR2011/000151
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French (fr)
Inventor
Bilgic Mahmut
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Bilgic Mahmut
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Priority to EP11749578.8A priority Critical patent/EP2575796A1/en
Publication of WO2011152810A1 publication Critical patent/WO2011152810A1/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
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2022—Organic macromolecular compounds
    • A61K9/2031—Organic macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, polyethylene oxide, poloxamers
    • 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
    • A61K31/12—Ketones
    • A61K31/122—Ketones having the oxygen directly attached to a ring, e.g. quinones, vitamin K1, anthralin
    • 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
    • A61K31/59—Compounds containing 9, 10- seco- cyclopenta[a]hydrophenanthrene ring systems
    • A61K31/592—9,10-Secoergostane derivatives, e.g. ergocalciferol, i.e. vitamin D2
    • 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
    • A61K31/59—Compounds containing 9, 10- seco- cyclopenta[a]hydrophenanthrene ring systems
    • A61K31/593—9,10-Secocholestane derivatives, e.g. cholecalciferol, i.e. vitamin D3
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A61K33/06—Aluminium, calcium or magnesium; Compounds thereof, e.g. clay
    • A61K33/10—Carbonates; Bicarbonates
    • 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
    • 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
    • A61K9/0002—Galenical forms characterised by the drug release technique; Application systems commanded by energy
    • A61K9/0007—Effervescent

Definitions

  • the present invention relates to formulations comprising calcium, vitamin D and vitamin K; and use of said formulations in prophylaxis and treatment of osteoporosis and related diseases.
  • Bone loss or in other terms “osteoporosis” is defined as a disease characterized by liability to bone fracture and increased risk of bone fracture as a consequence of low bone mass and deterioration of bone micro architecture. The disease does not generally result in death; however, it is a major health problem affecting life quality. Although osteoporosis is mostly seen in spine, hip and wrist; all the bones in the body are affected by the disease. 80% of the patients are female though the disease is encountered in both genders. Postmenopausal women lose 0,7-2% of total bone mass annually while this ratio is 0,5-0,7% for men. In parallel with this, total bone mass loss in men and women between 45-70 years of age is 15-30%. Some studies conducted nowadays indicate that insufficient calcium intake in childhood may increase the risk of osteoporosis later in life.
  • calcium taken by diet plays a significant role in prophylaxis of osteoporosis.
  • calcium absorption is reduced in postmenopausal term due to physical features of calcium and other factors.
  • One of the most important problems encountered in calcium intake is that calcium salts in all calcium sources do not dissolve at an equal rate or present desired bioavailability. Calcium salts have low water solubility. They are dissolved relatively better in gastric acid; however, carbon dioxide produced causes gas and pain in the stomach. Furthermore, gastric acid is reduced due to gastric acid inhibitors used in later ages and therefore calcium leaves the stomach without being dissolved.
  • Vitamin D is a fat-soluble hormone precursor and the studies conducted have indicated that efficient amounts of vitamin D increases calcium absorption.
  • Bone is a living tissue which is continuously being created and destroyed. This creation and destruction process is balanced in young, healthy individuals. An increase in the activity of osteoclasts that are responsible for destruction unbalances this process. Vitamin K plays a key role in reducing this increased activity of osteoclasts and therefore preventing bone degradation.
  • Cells that are responsible for bone formation are osteoblasts. Osteoblasts produce a protein named osteocalcin and calcium is stored in bones when this protein is activated.
  • vitamin K is required for osteocalcin to bind calcium and vitamin D is required for osteocalcin production.
  • the tablet formulations comprising vitamin calcium, vitamin D 3 and vitamin K that exist on the market now are formulations developed in line with this purpose.
  • effervescent formulations comprising calcium, vitamin D and vitamin K are user-friendly, have fewer side effects and present higher bioavailability compared with the existing tablet formulations; therefore, they display higher efficiency in the prophylaxis and treatment of osteoporosis and related diseases.
  • the present invention relates to effervescent formulations comprising calcium, vitamin D and vitamin K.
  • Effervescent formulation of the present invention can be in powder, granule, pellet, micro tablet or tablet form. Effervescent formulation of the present invention is preferably in tablet form.
  • Calcium used in the formulation of the present invention is preferably in salt form.
  • Calcium comprised in the formulation of the present invention can be selected from calcium, carbonate, chloride, phosphate, citrate, lactate, glubionate, gluceptate, gluconate salts though it is preferably carbonate salt.
  • Formulation of the present invention comprises 5-60% calcium or calcium salt by weight.
  • Formulation of the present invention comprises 200-2000 mg calcium or calcium salt in an equal amount to this.
  • Vitamin D comprised in the formulation of the present invention can be vitamin D 2 (ergocalciferol) or vitamin D 3 (cholecalciferol) though it is preferably vitamin D 3 (cholecalciferol).
  • Formulation of the present invention comprises 0,01-15% vitamin D by weight.
  • Formulation of the present invention comprises 200-1000 IU vitamin D.
  • Vitamin K comprised in the formulation of the present invention is vitamin K ⁇ , K 2 or a combination thereof.
  • Formulation of the present invention comprises 0,001 -5% vitamin K by weight.
  • Formulation of the present invention comprises 5-200 ⁇ g vitamin K.
  • the inventors added malic acid (powder) into the effervescent formulation comprising calcium, vitamin D and vitamin K in order to provide sufficient clarity of the solution after the formulation is dissolved.
  • the present invention relates to effervescent formulations comprising calcium, vitamin D and vitamin K and malic acid (powder).
  • Amount of the malic acid comprised in the formulation of the present invention is in the range of 3-20% by weight.
  • the formulation of the present invention comprises calcium, vitamin D and vitamin K as the active agents, and an effervescent couple to provide water solubility characteristic.
  • effervescent couple refers to use of an acidic agent and a basic agent together.
  • the pharmaceutically acceptable acidic agent of the present invention can be selected from a group comprising acetic acid, citric acid, lactic acid, phosphoric acid, propionic acid, malic acid, tartaric acid or combinations thereof.
  • the pharmaceutically acceptable acidic agent of the present invention is preferably citric acid, malic acid or a combination thereof.
  • the pharmaceutically acceptable basic agent of the present invention can be selected from a group comprising potassium carbonate, potassium bicarbonate, potassium citrate, potassium hydroxide, sodium carbonate, sodium hydrogen carbonate, sodium hydrogen citrate or combinations thereof.
  • the pharmaceutically acceptable basic agent of the present invention is preferably sodium carbonate or sodium hydrogen carbonate.
  • the formulation of the present invention in effervescent form can comprise pharmaceutically acceptable excipients in addition to calcium, vitamin D and vitamin K.
  • the effervescent formulation of the present invention can optionally comprise one or more of the excipients including binder, glidant, lubricant, diluent, disintegrant, flavoring agent, sweetener, coloring agent, anti-foam agent, stabilizing agent.
  • the said binder can be selected from a group comprising starches such as potato starch, corn starch, wheat starch; sugars such as sucrose, glucose, dextrose, lactose, maltodextrin; natural and synthetic gums; gelatin; cellulose derivatives such as microcrystalline cellulose, HPC, HEC, HPMC, carboxymethyl cellulose, methyl cellulose, ethyl cellulose; polyvinylpyrrolidone (povidone), polyethylene glycol (PEG); waxes; calcium carbonate; calcium phosphate; alcohols such as sorbitol, xylitol, mannitol, and water or a combination thereof.
  • the binder used in the formulation of the present invention is preferably lactose, povidone, polyethylene glycol or a combination thereof.
  • the said glidant can be selected from a group comprising sodium benzoate, sodium chloride, sodium acetate, sodium fumarate, carbowax 4000, L-leucine(17), polyethylene glycol or a combination thereof though it is preferably polyethylene glycol.
  • PEG that the formulation of the present invention comprises is PEG 4000, PEG 6000 or a combination thereof.
  • Polyethylene glycol that the formulation of the present invention comprises is more than 2% by weight.
  • the said lubricant can be selected from a group comprising talc, magnesium stearate, stearic acid, sodium stearil fumarate, polyoxyethylene glycol, leucine, alanine, glycine, sodium benzoate, sodium acetate, fumaric acid or a combination thereof.
  • the said diluent can be selected from a group comprising lactose, maltose, dextrin, maltodextrin, mannitol, sorbitol, starch or a combination thereof.
  • the said disintegrant can be selected from a group comprising starches such as potato starch, corn starch, wheat starch, pregelatinized starch, sodium starch glycolate; cellulose derivatives such as croscarmellose sodium or microcrystalline cellulose; polyvinylpyrrolidone; crospovidone; alginic acid and its salts; clays such as xanthan gum or Veegum; ion exchange resins or a combination thereof.
  • the said flavoring agent can be selected from a group comprising natural aroma oils (peppermint oil, wintergreen oil, clove bud oil, parsley oil, eucalyptus oil, lemon oil, orange oil), menthol, menthane, anethole, methyl salicylate, eucalyptol, cinnamon, 1 -methyl acetate, sage, eugenol, oxanone, alpha irisone, marjoram, lemon, orange, blackberry, propenyl guaetol acetyl, cinnamon, vanilla, thymol, linalol, cinnamaldehyde glycerol acetal, N-substituted p- menthane-3-carboxamide, 3,1-methoxy propane 1,2-diol or a combination thereof though it is preferably lemon, orange, blackberry flavor or a combination thereof.
  • natural aroma oils peppermint oil, wintergreen oil, clove bud oil, parsley oil,
  • the said sweetener can be selected from a group comprising sucralose, sucrose, fructose, glucose, galactose, xylose, dextrose, laevulose, lactose, maltose, maltodextrin, mannitol, maltitol, maltol, sorbitol, xylitol, erythritol, lactitol, isomalt, corn syrup, saccharine, saccharine salts, acesulfame potassium, aspartame, D-tryptophane, monoammonium glycyrrhizinate, neohesperidin dihydrochalcone, thaumatin, neotame, alitame, stevioside and cyclamates or a combination thereof though it is preferably sucralose, lactose, glucose, mannitol, sorbitol or a combination thereof.
  • the said coloring agent can be selected from a group comprising carotenoids and chlorophyl or a combination thereof.
  • the said antifoam agent can be selected from a group comprising simethicone emulsion and dimethyl siloxane, silicon oil or a combination thereof.
  • the said stabilizing agent and/or agents can be selected from a group comprising antioxidants, chelating agents, alkalinizing agents and photoprotective agents.
  • the antioxidants can be selected from substances including butylated hydroxyanisole (BHA), sodium ascorbate, butylhydroxytoluene (BHT), sodium sulphite, gallates (such as propyl gallate), tocoferole, citric acid, malic acid, ascorbic acid, acetylcysteine, fumaric acid, lecithin, ascorbyl palmitate, ethylenediamine tetraacetate or a combination thereof.
  • BHA butylated hydroxyanisole
  • BHT butylhydroxytoluene
  • gallates such as propyl gallate
  • tocoferole citric acid, malic acid, ascorbic acid, acetylcysteine, fumaric acid, lecithin, ascorbyl palmitate, ethylenediamine tetraacetate or a combination thereof.
  • the chelating agents can be selected from a group comprising disodium EDTA, edetic acid, citric acid, sodium citrate, potassium citrate or a combination thereof.
  • the alkalinizing agents can be selected from alkali metal salts such as sodium carbonate, sodium hydrogen carbonate, sodium hydroxide, sodium silicate, disodium hydrogen orthophosphate, sodium aluminate; alkaline earth metal salts such as calcium carbonate, calcium hydroxide, dibasic calcium phosphate, tribasic calcium phosphate, calcium sulphate, calcium acetate, calcium gluconate, calcium glycerophospate, magnesium carbonate, magnesium hydroxide, magnesium sulphate, magnesium acetate, magnesium silicate, magnesium aluminate; and primary, secondary and tertiary amines, cyclic amines; ⁇ , ⁇ '- dibenzyl ethylenediamine, dietanolamine, ethylenediamine, meglumine, monosodium glutamate, pola
  • the photoprotective agents can be selected from metal oxides such as titanium oxide, iron oxide and zinc oxide or a combination thereof.
  • the effervescent formulation comprises;
  • Vitamin D in the range of 0,01 - 10% by weight
  • Vitamin K in the range of 0,001 -5% by weight
  • Polyethylene glycol in the range of 2- 10% by weight
  • Sweetener in the range of 0-5% by weight
  • osteoporosis and related diseases comprises diseases such as osteoporosis; bone fracture including vertebral column and hip bones in postmenopausal women; bone fracture in men; idiopathic osteoporosis; osteoporosis resulting from various diseases; steroid and glucocorticoid-induced osteoporosis; osteopenia; osteomalacia; osteogenesis imperfecta; osteochondrodisplasia; sudeck atrophy; rheumatoid arthritis; atherosclerosis; Paget' s disease; metastasis of malignant tumors to bones; hypercalcemia; or hyperthyroidism.
  • prophylaxis of the disease refers to prevention of abovementioned diseases by administering said formulations to healthy people. This term also comprises use of said formulation in people who are in the first stage of the disease.
  • treatment of the disease refers to use of the formulation of the present invention for treatment purposes in people diagnosed with osteoporosis or osteoporosis-related diseases. All the components used in scope of the present invention are pharmaceutically acceptable.
  • pharmaceutically acceptable refers to the component's suitability for use in people; its having few or no side effects (toxicity, irritation, allergic response) and its providing the user an evident benefit.
  • the effervescent formulation of the present invention can be produced by direct compression, wet granulation and/or dry granulation methods applied conventionally.

Abstract

The present invention relates to formulations comprising calcium, vitamin D and vitamin K; and use of said formulations in the prophylaxis and treatment of osteoporosis and related diseases.

Description

FORMULATIONS COMPRISING CALCIUM, VITAMIN D AND VITAMIN K FOR
OSTEOPOROSIS
The present invention relates to formulations comprising calcium, vitamin D and vitamin K; and use of said formulations in prophylaxis and treatment of osteoporosis and related diseases.
Bone loss, or in other terms "osteoporosis", is defined as a disease characterized by liability to bone fracture and increased risk of bone fracture as a consequence of low bone mass and deterioration of bone micro architecture. The disease does not generally result in death; however, it is a major health problem affecting life quality. Although osteoporosis is mostly seen in spine, hip and wrist; all the bones in the body are affected by the disease. 80% of the patients are female though the disease is encountered in both genders. Postmenopausal women lose 0,7-2% of total bone mass annually while this ratio is 0,5-0,7% for men. In parallel with this, total bone mass loss in men and women between 45-70 years of age is 15-30%. Some studies conducted nowadays indicate that insufficient calcium intake in childhood may increase the risk of osteoporosis later in life.
It is known that calcium taken by diet plays a significant role in prophylaxis of osteoporosis. However, calcium absorption is reduced in postmenopausal term due to physical features of calcium and other factors. One of the most important problems encountered in calcium intake is that calcium salts in all calcium sources do not dissolve at an equal rate or present desired bioavailability. Calcium salts have low water solubility. They are dissolved relatively better in gastric acid; however, carbon dioxide produced causes gas and pain in the stomach. Furthermore, gastric acid is reduced due to gastric acid inhibitors used in later ages and therefore calcium leaves the stomach without being dissolved.
Another factor for reduced calcium absorption in postmenopausal women is vitamin D deficiency. Vitamin D is a fat-soluble hormone precursor and the studies conducted have indicated that efficient amounts of vitamin D increases calcium absorption.
However, calcium and vitamin D reinforcement alone may lead to vascular and soft tissue calcification including skin while satisfying calcium need of bones. Coronary artery calcification is a factor increasing risk of heart attack. Many studies conducted have pointed out that insufficient intake of vitamin K may cause arterial calcification, yet arterial calcification may recess in case of vitamin K reinforcement. Bone is a living tissue which is continuously being created and destroyed. This creation and destruction process is balanced in young, healthy individuals. An increase in the activity of osteoclasts that are responsible for destruction unbalances this process. Vitamin K plays a key role in reducing this increased activity of osteoclasts and therefore preventing bone degradation. Cells that are responsible for bone formation are osteoblasts. Osteoblasts produce a protein named osteocalcin and calcium is stored in bones when this protein is activated. However, vitamin K is required for osteocalcin to bind calcium and vitamin D is required for osteocalcin production.
The tablet formulations comprising vitamin calcium, vitamin D3 and vitamin K that exist on the market now are formulations developed in line with this purpose.
However, it frequently poses problems to administer solid dosage forms such as pills, tablets, capsules by the oral route in elderly patients. Due to the problems appearing particularly in pharyngeal and esophageal movements, the individuals may have a feel of obstruction or asphyxiation, and as a result, intake of the medicament may turn disgustful and painful for the patient. Thus, the patient does not take the drug regularly, and efficiency of the treatment is substantially affected by this.
The general problem encountered in tablet formulations comprising calcium is gas and pain in the stomach resulting from carbon dioxide produced while calcium is being dissolved in gastric acid. This influences quality of the patient's daily life negatively and leads the patient to ignore regular intake of the medicament.
However, amount of gastric acid is reduced due to gastric acid inhibitors used in advanced ages and in parallel with that calcium leaves the stomach without being dissolved. Thus, the patient cannot benefit sufficient bioavailability.
When the prior art is taken into consideration, there is need for development of user-friendly formulations which comprise calcium, vitamin D and vitamin K; overcome the technical problems that existing tablet formulations pose; have high bioavailability and few side effects in order to be used in the treatment of osteoporosis and related diseases.
The inventors have surprisingly found that effervescent formulations comprising calcium, vitamin D and vitamin K are user-friendly, have fewer side effects and present higher bioavailability compared with the existing tablet formulations; therefore, they display higher efficiency in the prophylaxis and treatment of osteoporosis and related diseases. In this respect, the present invention relates to effervescent formulations comprising calcium, vitamin D and vitamin K.
Effervescent formulation of the present invention can be in powder, granule, pellet, micro tablet or tablet form. Effervescent formulation of the present invention is preferably in tablet form.
Calcium used in the formulation of the present invention is preferably in salt form.
Calcium comprised in the formulation of the present invention can be selected from calcium, carbonate, chloride, phosphate, citrate, lactate, glubionate, gluceptate, gluconate salts though it is preferably carbonate salt. Formulation of the present invention comprises 5-60% calcium or calcium salt by weight.
Formulation of the present invention comprises 200-2000 mg calcium or calcium salt in an equal amount to this.
Vitamin D comprised in the formulation of the present invention can be vitamin D2 (ergocalciferol) or vitamin D3 (cholecalciferol) though it is preferably vitamin D3 (cholecalciferol).
Formulation of the present invention comprises 0,01-15% vitamin D by weight.
Formulation of the present invention comprises 200-1000 IU vitamin D.
Vitamin K comprised in the formulation of the present invention is vitamin K\, K2 or a combination thereof. Formulation of the present invention comprises 0,001 -5% vitamin K by weight. Formulation of the present invention comprises 5-200 μg vitamin K.
The inventors added malic acid (powder) into the effervescent formulation comprising calcium, vitamin D and vitamin K in order to provide sufficient clarity of the solution after the formulation is dissolved. In this aspect, the present invention relates to effervescent formulations comprising calcium, vitamin D and vitamin K and malic acid (powder). Amount of the malic acid comprised in the formulation of the present invention is in the range of 3-20% by weight.
The formulation of the present invention comprises calcium, vitamin D and vitamin K as the active agents, and an effervescent couple to provide water solubility characteristic. The term "effervescent couple" refers to use of an acidic agent and a basic agent together.
The pharmaceutically acceptable acidic agent of the present invention can be selected from a group comprising acetic acid, citric acid, lactic acid, phosphoric acid, propionic acid, malic acid, tartaric acid or combinations thereof.
The pharmaceutically acceptable acidic agent of the present invention is preferably citric acid, malic acid or a combination thereof.
The pharmaceutically acceptable basic agent of the present invention can be selected from a group comprising potassium carbonate, potassium bicarbonate, potassium citrate, potassium hydroxide, sodium carbonate, sodium hydrogen carbonate, sodium hydrogen citrate or combinations thereof. The pharmaceutically acceptable basic agent of the present invention is preferably sodium carbonate or sodium hydrogen carbonate.
The formulation of the present invention in effervescent form can comprise pharmaceutically acceptable excipients in addition to calcium, vitamin D and vitamin K.
The effervescent formulation of the present invention can optionally comprise one or more of the excipients including binder, glidant, lubricant, diluent, disintegrant, flavoring agent, sweetener, coloring agent, anti-foam agent, stabilizing agent.
The said binder can be selected from a group comprising starches such as potato starch, corn starch, wheat starch; sugars such as sucrose, glucose, dextrose, lactose, maltodextrin; natural and synthetic gums; gelatin; cellulose derivatives such as microcrystalline cellulose, HPC, HEC, HPMC, carboxymethyl cellulose, methyl cellulose, ethyl cellulose; polyvinylpyrrolidone (povidone), polyethylene glycol (PEG); waxes; calcium carbonate; calcium phosphate; alcohols such as sorbitol, xylitol, mannitol, and water or a combination thereof. The binder used in the formulation of the present invention is preferably lactose, povidone, polyethylene glycol or a combination thereof.
The said glidant can be selected from a group comprising sodium benzoate, sodium chloride, sodium acetate, sodium fumarate, carbowax 4000, L-leucine(17), polyethylene glycol or a combination thereof though it is preferably polyethylene glycol.
PEG that the formulation of the present invention comprises is PEG 4000, PEG 6000 or a combination thereof.
Polyethylene glycol that the formulation of the present invention comprises is more than 2% by weight. The said lubricant can be selected from a group comprising talc, magnesium stearate, stearic acid, sodium stearil fumarate, polyoxyethylene glycol, leucine, alanine, glycine, sodium benzoate, sodium acetate, fumaric acid or a combination thereof.
The said diluent can be selected from a group comprising lactose, maltose, dextrin, maltodextrin, mannitol, sorbitol, starch or a combination thereof. The said disintegrant can be selected from a group comprising starches such as potato starch, corn starch, wheat starch, pregelatinized starch, sodium starch glycolate; cellulose derivatives such as croscarmellose sodium or microcrystalline cellulose; polyvinylpyrrolidone; crospovidone; alginic acid and its salts; clays such as xanthan gum or Veegum; ion exchange resins or a combination thereof. The said flavoring agent can be selected from a group comprising natural aroma oils (peppermint oil, wintergreen oil, clove bud oil, parsley oil, eucalyptus oil, lemon oil, orange oil), menthol, menthane, anethole, methyl salicylate, eucalyptol, cinnamon, 1 -methyl acetate, sage, eugenol, oxanone, alpha irisone, marjoram, lemon, orange, blackberry, propenyl guaetol acetyl, cinnamon, vanilla, thymol, linalol, cinnamaldehyde glycerol acetal, N-substituted p- menthane-3-carboxamide, 3,1-methoxy propane 1,2-diol or a combination thereof though it is preferably lemon, orange, blackberry flavor or a combination thereof. The said sweetener can be selected from a group comprising sucralose, sucrose, fructose, glucose, galactose, xylose, dextrose, laevulose, lactose, maltose, maltodextrin, mannitol, maltitol, maltol, sorbitol, xylitol, erythritol, lactitol, isomalt, corn syrup, saccharine, saccharine salts, acesulfame potassium, aspartame, D-tryptophane, monoammonium glycyrrhizinate, neohesperidin dihydrochalcone, thaumatin, neotame, alitame, stevioside and cyclamates or a combination thereof though it is preferably sucralose, lactose, glucose, mannitol, sorbitol or a combination thereof.
The said coloring agent can be selected from a group comprising carotenoids and chlorophyl or a combination thereof. The said antifoam agent can be selected from a group comprising simethicone emulsion and dimethyl siloxane, silicon oil or a combination thereof.
The said stabilizing agent and/or agents can be selected from a group comprising antioxidants, chelating agents, alkalinizing agents and photoprotective agents.
The antioxidants can be selected from substances including butylated hydroxyanisole (BHA), sodium ascorbate, butylhydroxytoluene (BHT), sodium sulphite, gallates (such as propyl gallate), tocoferole, citric acid, malic acid, ascorbic acid, acetylcysteine, fumaric acid, lecithin, ascorbyl palmitate, ethylenediamine tetraacetate or a combination thereof.
The chelating agents can be selected from a group comprising disodium EDTA, edetic acid, citric acid, sodium citrate, potassium citrate or a combination thereof. The alkalinizing agents can be selected from alkali metal salts such as sodium carbonate, sodium hydrogen carbonate, sodium hydroxide, sodium silicate, disodium hydrogen orthophosphate, sodium aluminate; alkaline earth metal salts such as calcium carbonate, calcium hydroxide, dibasic calcium phosphate, tribasic calcium phosphate, calcium sulphate, calcium acetate, calcium gluconate, calcium glycerophospate, magnesium carbonate, magnesium hydroxide, magnesium sulphate, magnesium acetate, magnesium silicate, magnesium aluminate; and primary, secondary and tertiary amines, cyclic amines; Ν,Ν'- dibenzyl ethylenediamine, dietanolamine, ethylenediamine, meglumine, monosodium glutamate, polacrilin sodium, sodium alginate or a combination thereof.
The photoprotective agents can be selected from metal oxides such as titanium oxide, iron oxide and zinc oxide or a combination thereof. According to the present invention, the effervescent formulation comprises;
- Calcium or calcium salt in the range of 15-40% by weight
- Vitamin D in the range of 0,01 - 10% by weight
- Vitamin K in the range of 0,001 -5% by weight
- Effervescent couple in the range of 20-80% by weight
- Malic acid in the range of 3-20% by weight
Polyethylene glycol in the range of 2- 10% by weight
Sweetener in the range of 0-5% by weight
The expression "osteoporosis and related diseases" comprises diseases such as osteoporosis; bone fracture including vertebral column and hip bones in postmenopausal women; bone fracture in men; idiopathic osteoporosis; osteoporosis resulting from various diseases; steroid and glucocorticoid-induced osteoporosis; osteopenia; osteomalacia; osteogenesis imperfecta; osteochondrodisplasia; sudeck atrophy; rheumatoid arthritis; atherosclerosis; Paget' s disease; metastasis of malignant tumors to bones; hypercalcemia; or hyperthyroidism. The expression "prophylaxis of the disease" refers to prevention of abovementioned diseases by administering said formulations to healthy people. This term also comprises use of said formulation in people who are in the first stage of the disease. The expression "treatment of the disease" refers to use of the formulation of the present invention for treatment purposes in people diagnosed with osteoporosis or osteoporosis-related diseases. All the components used in scope of the present invention are pharmaceutically acceptable. The term 'pharmaceutically acceptable' refers to the component's suitability for use in people; its having few or no side effects (toxicity, irritation, allergic response) and its providing the user an evident benefit.
Example 1
The effervescent formulation of the present invention can be produced by direct compression, wet granulation and/or dry granulation methods applied conventionally.
Figure imgf000009_0001
Example 2
Figure imgf000010_0001

Claims

1. A formulation comprising calcium, vitamin D and vitamin K characterized in that said formulation is in effervescent form.
2. The effervescent formulation according to claim 1 characterized in that said formulation is formulated in powder, granule, pellet, micro tablet or tablet form.
3. The effervescent formulation according to claim 2 characterized in that said formulation is formulated in effervescent tablet form.
4. The effervescent formulation according to claim 1 characterized in that calcium comprised in said formulation is in salt form.
5. The effervescent formulation according to claim 4 characterized in that calcium comprised in said formulation is in carbonate, chloride, phosphate, citrate, lactate, glubionate, gluceptate, gluconate salt form.
6. The effervescent formulation according to claim 5 characterized in that calcium salt comprised in said formulation is calcium carbonate.
7. The effervescent formulation according to claim 1 characterized in that said formulation comprises 5-60% calcium by weight.
8. The effervescent formulation according to claim 1 characterized in that the amount of calcium that said formulation comprises is in the range of 200-2000 mg.
9. The effervescent formulation according to claim 1 characterized in that vitamin D that said formulation comprises is vitamin D2 (ergocalciferol) or vitamin D3
(cholecalciferol).
10. The effervescent formulation according to claim 9 characterized in that vitamin D that said formulation comprises is vitamin D3 (cholecalciferol).
11. The effervescent formulation according to claim 1 characterized in that said formulation comprises 0,01 - 15% vitamin D by weight.
12. The effervescent formulation according to claim 1 characterized in that the amount of vitamin D that said formulation comprises is in the range of 200-1000 IU.
13. The effervescent formulation according to claim 1 characterized in that vitamin K that said formulation comprises is Kj; K2 or a combination thereof.
14. The effervescent formulation according to claim 1 characterized in that said formulation comprises 0,001-5% vitamin K by weight.
15. The effervescent formulation according to claim 1 characterized in that the amount of vitamin K that said formulation comprises is in the range of 5-200 μπι.
16. The effervescent formulation according to claim 1 characterized in that said formulation comprises malic acid (powder).
17. The effervescent formulation according to claim 15 characterized in that the amount of malic acid that said formulation comprises is in the range of 3-20% by weight.
18. The effervescent formulation according to claim 1 characterized in that said formulation comprises an effervescent couple composed of an acidic and a basic agent in addition to calcium, vitamin D and vitamin K.
19. The effervescent formulation according to claim 18 characterized in that the acidic agent that said formulation comprises is selected from a group comprising acetic acid, citric acid, lactic acid, phosphoric acid, propionic acid, malic acid, tartaric acid or combinations thereof.
20. The effervescent formulation according to claim 19 characterized in that the acidic agent that said formulation comprises is citric acid, malic acid or a combination thereof.
21. The effervescent formulation according to claim 18 characterized in that the basic agent that said formulation comprises is selected from a group comprising potassium carbonate, potassium bicarbonate, potassium citrate, potassium hydroxide, sodium carbonate, sodium hydrogen carbonate, sodium hydrogen citrate or combinations thereof.
22. The basic agent according to claim 21 characterized in that the basic agent that said formulation comprises is sodium carbonate or sodium hydrogen carbonate.
23. The effervescent formulation according to claim 1 characterized in that said formulation can comprise pharmaceutically acceptable excipients in addition to calcium, vitamin D and vitamin K it comprises.
24. The effervescent formulation according to claim 23 characterized in that said formulation can comprise one or more of the excipients including binder, glidant, lubricant, diluent, disintegrant, flavoring agent, sweetener, coloring agent, anti-foam agent, stabilizing agent.
25. The effervescent formulation according to claim 24 characterized in that the binder that said formulation comprises is selected from a group comprising starches such as potato starch, corn starch, wheat starch; sugars such as sucrose, glucose, dextrose, lactose, maltodextrin; natural and synthetic gums; gelatin; cellulose derivatives such as microcrystalline cellulose, HPC, HEC, HPMC, carboxymethyl cellulose, methyl cellulose, ethyl cellulose; polyvinylpyrrolidone (povidone), polyethylene glycol (PEG); waxes; calcium carbonate; calcium phosphate; alcohols such as sorbitol, xylitol, mannitol, and water or a combination thereof.
26. The effervescent formulation according to claim 25 characterized in that the binder that said formulation comprises is lactose, povidone, polyethylene glycol or a combination thereof.
27. The effervescent formulation according to claim 24 characterized in that the glidant that said formulation comprises is selected from a group comprising sodium benzoate, sodium chloride, sodium acetate, sodium fumarate, carbowax 4000, L-leucine(17), polyethylene glycol or a combination thereof.
28. The effervescent formulation according to claim 27 characterized in that the glidant that said formulation comprises is polyethylene glycol.
29. The effervescent formulation according to claim 28 characterized in that polyethylene glycol that said formulation comprises is PEG 4000, PEG 6000 or a combination thereof.
30. The effervescent formulation according to claim 27 characterized in that said formulation comprises more than 2% polyethylene glycol (PEG).
31. The effervescent formulation according to claim 24 characterized in that the lubricant that said formulation comprises is selected from a group comprising talc, magnesium stearate, stearic acid, sodium stearyl fumarate, polyoxyethylene glycol, leucine, alanine, glycine, sodium benzoate, sodium acetate, fumaric acid or a combination thereof.
32. The effervescent formulation according to claim 24 characterized in that the diluent that said formulation comprises is selected from a group comprising lactose, maltose, dextrin, maltodextrin, mannitol, sorbitol, starch or a combination thereof.
33. The effervescent formulation according to claim 24 characterized in that the disintegrant that said formulation comprises is selected from a group comprising starches such as potato starch, corn starch, wheat starch, pregelatinized starch, sodium starch glycolate; cellulose derivatives such as croscarmellose sodium or microcrystalline cellulose; polyvinylpyrrolidone; crospovidone; alginic acid and its salts; clays such as xanthan gum or Veegum; ion exchange resins or a combination thereof.
34. The effervescent formulation according to claim 24 characterized in that the flavoring agent that said formulation comprises is selected from a group comprising natural aroma oils (peppermint oil, wintergreen oil, clove bud oil, parsley oil, eucalyptus oil, lemon oil, orange oil), menthol, menthane, anethole, methyl salicylate, eucalyptol, cinnamon, 1 -methyl acetate, sage, eugenol, oxanone, alpha irisone, marjoram, lemon, orange, blackberry, propenyl guaetol acetyl, cinnamon, vanilla, thymol, linalol, cinnamaldehyde glycerol acetal, N-substituted p-menthane-3-carboxamide, 3,1- methoxy propane 1 ,2-diol or a combination thereof.
35. The effervescent formulation according to claim 34 characterized in that the flavoring agent that said formulation comprises is lemon, orange, blackberry flavor or a combination thereof.
36. The effervescent formulation according to claim 24 characterized in that the sweetener that said formulation comprises is selected from a group comprising sucralose, sucrose, fructose, glucose, galactose, xylose, dextrose, laevulose, lactose, maltose, maltodextrin, mannitol, maltitol, maltol, sorbitol, xylitol, erythritol, lactitol, isomalt, corn syrup, saccharine, saccharine salts, acesulfame potassium, aspartame, D- tryptophane, monoammonium glycyrrhizinate, neohesperidin dihydrochalcone, thaumatin, neotame, alitame, stevioside and cyclamates or a combination thereof.
37. The effervescent formulation according to claim 36 characterized in that the sweetener that said formulation comprises is sucralose, lactose, glucose, mannitol, sorbitol or a combination thereof.
38. The effervescent formulation according to claim 24 characterized in that the coloring agent that said formulation comprises is selected from a group comprising carotenoids and chlorophyl or a combination thereof.
39. The effervescent formulation according to claim 24 characterized in that the anti-foam agent that said formulation comprises is selected from a group comprising simethicone emulsion and dimethyl siloxane, silicon oil or a combination thereof.
40. The effervescent formulation according to claim 24 characterized in that the stabilizing agent that said formulation comprises is selected from a group comprising antioxidants, chelating agents, alkalinizing agents and photoprotective agents.
41. The effervescent formulation according to claim 1 characterized in that said formulation comprises;
- calcium or calcium salt in the range of 15-40% by weight
- vitamin D in the range of 0,01 - 10% by weight
- vitamin K in the range of 0,001 -5% by weight
- effervescent couple in the range of 20-80% by weight
- malic acid in the range of 3-20% by weight - polyethylene glycol in the range of 2-10% by weight
- sweetener in the range of 0-5% by weight
42. The effervescent formulation according to claim 1 characterized in that said formulation is used in the manufacture of a drug in order to be used in the treatment of diseases such as osteoporosis; bone fracture including vertebral column and hip bones in postmenopausal women; bone fracture in men; idiopathic osteoporosis; osteoporosis resulting from various diseases; steroid and glucocorticoid-induced osteoporosis; osteopenia; osteomalacia; osteogenesis imperfecta; osteochondrodisplasia; sudeck atrophy; rheumatoid arthritis; atherosclerosis; Paget' s disease; metastasis of malignant tumours to bones; hypercalcemia; or hyperthyroidism.
PCT/TR2011/000151 2010-06-03 2011-06-02 Formulations comprising calcium, vitamin d and vitamin k for osteoporosis WO2011152810A1 (en)

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CN105492073A (en) * 2013-08-08 2016-04-13 卡帕生物科学研究院 Provitamins
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WO2018013873A1 (en) * 2016-07-14 2018-01-18 Companion Therapeutics Llc Pharmaceutical composition effective in preventing adverse effects associated with the use of glucocorticoids
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CN112741841A (en) * 2019-10-29 2021-05-04 湖北真奥医药研究院有限公司 Three-dimensional calcium self-emulsifying effervescent composition and preparation method of preparation thereof
CN110892991A (en) * 2019-12-27 2020-03-20 北京康比特体育科技股份有限公司 Composition for increasing bone density and preparation method and application thereof
CN112353813A (en) * 2020-12-10 2021-02-12 浙江艾兰得生物科技有限公司 Vitamin D and vitamin K soft capsules with good calcium supplementing effect

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