WO2012127431A1 - Compositions stabilisées de tétrahydrobioptérine - Google Patents

Compositions stabilisées de tétrahydrobioptérine Download PDF

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Publication number
WO2012127431A1
WO2012127431A1 PCT/IB2012/051355 IB2012051355W WO2012127431A1 WO 2012127431 A1 WO2012127431 A1 WO 2012127431A1 IB 2012051355 W IB2012051355 W IB 2012051355W WO 2012127431 A1 WO2012127431 A1 WO 2012127431A1
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composition
copolymer
acid
cellulose
derivative
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PCT/IB2012/051355
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English (en)
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Maharukh Tehmasp Rustomjee
Anilkumar Surendrakumar Gandhi
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Rubicon Research Private Limited
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2022—Organic macromolecular compounds
    • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
    • 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
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • 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
    • A61K9/2013—Organic compounds, e.g. phospholipids, fats
    • A61K9/2018—Sugars, or sugar alcohols, e.g. lactose, mannitol; Derivatives thereof, e.g. polysorbates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/28—Dragees; Coated pills or tablets, e.g. with film or compression coating
    • A61K9/2806—Coating materials
    • A61K9/2833—Organic macromolecular compounds
    • A61K9/284—Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/28—Dragees; Coated pills or tablets, e.g. with film or compression coating
    • A61K9/2806—Coating materials
    • A61K9/2833—Organic macromolecular compounds
    • A61K9/2853—Organic macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, polyethylene oxide, poloxamers, poly(lactide-co-glycolide)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/28—Dragees; Coated pills or tablets, e.g. with film or compression coating
    • A61K9/2806—Coating materials
    • A61K9/2833—Organic macromolecular compounds
    • A61K9/286—Polysaccharides, e.g. gums; Cyclodextrin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism

Definitions

  • the present invention relates to stabilized compositions of tetrahydrobiopterin and processes for producing such compositions. Particularly the present invention relates to stabilized compositions comprising sapropterin or pharmaceutically acceptable salts thereof and at least one coating agent.
  • Amino acids represent the source of life and make up twenty percent of the human body. They are divided into two categories - essential amino acids, which are not synthesized in the body and must be taken from food; and non-essential amino acids.
  • Phenylalanine is one of the eight essential amino acids that is an important precursor for the synthesis of tyrosine that serves as a precursor for synthesis of many neurotransmitters and thyroid hormones.
  • Physiologic requirements for phenylalanine are met exclusively by dietary protein intake. Usual dietary intake of protein provides excess amounts of phenylalanine and blood phenylalanine levels are maintained within non-toxic levels via utilization, metabolism and excretion.
  • Hyperphenylalaninemia is a congenital metabolic disorder inherited as an autosomal recessive trait and characterized by the presence of blood phenylalanine levels that exceed the limits of the upper reference range of 2 img/dL or 120 mmol/ L.
  • HPA is divided into (i) HPA caused due to deficiency in enzyme phenylalanine hydroxylase (PAH) that is required for the conversion of ingested phenylalanine to tyrosine, due to absent or mutated PAH enzyme; the condition being known as Phenylketonuria (PKU) or (ii) HPA resulting from a deficiency in tetrahydrobiopterin (BH4) cofactor of the enzyme PAH, due to defects in its biosynthesis or recycling.
  • PAH phenylalanine hydroxylase
  • PKU Phenylketonuria
  • BH4 tetrahydrobiopterin
  • Tetrahydrobiopterin is a biogenic amine of the naturally occurring pterin family that is a cofactor for a number of different enzymes, including phenylalanine hydroxylase, tyrosine hydroxylase, tryptophan hydroxylase and nitric oxide synthase regulating their activity and catalysis. These enzymes further are rate limiting in the biosynthesis of the neurotransmitters serotonin (5-hydroxytryptamine), melatonin, dopamine, norepinephrine (noradrenaline), epinephrine (adrenaline), and nitric oxide (NO).
  • serotonin 5-hydroxytryptamine
  • melatonin dopamine
  • norepinephrine norepinephrine
  • epinephrine adrenaline
  • NO nitric oxide
  • BH4-responsive PAH deficiency has also been diagnosed as a variant of hyperphenylalaninemia or phenylketonuria caused by mutations in the human PAH gene that responds to oral BH4 loading by stimulating enzyme activity and therefore lowering serum phenylalanine.
  • BH4 is said to have a chaperon-like effect on PAH synthesis and/or is a protecting cofactor against enzyme auto-inactivation and degradation.
  • Sapropterin dihydrochloride is a synthetic version of naturally occurring tetrahydrobiopterin.
  • Sapropterin dihydrochloride is chemically represented as (6R)-2- amino-6-[(1 R,2S)-1 ,2-dihydroxypropyl]-5,6,7,8-tetrahydro-4(1 H)-pteridinone
  • Sapropterin dihydrochloride is a crystalline powder, hygroscopic and very soluble in water with solubility being greater than 1 g/ml. It exhibits polymorphism and many crystalline forms have been identified; among all the polymorphic forms, Form B was identified to be thermodynamically stable crystalline anhydrate form.
  • Sapropterin dihydrochloride is currently available as oral soluble tablets of 100mg under the brand name KuvanTM. It is marketed by BioMarin in the US and Merck Serono in Europe.
  • KuvanTM has been designated as an orphan medication since hyperphenylalaninemia is a rare disease. KuvanTM is indicated to reduce blood phenylalanine levels in patients with hyperphenylalaninemia due to tetrahydrobiopterin responsive phenylketonuria. It is to be used in conjunction with phenylalanine restricted diet. In patients with phenylketonuria the role of sapropterin dihydrochloride is to enable endogenous phenylalanine hydroxylase activity and to partially restore oxidative metabolism of phenylalanine, resulting in decreased blood phenylalanine levels. In patients with BH4 deficiency, sapropterin dihydrochloride is proposed to restore endogenous phenylalanine hydroxylase activity by providing an exogenous source of the missing cofactor.
  • Tetrahydrobiopterin is an unstable compound; at ambient temperature it is prone to autoxidation in the presence of molecular oxygen (Davis et ai, Eur. J. Biochem., Vol 173, 345-351, 1988). It also undergoes auto-oxidation in aqueous solutions at pH 7.4 to form 7, 8-dihydrobiopterin (BH2) (Thony et ai, 2000). Tetrahydrobiopterin is also very hygroscopic. Therefore the development of stabilized oral composition comprising tetrahydrobiopterin that is prone to degradation at room temperature is a challenging task.
  • the formulation of KuvanTM as disclosed in the U.S. Patent 7566462 describes use of polymorph B, of (6R)-L-erythro-tetrahydrobiopterin dihydrochloride, an antioxidant, and a pharmaceutically acceptable excipient, diluent, or carrier for preparation of stable tablet formulation ; wherein a specific weight ratio of the antioxidant to the (6R)-L-erythro- tetrahydrobiopterin dihydrochloride of about 1 :5 to about 1 :30 has been used.
  • Such a composition after six months in a container at room temperature and about 60% humidity is said to retain at least about 95% of the initial amount of (6R)-L-erythro- tetrahydrobiopterin dihydrochloride.
  • KuvanTM has a shelf life of 3 years when stored below 25 °C.
  • Further European Publication 1757293A1 discloses a pharmaceutical preparation for the treatment of BH4-responsive hyperphenylalaninemia provided in the form of granule, fine granule, or dry syrup, comprising sapropterin hydrochloride as an active ingredient; a flavoring agent; a coloring agent which is stable to acid and oxidation; and ascorbic acid or L-cysteine hydrochloride as a stabilizer, wherein the preparation has a moisture content (weight loss on drying) of 0.9% or less.
  • This European Publication 1757293A1 discloses that the decomposition of sapropterin hydrochloride caused by moisture can be prevented by keeping the moisture content of the preparation at 0.9% or lower during the production.
  • U.S. Patent 4778794 discloses pharmaceutical compositions comprising in addition to carriers, antioxidants that stabilize tetrahydrobiopterin; with the weight ratio of the antioxidant to active ranging from 0.2 - 1 .5. Further tetrahydrobiopterin tablets from Schircks Laboratories contain antioxidant ascorbic acid in a ratio of 1 :1 with active and at room temperature these tablets have a shelf life of 2 months and at 5 °C or colder are stable for 4 months.
  • compositions of sapropterin comprising stabilizers in variety of ratios
  • the stability of these compositons is low at room temperature or 40 °C/75% relative humidity and need to be stored under refrigeration.
  • Low stability of such tetrahydrobiopterin compositions is commercially undesirable and significant degradation due to improper storage could hinder therapy. Need therefore, exists for preparations of tetrahydrobiopterin that are more stable and retain desired amount of active over a longer time even when not refrigerated.
  • the amount and type of stabilizer and other excipients present in the compositions of sapropterin also affect the stability of the active and compositions thereof. Too little or too much stabilizer can affect the stability of the compositions of sapropterin. Additionally stabilizers such as ascorbic acid themselves have a tendency to degrade and the resultant reduction in their concentrations may alter the stability profile of tetrahydrobiopterin. Further tetrahydrobiopterin also decomposes in the presence of moisture and it may also react with reducing sugars or may cause discoloration of some excipients due to its strong reducing power. The stability of sapropterin also needs to be ensured during the process of preparation of compositions thereof.
  • tetrahydrobiopterin and/or compositions thereof when coated with coating agents that provide oxygen and/or moisture barrier protection give formulations that are stable over a longer period of time even when not stored under refrigeration. Further with the use of coating agents that provide oxygen and/or moisture barrier protection, antioxidants may not be required in the formulations of tetrahydrobiopterin or the amount of antioxidants that may be required in the formulations may be lower.
  • the stabilized compositions of tetrahydrobiopterin according to the present invention thus provide desired amount of active over the entire shelf life of the product.
  • the present invention relates to stabilized pharmaceutical compositions comprising tetrahydrobiopterin and at least one coating agent. Particularly the present invention relates to stabilized compositions of sapropterin or pharmaceutically acceptable salts thereof.
  • the present invention relates to stabilized compositions of tetrahydrobiopterin, processes for producing such compositions and methods of using such compositions.
  • the present invention relates to pharmaceutical compositions comprising tertrahydrobiopterin and at least one coating agent.
  • Tetrahydrobiopterin as employed in the compositions of the present invention may be in the form of free base, free acid or pharmaceutically acceptable salts, prodrugs, precursors, active metabolites, derivatives, analogs, polymorphs, solvates, hydrates, amorphous forms, enantiomers, optical isomers, tautomers, racemic mixtures and the like or any mixtures thereof.
  • Suitable precursors of tetrahydrobiopterin that may be employed include, but are not limited to, dihydroneopterin triphosphate, biopterin, sepiapterin, 7, 8-dihydrobiopterin and the like or mixtures thereof.
  • Suitable derivatives of tetrahydrobiopterin include, but are not limited to, N2-methyl H4biopterin, N5-methyl H4-biopterin, N5-formyl H4-biopterin, N5-acetyl H4-biopterin, 1 ',2'-diacetyl-5,6,7,8-tetrahydrobiopterin, 6-methyl-5,6,7,8-tetrahydropterin, 6- hydroxymethyl-5,6,7,8-tetrahydropterin, 6-phenyl-5,6,7,8-tetrahydropterin, hydrazine derivatives of tetrahydrobiopterin, 2-N-stearoyl-1 ',2'-di-0-acetyl-L-biopterin, L- tetrahydrobiopterin, tetrahydrofuranylpyrimidine derivative, 7, 8-dihydrobiopterin, lipoic acid derivative of tetrahydrobiopterin such as di
  • Suitable analogs of tetrahydrobiopterin include, but are not limited to, 6-methoxymethyl-tetrahydropterin, pteridine, neopterin, biopterin, 7,8- dihydrobiopterin, 6-methyltetrahydropterin, 6-substituted tetrahydropterin, 6R-L-erythro- tetrahydrobiopterin, sepiapterin, 6,7- dimethyltetrahydropterin, 6-methyl biopterin, 7- tetrahydrobiopterin and the like or mixtures thereof.
  • Suitable pharmaceutically acceptable salts such as, but not limited to, acid or base addition salts may be employed.
  • Suitable pharmaceutically acceptable base addition salts of tetrahydrobiopterin may be formed with metals or amines, such as, but not limited to, alkali and alkaline earth metals or organic amines.
  • Pharmaceutically acceptable salts may also be prepared with a pharmaceutically acceptable cation such as, but not limited to, alkaline, alkaline earth, ammonium and quaternary ammonium cations.
  • Suitable metals include, but are not limited to sodium, potassium, magnesium, ammonium, calcium, or ferric, and the like.
  • Suitable amines include, but are not limited to isopropylamine, trimethylamine, histidine, ⁇ , ⁇ '-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine, dicyclohexylamine, ethylenediamine, N-methylglucamine, and procaine.
  • Suitable pharmaceutically acceptable acid addition salts include, but are not limited to, inorganic or organic acid salts. Examples of suitable acid salts include, but are not limited to, hydrochlorides, acetates, citrates, salicylates, nitrates, phosphates.
  • Suitable pharmaceutically acceptable salts include, for example, acetic, citric, oxalic, tartaric, or mandelic acids, hydrochloric acid, hydrobromic acid, sulfuric acid or phosphoric acid; with organic carboxylic, sulfonic, sulfo or phospho acids or N substituted sulfamic acids, for example acetic acid, propionic acid, glycolic acid, succinic acid, maleic acid, hydroxymaleic acid, methylmaleic acid, fumaric acid, malic acid, tartaric acid, lactic acid, oxalic acid, gluconic acid, glucaric acid, glucuronic acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, salicylic acid, 4-aminosalicylic acid, 2- phenoxybenzoic acid, 2-acetoxybenzoic acid, embonic acid, nicotinic acid or isonicotinic acid; and with amino acids, such as the 20 alpha amino acids
  • tetrahydrobiopterin employed in the compositions of the present invention is in the form of a dihydrochloride salt.
  • tetrahydrobiopterin employed in the compositions of the present invention is sapropterin.
  • tetrahydrobiopterin employed in the compositions of the present invention is (6R)-L-erythro-5, 6, 7, 8-tetrahydrobiopterin dihydrochloride or (6R)-2-amino- 6-[(1 R,2S)-1 ,2-dihydroxypropyl]-5,6,7,8-tetrahydro-4(1 H)-pteridinone dihydrochloride or sapropterin dihydrochloride.
  • the present invention contemplates amorphous or crystalline forms of sapropterin including, but not limited to, all the polymorphs, solvates, and hydrates.
  • the various crystalline polymorphic forms include, but are not limited to, Form A, B, C, D, E, F, G, H, I, J, K, L, M, N and O.
  • Form B of sapropterin dihydrochloride is present in the compositions of the present invention.
  • compositions of the present invention employ pharmaceutically effective amount of tetrahydrobiopterin.
  • pharmaceutically effective amount refers to an amount that is effective to achieve therapeutic and/or beneficial effect.
  • the amount of tetrahydrobiopterin used in the composition varies from about 1 wt% to about 95 wt %, of the total weight of the composition.
  • the amount of tetrahydrobiopterin in the composition varies from about 2 wt% to 90 wt% of the total weight of the composition.
  • the amount of tetrahydrobiopterin in the composition varies from about 5 wt% to about 85 wt% of the total weight of the composition.
  • compositions of the present invention may administer a dose of about 1 mg to about 900 mg of tetrahydrobiopterin or higher. In another embodiment the compositions of the present invention may administer a dose of about 5 mg to about 600 mg of tertrahydrobiopterin. In a further embodiment the compositions of the present invention may administer a dose of about 100mg.
  • Tetrahydrobiopterin may be employed in the formulations of the present invention in the form of, but not limited to, powder, granules, pellets, beads, minitablets, tablets or the like.
  • Granules of tetrahydrobiopterins may be prepared by methods such as, but not limited to, wet granulation, dry granulation or roll compaction, melt granulation or the like.
  • the compositions of the present invention comprise at least one coating agent.
  • coating agent or "oxygen/moisture barrier coating agent” for the purpose of the present invention has been used interchangeably and refers to agents that protect tetrahydrobiopterin or compositions thereof against oxygen and/or moisture.
  • the coating agent employed in the compositions of the present invention includes, but is not limited to, polysaccharide or derivative thereof, vinyl derivative or polymer or copolymer thereof, acrylic acid derivative or polymer or copolymer thereof, maleic acid derivative or polymer or copolymer thereof, protein or derivative thereof, lipid or derivative thereof or the like or any combination thereof.
  • Polysaccharides or derivatives thereof employed in the compositions of the present invention include, but are not limited to, cellulose, starch, chitosan, pullulan, carrageenan, alginate, gums and the like or derivatives thereof or combination thereof.
  • Cellulose and derivatives thereof employed in the compositions thereof include, but are not limited to, cellulose, hemicellulose, methylcellulose, hydroxypropylmethylcellulose, hydroxypropyl cellulose, hydroxyethyl cellulose, hydroxymethyl cellulose, hydroxypropyl ethylcellulose, carboxymethylethyl cellulose, carboxy ethylcellulose, carboxymethyl hydroxyethylcellulose, hydroxyethylm ethyl carboxymethyl cellulose, hydroxyethyl methyl cellulose, carboxymethyl cellulose, methylhydroxyethyl cellulose, methylhydroxypropyl cellulose, carboxymethyl sulfoethyl cellulose, sodium carboxymethyl cellulose, ethyl cellulose, cellulose acetate, or combinations thereof.
  • Starch and derivatives thereof employed in the compositions thereof include, but are not limited to, starch, maize starch, potato starch, amylose-rich starch, or combinations thereof.
  • Gums and derivatives thereof employed in the compositions thereof include, but are not limited to, guar gum, xanthan gum, fenugreek gum, pectin, gum arabic, or combinations thereof.
  • Vinyl derivatives, polymers or copolymers thereof employed in the compositions of the present invention include, but are not limited to, polyvinyl acetate, polyvinyl alcohol, mixture of polyvinyl acetate and polyvinylpyrrolidone, polyvinylpyrrolidone, copolymer of polyvinyl alcohol with acrylic acid and methyl methacrylates, vinyl alcohol-ethylene glycol graft copolymer, physical mixture of polyvinyl alcohol and vinyl alcohol-ethylene glycol graft copolymer, or combinations thereof.
  • Acrylic acid derivatives employed in the compositions of the present invention include, but are not limited to, methacrylic acids, polymethacrylic acids, polyacrylates, coplymer of methyl methacrylate and diethylaminoethyl methacrylate, polymethacrylates such as a) copolymer formed from monomers selected from methacrylic acid, methacrylic acid esters, acrylic acid and acrylic acid esters b) copolymer formed from monomers selected from butyl methacrylate, (2-dimethylaminoethyl)methacrylate and methyl methacrylate c) copolymer formed from monomers selected from ethyl acrylate, methyl methacrylate and trimethylammonioethyl methacrylate chloride or d) copolymers of acrylate and methacrylates with/without quarternary ammonium group in combination with sodium carboxymethylcellulose, or the like or any combinations thereof.
  • polymethacrylates such as a) copolymer
  • Maleic acid derivatives or polymers or copolymers thereof, employed in the compositions of the present invention include, but are not limited to, vinylacetate maleic acid anhydride copolymers, styrene ' maleic acid anhydride copolymers, styrene ' maleic acid monoester copolymers, vinylmethylether maleic acid anhydride copolymers, ethylene maleic acid anhydride copolymers, vinylbutylether ' maleic acid anhydride copolymers, acrylonitrile ' methyl acrylate ' maleic acid anhydride copolymers, butyl acrylate ' styrene ' maleic acid anhydride copolymers and the like, or combinations thereof.
  • Proteins or derivatives thereof, employed in the compositions of the present invention include, zein, whey protein, collagen, and the like, or combinations thereof.
  • Lipids or derivatives thereof, employed in the compositions of the present invention include, but are not limited to, fatty acids, long chain alcohols, fats and oils, waxes, phospholipids, terpenes, or combinations thereof.
  • Fatty acids that may be employed in the present invention include, but are not limited to, hydrogenated palm kernel oil, hydrogenated peanut oil, hydrogenated palm oil, hydrogenated rapeseed oil, hydrogenated rice bran oil, hydrogenated soybean oil, hydrogenated sunflower oil, hydrogenated castor oil, hydrogenated cottonseed oil, and the like, and mixtures thereof.
  • Long chain alcohols include, but are not limited to, cetyl alcohol, stearyl alcohol or mixtures thereof.
  • Waxes are esters of fatty acids with long chain alcohols. Waxes that may be employed in the present invention include, but are not limited to, natural waxes, such as animal waxes, vegetable waxes, and petroleum waxes (i.e., paraffin waxes, microcrystalline waxes, petrolatum waxes, mineral waxes), and synthetic waxes.
  • spermaceti wax carnauba wax, Japan wax, bayberry wax, flax wax, beeswax, Chinese wax, shellac wax, lanolin wax, sugarcane wax, candelilla wax, paraffin wax, microcrystalline wax, petrolatum wax, carbowax, and the like, or mixtures thereof. Mixtures of these waxes with the fatty acids may also be used.
  • Waxes are also monoglyceryl esters, diglyceryl esters, or triglyceryl esters (glycerides) and derivatives thereof formed from a fatty acid having from about 1 0 to about 22 carbon atoms and glycerol, wherein one or more of the hydroxyl groups of glycerol are substituted by a fatty acid.
  • Glycerides employed in the present invention include, but are not limited to, glyceryl monostearate, glyceryl distearate, glyceryl tristearate, glyceryl dipalmitate, glyceryl tripalmitate, glyceryl monopalmitate, glyceryl dilaurate, glyceryl trilaurate, glyceryl monolaurate, glyceryl didocosanoate, glyceryl tridocosanoate, glyceryl monodocosanoate, glyceryl monocaproate, glyceryl dicaproate, glyceryl tricaproate, glyceryl monomyristate, glyceryl dimyristate, glyceryl trimyristate, glyceryl monodecenoate, glyceryl didecenoate, glyceryl tridecenoate, glyceryl behenate
  • the coating agents employed in the compositions of the present invention include, but are not limited to, hydroxypropyl methylcellulose, polyvinyl alcohol, polyvinyl acetate, sodium carboxymethyl cellulose, pullulan, polyvinyl alcohol and vinyl alcohol-ethylene glycol copolymer; copolymer comprising methyl methacrylate and diethylaminoethyl methacrylate; poylmethacrylic acids, polymethacrylates, and the like or combinations thereof.
  • the coating agents employed in the compositions of the present invention are commercially available under the trade names
  • ® ® ® ® ® ® such as, but not limited to, Opadry II, Opadry fxTM, Opadry AMB, Kollicoat Protect, Kollicoat Smartseal 30D, Aquarius MG, INSTAMOISTSHIELD AQUA I I, and the like or combinations thereof.
  • the coating agent is employed in the compositions of the present invention in an amount of about 0.1 % to about 70% by weight of the composition. In another embodiment the coating agent is employed in the compositions of the present invention in an amount of about 0.2% to about 60% by weight of the composition. In a further embodiment the coating agent is employed in the compositions of the present invention in an amount of about 0.5% to about 50% by weight of the composition.
  • tetrahydrobiopterin is coated with at least one oxygen/moisture barrier coating agent. In further embodiment, tetrahydrobiopterin is film coated with at least one oxygen/moisture barrier coating agent. In another embodiment, tetrahydrobiopterin in the form of, but not limited to, powder, granules, pellets, beads, minitablets, tablets and like are coated with at least one coating agent. In a further embodiment, compositions comprising tetrahydrobiopterin are coated with at least one coating agent. In one embodiment, compositions comprising tetrahydrobiopterin are film coated with at least one coating agent. In a still further embodiment, solid compositions comprising tetrahydrobiopterin are coated with at least one coating agent.
  • tetrahydrobiopterin in the form of, but not limited to, powder, granules, pellets, beads, minitablets, tablets and like are coated with at least one coating agent, followed by coating of the solid dosage form made there from with at least one same or different coating agent.
  • tetrahydrobiopterin in the form of, but not limited to, powder, granules, pellets, beads, minitablets, tablets and like are film coated with at least one coating agent, followed by coating of the solid dosage form made there from with at least one same or different coating agent.
  • the coating is applied to tetrahydrobiopterin or compositions thereof using conventional coating processes such as, but not limited to, fluidized bed coating, wet granulation or spray drying.
  • the coatings may be applied to tetrahydrobiopterin or compositions thereof in any suitable equipment where coating can be achieved, such as, but not limited to, conventional coating pan, horizontal drum coater, immersion sword coater, perforated pan coater, side vented pan coater or a fluidized bed apparatus, or the like.
  • the coating agents of the present invention may be used for coating in admixture with at least one additional excipient, such as but not limited to, plasticizers, anti-tacking agents, pigments and the like or any mixtures thereof.
  • Suitable plasticizers include, but are not limited to, dibutyl sebacate, propylene glycol, polyethylene glycol, polyvinyl alcohol, triethyl citrate, acetyl triethyl citrate, acetyl tributyl citrate, tributyl citrate, triacetin or the like or any combinations thereof.
  • Suitable anti-tacking agents include, but are not limited to, talc, and the like or combinations thereof.
  • compositions of the present invention may optionally comprise, apart from active ingredient and at least one coating agent, one or more of stabilizing agents.
  • stabilizer and “stabilizing agent” for the purpose of the present invention has been used interchangeably and refers to compounds or pharmaceutically acceptable excipients that stabilize tetrahydrobiopterin and compositions thereof.
  • the stabilizing agents employed in the compositions of the present invention include, but are not limited to, antioxidants, chelating agents, disaccharides or higher polyols, cyclodextrins, moisture retaining agents, hydrophobic agents and the like or any combinations thereof.
  • the stabilizing agent employed in the compositions of the present invention is at least one antioxidant.
  • Antioxidants are included in the compositions of the present invention to prevent degradation of the active from oxidation.
  • Antioxidants employed in the compositions of the present invention include, but are not limited to, organic antioxidants and inorganic antioxidants or any combinations thereof.
  • the organic antioxidants employed in the compositions of the present invention include, but are not limited to, butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), tert-butyl- hydroquinone (TBHQ), 4-hydroxymethyl-2,6-di-tert-butylphenol (HMBP), 2,4,5- trihydroxybutyrophenone (THBP), alkylgallates, propyl gallate, octyl gallate, dodecyl gallate, ethoxyquin, gallic acid, nordihydroguaiaretic acid, glycine, ascorbic acid, fatty acid esters of ascorbic acid such as ascorbyl palmitate and ascorbyl stearate, and salts of ascorbic acid such as sodium, calcium, or potassium ascorbate; erythorbic acid, L- carnitine, acetyl L-carnitine, thioglycerol, thioglycolic acid (TGA
  • the organic antioxidant may be acidic, non-acidic or any combination thereof.
  • the inorganic antioxidants employed in the compositions of the present invention include, but are not limited to, sulfites, including but not limited to potassium and sodium salts of sulphurous acid such as sodium metabisulfite, potassium sulfite, sodium sulfite, sodium thiosulfate and sodium bisulfite.
  • the stabilizing agent employed in the compositions of the present invention is at least one chelating agent.
  • Chelating agents stabilize tetrahydrobiopterin and compositions thereof and/or enhance the action of antioxidants by reacting with heavy metal ions which catalyze oxidation.
  • Chelating agents such as, but not limited to, ethylene diaminetetraacetic acid (EDTA), desferrioxamine B, deferoxamine, dithiocarb sodium, penicillamine, pentetate calcium, a sodium salt of pentetic acid, succimer, trientine, nitrilotriacetic acid, trans- diaminocyclohexanetetraacetic acid (DCTA), diethylenetriaminepentaacetic acid, dihydroethylglycine, bis(aminoethyl)glycolether-N,N,N',N'-tetraacetic acid, iminodiacetic acid, poly(aspartic acid), citric acid, tartaric acid, fumaric acid, succinic acid, glycolic acid, lactic acid, oxalic acid, malic acid, lecithin or any salt thereof, and the like or a combination thereof may be employed.
  • EDTA ethylene diaminetetraacetic acid
  • the stabilizing agent employed in the compositions of the present invention is at least one disaccharide or higher polyol.
  • “Disaccharide or higher polyol” employed in the compositions of the present invention refers to hydrogenated disaccharide, oligosaccharide or polysaccharide or any derivatives thereof.
  • One or more disaccharide polyols that may be employed in the compositions of the present invention include, but are not limited to, isomalt, hydrogenated maltulose, lactitol, maltitol, isomaltitol, or derivatives thereof.
  • One or more higher oligosaccharide or polysaccharide polyols that may be employed in the compositions of the present invention include, but are not limited to, maltotriitol, maltotetraitol or other hydrogenated oligo- and polysaccharides obtained by hydrolysis of starch followed by a hydrogenation, cellobiitol, cellotriitol, xylobiitol, xylotriitol, inulotriitol or other hydrogenated oligo- and polysaccharides obtained by hydrolysis of cellulose, xylans or fructans such as for example inulin followed by hydrogenation; and the like or combinations thereof.
  • the stabilizing agent employed in the compositions of the present invention is at least one cyclodextrin.
  • Cyclodextrins are cyclic oligosaccharides formed from a-(1 , 4)-linked D-glucopyranose units ⁇ , ⁇ and ⁇ -cyclodextrins consist of six, seven and eight units respectively.
  • Suitable cyclodextrins for use in the compositions of the present invention include, but are not limited to, ⁇ , ⁇ and ⁇ -cyclodextrins, or alkylated, hydroxyalkylated, esterified, glycosylated or substituted derivatives thereof, such as (2,6- di-o-methyl)- -cyclodextrin (DIMEB), randomly methylated- -cyclodextrin (RAMEB), and hydroxypropyl- -cyclodextrin ( ⁇ ), hydroxyethyl- -cyclodextrin, dihydroxypropyl- ⁇ - cyclodextrin, methyl- -cyclodextrin, sulfobutyl ether cyclodextrin (SBE-CD), glucosyl-a- cyclodextrin, glucosyl- -cyclodextrin, diglucosyl- -cyclodextrin, maltosyl-Y-cycl
  • the stabilizing agent employed in the compositions of the present invention is at least one moisture retaining agent.
  • Moisture retaining agents may be employed in the compositions of the present invention, to preferentially absorb moisture and protect the active agent there from.
  • Such agents include, but are not limited to, ethylene glycol, propylene glycol, butylene glycol and glycerol and an aliphatic acid ester thereof; lactic acid and salts thereof such as, but not limited to sodium lactate, calcium lactate, magnesium lactate; colloidal silicon dioxide and the like or any combinations thereof.
  • the chelating agents, disaccharides or higher polyols, cyclodextrins, moisture retaining agents improve the action of antioxidants or preserve their action thereby increasing the stability of tetrahydrobiopterin and compositions thereof.
  • the stabilizing agent employed in the compositions of the present invention is at least one hydrophobic agent.
  • Hydrophobic agents may be employed in the compositions of the present invention, for providing protection against moisture. Such agents include, but are not limited to, the ones listed under lipids above.
  • the stabilizing agent is present in the compositions of the present invention in an amount from about 0.001 % to about 80% by weight of the composition.
  • the stabilizing agent is present in the compositions of the present invention in an amount from about 0.01 % to about 75% by weight of the composition.
  • the stabilizing agent is present in the compositions of the present invention in an amount from about 0.1 % to about 70% by weight of the composition.
  • forms such as, but not limited to, powder, granules, pellets, beads, minitablets, tablets and like comprising tetrahydrobiopterin and at least one stabilizer and at least one pharmaceutically acceptable excipient, are coated with at least one coating agent.
  • tetrahydrobiopterin is coated with a combination of at least one oxygen/moisture barrier coating agent and at least one stabilizer.
  • tetrahydrobiopterin in the form of, but not limited to, powder, granules, pellets, beads, minitablets, tablets and like are coated with at least one coating agent and at least one stabilizer.
  • compositions comprising tertrahydrobiopterin are coated with at least one coating agent and at least one stabilizer.
  • solid compositions comprising tetrahydrobiopterin are coated with at least one coating agent and at least one stabilizer.
  • forms such as, but not limited to, powder, granules, pellets, beads, minitablets, tablets and like comprising tetrahydrobiopterin and at least one stabilizer and at least one pharmaceutically acceptable excipient, are coated with at least one coating agent and at least one stabilizer.
  • the stabilized pharmaceutical compositions of the present invention may further comprise at least one pharmaceutically acceptable excipient.
  • pharmaceutically acceptable excipient is meant a material which is not biologically or otherwise undesirable, i.e., the material can be administered to an individual along with the active in a formulation without causing any undesirable biological effects or interacting in a deleterious manner with any of the components of the formulation in which it is contained.
  • Pharmaceutically acceptable excipients ease the manufacturing process as well as improve the performance of the dosage form.
  • the pharmaceutically acceptable excipients that may be present in the stabilized pharmaceutical compositions of the present invention include, but are not limited to, diluents, binders, disintegrants, lubricants, colorants, flavors, pH adjusters, buffers, viscolizers, antiadherents, glidants, acidulants, artificial and natural sweeteners, and the like.
  • Diluents that may optionally be incorporated in the compositions of the present invention include, but are not limited to, talc, mannitol, xylitol, sucrose, sorbitol, microcrystalline cellulose, silicified microcrystalline cellulose dibasic calcium phosphate, starch, maize starch, pregelatinized starch, partially pregelatinized starch and the like, and combinations thereof.
  • Binders employed in the compositions of the present invention include, but are not limited to, microcrystalline cellulose, calcium hydrogen phosphate, polyethylene glycol, polyvinylpyrrolidone, maize starch, pregelatinized starch, partially pregelatinized starch, hydroxypropyl methylcellulose, hydroxypropyl cellulose and the like, or combinations thereof.
  • Disintegrants employed in the compositions of the present invention include, but are not limited to, sodium starch glycolate, sodium carboxymethyl cellulose, croscarmellose sodium, crospovidone, polyvinylpyrrolidone, methyl cellulose, starch, pregelatinized starch, partially pregelatinized starch and the like or combinations thereof.
  • Lubricants that may be employed in the compositions of the present invention include, but are not limited to, magnesium stearate, calcium stearate, zinc stearate, sodium stearyl fumarate and the like, or combinations thereof.
  • Suitable glidants include but are not limited to, colloidal silica, silica gel, precipitated silica, and the like or combinations thereof.
  • Suitable anti-adherents employed include, but are not limited to, talc, magnesium stearate or finely divided silica, and the like or combinations thereof.
  • Suitable pH adjuster or buffer employed include, but are not limited to, sodium citrate, citric acid and the like or combinations thereof.
  • Suitable acidulants employed include, but are not limited to, citric acid, malic acid, tartaric acid, fumaric acid, succinic acid, glycolic acid, oxalic acid, mandelic acid, phosphoric acid, aspartic acid, glutamic acid and salts thereof and the like or combinations thereof.
  • Further anti-caking agents that may be optionally incorporated include, but are not limited to, colloidal silicon dioxide, tribasic calcium phosphate, powdered cellulose, magnesium trisilicate, starch, and mixtures thereof.
  • Suitable viscolizers include, but are not limited to, coprocessed microcrystalline cellulose such as but not limited to, microcrystalline cellulose and sodiumcarboxymethylcellulose sodium (Avicel RC591 , Avicel CL-61 1 ); D-sorbitol solution, polyalkylene oxides such as, but not limited to polyethylene oxide; cellulose ethers such as, but not limited to hydroxyethyl cellulose, hydroxypropylcellulose, hydroxypropyl methyl cellulose, methyl cellulose, ethyl cellulose, sodium carboxy methylcellulose, calcium carboxymethyl cellulose, microcrystalline cellulose; gums such as but not limited to gum arabic alginates, agar, sodium alginate guar gum, locust bean, carrageenan, tara, gum arabic, tragacanth, pectin, xanthan, gellan, maltodextrin, galactomannan, pusstulan, laminarin, scleroglucan, gum arabic, inulin
  • Suitable sweetening agent includes, but is not limited to, aspartame, stevia extract, glycyrrhiza, saccharine, saccharine sodium, acesulfame, sucralose, dipotassium glycyrrhizinate, sucrose, sugar, maltose, partially hydrolyzed starch, corn syrup solids, sorbitol, xylitol, mannitol and the like or mixtures thereof.
  • compositions may comprise one or more natural and/or artificial flavors such as, but not limited to, mint flavour, orange flavour, lemon flavors, strawberry aroma, vanilla flavour, raspberry aroma, cherry flavor, tutty frutty flavor, magnasweet 135, key lime flavor, grape flavor, trusil art 51 1 815, and fruit extracts and the like.
  • preservatives for use in a composition described herein include, but are not limited to, methyl or propylparabens, sorbic acid, chlorobutanol, phenol, thimerosal, sodium benzoate and the like or any combinations thereof.
  • Suitable colorants include, but are not limited to, pigments and dyes such as FD&C Red, riboflavin, carmine, FD&C Yellow, FD&C Green, and FD&C Blue and the like or combinations thereof.
  • compositions or “formulation” or “dosage form” has been employed interchangeably for the purpose of the present invention and mean that it is a pharmaceutical composition which is suitable for administration to a patient.
  • the stable pharmaceutical compositions of tetrahydrobiopterin are for oral delivery.
  • the compositions for oral delivery may be in any form, such as, but not limited to, liquid, solid or semi-solid preparations and the like.
  • Liquid preparations for oral administration may be in any form including, but not limited to, suspensions, syrups or the like.
  • Solid preparations for oral administration may be in any form including, but not limited to, soluble tablets, dispersible tablets, dry suspension for reconstitution, powder or granule for solution or suspension, granules, wafers, bite-dispersion tablets capsules, tablets, caplets, orally disintegrating tablets, and the like or any combinations thereof.
  • the stabilized pharmaceutical composition of tetrahydrobiopterin of the present invention is a soluble tablet.
  • soluble tablets are uncoated or film-coated tablets intended to be dissolved in water before administration and are required to disintegrate within 3 minutes in water at ⁇ ⁇ ⁇ .
  • compositions of the present invention are in the form of immediate release dosage form.
  • compositions of the present invention is a matrix type formulation. In another embodiment the compositions of the present invention is a multiparticulate type formulation. Tablets of the present invention may vary in shape including, but not limited to, oval, triangle, almond, peanut, parallelogram, pentagonal. It is contemplated within the scope of the invention that the dosage form can be encapsulated or coated.
  • the stable formulations of the invention may be provided, e.g. as tablets or pills or capsules in HDPE bottles provided with a desiccant capsule or pouch; or in foil-on-foil blister packaging, or in blister packaging.
  • the present invention also provides a process for the preparation of stable pharmaceutical composition comprising tetrahydrobiopterin.
  • a process comprises combining tetrahydrobiopterin with optionally at least one stabilizing agent and at least one pharmaceutically acceptable excipient to form a solid dosage form and coating the same with at least one oxygen/moisture barrier coating agent.
  • tablets may be manufactured using conventional techniques known in the art such as direct compression, dry granulation and wet granulation extrusion/ melt granulation and the like.
  • the stable solid compositions of the present invention can be prepared by dry blending the active and at least one stabilizing agent along with other pharmaceutically acceptable excipients followed by compression into tablets and coating of tablets with at least one coating agent.
  • granules of tetrahydrobiopterin may be prepared by any granulation method known to a person skilled in the art, including but not limited to, dry granulation, roll compaction, wet granulation, melt granulation and the like; without compromising on the stability of tetrahydrobiopterins and employed for preparation of pharmaceutical compositions.
  • granules of tetrahydrobiopterin, optionally at least one stabilizing agent and at least one pharmaceutically acceptable excipient may be prepared, coated with at least one coating agent, followed by blending of the coated granules with extragranular excipients and compression into stable tablets.
  • granules of tetrahydrobiopterin, optionally at least one stabilizing agent and at least one pharmaceutically acceptable excipient may be prepared, coated with at least one coating agent, followed by blending of the coated granules with extragranular excipients, compression into tablets and coating the compressed tablets with at least one coating agent.
  • the process of preparing stable compositions comprising tetrahydrobiopterin comprises the steps of:
  • step (b) lubricating and compressing the blend of step (a) to form tablets
  • step (c) coating the tablets of step (b) with at least one coating agent.
  • the process of preparing stable compositions comprising tetrahydrobiopterin comprises the steps of:
  • step (b) blending the drug granules of step (a) optionally with at least one stabilizer, and at least one pharmaceutically acceptable excipient to form a blend;
  • step (c) lubricating and compressing the blend of step (b) to form tablets
  • step (d) coating the tablets of step (c) with at least one coating agent.
  • the process of preparing stable compositions comprising tetrahydrobiopterin comprises the steps of: (a) granulating the active and at least one pharmaceutically acceptable excipient with binder solution to form drug granules;
  • step (b) coating the granules of step (a) with at least one coating agent
  • step (c) blending the coated drug granules of step (b) optionally with at least one stabilizer, and at least one pharmaceutically acceptable excipient to form a blend;
  • step (d) lubricating and compressing the blend of step (c) to form tablets
  • step (e) coating the tablets of step (d) with at least one coating agent.
  • compositions comprising tetrahydrobiopterin comprises the steps of:
  • step (b) coating the granules of step (a) with at least one coating agent
  • step (c) blending the drug granules of step (b) with at least one pharmaceutically acceptable excipient to form a blend;
  • step (d) lubricating and compressing the blend of step (c) to form tablets.
  • compositions comprising tetrahydrobiopterin comprises the steps of:
  • step (b) coating the granules of step (a) with at least one coating agent
  • step (c) blending the drug granules of step (b) with at least one pharmaceutically acceptable excipient to form a blend;
  • step (d) lubricating and compressing the blend of step (c) to form tablets
  • step (e) coating the tablets of step (d) with at least one coating agent.
  • the use of stable pharmaceutical compositions of tetrahydrobiopterin for the manufacture of a medicament for the treatment of hyperphenylalaninemia.
  • the present invention provides a method of treating hyperphenyalaninemia, comprising administering to the subject in need thereof stable pharmaceutical compositions of tetrahydrobiopterin of the present invention.
  • the tetrahydrobiopterins may be combined with other active agents or pharmaceutically acceptable salts thereof including, but not limited to, roflumilast; roflumilast-N-oxide.
  • compositions comprising tetrahydrobiopterins or derivatives, precursors or analogs thereof may be co-administered with organic nitrates such as glyceryl trinitrate; isosorbide dinitrate; isosorbide-5-mononitrate; atorvastatin; and amlodipine.
  • organic nitrates such as glyceryl trinitrate; isosorbide dinitrate; isosorbide-5-mononitrate; atorvastatin; and amlodipine.
  • the stable pharmaceutical compositions of the present invention may further comprise folates, including folate precursors, folic acids, or folate derivatives; and/or arginine; and/or vitamins, such as vitamin C and/or vitamin B2 (riboflavin) and/or vitamin B12; and/or neurotransmitter precursors such as L-dopa or carbidopa.
  • Example 1 Film coated soluble tablet of sapropterin dihydrochloride
  • Table 1 Composition of sapropterin dihydrochloride tablet
  • Total 400 Procedure The active ingredient was dry mixed with all the excipients other than lubricant to form a blend. The blend was then lubricated and compressed to form tablets of sapropterin dihydrochloride.
  • Example 2 Film coated soluble tablet of sapropterin dihydrochloride
  • the coating system was prepared as per the composition described above and the tablets were coated to a weight gain of 4% to obtain film coated soluble tablets of sapropterin dihydrochloride.
  • Example 3 Film coated soluble tablet of sapropterin dihydrochloride
  • Example 4 Film coated soluble tablet of sapropterin dihydrochloride
  • Example 5 Soluble tablets of sapropterin dihydrochloride
  • Granules of sapropterin dihydrochloride were prepared as per the composition of table 9 beneath
  • the resultant coated granules were then blended with remaining excipients except the lubricant, then lubricated and compressed into soluble tablets of sapropterin dihydrochloride.
  • the soluble tablets had a disintegration time of less than 3 minutes in water at ⁇ ⁇ ⁇ .

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Abstract

Cette invention concerne des compositions pharmaceutiques stabilisées de tétrahydrobioptérine et des procédés pour les préparer. En particulier, cette invention concerne des compositions pharmaceutiques stables comprenant une tétrahydrobioptérine et au moins un agent d'enrobage.
PCT/IB2012/051355 2011-03-24 2012-03-22 Compositions stabilisées de tétrahydrobioptérine WO2012127431A1 (fr)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103845302A (zh) * 2014-03-24 2014-06-11 江苏圣宝罗药业有限公司 一种性能优异的托法替尼的片剂
WO2021061065A1 (fr) * 2019-09-23 2021-04-01 Sanovel Ilac Sanayi Ve Ticaret Anonim Sirketi Formulations pharmaceutiques orales solides comprenant du dichlorhydrate de saproptérine et au moins un excipient pharmaceutique
WO2021061066A1 (fr) * 2019-09-23 2021-04-01 Sanovel Ilac Sanayi Ve Ticaret Anonim Sirketi Formulations effervescentes de dichlorhydrate de saproptérine

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7566462B2 (en) * 2004-11-17 2009-07-28 Biomarin Pharmaceutical Inc. Stable tablet formulation

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7566462B2 (en) * 2004-11-17 2009-07-28 Biomarin Pharmaceutical Inc. Stable tablet formulation

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103845302A (zh) * 2014-03-24 2014-06-11 江苏圣宝罗药业有限公司 一种性能优异的托法替尼的片剂
WO2021061065A1 (fr) * 2019-09-23 2021-04-01 Sanovel Ilac Sanayi Ve Ticaret Anonim Sirketi Formulations pharmaceutiques orales solides comprenant du dichlorhydrate de saproptérine et au moins un excipient pharmaceutique
WO2021061066A1 (fr) * 2019-09-23 2021-04-01 Sanovel Ilac Sanayi Ve Ticaret Anonim Sirketi Formulations effervescentes de dichlorhydrate de saproptérine

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