WO2013103357A1 - Formulation à libération prolongée pour réduire la fréquence de miction et son procédé d'utilisation - Google Patents

Formulation à libération prolongée pour réduire la fréquence de miction et son procédé d'utilisation Download PDF

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WO2013103357A1
WO2013103357A1 PCT/US2012/020650 US2012020650W WO2013103357A1 WO 2013103357 A1 WO2013103357 A1 WO 2013103357A1 US 2012020650 W US2012020650 W US 2012020650W WO 2013103357 A1 WO2013103357 A1 WO 2013103357A1
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release
pharmaceutical composition
analgesic
extended
agents
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PCT/US2012/020650
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English (en)
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David A. Dill
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Wellesley Pharmaceutical
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Priority claimed from US13/343,332 external-priority patent/US20120135050A1/en
Priority claimed from EP12150403.9A external-priority patent/EP2612660B1/fr
Application filed by Wellesley Pharmaceutical filed Critical Wellesley Pharmaceutical
Publication of WO2013103357A1 publication Critical patent/WO2013103357A1/fr

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    • 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
    • A61K31/60—Salicylic acid; Derivatives thereof
    • A61K31/612—Salicylic acid; Derivatives thereof having the hydroxy group in position 2 esterified, e.g. salicylsulfuric acid
    • A61K31/616—Salicylic acid; Derivatives thereof having the hydroxy group in position 2 esterified, e.g. salicylsulfuric acid by carboxylic acids, e.g. acetylsalicylic acid
    • 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
    • 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
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/192—Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
    • 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
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/216—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acids having aromatic rings, e.g. benactizyne, clofibrate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/4025—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil not condensed and containing further heterocyclic rings, e.g. cromakalim
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404—Indoles, e.g. pindolol
    • A61K31/405—Indole-alkanecarboxylic acids; Derivatives thereof, e.g. tryptophan, indomethacin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/46—8-Azabicyclo [3.2.1] octane; Derivatives thereof, e.g. atropine, cocaine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/472—Non-condensed isoquinolines, e.g. papaverine
    • A61K31/4725—Non-condensed isoquinolines, e.g. papaverine containing further heterocyclic rings
    • 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
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers

Definitions

  • the present application generally relates to methods and compositions for inhibiting the contraction of muscles and, in particular, to methods and compositions for inhibiting the contraction of smooth muscles of the urinary bladder.
  • the detrusor muscle is a layer of the urinary bladder wall made of smooth muscle fibers arranged in spiral, longitudinal, and circular bundles. When the bladder is stretched, this signals the parasympathetic nervous system to contract the detrusor muscle. This encourages the bladder to expel urine through the urethra.
  • the human adult urinary bladder usually holds about 300-350 ml of urine (the working volume), but a full adult bladder may hold up to about 1000 ml (the absolute volume), varying between individuals.
  • the ridges produced by folding of the wall of the bladder rugae
  • the wall of the bladder thins as it stretches, allowing the bladder to store larger amounts of urine without a significant rise in internal pressure.
  • the desire to urinate usually starts when the volume of urine in the bladder reaches around 125% of its working volume. At this stage it is easy for the subject, if desired, to resist the urge to urinate. As the bladder continues to fill, the desire to urinate becomes stronger and harder to ignore. Eventually, the bladder will fill to the point where the urge to urinate becomes overwhelming, and the subject will no longer be able to ignore it. In some individuals, this desire to urinate starts when the bladder is less than 100% full in relation to its working volume. Such increased desire to urinate may interfere with normal activities, including the ability to sleep for sufficient uninterrupted periods of rest. In some cases, this increased desire to urinate may be associated with medical conditions such as benign prostate hyperplasia or prostate cancer in men, or pregnancy in women. However, increased desire to urinate also occurs in individuals, both male and female, who are not affected by another medical condition.
  • compositions and methods for the treatment of male and female subjects who suffer from a desire to urinate when the bladder is less than 100% full of urine in relation to its working volume are needed for the inhibition of muscle contraction in order to allow in said subjects the desire to urinate to start when the volume of urine in the bladder exceeds around 100% of its working volume.
  • One aspect of the present application relates to a method for reducing the frequency of urination.
  • the method comprises administering to a subject in need thereof an effective amount of a pharmaceutical composition comprising a first analgesic agent selected from the group consisting of aspirin, ibuprofen, naproxen sodium, indomethacin,
  • nabumetone and acetaminophen, wherein the pharmaceutical composition is formulated in an extended-release formulation.
  • Another aspect of the present application relates to a method for reducing the frequency of urination.
  • the method comprises administering to a person in need thereof a first pharmaceutical composition comprising a diuretic; and administering to the person a second pharmaceutical composition comprising one or more analgesic agents, wherein the first pharmaceutical composition is dosed and formulated to have a diuretic effect within 6 hours of administration and is administered at least 8 hours prior to bedtime, and wherein the second pharmaceutical composition is formulated for extended-release and is administered within 2 hours prior to bedtime.
  • Another aspect of the present application relates to a method for treating nocturia.
  • the method comprises administering to a person in need thereof a pharmaceutical composition comprising one or more analgesic agents and one or more antidiuretic agent, wherein the pharmaceutical composition is formulated for extended-release.
  • Another aspect of the present application relates to a pharmaceutical composition
  • a pharmaceutical composition comprising two or more analgesic agents selected from the group consisting of aspirin, ibuprofen, naproxen sodium, indomethacin, nabumetone, and acetaminophen; and a pharmaceutically acceptable carrier, wherein the two or more analgesic agents are formulated for extended-release.
  • compositions comprising: a first component formulated for immediate-release, a second component formulated for extended-release and a pharmaceutically acceptable carrier, wherein each of the first and second component comprises one or more analgesic agents selected from the group consisting of aspirin, ibuprofen, naproxen sodium, indomethacin, nabumetone, and acetaminophen.
  • analgesic agents selected from the group consisting of aspirin, ibuprofen, naproxen sodium, indomethacin, nabumetone, and acetaminophen.
  • Figure 1 A and IB are diagrams showing that NSAID regulate expression of co-stimulatory molecules by Raw 264 macrophage cells in the absence ( Figure 1 A) or presence ( Figure IB) of LPS.
  • Cells were cultures for 24 hrs in the presence of NSAID alone or in together with salmonella typhymurium LPS (0.05 ⁇ ).
  • Results are mean relative % of CD40+CD80+ cells.
  • the term "effective amount” means an amount necessary to achieve a selected result.
  • analgesic refers to agents, compounds or drugs used to relieve pain and inclusive of anti-inflammatory compounds.
  • exemplary analgesic and/or anti-inflammatory agents, compounds or drugs include, but are not limited to, the following substances: salicylates, aspirin, salicylic acid, methyl salicylate, diflunisal, salsalate, olsalazine, sulfasalazine, para-aminophenol derivatives, acetanilide, acetaminophen, phenacetin, fenamates, mefenamic acid, meclofenamate, sodium meclofenamate, heteroaryl acetic acid derivatives, tolmetin, ketorolac, diclofenac, propionic acid derivatives, ibuprofen, naproxen sodium, daproxen, fenoprofen, ketoprofen, flurbiprofen, oxaprozin; enolic acids
  • coxib and "COX inhibitor” refer to a composition of compounds that is capable of inhibiting the activity or expression of COX2 enzymes or is capable of inhibiting or reducing the severity, including pain and swelling, of a severe inflammatory response.
  • the urinary bladder has two important functions: storage of urine and emptying. Storage of urine occurs at low pressure, which implies that the detrusor muscle relaxes during the filling phase. Emptying of the bladder requires a coordinated contraction of the detrusor muscle and relaxation of the sphincter muscles of the urethra. Disturbances of the storage function may result in lower urinary tract symptoms, such as urgency, frequency, and urge incontinence, the components of the overactive bladder syndrome.
  • the overactive bladder syndrome which may be due to involuntary contractions of the smooth muscle of the bladder (detrusor) during the storage phase, is a common and underreported problem, the prevalence of which has only recently been assessed.
  • One aspect of the present application relates to a method for reducing the frequency of urination by administering to a person in need thereof a pharmaceutical composition formulated in an extended-release formulation.
  • the pharmaceutical composition comprises one or more analgesic agents and, optionally, one or more antimuscarinic agents.
  • Extended-release also known as sustained-release (SR), sustained-action (SA), time-release (TR), controlled-release (CR), modified release (MR), or continuous- release (CR)
  • SR sustained-release
  • SA sustained-action
  • TR time-release
  • CR controlled-release
  • MR modified release
  • CR continuous- release
  • extended-release tablets or capsules are that they can often be taken less frequently than immediate-release formulations of the same drug, and that they keep steadier levels of the drug in the bloodstream, thus extending the duration of the drug action.
  • an extended-release analgesic may allow a person to sleep through the night without getting up for the bathroom.
  • the pharmaceutical composition is formulated for extended-release by embedding the active ingredient in a matrix of insoluble substance(s) such as acrylics or chitin.
  • a extended-release form is designed to release the analgesic compound at a predetermined rate by maintaining a constant drug level for a specific period of time. This can be achieved through a variety of formulations, including, but not limited to liposomes and drug-polymer conjugates, such as hydrogels.
  • An extended-release formulation can be designed to release the active agents at a predetermined rate so as to maintain a constant drug level for a specified, extended period of time, such as up to about 10 hours, about 9 hours, about 8 hours, about 7 hours, about 6 hours, about 5 hours, about 4 hours, about 3 hours, about 2 hours, or about 1 hour following administration or following a lag period associated with delayed release of the drug.
  • the active agents are released over a time interval of between about 2 to about 10 hours.
  • the active agents may be released over about 3, about 4, about 5, about 6, about 7, about 8, about 9, or about 10 hours.
  • the active agents are released over a time period between about three to about eight hours following administration.
  • the extended-release formulation comprises an active core comprised of one or more inert particles, each in the form of a bead, pellet, pill, granular particle, microcapsule, microsphere, microgranule, nanocapsule, or nanosphere coated on its surfaces with drugs in the form of e.g., a drug-containing coating or film- forming
  • the inert particle can be of various sizes, so long as it is large enough to remain poorly dissolved.
  • the active core may be prepared by granulating and milling and/or by extrusion and spheronization of a polymer composition containing the drug substance.
  • the active agents may be introduced to the inert carrier by techniques known to one skilled in the art, such as drug layering, powder coating, extrusion/spheronization, roller compaction or granulation.
  • the amount of drug in the core will depend on the dose that is required, and typically varies from about 5 to 90 weight %.
  • the polymeric coating on the active core will be from about 1 to 50% based on the weight of the coated particle, depending on the lag time required and/or the polymers and coating solvents chosen. Those skilled in the art will be able to select an appropriate amount of drug for coating onto or incorporating into the core to achieve the desired dosage.
  • the inactive core may be a sugar sphere or a buffer crystal or an encapsulated buffer crystal such as calcium carbonate, sodium bicarbonate, fumaric acid, tartaric acid, etc. which alters the microenvironment of the drug to facilitate its release.
  • Extended-release formulations may utilize a variety of extended-release coatings or mechanisms facilitating the gradual release of active agents over time.
  • the extended-release agent comprises a polymer controlling release by dissolution controlled release.
  • the active agent(s) are
  • the polymeric material may comprise a lipid barrier comprising a waxy material, such as carnauba wax, beeswax, spermaceti wax, candellila wax, shallac wax, cocoa butter, cetosteryl alcohol, partially hydrogenated vegetable oils, ceresin, paraffin wax, ceresine, myristyl alcohol, stearyl alcohol, cetyl alcohol and stearic acid, along with surfactants, such as polyoxyethylene sorbitan monooleate.
  • a waxy material such as carnauba wax, beeswax, spermaceti wax, candellila wax
  • cocoa butter cetosteryl alcohol
  • surfactants such as polyoxyethylene sorbitan monooleate.
  • the polymer coating When contacted with an aqueous medium, such as biological fluids, the polymer coating emulsifies or erodes after a predetermined lag-time depending on the thickness of the polymer coating.
  • the lag time is independent of gastrointestinal motility, pH, or gastric residence.
  • the extended-release agent comprises a polymeric matrix effecting diffusion controlled release.
  • the matrix may comprise one or more hydrophilic and/or water-swellable, matrix forming polymers, pH-dependent polymers, and/or pH-independent polymers.
  • the extended-release formulation comprises a water soluble or water-swellable matrix-forming polymer, optionally containing one or more solubility-enhancing excipients and/or release-promoting agents.
  • the active agent(s) dissolve (if soluble) and gradually diffuse through the hydrated portion of the matrix.
  • the gel layer grows with time as more water permeates into the core of the matrix, increasing the thickness of the gel layer and providing a diffusion barrier to drug release.
  • the polymer chains become completely relaxed and can no longer maintain the integrity of the gel layer, leading to disentanglement and erosion of the outer hydrated polymer on the surface of the matrix.
  • water-swellable polymers typically hydrate and swell in biological fluids forming a homogenous matrix structure that maintains its shape during drug release and serves as a earner for the drug, solubility enhancers and/or release promoters.
  • the initial matrix polymer hydration phase results in slow-release of the drug (lag phase). Once the water swellable polymer is fully hydrated and swollen, water within the matrix can similarly dissolve the drug substance and allow for its diffusion out through the matrix coating.
  • the porosity of the matrix can be increased due to the leaching out of pH-dependent release promoters so as to release the drug at a faster rate.
  • the rate of the drug release then becomes constant and is a function of drug diffusion through the hydrated polymer gel.
  • the release rate from the matrix is dependent upon various factors, including polymer type and level; drug solubility and dose; polymer: drug ratio; filler type and level; polymer to filler ratio; particle size of drug and polymer; and porosity and shape of the matrix.
  • Exemplary hydrophilic and/or water-swellable, matrix forming polymers include, but are not limited to, cellulosic polymers, including hydroxyalkyl celluloses and carboxyalkyl celluloses, such as hydroxypropylmethylcellulose (HPMC),
  • cellulosic polymers including hydroxyalkyl celluloses and carboxyalkyl celluloses, such as hydroxypropylmethylcellulose (HPMC)
  • hydroxypropylcellulose HPC
  • HEC hydroxyethylcellulose
  • MC methylcellulose
  • CMC carboxymethylcellulose
  • powdered cellulose such as microcrystalline cellulose, cellulose acetate, ethylcellulose, salts thereof, and combinations thereof
  • alginates, gums including heteropolysaccharide gums and homopolysaccharide gums, such as xanthan, tragacanth, pectin, acacia, karaya, alginates, agar, guar, hydroxypropyl guar, veegum, carrageenan, locust bean gum, gellan gum, and derivatives thereofrom
  • acrylic resins including polymers and copolymers of acrylic acid, methacrylic acid, methyl acrylate and methyl methacrylate and cross-linked polyacrylic acid derivatives such as Carbomers (e.g.
  • CARBOPOL® such as including CARBOPOL® 71 G NF, available in various molecular weight grades from Noveon, Inc., Cincinnati, OH
  • carageenan polyvinyl acetate (e.g., KOLLIDON® SR); polyvinyl pyrrolidone and its derivatives such as crospovidone;
  • polyethylene oxides polyethylene oxides; and polyvinyl alcohol.
  • Preferred hydrophilic and water-swellable polymers include the cellulosic polymers, especially HPMC.
  • the extended-release formulation may further comprise at least one binder that is capable of cross-linking the hydrophilic compound to form a hydrophilic polymer matrix (i.e. , a gel matrix) in an aqueous medium, including biological fluids.
  • binders include homopolysaccharides, such as galactomannan gums, guar gum, hydroxypropyl guar gum, hydroxypropylcellulose (HPC; e.g., Klucel EXF) and locust bean gum.
  • the binder is an alginic acid derivative, HPC or microcrystallized cellulose (MCC).
  • Other binders include, but are not limited to, starches, microcrystalline cellulose, hydroxypropyl cellulose, hydroxyethyl cellulose,
  • the introduction method is drug layering by spraying a suspension of active agent(s) and a binder onto the inert carrier.
  • the binder may be present in the bead formulation in an amount of from about 0.1% to about 15% by weight, and preferably of from about 0.2% to about 10% by weight.
  • the hydrophilic polymer matrix may further include an ionic polymer, a non-ionic polymer, or water-insoluble hydrophobic polymer to provide a stronger gel layer and/or reduce pore quantity and dimensions in the matrix so as to slow diffusion and erosion rates and concomitant release of the active agent(s). This may additionally suppress the initial burst effect and produce a more steady, "zero order release" of active agent(s).
  • Exemplary ionic polymers for slowing dissolution rate include both anionic and cationic polymers.
  • Exemplary anionic polymers include, for example, sodium
  • carboxymethylcellulose Na CMC
  • sodium alginate polymers of acrylic acid or carbomers ⁇ e.g., CARBOPOL ® 934, 940, 974P NF
  • enteric polymers such as polyvinyl acetate phthalate (PVAP), methacrylic acid copolymers ⁇ e.g., EUDRAGIT ® LI 00, L 30D 55, A, and FS 30D), hypromellose acetate succinate (AQUAT HPMCAS); and xanthan gum.
  • Exemplary cationic polymers include, for example, dimethylaminoethyl methacrylate copolymer ⁇ e.g., EUDRAGIT ® E 100). Incorporation of anionic polymers, particularly enteric polymers, is useful for developing a pH-independent release profile for weakly basic drugs as compared to hydrophilic polymer alone.
  • non-ionic polymers for slowing dissolution rate include, for example, hydroxypropylcellulose (HPC) and polyethylene oxide (PEO) ⁇ e.g., POLYOXTM)
  • Exemplary hydrophobic polymers include ethylcellulose ⁇ e.g. , ETHOCELTM, SURELEASE ® ), cellulose acetate, methacrylic acid copolymers ⁇ e.g., EUDRAGIT ® NE 30D), ammonio-methacrylate copolymers ⁇ e.g., EUDRAGIT ® RL 100 or PO RSI 00), polyvinyl acetatem glyceryl monostearate, fatty acids, such as acetyl tributyl citrate, and combinations and derivatives thereof.
  • the swellable polymer can be incorporated in the formulation in proportion from 1 % to 50% by weight, preferably from 5% to 40% by weight, most preferably from 5% to 20% by weight.
  • the swellable polymers and binders may be incorporated in the formulation either prior to or after granulation.
  • the polymers can also be dispersed in organic solvents or hydro-alcohols and sprayed during granulation.
  • Exemplary release-promoting agents include pH-dependent enteric polymers that remain intact at pH value lower than about 4.0 and dissolve at pH values higher than 4.0, preferably higher than 5.0, most preferably about 6.0, are considered useful as release- promoting agents for this invention.
  • Exemplary pH-dependent polymers include, but are not limited to, methacarylic acid copolymers, methacrylic acid-methyl methacrylate copolymers (e.g., EUDRAGIT® LI 00 (Type A), EUDRAGIT® S I 00 (Type B), Rohm GmbH, Germany; methacrylic acid-ethyl acrylate copolymers (e.g., EUDRAGIT® LI 00-55 (Type C) and EUDRAGIT® L30D-55 copolymer dispersion, Rohm GmbH, Germany); copolymers of methacrylic acid-methyl methacrylate and methyl methacrylate (EUDRAGIT® FS);
  • cellulose acetate phthalates CAP
  • HPMCP hydroxypropyl methylcellulose phthalate
  • PVAP polyvinyl acetate phthalates
  • COATERIC®, OPADRY® enteric white OY-P-7171 polyvinylbutyrate acetate
  • CAS hydroxypropyl methylcellulose acetate succinate
  • HPMCAS hydroxypropyl methylcellulose acetate succinate
  • CMEC carboxymethyl ethylcellulose
  • CAP cellulose acetate phthalates
  • CAT cellulose acetate trimellitates
  • enteric pH-dependent polymers are the pharmaceutically acceptable methacrylic acid copolymers. These copolymers are anionic polymers based on methacrylic acid and methyl methacrylate and, preferably, have a mean molecular weight of about 135,000. A ratio of free carboxyl groups to methyl-esterified carboxyl groups in these copolymers may range, for example, from 1 : 1 to 1 :3, e.g. around 1 : 1 or 1 :2.
  • Such polymers are sold under the trade name Eudragit such as the Eudragit L series e.g., Eudragit L 12.5 ® , Eudragit L 12.5P ® , Eudragit L100 ® , Eudragit L 100-55 ® , Eudragit L- 30D ® , Eudragit L-30 D-55 ® , the Eudragit S ® series e.g., Eudragit S 12.5 ® , Eudragit S 12.5P ® , Eudragit SI 00 ® .
  • the release promoters are not limited to pH dependent polymers. Other hydrophilic molecules that dissolve rapidly and leach out of the dosage form quickly leaving a porous structure can be also be used for the same purpose.
  • the release-promoting agent can be incorporated in an amount from 10% to 90%, preferably from 20% to 80% and most preferably from 30% to 70% by weight of the dosage unit.
  • the agent can be incorporated into the formulation either prior to or after granulation.
  • the release-promoting agent can be added into the formulation either as a dry material, or it can be dispersed or dissolved in an appropriate solvent, and dispersed during granulation.
  • the matrix may include a combination of release promoters and solubility enhancers.
  • the solubility enhancers can be ionic and non-ionic surfactants, complexing agents, hydrophilic polymers, pH modifiers, such as acidifying agents and alkalinizing agents, as well as molecules that increase the solubility of poorly soluble drug through molecular entrapment. Several solubility enhancers can be utilized simultaneously.
  • Solubility enhancers may include surface active agents, such as sodium docusate, sodium lauryl sulfate, sodium stearyl fumarate, Tweens ® and Spans (PEO modified sorbitan monoesters and fatty acid sorbitan esters), poly(ethylene oxide)-polypropylene oxide-poly(ethylene oxide) block copolymers (aka PluronicsTM); complexing agents such as low molecular weight polyvinyl pyrrolidone and low molecular weight hydroxypropyl methyl cellulose; molecules that aid solubility by molecular entrapment such as cyclodextrins, and pH modifying agents, including acidifying agents such as citric acid, fumaric acid, tartaric acid, and hydrochloric acid; and alkalizing agents such as meglumine and sodium hydroxide.
  • surface active agents such as sodium docusate, sodium lauryl sulfate, sodium stearyl fumarate, Tweens ® and Span
  • Solubility enhancing agents typically constitute from 1% to 80% by weight, preferably from 1 % to 60%, more preferably from 1% to 50%, of the dosage form and can be incorporated in a variety of ways. They can be incorporated in the formulation prior to granulation in dry or wet form. They can also be added to the formulation after the rest of the materials are granulated or otherwise processed. During granulation, solubilizers can be sprayed as solutions with or without a binder.
  • the extended-release formulation comprises a polymeric matrix that can provide for release of the drug after a certain time, independent of the pH.
  • pH independent is defined as having characteristics (e.g., dissolution) which are substantially unaffected by pH. pH independent polymers are often referred to in the context of "time-controlled” or “time-dependent” release profiles.
  • a pH independent polymer may be used to coat the active agent and/or provide a polymer for a hydrophilic matrix in the extended-release coating thereover.
  • the pH independent polymer may be water-insoluble or water soluble.
  • Exemplary water insoluble pH independent polymers include, but are not limited to, neutral methacrylic acid esters with a small portion of trimethylammonioethyl methacrylate chloride (e.g. ,
  • EUDRAGIT® RS and EUDRAGIT® RL neutral ester dispersions without any functional groups (e.g., EUDRAGIT® NE30D and EUDRAGIT® NE30); cellulosic polymers, such as ethylcellulose, hydroxyl ethyl cellulose, cellulose acetate or mixtures and other pH independent coating products.
  • cellulosic polymers such as ethylcellulose, hydroxyl ethyl cellulose, cellulose acetate or mixtures and other pH independent coating products.
  • Exemplary water soluble pH independent polymers include hydroxyalkyl cellulose ethers, such as hydroxypropyl methylcellulose (HPMC), and hydroxypropyl cellulose (HPC); polyvinylpyrrolidone (PVP), methylcellulose,
  • the extended-release formulation comprises a water- insoluble water-permeable polymeric coating or matrix comprising one or more water- insoluble water-permeable film-forming over the active core.
  • the coating may additionally include one or more water soluble polymers and/or one or more plasticizers.
  • the water- insoluble polymer coating comprises a barrier coating for release of active agents in the core, wherein lower molecular weight (viscosity) grades exhibit faster release rates as compared to higher viscosity grades.
  • the water-insoluble film-forming polymers include one or more alkyl cellulose ethers, such as ethyl celluloses and mixtures thereof, (e.g., ethyl cellulose grades PR100, PR45, PR20, PR10 and PR7; ETHOCEL®, Dow).
  • alkyl cellulose ethers such as ethyl celluloses and mixtures thereof, (e.g., ethyl cellulose grades PR100, PR45, PR20, PR10 and PR7; ETHOCEL®, Dow).
  • An exemplary water-soluble polymer such as polyvinylpyrrolidone
  • the water-insoluble polymer provides suitable properties (e.g., extended release characteristics, mechanical properties, and coating properties) without the need for a plasticizer.
  • suitable properties e.g., extended release characteristics, mechanical properties, and coating properties
  • coatings comprising polyvinyl acetate (PVA), neutral copolymers of acrylate/methacrylate esters such as commercially available Eudragit NE30D from Evonik Industries, ethyl cellulose in combination with hydroxypropylcellulose, waxes, etc. can be applied without plasticizers.
  • the water-insoluble polymer matrix may further include a plasticizer.
  • the amount of plasticizer required depends upon the plasticizer, the properties of the water-insoluble polymer, and the ultimate desired properties of the coating. Suitable levels of plasticizer range from about 1 % to about 20%, from about 3% to about 20%, about 3% to about 5%, about 7% to about 10%, about 12% to about 15%, about 17% to about 20%, or about 1 %, about 2%, about 3%, about 4%, about 5%, about 6%, about 7%, about 8%, about 9%, about 10%, about 15%, or about 20% by weight relative to the total weight of the coating, inclusive of all ranges and sub-ranges therebetween.
  • Exemplary plasticizers include, but are not limited to, triacetin, acetylated monoglyceride, oils (castor oil, hydrogenated castor oil, rape seed oil, sesame oil, olive oil, etc.); citrate esters, triethyl citrate, acetyl tri ethyl citrate acetyltributyl citrate, tributyl citrate, acetyl tri-n-butyl citrate, diethyl phthalate, dibutyl phthalate, dioctyl phthalate, methyl paraben, propyl paraben, propyl paraben, butyl paraben, diethyl sebacate, dibutyl sebacate, glyceroltributyrate, substituted triglycerides and glycerides, monoacetylated and diacetylated glycerides (e.g., MYVACET® 9-45), glyceroltribu
  • Plasticizers can be high boiling point organic solvents used to impart flexibility to otherwise hard or brittle polymeric materials and can affect the release profile for the active agent(s). Plasticizers generally cause a reduction in the cohesive intermolecular forces along the polymer chains resulting in various changes in polymer properties including a reduction in tensile strength, and increase in elongation and a reduction in the glass transition or softening temperature of the polymer. The amount and choice of the plasticizer can affect the hardness of a tablet, for example, and can even affect its dissolution or disintegration characteristics, as well as its physical and chemical stability. Certain plasticizers can increase the elasticity and/or pliability of a coat, thereby decreasing the coat's brittleness.
  • the extended-release formulation comprises a combination of at least two gel-forming polymers, including at least one non-ionic gel- forming polymer and/or at least one anionic gel-forming polymer.
  • the gel formed by the combination of gel-forming polymers provides controlled release, such that when the formulation is ingested and comes into contact with the gastrointestinal fluids, the polymers nearest the surface hydrate to form a viscous gel layer. Because of the high viscosity, the viscous layer dissolves away only gradually, exposing the material below to the same process. The mass thus dissolves away slowly, thereby slowly releasing the active ingredient into the gastrointestinal fluids.
  • the combination of at least two gel-forming polymers enables properties of the resultant gel, such as viscosity, to be manipulated in order to provide the desired release profile.
  • the formulation comprises at least one non-ionic gel-forming polymer and at least one anionic gel-forming polymer.
  • the formulation comprises two different non-ionic gel-forming polymers.
  • the formulation comprises a combination of non-ionic gel-forming polymers of the same chemistry, but having different solubilities, viscosities, and/or molecular weights (for example a combination of hydroxyproplyl methyl cellulose of different viscosity grades, such as HPMC K100 and HPMC K15M or HPMC K100M).
  • Exemplary anionic gel forming polymers include, but are not limited to, sodium carboxymethylcellulose (Na CMC), carboxymethyl cellulose (CMC), anionic polysaccharides such as sodium alginate, alginic acid, pectin, polyglucuronic acid (poly-a- and -P"l,4-glucuronic acid), polygalacturonic acid (pectic acid), chondroitin sulfate, carrageenan, furcellaran, anionic gums such as xanthan gum, polymers of acrylic acid or carbomers (Carbopol ® 934, 940, 974P NF), Carbopol ® copolymers, a Pemulen ® polymer, polycarbophil, and others.
  • Na CMC sodium carboxymethylcellulose
  • CMC carboxymethyl cellulose
  • anionic polysaccharides such as sodium alginate, alginic acid, pectin, polyglucuronic acid (poly-a- and -P"l,4-
  • non-ionic gel-forming polymers include, but are not limited to, Povidone (PVP: polyvinyl pyrrolidone), polyvinyl alcohol, copolymer of PVP and polyvinyl acetate, HPC (hydroxypropyl cellulose), HPMC (hydroxypropyl methylcellulose), hydroxyethyl cellulose, hydroxymethyl cellulose, gelatin, polyethylene oxide, acacia, dextrin, starch, polyhydroxyethylmethacrylate (PHEMA), water soluble nonionic polymethacrylates and their copolymers, modified cellulose, modified polysaccharides, nonionic gums, nonionic polysaccharides and/or mixtures thereof.
  • PVP polyvinyl pyrrolidone
  • HPC hydroxypropyl cellulose
  • HPMC hydroxypropyl methylcellulose
  • PHEMA polyhydroxyethylmethacrylate
  • water soluble nonionic polymethacrylates and their copolymers modified cellulose, modified poly
  • the formulation may optionally comprise an enteric polymer as described above, and/or at least one excipient, such as a filler, a binder (as described above), a disintegrant, and/or a flow aid or glidant.
  • excipient such as a filler, a binder (as described above), a disintegrant, and/or a flow aid or glidant.
  • Exemplary fillers include but are not limited to, lactose, glucose, fructose, sucrose, dicalcium phosphate, sugar alcohols also known as "sugar polyol” such as sorbitol, manitol, lactitol, xylitol, isomalt, erythritol, and hydrogenated starch hydrolysates (a blend of several sugar alcohols), corn starch, potato starch, sodium carboxymethycellulose, ethylcellulose and cellulose acetate, enteric polymers, or a mixture thereof.
  • sugar alcohols also known as "sugar polyol” such as sorbitol, manitol, lactitol, xylitol, isomalt, erythritol, and hydrogenated starch hydrolysates (a blend of several sugar alcohols)
  • corn starch potato starch
  • sodium carboxymethycellulose ethylcellulose and cellulose acetate
  • enteric polymers or
  • Exemplary binders include but are not limited to, water-soluble hydrophilic polymers, such as Povidone (PVP: polyvinyl pyrrolidone), copovidone (a copolymer of polyvinyl pyrrolidone and polyvinyl acetate), low molecular weight HPC (hydroxypropyl cellulose) low molecular weight HPMC (hydroxypropyl methylcellulose), low molecular weight carboxy methyl cellulose, ethylcellulose, gelatin, polyethylene oxide, acacia, dextrin, magnesium aluminum silicate, starch, and polymethacrylates such as Eudragit NE 30D, Eudragit RL, Eudragit RS, Eudragit E, polyvinyl acetate, and enteric polymers, or mixtures thereof.
  • PVP polyvinyl pyrrolidone
  • copovidone a copolymer of polyvinyl pyrrolidone and polyvinyl acetate
  • HPC hydroxypropyl cellulose
  • Exemplary disintegrants include but are not limited to low-substituted carboxymethyl cellulose sodium, crospovidone (cross-linked polyvinyl pyrrolidone), sodium carboxymethyl starch (sodium starch glycolate), cross-linked sodium carboxymethyl cellulose (Croscarmellose), pregelatinized starch (starch 1500), microcrystalline cellulose, water insoluble starch, calcium carboxymethyl cellulose, low substituted hydroxypropyl cellulose, and magnesium or aluminum silicate.
  • Exemplary glidants include but are not limited to, magnesium, silicon dioxide, talc, starch, titanium dioxide, and the like.
  • the extended-release formulation is formed by coating a water soluble/dispersible drug-containing particle, such as a bead or bead population therein (as described above), with a coating material, and, optionally, a pore former and other excipients.
  • the coating material is preferably selected from a group comprising cellulosic polymers, such as ethylcellulose (e.g., SURELEASE ® ),
  • the release-controlling coating for a given bead population may be controlled by at least one parameter of the release controlling coating, such as the nature of the coating, coating level, type and concentration of a pore former, process parameters and combinations thereof.
  • a parameter such as a pore former concentration, or the conditions of the curing, allows for changes in the release of active agent(s) from any given bead population, thereby allowing for selective adjustment of the formulation to a pre-determined release profile.
  • Pore formers suitable for use in the release controlling coating herein can be organic or inorganic agents, and include materials that can be dissolved, extracted or leached from the coating in the environment of use.
  • Exemplary pore forming agents include, but are not limited to, organic compounds such as mono-, oligo-, and polysaccharides including sucrose, glucose, fructose, mannitol, mannose, galactose, sorbitol, pullulan, dextran;
  • polymers soluble in the environment of use such as water-soluble hydrophilic polymers, hydroxyalkylcelluloses, carboxyalkylcelluloses, hydroxypropylmethylcellulose, cellulose ethers, acrylic resins, polyvinylpyrrolidone, cross-linked polyvinylpyrrolidone, polyethylene oxide, Carbowaxes, Carbopol, and the like, diols, polyols, polyhydric alcohols, polyalkylene glycols, polyethylene glycols, polypropylene glycols, or block polymers thereof, polyglycols, poly(a-Q)alkylenediols; inorganic compounds such as alkali metal salts, lithium carbonate, sodium chloride, sodium bromide, potassium chloride, potassium sulfate, potassium phosphate, sodium acetate, sodium citrate, suitable calcium salts, combination thereof, and the like.
  • the release controlling coating can further comprise other additives known in the art, such as plasticizers, anti-adherents, glidants (or flow aids), and antifoams.
  • the coated particles or beads may additionally include an "overcoat," to provide, e.g., moisture protection, static charge reduction, taste-masking, flavoring, coloring, and/or polish or other cosmetic appeal to the beads.
  • an overcoat to provide, e.g., moisture protection, static charge reduction, taste-masking, flavoring, coloring, and/or polish or other cosmetic appeal to the beads.
  • Suitable coating materials for such an overcoat are known in the art, and include, but are not limited to, cellulosic polymers such as hydroxypropylmethylcellulose, hydroxypropylcellulose and microcrystalline cellulose, or combinations thereof (for example, various Opadry coating materials).
  • the coated particles or beads may additionally contain enhancers that may be exemplified by, but not limited to, solubility enhancers, dissolution enhancers, absorption enhancers, permeability enhancers, stabilizers, complexing agents, enzyme inhibitors, p- glycoprotein inhibitors, and multidrug resistance protein inhibitors.
  • the formulation can also contain enhancers that are separated from the coated particles, for example in a separate population of beads or as a powder.
  • the enhancer(s) may be contained in a separate layer on a coated particles either under or above the release controlling coating.
  • the extended-release formulation is formulated to release the active agent(s) by an osmotic mechanism.
  • a capsule may be formulated with a single osmotic unit or it may incorporate 2, 3, 4, 5, or 6 push-pull units encapsulated within a hard gelatin capsule, whereby each bilayer push pull unit contains an osmotic push layer and a drug layer, both surrounded by a semi-permeable membrane. One or more orifices are drilled through the membrane next to the drug layer. This membrane may be additionally covered with a pH-dependent enteric coating to prevent release until after gastric emptying. The gelatin capsule dissolves immediately after ingestion.
  • the enteric coating breaks down, which then allows fluid to flow through the semi-permeable membrane, swelling the osmotic push compartment to force to force drugs out through the orifice(s) at a rate precisely controlled by the rate of water transport through the semi-permeable membrane. Release of drugs can occur over a constant rate for up to 24 hours or more.
  • the osmotic push layer comprises one or more osmotic agents creating the driving force for transport of water through the semi-permeable membrane into the core of the delivery vehicle.
  • osmotic agents include water-swellable hydrophilic polymers, also referred to as “osmopolymers” and “hydrogels,” including, but not limited to, hydrophilic vinyl and acrylic polymers, polysaccharides such as calcium alginate, polyethylene oxide (PEO), polyethylene glycol (PEG), polypropylene glycol (PPG), poly(2- hydroxyethyl methacrylate), poly( acrylic) acid, poly(methacrylic) acid, polyvinylpyrrolidone (PVP), crosslinked PVP, polyvinyl alcohol (PVA), PVA/PVP copolymers, PVA/PVP copolymers with hydrophobic monomers such as methyl methacrylate and vinyl acetate, hydrophilic polyurethanes containing large PEO blocks, sodium cros
  • osmogens which are capable of imbiging water to affect an osmotic pressure gradient across the semi-permeable membrane.
  • exemplary osmogens include, but are not limited to, inorganic salts, such as magnesium sulfate, magnesium chloride, calcium chloride, sodium chloride, lithium chloride, potassium sulfate, potassium phosphates, sodium carbonate, sodium sulfite, lithium sulfate, potassium chloride, and sodium sulfate; sugars, such as dextrose, fructose, glucose, inositol, lactose, maltose, mannitol, raffinose, sorbitol, sucrose, trehalose, and xylitol; organic acids, such as ascorbic acid, benzoic acid, fumaric acid, citric acid, maleic acid, sebacic acid, sorbic acid, adipic acid, edetic
  • Materials useful in forming the semipermeable membrane include various grades of acrylics, vinyls, ethers, polyamides, polyesters, and cellulosic derivatives that are water-permeable and water-insoluble at physiologically relevant pHs, or are susceptible to being rendered water-insoluble by chemical alteration, such as crosslinking.
  • the extended-release formulation may comprise a polysaccharide coating that is resistant to erosion in both the stomach and intestine.
  • a polysaccharide coating that is resistant to erosion in both the stomach and intestine.
  • Such polymers can be only degraded in the colon, which contains a large microflora containing biodegradable enzymes breaking down, for example, the polysaccharide coatings to release the drug contents in a controlled, time-dependent manner.
  • Exemplary polysaccharide coatings may include, for example, amylose, arabinogalactan, chitosan, chondroitin sulfate, cyclodextrin, dextran, guar gum, pectin, xylan, and combinations or derivatives therefrom.
  • the pharmaceutical composition is formulated for delayed extended-release.
  • delayed release refers to a medication that does not immediately disintegrate and release the active ingredient(s) into the body.
  • the term “delayed extended-release” is used with reference to a drug formulation having a release profile in which there is a predetermined delay in the release of the drug following administration.
  • the delayed extended-release formulation includes an extended-release formulation coated with an enteric coating, which is a barrier applied to oral medication that prevents release of medication before it reaches the small intestine.
  • Delayed-release formulations such as enteric coatings, prevent drugs having an irritant effect on the stomach, such as aspirin, from dissolving in the stomach.
  • Such coatings are also used to protect acid-unstable drugs from the stomach's acidic exposure, delivering them instead to a basic pH environment (intestine's pH 5.5 and above) where they do not degrade, and give their desired action.
  • pulsatile release is a type of delayed release, which is used herein with reference to a drug formulation that provides rapid and transient release of the drug within a short time period immediately after a predetermined lag period, thereby producing a "pulsed" plasma profile of the drug after drug administration.
  • Formulations may be designed to provide a single pulsatile release or multiple pulsatile releases at predetermined time intervals following administration.
  • a delayed release or pulsatile release formulation generally comprises one or more elements covered with a barrier coating, which dissolves, erodes or ruptures following a specified lag phase.
  • the pharmaceutical composition of the present application is formulated for extended-release or delayed extended-release and comprises 100% of the total dosage of a given active agent administered in a single unit dose.
  • the pharmaceutical composition further includes an "immediate-release” component.
  • the "immediate-release” component provide about 5-50% of the total dosage of the active agent(s) and the "extended-release” component provides 50- 95% of the total dosage of the active agent(s) to be delivered by the pharmaceutical formulation.
  • the immediate release component may provide about 20-40%, or about 20%, 25%, 30%, 35%, about 40%, of the total dosage of the active agent(s) to be delivered by the pharmaceutical formulation.
  • the extended-release component provides about 60%, 65%, 70%, 75% or 80% of the total dosage of the active agent(s) to be delivered by the formulation.
  • the extended-release component further comprises a barrier coating to delay the release of the active agent.
  • a barrier coating for delayed release may consist of a variety of different materials, depending on the objective.
  • a formulation may comprise a plurality of barrier coatings to facilitate release in a temporal manner.
  • the coating may be a sugar coating, a film coating ⁇ e.g.
  • the formulation may additionally include a time delay material such as, for example, glyceryl monostearate or glyceryl distearate.
  • the delayed, extended-release formulation includes an enteric coating comprised one or more polymers facilitating release of active agents in proximal or distal regions of the gastrointestinal tract.
  • enteric polymer coating is a coating comprising of one or more polymers having a pH dependent or pH-independent release profile. Typically the coating resists dissolution in the acidic medium of the stomach, but dissolves or erodes in more distal regions of the gastrointestinal tract, such as the small intestine or colon.
  • An enteric polymer coating typically resists releases of the active agents until some time after a gastric emptying lag period of about 3-4 hours after administration.
  • pH dependent enteric coatings comprises one or more pH-dependent or pH-sensitive polymers that maintain their structural integrity at low pH, as in the stomach, but dissolve in higher pH environments in more distal regions of the gastrointestinal tract, such as the small intestine, where the drug contents are released.
  • pH dependent is defined as having characteristics (e.g. , dissolution) which vary according to environmental pH.
  • Exemplary pH-dependent polymers include, but are not limited to, methacarylic acid copolymers, methacrylic acid-methyl methacrylate copolymers (e.g., EUDRAGIT® LI 00 (Type A), EUDRAGIT® SI 00 (Type B), Rohm GmbH, Germany; methacrylic acid-ethyl acrylate copolymers (e.g., EUDRAGIT® LI 00-55 (Type C) and EUDRAGIT® L30D-55 copolymer dispersion, Rohm GmbH, Germany); copolymers of methacrylic acid-methyl methacrylate and methyl methacrylate (EUDRAGIT FS);
  • cellulose acetate phthalates CAP
  • HPMCP hydroxypropyl methylcellulose phthalate
  • PVAP polyvinyl acetate phthalates
  • COATERIC®, OPADRY® enteric white OY-P-7171 cellulose acetate succinates
  • CAS hydroxypropyl methylcellulose acetate succinate
  • HPMCAS hydroxypropyl methylcellulose acetate succinate
  • pH-dependent polymers typically exhibit a characteristic pH optimum for dissolution.
  • the pH-dependent polymer exhibits a pH optimum between about 5.0 and 5.5, between about 5.5 and 6.0, between about 6.0 and 6.5, or between about 6.5 and 7.0.
  • the pH-dependent polymer exhibits a pH optimum of >5.0, of >5.5, of >6.0, of >6.5, or of >7.0.
  • the coating methodology employs the blending of one or more pH-dependent and one or more pH-independent polymers.
  • the blending of pH- dependent and pH-independent polymers can reduce the release rate of active ingredients once the soluble polymer has reached its optimum pH of solubilization.
  • a "time-controlled" or “time-dependent" release profile can be obtained using a water insoluble capsule body containing one or more active agents, wherein the capsule body closed at one end with an insoluble, but permeable and swellable hydrogel plug.
  • the plug Upon contact with gastrointestinal fluid or dissolution medium, the plug swells, pushing itself out of the capsule and releasing the drugs after a pre-determined lag time, which can be controlled by e.g., the position and dimensions of the plug.
  • the capsule body may be further coated with an outer pH-dependent enteric coating keeping the capsule intact until it reaches the small intestine.
  • Suitable plug materials include, for example, polymethacrylates, erodible compressed polymers (e.g., HPMC, polyvinyl alcohol), congealed melted polymer (e.g., glyceryl mono oleate) and enzymatically controlled erodible polymers (e.g., polysaccharides, such as amylose, arabinogalactan, chitosan, chondroitin sulfate, cyclodextrin, dextran, guar gum, pectin and xylan).
  • erodible compressed polymers e.g., HPMC, polyvinyl alcohol
  • congealed melted polymer e.g., glyceryl mono oleate
  • enzymatically controlled erodible polymers e.g., polysaccharides, such as amylose, arabinogalactan, chitosan, chondroitin sulfate, cyclodextrin
  • capsules or bilayered tablets may be formulated to contain a drug- containing core, covered by a swelling layer, and an outer insoluble, but semipermeable polymer coating or membrane.
  • the lag time prior to rupture can be controlled by the permeation and mechanical properties of the polymer coating and the swelling behavior of the swelling layer.
  • the swelling layer comprises one or more swelling agents, such as swellable hydrophilic polymers that swell and retain water in their structures.
  • Exemplary water swellable materials to be used in the delayed-release coating include, but are not limited to, polyethylene oxide (having e.g., an average molecular weight between 1 ,000,000 to 7,000,000, such as POLYOX®), methylcellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose; polyalkylene oxides having a weight average molecular weight of 100,000 to 6,000,000, including but not limited to poly(methylene oxide), poly(butylene oxide); poly(hydroxy alkyl methacrylate) having a molecular weight of from 25,000 to 5,000,000; poly(vinyl)alcohol, having a low acetal residue, which is cross- linked with glyoxal, formaldehyde or glutaraldehyde and having a degree of polymerization of from 200 to 30,000; mixtures of methyl cellulose, cross-linked agar and carboxymethyl cellulose; hydrogel forming copolymers produced by forming a dispersion of a finely divided copolymer
  • the release time of the drugs can be controlled by a
  • disintegration lag time depending on the balance between the tolerability and thickness of a water insoluble polymer membrane (such as ethyl cellulose, EC) containing predefined micropores at the bottom of the body and the amount of a swellable excipient, such as low substituted hydroxypropyl cellulose (L-HPC) and sodium glycolate.
  • a water insoluble polymer membrane such as ethyl cellulose, EC
  • L-HPC low substituted hydroxypropyl cellulose
  • GI fluids permeate through the micropores, causing swelling of the swellable excipients, which produces an inner pressure disengaging the capsular components, including a first capsule body containing the swellable materials, a second capsule body containing the drugs, and an outer cap attached to the first capsule body.
  • the enteric layer may further comprise anti-tackiness agents, such as talc or glyceryl monostearate and/or plasticizers.
  • the enteric layer may further comprise one or more plasticizers including, but not limited to, triethyl citrate, acetyl triethyl citrate, acetyltributyl citrate, polyethylene glycol acetylated monoglycerides, glycerin, triacetin, propylene glycol, phthalate esters (e.g., diethyl phthalate, dibutyl phthalate), titanium dioxide, ferric oxides, castor oil, sorbitol and dibutyl seccate.
  • plasticizers including, but not limited to, triethyl citrate, acetyl triethyl citrate, acetyltributyl citrate, polyethylene glycol acetylated monoglycerides, glycerin, triacetin, propylene glycol,
  • the delay release formulation employs a water- permeable but insoluble film coating to enclose the active ingredient and an osmotic agent. As water from the gut slowly diffuses through the film into the core, the core swells until the film bursts, thereby releasing the active ingredients.
  • the film coating may be adjusted to permit various rates of water permeation or release time.
  • the delay release formulation employs a water- impermeable tablet coating whereby water enters through a controlled aperture in the coating until the core bursts. When the tablet bursts, the drug contents are released immediately or over a longer period of time.
  • the active agents are delivered in a formulation to provide both delayed release and extended-release (delayed-sustained).
  • delayed- extended-release is used herein with reference to a drug formulation providing pulsatile release of active agents at a pre-determined time or lag period following administration, which is then followed by extended-release of the active agents thereafter.
  • immediate release, extended-release, delayed-release, or delayed-extended-release formulations comprises an active core comprised of one or more inert particles, each in the form of a bead, pellet, pill, granular particle, microcapsule, microsphere, microgranule, nanocapsule, or nanosphere coated on its surfaces with drugs in the form of e.g., a drug-containing film-forming composition using, for example, fluid bed techniques or other methodologies known to those of skill in the art.
  • the inert particle can be of various sizes, so long as it is large enough to remain poorly dissolved.
  • the active core may be prepared by granulating and milling and/or by extrusion and
  • the amount of drug in the core will depend on the dose that is required, and typically varies from about 5 to 90 weight %.
  • the polymeric coating on the active core will be from about 1 to 50% based on the weight of the coated particle, depending on the lag time and type of release profile required and/or the polymers and coating solvents chosen.
  • the inactive core may be a sugar sphere or a buffer crystal or an encapsulated buffer crystal such as calcium carbonate, sodium bicarbonate, fumaric acid, tartaric acid, etc. which alters the microenvironment of the drug to facilitate its release.
  • delayed release or delayed-extended- release compositions may formed by coating a water soluble/dispersible drug-containing particle, such as a bead, with a mixture of a water insoluble polymer and an enteric polymer, wherein the water insoluble polymer and the enteric polymer may be present at a weight ratio of from 4: 1 to 1 : 1, and the total weight of the coatings is 10 to 60 weight % based on the total weight of the coated beads.
  • the drug layered beads may optionally include an inner dissolution rate controlling membrane of ethylcellulose.
  • the composition of the outer layer, as well as the individual weights of the inner and outer layers of the polymeric membrane are optimized for achieving desired circadian rhythm release profiles for a given active, which are predicted based on in vitro/in vivo correlations.
  • the formulations may comprise a mixture of immediate release drug-containing particles without a dissolution rate controlling polymer membrane and delayed-extended-release beads exhibiting, for example, a lag time of 2-4 hours following oral administration, thus providing a two-pulse release profile.
  • the active core is coated with one or more layers of dissolution rate-controlling polymers to obtain desired release profiles with or without a lag time.
  • An inner layer membrane can largely control the rate of drug release following imbibition of water or body fluids into the core, while the outer layer membrane can provide for a desired lag time (the period of no or little drug release following imbibition of water or body fluids into the core).
  • the inner layer membrane may comprise a water insoluble polymer, or a mixture of water insoluble and water soluble polymers.
  • the polymers suitable for the outer membrane which largely controls the lag time of up to 6 hours may comprise an enteric polymer, as described above, and a water insoluble polymer at a thickness of 10 to 50 weight %.
  • the ratio of water insoluble polymer to enteric polymer may vary from 4: 1 to 1 :2, preferably the polymers are present at a ratio of about 1 :1.
  • the water insoluble polymer typically used is ethylcellulose.
  • Exemplary water insoluble polymers include ethylcellulose, polyvinyl acetate (ollicoat SR#0D from BASF), neutral copolymers based on ethyl acrylate and
  • methylmethacrylate copolymers of acrylic and methacrylic acid esters with quaternary ammonium groups such as EUDRAGIT ® NE, RS and RS30D, RL or RL30D and the like.
  • exemplary water soluble polymers include low molecular weight HPMC, HPC,
  • methylcellulose methylcellulose, polyethylene glycol (PEG of molecular weight>3000) at a thickness ranging from 1 weight % up to 10 weight % depending on the solubility of the active in water and the solvent or latex suspension based coating formulation used.
  • the water insoluble polymer to water soluble polymer may typically vary from 95:5 to 60:40, preferably from 80:20 to 65:35.
  • AMBERLITETM IRP69 resin is used as an extended release carrier.
  • AMBERLITETM IRP69 is an insoluble, strongly acidic, sodium form cation exchange resin that is suitable as carrier for cationic (basic) substances.
  • DUOLITETM API 43/1093 resin is used as an extended release carrier.
  • DUOLITETM API 43/1093 is an insoluble, strongly basic, anion exchange resin that is suitable as a carrier for anionic (acidic) substances.
  • API 43/1093 resin provides a means for binding medicinal agents onto an insoluble polymeric matrix. Extended release is achieved through the formation of resin-drug complexes (drug resinates). The drug is released from the resin in vivo as the drug reaches equilibrium with the high electrolyte concentrations, which are typical of the gastrointestinal tract. More hydrophobic drugs will usually elute from the resin at a lower rate, owing to hydrophobic interactions with the aromatic structure of the cation exchange system.
  • the formulations are designed with release profiles to limit interference with restful sleep, wherein the formulation releases the medicine when the individual would normally be awakened by an urge to urinate.
  • release profiles For example, consider an individual who begins sleeping at 11 PM and is normally awakened at 12:30 AM, 3:00 AM, and 6:00 AM to urinate.
  • a delayed release vehicle could deliver the medicine at 12:15 AM, thereby delaying the need to urinate for perhaps 2-3 hours.
  • the need to wake up to urinate may be reduced or eliminated altogether.
  • the pharmaceutical composition may be administered daily or administered on an as needed basis.
  • the pharmaceutical composition is administered to the subject prior to bedtime.
  • the pharmaceutical composition is administered immediately before bedtime.
  • the pharmaceutical composition is administered within about two hours before bedtime, preferably within about one hour before bedtime.
  • the pharmaceutical composition is administered about two hours before bedtime.
  • the pharmaceutical composition is administered at least two hours before bedtime.
  • the pharmaceutical composition is administered about one hour before bedtime.
  • the pharmaceutical composition is administered at least one hour before bedtime.
  • the pharmaceutical composition is administered less than one hour before bedtime.
  • the pharmaceutical composition is administered immediately before bedtime.
  • compositions for oral administration include, but are not limited to: tablets, coated tablets, dragees, capsules, powders, granulates and soluble tablets, and liquid forms, for example, suspensions, dispersions or solutions.
  • enteric coatings work by presenting a surface that is stable at the highly acidic pH found in the stomach, but breaks down rapidly at a less acidic (relatively more basic) pH. Therefore, an enteric coated pill will not dissolve in the acidic juices of the stomach (pH ⁇ 3), but they will in the alkaline (pH 7-9) environment present in the small intestine.
  • enteric coating materials include, but are not limited to, methyl acrylate-methacrylic acid copolymers, cellulose acetate succinate, hydroxy propyl methyl cellulose phthalate, hydroxy propyl methyl cellulose acetate succinate (hypromellose acetate succinate), polyvinyl acetate phthalate (PVAP), methyl methacrylate-methacrylic acid copolymers, sodium alginate and stearic acid.
  • the pharmaceutical composition is orally administered from a variety of drug formulations designed to provide delayed release.
  • Delayed oral dosage forms include, for example, tablets, capsules, caplets, and may also comprise a plurality of granules, beads, powders or pellets that may or may not be encapsulated. Tablets and capsules represent the most convenient oral dosage forms, in which case solid
  • one or more barrier coatings may be applied to pellets, tablets, or capsules to facilitate slow dissolution and concomitant release of drugs into the intestine.
  • the barrier coating contains one or more polymers encasing, surrounding, or forming a layer, or membrane around the therapeutic composition or active core.
  • the active agents are delivered in a formulation to provide delayed-release at a pre-determined time following administration.
  • the delay may be up to about 10 minutes, about 20 minutes, about 30 minutes, about 1 hour, about 2 hours, about 3 hours, about 4 hours, about 5 hours, about 6 hours, or longer.
  • the delayed-release is caused by an osmotic
  • a capsule may be formulated with a single osmotic unit or it may incorporate 2, 3, 4, 5, or 6 push-pull units encapsulated within a hard gelatin capsule, whereby each bilayer push pull unit contains an osmotic push layer and a drug layer, both surrounded by a semi-permeable membrane. One or more orifices are drilled through the membrane next to the drug layer. This membrane may be additionally covered with a pH- dependent enteric coating to prevent release until after gastric emptying. The gelatin capsule dissolves immediately after ingestion.
  • the enteric coating breaks down, which then allows fluid to flow through the semi-permeable membrane, swelling the osmotic push compartment to force to force drugs out through the orifice(s) at a rate precisely controlled by the rate of water transport through the semipermeable membrane. Release of drugs can occur over a constant rate for up to 24 hours or more.
  • the osmotic push layer comprises one or more osmotic agents creating the driving force for transport of water through the semi-permeable membrane into the core of the delivery vehicle.
  • osmotic agents include water-swellable hydrophilic polymers, also referred to as “osmopolymers” and “hydrogels,” including, but not limited to, hydrophilic vinyl and acrylic polymers, polysaccharides such as calcium alginate,
  • polyethylene oxide PEO
  • PEG polyethylene glycol
  • PPG polypropylene glycol
  • PVP poly(2- hydroxyethyl methacrylate)
  • acrylic acrylic
  • PEG polypropylene glycol
  • PPG polypropylene glycol
  • PVP poly(2- hydroxyethyl methacrylate)
  • acrylic acrylic
  • P(methacrylic) acid polyvinylpyrrolidone
  • PVA polyvinyl alcohol
  • PVA/PVP copolymers PVA/PVP copolymers with hydrophobic monomers such as methyl methacrylate and vinyl acetate, hydrophilic polyurethanes containing large PEO blocks, sodium croscarmellose, carrageenan, hydroxyethyl cellulose (HEC), hydroxypropyl cellulose (HPC), hydroxypropyl methyl cellulose (HPMC), carboxymethyl cellulose (CMC) and carboxyethyl, cellulose (CEC), sodium alginate, polycarbophil, gelatin
  • osmogens which are capable of imbibing water to affect an osmotic pressure gradient across the semi-permeable membrane.
  • exemplary osmogens include, but are not limited to, inorganic salts, such as magnesium sulfate, magnesium chloride, calcium chloride, sodium chloride, lithium chloride, potassium sulfate, potassium phosphates, sodium carbonate, sodium sulfite, lithium sulfate, potassium chloride, and sodium sulfate; sugars, such as dextrose, fructose, glucose, inositol, lactose, maltose, mannitol, raffinose, sorbitol, sucrose, trehalose, and xylitol; organic acids, such as ascorbic acid, benzoic acid, fumaric acid, citric acid, maleic acid, sebacic acid, sorbic acid, adipic acid, edetic
  • Materials useful in forming the semipermeable membrane include various grades of acrylics, vinyls, ethers, polyamides, polyesters, and cellulosic derivatives that are water-permeable and water-insoluble at physiologically relevant pHs, or are susceptible to being rendered water-insoluble by chemical alteration, such as crosslinking.
  • the delay release formulation employs a water- impermeable tablet coating whereby water enters through a controlled aperture in the coating until the core bursts. When the tablet bursts, the drug contents are released immediately or over a longer period of time.
  • the pharmaceutical composition is in a tablet or capsule form containing a single coating layer. In other embodiments, the pharmaceutical composition is in a tablet or capsule form containing multiple coating layers.
  • the pharmaceutical composition comprises a plurality of active ingredients.
  • the pharmaceutical composition comprises two active ingredients (e.g., two analgesic agents, or one analgesic agent and one antimuscarinic agent), formulated for delayed-release at about the same time.
  • the pharmaceutical composition comprises two active ingredients, one formulated as an immediate-release component and the other is formulated as a delayed-release component.
  • the pharmaceutical composition comprises two active ingredients formulated as two delayed-release components, each providing a different delayed-release profile. For example, a first delayed-release component releases a first active ingredient at a first time point and a second delayed-release component releases a second active ingredient at a second time point.
  • immediate-release is used herein with reference to a drug formulation that does not contain a dissolution rate controlling material. There is substantially no delay in the release of the active agents following administration of an immediate-release formulation .
  • An immediate-release coating may include suitable materials immediately dissolving following administration so as to release the drug contents therein.
  • Exemplary immediate-release coating materials include gelatin, polyvinyl alcohol polyethylene glycol (PVA-PEG) copolymers (e.g., KOLLICOAT ® ) and various others materials known to those skilled in the art.
  • An immediate-release composition may comprise 100% of the total dosage of a given active agent administered in a single unit dose.
  • an immediate-release component may be included as a component in a combined release profile formulation that may provide about 1% to about 50% of the total dosage of the active agent(s) to be delivered by the pharmaceutical formulation.
  • the immediate release component may provide at least about 5%, or about 10% to about 30%, or about 45% to about 50%» of the total dosage of the active agent(s) to be delivered by the formulation.
  • the immediate release component provides about 2, 4, 5, 10, 15, 20, 25, 30, 35, 40, 45 or 50% of the total dosage of the active agent(s) to be delivered by the formulation.
  • the immediate release or delayed-release formulation comprises an active core comprised of one or more inert particles, each in the form of a bead, pellet, pill, granular particle, microcapsule, microsphere, microgranule, nanocapsule, or nanosphere coated on its surfaces with drugs in the form of e.g., a drug-containing film- forming composition using, for example, fluid bed techniques or other methodologies known to those of skill in the art.
  • the inert particle can be of various sizes, so long as it is large enough to remain poorly dissolved.
  • the active core may be prepared by granulating and milling and/or by extrusion and spheronization of a polymer composition containing the drug substance.
  • the amount of drag in the core will depend on the dose that is required, and typically varies from about 5 to 90 weight %.
  • the polymeric coating on the active core will be from about 1 to 50% based on the weight of the coated particle, depending on the lag time and type of release profile required and/or the polymers and coating solvents chosen.
  • the inactive core may be a sugar sphere or a buffer crystal or an encapsulated buffer crystal such as calcium carbonate, sodium bicarbonate, fumaric acid, tartaric acid, etc. which alters the microenvironment of the drug to facilitate its release.
  • the delayed-release formulation is formed by coating a water soluble/dispersible drug-containing particle, such as a bead, with a mixture of a water insoluble polymer and an enteric polymer, wherein the water insoluble polymer and the enteric polymer may be present at a weight ratio of from 4: 1 to 1 :1 , and the total weight of the coatings is 10 to 60 weight % based on the total weight of the coated beads.
  • the drug layered beads may optionally include an inner dissolution rate controlling membrane of ethylcellulose.
  • the composition of the outer layer, as well as the individual weights of the inner and outer layers of the polymeric membrane are optimized for achieving desired circadian rhythm release profiles for a given active, which are predicted based on in vitro/in vivo correlations.
  • the formulations comprise a mixture of immediate release drug-containing particles without a dissolution rate controlling polymer membrane and delayed-release beads exhibiting, for example, a lag time of 2-4 hours following oral administration, thus providing a two-pulse release profile.
  • the formulations comprise a mixture of two types of delayed-release beads: a first type that exhibits a lag time of 1-3 hours and a second type that exhibits a lag time of 4-6 hours.
  • the active core is coated with one or more layers of dissolution rate-controlling polymers to obtain desired release profiles with or without a lag time.
  • An inner layer membrane can largely control the rate of drug release following imbibition of water or body fluids into the core, while the outer layer membrane can provide for a desired lag time (the period of no or little drug release following imbibition of water or body fluids into the core).
  • the inner layer membrane may comprise a water insoluble polymer, or a mixture of water insoluble and water soluble polymers.
  • the polymers suitable for the outer membrane which largely controls the lag time of up to 6 hours may comprise an enteric polymer, as described above, and a water insoluble polymer at a thickness of 10 to 50 weight %.
  • the ratio of water insoluble polymer to enteric polymer may vary from 4: 1 to 1 :2, preferably the polymers are present at a ratio of about 1 : 1.
  • the water insoluble polymer typically used is ethylcellulose.
  • Exemplary water insoluble polymers include ethylcellulose, polyvinyl acetate (Kollicoat SR#0D from BASF), neutral copolymers based on ethyl acrylate and
  • methylmethacrylate copolymers of acrylic and methacrylic acid esters with quaternary ammonium groups such as EUDRAGIT ® NE, RS and RS30D, RL or RL30D and the like.
  • exemplary water soluble polymers include low molecular weight HPMC, HPC,
  • methylcellulose methylcellulose, polyethylene glycol (PEG of molecular weight>3000) at a thickness ranging from 1 weight % up to 10 weight % depending on the solubility of the active in water and the solvent or latex suspension based coating formulation used.
  • the water insoluble polymer to water soluble polymer may typically vary from 95:5 to 60:40, preferably from 80:20 to 65:35.
  • the formulations are designed with release profiles to limit interference with restful sleep, wherein the formulation release the medicine when the individual would normally be awakened by an urge to urinate. For example, consider an individual who begins sleeping at 11 PM and is normally awakened at 12:30 AM, 3:00 AM, and 6:00 AM to urinate. A delayed, extended-release vehicle could deliver the medicine at 12: 15 AM, thereby delaying the need to urinate for perhaps 2-3 hours.
  • the pharmaceutical composition may be administered daily or administered on an as needed basis.
  • the pharmaceutical composition is administered to the subject prior to bedtime.
  • the pharmaceutical composition is administered immediately before bedtime.
  • the pharmaceutical composition is administered within about two hours before bedtime, preferably within about one hour before bedtime.
  • the pharmaceutical composition is administered about two hours before bedtime.
  • the pharmaceutical composition is administered at least two hours before bedtime.
  • the pharmaceutical composition is administered about one hour before bedtime.
  • the pharmaceutical composition is administered at least one hour before bedtime.
  • the pharmaceutical composition is administered less than one hour before bedtime.
  • the pharmaceutical composition is administered immediately before bedtime.
  • the pharmaceutical composition is administered orally.
  • the appropriate dosage ("therapeutically effective amount") of the active agent(s) in the immediate-release component or the extended-release component will depend, for example, the severity and course of the condition, the mode of administration, the bioavailability of the particular agent(s), the age and weight of the patient, the patient's clinical history and response to the active agent(s), discretion of the physician, etc.
  • the therapeutically effective amount of the active agent, the immediate-release component or the extended-release component is administered will be in the range of about 1 ng/kg body weight/day to about 100 mg/kg body weight/dose whether by one or more administrations.
  • the range of each active agent administered is from about 1 ng/kg body weight/dose to about 1 ⁇ g/kg body weight/dose, 1 ng/kg body weight/dose to about 100 ng/kg body weight/dose, 1 ng/kg body weight/dose to about 10 ng/kg body weight/dose, 10 ng/kg body weight/dose to about 1 ⁇ g/kg body weight/dose, 10 ng/kg body weight/dose to about 100 ng/kg body weight/dose, 100 ng/kg body weight/dose to about 1 ⁇ g/kg body weight/dose, 100 ng/kg body weight/dose to about 10 ⁇ g/kg body weight/dose, 1 ⁇ g/kg body weight/dose to about 10 ⁇ g/kg body weight/dose, 1 ⁇ 13 ⁇ 4 body weight/dose to about 100 ⁇ g/kg body weight/dose, 10 ⁇ g/kg body weight/dose to about 100 ⁇ g/kg body weight/dose, 10 ⁇ g/kg body weight/dose to about 1 mg/kg body weight
  • each active agent in the immediate-release component or the extended-release component is administered at a dosage range of 1 ng to 10 ng per dose, 10 ng to 100 ng per dose, 100 ng to 1 ⁇ g per dose, 1 ⁇ g to 10 ⁇ g per dose, 10 ⁇ g to 100 ⁇ g per dose, 100 ⁇ g to 1 mg per dose, 1 mg to 10 mg per dose, 10 mg to 100 mg per dose, 50 mg to 1000 mg per dose, 500 mg to 5000 mg per dose, 200 mg to 2000 mg per dose, 400 mg to 1000 mg per dose, 100 ng to 100 ⁇ g per dose, or 100 ng to 10 ⁇ g per dose.
  • each agent is administered at about 0.0006 mg/dose, 0.001 mg/dose, 0.003 mg/dose, 0.006 mg/dose, 0.01 mg/dose, 0.03 mg/dose, 0.06 mg/dose, 0.1 mg/dose, 0.3 mg/dose, 0.6 mg/dose, 1 mg/dose, 3 mg/dose, 6 mg/dose, 10 mg/dose, 30 mg/dose, 60 mg/dose, 100 mg/dose, 300 mg/dose, 600 mg/dose, 1000 mg/dose, 2000 mg/dose, 5000 mg/dose, or 10,000 mg/dose. As expected, the dosage will be dependant on the condition, size, age and condition of the patient. [0128] In some embodiments, the pharmaceutical composition comprises a single analgesic agent.
  • the single analgesic agent is aspirin. In another embodiment, the single analgesic agent is ibuprofen. In another embodiment, the s single analgesic agent is naproxen sodium. In another embodiment, the single analgesic agent is indomethacin. In another embodiment, the single analgesic agent is nabumetone. In another embodiment, the single analgesic agent is acetaminophen.
  • the single analgesic agent is given at a single daily dose of 1 ng-1000 mg.
  • the pharmaceutical composition comprises acetylsalicylic acid, ibuprofen, naproxen sodium, indomethancin, nabumetone or
  • acetaminophen as a single analgesic agent and the analgesic agent is given at a single daily dose in the range of 1-100 ng, 0.1-10 ⁇ 3 ⁇ 4 0.1-100 ig, 0.1-10 mg, 0.1-0.5 mg, 0.5-2.5 mg, 2.5- 10 mg, 10-50 mg, 50-250 mg, or 250-1000 mg.
  • the pharmaceutical composition comprises a pair of analgesic agents.
  • paired analgesic agents include, but are not limited to, acetylsalicylic acid and ibuprofen, acetylsalicylic acid and naproxen sodium, acetylsalicylic acid and nabumetone, acetylsalicylic acid and acetaminophen, acetylsalicylic acid and indomethancin, ibuprofen and naproxen sodium, ibuprofen and nabumetone, ibuprofen and acetaminophen, ibuprofen and indomethancin, naproxen sodium and nabumetone, naproxen sodium and acetaminophen, naproxen sodium and indomethancin, nabumetone and acetaminophen, naproxen sodium and indomethancin, nabumetone and acetaminophen,
  • the paired analgesic agents are mixed at a weight ratio of 0.3 : 1 to 3 : 1 , with a combined dose in the range of 1-100 ng, 0.1-10 ⁇ 0.1-100 ig, 0.1-10 mg, 0.1-0.5 mg, 0.5-2.5 mg, 2.5-10 mg, 10-50 mg, 50-250 mg. In one embodiment, the paired analgesic agents are mixed at a weight ratio of 1 : 1.
  • the pharmaceutical composition of the present application further comprises one or more antimuscurinic agents. Examples of the
  • antimuscurinic agents include, but are not limited to, oxybutynin, solifenacin, darifenacin, fesoterodine, tolterodine, trospium and atropine.
  • the pharmaceutical composition comprises an analgesic agent selected from the group consisting of cetylsalicylic acid, ibuprofen, naproxen sodium, nabumetone, acetaminophen and indomethancin, and an antimuscurinic agent selected from the group consisting of oxybutynin, solifenacin, darifenacin and atropine.
  • the dose of the analgesic is in the range of 1-100 ng, 0.1-10 ⁇ g, 0.1-100 ⁇ g, 0.1-10 mg, 0.1-0.5 mg, 0.5-2.5 mg, 2.5-10 mg, 10-50 mg, 50-250 mg, 250-1000 mg, 0.1-1 mg, 1-10 mg, 10-100 mg or 100-1000 mg.
  • the dose of antimuscurinic agent is in the range of 0.01-0.05 mg, 0.05-0.25 mg, 0.25-1 mg, 1-5 mg, 5-25 mg 0.01 -0.1 mg. 0.1-1 mg, 1-10 mg and 10-25 mg.
  • Another aspect of the present application relates to a method for reducing the frequency of urination by administering to a person in need thereof a pharmaceutical composition formulated in an immediate release formulation.
  • the pharmaceutical composition comprises a plurality of analgesic agents and/or antimuscarinic agents.
  • the pharmaceutical composition comprises two or more analgesic agents. In other embodiments, the pharmaceutical composition comprises one or more analgesic agents and one or more antimuscarinic agents.
  • the pharmaceutical composition may be formulated into a tablet, capsule, dragee, powder, granulate, liquid, gel or emulsion form. Said liquid, gel or emulsion may be ingested by the subject in naked form or contained within a capsule.
  • the analgesic agent is selected from the group consisting of salicylates, aspirin, salicylic acid, methyl salicylate, diflunisal, salsalate, olsalazine, sulfasalazine, para-aminophenol derivatives, acetanilide, acetaminophen, phenacetin, fenamates, mefenamic acid, meclofenamate, sodium meclofenamate, heteroaryl acetic acid derivatives, tolmetin, ketorolac, diclofenac, propionic acid derivatives, ibuprofen, naproxen sodium, daproxen, fenoprofen, ketoprofen, flurbiprofen, oxaprozin; enolic acids, oxicam derivatives, piroxicam, meloxicam, tenoxicam, ampiroxicam, droxicam, pivoxicam, pyrazolon
  • the pharmaceutical composition comprises a single analgesic agent and a single antimuscarinic agent.
  • the single analgesic agent is aspirin.
  • the single analgesic agent is ibuprofen.
  • the s single analgesic agent is naproxen sodium.
  • the single analgesic agent is indomethacin.
  • the single analgesic agent is nabumetone.
  • the single analgesic agent is aceaminophen.
  • the analgesic agent and anti-muscarinic agent may be given at doses in the ranges described above.
  • Another aspect of the present application relates to a method for treating nocturia by administering to a subject in need thereof (1) one or more analgesic agent and (2) one or more antidiuretic agents.
  • the antidiuretic agent(s) act to: (1) increase vasopressin secretion; (2) increase vasopressin receptor activation; (3) reduce secretion of atrial natriuretic peptide (ANP) or C-type natriuretic peptide (CNP); or (4) reduce ANP and/or CNP receptor activation.
  • antidiuretic agents include, but are not limited to, antidiuretic hormone (ADH), angiotensin II, aldosterone, vasopressin, vasopressin analogs (e.g. , desmopressin argipressin, lypressin, felypressin, ornipressin, terlipressin); vasopressin receptor agonists, atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) receptor (i.e., NPR1 , NPR2, NPR3) antagonists (e.g., HS-142-1 , isatin, [Asu7,23']b-ANP-(7- 28)], anantin, a cyclic peptide from Streptomyces coerulescens, and 3G12 monoclonal antibody); somatostatin type 2 receptor antagonists (e.g. , somatostatin), and
  • the one or more analgesic agent and one or more antidiuretic agents are formulated for extended-release.
  • Another aspect of the present application relates to a method for reducing the frequency of urination by administering to a person in need thereof a first pharmaceutical composition comprising a diuretic, followed with a second pharmaceutical composition comprising one or more analgesic agents.
  • the first pharmaceutical composition is dosed and formulated to have a diuretic effect within 6 hours of administration and is administered at least 8 hours prior to bedtime.
  • the second pharmaceutical composition is administered within 2 hours prior to bedtime.
  • the first pharmaceutical composition is formulated for immediate-release and the second pharmaceutical composition is formulated for extended- release or delayed, extended release.
  • diuretics include, but are not limited to, acidifying salts, such as CaCl 2 and NH 4 C1; arginine vasopressin receptor 2 antagonists, such as amphotericin B and lithium citrate; aquaretics, such as Goldenrod and Junipe; Na-H exchanger antagonists, such as dopamine; carbonic anhydrase inhibitors, such as acetazolamide and dorzolamide; loop diuretics, such as bumetanide, ethacrynic acid, furosemide and torsemide; osmotic diuretics, such as glucose and mannitol; potassium-sparing diuretics, such as amiloride, spironolactone, triamterene, potassium canrenoate; thiszides, such as bendroflumethiazide and
  • hydrochlorothiszide such as caffeine, theophylline and theobromine.
  • xanthines such as caffeine, theophylline and theobromine.
  • the second pharmaceutical composition further comprises one or more antimuscurinic agents.
  • antimuscurinic agents include, but are not limited to, oxybutynin, solifenacin, darifenacin, fesoterodine, tolterodine, trospium and atropine.
  • Another aspect of the present application relates to a method for treating nocturia by administering to a person in need thereof a first pharmaceutical composition comprising a diuretic, followed with a second pharmaceutical composition comprising one or more analgesic agents.
  • the first pharmaceutical composition is dosed and formulated to have a diuretic effect within 6 hours of administration and is administered at least 8 hours prior to bedtime.
  • the second pharmaceutical composition is formulated for extended-release or delayed, extended-release, and is administered within 2 hours prior to bedtime.
  • diuretics include, but are not limited to, acidifying salts, such as CaCl 2 and NH 4 C1; arginine vasopressin receptor 2 antagonists, such as amphotericin B and lithium citrate; aquaretics, such as Goldenrod and Junipe; Na-H exchanger antagonists, such as dopamine; carbonic anhydrase inhibitors, such as acetazolamide and dorzolamide; loop diuretics, such as bumetanide, ethacrynic acid, furosemide and torsemide; osmotic diuretics, such as glucose and mannitol; potassium-sparing diuretics, such as amiloride, spironolactone, triamterene, potassium canrenoate; thiszides, such as bendrofiumethiazide and
  • hydrochlorothiszide such as caffeine, theophylline and theobromine.
  • xanthines such as caffeine, theophylline and theobromine.
  • the second pharmaceutical composition further comprises one or more antimuscurinic agents.
  • antimuscurinic agents include, but are not limited to, oxybutynin, solifenacin, darifenacin, fesoterodine, tolterodine, trospium and atropine.
  • the second pharmaceutical composition may be formulated in immediate-release formulation or delayed release formulation.
  • the second pharmaceutical composition further comprises one or more antidiuretic agents.
  • Another aspect of the present application relates to a method for reducing the frequency of urination by administering to a subject in need thererof, two or more analgesic agents alternatively to prevent the development of drug resistance.
  • the method comprises administering a first analgesic agent for a first period of time and then administering a second analgesic agent for a second period of time.
  • the method further comprises administering a third analgesic agent for a third period of time.
  • the first, second and third analgesic agents are different from each other and at least one of which is formulated for extended-release or delayed, extended-release.
  • the first analgesic agent is acetaminophen
  • the second analgesic agent is ibuprofen
  • the third analgesic agent is naproxen sodium.
  • the length of each period may vary depending on the subject's response to each analgesic agent. In some embodiments, each period lasts from 3 days to three weeks.
  • the first, second and third analgesic are all formulated for extended-release or delayed, extended-release.
  • Another aspect of the present application relates to a pharmaceutical composition comprising a plurality of active ingredients and a pharmaceutically acceptable carrier, wherein at least one of the plurality of active ingredients is formulated for extended- release or delayed, extended release.
  • the plurality of active ingredients comprises one or more analgesics and/or one or more antimuscarinic agents.
  • the pharmaceutical composition comprises two analgesics selected from the group consisting of cetylsalicylic acid, ibuprofen, naproxen sodium, nabumetone, acetaminophen and indomethancin.
  • the pharmaceutical composition comprises one analgesic selected from the group consisting of cetylsalicylic acid, ibuprofen, naproxen sodium, nabumetone, acetaminophen and indomethancin; and an antimuscurinic agent selected from the group consisting of oxybutynin, solifenacin, darifenacin and atropine.
  • analgesic selected from the group consisting of cetylsalicylic acid, ibuprofen, naproxen sodium, nabumetone, acetaminophen and indomethancin
  • an antimuscurinic agent selected from the group consisting of oxybutynin, solifenacin, darifenacin and atropine.
  • pharmaceutically acceptable carrier includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, sweeteners and the like.
  • the pharmaceutically acceptable carriers may be prepared from a wide range of materials including, but not limited to, flavoring agents, sweetening agents and miscellaneous materials such as buffers and absorbents that may be needed in order to prepare a particular therapeutic composition.
  • flavoring agents, sweetening agents and miscellaneous materials such as buffers and absorbents that may be needed in order to prepare a particular therapeutic composition.
  • the use of such media and agents with pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the active ingredient, its use in the therapeutic compositions is contemplated.
  • This study is designed to determine the dose and in vitro efficacy of analgesics and antimuscurinic agents in controlling macrophage response to inflammatory and noninflammatory stimuli mediated by COX2 and prostaglandins (PGE, PGH, etc.). It establishes baseline (dose and kinetic) responses to inflammatory and non-inflammatory effectors in bladder cells. Briefly, cultured cells are exposed to analgesic agents and/or antimuscurinic agents in the absence or presence of various effectors.
  • the effectors include: lipopolysaccharide (LPS), an inflammatory agent and Cox2 inducer, as inflammatory stimuli; carbachol or acetylcholine, a stimulator of smooth muscle contraction, as non-inflammatory stimuli; botulinum neurotoxin A, a known inhibitor of acetylcholine release, as positive control; and rachidonic acid (AA), gamma linolenic acid (DGLA) or eicosapentaenoic acid (EPA) as precursors of prostaglandins, which are produced following the sequential oxidation of AA, DGLA or EPA inside the cell by cyclooxygenases (COX1 and COX2) and terminal prostaglandin synthases.
  • LPS lipopolysaccharide
  • COX1 and COX2 cyclooxygenases
  • the analgesic agents include: Salicylates such as aspirin, iso-butyl-propanoic- phenolic acid derivative (ibuprofen) such as Advil, Motrin, Nuprin, and Medipren, naproxen sodium such as Aleve, Anaprox, Antalgin, Feminax Ultra, Flanax, Inza, Midol Extended Relief, Nalgesin, Naposin, Naprelan, Naprogesic, Naprosyn, Naprosyn suspension, EC- Naprosyn, Narocin, Proxen, Synflex and Xenobid, acetic acid derivative such as
  • indomethacin Indocin
  • 1 -naphthaleneacetic acid derivative such as nabumetone or relafen
  • APAP N-acetyl-para-aminophenol
  • Tetaminophen or paracetamol Teylenol
  • Celecoxib N-acetyl-para-aminophenol
  • the antimuscarinic agents include: oxybutynin, solifenacin, darifenacin and atropine.
  • Macrophages are subjected to short term (1-2 hrs) or long term (24-48 hrs) stimulation of with:
  • Each analgesic agent at various doses in the presence of AA, DGLA, or EPA.
  • Botulinum neurotoxin A at various doses in the presence of corbachol or acetylcholine.
  • Botulinum neurotoxin A at various doses in the presence of AA, DGLA, or EPA.
  • the cells are then analyzed for the release of PGH 2 , PGE, PGE 2 , Prostacydin, Thromboxane, IL- ⁇ , IL-6, TNF-a, the COX2 activity, the production of cAMP and cGMP, the production of IL- ⁇ , IL-6, TNF-a and COX2 mRNA, and surface expression of CD80, CD86 and MHC class II molecules.
  • Murine RAW264.7 or J774 macrophage cells were used in this study. Cells were maintained in a culture medium containing RPMI 1640 supplemented with 10 % fetal bovine serum (FBS), 15 mM HEPES, 2 mM L-glutamine, 100 U/ml penicillin, and 100 ⁇ g / ml of streptomycin. Cells were cultured at 37° C in a 5 % C0 2 atmosphere and split (passages) once a week.
  • FBS fetal bovine serum
  • HEPES 15 fetal bovine serum
  • 2 mM L-glutamine 100 U/ml penicillin
  • streptomycin 100 ⁇ g / ml of streptomycin
  • RAW264.7 macrophage cells were seeded in 96-well plates at a cell density of 1.5xl0 5 cells per well in 100 ⁇ of the culture medium.
  • the cells were treated with (1) various concentrations of NSAID (acetaminophen, aspirin, ibuprophen or naproxiphen), (2) various concentrations of lipopolysaccharide (LPS), which is an effector of inflammatory stimuli to macrophage cells, (3) various concentrations of carbachol or acetylcholine, which are effectors of non-inflammatory stimuli, (4) NSAID and LPS or (5) NSAID and corbachol or acetylcholin.
  • NSAID acetaminophen, aspirin, ibuprophen or naproxiphen
  • LPS lipopolysaccharide
  • carbachol or acetylcholine which are effectors of non-inflammatory stimuli
  • NSAID and LPS or (5) NSAID and corbachol or acety
  • the NSAIDs were dissolved in FBS-free culture medium (i.e., RPMI 1640 supplemented with 15 mM HEPES, 2 mM L-glutamine, 100 U / ml penicillin, and 100 ⁇ g / ml of streptomycin), and diluted to desired concentrations by serial dilution with the same medium.
  • FBS-free culture medium i.e., RPMI 1640 supplemented with 15 mM HEPES, 2 mM L-glutamine, 100 U / ml penicillin, and 100 ⁇ g / ml of streptomycin
  • macrophages were diluted in 100 ⁇ of FACS buffer (phosphate buffered saline (PBS) with 2% bovine serum albumin (BSA) and 0.01% NaN 3 ) and stained 30 min at 4°C by addition of FITC-conjugated anti-CD40, PE-conjugated anti-CD80, PE-conjugated anti-CD86 antibody, anti MHC class II (I-A d ) PE (BD
  • COX2 activity in the cultured macrophages are determined by sequential competitive ELISA (R&D Systems).
  • the production of cAMP and cGMP is determined by the cAMP assay and cGMP assay. These assays are performed routinely in the art.
  • Table 1 summarizes the experiments performed with Raw 264 macrophage cell line and main findings in terms of the effects of NSAID on cell surface expression of costimulatory molecules CD40 and CD80. Expression of these molecules is stimulated by COX2 and inflammatory signals and thus, was evaluated to determine functional
  • acetaminophen, aspirin, ibuprophen and naproxiphen inhibit basal expression of co-stimulatory molecules CD40 and CD80 by macrophages at all the tested doses (i.e., 5x 10 5 nM, 5x 10 4 nM, 5x 10 3 nM, 5x 10 2 nM, 50 nM and 5 nM), except for the highest dose (i.e., 5x 10 6 nM), which appears to enhance, rather then inhibit, expression of the co-stimulatory molecules.
  • Table 3 summarizes the results of several studies that measured serum levels of NSAID after oral therapeutic doses in adult humans. As shown in Table 3, the maximum serum levels of NSAID after an oral therapeutic dose are in the range of 10 4 to 10 5 nM. Therefore, the doses of NSAID tested in vitro in Table 2 cover the range of concentrations achievable in vivo in human.
  • EXAMPLE 3 EFFECT OF ANALGESIC AGENTS. BOTULINUM NEUROTOXIN AND ANTIMUSCARINIC AGENTS ON MOUSE BLADDER SMOOTH MUSCLE CELL RESPONSES TO INFLAMMATORY AND NON-INFLAMMATORY STIMULI
  • Each analgesic agent at various doses in the presence of AA, DGLA, or EPA.
  • Botulinum neurotoxin A at various doses in the presence of corbachol or acetylcholine.
  • Botulinum neurotoxin A at various doses in the presence of AA, DGLA, or EPA.
  • the cells are then analyzed for the release of PGH 2 , PGE, PGE 2 , Prostacydin, Thromboxane, IL- ⁇ , IL-6, TNF-a, the COX2 activity, the production of cAMP and cGMP, the production of IL- ⁇ , IL-6, TNF-a and COX2 mRNA, and surface expression of CD80, CD86 and MHC class II molecules.
  • Bladder cells were removed from euthanized animals C57BL/6 mice (8-12 weeks old) and cells were isolated by enzymatic digestion followed by purification on a Percoll gradient. Briefly, bladders from 10 mice were minced with scissors to fine slurry in 10 ml of digestion buffer (RPMI 1640, 2% fetal bovine serum, 0.5 mg/ml collagenase, 30 ⁇ g/ml DNase). Bladder slurries were enzymatically digested for 30 minutes at 37°C.
  • digestion buffer RPMI 1640, 2% fetal bovine serum, 0.5 mg/ml collagenase, 30 ⁇ g/ml DNase.
  • Undigested fragments were further dispersed through a cell-trainer.
  • the cell suspension was pelleted and added to a discontinue 20%, 40% and 75% Percoll gradient for purification on mononuclear cells.
  • Each experiment used 50-60 bladders.
  • bladder cells were resuspended RPMI 1640 supplemented with 10 % fetal bovine serum, 15 mM HEPES, 2 mM L-glutamine, 100 U/ml penicillin, and 100 g / ml of streptomycin and seeded in clear-bottom black 96-well cell culture microculture plates at a cell density of 3xl0 4 cells per well in 100 ⁇ . Cells were cultured at 37° C in a 5 % C0 2 atmosphere.
  • Bladder cells were treated with NSAID solutions (50 ⁇ / well) either alone or together carbachol (10-Molar, 50 ⁇ / well), as an example of non-inflammatory stimuli, or lipopolysaccharide (LPS) of Salmonella typhymurium (1 ⁇ x ⁇ Jm ⁇ , 50 ⁇ / well), as an example of non-inflammatory stimuli.
  • carbachol 10-Molar, 50 ⁇ / well
  • 50 ⁇ of RPMI 1640 without fetal bovine serum were added to the wells to adjust the final volume to 200 ⁇ .
  • COX2 responses were analyzed by a Cell-Based ELISA using Human/mouse total COX2 immunoassay (R&D Systems), following the instructions of the manufacturer. Briefly, after cells fixation and permeabilization, a mouse anti-total COX2 and a rabbit anti- total GAPDH were added to the wells of the clear-bottom black 96-well cell culture microculture plates. After incubation and washes, an HRP-conjugated anti-mouse IgG and an AP-conjugated anti-rabbit IgG were added to the wells. Following another incubation and set of washes, the HRP- and AP-fluorogenic substrates were added.
  • R&D Systems Human/mouse total COX2 immunoassay
  • Prostaglandin E2 responses were analyzed by a sequential competitive ELISA (R&D Systems). More specifically, culture supematants or PGE2 standards were added to the wells of a 96-well polystyrene microplate coated with a goat anti-mouse polyclonal antibody. After one hour incubation on a microplate shaker, an HRP-conjugated PGE2 was added and plates incubated for an additional two hours at room temperature. The plates were then washed and HRP substrate solution added to each well. The color was allowed to develop for 30 min and the reaction stopped by addition sulfuric acid before reading the plate at 450 nm with wavelength correction at 570 nm. Results are expressed as mean pg/ml of PGE2.
  • NSAID inhibit COX2 responses of mouse bladder cells to an inflammatory stimuli
  • NSAIDs acetaminophen, aspirin, ibuprofen and naproxen
  • NSAID inhibit PGE2 responses of mouse bladder cells to an inflammatory stimuli
  • EXAMPLE 4 EFFECT OF ANALGESIC AGENTS, BOTULINUM NEUROTOXIN AND ANTIMUSCARINIC AGENTS ON MOUSE BLADDER SMOOTH MUSCLE CELL CONTRACTION.
  • Each analgesic agent at various doses in the presence of AA, DGLA, or EPA.
  • Botulinum neurotoxin A at various doses in the presence of corbachol or acetylcholine.
  • Botulinum neurotoxin A at various doses in the presence of AA, DGLA, or EPA.
  • EXAMPLE 5 EFFECT OF ORAL ANALGESIC AGENTS AND ANTIMUSCARINIC AGENTS ON COX2 AND PEG RESPONSES OF MOUSE BLADDER SMOOTH
  • mice and mice with over active bladder syndrome are given oral doses of aspirin, naproxen sodium, Ibuprofen, Indocin, nabumetone, Tylenol, Celecoxib, oxybutynin, solifenacin, darifenacin, atropine and combinations thereof.
  • Control groups include untreated normal mice and untreated OAB mice without over active bladder syndrome.
  • the bladders are collected and stimulated ex vivo with carbachol or acetylcholine.
  • the bladders are treated with botulinum neurotoxin A before stimulation with carbachol. Animals are maintained in metabolic cages and frequency (and volume) of urination are evaluated.
  • Bladder output are determined by monitoring water intake and cage litter weight. Serum PGH 2 , PGE, PGE 2 , Prostacydin, Thromboxane, IL- ⁇ , IL-6, TNF-a, cAMP, and cGMP levels are determined by ELISA. CD80, CD86, MHC class II expression in whole blood cells are determined by flow cytometry. [0186] At the end of the experiment, animal are euthanized and ex vivo bladder contractions are recorded with a Grass polygraph. Portions of bladders are fixed in formalin, and COX2 responses are analyzed by immunohistochemistry.
  • EXAMPLE 6 EFFECT OF ANALGESIC AGENTS. BOTULINUM NEUROTOXIN AND ANTIMUSCARINIC AGENTS ON HUMAN BLADDER SMOOTH MUSCLE CELL RESPONSES TO INFLAMMATORY AND NON-INFLAMMATORY STIMULI
  • This study is designed to characterize how the optimal doses of NSAID determined in Examples 1-5 affect human bladder smooth muscle cells in cell culture or tissue cultures, and to address whether different classes of NSAID can synergize to more efficiently inhibit COX2 and PEG responses.
  • Human bladder smooth muscle cells are subjected to short term (1-2 hrs) or long term (24-48 hrs) stimulation of with:
  • Each analgesic agent at various doses in the presence of AA, DGLA, or EPA.
  • Botulinum neurotoxin A at various doses in the presence of corbachol or acetylcholine.
  • Botulinum neurotoxin A at various doses in the presence of AA, DGLA, or EPA.
  • the cells are then analyzed for the release of PGH 2 , PGE, PGE 2 , Prostacydin, Thromboxane, IL- ⁇ , IL-6, TNF-a, the COX2 activity, the production of cAMP and cGMP, the production of IL- ⁇ , IL-6, TNF-a and COX2 mRNA, and surface expression of CD80, CD86 and MHC class II molecules.
  • EXAMPLE 7 EFFECT OF ANALGESIC AGENTS, BOTULINUM NEUROTOXIN AND ANTIMUSCARINIC AGENTS ON HUMAN BLADDER SMOOTH MUSCLE CELL CONTRACTION.
  • antimuscarinic agent at various concentration.
  • the stimuli-induced muscle contraction is measured to evaluate the inhibitory effect of the analgesic agent and/or antimuscarinic agent.
  • Human bladder smooth muscle cells are subjected to short term (1-2 hrs) or long term (24-48 hrs) stimulation of with:
  • Each analgesic agent at various doses in the presence of AA, DGLA, or EPA.
  • Botulinum neurotoxin A at various doses in the presence of corbachol or acetylcholine.
  • Botulinum neurotoxin A at various doses in the presence of AA, DGLA, or EPA.
  • Bladder smooth muscle cell contractions are recorded with a Grass polygraph (Quincy Mass, USA).

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Abstract

La présente invention concerne des procédés et des compositions pour réduire la fréquence de miction. Un procédé comprend l'administration à un sujet qui en a besoin, d'une quantité efficace d'une composition pharmaceutique comprenant un agent analgésique dans une formulation à libération prolongée. Un autre procédé comprend l'administration à un sujet qui en a besoin, d'une quantité efficace d'une composition pharmaceutique comprenant de multiples principes actifs dans une formulation à libération prolongée. Un autre procédé comprend l'administration à un sujet qui en a besoin, d'une quantité efficace d'un diurétique, suivie de l'administration d'une composition pharmaceutique comprenant un agent analgésique dans une formulation à libération prolongée.
PCT/US2012/020650 2012-01-04 2012-01-09 Formulation à libération prolongée pour réduire la fréquence de miction et son procédé d'utilisation WO2013103357A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US13/343,332 2012-01-04
US13/343,332 US20120135050A1 (en) 2010-07-08 2012-01-04 Extended-release formulation for reducing the frequency of urination and method of use thereof
EP12150403.9 2012-01-06
EP12150403.9A EP2612660B1 (fr) 2012-01-04 2012-01-06 Formule à libération étendue pour réduire la fréquence d'urination et son procédé d'utilisation

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
BE1023116B1 (nl) * 2015-07-24 2016-11-23 Nordic Specialty Pharma Bvba Paracetamol omvattend preparaat met vertraagde en aanhoudende afgifte

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007112581A1 (fr) * 2006-04-03 2007-10-11 Isa Odidi Dispositif d'administration à libération commandée comprenant un enrobage organosol
WO2011107755A2 (fr) * 2010-03-05 2011-09-09 University Of Strathclyde Administration immédiate / retardée de médicament
WO2011107750A2 (fr) * 2010-03-05 2011-09-09 University Of Strathclyde Administration retardée prolongée de médicament

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007112581A1 (fr) * 2006-04-03 2007-10-11 Isa Odidi Dispositif d'administration à libération commandée comprenant un enrobage organosol
WO2011107755A2 (fr) * 2010-03-05 2011-09-09 University Of Strathclyde Administration immédiate / retardée de médicament
WO2011107750A2 (fr) * 2010-03-05 2011-09-09 University Of Strathclyde Administration retardée prolongée de médicament

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
BE1023116B1 (nl) * 2015-07-24 2016-11-23 Nordic Specialty Pharma Bvba Paracetamol omvattend preparaat met vertraagde en aanhoudende afgifte

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