WO2020185214A1 - Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability - Google Patents
Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability Download PDFInfo
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- WO2020185214A1 WO2020185214A1 PCT/US2019/021763 US2019021763W WO2020185214A1 WO 2020185214 A1 WO2020185214 A1 WO 2020185214A1 US 2019021763 W US2019021763 W US 2019021763W WO 2020185214 A1 WO2020185214 A1 WO 2020185214A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/20—Pills, tablets, discs, rods
- A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
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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
- A61K31/33—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
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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
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
- A61K31/4015—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil having oxo groups directly attached to the heterocyclic ring, e.g. piracetam, ethosuximide
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
- A61K47/12—Carboxylic acids; Salts or anhydrides thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
- A61K9/0056—Mouth soluble or dispersible forms; Suckable, eatable, chewable coherent forms; Forms rapidly disintegrating in the mouth; Lozenges; Lollipops; Bite capsules; Baked products; Baits or other oral forms for animals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/20—Pills, tablets, discs, rods
- A61K9/2004—Excipients; Inactive ingredients
- A61K9/2013—Organic compounds, e.g. phospholipids, fats
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/20—Pills, tablets, discs, rods
- A61K9/2004—Excipients; Inactive ingredients
- A61K9/2013—Organic compounds, e.g. phospholipids, fats
- A61K9/2018—Sugars, or sugar alcohols, e.g. lactose, mannitol; Derivatives thereof, e.g. polysorbates
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61K9/20—Pills, tablets, discs, rods
- A61K9/2004—Excipients; Inactive ingredients
- A61K9/2022—Organic macromolecular compounds
- A61K9/2031—Organic macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, polyethylene oxide, poloxamers
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/20—Pills, tablets, discs, rods
- A61K9/2004—Excipients; Inactive ingredients
- A61K9/2022—Organic macromolecular compounds
- A61K9/2063—Proteins, e.g. gelatin
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- A—HUMAN NECESSITIES
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/20—Pills, tablets, discs, rods
- A61K9/2095—Tabletting processes; Dosage units made by direct compression of powders or specially processed granules, by eliminating solvents, by melt-extrusion, by injection molding, by 3D printing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P9/00—Drugs for disorders of the cardiovascular system
- A61P9/06—Antiarrhythmics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
- A61K9/19—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles lyophilised, i.e. freeze-dried, solutions or dispersions
Definitions
- This disclosure relates to orally-disintegrating porous glycopyrrolate tablets with an increased bioavailability and methods in which the tablets are used for administering to a patient.
- Glycopyrrolate is a quaternary ammonium compound with the following chemical name: 3-[(cyclopentylhydroxyphenylacetyl)oxy]- 1, 1-dimethylpyrrolidinium bromide. Its empirical formula is Ci 9 H 2 sBrN03, its molecular weight is 398.33. Glycopyrrolate is an active ingredient in medication ROBINUL R .
- Glycopyrrolate is an anticholinergic drug and is known to antagonize muscarinic symptoms. Accordingly, it can be used to control the volume and free acidity of gastric secretion. Glycopyrrolate can be also used to control excessive pharyngeal, tracheal, or bronchial secretions. Glycopyrrolate is used in the preoperative setting or during sedation as an adjunctive therapy for anesthesia. Glycopyrrolate can be also used to counter-act some of the post-operative effects.
- glycopyrrolate which cannot be easily dissolved in the patient’s saliva and may have to be swollen as an intact tablet with water.
- glycopyrrolate has been shown to be poorly absorbed after oral administration, with a range of bioavailability from 1-20%.
- there is a considerable variation in absorption among patients. (Buck et al. 2010).
- glycopyrrolate Some patients, including patients with dysphagia, cannot swallow a glycopyrrolate tablet. For these patients, oral glycopyrrolate is not recommended, yet, it is difficult to administer glycopyrrolate systemically several times a day. Furthermore, glycopyrrolate must be used with caution in patients with hepatic or renal disease.
- the injectable form of glycopyrrolate typically contains 0.9% benzyl alcohol as a preservative. (Buck et al. 2010). But excessive amounts of benzyl alcohol may lead to hypotension and metabolic acidosis. Accordingly, injectable forms of glycopyrrolate may not be suitable for neonates, and they should be used with caution in older infants. (Buck et al. 2010).
- US 5,298,261 provides methods for preparing tablets which are vacuum- dried, but there is no indication in US 5,298,261, that this method can be used with a quaternary amine compound without affecting the bioavailability of the compound.
- the present disclosure provides an orally-disintegrating porous tablet with microscopic pores, comprising a therapeutically effective amount of glycopyrrolate.
- the orally-disintegrating porous tablets disintegrate in the mouth in less than 60 seconds and they are prepared by freeze-drying a liquid suspension with a pH in the range from 4.0 to 6.5, the liquid suspension comprising at least one filler, at least one binder, at least one emulsifier, at least one disintegrating agent and water.
- the orally- disintegrating porous tablet has an increased bioavailability in comparison to a reference tablet comprising the same amount of glycopyrrolate.
- the therapeutically effective amount of glycopyrrolate may be in the range from 0.5 mg to 5 mg per one tablet.
- the disintegrating agent may comprise citric acid, succinic acid, tartic acid, or any combination thereof.
- the filler may comprise mannitol and the disintegrating agent may comprise citric acid.
- the disintegrating agent may comprise citric acid and the pH of the liquid suspension is in the range from 4.0 to 5.0.
- the filler may comprise mannitol, starch, modified starch, micro crystalline cellulose, xylitol, or any mixtures thereof.
- the binder may comprise gelatin, natural gum, synthetic gum, xanthan gum, acacia, pre- gelatinized starch, starch, methylcellulose, sodium carboxymethyl cellulose, ethyl cellulose, hydroxypropylmethyl cellulose, polyvinylpyrrolidone, polyacrylamide, or any mixtures thereof.
- the emulsifier may comprise Gelucire 44/14; Gelucire 50/13; Imwitor 91; Imwitor 308; Imwitor 380; Imwitor 742; Imwitor 780K; Imwitor 928; Imwitor 988; poloxamer 124; poloxamer 188, or any mixtures thereof.
- the orally-disintegrating porous tablet of this disclosure may further comprise one or more of the following: a sweetener, a flavoring agent, a coloring agent, an antibacterial agent, an anti-fungicidal agent, an absorption enhancer, a taste- masking agent, a lubricant and/or a wetting agent.
- the orally- disintegrating porous tablet of this disclosure may further comprise sucralose and at least one flavoring agent.
- the orally-disintegrating porous tablet of this disclosure may further comprise one or more of the following: sucralose, sucrose, glucose, aspartame, fructose, sorbitol, saccharin, cyclamate, or any mixtures thereof.
- the orally-disintegrating porous tablets of this disclosure may be used for treating sialorrhea, controlling excessive production of stomach acid, controlling excessive sweating, and/or managing stomach and/or abdominal pain.
- the orally-disintegrating porous tablets of this disclosure may be used as a medication for a patient afflicted with at least one of the following diseases: stroke, facial paralysis, face cancer, neck cancer, esophageal cancer, metal retardation, Alzheimer’s disease, Parkinson’s disease, cerebral palsy, amyotrophic lateral sclerosis, peptic ulcer, intestinal ulcer, thyroid disease, or neuromuscular disease.
- this disclosure provides a method of treating sialorrhea, controlling excessive production of stomach acid, controlling excessive sweating, and/or managing stomach and/or abdominal pain.
- the method comprises administering to the patient the orally-disintegrating porous tablet of this disclosure, wherein the orally- disintegrating porous tablet comprises a therapeutically effective amount of glycopyrrolate.
- the patient may be afflicted with at least one of the following diseases: stroke, facial paralysis, face cancer, neck cancer, esophageal cancer, metal retardation, Alzheimer’s disease, Parkinson’s disease, cerebral palsy, amyotrophic lateral sclerosis, peptic ulcer, intestinal ulcer, thyroid disease, or neuromuscular disease.
- the orally-disintegrating porous tablet of this disclosure may be administered without water.
- the patient may be a pediatric patient, a geriatric patient and/or the patient has dysphagia.
- the orally- disintegrating porous tablet may be administered in conjunction with an anesthetic agent. Further aspects of this disclosure include methods for treating a patient, the methods comprising administering to the patient the orally-disintegrating porous tablet during induction of anesthesia, intubation or post-surgery.
- compositions for treating a patient for surgical or drug-induced arrhythmia comprising administering to the patient the orally-disintegrating porous tablet of this disclosure.
- the patient may be undergoing a treatment for drug addition.
- this disclosure provides a method of making the orally- disintegrating porous tablet with microscopic pores and comprising a therapeutically effective amount of glycopyrrolate, the method comprising: mixing a water-based suspension of glycopyrrolate in the amount from 0.5 mg to 5 mg per one dosage with at least one filler, at least one binder, at least one emulsifier, and at least one disintegrating agent;
- adjusting a pH of the suspension to be in the range from about 4.0 to about 6.5;
- the disintegrating agent may comprise citric acid, succinic acid, tartic acid, or any combination thereof;
- the filler may comprise mannitol and the disintegrating agent may comprise citric acid;
- the disintegrating agent may comprise citric acid and the pH of the liquid suspension may be in the range from 4.0 to 5.0.
- the filler may comprise mannitol, starch, modified starch, microcrystalline cellulose, xylitol, or any mixtures thereof.
- the binder may comprise gelatin, natural gum, synthetic gum, xanthan gum, acacia, pre-gelatinized starch, starch, methylcellulose, sodium carboxymethyl cellulose, ethyl cellulose, hydroxypropylmethyl cellulose, polyvinylpyrrolidone, polyacrylamide, or any mixtures thereof.
- the emulsifier may comprise Gelucire 44/14; Gelucire 50/13; Imwitor 91; Imwitor 308; Imwitor 380; Imwitor 742; Imwitor 780K; Imwitor 928; Imwitor 988; poloxamer 124; poloxamer 188, or any mixtures thereof
- the suspension may be further mixed with one or more of the following: a sweetener, a flavoring agent, a coloring agent, an antibacterial agent, an anti-fungicidal agent, an absorption enhancer, a taste-masking agent, a lubricant and/or a wetting agent.
- the suspension may be further mixed with sucralose and at least one flavoring agent.
- the suspension may be further mixed with one or more of the following: sucralose, sucrose, glucose, aspartame, fructose, sorbitol, saccharin, cyclamate, or any mixtures thereof.
- This disclosure provides an orally-disintegrating porous tablet comprising a therapeutically effective amount of glycopyrrolate.
- the tablet is referred in the rest of this disclosure as the orally-disintegrating glycopyrrolate tablet.
- the orally-disintegrating glycopyrrolate tablets of this disclosure have an increased bioavailability in comparison to other oral glycopyrrolate tablets comprising the same amount of glycopyrrolate.
- the orally-disintegrating glycopyrrolate tablets of this disclosure disintegrate into a suspension in less than 60 seconds in the mouth and accordingly, these tablets can be taken without water, including by patients with dysphagia or facial paralysis.
- the orally- disintegrating glycopyrrolate tablets of this disclosure are particularly beneficial for pediatric patients, geriatric patients and other patients who may otherwise not be able to swallow their medication with water. Because the orally-disintegrating glycopyrrolate tablets of this disclosure have an increased bioavailability, patients can take glycopyrrolate in lower dosages. For example, a patient may be able to take 0.5 mg, 1 mg, 1. 5 mg or 1.75 mg of glycopyrrolate, instead of 2 mg of glycopyrrolate per one dose.
- the orally-disintegrating glycopyrrolate tablets may be therapeutically effective with lower dosages of glycopyrrolate and therefore, these tablets may help with avoiding or minimizing at least some of the adverse reactions of glycopyrrolate, including xerostomia, decreased sweating, urinary hesitancy and retention, blurred vision, tachycardia, palpitations, headaches, dizziness, nausea, vomiting, nervousness, and other reactions.
- the orally-disintegrating glycopyrrolate tablet of this disclosure is a solid dosage form.
- the orally-disintegrating glycopyrrolate tablet of this disclosure is porous and its surface comprises microscopic pores.
- the orally-disintegrating glycopyrrolate tablet of this disclosure disintegrates rapidly in the mouth and produces a suspension that can be easily swallowed by a patient without water.
- the orally-disintegrating glycopyrrolate tablet is particularly beneficial for people who may have difficulties with swallowing their medication.
- Such patients include patients suffering from dysphagia, pediatric patients, geriatric patients, as well as patients suffering from stroke, patients with brain injuries, patients afflicted with a thyroid disorder or a neurological disorder.
- the orally-disintegrating glycopyrrolate tablet of the present disclosure may be administered to any patient whose condition or symptom may be treated or improved with a formulation comprising glycopyrrolate.
- These patients include cancer patients, and in particular, cancer patients afflicted with face, neck or esophageal cancer.
- Other patients include patients with neurological disorders or neurological disfunctions, including mental retardation, facial paralysis, excessive drooling (sialorrhea), Alzheimer’s disease, Parkinson’s disease, cerebral palsy or amyotrophic lateral sclerosis.
- the orally- disintegrating glycopyrrolate tablet of this disclosure may be beneficial to patients with gastrointestinal diseases, including peptic and/or intestinal ulcer or any other gastrointestinal conditions in which excessive production of stomach acid and/or abnormal intestinal contractions must be controlled, and/or stomach/abdominal pain must be managed.
- the term“to manage or control a symptom” is understood as providing a treatment which minimizes or eliminates the symptom at least for a time period, e.g. until the next dosage of glycopyrrolate must to be taken in order to control/manage the symptom.
- the extent of management can be determined by a patient or caregiver, for example, the patient and/or caregiver reports less drooling or less pain.
- the orally-disintegrating glycopyrrolate tablets of this disclosure address these and other needs.
- the orally-disintegrating glycopyrrolate tablets of this disclosure have an increased bioavailability in comparison to other oral tablets comprising glycopyrrolate. Glycopyrrolate must be used with caution in patients with hepatic or renal disease.
- the orally-disintegrating glycopyrrolate tablets of this disclosure have an increased bioavailability, the orally-disintegrating glycopyrrolate tablets may be therapeutically effective with lower dosages of glycopyrrolate, which may ease the burden on the liver and/or kidneys.
- the increased bioavailability of the orally-disintegrating glycopyrrolate tablets of this disclosure includes both: a statistically significant increase in the rate of glycopyrrolate absorption and a statistically significant increase in the extent of glycopyrrolate absorption.
- the orally-disintegrating glycopyrrolate tablet of this disclosure may provide at least a 10%, and preferably at least a 20% increase in the extent of glycopyrrolate absorption in comparison to a reference oral glycopyrrolate tablet which comprises the same amount of glycopyrrolate, but which is not an orally-disintegrating porous tablet.
- the orally-disintegrating glycopyrrolate tablet of this disclosure may be taken without water, while other oral glycopyrrolate tablets are taken with substantial amounts of water, e.g. with a glass of water (approximately, 240 mL of water).
- Glycopyrrolate exists in four distinct stereoisomeric forms: (R,R)- glycopyrrolate and (S,S)-glycopyrrolate, (R,S)-glycopyrrolate and (S,R)-glycopyrrolate.
- a glycopyrrolate formulation of this disclosure comprises a mixture of at least two out of four stereoisomers: at least a mixture of (R,R)-glycopyrrolate and (S,S)-glycopyrrolate; at least a mixture of (R,R)-glycopyrrolate and (R,S)-glycopyrrolate or at least a mixture of (R,R)-glycopyrrolate and (S,R)-glycopyrrolate.
- a glycopyrrolate formulation of this disclosure comprises a mixture of any three out of four stereoisomers.
- a glycopyrrolate formulation comprises a mixture of all four stereoisomers.
- the formulation comprises only one stereoisomer: (R,R)-glycopyrrolate, (S,S)-glycopyrrolate, (R,S)- glycopyrrolate or (S,R)-glycopyrrolate.
- glycopyrrolate is to be understood broadly and means a dosage of glycopyrrolate effective to treat, ameliorate and/or at least partially improve at least some of the patient’s symptoms.
- the therapeutically effective amount of glycopyrrolate may be adjusted by a medical practitioner, based on the patient’s age, weight, severity of his/her symptoms, glycopyrrolate tolerance, and other factors.
- the therapeutically effective amount of glycopyrrolate may be in the range from 0.1 mg to 10 mg per one oral tablet.
- the therapeutically effective amount of glycopyrrolate may be in the range from 0.5 mg to 5 mg per one oral tablet.
- the orally-disintegrating glycopyrrolate tablets of this disclosure comprise from 0.5 mg to 3 mg of glycopyrrolate per one tablet.
- Preferred formulations may comprise 0.5 mg, 0.75 mg, 1 mg, 1.25 mg, 1.5 mg, 2 mg, 2.5 mg, 2.75 mg or 3 mg of glycopyrrolate per one tablet.
- the orally-disintegrating glycopyrrolate tablets of this disclosure may be taken from one to four times daily, e.g.
- the dosage and administration schedule may be further adjusted by a medical practitioner as needed. It will be appreciated that the effective dosage of glycopyrrolate is based on body weight, among other factors. For children, the dose and administration schedule must be determined by a medical doctor. The dose may be in the range from 0.01 mg of glycopyrrolate to 0.05 mg of glycopyrrolate per kilogram of body weight three times a day. A medical doctor may modify this dosage and administration schedule for each patient individually.
- glycopyrrolate tablet formulations of this disclosure disintegrate orally. These tablets dissolve or disintegrate rapidly, in less than 60 seconds in the patient’s mouth. Thus, there is no need for a patient to swallow an intact tablet or chew it. Instead, the tablet rapidly disintegrates in the mouth. Furthermore, orally-disintegrating glycopyrrolate tablets of this disclosure may be taken without water or only with a minimum amount of water, e.g. one sip of water.
- Rapid oral disintegration means that a tablet breaks up into smaller pieces and/or the tablet becomes at least partially dissolved, and/or forms a suspension soon after the tablet is placed in the mouth.
- the orally-disintegrating glycopyrrolate tablet formulations of the present disclosure are taken orally and they disintegrate in the mouth in less than 1 minute, less than 50 seconds, less than 40 seconds, less than 30 seconds, less than 20 seconds, or less than 10 seconds after being placed in the mouth.
- the orally-disintegrating glycopyrrolate tablets of this disclosure disintegrate in the mouth within 20 to 50 seconds.
- the orally-disintegrating glycopyrrolate tablets of this disclosure do not require water for swallowing.
- the present orally- disintegrating glycopyrrolate tablets make oral glycopyrrolate formulations available for patients who have difficulties in swallowing and/or cannot swallow water. These patients may include pediatric patients, patients with neurological disorders, geriatric patients and other patients who cannot swallow water and/or fluids.
- the orally-disintegrating glycopyrrolate tablets of this disclosure are porous.
- the orally-disintegrating glycopyrrolate tablet of this disclosure is replete with microscopic pores.
- a pore diameter may be in the range from 5 microns to 20 microns.
- a mean pore diameter may be in the range from 10 pm to 15 pm.
- the orally-disintegrating glycopyrrolate tablets of this disclosure comprise several ingredients, each of which will be now described. All percentages of ingredients in the orally-disintegrating glycopyrrolate tablets provided in this disclosure are calculated as weight-by-weight, unless stated otherwise.
- the orally-disintegrating glycopyrrolate tablets of this disclosure are prepared as liquid formulations (suspensions) with water as a main solvent which may be used in combination with other co-solvents.
- the liquid formulations for the orally- disintegrating glycopyrrolate tablet of this disclosure may comprise from 40% by weight to 90% by weight of water.
- the liquid formulations are subjected to freeze-drying by which water is sublimated, and the orally-disintegrating glycopyrrolate tablets are produced.
- the orally-disintegrating glycopyrrolate tablets of this disclosure may comprise from 0.1 mg to 10 mg of glycopyrrolate per one oral tablet.
- the orally- disintegrating glycopyrrolate tablets of this disclosure comprise from 0.5 mg to 5 mg of glycopyrrolate per one oral tablet.
- the orally-disintegrating glycopyrrolate tablets of this disclosure comprise from 0.5 mg to 3 mg of glycopyrrolate per one tablet.
- the orally-disintegrating glycopyrrolate tablets of the present disclosure may further comprise one or more excipients selected from a filler (bulking agent), a binder (gelling agent), a dispersant (emulsifier), a sweetener, a flavoring agent, a disintegrating agent, a lubricant, a colorant, a preservative and/or wetting agent.
- a filler bulking agent
- a binder gelling agent
- a dispersant emulsifier
- sweetener e.g., a sweetener, a flavoring agent, a disintegrating agent, a lubricant, a colorant, a preservative and/or wetting agent.
- Suitable fillers include, but are not limited to, mannitol, various starches, microcrystalline cellulose, xylitol or any mixtures thereof.
- the orally- disintegrating glycopyrrolate tablets of this disclosure comprise mannitol.
- the filler such as for example as mannitol, is used in an amount from 1% to 20% by weight of the liquid formulation before freeze-drying, including water, in the orally-disintegrating glycopyrrolate tablets of this disclosure.
- the filler such as for example as mannitol
- the filler is used in an amount from 1% to 10% by weight of the liquid formulation before freeze-drying, including water.
- the filler, such as for example as mannitol is used in an amount from 1% to 5% by weight of the liquid formulation before freeze-drying, including water.
- Suitable binders include, but are not limited to, gelatin, natural gum, synthetic gum, xanthan gum, acacia, pre-gelatinized starch, starch, methylcellulose, sodium carboxymethyl cellulose, ethyl cellulose, hydroxypropylmethyl cellulose, polyvinylpyrrolidone, polyacrylamide, or any mixtures thereof.
- the orally-disintegrating glycopyrrolate tablets of this disclosure comprise gelatin.
- the binder, such as for example as gelatin is used in an amount from 1% to 20% by weight of the liquid formulation before freeze-drying, including water, for the orally-disintegrating glycopyrrolate tablets of this disclosure.
- the binder, such as for example as gelatin is used in an amount from 1% to 10% by weight of the liquid formulation before freeze-drying, including water.
- Suitable emulsifiers include, but are not limited to, Gelucire 44/14; Gelucire
- the orally- disintegrating glycopyrrolate tablets of this disclosure comprise poloxamer 188.
- the emulsifier, such as for example as poloxamer 188 is used in an amount from 0.001% to 1% by weight of the liquid formulation before freeze-drying, including water, for the orally-disintegrating glycopyrrolate tablets of this disclosure.
- the emulsifier, such as for example as poloxamer 188 is used in an amount from 0.01% to 0.10% by weight of the liquid formulation before freeze-drying, including water.
- Suitable sweeteners include, but are not limited to, sucralose, sucrose, glucose, aspartame, fructose, sorbitol, saccharin and its salts, cyclamate and its salts, or any mixtures thereof.
- the orally-disintegrating glycopyrrolate tablets of this disclosure comprise sucralose.
- the sweetener such as for example as sucralose
- the sweetener is used in an amount from 0.001% to 1% by weight of the liquid formulation before freeze- drying, including water, for the orally-disintegrating glycopyrrolate tablets of this disclosure.
- the sweetener such as for example as sucralose, is used in an amount from 0.1% to 1.00% by weight of the liquid formulation before freeze drying, including water.
- Suitable flavoring agents include, but are not limited to, cherry flavor, black cherry flavor, mint flavor, vanilla flavor, strawberry flavor, grape flavor, cotton candy flavor or any other flavor, or mixtures thereof.
- the flavoring agent is used in an amount from 0.001 % wt to 5 % wt of the formulation total before freeze-drying, including water.
- the flavoring agent is used in an amount from 0.01 % wt to 1% of the formulation total, including water.
- Disintegrating agents include, but are not limited to, citric acid, succinic acid, and tartic acid. Other disintegrating agents may be also used.
- the orally- disintegrating glycopyrrolate tablets of this disclosure comprise citric acid.
- the disintegrating agent such as for example as citric acid
- the disintegrating agent is used in an amount sufficient to adjust pH of the liquid formulation for orally-disintegrating glycopyrrolate tablets to weakly acidic.
- a pH for the liquid formulation for the orally-disintegrating glycopyrrolate tablets may be in the range from 4.0 to 6.5, and preferably in the range from 4.0 to 5.0.
- from 0.01% to 1% wt of the disintegrating agent, such as for example citric acid may be used to adjust pH of the liquid formulation as necessary.
- the orally-disintegrating glycopyrrolate tablets of this disclosure may comprise some other ingredients such as one or more of the following: a coloring agent, an antibacterial agent, an anti-fungicidal agent, an absorption enhancer, a taste-masking agent such as for example, sodium bicarbonate, a lubricant and/or a wetting agent.
- a coloring agent such as one or more of the following: a coloring agent, an antibacterial agent, an anti-fungicidal agent, an absorption enhancer, a taste-masking agent such as for example, sodium bicarbonate, a lubricant and/or a wetting agent.
- a coloring agent such as one or more of the following: a coloring agent, an antibacterial agent, an anti-fungicidal agent, an absorption enhancer, a taste-masking agent such as for example, sodium bicarbonate, a lubricant and/or a wetting agent.
- a taste-masking agent such as for example, sodium bicarbonate, a lubric
- the present disclosure provides the orally-disintegrating glycopyrrolate tablet which comprises some other active ingredients in addition to glycopyrrolate. These other active ingredients may include, but are not limited to, an anti- inflammatory drug and/or an analgesic.
- the present disclosure provides methods for making the orally-disintegrating glycopyrrolate tablet of this disclosure.
- the orally-disintegrating glycopyrrolate tablet according to this disclosure is made by lyophilization (freeze-drying). In some freeze-drying methods, the liquid formulation comprising a therapeutically effective amount of glycopyrrolate is made with suitable excipients and water.
- the liquid formulation comprises an effective amount of glycopyrrolate, at least one filler, at least one binder, at least one emulsifier, at least one sweetener, at least one flavoring agent, and at least one disintegrating agent.
- these liquid formulations can be made with water as a solvent.
- the liquid formulation comprise ingredients listed in Table 1.
- pH of the liquid formulation is adjusted and is in the range from about 4.0 to about 6.5.
- pH of the suspension is adjusted and is in the range from about 4.0 to about 5.0.
- Preferred liquid formulations comprise glycopyrrolate in an amount from 0.5 mg to 2 mg per one tablet, mannitol, gelatin, poloxamer 188, sucralose, at least one flavoring agent, citric acid and water. pH of the liquid formulation is adjusted and is in the range from 4.0 to 5.0.
- the resulting liquid formulation which is a suspension
- the blister molds are passed through a freezing tunnel cooled by liquid nitrogen. A step of freezing may be performed at a temperature in the range from -40°C to -80°C. This freezes water in the glycopyrrolate suspension and makes it ready for loading into low-temperature storage ahead of a freeze-drying process. As soon as a sufficient number of blister molds have been filled and frozen, water sublimation can begin by drying the blister molds.
- the blister molds are transferred to a freeze-dryer.
- the drying causes frozen water to evaporate from the solid phase to the gas phase and creates microscopic pores in a tablet formulation.
- a temperature is kept below freezing.
- the primary drying temperature is in the range from - 10°C to -20°C.
- This step is completed in vacuum, such for example that the pressure is at about 0.1 mbar or lower.
- a temperature may be increased to room temperature (typically, 20°C). This step of secondary drying may also be carried in vacuum.
- the blister molds When lyophilization is complete and water is sublimated, the blister molds are passed through a blister sealer, where they are sealed with aluminium foil or a suitable paper laminate. The sheets of blister molds are cut to size, and the foil perforated to facilitate opening by a patient.
- this disclosure provides a kit comprising the orally- disintegrating porous glycopyrrolate tablets of this disclosure, prescribing information and a container, such a plastic vial, a box, and/or a sheet of blister molds.
- the container may be a sheet of blister molds.
- the prescribing information may be printed on the sheet of the blister molds.
- this disclosure relates to methods of treatment which comprise administering to a patient the orally-disintegrating porous glycopyrrolate tablet of this disclosure, which may be administered without water and which may be further administered as an adjunctive therapy with other medications and treatments.
- the patients include patients in need of managing sialorrhea (excessive drooling), managing excessive sweating, preventing vomiting, managing excessive stomach acid secretion, managing excessive intestinal contractions, and/or managing stomach and/or abdominal pain.
- the patients include, but are not limited to, a patient with any of the following diseases or conditions: a neurological disorder, motor deficits, cerebral palsy, facial paralysis, mental retardation, Parkinson’s disease, Alzheimer’s disease, stroke, cancer, thyroid disease, irritable bowel syndrome, inflammatory bowel disease, Crohn’s disease, gastric ulcer, stomach ulcer, or a neuromuscular disease.
- the patients also include any other patients for whom an anticholinergic drug can be beneficial.
- the patients include patients with dysphagia.
- the patients also include pediatric and geriatric patients.
- the present disclosure provides a method for administering the orally-disintegrating glycopyrrolate tablet of this disclosure in conjunction with a variety of anesthetic agents, including sedatives and barbiturates.
- the orally-disintegrating glycopyrrolate tablet of this disclosure may be useful for patients during a preoperative procedure in order to reduce salivary, tracheobronchial and pharyngeal secretions.
- this disclosure provides a method in which a patient is administered the orally-disintegrating porous glycopyrrolate tablet of this disclosure without water during induction of anesthesia and/or intubation. In further aspect, this disclosure provides a method in which a patient is administered the orally-disintegrating porous glycopyrrolate tablet of this disclosure without water during a surgical procedure.
- this disclosure provides a method in which a patient is administered the orally-disintegrating porous glycopyrrolate tablet of this disclosure without water in order to counteract surgical and/or drug-induced arrhythmia.
- the drug-induced arrhythmia may be induced by narcotics (opioids) or some other controlled substances.
- a patient may be in need of treatment for drug overdose or he/she may be undergoing a treatment for drug addiction
- the orally-disintegrating porous glycopyrrolate tablet with 2 mg of glycopyrrolate per one tablet was prepared by mixing a liquid formulation comprising glycopyrrolate, mannitol, gelatin, poloxamer 188, sucralose, a flavoring agent, and citric acid and water, as reported in Table 1.
- the pH of the liquid formulation with adjusted to 4.0-5.0. This suspension was then subjected to freeze-drying and tablets were produced. The resulting tablets were used as the test orally-disintegrating glycopyrrolate tablets (the test ODT) in a pharmacokinetic and bioavailability analysis as reported below.
- a pharmacokinetic and bioavailability analysis was conducted for the orally- disintegrating glycopyrrolate tablet comprising 2 mg of glycopyrrolate (the test ODT).
- the analysis was conducted in comparison to a reference oral tablet from Par Pharmaceutical Inc which also comprised 2 mg of glycopyrrolate, referred to as the reference tablet.
- the analysis included obtaining pharmacokinetic (PK) profiles of the test ODT tablet, glycopyrrolate 2 mg, and the reference tablet, glycopyrrolate 2 mg, Par Pharmaceuticals Inc.
- PK pharmacokinetic
- the PK profiles of glycopyrrolate were investigated after administration of a single dose of 2 mg of each of the two formulations, under fasting conditions.
- the dosage in this study included a single oral dose of glycopyrrolate 2 mg (as tablets), on each of two separate occasions, under fasting conditions.
- the dose administered is recommended for adults (18 years and older) for the treatment of chronic severe drooling.
- the reference tablet was swallowed whole with 240 mL water.
- the test ODT tablet was placed on the tongue until disintegration and then it was swallowed without water.
- Terminal elimination rate constant (l z ); and • Apparent terminal elimination half-life (t 1 ⁇ 2 z).
- Table 2 provides a summary of descriptive statistics of the PK parameters.
- Table 3 is a summary of statistical analyses of plasma glycopyrrolate pharmacokinetic parameters.
- CV coefficient of variation
- LS least square mean
- Reference Product (A) Glycopyrrolate 2 mg tablet, Par Pharmaceutical Inc., USA, given under fasting condition.
- the term“confidence interval” is abbreviated as Cl.
- the 90% CIs for the "test/reference” mean ratios of the primary parameters Cmax, AU o-p and AUC ( o- ) for glycopyrrolate are 103.67% to 156.86%, 101.45% to 143.32% and 102.26% to 143.31%, respectively.
- Dissolution of the test ODT product ranged between 11 seconds to 50 seconds with arithmetic mean dissolution time of 28 seconds.
- the tmax was 3.50 hours and 3.01 hours for the reference tablet and the test ODT tablet, respectively, and was not statistically different between the two products.
- the upper limit of the 90% CIs for all primary PK parameters were outside the pre-defined acceptance limits of 80.00% to 125.00%.
- the reference product, glycopyrrolate 2 mg tablets, and the test ODT product, glycopyrrolate 2 mg in oral disintegration tablet according to this disclosure are not equivalent with regards to both the rate and extent of absorption.
- the test ODT product has a higher rate and extent of absorption, leading to a conclusion that the bioavailability in the orally-disintegrating glycopyrrolate tablets according to the present disclosure is increased in comparison to a reference oral glycopyrrolate tablet.
- test ODT medication was well tolerated by all subjects (5 subjects experienced 8 AEs) during treatment with 2 mg of glycopyrrolate per treatment period. The most common AE was dry throat, experienced by 2 subjects. All the events of dry throat were considered by the investigator to be related to the IMP and of mild intensity. None of the subjects exhibited any redness, swelling or erosion/ulceration following administration of the test product. Laboratory tests, vital signs assessments, ECGs and physical examination results were compatible with expectations for a healthy male and female population.
- test ODT medication is not equivalent to the reference tablet with respect to the rate and extent of absorption of glycopyrrolate.
- the test ODT tablet has an increased bioavailability, including an increase in the rate and also in the extent of absorption of glycopyrrolate.
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Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN201980095960.1A CN113784711A (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablet comprising glycopyrronium bromide and method for increasing bioavailability |
PCT/US2019/021763 WO2020185214A1 (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability |
EP19918539.8A EP3923931A4 (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability |
US17/049,476 US20210161824A1 (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability |
JP2021555067A JP2022533510A (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablets containing glycopyrrolate and methods for increasing bioavailability |
BR112021017943A BR112021017943A2 (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating porous tablet with microscopic pores, and, method for preparing an orally disintegrating porous tablet with microscopic pores |
KR1020217029177A KR20210154964A (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability |
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PCT/US2019/021763 WO2020185214A1 (en) | 2019-03-12 | 2019-03-12 | Orally disintegrating tablets comprising glycopyrrolate and methods for increasing bioavailability |
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US (1) | US20210161824A1 (en) |
EP (1) | EP3923931A4 (en) |
JP (1) | JP2022533510A (en) |
KR (1) | KR20210154964A (en) |
CN (1) | CN113784711A (en) |
BR (1) | BR112021017943A2 (en) |
WO (1) | WO2020185214A1 (en) |
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US11672761B2 (en) | 2020-11-16 | 2023-06-13 | Orcosa Inc. | Rapidly infusing platform and compositions for therapeutic treatment in humans |
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- 2019-03-12 EP EP19918539.8A patent/EP3923931A4/en not_active Withdrawn
- 2019-03-12 BR BR112021017943A patent/BR112021017943A2/en not_active IP Right Cessation
- 2019-03-12 KR KR1020217029177A patent/KR20210154964A/en unknown
- 2019-03-12 JP JP2021555067A patent/JP2022533510A/en active Pending
- 2019-03-12 US US17/049,476 patent/US20210161824A1/en not_active Abandoned
- 2019-03-12 WO PCT/US2019/021763 patent/WO2020185214A1/en active Application Filing
- 2019-03-12 CN CN201980095960.1A patent/CN113784711A/en active Pending
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US11672761B2 (en) | 2020-11-16 | 2023-06-13 | Orcosa Inc. | Rapidly infusing platform and compositions for therapeutic treatment in humans |
Also Published As
Publication number | Publication date |
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EP3923931A1 (en) | 2021-12-22 |
US20210161824A1 (en) | 2021-06-03 |
JP2022533510A (en) | 2022-07-25 |
EP3923931A4 (en) | 2022-10-26 |
KR20210154964A (en) | 2021-12-21 |
CN113784711A (en) | 2021-12-10 |
BR112021017943A2 (en) | 2021-11-16 |
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