Compositions and methods to prevent abuse of opioids

专利摘要:
The present invention is directed to preventing abuse of opioid antagonist formulations comprising at least one effective amount of an aversive agent for reducing abusers administering the formulations via opioid agonists and intravenously, through the nose, and / or orally injured formulations. The composition and method for.
公开号:KR20040060917A
申请号:KR10-2004-7001878
申请日:2002-08-06
公开日:2004-07-06
发明作者:크리스토퍼 브레더；로버트 커루치；벤자민 오쉴랙；리차드 쌔클러；커티스 라이트
申请人:유로-셀티크 소시에떼 아노뉨；
IPC主号:

专利说明:

Compositions and methods to prevent abuse of opioids
[2] Opioid preparations are sometimes drugs that are abused. In general, certain oxycodone doses are more potent when administered parenterally than when compared to the same dose administered orally. Thus, certain modes of abuse of oral opioid formulations involve the extraction of opioids from the formulation to perform "high" and infusion of opioids (using any excipient "suitable for infusion").
[3] In the prior art, attempts have been made to control the likelihood of abuse associated with opioid analgesics. For example, Talwin Nx from Sanofi-Winthrop, which contains a combination of immediate-release pentazocine and naloxone in tablets, is sold in the United States. Talwin Nx comprises 50 mg of base isotropic pentazosin hydrochloride up to 50 mg and naloxone hydrochloride up to 0.5 mg base. The content of naloxone present in these combinations has low activity when administered orally and minimally interferes with the pharmaceutical action of pentazocin. However, this amount of naloxone administered parenterally has a deep antagonistic action against anesthetic analgesics. Therefore, the incorporation of naloxone is intended to inhibit the form of misuse of oral pentazosin that occurs when the formulation is dissolved or infused. Thus, such formulations have a lower probability of parenteral misuse than previous oral pentazosin preparations.
[4] Stable combination therapies, including tilidine (50 mg) and naloxone (4 mg), have been commercially sold in Germany since 1978 to treat pain. (Valoron N, Goedecke). Reasonable combinations of these drugs are effective in alleviating and preventing the pain of tilidine poisoning through naloxone-induced antagonism at morphine receptors.
[5] A stable combination of bufurenolpine and naloxone was introduced in 1991 in New Zealand for the treatment of pain (Temestic Nx, Reckitt & Colman).
[6] Currently, sustained-release oxycodone is marketed under the trademark OxyContin under Purdue Pharma L. P, containing 10, 20, 40 and 160 mg of oxycodone hydrochloride.
[7] U.S. Patent 5,266,331; 5,508,042; 5,549,912 and 5,656,295 describe slow release oxycodone formulations.
[8] In US Pat. Nos. 4,769,372 and 4,785,000, Kreek uses 1 to 2 dosage units containing 1 to 2 mg of opioid antagonist with 1.5 to 100 mg of opioid analgesic or 1 to 18 mg of opioid antagonist with little or no antagonism of tissue when orally administered. It describes how to treat a patient suffering from chronic pain or chronic cough that does not cause dysmotility of the intestine by double doses.
[9] In US Pat. No. 6,228,863, Palermo et al. Describe compositions and methods for preventing abuse of opioid formulations.
[10] Also in WO 99/32119, Kaiko et al. Describe compositions and methods for preventing abuse of opioid formulations.
[11] In US Pat. No. 5,472,943, Crain et al. Describe a method for increasing analgesic efficacy bimodally by administering an opioid agonist and an opioid antagonist together.
[12] In addition, Shaw et al., In US Pat. No. 3,980,766, describe a drug suitable for treatment by oral use in the treatment of drug addiction such as methadone, which has a thickening property that rapidly increases the viscosity in the concentration of aqueous solution. It is formulated to prevent infusion abuse through concentration of the active ingredient in an aqueous solution by inclusion of an ingestible solid drug in the form of a solid formulation or tablet.
[13] However, there is still a need for safe and effective drugs to treat pain with opioid analgesic formulations that can further suppress abuse than current treatments.
[14] All documents mentioned in the present invention, including the documents mentioned above, are incorporated herein by reference in their original form for the purposes of the present invention.
[1] The present invention relates to an oral formulation composition comprising an aversive agent to prevent abuse of the formulation when administering a damaged formulation to the opioid agonist, opioid antagonist in order to prevent abuse of the opioid, and a preparation method thereof.
[15] It is an object in a preferred embodiment of the present invention to provide oral formulations of opioid agonists with less parenteral abuse than other formulations.
[16] It is an object in a preferred embodiment of the present invention to provide oral formulations of opioid agonists with less abuse through the nose than other formulations.
[17] It is an object in a preferred embodiment of the present invention to provide oral formulations of opioid agonists with less oral abuse than other formulations.
[18] It is an object in a preferred embodiment of the present invention to provide oral formulations of opioid agonists with less diversion than other formulations.
[19] It is an object in a preferred embodiment of the present invention to provide a method for treating analgesia in a human patient using an oral formulation of an opioid agonist while reducing the likelihood of abuse of the formulation.
[20] The object in a preferred embodiment of the present invention is also to provide a method for preparing an oral formulation of an opioid analgesic, which formulation is less likely to be abused.
[21] These objects and others will be accomplished by the present invention, which includes opioid agonists; Opioid antagonists; And one or more aversive agents for reducing abuse of opioid agonists.
[22] In some embodiments of the invention, the oral dosage form of the invention comprises an opioid agonist; Opioid antagonists; And drugs as components of the formulation that can help prevent dosage abuse by reducing the "attractiveness" of the formulation to one or more aversive agents or abusers for reducing abuse of opioid agonists.
[23] In certain embodiments of the present invention, the formulation comprises an aversive agent, such as a bittering agent, which damages the formulation to abandon abusers, thereby inhaling and swallowing the damaged formulation. Preferably the bitter agent is released when it is damaged and gives the abuser a bad taste when inhaling and / or swallowing the damaged formulation.
[24] In certain embodiments of the invention, the formulation comprises an aversive agent, such as an irritant, which damages the formulation to discourage abusers, thereby inhaling and swallowing the damaged formulation. Preferably, the stimulant is released when damaged and will provide the burning or irritating effect on abusers when inhaling, injecting, and / or swallowing the damaged formulation.
[25] In certain embodiments of the present invention, the formulation comprises an aversive agent, such as a gelling agent, that damages the formulation to discourage abusers, thereby inhaling, injecting or swallowing the damaged formulation. Preferably, the gelling agent is released when it is damaged, making the damaged formulation into a gel-like form that slows the absorption of opioid agonists, thereby allowing abusers to get a faster "high" less.
[26] In some embodiments, when the formulation is damaged or exposed by small amounts (up to about 10 ml) of an aqueous liquid (eg, water), the formulation will be inadequate for administration and / or inhalation. In addition to such aqueous liquids, the impaired formulation will be thick and viscous to be inadequate for administration. The term "unsuitable for injection" is defined for the purposes of the present invention, since the injection of the formulation is actually difficult due to the viscosity of the formulation (e.g., to push the formulation through a syringe). Difficult or due to pain during administration), which prevents the abuse of opioid analgesics in the formulation. In certain embodiments, the gelling agent is a high viscosity material that is unsuitable for infusion by being present at such a content in the formulation that attempts to evaporate (heat) the aqueous mixture of the formulation in an effort to provide higher concentrations to the therapeutic drug. To manufacture.
[27] If the damaged formulation is inhaled through the nose, the gelling agent will be gelled through the nose due to the moisture of the mucous membrane. In addition, such formulations become repellent for administration through the nose, such as the gel sticking as they pass through the nose and minimizing absorption of the substance of abuse.
[28] In certain preferred embodiments of the present invention, the formulation comprises all or some combination of the above-mentioned aversive agents (gummy, stimulant, and / or gelling agents), which, after disabling abusers from damage to the formulation, Damaged formulations are inhaled, infused and / or swallowed.
[29] In particular contemplated embodiments, bitters; Gelling agents; irritant; Bitters and gelling agents; Bitter and stimulant; Gelling and stimulating agents; Bitters and gelling agents; Bitter and stimulant; Gelling and stimulating agents; And bitters, gelling agents and stimulants.
[30] In certain preferred embodiments, the dosage form is a controlled release oral dosage form comprising a therapeutically effective amount of an opioid analgesic and an opioid antagonist together with one or more aversive agents as described herein, wherein the dosage form is a human patient. When administered orally, it is effective at alleviating pain at least 12 hours, or at least 24 hours.
[31] In certain embodiments of the invention, the opioid antagonist present in the formulation is present in substantially non-release form (ie, sequestered) when the formulation is administered intact, as already mentioned. Preferably, the opioid antagonist present in the formulation is in fact a non-release form, so when administered orally in an intact form of the formulation, it does not substantially block the analgesic effect of the opioid agonist, but it does stop opioid resistance or patient dependence. Take no risk of dropping.
[32] In certain embodiments of the invention, the aversive agent present in the formulation is in place of or in addition to the opioid antagonist, which is substantially non-release form, in substantially non-release form (isolated).
[33] In other embodiments, the aversive agent is not "isolated" as described above, wherein the aversive agent is released or minimally released from the intact formulation, but discards the aversive agent in certain sections of the gastrointestinal tract as described above. Since it is deformed or sustained release in order not to support it, it may generate an unwanted effect such as excessive pain. Aversive agents can be combined with enteric carriers that can delay their release or can be combined with carriers to provide sustained release of the aversive agent. However, even if all of the aversive agents of the present invention are immediately released from oral dosages of intact formulations, the aversive agents of the present invention do not have any particular side effects (eg, side effects of the gastrointestinal tract). In addition, the aversive agents included in the formulation may be in any combination of releasable and non-release forms. For example, the formulations are in releasable and non-release forms in bitters, irritants, gels, or combinations thereof, which were incorporated in August 2002 under the title "Compositions and Methods for Preventing Abuse of Opioids". Filed on Day 6. In addition, the antagonists of the present invention, filed on August 6, 2002, in the form of a releasable, non-release form, or combination thereof, entitled "Pharmaceutical formulations comprising opioid agonists, release antagonists and sequestered antagonists" Described in US patents, these materials are incorporated by reference in the present invention, which may be combined with one of the aversive agents described herein.
[34] For example, the antagonist of the present invention may be an antagonist with minimal oral activity, such as naloxone in a release or "non-isolated" form. Including such antagonists can prevent parenteral abuse of the formulation, and the aversive agents of the invention (eg bitter, stimulant, gelling agents) can prevent abuse of the formulation orally and through the nose. . In addition, the formulations may include "isolated" antagonists, such as biocompatible antagonists, and may further prevent oral and nasal abuse of the formulations due to administration of the impaired formulation.
[35] "Aversive agent" is intended to fulfill the purpose of the present invention and means such as bitters, irritants or gelling agents.
[36] “Damaged formulation” is for the purposes of the present invention and means a formulation modified by mechanical, thermal, and / or chemical methods that change the physical properties of the formulation, for example, if it is sustained release, ie To make opioid agonists useful for improper use, such as liberate opioid agonists for analgesia or administered via selective routes such as parenteral. The damage here can be carried out by grinding, shearing, grinding, chewing, dissolving in a solvent, heating (for example at least 45 ° C.) or any combination thereof.
[37] The term "substantially non-releasable form" refers to oral administration (without damage) of an intact formulation comprising an opioid agonist, an opioid antagonist, and one or more aversive agents, 1 Opioid antagonists and / or aversive agents that are not released in time or are not actually released. Practically including formulations of opioid antagonists in non-release forms of formulations are described in US patent application Ser. No. 09 / 781,081, entitled “Damage Resistant Oral Opioid Agonist Formulations,” February 8, 2001. And is incorporated by reference of the present invention. For the purposes of the present invention, the amount released after oral administration of an intact formulation is 75 ml at 37 rpm using USP Type II (paddle) apparatus in 900 ml of simulated gastric fluid in vitro (in-vitro) ) It was measured based on the eluted. Such formulations are also referred to as including "isolated antagonists" and / or "isolated aversive agents," depending on the drug or drugs that are not released or are not actually released. In certain preferred embodiments of the present invention, substantially non-releasing formulations of antagonists and / or agonists are used to maintain delayed colon transport and to be resistant to achlorhydric states. For example, mineral oil). Preferably, the aversive agent is not released or actually released at 4, 8, 12 and / or 24 hours after oral administration.
[38] "At least partially blocking the opioid effect" is consistent with the object of the present invention that an opioid antagonist at least completely blocks the euphoric effect of an opioid agonist and thereby opioids in the formulation. Reduces the potential for abuse of agonists.
[39] The term "anagesic effectiveness" is measured by human patients and is consistent with the object of the present invention as being able to sufficiently reduce or eliminate the pain of acceptable side effects.
[40] "Not substantially blocking the analgesic effect of an opioid agonist" means that an opioid antagonist is provided as an analgesic to a sufficient extent, such as to be a less therapeutically effective formulation. It does not block the effect.
[41] The term "sustained release" refers to the rate of blood (eg, plasma) concentration (level) maintained within the therapeutic range (the minimum effective analgesic concentration or "MEAC"). It refers to the release of opioid agonists from oral formulations, but below the toxic level of at least 8 to 24 hours, preferably at least twice a day or at least one time per day.
[42] The term "particles" of an opioid antagonist, as used herein, consists of granules, spherioids, beads or pellets composed of opioid antagonists. In certain preferred embodiments, the opioid antagonist particles have a diameter of about 0.2-2 mm, more preferably about 0.5-2 mm.
[43] The term "parenterally" as used herein includes subcutaneous injection, intravenous injection, intramuscular injection, injection through the sternum, infusion techniques or infusion techniques well known in the art.
[44] "Inhaled" includes lubricates through the mucosa, through the bronchus and through the nose.
[45] A "bittering agent" is an administration of an impaired formulation of the invention to an abuser and includes compounds used to impart bitterness, bitter aroma.
[46] An "irritant" includes a compound used to arouse a feeling of burning, discomfort, etc. by administering a damaged formulation of the invention to an abuser.
[47] A "gelling agent" includes a compound or composition that is used to impart gel-like or viscous properties to additional moisture or liquid of a damaged formulation.
[48] The aversive agents of the present invention are preferably used in connection with oral formulations comprising opioid analgesics and opioid antagonists, which are beneficial as analgesics but can be abused. Specifically controlled release opioid analgesic products have large doses of certain opioid analgesics that are induced to be released over a period of time in each dose unit. In general, drug abusers take controlled release products, and due to grinding, shearing, grinding, chewing, dissolving and / or heat, extraction or other intermingling, the total content of the formulation may be injected, inhaled, and / or oral It is useful for immediate absorption.
[49] In certain embodiments, the present invention includes methods that, together with opioid antagonists and opioid analgesics, can prevent or inhibit abuse of opioid analgesics by inclusion of one or more aversive agents in the formulation.
[50] In certain embodiments of the present invention, the formulation comprises an aversive agent comprising a bitter agent, and various bitter agents are, for example, not particularly limited, natural, artificial and synthetic flavor oils and flavor aromatic aromatics and / or Oils, resins and extracts derived from plants, leaves, flowers, fruits and the like and combinations thereof. Representative non-limiting flavor oils include spearmint oil, peppermint oil, eucalyptus oil, nutmeg, allspice, mace, bitter almond oil, menthol and the like. Useful bitters also include citrus oils, including artificial, natural and synthetic aromatic fruits, including, for example, lemons, oranges, limes, grapefruits, fruit water and the like. Additional bitters include sucrose derivatives (eg sucrose octaacetate), chlorosucrose derivatives, quinine sulfate and the like. A preferred bitter of the present invention is Denatonium Benzoate NF-Anhydrous, sold under the trade name Bitrex.
[51] The inclusion of a bitter agent in the formulation damages the formulation resulting in inhalation or a bitter taste upon inhalation or oral administration, which in certain embodiments ruins or hides the pleasure of obtaining a "high" from the damaged formulation. Prevent abuse of the formulation.
[52] These bitter agents will vary depending on the particular bitter agent used, but are less than 50% by weight, preferably less than 10% by weight, even more preferably less than 5% by weight, most preferably 0.1 to 1.0% by weight in the formulation. Included as. Formulations containing bitter agents will give up the impaired taste or odor to the impaired formulation, thereby discouraging improper use of the impaired formulation.
[53] In certain embodiments of the invention, the formulation herein comprises an aversive agent, including a stimulant, and various stimulants that may be included are capsaicin analogs having similar forms of properties, such as capsaicin, capsaicin, and the like. Some capsaicin analogues or derivatives include, for example, resiniferatoxin, tinyatoxin, heptanoylisobutylamide, heptanoylguaiacylamide, other isobutylamides or spheres Iacylamides, dihydrocapsaicin, homovanylyloctylesters, nonanoyl vanylylamides, or other compounds of the species known as vanilloids, and the like, but are not limited thereto. For example, US Pat. No. 5,290,816 (Blumberg), registered March 1, 1994, describes resin eferatosine; US Pat. No. 4,812,446 (Brand), registered March 14, 1989, describes capsaicin analogs and methods for their preparation. In addition, US Pat. No. 4,424,205 (LaHann et al.), Registered January 3, 1984, cites "natural and synthetic pepper-aromatics" issued in 1954 as a stimulus list of capsaicin-like analogs. In the UK Pharmacology Journal (10, pp. 175-182, 1995), Ton et al. Describe the pharmaceutical action of capsaicin and its analogs.
[54] When containing a stimulant (e.g. muxisin) in the formulation, when the formulation is damaged by capsaicin, give the abuser a feeling of burning or discomfort, giving up inhalation, injection or oral administration of the damaged formulation. To prevent abuse of the formulation. Suitable capsaicin compositions comprise 0.00125-50% by weight, preferably 1-7.5% by weight, more preferably 1-5% by weight of capsaicin (trans 8-methyl-N-vanylyl-6-nonaneamide) or analogs thereof Included in concentration.
[55] In certain embodiments of the invention, the formulation includes an aversive agent comprising a gelling agent, wherein the various gelling agents include alcohols derived from alcohols such as sugar, mannitol, sorbitol, starch and starch derivatives, microcrystalline cellulose, Cellulose derivatives such as sodium carboxymethyl cellulose, methylcellulose, ethyl cellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, and hydroxypropyl methylcellulose, attapulgite, bentonite, dextrin, alginate, carrageenan, tragacont Gum, acacia gum, guar gum, xanthan gum, pectin, gelatin, kaolin, lecithin, magnesium aluminum silicate, carbomer and carbopol, polyvinylpyrrolidone, polyethylene glycol, polyethylene oxide, polyvinyl alcohol , Silicon dioxide, surfactants, surfactant / wetting agent mixing system, emulsifier, other high It includes a character materials and a mixture thereof, but the embodiment is not limited thereto. In certain embodiments, the gelling agent is xanthan gum. In another preferred embodiment, the gelling agent of the present invention is pectin. Pectin or pectin materials useful in the present invention include not only purified or isolated pectates, but also natural pectin raw materials, such as apples, citrus or squeezable sugar beet residues and the like. If necessary, it can be esterified or de-esterified by acali or enzyme. Preferably, the pectin used in the present invention is derived from citrus fruit such as lime, lemon, grapefruit and orange.
[56] When the formulation contains a gelling agent, when the formulation is damaged, the gelling agent makes the damaged formulation feel like a gel, thereby quickly “high” from the damaged formulation due to the gel-like feeling of continuous contact with the thickening membrane. To impair or hide the feeling of obtaining, in some embodiments, to prevent abuse of the formulation by minimizing absorption, such as in the passage of the nose. The gelling agent added to the formulation is about 1:40 to 40: 1 weight ratio, preferably 1: 1 to 30: 1 weight ratio, more preferably 2: 1 to 10: 1 in the ratio of gelling agent to opioid agonist It is weight ratio.
[57] In certain other embodiments, the formulation is dissolved in an aqueous liquid (0.5-10 ml and preferably 1-5 ml) to form a viscous gel after the formulation is damaged so that the mixture has a viscosity of at least 10 cP. Most preferably, the resulting mixture will have a viscosity of at least 60 cP.
[58] In certain preferred embodiments, the formulation is dissolved in an aqueous liquid (0.5 to 10 ml and preferably 1 to 5 ml) to form a viscous gel after the formulation is damaged and then heated (at least 45 ° C.) and the mixture is at least 10 cP Has a viscosity. Most preferably, the resulting mixture will have a viscosity of at least 60 cP.
[59] In other embodiments, the formulation will comprise one or more of the aforementioned aversive agents. For stability, certain amounts of scents, stimulants, or gelling agents can be included in the formulations of the present invention, which are not toxic to humans.
[60] Opioid antagonists useful in the present invention include naltrexone, naloxone, nalmefene, nalide, nalide, nalmexone, nalorphine and dinicotinate. Cyclazocine, levalorphan, pharmacologically acceptable salts thereof, and mixtures thereof. In certain specific embodiments, the opioid antagonist is naloxone or nalroxone. In certain embodiments, the amount of opioid antagonist in the formulation is 10 ng to 275 mg.
[61] Naloxone is an opioid antagonist with little agonist effect. Subcutaneous doses of more than 12 mg of naloxone show no pronounced effect, with only 24 mg of naloxone showing only slight drowsiness. Small doses of naloxone doses (0.4-0.8 mg) are administered intramuscularly or intravenously in humans to rapidly switch or prevent the effects of morphine-based opioid agonists. Intravenously, 1 mg of naloxone has been reported to completely block the effects of 25 mg of heroin. The effect of naloxone appears to appear almost immediately after intravenous administration. However, drugs absorbed after oral administration have been reported to rapidly convert metabolism into inactive form in the first transport of the drug through the liver, which has been reported to have sufficiently lower efficacy than when administered parenterally. Oral administration of more than 1 g is reported to convert metabolism almost completely within 24 hours. It is reported that naloxone administered via the sublingually is absorbed by 25%. Weinberg, et al., Sublingual Absorption of selected Opioid Analgesics, Clin Pharmacol Ther . (1988); 44: 335-340.
[62] Other opioid antagonists, such as cyclazosin and naltrexone, both have cyclopropyl methyl substituents on nitrogen and retain most of their efficacy by the oral route, the duration of their action reaching up to 24 hours after oral administration, Lasts longer.
[63] In the treatment of patients who have previously been addicted to opioids, naltrexone has used large oral doses (more than 100 mg) to prevent the narcotic effects of opioid agonists. Naltrexone has been reported to be used as a strong priority blocking action on the mu receptors on delta sites.
[64] Naltrexone is known to have the same properties as a synthetic oxymolphone that does not have the properties of an opioid agonist, and differs in structure from oxymolphone in that a methyl group is substituted for a nitrogen atom of an oxymolphone having a cyclopropylmethyl group.
[65] The hydrochloride salt of naltrexone is soluble in water up to about 100 mg / cc. The pharmacological and pharmacokinetic properties of naltrexone have been revealed in a number of animal and clinical studies. See, for example, Gonzalez JP, et al, Naltrexone: Review of pharmacological and pharmacokinetic properties and therapeutic effects in opioid dependency management, Drugs 1988; See 35: 192-213, which is incorporated herein.
[66] After oral administration, naltrexone is rapidly absorbed (within 1 hour) and this oral bioavailability ranges from 5-40%. The protein binding of naltrexone is about 21% and the volume distributed after single-dos administration is 16.1 L / kg.
[67] Naltrexone is a commercially available tablet form (Revia, DuPont) for alcohol dependent treatment and blocking of externally administered opioids, see for example Revia (Naltrexone hydrochloride tablets). Physician's Desk Reference 51st ed., Montvale, NJ. "Medical Economics"1997; 51: 957-959. The drug effect of heroin 25mg IV administered with the administration of Revia 50mg is blocked for at least 24 hours.
[68] When morphine, heroin or other opioids are administered together on a chronic basis, naltrexone blocks the manifestation of physical dependence on opioids. This has been believed to be possible because naltrexone, which blocks the effects of heroin, is fully bound at the opioid receptor. Naltrexone has been used to treat drug addiction by completely blocking the effects of opioids. The most effective use of naltrexone for drug addiction is part of a program for understanding occupations or rehabilitation that involves ways of improving the regulation of behavior or other consents, including those with drug prognosis with good prognosis. It is to use.
[69] For the treatment of drug dependence with naltrexone, it is desirable to free the patient from opioids for at least 7 to 10 days. The initial dose of naltrexone used for this purpose is generally about 25 mg and can be increased to 50 mg per day if no signs of discontinuation occur. Dosages of 50 mg per day are considered to indicate adequate clinical obstruction of the action of opioids administered parenterally. Naltrexone, used for alcoholics, is accompanied by social and psychological treatments.
[70] In certain embodiments of the invention, the aversive and / or opioid antagonist included in the formulation is in practically non-release form. Wherein the opioid antagonist is in substantially non-release form, and the substantially non-release form of the opioid antagonist comprises an opioid antagonist formulated with one or more pharmaceutically acceptable hydrophobic materials, such an antagonist being derived When administered orally as intact, it is not released during transport through the gastrointestinal tract, or is not actually released.
[71] Further, in some embodiments, the aversive agent is in substantially non-release form, and the non-release form of aversive agent comprises an aversive agent formulated with one or more pharmaceutically acceptable hydrophobic materials. Aversive agents are not released during transport through the gastrointestinal tract, or are not actually released when administered orally as intact as induced.
[72] In certain embodiments of the invention, the opioid antagonist in a substantially non-release form is subjected to mechanical, thermal and / or chemical damage such as grinding, shearing, grinding, chewing and / or heating the oral formulation (about 45 ° C.). The combination of the above) is susceptible to damage such as dissolution in the solvent. Thus, this damage actually damages the shape of the opioid antagonist in the non-release form, causing the opioid antagonist to be released. In certain embodiments, the analgesic or narcotic effect of opioids administered orally, through the nose, parenterally or under the tongue is reduced or eliminated when the formulation is chewed, ground, dissolved in solvent or heated. In certain embodiments, the effect of the opioid agonist is at least partially blocked by the opioid antagonist. In another embodiment, the effect of the opioid agonist is substantially blocked by the opioid antagonist.
[73] In addition, in practice, the non-release forms of aversive agents are a combination of mechanical, thermal and / or chemical damage, such as grinding, shearing, grinding, chewing and / or heating the oral formulation (above about 45 ° C.). It is susceptible to damage such as dissolution in a solvent. Thus, this damage actually damages the appearance of the non-release form of the aversive agent, causing the aversive agent to be released. In some embodiments, when the formulation is chewed, crushed, dissolved in solvent or heated, the release of aversive agents administered orally, through the nose, parenterally or under the tongue is reduced or eliminated.
[74] In certain embodiments of the invention, the ratio of opioid agonists to non-release form of opioid antagonists in an oral dosage form is such that the effect of the opioid is that the dosage form is chewed or crushed or dissolved by solvent and heat, and oral, parenteral It is at least partially blocked when administered through the mouth, the nose and through the sublingual.
[75] When the oral dosage form of the present invention is properly administered as intended, since the opioid antagonist is not actually released, the content of such antagonist may vary more widely than the effectiveness of the opioid antagonist to be orally administered and released into the gastrointestinal system. . For safety reasons, the amount of antagonist actually present in the non-release form is not harmful to humans, even if released completely. The ratio of specific opioid agonists to antagonists can be measured by those skilled in the art without undue experimentation.
[76] In certain embodiments of the invention, the ratio of the opioid agonist to the opioid antagonist that is actually present in non-release form is from about 1: 1 to about 50: 1 weight ratio, preferably from about 1: 1 to 20: 1 weight ratio. . In certain preferred embodiments, this ratio is 1: 1 to 10: 1 weight ratio. In a preferred embodiment of the invention, the opioid agonist consists of oxycodone or hydrocodone, the content of which is present in about 15-45 mg, the opioid antagonist consists of naltrexone, the content is about 0.5-10 mg, preferably The following is 0.5 to 5 mg.
[77] In alternative embodiments, opioid antagonists of the invention may be included in the formulations, which are analgesically effective when administered orally, but do not produce analgesia, euphoria, or body dependence when administered parenterally. In certain embodiments, the opioid antagonist is preferably naltrexone, which is not an orally effective amount, but is effective when administered parenterally as described in US Pat. No. 3,773,955, which is incorporated herein by reference. It became. In this embodiment, naloxone is released from the formulation when administered orally, but the oral activity of the opioid analgesics included in the formulation cannot be eliminated.
[78] Optionally, the opioid antagonist of the present invention is released from the formulation by oral administration and may be included in the formulation in an amount as described in WO 99/32119. This data is incorporated in the present invention, which content does not cause a reduction in the level of analgesics that can lead to 1) formulation from oral administration to non-therapeutic levels; 2) When taking one or more formulations, in a physically dependent human patient, such as physically dependent addiction (eg, precipitated abstinence syndrom), "dislike" To provide at least some negative response to the experience. Preferably, the amount of antagonist included in the intact oral dosage form is positively lessened by non-body dependent opioid intoxication than comparable oral dosage forms that do not include antagonist (eg, less favorably). Preferably, such agents provide effective analgesia when administered orally. In certain preferred embodiments, the oral dosage form comprises an orally therapeutically effective amount of dose of an opioid agonist and an opioid antagonist, the ratios of which are analgesically effective when administered orally in combination thereof. To provide a product, but when administered in the same dose or more doses as said therapeutically effective amount, it is repellent to body-dependent human patients.
[79] As described in WO 99/32119, based on the preferred ratio of naltrexone in the content of about 0.5 to 4 mg per 15 mg of hydrocodone, the ratio of naltrexone to 1 mg of a particular opioid is shown in Table 1 below.
[80] Weight ratio of naltrexone per DOS of opioid Opioid The weight ratio of naltrexone per 1 mg of opioid Oxycodone 0.037-0.296 codeine 0.005-0.044 Hydrocodone 0.033-0.267 Hydromolephone 0.148 to 1.185 Lever panol 0.278-2.222 Meperidine 0.0037-0.0296 Methadone 0.056-0.444 Morphine 0.018-0.148
[81] As described in WO 99/32119, based on a more preferred ratio of 0.75 to 3 mg of naltrexone per 15 mg of naltrexone hydrocodone, the approximate ratio of naltrexone per mg of each opioid is shown in Table 2 below.
[82] The weight ratio of naltrexone per opioid dose Opioid The weight ratio of naltrexone per 1 mg of opioid Oxycodone 0.056 to 0.222 codeine 0.0083-0.033 Hydrocodone 0.050 to 0.200 Hydromolephone 0.222-0.889 Lever panol 0.417 to 1.667 Meperidine 0.0056 to 0.022 Methadone 0.083-0.333 Morphine 0.028 to 0.111
[83] In certain embodiments, the present invention relates to a portion for an oral formulation comprising orally analgesically effective amounts of opioid agonists and opioid antagonists in combination with one or more aversive agents as described herein. It is related to.
[84] In alternative embodiments, when the opioid antagonist is naloxone, the opioid agonist and opioid antagonist (eg, naloxone) included in the formulations of the present invention are in a preferred ratio as described in US Pat. No. 4,457,933 (Gordon et al.). will be. This can reduce both the oral and parenteral abuse potential of the opioid agonist without significantly affecting the oral analgesic activity of the opioid agonist.
[85] In certain optional embodiments, the opioid antagonist may contain an opioid antagonist in a dosage form in an amount that can reduce side effects such as anti-pain effects, dysentery, hyperalgesia, physical dependence, tolerance, and any combination thereof. Can be. For example, in certain embodiments, the content of opioid antagonist is from 100 to 1000 times less than the content of opioid agonist. Consistent with this embodiment, preferred amounts of opioid antagonists for agonists are described in US Pat. No. 5,472,943; 5,512,578; 5,580,876; 5,767,125; RE 36,547 and 6,096,256 (both Crain et al.) And the like, and these data are also reflected in the reference of the present invention.
[86] United States Patent 3,773,955 (Pachter et al.), United States Patent 3,493,657 (Lewenstein et al.), United States Patent 4,457,933 (Gordon et al.), United States Patent 4,582,835 (Lewis), United States Patent 5,512,578, 5,472,943; 5,580,876; And all known references to opioid agonists and releasing opioid antagonists, such as 5,767,125 (Crain) and US Pat. Nos. 4,769,372 and 4,785,000 (Kreek), may be combined with isolated antagonists, as described herein. All are incorporated by reference of the present invention.
[87] All commercial products of opioid agonists and release antagonists can be combined with isolated antagonists as described herein. For example, Talwin NX may be formulated with isolated antagonists to reduce misuse for oral use and parenteral misuse of opioids therein.
[88] In a preferred embodiment, the opioid agonists useful in the present invention include alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, benzitramide ( benzitramide, buprenorphine, butorphanol, clonitazene, codeine, desomorphine, dexmorpholamide, dezocine, deazopro Diampromide, diamorphone, dihydrocodeine, dihydromorphine, dihydromorphine, dimenoxadol, dimepeheptanol, dimethylthiambutene, dioxiambutene Dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazene, et al. Torphine, dehydro Etholin (dihydroetorphine), fentanyl and derivatives thereof, heroin, hydrocodone, hydromorphone, hydroxypethidine, isometadone, ketobemidone ketobemidone, levanphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, methopone (metopon), morphine (morphine), myropine (myrophine), narceine, nicomorphine, norlevorphanol, normethadone, nalmethphone, nalorphine, nalbuphene ), Normorphine, norpipanone, norpipanone, opium, oxycodone, oxymorphone, papaaveretum, pentazocine, phenadoxone , Phenomorphan, phenazocine, phenoperidine, piminodine , Pyritramide, propheptazine, promedol, promedol, properidine, propoxyphene, sulfentannil, tilidine, tramadol ), Certain mixtures thereof, certain salts thereof, and the like, but are not limited thereto. In an embodiment of the invention, the amount of opioid agonist in the opioid composition described in the claims is about 75 ng to 750 mg.
[89] In certain preferred embodiments, the opioid agonist is hydrocodone, morphine, hydromorphone, oxycodone, codeine, leverpanol, meperidine, methadone, oxymolphone, bufurenolpin, fentanyl and derivatives thereof, dipypanone, heroin, tramadol , Etholin, dihydroetopine, butopanol, leverpanol, or salts thereof or mixtures thereof. In certain specific embodiments, the opioid agonist is oxycodone or hydrocodone.
[90] In an embodiment of an opioid analgesic comprising hydrocodone, the formulation may comprise between 2 and 50 mg of hydrocodone vitalate in analgesic dose. In opioid analgesics comprising hydromolphone, the formulation comprises between 2 and 64 mg of hydromolphone hydrochloride. In opioid analgesics comprising morphine, the formulation may comprise 2.5 to 800 mg of morphine sulfate. In opioid analgesics comprising oxycodone, the formulation may comprise 2.5 to 320 mg of oxycodone hydrochloride. The formulation may comprise one or more opioid analgesics to provide a therapeutic effect. Optionally, the formulation may comprise other salts of the opioids useful in the present invention in the same molar content.
[91] Although hydrocodone and oxycodone are effective in treating analgesia, there has been an increase in abuse by people who are mentally dependent on opioids or who are misusing opioids for non-therapeutic reasons.
[92] Previous experiments with other opioids have shown that abuse potential is reduced, especially when a combination of opioid and anesthetic antagonist is administered to a patient who has previously been addicted. Weinhold LL, et al Buprenorphine Alone and in Combination with Naltrexone in Non-Dependent Humans, Drug and Alcohol Dependence 1992; 30: 263-274; mendelson J., et al., Buprenorphine and Naloxone Interactions in Opiate-Dependent Volunteer, Clin Pharm Ther 1996 '60: 105-114; All of which are incorporated herein by reference.
[93] However, these combinations do not actually contain opioid antagonists in non-release forms. Rather, when administered orally, the host's physiology metabolizes agonists and antagonists differently, relying on nullifying agonist effects, such that the opioid antagonist is released from the gastrointestinal system and makes absorption useful.
[94] Hydrocodone is a semisynthetic narcotic analgesic and antitussive with a number of central nervous systems and gastrointestinal action. The chemical formula of hydrocodone is 4,5-epoxy-3-methoxy-17-methylmorphinan-6-one and dihydrocodeinone. It is well known as (dihydrocodeinone). Like other opioids, hydrocodone has a habit forming habit and can produce drug dependence of morphine type. Excess dose of hydrocodone, like other opioid derivatives, can lead to decreased respiratory activity.
[95] Oral hydrocodone is commercially sold as an antitussive agent in Europe (Belgium, Germany, Greece, Italy, Luxembourg, Norway and Switzerland). Parenteral preparations are also commercially available as antitussives in Germany. For use as analgesics, hydrocodone vitalate is commercially and commercially available only in the United States as immobilized in combination with non-opiate drugs as useful for alleviating or alleviating severe analgesia.
[96] Typical formulations of hydrocodone, combined with acetaminophen, are sold commercially as Lortab of UCB Pharmaceuticals, USA, with 2.5 / 500 mg, 5/500 mg, 7.5 / 500 mg and 10/500 mg of hydrocodone / acetaminophen. Tablets. This tablet is also effective in a ratio of 7.5 mg hydrocodone vitalate and 650 mg acetaminophen and 7.5 mg hydrocodone vitalate and 750 mg acetaminophen. Hydrocodone in combination with aspirin is administered 1-2 tablets every 4-6 hours to relieve analgesia when administered orally to adults. This tablet form contains 5 mg hydrocodone vitalate and 224 mg aspirin, 32 mg caffeine, or 5 mg hydrocodone vitalate and 500 mg aspirin. Relatively new formulations consist of hydrocodone vitalate and ibuprofen.
[97] Vicoprofen is commercially available in Knoll Laboratories in the United States and is a tablet containing 7.5 mg of hydrocodone vitalate and 200 mg of ibuprofen. The present invention encompasses all of these formulations, including the inclusion of opioid antagonist particles coated with a coating to make sure that the antagonist is not actually released.
[98] Oxycodone is chemically 4,5-epoxy-14-hydroxy-3-methoxy-17-methylmorphin-6-one (4,5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan- Opioid agonists, known as 6-one), whose main therapeutic action is analgesics.
[99] Other therapeutic effects of oxycodone are anxiolysis, feeling of euphoria and feeling of relaxation. The exact mechanism of its analgesic activity is unknown, but certain CNS opioid receptors as opioid-based compounds with opioid action have been identified through brain, spinal cord and behavior.
[100] Oxycodone is known under the trade name oxycontin of Purdue Pharmaceutical Co., Ltd. LP, and is a sustained release tablet containing 10, 20, 40, or 80 mg of oxycodone hydrochloride, while OxyIR is the United States. An immediate release capsule containing 5 mg of oxycodone hydrochloride from Purdue Pharmaceuticals LP.
[101] The present invention is contemplated to encompass all such agents having, in practice, opioid antagonist content in non-release form.
[102] Preparation of aversive agents in practically non-release form
[103] In certain embodiments of the present invention, the aversive agent in actual non-release form may be prepared by combining one or more pharmacologically acceptable hydrophobic substances with an aversive agent. For example, the aversive particles can be coated with a coating that can actually prevent the release of the aversive agent by coating it with a hydrophobic material.
[104] In another example, by actually dispersing the aversive agent in a matrix that can cause the aversive agent to be non-released, the matrix consists of a hydrophobic material. In certain embodiments, the pharmacologically acceptable hydrophobic materials include ethylcellulose, cellulose acetate, cellulose propionate (low, medium or high molecular weight), cellulose acetate propionate, cellulose acetate butyrate, cellulose acetate phthalate and cellulose tricellulose And a cellulose polymer selected from the group consisting of acetates. Some celluloses contain an ethoxy content of 44-55%. Ethylcellulose can be used in the form of alcohol solutions.
[105] In some other embodiments, the hydrophobic material consists of polylactic acid, polyglycolic acid or a copolymer of polylactic acid and polyglycolic acid.
[106] In certain embodiments, the hydrophobic material may be composed of a cellulose polymer selected from the group consisting of cellulose ethers, cellulose esters, cellulose ester ethers, and cellulose. Cellulose polymers have a degree of substitution (DS) of 0 to 3 for anhydroglucose. Degree of substitution means the average number of hydroxyl groups present in anhydroglucose units composed of cellulose polymers replaced by substituents. Representative materials include cellulose acrylate, cellulose diacrylate, cellulose triacrylate, cellulose acetate, cellulose diacetate, cellulose triacetate, mono-, di- and tricellulose alkanylate, mono-, di- and tri- Cellulose aroylates, and polymers selected from the group consisting of mono-, di- and tricellulose alkenylates.
[107] Typical polymers include cellulose acetates containing at least 21% substitution and acetyl content; Cellulose acetate having an acetyl content of at least 32 to 39.8%, cellulose acetate having a degree of substitution of 1 to 2 and containing an acetyl content of 21% to 35%; Cellulose acetate having a degree of substitution of 2-3 and containing an acetyl content of 35 to 44.8%.
[108] More specific cellulose polymers include cellulose propionate containing a substitution degree of 1.8 and a propyl content of 39.2 to 45% and a hydroxyl content of 2.8 to 5.4%; Cellulose acetate butyrate containing a substitution degree of 1.8 and an acetyl content of 13 to 15% and a butyryl content of 34 to 39%; Cellulose acetate butyrate containing 2 to 29% acetyl content, 17 to 53% butyryl content and 0.5 to 4.7% hydroxyl group content; 2.9 such as cellulose trivalerate, cellulose trilaurate, cellulose tripatmitate, cellulose trisuccinate and cellulose trioctanoate Cellulose triacrylate with a degree of substitution of 3 to 3; Cellulose diacrylate and cellulose acetate butyrate, cellulose acetate octanoate butyrate, such as cellulose disuccinate, cellulose dipalmitate, cellulose dioctanoate, cellulose dipentanoate with a degree of substitution of 2.2 to 2.6 And coesters of cellulose such as cellulose acetate propionate.
[109] Additional cellulose polymers that are actually useful for the preparation of non-release forms of aversive agents include acetaldehyde dimethyl cellulose acetate, cellulose acetate ethylcarbamate, cellulose acetate methylcarbamate and cellulose acetate dimethylaminocellulose acetate.
[110] In practice, acrylic polymers useful for the preparation of non-release forms of aversive agents include acrylic and methacrylic acid esters (e.g. acrylic acid) containing from 0.02 to 0.03 moles of three (lower alkyl) ammonium groups per mole of acrylic and methacrylic monomers used. Acrylic resin composed of a copolymer synthesized from a lower alkyl ester and a methacrylic acid lower alkyl ester), but is not limited thereto.
[111] An example of a suitable acrylic resin is a polymer sold under the trade name Eudragit RS and manufactured by Rohm Pharma GmbH. Eudragit RS30D is preferred. Eudragit RS is insoluble in water and is a copolymer of ethyl acrylate (EA), methyl methacrylate (MM) and trimethylammoniumethyl methacrylate chloride (TAM). The molar ratio of TAM to residual components (EA and MM) is 1:40. Acrylic resins such as Eudragit RS are available in the form of aqueous suspensions.
[112] In some embodiments of the invention, the acrylic polymer is a copolymer of acrylic acid and methacrylic acid, methyl methacrylate copolymer, ethoxyethyl methacrylate, cyanoethyl methacrylate, poly (acrylic acid), poly (methacrylic) Acid), methacrylic acid alkylamide copolymer, poly (methyl methacrylate), polymethacrylate, poly (methyl methacrylate) copolymer, polyacrylamide, aminoalkyl, methacrylate copolymer, poly (meth Methacrylate unhydride) and glycidyl methacrylate copolymers.
[113] Indeed, the non-releasing form of aversive agents consists of aversive particles coated with a coating in which the aversive agent is not actually released, and when a cellulose polymer or an acrylic polymer is used in the preparation of the coating composition, a suitable plasticizer, for example acetyl triethyl Citrate (acetyl triethyl citrate) and / or acetyl tributyl citrate can be used in combination with the polymer. The coating may contain as additives those well known in coating techniques such as colorants, talc and / or magnesium stearate.
[114] When applying the coating composition to the aversive particles, it is also possible to coat the particles using any suitable spraying apparatus well known in the art. For example, spraying a Wuster fluidized-bed system using an air jet when injected from the bottom, while spraying with an insoluble polymer coating is effective for fluidizing and drying the coated material. . The coating thickness can vary depending on the particle characteristics of the coating composition used. However, those skilled in the art will be able to determine, through routine experimentation, the optimum thickness of a particular coating needed for a particular formulation of the invention.
[115] In practice, pharmacologically acceptable hydrophobic materials useful for the preparation of non-release forms of aversive agents are poly (lactic / glycolic acid) (“PLGA”), polylactide, polyglycol. Polyglycolide, polyanhydride, polyorthoester, polycarprolactones, polyphosphazene, polysaccharides, protein polymers, polyesters, polydi Oxanone, polygluconate, polylactic acid-polyethylene oxide copolymer, poly (hydroxybutyrate), polyphosphoester, or mixtures thereof Biodegradable polymers composed of any form of blend.
[116] In certain embodiments of the invention, the biodegradable polymer consists of a copolymer of poly (ratic / glycolic acid), ratic acid and glucolic acid having a molecular weight of about 2,000 to about 500,000 daltons. The ratio of lactic acid to glycolic acid is about 100: 0 to 25:75, preferably 65:35.
[117] Poly (ratic / glycolic acid) was prepared by the method described in US Pat. No. 4,293,539 (Ludwig et al.), All of which were incorporated by reference herein. Briefly, Ludwig prepared the copolymer by condensation polymerization of lactic acid and glycolic acid under an easily removable polymerization catalyst (eg, strong acid ion exchange resin such as Dowex HCR-W2-H). The amount of catalyst used is not critical to the polymerization, but is typically included in about 0.01 to 20 parts by weight relative to the total weight of the combined ratic acid and glycolic acid. The polymerization reaction is carried out at about 100 to 250 ° C. for about 48 to 96 hours without solvent, preferably under reduced pressure in order to carry out the removal of water and by-products. The reaction mixture is then dissolved in an organic solvent such as dichloromethane or acetone, then filtered off, from which the catalyst is removed and filtered to give the final product.
[118] Indeed, once a non-release form of aversive agent is prepared, it can be combined with opioid agonists and opioid antagonists, and the oral formulation of the present invention can be prepared with conventional excipients known in the art.
[119] The best aversive agents that can be included in sequestered preparations are considered to be bitter and capsaicin. The above polymers and other ingredients are used to formulate aversive agents that delay or slow release as described above.
[120] In certain preferred embodiments of the invention, the oral dosage form is a capsule or tablet. If the formulation prepared is a tablet, the aversive and opioid agonist and opioid antagonist may be combined with one or more inert, non-toxic pharmacological excipients suitable for the manufacture of tablets. Such excipients include inert diluents such as lactose, granules such as cornstarch and disintergratingagents; Binders such as starch; And lubricants such as magnesium stearate.
[121] Oral formulations of the present invention may be formulated to provide immediate release of the opioid agonist contained within the opioid agonist contained therein.
[122] However, opioid agonists of oral formulations in other embodiments of the present invention provide sustained release.
[123] In certain embodiments, oral formulations that provide sustained release of an opioid agonist can be prepared by mixing an aversive agent with an opioid agonist in actual, non-release form and certain pharmaceutical excipients provided for opioid antagonists and tablets, The tablet is then coated with a sustained release tablet coating.
[124] In certain embodiments of the invention, the sustained release opioid agonist tablets may be prepared by mixing an aversive agent with a substantially non-release form of aversive agent in a matrix that can provide a tablet with sustained release.
[125] Formulation
[126] The combination of an opioid analgesic / opioid antagonist formulation with one or more aversive agents makes it an immediate or controlled release oral formulation well known to those skilled in the art, such as any suitable tablet, coated tablet or multiparticulate. Can lose. Controlled release formulations may include a modulatory release material that can be incorporated into the matrix with opioid analgesics and opioid antagonists. In addition, the aversive agent can be separated from the matrix or can be enclosed into the matrix.
[127] Optionally, the sustained release formulation may include particles containing or containing opioid analgesics, wherein the particles have a diameter of 0.1 to 2.5 mm, preferably 0.5 to 2 mm. Opioid antagonists can be entrapped into such particles or encapsulated into tablets or capsules containing such particles. Optionally, the aversive agent can be entrapped into such particles or encapsulated into a tablet or capsule comprising such particles. Preferably, these particles are films coated with materials that enable release of opioid analgesics at controlled rates in environmental use. Film coating is chosen to be performed in combination with other states of properties, with the desired in vitro release rate. The controlled release coating formulations of the present invention should be capable of making strong, soft and comfortable continuous films and capable of supporting pigments and other coating additives that are non-toxic, inert and viscous.
[128] In certain embodiments, formulations of the invention comprise conventional release matrices comprising opioid analgesics, opioid antagonists, and aversive agents.
[129] Coated beads
[130] In certain embodiments of the invention, when the hydrophobic material is used to coat inert pharmaceutical beads, such as nu pariel 18/20 beads, which are already coated with an opioid agonist, the plurality of solid sustained release bead products are in fact non-release opioids. Placed in gelatin capsules with antagonist. This formulation provides an effective sustained release dose of an opioid agonist when contacted or ingested by an environmental fluid such as gastrointestinal fluid or eluent medium.
[131] Beads comprising opioid analgesics are further prepared as independent beads, including opioid antagonists and / or one or more aversive agents, or opioid antagonists and one or more aversive agents, opioid agonists, or opioid antagonists, and And / or are combined in a formulation comprising a release-controlled bead comprising one or more aversive agents and mixed in a formulation with the release-controlled beads comprising an opioid analgesic. In a preferred embodiment, the opioid analgesic and the aversive agent are mixed into other beads in a capsule, and these beads have an accurate or similar shape to reduce abuse from manually separated beads prior to abuse to avoid repellent material. . In tablet formulations, the aversive agent is preferably not included in a separate layer that is prone to isolation from the active drug, although the present invention does not emphasize this embodiment.
[132] The controlled release bead formulations of the present invention, when digested and exposed to intestinal fluids, slowly release opioid agonists and then reach intestinal fluids. The sustained release profile of the formulations of the present invention may be further modified by varying the amount of plasticizer relative to the hydrophobic material, for example, by varying the amount of protective coating with the hydrophobic material, according to the method of adding the plasticizer to the hydrophobic material. Depending on the component or the excipients, it may be changed according to changes in the manufacturing method. The dissolution profile of the final product is deformable by increasing or decreasing the thickness of the delayed coating.
[133] Ellipsoids or beads coated with an opioid agonist can be prepared by dissolving the drug in water and then spraying this solution onto the substrate, for example nu pariel 18/20 beads using a Wooster insert. . The opioid antagonist and / or aversive agent is then added to the beads prior to selective coating. Optionally, additional components may be added prior to bead coating. For example, this product includes hydroxypropylmethylcellulose and the like (e.g., such as Opadry, commercially available from colorcon). It is added to the mixed solution (eg for about 1 hour). Coated substrate results, such as beads of this example, may optionally undergo a protective coating as a barrier agent to separate the therapeutic agent from the hydrophobic sustained release coating. Examples of suitable blocking agents include hydroxypropylmethylcellulose. However, it is also possible to use any film-forming agent known in the art. The blocking agent preferably does not affect the dissolution rate of the final product.
[134] The beads are then overcoat with an aqueous dispersion of hydrophobic material. The aqueous dispersion of hydrophobic material preferably further contains an effective amount of plasticizer, such as triethyl citrate. Aqueous dispersions of pre-manufactured ethylcellulose such as Aquacoat or Surelease can also be used. If you use Surelease, you do not need to add plasticizer. Alternatively, pre-made aqueous dispersions of acrylic polymers such as Eudragit may be used.
[135] The hydrophobic material treated with the plasticizer can be applied to a substrate composed of a therapeutically effective drug dispensed using any suitable spraying device known in the art. In a preferred method, a Worcester fluidization-bed system with air jet is used for injection from the bottom, and spraying the acrylic polymer coating is effective for fluidizing the core material and drying. When the coated substrate is exposed to an aqueous solution such as gastrointestinal fluid, it is desirable to add a sufficient amount of hydrophobic material to obtain the predicted sustained release of the therapeutically effective drug, which is a method of mixing a plasticizer or the like, This is possible by taking the calculation of physical properties. After coating with a hydrophobic material, a protective coating can optionally be added to the beads with a film-forming agent such as Opadry. By carrying out such protective coating, in all cases it is possible to actually reduce the agglomeration of beads.
[136] The release of opioid analgesics from the sustained release formulations of the present invention can be further influenced by tailoring at the desired rate, which is achieved by adding one or more release-modifying agents or by coating. By providing more than one passageway. The ratio of hydrophobic material to water soluble material is determined by other factors such as the required release rate and the solubility properties of the selected material.
[137] The release-modulating agent functions as a pore-former, which can be organic or inorganic, and these materials can be dissolved, extracted or filtered from the coating in the environment of use. The pore-former is composed of one or more hydrophilic materials such as hydroxypropylmethylcellulose.
[138] Sustained release coatings of the present invention may include erosion-promoting agents such as starch and gum.
[139] Sustained release coatings of the present invention include materials suitable for producing micropores of lamina in use, such as polycarbonates consisting of linear polyesters of carbonic acid, a group of carbonates regenerated within the polymer chain. can do.
[140] In addition, the release-controlling agent may be composed of a semi-permeable polymer.
[141] In a preferred embodiment of the invention, the release-modifying agent can be selected from hydroxypropylmethylcellulose, lactose, metal stearate and any mixture thereof.
[142] In addition, the sustained release coating of the present invention includes exit means consisting of one or more passageways, orifices and the like. These passages are described in US Pat. No. 3,845,770; 3,916,889; It may be prepared by the method as described in 4,063,064 and 4,088,864 (all of which are incorporated by reference in the present invention). The passage can be round, triangular, square, oval, or rugged.
[143] Matrix formulations
[144] In another embodiment of the invention, the sustained release formulation may optionally be carried out via a matrix with a release controlling coating as described herein. The present invention also includes sustained release tablets comprising opioid agonists and opioid antagonists coated with a coating such that the antagonist is not actually released, wherein the agonists and antagonists are within the desired range of in vitro -vitro) dissolution rate can be provided and dispersed in a sustained release matrix that can release the opioid agonist in a pH- or pH-independent method.
[145] Suitable materials that may be contained in the sustained release matrix according to the present invention include, but are not limited to, hydrophilic and / or hydrophobic materials such as gum, cellulose ethers, acrylic resins, materials derived from proteins; Oils such as waxes, shellac and hydrogenated castor oils and hydrogenated vegetable oils. However, any of the pharmaceutically acceptable hydrophobic and hydrophilic sustained release materials that can provide the sustained release of opioid analgesics that can be used in accordance with the present invention is possible. Preferred hydrophobic polymers include alkylcelluloses such as ethylcellulose, acrylic and methacrylic acid polymers and copolymers; And cellulose ethers, in particular hydroxyalkylcelluloses (particularly hydroxypropylmethylcellulose) and carboxyalkylcelluloses. Preferred acrylic and methacrylic acid polymers and copolymers are methyl methacrylate, methyl methacrylate copolymer, ethoxyethyl methacrylate, ethyl acrylate, trimethyl ammonioethyl methacrylate, cyanoethyl methacrylate, amino Alkyl methacrylate copolymer, poly (acrylic acid), poly (methacrylic acid), methacrylic acid alkylamine copolymer, poly (methylmethacrylate), poly (methacrylic acid) (unhydride), polymethacryl Latex, polyacrylamide, poly (methacrylic acid anhydride) and glycidyl methacrylate copolymers. In certain preferred embodiments, a mixture of any combination of the aforementioned sustained release materials can be used within the matrix of the present invention.
[146] In addition, the matrix may comprise a binder, in one embodiment, the binder contributes to provide sustained release of its pharmaceutically acceptable salts from oxycodone or sustained release matrix.
[147] If further hydrophobic binder materials are included, one selected from natural or synthetic waxes, fatty acids, fatty alcohols and mixtures thereof. Examples include beeswax, carnauba wax, stearyl acid and stearyl alcohol. Without being limited to this example, in certain preferred embodiments, two or more hydrophobic binder materials may be included in the matrix formulation.
[148] Preferred hydrophobic binder materials that can be used to conform to the present invention are digestible, long-chain (8 to 50 carbon atoms, especially 12 to 40 carbon atoms), substituted or unsubstituted hydrocarbons such as fatty acids, aliphatic Alcohols, glyceryl esters of fatty acids, inorganic and vegetable oils and natural and synthetic waxes, polyalkylene glycols, and the like.
[149] In addition, the hydrocarbon has a melting point of 25 to 90 ℃ is preferred. Long chain hydrocarbon materials, aliphatic alcohols are preferred in some embodiments. Oral formulations may contain up to 80% (by weight) of one or more digestible, long chain hydrocarbons.
[150] In certain embodiments, the hydrophobic binder material may be a natural or synthetic wax, fatty alcohol (lauryl), myristyl, stearyl, cetyl or preferably cetostearyl alcohol ( cetostearyl alcohol), fatty acids, including but not limited to fatty acid esters, fatty acid glycerides (mono-, di- and triglycerides), hydrogenated fats, hydrocarbons, common waxes, stearic acid, stearyl alcohols and hydrocarbons And hydrophobic and hydrophilic materials with excitation.
[151] Suitable waxes include beeswax, glycowax, castor wax, carnauba wax, and the like. For the purposes of the present invention, waxy materials are generally defined as any material that is solid at room temperature and has a melting point of about 30 to 100 ° C. In certain specific embodiments, the formulations include opioid agonists; Opioid antagonists; One or more aversive agents; A sustained release matrix comprising at least one water soluble hydroxyalkyl cellulose, at least one C ₁₂ -C ₃₆ aliphatic alcohol, preferably C ₁₄ -C ₂₂ , and optionally at least one polyalkylene glycol do. The hydroxyalkyl cellulose is preferably hydroxy (C ₁ -C ₆ ) alkyl cellulose, such as hydroxypropyl cellulose, hydroxypropylmethylcellulose, especially hydroxyethyl cellulose.
[152] The content of one or more hydroxyalkyl celluloses present in the oral formulation may be determined by the exact rate of opioid release required. At least one aliphatic alcohol is such as lauryl alcohol, myristyl alcohol or stearyl alcohol.
[153] However, in particularly preferred embodiments in the oral dosage form the aliphatic alcohol is at least one cetyl alcohol or cetostearyl alcohol. The content of at least one aliphatic alcohol in the oral dosage form of the invention will be determined by the exact rate of opioid release required as above. It also depends on the presence or absence of at least one polyalkylene glycol from the oral formulation. When at least one polyalkylene glycol is not present, the oral formulation preferably contains between 20 and 50% (weight ratios) of at least one aliphatic alcohol. If at least one polyalkylene glycol is present in the oral formulation, it is preferred that the combined weight of at least one aliphatic alcohol and at least one polyalkylene glycol is comprised between 20 and 50% of the total dose.
[154] In one embodiment, the ratio of one or more hydroxyalkyl cellulose or acrylic resins to one or more aliphatic alcohols / polyalkylene glycols was determined to a large number of opioid release rates from the formulation. The ratio of at least one hydroxyalkyl cellulose to at least one aliphatic alcohol / polyalkylene glycol is preferably between 1: 1 and 1: 4, particularly preferably between 1: 2 and 1: 3.
[155] At least one polyalkylene glycol is propylene glycol or preferably polyethylene glycol. The number average molecular weight of the at least one polyalkylene glycol is preferably between 1,000 and 15,000, in particular between 1,500 and 12,000.
[156] Other suitable sustained release matrices include alkylcelluloses (especially ethyl cellulose), aliphatic alcohols having 12 to 36 carbon atoms, and optionally polyalkylene glycols.
[157] In addition to the above materials, the sustained release matrix may contain other materials in suitable amounts such as diluents, lubricants, binders, granulating aids, colorants, fragrances and glidants, used in conventional pharmaceutical techniques.
[158] In order to carry out the preparation of the solid, sustained release oral dosage form according to the invention, in a further aspect of the invention, the process of preparation of the solid, sustained release oral dosage form according to the invention is an opioid analgesic in the sustained release matrix. Inclusion of the drug. Inclusion in the matrix is achieved by:
[159] (a) preparing a granule comprising at least one hydrophobic and / or hydrophilic material as described above (eg, water soluble hydroxyalkyl cellulose) and an opioid agonist, an opioid antagonist and at least one aversive agent step;
[160] (b) mixing the granules containing at least one hydrophobic and / or hydrophilic material with at least one aliphatic alcohol having 12 to 36 carbon atoms; And
[161] (c) optionally, compressing and modeling the granules.
[162] The granules prepared are one of the procedures well known to those of ordinary skill in the pharmaceutical formulation art. For example, in a preferred method, granules are those prepared by wet granulation with hydroxyalkyl cellulose, opioid agonists, opioid antagonists and one or more aversive agents with water. In a particularly preferred embodiment in this process, the content of water added in the wet granulation step is preferably between 1.5 and 5 times the dry weight of the opioid summary, particularly between 1.75 and 3.5 times. Optionally, opioid agonists, opioid antagonists and / or one or more aversive agents are added extragranulary, respectively.
[163] Sustained release matrices may also be prepared via melt-granulation or melt-extrusion molding techniques. Generally, melt-granulation techniques involve the melting of common solid hydrophobic binder materials, such as waxes, and enveloping them into the drug in powder form. To obtain a sustained release formulation, it is necessary to enclose hydrophobic sustained release materials such as ethylcellulose or acrylic polymers insoluble in water into the dissolved wax hydrophobic binder material. Examples of sustained-release preparations prepared using melt-granulation techniques can be found in US Pat. No. 4,861,598.
[164] The additional hydrophobic material may be blended with one or more non-aqueous waxes such as one or more waxes that are less hydrophobic than one or more non-aqueous waxes. Can be configured. In order to obtain a constant release, each wax-like material in the formulation must be actually non-degradable and insoluble in the gastrointestinal fluid in the initial release step. Useful materials such as water-insoluble waxes have a solubility in water of less than about 1: 5,000 (w / w).
[165] The preparation of suitable melt-extruded matrices according to the present invention comprises blending opioid analgesics, opioid antagonists and at least one or more aversive agents with a binder material to obtain a sustained release material, preferably a homogeneous mixture. The homogeneous mixture is then heated to a temperature above which the mixture can be softened and sufficiently extruded. The homogeneous mixing result is extruded using a twin-screw extruder to make a strand. The extrudate is cooled and cut into multiparticulates by any method known in the art. Divide the matrix multiparticers into unit doses. The extrudate is preferably between about 0.1 to 5 mm in diameter and provides sustained release of oxycodone or their pharmaceutically useful salts for a time period up to about 24 hours.
[166] Optional procedures for preparing the melt extrudates of the present invention include injecting hydrophobic sustained release materials, opioid analgesics, opioid antagonists, one or more aversive agents and any binder material directly into the extruder; Heating the uniform mixture; Extruding the homogeneous mixture thereby to string; Cooling the strings containing the homogeneous mixture; Cutting with a string having a particle size of about 0.1 to about 12 mm; And mixing the coated opioid antagonist particles with the particles and dividing them into respective doses. This aspect of the invention is understood as a relatively continuous manufacturing process.
[167] Optionally, the opioid antagonist and / or one or more aversive agents produce divided multiparticulates (not including opioid agonists), and then the opioid agonists (antagonists and / or one or more) in the formulation In combination with multiparticulates) (not including aversive agents).
[168] Plasticizers such as those described above are included in the melt-extruded matrix. The plasticizer is preferably included in 0.1 to 30% by weight of the matrix. Other pharmaceutical excipients such as talc, monosaccharides or polysaccharides, lubricants and the like can be included in the sustained release matrix of the present invention if desired. Amounts included may be performed differently depending on the desired properties.
[169] The diameter of the extruder hole or outlet port can be tailored depending on the thickness of the extruded string. Moreover, the outlet portion of the extruder need not be spherical, but may be elliptical, rectangular or the like. The discharged string may be reduced to particles using a guillotine or the like, which is a hot wire cutter.
[170] Melt-extrusion multiparticulate systems are possible in the form of granules, ellipsoids or pellets depending on the exit hole of the extruder. In accordance with the object of the present invention, "melt-extruded multiparticulate system (s)" and "melt-extruded multiparticulate system (s)" and "melt-extruded multiparticulate system (s)" and "melt-extruded multiparticulate system (s)" The term “melt-extruded particles” refers to a plurality of units, preferably within a range of similar size and / or shape, with one or more active agents and one or more It contains the above excipients, and preferably includes the hydrophobic material described herein.
[171] In this regard, the melt-extruded multiparticulates will be in the range of about 0.1 to 12 mm in length and about 0.1 to 5 mm in diameter. In addition, the melt-extruded multiparticulates can have any geometric shape within this size range. Optionally, the extrudate can be simply ground to the desired length and divided into unit doses of the therapeutically effective drug without going through the spheronization step.
[172] In certain preferred embodiments of the present invention, oral formulations may be prepared to contain an effective amount of melt-extruded multiparticulates in a capsule. For example, by placing an effective amount of multiple melt-extruded multiparticulates in gelatin capsules it is possible to provide an effective sustained release dose when digested or in contact with gastrointestinal fluid.
[173] In another preferred embodiment, a suitable amount of multiparticulate extrudate is combined with coated opioid antagonist particles and compressed into oral tablets by standard techniques using conventional purification apparatus. Techniques and compositions for making tablets (compressed and molded), capsules (hard and soft gelatin) and pills are described in Remington's Pharmaceutical Science (Arthur Osol, editor), 1553-1593 (1980). Merged as reference.
[174] In another preferred embodiment, the extrudate can be tableted by the method shown in US Pat. No. 4,957,681 (Klimesch et al.).
[175] Optionally, the sustained release matrix multiparticulate system, tablet or capsule may be coated with a sustained release coating, such as the sustained release coating described herein. Although the protective coating is more dependent on the physical properties of the particular opioid analgesic compound employed and the desired release rate between others, such coatings contain sufficient amounts of hydrophobic material to achieve weight gain levels of about 2-30%. can do.
[176] The formulations of the present invention further comprise a combination of melt-extruded multiparticulates comprising opioid agonists, opioid antagonists, one or more aversive agents or mixtures thereof. In addition, such formulations contain an amount of an immediate release opioid agonist for an immediate therapeutic effect. The immediate release opioid agonist may be mixed into discrete pellets in gelatin capsules or coated on surfaces such as melt extruded matrix multiparticles.
[177] The sustained release profile of the melt-extruded formulations of the present invention is further added, for example, with a change in the amount of plasticizer relative to other matrix components, with a change in the amount of hydrophobic material, with a change in the amount of the sustained release material. Depending on the component or the excipients, it may be changed according to changes in the manufacturing method.
[178] In another embodiment of the invention, the melt-extruded formulation comprises an opioid agonist; Opioid antagonists; One or more aversive agents; Or a mixture thereof, which is then added into the extrudate. Typically such agents are opioid agonists; Opioid antagonists; One or more aversive agents; Or a mixture of these with the extruded matrix material and then the mixture is tableted to provide a sustained release formulation. Such agents include opioid agonists; Opioid antagonists; One or more aversive agents; Or incorporating mixtures thereof into the formulation, has the advantage of being temperature sensitive as it requires softening of the hydrophobic and / or retardant materials.
[179] Typical melt-extrusion manufacturing systems consistent with the present invention include suitable extruder drive motors having various speeds and constant torque regulators, start-end adjustments and beats. In addition, such a manufacturing system includes a temperature sensor, a cooling device and a temperature sensor through the length of the extruder. In addition, such a manufacturing system would include an extruder such as a twin screw extruder consisting of two oppositely rotating intermeshing screws provided in a cylinder or barrel with holes or dies at the outlet. The feed materials entering through the feed hopper are moved through the barrel by the screw, pushed into the string through the die, left to cool by being moved by such as a continuously moving belt, and extruded into the matrix multi-particle system. Preferably move to a pelletizer or other suitable device. Pelletizers consist of rollers, fixed knives, rotary cutters, and the like. Suitable instruments and systems are commercially available from suppliers such as C. W. Brabender Instrument (Sough Hackensack, NJ). Other suitable devices will be apparent to those skilled in the art.
[180] A further aspect of the present invention is to prepare melt-extruded matrix multiparticulates as described above which control the amount of air contained in the extruded product. By controlling the amount of air contained in the extrudate, it is possible to control the release rate of the opioid agonist, opioid antagonist, one or more aversive agents or mixtures thereof.
[181] Thus, in a further aspect of the present invention, the melt-extruded product is produced through a method that practically excludes air during in-process extrusion. This can be done by using a Leistritz extruder with a vacuum connection. According to the present invention, the extruded matrix multiparticulates produced under vacuum using a Leistritz extruder provide melt-extruded products with different properties. In particular, the extrudate is practically non-porous when magnified using SEM. Indeed, non-porous formulations release the therapeutically active drug faster than the same formulations prepared without the application of vacuum. Matrix multiparticulates prepared using an extruder under vacuum conditions appear very smoothly in the SEM image, and the multiparticulates are more robust than the shape of the multiparticulates prepared without applying vacuum. This is observed at least in certain formulations to provide an extruded matrix multiparticulate product that is more pH-dependent than a relative formulation prepared without the application of a vacuum by using an extruder under vacuum.
[182] Optionally, the melt-extruded product is made using a Werner-Pfleiderer twin screw extruder.
[183] In certain preferred embodiments, the spheronizing agent is added to the granules or matrix multiparticulates and then spheronized to produce sustained release ellipsoids. The ellipsoid is then optionally subjected to a protective coating with a sustained release coating according to the method described herein.
[184] The spheronizing agent that can be used to prepare the matrix multiparticulate formulation according to the invention can use any of the well known spheronizing agents. As suitable microcrystalline cellulose, a material sold under Avicel PH 101 (trade name, FMC) is suitable. The spheronizing agent is preferably included from 1 to 99% by weight of the matrix multiparticle.
[185] In certain embodiments, the ellipsoid also comprises a binder, by adding an opioid agonist, an opioid antagonist, one or more aversive agents, and a spheronizing agent. Suitable binders are such as low viscosity, water soluble polymers, which are well known to those skilled in the pharmaceutical art. However, water soluble hydroxy lower alkyl cellulose, such as hydroxy propyl cellulose, is preferred. In addition (or optionally), the ellipsoid is a water-insoluble polymer, in particular an acrylic polymer such as methacrylic acid-ethyl acrylate copolymer, or ethyl cellulose, an acrylic copolymer.
[186] In certain embodiments, the sustained release coating is applied to sustained release spherioids, granules, matrix multiparticles, and the like. In such embodiments, the sustained release coating may comprise a) wax alone or in admixture with fatty alcohols; Or b) shellac or zein. The coating is derived from an aqueous dispersion of hydrophobic sustained release material.
[187] In certain embodiments, a matrix multiparticulate comprising a sustained-release ellipsoid, granule, or opioid agonist, one or more opioid antagonists, and a sufficient amount of a sustained release carrier such as an alkylcellulose or acrylic polymer. Protective coatings may be obtained to obtain sustained release formulations with weight gain levels of 2-50%, about 2-25%. The protective coating can be added or reduced depending on the desired release rate, the presence of plasticizers in the aqueous dispersion, the inclusion method, and the like. Cellulose materials and polymers, including alkylcelluloses, are suitable materials for coating the sustained release ellipsoids, granules or matrix multiparticulates of the invention. Although it is clear for the skilled person to readily apply other cellulose and / or alkylcellulose polymers, the preferred alkylcellulose polymer is ethylcellulose, which, alone or in combination, is carried out in whole or in part with the hydrophobic coating according to the invention. do.
[188] One aqueous dispersion of ethyl cellulose sold commercially is Aquacoat (FMC Corp., Philadelphia, Pennsylvania, U.S.A.). Aquacoats can be prepared by dissolving ethylcellulose in an organic solvent that is incompatible with water, and then emulsified equally in water in the presence of surfactants and stabilizers. Homogenize to make droplets of micron or smaller particles, and then evaporate the organic solvent under vacuum to produce pseudolatex. The plasticizer is not included into the pseudolatex during manufacture. Thus, prior to use, such as coatings, it is necessary to mix intimately with the aquacoat using a suitable plasticizer before use.
[189] Another commercially available aqueous dispersion of ethyl cellulose is Surrelease (Surelease, Colorcon, Inc., West point, Pennsylvania, U.S.A.). This product is made by mixing the plasticizer into the dispersion during the manufacturing process. Hot melts of polymers, plasticizers (dibutyl sebacate), and plasticizers (oleic acid) are prepared in a homogeneous mixture and then diluted with an alkaline solution to obtain an aqueous dispersion that can be applied directly to the substrate.
[190] In another preferred embodiment of the invention, the sustained release materials comprising the sustained release coating are acrylic and methacrylic acid copolymers, methyl methacrylate copolymers, ethoxyethyl methacrylate, cyanoethyl methacrylate, poly ( Acrylic acid), poly (methacrylic acid), methacrylic acid alkylamide copolymer, poly (methyl methacrylate), polymethacrylate, poly (methyl methacrylate) copolymer, polyacrylamide, aminoalkyl methacrylate Pharmacologically acceptable acrylic polymers including, but not limited to, copolymers, poly (methacrylic anhydride) and glycidyl methacrylate copolymers.
[191] In another preferred embodiment, the acrylic polymer is composed of one or more ammonio methacrylate copolymers. Ammonio methacrylate copolymers are well known in the art, and both methods for preparing polymerized copolymers of acrylic acid and methacrylic acid esters with small amounts of quaternary ammonium groups in NF XVII are described. In order to obtain the desired elution profile, it is necessary to mix two or more ammonio methacrylate copolymers with different physical properties, such as different molar ratios of quaternary ammonium groups to neutral (meth) acrylic esters.
[192] Several methacrylic acid ester-type polymers are useful for pH-dependent coatings that can be used to conform to the present invention. For example, as a group of copolymers synthesized from diethylaminoethyl methacrylate and other neutral methacrylate esters, they are also known as methacrylic acid copolymers or polymer methacrylates, commercially available from Rohm GMBH and Co. Known as Eudragit from Kg Darmstadt. These are several different forms of Eudragit, for example Eudragit E is an example of methacrylic acid copolymers that swell and dissolve in acidic media, and Eudragit L does not swell at about pH <5.7, but at about pH> 6 Soluble methacrylic acid copolymer. In addition, Eudragit S is not swellable at about pH <6.5, is soluble at about pH> 7, Eudragit RL and Eudragit RS are swellable in water, and the amount of water absorbed by these polymers is pH-dependent. Formulations coated with Eudragit RL and RS are pH-independent.
[193] In another preferred embodiment of the invention, the acrylic coating may consist of a mixture of two acrylic resin lacquers, which are commercially available from Rohm under the trade names Eudragit RL30D and Eudragit RS30D, respectively.
[194] Eudragit RL30D and Eudragit RS30D are copolymers of acrylic and methacrylic esters containing small amounts of quaternary ammonium groups, the molar ratio of ammonium groups to residual neutral (meth) acrylic esters is Eudragit RL30D 1:20, Is 1:40 and the average molecular weight is about 150,000. Code design RL (high permeability) and RS (low permeability) account for the permeation characteristics of these reagents. Eudragit RL / RS mixtures are insoluble in water and digestive fluids. Such identically produced coatings are swellable and permeable to aqueous solutions and digestive fluids.
[195] The Eudragit RL / RS dispersions of the present invention can be mixed with each other in any desired ratio to finally obtain a sustained release formulation with the desired elution profile. For example, the desired sustained release formulation can be obtained from a delayed coating derived from 100% Eudragit RL, 50% Eudragit RL and 50% Eudragit RS, and 10% Eudragit RL and 90% Eudragit RS. Of course, those skilled in the art will recognize the use of other acrylic polymers, such as Eduragit L.
[196] In embodiments of the present invention with a coating consisting of an aqueous dispersion of hydrophobic material, an effective amount of plasticizer may be included in the aqueous dispersion of hydrophobic material to further improve the physical properties of the sustained release coating.
[197] For example, ethyl cellulose has a relatively high glass transition temperature and does not form a flexible film under normal coating conditions. Therefore, it is preferable to mix the plasticizer into the ethylcellulose coating containing the sustained release coating before using the same as the coating material above.
[198] In general, the amount of plasticizer that may be included in the coating solution is most typically about 1 to 50% of the weight of the film-forming agent based on the concentration of the film-former. However, the concentration of plasticizer may only be properly calculated after careful experimentation, depending on the particular coating solution and application method.
[199] Examples of suitable plasticizers for ethylcellulose are dibutyl sebacate, diethyl phthalate, triethyl citrate, tributyl citrate, triacetin and It is also possible to use other non-water soluble plasticizers (such as acetylated monoglycerides, phthalate esters, castor oil, etc.), including the same non-water soluble plasticizers. Triethyl citrate is a particularly preferred plasticizer for the aqueous dispersion of ethyl cellulose of the present invention.
[200] Examples of suitable plasticizers for the acrylic polymer of the present invention include, but are not limited to, citric acid esters such as triethyl citrate NF XVI, tributyl citrate, dibutyl phthalate and 1,2-propylene glycol. Other plasticizers that have been found suitable for improving the elasticity of films made from acrylic films such as Eudragit RL / RS lacquer solutions include polyethylene glycol, propylene glycol, diethyl phthalate, castor oil and triacetin and the like. Triethyl citrate is a particularly preferred plasticizer for the aqueous dispersion of ethyl cellulose of the present invention.
[201] In certain embodiments, uncoated / coated sustained release ellipsoid, granule, or opioid agonist, opioid antagonist; And matrix multiparticles comprising one or more aversive agents include sustained release ellipsoids, granules, or opioid agonists, opioid antagonists; And matrix multiparticulates comprising one or more aversive agents will cure to an endpoint leading to stable elution of the opioid. Curing endpoints can be determined by comparing the dissolution profile of the formulation immediately after curing, after exposing the dissolution profile of the formulation at accelerated storage conditions, for example, at a temperature of 40 ° C., at a relative humidity of 75%, for at least one month. . US Pat. No. 5,273,760 for cured formulations; 5,286,493; 5,500,227; 5,580,578; 5,639,476; 5,681,585; And patents such as 6,024,982. Other examples of sustained release formulations and coatings that can be used to conform to the present invention are described in US Pat. 5,356,467; And 5,472,712.
[202] In addition to the above criteria, ellipsoids, granules or matrix multiparticulates may be suitable for other materials such as diluents, lubricants, binders, granulating aids, colorants, fragrances and glidants used in conventional pharmaceutical techniques. In amounts, if desired, the weight of the formulation can be increased by 50%. Such additional materials will be sufficient to provide the desired effect on the desired formulation.
[203] Specific examples of pharmaceutically acceptable carriers and excipients that can be used to prepare oral formulations are described in the Handbook of Pharmaceutical Excipients, American Pharmaceutical Society (1986), hereby incorporated by reference. Merged.
[204] In addition, a small amount of talc may be added to the sustained release coating to act as a lubricant to reduce the property of the aqueous dispersion to stick during the manufacturing process.
[205] Osmotic Dosage Forms
[206] Sustained release formulations according to the invention may also be prepared in osmotic dosage forms. The osmotic dosage form preferably comprises a drug layer (comprising an opioid agonist and any opioid antagonist and / or one or more aversive agents) and a delivery or expansion layer (also an opioid antagonist and / or one or more). A bilayer core, comprising an aversive agent, wherein the bilayer core has at least one passageway surrounded by and optionally exposed to the semipermeable wall.
[207] The expression "passageway" as used for the purposes of the present invention may or may not include apertures, apertures, bores, pores, opioid analgesics supplied (with or without antagonists). Or a porous component that diffuses or migrates through fibers, osmotic tubes, porous overlays, porous inserts, microporous members, or porous compositions. Such passages also include compounds that corrode or filter out from the walls in the environmental fluid used to create the at least one passageway. Representative compounds capable of forming passages include corrosive poly (glycolic) acids, or poly (ratic) acids in walls; Filaments of gelatin; Water-removable poly (vinyl alcohol); Inducible solution removable filterable compounds such as pore-forming polysaccharides, acids, salts or oxides. Such passages are formed by filtering the compound from walls such as sorbitol, sucrose, lactose, maltose or furtose, and form sustained-release pore-pathways. Such a passage may have any form, such as spherical, triangular, square and elliptical, as long as it can assist in the sustained release of the opioid analgesic from the formulation. Such formulations may produce one or more passageways in portions having a relationship at a distance from the surface of one or more formulations. Pathways and mechanisms for the formation of passages are described in US Pat. No. 3,845,770; 3,916,899; 4,063,064; And 4,088,864. Sustained-release dimensions designed, made, and tailored with release-pores formed by aqueous filtration to provide release-pores at slow release rates described in US Pat. Nos. 4,200,098 and 4,285,987.
[208] In some embodiments, the bilayer core comprises a layer of drug with an opioid analgesic and a displacement or expansion layer optionally comprising an antagonist and / or one or more aversive agents. The antagonist and / or the one or more aversive agents optionally comprise a drug layer further in place of or including the extension layer. In some embodiments, the drug layer can also include at least one polymer hydrogel. The polymer hydrogel has a number average molecular weight of about 500 to about 6,000,000. Examples of polymer hydrogels include, but are not limited to, maltodextrin polymers having the general formula (C ₆ H ₁₂ O ₅ ) n.H ₂ O (where n is 3 to 7,500), and a number average molecular weight of 500 to 1,250,000. Phosphorus maltodextrin polymers; For example poly (alkylene oxide) represented by poly (ethylene oxide) and poly (propylene oxide) having a weight average molecular weight of 50,000 to 750,000, more particularly at least one weight average molecular weight of 100,000, 200,000, 300,000 or 400,000 Poly (alkylene oxide) represented by poly (ethylene oxide); Alkali carboxyalkylcelluloses, where alkali is sodium or potassium, and alkyl is methyl, ethyl, propyl, or butyl having a weight average molecular weight of 10,000 to 175,000; And as a copolymer of ethylene-acrylic acid, it contains methacrylic acid and etacrylic acid, and the number average molecular weight is 10,000-500,000.
[209] In some embodiments of the invention, the transport or expansion layer comprises an osmopolymer. Examples of the osmotic polymer may be, but are not limited to, a group selected from the group consisting of polyalkylene oxide and carboxyalkyl cellulose. Such polyalkylene oxides have a weight average molecular weight of 1,000,000 to 10,000,000. Polyalkylene oxides include polymethylene oxide having an average molecular weight of 1,000,000, polyethylene oxide, polypropylene oxide, polyethylene oxide, polyethylene oxide having an average molecular weight of 5,000,000, polyethylene oxide having an average molecular weight of 7,000,000, crosslinked polymethylene oxide having an average molecular weight of 1,000,000, And polypropylene oxide having a number average molecular weight of 1,200,000. Typical osmotic polymer carboxyalkylcelluloses are alkali carboxyalkylcelluloses, sodium carboxymethylcellulose, potassium carboxymethylcellulose, sodium carboxyethylcellulose, lithium carboxymethylcellulose, sodium carboxyethylcellulose, carboxyalkylhydroxyhydroxycellulose, carboxymethylhydroxyethyl Cellulose, carboxyethylhydroxyethylcellulose and carboxymethylhydroxypropylcellulose. The osmotic polymer used for the filtration layer shows an osmotic pressure change across the semipermeable wall. The osmotic polymer absorbs the fluid into the formulation, expands by it and expands with the osmotic hydrogel (or what is known as osmogel), thereby expanding the hydrocodone or pharmaceutically acceptable salts thereof from the osmotic formulation. .
[210] The enhancement layer may also include one or more osmotically effective compounds, also known as osmotic agents and osmotically effective solutes. They absorb, for example, environmental fluid from the gastrointestinal tract track into the formulation and contribute to the transport kinetics of the filtration layer. Examples of osmotic active drugs are selected from the group consisting of osmotic salts and osmotic carbohydrates. Examples of specific osmotic agents include, but are not limited to, sodium chloride, potassium chloride, magnesium sulfate, lithium phosphate, lithium chloride, sodium phosphate, potassium sulfate, sodium sulfate, potassium phosphate, glucose, fructose and maltose .
[211] The extension layer optionally comprises hydroxypropylalkylcellulose, which is represented as selected from the group consisting of hydroxypropylmethylcellulose, hydroxypropylethylcellulose, hydroxypropylisopropylcellulose, hydroxypropylbutylcellulose and hydroxypropylpentylcellulose. can do.
[212] The enhancement layer may also optionally include an antioxidant to inhibit oxidation of the raw material. Some examples of antioxidants include, but are not limited to, ascorbic acid, ascorbyl palmitate, butylated hydroxyanisole, 2 tert-butyl-4-hydroxyanisole and 3 tert-butyl-4 Mixtures of hydroxyanisole, butylated hydroxytoluene, sodium isocorsorbate, dihydroguaretic acid, potassium sorbate, sodium bisulfate, sodium metabisulfate, sorbic acid, potassium ascorbate, vitamin E , 4-chloro-2,6-diary butylphenol, alphatocopherol and propylgallate.
[213] In some alternative embodiments, the formulation may be an opioid analgesic, an opioid antagonist, one or more aversive agents, a pharmaceutically acceptable polymer (eg, polyethylene oxide), optionally a disintegrant (eg, poly Vinylpyrrolidone), optionally a homogeneous core including absorption promoters (eg, fatty acids, surfactants, chelating agents, bile salts, etc.). This substantially homogeneous core is surrounded by a semipermeable wall having an opioid agonist, an opioid antagonist, and a passageway (as defined herein) for the release of one or more aversive agents.
[214] In certain embodiments, the semipermeable wall comprises one selected from the group consisting of cellulose ester polymers, cellulose ether polymers, and cellulose ester-ether polymers. Typical wall polymers include cellulose acrylate, cellulose diacrylate, cellulose triacrylate, cellulose acetate, cellulose diacetate, cellulose triacetate, mono-, di- and tricellulose alkenylates, and mono-, di and tricellulose alkys. And those selected from the group consisting of nilates. Poly (cellulose) used in the present invention includes those having a number average molecular weight of 20,000 to 7,500,000.
[215] Additional semipermeable polymers for the purposes of the present invention include acetaldehyde dimethylcellulose acetate, cellulose acetate ethylcarbamate, cellulose acetate methylcarbamate, cellulose diacetate, propylcarbamate, cellulose acetate diethylaminoacetate; Semipermeable polyamides; Semipermeable polyurethanes; Semipermeable sulfonated polystyrene; Semipermeable crosslinked polymers formed by coprecipitation of anionic polymers with cationic polymers as described in US Pat. Nos. 3,173,876, 3,276,586, 3,541,005, 3,541,006 and 3,546,876; Semipermeable polymers described in US Pat. No. 3,133,132; Semipermeable crosslinked polystyrene; Semipermeable crosslinked poly (sodium styrene sulfonate); Semipermeable crosslinked poly (vinylbenzyltrimethyl ammonium chloride); And semipermeable polymers having a fluid permeability of 2.5 × 10 ⁻⁸ to 2.5 × 10 ⁻² (cm 2 / hr · atm) expressed as for hydrodynamic atmospheric or osmotic pressure differences across the semipermeable wall. Other polymers useful in the present invention include US Pat. Nos. 3,845,770, 3,916,899 and 4,160,020; Handbook of Common Polymers (Scott, JR and WJRoff, 1971, CRC Press, Cleveland, Ohio) is well known in the art.
[216] In some embodiments, preferably the semipermeable wall is non-toxic, inert and maintains physical and chemical properties during the dispersing phase of the drug. In certain embodiments, the formulation comprises a binder. Examples of the binder include, but are not limited to, a therapeutically acceptable vinyl polymer having a viscosity average molecular weight of 5,000 to 350,000, poly-n-vinylamide, poly-n-vinylacetamide, poly (vinyl pyrrolidone) Polymers represented by the group selected from the group, also poly-n-vinylpyrrolidone, poly-n-vinylcaprolactone, poly-n-vinyl-5-methyl-2-pyrrolidone and vinyl acetate, vinyl alcohol, vinyl And poly-n-vinyl-pyrrolidone copolymers comprising a group selected from the group consisting of chloride, vinyl fluoride, vinyl futirate vinyl laureate, and vinyl stearate. Other examples of the binder include acacia, starch, gelatin and hydroxypropylalkylcellulose having an average molecular weight of 9,200 to 250,000.
[217] In some embodiments, the formulation includes a lubricant to prevent adhesion to the die wall or punch side during manufacture of the formulation. Examples of lubricants include, but are not limited to, magnesium stearate, sodium stearate, stearic acid, calcium stearate, magnesium oleate, oleic acid, potassium oleate, caprylic acid, sodium stearyl fumarate, and magnesium palmitate do.
[218] Transdermal Delivery System
[219] The formulations of the present invention may be formulated into a transdermal delivery system such as a transdermal patch. In certain embodiments of the invention, the transdermal patch comprises an opioid agonist contained in a reservoir or matrix and an adhesive that imparts adhesion to the skin to act as a transdermal device, thereby allowing the active drug from the transdermal device through the skin of the patient. It does not release when the formulation is administered intact, containing an agonist and opioid antagonist as described herein, but the formulation is torn or damaged to release the opioid from the system through the skin. Is released.
[220] Transdermal delivery systems provided as controlled release opioid agonists are well known. For example, Duragesic patches (commercially available from Janssen Pharmaceutical) include opioid agonists (fentanyl) and provide adequate analgesic effects from 48 hours to 72 hours (2 to 3 days). This formulation may be re-formulated with aversive and antagonists as described herein.
[221] Various forms of such transdermal formulations of bufurenol are described in US Pat. No. 5,240,711 (Hille et al.), US Pat. No. 5,225,199 (Hidaka et al.), US Pat. No. 5,069,909 (Sharma et al.), US Pat. No. 4,806,341 (Chien et al. ) And US Pat. No. 5,026,556 to Rust et al., All of which are incorporated by reference herein. Such transdermal devices may be re-formulated with aversive and antagonists as described herein.
[222] The transdermal delivery system used in the present invention was prepared in a manner consistent with US Pat. No. 5,069,909 (Sharma et al.), Which was incorporated into the present invention. This patent describes a lamination composition in which percutaneous administration of bufurenolpin is administered to treat analgesia. Transdermal delivery systems used in the present invention can also be prepared in the same manner as in US Pat. No. 4,806,341 (Chien et al.), Which is incorporated into the present invention. This patent describes a transdermal morphanic drug analgesic or antagonist that includes a polymeric matrix disk layer that is actually adhered to a backing layer and a thick layer that is impermeable to bufurenol, and has finely dispersed the effective dose of bupurenol in it. Pharmaceutical polymeric matrix dose units (including bufurenol pin) are described.
[223] Transdermal delivery systems used in the present invention can also be prepared by the methods described in US Pat. No. 5,026,556 to Rust et al., Which is incorporated herein. Herein, a polar solvent material selected from the group consisting of diols having 3 to 4 carbon atoms, triols having 3 to 6 carbon atoms, and mixtures thereof, and a polar lipid material selected from the group consisting of fatty alcohol esters, fatty acid esters, and mixtures thereof Described herein are compositions for transdermal delivery of bufurenol, including bufurenol in a carrier, wherein the polar solvent material and lipid material have a weight ratio of solvent material: lipid material in the range of 60:40 to 99: 1. . The transdermal delivery system used in the present invention can be prepared by the method described in US Pat. No. 4,588,580 to Gale, et al., Which is incorporated herein. The system includes a reservoir for drug in proximity to the skin, with a material release surface area of 5 to 100 cm 2 and a skin penetrable form of bufurenol in 0.1 to 50%. The reservoir comprises an aqueous gel comprising 47-5% ethanol, 1-10% gelling agent, 0.1-10% bufurenolpin, and the release rate is determined by a method dispersed in the drug distribution channel into the skin. By being regulated, the flux of bufurenol pin from the system through the skin is limited.
[224] Transdermal delivery systems used in the present invention can be prepared as described by Oshlack et al. In PCT / US01 / 04347.
[225] The present invention has been contemplated to include all transdermal preparations, for example, both techniques as described above and the inclusion of aversive and antagonists, which are formulations that can prevent abuse of opioids.
[226] When administered intact, non-release forms of aversive and antagonists can be formulated to conform to US Pat. No. 5,149,538 (Granger), which is incorporated herein. Alternatively, the aversive and opioid agonists may be separated by layers from the opioid, which collapses when the formulation is damaged and mixes the agonist and opioid agonist. Alternatively, a combination of the two systems can be used.
[227] Suppositories
[228] The controlled release formulations of the present invention may also be formulated as pharmaceutical suppositories for administration to the rectum, including opioid analgesics, opioid antagonists and at least one aversive agent and suppository base in a sustained release matrix. The preparation of controlled release suppository formulations is described in US Pat. No. 5,215,758.
[229] The choice of suppository base is competitive with the drug of the invention. Furthermore, base suppositories are preferably non-toxic, non-irritating, and stable during storage in a viscous membrane, rectal fluid.
[230] In a preferred embodiment of the invention for both water soluble and non-water soluble drugs, the base suppository comprises a fatty acid wax selected from the group consisting of saturated mono-, di- and natural fatty acids having 12 to 18 carbon atoms.
[231] In preparing the suppositories of the present invention, other excipients may be used. For example, the wax can be used to make a shape suitable for administration via the rectal route. Such systems may also use no wax, but must further fill diluents in gelatin capsules both rectally and for oral administration.
[232] Examples of suitable mono-, di-, and triglycerides sold commercially are called Novata TM (types AB, AB, B, BC, BD, BBC, E, BCF, C, D and 299) manufactured by HenkelL. Saturated natural fatty acids with 12 to 18 carbon atoms sold under the trade name, and Witepsol ™ (H5, H12, H15, H175, H185, H19, H32, H35, H42, W25, W31, W35, W45) manufactured by Dynamit Nobel. , S55, S58, E75, E76 and E85 types).
[233] Other pharmaceutically acceptable suppository bases may be substituted for some or all of the aforementioned mono-, di-, and triglycerides. The content of base in suppositories is determined by the size of the formulation, the content of base (eg alginate) and the drug used. Generally, the content of suppository base is 20 to 90% by weight of the total weight of the suppository. Preferably, 65 to 80 weight percent of the total suppositories.
[234] In certain embodiments of the formulations of the invention, a surfactant is included. Useful surfactants consistent with the present invention include, but are not limited to, ionic and nonionic surfactants or wetting agents generally used in the preparation of drugs, castor oil derivatives, cholesterol, polyglycolated glycerides, acetylated mono Glycerides, sorbitan fatty acid esters, poloxamers, polysorbates, polyoxyethylene sorbitan fatty acid esters, polyoxyethylene compounds, monoglycerides or ethoxylated derivatives thereof, diglycerides or polyoxyethylene derivatives thereof, sodium docusate , Sodium laurylsulfate, cholic acid or derivatives thereof, ethoxylated alcohols, ethoxylated esters, ethoxylated amides, polyoxypropylylene compounds, propoxylated alcohols, ethoxylated / propoxylated blocks Polymers, propoxylated esters, alkanolamides, amine oxides, polyha Idric alcohol fatty acid esters, ethylene glycol esters, diethylene glycol esters, propylene glycol esters, glycerol esters, polyglycerol fatty acid esters, SPAN's (e.g. sorbitan esters), TWEEN's (ie sucrose esters), glutose (Dextrose) esters, alkali metal sulfates, quaternary ammonium compounds, amidoamines, and amineimides, simethicones, lecithins, alcohols, phospholipids and mixtures thereof.
[235] Mixed surfactants / wetting agents useful to comply with the present invention include sodium lauryl sulfate / polyethylene glycol (PEG) 6000 and sodium lauryl sulfate / PEG 6000 / stearyl acid and the like.
[236] In certain embodiments of the invention, the formulation comprises an emulsifier. Emulsifiers useful to comply with the present invention include potassium and sodium salts of monoglycerides, sucrose / fatty acid esters, polyglycerols / fatty acid esters, sorbitan / fatty acid esters, lecithin, rosin acid and higher fatty acids, as well as sulfates of these acids. And amine salts of hydroxyamines of sulfonates, long chain fatty acid esters, quaternary ammonium salts such as stearyl dimethylbenzylammonium chloride and tridecylbenzenehydroxyethylimidazole chloride, and higher alcohols such as capuryl and octyl alcohol. Phosphoric esters, and monoesters of oleic acid, and pentaerythritol, such as sorbitan monooleate, and mixtures thereof.
[237] Oral formulations and methods of use of the invention further include one or more drugs that may or may not act synergistically with opioid analgesics and opioid antagonists, opioid analgesics. For example, the formulation may include two opioid analgesics with different properties such as half-life, solubility, efficacy, and any combination thereof.
[238] In further embodiments, still one or more opioid analgesics are included, in addition non-opioid drugs. Such non-opioid drugs are preferred in that such non-opioid drugs are provided as additional analgesics, for example, non-steroidal anti-inflammatory drugs such as aspirin, acetaminophen, ibufurophen, ketoprofen, etc. "NSAIDS"), NMDA receptor antagonists such as dextrometopan or morphinan such as dextrose or ketamine; And cyclooxygenase-II inhibitors ("COX-II inhibitors"); And / or glycine receptor antagonists.
[239] In another preferred embodiment of the present invention, it is also possible to use lower doses of opioid analgesics by efficacy of the inclusion of additional non-opioid agonists such as NSAIDS or COX-2 inhibitors. Lower amounts of either of these two drugs, or both, can be used to reduce the side effects associated with effectively treating human pain.
[240] Suitable nonsteroidal anti-inflammatory drugs are ibuprofen, diclofenac, naproxen, benoxaprofen, flurbiprofen, fenoprofen, flubufen ( flubufen, ketoprofen, indoprofen, pyroprofen, carprofen, oxaprozin, pramoprofen, muroprofen ), Trioxaprofen, suprofen, aminoprofen, thiaprofenic acid, fluprofen, bucloxic acid, indometha God (indomethacin), sulindac, tolmetin, tomemetac, zomepirac, tiopinac, zidomethacin, acemethacin, acemetacin, fentiazac , Clidanac, oxpinac, mefenamic acid, meclofenamic acid, flufenamic acid ( flufenamic acid, niflumic acid, tolfenamic acid, diflurisal, flufenisal, piroxicam, sudoxicam or isosi Isoxicam and the like. Effective dosages of these drugs are well known to those skilled in the art.
[241] N-methyl-D-aspartate (NMDA) receptor antagonists are well known in the art and are known as dextromethorphan or dextrorphan, ketamine, d- Morphinan such as methadone (d-methadone) or pharmaceutically acceptable salts thereof.
[242] n-methyl-d-aspartate (NMDA) receptor antagonists are well known in the art and include, for example, morphinan, such as dextrometophan or dextrose, ketamine or pharmaceutically acceptable salts thereof. In accordance with the present invention, "NMDA antagonist" refers to NMDA-receptor activity, for example, gangliosides such as GM ₁ or GT _1b , phenothiazines such as trifluoperazine, The major intracellular effects of naphthalenesulfonamides such as N- (6-aminothexyl) -5-chloro-1-naphthalenesulfonamide (N- (6-aminothexyl) -5-chloro-1-naphthalenesulfonamide) There is a tendency to include drugs that block. These drugs inhibit the expression of dependence and / or resistance to addictive drugs, such as narcotic analgesics such as morphine and codeine, shown in US Pat. Nos. 5,321,012 and 5,556,838 (all in Mayer et al.), Incorporated herein by this reference 5,502,058 (Mayer et al.) Reported the treatment of chronic pain. NMDA antagonists may be included alone or in combination with a local anesthetic such as lidocaine, as indicated in the Mayer et al. Patent.
[243] Treatment of chronic patients with glycine receptor antagonists and the demonstration of such drugs shown in US Pat. No. 5,514,680 (Weber et al.) Are hereby incorporated by reference.
[244] COX-2 inhibitors have been reported a lot in the prior art, and many chemical structures are known to exhibit cyclooxygenase-2 inhibitory action. U.S. Patent 5,616,601; 5,604,260; 5,593,994; 5,550,142; 5,536,752; 5,521,213; 5,475,995; 5,639,780; 5,604,253; 5,552,422; 5,510,368; 5,436,265; 5,409,944; And all COX-2 inhibitors shown at 5,130,311 are hereby incorporated by reference. Some preferred COX-2 inhibitors are celecoxib (SC-58635), DUP-697, flosulfide (CGP-28238), meloxicam, 6-methoxy-2-naphthylacetic acid (6 MNA), MK-966 (also known as Vixx), nabumetone (prodrug for 6-MNA), nimesulfide, NS-398, SC-5766, SC-58215, T -614; Or combinations thereof. The dosage level of COX-2 inhibitor in the order of about 0.005 mg to about 140 mg per kg body weight per day is therapeutically effective in combination with opioid analgesics. Optionally, the COX-2 inhibitor may be administered from about 0.25 mg to about 7 g in combination with an opioid analgesic per patient per day.
[245] In another embodiment, providing non-opioid drugs for other desired effects other than analgesics, such as antitussive, expectorant, decongestant, antihistamin drugs, local anesthetics, and the like. May be included.
[246] The invention described herein includes all of the pharmacologically acceptable salts of the opioid agonists described. Pharmaceutically acceptable salts include metal salts such as sodium salts, potassium salts, cesium salts, and the like; Alkaline earth metals such as calcium salt, magnesium salt and the like; Organic amine salts such as triethylamine salt, pyridine salt, picoline salt, ethanolamine salt, triethanolamine salt, dicyclohexylamine salt, N, N'-dibenzylethylenediamine salt and the like; Inorganic acid salts such as hydrochloride, hydrobromide, sulfate, phosphate and the like; Organic acid salts such as formate, acetate, trifluoroacetate, maleate, tartrate and the like; Sulfonates such as methanesulfonate, benzenesulfonate, p-toluenesulfonate and the like; Amino acid salts such as alginate, asparginate, glutamate, and the like, and the like, but are not limited thereto.
[247] Some of the opioid analgesics described herein may contain one or more asymmetric centers and thus have enantiomers, diastereomers, and other stereoisomeric forms.
[248] The invention also encompasses racemic mixtures thereof, modified forms and mixtures thereof as well as all possible forms. When the compounds described herein contain olefinic double bonds or other geometrically asymmetric centers and are not in other specific forms, this means that they include both E and Z geometric isomers. The present invention also includes all tautomers.
[249] Oral formulations of the present invention may be in the form of tablets, pills, rhombuses, paudo, granules, hard or soft capsules, microparticles (e.g. microcapsules, microspheres, etc.), buccal tablets. It is also possible.
[250] In certain embodiments, the present invention also provides a method for preventing abuse of an oral controlled release formulation of an opioid analgesic comprising the step of preparing a formulation as described above.
[251] In certain embodiments, the present invention also provides a method of preventing the diversion of an oral controlled release formulation of an opioid analgesic comprising the step of preparing a formulation as described above.
[252] In certain embodiments, the present invention also provides a method of treating analgesia by administering a formulation described as fraudulent to a human patient.
[253] The following examples describe various aspects of the present invention. However, the invention is not intended to limit the claims in any other way.
[254] Example 1: 20 mg of oxycodone formulation prepared by containing naloxane as antagonist and xanthan gum as aversive agent
[255] In this example, a small amount of xanthan gum was added to the oxycodone formulation during the granulation process. Other gelling agents are curdlan, carrageenan, alginate, pectin, gelatin, furcelleran, agar0, guar gum, locust bean gum, tara gum, tragacanth, acacia, glucoman , Gelaya, starch and starch derivatives, egg white powder, lacto albumin, soy protein, jargel, gellan gum, welan gum, rhamsan gum and the like can be used as the gelling agent. Semi-synthetic materials, chitosan, pullulan, polylaevulan, hydroxypropyl cellulose, methylcellulose, hydroxypropyl methylcellulose, carboxymethyl cellulose, ethoxyhydroxyethyl cellulose, all derivatives of these celluloses Alternative gelling agents can be used, such as etc. The formulation of Example 1 is shown in Table 3 below.
[256] ingredientContent / unit (mg)Content / batch (gm) Oxycodone HCl20.0209.6 ^*Spray-dried lactose59.25592.5 Povidone5.0050.0 Eudragit RS 30D (Solid)10.00100 Triacetin2.020.0 Naloxone HCl0.616.12 ^**Xanthan sword9.090.0 Stearyl alcohol25.0250.0 Talc2.525.0 Magnesium stearate1.2512.5 Opadry Pink5.050.0 *: Adjusted to 99.6% analyte and 4.2% residual moisture **: Adjusted to 99.23% analyte and 0.5% residual moisture.
[257] Manufacture process:
[258] 1. dispersion; Naltrexone HCl was dissolved in distilled water and this solution was added to the Eduragit / triacetin dispersion.
[259] 2. Granulation: Eduragit / triacetin dispersion was added to oxycodone HCl, spray dried lactose, xanthan gum and povidone using a fluid bed coating machine.
[260] 3. Milling: Granules were added and the granules were passed through a grinder.
[261] 4. Waxing: Stearyl alcohol was dissolved and added to the milled granules using a mixer. It was left to cool.
[262] 5. Milling: The cooled granules were passed through a mill.
[263] 6. Lubrication: The granules were lubricated with talc, magnesium stearate using a mixer.
[264] 7. Compression: The granules were compressed into tablets using a tablet press.
[265] Example 2 40 mg of oxycodone formulation prepared by containing naloxane as antagonist and xanthan gum as aversive agent
[266] Three levels of xanthan gum were added to 40 mg of oxycodone granules and compressed into tablets to determine the gel properties and the elution rate of the oxycodone tablets. The resilience and drug release rate of oxycodone were determined from extraction from the water of the tablet. The preparation of the oxycodone granules of Example 2 is shown in Table 4 below.
[267] ingredientContent / unit (mg) Oxycodone HCl40.0 Spray-dried lactose39.25 Povidone5.0 Eudragit RS 30D (Solid)10.0 Triacetin2.0 Naloxone HCl0.9 Stearyl alcohol25.0 Talc2.5 Magnesium stearate1.25 sum125.9
[268] Examples 2A to 2C were prepared by changing the content of xanthan gum (3 mg, 5 mg, and 9 mg) to 125.9 mg of the oxycodone granules of Example 2, and are shown in Tables 5 to 7 below.
[269] Example 2A ingredientContent / unit (mg) Oxycodone granules125.9 Xanthan sword3.0 sum128.9
[270] Example 2B ingredientContent / unit (mg) Oxycodone granules125.9 Xanthan sword5.0 sum130.9
[271] Example 2C ingredientContent / unit (mg) Oxycodone granules125.9 Xanthan sword9.0 sum134.9
[272] Manufacture process:
[273] 1. dispersion; Naltrexone HCl was dissolved in distilled water and the solution was added to an Eduragit / triacetin dispersion.
[274] 2. Granulation: Eduragit / triacetin dispersion was added to oxycodone HCl, spray dried lactose, and povidone using a fluid bed coating machine.
[275] 3. Milling: Granules were added and the granules were passed through a grinder.
[276] 4. Waxing: Stearyl alcohol was dissolved and added to the milled granules using a mixer. It was left to cool.
[277] 5. Milling: The cooled granules were passed through a mill.
[278] 6. Lubrication: The granules were lubricated with talc, magnesium stearate using a mixer.
[279] 7. Xanthan gum (3 levels) was added to the granules and mixed well.
[280] 8. Compression: The granules were compressed into tablets using a tablet press.
[281] Example 3
[282] The granules of Example 2 were compressed into tablets using a tablet press without the addition of xanthan gum. In addition, Examples 2, 2A to 2C were tested under the following elution conditions, and the results are shown in Table 8 below.
[283] 1. Apparatus: USP Type II (paddle), 150 rpm.
[284] 2. Medium: 1 hour in 700 mg SGF, then 900 ml of phosphate buffer to pH 7.5.
[285] 3. Sampling time: 1,2,4,8,12,18 and 24 hours
[286] 4. Analysis: HPLC
[287] time% Eluted Example 2A (Xantane 3 mg)Example 2B (Xanthan 5mg)Example 2C (Xantane 9 mg)Example 2 (without xanthan)Spec One4843464528-58 48673797555-88 12101989993> 80
[288] The dissolution results showed similar dissolution profiles in all the tablets prepared. The inclusion of xanthan gum does not appear to substantially change the oxycodone dissolution rate.
[289] When 1 ml of water is added to a tablet containing xanthan gum, the solution is not viscous. However, if the sample is heated and left to cool, the sample is very viscous. This is very difficult to administer such a gel solution through a syringe.
[290] Example 4 20 mg of an oxycodone formulation containing naloxane as an antagonist and a bitter agent as an aversive agent was prepared.
[291] In Example 4, a small amount of denatonium benzoate was added to the oxycodone formulation during the granulation process. Bitter taste may reduce the abuse of oxycodone orally or through the nose. The oxycodone formulation of Example 4 is shown in Table 9 below.
[292] ingredientContent / unit (mg)Content / batch (gm) Oxycodone HCl20.0209.6 ^*Spray-dried lactose59.25592.5 Povidone5.0050.0 Eudragit RS 30D (Solid)10.00100 Triacetin2.020.0 Naloxone HCl0.616.12 ^**Denatonium benzoate0.070.68 Stearyl alcohol25.0250.0 Talc2.525.0 Magnesium stearate1.2512.5 Opadray Y-S-14518A5.050.0 *: Adjusted to 99.6% analyte and 4.2% residual moisture **: Adjusted to 99.23% analyte and 0.5% residual moisture.
[293] Manufacture process:
[294] 1. dispersion; Naltrexone HCl and denatonium benzoate were dissolved in distilled water and this solution was added to the Eduragit / triacetin dispersion.
[295] 2. Granulation: Eduragit / triacetin dispersion was added to oxycodone HCl, spray dried lactose, xanthan gum and povidone using a fluid bed coating machine.
[296] 3. Milling: Granules were added and the granules were passed through a grinder.
[297] 4. Waxing: Stearyl alcohol was dissolved and added to the milled granules using a mixer. It was left to cool.
[298] 5. Milling: The cooled granules were passed through a mill.
[299] 6. Lubrication: The granules were lubricated with talc, magnesium stearate using a mixer.
[300] 7. Compression: The granules were compressed into tablets using a tablet press.
[301] Example 5
[302] In Example 5, practically the unreleased form of bitter agent (denatonium benzoate) was prepared by coating the benatonium benzoate particles with a coating such that it was actually a releasable denatonium benzoate. The formulation of Example 5 is shown in Table 10 below.
[303] ingredientContent / unit (mg) Stage 1. Drug loadingDenatonium benzoate0.07 Spherical Sugar (30/35 Mesh)50.0 Opadray white Y-5-70682.5 Distilled water42.5 * Step 2. OvercoatingOpadray white Y-5-70683.02 Distilled water17.11 ** Step 3. Sustained release coatings (actually for the manufacture of non-release tackifiers)Eudragit RS30D (Dry Weight)12.10 Triethyl citrate2.42 Talc4.84 Distilled water49.21 * Step 4. OvercoatingOpadray white Y-5-70684.12 Distilled water23.35 * Total (dry basis)79.07 *: Only remaining in the product as residual moisture.
[304] Manufacture process:
[305] 1. Solution preparation: Dentonium benzoate was dissolved in distilled water. Once dissolved, Opadry White was added and subsequently mixed until a uniform dispersion was formed.
[306] 2. Charge: The dispersion was added to the spherical sugars using an induction liquid bed coating machine.
[307] 3. Protective coating: Opadry White was dispersed in distilled water to prepare a protective coating solution. This dispersion was added to charged spherical sugars containing benatonium benzoate using a fluid bed coater.
[308] 4. Delay coating: Eudragit RS30D, triethyl citrate, talc and distilled water were mixed to prepare a non-release coating solution. This dispersion was added to a spherical, protective coated spherical sugar using a fluid bed coater.
[309] 5. Protective coating: Opadry White was dispersed in distilled water to prepare a second protective coating solution. This dispersion was added to a non-release coated benatonium benzoate sphere using a fluid bed coater.
[310] 6. The spheres were cured at 45 ° C. for about 48 hours.
[311] Example 6
[312] In Example 6, a substantially non-release form of bitter (denatonium benzoate) was prepared with denatonium benzoate including granules. These granules consist of denatonium benzoate dispersed in the matrix so that denatonium benzoate is actually unreleased. The formulation of Example 6 is shown in Table 11 below.
[313] ingredientContent / unit (mg) Denatonium benzoate0.07 Dicalcium phosphate53.0 Poly (DI-Lactide-Co-Glycolide) polymer (PLGA), molecular weight-100,00012.0 Ethyl acetate *sum65.07 *: Used as excipient of PLGA polymer
[314] Manufacture process:
[315] 1. Solution Preparation: PLGA was mixed and dissolved in ethyl acetate.
[316] 2. Granulation: Denatonium benzoate, and dicalcium phosphate were placed in a fluid bed granulator and the solution was added.
[317] Example 7
[318] The specific prescription is shown in Table 7 below.
[319] In Example 7, practically unreleased bitumen (denatonium benzoate) was prepared from denatonium benzoate extruded pellets. The formulation of Example 7 is shown in Table 12 below.
[320] ingredientContent / unit (mg) Denatonium benzoate0.07 Eudragit RSPO180.0 Stearyl alcohol55.0 sum235.07
[321] Manufacturing process:
[322] 1. Milling: Stearyl alcohol flakes were passed using an impact mill.
[323] 2. Blending: Denatonium benzoate, Eudragit and ground stearyl alcohol were mixed in a twin shell blender.
[324] 3. Extrusion: The blended material was continuously injected into a twin screw extruder and the strand result was collected on a conveyor.
[325] 4. Cooling: The strings were left to cool on the conveyor.
[326] 5. Pelletizing: The cooled straps were cut into pellets using a pelletizer.
[327] 6. Screening: The pellets were screened and collected at a sieve fraction of the desired size.
[328] Example 8 Naltrexone HCl Beads
[329] In Example 8, naltrexone HCl beads having the formulations according to Table 13 were prepared, which were intended to be enclosed into capsules.
[330] ingredientContent / unit (mg) Stage 1. Drug layeringNaltrexone HCl2.1 Non-pareil Beads (30/35 Mesh)39.98 Opadry Clear (hydroxypropylmethyl cellulose)0.4 Sodium ascorbate0.027 Asokobic acid0.05 Step 2. Anionic polymer coatEudragit L30D (dried)2.164 Triethyl citrate0.433 Cabosil0.108 Step 3. Sustained release coatEudragit RS30D (dried)17.475 Triethyl citrate3.495 Cabosil0.874 Step 4. Seal coatOpadry Clear (hydroxypropylmethyl cellulose)1.899 Cabosil0.271 Total (dry basis) 69.287
[331] Manufacturing process:
[332] 1. Naltrexone HCl and ascorbic acid, sodium ascorbate and Opadry Clear were dissolved in water. The drug solution was sprayed onto non-pareil beads in a fluid bath coater with Worster insert.
[333] 2. Eudragit L30D, triethyl citrate and carbosil were dispersed in water. The dispersion was sprayed onto drug-injected beads in a fluid bed coater.
[334] 3. Eudragit L30D, triethyl citrate and carbosil were dispersed in water. The dispersion was sprayed onto the beads in a fluid bath coater.
[335] 4. Opadry Clear was dissolved in water. The dispersion was sprayed onto the beads in a fluid bath coater.
[336] 5. The beads were cured at 60 ° C. for 24 hours.
[337] Example 9 Naltrexone Multiparticles
[338] Naltrexone melt extruded multiparticulate formulations were prepared. The melt extruded multiparticulate formulation is shown in Table 14 below.
[339] ingredientContent / unit (mg) Naltrexone HCl2.0 Eudragit RSPO88.0 Stearyl alcohol15.0 Stearic acid15.0 BHT1.0 sum121.0
[340] Manufacture process:
[341] 1. Stearyl acid, stearyl alcohol, naltrexone HCl, BHT and Eudragit RSPO were milled and blended using a V-blend.
[342] 2. The mixture was extruded using a powder feeder, melt extruder (with 6x1 mm diameter head), conveyor, lasermike and pelletizer.
[343] -Powder feed rate: 4.2 kg / hr; Vacuum: up to 980 mBar
[344] Conveyor: The diameter of this extrudate is 1mm.
[345] Pelletizer: Cut these pellets into 1mm lengths.
[346] 3. Pellets were screened using a screen of # 16 mesh and # 20 mesh. The material that passed through the # 16 mesh screen was collected and kept on the screen of the # 20 mesh.
[347] 4. Fill pellet into # 2 sized clear gelatin capsules.
[348] Range: NLT 114mg and NMT 126mg
[349] Example 10 Naltrexone CR Beads
[350] Sustained release naltrexone bead formulations were prepared by inclusion into opioid release granules and compaction into tablets. The controlled release naltrexone bead formulations are shown in Table 15 below.
[351] ingredientContent / unit (mg) Stage 1. Drug layeringNaltrexone HCl0.609 Non-pareil Beads (30/35 Mesh)67.264 Opadry Clear (hydroxypropylmethyl cellulose)0.547 Step 2. Seal coatEudragit L2.545 Triethyl citrate0.636 Glyceryl Monostearate0.239 Step 3. Sustained release coatEudragit RS30D (dried)43.789 Triethyl citrate8.758 Cabosil2.189 Step 4. Seal coatOpadry Clear (hydroxypropylmethyl cellulose)2.053 Cabosil1.365 Total (dry basis) 130
[352] Manufacture process:
[353] 1. Naltrexone HCl and Opadry Clear (HPMC) were dissolved in water. The drug solution was sprayed onto non-pareil beads in a fluid bath coater with Worster insert.
[354] 2. Eudragit L, triethyl citrate and glyceryl monostearate were dispersed in water. The dispersion was sprayed onto drug-injected beads in a fluid bed coater.
[355] 3. Eudragit RS, triethyl citrate and carbosyl were dispersed in water. The dispersion was sprayed onto the beads in a fluid bath coater.
[356] 4. Opadry Clear was dissolved in water. The dispersion was sprayed onto the beads in a fluid bath coater.
[357] 5. The beads were cured at 60 ° C. for 24 hours.
[358] Example 11 Release Control Oxycodone
[359] In Example 11, 20 mg of a sustained release oxycodone formulation was prepared according to the prescription in Table 16 below.
[360] ingredientContent / unit (mg) Oxycodone HCl20.0 Spray dried lactose59.25 Povidone5.0 Eudragit RS30D (Solid)10.0 Triacetin2.0 Stearyl alcohol25.0 Talc2.5 Magnesium stearate1.25 Opadray pink Y-S-14518A4.0 sum129.0
[361] Manufacturing process:
[362] 1. Granulation: Eudragit / triacetin dispersion was sprayed on oxycodone HCl, spray dried lactose and povidone using a fluid bed granulator.
[363] 2. Grinding: The granules were put through the mill.
[364] 3. Waxing: Stearyl alcohol was dissolved, added to the ground granules using a mixer, and placed in a cool place.
[365] 4. Grinding: The cooled granules were passed through a mill.
[366] 5. Lubrication: The granules were lubricated with a mixer using talc and magnesium stearate.
[367] 6. Compression: The granules were compressed into tablets using a tablet press.
[368] 7. Film coating: The tablets were subjected to a water soluble film coating.
[369] Example 12
[370] In Example 12, naltrexone beads prepared in the same manner as in Example 10 were entrapped into 20 mg of sustained-release oxycodone tablets prepared in the same manner as in Example 11, the prescription of which is shown in Table 17 below.
[371] ingredientContent / unit (mg) Stage 1. GranulationOxycodone HCl20.0 Spray dried lactose59.25 Povidone5.0 Eudragit RS30D (dry)10.0 Triacetin2.0 Stearyl alcohol25.0 Talc2.5 magnesium1.25 Step 2. Tablet combinationOxyContin Granules (Example 3)125 Naltrexone CR Beads (Prescription 2)140
[372] Manufacture process:
[373] 1. Eudragit / triacetin dispersion was sprayed on oxycodone HCl, spray dried spray dried lactose and povidone using a fluid bed granulator.
[374] 2. Add granules and pass through the grinder.
[375] 3. Stearyl alcohol was dissolved, added to the ground granules using a mixer, and placed in a cool place.
[376] 4. The cooled granules were passed through a mill.
[377] 5. The granules were lubricated with a mixer using talc and magnesium stearate.
[378] 6. Naltrexone beads and the granules were mixed and compressed into tablets.
[379] Optional manufacturing process:
[380] 1. Eudragit / triacetin dispersion was sprayed on oxycodone HCl, spray dried spray dried lactose and povidone using a fluid bed granulator.
[381] 2. Add granules and pass through the grinder.
[382] 3. Naltrexone beads (Example 2) and the granules were mixed in a Hobar mixer.
[383] 4. Stearyl alcohol was dissolved and added to the mixture and placed in a cool place.
[384] 5. The cooled granules were passed through a mill.
[385] 6. The granules were lubricated with a mixer using talc and magnesium stearate.
[386] 7. Compressed into tablets.
[387] The releasing naltrexone may comprise a) protective coating on a tablet, such as comprising the tablet in an opadry solution, b) modifying the sequestered component with the desired naltrexone release, c) comprising naltrexone with an opioid agonist, or And any other method well known in the art. The content of naltrexone will be such that it can have the desired pharmaceutical effect as described herein, providing immediate or sustained release.
[388] Inclusion of one or more aversive agents as described herein into oxycodone tablets is well known to those skilled in the art. One or more aversive agents are in release, non-release or indeed non-release form or combinations thereof.
[389] Example 13 Controlled Release Hydrocodone
[390] Sustained release hydrocodone formulations were prepared according to the prescription in Table 18 below.
[391] ingredientContent / unit (mg)Content / batch (g) Hydrocodone Vitalate15.0320.0 Eudragit RSPO76.01520.0 Eudragit RLPO4.080.0 Stearyl alcohol25.0500.0 sum120.02400.0
[392] Manufacture process:
[393] 1. Stearyl alcohol, Eudragit RLPO, hydrocodone vitalate and Eudragit RSPO were ground and blended using a Hobart mixer.
[394] 2. The granules were extruded using a powder feeder, melt extruder (with 6x1 mm diameter head), conveyor, lasermike and pelletizer.
[395] -Powder feed rate: 40 g / min; Vacuum: up to 980 mBar
[396] Conveyor: The diameter of this extrudate is 1mm.
[397] Pelletizer: Cut these pellets into 1mm lengths.
[398] 3. Pellets were screened using a screen of # 16 mesh and # 20 mesh. The material that passed through the # 16 mesh screen was collected and kept on the screen of the # 20 mesh.
[399] 4. Fill pellet into # 2 sized clear gelatin capsules.
[400] Range: NLT (not less than) 114mg and NMT (not more than) 126mg
[401] The isolated naltrexone formulation of Example 9 was encapsulated into a capsule with hydrocodone pellets. Preferably, the isolated naltrexone pellets are not distinguished from hydrocodone pellets.
[402] The releasing naltrexone may comprise a) protective coating on a tablet, such as comprising the tablet in an opadry solution, b) modifying the sequestered component with the desired naltrexone release, c) comprising naltrexone with an opioid agonist, or And any other method well known in the art. The content of naltrexone will be such that it can have the desired pharmaceutical effect as described herein, providing immediate or sustained release.
[403] Inclusion of one or more aversive agents as described herein into oxycodone tablets is well known to those skilled in the art. One or more aversive agents are in release, non-release or indeed non-release form or combinations thereof.
[404] Example 14 Oxycodone HCl Beads
[405] Sustained release oxycodone HCl bead formulations were prepared according to the formulation in Table 19 below.
[406] ingredientContent / unit (mg) Stage 1. Drug injectionOxycodone HCl10.5 non-pareil beads (30/35 mesh)45.349 Opadry Clear2.5 Step 2. Sustained release coatingEudragit RS30D (dried)7.206 Eudragit RL30D (Dry)0.379 Triethyl citrate1.517 Cabosil0.379 Step 3. Sealing coatingOpadry Clear (hydroxypropylmethyl cellulose)1.899 Cabosil0.271 sum70.0
[407] Manufacture process:
[408] 1. Oxycodone HCl and Opadry (HPMC) were dissolved in water. The drug solution was sprayed onto non-pareil beads in a fluid bath coater with Worster insert.
[409] 2. Eudragit RS, Eudragit RL, triethyl citrate and cobosyl were dispersed in water. The dispersion was sprayed onto the beads in a fluid bath coater.
[410] 3. Opadry was dissolved in water. This solution was sprayed onto the beads in a fluid bed coater.
[411] 4. The beads were cured at 60 ° C. for 24 hours.
[412] The isolated naltrexone formulation of Example 8 was encapsulated into a capsule containing oxycodone pellets. Preferably, the isolated naltrexone pellets do not separate from the oxycodone pellets.
[413] The releasing naltrexone comprises a) protective coating on a tablet, such as comprising a tablet in an opadry solution, b) modifying the sequestered component with the desired naltrexone release, c) comprising naltrexone with an opioid agonist, or And any other method well known in the art. The content of naltrexone will be such that it can have the desired pharmaceutical effect as described herein, providing immediate or sustained release.
[414] Inclusion of one or more aversive agents as described herein into oxycodone tablets is well known to those skilled in the art. One or more aversive agents are in release, non-release or indeed non-release form or combinations thereof. Preferably, when the beads containing the aversive agent are encapsulated into the capsule, they are not separated from the oxycodone beads.
[415] Example 15 Controlled Release Hydromolphone
[416] Sustained release hydromolphone HCl formulations were prepared from the formulations shown in Table 20 below:
[417] ingredientContent / unit (mg) Hydromoldon HCl12.0 Eudragit RSPO76.5 Ethocel4.5 Stearic acid27.0 sum120.0
[418] Manufacture process:
[419] 1. Stearyl acid, etocel, hydrocodone vitalate, and Eudragit RSPO were ground and blended using a V-blend.
[420] 2. The granules were extruded using a powder feeder, melt extruder (with 6x1 mm diameter head), conveyor, lasermike and pelletizer.
[421] -Powder feed rate: 4.2 kg / hr; Vacuum: up to 980 mBar
[422] Conveyor: The diameter of this extrudate is 1mm.
[423] Pelletizer: Cut these pellets into 1mm lengths.
[424] 3. Pellets were screened using a screen of # 16 mesh and # 20 mesh. The material that passed through the # 16 mesh screen was collected and kept on the screen of the # 20 mesh.
[425] 4. Fill pellet into # 2 sized clear gelatin capsules.
[426] Range: NLT (not less than) 114mg and NMT (not more than) 126mg
[427] The isolated naltrexone formulation of Example 15 was encapsulated into a capsule with hydrocodone pellets. Preferably, the isolated naltrexone pellets are not distinguished from hydrocodone pellets.
[428] The releasing naltrexone may comprise a) protective coating on a tablet, such as comprising the tablet in an opadry solution, b) modifying the sequestered component with the desired naltrexone release, c) comprising naltrexone with an opioid agonist, or And any other method well known in the art. The content of naltrexone will be such that it can have the desired pharmaceutical effect as described herein, providing immediate or sustained release.
[429] Inclusion of one or more aversive agents as described herein into oxycodone tablets is well known to those skilled in the art. One or more aversive agents are in release, non-release or indeed non-release form or combinations thereof. Preferably, when the pellets containing the aversive agent are encapsulated into the capsule, they are not separated from the hydromolphone pellets.
[430] Example 16 20 mg of an oxycodone formulation was prepared comprising naltrexone as an antagonist and various inhibitors.
[431] The various deterring agents used in this embodiment are combined into the product to produce tablets that can provide damage resistance to various aspects of abuse by poisoning. Small amounts of naloxone hydrochloride, denatonium benzoate, and xanthan gum are added into the oxycodone formulation during the granulation process. The oxycodone granule formulation of Example 16 is shown in Table 21 below.
[432] ingredientContent / unit (mg)Content / batch (gm) Oxycodone HCl20.0209.6 ^*Spray-dried lactose59.25592.5 Povidone5.0050.0 Eudragit RS 30D (Solid)10.00100 Triacetin2.020.0 Naloxone HCl0.616.12 ^**Denatonium benzoate0.070.68 Xanthan sword9.090.0 Stearyl alcohol25.0250.0 Talc2.525.0 Magnesium stearate1.2512.5 Opadray Y-S-14518A5.050.0 *: Adjusted to 99.6% analyte and 4.2% residual moisture **: Adjusted to 99.23% analyte and 0.5% residual moisture.
[433] Manufacture process:
[434] 1. Dispersion: Naltrexone HCl and denatonium benzoate were dissolved in distilled water and the solution was added to the Eduragit / triacetin dispersion.
[435] 2. Granulation: Eduragit / triacetin dispersion was added to oxycodone HCl, spray dried lactose, xanthan gum and povidone using a fluid bed coating machine.
[436] 3. Milling: Granules were added and the granules were passed through a grinder.
[437] 4. Waxing: Stearyl alcohol was dissolved and added to the milled granules using a mixer. It was left to cool.
[438] 5. Milling: The cooled granules were passed through a mill.
[439] 6. Lubrication: The granules were lubricated with talc, magnesium stearate using a mixer.
[440] 7. Compression: The granules were compressed into tablets using a tablet press.
[441] Examples 17-20
[442] Examples 4 to 7 were repeated by adding or adding capsaicin in a sufficient amount to the aversive agent described herein.
[443] While the invention has been described and illustrated in accordance with certain preferred embodiments, those skilled in the art will recognize that modifications can be made without departing from the spirit and aspects of the invention. Such modifications may be made within the scope of the appended claims.
[444] The present invention provides oral formulations of opioid agonists useful for reducing the abuse of opioid agonists contained in opioid agonists, affecting the analgesic effects of opioid agonists or prompting discontinuation. Provided are oral formulations of opioid analgesics useful for reducing the abuse potential of opioid agonists that are unlikely to pose a risk, and provide oral formulations of opioid agonists that are resistant to misuse, abuse or diversion. .

权利要求:
Claims (81)
[1" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic;
Opioid antagonists; And
An oral formulation comprising an effective amount of bitter agent that can give a bitter taste to an abuser when administered after the formulation is impaired.
[2" claim-type="Currently amended] The method of claim 1, wherein the flavoring agent is flavor oil; Flavoursome aromatics; Oleoresin; Extracts derived from plants, leaves, flowers, flavor fruit; Sucrose derivatives; Chloro sucrose derivatives; Quinine sulfate, denatonium benzoate; And oral mixtures thereof.
[3" claim-type="Currently amended] The oral preparation of claim 1, wherein the bitter agent is selected from the group consisting of spearmint oil, peppermint oil, eucalyptus oil, nutmeg oil, allspice, mace, bitter almond oil, menthol, and combinations thereof. Formulation.
[4" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is a fruit flavor selected from the group consisting of lemon, orange, lime, grapefruit, and mixtures thereof.
[5" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is denatonium benzoate.
[6" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is in an isolated form.
[7" claim-type="Currently amended] The oral dosage form of claim 1, wherein the antagonist is in an isolated form.
[8" claim-type="Currently amended] 2. The oral dosage form of claim 1, wherein the antagonist and bitter agent are both in an isolated form.
[9" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is included in less than 50% by weight of the total dosage form.
[10" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is included in less than 10% by weight of the total dosage form.
[11" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is included in less than 5% by weight of the total dosage form.
[12" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is included in an amount of 0.1 to 1.0% by weight of the total formulation.
[13" claim-type="Currently amended] The oral dosage form of claim 1 further comprising a pharmaceutically acceptable excipient.
[14" claim-type="Currently amended] 14. The oral dosage form of claim 13, wherein the excipient is a sustained release excipient.
[15" claim-type="Currently amended] The oral dosage form of claim 13, wherein the dosage form provides an analgesic effect for at least 12 hours after oral administration to a human patient.
[16" claim-type="Currently amended] The oral dosage form of claim 1, wherein the bitter agent is at least partially interdispersed with the opioid analgesic.
[17" claim-type="Currently amended] The opioid of claim 1, wherein the formulation is analgesically effective when administered in combination orally, but when administered in the same or greater amount than the therapeutically effective amount, is an opioid exhibiting repellency in a body dependent human patient. Formulation characterized in that it has a ratio of opioid antagonist to agonist.
[18" claim-type="Currently amended] 18. The analgesic of the opioid agonist according to claim 17, wherein the ratio of the opioid antagonist to the opioid agonist maintains an analgesic effect, but when administered to a human patient without the opioid antagonist, compared to the same therapeutic amount of the opioid analgesic. Formulations characterized in that the effect is not increased.
[19" claim-type="Currently amended] The method of claim 1, wherein the antagonist is an amount that can alleviate the side effects of the opioid agonist selected from the group consisting of anti- analgesics, hyperalgesia, hyperalgesia, body dependence, resistance and any combination thereof. Oral Formulations.
[20" claim-type="Currently amended] The oral dosage form of claim 1 wherein the amount of antagonist released during the DOS cycle is to enhance the analgesic efficacy of the opioid agonist.
[21" claim-type="Currently amended] The oral dosage form of claim 1, wherein the amount of the release opioid receptor antagonist is 100 to 1000 times less than the content of the opioid agonist.
[22" claim-type="Currently amended] A pain treatment method comprising administering the oral dosage form of claim 1 to a human patient.
[23" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; And an antagonist in the formulation comprising an effective amount of a bitter agent that can give a bitter taste to the abuser when administered after the formulation has been impaired.
[24" claim-type="Currently amended] 24. The method of claim 23, wherein the bitter agent is at least partially interdispersed with the opioid analgesic.
[25" claim-type="Currently amended] Analgesically effective amount of opioid analgesic; Antagonists; And preparing the formulation as an effective amount of bitter agent that can give the abuser a bitter taste when administered after the formulation is impaired.
[26" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And an effective amount of a stimulant that can cause an unpleasant mood to the abuser when administered after the formulation is impaired.
[27" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is selected from the group consisting of capsaicin, capsaicin analogs, and mixtures thereof.
[28" claim-type="Currently amended] 27. The method of claim 26, wherein the stimulant is resiniperatosine, tinyatosine, heptanoxobutylamide, heptanol guaiacylamide, other isobutylamide or guiaacylamide, dihydrocapsaicin, homovanylyl octyl ester Or a capsaicin analogue selected from the group consisting of nonanoyl vanylylamide and mixtures thereof.
[29" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is capsaicin.
[30" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is vanillylamide.
[31" claim-type="Currently amended] The oral dosage form of claim 26, wherein the stimulant is in an isolated form.
[32" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the antagonist is in an isolated form.
[33" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant and the antagonist are both in isolated form.
[34" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is 0.00125 to 50% by weight of the total formulation.
[35" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is 1 to 7.5 wt% of the total formulation.
[36" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is 1 to 5% by weight of the total formulation.
[37" claim-type="Currently amended] The oral dosage form of claim 26 further comprising a pharmaceutically acceptable excipient.
[38" claim-type="Currently amended] 38. The oral dosage form of claim 37, wherein the excipient is a sustained release excipient.
[39" claim-type="Currently amended] 38. The oral dosage form of claim 37, wherein the dosage form provides an analgesic effect for at least about 12 hours after oral administration to a human patient.
[40" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the stimulant is at least partially interdispersed with the opioid analgesic.
[41" claim-type="Currently amended] 27. The method of claim 26, wherein the formulation is analgesically effective when administered in combination orally, but when administered in an amount equal to or greater than the therapeutically effective amount, exhibits repellency in body dependent human patients. Formulation having an ratio of opioid antagonist to opioid agonist.
[42" claim-type="Currently amended] 42. The analgesic of claim 41 wherein the ratio of opioid antagonist to opioid agonist maintains an analgesic effect but when administered to a human patient without the opioid antagonist, compared to the same therapeutic amount of opioid analgesic Formulations characterized in that the effect is not increased.
[43" claim-type="Currently amended] 27. The method of claim 26, wherein the antagonist is an amount that can alleviate the side effects of the opioid agonist selected from the group consisting of anti- analgesics, hyperalgesia, hyperalgesia, body dependence, tolerance and any combination thereof. Oral Formulations.
[44" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the amount of antagonist released during the DOS cycle is to enhance the analgesic efficacy of the opioid agonist.
[45" claim-type="Currently amended] 27. The oral dosage form of claim 26, wherein the amount of the release opioid receptor antagonist is 100 to 1000 times less than the content of the opioid agonist.
[46" claim-type="Currently amended] A pain treatment method comprising administering the oral dosage form of claim 26 to a human patient.
[47" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; And an antagonist in the formulation comprising an effective amount of a stimulant that can give a bitter taste to the abuser upon administration after the formulation has been impaired.
[48" claim-type="Currently amended] 48. The oral dosage form of claim 47 wherein the stimulant is at least partially interdispersed with the opioid analgesic.
[49" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And preparing the formulation as an effective amount of an irritant that can cause an unpleasant sensation to the abuser when administered after the formulation is impaired.
[50" claim-type="Currently amended] In an oral dosage form comprising a therapeutically effective amount of opioid analgesic, an opioid antagonist, and one or more pharmaceutically acceptable excipients;
The formulation further has an effective amount that can give an unsuitable viscosity for administration selected from the group consisting of parenteral and nasal administration to the resulting melt mixture when the formulation is ground and mixed with 0.5-10 ml of an aqueous liquid. Oral formulation, characterized in that it comprises a gelling agent.
[51" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the excipient comprises a sustained release material and wherein the dosage form provides pain relief for at least 12 hours when administered orally to a human patient.
[52" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the gelling agent comprises a sustained release material and wherein the dosage form provides analgesic relief for at least 12 hours when administered orally to a human patient.
[53" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is selected from the group consisting of leverpanol, meperidine, dihydrocodeine, dihydromorphine, pharmaceutically acceptable salts thereof, and mixtures thereof. .
[54" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is morphine or a pharmaceutically acceptable salt thereof.
[55" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is hydromolphone or a pharmaceutically acceptable salt thereof.
[56" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is hydrocodone or a pharmaceutically acceptable salt thereof.
[57" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is oxycodone or a pharmaceutically acceptable salt thereof.
[58" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is codeine or a pharmaceutically acceptable salt thereof.
[59" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the opioid analgesic is oxymolphone or a pharmaceutically acceptable salt thereof.
[60" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the ratio of gelling agent to opioid analgesic is 1:40 to 40: 1.
[61" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the ratio of the gelling agent to the opioid analgesic is 1: 1 to 30: 1.
[62" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the ratio of the gelling agent to the opioid analgesic is 2: 1 to 10: 1.
[63" claim-type="Currently amended] 51. The oral dosage form of claim 50 wherein the gelling agent is selected from the group consisting of sugars, alcohol derived sugars, cellulose derivatives, gums, surfactants, emulsifiers, and mixtures thereof.
[64" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the gelling agent is pectin.
[65" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the gelling agent is xanthan gum.
[66" claim-type="Currently amended] 51. The oral dosage form of claim 50 wherein the inappropriate viscosity is achieved when 1-3 ml of an aqueous liquid is mixed with the ground formulation.
[67" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And preparing a formulation with one or more pharmaceutically acceptable excipients;
Here, the formulation may further give an unsuitable viscosity for administration selected from the group consisting of parenteral and nasal administration to the molten mixture formed when the formulation is ground and mixed with 0.5-10 ml of an aqueous liquid. A method for preventing abuse of an oral dosage form of opioid analgesic, characterized in that it comprises an effective amount of a gelling agent.
[68" claim-type="Currently amended] 68. The method of claim 67, wherein the excipient comprises a sustained release material and the formulation provides effective analgesic relief for at least 12 hours when administered orally to a human patient.
[69" claim-type="Currently amended] 68. The method of claim 67, wherein the gelling agent comprises a sustained release material and wherein the formulation provides effective analgesic relief for at least 12 hours when administered orally to a human patient.
[70" claim-type="Currently amended] 68. The method of claim 67, wherein the addition of 0.5-10 ml of the aqueous liquid is such that the molten mixture has a viscosity of at least 60 cP or greater.
[71" claim-type="Currently amended] 68. The method of claim 67, wherein the opioid analgesic is morphine, hydromorphone, hydrocodone, oxycodone, codeine, leverpanol, meperidine, dihydrocodeine, dihydromorphine, oxymolphone, pharmaceutically acceptable salts thereof, and Characterized in that it is selected from the group consisting of mixtures thereof.
[72" claim-type="Currently amended] 68. The method of claim 67, wherein the gelling agent is selected from the group consisting of sugars, alcohol derived sugars, cellulose derivatives, gums, surfactants, emulsifiers, and mixtures thereof.
[73" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And one or more pharmaceutically acceptable excipients,
Wherein the formulation is further ineligible for administration selected from the group consisting of parenteral and nasal administration to the resulting melt mixture when the formulation is ground, mixed with 0.5-10 ml of an aqueous liquid and then heated. Contains an effective amount of gelling agent to give,
The dosage form for controlled release oral use, characterized in that, when administered orally to a human patient, it provides pain relief for at least 12 hours.
[74" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And preparing one or more pharmaceutically acceptable excipients,
Wherein the formulation further has inadequate viscosity for administration selected from the group consisting of parenteral and nasal administration to the molten mixture formed when the formulation is ground, mixed with 0.5-10 ml of an aqueous liquid and then heated. Contains an effective amount of gelling agent,
Wherein said formulation provides analgesic relief for at least 12 hours when orally administered to a human patient.
[75" claim-type="Currently amended] A therapeutically effective amount of opioid analgesic to provide analgesic relief for at least 12 hours when administered orally to a human patient; Opioid antagonists; And administering a pharmaceutically acceptable excipient to the patient,
The formulation may further give an unsuitable viscosity for administration selected from the group consisting of parenteral and nasal administration to the molten mixture formed when the formulation is ground, mixed with 0.5-10 ml of aqueous liquid and then heated. Pain treatment method characterized in that it comprises an effective amount of a gelling agent.
[76" claim-type="Currently amended] 51. The formulation of claim 50, wherein the antagonist is in an isolated form.
[77" claim-type="Currently amended] 51. The method of claim 50, wherein the antagonist is an amount that is capable of alleviating the side effects of the opioid agonist selected from the group consisting of anti- analgesic, hyperalgesia, hyperalgesia, body dependence, tolerance and any combination thereof. Oral Formulations.
[78" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the amount of antagonist released during the DOS cycle is to enhance the analgesic efficacy of the opioid agonist.
[79" claim-type="Currently amended] 51. The oral dosage form of claim 50, wherein the amount of the release opioid receptor antagonist is 100 to 1000 times less than the content of the opioid agonist.
[80" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And an effective amount of a gelling agent that can give the abuser an inadequate viscosity to be absorbed in the nose when administered through the nasal passage after the formulation is damaged.
[81" claim-type="Currently amended] Therapeutically effective amount of opioid analgesic; Opioid antagonists; And an effective amount of a gelling agent that can give an unsuitable viscosity for parenteral administration after the formulation is impaired.

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同族专利:

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公开号 | 公开日

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HU0401195A3|2006-11-28|

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CA2456322A1|2003-02-20|

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HU0401195A2|2004-10-28|

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DE20220910U1|2004-08-05|

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AU2002319774B2|2005-04-21|

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MXPA04001208A|2004-07-08|

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WO2003013479A1|2003-02-20|

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JP2005501067A|2005-01-13|

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EP1414418A1|2004-05-06|

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BR0212019A|2005-08-09|

引用文献:

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公开号 | 申请日 | 公开日 | 申请人 | 专利标题

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法律状态:
2001-08-06|Priority to US60/310,537

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2001-08-06|Priority to US31053701P

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2001-08-06|Priority to US31051601P

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2001-08-06|Priority to US31051501P

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2001-08-06|Priority to US60/310,516

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2001-08-06|Priority to US60/310,515

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2002-08-06|Application filed by 유로-셀티크 소시에떼 아노뉨

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2002-08-06|Priority to PCT/US2002/024934

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2004-07-06|Publication of KR20040060917A

优先权:

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申请号 | 申请日 | 专利标题

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US31053701P| true| 2001-08-06|2001-08-06|

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US31051601P| true| 2001-08-06|2001-08-06|

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US31051501P| true| 2001-08-06|2001-08-06|

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US60/310,516|2001-08-06|

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US60/310,515|2001-08-06|

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US60/310,537|2001-08-06|

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PCT/US2002/024934|WO2003013479A1|2001-08-06|2002-08-06|Compositions and methods to prevent abuse of opioids|