CN100335136C - 具有降低的药物结晶趋势的药物组合物 - Google Patents
具有降低的药物结晶趋势的药物组合物 Download PDFInfo
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- CN100335136C CN100335136C CNB028067665A CN02806766A CN100335136C CN 100335136 C CN100335136 C CN 100335136C CN B028067665 A CNB028067665 A CN B028067665A CN 02806766 A CN02806766 A CN 02806766A CN 100335136 C CN100335136 C CN 100335136C
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Abstract
本发明提供了口服药物组合物,其中含有低水溶性药物、包含至少一种可药用溶剂的溶剂液体和降低浊度的聚合物,其中(a)有相当比例的例如至少约15%重量的药物在溶剂液体中呈溶解形式,和(b)聚合物以足以实质性地抑制药物在模拟的胃液中结晶和/或沉淀的量存在。
Description
发明领域
本发明涉及包含低水溶性药物的口服药物组合物,更特别涉及其中药物是溶解形式的这样的组合物。
发明背景
适于口服给药的液体剂型,例如溶液已成为给个体递送药物的重要方法,特别是当需要迅速开始治疗作用时更是如此。还已知的是将液体制剂包囊,例如包在软或硬明胶胶囊中以提供不连续的剂型,来作为直接饮用液体药物制剂的替换选择。
不幸的是,许多有用的药物在水中具有低的溶解度,从而难以以适宜的浓度在水性载体中配制成溶液。甚至当发现合适的溶剂是这样的药物的载体时,在药物与水接触下例如在胃肠道的水性环境中,药物经常会趋于从溶液中沉淀出来和/或结晶,特别是对于低水溶性的结晶性药物更是如此。这样的沉淀和/或再结晶可抵消或降低通过将药物配制成溶液所希望达到的迅速开始作用的有益效果。
已知将弱水溶性药物的液体剂型,包括包囊的液体剂型作为自乳化制剂来提供。这些制剂一般是设计成当与胃肠液体混合时形成乳液,在某些情况下形成微乳液。然而,即使采用自乳化制剂,一些药物仍然具有在胃肠液体中沉淀和/或结晶的趋势。
因此,本领域需要抑制弱水溶性药物在胃肠液体中沉淀和/或结晶的手段,特别是需要可合并到自乳化液体剂型中的手段。
有此需要的一类示例性药物是低水溶性的选择性环加氧酶-2(COX-2)抑制药物。
据报道有多种化合物具有治疗和/或预防上有用的选择性COX-2抑制作用,并且已经被公开了具有治疗或预防特异性COX-2介导的病症或一般性这类病症的用途。在这样的化合物当中,有多种取代的吡唑基苯磺酰胺化合物报道在Talley等人的U.S.专利5,466,823中,包括例如化合物4-[5-(4-甲基苯基)-3-(三氟甲基)-1H-吡唑-1-基]苯磺酰胺,本文还称为塞来昔布(celecoxib)(I)和化合物4-[5-(3-氟-4-甲氧基苯基)-3-二氟甲基)-1H-吡唑-1-基]苯磺酰胺,本文还称为deracoxib(II)。
据报道具有治疗和/或预防上有用的选择性COX-2抑制作用的其它化合物是在Talley等人的U.S.专利5,633,272中报道的取代的异唑基苯磺酰胺化合物,包括4-[5-甲基-3-苯基异唑-4-基]苯磺酰胺,本文还称为valdecoxib(III)。
据报道具有治疗和/或预防上有用的选择性COX-2抑制作用的其它化合物是在Ducharme等人的U.S.专利5,474,995中公开的取代的(甲基磺酰基)苯基呋喃酮化合物,包括化合物3-苯基-4-[4-(甲基磺酰基)苯基]-5H-呋喃-2-酮,本文亦称为rofecoxib(IV)。
Belley等人的U.S.专利5,981,576公开了另外一系列可用作选择性COX-2抑制药物的(甲基磺酰基)苯基呋喃酮化合物,包括3-(1-环丙基甲氧基)-5,5-二甲基-4-[4-(甲基磺酰基)苯基]-5H-呋喃-2-酮和3-(1-环丙基乙氧基)-5,5-二甲基-4-[4-(甲基磺酰基)苯基]-5H-呋喃-2-酮。
Dube等人的U.S.专利5,861,419公开了据述可用作选择性COX-2抑制药物的取代的吡啶化合物,包括例如化合物5-氯-3-(4-甲基磺酰基)苯基-2-(2-甲基-5-吡啶基)吡啶,在本文中也称为etoricoxib(V)。
欧洲专利申请0863134公开了可用作选择性COX-2抑制药物的化合物2-(3,5-二氟苯基)-3-[4-(甲基磺酰基)苯基]-2-环戊烯-1-酮。
Carter等人的U.S.专利6,034,256公开了据述可用作选择性COX-2抑制药物的一系列苯并吡喃化合物,包括化合物(S)-6,8-二氯-2-(三氟甲基)-2H-1-苯并吡喃-3-甲酸(VI)。
国际专利出版物WO 00/24719公开了据述可用作选择性COX-2抑制药物的哒嗪酮化合物,包括化合物2-(3,4-二氟苯基)-4-(3-羟基-3-甲基-1-丁氧基)-5-[4-(甲基磺酰基)苯基]-3-(2H)-哒嗪酮。
存在选择性COX-2抑制药物的配制组合物,特别是这类药物的速效组合物的需求。速效药物递送系统可提供许多优于常规剂型的优点。速效制剂一般提供比标准剂型更迅速的疗效。例如,在急性疼痛例如头痛或偏头痛的治疗中,速效剂型可用于提供迅速的头痛缓解。
澳大利亚专利申请200042711、200043730和200043736公开了据述可用于治疗偏头痛的含有选择性COX-2抑制药物、5HT1受体激动剂和咖啡因的组合物。
Crison & Amidon的U.S.专利5,993,858公开了用于提高弱水溶性药物的生物利用度的赋形剂制剂。据述该制剂是自微乳化的,并且包含油或其它液体材料、表面活性剂和亲水性辅助表面活性剂。据描述,表面活性剂的选择不如辅助表面活性剂的选择重要,其描述辅助表面活性剂应当具有大于8的HLB(亲水亲油平衡)值。据描述,这样的辅助表面活性剂的一个优选实例是Gattefossé的LabrasolTM,经确定其是HLB值为14的“由衍生自椰子油的中链甘油三酯组成的”产品。据其描述,所制得的在1型(0.5ml)胶囊中含有15mg硝苯地平,即浓度为30mg/ml的制剂在70℃是“澄清溶液”,但是在室温是“半固体”。
在上述U.S.专利5,993,858中引用了Farah等人的较早工作,其中研究了自微乳化制剂来改善消炎痛的体外溶解。据述Farah等人的制剂含有油相材料Gattefossé Corporation的GelucireTM,和HLB值为10的聚乙二醇癸酸/辛酸甘油酯产品,HLB值为4的丙二醇月桂酸酯和二甘醇一乙醚。
低水溶性药物有时在可饮用含水液体内的悬浮液中口服给药。例如,国际专利出版物WO 00/32189中公开了塞来昔布颗粒在苹果汁载体中的悬浮液,该专利通过引用并入本文以作参考。该专利中还公开了塞来昔布在PEG-400(平均分子量为约400的聚乙二醇)与水的体积比为2∶1的混合物中的稀溶液。
据描述,WO 00/32189的悬浮液和溶液组合物具有相差不大的生物利用度。然而,对狗口服给药后,对于溶液组合物,血清塞来昔布浓度达到最大水平(Tmax)的时间比悬浮液短。
上述U.S.专利5,760,068公开,以塞来昔布和deracoxib作为实例的该专利的吡唑基苯磺酰胺化合物可作为在一些溶剂,包括聚乙二醇和丙二醇中的等渗溶液来非胃肠道给药。其中还公开了该专利的化合物可以在口服控释胶囊或片剂中给药,其中例如这样的化合物分散在羟丙基甲基纤维素(HPMC)中。
上述U.S.专利5,633,272公开,以valdecoxib作为实例的该专利的异唑基苯磺酰胺化合物可作为在一些溶剂,包括聚乙二醇和丙二醇中的等渗溶液来非胃肠道给药。其中还公开了该专利的化合物可以在口服控释胶囊或片剂中给药,其中例如这样的化合物分散在HPMC中。
上述U.S.专利5,474,995公开,以rofecoxib作为实例的该专利的(甲基磺酰基)苯基呋喃酮化合物可作为在1,3-丁二醇中的等渗溶液来非胃肠道给药。其中还公开了用甜味剂例如丙二醇配制的口服水包油乳剂、糖浆剂和酏剂,以及用包括甲基纤维素和HPMC在内的悬浮剂配制的水悬浮液。
上述U.S.专利5,861,419公开,以etoricoxib作为实例的该专利的取代的吡啶化合物可作为在1,3-丁二醇中的等渗溶液来非胃肠道给药。其中还公开了用甜味剂例如丙二醇配制的口服水包油乳剂、糖浆剂和酏剂,以及用包括甲基纤维素和HPMC在内的悬浮剂配制的水悬浮液。
许多选择性COX-2抑制化合物,包括塞来昔布、deracoxib、valdecoxib、rofecoxib和etoricoxib在水性介质中具有低的溶解度。此外,某些这样的化合物,例如塞采昔布具有较高的剂量需求。这些性质给配制用于速效口服给药的选择性COX-2抑制药物的浓溶液带来了实际问题。对于这样的高剂量、低溶解度药物,提供治疗剂量所需的胶囊大小或溶液体积成为了限制性因素。例如,在给定溶剂中的溶解度为10mg/ml,且治疗剂量为400mg/天的药物将需要摄入40ml溶液。对于饮用形式的使用,这样的体积可能是不便或不可接受的;当需要包囊剂型时,该体积还带来了特别的问题,因为含有多于约1.0ml-约1.5ml液体的胶囊通常被认为太大而不能舒服地吞咽。因此,当以胶囊形式给药时,可能需要摄入多个胶囊以提供所需剂量。为了避免这样的问题,必须选择其中药物具有较高溶解度的溶剂。
如下所述,低水溶性的选择性COX-2抑制药物的适应症是非常宽范围的COX-2介导的疾病和状况。因此,如果在胃肠液中从溶液制剂例如自乳化制剂中沉淀或结晶的问题可以得到克服,则在COX-2介导的状况和疾病的治疗中,特别是在需要缓解疼痛或其它症状的急性病症的治疗中可实现显著进展。这将在本领域中代表特别重要的进展,以提供使用这样的制剂治疗疼痛,例如头痛和偏头痛的有效方法。
发明概述
本发明提供了口服药物组合物,其中含有低水溶性药物、包含至少一种可药用溶剂的溶剂液体和降低浊度的聚合物。在优选的实施方案中,所述聚合物是具有至少一部分被甲氧基和/或羟基丙氧基取代的可取代羟基的纤维素聚合物,其中(a)有相当比例的例如至少约15%重量的药物在溶剂液体中呈溶解形式,和(b)聚合物以足以实质性地抑制药物在模拟的胃液中结晶和/或沉淀的量存在。
在本发明中,给定的聚合物是否是“降低浊度的聚合物”可依据下文所述的测试I来确定。
在本文中,术语“溶剂液体”包括特定药物溶解于其中的、除如上所定义的聚合物组分之外的液体介质的所有组分。因此,“溶剂液体”不仅包括一种或多种溶剂,还包括任选的另外的赋形剂例如助溶剂、表面活性剂、辅助表面活性剂、抗氧化剂、甜味剂、矫味剂、着色剂等。
在优选的本发明组合物中,基本上所有药物都在溶剂液体中呈溶解形式,并且基本上没有药物呈固体颗粒形式。这样的组合物在本文中称为“溶液”。特别优选的是,该溶液在如下文所述的模拟胃液中是可以自细乳化的。
另一本发明组合物除了包含第一部分溶解形式的药物以外,还包含第二部分分散在溶剂液体中的颗粒形式的药物。在该实施方案中,一部分药物在溶液中,另一部分药物在悬浮液中。这样的组合物在本文中称为“溶液/悬浮液”。
在本文中缩写为“SGF”的“模拟胃液”是0.01M盐酸和0.15M氯化钠的pH为约2的水溶液。
在优选的本发明实施方案中,溶液或溶液/悬浮液包囊在一个或多个胶囊中,其中在进入胃肠道之后,所述胶囊的壁在短时间内在胃肠液体中破碎以释放出药物。
在本发明中,如上所定义的降低浊度的聚合物有时称为“结晶抑制剂”。该结晶抑制剂可以存在于(a)在溶剂液体内的溶液或悬浮液中,和/或(b)作为胶囊壁的组分存在。
在一个实施方案中,本发明提供了口服药物组合物,所述组合物含有包囊在胶囊壁内的低水溶性药物的可自细乳化的液体制剂,所述胶囊壁包含降低浊度的聚合物,优选具有至少一部分被甲氧基和/或羟基丙氧基取代的可取代羟基的纤维素聚合物,所述聚合物以实质性地抑制药物在模拟胃液中结晶和/或沉淀的有效量存在。胶囊壁优选主要由降低浊度的纤维素聚合物例如HPMC组成。
该实施方案可视为本发明较宽的实施方案的一部分,依据该实施方案,本发明提供了口服药物组合物,所述组合物含有包囊在胶囊壁内的呈高能相的低水溶性药物和一种或多种可药用赋形剂,所述胶囊壁包含降低浊度的聚合物,优选具有至少一部分被甲氧基和/或羟基丙氧基取代的可取代羟基的降低浊度的纤维素聚合物,所述聚合物以实质性地抑制药物在模拟胃液中结晶和/或沉淀的有效量存在。
在本发明中,“高能相”是药物的任何形式,包括固体、碱或酸的盐、半固体和液体,它们在水性介质中表现出比热力学最稳定的结晶形式的该药物要快的溶解速度和/或更大的过饱和趋势。因此,在该实施方案中,药物可呈不是最低能量的结晶形式(例如无定形)的任何高能相,例如固态颗粒形式。
例如,当药物是选择性COX-2抑制药物时,本发明组合物是有用的,并且已经发现能以令人惊奇的有效方式解决至少一些上文提及的困难。因此,依据本发明,提供了呈高能相的低水溶性药物,例如在可自细乳化的溶液制剂中的药物,如通过例如体外释放到SGF中所表明的那样,这样的药物在释放到胃肠液体中时发生沉淀和/或结晶的趋势大大降低了。这样的制剂优选呈便于口服给药的剂型。本发明制剂是特别有利的,因为它们使得高浓度药物适于包囊,并且在口服给药之后,可通过抑制药物沉淀和/或结晶而使得药物迅速吸收到血流中。由于迅速被吸收,本发明制剂可提供迅速开始的治疗作用。
可以推理,当在溶液、特别是自乳化溶液中口服给药时,弱水溶性药物能够提供比颗粒形式快的疗效开始,这是因为不需要在胃肠道中的溶解过程。可以假定,与固体制剂例如片剂相比,溶液组合物将更加有利,因为其既不需要崩解,也不需要溶解。
此外,与只有当载体制剂在胃或肠中崩解时才能被利用的组合物相比,在饮用溶液中施用的药物可以在消化道例如口和食管中获得更高的吸收。
对于许多个体来说,液体剂型例如可饮用溶液和溶液/悬浮液的另一个优点是这些剂型易于吞咽。可饮用液体剂型的另一个优点是可以连续地改变剂量的计量,提供了无限的剂量灵活性。对于婴儿、儿童和老年人,易于吞咽和剂量灵活的优点特别有价值。
当包囊时,除了胶囊形式的不连续和易于吞咽方面的便利之外,溶液或溶液/悬浮液还可以给个体提供与液体制剂有关的有益的迅速吸收特征。
本发明所容许的高浓度溶液之所以是有利的是出于下述几个原因。首先,浓溶液比稀溶液的包装成本低,并易于运输和处理。其次,浓溶液在给药方面提供了灵活性,因为它们可以用任何所需的稀释度来给药。再者,浓的药物溶液,尤其是当包囊时,不需要摄入可给许多患者带来不适的大体积液体。
在一个实施方案中,本发明提供了止痛方法,包括给需要止痛的患者口服施用疼痛缓解有效量的本发明选择性COX-2抑制药物组合物。在另一个实施方案中,本发明提供了治疗和/或预防头痛或偏头痛的方法,包括给需要这样的治疗或预防的个体口服施用本发明选择性COX-2抑制药物组合物和血管调节剂例如甲基黄嘌呤,其中所述选择性COX-2抑制药物和血管调节剂以有效缓解疼痛的总体和相对量施用。选择性COX-2抑制药物和血管调节剂可以作为独立组合物或单一组合物的组分给药。包含(a)按照本发明配制和提供的选择性COX-2抑制药物和(b)血管调节剂的单一组合物是本发明的另一个实施方案。本发明优选的甲基黄嘌呤是咖啡因。
本发明的其它特征在下文中是部分显而易见的,并且被部分指出来。
附图简述
附图1表示的是实施例2的塞来昔布组合物SF-1A、SF-1B和SF-1C在SGF中的体外溶解特性。
附图2表示的是,与塞来昔布组合物SF-3A相比,本发明塞来昔布组合物SF-2A和SF-3B在SGF中的体外溶解特性,其中所有这些组合物都是在实施例3中描述的。
附图3表示的是,与塞来昔布组合物SF-4B相比,本发明塞来昔布组合物SF-4A在SGF中的体外溶解特性,其中这两种组合物都是在实施例4中描述的。
附图4表示的是,与塞来昔布组合物SF-6A相比,本发明塞来昔布测试组合物SF-5A和SF-7A对禁食的狗口服给药后的体内生物利用度,其中所有这些组合物都是在实施例5中描述的。
附图5表示的是,比较用紫杉醇溶液制剂SF-8和本发明溶液制剂SF-9在SGF中的体外溶解特性,其中这两种制剂都是在实施例7中描述的。
发明详述
本发明新的药物组合物包含一个或多个口服剂量单位。在本发明中,术语“口服”是指适于口服给药的手段。在本发明中,术语“口服给药”包括将治疗剂或其组合物递送给个体的任意形式,其中是将治疗剂或组合物置于个体的口中,无论治疗剂或组合物被吞咽与否。因此,“口服给药”包括颊和舌下以及食管给药。治疗剂的吸收可在胃肠道的任何部分,包括口、食管、胃、十二指肠、空肠、回肠和结肠中发生。在本发明中,术语“剂量单位”是指含有适于单次口服以提供治疗作用的量的治疗剂的药物组合物部分。一个剂量单位或多个(高达约4个)小的剂量单位一般提供足以达到所需疗效的量的药物。
低水溶性药物
每个剂量单位或多个小的剂量单位包含治疗和/或预防有效总量的低水溶性药物。在本发明中,“低水溶性药物”或“弱水溶性药物”是指这样的任何药物化合物,当在37℃测定时,其在水中的溶解度不大于约10mg/ml,优选不大于约1mg/ml。对于在37℃测定时在水中的溶解度不大于约0.1mg/ml的药物,本发明组合物是特别有利的。
对于多种药物,在水中的溶解度可依据标准药物参考书容易地确定,所述标准参考书有例如The Merck Index,11th ed.,1989(Merck& Co.,Inc.,Rahway,NJ出版);美国药典,24th ed.(USP 24),2000;The Extra Pharmacopoeia,29th ed.,1989(PharmaceuticalPres s,London出版);和Physicians Desk Reference(PDR),2001ed.(Medical Economics Co.,Montvale,NJ出版),通过引用将其分别独立地并入本文。
例如,在本发明中定义的低溶解性药物包括在USP 24,pp.2254-2298中以标题“弱溶解的”、“非常弱溶解的”、“几乎不溶的”和“不溶的”归类的那些药物;和在USP 24,pp.2299-2304中列出的溶解1g药物需要100ml或更多水的那些药物。
例如,合适的低水溶性药物包括但不限于下列种类的药物:堕胎药、ACE抑制剂、α-和β-肾上腺素能激动剂、α-和β-肾上腺素能阻断剂、肾上腺皮质抑制剂、促肾上腺皮质激素、酒精遏制剂、醛糖还原酶抑制剂、醛固酮拮抗剂、组成代谢剂、止痛剂(包括麻醉性和非麻醉性止痛剂)、雄激素类、血管紧张素II受体拮抗剂、减食欲剂、抗酸剂、驱肠虫剂、抗痤疮剂、抗过敏剂、抗脱发剂、抗阿米巴药、抗雄激素类、抗心绞痛剂、抗心律失常药、抗动脉硬化剂、抗关节炎/抗风湿剂(包括选择性COX-2抑制剂)、平喘药、抗菌剂、抗菌助剂、抗胆碱能剂、抗凝血剂、抗惊厥剂、抗抑郁剂、抗糖尿病剂、止泻剂、制尿剂、解毒剂、抗运动障碍剂、抗湿疹剂、止吐剂、抗雌激素类、抗纤维变性剂、排气剂、杀真菌剂、抗青光眼剂、抗促性腺素剂、抗痛风剂、抗组胺剂、抗活动过强剂、抗高脂蛋白血症剂、抗高磷酸盐血症剂、抗高血压药、抗甲状腺机能亢进剂、抗低血压剂、抗甲状腺机能减退剂、抗炎剂、抗疟药、抗躁狂剂、抗高铁血红蛋白血症剂、抗偏头痛剂、抗毒蕈碱剂、抗分支杆菌剂、抗肿瘤剂和助剂、抗中性白细胞减少症剂、抗骨质疏松剂、抗佩吉特氏病剂、抗震颤麻痹药、抗嗜铬细胞瘤剂、抗卡氏肺囊虫剂、抗前列腺肥大剂、抗原生动物剂、止痒剂、抗牛皮癣剂、抗精神病剂、退热剂、抗立克次氏体剂、抗皮脂溢剂、防腐剂/消毒剂、解痉剂、抗梅毒剂、抗血小板增多剂、抗血栓形成剂、镇咳剂、抗溃疡剂、抗尿石剂、抗蛇毒血清、抗病毒剂、抗焦虑药、芳香酶抑制剂、收敛剂、苯并二氮杂类拮抗剂、骨再吸收抑制剂、心搏徐缓剂、缓激肽拮抗剂、支气管扩张药、钙通道阻断剂、钙调剂、碳酸酐酶抑制剂、强心剂、CCK拮抗剂、螯合剂、溶胆结石剂、利胆剂、胆碱能药、胆碱酯酶抑制剂、胆碱酯酶反应剂、CNS刺激剂、避孕药、清创剂、减充血剂、脱色素剂、疱疹样皮炎抑制剂、助消化剂、利尿剂、多巴胺受体激动剂、多巴胺受体拮抗剂、杀外寄生虫剂、催吐药、脑啡肽酶抑制剂、酶、酶辅因子、雌激素类、祛痰剂、血纤蛋白原受体拮抗剂、氟化物补充物、胃和胰腺分泌刺激剂、胃细胞保护剂、胃质子泵抑制剂、胃分泌抑制剂、胃动力药、糖皮质激素、α-葡萄糖苷酶抑制剂、性腺刺激物质、生长激素抑制剂、生长激素释放因子、生长刺激剂、补血药、生血剂、溶血剂、止血剂、肝素拮抗剂、肝酶诱导剂、保肝剂、组胺H2受体拮抗剂、HIV蛋白酶抑制剂、HMG CoA还原酶抑制剂、免疫调节剂、免疫抑制剂、胰岛素敏化剂、离子交换树脂、溶角蛋白剂、泌乳刺激激素、泻药/通便药、白三烯拮抗剂、LH-RH激动剂、抗脂肪肝剂、5-脂氧合酶抑制剂、红斑狼疮抑制剂、基质金属蛋白酶抑制剂、盐皮质激素、缩瞳药、单胺氧化酶抑制剂、粘液溶解剂、肌肉松弛剂、散瞳药、麻醉拮抗剂、神经保护剂、亲精神物质、卵巢激素、催产剂、胃蛋白酶抑制剂、色素沉着剂、血浆增容剂、钾通道激活剂/打开剂、孕激素类、促乳素抑制剂、前列腺素、蛋白酶抑制剂、放射性药物、5α-还原酶抑制剂、呼吸刺激剂、逆转录酶抑制剂、镇静剂/安眠剂、促宁静剂、血清素去甲肾上腺素再摄取抑制剂、血清素受体激动剂、血清素受体拮抗剂、血清素摄取抑制剂、促生长素抑制素类似物、血栓溶解剂、血栓烷A2受体拮抗剂、甲状腺激素、促甲状腺激素、保胎剂、拓扑异构酶I和II抑制剂、促尿酸剂、血管调节剂包括血管舒张剂和血管收缩剂、血管保护剂、黄嘌呤氧化酶抑制剂,及其组合。
合适的低水溶性药物的非限制性实例包括例如醋磺己脲、乙酰水杨酸、阿氯芬酸、别嘌醇、阿托品、苄噻嗪、卡洛芬、塞来昔布、利眠宁、氯丙嗪、可乐定、可待因、磷酸可待因、硫酸可待因、deracoxib、双醋瑞因、双氯芬酸、地尔硫、雌二醇、依托度酸、依托泊苷、etoricoxib、芬布芬、芬氯酸、fenprofen、芬替酸、氟比洛芬、灰黄霉素、氟哌啶醇、布洛芬、消炎痛、吲哚洛芬、酮洛芬、劳拉西泮、乙酸甲羟孕酮、甲地孕酮、甲氧沙林、甲基强的松、吗啡、硫酸吗啡、萘普生、尼麦角林、硝苯地平、尼氟酸、奥沙普秦、奥沙西泮、羟布宗、紫杉醇、苯茚二酮、苯巴比妥、吡罗昔康、吡洛芬、强的松龙、强的松、普鲁卡因、孕酮、乙胺嘧啶、rofecoxib、磺胺嘧啶、磺胺甲嘧啶、磺胺异唑、舒林酸、舒洛芬、替马西泮、噻洛芬酸、噻氯咪索、tolmetic、valdecoxib等。
掺入到本发明剂型中的药物的量可根据已知的药剂准则来选择。具体来说是选择治疗有效量的药物。本文所用术语“治疗和/或预防有效量”是指足以引起所需或理想的治疗和/或预防反应的药物的量。
在特别优选的实施方案中,药物是低水溶性的选择性COX-2抑制药物。可使用本领域已知的任何这样的选择性COX-2抑制药物,包括但不限于在下列专利和出版物中公开的化合物,这些专利和出版物通过引用分别并入本文。
Reitz & Li的U.S.专利5,344,991。
Norman等人的U.S.专利5,380,738。
Reitz等人的U.S.专利5,393,790。
Lee的U.S.专利5,401,765。
Huang & Reitz的U.S.专利5,418,254。
Koszyk & Weier的U.S.专利5,420,343。
Talley & Rogier的U.S.专利5,434,178。
Black等人的U.S.专利5,436,265。
上面引述的U.S.专利5,466,823。
上面引述的U.S.专利5,474,995。
Lee & Bertenshaw的U.S.专利5,475,018。
Lee等人的U.S.专利5,486,534。
Lau等人的U.S.专利5,510,368。
Prasit等人的U.S.专利5,521,213。
Ducharme等人的U.S.专利5,536,752。
Cromlish等人的U.S.专利5,543,297。
Talley等人的U.S.专利5,547,975。
Ducharme等人的U.S.专利5,550,142。
Gauthier等人的U.S.专利5,552,422。
Desmond等人的U.S.专利5,585,504。
Adams等人的U.S.专利5,593,992。
Lee的U.S.专利5,596,008。
Lau等人的U.S.专利5,604,253。
Guay & Li的U.S.专利5,604,260。
Lipsky等人的U.S.专利5,616,458。
Khanna等人的U.S.专利5,616,601。
Weier等人的U.S.专利5,620,999。
上面引述的U.S.专利5,633,272.
Lau等人的U.S.专利5,639,780。
Talley等人的U.S.专利5,643,933。
Adams等人的U.S.专利5,658,903。
Talley等人的U.S.专利5,668,161。
Huang & Reitz的U.S.专利5,670,510。
Lau的U.S.专利5,677,318。
Dellaria & Gane的U.S.专利5,681,842。
Nicolai等人的U.S.专利5,686,460。
Weier等人的U.S.专利5,686,470。
Talley等人的U.S.专利5,696,143。
Ducharme等人的U.S.专利5,710,140。
Adams等人的U.S.专利5,716,955。
Giingor & Teulon的U.S.专利5,723,485。
Reitz等人的U.S.专利5,739,166。
Lazer等人的U.S.专利5,741,798。
Adams等人的U.S.专利5,756,499。
Isakson & Talley的U.S.专利5,756,529。
Kreft等人的U.S.专利5,776,967。
Beers & Wachter的U.S.专利5,783,597。
Black等人的U.S.专利5,789,413。
Nicolai & Teulon的U.S.专利5,807,873。
Dube等人的U.S.专利5,817,700。
Failli等人的U.S.专利5,830,911。
Atkinson & Wang的U.S.专利5,849,943。
Sartori等人的U.S.专利5,859,036。
上面引述的U.S.专利5,861,419.
Sartori & Teulon的U.S.专利5,866,596。
Failli的U.S.专利5,869,524。
Adams等人的U.S.专利5,869,660。
Rossen等人的U.S.专利5,883,267。
Zhi等人的U.S.专利5,892,053。
Black等人的U.S.专利5,922,742。
Adams & Garigipati的U.S.专利5,929,076。
Talley等人的U.S.专利5,932,598。
Khanna等人的U.S.专利5,935,990。
Haruta等人的U.S.专利5,945,539。
Yamazaki等人的U.S.专利5,958,978。
Guay等人的U.S.专利5,968,958。
Picolai & Teulon的U.S.专利5,972,950。
Marnett & Kalgutkar的U.S.专利5,973,191。
上面引述的U.S.专利5,981,576.
Haruta等人的U.S.专利5,994,381。
Haruta等人的U.S.专利6,002,014。
Li等人的U.S.专利6,004,960。
Hopper等人的U.S.专利6,005,000。
Belley等人的U.S.专利6,020,343。
DeLaszlo & Hagmann的U.S.专利6,020,347。
上面引述的U.S.专利6,034,256.
Corley等人的U.S.专利6,040,319。
Davies等人的U.S.专利6,040,450。
Adams等人的U.S.专利6,046,208。
Friesen等人的U.S.专利6,046,217。
Black等人的U.S.专利6,057,319。
De Nanteuil等人的U.S.专利6,063,804。
Chabrier de Lassauniere & Broquet的U.S.专利6,063,807。
LeBlanc等人的U.S.专利6,071,954。
Cook等人的U.S.专利6,077,868。
Sui & Wachter的U.S.专利6,077,869。
Ferro等人的U.S.专利6,083,969。
Spohr等人的U.S.专利6,096,753。
Wang等人的U.S.专利6,133,292。
国际专利出版物WO 94/15932。
国际专利出版物WO 96/19469。
国际专利出版物WO 96/26921。
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国际专利出版物WO 99/64415。
国际专利出版物WO 00/01380。
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国际专利出版物WO 00/18753。
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上面引述的国际专利出版物WO 00/24719。
国际专利出版物WO 00/26216。
国际专利出版物WO 00/31072。
国际专利出版物WO 00/40087。
国际专利出版物WO 00/56348。
欧洲专利申请0 799 823。
欧洲专利申请0 846 689。
上面引述的欧洲专利申请0 863 134。
欧洲专利申请0 985 666。
本发明组合物尤其可用于式(VIII)化合物:
其中R3是甲基或氨基,R4是氢或C1-4烷基或烷氧基,X是N或CR5,其中R5是氢或卤素,且Y和Z独立地为碳或氮原子,并且Y和Z是限定5-6元环的相邻原子;所述5-6元环未取代或者在一个或多个位置上被氧代基、卤素、甲基或卤代甲基取代。优选的这样的5-6元环是在不多于一个的位置被取代的环戊烯酮、呋喃酮、甲基吡唑、异唑和吡啶环。
例如,塞来昔布、deracoxib、valdecoxib、rofecoxib、etoricoxib、2-(3,5-二氟苯基)-3-[4-(甲基磺酰基)苯基]-2-环戊烯-1-酮、(S)-6,8-二氯-2-(三氟甲基)-2H-1-苯并吡喃-3-甲酸和2-(3,4-二氟苯基)-4-(3-羟基-3-甲基-1-丁氧基)-5-[4-(甲基磺酰基)苯基]-3-(2H)-哒嗪酮,更特别是塞来昔布、valdecoxib、rofecoxib和etoricoxib,仍然更特别是塞来昔布和valdecoxib可用于本发明的方法和组合物。
在本文中,特别用塞来昔布来举例说明本发明,应当理解,如果需要的话,可用任何其它低水溶性的选择性COX-2抑制药物来完全或部分替代组合物中的塞来昔布。例如,本发明组合物适于配制单独或者与塞来昔布联合使用的valdecoxib。
当药物是塞来昔布时,本发明组合物一般包含约10mg-约1000mg/剂量单位的治疗和/或预防有效总量的塞来昔布。当药物是除塞来昔布之外的选择性COX-2抑制药物时,每个剂量单位中药物的量是相当于约10mg-约1000mg塞来昔布的治疗等价量。
应当理解,对于个体,药物的治疗和/或预防有效量特别取决于个体的体重。在本文中,可以施用治疗剂或其组合物的“个体”包括任何性别和任何年龄的人类患者,并且还包括非人动物,特别是驯养动物或宠物,例如猫、狗或马。
例如,当个体是儿童或小的动物(例如狗)时,在约10mg-约1000mg的优选范围内的较低量的塞来昔布可能与治疗有效性一致。当个体是成人或大的动物(例如马时),治疗有效性可能需要含有较大量塞来昔布的剂量单位。对于成人,在本发明组合物中每个剂量单位塞来昔布的治疗有效量一般是约50mg-约400mg。每个剂量单位尤其优选的塞来昔布的量是约100mg-约200mg,例如约100mg或约200mg。
对于其它选择性COX-2抑制药物,每个剂量单位药物的量可以在已知这样的药物能产生治疗有效性的范围内。每个剂量单位的量优选在这样的范国内,该范围的量提供与在上述剂量范围内的塞来昔布等价的治疗作用。
本发明组合物的形式
本发明组合物优选呈浓溶液形式,该溶液可以或可以不作为不连续产品被包囊。如果包囊的话,一个这样的产品或多个(高达约10个,更优选不超过约4个)小的产品优选足以提供日剂量。或者,本发明组合物呈浓的可饮用液体的形式。本文所用术语“可饮用液体”是指未包囊的基本上均匀的可流动物质例如溶液或溶液/悬浮液,其以液体形式口服给药和吞咽,并且从其中可以以可计量的方式取出一个剂量单位。在描述包含几个组分的药物组合物时,术语“基本上均匀”是表示组分被充分地混合,使得各个组分不作为不连续的层存在,并且不在组合物内形成浓缩梯度。
可选择特定的剂量单位以与用于实现特定日剂量的所需给药频率相适应。例如,通过每天给药2次,每次施用一个200mg的剂量单位或每个施用2个100mg的剂量单位可提供400mg的日剂量。对于治疗状况或疾病,组合物的给药量和给药方案将取决于多种因素,包括个体的年龄、体重、性别和健康状况,状况或疾病的性质和严重程度,给药途径和频率,以及所选的特定药物,因此可在宽的范围内变化。然而,对于大部分用途,每天一次或每天两次的给药方案可提供所需的疗效。
本发明组合物包含低水溶性药物,其中至少一部分药物在适于口服给药的溶剂液体中呈溶解的形式。
溶剂液体包含至少一种可药用溶剂和任选一种或多种另外的组分,包括可药用赋形剂。在本发明中,术语“赋形剂”是指这样的任何物质,它们自身不是治疗剂,用作将治疗剂递送给个体的载体或媒介物,或加到药物组合物中以改善其处理、贮藏、崩解、分散、溶解、释放或感官性质,或者容许或促进组合物的剂量单位形成不连续产品例如适于口服给药的胶囊。赋形剂可包括例如但不限于稀释剂、崩解剂、分散剂、粘合剂、胶粘剂、润湿剂、润滑剂、助流剂、结晶抑制剂、稳定剂、抗氧化剂、为了遮蔽或抵消不良味道或气味而加入的物质、矫味剂、染料、香料、防腐剂和为了改善组合物的外观而加入的物质。
这样的任选的另外组分应当在物理和化学上与组合物的其它组分相容,并且应当对接受者无害。重要的是某些上文列出的赋形剂种类彼此重叠。通过选择合适的溶剂液体组分和有效治疗所需的药物剂量,可使本发明组合物适于通过任意合适的口服途径给药。因此,在溶剂液体中采用的组分自身可以是固体、半固体、液体或其组合。
本发明的可饮用组合物可以呈例如溶液、溶液/悬浮液、酏剂、糖浆剂形式或适当地与口服给药相适应的任何其它液体形式。这样的组合物还可以包含选自例如乳化剂和悬浮剂、甜味剂和矫味剂、表面活性剂和辅助表面活性剂的赋形剂。
或者,如下文所述,本发明组合物可制成不连续单位剂量产品的形式,例如具有包含明胶和/或纤维素聚合物例如HPMC的壁的胶囊,每粒胶囊含有在溶剂液体中包含预定量药物的液体组合物。在胶囊内的液体组合物在与胃肠液体接触时通过壁的破碎而释放出来。胶囊壁破碎的具体机制不重要,并且可以包括诸如侵蚀、降解、溶解等这样的机制。
本发明组合物可通过包括将药物与溶剂液体组分混合的步骤的任意合适的制药方法制得。本发明的塞来昔布组合物一般是这样制得的:将塞来昔布与溶剂液体以使得至少一部分、优选基本上所有塞来昔布溶解在溶剂液体中的方式均匀且充分混合;然后如果需要的话,将所得溶液或溶液/悬浮液包囊在例如硬或软的胶囊中。
本发明优选的实施方案是组合物,其中包含治疗有效量的低水溶性药物例如塞来昔布或valdecoxib,所述药物基本上完全溶解在包含至少一种可药用溶剂的溶剂液体中。在该实施方案中,基本上没有药物部分以固体颗粒形式存在。该实施方案的组合物可配制成可饮用或不连续剂型(例如包囊的)。这样的组合物还包含在下文中更充分描述的结晶抑制剂,结晶抑制剂存在于溶剂液体中和/或作为胶囊壁的组分存在。该实施方案的浓溶液的药物浓度优选为占组合物重量的约10%-约75%、更优选约20%-约75%。
溶剂
优选的溶剂是二醇或二醇醚。合适的二醇醚包括下式(IX)所示的那些:
R1-O-((CH2)mO)n-R2 (IX)其中R1和R2独立地为氢或C1-6烷基、C1-6链烯基、苯基或苄基,但是R1和R2当中有不超过一个是氢;m是2-约5的整数;n是1-约20的整数。优选的是,R1和R2当中有一个是C1-4烷基,另一个是氢或C1-4烷基;更优选的是,R1和R2当中至少有一个是甲基或乙基。m优选为2。n优选为1-约4的整数,更优选为2。
用作本发明组合物中的溶剂的二醇醚的分子量一般是约75-约1000、优选约75-约500、更优选约100-约300。重要的是,用于本发明组合物中的二醇醚必须是可药用的,并且必须满足本文指定的所有其它条件。
可用于本发明组合物中的二醇醚的非限制性实例包括乙二醇一甲醚、乙二醇二甲醚、乙二醇一乙醚、乙二醇二乙醚、乙二醇一丁醚、乙二醇二丁醚、乙二醇一苯醚、乙二醇一苄醚、乙二醇丁基苯基醚、乙二醇萜品基醚、二甘醇一甲醚、二甘醇二甲醚、二甘醇一乙醚、二甘醇二乙醚、二甘醇二乙烯基醚、二甘醇一丁醚、二甘醇二丁醚、二甘醇一异丁醚、三甘醇二甲醚、三甘醇一乙醚、三甘醇一丁醚、四甘醇二甲醚和它们的混合物。参见例如Flick(1998):IndustrialSolvents Handbook,5th ed.,Noyes Data Corporation,Westwood,NJ。特别合适的二醇醚溶剂是在本领域中有时称为DGME或乙氧基二甘醇的二甘醇一乙醚。其可以以例如Gattefossé Corporation的商标TranscutolTM获得。
适于在本发明组合物中用作溶剂的二醇包括丙二醇、1,3-丁二醇和聚乙二醇。本发明优选的溶剂是聚乙二醇(PEG)。
可使用任意合适的可药用PEG。PEG的平均分子量优选为约100-约10,000、更优选为约100-约1,000。PEG更优选是液体级的。可在本发明溶剂液体中使用的PEG的非限制性实例包括PEG-200、PEG-350、PEG-400、PEG-540和PEG-600。参见例如Flick(1998),op.cit.,p.392。本发明优选的PEG的平均分子量为约375-约450,例如PEG-400。
PEG例如PEG-400具有多种作为弱水溶性药物的溶剂的理想性质。例如,对于塞来昔布,该药物可以以非常高的浓度溶解在PEG-400中,使得能够在非常小体积的溶剂液体中配制治疗有效剂量。当将所得溶液包囊起来时,这特别重要,因为可制得含有治疗有效量的甚至是实现疗效需要较高剂量的药物例如塞来昔布的大小便于吞咽的胶囊。
然而,当在水性介质例如在胃肠道中存在的水性介质中被稀释时,弱水溶性药物在溶剂例如PEG中的溶液组合物表现出很强的药物结晶或沉淀的趋势。在体外实验中,通过将无论是包囊与否的这样的组合物加到SGF中可研究这个问题。依据本发明,已经发现,通过使用结晶抑制剂,已经令人惊奇地有效地解决了该问题。
结晶抑制剂
我们已经发现,当药物在基本上非水溶剂中的溶液暴露于SGF中时,一些聚合物可实质上抑制弱水溶性药物的沉淀和/或结晶。因此,本发明组合物包含结晶抑制剂,所述结晶抑制剂包含至少一种聚合物。所述聚合物可以是纤维素类或非纤维素类聚合物,并且优选是基本上水溶性的。
应当理解,一些聚合物在抑制所选弱水溶性药物沉淀和/或结晶方面的有效性要强于其它聚合物,并且不是所有聚合物都能抑制如本文所述的每一个弱水溶性的药物的沉淀和/或结晶。特定的聚合物是否能够用作本发明特定弱水溶性药物的结晶抑制剂可由本领域普通技术人员例如依据测试I来容易地确定。
测试I:
A.将适当量的药物溶解在溶剂(例如乙醇、二甲亚砜或—当药物是酸或碱时—水)以获得浓的药物溶液;
B.将—定体积的水或具有固定pH的缓冲液置于第一个容器中并在室温保持;
C.将等分试样的浓药物溶液加到第一个容器的内容物中,以获得具有所需目标药物浓度的第一个样本溶液。所选的药物浓度应当是这样的,其产生大量沉淀,并因此比不具有这样的沉淀的饱和溶液要高的表观吸收度(即浊度);
D.选择测试聚合物,在第二个容器中,将聚合物以足以形成0.25%-2%w/w聚合物溶液的量溶解在水或具有固定pH的缓冲液(在组成、pH和体积方面与步骤C所用的缓冲液相同)中;
E.为了形成第二个样本溶液,将等分试样的在步骤A中制备的浓药物溶液加到在第二个容器内的聚合物溶液中,以形成药物终浓度与第一个样本溶液相同的样本溶液;
F.在制备了这两种样本溶液之后60分钟,使用波长为650nm的光测定每个样本溶液的表观吸收度(即浊度);
G.如果第二个样本溶液的浊度小于第一个样本溶液的浊度,则认为测试的聚合物是“降低浊度的聚合物”,并且可用作测试药物的结晶抑制剂。
进行测试I的技术人员易于通过常规实验找到在上面提供的聚合物浓度范围内的适于该测试的聚合物浓度。在特别优选的实施方案中,所选的聚合物浓度是这样的,当进行测试I时,第二个样本溶液的表观吸收度不超过第一个样本溶液的表观吸收度的约50%。
在另一个实施方案中,本发明组合物包含结晶抑制剂,所述结晶抑制剂包含至少一种纤维素聚合物。优选的纤维素聚合物选自HPMC、甲基纤维素、乙基纤维素、羧甲基纤维素钠和羟丙基纤维素。更优选地,至少一种纤维素聚合物选自具有至少一部分被甲氧基和/或羟基丙氧基取代的可取代羟基的纤维素聚合物。仍然更优选的是,至少一种纤维素聚合物是HPMC。
可用作本发明结晶抑制剂的HPMC在2%水溶液中的粘度为约100-约20,000cP。HPMC在纤维素骨架上的可被甲氧基和羟基丙氧基取代的羟基的取代程度可以不同。随着羟基丙氧基取代的增加,所得HPMC的亲水性变得更强。优选使用具有约15%-约35%、更优选约19%-约30%、最优选约19%-约24%的甲氧基取代,和具有约3%-约15%、更优选约4%-约12%、最优选约7%-约12%的羟基丙氧基取代的HPMC。
具有较强亲水性的合适的HPMC的实例是可以以Dow Chemical Co.的商品名MethocelTM和Shin-Etsu Chemical Co.的MetoloseTM获得的那些。
本发明优选的HPMC的实例是具有2208取代型的HPMC,这是指约19%-约24%的甲氧基取代和约7%-约12%的羟基丙氧基取代,并且在2%水溶液中的标称粘度为约4000cP。
令人惊奇的是,已经发现,结晶抑制剂无需作为溶剂液体的组分。任选地,如下所述,结晶抑制剂例如HPMC可以是其中包囊本发明溶液组合物的胶囊壁组分。在一个实施方案中,基本上没有HPMC或其它结晶抑制剂存在于溶剂液体中,但是胶囊壁包含结晶抑制剂例如HPMC。胶囊壁甚至可以主要由这样的结晶抑制剂组成。
结晶抑制剂优选以当组合物在SGF中被稀释时足以实质性地抑制药物结晶和/或沉淀的总量存在。在本文中,足以“实质性地抑制药物结晶和/或沉淀”的量是指该量足以阻止、减慢、抑制或延迟药物从溶液中沉淀和/或阻止、减慢、抑制或延迟从溶解的药物颗粒形成药物结晶。对于实际的应用,在给定的测试组合物中,结晶抑制剂的量是否足以实质性地抑制药物结晶和/或沉淀可依据测试II来确定,测试II还可用于测定特定的聚合物组分是否能在特定的本发明组合物中用作结晶抑制剂。
测试II:
A.将一定体积的未包囊或包囊形式的具有聚合物组分的测试组合物置于一定体积的SGF中以形成具有约1g-约2g组合物/100ml SGF固定比例的混合物;
B.将该混合物在约37℃的恒温下保持,并用II型桨(USP 24)以75rpm的速度搅拌4小时;
C.在搅拌至少约15分钟之后但是在搅拌约4小时之前期间的一个或多个时间点,经由例如具有0.8μm VersaporTM膜的非灭菌AcrodiscTM注射滤器吸滤等分试样的混合物;
D.在容器中收集滤液;
E.使用高效液相色谱法(HPLC)测定滤液中的药物浓度;
F.用比较组合物同样重复该测试,比较组合物除了没有聚合物组分以外与测试组合物基本上类似。当测试组合物中的聚合物组分存在于溶剂液体中时,在比较组合物中用聚乙二醇溶剂代替该聚合物。当测试组合物中的聚合物组分存在于胶囊壁中时,在比较组合物中用明胶代替该聚合物;
G.如果得自测试组合物的滤液中的药物浓度大于得自比较组合物的滤液时,则认为存在于测试组合物中的聚合物组分能实质性地抑制药物在SGF中的结晶和/或沉淀。
当存在于溶剂液体中时,结晶抑制剂,例如HPMC,一般以约占溶剂液体重量的1%-约20%、优选约1%-约15%、最优选约1%-约10%的总量存在。一般情况下,组合物中的药物浓度越高,提供结晶抑制作用所需的纤维素聚合物就越多。纤维素聚合物与药物一般以约1∶100-约1∶1、优选约1∶50-约1∶1、更优选约1∶25-约1∶1重量的比例存在。
依据本发明使用结晶抑制剂在某些情况下可使得能够降低表面活性剂在溶液组合物中的量,特别是在自乳化溶液组合物中的量。这可能是有益的,因为当以大量口服给药时,一些表面活性剂会有不利的副作用。这样的副作用包括刺激胃肠道、可导致气体包埋的发泡和在某些情况下可危及生命的过敏性样反应。
其它赋形剂
本发明组合物任选包含除溶剂和结晶抑制剂之外的可药用赋形剂。例如,对于溶液组合物,这样的赋形剂可包括助溶剂、甜味剂、抗氧化剂、防腐剂、分散剂、乳化剂等。通过选择和赋形剂的组合,组合物可在药物浓度、溶解、分散、乳化、效力、味道、患者依从性以及其它性质方面表现出改善的性能。
本发明组合物,特别是溶液组合物可任选包含一种或多种可药用助溶剂。合适的助溶剂的非限制性实例包括另外的二醇,醇例如乙醇和正丁醇;油酸和亚油酸甘油三酯例如豆油;辛酸/癸酸甘油三酯,例如Huls的MiglyolTM812;辛酸/癸酸甘油单酯和甘油二酯,例如Abitec的CapmulTM MCM;聚氧乙烯辛酸/癸酸甘油酯例如聚氧乙烯(8)辛酸/癸酸甘油单酯和甘油二酯,例如Gattefossé的LabrasolTM;丙二醇脂肪酸酯,例如丙二醇月桂酸酯;聚氧乙烯(35)蓖麻油,例如BASF的CremophorTM EL;聚氧乙烯甘油三油酸酯,例如的Goldschmidt的TagatTMTO;脂肪酸的低级烷基酯,例如丁酸乙酯、辛酸乙酯和油酸乙酯;和水。
本发明组合物,特别是溶液组合物任选包含可药用脂肪酸和可药用有机胺(在本文中还称为“脂肪酸/有机胺对”),其总体和相对量使得组合物可在SGF中自细乳化。虽然不希望受缚于理论,但是据信,当存在于本发明组合物中时,在组合物暴露于水性介质例如SGF时,脂肪酸/有机胺对促进带电荷的细乳滴的形成。
组合物在SGF中是否是如本文所定义的“可自细乳化的”可依据例如测试III来确定。
测试III:
A.将400μl等分试样的测试组合物置于含有20ml SGF的有螺旋顶端和侧臂的容器(在整个测试期间保持在37℃)以形成测试液体;
B.使用轨道式摇动器将测试液体以75rpm的速度轻微搅动2分钟以发生乳化;
C.使用吸移管经由侧臂抽吸出5-50μl测试液体的等分试样,并从吸移管排放到取样容器中;
D.使用泵(例如model RHOCKC-LF,Fluid Metering Inc.,Syosset,NY)将测试液体从取样容器经由联合散射/遮蔽传感器(combination scattering/obscuration sensor)(例如LE400-0.5,Particle Sizing Systems,Santa Barbara,CA)以1ml/分钟的速度吸引1分钟;
E.使用vendor′s软件(例如Version 1.59),在0.5-1μm的粒径(即直径)范围内通过光散射,在1μm以上的粒径范围内通过光遮蔽来独立地计数乳液颗粒;
F.用乳液颗粒的数目(即未加权的)或体积(即加权的)对颗粒直径绘图;
G.将关于所有稀释度的图整合以估计存在于测试液体中的大至足以通过传感器检测的乳液颗粒的总数目或体积;
H.如果测试III的结果是有约25%或更多体积的直径为1μm或更小的乳液颗粒,则认为测试组合物是可自细乳化的。
优选的脂肪酸具有饱和或不饱和C6-14碳链。合适的脂肪酸的非限制性实例包括油酸、辛酸、己酸、辛酸、癸酸、桐酸、月桂酸、肉豆蔻酸、棕榈酸、硬脂酸、二十烷酸、反油酸、亚油酸、亚麻酸、二十碳五烯酸和二十二碳六烯酸。油酸是特别优选的脂肪酸。
优选的有机胺具有有一个或两个胺基的C2-8碳链。有机胺可更优选选自C2-8烷基胺、亚烷基二胺、链烷醇胺、烷基链烷醇胺、二醇醚胺和芳基胺。合适的有机胺的非限制性实例包括一乙醇胺、二乙醇胺、三乙醇胺、二甲基氨基乙醇、氨丁三醇(tromethamine)等。特别优选的有机胺是叔胺,例如三乙醇胺和二甲基氨基乙醇。
优选地,如果存在的话,脂肪酸/有机胺对这样选择(关于每个组分的类型和量),使得当用测试II测定本发明组合物时,至少约50%、更优选至少约75%体积的所计数的乳液颗粒具有约1μm或更小的直径。尤其优选的是,大部分(体积)所计数的乳液颗粒,更优选至少约75%、更优选至少约85%、最优选至少约90%的乳液颗粒具有约0.5μm或更小的直径。
脂肪酸与有机胺中的氨基的优选摩尔比为约5∶1-约1∶100,更优选为约3∶1-约1∶50,仍然更优选为约2∶1-约1∶10,例如约为约1∶1。优选地,如果存在的话,脂肪酸与有机胺一起以占组合物重量约1%-约50%、更优选约2%-约30%、仍然更优选约5%-约15%的量存在。
虽然不受缚于理论,但是据信,本发明可自细乳化的溶液组合物,特别是具有如上所述的脂肪酸/有机胺对的组合物将提供可在胃肠道中被特别迅速地吸收的形式的药物。
已经发现,当一些弱水溶性药物被配制成在PEG中的溶解形式时,在贮藏期间可产生杂质。例如,对于在PEG-400中的塞来昔布溶液组合物,已经追踪发现塞来昔布与PEG-400自身不反应,但是与PEG-400的分解产物反应造成杂质。虽然不想受缚于理论,但是据信,与塞来昔布反应的分解产物是氧化乙烯。反应产物包括加成化合物。具有氨基磺酰基官能团的任何药物化合物都有可能以类似方式与聚乙二醇分解产物反应。
这样的药物在聚乙二醇溶剂中的化学不稳定问题,或者实际上可与聚乙二醇或其分解产物反应以生成加成化合物的任何药物可通过在溶剂液体中包含自由基清除性抗氧化剂来得到克服。
因此,本发明组合物任选还包含至少一种可药用的自由基清除性抗氧化剂。自由基清除性抗氧化剂与“与非自由基清除性抗氧化剂”,即不具有自由基清除性质的抗氧化剂相反。合适的自由基清除性抗氧化剂的非限制性实例包括α-生育酚(维生素E),抗坏血酸(维生素C)及其盐,包括抗坏血酸钠和棕榈酸抗坏血酸酯(ascorbic acidpalmitate),丁基化羟基茴香醚(BHA)、丁基化羟基甲苯(BHT)、富马酸及其盐、次磷酸(hypophosphorous acid)、苹果酸,没食子酸烷基酯,例如没食子酸丙酯、没食子酸辛酯和没食子酸十二烷基酯,亚硫酸钠、亚硫酸氢钠和焦亚硫酸氢钠。优选的自由基清除性抗氧化剂是没食子酸烷基酯、维生素E、BHA和BHT。至少一种自由基清除性抗氧化剂更优选是没食子酸丙酯。
一种或多种自由基清除性抗氧化剂任选以能有效地实质性地减少加成化合物形成的总量存在于本发明组合物中,其总量一般为占组合物重量的约0.01%-约5%、优选约0.01%-约2.5%、更优选约0.01%-约1%。
本发明组合物任选包含一种或多种可药用甜味剂。合适的甜味剂的非限制性实例包括甘露糖醇、丙二醇、糖精钠、丁磺氨K、neotame和天冬甜素。或者,或此外,可使用粘性甜味剂例如山梨醇溶液、糖浆(蔗糖溶液)或高果糖玉米糖浆,除了甜化作用以外,它们还用于提高粘度和延迟沉淀。在本发明的可饮用组合物中使用甜味剂是特别有利的,因为它们可由个体在吞咽之前尝到味道。包囊的组合物一般不与口中的味觉器官接触,这样一般无需使用甜味剂。
本发明组合物任选包含一种或多种除自由基清除性抗氧化剂之外的可药用防腐剂。合适的防腐剂的非限制性实例包括苯扎氯铵、苄索氯铵、苯甲醇、氯丁醇、苯酚、苯基乙醇、硝酸苯基汞、硫汞撒等。
本发明组合物任选包含一种或多种可药用润湿剂。表面活性剂、亲水性聚合物和一些粘土也可用作润湿剂来帮助疏水性药物例如塞来昔布溶解和分散。合适的表面活性剂的非限制性实例包括苯扎氯铵、苄索氯铵、氯化十六烷基吡啶、二辛基磺基琥珀酸钠、壬苯醇醚9、壬苯醇醚10、辛苯昔醇9、泊咯沙姆、聚氧乙烯(8)辛酸/癸酸甘油单酯和甘油二酯(例如Gattefossé的LabrasolTM)、聚氧乙烯(35)蓖麻油、聚氧乙烯(20)鲸蜡硬脂基醚、聚氧乙烯(40)氢化蓖麻油、聚氧乙烯(10)油基醚、聚氧乙烯(40)硬脂酸酯、聚山梨醇20、聚山梨醇40、聚山梨醇60、聚山梨醇80(例如ICI的TweenTM 80)、丙二醇月桂酸酯(例如Gattefossé的LauroglycolTM)、十二烷基硫酸钠、脱水山梨醇一月桂酸酯、脱水山梨醇一油酸酯、脱水山梨醇一棕榈酸酯、脱水山梨醇一硬脂酸酯、泰洛沙泊及其混合物。
此外,本发明组合物任选包含一种或多种可药用缓冲剂、矫味剂、着色剂、稳定剂和/或增稠剂。缓冲剂可用于控制制剂的pH,并且可因此调节药物溶解性。矫味剂可通过使组合物,特别是可饮用组合物更适口来提高患者依从性,着色剂可给产品提供更美观和/或有特色的外观。合适的着色剂的非限制性实例包括D&C Red No.33、FD&C Red No.3、FD&C Red No.40、D&C Yellow No.10和C Yellow No.6。
溶液/悬浮液组合物
在一个实施方案中,溶剂液体,根据其中所存在的特定组分,适于将第一部分药物保持在溶液中以提供治疗有效的速效剂量,同时还将第二部分药物保持非溶解但是悬浮状态。悬浮部分一般提供较慢的药物释放,因此可延长治疗作用的持续时间,虽然这种延长的持续时间不是本发明该实施方案的要求。
因此,依据该实施方案,本发明提供了包含治疗有效量弱水溶性药物的组合物,其中所述药物有一部分溶解在、另一部分分散在包含至少一种可药用溶剂的溶剂液体中。在该实施方案中,有一部分药物在溶液中,另一个部分药物在悬浮液中。所述组合物还包含如上所述的结晶抑制剂,所述结晶抑制剂存在于溶剂液体中和/或作为胶囊壁的组分存在。
优选地,选择溶剂液体的组分,使至少约15%重量的药物在溶剂液体中呈溶解形式。与溶液相反,调节溶剂液体以提高弱水溶性药物在悬浮液中的量的一种途径是加入所需量的水以使药物在溶剂液体中的溶解度达到所需降低。
对于施用药物所针对的适应症,根据迅速作用和持续作用的相对重要性,溶解和分散的药物的相对比例可显著不同。例如,对于急性疼痛适应症,约50%的药物可在溶液中,约50%的药物可以以颗粒形式分散。或者,对于需要较长时间的作用治疗有效性的适应症,例如有约20%的药物可在溶液中,约80%的药物可以以颗粒形式分散。
颗粒形式的药物可通过机械手段例如通过研磨或粉碎来产生,或者通过从溶液中沉淀来产生。直接由这样的方法形成的颗粒在本文中作为“一次颗粒”描述,并且可团聚以形成二次团聚颗粒。除非上下文另有说明,本文所用术语“粒径”是指一次颗粒在最长尺寸上的大小。据信,粒径是影响塞来昔布和其它低水溶性药物的临床有效性的重要参数。
粒径可以作为直径小于给定参照直径的所有颗粒的百分比来表示。例如,一种有用的参数是“D90粒径”。按照定义,一批具有60μm的D90粒径的药物是指,90%体积的颗粒具有小于60μm的直径。对于特定用途,基于90%重量而不是体积的D90测定通常是合适的。
该实施方案的组合物优选具有悬浮药物粒径分布,使得颗粒在其最长尺寸上的D90是约0.5μm-约200μm、优选约0.5μm-约75μm、更优选约0.5μm-约25μm。例如,当药物是塞来昔布时,依据本发明的该实施方案,粒径下降一般会改善药物生物利用度。此外,或者另一方面,在本发明组合物中,悬浮的塞来昔布颗粒的平均粒径优选为小于约10μm,更优选为约0.1μm-约10μm,最优选为约0.5μm-约5μm,例如约1μm。
该实施方案的组合物可任选包含另外的赋形剂例如如上所述的分散剂、助溶剂、甜味剂、防腐剂、乳化剂等。此外,该实施方案的组合物可配制成可饮用或不连续的剂型。
另外,当在例如溶液/悬浮液组合物中需要悬浮的药物颗粒时,一些赋形剂例如悬浮剂、增稠剂和絮凝剂可能是特别有用的。通过赋形剂的选择和组合,可提供在药物浓度、物理稳定性、效力、味道和总体患者依从性方面表现出改善的性能的溶液/悬浮液组合物。
本发明溶液/悬浮液组合物任选包含一种或多种可药用悬浮剂。使用悬浮剂是为了赋予增加的粘度和延迟沉降。有各类不同的悬浮剂,包括纤维素衍生物、粘土、天然树胶、合成树胶和各种其它悬浮剂。可用于本发明组合物的悬浮剂的非限制性实例包括阿拉伯胶、琼脂、藻酸、一硬脂酸铝、石绒、膨润土、羧甲基纤维素钙、羧甲基纤维素钠、角叉菜胶、卡波姆例如卡波姆910、糊精、乙基甲基纤维素、明胶、瓜尔胶、HPMC、甲基纤维素、乙基纤维素、乙基羟基乙基纤维素、羟乙基纤维素、羟丙基纤维素、高岭土、硅酸镁铝、微晶纤维素、含有羧甲基纤维素钠的微晶纤维素、纤维素粉末、硅胶、胶态二氧化硅、槐树豆胶、果胶、藻酸钠、丙二醇藻酸酯、罗望籽胶、西黄蓍胶、黄原胶、聚维酮、veegum、甘草甜素、预胶凝化淀粉、羟乙酸淀粉钠及其混合物。
在一些情况下,可能希望在本发明溶液/悬浮液组合物中使用絮凝剂。絮凝剂能够让颗粒以松散的聚集体或絮凝物的形式连结在一起,并包括表面活性剂、亲水性聚合物、粘土和电解质。合适的絮凝剂的非限制性实例包括十二烷基硫酸钠、多库酯钠(docusate sodium)、苯扎氯铵、氯化十六烷基吡啶、聚山梨醇80、脱水山梨醇一月桂酸酯、羧甲基纤维素钠、黄原胶、西黄蓍胶、甲基纤维素、PEG、硅酸镁铝、石绒、膨润土、磷酸二氢钾、氯化铝、氯化钠及其混合物。
不连续剂型
已经发现,含有作为不连续剂量单位产品包囊的本发明溶液或溶液/悬浮液的制剂令人惊异好地满足了对于速效制剂的需求。因此,本发明另一个实施方案是溶液或溶液/悬浮液形式的浓的组合物,其中所述组合物被配制成一个或多个不连续的剂量单位例如软或硬的明胶胶囊。
可使用任意合适的包囊材料例如明胶或HPMC。如上所述,HPMC可以是用于胶囊壁的有利材料,因为在组合物暴露于胃肠液体时,它起结晶抑制剂的作用。如本文所述,如果聚合物(a)与任何其它的胶囊壁组分分散或混合在一起,(b)是唯一的胶囊壁组分,或(c)作为涂层存在于胶囊壁的外侧或内侧,则聚合物组分例如HPMC“存在于胶囊壁中”或者“是胶囊壁组分”。
在本发明优选的实施方案中,聚合物,优选具有如上文所述的甲氧基和/或羟基丙氧基取代的聚合物,更优选HPMC以占胶囊壁重量的约5%-基本上100%、优选约15%-基本上100%的总量存在于胶囊壁中。
结晶抑制剂以当组合物在SGF中溶解、稀释和/或降解时足以实质性地抑制药物结晶和/或沉淀的总量存在于胶囊壁中。对于实际应用,存在于给定测试组合物的胶囊壁中的结晶抑制剂的量是否足以实质性地抑制药物结晶和/或沉淀可依据测试IV来确定,测试VI还可以用于测定当存在于本发明特定组合物的胶囊壁中时,特定的聚合物组分是否能用作结晶抑制剂。
测试IV:
A.将一定体积的如本文所述的溶液或溶液/悬浮液包封在含有测试聚合物的胶囊中以形成测试组合物,并置于一定体积的SGF中以形成具有约1g-约2g组合物/100ml SGF固定比例的混合物;
B.将该混合物在约37℃的恒温下保持,并用II型桨(USP 24)以75rpm的速度搅拌4小时;
C.在搅拌至少约15分钟之后但是在搅拌约4小时之前期间的一个或多个时间点,经由例如具有0.8μm VersaporTM膜的非灭菌AcrodiscTM注射滤器吸滤等分试样的混合物;
D.在容器中收集滤液;
E.使用高效液相色谱法(HPLC)测定滤液中的药物浓度;
F.用比较组合物同样重复该测试,比较组合物包含基本上类似于在步骤A中使用的溶液或溶液/悬浮液,但是包封在没有结晶抑制剂的胶囊中(即不包含聚合物,或者如果存在聚合物的话,其是不抑制结晶和/或沉淀的聚合物例如明胶)。在包封比较组合物的胶囊中用明胶代替聚合物组分;
G.如果得自测试组合物的滤液中的药物浓度大于得自比较组合物的滤液时,则认为聚合物组分是以足以实质性地抑制药物在SGF中结晶和/或沉淀的量存在于测试组合物的胶囊壁中。
除了一种或多种这样的结晶抑制剂以外,合适的胶囊壁可包含本领域可使用的任何另外的组分,例如明胶、淀粉、角叉菜胶、藻酸钠、增塑剂、氯化钾、着色剂等。本发明合适的胶囊可具有硬或软的壁。
当结晶抑制性聚合物作为胶囊壁组分存在时,包含在其中的溶液或溶液/悬浮液还可以但是任选地包含另外量的结晶抑制剂。
优选地,每天使用1-约6个、更优选1-约4个、仍然更优选1或2个这样的不连续剂量单位来提供治疗有效剂量的药物。
该实施方案的组合物优选这样配制,使每个不连续剂量单位包含约0.3ml-约1.5ml,更优选约0.3ml-约1ml,例如约0.8ml或约0.9ml溶液或溶液/悬浮液。
可通过本领域已知的任何方法,包括板式法(plate process)、真空法或旋转冲模法将浓的溶液或溶液/悬浮液包囊。参见例如Ansel等人.(1995),Pharmaceutical Dosage Forms and Drug DeliverySystems,6th ed.,Williams & Wilkins,Baltimore,MD,pp.176-182。通过旋转冲模法,从高架罐流出的液体包囊材料例如明胶通过旋转冲模机形成两个连续的条带,并通过双旋转冲模结合在一起。同时将计量填充的材料注射到在两个条带之间,同时冲模形成条带的袋。通过压力和热将这些含有填充物的包囊材料的袋密封,从机器中供应出胶囊。
软胶囊可以制成不同形状,包括圆形、椭圆形、长方形等。此外,通过使用两个不同颜色的条带,可制得具有两种色调的胶囊。
包含HPMC的胶囊是本领域已知的,并且可依据例如但不限于在下列专利和出版物中公开的方法制备、密封和/或包衣,这些专利和出版物通过引用分别独立地引入本发明以作参考。
Bodenmann等人的美国专利4,250,997。
Yamamoto等人的美国专利5,264,223。
Yamamoto等人的美国专利5,756,123。
国际专利出版物WO 96/05812。
国际专利出版物WO 97/35537。
国际专利出版物WO 00/18377。
国际专利出版物WO 00/27367。
国际专利出版物WO 00/28976。
国际专利出版物WO 01/03676。
欧洲专利申请0 211 079。
欧洲专利申请0 919 228。
欧洲专利申请1 029 539。
合适的包含HPMC的胶囊的非限制性实例包括Bioprogress的XGelTM胶囊和Shionogi的QualicapsTM。
可饮用剂型
本发明的另一个实施方案是浓溶液或浓溶液/悬浮液形式的浓的组合物,所述组合物可直接饮用,或者用惰性稀释剂和/或其它载体稀释后再饮用;无论稀释与否,这样的本发明组合物都在本文中都方便地称为“可饮用组合物”。可饮用组合物可通过任何合适的制药方法制得,所述方法包括将低水溶性药物例如塞来昔布与溶剂液体和结晶抑制剂混合的步骤。因为在该实施方案中没有任何胶囊壁,所以结晶抑制剂必须存在于溶剂液体中。当药物是塞来昔布时,该实施方案的组合物优选包含约40mg/ml-约750mg/ml,更优选约50mg/ml-约500mg/ml,仍然更优选约50mg/ml-约350mg/ml,最优选约100mg/ml-约300mg/ml,例如约200mg/ml塞来昔布。
在另一个实施方案中,提供了需要稀释以提供适于直接饮用给药的稀释液的本发明溶液或溶液/悬浮液。在该实施方案中,将本发明溶液或溶液/悬浮液以治疗有效剂量加到约1ml-约20ml惰性液体中。优选将本发明溶液或溶液/悬浮液加到约2ml-约15ml、更优选约5ml-约10ml惰性液体中。本文所用术语“惰性液体”是指可药用、优选适口的液体载体。这样的载体一般是水性的。实例包括水、果汁、充碳酸气的饮料等。
高能相药物
低能、疏水性结晶固体由于其高度组织的晶格结构而一般需要大量能量来溶解。例如,药物分子从晶体中逃逸出来所需的能量大于相同药物分子从非晶体、无定形或较高能量多晶形中逃逸出来所需的能量。因此,高能相药物比低能晶态的相同药物更易于从胃肠道吸收到血流中。然而,重要的是,随着时间的延长和与含水液体例如SGF接触,高能相药物往往会转化成低能稳态,例如转化成低能晶态。
因此,本发明另一个实施方案提供了包含高能相低水溶性药物和一种或多种可药用赋形剂的口服药物组合物,所述药物组合物包囊在胶囊壁中,该胶囊壁包含具有至少一部分被甲氧基和/或羟基丙氧基取代的可取代羟基的纤维素聚合物,所述聚合物以实质性地抑制药物在模拟胃液中结晶和/或沉淀的有效量存在。
胶囊是否包含实质性地抑制药物结晶和/或沉淀的有效量的甲氧基和/或羟基丙氧基取代的纤维素聚合物可依据上述测试II来确定。
包含选择性COX-2抑制药物的组合物的用途
在优选的实施方案中,本发明组合物包含低水溶性选择性COX-2抑制药物。该实施方案的组合物可用于治疗和预防多种由COX-2介导的病症,包括但不限于其特征是炎症、疼痛和/或发热的病症。这样的组合物尤其可用作抗炎剂,例如在关节炎的治疗中用作抗炎剂,其另外的优点是,与相对于COX-1对COX-2缺乏选择性的常规非甾体抗炎药物(NSAIDs)的组合物相比,其有害的副作用显著减小。特别是,与常规NSAIDs的组合物相比,这样的组合物引起胃肠毒性和胃肠刺激,包括上部胃肠溃疡和出血的可能性减小了,引起肾副作用例如导致流体潴留和高血压加剧的肾功能减弱的可能性减小了,对出血时间的影响,包括抑制血小板功能减弱了,并且有可能降低在阿司匹林敏感性哮喘个体中引起哮喘发作的可能性。因此,当常规NSAID受到禁忌,例如在下列患者中:患有消化性溃疡、胃炎、局部肠炎、溃疡性结肠炎、憩室炎或具有胃肠损害复发史;患有胃肠出血,患有凝血病症,包括贫血例如血凝血酶原过少、血友病或其它出血问题;患有肾病;或手术之前的患者或施用抗凝血剂的患者,包含选择性COX-2抑制药物的本发明组合物可特别用作常规NSAID的替代品。
这样的组合物可用于治疗多种关节炎病症,包括但不限于类风湿性关节炎、脊椎关节病、痛风性关节炎、骨关节炎、全身性红斑狼疮和青少年关节炎。
这样的组合物还可用于治疗哮喘、支气管炎、月经痉挛、早产、腱炎、粘液囊炎、过敏性神经炎、巨细胞病毒感染、细胞凋亡,例如HIV引起的细胞凋亡,腰痛,肝病,包括肝炎,涉及皮肤的状况例如牛皮癣、湿疹、痤疮、烧伤、皮炎和紫外线照射损伤例如晒伤,和手术后炎症,包括眼科手术例如白内障手术或屈光手术后的炎症。
这样的组合物可用于治疗胃肠病症例如炎性肠疾病、局限性回肠炎、胃炎、易激性肠综合征和溃疡性结肠炎。
这样的组合物可用于在例如下列疾病中治疗炎症:偏头痛性头痛、结节性动脉外膜炎、甲状腺炎、再生障碍性贫血、何杰金氏病、硬化病、风湿热、I型糖尿病,神经肌肉接合处疾病,包括重症肌无力,白质疾病,包括多发性硬化,类肉瘤病、肾病综合征、Behcet′s综合征、多肌炎、龈炎、肾炎、过敏症、手术后发生的肿胀,包括脑水肿,心肌缺血等。
这样的组合物可用于治疗眼睛疾病,例如视网膜炎、结膜炎、视网膜病、眼色素层炎、眼睛畏光和眼睛组织的急性损伤。
这样的组合物可用于治疗肺炎症,例如与病毒感染和囊性纤维变性有关的肺炎症,以及在骨再吸收中的肺炎症,例如与骨质疏松有关的肺炎症。
这样的组合物可用于治疗一些中枢神经系统病症,例如皮质性痴呆症,包括阿尔茨海默氏病,神经变性和由于中风、缺血和创伤所导致的中枢神经系统损伤。在本发明上下文中,术语“治疗”包括部分或完全抑制痴呆,包括阿尔茨海默氏病、血管性痴呆、多梗塞性痴呆、早老性痴呆、酒精中毒性痴呆和老年痴呆。
这样的组合物可用于治疗过敏性鼻炎、呼吸窘迫综合征、内毒素性休克综合征和肝病。
这样的组合物可用于治疗疼痛,包括但不限于手术后疼痛、牙疼、肌肉疼痛和癌症所导致的疼痛。例如,这样的组合物可用于缓解多种状况中的疼痛、发热和炎症,所述状况包括风湿热、流行性感冒和其它病毒感染包括伤风、腰背和颈疼痛、痛经、头痛、牙痛、扭伤和劳损、肌炎、神经痛、滑膜炎、关节炎,包括类风湿性关节炎,关节变性疾病(骨关节炎)、痛风和僵硬性脊椎炎、粘液囊炎、烧伤和手术以及牙科手术后创伤。
这样的组合物可用于治疗和预防与炎症有关的心血管病症,包括血管疾病、冠状动脉疾病、动脉瘤、血管排斥、动脉硬化、动脉粥样硬化,包括心脏移植动脉粥样硬化,心肌梗塞、栓塞、中风,血栓形成,包括静脉血栓形成,心绞痛,包括不稳定的心绞痛,冠状斑炎症,细菌引起的感染,包括衣原体引起的炎症,病毒引起的炎症,和与手术有关的炎症,这样的手术是例如血管移植手术,包括冠状动脉旁路手术,血管再造手术,包括血管成形术,斯滕特氏印模放置,动脉内膜切除术,或涉及动脉、静脉和毛细血管的其它侵入性手术。
这样的组合物可用于治疗个体中的与血管生成有关的病症,例如抑制肿瘤血管生成。这样的组合物可用于治疗肿瘤形成,包括肿瘤转移;眼科病症例如角膜移植物排斥、眼睛新血管生成,肾新血管生成,包括损伤或感染之后的新血管生成,糖尿病性视网膜病、黄斑变性、晶状体后纤维组织形成和新血管性青光眼;溃疡性疾病例如胃溃疡;病理性但非恶性的病症,例如血管瘤,包括婴儿血管瘤,鼻咽血管纤维瘤和骨无血管坏死;和女性生殖系统病症例如子宫内膜异位。
这样的组合物可用于预防和治疗良性和恶性肿瘤和肿瘤形成,包括癌症,例如结肠直肠癌、脑癌、骨癌、上皮细胞衍生的肿瘤形成(上皮癌)例如基底细胞癌、腺癌、胃肠癌例如唇癌、口腔癌、食管癌、小肠癌、胃癌、结肠癌、肝癌、膀胱癌、胰腺癌、卵巢癌、子宫颈癌、肺癌、乳腺癌、皮肤癌例如鳞状细胞和基底细胞癌、前列腺癌、肾细胞癌和影响身体上皮细胞的其它已知癌症。可特别用本发明组合物治疗的肿瘤形成是胃肠癌、Barrett′s食管、肝癌、膀胱癌、胰腺癌、卵巢癌、前列腺癌、子宫颈癌、肺癌、乳腺癌和皮肤癌。这样的组合物还可用于治疗在放疗时发生的纤维变性。这样的组合物可用于治疗具有腺瘤性息肉的个体,包括具有家族性腺瘤性息肉病(FAP)的个体。此外,这样的组合物可用于在有患FAP危险性的患者中预防息肉形成。
这样的组合物通过抑制有收缩作用的前列腺素类物质的合成来抑制前列腺素类物质引起的平滑肌收缩,因此可用于治疗痛经、早产、哮喘和与嗜酸性细胞有关的病症。它们还可用于减少骨损失,特别是在绝经后的女性中减少骨损失(即治疗骨质疏松),和治疗青光眼。
对于急性COX-2介导的病症的治疗,特别是对于疼痛的缓解,例如在头痛,包括窦性头痛和偏头痛的治疗中,由于本发明组合物所表现出的迅速开始的治疗作用,这些组合物与现有技术制剂相比具有特别的优点。
本发明组合物的优选应用是治疗类风湿性关节炎和骨关节炎,一般性的疼痛控制(特别是口腔手术后疼痛、普通手术后疼痛、整形手术后疼痛和骨关节炎的急性突发),预防和治疗头痛和偏头痛,治疗阿尔茨海默氏病和用于结肠癌的化学预防。
对于类风湿性关节炎或骨关节炎的治疗,可使用本发明组合物以提供日剂量为约50mg-约1000mg、优选约100mg-约600mg、更优选约150mg-约500mg、仍然更优选约175mg-约400mg、例如约200mg的塞来昔布。当在本发明组合物中给药时,塞来昔布的日剂量为约0.7-约13mg/kg体重、优选约1.3-约8mg/kg体重、更优选约2-约6.7mg/kg体重、仍然更优选约2.3-约5.3mg/kg体重、例如约2.7mg/kg体重通常是合适的。该日剂量每天可分1-约4次、优选1或2次施用。
对于阿尔茨海默氏病或癌症的治疗,可使用本发明组合物以提供日剂量为约50mg-约1000mg、优选约100mg-约800mg、更优选约150mg-约600mg、仍然更优选约175mg-约400mg、例如约400mg的塞来昔布。当在本发明组合物中给药时,塞来昔布的日剂量为约0.7-约13mg/kg体重、优选约1.3-约10.7mg/kg体重、更优选约2-约8mg/kg体重、仍然更优选约2.3-约5.3mg/kg体重、例如约5.3mg/kg体重通常是合适的。该日剂量每天可分1-约4次、优选1或2次施用。
对于一般性的疼痛控制,尤其是治疗和预防头痛和偏头痛,可使用本发明组合物以提供日剂量为约50mg-约1000mg、优选约100mg-约600mg、更优选约150mg-约500mg、仍然更优选约175mg-约400mg、例如约200mg的塞来昔布。当在本发明组合物中给药时,塞来昔布的日剂量为约0.7-约13mg/kg体重、优选约1.3-约8mg/kg体重、更优选约2-约6.7mg/kg体重、仍然更优选约2.3-约5.3mg/kg体重、例如约2.7mg/kg体重通常是合适的。该日剂量每天可分1-约4次施用。以每次一个50mg的剂量单位、每天给药4次,每次一个100mg的剂量单位或两个50mg的剂量单位、每天给药2次,或每次一个200mg的剂量单位或两个100mg的剂量单位、每天给药1次的速度进行给药是优选的。
对于除塞来昔布之外的选择性COX-2抑制药物,可参考上文提及的专利文献来选择合适的剂量。
除了可用于人类治疗以外,本发明组合物还可用于宠物、珍奇动物、农业动物等,特别是哺乳动物的兽医治疗。更特别地,本发明组合物可用于在马、狗和猫中治疗COX-2介导的病症。
本发明实施方案还涉及治疗是COX-2抑制药物适应症的状况或疾病的方法,所述方法包括给有此需要的个体口服施用本发明组合物。预防、缓解或改善所述状况或疾病的给药方案优选相当于每天一次或每天两次的治疗,但是可依据多种因素来调节。这些因素包括个体的类型、年龄、体重、性别、饮食和医疗状况和疾病的性质和严重程度。因此,实际上采用的给药方案可在宽的范围内改变,并因此可以背离上文提出的优选给药方案。
初始治疗可用上文提出的给药方案来开始。按照需要,治疗一般继续数周至数月或数年,直至状况或疾病被控制住或消除。可通过本领域众所周知的方法例行监测用本发明组合物进行治疗的个体以确定治疗的有效性。连续分析监测数据使得能够在治疗期间调整治疗方案,这样可在任意时间点施用最有效的剂量,并且可决定治疗持续时间。通过这种方式,可在治疗过程中合理地调整治疗方案和给药程序,从而施用表现出满意疗效的最低量的组合物,和只有在成功地治疗状况或疾病所需要的情况下才继续给药。
本发明组合物可以与类阿片物质和其它镇痛剂,包括麻醉类镇痛剂,、Mu受体拮抗剂、Kappa受体拮抗剂、非麻醉类(即非成瘾性)镇痛剂、单胺摄取抑制剂、腺苷调节剂、大麻素衍生物、P物质拮抗剂、神经激肽-1受体拮抗剂和钠通道阻断剂等用于联合治疗。优选的联合治疗包括使用本发明组合物与一种或多种选自下列的化合物:醋氯芬酸、阿西美辛、e-乙酰氨基己酸、对乙酰氨基酚、醋氨沙洛、退热冰、乙酰水杨酸(阿司匹林)、S-腺苷蛋氨酸、阿氯芬酸、阿芬太尼、烯丙罗定、阿明洛芬、阿洛普令、阿法罗定、二(乙酰水杨酸)铝、氨芬酸、氨氯苯嗪、3-氨基-4-羟基丁酸、2-氨基-4-甲基吡啶、氨丙吡酮、氨基比林、阿米西群、水杨酸铵、安吡昔康、呱氨托美丁、阿尼利定、安替比林、水杨酸安替比林、安曲非宁、阿扎丙宗、苄达酸、贝诺酯、苯洛芬、苄哌立隆、苄达明、苯甲基吗啡、柏莫洛芬、苯腈米特、α-bisabolol、溴芬酸、对溴乙酰苯胺、5-溴水杨酸乙酸酯、溴水杨醇、布西丁、布氯酸、布可隆、丁苯羟酸、布马地宗、丁丙诺啡、布他西丁、异丁苯丁酸、布托啡诺、乙酰水杨酸钙、卡马西平、卡比芬、卡洛芬、卡沙兰、氯丁醇、氯西诺嗪、水杨酸胆碱、辛可芬、桂美辛、西拉马朵、环氯茚酸、氯美辛、氯尼他秦、氯尼辛、氯吡酸、clove、可待因、可待因甲基溴化物、磷酸可待因、硫酸可待因、克罗丙胺、克罗乙胺、地索吗啡、右奥沙屈、右吗拉胺、地佐辛、地恩丙胺、双氯芬酸钠、二苯酰胺吡唑、联苯吡胺、二氟尼柳、双氢可待因、双氢可待因酮烯醇乙酸酯、双氢吗啡、乙酰水杨酸二羟铝、地美沙朵、地美庚醇、二甲噻丁、吗苯丁酯、地匹哌酮、diprocetyl、安乃近、地他唑、屈俺昔康、依莫法宗、enfenamic acid、依匹唑、依他佐辛、依特柳酯、乙水杨胺、依索庚嗪、依托沙秦、乙甲噻丁、乙基吗啡、依托度酸、依托芬那酯、依托尼秦、丁子香酸、联苯乙酸、芬布芬、芬克洛酸、芬度柳、非诺洛芬、芬太尼、芬替酸、非普地醇、非普拉宗、夫洛非宁、氟芬那酸、氟诺洛芬、氟苯乙砜、flupirtine、氟丙喹宗、氟比洛芬、磷柳酸、龙胆酸、格拉非宁、葡美辛、水杨酸乙二醇酯、愈创蓝油烃、氢可酮、氢吗啡酮、羟哌替啶、异丁芬酸、布洛芬、异丁普生、咪唑水杨酸盐、消炎痛、吲哚洛芬、三苯唑酸、isoladol、异美沙酮、异尼辛、伊索克酸、伊索昔康、凯托米酮、酮洛芬、酮咯酸、p-lactophenetide、lefetamine、左吗啡、洛芬太尼、氯那唑酸、氯诺昔康、洛索洛芬、赖氨酸乙酰水杨酸、乙酰水杨酸镁、甲氯芬那酸、甲芬那酸、哌替啶、美普他酚、mesalamine、美他佐辛、盐酸美沙酮、左美丙嗪、甲嗪酸、甲氧夫啉、美托酮、莫非布宗、莫苯唑酸、吗拉宗、吗啡、盐酸吗啡、硫酸吗啉、水杨吗啉、麦罗啡、萘丁美酮、纳布啡、1-萘基水杨酸酯、萘普生、那碎因、奈福泮、尼可吗啡、尼芬那宗、尼氟灭酸、尼美舒利、5′-硝基-2′-丙氧基乙酰苯胺、去甲左啡诺、去甲美沙酮、去甲吗啡、诺匹哌酮、奥沙拉秦、阿片、奥沙西罗、奥沙美辛、奥沙普秦、羟考酮、羟吗啡酮、羟布宗、阿片全碱、瑞尼托林、帕沙米特、喷他佐辛、哌立索唑、非那西汀、苯吗庚酮、非那佐辛、非那吡啶盐酸盐、非诺可、苯哌利定、非诺吡酮、乙酰水杨酸苯酯、保泰松、水杨酸苯酯、非尼拉朵、吡酮洛芬、匹米诺定、哌布宗、哌立酮、piprofen、吡拉唑酸、哌腈米特、吡罗昔康、普拉洛芬、丙谷美辛、普罗庚嗪、二甲哌替啶、丙帕他莫、丙吡兰、丙氧芬、异丙安替比林、普罗喹宗、吩噻嗪丙酸、雷米那酮、瑞芬太尼、甲硫利马唑、醋水杨胺、水杨苷、水杨酰胺、水杨酰胺邻乙酸、水杨基硫酸、双水杨酯、沙维林、西美曲特、水杨酸钠、舒芬太尼、柳氮磺胺吡啶、舒林酸、超氧化物歧化酶、舒洛芬、琥布宗、他尼氟酯、替尼达普、滕诺息卡、特罗芬那酯、汉防己碱、噻唑丁炎酮、噻洛芬酸、噻拉米特、替利定、替诺立定、托芬那酸、托美丁、曲马多、tropesin、维米醇、联苯丁酸、希莫洛芬、扎拖洛芬和佐美酸(参见The Merck Index,12th Edition(1996),Therapeutic Category andBiological Activity Index,其中以标题“镇痛剂”、“抗炎剂”和“退热剂”列出的内容)。
特别优选的治疗组合包括使用该实施方案的组合物和类阿片化合物,更特别是其中类阿片化合物是可待因、哌替啶、吗啡或其衍生物。
与选择性COX-2抑制药物联合给药的化合物可以与选择性COX-2抑制药物独立地配制,或者与选择性COX-2抑制药物一起配制在本发明组合物中。当选择性COX-2抑制药物与第二药物例如类阿片药物一起配制时,该第二药物可以配制成即释型、速释型、持续释放型或双重释放型。
在本发明的实施方案中,特别是当COX-2介导的状况是头痛或偏头痛时,本发明选择性COX-2抑制药物组合物与血管调节剂,优选具有血管调节作用的黄嘌呤衍生物,更优选烷基黄嘌呤化合物进行联合治疗。
本发明提供的其中烷基黄嘌呤化合物与选择性COX-2抑制药物组合物共同给药的联合治疗包括在本发明的实施方案中,无论烷基黄嘌呤是否是血管调节剂,无论联合治疗的治疗有效性是否在任何程度上归因于血管调节作用。在本文中,术语“烷基黄嘌呤”包括具有一个或多个C1-4烷基、优选甲基取代基的黄嘌呤衍生物以及这样的黄嘌呤衍生物的可药用盐。二甲基黄嘌呤和三甲基黄嘌呤,包括咖啡因、可可碱和茶碱是特别优选的。烷基黄嘌呤化合物最优选是咖啡因。
选取选择性COX-2抑制药物与血管调节剂或烷基黄嘌呤的总体和相对剂量以使其能治疗和/或预防有效地解除与头痛或偏头痛相关的的疼痛。合适的剂量将取决于所选的特定选择性COX-2抑制药物和特定血管调节剂或烷基黄嘌呤。例如,在用塞来昔布和咖啡因进行的联合治疗中,一般,塞来昔布将以约50mg-约1000mg、优选约100mg-约600mg的日剂量给药,而咖啡因以约1mg-约500mg、优选约10mg-约400mg、更优选约20mg-约300mg的日剂量给药。
联合治疗的血管调节剂或烷基黄嘌呤组分可以在任意合适的剂型中通过合适的途径给药,优选口服给药。血管调节剂或烷基黄嘌呤可任选与选择性COX-2抑制药物一起配制在单一口服剂型中。因此,本发明的溶液或溶液/悬浮液制剂任选包含总量和相对量与上文所述剂量相一致的具有氨基磺酰基的选择性COX-2抑制药物和血管调节剂或烷基黄嘌呤例如咖啡因。
关于该实施方案的组合物中的选择性COX-2抑制药物与血管调节剂或烷基黄嘌呤的量的术语“有效地缓解疼痛的总体和相对量”是指这些量是这样的,(a)这些组分一起能有效地缓解疼痛,和(b)如果另一个组分不以这么大的量存在以排除这种贡献,每个组分能够对疼痛解除作用作出贡献。
实施例
实施例1
依据上文描述的测试I来测定几种聚合物作为塞来昔布和valdecoxib的结晶抑制剂的能力。所测试的聚合物包括聚乙烯吡咯烷酮(PVP),MW 10,000、29,000和55,000;羧甲基纤维素钠(Na CMC),MW 250,000;葡聚糖(MW 65,000);羟丙基纤维素(HPC),MW 80,000;乙基纤维素A15;羟丙基甲基纤维素(HPMC)E15;和聚乙二醇(PEG),MW 8,000和20,000)。为了进行比较,还测试非聚合物甘油。在每种情况下,用于制备浓药物溶液的溶剂都是乙醇,并且在测试I步骤B中使用的缓冲液包含pH 7磷酸盐缓冲剂。在每种情况下,样本溶液含有2.5%源自浓药物溶液的乙醇。
如表1所示,当测试在没有聚合物存在的情况下产生了大量沉淀(浊度为0.376)的高浓度(250μg/ml)塞来昔布时,PVP 10,000、PVP 29,000、PVP 55,000、Na CMC 250,000、HPC 80,000、乙基纤维素A15和HPMC E15都降低了各个样本溶液的浊度。当测试在没有聚合物存在的情况下产生了较少沉淀(浊度为0.146)的低浓度塞来昔布(125μg/ml)时,PVP 10,000、PVP 29,000、PVP 55,000、Na CMC250,000、HPC 80,000、乙基纤维素A15和HPMC E15都降低了各个样本溶液的浊度。还测试了两个更低浓度(62.5和31.3μg/ml)的塞来昔布,但是在没有聚合物存在的情况下没有产生足以充分进行测试I的沉淀。浊度读取的背景噪音一般是约0.03的信号。
以125、62.5和31.3μg/ml的低浓度测试valdecoxib-溶解度比塞来昔布稍高的一种药物,在没有聚合物存在的情况下没有产生足以充分进行测试I的沉淀。然而,对于其中在没有聚合物存在的情况下观测的浊度读数为0.185的250μg/ml的valdecoxib,PVP29,000、PVP 55,000、Na CMC 250,000、HPC 80,000、乙基纤维素A15和HPMC E15都降低了各个样本溶液的浊度。
表1.用几种聚合物测试塞来昔布和valdecoxib的结果
药物 | 聚合物(0.5%w/w) | 4个药物浓度的吸收度(μg/ml) | |||
250 | 125 | 62.5 | 31.3 | ||
Celecoxib | PVP 10,000 | 0.2 | 0.072 | 0.041 | 0.035 |
Celecoxib | PVP 29,000 | 0.118 | 0.064 | 0.037 | 0.031 |
Celecoxib | PVP 55,000 | 0.105 | 0.048 | 0.049 | 0.04 |
Celecoxib | Na CMC 250,000 | 0.148 | 0.083 | 0.078 | 0.046 |
Celecoxib | 葡聚糖65,000 | 0.379 | 0.266 | 0.076 | 0.033 |
Celecoxib | HPC 80,000 | 0.11 | 0.05 | 0.038 | 0.034 |
Celecoxib | 乙基纤维素A15 | 0.085 | 0.06 | 0.039 | 0.041 |
Celecoxib | HPMCE15 | 0.093 | 0.049 | 0.039 | 0.037 |
Celecoxib | PEG 8,000 | 0.485 | 0.308 | 0.169 | 0.031 |
Celecoxib | PEG 20,000 | 0.654 | 0.342 | 0.16 | 0.039 |
Celecoxib | 甘油 | 0.41 | 0.184 | 0.07 | 0.038 |
Celecoxib | 无 | 0.376 | 0.146 | 0.069 | 0.036 |
Valdecoxib | PVP 10,000 | 0.321 | 0.032 | 0.034 | 0.032 |
Valdecoxib | PVP 29,000 | 0.183 | 0.032 | 0.03 | 0.03 |
Valdecoxib | PVP 55,000 | 0.162 | 0.032 | 0.031 | 0.032 |
Valdecoxib | Na CMC 250,000 | 0.174 | 0.09 | 0.036 | 0.03 |
Valdecoxib | 葡聚糖65,000 | 0.289 | 0.033 | 0.031 | 0.03 |
Valdecoxib | HPC 80,000 | 0.093 | 0.046 | 0.032 | 0.031 |
Valdecoxib | 乙基纤维素A15 | 0.052 | 0.033 | 0.033 | 0.033 |
Valdecoxib | HPMCE15 | 0.064 | 0.034 | 0.034 | 0.032 |
Valdecoxib | PEG 8,000 | 0.345 | 0.03 | 0.03 | 0.03 |
Valdecoxib | PEG 20,000 | 0.433 | 0.031 | 0.031 | 0.031 |
Valdecoxib | 甘油 | 0.229 | 0.029 | 0.028 | 0.03 |
Valdecoxib | 无 | 0.185 | 0.029 | 0.029 | 0.031 |
实施例2
制备如表2所示的塞来昔布溶液制剂SF-1。
表2.塞来昔布溶液制剂SF-1的组成(mg/g)
组分 | SF-1 |
塞来昔布 | 200 |
PEG-400 | 300 |
聚山梨醇80 | 270 |
油酸 | 70 |
氨丁三醇 | 30 |
水 | 30 |
无水乙醇 | 100 |
总计 | 1000 |
使用SF-1制备3种不同的测试组合物SF-1A、SF-1B和SF-1C。组合物SF-1A由未包囊的饮用形式的0.8g SF-1组成。测试组合物SF-1B由包囊在硬明胶胶囊(Capsugel)中的0.8g SF-1组成,测试组合物SF-1C由包囊在100mg硬HPMC胶囊(Shionogi)中的0.8g SF-1组成。
以1g SF-1/50ml SGF的固定稀释度进行体外测试以评价上述3种测试组合物中的塞来昔布在保持在37℃的限定体积的SGF中的溶解性能。将测试组合物SF-1A溶解在已经包含0.2%预溶的HPMC的SGF中。将测试组合物SF-1B和SF-1C单独地溶解在不含预溶的HPMC的SGF中。使用II型桨(USP 24)施加75rpm的恒定搅拌速度。通过经由具有0.8μm VersaporTM膜的非灭菌AcrodiscTM注射滤器过滤除去在SGF中沉淀出的任何固体药物。通过HPLC测定在不同时间的SGF中的药物浓度,以反映出保持溶解状态(作为在溶液中或分配到乳滴中的游离药物存在)的药物的量。
很明显,附图1所示结果表明,当溶解在SGF中时,存在的HPMC(在测试组合物SF-1A中,预先溶解在SGF中,或者在测试组合物SF-1C中,源自HPMC胶囊壁)有效地保持了塞来昔布的超饱和溶液(约2-3mg/ml)至少5小时。与之相反,在没有HPMC存在的情况下(测试组合物SF-1B),由于药物结晶和沉淀,塞来昔布浓度低得多(约0.35mg/ml)。
实施例3
制备如表3所示的塞来昔布溶液制剂SF-2和SF-3。
表3.塞来昔布溶液制剂SF-2和SF-3的组成(mg/g)
组分 | SF-2 | SF-3 |
塞来昔布 | 200 | 200 |
水USP | 26 | 26 |
HPMC(E5) | 38 | - |
乙醇 | 113 | 100 |
PEG-400 | 271 | 322 |
聚乙烯吡咯烷酮 | 47 | 47 |
聚山梨醇80 | 217 | 217 |
氨丁三醇 | 26 | 26 |
油酸 | 61 | 61 |
没食子酸丙酯NF | 1 | 1 |
总计 | 1000 | 1000 |
如下所述制备3种测试组合物。测试组合物SF-2A由在硬明胶胶囊(Capsugel)中的1g SF-2(已经含有38mg/ml HPMC)组成;比较测试组合物SF-3A由在硬明胶胶囊(Capsugel)中的1g SF-3(不含有HPMC)组成;测试组合物SF-3B由在100mg HPMC胶囊(Shionogi)中的1g SF-3(不含有HPMC)组成。
如实施例2所述进行体外溶解测试(但是稀释度为1g测试组合物/100ml SGF,并且在任何情况下HPMC都没有预先溶解在SGF中)。附图2所示的数据表明,当使用明胶胶囊,并且溶液制剂不含有HPMC时(SF-3A),塞来昔布迅速发生沉淀,而使用悬浮在溶液制剂自身的HPMC(SF-2A)或存在于胶囊壁但是不存在于溶液制剂中的HPMC(SF-3B)获得了超饱和的塞来昔布溶液(1-1.2mg/ml)。
实施例4
制备如表4所示的塞来昔布溶液制剂(SF-4)。
表4.塞来昔布溶液制剂SF-4的组成(mg/g)
组分 | SF-4 |
塞来昔布 | 200 |
PEG-400 | 442 |
聚山梨醇80 | 252 |
油酸 | 80 |
二甲基乙醇胺 | 26 |
总计 | 1000 |
如下所述制备3种测试组合物。测试组合物SF-4A由在100mgHPMC胶囊(Shionogi)中的1g SF-4组成,比较测试组合物SF-4B由在硬明胶胶囊(Capsugel)中的1g SF-4组成。
如实施例3所述进行体外溶解测试。附图3所示的结果表明,当HPMC存在于胶囊壁中时(SF-4A),获得了超饱和的塞来昔布溶液(4小时后约1.5mg/ml),而当胶囊壁中不存在HPMC时(SF-4B),塞来昔布迅速发生沉淀。
实施例5
制备具有表5所示组成的塞来昔布溶液制剂SF-5至SF-7。
表5.塞来昔布溶液制剂SF-5至SF-7的组成(mg/g)
组分 | SF-5 | SF-6 | SF-7 |
塞来昔布 | 200 | 200 | 200 |
PEG-400 | 300 | 300 | 288 |
聚山梨醇80 | 270 | 270 | 232 |
脱水酒精 | 100 | 100 | 120 |
油酸 | 70 | 70 | 65 |
氨丁三醇 | 30 | 30 | 27.5 |
水 | 30 | 30 | 27.5 |
HPMC(E5) | -- | -- | 40 |
总计 | 1000 | 1000 | 1000 |
将等分试样(1g)的SF-5独立地填充到几个分别是100mg的HPMC胶囊(Shionogi)以形成测试组合物SF-5A,将1g等分试样的SF-6和SF-7独立地填充到几个硬明胶胶囊(Capsugel)中以分别形成比较测试组合物SF-6A和测试组合物SF-7A。
采用三向交叉设计,在禁食狗中评价将测试组合物SF-5A、SF-6A和SF-7A给药后塞来昔布的生物利用度。6只狗每只接受提供10mg/kg塞来昔布剂量的测试组合物。在基准以及给药0.5、0.75、1.0、1.5、2、3、5、8和24小时后通过HPLC测定血清塞来昔布浓度。依据本领域标准方法,由数据计算Cmax(最大血清浓度)和AUC(曲线下面积,总生物利用度衡量指标)。如附图4所示,作为溶液制剂SF-7A的组分或作为SF-5A的胶囊壁组分的HPMC使得Cmax和AUC大于用不含HPMC的比较组合物SF-6A测定的值。
实施例6
为了比较,如下所述制备塞来昔布悬浮液制剂:
(a)将5.0g吐温80(聚山梨醇80)置于容量瓶中;
(b)加入乙醇(至100ml)以形成混合物,将该混合物涡旋以形成均匀溶液;
(c)将5ml该均匀溶液转移到另一个含有200mg塞来昔布的100ml瓶以形成预混合物;
(d)将75ml苹果汁加到该预混合物中以形成中间塞来昔布悬浮液;和
(e)将该中间塞来昔布悬浮液静置5分钟,然后振摇以形成塞来昔布悬浮液。
在包括24名人类受试者、随机、四期、平衡交叉试验中,评价与实施例6的比较塞来昔布悬浮液组合物和市售塞来昔布(Pharmacia的Celebrex)200mg胶囊相比,施用实施例3的测试组合物SF-2A所获得的生物利用度参数。在该试验中还包括了与本发明无关的第四种组合物,但是在本文中没有报告。试验持续时间是大约15天,在第1、5、9和12天,给受试者随机施用这四种剂型当中的一种;在每次给药之前先禁食8小时,并且在每次给药的同时给予180ml水。在给药之前和给药后15、30、45分钟和1、1.5、2、3、4、6、8、12和24小时,测定每名受试者的血浆水平。依据本领域标准方法,由数据计算Cmax和AUC。如表6所示,摄入测试组合物SF-2A所获得的Cmax比摄入比较塞来昔布悬浮液或市售塞来昔布胶囊所获得Cmax的大2.5倍以上。摄入测试组合物SF-2A所获得的AUG比摄入比较塞来昔布悬浮液所获得的AUC大43%,而Tmax与摄入比较塞来昔布悬浮液所获得的Tmax基本上类似。
表6.塞来昔布在人个体中的体内生物利用度
参数 | 市售胶囊 | 比较悬浮液 | 测试组合物 |
Cmax(ng/ml) | 621 | 804 | 2061 |
Tmax(hr) | 2.15 | 0.97 | 1.03 |
AUC(ng/ml)*hr | 5060 | 4892 | 7593 |
实施例7
制备如表7所示的两种紫杉醇溶液制剂,即比较制剂SF-8和本发明溶液制剂SF-9。
表7.紫杉醇溶液制剂SF-8和SF-9的组成(mg/g)
组分 | SF-8 | SF-9 |
紫杉醇 | 60 | 60 |
PEG-400 | 160 | 150 |
CremophorTM EL | 420 | 400 |
无水乙醇 | 160 | 150 |
HPMC(E5) | - | 50 |
甘油二油酸酯 | 200 | 190 |
总计 | 1000 | 1000 |
在如实施例2所述的体外溶解实验中,以1/50的稀释度、一式两份的方式独立地评价制剂SF-8和SF-9。如附图5所示的数据表明,在不含有HPMC的溶液制剂SF-8的两个一式两份的测试中,紫杉醇都迅速发生沉淀,而当HPMC存在于溶液制剂中时(SF-9),在两个一式两份的测试中都获得了超饱和的紫杉醇溶液。
实施例8
制备如表8所示的两个紫杉醇溶液制剂SF-10和SF-11。在雄性Sprague-Dawley大鼠(n=8)中评价制剂SF-10和SF-11的口服生物利用度(体内)。所有制剂都是以10mg/kg的剂量口服给药。
表8.紫杉醇溶液制剂SF-10和SF-11的组成(mg/g)
组分 | SF-10 | SF-11 |
紫杉醇 | 57 | 62.5 |
无水乙醇 | 151.5 | 156.25 |
PEG 400 | 151.5 | 156.25 |
CremophorTM EL | 400 | 417 |
甘油二油酸酯 | 190 | 208 |
HPMC E5 | 50 | -- |
总计 | 1000 | 1000 |
如表9所示,口服施用溶液制剂SF-10所获得的Cmax比施用比较溶液制剂SF-11所获得的Cmax大20倍以上,并且AUC比施用比较溶液制剂SF-11所获得的AUC大。施用溶液制剂SF-10所获得的Tmax与施用溶液制剂SF-11所获得的Tmax基本上类似。
表9.紫杉醇在雄性Sprague-Dawley大鼠中的体内生物利用度
参数 | SF-10 | SF-11 |
Cmax(ng/ml) | 277 | 13.1 |
Tmax(hr) | 0.63 | 0.42 |
AUC(ng/ml)*hr | 329 | 26.8 |
Claims (14)
1.口服药物组合物,其中包含
(a)塞来昔布;
(b)可药用溶剂液体,其选自二醇和二醇醚;和
(c)降低浊度的聚合物,该聚合物为羟丙基甲基纤维素;其中至少相当一部分塞来昔布在溶剂液体中呈溶解形式,并且所述聚合物以足以实质性地抑制塞来昔布在模拟胃液中结晶和/或沉淀的量存在。
2.权利要求1的组合物,其中所述塞来昔布以占组合物重量1%-75%的总量存在。
3.权利要求1或2的组合物,其中所述组合物包含一个或多个剂量单位,所述每个剂量单位包含10mg-400mg塞来昔布。
4.权利要求1或2的组合物,其中所述羟丙基甲基纤维素具有15%-35%的甲氧基取代和3%-15%的羟基丙氧基取代。
5.权利要求1的组合物,其中所述降低浊度的聚合物以占溶剂液体重量1%-20%的量存在于溶剂液体中。
6.权利要求1的组合物,其中所述组合物还包含水溶性胶囊壁,塞来昔布和溶剂液体被包囊在其中。
7.权利要求6的组合物,其中所述降低浊度的聚合物以占胶囊壁重量5%-100%的量存在于胶囊壁中。
8.权利要求1的组合物,其中所述溶剂是聚乙二醇。
9.权利要求8的组合物,其中所述聚乙二醇的平均分子量为100-10,000。
10.权利要求1或2的组合物,其中所述组合物还包含血管调节剂,所述塞来昔布与血管调节剂以能有效地缓解头痛或偏头痛中的疼痛的总体和相对量存在。
11.权利要求1或2的组合物,其中所述组合物还包含烷基黄嘌呤化合物,所述塞来昔布与烷基黄嘌呤化合物以能有效地缓解头痛或偏头痛中的疼痛的总体和相对量存在。
12.权利要求11的组合物,其中所述烷基黄嘌呤化合物选自咖啡因、茶碱和可可碱。
13.权利要求11的组合物,其中所述烷基黄嘌呤化合物是咖啡因。
14.权利要求1的组合物在制备治疗是环加氧酶-2抑制剂的适应症的病症或疾病的药物中的用途。
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- 2002-01-15 NZ NZ526976A patent/NZ526976A/en unknown
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- 2002-01-15 PL PL02363215A patent/PL363215A1/xx not_active Application Discontinuation
- 2002-01-15 WO PCT/US2002/000971 patent/WO2002056878A2/en active IP Right Grant
- 2002-01-15 EA EA200300752A patent/EA006383B1/ru not_active IP Right Cessation
- 2002-01-15 CN CNB028067665A patent/CN100335136C/zh not_active Expired - Fee Related
- 2002-01-15 CA CA002434338A patent/CA2434338A1/en not_active Abandoned
- 2002-01-15 KR KR10-2003-7009549A patent/KR20030070118A/ko not_active Application Discontinuation
- 2002-01-15 MX MXPA03006357A patent/MXPA03006357A/es not_active Application Discontinuation
- 2002-01-15 IL IL15691602A patent/IL156916A0/xx unknown
- 2002-01-15 US US10/047,222 patent/US20030045563A1/en not_active Abandoned
- 2002-01-15 JP JP2002557386A patent/JP2004520359A/ja not_active Withdrawn
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Also Published As
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EP1365812A2 (en) | 2003-12-03 |
EA200300752A1 (ru) | 2004-02-26 |
US20030045563A1 (en) | 2003-03-06 |
US20020156124A1 (en) | 2002-10-24 |
KR20030070118A (ko) | 2003-08-27 |
WO2002056878A3 (en) | 2002-12-19 |
IL156916A0 (en) | 2004-02-08 |
NO20033244D0 (no) | 2003-07-17 |
BR0206580A (pt) | 2003-12-16 |
WO2002056878A2 (en) | 2002-07-25 |
CZ20031844A3 (cs) | 2003-12-17 |
PE20020799A1 (es) | 2002-09-11 |
CA2434338A1 (en) | 2002-07-25 |
AR035735A1 (es) | 2004-07-07 |
US7115565B2 (en) | 2006-10-03 |
NZ526976A (en) | 2005-02-25 |
NO20033244L (no) | 2003-09-17 |
MXPA03006357A (es) | 2003-10-06 |
HK1065959A1 (en) | 2005-03-11 |
PL363215A1 (en) | 2004-11-15 |
JP2004520359A (ja) | 2004-07-08 |
EA006383B1 (ru) | 2005-12-29 |
CN1498114A (zh) | 2004-05-19 |
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