Patent Application
20090114220
The invention relates to the field of medicament dispensing devices with a multi-dose magazine, particularly multi-dose powder inhalers, and relates to a medicament dispensing device according to the preamble of the independent claim. Also claimed is a medicament magazine for use in the medicament dispensing device, and a method of removing a medicament, particularly a powdered medicament.
Inhalers are known from the prior art in which a connection is made directly to a medicament chamber by means of a vacuum flow produced by inhaling (Venturi) and a powdered medicament contained therein is removed. In U.S. Pat. No. 6,655,381 a powdered medicament is placed in wells arranged in a circle in an annular magazine. A seal that closes off the wells is removed substantially in its entirety and a Venturi tube is arranged parallel to the magazine with the constriction above the well. Attached to the Venturi tube is a longer turbulence chamber which is needed as the medicament is essentially removed from the well all in one go. With this device it is not possible to achieve accurate dosing of a medicament or adjustment to different dosages.
In addition, there are various inhalers in which a medicament chamber is opened by piercing. However, openings in a film made by piercing are not very precisely defined, which means that on the one hand the precise amount of a medicament removed is not known and also differences occur between successive removals. This is undesirable particularly with medicaments the activity of which depends to a very high degree on the dosage.
In order to achieve the best possible turbulence in a medicament and thereby dissolve the carrier material and the active substance itself, in EP 1 475 115 and GB 2 340 758, a medicament chamber is essentially divided into an entry and exit chamber which are joined together by a constricted passage. A medicament is placed only in the entry chamber. By piercing or introducing cannulas, an air flow is produced through the medicament chamber from the entry chamber through the constriction into the exit chamber and out of the medicament chamber. In EP 1 475 115, for improved emptying of the medicament chamber, the entry and exit caber are each provided with two openings. In both specifications, the openings in the chambers are defined by the piercing.
In U.S. Pat. No. 5,715,810 a medicament chamber incorporated in an annular magazine is pierced on both sides. One piercing cannula is attached to a Venturi current, so as to produce an air flow through the chamber. The removal takes place in one step and cannot be metered, or can only be metered poorly. Here, too, the chambers are defined by piercing and pins used for this.
In WO 03/045483 a medicament chamber is pierced and a medicament contained therein is emptied out using an air flow produced by a compressed air source.
EP 0 547 429 discloses a cylindrical medicament magazine in which a fresh medicament chamber is brought into registry with a removal opening inside the apparatus by a screwing movement. In the apparatus, the air flow is subdivided: while one part empties the medicament chamber, the other part is passed through the apparatus and is combined with the medicament air current as an encircling air current.
In WO 2005/002654 an air flow is injected through a medicament chamber. Individual medicament pouches are housed in an annular magazine. During use the pouches are pushed out of the magazine from behind, thereby severing a sealing film and are coupled with a removal mechanism. At the same time an air current is guided into and through the pouch at the maximum possible speed. To trigger aggregation of a powder and prevent medicament from being carried forward into successive inhalations, an individual channel is provided downstream of each pouch. With an additional bypass channel that circumvents the pouch and also opens into a mouthpiece, the total volume of air inhaled is increased and inhalation facilitates or guarantees a sufficient air current being present to transport the medicament to the user. Owing to the fact that some of the air current is deflected through the bypass channel, the air current through the pouch is reduced, so that the removal process is prolonged. The removal of the medicament can thus be spread over a somewhat longer period of time instead of all being removed at once.
The powder inhaler from WO 2005/002654 is relatively complicated in construction. A number of different parts are present, some of which move and have to be coordinated with one another. Moreover, the removal of the medicament is not triggered by an actual Venturi principle, but rather there is an intake current passing directly through the medicament pouches, and this can be weakened by a bypass flow.
The aim of the invention is therefore to provide a medicament dispensing device, a medicament magazine for use in such a medicament dispensing device and a method of removing a medicament form a medicament chamber in which the removal is based on the Venturi principle and the amount taken out can be metered accurately and reproducibly.
This aim is achieved by the medicament dispensing device, the medicament magazine, and the method, as defined in the claims.
The invention is based on the principle known from U.S. Pat. No. 6,655,381, for example, of applying a Venturi-like vacuum flow to a medicament chamber and sucking the medicament contained therein out of the chamber by the vacuum and transporting it with the flow towards a mouthpiece. There, the medicament travels with the air current in the lungs of the user inhaling it.
In the device and method according to the invention, a drive current is now produced in an air channel, which as a result of a constriction in the air channel produces a vacuum flow in this region. The narrowest part of the air channel causing the reduced pressure flow is connected to a removal opening of a medicament chamber. The removal opening is connected to a control opening, so that an emptying current is formed through the control opening via the removal opening and through the medicament chamber. The emptying current is not connected to the drive current before entering the medicament chamber, but combines with the drive current after leaving the removal opening, so that a medicament carried along with the emptying current is transported with the drive current towards the mouthpiece.
The removal and control openings are preferably integrated directly in a medicament magazine. If the openings or the medicament magazine as a whole are produced by injection moulding from plastics, for example, these openings are very precisely defined, in a way which is not possible when an opening is produced by piercing, for example. By integrating the removal and control openings in the medicament magazine, these two openings are pre-defined and are fixed both before and after opening a medicament chamber.
The control and removal openings form a major part of a throttle arrangement by which it is possible to control the emptying current and hence to vary the quantity of medicament removed per unit of time. Other elements of the throttle arrangement with different effects may be the inner configuration of the medicament chamber itself, and the construction of the air channel connected to the removal opening, particularly its diameter.
As a result, the removal can be deliberately controlled, is precisely defined and above all reproducible. A throttle effect and hence an emptying current can be deliberately selected on the basis of the accurately defined but variable elements such as the control opening, removal opening, inner configuration of the medicament chamber and can also easily be changed to other dosages, quantities and types of medicaments.
The inhaler may also have at least one bypass opening to assist the inhalation process, e.g. for children or people with weakened lungs. This bypass opening serves to form a bypass flow which also leads to the mouthpiece and is preferably arranged downstream of a removal opening in the direction of the mouthpiece. However, it does not have any direct influence on a defined correlation between the vacuum flow, the removal opening and control opening.
A medicament chamber is preferably constructed so that at least some of the emptying current flows away over the medicament contained in the medicament chamber. By a suitable inner configuration of the medicament chamber it is also possible to influence the disaggregation and dispersion of a medicament. For example, additional turbulence can be introduced into an emptying current by means of a turbulence element, which is preferably formed by at least one part of the wall of the medicament chamber itself. This can increase the throttling effect or, if necessary, reduce it.
In the medicament chamber an additional vacuum flow can be produced, for example by means of a special configuration of a chamber wall or by means of a turbulence element. This is preferably arranged in a direct line between the control and removal openings, such that a medicament located on the floor of the medicament chamber is detached by this additional vacuum flow in the chamber. This can be achieved by, for example, the medicament chamber itself forming a kind of Venturi tube in all or part of the region between the control and removal openings.
A medicament magazine typically has a fill opening in addition to a control and removal opening. This fill opening is preferably formed independently of the other two openings in the magazine. This has the advantage that the fill opening can be very large, to assist with the filling operation. The fill opening is closed off, preferably sealed with a foil, after the introduction of a powder. If the medicament magazine is constructed as an annular magazine with a plurality of medicament chambers arranged in a circle therein, the control and removal openings of each chamber are spaced from one another, preferably on one side of the magazine, while the fill opening is arranged on the opposite side of the magazine. Thus, the opening of the control and removal openings is also independent of the removal of a sealing foil. Preferably a medicament magazine has a plurality of medicament chambers and single doses contained therein. The number is preferably in the range from 1 to 100 or up to 200 single doses, preferably in the range from 1-60, for example between 7-180 or 14-150, e.g. 30-120, 45-100, 30, 90, 60, 120. For inhalers the maximum number of single doses is preferably 60, for reasons of convenience and therapy.
An inhaler with a medicament magazine of this kind is very versatile in use. Besides the various possibilities of coordination and deliberate and very precise dosing possibilities, particularly their reproducibility, there is also the option of using the inhaler with a wide range of amounts and types of medicament. It is relatively simple to use a different medicament magazine, e.g. with a medicament chamber with a different, e.g. greater or smaller, capacity. If a removal opening is accurately defined by the medicament magazine itself, an adjacent (vacuum) opening in the Venturi suction tube may also be made larger without affecting the removal opening and hence the emptying current. As a result an inhaler can also be used with different medicament magazines, e.g. those with differently designed removal openings. Owing to the fact that only one removal opening has to be coupled at the inhaler end, the remainder of the construction of the inhaler and also the medicament chamber, in relation to a removal mechanism, is substantially independent of the medicament magazine and vice versa. In particular, a medicament chamber may be very elongated, may have an angle, etc., and a control opening may be arranged accordingly at different locations in the magazine. This is possible as the control opening is not directly connected to the arrangement of the Venturi tube, and in particular, the drive current produced in the Venturi tube and the emptying current formed by the coupling of the vacuum flow to the magazine have a different origin.
In the inhaler according to the invention essentially any kind of opening mechanism is possible: a medicament chamber can be opened before the removal of the medicament by piercing, scraping or peeling off a sealing foil that closes off the medicament chamber. A medicament chamber is designed accordingly, preferably such that the removal and control opening, which may also be referred to as control openings, are not affected by the opening mechanism. In particular, they are not affected by openings in the sealing foil itself or by an opening mechanism of the apparatus which produces such openings. This may be achieved for example by removing a sealing foil entirely from the control openings before the medicament is taken out, or by making an opening in a sealing foil so big that its effect on the control openings is negligible.
In one embodiment of the magazine, a medicament is emptied into a preliminary chamber, the preliminary chamber having a corresponding control and removal opening which is connected to a vacuum flow for removing the medicament. For this purpose, a medicament may be sealed in its own medicament chamber with a sealing foil which is preferably opening by an opening means that may be installed in the chamber itself. In this embodiment this fill opening is arranged substantially on the same side as the control openings. The preliminary chamber may be an integral part of the medicament chamber or the medicament magazine, or it may be an integral part formed on an air channel. The advantage of the first variant is that a new unused chamber is available each time medicament is taken.
In a preferred embodiment of the inhaler, two medicament chambers are joined together through a common mouthpiece. In this way, the number of single doses of medicament can be doubled. For this, the individual medicament chambers of the two magazines are preferably arranged offset from one another. However, it is also possible, when removing the medicament, to open one chamber of each magazine and take one medicament from each. This is particularly advantageous if two medicaments have to be taken which cannot be stored together, or if every second time a double quantity of a medicament or medicament mixture has to be taken. For producing a medicament magazine and optionally also certain parts of a device, pharmaceutically permitted materials are preferably used. The films used may be multi-layer films, for example, which are suitable as films for peeling or piercing or for scraping off. Multi-layer films usually have a layer of PE, PP or PVC and an aluminium layer. Dependingon the particular requirement, a film is made more stable or tear-resistant, and this is pref done by incorporating a PET layer. In preferred material combinations, an outer layer of a film comprises the same material as an injected-moulded magazine, for example. In this way it is possible to seal or weld the different elements of a medicament magazine with the same materials. It is also possible to use sealing lacquer, e.g. heat-sealing lacquer. As a result, there are more possible material combinations for the individual elements. A sealing lacquer is applied, for example, to a film and/or to a magazine that is to be closed off. It is also possible for a foil to have a layer of sealing lacquer directly. The strength of the seal is preferably also optimally tailored to the use, so that, for example, a peelable film adheres directly but removably to an elements which is to be sealed.
The compounds specified below may be used in the apparatus according to the invention on their own or in combination. In the compounds specified below, W is a pharmacologically active substance and (for example) is selected from among the betamimetics, anticholinergics, corticosteroids, PDE4-inhibitors, LTD4-antagonists, EGFR-inhibitors, dopamine agonists, H1-antihistamines, PAF-antagonists and PI3-kinase inhibitors. Moreover, double or triple combinations of W may be combined and used in the apparatus accin. Combinations of W might be, for example:
The compounds used as betamimetics are preferably compounds selected from among albuterol, arformoterol, bambuterol, bitolterol, broxaterol, carbuterol, clenbuterol, fenoterol, formoterol, hexoprenaline, ibuterol, isoetharine, isoprenaline, levosalbutamol, mabuterol, meluadrine, metaproterenol, orciprenaline, pirbuterol, procaterol, reproterol, rimiterol, ritodrine, salmefamol, salmeterol, soterenol, sulphonterol, terbutaline, tiaramide, tolubuterol, zinterol, CHF-1035, HOKU-81, KUL-1248 and
The anticholinergics used are preferably compounds selected from among the tiotropium salts, preferably the bromide salt, oxitropium salts, preferably the bromide salt, flutropium salts, preferably the bromide salt, ipratropium salts, preferably the bromide salt, glycopyrronium salts, preferably the bromide salt, trospium salts, preferably the chloride salt, tolterodine. In the above-mentioned salts the cations are the pharmacologically active constituents. As anions the above-mentioned salts may preferably contain the chloride, bromide, iodide, sulphate, phosphate, methanesulphonate, nitrate, maleate, acetate, citrate, fumarate, tartrate, oxalate, succinate, benzoate or p-toluenesulphonate, while chloride, bromide, iodide, sulphate, methanesulphonate or p-toluenesulphonate are preferred as counter-ions. Of all the salts the chlorides, bromides, iodides and methanesulphonates are particularly preferred.
Other preferred anticholinergics are selected from among the salts of formula AC-1
wherein X− denotes an anion with a single negative charge, preferably an anion selected from among the fluoride, chloride, bromide, iodide, sulphate, phosphate, methanesulphonate, nitrate, maleate, acetate, citrate, fumarate, tartrate, oxalate, succinate, benzoate and p-toluenesulphonate, preferably an anion with a single negative charge, particularly preferably an anion selected from among the fluoride, chloride, bromide, methanesulphonate and p-toluenesulphonate, particularly preferably bromide, optionally in the form of the racemates, enantiomers or hydrates thereof. Of particular importance are those pharmaceutical combinations which contain the enantiomers of formula AC-1-ene
wherein X− may have the above-mentioned meanings. Other preferred anticholinergics are selected from the salts of formula AC-2
wherein R denotes either methyl or ethyl and wherein X− may have the above-mentioned meanings. In an alternative embodiment the compound of formula AC-2 may also be present in the form of the free base AC-2-base.
Other specified compounds are:
The above-mentioned compounds may also be used as salts within the scope of the present invention, wherein instead of the methobromide the salts metho-X are used, wherein X may have the meanings given hereinbefore for X−.
As corticosteroids it is preferable to use compounds selected from among beclomethasone, betamethasone, budesonide, butixocort, ciclesonide, deflazacort, dexamethasone, etiprednol, flunisolide, fluticasone, loteprednol, mometasone, prednisolone, prednisone, rofleponide, triamcinolone, RPR-106541, NS-126, ST-26 and
PDE4-inhibitors which may be used are preferably compounds selected from among enprofyllin, theophyllin, roflumilast, ariflo (cilomilast), tofimilast, pumafentrin, lirimilast, arofyllin, atizoram, D-4418, Bay-198004, BY343, CP-325,366, D-4396 (Sch-351591), AWD-12-281 (GW-842470), NCS-613, CDP-840, D-4418, PD-168787, T-440, T-2585, V-11294A, CI-1018, CDC-801, CDC-3052, D-22888, YM-58997, Z-15370 and
The LTD4-antagonists used are preferably compounds selected from among montelukast, pranlukast, zafirlukast, MCC-847 (ZD-3523), MN-001, MEN-91507 (LM-1507), VUF-5078, VUF-K-8707, L-733321 and
EGFR-inhibitors which may be used are preferably compounds selected from among cetuximab, trastuzumab, ABX-EGF, Mab ICR-62 and
The dopamine agonists used are preferably compounds selected from among bromocriptin, cabergoline, alpha-dihydroergocryptine, lisuride, pergolide, pramipexol, roxindol, ropinirol, talipexol, tergurid and viozan, optionally in the form of the racemates, enantiomers, diastereomers thereof and optionally in the form of the pharmacologically acceptable acid addition salts, solvates or hydrates thereof. According to the invention these acid addition salts are preferably selected from among the hydrochloride, hydrobromide, hydriodide, hydrosulphate, hydrophosphate, hydromethanesulphonate, hydronitrate, hydromaleate, hydroacetate, hydrocitrate, hydrofumarate, hydrotartrate, hydrooxalate, hydrosuccinate, hydrobenzoate and hydro-p-toluenesulphonate.
H1-Antihistamines which may be used are preferably compounds selected from among epinastine, cetirizine, azelastine, fexofenadine, levocabastine, loratadine, mizolastine, ketotifen, emedastine, dimetindene, clemastine, bamipine, cexchlorpheniramine, pheniramine, doxylamine, chlorophenoxamine, dimenhydrinate, diphenhydramine, promethazine, ebastine, desloratidine and meclozine, optionally in the form of the racemates, enantiomers, diastereomers thereof and optionally in the form of the pharmacologically acceptable acid addition salts, solvates or hydrates thereof. According to the invention these acid addition salts are preferably selected from among the hydrochloride, hydrobromide, hydriodide, hydrosulphate, hydrophosphate, hydromethanesulphonate, hydronitrate, hydromaleate, hydroacetate, hydrocitrate, hydrofumarate, hydrotartrate, hydroxalate, hydrosuccinate, hydrobenzoate and hydro-p-toluenesulphonate.
In addition, inhalable macromolecules may be used as disclosed in EP 1 003 478.
In addition, the compound may from the group of the derivatives of ergot alkaloids, triptanes, CGRP-inhibitors, phosphodiesterase-V inhibitors, optionally in the form of the racemates, enantiomers or diastereomers thereof, optionally in the form of the pharmacologically acceptable acid addition salts, solvates and/or hydrates thereof.
Examples of ergot alkaloid derivatives are: dihydroergotamine, ergotamine.
Examples of substances suitable for inhalation include medicaments, medicament formulations and mixtures containing the above-mentioned active substances, and the salts and esters thereof and combinations of these active substances, salts and esters.
The invention is hereinafter described in more detail by means of examples. In the drawings:
Every one of these measures and effects increases the formation of turbulence in the cavity and hence the dispersion. Any clumps in the powder can also be broken up in this way. The shape of the removal opening and the combining of the vacuum and emptying currents also influence the dispersion of the powder.
The medicament chamber comprises a fill opening 13 on the bottom, opposite the top. The fill opening 13 extends substantially over the entire lower surface of the cavity and is closed off with a sealing film 12 once the powder has been placed in the cavity.
With this removal concept the removal of the medicament can be adapted very sensitively and in versatile manner to all kinds of medicaments, dosages and user requirements. This can be done by varying and adapting the emptying flow, which is affected by several parameters: the diameter of the air channel above the removal opening, the dimensions of the removal opening, the configuration of the cavity, and the dimensions of the control opening. The special configuration of the medicament magazine also allows easy adaptation to different amounts, compositions or consistencies of medicaments, e.g. by enlarging the cavity and/or changing the opening diameter. The separate fill opening also allows this to be made as large as possible, so that a powder can be poured in very quickly and without having to be tailored to a special (small) fill opening. Also, because of the direct connection of a removal opening to the air channel and the vacuum flow prevailing therein, no powder is lost along lengthy passages or ducts.
If required, the air channel 4 has additional sidestream or bypass openings which terminate in the air channel and are arranged offset downstream of a removal opening, towards the mouthpiece 9. This reduces the suction force needed or creates crosscurrents in the air channel to assist with the dispersion of a powder contained therein.
The quantity of fill volume of a single dose may be varied relatively easily by changing the depth and/or length of the cavity. As only the removal opening can be connected to a vacuum flow, the control opening can be arranged virtually anywhere in the magazine. It must not be adjacent to the removal opening on the same side of the annular magazine but it could, for example, be arranged on an inner diameter of the magazine.
The foil blister 101 has, in the region of the actual medicament chamber, a preliminary chamber 105. The preliminary chamber 105 has a removal opening 2 and a control opening 3. The delivery of the powder 6 from the blister is preferably effected as follows: the contents of the blister are emptied or introduced into the preliminary chamber 105 with the aid of the internal structure, preferably directly during the action of loading an inhaler. The preliminary chamber has a removal opening 2 which may be in the form of a through-bore and is connected to a Venturi suction tube 104. As a result of the Venturi effect, the maximum pressure difference is present at the through-bore, enabling the powder to be drawn out of the preliminary chamber 105 in metered amounts. At this point the air current 5 reaches its maximum speed, thus allowing efficient detachment (dispersion) of an active substance from the carrier.
Preferably a blister with an integrated preliminary chamber is produced, such that a medicament magazine with a fill opening, removal opening and control opening in turn forms a unit, while the openings are matched to one another, depending on the application. One advantage of this variant is that a fresh preliminary chamber is provided for each inhalation. Another variant in which a fresh suction tube or part of a suction tube is available for each removal is when the blister is formed with an integrated preliminary chamber and suction tube. Any medicament residues on the walls of the suction tube, which in particular occur directly in the region of the removal opening would thus not affect subsequent removals. In another variant the preliminary chamber is in turn an integral part of the suction tube, but is independent of the foil blister and the actual medicament chamber.
To illustrate blisters with an internal structure 101
The internal structure may be connected to the blister, e.g. sealed on its reverse side with a film so as not to fall into the preliminary chamber depending on the position of the blister. However, if the preliminary chamber is an integral part of the blister or each individual medicament chamber located therein, this measure may not be necessary. An internal structure of this kind may also serve as a turbulence element as well or in particular if it is freely positioned in the preliminary chamber. The internal structure may also provide additional turbulence by means of an emptying current passing through the preliminary chamber and thus additionally contribute to the disaggregation and dispersion of the powder. The internal structure is preferably very open in design, so that an air current can penetrate into and through the internal structure is possible from many sides. This contributes to emptying a medicament chamber as completely as possible and additional air turbulence.
The internal structure, preliminary chamber and suction tube are preferably formed by injection moulding a plastic. However, it is also possible to produce individual parts thereof by a thermoforming process or, in the case of internal structures, to stamp and form them from a foil, e.g. a metal foil.
| Number | Date | Country | Kind |
|---|---|---|---|
| 06405160.0 | Apr 2006 | EP | regional |
This application is the national phase entry under 35 U.S.C. § 371 of International Application No. PCT/CH2007/000182, filed Apr. 13, 2007, which claims priority to European Application No. EP 06405160.0, filed Apr. 13, 2006, each of which is hereby incorporated by reference in its entirety.
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/CH2007/000182 | 4/13/2007 | WO | 00 | 12/30/2008 |
