Methods of treating acute pain using diclofenac

Abstract

New pharmaceutical compositions for oral use containing diclofenac preferably together with alkali metal bicarbonates in amounts of from about 20 to about 80 by weight with respect to diclofenac are described. These compositions are entirely palatable and free from any unpleasant taste or other, side effects; in particular, these formulations permit to obtain in human patients higher Cmax of the active principle and shorter Tmax together with a lower coefficient of variation.

Description

FIELD OF INVENTION

The present invention relates to new immediate release pharmaceutical compositions containing [(2,6-dichloro-anilino)-2-phenyl]-2-acetic acid (more commonly known as diclofenac) in acid and/or salt form, and therapeutic regimens involving same for the treatment of acute pain.

BACKGROUND OF INVENTION

Diclofenac is a non-steroidal drug which was invented at the end of the sixties by A. Sallmann and R. Pfister (NL-6,604,752 and U.S. Pat. No. 3,558,690 both to Ciba-Geigy) and whose structural formula is indicated below.

Diclofenac is widely dispensed and used owing to its well-known analgesic, anti-pyretic, anti-arthritic, anti-phlogistic and anti-rheumatic properties. It is generally taken orally in the form of normal tablets or tablets covered with coatings resistant to gastric juices, or rectally, or by injection, or topically.

The possibility of taking it in the form of sweets, tablets dissolving in the mouth, drages, chewing gum or other similar pharmaceutical forms or in formulations for the extemporary preparation of diclofenac-based aqueous solutions and/or suspensions would represent a different mode of administration which is definitely more suitable, especially for children and elderly persons.

Owing to its poor solubility in water, diclofenac is normally used in salt form; the salts of diclofenac customarily used are those of sodium, potassium or other alkali and alkaline earth metals, together with salts of organic nature, such as the salts of basic amino acids, such as lysine, arginine and omithine, or other pharmacologically acceptable organic bases which have the ability to render the resulting salt soluble in water.

The pharmaceutical compositions of the diclofenac salts for oral use are generally accompanied by side effects of not inconsiderable consequence: Diclofenac salts are in fact characterised by a particularly unpleasant and bitter taste and by the fact that they produce a sensation of strong astringency and cause an especially intense form of irritation in the buccal cavity, especially in the area of the larynx.

Although the first problem has been partly solved by using flavorings which are able in some manner to mask the taste, satisfactory solutions have still not been proposed for the two remaining problems.

Therefore, the pharmaceutical compositions containing diclofenac salts still have a poor palatability which limits their adoption and possible fields of application, despite the excellent therapeutic effect with which they are associated.

A second problem connected to diclofenac is that, when it is orally administered by means of immediate release formulations, the corresponding T_max (the time to the maximum plasma concentration) is usually located at about 1 hour since administration, this being of course a not completely satisfactory result when a prompt and strong analgesic/anti-pyretic effect is sought for. Furthermore, the corresponding coefficient of variation is normally in the range of 70-90%, which means that the T_max is strongly variable and dependent on the physical characteristics of the patient (Physicians' Desk Reference, 52 edition, 1998, page 1831). Attempts are therefore still being made in order to enhance the rate of absorption of diclofenac and to provide an earlier onset of the therapeutic effect (N. Davies, K. Anderson; Clinical Pharmacokinetics of Diclofenac, Clin. Pharmacokinet., 1997, September. 33(3)).

The object of the present invention is therefore that of providing a fully palatable formulation of diclofenac which is able to generate a more rapid, uniform and foreseeable release of the active principle if compared to the compositions known in the art and presently available on the market. For the purposes of the present invention T_max means the time to the maximum plasma concentration whereas C_max is the maximum plasma concentration of the active principle, namely diclofenac.

DISCUSSION

It has now been found that, by adding alkali metal bicarbonates or mixtures thereof to the diclofenac in its acid and/or salt form, preferably in amounts of from 20 to 80% by weight based on the acid-form of diclofenac, pharmaceutical compositions can be obtained which are substantially free from the side effects mentioned above. The first object of the present invention is therefore represented by a pharmaceutical formulation for oral use containing diclofenac in acid and/or salt form together with alkali metal bicarbonates or mixtures thereof and customary excipients and adjuvants, wherein said alkali metal bicarbonates are preferably present in amounts of from 20 to 80% by weight based on the weight of diclofenac.

It has in fact been surprisingly demonstrated that the use of alkali metal bicarbonates in the above-mentioned ratio permits to achieve constant, reproducible and foreseeable blood levels of the active ingredient, with the consequent indisputable advantages from the therapeutic point of view; furthermore, it has also been found that the combined use of diclofenac together with alkali metal bicarbonates yields diclofenac-based pharmaceutical compositions in which the active ingredient is released more rapidly compared with normal formulations, bringing about higher blood levels and therefore a more immediate therapeutic effect; finally the so-obtained immediate release formulations are substantially palatable and free from aftertaste.

According to the preferred embodiment of the present invention, the amount of alkali metal bicarbonates to be added is comprised between 40 and 80% by weight, based on the weight of the acid-form diclofenac, whereas the alkali metal bicarbonates are selected from sodium and/or potassium bicarbonates, diclofenac being normally present in the form of its sodium and/or potassium salts. In various further embodiments, alkali metal carbonates and bicarbonates are employed in a weight ratio relative to the diclofenac of greater than about 1:5, 2:5, 2:1, 3:1 or 5:1. If desired, an upper limit on the buffer:diclofenac ratio can be placed at about 20:1, 10:1, 5:1, 1:1, 4:5 or 3:5. Ranges can be selected from any two of the foregoing values that are mathematically possible. In a preferred embodiment, the buffer:diclofenac weight ratio ranges from about 1:5 to about 4:5.

Although the compositions of the present invention are useful in chronic pain conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis; and periarticular disorders such as bursitis and tendonitis; they are particularly useful in the treatment of acute pain conditions, including soft tissue disorders such as sprains and strains, migraine attacks, and other painful conditions such as renal colic, acute gout, dysmenorrhoea, and following some surgical procedures.

It has also been found, and forms a second subject of the present invention, that the addition of flavoring substances selected from mint, aniseed, ammonium glycyrrhizinate and mixtures thereof to the compositions containing the diclofenac salts and alkali metal bicarbonates produces a synergistic effect which completely eliminates all the above-mentioned palatability/astringency effects, providing pharmaceutical compositions which are entirely palatable (and/or drinkable in the case of those used for the preparation of solutions and/or suspensions) and free from aftertaste.

The flavoring substances may be used as such or supported on inert materials, for example maltodextrin, in order to obtain a better distribution of the granulates and to facilitate excellent dispersibility of the flavoring in solution. Preferably, they are absorbed on maltodextrin with a power of 1 to 2000 and 1 to 1000.

The amount of flavoring substances in its pure form is also preferably from 1/5 to 3 times the weight of the acid-form diclofenac.

These flavoring substances are used in the implementation of the present invention without altering their organoleptic properties and without depriving them of their intrinsic qualities of flavorings which are liposoluble and generally oily in the pure state.

As it will be clear from the examples, the immediate release formulations for oral use of the present invention containing from 10 to 60 mg of diclofenac in acid and/or salt form together with alkali metal bicarbonates or mixtures thereof in amounts of from 20 to 80% by weight based on the weight of diclofenac permit to generate in human patients an average C_max of diclofenac comprised between 400 and 2500 ng/ml independently on the age, sex or weight of the patients themselves.

Secondly, the formulations according to the present invention permit to obtain in humans an average T_max of Diclofenac after 5-30 minutes since administration, generally 13-27, independently on the amount of diclofenac contained therein and also independently on the age, sex, weight of the patient.

Furthermore, the T_max of the formulations of the present invention show a coefficient of variation which is about 44-86% lower than the presently marketed formulations; this is evidently an extremely important result from the clinical point of view as it is now possible to have a therapeutic effect of diclofenac which is foreseeable, reproducible and independent of the sex, weight and health conditions of the patient.

Thus, the presently claimed diclofenac-based formulations permit to achieve a higher C_max in a shorter T_max and with a lower coefficient of variation if compared to the formulations available on the market, with therapeutic advantages which do not need to be commented.

Preferred Cmax and Tmax ranges for various formulations of the invention are set forth below in Table 1:

TABLE 1
	Mean Cmax (ng/ml)	Mean Tmax (min)
50 mg.	1500-2100; 1750-2000; 1600-1900	5-35; 10-30;
diclofenac		12-25; 15-20
tablet
25 mg.	700-1150; 750-950; 800-900;	5-35; 10-30;
diclofenac	850-1050; 900-1000	15-30; 15-25
tablet
12.5 mg.	350-650; 400-600; 450-550	5-35; 10-30; 15-25
diclofenac
tablet
50 mg.	1450-1850; 1500-2000; 1500-1750;	5-35; 8-20; 10-18
diclofenac	1900-2500; 2000-2400;
K powder	2100-2300
sachet

The amount of diclofenac used in the unit dosage forms of the present invention is preferably 12.5, 25, 50, 75 or 100 mg. According to the best mode for carrying out the present invention the pharmaceutical formulations will contain from 10 to 60 mg/dose of diclofenac in its potassium or sodium salt form together with 40 to 80% by weight of potassium or sodium bicarbonate based on the weight of diclofenac in its acid form, together with the usual excipients and adjuvants; even more preferably they will packaged as:

• • a sachet or tablet formulation containing 50 mg of diclofenac potassium salt and 22 mg of potassium bicarbonate, or a sachet or tablet containing 100 mg., 75 mg., 25 mg. or 12.5 mg of diclofenac potassium and potassium bicarbonate in an amount of 44 wt. % based on the weight of the diclofenac.
  • a sachet or tablet formulation containing 50 mg of diclofenac sodium salt and 19 mg of sodium bicarbonate, or a sachet or tablet containing 100 mg., 75 mg., 25 mg. or 12.5 mg of diclofenac sodium and sodium bicarbonate in an amount of 38 wt. % based on the weight of the diclofenac.

It will be by the way evident to any skilled in this art that the present formulations can also be used as immediate release layers of multilayered release pharmaceutical formulations containing diclofenac as one of the active ingredients; said formulations are therefore a further object of the present invention.

EXAMPLES

The following Examples are given purely by way of non-limiting illustration.

Example 1

Composition Dissolving Instantly in Water

Active ingredients
1)	Diclofenac potassium salt*:	50	mg
2)	Potassium bicarbonate:	22	mg
3)	Mint flavoring on maltodextrin (1:2000)**:	60	mg
4)	Aniseed flavoring on maltodextrin (1:1000)***:	104	mg
	Excipients and adjuvants
5)	Saccharin:	4	mg
6)	Aspartame:	10	mg
7)	Mannitol:	50	mg
8}	Saccharose****q.s.:	2	g
*If it is desired to prepare compositions based on diclofenac sodium salt, it is advantageous to use sodium bicarbonate in a quantity of approximately 38% by weight based on the weight of the diclofenac sodium salt present.
Sodium carbonate may also be added to the sodium bicarbonate, maintaining the following optimum proportions: 27% of sodium bicarbonate and 4-5% of sodium carbonate, always based on the amount by weight of diclofenac sodium salt present.
**The title of the pure mint essence, as obtained according to the Dean-Stark method, is of 18% by weight; the related amount is therefore in this case of 10.8 mg.
***The title of the pure anise essence, as obtained according to the Dean-Stark method, is of 14.5% by weight, the related amount is therefore in this case of 16 mg.
****The presence of saccharose is not strictly necessary; in its absence, a composition having a very limited granulate content is obtained which is perfectly 20 soluble in contact with water. In that case, nothing is changed from the point of view of tolerability in contact with the mucosa and. from the point of view of the palatability of the drinkable solution.

Preparation

Components 1, 2, 5, 6 and 7 are mixed in a suitable mixer, and the mixture so obtained is wetted with 95% ethanol. Granulation is carried out with a 66 mm mesh and the granulate is preferably dried in current of air.

Components 3, 4 and 8, which have already been granulated using a mesh of the same granulometry, are then added and the whole is mixed.

The mixture is then introduced into a metering machine for filling packets or similar containers.

Example 2

Tablet for Dissolving in the Mouth

	Active ingredients
	1)	Diclofenac potassium salt*:	50 mg
	2)	Potassium bicarbonate:	35 mg
	3)	Mint flavoring on maltodextrin**	50 mg
		(1:2000) + gum arabic (E 414):
	4)	Aniseed flavoring (1:1000)	120 mg
		on maltodextrin*** + silicon
		dioxide(E551):
		Excipients and adjuvants
	5)	Saccharin:	50 mg
	6)	Aspartame:	12 mg
	7)	Mannitol:	20 mg
	8)	Saccharose****:	300 mg
	*to **** see Example 1

Example 3

Gum Tablet

	Active ingredients
	1)	Diclofenac potassium salt*:	50 mg
	2)	Potassium bicarbonate:	35 mg
	3)	Mint flavoring on maltodextrin**:	30 mg
	4)	Aniseed flavoring on maltodextrin***:	80 mg
		Excipients and adjuvants
	5)	Mannitol:	30 mg
	6)	Menthol:	0.01 mg
	7)	Gum base:	600 mg
	8)	Sorbitol:	700 mg
	9)	Saccharin:	3 mg
	10)	Hydroxypropylmethylcellulose:	33 mg
	11)	Coloring agent:	7 mg
	*to *** see Example 1

Example 4

Comparative Test

The packaged composition containing 50 mg of diclofenac potassium of Example 1 (formulation C) was subjected to a pharmacokinetic test for comparison with a similar composition not containing alkali metal carbonates and bicarbonates (formulation B), and with a second composition in tablet form (formulation A) produced by Ciba-Geigy (Voltaren Rapid®), also in this case not containing alkali metal carbonates and bicarbonates, both formulations A and B containing 50 mg of diclofenac potassium.

This comparative evaluation was carried out on the same 6 healthy volunteers in accordance with the experimental plan described hereinafter.

• • Experimental scheme: Single-dose study using three methods in randomized 15 cross-over with a wash-out of three days.
  • Sampling times: 0 h (before administration), 5 min, 10 min, 30 min, 45 min, 1 h, 1.5 h, 2 h, 3 h, 4 h, 6 h, 8 h, after each administration.
  • Blood sample treatment: 8MI in heparinised test tubes, centrifugation for 15 min at 1500 rev/min, subdivided into two fractions and subsequently frozen at −200 C.
  • Times: wash-out of two days between treatments.
  • Determination method: HPLC, with internal standard, sensitivity 10 ng/ml

Analysis Method

• • Column: Nova Pak C18, 3.9×150 mm, 4 um Waters S.p.A.—Vimodrone, Italy.
  • Eluant: NaH2PO4 0.01 M+0.1% TEA, pH 3.0 (H3PO4)/acetonitrile, 60/40.
  • Flow: 1.2 ml/min
  • Detection: UV/275 nm
  • Temperature: 30° C.
  • Injection: 50 al
  • Analysis time: 16 min.

Sample Preparation

10 al of the internal standard methanolic solution, and flufenamic acid (corresponding to 1320 ng) are added to 1 ml of defrosted plasma in 10 ml glass test tubes. The tubes are agitated in a Vortex mixer for 1 minute. 0.5 ml of a 0.5N HCl/1N NaCl solution is added. The whole is agitated in a Vortex mixer for 1 minute. 6 ml of a 95/5 n-hexane/isopropanol solution are added.

The mixture is then agitated in the Vortex mixer for a further 15 minutes. Centrifugation is carried out at 3000 rev/min for 15 minutes and the organic phase is transferred to fresh 10 ml glass test tubes and evaporated to dryness in a centrifugal evaporator under vacuum at ambient temperature. The whole is taken up in 200 al of a 70/30 acetonitrile/water solution, and the precipitate is dissolved under ultrasound for 2 minutes.

FIGS. 1, 2 and 3 show the concentrations of diclofenac in the blood of the six volunteers as regards formulations A, B (Ciba-Geigy comparative formulations) and C (formulation corresponding to the composition of Example 1), respectively.

As will be appreciated, the blood concentration of the formulation of the present invention has, compared with the comparative formulations, a more constant and uniform pattern. This characteristic is also found in FIGS. 4, 5 and 6 which show the average values corresponding to the blood levels of the six volunteers together with the corresponding standard deviation.

The result is clear and surprising: compared with the sample compositions, the compositions of the present invention permit constant, reproducible and foreseeable blood levels of the active ingredient, irrespective of the characteristics of the volunteer (weight, age, etc), with the consequent indisputable advantages from the therapeutic point of view.

Finally, FIG. 7 shows, by comparison, the graphs relating to the average values of the six volunteers (that is to say, the preceding FIGS. 4, 5 and 6); as will be noted, the formulation of the present invention permits, in addition to the advantages already mentioned, the attainment of a blood peak higher than that of the other formulations.

Example 5

Two Layered Tablet (Fast and Slow Release)

Fast release layer
1) Diclofenac potassium salt:    15 mg
2) Potassium bicarbonate:        30 mg
3) Lactose:                      13.2 mg
4) Maize starch (intragranular): 6 mg
5) Methyl cellulose:             0.12 mg
6) Sodium laurylsulfate:         0.06 mg
7) Maize starch (extragranular): 9 mg
8) Crospovidone:                 0.6 mg
9) Sodium carboxymethylstarch:   1.5 mg
10) Magnesium stearate:          2.7 mg
11) Colloidal silicon dioxide:   0.6 mg
Slow release layer
1) Diclofenac potassium salt:    70 mg
2) Potassium bicarbonate:        30.8 mg
3) Lactose:                      32.2 mg
4) Polyvinylpyrrolidone:         1.16 mg
5) Hydroxypropylmethylcellulose: 70 mg
6) Magnesium stearate:           0.84 mg
7) Colloidal silicon dioxide:    0.21 mg
8) Talc:                         3.92 mg
9) Polyethylene glycol:          0.56 mg

Example 6

Drops

1) Diclofenac potassium salt: 75 g
2) Methyl p-oxybenzoate:      2.7 g
3) Propyl p-oxybenzoate:      0.3 g
4) Aspartame:                 37.5 g
5) Potassium bicarbonate:     37.5 g
6) Glycerol:                  300 g
7) Ethyl alcohol:             450 g
8) Water q.s.:                1500 g
Possible modifications:
a) Addition of sodium metabisulfite (0.06%)
b) Addition of sodium metabisulfite (0.06%)
Mint flavoring (1.25%)
Strawberry flavoring (0.75%)

Example 7

Drops

1) Diclofenac potassium salt: 37.5 g
2) Methyl p-oxybenzoate:      2.7 g
3) Propyl p-oxybenzoate:      0.3 g
4) Aspartame:                 37.5 g
5) Potassium bicarbonate:     18.75 g
6) Saccharin:                 6.0 g
7) Glycerol:                  300 g
8) Ethyl alcohol:             450 g
9) Water q.s.:                1500 g
Possible modifications:
a) Addition of sodium metabisulfite (0.03%)
b) Addition of sodium metabisulfite (0.03%)
Mint flavoring (1.25%)
Strawberry flavoring (0.75%)

Example 8

Mouthwash

	1) Diclofenac potassium salt:	0.75	g
	2) Glycerol:	50	g
	3) Sorbitol:	12	g
	4) Saccharin:	0.5	g
	5) Aspartame:	1.0	g
	6) Methyl p-oxybenzoate:	0.5	g
	7) Propyl p-oxybenzoate:	0.1	g
	8) Mint flavoring:	1.0	g
	9) Ethyl alcohol:	100	g
	10) Potassium bicarbonate:	0.33	g
	11) Water q.s.:	500	ml

Example 9

Gum-Paste

1) Diclofenac potassium salt:	5.0	g
2) Glycerol:	630	g
3) Sodium benzoate:	5.0	g
4) Silica (Wessalon S ® - Degussa):	120	g
5) Silica (Siddent 9 ® - Degussa):	80	g
6) Cellulose gum:	3.0	g
7) Polyethyleneglycol 600:	30	g
8) Sodium lauroyl sarcosinate (or sodium lauryl sulfate):	60	g
9) Mint flavoring:	10	g
10) Sodium saccharin:	1.0	g
11) Aspartame:	3.0	g
12) Potassium bicarbonate:	2.2	g
13) Water q.s.:	1	kg

Example 10

Tooth-Paste

1) Diclofenac potassium salt:	5.0	g
2) Glycerol:	630	g
3) Sodium benzoate:	5.0	g
4) Silica (Wessalon S ® - Degussa):	20	g
5) Silica (Siddent 9 ® - Degussa):	80	g
6) Cellulose gum:	3.0	g
7) Polyethylenglycol 600:	30	g
8) Sodium lauroyl sarcosinate (or sodium lauryl sulfate):	60	g
9) Mint flavoring:	10	g
10) Sodium saccharin:	1.0	g
11) Aspartame:	3.0	g
12) NaF:	1.0	g
13) Na2FPO3	4.0	g
14) Potassium bicarbonate:	2.2	g
15) Water q.s.:	1	kg

Example 11

Tablet

	1) Diclofenac potassium salt:	50	mg
	2) Mannitol:	50	mg
	3) Potassium bicarbonate:	22	mg
	4) Maize starch (intragranular):	10	mg
	5) Methyl cellulose:	0.2	mg
	6) Sodium laurylsulfate:	0.1	mg
	7) Maize starch (extragranular):	15	mg
	8) Crospovidone:	1.0	mg
	9) Sodium carboxymethylstarch:	2.5	mg
	10) Magnesium stearate:	4.5	mg
	11) Colloidal silicon dioxide:	10	mg

Example 12

Comparative Test

In the present experiment a sachet formulation containing 50 mg of diclofenac potassium was compared to a bioequivalent sugar coated fast release tablet also containing 50 mg of diclofenac potassium, produced and marketed in Italy by Novartis as Cataflam®.

The sachet formulation according to the present invention had the following composition:

	1) diclofenac potassium salt:	50	mg
	2) Potassium bicarbonate:	22	mg
	3) Mint flavor:	50	mg
	4) Anice flavor:	100	mg
	5) Saccharin sodium:	4	mg
	6) Aspartame:	10	mg
	7) Mannitol:	50	mg
	8) Sucrose sugar crystals:	1714	g

The above test formulation and the Cataflam® formulation were administered as a single dose to 24 healthy volunteers of both sexes. The pharmacokinetic parameters obtained with the two different formulations are reported in table 1 and in FIG. 5. As it will be easily appreciated, the rate of absorption was considerably faster with the sachet formulation of the present invention than with Cataflam®, the sachet formulation having a higher average C_max (2213 vs 1071 ng/ml) and a shorter average T_max (0.228 vs 0.885 hours); furthermore, the T_max of the sachet formulation shows a coefficient of variation lower than the reference formulation (16% vs 97%), this being an extremely important result from the clinical point of view regarding the healing of the pain in terms of quick time and repeatability inter-subjects in order to reach the C_max.

Example 13

Comparative Test

Following to the excellent results obtained in example 12, two tablet formulations containing 12.5 or 25 mg. of diclofenac sodium salt and potassium bicarbonate (in the same weight ratio) have been prepared.

The tablet formulations had the following composition (in mg):

	Cores
	Diclofenac sodium	12.5	25
	Mannitol	25	50
	Lactose monohydrate	23.75	47.5
	Potassium bicarbonate	5.5	11
	Maize starch	22.5	45
	Methylcellulose	0.075	0.15
	Sodium laurylsulphate	0.125	0.25
	Crospovidone	3	6
	Ultramyl	5	10
	Colloidal silica	0.55	1.1
	Cellulose microcrystalline	0.5	1
	Magnesium stearate	1.5	3
	Purified water q.s.	100	200
	Coating
	Opadry OY-3 5009 red	2	4
	Macrogol 400	0.25	0.5

A four-way comparative bioavailability study was carried out on 18 healthy volinteers of both sexes in order to evaluate the in vivo results of the pharmacokinetic profiles of the present formulations if compared to those of bioequivalent fast release formulations such as Cataflam® (25 mg of diclofenac potassium) and Voltarol® (50 mg of diclofenac sodium), both by Novartis. The results, which are summarized in FIG. 6, indicate that T_max is prompter with the present formulations (T1=26 min, T2=24.6 min vs R1=71.4 min and R2=40.8 min) and that C_max is higher (T1=847 ng/ml and T2=861 ng/ml vs R1=452 ng/ml and R2=703 ng/ml); furthermore, the T_max of both present formulations shows a coefficient of variation lower than reference formulations (T1=46% and T2=49% vs R1=87% and R2=96%).

Example 14

Comparative Test

A further comparative test was carried out on immediate release formulations according to the present invention, containing 50 mg of diclofenac potassium and 22 mg of potassium bicarbonate, manufactured with different that is, respectively: T1=wet granulation using alcohol, T2=dry granulation by direct compression. The composition in mg of the two formulations is herebelow reported:

	Diclofenac potassium	50	50
	Potassium bicarbonate	22	22
	Mannitol/pearlitol 400 DC	119.9
	Mannitol EP cf		50
	Maize starch		25
	Methocel A4C		0.2
	Sodium laurylsulphate	0.1	0.1
	Polyplasdone XL	6	1
	Ultramyl		2.5
	Magnesium stearate	2	4.5
	Silicium aerosil		1
	Core mass	200	156.3

A comparative bioavailabilty study was carried out on 6 healthy volunteers of both sexes in order to evaluate the in vivo results of the pharmacokinetic profiles of the present formulations if compared to those of a bioequivalent fast release formulation such as Voltaren Rapid® (50 mg of diclofenac potassium), both by Novartis. The results, which are reported in FIGS. 7-10 are also in this case excellent: the T_max is in fact prompter with the present formulations (T1=18.6 min, T2=16.8 min vs R1 40.8 min) and the C_max is higher (T1=1878.3 ng/ml and T2=1744.8 ng/ml vs R1 1307 ng/ml); furthermore, also in this case the T_max of both present formulations shows a coefficient of variation lower than reference formulation (T1=12.9% and T2=25% vs R1=95.6%).

Example 15

50 mg. Diclofenac K Tablet Comparison

• Test Formulations:
  • T1: Diclofenac potassium 50 mg film-coated tablets, alcohol granulation
  • T2: Diclofenac potassium 50 mg film-coated tablets, dry granulation
• Reference Formulation: Diclofenac potassium, 50 mg film-coated tablets, Voltarene® Rapid by Novartis Pharma
• Study design: Single dose, 3-way, crossover randomised on 6 healthy volunteers
• Blood samples drawn: 0 (pre-dose), 5, 10, 15, 20, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 8, 10, 12 h

Assay: LC-MS-MS //LOQ 5 ng/ml

			Reference, K salt, 50 mg,
	T1, K salt, 50 mg, tablets	T2, K salt, 50 mg, tablets	Voltaren ® Rapid tablets
Description	Diclofenac potassium	Diclofenac potassium	Diclofenac potassium
	50 mg film-coated tablets	50 mg film-coated tablets	50 mg film-coated tablets
	(by alcoholic granulation)	(by direct compression)
Active	Diclofenac potassium mg 50	Diclofenac potassium mg 50	Diclofenac potassium mg 50
ingredient
Excipients	Potassium bicarbonate mg 22	Potassium bicarbonate mg 22	Calcium phosphate
	Mannitol mg 50	Mannitol 400 mg 119.9	Saccharose
	Maize starch mg 25	Sodium laurylsulfate mg 0.1	Maize starch
	Hydroxypropylmethylcellulose mg 0.2	Polyvinylpyrrolidone mg 6	Talc
	Sodium laurylsulfate mg 0.1	Magnesium stearate mg 2	Sodium carboxymethylcellulose
	Polyvinylpyrrolidone mg 1	Film Coating Opadry Clear	Colloidal anhydrous silicium
	Sodium starch glycollate mg 2.5	(HPMC 2910,	Polyvinylpyrrolidone
	Magnesium stearate mg 4.5	polyethyleneglycol 400) mg 4	Microcrystalline cellulose
	Silicium aerosil FK 160 mg 1		Magnesium stearate
	Coating Opadry Clear (HPMC 2910		Polyethylenglycole
	and polyethyleneglycol 400) mg 4		Titanidioxide (E171)
			Iron oxide red (E172)
Total weight	160.3 mg	204 mg
	PK results
			Test 1 (K, tablets 50 mg)	Test 2 (K, tablets 50 mg)	Reference (K, tablets 50 mg)
	Cmax	Mean	1873.30	1744.8	1307.0
		SD	553.80	572.3	558.4
		CV %	29.5	32.8	42.7
		Min	1228.9	1057.4	581.8
		Max	2516.5	2468.9	1935.5
	AUC	Mean	1219	1237	1168
		SD	246	276	282
		CV %	20.2	22.3	24.1
		Min	874	848	913
		Max	1615	1668	1642
	tmax	Mean	0.31 h (18.6 min)	0.28 h (16.8 min)	0.68 h (40.8 min)
		SD	0.04	0.07	0.65
		CV %	12.9	25.0	95.6
		Min	0.25 h (15 min)	0.17 h (10.2 min)	0.25 h (15 min)
		Max	0.33 h (19.8 min)	0.33 h (19.8 min)	2.00 h (120 min)

Example 16

50 and 25 mg. Diclofenac K Tablet Comparison

• Test Formulations:
  • T1: Diclofenac potassium 25 mg film-coated tablets
  • T2: Diclofenac potassium 50 mg film-coated tablets
• Reference Formulation: Diclofenac potassium, 50 mg film-coated tablets, Voltarene® Rapid by Novartis Pharma
• Study design: Single dose, 3-way, crossover randomised on 24 healthy volunteers
• Blood samples drawn: 0 (pre-dose), 5, 10, 15, 20, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 8, 10, 12 h

Assay: LC-MS-MS //LOQ 5 ng/ml

			Reference, K salt, 50 mg,
	T1, K salt, 25 mg, tablets	T2, K salt, 50 mg, tablets	Voltaren ® Rapid tablets
Description	Diclofenac potassium 25 mg film-	Diclofenac potassium 50 mg	Diclofenac potassium 50 mg film-
	coated tablets	film-coated tablets	coated tablets
Active	Diclofenac potassium mg 25	Diclofenac potassium mg 50	Diclofenac potassium mg 50
ingredient
Excipients	Potassium bicarbonate mg 11	Potassium bicarbonate mg 22	Calcium phosphate
	Mannitol 400, mg 58.2	Mannitol 400, mg 116.4	Saccharose
	Sodium laurylsulfate mg 0.05	Sodium laurylsulfate mg 0.1	Maize starch
	Polyvinylpyrrolidone mg 3	Polyvinylpyrrolidone mg 6	Talc
	Polyethylenglycole mg 0.75	Polyethylenglycole mg 1.5	Sodium carboxymethylcellulose
	Magnesium stearate mg 2	Magnesium stearate mg 4	Colloidal anhydrous silicium
	Film Coating Opadry Clear (HPMC	Film Coating Opadry Clear	Polyvinylpyrrolidone
	2910, polyethyleneglycol 400) mg 2	(HPMC 2910,	Microcrystalline cellulose
		polyethyleneglycol 400) mg 4	Magnesium stearate
			Polyethylenglycole
			Titanidioxide (E171)
			Iron oxide red (E172)
Total weight	102 mg	204 mg
	PK results
				T2 (K, film-coated tablets
			T1 (K, tablets 25 mg)	50 mg)	Reference (K, tablets 50 mg)
	Cmax	Mean	940.2 (1880.4)*	1766.7	1339.6
		SD	387.0	1020.2	627.5
		CV %	41.2	57.7	46.8
		Min	228.5	317.3	336.5
		Max	1595.4	4516.9	2655.4
	AUC	Mean	611.81 (1223.63)*	1267.67	1286.43
		SD	144.76	356.46	351.22
		CV %	23.7	28.1	27.3
		Min	380.13	681.89	852.09
		Max	919.81	2123.22	2185.01
	tmax	Mean	0.354 h (21.2 min)	0.489 h (29.8 min)	0.847 h (50.8 min)
		SD	0.119	0.366	0.887
		CV %	33.6	78.8	104.7
		Min	0.250 h (15 min)	0.167 h (10 min)	0.333 h (20 min)
		Max	0.750 h (45 min)	1.5 h (90 min)	4 h (240 min)
	*values normalized to the dose of 50 mg

Example 17

25 mg. Diclofenac Na Tablet and Sachet Comparison

• Test Formulations:
  • T1: Diclofenac sodium 25 mg sachets
  • T2: Diclofenac sodium 25 mg film-coated tablets
• Reference Formulation: Diclofenac sodium, 25 mg film-coated tablets, Novapirina® by Novartis Consumer Health
• Study design: Single dose, 3-way, crossover randomised on 24 healthy volunteers
• Blood samples drawn: 0 (pre-dose), 10, 20, 30, 45, 60, 75, 90, 105 min, 2, 2.5, 3, 4, 6, 8, 10 h

Assay: LC-MS-MS //LOQ 0.5 ng/ml

			Reference, Na salt,
	Na salt, 25 mg, sachets	Na salt, 25 mg, tablets	Novapirina ® tablets
Description	NA	Diclofenac sodium 25 mg	Diclofenac sodium 25 mg film-
		film-coated tablets	coated tablets
Active	NA	Diclofenac sodium 25 mg
ingredient
Excipients	NA	Potassium bicarbonate mg 11	Colloidal silicium
		Mannitol SD200, mg 58.25	Cellulose
		Sodium laurylsulfate mg 0.25	Lactose
		Polyvinylpyrrolidone mg 3	Magnesium stearate
		Magnesium stearate mg 1	Polyvidone
		Glyceryl Dibehenate mg 1.5	Sodium
		Film Coating Opadry Clear	carboxymethylcellulose
		(HPMC 2910,	Hydroxypropylmethylcellulose
		polyethyleneglycol 400) mg 2	Polysorbate
			Talc
			Titanidioxide (E171)
Total weight	NA	102 mg
	PK results
		Test 1 (Na, sachets 25 mg)	Test 2 (Na, tablets 25 mg)	Reference (Na, tablets 25 mg)
Cmax	Mean	NA	863	554
	SD	NA	373	255
	CV %	NA	43.2	87
	Min	NA	382	222
	Max	NA	1620	1360
AUC	Mean	NA	632	581
	SD	NA	175	151
	CV %	NA	27.7	26
	Min	NA	375	355
	Max	NA	974	860
tmax	Mean	NA	0.32 h (19.2 min)	0.67 h (40.2 min)
	SD	NA	0.07	0.62
	CV %	NA	21.9	92.5
	Min	NA	0.17 h (10.2 min)	0.17 h (10.2 min)
	Max	NA	0.50 h (30 min)	2.50 h (150 min)

Example 18

50 mg. Diclofenac K Tablet Comparison

• Test Formulation: Diclofenac potassium 50 mg film-coated tablets
• Reference Formulation: Diclofenac potassium, 50 mg film-coated tablets, Voltfast® by Novartis Pharma
• Study design: Single dose, 2-way, crossover randomised on 26 healthy volunteers
• Blood samples drawn: 0 (pre-dose), 10, 20, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 8, 10, 12 h

Assay: LC-MS-MS //ILOQ 3.3 ng/ml

		Reference, K salt, 50 mg,
	K salt, 50 mg, tablets	Voltfast ® tablets
Description	Diclofenac potassium	Diclofenac potassium 50 mg
	50 mg film-coated tablets	film-coated tablets
Active	Diclofenac potassium	Diclofenac potassium mg 50
ingredient	mg 50
Excipients	Potassium bicarbonate	Calcium phosphate
	mg 22	Saccharose
	Mannitol 400, mg 116.4	Maize starch
	Sodium laurylsulfate	Talc
	mg 0.1	Sodium carboxymethylcellulose
	Polyvinylpyrrolidone	Colloidal anhydrous silicium
	mg 6	Polyvinylpyrrolidone
	Polyethylenglycole	Microcrystalline cellulose
	mg 1.5	Magnesium stearate
	Magnesium stearate mg 4	Polyethylenglycole
	Film Coating Opadry	Titanidioxide (E171)
	Clear (HPMC 2910,	Iron oxide red (E172)
	polyethyleneglycol 400)
	mg 4
Total weight	204 mg
	PK result
		Test (K, tablets 50 mg)	Reference (K, tablets 50 mg)
Cmax	Mean	1768.6	1386.5
	SD	771.6	693.3
	CV %	43.6	50.0
	Min	514.3	300.2
	Max	3726.4	2744
AUC	Mean	1248	1220.2
	SD	326	352.7
	CV %	26.1	28.9
	Min	661.8	609
	Max	1918.4	1971.3
tmax	Mean	0.455 h (27.3 min)	0.904 h (54.24 min)
	SD	0.275	0.838
	CV %	60.0	92.7
	Min	0.166 h (10 min)	0.333 h (20 min)
	Max	1.5 h (90 min)	4.00 h (240 min)

Example 19

12.5 mg. Diclofenac K Tablet Comparison

• Test Formulations: Diclofenac potassium 12.5 mg film-coated tablets
• Reference Formulation: Diclofenac potassium, 12.5 mg immediate release film-coated tablets, Voltaren Dolo® by Novartis Consumer Health
• Study design: Single dose, 2-way, crossover randomised on 24 healthy volunteers
• Blood samples drawn: 0 (pre-dose), 5, 10, 15, 20, 30, 45, 60, 75, 90 min, 2, 3, 4, 5, 6, 8, 12 h

Assay: LC-MS-MS //LOQ 0.2 ng/ml

		Reference, K salt, 12.5 mg,
	K salt, 12.5 mg, tablets	Voltaren Dolo ®
Description	Diclofenac potassium	Diclofenac potassium 12.5 mg
	12.5 mg film-coated	film-coated tablets
	tablets
Active	Diclofenac potassium	Diclofenac potassium mg 12.5
ingredient	mg 12.5
Excipients	Potassium hydrogen	Colloidal anhydrous silica
	carbonate mg 5.50	Lactose
	Mannitol mg 76.25	Maize starch
	Sodium laurylsulfate	Sodium starch glycollate
	mg 0.25	Polyvidone
	Glycerol dibehenate	Magnesium stearate
	mg 1.50	Microcrystalline cellulose
	Crospovidone mg 3.00	Hydroxypropylmethylcellulose
	Magnesium stearate	Titanidioxide (E171)
	mg 1.00	Macrogol
	Film Coating Opadry	Polysorbate 80
	Clear (HPMC 2910 and	Maltodextrin
	polyethyleneglycol 400)
	mg 2.00
Total weight	102.00 mg
	PK results
		Test
		(K, tablets 12.5. mg)	Reference (K, tablets 12.5 mg)
Cmax	Mean	494.09	435.80
	SD	223.36	228.92
	CV %	45.21	52.53
	Min	130.50	162.50
	Max	909.10	959.00
AUC	Mean	331.19	330.14
	SD	71.42	84.70
	CV %	21.56	25.66
	Min	172.54	171.38
	Max	435.39	445.72
tmax	Mean	0.35 h (21 min)	0.48 h (28.8 min)
	SD	0.20	0.35
	CV %	57.14	72.92
	Min	0.17 h (10.2 min)	0.17 h (10.2 min)
	Max	1.0 h (60 min)	1.50 h (90 min)

Example 20

12.5, 25 and 50 mg. Diclofenac K and Diclofenac K Tablet Comparison

• Test Formulations:
  • T1: Diclofenac sodium 12.5 mg tablets
  • T2: Diclofenac sodium 25 mg film-coated tablets
• Reference Formulations:
• R1: Diclofenac potassium, 25 mg film-coated tablets, Cataflam® by CIBA GEIGY
• R2: Diclofenac 50 mg dispersible tablets, Voltarol® by CIBA GEIGY
• Study design: Single dose, 4-way, crossover randomised on 24 healthy volunteers
• Blood samples drawn: 0 (pre-dose), 5, 10, 15, 20, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 8, 10 h

Assay: HPLC-UV //LOQ 10 ng/ml

				Reference, acid as such,
			Reference, K salt, 50 mg,	50 mg, Voltarol ®
	Na salt, 2 × 12.5 mg, tablets	Na salt, 25 mg, tablets	Cataflam ® tablets	dispersible tablets
Description	Diclofenac sodium 12.5 mg	Diclofenac sodium 25 mg	Diclofenac potassium 50 mg	Diclofenac free acid 46.5 mg
	film-coated tablets	film-coated tablets	film-coated tablets	dispersible tablets
Active	Diclofenac sodium 12.5 mg	Diclofenac sodium 25 mg	Diclofenac potassium 50 mg	Diclofenac acid 46.5 mg
ingredient				(equivalent to 50 mg as
				sodium salt)
Excipients	Potassium bicarbonate mg 5.5	Potassium bicarbonate	Calcium phosphate	Microcrystalline cellulose
	Mannitol mg 25	mg 11	Saccharose	Croscarmellose sodium
	Lactose mg 23.75	Mannitol mg 50	Maize starch	Sodium starch glycollate
	Maize starch mg 22.5	Lactose mg 47.5	Talc	Sodium saccharin
	Cellulose methylether mg	Maize starch mg 45	Sodium	Cellulose
	0.075	Cellulose methylether	carboxymethylcellulose	Hydrogenated castor oil
	Sodium laurylsulfate mg	mg 0.15	Colloidal anhydrous	Talc
	0.125	Sodium laurylsulfate mg	silicium	Silicion dioxide
	Polyvinylpyrrolidone mg 3	0.25	Polyvinylpyrrolidone	Erythrosine
	Sodium starch glycollate mg 5	Polyvinylpyrrolidone mg 6	Microcrystalline cellulose	Aluminium oxide
	Magnesium stearate mg 1.5	Sodium starch glycollate	Magnesium stearate	Blackcurrant flavour
	Colloidal hydrated silicium	mg 10	Polyethylenglycole
	mg 0.55	Magnesium stearate mg 3	Titanidioxide (E171)
	Microcrystalline cellulose mg	Colloidal hydrated	Iron oxide red (E172)
	0.5	silicium mg 1.1
	Film Coating Opadry Red	Microcrystalline
	(HPMC 2910,	cellulose mg 1
	polyethyleneglycol 400) mg	Film Coating Opadry
	2.25	Red (HPMC 2910,
		polyethyleneglycol 400)
		mg 4.5
Total weight	102.25	204.5 mg
	PK results
						Reference 2
				Test 2 (Na, tablets	Reference 1 (K,	(dispersible tablets
			Test 1 (Na, tablets 2 × 12.5 mg)	25 mg)	tablets 25 mg)	50 mg)*
	Cmax	Mean	847.0	861.3	453.4	351.4
		SD	440.7	395.1	265.49	179.4
		CV %	0.52	0.46	0.59	0.51
		Min	314.4	221.2	1799.9	108.9
		Max	1700.9	1569.3	992.3	635.2
	AUC	Mean	570.50	565.59	518.46	506.26
		SD	126.23	159.77	154.54	161.92
		CV %	22	26	30	32
		Min	346.13	304.44	322.04	322.71
		Max	859.60	911.34	836.58	858.59
	tmax	Mean	0.44 h (26.4 min)	0.41 h (24.6 min)	1.19 h (71.4 min)	0.68 h (40.8 min)
		SD	0.20	0.20	1.03	0.66
		CV %	46	49	87	96
		Min	0.17 h (10.2 min)	0.17 h (10.2 min)	0.25 h (15 min)	0.17 h (10.2 min)
		Max	1.0 h (60 min)	1.00 h (60 min)	4.00 h (360 min)	2.00 h (120 min)

TABLE 1
Pharmacokinetic parameters for two different diclofenac formulations: test (Diclofenac
potassium salt sachets) and reference (Diclofenac potassium salt sugar coated tablets)
	tmax	Cmax	t1/2	AUC0-1
	(h)	(ng/mL)	(h)	(ng · mL−1-h)
Vol. No.	Test	Ref.	Test	Ref.	Test	Ref.	Test	Ref.
Vol. 1	0.250	0.500	1573.000	1186.211	1.505	0.939	1024.511	885.549
Vol. 2	0.250	4.000	2382.368	965.100	0.875	1.358	1653.124	2092.036
Vol. 3	0.184	1.000	2614.655	1352.400	0.796	1.610	1687.529	1763.484
Vol. 4	0.250	3.000	2404.848	735.454	0.996	1.132	1881.944	1834.958
Vol. 5	0.250	0.500	2971.457	1405.000	1.667	1.903	1819.756	1687.075
Vol. 6	0.250	0.750	2158.700	1351.500	0.843	0.650	1197.716	1091.996
Vol. 7	0.250	0.750	1739.200	1741.717	0.596	0.658	1448.713	1301.887
Vol. 8	0.250	0.500	1715.350	543.300	0.818	1.111	991.864	1126.414
Vol. 9	0.250	0.750	444.112	747.800	0.787	1.188	669.084	886.300
Vol. 10	0.267	0.750	2350.100	1110.400	.0960	1.070	1327.808	1020.286
Vol. 11	0.167	0.500	1867.200	1465.502	1.141	0.762	1337.821	892.870
Vol. 12	0.167	0.500	4273.026	1432.200	1.052	0.697	1703.655	1139.003
Vol. 13	0.250	0.500	2097.089	1155.371	1.313	1.198	1486.526	1233.531
Vol. 14	0.167	0.250	2242.684	967.795	0.997	0.837	987.522	927.726
Vol. 15	0.184	0.500	2040.247	1129.957	0.724	0.804	1213.725	1040.424
Vol. 16	0.250	0.750	2143.692	818.200	0.560	1.199	1186.603	1250.221
Vol. 17	0.250	1.500	1527.845	480.900	2.752	1.309	958.821	987.797
Vol. 18	0.250	1.000	1859.608	666.500	1.630	1.383	1131.413	933.008
Vol. 19	0.250	0.750	1537.508	770.100	1.726	1.137	980.348	906.275
Vol. 20	0.250	0.250	1956.004	655.100	0.853	0.883	1309.289	1036.836
Vol. 21	0.250	0.500	3551.360	2421.060	1.322	1.233	2147.217	1639.619
Vol. 22	0.167	0.500	2464.978	1274.648	0.611	0.624	1038.817	816.924
Vol. 23	0.167	0.750	2304.351	453.500	2.066	0.862	1161.414	1049.327
Vol. 24	0.250	0.500	2901.504	894.337	0.970	1.279	1645.384	1086.512
Mean	0.228	0.885	2213.370	1071.461	1.148	1.076	1332.942	1192.544
SD	0.038	0.860	743.099	450.780	0.523	0.320	358.048	350.116
CV %	16.300	97.091	33.573	42.072	45.557	29.700	26.862	29.359
Min.	0.167	0.250	444.112	453.500	0.560	0.624	669.084	816.924
Max.	0.267	4.000	4273.026	2421.060	2.752	1.903	2147.217	2092.036
Geom.Mean	0.225	0.692	2070.719	987.480	1.056	1.032	1287.195	1150.713
Median	0.250	0.625	2151.196	1039.098	0.983	1.122	1261.507	1067.920
				AUC
	AUC0-0		Cmax/AUCU-o	extrapolated
	(ng · mL−1-h)	C1	(h1)	(%)
	Vol. No.	Test	Ref.	Test	Ref.	Test	Ref.	Test	Ref.
	Vol. 1	1050.137	910.868	11.800	18.700	1.498	1.302	2.37	0.00
	Vol. 2	1693.172	2092.036	31.700	13.500	1.407	0.461	1.82	1.38
	Vol. 3	1718.755	1788.111	27.200	10.600	1.521	0.756	0.83	1.15
	Vol. 4	1897.754	1856.346	11.000	13.100	1.267	0.396	1.39	1.88
	Vol. 5	1845.486	1719.478	10.700	11.800	1.610	0.817	1.56	1.90
	Vol. 6	1216.693	1113.146	15.600	22.500	1.774	1.214	2.50	1.79
	Vol. 7	1485.867	1325.661	43.200	25.500	1.170	1.314	1.46	1.78
	Vol. 8	1006.522	1146.775	12.400	12.700	1.704	0.466	3.08	2.75
	Vol. 9	690.354	911.329	18.700	14.600	0.643	0.821	1.74	1.80
	Vol. 10	1351.357	1038.971	17.000	12.100	1.739	1.069	3.01	3.01
	Vol. 11	1379.311	920.579	25.200	25.200	1.354	1.592	1.62	2.03
	Vol. 12	1731.709	1162.638	18.500	23.500	2.468	1.232	1.26	1.56
	Vol. 13	1505.454	1253.088	10.000	11.300	1.393	0.922	2.58	2.26
	Vol. 14	1013.665	949.163	18.200	17.700	2.212	1.020	1.91	2.86
	Vol. 15	1237.399	1071.029	22.700	126.400	1.649	1.055	1.33	1.58
	Vol. 16	1202.653	1270.280	19.900	11.600	1.782	0.644	4.16	2.80
	Vol. 17	100.433	1006.986	10.500	14.900	1.527	0.478	5.51	2.26
	Vol. 18	1197.411	954.597	28.100	10.800	1.553	0.698	2.57	2.11
	Vol. 19	1006.229	925.835	10.400	11.900	1.528	0.832	2.03	2.02
	Vol. 20	1336.472	1058.242	22.400	16.800	1.464	0.619	1.19	1.07
	Vol. 21	2173.030	1657.372	13.500	10.000	1.634	1.461	1.75	1.68
	Vol. 22	1057.293	830.908	21.000	15.500	2.331	1.534	3.13	1.80
	Vol. 23	1198.950	1068.588	12.600	15.500	1.922	0.424	2.19	1.94
	Vol. 24	1682.290	1108.024	26.400	11.700	1.725	0.807	2.10	1.78
	Mean	1361.600	1214.169	19.113	15.725	1.620	0.914	2.213	1.883
	SD	358.359	348.108	8.244	5.160	0.377	0.365	1.035	0.641
	CV %	26.319	28.671	43.134	32.812	23.277	39.991	46.795	34.056
	Min.	690.354	830.908	10.000	10.000	0.643	0.396	0.833	0.000
	Max.	2173.030	2092.036	43.200	26.400	2.468	1.592	5.512	3.010
	Geom.Mean	1316.580	1173.325	17.609	15.011	1.573	0.841	2.023	//
	Median	1286.936	1089.527	18.350	14.050	1.582	0.827	1.974	1.843

Claims

1) A method of treating acute pain comprising administering an immediate release oral dosage form comprising diclofenac potassium together with one or more alkali metal bicarbonates and customary excipients and adjuvants, wherein said alkali metal bicarbonates are present in an amount of greater than about 20% by weight based on the weight of diclofenac.

2) The method of claim 1 wherein said one or more alkali metal carbonates or bicarbonates are present in an amount of from about 20 to about 80% by weight based on the weight of diclofenac.

3) The method of claim 1 wherein said dosage form is a tablet comprising about 50 mg. of diclofenac potassium.

4) The method of claim 1 wherein said dosage form is a capsule comprising about 50 mg. of diclofenac potassium.

5) The method of claim 1 wherein said dosage form is a powder dosage form comprising about 50 mg. of diclofenac potassium dissolved or dispersed in water.

6) The method of claim 1 wherein said dosage form is a tablet comprising 25 mg. of diclofenac potassium.

7) The method of claim 1 wherein said dosage form is a capsule comprising 25 mg. of diclofenac potassium.

8) The method of claim 1 wherein said dosage form is a powder dosage form comprising 25 mg. of diclofenac potassium dissolved or dispersed in water.

9) The method of claim 1 wherein said dosage form is a tablet comprising 12.5 mg. of diclofenac potassium.

10) The method of claim 1 wherein said dosage form is a capsule comprising 12.5 mg. of diclofenac potassium.

11) The method of claim 1 wherein said dosage form is a powder dosage form comprising 12.5 mg. of diclofenac potassium dissolved or dispersed in water.

12) A method of treating acute pain comprising orally administering an immediate release oral dosage form comprising diclofenac in acid and/or salt form together with one or more alkali metal carbonates or bicarbonates and customary excipients and adjuvants, wherein said one or more alkali metal carbonates or bicarbonates are present in an amount of greater than about 20% by weight based on the weight of diclofenac.

13) The method of claim 12 wherein said one or more alkali metal carbonates or bicarbonates are present in an amount of from about 20 to about 80% by weight based on the weight of diclofenac.

14) The method of claim 12 wherein said dosage form is a tablet.

15) The method of claim 12 wherein said dosage form is a capsule.

16) The method of claim 12 wherein said dosage form is a powder dosage form dissolved or dispersed in water.

17) A method of treating acute pain comprising administering an immediate release pharmaceutical dosage form for oral use comprising diclofenac in acid and/or salt form and means for decreasing, average Tmax and increasing average Cmax of said diclofenac.

18) The method of claim 17 wherein said dosage form is a tablet comprising about 50 mg. of diclofenac potassium.

19) The method of claim 17 wherein said dosage form is a capsule comprising about 50 mg. of diclofenac potassium.

20) The method of claim 17 wherein said dosage form is a powder dosage form comprising about 50 mg. of diclofenac potassium dissolved or dispersed in water.

21) The method of claim 17 wherein said dosage form is a tablet comprising 25 mg. of diclofenac potassium.

22) The method of claim 17 wherein said dosage form is a capsule comprising 25 mg. of diclofenac potassium.

23) The method of claim 17 wherein said dosage form is a powder dosage form comprising 25 mg. of diclofenac potassium dissolved or dispersed in water.

24) The method of claim 17 wherein said dosage form is a tablet comprising 12.5 mg. of diclofenac potassium.

25) The method of claim 17 wherein said dosage form is a capsule comprising 12.5 mg. of diclofenac potassium.

26) The method of claim 17 wherein said dosage form is a powder dosage form comprising 12.5 mg. of diclofenac potassium dissolved or dispersed in water.

27) The method of claim 17 wherein said dosage form is a tablet comprising about 50 mg. of diclofenac sodium.

28) The method of claim 17 wherein said dosage form is a capsule comprising about 50 mg. of diclofenac sodium.

29) The method of claim 17 wherein said dosage form is a powder dosage form comprising about 50 mg. of diclofenac sodium dissolved or dispersed in water.

30) The method of claim 17 wherein said dosage form is a tablet comprising 25 mg. of diclofenac sodium.

31) The method of claim 17 wherein said dosage form is a capsule comprising 25 mg. of diclofenac sodium.

32) The method of claim 17 wherein said dosage form is a powder dosage form comprising 25 mg. of diclofenac sodium dissolved or dispersed in water.

33) The method of claim 17 wherein said dosage form is a tablet comprising 12.5 mg. of diclofenac sodium.

34) The method of claim 17 wherein said dosage form is a capsule comprising 12.5 mg. of diclofenac sodium.

35) The method of claim 17 wherein said dosage form is a powder dosage form comprising 12.5 mg. of diclofenac sodium dissolved or dispersed in water.

36) The method of claim 17 wherein said dosage form is a tablet comprising about 50 mg. of diclofenac potassium, and said tablet exhibits an average Cmax of from about 1750 to about 2000 and an average Tmax of from about 12 to about 25 minutes.

37) The method of claim 17 wherein said dosage form is a powder sachet comprising about 50 mg. of diclofenac potassium, and said sachet exhibits an average Cmax of from about 1500 to about 2000 and an average Tmax of from about 8 to about 20 minutes.

38) The method of claim 17 wherein said dosage form is a powder sachet comprising about 50 mg. of diclofenac potassium, and said sachet exhibits an average Cmax of from about 1900 to about 2500 and an average Tmax of from about 8 to about 20 minutes.