The present invention relates to novel galenic compositions, in particular novel galenic compositions in which the active ingredient is a poorly water soluble drug e.g. a macrolide, or in particular a cyclic poly-N-methylated undecapeptide, or a cyclosporin. Cyclosporins also include peptolide variants. See e.g. GB patent publications nos. 2 222 770 and 2 257 359 A and equivalents world-wide.
As discussed in the said GB patent publications, the cyclosporins present highly specific difficulties in relation to administration generally and galenic composition in particular, including in particular problems of stability, drug bioavailability, and variability in inter- and intra-patient dose response.
In order to meet these and related difficulties, in GB patent publication no. 2 222 770 and 2 257 359 A, galenic compositions are disclosed comprising a cyclosporin as active ingredient and which take the form of, inter alia, an emulsion, e.g. microemulsion, or emulsion, e.g. microemulsion, pre-concentrate. Such compositions typically comprise 1) a hydrophilic component, 2) a lipophilic component, and 3) a surfactant.
In accordance with the present invention it has now surprisingly been found that particularly suitable galenic compositions with poorly water soluble drugs having particularly interesting bioavailability characteristics and reduced variability in inter- and intra-subject bioavailability parameters, are obtainable using a component which solubilizes the poorly water soluble drug, e.g. a lipophilic component, and a surfactant which is semisolid or solid at room temperature wherein the weight ratio of surfactant to solubilizing component is from about 0.3-4, e.g. 1-4, to 1. On dilution with an aqueous medium the composition forms an emulsion or microemulsion and/or particulate system.
The present invention provides in one aspect a pharmaceutical composition in solid form comprising
1) a poorly water soluble drug,
2) a solubilzing component, e.g. a lipophilic component
3) a surfactant which is semisolid or solid,
wherein the ratio of surfactant to solubilizing component, e.g. lipophilic component, is from about 0.3-4, e.g. 1-4, to 1, and
which on dilution with an aqueous medium forms an emulsion or microemulsion and/or a particulate system.
Preferably the composition does not contain any organic hydrophilic component. Under “organic hydrophilic component” is to be understood any hydrophilic component or any hydrophilic co-component as described in the above mentioned British patent application 2 222 770, e.g. no added ethanol, propylene glycol or water, e.g. less than 0.5% by weight of the composition organic hydrophilic component.
Accordingly, in one aspect the present invention provides a composition as described above which is free, e.g. substantially free, from an organic hydrophilic component.
In one embodiment the present invention further provides a composition which is not an emulsion, e.g. microemulsion, preconcentrate.
The poorly water soluble drug preferably is a lipophilic drug, e.g. a cyclosporin or a macrolide. The term “poorly water soluble”, as used herein, is understood to mean a solubility in water at 20° C. of less than 1, e.g. 0.01, % weight/volume, e.g. a sparingly soluble to very slightly soluble drug as described in Remington: The Science and Practice of Pharmacy, 19th Edition, Ed. A. R. Gennaro, Mack Publishing Company, US, 1995, vol. 1, p 195.
Suitable drugs, e.g. pharmacologically active agents, include e.g. cyclosporins and macrolides.
Cyclosporins to which the present invention applies are any of those having pharmaceutical utility, e.g. as immunosuppressive agents, anti-parasitic agents and agents for the reversal of multi-drug resistance, as known and described in the art, in particular Cyclosporin A (also known as Ciclosporin), Cyclosporin G, [0-(2-hydroxyethyl)-(D)Ser]8-Ciclosporin, and [3′-deshydroxy-3′-keto-MeBmt]1-[Val]2-Ciclosporin. Cyclosporin A is preferred.
In one aspect the present invention provides a composition according to the present Invention wherein the cyclosporine is Cyclosporin A.
The term “macrolide” as used herein, refers to a macrocyclic lactone, for example a compound having a 12-membered or larger lactone ring. Of particular interest are the “lactam macrolides”, i.e., macrocyclic compounds having a lactam (amide) bond in the macrocycle in addition to a lactone (ester) bond, for example the lactam macrolides produced by microorganisms of the genus Streptomyces such as rapamycin, ascomycin, and FK-506, and their numerous derivatives and analogues. Such lactam macrolides have been shown to have interesting pharmaceutical properties, particularly immunosuppressive and anti-inflammatory properties.
Rapamycin is an immunosuppressive lactam macrolide that is produced by Streptomyces hygroscopicus. The structure of rapamycin is given in Kesseler, H., et al.; 1993; Helv. Chim. Acta; 76: 117. See, e.g., McAlpine, J. B., et al., J. Antibiotics (1991) 688; Schreiber, S I., et al., J. Am. Chem. Soc. (1991) 113: 7433; U.S. Pat. No. 3,929,992. Rapamycin is an extremely potent immunosuppressant and has also been shown to have antitumor and antifungal activity. Its utility as a pharmaceutical, however, is restricted by its very low and variable bioavailability as well as its high toxicity. Moreover, rapamycin is highly insoluble, making it difficult to formulate stable galenic compositions. Numerous derivatives of rapamycin are known. Certain 16-O-substituted rapamycins are disclosed in WO 94/02136, the contents of which are incorporated herein by reference. 40-O-substituted rapamycins are described in, e.g., in U.S. Pat. No. 5,258,389 and WO 94/09010 (O-aryl and O-alkyl rapamycins); WO 92/05179 (carboxylic acid esters), U.S. Pat. No. 5,118,677 (amide esters), U.S. Pat. No. 5,118,678 (carbamates), U.S. Pat. No. 6,100,883 (fluorinated esters), U.S. Pat. No. 5,151,413 (acetals), U.S. Pat. No. 5,120,842 (silyl ethers), WO 93/11130 (methylene rapamycin and derivatives), WO 94/02136 (methoxy derivatives), WO 94/02385 and WO 95/14023 (alkenyl derivatives) all of which are incorporated herein by reference. 32-O-dihydro or substituted rapamycins are described, e.g., in U.S. Pat. No. 5,256,790, incorporated herein by reference.
Rapamycin and its structurally similar analogues and derivatives are termed collectively as “rapamycins”.
Ascomycins, of which FK-506 and ascomycin are the best known, comprise another class of lactam macrolides, many of which have potent immunosuppressive and anti-inflammatory activity. FK506 is a lactam macrolide immunosuppressant that is produced by Streptomyces tsukubaensis No 9993. The structure of FK506 is given in the appendix to the Merck Index, 11th ed. (1989) as item A5. Ascomycin is described, e.g., . in U.S. Pat. No. 3,244,592. Many derivatives of ascomycin and FK-506 have been synthesized, including halogenated derivatives such as 33-epi-chloro-33-desoxy-ascomycin described in EP 427 680. Ascomycin, FK-506 and their structurally similar analogues and derivatives are termed collectively “ascomycins”.
The macrolide may, therefore, be rapamycin or an O-substituted derivative in which the hydroxyl group on the cyclohexyl ring of rapamycin is replaced by —OR1 in which R1 is hydroxyalkyl, hydroalkoxyalkyl, acylaminoalkyl and aminoalkyl; for example 40-O-(2-hydroxy)ethyl-rapamycin, 40-O-(3-hydroxy)propyl-rapamycin, 40-O-[2-(2-hydroxy)ethoxy]-ethyl-rapamycin and 40-O-(2-acetaminoethyl)-rapamycin.
A preferred compound is 40-O-(2-hydroxy)ethyl rapamycin as disclosed in WO 94/09010.
Examples of compounds of the FK 506 class are those mentioned above. They include for example FK 506, ascomycin and other naturally occurring compounds. They include also synthetic analogues.
A preferred compound of the FK 506 class is disclosed in EP 427 680, e.g. Example 66a also known as 33-epi-chloro-33-desoxy-ascomycin. Other preferred compounds are disclosed in EP 465 426, and in EP 569 337, e.g. the compound of Example 71 in EP 569 337.
In accordance with the present invention, it has surprisingly been found that a cyclosporine or macrolide has a high solubility, e.g. a solubility of from about 20 to about 50%, in the solubilizing component, e.g. lipophilic component, of the present invention. The solubilizing component can be one of a large variety of components. A person skilled in the art can choose the appropriate solubilizing component.
The solubilizing, e.g. lipophilic component, is for example:
For example the solubility of a cyclosporin or a macrolide in Sunfat®GDC-N is about 33%, in Lauroglycol®90 about 40%, in Sefsol®218 about 50%, in oleyl alcohol more than 20%. It is to be appreciated that the solubilizing capacity may depend on the poorly water soluble drug, e.g. pharmacologically active agent, used. In general, for active agents used in dosages of from 0.25 to 100 mg per day, e.g. 0.5 to 10 mg per day, e.g. for macrolides, a solubility of from about 5 to about 10% in the lipophilic component of the present invention may be desirable. For drugs used in dosages of from 10 to 1000 mg, e.g. 10 to 500 mg, e.g. 50 to 500 mg per day, e.g. for cyclosporin, a solubility of from about 20 to about 50% in the lipophilic component of the present invention may be desirable.
Accordingly, the present invention provides in one aspect a composition in solid form comprising
1) a cyclosporine or macrolide
2) a solubilizing component, e.g. lipophilic component, wherein component 1) has a solubility of from about 5 to about 50%
3) a surfactant which is semisolid or solid,
wherein the ratio of surfactant to solubilizing component, e.g. lipophilic component, is from about 0.3-4, e.g. 1-4, to 1 and
which on dilution with an aqueous medium forms an emulsion or microemulsion and/or particulate system.
The solubilizing component, e.g. lipophilic component, may be any one of components i) to xiii) individually or in combination with one, two or more of the other components i) to xiii).
Further details for these solubilizing components, e.g. lipophilic components, are given below.
Although any pharmaceutically acceptable components selected from the group specified above may be used in the composition of the invention, certain components are preferred. These include oleyl alcohol, Lauroglycol®90, Sefsol® 218, Capryol®90 or Sunfat® GDC-N.
Accordingly, the present invention provides in one aspect a composition according to the present invention, wherein the solubilizing component, e.g. lipophilic component, is selected from the group consisting of
In the pharmaceutical composition of the present invention, in a further alternative aspect the constitutional ratio of the solubilizing component, e.g. lipophilic component, : cyclosporin may be from about 15 to 1 : 1 and preferably from about 10 to 1.5:1, on the basis of weight.
The term “semisolid or solid”, as used herein, is understood to mean a surfactant having a melting point of e.g. above 30° C. to about 40° C. (semisolid) or above 40° C. (solid), respectively.
Examples of suitable surfactants for use in this invention are:
Similar or identical products which may also be used are available under the trade names Nikkol® (e.g. Nikkol® HCO-40 and HCO-60), Mapeg® (e.g. Mapeg® CO-40h), Incrocas® (e.g. Incrocas® 40), Tagat® (for example polyoxyethylene-glycerol-fatty acid esters e.g. Tagat® RH 40) and Simulsol OL-50 (PEG-40 castor oil, having a saponification value of about 55 to 65, an acid value of max. 2, an iodine value of 25 to 35, a water content of max. 8%, and an HLB of about 13, available from Seppic). These surfactants are further described in Fiedler loc. cit.
Similar products which may also be used are polyoxyethylene-polyoxypropylene-alkyl ethers, e.g. polyoxyethylene-polyoxypropylene-ethers of C12 to C18 alcohols, e.g. polyoxyethylen-20-polyoxypropylene-4-cetylether which is known and commercially available under the trade mark Nikkot PBC® 34, from e.g. Nikko Chemicals Co., Ltd. (Fiedler, loc. cit., vol. 2, pp. 1239). Polyoxypropylene fatty acid ethers, e.g. Acconon® E may also be used.
It is to be appreciated that surfactants may be complex mixtures containing side products or unreacted starting products involved in the preparation thereof, e.g. surfactants made by polyoxyethylation may contain another side product, e.g. polyethylene glycol.
A surfactant having a hydrophilic-lipophilic balance (HLB) value of 8 to 17 is preferred. The surfactant selected preferably has a hydrophilic-lipophilic balance (HLB) of at least 10, for example Cremophor. The HLB value is preferably the mean HLB value.
In one aspect the present invention provides a composition according to the present invention wherein the surfactant is a reaction product of natural or hydrogenated vegetable oil and ethylene oxide, or sodium lauryl sulfate, preferably sodium lauryl sulfate.
In the pharmaceutical composition of the present invention, in a further alternative aspect the constitutional ratio of the surfactant:drug, e.g. cyclosporin, may be from about 0.6-80, e.g. 1-80, : 1 and preferably from about 1.5 to 25:1, on the basis of weight.
Preferably the composition on dilution with an aqueous medium, for example water, for example on dilution of 1:1 to 1:300, e.g. 1:1 to 1:70, e.g. 1:10 to 1:70, e.g. 1:10, or in the gastric juices after oral application, spontaneously forms an o/w (oil-in-water) emulsion, e.g. microemulsion.
A microemulsion is thermodynamically stable and contains dispersed particles of a mean size less than about 200 nm. Generally microemulsions comprise droplets or particles having a mean diameter of less than about 150 nm; typically less than 100 nm, generally greater than 10 nm, and stable over periods in excess of 24 hours. A “microemulsion” may be a non-opaque or substantially non-opaque, alternatively it may be a translucent colloidal dispersion that is formed spontaneously or substantially spontaneously when its components are brought into contact. Further characteristics can be found in the above mentioned British patent application 2 222 770, the disclosure of which is incorporated herein by reference.
In one aspect the present invention provides a composition according to the present invention, the relative proportion of the poorly water soluble drug, e.g. cyclosporine or macrolide, the solubilizing component, and the surfactant in said composition being such that upon dilution with water, for example in a ratio of 1:1 to 1:300, e.g. 1:1 to 1:70, e.g. 1:10 to 1:70, e.g. 1:10, an oil-in-water microemulsion having particles of a mean size of less than 200 nm, is spontaneously formed.
Preferably, after dilution of the composition in an aqueous medium, the relative proportion of the solubilizing component and the surfactant lie within the “microemulsion” region on a standard three way plot. The compositions thus obtained are of high stability that are capable, on addition to an aqueous medium, of providing microemulsions having a mean particle size of <200 nm.
Standard three way plots, e.g. phase diagrams, can be generated in a conventional manner as described in e.g. GB patent publication no. 2 222 770 or WO 96/13273.
In a further aspect of the present invention, after dilution with an aqueous medium a particulate system, e.g. of solid particles of the drug, e.g. of a size of from 50 nm to 2000 nm, is formed, e.g. in addition to the emulsion or microemulsion as described above.
The drug may be present in an amount by weight of up to about 35% by weight of the composition. The drug is preferably present in an amount of 1 to 25% by weight of the composition, for example about 2 to 20%.
In one aspect the present invention provides a composition according to the present invention comprising the cyclosporine or macrolide in an amount of 1 to 35% by weight of the composition.
In a further alternative aspect the solubilizing, e.g. lipophilic component, may comprise 10 to 75%, e.g. 10 to 50%, by weight of the total weight of the composition, e.g. 15 to 45%; preferably 20 to 40% by weight of the composition.
In a further alternative aspect the surfactant may comprise 20 to 90% by weight of the total weight of the composition, preferably 30 to 80% by weight, more preferably 40 to 70% by weight of the composition.
In one aspect the present invention provides a composition according to the present invention comprising the solubilizing, e.g. lipophilic component, in an amount of 10 to 75%, e.g. 10 to 50%, and the surfactant in an amount of 20 to 90% by weight of the total weight of the composition.
Another substance which may be present is a carrier, e.g. a solid carrier. Suitable carriers for use according to the present invention, e.g. to obtain compositions in solid form, e.g. powder form, are, e.g. polymers, e.g. water soluble polymers, e.g. polyethylene glycol or polyvinylpyrrolidone, maltodextrin, e.g. Glucidex®, gummi arabicum, or gelatine; or water insoluble polymers, e.g. microcrystalline cellulose and derivatives thereof, or colloidal silica, e.g. Aerosil®; or lactose; or dibasic anhydrous calcium phosphate, e.g. Fujicalin®.
In one aspect the present invention provides a composition according to the present invention wherein a carrier, e.g. a polymer, e.g. maltodextrin, gummi arabicum, or gelatine, or lactose is additionally present.
In the pharmaceutical composition according to the present invention, in a further alternative aspect the ratio of drug and solubilizing component:carrier is preferably in the range of 1 :0.5-5, e.g. 1:1-5, more preferably 1:1-2 on the basis of weight.
In a further alternative aspect the present invention provides a composition according to the present invention wherein the solubilizing component and the drug are encapsulated in a polymeric matrix, e.g. according to a process comprising the following steps: (I) dissolving the drug in the solubilizing, e.g lipophilic, component; (ii) mixing the solution obtained by step (i) with a solution of a polymer in a suitable, e.g. organic, solvent; (iii) delivering the monophasic system containing the polymer, the solubilizing, e.g. lipophilic, component and the drug to a mixer together with e.g. a buffered gelatin solution to form e.g. an o/w emulsion; (iv) hardening the microparticles by solvent evaporation, washing for excipients removal and receiving the microparticles. In order to e.g. increase flowability of the final microparticle powder, the obtained microparticles may be further worked up by adding an aqueous solution of a carrier, e.g. lactose, and lyophilization of the resulting suspension to obtain a flowable powder.
Accordingly, in one aspect the present invention provides a composition of the invention wherein the drug dissolved in the solubilizing component is encapsulated in a polymeric matrix.
According to the present invention the polymeric matrix may comprise e.g. a water soluble polymer, e.g. polyethylene glycol or polyvinylpyrrolidone, or a water insoluble polymer, e.g. d,l-poly(lactide-co-glycolide), especially d,l-poly(lactide-co-glycolide)/glucose. In a further alternative aspect of the present invention, e.g. to control drug release kinetics, mixtures of polymers, e.g. of a water insoluble polymer, e.g. d,l-poly(lactide-co-glycolide), e.g. d,l-poly(lactide-co-glycolide)/glucose, and a water soluble polymer, e.g. polyethylene glycol, or polyvinylpyrrolidone, or a polymer of dimethylaminoethylmethacrylates and methacrylic acid esters, e.g. Eudragit® E, may be used.
The polymer used to encapsulate the drug together with the solubilizing component may be present in an amount of from 20 to 80%, e.g. 40 to 50%, by weight of the total weight of the microparticles comprising e.g. drug, solubilizing component and polymer.
In a further alternative aspect the invention also provides a process for the production of a pharmaceutical composition as defined above, e.g. in solid form, e.g. powder form, which process may comprise (i) dissolving the drug in the solubilizing component; (ii) encapsulating the solution obtained by step (i) in a polymeric matrix; (iii) spray drying or freeze drying the microparticles obtained by step (ii), optionally together with a suitable carrier, to obtain e.g. a powder; (iv) admixing the composition, e.g. powder, obtained by step (iii) with the surfactant.
in a further alternative aspect the present invention provides a composition of the invention which is in freeze-dried form.
Typically, when the compositions of the invention are formulated according to the process described above, the weight ratio of the sum of (i) drug, e.g. cyclosporin or macrolide, (ii) solubilizing component, and (iii) polymer: (iv) carrier may be from (i, ii, and iii) 1: (iv) 0.1-2.
The surfactant may be present in an amount of from 5 to 60%, e.g. 10 to 55%, e.g. 50%, by weight of the total weight of the composition comprising e.g. drug, solubilizing component, polymer, carrier and surfactant.
In yet a further alternative aspect the invention also provides a process for the production of a pharmaceutical composition as defined above, e.g. in solid form, e.g. powder form, which process may comprise (i) dissolving the surfactant in an aqueous solution, (ii) dissolving the drug in the solubilizing component, e.g. lipophilic component, (iii) mixing the aqueous solution of the surfactant with the drug solubilized in the lipophilic component, and (iv) spray-drying the mixture together with a suitable carrier in a conventional manner.
Accordingly, in one aspect the present invention provides a composition of the invention which is in spray-dried form.
Typically, when the compositions of the invention are formulated according to the process described above, the weight ratio of the sum of (i) drug, e.g. cyclosporin or macrolide, (ii) solubilizing component, and (iii) surfactant: (iv) carrier may be from (i, ii, and iii) 1-3: (iv) 0.25-4.
The compositions, e.g. those in the examples hereinafter, show good stability characteristics as indicated by standard stability trials, for example having a shelf life stability of up to one, two or three years, and even longer. The compositions of this invention may produce stable emulsions or microemulsions and/or particulate systems, e.g. for up to one day or longer, e.g. one day.
The pharmaceutical composition may also include further additives or ingredients, for example antioxidants, such as ascorbyl palmitate, butyl hydroxy anisole (BHA), butyl hydroxy toluene (BHT) and tocopherols, and/or preserving agents. In a further alternative aspect these additives or ingredients may comprise about 0.05 to 1% by weight of the total weight of the composition. The pharmaceutical composition may also include sweetening or flavoring agents in an amount of up to about 2.5 or 5% by weight based on the total weight of the composition. Preferably the antioxidant is α-tocopherol (vitamin E).
Details of excipients of the invention are described in e.g. Fiedler, H. P., loc.cit; “Handbook of Pharmaceutical Excipients”, loc cit; or may be obtained from the relevant manufacturers, the contents of which are hereby incorporated by reference.
Any carbon chain not otherwise specified herein conveniently contains 1 to 18 carbon atoms, e.g. 10 to 18 carbon atoms, when a terminal group or 2 or 3 carbon atoms when a polymer moiety.
It will be appreciated that the present invention encompasses
When required, the composition of the invention may be compounded into unit dosage form, for example filling the composition into gelatine capsules, e.g. hard gelatine capsules. Alternatively, the powder composition may be compressed into tablets in a conventional manner.
The composition of the invention may be combined with water or an aqueous solvent medium such that an emulsion, e.g. microemulsion, and/or a particulate system, is obtained. The emulsion, e.g. microemulsion, and/or particulate system, may be administered enterally, e.g orally, e.g. as a capsule, e.g. soft gelatine capsule, or parenterally, e.g. as an infusion concentrate. Oral administration is preferred.
The compositions of the invention in solid form, e.g. powder form, e.g. spray-dried or freeze-dried form, are particularly suitable for the formulation of solid oral dosage forms, e.g. hard gelatine capsules or tablets.
It has also been found that stable compositions containing macrolides may be obtained by formulating the macrolide in an acidic environment. Compositions are understood herein to be stable when the macrolide drug substance remains substantially intact after a period of days or weeks at room temperature (25° C.).
The acid may be lipid soluble and/or ethanol soluble. The acid may be for example a fatty acid, e.g. oleic acid. The acid may be a carboxylic acid, for example a mono-, di- or tri-carboxylic acid, and preferably a mono- or dicarboxylic acid. The acid may comprise one or more hydrophilic groups, e.g. hydroxy groups, and preferably one or two hydrophilic groups. Suitable acids for use in this invention include malonic acid, fumaric acid, maleic acid, D-malic acid, L-malic acid, citric acid, ascorbic acid, succinic acid, oxalic acid, benzoic acid or lactic acid or an acid with a similar pKa, e.g. 2-7. Preferred acids include malonic acid, oxalic acid, citric acid and lactic acid. Malonic acid is more preferred.
The preferred amount of acid may be determined by routine experimentation. The ratio by weight of macrolide to acid in the compositions of this invention may be up to 20:1, for example from 1:5 to 5:1, e.g. 1:1. In a further alternative aspect the acid may be present in an amount of between 0.05% and 5% by weight of the composition.
In a further alternative aspect the macrolide may be present in an amount of 1 to 15% by weight of the composition.
The macrolide may, for example, be formulated into a composition according to the present invention as defined above, and combined with an amount of acid. The acid-stabilised composition may be administered enterally, e.g orally, e.g. as a capsule or drink solution, or parenterally, e.g. as an infusion concentrate. Oral administration is preferred.
The pharmaceutical compositions of the invention exhibit especially advantageous properties when administered orally; for example in terms of consistency and high level of bioavailability obtained in standard bioavailability trials. These trials are performed in animals e.g. rats or dogs or healthy volunteers using HPLC or a specific or nonspecific monoclonal kit to determine the level of the drug substance, e.g. cyclosporin macrolide in the blood. For example, the composition of Example 1 administered p.o. to dogs may give surprisingly high Cmax values as detected by ELISA using a specific monoclonal antibody.
In one aspect the present invention provides a method of orally administering a pharmaceutical composition, said method comprising orally administering to a patient in need of cyclosporin or macrolide therapy a composition according to the present invention.
Pharmacokinetic parameters, for example absorption and blood levels, also become surprisingly more predictable and problems in administration with erratic absorption may be eliminated or reduced. Additionally the pharmaceutical compositions are effective with biosurfactants or tenside materials, for example bile salts, being present in the gastro-intestinal tract. That is, the pharmaceutical compositions of the present invention are fully dispersible in aqueous systems comprising such natural tensides and thus capable of providing emulsion or microemulsion systems and/or particulate systems in situ which are stable. The function of the pharmaceutical compositions upon oral administration remain substantially independent of and/or unimpaired by the relative presence or absence of bile salts at any particular time or for any given individual.
The compositions of this invention reduce variability in inter- and intra-patient dose response.
In one aspect the present invention provides a method of reducing the variability of bioavailability levels of a cyclosporin or macrolide for patients during cyclosporin or macrolide therapy, said method comprising orally administering an oral pharmaceutical composition according to the present invention.
The utility of all the pharmaceutical compositions of the present invention may be observed in standard clinical tests in, for example, known indications of drug dosages giving equivalent blood levels of drug; for example using dosages in the range of 2.5 mg to 1000 mg of drug per day for a 75 kilogram mammal, e.g. adult and in standard animal models. The increased bioavailability of the drug provided by the compositions may be observed in standard animal tests and in clinical trials, e.g. as described above.
The optimal dosage of drug to be administered to a particular patient may be considered carefully as individual response to and metabolism of the drug, e.g. cyclosporin or macrolide, may vary, e.g. by monitoring the blood serum levels of the drug by radioimmunoassay, monoclonal antibody assay, or other appropriate conventional means. Dosages of the e.g. macrolide will generally range from 1 to 1000 mg per day, e.g. 2.5 mg to 1000 mg per day for a 75 kilogram adult, preferably 25 mg to 500 mg, with the optimal dosage being approximately 50 to 100 mg per day. Satisfactory results are obtained by administering about 75 mg per day for example in the form of two capsules, one containing 50 mg and one containing 25 mg; or three capsules each containing 25 mg. Cyclosporin dosages may be 25 to 1000 mg per day (preferably 50 mg to 500 mg) and the FK 506 dosage may be 1 mg to 1000 mg, e.g. 2.5 to 1000 mg, per day (preferably 10 mg to 250 mg). A daily dosage of between 0.01 and 5 mg/kg body weight/day, e.g. 0.5 and 5 mg/kg body weight/day, is indicated for administration of 40-O-(2-hydroxy)ethyl rapamycin.
The pharmaceutical compositions are preferably compounded in unit dosage form, for example by filling them into orally administrable capsule shells. The capsule shells may be soft or hard gelatine capsule shells, preferably hard gelatine capsule shells. Where the pharmaceutical composition is in unit dosage form, each unit dosage will suitably contain between 10 and 100 mg of the drug, more preferably between 10 and 50 mg; for example 15, 20, 25, or 50 mg. Such unit dosage forms are suitable for administration 1 to 5 times daily depending upon the particular purpose of therapy, the phase of therapy and the like.
However, if desired, the pharmaceutical compositions of the invention may be in drink solution form upon dilution with water or any other aqueous system, to provide emulsion, e.g. microemulsion, and/or particulate systems suitable for drinking.
The pharmaceutical compositions of the invention are useful for the same indications as the poorly water soluble drugs. The pharmaceutical compositions are particularly useful for treatment and prevention of the conditions disclosed at pages 40 and 41 in EP 427 680, and at pages 5 and 6 in PCT/EP93/02604, the contents of which applications are incorporated herein by reference.
The pharmaceutical compositions comprising e.g. an immunosuppressant, e.g cyclosporin, as pharmacologically active agent, are particularly useful for:
a) treatment and prevention of organ or tissue transplant rejection, for example for the treatment of the recipients of heart, lung, combined heart-lung, liver, kidney, pancreatic, skin or corneal transplants. The pharmaceutical compositions are also indicated for the prevention of graft-versus-host disease, such as sometimes occurs following bone marrow transplantation;
b) treatment and prevention of autoimmune disease and of inflammatory conditions, in particular inflammatory conditions with an aetiology including an autoimmune component such as arthritis (for example rheumatoid arthritis, arthritis chronic progrediente and arthritis deformans) and rheumatic diseases; and
c) treatment of multi-drug resistance (MDR).
In a further aspect the present invention provides the use of a composition according to the present invention in the manufacture of a medicament for the treatment and prevention of an autoimmune or inflammatory condition or for the treatment and prevention of transplant rejection or for the treatment of multi-drug resistance.
The macrolide drugs also exhibit anti-tumour and antifungal activity and hence the pharmaceutical compositions can be used as anti-tumour and anti-fungal agents.
The contents of all the references referred to above especially the exemplified compounds are incorporated herein by reference, and each of the exemplified compounds may be used as a macrolide in the examples listed below.
Following is a description by way of example only of compositions of this invention. Unless otherwise indicated, components are shown in % by weight based on each composition.
Sunfat® GDC-N is from Taiyo Kagaku Co., Japan.
Oleyl alcohol from Henkel, Germany
Lauroglycol 90® from Gattefossé, France
Capryol 90® from Gattefossé, France
Sefsol 218® from Nikkol, Japan
Cremophor® RH 40 is from BASF, Germany.
SDS (Texapon K12®) from Fluka, Switzerland and Henkel, Germany
Solutol HS15® from BASF, Germany
Myrj 52® from Uniqema, Great Britain
Pluronic F68® from BASF, Germany
Brji 35® from Uniqema, Great Britain
Particle size measurements are made at 20° C. at a dilution of 1 g composition In 10 to 100 ml water by photon correlation spectroscopy using, for example a Brookhaven BI-200 SM from Brookhaven Instruments, and by microscopy using, for example a Zeiss DMLB microscope.
Compositions are made up by (i) dissolving the surfactant in water, (ii) dissolving the drug in the solubilizing component, and (iii) mixing the aqueous solution of the surfactant with the solution obtained by step (ii).
Particle size is measured by a Zetasizer or a microscope.
1)max droplet size
The compositions are spray-dried together with Glucidex® as a carrier in an amount of about 23% by weight of the total composition consisting of drug, solubilizing component, surfactant and carrier, and encapsulated Into hard gelatine capsules or compressed to tablets.
Further examples may be made replacing Cyclosporin A by any of the drugs specified above, e.g. 2 mg 40-O-(2-hydroxy)ethyl-rapamycin, or 30 mg 33-epi-chloro-33-desoxy-ascomycin.
Other examples may be made by replacing Oleyl alcohol, Lauroglycol®90, Capryol®90, Sefsol®218, Sunfat®GDC-N by any of the solubilizing components specified above.
Other examples may be made by replacing Sodium lauryl sulfate, Cremophor®RH40, Solutol®HS15, Myrj®52, Pluronic®F68, Brij®35 by any of the surfactants specified above.
The examples illustrate compositions useful for example in the prevention of transplant rejection or for the treatment of autoimmune disease, on administration of from 1 to 5 unit dosages/day at a dose of 2 to 5 mg/kg per day. The examples are described with particular reference to Cyclosporin A but equivalent compositions may be obtained employing any macrolide or other drug.
On visual inspection after dilution, each of the compositions forms a stable microemulsion or emulsion.
Number | Date | Country | Kind |
---|---|---|---|
0008785.8 | Apr 2000 | GB | national |
Number | Date | Country | |
---|---|---|---|
Parent | 11300575 | Dec 2005 | US |
Child | 12774452 | US | |
Parent | 10239456 | Sep 2002 | US |
Child | 11300575 | US |