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Tftle: Antitussive drugs delivered by ion exchange resins
United States Patent: 6,001,392
Inventors: Wen; Betty (Scarborough, CA); Ramsay; Michael P.
(Ajax, CA); Scheurer; Heinrich (Scarborough, CA); Dokuzovic; Val
(Mississauga, CA); Lam; Vincent (Markham, CA)
Assignee: Warner-Lambert Company (Morris Plains, NJ)
Appl. No.: 994406
Filed: December 19, 1997
Abstract
The present invention relates generally to a mixture of coated and
non-coated sulfonic acid cation exchange resins (Amberlite IR69)
cross-linked with about 8% divinyl benzene onto which dextromethorphan has
been loaded. About 30% of the drug/resin complexes are coated with a
mixture of ethyl cellulose or ethyl cellulose latexes with plasticizers
and water dispersible polymers such as SURELEASE. The coating level is
about 50% w/w drug. Coated and uncoated drug/resin complexes are loaded
with drug to about 45% by weight drug/resin complex. The ratio of coated
and uncoated drug/resin complexes is about 55/45. The particle sizes of
the coated and uncoated drug/resin complexes is about 20 to about 300 and
about 20 to about 250 microns, respectively.
DETAILED DESCRIPTION OF THE INVENTION
The ion exchange resins suitable for use in these
preparations are water-insoluble and consist of a pharmacologically inert
organic or inorganic matrix containing covalently bound functional groups
that are ionic or capable of being ionized under the appropriate
conditions of pH. The organic matrix may be synthetic (e.g., polymers or
copolymers of acrylic acid, methacrylic acid, sulfonated styrene,
sulfonated divinylbenzene), or partially synthetic (e.g., modified
cellulose and dextrans). The inorganic matrix can also be, e.g., silica
gel modified by the addition of ionic groups. The covalently bound ionic
groups may be strongly acidic (e.g., sulfonic acid), weakly acidic (e.g.,
carboxylic acid), strongly basic (e.g., quaternary ammonium), weakly basic
(e.g., primary amine), or a combination of acidic and basic groups. In
general, those types of ion exchangers suitable for use in ion exchange
chromatography and for such applications as deionization of water are
suitable for use in these controlled release drug preparations. Such ion
exchangers are described by H. F. Walton in "Principles of Ion
Exchange" (pp. 312-343), incorporated by reference herein. The ion
exchange resins useful in the present invention have exchange capacities
below about 6 milliequivalents per gram (meq./g) and preferably below
about 5.5 meq./g.
The resin is cross-linked with a crosslinking agent selected from
difunctional compounds capable of cross-linking polystyrenes; these are
commonly known in the art. Preferably, the cross-linking agent is a
divinyl or polyvinyl compound. Most preferably the cross-linking agent is
divinylbenzene. The resin is cross-linked to an extent of about 3 to about
20%, preferably about 4 to about 16%, more preferably about 6 to about
10%, and most preferably about 8% by weight based on the total resin. The
resin is cross-linked with the cross-linking agent by means well known in
the art.
The size of the ion-exchange resins should preferably fall within the
range of about 20 to about 200 um Particle sizes substantially below the
lower limit are difficult to handle in all steps of the processing.
Particle sizes substantially above the upper limit, e.g.
commercially-available ion-exchange resins having a spherical shape and
diameters up to about 1000 um, are gritty in liquid dosage forms and have
a greater tendency to fracture when subjected to drying-hydrating cycles.
Moreover, it is believed that the increased distance that a displacing ion
must travel in its diffusion into these large particles, and the increased
distance the displaced drug must travel in its diffusion out of these
large particles, cause a measurable but not readily controlled
prolongation of release even when the drug/resin complexes are uncoated.
Representative resins useful in this invention include Amberlite IRP-69
(obtained from Rohm and Haas) and Dow XYS-40010.00 (obtained from The Dow
Chemical Company). Both are sulfonated polymers composed of polystyrene
cross-linked with 8% of divinylbenzene, with an ion exchange capacity of
about 4.5 to 5.5 meq./g of dry resin (H+-form). Their essential difference
is in physical form. Amberlite IRP-69 consists of irregularly-shaped
particles with a size range of 47 to 149 um, produced by milling the
parent, large-sized spheres of Amberlite IRP-120. The Dow XYS-40010.00
product consists of spherical particles with a size range of 45 to 150 um.
Another useful exchange resin, Dow XYS-40013.00, is a polymer composed of
polystyrene cross-linked with 8% of divinylbenzene and functionalized with
a quaternary ammonium group; its exchange capacity is normally within the
range of approximately 3 to 4 meq./g of dry resin.
The most preferable resin for complexing with antitussives, such as
dextromethorphan, is commercially available under the trade name Amberlite
IRP-69 (Rohm and Haas).
Adsorption of the drug onto the ion exchange resin particles to form the
drug/resin complex is a well known technique as shown in U.S. Pat. Nos.
2,990,332 and 4,221,778. In general the drug is mixed with an aqueous
suspension of the resin, and the complex is then washed and dried.
Adsorption of drug onto the resin may be detected by measuring a change in
the pH of the reaction medium, or by measuring a change in concentration
of sodium or drug.
Binding of drug to resin can be accomplished according to four general
reactions. In the case of a basic drug, these are: (a) resin (Na-form)
plus drug (salt form); (b) resin (Na-form) plus drug (as free base); (c)
resin (H-form) plus drug (salt form); and (d) resin (H-form) plus drug (as
free base). All of these reactions except (d) have cationic by-products,
by competing with the cationic drug for binding sites on the resin, reduce
the amount of drug bound at equilibrium. For basic drugs, stoichiometric
binding of drug to resin is accomplished only through reaction (d).
Four analogous binding reactions can be carried out for binding an acidic
drug to an anion exchange resin. These are: (a) resin (Cl--form) plus drug
(salt form); (b) resin (Cl--form) plus drug (as free acid); (c) resin
(OH--form) plus drug (salt form); and (d) resin (OH--form) plus drug (as
free acid). All of these reactions except (d) have ionic by-products and
the anions generated when the reactions occur compete with the anionic
drug for binding sites on the resin with the result that reduced levels of
drug are bound at equilibrium. For acidic drugs, stoichiometric binding of
drug to resin is accomplished only through reaction (d). The binding may
be performed, for example, as a batch or column process, as is known in
the art.
The drug/resin complex formed is collected and washed with ethanol and/or
water to insure removal of any unbound drug. The complexes are usually
air-dried in trays at room or elevated temperature.
The drug/resin complex has a ratio of dextromethorphan to resin of about
1:3 to about 3:1, preferably about 1:2 to about 2:1, most preferably about
1:1. The only limit to using ratios in excess of 1:6 is an economic and
aesthetic one.
The amount of the drug bonded to the ion exchange resin is in the range
from about 25 to about 75% by weight of the drug/resin complex. More
preferably, the amount of the drug bonded to the ion exchange resin is in
the range from about 33 to about 77% by weight of the drug/resin complex.
Most preferably, the amount of the drug bonded to the ion exchange resin
is in the range from about 40 to about 60% by weight of the drug/resin
complex.
The amount of resinate in the formulation is sufficient to deliver, when
administered at one dose every 12 hours, an antitussive effective amount
of a drug like dextromethorphan over a period of approximately 12 hours to
a patient in need of such administration. A typical adult dose of 10 mL
will contain approximately 120 mg of drug/resin complex, i.e. to deliver
equivalent to 60 mg of dextromethorphan hydrobromide when the average
drug:resin ratio is about 1:1.
The antitussive drugs that are suitable for use in these preparations are
acidic, amphoteric or most often basic antitussives. Examples of basic
drugs useful in the present invention include, but are not limited to
dextromethorphan, diphenhydramine, caramiphen, carbapentane, ethylmorphine,
noscapine and codeine.
In the preferred embodiment, the invention relates to pharmaceutical
compositions of matter comprising drug/resin complexes having only one
active ingredient. In another embodiment, the invention also relates to
pharmaceutical compositions of matter comprising the drug/resins in
combination with suitable pharmaceutically acceptable non-toxic carriers
or excipients, and optionally at least one of an antihistamine,
sympathomimetic drug (nasal decongestant, bronchodilator), analgesic,
antiinflammatory, cough suppressant and/or expectorant. Compounds which
are antihistamines, sympathomimetic drugs (nasal decongestant,
bronchodilator), analgesic, antiinflammatory, cough suppressants and/or
expectorants are well known to those of skill in the art and need not be
discussed in detail herein.
Only a certain percentage of the compositions disclosed herein will
contain non-coated drug/resin complexes. The remaining drug/resin
complexes are further characterized by the presence of a coating. In the
preferred embodiment of the present invention, about 20 to about 80% of
the drug/resin complexes in the sustained-release compositions are coated,
most preferably about 40 to about 60% of the drug/resin complexes. The
coating is a water-permeable, diffusion barrier coating material. The
presence of a coating allows one to selectively modify the dissolution
profile as desired of a pharmaceutical composition comprising the
drug/resin complexes of the present invention.
The coating materials can in general be any of a large number of
conventional natural or synthetic film-forming materials used singly, in
admixture with each other, and in admixture with plasticizers, pigments,
etc. with diffusion barrier properties and with no inherent
pharmacological or toxic properties. In general, the major components of
the coating should be insoluble in water, and permeable to water and drug.
However, it might be desirable to incorporate a water-soluble substance,
such as methyl cellulose, to alter the permeability of the coating, or to
incorporate an acid-insoluble, base-soluble substance to act as an enteric
coating. The coating materials may be applied as a suspension in an
aqueous fluid or as a solution in organic solvents. Suitable examples of
such coating materials are described by R. C. Rowe in Materials used in
Pharmaceutical Formulation. (A. T. Florence, editor), Blackwell Scientific
Publications, Oxford, 1-36(1984), incorporated by reference herein.
Preferably the water-permeable diffusion barrier is selected from the
group consisting of ethyl cellulose, methyl cellulose and mixtures thereof
Most preferably, the coating material is SURELEASE, manufactured by
Colorcon which is water based ethyl cellulose latex, plasticized with
dibutyl sebacate or with vegetable oils. Other non-limiting coating
materials included within the scope of the present invention are AQUACOAT,
manufactured by FMC Corporation of Philadelphia, which is ethylcellulose
pseudolatex; solvent based ethylcellulose; shellac; zein; rosin esters;
cellulose acetate; EUDRAGITS, manufactured by Rohm and Haas of
Philadelphia, which are acrylic resins; silicone elastomers; poly(vinyl
chloride) methyl cellulose; and hydroxypropylmethyl cellulose.
Conventional coating solvents and coating procedures (such as fluid bed
coating and spray coating) can be employed to coat the particles.
Techniques of fluid bed coating are taught, for example, in U.S. Pat. Nos.
3,089,824; 3,117,027; and 3,253,944. The coating is normally applied to
the drug/resin complex, but alternatively can be applied to the resin
before complexing with the drug. Non-limiting examples of coating solvents
include ethanol, a methylene chloride/acetone mixture, coating emulsions,
methyl acetone, tetrahydrofuran, carbonetetrachloride, methyl ethyl ketone,
ethylene dichloride, trichloroethylene, hexane, methyl alcohol, isopropyl
alcohol, methyl isobutyl ketone, toluene, 2-nitropropane, xylene, isobutyl
alcohol, n-butyl acetate.
It is preferred that the coated drug/resin complexes are coated in the
range from about 40 to about 70% w/w drug/resin complex. More preferably,
the drug/resin complex is coated in the range from about 45 to about 55%
w/w drug/resin complex. Most preferably, the drug/resin complex is coated
about 50% w/w drug/resin complex. Variation in the amount of coating
and/or the use of coated/uncoated complex mixtures can be employed to
selectively modify the dissolution profile as desired.
The average particle sizes of the non-hydrated coated and uncoated
drug/resin complexes is about 60 to about 200 and about 60 to about 250
um, respectively. More preferably, average particle sizes of the coated
drug/resin complexes is between about 70 and about 190 um, and most
preferably about 70 to about 180 um. More preferably, average particle
sizes of the uncoated drug/resin complexes is between about 55 and about
160 um, and most preferably about 60 to about 150 um. It is desirable that
about 85%, preferably about 95%, and most preferably about 98% of the
resin particles have sizes within the ranges set forth above. Adjustments
within these ranges can be made to accommodate desired aesthetic qualities
of the final formulation product. It is more preferable that the resin
dextromethorphan complex have particle sizes within these ranges as well.
Preparation of the compositions as disclosed above leads to the reduction
in the amount of dextromethorphan/ion exchange resin complexes required in
a composition while still achieving a pharmaceutically effective activity
level over a twelve hour period of time. While not intending to be limited
by theory, it is believed that the inventors have discovered a way to use
coatings in conjunction with increased drug loading to achieve plasma drug
concentration levels that will provide relief for up to twelve hours. The
amount of drug/resin in DELSYM DM dextromethorphan/resin compositions is
estimated to be about 100 mg/5 ml, whereas the amount of drug/resin in the
compositions of the present invention can be about 60 mg/ml.
Furthermore, unlike the drug/ion exchange resin preparations of the prior
art, the sustained-release antitussivelion exchange resin compositions of
the present invention have been surprisingly and unexpectedly found to
release up to about 90%, and even up to about 95% of an antitussive like
dextromethorphan from the compositions over a twelve hour period. The
bioavailability of dextromethorphan from the compositions of the present
invention is high despite the strong bond between residual amounts of
dextromethorphan and the ion exchange resin. If equivalent amounts of
dextromethorphan/resin compositions of the present invention and DELSYM DM
dextromethorphan/resin compositions are compared, the activity levels of
the compositions of the present invention can be up to 15% more active
than the DELSYM DM compositions. The foregoing assertions are evidenced by
FIG. 1 which illustrates the in vitro dissolution profiles of the
compositions of the present invention and DELSYM DM.
An additional advantages achieved by the compositions of the present
invention, not available from other sustained-release dextromethorphan
compositions relates to taste. Dextromethorphan is a drug which is
unpleasant to take orally. Compositions, such as liquid suspension,
comprising the drug/resin complexes of the present invention surprisingly
and unexpectedly are pleasant tasting with good mouth-feel, even in the
absence of sugars.
The drug/resin composition thus prepared may be stored for future use or
formulated with conventional pharmaceutically acceptable carriers to
prepare liquid compositions. The compositions according to this invention
may, for example, take the form of liquid preparations such as
suspensions, or solid preparations such as capsules, tablets, caplets,
liquigells, powders.
The compositions may be formulated using conventional carriers or
excipients and well established techniques. Without being limited thereto,
such conventional carriers or excipients include diluents, binders and
adhesives (i.e., cellulose derivatives and acrylic derivatives),
lubricants (i.e., magnesium or calcium stearate, or vegetable oils,
polyethylene glycols, talc, sodium lauryl sulphate, polyoxy ethylene
monostearate), solubilizers, humectants, disintegrants, colorants,
flavorings, preservatives, sweeteners and miscellaneous materials such as
buffers and adsorbents in order to prepare a particular medicated
composition.
Suitable thickeners include: tragacanth; xanthan gum; bentonite; acacia
and lower alkyl ethers of cellulose (including the hydroxy and carboxy
derivatives of the cellulose ethers). Preferably, tragacanth is used and
incorporated in an amount of from about 0.1 to about 1.0% w/v of the
composition, and more preferably about 0.5% w/v of the composition.
Xanthan gum is used in the amount of from about 0.025 to about 0.5% w/v
and preferably about 0.25% w/v.
The sustained-release antitussive/ion exchange resin compositions also
include a humectant composition to also give the liquid greater viscosity
and stability. Suitable humectants useful in the formulations of the
present invention include glycerin, polyethylene glycol, propylene glycol
and mixtures thereof. Preferably, polyethylene glycol is used and
incorporated in an amount of from about 5 to about 20% w/v of the
composition and preferably in an amount of from about 5 to about 15% w/v
of the composition and most preferably in an amount of about 8% w/v of the
composition.
The oral liquid compositions of the present invention will also comprise
at least one and preferably two surfactants in amounts of up to about 5.0%
w/v and preferably from about 0.02 to about 3.0% w/v of the total
formulation. The surfactants useful in the preparation of the compositions
of the present invention are generally organic materials which aid in the
stabilization and dispersion of the ingredients in aqueous systems for a
suitable homogenous composition. Preferably, the surfactants of choice are
non-ionic surfactants such as poly(oxyethylene)(20)sorbitan monooleate and
sorbitan monooleate. These are commercially known as Tweens and Spans and
are produced in a wide variety of structures and molecular weights.
Whereas any one of a number of surfactants may be used, preferably a
compound from the group comprising polysorbate copolymers
(sorbitan-mono-9-octadecenoate-poly(oxy-1,2-ethanediyl)) is employed. This
compound is also added and functions to keep any flavors and sweeteners
homogeneously dissolved and dispersed in solution. It is also believed
without being bound to any theory, that the polymers may provide a taste
masking function as well by binding with the active.
Suitable polysorbates include polysorbate 20, polysorbate 40, polysorbate
80 and mixtures thereof Most preferably, polysorbate 80 is employed. The
surfactant component will comprise from about 0.01 to about 2.0% w/v of
the total composition and preferably will comprise about 0.1% w/v of the
total weight of the composition.
A second emulsifier/surfactant useful in combination with polysorbates in
the practice of the present invention may be employed and is preferably a
poloxamer such as Poloxamer 407. Polyxamer 407 has an HLB (hydrophilic/lipophilic
balance) of about 22 and is sold under the tradename Pluoronic-127
(BASF-Wyandotte; Parsippany, N.J.). The two surfactants can be employed in
substantially equivalent amounts. For example, the Poloxamer 407 and
polysorbate 80 may each be employed together at levels of approximately
from about 0.02 to about 4.0% w/v of the total weight of the formulation.
Aqueous suspensions may be obtained by dispersing the drug/resin
compositions in a suitable aqueous vehicle, optionally with the addition
of suitable viscosity enhancing agent(s) (e.g., cellulose derivatives,
xanthan gum, etc.). Non-aqueous suspensions may be obtained by dispersing
the drug/resin compositions in a suitable non-aqueous based vehicle,
optionally with the addition of suitable viscosity enhancing agent(s)
(e.g., hydrogenated edible fats, aluminum stearate, etc.). Suitable
non-aqueous vehicles include, for example, almond oil, arachis oil,
soybean oil or fractionated vegetable oils such as fractionated coconut
oil.
Preservatives useful in the present invention include, but are not limited
to sodium benzoate, potassium sorbate, salts of edetate (also known as
salts of ethylenediaminetetraacetic acid, or EDTA, such as disodium EDTA)
and parabens (e.g., methyl, ethyl, propyl or butyl-hydroxybenzoates, etc.)
or sorbic acid. The preservatives listed above are exemplary, but each
preservative must be evaluated on an empirical basis, in each formulation,
to assure the compatibility and efficacy of the preservative. Methods for
evaluating the efficacy of preservatives in pharmaceutical formulations
are known to those skilled in the art. Preferred preservatives are the
paraben preservatives are methyl, ethyl, propyl, and butyl paraben. methyl
and propyl paraben are most preferable. Preferably, both methyl and propyl
paraben are present in the formulation in a ratio of methyl paraben to
propyl paraben of from about 2.5:1 to about 7.5:1, preferably 3:1.
In the instance where auxiliary sweeteners are utilized, the present
invention contemplates the inclusion of those sweeteners well known in the
art, including both natural and artificial sweeteners. Thus, additional
sweeteners may be chosen from the following non-limiting list:
A. Water-soluble sweetening agents such as monosaccharides, disaccharides
and polysaccharides such as xylose, ribose, glucose, mannose, galactose,
fructose, dextrose, sucrose, sugar, maltose, partially hydolyzed starch,
or corn syrup solids and sugar alcohols such as sorbitol, xylitol,
mannitol and mixtures thereof
B. Sucralose.
C. Dipeptide based sweeteners such as L-aspartyl-phenylalanine methyl
ester and materials described in U.S. Pat. No. 3,492,131 and the like.
In general, the amount of sweetener will vary with the desired amount of
sweeteners selected for a particular liquid formulation. This amount will
normally be 0.001 to about 90% by weight when using an easily extractable
sweetener. The water-soluble sweeteners described in category A above, are
preferably used in amounts of about 5 to about 70% by weight, and most
preferably from about 10 to about 50% by weight of the final liquid
composition. In contrast, the artificial sweeteners described in
categories B and C are used in amounts of about 0.005 to about 5.0% and
most preferably about 0.01 to about 2.5% by weight of the final liquid
composition. These amounts are ordinarily necessary to achieve a desired
level of sweetness independent from the flavor level achieved from flavor
oils.
Suitable flavorings include both natural and artificial flavors, and mints
such as peppermint, menthol, artificial vanilla, cinnamon, various fruit
flavors, both individual and mixed, essential oils (i.e. thymol, eculyptol,
menthol and methyl salicylate) and the like are contemplated. The amount
of flavoring employed is normally a matter of preference subject to such
factors as flavor type, individual flavor, and strength desired. Thus, the
amount may be varied in order to obtain the result desired in the final
product. Such variations are within the capabilities of those skilled in
the art without the need for undue experimentation. The flavorings are
generally utilized in amounts that will vary depending upon the individual
flavor, and may, for example, range in amounts of about 0.01 to about 3%
by weight of the final composition weight.
The colorants useful in the present invention, include the pigments such
as titanium dioxide, that may be incorporated in amounts of up to about 1%
by weight, and preferably up to about 0.6% by weight. Also, the colorants
may include other dies suitable for food, drug and cosmetic applications,
and known as D&C 10 and F.D. & C. dyes and the like. The materials
acceptable for the foregoing spectrum of use are preferably water-soluble.
Illustrative examples include indigoid die, known as F.D. & C. Blue
No. 2, which is the disodium salt of 5,5'indigotindisulfonic acid.
Similarly, the dye known as F.D. & C. Green No. 1, comprises a
triphenylmethane dye and is the monosodium salt of
4-[4-Nethyl-p-sulfobenzylamino)diphenylmethylene]-[1-(N-ethyl-N-p-sulfoniu
mbenzyl)-2,5-cyclohexadienimine]. A full recitation of all F.D. & C.
and D. & C. and their corresponding chemical structures may be found
in the Kirk-Othmer Encyclopedia of Chemical Technology, in Volume 5, at
Pages 857-884, which text is accordingly incorporated herein by reference.
Suitable oils and fats that are useable would include partially
hydrogenated vegetable or animal fats, such as coconut oil, palm kernel
oil, beef tallow, lard, and the like. These ingredients are generally
utilized in amounts with respect to the comestible product of up to about
7.0% by weight, and preferably up to about 3.5% by weight of the final
product.
Wetting agents also may be employed in the inventive compositions to
facilitate the dispersion of any hydrophobic ingredients. The
concentration of wetting agents in the composition should be selected to
achieve optimum dispersion of the ingredient within the composition with
the lowest feasible concentration of wetting agent. It should be
appreciated that an excess concentration of wetting agent may cause the
composition, as a syrup suspension, to flocculate. Those skilled in the
art are well versed in suitable empirical methods to determine the
appropriate wetting agents and concentrations to achieve optimum
dispersion and avoid flocculation. Suitable wetting agents are listed in
the U.S. Pharmacoepia XXI.
The invention further relates to methods of using the compositions in the
treatment, management or mitigation of cough, cold, cold-like and/or flu
symptoms and the discomfort, pain, fever and general malaise associated
therewith.
Claim 1 of 18 Claims
1. A sustained release pharmaceutical composition
comprising:
a drug/resin complex including a coated portion that comprises about 20 to
about 80% of the drug/resin complex, and
an uncoated portion; wherein the coated portion is coated with a water
permeable diffusion barrier in an amount from about 33 to about 70% w/w of
the coated portion and both the coated and uncoated portions include the
same drug in an amount from about 25 to about 75% w/w of the drug/resin
complex.
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