Title:  Methods of treating mammals using nanocrystalline formulations of human immunodeficiency virus (HIV) protease inhibitors

United States Patent:  6,221,400

Assignee:  Elan Pharma International Limited (Shannon, IE)

Filed:  January 6, 1999

The present invention describes formulations of nanoparticulate HIV protease inhibitors comprising a cellulosic surface stabilizer. The nanoparticulate formulations have an increased rate of dissolution in vitro, an increased rate of absorption in vivo, a decreased fed/fasted ratio variability, and a decreased variability in absorption. The present invention is also directed to methods of making the novel formulations. In particular, nanoparticulate formulations of HIV type 1 (HIV-1) and type 2 (HIV-2) protease inhibitors are described.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The invention is directed to the unexpected discovery that nanoparticulate formulations of highly insoluble HIV protease inhibitors having an extremely small effective average particle size can be prepared using a cellulosic surface stabilizer. The nanoparticles are stable and do not appreciably flocculate or agglomerate due to interparticle attractive forces. In addition, such nanoparticles can be formulated into pharmaceutical compositions exhibiting unexpectedly high bioavailability.

The nanoparticles of the present invention comprise a drug substance as a discrete, crystalline phase. The crystalline phase differs from a non-crystalline or amorphous phase which results from precipitation techniques.

Poorly water soluble HIV protease inhibitor drug substances, many of which could not have been administered intravenously prior to the present invention, may be safely and effectively administered by intravenous methods in formulations according to the invention. Additionally, many HIV protease inhibitor drug substances which prior to the present invention could not have been administered orally due to poor bioavailability, may also be safely and effectively administered orally in formulations according to the present invention. Pharmaceutical compositions according to the present invention include the nanoparticles described above and a pharmaceutically acceptable carrier therefor. Suitable pharmaceutically acceptable carriers are well known to those skilled in the art and include, for example, non-toxic physiologically acceptable carriers, adjuvants, or vehicles for parenteral injection, for oral administration in solid or liquid form, for rectal administration, and the like.

Pharmaceutical compositions according to the present invention may also comprise binding agents, filling agents, lubricating agents, disintegrating agents, suspending agents, sweeteners, flavoring agents, preservatives, buffers, wetting agents, and other excipients. Examples of filling agents are lactose monohydrate, lactose hydrous, and various starches; examples of binding agents are various celluloses, preferably low-substituted hydroxylpropyl cellulose, and cross-linked polyvinylpyrrolidone; an example of a disintegrating agent is croscarmellose sodium; and examples of lubricating agents are talc, magnesium stearate, stearic acid, and silica gel. Examples of suspending agents are hydroxypropyl cellulose, methyl cellulose, hydroxyethyl cellulose, carboxymethyl cellulose sodium, hydroxypropyl methylcellulose, acacia, alginic acid, carrageenin, and other hydrocolloides. Examples of sweeteners are any natural or artificial sweetener, such as sucrose, xylitol, sodium saccharin, cyclamate, aspartame, and acsulfame. Examples of flavoring agents are Magnasweet.RTM. (trademark of MAFCO), bubble gum flavor, and fruit flavors, such as orange, grape, cherry, berry, lemon-lime, and the like. Examples of preservatives, which control microbial contamination, are potassium sorbate, methylparaben, propylparaben, benzoic acid and its salts, other esters of parahydroxybenzoic acid such as butylparaben, alcohols such as ethyl or benzyl alcohol, phenolic compounds such as phenol, or quaternary compounds such as benzalkonium chloride.

The pharmaceutical compositions according to the present invention are particularly useful in oral and parenteral, including intravenous, administration formulations. The pharmaceutical compositions may also be administered enterally. Examples of parenteral routes of administration include, but are not limited to, subcutaneous, intramuscular, respiratory, and intravenous injection, as well as nasopharyngeal, mucosal, and transdermal absorption. It is a particularly advantageous feature that the pharmaceutical compositions of the present invention exhibit unexpectedly high bioavailability, they provide more rapid onset of drug action, and they provide decreased gastrointestinal irritancy.

A method of treating a mammal in accordance with the present invention comprises the steps of administering to the mammal in need of treatment an effective amount of the nanoparticulate pharmaceutical composition described above. The selected dosage level of the drug substance for treatment is effective to obtain a desired therapeutic response for a particular composition and method of administration. The selected dosage depends, therefore, upon the particular drug substance, the desired therapeutic effect, the route of administration, the desired duration of treatment, and other factors. In addition, because the particle size of the drug has been dramatically reduced, the pharmaceutical composition of the present invention can comprise an identical dosage to a prior art large drug size dosage in a much smaller volume. Alternatively, the pharmaceutical composition of the present invention can deliver a smaller dosage as a greater percentage of the drug will be absorbed into the bloodstream of the patient as compared to prior art large drug size dosage. Both pharmaceutical compositions allow for greater camouflage of the poor taste of HIV protease inhibitors. The pharmaceutical compositions comprising the nanoparticulate drug substance are also useful in treatment of mammals in combination with other antivirals, immunomodulators, antibiotics, vaccines, or the like.

Description of Drug Substance

The HIV protease inhibitor drug substance is preferably present in an essentially pure form. In addition, the HIV protease inhibitor drug substance is poorly soluble, although it is dispersible in at least one liquid medium. By "poorly soluble" it is meant that the drug substance has a solubility in the liquid dispersion medium of less than about 10 mg/ml, and preferably less than about 1 mg/ml. A preferred liquid dispersion medium is water. However, the invention can be practiced with other liquid media in which the HIV protease inhibitor drug substance is poorly soluble and dispersible including, for example, aqueous salt solutions, safflower oil, and solvents such as ethanol, t-butanol, hexane, and glycol. The pH of the aqueous dispersion media can be adjusted by techniques known in the art.

Suitable HIV protease inhibitor drug substances can be selected from a variety of known drugs including but not limited to, for example, saquinavir, retinovir, VX-478, MK-639 (i.e, indinavir), AG1343, ABT-538, U-103,017, DMP-450, and KNI-272. The drug substances are commercially available and/or can be prepared by techniques known in the art.

As described below in the Examples, it has been discovered that stable and dispersible nanoparticulate formulations of HIV protease inhibitors can only be formed using cellulosic surface stabilizers, and that the use of other known surface stabilizers results in a composition which is not stable and dispersible. This discovery is significant in that, as noted above, the use of HIV protease inhibitors in the treatment of HIV infection has been limited prior to the present invention because of the low solubility and corresponding low bioavailability of the drugs. Moreover, the formation of nanoparticulate HIV protease inhibitor compositions enables the preparation of pharmaceutical compositions which are more palatable to patients. This is because as noted above, the use of a smaller volume, but the same dose, of drug allows for greater camouflage of the unpleasant taste of the HIV protease inhibitor using larger doses of sweeteners.

Pharmaceutically acceptable salts of the HIV protease inhibitor drug substance can also be used in the invention and include the conventional non-toxic salts or the quaternary ammonium salts which are formed, for example, from inorganic or organic acids or bases. Examples of such acid addition salts include, but are not limited to, acetate, adipate, alginate, aspartate, benzoate, benzenesulfonate, bisulfate, butyrate, citrate, camphorate, camphorsulfonate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptanoate, glycerophosphate, hemisulfate, heptanoate, hexanoate, hydrochloride, hydrobromide, hydroiodide, 2-hydroxy-ethanesulfonate, lactate, maleate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, oxalate, palmoate, pectinate, persulfate, 3-phenylpropionate, picrate, pivalate, propionate, succinate, tartrate, thiocyanate, tosylate, and undecanoate. Examples of base salts include, but are not limited to, ammonium salts, alkali metal salts such as sodium and potassium salts, alkaline earth metal salts such as calcium and magnesium salts, salts with organic bases such as dicyclohexylamine salts, N-methyl-D-glucamine, and salts with amino acids such as arginine, lysine, and the like. In addition, the basic nitrogen-containing groups may be quaternized with such agents as lower alkyl halides, such as methyl, ethyl, propyl, and butyl chloride, bromides, and iodides; dialkyl sulfates such as dimethyl, diethyl, dibutyl, and diamyl sulfates; long chain halides such as decyl, lauryl, myristyl, and stearyl chlorides, bromides, and iodides; aralkyl halides such as benzyl and phenethyl bromides and the like. Other pharmaceutically acceptable salts include the sulfate salt ethanolate and sulfate salts.

Surface Stabilizer

The surface stabilizer of the present invention is a cellulosic stabilizer. Cellulosic surface stabilizers are non-ionic and water soluble. Examples of cellulosic stabilizers include, but are not limited to, hydroxypropyl cellulose (HPC), which is an ether of cellulose, HPC super low viscosity (HPC-SL), HPC-low viscosity (HPC-L), and hydroxypropyl methyl cellulose (HPMC).

The surface stabilizer is present at an amount of about 1 to about 100 mg/ml, preferably, about 10 mg/ml to about 20 mg/ml, and most preferably at about 10 mg/ml.

The cellulosic surface stabilizer can also be used in conjunction with one or more other surface stabilizers. Suitable additional surface stabilizers can preferably be selected from known organic and inorganic pharmaceutical excipients. Such excipients include various polymers, low molecular weight oligomers, natural products and surfactants. Preferred additional surface stabilizers include nonionic and anionic surfactants. Representative examples of excipients include gelatin, casein, lecithin (phosphatides), gum acacia, cholesterol, tragacanth, stearic acid, benzalkonium chloride, calcium stearate, glyceryl monostearate, cetostearyl alcohol, cetomacrogol emulsifying wax, sorbitan esters, polyoxyethylene alkyl ethers, e.g., macrogol ethers such as cetomacrogol 1000, polyoxyethylene castor oil derivatives, polyoxyethylene sorbitan fatty acid esters, e.g., the commercially available Tweens, polyethylene glycols, polyoxyethylene stearates, colloidol silicon dioxide, phosphates, sodium dodecylsulfate, carboxymethylcellulose calcium, carboxymethylcellulose sodium, methylcellulose, hydroxyethylcellulose, hydroxypropyl methycellulose phthalate, noncrystalline cellulose, magnesium aluminum silicate, triethanolamine, polyvinyl alcohol, and polyvinylpyrrolidone (PVP). Most of these excipients are described in detail in the Handbook of Pharmaceutical Excipients, published jointly by the American Pharmaceutical Association and The Pharmaceutical Society of Great Britain (The Pharmaceutical Press, 1986), the disclosure of which is hereby incorporated by reference in its entirety. The surface stabilizers are commercially available and/or can be prepared by techniques known in the art.

Particularly preferred surface stabilizers which can be used in conjunction with the cellulosic surface stabilizer, include polyvinyl pyrrolidone, Pluronic F68.RTM. and F108.RTM., which are block copolymers of ethylene oxide and propylene oxide, Tetronic 908.RTM., which is a tetrafunctional block copolymer derived from sequential addition of ethylene oxide and propylene oxide to ethylenediamine, dextran, lecithin, Aerosol OT.RTM., which is a dioctyl ester of sodium sulfosuccinic acid, available from American Cyanamid, Duponol P.RTM., which is a sodium lauryl sulfate, available from DuPont, Triton X-200.RTM., which is an alkyl aryl polyether sulfonate, available from Rohm and Haas, Tween 80.RTM., which is a polyoxyethylene sorbitan fatty acid ester, available from ICI Specialty Chemicals, and Carbowax 3350.RTM. and 934.RTM., which are polyethylene glycols available from Union Carbide.

The nanoparticles of the invention contain a discrete phase of an HIV protease inhibitor drug substance with the cellulosic surface stabilizer adsorbed on the surface thereof. It has been discovered that the cellulosic surface stabilizer physically adheres to the drug substance, but it does not chemically bond to or chemically react with the drug. Such chemical bonding or interaction would be undesirable as it could result in altering the function of the drug. The surface stabilizer is adsorbed on the surface of the drug substance in an amount sufficient to maintain an effective average particle size of less than about 1000 nm, and more preferably, less than about 400 nm. Furthermore, the individually adsorbed molecules of the surface stabilizer are essentially free of intermolecular cross-linkages.

Quantities of Drug Substance and Surface Stabilizer

The relative amount of the HIV protease inhibitor drug substance and cellulosic surface stabilizer can vary widely. The optimal amount of the cellulosic surface stabilizer, and any other additional surface stabilizer, can depend upon, for example, the particular HIV protease inhibitor employed, the hydrophilic-lipophilic balance (HLB) of the stabilizer, the melting point and water solubility of the stabilizer, the surface tension of water solutions of the stabilizer, and the like.

The cellulosic surface stabilizer is preferably present in an amount of about 0.1 to about 10 mg per square meter of surface area of the drug substance, or in an amount of about 0.1 to about 90%, and more preferably about 20 to about 60% by weight based upon the total weight of the dry drug particle. Additional stabilizer, such as Aerosol OT.RTM., in an amount of 0.01% to 1% by weight based upon the total weight of the dry particle are also preferable.

Reducing the Particle Size of the HIV Protease Inhibitor Drug Substance to Nanoparticles

The nanoparticulate HIV protease inhibitor particles of the present invention can be prepared by first dispersing an HIV protease inhibitor in a liquid dispersion medium followed by applying mechanical means in the presence of grinding media to reduce the particle size of the drug substance to an effective average particle size of less than about 1000 nm, and more preferably, less than about 400 nm. The HIV protease inhibitor particles can be reduced in size in the presence of the cellulosic surface stabilizer or the drug particles can be contacted with the cellulosic surface stabilizer following attrition.

A general procedure for preparing the HIV protease inhibitor nanoparticles of the invention is set forth below. The HIV protease inhibitor is either obtained commercially or prepared by techniques known in the art in a conventional coarse form. It is preferred, but not essential, that the particle size of the selected drug be less than about 100 .mu.m as determined by sieve analysis. If the coarse particle size of the drug is greater than about 100 .mu.m, then it is preferred that the drug particles be reduced in size to less than about 100 .mu.m using a conventional milling method, such as airjet or fragmentation milling, prior to reducing the particulate drug to submicron particle size.

The coarse HIV protease inhibitor particles can then be added to a liquid medium in which the drug is essentially insoluble to form a premix. The concentration of the drug in the liquid medium can vary from about 0.1 to about 60%, but is preferably from about 5 to about 30% (w/w). It is preferred, but not essential, that the cellulosic surface stabilizer is present in the premix. The concentration of the cellulosic surface stabilizer can vary from about 0.1 to about 90%, but it is preferably from about 1 to about 75%, and more preferably from about 20 to about 60%, by weight based upon the total combined weight of the HIV protease inhibitor and surface stabilizer. The apparent viscosity of the premix suspension is preferably less than about 1000 centipoise.

The premix can be used directly by subjecting it to mechanical means to reduce the average particle size in the dispersion to less than about 1000 nm, and more preferably, less than about 400 nm. It is preferred that the premix be used directly when a ball mill is used for attrition. Alternatively, the HIV protease inhibitor, and optionally the cellulosic surface stabilizer, can be dispersed in the liquid medium using suitable agitation, such as a roller mill or a Cowles-type mixer, until a homogeneous dispersion is observed. In a homogeneous dispersion, no large agglomerates are visible to the naked eye. It is preferred that the premix be subjected to such a premilling dispersion step when a recirculating media mill is used for attrition.

The mechanical means applied to reduce the particle size of the HIV protease inhibitor can be a dispersion mill. Suitable dispersion mills include, but are not limited to, a ball mill, an attritor mill, a vibratory mill, and media mills such as a sand mill or a bead mill. A media mill is preferred due to the relatively shorter milling time required to provide the desired reduction in particle size. For media milling, the apparent viscosity of the premix is preferably from about 100 to about 1000 centipoise. For ball milling, the apparent viscosity of the premix is preferably from about 1 to about 100 centipoise. Such ranges tend to afford an optimal balance between efficient particle fragmentation and media erosion.

The attrition time can vary widely and depends primarily upon the particular mechanical means and processing conditions selected. For ball mills, processing times of up to five days or longer may be required. Using a high shear media mill, processing times of less than 1 day (residence times of from one minute up to several hours) have provided the desired results.

The HIV protease inhibitor particles must be reduced in size at a temperature which does not significantly degrade the drug substance. Processing temperatures of less than about 30-40^oC. are ordinarily preferred. If desired, the processing equipment can be cooled with conventional cooling equipment. Generally, the methods of the invention can be conveniently carried out under conditions of ambient temperature and at processing pressures which are safe and effective for the milling process. For example, ambient processing pressures are typical of ball mills, attritor mills, and vibratory mills. Control of the temperature, for example, by jacketing or immersion of the milling chamber in ice water, is encompassed by the invention.

Processing pressures from about 1 psi (0.07 kg/cm²) up to about 50 psi (3.5 kg/cm²) are encompassed by the invention. Processing pressures typically range from about 10 psi to about 20 psi.

The surface stabilizer, if not present in the premix, must be added to the dispersion after attrition in an amount as described for the premix above. Thereafter, the dispersion can be mixed by, for example, shaking vigorously. Optionally, the dispersion can be subjected to a sonication step using, for example, an ultrasonic power supply. In such a method, the ultrasonic power supply can, for example, release ultrasonic energy having a frequency of about 20 to about 80 kHz for a time of about 1 to about 120 seconds.

After attrition is completed, the grinding media is separated from the milled particulate product using conventional separation techniques, such as by filtration, sieving through a mesh screen, and the like. The surface stabilizer may be added to the milled particulate product either before or after the milled product is separated from the grinding media

In a preferred grinding process, the particles are made continuously. In such a continuous method, the slurry of HIV protease inhibitor/cellulosic surface stabilizer and optionally an additional surface stabilizer is continuously introduced into a milling chamber, the HIV protease inhibitor is continuously contacted with grinding media while in the chamber to reduce the particle size of the HIV protease inhibitor, and the HIV protease inhibitor is continuously removed from the milling chamber. The cellulosic surface stabilizer, either alone or in conjunction with one or more additional surface stabilizers, can also be continuously added to the media chamber along with the HIV protease inhibitor, or it can be added to the HIV protease inhibitor which is removed from the chamber following grinding.

The resulting dispersion of the present invention is stable and comprises the liquid dispersion medium described above. The dispersion of surface stabilizer and nanoparticulate HIV protease inhibitor can be spray dried, spray coated onto sugar spheres or onto a pharmaceutical excipient using techniques well known in the art.

Grinding Media

The grinding media for the particle size reduction step can be selected from rigid media which is preferably spherical or particulate in form and which has an average size of less than about 3 mm and, more preferably, less than about 1 mm. Such media can provide the desired drug particles of the invention with shorter processing times and impart less wear to the milling equipment. The selection of material for the grinding media is not believed to be critical. Zirconium oxide, such as 95% ZrO stabilized with yttrium and 95% ZrO stabilized with magnesia, zirconium silicate, and glass grinding media have been found to provide particles having acceptable minimal levels of contamination for the preparation of pharmaceutical compositions. Other media, such as stainless steel, titania, and alumina can also be used. Preferred grinding media have a density greater than about 3 g/cm³.

Polymeric Grinding Media

The grinding media can comprise particles, preferably spherical in shape, such as beads, consisting of essentially polymeric resin. Alternatively, the grinding media can comprise particles having a core with a coating of the polymeric resin adhered thereto. The media can range in size from about 0.1 to about 3 mm. For fine grinding, the particles preferably are from about 0.2 to about 2 mm, and more preferably, from about 0.25 to about 1 mm in size.

The polymeric resin can have a density from about 0.8 to about 3.0 g/cm³. Higher density resins are preferred as such resins can provide more efficient particle size reduction.

In general, polymeric resins suitable for use in the present invention are chemically and physically inert, substantially free of metals, solvent, and monomers, and of sufficient hardness and friability to enable them to avoid being chipped or crushed during grinding. Suitable polymeric resins include, but are not limited to, cross-linked polystyrenes, such as polystyrene cross-linked with divinylbenzene, styrene copolymers, polycarbonates, polyacetals such as Delrin.RTM., vinyl chloride polymers and copolymers, polyurethanes, polyamides, poly(tetrafluoroethylenes), such as Teflon.RTM. and other fluoropolymers, high density polyethylenes, polypropylenes, cellulose ethers and esters such as cellulose acetate, polyhydroxymethacrylate, polyhydroxyethyl acrylate, silicone containing polymers such as polysiloxanes, and the like. The polymer can also be biodegradable. Exemplary biodegradabe polymers include, but are not limited to, poly(lactides), poly(glycolide) copolymers of lactides and glycolide, polyanhydrides, poly(hydroxyethyl methacylate), poly(imino carbonates), poly(N-acylhydroxyproline)esters, poly(N-palmitoyl hydroxyproline) esters, ethylene-vinyl acetate copolymers, poly(orthoesters), poly(caprolactones), and poly(phoshazenes). For biodegradable polymers, contamination of the resultant composition from the media itself can advantageously metabolize in vivo into biologically acceptable products that can be eliminated from the body.

The grinding media is separated from the milled particulate HIV protease inhibitor using conventional separation techniques in a secondary process, such as by filtration, sieving through a mesh filter or screen, and the like. Other separation techniques such as centrifugation may also be employed.

Particle Size

As used herein, particle size is determined on the basis of the average particle size as measured by conventional techniques well known to those skilled in the art, such as sedimentation field flow fractionation, photon correlation spectroscopy, or disk centrifugation. When photon correlation spectroscopy (PCS) is used as the method of particle sizing, the average particle diameter is the Z-average particle diameter known to those skilled in the art. By "an average effective particle size of less than about 1000 mm," it is meant that at least 90% of the particles, by weight, have a particle size of less than about 1000 nm when measured by the above-noted techniques. In a preferred embodiment of the invention, the effective average particle size is less than about 400 nm, more preferred is less than about 250 nm, and in an even more preferred embodiment, the effective average particle size is less than about 100 nm. It is preferred that at least 95% and, more preferably, at least 99% of the particles have a particle size less than the effective average, e.g., 1000 nm. In a particularly preferred embodiment, essentially all of the particles have a size of less than about 400 nm, in a more preferred embodiment, essentially all of the particles have a size of less than about 250 nm, and in a most preferred embodiment, essentially all of the particles have a size of less than about 100 nm.

Preparing Tablet Formulations

An exemplary process for preparing nanoparticulate HIV protease inhibitors in a tablet formulation comprises: (1) using the method described below to obtain spray-dried nanoparticles of the drug substance; (2) sieve-screening the spray-dried nanoparticles to obtain uniform particles of less than about 20 mesh; (3) blending the nanoparticulate drug substance with tableting excipients; (4) compressing the uniform particles into tablets using a tableting apparatus; and (5) film coating the tablets.

The spray drying process is used to obtain an "intermediate" nanoparticulate powder subsequent to the milling process used to transform the HIV protease inhibitor into nanoparticles. In an exemplary spray drying process, the high-solids drug substance nanosuspension and the cellulosic surface stabilizer are fed to an atomizer using a peristatic pump and atomized into a fine spray of droplets. The spray is contacted with hot air in the drying chamber resulting in the evaporation of moisture from the droplets. The resulting spray is passed into a cyclone where the powder is separated and collected.

At the completion of the spray drying process, the collected spray-dried intermediate comprises the nanoparticles of the HIV protease inhibitor suspended in a solid polymer matrix of the cellulosic surface stabilizer. The moisture content of the intermediate is controlled by the operating conditions of the spray drying process. The characteristics of the nanoparticulate powder are critical to the development of a free flowing powder that can be blended with other excipients suitable for a directly compressible tablet formulation.

Tablets can be made using a direct compression tablet process or using a roller compaction process. In an exemplary direct compression process, the spray-dried intermediate and stabilizer are sieved through a screen and the screened material is blended. The desired excipients are sieved and added to the blender. At the completion of blending, the contents of the blender can be discharged into a tared collection container and compression of tablet cores can be completed on a tablet press. The blended material can be fed into a feed hopper and force-fed into the die cavities using an automatic feeder. The tablet press operating conditions can be set to meet thickness, hardness, and weight specifications. Upon completion of the compression operation, a film-coating can be applied to the tablet cores using, for example, a Vector-Freund Hi-Coater machine.

In an exemplary roller compaction process following the media milling process, the nanoparticulate HIV protease inhibitor suspension can be spray dried to form an intermediate. The spray dryer can be assembled in a co-current configuration using a rotary atomization nozzle and the nanosuspension can be fed to the rotary atomizer using a peristaltic pump. Acceptable spray-dried product has a moisture content which does not exceed 1.0% (w/w).

A dry granulation operation can be used to manufacture tablets comprising the HIV protease inhibitor drug substance. Required amounts of the HIV protease inhibitor drug substance/cellulosic surface stabilizer spray-dried intermediate and appropriate excipients can be screened and blended. The blended material is then compacted using, for example, a roller compactor. The compacted material can then be granulated. Following granulation, additional excipients can be screened and blended with the granulation. The blended materials can then be compressed into tablets using a tablet press followed by coating.

Claim 1 of 13 Claims

We claim:

1. A method of treating Human Immunodeficiency Virus (HIV) in a mammal comprising administering to the mammal an effective amount of a pharmaceutical composition comprising:

(a) a crystalline HIV protease inhibitor having a solubility in water of less than about 10 mg/ml, and

(b) a cellulosic surface stabilizer adsorbed on to the surface of the HIV protease inhibitor in an amount sufficient to maintain an effective average particle size of less than about 1000 nm, and a pharmaceutically acceptable carrier therefor.

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