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Title: Inhalation composition containing lactose pellets
United States Patent: 6,183,782
Inventors: Hallworth; Gerald Wynn (Ware, GB)
Assignee: Glaxo Group Limited (Greenford, GB)
Appl. No.: 702700
Filed: September 13, 1996
PCT Filed: March 13, 1995
PCT NO: PCT/EP95/00917
371 Date: September 13, 1996
102(e) Date: September 13, 1996
PCT PUB.NO.: WO95/24889
PCT PUB. Date: September 21, 1995
Foreign Application Priority Data: Mar 15, 1994[GB]
(9404945)
Abstract
The present invention relates to a pharmaceutical composition which is
suitable for the administration of medicaments by inhalation. In
particular, the pharmaceutical composition comprises microfine particles
of medicament and at least one lactose pellet having a diameter of from
about 10 to about 1500 micrometers, which pellet comprises a plurality of
microfine lactose particles. A method of treating respiratory disorders
which comprises administration by inhalation of an effective amount of
medicament selected from the group consisting of anti-allergics,
bronchodilators, anti-inflammatory steroids and mixtures thereof in the
pharmaceutical composition as defined is also described.
Description of the Invention
The present invention relates to an improved
pharmaceutical composition, in particular a powder composition suitable
for inhalation.
Numerous medicaments, especially those for the treatment of respiratory
conditions such as asthma, are administered by inhalation. Since the drug
acts directly on the target organ much smaller quantities of the active
ingredient may be used, thereby minimising any potential side effects
caused as a result of systemic absorption. The efficacy of this route of
administration has been limited by the problems encountered in making
appropriate and consistent dosages available to the lungs. The delivery
systems currently available are pressurised metered dose inhalers,
nebulisers and dry powder inhalers.
Metered dose inhalers require good coordination of actuation and
inhalation in order to achieve consistent dose administration; this
coordination may be difficult for some patients. Nebulisers are effective
but are relatively expensive and bulky and as a result are mainly used in
hospitals. A variety of dry powder inhalers have been developed and, since
dry powder inhalers rely on the inspiratory effect of the patient to
produce a fine cloud of drug particles, the coordination problems
associated with the use of metered dose inhalers do not apply.
It has been found that medicaments for administration by inhalation should
be of a controlled particle size in order to achieve maximum penetration
into the lungs, preferably in the range of 1 to 10 micrometers in
diameter. Unfortunately, powders in this particle size range, for example
micronised powders, have a high bulk volume and have very poor flow
characteristics due to the cohesive forces between the individual
particles. These characteristics create handling and metering difficulties
during manufacture of the medicament powder and, most importantly,
adversely affect the accurate dispensing of the powder within the
inhalation device. A number of proposals have been made in the literature
to improve the fluidity of dry powder pharmaceutical formulations.
GB1520248 describes the preparation of soft pellets of finely powdered
sodium cromoglycate which have satisfactory fluidity within the reservoir
of the inhaler device but have sufficiently low internal coherence to
break up into finer particles of medicament when introduced into the
turbulent air stream in the mouthpiece of the device. Numerous other
published patent applications suggest the use of carrier materials, for
example GB1402423, particularly of coarser carriers with particles having
sizes falling within a given range, for example GB1242211, GB1381872,
GB1410588, GB1478020 and GB1571629. More recently WO87/05213 describes a
carrier which comprises a conglomerate of one or more solid water-soluble
diluents and a lubricant, EP-0260241 describes a lipid-based dry powder
composition and U.S. Pat. No. 5,143,126 describes a method of preparing
flowable grain agglomerations of formoterol and lactose. Unfortunately the
selection of the particle size of the drug and excipient and of the ratio
of drug to excipient inevitably involves a compromise between adequate
bulk and flow properties for metering and the desired redispersability of
fine particle drug in the inhaled air flow.
According to the present invention there is provided a pharmaceutical
powder composition suitable for inhalation which comprises microfine
particles of medicament and at least one lactose pellet having a diameter
of from about 10 to about 1500 micrometers, which pellet comprises a
plurality of microfine lactose particles.
The particle size of the "microfine" particles of medicament and
lactose should be such as to permit substantially all of the particles to
be potentially available for inhalation into the lungs upon administration
of the powder composition. Thus, for example, at least 90%, preferably at
least 95% by weight of the particles will have a diameter of less than 15
micrometers, preferably in the range of 1 to 10 micrometers, for example 1
to 5 micrometers.
Medicaments which may be administered in the powder compositions according
to the invention include any drugs usefully delivered by inhalation for
example, analgesics, e.g. codeine, dihydromorphine, ergotamine, fentanyl
or morphine; anginal preparations, e.g. diltiazem; antiallergics, e.g.
cromoglycate, ketotifen or nedocromil; anti-infectives, e.g.
cephalosporins, penicillins, streptomycin, sulphonamides, tetracyclines or
pentamidine; antihistamines, e.g. methapyrilene; anti-inflammatories, e.g.
beclomethasone, flunisolide, budesonide, tipredane, triamcinolone
acetonideor fluticasone; antitussives, e.g. noscapine; bronchodilators,
e.g. ephedrine, adrenaline, fenoterol, formoterol, isoprenaline,
metaproterenol, phenylephrine, phenylpropanolamime, pirbuterol, reproterol,
rimiterol, salbutamol, salmeterol, terbutalin; isoetharine, tulobuterol,
orciprenaline or
(-)-4-amino-3,5-dichloro-.alpha.-[[[6-[2-(2-pyridinyl)ethoxy]hexyl]amino]m
ethyl]benzenemethanol; diuretics, e.g. amiloride; anticholinergics e.g.
ipratropium, atropine or oxitropium; hormones, e.g. cortisone,
hydrocortisone or prednisolone; xanthines e.g. aminophylline, choline
theophyllinate, lysine theophyllinate or theophylline; and therapeutic
proteins and peptides, e.g. insulin or glucagon. It will be clear to a
person skilled in the art that, where appropriate, the medicaments may be
used in the form of salts (e.g. as alkali metal or amine salts or as acid
addition salts) or as esters (e.g. lower alkyl esters) or as solvates
(e.g. hydrates) to optimise the activity and/or stability of the
medicament.
Particularly preferred medicaments for administration using powder
compositions in accordance with the invention include anti-allergics,
bronchodilators and anti-inflammatory steroids of use in the treatment of
respiratory disorders such as asthma by inhalation therapy, for example
cromoglycate (e.g. as the sodium salt), salbutamol (e.g. as the free base
or as the sulphate salt), salmeterol (e.g. as the xinafoate salt),
terbutaline (e.g. as the sulphate salt), reproterol (e.g. as the
hydrochloride salt), beclomethasone dipropionate (e.g. as the
monohydrate), fluticasone propionate or
(-)-4-amino-3,5-dichloro-.alpha.-[[[6-[2-(2-pyridinyl)ethoxy]hexyl]amino]m
ethyl]benzenemethanol. Salmeterol, salbutamol, fluticasone propionate,
beclomethasone dipropionate and physiologically acceptable salts and
solvates thereof are especially preferred.
It will be appreciated by those skilled in the art that the powder
compositions according to the invention may, if desired, contain a
combination of two or more active ingredients. Medicaments may be selected
from suitable combinations of the medicaments mentioned hereinbefore.
Thus, suitable combinations of bronchodilatory agents include ephedrine
and theophylline, fenoterol and ipratropium, and isoetharine and
phenylephrine formulations.
Other powder compositions may contain bronchodilators such as salbutamol
(e.g. as the free base or as the sulphate salt), salmeterol (e.g. as the
xinafoate salt) or isoprenaline in combination with an antiinflammatory
steroid such as a beclomethasone ester (e.g. the dipropionate) or a
fluticasone ester (e.g. the propionate) or a bronchodilator in combination
with an antiallergic such as cromoglycate (e.g. the sodium salt).
Combinations of isoprenaline and sodium cromoglycate, salmeterol and
fluticaseone propionate, or salbutamol and beclomethasone dipropionate as
especially preferred.
The final powder composition desirably contains 0.1 to 90% w/w,
preferably0.5 to 75% w/w, especially 1-50% w/w, of medicament relative to
the weight of the lactose pellets.
The internal strength or coherence of the lactose pellets of use in the
present invention may be high ("hard" lactose pellets) or low
("soft" lactose pellets) or a mixture of "hard" and
"soft" pellets. However, a preferred embodiment of the invention
contains "soft" lactose pellets with a low internal coherence.
These lactose pellets are friable and have an internal coherence such that
the pellets remain substantially intact under conditions of packaging,
transport, storage and when fluidised within a container in the inhalation
device from which it is intended to dispense the composition according to
the invention e.g. unit dose container or bulk reservoir and yet may be
disrupted into independent microfine lactose particles upon egress into
the turbulent air stream within the mouthpiece of the inhaler device. The
coherence or strength of the pellets may be determined by methods known to
those skilled in the art, for example by a simple strength test such as
that described in GB1520247. Preferred lactose pellets have a crushing
weight of between 50 and 500 mg, preferably between 50 and 200 mg,
especially between 50 and 100 mg, when measured in accordance with the
crushing test described herein.
The lactose pellets optionally contain one or more conventional
pharmaceutically acceptable ingredients such as diluents, binders,
solvents, surfactants, colouring and flavouring agents. However, the
lactose pellets preferably consist essentially of microfine lactose
particles.
The lactose pellets maybe prepared by dry or wet pelleting methods known
in the art. Thus, for example, microfine lactose particles may be dry
pelleted using a tumbling or agitation process known as"balling",
for example as described in U.S. Pat. No. 5,143,126. Alternatively,
microfine lactose particles may be wet pelleted by tumbling in a container
together with a minimal amount of liquid (see for example, review by C.
Orr (1966), Particulate Technology, Chapter 9, published McMillan, New
York). Suitable liquids wet the lactose particles adequately without
dissolving them and have a sufficiently low boiling point to ensure rapid
evaporation from the pellets thus formed and may be selected from, for
example, alkanes, halogenated alkanes, alcohols, esters and ethers.
Suitable liquids include, for example cyclohexane, n-hexane, chloroform,
methylene chloride, CFC-113, methanol, ethanol, isopropanol, ethyl acetate
and acetone and mixtures thereof. Lactose pellets may also be prepared,
for example by controlled agglomeration in a fluidised bed or by spray
drying a slurry of the lactose particles.
The preparation and storage of lactose pellets is desirably carried out
under anhydrous conditions to obviate any adverse effects of free moisture
on the strength of the lactose pellets. Lactose is generally utilised in
the form of its monohydrate, which solvate contains approximately 5% w/w
bound water. Desirably, the lactose pellets are substantially free of
unbound water (free moisture), for example containing less than 1%,
particularly less than 0.1% by weight of unbound water. The use of
anhydrous lactose particles may be preferred.
Once formed, the lactose pellets may be admixed with microfine particles
of one or more medicaments, optionally together with one or more
conventional pharmaceutically acceptable ingredients, using conventional
techniques to prepare the powder compositions according to the invention.
In one preferred embodiment of the invention the microfine medicament
particles are coated onto the lactose pellets while tumbling, either as a
fine powder, liquid suspension or solution of medicament. Coating with a
liquid suspension of medicament particles by a process known as
"layering" is preferred. Thus, the lactose pellets may be
tumbled with a dispersion of microfine medicament particles in a suitable
low boiling point, non-solublising liquid, such as an alkane, halogenated
alkane, alcohol, ester or ether. Suitable liquids will vary according to
the medicament used but may include, for example, cyclohexane, n-hexane,
chloroform, methylene chloride, CFC-113, methanol, ethanol, isopropanol,
ethyl acetate and acetone and mixtures thereof.
Suitably a low wetting volume, for example 0.6:1 v/w liquid:medicament
powder is employed in the layering process to prepare coated pellets.
However, such concentrated suspensions of certain medicament and liquid
combinations may be too viscous to be layered in this manner and it may be
necessary and/or desirable to prepare coated pellets by continuous or
intermittent spraying of a more dilute medicament suspension onto the
lactose pellets under conditions of controlled evaporation. Alternatively,
the lactose pellets may be slurried or sprayed with a suspension of
medicament in a suitable non-solubilising liquid, followed by evaporation
of the liquid to provide medicament-coated lactose pellets.
For all layering processes it is desirable to restrict the size range of
the core pellets and hence it may be advantageous to pass the lactose
pellets through one or more sieves to remove over or under-size pellets
before layering with medicament. Desirably the lactose pellets have a
diameter within the range of 50 to 1000 micrometers, particularly 150 to
1000 micrometers, for example in the range of 200 to 800 micrometers.
In an alternative embodiment the micronised medicament particles may be
pelleted by methods known or analogous to methods known in the art. After
pelleting, the medicament pellets may be admixed with the lactose pellets
to provide a powder composition according to the invention which comprises
at least one medicament pellet comprising a plurality of microfine
medicament particles and at least one lactose pellet comprising a
plurality of microfine lactose particles, each of said pellets having a
diameter of from about 50 to about 1500 micrometers.
The powder compositions according to the invention optionally contain one
or more conventional pharmaceutically acceptable ingredients such as
diluents and flavouring agents. The particle size of any such ingredients
will preferably be such as to substantially prevent their inhalation into
the bronchial system upon administration of the powder composition,
desirably in the range of 50 to 1000 micrometers.
The final powder composition desirably contains0.1 to 90% w/w, preferably
1 to 20% w/w of medicament and 10 to 99.9% w/w, preferably 50 to 99% w/w
of lactose pellets.
It is important that the powder compositions according to the invention
are manufactured, packed and stored under substantially anhydrous
conditions. Preferably the powder compositions contain less than 1%,
especially less than 0.1% w/w of unbound water.
The compositions according to the invention may conveniently be filled
into a bulk storage container, such as a multi-dose reservoir, or into
unit dose containers such as capsules, cartridges or blister packs, which
may be used with an appropriate inhalation device, for example as
described in GB2041763, WO91/13646, GB1561835, GB2064336, GB2129691 or
GB2246299. Such inhalers which contain a composition according to the
invention are novel and form a further aspect of the invention. The
compositions of the invention are particularly suitable for use with
multi-dose reservoir-type inhaler devices in which the composition is
metered e.g. by volume from a bulk powder container into dose-metering
cavities. The lower limit of powder delivery which may be accurately
metered from a multi-dose reservoir-type inhaler device is in the region
of 100 to 200 micrograms. The formulations of the present invention are
therefore particularly advantageous for highly potent and hence low dose
medicaments which require a high ratio of excipient for use in a
multi-dose reservoir-type inhaler device.
Dry powder inhalers are designed to deliver a fixed unit dosage of
medicament per actuation, for example in the range of 10 to 5000
micrograms medicament per actuation, preferably 25 to 500 micrograms.
Administration of medicament may be indicated for the treatment of mild,
moderate or severe acute or chronic symptoms or for prophylactic
treatment. It will be appreciated that the precise dose administered will
depend on the age and condition of the patient, the particular medicament
used and the frequency of administration and will ultimately be at the
discretion of the attendant physician. When combinations of medicament are
employed the dose of each component of the combination will in general be
that employed for each component when used alone. Typically,
administration may be one or more times, for example from 1 to 8 times per
day, giving for example 1,2,3 or 4 unit doses each time.
Thus, for example, each actuation may deliver25 micrograms salmeterol, 100
micrograms salbutamol, 25, 50, 125 or 250 micrograms fluticasone
propionate or 50, 100, 200 or 250 micrograms beclomethasone dipropionate.
Crushing Test
A number of tests for the friability (strength or internal coherence) of
pellets or granules have been described in the literature, see for example
GB1520247 and Ganderton & Hunter (1971), J.Pharm.Pharmacol 23, Suppl.
1S-10S, and instrumentation specifically devised for this purpose is now
available, for example from Etewe GmbH, Karlsruhe. A simple method was
devised and used to assess the crushing weight of pellets according to the
invention.
Thus, a single pellet was placed on a marked centre position on a base
slide and viewed from above through a stereomicroscope. Microscopy glass
coverslips were used as weights, either 22 mm square (mean170 mg, SD 4 mg)
or 16 mm circular (mean 75 mg, SD 4 mg). The first weight was supported at
one side and released by sliding the support away laterally. Any free-fall
was minimised by standardising the pellet diameter. When a single weight
did not fracture or crush the pellet, further weights were applied
sequentially.
Weak pellets characteristically showed crushing of the upper surface and a
sharp diametric break, at mean crushing weights of less than 500 mg,
preferably less than 250 mg.
Claim 1 of 23 Claims
What is claimed is:
1. A pharmaceutical powder composition suitable for inhalation comprising
microfine particles of medicament and at least one lactose pellet having a
diameter of from about 10 to about 1500 micrometers, which pellet
comprises a plurality of microfine lactose particles.
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