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Title:
Solid preparation comprising an insulin sensitizer, an insulin
secretagogue and a polyoxyethylene sorbitan fatty acid ester
United States Patent: 7,700,128
Issued: April 20, 2010
Inventors: Doken; Kazuhiro
(Osaka, JP), Kawano; Tetsuya (Osaka, JP), Koyama; Hiroyoshi (Osaka, JP),
Hamaguchi; Naoru (Osaka, JP)
Assignee: Takeda
Pharmaceutical Company Limited (Osaka, JP)
Appl. No.: 10/544,581
Filed: October 21, 2004
PCT Filed: October 21, 2004
PCT No.: PCT/JP2004/015958
371(c)(1),(2),(4) Date: April
05, 2006
PCT Pub. No.: WO2005/041962
PCT Pub. Date: May 12, 2005
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Executive MBA in Pharmaceutical Management, U. Colorado
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Abstract
A solid preparation useful as a
diabetes-treating agent or the like and excellent in the dissolution
properties of an insulin sensitizer and an insulin secretagogue, which
comprises an insulin sensitizer, an insulin secretagogue and a
polyoxyethylene sorbitan fatty acid ester is provided.
Description of the
Invention
The present inventors studied intensively
in order to solve the above problem. As a result, they found that the
dissolution property of an insulin secretagogue could be improved by
incorporating a polyoxyethylene sorbitan fatty acid ester in the solid
preparation and accordingly completed the present invention.
That is, the present invention provides
(1) a solid preparation comprising an insulin sensitizer, an insulin
secretagogue and a polyoxyethylene sorbitan fatty acid ester;
(2) the solid preparation according to the above (1), wherein the insulin
sensitizer is pioglitazone hydrochloride;
(3) the solid preparation according to the above (1), wherein the insulin
secretagogue is a sulfonylurea agent;
(4) the solid preparation according to the above (3), wherein the
sulfonylurea agent is glimepiride;
(5) the solid preparation according to the above (1), wherein the
polyoxyethylene sorbitan fatty acid ester is Polysorbate 80;
(6) a solid preparation comprising pioglitazone hydrochloride, glimepiride
and Polysorbate 80; and the like.
DETAILED EXPLANATION OF THE INVENTION
An insulin sensitizer used in the present invention means any drug that
restores the impaired function of an insulin receptor to the original
state and thereby improves the insulin resistance. Specific examples of
the insulin sensitizer include pioglitazone, rosiglitazone, reglixane
(JTT-501), GI-262570, netoglitazone (MCC-555), balaglitazone (DRF-2593),
MB-13.1258,
5-(2,4-dioxothiazolidin-5-ylmethyl)-2-methoxy-N-[4-(trifluoromethyl)benzy-
l]benzamide (KRP-297), rivoglitazone (CS-011), FK-614, compounds described
in W099/58510 (e.g.
(E)-4-[4-(5-methyl-2-phenyl-4-oxazolylmethoxy)benzyloxyimino]-4-phenylbut-
yric acid), tesaglitazar (AZ-242), ragaglitazar (NN-622), Muraglitazar
(BMS-298585), ONO-5816, LM-4156, MBX-102, LY-519818, MX-6054, LY-510929,
T-131, THR-0921 and the like.
The insulin sensitizer may be in the form of a salt. Such a salt may be a
pharmacologically acceptable salt, such as salts with inorganic bases,
salts with organic bases, salts with inorganic acids, salts with organic
acids, and salts with basic or acidic amino acids.
Preferred examples of the salts with inorganic bases include salts with
alkali metals such as sodium and potassium; alkaline earth metals such as
calcium and magnesium; aluminum, ammonium and the like.
Preferred examples of the salts with organic bases include salts with
trimethylamine, triethylamine, pyridine, picoline, ethanolamine,
diethanolamine, triethanolamine, dicyclohexylamine,
N,N-dibenzylethylenediamine and the like.
Preferred examples of the salts with inorganic acids include salts with
hydrochloric acid, hydrobromic acid, nitric acid, sulfuric acid,
phosphoric acid and the like.
Preferred examples of the salts with organic acids include salts with
formic acid, acetic acid, trifluoroacetic acid, fumaric acid, oxalic acid,
tartaric acid, maleic acid, citric acid, succinic acid, malic acid,
methanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid and the
like.
Preferred examples of the salts with basic amino acids include salts with
arginine, lysine, ornithine and the like.
Preferred examples of the salts with acidic amino acids include salts with
aspartic acid, glutamic acid and the like.
The insulin sensitizer may be anhydrous or hydrous.
The insulin sensitizer is preferably pioglitazone or a salt thereof
(preferably, hydrochloride) or rosiglitazone or a salt thereof
(preferably, maleate) and more preferably pioglitazone hydrochloride.
The insulin sensitizer used in the present invention may be a mixture of
two or more insulin sensitizers at an appropriate proportion.
An insulin secretagogue used in the present invention includes
sulfonylurea agents (e.g. tolbutamide, glibenclamide, gliclazide,
chlorpropamide, tolazamide, acetohexamide, glyclopyramide, glimepiride,
glipizide, glybuzole) and non-sulfonylurea insulin secretagogues (e.g.
repaglinide, nateglinide, mitiglinide or its calcium salt hydrate).
The insulin secretagogue may be in the salt form similar to that of the
above-mentioned insulin sensitizer and may be either anhydrous or hydrous.
The insulin secretagogue is preferably a sulfonylurea agent, more
preferably glimepiride.
The insulin secretagogue used in the present invention may be a mixture of
two or more insulin secretagogues at an appropriate proportion.
A polyoxyethylene sorbitan fatty acid ester used in the present invention
includes Polysorbate 20, Polysorbate 40, Polysorbate 60, Polysorbate 65,
Polysorbate 80 and the like.
The polyoxyethylene sorbitan fatty acid ester is preferably Polysorbate
80.
The polyoxyethylene sorbitan fatty acid ester used in the present
invention may be a mixture of two or more polyoxyethylene sorbitan fatty
acid esters at an appropriate proportion.
If sodium lauryl sulfate, a sucrose stearate ester (HLB16) or
polyoxyethylene(160)polyoxypropylene(30)glycol (trade name: Pluronic F68)
is used in place of the polyoxyethylene sorbitan fatty acid ester in the
solid preparation of the present invention, an excellent improving effect
on the dissolution property of an insulin secretagogue can not be
achieved.
The solid preparation of the present invention is particularly preferably
a solid preparation comprising pioglitazone hydrochloride, glimepiride and
Polysorbate 80.
The solid preparation of the present invention may contain additives
conventionally used in the pharmaceutical technology field. Such additives
include excipients, disintegrants, binders, lubricants, coloring agents,
pH adjusters, stabilizers, corrigents, sweetenings, flavors, fluidizing
agents and the like. The amounts used of additives are determined in
accordance with quantities conventionally used in the pharmaceutical
technology field.
Excipients include starches such as corn starch, potato starch, wheat
starch, rice starch, partially pregelatinized (.alpha.) starch,
pregelatinized (.alpha.) starch and porous starch; saccharides or sugar
alcohols such as lactose, fructose, glucose, mannitol and sorbitol;
anhydrous calcium phosphate, crystalline cellulose, precipitated calcium
carbonate, calcium silicate, and the like. Because the solid preparation
of the present invention contains a polyoxyethylene sorbitan fatty acid
ester, its hardness tends to decrease. Therefore, the solid preparation of
the present invention preferably contains crystalline cellulose as an
excipient in order to increase the hardness. The amount used of
crystalline cellulose is preferably 5 to 60 parts by weight, more
preferably 10 to 50 parts by weight based on 100 parts by weight of the
solid preparation.
Disintegrants include carboxymethylcellulose, carboxymethylcellulose
calcium, carboxymethylstarch sodium, croscarmellose sodium, crospovidone,
low-substituted hydroxypropylcellulose, hydroxypropyl starch and the like.
The amount used of the disintegrant is preferably 0.5 to 25 parts by
weight, more preferably 1 to 15 parts by weight based on 100 parts by
weight of the solid preparation.
Binders include hydroxypropylcellulose, hydroxypropylmethylcellulose,
povidone (polyvinylpyrrolidone), gum arabic powder and the like. The
amount used of the binder is preferably 0.1 to 50 parts by weight, more
preferably 0.5 to 40 parts by weight based on 100 parts by weight of the
solid preparation.
Lubricants include magnesium stearate, calcium stearate, talc, sucrose
fatty acid ester, sodium stearyl fumarate and the like.
Coloring agents include food dyes such as food Yellow No. 5 (sunset
yellow, the same as food Yellow No. 6 in the United states), food Red No.
2 and food Blue No. 2; food lake pigments, iron sesquioxide and the like.
PH adjusters include citrate, phosphate, carbonate, tartrate, fumarate,
acetate, amino acid salt and the like.
Stabilizers include tocopherol, edetate tetrasodium, nicotinic acid amide,
cyclodextrins and the like.
Corrigents include ascorbic acid, citric acid, tartaric acid, malic acid
and the like.
Sweetenings include Aspartame, Acesulfame K, thaumatin, saccharin sodium,
dipotassium glycyrrhizinate and the like.
Flavors include menthol, peppermint oil, lemon oil, vanillin and the like.
Fluidizing agents include light anhydrous silicic acid, hydrous silicon
dioxide and the like. The light anhydrous silicic acid contains hydrous
silicon dioxide (SiO.sub.2.nH.sub.2O) (wherein n indicates an integer) as
the main constituent and specifically includes Sylysia 320 (trade name;
Fuji Silysia Chemical LTD), AEROSIL 200 (trade name, Nippon Aerosil CO.,
LTD) and the like.
Two or more of the above-mentioned additives may be used as a mixture at
an appropriate proportion.
The dosage forms of the solid preparation of the present invention include
oral preparations such as tablets (including sublingual tablets and
intraorally disintegrating tablets), capsules (including soft capsules and
microcapsules), powders, granules and troches; and parenteral preparations
such as external preparations (for example, transdermal preparations and
ointments), suppositories (for example, rectal suppositories and vaginal
suppositories) and pellets. These preparations may be controlled-release
preparations such as immediate-release preparations or sustained-release
preparations (for example, sustained-release microcapsules). The solid
preparation of the present invention is preferably a tablet (preferably a
layered tablet).
The solid preparation of the present invention may be in round, caplet or
oblong form.
The content of an insulin sensitizer in the solid preparation of the
present invention is, for example, 0.01 to 98 parts by weight, preferably
1 to 90 parts by weight per 100 parts by weight of the solid preparation
of the present invention.
Specifically, when the insulin sensitizer is pioglitazone hydrochloride,
the content of pioglitazone hydrochloride in the solid preparation of the
present invention is preferably 0.01 to 70 parts by weight, more
preferably 2 to 60 parts by weight per 100 parts by weight of the solid
preparation of the present invention.
The content of an insulin secretagogue in the solid preparation of the
present invention is, for example, 0.01 to 95 parts by weight, preferably
0.03 to 90 parts by weight per 100 parts by weight of the solid
preparation of the present invention.
The content of a polyoxyethylene sorbitan fatty acid ester in the solid
preparation of the present invention is, for example, 0.01 to 30 parts by
weight, preferably 0.05 to 20 parts by weight, more preferably 0.2 to 1
parts by weight per 100 parts by weight of the solid preparation of the
present invention.
When a polyoxyethylene sorbitan fatty acid ester is incorporated into a
preparation, the polyoxyethylene sorbitan fatty acid ester is oxidized to
generate formaldehyde which may adversely affect the stability of an
active ingredient in the preparation. Further, a decrease in the hardness
of a preparation is caused by an increase in the content of a
polyoxyethylene sorbitan fatty acid ester in the preparation. Therefore,
the content of a polyoxyethylene sorbitan fatty acid ester in the
preparation of the present invention is preferably the minimum amount
which is enough to bring about the desired effect (e.g. improvement in the
dissolution property of an insulin secretagogue), for example, 0.7 parts
by weight or less per 100 parts by weight of the solid preparation of the
present invention.
The solid preparation of the present invention can be produced by
formulating an insulin sensitizer, an insulin secretagogue and a
polyoxyethylene sorbitan fatty acid ester together with, if necessary, the
above-mentioned additives according to a conventional method in the
pharmaceutical technology field.
The formulation may be performed by combining mixing, granulation, filling
into capsules, compression, coating and the like appropriately. The mixing
is performed using a mixer such as a V-shape mixer or a tumbling mixer and
the granulation is performed using a granulator such as a high-speed
stirring granulator or a fluid bed granulator. The compression is
performed, for example, using a single-punch tableting machine or a rotary
tableting machine and usually under a pressure of 1 to 35 kN/cm.sup.2. The
coating is performed, for example, using a film coating machine and a
coating base may be, for example, a sugar-coating base, a water soluble
film coating base, an enteric film coating base, sustained-release film
coating base or the like.
The sugar-coating base may be, for example, saccharide or sugar alcohol
such as saccharose or erythritol, and may be also used in combination with
one or more species selected from talc, precipitated calcium carbonate,
gelatin, gum arabic, pullulan, carnauba wax and the like.
The water soluble film coating base includes cellulose polymers such as
hydroxypropylcellulose, hydroxypropylmethylcellulose,
hydroxyethylcellulose and methylhydroxyethyl cellulose; synthesized
polymers such as polyvinylacetal diethylaminoacetate,
aminoalkylmethacrylate copolymer E [Eudragit E (trade name), Roehm Pharma]
and povidone (polyvinylpyrrolidone); polysaccharides such as pullulan; and
the like.
The enteric film coating base includes cellulose polymers such as
hydroxypropylmethylcellulose phthalate, hydroxypropylmethylcellulose
acetate succinate, carboxymethylethylcellulose and cellulose acetate
phthalate; acrylic acid polymers such as methacrylic acid copolymer L [Eudragit
L (trade name), Roehm Pharma], methacrylic acid copolymer LD [Eudragit
L-30D55 (trade name), Roehm Pharma] and methacrylic acid copolymer S [Eudragit
S (trade name), Roehm Pharma]; natural products such as shellac; and the
like.
The sustained-release film coating base includes cellulose polymers such
as ethyl cellulose; acrylic acid polymers such as aminoalkylmethacrylate
copolymer RS [Eudragit RS (trade name), Roehm Pharma] and ethyl acrylate/methyl
methacrylate copolymer suspension [Eudragit NE (trade name), Roehm Pharma];
cellulose acetate; and the like.
Two or more of the above-mentioned coating bases may be mixed at an
appropriate proportion and then used. In a coating step, coating additives
may be also used.
The coating additives include a light-blocking agent and/or a coloring
agent such as titanium dioxide, talc and iron sesquioxide; a plasticizer
such as polyethylene glycol, triethyl citrate, castor oil and polysorbates;
organic acid such as citric acid, tartaric acid, malic acid and ascorbic
acid; and the like.
The coating is performed by a known method, for example, by using a
film-coating machine.
The solid preparation of the present invention may be printed with a mark
or a letter for discrimination and may have a cleavage line for being
divided.
The solid preparation of the present invention is produced preferably by
the following processes.
1) After an insulin sensitizer and an insulin secretagogue are mixed
together with additives such as excipients, the mixture is granulated
while sprayed with a dispersion or solution of a polyoxyethylene sorbitan
fatty acid ester (preferably Polysorbate 80) and additives such as binders
in a solvent (e.g. water). The resulting granules are mixed with additives
such as disintegrants and lubricants and then, if necessary, compressed to
produce the solid preparation of the present invention.
2) After an insulin sensitizer is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of
an insulin secretagogue, a polyoxyethylene sorbitan fatty acid ester
(preferably Polysorbate 80) and additives such as binders in a solvent
(e.g. water). The resulting granules are mixed with additives such as
disintegrants and lubricants and then, if necessary, compressed to produce
the solid preparation of the present invention.
3) After an insulin sensitizer is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of
additives such as binders (preferably povidone) in a solvent (e.g. water).
After an insulin secretagogue is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of a
polyoxyethylene sorbitan fatty acid ester (preferably Polysorbate 80) and
additives such as binders in a solvent (e.g. water).
The granules containing an insulin sensitizer and the granules containing
an insulin secretagogue thus obtained are mixed together with additives
such as disintegrants and lubricants and then, if necessary, compressed to
produce the solid preparation of the present invention.
4) After an insulin sensitizer is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of
additives such as binders (preferably povidone) in a solvent (e.g. water).
A dispersion or solution of an insulin secretagogue, a polyoxyethylene
sorbitan fatty acid ester (preferably Polysorbate 80) and additives such
as binders in a solvent (e.g. water) is granulated by spraying it on
additives such as excipients.
The granules containing an insulin sensitizer and the granules containing
an insulin secretagogue thus obtained are mixed together with additives
such as disintegrants and lubricants and then, if necessary, compressed to
produce the solid preparation of the present invention.
5) After an insulin sensitizer is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of
additives such as binders (preferably povidone) in a solvent (e.g. water).
The resulting granules are mixed with additives such as disintegrants and
lubricants to obtain mixed powder.
A dispersion or solution of an insulin secretagogue, a polyoxyethylene
sorbitan fatty acid ester (preferably Polysorbate 80) and additives such
as binders in a solvent (e.g. water) is granulated by spraying it on
additives such as excipients. The resulting granules are mixed with
additives such as disintegrants and lubricants to obtain mixed powder.
The mixed powder containing an insulin sensitizer and the mixed powder
containing an insulin secretagogue thus obtained are layered and then
compressed to produce the solid preparation (a two-layered tablet) of the
present invention.
6) After an insulin sensitizer is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of
additives such as binders (preferably povidone) in a solvent (e.g. water).
The resulting granules are mixed with additives such as disintegrants and
lubricants and then compressed into a core-tablet.
A dispersion or solution of an insulin secretagogue, a polyoxyethylene
sorbitan fatty acid ester (preferably Polysorbate 80) and additives such
as binders in a solvent (e.g. water) is granulated by spraying it on
additives such as excipients. The resulting granules are mixed with
additives such as disintegrants and lubricants to obtain mixed powder.
The mixed powder thus obtained as an outer layer and the above described
core-tablet are compressed to produce the solid preparation (a dry-coated
tablet) of the present invention.
7) After an insulin sensitizer is mixed with additives such as excipients,
the mixture is granulated while sprayed with a dispersion or solution of
additives such as binders (preferably povidone) in a solvent (e.g. water).
The resulting granules are mixed with additives such as disintegrants and
lubricants and then compressed into a tablet. This tablet is coated with a
film solution of an insulin secretagogue, a polyoxyethylene sorbitan fatty
acid ester (preferably Polysorbate 80), a coating base and additives such
as light-blocking agents to produce the solid preparation (a film-coated
tablet) of the present invention.
Among these processes, the above 5) is preferred. A solid preparation
obtained by the above 5) is excellent in the dissolution properties of an
insulin sensitizer and an insulin secretagogue, and specifically has the
excellent dissolution property of an insulin secretagogue which is
equivalent to that of "a solid preparation containing an insulin
secretagogue as a single active ingredient". A solid preparation obtained
by the above 5) is also excellent in the content uniformity of an insulin
secretagogue.
Between individual dosage units (e.g. tablets) of the solid preparation of
the present invention, there is little variation in the insulin
secretagogue content. The solid preparation of the present invention also
has good storage stability and exhibits stable medical efficacy.
The solid preparation of the present invention is preferably a solid
preparation consisting of "a layer containing an insulin sensitizer" and
"a layer containing an insulin secretagogue and a polyoxyethylene sorbitan
fatty acid ester".
The "layer containing an insulin sensitizer" preferably further contains
excipients (e.g. lactose) and binders (e.g. povidone) and further may
contain disintegrants (e.g. croscarmellose sodium) and lubricants (e.g.
magnesium stearate). When the "layer containing an insulin sensitizer"
contains povidone as a binder, a solid preparation which is excellent in
dissolution of an insulin sensitizer from said solid preparation, for
example, a solid preparation which has a stable dissolution pattern of an
insulin sensitizer and wherein there is little difference in the
dissolution pattern (in particular, the dissolution pattern in the
beginning of the dissolution) between individual dosage units of said
solid preparation, is obtained.
The insulin sensitizer of the "layer containing an insulin sensitizer" is
preferably pioglitazone hydrochloride.
The "layer containing an insulin secretagogue and a polyoxyethylene
sorbitan fatty acid ester" preferably further contains excipients (e.g.
lactose, crystalline cellulose, or a mixture thereof) and binders (e.g.
hidroxypropylcellulose) and further may contain disintegrants (e.g.
croscarmellose sodium) and lubricants (e.g. magnesium stearate). When the
"layer containing an insulin secretagogue and a polyoxyethylene sorbitan
fatty acid ester" contains crystalline cellulose as an excipient, a solid
preparation with increased hardness, for example, a solid preparation
which does not crack or chip when it is formulated, transferred, dispensed
or administered, is obtained.
The insulin secretagogue and the polyoxyethylene sorbitan fatty acid ester
of the "layer containing an insulin secretagogue and a polyoxyethylene
sorbitan fatty acid ester" are preferably glimepiride and Polysorbate 80,
respectively.
The above-mentioned "solid preparation consisting of a layer containing an
insulin sensitizer and a layer containing an insulin secretagogue and a
polyoxyethylene sorbitan fatty acid ester" is preferably a solid
preparation (preferably a layered tablet) obtained by the above 5).
The solid preparation of the present invention can be orally or
parenterally administered to mammals (for example, mice, rats, rabbits,
cats, dogs, bovines, horses, monkeys, human being, and others) safely.
The solid preparation of the present invention is useful as a preventing
and treating agent for, for example, diabetes (e.g., type 1 diabetes, type
2 diabetes, gestational diabetes, etc.), hyperlipemia (e.g.,
hypertriglyceridemia, hypercholesterolemia, hypo-high density
lipoproteinemia, postprandial hyperlipemia, etc.), impaired glucose
tolerance (IGT), diabetic complications [e.g., neuropathy, nephropathy,
retinopathy, cataract, macroangiopathy, osteopenia, diabetic hyperosmolar
coma, infections (e.g., respiratory tract infection, urinary tract
infection, alimentary canal infection, dermal soft tissue infection,
inferior limb infection, etc.), diabetic gangrene, xerostomia, hypacusis,
cerebrovascular disorder, peripheral blood circulation disorder, etc.],
obesity, osteoporosis, cachexia (e.g., cancerous cachexia, tuberculous
cachexia, diabetic cachexia, hemopathic cachexia, endocrinopathic cachexia,
infectious cachexia, or AIDS-induced cachexia), fatty liver, hypertension,
polycystic ovary syndrome, renal diseases (e.g., diabetic nephropathy,
glomerulonephritis, glomerulosclerosis, nephrotic syndrome, hypertensive
nephrosclerosis, end-stage renal diseases, etc.), muscular dystrophy,
myocardial infarction, angina pectoris, cerebrovascular disorder (e.g.,
cerebral infarction, cerebral stroke), insulin resistant syndrome,
syndrome X, dysmetabolic syndrome, hyperinsulinemia, hyperinsulinemia-induced
sensory disorder, tumors (e.g., leukemia, breast cancer, prostate cancer,
skin cancer, etc.), irritable bowel syndrome, acute/chronic diarrhea,
inflammatory diseases [e.g., Alzheimer's disease, chronic rheumatoid
arthritis, spondylitis deformans, arthritis deformans, lumbago, gout,
postoperative or traumatic inflammation, swelling, neuralgia, pharyngitis,
cystitis, hepatitis (including non-alcoholic fatty hepatitis), pneumonia,
pancreatitis, inflammatory colonic disease, ulcerative colitis, etc.],
visceral obesity syndrome, or arteriosclerosis (e.g., atherosclerosis,
etc.).
The solid preparation of the present invention is also useful for
secondary prevention of the above-mentioned various diseases (e.g.,
secondary prevention of cardiovascular events such as myocardial
infarction) and inhibition of progression in these diseases (e.g.,
inhibition of the progression from impaired glucose tolerance to diabetes,
or inhibition of the progression to arteriosclerosis in diabetic
patients).
A dose of the solid preparation of the present invention may be an
effective amount based on an insulin sensitizer and an insulin
secretagogue contained in said solid preparation.
The effective amount of an insulin sensitizer is usually 0.01 to 500
mg/day, preferably 0.1 to 100 mg/day per adult (60 kg body weight).
In the case where the insulin sensitizer is pioglitazone hydrochloride,
the effective amount of pioglitazone hydrochloride is usually 7.5 to 60
mg/day, preferably 15 to 60 mg/day per adult (60 kg body weight).
In the case where the insulin sensitizer is rosiglitazone maleate, the
effective amount of rosiglitazone maleate is usually 1 to 12 mg/day,
preferably 2 to 8 mg/day per adult (60 kg body weight).
The effective amount of an insulin secretagogue is usually 0.01 to 10000
mg/day, preferably 0.1 to 5000 mg/day per adult (60 kg body weight).
In the case where the insulin secretagogue is a sulfonylurea agent
(preferably glimepiride), the effective amount of a sulfonylurea agent
(preferably glimepiride) is usually 0.1 to 100 mg/day, preferably 1 to 10
mg/day per adult (60 kg body weight).
The solid preparation of the present invention is administered preferably
once or twice a day, more preferably once a day to the above-mentioned
mammals. Particularly, the solid preparation of the present invention is
preferably administered once before breakfast to the mammals.
The solid preparation of the present invention is preferably a solid
preparation containing pioglitazone hydrochloride and glimepiride, more
preferably a tablet (preferably a layered tablet) containing 30 mg of
pioglitazone hydrochloride and 2 mg of glimepiride, a tablet (preferably a
layered tablet) containing 30 mg of pioglitazone hydrochloride and 4 mg of
glimepiride, a tablet (preferably a layered tablet) containing 45 mg of
pioglitazone hydrochloride and 4 mg of glimepiride, or the like.
The solid preparation of the present invention may be used in combination
with one or more drugs (hereinafter referred to as concomitant drugs)
selected from diabetic treating agents, diabetic complication treating
agents, hyperlipemia treating agents, hypotensive drugs, anti-obesity
drugs, diuretics and antithrombotic drugs. These active components may be
low-molecular compounds or macromolecular protein, polypeptides,
antibodies, vaccines or the like. Two or more of these active components
may be mixed at an appropriate proportion for use.
The diabetic treating agents include insulin preparations (e.g.,
animal-derived insulin preparations extracted from bovine or swine
pancreas; human insulin preparations which are synthesized with genetic
engineering using Escherichia coli or yeast; insulin zinc; protamine
insulin zinc; insulin fragments or derivatives (for example, INS-1) etc.),
.alpha.-glucosidase inhibitors (e.g., voglibose, acarbose, miglitol,
emiglitate, etc.), biguanide agents [e.g., phenformin, metformin, buformin,
or their salts (e.g., hydrochloride, fumarate, succinate), etc.],
dipeptidylpeptidase IV inhibitors (e.g., NVP-DPP-278, PT-100, NVP-DPP-728,
LAF237, P32/98, P93/01, TS-021 etc.), .beta.3 agonists (e.g., CL-316243,
SR-58611-A, UL-TG-307, SB-226552, AJ-9677, BMS-196085, AZ-40140, etc.),
amylin agonists (e.g., pramlintide etc.), phosphotyrosine phosphatase
inhibitors (e.g., sodium vanadate etc.), glyconeogenesis inhibitors (e.g.,
glycogen phosphorylase inhibitors, glucose-6-phosphatase inhibitors,
glucagon antagonists, etc.), sodium-glucose cotransporter (SGLUT)
inhibitors (e.g., T-1095 etc.), 11.beta.-hydroxysteroiddehydrogenase
inhibitors (e.g., BVT-3498), adiponectin or agonists thereof, IKK
inhibitors (e.g., AS-2868), leptin sensitivity-improving agents,
somatostatin receptor agonists (e.g., compounds described in WO01/25228,
WO03/42204, WO98/44921, WO98/45285, and WO99/22735), glucokinase
activators (e.g., Ro-28-1675) and the like.
The diabetic complication treating agents include aldose reductase
inhibitors (e.g., tolrestat, epalrestat, zenarestat, zopolrestat,
minalrestat, fidarestat (SNK-860), CT-112, etc.), neurotrophic factors
(e.g., NGF, NT-3, BDNF, etc.), neurotrophic factor production/secretion
promotors [e.g., neurotrophin production/secretion promotors described in
WO01/14372, for example,
4-(4-chlorophenyl)-2-(2-methyl-1-imidazolyl)-5-(3-(2-methylphenoxy)propyl-
)oxazole) etc.], PKC inhibitors (e.g., ruboxistaurin mesylate (LY-333531)
etc.), AGE inhibitors (e.g., ALT946, pimagedine, piratoxathin, N-phenacylthiazolium
bromide (ALT766), EXO-226, ALT-711, pyridorin, pyridoxamine etc.),
reactive oxygen scavengers (e.g., thioctic acid etc.), cerebral
vasodilators (e.g., tiapride, mexiletine, etc.), somatostatin receptor
agonists (e.g., BIM23190), and apoptosis signal regulating kinase-1
(ASK-1) inhibitors.
The hyperlipemia treating agents include HMG-CoA reductase inhibitors
(e.g., pravastatin, simvastatin, lovastatin, atorvastatin, fluvastatin,
lipantil, cerivastatin, itavastatin (pitavastatin), rosuvastatin (ZD-4522)
or their salts (sodium salts, calcium salts, etc.) etc.), fibrate
compounds (e.g., benzafibrate, beclobrate, binifibrate, ciprofibrate,
clinofibrate, clofibrate, clofibric acid, etofibrate, fenofibrate,
gemfibrozil, nicofibrate, pirifibrate, ronifibrate, simfibrate,
theofibrate, etc.), squalene synthase inhibitors (e.g., the compounds
described in WO97/10224, for example,
1-[[(3R,5S)-1-(3-acetoxy-2,2-dimethylpropyl)-7-chloro-5-(2,3-dimethoxyphe-
nyl)-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepine-3-yl]acetyl]piperidine-4-a-
cetic acid, etc.), ACAT inhibitors (e.g., Avasimibe, Eflucimibe, etc.),
anion-exchange resins (e.g., cholestyramine etc.), probucol, nicotinic
acid drugs (e.g., nicomol, niceritrol, etc.), ethyl icosapentate,
phytosterol (e.g., soysterol), .gamma.-oryzanol, etc.), and the like.
The hypotensive drugs include angiotensin converting enzyme inhibitors
(e.g., captopril, enalapril, delapril, etc.), angiotensin II antagonists
(e.g., candesartan, cilexetil, losartan, eprosartan, valsartan,
telmisartan, irbesartan, tasosartan, olmesartan medoxomil,
1-[[2'-(2,5-dihydro-5-oxo-4H-1,2,4-oxadiazol-3-yl)biphenyl-4-yl]methyl]-2-
-ethoxy-1H-benzimidazole-7-carboxylic acid, etc.), calcium antagonists
(e.g., manidipine, nifedipine, nicardipine, amlodipine, efonidipine,
etc.), potassium channel openers (e.g., levcromakalim, L-27152, AL 0671,
NIP-121, etc.), clonidine and the like.
The anti-obesity drugs include anti-obesity drugs acting on the central
nervous system [e.g., dexfenfluramine, fenfluramine, phentermine,
sibutramine, amphepramone, dexanphetamine, mazindol, phenylpropanolamine,
clobenzorex; MCH receptor antagonists (e.g., SB-568849, SNAP-7941,
compounds described in WO01/82925 and WO01/87834) etc.); neuropeptide Y
antagonists (e.g., CP-422935); cannabinoid receptor antagonists (e.g.,
SR-141716, SR-147778); ghrelin antagonists;
11.beta.-hydroxysteroiddehydrogenase inhibitors (e.g., BVT-3498), etc.],
pancreatic lipase inhibitors (e.g., orlistat, ATL-962 etc.), .beta.3
agonists (e.g., CL-316243, SR-58611-A, UL-TG-307, SB-226552, AJ-9677,
BMS-196085, AZ-40140, etc.), peptidic anorectics (e.g., leptin, CNTF (ciliary
neurotrophic factors), etc.), cholecystokinin agonists (e.g., lintitript,
FPL-15849, etc.), feeding inhibitors (e.g., P-57) and the like.
The diuretics include xanthine derivatives (e.g., sodium salicylate
theobromine, calcium salicylate theobromine, etc.), thiazide agents (e.g.,
ethiazide, cyclopenthiazide, trichlormethiazide, hydrochlorothiazide,
hydroflumethiazide, benzylhydrochlorothiazide, penflutizide, polythiazide,
methyclothiazide, etc.), anti-aldosterone drugs (e.g., spironolactone,
triamterene, etc.), carbonic anhydrase inhibitors (e.g., acetazolamide,
etc.), chlorobenzenesulfonamide drugs (e.g., chlorthalidone, mefruside,
indapamide, etc.), azosemide, isosorbide, etacrynic acid, piretanide,
bumetanide and furosemide.
The antithrombotic drugs include heparin (e.g., heparin sodium, heparin
calcium, dalteparin sodium, etc.), warfarin (e.g., warfarin potassium
etc.), anti-thrombin agents (e.g., aragatroban etc.), thrombolytic agents
(e.g., urokinase, tisokinase, alteplase, nateplase, monteplase,
pamiteplase, etc.), platelet aggregation inhibitors (e.g., ticlopidine
hydrochloride, etc.), cilostazol, ethyl icosapentate, beraprost sodium and
sarpogrelate hydrochloride and the like.
The timing of administration of the solid preparation of the present
invention and a concomitant drug is not limited and they may be
administered simultaneously or at staggered times. Alternatively, a single
dosage form containing the solid preparation of the present invention and
a concomitant drug may be administered to a subject.
A dose of a concomitant drug can be selected appropriately based on the
clinical dose. The combination ratio between the solid preparation of the
present invention and a concomitant drug can be selected appropriately
depending on a subject to be administered, an administration route,
disease to be treated, symptoms and a combination of drugs. In the case
where a subject to be administered is a human, 0.01 to 100 parts by weight
of a concomitant drug may be used per 1 part by weight of the solid
preparation.
Thus, by using a concomitant drug, superior effects such as 1) enhanced
actions of the solid preparation of the present invention and a
concomitant drug (synergistic action of the drugs), 2) reduced doses of
the solid preparation of the present invention or a concomitant drug
(reduction in doses compared with those when they are administered
individually) and 3) reduced adverse effects of the solid preparation of
the present invention and a concomitant drug can be obtained.
Claim 1 of 5 Claims
1. A solid preparation comprising a layer
containing pioglitazone or a salt thereof; and a layer containing
glimepiride and a Polysorbate 80, wherein the content of Polysorbate 80 is
0.01 to 30 parts by weight based on 100 parts by weight of the solid
preparation. ____________________________________________
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