U.S. patent application number 10/890763 was filed with the patent office on 2006-01-05 for abuse-proofed oral dosage form.
Invention is credited to Johannes Bartholomaus, Heinrich Kugelmann.
Application Number | 20060002860 10/890763 |
Document ID | / |
Family ID | 35508085 |
Filed Date | 2006-01-05 |
United States Patent
Application |
20060002860 |
Kind Code |
A1 |
Bartholomaus; Johannes ; et
al. |
January 5, 2006 |
Abuse-proofed oral dosage form
Abstract
The present invention relates to an abuse-proofed, oral dosage
form with controlled opioid-release for once daily administration,
characterised in that it comprises at least one opioid with
potential for abuse (A), at least one synthetic or natural polymer
(C), optionally delayed-release matrix auxiliary substances,
physiologically acceptable auxiliary substances (B), optionally a
wax (D) and optionally at least one delayed-release coating,
component (C) or (D) in each case exhibiting a breaking strength of
at least 500 N, preferably of at least 1000 N.
Inventors: |
Bartholomaus; Johannes;
(Aachen, DE) ; Kugelmann; Heinrich; (Aachen,
DE) |
Correspondence
Address: |
PERMAN & GREEN
425 POST ROAD
FAIRFIELD
CT
06824
US
|
Family ID: |
35508085 |
Appl. No.: |
10/890763 |
Filed: |
July 14, 2004 |
Current U.S.
Class: |
424/10.1 ;
514/282 |
Current CPC
Class: |
A61K 9/0002 20130101;
A61K 31/485 20130101; A61K 9/2013 20130101; A61P 25/04 20180101;
A61K 9/2031 20130101; A61K 9/2027 20130101; A61K 9/2893 20130101;
A61K 9/2054 20130101; A61K 9/28 20130101; A61K 9/2095 20130101;
A61K 9/0053 20130101; A61K 9/2068 20130101 |
Class at
Publication: |
424/010.1 ;
514/282 |
International
Class: |
A61K 49/00 20060101
A61K049/00; A61K 31/485 20060101 A61K031/485 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 1, 2004 |
DE |
10 2004 032 049.7 |
Claims
1. An abuse-proofed oral dosage form with controlled opioid release
for once daily administration, characterised in that it comprises
at least one opioid with potential for abuse (A) and/or one of the
physiologically acceptable compounds thereof, at least one
synthetic or natural polymer (C), optionally delayed-release
auxiliary substances, optionally physiologically acceptable
auxiliary substances (B), optionally a wax (D) and optionally at
least one delayed-release coating, component (C) or (D) in each
case exhibiting a breaking strength of at least 500 N, preferably
of at least 1000 N.
2. A dosage form according to claim 1, characterised in that the
opioid is at least one opioid selected from among the group
comprising oxycodone, hydromorphone, morphine, tramadol, the
stereoisomers thereof, the enantiomers thereof, the diastereomers
thereof in any desired mixtures, the physiologically acceptable
compounds thereof, preferably salts and solvates and the
derivatives thereof, preferably esters or ethers.
3. A dosage form according to claim 1, characterised in that, the
opioid used was at least one opioid selected from among the group
comprising
(2R,3R)-1-dimethylamino-3-(3-methoxyphenyl)-2-methyl-pentan-3-ol,
(1RS,3RS,6RS)-6-dimethylaminomethyl-1-(3-methoxyphenyl)-cyclohexane-1,3-d-
iol, (1RS,2RS)-3-(2-dimethylaminomenthyl-cyclohexyl)phenol, the
physiologically acceptable salts thereof, preferably
hydrochlorides, physiologically acceptable enantiomers,
stereoisomers, diastereoisomers and racemates and the
physiologically acceptable derivatives thereof, preferably ethers,
esters or amides.
4. A dosage form according to claim 1, characterised in that it is
in the form of a tablet.
5. A dosage form according to claim 1, characterised in that it is
in multiparticulate form, preferably in the form of microtablets,
micropellets, granules, spheroids, beads or pellets, optionally
press-moulded into tablets or packaged in capsules.
6. A dosage form according to claim 1, characterised in that the
polymer (C) is at least one polymer selected from among the group
comprising polyethylene oxides, polyethylenes, polypropylenes,
polyvinyl chlorides, polycarbonates, polystyrenes, polyacrylates,
and the copolymers thereof, preferably a polyethylene oxide.
7. A dosage form according to claim 6, characterised in that the
polyethylene oxide is of high molecular weight.
8. A dosage form according to claim 6, characterised in that the
polymer (C) is a water-soluble or water-swellable polymer.
9. A dosage form according to claim 1, characterised in that the
wax (D) is at least one natural, semi-synthetic or synthetic was
with a softening point of =60.degree. C.
10. A dosage form according to claim 9, characterised in that the
wax (D) is carnauba wax or beeswax.
11. A dosage form according to claim 1, characterised in that the
component(s) (C) and optionally (D) are present in such quantities
that the dosage form exhibits a breaking strength of at least 500
N, preferably of 1000 N.
12. A dosage form according to claim 1, characterised in that the
active ingredient is present in a delayed-release matrix.
13. A dosage form according to claim 1, characterised in that
component (C) and/or component (D) also serves as an additional
delayed-release component.
14. A dosage form according to claim 1, characterised in that it
comprises a delayed-release coating.
15. A dosage form according to claim 1, characterised in that it
comprises at least one of the following components (a)-(f) as the
auxiliary substance (B): (a) at least one substance which irritates
the nasal passages and/or pharynx, (b) at least one
viscosity-increasing agent, which, with the assistance of a
necessary minimum quantity of an aqueous liquid, preferably as an
aqueous extract obtained from the dosage form, forms a gel which
preferably remains visually distinguishable when introduced into a
further quantity of an aqueous liquid, (c) at least one antagonist
for each of the opioids with potential for abuse, (d) at least one
emetic, (e) at least one dye as an aversive agent, (f) at least one
bitter substance.
16. A dosage form according to claim 1, characterised in that it
comprises as the viscosity-increasing agent at least one polymer
selected from among the group comprising carboxymethylcellulose
sodium, polyacrylic acid, locust bean flour, pectin, waxy maize
starch, alginate, guar flour, iota-carrageenan, karaya gum, gellan
gum, galactomannan, tara stone flour, propylene glycol alginate,
hyaluronate, tragacanth, tara gum, fermented polysaccharide welan
gum and xanthan.
17. A dosage form according to claim 1, characterised in that
component (C) serves as an additional viscosity-increasing
agent.
18. A process for the production of a dosage form according to
claim 1, characterised in that (1) components (A), (C), optionally
(B) and optionally (D) and optionally delayed-release matrix
compounds are mixed and (2) the resultant mixture, optionally after
pelletisation, is formed into the dosage form by application of
force optionally with preceding or simultaneous exposure to heat
and is optionally provided with a delayed-release coating.
19. A process according to claim 18, characterised in that
pelletisation is performed by a melt method.
20. A process according to claim 18, characterised in that
pelletisation is performed by wet method.
21. A process for the production of a dosage form according to
claim 1, characterised in that (1) a mixture containing components
(A), (C), optionally (B) and optionally (D) and optionally
delayed-release matrix compounds is formed into formed articles by
application of force, (2) the formed articles obtained are
optionally singulated and optionally in each case graded by size
and (3) after or during heating to at least the softening point of
component (C), the formed articles are exposed to force until the
formed articles exhibit breaking hardness of at least 500 N,
preferably of 1000 N, (4) are optionally provided with an
optionally delayed-release coating and the formed articles are
optionally all mixed together again.
22. A dosage form obtainable by processes according to claim 18.
Description
[0001] The present invention relates to an abuse-proofed oral
dosage form with controlled opioid release for once daily
administration, comprising at least one opioid with potential for
abuse (A), at least one synthetic or natural polymer (C),
optionally delayed-release matrix auxiliary substances, optionally
physiologically acceptable auxiliary substances (B), optionally a
wax (D) and optionally a delayed-release coating, component (C) or
(D) in each case exhibiting a breaking strength of at least 500 N,
preferably of 1000 N.
[0002] The name opioids is taken according to the invention to mean
compounds which interact with at least one opioid receptor. In
particular, with the exception of
(1R,2R)-3-(3-dimethylamino-1-ethyl-2-methyl-propyl)phenol, the
physiologically acceptable salts or derivatives thereof, opioids
are taken to mean those compounds which exhibit a potential for
abuse.
[0003] Preferably, opioids are used for combatting pain. To this
end, analgesics are frequently used in long-term treatment, for
example in the case of chronic pain or pain caused by tumours. In
long-term treatment, in particular, it is important to enable the
patient to enjoy a good quality of life. The measures which improve
the quality of life of a patient include dosage forms which allow
once daily administration. However, because of the relatively large
quantity of opioid, such dosage forms, which provide delayed
release of the active ingredient, are particularly attractive to
the abuser who wishes to induce the desired state of narcosis or
euphoria as quickly as possible.
[0004] Since, however, delayed-release dosage forms containing
opioids with potential for abuse do not usually give rise to the
kick desired by the abuser when taken orally even in abusively high
quantities, these dosage forms for example in the form of tablets
or capsules are also comminuted, e.g. ground, and sniffed by the
abuser for the purpose of abuse or the active ingredients are
extracted from the powder obtained in this way by means of an
aqueous liquid and the resultant solution is administered
parenterally, in particular intravenously, optionally after
filtration through cotton wool or cellulose wadding. This type of
administration produces even more accelerated increase in opioid
levels than with oral or nasal abuse, with the result desired by
the abuser, namely the "kick" or "rush".
[0005] U.S. Pat. No. 4,070,494 proposed adding a swellable agent to
the dosage form in order to prevent abuse. When water is added to
extract the opioid, this agent swells and ensures that the filtrate
separated from the gel contains only a small quantity of active
ingredient.
[0006] The multilayer tablet disclosed in WO 95/20947 is based on a
similar approach to preventing parenteral abuse, said tablet
containing the opioid with potential for abuse and at least one gel
former, each in different layers.
[0007] WO 03/015531 A2 discloses another approach to preventing
parenteral abuse. A dosage form containing an analgesic opioid and
a dye as an aversive agent is described therein. The colour
released by tampering with the dosage form is intended to
discourage the abuser from using the dosage form which has been
tampered with. Another known option for complicating abuse involves
adding to the dosage form an antagonist to the opioid, such as for
example naloxone or naltexone, or compounds which cause a
physiological defence response, such as for example ipecacuanha
(ipecac) root, or bitter substances.
[0008] However, since in most cases of abuse of dosage forms with
delayed-release of an opioid, it is still necessary to pulverise
the dosage form, it was the object of the present invention to
complicate or prevent the pulverisation preceding abuse of the
dosage form comprising the means conventionally available for
potential abuse and accordingly to provide a dosage form with
controlled release of opioids with potential for abuse which
ensures the desired therapeutic effect when correctly administered
once daily, but from which the opioids cannot be converted into a
form suitable for abuse simply by pulverisation.
[0009] This object was achieved by the preparation of the
abuse-proofed oral dosage form, according to the invention, with
controlled release of at least one opioid for once daily
administration, which dosage form comprises, in addition to at
least one opioid and/or at least one of the physiologically
acceptable compounds thereof, preferably salts or derivatives,
preferably esters or ethers, with potential for abuse (A), at least
one synthetic or natural polymer (C), optionally delayed-release
matrix auxiliary substances, optionally physiologically acceptable
auxiliary substances (B), optionally a wax (D), and optionally at
least one delayed-release coating, component (C) or (D) in each
case exhibiting a breaking strength of at least 500 N, preferably
of 1000 N.
[0010] By using components (C) and optionally (D) with the stated
minimum breaking strength, preferably in such quantities that the
dosage form also exhibits such a minimum breaking strength,
pulverisation of the dosage form with conventional means and thus
subsequent abuse, preferably nasal or parenteral abuse, may be
complicated considerably or prevented.
[0011] Preferably, the components (C) and optionally (D) are
present in such quantities that the dosage form exhibits a breaking
strength of at least 500 N, preferably of at least 1000 N.
[0012] Without sufficient comminution of the dosage form,
non-hazardous parenteral, in particular intravenous or nasal
administration is impossible or extraction of the active ingredient
takes the abuser too long, or no or an inadequate kick is obtained
on abusive oral administration, since spontaneous release does not
occur.
[0013] According to the invention, comminution is taken to mean
pulverisation of the dosage form with conventional means which are
available to an abuser, such as for example a pestle and mortar, a
hammer, a mallet or other usual means for pulverisation by
application of force.
[0014] The dosage form according to the invention is thus suitable
for preventing parenteral, nasal and/or oral abuse of opioids with
potential for abuse.
[0015] Opioids with potential for abuse are known to the person
skilled in the art, as are the dosages thereof to be used and
processes for the production thereof, and may be present in the
dosage form according to the invention as such, in the form of the
corresponding derivatives thereof, in particular esters or ethers,
or in each case in the form of corresponding physiologically
acceptable compounds, in particular in the form of the salts or
solvates thereof, as racemates or stereoisomers. The dosage form
according to the invention is also suitable for the administration
of a plurality of opioids. Preferably it is used to administer to
humans or mammals, preferably to humans, a particular opioid for
combatting pain for a duration of at least 24 hours.
[0016] The dosage forms according to the invention are very
particularly suitable for preventing the abuse of an opioid which
is selected from the group consisting of
N-{1-[2-(4Ethyl-5-oxo-2-tetrazolin-1-yl)ethyl]-4-methoxymethyl-4-piperidy-
l}propionanilide (alfentanil), allylprodine, alphaprodine,
anileridine, bemidone, benzylmorphine, bezitramide,
17-cyclopropylmethyl-4,5a-epoxy-7a[(S)-1-hydroxy-1,2,2-trimethyl-propyl]--
6-methoxy-6,14-endoethanomorphinan-3-ol (buprenorphine),
butorphanol, carfentanil, clofedanol, clonitazene,
(-)methyl-[3.beta.-benzoyloxy-2.beta.(1aH,5aH)-tropane carboxylate]
(cocaine), 4,5a-epoxy-3-methoxy-17-methyl-7-morphinen-6a-ol
(codeine), desomorphine, dextromoramide,
(+)-(1-benzyl-3-dimethylamino-2-methyl-1-phenylpropyl)propionate
(dextropropoxyphene), dezocine, diampromide, diamorphone,
4,5a-epoxy-3methoxy-17-methyl-6a-morphinanol (dihydrocodeine),
4,5a-epoxy-17-methyl-3,6a-morphinandiol (dihydromorphine),
dimenoxadol, dimephetamol, dimethylthiambutene, dioxaphetyl
butyrate, dipipanone, dihydromorphone, eptazocine, ethoheptazine,
ethylmethylthiambutene,
4,5a-epoxy-3-ethoxy-17-methyl-7-morphinen-6a-ol (ethylmorphine),
etonitazene,
4,5-epoxy-7-(1-hydroxy-1-methylbutyl)-6-methoxy-17-methyl-6,14-endo-ethen-
o-morphinan-3-ol (etorphine), fenpipramide,
N-(1-phenethyl-4-piperidyl)propionanilide (fentanyl), heroin,
4,5-epoxy-3-methoxy-17-methyl-6-morphinanone (hydrocodone),
4,5a-epoxy-3-hydroxy-17-methyl-6-morphinanone (hydromorphone),
hydroxypethidine, isomethadone, hydroxymethylmorphinan,
1-[4-(3-hydroxyphenyl)-1-methyl-4-piperidyl]-1-propanone
(ketobemidone), (3S,6S)-6-dimethylamino-4,4-diphenylheptan-3-yl
acetate (levacetylmethadol),
(-)-6-dimethylamino-4,4-diphenol-3-heptanone (levomethadone),
(-)-17-methyl-3-morphinanol (levorphanol), levophenacylmorphane,
levoxemacin, lofentanil, meperidine, 2-methyl-2-propyltrimethylene
dicarbamate, meptazinol, metazocine, methadone, methylmorphine,
metapon, 3-methylfentanyl, 4-methylfentanyl,
4,5a-epoxy-17-methyl-7-morphinen-3,6a-diol (morphine), myrophine,
nalbuphene, nalorphine, narceine, nicomorphine,
6-dimethylamino-4,4-diphenyl-3-hexanone (normethadone),
normorphine, norpipanone, the exudation from plants belonging to
the species Papaver somniferum (opium),
4,5a-epoxy-14hydroxy-3-methoxy-17-methyl-6-morphinanone
(oxycodone), oxymorphone, plants and parts of plants belonging to
the species Papaver somniferum (including the subspecies setigerum)
(Papaver somniferum), papaveretum,
1,2,3,4,5,6-hexahydro4,11-dimethyl-3-(3-methyl-2-butenyl)-2,6-methano-3-b-
enzazocin-8-ol (pentazocine),
ethyl-(1-methyl-4-phenyl-4-piperidinecarboxylate) (pethidine),
phenadoxone, phenomorphane, phenazocine, phenoperidine, piminodine,
pholcodeine,
1'-3-cyano-3,3-diphenylpropyl)[1,4'-bipiperidine]-4'-carboxamide
(piritramide), proheptazine, promedol, properidine, propoxyphene,
methyl
{3-[4-methoxycarbonyl-4-(N-phenylpropanamido)piperidino]-propanoate)
(remifentanil),
N-{4-methoxymethyl-1-[2-(2-thienyl)ethyl]-4-piperidyl}propionanilide
(sufentanil), ethyl
(2-dimethylamino-1-phenyl-cyclohexene-1-carboxylate) (tilidine, cis
and trans), tramadol,
(1R,2R,4S)-2-(dimethylamino)methyl-4-(p-fluorobenzyloxy)-1-(m-methoxyphen-
yl)cyclohexanol,
(1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl)phenol,
(1S,2S)-3(3-dimethylamino-1-ethyl-2-methyl-propyl)phenol,
(2R,3R)-1-dimethylamino-3(3-methoxyphenyl)-2-methyl-pentan-3-ol,
(1RS,3RS,6RS)-6-dimethylaminomethyl-1-(3-methoxyphenyl)-cyclohexane-1,3-d-
iol, preferably as racemate,
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)phenyl
2-(4isobutoxy-phenyl)propionate,
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)phenyl
2-(6-methoxy-naphthalen-2-yl)propionate,
3-(2-dimethylaminomethyl-cyclohex-1-enyl)-phenyl
2-(4isobutyl-phenyl)propionate,
3-(2-dimethylaminomethyl-cyclohex-1-enyl)-phenyl
2-(6-methoxy-naphthalen-2-yl)propionate,
(RR-SS)-2-acetoxy-4-trifluoromethyl-benzoic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)phenyl ester,
(RR-SS)-2-hydroxy-4-trifluoromethyl-benzoic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)phenyl ester,
(RR-SS)-4-chloro-2-hydroxy-benzoic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexylphenyl ester,
(RR-SS)-2-hydroxy-4-methyl-benzoic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)-phenyl ester,
(RR-SS)-2-hydroxy-4-methoxy-benzoic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)-phenyl ester,
(RR-SS)-2-hydroxy-5-nitro-benzoic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)-phenyl ester,
(RR-SS)-2',4'-difluoro-3-hydroxy-biphenyl-4-carboxylic acid
3-(2-dimethylaminomethyl-1-hydroxy-cyclohexyl)-phenyl ester
together with corresponding stereoisomeric compounds, in each case
the corresponding derivatives thereof, in particular amides, esters
or ethers, and in each case the physiologically acceptable
compounds thereof, in particular the salts and solvates thereof,
particularly preferably hydrochlorides.
[0017] The dosage form according to the invention is particularly
suitable for preventing abuse of an opioid active ingredient
selected from among the group comprising oxycodone, hydromorphone,
morphine, tramadol and the physiologically acceptable derivatives
or compounds thereof, preferably the salts and solvates thereof,
preferably the hydrochlorides thereof.
[0018] Furthermore, the dosage form according to the invention is
particularly suitable for preventing the abuse of an opioid active
ingredient selected from among the group comprising
(2R,3R)-1-dimethylamino-3(3-methoxyphenyl)-2-methyl-pentan-3-ol,
(1RS,3RS,6RS)-6-dimethylaminomethyl-1-(3-methoxy-phenyl)-cyclohexane-1,3
diol, (1R,2R)-3-(2dimethylaminomethyl-cyclohexyl)phenol, the
physiologically acceptable salts thereof, preferably
hydrochlorides, physiologically acceptable enantiomers,
stereoisomers, diastereomers and racemates and the physiologically
acceptable derivatives thereof, preferably ethers, esters or
amides.
[0019] These compounds and the process for the production thereof
are described in EP-A-693475 and EP-A-780369 respectively. The
corresponding descriptions are hereby introduced as a reference and
are deemed to be part of the disclosure.
[0020] The dosage in the delayed-release dosage form is selected
such that once daily administration is ensured. The corresponding
dosages are known to the person skilled in the art.
[0021] In order to achieve the necessary breaking strength of the
dosage form according to the invention, at least one synthetic,
semi-synthetic or natural polymer (C) is used which has a breaking
strength, measured using the method disclosed in the present
application, of at least 500 N, preferably of 1000 N. Preferably,
at least one polymer is selected for this purpose from among the
group comprising polyalkylene oxides, preferably polymethylene
oxides, polyethylene oxides, polypropylene oxides, polyolefins,
preferably polyethylenes, polypropylenes, polyvinyl chlorides,
polycarbonates, polystyrenes, polymethacrylates, the copolymers
thereof, and mixtures of at least two of the stated polymer classes
or polymers. Particularly preferably, a water-soluble or
water-swellable polymer is used. The polymers are distinguished by
a molecular weight of at least 0.5 million, preferably of at least
1 million to 15 million, determined by Theological measurement.
Particularly preferably suitable are thermoplastic polyalkylene
oxides, such as polyethylene oxides, with a molecular weight of at
least 0.5 million, preferably of at least 1 million to 15 million,
determined by rheological measurement. The polyethylene oxides have
a viscosity at 25.degree. C. of 4500 to 17600 cP, measured on a 5
wt. % aqueous solution using a model RVF Brookfield viscosimeter
(spindle no. 2/rotational speed 2 rpm), of 400 to 4000 cP, measured
on a 2 wt. % aqueous solution using the stated viscosimeter (but
with spindle no. 1 or 3/rotational speed 10 rpm) or of 1650 to
10000 cP, measured on a 1 wt. % aqueous solution using the stated
viscosimeter (but with spindle no. 2/rotational speed 2 rpm).
[0022] The polymers are preferably used as powder to produce the
dosage form according to the invention.
[0023] Moreover, in addition to the above-stated polymers, at least
one natural, semi-synthetic or synthetic wax (D) with a breaking
strength, measured using the method disclosed in the present
application, of at least 500 N. preferably of 1000 N, may
additionally be used to achieve the necessary breaking strength of
the dosage form according to the invention. Waxes with a softening
point of at least 60.degree. C. are preferred. Carnauba wax and
beeswax are particularly preferred. Carnauba wax is very
particularly preferred. Carnauba wax is a natural wax which is
obtained from the leaves of the carnauba palm and has a softening
point of at most 90.degree. C. When additionally using the wax
component, the latter is used together with at least one polymer
(C), preferably a polyethylene oxide, in such quantities that the
dosage form-exhibits a breaking strength of at least 500 N,
preferably of 1000 N, measured using the method stated in the
present application.
[0024] The dosage forms according to the invention are
distinguished in that, they cannot be pulverised using conventional
comminution tools, such as grinders, due to their hardness. Oral,
parenteral, in particular intravenous, or nasal abuse is
complicated a very great deal thereby, if not ruled out altogether.
However, in order to prevent any possible abuse of the dosage forms
according to the invention, in a preferred embodiment, the dosage
forms according to the invention may contain further
abuse-complicating or -preventing agents as auxiliary substances
(B).
[0025] Thus, the abuse-proofed dosage form according to the
invention may comprise, in addition to at least one opioid, at
least one polymer (C) and optionally at least one wax (D), at least
one of the following components (a)4f) as auxiliary substances (B):
[0026] (a) at least one substance which irritates the nasal
passages and/or pharynx, [0027] (b) at least one
viscosity-increasing agent, which, with the assistance of a
necessary minimum quantity of an aqueous liquid, preferably as an
aqueous extract obtained from the dosage form, forms a gel which
preferably remains visually distinguishable when introduced into a
further quantity of an aqueous liquid, [0028] (c) at least one
antagonist for the present opioids with potential for abuse, [0029]
(d) at least one emetic, [0030] (e) at least one dye as an aversive
agent, [0031] (f) at least one bitter substance.
[0032] The components (a) to (f) are each suitable on their own as
additional protection of the dosage form according to the invention
against abuse. Accordingly, component (a) is preferably suitable
for proofing the dosage form against nasal, oral and/or parenteral,
preferably intravenous, abuse, component (b) is preferably suitable
for proofing against parenteral, particularly preferably
intravenous and/or nasal abuse, component (c) is preferably
suitable for proofing against nasal and/or parenteral, particularly
preferably intravenous, abuse, component (d) is preferably suitable
for proofing against parenteral, particularly preferably
intravenous, and/or oral and/or nasal abuse, component (e) is
suitable as a visual deterrent against oral or parenteral abuse and
component (f) is suitable for proofing against oral or nasal abuse.
Through the co-use of at least one of the above-stated components,
it is possible to complicate abuse even more effectively for the
dosage forms according to the invention.
[0033] In one embodiment, the dosage form according to the
invention may also comprise two or more of components (a)-(f) in a
combination, preferably in the combinations (a), (b) and optionally
(c) and/or (f) and/or (e) or (a), (b) and optionally (d) and/or (f)
and/or (e).
[0034] In another embodiment, the dosage form according to the
invention may comprise all of components (a)-(f).
[0035] If the dosage form according to the invention comprises
component (a) as additional protection against abuse, substances
which irritate the nasal passages and/or pharynx which may be
considered according to the invention are any substances which,
when administered via the nasal passages and/or pharynx, bring
about a physical reaction which is either so unpleasant for the
abuser that he/she does not wish to or cannot continue
administration, for example burning, or physiologically counteracts
taking of the corresponding opioid(s) and/or opiate(s), for example
due to increased nasal secretion or sneezing. These substances
which conventionally irritate the nasal passages and/or pharynx may
also bring about a very unpleasant sensation or even unbearable
pain when administered parenterally, in particular intravenously,
such that the abuser does not wish to or cannot continue taking the
substance.
[0036] Particularly suitable substances which irritate the nasal
passages and/or pharynx are those which cause burning, itching, an
urge to sneeze, increased formation of secretions or a combination
of at least two of these stimuli. Appropriate substances and the
quantities thereof which are conventionally to be used are known
per se to the person skilled in the art or may be identified by
simple preliminary testing.
[0037] The substance which irritates the nasal passages and/or
pharynx of component (a) is preferably based on one or more
constituents or one or more plant parts of at least one hot
substance drug.
[0038] Corresponding hot substance drugs are known per se to the
person skilled in the art and are described, for example, in
"Pharmazeutische Biologie--Drogen und ihre Inhaltsstoffe" by Prof.
Dr. Hildebert Wagner, 2nd., revised edition, Gustav Fischer Verlag,
Stuttgart-New York, 1982, pages 82 et seq.. The corresponding
description is hereby introduced as a reference and is deemed to be
part of the disclosure.
[0039] One or more constituents of at least one hot substance drug
selected from the group consisting of Allii sativi bulbus (garlic),
Asari rhizoma cum herba (Asarum root and leaves), Calami rhizoma
(calamus root), Capsici fructus (capsicum), Capsici fructus acer
(cayenne pepper), Curcumae longae rhizoma (turmeric root), Curcumae
xanthorrhizae rhizoma (Javanese turmeric root), Galangae rhizoma
(galangal root), Myristicae semen (nutmeg), Piperis nigri fructus
(pepper), Sinapis albae semen (white mustard seed), Sinapis nigri
semen (black mustard seed), Zedoariae rhizoma (zedoary root) and
Zingiberis rhizoma (ginger root), particularly preferably from the
group consisting of Capsici fructus (capsicum), Capsici fructus
acer (cayenne pepper) and Piperis nigri fructus (pepper) may
preferably be added as component (a) to the dosage form according
to the invention.
[0040] The constituents of the hot substance drugs preferably
comprise o-methoxy(methyl)phenol compounds, acid amide compounds,
mustard oils or sulfide compounds or compounds derived
therefrom.
[0041] Particularly preferably, at least one constituent of the hot
substance drugs is selected from the group consisting of
myristicin, elemicin, isoeugenol, a-asarone, safrole, gingerols,
xanthorrhizol, capsaicinoids, preferably capsaicin, capsaicin
derivatives, such as N-vanillyl-9E-octadecenamide,
dihydrocapsaicin, nordihydrocapsaicin, homocapsaicin, norcapsaicin
and nomorcapsaicin, piperine, preferably trans-piperine,
glucosinolates, preferably based on non-volatile mustard oils,
particularly preferably based on p-hydroxybenzyl mustard oil,
methylmercapto mustard oil or methylsulfonyl mustard oil, and
compounds derived from these constituents.
[0042] The dosage form according to the invention may preferably
contain the plant parts of the corresponding hot substance drugs in
a quantity of 0.01 to 30 wt. %, particularly preferably of 0.1 to
0.5 wt. %, in each case relative to the total weight of the dosage
unit. If one or more constituents of corresponding hot substance
drugs are used, the quantity thereof in a dosage unit according to
the invention preferably amounts to 0.001 to 0.005 wt. %, relative
to the total weight of the dosage unit. A dosage unit is taken to
mean a separate or separable administration unit, such as for
example a tablet or a capsule.
[0043] Another option for preventing abuse of the dosage form
according to the invention consists in adding at least one
viscosity-increasing agent as a further abuse-preventing component
(b) to the dosage form, which, with the assistance of a necessary
minimum quantity of an aqueous liquid, preferably as an aqueous
extract obtained from the dosage form, forms a gel which is
virtually impossible to administer safely and preferably remains
visually distinguishable when introduced into a further quantity of
an aqueous liquid
[0044] For the purposes of the present application, visually
distinguishable means that the opioid- or opiate-containing gel
formed with the assistance of a necessary minimum quantity of
aqueous liquid, when introduced, preferably with the assistance of
a hypodermic needle, into a further quantity of aqueous liquid at
37.degree. C., remains substantially insoluble and cohesive and
cannot straightforwardly be dispersed in such a manner that it can
safely be administered parenterally, in particular intravenously.
The material preferably remains visually distinguishable for at
least one minute, preferably for at least 10 minutes.
[0045] Increasing the viscosity to a gel makes it more difficult or
even impossible for it to be passed through a needle or injected.
If the gel remains visually distinguishable, this means that the
gel obtained on introduction into a further quantity of aqueous
liquid, for example by injection into blood, initially remains in
the form of a largely cohesive thread, which, while it may indeed
be broken up mechanically into smaller fragments, cannot be
dispersed or even dissolved in such a manner that it can safely be
administered parenterally, in particular intravenously. In
combination with at least one further present component (a), (d) to
(f), this additionally leads to unpleasant burning, vomiting, bad
flavour and/or visual deterrence.
[0046] Intravenous administration of such a gel would most probably
result in obstruction of blood vessels, associated with serious
damage to the health of the abuser.
[0047] In order to verify whether a viscosity-increasing agent is
suitable as component (b) for use in the dosage form according to
the invention, the opioid(s) and/or opiate(s) is(are) mixed with
the viscosity-increasing agent and suspended in 10 ml of water at a
temperature of 25.degree. C. If this results in the formation of a
gel which fulfils the above-stated conditions, the corresponding
viscosity-increasing agent is suitable for additionally preventing
or averting abuse of the dosage forms according to the
invention.
[0048] If component (b) is added to the dosage form obtained by the
process according to the invention, preferably one or more
viscosity-increasing agents are used, which are selected from the
group comprising microcrystalline cellulose with 11 wt. %
carboxymethylcellulose sodium (Avicel.RTM. RC 591),
carboxymethylcellulose sodium (Blanose.RTM., CMC-Na C300P.RTM.,
Frimulsion BLC-5.RTM., Tylose C300 P.RTM.), polyacrylic acid
(Carbopol.RTM. 980 NF, Carbopol.RTM. 981), locust bean flour
(Cesagum.RTM. LA-200, Cesagum.RTM. LID/150, Cesagum.RTM. LN-1),
pectins, preferably from citrus fruits or apples (Cesapectin.RTM.
HM Medium Rapid Set), waxy maize starch (C*Gel 04201.RTM.), sodium
alginate (Frimulsion ALG (E401).RTM.), guar flour (Frimulsion
BM.RTM., Polygum 26/1-75.RTM.), iota-carrageenan (Frimulsion
D021.RTM.), karaya gum, gellan gum (Kelcogel F.RTM., Kelcogel
LT100.RTM.), galactomannan (Meyprogat 150.RTM.), tara stone flour
(Polygum 43/1.RTM.), propylene glycol alginate (Protanal-Ester
SD-LB.RTM.), sodium-hyaluronate, tragacanth, tara gum (Vidogum SP
200.RTM.), fermented polysaccharide welan gum (K1A96), xanthans
such as xanthan gum (Xantural 180.RTM.). Xanthans are particularly
preferred. The names stated in brackets are the trade names by
which the materials are known commercially. In general, a quantity
of 0.1 to 5 wt. %, relative to the total quantity of the dosage
form, of the stated viscosity-increasing agent(s) is sufficient to
fulfil the above-stated conditions.
[0049] The component (b) viscosity-increasing agents, where
provided, are preferably present in the dosage form according to
the invention in quantities of =5 mg per dosage unit, i.e. per
administration unit.
[0050] In a particularly preferred embodiment of the present
invention, the viscosity-increasing agents used as component (b)
are those which, preferably by extraction from the dosage form with
the necessary minimum quantity of aqueous liquid, form a gel which
encloses air bubbles. The resultant gels are distinguished by a
turbid appearance, which provides the potential abuser with an
additional optical warning and discourages him/her from
administering the gel parenterally.
[0051] The component (C) may also optionally serve as an additional
viscosity-increasing agent, which forms a gel with the assistance
of a necessary minimum quantity of aqueous liquid.
[0052] It is also possible, to arrange the viscosity-increasing
component and the other constituents of the dosage form according
to the invention spatially separately from one another.
[0053] Moreover, in order to discourage and prevent abuse, the
dosage form according to the invention may furthermore comprise
component (c), namely one or more antagonists for the opioid(s)
and/or opiate(s) with potential for abuse, wherein the antagonist
is preferably spatially separated from the remaining constituents
of the dosage form according to the invention and, when correctly
used, do not exert any effect.
[0054] Suitable antagonists for preventing the abuse of opioids are
known per se to the person skilled in the art and may be present in
the dosage form according to the invention as such or in the form
of corresponding derivatives, in particular esters or ethers, or in
each case in the form of corresponding physiologically acceptable
compounds, in particular in the form of the salts or solvates
thereof.
[0055] The antagonist used is preferably selected from the group
comprising naloxone, naltrexone, nalmefene, nalide and nalmexone,
in each case optionally in the form of a corresponding
physiologically acceptable compound, in particular in the form of a
base, a salt or solvate. The corresponding antagonists, where
component (c) is provided, are preferably used in a quantity of =1
mg, particularly preferably in a quantity of 3 to 100 mg, very
particularly preferably in a quantity of 5 to 50 mg per dosage
form, i.e. per administration unit.
[0056] The dosage form according to the invention preferably
comprises the antagonist component in a conventional therapeutic
dose known to the person skilled in the art, particularly
preferably in a quantity of twice to three times this dose per
administration unit.
[0057] If the combination for additional discouragement and
prevention of abuse of the dosage form according to the invention
comprises component (d), it may comprise at least one emetic, which
is preferably present in a spatially separated arrangement from the
other components of the dosage form according to the invention and,
when correctly used, is intended not to exert its effect in the
body.
[0058] Suitable emetics for additionally preventing abuse of an
opioid are known per se to the person skilled in the art and may be
present in the dosage form according to the invention as such or in
the form of corresponding derivatives, in particular esters or
ethers, or in each case in the form of corresponding
physiologically acceptable compounds, in particular in the form of
the salts or solvates thereof.
[0059] An emetic based on one or more constituents of ipecacuanha
(ipecac) root, preferably based on the constituent emetine may
preferably be considered for the dosage form according to the
invention, as are, for example, described in "Pharmazeutische
Biologie--Drogen und ihre Inhaltsstoffe" by Prof. Dr. Hildebert
Wagner, 2nd, revised edition, Gustav Fischer Verlag, Stuttgart, New
York 1982. The corresponding literature description is hereby
introduced as a reference and is deemed to be part of the
disclosure.
[0060] The dosage form according to the invention may preferably
comprise the emetic emetine as component (d), preferably in a
quantity of =3 mg, particularly preferably of =10 mg and very
particularly preferably in a quantity of =20 mg per dosage form,
i.e. administration unit.
[0061] Apomorphine may likewise preferably be used as an emetic for
additional abuse proofing, preferably in a quantity of preferably
=3 mg, particularly preferably of =5 mg and very particularly
preferably of =7 mg per administration unit.
[0062] If the dosage form according to the invention contains
component (e) as a further abuse-preventing auxiliary substance,
the use of such a dye brings about an intense coloration of a
corresponding aqueous solution, in particular when the attempt is
made to extract the opioid(s) for parenteral, preferably
intravenous administration, which coloration may act as a deterrent
to the potential abuser. Oral abuse, which conventionally begins by
means of aqueous extraction of the opioid(s), may also be prevented
by this coloration. Suitable dyes and the quantities required for
the necessary deterrence may be found in WO 03/015531, wherein the
corresponding disclosure should be deemed to be part of the present
disclosure and is hereby introduced as a reference.
[0063] If the dosage form according to the invention contains
component (f) as a further abuse-preventing auxiliary substance,
this addition of at least one bitter substance and the consequent
impairment of the flavour of the dosage form additionally prevents
oral and/or nasal abuse.
[0064] Suitable bitter substances and the quantities effective for
use may be found in U.S. 2003/0064099, the corresponding disclosure
of which should be deemed to be the disclosure of the present
application and is hereby introduced as a reference. Suitable
bitter substances are preferably aromatic oils, preferably
peppermint oil, eucalyptus oil, bitter almond oil, menthol, fruit
aroma substances, preferably aroma substances from lemons, oranges,
limes, grapefruit or mixtures thereof, and/or denatonium benzoate
(Bitrex.RTM.). Denatonium benzoate is particularly preferably
used.
[0065] To ensure once daily administration, the dosage form
according to the invention comprises the opioid (s) and/or
opiate(s) with potential for abuse at least in part in
delayed-release form, wherein the delayed release of the active
ingredient may be achieved with the assistance of conventional
materials and processes known to the person skilled in the art, for
example by embedding the opioid(s) in a delayed-release matrix or
by applying one or more delayed-release coatings. Opioid release
must, however, be controlled such that the abovestated conditions
are fulfilled in each case, for example that, in the event of
correct administration of the dosage form, the opioid(s) are
virtually completely released before the optionally present
component (c) and/or (d) can exert an impairing effect. In
particular, release of the opioid must ensure analgesic action for
at least 24 hours.
[0066] If release of the opioid(s) from the dosage form according
to the invention is controlled with the assistance of at least one
delayed-release coating, the delayed-release coating may consist of
conventional materials known to the person skilled in the art.
[0067] In a preferred embodiment of the dosage form according to
the invention, the delayed-release coating is preferably based on a
water-insoluble, optionally modified natural and/or synthetic
polymer or on a natural, semi-synthetic or synthetic wax or on a
fat or a fatty alcohol or on a mixture of at least two of the
above-stated components.
[0068] To produce a delayed-release coating, the water-insoluble
polymers preferably comprise poly(meth)acrylates, particularly
preferably poly(C.sub.1-4)-alkyl(meth)acrylates,
poly(C.sub.1-4)-dialkylamino-(C.sub.1-4)-alkyl(meth)acrylates
and/or the copolymers thereof, very particularly preferably
copolymers of ethyl acrylate and methyl methacrylate with a molar
ratio of monomers of 2:1 (Eudragit NE30D.RTM.), copolymers of ethyl
acrylate, methyl methacrylate and trimethylammonium methyl
methacrylate chloride with a molar ratio of monomers of 1:2:0.1
(Eudragit RS.RTM.), copolymers of ethyl acrylate, methyl
methacrylate and trimethylammonium methyl methacrylate chloride
with a molar ratio of monomers of 1:2:0.2 (Eudragit RL.RTM.) or a
mixture of at least two of these above-stated copolymers. These
coating materials are commercially obtainable as 30 wt. % aqueous
latex dispersions, i.e. as Eudragit RS30D.RTM., Eudragit NE30D.RTM.
or Eudragit RL30D.RTM. and are preferably also used as such as
coating material.
[0069] Polyvinyl acetates optionally in combination with further
auxiliary substances may likewise preferably be used as
water-insoluble polymers for the production of a delayed-release
coating for the dosage forms according to the invention. These are
commercially obtainable as aqueous dispersions containing 27 wt. %
of polyvinyl acetate, 2.5 wt. % of povidone and 0.3 wt. % of sodium
lauryl sulfate (Kollicoat SR 30 D.RTM.).
[0070] In a further preferred embodiment, the delayed-release
coatings for the dosage form according to the invention are based
on water-insoluble cellulose derivatives, preferably
alkylcelluloses such as for example ethylcellulose, or cellulose
esters, such as for example cellulose acetate. The coatings of
ethylcellulose or cellulose acetate are preferably applied from an
aqueous pseudolatex dispersion. Aqueous ethylcellulose pseudolatex
dispersions are commercially obtainable as 30 wt. % dispersions
(Aquacoat.RTM.) or as 25 wt. % dispersions (Surelease.RTM.).
[0071] If the delayed-release coating is based a water-insoluble,
optionally modified natural and/or synthetic polymer, the coating
dispersion or solution may comprise, in addition to the
corresponding polymer, a conventional physiologically acceptable
plasticiser known to the person skilled in the art, in order to
reduce the necessary minimum film temperature.
[0072] Suitable plasticisers are for example lipophilic diesters
from an aliphatic or aromatic dicarboxylic acid with
C.sub.6-C.sub.40 and an aliphatic alcohol with C.sub.1-C.sub.8,
such as for example dibutyl phthalate, diethyl phthalate, dibutyl
sebacate or diethyl sebacate, hydrophilic or lipophilic esters of
citric acid, such as triethyl citrate, tributyl citrate, acetyl
tributyl citrate or acetyl triethyl citrate, polyethylene glycols,
propylene glycol, esters of glycerol, such as for example
triacetin, Myvacet.RTM. (acetylated mono- and diglycerides,
C.sub.23H.sub.44O.sub.5 to C.sub.25H.sub.47O.sub.7), medium-chain
triglycerides (Miglyol.RTM.), oleic acid or mixtures of at least
two of the stated plasticisers. Aqueous dispersions of Eudragit
RS.RTM. and optionally Eudragit RL.RTM. preferably contain triethyl
citrate.
[0073] Preferably, a delayed-release coating for the dosage form
according to the invention contains plasticisers in quantities of 5
to 50 wt. %, particularly preferably of 10 to 40 wt. % and very
particularly preferably of 10 to 30 wt. %, relative to the quantity
of polymer used. In individual cases, for example for cellulose
acetate, it is also possible to use larger quantities of
plasticisers.
[0074] Moreover, a delayed-release coating may comprise further
conventional auxiliary substances known to the person skilled in
the art, such as for example slip agents, preferably talcum or
glycerol monostearate, colouring pigments, preferably iron oxides
or titanium dioxide, or surfactants, such as for example Tween
80.RTM..
[0075] The release profile obtained for the opioid(s) may
furthermore be adjusted by conventional options known to the person
skilled in the art, such as for example the thickness of the
coating or by the use of further auxiliary substances as
constituents of the coating. Suitable auxiliary substances are for
example hydrophilic or pH-dependent pore formers, such as for
example sodium carboxymethylcellulose, cellulose acetate phthalate,
hydroxypropylmethylcellulose acetate succinate, lactose,
polyethylene glycol or mannitol or water-soluble polymers, such as
for example polyvinylpyrrolidone or water-soluble celluloses,
preferably hydroxypropylmethylcellulose or
hydroxypropylcellulose.
[0076] The dosage forms according to the invention for release of
the oploid(s) may additionally also comprise a coating which is
resistant to gastric juices, which dissolves in pH-dependent
manner. This coating makes it possible to ensure that the dosage
forms according to the invention pass through the stomach
undissolved and the opioid(s) is(are) not released until it(they)
reach(es) the intestine.
[0077] The coating resistant to gastric juices is preferably based
on methacrylic acid/alkyl methacrylate copolymers, preferably
methyl methacrylate, such as methacrylic acid or ethylene
methacrylate copolymers with a molar ratio of the particular
monomers of 1:1 to 1:2, such as Eudragit L.RTM., Eudragit S.RTM.,
Eudragit L30D-55.RTM., Eudragit FS.RTM..
[0078] A delayed-release coating may be applied by conventional
methods known to the person skilled in the art, such as for example
by spraying of solutions, dispersions or suspensions, by melt
methods or by powder application methods. The solutions,
dispersions or suspensions may be used in the form of aqueous or
organic solutions or dispersions. Aqueous dispersions are
preferably used in this connection. Organic solvents which may be
used are alcohols, for example ethanol or isopropanol, ketones,
such as for example acetone, esters, for example ethyl acetate,
wherein alcohols and ketones are preferably used. The coating
methods are known from the prior art, for example H. Sucker, Georg
Thieme Verlag, 1991, pages 347 et seq.. They are hereby introduced
as a reference and are accordingly deemed to be part of the
disclosure.
[0079] If the dosage form according to the invention is in
multiparticulate form, the delayed-release coating is preferably
applied in such a manner that the multiparticulate forms containing
the opioid(s) are coated, after the production thereof, with the
particular polymers and optionally further auxiliary substances
from aqueous and/or organic media, preferably from aqueous media,
with the assistance of the fluidised bed method and the coating is
preferably simultaneously dried at conventional temperatures in the
fluidised bed.
[0080] A poly(meth)acrylate-based coating is preferably dried at
temperatures in the range from 30 to 50.degree. C., particularly
preferably from 35 to 45.degree. C. For cellulose-based coatings,
such as for example ethylcellulose, drying preferably proceeds at a
temperature in the range from 50 to 80.degree. C., particularly
preferably in the range from 55 to 65.degree. C. If necessary,
drying may additionally be followed by a temperature-controlled
treatment in order to obtain a stable release profile. Delayed
release of the active ingredient from the dosage form according to
the invention may also be achieved by embedding the opioid(s) in a
delayed-release matrix.
[0081] Materals which may be used for a delayed-release matrix are
preferably physiologically acceptable, hydrophilic polymers,
preferably cellulose ethers, cellulose esters and/or acrylic
resins. Ethylcellulose, hydroxypropylmethylcellulose,
hydroxypropylcellulose. hydroxyethylcellulose, methylcellulose,
poly(meth)acrylic acid and/or the derivatives thereof, such as the
salts, amides or esters thereof, are particularly preferably
used.
[0082] Where hydrophobic compounds are used as the delayed-release
matrix, fatty acids, fatty alcohols or corresponding esters or
ethers or mixtures thereof may be used. Mono- or diglycerides of
C12-C30 fatty acids and/or C12-C30 fatty alcohols and/or waxes or
mixtures thereof are particularly preferably used as hydrophobic
compounds.
[0083] It is also possible to use mixtures of the above-stated
hydrophilic and hydrophobic matrix materials.
[0084] Component (b) as a viscosity-increasing agent may preferably
also serve as a material for a delayed-release matrix, if this is
permitted by the structure of the dosage form according to the
invention.
[0085] Component (C) and the optionally present component (D),
which serve to obtain the breaking strength of at least 500 N,
preferably of 1000 N, which is necessary according to the
invention, may optionally also serve as additional delayed-release
matrix materials.
[0086] Corresponding delayed-release compounds and methods for the
delayed release of the dosage forms according to the invention and
for the application of coatings which are resistant to gastric
juices are known to the person skilled in the art, for example from
"Coated Pharmaceutical Dosage Forms--Fundamentals, Manufacturing
Techniques, Biopharmaceutical Aspects, Test Methods and Raw
Materials" by Kurt H. Bauer, K. Lehmann, Hermann P. Osterwald,
Rothgang, Gerhart, 1st edition, 1998, Medpharm Scientific
Publishers. The corresponding literature description is hereby
introduced as a reference and is deemed to be part of the
disclosure.
[0087] The dosage form according to the invention may assume
multiparticulate form, preferably the form of microtablets,
micropellets, granules, spheroids, beads or pellets, optionally
packaged in capsules or press-moulded into tablets. The
multiparticulate forms preferably have a size or size distribution
in the range from 0.1 to 3 mm, particularly preferably in the range
from 0.5 to 2 mm. Depending on the desired dosage form,
conventional auxiliary substances (B) are optionally also used for
the formulation of the dosage form.
[0088] In a particularly preferred embodiment, the dosage form
according to the invention assumes the form of a tablet, a capsule
or is in the form of an oral osmotic therapeutic system (OROS),
preferably if at least one further abuse-preventing component
(a)-(f) is also present.
[0089] The abuse-proofed, solid dosage form according to the
invention is preferably produced by mixing components (A), (C) and
optionally (D), optionally at least one of the additional
abuse-preventing components (a)-(f) and optionally further
auxiliary substances (B), in particular the delayed-release matrix
compounds, and, with preceding or simultaneous exposure to heat,
forming the resultant mixture, optionally after pelletisation, into
the dosage form by application of force.
[0090] Pelletisation may be performed by a melt method or by wet
pelletisation.
[0091] Mixing of components (A), (C) and optionally (D) and of the
optionally present further components (a)-(f) and optionally the
further auxiliary substances (B), in particular the delayed-release
matrix compounds, may proceed in a mixer known to the person
skilled in the art. The mixer may, for example, be a roll mixer,
shaking mixer, shear mixer or compulsory mixer.
[0092] The resultant mixture is preferably directly formed into the
dosage form according to the invention by application of force with
preceding or simultaneous exposure to heat. The mixture may, for
example, be formed into tablets by direct tabletting. In direct
tabletting with preceding exposure to heat, the material to be
press-moulded is heated immediately prior to tabletting at least to
the softening temperature of component (C) and then pressed.
[0093] The resultant mixture of components (A), (C), optionally
(D), the optionally present components (a) to (f) and optionally
further auxiliary substances (B), in particular the delayed-release
matrix compounds, may also first be pelletised and then formed into
the dosage form according to the invention by application of force
with preceding or simultaneous exposure to heat.
[0094] It is also possible to form the resultant mixture containing
one or more opioid(s) with potential for abuse (A) and optionally
physiologically acceptable auxiliary substances (B), such as
components (a) to (f) and optionally the delayed-release matrix
compounds and at least one synthetic or natural polymer (C) and
optionally a wax (D), into the dosage form by application of force,
optionally to singulate the formed articles and optionally in each
case to grade them by size and, after or during heating to at least
the softening point of component (C), to expose them to force until
the formed articles exhibit a breaking hardness of at least 500 N,
preferably of 1000 N, optionally to provide them with a cover,
which optionally has delayed-release properties, and optionally to
mix all the formed articles together again.
[0095] If components (c) and/or (d) and/or (f) are present in the
dosage form according to the invention, care must be taken to
ensure that they are formulated in such a manner or are present in
such a low dose that, when correctly administered, the dosage form
is able to bring about virtually no effect which impairs the
patient or the efficacy of the opioid(s).
[0096] If the dosage form according to the invention contains
component (d) and/or (f), the dosage must be selected such that,
when correctly orally administered, no negative effect is caused.
If, however, the intended dosage of the dosage form is exceeded
inadvertently, in particular by children, or in the event of abuse,
nausea or an inclination to vomit or a bad flavour are produced.
The particular quantity of component (d) and/or (f) which can still
be tolerated by the patient in the event of correct oral
administration may be determined by the person skilled in the art
by simple preliminary testing.
[0097] If, however, irrespective of the fact that the dosage form
according to the invention is virtually impossible to pulverise,
the dosage form containing the components (c) and/or (d) and/or (f)
is provided with protection, these components should preferably be
used at a dosage which is sufficiently high that, when abusively
administered, they bring about an intense negative effect on the
abuser. This is preferably achieved by spatial separation of at
least the opioid(s) from components (c) and/or (d) and/or (f),
wherein the opioid(s) is/are present in at least one subunit (X)
and components (c) and/or (d) and/or (f) is/are present in at least
one subunit (Y), and wherein, when the dosage form is correctly
administered, components (c), (d) and (f) do not exert their effect
on taking and/or in the body and the remaining components of the
formulation, in particular component (C), are identical.
[0098] If the dosage form according to the invention comprises at
least 2 of components (c) and (d) or (f), these may each be present
in the same or different subunits (Y). Preferably, when present,
all the components (c) and (d) and (f) are present in one and the
same subunit (Y).
[0099] In the case of spatial separation into subunit(s) (X) and
subunit(s) (Y) and irrespective of the arrangement of these
subunits in the dosage form, a subunit (X) contains the active
ingredient in delayed-release form, such that said active
ingredient ensures controlled release with once daily
administration.
[0100] For the purposes of the present invention, subunits are
solid formulations, which in each case, apart from conventional
auxiliary substances known to the person skilled in the art,
contain the opioid(s), at least one polymer (C) and optionally at
least one of the optionally present components (a) and/or (b)
and/or (e) or in each case at least one polymer (C) and the
antagonist(s) and/or emetic(s) and/or component (e) and/or
component (f) and optionally at least one of the optionally present
components (a) and/or (b) and optionally the delayed-release matrix
compounds. Care must here be taken to ensure that each of the
subunits is formulated in accordance with the above-stated
process.
[0101] One substantial advantage of the separated formulation of
the opioid(s) from components (c) or (d) or (f) in subunits (X) and
(Y) of the dosage form according to the invention is that, when
correctly administered, components (c) and/or (d) and/or (f) are
hardly released on taking and/or in the body or are released in
such small quantities that they exert no effect which impairs the
patient or therapeutic success or, on passing through the patient's
body, they are only liberated in locations where they cannot be
sufficiently absorbed to be effective. When the dosage form is
correctly administered, preferably hardly any of components (c)
and/or (d) and/or (f) is released into the patient's body or they
go unnoticed by the patient.
[0102] The person skilled in the art will understand that the
above-stated conditions may vary as a function of the particular
components (c), (d) and/or (f) used and of the formulation of the
subunits or the dosage form. The optimum formulation for the
particular dosage form may be determined by simple preliminary
testing. What is vital is that each subunit contains the polymer
(C) and has been formulated in the stated manner.
[0103] Should, contrary to expectations, the abuser succeed in
comminuting such a dosage form according to the invention, which
comprises components (c) and/or (e) and/or (d) and/or (f) in
subunits (Y), for the purpose of abusing the opioid(s) and obtain a
powder which is to be extracted with a suitable extracting agent,
not only the opioid(s) but also the particular component (c) and/or
(e) and/or (f) and/or (d) will be obtained in a form in which it
cannot readily be separated from the opioid(s), such that when the
dosage form which has been tampered with is administered, in
particular by oral and/or parenteral administration, it will exert
its effect immediately on taking and/or in the body combined with
an additional negative effect on the abuser corresponding to
component (c) and/or (d) and/or (f) or, when the attempt is made to
extract the active ingredient, the coloration will act as a
deterrent and so prevent abuse of the dosage form.
[0104] A dosage form according to the invention, in which the
opioid(s) is/are spatially separated from components (c), (d)
and/or (e), preferably by formulation in different subunits, may be
formulated in many different ways, wherein the corresponding
subunits may each be present in the dosage form according to the
invention in any desired spatial arrangement relative to one
another, provided that the above-stated conditions for the release
of components (c) and/or (d), on the one hand, and for release of
the opioid, namely controlled release for once daily
administration, on the other, are fulfilled.
[0105] The person skilled in the art will understand that
component(s) (a) and/or (b) which are optionally also present may
preferably be formulated in the dosage form according to the
invention both in the particular subunits (X) and (Y) and in the
form of independent subunits (Y') corresponding to subunits (X) and
(Y), provided that neither the abuse-proofing nor the opioid
release over 24 hours in the event of correct administration is
impaired by the nature of the formulation and the polymer (C) is
included in the formulation and formulation is carried out in
accordance with the above-stated processes.
[0106] In a preferred embodiment of the dosage form according to
the invention, subunits (X) and (Y) are present in multiparticulate
form, wherein microtablets, microcapsules, micropellets, granules,
spheroids, beads or pellets are preferred and the same form, i.e.
shape, is selected for both subunit (X) and subunit (Y), such that
it is not possible to separate subunits (X) from (Y) by mechanical
selection. The multiparticulate forms are preferably of a size in
the range from 0.1 to 3 mm, preferably of 0.5 to 2 mm.
[0107] The subunits (X) and (Y) in multiparticulate form may also
preferably be packaged in a capsule or be press-moulded into a
tablet, wherein the final formulation in each case proceeds in such
a manner that the subunits (X) and (Y) are also retained in the
resultant dosage form.
[0108] The multiparticulate subunits (X) and (Y) of identical shape
should also not be visually distinguishable from one another so
that the abuser cannot separate them from one another by simple
sorting. This may, for example, be achieved by the application of
identical coatings which, apart from this disguising function, may
also incorporate further functions, such as, for example,
controlled release of one or more opioid(s) or provision of a
finish resistant to gastric juices on the particular subunits.
[0109] In a further preferred embodiment of the present invention,
subunits (X) and (Y) are in each case arranged in layers relative
to one another.
[0110] The layered subunits (X) and (Y) are preferably arranged for
this purpose vertically or horizontally relative to one another in
the dosage form according to the invention, wherein in each case
one or more layered subunits (X) and one or more layered subunits
(Y) may be present in the dosage form, such that, apart from the
preferred layer sequences (X)-(Y) or (X)-(Y)-(X), any desired other
layer sequences may be considered, optionally in combination with
layers containing components (a) and/or (b).
[0111] Another preferred dosage form according to the invention is
one in which subunit (Y) forms a core which is completely enclosed
by the delayed-release subunit (X), wherein a separation layer (Z)
may be present between said layers. Such a structure is preferably
also suitable for the above-stated multiparticulate forms, wherein
both subunits (X) and (Y) and an optionally present separation
layer (Z), which must satisfy the hardness requirement according to
the invention, are formulated in one and the same multiparticulate
form.
[0112] In a further preferred embodiment of the dosage form
according to the invention, the subunit (X) forms a core, which is
enclosed by subunit (Y), wherein the latter comprises at least one
channel which leads from the core to the surface of the dosage
form.
[0113] The dosage form according to the invention may comprise,
between one layer of the subunit (X) and one layer of the subunit
(Y), in each case one or more, preferably one, optionally swellable
separation layer (Z) which serves to separate subunit (X) spatially
from (Y).
[0114] If the dosage form according to the invention comprises the
layered subunits (X) and (Y) and an optionally present separation
layer (Z) in an at least partially vertical or horizontal
arrangement, the dosage form preferably takes the form of a tablet,
a coextrudate or a laminate.
[0115] In one particularly preferred embodiment, the entirety of
the free surface of subunit (Y) and optionally at least part of the
free surface of subunit(s) (X) and optionally at least part of the
free surface of the optionally present separation layer(s) (Z) may
be coated with at least one barrier layer (Z') which prevents
release of component (c) and/or (e) and/or (d) and/or (f). The
barrier layer (Z') must also fulfil the hardness conditions
according to the invention.
[0116] Another particularly preferred embodiment of the dosage form
according to the invention comprises a vertical or horizontal
arrangement of the layers of subunits (X) and (Y) and at least one
push layer (p) arranged therebetween, and optionally a separation
layer (Z), in which dosage form the entirety of the free surface of
the layer structure consisting of subunits (X) and (Y), the push
layer and the optionally present separation layer (Z) is provided
with a semipermeable coating (E), which is permeable to a release
medium, i.e. conventionally a physiological liquid, but
substantially impermeable to the opioid(s) and to component (c)
and/or (d) and/or (f), and wherein this coating (E) comprises at
least one opening for release of the opioid(s) in the area of
subunit (X).
[0117] A corresponding dosage form is known to the person skilled
in the art, for example under the name oral osmotic therapeutic
system (OROS), as are suitable materials and methods for the
production thereof, inter alia from U.S. Pat. No. 4,612,008, U.S.
Pat. No. 4,765,989 and U.S. Pat. No. 4,783,337. The corresponding
descriptions are hereby introduced as a reference and are deemed to
be part of the disclosure.
[0118] An osmotic dosage form containing an analgesic opioid and a
dye as an aversive agent is likewise known to the person skilled in
the art from the prior art (WO 03/015531). The tablet core
preferably consists of two layers, an opioid-containing layer and a
push layer, wherein the push layer contains the dye as the aversive
agent. The corresponding description is hereby introduced as a
reference and is deemed to be part of the disclosure.
[0119] In a further preferred embodiment of the claimed invention,
the subunit (X) of the dosage form according to the invention is in
the form of a tablet, the edge face and optionally one of the two
main faces of which is covered with a barrier layer (Z') containing
component (c) and/or (d) and/or (f).
[0120] The person skilled in the art will understand that the
auxiliary substances of the subunit(s) (X) or (Y) and of the
optionally present separation layer(s) (Z) and/or of the barrier
layer(s) (Z') used in formulating the dosage form according to the
invention will vary as a function of the arrangement thereof in the
dosage form according to the invention, the mode of administration
and as a function of the particular opioid, of the optionally
present components (a) and/or (b) and/or (e) and of component (c)
and/or (d) and/or (f), while maintaining release of the active
ingredient over 24 hours. The materials which have the requisite
properties are in each case known per se to the person skilled in
the art.
[0121] If release of component (c) and/or (d) and/or (f) from
subunit (Y) of the dosage form according to the invention is
prevented with the assistance of a cover, preferably a barrier
layer, the subunit may consist of conventional materials known to
the person skilled in the art, providing that it contains at least
one polymer (C) to fulfil the hardness condition of the dosage form
according to the invention.
[0122] If a corresponding barrier layer (Z') is not provided to
prevent release of component (c) and/or (d) and/or (f), the
materials of the subunits should be selected such that release of
the particular component (c) and/or (d) from subunit (Y) is
virtually ruled out.
[0123] The materials which are stated below to be suitable for
production of the barrier layer may preferably be used for this
purpose. Preferred materials are those which are selected from the
group comprising alkylcelluloses, hydroxyalkylcelluloses, glucans,
scleroglucans, mannans, xanthans, copolymers of
poly[bis(p-carboxyphenoxy)propane: sebacic acid], preferably in a
molar ratio of 20:80 (marketed under the name Polifeprosan
20.RTM.), carboxymethylcelluloses, cellulose ethers, cellulose
esters, nitrocelluloses, polymers based on (meth)acrylic acid and
the esters thereof, polyamides, polycarbonates, polyalkylenes,
polyalkylene glycols, polyalkylene oxides, polyalkylene
terephthalates, polyvinyl alcohols, polyvinyl ethers, polyvinyl
esters, halogenated polyvinyls, polyglycolides, polysiloxanes and
polyurethanes and the copolymers thereof.
[0124] Particularly suitable materials may be selected from the
group comprising methylcellulose, ethylcellulose,
hydroxypropylcellulose, hydroxypropylmethylcellulose,
hydroxybutylmethylcellulose, cellulose acetate, cellulose
propionate (of low, medium or high molecular weight), cellulose
acetate propionate, cellulose acetate butyrate, cellulose acetate
phthalate, carboxymethylcellulose, cellulose triacetate, sodium
cellulose sulfate, polymethyl methacrylate, polyethyl methacrylate,
polybutyl methacrylate, polyisobutyl methacrylate, polyhexyl
methacrylate, polyisodecyl methacrylate, polylauryl methacrylate,
polyphenyl methacrylate, polymethyl acrylate, polyisopropyl
acrylate, polyisobutyl acrylate, polyoctatdecyl acrylate,
polyethylene, low density polyethylene, high density polyethylene,
polypropylene, polyethylene glycol, polyethylene oxide,
polyethylene terephthalate, polyvinyl alcohol, polyvinyl isobutyl
ether, polyvinyl acetate and polyvinyl chloride.
[0125] Particularly suitable copolymers may be selected from the
group comprising copolymers of butyl methacrylate and isobutyl
methacrylate, copolymers of methyl vinyl ether and maleic acid of
high molecular weight, copolymers of methyl vinyl ether and maleic
acid monoethyl ester, copolymers of methyl vinyl ether and maleic
anhydride and copolymers of vinyl alcohol and vinyl acetate.
[0126] Further materials which are suitable for formulating the
barrier layer are starch-filled polycaprolactone (WO98/20073),
aliphatic polyesteramides (DE 19 753 534 A1, DE 19 800 698 A1, EP 0
820 698 A1), aliphatic and aromatic polyester urethanes (DE
19822979), polyhydroxyalkanoates, in particular
polyhydroxybutyrates, polyhydroxyvalerates, casein (DE 4 309 528),
polylactides and copolylactides (EP 0 980 894 A1). The
corresponding descriptions are hereby introduced as a reference and
are deemed to be part of the disclosure.
[0127] The above-stated materials may optionally be blended with
further conventional auxiliary substances known to the person
skilled in the art, preferably selected from the group consisting
of glyceryl monostearate, semi-synthetic triglyceride derivatives,
semi-synthetic glycerides, hydrogenated castor oil, glyceryl
palmitostearate, glyceryl behenate, polyvinylpyrrolidone, gelatine,
magnesium stearate, stearic acid, sodium stearate, talcum, sodium
benzoate, boric acid and colloidal silica, fatty acids, substituted
triglycerides, glycerides, polyoxyalkylene glycols and the
derivatives thereof.
[0128] If the dosage form according to the invention comprises a
separation layer (Z'), said layer, like the uncovered subunit (Y),
may preferably consist of the above-stated materials described for
the barrier layer. The person skilled in the art will understand
that release of the opioid(s) and/or opiate(s) or of component (c)
and/or (d) from the particular subunit may be controlled by the
thickness of the separation layer.
Method for Determining Breaking Strength
[0129] In order to verify whether a polymer or a wax may be used as
component (C) or (D) respectively, the polymer or wax is
press-moulded to form a tablet with a diameter of 10 mm and a
height of 5 mm using a force of 150 N at a temperature which at
least corresponds to the softening point of the polymer or wax and
is determined with the assistance of a DSC diagram of the polymer
or wax. Using tablets produced in this manner, breaking strength is
determined with the apparatus described below in accordance with
the method for determining the breaking strength of tablets
published in the European Pharmacopoeia 1997, page 143, 144, method
no. 2.9.8. The apparatus used for the measurement is a "Zwick Z
2.5" materials tester, Fmax=2.5 kN, draw max. 1150 mm with the
setup comprising a column and a spindle, clearance behind of 100
mm, a test speed of 0.1800 mm/min and testControl software.
Measurement was performed using a pressure piston with screw-in
inserts and a cylinder (diam. 10 mm), a force transducer, (Fmax. 1
kN, diameter=8 mm, class 0.5 from 10 N, class 1 from 2 N to ISO
7500-1, with manufacturer's test certificate M to DIN 55350-18,
Zwick gross force Fmax=1.45 kN) (all apparatus from Zwick GmbH
& Co. KG, Ulm, Germany).
[0130] The tablets deemed to be resistant to breaking under a
specific load include not only those which have not broken but also
those which may have suffered plastic deformation under the action
of the force.
[0131] The breaking strength of the dosage forms according to the
invention is determined using the same measurement method.
[0132] The invention is explained below with reference to Examples.
These explanations are given merely by way of example and do not
restrict the general concept of the invention.
EXAMPLE 1
a) Production of an Abuse-proofed Tablet Containing Oxycodone
[0133] The quantities of oxycodone hydrochloride, polyethylene
oxide powder and hydroxypropylmethylcellulose (Metholose 90 SH 100
000) as the delayed-release matrix material listed in Table 1 were
mixed in a free-fall mixer. The tabletting tool, which consists of
die, top punch and bottom punch with a diameter of 10 mm, was
heated to 90.degree. C. in a heating cabinet. 600 mg portions of
the powder mixture were press-moulded by means of the heated tool,
the pressure being maintained for at least 15 seconds.
TABLE-US-00001 TABLE 1 Components Per tablet Complete batch
Oxycodone HCl 80.0 mg 40.0 g Polyethylene oxide, NF, MW 7 000 000
470.0 mg 235.0 g (Polyox WSR 303, Dow Chemicals)
Hydroxypropylmethylcellulose 100 000 50.0 mg 25.0 g mPas (Metholose
90 SH 100 000) Total weight 600.0 mg 300.0 g
[0134] The breaking strength of the tablets is determined using the
above-described method. No breakage occurred when a force of 500 N
was applied. The tablets could not be comminuted using a hammer,
nor with the assistance of a pestle and mortar.
In Vitro Release From the Tablets Produced According to a)
[0135] In vitro release of oxycodone hydrochloride from the tablets
produced according to a) was determined in a paddle stirrer
apparatus with sinker according to the method described in the
European Pharmacopoeia. The temperature of the release medium was
37.degree. C. and the rotational speed of the stirrer 75
min.sup.-1. The release medium used was intestinal juice, pH 6.8.
The quantity of oxycodone hydrochloride released in each case into
the dissolution medium at any one time was determined by
spectrophotometry. The percentage released quantity, relative to
the total quantity of oxycodone hydrochloride, at each point in
time is shown in Table 2. TABLE-US-00002 TABLE 2 Time, minutes
Released quantity, wt. % 30 11 240 40 480 61 720 76 1080 92 1440
97
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