U.S. patent application number 13/042570 was filed with the patent office on 2011-08-18 for bifeprunox mesylate maintenance dose compositions and methods for using the same.
This patent application is currently assigned to Solvay Pharmaceuticals B.V.. Invention is credited to Maria J.L. Terhorst-Van Amstel, Caroline BOON, Nico BRUINS, Ellen Bech CHRISTENSEN, Michiel H. De Vries, Irene EIJGENDAAL, Erik GOUT, Gerrit Klein, Dorte MALLING, Jeff PAUL, Sangeeta RAJE, Hendrikus T. RIGTER, Anneke WINSEMIUS, Klaas ZWIER.
Application Number | 20110200687 13/042570 |
Document ID | / |
Family ID | 46328615 |
Filed Date | 2011-08-18 |
United States Patent
Application |
20110200687 |
Kind Code |
A1 |
EIJGENDAAL; Irene ; et
al. |
August 18, 2011 |
BIFEPRUNOX MESYLATE MAINTENANCE DOSE COMPOSITIONS AND METHODS FOR
USING THE SAME
Abstract
The present disclosure provides novel pharmaceutical dosage
forms such as a maintenance treatment dose and methods for making
the same, and methods for using said compounds and maintenance
treatment doses to treat and prevent diseases and/or disorders.
Inventors: |
EIJGENDAAL; Irene; (Weesp,
NL) ; Klein; Gerrit; (Weesp, NL) ; Amstel;
Maria J.L. Terhorst-Van; (Weesp, NL) ; ZWIER;
Klaas; (Weesp, NL) ; BRUINS; Nico; (Weesp,
NL) ; RIGTER; Hendrikus T.; (Weesp, NL) ;
GOUT; Erik; (Weesp, NL) ; BOON; Caroline;
(Weesp, NL) ; De Vries; Michiel H.; (Weesp,
NL) ; MALLING; Dorte; (Valby-Copenhagen, DK) ;
WINSEMIUS; Anneke; (Weesp, NL) ; RAJE; Sangeeta;
(Collegeville, PA) ; CHRISTENSEN; Ellen Bech;
(Valby-Copenhagen, DK) ; PAUL; Jeff; (Berwyn,
PA) |
Assignee: |
Solvay Pharmaceuticals B.V.
|
Family ID: |
46328615 |
Appl. No.: |
13/042570 |
Filed: |
March 8, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11727173 |
Mar 23, 2007 |
7964604 |
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13042570 |
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11354652 |
Feb 16, 2006 |
7423040 |
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11727173 |
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60654149 |
Feb 18, 2005 |
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Current U.S.
Class: |
424/722 ;
514/13.5; 514/217; 514/254.02 |
Current CPC
Class: |
A61K 31/496 20130101;
A61K 45/06 20130101; A61K 9/2018 20130101; A61P 25/00 20180101;
A61K 9/2054 20130101; A61K 31/498 20130101; A61K 9/2009 20130101;
A61K 31/496 20130101; A61K 2300/00 20130101 |
Class at
Publication: |
424/722 ;
514/254.02; 514/217; 514/13.5 |
International
Class: |
A61K 31/496 20060101
A61K031/496; A61K 31/55 20060101 A61K031/55; A61K 38/17 20060101
A61K038/17; A61K 33/00 20060101 A61K033/00; A61P 25/00 20060101
A61P025/00 |
Claims
1-34. (canceled)
35. A method of treating at least one central nervous system (CNS)
disorder in a human patient in need thereof, comprising
co-administering to the patient a pharmaceutical composition
comprising an effective amount of bifeprunox, a crystalline
polymorph of
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
monomethanesulfonate and at least one pharmaceutically acceptable
excipient, and at least one other pharmaceutically active agent,
wherein the effective amount of bifeprunox comprises a maintenance
treatment dose.
36. The method according to claim 35, wherein the at least one
other pharmaceutically active agent is chosen from CYP2C9
inhibitors, CYP3A4 inhibitors, CYP2A4 inhibitors, CYP3A4 inducers,
and any pharmacologically acceptable combination thereof.
37. The method according to claim 35, wherein the at least one
other pharmaceutically active agent is chosen from fluconazole,
ketoconazole, paroxetine, carbamazepine, warfarin, lithium,
prothrombin, famotidine, and any pharmacologically acceptable
combination thereof.
Description
[0001] This application is a continuation-in-part of U.S.
application Ser. No. 11/354,652, filed on Feb. 16, 2006, which
claims the benefit of priority of U.S. Provisional Application No.
60/654,149, filed on Feb. 18, 2005, both of which are incorporated
herein by reference in their entirety.
[0002] The present disclosure relates to stable polymorphic forms
of the compound
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazo-
lone monomethanesulfonate, methods for the preparation of such
polymorphic forms, pharmaceutical dosage forms such as a
maintenance treatment dose comprising said polymorphic forms, and
methods for using the maintenance treatment dose for the treatment
of various disorders such as, CNS disorders.
[0003] The mesylate salt of the compound
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
monomethanesulfonate (INNM bifeprunox mesylate) has the formula
##STR00001##
[0004] The hydrochloric acid salt of this compound
(7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
(bifeprunox) is described and claimed in WO97/36893 and the
monomethanesulfonate salt is described and claimed in WO02/066449.
In the second of these patent publications the direct formation of
the monomethanesulfonate salt by the reaction between the reactive
mesylate ester of N,N,N-bis(2-ethanol)-m-phenylbenzyl amine and
7-amino-2(3H)-benzoxazolone is disclosed.
[0005] It has been discovered that by the method described in
WO02/066449 bifeprunox mesylate is normally obtained as a crude
product (melting range indicated in WO02/066449 as 263-275.degree.
C.) in a polymorphic form further indicated in this application as
polymorph .delta. (delta). Upon further purification, the product
is obtained in two different crystal modifications or a mixture of
these two modifications. The first of the two modifications is the
already mentioned polymorph .delta. (delta) and has a melting point
in pure form of 265.degree. C. The second modification is further
indicated as polymorph .gamma. (gamma). When the .gamma. polymorph
is predominantly obtained, it is in almost all cases obtained in a
mixture of said polymorph with polymorph .delta., the mixture
having a melting point of approximately 273.degree. C.
[0006] During further investigations it appeared that polymorphs
.gamma. and .delta. are metastable, and therefore may have
drawbacks when used in a pharmaceutical formulation. The
unpredictable formation of one of the two polymorphs .gamma. and
.delta. or a mixture thereof is also undesirable. It would be
desirable, therefore, to provide a stable crystalline form of
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
monomethanesulfonate for pharmaceutical use which can be
consistently produced.
[0007] It has surprisingly been found that
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
monomethanesulfonate also has another crystalline polymorphic form
(referred to below as polymorph .alpha. (alpha)) which does not
have the disadvantages of the aforementioned polymorphs. This
crystalline form of bifeprunox mesylate is more thermodynamically
stable. Polymorphic form .alpha. does not undergo conversion, even
at high atmospheric humidity or higher temperature. Furthermore
this crystalline form crystallizes in the form of large crystals
which can be easily filtrated and have a high purity. Therefore
this polymorph .alpha. is particularly suitable for the formulation
of bifeprunox mesylate in a solid form, if desired after particle
size reduction.
[0008] In various embodiments, the present disclosure provides the
polymorphic .alpha. form of bifeprunox mesylate at various levels
of purity. In another embodiment, the present disclosure provides
pharmaceutical dosage forms such as a maintenance treatment dose
comprising the polymorphic .alpha. form of bifeprunox mesylate. In
yet another embodiment, the present disclosure provides methods for
using the maintenance treatment dose for treatment or prevention of
various diseases and disorders. These embodiments, while providing
some general overview of various embodiments of the present
disclosure, are not intended to limit the scope of the present
disclosure in any manner.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] FIG. 1 shows an XRPD pattern of polymorphic form .alpha. of
bifeprunox mesylate.
[0010] FIG. 2 shows a DSC trace of polymorphic form .alpha. of
bifeprunox mesylate.
[0011] FIG. 3 shows an IR (ATR) spectrum of polymorphic form
.alpha. of bifeprunox mesylate.
[0012] FIG. 4 shows a .sup.13C solid state NMR spectrum of
polymorphic form .alpha. of bifeprunox mesylate.
[0013] FIG. 5 shows configuration of polymorphic form .alpha. of
bifeprunox mesylate derived from X-ray crystallography.
[0014] FIG. 6 shows an XRPD pattern of polymorphic form .gamma. of
bifeprunox mesylate.
[0015] FIG. 7 shows a DSC trace of polymorphic form .gamma. of
bifeprunox mesylate.
[0016] FIG. 8 shows an IR (ATR) spectrum of polymorphic form
.gamma. of bifeprunox mesylate.
[0017] FIG. 9 shows a .sup.13C solid state NMR spectrum of
polymorphic form .gamma. of bifeprunox mesylate.
[0018] FIG. 10 shows configuration of polymorphic form .gamma. of
bifeprunox mesylate derived from X-ray crystallography.
[0019] FIG. 11 shows an XRPD pattern of polymorphic form .delta. of
bifeprunox mesylate.
[0020] FIG. 12 shows a DSC trace of polymorphic form .delta. of
bifeprunox mesylate.
[0021] FIG. 13 shows an IR (ATR) spectrum of polymorphic form
.delta. of bifeprunox mesylate.
[0022] FIG. 14 shows a .sup.13C solid state NMR spectrum of
polymorphic form .delta. of bifeprunox mesylate.
[0023] FIG. 15 shows configuration of polymorphic form .delta. of
bifeprunox mesylate derived from X-ray crystallography.
[0024] FIG. 16 shows the plasma concentration-time profile
following multiple-dose administration of bifeprunox at 40 mg/day
in healthy subjects (n=16).
[0025] FIG. 17 shows bifeprunox plasma concentration-time profiles
with and without (A) ketoconazole, (B) fluconazole, (C) paroxetine,
and (D) carbamazepine.
[0026] FIG. 18 shows a mean prothrombin time profile as a function
of study day (i.e., the day after treatment) with warfarin alone
and in combination with bifeprunox (40 mg/day)
[0027] In one embodiment, the crystalline polymorphic form of
bifeprunox mesylate according to the present disclosure is defined
by at least one of the following physicochemical parameters:
[0028] X-Ray diffraction patterns (Table 1 and FIG. 1);
[0029] The melting point of polymorphic form .alpha. is 277.degree.
C. (DSC heating rate 10 K/min) (see DSC thermogram, FIG. 2);
[0030] IR spectrum (Table 2 and FIG. 3), wherein the characteristic
IR absorption bands of form .alpha. of bifeprunox mesylate which
can be used to distinguish this form from forms .gamma. and .delta.
are given in Table 2a;
[0031] Solid state .sup.13C-NMR spectrum (Table 3 and FIG. 4),
wherein the characteristic .sup.13C-NMR shifts of form .alpha. of
bifeprunox mesylate which can be used to distinguish this form from
forms .gamma. and .delta. are given in Table 3a;
[0032] Single crystal X-ray diffraction (Tables 4 and 5 and FIG.
5).
[0033] Table 1 shows characteristic X-ray powder diffractions
(XRPD) of forms .alpha., .gamma. and .delta. of bifeprunox
mesylate. FIG. 1 provides a representative XRPD pattern of
polymorphic form .alpha. of bifeprunox mesylate.
TABLE-US-00001 TABLE 1 Characteristic reflexes (expressed in degree
of diffraction angle 2.theta. Form at room temperature) .alpha.
7.0, 9.3, 10.0, 12.5, 15.4, 16.7, 17.2, 17.4, 17.7, 18.7, 21.3,
22.2, 25.2, 27.2, 28.3, 28.8, 30.1 .gamma. 10.4, 11.4, 11.7, 14.1,
15.1, 21.0, 26.9 .delta. 6.4, 10.2, 12.1, 16.4, 16.8, 19.3, 19.7,
20.6, 24.1, 26.6
[0034] Table 2 shows characteristic IR absorption bands of forms
.alpha., .gamma. and .delta. of bifeprunox mesylate. FIG. 2
provides a representative IR spectrum of polymorphic form .alpha.
of bifeprunox mesylate.
TABLE-US-00002 TABLE 2 Form Characteristic IR absorption bands
(expressed in cm.sup.-1) .alpha. 1764, 1636, 1284, 1217, 809, 795,
746, 694, 663, 509 .gamma. 1777, 1279, 1258, 1210, 1124, 800, 764,
749, 627, 518 .delta. 1865, 1769, 1434, 1282, 1253, 1212, 1126,
935, 767, 751
[0035] Table 2a also shows important IR absorption bands of forms
.alpha., .gamma. and .delta. of bifeprunox mesylate which can be
used to distinguish the three forms.
TABLE-US-00003 TABLE 2a Form Characteristic IR absorption bands
(expressed in cm .sup.-1) .alpha. 1764, 1217, 795, 746, 694 .gamma.
1777, 1210, 764, 749, 518 .delta. 1769, 1212, 935, 767, 751
[0036] Table 3 shows characteristic .sup.13C solid state NMR
chemical shifts in forms .alpha., .gamma. and .delta. of bifeprunox
mesylate. FIG. 3 provides a representative
.sup.13C solid state NMR spectrum of polymorphic form .alpha. of
bifeprunox mesylate.
TABLE-US-00004 TABLE 3 Characteristic chemical shift (expressed in
ppm relative to Form glycine (.delta..sub.c = 176.03 for the
C.dbd.O resonance) .alpha. 40.4, 48.7, 50.3, 56.5, 106.8, 110.7,
124.9, 126.9, 127.8, 129.2, 130.8, 134.2, 137.7, 141.6, and *153.8.
.gamma. 38.2, *44.3, *45.9, 50.1, 54.5, 59.4, 103.5, 109.3, 125.3,
127.9, 128.9, 131.1, 133.2, 134.5, 141.2, 143.2 and *153.7 .delta.
39.1, *44.3, *46.3, 49.3, 53.4, 58.8, 104.6, 110.4, 124.6, 127.0,
128.5, 129.7, 130.5, 134.4, 141.5, 143.5, and *154.7 *denotes
carbon resonances which show typical asymmetric residual
quadrupolar splittings. Chemical shift are given for the high-field
resonance maximum.
[0037] Table 3a also shows important .sup.13C solid state NMR
chemical shifts bands of forms .alpha., .gamma. and .delta. of
bifeprunox mesylate which can be used to distinguish the three
forms.
TABLE-US-00005 TABLE 3a Characteristic chemical shift (expressed in
ppm relative to Form glycine (.delta..sub.c = 176.03 for the
C.dbd.O resonance) .alpha. 40.4, 48.7, 56.5, 106.8 and 137.7
.gamma. 38.2, 54.5, 103.5, 109.3 and 133.2 .delta. 39.1, 49.3,
53.4, 58.8 and 104.6
[0038] Table 4 shows relevant Single Crystal X-ray Diffraction data
collection parameters for the crystal structure determination of
forms .alpha., .gamma. and .delta. of bifeprunox mesylate.
TABLE-US-00006 TABLE 4 Alpha (.alpha.) Gamma (.gamma.) Delta
(.delta.) Temperature (K) 150 133 150 Wavelength (.ANG.)
0.71073.sup.1 0.71073 0.71073 Crystal size 0.10 .times. 0.15
.times. 0.27 0.24 .times. .13 .times. 0.07 0.10 .times. 0.15
.times. 0.35 (mm .times. mm .times. mm) Crystal system triclinic
monoclinic triclinic Space group P-1 P2.sub.1/c P-1 Z 2 4 2 Unit
cell dimensions; A (.ANG.) 9.823 9.0975 9.1832 B (.ANG.) 10.737
15.269 9.3963 C (.ANG.) 12.690 17.128 14.106 .alpha. (.degree.)
98.553 90 76.968 .beta. (.degree.) 93.749 100.694 83.809 .GAMMA.
(.degree.) 116.097 90 89.157 Calculated density (g cm.sup.-3) 1.481
1.368 1.3556 Completeness of data (%) 100.0 100.0 99.8 Total number
of reflections 27105 23759 27207 Number of unique 5355 5809 4149
reflections Nr. Of refined parameters 314 316 314
[0039] Table 5 shows atomic coordinates (.times.10.sup.4) and
equivalent isotropic displacement parameters
(.ANG..sup.2.times.10.sup.3) of crystal structure of form .alpha.
of bifeprunox mesylate. U(eq) is defined as one third of the trace
of the orthogonalized U.sub.ij tensor.
TABLE-US-00007 TABLE 5 x y z U(eq) O1 3471.7(11) 3848.0(10)
2910.8(8) 26.4(3) O2 2785.8(13) 1499.8(11) 2541.1(10) 38.1(4) N1
5215.5(15) 3175.4(14) 3398.0(11) 29.3(4) N2 3880.6(13) 6773.4(13)
3211.0(10) 24.6(4) N3 1702.0(14) 7879.1(13) 3177.7(11) 24.9(4) C1
3755.9(18) 2687.4(17) 2914.9(13) 28.6(5) C2 4801.7(16) 5042.8(16)
3421.0(12) 23.7(4) C3 5896.6(17) 4637.6(16) 3727.8(12) 25.8(5) C4
7334.0(17) 5622.3(17) 4265.8(12) 28.3(5) C5 7587.8(18) 7016.7(18)
4470.3(12) 30.7(5) C6 6489.3(17) 7425.7(17) 4145.1(12) 28.2(5) C7
5035.3(17) 6432.4(16) 3594.8(12) 24.3(4) C8 4371.2(18) 8285.6(16)
3280.4(14) 29.8(5) C9 3141.4(17) 8515.3(17) 2694.6(13) 29.2(5) C10
1196.3(17) 6328.4(15) 3094.7(13) 25.8(5) C11 2450.2(16) 6106.0(16)
3661.4(12) 25.9(5) C12 465.7(18) 8238.1(17) 2763.9(13) 29.1(5) C13
-273.5(18) 7526.6(18) 1622.4(13) 30.9(5) C14 .sup. 166(2) 8245(2)
780.4(15) 46.7(7) C15 -586(2) 7574(3) -256.4(16) 57.6(8) C16
-1734(2) 6194(2) -466.0(15) 49.2(7) C17 -2206.8(19) 5456.1(19)
362.2(13) 34.9(6) C18 -1474.4(18) 6157.3(18) 1409.5(13) 30.8(5) C19
-3495(2) 4003.7(19) 170.3(13) 37.1(6) C20 -4751(2) 3585(2)
-623.3(14) 43.7(6) C21 -5976(2) 2260(2) -766.8(17) 54.6(7) C22
-5989(2) 1318(2) -129.3(18) 58.2(8) C23 -4750(3) 1709(2) 655.0(17)
54.6(7) C24 -3520(2) 3039(2) 804.2(15) 45.3(6) S1 8220.4(4)
1865.1(4) 3801.4(3) 26.8(1) O3 6650.8(13) 1454.8(12) 3355.9(10)
40.2(4) O4 8282.1(15) 1197.6(13) 4711.2(9) 42.6(4) O5 9171.5(14)
3369.6(12) 4040.9(11) 48.7(4) C25 8951(2) 1114(2) 2801.2(15)
51.0(7) .sup.1(Mo K.alpha. radiation)
[0040] Table 6 shows atomic coordinates (.times.10.sup.4) and
equivalent isotropic displacement parameters
(.ANG..sup.2.times.10.sup.3) of crystal structure of form .gamma.
of bifeprunox mesylate. U(eq) is defined as one third of the trace
of the orthogonalized U.sub.ij tensor.
TABLE-US-00008 TABLE 6 x y z U(eq) O(1) 6610.7(11) 756.7(7)
6306.4(6) 26.6(2) O(2) 9117.5(12) 552.8(8) 6513.4(8) 40.3(3) C(2)
7882.4(17) 240.9(11) 6352.9(10) 29.1(4) N(3) 7439.1(14) -598.9(9)
6206.3(8) 27.4(3) C(3A) 5878.6(17) -646.4(10) 6063.5(9) 24.5(3)
C(4) 4896.5(18) -1346.6(11) 5948.7(9) 31.7(4) C(5) 3392.7(19)
-1133.4(11) 5866.9(10) 35.5(4) C(6) 2894.2(18) -281.1(11) 5915.0(9)
32.3(4) C(7) 3884.2(17) 428.8(10) 6069.0(9) 26.2(3) C(7A)
5382.3(16) 199.5(10) 6119.9(8) 23.7(3) N(1') 3465.6(14) 1286.2(8)
6230.9(8) 28.4(3) C(2') 1876.4(18) 1434.5(11) 6215.9(11) 35.7(4)
C(3') 1661.2(18) 2283.3(11) 6630.8(11) 36.5(4) N(4') 2322.4(14)
3039.8(9) 6262.9(8) 28.0(3) C(5') 3942.4(17) 2861.2(11) 6265.4(10)
30.0(4) C(6') 4103.6(17) 2010.2(10) 5840.3(9) 27.2(3) C(10) 2051(2)
3884.9(11) 6667.0(10) 35.6(4) C(11) 2788.0(18) 4658.9(11) 6354.3(9)
30.7(4) C(12) 2314.0(17) 4949.2(10) 5577.8(9) 27.8(4) C(13)
3015.0(17) 5646.9(10) 5277.0(9) 26.8(3) C(14) 4183.8(18) 6072.6(11)
5781.3(10) 33.7(4) C(15) 4644(2) 5795.6(12) 6554.8(11) 40.5(4)
C(16) 3964.4(19) 5086.4(12) 6836.9(10) 38.5(4) C(21) 2576.4(16)
5917.7(10) 4432.7(9) 25.3(3) C(22) 2266.8(17) 5286.3(11) 3836.1(9)
29.8(4) C(23) 1921.6(19) 5532.9(11) 3043.3(10) 35.0(4) C(24)
1900.5(18) 6409.3(11) 2833.0(10) 33.3(4) C(25) 2200.7(17)
7041.3(11) 3419.1(10) 31.8(4) C(26) 2519.2(17) 6797.7(10)
4209.4(10) 29.3(4) S 9163.9(4) -2786.7(3) 5975.1(2) 28.4(1) O(3)
9584.0(13) -1870.9(7) 6067.6(8) 39.5(3) O(4) 7714.0(13) -2961.4(8)
6156.0(8) 48.0(4) O(5) 9327.4(15) -3123.8(9) 5197.7(7) 50.7(4)
C(1M) 10484.0(18) -3388.0(11) 6647.3(9) 33.1(4)
[0041] Table 7 shows atomic coordinates (.times.10.sup.4) and
equivalent isotropic displacement parameters
(.ANG..sup.2.times.10.sup.3) of crystal structure of form .delta.
of bifeprunox mesylate. U(eq) is defined as one third of the trace
of the orthogonalized U.sub.ij tensor.
TABLE-US-00009 TABLE 7 x y z U(eq) O1 4353.9(14) 2151.8(14) 9.8(9)
31.7(5) O2 2013.8(15) 1799.9(16) -260.0(11) 41.7(6) N1 3473.0(19)
3697(2) -1220.7(13) 33.0(6) N2 7357.2(17) 2103.5(19) 550.2(12)
32.1(6) N3 8449.3(17) 325.4(19) 2265.2(12) 30.5(6) C1 3130(2)
2515(2) -491.7(15) 31.6(8) C2 5441(2) 3184(2) -431.7(14) 27.6(7) C3
4912(2) 4146(2) -1202.7(15) 29.5(7) C4 5792(2) 5233(2) -1804.5(16)
38.0(8) C5 7222(2) 5295(2) -1576.5(17) 40.4(8) C6 7745(2) 4328(2)
-796.9(16) 35.7(8) C7 6862(2) 3203(2) -190.9(15) 29.9(7) C8 8926(2)
2107(2) 662.0(15) 36.3(8) C9 9346(2) 659(2) 1284.5(15) 36.0(7) C10
6854(2) 364(2) 2127.3(15) 33.3(7) C11 6484(2) 1826(2) 1508.8(14)
34.0(7) C12 8900(2) -1091(2) 2896.8(15) 35.7(8) C13 7978(2)
-1468(2) 3868.2(15) 32.6(7) C14 6997(2) -2644(2) 4086.9(17) 40.5(8)
C15 6109(2) -2941(2) 4966.4(17) 42.7(8) C16 6171(2) -2068(2)
5624.7(16) 39.1(8) C17 7146(2) -888(2) 5437.5(15) 32.1(7) C18
8054(2) -613(2) 4552.0(15) 32.2(7) C19 7171(2) 74(2) 6137.9(15)
31.4(7) C20 7068(2) -494(2) 7144.3(15) 34.8(7) C21 7028(2) 422(3)
7794.2(16) 38.2(8) C22 7099(2) 1919(3) 7448.1(16) 39.7(8) C23
7201(2) 2497(2) 6453.5(16) 41.0(8) C24 7234(2) 1589(2) 5798.4(16)
37.9(8) S1 8731.8(6).sup. 3909.1(6).sup. 3076.9(4) 33.3(2) O3
9471.7(16) 2602.8(16) 2887.4(12) 50.3(6) O4 7233.7(16) 3640.6(18)
3484.5(11) 50.4(6) O5 8877.7(16) 5117.0(17) 2228.8(11) 47.6(5) C25
9712(3) 4404(3) 3958.1(17) 48.8(9)
[0042] The polymorphic form .alpha. differs substantially from the
forms .gamma. and .delta. in its physicochemical parameters: DSC
melting behavior, X-ray diffraction pattern, IR spectrum and solid
state .sup.13C-NMR spectrum. The physicochemical parameters of the
forms .gamma. and .delta. are given in Tables 1-4, 6 and 7 and
FIGS. 6-15.
[0043] In another embodiment, the present disclosure provides
bifeprunox mesylate in which at least about 50 percent by weight
(wt. %), at least about 60 wt. %, at least about 70 wt. %, at least
about 80 wt. %, at least about 90 wt. %, or at least about 95 wt. %
of the bifeprunox mesylate is in the polymorphic .alpha. form. In
other embodiment, such embodiments are substantially devoid of any
.gamma. or .delta. polymorphic forms of bifeprunox mesylate. In
another embodiment, the bifeprunox mesylate provided by the present
disclosure comprises less than 10 wt. %, less than 5 wt. %, or less
than 2.5 wt. % of the .gamma. or .delta. polymorphic forms of
bifeprunox mesylate. In another embodiment, at least about 99 wt. %
of bifeprunox mesylate is in the polymorphic .alpha. form.
[0044] In one embodiment, the preparation of the polymorphic form
.alpha. is carried out by recrystallization from an organic solvent
or a mixture of an organic solvent with water, preferably a mixture
of a (C.sub.1-C.sub.6) alcohol and water or a mixture of
acetonitrile and water. In another embodiment, the solvent is a
mixture is 2-propanol and water or a mixture of acetonitrile and
water. In another embodiment, the solvent is a mixture of
acetonitrile and water. The polymorphic form .gamma. can be
prepared by making the free base of bifeprunox directly followed by
the addition of methane sulphonic acid and crystallization from
methylethylketone.
[0045] The polymorphic form .alpha. and .gamma. according to the
present disclosure can be formulated into dosage forms in which the
crystalline active substance is present in the solid form by
methods known in the art. Examples of said dosage forms are
(optionally coated) tablets, capsules, granular aerosols,
suppositories and suspensions. Such dosage forms can be prepared by
mixing the polymorphic form .alpha. or .gamma. of the active
substance with inert pharmaceutically acceptable excipients and
carriers.
[0046] In one embodiment, one to a small plurality (e.g. 1 to about
4) of dosage units of a composition of the present disclosure
comprise about 0.05 to about 40 mg, about 0.75 to about 35 mg,
about 0.1 to about 30 mg or about 0.125 to about 20 mg of
bifeprunox mesylate (in .alpha., .delta., and/or .gamma. form) per
dosage unit. Illustratively, such a dosage unit can comprise 0.125
mg, 1 mg, 5 mg, 10 mg, or 20 mg of bifeprunox mesylate. In another
embodiment of the present invention, the dosage units of the
composition comprise about 20 mg to about 40 mg of bifeprunox
mesylate, such as 20 mg or 40 mg of bifeprunox mesylate.
[0047] Any of the dosage units of the present invention may
comprise a treatment maintenance dose. For example, a maintenance
treatment dose may include about 20 mg or about 40 mg of bifeprunox
mesylate. As used herein, the term "maintenance treatment dose"
refers to a target dose or final dose for treatment, which dose is
reached after a titration schedule during a period of time in which
the strength or amount of bifeprunox compound in each unit dosage
increases incrementally over certain time intervals. Moreover, the
maintenance treatment dose may be given to a patient over a long
period of time, even chronically. Generally, the maintenance
treatment dose is administered daily, however, other time intervals
may also be considered.
[0048] Compositions of the present disclosure can comprise one or
more pharmaceutical excipients. Non-limiting examples of suitable
excipients include suspending agents (for example, gums, xanthans,
cellulosics and sugars), humectants (for example, sorbitol),
solubilizers (for example, ethanol, water, PEG and propylene
glycol), surfactants (for example, sodium lauryl sulfate, Spans,
Tweens, and cetyl pyridine), preservatives, antioxidants (for
example, parabens, and vitamins E and C), anti-caking agents,
coating agents, chelating agents (for example, EDTA), stabilizers,
antimicrobial agents, antifungal or antibacterial agents (for
example, parabens, chlorobutanol, phenol, sorbic acid), isotonic
agents (for example, sugar, sodium chloride), thickening agents
(for example, methyl cellulose), flavoring agents (for example,
chocolate, thalmantin, aspartame, root beer or watermelon or other
flavorings stable at pH 7 to 9), anti-foaming agents (e.g.,
simethicone, Mylicon.RTM.), disintegrants, flow aids, lubricants,
adjuvants, colorants, diluents, moistening agents, preservatives,
carriers, binders (for example, hydroxypropylmethylcellulose,
polyvinyl pyrilodone, other cellulosic materials and starch),
diluents (for example, lactose and other sugars, starch, dicalcium
phosphate and cellulosic materials), disintegrating agents (for
example, starch polymers and cellulosic materials), glidants and
water insoluble or water soluble lubricants or lubricating
agents.
[0049] One illustrative dosage form comprises, apart from the
milled and sieved active substance (bifeprunox as described
herein), lactose monohydrate, microcrystalline cellulose, sodium
starch glycolate (for example, type A), sodium stearyl fumarate and
optionally colloidal anhydrous silica. In one embodiment, lactose
is present in an amount of about 20% to about 90% by weight, about
70% to about 90% by weight, or about 75% to about 85% by weight,
based on the total weight of the tablet core. Microcrystalline
cellulose is present in an amount of about 5% to about 90% by
weight, about 10% to about 15% by weight, or about 11% to about 12%
by weight, based on the total weight of the tablet core. Sodium
starch glycolate (e.g. type A) is present in an amount of about
0.1% to about 2.5% by weight, about 0.3% to about 0.7% by weight,
or about 0.5% by weight, based on the total weight of the tablet
core. Sodium stearyl fumarate is present in an amount of about 0.1%
to about 1.5% by weight, about 0.6% to about 1.3% by weight, or
about 1.0% by weight, based on the total weight of the tablet core.
Colloidal anhydrous silica is optionally added to the formulation
in order to improve the flow properties of the powder. If desired,
colloidal anhydrous silica is typically present in an amount of
about 0.05% to about 0.5% by weight or about 0.4% by weight, based
on the total weight of the tablet core. The amount of optional
coating is about 2.0% to about 5.0% by weight, about 3.0% to about
4.0% by weight, or about 3.5% by weight, based on the total weight
of the tablet core.
[0050] In another embodiment, the present disclosure relates to a
method of producing the formulation described above, wherein the
active substance having the polymorphic form .alpha. or .gamma.
according to the present disclosure is milled and subsequently
using a suitable mixer (e.g. an orbital screw mixer (Nauta mixer)
or a combination of a diffusion mixer (bin blender) with a rotating
impeller mill (quadro co-mill)) with lactose monohydrate,
microcrystalline cellulose, sodium starch glycolate type A, sodium
stearyl fumarate and optionally with colloidal anhydrous silica.
The mixture is then pressed into tablets of the desired active
ingredient strength. During tabletting any suitable pressure can be
used, for example about 200 MPa to about 400 MPa, about 250 MPa to
about 350 MPa, or about 300 MPa. The dosage form is optionally
coated with a color and taste coating by spraying of a coating
suspension onto the tablet core using any suitable coating
equipment (e.g. a perforated pan coater or a fluidized bed
coater).
[0051] Pharmaceutical compositions comprising the polymorphic form
.alpha. and/or .gamma. according to the present disclosure can be
administered to a subject, for example a human subject, in need
thereof. Such compositions are useful for, inter alia, the
treatment of humans suffering from psychotic disorders (e.g.
schizophrenia) or Parkinson's disease.
[0052] In one embodiment of the present disclosure, upon oral
administration of a composition of the present invention to a human
subject (or a plurality thereof), for example a fasted adult human
subject, the subject exhibits a plasma T.sub.max (or a mean plasma
T.sub.max if administered to a plurality of human subjects) of
bifeprunox within about 3 hours, within about 2.8 hours, within
about 2.7 hours, within about 2.6 hours, within about 2.5 hours,
within about 2.4 hours, within about 2.3 hours, within about 2.2
hours, within about 2.1 hours or within about 2 hours. In a further
embodiment of the present invention, upon administration of a
composition of the present disclosure to a human subject, the
subject exhibits a plasma T.sub.max ranging from 0.5 hour to 8.0
hours, such as 1.5 hours or 2.0 hours. The term "T.sub.max" refers
to the time at which the maximum plasma concentration of bifeprunox
is attained following administration of bifeprunox mesylate to the
subject.
[0053] In another embodiment of the present disclosure, upon oral
administration of a composition of the present invention to a human
subject (or a plurality thereof), for example a fasted adult human
subject, the subject exhibits a plasma C.sub.max (or a mean
C.sub.max if administered to a plurality of human subjects) of
bifeprunox of at least about 0.1 ng/ml, at least about 0.12 ng/ml,
at least about 0.13 ng/ml, at least about 0.14 ng/ml, at least
about 0.15 ng/ml, at least about 0.16 ng/ml, at least about 0.17
ng/ml, at least about 0.18 ng/ml, at least about 0.19 ng/ml, at
least about 0.2 ng/ml, at least about 0.21 ng/ml, at least about
0.22 ng/ml, at least about 0.23 ng/ml, at least about 0.24 ng/ml,
at least about 0.25 ng/ml, at least about 0.26 ng/ml, at least
about 0.27 ng/ml, or at least about 0.28 ng/ml. In a further
embodiment of the present disclosure, upon administration of a
composition of the present invention to a human subject, the
subject exhibits a plasma C.sub.max of at least about 62.1.+-.38.2
ng/ml, such as a plasma C.sub.max that ranges from about 23.9 ng/ml
to about 100.3 ng/ml. The term "C.sub.max" refers to the maximum
plasma concentration of bifeprunox.
[0054] In another embodiment of the present disclosure, upon oral
administration of a composition of the present invention to a human
subject (or a plurality thereof), for example a fasted adult human
subject, the subject exhibits a plasma AUC.sub.0-24 (or a mean
plasma AUC.sub.0-24 if administered to a plurality of human
subjects) of bifeprunox of at least about 0.9 hrng/ml, 1.0 hrng/ml,
1.1 hrng/ml, 1.2 hrng/ml, 1.3 hrng/ml, or 1.4 hrng/ml. In a further
embodiment, upon administration of a composition of the present
invention to a human subject, the subject exhibits a plasma
AUC.sub.0-24 of bifeprunox ranging from about 100 hrng/ml to about
900 hrng/ml, such as at least about 401.5.+-.292.2 hrng/ml or for
example, the AUC.sub.0-24 may range from about 109.3 hrng/ml to
about 693.7 hrng/ml, and further for example, the plasma
AUC.sub.0-24 may be about 381.5 hrng/ml or may be about 825.1
hrng/ml. The term "AUC.sub.0-24" refers to the area under the
plasma concentration versus time curve for the twenty-four hour
period after administration.
[0055] AUC is a common measure of the extent of bioavailability
(relative) of a pharmaceutically active agent provided by a
particular route of administration (e.g., oral intravenous, buccal,
etc.). As used herein, the term "bioavailability" refers to the
amount of unchanged active agent, e.g., bifeprunox, reaching the
systemic circulation following administration by a particular
route. In yet a further embodiment of the present invention, upon
administration of a composition of the present invention to a human
subject, the composition displays a bioavailability of at least
50%, such as at least about 54%. That bioavailability was predicted
by considering hepatic blood flow and oral clearance.
[0056] In another embodiment of the present disclosure, upon oral
administration of a composition of the present invention to a human
subject (or a plurality thereof), for example a fasted adult human
subject, the subject exhibits a steady-state elimination half life
(t.sub.1/2) following multiple dose administration of at least
about 14.4.+-.5.3 hours, such as from about 9.1 hours to about 19.7
hours. As used herein, the term "t.sub.1/2" refers to the time
required to change the amount of active agent, e.g., bifeprunox, in
the subject by one-half during elimination.
[0057] In yet a further embodiment of the present invention, upon
oral administration of a composition of the present invention to a
human subject (or plurality thereof), for example a fasted human
subject, the subject exhibits an apparent volume of distribution
corrected by body weight ranging from about 7.9 V.sub.Zbw/F to
about 26.7 V.sub.Zbw/F (L/kg), such as about 17.3 V.sub.Zbw/F.
Moreover, the subject may exhibit a weight normalized clearance
ranging from about 0.6 CL.sub.bw/F to about 1.2 CL.sub.bw/F, such
as 0.9 CL.sub.bw/F (L/h/kg).
[0058] In still another embodiment, upon oral administration of a
composition of the present invention to a human subject (or a
plurality thereof), for example a fasted adult human subject, the
subject exhibits at least one of:
[0059] A. A plasma T.sub.max (or a mean T.sub.max if administered
to a plurality of human subjects) of bifeprunox within about 0.5 to
about 8 hours, within about 3 hours, within about 2.8 hours, within
about 2.7 hours, within about 2.6 hours, within about 2.5 hours,
within about 2.4 hours, within about 2.3 hours, within about 2.2
hours, within about 2.1 hours or within about 2 hours;
[0060] B. A plasma C.sub.max (or a mean C.sub.max if administered
to a plurality of human subjects) of bifeprunox of at least about
0.1 ng/ml, at least about 0.12 ng/ml, at least about 0.13 ng/ml, at
least about 0.14 ng/ml, at least about 0.15 ng/ml, at least about
0.16 ng/ml, at least about 0.17 ng/ml, at least about 0.18 ng/ml,
at least about 0.19 ng/ml, at least about 0.2 ng/ml, at least about
0.21 ng/ml, at least about 0.22 ng/ml, at least about 0.23 ng/ml,
at least about 0.24 ng/ml, at least about 0.25 ng/ml, at least
about 0.26 ng/ml, at least about 0.27 ng/ml, at least about 0.28
ng/ml, or at least about 62.1.+-.38.2 ng/ml; or
[0061] C. A plasma AUC.sub.0-24 (or a mean AUC.sub.0-24 if
administered to a plurality of human subjects) of bifeprunox of at
least about 0.9 hrng/ml, 1.0 hrng/ml, 1.1 hrng/ml, 1.2 hrng/ml, 1.3
hrng/ml, or 1.4 hrng/ml, or at least about 401.5.+-.292.2
hrng/ml.
[0062] In yet another embodiment, the present invention provides
for methods for treating at least one central nervous system (CNS)
disorder in a human subject in need thereof, comprising
administering to the subject a pharmaceutical composition
comprising an effective amount of bifeprunox, a crystalline
polymorph of
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
monomethanesulfonate, and at least one pharmaceutically acceptable
excipient, wherein the effective amount of bifeprunox comprises a
maintenance treatment dose and following administration of an
effective amount of the composition to the subject, the subject
exhibits at least one of:
[0063] (a) a plasma T.sub.max from about 0.5 to about 8.0
hours;
[0064] (b) a plasma C.sub.max of at least about 62.1.+-.38.2 ng/ml;
or
[0065] (c) a plasma AUC.sub.0-24 of at least about 401.5.+-.292.2
hrng/ml.
[0066] The present invention further provides for methods for
treating at least one central nervous system (CNS) disorder in a
human subject in need thereof, comprising co-administering to the
subject a pharmaceutical composition comprising an effective amount
of bifeprunox, a crystalline polymorph of
7-[4-([1,1'-biphenyl]-3-ylmethyl)-1-piperazinyl]-2(3H)-benzoxazolone
monomethanesulfonate and at least one pharmaceutically acceptable
excipient, and at least one other pharmaceutically active agent,
wherein the effective amount of bifeprunox comprises a maintenance
treatment dose.
[0067] The at least one pharmaceutically active agent other than
bifeprunox that can be used includes, but is not limited to, CYP2C9
inhibitors, CYP3A4 inhibitors, CYP2A4 inhibitors, CYP3A4 inducers,
and any pharmacologically acceptable combination thereof. Further
for example, the at least one pharmaceutically active agent can
include, but is not limited to, fluconazole, ketoconazole,
paroxetine, carbamazepine, warfarin, lithium, prothrombin,
famotidine, and any pharmacologically acceptable combination
thereof. Those of skill in the art are familiar with examples of
the techniques for incorporating additional active agents for
co-administration. Such additional pharmaceutically active agents
can be provided in a separate formulation and co-administered to a
subject with a formulation according to the present invention. Such
separate formulations can be administered before, after, or
simultaneously with the administration of compositions of the
present invention. Moreover, any of the pharmaceutical compositions
and dosage forms such as the maintenance treatment dose described
herein can further comprise at least one pharmaceutically active
agent other than bifeprunox. Those of skill in the art are familiar
with examples of the techniques for incorporating additional active
agents into compositions comprising bifeprunox.
[0068] U.S. patent application Ser. Nos. 10/920,361 and 10/920,386
are hereby incorporated herein by reference in their entireties.
All data herein are understood to be approximate and subject to
normal measurement error depending, for example, on the apparatus
used and other parameters influencing peak positions and peak
intensities. Unless specifically defined otherwise or unless the
context demands otherwise, the word "about" as used herein
generally means.+-.5% of the recited value.
EXAMPLES
[0069] The following examples are only intended to further
illustrate the present disclosure, in more detail, and therefore
these examples are not deemed to restrict the scope of the present
disclosure in any way.
Example 1
Preparation of Bifeprunox Mesylate
Example 1a
Preparation of N-(5-chloro-2-hydroxyphenyl)acetamide
[0070] 143.6 g (1 mole) of 2-amino-4-chlorphenol was suspended in
550 ml of methyl t-butyl ether under mild nitrogen purge. The
mixture was heated to reflux until the material was dissolved.
After 40 minutes, 112.3 g of acetic anhydride was added. After the
addition the mixture was cooled to
20-25.degree. C. in one hour. After stirring for an additional hour
the mixture was cooled to 0-5.degree. C. under stirring and kept on
this temperature for an additional hour. The product was filtered
off, washed with 200 ml of methyl t-butyl ether twice and dried at
50.degree. C. and 100 mbar under a gentle nitrogen stream till dry.
Yield about 92%.
Example 1b
Preparation of N-(5-chloro-2-hydroxy-3-nitrophenyl)acetamide
[0071] 224.5 g of sulphuric acid (50% w/w) was dissolved in 300 ml
of water and cooled to 25.degree. C. while stirring under a mild
nitrogen purge. 185.1 g (1 mole) of
N-(5-chloro-2-hydroxyphenyl)acetamide prepared according to Example
1a was added to the diluted sulphuric acid and mixed intensively. 4
ml of nitric acid 65% w/w was added to the foam formed on top of
the reaction mixture at low stirring speed. The stirring speed was
increased and 75 ml of nitric acid 65% w/w was added in 45 minutes,
while maintaining the temperature between 23 and 26.degree. C. The
mixture was stirred vigorously for an additional
1 hour at 23-26.degree. C. Then the mixture was cooled to
0-5.degree. C. and vigorously stirred at this temperature for 1
hour. The solid was filtered off quickly, washed three times with
300 ml of cold water, sucked for at least 30 minutes and dried at
50.degree. C. and 100 mbar under a gentle nitrogen stream till
dry.
[0072] The crude product was suspended in 2000 ml 96% ethanol,
heated till reflux and refluxed under stirring for about 15 minutes
until a clear solution was obtained. The solution was cooled to
25-30.degree. C. in about 1 hour, while stirring slowly, further
cooled to 0-5.degree. C. and stirred at this temperature for an
additional hour. The solid was filtered off, washed twice with 250
ml of cold 96% ethanol, and dried at 50.degree. C. and 100 mbar
under a gentle nitrogen stream till dry. Yield about 78%.
Example 1c
Preparation of 6-amino-4-chloro-2-nitrophenol
[0073] 230.6 g (1 mole) of
N-(5-chloro-2-hydroxy-3-nitrophenyl)acetamide prepared according to
Example 1b was suspended in a mixture of 950 ml of water and 100 ml
of 2-propanol under a mild nitrogen purge. 345 ml of 36% w/w
hydrochloric acid was added followed by 25 ml of water. The mixture
was heated to reflux in about 30.degree. C., while vigorously
stirring and refluxed for 2 hours. The mixture was cooled to
0-5.degree. C. in about one hour and stirred for an additional hour
at 0-5.degree. C. The solid was filtered off, washed twice with 250
ml of water, and dried at 50.degree. C. and 100 mbar under a gentle
nitrogen stream till dry. Yield about 91%.
Example 1d
Preparation of 5-chloro-7-nitro-2(3H)-benzoxazolone
[0074] 188.6 g (1 mole) of 6-amino-4-chloro-2-nitrophenol prepared
according to Example 1c was suspended in 1000 ml of ethyl acetate
under mild nitrogen purge and the optional present water was
removed by azeotropic distillation of 250 ml of the solvent. The
mixture was cooled to 20-25.degree. C. and
224 g of carbonyldiimidazole was added as a slurry in 650 ml of
ethyl acetate. An additional 100 ml of ethyl acetate was added and
the mixture was vigorously stirred during two hours, without the
application of cooling. 1000 ml of water was added and the mixture
was stirred for 15 minutes. 1450-1500 ml of ethyl acetate was
distilled off at about 200 mBar and about 50.degree. C. The mixture
was cooled to 0-5.degree. C., 225 ml of 36% HCl was added and the
mixture was cooled again to 0-5.degree. C. and stirred at this
temperature for 15 minutes. The solid was filtered off, washed with
400 ml of 1N HCl, washed twice with 500 ml of cold water and once
with 500 ml of cold water/ethanol (4/1), and dried at 50.degree. C.
and 100 mbar under a gentle nitrogen stream till dry. Yield about
99%.
Example 1e
Preparation of 7-amino-2(3H)-benzoxazolone
[0075] 107.5 g (1 mole) of 5-chloro-7-nitro-2(3H)-benzoxazolone
prepared according to Example 1d was suspended in 1000 ml of
ethanol. 9.25 g of Pd/C.sub.5% and 50 ml of ethanol were added and
the mixture was hydrogenated at 4 bar hydrogen pressure for four to
six hours at 60-65.degree. C. while vigorously stirring. When the
hydrogenation was complete, the mixture was cooled to 45.degree. C.
and filtered over Hyflo.RTM.. The Hyflo.RTM. was washed twice with
175 ml of methanol. 500 ml of solvent was distilled off under
reduced pressure at 50.degree. C., followed by addition of 250 ml
of water and removal of 300 ml of solvent was by distillation under
reduced pressure at 50.degree. C. The last procedure was repeated
twice and finally 250 ml of water was added and 400 ml of solvent
was distilled off. The resulting mixture was cooled to 0-5.degree.
C. in about one hour. The solid was filtered off, washed three
times with 125 ml of cold water, and dried at 50.degree. C. and
100 mbar under a gentle nitrogen stream till dry. Yield about
94%.
Example 1f
Preparation of
3-[[bis(2-hydroxyethyl)amino]methyl]-1,1'-biphenyl
[0076] A mixture was prepared of 123.4 g of diethanolamine, 100 ml
of water and 100 ml of methylethylketone (MEK) and 500 ml of methyl
t-butyl ether while stirring under a mild nitrogen purge 124.75 g
of 3-(bromomethyl)-1,1'-biphenyl was added together with 750 ml of
methyl t-butyl ether. The mixture was heated to reflux and refluxed
for 18 hours, followed by cooling till room temperature. Thereafter
the mixture was washed once with 375 ml of 2N NaOH and four times
with 375 ml of water. The combined 2N NaOH and water layers were
extracted with 750 ml of methyl t-butyl ether. The combined methyl
t-butyl ether layers were washed with 250 ml of water followed by
distillation of as much methyl t-butyl ether as possible from the
organic layer. 1350 ml of methylethylketone was added and 600 ml of
solvent was distilled of at atmospheric pressure. The solution was
cooled to room temperature and stored for use in the next step.
Yield based on quantitative assay 97%.
Example 1g
Preparation of Bifeprunox Mesylate (Crude)
[0077] A solution of 128.9 g of
3-[[bis(2-hydroxyethyl)amino]methyl]-1,1'-biphenyl in approximately
750 ml of methylethylketone prepared according to Example 1f was
stirred under mild nitrogen purge. In a separate vessel 202 g of
methanesulfonic anhydride was dissolved in 600 ml of
methylethylketone at
10-20.degree. C. To the solution of
3-[[bis(2-hydroxyethyl)amino]methyl]-1,1-biphenyl in
methylethylketone 212.8 g of triethylamine was added and 60 ml of
methylethylketone. The solution of methanesulfonic anhydride was
added in about 45-60 minutes to the
3-[[bis(2-hydroxyethyl)amino]methyl]-1,1'-biphenyl/triethylamine
solution, while maintaining the temperature below 10.degree. C. 60
ml of methylethylketone was added and the mixture was stirred for
another 15 minutes, followed by drop wise addition of 109.7 g of
methanesulfonic acid and addition of 60 ml of methylethylketone in
order to rinse the addition vessel.
[0078] 71.3 g of 7-amino-2(3H)-benzoxazolone, prepared according to
Example 1e was suspended in 100 ml of methylethylketone and added
to the reaction mixture followed by 60 ml of methylethylketone. The
reaction mixture was heated to reflux and refluxed for 20-24 hours.
After 20-24 hours of reflux
48 ml of water was added and the mixture was refluxed again for 1
hour. 420 ml of methylethylketone was added and 490 ml of
methylethylketone/water was distilled of. This last step was
repeated three times. 46.1 g of methanesulphonic acid was added,
the mixture was refluxed for an additional hour and cooled down to
room temperature in 1 hour. The mixture was further cooled down to
0-5.degree. C. and stirred at this temperature for another hour.
The solid was filtered off and, washed twice with 75 ml of cold
methylethylketone, and dried at 50.degree. C. and 100 mbar under a
gentle nitrogen stream till dry. Yield about 76%.
Example 2
Preparation of Polymorphic Form .alpha. of Bifeprunox Mesylate in
2-Propanol
[0079] 10.06 g of bifeprunox mesylate crude prepared as described
Example 1g was suspended in a mixture of 200 ml of 2-propanol and
40 ml of water under nitrogen purge. The suspension was heated
until reflux and cooled down to room temperature in 120 minutes
under stirring. The formed suspension was further cooled down under
stirring to 0.degree. C. and stirred at this temperature for a
further 120 minutes. The crystals were filtered of and dried at
50.degree. C. and 100 mbar.
Example 3
Preparation of Polymorphic Form .alpha. of Bifeprunox Mesylate in
Acetonitrile
[0080] 50 g of bifeprunox mesylate prepared crude as described in
Example 1g was suspended in a mixture of 875 ml of acetonitrile and
250 ml of water under nitrogen purge. 375 ml of acetonitrile was
added and the reaction mixture was heated till reflux. 500 ml of
solvent was distilled off and 500 ml of acetonitrile were added and
this procedure was repeated for a second time. After distilling
another 500 ml of solvent the mixture was cooled down to room
temperature in 120 minutes. The mixture was further cooled down to
0-5.degree. C. and stirred for 120 minutes at this temperature. The
formed crystals were filtered off and washed twice with
acetonitrile. The isolated crystals were dried at 50.degree. C. and
100 mbar under a mild nitrogen purge. Yield 85.6%.
Example 4
Preparation of Polymorphic Form .gamma. of Bifeprunox Mesylate
[0081] To a suspension of 12.50 g of bifeprunox mesylate (crude)
prepared as described in Example 1g in 150 ml of methylethylketone
(MEK)
75 ml of a 5% NaHCO.sub.3 solution was added in about 10-15 min.
After 5-10 minutes of stirring the suspension was filtered over
Hyflo.RTM. or Celite.RTM. into another vessel where the layers were
separated. The water layer was extracted with 125 and 75 ml of
methylethylketone. The methylethylketone layers were combined and
washed with a mixture of 50 ml of water and 10 ml of ethanol
96%.
[0082] The methylethylketone layer was filtered through a 1 .mu.m
filter into a clean vessel, after which the filter was rinsed with
25 ml of methylethylketone. Methylethylketone was distilled off
until a volume of about 130 ml was reached, 200 ml of
methylethylketone was added and again methylethylketone was
distilled off to reach a volume of 175 ml.
[0083] Next, a solution of 3.00 grams of methane sulphonic acid in
50 ml of methylethylketone was added in about 30 min. After cooling
to 5.degree. C. and stirring for 11/2 hours at this temperature the
product was filtered off and washed twice with 50 ml of cold
methylethylketone. After drying at 50.degree. C. and 100 mbar under
a mild nitrogen purge the gamma (.gamma.) polymorph of bifeprunox
mesylate yield was about 80%.
Example 5
Preparation of a 10 mg Capsule Formulation of Polymorphic Form
.alpha. of Bifeprunox Mesylate
[0084] 2.227 kg of lactose was sieved and filled into a high shear
mixer. 125 g of bifeprunox mesylate in its polymorphic form .alpha.
was sieved and added. The composition was mixed with a high shear
mixer (e.g. Collette Gral 10 or Collette Gral 75) until it was
homogenous (approximately 4 minutes). 24 g of a disintegrant (e.g.
sodium starch glycolate USP-NF such as Primojel.RTM.) and 24 g of a
lubricant (e.g. sodium stearyl fumarate such as PRUV.RTM.) were
added and the composition was mixed again until it was homogenous
(approximately 1 minute). The powder was filled into capsules size
0, 240 mg per capsule by means of a capsule filling machine (e.g.
Zanasi LZ 64 or Zanasi RM63 plug filler). Approximately 10,000
filled capsules were obtained.
Example 6
Preparation of a 10 mg Tablet Formulation of Bifeprunox Mesylate
Polymorphic Form .alpha.
[0085] Tablets with a strength of 10 mg were prepared according to
the following procedures (required quantities are given in Table
8). One third of the given amount of lactose monohydrate was sieved
and filled into a high shear mixer and mixed during 5 minutes. The
required amount of milled bifeprunox mesylate in its polymorphic
form a was added to the mixture, together with
0.100 kg sodium starch glycolate, type A, 2.32 kg microcrystalline
cellulose and the remainder of the lactose monohydrate. The
composition was mixed with a high shear mixer (e.g. Collette Gral
10 or Collette Gral 75) until it was homogenous (approximately 10
minutes). The required amount of a sodium stearyl fumarate (such as
PRUV.RTM.), sieved through a 0.42 mm sieve was added and the
composition was mixed again until it was homogenous (approximately
5 minutes). The final product was compressed with 300 MPa into
tablets. The product was coated using 15% m/m of the indicated
Opadry II HP water suspension to 3.5% of the core weight.
[0086] Table 8 shows the amount of active ingredient and auxiliary
materials used in a large scale production of 10 mg bifeprunox
mesylate tablets.
TABLE-US-00010 TABLE 8 Per batch of 83333 10 mg tablets Components
(in kg) Core components Bifeprunox mesylate (milled) 1.041 Lactose
monohydrate 16.33 Microcrystalline cellulose 2.32 Sodium starch
glycolate, type A 0.100 Sodium stearyl fumarate 0.200 Coating
components Opadry II HP beige 85F27126 0.700 Purified water
3.968
Example 7
Analytical Methods
[0087] XRPD patterns were measured on a diffractometer using
monochromatic CuKa radiation (tube voltage 40 kV, tube current 40
mA) at room temperature. IR spectra were recorded on a Fourier
transform IR spectrometer in attenuated total reflectance (silicon
crystal) with a spectral resolution of 2 cm.sup.-1 using a mercury
cadmium telluride detector.
[0088] Melting points were determined on a DSC apparatus as onset
temperatures of the melting endotherm using 40 .mu.L aluminum
crucibles with a pierced lid. Temperature program: heating from
25.degree. C. up to 300.degree. C. with 10 K min.sup.-1. N.sub.2
atmosphere at a flow of 80 mL min.sup.-1.
[0089] The solid state .sup.13C NMR spectra were obtained using the
cross-polarisation magic-angle spinning (CP/MAS) accessory on a
Bruker AM300 instrument (contact time of 4 ms, recycle delay 3 s,
spectral width 30 kHz,
.sup.1H 90.degree. pulse of 6 .mu.s, spinning rate about 8.5 kHz. A
standard 4 mm Bruker CP/MAS probe was used. Chemical shifts are
referred to glycine (.delta..sub.c=176.03 ppm for the C.dbd.O
resonance).
[0090] Crystals of the alpha (.alpha.) form appeared under the
microscope as block-shaped, those of the gamma (.gamma.) crystal
form were plate- or rod-shaped, whereas crystals of the delta
(.delta.) crystal form looked block-shaped with rounded edges.
[0091] For each crystal form, a crystal was transferred into the
cold nitrogen stream on a rotating anode X-ray diffractometer. The
structures were solved by automated direct methods. Hydrogen atoms
bonded to nitrogen were located on an electron-density map and
their coordinates were included as parameters in the refinement.
Other hydrogen atoms were included in the refinement on calculated
positions riding on their carrier atoms. All non-hydrogen atoms
were refined with anisotropic atomic displacement parameters.
Hydrogen atoms were given fixed displacement factors, related to
those of their carrier atoms.
Example 8
Pharmacokinetic Study
[0092] A single center, open label, randomized, double two-way
cross-over study was used to assess the relative bioavailability of
a 0.125 mg and a 20 mg (active ingredient amount) capsule
formulation (.delta. polymorphic form of bifeprunox mesylate)
respectively with a 0.125 mg and 20 mg (active ingredient amount)
tablet formulation of the .alpha. polymorphic form of bifeprunox
mesylate after oral administration to healthy male and female
volunteers. Capsules and tablets were prepared substantially as
described in Examples 5 and 6 with appropriate adjustments for dose
and formulation, e.g., capsules or tablets.
[0093] Treatment started with a single dose of 0.125 mg bifeprunox
mesylate as either a capsule or tablet formulation. The first
cross-over started on Day 3 when a single dose of 0.125 mg
bifeprunox mesylate, in the opposite formulation than that started
with, was given. Next, after one drug free day, the subjects were
uptitrated with the Day 3 formulation over a period of 8 days
(Days 5-12). Subsequently, the 20 mg formulation was given for an
additional 3 days (Days 13-15), followed by a second cross-over to
a 20 mg treatment of the first formulation (capsule or tablet) for
four days (Days 16-19).
[0094] Pharmacokinetic parameters were determined two times for 48
hours starting on Days 1 and 3 (for the single dose
pharmacokinetics), and two times for 24 hours starting on Days 15
and 19 (for multiple dose pharmacokinetics). For differences
between the test (tablet) and the reference (capsule) treatment,
90% confidence intervals are given for the 0.125 mg and
20 mg treatments. The information for the 0.125 data is extracted
out of the Day 1 and Day 3 measurements, while the steady state
plasma levels of Day 15 and Day 19 are used for the pharmacokinetic
information of the 20 mg regimen.
[0095] Pharmacokinetic results are shown in Table 9.
TABLE-US-00011 TABLE 9 AUC.sub.0-t AUC.sub.0-24 AUC Dose T.sub.max
C.sub.max (hr (hr (hr (mg) Formulation (hr) (ng/ml) ng/ml) ng/ml)
ng/ml) 0.125 Capsule (.delta.) 3.16 0.155 0.904 -- 1.31 0.125
Tablet (.alpha.) 2.31 0.281 1.46 -- 1.69 20 Capsule (.delta.) 2.00
50.8 -- 352 -- 20 Tablet (.alpha.) 1.81 54.1 -- 349 --
[0096] As is shown above, the bioavalability (AUC, C.sub.max) of
the 0.125 mg tablet was higher compared to the reference capsule.
Compared to the capsule, that tablet also exhibited a faster
T.sub.max. From 6 hours post administration up to the last
measurable plasma concentrations, the average plasma concentration
time profiles were nearly congruent for both formulations.
[0097] Following multiple 20 mg doses, no major differences were
found between the capsule and tablet formulation. For the AUC, the
90% confidence intervals of the ratio tablet/capsule were within
the 80%-125% range.
Example 9
Tablet Dissolution
[0098] Three different strengths of tablets (10 mg, 5 mg and 1 mg
of bifeprunox mesylate) were prepared having the compositions shown
in Table 10; the tablets were designated T1, T2 and T3,
respectively.
TABLE-US-00012 TABLE 10 T1 T2 T3 Label claim, mg/tablet 10.0 5.0
1.0 Component Quantity (mg) Bifeprunox 12.49 6.25 1.25 Lactose
monohydrate 3.75 4.50 3.60 Lactose monohydrate .sup.1 106.26 136.25
112.75 Sodium starch glycolate 1.25 1.50 1.20 Sodium stearyl
fumarate 1.25 1.50 1.20 .sup.1 Direct Compression
[0099] Each of the tablets were placed in a dissolution test under
the following conditions: Apparatus: paddle method; Stirring speed:
50 rpm; Amount of test dissolution medium: 900 ml; Temperature of
dissolution medium:
37.degree. C..+-.0.5.degree. C.
[0100] Six different dissolution media were used as follows:
[0101] Media 1: Dissolve 2.0 g of sodium chloride dissolved in 7.0
ml of hydrochloric acid, q.s. with water to make 1000 ml (pH
1.2);
[0102] Media 2: MclLvaine buffer solution (pH 3.0), pH adjusted
with 0.05 mol/L of sodium hydrogen phosphate and 0.025 mol/L of
citric acid;
[0103] Media 3: MclLvaine buffer solution (pH 4.0);
[0104] Media 4: MclLvaine buffer solution (pH 5.0);
[0105] Media 5: Water;
[0106] Media 6: To 250 ml of 0.2 mol/L potassium
dihydrogenphosphate TS add 118 ml of 0.2 mol/L sodium hydroxide TS
and water to make 1000 ml.
[0107] Tables 11-16 show dissolution results in each of the above
media, respectively. Dissolution testing was performed in
triplicate.
TABLE-US-00013 TABLE 11 Media 1 10 .times. 1.0 mg tablets 2 .times.
5.0 mg tablets 1 .times. 10.0 mg tablets % RLC dissolved bifeprunox
% RLC dissolved bifeprunox % RLC dissolved bifeprunox Time in
Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel
minutes 1 2 3 1 2 3 1 2 3 0 <LOD <LOD <LOD <LOD <LOD
<LOD <LOD <LOD <LOD 60 24.1 24.4 23.7 24.0 22.5 14.6
14.0 13.1 1.5 120 26.1 26.5 25.9 26.3 24.9 18.2 17.6 16.7 1.8 180
27.1 27.5 27.1 27.5 26.2 20.1 19.6 18.8 2.1 240 27.9 28.1 27.9 28.4
27.0 21.5 20.9 20.2 2.3 300 28.4 28.7 28.4 28.9 27.4 22.4 21.9 21.3
2.5
TABLE-US-00014 TABLE 12 Media 2 10 .times. 1.0 mg tablets 2 .times.
5.0 mg tablets 1 .times. 10.0 mg tablets % RLC dissolved bifeprunox
% RLC dissolved bifeprunox % RLC dissolved bifeprunox Time in
Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel
minutes 1 2 3 1 2 3 1 2 3 0 <LOD <LOD <LOD <LOD <LOD
<LOD <LOD <LOD <LOD 6 68.7 70.4 78.2 70.2 69.0 78.7
99.3 96.4 94.9 12 95.3 91.6 94.6 93.6 92.9 94.5 103.6 102.0 102.8
20 99.2 97.1 97.4 97.8 99.6 97.9 106.5 104.8 103.2 30 100.3 97.7
98.5 99.6 101.6 98.0 106.1 105.5 104.1 45 101.1 99.1 97.9 100.3
102.5 98.2 107.6 107.3 104.3 60 100.9 100.2 99.2 99.8 102.6 98.7
107.0 106.7 104.7
TABLE-US-00015 TABLE 13 Media 3 10 .times. 1.0 mg tablets 2 .times.
5.0 mg tablets 1 .times. 10.0 mg tablets % RLC dissolved bifeprunox
% RLC dissolved bifeprunox % RLC dissolved bifeprunox Time in
Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel
minutes 1 2 3 1 2 3 1 2 3 0 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 6
59.9 58.8 65.0 33.9 36.2 33.1 47.1 52.0 57.7 12 80.2 79.8 84.6 50.5
50.6 50.3 67.7 69.6 79.0 20 90.1 92.9 91.0 67.0 64.2 66.5 89.4 82.5
84.1 30 92.3 96.5 93.1 75.1 74.8 74.1 91.3 90.4 89.8 45 95.2 98.8
95.1 82.6 82.4 82.9 97.4 94.8 96.0 60 96.5 98.9 94.9 86.4 86.5 86.8
97.1 96.5 96.6
TABLE-US-00016 TABLE 14 Media 4 10 .times. 1.0 mg tablets 2 .times.
5.0 mg tablets 1 .times. 10.0 mg tablets % RLC dissolved bifeprunox
% RLC dissolved bifeprunox % RLC dissolved bifeprunox Time in
Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel
minutes 1 2 3 1 2 3 1 2 3 0 <LOD <LOD <LOD <LOD <LOD
<LOD <LOD <LOD <LOD 60 34.9 38.0 34.4 41.7 32.6 37.6
35.6 22.6 25.4 120 46.5 34.1 47.4 46.9 43.6 38.5 41.0 41.6 37.0 180
39.6 39.4 45.8 33.4 44.1 41.1 39.2 43.5 34.2 240 38.8 45.5 43.0
45.6 50.8 49.0 44.0 50.9 36.9 300 47.1 34.0 40.5 57.1 42.3 37.1
53.7 50.6 58.1
TABLE-US-00017 TABLE 15 Media 5 10 .times. 1.0 mg tablets 2 .times.
5.0 mg tablets 1 .times. 10.0 mg tablets % RLC dissolved bifeprunox
% RLC dissolved bifeprunox % RLC dissolved bifeprunox Time in
Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel
minutes 1 2 3 1 2 3 1 2 3 0 <LOD <LOD <LOD <LOD <LOD
<LOD <LOD <LOD <LOD 6 65.3 64.9 71.6 73.6 72.3 60.4
70.8 84.9 77.1 12 82.8 88.5 91.0 86.7 86.4 87.9 92.7 89.5 96.8 20
89.9 95.9 96.0 91.1 90.2 94.7 97.1 97.8 102.2 30 91.3 97.0 97.2
92.5 91.2 97.1 100.4 98.6 105.7 45 92.0 97.8 97.7 93.0 91.2 98.7
101.6 100.5 106.4 60 91.9 98.0 97.8 92.7 91.1 99.6 102.5 101.1
107.8
TABLE-US-00018 TABLE 16 Media 6 10 .times. 1.0 mg tablets 2 .times.
5.0 mg tablets 1 .times. 10.0 mg tablets % RLC dissolved bifeprunox
% RLC dissolved bifeprunox % RLC dissolved bifeprunox Time in
Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel Vessel
minutes 1 2 3 1 2 3 1 2 3 0 <LOD <LOD <LOD <LOD <LOD
<LOD <LOD <LOD <LOD 60 6.9 8.2 7.9 7.1 4.1 <LOD
<LOD <LOD <LOD 120 6.6 8.3 7.2 7.7 5.4 <LOD <LOD
<LOD <LOD 180 7.1 10.3 7.5 7.6 5.2 <LOD <LOD <LOD
<LOD 240 9.9 9.2 7.8 8.0 7.3 <LOD <LOD <LOD <LOD 300
7.5 9.1 8.0 8.3 7.6 <LOD <LOD <LOD <LOD
[0108] As can be seen in the above tables, there is no difference
in dissolution behavior between 1.0 mg, 5.0 mg and 10.0 mg tablets
of bifeprunox. Bifeprunox dissolves almost immediately in MclLvaine
buffer pH 3.0.
[0109] It is believed that the difference in dissolved bifeprunox
in Table 11 between 1.0 mg, 5.0 mg and 10.0 mg tablets is caused by
the different amounts of excipients, e.g. 10 tablets of 1.0 mg, 2
tablets of 5.0 mg and 1 tablet of 10.0 mg in the dissolution
vessels. Some of the excipients are surface active.
[0110] Overall, the dissolution behavior of tablets with the
strengths of 1.0 mg, 5.0 mg and 10.0 mg bifeprunox are
substantially the same.
Example 10
Clinical Studies of Bifeprunox Using Maintenance Doses
[0111] The pharmacokinetics of bifeprunox in healthy subjects were
investigated based on a pooled analysis of pharmacokinetic (PK)
parameters from 21 clinical pharmacology studies. The pooled
analysis included PK profiles obtained following single and
multiple doses administered to 132 and 399 subjects, respectively,
and explored the potential effects of age, gender, body weight and
race. In addition, PK in patients (PTS) with schizophrenia were
investigated using a population PK approach based on samples from
376 subjects in phase II studies and 434 subjects in phase III
studies.
[0112] In healthy subjects and patients with schizophrenia, the
maximum tolerated single dose of bifeprunox was 0.5 mg. Tolerance
to dose-limiting side effects (nausea, dizziness, vomiting, and
orthostatic hypotension) developed as the dosage was titrated
upwards. All PK assessments at doses higher than 0.5 mg were
performed following multiple dosages under steady-state conditions.
Doses of 5-40 mg were administered in efficacy studies. PK
parameters describing absorption, distribution, metabolism, and
elimination were calculated based on non-compartmental analysis. PK
parameter values from each study were combined to create a pooled
dataset. The potential influence of gender, body weight, and race
on bifeprunox PK was analyzed.
[0113] Bifeprunox PK parameters following multiple dose
administration are shown in Table 17.
TABLE-US-00019 TABLE 17 Dose *C.sub.max *AUC.sub.0-24 V.sub.Zbw/F
CL.sub.bw/F (mg/day) (ng/mL) (ng hr/mL) T.sub.max (h) T.sub.1/2 (h)
(L/kg) (L/h/kg) N 334 334 334 196 196 335 20 and 40 62.1 .+-. 38.2
401.5 .+-. 292.2 2.0 (0.5-8.0) 14.4 .+-. 5.3 17.3 .+-. 9.4 0.9 .+-.
0.3 mg/day V.sub.Zbw/F = apparent volume of distribution corrected
by body weight. CL.sub.bw/F = weight normalized oral clearance.
Data presented as mean .+-. SD for all parameters except T.sub.max,
which is presented as median (range) *Dose normalized to 20 mg.
[0114] Absorption
[0115] Bifeprunox was rapidly absorbed after oral administration.
The median time to peak plasma concentration (T.sub.max) was
approximately 2 hours. See FIG. 16. Multiple patients were dosed
proportional in the 20 to 40 mg/day range (mean AUC.sub.0-24 for 20
mg: 381.5 nghr/mL and mean AUC.sub.0-24 for 40 mg: 825.1 nghr/mL).
Administration with a high-fat meal was studied at the 40 mg dose,
and appeared to have a minimal impact: T.sub.max was delayed by 1.5
hours and C.sub.max (maximum observed plasma concentration-time
curve over the dosing interval of 24 hours) increased by 29%.
Moreover, it was demonstrated that bifeprunox can be administered
with or without food. Bioavailability was predicted to be 54% based
on hepatic blood flow and oral clearance. Absolute oral
bioavailability of the bifeprunox tablets used in the pooled
studies has not been determined.
[0116] Distribution
[0117] Apparent volume of distribution (Vz/F) was 1300 L. Based
upon the volume of distribution, bifeprunox was extensively
distributed into the peripheral tissues. No extensive distribution
of bifeprunox or its metabolites into red blood cells occurred.
Bifeprunox was more than 99% bound to plasma proteins in healthy
patients as well as those with renal or hepatic impairment. The
blood/plasma ratio for bifeprunox was observed to be in the range
of 0.7 to 0.9.
[0118] Metabolism
[0119] Based on in vitro data, bifeprunox was metabolized in the
liver primarily by the CYP2C9 and CYP3A4 enzymes, with minor
contribution from CYP2A4. Among healthy subjects with reduced
enzyme activity for CYP2C ((intermediates/slow metabolizers),
bifeprunox C.sub.max were 3.1 to 3.9 fold, respectively, higher
than for extensive metabolizers. Likewise, AUC values were,
respectively, 3.7 and 7.1-fold higher for intermediate and slow
metabolizers, than for extensive metabolizers.
[0120] Elimination
[0121] Steady-state mean oral clearance (CL/F) was 62.2 L/h. The
mean steady-state elimination half-life (t.sub.1/2) following
multiple dose administration was 14.4 hours. Steady-state levels
were reached within 2 to 4 days. Administration of a single-dose of
[.sup.14C]-labeled bifeprunox (0.25 mg) showed that 13% of
radioactivity was excreted via the urine, and 73% via the feces.
Overall, 89% of radioactivity was excreted. The amounts of
unchanged bifeprunox excreted in the urine and feces were 2% and
17%, respectively.
[0122] Effects of Age, Gender, Body Weight and Race
[0123] Pooled analysis showed no clinically relevant age-, gender-,
body weight-, or race-related effects on bifeprunox PK.
[0124] Drug-Drug Interactions
[0125] Co-administration with the potent CYP2C9 inhibitor and weak
CYP3A4 inhibitor, fluconazole increased mean bifeprunox C.sub.max
and AUC.sub.0-24 by 2.5- and 3.7-fold, respectively. See FIG. 17B.
The CYP3A4 inhibitor ketoconazole increased bifeprunox C.sub.max
and AUC.sub.0-24 by 44% and 63%, respectively. See FIG. 17A.
Co-administration with CYP2A4 inhibitor paroxetine had no effect on
bifeprunox PK. See FIG. 17C. Bifeprunox exposure was reduced by
approximately 50% after co-administration with the CYP3A4 inducer
carbamazepine. See FIG. 17D. Carbamazepine decreased mean C.sub.max
and AUC.sub.0-24 by 50% and 54%, respectively. Bifeprunox had no
effect on the PK and pharmacodynamics of warfarin and the PK of
lithium. The prothrombin time profile as a function of study day
following treatment with warfarin was comparable in the presence
and absence of bifeprunox. See FIG. 18.
[0126] Administration of famotidine, an H2 antagonist that inhibits
gastric acid secretion, had no effect on bifeprunox PK.
[0127] PK in Patients
[0128] A population-based PK assessment using compartmental methods
was conducted in 810 patients with schizophrenia enrolled in
several clinical studies. Bifeprunox PK were similar in healthy
subjects (HS) and schizophrenia patients (SP): bifeprunox Vz/F was
approximately 1300 L in HS versus 1100 L in SP; bifeprunox Cl/F was
62.2 L/hr in HS versus 57 L/hr in SP; and bifeprunox t.sub.1/2 was
14 hrs in HS versus 15 hrs in SP.
[0129] Based on those pharmacokinetics, bifeprunox (an
investigational partial dopamine agonist antipsychotic compound)
was rapidly absorbed after oral administration. Multiple-dose PK of
bifeprunox were dose proportional over the range of 20 to 40 mg
doses. Bifeprunox was extensively distributed into peripheral
tissues and highly protein bound. It was primarily eliminated in
the feces. Based on in vivo data, bifeprunox was primarily
metabolized by CYP2C9 and to a lesser extent by CYP3A4. Bifeprunox
was eliminated from the systemic circulation with a steady-state
elimination t.sub.1/2 of approximately 14 hours; steady-state was
reached within 2 to 4 days. Bifeprunox has a low drug interaction
potential with other drugs used in these studies (e.g. lithium,
warfarin and famotidine).
* * * * *