ANTIRETROVIRAL COMPOSITION
FIELD OF INVENTION
The present invention relates to a pharmaceutical solid oral sprinkle composition comprising
one or more anti-retroviral drugs, such as ritonavir, a manufacturing process thereof, and a
use of said composition for the treatment of diseases caused by retroviruses, especially
acquired immune deficiency syndrome or an HTV infection. In particular, the present
invention relates to a sprinkle formulation comprising one or more anti-retroviral drug, such
as ritonavir.
BACKGROUND AND PRIOR ART
Acquired Immune Deficiency Syndrome (AIDS) causes a gradual breakdown of the body's
immune system as well as progressive deterioration of the central and peripheral nervous
systems. Two distinct retroviruses, human immunodeficiency virus (HIV) type-1 (HTV-l) or
type-2 (HIV-2), have been etiologically. linked to the immunosuppressive disease, acquired
immunodeficiency syndrome (AIDS). HIV seropositive individuals are initially
asymptomatic but typically develop AIDS related complex (ARC) followed by AXDS.
Affected individuals exhibit severe immunosuppression, which predisposes them to
debilitating and ultimately fatal opportunistic infections. Retroviral replication routinely
features post-translational processing of polyproteins. This processing is accomplished by
virally encoded HIV protease enzyme. This yields mature polypeptides that will
subsequently aid in the formation and function of infectious virus. If this molecular
processing is stifled, then the normal production of HIV is terminated. Therefore, inhibitors
of HIV protease may function as anti-HTV viral agents.
There are various compositions comprising HIV protease inhibitors and methods of
preparing the same.
Ritonavir is chemically designated as l,3-thiazol-5-ylmethyl N-[(2S,3S,5S)-3-hydroxy-5-
[(2S)-3-methyl-2-{[methyl({[2-(propan-2-yl)-l,3-thiazol-
4yl]methyl})carbamoyl]amino}butanamido]-l,6-diphenylhexan-2-yl]carbamate and has the
following structure.
Ritonavir is a protease inhibitor with activity against Human Immunodeficiency Virus Type
1 (HIV-1). Protease inhibitors block the part of HIV called protease. HIV- 1 protease is an
enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the
individual functional proteins found in infectious HTV-1. Ritonavir binds to the protease
active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the
viral poly proteins resulting in the formation of immature non-infectious viral particles. A
preferred dosage of ritonavir is from about 1 to 200 mg. Further, protease inhibitors are
typically used in combination with at least one other anti-HIV drug. Ritonavir is widely
given in combination with lopinavir. Ritonavir is commercially available as tablets and oral
solution under the trade name NORVIR ® in the United States and Europe.
Ritonavir and its salts were first described in US patent 5541206. Said patent describes the
structure of ritonavir and the processes for its preparation. Further it describes
pharmaceutical compositions and process for making compositions comprising ritonavir.
The compositions described are administered orally, parenterally, sublingually, by inhalation
spray, rectally, or topically in dosage unit formulations containing conventional nontoxic
pharmaceutically acceptable carriers, adjuvants, and vehicles. Solid dosage forms for oral
administration include capsules, tablets, pills, powders, and granules. However, said patent
does not disclose taste masked compositions of ritonavir.
Lopinavir and its. salts are first described in US patent 5914332. Said patent describes the
structure of lopinavir and the processes for its preparation. Further it describes
pharmaceutical compositions comprising lopinavir. The patent further describes a preferred
dosage form as a soft elastic gelatin capsule. (SEC) or a hard gelatin capsule. The
combination of lopinavir with ritonavir and the use for inhibition or treatment of HIV or
AIDS in combination is also described in said patent. Ritonavir on co-administration with
lopinavir causes an improvement in the pharmacokinetics (i.e., increases half-life, increases
the time to peak plasma concentration, increases blood levels) of lopinavir. However, for
specific patient populations such as geriatrics and paediatrics, the dosage form as suggested
may be of concern as these patient populations may experience difficulty in swallowing
larger sized tablets or capsules, leading to poor patient compliance.
WO9822106 describes a liquid pharmaceutical composition of compounds which are
inhibitors of HIV protease with improved oral bioavailability. This application, in particular,
describes a composition in the form of a solution which comprises (a) the HIV protease
inhibitor, (b) a pharmaceutically acceptable organic solvent and, optionally, (c) a surfactant.
It is further described that the composition ca be optionally encapsulated in either hard
gelatin capsules or soft elastic capsules (SEC). The preferred HIV protease inhibitor is a
lopinavir/ritonavir combination. The above process involves a complex manufacturing
process. However, said patent does not disclose taste masked sprinkle compositions of
ritonavir.
WO02096395 relates to soft elastic capsules and HIV protease inhibiting compounds
contained in the soft elastic capsule. The application describes soft elastic capsules that
have: a fill, which includes pharmaceutical agents; an alcohol; a fatty acid; and a shell,
which includes gelatin and plasticizing agents. It is well known in the art that there is a
limited choice of excipients/carriers compatible with gelatin. In general, capsules have
crosslinking problems, and to overcome these problems, fillers and stabilizers like citric
acid, glycine needs to be incorporated. However, said patent does not disclose taste masked
compositions of ritonavir.
WO20080 17867 relates to a solid oral composition comprising one or more anti-retroviral
drugs, such as lopinavir and ritonavir, with a water insoluble polymer, however, the specific
formulation is silent on the dosage forms for specific patient populations such as geriatrics
and paediatrics. .
W.095/07696 discloses an encapsulated solid or semi-solid dosage form for ritonavir.
However, said patent does not disclose taste masked compositions of ritonavir.
For most of the therapeutic agents, to produce systemic effects, the oral route still represents
the preferred way of administration, .owing to its several advantages and high patient
compliance, as compared to any other routes of administration. Tablets and hard gelatin
capsules still constitute a major portion of drug delivery systems that are currently available.
However, many patient groups such as the elderly, children, and patients who are mentally
retarded, uncooperative, nauseated, or on reduced liquid-intake/diets, have difficulties
swallowing dosage forms such as tablets and hard gelatin capsules. Further, those who are
traveling or have little access to water are similarly affected.
Also, the route of drug administration, appearance, colour, taste, tablet size -and dosing
regimen are most important parameters that govern patient compliance.
Patient compliance is an important aspect of HIV treatment. If patient compliance decreases,
the therapeutic efficiency of the treatment decreases, which in turn may increase resistance
to the said treatment. Dosage forms which lead to improved patient compliance therefore^
improve the overall long term therapeutic efficacy of the treatment. Issues surrounding
patient compliance are particularly important for long-term treatments involving chronic
infections such as HIV.
In particular, geriatric an paediatric patients often experience difficulty in swallowing
larger sized tablets, since large size tablets may result in oesophageal damage due to their
physical characteristics, if they are not swallowed properly, which may lead to poor patient
compliance.
Also, oral administration of bitter drugs with a acceptable degree of palatability is a key
issue for health care providers, especially for paediatric patients. In the case of paediatric
and geriatric patients, unpleasant taste should be avoided, since it leads to noncompliance
resulting in decreased therapeutic efficacy.
Patients particularly prefer oral dosage forms that are easy to swallow and have a pleasant
taste or no taste at all. Objectionable taste is one of the most important formulation problems
that are found with certain drugs. This is a distinct problem for drugs which are required to
be formulated in an oral dosage form. Thus oral administration of bitter drugs is a major
concern for patient compliance.
Further, there has been an enhanced demand for dosage forms that are more patient-friendly
and compliant. Since the development cost of a new drug molecule is very high, efforts are
now being made to focus on the development of new drug dosage forms for existing drugs
with improved safety and efficacy together with reduced dosing frequency as well as which
are cost-effective.
Several taste masking techniques are available, such as sensory masking by adding
correctives, an . chemical masking by chemical modification, such as preparation of
inclusion compounds and prodrugs, masking by using a matrix, and physical masking by use
of additives. Many techniques have been developed, not only to improve the taste of the
molecule but also the formulation and performance of the molecule. These include
inclusion complex formation with cyclodextrin, use of ion exchange resin, solubility limiting
methods, liposome and multiple emulsions, etc. However all such techniques involve use of
complex methods or systems and moreover are expensive.
Hence, to fulfil these medical needs, and to overcome the issues of patient compliance, there
remains a need to produce suitable dosage forms which meet the aforementioned
requirements.
OBJECT OF THE INVENTION
An object of the present invention is to provide a pharmaceutical solid oral composition, in
the form of a sprinkle formulation, for use with children and other patients, who have
difficulty swallowing the conventional solid dosage forms.
Another object of the present invention is to provide a pharmaceutical solid oral
composition, in the form of a sprinkle formulation, which may be administered without the
need to take it with water.
Another object of the present invention is to provide a pharmaceutical solid oral
composition, in the form of a sprinkle formulation, weighing a minimal amount for use in
children and other patients.
Another object of the present invention is to provide a pharmaceutical solid oral
composition, in the form of a sprinkle formulation, with a taste masking property and for
providing better patient compliance for use with children and other patients.
Another object of the present invention is to provide a pharmaceutical solid oral
composition, which is a sprinkle formulation, in the form of powders, powders for
reconstitution, pellets, beads, mini-tablets, film coated tablets, film coated tablets MUPS,
orally disintegrating MUPS, pills, micro-pellets, small tablet units, MUPS (multiple unit
pellet system), disintegrating tablets, dispersible tablets, granules, effervescent granules and
microspheres.
Still another object of the present invention is to provide a pharmaceutical solid oral
composition, in the form of a sprinkle formulation, which is easy to manufacture.
Another object of the present invention is to provide a process for preparing the
pharmaceutical solid oral composition, in the form of a sprinkle formulation.
Yet another object of the present invention is to provide a method of treating diseases
caused by retroviruses, especially acquired immune deficiency syndrome or an HIV
infection, which method comprises administering the said pharmaceutical solid oral
composition, in the form of a sprinkle formulation.
• . • .
Another object of the present invention is to provide, use of the pharmaceutical solid oral
composition, in the manufacture of a medicament for the treatment of an acquired immune
deficiency syndrome or in HIV infection, which medicament is in the form of a sprinkle
formulation.
SUMMARY OF THE INVENTION
According to one aspect of the present invention, there is provided a pharmaceutical solid
oral composition, - in the form of a sprinkle formulation, comprising one or more
antiretroviral drugs.
According to an aspect of the present invention, there is provided a pharmaceutical solid oral
composition, in the form of a sprinkle formulation, comprising ritonavir.
According to another aspect of the present invention, there is provided a pharmaceutical
solid oral composition, in the form of a sprinkle formulation, comprising one or more
antiretroviral drugs and at least one polymer.
According to another aspect of the present invention, there is provided a pharmaceutical
solid oral composition, in the form of a sprinkle formulation, comprising ritonavir and at
least one polymer.
According to yet another aspect of the present invention there is provided a process of
manufacturing a pharmaceutical solid oral composition in the form of a sprinkle
formulation, comprising one or more antiretroviral drugs and one or more pharmaceutically
acceptable excipients.
According to yet another aspect of the present invention there is provided a process of
manufacturing a pharmaceutical solid oral composition, which is a sprinkle formulation,
comprising a plurality of particles or sub-units, the plurality of particles comprising one or
more antiretroviral drugs, a polymer, and optionally one or more pharmaceutically
acceptable excipients, comprising hotmelt extruding the one or more antiretroviral drug to
form an extrudate, then formulating the extrudate into the plurality of particles or sub-units,
and combining the plurality of particles or sub-units to provide the solid oral composition.
According to yet another aspect of the present invention there is provided a process of
manufacturing a pharmaceutical solid oral composition, which is a sprinkle formulation,
comprising a plurality of particles or sub-units, the plurality of particles comprising
ritonavir, a polymer and optionally one or more pharmaceutically acceptable excipients,
comprising hot melt extruding ritonavir to form an extrudate, then formulating the extrudate
into the plurality of particles or sub-units, and combining the plurality of particles or subunits
to provide the solid oral composition.
According to yet another aspect of the present invention there is provided a method of
treating diseases caused by retroviruses, especially acquired immune deficiency syndrome or
an HIV infection, which method comprises administering pharmaceutical solid oral
composition, in the form of sprinkle formulation, comprising one or more .antiretroviral
drugs.
According to yet another aspect of the present invention there is provided a method of
treating diseases caused by retroviruses, especially acquired immune deficiency syndrome or
an HIV infection, which method comprises administering a pharmaceutical solid oral
composition, in the form of a sprinkle formulation, comprising ritonavir.
According to yet another aspect, the present invention provides a use of the pharmaceutical
solid oral composition in the manufacture of a medicament for the treatment of an acquired
immune deficiency syndrome or an HIV infection.
DETAILED DESCRIPTION OF THE INVENTION
The inventors of the present invention have developed a pharmaceutical solid oral
composition comprising one or more antiretroviral drugs, and a polymer comprising; a water
swellable polymer; a water insoluble polymer; and any combination thereof, wherein the
solid oral composition is in the form of a sprinkle formulation, which may be conveniently
administered to specific patient populations such as geriatrics and paediatrics.
. . • .
Accordingly, the pharmaceutical solid oral composition may comprise one antiretroviral
drug, preferably ritonavir or two antiretroviral drugs, preferably ritonavir and lopinavir.
As discussed above, the present invention relates to a pharmaceutical solid oral composition
comprising one or more antiretroviral drugs and one o more pharmaceutically acceptable
excipients, wherein the pharmaceutical solid oral composition may be administered without
water or any other suitable liquid.
Further, said pharmaceutical solid oral composition comprises suitable excipients within
limited ranges, or minimal amounts, so as to provide a bare minimum weight to the
pharmaceutical solid oral composition, which may be achieved by the use of a simple
manufacturing process and further exhibits taste masking property along with enhanced
bioavailability.
After rigorous experimentation it was surprisingly found that the bitter taste of the one or
more antiretroviral drug can be masked by simple and cost-effective process to obtain a
taste-masked solid oral composition. .
For specific patient populations such as geriatrics and paediatrics, the dosage form as
suggested may be of concern as these patient populations may experience difficulty in
swallowing larger sized tablets or capsules, leading to poor patient compliance.
The present invention further relates to a pharmaceutical solid oral sprinkle composition
comprising one or more antiretroviral drugs and one or more pharmaceutically acceptable
excipients, for use in geriatrics and paediatrics.
Thus, the present invention provides a pharmaceutical solid oral sprinkle composition is in
the form of a sprinkle formulation comprising one or more antiretroviral drugs and one or
more pharmaceutically acceptable excipients, for use in geriatrics and paediatrics.
Further, the inventors have found that when, by a process comprising hot melt extrusion of
one or more antiretroviral drugs, preferably ritonavir, with a polymer comprising: a water
soluble polymer; ,a water swellable polymer; a water insoluble polymer; or any combination
thereof, the resulting product acquires taste masking property wherein the ratio of drug:
polymer is 1:1 to 1: 6 by weight. This surprising taste-masked property of the resulting
product therefore obviates the need for any other further processing techniques that are used
to mask taste, such as addition of flavouring agent, complexation with ion-exchange,
microencapsulation, prodrug approach, inclusion complexation, multiple emulsion
technique, bitterness inhibitor and providing film and/or seal coatings. Since these
techniques would involve additional process steps, and would typically provide further bulk
to the composition, .the present invention may allow for a simpler manufacturing process
and/or reduced bulk of the final pharmaceutical solid oral composition.
According to the present invention, the pharmaceutical solid oral composition may be in the
form of a "sprinkle formulation". The term "sprinkle formulation" as used throughout the
specification is a formulation comprising a plurality of particles that can be sprinkled on and
mixed with consumable item.
The sprinkle formulation may comprise a plurality of particles or sub-units, which may be
provided in a form comprising: a powder; powders for reconstitution; beads; pellets; minitablets;
film coated tablets; film coated tablets MUPS; orally disintegrating MUPS; pills;
micro-pellets; small tablet units; MUPS; disintegrating tablets; dispersible tablets; granules;Y
effervescent granules; microspheres; or any combination thereof. Such particles may be
incorporated in capsules or sachets. Preferably, the pharmaceutical solid oral composition
according to the present invention is a sprinkle formulation comprising particles in the form
of mini-tablets or granules that may be incorporated in a hard gelatin capsule, sachet or
packet.
The term "particle " in context of the of the composition of the present invention would be
defined as the smallest unit of the composition.
The pharmaceutical solid oral sprinkle composition according to the present invention may
comprise one or more antiretroviral drugs and one or more pharmaceutically acceptable
excipients, and may comprise a plurality of particles or sub-units which may be provided in
a form comprising: powders; powders for reconstitution; beads; pellets; mini-tablets; film
coated tablets; film coated tablets MUPS; orally disintegrating MUPS; pills; micro-pellets;
small tablet units; MUPS; disintegrating tablets; dispersible tablets; granules; effervescent
granules; microspheres; or any combination thereof, that may be directly administered by
sprinkling the formulation with regular meals.
Alternatively, pharmaceutical solid oral sprinkle composition according to the present
invention may be administered with a liquid or semi-solid beverage, such as a juice or water.
Preferably, the solid oral composition according to the present invention may be
administered by incorporating into a capsule, sachet or packet and then administered through
the oral route.
Thus, as used herein, the term "sprinkle formulation" includes any formulation that is
suitable for oral administration, wherein the formulation is sprinkled upon any consumable
item.
The pharmaceutical solid oral sprinkle composition according to the present invention may
comprise one or more antiretroviral drugs and one or more pharmaceutically acceptable
excipients that are incorporated in a hard gelatin capsule, sachet or packet to be administered
by sprinkling the formulation onto a regular meal, or to be administered with a liquid or
semi-solid beverage, such as fruit juices, water, milk, baby formulas, soft foods, apple sauce,
yogurt, and the like.
The pharmaceutical solid oral sprinkle composition according to the present invention may
be in the form of mini-tablets or granules that are incorporated in a hard gelatin capsule, a
sachet or packet comprising one or more antiretroviral drugs, such as ritonavir, and one or
more pharmaceutically acceptable excipients to form a sprinkle composition to be
administered by sprinkling the formulation onto a regular meal or to be administered with a
liquid or a semi-solid beverage, such as fruit juices, water, milk, baby formulas, soft foods,
apple sauce, yogurt, and the like.
Accordingly, whe the pharmaceutical solid oral sprinkle composition of the present
invention is in the form of a capsule, the said capsule may be swallowed whole, or the
capsule may opened and the contents sprinkled onto a regular meal or be administered with
a liquid or a semi-solid beverage, such as fruit juices, water, milk, baby formulas, soft foods,
apple sauce, yogurt, and the like.
Accordingly, when the pharmaceutical solid oral sprinkle composition of the present
invention is in the form of a packet or sachet, the said packet or sachet is typically torn open,
thereby allowing the contents to be sprinkled onto a regular meal, or be administered with a
liquid or a semi-solid beverage, such as fruit juices, water, milk, baby formulas, soft foods,
apple sauce, yogurt, and the like.
Further, the pharmaceutical solid oral sprinkle composition of the present invention may
also be provided in the form of kit compositions which has an advantage since the patient
always has access to the set of instructions for administration contained in the kit. The
inclusion of a set of instructions for administration has been shown to improve patient
compliance.
It will be understood that the administration of the pharmaceutical solid oral sprinkle
composition of the present invention by means of a kit, with a set of instructions for
administration diverting the patient to the correct use of the invention is a desirable,
additional feature of this invention.
As used herein, the term "an antiretroviral drug" or "one or more antiretroviral drugs" is
used to denote either a single antiretroviral drug, or a combination of two, three, four or
more such antiretroviral drugs.
The antiretroviral drug may comprise a protease inhibitor. The protease inhibitor may
comprise: lopinavir, saquinavir; ritonavir; nelfinavir; amprenavir; indinavir; nelfinavir;
atazanavir; lasinavir; palinavir; tirpranavir; fosamprenavir; darunavir; or any combination
thereof.
Accordingly, the pharmaceutical solid oral sprinkle composition may comprise one
antiretroviral drug, preferably ritonavir, or two antiretroviral drugs, preferably ri tonavir and
lopinavir.
However, other class of drugs such as nucleoside and nucleotide reverse transcriptase
inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase
inhibitors and maturation inhibitors may be used as the one or more antiretroviral drugs.
Each antiretroviral drug may be disposed in the same particle, or in different particles.
Thus, in one aspect, each particle may comprise the first antiretroviral drug, the second
antiretroviral drug and the at least one polymer. In another aspect, the first antiretroviral
drug and the second antiretroviral drug may be disposed in separate particles. Where the
two drugs are found in separate particles, the at least one polymer is disposed in the particle
comprising the first antiretroviral drug, the second antiretroviral drug, or both.
In one aspect of the present invention, the pharmaceutical solid oral sprinkle composition
comprising ritonavir may be administered in combination with lopinavir.
The compositions of the present invention may comprise a nucleoside reverse transcriptase
inhibitor (NRTI). The nucleoside reverse transcriptase inhibitor may comprise: zidovudine;
didanosine; stavudine; lamivudine; abacavir; adefovir; lobucavir; entecavir; apricitabine;
emtricitabine; zalcitabine; dexelvucitabine; alovudine; amdoxovir; elvucitabine; phosphazid;
racivir; stampidine; or any combination thereof.
The compositions of the present invention may further comprise a nucleotide reverse
transcriptase inhibitor (NtRTI). The nucleotide reverse transcriptase inhibitor may comprise
tenofovir; adefovir; or any combination thereof.
The compositions of the present invention may further comprise a non-nucleotide reverse
transcriptase inhibitor (N TI). The non-nucleotide reverse transcriptase inhibitor may
comprise: nevirapine; rilpiverine; delaviridine; efavirenz; etravirine; or any combination
thereof.
. .
The compositions of the present invention may further comprise an integrase inhibitor. The
integrase inhibitor may comprise raltegravir; elvitegravir; or any combinations thereof.
It will be appreciated that whenever the term for a specific drug is used in the specification,
for instance, the term "ritonavir", or "lopinavir", such a term is used in broad sense to
include not only "ritonavir" per se, or "lopinavir" per se, but also their pharmaceutically
acceptable salts, pharmaceutically acceptable solvates, pharmaceutically acceptable
hydrates, pharmaceutically acceptable esters, pharmaceutically acceptable enantiomers,
pharmaceutically acceptable derivatives, pharmaceutically acceptable polymorphs,
pharmaceutically acceptable prodrugs, and pharmaceutically acceptable complexes. Thus
the meaning of the term "ritonavir", as used throughout the specification, also includes, for
instance, solvates of ritonavir, such as, but not limited to, ritonavir ethanolate solvate,
ritonavir formamide solvate and partially desolvated formamide solvate. The terms for the
other specific drugs are used similarly in a broad sense.
The pharmaceutical solid oral sprinkle composition may comprise ritonavir in an amount
from about 10 g to about 200 g. Lopinavir, when present, may be present in an amount
from about 40 mg to about 800 mg. These doses of ritonavir and lopinavir are suitable for
both paediatric and geriatric patients.
The pharmaceutical solid oral sprinkle composition of the present invention may comprise
one or more pharmaceutically acceptable excipients comprising polymers, fillers or diluents,
surfactants, solubility enhancers, disintegrants, binders, lubricants, non-ionic solubilisers,
glidants, and combinations thereof.
The pharmaceutical solid oral sprinkle composition of the present invention may comprise a
water insoluble polymer. The water insoluble polymer may comprise: an acrylic copolymer,
e.g. Eudragit El 0 (a cationic copolymer based on dimethylaminoethyl methacrylate, butyl
methacrylate, and methyl methacrylate), Eudragit EPO (a cationic copolymer based on
dimethylaminoethyl methacrylate, basic butylated methacrylate copolymer, butyl
methacrylate, and methyl methacrylate), Eudragit L30D-55 (an aqueous dispersion of
anionic polymers with methacrylic acid as a functional group), Eudragit FS3 D (an aqueous
dispersion of an anionic copolymer based on methyl acrylate, methyl methacrylate and
methacrylic acid), Eudragit RL30D (a copolymer of ethyl acrylate, methyl methacrylate and
a low content of methacrylic acid ester with quaternary ammonium groups), Eudragit
RS30D (a copolymer of ethyl acrylate, methyl methacrylate and a low content of
methacrylic acid ester with quaternary ammonium groups.), Eudragit NE30D (an aqueous
dispersion of a neutral copolymer based on ethyl acrylate and methyl methacrylate), or
Acryl-Eze; a polyvinylacetate; a cellulose derivative such as ethylcellulose, cellulose acetate
Aquacoat ECD (an aqueous dispersion of ethylcellulose (EC) polymer) and Aquacoat CPD
(a Cellulose Acetate Phthalate Aqueous Dispersion); or any combinations thereof
The pharmaceutical solid oral sprinkle composition of the present invention may comprise a
water soluble polymer. The water soluble polymer may comprise: copovidone;
homopolymer of N-vinyl lactam or copolymer comprising N-vinyl lactam, for instance,
homopolymer consisting of or co-polymer comprising N-vinyl pyrrolidine, for instance,
polyvinylpyrrolidone (PVP), co-polymer of PVP and vinyl acetate, co-polymer of N-vinyl
pyrrolidone and vinyl acetate or vinyl propionate; cellulose ester; cellulose ether; high
molecular weight polyalkylene oxide such as polyethylene oxide, polypropylene oxide, or a
co-polymer of ethylene oxide and propylene oxide; or any combination thereof.
The pharmaceutical solid oral sprinkle composition of the present invention may comprise a
water swellable polymer. The water swellable polymer may comprise: polyethylene oxide;
poly (hydroxy alkyl methacrylate); poly (vinyl) alcohol, having low acetal residue and
which is cross-linked with glyoxal, formaldehyde or glutaraldehyde and having a degree of
polymerization of from 200 to 30,000; mixture of methyl cellulose, cross-linked agar and
carboxymethyl cellulose; Carbopol® carbomer which is an acidic carboxy polymer; a
Cyanamer®polyacrylamide; cross-linked water swellable indene-maleic anhydride polymer;
Goodrich® polyacrylic acid; starch graft copolymer; Aqua Keeps® acrylate polymer
polysaccharide comprised of condensed glucose units such as diester cross-linked
polyglucan, and the like; Amberlite® ion exchange resin; Explotab® sodium starch glycolate;
Ac-Di-Sol® croscarmellose sodium, or any combination thereof.
The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a diluent or filler. The diluent or filler for use in a low dose pharmaceutical
composition of the present invention may comprise one or more of: sucrose, calcium
silicate; pregelatinized starch; croscarmellose sodium; sodium starch glycolate; lactose;
lactose monohydrate (for example, spray-dried lactose, a-lactose, -lactose); lactose
available under the trade mark Tablettose; various grades of lactose available under the trade
mark Pharmatose or other commercially available forms of lactose; lactitol; saccharose;
5 sorbitol; mannitol; dextrates; dextrins; dextrose; maltodextrin; croscarmellose sodium;
silicified microcrystalline cellulose; microcrystalline cellulose (for example,
microcrystalline cellulose available under the trade mark Avicel); hydroxypropylcellulose;
L-hydroxypropylcellulose (low substituted); hydroxypropyl methylcellulose (HPMC);
methylcellulose polymers (for example, Methocel A, Methocel A4C, Methocel A15C,
0 Methocel A4M); silicified microcrystalline cellulose; hydroxyethylcellulose; sodium
carboxymethylcellulose; carboxymethylene; carboxymethyl hydroxyethylcellulose; other
cellulose derivatives, starches or modified starches (including potato starch, corn starch,
maize starch and rice starch); or any mixture thereof.
15 The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a binder. The binder may comprise: polyvinyl pyrrolidone (also known as
povidone); polyethylene glycol; acacia; alginic acid; agar; calcium carragenan; cellulose
derivative such as ethyl cellulose, methyl cellulose* hydroxypropyl cellulose, hydroxypropyl
methyl cellulose or sodium carboxymethylcellulose; microcrystalline cellulose; dextrin;
20 gelatin; gum arabic; guar gum; tragacanth; sodium alginate; copovidone; starches; any other
pharmaceutically acceptable substances with cohesive properties; or any combination
thereof. .
The pharmaceutical solid oral sprinkle composition of the present invention may further
25 comprise a disintegrant. The disintegrant may comprise: crospovidone; ac-di-sol; sodium
starch glycolate; hydroxylpropyl cellulose (HPC); low density HPC; carboxymethylcellulose
(CMC); sodium CMC; calcium CMC; croscarmellose sodium;; carboxymethyl starch;
hydroxylpropyl starch; modified starch; crystalline cellulose; sodium starch glycolate;
alginic acid or a salt thereof, such as sodium alginate; or any combination thereof:
-.30 - . • • • . . ...• . . . . . .
The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a solubility enhancer. The solubility enhancer may comprise: stearoyl macrogol
glyceride; sorbitan monolaurate (Span 20); Polyoxyl castor oil; or any combination thereof.
The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a lubricant, glidant and/or an anti-adherent. The glidant, anti-adherents and/or
lubricant may comprise: stearic acid and pharmaceutically acceptable salts or esters thereof
(for example, magnesium stearate, calcium stearate, sodium stearyl fumarate or other
metallic stearate); talc; waxes (for example, microcrystalline waxes) and glycerides; light
mineral oil; PEG; silica acid or a derivative or salt thereof (for example, silicates, silicon
dioxide, colloidal silicon dioxide and polymers thereof, crospovidone, magnesium stearate,
magnesium aluminosilicate and/ or magnesium alumino metasilicate); sucrose ester of fatty
acids; hydrogenated vegetable oils (for example, hydrogenated castor oil); or any mixture
thereof. .
The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a preservative. The preservative may comprise: benzoic acid; sorbic acid;
butylparaben; ethylparaben; methylparaben; propylparaben; sodium benzoate; sodium'
propionate; or any combination thereof.
The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a sweetener. The sweetener may comprise: saccharin sodium, aspartame,
acesulfame, cyclamate, alitame, a dihydrochalcone sweetener, monellin, neohesperidin,
neotame, stevioside, sucralose, any pharmaceutically acceptable salts thereof, and the like,
or combination thereof.
The pharmaceutical solid oral sprinkle composition of the present invention may be
administered orally through known solid dosage forms.
The pharmaceutical solid oral sprinkle composition may be provided in the form of a
sprinkle formulation. In other words, the pharmaceutical solid oral composition is in a form
suitable for administration by sprinkling onto a consumable item,. The sprinkle formulation
may comprise a plurality of particles or sub-units, which may be provided in a form
comprising: a powder; powders for reconstitution; a pellet; a bead; a mini-tablet; a pills; a
micro-pellet; a small tablet unit; a MUPS; film coated tablets, film coated tablets MUPS,
orally disintegrating MUPS a disintegrating tablet; a dispersible tablet; a granule; an
effervescent granules; a microsphere; or any combination thereof. More preferably, the
pharmaceutical solid oral composition is in the form of mini-tablets or granules.
Accordingly, when a patient intakes the pharmaceutical solid oral sprinkle composition
sprinkled onto a consumable item, it is preferable that the patient does not chew or crush the
composition; instead, the composition should be preferably swallowed whole with the
consumable item.
According to the generality of the concept, it is thought that large particle sizes trigger a
chewing reflex in a patient, and thus the size of the plurality of particles or sub-units of the
pharmaceutical solid oral composition is preferably small enough to prevent a patient's
chewing reflex. In other words, it is thought that a patient will find it easier to ingest a
consumable item onto which the pharmaceutical solid oral composition of the present
invention has been sprinkled, without chewing, if the diameter of the plurality of particles or
sub-units is small. Thus, in an aspect, the upper limit of the median or average diameter of
the particles of the sprinkle formulation may be less than 2.8 mm, preferably less than 2 mm,
more preferably less than 1.5 mm, and most preferably less than 1 mm. The lower limit of
the median or average diameter of the particles may be greater than 0.2 mm, most preferably
0.5 mm. A preferred range for the median or average particle diameter is 0.2 mm to 2.8
mm.
The plurality of particles or sub-units of the pharmaceutical solid oral sprinkle composition
of the present invention may be enclosed in a hard gelatin capsule, sachet or packet. The
capsule may be swallowed whole or opened. The sachet or packet may be torn open, and its
contents sprinkled : onto consumable item, prior to administration. Preferably, the
pharmaceutical solid oral composition of present invention comprises mini-tablets or
granules filled in a hard gelatin capsule, a sachet or a packet.
Preferably, the plurality of particles or sub-units are directly administered by sprinkling
them on a regular meal, which may then be consumed normally by the patient, for ease of
administration. Alternatively, the plurality of particles or sub-units may be administered by
sprinkling them into a liquid or semi-solid beverage, such as fruit juices, water, milk, baby
formulas, soft foods, apple sauce, or yogurt, and the like, which may then be consumed
normally by the patient.
The plurality of particles or sub-units of the present invention may also optionally be coated.
Preferably, the plurality of particles or sub-units may be film coated. More preferably, the
plurality of particles or sub-units may be seal coated and then film coated. Alternatively, the
particles may be film coated and then seal coated.
Such coats have a number of advantages, preventing the one or more antiretroviral drugs
from being released into, or interacting with, the consumable item onto which it is sprinkled,
and these benefits make coated particulates provide a further advantage of the compositions
of the present invention.
Additional exeipients such as film forming polymers, solvents, plasticizers, anti-adherents,i
opacifiers, colorants, pigments, antifoaming agents, and polishing agents can be used in
coatings.
Suitable seal forming material may comprise: hydroxypropylmethylcellulose (optionally
HPMC 6 CPS, or HPMC 6 CPS to HPMC 15CPS grade); hydroxypropylcellulose;
polyvinylpyrrolidone; methylcellulose; carboxymethylcellulose; hypromellose; acacia;
gelatin; or any combination thereof, to increase adherence and coherence of the seal coat.
Preferably the seal coat comprises hydroxypropylmethylcellulose.
The HPMC component of the seal coating, if present, may be mixed with a solvent, wherein
said solvent may comprise: acetone; methylene chloride; isopropyl alcohol; or any
combination thereof The seal coating may also comprise talc.
Suitable film-forming agents include, but are not limited to, cellulose derivatives, such as,
soluble alkyl- or hydroalkyl-cellulose derivatives such as methylcelluloses, hydroxymethyl .
celluloses, hydroxyethyl celluloses, hydroxypropyl celluloses, hydroxymethylethyl
celluloses, hydroxypropyl methylcelluloses, sodium carboxymethyl celluloses, insoluble
cellulose derivatives such as ethylcelluloses and the like, dextrins, starches and starch
derivatives, polymers based on carbohydrates and derivatives thereof, natural gums such as
gum Arabic, xanthans, alginates, polyacrylic acids, polyvinyl alcohols, polyvinyl acetates,
polyvinylpyrrolidones, polymethacrylates and derivatives thereof, chitosan and derivatives
thereof, shellac and derivatives thereof, waxes, fat substances and any mixtures or
combinations thereof.
Suitable enteric coating materials, include, but are not limited to, cellulosic polymers like
cellulose acetate phthalates, cellulose acetate trimellitates, hydroxypropyl methylcellulose
phthalates, polyvinyl acetate phthalates, methacrylic acid polymers, any copolymer thereof,
any mixture thereof, or combination thereof.
Some of the excipients are used as adjuvant to the coating process, including excipients such
as plasticizers, opacifiers, antiadhesives, polishing agents, and the like.
Suitable plasticizers include, but are not limited to, stearic acid, castor oil, diacetylated
monoglycerides, dibutyl sebacate, diethyl phthalate, glycerin, polyethylene glycols,
propylene glycols, triacetin, triethyl citrate, or mixtures thereof.
Suitable opacifiers include, but are not limited to, titanium dioxide.
.
Suitable anti-adhesives include, but are not limited to, talc.
Suitable polishing agents include, but are not limited to, polyethylene glycols of various
molecular weights or mixtures thereof, talc, surfactants (glycerol monostearate and
poloxamers), fatty alcohols (stearyl alcohol, cetyl alcohol, lauryl alcohol and myristyl
alcohol) and waxes (carnauba wax, candelilla wax and white wax), or mixtures thereof.
Suitable solvents used in the processes of preparing the pharmaceutical solid oral
composition of the present invention, include, but are not limited to, water, methanol,
ethanol, acidified ethanol, acetone, diacetone, polyols, polyethers, oils, esters, a ky ketones,
methylene chloride, isopropyl alcohol, butyl alcohol, methyl acetate, ethyl acetate, isopropyl
acetate, castor oil, ethylene glycol monoethyl ether, diethylene glycol riionobutyl ether,
diethylene glycol monoethyl ether, dimethylsulphoxide, N,N-dimethylformarnide
tetrahydrofuran, or mixtures thereof.
According to another aspect of the present invention, the solid oral sprinkle composition
may be seal coated followed by film coating..
The present invention may be manufactured through various techniques or processes
including melt granulation, melt extrusion, spray drying, solution evaporation, direct
blending, direct compression, wet granulation, dry granulation, melt lyophilisation, hot melt
extrusion, extrusion-spheronization and the like, or combinations thereof. More preferably,
the pharmaceutical solid oral composition of the present invention may be manufactured by
melt extrusion.
According to one aspect the present invention, there is provided a process for preparing a
pharmaceutical solid oral sprinkle composition comprising one or more antiretroviral drugs,
such as ritonavir, the process comprising melt extruding comprising the steps: (a) preparing
a homogeneous melt of the one or more antiretroviral drugs; a polymer comprising: a water
soluble polymer; a water swellable polymer; a water insoluble polymer; or any combination
thereof, and optionally one or more excipients; (b) cooling the melt obtained in step (a); (c)
allowing the cooled melt to solidify to obtain an extrudate; and (d) processing the extrudate
into a desired shape.
Optionally, step (a) is carried out at a temperature ranging from about 70 °C to about 200°C
typically about at a temperature ranging from about 90°C to about 150°C.
•. . • . - . • ; •
.•
Step (d) may comprise shaping the extrudate into a mini-tablet or granule. Alternatively,
step (d) may comprise cutting the extrudate into pieces and further processing the cut
extrudate into a suitable dosage form. Alternatively, step (d) may comprise milling and
grinding the extrudate to form granules.
Alternatively, the process for manufacturing the pharmaceutical solid oral sprinkle
composition in the form of a mini-tablet, which process further comprises step (e) drying
and lubricating the granules and compressing the lubricated dried granules to form the minitablet.
Alternatively, the process may further comprise step (f) seal coating the mini-tablet or
granule, or film coatmg the mini-tablet or granule. Alternatively, the process may further
comprise step (f) seal coating the. mini-tablet or granule; and step (g) comprising film
coating the seal coated mini-tablet or granule.
The seal coat material may be hydroxypropylmethylcellulose. Typically, the
hydroxypropylmethylcellulose is hydroxypropylmethylcellulose comprising: hydroxypropyl
methylcellulose (HPMC) 6CPS to hydroxypropyl methylcellulose (HPMC) 1 CPS.
As mentioned above, the present invention may be manufactured through various
techniques.
According to a further aspect of the present invention, there is provided a process for
preparing a pharmaceutical solid oral - sprinkle composition comprising one or more
antiretroviral drugs, such as ritonavir, the process comprising: (a) melt granulating one or
more solubility enhancers and one or more first pharmaceutically acceptable excipients with
the one or more antiretroviral drugs in water or any other suitable solvent to form a
granulated material; (b) sieving the granulated material; (c) drying the sieved granulated
material to form dried granules; (d) lubricating the dried granules with one or more
lubricants and optionally one or more other pharmaceutically acceptable excipients; and (e)
optionally further processing the lubricated dried granules.
The present invention further provides a process for manufacturing a pharmaceutical solid
oral sprinkle composition, which process comprises: (1) coating one or more antiretroviral
drugs, such as ritonavir , with a polymer comprising: a water soluble polymer; a water
swellable polymer; a water insoluble polymer; or any combination thereof, to form coated
granules containing one or more antiretroviral drugs; (2) mixing the coated granules
obtained in step (1) with one or more pharmaceutically acceptable excipients; and (3)(i)
filling the mixture formed in step (2) into a hard gelatin capsule, sachet or packet which may
be suitable for sprinkling onto any consumable item by a patient for ease of administration,
or (ii) compressing the mixture formed in step (2) to form mini-tablets which optionally may
be filled into a capsule, sachet or packet.
Accordingly, the inventors have surprisingly found that when, by a process comprising hot
melt extrusion of one or more antiretroviral drugs with a polymer comprising: a water
soluble polymer; a water swellable polymer; a water insoluble polymer; and any
combination thereof, the resulting product acquires taste masking property wherein the ratio
of drug: polymer is 1 :1 to 1 : 6.
It was surprisingly found that, while carrying out the melt extrusion process, an in-situ
reaction occurred between the drug and the polymer. This in-situ reaction led to an ionic
interaction between the drug and the polymer eventually leading to taste masked product.
In general terms, the process of hot melt extrusion is carried out in conventional extruders .
known to a person skilled in the art. The melt-extrusion process comprises the steps of
preparing a homogeneous melt of the one or more antiretroviral drugs, the polymer and any
the excipients, if present, and cooling the melt until it solidifies. "Melting" means a
transition into a liquid or rubbery state in which it is possible for one component to become
embedded homogeneously in the other. Typically, one component will melt and the other
components will dissolve i the melted component, thus forming a solution. Melting usually
involves heating above the softening point of the polymer. The preparation of the melt can.
take place in a variety of ways. The mixing of the components can take place before, during
or after the formation of the melt. For example, the components can be mixed first and then
melted, or be simultaneously mixed and melted. Usually, the melt is homogenized in order
to disperse the active ingredients efficiently. Also, it may be convenient first to melt the
polymer and then to mix in and homogenize the active ingredients.
The formation of the extrudate leads to a further advantage, such that the homogenous melt
of the one or more antiretroviral drug i the polymer converts the drug into its amorphous
form. Drugs thus converted into its amorphous form may exhibit improved bioavailability
as compared to its crystalline forms. This is particularly advantageous for drugs whose
crystalline forms exhibit poor bioavailability, such as ritonavir.
Usually, the melt temperature is in the range of about 70°C to about 200°C, preferably from
about 80°C to about 180°C, and most preferably from about 90°C to about 150°C.
Suitable extruders include single screw extruders, intermeshing screw extruders or else
multiscrew extruders, preferably twin screw extruders, which can be co-rotating or counterrotating
and, optionally, be equipped with kneading disks. It will be appreciated that the
working temperatures will also be determined by the kind of extruder or the kind of
configuration within the extruder that is used.
The extrudates can be in the form of beads, granulates, tube, strand or cylinder, and these
can be further processed into any desired shape.
The term 'extrudates' as used herein refers to solid product solutions, solid dispersions and
glass solutions of one or more drugs in one or more polymers comprising: a water soluble
polymer; a water swellable polymer; a water insoluble polymer; or any combination thereof,
and optionally pharmaceutically acceptable excipients. Preferably, a powder blend of the
one or more antiretroviral drugs, such as ritonavir, the one or more polymer and optionally
pharmaceutical excipients are transferred by a rotating screw of a single screw extruder
through the heated barrel of an extruder, whereby the powder blend melts, and a molten
solution product is collected on a conveyor, where it is allowed to cool to form an extrudate.
Shaping of the extrudate may be conveniently be carried out by a calendar with two counterrotating
rollers with mutually matching depressions on their .surface. A broad range of tablet
forms may be attained by using rollers with different forms of depressions. Alternatively, the
extrudate may be cut into pieces after solidification and further processed into suitable
dosage forms. More preferably, the extrudates thus obtained from the above process may be
then milled and ground to granules by means known to a person skilled in the art.
Further, hot melt extrusion is a fast, continuous manufacturing process without requirement
of further drying or discontinuous process steps; it provides short thermal exposure of active
allows processing of heat sensitive actives; the process temperatures can be reduced by
addition of plasticizers; and comparatively lower investment is required for the equipment as
compared to other processes. The entire process may be anhydrous and the intense mixing
and agitation of the powder blend that occur during processing contributes to a very
homogenous extrudate.
In one aspect, the present invention provides a pharmaceutical solid oral sprinkle
composition comprising one or more antiretroviral drugs, such as ritonavir alone, or a
combination comprising ritonavir and lopinavir, and a polymer comprising: a water soluble
polymer; a water swellable polymer; a water, insoluble polymer; and any combination
thereof, which are melt extruded by any process as described herein, where the powder
blend comprises the one or . more antiretroviral drugs, the one or more polymers, and
optionally an excipient which may comprise a bulking agent and/or a flavourant. These are
so processed to form a powder blend which may be transferred through the heated barrel of
the extruder, most preferably single screw extruder, whereby the powder blend melts and
molten solution product may be collected on a conveyor whereby it is allowed to cool and
form an extrudate. Alternatively, the extrudate is cut into pieces after solidification and may
be further processed into suitable dosage forms. More preferably the extrudates thus
obtained from the above process may be then milled and ground to granules by means
known to a person skilled in the art.
In another aspect, the present invention provides a pharmaceutical solid oral sprinkle
composition comprising one or more antiretroviral drugs and a combination of polymers
comprising: a water soluble polymer and a water insoluble polymer; a water soluble polymer
and a water swellable polymer; a water insoluble polymer and a water swellable polymer; or
a water swellable polymer, a water soluble an a water insoluble polymer, which are melt
extruded by any process as described herein, where the powder blend comprises one or more
antiretroviral drugs, preferably ritonavir alone, or a combination of ritonavir and lopinavir,
and at least one polymer, and optionally further comprising at least one or more excipients.
These are so processed to form a powder blend which may be transferred through the heated
barrel of the extruder, whereby the powder blend melts and molten solution product is
collected on a conveyor whereby it is allowed to cool and form an extrudate. Alternatively,
the extrudate may be cut into pieces after solidification and further processed into suitable
dosage forms. More preferably the extrudates thus finally obtained from the above process
are then milled and ground to granules by means known to a person skilled in the art.
The pharmaceutical solid oral sprinkle composition of the present invention may further
comprise a plasticizer. The plasticizer may be incorporated into the composition, depending
on the polymer and the process requirement. The plasticizer, advantageously, when used in
the hot melt extrusion process, may decrease the glass transition temperature of the polymer.
The plasticizer may also help in reducing the viscosity of the polymer melt and thereby
allow for lower processing temperature and extruder torque during hot melt extrusion. The
plasticizer may comprise: sorbitan monolaurate (Span 20); sorbitan monopalmitate; sorbitan
monostearate; sorbitan monoisostearate; a citrate ester type plasticizer, such as triethyl
citrate or citrate phthalate; propylene glycol; glycerin; low molecular weight polyethylene
glycol; triacetin; dibutyl sebacate; tributyl sebacate; dibutyltartrate; dibutyl phthalate and the
like; or any combination thereof. The plasticizer may be present in an amount ranging from
0% to 10% by weight of polymer.
In one aspect, the present invention may be formulated for paediatric patients. From the
point of view of paediatric patient acceptability, the bulking agent, when present in the
pharmaceutical solid oral composition, may comprise: a saccharide, such as a
monosaccharide, a disaccharide, a polysaccharide and the like, or any combinations thereof;
a sugar alcohol, such as arabinose, lactose, dextrose, sucrose, fructose, maltose, mannitol,
erythritol, sorbitol, xylitol, lactitol and the like, or any combination thereof; or a
combination of a saccharide and a sugar alcohol. Alternatively, the bulking agent may
comprise: powdered cellulose; a microcrystalline cellulose; a purified sugar; a sugar
derivative; or. any. combination thereof. Most preferably, the bulking agent comprises
purified sugar.
Accordingly, the pharmaceutical solid oral sprinkle composition of the present invention
may further incorporate pharmaceutically acceptable flavourants. The. pharmaceutically
acceptable flavourants may comprise: citric acid; tartaric acid; lactic acid; a natural
flavourant and the like; or any combination thereof.
In a further aspect, the pharmaceutical solid oral sprinkle composition according to the
present invention may also comprise the one or more antiretroviral drugs in nano-size form.
Preferably, the active pharmaceutical ingredients have average or median particle size less
than about 2000 nm, preferably less than about 1000 nm, more preferably less than 800 nm,
and most preferably less than 500 nm. The average or median particle size is greater than 50
nm, more preferably greater than 100 nm, most preferably greater than 200 nm
Nanonization of hydrophobic or poorly water-soluble drugs generally involves the
production of drug nano crystals through either chemical precipitation (bottom-up
technology) or disintegration (top-down technology). Different methods may be utilized to
reduce the particle size of the hydrophobic or poorly water soluble drugs. [Huabing Chen et
ah, discusses the various methods to develop nano-formulations in "Nanonization strategies
for poorly water-soluble drugs," Drug Discovery Today, Volume 00, Number 00, March
2010].
Nano-sizing leads to increase in the exposure of surface area of particles leading to an
increase in the rate of dissolution.
The nanoparticles of the present invention may be obtained by any of the process such as,
but not limited to: milling; precipitation; homogenization; high pressure homogenization;
spray-freeze drying; use of supercritical fluid technology; the double emulsion/solvent
evaporation technique; use of PRINT technology; thermal condensation; ultra-sonication; or
any combination thereof.
Accordingly, the process of milling may comprise dispersing drug particles in a liquid
dispersion medium in which the drug is poorly soluble, followed by applying mechanical
means in the presence of grinding media to reduce the particle size of drug to the desired
effective average particle size.
Accordingly, the process of precipitation may involve the formation of crystalline or semicrystalline
drug nanoparticles by nucleation and the growth of drug crystals. In a typical
procedure, drug molecules are first dissolved in an appropriate organic solvent such as
acetone, tetrahydrofuran or N-methyl-2-pyrrolidone at a super saturation concentration to
allow for the nucleation of drug seeds. Drug nano-crystals are then formed by adding the
organic mixture to an antisolvent, such as water, in the presence of a stabilizer, such a
surfactant. The choice of solvent, stabilizer and the mixing process are key factors to control
the size and stability of the drug nano-crystals.
Accordingly, the process of homogenization may involve passing a suspension of crystalline
drug and a stabilizer through the narrow gap of a homogenizer at high pressure (which may
fall within the range of 500 - 2000 bar). The pressure creates powerful disruptive forces
such as cavitation, collision and shearing, which may disintegrate coarse particles to
nanoparticles.
Accordingly, the process of high pressure homogenization may comprise drug presuspension
(containing drug particles in the micrometer range) by subjecting the drug to air
jet milling in the presence of an aqueous surfactant solution. The pre-suspension may thenbe
subjected to high-pressure homogenization in which it passes through a very small
homogenizer gap of around 25 , which leads to a high streaming velocity. High-pressure
homogenization is based on the principle of cavitations (i.e. the formation, growth, and
implosive collapse of vapor bubbles in a liquid).
Accordingly, the process of spray-freeze drying involves the atomization of an aqueous drug
solution into a spray chamber filled with a cryogenic liquid (liquid nitrogen) or halocarbon
refrigerant, such as a chlorofluorocarbon or a fluorocarbon. The water is removed by
sublimation after the liquid droplets solidify.
Accordingly, the process of supercritical fluid technology involves controlled crystallization
of drug from dispersion in super critical fluids, such as carbon dioxide. .
Accordingly, the process of double emulsion/solvent evaporation technique may. involve
preparation of an oil/water (o/w) emulsion with subsequent removal of the oil phase through
evaporation. The emulsion may be prepared by emulsifying the organic phase containing
drug, polymer and organic solvent in an aqueous solution containing an emulsifier. The
organic solvent diffuses out of the polymer phase and into the aqueous phase, and is then
evaporated, forming drug-loaded polymeric nano-particles.
Accordingly, the process of PRINT (Particle replication in non-wetting templates)- may
involve utilization of a low surface energy fluoro polymeric mould that enables highresolution
imprint lithography, to fabricate a variety of organic particles. PRINT ca
precisely manipulate particle size of drug ranging from 20 nm to more than 100 nm.
-
Accordingly, the process of thermal condensation may involve the use of a capillary aerosol
generator (CAG) to produce high concentration condensation submicron to micron sized
aerosols from drug solutions
Accordingly, the process of ultra-sonication involves application of ultrasound during
particle synthesis or precipitation, which leads to smaller particles of drug and increased size
uniformity.
Accordingly, the process of spray drying may involve supplying a feed solution at room
temperature and pumping it through a nozzle where it is atomized by the nozzle gas. The
atomized solution is then dried by preheated drying gas in a special chamber to remove
water moisture from the system, thus forming dry particles of drug.
In a preferred aspect of the present invention, the nano-milled one or more antiretroviral
drugs may be. obtained by nano-milling of the one or more antiretroviral drugs with at least
one surface stabilizer, at least one viscosity building agent and at least one polymer.
The pharmaceutical solid oral sprinkle composition of the present invention ca be
manufactured by any of the processes as described above.
The present invention also provides a method of treating diseases caused by retroviruses,
especially acquired immune deficiency syndrome or an HIV infection, which method
comprises administering a pharmaceutical solid oral composition.
The present invention also provides a use of a pharmaceutical solid oral sprinkle
composition in the manufacture of a medicament for the treatment of an acquired immune
deficiency syndrome or an HIV infection of a patient.
The following examples are for the purpose of illustration of the invention only and are not
intended in any way to limit the scope of the present invention.
Example 1
Process:
(1) A dry mix of lopinavir, ritonavir, colloidal silicon dioxide, was prepared.
(2) Sorbitan monolaurate was added over Copovidone in a suitable granulator separately to
form polymer premix.
(3) The dry mix obtained in step (1) and step (2) was mixed in a suitable granulator followed
by melt extrusion (hot).
(4) Colloidal silicon dioxide was blended with the dried granules and lubricated by using
sodium stearyl fumarate.
(5) The lubricated granules were compressed into mini-tablets.
(6) The compressed mini-tablets were coated with seal coating solution.
(7) The mini-tablets obtained in step (6) were filled into hard gelatin capsules.
Example 2
Process:
1. Dry mix of ritonavir, colloidal silicon dioxide and eudragit was prepared.
2. Dry mix obtained in step (1) was extruded using hot melt extrusion technique.
3. Extrudes obtained in step (2) were sized and sifted to form granules.
4. Granules obtained in step (3) were blended with colloidal silicon dioxide and sugar.
Example 3
1. Dry mix of ritonavir, colloidal silicon dioxide, sugar and eudragit was prepared.
2. Dry mix obtained in step (l).was extruded using hot melt extrusion technique.
3. Extrudes obtained in step (2) were sized and sifted to form granules.
4. Granules obtained in step (3) were blended adding colloidal silicon dioxide.
Example 4
1. Dry mix of ritonavir, colloidal silicon dioxide, sucrose, saccharin sodium, basic
butylated methacrylate copolymer and stearic acid was prepared.
2. Dry mix obtained in step (1) was extruded using hot melt extrusion technique.
3. Extrudes obtained in step (2) were sized and sifted to form granules.
4. Granules obtained in step (3) were blended adding colloidal silicon dioxide.
5. The blended granules obtained in step (4) were filled in capsules.
It will be readily apparent to one skilled in the art that varying substitutions and
modifications may be made to the invention disclosed herein without departing from the
spirit of the invention. Thus, it should be understood that although the present invention has
been specifically disclosed by the preferred embodiments and optional features,
modification and variation of the concepts herein disclosed ma be resorted to by those
skilled in the art, and such modifications and variations are considered to fall within the
scope of the invention.
It is to be understood that the phraseology and terminology used herein is for the purpose of
description and should not be regarded as limiting. The use of "including," "comprising," or
"having" and variations thereof herein is meant to encompass the items listed thereafter and
equivalents thereof as well as additional items.
It must be noted that, as used in this specification and the appended claims, the singular
forms "a," "an" and "the" include plural references unless the context clearly dictates
otherwise. Thus, for example, reference to "an excipient" includes a single excipient as well
as two or more different excipients, and the like.
It will be appreciated that the invention may be modified within the scope of the claims
which follow.
CLAIMS:
. A pharmaceutical solid oral sprinkle composition, comprising a plurality of particles,
the plurality of particles comprising a first and a second antiretroviral drug and at least one
5 polymer, wherein the first antiretroviral drug comprises ritonavir.
2. A pharmaceutical solid oral sprinkle composition according to claim 1, wherein the.
ritonavir is provided as a pharmaceutically acceptable salt, pharmaceutically acceptable
solvate, pharmaceutically acceptable hydrate, pharmaceutically acceptable ester,
10 pharmaceutically acceptable enantiomer, pharmaceutically acceptable derivative,
pharmaceutically acceptable polymorph, pharmaceutically acceptable prodrug, or
pharmaceutically acceptable complex thereof.
3. A pharmaceutical solid oral sprinkle composition according to claim 1 or 2 wherein
15 the ritonavir is provided as a pharmaceutically acceptable solvate thereof.
4. A pharmaceutical solid oral sprinkle composition according to claim 1, 2 or 3
wherein the ritonavir is provided as its ethanolate solvate, formamide solvate or partially
desolvated formamide solvate.
20
5. A pharmaceutical solid oral sprinkle composition according to any preceding claim ,
wherein the second antiretroviral drug comprises a protease inhibitor; a nucleoside reverse
transcriptase inhibitor; a nucleotide reverse transcriptase inhibitor; a non-nucleoside reverse
transcriptase inhibitor; an integrase inhibitor; a maturation inhibitor; or any combination
25 thereof.
6. A pharmaceutical solid oral sprinkle composition according to claim 5, wherein the
protease inhibitor comprises saquinavir; nelfinavir; amprenavir; lopinavir, indinavir;
nelfmavir; atazanavir; lasinavir; palinavir; tirpranavir; fosamprenavir; darunavir or any
- 30 combination thereof.
7. A pharmaceutical solid oral sprinkle composition according to claim 5 or 6, wherein
nucleoside reverse transcriptase inhibitor comprises zidovudine; didanosine; stavudine;
lamivudine; abacavir; adefovir; lobucavir; entecavir; apricitabine; emtricitabine; zalcitabine;
dexelvucitabine; alovudine; amdoxovir; elvucitabine; phosphazid; racivir; stampidine; or
any combination thereof.
8. A pharmaceutical solid oral sprinkle composition according to claim 5, 6 or 7,
wherein nucleotide reverse transcriptase inhibitor comprises tenofovir and/or adefovir.
9. A pharmaceutical solid oral sprinkle composition according to claim 5, 6, 7 or 8,
wherein the non-nucleotide reverse transcriptase inhibitor comprises nevirapine; rilpiverine;
delaviridine; efavirenz; etravirine; or any combination thereof.
10. A pharmaceutical solid oral sprinkle composition according to any one of claims 5 to
9, wherein the integrase inhibitor comprises raltegravir and/or elvitegravir.
11. A pharmaceutical solid oral sprinkle composition according to any one of claims 6
to 10, wherein the saquinavir; nelfinavir; amprenavir; lopinavir, indinavir; nelfinavir;
atazanavir; lasinavir; palinavir; tirpranayir; fosamprenavir; darunavir; zidovudine;
didanosine; stavudine; lamivudine; abacavir; adefovir; lobucavir; entecavir; apricitabine;
emtricitabine; zalcitabine; dexelvucitabine; alovudine; amdoxovir; elvucitabine; phosphazid;
racivir; stampidine; tenofovir; adefovir; nevirapine; rilpiverine; delaviridine; efavirenz;
etravirine; raltegravir or elvitegravir is provided as a pharmaceutically acceptable salt,
pharmaceutically acceptable solvate, pharmaceutically acceptable hydrate, pharmaceutically
acceptable ester, pharmaceutically acceptable enantiomer, pharmaceutically acceptable
derivative, pharmaceutically acceptable polymorph, pharmaceutically acceptable prodrug, or
pharmaceutically acceptable complex thereof.
12. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
wherein the second antiretro viral drug comprises lopinavir.
13. A pharmaceutical solid oral sprinkle. composition according to any preceding claim
for geriatric patients, comprising ritonavir and. lopinavir.
14. A pharmaceutical solid oral sprinkle composition according to any preceding claim
5 for paediatric patients, comprising ritonavir and lopinavir.
15. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
comprising ritonavir in an amount from about 0 mg to about 200 mg.
10 16. A pharmaceutical solid oral sprinkle composition according to any one of claims 12
to 15, comprising lopinavir in an amount from about 40 mg to about 800 mg.
17. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
wherein each particle comprises the first antiretroviral drug, the second antiretroviral drug
15 and the at least one polymer.
1 . A pharmaceutical solid oral sprinkle composition according to any one of claims 1 to
16 wherein the first antiretroviral drug and the second antiretroviral drug are disposed i
separate particles.
0
19. A pharmaceutical solid oral sprinkle composition according to claim 17, wherein the
at least one polymer is disposed in the particle comprising the first antiretroviral drug.
20. A pharmaceutical solid oral sprinkle composition according to claim 17 or 18,
5 wherein the at least one polymer is disposed in the particle comprising the second
antiretroviral drug.
21. A pharmaceutical solid oral sprinkle composition form according to any preceding
claim, wherein the at least one polymer comprises a water insoluble polymer.. . .
0
22. A pharmaceutical solid oral sprinkle composition form according to claim 21,
wherein the water insoluble polymer comprises: an acrylic copolymer; a polyvinylacetate; a
cellulose derivative, such as ethylcellulose or cellulose acetate; or any combination thereof.
5 23. A pharmaceutical solid oral sprinkle composition form according to any preceding
claim, wherein the at least one polymer comprises a water soluble polymer.
24. A pharmaceutical solid oral sprinkle composition according to claim 23, wherein the
water soluble polymer comprises: copovidone; a homopolymer of a N-vinyl lactam, such as
10 N-vinyl pyrrolidine or N-vinyl pyrrolidone; a copolymer comprising a N-vinyl lactam, such
as N-vinyl pyrrolidine or N-vinyl pyrrolidone; polyvinylpyrrolidone (PVP); a copolymer of
PVP and vinyl acetate; a co-polymer of N-vinyl pyrrolidone and vinyl acetate or vinyl
propionate; a cellulose ester; a cellulose ether; a high molecular weight polyalkylene oxide,
such as polyethylene oxide, polypropylene oxide, or a co-polymer of ethylene oxide and
15 propylene oxide; or any combination thereof.
25. A pharmaceutical solid oral sprinkle composition form according to any preceding
claim, wherein the at least-one polymer comprises a water swellable polymer.
20 26. A pharmaceutical solid oral sprinkle composition according to claim 25, wherein the
water swellable polymer comprises: a polyethylene oxide; a poly (hydroxy alkyl
methacrylate); a poly (vinyl) alcohol having a low acetal residue and which is cross-linked
with glyoxal, formaldehyde or glutaraldehyde; a mixture of methyl cellulose, cross-linked
agar and carboxymethyl cellulose; a an acidic carboxy polymer; a polyacrylamide; a cross-
25 linked water swellable indene-maleic anhydride polymer; a polyacrylic acid; a starch graft
copolymer; an acrylate polymer polysaccharide comprising a condensed glucose unit, such
as diester cross-linked polyglucan; an ion exchange resin; a sodium starch glycolate; a
croscarmellose sodium, or any combination thereof.
30 . 27. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
having a ratio of the ritonavir and the second antiretroviral drug to the polymer in the range
of from about 1:1 to about 1:6 by weight.
28. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
wherein the composition has a taste-masking property.
5 29. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
wherein the plurality of particles are provided in a dosage form comprising: powders,
powders for reconstitution, pellets, beads, mini-tablets, film coated tablets, film coated
tablets MUPS, orally disintegrating MUPS, pills, micro-pellets, small tablet units, MUPS,
disintegrating tablets, dispersible tablets, capsules, granules, effervescent granules, sachets
10 or any combination thereof.
30. A pharmaceutical solid oral, sprinkle composition according to any preceding claim
further comprising one or more excipients comprising plasticizers, fillers or diluents;
surfactants; solubility enhancers; disintegrants; binders; lubricants; non-ionic solubilisers;
1 glidants; or any combination thereof.
. 31. A pharmaceutical solid oral sprinkle composition comprising ritonavir and lopinavir;
•- and a least one polymer comprising: a water soluble polymer; a water swellable polymer;
water insoluble polymer; or any combination thereof.
20
32. A pharmaceutical solid oral sprinkle composition according to any preceding claim,
wherein the plurality of particles are provided with a film coat; provided with film coat and
a seal coat external to the film coat; or provided with a seal coat and a film coat external to
the seal coat.
2 5
33. A pharmaceutical solid oral sprinkle composition according to any one of claims 1 to
31, wherein the plurality of particles are uncoated.
34. A kit comprising a pharmaceutical solid oral sprinkle composition according to any
30 preceding claim, the kit further comprising instructions for administration.
35. A process for preparing a pharmaceutical solid oral sprinkle composition according
to any one of claims 1 to 33, comprising hot melt extruding the first an second
antiretroviral drugs to form an extrudate, then formulating the extrudate into the plurality of
particles, and combining the plurality of particles to provide the solid oral composition.
5
36. A method according to claim 35, wherein the first and second antiretroviral drugs are
mixed with the at least one polymer prior the hot melt extrusion step.
37. A method according to claim 35 or 36, comprising preparing a substantially
10 homogeneous melt of the first and second antiretroviral drugs and optionally one or more
excipient, extruding the melt, and cooling the melt until it solidifies, wherein the melt is
preferably formed at a temperature from substantially 50° C to substantially -200° C, and
wherein the cooled extruded melt is preferably processed into said plurality of particles.
15 38. A method according to claim 35, 36 or 37, wherein the first and second antiretroviral
drugs, the at least one polymer, and optionally one or more excipient are processed to form a
powder blend, which is transferred through the heated barrel of an extruder, whereby the
powder blend melts and a molten solution product is formed which is allowed to cool to
form the extrudate.
0
39. A process for preparing a pharmaceutical solid oral sprinkle composition which is a
sprinkle formulation comprising a plurality of particles, the plurality of particles comprising
a first and a second antiretroviral drug, wherein the first antiretroviral drug comprises
ritonavir, the process comprising:
5 (a) melt granulating one or more solubility enhancers and one or more pharmaceutically
acceptable excipients with the or each drugs in purified water to form a granulated material;
(b) sieving the granulated material;
(c) drying the sieved granulated material to form dried granules;
(d) lubricating the dried granules with one or more lubricants and one or more second
0 pharmaceutically acceptable excipients; and .
(e) optionally further processing the lubricated dried granules to provide the dosage form.
40. A method of treatment of HIV infection or AIDS by administering a pharmaceutical
solid oral sprinkle composition according to claims 1 to 33 to a patient in need thereof.
41. A pharmaceutical solid oral sprinkle composition according to any one of claims 1 to
5 33 for use in the treatment of an HIV infection or AIDS.
42. A use of a pharmaceutical solid oral composition according to any one of claims 1 to
33 in the manufacture of a medicament for the treatment of an HIV infection or AIDS.
43. A pharmaceutical solid oral sprinkle composition as substantially described herein,
with reference to any one of the examples.
44. A process for preparing a pharmaceutical solid oral sprinkle composition as
substantially described herein, with reference to any one of the examples.