CONTROLLED ABSORPTION PHARMACEUTICAL COMPOSITION

Abstract: A controlled absorption verapamil containing pellet formulation for oral administration comprises a core of a powder mixture containing verapamil or a pharmaceutically acceptable salt thereof and an organic acid and a polymeric material, said core comprising layers of said powder mixture and said polymeric material superimposed one upon the other and said polymeric material being present in an amount effective to ensure that all of said powder mixture is coated into said core and a multi-layer membrane surrounding said core, the number of layers in said membrane and the ratio of the various polymers comprising the membrane being effective to permit release of the verapamil from the pellet at a rate allowing controlled absorption thereof over a 24 hour period following oral administration, said rate being measured in vivo and having a Tmax between 6 and l6 hours.

Description: This invention relates to a verapamil pellet formulation for oral administration and the use thereof in the preparation of verapamil-containing pharmaceutical formulations which allow one to achieve a controlled absorption of verapamil in vivo . The invention relates, in particular, to a verapamil formulation suitable for once daily administration. Verapamil (δ-[N-(3,4-dimethoxyphenethyl)-N-methylamino]-α-(3,4-dimethoxyphenyl)-α-isopropylvaleronitrile) decreases the oxygen requirements of the myocardium and also reduces the work load of the heart by diminishing peripheral resistance. Verapamil hydrochloride is used in the prophylaxis and treatment of angina of effort in doses of 40 to 80 mg thrice daily by mouth according to the severity of the condition. It is also used by slow intravenous injection in doses of 5 mg up to thrice daily in severe angina of effort not responsive to oral therapy. Verapamil is also used in the treatment of hypertension. Verapamil hydrochloride is sold under the Trade Mark "Cordilox" as 2-ml ampoules of an injection containing 2.5 mg per ml, for intravenous use, and as tablets of 40 mg. EP-A-0 063 266 describes a sustained release form of verapamil which it is stated allows the frequency of administration to be reduced to once or twice daily. The formulation contains a rapid release form of verapamil and a sustained (slow) release form of verapamil in a ratio of l:0.6 to l:6. No data is presented in the Specification of EP-A-0 063 266 demonstrating in vivo plasma concentration levels following administration. It is an object of the present invention to provide a controlled absorption form of verapamil which is suitable for once daily administration, which is characterised by a high degree of absorption, which is substantially invariable from subject to subject, and by significant plasma levels of verapamil which are maintained for an extended period after administration. Accordingly, the invention provides a controlled absorption verapamil containing pellet formulation for oral administration, said pellet comprising: (i) a core of (a) a powder mixture containing verapamil or a pharmaceutically acceptable salt thereof and an organic acid selected from adipic acid, ascorbic acid, citric acid, fumaric acid, malic acid, succinic acid and tartaric acid or a mixture thereof, and (b) a polymeric material containing a major proportion of a pharmaceutically acceptable water soluble polymer and optionally a minor proportion of a pharmaceutically acceptable water insoluble polymer, said core comprising layers of said powder mixture and said polymeric material superimposed one upon the other and said polymeric material being present in an amount effective to ensure that all of said powder mixture is coated into said core; and (ii) a multi-layer membrane surrounding said core and containing a major proportion of a pharmaceutically acceptable film-forming, water-insoluble polymer and a minor proportion of a pharmaceutically acceptable film-forming, water-soluble polymer, the number of layers in said membrane and the ratio of said water-soluble polyners to said water-insoluble polymers bing effective to permit release of said verapamil from said pellet at a rate allowing controlled absorption thereof over a 24 hour period following oral administration, said rate being measured in vivo and having a Tmax between 6 and l6 hours. Preferably, the pellet formulation according to the invention has a Tmax in vivo between 7 and l0 hours. The invention also provides a controlled absorption verapamil containing pellet formulation for oral administration, said pellet comprising: (i) a core of (a) a powder mixture containing verapamil or a pharmaceutically acceptable salt thereof and an organic acid selected from adipic acid, ascorbic acid, citric acid, fumaric acid, malic acid, succinic acid and tartaric acid or a mixture thereof, and (b) a polymeric material containing a major proportion of a pharmaceutically acceptable water soluble polymer and optionally a minor proportion of a pharmaceutically acceptable water insoluble polymer, said core comprising layers of said powder mixture and said polymeric material superimposed one upon the other and said polymeric material being present in an amount effective to ensure that all of said powder mixture is coated into said core; and (ii) a multi-layer membrane surrounding said core and containing a major proportion of a pharmaceutically acceptable film-forming, water-insoluble polymer and a minor proportion of a pharmaceutically acceptable film-forming, water-soluble polymer, the number of layers in said membrane and the ratio of said water-soluble polymers to said water-insoluble polymers being effective to permit release of said verapamil from said pellet at a rate allowing controlled absorption thereof over a 24 hour period following oral administration, said rate being measured in vitro as a dissolution rate of said pellet in a potassium chloride medium which, when measured in a basket assembly according to U.S. Pharmacopoeia XXI at 37°C, substantially corresponds to the following: a) from 0 to 25% of the total verapamil is released after one hour of measurement in said assembly; b) from 0 to 35% of the total verapamil is released after four hours of measurement in said assembly; c) from 30 to 60% of the total verapamil is released after a total of eight hours of measurement in said assembly; d) from 50 to 75% of the total verapamil is released after eleven hours of measurement in said assembly; and e) not less than 80% of the total verapamil is released after twenty-four hours of measurement in said assembly. More particularly, the potassium chloride medium is a medium as defined in Example l. Verapamil is widely used in anti-anginal therapy and where the patient for one reason or another (for example, takes the dose later than due, is switching from conventional frequently administered immediately released products, etc.) the patient may require a rapid attainment of effective therapeutic blood levels for fast relief of onset of anginal attack. Accordingly, the invention further provides a controlled absorption verapamil formulation for oral administration comprising a blend of pellets as hereinbefore specified in admixture with pellets of a rapid release form of verapamil to ensure a rapid attainment of effective therapeutic blood levels of verapamil within one hour following administration, said rapid release pellets comprising pellets as hereinbefore specified without said multi-layer membrane, the formulation having a dissolution rate which is substantially pH independent and which when measured in a basket assembly according to U.S. Pharmacopoeia XXI at 37°C has the following characteristics: a) from l0 to 25% of the total verapamil is released after one hour of measurement in said assembly; b) from 20 to 35% of the total verapamil is released after four hours of measurement in said assembly; c) from 35 to 60% of the total verapamil is released after eight hours of measurement in said assembly; d) from 50 to 75% of the total verapamil is released after eleven hours of measurement in said assembly; and e) not less than 80% of the total verapamil is released after twenty-four hours of measurement in said assembly. Preferably, the verapamil is in the form of a pharmaceutically acceptable salt thereof, more particularly the hydrochloride salt thereof. The verapamil component and organic acid are preferably present in a ratio of from l:l to l0:l. As used herein the term water-soluble polymer is intended to include polymers which are freely water permeable and porous polymers. The term water-insoluble polymer as used herein is intended to include polymers which are slightly water permeable or water impermeable and non-porous polymers. The polymeric material may consist solely of a water soluble polymer or a polymer which is freely permeable to verapamil and water. Alternatively, the polymeric material of the core may include a minor proportion of a water insoluble polymer or a polymer which is slightly permeable to verapamil and water. The ratio of water soluble/freely permeable to water insoluble/slightly permeable polymer is determined by the particular combination of polymers selected. The water soluble polymer is suitably hydroxypropylmethylcellulose or polyvinylpyrrolidone. A suitable polymer which is freely permeable to verapamil and water is a polymer sold under the Registered Trade Mark EUDRAGIT RL. The water insoluble polymer is suitably a cellulose ether such as methyl-, ethyl- or propylcellulose or shellac. A suitable polymer which is slightly permeable to verapamil and water is a polymer sold under the Registered Trade Mark EUDRAGIT RS. EUDRAGIT polymers are polymeric lacquer substances based on acrylates and/or methacrylates. Polymeric materials sold under the Registered Trade Marks EUDRAGIT RL and RS are acrylic resins comprising copolymers of acrylic and methacrylic acid esters with a low content of quaternary ammonium groups and are described in the "EUDRAGIT" brochure of Messrs. Rohm and Haas (l985) wherein detailed physical-chemical data of these products is given. The ammonium groups are present as salts and give rise to the permeability of the lacquer films. EUDRAGIT RL and RS are freely permeable (RL) or slightly permeable (RS), respectively, independent of pH. The core suitably has between 20 and l20 layers of the core-forming materials and is built up in a manner known per se . Preferably, the multi-layer arrangement of verapamil, organic acid and polymeric material is built up on a central inert core suitably consisting of a non-pareil seed of sugar or starch having an average diameter in the range of 0.3-0.7 mm, especially 0.4 - 0.5 mm, in a conventional coating pan. The core may also include other components such as a lubricant, a dispersing agent or a surfactant. A suitable and particularly preferred lubricant is talc and a suitable surfactant is sodium lauryl sulphate. The verapamil or pharmaceutically acceptable salt thereof, organic acid and optionally other components such as a lubricant are blended to form a homongenous powder. The blend is suitably passed through a No. l00 mesh screen using a milling machine. Alternate layers of a coating solution/suspension of the polymeric material and the powder are applied to the central inert core so as to build up the multi-layer arrangement of the active core. The coating solution/suspension of the polymeric material comprises one or more polymers dissolved/suspended in a suitable solvent or mixture of solvents. The concentration of the polymeric material in the coating solution/suspension is determined by the viscosity of the final solution. A suitable plasticizer such as diethylphthalate may be added to the coating solution/suspension. Especially preferred coating solutions/suspensions include: a) l0% polyvinylpyrrolidone in isopropanol or ethanol; b) 5% hydroxypropylmethylcellulose in methanol/methylene chloride 60/40; and c) 5% EUDRAGIT RL in isopropanol/acetone 60/40; The membrane of the film-forming polymer or mixture of polymers surrounding the core has a major proportion of a water insoluble polymer and a minor proportion of a water soluble polymer as hereinbefore defined, the ratio of water insoluble to water soluble polymer being determined by the inherent solubility characteristics of the polymers selected. Suitable combinations of water insoluble and water soluble polymers for the membrane include: ethylcellulose and hydroxypropylmethylcellulose in a ratio of from 7:l to 9:3; shellac and polyvinylpyrrolidone in the ratio of from 8:0.5 to 9.5:2; and cellulose acetate and polyvinylalcohol in a ratio of from 7:l to 9:3. The membrane may also be composed of a major proportion of a non-porous polymer and a minor proportion of a porous polymer, the ratio of non-porous to porous polymer being determined by the inherent porosity of the respective polymers. Examples of porous polymers include polyvinylpyrrolidone, Eudragit RL, polyvinylalcohol and hydroxypropylmethylcellulose. Examples of non-porous polymers include Eudragit RS, methyl-, ethyl- or propyl cellulose and shellac. The membrane may further be composed of a major proportion of a polymer which is slightly permeable to verapamil and water and a minor proportion of a polymer which is freely permeable to verapamil and water, the ratio of slightly permeable to freely permeable polymer being determined by the inherent permeability of the respective polymers. A suitable combination of a polymer which is slightly permeable to verapamil and water and a polymer which is freely permeable to verapamil and water is EUDRAGIT RS and EUDRAGIT RL in a ratio of from 7.5:0.5 to 9.5:2.5. The membrane is built up by applying a plurality of coats of membrane polymer solution or suspension to the core as hereinafter described. The membrane solution or suspension contains the polymer(s) dissolved or suspended, respectively, in a suitable solvent or mixture of solvents, optionally in the presence of a lubricant. Suitable lubricants are talc, stearic acid and magnesium stearate. A preferred lubricant is talc in an amount of 5% by weight. Preferably, the number of coats of membrane solution or suspension applied is between 8 and 30 coats. Further, preferably, 2-25 ml of membrane solution or suspension is applied per kilogram of cores. The membrane solution or suspension may include a suitable plasticizer such as diethylphthalate. Especially preferred membrane suspensions include: a) 0.5 to 2 parts by volume l0% polyvinylpyrrolidone in isopropanol or ethanol, 8 to 9.5 parts by volume l7.5% shellac in ethanol, and 5 parts by weight talc; b) 0.5 to 2.5 parts by volume 5% EUDRAGIT RL in isopropanol/acetone 60/40, 7.5 to 9.5 parts by volume 5% EUDRAGIT RS in isopropanol/acetone 60/40, and 5 parts by weight talc; c) l to 3 parts by volume hydroxypropylmethylcellulose in methanol/methylene chloride 60/40, 7 to 9 parts by volume ethylcellulose in methanol/methylene chloride 60/40, 5 parts by weight talc, and d) l to 3 parts by volume l0% polyvinylalcohol in ethanol, 7 to 9 parts by volume l0% cellulose acetate in acetone/isopropanol 50/50, 5 parts by weight talc. The pellets may be filled into hard or soft gelatine capsules. The pellets may also be compressed into tablets using a binder and/or hardening agent commonly employed in tableting such as microcrystalline cellulose sold under the Registered Trade Mark "AVICEL" or a co-crystallised powder of highly modified dextrins (3% by weight) and sucrose sold under the Registered Trade Mark "DI-PAC", in such a way that the specific dissolution rate of the pellets is maintained. Description of the Drawings In the accompanying drawings: Fig. l is a graphic representation of the dissolution rates at pH 7.5 of slow release pellets (curve a) and rapid release pellets (curve b) as prepared in Example l; Fig. 2 is a graphic representation of the dissolution rates at pH 3.0, 6.0 and 7.5 for a blend of pellets as prepared in Example l; Fig. 3 is a graphic representation of the dissolution rates at pH 3.0, 6.0 and 7.5 for a blend of pellets as prepared in Example 2; Fig. 4 is a graph of plasma levels (ng/ml) of verapamil versus time after administration (hours) for verapamil capsules as prepared in Example l (curve a) compared with conventional tablets (curve b); Fig. 5 is a graph of plasma levels (ng/ml) of norverapamil versus time after administration (hours) for verapamil capsules as prepared in Example l (curve a) compared with conventional tablets (curve b); Fig. 6 is a graph of plasma levels (ng/ml) of verapamil versus time after administration (hours) for verapamil capsules as prepared in Example 2 (curve a) compared with conventional tablets (curve b); Fig. 7 is a graph of plasma levels (ng/ml) of norverapamil versus time after administration (hours) for verapamil capsules as prepared in Example 2 (curve a) compared with conventional tablets (curve b); Fig. 8 is a graph of plasma levels (ng/ml) of verapamil at day 9 of administration versus time after administration (hours) for verapamil capsules as prepared in Example 2 (curve a) compared with conventional tablets (curve b); and Fig. 9 is a graph of plasma levels (ng/ml) of norverapamil at day 9 of adminstration versus time after administration (hours) for verapamil capsules as prepared in Example 2 (curve a) compared with conventional tablets (curve b). The invention will be further illustrated by the following Examples. EXAMPLE l Verapamil hydrochloride (30 kg), malic acid (l0 kg) and talc (2.4 kg) were blended and passed through a No. l00 mesh screen using a conventional milling machine. A polymer suspension was prepared containing 5% hydroxypropylmethylcellulose in methanol/methylene chloride 60/40. Sugar/starch seeds (0.4 to 0.5 mm) (9 kg) were placed in a standard coating pan and rotation commenced. The seeds were wetted with sufficient polymer suspension to dampen them thoroughly and then an amount of the powder blend was dusted on until no more adhered. This step was repeated until all of the powder blend had been applied. The coated seeds were allowed to dry after each application of polymer suspension. When all of the powder had been applied the coated seeds were dried at 40-60°C until all of the solvent had been driven off. A membrane suspension was prepared from the following components: 2 parts by volume 5% hydroxypropylmethylcellulose in methanol/methylene chloride 60/40; 8 parts by volume 5% ethylcellulose in methanol/methylene chloride 60/40; 5 parts by weight talc. The coated seeds prepared above and which define the active core of the pellets being prepared were placed in a coating pan and rotation commenced. The membrane suspension was applied to the coated seeds in separate coats, each coat corresponding to l0 ml of the membrane suspension per kg of coated seeds. After each coat had been applied the pellets were air dried in the coating pan. After the final coat had been applied the pellets were dried at 40-60°C to evaporate all traces of solvent. The finished pellets were then subjected to a dissolution test as follows: Apparatus : basket assembly described in U.S.P. XXI at 37°C and 75 r.p.m. Medium : pH 7.5 solution (25 ml of 2.0 M potassium chloride plus 950 ml water adjusted to pH 7.5 with sodium hydroxide and to 1000 ml with water). Method : 2 g of pellets were placed in the basket and the test commenced. 1 ml of medium was removed at the specified time points and diluted to 50 ml with 0.1 N hydrochloric acid. The absorbance of this solution was read at 279 nm. The absorbance equivalent to 100% dissolution was determined by dissolving 200 mg of ground pellets in sufficient 0.1 N hydrochloric acid to produce 100 ml. 1 ml of this solution was diluted to 50 ml with 0.1 N hydrochloric acid and its absorbance determined at 279 nm. The percentage dissolution at each sampling time was calculated by dividing the absorbance of that sample by the 100% absorbance reading. The dissolution should be in the following range: Time (h) Dissolution (%) 1 0 - 25 4 0 - 35 8 30 - 60 11 50 - 75 24 Not less than 80 Application of coats of the membrane suspension is continued until the desired dissolution pattern is obtained. Pellets with a dissolution pattern within the above range correspond to slow release pellets for use in the controlled absorption pharmaceutical formulation of the invention. Rapid release pellets as used in the controlled absorption pharmaceutical formulation of the invention are prepared by forming active cores without the subsequent application of a membrane thereto. The dissolution of these rapid release pellets is determined in the manner outlined above but sampling after only one hour, when the dissolution should be greater than 90%. The slow release and rapid release pellets are then combined in suitable proportions to produce a blend which has a dissolution rate which falls within the following range: Time (h) Dissolution (%) 1 10 - 25 4 20 - 35 8 35 - 60 11 50 - 75 24 Not less than 80 A graphic representation of the dissolution rates of the rapid release pellets and the slow release pellets at pH 7.5 is depicted in Fig. 1 wherein curve a corresponds to the slow release pellets and curve b corresponds to the rapid release pellets. Dissolution rates for a blend of the rapid and slow release pellets were also determined at pH 3.0, pH 6.0 and PH 7.5. The pH 3.0 and 6.0 buffers were prepared as for the buffer of pH 7.5 using hydrochloric acid or sodium hydroxide, as necessary, to adjust the pH. The results are shown in Table l and are represented graphically in Fig. 2. A blend of the rapid and slow release pellets having the desired in vitro dissolution rates was filled into hard gelatine capsules. EXAMPLE 2 Example l was repeated except that malic acid was replaced as the organic acid by fumaric acid (l5 kg). Also hydroxypropylmethylcellulose was replaced by l0% polyvinylpyrrolidone in ethanol as the polymer suspension. The membrane suspension was prepared from the following components: l part by volume l0% polyvinylpyrrolidone in ethanol; 9 parts by volume l7.5% shellac in ethanol; 5 parts by weight talc. Dissolution tests were carried out as in the case of Example l at pH 3.0, 6.0 and 7.5 and the results are given in Table 2. A graphic representation of the results is indicated in Fig. 3. A blend of the rapid and slow release pellets having the desired in vitro dissolution rates was filled into hard gelatine capsules. PHARMACOLOGICAL DATA FOR THE VERAPAMlL FORMULATION PREPARED IN EXAMPLE l As will be observed from the data given in Tables 3 -l0 and as represented graphically in Figures 4 -9, a 240 mg single-dose of a blend of pellets as prepared in Example l in capsule form had an equivalent plasma verapamil (Tables 3 and 4) and norverapamil (Tables 5 and 6) level area under the curve (AUC) (l057 and l580 ng × h/ml, respectively) as conventional Cordilox (Cordilox is a Trade Mark) tablets (Tables 7-l0) given as 80 mg at 0, 8 and l6 hours (l099 and l323 ng × h/ml, respectively). Norverapamil is an active metabolite of verapamil. The blend of pellets as prepared in Example l showed a peak plasma verapamil level (90.l ng/ml) (Table 4) at 8 hours and a peak norverapamil level (83.9 mg/ml) (Table 6) at 9.4 hours. In contrast Cordilox is rapidly absorbed with an initial peak verapamil level (l23.6 ng/ml) (Table 8) and norverapamil (l0l.l ng/ml) (Table l0) occurring at 0.64 hours. In terms of variability, the verapamil formulation of Example l was similar to Cordilox tablets: AUC variability for the verapamil formulation of Example l has % CV (coefficient of variation) = 39.3 for verapamil levels and % CV = 35.9 for norverapamil levels. The AUC variability for Cordilox tablets has % CV = 4l.5 for verapamil levels and % CV = 33.5 for norverapamil levels. Fig. 4 is a graph of plasma levels (ng/ml) of verapamil versus time after administration (hours) for a single-dose (240 mg) of verapamil capsules as prepared in Example l (curve a ) compared with a single-dose (80 mg) of Cordilox tablets (curve b ). The graphs of Fig. 4 were drawn from the mean values obtained for eight subjects according to the data listed in Tables 3, 4, 7 and 8. Fig. 5 is a graph of plasma levels (ng/ml) of norverapamil versus time after administration (hours) for a single-dose (240 mg) of verapamil capsules prepared in Example I (curve a ) compared with a single-dose (80 mg) of Cordilox tablets (curve b ). The graphs of Fig. 5 were drawn from the mean values obtained for 8 subjects according to the data listed in Tables 5, 6, 9 and l0. VERAPAMIL OF EXAMPLE 2 PERCENTAGE DISSOLUTION TIME (HOURS) PH 0.00 1.00 4.00 8.00 11.00 24.00 3.0 0.00 17.40 23.80 40.80 60.60 99.99 6.0 0.00 17.90 24.60 41.50 63.00 99.88 7.5 0.00 18.90 25.80 42.40 63.10 98.99 MEAN 0.00 18.07 24.73 41.57 62.23 99.62 ST DEV 0.00 0.76 1.01 0.80 1.42 0.55 CV (%) 0.00 4.23 4.07 1.93 2.27 0.55 VERAPAMIL - EXAMPLE 1 - 240 mg AS SINGLE DOSE PHARMACOKINETIC PARAMETERS AUC PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 24.00 HOURS MEAN 1057.41 8.00 90.06 5.64 ST DEV 415.23 2.58 58.94 2.79 CV (%) 39.27 32.27 65.45 49.40 BASED ON MEAN BLOOD LEVEL CURVE MEAN 6.00 73.16 3.84 VERAPAMIL - EXAMPLE 1 - 240 mg AS SINGLE DOSE PHARMACOKINETIC PARAMETERS AUC PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 24.00 HOURS MEAN 1580.21 9.43 83.89 2.13 ST DEV 567.88 3.60 40.34 0.58 CV (%) 35.94 38.17 48.09 27.09 BASED ON MEAN BLOOD LEVEL CURVE MEAN 8.00 72.47 1.80 VERAPAMIL - CORDILOX 80 mg PHARMACOKINETIC PARAMETERS AUC PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 22.00 HOURS MEAN 1099.16 0.64 123.64 4.51 ST DEV 456.41 0.24 54.52 0.95 CV (%) 41.52 37.95 44.09 21.04 BASED ON MEAN BLOOD LEVEL CURVE MEAN 0.50 113.97 4.16 VERAPAMIL - CORDILOX 80 mg PHARMACOKINETIC PARAMETERS AUC PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 22.00 HOURS MEAN 1322.95 0.64 101.09 1.77 ST DEV 443.37 0.24 27.26 0.22 CV (%) 33.51 37.95 26.97 12.54 BASED ON MEAN BLOOD LEVEL CURVE MEAN 0.50 99.70 1.72 PHARMACOLOGICAL DATA FOR THE VERAPAMIL FORMULATION PREPARED IN EXAMPLE 2 As will be observed from the data given in Tables ll-l6 peak plasma verapamil levels following single-dose administration of the verapamil preparation prepared in Example 2 (240 mg; in capsule form) (83.8 ng/ml) were not significantly different from peak plasma verapamil levels for a single-dose (80 mg) of Cordilox tablets (78.8 ng/ml). As will be observed from the data given in Tables l7-22 peak plasma norverapamil levels were, however, higher with the verapamil formulation of Example 2 (69.6 ng/ml) relative to Cordilox tablets (52.7 ng/ml). Fig. 6 is a graph of plasma levels (ng/ml) of verapamil versus time after administration (hours) for a single-dose (240 mg) of verapamil capsules prepared from a blend of pellets as prepared in Example 2 (curve a ) compared with a single dose (80 mg) of Cordilox tablets (curve b ). The graphs of Fig. 6 were drawn from the mean values obtained for 22 subjects according to the data listed in Tables ll-l6. Fig. 7 is a graph of plasma levels (ng/ml) of norverapamil versus time after administration (hours) for a single-dose (240 mg) of verapamil capsules prepared from a blend of pellets as prepared in Example 2 (curve a ) compared with a single-dose (80 mg) of Cordilox tablets (curve b ). The graphs of Fig. 7 were drawn from the mean values obtained for 22 subjects according to the data listed in Tables l7-22. Results of steady-state studies performed at day 9 of administration for the blend of tablets prepared in Example 2 and Cordilox tablets are presented in Tables 23-34. Steady-state peak plasma verapamil and norverapamil levels for the verapamil capsules prepared from a blend of pellets as prepared in Example 2 (240 mg) (ll7.6 ng/ml and ll2.8 ng/ml, respectively) were significantly lower than those of Cordilox tablets (80 mg) (l72.2 ng/ml and l40.0 ng/ml, respectively). The verapamil formulation of Example 2 showed markedly delayed single-dose peaking times based both on verapamil (7.6 hours) and norverapamil (9.4 hours) levels compared with Cordilox tablets (l.l hours and l.9 hours, respectively). The verapamil and norverapamil peak to 24-hour trough fluctuations of the verapamil formulation of Example 2, (4.8 and 2.l, respectively) were significantly lower than that of the peak to 8-hour trough Cordilox values (ll.6 and 2.6, respectively). The verapamil formulation of Example 2 showed significantly delayed peaking times based both on verapamil (7.7 hours) and norverapamil (9.0 hours) levels compared with Cordilox (l.2 hours, and l.8 hours, respectively). At steady-state the peak to dosing interval trough plasma verapamil fluctuations of the verapamil formulation of Example 2 (3.7) was significantly lower than that of Cordilox (5.l) whereas the norverapamil peak-to-trough fluctuations were not different (l.8 versus l.9, respectively). The apparent verapamil and norverapamil elimination rates of Cordilox (0.29 h⁻¹ and 0.l2 h⁻¹, respectively) were significantly faster than the corresponding single-dose values for the verapamil formulation of Example 2 (0.08 h⁻¹ and 0.06 h⁻¹, respectively). Apparent half lives for verapamil and norverapamil were significantly longer with the verapamil formulation of Example 2 (8.88 h and ll.5 h, respectively) than with Cordilox (2.6l h and 7.04 h, respectively). These data are consistent with prolonged absorption for the verapamil formulation of Example 2. At steady-state the apparent verapamil and norverapamil elimination rates of Cordilox (0.l2 h⁻¹ and 0.07 h⁻¹, respectively) were significantly higher than the corresponding values for the verapamil formulation of Example 2 (0.08 h⁻¹ and 0.06 h⁻¹, respectively). Apparent half lives for verapamil and norverapamil were significantly longer with the verapamil formulation of Example 2 (9.0l h and l2.37 h, respectively) than with Cordilox (6.38 h and l0.03 h, respectively). Based on dose-adjusted area under the plasma verapamil concentration-time curve (AUC) (see Fig. 8) the relative bioavailability of the verapamil formulation of Example 2 (ll28.5 ng × h/ml) was l34% compared with Cordilox (842.5 ng × h/ml). The dose-adjusted norverapamil AUC (see Fig. 9) indicated that the verapamil formulation of Example 2 (l459.6 ng × h/ml) was l04% bioavailable relative to Cordilox (l400.7 ng × h/ml). The single-dose coefficient of variation of such parameters as AUC (53.7%), Cmax (55.9%) and the average CV (coefficient of variation) across all the sampling times (l24.l%) were relatively high with the Cordilox tablets. The corresponding CV values for the verapamil formulation of Example 2 were lower and indicated a more consistent absorption pattern, for example, AUC (39.0%), Cmax (39.2%) and average over the sampling times (59.0%). As was observed in the single-dose phase, the verapamil formulation of Example 2 was consistently lower in terms of the extent of intersubject variability in the steady-state profile compared with Cordilox. Following Cordilox the CV of the AUC (62.4%), Cmax (6l.8%) and the average CV across the sampling times (7l.9%) were higher than the corresponding values for the verapamil formulation of Example 2 (AUC, 43.3%; Cmax, 44.8% and sampling times 55.0%). Fig. 8 is a graph of plasma levels (ng/ml) of verapamil at day 9 of administration versus time after administration (hours) for the verapamil formulation of Example 2 (240 mg) (curve a ) compared with Cordilox tablets (80 mg) (curve b ). The graphs of Fig. 8 were drawn from the mean values obtained from 22 subjects according to the data listed in Tables 23-28. Fig. 9 is a graph of plasma levels (ng/ml) of norverapamil at day 9 of administration versus time after administration (hours) for the verapamil formulation of Example 2 (240 mg) (curve a ) compared with Cordilox tablets (80 mg) (curve b ). The graphs of Fig. 9 were drawn from the mean values obtained for 22 subjects according to the data listed in Tables 29-34. VERAPAMIL LEVELS - EXAMPLE 2 - 240 mg SINGLE-DOSE PHARMACOKINETIC PARAMETERS AUC 0-48H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 24.00 HOURS MEAN 1128.48 7.55 83.82 4.77 ST DEV 439.83 0.86 32.87 1.97 CV (%) 38.98 11.37 39.22 41.26 BASED ON MEAN BLOOD LEVEL CURVE MEAN 8.00 81.00 4.25 VERAPAMIL LEVELS - EXAMPLE 2 - 240 mg SINGLE-DOSE K EL. T 1/2 MEAN 0.06 8.88 S.D. 0.02 1.99 CV (%) 25.60 22.43 VERAPAMIL LEVELS - CORDILOX 80 mg - SINGLE-DOSE PHARMACOKINETIC PARAMETERS AUC 0-48H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 8.00 HOURS MEAN 280.82 1.05 78.84 11.55 ST DEV 150.83 0.34 44.04 3.84 CV (%) 53.71 32.70 55.86 33.26 BASED ON MEAN BLOOD LEVEL CURVE MEAN 1.00 76.74 10.71 CORDILOX 80 mg SINGLE-DOSE - VERAPAMIL LEVELS K EL. T 1/2 MEAN 0.29 2.61 S.D. 0.08 1.04 CV (%) 27.81 39.93 NORVERAPAMIL LEVELS - CAPSULES OF EXAMPLE 2 - 240 mg SINGLE-DOSE PHARMACOKINETIC PARAMETERS AUC 0-48H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 24.00 HOURS MEAN 1459.55 9.41 69.60 2.11 ST DEV 358.00 1.92 14.61 0.62 CV (%) 24.53 20.39 20.99 29.36 BASED ON MEAN BLOOD LEVEL CURVE MEAN 8.00 65.53 1.88 NORVERAPAMIL LEVELS - CAPSULES OF EXAMPLE 2 - 240 mg SINGLE-DOSE K EL. T 1/2 MEAN 0.06 11.50 S.D. 0.01 2.30 CV (%) 17.77 20.41 NORVERAPAMIL LEVELS - FROM CORDILOX 80 mg SINGLE-DOSE PHARMACOKINETIC PARAMETERS AUC 0-48H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 8.00 HOURS MEAN 466.90 1.86 52.74 2.57 ST DEV 141.45 0.89 14.30 0.47 CV (%) 30.30 47.69 27.12 18.12 BASED ON MEAN BLOOD LEVEL CURVE MEAN 2.00 49.44 2.33 CORDILOX 80 mg SINGLE-DOSE - NORVERAPAMIL LEVELS K EL. T 1/2 MEAN 0.12 7.04 S.D. 0.05 2.83 CV (%) 40.77 40.16 VERAPAMIL LEVELS - EXAMPLE 2 - 240 mg SINGLE-DOSE PHARMACOKINETIC PARAMETERS AUC 0-24H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 24.00 HOURS MEAN 1572.98 7.68 117.60 3.69 ST DEV 680.48 2.03 52.69 1.40 CV (%) 43.26 26.46 44.80 38.01 BASED ON MEAN BLOOD LEVEL CURVE MEAN 8.00 113.35 3.26 VERAPAMIL - EXAMPLE 2 - 240 mg SINGLE-DOSE K EL. T 1/2 MEAN 0.08 9.01 S.D. 0.02 2.24 CV (%) 25.70 24.91 VERAPAMIL LEVELS - CORDILOX 80 mg SINGLE-DOSE PHARMACOKINETIC PARAMETERS AUC-SS 0-8H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 8.00 HOURS MEAN 694.15 1.16 172.23 5.07 ST DEV 433.20 0.42 106.38 1.23 CV (%) 62.41 36.18 61.77 24.35 BASED ON MEAN BLOOD LEVEL CURVE MEAN 1.00 168.12 4.50 CORDILOX 80 mg DAY 9 VERAPAMIL LEVELS K EL. T 1/2 MEAN 0.12 6.38 S.D. 0.03 1.67 CV (%) 25.11 26.13 NORVERAPAMIL LEVELS 240 mg PHARMACOKINETIC PARAMETERS AUC-SS 0-24H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 24.00 HOURS MEAN 1981/23 9.02 112.84 1.91 ST DEV 552.36 3.23 33.64 0.41 CV (%) 27.88 35.81 29.81 21.19 BASED ON MEAN BLOOD LEVEL CURVE MEAN 8.00 108.27 1.75 CAPSULES OF EXAMPLE 2 - 240 mg DAY 9 NORVERAPAMIL LEVELS K EL. T 1/2 MEAN 0.06 12.37 S.D. 0.01 2.41 CV (%) 22.72 19.44 NORVERAPAMIL LEVELS - CORDILOX 80 mg PHARMACOKINETIC PARAMETERS AUC-SS 0-8H PEAKING TIME T(MAX) PEAK HEIGHT C(MAX) C(MAX)/C(MIN) at 8.00 HOURS MEAN 888.69 1.77 140.00 1.76 ST DEV 298.95 0.75 45.22 0.31 CV (%) 33.64 42.40 32.30 17.67 BASED ON MEAN BLOOD LEVEL CURVE MEAN 2.00 135.93 1.64 CORDILOX 240 mg DAY 9 NORVERAPAMIL LEVELS K EL. T 1/2 MEAN 0.07 10.03 S.D. 0.01 1.94 CV (%) 16.31 19.30 The results of the bioavailability studies above show that the controlled absorption verapamil formulation according to the present invention is an effective once daily form of verapamil, as demonstrated by good bioavailability, delayed peaking time and prolonged effective plasma levels through to 24 hours after administration. The formulation of Example 2 was tested in in vivo clinical trials in subjects suffering from mild to moderate hypertension. A total group of ll8 patients were enrolled in these studies, medically diagnosed as suffering from mild to moderate hypertension and exhibiting associated raised blood pressure values. The subjects were titrated on various dosage strengths of the formulation of Example 2 in order to determine the optimum dosage for reduction and control of blood pressure in each individual patient. It will be observed from Table 35 that 39 subjects were successfully titrated at l20 mg once-daily, 55 subjects were successfully titrated at 240 mg and 24 subjects were successfully titrated at a dose greater than 240 mg once-daily (which was 360 mg or 480 mg). All subjects were then given the titrated dose in a once-daily regimen and blood pressured monitored for l month's therapy. It can be seen from Table 35 that blood pressure was effectively reduced and controlled for l month by administration of a once-daily dose of the formulation of Example 2. This reduction averaged 22/l6 mmHg when compared to baseline values. Additionally, 6l subjects who were similarly titrated to optimum once-daily dosage levels of the formulation of Example 2 were given this titrated dose on a once-daily regimen for 3 months and blood pressure was monitored over this period. It can be seen from table 36 that blood pressure was effectively reduced and controlled for 3 months by administration of a once-daily dose of the formulation of Example 2, and it is further demonstrated that this formulation is effective in the long-term control of blood pressure in mild to moderate hypertension, in a once-daily dosage regimen. This reduction averaged 24/l8 mmHg when compared to baseline values. COMBINED DATA - ONE MONTH PLATEAU DOSAGE THERAPY VERAPAMIL CAPSULES OF EXAMPLE 2 - HYPERTENSION BP VALUES Dosage Groups Mean Supine Systolic/Diastolic BP (mmHg) Baseline Completed Titration 1 Month Therapy 120 mg (N=39) 172/102 150/87 150/87 240 mg (N=55) 168/102 148/87 146/86 > 240 mg (N=24) 179/107 158/90 157/88 All groups (N=118) 172/103 151/88 150/87 COMBINED DATA - 3 MONTH PLATEAU DOSAGE THERAPY VERAPAMIL CAPSULES OF EXAMPLE 2 - HYPERTENSION BP VALUES Dosage Groups Mean Supine Systolic/Diastolic BP (mmHg) Baseline Completed Titration 1 Month Therapy 3 Month Therapy 120 mg (N=28) 170/102 151/87 149/86 149/84 240 mg (N=23) 171/104 145/87 145/87 143/88 > 240 mg (N=10) 186/108 162/89 159/87 162/87 All groups (N=61) 173/104 151/87 149/87 149/86 The formulation of Example 2 was also tested in vivo in a randomized, double blind, placebo controlled crossover study in a determination of efficacy in the treatment of chronic stable angina pectoris. A total of l8 subjects completed this trial. The formulation of Example 2 was administered as a single daily dose of 360 mg to all patients. Assessment was by computer-assisted multistage exercise testing, performed 22-24 hours after drug administration, and by 24 hour ambulatory electrocardiography. Mean exercise time for the subjects at the placebo dosing stage was 6.6 minutes. The formulation of Example 2 resulted in a significant increase in mean exercise time, as compared with placebo, of 8.89 minutes, (or an increase of 2.29 minutes, p < 0.00l). This increase in exercise time was sustained during the 4 wks of therapy. The time to the development of a l mm S-T depression (as determined by electrocardiography) was also increased with the formulation of Example 2. Peak S-T depression during exercise was unaltered by therapy with the formulation of Example 2, despite the increased exercise tolerance. All of these effects were observed 22-24 hours after the preceding dose of medication, indicating that satisfactory effect was being achieved throughout the day. In conclusion, the formulation of Example 2 was shown to be satisfactory for the treatment of angina pectoris, in a once-daily dosage regimen.

Claims: A controlled absorption verapamil containing pellet formulation for oral administration, characterised in that the pellet comprises: (i) a core of (a) a powder mixture containing verapamil or a pharmaceutically acceptable salt thereof and an organic acid selected from adipic acid, ascorbic acid, citric acid, fumaric acid, malic acid, succinic acid and tartaric acid or a mixture thereof, and (b) a polymeric material containing a major proportion of a pharmaceutically acceptable water soluble polymer and optionally a minor proportion of a pharmaceutically acceptable water insoluble polymer, said core comprising layers of said powder mixture and said polymeric material superimposed one upon the other and said polymeric material being present in an amount effective to ensure that all of said powder mixture is coated into said core; and (ii) a multi-layer membrane surrounding said core and containing a major proportion of a pharmaceutically acceptable film-forming, water-insoluble polymer and a minor proportion of a pharmaceutically acceptable film-forming, water-soluble polymer, the number of layers in said membrane and the ratio of said water-soluble polymers to said water-insoluble polymers being effective to permit release of said verapamil from said pellet at a rate allowing controlled absorption thereof over a 24 hour period following oral administration, said rate being measured in vivo and having a Tmax between 6 and l6 hours, preferably between 7 and l0 hours. A controlled absorption verapamil containing pellet formulation for oral administration, characterised in that the pellet comprises: (i) a core of (a) a powder mixture containing verapamil or a pharmaceutically acceptable salt thereof and an organic acid selected from adipic acid, ascorbic acid, citric acid, fumaric acid, malic acid, succinic acid and tartaric acid or a mixture thereof, and (b) a polymeric material containing a major proportion of a pharmaceutically acceptable water soluble polymer and optionally a minor proportion of a pharmaceutically acceptable water insoluble polymer, said core comprising layers of said powder mixture and said polymeric material superimposed one upon the other and said polymeric material being present in an amount effective to ensure that all of said powder mixture is coated into said core; and (ii) a multi-layer membrane surrounding said core and containing a major proportion of a pharmaceutically acceptable film-forming, water-insoluble polymer and a minor proportion of a pharmaceutically acceptable film-forming, water-soluble polymer, the number of layers in said membrane and the ratio of said water-soluble polymers to said water-insoluble polymer being effective to permit release of said verapamil from said pellet at a rate allowing controlled absorption thereof over a 24 hour period following oral administration, said rate being measured in vitro as a dissolution rate of said pellet in a potassium chloride medium which, when measured in a basket assembly according to U.S. Pharmacopoeia XXI at 37°C, substantially corresponds to the following: a) from 0 to 25% of the total verapamil is released after one hour of measurement in said assembly; b) from 0 to 35% of the total verapamil is released after four hours of measurement in said assembly; c) from 30 to 60% of the total verapamil is released after a total of eight hours of measurement in said assembly; d) from 50 to 75% of the total verapamil is released after eleven hours of measurement in said assembly; and e) not less than 80% of the total verapamil is released after twenty-four hours of measurement in said assembly. A pellet formulation according to Claim l or 2, characterised in that the verapamil or pharmaceutically acceptable salt thereof and organic acid are present in a ratio of from l:l to l0:l. A pellet formulation according to any one of Claims l to 3, characterised in that the polymeric material of the core includes a major proportion of a polymer which is freely permeable to verapamil and water. A pellet formulation according to any preceding claim, characterised in that the polymeric material of the core includes a minor proportion of a polymer which is slightly permeable to verapamil and water. A pellet formulation according to any one of Claims l to 3, characterised in that the water soluble polymer is selected from hydroxypropylmethylcellulose and polyvinylpyrrolidone. A pellet formulation according to Claim 4, characterised in that the polymeric material which is freely permeable to verapamil and water comprises a copolymer of acrylic and methacrylic acid esters. A pellet formulation according to any one of Claims l to 3, characterised in that the water insoluble polymer is selected from methylcellulose, ethylcellulose, propylcellulose and shellac. A pellet formulation according to Claim 5, characterised in that the polymer which is slightly permeable to verapamil and water comprises a copolymer of acrylic and methacrylic acid esters. A pellet formulation according to any preceding claim, characterised in that the verapamil, organic acid and polymeric material are built up on an inert core. A pellet formulation according to any preceding claim, characterised in that the core includes one or more additional components selected from a lubricant, a dispersing agent and a surfactant. A pellet formulation according to any preceding claim, characterised in that the water insoluble polymer of the membrane is selected from shellac, cellulose acetate and ethylcellulose. A pellet formulation according to Claim l2, characterised in that the water soluble polymer of the membrane is selected from polyvinylpyrrolidone, polyvinylalcohol and hydroxypropylmethylcellulose. A pellet formulation according to any one of Claims l to l2, characterised in that the multi-layer membrane is composed of a major proportion of a polymer which is slightly permeable to verapamil and water and a minor proportion of a polymer which is freely permeable to verapamil and water. A pellet formulation according to Claim l4, characterised in that each of the slightly permeable and freely permeable polymers comprises a copolymer of acrylic and methacrylic acid esters having the desired permeability characteristics. A pellet formulation according to any one of Claims l to l2, characterised in that the multi-layer membrane is composed of a major proportion of a non-porous polymer and a minor proportion of a porous polymer. A process for the production of a pellet formulation according to any one of Claims l to l6, characterised in that a core of verapamil or a pharmaceutically acceptable salt thereof and an organic acid is formed and in that the core is enclosed in a membrane of a film-forming polymer or mixture thereof which permits release of the verapamil or a pharmaceutically acceptable salt thereof in the manner set out in Claim l or 2. A controlled absorption verapamil formulation for oral administration, characterised in that it comprises a blend of pellets as defined in Claim l in admixture with pellets of a rapid release form of verapamil to ensure a rapid attainment of effective therapeutic blood levels of verapamil within one hour following administration, said rapid release pellets comprising pellets as defined in Claim l without said multi-layer membrane. A controlled absorption verapamil formulation for oral administration, characterised in that it comprises a blend of pellets as defined in any one of Claims 2 to l6 in admixture with pellets of a rapid release form of verapamil to ensure a rapid attainment of effective therapeutic levels of verapamil within one hour following administration, said rapid release pellets comprising pellets as defined in any one of Claims l to l6 without said multi-layer membrane, the formulation having a dissolution rate which is substantially pH independent and which when measured in a basket assembly according to U.S. Pharmacopoeia XXI at 37°C has the following characteristics: a) from l0 to 25% of the total verapamil is released after one hour of measurement in said assembly; b) from 20 to 35% of the total verapamil is released after four hours of measurement in said assembly; c) from 35 to 60% of the total verapamil is released after eight hours of measurement in said assembly; d) from 50 to 75% of the total verapamil is released after eleven hours of measurement in said assembly; and e) not less than 80% of the total verapamil is released after twenty-four hours of measurement in said assembly. A pellet formulation according to Claim l8 or l9, characterised in that it contains up to l2.5% by weight of said rapid release form of verapamil. A capsule or tablet comprising a formulation of pellets according to any one of Claims l8 to 20.

Inventors: GEOGHEGAN, EDWARD JAMES, PANOZ, DONALD EUGENE
Applicants: ELAN CORPORATION P.L.C.
Application year: 1987
Main classification: A61K9
IPC codes: A61P9, A61K31, A61K9