Title of Invention

MELT-EXTRUDED ORALLY ADMINISTRABLE OPIOID FORMULATIONS

Abstract Bioavailable sustained release oral opioid analgesic dosage forms, comprising a plurality of multiparticulates produced via melt extrusion techniques are disclosed.
Full Text MELT-EXTRUDED ORALLY ADMINISTRABLE OPIOID FORMULATTONS
BACKGROUND OF THE INVENTION
The present invention relates to the use of melt extrusion technology in the
production of bioavailable sustained-release matrix pharmaceutical formulations.
Previously, melt extrusion has been used in the production of immediate release
formulations.
It is known in the pharmaceutical art to prepare compositions which provide
for controlled release of pharmacologically active substances contained in the
compositions after oral administration to humans and animals. Such slow release
compositions are used to delay absorption of a medicament until it has reached certain
portions of the alimentary tract. Such sustained-release of a medicament in the
alimentary tract further maintains a desired concentration of said medicament in the
blood stream for a longer duration than would occur if conventional rapid release
dosage forms are administered.
Different methods of preparing controlled release pharmaceutical dosage forms
have been suggested. For example, direct compression techniques, wet granulation
techniques, encapsulation techniques and the like have been proposed to deliver
pharmaceutically active ingredients to the alimentary tract over extended periods.
Additionally, various types of sustained release formulations are known in the
art, including specially coated pellets, coated tablets and capsules wherein the slow ire-
lease of the active medicament is brought about through selective breakdown of the
coating of the preparation or through compounding with a special matrix to affect the
release of a drug. Some sustained release formulations provide for related sequential
release of a single dose of an active compound at predetermined periods after administration.
It is the intent of all sustained-release preparations to provide a longer period
of pharmacologic response after the administration of the drug and is ordinarily
experienced after the administration of the rapid release dosage forms. Such longer
periods of response provide for many inherent therapeutic benefits that are not
achieved with corresponding short acting, immediate release preparations. This is
especially true in the treatment of cancer patients or other patients in need of treatment
for the alleviation of moderate to severe pain, where blood levels of an opioid
analgesic medicament must be maintained at a therapeutically effective level to provide
pain relief. Unless conventional rapid acting drug therapy is carefully administered at
frequent intervals to maintain effective steady state blood levels of the drug, peaks and
valleys in the blood level of the active drug occur because of the rapid absorption,
systemic excretion of the compound and through metabolic inactivation, thereby
producing special problems in maintenance of analgesic efficacy.
The prior art teaching of the preparation and use of compositions providing the
sustained-release of an active compound from a carrier is basically concerned with the
release of the active substance into the physiologic fluid of the alimentary tract. How-
ever, it is generally recognized that the mere presence of an active substance in the
gastrointestinal fluids does not, by itself, insure bioavailability.
In order to be absorbed, the active drug substance must be in solution. The
time required for a given proportion of an active substance from a unit dosage form is
determined as the proportion of the amount of active drug substance released from a
unit dosage form over a specified time base by a test method conducted under
standardized conditions. The physiologic fluids of the gastrointestinal tract are the
media for determining dissolution time. The present state of the art recognizes many
satisfactory test procedures to measure dissolution time for pharmaceutical compo-
sitions, and these test procedures are described in official compendia world wide.
Although there are many diverse factors which influence the dissolution of drug
substance from its carrier, the dissolution time determined for a pharmacologically
active substance from the specific composition is relatively constant and reproducible.
Among the different factors affecting the dissolution time are the surface area of the
drug substance presented to the dissolution solvent medium, the pH of the solution,
the solubility of the substance in the specific solvent medium, and the driving forces of
the saturation concentration of dissolved materials in the solvent medium. Thus, the
dissolution concentration of an active drug substance is dynamically modified in its
steady state as components are removed from the dissolution medium through
absorption across the tissue site. Under physiologic conditions, the saturation level of
the dissolved materials is replenished from the dosage form reserve to maintain a
relatively uniform and constant dissolution concentration in the solvent medium
providing for a steady state absorption.
The transport across a tissue absorption site of the gastrointestinal tract is
influenced by the Donnan osmotic equilibrium forces on both sides of the membrane
since the direction of the driving force is the difference between the concentrations of
active substance on either side of the membrane, i.e., the amount dissolved in the
gastrointestinal fluids and the amount present in the blood. Since the blood levels are
constantly being modified by dilution, circulatory changes, tissue storage, metabolic
conversion and systemic excretion, the flow of active materials is directed from the
gastrointestinal tract into the blood stream.
Notwithstanding the diverse factors influencing both dissolution and absorption
of a drug substance, a strong correlation has been established between the in-vitro
dissolution time determined for a dosage form and (in-vivo) bioavailability. The
dissolution time and the bioavailability determined for a composition are two of the
most significant fundamental characteristics for consideration when evaluating
sustained-release compositions.
Melt granulation techniques have also been suggested to provide controlled
release formulations. Generally, melt granulation involves mechanically working an
active ingredient in paniculate form with one or more suitable binders and/or
pharmaceutically acceptable excipients in a mixer until one or more of the binders
melts and adheres to the surface of the particulate, eventually building up granules.
U.S. Patent No. 4,957,681 (Klimesch, et. al.) discloses a continuous process
for preparing pharmaceutical mixtures having at least two components which are
continuously metered. The process includes continuously metering the individual
components of the pharmaceutical mixture at a rate of at least 50 g/h on electronic
differential metering balances having a metering accuracy of at least ± 5% within time
intervals of less than one minute and, additionally, having screw conveyors, thereby
obtaining a substantially uniformly metered mixture; and shaping the mixture. Example
1 of the '681 patent is representative of the process. The requisite amounts of a
copolymer having a K value of 30 and obtained from 60% of N-vinylpyrrolid-2-one
(NVP), stearyl alcohol and theophylline are metered via three metering balances into
the hopper of an extruder and extruded. The temperatures of the extruder cylinder
consisting of six shots ranged from 30-60°C and the die is heated to 100°C. The
resultant extrudate is then pressed into tablets of the required shape. The '681 patent
does not disclose preparation of sustained release opioid pharmaceutical formulations.
N. Follonier., et al., Hot-Melt Extruded Pellets for the Sustained Release of
Highly Dosed Freely Soluble Drugs. Proceed. Intern. Symp. Control. Rel. Bioact.
Mater., 18 (1991) describes certain diltiazem hydrochloride formulations prepared
using hot-melt screw-extrusion to obtain sustained-release pellets to be filled into hard
gelatin capsules. The polymers used were ethylcellulose, a copolymer of ehtyl acrylate
and methyl methacrylate containing quaternary ammonium groups, cellulose acetate
butyrate, poly(vinyl chloride-co-vinyl acetate) and a copolymer of ethylene and vinyl
acetate. In order to lower the extrusion temperature, some plasticizers were used.
WO 93/07859 describes drug loaded pellets produced through melt
spheronization wherein the therapeutically active agent is blended with various
excipoients and binders; the formulation is fed to an extruder where it is heated and
extruded at a speed of about 0.05 to 10 mm/sec, at approximately 60-180° C. The
extrudate is then cut into pieces in a pelletizer and subsequently fed to a spheronizer
for uniform pellet formulation.
Despite the foregoing advances and the various techniques for preparing
sustained release formulations available in the pharmaceutical art, there is a need in the
art for an orally administrate opioid formulation which would provide an extended
duration of effect which is also easy to prepare, e.g via melt-granulation techniques.
OBJECTS AND SUMMARY OF THE INVENTION
It is therefore an object of the present invention to provide sustained- release
pharmaceutical formulations suitable for oral administration and methods for preparing
the same utilizing melt-extrusion techniques.
It is also an object of the present invention to provide improved methods for
producing pharmaceutical extrudates containing opioid analgesics and pharmaceutical
acceptable hydrophobic materials via melt extrusion techniques.
It is also an object of the present invention to provide methods of treatment for
human patients in need of opioid analgesic therapy using dosage forms prepared in
accordance with the methods disclosed herein.
In accordance with the above objects and others which will be apparent from
the further reading of the specification and of the appended claims, the present
invention is related in part to the surprising discovery that sustained-release oral opioid
analgesic formulations may be prepared utilizing melt extrusion techniques to provide
bioavailable unit dose products which provide analgesia in a patient for, e.g., 8-24
hours..
The invention is also related in part to a new melt-extruded oral sustained-
release dosage forms which comprise a pharmaceutically acceptable hydrophobic
material, a retardant selected from waxes, fatty alcohols, and fatty acids, and a drug.
More particularly, one aspect of the present invention is related to a
pharmaceutical extrudate including an opioid analgesic dispersed in a matrix.
Preferably, the extrudate is strand or spaghetti-shaped and has a diameter from about
0.1 to about 5 mm. The extrudate is divided into unit doses of the opioid analgesic
for oral administration to a patient, and provides a sustained analgetic effect for 8-24
hours or more.
The matrices preferably include a hydrophobic material and a second retardant
material which acts to further slow or control the release of the therapeutically active
agent when the formulation is exposed to aqueous solutions in-vitro, or exposed to
gastic and/or intestinal fluids.
Preferably, the hydrophobic material is selected from the group consisting of
alkylcelluloses, acrylic and methacrylic acid polymers and copolymers, shellac, zein,
hydrogenated castor oil or hydrogenated vegetable oil, or mixtures thereof.
The retardant material is preferably selected from natural and synthetic waxes,
fatty acids, fatty alcohols and mixtures of the same. Examples include beeswax and
carnauba wax, stearic acid, and stearyl alcohol. This list is of course not meant to be
exclusive.
The extrudate may be cut into multiparticulates by any cutting means known in
the art. Preferably, the multiparticulates have a length of from about 0.1 to 5 mm in
length. The multiparticulates may then be divided into unit doses such that each
individual unit dose includes a dose of opioid analgesic sufficient to provide analgesia
to a mammal, preferably a human patient.
The unit doses of multiparticulates may then be incorporated into a solid
pharmaceutical dosage formulation, e.g. via compression or shaping into tablets, or by
placing a requisite amount inside a gelatin capsule.
The pharmaceutical extrudates of the present invention may be prepared by
blending the drug together with all matrix ingredients (hydrophobic material, binder
and any additional (optional) excipients), feeding the resultant mixture into an extruder
heated to the requisite temperature necessary to melt the mixture; extruding the
viscous, heated mass as a spaghetti-like strand; allowing the extrudate to congeal and
harden, and then dividing the strand into desired pieces. This may be accomplished,
e.g., by cutting the strands into pellets of 1,5 mm in diameter and 1.5 mm in length.
A therapeutically effective amount of an opioid analgesic is dispersed in the
matrix to form a homogeneous mixture. The homogeneous mixture to is extruded to
form the extrudate comprising the opioid analgesic dispersed within a matrix of the
hydrophobic material and the retardant material. In certain preferred embodiments,
the opioid analgesic is homogeneously (uniformly) dispersed throughout the matrix.
Preferably, the extrudate has a diameter of from about 0.1 to about 5 mm and provides
sustained release of said opioid analgesic for a time period of from about 8 to about 24
hours.
Another aspect of the invention is directed to pharmaceutical dosage forms
including the extrudate prepared as outlined above. The extrudate is cut into
multiparticulates using any cutting means known in the art, e.g a blade. The
multiparticulates are then divided into unit doses containing an effective amount of
opioid analgesic to provide analgesia or pain relief in a human patient over the desired
dosing interval. The unit dose of multiparticulates may then be incorporated into
tablets, e.g. via direct compression, or encapsulated by any means known in the art.
In yet a further aspect of the invention, there is provided a method of treating a
patient with sustained-release formulations prepared as described above. This method
includes administering a dosage form containing the novel extrudate to a patient in
need of opioid analgesic therapy. For purposes of the present invention, a unit dose is
understood to contain an effective amount of the therapeuticaily active agent to
produce pain relief and/or analgesia to the patient. One skilled in the art will recognize
that the dose of opioid analgesic administered to a patient will vary due to numerous
factors; e.g. the specific opioid analgesic(s) being administered, the weight and
tolerance of the patient, other therapeutic agents concomitantly being administered,
etc.
As mentioned above, in order for a dosage form to be effective for its intended
purpose, the dosage form must be bioavailable. For purposes of the present invention,
the term "bioavailable" is defined as the total amount of a drug substance that is
absorbed and available to provide the desired therapeutic effect after administration of
a unit dosage form. Generally, the bioavailabifity of a given dosage form is determined
by comparison to a known reference drug product, as commonly determined and
accepted by Governmental Regulatory Agencies, such as the United States FDA.
The term "bioavailability" is defined for purposes of the present invention as
the extent to which the drug (e.g., opioid analgesic) is absorbed from the unit dosage
form and is available at the site of drug action.
The terms "sustained release", "extended duration", and "controlled release"
are defined for purposes of the present invention as the release of the drug (e.g., opioid
analgesic) at such a rate that blood (e.g., plasma) levels are maintained within the
therapeutic range but below toxic levels over a period of time greater than 8 hours,
more preferably for about 12 to about 24 hours, or longer.
The term "unit dose" is defined for purposes of the present invention as the
total amount of multiparticulates needed to administer a desired dose of therapeutically
active agent (e.g., opioid analgesic) to a patient.
The extrudates of the present invention preferably permit release of the opioid
(or salts thereof) over a sustained period of time in an aqueous medium. The term
"aqueous medium" is defined for purposes of the present invention as any water-
containing medium, e.g. water, pharmaceutically acceptable dissolution medium,
gastric fluid and/or intestinal fluid and the like.
BRIEF DESCRIPTION OF THE DRAWINGS
The following drawing is illustrative of an embodiment of the invention and is
not meant to limit the scope of the invention as encompassed by the claims.
Figure 1 is a graph displaying the dissolution results of Examples 1 and 2;
Figure 2 is a graph displaying the dissolution rates of Examples 3-6;
Figures 3 and 4 are graphs displaying the pH dependency of the dissolution
results of Examples 3 and 6 respectively;
Figure 5 is a graph displaying the dissolution results of Examples 7 and 8 vs.
Example 6;
Figure 6 is a graph displaying the dissolution results of Examples 9 and 10;
Figure 7 is a graph displaying the dissolution results of Examples 11 and 12;
Figure 8 is a graph displaying the dissolution results of Examples 15 and 16;
Figure 9 is a schematic representation of a system for carrying out the present
invention;
Figure 10 is a graph displaying the fed/fast bioavailability results for Example
20;
Figure 11 is a graph displaying the plasma morphine concentrations of Example
21 obtained from administration of the capsules from Example 6 vs. MS Contin ®;
Figure 12 is a graph displaying the plasma oxycodone concentrations of
Example 22 obtained from administrating the capsules from Examples 11 and 13 vs.
OxyContin ®;
Figure 13 is a graphical representation of the plasma oxycodone concentrations
of Example 14;
Figure 14 is a graphical representation of the hydromorphone concentrations of
Example 24 using the capsules from Example 17 vs. Dilaudid®;
Figure 15 is a graph displaying the plasma hydromorphone concentrations of
Example 24 using capsules from Example 18 vs. Dilaudid® ;
Figure 16 is a graph of the steady-state plasma hydromorphone concentrations
of Example 25 using the capsules of Example 17; and
Figure 17 is a graph of the plasma hydromorphone concentrations of Example
26 using the capsules of Example 19.
DETAILED DESCRIPTION
In one aspect of the invention, the sustained-release dosage forms comprise an
opioid analgesic as the therapeuticaily active agent. In such formulations, the drug is
incorporated into a melt-extruded strand which includes a pharmaceutically acceptable
hydrophobic material such as an alkylcellulose or an acrylic polymer or copolymer;
together with a suitable plasticizer, alternatively (preferably) together with an
additional retardant material that has binding properties, such as a wax, a fatty acid
and/or a fatty alcohol; and any further pharmaeutical excipients known to those skilled
in the art.
Another aspect of the invention is directed to improved melt extruded matrices
which comprise a hydrophobic material and a fatty binder such as previously specified.
In accordance therewith, a therapeutically active agent is combined with one or more
suitable hydrophobic materials and a further retardant material is extruded to form an
extrudate. The extrudate may then be cut into multiparticulates which are
subsequently incorporated into sustained release dosage forms.
Tharapeutically Active Agents
Therapeutically active agents which may be used in accordance with the
present invention include both water soluble and water insoluble drugs. Examples of
such therapeutically active agents include antihistamines (e.g., dimenhydrinate,
diphenhydramine, chlorpheniramine and dexchlorpheniramine maleate), analgesics
(e.g.', aspirin, codeine, morphine, dihydromorphone, oxycodone, etc.), non-steroidal
anti-inflammatory agents (e.g., naproxen, diclofenac, indomethacin, ibuprofen,
sulindac), anti-emetics (e.g., metoclopramide, methylnaltrexone), anti-epileptics (e.g.,
phenytoin, meprobamate and nitrazepam), vasodilators (e.g., nifedipine, papaverine,
diltiazem and nicardipine), anti-tussive agents and expectorants (e.g., codeine
phosphate), anti-asthmatics (e.g. theophylline), antacids, anti-spasmodics (e.g.
atropine, scopolamine), antidiabetics (e.g., insulin), diuretics (e.g., ethacrynic acid,
bendrofluthiazide), anti-hypotensives (e.g., propranolol, clonidine), antihypertensives
(e.g, cionidine, methyldopa), bronchodilators (e.g., albuterol), steroids (e.g.,
hydrocortisone, triamcinolone, prednisone), antibiotics (e.g., tetracycline),
antihemorrhoidais, hypnotics, psychotropics, antidiarrheals, mucolytics, sedatives,
decongestants, laxatives, vitamins, stimulants (including appetite suppressants such as
phenylpropanolamine), as well as salts, hydrates, and solvates of the same.
In embodiments of the invention directed to opioid analgesics, the opioid
analgesics used in accordance with the present invention include alfentanil, allylpro-
dine, alphaprodine, anileridine, benzyl morphine, bezitramide, buprenorphine,
butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide,
dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimephep-
tanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, etho-
heptazine, ethylmethylthiambutene, ethylmorphine, etonitazene fentanyl, heroin,
hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone,
levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol,
metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine,
nicomorphine, norlevorphanol, normethadone, nalorphine, normorphine, norpipanone,
opium, oxycodone, oxymorphone, papaveretum, pentazocine, phenadoxone,
phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine,
promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, salts
thereof, mixtures of any of the foregoing, mixed mu-agonists/antagonists, mu-
antagonist combinations, and the like. The opioid analgesic may be in the form of the
free base, or in the form of a pharmaceutically acceptable salt, or in the form of a
pharmaceutically acceptable complex.
In certain preferred embodiments, the opioid analgesic is selected from
morphine, codeine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine,
dihydromorphine, oxymorphone, tramadol or mixtures thereof.
In one preferred embodiment the sustained-release opioid oral dosage form of
the present invention includes hydromorphone as the therapeutically active ingredient
in an amount from about 4 to about 64 mg hydromorphone hydrochloride.
Alternatively, the dosage form may contain molar equivalent amounts of other hydro-
morphone salts or of the hydromorphone base. In other preferred embodiments where
the opioid analgesic is other than hydromorphone, the dosage form contains an
appropriate amount to provide a substantially equivalent therapeutic effect. For
example, when the opioid analgesic comprises morphine, the sustained-release oral
dosage forms of the present invention include from about 5 mg to about 800 mg
morphine, by weight (based on morphine sulfate). When the opioid analgesic
comprises oxycodone, the sustained-release oral dosage forms of the present invention
include from about 5 mg to about 400 mg oxycodone. When the opioid analgesic is
tramadol, the sustained-release oral dosage forms of the invention include from about
50 mg to about 800 mg tramadol by weight, based on the hydrochloride salt.
The sustained-release dosage forms of the present invention generally achieve
and maintain therapeutic levels substantially without significant increases in the
intensity and/or degree of concurrent side effects, such as nausea, vomiting or
drowsiness, which are often associated with high blood levels of opioid analgesics.
There is also evidence to suggest that the use of the present dosage forms leads to a
reduced risk of drug addiction.
In the present invention, the oral opioid analgesics have been formulated to
provide for an increased duration of analgesic. Surprisingly, these formulations, at
comparable daily dosages of conventional immediate-release drug, are associated with
a lower incidence in severity of adverse drug reactions and can also be administered at
a lower daily dose than conventional oral medication while maintaining pain control.
When the therapeutically active agent included in the dosage forms of the
present invention is an opioid analgesic, the dosage form may further include one or
more additional which may or may not act synergistically with the opioid analgesics of
the present invention. Examples of such additional therapeutically active agents
include non-steroidal anti-inflammatory agents, including ibuprofen, diclofenac,
naproxen, benoxaprofen, flurbiprofen, fenoprofen, flubufen, ketoprofen, indoprofen,
piroprofen, carprofen, oxaprozin, pramoprofen, muroprofen, trioxaprofen, suprofen,
aminoprofen, tiaprofenic acid, fluprofen, bucloxic acid, indomethacin, sulindac,
tolmetin, zomepirac, tiopinac, zidometacin, acemetacin, fentiazac, clidanac, oxpinac,
mefenamic acid, meclofenamic acid, flufenamic acid, niflumic acid tolfenamic acid,
diflurisal, flufenisal, piroxicam, sudoxicam or isoxicam, and the like. Other suitable
additional drugs which may be included in the dosage forms of the present invention
include acetaminophen, aspirin, salicylate-derived analgesics and antipyretics or salts
thereof, and other non-opioid analgesics.
The additional (non-opioid) therapeutically active agent may be included in
controlled release form or in immediate release form. The additional drug may be
incorporated into the controlled release matrix along with the opioid; incorporated as a
separated controlled release layer or immediate release layer; or may be incorporated
as a powder, granulation, etc., in a gelatin capsule with the extrudates of the present
invention.
Matrix Ingredients
The extrudates of the present invention include at least one hydrophobic
material. The hydrophobic material will preferably impart sustained release of the
opioid analgesic to the final formulation. Preferred hydrophobic materials which may
be used in accordance with the present invention include alkylcelluloses such as natural
or synthetic celluloses derivatives (e.g. ethylcellulose), acrylic and methacrylic acid
polymers and copolymers, shellac, zein, wax-type substances including hydrogenated
castor- oil or hydrogenated vegetable oil, or mixtures thereof. This list is not meant to
be exclusive, and any pharmaceutically acceptable hydrophobic material which is
capable of imparting sustained release of the active agent and which melts (or softens
to the extent necessary to be extruded) may be used in accordance with the present
invention.
In certain preferred embodiments of the present invention, the hydrophobic
material is a pharmaceutically acceptable acrylic polymer, including but not limited to
acrylic acid and methacrylic acid copolymers, methyl methacrylate, methyl
methacrylate copolymers, ethoxyethyl methacrylates, cynaoethyl methacrylate,
aminoalkyl methacrylate copolymer, poly(acrylic acid), poly(methacrylic acid),
methacrylic acid alkylamine copoiymer, poly(methyl metliacrylate), poly(methacrylic
acid)(anhydride), polymethacrylate, polyacrylamide, poly(methacrylic acid anhydride),
and glycidyl methacrylate copolymers. In other embodiments, the hydrophobic
material is selected from materials such as hydroxyalkylcelluloses such as
hydroxypropylmethylcellulose and mixtures of the foregoing.
The retardant material may consist of one or more water-insoluble wax-like
thermoplastic substances possibly mixed with one or more wax-like thermoplastic
substances being less hydrophobic than said one or more water-insoluble wax-like
substances. In order to achieve constant release, the individual wax-like substances in
the binder material should be substantially non-degradable and insoluble in
gastrointestinal fluids during the initial release phases.
Useful water-insoluble wax-like substances may be those with a water-
solubility that is lower than about 1:5,000 (w/w).
Retardant materials are preferably water-insoluble with more or less
pronounced hydrophilic and/or hydrophobic trends. Preferably, the retardant materials
useful in the invention have a melting point from about 30 to about IOO°C, preferably
from about 45 to about 90°C. Specifically, the retardant material may comprise
natural or synthetic waxes , fatty alcohols (such as lauryl, myristyl stearyl, cetyl or
preferably cetostearyl alcool), fatty acids, including but not limited to fatty acid esters,
fatty acid glycerides (mono-, di-, and tri-glycerides), hydrogenated fats, hydrocarbons,
normal waxes, stearic aid, stearyl alcohol and hydrophobic and hydrophilic polymers
having hydrocarbon backbones. Suitable waxes include, for example, beeswax,
glycowax, castor wax and carnauba wax. For purposes of the present invention, a
wax-like substance is defined as any material which is normally solid at room
temperature and has a melting point of from about 30 to about 100°C.
Suitable retardant materials which may be used in accordance with the present
invention include digestible, long chain (C8.C50, especially C12-C40), substituted or
unsubstituted hydrocarbons, such as fatty acids, fatty alcohols, glyceryl esters of fatty
acids, mineral and vegetable oils and natural and synthetic waxes. Hydrocarbons
having a melting point of between 25° and 90°C are preferred. Of the long chain
hydrocarbon materials, fatty (aliphatic) alcohols are preferred in certain embodiments..
The oral dosage form may contain up to 60% (by weight) of at least one digestible,
long chain hydrocarbon.
In addition to the above ingredients, a sustained-release matrix may also
contain suitable quantities of other materials, e.g., diluents, lubricants, binders,
granulating aids, colorants, flavorants and glidants that are conventional in the
pharmaceutical art. The quantities of these additional materials will be sufficient to
provide the desired effect to the desired formulation. In addition to the above
ingredients, a sustained-release matrix incorporating melt-extruded multiparticulates
may also contain suitable quantities of other materials, e.g. diluents, lubricants, binders,
granulating aids, colorants, flavorants and glidants that are conventional in the
pharmaceutical art in amounts up to about 50% by weight of the particulate if desired.
Specific examples of pharmaceutically acceptable carriers and excipients that may be
used to formulate oral dosage forms are described in the Handbook of Pharmaceutical
Excipients. American Pharmaceutical Association (1986), incorporated by reference
herein.
In order to facilitate the preparation of a solid, sustained-release oral dosage
form according to this invention there is provided, in a further aspect of the present
invention, a process for the preparation of a solid, sustained-release oral dosage form
according to the present invention comprising incorporating opioids or a salt thereof in
a sustained-release melt-extruded matrix. Incorporation in the matrix may be effected,
for example, blending the opioid analgesic, together with at least one hydrophobic
material and preferably the additional retardant material to obtain a homogeneous
mixture. The homogeneous mixture is then heated to a temperature sufficient to at
least soften the mixture sufficiently to extrude the same. The resulting homogeneous
mixture is then extruded, e.g., using a twin-screw extruder, to form strands. The
extrudate is preferably cooled and cut into multiparttculates by any means known in the
art. The strands are cooled and cut into multiparttculates. The multiparttculates are
then divided into unit doses. The extrudate preferably has a diameter of from about
0.1 to about 5 mm and provides sustained release of the therapeutically active agent
for a time period of from about 8 to about 24 hours.
An optional process for preparing the melt extrusions, multiparticulates and
unit doses of the present invention includes directly metering into an extruder a water-
insoluble retardant, a therapeutically active agent, and an optional binder; heating said
homogenous mixture; extruding said homogenous mixture to thereby form strands;
cooling said strands containing said homogeneous mixture; and cutting said strands
into particles having a size from about 0.1 mm to about 12 mm; and dividing said
particles into unit doses. In this aspect of the invention, a relatively continuous
manufacturing procedure is realized.
The diameter of the extruder aperture or exit port can also be adjusted to vary
the thickness of the extruded strands. Furthermore, the exit part of the extruder need
not be round; it can be oblong, rectangular, etc. The exiting strands can be reduced to
particles using a hot wire cutter, guillotine, etc.
The melt extruded multiparticulate system can be, for example, in the form of
granules, spheroids or pellets depending upon the extruder exit orifice. For purposes
of the present invention, the terms "melt-extruded multiparticulate(s)" and "melt-
extruded multiparticulate system(s)" and "melt-extruded particles" shall refer to a
plurality of units, preferably within a range of similar size and/or shape and containing
one or more active agents and one or more excipients, preferably including a retardant
as described herein. In this regard, the melt-extruded multiparticulates will be of a
range of from about 0.1 to about 12 mm in length and have a diameter of from about
0.1 to about 5 mm. In addition, it is to be understood that the melt-extruded multipar-
ticulates can be any geometrical shape within this size range such as beads,
microspheres, seeds, pellets, etc.
In one preferred embodiment, oral dosage forms are prepared to include an
effective amount of melt-extruded multiparticulates within a capsule. For example, a
plurality of the melt-extruded multiparticulates may be placed in a gelatin capsule in an
amount sufficient to provide an effective sustained-release dose when ingested and
contacted by gastric fluid.
In another preferred embodiment, a suitable amount of the multiparticulate
extrudate is compressed into an oral tablet using conventional tableting equipment
using standard techniques.
Techniques and compositions for making tablets (compressed and molded),
capsules (hard and soft gelatin) and pills are also described in Remington's
Pharmaceutical Sciences. (Arthur Osol, editor), 1553-1593 (1980), incorporated by
reference herein.
• In yet another preferred embodiment, the extrudate can be shaped into tablets
as set forth in U.S. Patent No. 4,957,681 (Klimesch, et. al.), described in addtional
detail above and hereby incorporated by reference.
Optionally, the sustained-release melt-extruded multiparticulate systems or
tablets can be coated, or the gelatin capsule can be further coated, with a sustained-
release coating comprising one of the hydrophobic materials described above. Such
coatings preferably include a sufficient amount of hydrophobic material to obtain a
weight gain level from about 2 to about 30 percent, although the overcoat may be
greater depending upon the physical properties of the particular opioid analgesic
compound utilized and the desired release rate, among other things. In certain
preferred embodiments of the present invention, the hydrophobic polymer comprising
the sustained-release coating is a pharmaceutically acceptable acrylic polymer, such as
those described hereinabove. The solvent which is used for the hydrophobic material
in the coating may be any pharmaceutically acceptable solvent, including water,
methanol, ethanol, methylene chloride and mixtures thereof.
The unit dosage forms of the present invention may further include
combinations of melt-extruded multiparticulates containing one or more of the
therapeutically active agents disclosed above before being encapsulated. Furthermore,
the unit dosage forms can also include an amount of an immediate release
therapeutically active agent, for prompt therapeutic effect. The immediate release
therapeutically active agent may be incorporated, e.g., as separate pellets within a.
gelatin capsule, or may be coated on the surface of the compressed tablet which has
been prepared from the multiparticulate extrudate as set forth above.
The controlled-release formulations of the present invention slowly release the
therapeutically active agent, e.g., when ingested and exposed to gastric fluids, and then
to intestinal fluids. The controlled-release profile of the melt-extruded formulations of
the invention can be altered, for example, by varying the amount of retardant, i.e.,
hydrophobic polymer, by varying the amount of plasticizer relative to hydrophobic
polymer, by the inclusion of additional ingredients or excipients, by altering the method
of manufacture, etc. In certain embodiments of the invention, the the sustained-release
dosage forms of the present invention preferably release the therapeutically active
agent at a rate that is independent of pH, e.g., between pH 1.6 and 7.2. In other
embodiments, the formulations can be designed to provide a pH-dependent release of
the therapeutically active agent.
In other embodiments of the invention, the melt extruded material is prepared
without the inclusion of the therapeutically active agent, which is added therafter to the
extrudate. Such formulations typically will have the therapeutically active agent
blended together with the extruded matrix material, and then the mixture would be
tabletted in order to provide a slow release formulation. Such formulations may be
advantageous, for example, when the therapeutically active agent included in the
formulation is sensitive to temperatures needed for softening the hydrophobic material
and/ or the retardant material.
Opioid Analgesic Formulations
In certain preferred embodiments, the invention is directed to sustained-release
oral opioid formulations which are administrable on a once-a-day basis, and which are
prepared from the melt extrudates described herein. Such dosage forms will provide
an in-vitro release (when assessed by the USP Paddle or Basket Method at 100 prm at
900 ml aqueous buffer (pH between 1.6 and 7.2) at 37°C from about 1 to about
42.5% opioid released after one hour, from about 5 to about 65% opioid released after
2 hours, from about 15 to about 85% opioid released after 4 hours, from about 20 to
about 90% opioid released after 6 hours, from about 3 5 to about 95% opioid released
after 12 hours, from about 45 to about 100% opioid released after 18 hours, and from
about.5 5 to about 100% opioid released after 24 hours, by weight. Such formulations
may further be characterized by a peak plasma level at from about 2 to about 8 hours
after oral administration, and preferably from about 4 to about 6 hours after
administration. Such formulations are further characterized by a W50 from about 4 to
about 12 hours.
In certain preferred embodiments, the oral 24 hour sustained-release opioid
dosage form provides a rapid rate of initial rise in the plasma concentration of the
opioid after oral administration, such that the peak plasma level obtained in-vivo
occurs from about 2 to about 8 hours after oral administration, and/or the absorption
half-life is from about 1 to about 8 hours after oral administration (in the fasted state).
More preferably in this embodiment the absorption half-life is 1-6 hours and possibly
1-3 hours after oral administration (in the fasted state). Such formulations provide an
in-vitro dissolution under the conditions specified above, from about 12.5 to about
42.5% opioid released after one hour, from about 25 to about 65% opioid released
after 2 hours, from about 45 to about 85% opioid released after 4 hours, and greater
than about 60% opioid released after 8 hours, by weight.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The following examples illustrate various aspects of the present invention.
They are not to be construed to limit the claims in any manner whatsoever.
MELT-EXTRUSION TECHNIQUES
Typical melt extrusion systems capable of carrying-out the present invention
include a suitable extruder drive motor having variable speed and constant torque
control, start-stop controls, and ammeter. In addition, the system will include a
temperature control console which includes temperature sensors, cooling means and
temperature indicators throughout the length of the extruder. In addition, the system
will include an extruder such as twin-screw extruder which consists of two counter-
rotating intermeshing screws enclosed within a cylinder or barrel having an aperture or
die at the exit thereof. The feed materials enter through a feed hopper and is moved
through the barrel by the screws and is forced through the die into strands which are
thereafter conveyed such as by a continuous movable belt to allow for cooling and
being directed to a pelletizer or other suitable device to render the extruded ropes into
the multiparticulate system. The pelletizer can consist of rollers, fixed knife, rotating
cutter and the like. Suitable instruments and systems are available from distributors
such as C.W Brabender Instruments, Inc. of South Hackensack, New Jersey. Other
suitable apparatus will be apparent to those of ordinary skill in the art.
General Pellet Manufacturing Procedure
The following technique was used to manufacture the extrudate and
multiparticulates for Examples 1-26:
Blend the required amount of drug, hydrophobic material and binder along with
any additional excipients.
Charge a powder feeder with proper amount of drug/ excipient blend.
Set temperatures of extruder heating zones to the required temperature,
depending on the formulation. Typically, the temperature should be set at about 83°
C. Wait until the corresponding heating zones reach steady temperatures. Set the
extruder screw rotation speed to 20 rpm. Start the feeder, the conveyor and the
pelletizer. After the excipients are melted and the drug is embedded in the molten
mixture, the resultant viscous mass is extruded as spaghetti-like strands. The diameter
of the extruder aperture can be adjusted to vary the thickness of the resulting strand.
Set the conveyor belt speed to an appropriate speed (e.g., 3-100 ft/min).
Allow the extruded semisolid strand(s) to be congealed and/or hardened while
transported to the pelletizer on the conveyor belt. Additional cooling devices may be
needed to ensure proper congealing. (The conveyor belt may not be needed to cool
the strand, if the material congeals rapidly enough.)
, Set the roller knife to an appropriate speed (e.g., to 3-100 ft/min and 100-800
rpm). Cut the congealed strands to desired size (e.g., 3-5 mm in diameter, 0.3-5 mm in
length).
Collect the pellet product.
Fill a desired weight of pellets into hard gelatin capsules to obtain an
appropriate doses of the drug.
Dissolution Method
The following dissolution method was used to obtain dissolution profiles for
the dosage forms of Examples 1-25:
(USP II Paddle at 100 rpm at 37°C)
Media - 1st hour in 700 ml simulated gastric fluid (SGF), pH 1.2 without enzyme
thereafter, 900 ml simulated intestinal fluid (SIF), pH 7.5 without enzyme
Using HPLC procedures for assay
The following examples illustrate various aspects of the present invention.
They are not meant to be construed to limit the claims in any manner whatsoever.
EXAMPLES 1-2
CONTROLLED RELEASE CHLORPHENIRAMINE FORMULATIONS
In these examples, chlorpheniramine maleate controlled release pellets were
prepared according to the above manufacturing procedure using ethylcellulose and an
acrylic polymer (Eudragit RSPO), respectively as the retardant. The formulations are
set forth in Tables 1 and 2 below. The dissolution of these formulations is set forth in
Figure 1. Drug release rate from ethylcellulose pellets (prepared at 105°C) is
significantly slower than that from Eudragit RSPO pellets (prepared at 85CC).
The drug release rate of Example 3 was slower than expected especially during
later hours of the dissolution.
Ex. 4-5 Examples 4-5 were prepared in accordance with Example 3
above. To increase the drug dissolution rate during later hours, varying amounts of
Eudragit L-100 were incorporated in the formulation. The drug dissolution rate
increases with increasing amount of Eudragit L-100 in the formulation. The morphine
sulfate capsule formulation are set forth in tables 4-6 below:
Ex. 6. A sustained release morphine sulfate formulation was prepared
having the ingredients listed in Table 6 below:
The formulation of Example 6 was prepared as follows:
Pellet Manufacture
a. Extruder system description- The twin screw extruder is consisted of a pair of
counterrotating screws and a barrel block equipped with heating/cooling zones. The
extrudate is delivered to a pelletizer through a conveyor belt and cut into pellets of the
desirable size.
b. ' Manufacturing procedure-
1. Blend the drug and all the excipients in a proper mixer.
2. Place the mixture in a powder feeder.
3. Set temperatures of the extruder heating zones to approximately 83°C.
4. Set the extruder screw rotation speed to 20 rpm.
5. Start the feeder, the conveyor and the pelletizer.
6. After the excipients are melted and the drug embedded in the molten mixture,
the viscous mass is extruded as spaghetti-like strands.
7. The extrudate is congealed and hardened while being delivered to the pelletizer
on the conveyor belt.
8. The roller knife of the pelletizer cuts the strands into pellets of 1.5 mm in
diameter and 1.5 mm in length.
Encapsulation
After the pellets were manufactured, 120 mg of pellets are encapsulated in size
#2 hard gelatin capsules, rendering capsules containing 60 mg of morphine sulfate.
These capsules were then tested using the following dissolution methodology:
The capsules of Example 6 were found to have the following dissolution
results:
As seen in Figure 3, the drug dissolution rate obtained from the product of Ex.
3 showed a significant pH dependency. The release rate was slower in S1F (simulated
intestinal fluid) than in SGF (simulated gastric fluid).
In Figure 4, it can be seen that due to the addition of Eudragit L-100, the drug
dissolution rate obtained from Ex. 6 was less pH dependent. The drug release rate was
faster in SIF during later hours of dissolution which is desirable for complete
bioavailability.
EXAMPLES 7-8
As demonstrated in Fig. 5, with proper choice of plasticizers, the drug release
rate from the formula containing Eudragit L-100 can be reduced. This may be
necessary to achieve desirable plasma drug concentration profiles after oral
administration of the pellets.
EXAMPLES 9-10
A different polymer/wax combination was used as an alternative formulation.
As seen in Figure 6, the drug dissolution rate from ethylcellulose/polyviny! acetate
phthalate was somewhat faster.
EXAMPLES 11-14
CONTROLLED RELEASE OXYCODONE FORMULATIONS
The formula used in Ex. 6 was applied to oxycodone hydrochloride. Due to
the higher potency of oxycodone, only 20 mg of drug was used. The missing 40 mg
was replaced by 40 mg of talc (Ex. 12). No replacement was used in Ex. 11. When
tested in only SGF or SlF, the use of Eudragit L causes the formulation to become less
pH dependent. The results are shown in Figure 7.
The pellet manufacturing procedure and the dissolution method are the same as
described in Example 6.
The above capsules were found to have the dissolution results set forth in Table
lla below:
Ex- 13 Oxycodone HC1 once-a-day capsules were produced with the
following formula using the technology described in Example 6. The formulation is set
forth in Table 13 below.
The pellet manufacturing procedure is the same as described in Example 6.
However, 80 mg of pellets were encapsulated to contain 20 mg of oxycodone HCL.
The above capsules were tested using the following dissolution methodology:
1. Apparatus-USP type II (paddle), 100rpm at 37°C
2. Media- Either 900 ml simulated gastric fluid (SGF), pH 1.2 without enzyme;
or 900 ml simulated intestinal fluid (SIF), pH 7.5 without enzyme.
3. Analytical method- High performance liquid chromatography.
The dissolution results are set forth in Table 13a below:
Ex, 14 To prepare an oxycodone HC1 controlled release tablet which
would dissolve preferentially in a lower pH, the following formula is used:
Total Manufacture
1. Mix Eudragit RS30D (suspension) and Triacetin for 5 minutes.
2. Place spray dried lactose, oxycodone HCI, PVP, in a fluid bed drier.
3. Spray the suspension onto the powders under fluidization.
4. Pass the granulation through a Comil to reduce lumps.
5. Melt stearyl alcohol at 70°C.
6. Incorporate the molten stearyl alcohol into the dry granulation in a Collete
Mixer.
7. Transfer the waxed granulation to a cooling tray and allow the granulation to
congeal.
8. Pass the granulation through a Comil.
9. Mix the waxed granulation with talc and magnesium stearate in a Collete
Mixer.
10. Compress the lubricated granulation into tablets using a rotary tablet press.
11. Film coat the tablets.
These tablets were then tested using the following dissolution methodology
described in Example 13.
The above tablets were found to have the following dissolution results:
EXAMPLES 15-19
CONTROLLED RELEASE HYDROMORPHONE FORMULATIONS
Ex. 15-16 The formula used in Ex. 6 was applied to hydromorphone
hydrochloride. Due to the higher potency of hydromorphone, only & trig of drug was
used. The missing 52 mg was replaced by 52 mg of talc (Ex. 16) or 52 mg of
excipients (Ex. 15). The results are shown in Figure 8.
Ex. 17 Hydromorphone HC1 once-a-day capsules were produced with
the formula set forth in Table 17 below using the technology described in Example 6.
The pellet manufacturing procedure is the same as described in Example 6.
However, pellets of 1.0 mm in diameter and 1.0 mm in length were prepared. Each
capsule holds 80 mg of pellets and contains 8 mg of hydromorphone HCL.
The above capsules were tested using the dissolution methodology described in
Example 6.
The above capsules were found to have the dissolution results set forth in Table
17a below:
Ex. 18 Hydromorphone HC1 once-a-day capsules were produced with
the formula set forth in Table 18 below as the second example of the technology
described in Example 6.
The pellet manufacturing procedure and the dissolution method are the same as
described in Example 6
The above capsules were found to have the dissolution results set forth in
Table 18a below
Ex. 19 Hydromorphone HC1 once-a-day capsules were produced with
the following formula according to the method described Example 6.
The manufacturing procedure of the pellets and the dissolution method are the
same as described in Example 6.
The above capsules were found to have the following dissolution results:
EXAMPLE 20
In this Example, a bioavailability study was undertaken. Fourteen subjects were given
the morphine sulfate formulations of Example 3. The results are provided in Table 20
below in Figure 10.
From the above data, it can be seen that the formulation is an ideal candidate
for an extended release or once-a-day product without a food effect.
EXAMPLE 21
Bioavailability of morphine sulfate melt extrusion imltiparticulate 60 ing
capsules.
A bioavailability study of morphine capsules of Example 6 was conducted in 12
normal male volunteers. Capsules of 60 mg in strength were administered either with
or without food in a single dose, two-way crossover study. Blood samples were taken
periodically and assayed for morphine concentrations using gas chromatography with
mass detection (G/MS). From the data, the following pharmacokinetic parameters
were calculated and are indicated in Table 20 below.
When compared to the typical blood levels of MS Contin®, a single dose
twice-a-day marketed morphine sulfate 30 mg tablets, in the fasted state, it can be seen
that the capsules of Example 6 are suitable for once daily administration. At the 24th
hour the blood levels are well above MS-Contin and within the therapeutic range
(Figure 11).
EXAMPLE 22
Bioavailability of OXY-MEM 20 ing capsules.
A bioavailability study of oxycodone capsules of examples 11 and 13 was
conducted in 10 normal male volunteers. Capsules of example 13 were administered
either with or without food. Capsules of example 11 were administered without food.
The study was conducted in a single dose, four-way crossover design. Blood samples
were taken periodically and assayed for oxycodone concentrations using gas
chromatography with mass detection (G/MS).
From the data, the following pharmacokinetic parameters were calculated as
set forth in Table 22 below:
From the above data, it can be concluded that both Examples 11 and 13, but
particularly Example 13, are suitable for once daily administration. This is shown
graphically in Figure 12.
EXAMPLE 23
Bioavailability of Example 14 Tablets.
A bioavailability study of oxycodone controlled release tablets of example 14
was conducted in 25 normal volunteers. These tablets were administered either with
or without food. The study was conducted in a single dose, randomized crossover
design. Blood samples were taken periodically and assayed for oxycodone
concentrations using gas chromatography with mass detection (GC/MS). The plasma
oxycodone concentration versus time curves are shown in Figure 13.
From the data, the following pharmacokinetic parameters were calculated.
Surprisingly, it was found that the controlled release oxycodone HC1
preparation, which dissolved preferentially in low pH, does not show substantial food
effect. From the Cmax data, it can be seen that there is no significant change in blood
oxycodone levels when the drug was taken with food than without food
(35.3/39.3=09). From the AUC (area under the curve) data, it appears that the
amount of drug absorbed with or without food is similar (416/422=0.986).
EXAMPLE 24
Bioavailability of HH-MEM 8 mg capsules.
A bioavailability study of hydromorphone capsules of Examples 17 and 18 was
conducted using a single dose, five-way crossover study in 12 normal male volunteers.
The subjects received either 8 mg of Dilaudid tablet (immediate release) or 8 mg of
HH-MEM capsules. Dilaudid tablets were administered after an overnight fast. MEM
capsules were administered with or without food. Blood samples were taken
periodically and assayed for hydromorphone concentrations using gas chromatography
with mass detection (G/MS). From the data, the following pharmacokinetic
parameters were calculated.
From the above data, both formulations 17 and 18 would be suitable for once-
a-day administration both not having a food effect, and in fact Example 17 looks ideal.
The data of Example 17 is shown graphically in Figure 14 and the data of Example 18
is shown graphically in Figure 15.
EXAMPLE 25
Steady State Bioavailability of HH-MEM 8 mg capsules.
To assess steady state plasma levels and the effect of food on hydromorphoae,
a single dose, two-way crossover study was conducted in 12 normal male volunteers.
The subjects received either 4 mg of Dilaudid (immediate release) every 6 hours or 16
mg of the capsules according to Example 17 every 24 hours. Venous blood samples
were taken at predetermined time points. The plasma hydromorphone concentrations
were quantitated using gas chromatography with mass detection (G/MS).
From the data from day 4, the following pharmacokinetic parameters were
calculated and are set forth in Table 25 below.
The results are shown graphically in Figure 16. From this data it can be seen
that Example 17 is an ideal product for once-a-day administration for either single dose
or multiple dose administration.
EXAMPLE 26
Bioavailability of HH-MEM 8 mg capsules.
To assess bioavailability and effect of food on hydromorphone MEM capsules,
a single dose, three-way crossover study was conducted in 12 normal male volunteers.
The subjects received either 8 mg of Dilaudid tablet (immediate release) or 8 mg of
HH-MEM (Example 19.) Dilaudid tablets were administered after an overnight fast.
MEM capsules were administered with or without food. Venous blood samples were
taken at predetermined at time points. The plasma hydromorphone concentrations
were quantitated using gas chromatography with mass detection (G/MS).
From the data, the following pharmacokinetic parameters were calculated and
are set forth in Table 26 below.
From the above data it can be concluded that a once-a-day Hydromorphone
product can be produced using other ingredients than are used for Examples 17 and
18. This data is shown graphically in Figure 17.
EXAMPLE 27
Tramadol HOl 200 mg SR Tablet
The following formula is used to prepare melt extrusion granulation and tablet.
Granulation Manufacture
a. Extruder system description- The twin screw extruder is consisted of a pair of
counterrotating screws and a barrel block equipped with heating/cooling zones. The
stranded extrudate is congealed on a conveyor belt and cut into pellets of the desirable
size.
b. Manufacturing procedure-
1.Blend the drug and all the excipients in a proper mixer.
2.Place the mixture in a powder feeder.
3. Set temperatures of the extruder heating zones to approximately 65 °C.
4.Set the extruder screw rotation speed to 40 rpm.
5. Start the feeder and the conveyor.
6. After the excipients are melted and the drug embedded in the molten mixture, the
viscous mass is extruded as spaghetti-like strands.
7.The extrudate is congealed and hardened while being carried away on a conveyor
belt.
8.The stranded extrudate was cut into pellets of 2 mm in diameter and 2-8 cm in
length.
Tabletting
The pellets were milled into granules through a suitable screen. The granulation was
blended with talc and magnesium stearate. The mixture was then compressed into
capsule-shaped tablets.
Dissolution Method
1. Apparatus- USP Type II (paddle), 100 rpm at 37°C.
2. The tablet was placed in a tablet sinker clip and immersed in each vessel.
3. Media- 900 ml pH 6.5 phosphate buffer.
4. Analytical method- High performance liquid chromatography.
The above tablets were found to have the following dissolution results:
EXAMPLE 28
Tramadol HC1 200 mg SR Tablet
The following formula is used to prepare melt extrusion granulation and tablet with a
slower dissolution profile than example 27.
The manufacturing procedure and dissolution method are the same as described
in example 27. Additional dissolution media used include pH 1.2 simulated gastric fluid
(SGF) without enzyme, pH 7.5 simulated intestinal fluid (SIF) without enzyme, and
pH 4 phosphate buffer.
The above tablets were found to have the following dissolution results:
The results show that the dissolution profiles of Tramadol SR tablets in media
of different pH values are similar. Based on our experience with similar formulae of
other opiates, a formula which demonstrates pH independent dissolution profile would
provide a consistent drug release profile in vivo without food effect.
The examples provided above are not meant to be exclusive. Many other
variations of the present invention would be obvious to those skilled in the art, and are
contemplated to be within the scope of the appended claims.
WE CLAlM:
1. A sustained-release pharmaceutical formulation, comprising:
an extruded blend of a therapeutically active agent,
one or more hydrophobic materials selected from the group consisting of alkylcelluloses,
acrylic and methacrylic acid polymers and copolymers, shellac, zein, hydrogenated castor oil,
hydrogenated vegetable oil, and mixtures thereof, and
one or more retardant materials having a melting point from 30 to .100 °C selected from
the group consisting of natural or synthetic waxes, fatty acids, fatty alcohols, and mixtures
thereof,
said extruded blend divided into a unit dose containing an effective amount of said
therapeutically active agent to render a desired therapeutic effect and providing a sustained-
release of said therapeutically active agent for a time period of from 8 to 24 hours,
said extruded blend being formed by mixing the therapeutically active agent, the one or
more hydrophobic materials, and the one or more retardant materials in an extruder to form said
blend and extending said blend through the extruder.
2. The formulation of claim 1, wherein said extrudate comprises a strand-shaped matrix cut
into multi-particulates having a length of from 0.1 to 5 mm.
3. The formulation of claim 1, wherein said extrudate has a diameter of from 0.1 to 5 mm.
4. The formulation of claim 1, wherein said therapeutically active agent is an opioid
analgesic.
5. The formulation of claim 4, wherein said opioid analgesic is selected from the group
consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide,
buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide,
dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol,
dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine,
ethylmethylthiambutene, ethylmorphine, etonitazene, fentanyl, heroin, hydrocodone,
hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol,
levophenacyl morphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon,
morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone,
nalorphine, normorphine, norpipanone, opium, oxycodone, oxymorphone, papaveretum,
pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide,
propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine,
salts thereof and mixtures thereof.
6. The extrudate of claim 4, wherein said opioid analgesic is selected from the group
consisting of morphine, codeine, hydromorphone, hydrocodone, oxycodone, oxymorphone,
dihydrocodeine, dihydromorphine, tramadol and mixtures thereof.
7. The formulation of claim 2, wherein a unit dose comprising an effective amount of said
multiparticulates to render a therapeutic effect is contained within a gelatin capsule.
8. The formulation of claim 2, wherein a unit dose comprising an effective amount of said
multiparticulates to render a therapeutic effect is compressed into a tablet.
9. The formulation of claim 8, wherein said therapeutically active agent is tramadol.
10. The formulation of claim 7 wherein said therapeutically active agent is an opioid
analgesic selected from the group consisting of morphine, codeine, hydromorphone,
hydrocodone, oxycodone, oxymorphone, dihydrocodeine, dihydromorphine, tramadol and
mixtures thereof.
11. The formulation of claim 10, which provides an in-vitro release when assessed by the
USP Paddle or Basket Method at 100 prm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at
37"C from 1 to 42.5% opioid released after one hour, from 5 to 65% opioid released after 2 hours,
from 15 to 85% opioid released after 4 hours, from 20 to 90% opioid released after 6 hours, from
35 to 95% opioid released after 12 hours, from 45 to 100% opioid released after 18 hours, and
from 55 to 100% opioid released after 24 hours, by weight.
12. The formulation of claim 10, which provides a peak plasma level at from 2 to 8 hours
after oral administration.
13. The formulation of claim 10, which provides a W50 from 4 to 12 hours.
14. The formulation of claim 10, which provides a rapid rate of initial rise in the plasma
concentration of the opioid after oral administration, such that the peak plasma level obtained in-
vivo occurs from 2 to 8 hours after oral administration.
15. The formulation of claim 10, which provides a rapid rate of initial rise in the plasma
concentration of the opioid after oral administration, such that the absorption half-life is from 1
to 8 hours after oral administration (in the fasted state).
16. The formulation of claim 10, which provides an in-vitro release when assessed by the
USP Paddle or Basket Method at 100 rpm in 900 ml aqueous buffer (pH between 1.6 and 7.2) at
37°C from 12.5 to 42.5% opioid released after one hour, from 25 to 65% opioid released after 2
hours, from 45 to 85% opioid released after 4 hours, and greater than 60% opioid released after 8
hours, by weight.
17. A method of preparing a sustained-release pharmaceutical extrudate suitable for oral
administration, comprising:
blending a therapeutically active agent together with (1) a hydrophobic material selected
from the group consisting of alkylcelluloses, acrylic and methacrylic acid polymers and
copolymers, shellac, zein, hydrogentated castor oil, hydrogenated vegetable oil, and mixtures
thereof and (2) a retardant material selected from the group consisting of natural or synthetic
waxes, fatty acids, fatty alcohols, and mixtures thereof, said retardant material having a melting
point between 30-100°C and being included in an amount sufficient to further slow the release of
the therapeutically active agent,
heating said blend to a temperature sufficient to soften the mixture sufficiently to extrude
the same;
extruding said heated mixture as a strand having a diameter of from 0.1 to 3 mm;
cooling said strand; and
dividing said strand to form non-spheroidal multi-particulates of said extrudate having a
length from 0.1 -5 mm, and dividing said non-spheroidal multi-particulates into unit doses
containing an effective amount of said therapeutically active agent, said unit dose providing a
sustained-release of said therapeutically active agent for a time period of from about 8 to about
24 hours.
18. The method of claim 17, wherein said therapeutically active agent is an opioid analgesic
is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine,
benzylmorphine, bezitramide, buprenorphine, butorphanol. clonitazene, codeine, cyclazocine,
desomorphine, dextromoramide, dezoctne, diampromide, dihydrocodeine, dihydromorphine,
dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone,
eptazocine, ethoheptazine, ethylmethylthiambmene, ethylmorphine, etonitazene, fetanyl, heroin,
hydrocodone, hydromorphone, hydroxypethidine, isomethandone, ketobemidone, levallorphan,
levorphanol, levophenacyl morphan, lofentanil, meperidine, meptazinol, metazocine, methadone,
metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol,
normethadone, nalorphine, normorphine, norpipanone, opium, oxycodone, oxymorphone,
papaveretum, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine,
piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene,
sufentanil, tramadol, tilidine, salts thereof and mixtures thereof.
19. The method of claim 17, further comprising containing said unit dose of said
multiparticulates within a gelatin capsule.
20. The method of claim 17, further comprising compressing said unit dose of multi-
particulates into a tablet.
21. The method of claim 18, further comprising extruding said heated mixture under vacuum
conditions to provide a substantially non-porous extrudate.
22. A sustained-release pharmaceutical formulation comprising:
an extruded blend of oxycodone;
one or more hydrophobic materials selected from the group consisting of alkylcelluloses,
acrylic and methacrylic acid polymers and copolymers, shellac, zein, hydrogenated castor oil,
hydrogenated vegetable oil, and mixtures thereof; and
one or more retardant materials having a melting point from 30 to 100 °C and selected
from the group consisting of natural or synthetic waxes, fatty acids, fatty alcohols, and mixtures
thereof,
said extruded blend divided into a unit dose containing an effective amount of said
therapeutically active agent to render a desired therapeutic effect and providing a sustained-
release of said therapeutically active agent for a time period of from 8 to 24 hours,
said extruded blend being formed by mixing the therapeutically active agent, the one or
more hydrophobic materials, and the one or more retardant materials in an extruder to form said
blend and extruding said blend through the extruder,
said formulation providing an in-vitro release when assessed by the USP Paddle or
Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at 37 °C from 1 to
42.5% oxycodone released after one hour, from 5 to 65% oxycodone released after 2 hours, from
15 to 85% oxycodone released after 4 hours, from 20 to 90% oxycodone released after 6 hours,
from 35 to 95% oxycodone released after 12 hours, from 45 to 100% oxycodone released after
18 hours, and from 55 to 100% oxycodone released after 24 hours, by weight.
23. The formulation of claim 22 which provides an in-vitro dissolution from 12.5 to 42.5%
oxycodone released after one hour, from 25 to 65% oxycodone released after 2 hours, from 45 to
85% oxycodone released after 4 hours, and greater than 60% oxycodone released after 8 hours,
by weight.
24. The sustained-release formulation of claim 22 wherein the blend is subjected to a
sufficient amount of heat to at least soften said blend during the extrusion process.
25. The formulation of claim 22, wherein said extrudate comprises a strand-shaped matrix
cut into multi-particulates having a length of from 0.1 to 5 mm and a diameter of from 0.1 to 5
mm.
26. The formulation of claim 24, wherein a unit dose comprising an effective amount of said
multi-particulates to render a therapeutic effect is contained within a gelatin capsule.
27. The formulation of claim 22, which provides a peak plasma level at from 2 to 8 hours
after oral administration.
28. The formulation of claim 22, which provides a W50 from 4 to 12 hours.
29. The formulation of claim 22 which provides an absorption half-life from 1 to 8 hours
after oral administration.
30. The formulation of claim 22, which provides an in-vitro release when assessed by the
USP Paddle or Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at
37 °C from 12.5 to 42.5% oxycodone released after one hour, from 25 to 65% oxycodone
released after 2 hours, from 45 to 85% oxycodone released after 4 hours, and greater than 60%
oxycodone released after 8 hours, by weight.
31. A sustained-release pharmaceutical formulation comprising:
an extruded blend of an opioid analgesic;
one or more hydrophobic materials selected from the group consisting of alkylcellulose,
acrylic and methacrylic acid polymers and copolymers, shellac, zein, hydrogenated castor oil,
hydrogenated vegetable oil, and mixtures thereof; and
one or more retardant materials having a melting point from 30 to 100 °C and selected
from the group consisting of natural or synthetic waxes, fatty acids, fatty alcohols, and mixtures
thereof,
said extruded blend divided into a unit dose containing an effective amount of said
therapeutically active agent to render a desired therapeutic effect and providing a sustained-
release of said therapeutically active agent for a time period of from 8 to 24 hours,
said extruded blend being formed by mixing the therapeutically active agent, the one or
more hydrophobic materials, and the one or more retardant materials in an extruder to form said
blend and extruding said blend through the extruder.

32. The extrudate of claim 31, wherein said opioid analgesic is selected from the group
consisting of morphine, codeine, hydromorphone. hydrocodone, oxycodone, oxymorphone,
dihycrocodeine, hydromorphine, tramadol and mixtures thereof.
33. The sustained-release pharmaceutical formulation of claim 31 wherein said opioid
analgesc, the one or more hydrophobic materials, and the one or more retardant materials enler
said extruder in powder form.
34. The sustained-release pharmaceutical formulation of claim 33 wherein said opioid
analgesic, the one or more hydrophobic materials, and the one or more retardant materials, all in
powder form, are mixed to form a powder mixture prior to entering the extruder.
35. A sustained-release pharmaceutical formulation comprising:
an extruded blend of tramadol;
one or more hydrophobic materials selected from the group consisting of alkylcelluloses,
acrylic and methacrylic acid polymers and copolymers, shellac, zein, hydrogenated castor oil,
hydrogenated vegetable oil, and mixtures thereof; and
one or more retardant materials having a melting point from 30 to 100 °C and selected
from the group consisting of natural or synthetic waxes, fatty acids, fatty alcohols, and mixtures
thereof, said extruded blend divided into a unit dose containing an effective amount of said
therapeutically active agent to render a desired therapeutic effect and providing a sustained-
release of said therapeutically active agent for a time period of from 8 to 24 hours,
said extruded blend being formed by mixing the therapeutically active agent, the one or
more hydrophobic materials, and the one or more retardant materials in an extruder to form said
blend and extruding said blend through the extruder,
said formulation providing an in-vitro release when assessed by the USP Paddle or
Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at 37 °C from 1 to
42.5% tramadol released after one hour, from 5 to 65% tramadol released after 2 hours, from 15
to 85% tramadol released after 4 hours, from 20 to 90% tramadol released after 6 hours, from 35
to 95% tramadol released after 12 hours, from 45 to 100% tramadol released after 18 hours, and
from 55 to 100% tramadol released after 24 hours, by weight.
36. The sustained-release formulation of claim 35 wherein the blend is subjected to a
sufficient amount of heat to at least soften said blend during the extrusion process.
37. The sustained-release formulation of claim 35 wherein an effective amount of said
extrudate is compressed into a tablet.
38. The formulation of claim 35, which provides a peak plasma level at from 2 to 8 hours
after oral administration.
39. The formulation of claim 35, which provides a W50 from 4 to 12 hours.
40. The formulation of claim 35, which provides a rapid rate of initial rise in the plasma
concentration of tramadol after oral administration, such that the absorption half-life is from 1 to
8 hours after oral administration in the fasted state.
41. The formulation of claim 35, which provides an in-vitro release when assessed by the
USP Paddle or Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at
37 0C from 12.5 to 42.5% tramadol released after one hour, from 25 to 65% tramadol released
after 2 hours, from 45 to 85% tramadol released after 4 hours, and greater than 60% tramadol
released after 8 hours, by weight.
42. The formulation of claim 35 which provide an in-vitro dissolution from 12.5 to 42.5%
tramadol released after one hour, from 25 to 65% tramadol released after 2 hours, from 45 to
85% tramadol released after 4 hours, and greater than 60% tramadol released after 8 hours, by
weight.
43. A sustained-release pharmaceutical formulation comprising:
an extruded blend of hydromorphone;
one or more hydrophobic materials selected from the group consisting of alkylcelluloses,
acrylic and methacrylic acid polymers and copolymers, shellac, zein, hydrogenated castor oil,
hydrogenated vegetable oil, and mixtures thereof; and
one or more retardant materials having a melting point from 30 to 100 °C and selected
from the group consisting of natural or synthetic waxes, fatty acids, fatty alcohols, and mixtures
thereof, said extruded blend divided into a unit dose containing an effective amount of said
therapeutically active agent to render a desired therapeutic effect and providing a sustained-
release of said therapeutically active agent for a time period of from 8 to 24 hours,
said extruded blend being formed by mixing the therapeutically active agent, the one or
more hydrophobic materials, and the one or more retardant materials in an extruder to form said
blend and extruding said blend through the extruder,
said formulation providing an in-vitro release when assessed by the USP Paddle or
Basket Method at 100 rptn at 900 ml aqueous buffer (pH between 1.6 and 7.2) at 37 °C From 1 to
42.5% hydromorphone released after one hour, from 5 to 65% hydromorphone released after 2
hours, from 15 to 85% hydromorphone released after 4 hours, from 20 to 90% hydromorphone
released after 6 hours, from 35 to 95% hydromorphone released after 12 hours, from 45 to 100%
hydromorphone released after 18 hours, and from 55 to 100% hydromorphone released after 24
hours, by weight.
44. The sustained-release formulation of claim 43 wherein the blend is subjected to a
sufficient amount of heat to at least soften said blend during the extrusion process.
45. The formulation of claim 43, wherein said extrudate comprises a strand-shaped matrix
cut into multi-particulates having a length of from 0.1 to 5 mm and a diameter of from 0.1 to 5
mm.
46. The formulation of claim 45, wherein a unit dose comprising an effective amount of said
multi-particulates to render a therapeutic effect is contained within a gelatin capsule.
47. The formulation of claim 43, which provides a peak plasma level at from 2 to 8 hours
after oral administration.
48. The formulation of claim 43, which provides a W50 from 4 to 12 hours.
49. The formulation of claim 43 wherein the absorption half-life is from 1 to 8 hours after
oral administration.
50. The formulation of claim 43, which provides an in-vitro release when assessed by the
USP Paddle or Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at
37°C from 12.5 to 42.5% hydromorphone released after one hour, from 25 to 65%
hydromorphone released after 2 hours, from 45 to 85% hydromorphone released after 4 hours,
and greater than 60% hydromorphone released after 8 hours, by weight.
51. The formulation of claim 43 which provide an in-vitro dissolution from 12.5 to 42.5%
hydromorphone released after one hour, from 25 to 65% hydromorphone released after 2 hours,
from 45 to 85% hydromorphone released after 4 hours, and greater than 60% hydromorphone
released after 8 hours, by weight.
52. The formulation of claim 43 which contains 10% hydromorphone, from 60% to 66%
hydrophobic material and from 24% to 30% retardant material.
53. A sustained-release pharmaceutical formulation comprising:
an extruded blend of morphine;
one or more hydrophobic materials selected from the group consisting of alkylcelluloses,
acrylic and methacrylic acid polymers and copolymers, shellac, zein, hydrogenated castor oil,
hydrogenated vegetable oil, and mixtures thereof; and
one or more retardant materials having a melting point from 30 to 100 °C and selected
from the group consisting of natural or synthetic waxes, fatty acids, fatty alcohols, and mixtures
thereof, said extruded blend divided into a unit dose containing an effective amount of said
therapeutically active agent to render a desired therapeutic effect and providing a sustained-
release of said therapeutically active agent for a time period of from 8 to 24 hours,
said extruded blend being formed by mixing the therapeutically active agent, the one or
more hydrophobic materials, and the one or more retardant materials in an extruder to form said
blend and extruding said blend through the extruder,
said formulation providing an in-vitro release when assessed by the USP Paddle or
Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at 37 °C from 1 to
42.5% morphine released after one hour, from 5 to 65% morphine released after 2 hours, from 15
to 85% morphine released after 4 hours, from 20 to 90% morphine released after 6 hours, from
35 to 95% morphine released after 12 hours, from 45 to 100% morphine released after 18 hours,
and from 55 to 100% morphine released after 24 hours, by weight.
54. The sustained-release formulation of claim 53 wherein the blend is subjected to a
sufficient amount of heat to at least soften said blend during the extrusion process.
55. The formulation of claim 53, which provides a peak plasma level at from 2 to 8 hours
after oral administration.
56. The formulation of claim 53. wherein said extrudate comprises a strand-shaped matrix
cut into multi-particulatcs having a length of from 0.1 to 5 mm and a diameter of from 0.1 to 5
mm.
57. The formulation of claim 54, wherein a unit dose comprising an effective amount of said
multi-particulates to render a therapeutic effect is contained within a gelatin capsule.
58. The formulation of claim 54, which provides a peak plasma level at from 4 to 6 hours
after administration.
59. The formulation of claim 53, which provides a W50 from 4 to 12 hours.
60. The formulation of claim 53, which provides a rapid rate of initial rise in the plasma
concentration of morphine after oral administration, such that the absorption half-life is from 1 to
8 hours after oral administration in the fasted state.
61. The formulation of claim 53, which provides an in-vitro release when assessed by the
USP Paddle or Basket Method at 100 rpm at 900 ml aqueous buffer (pH between 1.6 and 7.2) at
37 °C from 12.5 to 42.5% morphine released after one hour, from 25 to 65% morphine released
after 2 hours, from 45 to 85% morphine released after 4 hours, and greater than 60% morphine
released after 8 hours, by weight.
62. The formulation of claim 53 which provides an in-vitro dissolution from 12.5 to 42.5%
morphine release after one hour, from 25 to 65% morphine released after 2 hours, from 45 to
85% morphine released after 4 hours, and greater than 60% morphine released after 8 hours, by
weight.
63. The formulation of claim 53 which contains 50% morphine, 35% hydrophobic material
and 15% retardant material.
64. The formulation of claim 10 which said provides a peak plasma level at from 4 to 6 hours
after oral administration.
65. The sustained-release formulation of claim 1 wherein the blend is subjected to sufficient
amount of heat to at least soften said blend during the extrusion process.
66. The sustained-release formulation of claim 1 wherein an effective amount of said
extrudate is compressed into a tablet.
67. The formulation of claim 1 wherein said retardant material has a melting point from 45 to
90 °C.
68. The sustained-release pharmaceutical formulation of claim 1 wherein said therapeutically
active agent, the one or more hydrophobic materials, and the one or more retardant materials
enter said extruder in powder form.
69. The sustained-release pharmaceutical formulation of claim above claim wherein said
therapeutically active agent, the one or more hydrophobic materials, and the one or more
retardant materials, all in powder form, are mixed to form a powder mixture prior to entering the
extruder.
Bioavailable sustained release oral opioid analgesic dosage forms, comprising a
plurality of multiparticulates produced via melt extrusion techniques are disclosed.

Documents:

1403-CAL-1995-FOR ALTERATION OF ENTRY IN THE PATENT REGISTER.pdf

1403-cal-1995-granted-abstract.pdf

1403-cal-1995-granted-claims.pdf

1403-cal-1995-granted-correspondence.pdf

1403-cal-1995-granted-description (complete).pdf

1403-cal-1995-granted-drawings.pdf

1403-cal-1995-granted-examination report.pdf

1403-cal-1995-granted-form 1.pdf

1403-cal-1995-granted-form 18.pdf

1403-cal-1995-granted-form 2.pdf

1403-cal-1995-granted-form 3.pdf

1403-cal-1995-granted-form 5.pdf

1403-cal-1995-granted-pa.pdf

1403-cal-1995-granted-reply to examination report.pdf

1403-cal-1995-granted-specification.pdf


Patent Number 225432
Indian Patent Application Number 1403/CAL/1995
PG Journal Number 46/2008
Publication Date 14-Nov-2008
Grant Date 12-Nov-2008
Date of Filing 06-Nov-1995
Name of Patentee EURO-CELTIQUE, S.A.
Applicant Address 122 BD DE LA PETRUSSE L
Inventors:
# Inventor's Name Inventor's Address
1 BENJAMIN OSHLACK 351 EAST 84 STREET, NEW YORK, NEW YORK 10028
2 MARK CHASIN 3 WAYNE COURT, MANALAPAN, NEW JERSEY 07726
3 HUA-PIN HUANG 68 BIRCH STREET, ENGLEWOOD CLIFFS, NEW JERSEY 07632
PCT International Classification Number A61K 9/22
PCT International Application Number N/A
PCT International Filing date
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 NA