[0001] The present invention is directed to a solid pharmaceutical dosage form comprising
at least ritonavir and a process for preparing same.
[0002] The virus causing acquired immunodeficiency syndrome (AIDS) is known by different
names, including T-lymphocyte virus III (HTLV-III) or lymphadenopathy-associated virus
(LAV) or AIDS-related virus (ARV) or human immunodeficiency virus (HIV). Up until
now, two distinct families have been identified, i. e., Hun-1 and HIV-2.
[0003] One of the critical pathways in a retroviral life cycle is the processing of polyprotein
precursors by aspartic protease. For instance with the HIV virus the gag-pol protein
is processed by HIV protease. The correct processing of the precursor polyproteins
by the aspartic protease is required for the assembly of infectious virions, thus
making the aspartic protease an attractive target for antiviral therapy. In particular
for HIV treatment, the HIV protease is an attractive target.
[0004] A measure of the potential usefulness of an oral dosage form of a pharmaceutical
agent is the bioavailability observed after oral administration of the dosage form.
Various factors can affect the bioavailability of a drug when administered orally.
These factors include aqueous solubility, drug absorption throughout the gastrointestinal
tract, dosage strength and first pass effect. Aqueous solubility is one of the most
important of these factors. Unfortunately, HIV protease inhibiting compounds typically
are characterized by having poor aqueous solubility.
[0005] For a variety of reasons, such as patient compliance and taste masking, a solid dosage
form is usually preferred over a liquid dosage form. In most instances however, oral
solid dosage forms of a drug provide a lower bioavailability than oral solutions of
the drug.
[0006] There have been attempts to improve the bioavailability provided by solid dosage
forms by forming solid solutions of the drug. The term "solid solution" defines a
system in a solid state wherein the drug is molecularlv dispersed throughout a matrix
such that the system is chemically and physically uniform or homogenous throughout.
Solid solutions are preferred physical systems because the components therein readily
form liquid solutions when contacted with a liquid medium such as gastric juice. The
ease of dissolution may be attributed at least in part to the fact that the energy
required for dissolution of the components from a solid solution is less than that
required for the dissolution of the components from a crystalline or microcrystalline
solid phase. If, however, the drug absorption in the gastrointestinal tract is slow
the drug released from the solid solution may result in a high supersaturation and
precipitate in the aqueous fluids of the gastrointestinal tract.
[0007] There is a continuing need for the development of improved oral solid dosage forms
for HIV protease inhibitors which have suitable oral bioavailability and stability
and which do not necessitate high vehicle volumes.
[0008] WO 01/034119 discloses a pharmaceutical composition comprising a solid dispersion of ritonavir.
[0009] The present invention provides a solid pharmaceutical dosage form comprising a solid
dispersion of at least ritonavir in at least one pharmaceutically acceptable water-soluble
polymer and at least one pharmaceutically acceptable surfactant. In one embodiment,
the pharmaceutically acceptable water-soluble polymer has a glass transition temperature
(Tg) of at least about 50 °C.
[0010] The term "solid dispersion" defines a system in a solid state (as opposed to a liquid
or gaseous state) comprising at least two components, wherein one component is dispersed
evenly throughout the other component or components. For example, the active ingredient
or combination of active ingredients is dispersed in a matrix comprised of the pharmaceutically
acceptable water-soluble polymer(s) and pharmaceutically acceptable surfactant(s).
The term "solid dispersion" encompasses systems having small particles, typically
of less than 1 µm in diameter, of one phase dispersed in another phase. When said
dispersion of the components is such that the system is chemically and physically
uniform or homogenous throughout or consists of one phase (as defined in thermodynamics),
such a solid dispersion will be called a "solid solution" or a "glassy solution".
A glassy solution is a homogeneous, glassy system in which a solute is dissolved in
a glassy solvent. Glassy solutions and solid solutions of HIV protease inhibitors
are preferred physical systems. These systems do not contain any significant amounts
of active ingredients in their crystalline or microcrystalline state, as evidenced
by thermal analysis (DSC) or X-ray diffraction analysis (WAXS).
[0011] In one embodiment of the present invention, the pharmaceutical dosage form is comprising
from about 5 to about 30 % by weight of the total dosage form (preferably from about
10 to about 25 % by weight of the total dosage form) of an HIV protease inhibitor
or a combination of HIV protease inhibitors wherein said HIV protease inhibitor comprises
ritonavir, from about 50 to about 85 % by weight of the total dosage form (preferably
from about 60 to about 80 % by weight of the total dosage form) of a water-soluble
polymer (or any combination of such polymers), from about 2 to about 20 % by weight
of the total dosage form (preferably from about 3 to about 15 % by weight of the total
dosage form) of the surfactant (or combination of surfactants), and from about 0 to
about 15 % by weight of the total dosage form of additives.
[0012] HIV protease inhibiting compounds suitable for use in the present invention include
for example, but are not limited thereto:
(2S,3S,5S)-5-(N-(N-((N-methyl-N-((2-sopropyl-4-thiazolyl)methyl)amino)carbonyl)-L-valinyl)amino-2-(N-((5-thiazolyl)methoxy-carbonyl)-amino)-amino-1,6-diphenyl-3hydroxyhexane
(ritonavir);
(2S,3S,5S)-2-(2,6-Dimethylphenoxyacetyl)amino-3-hydroxy-5-[2S-(1-tetrahydro-pyrimid-2-onyl)-3-methylbutanoyl]-amino-1,6-diphenylhexane
(ABT-378; lopinavir);
N-(2(R)-hydroxy-1(S)-indanyl)-2(R)-phenylmethyl-4(S)-hydroxy-5-(1-(4-(3-pyridylmethyl)-2(S)-N'-(t-butylcarboxamido)-piperazinyl))-pentaneamide
(indinavir);
N-tert-butyl-decahydro-2-[2(R)-hydroxy-4-phenyl-3(S)-[[N-(2-quinolylcarbonyl)-L-asparaginyl]amino]butyl]-(4aS,8aS)-isoquinoline-3(S)-carboxamide
(saquinavir);
5(S)-Boc-amino-4(S)-hydroxy-6-phenyl-2(R)phenylmethylhexanoyl-(L)-Val-(L)-Phemorpholin-4-ylamide;
1-Naphthoxyacetyl-beta-methylthio-Ala-(2S,3S)3-amino-2-hydroxy-4-butanoyl-1,3-thiazolidine-4t-butylamide;
5-isoquinolinoxyacetyl-beta-methylthio-Ala-(2S,3S)-3amino-2-hydroxy-4-butanoyl-1,3-thiazolidine-4-tbutylamide;
[1S-[1R-(R-),2S*])-N1 [3-[[[(1,1-dimethylethyl)amino]carbonyl](2-methylpropyl)amino]-2hydroxy-1-(phenylmethyl)propyl]-2-[(2-quinolinylcarbonyl)amino]-butanediamide;
amprenavir (VX-478); DMP-323; DMP-450; AG1343 (nelfinavir);
atazanavir (BMS 232,632);
tipranavir;
palinavir,
TMC-114;
RO033-4649;
fosamprenavir (GW433908);
P-1946;
BMS 186,318; SC-55389a; BILA 1096 BS; and U-140690, or combinations thereof.
[0013] Ritonavir (Abbott Laboratories, Abbott Park, IL, USA) is an HIV protease inhibitor
which is forrmulated into the dosage form of the invention. This and other compounds
as well as methods for preparing same are disclosed in
U. S. Patent Nos. 5,542,206 and
5,648,497. The present invention provides a dosage form wherein said HIV protease inhibitor
is ritonavir or a combination of ritonavir and at least one other HIV protease inhibitor.
In an embodiment the dosage form shows a dose-adjusted AUC of ritonavir plasma concentration
in dogs of at least about 9 µg.h/ml/100 mg.
[0014] In another embodiment, lopinavir (Abbott Laboratories, Abbott Park, IL, USA) is an
HIV protease inhibitor which may be formulated into the dosage form of the invention.
This and other compounds, as well as methods for preparing same, are identified in
U. S. Patent No. 5,914,332.
[0015] In yet another embodiment, nelfinavir mesylate (marketed under the tradename Viracept
by Agouron Pharmaceuticals, Inc. in La Jolla, CA) is an HIV protease inhibitor which
may be formulated into the dosage form of the invention.
[0016] The dosage forms of the present invention exhibit a release and absorption behaviour
that is characterized by high attainable AUC, high attainable C
max (maximum plasma concentration), and low T
max (time to reach maximum plasma concentration).
[0017] In still another embodiment, the present invention provides a dosage form wherein
said HIV protease inhibitor is a combination of ritonavir and lopinavir, the dosage
form showing a dose-adjusted AUC of ritonavir plasma concentration in dogs of at least
about 9 µg.h/ml/100 mg and a dose-adjusted AUC of lopinavir plasma concentration of
at least about 20 µg.h/ml/100 mg (preferably at least about 22.5 µg.h/ml/100 mg, most
preferred at least about 35 µg.h/ml/100 mg).
[0018] The term "AUC" means "Area Under the Curve" and is used in its normal meaning, i.
e. as the area under the plasma concentration-time curve from 0 to 24 hours, where
the dosage form has been administered orally to dogs (beagle) under non-fasting conditions.
"Non-fasting condition" means that the dogs receive a nutritionally balanced daily
ration during the pre-test period and the whole test period. The AUC has units of
concentration times time. Once the experimental concentration-time points have been
determined, the AUC may conveniently be calculated, e.g. by a computer program or
by the trapezoidal method. All AUC data herein were dose adjusted to the 100 mg dose
level. For the purposes herein, the AUC is determined within a dose range where the
AUC increases proportionally with dose. Administration of 50 mg ritonavir or 200 mg
lopinavir, respectively, to dogs is considered suitable for determining the AUC values
as used herein.
[0019] The dosage forms according to the invention are characterized by an excellent stability
and, in particular, exhibit high resistance against recrystallization or decomposition
of the active ingredient(s). Thus, upon storage for 6 weeks at 40 °C and 75% humidity
(e.g., when kept in high density polyethylene (HDPE) bottles without desiccant), the
dosage forms according to the present invention usually do not exhibit any sign of
crystallinity (as evidenced by DSC or WAXS analysis) and contain at least about 98
% of the initial active ingredient content (as evidenced by HPLC analysis).
[0020] The term "pharmaceutically acceptable surfactant" as used herein refers to a pharmaceutically
acceptable non-ionic surfactant. In one embodiment, the dosage form is comprising
at least one surfactant having an hydrophilic lipophilic balance (HLB) value of from
about 4 to about 10, preferably from about 7 to about 9. The HLB system (
Fiedler, H.B., Encylopedia of Excipients, 5th ed., Aulendorf: ECV-Editio-Cantor-Verlag
(2002)) attributes numeric values to surfactants, with lipophilic substances receiving
lower HLB values und hydrophilic substances receiving higher HLB values. Surfactants
having an HLB value of from about 4 to about 10 suitable for use in the present invention
include for example, but are not limited thereto:
polyoxyethylene alkyl ethers, e.g. polyoxyethylene (3) lauryl ether, polyoxyethylene
(5) cetyl ether, polyoxyethylene (2) stearyl ether, polyoxyethylene (5) stearyl ether;
polyoxyethylene alkylaryl ethers, e.g. polyoxyethylene (2) nonylphenyl ether, polyoxyethylene
(3) nonylphenyl ether; polyoxyethylene (4) nonylphenyl ether, polyoxyethylene (3)
octylphenyl ether;
polyethylene glycol fatty acid esters, e.g. PEG-200 monolaurate, PEG-200 dilaurate,
PEG-300 dilaurate, PEG-400 dilaurate, PEG-300 distearate, PEG-300 dioleate;
alkylene glycol fatty acid mono esters, e.g. propylene glycol monolaurate (Lauroglycol®);
sucrose fatty acid esters, e.g. sucrose monostearate, sucrose distearate, sucrose
monolaurate, sucrose dilaurate; or
sorbitan fatty acid mono esters such as sorbitan mono laurate (Span@ 20), sorbitan
monooleate, sorbitan monopalmitate (Span® 40), or sorbitan stearate, or
mixtures of one or more thereof.
[0021] The sorbitan mono fatty acid esters are preferred, with sorbitan mono laurate and
sorbitan monopalmitate being particularly preferred.
[0022] Besides the surfactant having an HLB value of from about 4 to about 10, the dosage
form may comprise additional pharmaceutically acceptable surfactants such as polyoxyethylene
castor oil derivates, e.g. polyoxyethyleneglycerol triricinoleate or polyoxyl 35 castor
oil (Cremophor® EL; BASF Corp.) or polyoxyethyleneglycerol oxystearate such as polyethylenglycol
40 hydrogenated castor oil (Cremophor® RH 40) or polyethylenglycol 60 hydrogenated
castor oil (Cremophor® RH 60); or block copolymers of ethylene oxide and propylene
oxide, also known as polyoxyethylene polyoxypropylene block copolymers or polyoxyethylene
polypropyleneglycol, such as Poloxamer® 124, Poloxamer® 188, Poloxamer® 237, Poloxamer®
388, Poloxamer® 407 (BASF Wyandotte Corp.); or a mono fatty acid ester of polyoxyethylene
(20) sorbitan, e.g. polyoxyethylene (20) sorbitan monooleate (Tween® 80), polyoxyethylene
(20) sorbitan monostearate (Tween® 60), polyoxyethylene (20) sorbitan monopalmitate
(Tween® 40), polyoxyethylene (20) sorbitan monolaurate (Tween® 20).
[0023] Where such additional surfactants are used, the surfactant having an HLB value of
from about 4 to about 10 generally accounts for at least about 50 % by weight, preferably
at least about 60 % by weight, of the total amount of surfactant used.
[0024] The water-soluble polymer employed in the present invention has a Tg of at least
about 50 °C, preferably at least about 60°C, most preferred from about 80°C to about
180 °C. Methods for determining Tg values of the organic polymers are described in
"
Introduction to Physical Polymer Science", 2nd Edition by L.H. Sperling, published
by John Wiley & Sons, Inc., 1992. The Tg value can be calculated as the weighted sum of the Tg values for homopolymers
derived from each of the individual monomers, i.e., that make up the polymer: Tg =
E W
i X
i where W is the weight percent of monomer i in the organic polymer, and X is the Tg
value for the homopolymer derived from monomer i. Tg values for the homopolymers may
be taken from "
Polymer Handbook", 2nd Edition by J. Brandrup and E.H. Immergut, Editors, published
by John Wiley & Sons, Inc., 1975.
[0025] Water-soluble polymers having a Tg as defined above allow for the preparation of
solid dispersions that are mechanically stable and, within ordinary temperature ranges,
sufficiently temperature stable so that the solid dispersions may be used as dosage
forms without further processing or be compacted to tablets with only a small amount
of tabletting aids.
[0026] The water-soluble polymer comprised in the dosage form is a polymer that preferably
has an apparent viscosity, when dissolved at 20 °C in an aqueous solution at 2 % (w/v),
of about 1 to about 5000 mPa.s. more preferably of about 1 to about 700 mPa.s, and
most preferred of about 5 to about 100 mPa.s. Water-soluble polymers suitable for
use in the present invention include for example, but are not limited thereto:
homopolymers and copolymers of N-vinyl lactams, escpecially homopolymers and copolymers
of N-vinyl pyrrolidone, e.g. polyvinylpyrrolidone (PVP), copolymers of N-vinyl pyrrolidone
and vinyl acetate or vinyl propionate,
cellulose esters and cellulose ethers; in particular methylcellulose and ethylcellulose,
hydroxyalkylcelluloses, in particular hydroxypropylcellulose, hydroxyalkylalkylcelluloses,
in particular hydroxypropylmethylcellulose, cellulose phthalates or succinates, in
particular cellulose acetate phthalate and hydroxypropylmethylcellulose phthalate,
hydroxypropylmethylcellulose succinate or hydroxypropylmethylcellulose acetate succinate;
high molecular polyalkylene oxides such as polyethylene oxide and polypropylene oxide
and copolymers of ethylene oxide and propylene oxide,
polyacrylates and polymethacrylates such as methacrylic acid/ethyl acrylate copolymers,
methacrylic acid/methyl methacrylate copolymers, butyl methacrylate/2-dimethylaminoethyl
methacrylate copolymers, poly(hydroxyalkyl acrylates), poly(hydroxyalkyl methacrylates),
polyacrylamides,
vinyl acetate polymers such as copolymers of vinyl acetate and crotonic acid, partially
hydrolyzed polyvinyl acetate (also referred to as partially saponified "polyvinyl
alcohol"),
polyvinyl alcohol,
oligo- and polysaccharides such as carrageenans, galactomannans and xanthan gum, or
mixtures of one or more thereof.
[0027] Of these, homopolymers or copolymers of N-vinyl pyrrolidone, in particular a copolymer
ofN-vinyl pyrrolidone and vinyl acetate, are preferred. A particularly preferred polymer
is a copolymer of about 60 % by weight of the copolymer, N-vinyl pyrrolidone and about
40 % by weight of the copolymer, vinyl acetate.
[0028] The dosage forms of the invention may contain at least one conventional additive,
such as flow regulators, lubricants, bulking agents (fillers) and disintegrants. In
general, the additive is contained in an amount of about 0.01 to about 15 % by weight
relative to the weight of the dosage form.
[0029] Various methods can be used for manufacturing the solid dosage forms according to
the invention. These methods comprise the preparation of a solid solution of the HIV
protease inhibitor or the combination of HIV protease inhibitors in a matrix of the
water-soluble polymer and the surfactant, and shaping into the required tablet form.
Alternatively, the solid solution product may be subdivided to granules, e.g. by grinding
or milling, and the granules may subsequently be compacted to tablets.
[0030] Various techniques exist for preparing solid solutions including melt-extrusion,
spray-drying and solution-evaporation with melt-extrusion being preferred.
[0031] The melt-extrusion process comprises the steps of preparing a homogeneous melt of
the HIV protease inhibitor or the combination of HIV protease inhibitors, the water-soluble
polymer and the surfactant, and cooling the melt until it solidifies. "Melting" means
a transition into a liquid or rubbery state in which it is possible for one component
to get embedded homogeneously in the other. Typically, one component will melt and
the other components will dissolve in the melt thus forming a solution. Melting usually
involves heating above the softening point of the water-soluble polymer. The preparation
of the melt can take place in a variety of ways. The mixing of the components can
take place before, during or after the formation of the melt. For example, the components
can be mixed first and then melted or be simultaneously mixed and melted. Usually,
the melt is homogenized in order to disperse the active ingredients efficiently. Also,
it may be convenient first to melt the water-soluble polymer and then to mix in and
homogenize the active ingredients.
[0032] Usually, the melt temperature is in the range of about 70 to about 250 °C, preferably
from about 80 to about 180 °C, most preferred from about 100 to about 140 °C.
[0033] The active ingredients can be employed as such or as a solution or dispersion in
a suitable solvent such as alcohols, aliphatic hydrocarbons or esters. Another solvent
which can be used is liquid carbon dioxide. The solvent is removed, e.g. evaporated,
upon preparation of the melt.
[0034] Various additives may be included in the melt, for example flow regulators such as
colloidal silica; lubricants, fillers, disintegrants, plasticizers, stabilizers such
as antioxidants, light stabilizers, radical scavengers, stabilizers against microbial
attack.
[0035] The melting and/or mixing takes place in an apparatus customary for this purpose.
Particularly suitable ones are extruders or kneaders. Suitable extruders include single
screw extruders, intermeshing screw extruders or else multiscrew extruders, preferably
twin screw extruders, which can be corotating or counterrotating and, optionally,
be equipped with kneading disks. It will be appreciated that the working temperatures
will also be determined by the kind of extruder or the kind of configuration within
the extruder that is used. Part of the energy needed to melt, mix and dissolve the
components in the extruder can be provided by heating elements. However, the friction
and shearing of the material in the extruder may also provide a substantial amount
of energy to the mixture and aid in the formation of a homogeneous melt of the components.
[0036] The melt ranges from pasty to viscous. Shaping of the extrudate conveniently is carried
out by a calender with two counter-rotating rollers with mutually matching depressions
on their surface. A broad range of tablet forms can be attained by using rollers with
different forms of depressions: Alternatively, the extrudate is cut into pieces, either
before (hot-cut) or after solidification (cold-cut).
[0037] Optionally, the resulting solid solution product is milled or ground to granules.
The granules may then be compacted. Compacting means a process whereby a powder mass
comprising the granules is densified under high pressure in order to obtain a compact
with low porosity, e.g. a tablet. Compression of the powder mass is usually done in
a tablet press, more specifically in a steel die between two moving punches. Where
a solid dosage form of the invention comprises a combination of more than one HIV
protease inhibitor (or a combination of an HIV- protease inhibitor with one or more
other active ingredients) it is of course possible to separately prepare solid solution
products of the individual active ingredients and to blend the milled or ground products
before compacting.
[0038] At least one additive selected from flow regulators, disintegrants, bulking agents
(fillers) and lubricants is preferably used in compacting the granules. Disintegrants
promote a rapid disintegration of the compact in the stomach and keeps the granules
which are liberated separate from one another. Suitable disintegrants are crosslinked
polymers such as crosslinked polyvinyl pyrrolidone and crosslinked sodium carboxymethylcellulose.
Suitable bulking agents (also referred to as "fillers") are selected from lactose,
calcium hydrogenphosphate, microcrystalline cellulose (Avicell®), silicates, in particular
silicium dioxide, magnesium oxide, talc, potato or com starch, isomalt, polyvinyl
alcohol.
[0039] Suitable flow regulators are selected from highly dispersed silica (Aerosil®), and
animal or vegetable fats or waxes.
[0040] A lubricant is preferably used in compacting the granules. Suitable lubricants are
selected from polyethylene glycol (e.g., having a Mw of from 1000 to 6000), magnesium
and calcium stearates, sodium stearyl fumarate, and the like.
[0041] Various other additives may be used, for example dyes such as azo dyes, organic or
inorganic pigments such as aluminium oxide or titanium dioxide, or dyes of natural
origin; stabilizers such as antioxidants, light stabilizers, radical scavengers, stabilizers
against microbial attack.
[0042] Dosage forms according to the invention may be provided as dosage forms consisting
of several layers, for example laminated or multilayer tablets. They can be in open
or closed form. "Closed dosage forms" are those in which one layer is completely surrounded
by at least one other layer. Multilayer forms have the advantage that two active ingredients
which are incompatible with one another can be processed, or that the release characteristics
of the active ingredient(s) can be controlled. For example; it is possible to provide
an initial dose by including an active ingredient in one of the outer layers, and
a maintenance dose by including the active ingredient in the inner layer(s). Multilayer
tablets types may be produced by compressing two or more layers of granules. Alternatively,
multilayer dosage forms may be produced by a process known as "coextrusion". In essence,
the process comprises preperation of at least two different melt compositions as explained
above, and passing these molten compositions into a joint coextrusion die. The shape
of the coextrusion die depends on the required drug form. For example, dies with a
plain die gap, called slot dies, and dies with an annular slit are suitable.
[0043] In order to faciliate the intake of such a dosage form by a mammal, it is advantageous
to give the dosage form an appropriate shape. Large tablets that can be swallowed
comfortably are therefore preferably elongated rather than round in shape.
[0044] A film coat on the tablet further contributes to the ease with which it can be swallowed.
A film coat also improves taste and provides an elegant appearance. If desired, the
film-coat may be an enteric coat. The film-coat usually includes a polymeric film-forming
material such as hydroxypropyl methylcellulose, hydroxypropylcellulose, and acrylate
or methacrylate copolymers. Besides a film-forming polymer, the film-coat may further
comprise a plasticizer, e.g. polyethylene glycol, a surfactant, e.g. a Tween® type,
and optionally a pigment, e.g. titanium dioxide or iron oxides. The film-coating may
also comprise talc as anti-adhesive. The film coat usually accounts for less than
about 5 % by weight of the dosage form.
[0045] The exact dose and frequency of administration depends on the particular condition
being treated, the age, weight and general physical condition of the particular patient
as well as other medication the individual may be taking, as is well known to those
skilled in the art.
[0046] Exemplary compositions of the present invention for combined administration of ritonavir/
lopinavir are shown below in Table 1, and the values are % by weight.
Table 1.
| Ritonavir |
18 |
4.17 |
4.17 |
| Lopinavir |
-22.5 in total |
16.67 |
16.67 |
| Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40) |
65 - 75 |
71.16 |
70.12 |
| Span 20 (Sorbitan monolaurate) |
4 - 10 |
7.0 |
5.02 |
| Cremophor RH40 (polyoxyethyleneglycerol oxystearate) |
0 - 10 |
- |
3.02 |
| Colloidal silica |
0 - 3 |
1.0 |
1.0 |
[0047] Exemplary compositions of the invention for administration of ritonavir only are
shown below in Table 2. The values are % by weight.
| Ritonavir |
18 - 22.5 |
20.8 |
| Lopinavir |
- |
- |
| Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40) |
60 - 75 |
63.15 |
| Span 20 (Sorbitan monolaurate) |
5 -15 |
- |
| Cremophor RH40 (polyoxyethyleneglycerol oxystearate) |
in total |
10.00 |
| PEG 6000 |
0 - 8 |
5.00 |
| Colloidal silica |
0 - 3 |
1.04 |
[0048] The above compositions are processed by melt extrusion. The resulting extrudates
may be used as such or milled and compressed into tablets, preferably by the use of
suitable tabletting aids such as sodium stearyl fumarate, colloidal silica, lactose,
isomalt, calcium silicate, and magnesium stearate, cellulose or calcium hydrogenphosphate.
[0049] The following examples will serve to further illustrate the invention without limiting
it.
Protocol for the oral bioavailability studies
[0050] Dogs (beagle dogs, mixed sexes, weighing approximately 10 kg) received a balanced
diet with 27 % fat and were permitted water ad iibitum. Each dog received a 100 µg/kg
subcutaneous dose of histamine approximately 30 minutes prior to dosing. A single
dose corresponding to about 200 mg lopinavir, about 50 mg ritonavir, or about 200
mg lopinavir and about 50 mg ritonavir, respectively, was administered to each dog.
The dose was followed by approximately 10 milliliters of water. Blood samples were
obtained from each animal prior to dosing and 0.25, 0.5, 1.0, 1.5, 2, 3, 4, 6, 8,
10, 12 and 24 hours after drug administration. The plasma was separated from the red
cells by centrifugation and frozen (-30 °C) until analysis. Concentrations of HIV
protease inhibitors were determined by reverse phase HPLC with low wavelength UV detection
following liquid-liquid extraction of the plasma samples. The area under the curve
(AUC) was calculated by the trapezoidal method over the time course of the study.
Each dosage form was evaluated in a group containing 8 dogs; the values reported are
averages for each group of dogs.
Comparative example
[0051] Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40; 78.17 parts by weight)
was mixed with ritonavir (4.16 parts by weight), lopinavir (16.67 parts by weight)
and colloidal silica (1.0 part by weight). The powdery mixture was then fed into a
twin-screw extruder (screw diameter 18 mm) at a rate of 2.0 kg/h and a melt temperature
of 133 °C. The clear, fully transparent melt was fed to a calender with two counter-rotating
rollers having mutually matching cavities on their surfaces. Tablets of 1080 mg were
thus obtained. DSC and WAXS analysis did not reveal any evidence of crystalline drug
material in the formulation.
[0052] The dose-adjusted AUC in dogs was 0.52 µg.h/ml/100 mg for ritonavir and 4.54 µg.h/ml/100
mg for lopinavir. This example shows that solid solutions of HIV protease inhibitors
without added surfactant yield a very poor bioavailabilty.
Example 1
[0053] Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40; 68.17 parts by weight)
was blended with Cremophor RH40 (polyoxyethyleneglycerol oxystearate; 10.00 parts
by weight) in a Diosna high-shear mixer. The resulting granules were mixed with ritonavir
(4.17 parts by weight), lopinavir (16.67 parts by weight) and colloidal silica (1.00
parts by weight). The powdery mixture was then fed into a Leistritz Micro 18 twin-screw
extruder at a rate of 2.3 kg/h and a melt temperature of 126 °C. The extrudate was
cut into pieces and allowed to solidify. The extruded pieces were milled using a high
impact universal mill. The milled material (86.49 parts by weight) was blended in
a bin blender with lactose monohydrate (6.00 parts by weight), crosslinked PVP (6.00
parts by weight), colloidal silica (1.00 part by weight) and magnesium stearate (0.51
parts by weight). The powdery blend was compressed to tablets of 1378.0 mg on a Fette
E 1 single punch tablet press. The tablets were then film-coated in a coating pan
by spraying an aqueous dispersion for film coating (Opadry, available from Colorcon)
at a temperature of 60 °C.
[0054] The dose-adjusted AUC in dogs was 0.60 µg.h/ml/100 mg for ritonavir and 7.43 µg.h/ml/100
mg for lopinavir. This example shows that inclusion of a surfactant into solid solutions
of HIV protease inhibitors improves the bioavailabilty attained.
Example 2
[0055] Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40; 853.8 parts by weight)
was blended with Span 20 (Sorbitan monolaurate; 83.9 parts by weight) in a Diosna
high-shear mixer. The resulting granules were mixed with ritonavir (50 parts by weight),
lopinavir (200 parts by weight) and colloidal silica (12 parts by weight). The powdery
mixture was then fed into a twin-screw extruder (screw diameter 18 mm) at a rate of
2.1 kg/h and a melt temperature of 119 °C. The extrudate was fed to a calender with
two counter-rotating rollers having mutually matching cavities on their surfaces.
Tablets of 1120 mg were thus obtained.
[0056] The dose-adjusted AUC in dogs was 10.88 µg.h/ml/100 mg for ritonavir and 51.2 µg.h/ml/100
mg for lopinavir. This example shows that inclusion of a surfactant having an HLB
of 4 to 10 into solid solutions of HIV protease inhibitors markedly improves the bioavailability
attained.
Example 3
[0057] Example 2 was repeated, however, the extrudate was cut into pieces and allowed to
solidify. The extruded pieces were milled to a particle size of about 250 µm, using
a high impact universal mill. The milled material was blended in a bin blender with
sodium stearyl fumarate (12.3 parts by weight) and colloidal silica (8.0 parts by
weight) for 20 min. The powdery blend was compressed on a rotary tablet machine with
3 punches (6500 tablets/h). The tablets were then film-coated in a coating pan by
spraying an aqueous dispersion for film coating (Opadry) at a temperature of 60 °C.
[0058] The dose-adjusted AUC in dogs was 14.24 µg.h/ml/100 mg for ritonavir and 52.2 µg.h/ml/100
mg for lopinavir.
Example 4
[0059] Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40; 841.3 parts by weight)
was blended with Cremophor RH40 (polyoxyethyleneglycerol oxystearate; 36.2 parts by
weight), Span 20 (Sorbitan monolaurate; 60.2 parts by weight) in a Diosna high-shear
mixer. The resulting granules were mixed with ritonavir (50 parts by weight), lopinavir
(200 parts by weight) and colloidal silica (12 parts by weight). The powdery mixture
was then fed into a twin-screw extruder (screw diameter 18 mm) at a rate of 2.1 kg/h
and a melt temperature of 114 °C. The extrudate was fed to a calender with two counter-rotating
rollers having mutually matching cavities on their surfaces. Tablets of 1120 mg were
thus obtained.
[0060] The dose-adjusted AUC in dogs was 10.96 µg.h/ml/100 mg for ritonavir and 46.5 µg.h/ml/100
mg for lopinavir. This example shows that a combination of a surfactant having an
HLB of 4 to 10 and a further surfactant can successfully be used.
Example 5
[0061] Example 4 was repeated, however, the extrudate was cut into pieces and allowed to
solidify. The extruded pieces were milled to a particle size of about 250 µm, using
a high impact universal mill. The milled material was blended in a bin blender with
sodium stearylfumarate (13.9 parts by weight), colloidal silica (7.0 parts by weight),
isomalt DC100 (159.4 parts by weight) and calcium silicate (7.0 parts by weight) for
20 min. The blend was compressed and film-coated as described in example 1.
[0062] The dose-adjusted AUC in dogs was 10.38 µg.h/ml/100 mg for ritonavir and 42.7 µg.h/ml/100
mg for lopinavir.
Example 6
[0063] Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40; 683.3 parts by weight)
was blended with Span 40 (sorbitan monopalmitate; 67.2 parts by weight) in a Diosna
high-shear mixer. The resulting granules were mixed with lopinavir (200 parts by weight)
and colloidal silica (9.6 parts by weight). The powdery mixture was then fed into
a twin-screw extruder (screw diameter 18 mm) at a rate of 2.1 kg/h and a melt temperature
of 119°C. The extrudate was cut into pieces and allowed to solidify. The extruded
pieces were milled using a high impact universal mill. The milled material was blended
in a bin blender with sodium stearylfiunarate (7.9 parts by weight), colloidal silica
(11.3 parts by weight), isomalt DC100 (129.1 parts by weight) and sodium dodecyl sulfate
(15.6 parts by weight). The blend was compressed and film-coated as described in example
1.
[0064] Tablets corresponding to 200 mg lopinavir were coadministered to dogs together with
50 mg ritonavir. The dose-adjusted AUC of lopinavir was 38.8 µg.h/ml/100 mg.
Example 7
[0065] Copovidone (N-vinyl pyrrolidone/vinyl acetate copolymer 60:40; 151.5 parts by weight)
was blended with Cremophor RH40 (24 parts by weight) and PEG 6000 (12 parts by weight)
in a Diosna high-shear mixer. The resulting granules were mixed with ritonavir (50
parts by weight) and colloidal silica (2.4 parts by weight). The powdery mixture was
then fed into a twin-screw extruder and was melt-extruded. The extrudate was cut into
pieces and allowed to solidify. The extruded pieces were milled using a high impact
universal mill. The milled material was blended in a bin blender with colloidal silica
(1.4 parts by weight), isomalt DC 100 (31.9 parts by weight) and calcium silicate
(4.2 parts by weight). The blend was compressed and film-coated as described in example
1.
[0066] The dose-adjusted AUC in dogs was 9.98 µg.h/ml/100 mg.
1. A solid pharmaceutical dosage form which comprises a solid dispersion of at least
one HIV protease inhibitor and at least one pharmaceutically acceptable water-soluble
polymer and at least one pharmaceutically acceptable surfactant, wherein said HIV
protease inhibitor comprises (2S,3S,5S)-5-(N-(N-((N-methyl-N-((2-isopropyl-4-thiazolyl)methyl)amino)carbonyl)-L-valinyl)amino-2-(N-((5-thiazolyl)methoxy-carbonyl)amino-1,6-diphenyl-3-hydroxyhexane
(ritonavir), and said pharmaceutically acceptable water-soluble polymer has a Tg of
at least 50 °C, and wherein the dosage form comprises from 50 to 85 % by weight of
said water-soluble polymer, relative to the weight of the dosage form.
2. The dosage form of claim 1, comprising a glassy solution or solid solution of said
HIV protease inhibitor.
3. The dosage form of claim 1 or 2, wherein said pharmaceutically acceptable surfactant
has an HLB value of from 4 to 10.
4. The dosage form of claim 3, wherein said pharmaceutically acceptable surfactant is
selected from the group consisting of polyoxyethylene alkyl ethers, polyoxyethylene
alkylaryl ethers, polyethylene glycol fatty acid esters, alkylene glycol fatty acid
mono esters, sucrose fatty acid esters, sorbitan fatty acid mono esters or mixtures
of one or more thereof.
5. The dosage form of claim 3 wherein said pharmaceutically acceptable surfactant is
a sorbitan fatty acid ester.
6. The dosage form of claim 3, wherein said pharmaceutically acceptable surfactant is
selected from the group consisting of polyoxyethylene (3) lauryl ether, polyoxyethylene
(5) cetyl ether, polyoxyethylene (2) stearyl ether, polyoxyethylene (5) stearyl ether;
polyoxyethylene (2) nonylphenyl ether, polyoxyethylene (3) nonylphenyl ether, polyoxyethylene
(4) nonylphenyl ether, polyoxyethylene (3) octylphenyl ether; PEG-200 monolaurate,
PEG-200 dilaurate, PEG-300 dilaurate, PEG-400 dilaurate, PEG-300 distearate, PEG-300
dioleate; propylene glycol monolaurate; sucrose monostearate, sucrose distearate,
sucrose monolaurate, sucrose dilaurate; sorbitan mono laurate, sorbitan monooleate,
sorbitan monopalmitate, sorbitan stearate, or mixtures of one or more thereof.
7. The dosage form of any of claims 3 to 6, wherein the dosage form comprises at least
one further pharmaceutically acceptable surfactant.
8. The dosage form of claim 7, wherein said further pharmaceutically acceptable surfactant
is selected from the group consisting of polyoxyethylene castor oil derivates, block
copolymers of ethylene oxide and propylene oxide, or a mono fatty acid ester of polyoxyethylene
(20) sorbitan.
9. The dosage form of any of the preceding claims, which comprises, relative to the weight
of the dosage form, from 5 to 30 % by weight of said HIV protease inhibitor, from
2 to 20 % by weight of said surfactant, and from 0 to 15 % by weight of additives.
10. The dosage form of any of the preceding claims, wherein said HIV protease inhibitor
further includes (2S,3S,5S)-2-(2,6-Dimethylphenoxyacetyl)-amino-3-hydroxy-5-[2S-(1-tetrahydropyrimid-2-onyl)-3-methyl-butanoyl]
amino-1,6-diphenylhexane (lopinavir).
11. The solid dosage form of any of the preceding claims, wherein said water-soluble polymer
has a Tg of from 80 to 180 °C.
12. The solid dosage form of any of the preceding claims, wherein said water-soluble polymer
is selected from the group consisting of homopolymers and copolymers of N-vinyl lactams,
cellulose esters, cellulose ethers, high molecular polyalkylene oxides, polyacrylates;
polymethacrylates, polyacrylamides, vinyl acetate polymers, polyvinyl alcohol, oligo-
and polysaccharides or mixtures of one or more thereof.
13. The solid dosage form of claim 12, wherein said water-soluble polymer is selected
from the group consisting of homopolymers of N-vinyl pyrrolidone, copolymers of N-vinyl
pyrrolidone, copolymers of N-vinyl pyrrolidone and vinyl acetate, copolymers of N-vinyl
pyrrolidone and vinyl propionate, methylcellulose, ethylcellulose, hydroxyalkylcelluloses,
hydroxypropylcellulose, hydroxyalkyl-alkylcelluloses, hydroxypropylmethylcellulose,
cellulose phthalates, cellulose succinates, cellulose acetate phthalate, hydroxypropylmethylcellulose
phthalate, hydroxypropylmethylcellulose succinate, hydroxypropylmethylcellulose acetate
succinate; polyethylene oxide, polypropylene oxide, copolymers of ethylene oxide and
propylene oxide, methacrylic acid/ethyl acrylate copolymers, methacrylic acid/methyl
methacrylate copolymers, butyl methacrylate/2-dimethylaminoethyl methacrylate copolymers,
poly(hydroxyalkyl acrylates), poly(hydroxyalkyl methacrylates), copolymers of vinyl
acetate and crotonic acid, partially hydrolyzed polyvinyl acetate, carrageenans, galactomannans,
xanthan gum or mixtures of one or more thereof.
14. The solid dosage form of any of the preceding claims, wherein said water-soluble polymer
is a homopolymer or copolymer of N-vinyl pyrrolidone.
15. The solid dosage form of any of the preceding claims, wherein said water-soluble polymer
is a copolymer of N-vinyl pyrrolidone and vinyl acetate.
16. The solid dosage form of any of the preceding claims, wherein said water-soluble polymer
comprises a combination of polymers.
17. The solid dosage form of any of the preceding claims, containing at least one additive
selected from flow regulators, disintegrants, bulking agents and lubricants.
18. The solid dosage form of any of the preceding claims, wherein said water-soluble polymer
is copovidone, and said pharmaceutically acceptable surfactant is sorbitan monolaurate.
19. The solid dosage form of any of the preceding claims, which contains, upon storage
for about 6 weeks at about 40°C and about 75% humidity, at least 98% of the initial
content of HIV protease inhibitor.
20. A method of preparing a solid-dosage-form of claim 1 which comprises:
i. preparing a homogeneous melt of said HIV protease inhibitor (s), said water- soluble
polymer (s) and said surfactant (s), and
ii. allowing the melt to solidify to obtain a solid dispersion product.
21. The method of claim 20 additionally comprising grinding said solid dispersion product
and compressing said solid dispersion product into a tablet.
22. The use of the solid dosage form of any of claims 1 to 19 for the manufacture of a
medicament for treating an HIV infection in a mammal.
1. Feste pharmazeutische Dosierungsform, die eine feste Dispersion wenigstens eines HIV-Proteaseinhibitors
und wenigstens ein pharmazeutisch akzeptables, wasserlösliches Polymer und wenigstens
ein pharmazeutisch akzeptables grenzflächenaktives Mittel umfasst, wobei der HIV-Proteaseinhibitor
(2S,3S,5S)-5-(N-(N-((N-Methyl-N-((2-isopropyl-4-thiazolyl)methyl)amino)carbonyl)-L-valinyl)amino-2-(N-((5-thiazolyl)methoxy-carbonyl)amino-1,6-diphenyl-3-hydroxyhexan
(Ritonavir) umfasst, und wobei das pharmazeutisch akzeptable wasserlösliche Polymer
eine Tg von wenigstens 50 °C aufweist, und wobei die Dosierungsform 50 bis 85 Gew.%
wasserlösliches Polymer umfasst, bezogen auf das Gewicht der Dosierungsform.
2. Dosierungsform nach Anspruch 1, umfassend eine glasartige Lösung oder eine feste Lösung
des HIV-Proteaseinhibitors.
3. Dosierungsform nach Anspruch 1 oder Anspruch 2, wobei das pharmazeutisch akzeptable
grenzflächenaktive Mittel einen HLB-Wert von 4 bis 10 aufweist.
4. Dosierungsform nach Anspruch 3, wobei das pharmazeutisch akzeptable grenzflächenaktive
Mittel ausgewählt ist unter Polyoxyethylenalkylethern, Polyoxyethylenalkylarylethern,
Polyethyleneglykolfettsäureestern, Alkylenglykolfettsäuremonoestern, Saccharosefettsäureestern,
Sorbitanfettsäuremonoestern oder Gemischen eines oder mehrerer Vertreter davon.
5. Dosierungsform nach Anspruch 3, wobei das pharmazeutisch akzeptable grenzflächenaktive
Mittel ein Sorbitanfettsäureester ist.
6. Dosierungsform nach Anspruch 3, wobei das pharmazeutisch akzeptable grenzflächenaktive
Mittel ausgewählt ist unter Polyoxyethylen(3)laurylether, Polyoxyethylen(5)cetylether,
Polyoxyethylen(2)stearylether, Polyoxyethylen(5)stearylether; Polyoxyethylen(2)nonylphenylether,
Polyoxyethylen(3)nonylphenylether, Polyoxyethylen(4)nonylphenylether, Polyoxyethylen(3)octylphenylether;
PEG-200 Monolaurat, PEG-200 Dilaurat, PEG-300 Dilaurat, PEG-400 Dilaurat, PEG-300
Distearat, PEG-300 Dioleat; Propylenglykolmonolaurat; Saccharosemonostearat, Saccharosedistearat,
Saccharosemonolaurat, Saccharosedilaurat; Sorbitanmonolaurat, Sorbitanmonooleat, Sorbitanmonopalmitat,
Sorbitanstearat, oder Gemischen eines oder mehrerer Vertreter davon.
7. Dosierungsform nach einem der Ansprüche 3 bis 6, wobei die Dosierungsform wenigstens
ein weiteres pharmazeutisch akzeptables grenzflächenaktives Mittel umfasst.
8. Dosierungsform nach Anspruch 7, wobei das weitere pharmazeutisch akzeptable grenzflächenaktive
Mittel ausgewählt ist unter Polyoxyethylen-Rhizinusöl-Derivaten, Blockcopolymeren
von Ethylenoxid und Propylenoxid, oder einem Monofettsäureester von Polyoxyethylen(20)sorbitan.
9. Dosierungsform nach einem der vorhergehenden Ansprüche, der, relativ auf das Gewicht
der Dosierungsform bezogen, 5 bis 30 Gew.% HIV-Proteaseinhibitor, 2 bis 20 Gew.-%
grenzflächenaktives Mittel, und 0 bis 15 Gew.-% Zusatzstoffe umfasst.
10. Dosierungsform nach einem der vorhergehenden Ansprüche, wobei der HIV-Proteaseinhibitor
weiterhin (2S,3S,5S)-2-(2,6-Dimethylphenoxyacetyl)-amino-3-hydroxy-5-[2S-(1-tetrahydropyrimid-2-onyl)-3-methyl-butanoyl]amino-1,6-diphenylhexan
(Lopinavir) umfasst.
11. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, wobei das wasserlösliche
Polymer eine Tg von 80 bis 180°C aufweist.
12. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, wobei das wasserlösliche
Polymer ausgewählt ist unter Homopolymeren und Copolymeren von N-Vinyllactamen, Zelluloseestern,
Zelluloseethern, hochmolekularen Polyalkylenoxiden, Polyacrylaten, Polymethacrylaten,
Polyacrylamiden, Vinylacetatpolymeren, Polyvinylalkohol, Oligo- und Polysacchariden
oder Gemischen eines oder mehrerer Vertreter davon.
13. Feste Dosierungsform nach Anspruch 12, wobei das wasserlösliche Polymer ausgewählt
ist unter Homopolymeren von N-Vinylpyrrolidon, Copolymeren von N-vinylpyrrolidon,
Copolymeren von N-Vinylpyrrolidon und Vinylacetat, Copolymeren von N-Vinylpyrrolidon
und Vinylpropionat, Methylzellulose, Ethylzellulose, Hydroxyalkylzellulosen, Hydroxypropylzellulose,
Hydroxyalkylalkylzellulosen, Hydroxypropylmethylzellulose, Zellulosephthalaten, Zellulosesuccinaten,
Zelluloseacetatphthalat, Hydroxypropylmethylzellulosephthalat, Hydroxypropylmethylzellulosesuccinat,
Hydroxypropylmethylzelluloseacetatsuccinat; Polyethylenoxid, Polypropylenoxid, Copolymeren
von Ethylenoxid und Propylenoxid, Methacrylsäure/Ethylacrylat-Copolymeren, Methacrylsäure/Methylmethacrylat-Copolymeren,
Butylmethacrylat/2-Dimethylaminoethylmethacrylat-Copolymeren, Poly(hydroxyalkylacrylaten),
Poly(hydroxyalkylmethacrylaten), Copolymeren von Vinylacetat und Krotonsäure, teilweise
hydrolysiertem Polyvinylacetat, Carrageenanen, Galactomannanen, Xanthangummi oder
Gemischen eines oder mehrerer Vertreter davon.
14. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, wobei das wasserlösliche
Polymer ein Homopolymer oder ein Copolymer von N-Vinylpyrrolidon ist.
15. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, wobei das wasserlösliche
Polymer ein Copolymer von N-Vinylpyrrolidon und Vinylacetat ist.
16. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, wobei das wasserlösliche
Polymer eine Kombination von Polymeren umfasst.
17. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, umfassend wenigstens
einen Zusatzstoff, der ausgewählt ist unter Fließregulierungsmitteln, Zerfallshilfsmitteln,
Füllmittein und Gleitmitteln.
18. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, wobei das wasserlösliche
Polymer Copovidon ist, und das pharmazeutisch akzeptable grenzflächenaktive Mittel
Sorbitanmonolaurat ist.
19. Feste Dosierungsform nach einem der vorhergehenden Ansprüche, die bei Lagerung für
etwa sechs Wochen bei etwa 40°C und etwa 75 % Feuchtigkeit wenigstens 98 % des anfänglichen
Gehalts an HIV-Proteaseinhibitor enthält.
20. Verfahren zur Herstellung einer festen Dosierungsform nach Anspruch 1, wobei man
i. eine homogene Schmelze des HIV-Proteaseinhibitors (der HIV-Proteaseinhibitoren),
des wasserlöslichen Polymers (der wasserlöslichen Polymere) und des grenzflächenaktiven
Mittels (der grenzflächenaktiven Mittel) herstellt, und
ii. die Schmelze fest werden lässt, um ein festes Dispersionsprodukt zu erhalten.
21. Verfahren nach Anspruch 20, wobei man zusätzlich das feste Dispersionsprodukt mahlt
und das feste Dispersionsprodukt zu einer Tablette verpresst.
22. Verwendung der festen Dosierungsform nach einem der Ansprüche 1 bis 19 zur Herstellung
eines Medikaments zur Behandlung einer HIV-Infektion bei einem Säuger.
1. Forme posologique pharmaceutique solide qui comprend une dispersion solide d'au moins
un inhibiteur de la protéase du VIH et d'au moins un polymère hydrosoluble pharmaceutiquement
acceptable et d'au moins un tensioactif pharmaceutiquement acceptable, où ledit inhibiteur
de la protéase du VIH comprend le (2S,3S,5S)-5-(N-(N-((N-méthyl-N-((2-isopropyl-4-thiazolyl)méthyl)amino)carbonyl)-L-valinyl)amino-2-(N-((5-thiazolyl)méthoxy-carbonyl)amino-1,6-diphényl-3-hydroxyhexane
(ritonavir) et ledit polymère hydrosoluble pharmaceutiquement acceptable a une Tg
d'au moins 50°C et où la forme posologique comprend de 50 à 85 % en poids dudit polymère
hydrosoluble, par rapport au poids de la forme posologique.
2. Forme posologique selon la revendication 1, comprenant une solution vitreuse ou une
solution solide dudit inhibiteur de la protéase du VIH.
3. Forme posologique selon la revendication 1 ou 2, où ledit tensioactif pharmaceutiquement
acceptable a une valeur HLB de 4 à 10.
4. Forme posologique selon la revendication 3, où ledit tensioactif pharmaceutiquement
acceptable est sélectionné dans le groupe constitué des éthers alkyliques de polyoxyéthylène,
des éthers alkylary-liques de polyoxyéthylène, des esters d'acides gras de polyéthylèneglycol,
des monoesters d'acides gras d'alkylèneglycol, des esters d'acides gras de saccharose,
des monoesters d'acides gras de sorbitan et de mélanges d'un ou plusieurs de ces éléments.
5. Forme posologique selon la revendication 3, où ledit tensioactif pharmaceutiquement
acceptable est un ester d'acide gras de sorbitan.
6. Forme posologique selon la revendication 3, où ledit tensioactif pharmaceutiquement
acceptable est sélectionné dans le groupe constitué de l'éther laurylique de polyoxyéthylène
(3), l'éther cétylique de polyoxyéthylène (5), l'éther stéarylique de polyoxyéthylène
(2), l'éther stéarylique de polyoxyéthylène (5) ; l'éther nonylphénylique de polyoxyéthylène
(2), l'éther nonylphénylique de polyoxyéthylène (3), l'éther nonylphénylique de polyoxyéthylène
(4), l'éther octylphénylique de polyoxyéthylène (3) ; du monolaurate de PEG-200, du
dilaurate de PEG-200, du dilaurate de PEG-300, du dilaurate de PEG-400, du distéarate
de PEG-300, du dioléate de PEG-300 ; du monolaurate de polypropylène-glycol ; du monostéarate
de saccharose, du distéarate de saccharose, du monolaurate de saccharose, du dilaurate
de saccharose ; du monolaurate de sorbitan, du monooléate de sorbitan, du monopalmitate
de sorbitan, du stéarate de sorbitan ou de mélanges d'un ou plusieurs de ces éléments.
7. Forme posologique selon l'une quelconque des revendications 3 à 6, où la forme posologique
comprend au moins un tensioactif supplémentaire pharmaceutiquement acceptable.
8. Forme posologique selon la revendication 7, où ledit tensioactif supplémentaire pharmaceutiquement
acceptable est sélectionné dans le groupe constitué de dérivés d'huile de ricin et
de polyoxyéthylène, de copolymères blocs d'oxyde d'éthylène et d'oxyde de propylène
ou d'un ester de monoacide gras de polyoxyéthylène (20)-sorbitan.
9. Forme posologique selon l'une quelconque des revendications précédentes, laquelle
comprend, par rapport au poids de la forme posologique, de 5 à 30 % en poids dudit
inhibiteur de la protéase du VIH, de 2 à 20 % en poids dudit tensioactif et de 0 à
15 % en poids d'additifs.
10. Forme posologique selon l'une quelconque des revendications précédentes, où ledit
inhibiteur de la protéase du VIH comprend en outre du (2S,3S,5S)-2-(2,6-diméthylphénoxyacétyl)-amino-3-hydroxy-5-[2S-(1-tétrahydropyrimid-2-onyl)-3-méthyl-butanoyl]amino-1,6-diphényl-hexane
(lopinavir).
11. Forme posologique solide selon l'une quelconque des revendications précédentes, où
ledit polymère hydrosoluble a une Tg de 80 à 180°C.
12. Forme posologique solide selon l'une quelconque des revendications précédentes, où
ledit polymère hydrosoluble est sélectionné dans le groupe constitué des homopolymères
et des copolymères des N-vinyl-lactames, des esters de cellulose, des éthers de cellulose,
des poly(oxydes d'alkylène) de masse moléculaire élevée, des polyacrylates, des poly-méthacrylates,
des polyacrylamides, des polymères d'acétate de vinyle, de l'alcool polyvinylique,
des oligo- et des polysaccharides ou de mélanges d'un ou plusieurs de ces éléments.
13. Forme posologique solide selon la revendication 12, où ledit polymère hydrosoluble
est sélectionné dans le groupe constitué des homopolymères de N-vinylpyrrolidone,
des copolymères de N-vinylpyrrolidone, des copolymères de N-vinylpyrrolidone et d'acétate
de vinyle, des copolymères de N-vinylpyrrolidone et de propionate de vinyle, de la
méthylcellulose, de l'éthylcellulose, des hydroxyalkylcelluloses, de l'hydroxypropylcellulose,
des hydroxyalkylalkylcelluloses, de l'hydroxypropylméthylcellulose, des phtalates
de cellulose, des succinates de cellulose, de l'acétophtalate de cellulose, du phtalate
d'hydroxypropylméthylcellulose, du succinate d'hydroxypropylméthyl-cellulose, de l'acétosuccinate
d'hydroxypropylméthylcellulose ; du poly(oxyde d'éthylène), du poly(oxyde de propylène),
des copolymères d'oxyde d'éthylène et d'oxyde de propylène, des copolymères acide
méthacrylique/acrylate d'éthyle, des copolymères acide méthacrylique/méthacrylate
de méthyle, des copolymères méthacrylate de butyle/méthacrylate de 2-diméthylaminométhyle,
des poly(hydroxyalkylacrylates), des poly(hydroxyalkylméthacrylates), des copolymères
d'acétate de vinyle et d'acide crotonique, du poly(acétate de vinyle) partiellement
hydrolysé, des carragénines, des galactomannanes, de la gomme de xanthane ou de mélanges
d'un ou de plusieurs de ces composés.
14. Forme posologique solide selon l'une quelconque des revendications précédentes, où
ledit polymère hydrosoluble est un homopolymère ou un copolymère de N-vinylpyrrolidone.
15. Forme posologique solide selon l'une quelconque des revendications précédentes, où
ledit polymère hydrosoluble est un copolymère de N-vinylpyrrolidone et d'acétate de
vinyle.
16. Forme posologique solide selon l'une quelconque des revendications précédentes, où
ledit polymère hydrosoluble comprend une combinaison de polymères.
17. Forme posologique solide selon l'une quelconque des revendications précédentes, contenant
au moins un additif sélectionné parmi des régulateurs de fluidité, des désintégrants,
des agents de lest et des lubrifiants.
18. Forme posologique solide selon l'une quelconque des revendications précédentes, où
ledit polymère hydrosoluble est la copovidone et ledit tensioactif pharmaceutiquement
acceptable est le monolaurate de sorbitan.
19. Forme posologique solide selon l'une quelconque des revendications précédentes, qui
contient, après environ 6 semaines de stockage à environ 40°C et pour une humidité
d'environ 75 %, au moins 98 % de la teneur initiale en inhibiteur de la protéase du
VIH.
20. Procédé de préparation d'une forme posologique solide selon la revendication 1, lequel
comprend :
i. la préparation d'une masse fondue homogène dudit ou desdits inhibiteurs de la protéase
du VIH, dudit ou desdits polymères hydrosolubles et dudit ou desdits tensioactifs
et
ii. la solidification de la masse fondue pour obtenir un produit de dispersion solide.
21. Procédé selon la revendication 20 comprenant additionnellement le broyage dudit produit
de dispersion solide et la compression dudit produit de dispersion solide en un comprimé.
22. Utilisation de la forme posologique solide selon l'une quelconque des revendications
1 à 19 pour la préparation d'un médicament destiné à traiter une infection par le
VIH chez un mammifère.