Tranexamic acid formulations with reduced adverse effects
Tranexamic acid formulated in an oral dosage form with at least one agent that decreases tranexamic acid release in the stomach. Such formulations minimize nausea, vomiting, and other adverse gastric effects that may accompany tranexamic acid therapy, for example, to treat heavy menstrual bleeding. One embodiment is an extended release formulation with waxes, polymers, etc. that prevent a bolus release of tranexamic acid in the stomach. An alternative embodiment is a delayed release formulation with polymers that prevent release of tranexamic acid in the acid environment of the stomach and delay its release until the formulation reaches the less acid environment of the intestines. Such formulations enhance patient compliance with therapy because adverse effects of tranexamic acid therapy are reduced.
1. A method of treating menorrhagia comprising administering by oral ingestion to a human patient in need of such treatment a therapeutically effective dose of a delayed release oral dosage form, wherein the delayed release oral dosage form comprises:
a core comprising tranexamic acid or a pharmaceutically acceptable salt thereof; and
a delayed release material coated on the core;
wherein the delayed release material comprises a copolymer of methacrylic acid with an acrylate or methacrylate ester;
wherein the delayed release oral dosage form provides for the delayed release of the tranexamic acid such that the dosage form is suitable for administration on a two or three times a day basis; and
wherein the delayed release oral dosage form provides an in-vitro dissolution release rate of the tranexamic acid or pharmaceutically acceptable salt thereof when measured by the USP 27 Dissolution Apparatus Type II Paddle Method @ 50 RPM and 37±0.5° C. wherein:
from 0% to about 10% by weight tranexamic acid or pharmaceutically acceptable salt thereof is released by about 120 minutes in acid medium (1000 ml of 0.1 N hydrochloric acid), and
at least 75% by weight of said tranexamic acid or pharmaceutically acceptable salt thereof is released by about 45 minutes after subsequent immersion of the oral dosage form in buffer medium (1000 ml of pH 6.8 phosphate buffer).
2. The method of claim 1 , wherein the dosage form provides an in-vitro dissolution release rate of the tranexamic acid or pharmaceutically acceptable salt thereof when measured by the USP 27 Dissolution Apparatus Type II Paddle Method @ 50 RPM and 37±0.5° C. wherein:
from 0% to about 5% by weight tranexamic acid or pharmaceutically acceptable salt thereof is released by about 120 minutes in the acid medium (1000 ml of 0.1 N hydrochloric acid) and
at least 90% by weight tranexamic acid or pharmaceutically acceptable salt thereof is released by about 45 minutes after subsequent immersion of the oral dosage form in the buffer medium (1000 ml of pH 6.8 phosphate buffer).
3. The method of claim 2 , wherein, after administration of said dosage form:
from 0% to about 5% by weight of said tranexamic acid is released from said dosage form after exposure of said dosage form for a period of 2 hours to an environmental fluid having a pH of less than 3, and
at least 95% by weight of said tranexamic acid is released from said dosage form after exposure of said dosage form for a period of 1 hour to an environmental fluid having a pH of at least 5.
4. The method of claim 1 , wherein, after administration of said dosage form:
from 0% to about 10% by weight of said tranexamic acid is released from said dosage form after exposure of said dosage form for a period of 2 hours to an environmental fluid having a pH of less than 3, and
at least 75% by weight of said tranexamic acid is released from said dosage form after exposure of said dosage form for a period of 1 hour to an environmental fluid having a pH of at least 5.
5. The method of claim 1 , wherein the tranexamic acid or pharmaceutically acceptable salt thereof is tranexamic acid.
6. The method of claim 1 , wherein the delayed release material comprises a lower alkyl acrylic acid copolymer.
7. The method of claim 1 , wherein the delayed release material comprises a copolymer of methacrylic acid with ethyl acrylate.
8. The method of claim 1 , wherein the delayed release material comprises a copolymer of methacrylic acid with methyl methacrylate.
9. The method of claim 1 , wherein the delayed release material comprises methacrylic acid copolymer, type C.
10. The method of claim 1 , wherein the delayed release oral dosage form is in the form of a tablet.
11. The method of claim 1 , wherein the delayed release oral dosage form is in the form of a capsule.
12. The method of claim 1 , wherein the delayed release oral dosage form is in the form of a multiparticulate formulation.
13. The method of claim 1 , wherein the delayed release oral dosage form comprises from about 585 to about 715 mg of tranexamic acid or pharmaceutically acceptable salt thereof.
14. The method of claim 13 , wherein the delayed release oral dosage form comprises from about 617 to about 683 mg of tranexamic acid or pharmaceutically acceptable salt thereof.
15. The method of claim 14 , wherein the delayed release oral dosage form comprises about 650 mg of tranexamic acid or pharmaceutically acceptable salt thereof.
16. The method of claim 13 , wherein the method comprises administering three unit dosage forms of the delayed release dosage form on a twice a day basis for a total therapeutically effective daily dose of tranexamic acid ranging from about 3.51 gm to about 4.29 gm.
17. The method of claim 13 , wherein the method comprises administering two unit dosage forms of the delayed release dosage form on a three times a day basis for a total therapeutically effective daily dose of tranexamic acid ranging from about 3.51 gm to about 4.29 gm.
18. The method of claim 17 , wherein the method comprises administering a total daily dose of tranexamic acid of about 3.9 gm.