Pharmaceutical compositions for glucocorticoid replacement therapy
The invention relates to glucocorticoid replacement therapy and provides pharmaceutical compositions and kits designed to deliver one or more glucocorticoids to a subject in need thereof in a manner that results in serum levels of the glucocorticoid that essentially mimic that of a healthy subject for a clinically relevant period of time. The pharmaceutical composition comprises one or more glucocorticoids, wherein a first part of one or more glucocorticoids is substantially immediately released and a second part of one or more glucocorticoids is released over an extended period of time of at least about 8 hours, and the amount of the one or more glucocorticoids of the first part, expressed as hydrocortisone equivalents, is in a range of from about 15 to about 50% of the total hydrocortisone equivalents. The invention also relates to a kit comprising a first and a second component, the first component designed to release one or more glucocorticoids substantially immediately and the second component is designed to release one or more glucocorticoids over an extended period of time of at least 8 hours. The invention also relates to a method for treating diseases requiring glucocorticoid treatment such as in subjects having a glucocorticoid deficiency disorder. In another aspect the invention relates to the use of a first and a second amount of one or more glucocorticoids for the preparation of a pharmaceutical composition or kit for the treatment of a glucocorticoid deficiency disorder.
1. A coated tablet dosage form for delivery of glucocorticoid replacement therapy, comprising:
(a) an extended release tablet core and an immediate release coating surrounding said tablet core,
(b) said extended release tablet core comprising hydrocortisone and an extended release excipient composition consisting of (i) a combination of hydroxypropylmethylcellulose, microcrystalline cellulose and pregelatinized starch (ii) colloidal silicon dioxide, and (iii) magnesium stearate, the amount of hydrocortisone present in said extended release core being 60% to 80% of the total amount of hydrocortisone present in said dosage form;
(c) said immediate release coating comprising hydrocortisone and at least one coating material selected from the group consisting of hydroxypropylmethylcellulose, hydroxypropylcellulose, polyvinylalcohol, sodium carboxymethylcellulose, gelatin, polyethylene glycol, said immediate release coating further comprising at least one of titanium dioxide and talc, with the amount of hydrocortisone present in said immediate release coating material being 20% to 40% of the total amount of hydrocortisone present in said dosage form; and
(d) said dosage form being effective to deliver a daily dose of from about 5 to about 40 mg of hydrocortisone.
2. The coated tablet dosage form according to claim 1 , wherein said immediate release coating comprises hydrocortisone, hydroxypropylmethylcellulose and talc.
3. The coated tablet dosage form according to claim 1 , said dosage form being effective to deliver a daily dose of about 10 to about 30 mg of hydrocortisone.
4. A coated tablet dosage form according to claim 1 , wherein the amount of hydrocortisone present in said extended release core is about 74% of the total amount of hydrocortisone present in said dosage form; the amount of hydrocortisone present in said immediate release coating material is about 26% of the total amount of hydrocortisone present in said dosage form and the relative amounts of hydroxypropylmethylcellulose, microcrystalline cellulose, pregelatinized starch, colloidal silicon dioxide, and magnesium stearate, by weight, in said extended release excipient composition are 35.5:54.4:8.9:0.6:0.6.