Controlled release formulations of levodopa and uses thereof
The current invention provides a controlled release oral solid formulation of levodopa comprising levodopa, a decarboxylase inhibitor, and a carboxylic acid. Also provided by this invention is multiparticulate, controlled release oral solid formulations of levodopa comprising: i) a controlled release component comprising a mixture of levodopa, a decarboxylase inhibitor and a rate controlling excipient; ii) a carboxylic acid component; and iii) an immediate release component comprising a mixture of levodopa and a decarboxylase inhibitor.
1. A method for treating Parkinson's disease comprising orally administering to a human patient in need of such treatment a multiparticulate formulation comprising about 10 mg to about 300 mg of carbidopa and about 25 mg to about 1200 mg of levodopa wherein the multiparticulate formulation comprises:
a. an immediate release component comprising a mixture of carbidopa and levodopa in a ratio of about 1 to about 4; and
b. a controlled release component comprising at least one controlled release excipient that provides for the controlled release of carbidopa, levodopa and a carboxylic acid that is not carbidopa or levodopa,
wherein the molar ratio of carboxylic acid to levodopa in the controlled release component is greater than 1:4 and less than 4:1 and following oral administration of the multiparticulate formulation the carbidopa, levodopa and carboxylic acid are released over a period of time of about 6 hours, and
wherein following a single dose administration of the multiparticulate formulation the patient's levodopa plasma concentration profile comprises:
(i) a time of administration;
(ii) a first concentration that occurs at a first time and within one hour of the time of administration;
(iii) a second concentration that occurs at a second time after said first time; and
(iv) a third concentration that occurs after said second concentration and at a third time that is at least four hours after said second concentration, and the second concentration is the maximum concentration of levodopa in the profile; the first concentration is greater than or equal to about fifty percent of the second concentration; said third concentration is about fifty percent to about sixty percent of the second concentration and the levodopa plasma concentration decreases after the third concentration, and
wherein the administration of the multiparticulate formulation is effective in alleviating at least one symptom of Parkinson's disease.
2. The method of claim 1 wherein the disease is secondary Parkinsonism.
3. The method of claim 1 wherein following a single dose administration of the multiparticulate formulation the levodopa blood plasma levels do not fluctuate more than 40% between 0.5 hours and six hours after administration.
4. The method of claim 1 wherein the first concentration is about fifty percent of the second concentration.
5. The method of claim 1 wherein the third concentration occurs about four hours after the second concentration.
6. The method of claim 1 wherein the third concentration occurs about six hours after the time of administration.
7. The method of claim 1 wherein the second concentration occurs about one hour after the first concentration.
8. The method of claim 1 wherein the third concentration is about fifty percent of the second concentration.
9. The method of claim 1 wherein the first, second and third concentrations are mean plasma concentrations.
10. The method of claim 1 wherein the first, second and third concentrations are median plasma concentrations.
11. The method of claim 1 wherein the multiparticulate formulation is administered three times a day.
12. The method of claim 11 wherein the multiparticulate formulation is administered every six hours.
13. The method of claim 1 wherein the carboxylic acid is selected from the group consisting of tartaric acid, adipic acid, succinic acid, citric acid, benzoic acid, acetic acid, ascorbic acid, edetic acid, fumaric acid, lactic acid, malic acid, oleic acid, sorbic acid, stearic acid, palmitic acid, boric acid and mixtures thereof.
14. The method of claim 13 wherein the carboxylic acid is tartaric acid.
15. The method of claim 1 wherein the at least one controlled release excipient comprises a delayed release polymer.
16. The method of claim 15 wherein the delayed release polymer comprises an enteric polymer.
17. The method of claim 1 wherein the controlled release component comprises more than one controlled release bead, pellet or granule.
18. The method of claim 17 wherein the carbidopa, levodopa and the carboxylic acid are in the same controlled release bead, pellet or granule.
19. The method of claim 17 wherein the carbidopa and levodopa are in a different controlled release bead, pellet or granule from the carboxylic acid.
20. The method of claim 1 wherein the molar ratio of carboxylic acid to levodopa is greater than 1:4 and less than 3:2.
21. The method of claim 1 wherein the molar ratio of carboxylic acid to levodopa is greater than 1:2 and less than 4:3.
22. The method of claim 1 wherein the immediate release component and controlled release component are in a capsule.
23. The method of claim 17 wherein the controlled release component comprises at least two different populations of controlled release beads, pellets or granules wherein the first population of controlled release beads, pellets or granules exhibits a slower in vitro dissolution profile of levodopa compared to the second population of controlled release beads pellets or granules.
24. The method of claim 23 wherein the carboxylic acid is selected from the group consisting of tartaric acid, adipic acid, succinic acid, citric acid, benzoic acid, acetic acid, ascorbic acid, edetic acid, fumaric acid, lactic acid, malic acid, oleic acid, sorbic acid, stearic acid, palmitic acid, boric acid and mixtures thereof.
25. The method of claim 24 wherein the carboxylic acid is tartaric acid.
26. A method for treating Parkinson's disease comprising orally administering to a human patient in need of such treatment a multiparticulate formulation comprising about 10 mg to about 300 mg of carbidopa, about 25 mg to about 1200 mg of levodopa, and carboxylic acid that is not carbidopa or levodopa wherein the multiparticulate formulation comprises:
a. an immediate release component comprising a mixture of carbidopa and levodopa in a ratio of about 1 to about 4; and
b. a controlled release component comprising at least one controlled release excipient that provides for the controlled release of carbidopa, levodopa and the carboxylic acid,
wherein the molar ratio of carboxylic acid to levodopa in the controlled release component is greater than 1:4 and less than 4:1, and following oral administration of the multiparticulate formulation the carbidopa, levodopa and carboxylic acid are released over a period of time of about 6 hours, and
wherein following a single dose administration of the multiparticulate formulation the patient's levodopa plasma concentration profile comprises:
(i) a time of administration;
(ii) a first concentration that occurs at a first time and within one hour of the time of administration;
(iii) a second concentration that occurs at a second time after said first time; and
(iv) the second concentration is the maximum concentration of levodopa in the profile; the first concentration is greater than or equal to about fifty percent of the second concentration;
wherein following a single dose administration of the multiparticulate formulation the levodopa blood plasma levels do not fluctuate more than 40% between 0.5 hours and six hours after administration, and
wherein the administration of the multiparticulate formulation is effective in alleviating at least one symptom of Parkinson's disease.
27. The method of claim 26 wherein the disease is secondary Parkinsonism.
28. The method of claim 26 wherein a third concentration occurs about four hours after the second concentration and such third concentration is about fifty percent to about sixty percent of the second concentration.
29. The method of claim 28 wherein the third concentration occurs about six hours after the time of administration.
30. The method of claim 26 wherein the second concentration occurs about one hour after the first concentration.
31. The method of claim 28 wherein the third concentration is about fifty percent of the second concentration.
32. The method of claim 28 wherein the first, second and third concentrations are mean plasma concentrations.
33. The method of claim 28 wherein the first, second and third concentrations are median plasma concentrations.
34. The method of claim 26 wherein the multiparticulate formulation is administered three times a day.
35. The method of claim 26 wherein the multiparticulate formulation is administered every six hours.
36. The method of claim 26 wherein the carboxylic acid is selected from the group consisting of tartaric acid, adipic acid, succinic acid, citric acid, benzoic acid, acetic acid, ascorbic acid, edetic acid, fumaric acid, lactic acid, malic acid, oleic acid, sorbic acid, stearic acid, palmitic acid, boric acid and mixtures thereof.
37. The method of claim 36 wherein the carboxylic acid is tartaric acid.
38. The method of claim 26 wherein the at least one controlled release excipient comprises a delayed release polymer.
39. The method of claim 38 wherein the delayed release polymer comprises an enteric polymer.
40. The method of claim 26 wherein the controlled release component comprises more than one controlled release bead, pellet or granule.
41. The method of claim 40 wherein the carbidopa, levodopa and the carboxylic acid are in the same controlled release bead, pellet or granule.
42. The method of claim 40 wherein the carbidopa and levodopa are in a different controlled release bead, pellet or granule from the carboxylic acid.
43. The method of claim 26 wherein the molar ratio of carboxylic acid to levodopa is greater than 1:4 and less than 3:2.
44. The method of claim 26 wherein the molar ratio of carboxylic acid to levodopa is greater than 1:2 and less than 4:3.
45. The method of claim 26 wherein the immediate release component and controlled release component are in a capsule.
46. The method of claim 40 wherein the controlled release component comprises at least two different populations of controlled release beads, pellets or granules wherein the first population of controlled release beads, pellets or granules exhibits a slower in vitro dissolution profile of levodopa compared to the second population of controlled release beads pellets or granules.
47. The method of claim 46 wherein the carboxylic acid is selected from the group consisting of tartaric acid, adipic acid, succinic acid, citric acid, benzoic acid, acetic acid, ascorbic acid, edetic acid, fumaric acid, lactic acid, malic acid, oleic acid, sorbic acid, stearic acid, palmitic acid, boric acid and mixtures thereof.
48. The method of claim 47 wherein the carboxylic acid is tartaric acid.
49. The method of claim 1 wherein the molar ratio of carboxylic acid to levodopa is greater than 2:3 and less than 5:4.
50. The method of claim 26 wherein the molar ratio of carboxylic acid to levodopa is greater than 2.3 and less than 5:4.
51. A method for treating Parkinson's disease comprising orally administering to a human patient in need of such treatment a multiparticulate formulation comprising about 10 mg to about 300 mg of carbidopa and about 25 mg to about 1200 mg of levodopa wherein the multiparticulate formulation comprises:
a. an immediate release component comprising a mixture of carbidopa and levodopa in a ratio of about 1 to about 4; and
b. a controlled release component comprising at least one controlled release excipient that provides for the controlled release of carbidopa, levodopa and tartaric acid wherein the molar ratio of tartaric acid to levodopa in the controlled release component is greater than 1:4 and less than 4:1 and
wherein following a single dose administration of the multiparticulate formulation the patient's levodopa plasma concentration profile comprises:
(i) a time of administration;
(ii) a first concentration that occurs at a first time and within one hour of the time of administration;
(iii) a second concentration that occurs at a second time after said first time; and
(iv) a third concentration that occurs after said second concentration and at a third time that is at least four hours after said second concentration, and the second concentration is the maximum concentration of levodopa in the profile; the first concentration is greater than or equal to about fifty percent of the second concentration; said third concentration is about fifty percent to about sixty percent of the second concentration and the levodopa plasma concentration decreases after the third concentration, and
wherein the administration of the multiparticulate formulation is effective in alleviating at least one symptom of Parkinson's disease.
52. The method of claim 51 wherein the molar ratio of tartaric acid to levodopa is greater than 1:4 and less than 3:2.
53. The method of claim 51 wherein the molar ratio of tartaric acid to levodopa is greater than 1:2 and less than 4:3.
54. The method of claim 51 wherein the molar ratio of carboxylic acid to levodopa is greater than 2.3 and less than 5:4.