Biguanide compositions and methods of treating metabolic disorders
Provided herein are methods for treating certain conditions, including diabetes, obesity, and other metabolic diseases, disorders or conditions by administrating a composition comprising a biguanide or related heterocyclic compound, e.g., metformin. Also provided herein are biguanide or related heterocyclic compound compositions, and methods for the preparation thereof for use in the methods of the present invention. Also provided herein are compositions comprising metformin and salts thereof and methods of use.
1. A method for lowering blood glucose levels in a patient in need thereof, comprising administering a therapeutically effective amount of metformin or a salt thereof to said subject in a delayed-release formulation adapted to have an onset of release of said metformin or a salt thereof distal of the duodenum and to minimize the circulating plasma concentration of metformin in the patient, wherein the resulting circulating plasma concentration of said metformin is below about 0.5 μg/mL.
2. A method for treating a disorder of glucose metabolism in a patient in need thereof, comprising administering a therapeutically effective amount of metformin or a salt thereof to said subject in a delayed-release formulation adapted to have an onset of release of said metformin or a salt thereof distal of the duodenum and to minimize the circulating plasma concentration of metformin in the patient, wherein the resulting circulating plasma concentration of said metformin is below about 0.5 μg/mL.
3. The method according to claim 1 or 2 , wherein the resulting circulating plasma concentration of metformin is below about 0.25 μg/mL.
4. The method according to claim 1 or 2 , wherein said delayed-release formulation is adapted to provide at least 20% less relative bioavailability of metformin compared to an immediate release composition having the same amount of said metformin or a salt thereof.
5. The method according to claim 1 or 2 , wherein said delayed-release formulation is adapted to provide at least 30% less relative bioavailability of metformin compared to an immediate release composition having the same amount of said metformin or a salt thereof.
6. The method according to claim 1 or 2 , wherein said delayed-release formulation is adapted to provide at least 40% less relative bioavailability of metformin compared to an immediate release composition having the same amount of said metformin or a salt thereof.
7. The method according to claim 1 or 2 , wherein said delayed-release formulation is adapted to provide at least 50% less relative bioavailability of metformin compared to an immediate release composition having the same amount of said metformin or a salt thereof.
8. The method according to claim 1 or 2 , wherein the daily dose of said metformin or a salt thereof is between about 50 mg and about 2000 mg.
9. The method according to claim 1 or 2 , wherein said delayed-release formulation comprises an enteric coating formulated to have an onset of release of said metformin or a salt thereof at a pH of about 5.0.
10. The method according to claim 1 or 2 , wherein said delayed-release formulation comprises an enteric coating formulated to have an onset of release of said metformin or a salt thereof at a pH of about 5.5.
11. The method according to claim 1 or 2 , wherein said delayed-release formulation comprises an enteric coating formulated to have an onset of release of said metformin or a salt thereof at or above about pH 6.0.
12. The method according to claim 1 or 2 , wherein said delayed-release formulation comprises an enteric coating formulated to have an onset of release of said metformin or a salt thereof at or above about pH 6.5.
13. The method according to claim 1 or 2 , wherein said delayed-release formulation comprises an enteric coating formulated to have an onset of release of said metformin or a salt thereof at or above about pH 7.0.
14. The method according to claim 1 or 2 , further comprising co-administering a second antidiabetic agent selected from the group consisting of thiazolidinediones, sulfonylureas, meglitinides, alpha-glucosidase inhibitors, a second DPP-IV inhibitor, incretin mimetics, and SGLT inhibitors.
15. The method according to claim 14 , wherein said second antidiabetic agent is an SGLT inhibitor.
16. The method according to claim 14 , wherein said second antidiabetic agent is a second DPP-IV inhibitor.
17. The method according to claim 14 , wherein said second antidiabetic agent is co-formulated with said metformin or a salt thereof and administered simultaneously in a combined formulation.
18. The method according to claim 17 , wherein said combined formulation is provided in the form of a delayed-release component coupled with an immediate release component in a unitary dosage form.
19. The method according to claim 1 or 2 , further comprising co-administering an antiobesity agent.
20. The method according to claim 19 , wherein said antiobesity agent is lorcaserin.
21. The method according to claim 19 , wherein said antiobesity agent is phentermine.
22. The method according to claim 19 , wherein said antiobesity agent is a combination of lorcaserin and phentermine.
23. The method according to claim 19 , wherein said antiobesity agent is a combination of topiramate and phentermine.
24. The method according to claim 19 , wherein said antiobesity agent is a combination of bupropion and naltrexone.
25. The method according to claim 19 , wherein said antiobesity agent is co-formulated with said metformin or a salt thereof and administered simultaneously in a combined formulation.
26. The method according to claim 25 , wherein said combined formulation is provided in the form of a delayed-release component coupled with an immediate release component in a unitary dosage form.
27. The method according to claim 1 or 2 , wherein said metformin or a salt thereof is metformin hydrochloride.