Compositions and methods for treatment of disorders ameliorated by muscarinic receptor activation

1. An oral pharmaceutical composition, comprising:

a plurality of xanomeline beads having a size between 0.425 mm and 1.18 mm, and a core comprising between 30 wt. % and 80 wt. % xanomeline tartrate, between 15 wt. % and 65 wt. % microcrystalline cellulose, and between 0 wt. % and 2 wt. % talc; and

a plurality of trospium beads having a size between 0.425 mm and 1.18 mm, and a core comprising between 8 wt. % and 35 wt. % trospium chloride, between 25 wt. % and 80 wt. % microcrystalline cellulose, between 15 wt. % and 70 wt. % lactose monohydrate, and between 0 wt. % and 2 wt. % talc;

the plurality of xanomeline beads and the plurality of trospium beads each having a dissolution rate of more than about 95% within about the first 45 minutes following entry of the dosage form into an aqueous solution; and wherein, when administered to a patient for at least 7 days at 20 mg trospium twice daily, providing a mean C max of trospium at 7850±3360 pg/mL and a mean AUC 0-12 of 41900±15500 hr·pg/mL.

2. The oral pharmaceutical composition of claim 1 , wherein the size of the xanomeline beads is between 0.6 mm and 0.85 mm.

3. The oral pharmaceutical composition of claim 1 , wherein the size of the trospium beads is between 0.6 mm and 0.85 mm.

4. The oral pharmaceutical composition of claim 1 , wherein the xanomeline beads contain about 2.5 times as much xanomeline tartrate as the trospium beads contain trospium chloride.

5. The oral pharmaceutical composition claim 1 , having a dissolution rate of the xanomeline tartrate and the trospium chloride of more than about 95% within about the first 20 minutes following entry of the dosage form into an aqueous solution.

6. The oral pharmaceutical composition claim 1 , wherein the xanomeline beads comprise 66 wt. % xanomeline tartrate, 33.5 wt. % microcrystalline cellulose, and 0.5 wt. % talc.

7. The oral pharmaceutical composition claim 1 , wherein the trospium beads comprise 17.7 wt. % trospium chloride, 46.8 wt. % microcrystalline cellulose, 35 wt. % lactose monohydrate, and 0.5 wt. % talc.

8. The oral pharmaceutical composition of claim 1 , further comprising a capsule containing the plurality of xanomeline beads and the plurality of trospium beads.

9. An oral pharmaceutical composition, comprising:

a capsule containing a plurality of xanomeline beads and a plurality of trospium beads;

the plurality of xanomeline beads having a size between 0.6 mm and 0.85 mm, and a core comprising 66 wt. % xanomeline tartrate, 33.5 wt. % microcrystalline cellulose, and 0.5 wt. % talc; and

the plurality of trospium beads having a size between 0.6 mm and 0.85 mm, and a core comprising 17.7 wt. % trospium chloride, 46.8 wt. % microcrystalline cellulose, 35 wt. % lactose monohydrate, and 0.5 wt. % talc;

the plurality of xanomeline beads and the plurality of trospium beads each having a dissolution rate of more than about 95% within about the first 20 minutes following entry of the dosage form into an aqueous solution; and

wherein, when administered to a patient for at least 7 days at 20 mg trospium twice daily, providing a mean C max of trospium at 7850±3360 pg/mL and a mean AUC 0-12 of 41900±15500 hr·pg/mL.

10. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 25 mg xanomeline free base and 10 mg trospium chloride.

11. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 50 mg xanomeline free base and 20 mg trospium chloride.

12. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 50 mg xanomeline free base and 10 mg trospium chloride.

13. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 75 mg xanomeline free base and 10 mg trospium chloride.

14. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 75 mg xanomeline free base and 20 mg trospium chloride.

15. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 125 mg xanomeline free base and 20 mg trospium chloride.

16. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 125 mg xanomeline free base and 30 mg trospium chloride.

17. The oral pharmaceutical composition of claim 9 , wherein the capsule has a dosage strength of 125 mg xanomeline free base and 40 mg trospium chloride.

18. The oral pharmaceutical composition of claim 9 , wherein the xanomeline beads comprise less than 0.5 wt. % 3-[(4-hexyloxy)-1,2,5-thiadizaol-3-yl]-5-hydroyl-1-methylpyridin-1-ium.