Method for treatment of depression with oral dosage forms of ketamine
The present invention relates to an oral dosage form for administration of ketamine and a method of preparing an oral dosage form for administration of ketamine, preferably once or twice a day.
1. A method for treatment of depression said method comprising orally administering an oral dosage form comprising ketamine or a pharmaceutically acceptable salt or solvate thereof to a patient suffering from depression,
wherein the oral dosage form provides an in vitro release of ketamine, when measured according to the USP Basket Method I in 0.1M HCl at 37° C. at 100 rpm of 0 to 40% after 2 hours, of 10 to 70% after 4 hours, of 30 to 85% after 6 hours and of 45 to 100% after 8 hours,
wherein the oral dosage form provides an in vitro release of ketamine, when measured according to the USP 1 Basket Method in 0.1M HCl at 100 rpm, after one hour at 37° C., in an aqueous solution containing 20% by volume of ethanol, in a ratio of less than 2:1 relative to the amount of ketamine released, so measured, after one hour at 37° C. in an ethanol-free aqueous solution, and
wherein the oral dosage form is a matrix controlled release dosage form, an osmotic controlled release dosage form, or a multi particulate controlled release dosage form.
2. The method according to claim 1 wherein the oral dosage form is a tablet.
3. The method according to claim 1 , wherein the ketamine is a ketamine salt, wherein the ketamine salt is ketamine hydrochloride and wherein the amount comprised in the oral dosage form is in the range of from 5 to 400 mg ketamine hydrochloride.
4. The method according to claim 1 , wherein the oral dosage form is administered once or twice daily.
5. The method according to claim 1 wherein the oral dosage form is a multi-particulate tablet, wherein the tablet comprises
i) ketamine-containing cores comprising
1 to 30 wt. % inert beads,
1 to 40 wt. % ketamine,
0.01 to 10 wt. % binder, and
0 to 10 wt. % glidant,
ii) a release-control layer coated on each ketamine-containing core, comprising
1 to 40 wt. % release-control substance,
0.01 to 10 wt % pore builder,
0.01 to 10 wt. % plasticizer,
0 to 15 wt. % glidant,
and
iii) an external phase comprising
20 to 85 wt. % filler,
0 to 3 wt. % lubricant and
0 to 5 wt. % glidant,
wherein all wt. % are based on the total weight of the tablet.
6. The method according to claim 1 , wherein administration of a single oral dosage form leads in vivo to a C max of ketamine of 1 to 150 ng/ml and to a AUC 0-∞ of 5 to 1000 h·ng/ml.
7. The method according to claim 1 wherein the oral dosage form has an absolute bioavailability F abs of 5% to 25%.
8. The method according to claim 1 , wherein the oral dosage form is an osmotic controlled release dosage form.
9. The method according to claim 8 wherein the osmotic controlled release dosage form comprises an osmotic controlled release device selected from the group consisting of a one-chamber system, a two-chamber system, an asymmetric membrane technology, and an extruding core system.
10. The method according to claim 8 wherein the osmotic controlled release dosage form comprises an osmotic controlled release device, wherein the osmotic controlled release device comprises a core comprising ketamine, a pharmaceutically acceptable salt thereof, or solvate thereof, which is enveloped by a semipermeable membrane having at least one orifice.
11. The method according to claim 10 , wherein the semipermeable membrane comprises acrylics, vinyls, ethers, polyamides, polyesters cellulosic derivatives, or combinations thereof.
12. The method according to claim 1 , wherein the administration of a single oral dosage form leads in vivo to a C max of norketamine of 5 to 750 ng/ml and to a AUC 0-∞ of 100 to 8000 h·ng/ml and/or wherein T max of norketamine is 3 to 9 h, and/or having an absolute bioavailability F abs of 5% to 25%.
13. The method according to claim 1 , wherein administration of the oral dosage form provides for a T max of ketamine that is 3 h to 9 h.
14. The method according to claim 1 , wherein administration of the oral dosage form provides for a T max of ketamine that is 4 h to 7 h.
15. The method according to claim 1 , wherein the oral dosage form is a multi-particulate controlled release dosage form.
16. The method according to claim 15 , wherein the multi particulate controlled release dosage form comprises pellets, wherein the pellets comprise (i) a core comprising ketamine or a pharmaceutically acceptable salt or solvate thereof, and (ii) a release control layer coated upon the core.
17. The method according to claim 16 wherein the release control layer comprises a release control substance coated upon the core, wherein the release control substance is a water insoluble polymer.
18. The method according to claim 17 , wherein the release control substance is ethylcellulose.
19. The method according to claim 17 , wherein the pellets are contained in an external phase.
20. The method according to claim 19 , wherein the external phase comprises carboxymethyl cellulose, optionally in the form of a salt, as a pharmaceutically acceptable excipient.
21. The method according to claim 1 , wherein the oral dosage form is a matrix controlled release dosage form.
22. The method according to claim 21 , wherein the ketamine, pharmaceutically acceptable salt thereof, or solvate thereof, is dissolved or dispersed in an inert matrix and is released by diffusion through the inert matrix once administered.
23. The method according to claim 21 , wherein the matrix controlled release dosage form is a tablet.
24. The method according to claim 21 , wherein the ketamine is a ketamine salt, wherein the ketamine salt is ketamine hydrochloride and wherein the amount comprised in the matrix controlled release dosage form is in the range of from 5 to 400 mg ketamine hydrochloride.
25. The method according to claim 21 , wherein the matrix controlled release dosage form is administered once or twice daily.
26. The method according to claim 21 , wherein administration of a single matrix controlled release dosage form leads in vivo to a C max of ketamine of 1 to 150 ng/ml and to a AUC 0-∞ of 5 to 1000 h·ng/ml.
27. The method according to claim 21 , wherein the matrix controlled release dosage form has an absolute bioavailability F abs of 5 % to 25 %.
28. The method according to claim 8 , wherein the osmotic controlled release dosage form is a tablet.
29. The method according to claim 8 , wherein the ketamine is a ketamine salt, wherein the ketamine salt is ketamine hydrochloride and wherein the amount comprised in the osmotic controlled release dosage form is in the range of from 5 to 400 mg ketamine hydrochloride.
30. The method according to claim 8 , wherein the osmotic controlled release dosage form is administered once or twice daily.
31. The method according to claim 8 , wherein administration of a single osmotic controlled release dosage form leads in vivo to a C max of ketamine of 1 to 150 ng/ml and to a AUC 0-∞ of 5 to 1000 h·ng/ml.
32. The method according to claim 8 , wherein the osmotic controlled release dosage form has an absolute bioavailability F abs of 5% to 25%.
33. The method according to claim 15 , wherein the multi-particulate controlled release dosage form is a tablet.
34. The method according to claim 15 , wherein the ketamine is a ketamine salt, wherein the ketamine salt is ketamine hydrochloride and wherein the amount comprised in the multi-particulate controlled release dosage form is in the range of from 5 to 400 mg ketamine hydrochloride.
35. The method according to claim 15 , wherein the multi-particulate controlled release dosage form is administered once or twice daily.
36. The method according to claim 15 , wherein administration of a single multi-particulate controlled release dosage form leads in vivo to a C max of ketamine of 1 to 150 ng/ml and to a AUC 0-∞ of 5 to 1000 h˜ng/ml.
37. The method according to claim 15 , wherein the multi-particulate controlled release dosage form has an absolute bioavailability F abs of 5% to 25%.
38. The method according to claim 16 wherein
i) the core comprises
1 to 30 wt. % inert beads,
1 to 40 wt. % ketamine,
0.01 to 10 wt. % binder, and
0 to 10 wt. % glidant,
ii) the release-control layer comprises
1 to 40 wt. % release-control substance,
0.01 to 10 wt % pore builder,
0.01 to 10 wt. % plasticizer,
0 to 15 wt. % glidant,
and
iii) wherein the pellet further comprises an external phase, comprising
20 to 85 wt. % filler,
0 to 3 wt. % lubricant and
0 to 5 wt. % glidant,
wherein all wt. % are based on the total weight of the tablet.