Modified release gamma-hydroxybutyrate formulations having improved pharmacokinetics
Modified release formulations of gamma-hydroxybutyrate having improved dissolution and pharmacokinetic properties are provided, and therapeutic uses thereof.
1. A method of treating cataplexy or excessive daytime sleepiness in a human patient with narcolepsy, the method comprising:
determining the patient has an apnea/hypopnea index equal to or lower than 15;
prescribing to the patient a once-nightly formulation that, after oral administration, releases gamma-hydroxybutyrate into the bloodstream of the patient, wherein the formulation includes an immediate-release portion and a modified-release portion, wherein each once-nightly dosage of the formulation releases an amount of gamma-hydroxybutyrate into the bloodstream equivalent to 3 g to 9 g of sodium oxybate, and wherein the prescribing takes place after the determining; and
instructing the patient to take the formulation only once per night while in bed and to lie down immediately after dosing.
2. The method of claim 1 , wherein oral administration to the patient does not provide a clinically significant worsening of respiratory function as measured by apnea/hypopnea index and pulse oximetry.
3. The method of claim 1 , wherein oral administration to the patient provides fewer instances of central apnea as compared to immediate-release sodium oxybate.
4. The method of claim 1 , wherein oral administration to the patient does not result in an oxygen desaturation of ≤55%.
5. The method of claim 1 , further comprising measuring polysomnography (PSG) of the patient.
6. A method of treating cataplexy or excessive daytime sleepiness in a human subject with narcolepsy:
identifying a first and a second human subject as having narcolepsy and being in need of treatment for cataplexy or excessive daytime sleepiness;
determining that the first subject has an apnea/hypopnea index equal to or lower than 15 and that the second subject has an apnea/hypopnea index greater than 15;
based, at least in part on the determining, prescribing to the first subject a once-nightly formulation that, after oral administration, releases gamma-hydroxybutyrate into the bloodstream of the patient, wherein the formulation includes an immediate-release portion and a modified-release portion, wherein each once-nightly dosage of the formulation releases an amount of gamma-hydroxybutyrate into the bloodstream equivalent to 4.5 g to 9 g of sodium oxybate; and
excluding the second subject from treatment with the formulation based, at least in part, on the determining.