Ethanol-resistant sustained release formulations
The invention provides formulations that resist dose dumping in the presence of ethanol and methods of use thereof. The formulations can be used to prevent dose dumping, to increase safety of drugs, and to reduce abuse of drugs prone to such abuse. The formulations comprise at least one drug and a sustained release delivery system. In one embodiment, the drug is an opioid.
1 . A method of preventing dose-dumping of a drug in the presence of ethanol comprising: providing a patient likely to consume ethanol while being treated with the drug an effective amount of the drug in the form of an ethanol-resistant sustained release formulation comprising:
the drug; and
a sustained release delivery system,
the delivery system comprising at least one heteropolysaccharide gum, at least one homopolysaccharide gum and at least one pharmaceutical diluent, wherein the ethanol-resistant sustained release formulation essentially retains its sustained release dissolution profile in the presence of ethanol.
2 . The method of claim 1 , wherein the patient has a history of substance abuse.
3 . The method of claim 2 , wherein the substance abuse is alcohol abuse.
4 . The method of claim 2 , wherein the substance abuse is drug abuse.
5 . The method of claim 1 , wherein the ethanol-resistant sustained release formulation is a solid dosage formulation.
6 . The method of claim 5 , wherein the solid dosage formulation retains its dissolution profile when crushed or powdered.
7 . The method of claim 5 , wherein the solid dosage formulation forms a gel matrix with muco-adhesive properties when crushed or powdered upon contact with a fluid.
8 . The method of claim 5 , wherein the solid dosage formulation forms a viscous solution when crushed or powdered upon contact with a fluid.
9 . The method of claim 5 , wherein the solid dosage formulation is a tablet.
10 . The method of claim 1 , wherein the sustained release delivery system further comprises at least one hydrophobic polymer in an amount of less than about 5% by weight.
11 . The method of claim 1 , wherein the delivery system further comprises at least one cationic cross-linking compound selected from monovalent cations, multivalent cations, and salts.
12 . The method of claim 1 , wherein the drug is an anti-depressant.
13 . The method of claim 1 , wherein the drug is a drug used to treat bipolar disorder, panic disorder, epilepsy, migraine, and/or attention deficit hyperactivity disorder.
14 . The method of claim 1 , wherein the drug is an opioid.
15 . The method of claim 14 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
16 . The method of claim 14 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
17 . A method of preventing dose-dumping of a drug in the presence of ethanol comprising: providing a patient likely to consume ethanol while being treated with the drug an effective amount of the drug in the form of an ethanol-resistant sustained release formulation comprising:
the drug; and
a sustained release delivery system,
the delivery system comprising at least one heteropolysaccharide gum, at least one cationic cross-linking compound selected from monovalent metal cations, multivalent metal cations and salts, and at least one pharmaceutical diluent, wherein the ethanol-resistant sustained release formulation essentially retains its sustained release dissolution profile in the presence of ethanol.
18 . The method of claim 17 , wherein the patient has a history of substance abuse.
19 . The method of claim 18 , wherein substance abuse is alcohol abuse.
20 . The method of claim 18 , wherein the substance abuse is drug abuse.
21 . The method of claim 17 , wherein the ethanol-resistant sustained release formulation is a solid dosage formulation.
22 . The method of claim 21 , wherein the solid dosage formulation retains its dissolution profile when crushed or powdered.
23 . The method of claim 21 , wherein the solid dosage formulation forms a gel matrix with muco-adhesive properties when crushed or powdered upon contact with a fluid.
24 . The method of claim 21 , wherein the solid dosage formulation forms a viscous solution when crushed or powdered upon contact with a fluid.
25 . The method of claim 21 , wherein the solid dosage formulation is a tablet.
26 . The method of claim 17 , wherein the sustained release delivery system further comprises at least one hydrophobic polymer in an amount of less than about 5% by weight.
27 . The method of claim 17 , wherein the at least one cationic cross-linking compound is a sodium salt.
28 . The method of claim 17 , wherein the drug is an anti-depressant.
29 . The method of claim 17 , wherein the drug is a drug used to treat bipolar disorder, panic disorder, epilepsy, migraine, and/or attention deficit hyperactivity disorder.
30 . The method of claim 17 , wherein the drug is an opioid.
31 . The method of claim 30 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
32 . The method of claim 30 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
33 . A method of improving safety of a drug compared to conventional sustained release formulations in the presence of ethanol comprising providing a patient likely to consume ethanol while being treated with the drug an effective amount of the drug in the form of an improved-safety ethanol-resistant sustained release formulation comprising:
the drug; and
a sustained release delivery system,
the sustained release delivery system comprising at least one heteropolysaccharide gum, at least one homopolysaccharide gum and at least one pharmaceutical diluent, wherein the improved-safety is a result of ethanol-resistant sustained release properties of the formulation.
34 . The method of claim 33 , wherein the patient has a history of substance abuse.
35 . The method of claim 34 , wherein the substance abuse is alcohol abuse.
36 . The method of claim 34 , wherein the substance abuse is drug abuse.
37 . The method of claim 33 , wherein the ethanol-resistant sustained release formulation is a solid dosage formulation.
38 . The method of claim 37 , wherein the solid dosage formulation retains its dissolution profile when crushed or powdered.
39 . The method of claim 37 , wherein the solid dosage formulation forms a gel matrix with muco-adhesive properties when crushed or powdered upon contact with a fluid.
40 . The method of claim 37 , wherein the solid dosage formulation forms a viscous solution when crushed or powdered upon contact with a fluid.
41 . The method of claim 37 , wherein the solid dosage formulation is a tablet.
42 . The method of claim 33 , wherein the sustained release delivery system further comprises at least one hydrophobic polymer in an amount of less than about 5% by weight.
43 . The method of claim 33 , wherein the delivery system further comprises at least one cationic cross-linking compound selected from monovalent cations, multivalent cations, and salts.
44 . The method of claim 33 , wherein the drug is an anti-depressant.
45 . The method of claim 33 , wherein the drug is a drug used to treat bipolar disorder, panic disorder, epilepsy, migraine, and/or attention deficit hyperactivity disorder.
46 . The method of claim 33 , wherein the drug is an opioid.
47 . The method of claim 46 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
48 . The method of claim 46 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
49 . A method of improving safety of a drug compared to conventional sustained release formulations in the presence of ethanol comprising providing a patient likely to consume ethanol while being treated with the drug an effective amount of the drug in the form of an improved-safety ethanol-resistant sustained release formulation comprising:
the drug; and
a sustained release delivery system,
the delivery system comprising at least one heteropolysaccharide gum, at least one cationic cross-linking compound selected from monovalent metal cations, multivalent metal cations and salts, and at least one pharmaceutical diluent, wherein the improved-safety is a result of ethanol-resistant sustained release properties of the formulation.
50 . The method of claim 49 , wherein the patient has a history of substance abuse.
51 . The method of claim 50 , wherein substance abuse is alcohol abuse.
52 . The method of claim 50 , wherein the substance abuse is drug abuse.
53 . The method of claim 49 , wherein the ethanol-resistant sustained release formulation is a solid dosage formulation.
54 . The method of claim 53 , wherein the solid dosage formulation retains its dissolution profile when crushed or powdered.
55 . The method of claim 53 , wherein the solid dosage formulation forms a gel matrix with muco-adhesive properties when crushed or powdered upon contact with a fluid.
56 . The method of claim 53 , wherein the solid dosage formulation forms a viscous solution when crushed or powdered upon contact with a fluid.
57 . The method of claim 53 , wherein the solid dosage formulation is a tablet.
58 . The method of claim 49 , wherein the sustained release delivery system further comprises at least one hydrophobic polymer in an amount of less than about 5% by weight.
59 . The method of claim 49 , wherein the at least one cationic cross-linking compound is a sodium salt.
60 . The method of claim 49 , wherein the drug is an anti-depressant.
61 . The method of claim 49 , wherein the drug is a drug used to treat bipolar disorder, panic disorder, epilepsy, migraine, and/or attention deficit hyperactivity disorder.
62 . The method of claim 49 , wherein the drug is an opioid.
63 . The method of claim 62 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
64 . The method of claim 62 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
65 . A method for making a solid dosage ethanol-resistant sustained release formulation comprising:
at least one drug; and
a sustained release delivery system,
wherein the sustained release delivery system comprises at least one heteropolysaccharide gum, at least one homopolysaccharide gum, and at least one pharmaceutical diluent, the method comprising:
mixing the at least one heteropolysaccharide gum, the at least one homopolysaccharide gum and the at least one pharmaceutical diluent to form granules;
mixing the granules with at least one drug or a pharmaceutically acceptable salt thereof to form a granulated composition;
applying pressure to the granulated composition to make the formulation; and
recording a dissolution profile of the ethanol-resistant formulation in an ethanol-containing solution.
66 . The method of claim 65 , further comprising applying an outer coating onto at least part of the sustained release formulation.
67 . The method of claim 65 , wherein the at least one drug is an opioid.
68 . The method of claim 67 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
69 . The method of claim 67 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
70 . A method for making a solid dosage ethanol-resistant formulation comprising:
at least one drug; and
a sustained release delivery system,
wherein the sustained release delivery system comprises at least one heteropolysaccharide gum, at least one cationic cross-linking compound selected from monovalent metal cations, multivalent metal cations and salts, and at least one pharmaceutical diluent, the method comprising:
mixing the at least one heteropolysaccharide gum, the at least one cationic cross-linking compound selected from monovalent metal cations, multivalent metal cations and salts, and the at least one pharmaceutical diluent to form granules;
mixing the granules with at least one drug or a pharmaceutically acceptable salt thereof to form a granulated composition;
applying pressure to the granulated composition to make the formulation; and
recording a dissolution profile of the ethanol-resistant formulation in an ethanol-containing solution.
71 . The method of claim 70 , further comprising applying an outer coating onto at least part of the sustained release formulation.
72 . The method of claim 70 , wherein the at least one drug is an opioid.
73 . The method of claim 72 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
74 . The method of claim 72 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
75 . A method for treating a patient comprising providing a patient having a history of substance abuse an effective amount of the drug in the form of an ethanol-resistant sustained release formulation comprising:
at least one drug; and
a sustained release delivery system,
the delivery system comprising at least one heteropolysaccharide gum, at least one homopolysaccharide gum, and at least one pharmaceutical diluent, wherein the ethanol-resistant sustained release formulation essentially retains its sustained release dissolution profile in the presence of ethanol.
76 . The method of claim 75 , wherein the substance abuse is alcohol abuse.
77 . The method of claim 75 , wherein the substance abuse is drug abuse
78 . The method of claim 75 , wherein the ethanol-resistant formulation is a solid dosage formulation.
79 . The method of claim 78 , wherein the solid dosage formulation retains its dissolution profile when crushed or powdered.
80 . The method of claim 78 , wherein the solid dosage formulation forms a gel matrix with muco-adhesive properties when crushed or powdered upon contact with a fluid.
81 . The method of claim 78 , wherein the solid dosage formulation forms a viscous solution when crushed or powdered upon contact with a fluid.
82 . The method of claim 78 , wherein the solid dosage formulation is a tablet.
83 . The method of claim 75 , wherein the delivery system further comprises at least one hydrophobic polymer in an amount of less than about 5% by weight.
84 . The method of claim 75 , wherein the delivery system further comprises at least one cationic cross-linking compound selected from monovalent cations, multivalent cations, and salts.
85 . The method of claim 75 , wherein the drug is an anti-depressant.
86 . The method of claim 75 , wherein the drug is a drug used to treat bipolar disorder, panic disorder, epilepsy, migraine, and/or attention deficit hyperactivity disorder.
87 . The method of claim 75 , wherein the drug is an opioid.
88 . The method of claim 87 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
89 . The method of claim 87 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.
90 . A method for treating a patient comprising providing a patient having a history of substance abuse an effective amount of the drug in the form of an ethanol-resistant sustained release formulation comprising:
at least one drug; and
a sustained release delivery system,
the delivery system comprising at least one heteropolysaccharide gum, at least one cationic cross-linking compound selected from monovalent metal cations, multivalent metal cations and salts, and at least one pharmaceutical diluent, wherein the ethanol-resistant sustained release formulation essentially retains its sustained release dissolution profile in the presence of ethanol.
91 . The method of claim 90 , wherein the substance abuse is alcohol abuse.
92 . The method of claim 90 , wherein the substance abuse is drug abuse
93 . The method of claim 90 , wherein the ethanol-resistant formulation is a solid dosage formulation.
94 . The method of claim 93 , wherein the solid dosage formulation retains its dissolution profile when crushed or powdered.
95 . The method of claim 93 , wherein the solid dosage formulation forms a gel matrix with muco-adhesive properties when crushed or powdered upon contact with a fluid.
96 . The method of claim 93 , wherein the solid dosage formulation forms a viscous solution when crushed or powdered upon contact with a fluid.
97 . The method of claim 93 , wherein the solid dosage formulation is a tablet.
98 . The method of claim 90 , wherein the delivery system further comprises at least one hydrophobic polymer in an amount of less than about 5% by weight.
99 . The method of claim 90 , wherein the delivery system further comprises at least one cationic cross-linking compound selected from monovalent cations, multivalent cations, and salts.
100 . The method of claim 90 , wherein the drug is an anti-depressant.
101 . The method of claim 90 , wherein the drug is a drug used to treat bipolar disorder, panic disorder, epilepsy, migraine, and/or attention deficit hyperactivity disorder.
102 . The method of claim 90 , wherein the drug is an opioid.
103 . The method of claim 102 , wherein the opioid is a mu-agonist or a mixed mu-agonist/antagonist.
104 . The method of claim 102 , wherein the opioid is selected from the group consisting of alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazine, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, nalorphine, normophine, norpipanone, opium, oxycodone, oxymorphone, 6-hydroxyoxymorphone, papavereturn, pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine, piminodine, piritramide, propheptazine, promedol, properidine, propiram, propoxyphene, sufentanil, tramadol, tilidine, a stereoisomer thereof, a metabolite thereof, a salt thereof, an ether thereof, an ester thereof and a derivative thereof.