WO2003004032A1 - Oral administration of 6-hydroxy-oxymorphone for use as an analgesic - Google Patents

Oral administration of 6-hydroxy-oxymorphone for use as an analgesic Download PDF

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Publication number
WO2003004032A1
WO2003004032A1 PCT/US2002/021400 US0221400W WO03004032A1 WO 2003004032 A1 WO2003004032 A1 WO 2003004032A1 US 0221400 W US0221400 W US 0221400W WO 03004032 A1 WO03004032 A1 WO 03004032A1
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WO
WIPO (PCT)
Prior art keywords
hydroxy
oxymoφhone
pharmaceutical composition
plasma levels
blood plasma
Prior art date
Application number
PCT/US2002/021400
Other languages
French (fr)
Inventor
Huai-Hung Kao
Richard Smith-Carliss
Troy Mccall
David Lee
Original Assignee
Endo Pharmaceuticals, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Family has litigation
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Application filed by Endo Pharmaceuticals, Inc. filed Critical Endo Pharmaceuticals, Inc.
Priority to AU2002316582A priority Critical patent/AU2002316582B2/en
Priority to CA002452874A priority patent/CA2452874A1/en
Priority to DE60219478T priority patent/DE60219478T2/en
Priority to EP02746895A priority patent/EP1414458B1/en
Priority to JP2003510043A priority patent/JP2005515966A/en
Publication of WO2003004032A1 publication Critical patent/WO2003004032A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/485—Morphinan derivatives, e.g. morphine, codeine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/02—Inorganic compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
    • A61K47/38—Cellulose; Derivatives thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2009—Inorganic compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2013—Organic compounds, e.g. phospholipids, fats
    • A61K9/2018—Sugars, or sugar alcohols, e.g. lactose, mannitol; Derivatives thereof, e.g. polysorbates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2022—Organic macromolecular compounds
    • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2022—Organic macromolecular compounds
    • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
    • A61K9/2054—Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
    • A61K9/2086—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
    • A61K9/209—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat containing drug in at least two layers or in the core and in at least one outer layer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/04—Centrally acting analgesics, e.g. opioids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • the invention relates to methods for alleviating pain. More particularly, the invention relates to methods for alleviating pain by administering 6-hydroxy oxymorphone. Most particularly, the invention relates to methods of inducing analgesia by increasing blood plasma levels of 6-hydroxy oxymo ⁇ hone through oral administration of a pharmaceutical composition containing 6-hydroxy oxymo ⁇ hone.
  • the present invention provides methods of treating pain by administering a pharmaceutical composition comprising 6-hydroxy oxymo ⁇ hone in an amount sufficient to induce analgesia.
  • the pharmaceutical composition is administered orally. Any known or later developed method of oral delivery may be used.
  • blood plasma levels of 6-hydroxy oxymo ⁇ hone are raised to at least about 0.2 ng/mL. Most preferably blood plasma levels of 6-hydroxy oxymo ⁇ hone of at least about 0.3 ng/mL during treatment.
  • Methods for administering compositions comprising 6-hydroxy oxymo ⁇ hone, and one or more carriers, diluents, and excipients in an amount sufficient to induce analgesia are also provided.
  • Fig. 1 is a pharmacokinetic profile for 6-hydroxy oxymo ⁇ hone with PID scores.
  • Fig. 2 is a pharmacokinetic profile for oxymo ⁇ hone with PID scores.
  • Fig. 3 is a pharmacokinetic profile for 6-hydroxy oxymo ⁇ hone with categorical pain scores.
  • Fig. 4 is a pharmacokinetic profile for oxymo ⁇ hone with categorical pain scores. Detailed Description
  • the methods described herein provide for the administration of a pharmaceutical composition containing 6-hydroxy oxymo ⁇ hone as an active ingredient.
  • the preferred composition comprises 6-hydroxy oxymo ⁇ hone alone (excepting, of course, carriers, diluents, and other excipients).
  • 6-hydroxy oxymo ⁇ hone may be combined with other opioids or other pharmaceutical agents.
  • another preferred embodiment provides compositions comprising both 6-hydroxy oxymo ⁇ hone and its parent, oxymo ⁇ hone.
  • FIGs. 1-4 show graphical representation of the data combining the two studies such that the effect of blood plasma levels of oxymo ⁇ hone and its metabolite , 6-hydroxy oxymo ⁇ hone on pain can be evaluated.
  • Oxymo ⁇ hone levels peak within 2 hours, fall slightly, and plateau. Interestingly, the level spikes again at 4-6 hours from administration. After this time, oxymo ⁇ hone levels again drop and eventually fall to levels near the earlier plateau.
  • 6-hydroxy oxymo ⁇ hone blood plasma levels peak within 2 hours after administration. After the initial peak, however, a more or less steady decline in the 6-hydroxy oxymo ⁇ hones plasma levels is observed.
  • Formulation as a suspension, syrup, or other liquid, tablet, capsule, liquid-filled gel cap, or other solid or semi-solid means may be used.
  • the composition may alternately be in the form of a time release formulation, including timed, suspended and extended release formulations.
  • an amount of 6-hydroxy oxymo ⁇ hone sufficient to induce analgesia will be supplied to the patient.
  • Blood plasma levels of 6-hydroxy oxymo ⁇ hone must be raised to levels sufficient to induce the desired level of analgesia.
  • the amount administered will be dependent upon normal criteria such as patient weight, intensity of pain, and other factors. Based on the pharmacokinetic studies, blood plasma levels around at least 0.2 ng mL will provide some analgesia. The upper plasma level limit will be ultimately established by safety concerns.
  • the blood plasma level of 6-hydroxy oxymo ⁇ hone will be raised to at least 0.3 ng/mL. Subsequent doses may be required to maintain these blood levels.
  • the preferred administration is of 6-hydroxy oxymo ⁇ hone with appropriate carriers and excipients as will be readily apparent to those skilled in the art.
  • the resulting blood plasma in these preferred administrations will therefore be substantially free of oxymo ⁇ hone.

Abstract

In a method of treating pain, a patient is administered a pharmaceutical composition of 6-hydroxy oxymorphone in an amount sufficient to induce analgesia. In one embodiment, the pharmaceutical composition is administered orally. Any known or later developed method of oral delivery may be used. To achieve the desired analgesic effect, blood plasma levels of 6-hydroxy oxymorphone are raised to at least approximately 0.2 ng/mL. Most preferably blood plasma levels of 6-hydroxy oxymorphone range at least 0.3 ng/mL during treatment. Administration of compositions containing 6-hydroxy oxymorphone, and one or more carriers, diluents, and excipients in an amount sufficient to induce analgesia is also contemplated.

Description

ORAL ADMINISTRATION OF 6-HYDROXY-OXYMORPHONE FOR USE AS AN ANALGESIC
This application relates to provisional patent application serial nos. 60/329,445 filed October 15, 2001, .60/329,432 filed October 15, 2001, 60/303,357 filed July 6, 2001, and 60/329,444 filed October 15, 2001.
Background Field of Invention
The invention relates to methods for alleviating pain. More particularly, the invention relates to methods for alleviating pain by administering 6-hydroxy oxymorphone. Most particularly, the invention relates to methods of inducing analgesia by increasing blood plasma levels of 6-hydroxy oxymoφhone through oral administration of a pharmaceutical composition containing 6-hydroxy oxymoφhone.
Summary of the Invention
The present invention provides methods of treating pain by administering a pharmaceutical composition comprising 6-hydroxy oxymoφhone in an amount sufficient to induce analgesia. In one embodiment, the pharmaceutical composition is administered orally. Any known or later developed method of oral delivery may be used. To achieve the desired analgesic effect, blood plasma levels of 6-hydroxy oxymoφhone are raised to at least about 0.2 ng/mL. Most preferably blood plasma levels of 6-hydroxy oxymoφhone of at least about 0.3 ng/mL during treatment. Methods for administering compositions comprising 6-hydroxy oxymoφhone, and one or more carriers, diluents, and excipients in an amount sufficient to induce analgesia are also provided.
Brief Description of the Drawings
Fig. 1 is a pharmacokinetic profile for 6-hydroxy oxymoφhone with PID scores. Fig. 2 is a pharmacokinetic profile for oxymoφhone with PID scores. Fig. 3 is a pharmacokinetic profile for 6-hydroxy oxymoφhone with categorical pain scores.
Fig. 4 is a pharmacokinetic profile for oxymoφhone with categorical pain scores. Detailed Description
The methods described herein provide for the administration of a pharmaceutical composition containing 6-hydroxy oxymoφhone as an active ingredient. In a preferred embodiment the preferred composition comprises 6-hydroxy oxymoφhone alone (excepting, of course, carriers, diluents, and other excipients). In other preferred embodiments, 6-hydroxy oxymoφhone may be combined with other opioids or other pharmaceutical agents. For example, another preferred embodiment provides compositions comprising both 6-hydroxy oxymoφhone and its parent, oxymoφhone.
In two separate studies, blood plasma levels and indications of pain relief were recorded over a 12 hour period after. Figs. 1-4 show graphical representation of the data combining the two studies such that the effect of blood plasma levels of oxymoφhone and its metabolite , 6-hydroxy oxymoφhone on pain can be evaluated.
The administration of oxymoφhone yields blood plasma levels of oxymoφhone and all of its metabolites, 6-hydroxy oxymoφhone. Oxymoφhone levels peak within 2 hours, fall slightly, and plateau. Interestingly, the level spikes again at 4-6 hours from administration. After this time, oxymoφhone levels again drop and eventually fall to levels near the earlier plateau.
Like oxymoφhone, 6-hydroxy oxymoφhone blood plasma levels peak within 2 hours after administration. After the initial peak, however, a more or less steady decline in the 6-hydroxy oxymoφhones plasma levels is observed.
Comparing these levels to the pain profiles, a correlation between the 6-hydroxy oxymoφhone blood plasma levels and pain relief can be seen. The pain levels nearly mirror the 6-hydroxy oxymoφhone levels, with substantial rises in relief near the spikes associated with 6-hydroxy oxymoφhone blood levels. Thus, pain relief can be achieved through administration of 6-hydroxy oxymoφhone alone.
In addition to the pharmacokinetic studies, binding studies have been conducted to compare the binding affinity of 6-hydroxy oxymoφhone to that of oxymoφhone. The results are reported in TABLE 1. These results clearly indicate that 6-hydroxy oxymoφhone has great binding affinity for the δ, K, and μ receptor cites, comparable to the binding affinity of its parent. The inventors believe that by virtue of this binding affinity, 6-hydroxy oxymoφhone has similar analgesic effects to its parent, oxymoφhone.
TABLE 1: ASSAY REPORT
Figure imgf000005_0001
Accordingly, methods of administering the metabolite, 6-hydroxy oxymoφhone, directly have been developed. It is believed that the β isomer has greater efficacy in the treatment of pain, but this disclosure is not limited to use of that isomer alone. Pharmaceutical compositions containing either 6-α-hydroxy oxymoφhone, 6-β-hydroxy oxymoφhone, or mixtures thereof can be used in the invention.
Formulation as a suspension, syrup, or other liquid, tablet, capsule, liquid-filled gel cap, or other solid or semi-solid means may be used. The composition may alternately be in the form of a time release formulation, including timed, suspended and extended release formulations. Regardless of the formulation, an amount of 6-hydroxy oxymoφhone sufficient to induce analgesia will be supplied to the patient. Blood plasma levels of 6-hydroxy oxymoφhone must be raised to levels sufficient to induce the desired level of analgesia. The amount administered will be dependent upon normal criteria such as patient weight, intensity of pain, and other factors. Based on the pharmacokinetic studies, blood plasma levels around at least 0.2 ng mL will provide some analgesia. The upper plasma level limit will be ultimately established by safety concerns. Over-dosing of any opioid, including 6-hydroxy oxymoφhone, may lead to respiratory failure and other undesirable side effects and can even result in death. Preferably, the blood plasma level of 6-hydroxy oxymoφhone will be raised to at least 0.3 ng/mL. Subsequent doses may be required to maintain these blood levels.
The preferred administration is of 6-hydroxy oxymoφhone with appropriate carriers and excipients as will be readily apparent to those skilled in the art. The resulting blood plasma in these preferred administrations will therefore be substantially free of oxymoφhone.
The above description encompasses some preferred embodiments of the invention. This disclosure is merely illustrative in nature and is not intended to limit the following claims.

Claims

CLAIMSWhat is claimed is:
1. A method of treating pain comprising the step of: administering to a patient a pharmaceutical composition comprising 6-hydroxy oxymoφhone in an amount sufficient to induce analgesia.
2. The method of claim 1 wherein said pharmaceutical composition is administered orally.
3. The method of claim 2 wherein said pharmaceutical composition is administered in a form selected from a liquid formulation, syrup, suspension, solid formulation, tablet, capsule, liquid-filled gel cap, and a semi-solid formulation.
4. The method of claim 1 wherein said administration is sufficient to raise bipod plasma levels of 6-hydroxy oxymoφhone to at least about 0.2 ng/mL.
5. The method of claim 1 wherein said administration is sufficient to raise blood plasma levels of 6-hydroxy oxymoφhone to at least about 0.3 ng/mL.
6. A method of treating pain comprising the step of: orally administering to a patient a pharmaceutical composition comprising 6- hydroxy oxymoφhone, and one or more carriers, diluents, and excipients in an amount sufficient to induce analgesia.
7. A method of treating pain comprising the step of: orally administering to a patient a pharmaceutical composition comprising 6- hydroxy oxymoφhone and oxymoφhone in an amount sufficient to induce analgesia.
8. A pharmaceutical composition comprising 6-hydroxy oxymoφhone in a formulation for oral delivery to animals including hormone.
PCT/US2002/021400 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic WO2003004032A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
AU2002316582A AU2002316582B2 (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic
CA002452874A CA2452874A1 (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic
DE60219478T DE60219478T2 (en) 2001-07-06 2002-07-03 ORAL GIVEN OF 6-HYDROXY-OXYMORPHONE AS ANALGETIC
EP02746895A EP1414458B1 (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic
JP2003510043A JP2005515966A (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US30335701P 2001-07-06 2001-07-06
US60/303,357 2001-07-06
US32944401P 2001-10-15 2001-10-15
US32943201P 2001-10-15 2001-10-15
US32944501P 2001-10-15 2001-10-15
US60/329,444 2001-10-15
US60/329,432 2001-10-15
US60/329,445 2001-10-15

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WO2003004032A1 true WO2003004032A1 (en) 2003-01-16

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PCT/US2002/021398 WO2003004031A1 (en) 2001-07-06 2002-07-03 Parenteral administration of 6-hydroxy-oxymorphone for use as an analgesic
PCT/US2002/021400 WO2003004032A1 (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic
PCT/US2002/021396 WO2003004030A1 (en) 2001-07-06 2002-07-03 Oxymorphone controlled release formulations

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PCT/US2002/021396 WO2003004030A1 (en) 2001-07-06 2002-07-03 Oxymorphone controlled release formulations

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US (13) US9820982B2 (en)
EP (4) EP1404333A1 (en)
JP (4) JP2005520778A (en)
KR (1) KR20030034171A (en)
CN (3) CN1551770A (en)
AT (1) ATE359077T1 (en)
AU (3) AU2002318211B2 (en)
BR (1) BR0205721A (en)
CA (3) CA2452871C (en)
DE (1) DE60219478T2 (en)
ES (1) ES2284888T3 (en)
NO (1) NO20031018L (en)
WO (3) WO2003004031A1 (en)

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