CA2417930A1 - Pharmaceutical compositions containing lithium carbonate - Google Patents
Pharmaceutical compositions containing lithium carbonate Download PDFInfo
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- CA2417930A1 CA2417930A1 CA002417930A CA2417930A CA2417930A1 CA 2417930 A1 CA2417930 A1 CA 2417930A1 CA 002417930 A CA002417930 A CA 002417930A CA 2417930 A CA2417930 A CA 2417930A CA 2417930 A1 CA2417930 A1 CA 2417930A1
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- lithium carbonate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K33/00—Medicinal preparations containing inorganic active ingredients
-
- 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
- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
- A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
- A61K9/5005—Wall or coating material
- A61K9/5021—Organic macromolecular compounds
- A61K9/5036—Polysaccharides, e.g. gums, alginate; Cyclodextrin
- A61K9/5042—Cellulose; Cellulose derivatives, e.g. phthalate or acetate succinate esters of hydroxypropyl methylcellulose
- A61K9/5047—Cellulose ethers containing no ester groups, e.g. hydroxypropyl methylcellulose
-
- 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
-
- 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
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/06—Antimigraine agents
-
- 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
- A61P25/18—Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
-
- 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
- A61P25/24—Antidepressants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
- A61P31/14—Antivirals for RNA viruses
- A61P31/18—Antivirals for RNA viruses for HIV
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P37/00—Drugs for immunological or allergic disorders
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P7/00—Drugs for disorders of the blood or the extracellular fluid
Abstract
"Once-a-Day" pharmaceutical composition containing an amount of lithium carbonate from 300 mg to 900 mg, in the form of coated granules having the following composition: lithium carbonate 93%, ethylcellulose 1.7%, talc 0.8% , polyvinylpyrrolidone 4.5%.
Description
PHARMACEUTICAL COMPOSITIONS CONTAINING LITHIUM
CARBONATE
The present invention relates to a "Once-a-Day" lithium carbonate formulation.
The use of lithium salts in the treatment of depressive and manic disorders, psychosis, some types of cephalalgia, has been known for many years. One of the major drawbacks related with lithium therapy is its low therapeutic index on the one hand, and the need to ensure constant therapeutically useful concentrations, below the toxicity levels, on the other. An appropriate therapeutical regimen can be obtained with the preparations commercially available at present, carrying out two to three, daily administrations. Lithium carbonate is completely absorbed in 1 o the gastro-intestinal tract in about 8 hours, the plasma concentration peak being between 2 and 4 hours. After being absorbed, the cation is slowly distributed inside the cells of different organs and its distribution volume approaches 1 (0.7-0.9), reaching the steady state at a concentration in the liquor below 50%
compared with the plasmatic one. The starting half life, after the first administration, is reduced by the redistribution. The plasma half life at the steady state is 20-24 hours. More than 95% of lithium is eliminated through urine;
like sodium, 80% thereof is reabsorbed in the proximal convoluted tubule and has clearance corresponding to about 20% of that of the creatinine. The lower the peak lithium concentration in the plasma, the steadier its elimination. It is therefore desirable to have controlled release formulations to decrease the number of daily administrations and the value of the plasma peaks, thus avoiding to attain toxic concentrations while increasing the patient compliance.
The present invention relates to a "Once-a-Day" controlled release formulation of lithium carbonate which fulfils the pharmacokinetic requirements 2 5 mentioned above, ensuring a constant plasma concentration over the 24 hours at levels compatible with the established safety margins. The composition of the invention is in the form of a coated granulate and has the following contents, expressed in % by weight: lithium carbonate 93%, ethylcellulose 1.7%, talc 0.8%, polyvinylpyrrolidone 4.5%. The granules can be coated with known s techniques, preferably with the fluidized bed technique by spraying a solution of the coating agent (ethylcellulose) in ethanol, acetone and water on the active ingredient granules. The coated granules are then incorporated in a suitable carrier for the oral administration. Hard-gelatin capsules are the most preferred administration forms. Capsules are prepared according to conventional techniques, for example as described in Remington's Pharmaceutical Sciences Handbook, Mack Pub. Co., NY, USA, XVII Ed. In addition to gelatin and any dyes, the capsules can contain sodium lauryl sulfate and magnesium stearate, as solubilizer and diluent respectively.
The coated granules, incorporated in a suitable carrier, preferably in hard-is gelatin capsules, ensure a constant release rate of the active ingredient over the 24 hours, without giving raise to the plasma absorption peaks usually observed after lithium administration.
In a typical dissolution test carried out on six formulation samples, using a pH 1.1 solution in a flow-through dissolution apparatus (25 ml/min, 37°C), the 2o following release percentages over the 24 hours were obtained:
Table Release percentages HrsSamp.lSamp.2Samp.3Samp.4Samp.SSamp.6Mean M Max CV
in 1 9.1 8.5 8.5 8.9 9.2 8.9 8.9 _ 9.2 3.33 8.5 4 38.7 34.2 35.3 36.8 38.2 36.5 36.6 34.2 38.74.65 8 59.4 59.1 59.7 62.2 65.1 62.4 61.3 59.1 65.13.82 12 69.8 69.4 69.9 73.4 76.8 72.1 71.9 69.4 76.83.98 16 82.8 83.6 84 88.2 90.1 87.9 86.1 82.8 90.13.49 24 90 93.3 91.6 94.3 95.7 93.0 90 95.72.41 The data reported in the table clearly show the constant release rate of the active ingredient over the whole tested time.
Bioequivalence studies in comparison with a commercially available composition (CARBOLITHIUM~) containing lithium carbonate granules in microcapsules consisting of magnesium stearate, gelatin, titanium dioxide, indigotin, lactose, starch, methylcellulose, have been carried out. The results, s reported in the following examples, clearly show that the lithium plasma concentration remains constant over 24 hours after administration of the composition of the invention, avoiding the absorption peaks observed with the comparison formulation.
The particularly favourable pharmacokinetic allows the administration of a to single daily dose, remarkably increasing the patient compliance. The envisaged dosages for the active ingredient can range from a minimum of 300 mg to a maximum of 900 mg, depending on a number of factors such as the severity of the disorder to treat, the age, weight and conditions of the patient. Dosages of 300, 450 or, preferably, 600 mg of lithium carbonate in a single daily dose ensure ~s optimal results.
The "Once-a-Day" (in the following: 0aD) composition of the present invention will be used in the treatment of all those disorders which require the administration of lithium, such as depressive and manic conditions, psychosis, cephalalgia, drug leukopenia, hemopoietic diseases, immunologic diseases, AIDS
20 (in combination with AZT) and as antitumor agent.
The following examples illustrate the invention in greater detail.
CARBONATE
The present invention relates to a "Once-a-Day" lithium carbonate formulation.
The use of lithium salts in the treatment of depressive and manic disorders, psychosis, some types of cephalalgia, has been known for many years. One of the major drawbacks related with lithium therapy is its low therapeutic index on the one hand, and the need to ensure constant therapeutically useful concentrations, below the toxicity levels, on the other. An appropriate therapeutical regimen can be obtained with the preparations commercially available at present, carrying out two to three, daily administrations. Lithium carbonate is completely absorbed in 1 o the gastro-intestinal tract in about 8 hours, the plasma concentration peak being between 2 and 4 hours. After being absorbed, the cation is slowly distributed inside the cells of different organs and its distribution volume approaches 1 (0.7-0.9), reaching the steady state at a concentration in the liquor below 50%
compared with the plasmatic one. The starting half life, after the first administration, is reduced by the redistribution. The plasma half life at the steady state is 20-24 hours. More than 95% of lithium is eliminated through urine;
like sodium, 80% thereof is reabsorbed in the proximal convoluted tubule and has clearance corresponding to about 20% of that of the creatinine. The lower the peak lithium concentration in the plasma, the steadier its elimination. It is therefore desirable to have controlled release formulations to decrease the number of daily administrations and the value of the plasma peaks, thus avoiding to attain toxic concentrations while increasing the patient compliance.
The present invention relates to a "Once-a-Day" controlled release formulation of lithium carbonate which fulfils the pharmacokinetic requirements 2 5 mentioned above, ensuring a constant plasma concentration over the 24 hours at levels compatible with the established safety margins. The composition of the invention is in the form of a coated granulate and has the following contents, expressed in % by weight: lithium carbonate 93%, ethylcellulose 1.7%, talc 0.8%, polyvinylpyrrolidone 4.5%. The granules can be coated with known s techniques, preferably with the fluidized bed technique by spraying a solution of the coating agent (ethylcellulose) in ethanol, acetone and water on the active ingredient granules. The coated granules are then incorporated in a suitable carrier for the oral administration. Hard-gelatin capsules are the most preferred administration forms. Capsules are prepared according to conventional techniques, for example as described in Remington's Pharmaceutical Sciences Handbook, Mack Pub. Co., NY, USA, XVII Ed. In addition to gelatin and any dyes, the capsules can contain sodium lauryl sulfate and magnesium stearate, as solubilizer and diluent respectively.
The coated granules, incorporated in a suitable carrier, preferably in hard-is gelatin capsules, ensure a constant release rate of the active ingredient over the 24 hours, without giving raise to the plasma absorption peaks usually observed after lithium administration.
In a typical dissolution test carried out on six formulation samples, using a pH 1.1 solution in a flow-through dissolution apparatus (25 ml/min, 37°C), the 2o following release percentages over the 24 hours were obtained:
Table Release percentages HrsSamp.lSamp.2Samp.3Samp.4Samp.SSamp.6Mean M Max CV
in 1 9.1 8.5 8.5 8.9 9.2 8.9 8.9 _ 9.2 3.33 8.5 4 38.7 34.2 35.3 36.8 38.2 36.5 36.6 34.2 38.74.65 8 59.4 59.1 59.7 62.2 65.1 62.4 61.3 59.1 65.13.82 12 69.8 69.4 69.9 73.4 76.8 72.1 71.9 69.4 76.83.98 16 82.8 83.6 84 88.2 90.1 87.9 86.1 82.8 90.13.49 24 90 93.3 91.6 94.3 95.7 93.0 90 95.72.41 The data reported in the table clearly show the constant release rate of the active ingredient over the whole tested time.
Bioequivalence studies in comparison with a commercially available composition (CARBOLITHIUM~) containing lithium carbonate granules in microcapsules consisting of magnesium stearate, gelatin, titanium dioxide, indigotin, lactose, starch, methylcellulose, have been carried out. The results, s reported in the following examples, clearly show that the lithium plasma concentration remains constant over 24 hours after administration of the composition of the invention, avoiding the absorption peaks observed with the comparison formulation.
The particularly favourable pharmacokinetic allows the administration of a to single daily dose, remarkably increasing the patient compliance. The envisaged dosages for the active ingredient can range from a minimum of 300 mg to a maximum of 900 mg, depending on a number of factors such as the severity of the disorder to treat, the age, weight and conditions of the patient. Dosages of 300, 450 or, preferably, 600 mg of lithium carbonate in a single daily dose ensure ~s optimal results.
The "Once-a-Day" (in the following: 0aD) composition of the present invention will be used in the treatment of all those disorders which require the administration of lithium, such as depressive and manic conditions, psychosis, cephalalgia, drug leukopenia, hemopoietic diseases, immunologic diseases, AIDS
20 (in combination with AZT) and as antitumor agent.
The following examples illustrate the invention in greater detail.
Example I - Standard amounts for manufacturing 250,000 caasules of 600 m~ lithium carbonate controlled release capsules:
Lithium Carbonate 150 Kg Povidone 7,300 Kg s Ethylcellulose 2,575 Kg Talc 1,125 Kg Acetone* q. s.
Denaturated ethanol* q.s.
Water* q.s.
to * solvents used in the manufacturing process.
Preparation of the binder solution Water is placed in a stainless steel container equipped with pneumatic stirrer, then Povidone is poured therein, in small amounts. Stirring is continued until dissolution.
15 Preparation of the uncoated lithium carbonate anules One part of lithium carbonate is weighed and granulated in the granulator using the above described binder solution as granulation agent.
The humid granulate is passed through a 840 micron wire screen, dried at 40°C for 15 hours in a forced air circulation thermostatized drier and 2o subsequently the granulate is sieved through sieve with openings of 500 and micron.
The powder and the granules smaller than 500 micron are regranulated with the same procedure as described above, but using water as binder. At the end of the granulation process, granules are sieved through sieve with openings of 2s and 840 micron.
The resulting granulate is weighed and placed in the stainless steel container of the coating pan. While it rotates at a suitable rate to ensure efficient rotation of the mass (about 12 rpm), the binder solution is sprayed on the granules by a spraying device and the lithium carbonate powder is added.
Spraying is carned out at intervals to provide better evaporation of the solvent, which is removed by an aspiration system, and to avoid any bubbles.
Finally, the granulate is sieved through a 1200 micron wire screen and dried at 40°C for 15 hours in a forced air circulation thermostatized drier.
The granulate is sieved again through an 840 and 1200 micron mesh sieve.
Preparation of the coating_film in solution Acetone and denatured ethanol are placed in the stainless steel container, ethylcellulose is added, with stirnng. Stirring is continued until complete 1o dissolution.
Coating of the lithium carbonate anules The lithium carbonate granules are placed in a fiuidized bed and sprayed with the coating film.
Furthermore, small amounts of talc are poured onto the mass at the end of 1s each spraying stage, to improve free-flowing of the mass.
At the end of the operation, granules are forced through a 1200 micron wire screen. After completion of the coating cycle, the granulate is dried.
Finally the granulate is sieved through sieve with openings of 840 and 1340 micron.
2o Capsule filling The lithium carbonate formulation is filled into hard-gelatin capsules by means of a capsule filling machine programmed to fill hard-gelatin capsules with the desired weight (mg) of granulate.
Filled capsules are closed and collected under continuous visual control in a 25 double polyethylene bag placed in a tightly sealed metal container.
Example 2 - Bioe~uivalence study on the OaD lithium carbonate 600 m~
capsule formulation of the invention upon single administration compared with the 300 rn~ capsule Carbolithium ~ 300 formulation administered twice daily., s Experimental protocol A two phases clinical trial has been designed and carried out according to the EEC guidelines for clinical trials on pharmaceuticals.
The study was carried out on 1 ~ healthy volunteers.
s Figures 1 and 2 report the graphs based on the arithmetic means of the obtained results (each point is the mean of 1 ~ measurements = patients).
Comments on the results The 300+300 mg lithium formulation covers the 24 hours with its two peaks, between which an about 50% fall occurs; the 600 mg OaD lithium formulation of the invention has Cmax slightly higher than the first peak of the 300+300 mg formulation, but after 24 hours the plasma concentration is reduced by 25% only. The lithium 300+300 mg formulation has plasma half life of about 20 hours; the OaD lithium 600 mg formulation of the invention has half life of about 36 hours. These data prove that the formulation of the invention is ~s effective as expected, but that possible accumulation may occur after repeated administrations.
Example 3 - Bioequivalence stud~on the OaD lithium carbonate 300 mg capsule formulation of the invention upon single administration compared with the 300 m~ capsule Carbolithium ~ 300 formulation upon single administration 2o In order to better evaluate any accumulation risks, five healthy volunteers were subjected to single administration of the OaD 300 mg formulation of the invention in comparison with Carbolithium~ 300 mg control formulation.
The lithium plasma concentration of each subject was monitored up to 72 hours, and urine lithium content up to 96 hours after administration was 2s evaluated.
The graphs of Figures 3 and 4 disclose the results of the study.
Comments on the results 1. The plasma lithium profile confirms the observations of the phase 1 study:
the Cmax of the OaD formulation is half that of the Cmax of the control formulation, dosages being equal.
2. The Cmax of the control formulation is consistent with the known literature data.
3. After 24 hours, the plasma lithium concentration of both formulations is comparable (within the limits of the experimental fluctuations ascribable to the subj acts).
4. The OaD formulation of the invention provides better therapeutic efficacy as it can be seen from the graphs of the phase I study since, without inducing toxic plasma peaks (one peak only, below the Ctox value, compared with two peaks of the control formulation), prevents the fall of lithium plasma concentration (to 50%) which always takes place between the two administrations of the control formulation.
Lithium Carbonate 150 Kg Povidone 7,300 Kg s Ethylcellulose 2,575 Kg Talc 1,125 Kg Acetone* q. s.
Denaturated ethanol* q.s.
Water* q.s.
to * solvents used in the manufacturing process.
Preparation of the binder solution Water is placed in a stainless steel container equipped with pneumatic stirrer, then Povidone is poured therein, in small amounts. Stirring is continued until dissolution.
15 Preparation of the uncoated lithium carbonate anules One part of lithium carbonate is weighed and granulated in the granulator using the above described binder solution as granulation agent.
The humid granulate is passed through a 840 micron wire screen, dried at 40°C for 15 hours in a forced air circulation thermostatized drier and 2o subsequently the granulate is sieved through sieve with openings of 500 and micron.
The powder and the granules smaller than 500 micron are regranulated with the same procedure as described above, but using water as binder. At the end of the granulation process, granules are sieved through sieve with openings of 2s and 840 micron.
The resulting granulate is weighed and placed in the stainless steel container of the coating pan. While it rotates at a suitable rate to ensure efficient rotation of the mass (about 12 rpm), the binder solution is sprayed on the granules by a spraying device and the lithium carbonate powder is added.
Spraying is carned out at intervals to provide better evaporation of the solvent, which is removed by an aspiration system, and to avoid any bubbles.
Finally, the granulate is sieved through a 1200 micron wire screen and dried at 40°C for 15 hours in a forced air circulation thermostatized drier.
The granulate is sieved again through an 840 and 1200 micron mesh sieve.
Preparation of the coating_film in solution Acetone and denatured ethanol are placed in the stainless steel container, ethylcellulose is added, with stirnng. Stirring is continued until complete 1o dissolution.
Coating of the lithium carbonate anules The lithium carbonate granules are placed in a fiuidized bed and sprayed with the coating film.
Furthermore, small amounts of talc are poured onto the mass at the end of 1s each spraying stage, to improve free-flowing of the mass.
At the end of the operation, granules are forced through a 1200 micron wire screen. After completion of the coating cycle, the granulate is dried.
Finally the granulate is sieved through sieve with openings of 840 and 1340 micron.
2o Capsule filling The lithium carbonate formulation is filled into hard-gelatin capsules by means of a capsule filling machine programmed to fill hard-gelatin capsules with the desired weight (mg) of granulate.
Filled capsules are closed and collected under continuous visual control in a 25 double polyethylene bag placed in a tightly sealed metal container.
Example 2 - Bioe~uivalence study on the OaD lithium carbonate 600 m~
capsule formulation of the invention upon single administration compared with the 300 rn~ capsule Carbolithium ~ 300 formulation administered twice daily., s Experimental protocol A two phases clinical trial has been designed and carried out according to the EEC guidelines for clinical trials on pharmaceuticals.
The study was carried out on 1 ~ healthy volunteers.
s Figures 1 and 2 report the graphs based on the arithmetic means of the obtained results (each point is the mean of 1 ~ measurements = patients).
Comments on the results The 300+300 mg lithium formulation covers the 24 hours with its two peaks, between which an about 50% fall occurs; the 600 mg OaD lithium formulation of the invention has Cmax slightly higher than the first peak of the 300+300 mg formulation, but after 24 hours the plasma concentration is reduced by 25% only. The lithium 300+300 mg formulation has plasma half life of about 20 hours; the OaD lithium 600 mg formulation of the invention has half life of about 36 hours. These data prove that the formulation of the invention is ~s effective as expected, but that possible accumulation may occur after repeated administrations.
Example 3 - Bioequivalence stud~on the OaD lithium carbonate 300 mg capsule formulation of the invention upon single administration compared with the 300 m~ capsule Carbolithium ~ 300 formulation upon single administration 2o In order to better evaluate any accumulation risks, five healthy volunteers were subjected to single administration of the OaD 300 mg formulation of the invention in comparison with Carbolithium~ 300 mg control formulation.
The lithium plasma concentration of each subject was monitored up to 72 hours, and urine lithium content up to 96 hours after administration was 2s evaluated.
The graphs of Figures 3 and 4 disclose the results of the study.
Comments on the results 1. The plasma lithium profile confirms the observations of the phase 1 study:
the Cmax of the OaD formulation is half that of the Cmax of the control formulation, dosages being equal.
2. The Cmax of the control formulation is consistent with the known literature data.
3. After 24 hours, the plasma lithium concentration of both formulations is comparable (within the limits of the experimental fluctuations ascribable to the subj acts).
4. The OaD formulation of the invention provides better therapeutic efficacy as it can be seen from the graphs of the phase I study since, without inducing toxic plasma peaks (one peak only, below the Ctox value, compared with two peaks of the control formulation), prevents the fall of lithium plasma concentration (to 50%) which always takes place between the two administrations of the control formulation.
5. Furthermore, considering 100 the urine lithium removed with reference to ~5 the single administration of the control formulation, it can be deduced that the lithium removal with the formulation of the invention is reduced by half.
6. Residual lithium does not circulate in blood (it is apparently absorbed by the tissues) neither contributes to induce accumulation.
These data are due to the chemical nature of the product and to the fact that 20 lithium absorption, transport and elimination take place with a passive diffusion process and therefore with a rate which is linearly related with the originally available lithium concentration (upon administration). Therefore the administrations of lithium in low concentrations induce lower diffusion and elimination rates which, combined with the continuous release carried out by the 2s OaD formulation of the invention, allows to attain a steady state with constant lithium plasma concentration and no risks of accumulation.
The results prove that when using the OaD lithium carbonate formulation of the invention, accumulation is most unlikely to take place, and the product can be considered both clinically effective and safe.
Example 4 - Clinical trial with repeated administrations of OaD lithium carbonate formulation.
A clinical trial has been carried out by administration of the lithium carbonate formulation of the invention, in the form of controlled release 450 mg (C.450 OaD) and 600 g (C.600OaD) capsules, by single administration for 10 consecutive days to a group of 20 patients already under conventional therapy with lithium carbonate for a total of 20 days.
This trial aimed at verifying whether the formulations of the invention were to capable of producing a constant plasma concentration of Li+ upon repeated administrations at the steady state without inducing accumulation and with peaks compatible with the determined safety dosages.
The results of this trial are expressed in the two graphs of Figures 4 and 5, corresponding to the two tested dosages.
1s Fig. 4: Lithium plasma concentration (each point corresponds to a mean of 20 patients) upon repeated administrations of 450 mg OaD formulation of the invention.
Fig. 5: Lithium plasma concentration (mean of 20 patients) upon repeated administrations of 600 mg OaD formulation of the invention.
2o Comments on the results The lithium plasma concentration profiles clearly show that:
- the OaD lithium carbonate formulation of the invention is therapeutically effective;
- the "therapeutical yield" is higher, as the subjects who had been stabilised 2s with a therapeutical daily dose of 900 mg lithium carbonate conventional formulation maintained the steady state by single administration of the 600 mg OaD formulation;
- patients who had been stabilised with 600 mg of the conventional lithium s carbonate formulation maintained the steady state by single administration of the 450 mg OaD formulation.
Therefore the OaD formulation of the invention is a therapeutically effective, safer formulation, and solves the problem involved by the rather low s therapeutical index of lithium and can provide different dosages thus allowing to modulate the therapy according with the individual requirements of the patients.
These data are due to the chemical nature of the product and to the fact that 20 lithium absorption, transport and elimination take place with a passive diffusion process and therefore with a rate which is linearly related with the originally available lithium concentration (upon administration). Therefore the administrations of lithium in low concentrations induce lower diffusion and elimination rates which, combined with the continuous release carried out by the 2s OaD formulation of the invention, allows to attain a steady state with constant lithium plasma concentration and no risks of accumulation.
The results prove that when using the OaD lithium carbonate formulation of the invention, accumulation is most unlikely to take place, and the product can be considered both clinically effective and safe.
Example 4 - Clinical trial with repeated administrations of OaD lithium carbonate formulation.
A clinical trial has been carried out by administration of the lithium carbonate formulation of the invention, in the form of controlled release 450 mg (C.450 OaD) and 600 g (C.600OaD) capsules, by single administration for 10 consecutive days to a group of 20 patients already under conventional therapy with lithium carbonate for a total of 20 days.
This trial aimed at verifying whether the formulations of the invention were to capable of producing a constant plasma concentration of Li+ upon repeated administrations at the steady state without inducing accumulation and with peaks compatible with the determined safety dosages.
The results of this trial are expressed in the two graphs of Figures 4 and 5, corresponding to the two tested dosages.
1s Fig. 4: Lithium plasma concentration (each point corresponds to a mean of 20 patients) upon repeated administrations of 450 mg OaD formulation of the invention.
Fig. 5: Lithium plasma concentration (mean of 20 patients) upon repeated administrations of 600 mg OaD formulation of the invention.
2o Comments on the results The lithium plasma concentration profiles clearly show that:
- the OaD lithium carbonate formulation of the invention is therapeutically effective;
- the "therapeutical yield" is higher, as the subjects who had been stabilised 2s with a therapeutical daily dose of 900 mg lithium carbonate conventional formulation maintained the steady state by single administration of the 600 mg OaD formulation;
- patients who had been stabilised with 600 mg of the conventional lithium s carbonate formulation maintained the steady state by single administration of the 450 mg OaD formulation.
Therefore the OaD formulation of the invention is a therapeutically effective, safer formulation, and solves the problem involved by the rather low s therapeutical index of lithium and can provide different dosages thus allowing to modulate the therapy according with the individual requirements of the patients.
Claims (5)
1. "Once-a-Day" pharmaceutical composition containing an amount of lithium carbonate from 300 mg to 900 mg, in the form of coated granules having the following composition: lithium carbonate 93%, ethylcellulose 1.7%, talc 0.8%, polyvinylpyrrolidone 4.5%.
2. Composition as claimed in clam 1, in which said amount of lithium carbonate is selected from 300 mg, 450 mg and 600 mg.
3. Composition as claimed in claims 1-2, in which granules are filled into hard gelatin capsules.
4. The use of lithium carbonate for the preparation of a "once-a-day"
pharmaceutical composition as claimed in the above claims.
pharmaceutical composition as claimed in the above claims.
5. The use as claimed in clean 4, for the treatment of depressive and manic disorders, psychosis, cephalalgia, medicament leukopenia, hemopoietic diseases, immunolog diseases, tumors and AIDS.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| IT2000MI001868A IT1318677B1 (en) | 2000-08-10 | 2000-08-10 | Pharmaceutical composition useful in the treatment of depressive and manic disorders comprises lithium carbonate, ethyl cellulose, talc and polyvinylpyrrolidone |
| ITMI2000A001868 | 2000-08-10 | ||
| ITMI2001A000299 | 2001-02-14 | ||
| ITMI20010299 ITMI20010299A1 (en) | 2001-02-14 | 2001-02-14 | PHARMACEUTICAL COMPOSITION CONTAINING LITHIUM CARBONATE |
| PCT/EP2001/009054 WO2002011740A2 (en) | 2000-08-10 | 2001-08-06 | 'slow release' pharmaceutical compositions comprising lithium carbonate |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2417930A1 true CA2417930A1 (en) | 2002-02-14 |
Family
ID=26332755
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002417930A Abandoned CA2417930A1 (en) | 2000-08-10 | 2001-08-06 | Pharmaceutical compositions containing lithium carbonate |
Country Status (11)
| Country | Link |
|---|---|
| US (3) | US6989159B2 (en) |
| EP (1) | EP1315480B1 (en) |
| JP (1) | JP2004505923A (en) |
| CN (1) | CN1230150C (en) |
| AT (1) | ATE295154T1 (en) |
| AU (1) | AU2001291738A1 (en) |
| BR (1) | BR0113070A (en) |
| CA (1) | CA2417930A1 (en) |
| DE (1) | DE60110814D1 (en) |
| EA (1) | EA200300128A1 (en) |
| WO (1) | WO2002011740A2 (en) |
Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| ITMI20010220A1 (en) * | 2001-02-05 | 2002-08-05 | Valpharma Sa | MULTI-PARTICULAR FORMULATIONS FOR ORAL ADMINISTRATION OF LITHIUM SALTS SUITABLE FOR ADMINISTRATION PER DAY |
| US20040241252A1 (en) * | 2003-05-29 | 2004-12-02 | Abney Christopher Charles | Pharmaceutical compositions for oral administration comprising lithium carbonate, processes of making the same, and methods of administering the same |
| WO2005102366A2 (en) * | 2004-04-19 | 2005-11-03 | Philip Maxwell Satow | Lithium combinations, and uses related thereto |
| WO2008022472A1 (en) * | 2006-08-23 | 2008-02-28 | Heinz Forster | Pharmaceutical composition |
| WO2008067409A2 (en) * | 2006-11-28 | 2008-06-05 | Polyplus Battery Company | Protected lithium electrodes for electro-transport drug delivery |
| US20090005824A1 (en) * | 2007-06-29 | 2009-01-01 | Polyplus Battery Company | Electrotransport devices, methods and drug electrode assemblies |
| US20090069740A1 (en) * | 2007-09-07 | 2009-03-12 | Polyplus Battery Company | Protected donor electrodes for electro-transport drug delivery |
| FR2999426B1 (en) * | 2012-12-13 | 2015-01-02 | Flamel Tech Sa | MULTIPARTICULAR ORAL FORM WITH IMMEDIATE RELEASE OF AT LEAST ONE ACTIVE COMPOUND, INCLUDING MILL RESISTANT MIXED PARTICLES. |
Family Cites Families (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2016922B (en) | 1978-02-17 | 1982-08-18 | Delandale Lab Ltd | Sustained release lithium carbonate tables |
| US4264573A (en) * | 1979-05-21 | 1981-04-28 | Rowell Laboratories, Inc. | Pharmaceutical formulation for slow release via controlled surface erosion |
| SE509029C2 (en) * | 1988-08-16 | 1998-11-30 | Ss Pharmaceutical Co | Long-acting diclofenac sodium preparations |
| US5133974A (en) * | 1989-05-05 | 1992-07-28 | Kv Pharmaceutical Company | Extended release pharmaceutical formulations |
| HU206824B (en) | 1990-08-24 | 1993-01-28 | Biogal Gyogyszergyar | Process for the production of a table crystallizing in the monoclinic system, which contains light-, heat-, and moisture- sensitive active agents |
| JP2001518493A (en) * | 1997-10-03 | 2001-10-16 | スミスクライン・ビーチャム・コーポレイション | Controlled release solid dosage form of lithium carbonate |
-
2001
- 2001-08-06 AT AT01971873T patent/ATE295154T1/en active
- 2001-08-06 EA EA200300128A patent/EA200300128A1/en unknown
- 2001-08-06 CN CNB018139760A patent/CN1230150C/en not_active Expired - Fee Related
- 2001-08-06 JP JP2002517075A patent/JP2004505923A/en active Pending
- 2001-08-06 EP EP01971873A patent/EP1315480B1/en not_active Expired - Lifetime
- 2001-08-06 CA CA002417930A patent/CA2417930A1/en not_active Abandoned
- 2001-08-06 BR BR0113070-6A patent/BR0113070A/en not_active IP Right Cessation
- 2001-08-06 DE DE60110814T patent/DE60110814D1/en not_active Expired - Lifetime
- 2001-08-06 WO PCT/EP2001/009054 patent/WO2002011740A2/en active Application Filing
- 2001-08-06 US US10/343,997 patent/US6989159B2/en not_active Expired - Fee Related
- 2001-08-06 AU AU2001291738A patent/AU2001291738A1/en not_active Abandoned
-
2005
- 2005-05-05 US US11/122,742 patent/US20050208154A1/en not_active Abandoned
-
2007
- 2007-10-29 US US11/978,703 patent/US20080124390A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| AU2001291738A1 (en) | 2002-02-18 |
| ATE295154T1 (en) | 2005-05-15 |
| DE60110814D1 (en) | 2005-06-16 |
| EP1315480B1 (en) | 2005-05-11 |
| US20080124390A1 (en) | 2008-05-29 |
| EA200300128A1 (en) | 2003-08-28 |
| CN1446082A (en) | 2003-10-01 |
| CN1230150C (en) | 2005-12-07 |
| BR0113070A (en) | 2003-07-08 |
| EP1315480A2 (en) | 2003-06-04 |
| WO2002011740A3 (en) | 2002-04-18 |
| US6989159B2 (en) | 2006-01-24 |
| WO2002011740A2 (en) | 2002-02-14 |
| JP2004505923A (en) | 2004-02-26 |
| US20040013746A1 (en) | 2004-01-22 |
| US20050208154A1 (en) | 2005-09-22 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| FZDE | Discontinued |