CA2452874A1 - 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
CA2452874A1
CA2452874A1 CA002452874A CA2452874A CA2452874A1 CA 2452874 A1 CA2452874 A1 CA 2452874A1 CA 002452874 A CA002452874 A CA 002452874A CA 2452874 A CA2452874 A CA 2452874A CA 2452874 A1 CA2452874 A1 CA 2452874A1
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CA
Canada
Prior art keywords
oxymorphone
hydroxy
pharmaceutical composition
hydroxy oxymorphone
blood plasma
Prior art date
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Abandoned
Application number
CA002452874A
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French (fr)
Inventor
Huai-Hung Kao
Richard Smith-Carliss
Troy Mccall
David Lee
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Endo Pharmaceuticals Inc
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Individual
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Filing date
Publication date
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Application filed by Individual filed Critical Individual
Publication of CA2452874A1 publication Critical patent/CA2452874A1/en
Abandoned legal-status Critical Current

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Classifications

    • 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]

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

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 oxymorphone through oral administration of a pharmaceutical composition containing 6-hydroxy oxymorphone.
Summary of the Invention The present invention provides methods of treating pain by administering a pharmaceutical composition comprising 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 about 0.2 ng/mL. Most preferably blood plasma levels of 6-hydroxy oxymorphone of at least about 0.3 ng/mL during treatment. Methods for administering compositions comprising 6-hydroxy oxymorphone, 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 oxymorphone with PID scores.
Fig. 2 is a pharmacokinetic profile for oxymorphone with PID scores.
Fig. 3 is a pharmacokinetic profile for 6-hydroxy oxymorphone with categorical pam scores.
Fig. 4 is a pharmacokinetic profile for oxymorphone with categorical pain scores.

Detailed Description The methods described herein provide for the administration of a pharmaceutical composition containing 6-hydroxy oxymorphone as an active ingredient. In a preferred embodiment the preferred composition comprises 6-hydroxy oxymorphone alone (excepting, of course, carriers, diluents, and other excipients). In other preferred embodiments, 6-hydroxy oxyrnorphone may be combined with other opioids or other pharmaceutical agents. For example, another preferred embodiment provides compositions comprising both 6-hydroxy oxymorphone and its parent, oxymorphone.
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 oxymorphone and its metabolite , 6-hydroxy oxymorphone on pain can be evaluated.
The administration of oxymorphone yields blood plasma levels of oxymorphone and all of its metabolites, 6-hydroxy oxymorphone. Oxymorphone levels peak within 2 hours, fall slightly, and plateau. Interestingly, the level spikes again at 4-6 hours from administration. After this time, oxymorphone levels again drop and eventually fall to levels near the earlier plateau.
Like oxymorphone, 6-hydroxy oxymorphone blood plasma levels peak within 2 hours after administration. After the initial peak, however, a more or less steady decline in the 6-hydroxy oxymorphones plasma levels is observed.
Comparing these levels to the pain profiles, a correlation between the 6-hydroxy oxymorphone blood plasma levels and pain relief can be seen. The pain levels nearly mirror the 6-hydroxy oxymorphone levels, with substantial rises in relief near the spikes associated with 6-hydroxy oxymorphone blood levels. Thus, pain relief can be achieved through administration of 6-hydroxy oxymorphone alone.
In addition to the pharmacokinetic studies, binding studies have been conducted to compare the binding affinity of 6-hydroxy oxymorphone to that of oxymorphone.
The results are reported in TABLE 1. These results clearly indicate that 6-hydroxy oxymorphone has great binding affinity for the 8, K, and p receptor cites, comparable to the binding affinity of its parent. The inventors believe that by virtue of this binding affinity, 6-hydroxy oxymorphone has similar analgesic effects to its parent, oxymorphone.
TABLE 1: ASSAY REPORT

OXYMORPHONE

lOnm lOpm lOnm 10~.m 1.0 E-8 1.0 E-5 1.0 E-8 1.0 E-5 Opiate, Delta-4.12% 90.48% -18.26% 89.03%

Opiate, Delta7.19% 55.45% 7.76% 72.74%

(Human Recombinant) Opiate, Kappa2.45% 62.47% 10.35% 89.41%

(Human Recombinant) Opiate, Mu 63.16% 99.91% 85.42% 100.39%

(Human Recombinant) Accordingly, methods of administering the metabolite, 6-hydroxy oxymorphone, directly have been developed. It is believed that the ~i 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-a-hydroxy oxymorphone, 6-(3-hydroxy oxymorphone, 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 oxymorphone sufficient to induce analgesia will be supplied to the patient.
Blood plasma levels of 6-hydroxy oxymorphone 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 oxymorphone, may lead to respiratory failure and other undesirable side effects and can even result in death. Preferably, the blood plasma level of 6-hydroxy oxyrnorphone 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 oxymorphone 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 oxymorphone.
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 (8)

What is claimed is:
1. A method of treating pain comprising the step of:
administering to a patient a pharmaceutical composition comprising 6-hydroxy oxymorphone 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 blood plasma levels of 6-hydroxy oxymorphone 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 oxymorphone 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 oxymorphone, 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 oxymorphone and oxymorphone in an amount sufficient to induce analgesia.
8. A pharmaceutical composition comprising 6-hydroxy oxymorphone in a formulation for oral delivery to animals including hormone.
CA002452874A 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic Abandoned CA2452874A1 (en)

Applications Claiming Priority (9)

Application Number Priority Date Filing Date Title
US30335701P 2001-07-06 2001-07-06
US60/303,357 2001-07-06
US32943201P 2001-10-15 2001-10-15
US32944401P 2001-10-15 2001-10-15
US32944501P 2001-10-15 2001-10-15
US60/329,432 2001-10-15
US60/329,444 2001-10-15
US60/329,445 2001-10-15
PCT/US2002/021400 WO2003004032A1 (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic

Publications (1)

Publication Number Publication Date
CA2452874A1 true CA2452874A1 (en) 2003-01-16

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ID=27501826

Family Applications (3)

Application Number Title Priority Date Filing Date
CA2452871A Expired - Fee Related CA2452871C (en) 2001-07-06 2002-07-03 Oxymorphone controlled release formulations
CA002452874A Abandoned CA2452874A1 (en) 2001-07-06 2002-07-03 Oral administration of 6-hydroxy-oxymorphone for use as an analgesic
CA002452872A Abandoned CA2452872A1 (en) 2001-07-06 2002-07-03 Parenteral administration of 6-hydroxy-oxymorphone for use as an analgesic

Family Applications Before (1)

Application Number Title Priority Date Filing Date
CA2452871A Expired - Fee Related CA2452871C (en) 2001-07-06 2002-07-03 Oxymorphone controlled release formulations

Family Applications After (1)

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CA002452872A Abandoned CA2452872A1 (en) 2001-07-06 2002-07-03 Parenteral administration of 6-hydroxy-oxymorphone for use as an analgesic

Country Status (13)

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US (13) US20040214849A1 (en)
EP (4) EP1406630A1 (en)
JP (4) JP4440635B2 (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) WO2003004032A1 (en)

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