CN1646102B - 含有羟氢可待酮和烯丙羟吗啡酮的药物制剂 - Google Patents

含有羟氢可待酮和烯丙羟吗啡酮的药物制剂 Download PDF

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CN1646102B
CN1646102B CN038077965A CN03807796A CN1646102B CN 1646102 B CN1646102 B CN 1646102B CN 038077965 A CN038077965 A CN 038077965A CN 03807796 A CN03807796 A CN 03807796A CN 1646102 B CN1646102 B CN 1646102B
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dihydrohydroxycodeinone
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比安卡·布罗格曼
西尔克·米劳
克里斯托弗·斯皮茨利
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Abstract

本发明是关于一种含有用于治疗疼痛的羟氢可待酮及纳洛酮的贮存稳定性药物制剂，其特征在于活性化合物是以持续、稳定及独立的方式自该制剂释放。

Description

含有羟氢可待酮和烯丙羟吗啡酮的药物制剂
本发明涉及一种含有羟氢可待酮(oxycodone)及纳洛酮(naloxone)的贮存稳定的药物制剂。 
治疗癌症、风湿病及关节炎等疾病造成的严重疼痛是治疗这些疾病的核心。肿瘤患者所感受到的疼痛范围包括骨膜及骨头本身的疼痛，以及内脏痛与软组织痛。所有这类疼痛使得患者日常生活难以忍受且经常导致抑郁状态。因此，可让病人生活质量持续改善成功的疼痛治疗，与综合疗法(此疗法是针对该疾病的实际病因加以治疗)的成功同等重要。 
有关成功疼痛治疗的重要性，世界卫生组织(WHO)已经开发出治疗肿瘤疼痛患者的四步骤模式。此模式在日常操作上已经证明是有效的，且可延伸至患有慢性疼痛的患者、或患有癌症以外的疾病所造成的疼痛类型的患者。根据疼痛的强度、性质及位置，此疗法过程中可区分出四步骤，且直到所使用的疼痛缓解药物的效果不再足够，则需要下一步骤(Ebell.H.J.；Bayer A.(Ed.)：Die Schmerzbehandlung von Tmuorpatienten，Thieme1994(Supportive Maβnahmen in der Onkologie，Band 3)和Zech，D.；Grond，S.；Lynch，J.；Hertel，D.；Lehmann，K.：Validation of World Health OrganisationGuidelines for Cancer Pain Relief：a 10-year prospective study，Pain(1995)，63，65-76)。 
根据WHO的这种四步骤模式，类鸦片(opioid)止痛剂在治疗疼痛上扮演着核心角色。除了代表这种药学活性药剂原型的吗啡之外，类鸦片止痛剂也包括羟氢可待酮、二氢吗啡酮(hydromorphone)、二烟酰吗啡(nicomorphine)、二氢可待因(dihydrocodeine)、海洛因(diamorphine)、阿片金碱(papaveretum)、可待因、乙基吗啡、苯基哌啶及其衍生物；美沙酮(methadone)、右丙氧芬(dextropropoxyphene)、叔丁啡(buprenorphine)、喷他佐辛(pentazocine)、痛立定(tilidine)、曲马多(tramadol)及二氢可待因酮(hydrocodone)。WHO的ATC分类法(解剖学治疗化学分类法)指明一药学活性药物是否代表一类鸦片止痛剂。类鸦片止痛剂的显著疼痛缓解作用是由  于模拟内源性、吗啡样作用物质(内源性阿片样物质)的作用所致，该内源性吗啡样作用物质的生理学功能在于控制疼痛刺激的接收与处理。 
类鸦片抑制疼痛刺激的扩散。除了立即压抑脊髓内由类鸦片所引起的神经元兴奋性讯息传导作用之外，一种自脑杆发射至脊髓的神经途径活化作用也有关联。此活化作用导致脊髓内的疼痛扩散现象受到抑制。再者，类鸦片限制丘脑接收疼痛，并通过对边缘系统(limbic sytem)发生作用而影响情感性疼痛的评价。 
类鸦片受体可于体内不同位置发现。肠与脑的受体对通过类鸦片的疼痛治疗尤其重要，特别是当这些受体被占据而导致不同副作用时。 
若类鸦片止痛剂以高亲合性结合至类鸦片受体、且诱使疼痛的接收受到强烈抑制，则该类鸦片止痛剂视为强效的激动剂。以高亲合力与类鸦片受体结合但不引起疼痛接收减少从而拮抗类阿片激动剂的物质被设计为拮抗剂。根据结合行为及所诱发的活性，类鸦片可分类为单纯激动剂、混合型激动剂/拮抗剂、及单纯拮抗剂。举例而言，单纯拮抗剂包括例如纳曲酮(naltrexone)、纳洛酮(naloxone)、纳美芬(nalmefene)、烯丙吗啡(nalorphine)、环丁甲羟氢吗啡(nalbuphine)、纳洛酮爱新(naloxoneazinen)、甲基纳曲酮(methylnaltrexone)、凯迪赛新(ketylcyclazocine)、若宾纳芬明(norbbinaltorphimine)、纳屈吲哚(naltrindol)、6-β-纳龙头(naloxol)及6-β-纳淬头(naltrexol)(Forth W.，；Henschler，D.；Rummel W.；Starke，K.：Allgemeineund Spezielle Pharmakologie und Toxikologie，7.Auflage，1996，SpetrumAkademischer Verlag，Heidelberg Berlin Oxford)。 
由于其良好的止痛功效，羟氢可待酮、痛立定、叔丁啡及喷他佐辛等化合物早已以治疗疼痛的药物形式而使用。例如 
Figure S03807796519960401D000021
(其中羟氢可待因是止痛活性的化合物)及 
Figure S03807796519960401D000022
(其中痛立定是止痛活性的化合物)等药物已经证实对治疗疼痛有效。 
然而，使用类鸦片止痛剂治疗疼痛可能一并伴随着不理想的副作用。故长期使用类鸦片止痛剂可导致心理及生理依赖性。 
特别是受疼痛所苦的患者对于类鸦片止痛剂的生理依赖性会导致耐药性的发展，这意味着伴随着长期摄入药物，患者为了要获得疼痛缓解，则渐渐提高疼痛缓解药物的剂量。类鸦片止痛剂令人心情愉快的作用经常造成疼痛缓解药物的滥用。药物滥用及心理依赖性是常见现象，尤其发生在  青少年之间。这些危险性的影响尤其是由强效止痛能力的物质引起的，影响范围由不理想的习惯到完全发展为成瘾。但是这些物质是合法地使用于医疗用途上，且药物中不能没有这些物质。 
除了上述缺点之外，使用类鸦片止痛剂治疗疼痛通常也会导致下列不理想的副作用：例如顽固性便秘、呼吸压抑(breath depression)、呕吐及镇静。比较不常观察到是，迫切需要喝水或无法喝水。已经完成各种尝试来对抗上瘾过程发生于疼痛治疗中的其他副作用。可利用例如传统治疗等方法造成这类尝试。就药物成瘾而言，可尝试药物停止疗法；就顽固性便秘而言，可施用通泻剂。 
其他尝试通过施用对抗该类鸦片止痛剂的拮抗剂，其目的在于将上瘾和习惯养成倾向以及其他副作用减少至最低。这类拮抗剂可以是纳曲酮或纳洛酮。 
目前有关如何施用上述活性化合物而能避免不理想的习惯养成及依赖性，或甚至成瘾已经有许多建议与教导。 
美国专利US 3,773,955及3,966,940建议，当肠胃外给药时，为了预防依赖性增进作用例如心情愉快等，将止痛剂与纳曲酮组合制剂。至今尚无法避免顽固性便秘等副作用。 
为了限制经口用药形式的肠胃外滥用，美国专利US 4,457,933建议将吗啡与纳曲酮于特定剂量范围内组合。该专利也没有提及如何避免顽固性便秘等副作用。 
同样为了避免滥用，美国专利US 4,582,835描述一种不是肠胃外施用或舌下施用的制剂，其含有叔丁啡与纳曲酮的组合。 
德国专利申请DE 0352361A1涉及通过口服类鸦片止痛剂与拮抗剂治疗疼痛治疗过程中的顽固性便秘，该拮抗剂是纳曲酮或纳洛酮的前药形式。避免类鸦片止痛剂的滥用并非该申请案的重点。 
德国专利申请DE 4325465A1也涉及利用含有类鸦片止痛剂与拮抗剂的制剂治疗疼痛治疗过程中的顽固性便秘。该案揭示的技术特征为：拮抗剂(可以是烯丙烃吗啡酮)的剂量一定要比类鸦片止痛剂(优选吗啡)的剂量更高。这是为了确保拮抗剂可表现抗顽固性便秘的功效，但不降低激动剂的止痛活性。避免类鸦片止痛剂的滥用并非该申请案的重点。 
为了要避免疼痛治疗过程中的副作用，例如顽固性便秘及呼吸抑制，  市面上已经导入可经口施用的制剂，其含有类鸦片止痛剂与类鸦片拮抗剂(纳洛酮)。Windrop/Sterling公司的药品 
Figure S03807796519960401D000041
含有喷他佐辛与纳洛酮。Godeke公司的药品 含有痛立定-纳洛酮的组合。 
除了强止痛功效、减少成瘾可能性及避免副作用之外，适用于疼痛治疗的药物还应该提供更多特征。 
一般而言，药物必须配制成活性化合物于标准贮存条件下尽可能稳定的方式。药物也必须配制成活性化合物预定的释放模式(release profiles)不随长期贮存而改变的形式。 
再者，(同样也就激动剂/拮抗剂的组合而论)每一个单一活性化合物的释放模式应该可以视需要选择。为了达到此目的，所采用的措施不应该阻扰、甚至阻止其它活性化合物(例如，就不同活性化合物的组合时)的释放模式。因此，释放模式应该没有相互依赖性。 
适用于疼痛治疗的药物应该含有活性化合物的剂量为患者只有在极少情况下才必须服用，或者应该以患者只有在极少情况下才必须服用该药物的方式调配。疼痛缓解剂的用药流程愈简单，患者愈能掌握其为何应该且应该以多高频率服用哪一个片剂，则病人更能确实遵照医生的命令。只是偶尔才有服用疼痛缓解剂的必要，将使得病人服用该疼痛解除剂的意愿高(顺从性)。 
曾经尝试经由使用所谓的缓释制剂(即，活性化合物以长时间自药物释放的药物制剂)来减少止痛药物必须用药的频率，藉此增加患者的顺从性。这种缓释制剂也使得“类鸦片止痛剂的缓释可减少该活性化合物的成瘾可能性”一事得以理解。 
由于活性化合物的成瘾可能性并非由该化合物本身决定，而是由施用该化合物的方式及所得到的药效学而定。除了类鸦片的促精神作用之外，大脑与类鸦片接触的频率，比该活性化合物本身而言，更是产生依赖性风险的决定性指标(Nolte，T.：STK-Zeitschrift fur angewandte Schmerztherapie，2001，Vol.2)。 
Purdue公司的药物 是类鸦片止痛剂羟氢可待酮以持续方式释放的制剂。由于此种配方，必须服用该药物的频率与上瘾可能性降低，然而副作用仍存在，且无法排除发展成瘾的危险，因为 
Figure S03807796519960401D000044
不含有类鸦片拮抗剂。 
根据先前提及的欧洲专利申请EP 0352361A，类鸦片止痛剂或拮抗剂都没有配制成以持续方式释放。故此种制剂能有效作用的时间受到限制，且该制剂必须每天施用多次，无法达到所期望的病人顺从性。此专利申请案中也没有揭示该制剂配方的优点是以活性化合物的经时稳定和独立释放为特征。该制剂的贮存稳定性也未记载于该案的技术内容中。 
德国专利申请DE 4325465A1揭示的配方可预防疼痛治疗过程中发生的顽固性便秘，其是利用持续释放类鸦片止痛剂，超量存在的拮抗剂则一定不能以持续方式释放。由于纳洛酮的高首过效应，因此必须使用相当大量的该化合物。此专利申请案并没有揭示制剂的优点，也无该制剂的配方，该制剂是以活性合物的经时稳定和独立释放为特征。这类制剂的贮存稳定性并非该案技术内容的重点。故医生根据此案技术内容而使用制剂时，每次当他想增加剂量，就必须进行大量的滴定实验。 
Godeke公司提供商品名为 
Figure S03807796519960401D000051
的疼痛缓解剂，其含有痛立定-纳洛酮的组合。根据产品说明，其是使用一种配方可让两种活性化合物以持续方式释放。所使用的基质包括适当比例的水可膨胀物质(HPMC)，故该基质被视为一种可膨胀(可能有部分腐蚀性)的扩散基质(diffusion matrix)。此种已知配方的缺点为，痛立定与纳洛酮是给予相同的质量比，但绝对含量不同，故两种化合物会呈现不同的释放模式。激动剂与拮抗剂的释放速率互相独立，可能是由所使用的持续释放配方所致。因此，医生若想要增加剂量，即使并不改变痛立定：纳洛酮的质量比时，由于他无法确定两种组分的释放模式将维持不变，医生必须对于每一位个体患者进行大量滴定实验。因此，医生对于该止痛剂可采用的治疗上有用的剂量范围受到限制。 
本发明的目的之一是提供一种具有高止痛活性的用于疼痛治疗的药物制剂，其特征在于降低了滥用可能性及副作用，该制剂也以用药频率降低为特征，故该制剂也提供更高的顺从性以及每位患者独立适应剂量的能力。本发明的另一目的在于提供在疼痛治疗中有效的药物制剂的配方，其确保该药物制剂的活性化合物经历一段长贮存期间仍是稳定的，且即使经过长期贮存之后，该活性化合物的释放可再现地保持不变且独立。 
本案独立权利要求的特征组合能够实现本发明的这些目的，本发明的其他目的可参见本发明的说明内容。本发明的优选实施方案则定义于从属权利要求中。 
根据本发明，其目的通过提供一种含有羟氢可待酮及纳洛酮的贮存稳定性药物制剂而达成，其中该制剂调配制成得活性化合物以持续、稳定及独立的方式释放。 
通过羟氢可待酮(止痛有效的量)及纳洛酮的组合，确保本发明的制剂呈现有效的止痛活性，同时抑制或至少显著降低常见的副作用，例如顽固性便秘、呼吸压抑及发展为成瘾。长期稳定的基质配方能长期地确保激动剂与拮抗剂总是以预先设定的百分比释放，且其释放速率彼此之间互不干扰。如此，阻止了该药物的滥用，该滥用需要羟氢可待酮可自该配方选择性地提取出来。根据本发明的配方使得激动剂无法从没有对应量的拮抗剂的制剂选择性地提取出来，此与所选择的激动剂与拮抗剂的绝对及相对含量无关。 
再者，根据本发明的药物的配方确保相对含量一样的活性化合物会呈现一样的释放模式，与绝对含量无关。当最佳的激动剂/拮抗剂比例为已知时，则此种独立的释放行为给医师提供止痛活性物质大范围的可使用的绝对剂量。因此，每一位个别的患者有可能舒服自在地调整剂量，逐步增加剂量，或者若有必要，逐步降低剂量。由医药观点而言，个别患者具有可调整剂量的能力是极为有用的。 
本发明的技术特征，包括持续、稳定且独立地释放活性化合物，更可保证根据本发明所生产的药物制剂是以用药频率低为其特征，因此可达到高度的患者顺从性。此外，本发明的制剂允许医生针对个别患者调整剂量。本发明的制剂保证可使用大范围的活性化合物所适用的绝对剂量，并保证活性化合物即使在长期贮存之后仍可恢复功效、且有相同的释放模式。 
根据本发明，活性化合物的持续释放是指药学活性物质自药物释放所经历的时间比该物质由用于快速释放的已知配方所释放的时间更长。优选释放经历2至24小时，2至20小时，更优选历经2至16小时或2至12小时，此是根据合乎法律与管制要求的说明。 
根据本发明，能够确保活性化合物自制剂如上所述般持续释放的药物配方称之为阻滞((retard)配方、持续释放配方或缓释(prolonged release)配方。本发明的技术内容中，“持续释放”并不表示活性化合物自配方或药物释放是以pH-依赖性方式。根据本发明，活性化合物的释放是以不依赖pH的方式。根据本发明，“持续释放”一词是表示活性化合物历经长时间自药物释  放。此并不意味着在某一特定位置控制释放，故并不表示该活性化合物只在胃内释放，或仅在肠道释放。(当然此种在特定位置的释放可分别通过药物的肠溶衣实现，但目前此种方式似乎并无好处。) 
根据本发明，“独立释放”是指假定至少存在两种活性化合物，改变一种化合物的绝对含量并不影响另一化合物的释放模式，故另一化合物的释放模式没有改变。根据本发明的配方，此种独立释放行为不依赖于测量释放的pH值、标的或制备方法。pH独立性尤其应用于酸性范围，即pH值小于7。释放模式(或释放行为)定义为活性化合物自配方释放的随时间、所释放的每一种活性化合物的量(以占活性化合物总量的百分比表示)的变化。释放模式的测定是利用已知测试方法。 
详言之，例如以乙羟氢可待酮的释放模式为例，若具有相同配方的对应制剂中含有12mg羟氢可待酮、但含有6mg纳洛酮，则可发现具有12mg羟氢可待酮与4mg纳洛酮的羟氢可待酮/纳洛酮-组合并不改变乙羟氢可待酮的释放模式。 
独立释放的特征优选涉及一种将具有实质上相等组成的制剂的释放模式作一比较的状况。具有实质上相等组成的制剂具有不同含量的活性化合物，但实质上影响释放行为的组合组份基本上是相同的。 
若比较上述制剂(第一制剂含有12mg羟氢可待酮与4mg纳洛酮，第二制剂含有12mg羟氢可待酮与6mg纳洛酮)，假设两种制剂的总重量相同，若纳洛酮含量的差异被取代为配方中一种通常不会影响释放行为的组成份时，则将得到相同的羟氢可待酮与纳洛酮的释放模式。如下文实施例部分所示，纳洛酮的含量差异可被取代为一典型的药学惰性填充剂，例如乳糖，此取代不改变释放模式。 
本领域技术人员知道，若两种制剂的差异在于活性化合物的含量，将该化合物的含量取代为该配方的释放行为所必须的物质时，例如乙基纤维素或脂肪醇，可产生释放行为的差异。因此，独立释放特征优选应用在下列配方，其具有不同含量的活性化合物，而实质上影响释放行为的组成份是相同的、或至少高度相似(设定比较具有相同总重的配方)。 
根据本发明，“稳定释放行为”或“稳定释放模式”定义为若绝对含量改变，每单位时间所释放的每一种活性化合物的绝对含量百分比不明显改变且充分地保持恒定(故不实质上改变)。充分恒定的百分比是指每单位时间  所释放的百分比与平均值的差异不超过20％，优选不超过15％，更优选不超过10％。平均值是由释放模式的六次测量值计算出来的。当然，每单位时间的释放量必须符合法律与管制要求。 
详言之，若设定一种羟氢可待酮/纳洛酮的组合含有12mg羟氢可待酮与4mg纳洛酮，于最初的4小时释放25％的羟氢可待酮及20％的纳洛酮。若该羟氢可待酮/纳洛酮的组合含有24mg羟氢可待酮及8mg纳洛酮，于最初的4小时也释放25％羟氢可待酮及20％纳洛酮。两种情况中，差异都将不超过平均值的20％(此例子的平均值为25％的羟氢可待酮及20％的纳洛酮)。 
如同简要描述独立释放行为，稳定释放特征也优选指一种将具有实质上相等组成的制剂的释放模式作一比较的状况。这类制剂的活性化合物含量不同，但就影响释放的制剂组分而言，这类制剂的组成相同或至少高度相似。典型地，活性化合物的含量差异将以实质上不影响该制剂的释放行为的药学惰性赋形剂取代。这类药学赋形剂可以是乳糖，其为药物制剂中的典型填充剂。本领域技术人员将充分理解此稳定释放特征不能应用在下列制剂，其中活性化合物含量的差异被实质上影响该制剂释放行为的已知物质取代，例如乙基纤维素或脂肪醇。 
实施例部分中已经说明，若一制剂含有20mg羟氢可待酮与1mg纳洛酮、或含有20mg羟氢可待酮与10mg纳洛酮，其差异在于纳洛酮被乳糖取代，如此具有相同重量的两种制剂提供相同的释放模式，故这两种制剂呈现持续、稳定且独立的释放行为。 
根据本发明，“贮存稳定的”或“贮存稳定性”表示在标准条件下(于室温及一般湿度下至少2年)，药物配方中的活性化合物含量与最初含量的差异不超过一般药典的说明或指导方针所示的数值。根据本发明，贮存稳定性也指根据本发明制备的制剂可在标准条件下(60％相对湿度，25℃)贮存，如同获得上市许可所需的条件。 
根据本发明，“贮存稳定的”或“时间稳定的”也表示在标准条件下贮存之后，活性化合物呈现的释放模式同该化合物不贮存而立即使用一样。根据本发明，释放模式有关的可接受的变化特征在于，每单位时间的释放量变化相对于平均值不超过20％，优选不超过15％，且特别优选不超过10％。平均值是由释放模式的六次测量值计算出来的。 
优选地，根据美国药典(USP)的药蓝(Basket Method)方法，于pH＝1.2或pH＝6.5利用HPLC测定活性化合物自持续释放配方中的释放。 
贮存稳定性的测定优选按照USP的药篮方法，于pH＝1.2、利用HPLC进行。 
根据本发明，“非可膨胀的(non-swellable)”或“基本上非可膨胀的”扩散基质是一种基质配方，活性化合物的释放不受该基质的膨胀(尤其是在病人体内的相关靶位置的生理液体内)的影响(或至少相当程度不受影响)。 
根据本发明，“基本上非可膨胀的”扩散基质也指一种基质，其体积于水溶液中(尤其是在病人体内相关靶位置的生理液体内)将增加约300％，优选约200％，更优选约100％、约75％或约50％，甚至更优选约30％或约20％，且最优选约15％、约10％、约5％或约1％。 
本发明的技术内容中，“激动剂”或“止痛剂”总是指羟氢可待酮。本发明的技术内容中，“拮抗剂”总是指纳洛酮。 
根据本发明制备的制剂可经口、经鼻、经直肠和/或通过吸入而施用于疼痛治疗。根据本发明，肠胃外用药并未设想。特别优选经口施用的配方。 
尽管并未详细说明，术语“激动剂”或“拮抗剂”总是包括可药用且同等作用的衍生物、盐类等。例如，若提及羟氢可待酮或纳洛酮，除了游离碱之外，还包括其盐酸盐、硫酸盐、硫酸氢盐、酒石酸盐、硝酸盐、柠檬酸盐、酒石酸氢盐、磷酸盐、苹果酸盐、马来酸盐、氢溴酸盐、氢磺酸盐、富马酸盐、琥珀酸盐等。 
根据本发明，激动剂及拮抗剂以下述方式配制：使两者以持续、独立且稳定的方式由所制得的药物制剂中释放。此并不意味着拮抗剂比激动剂过量。相反，在含有激动剂/拮抗剂的组合的配方中(其显示根据本发明的释放模式)，优选激动剂比拮抗剂过量。 
激动剂的过量根据组合制剂中拮抗剂的单位剂量的含量而定。类鸦片激动剂的过量程度通常以激动剂相对于拮抗剂的重量比表示。 
羟氢可待酮及纳洛酮的情况下，激动剂相对于拮抗剂的优选重量比在最大为25∶1的重量比范围内，特别是重量比范围为15∶1、10∶1、5∶1、4∶1、3∶1、2∶1及1∶1。 
所使用的激动剂与拮抗剂的绝对含量依赖于活性化合物的选择。根据本发明，必须注意到激动剂与拮抗剂是以独立且稳定的方式，由已经制备 成稳定释放的药物制剂释放。 
若使用羟氢可待酮与纳洛酮来调配组合制剂，每单位剂量优选包含10至150mg、更优选包含10至80mg羟氢可待酮(应用的典型剂量)，并优选包含1至50mg纳洛酮。 
本发明的其他优选实施方案中，该制剂可含有5至50mg羟氢可待酮、10至40mg羟氢可待酮、10至30mg羟氢可待酮、或约20mg羟氢可待酮。本发明的优选实施方案也可包括每单位剂量具有1至40mg纳洛酮、1至30mg纳洛酮、1至20mg纳洛酮、或1至10mg纳洛酮的制剂。 
根据本发明，选择羟氢可待酮与纳洛酮的比例，必须保证得到根据本发明的两种活性物质的释放模式，且激动剂可发挥其止痛功效；并采取可减少或消除激动剂的习惯成性或成瘾增进作用及副作用的方式来选择拮抗剂的剂量，但不(实质上)影响激动剂的止痛作用。根据本发明，形成习惯及成瘾，以及顽固性便秘与呼吸压抑，皆视为具有止痛作用的类鸦片激动剂的副作用。 
根据本发明，可使用普遍常用的配方，只要这些配方能确保活性化合物以持续、独立且稳定的方式自该制剂释放。根据本发明，必须选择可让活性化合物贮存稳定的配方。 
优选使用基于基质(Matrix-based)的阻滞(retardation)配方，作为提供根据本发明的激动剂与拮抗剂释放的配方。根据本发明，特别优选基于基本上非可膨胀性扩散基质的配方。此时，不优选具有腐蚀性基质或可膨胀的扩散基质的配方。 
根据本发明，必须选择可提供活性化合物持续释放的基质，使该活性化合物以持续、独立且稳定的方式释放。优选此种基质含有基于乙基纤维素的聚合物，而乙基纤维素是特别优选的聚合物。特别优选含有市售的商品名为 的聚合物的基质。尤其优选使用 
Figure DEST_PATH_RE-S03807796520070123D000022
E-7-7050。 
具有本发明释放行为的配方特别包括下述基质，该基质含有乙基纤维素与至少一种脂肪醇作为实质上影响该基质释放特性的组分。乙基纤维素及至少一种脂肪醇的含量可明显不同，如此可得到具有不同释放模式的制剂。尽管创新的(inventive)制剂通常含有上述两种组分，有些情况下，优选制剂只含有乙基纤维素或脂肪醇作为决定释放的组分。 
根据本发明，目前优选避免下列基质：基于聚甲基丙烯酸酯的基质(例 如， RS30D及 RL30D)、或含有适量水可膨胀材料的基质，尤其是羟烷基纤维素衍生物，例如HPMC。 
根据本发明的基质可用来生产以持续、独立且稳定的方式释放活性化合物、且每单位时间释放等量活性化合物的制剂。具体是指，就含有12mg羟氢可待酮及4mg纳洛酮的羟氢可待酮/纳洛酮组合而言，在最初4小时内释放25％的可待酮及25％的羟丙羟吗啡酮；相应地，就含有24mg羟氢可待酮及8mg纳洛酮的羟氢可待酮/纳洛酮组合而言，在最初4小时内释放25％的羟氢可待酮及25％的纳洛酮；此两种情况下的变化都不超过平均值(此时为25％的羟氢可待酮或纳洛酮)的20％。 
从医药方面考虑，两种活性化合物有这种相同的释放行为是理想的。 
本发明的优选实施方案是关于15分钟之后释放1％至40％、优选5％至35％、更优选10％至30％、进一步优选15％至25％的羟氢可待酮和/或纳洛酮的制剂的制备。本发明的其他优选实施方案中，15％至20％、20％至25％、约15％、约20％或约25％的羟氢可待酮和/或纳洛酮于15分钟之后释放。 
本发明的另一优选实施方案是关于1小时之后，释放25％至65％、优选30％至60％、更优选35％至55％、特别优选40％至50％的羟氢可待酮和/或纳洛酮的制剂。本发明的优选实施方案也涉及40％至45％、45％至50％、约40％、约45％或约50％的羟氢可待酮和/或纳洛酮于1小时之后释放的制剂。 
本发明又一优选实施方案是关于2小时之后，释放40％至80％、优选45％至75％、更优选45％至70％、进一步优选45％至50％、50％至55％、55％至60％、60％至65％或65％至70％的羟氢可待酮和/或纳洛酮的制剂。优选实施方案也包括约45％、约50％、约55％、约60％、约65％或约70％的羟氢可待酮和/或纳洛酮于2小时之后释放的制剂。 
本发明的一个优选实施方案是关于4小时之后，释放70％至100％、优选75％至95％、更优选80％至95％、进一步优选80％至90％的羟氢可待酮和/或纳洛酮的制剂。本发明的优选实施方案也涉及80％至85％、85％至90％、约80％、约85％、或约90％的羟氢可待酮和/或纳洛酮于4小时之后释放的制剂。 
本发明的一个优选实施方案也涉及7小时之后，释放70％至100％、优选75％至100％、更优选80％至95％、进一步优选80％至85％、85％至90％、或90％至95％的羟氢可待酮和/或纳洛酮的制剂。本发明的优选实施方案也涉及约80％、约85％、约90％或约95％的羟氢可待酮和/或纳洛酮于7小时之后释放的制剂。
本发明又一个优选实施方案是关于12小时之后，释放85％至100％、优选90％至100％、更优选95％至100％、进一步优选约95％或100％的羟氢可待酮和/或纳洛酮的制剂。 
根据本发明，提供按照本发明而释放活性化合物的配方，除了形成基质的聚合物之外，还可含有填充剂及添加物，例如粒化辅助剂、润滑剂、着色剂、流动剂及增塑剂。 
乳糖、葡萄糖或蔗糖、淀粉类及其水解产物、微晶纤维素、纤维素(cellatose)、山梨糖醇或甘露糖醇等糖醇类，多溶性钙盐例如磷酸氢钙、磷酸二钙或磷酸三钙，可用来作为填充剂。 
聚维酮(povidone)可用来作为粒化辅助剂。 
优选使用高度分散性硅石( 
Figure DEST_PATH_RE-S03807796520070123D000031
)、滑石粉、玉米淀粉、氧化镁及硬脂酸镁或硬脂酸钙作为流动剂或润滑剂。 
可优选使用硬脂酸镁和/或硬脂酸钙作为润滑剂，也可优选使用脂肪酸类(例如硬脂酸)、或脂肪类(例如氢化蓖麻油)。 
也可使用聚乙二醇及脂肪醇[例如鲸蜡醇、和/或硬脂醇、和/或十六醇十八醇混合物(cetostearylalcohol)]，作为影响阻滞作用(retardation)的添加物。 
若使用填充剂及添加物，例如着色剂及上述润滑剂、流动剂及增塑剂，则必须注意到，根据本发明，只可使用保证得到根据本发明的活性化合物的释放模式的上述组合与基质形成物质和/或基质形成物质。 
配方的所有附加成分以可让释放基质获得一种基本上非水膨胀、或非缓冲液膨胀(non-buffer-swellable)且非腐蚀性扩散的基质的特性的方式进行选择。 
根据本发明，配方特别优选含有乙基纤维素或 E-7-7050作为基质构筑物质，硬脂醇作为脂肪醇，硬脂酸镁作为润滑剂，乳糖作为填充剂，及聚维酮作为粒化辅助剂。 
根据本发明，配方可以制成任何常见的用药形式，原则上，此用药形式适合阻滞配方并保证活性化合物以本发明的方式释放。尤其适合者是片 剂、多层片剂及胶囊。可使用其他用药形式，例如颗粒剂或粉剂，但只有提供足够阻滞作用及根据本发明的释放行为的用药形式是可接受的。 
药物制剂也可包括薄膜包衣。然而，必须保证该薄膜涂料不会负面影响活性化合物自基质释放的性质，及活性化合物于基质中的贮存稳定性。此种薄膜包衣可以染色，或者若有需要，可含有活性化合物的初次剂量。该初次剂量的活性化合物将立刻释放，如此可非常快速地达到治疗有效的血浆浓度。 
可利用累加式(build-up)或削减式(build-down)造粒法制造根据本发明的药物制剂或其前驱物。优选实施方案是采用喷雾造粒和随后干燥颗粒的制法。另一优选实施方案是于滚筒中或粒化圆盘上，通过用累加式造粒法制造颗粒。然后利用适合的添加物与方法将该颗粒压成例如片剂。 
本领域技术人员熟知应用在制药技术上的造粒技术。实施例(参见下文)揭示本发明的具体实施方案。然而，为了要达到特定目的而修改该制法的参数，此乃属于本领域技术人员可充分理解的范畴之内。 
根据本发明，利用挤压(extrusion)技术制造药物制剂或其前驱物的方法特别有利。在一个优选实施方案中，利用熔解挤压法制造药物制剂或其前驱物，其是使用配备同向或反向转动的挤压器(包含两个螺杆(screw))。另一优选实施方案是通过挤压制造的方法，其利用含有一个或一个以上螺杆的挤压器。这些挤压器也可包括捏合元件。 
挤压法也是制药技术上一种已经充分建立的生产方法，为本领域技术人员公知。本领域技术人员可充分理解，为了生产具有所需特性的产物，于挤压制法过程中可改变各种参数，例如进料速度、旋转速度、不同挤压器区域的加热温度(若可以做到的话)、水含量等。实施例部分提供根据本发明的制剂的多种实施例，其是利用挤压法制得的。 
上述参数将由所使用的挤压器的特殊种类而决定。挤压过程中，加热区(本发明配方的组分于其中熔解)的温度可以为40至120℃、优选50至100℃、更优选50至90℃、进一步优选50至70℃、最优选50至65℃，特别是使用反向转动双螺旋挤压器(例如Leistritz Micro 18GGL)的情况。本领域技术人员将可充分理解，并非每一个加热区都必须加热。特别是进料器(将组分混合之处)的后面，可能有必要冷却为约25℃。旋转速度可以是每分钟100至500次旋转(rpm)、优选100至250rpm、更优选100至200rpm、且最  优选约150rpm，特别是使用反向转动双螺旋挤压器(例如Leistritz Micro 18GGL)的情况。喷嘴的几何构形及直径可视所需加以选择。常用挤压器的喷嘴直径通常是1至10mm、优选2至8mm、最优选3至5mm。可用来生产本发明制剂的挤压器，其螺杆(screw)长度相对于直径的比率通常约为40∶1。 
一般而言，加热区的温度必须加以选择，以不会产生破坏该药学活性化合物的温度。选择进料速度与旋转速度以使药学活性化合物以持续、独立且稳定的方式自利用挤压法所制得的制剂释放，且该药学活性化合物于基质中可稳定贮存。例如，若增加进料速度，则旋转速度必须相对地增加以确保得到相同的阻滞作用。 
本领域技术人员知道上述全部参数皆取决于特殊生产条件(挤压器种类、螺旋几何构形、组分的数量等等)，可能有必要加以修改，以使通过挤压法制得的制剂提供持续、独立且稳定的释放，及上述贮存稳定性。 
本领域技术人员可由实施例(参见下文)推知，通过改变挤压过程中的参数，以及改变实质上负责该制剂的释放行为的化合物的组成关系，可得到具有不同释放模式的制剂。故本发明允许首先制备具有所需的羟氢可待酮及纳洛酮的释放模式的制剂，例如，通过改变脂肪醇或基质形成聚合物乙基纤维素的含量，以及制备参数，例如温度、旋转速度(挤压过程中)、或制造片剂过程中的压力。 
一旦获得具有所欲释放模式的制剂，则根据本发明的创新制剂可允许本领域技术人员改变该制剂中于上文列示的活性化合物的含量。含有不同量的活性化合物、但具有实质上相同组成的制剂，将可提供持续、稳定且独立释放的特性。 
因此，实施例部分公开多种实施例，证实可通过改变用量(例如乙基纤维素)而得到具有不同释放模式的制剂。其他实施例证实一旦建立了某一制剂具有所欲的释放模式，若活性化合物的含量差异被药学活性赋形剂(例如乳糖)取代，则改变纳洛酮的含量并不影响该制剂的释放行为。 
展现本发明极为有利的实施方案的实施例列示于下文。也提供其他实施例验证本发明的制剂与常见配方比较下的优点。这些实施例不应该被解释成限制本发明的可能实施方案。 
实施例1：利用喷雾造粒法(spray granulation)生产非可膨胀性扩散基质中含  有不同量的羟氢可待酮/纳洛酮的片剂 
下表列出的组分含量用来制备根据本发明的羟氢可待酮/纳洛酮片剂。 
所使用的 E-7-7050聚合物混合物具有下列组成。 
为了要制备片剂，于翻滚式搅拌器(Bohle)中混合羟氢可待酮盐酸盐、纳洛酮盐酸盐、聚维酮30及乳糖Flow Lac 100，然后在流化浴造粒装置(GPCG3)中使用 
Figure S03807796519960401D000154
E-7-7050进行喷雾粒化。将此原料通过Comill1.4mm筛网过筛。于强力切割搅拌器(Collette)中与熔融的脂肪醇进行另一造粒步骤。通过上述方法制得的全部片芯具有123mg重量(按干物量计)。 
实施例2：利用挤压法生产在非可膨胀性扩散基质中含有羟氢可待酮和纳洛酮的片剂 
下表列出的组分含量是用来制造根据本发明的羟氢可待酮/纳洛酮的片剂。 
  制剂(名称)   Oxy/Nal-Extr
  羟氢可待酮盐酸盐   20mg
  纳洛酮盐酸盐   10mg
  Kollidon 30   6mg
  乳糖Flow Lac 100   49.25mg
  乙基纤维素45cpi   10mg
  硬脂醇   24mg
  滑石粉   2.5mg
  硬脂酸镁   1.25mg
将上表列示用量的羟氢可待酮盐酸盐、乙基纤维素45cpi、聚维酮30、硬脂醇及乳糖Flow Lac 100在翻滚式搅拌器(Bohle)中混合。随后利用反向转动双螺旋挤压器，型号为Micro 18GGL(Leistritz AG，Nurnberg，德国)，挤压该混合物。加热区1的温度是25℃，加热区2的温度是50℃，加热区3至5的温度是60℃，加热区6至8的温度是55℃，加热区9的温度是60℃，加热区10的温度是65℃。螺旋转动速度是每分钟150转(rpm)，所得的熔解温度是87℃，进料速度是1.5kg/h，喷嘴开口的直径是3mm。经挤压的原料用Frewitt 0.68×1.00mm的筛网过筛。然后混合辗磨后的挤压物与滑石粉及硬脂酸镁(其事先经过添加至1mm手动式筛网之上的处理)，随后压制成片剂。挤压器有一螺旋几何构造，如图1所示。 
与同样含有以 为基础( 
Figure S03807796519960401D000162
-based)的非可膨胀性扩散基质、但利用喷雾造粒法(参见实施例1)生产的羟氢可待酮/纳洛酮片剂相比，挤压的制剂含有较少的组分。 
实施例3：实施例1制得的羟氢可待酮/纳洛酮片剂的释放模式 
于pH＝1.2、使用HPLC根据USP的药蓝方法历经12小时测量的活性化合物的释放。测试了片剂Ox/Nal-0、Ox/Nal-5及Ox/Nal-10。 
由图2与下列所列数值可确认一事实，基于 
Figure S03807796519960401D000163
的非可膨胀性扩散基质而言，不同含量的羟氢可待酮的释放速率仍能维持相同(稳定)，不受  纳洛酮含量的影响。相应地，在羟氢可待酮含量不同时，也观察到纳洛酮有稳定的释放模式。 
Figure S03807796519960401D000171
释放数值涉及羟氢可待酮或纳洛酮(第2列)，其是以百分比表示。例如，纳洛酮于420分钟的释放平均值为92.7％。于420分钟的最大偏差是1％。Oxy及Nal分别表示羟氢可待酮及纳洛酮，且指明所测定的活性化合物。 
实施例4：实施例2制得的羟氢可待酮/纳洛酮片剂于不同pH值的释放模式 
活性化合物自片剂的释放是于pH＝1.2历经12小时测量的；或者，于pH＝1.2历经1小时测量的，然后于pH＝6.5历经11小时测量。根据USP的药篮方法，利用HPLC测定释放速率。 
下列的释放速率是于pH＝1.2历经12小时测量的。 
下表的释放速率是于pH＝1.2历经1小时测量，以及于pH＝6.5历经11小时测量的。 
Figure S03807796519960401D000181
释放数值涉及羟氢可待酮或纳洛酮(第2列)，其是以百分比表示。Oxy及Nal分别表示羟氢可待酮及纳洛酮，且指明所测定的活性化合物。 
将实施例4表格与实施例3表格中的数值相比较，明确得知活性化合物以等量自制剂释放，不受制备方法的影响。例如，420分钟时，89.4％的羟氢可待酮自喷雾造粒型片剂释放(Ox/Nal-10-片剂，参见实施例3)，而420分钟时，92.9％的羟氢可待酮自经挤压的片剂释放(Oxy/Nal-Extr-1.2-O，实施例4)。羟氢可待酮自挤压型片剂释放的数值、与羟氢可待酮自喷雾造粒型片剂释放的平均值(420分钟时，91.9％)相差1.1％。420分钟时，93.5％的纳洛酮自喷雾造粒的片剂释放(Ox/Nal-10-片剂，参见实施例3)，而420分钟时，93.9％的纳洛酮自挤压型片剂释放(Ox/Nal-Extr-1.2-O，实施例4)。纳洛酮自挤压型片剂释放的数值、与烯丙烯吗啡酮自喷雾造粒型片剂释放的平均值(420分钟时，92.7％)相差1.3％。 
再者，由实施例4表格的数值比较及图3a及3b可以推断，释放速率不受pH的影响，羟氢可待酮纳洛酮的释放维持相同且稳定。 
实施例5：比较性实施例： 片剂的释放行为 
检视7小时期间的活性物质自片剂释放的情形。根据USP的药篮方法，于pH＝1.2测定 片剂1小时，然后利用HPLC于pH＝6.5另外再测试6小时，该 片剂含有50mg痛立定与4mg纳洛酮(Ti/Nal-50/4)、或含有100mg痛立定与8mg纳洛酮(Ti/Nal-100/8)、或含有150mg痛立定与  12mg纳洛酮(Ti/Nal-150/12)。 
由图4A和4B以及下表所示数值[就具有适量HPMC的可膨胀的(且可能是腐蚀性)扩散基质而言]知道，不同含量的痛立定的释放情形明显不同，且不同含量的纳洛酮的释放情形不是稳定的。此适用于纳洛酮。这表示在该pH时，活性化合物的释放情形并非互不依赖的。 
释放数值涉及痛立定或纳洛酮(第2列)，其是以百分比表示。纳洛酮的释放平均值，例如于420分钟时，为78.87％。于420分钟的最大偏差是20.4％。Til及Nal分别表示痛立定及纳洛酮，且指明所测定的活性化合物。 
实施例6：利用电子显微镜进行实施例1及2的片剂与 
Figure S03807796519960401D000192
N片剂的结构比较。 
为了进行电子显微镜，使用含有20mg羟氢可待酮及10mg纳洛酮的片剂，此片剂通过实施例1的喷雾造粒法制备(Ox/Nal-10)、或通过实施例2的挤压法制备(Oxy/Nal-Extr)。再者，使用含有100mg痛立定及8mg纳洛酮的 N片剂。图5A及5B显示Ox/Nal-10-片剂的扫描式电子显微镜照片的不同放大倍数，该片剂含有本发明配方，且是利用喷雾造粒法制备。图6A及6B显示Oxy/Nal-Extr-片剂的扫描式电子显微镜照片的不同放大倍  数，该片剂含有本发明配方，且是利用挤压法制备。图7A及7B显示 N-片剂的扫描式电子显微镜照片。 
由这些图示的比较，可以清楚看见，含有本发明配方的片剂具有实质上比较细致且比较均质结构的表面，比 
Figure S03807796519960401D000202
片剂的裂痕更少，无论该片剂是否是以喷雾造粒法或挤压法生产的。结构上的差异可能就是不同制剂有不同释放行为的原因。 
实施例7：利用挤压法生产非可膨胀性扩散基质中含有不同羟氢可待酮/纳洛酮含量的片剂 
下表列出的组分含量是用来生产根据本发明的羟氢可待酮/纳洛酮片剂。 
  制剂(名称)   OxN20/1-Ext  r-A   OxN20/1-Ext  r-B   OxN20/1-Ext  r-C   OxN20/10-E  xtr-A
  羟氢可待酮盐酸盐   20mg   20mg   20mg   20mg
  纳洛酮盐酸盐   1mg   1mg   1mg   10mg
  乳糖Flow Lac 100   58.25mg   58.25mg   58.25mg   49.25mg
  Kollidone 30   6mg   6mg   6mg   6mg
  乙基纤维素   10mg   10mg   10mg   10mg
  硬脂醇   24mg   24mg   24mg   24mg
  滑石粉   1.25mg   1.25mg   1.25mg   1.25mg
  硬脂酸镁   2.5mg   2.5mg   2.5mg   2.5mg
如上所述(实施例2)进行挤压法，采用下列参数： 
OxN20/1-Extr-A：温度：55-63℃ 
                rpm(转速(screw))：150rpm 
                进料速度：1.5kg/h 
OxN20/1-Extr-B：温度：55-63℃ 
                rpm(转速)：155rpm 
                进料速度：1.5kg/h 
OxN20/1-Extr-C：温度：55-63℃ 
                rpm(转速)：1505rpm 
                 进料速度：1.5kg/h 
OxN20/10-Extr-A：温度：55-63℃ 
                 rpm(转速)：160rpm 
                 进料速度：1.75kg/h 
利用常见的打片装置进行片剂生产，采用下列参数： 
OxN20/1-Extr-A：rpm：40rpm 
                压力：9kN 
OxN20/1-Extr-B：rpm：42rpm 
                压力：8.9kN 
OxN20/1-Extr-C：rpm：36rpm 
                压力：9kN 
OxN20/10-Extr-A：rpm：36rpm 
                 压力：7.5kN 
应用USP的药篮方法，于pH＝1.3使用HPLC历经12小时测量活性化合物的释放。测试了下列片剂：OxN20/1-Extr-A、OxN20/1-Extr-B、OxN20/1-Extr-C及OxN20/10-Extr-A。 
由下表所列的数值可知，就以乙基纤维素为基础的非可膨胀性扩散基质而言，不同含量的纳洛酮的释放速率实质上维持相同，不受到羟氢可待酮含量的影响。相应的，这些制剂提供该活性化合物的独立且稳定的释放。 
释放数值涉及羟氢可待酮或纳洛酮(第2列)，其是以百分比表示。纳洛  酮的释放平均值，例如于420分钟时，为92.3％。于420分钟的最大偏差是7.4％。Oxy及Nal分别表示羟氢可待酮及纳洛酮，且指明所测定的活性化合物。 
因此，一旦具有所欲释放模式的制剂发展出来，则可以改变该活性化合物的含量，但不显著改变活性化合物的释放模式。含有不同量的活性化合物的制剂仍可提供一种持续、独立且稳定的释放。 
实施例8：利用挤压法生产非可膨胀性扩散基质中含有羟氢可待酮/纳洛酮的片剂 
下列实施例表明，利用本发明的配方、可制得含有羟氢可待酮及纳洛酮、并具有特别释放行为的制剂。 
下表列出组分的含量是用来生产根据本发明的羟氢可待酮/纳洛酮的片剂。 
Figure S03807796519960401D000221
如上所述(实施例2)进行挤压法，采用下列参数： 
OxN20/1-Extr-D：温度：55-63℃ 
                rpm(转速)：150rpm 
                进料速度：1.5kg/h 
OxN20/1-Extr-E：温度：55-63℃ 
                 rpm(转速)：150rpm 
                 进料速度：1.5kg/h 
OxN20/10-Extr-B：温度：55-63℃ 
                 rpm(转速)：160rpm 
                 进料速度：1.75kg/h 
OxN20/10-Extr-C：温度：55-63℃ 
                 rpm(转速)：160rpm 
                 进料速度：1.75kg/h 
OxN20/10-Extr-D：温度：55-63℃ 
                 rpm(转速)：150rpm 
                 进料速度：1.5kg/h 
OxN20/10-Extr-E：温度：55-63℃ 
                 rpm(转速)：150rpm 
                 进料速度：1.5kg/h 
利用常见的压片装置进行片剂生产，采用下列参数： 
OxN20/1-Extr-D：rpm：39rpm 
                压力：11kN 
OxN20/1-Extr-E：rpm：39rpm 
                压力：10.5kN 
OxN20/10-Extr-B：rpm：36rpm 
                 压力：9.5kN 
OxN20/10-Extr-C：rpm：36rpm 
                 压力：7.8kN 
OxN20/10-Extr-D：rpm：39rpm 
                 压力：9kN 
OxN20/10-Extr-E：rpm：39rpm 
                 压力：7.5kN 
应用USP的药篮方法，于pH＝1.2、使用HPLC历经12小时测量活性化合物的释放。测试了下列片剂：OxN20/1-Extr-D、OxN20/1-Extr-E、  OxN20/10-Extr-B、OxN20/10-Extr-C、OxN20/10-Extr-D及OxN20/10-Extr-E。 
Figure S03807796519960401D000241
释放数值涉及羟氢可待酮或纳洛酮(第2列)，其是以百分比表示。Oxy及Nal分别表示羟氢可待酮及纳洛酮，且指明所测定的活性化合物。 
此实施例证实，若用乙基纤维素及脂肪醇是作为实质上影响该制剂的释放特性的基质组分，则可生产具有特定释放模式的制剂。一旦制得具有所需释放特性的制剂，则可改变活性化合物的含量。该制剂将仍可提供持续、独立且稳定的释放行为(参见实施例7)。 

Claims (9)

1.一种贮存稳定的药物制剂，该制剂在基本上非可膨胀性扩散基质中含有羟氢可待酮盐酸盐及纳洛酮盐酸盐，所述基质包含乙基纤维素和至少一种脂肪醇，其中羟氢可待酮盐酸盐及纳洛酮盐酸盐是以持续、稳定并且独立的方式从该制剂中释放，其中羟氢可待酮盐酸盐的量为10至80mg，纳洛酮盐酸盐的量为1至50mg，并且其中羟氢可待酮盐酸盐及纳洛酮盐酸盐的重量比为2∶1，且其中所述制剂不含有聚甲基丙烯酸酯和/或HPMC。
2.权利要求1所述的制剂，其特征在于该制剂含有基本上非腐蚀性的扩散基质。
3.上述权利要求中任意一项所述的制剂，其特征在于该制剂含有普通填充物、润滑剂、流动剂和增塑剂。
4.权利要求3所述的制剂，其特征在于该制剂含有一种或多种选自以下的润滑剂：硬脂酸镁、硬脂酸钙、月桂酸钙和脂肪酸。
5.权利要求4所述的制剂，其中所述脂肪酸为硬脂酸。
6.权利要求3所述的制剂，其特征在于该制剂含有高度分散的硅石、滑石粉、玉米淀粉、氧化镁、硬脂酸镁或硬脂酸钙作为流动剂。
7.上述权利要求中任意一项所述的制剂，其特征在于将该制剂制备成口服制剂、鼻用制剂、直肠用制剂或吸入制剂。
8.上述权利要求中任意一项所述的制剂，其特征在于该制剂是片剂、丸剂、胶囊、颗粒剂和/或粉剂。
9.上述权利要求中任意一项所述的制剂，其特征在于该制剂可于60％相对湿度和25℃下贮存至少两年。
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