(12) United States Patent (10) Patent No.: US 6,869,615 B2 Chen Et Al
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USOO68696.15B2 (12) United States Patent (10) Patent No.: US 6,869,615 B2 Chen et al. (45) Date of Patent: *Mar. 22, 2005 (54) PHARMACEUTICAL FORMULATIONS 3,385,886 A 5/1968 Nicholson et al. .......... 562/492 CONTAINING ANON-STEROIDAL ANTINFLAMMATORY DRUG AND A (List continued on next page.) PROTON PUMP INHIBITOR FOREIGN PATENT DOCUMENTS EP OOO5129 4/1979 ......... CO7D/403/12 (75) Inventors: Chih-Ming Chen, Davie, FL (US); EP O166287 6/1985 ......... CO7D/401/12 Unchalee Kositprapa, Davie, FL (US) EP O174726 7/1985 ......... CO7D/401/12 EP O295603 6/1988 ......... CO7D/401/12 (73) Assignee: Andrx Labs LLC, Davie, FL (US) EP OS19365 6/1992 ............ A61 K/9/20 GB 2163747 3/1986 ......... CO7D/235/28 (*) Notice: Subject to any disclaimer, the term of this WO 9427988 12/1994 ......... CO7D/401/12 patent is extended or adjusted under 35 WO 95O1977 1/1995 ......... CO7D/401/12 U.S.C. 154(b) by 0 days. WO 9725064 7/1997 .......... A61Kf45/06 This patent is Subject to a terminal dis OTHER PUBLICATIONS claimer. Hawkey, Chrisotpher J., et al., Omeprazole Compared with Misoprostol for Ulcers Associated with Nonsteriodal Anti (21) Appl. No.: 10/282,820 inflammatory Drugs, New England Journal of Medicine (Mar. 12, 1988), 338:727–734. (22) Filed: Oct. 28, 2002 Primary Examiner James M. Spear (65) Prior Publication Data (74) Attorney, Agent, or Firm-Davidson, Davidson & US 2003/0129235 A1 Jul. 10, 2003 Kappel, LLC (57) ABSTRACT Related U.S. Application Data An oral Solid dosage form includes a therapeutically effec (63) Continuation of application No. 09/659,222, filed on Sep. tive amount of an NSAID and a proton pump inhibitor in an 11, 2000, now Pat. No. 6,544,556. amount effective to inhibit or prevent gastrointestinal side (51) Int. Cl. ............................ A61K9/20: A61K 9/22; effects normally associated with the NSAID. Also disclosed A61K 9/26; A61 K9/28: A61 K9/54 is a method of treating a human patient in need of (52) U.S. Cl. ....................... 424/469; 424/451; 424/452; antiinflammatory, analgesic and/or antipyretic therapy, com 424/457; 424/458; 424/465; 424/468; 424/489; prising orally administering to the patient an oral pharma 424/470; 424/474; 424/490 ceutical dosage form which includes a therapeutically effec (58) Field of Search ................................. 424/489, 490, tive amount of an NSAID and an amount of a proton pump 424/469,451, 452, 457, 458, 464, 465, inhibitor effective to substantially inhibit gastrointestinal 470, 472, 468, 474, 484, 455, 456, 480, side effects of the NSAID. The invention is further related to 481,482, 493, 494, 495, 497, 496, 477 a method of prophylactically treating a human patient who is on a therapy known to have significant gastrointestinal (56) References Cited Side effects or is about to begin Such a therapy, via concur rent administration of an NSAID and a proton pump inhibi U.S. PATENT DOCUMENTS tor in a combination (single) oral dosage form. 3,161,654 A 12/1964 Shen .......................... 548/500 3.228,831 A 1/1966 Nicholson et al. .......... 514/568 26 Claims, 4 Drawing Sheets DECOFENAC Na ROMEPRAZOEDRABE 100 80 46OO 2O O 5 10 15 20 25 30 DISSOLUTIONTIME (min) O INITIAL O2 WEEKS US 6,869,615 B2 Page 2 U.S. PATENT DOCUMENTS 5,008,283 A 4/1991 Blackburn et al. .......... 514/.414 5,039,806 A 8/1991 Brandstram et al. ........ 546/271 g A 1/1971 A. al. ............... S. 5,045,321. A 9/1991 Makino et al. ............. 424/475 3. A s 2. R Ener s: 5,045,552. A 9/1991 Souda et al. ................ 514/338 3,766.263 A 10/1973 E. - - - - - 562.465 5,068,458. A 11/1991 Dales et al. ................ 568/634 3,843,681. A 10/1974 Demerson et al. .......... 548/432 5,204,118 A 4/1993 Goldman et al. 424/489 3.845.215 A 10/1974 Godfrey ........ ... 514/557 5,312.824. A 5/1994 Sohda et al. ................ 514/338 3904682 A 9/1975 Fried et all 562/466 5,417,980 A 5/1995 Goldman et al. ........... 424/464 4.00997 A 2/1977 Fried et al. - - - - - - - - - - - - - - - - - 560/56 5,510,382 A 4/1996 Stjernschantz et al. 514/530 2Y- - - 2 - - - - - - - - - - - - - - - - - - - - 5629,305 A 5/1997 Eek et al. ................... 514/199 4,045,563 A 8/1977 Berntsson et al. .......... 514/338 5,708.017Y/1 - 2 A 1/1998 Dave et al. ................. 514/393 4.255.431 A 3/1981 Junggren et al. ........... 514/338 2 - Y - 4,359,465. A 11/1982 Ruwart ....................... 514/314 5,798,120 A 8/1998 Tomohisa et al... 424/482 4472.409 A 9/1984 Senn-Bilfinger 514/338 5,817.338 A 10/1998 Bergstrand et al. ......... 424/468 2 - . 12 SCI . 5.877,192 A 3/1999 Lindberg et al............. 514/338 4,508.905 A 4/1985 Junggren et al. ........ 546/273.7 6,365,1842Y B1 * 4/2002 Depui et al. ... 424/469 4,628,098 A 12/1986 Nohara et al. ........... 546/273.7 2- Y-a-2 6544,556 B1 4/2003 Chen et al. ... 424/469 4,738.975 A 4/1988 Nohara et al. .... ... 514/338 6,613.354 B2 9/2003 Depui et all 424/458 4.786,505 A 11/1988 Lovgren et al. ............ 424/468 2Y------ CPUllel al. 4,853.230 A 8/1989 Lovgren et al. ............ 424/466 5,006,547 A 4/1991 Loose ........................ 514/.414 * cited by examiner U.S. Patent US 6,869,615 B2 (H)EWILNOILOTOSSIG U.S. Patent Mar. 22, 2005 Sheet 3 of 4 US 6,869,615 B2 ETTSCHWOHCETOZ\/?)dEWORJEENOWNE-HOTO|0 C od O S3 cC r N (eNOWN3O80%) OAOSSIONnOWW US 6,869,615 B2 1 2 PHARMACEUTICAL FORMULATIONS activity and inhibit hormone-induced uterine contractions CONTAINING ANON-STEROIDAL and certain types of cancer growth through inhibition of ANTINFLAMMATORY DRUG AND A prostaglandin G/HSynthase, also known as cyclooxygenase. PROTON PUMP INHIBITOR Inhibition of COX-1 causes a number of side effects includ ing inhibition of platelet aggregation associated with disor ders of coagulation, and gastrointestinal Side effects with the This application is a continuation of U.S. application Ser. possibility of ulcerations and of hemorrhage. It is believed No. 09/659,222, filed on Sep. 11, 2000 now U.S. Pat. No. that the gastrointestinal Side effects are due to a decrease in 6,544,556, the disclosure of which is hereby incorporated by the biosynthesis of prostaglandins which are cytoprotective reference in its entirety. of the gastric mucosa. FIELD OF THE INVENTION A high incidence of Side effects has historically been The present invention is related to the combination of a asSociated with chronic use of classic cyclooxygenase non-steroidal antiinflammatory drug (“NSAID") or one of inhibitors, all of which are about equipotent for COX-1 or its single enantiomers or salt of the NSAID, and a proton COX-2, or which are COX-1-selective. While renal toxicity pump inhibitor or one of its Single enantiomers, or an 15 occurs, it usually becomes evident in patients who already alkaline Salt of the proton pump inhibitor or one of its single exhibit renal insufficiency (D. Kleinknecht, Sem. Nephrol. enantiomers, in a Single oral pharmaceutical dosage form. 15: 228, 1995). By far, the most prevalent and morbid toxicity is gastrointestinal. Even with relatively nontoxic BACKGROUND drugs. Such as piroXicam, up to 4% of patients experience Although NSAIDs are often used for their gross bleeding and ulceration (M. J. S. Langman et al., antiinflammatory, analgesic, and/or antipyretic effects, it is Lancet 343: 1075, 1994). In the United States, it is estimated well known that NSAIDs have the potential to cause gas that some 2000 patients with rheumatoid arthritis and 20,000 trointestinal (GI) bleeding through a variety of mechanisms patients with Osteoarthritis die each year due to gastrointes related to their topical and systemic effects. The GI bleeding tinal side effects related to the use of COX inhibitors. In the may depend on the length of the treatment and on the 25 UK, about 30% of the annual 4000 peptic ulcer-related particular drug. This problem is important in cases where the deaths are attributable to COX inhibitors (Scrip 2162, p.17). therapy must be continued for a long period of time. For COX inhibitors cause gastrointestinal and renal toxicity due example, osteoarthritis and rheumatoid arthritis in the eld to the inhibition of Synthesis of homeostatic prostaglandins erly is often treated with long-term NSAID therapy, as responsible for epithelial mucus production and renal blood chronic treatment is needed to control pain and inflammation flow, respectively. and to improve quality of life. The Second form of cyclooxygenase, COX-2, is rapidly Additionally it is well known that because of their side and readily inducible by a number of agents including effects on the GI tract, NSAIDs are invariably administered mitogens, endotoxins, hormones, cytokines and growth fac after meals or, generally, when the Stomach is not empty. tors. It has been proposed that COX-2 is mainly responsible This pharmacological principle is confirmed by the recom 35 for the pathological effects of prostaglandins, which arise mendations found in the labeling of these medications. when rapid induction of COX-2 occurs in response to Such Patients who have an ulcer or who are susceptible to agents as inflammatory agents, hormones, growth factors, developing ulcers are commonly advised to avoid taking and cytokines. Selective inhibitors of COX-2 have anti NSAIDs for pain, inflammation, and/or fever. inflammatory, antipyretic and analgesic properties similar to Other measures which can be taken to decrease GI side 40 those of a conventional non-Steroidal anti-inflammatory affects associated with NSAID therapy is to coadminister an drug (NSAID), but COX-2 inhibitors have been touted as H2 blocker e.g.