Title of Invention

A COMPOSITION FOR APPLICATION TO MUCOSAL MEMBRANES IN THE MOUTH

Abstract The present invention pertains to compositions having improved delivery of pharmaceutical actives. These compositions comprise pharmaceutical actives in an anhydrous solvent. The compositions may take the form of liquid elixirs placed into the mouth and eventually swallowed, or can be delivered via liquid-filled drops, metered liquid dosing devices, atomizers and liquid-releasing, edible capsules.
Full Text TECHNICAL FIELD
The present invention pertains to compositions having improved delivery of pharmaceutical active ingredients. These compositions comprise pharmaceutical actives in an anhydrous, hydrophilic solvent. These compositions may take the form of liquid elixirs placed into the mouth and eventually swallowed, or can be delivered via liquid-filled lozenges and gums, metered liquid dosing devices, atomizers and liquid-releasing, edible capsules. Such compositions are particularly useful for treating symptoms associated with respiratory illnesses.
BACKGROUND OF THE INVENTION
Routes for delivering pharmaceutical actives include delivering actives by intranasal, pulmonary, buccal, sublingual, transdermal. and rectal administration. These routes tend to be used for avoiding first-pass metabolism of drugs that are swallowed. "First past metabolism" refers to the arrangement and order of placement of the metabolizing enzymes within the body of a human, with respect to the path followed by substances that enter the gastrointestinal tract by swallowing, and are absorbed into the general blood circulation. Items swallowed by humans, including food, dnnk, and medicines, enter the stomach and from there flow into the intestine. Many of the chemicals associated with the food, drink, or medicine pass through the mucosal membranes in the gastrointestinal tract and into the blood in the mesenteric veins draining from the intestine. The blood flow from the mesentenc veins passes into the liver. Metabolizing enzymes in the mucosal membranes of the intestine and in the liver can chemically alter the nature of substances passing from the intestine, through the liver, and into the common blood circulation of the body. Since all swallowed medicines are subject to the metabolizing capacity of the intestinal mucosal membranes and the liver before entering the general blood circulation of the body, frequently only a small fraction of those substances go unmetabolized, and reach the general blood circulation
Avoiding first pass metabolism can increase the bioavailability, or blood concentrations of the administered compound. Metabolic formation of metabolites of the administered
compound, however, can at the same time decrease. Where formation of metabolites from the first pass metabolism is desirable, avoiding the first pass metabolism is not preferred since it logically leads to lower amounts of the metabolite in the blood. Furthermore, the blood concentrations of the active substance can increase, leading to potential toxicity or side effects attributable to the active per se. Reducing the amount of active in the dose for avoiding toxiciry. concomitantly decreases the circulating blood levels of the active metabolite. This results in loss of therapeutic affect and ultimately, benefit to the patient. In order to provide a medication that is effective and avoids unwanted side effects, the composition and its means of delivery must be modified.
Respiratory illnesses covers a broad range of ailments, including viral infections and allergic reaction to inhaled allergens. Viral infections in the upper respiratory tract of humans leads to illness usually referred to as colds, or influenza. Such an illness is quite common in the general population and can be the cause of significant discomfort and suffering. Allergen inhalation also negatively impacts a fair number in the population at the same or even at a greater degree than those having a viral infection.
There are no generally regarded .effective and convenient methods for preventing viral infections or allergies. In the case of viral infections, the body's natural defense mechanisms fight the infection for a period of time normally ranging from 3 days to 2 weeks. This being the case, the most commonly employed medicines treat the uncomfortable, problematic symptoms of these respiratory ailments. These symptoms include stuffy and runny noses, soreness and inflammation in the nose and throat, fits of coughing, general aches in the body, fever, and headache. Of these symptoms, coughing in uncontrollable fits is considered by many to be the most problematic and uncomfortable. Coughing disrupts normal respiration, leading to increased headache and sore throat as well as loss of sleep to the sufferer and others living with the sufferer The compositions used to treat the above mentioned symptoms generally fall into one of the following pharmacological classifications: antihistamines; decongestants; antitussives; expectorants; mucolytics; analgesics, antipyretic and anti-inflammatory agents. The compositions are manufactured in a number of product forms, the most common being liquid syrups and elixirs for swallowing, mouth drops and lozenges as well as inhalants and topical creams or lotions that release volatile agents that are inhaled through the nose into respiratory tract. The compositions are typically swallowed immediately, or slowly dissolved in the mouth. They typically contain actives such as guaifenesin, that aids the body in the removal of excess respiratory mucus or phlegm, diphenhydramine, that lessens the negative effects including coughing and other symptoms due to histamine produced in the body in response to the viral infection, and dextromethorphan, that acts within the part of the human brain controlling the
coughing reflex. Among these actives, Dextromethorphan is the most commonly used active in the world for relief of cough.
Dextromethorphan, by virtue of it's physicochemical. absorption, and bioavailability properties, is a very good candidate for increasing bioavailability via methods of administration other than swallowing. For example it has been reported in patents and pharmaceutical literature that substantial increases in bioavailability can be achieved using intranasal formulations; see H. Char et al. Nasal. ..Delivery of 14-C Dextromethorphan in Rats. Journal of Pharmaceutical Sciences 81:750, 1992.
What has not been realized until now is that after careful and diligent research into pharmaceutic, therapeutic, and side effect properties of active compounds, compositions can be made to positively improve the therapeutic effect without increased side effects or toxicity.
SUMMARY OF THE INVENTION
An object, therefore, of the present invention is to provide improved compositions for treating the symptoms associated with respiratory ailments, particularly minimizing fits of coughing. The compositions are solutions of pharmaceutical actives in small volumes of anhydrous, hydrophilic liquids providing rapid delivery of pharmaceutical actives including antitussives: antihistamines (including non-sedating antihistamines); decongestants; expectorants; mucolytics; analgesic, antipyretic and anti-inflammatory agents and local anesthetics for treating the symptoms of respiratory illnesses. The compositions can be dosed using a variety of product forms and. or package delivery options. The compositions of the present invention provide improved activity while minimizing potential side effects of the pharmaceutical active. It is also an objective of the subject invention to provide methods for achieving rapid transmucosal delivery of the aforementioned compositions.
Definitions and Terms
The following are definitions of terms found in the present specification: 1. transmucosal delivery:
Refers to application of drugs to the mucosal membranes of the oral cavity, including buccal (cheek), lips, gums, palates, and tongue, with the goal of the drug passing through the skin covering these places and entering the bloodstream.
2. therapeutic dose
Refers to the amount of the substance that when administered to a person in the proper form, will produce the desired effect within the body with minimal undesired side.
3. pharmaceutical active/active:
Refers to the chemical molecule which exerts the desired effect on the body, when administered in the proper amount and form.
4. active metabolites
Refers to the chemical species of the pharmaceutical active upon the active undergoing metabolism.
5. monomolecular dispersion
Refers to the fact that molecules of the active are free and unencumbered from diffusion by association in crystalline or amorphous solid forms, or poly molecular association.
6. percent solubility value
Refers to the equilibrium solubility limit or maximum solubility of a molecule in a solvent at usual room temperature, expressed as the weight percent of the molecule in the composition.
DETAILED DESCRIPTION OF THE INVENTION
The compositions of the present invention comprise pharmaceutical actives referred to herein as "actives" for treating illnesses, particularly symptoms associated with respiratory-ailments such as colds, influenza as well as allergy. These actives are most frequently used for treating the most problematic symptoms including a stuffy and runny nose, soreness and inflammation in the nose and throat, fits of coughing, general aches in the body, fever, and headache. In the present invention, when actives are combined with small volumes of anhydrous solvents, the actives obtain enhanced transmucosal delivery into the blood In the case that active metabolites contribute to the desired therapeutic effect, this enhanced delivery is achieved without appreciably lowering the level of the corresponding active metabolites. Furthermore, the level of active in the blood is maintained at a level that avoids unwanted side effects brought on by too high of levels of active in the blood.
The composition comprises a pharmaceutical active in an hydrophilic, water-miscible, anhydrous solvent wherein the pharmaceutical active in its un-ionized form has a percent solubility value in the solvent at ambient temperature that is equal to or greater than 0.075% and the pharmaceutical active is in its free, un-iomzed form as a monomolecular dispersion in the solvent.
The pharmaceutical active of the present invention has a molecular weight of less than 500 grams per mole, is capable of being ionized when in an aqueous solvent and has an octanol-water partition coefficient when in the un-ionized form of at least 100. The octanol-water partition coefficient is disclosed in A. Martin, P. Bustamante, and A.H.C. Chun, Physical Pharmacy. Fourth Edition, Lea and Febiger publishers, Philadelphia, 1993, page 237; herein incorporated by reference.
The actives that comprise compositions of the present invention fall into at least one of the following pharmacological classifications: antitussives; antihistamines; non-sedating

antihistamines; decongestants: expectorants: mucolytics, analgesic, antipyretic ann-inflammatory
agents, local anesthetics and mixtures thereof. References that describe the use of such actives
include J. G. Hardman, The Pharmacolouic Basis, of Therapeutics. Ninth Edition, McGraw-Hill.
New York, 1995. Antitussives useful in the present invention include, but. are not restricted to
the group consisting of codeine, dexrromethorphan, dextrorphan. diphenhydramme,
hydrocodone. noscapine, oxycodone. pentoxyvenne and mixtures thereof. Antihistammes useful
in the present invention include, but. are not restricted to the group consisting of acrivastine,
azatadme, brompheniramme. chlorpheniramine, clemastine, cyproheptadine.
dexbrompheniramine. dimenhydnnate, diphenhydramme, doxylamine, hydroxyzme, meclizine, phenmdamme, phenyltoloxamme, promethazine, pyrilamine, rnpelennamme, tnprolidme and mixtures thereof. Non-sedating antihistammes useful in the present invention include, but, are not restricted to the group consisting of astemizole, cetirizine, ebastine, fexofenadine, loratidine. terfenadine, and mixtures thereof. Decongestants useful in the present invention include, but, are not restricted to the group consisting of phenylpropanolamine, pseudoephedrine, ephednne, phenylephrine oxymetazoline. and mixtures thereof Expectorants useful in the present invention include, but, are not restricted to the group consisting of ammonium chloride, guaifenesin, ipecac fluid extract, potassium iodide and mixtures thereof. Mucolytics useful in the present invention include, but, are not restricted to the group consisting of acetylcycsteine, ambroxol, bromhexine and mixtures thereof. Analgesic, antipyretic and anti-inflammatory agents useful in the present invention include, but, are not restricted to the group consisting of acetaminophen, aspirin, diclofenac, diflunisal. etodolac, fenoprofen, flurbiprofen, ibuprofen, ketoprofen, ketorolac, nabumetone, naproxen, piroxicam, caffeine and mixtures thereof. Local anesthetics useful in the present invention include, but, are not restricted to the group consisting of lidocame, benzocaine, phenol, dyclomne. benzonotate and mixtures thereof.
Actives in compositions of the present invention are soluble in the anhydrous solvent. The concentration of actives in the solvent is preferably less than or equal to 125% of the percent solubility value, more preferably less than or equal to the percent solubility value of the pharmaceutical active. To maximize the benefits of the compositions of the present invention, the active is preferably in solution as monomolecular dispersion. The actives useful in the present invention are present in the solvent system at a level from about 0.075% to about 25.0%, preferably from about 0.28% to 10.0% by weight of the composition.
It is preferred that the active is in it free form, however the salt form of the active is also useful in the present invention. Regardless of its form, the active is in its un-ionized state in the monomolecular dispersion in said solvent system.
Actives of particularly use are those that arrest uncontrollable fits coughing. Of the antitussives available, dextromethorphan is preferred. Dextromethorphan is known to have pharmacological activity as an antirussive agent and is described in US Patent 5.196,436, Smith; incorporated herein by reference. As used herein, "dextromethorphan" means racemethorphan, 3-methoxy-17-methylmorphinan (dl-cis-1.3,4,9,10.1 Oa-hexahydro-6-methoxy-11 -methyl-2H-10,4a-imjnoethanophenanthrene and pharmaceutically-acceptable salts thereof. Compositions of the present comprising dextromethorphan preferably comprise from about 0.1% to about 9.3%. more preferably from about 0.26% to about 6.2% and most preferably from about 1.16% to about 4.6% dextromethorphan. Other safe and effective amounts of other cough/cold drug actives may be included in such dextromethorphan-containing compositions.
In the composition of the present invention to the user, dose level of dextromethorphan delivered to the consumer is from about 6.85 milligrams to about 30.83 milligrams per dose. In the case where the hydrobromide monohydrate salt of dextromethorphan is in the composition, the dose level of the hydrobromide monohydrate salt of dextromethorphan delivered to the consumer is from about 10.0 milligrams to about 45 milligrams per dose.
The un-ionized form of the pharmaceutical active is maintained using an anhydrous solvent. By anhydrous it is meant that the solvent contains less than about 5 % water. The anhydrous solvent of the present invention comprises from about 60% to about 99.975%, preferably from 70% to about 99% and most preferably from about 85% to about 98% by weight of the composition.
The anhydrous solvent of the present invention is normally liquid at ambient or room temperatures. It is water-soluble or water-miscible. The solvents are selected from the group consisting propylene glycol, ethanol, poly(ethylene glycol) or PEG, propylene carbonate, diethylene glycol monoethyl ether, poloxamer, glycofurol, glycerol, and mixtures thereof There are mixtures of these solvents that are particularly preferred for certain product forms of the present invention. For example, if the product form is an elixir, liquid capsule or liquid containing lozenge, the solvent is a combination of propylene glycol, ethanol, and PEG. If the product form is a spray, the solvents is a combination of propylene glycol, ethanol, PEG and usually propylene carbonate. The level of each solvent that makes up these mixtures is partially dependent on aesthetic benefits sought by the formulator. Optional Ingredients
Ingredients normally associated with cold and influenza treatment medicines can be used with the pharmaceutical actives disclosed herein. Such ingredients are disclosed in US Patent 5,196,436, incorporated herein by reference. Additionally, the following ingredients may be used in the present invention:
Buffers and mixtures of buffering agents, including basic buffers as single components with pKa of from 8 to 1 1. include triethanolamine, salts of ammo acids, including alkaline salts of glycine, glycylglycine. glutamme or other ammo acids, alkaline salts of phosphate, carbonate and mixtures thereof. The buffers provide compositional resistance to pH changes upon dilution of the composition with saliva within the range of 7 to 10, preferably 8 to 10.
Sweeteners, including aspaname. saccharin and its salts, Sucralose™ (sold by the McNeil Specialty Products Co., New Brunswick, NJ); Prosweet™ (sold by the Virginia Dare Extract Co.. New York, NY): Magnasweet™ (sold by MAFCO Worldwide Corp., Licorice Division, Camden, NJ); ammonium glycyrrhizmate, its salts, Talin™ (Thaumatin) and its diluted products, such as Talin GA90, (sold by the Talin Food Company. Birkenhead, England); and , Acesulfame K, and mixtures thereof.
Flavorants, include anise, oil of peppermint, oil of clove, eucalyptus, lemon, lime, honey lemon, red fruit, mint, grapefruit, orange, cherry cola and mixtures thereof.
Sensory agents. Also useful herein are sensory agents selected from the group consisting of coolants, salivating agents, warming agents. Preferably these agents are present in the compositions at a level of from about 0.001% to about 10 %, preferably from about 0.1% to about 1%, by weight of the composition.
Suitable cooling agents include carboxamides, menthols, thymol, camphor, capsicum, phenol, eucalyptus oil, benzyl alcohol, salicyl alcohol, ethanol, clove bud oil, and hexylresorcinol, ketals, diols, and mixtures thereof. Preferred coolants are the paramenthan carboxyamide agents such as N-ethyl-p-menthan-3-carboxamide (WS-3 supplied by Sterling Orgamcs), taught by U.S. Patent 4,136.163, issued January 23, 1979, to Watson et al., which is incorporated herein by reference in its entirety. Another preferred paramenthan carboxyamide agent is N,2,3-trimethyl-2-isopropylbutanamide, known as "WS-23", and mixtures of WS-3 and WS-23.
Additional preferred coolants are selected from the group consisting of menthol, 3-1-menthoxypropane-l,2-diol, known as TK-10 supplied by Takasago Perfumery Co., Ltd., Tokyo, Japan, menthone glycer.ol acetal known as MGA, manufactured by Haarmann and Reimer, menthyl lactate known as Frescolat manufactured by Haarmann and Reimer, and mixtures thereof.
Additonal cooling agents include cyclic sulphones and sulphoxides and others, all of which are described in U.S. Patent 4,032,661, issued June 28, 1977, to Rowsell et al., which is herein incorporated by reference.
The terms "menthol" and "menthyl" as used herein include dextro- and levoratotory isomers of these compounds and racemic mixtures thereof.
TK-10 is described in detail in U.S. Patent 4,459.425, issued July 10. 1984 to Amano et. al. and incorporated herein by reference.
Salivating agents of the present invention include Jambu® manufactured by Takasago Perfumery Co., Ltd.. Tokyo, Japan.
Warming agents include capsicum and nicotmate esters, such as benzyl nicotinate.
METHOD OF USE
In terms of the methods of delivery of the active, it is generally accepted that oral mucosal delivery inside the mouth must be targeted to the sub-lingual region in order to achieve a very rapid therapeutic effect; see D. Hams and J.R. Robinson, Drug Delivery via the Mucus Membranes of the Oral Cavity. Journal of Pharmaceutical Sciences 81: 1, 1992. Such dosage forms are designed to be placed under the tongue, on the floor of the mouth, and held there for some extended time. The inventors have found, however, that a large increase in bioavailabiliry with very rapid absorption can be achieved when the subject compositions are placed against any of the mucosal membranes of the mouth, even onto the tongue and swallowed. The form of the invention is a liquid elixir solution. It is intended to be applied to any of the mucosal membranes within the mouth. This can be achieved using a medicine dropper that is calibrated to indicate the proper amount to be administered, and squirting the elixir onto the tongue prior to swallowing. The elixir can be atomized into mouth and throat and then swallowed. It can be encapsulated into some sort of shell which makes it portable and convenient to transport and administer without having to measure the quantity of liquid elixir. Examples of encapsulation shells include hard candies as are used for lozenges, chewing gums, gelatin, or non-gelatin (e.g. starch-based) shells. The elixir may be packaged into a small, disposable vial which can readily be opened and squirted into the mouth, the entire vial containing exactly one therapeutic dose. Typical dosage forms of the composition of the present invention contain no more than about 3 ml., preferable from about 0.2 ml. to about 3ml..
One preferred form is to encapsulate the liquid into a shell of hard candy or gelatin. The shell containing substances to pretreat the mucosa and thereby enhance the absorption of the active from the liquid center. The pretreatment occurs by sucking or chewing the shell matenal, and the advantage is gamed by separating in time the treatment of the mucosa, which occurs first, followed by the presentation of the active to be absorbed. Examples of substances for pretreatment of the mucosal membranes are membrane penetration enhancers that are commonly known in the art, examples including menthol, peppermint oil, surfactants such as polysorbate 80 or poloxamer. Another example of a mucosal membrane pretreatment are buffers as listed above, which would precondition salivary micro environment pH in the range of 8 to 10.

EXAMPLES
Example I
Liquid Elixir

(Table Removed)
Add a portion of Ethanol to the active (Dextromethorphan Base) and solid sweetening agents (Sucralose, Monoammonium Glycyrrizmate) and continuously mix at low heat (30°C). To this vessel add the additional solvents (Propylene Glycol, Polyethylene Glycol 600) and liquid sweeteners (Pro-sweet Liquid K). Mix until all materials are in solution, about 2 hours time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol, and add to the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh sieve (product density = 1.07 g/ml.). Fill into amber glass bottles, and cap with an integrated cap / calibrated medicine dropper assembly.
About 1.0 ml. of the elixir dropped onto the tongue and then swallowed. Dextromethorphan is rapidly absorbed into the blood.
Example II
Liquid Elixir
(Table Removed)
Add a portion of Ethanol to the active (Dextromethorphan Base) and solid sweetening agents (Sucralose, Monoammonium Glycyrrizmate) and continuously mixed at low heat (30°C).
To this vessel add the additional solvents (Propylene Glycol, Polyethylene Glycol 600), liquid sweeteners (Pro-sweet Liquid K), and buffer (Tnethanolairnne, a liquid). Mix until all materials are in solution, about 2 hours time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol, and add to the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh sieve (product density = 1.07 g/ml.). Fill into amber glass bottles, and cap with an integrated cap / calibrated medicine dropper assembly.
About 1.0 ml. of the elixir dropped onto the tongue and then swallowed. Dexrromethorphan is rapidly absorbed into the blood.
Example III
Liquid Spray
(Table Removed)
* - obtained from the Warner Jenkins Co., St. Louis, MO, USA.
Add a portion of Ethanol to the active (Dexrromethorphan Base) and solid sweetening
agents (Sucralose, Monoammonium Glycyrrizinate) and continuously mixed at low heat (30°C).
To this vessel add the additional solvents (Propylene Carbonate, Polyethylene Glycol 400) and
liquid sweeteners (Pro-sweet Liquid K). Mix until all materials are in solution, about 2 hours
time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol, and add
to the vessel containing the nearly completed solution. Mix until a homogenous solution is
obtained, and filter through a US # 100 mesh sieve (product density = 1.075 g/ml.). Fill into
manually operated atomization pump and bottle. An example is manufactured by Calmar-Albert
GmbH, the Mistette Mark II fitted with a 16 mm high viscosity head assembly which delivers 0.2
ml. /actuation.
Three individual actuations are sprayed into the mouth. Dexrromethorphan is rapidly absorbed into the blood, and dunng spraying some portion of the sprayed liquid contacts the throat area, providing the additional benefit such as numbing of the irritated cough receptors there.
Example IV
Liquid Spray
(Table Removed)
Add a portion of Ethanol to the active (Dextromethorphan Base) and solid sweetening agents (Sucralose, Monoammonium Glycymzinate) and continuously mixed at low heat (30°C). To this vessel add the additional solvents (Propylene Carbonate, Polyethylene Glycol 400), liquid sweeteners (Pro-sweet Liquid K) and buffer (Triethanolamine, a liquid). Mix until all materials are in solution, about 2 hours time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol, and add to the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh sieve (product density = 1.075 g/ml.). Fill into manually operated atormzation pump and bottle. An example is
manufactured by Calmar-Albert GmbH, the Mistette Mark II fitted with a 16 mm high viscosity
head assembly.
Three individual actuations are sprayed into the mouth. Dextromethorphan is rapidly
absorbed into the blood, and during spraying some portion of the sprayed liquid contacts the
throat area, providing the additional benefit such as numbing of the irritated cough receptors
there.
Example V
Liquid Centered Lozenge
(Table Removed)

Add a portion of Ethanol to the active (Dextromethorphan Base) and solid sweetening agents (Sucralose, Monoammonium Glycymzinate) and continuously mixed at low heat (30°C). To this vessel add the additional solvents (Propylene Glycol, Polyethylene Glycol 600) and liquid sweeteners (Pro-sweet Liquid K). Mix until all materials are in solution, about 2 hours time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol and water, and add to the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh sieve (product density = 1.07 g/ml.). Make individual filled lozenges containing about 1.0 ml. of liquid per lozenge by a commonly used method such as extrusion
A person places a liquid filled lozenge into the mouth and sucks on the lozenge until the liquid fill is released. Some cough relief is obtained through the action of sucking on the shell of the lozenge. When the liquid center is released, dextromethorphan is rapidly absorbed into the blood.
Example V
Liquid Centered Lozenge
(Table Removed)
Add a portion of Ethanol to the active (Dextromethorphan Base) and solid sweetening agents (Sucralose. Monoammonium Glycyrrizmate) and continuously mixed at low heat (30°C). To this vessel add the additional solvents (Propylene Glycol, Polyethylene Glycol 600) and liquid sweeteners (Pro-sweet Liquid K). Prepare an aqueous premix of buffer (Sodium Glycinate) and add to the vessel. Mix until all materials are in solution, about 2 hours time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol, and add to the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh sieve (product density = 1.07 g/ml.). Make individual filled lozenges containing about 1.0 ml. of liquid per lozenge by a commonly used method such as extrusion
A person places a liquid filled lozenge into the mouth and sucks until the liquid fill is released. Some cough relief is obtained through the action of sucking on the shell of the lozenge. When the liquid center is released, dextromethorphan is rapidly absorbed into the blood, and relief from coughing is obtained within 10 minutes time.
Example VII
Liquid Elixir
(Table Removed)

The composition is made according to the direction of Examples I and II.

Example VIII
Liquid Elixir
(Table Removed)

The composition is made according to the direction of Examples I and II.
Example IX
Liquid Elixir
(Table Removed)
Procedure: Dissolve Dextromethorphan Base and Pseudoephedrine Base in portion of alcohol to make a premix. In separate container heat PEG 1000, PEG 600, PVP-KI7pf and
propylene glycol to (a 70°C. Once all material is melted and in clear liquid form Acetoamonophen and continue to heat to 110-120°C with continuous mixing. Remove heal once liquid is clear. Cool it to room temperature. Add the mixture to the Dextromethorphan and Pseudoephednne premix. Also add liquid sweetener (Pro-sweet Liquid K) and buffer (Triethanolamine).
Mix until all materials are in solution. Prepare a premix of flavorants and colorants in
the remaining portion of alcohol, and add to the vessel containing the nearly completed solution.
Mix until homogeneous and filter through a US #100 mesh sieve. Fill in a amber glass bottles.
and cap with an integrated cap/ calibrated medicine dropper assembly. About 1.84 grams of the
elixir is dropped onto the tongue and then swallowed. Liquid Centered Lozenge with mucosal
pretreating agents in the shell.
Example X
Liquid Centered Lozenge

(Table Removed)
Add a portion of Ethanol to the Dextromethorphan HBR and solid sweetening agents (Sucralose, Monoammonium glycyrrzinate) and continuously mixed at low heat (30°C). To this vessel add the additional solvents (Propylene Glycol, Polyethylene Glycol 600, glycerine) and liquid sweeteners (Pro-sweet Liquid K). Mix until all materials are in solution, about 2 hours time. Prepare a premix of flavorants and colorants in the remaining portion of ethanol, and add to
the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh. The liquid, solution is then filled into individual filled cough drops containing about 1.5 mL of liquid per drop by a commonly used method, for example, by extrusion. The candy mass of the cough drop is made to contain per drop; 5 milligrams peppermint oil. 2.5 milligrams menthol, 0.50 milligrams polysorbate 80. and 5 milligrams sodium glycinate.
A person places a liquid filled lozenge into the mouth and sucks. The mucosal tissues of the mouth are pretreated by the peppermint oil, menthol, polysorbate 80, and glycinate in the shell of the drop, so that dextromethorphan is more readily absorbed upon release of the liquid fill into the mouth. Some cough relief is obtained through the action of sucking on the shell of the lozenge. When the liquid center is released, dextromethorphan is rapidly absorbed into the blood, and relief from coughing is obtained within 10 minutes time.
Example XI
Liquid Elixir

(Table Removed)Add a portion of Ethano] to the Dextromethorphan HBR and solid sweetening agents (Sucralose, Monoammonium glycyrrizmate) and continuously mix at low heat (30°C). To this vessel add the additional solvents (Propylene Glycol, Polyethylene Glycol 600) and liquid sweeteners (Pro-sweet Liquid K). Mix until all materials are in solution, about 2 hours time. Add the water and mix briefly. Prepare a premix of flavorants and colorants in the remaining portion of ethanol and add to the vessel containing the nearly completed solution. Mix until a homogenous solution is obtained, and filter through a US # 100 mesh. Fill into amber glass bottles and cap.
One half teaspoon (2.5 ml) is taken into the mouth and swallowed. Dextromethorphan is rapidly absorbed into the blood.



We Claim:-
1. A composition for application 10 mucosal membranes in the mouth comprising a pharmaceutical active in an hydrophilic, water-misciblc, anhydrous solvent wherein the pharmaceutical active in its un-ionized state has a percent solubility value in the solvent at ambient temperature that is equal to or greater than 0.075% and the pharmaceutical active is in it free, un-ionized form as a monomolecular dispersion in the solvent.
2. The composition according to claim 1 wherein the pharmaceutical active has a molecular
weight of Jess than 500 grams per mole, is capable of being ionized when in an aqueous solvent and has an octanol-water partition coefficient when in the unionized form of at least 100.
3. The composition according to claims 1 and 2 wherein the pharmaceutical active is
selected from the group consisting of antitussices, antihistamines, non-sedating antihistamines, decongestants, expectorants, analgesic mucolytics, antipyretic anti-inflammatory agents, local anesthetics and mixtures thereof.
4. The composition according to claims 1 though 3 wherein the concentration of the pharmaceutical active in the solvent is less than or equal to 125% of the percent solubility value of said active.
5. The composition according to claims 1 through 4 wherein the pharmaceutical active is
present in the solvent at a level from 0.075% to 25.0%, preferably from 0.28% to 10.0%
by weight of the composition.
6. The composition according to claims 1 through 5 wherein the pharmaceutical active is
dextromethorphan in a concentration from 0.1% to 9.3%, preferably from 0.26% to 6.2%
and most preferably from 1.16% to 4.6% by weight of the composition.
7. The composition according to claims 1 through 6 wherein the an hydrophilic, water-
miscible, anhydrous solvent comprises from 60% to 99.975%, preferably from 70% to
about 99%, and most preferably 85% to about 98% by weight of the composition,

8. The composition according to claims 1 through 7 wherein the hydrophilic, water-
miscible, anhydrous solvent is selected from the group consisting propylene glycol,
ethanol, poly(ethylene glycol) or PEG, propylene carbonate, diethylene glycol monoethyl
ether, poloxamer, glycofurol, glycerol and mixtures thereof.
9. The composition according to claims 1 through 8 comprising in addition to the
pharmaceutical active., other pharmaceutical actives selected from the group consisting of
antitussivcs, antihistamines, non-sedating antihistamines, decongestants, expectorants,
analgesic mucolyties, antipyretic anti-inflammatory agents, local anesthetics and
mixtures thereof.
10. The composition according to claim 9 wherein said other pharmaceutical actives are
selected from the group consisting of pseudoephedrine, phenylpropylamme,
acetoaminophen, chlorphenvramine, doxylamine, phcnindamine, triprolidine, their salts
and mixtures thereof.
11 The composition according to claims 1 through 11 wherein the product form is any from the group of chewable capsules, liquid-filled chewing gums, elixirs, sprays and lozenges.
12. The composition according to claim 1 through 12 wherein the composition is contained
within said product form having an outer shell that comprises a substances to pretreat the
mucosal membranes of the mouth prior to delivery of said composition to said mucosal
membranes.
13. A process for making a composition of claims 1 through 13 wherein said composition is
used for orally administering the pharmaceutical active in a sufficient volume of said
composition wherein the level of dextromethorphan delivered to the consumer is from
6.85 milligrams to 30.83 milligrams per dose of the composition.
14. A process for making a composition of claims 1 through 13 wherein said composition is
used for orally administering said pharmaceutical active in a sufficient volume of said
composition wherein the level of dextromethorphan delivered to the consumer from the hydrobromide monohydrate salt of dextromethorphan is from 10.0 milligrams to 45 milligrams per dose of the composition.
15. The process according to claim 14 and 15 wherein the
composition is placed against any of the oral mucosal
tissues in the mouth.
16. A process for making a composition of claims 1 through 13
wherein said composition is used for orally administering
said pharmaceutical active in a total dosage volume of no
more than 3.0 mls.
17. A composition for application to mucosal membranes in the
mouth, substantially as hereinbefore described with
reference to the foregoing examples.
18. A process for making a composition, substantially as
hereinbefore described with reference to the foregoing
examples.

Documents:

in-pct-2001-600-del-abstract.pdf

in-pct-2001-600-del-assignment.pdf

in-pct-2001-600-del-claims.pdf

in-pct-2001-600-del-correspondence-others.pdf

in-pct-2001-600-del-correspondence-po.pdf

in-pct-2001-600-del-description (complete).pdf

in-pct-2001-600-del-form-1.pdf

in-pct-2001-600-del-form-13.pdf

in-pct-2001-600-del-form-19.pdf

in-pct-2001-600-del-form-2.pdf

in-pct-2001-600-del-form-26.pdf

in-pct-2001-600-del-form-3.pdf

in-pct-2001-600-del-form-5.pdf

in-pct-2001-600-del-pct-304.pdf

in-pct-2001-600-del-pct-409.pdf

in-pct-2001-600-del-pct-416.pdf

in-pct-2001-600-del-petition-137.pdf


Patent Number 212550
Indian Patent Application Number IN/PCT/2001/00600/DEL
PG Journal Number 50/2007
Publication Date 14-Dec-2007
Grant Date 04-Dec-2007
Date of Filing 05-Jul-2001
Name of Patentee THE PROCTER & GAMBLE COMPANY
Applicant Address ONE PROCTER & GAMBLE PLAZA, CINCINNATI, STATE OF OHIO U.S.A.
Inventors:
# Inventor's Name Inventor's Address
1 DOBROZSI, DOUGLAS JOSEPH 9273 KEMPERGROVE LN., LOVELAND, OHIO, 45140, U.S.A.
2 HAYES, JERRY WILLIAM II 5836 BLUE SPRUCE LANE, CINCINNATI, OHIO, 45224, U.S.A.
3 DESAI, KISHOR JIVANLAL 648 RUPP FARM DR. WEST CHESTER, OHIO, 45069, U.S.A.
4 ROBBINS, BRIAN JAMES 17 KESTREL AVE. STAINES, MIDDLESEX TW18U 4RU, U.K.
PCT International Classification Number A61K 31/485
PCT International Application Number PCT/US00/00575
PCT International Filing date 2000-01-10
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/115378 1999-01-11 U.S.A.