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1. WO2002064109 - PREPARATIONS PHARMACEUTIQUES

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CLAIMS :

1. A pharmaceutical formulation for use in administration of a lipophilic medicament via a mucosal surface, which formulation comprises at least one lipophilic medicament and at least one self emulsifying agent, wherein upon hydration the
formulation forms an emulsion containing the
lipophilic medicament which is capable of adhering to a mucosal surface and allowing controlled release of the medicament.

2. A formulation according to claim 1 which is not in the form of a propellant-driven aerosol or a propellant-driven liquid spray.

3. A formulation according to claim 1 or claim 2 which further comprises one or more viscolising agents .

4. A formulation according to claim 3 wherein the viscolising agent (s) is/are not block copolymers of oxyethylene and oxypropylene.

5. A formulation according to claim 3 wherein the viscolising agent (s) is/are not nonionic
surfactants .

6. A formulation according to claim 5 which comprises at least one viscolising agent that when hydrated forms a gel having positive surface
electrical charge and at least one viscolising agent that when hydrated forms a gel having negative surface electrical charge.

7. A formulation according to claim 6 which comprises at least one viscolising agent that when hydrated forms a gel having positive surface
electrical charge which is gelatin or glycogelatin and at least one viscolising agent that when hydrated forms a gel having negative surface electrical charge which is starch, pre-gelatinised starch, acacia or polydextrose.

8. A formulation according to any one of claims 3 to 7 wherein at least one of the viscolising agents is solubilised by the action of an enzyme present in saliva.

9. A formulation according to any one of the preceding claims which is a solid dosage form, preferably a gel, compressed tablet or capsule.

10. A formulation according to claim 9 which is in the form of a gel for administration of a
lipophilic medicament via the sublingual and/or buccal mucosae, wherein on contact with saliva the gel or gel-spray forms an emulsion containing the lipophilic medicament that adheres to the sublingual and/or buccal mucosae.

11. A formulation according to claim 9 which is in the form of a compressed tablet for administration of a lipophilic medicament via the sublingual and/or buccal mucosae, wherein on contact with saliva the tablet disintegrates completely and forms an emulsion containing the lipophilic medicament that adheres reversibly to the sublingual and/or buccal mucosae.

12. A formulation according to any one of claims 9 to 11 wherein the total amount of viscolising agent (s) included in the formulation is greater than 60% w/w of the formulation.

13. A formulation according to any one of claims 9 to 11 wherein the self-emulsifying agent (s) is/are present in an amount at least 5% w/w, preferably at least 10% w/w of the formulation.

14. A formulation according to claim 1 or claim 2 which further contains at least one solvent.

15. A formulation according to claim 1 or claim 2 which further contains at least one co-solvent.

16. A formulation according to claim 15 wherein the co-solvent is a solubilising agent.

17. A formulation according to claim 16 wherein the solubilising agent is a polyoxyethylene castor oil derivative .

18. A formulation according to claim 17 wherein the polyoxyethylene castor oil derivative is
cremophor, preferably cremophor RH40.

19. A formulation according to any one of claims 14 to 18 which is a gel-spray.

20. A formulation according to claim 19 which is in the form of a gel-spray for administration of a lipophilic medicament via the sublingual and/or buccal mucosae, wherein on contact with saliva the gel or gel-spray forms an emulsion containing the lipophilic medicament that adheres to the sublingual and/or buccal mucosae.

21. A formulation according to any one of claims 14 to 20 which further contains one or more
viscolising agents, wherein the total amount of viscolising agent (s) included in the formulation is at least 1% w/w of the formulation.

22. A formulation according to any one of claims 14 to 21 wherein the self-emulsifying agent (s) is/are present in an amount at least 2% w/w, preferably at least 5% w/w of the formulation.

23. A formulation according to any one of the preceding claims which includes at least one self-emulsifying agent selected from glyceryl mono-oleate, glyceryl monostearate and self-emulsifying grade glyceryl monostearate.

24. A formulation according to any one of claims 1 to 23 wherein the lipophilic medicament is at least one cannabis extract.

25. A formulation according to any one of claims 1 to 23 wherein the lipophilic medicament comprises one or more natural or synthetic cannabinoids.

26. A formulation according to claim 25 wherein the lipophilic medicament comprises
tetrahydrocannabinol, Δ9-tetrahydrocannabinol, Δ9-tetrahydrocannabinol propyl analogue, cannabidiol, cannabidiol propyl analogue, cannabinol, cannabichromene, cannabichromene propyl analogue, cannabigerol or any mixture thereof.

27. A pharmaceutical formulation for use in administration of a lipophilic medicament via a mucosal surface, which formulation comprises at least one lipophilic medicament and at least one self emulsifying agent, wherein upon hydration the
formulation forms an emulsion containing the
lipophilic medicament which is capable of adhering to a mucosal surface and allowing controlled release of the medicament, wherein the lipophilic medicament is at least one extract from at least one cannabis plant .

28. A pharmaceutical formulation for use in administration of a lipophilic medicament via a mucosal surface, which formulation comprises at least one lipophilic medicament and at least one self emulsifying agent, wherein upon hydration the
formulation forms an emulsion containing the
lipophilic medicament which is capable of adhering to a mucosal surface and allowing controlled release of the medicament, wherein the lipophilic medicament comprises a combination of two or more natural or synthetic cannabinoids.

29. A formulation according to claim 28 wherein the lipophilic medicament comprises any combination of two or more cannabinoids selected from
tetrahydrocannabinol, Δ9-tetrahydrocannabinol, Δ9-tetrahydrocannabinol propyl analogue, cannabidiol, cannabidiol propyl analogue, cannabinol,
cannabichromene, cannabichromene propyl analogue and cannabigerol.

30. A pharmaceutical formulation for use in administration of a lipophilic medicament via a mucosal surface, the formulation comprising at least one lipophilic medicament, at least one solvent, at least one co-solvent and at least one self emulsifying agent, wherein upon hydration the formulation forms an emulsion containing the lipophilic medicament which is capable of adhering to a mucosal surface and allowing controlled release of the medicament, characterised in that the total amount of solvent and co-solvent present in the formulation is greater than 55% w/w of the formulation.

31. A formulation according to claim 30 wherein the total amount of solvent plus co-solvent present in the formulation is greater than 65% w/w, preferably greater than 70% w/w, more preferably greater than 75% w/w, more preferably greater than 80% w/w, more preferably greater than 85% w/w of the formulation.

32. A formulation according to claim 31 which comprises between 80% w/w and 95% w/w of solvent plus co-solvent.

33. A formulation according to any one of claims 30 to 32 wherein the solvent is a lower alkyl (Ci-C alcohol and the co-solvent is propylene glycol, glycerol, a macrogol or a polyoxy hydrogenated castor oil .

34. A formulation according to claim 33 wherein the solvent is ethanol and the co-solvent is propylene glycol.

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35. A formulation according to claim 34 wherein the ratio of ethanol to propylene glycol present in the formulation is between 4:1 and 1:4.

36. A formulation according to claim 35 wherein the ratio of ethanol to propylene glycol present in the formulation is about 1:1.

37. A formulation according to claim 33 wherein the solvent is ethanol and the co-solvent is a polyoxy hydrogenated castor oil, preferably cremophor RH40™.

38. A formulation according to claim 37 wherein the amount of polyoxy hydrogenated castor oil present in the formulation is between 5 and 55% w/w of the total amount of polyoxy hydrogenated castor oil plus ethanol present in the formulation.

39. A formulation according to claim 38 wherein the amount of polyoxy hydrogenated castor oil present in the formulation is between 20 and 40% w/w of the total amount of polyoxy hydrogenated castor oil plus ethanol present in the formulation.

40. A formulation according to claim 39 wherein the amount of polyoxy hydrogenated castor oil present in the formulation is approximately 30% w/w of the total amount of polyoxy hydrogenated castor oil plus ethanol present in the formulation.

41. A formulation according to any one of claims 30 to 40 wherein the self-emulsifying agent (s) is/are present in an amount greater than 1% w/w of the formulation.

42. A formulation according to any one of claims 30 to 41 which comprises glyceryl mono-oleate as a self-emulsifying agent.

43. A formulation according to any one of claims 30 to 42 wherein the lipophilic medicament comprises at least one cannabis extract.

44. A formulation according to any one of claims 30 to 42 wherein the lipophilic medicament comprises one or more natural or synthetic cannabinoids.

45. A formulation according to claim 44 wherein the lipophilic medicament comprises
tetrahydrocannabinol, Δ9-tetrahydrocannabinol, Δ9-tetrahydrocannabinol propyl analogue, cannabidiol, cannabidiol propyl analogue, cannabinol,
cannabichromene, cannabichromene propyl analogue, cannabigerol or any mixture thereof.

46. A cannabis-based pharmaceutical formulation which comprises both the cannabinoids cannabidiol

(CBD) and tetrahydrocannabinol (THC) , or the
cannabinoids, or the cannabinoids
tetrahydrocannabinovarin (THCV) and cannabidivarin (CBDV), in a pre-defined ratio by weight.

47. A pharmaceutical formulation according to claim 43 which comprises both the cannabinoids
cannabidiol (CBD) and tetrahydrocannabinol (THC) in approximately equal amounts by weight.

48. A pharmaceutical formulation according to claim 43 which comprises both the cannabinoids
cannabidiol (CBD) and tetrahydrocannabinol (THC) , wherein the THC is present in an amount by weight which is greater than the amount by weight of CBD.

49. A pharmaceutical formulation according to claim 43 which comprises both the cannabinoids cannabidiol (CBD) and tetrahydrocannabinol (THC) , wherein the CBD is present in an amount by weight which is greater than the amount by weight of THC.

50. A formulation according to claim 49 wherein the ratio by weight of CBD to THC is greater than 2.5:1.

51. A formulation according to claim 49 or claim 50 wherein the ratio by weight of CBD to THC is between 99:1 and 2.5:1, preferably between about 20:1 and about 2.5:1.

52. A formulation according to any one of claims 49 to 51 wherein the ratio by weight of CBD to THC is about 19:1.

53. A formulation according to any one of claims 49 to 51 wherein the ratio by weight of CBD to THC is in the range from about 5:1 to about 3:1.

54. A formulation according to any one of claims 49 to 53 which is substantially free of cannabinoids other than CBD and THC.

55. A formulation according to claim 54 which is substantially free of other cannabinoids found in Cannabis sp .

56. A formulation according to any one of claims 49 to 55 wherein said CBD and THC are in substantially pure form.

57. A formulation according to any one of claims 49 to 53 which further comprises one or more other cannabinoids .

58. A formulation according to claim 57 wherein the one or more other cannabinoids are
tetrahydrocannabinovarin (THCV) and/or cannabidivarin (CBDV) .

59. A formulation according to any one of claims 49 to 53, 57 or 58 wherein the CBD and THC are derived from at least one extract from at least one Cannabis plant, said at least one extract comprising all the naturally occurring cannabinoids in said plant.

60. A formulation according to claim 59 wherein the Cannabis plant is selected from Cannabis sativa, Cannabis indica, a genetic cross between them, a self-cross or a hybrid thereof.

61. A formulation according to claim 60 wherein the Cannabis plant is Cannabis sativa, subspecies indica and is selected from var. indica and var.
kafiristanica .

62. A formulation as claimed in any one of claims 59 to 61 which comprises extracts from two or more different Cannabis varieties wherein in the final formulation the amount of CBD is greater than the amount of THC by weight.

63. A formulation according to any one of claims 59 to 61 wherein said extract is prepared by
supercritical or sub-critical fluid extraction of dried Cannabis plant.

64. A method of preparing a Cannabis-based pharmaceutical formulation which comprises CBD and THC in a pre-defined ratio by weight which method
comprises the steps of :

a) providing at least one dried Cannabis plant for which the amount of CBD and THC by weight is known;

b) preparing an extract of said at least one Cannabis plant

c) formulating a material from said extract or extracts prepared in step (c) which exhibits said pre-defined ratio of CBD to THC; and

d) further formulating the product of step (c) into a pharmaceutical formulation with a
pharmaceutically acceptable carrier or diluent.

65. A method according to claim 64 wherein the extract of step (b) is prepared using at least one of the following procedures:

(i) maceration (ii) percolation
(iii) extraction with solvent such as C^Cs alcohols, norflurane or HFA227
(iv) subcritical or supercritical fluid extraction

66. A method according to claim 64 or claim 65 wherein prior to extraction said dried Cannabis is heated to a temperature of from about 60°C to about 225°C, preferably about 100°C to about 150°C, to decarboxylate the acid form of any cannabinoids present in the extract.

67. A method according to claims 64 to 66 which comprises extracting said at least one Cannabis plant with supercritical or subcritical C02.

68. A method according to any one of claims 64 to 67 wherein after extraction with said supercritical or subcritical fluid said extract is subjected to "winterisation" to remove waxes from the extract.

69. A method according to any one of claims 64 to 68 wherein the amount by weight of CBD in the formulation is greater than the amount by weight of THC.

70. A method according to any one of claims 64 to 69 wherein said pre-defined ratio of CBD to THC by weight is between 99:1 and 2.5:1, preferably between about 20:1 and about 2.5:1.

71. A method according to any one of claims 64 to 70 wherein said pre-defined ratio by weight of CBD to THC is about 19:1.

72. A method according to any one of claims 64 to 69 wherein said pre-defined ratio by weight of CBD to THC is in the range from about 5:1 to 3:1.

73. A method according to any one of claims 64 to 68 wherein the formulation comprises approximately equal amounts of CBD and THC by weight.

74. A method according to any one of claims 64 to 68 wherein the amount by weight of THC in said formulation is greater than the amount by weight of CBD.

75. A method according to any one of claims 64 to 68 wherein said pre-defined ratio by weight of CBD to THC is between 1:99 and 1:1.5.

76. A method according to any one of claims 64 to 68 wherein said pre-defined ratio by weight of CBD to THC is about 1:39.

77. A method according to any one of claims 64 to 68 wherein said pre-defined ratio by weight of CBD to THC is about 1:2.

78. A method according to any one of claims 64 to 77 wherein said formulation is formulated for delivery nasally, sub-lingually, buccally, topically, orally, rectally, intravenously, intra-peritoneally, intra-muscularly, sub-cutaneously, transdermally, intra-vaginally, intra-urethrally, by nebulizer, as inhaled vapour or by installation directly into the bladder .

79. A method according to any one of claims 64 to 77 wherein said formulation is formulated to deliver CBD prior to delivery of THC and/or to provide a controlled release formulation.

80. A Cannabis-based pharmaceutical formulation which is obtainable by the method of any one of claims 64 to 79.

81. A pharmaceutical formulation according to claim 46 which comprises both the cannabinoids
tetrahydrocannabinovarin (THCV) and cannabidivarin (CBDV) wherein the CBDV is present in an amount by weight which is greater than the amount by weight of THCV.

82. A formulation according to claim 81 which further comprises CBD and/or THC.

83. A formulation according to claim 81 or 82 wherein the ratio by weight of CBDV to THCV is greater than 1.5:1.

84. A formulation according to any one of claims 81 to 83 wherein the ratio by weight of CBDV to THCV is in the range from about 99:1 to about 1.5:1, preferably from about 20:1 to about 2.5:1.

85. A formulation according to any one of claims 81 to 84 wherein the ratio by weight of CBDV to THCV is about 9:1.

86. A formulation according to any one of claims 81 to 84 wherein the ratio of CBDV to THCV by weight is from about 5:1 to 3:1.

87. A formulation according to claim 81 or any one of claims 83 to 86 which is substantially free from other cannabinoids found in Cannabis sp.

88. A formulation according to any one of claims 81 to 87 wherein the CBDV and THCV form part of an extract from a Cannabis plant, said extract comprising all of the naturally occurring cannabinoids in said plant .

89. A formulation according to claim 88 wherein the Cannabis plant is selected from Cannabis sativa, Cannabis indica or a genetic cross between them, a self-cross or a hybrid thereof.

90. A modification of the method according to any one of claims 64 to 79 wherein in step (a) at least one dried Cannabis plant is provided for which the amount of CBDV and THCV is known and a
pharmaceutical formulation is prepared comprising a pre-determined ratio by weight of CBDV to THCV instead of CBD and THC.

91. A pharmaceutical formulation which comprises both the cannabinoids THC and THCV wherein the THCV is present in an amount by weight which is approximately equal to or greater than the amount by weight of THC.

92. A pharmaceutical formulation according to claim 91 wherein the ratio by weight of THCV to THC is between 99:1 and 1.5:1

93. A formulation according to claim 91 or 92 wherein the ratio by weight of THCV to THC is
approximately 17:3.

94. A formulation according to any one of claims 91 to 93 which also comprises CBD and/or CBDV at an amount by weight which is less than the amount by weight of THCV.

95. A formulation according to any one of claims 91 to 94 wherein the THCV and THC form part of an extract from a Cannabis plant, said extract comprising all the naturally occurring cannabinoids in said plant .

96. A formulation according to claim 95 wherein said Cannabis plant is selected from Cannabis sativa, Cannabis indica or the result of a genetic cross between them, a self-cross or a hybrid thereof.

97. A modification of the method according to any one of claims 64 to 79 wherein in step (a) at least one dried cannabis plant is provided for which the amount of THCV and THC is known and a
pharmaceutical formulation is prepared comprising a pre-determined ratio by weight of THCV to THC instead of CBD to THC.

98. A Cannabis-based pharmaceutical formulation which is obtainable by the method of claim 90 or claim 97.

99. A pharmaceutical formulation according to any one of claims 46 to 63, 80 to 89, 91 to 95 or 98 for use in the treatment of inflammatory disease or any disease or condition during the course of which oxidative stress plays a part.

100. A pharmaceutical formulation according to claim 53 or 86 for use in the treatment of rheumatoid arthritis, or inflammatory bowel disease or Crohn's disease..

101. A pharmaceutical formulation for use
according to claim 100 wherein in the formulation the CBD and THC and/or the CBDV and THCV form part of an extract from a Cannabis plant, said extract comprising all the naturally occurring cannabinoids in said plant .

102. A pharmaceutical formulation according to claim 52 or 85 for use in the treatment of psychotic disorders, epilepsy, movement disorders, stroke, head injury, or diseases which require appetite
suppression.

103. A pharmaceutical formulation for use
according to claim 102 wherein in the formulation the CBD and THC and/or CBDV and THCV form part of an extract from a Cannabis plant, said extract comprising all the naturally occurring cannabinoids in said plant.

104. A pharmaceutical formulation obtainable by the method of claim 64 or 90 which comprises
approximately equal amounts of CBD and THC or THCV and CBDV for the treatment of multiple sclerosis, spinal cord injury, peripheral neuropathy or other neurogenic pain.

105. A pharmaceutical formulation which comprises a ratio by weight of THC to CBD or THCV to CBDV of from about 39:1 to about 99:1 for use in the treatment of cancer pain or migraine or for stimulation of appetite.

106. A pharmaceutical formulation for use
according to claim 105 wherein the ratio by weight of THC to CBD or THCV to CBDV is approximately 39:1.

107. A pharmaceutical formulation for use
according to claim 105 or 106 wherein in the
formulation the THC and CBD and/or THCV and CBDV form part of an extract from a Cannabis plant , said extract comprising all the naturally occurring
cannabinoids in said plant.

108. The pharmaceutical formulation of any of claims 91 to 95 for use in the treatment of cancer pain or migraine or for stimulation of the appetite.

109. Use of Cannabidiol (CBD) to extend the shelf-life of a pharmaceutical product which comprises one or more other biologically active components .

110. The use according to claim 109 wherein the biologically active component is a lipophilic
substance.

111. The use according to claim 110 wherein the biologically active molecule is selected from
cannabinol (CBN) , cannabigerol (CBG) , THC, CBDV and THCV.

112. A pharmaceutical formulation according to any one of claims 1 to 45 which further includes the features of any one of claims 46 to 63, 80 to 89, 91 to 96 or 98.

113. A pump-action spray comprising a
pharmaceutical formulation as according to any one of claims 1 to 45, 46 to 63, 80 to 89, 91 to 96 or 98.

114. A pump-action spray according to claim 113 wherein the formulation is delivered through a nozzle such that the mean aerodynamic diameter of the particles produced is between 15 and 45 microns.