Novel controlled release pharmaceutical compositions for oral use containing midodrine and/or its active metabolite desglymidodrine. The novel compositions are designed to release midodrine and/or desglymidodrine after oral intake in a manner which enables absorption to take place in the gastrointestinal tract so that a relatively fast peak plasma concentration of the active metabolite desglymidodrine is obtained followed by a prolonged and relatively constant plasma concentration of desglymidodrine.
The novel compositions may be designed for administration once or twice daily, i.e. a therapeutically effective concentration of desglymidodrine is maintained for a period of at least 10-16 hours followed by a wash out period of about 8-12 hours in order to avoid the well-known midodrine related side effect with respect to supine hypertension. The therapeutically effective concentration of desglymidodrine is regarded as a plasma concentration of desglymidodrine of at least about 3 ng/ml. A composition is designed to release midodrine and/or desglymidodrine in at least the following consecutive steps: i) an initial relatively fast release of midodrine and/or desglymidodrine (in order to obtain a relatively fast onset of action), ii) a steady release or a slower release than in step 1 of midodrine and/or desglymidodrine (in order to maintain a plasma concentration of desglymidodrine which is prolonged and relatively constant), iii) a second rise in release of midodrine and/or desglymidodrine (in order to take advantage of absorption from the colon, i.e. such a second rise release is designed to take place when the composition (or the disintegrated parts of the composition) reaches the colon; normally this is regarded to take about 8 hours after oral intake, and iv) a decline in release rate corresponding to that essentially all midodrine and/or desglymidodrine have been released from the composition.
Also disclosed is a method for treating orthostatic hypotension and/or urinary incontinence, the method comprising administration to a patient in need thereof of an effective amount of midodrine and/or desglymidodrine in a composition according to the invention.
含有
米多君和/或其活性代谢物去甘
米多君的新型口服控释药物组合物。这些新型组合物的设计目的是在口服后释放
米多君和/或
去甲斑蝥素,其释放方式可使胃肠道吸收,从而使活性代谢物
去甲斑蝥素的血浆浓度相对较快达到峰值,随后
去甲斑蝥素的血浆浓度长时间保持相对稳定。
新型组合物可设计为每天给药一次或两次,即去
氨加
米多君的治疗有效浓度至少维持 10-16 小时,然后经过约 8-12 小时的冲淡期,以避免众所周知的与
米多君有关的仰卧位高血压副作用。去
氨加
米多君的治疗有效浓度是指去
氨加
米多君的血浆浓度至少约为 3 纳克/毫升。一种组合物可至少按以下连续步骤释放
米多君和/或去甘
米多君:i) 最初相对快速地释放
米多君和/或去
氨加
米多君(以获得相对快速的起效时间),ii) 稳定释放
米多君和/或去
氨加
米多君或比步骤 1 更慢地释放
米多君和/或去
氨加
米多君(以维持去
氨加
米多君血浆浓度的长期和相对稳定),iii)
米多君和/或去
氨加
米多君的第二次上升释放(以利用从结肠吸收的优势,即这种第二次上升释放是通过结肠吸收),iii)
米多君和/或去
氨加
米多君的第二次上升释放(以利用从结肠吸收的优势,即这种第二次上升释放是通过结肠吸收)。例如,当组合物(或组合物的崩解部分)到达结肠时,第二次释放上升就会发生;通常这被认为是在口服后 8 小时左右;以及 iv) 释放率下降,这与基本上所有
米多君和/或去甲
米多君都从组合物中释放出来相对应。
本发明还公开了一种治疗直立性低血压和/或尿失禁的方法,该方法包括向有需要的患者施用有效量的
米多君和/或去
氨加
米多君组合物。