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US20180028662A1 - Method for Suppressing Bitterness of Quinoline Derivative - Google Patents

Method for Suppressing Bitterness of Quinoline Derivative Download PDF

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US20180028662A1
US20180028662A1 US15/550,124 US201615550124A US2018028662A1 US 20180028662 A1 US20180028662 A1 US 20180028662A1 US 201615550124 A US201615550124 A US 201615550124A US 2018028662 A1 US2018028662 A1 US 2018028662A1
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pharmaceutically acceptable
acceptable salt
basic substance
bitterness
pharmaceutical composition
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Kentaro Nagane
Yosuke Ueki
Shusuke Sano
Takahisa Sakaguchi
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Eisai R&D Management Co Ltd
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Eisai R&D Management Co Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/02—Inorganic compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
    • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/10—Dispersions; Emulsions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the present invention relates to a method for suppressing bitterness of a medicine.
  • Patent Literature 1 4-(3-Chloro-4-(cydopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide (hereinafter also referred to as Compound 1 or lenvatinib) or a salt thereof, which is a quinoline derivative having an antiangiogenic effect, is known (Patent Literature 1).
  • a pharmaceutical composition comprising Compound 1 or a salt thereof
  • a pharmaceutical composition comprising Compound 1 or a salt thereof and (i) a compound, a 5% (w/w) solution or suspension of which has a pH of 8 or more and/or (ii) a silicic acid to reduce a degradation under humidified and heated conditions or inhibit a gelation on a surface of the pharmaceutical composition (Patent Literature 2).
  • Patent Literature 3 As a pharmaceutical composition excellent in dissolution properties of Compound 1 and stable through long-term storage, a pharmaceutical composition comprising (1) Compound 1 or a salt thereof; and (2) a basic substance is known (Patent Literature 3).
  • composition comprising a pharmacologically active ingredient of an organic sulfonate, a disintegrating agent and a water-soluble salt, a 2.5% aqueous solution of which has a pH of 3 to 9 (Patent Literature 4).
  • Patent Literature 1 U.S. Patent Application Publication No. 2004/0053908
  • Patent Literature 2 U.S. Patent Application Publication No. 2008/0214604
  • Patent Literature 4 U.S. Patent Application Publication No. 2008/0214557
  • a pharmaceutical composition such as a capsule dissolved or suspended in water or the like is administered in some cases from the viewpoint of medication compliance. If a drug having bitterness dissolved or suspended in water or the like is administered to a patient, however, it is apprehended that the patient may have trouble taking the drug due to the bitterness, and this tendency is increased if the patient is a child.
  • an administration form that can be easily swallowed, such as a suspension is sometimes employed, but due to the size of the digestive tract of the child, there is an upper limit in the amount of a solvent used for the suspension.
  • due to the physical properties of an active pharmaceutical ingredient such as consistency and solubility, not only the bitterness but also the active pharmaceutical ingredient contained in the suspension may remain in a vessel, and thus, the recovery may not be sufficient in some cases.
  • Compound 1 or a pharmaceutically acceptable salt thereof has bitterness.
  • the present inventors have found that the bitterness of Compound 1 or the pharmaceutically acceptable salt thereof can be suppressed by mixing a basic substance such as calcium carbonate with Compound 1 or the pharmaceutically acceptable salt thereof.
  • an administration method comprising: 1) suspending, in an aqueous solvent in a vessel, a pharmaceutical composition comprising Compound 1 or a pharmaceutically acceptable salt thereof and a basic substance; 2) administering a suspension obtained in 1) from the vessel to a patient 3) rinsing the vessel with an aqueous solvent; and 4) administering a rinsing solution obtained in 3) to the patient is employed, the suspension of Compound 1 can be administered to a child at high recovery without causing the child to feel bitterness and in a liquid amount administrable to the child.
  • the present invention provides the following [1] to [33]:
  • [1] A method for suppressing bitterness of 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide, comprising mixing 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof and a basic substance.
  • [2] The method according to [1], wherein 0.01 to 50 parts by weight of the basic substance is mixed per 1 part by weight of 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or the pharmaceutically acceptable salt thereof.
  • a pharmaceutical composition comprising 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof, and a basic substance in an amount effective for suppressing bitterness.
  • a pharmaceutical composition comprising 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof, the pharmaceutical composition comprising means for mixing a basic substance for suppressing bitterness.
  • a pharmaceutical composition comprising 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof and a basic substance, the pharmaceutical composition having bitterness suppressed.
  • the pharmaceutical composition according to any one of [8] to [10], comprising 0.01 to 50 parts by weight of the basic substance per 1 part by weight of 4-(3-chloro-4-(cydopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or the pharmaceutically acceptable salt thereof.
  • the pharmaceutical composition according to any one of [8] to [16] in a dosage form of an orally disintegrating tablet, a chewable preparation, an effervescent tablet, a dispersible tablet, a soluble tablet, a syrup, a preparation for a syrup, a troche, or an oral liquid preparation.
  • the pharmaceutical composition according to any one of [8] to [16] being a preparation that can be suspended in an aqueous solvent upon an administration to prepare a suspension.
  • a bitterness suppressing agent comprising a basic substance, for 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof.
  • the bitterness suppressing agent according to [19], wherein the basic substance added is in an amount of 0.01 to 50 parts by weight per 1 part by weight of 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or the pharmaceutically acceptable salt thereof.
  • the bitterness suppressing agent according to [19], wherein the basic substance added is in an amount of 0.16 to 80 mol per 1 mol of 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or the pharmaceutically acceptable salt thereof.
  • bitterness suppressing agent according to any one of [19] to [21], wherein the basic substance is calcium carbonate.
  • a method for administering a suspension comprising 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof, and a basic substance
  • the method comprising: 1) suspending, in an aqueous solvent in a vessel, a pharmaceutical composition comprising 1 to mg of 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or the pharmaceutically acceptable salt thereof, and the basic substance; 2) administering a suspension obtained in 1) to a patient from the vessel; 3) rinsing the vessel with an aqueous solvent; and 4) administering a rinsing solution obtained in 3) to the patient.
  • a method for treating a cancer by administering a suspension containing 1 to 24 mg of 4-(3-chloro-4-(cyclopropylaminocarbonyl)aminophenoxy)-7-methoxy-6-quinolinecarboxyamide or a pharmaceutically acceptable salt thereof, and a basic substance.
  • Compound 1 or a pharmaceutically acceptable salt thereof is known as an anticancer agent for thyroid cancer and the like, and a cancer can be treated without causing a patient to feel bitterness upon drug administration by the method of the present invention.
  • FIG. 1 is a diagram illustrating relative comparison of bitterness of lenvatinib mesylate and quinine hydrochloride.
  • FIG. 2 is a diagram illustrating concentration dependence of the bitterness suppressing effect of calcium carbonate.
  • FIG. 3 is a diagram illustrating concentration dependence of the bitterness suppressing effect of magnesium oxide.
  • FIG. 4 is a diagram illustrating the bitterness suppressing effect of various polymers.
  • FIG. 5 is a diagram illustrating the bitterness suppressing effect of various low molecular weight compounds.
  • FIG. 6 is a diagram illustrating the bitterness suppressing effect of a lenvatinib mesylate-containing composition.
  • FIG. 7 is a diagram illustrating the bitterness suppressing effect of respective components of the lenvatinib mesylate-containing composition.
  • FIG. 8 is a diagram illustrating results of a dissolution test of orally disintegrating tablets.
  • FIG. 9 is a diagram illustrating the bitterness suppressing effect of a lenvatinib mesylate-containing composition.
  • FIG. 10 is a diagram illustrating the bitterness suppressing effect of various low molecular weight compounds.
  • FIG. 11 is a diagram illustrating the bitterness suppressing effect of various low molecular weight compounds.
  • FIG. 12 is a diagram illustrating the bitterness suppressing effect of various silicic acid compounds.
  • a basic substance may be a low molecular weight compound or a high molecular weight compound as long as it is a substance exhibiting basicity
  • preferable examples include a basic oxide, a basic carbonate, a basic hydroxide or a sodium salt of a polymer having a carboxyl group, and it is more preferably calcium carbonate, magnesium carbonate, potassium carbonate, magnesium oxide, magnesium hydroxide, sodium carboxymethyl starch or croscarmellose sodium, further preferably calcium carbonate or magnesium oxide, and most preferably calcium carbonate.
  • the basic substance is a low molecular weight compound, preferably 0.16 to 80 mol, more preferably 0.3 to 60 mol, and most preferably 0.5 to 40 mol of the basic substance is mixed per 1 mol of Compound 1.
  • a pharmaceutically acceptable salt means a hydrochloride, a hydrobromide, a tosylate, a sulfate, a mesylate or an esylate, and is preferably a mesylate.
  • the “bitterness” of Compound 1 or the pharmaceutically acceptable salt thereof is measured by the following method.
  • a solution of Compound 1 at a concentration of 8 mg/mL as a free form is prepared by dissolving Compound 1 or the pharmaceutically acceptable salt thereof in a 10 mM potassium chloride aqueous solution.
  • an additive is added if necessary, and the resultant is stirred for 30 minutes and then centrifuged to give a liquid phase component.
  • the bitterness of the liquid phase component is measured using a taste sensor (AC0) for measuring bitterness, and the thus obtained value is used as a bitterness index.
  • AC0 taste sensor
  • the term “suppress the bitterness” of Compound 1 or the pharmaceutically acceptable salt thereof means that as measured “bitterness” according to the above-described method, the relative ratio of a measured value of a sample obtained by adding an additive into a control, which comprising Compound 1 or the pharmaceutically acceptable salt thereof, to a measured value of the control is less than 100%, and preferably 70% or less.
  • the control comprising Compound 1 or the pharmaceutically acceptable salt thereof may be Compound 1 itself or the pharmaceutically acceptable salt thereof itself, or may be a mixture also comprising an additional component (such as a capsule) if necessary.
  • a pharmaceutical composition of the present invention is not particularly limited as long as it is a preparation in which the bitterness of Compound 1 or the pharmaceutically acceptable salt thereof may possibly be felt in a usual administration method or in an administration method comprising dissolving or suspending in water or the like without impairing a specific function such as an enteric property.
  • Examples of a preferable form include an orally disintegrating tablet, a chewable preparation, an effervescent tablet, a dispersible tablet, a soluble tablet, a syrup, a preparation for a syrup, a troche and an oral liquid preparation, which stay hi oral cavity for a comparatively long period of time and hence possibly cause a patient to feel the bitterness.
  • a dosage form of a capsule or the like can be included in the preferable form if an oral liquid preparation can be prepared from the preparation at time of use using a solvent such as water.
  • the pharmaceutical composition of the present invention can be produced by any of known methods such as methods described in The Japanese Pharmacopoeia, Sixteenth Edition, General Rules for Preparations.
  • a granule can be produced by adding, if necessary, a diluting agent, a binding agent, a disintegrator, a solvent or the like to Compound 1 or the pharmaceutically acceptable salt thereof; and subjecting the resultant to stirring granulation, extrusion granulation, oscillating granulation, fluidized bed granulation, spray granulation or the like.
  • a core substance of a purified sucrose spherical granule, a lactose-crystalline cellulose spherical granule, a sucrose-starch spherical granule or a granular crystalline cellulose may be coated with an epipastic comprising an additive such as water, sucrose, hydroxypropylcellulose, methylcellulose or polyvinylpyrrolidone.
  • the resultant may be further sized or ground.
  • a suspension prepared by suspending a mixture (including a dosage form such as a tablet or a capsule) of 1 to 24 mg of Compound 1 or the pharmaceutically acceptable salt thereof with a basic substance in an aqueous solvent in a vessel such as a vial, a syringe or a syringe equipped with a nasogastric tube (NG tube).
  • the amount of the aqueous solvent used for the suspension (which can be a sweet drink such as an apple juice according to patients preference) is preferably 1 to 10 mL, more preferably 2 to 5 mL and further preferably about 3 mL.
  • the mixture At the time of suspending, it is preferable to allow the mixture to stand still for a while, preferably about 10 minutes, after adding the aqueous solvent, and then to shake the resultant for a while, preferably about 3 minutes.
  • the vessel used for the suspension may be rinsed with 1 to 10 mL, more preferably 1 to 5 mL and further preferably about 2 mL of an aqueous solvent, and the resultant rinsing solution may be further administered.
  • a numerical value with the term “about” encompasses a numerical value obtained by rounding off to the nearest whole number, and for example, “about 3” corresponds to a range of 2.5 to 3.4.
  • Crystalline Asahi Kasei Ceolus PH-101 Cellulose Chemicals Japanese (PH101) Corporation Pharmacopoeia Hydroxypropyl- Nippon Soda HPC-L cellulose Co., Ltd. Low-substituted Shin-Etsu L-HPC LH-21 Hydroxypropyl- Chemical cellulose Co., Ltd. Crystalline Asahi Kasei Ceolus PH-102, Cellulose Chemicals Japanese (PH102) Corporation Pharmacopoeia Talc Matsumura Hi-Filler #17 Sangyo Co., Ltd.
  • Relative bitterness to Reference Example 7(%) (Measured value of each sample ⁇ Measured value of 10 mM potassium chloride aqueous solution)/(Measured value of Reference Example 7 ⁇ Measured value of 10 mM potassium chloride aqueous solution) ⁇ 100%
  • Lenvatinib mesylate was dissolved in a 10 mM potassium chloride aqueous solution to a concentration of 9.8 mg/mL.
  • the measurement with the taste perception apparatus was performed four times on each sample, and three measurement results of the second to fourth measurements were used for the analysis.
  • the relative bitterness to Comparative Example 1 was calculated in accordance with the following equation, and an average of the three measured values is shown in Table 5 and FIG. 2 . It is noted that the relative bitterness was calculated using merely data obtained through a series of continuous measurements.
  • Relative bitterness to Comparative Example 1 (Measured value of each sample ⁇ Measured value of 10 mM potassium chloride aqueous solution)/(Measured value of Comparative Example 1 ⁇ Measured value of 10 mM potassium chloride aqueous solution) ⁇ 100%
  • Example 1 Lenvatinib Mesylate 9.8 9.8 9.8 9.8 9.8 9.8 9.8 (mg/mL) Calcium Carbonate 26.4 2.64 1.32 0.66 0.26 0.026 (mg/mL) Molar Ratio 14.1 1.41 0.70 0.35 0.14 0.01 (Additive/Lenvatinib Mesylate) Relative Bitterness to 46% 44% 43% 66% 80% 92% 100% Comparative Example 1 (%)
  • lenvatinib mesylate 9.8 mg/mL of lenvatinib mesylate is equivalent to 8 mg/mL of a free form of lenvatinib.
  • Example 1 Lenvatinib Mesylate 9.8 9.8 9.8 9.8 9.8 9.8 9.8 9.8 9.8 9.8 (mg/mL) Magnesium Oxide 26.4 2.64 1.32 0.66 0.26 0.026 (mg/mL) Molar Ratio 35.0 3.50 1.75 0.87 0.35 0.03 (Additive/Lenvatinib Mesylate) Relative Bitterness to 16% 12% 9% 7% 44% 89% 100% Comparative Example 1 (%)
  • lenvatinib mesylate 9.8 mg/mL of lenvatinib mesylate is equivalent to 8 mg/mL of a free form of lenvatinib.
  • lenvatinib mesylate 9.8 mg/mL of lenvatinib mesylate is equivalent to 8 mg/mL of a free form of lenvatinib.
  • the measurement sample of Example 18 was prepared by the following method: The amounts of respective raw materials used in preparation of a sized granule are shown in Table 10. Lenvatinib mesylate and calcium carbonate were charged and mixed in a vertical granulator. To thus obtained mixture, mannitol, crystalline cellulose (PH101) and low-substituted hydroxypropylcellulose were added to be mixed in the vertical granulator. To the resultant mixture, an aqueous solution of hydroxypropylcellulose and an appropriate amount of purified water were gradually added in this order under stirring. After completing the addition, the resultant was further stirred in the vertical granulator to obtain a granulated granule.
  • the granulated granule was dried using a fluidized bed with an inlet air temperature set to 70° C., and the resultant was sized using a Comil equipped with a screen having a pore size of 1 mm to obtain a sized granule.
  • the sized granule, crystalline cellulose (PH102) and talc were mixed in a tumbler mixer to obtain a composition comprising lenvatinib mesylate, the composition of which is shown in Table 9.
  • the resultant was stirred for 30 minutes with a stirrer. After stirring, the centrifugation operation described in (3) of Test Example 2 was performed to collect a supernatant portion as a measurement sample.
  • Example 18 As a result, it was found that the relative bitterness of Example 18 to Comparative Example 1 was 70% or less.
  • compositions of measurement samples and measurement results of the relative bitterness of Example 19 and Comparative Examples 1 and 11 to 15 to Comparative Example 1 are shown in Table 11 and FIG. 7 .
  • the measurement of the relative bitterness was performed in the same manner as in Test Example 2. In this examination, the bitterness suppressing effect of each component of the lenvatinib mesylate-containing composition of Example 18 was evaluated.
  • the measurement sample of Example 25 was prepared by the following method.
  • a 10 mM potassium chloride aqueous solution was added to a concentration shown in Table 16, and the resultant was stirred for 30 minutes with a stirrer. After stirring, the centrifugation operation described in (3) of Test Example 2 was performed to collect a supernatant portion as a measurement sample.
  • Example 1 Lenvatinib Mesylate (mg/mL) 9.8 a) 9.8 Calcium Carbonate (mg/mL) 26.4 a) Mannitol(mg/mL) 7.0 a) Crystalline Cellulose (PH101) (mg/mL) 8.0 a) Hydroxypropylcellulose (mg/mL) 2.4 a) Low-substituted Hydroxypropylcellulose 20.0 a) (mg/mL) Crystalline Cellulose (PH102) (mg/mL) 4.0 Talc(mg/mL) 2.4 No. 4 Hypromellose Capsule (Capsule/mL) 0.8 Relative Bitterness to Comparative 22% 100% Example 1 (%)
  • lenvatinib mesylate 9.8 mg/mL of lenvatinib mesylate is equivalent to 8 mg/mL of a free form of lenvatinib.
  • lenvatinib mesylate 9.8 mg/mL of lenvatinib mesylate is equivalent to 8 mg/mL of a free form of lenvatinib.
  • lenvatinib mesylate 9.8 mg/mL of lenvatinib mesylate is equivalent to 8 mg/mL of a free form of lenvatinib.
  • Capsules described in Examples 1 to 3 of U.S. Patent Application Publication No. 2012/0077842 were put in the 20 mL vial (specifically, one to five capsules were put in the vial).
  • the vial was closed with the screw cap, and was allowed to stand still for about 10 minutes.
  • the vial was shaken for about 3 minutes to dissolve capsule shell and suspend a granule, and the cap of the vial was removed to administer 3 mL of the thus obtained suspension contained in the vial to a patient.
  • the vial was shaken ten times, and the cap of the vial was removed to administer 2 mL of the resultant rinsing solution contained in the vial to the patient.
  • the total amount of the suspension and the rinsing solution to be administered per one to five capsules was 5 mL.
  • a piston was pushed into the end of the syringe by about 2 cm, and the syringe was allowed to stand still for about 10 minutes. After standing for 10 minutes, the syringe was shaken for about 3 minutes to dissolve capsule shell and suspend a granule. The cap was removed from the syringe, the piston was slid to remove the air from the syringe, and 3 mL of the thus obtained suspension was administered from the syringe to a patient.
  • the piston was pushed into the end of the syringe by about 2 cm, followed by shaking ten times.
  • the cap was removed from the syringe, the piston was slid to remove the air from the syringe, and 2 mL of the resultant rinsing solution was administered to the patient.
  • the total amount of the suspension and the rinsing solution to be administered per one to five capsules was 5 mL.
  • a piston was pushed into the end of the syringe by about 2 cm, and the syringe was allowed to stand still for about 10 minutes. After standing for 10 minutes, the syringe was shaken for about 3 minutes to dissolve capsule shell and suspend a granule. The cap was removed from the syringe, and the piston was slid to remove the air from the syringe.
  • the NG tube was attached to the syringe, and 3 mL of the thus obtained suspension was administered through the NG tube to a patient.
  • the NG tube was removed from the syringe, and the cap was attached to the syringe again.
  • the piston was pushed into the end of the syringe by about 2 cm, and then, the syringe was shaken ten times.
  • the cap was removed from the syringe, and the piston was slid to remove the air from the syringe.
  • the NG tube was attached to the syringe, and 2 mL of the resultant rinsing solution was administered through the NG tube to the patient.
  • the total amount of the suspension and the rinsing solution to be administered per one to five capsules was 5 mL.
  • Screw cap and vial (20 mL, manufactured by Niommenrika-Glass Co., Ltd.)
  • Apple juice (100%, manufactured by Dole Food Company, Inc.)
  • a vial was charged with one 1, 4 or 10 mg lenvatinib capsule or five capsules of a total lenvatinib amount of 17 mg (namely, three 1 mg capsules, one 4 mg capsule and one 10 mg capsule).
  • 3 mL of water or the apple juice was added thereto using a syringe, and the vial was closed with the cap.
  • the resultant vial was allowed to stand still for about 10 minutes, and then was shaken for about 3 minutes to dissolve capsule shell.
  • the thus obtained suspension was taken out of the vial, and was subjected to dilution and centrifugation to prepare a sample liquid.
  • a 20 mL syringe was charged with one 1, 4 or 10 mg lenvatinib capsule or five capsules of a total lenvatinib amount of 17 mg (namely, three 1 mg capsules, one 4 mg capsule and one 10 mg capsule).
  • the syringe was closed with the cap, and after adding 3 mL of water or the apple juice thereto using another fresh syringe, a piston was pushed into the end of the syringe by about 2 cm, and the syringe was allowed to stand still for about 10 minutes. After standing for 10 minutes, the syringe was shaken for about 3 minutes to dissolve capsule shell. The piston was then pushed into the syringe to remove the air from the syringe, and the thus obtained suspension was taken out of the syringe and then subjected to dilution and centrifugation to prepare a sample liquid.
  • the whole amount of each suspension of the 1 mg, 4 mg or 10 mg capsules was transferred to a 50 mL volumetric flask, and the whole amount of the suspension of the 17 mg capsules (including three 1 mg capsules, one 4 mg capsule and one 10 mg capsule) was transferred to a 200 mL volumetric flask, and the resultant was diluted with a diluent (methanol, water and sodium dihydrogen phosphate dihydrate in 800:200:1 (v/v/w)) to the volume of the flask.
  • the centrifugation was performed after extraction by stirring and an ultrasonic treatment in a water bath.
  • the final lenvatinib concentration of the suspensions of the 1 mg and 4 mg capsules were respectively 0.02 mg/mL and 0.08 mg/mL.
  • the suspension of the 10 mg capsule after performing the centrifugation in the same manner as the suspensions of the 1 mg and 4 mg capsules, 5 mL of a supernatant was transferred to a 10 mL flask and then diluted with the diluent. The final lenvatinib concentration of the suspension of the 10 mg capsule was 0.10 mg/mL.
  • the suspension of 17 mg capsules after performing the centrifugation in the same manner as the suspension of the 10 mg capsule, 5 mL of a supernatant was transferred to a 20 mL flask and then diluted with the diluent.
  • the final lenvatinib concentration of the suspension of the 17 mg capsules was 0.085 mg/mL.
  • the selection of water or the apple juice caused no difference in the recovery. If the rinsing step was not performed, the recovery was lowered. There was no difference whether the rinsing step was performed once or twice, and the recovery of 90% or more was attained if the rinsing step was performed at least once.
  • each of 1 mg, 4 mg and 10 mg capsules was suspended in 3 mL of water or the apple juice in a vial.
  • the whole amount of the resultant suspension at the initial stage or 24 hours after was transferred to a 50 mL volumetric flask, and a diluent (methanol, water and sodium dihydrogen phosphate dihydrate in 800:200:1 (v/v/w)) was added thereto for dilution to the volume of the flask.
  • a diluent methanol, water and sodium dihydrogen phosphate dihydrate in 800:200:1 (v/v/w)
  • the amount of the impurity X was not increased from the initial value even after 24 hours, and hence it was found that the lenvatinib suspension in water or the apple juice was stable for 24 hours.
  • each of 1, 4 and 10 mg lenvatinib capsules or each combination of capsules shown in Table 30 was suspended in a syringe by using 3 mL of water.
  • Results of viscosities (unit: ⁇ /mPas) of the respective suspensions obtained by measurement performed under conditions shown in Table 29 are shown in Table 30.
  • each of 1, 4 and 10 mg lenvatinib capsules or each combination of capsules shown in Table 30 was suspended in a syringe by using 3 mL of water, and then an NG tube was connected to the syringe.
  • Results of an NG tube passability test thus performed are shown in Table 31.

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