Pharmaceutical antiretroviral composition

Abstract

A pharmaceutical composition comprises at least one integrase inhibitor or its salt, solvate, complex, hydrate, isomer, ester, tautomer, anhydrate, enantiomer, polymorph or prodrug and at least one antiretroviral or anti-HIV agent or its salt, solvate, complex, hydrate, isomer, ester, tautomer, anhydrate, enantiomer, polymorph or prodrug.

Claims

1. A pharmaceutical composition that is a single unit dosage form for oral administration in the form of a coated bi-layer tablet comprising a first layer and a second layer, wherein the first layer consists of 1 mg to 50 mg dolutegravir or a pharmaceutically acceptable salt thereof, and one or more pharmaceutically acceptable excipients; and wherein the second layer consists of 150 mg lamivudine, 300 mg zidovudine, microcrystalline cellulose, silicon dioxide, sodium starch glycolate and magnesium stearate.

2. The pharmaceutical composition according to claim 1, wherein the one or more pharmaceutically acceptable excipients are selected from carriers, diluents, fillers, hinders, lubricants, glidants, disintegrants, bulking agents, flavourants or any combination thereof.

3. The pharmaceutical composition according to claim 1, for use in the treatment of diseases caused by retroviruses.

4. A process for preparing a pharmaceutical composition as claimed in claim 1, wherein the process comprises the steps of: forming a first layer by admixing dolutegravir with one or more pharmaceutically acceptable excipients; forming a second layer by admixing lamivudine, zidovudine, microcrystalline cellulose, silicon dioxide, sodium starch glycolate and magnesium stearate; and after forming the first layer and the second layer, combining the first layer and the second layer to form a bi-layer tablet.

5. The process according to claim 4, comprising the steps of: (a) sifting and dry mixing the dolutegravir and pharmaceutically acceptable excipients (b) forming granules of the dolutegravir and optionally pharmaceutically acceptable excipients.

6. A process comprising utilizing the pharmaceutical composition according to claim 1, in the manufacture of a medicament for the treatment of diseases caused by retroviruses.

7. A method of treating diseases caused by retroviruses, the method comprising administering a pharmaceutical composition according to claim 1 to a subject in need of treatment for diseases caused by retroviruses.

8. The method of claim 7, wherein the treatment for diseases caused by retroviruses includes treatment of acquired immune deficiency syndrome or an HIV infection.

Description

DETAILED DESCRIPTION

(1) As discussed above, there is a need to develop and formulate a suitable pharmaceutical composition which would not only be convenient for patient administration but would also maintain patient adherence to the therapy. The inventors of the present invention have now surprisingly found combinations of integrase inhibitors with antiretroviral agents or anti-HIV agents for the treatment, prevention and prophylaxis of retroviral diseases.

(2) The present invention thus provides a pharmaceutical composition comprising at least one integrase inhibitor and at least one anti-HIV or anti-retroviral agent optionally with pharmaceutically acceptable excipients.

(3) Integrase inhibitors are a class of antiretroviral drug designed to block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell. Since integration is a vital step in retroviral replication, blocking it can halt further spread of the virus.

(4) The present invention thus provides a pharmaceutical composition comprising at least one integrase inhibitor and at least one antiretroviral agent or anti-HIV agent, optionally with at least one pharmaceutically acceptable excipients.

(5) It will be appreciated that the respective therapeutic agents may be administered simultaneously or separately either in the same or different pharmaceutical compositions. If there is separate administration, it will also be appreciated that the subsequently administered therapeutic agents should be administered to a patient within a time scale so as to achieve, or more particularly optimize, synergistic therapeutic effect of such a combined preparation.

(6) The term pharmaceutical composition includes tablets, capsules (filled with powders, pellets, beads, mini-tablets, pills, micro-pellets, small tablet units, MUPS, disintegrating tablets, dispersible tablets, granules, and microspheres, multiparticulates), sachets (filled with powders, pellets, beads, mini-tablets, pills, micro-pellets, small tablet units, MUPS, disintegrating tablets, dispersible tablets, granules, and microspheres, multiparticulates) and sprinkles, however, other dosage forms such as controlled release formulations, lyophilized formulations, modified release formulations, delayed release formulations, extended release formulations, pulsatile release formulations, dual release formulations and the like; liquid dosage form (liquids, suspensions, solutions, emulsions, microemulsions, sprays, spot-on), injection preparations, nano formulation etc. may also be envisaged under the ambit of the invention. Suitable excipients may be used for formulating the various dosage forms according to the present invention.

(7) The term integrase inhibitor(s) (for example dolutegravir, elvitegravir or raltegravir) or anti-HIV agent(s) and antiretroviral agent(s) (for example nucleoside and nucleotide reverse transcription inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and maturation inhibitors (MIs)) used throughout the description and claims are used in a broad sense to include not only the active ingredient per se but also pharmaceutically acceptable derivatives thereof. Suitable derivatives include pharmaceutically acceptable salts, pharmaceutically acceptable solvates, pharmaceutically acceptable hydrates, pharmaceutically acceptable isomers, pharmaceutically acceptable esters, pharmaceutically acceptable anhydrates, pharmaceutically acceptable enantiomers, pharmaceutically acceptable polymorphs, pharmaceutically acceptable prodrugs, pharmaceutically acceptable tautomers and/or pharmaceutically acceptable complexes thereof and combinations thereof.

(8) Examples of suitable integrase inhibitors include but are not limited to dolutegravir, raltegravir, MK-2048, JTK-656, elvitegravir.

(9) Preferably, the integrase inhibitor is dolutegravir, raltegravir or elvitegravir.

(10) The dose of dolutegravir is in the range of 1 to 50 mg, preferably in the range of 25 to 50 mg.

(11) The dose of raltegravir is in the range of 25 to 500 mg. For example, 25, 100, 400, 500 mg. The preferred form of raltegravir is raltegravir potassium.

(12) The dose of elvitegravir is in the range of 1 to 200 mg, preferably in the range of 25 to 180 mg.

(13) Antiretroviral drugs/agents or the anti-HIV agents for the purpose of the present invention may be selected from nucleoside and nucleotide reverse transcription inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and maturation inhibitors (MIs) and any combination thereof.

(14) The term nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) as used herein means nucleosides and nucleotides and analogues thereof that inhibit the activity of HIV-1 reverse transcriptase, the enzyme which catalyzes the conversion of viral genomic HIV-1 RNA into proviral HIV-1 DNA.

(15) Suitable nucleoside reverse transcriptase inhibitors (NRTIs) that may be employed in the pharmaceutical composition of the present invention may comprise zidovudine; didanosine; stavudine; lamivudine; abacavir; adefovir; lobucavir; entecavir; apricitabine; emtricitabine; zalcitabine; dexelvucitabine; alovudine; amdoxovir; elvucitabine; AVX754; BCH-189; phosphazid; racivir; SP1093V; stampidine; BCH-10652, ?-L-FD4 (also called ?-L-D4C and named ?-L-2,3-dicleoxy-5-fluoro-cytidene); DAPD, the purine nucleoside, (?)-?-D-2,6-diamino-purine dioxolane; and lodenosine (FddA), 9-(2,3-dideoxy-2-fluoro-?-D-threo-pentofuranosyl)adenine and any combination thereof.

(16) Suitable nucleotide reverse transcriptase inhibitors (NtRTIs) that may be employed in the pharmaceutical composition of the present invention may comprise tenofovir and adefovir.

(17) Preferably, the NRTIs/NtRTIs are selected from tenofovir, emtricitabine, lamivudine or zidovudine, or any combination thereof.

(18) Suitable non-nucleotide reverse transcriptase inhibitors (NNRTIs) that may be employed in the pharmaceutical composition of the present invention may comprise nevirapine, rilpivirine, delaviridine, efavirenz, etravirine. Other NNRTIs include PNU-142721, a furopyridine-thiopyrimide; capravirine (S-1153 or AG-1 549; 5-(3,5-dichlorophenyl)-thio-4-isopropyl-1-(4-pyridyl)methyl-1H-imidazol-2-ylmethyl carbonate); emivirine [MKC-442; (1-(ethoxy-methyl)-5-(1-methylethyl)-6-(phenylmethyl)-(2,4(1H,3H)-pyrimid-inedione)]; (+)-calanolide A (NSC-67545 1) and B, coumarin derivatives; DAPY (TMC120; 4-{4-[4-((E)-2-cyano-vinyl)-2,6-dimethyl-phenylamino]-pyrimidin-2-ylamino-}-benzonitrile); BILR-355 BS (12-ethyl-8-[2-(1-hydroxy-quinolin-4-yloxy)-ethyl]-5-methyl-11,12-dihydro-5H-1,5,10,12-tetraaza-dibenzo[a,e]cycloocten-6-one; PHI-236 (7-bromo-3-[2-(2,5-dimethoxy-phenyl)-ethyl]-3,4-dihydro-1H-pyrido[1,2-a][-1,3,5]triazine-2-thione) and PHI-443 (TMC-278, 1-(5-bromo-pyridin-2-yl)-3-(2-thiophen-2-yl-ethyl)-thiourea).

(19) Suitable protease inhibitors (PIs) that may be employed in the pharmaceutical composition of the present invention may comprise saquinavir; ritonavir; nelfinavir; amprenavir; lopinavir, indinavir; nelfinavir; atazanavir; lasinavir; palinavir; tipranavir; fosamprenavir; darunavir; TMC114; DMP450, a cyclic urea; BMS-2322623, BMS-232623; GS3333; KNI-413; KNI-272; LG-71350; CGP-61755; PD 173606; PD 177298; PD 178390; PD 178392; U-140690; ABT-378; and AG-1549 an imidazole carbamate. Additional PIs include N-cycloalkylglycines, ?-hydroxyarylbutanamides; ?-hydroxy-?-[[(carbocyclic- or heterocyclic-substituted)amino)carbonyl]alkanamide derivatives; ?-hydroxy-2-(fluoroalkylaminocarbonyl)-1-piperazinepentanamides; dihydropyrone derivatives and ?- and ?-amino acid hydroxyethylaminosulfonamides; and N-aminoacid substituted L-lysine derivatives.

(20) The antiretroviral agents according to the present invention may be used in the form of salts or esters derived from inorganic or organic acids. These salts include but are not limited to acetate, adipate, alginate, citrate, aspartate, benzoate, benzenesulfonate, bisulfate, butyrate, camphorate, camphorsulfonate, digluconate, cyclopentanepropionate, dodecylsulfate, ethanesulfonate, glucoheptanoate, glycerophosphate, hemisulfate, heptanoate, hexanoate, fumarate, hydrochloride, hydrobromide, hydroiodide, 2-hydroxy-ethanesulfonate (isethionate), lactate, maleate, methanesulfonate, nicotinate, 2-naphthalenesulfonate, oxalate, pamoate, pectinate, persulfate, 3-phenylpropionate, picrate, pivalate, propionate, succinate, tartrate, thiocyanate, p-toluenesulfonate and undecanoate. Also, the basic nitrogen-containing groups can be quaternized with such agents as loweralkyl halides, such as methyl, ethyl, propyl, and butyl chloride, bromides, and iodides; dialkylsulfates like dimethyl, diethyl, dibutyl, and diamylsulfates, long chain halides such as decyl, lauryl, myristyl and stearyl chlorides, bromides and iodides, aralkyl halides like benzyl and phenethyl bromides, and the like.

(21) Preferably, the pharmaceutical composition comprises dolutegravir, tenofovir and emtricitabine/lamivudine optionally with one or more pharmaceutically acceptable excipients.

(22) Alternatively, the pharmaceutical composition comprises elvitegravir, tenofovir and lamivudine optionally with one or more pharmaceutically acceptable excipients.

(23) Alternatively, the pharmaceutical composition comprises elvitegravir, tenofovir and emtricitabine optionally with one or more pharmaceutically acceptable excipients.

(24) Alternatively, the pharmaceutical composition comprises raltegravir, tenofovir and emtricitabine/lamivudine optionally with one or more pharmaceutically acceptable excipients.

(25) Alternatively, the pharmaceutical composition comprises dolutegravir, lamivudine and zidovudine optionally with one or more pharmaceutically acceptable excipients.

(26) Alternatively, the pharmaceutical composition comprises elvitegravir, lamivudine and zidovudine optionally with one or more pharmaceutically acceptable excipients.

(27) Alternatively, the pharmaceutical composition comprises raltegravir, lamivudine and zidovudine optionally with one or more pharmaceutically acceptable excipients.

(28) Alternatively, the pharmaceutical composition comprises dolutegravir, emtricitabine and lamivudine/zidovudine optionally with one or more pharmaceutically acceptable excipients.

(29) Alternatively, the pharmaceutical composition comprises dolutegravir, tenofovir and zidovudine optionally with one or more pharmaceutically acceptable excipients.

(30) Alternatively, the pharmaceutical composition comprises raltegravir, emtricitabine and lamivudine/zidovudine optionally with one or more pharmaceutically acceptable excipients.

(31) Alternatively, the pharmaceutical composition comprises raltegravir, tenofovir and zidovudine optionally with one or more pharmaceutically acceptable excipients.

(32) Alternatively, the pharmaceutical composition comprises dolutegravir, abacavir and lamivudine optionally with one or more pharmaceutically acceptable excipients.

(33) Alternatively, the pharmaceutical composition comprises raltegravir, abacavir and lamivudine optionally with one or more pharmaceutically acceptable excipients.

(34) Alternatively, the pharmaceutical composition comprises dolutegravir, abacavir and emtricitabine optionally with one or more pharmaceutically acceptable excipients.

(35) Alternatively, the pharmaceutical composition comprises raltegravir, abacavir and emtricitabine optionally with one or more pharmaceutically acceptable excipients.

(36) Suitably, the pharmaceutical composition according to the present invention are presented in solid dosage form suitable for oral or buccal administration, however, other dosage forms such as liquid dosage form may be envisaged under the ambit of the invention.

(37) The pharmaceutical composition according to the present invention may be administered orally through unit dosage forms including tablets, capsules (filled with powders, pellets, beads, mini-tablets, pills, micro-pellets, small tablet units, MUPS, disintegrating tablets, dispersible tablets, granules, and microspheres, multiparticulates), sachets (filled with powders, pellets, beads, mini-tablets, pills, micro-pellets, small tablet units, MUPS, disintegrating tablets, dispersible tablets, granules, and microspheres, multiparticulates) and sprinkles, however, other dosage forms such as controlled release formulations, lyophilized formulations, modified release formulations, delayed release formulations, extended release formulations, pulsatile release formulations, dual release formulations and the like; liquid dosage form (liquids, suspensions, solutions, emulsions, microemulsions, sprays, spot-on), injection preparations, nano formulation, self emulsifying drug delivery formulations etc. may also be envisaged under the ambit of the invention.

(38) Suitably, the pharmaceutical antiretroviral composition according to the present invention may also be presented in the form of a kit comprising at least one integrase inhibitor and at least one antiretroviral or anti-HIV agent and provides the patient with his daily regimen of drugs in a single package. This further facilitates the patient in getting the drug regimen of the entire day in a single package which also enables the patient to avoid carrying of numerous medications and also confirm if the same are administered. The kit composition has an advantage over the other packaged dosage forms in that the patient always has access to the set of instructions for administration contained in the kit. The inclusion of a set of instructions for administration has been shown to improve patient compliance.

(39) Preferably, the present invention provides a pharmaceutical antiretroviral composition comprising dolutegravir, tenofovir, emtricitabine/lamivudine and zidovudine in a kit form.

(40) Alternatively, the present invention provides a pharmaceutical antiretroviral composition comprising raltegravir, tenofovir, emtricitabine/lamivudine and zidovudine in a kit form.

(41) Alternatively, the pharmaceutical antiretroviral composition in a kit form may comprise a separate unit dosage form of dolutegravir/raltegravir, a separate unit dosage form of tenofovir, separate unit dosage form of emtricitabine/lamivudine and separate unit dosage form of zidovudine.

(42) The mini-tablets or granules filled in hard gelatin capsules or sachets can be directly administered or can be administered by sprinkling the mini-tablet or granules on regular meals. Alternatively, the mini-tablets or granules filled in hard gelatin capsules or sachets may be administered with liquid or semi-solid beverages such as but not limited to, juices, water.

(43) The mini-tablets or granules according to the present invention may also optionally be coated. Preferably, mini-tablets or granules according to the present invention may be film coated. More preferably, the mini-tablets or granules may be seal coated and then film coated and further filled in hard gelatin capsules or sachets.

(44) A tablet formulation is the preferred solid dosage form due to its greater stability, less risk of chemical interaction between different medicaments, smaller bulk, accurate dosage, and ease of production.

(45) Solid unit dosage forms are preferably in the form of tablets either single or bilayered or multilayered tablets but other conventional dosages such as powders, pellets, capsules and sachets may fall within the scope of this invention.

(46) The pharmaceutical antiretroviral composition may be administered simultaneously, separately or sequentially in a single unit dosage form.

(47) The pharmaceutical antiretroviral composition may be administered as a single layered or bilayered or multilayered tablet wherein each layer may or may not contain drug/drugs along with pharmaceutically acceptable excipients which are then compressed to provide either a single layered, bilayered or multilayered tablet.

(48) Suitable excipients may be used for formulating the various dosage forms.

(49) The term excipient used herein includes one or more of pharmaceutically acceptable ingredients but are not limited to carriers, diluents or fillers, binders, lubricants, glidants and disintegrants.

(50) Non-limiting examples of suitable pharmaceutically acceptable carriers, diluents or fillers for use in the pharmaceutical composition include lactose (for example, spray-dried lactose, ?-lactose, ?-lactose) lactose available under the trade mark Tablettose, various grades of lactose available under the trade mark Pharmatose or other commercially available forms of lactose, lactitol, saccharose, sorbitol, mannitol, dextrates, dextrins, dextrose, maltodextrin, croscarmellose sodium, microcrystalline cellulose (for example, microcrystalline cellulose available under the trade mark Avicel), hydroxypropylcellulose, L-hydroxypropylcellulose (low substituted), hydroxypropyl methylcellulose (HPMC), methylcellulose polymers (such as, for example, Methocel A, Methocel A4C, Methocel A15C, Methocel A4M), hydroxyethylcellulose, sodium carboxymethylcellulose, carboxymethylene, carboxymethyl hydroxyethylcellulose and other cellulose derivatives, pre-gelatinized starch, starches or modified starches (including potato starch, corn starch, maize starch and rice starch) and the like.

(51) Typically glidants and lubricants may also be included in the pharmaceutical composition. Non-limiting examples include stearic acid and pharmaceutically acceptable salts or esters thereof (for example, magnesium stearate, calcium stearate, sodium stearyl fumarate or other metallic stearate), talc, waxes (for example, microcrystalline waxes) and glycerides, light mineral oil, PEG, silica acid or a derivative or salt thereof (for example, silicates, silicon dioxide, colloidal silicon dioxide and polymers thereof, crospovidone, magnesium aluminosilicate and/or magnesium alumina metasilicate), sucrose ester of fatty acids, hydrogenated vegetable oils (for example, hydrogenated castor oil), or mixtures thereof or any other suitable lubricant.

(52) Suitably one or more binders may also be present in the pharmaceutical composition and non-limiting examples of suitable binders are, for example, polyvinyl pyrrolidone (also known as povidone), polyethylene glycol(s), acacia, alginic acid, agar, calcium carragenan, cellulose derivatives such as ethyl cellulose, methyl cellulose, hydroxypropyl cellulose, hydroxypropyl methyl cellulose, sodium carboxymethylcellulose, dextrin, gelatin, gum arabic, guar gum, tragacanth, sodium alginate, or mixtures thereof or any other suitable binder.

(53) Suitable disintegrants may also be present in the pharmaceutical composition.

(54) Examples include, but are not limited to, hydroxylpropyl cellulose (HPC), low density HPC, carboxymethylcellulose (CMC), sodium CMC, calcium CMC, croscarmellose sodium; starches exemplified under examples of fillers and also carboxymethyl starch, hydroxylpropyl starch, modified starch; crystalline cellulose, sodium starch glycolate; alginic acid or a salt thereof, such as sodium alginate or their equivalents and any combination thereof.

(55) There is also provided a hot melt extruded pharmaceutical composition comprising antiretroviral drug(s), for example at least one integrase inhibitor and at least one antiretroviral agent or anti-HIV agent as described previously, and at least one water soluble and/or water swellable and/or water insoluble polymer or combination thereof and optionally one or more pharmaceutically acceptable excipients.

(56) Water soluble polymers which may be used in the pharmaceutical composition of the present invention, include, but are not limited to, homopolymers and co-polymers of N-vinyl lactams, especially homopolymers and co-polymers of N-vinyl pyrrolidone e.g. polyvinylpyrrolidone (PVP), co-polymers of PVP and vinyl acetate, co-polymers of N-vinyl pyrrolidone and vinyl acetate (Copovidone) or vinyl propionate, dextrins such as grades of maltodextrin, cellulose esters and cellulose ethers, high molecular polyalkylene oxides such as polyethylene oxide and polypropylene oxide and co-polymers of ethylene oxide, propylene oxide and mixtures thereof.

(57) Water insoluble polymers which may be used in the pharmaceutical composition of the present invention, include, but are not limited to, acrylic copolymers e.g. Eudragit E100 or Eudragit EPO; Eudragit L30D-55, Eudragit FS30D, Eudragit RL30D, Eudragit RS30D, Eudragit NE30D, Acryl-Eze; polyvinylacetate, for example, Kollicoat SR 30D; cellulose derivatives such as ethylcellulose, cellulose acetate e.g. Surelease, Aquacoat ECD and Aquacoat CPD and mixtures thereof.

(58) Water swellable polymers that may be used in the pharmaceutical composition of the present invention include but are not limited to polyethylene oxide; poly (hydroxy alkyl methacrylate); poly (vinyl) alcohol, having a low acetal residue, which is cross-linked with glyoxal, formaldehyde or glutaraldehyde and having a degree of polymerization of from 200 to 30,000; a mixture of methyl cellulose, cross-linked agar and carboxymethyl cellulose; Carbopol? carbomer which is an acidic carboxy polymer; Cyanamer? polyacrylamides; cross-linked water swellable indene-maleic anhydride polymers; Goodrich? polyacrylic acid; starch graft copolymers; Aqua Keeps? acrylate polymer polysaccharides composed of condensed glucose units such as diester cross-linked polyglucan, and the like; Amberlite? ion exchange resins; Explotab? sodium starch glycolate; Ac-Di-Sol? croscarmellose sodium or mixtures thereof.

(59) The one or more optional pharmaceutically acceptable excipients may include a plasticizer.

(60) Plasticizers reduce the viscosity of the polymer melt and thereby allow for lower processing temperature and extruder torque during hot melt extrusion. They further decrease the glass transition temperature of the polymer.

(61) Plasticizers which may be used in the pharmaceutical composition of the present invention, include, but are not limited to, polysorbates such as sorbitan monolaurate (Span 20), sorbitan monopalmitate, sorbitan monostearate, sorbitan monoisostearate; citrate ester type plasticizers like triethyl citrate, citrate phthalate; propylene glycol; glycerin; polyethylene glycol (low & high molecular weight); triacetin; dibutylsebacate, tributylsebacate; dibutyltartrate, dibutyl phthalate, glycerol palmitosterate and mixtures thereof.

(62) The pharmaceutical composition may be prepared by admixing at least one integrase inhibitor, at least one antiretroviral or anti HIV agent according to the present invention with other suitable pharmaceutically acceptable excipients such as sweeteners, vehicle/wetting agents, buffering agents, coloring agents, flavoring agents, preservatives, viscosity enhancing/thickening agents and the like or combinations thereof.

(63) The pharmaceutical composition of the present invention may be prepared by admixing the at least one integrase inhibitor, the at least one antiretroviral or anti-HIV agent either separately or in combination, optionally, with one or more pharmaceutically acceptable excipients. This blend may be subjected to granulation or directly compacted to obtain granules.

(64) The pharmaceutical composition according to the present invention may be prepared through various techniques or processes known in the art which includes, but are not limited to direct compression, wet granulation, roll compaction, dry granulation, melt granulation, melt extrusion, spray drying, solution evaporation or combinations thereof.

(65) It may be acknowledged by a person skilled in the art that the above mentioned techniques may either be used alone or in combination thereof.

(66) The pharmaceutical composition of the present invention can be processed by roll compaction.

(67) The process comprises sifting and dry mixing the at least one integrase inhibitor, the at least one antiretroviral agent or anti-HIV agent and optionally with one or more excipients followed by compaction and sizing to obtain granules.

(68) The process further comprises lubricating the granules and either compressing the lubricated granules to form a single layered tablet, bi/multi layered tablet or a mini-tablet; or filling the lubricated granules into hard gelatin capsules or sachets.

(69) The pharmaceutical composition according to the present invention may also optionally be coated, i.e. seal coated or film coated. Preferably, the pharmaceutical composition may be seal coated and then film coated.

(70) The pharmaceutical composition may be film coated with, but not limited to, Ready colour mix systems (such as Opadry? colour mix systems) and polyvinyl alcohol-polyethylene glycol copolymer and polyvinyl alcohol.

(71) The pharmaceutical antiretroviral composition may be seal coated followed by film coating using polymeric materials, such as but not limited to hydroxypropylmethylcellulose (HPMC 6 CPS, or HPMC 6 CPS to HPMC 15CPS grade), hydroxypropylcellulose, polyvinylpyrrolidone, methylcellulose, carboxymethylcellulose, hypromellose, acacia, gelatin, and polyvinyl alcohol-polyethylene glycol copolymer and polyvinyl alcohol and the like or combinations thereof.

(72) The pharmaceutical composition of the present invention may be formulated for paediatric patients and from the point of view of paediatric patient acceptability suitable bulking agents may be incorporated, in the pharmaceutical antiretroviral composition comprising saccharides, including monosaccharides, disaccharides, polysaccharides and sugar alcohols but not limited to arabinose, lactose, dextrose, sucrose, fructose, maltose, mannitol, erythritol, sorbitol, xylitol, lactitol, powdered cellulose, microcrystalline cellulose, purified sugar and their derivatives and the like or combinations thereof.

(73) Accordingly, the pharmaceutical composition of the present invention may further incorporate suitable pharmaceutically acceptable flavourants, such as, but not limited to, citric acid, tartaric acid, lactic acid, orange permaseal, strawberry cream flavour or other natural flavourants and sweeteners such as, but not limited to, aspartame and the like or combinations thereof.

(74) The pharmaceutical composition according to the present invention may further incorporate suitable pharmaceutically acceptable colourants, such as, but not limited to, red oxide of iron and ferric oxide yellow.

(75) The pharmaceutical composition according to the present invention may also comprise the actives in nano size form. In other words, the at least one integrase inhibitor and/or at least one antiretroviral agent or anti-HIV agent can be in the form of nano-size particles. Preferably, these active pharmaceutical ingredients have average particle size less than about 2000 nm, preferably less than about 1000 nm.

(76) Nanonization of hydrophobic or poorly water-soluble drugs generally involves the production of drug nanocrystals through either chemical precipitation (bottom-up technology) or disintegration (top-down technology). Different methods may be utilized to reduce the particle size of the hydrophobic or poorly water soluble drugs. [Huabing Chen et al., discusses the various methods to develop nano-formulations in Nanonization strategies for poorly water-soluble drugs, Drug Discovery Today, Volume 00, Number 00, March 2010].

(77) Nano-sizing leads to an increase in the exposure of surface area of particles leading to an increase in the rate of dissolution.

(78) The nanoparticles of the present invention may be obtained by any of the process such as, but not limited to, milling, precipitation, high pressure homogenization, spray freeze drying, super-critical fluid technology, double emulsion or solvent evaporation, Particle replication in non-wetting templates, thermal condensation, ultrasonication and spray drying.

(79) The nano-milled drugs may be obtained by nano-milling of drugs with at least one surface stabilizer, at least one viscosity building agent and at least one polymer.

(80) The present invention provides a method of prevention, treatment or prophylaxis of diseases caused by retroviruses, especially acquired immune deficiency syndrome or an HIV infection, which method comprises administering the pharmaceutical antiretroviral composition substantially as hereinbefore described. There is further provided by the present invention an antiretroviral composition substantially as hereinbefore described, for use in treating disorders or conditions that respond to, or are prevented, ameliorated or eliminated by administering the pharmaceutical antiretroviral composition comprising substantially as hereinbefore described.

(81) The present invention also provides a pharmaceutical composition as substantially described herein by reference to the examples.

(82) The following examples are for the purpose of illustration of the invention only and are not intended in any way to limit the scope of the present invention.

EXAMPLE 1

(83) Manufacturing Formula

(84) TABLE-US-00001 Sr. Qty (mg)/ No. Ingredients Tablet Part I : Dolutegravir Layer Dry Mix 1 Dolutegravir 50.00 2 Microcrystalline Cellulose PH 102 415.00 3 Croscarmellose Sodium 25.00 4 Colloidal Silicon Dioxide 2.50 Blending & Lubrication 5 Colloidal Silicon Dioxide 2.50 6 Magnesium Stearate 5.00 Total weight Part I 500.00 Part II : Tenofovir & Emtricitabine Layer Dry Mix 1 Emtricitabine 200.00 2 Tenofovir Disoproxil Fumarate 300.00 3 Microcrystalline Cellulose PH 102 50.30 4 Croscarmellose Sodium 31.70 5 Red Oxide Of Iron 0.20 6 Magnesium Stearate 7.70 Blending & Lubrication 7 Croscarmellose Sodium 16.30 8 Magnesium Stearate 6.80 Total Weight Part II 613.00 Tablet weight (Part I + Part II) 1113.00 Film Coating to Bilayer Tablet 1 Opadry? 27.00 2 Purified Water q.s. Final Coated Tablet weight 1140.00

(85) Manufacturing Process:

(86) 1. All the materials of each part were sifted& dry mixed in separately.

(87) 2. The sifted material was compacted and sized to get the free flowing granules of each part.

(88) 3. The granules of each part obtained in step 2 were blended with croscarmellose sodium and lubricated with pre-sifted with Magnesium stearate and then compressed into bilayer tablet.

(89) 4. The bilayer tablets were film coated using dispersion of Opadry?.

EXAMPLE 2

(90) Manufacturing Formula:

(91) TABLE-US-00002 Sr. Qty (mg)/ No. Ingredients Tablet Part I : Dolutegravir Layer Dry Mix 1 Dolutegravir 50.00 2 Microcrystalline Cellulose PH 102 415.00 3 Croscarmellose Sodium 25.00 4 Colloidal Silicon Dioxide 2.50 Blending & Lubrication 5 Colloidal Silicon Dioxide 2.50 6 Magnesium Stearate 5.00 Total weight Part I 500.00 Part II : Tenofovir & Lamivudine Layer I Tenofovir DF Part 1 Tenofovir Disoproxil Fumarate 300.00 2 Croscarmellose Sodium 22.50 3 Microcrystalline Cellulose PH 101 45.00 4 Ferric Oxide Yellow 0.20 5 Magnesium Stearate 2.50 II Lamivudine Part 6 Lamivudine 300.00 7 Croscarmellose Sodium 22.50 8 Microcrystalline Cellulose PH 101 50.60 9 Ferric Oxide Yellow 0.20 10 Pregelatinized Starch 18.00 11 Magnesium Stearate 2.50 III Blending & Lubrication 12 Croscarmellose Sodium 30.00 13 Magnesium Stearate 6.00 Total Weight of Part II 800.00 Tablet weight (Part I + Part II) 1300.00 Film Coating to Bilayer Tablet 1 Opadry? 32.00 2 Purified Water q.s. Final Coated Tablet weight 1332.00

(92) Manufacturing Process:

(93) 1. All the materials of each part were sifted & dry mixed separately.

(94) 2. The sifted material was compacted and sized to get the free flowing granules of each part.

(95) 3. The granules of each part obtained in step 2 were blended with croscarmellose sodium and lubricated with pre-sifted with Magnesium stearate and then compressed into bilayer tablet.

(96) 4. The bilayer tablets were film coated using dispersion of Opadry?.

EXAMPLE 3

(97) Manufacturing Formula:

(98) TABLE-US-00003 Sr. Qty (mg)/ No. Ingredients Tablet Part I : Dolutegravir Layer Dry Mix 1 Dolutegravir 50.00 2 Microcrystalline Cellulose PH 102 415.00 3 Croscarmellose Sodium 25.00 4 Colloidal Silicon Dioxide 2.50 Blending & Lubrication 5 Colloidal Silicon Dioxide 2.50 6 Magnesium Stearate 5.00 Total weight Part I 500.00 Part II : Lamivudine & Zidovudine Layer 1 Lamivudine 150.00 2 Zidovudine 300.00 3 Microcrystalline Cellulose PH 102 269.42 4 Colloidal Silicon Dioxide 2.25 5 Sodium Starch Glycolate 22.50 6 Ferric Oxide Yellow 0.20 Lubrication 7 Magnesium Stearate 5.63 Total Weight of Part II 750.00 Tablet weight (Part I + Part II) 1250.00 Film Coating to Bilayer Tablet 1 Opadry? 32.00 2 Purified Water q.s. Final Coated Tablet weight 1282.00

(99) Manufacturing Process:

(100) 1. All the materials of each part were sifted & dry mixed separately.

(101) 2. The sifted material was compacted and sized to get the free flowing granules of each part.

(102) 3. The granules of each part obtained in step 2 were blended with croscarmellose sodium and lubricated with pre-sifted with Magnesium stearate and then compressed into bilayer tablet.

(103) 4. The bilayer tablets were film coated using dispersion of Opadry?.

EXAMPLE 4

(104) Manufacturing Formula:

(105) TABLE-US-00004 Sr. Qty/ No. Ingredients Tablet Part I : Raltegravir Layer 1 Raltegravir Potassium 434.40 2 MCC PH102 114.11 3 Lactose Monohydrate 26.06 4 Calcium Phosphate Dibasic Anhydrous 73.85 5 Hypromellose 2208 26.06 6 Poloxamer 407 (Contains 0.01% BHT) 173.80 7 Sodium Stearyl Fumarate 8.69 8 Magnesium Stearate 13.03 Total weight Part I 870.00 Part II : Tenofovir & Emtricitabine Layer Dry Mix 1 Emtricitabine 200.00 2 Tenofovir Disoproxil Fumarate 300.00 3 Microcrystalline Cellulose PH 102 50.30 4 Croscarmellose Sodium 31.70 5 Red Oxide Of Iron 0.20 6 Magnesium Stearate 7.70 Blending & Lubrication 7 Croscarmellose Sodium 16.30 8 Magnesium Stearate 6.80 Total Weight Part II 613.00 Tablet weight (Part I + Part II) 1483.00 Film Coating to Bilayer Tablet 1 Opadry? 37.00 2 Purified Water q.s. Final Coated Tablet weight 1520.00

(106) Manufacturing Process:

(107) 1. All the materials of each part were sifted & dry mixed separately.

(108) 2. The sifted material was compacted and sized to get the free flowing granules of each part.

(109) 3. The granules of each part obtained in step 2 were blended with croscarmellose sodium and lubricated with pre-sifted with Magnesium stearate and then compressed into bilayer tablet.

(110) 4. The bilayer tablets were film coated using dispersion of Opadry?.

EXAMPLE 5

(111) Manufacturing Formula:

(112) TABLE-US-00005 Sr. No. Ingredients Qty/Tablet Part I : Raltegravir Layer 1 Raltegravir Potassium 434.40 2 MCC PH102 114.11 3 Lactose Monohydrate 26.06 4 Calcium Phosphate Dibasic Anhydrous 73.85 5 Hypromellose 2208 26.06 6 Poloxamer 407 (Contains 0.01% BHT) 173.80 7 Sodium Stearyl Fumarate 8.69 8 Magnesium Stearate 13.03 Total weight of part I 870.00 Part II : Tenofovir & Lamivudine Layer I Tenofovir DF Part 1 Tenofovir Disoproxil Fumarate 300.00 2 Croscarmellose Sodium 22.50 3 Microcrystalline Cellulose PH 101 45.00 4 Ferric Oxide Yellow 0.20 5 Magnesium Stearate 2.50 II Lamivudine Part 6 Lamivudine 300.00 7 Croscarmellose Sodium 22.50 8 Microcrystalline Cellulose PH 101 50.60 9 Ferric Oxide Yellow 0.20 10 Pregelatinized Starch 18.00 11 Magnesium Stearate 2.50 III Blending & Lubrication 12 Croscarmellose Sodium 30.00 13 Magnesium Stearate 6.00 Total Weight of Part II 800.00 Tablet weight (Part I + Part II) 1670.00 Film Coating to Bilayer Tablet 1 Opadry? 42.00 2 Purified Water q.s. Final Coated Tablet weight 1712.00

(113) Manufacturing Process:

(114) 1. All the materials of each part were sifted & dry mixed separately.

(115) 2. The sifted material was compacted and sized to get the free flowing granules of each part.

(116) 3. The granules of each part obtained in step 2 were blended with croscarmellose sodium and lubricated with pre-sifted with Magnesium stearate and then compressed into bilayer tablet.

(117) 4. The bilayer tablets were film coated using dispersion of Opadry?.

EXAMPLE 6

(118) Manufacturing Formula:

(119) TABLE-US-00006 Sr. No. Ingredients Qty/Tablet Part I : Raltegravir Layer 1 Raltegravir Potassium 434.40 2 MCC PH102 114.11 3 Lactose Monohydrate 26.06 4 Calcium Phosphate Dibasic Anhydrous 73.85 5 Hypromellose 2208 26.06 6 Poloxamer 407 (Contains 0.01% BHT) 173.80 7 Sodium Stearyl Fumarate 8.69 8 Magnesium Stearate 13.03 Total weight of part I 870.00 Part II : Lamivudine & Zidovudine Layer 1 Lamivudine 150.00 2 Zidovudine 300.00 3 Microcrystalline Cellulose PH 102 269.42 4 Colloidal Silicon Dioxide 2.25 5 Sodium Starch Glycolate 22.50 6 Ferric Oxide Yellow 0.20 Lubrication 7 Magnesium Stearate 5.63 Total Weight of Part II 750.00 Tablet weight (Part I +Part II) 1620.00 Film Coating to Bilayer Tablet 1 Opadry? 40.00 2 Purified Water q.s. Final Coated Tablet weight 1660.00

(120) Manufacturing Process:

(121) 1. All the materials of each part were sifted & dry mixed separately.

(122) 2. The sifted material was compacted and sized to get the free flowing granules of each part.

(123) 3. The granules of each part obtained in step 2 were pre-sifted with Magnesium stearate and then compressed into bilayer tablet.

(124) 4. The bilayer tablets were film coated using dispersion of Opadry?.

EXAMPLE 7

(125) Manufacturing Formula:

(126) TABLE-US-00007 Sr. Qty (mg)/ No. Ingredients Tablet Dry Mix 1 Dolutegravir 50.00 2 Emtricitabine 200.00 3 Tenofovir Disoproxil Fumarate 300.00 4 Microcrystalline Cellulose PH 102 350.00 5 Croscarmellose Sodium 25.00 Binder 6 Hypromellose E15 cps 20.00 7 Purified Water q.s. Blending & Lubrication 8 Colloidal Silicon Dioxide 2.50 9 Microcrystalline Cellulose PH 102 50.00 10 Croscarmellose Sodium 25.00 11 Magnesium Stearate 7.50 Total weight uncoated tablet 1030.00 Film Coating 12 Opadry? 25.00 13 Purified Water q.s. Final Coated Tablet weight 1055.00

(127) Manufacturing Process:

(128) 1. All the materials of each part were sifted & dry mixed separately.

(129) 2. Binder solution was prepared by adding hypromellose in purified water

(130) 3. The granules were prepared by spraying binder solution of step 2 on to the dry mix.

(131) 4. The granules obtained were sized and blended with colloidal silicon dioxide, microcrystalline cellulose and croscarmellose sodium and further lubricated with magnesium stearate.

(132) 5. The lubricated granules of step 4 were compressed to form tablets and then film coated with Opadry? dispersion.

EXAMPLE 8

(133) Manufacturing Formula:

(134) TABLE-US-00008 Sr. Qty (mg)/ No. Ingredients Tablet Dry Mix 1 Dolutegravir 50.00 2 Tenofovir Disoproxil Fumarate 300.00 3 Lamivudine 300.00 4 Microcrystalline Cellulose PH 102 395.50 5 Croscarmellose Sodium 25.00 Binder 6 Hypromellose E15 cps 23.00 7 Purified Water q.s. Blending & Lubrication 8 Colloidal Silicon Dioxide 2.50 9 Microcrystalline Cellulose PH 102 50.00 10 Magnesium Stearate 9.00 Total weight Uncoated tablet 1155.00 Film Coating 11 Opadry? 25.00 12 Purified Water q.s. Final Coated Tablet weight 1180.00

(135) Manufacturing Process:

(136) 1. All the materials of each part were sifted & dry mixed separately.

(137) 2. Binder solution was prepared by adding hypromellose in purified water

(138) 3. The granules were prepared by spraying binder solution of step 2 on to the dry mix.

(139) 4. The granules obtained were sized and blended with colloidal silicon dioxide, microcrystalline cellulose and further lubricated with magnesium stearate.

(140) 5. The lubricated granules of step 4 were compressed to form tablets and then film coated with Opadry? dispersion.

EXAMPLE 9

(141) Manufacturing Formula:

(142) TABLE-US-00009 Sr. Qty (mg)/ No. Ingredients Tablet Dry Mix 1 Dolutegravir 50.00 2 Lamivudine 150.00 3 Zidovudine 300.00 4 Microcrystalline Cellulose PH 102 395.00 5 Croscarmellose Sodium 25.00 Binder 6 Hypromellose E15 cps 20.00 7 Purified Water q.s. Blending & Lubrication 8 Colloidal Silicon Dioxide 2.50 9 Microcrystalline Cellulose PH 102 50.00 10 Magnesium Stearate 7.50 Total weight uncoated tablet 1000.00 Film Coating 1 Opadry 25.00 2 Purified Water q.s. Final Coated Tablet weight 1025.00

(143) Manufacturing Process:

(144) 1. All the materials of each part were sifted & dry mixed separately.

(145) 2. Binder solution was prepared by adding hypromellose in purified water

(146) 3. The granules were prepared by spraying binder solution of step 2 on to the dry mix.

(147) 4. The granules obtained were sized and blended with colloidal silicon dioxide, microcrystalline cellulose and further lubricated with magnesium stearate.

(148) 5. The lubricated granules of step 4 were compressed to form tablets and then film coated with Opadry? dispersion.

(149) It will be readily apparent to one skilled in the art that varying substitutions and modifications may be made to the invention disclosed herein without departing from the spirit of the invention. Thus, it should be understood that although the present invention has been specifically disclosed by the preferred embodiments and optional features, modification and variation of the concepts herein disclosed may be resorted to by those skilled in the art, and such modifications and variations are considered to be falling within the scope of the invention.

(150) It is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of including, comprising, or having and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.

(151) It must be noted that, as used in this specification and the appended claims, the singular forms a, an and the include plural references unless the context clearly dictates otherwise. Thus, for example, reference to a polymer includes a single polymer as well as two or more different polymers; reference to a plasticizer refers to a single plasticizer or to combinations of two or more plasticizer, and the like.