GB2127689A - Calcitonin inhalation compositions - Google Patents

Calcitonin inhalation compositions Download PDF

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GB2127689A
GB2127689A GB08326436A GB8326436A GB2127689A GB 2127689 A GB2127689 A GB 2127689A GB 08326436 A GB08326436 A GB 08326436A GB 8326436 A GB8326436 A GB 8326436A GB 2127689 A GB2127689 A GB 2127689A
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composition according
composition
nasal
calcitonin
application
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Moise Azria
Thomas Cavanak
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Sandoz AG
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Sandoz AG
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Priority claimed from GB838322528A external-priority patent/GB8322528D0/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0043Nose
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/16Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/22Hormones
    • A61K38/23Calcitonins
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/28Steroids, e.g. cholesterol, bile acids or glycyrrhetinic acid

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  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
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  • Animal Behavior & Ethology (AREA)
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  • Medicinal Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Gastroenterology & Hepatology (AREA)
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  • Bioinformatics & Cheminformatics (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
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  • Endocrinology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Oil, Petroleum & Natural Gas (AREA)
  • Otolaryngology (AREA)
  • Medicinal Preparation (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

Pharmaceutical compositions for nasal administration comprising i) a calcitonin, and ii) benzalkonium chloride, and/or iv) a surfactant, suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier, suitable for application to the nasal mucosa. The compositions are suitably adapted for administration in the form of a nasal spray.

Description

SPECIFICATION Galenic compositions comprising calcitonin and their use The present invention relates to novel galenic compositions comprising a calcitonin as active ingredient.
The caicitonins comprise a known class of pharmaceutically active, long-chain polypeptides of varying, well documented pharmaceutical utility. Various calcitonins, including e.g. salmon and eel calcitonin, are commercially available and commonly employed in the treatment of e.g. Paget's disease, hypercalcaemia and osteoporosis.
As is commonly the case with polypeptides however, provision of convenient and effective means of administering calcitonins has presented many diffuculties. Being polypeptides, the calcitonins are susceptible to degradation on administration and only pass with difficulty into the body fluids. For this reason parenteral administration has hitherto been the only route commonly available which permits effective treatment. Generally administration is by injection. Such means of aministration are always inconvenient and when administration is to be effected at regular intervals can cause considerabie pain to the patient.The finding of viable alternative means of administration causing less discomfort to the patient and preferably allowing ready self-application while at the same time achieving bio-availability levels sufficient for effective treatment in clinic has accordingly remained, for many years, a major goal.
We have now found that it is possible to provide effective clinical treatment with calcitonins by administration via the nasal route, i.e. by application to the nasal mucosa. More particularly we have found that in accordance with the particular teachings of the present invention, calcitonin bioavailability levels equivalent to those obtained on administration of standard intra-muscular doses can be achieved on nasal administration at dosage levels which are fully within the limits of tolerability and practicability. It has further been found that the fish calcintonins and their derivatives e.g. salmon calcitonin and the eel calcitonin derivative 1,7-Asu-eel calcitonin, herein referred to as Elcatonin, and in particular salmon calcitonin, are especially suited for application via the nasal route in accordance with the teachings of the invention.
The nasal route provides a simple and painless mode of administration which may be easily carried out by the patient himself, for example administering a nasal spray or drop solution from a nasal applicator. This route is clearly of great advantage over parenteral administration which has generally to be given under medical supervision.
While administration via the nasal route will clearly be preferZabie to parenteral administration, e.g.
injection as hitherto commonly practiced, the provision of a comp'osition suitable for use for a nasal dosage form itself presents many difficulties. One problem, especially acute in relation to nasal administration of complex pharmaceutical agents such as the calcitonins, is that of providing a fully compatible and effective means for avoiding contamination e.g. by pathogenic or other undesired micro-organisms. Provision of an appropriate active-ingredient-compatible and effective preserving agent to protect against contamination is especially critical for a nasal pharmaceutical composition where the risk of contamination is particularly high.The preserving agent must suffice to provide not only for initial contamination avoidance, e.g. during formulation and filling of the composition into its container, but continued contamination avoidance during use particularly where multiple dosaging from a single container/applicator is required. In particular problems arise where e.g. a nasal applicator is, as is often the case, subsequently stored for months before use. During this phase the selected preserving agent may be rendered useless, e.g. by absorption onto the inside surfaces of the applicator, by heatdegradation, or, where the preserving agent is to any degree unduly volatile, as a consequence of leakage from the applicator.Further, during the actual phase of use (and where multiple dosaging from a single applicator is foreseen this may extend over a period of several days or weeks), there is danger that the applicator may leak or otherwise let in unwanted micro-organisms or other contaminants from the outside atmosphere generally, or from the nostrils. Moreover the composition may be subjected to brief periods of elevated temperature, e.g. during transport or storage.
In addition to the above mentioned difficulties a pharmaceutical composition developed for nasal application must at the same time be appropriately tolerated in particular at the immediate site of application. It should, for example, neither cause irritation to the nasal mucosa (e.g. should cause no significant prickling sensation) nor cause significant reduction of the ciliary beating frequency.
Very many well-known preserving agents present themselves for possible use in calcitonin pharmaceutical compositions. However experiment has shown that not all are suitable for practical use in relation to a calcitonin nasal spray. Thus chlorbutanol at 0.6% in calcitonin nasal pharmaceutical compositions showed insufficient activity against the test fungus Pen. steckii, more than 3 days being required to reduce the cell count to less than 0. 1%. Moreover, chlorbutanol was found to attack rubber stoppers and other joints used in nasal spray applicators between the spray pump and a bottle.
Chlorbutanol additionally caused at 0.6% more than 50% inhibition of the ciliary beating frequency of rat trachea within 20 minutes according to the microphoto-oscillographic method of L. Chevance et al, Acta Otolaryng. 70, 16:28 (1970). These are just some of the disadvantageous effects that can be encountered.
In accordance with the present invention it has now been surprisingly found that pharmaceutical compositions can be obtained comprising a calcitonin as active ingredient which meet the high standards of stability and tolerability required for nasal application and which are, for example, eminently suitable for use in multiple dose nasal spray applicators, i.e. applicators capable of delivering a series of individual dosages over e.g. period of several days or weeks, by the use of benzalkonium chloride as a co-ingredient and preserving agent.Surprisingly it has also been found that use of benzalkonium chloride, even at the very low concentration required for use as a preserving agent, may confer beneficial advantages in relation to the nasal resorption characteristics of calcitonin containing compositions and hence enhance calcitonin bio-availability levels consequential to nasal application.
In accordance with the foregoing the present invention provides, in a first aspect, a pharmaceutical composition for nasal administration, comprising: i) a calcitonin, and ii) benzalkonium chloride, in iii) a liquid diluent or carrier, suitable for application to the nasal mucosa.
The term "calcitonin" is used throughout the present specification and claims in a broad sense to include not only the naturally occurring caicitonins, but also their pharmaceutically active derivatives and analogues, e.g. in which one or more of the peptide residues present in the naturally occurring product is replaced, or in which the N- or C-terminal is modified.
Preferred calcitonins for use in accordance with the invention are salmon, human and porcine calcitonins and Elcatonin. All of these compounds are commercially available and have been extensively described, together with their pharmaceutical properties, in the literature.
As previously indicated it has been found that exceptionaliy good results, e.g. in terms of bioavailability levels and duration of presence in the blood plasma, are obtained on nasal administration of salmon calcitonin. Salmon caicitonin is accordingly the most preferred calcitonin for use in accordance with the invention.
As will be appreciated the calcitonins for use in the invention may be in free form or in pharmaceutically acceptable salt or complex form, e.g. in pharmaceutically acceptable acid addition salt form. -Such salts and complexes are known and possess an equivalent degree of activity and tolerability to the free forms. Suitable acid addition salt forms for use in accordance with the invention include e.g.
the hydrochlorides and acetates.
Benzalkonium chloride is the name commonly employed for known mixtures of quaternary ammonium salts typically of the generalized formula C6H5-CH 2-NR(CH3)2C1, -wherein R is C8H,7 to C8H37. A preferred concentration for the benzalkonium chloride component in the compositions of the invention is from about 0.002 to about 0.02, typically about 0.01% (w/v) of the total composition.
The above defined compositions may be applied in accordance with the invention to the nasal mucosa e.g. either in drop or in spray form. As hereinafter described however, they are most preferably applied in spray form, i.e. in the form of finely divided droplets.
The composition of the invention may of course also include additional ingredients, in particular components belonging to the class of conventional pharmaceutically applicable surfactants. In this connection it has in accordance with a further aspect of the present invention been found that the use of surface active agents generally in relation to the nasal application of calcitonins, in particular salmon calcitonin, may increase resorption via the nasal mucosa and hence improve obtained bio-availability rates. Accordingly in a further aspect the present invention also provides a composition adapted for administration in the form of a liquid nasal spray, comprising: i) a calcitonin, and iv) a surfactant suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier suitable for application to the nasal mucosa.
Preferably the liquid diluent or carrier (iii) for use in the compositions of the invention [i.e., whether comprising ii) benzalkonium chloride and/or iv) a conventional surfactant as a necessary component] will comprise water (pharmaceutical grade). Most preferably it comprises aqueous saline. The compositions of the invention are formulated so as to permit administration via the nasal route. For this purpose they may also contain, e.g. minimum amounts of any additional ingredients or excipients desired, for example, additional preservatives or e.g. ciliary stimulants such as caffeine. Generally for nasal administration a mildly acid pH will be preferred. Preferably the composition of the invention have a pH of from about 3 to 5, most preferably from about 3.5 to about 4.5. Adjustment of the pH is achieved by addition of an appropriate acid, such as hydrochloric acid.
The compositions of the invention should also possess an appropriate isotonicity and viscosity.
Preferably they have an osmotic pressure of from about 260 to about 380 mOsm/litre. Desired viscosity for the compositions of the invention will depend on the particular form for administration, e.g. whether administration is to be by nasal drops o nasal spray. For nasal drops an appropriate viscosity is from about 2 to about 40 x 10-3 Pa.S.. For nasal sprays the viscosity will suitably be less than 2 x 10-3 Pa.S., e.g. from 1 to 2 x 10-3 Pa.S.
Where compositions in accordance with the invention comprise a conventional surfactant (whethe or not they also comprise benzalkonium chloride) non-ionic surfactants are preferred. Especially preferred surfactants are polyoxyalkylene higher alcohol ethers, e.g. of the general formula (I)
wherein RO is the residue of a higher alcohol especially a higher alkanol or alkylphenol, such as a lauryl or cetyl alcohol, or a sterol residue, especially a lanosterol, dihydrocholesterol or cholesterol residue, as well as mixtures of two or more such ethers. Preferred polyoxyalkylene ethers for use in accordance with the invention are polyoxyethylene and polyoxypropylene ethers (i.e. wherein n in the formula above is 2 or-3) in particular polyoxyethylene and poiyoxypropylenelauryl, cetyl and cholesteryl ethers as well as mixtures of two or more such ethers.
The hydroxy group at the end alkylene unit of such ethers as aforesaid may be partially or completely acylated, by e.g. acyl residues of aliphatic carboxylic acids, such as acetic acid.
Preferred ethers for use in accordance with the invention have -a hydrophilic-lipophilic balance (HLB group number) of from about 10 to about 20, especially from about 12 to about 1 6.
Especially suitable ethers for use in accordance with the invention are those wherein the average number of repeating units in the polyoxyalkylene moiety (x in the formula above) is from 4 to 75, suitably 8 to 30, more especially 16 to 26. The ethers may be obtained in accordance with known techniques. A wide variety of such products are commercially available and e.g. offered for sale e.g. by the company Amerchol under the trade-name SolulanB1, the companies KAO Soap, ICI and Atlas under the trade-names Emalex, Brij and Laureth and from the company Croda under the trade-name Cetornacrogol.
Examples of polyoxyalkylene ethers suitable for use in accordance with the invention are as follows: (POE = polyoxyethylene ether; POP = polypropylene ether; x = average No. of repeating units in the POP/POE moiety).
1. Cholesteryl ethers: 1.1 Solulan C-24 - POE, x = 24.
2. Ethers ofLanolin alcohols: 2.1 Solulan(316POE, x = 16.
2.2 Solulan 25 - POE, x = 25.
2.3 Solulan) 75-POE, x = 75.
2.4 Solulan PB-i 0 - PPE, x = 10.
2.5 Solulan 98 - POE, x = 10 - partially acetylated.
2.6 Solulan 97 - POE, x = fully acetylated.
3. Laurylethers: 3.1 Emalex(!) 709/Laureth 9 - POE, x = 9.
3.2 Laureth 4/BrijR 30 -- POE, x = 4.
3.3 Laureth(H) 23/Brij 35 - POE, x = 23.
4. Cetyl ethers: 4.1 CetamacrogolR-- POE, x = 20 to 24.
Lanolin alcohols are also known as wool fat alcohols and are a mixture of cholesterol, dihydrocholesterol and lanosterol.
Preferred esters for use in accordance with the present invention are polyoxyethylene cholesteryl ethers, i.e. of the above formula I, wherein n = 2 and RO is a cholesterol residue, especially such ethers wherein the number of repeating units in the polyoxyethylene moiety is from 16 to 26, most preferably about 24.
More preferably such ethers are substantially free from contaminents in particular from other polyoxyalkylene ethers. Most preferably they comprise at least 75%, more preferably at least 85%, and most preferably at least 90% by weight of pure polyoxyethylene cholesteryl ether.
When a surfactant, e.g. a polyoxyalkylene ether is employed, the amount present in the compositions of the invention will vary depending on the particular surfactant chosen, the particular mode of administration (e.g. drop or spray) and the effect desired. In general, however, the amount present will be of the order of from about 2.0 to about 200 (preferably to about 100, more preferably to about 20), suitably from about 5 to about 30 (preferably to about 15), and most preferably about 10 mg/ml.
The amount of calcitonin to be administered in accordance with the method of the invention and hence the amount of active ingredient in the composition of the invention will, of course, depend on the particular calcitonin chosen, the condition to be treated, the desired frequency of administration and the effect desired.
As indicated in the following example 2, bio-availability for calcitonins, in particular salmon calcitonin, as determined in terms of blood-plasma concentration following nasal administration in accordance with the teachings of the present invention has been found to be surprisingly high, generally of the order of ca. 50% of levels achieved on intra-muscular injection. Accordingly administration in accordance with the invention will appropriately be effected so as to give a dosage rate of the order of 2x or more, e.g. from about 2 to 4x the dosage rate required for treatment via intra-parietal, e.g. intramuscular, administration.
Hitherto, where calcitonin, e.g. salmon calcitonin, treatment has been effected by intra-muscular injection, individual dosages of ca. 50 to 100 MRC units are applied at a rate of from ca. lx daily to ca.
3x weekly. For nasal administration in accordance with the present invention, treatment will therefore suitably comprise administration of dosages of from about 50 to about 400 MRC units, more preferably from about 100 to about 200 MRC units at a frequency of from about lx daily to about 3x weekly.
Conveniently dosages as aforesaid will be administered in a single application, i.e. treatment will comprise administration of single nasal dosages comprising about 50 to about 400 MRC units, preferably about 100 to about 200 MRC units, calcitonin. Alternatively such dosages may be split over a series of e.g. 2 to 4 applications taken at intervals during the day, the dosage at each application then comprising about 10 to about 200, preferably about 25 to about 100 MRC units.
The total composition quantity administered at each nasal application suitably comprises from about 0.05 to 0.15 ml, typically about 0.1 ml e.g. 0.09 ml. Compositions for use in accordance with the invention accordingly suitably comprise from about 1 50 to about 8,000, preferably from about 500 to about 4,000, more preferably from about 500 to about 2,500, and most preferably from about 1,000 to about 2,000 MRC units calcitonin, e.g. salmon calcitonin, per ml.
For the purposes of nasal administration, the compositions of the invention will preferably be put up in a container provided with means enabling application of the contained composition to the nasal mucosa, e.g. put up in a nasal applicator device. Suitable applicators are known in the art and include those adapted for administration of liquid compositions to the nasal mucosa in drop or spray form. Since dosaging with calcitonins should be as accurately controlled as possible use of spray applicators for which the administered quantity is susceptible to precise regulation will generally be preferred. Suitable administrators include e.g. atmosing devices, e.g. pump-atomizers and aerosol dispensers. In the latter case, the applicator will contain composition in accordance with the invention together with a propellant medium suitable for use in a nasal applicator.The atomising device will be provided with an appropriate spray adaptor allowing delivery of the contained composition to the nasal mucosa. Such devices are well known in the art.
The container, e.g, nasal applicator, may contain sufficient composition for a single nasal dosaging or for the supply of several sequential dosages, e.g. over a period of days or weeks. Quantities of individual dosages supplied will preferably be as hereinbefore defined.
In accordance with the foregoing the present invention further provides: A. A container containing a pharmaceutical composition for nasal administration comprising i) a calcitonin, and ii) benzalkonium chloride, in iii) a liquid diluent or carrier, suitable for application to the nasal mucosa, said container being provided with means enabling application of the contained composition to the nasal mucosa, preferably in spray form; B. An applicator device containing a pharmaceutical composition and provided with means enabling application of the contained composition to the nasal mucosa in spray form, said contained composition comprising i) calcitonin, and iv) a surfactant suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier suitable for application to the nasal mucosa; as well as C.A method of administering a calcitonin to a subject requiring calcitonin treatment, which method comprises administering a composition for nasal administration comprising components i), ii) and iii) as defined under A above, or comprising components (i), iv) and iii) as defined under B above, to said subject via the nasal route.
Containers/applicator devices as defined under A and B above are suitably nasal aerosol applicators. Preferably they enable application of the contained composition in individual fixed quantities of from about 0.05 to about 0.1 5 ml, e.g. about 0.1 mi.
Suitable composition as well as individual components (i), (ii), (iii) or (iv) for use in relation to the containers/applicator devices/methods defined under A, B and C above are as hereinbefore described.
Suitable dosaging regimens for use in relation to the method C of the invention are also as hereinbefore described.
In addition to the foregoing the present invention also provides a method for the production of a liquid pharmaceutical composition for nasal administration comprising i) a calcitonin, and ii) benzalkonium chloride, and/or iv) a surfactant suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier suitable for application to the nasal mucosa, which method comprises bringing component (i) together with component (ii) and/or component (iv) into intimate admixture, e.g. into solution in component iii), and when required introducing the obtained composition into a container provided with means enabling application of the said obtained composition to the nasal mucosa, suitably enabling application of the said obtained composition to the nasal mucosa in spray form.
The stability of the compositions of the invention may be determined in conventional manner.
The calcitonin content of the compositions of the invention under an inert nitrogen atmosphere will degrade less than 10% in 2 years at 200C as indicated by standard analytical tests.
For example the nasal spray composition of Example 1 hereinafter described was stored for 2 months at 50C, 200C and 300C under nitrogen in a glass container. No detectable (less than 1%) degradation of calcitonin was observed at 50C and 200 C. At 300C a 4% degradation was observed this being no more than expected for a pure aqueous solution. These results indicate adequate stability, i.e.
less than 10% degradation over 2 years under nitrogen in a sealed container.
Also the compositions of the invention containing benzalkonium chloride are stable towards contamination by germs, e.g. according to standard tests, e.g. according to the procedures set out in S.
Urban, Acta Pharm, Technol. 22,247-253 (1976), For example the cell count of standard bacteria, namely E. coli ATCC 8739, Pseud. aeruginosa ATCC 9027, Staph, aureus ATCC 6538, Strept. pyogenes ATCC 8668, and standard fungi Cand. albicans ATCC 10231, Sacch. cerevisae ATCC 9763, Aspergillus niger ATCC 1 6404 and Pen. steckii ATCC 10499 following innoculation of the composition will be reduced to 0.1% or less within 24 hours as indicated by standard tests.
In one stability test the nasal spray composition of Example 1 hereinafter was stored at 300C for 3 months under a nitrogen atmosphere in a glass container. Pseud. aeruginosa ATCC 9027, Staph. aureus ATCC 6538, Strept. pyogenes ATCC 8668 and the fungi Cand. Albicans ATCC 10231, Sacch. cerevisae ATCC 9763, Aspergilles niger ATCC 1 6404 and Pen. stechii ATCC 10499 were added to give a cell count of ca. 2 x 105 organisms in the inoculated liquid. Within 2 hours the cell count had decreased to less than 0.1%. Within 4 weeks no cells could be detected.
Moreover the compositions are well tolerated as indicated in standard tests, e.g. in that less than 50% inhibition of ciliary beating frequency is observed up to 20 minutes after administration, according to the microphoto-oscillographic method of L. Chevance et al, Acta Otolaryng. 70, 26-28 (1970).
Insignificant or no prickling sensation and good stability against contamination during use, may also be demonstrated in standard clinical testing.
The following examples illustrate the invention.
EXAMPLE 1 Composition containing salmon calcitonin suitable for nasal administration: Ingredient Quantity (per ml) 1) Salmon calcitonin (active ingredient) 0.1375 mg 10% excess 0.01375 mg 0.15125 mg 2) NaCI 7.5 mg 3) Benzalkonium chloride 0.1 mg 4) HCI (1 N) added to pH 3.7 5) Distilled water to an end volume of 1.0 ml.
Components 1 to 3 are combined under protection of nitrogen gas (on a scale to produce a final volume of 2500 ml) in conventional manner, with 10% of salmon calcitonin being added to allow for loss at filtration. 4) is then added to bring the pH to 3.7 and distilled water added to an end-volume of 2500 ml.
The obtained solution is filtered (e.g. using a 0.2 ,um filter) to give a composition suitable for nasal application and for filling into a spray nasal dispensor with a solution volume of 2 ml. The composition comprises ca. 550 MRC-units active ingredient/ml, and the applicator delivers a quantity comprising 5-5 units per actuation.
EXAMPLE 2 Relative bio-availability study: nasal administration/intra-muscular injection of salmon calcitonin The study is conducted with 1 2 healthy volunteers, 6 male and 6 female, with a body weight of from 50 to 85 kg. Each subject receives 4 administrations of salmon calcitonin, one intra-muscularly and 3 nasally. Administration is effected at the following dosages: A Nasal: Al. 55 MRC units.
A2. 110 MRC units.
A3. 220 MRC units.
B. Intra-muscular: 50 MRC units.
Nasal administration is effected using composition in accordance with example 1 and a sprayapplicator delivering 55 MRC units per individual spray dosage. For the purposes of administration the subject is laid on the back with the head tilted backwards for 5 minutes. The nostrils are cleaned by blowing of the nose immediately prior to administration.
Intra-muscular administration is effected by injection of a single 1 ml dose of a composition similar to that of example 1, but omitting benzalkonium chloride and containing 50 MRC units into the glutaeus medius muscle.
Each subject receives the 4 administrations in randomised sequence, and at least 3 days are allowed between consecutive administrations. Each administration is effected in the morning after a light breakfast from which milk, butter and cheese is excluded. 100 ml water or orange juice is taken hourly following treatment to maintain urinary output. Further food is allowed not earlier than 4 hours after treatment.
Blood samples are taken immediately prior to administration (control), and at intervals of 5, 15, 30, 60, 90, 120, 180, 240, 360 and 480 minutes following administration. For the control a 20 ml sample is taken. All subsequent samples are 2 ml samples.
The concentration of salmon calcitonin in each serum sample is measured by radio-immuno assay. Blood-pressure is controlled during the course of the trial and urine-samples tested for possible adverse reaction. Occurrence of side-effects, e.g. symptoms of nausea, is noted.
The AUC ("area under curve") for salmon calcitonin plasma concentration is calculated statistically, once employing all value, including those below the 26 pg/ml detectability limit, once with values below the detectability limit read as zero. Maximal plasma concentration and time at which this is reached are also determined. Relative bio-availability for nasal administration is determined from the relative dosage-standardized AUC (i.e. based on 50 MRC units) following nasal and intra-muscular administration.
Results obtained indicate that AUC values following administration of both 110 and 220 MRC units intra-nasally, are comparable with AUC values obtained following administration of 50 MRC units i.m., with serum levels for salmon calcitonin remaining above the detectability limit for 8 hours following nasal application of 110 MRC units as compared with 6 hours following i.m. application of 50 MRC units. No adverse side-effects were recorded following nasal administrations, even at the highest dosage of 220 MRC units.
EXAMPLE 3 Compositions containing salmon calcitonin suitable for nasal administration Composition No. Quantity of salmon calcitonin employed 3a 0.06875 mg/ml 3b 0.275 mg/ml 3c 0.44 mg/ml 3d 1.1 mg/ml The compositions are prepared analogously to example 1 employing the same quantities of components 2) and 3) (7.5 mg or 0.1 mg/ml respectively), identical adjustment to pH 3.7 employing component 4) and topping up to the required end-volume employing component 5).The obtained composition comprise ca. 250 (composition 3a), 1000 (3b).2,000 (3c) and 4,000 (3d) MRC-units active ingredient/ml and are filled into an nasal spray dispensor delivering 0.2 ml active ingredient per actuation [= 25,1 00,200 and 400 MRC units/actuation for compositions 3a, 3b, 3c and 3d respectively]. It will of course be appreciated that where salmon caicitonin preparations of different activity are employed, differing quantities may be required to achieve the required concentration as defined in terms of MRC-units.
EXAMPLE 4 Compositions containing salmon calcitonin together with a non-ionic surfactant suitable for nasal administration The compositions are prepared in analogous manner to example 1 but with the addition of the following ingredients: Composition Additional Ingredient Quantity 4a polyoxyethylene cholesteryl ether: x = 24 30 mg/ml 4b polyoxyethylene cholesteryl ether: x = 24 10 mg/ml 4c polyoxyethylene cetyl ether: x = 20 to 24 100 mg/ml The compositions are put up in a nasal applicator as described in Example 1.
EXAMPLE 5 Comparative bio-availability study for the compositions of examples 1 and 4a 0.2 ml portions of composition 1 or 4a were administered nasally by means of a nasal spray applicator to Rhesus monkeys (0.1 ml/nostril) giving a dosage rate of ca. 100 MRC units salmon calcitonin/monkey, and salmon calcitonin plasma levels were measured in the subsequent hours. 3 runs were conducted per composition, and the combined results plotted graphically. Results (c.f. graph following) indicate that the bio-availability for both compositions (area under curve) is substantially equivalent, with the peak maximum being achieved somewhat earlier in the case of the composition of Example 4a.

Claims (36)

1. A liquid pharmaceutical composition for nasal administration, comprising: i) a calcitonin, and ii) benzalkonium chloride, in iii) a liquid diluent or carrier, suitable for application to the nasal mucosa.
2. A composition according to claim 1, wherein ii) is present in a concentration of from about 0.002 to about 0.02% (w/v).
3. A composition according to claim 1 or 2 additionally comprising iv) a surfactant suitable for application to the nasal mucosa.
4. A composition according to any one of the preceding claims adapted for administration in the form of a nasal spray.
5. A liquid pharmaceutical composition adapted for administration in the form of a liquid nasal spray, comprising: i) a calcitonin, and iv) a surfactant suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier suitable for application to the nasal mucosa,
6. A composition according to any one of the preceding claims, wherein i) is selected from the group consisting of salmon calcitonin, human calcitonin, porcine calcitonin and elcatonin.
7. A composition according to any one of the preceding claims, wherein iii) comprises water.
8. A composition according to claim 7, wherein iii) comprises aqueous saline.
9. A composition according to any one of the preceding claims, wherein i) is present in an amount of from about 100 to about 8,000 MRC units/ml.
10. A composition according to claim 9, wherein i) is present in an amount of from about 500 to about 4,000 MRC units/ml.
11. A composition according to claim 10, wherein i) is present in an amount of from about 500 to about 2,500 MRC units/ml.
12. A composition according to claim 11, wherein i) is present in an amount of from about 1.000 to about 2,000 MRC units/ml.
13. A composition according to any one of claims 9 to 12 wherein i) is salmon calcitonin.
14. A composition according to claim 3 or 5, wherein iv) is a non-ionic surfactant.
1 5. A composition according to claim 14, wherein iv) comprises a polyoxyalkylene higher alcohol ether.
1 6. A composition according to claim 15, wherein iv) comprises a polyoxyethylene or polyoxypropylene'ether.
1 7. A composition according to claim 1 5 or 16, wherein iv) comprises a polyoxyalkylene higher alkanyl or steryl ether.
1 8. A composition according to claim 17, wherein iv) comprises a polyoxyalkylene lauryl, cetyl, lanosteryl, dihydrocholesteryl or cholesteryl ether.
1 9. A composition according to claim 18, wherein iv) comprises a polyoxyethylene lauryl, cetyl or cholesteryl ether.
20. A composition according to claim 19, wherein iv) comprises a polyoxyethylene cholesteryl ether in which the number of repeating units in the polyoxyethylene moiety is from 1 6 to 26.
21. A composition according to any one of claims 3, 5 or 14 to 20 wherein iv) is present in an amount of from about 2.0 to about 200 mg/ml.
22. A composition according to claim 21 wherein iv) is present in an amount of from about 5 to about 1 5 mg/ml.
23. A composition according to any one of the preceding claims having a pH of from about 3 to about 5.
24. A composition according to claim 23 having a pH of from about 3.5 to 4.5.
25. A composition according to 23 or 24 comprising hydrochloric acid as the means to obtain the desired pH.
26. A composition according to any one of the preceding claims having an osmotic pressure of from about 260 to 380 mOsm/litre.
27. A composition according to any one of the preceding claims for administration in the form of a spray and having a viscosity of less than 2 x 10-3 Pa.S.
28. A container containing a composition as claimed in any one of claims 1 to 4 or 6 to 27 and provided with means enabling application of the contained composition to the nasal mucosa.
29. A container according to claim 28 provided with means enabling application of the contained composition to the nasal mucosa in spray form.
30. A container according to claim 29 which is a nasal aerosol applicator.
31. An applicator device containing a pharmaceutical composition and provided with means enabling application of the contained composition to the nasal mucosa in spray form, said contained composition comprising: i) a calcitonin, and iv) a surfactant suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier suitable for application to the nasal mucosa.
32. An applicator device as claimed in claim 31 wherein, in the contained composition, components i), iv) and iii) are as defined or are present in an amount as specified in any one of claims 6 to 22, or wherein the contained composition comprises an additional component or possesses physical characteristics as defined in any one of claims 23 to 27
33. A method of administering a calcitonin to a subject requiring calcitonin treatment, which method comprises administering a composition as defined in any one of claims 1 to 27 via the nasal route.
34. A method of administering a calcitonin to a subject requiring calcitonin treatment, which method comprises administering a pharmaceutical composition comprising: i) a calcitonin, and iv) a surfactant suitable for application to the nasal mucosa, in iii) a liquid diluent or carrier suitable for application to the nasal mucosa, to said subject via the nasal route.
35. A method according to claim 34 wherein, in the administered composition, components i), iv) and iii) are as defined or are present in an amount as specified in any one of claims 6 to 22, or wherein the administered composition comprises an additional component or possesses physical characteristics as defined in any one of claims 23 to 27.
36. A method according to any one of claims 33 to 35 wherein the composition is administered in the form of a spray.
GB08326436A 1982-10-05 1983-10-03 Calcitonin inhalation compositions Expired GB2127689B (en)

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Application Number Priority Date Filing Date Title
GB08326436A GB2127689B (en) 1982-10-05 1983-10-03 Calcitonin inhalation compositions
CY146689A CY1466A (en) 1982-10-05 1989-07-21 Galenic compositions comprising calcitonin and their use

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GB8228390 1982-10-05
GB8236928 1982-12-30
GB838320865A GB8320865D0 (en) 1983-08-03 1983-08-03 Organic compounds
GB838322528A GB8322528D0 (en) 1983-08-22 1983-08-22 Organic compounds
GB08326436A GB2127689B (en) 1982-10-05 1983-10-03 Calcitonin inhalation compositions

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GB2127689A true GB2127689A (en) 1984-04-18
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Cited By (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0183527A2 (en) * 1984-11-26 1986-06-04 Yamanouchi Pharmaceutical Co. Ltd. Absorbable calcitonin medicament
EP0193372A2 (en) * 1985-02-25 1986-09-03 Teijin Limited Intranasally applicable powdery pharmaceutical composition
EP0199992A1 (en) 1985-03-28 1986-11-05 Eisai Co., Ltd. Adsorption-resistant peptide composition and use of benzalkonium or benzethonium chloride in the preparation thereof
GB2176105B (en) * 1985-06-04 1990-03-07 Sandoz Ltd Nasal inserts dispensing pharmaceuticals.
US4994439A (en) * 1989-01-19 1991-02-19 California Biotechnology Inc. Transmembrane formulations for drug administration
US5093105A (en) * 1991-04-09 1992-03-03 Merck Frosst Canada, Inc. Radiopharmaceutical bacteriostats
EP0486854A1 (en) * 1990-11-20 1992-05-27 ISTITUTO FARMACO BIOLOGICO RIPARI-GERO S.p.A. Aqueous compositions containing calcitonin for the nasal administration
US5122376A (en) * 1989-05-12 1992-06-16 Isf Societa Per Azioni Calcitonin gene related peptide
WO1992021332A1 (en) * 1991-05-25 1992-12-10 Boehringer Ingelheim Kg Process for producing therapeutically usable aerosols
GB2257908A (en) * 1991-07-15 1993-01-27 Sandoz Ltd Peptide compositions
US5183802A (en) * 1987-11-13 1993-02-02 Isf Societa Per Azioni Pharmaceutical compositions for intranasal administration of calcitonin
US5227152A (en) * 1991-04-09 1993-07-13 Merck Frosst Canada, Inc. Radiopharmaceutical bacteriostats
AT396870B (en) * 1986-08-07 1993-12-27 Sandoz Ag Process for the production of a pharmaceutical formulation for the nasal administration of serotonin antagonists
GR1001447B (en) * 1992-12-08 1993-12-30 Ron Poulenk Rorer Anonymos Emp Pharmaceutical products for the endonosal administration of caltcitonine.
US5281580A (en) * 1990-08-16 1994-01-25 Toyo Jozo Company, Ltd. Calcitonin-containing emulsion for nasal administration
US5306482A (en) * 1991-04-09 1994-04-26 Merck Frosst Canada, Inc. Radiopharmaceutical bacteriostats
US5393738A (en) * 1986-05-27 1995-02-28 Sandoz, Ltd. Pharmaceutical compositions containing octreotide and excipients for oral or rectal administration
US5514670A (en) * 1993-08-13 1996-05-07 Pharmos Corporation Submicron emulsions for delivery of peptides
US5514365A (en) * 1988-10-11 1996-05-07 Schiapparelli Salute S.P.A. Pharmaceutical compositions comprising calcitonin for intranasal administration
EP0761211A1 (en) * 1995-08-30 1997-03-12 F. Hoffmann-La Roche Ag Sustained release composition
US5744155A (en) * 1993-08-13 1998-04-28 Friedman; Doron Bioadhesive emulsion preparations for enhanced drug delivery
US5824646A (en) * 1988-03-11 1998-10-20 Teikoku Seiyaku Co., Ltd. Intravaginal delivery of biologically active polypeptides
US6087338A (en) * 1995-02-08 2000-07-11 Therapicon S.R.L. Pharmaceutical non inorganic saline solutions for endonasal administration of a calcitonin
WO2000044393A2 (en) * 1999-01-29 2000-08-03 Phylomed Corporation Buccal delivery system for proteinaceous medicaments
US6328728B1 (en) 1994-11-17 2001-12-11 Alza Corporation Composition and method for enhancing electrotransport agent delivery
CN1109558C (en) * 1993-06-29 2003-05-28 凡林有限公司 Stabilized pharmaceutical peptide compositions

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GB1354526A (en) * 1971-04-19 1974-06-05 Armour Pharma Preparation for obtaining diuresis in animals
GB1525181A (en) * 1975-05-27 1978-09-20 Syntex Inc Form of flunisolide and the use of flunisolide to treat respiratory diseases
GB1592513A (en) * 1977-10-28 1981-07-08 Okido Y Multipurpose tooth cleaner

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Publication number Priority date Publication date Assignee Title
GB763168A (en) * 1953-12-31 1956-12-12 Abbott Lab Inhalant preparation
GB1213985A (en) * 1967-03-29 1970-11-25 Ransomes Sims & Jefferies Ltd Improvements in combine harvesters
GB1354526A (en) * 1971-04-19 1974-06-05 Armour Pharma Preparation for obtaining diuresis in animals
GB1525181A (en) * 1975-05-27 1978-09-20 Syntex Inc Form of flunisolide and the use of flunisolide to treat respiratory diseases
GB1592513A (en) * 1977-10-28 1981-07-08 Okido Y Multipurpose tooth cleaner

Cited By (36)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0183527A3 (en) * 1984-11-26 1987-09-23 Yamanouchi Pharmaceutical Co. Ltd. Absorbable calcitonin medicament
EP0183527A2 (en) * 1984-11-26 1986-06-04 Yamanouchi Pharmaceutical Co. Ltd. Absorbable calcitonin medicament
EP0193372A3 (en) * 1985-02-25 1987-07-01 Teijin Limited Intranasally applicable powdery pharmaceutical composition
EP0193372A2 (en) * 1985-02-25 1986-09-03 Teijin Limited Intranasally applicable powdery pharmaceutical composition
EP0199992A1 (en) 1985-03-28 1986-11-05 Eisai Co., Ltd. Adsorption-resistant peptide composition and use of benzalkonium or benzethonium chloride in the preparation thereof
GB2176105B (en) * 1985-06-04 1990-03-07 Sandoz Ltd Nasal inserts dispensing pharmaceuticals.
US5393738A (en) * 1986-05-27 1995-02-28 Sandoz, Ltd. Pharmaceutical compositions containing octreotide and excipients for oral or rectal administration
AT396870B (en) * 1986-08-07 1993-12-27 Sandoz Ag Process for the production of a pharmaceutical formulation for the nasal administration of serotonin antagonists
US5183802A (en) * 1987-11-13 1993-02-02 Isf Societa Per Azioni Pharmaceutical compositions for intranasal administration of calcitonin
US5840685A (en) * 1988-03-11 1998-11-24 Teikoku Seiyaku Co., Ltd. Intravaginal delivery of biologically active polypeptides
US5824646A (en) * 1988-03-11 1998-10-20 Teikoku Seiyaku Co., Ltd. Intravaginal delivery of biologically active polypeptides
US5514365A (en) * 1988-10-11 1996-05-07 Schiapparelli Salute S.P.A. Pharmaceutical compositions comprising calcitonin for intranasal administration
US4994439A (en) * 1989-01-19 1991-02-19 California Biotechnology Inc. Transmembrane formulations for drug administration
US5122376A (en) * 1989-05-12 1992-06-16 Isf Societa Per Azioni Calcitonin gene related peptide
US5281580A (en) * 1990-08-16 1994-01-25 Toyo Jozo Company, Ltd. Calcitonin-containing emulsion for nasal administration
EP0486854A1 (en) * 1990-11-20 1992-05-27 ISTITUTO FARMACO BIOLOGICO RIPARI-GERO S.p.A. Aqueous compositions containing calcitonin for the nasal administration
US5306482A (en) * 1991-04-09 1994-04-26 Merck Frosst Canada, Inc. Radiopharmaceutical bacteriostats
US5227152A (en) * 1991-04-09 1993-07-13 Merck Frosst Canada, Inc. Radiopharmaceutical bacteriostats
US5093105A (en) * 1991-04-09 1992-03-03 Merck Frosst Canada, Inc. Radiopharmaceutical bacteriostats
WO1992021332A1 (en) * 1991-05-25 1992-12-10 Boehringer Ingelheim Kg Process for producing therapeutically usable aerosols
FR2682598A1 (en) * 1991-07-15 1993-04-23 Sandoz Sa PHARMACEUTICAL COMPOSITIONS OF PEPTIDES AND METHODS FOR THEIR PREPARATION.
GB2257908A (en) * 1991-07-15 1993-01-27 Sandoz Ltd Peptide compositions
BE1007752A5 (en) * 1991-07-15 1995-10-17 Sandoz Sa Pharmaceutical peptides and methods for their preparation.
GB2257908B (en) * 1991-07-15 1995-12-20 Sandoz Ltd Calcitonin analogue for transmucosal administration
GR1001447B (en) * 1992-12-08 1993-12-30 Ron Poulenk Rorer Anonymos Emp Pharmaceutical products for the endonosal administration of caltcitonine.
CN1109558C (en) * 1993-06-29 2003-05-28 凡林有限公司 Stabilized pharmaceutical peptide compositions
US5993846A (en) * 1993-08-13 1999-11-30 Pharmos Corporation Bioadhesive emulsion preparations for enhanced drug delivery
US5744155A (en) * 1993-08-13 1998-04-28 Friedman; Doron Bioadhesive emulsion preparations for enhanced drug delivery
US5514670A (en) * 1993-08-13 1996-05-07 Pharmos Corporation Submicron emulsions for delivery of peptides
US6328728B1 (en) 1994-11-17 2001-12-11 Alza Corporation Composition and method for enhancing electrotransport agent delivery
US6087338A (en) * 1995-02-08 2000-07-11 Therapicon S.R.L. Pharmaceutical non inorganic saline solutions for endonasal administration of a calcitonin
US6107277A (en) * 1995-02-08 2000-08-22 Therapicon S.R.L. Calcitonin salmon analogues
US5759583A (en) * 1995-08-30 1998-06-02 Syntex (U.S.A.) Inc. Sustained release poly (lactic/glycolic) matrices
EP0761211A1 (en) * 1995-08-30 1997-03-12 F. Hoffmann-La Roche Ag Sustained release composition
WO2000044393A2 (en) * 1999-01-29 2000-08-03 Phylomed Corporation Buccal delivery system for proteinaceous medicaments
WO2000044393A3 (en) * 1999-01-29 2000-12-14 Phylomed Corp Buccal delivery system for proteinaceous medicaments

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GB2127689B (en) 1986-07-09
CY1466A (en) 1989-07-21

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