JP2008273867A - Preparation for transmucosal administration - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a preparation containing an SNRI (selective serotonin, noradrenalin reuptake inhibitor), having a higher absorptivity than those of the known SNRI preparation, showing early expression of efficacy and also easily administered to patients to whom oral administration is difficult. <P>SOLUTION: This preparation for transmucosal administration is provided by containing a selective serotonin, noradrenaline reuptake inhibitor and a thickening agent. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a preparation containing a selective serotonin / noradrenaline reuptake inhibitor as an active ingredient. More preferably, it relates to a preparation containing milnacipran or a salt thereof.

A selective serotonin and noradrenaline reuptake inhibitor (hereinafter sometimes abbreviated as SNRI) selectively binds to the reuptake sites of serotonin and noradrenaline, which are neurotransmitters, in the brain neuronal junction and inhibits the uptake thereof. This is a fourth-generation antidepressant widely known as a drug that exhibits an antidepressant effect. Milnacipran (chemical name: cis- (±) -2- (aminomethyl) -N, N-diethyl-1-phenylcyclopropanecarboxamide), one of the representative SNRIs, is added to serotonin. Since it inhibits reuptake of noradrenaline, it exhibits an action comparable to that of tricyclic antidepressants such as imipramine and has extremely low affinity for receptors for various neurotransmitters in the brain. Developed as a new antidepressant called SNRI (Serotonine Noradrenarine Selective Reuptake Inhibitor) with reduced side effects (anticholinergic effects, effects on the heart and circulatory organs) possessed by antidepressants. As a coated tablet (trade name: Toledomine Tablet) In addition, it is sold overseas as a capsule (trade name: IXEL). Regarding milnacipran, the production method is reported in Patent Documents 1 to 3. Further, milnacipran-containing preparations are reported in Patent Documents 4 and 5.
Currently, the efficacy and safety of high-dose administration of milnacipran hydrochloride is being investigated in the treatment of diseases in which milnacipran is effective, such as depressive symptoms, and the possibility of high-dose administration is increasing (Non-Patent Document 1). When administering high doses, it is necessary to take multiple tablets, take large tablets containing high doses, or increase the number of doses. May be accompanied by a problem.
Japanese Patent Publication No. 63-23186 Japanese Patent Publication No. 05-67136 Japanese Patent No. 2964041 Special Table 2000-516946 Japanese translation of PCT publication No. 2002-519370 Clinical psychopharmacology, vol. 5 No. 1, 2002, p93-99

  An object of the present invention is to provide a SNRI-containing preparation that has higher therapeutic effect and absorbability than the conventionally known preparations for oral administration of SNRI, has a rapid onset of effects, and is easy to administer. In particular, the present invention is to provide a milnacipran-containing preparation that has higher therapeutic effect and absorbability than the conventionally known milnacipran preparation, has a rapid onset of effect, and is easy to administer to patients who are difficult to administer orally. .

  As a result of intensive studies to solve the above problems, the present inventors efficiently absorbed milnacipran by nasally administering milnacipran, which is a typical example of SNRI, or a salt thereof. First, it was found that it comes out in the blood much faster than when it was orally administered. Further, it was found that by nasally administering milnacipran or a salt thereof, milnacipran is efficiently transferred to the central nervous system, and the effect is manifested faster than oral administration, and the effect appears at a low dose. And, as a result of intensive studies to find a preparation containing milnacipran or a salt thereof, which is a typical example of SNRI, which has a higher therapeutic effect than before, as a representative example of SNRI By combining a certain milnacipran or a salt thereof with a thickening agent, especially chitosan (hereinafter sometimes referred to as Chitosan), the retention of the drug in the nasal cavity can be improved and the systemic circulation system can be improved. In addition to enhancing the absorbability of drugs, it has succeeded in promoting the transfer of drugs from the olfactory nerve region directly to the central nervous system (hereinafter abbreviated as CNS), and has a very therapeutic effect We have succeeded in finding a preparation containing milnacipran or a salt thereof, which is a typical example of high SNRI.

That is, the present invention includes the following.
[A1] A preparation for transmucosal administration containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent;
[A1-2] The preparation according to [A1], wherein the preparation for transmucosal administration is a preparation for nasal administration;
[A2] The preparation according to [A1] or [A1-2] above, wherein the selective serotonin / noradrenaline reuptake inhibitor is milnacipran or a salt thereof;
[A3] The preparation according to [A2], wherein the milnacipran or a salt thereof is milnacipran hydrochloride;
In addition, when the term number quoted in the range is shown as [A1] to [A3] and a term having a branch number such as [A1-2] is arranged in the range, [A1 -2] means that a term having a branch number such as is also cited. The same applies to the following.
[A3-2] The preparation according to any one of [A1] to [A3], wherein the thickening agent is chitosan or chitin;
[A3-3] The preparation according to any one of [A1] to [A3], wherein the thickening agent is chitosan;
[A4] The preparation according to any one of [A1] to [A3-2], wherein the preparation is a solution;
[A5] The preparation according to any one of [A1] to [A3], wherein the preparation is a suspension;
[A6] The preparation according to any one of [A1] to [A3], wherein the preparation is an emulsion;
[A7] The preparation according to any one of [A4] to [A6], wherein the osmotic pressure ratio of the solution, suspension, or emulsion is 0.5 to 5.0;
[A7-2] The preparation according to any one of [A4] to [A6], wherein the osmotic pressure ratio of the solution, suspension, or emulsion is 0.5 to 2.5;
[A7-3] The preparation according to any one of [A4] to [A6], wherein the osmotic pressure ratio of the solution, suspension, or emulsion is 0.5 to 1.5;
[A7-4] The preparation according to any one of [A4] to [A6] above, wherein the osmotic pressure ratio of the solution, suspension, or emulsion is about 1 or less;
[A8] The preparation according to any one of [A1] to [A7-4], wherein the preparation is an aerosol;
[A9] The preparation according to any one of [A1] to [A3], wherein the preparation is a powder;
[A10] The preparation according to any one of [A1] to [A9], which contains one or more preservatives selected from quaternary ammonium salts and parabens;
[A10-2] The preparation according to any one of [A1] to [A9], which contains at least one preservative selected from quaternary ammonium salts;
[A11] The preparation according to any one of [A1] to [A10-2], wherein the bioavailability is 20% or more;
[A11-2] The preparation according to any one of [A1] to [A10-2], wherein the bioavailability is 60% or more;
[A11-3] The preparation according to any one of [A1] to [A10-2], wherein the bioavailability is 80% or more;
[A11-4] The preparation according to any one of [A1] to [A10-2], wherein the bioavailability is 90% or more;
[A12] The preparation according to any one of [A1] to [A11-4], wherein the time to reach the maximum blood concentration is 60 minutes or less;
[A13] The preparation according to any one of the above [A1] to [A12] for patients who cannot be administered orally;
[A14] The preparation according to any one of [A1] to [A13], wherein the preparation is an antidepressant;
[A15] The preparation according to any one of [A1] to [A13], wherein the preparation is an analgesic;
[A16] The preparation according to any one of [A1] to [A15], wherein the daily dose of milnacipran or a salt thereof as an active ingredient is 1 mg or more;
[A16-2] The preparation according to any one of [A1] to [A15] above, wherein the daily dose of milnacipran or a salt thereof as an active ingredient is 20 mg or more;
[A16-3] The preparation according to any one of [A1] to [A15], wherein the daily dose of milnacipran or a salt thereof as an active ingredient is 50 mg or more;
[A17] a method of administering a selective serotonin / noradrenaline reuptake inhibitor in combination with a thickening agent transmucosally or transdermally;
[A17-2] a method wherein a selective serotonin / noradrenaline reuptake inhibitor is administered through a transmucosal in combination with a thickening agent;
[A17-3] a method of administering a selective serotonin / noradrenaline reuptake inhibitor in combination with a thickening agent by instillation;
[A17-4] The method according to any one of [A17] to [A17-3] above, wherein the selective serotonin / noradrenaline reuptake inhibitor is milnacipran or a salt thereof;
[A17-5] The method according to [A17-4] above, wherein the milnacipran or a salt thereof is milnacipran hydrochloride;
[A17-6] In the method described in any one of [A17] to [A17-5], the method having the characteristics described in any one of [A2] to [A16-3];
[A18] Use of milnacipran or a salt thereof for the manufacture of a transmucosal preparation or a transdermal preparation containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent;
[A18-2] Use of milnacipran or a salt thereof for the manufacture of a preparation for transmucosal administration containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent;
[A18-3] Use of milnacipran or a salt thereof for the manufacture of a preparation for nasal administration containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent;
[A19] A nasal preparation containing an antidepressant and a thickener;
[A20] a preparation for transdermal administration containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent;
[A20-2] The preparation according to [A20] above, wherein the selective serotonin / noradrenaline reuptake inhibitor is milnacipran or a salt thereof;
[A20-3] The preparation according to [A20-2], wherein the milnacipran or a salt thereof is milnacipran hydrochloride;
[A21] a method of administering a selective serotonin / noradrenaline reuptake inhibitor in combination with a thickening agent through the skin;
[A21-2] The method according to [A21] above, wherein the selective serotonin / noradrenaline reuptake inhibitor is milnacipran or a salt thereof;
[A21-3] The method according to [A21-2] above, wherein the milnacipran or a salt thereof is milnacipran hydrochloride;
[A22] Use of milnacipran or a salt thereof for the manufacture of a preparation for transdermal administration containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent;

  According to the present invention, an SNRI-containing preparation for transmucosal administration, particularly an SNRI-containing preparation for nasal administration, which is more absorbable than the conventionally known SNRI-containing preparation, has a rapid onset of therapeutic effect, and is easy to administer. Can be provided. In addition, the absorbency is higher than the conventionally known milnacipran formulation, the onset of the therapeutic effect is fast, the retention of the drug in the nasal cavity is improved, and the absorption of the drug into the systemic circulatory system is enhanced. A milnacipran-containing preparation for transmucosal administration, particularly a milnacipran-containing preparation for nasal administration, can be provided. Furthermore, a preparation for transdermal administration containing a selective serotonin / noradrenaline reuptake inhibitor, particularly a preparation for transdermal administration containing milnacipran can be provided. According to the present invention, it is possible to administer milnacipran or a salt thereof and a high dose to a patient who is inappropriate for oral administration.

  As used herein, “selective serotonin / noradrenaline reuptake inhibitor (SNRI)” includes an agent that selectively inhibits reuptake of both serotonin and noradrenaline. The SNRI used in the present invention is not particularly limited as long as it is a compound that selectively inhibits reuptake of both serotonin and noradrenaline, and specifically includes venlafaxine, duloxetine, milnacipran, and the like. Milnacipran is a more preferred example.

  In the present invention, “venlafaxine” is a compound known by the chemical name of (±) -1- [2- (dimethylamino) -1- (4-methoxyphenyl) ethyl] cyclohexanol, or in some cases as appropriate. And can be synthesized by a known method (for example, US Pat. No. 4,535,186, Merck Index 12th Edition, entry 10079).

  In the present invention, “duloxetine” is a compound known by the chemical name of (S) —N-methyl-γ- (1-naphthalenyloxy) -2-thiophenpropanamine, or in some cases, an appropriate salt thereof. It can be synthesized by a known method (for example, US Pat. No. 5,023,269, Merck Index 12th Edition, entry 3518).

  In the present invention, “milnacipran” is also known as F2207, TN-912, dulcipran, midariplan, or midariplan, and its chemical name is cis- (±) -2- (aminomethyl)- N, N-diethyl-1-phenyl-cyclopropanecarboxamide. Milnacipran or an appropriate salt thereof can be used, but milnacipran can be synthesized by a known method (for example, US Pat. No. 4,478,836, Merck Index 12th edition entry 6281).

  In the present invention, SNRI is preferably provided as its free form or as a pharmaceutically acceptable salt. The pharmaceutically acceptable salt is not particularly limited as long as it is a salt formed by SNRI with a pharmaceutically acceptable acidic substance, but it is not limited to the acidic substance used in the formation of a salt of milnacipran described below. Salts are exemplified, and hydrochloride is a preferred example.

The salt of milnacipran is preferably a pharmaceutically acceptable salt, and is not limited as long as it is a salt formed with pharmaceutically acceptable acidic substance and milnacipran. For example, hydrochloride, hydrobromic acid Salt, nitrate, sulfate, hydrogen sulfate, phosphate, acetate, lactate, succinate, citrate, maleate, tartrate, fumarate, methanesulfonate, p-toluenesulfonic acid Examples thereof include salts, camphor sulfonate, and mandelate. Among them, hydrochloride, that is, milnacipran hydrochloride is preferable, and milnacipran hydrochloride is sometimes called toledomine or ixel.
In this specification, “milnacipran-containing preparation” means “preparation containing milnacipran or a salt thereof”.

  Milnacipran is an antidepressant already on the market, is well tolerated, and is a highly safe drug as an antidepressant. The daily dosage when the preparation of the present invention is administered to a patient may be appropriately determined in consideration of the subject to be treated, the severity of the pain, and the judgment of the prescribing physician. In terms of milnacipran, the upper limit is preferably 400 mg or less, more preferably 200 mg or less, and even more preferably 150 mg or less. The lower limit is not limited as long as it is the minimum amount that recognizes the effectiveness of milnacipran as an antidepressant or analgesic, but is preferably 15 mg or more, more preferably 25 mg or more, further preferably 30 mg or more, 50 mg The above is particularly preferable, and 100 mg or more is most preferable. Further, the lower limit is preferably 1 mg or more, more preferably 5 mg or more, further preferably 10 mg or more, and further preferably 20 mg or more.

  When administered at a high dose, in terms of milnacipran hydrochloride as an active ingredient, the lower limit is preferably 50 mg or more, more preferably 75 mg or more, further preferably 100 mg or more, particularly preferably 125 mg or more, and the upper limit Although it can set similarly to the upper limit of the daily dose in terms of milnacipran hydrochloride, it is not limited to these.

  As for the number of administrations, the dose can be administered once a day or divided into a plurality of times.

  The preparation containing the SNRI of the present invention can be used as a preparation for transdermal administration or a preparation for transmucosal administration, but is more preferably used as a preparation for transmucosal administration. Among them, it is more preferable to use as a preparation for nasal administration.

  Examples of the mucosa in the preparation for transmucosal administration of the present invention include buccal mucosa, oral mucosa, gingival mucosa, nasal mucosa, ocular mucosa, pulmonary mucosa, gastric mucosa, intestinal mucosa, and endometrium. Oral mucosa, gingival mucosa, ocular mucosa, nasal mucosa or pulmonary mucosa are preferred, and ocular mucosa or nasal mucosa are more preferred examples, but are not limited thereto. Of these, the nasal mucosa is particularly preferable, and can be used as a preparation for nasal administration.

  A preparation containing milnacipran or a salt thereof exemplified as a particularly preferred embodiment of the present invention as an active ingredient can be used as a transmucosal preparation. Examples of the mucous membrane include the above-mentioned examples. Among them, use as a preparation for nasal administration is one of particularly preferred embodiments in the present invention. Since the milnacipran-containing preparation of the present invention is administered nasally, the bioavailability of the active ingredient is high and the time to reach the maximum blood concentration is short compared to oral administration. Can be used. Nasal administration is sometimes referred to as intranasal administration.

  In the present invention, the thickening agent to be combined with the selective serotonin / noradrenaline reuptake inhibitor includes substances added for the purpose of increasing the viscosity of the liquid, particularly if the retention in the nasal cavity is improved. It is not limited. Further, the thickening agent itself may be either liquid or solid.

  Specific examples of the thickening agent include, for example, sodium alginate, propylene glycol alginate, ethyl cellulose, carboxyvinyl polymer, carmellose sodium, xanthan gum, glycerin, sodium chondroitin sulfate, D-sorbitol solution, concentrated glycerin, hydroxyethyl cellulose, hydroxyethyl. Examples include methylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, propylene glycol, povidone, polysorbate 80, polyvinyl alcohol, macrogol 400, macrogol 4000, methylcellulose, cottonseed oil / soybean oil mixture, or poly-L-arginine. Moreover, chitosan or chitin is mentioned. Sodium alginate, propylene glycol alginate, ethyl cellulose, carboxyvinyl polymer, carmellose sodium, xanthan gum, glycerin, sodium chondroitin sulfate, hydroxyethyl cellulose, hydroxyethyl methylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, povidone, polyvinyl alcohol, macrogol, methylcellulose Or poly-L-arginine is a preferred example. Also, carboxyvinyl polymer, carmellose sodium, glycerin, sodium chondroitin sulfate, D-sorbitol solution, concentrated glycerin, hydroxypropylcellulose, propylene glycol, povidone, polysorbate 80, macrogol 400, macrogol 4000, cottonseed oil / soybean oil mixture, There is also another embodiment in which poly-L-arginine is preferred. Among the above, chitosan or chitin is mentioned as a more preferable example, and chitosan is more preferable. There is another embodiment in which chitin is more preferable.

  The chitosan includes chitosan oligosaccharide (oligoglucosamine) in which glucosamine or glucosamine as a structural unit is bound in a straight chain. The chitin includes N-acetylglucosamine or chitin oligosaccharide (oligo N-acetylglucosamine) bonded in a straight chain with N-acetylglucosamine as a structural unit. Chitosan can also be used as a salt of chitosan such as glutamate.

  As the thickening agent, one kind or a combination of two or more kinds can be used.

  The molecular weight of chitosan is not particularly limited as long as the retention in the nasal cavity is improved, but the upper limit of the molecular weight is preferably 30000 or less, more preferably 20000 or less, further preferably 10,000 or less, and particularly preferably 5000 or less. Preferably, the lower limit is preferably 100 or more, more preferably 200 or more, and still more preferably 300 or more.

  The molecular weight of chitin is not particularly limited as long as the retention in the nasal cavity is improved, but the upper limit of the molecular weight is preferably 30000 or less, more preferably 20000 or less, further preferably 10,000 or less, and particularly preferably 5000 or less. Preferably, the lower limit is preferably 100 or more, more preferably 200 or more, and still more preferably 300 or more.

  As shown in the examples described later, when the milnacipran hydrochloride-containing preparation of the present invention containing a thickener, especially chitosan, is administered nasally, the retention in the nasal cavity is improved, and higher biological utilization Not only can the rate be obtained, but also the retention of the drug in the olfactory nerve region can be improved, facilitating direct transition to the CNS.

The content (weight) of the thickening agent used in the milnacipran hydrochloride-containing preparation of the present invention is, for example, when the milnacipran hydrochloride-containing preparation is a solution such as a solution, suspension, or emulsion, The upper limit of the volume of the plan-containing preparation is preferably 10.0% or less, more preferably 5% or less, still more preferably 2% or less, and the lower limit is preferably 0.1% or more, more preferably 0.2% or more. More preferably, 0.4% or more is further preferable, and 0.5% or more is particularly preferable.
The viscosity of the milnacipran hydrochloride-containing preparation of the present invention is, for example, when the milnacipran hydrochloride-containing preparation is a solution such as a solution, suspension, or emulsion, as long as the viscosity in the nasal cavity is improved. Although not limited, the upper limit is preferably 50 cP or less, more preferably 20 cP or less, still more preferably 10 cP or less, and the lower limit is preferably 0.1 cP or more, more preferably 0.5 cP or more, and even more preferably 1.0 cP or more.

  The preparation for transmucosal administration of the present invention is not particularly limited as long as it is a dosage form that can be absorbed transmucosally. For example, powder, solution, suspension, emulsion, sublingual tablet, sublingual capsule, vagina Tablets, ointments, creams, gels, pastes, patches, and the like can be mentioned. In preparing the preparation, various known pharmaceutically acceptable additives can be blended.

  For example, for the pulmonary mucosa, it is possible to make the formulation reach the pulmonary mucosa by reducing the particle size after spraying as a dosage form of fine particles such as solution or powder and reducing the particle diameter after spraying become. It can be used as an oral mucosa patch for the oral mucosa, and as an acupuncture patch or eye drop for the ocular mucosa. For the nasal mucosa, the nebulizer is devised as a dosage form of fine particles such as solution or powder to reduce the particle diameter after spraying and sprayed into the nasal cavity, or the dosage form of cream or ointment is intranasal However, it is not limited to these. Thus, a specific administration method may be appropriately selected depending on the dosage form and depending on the administration site. Other suitable drugs for transmucosal administration include, for example, JP-A-62-195336, JP-A-3-209327, JP-B5-22685, JP-A-6-107557, JP-B-7-53671. Since the pharmaceuticals described in JP-A-8-183741 and the like are known, the pharmaceutical forms described in these publications can be appropriately employed.

  The preparation for transmucosal administration of the present invention is preferably used as a solution, suspension (suspension) or emulsion (emulsion), and more preferably used as a solution. Moreover, it can also prepare by adding an additive to an active ingredient, respectively.

  The solution of the preparation for transmucosal administration of the present invention is preferably made pH-adjusted and isotonic by dissolving an active ingredient in a solvent. That is, the composition of the solution is preferably composed of at least an active ingredient, a solvent, a pH adjuster, and an isotonic agent, but is not limited thereto.

  The suspension can be obtained by adding a suspending agent or other suitable additive and purified water or oil to the active ingredient, suspending it by an appropriate method, and making the whole quality uniform. The suspension is preferably pH adjusted and isotonic. That is, the composition of the suspension is preferably composed of at least an active ingredient, a solvent, a suspending agent, a pH adjusting agent, and an isotonic agent, but is not limited thereto.

  An emulsion is obtained by adding an emulsifier and purified water to an active ingredient, emulsifying by an appropriate method, and making the whole quality uniform. The emulsion is preferably pH adjusted and isotonic. That is, the composition of the emulsion is preferably composed of at least an active ingredient, a solvent, an emulsifier, a pH adjuster, and an isotonic agent, but is not limited thereto.

  In the preparation for transmucosal administration of the present invention, the solvent used in the solution, suspension (suspension), and emulsion (emulsion) includes water or ethanol, and water is a more preferable example. It is also preferable to use it as a mixture of water and ethanol. The water is preferably ordinary water listed in JP, water for injection, purified water, or sterilized purified water.

  In the preparation for transmucosal administration of the present invention, the suspending agent used in the suspension (suspension) is not particularly limited as long as it is usually used as a suspending agent. 1 type or 2 or more types may be contained in (suspending agent), for example, gum arabic, gum arabic powder, sodium alginate, carrageenan, carboxyvinyl polymer, carmellose sodium, agar powder, glycerin, crystalline cellulose, Tragacanth, tragacanth powder, hydroxypropylcellulose, propylene glycol, benzyl alcohol, popidone, polyoxyethylene hydrogenated castor oil, polyoxyethylene castor oil 60, polysorbate 80, macrogol 4000, macrogol 6000, olive oil, sesame oil, soybean oil, cottonseed oil , Peanut oil, fluid paraffin Gum arabic, gum arabic powder, sodium alginate, carrageenan, carmellose sodium, glycerin, crystalline cellulose, tragacanth, tragacanth powder, hydroxypropyl cellulose, popidone, polyoxyethylene hydrogenated castor oil, polyoxyethylene castor oil 60 , Macrogol 4000, Macrogol 6000, Olive oil, Sesame oil, Soybean oil, Cottonseed oil, Peanut oil, Liquid paraffin are more preferable, and Olive oil, Sesame oil, Soybean oil, Cottonseed oil, or Peanut oil are more preferable examples. In addition, there is another embodiment in which carboxyvinyl polymer, carmellose sodium, agar powder, glycerin, crystalline cellulose, hydroxypropyl cellulose, propylene glycol, benzyl alcohol, popidone, polysorbate 80, or macrogol 4000 is further preferable.

  In the preparation for transmucosal administration of the present invention, the emulsifier used in the emulsion (emulsion) is not particularly limited as long as it is usually used as an emulsifier, but is contained in the emulsion (emulsion) one or more kinds. For example, carboxyvinyl polymer, carmellose sodium, highly purified egg yolk lecithin, glycerin, hydrogenated soybean phospholipid, squalane, squalene, polyoxyl 45 stearate, stearic acid, polyoxyl stearate 55, purified soybean lecithin, purified egg yolk Lecithin, sorbitan sesquioleate, sulbitan fatty acid ester, soybean lecithin, hydroxypropyl cellulose, partially hydrogenated soybean phospholipid, propylene glycol, polyoxyethylene hydrogenated castor oil, polyoxyethylene hydrogenated castor oil 5, polyoxyethylene Castor oil 10, polyoxyethylene hydrogenated castor oil 20, polyoxyethylene hydrogenated castor oil 40, polyoxyethylene hydrogenated castor oil 50, polyoxyethylene hydrogenated castor oil 60, polyoxyethylene castor oil, polyoxyethylene behenyl ether, poly Oxyethylene (160) polyoxypropylene (30) glycol, polyoxyethylene (1) polyoxypropylene (1) cetyl ether, polyoxyethylene (10) polyoxypropylene (4) cetyl ether, polyoxyethylene (20) poly Examples include oxypropylene (4) cetyl ether, polyoxyethylene (20) polyoxypropylene (8) cetyl ether, polysorbate 80, macrogol 400, cottonseed oil / soybean oil mixture, or sorbitan monostearate. , Highly purified egg yolk lecithin, hydrogenated soybean phospholipid, squalane, squalene, polyoxyl stearate 45, polyoxyl stearate, purified soybean lecithin, purified egg yolk lecithin, sorbitan sesquioleate, sulbitan fatty acid ester, soybean lecithin, partially hydrogenated soybean Phospholipid, polyoxyethylene hydrogenated castor oil, polyoxyethylene hydrogenated castor oil 5, polyoxyethylene hydrogenated castor oil 10, polyoxyethylene hydrogenated castor oil 20, polyoxyethylene hydrogenated castor oil 40, polyoxyethylene hydrogenated castor oil 50, Polyoxyethylene hydrogenated castor oil 60, polyoxyethylene castor oil, polyoxyethylene behenyl ether, polyoxyethylene (160) polyoxypropylene (30) glycol, polyoxyethylene (1) poly Reoxypropylene (1) cetyl ether, polyoxyethylene (10) polyoxypropylene (4) cetyl ether, polyoxyethylene (20) polyoxypropylene (4) cetyl ether, polyoxyethylene (20) polyoxypropylene (8 ) Cetyl ether or sorbitan monostearate is a preferred example. There is also another embodiment in which carboxyvinyl polymer, carmellose sodium, glycerin, stearic acid, hydroxypropyl cellulose, propylene glycol, polysorbate 80, macrogol 400, or cottonseed oil / soybean oil mixture is preferred.

  In the preparation for transmucosal administration of the present invention, the upper limit of the pH of the solution exemplified by a solution, suspension, or emulsion is preferably 10 or less, more preferably 9 or less, further preferably 8 or less, and 7 or less. The lower limit is preferably 2 or more, more preferably 3 or more, still more preferably 4 or more, and particularly preferably 5 or more. The upper limit of pH is preferably 8.5 or less, preferably 7.5 or less, more preferably 6.5 or less, and the lower limit is preferably 3.8 or more, more preferably 4.3 or more, and 4.8. The above is more preferable, 5.3 or more is particularly preferable, and there is another embodiment in which 5.5 or more is most preferable.

  The pH can be adjusted depending on the amount of pH adjuster added, and the pH adjuster is not particularly limited as long as it is usually used as a pH adjuster. Two or more types may be included, for example, adipic acid, aqueous ammonia, hydrochloric acid, dry sodium carbonate, dilute hydrochloric acid, citric acid, sodium citrate, sodium dihydrogen citrate, glycine, glucono-γ-lactone, gluconic acid, Crystalline sodium dihydrogen phosphate, succinic acid, acetic acid, ammonium acetate, sodium acetate, diisopropanolamine, tartaric acid, D-tartaric acid, sodium L-tartrate, potassium hydroxide, calcium hydroxide, sodium hydroxide, magnesium hydroxide, carbonic acid Sodium hydrogen, sodium carbonate, triisopropanolamine, triethanolamine , Lactic acid, calcium lactate, sodium lactate, glacial acetic acid, monosodium fumarate, sodium propionate, boric acid, ammonium borate, borax, maleic acid, anhydrous citric acid, anhydrous sodium acetate, anhydrous sodium monohydrogen phosphate, Anhydrous sodium dihydrogen phosphate, meglumine, methanesulfonic acid, monoethanolamine, sulfuric acid, potassium aluminum sulfate, DL-malic acid, phosphoric acid, trisodium phosphate, sodium hydrogen phosphate, dipotassium phosphate, dihydrogen phosphate Potassium or sodium dihydrogen phosphate, preferably hydrochloric acid, dry sodium carbonate, dilute hydrochloric acid, citric acid, sodium citrate, sodium dihydrogen citrate, glycine, crystalline sodium dihydrogen phosphate, succinic acid, acetic acid, Ammonium acetate, sodium acetate, tartaric acid, D- Stone acid, sodium L-tartrate, potassium hydroxide, calcium hydroxide, sodium hydroxide, magnesium hydroxide, sodium bicarbonate, sodium carbonate, lactic acid, calcium lactate, sodium lactate, glacial acetic acid, monosodium fumarate, sodium propionate , Boric acid, ammonium borate, borax, anhydrous citric acid, anhydrous sodium acetate, anhydrous sodium hydrogen phosphate, anhydrous sodium dihydrogen phosphate, methanesulfonic acid, sulfuric acid, potassium aluminum sulfate, DL-malic acid, phosphoric acid , Trisodium phosphate, sodium hydrogen phosphate, dipotassium phosphate, potassium dihydrogen phosphate, or sodium dihydrogen phosphate, more preferably hydrochloric acid, citric acid, sodium citrate, sodium dihydrogen citrate , Crystalline sodium dihydrogen phosphate, sodium acetate Sodium, sodium hydroxide, sodium propionate, boric acid, borax, anhydrous citric acid, anhydrous sodium dihydrogen phosphate, sodium hydrogen phosphate, dipotassium phosphate, potassium dihydrogen phosphate, or sodium dihydrogen phosphate Can be mentioned.

  The upper limit of the osmotic pressure ratio of the solution, suspension or emulsion of the present invention is preferably 1.5 or less, more preferably 1.4 or less, and further preferably 1.3 or less. 1.2 or less, most preferably 1.1 or less, the lower limit is preferably 0.5 or more, more preferably 0.6 or more, 0.7 More preferably, it is more preferably 0.8 or more, and most preferably 0.9 or more. The upper limit of the osmotic pressure ratio of the solution, suspension or emulsion of the present invention is preferably 5.0 or less, more preferably 4.0 or less, and preferably 3.0 or less. More preferably, it is particularly preferably 2.5 or less, most preferably 2.0 or less, and the lower limit is preferably 0.85 or more, more preferably 0.95 or more, It is more preferably 0.05 or more, particularly preferably 1.15 or more, and there is another embodiment in which it is most preferably 1.25 or more. Further, there is another embodiment in which the vicinity of 1 is preferable.

  The osmotic pressure can be measured by measuring the osmolarity of the sample using the freezing point depression method. Specifically, the osmotic pressure is measured by the osmotic pressure measuring method of the Japanese Pharmacopoeia (14th revision).

  The osmotic pressure ratio can be adjusted depending on the amount of isotonic agent added, and the isotonic agent is not particularly limited as long as it is usually used as an isotonic agent, but in a solution, suspension or emulsion. 1 or 2 or more types may be contained in, for example, aminoethylsulfonic acid, sodium bisulfite, calcium chloride, potassium chloride, sodium chloride, benzalkonium chloride, magnesium chloride, fructose, citric acid, sodium citrate Glycerin, crystalline sodium dihydrogen phosphate, calcium bromide, sodium bromide, sodium hydroxide, physiological saline, sodium bicarbonate, D-sorbitol solution, nicotinamide, sodium lactate solution, concentrated glycerin, propylene glycol, benzyl Alcohol, boric acid, borax, macrogol 4000, anhydrous sodium phosphate , Phosphoric acid, sodium hydrogen phosphate, sodium dihydrogen phosphate, or potassium dihydrogen phosphate, aminoethyl sulfonic acid, sodium hydrogen sulfite, calcium chloride, potassium chloride, sodium chloride, benzalkonium chloride, chloride Magnesium, citric acid, sodium citrate, glycerin, crystalline sodium dihydrogen phosphate, calcium bromide, sodium bromide, sodium hydroxide, physiological saline, sodium bicarbonate, D-sorbitol solution, nicotinamide, sodium lactate solution , Concentrated glycerin, propylene glycol, benzyl alcohol, boric acid, borax, macrogol 4000, anhydrous sodium prophosphate, phosphoric acid, sodium hydrogen phosphate, sodium dihydrogen phosphate, or potassium dihydrogen phosphate, preferably calcium chloride ,chloride Lithium, sodium chloride, magnesium chloride, citric acid, sodium citrate, glycerin, crystalline sodium dihydrogen phosphate, sodium hydroxide, physiological saline, sodium bicarbonate, concentrated glycerin, phosphoric acid, sodium hydrogen phosphate, diphosphate Sodium hydride or potassium dihydrogen phosphate is a more preferable example.

  In addition, as a tonicity agent, sodium bisulfite, calcium chloride, potassium chloride, sodium chloride, benzalkonium chloride, magnesium chloride, fructose, citric acid, sodium citrate, glycerin, crystalline sodium dihydrogen phosphate, sodium hydroxide , Physiological saline, sodium bicarbonate, D-sorbitol, nicotinamide, concentrated glycerin, propylene glycol, benzyl alcohol, boric acid, borax, macrogol 4000, phosphoric acid, sodium hydrogen phosphate, sodium dihydrogen phosphate Or potassium dihydrogen phosphate is more preferable, sodium hydrogen sulfite, sodium chloride, benzalkonium chloride, fructose, sodium citrate, glycerin, crystalline sodium dihydrogen phosphate, sodium hydroxide, physiological saline, D-sorbitol solution ,nicotine Amides, concentrated glycerin, propylene glycol, benzyl alcohol, borax, macrogol 4000, sodium hydrogen phosphate, is phosphate dihydrogen sodium hydrogen or potassium dihydrogen phosphate is also still another preferred embodiment.

  When the preparation for transmucosal administration of the present invention is a solution such as a solution, suspension or emulsion, a preservative can be added to stabilize the active ingredient. The preservative is not particularly limited as long as it is usually used as a preservative, but may be contained in a solution, suspension, or emulsion in one or more kinds, for example, cetylpyridinium chloride, Quaternary ammonium salts such as benzalkonium chloride, benzethonium chloride, or benzethonium chloride solution, isobutyl paraoxybenzoate, isopropyl paraoxybenzoate, ethyl paraoxybenzoate, butyl paraoxybenzoate, propyl paraoxybenzoate, methyl paraoxybenzoate, etc. Parabens, ethanol, sodium edetate, thimerosal, sodium dehydroacetate, phenol, borax, or boric acid, quaternary such as cetylpyridinium chloride, benzalkonium chloride, benzethonium chloride, or benzethonium chloride solution Ammoni Preferred examples include parabens such as methyl salt, or isobutyl paraoxybenzoate, isopropyl paraoxybenzoate, ethyl paraoxybenzoate, butyl paraoxybenzoate, propyl paraoxybenzoate, or methyl paraoxybenzoate, and cetylpyridinium chloride. More preferred examples include quaternary ammonium salts such as benzalkonium chloride, benzethonium chloride, or benzethonium chloride. Also preferred are benzalkonium chloride, ethyl paraoxybenzoate, butyl paraoxybenzoate, propyl paraoxybenzoate, methyl paraoxybenzoate, ethanol, sodium edetate, thimerosal, sodium dehydroacetate, phenol, borax, or boric acid. There is another aspect.

  The preparation for transmucosal administration of the present invention can be used as a powder or an aerosol. The aerosol agent is manufactured so as to be used at the time of use by the pressure of liquefied gas or compressed gas filled with the above-mentioned solution, suspension, emulsion, etc. of milnacipran in the same container or another container. The aerosol agent can be produced, for example, according to the description of the aerosol agent in the Japanese Pharmacopoeia (14th revision).

  The preparation for transmucosal administration of the present invention can be spray-administered to the mucous membrane as a solution, suspension, or solution exemplified by emulsion. For example, when sprayed into the nasal cavity, solutions can be used in nasal containers, spray containers, or similar containers suitable for applying such liquids into the nasal cavity. The concentration of the solution is not particularly limited as long as it is suitable for nasal administration, but the upper limit in terms of milnacipran hydrochloride is exemplified by 1000 mg / ml or less, preferably 800 mg / ml or less, preferably 600 mg / ml or less. Is more preferably 400 mg / ml or less, particularly preferably 300 mg / ml or less, most preferably 250 mg / ml or less, and the lower limit is exemplified by 10 mg / ml or more, preferably 15 mg / ml or more, and preferably 20 mg / ml or more. Is more preferably 50 mg / ml or more, particularly preferably 100 mg / ml or more, and most preferably 150 mg / ml or more.

  The upper limit of the liquid dose per spray administration is exemplified by 1000 μL or less, preferably 500 μL or less, more preferably 250 μL or less, further preferably 200 μL or less, particularly preferably 150 μL or less, most preferably 125 μL or less, The lower limit is exemplified by 10 μL or more, preferably 30 μL or more, more preferably 50 μL, further preferably 60 μL or more, particularly preferably 70 μL or more, and most preferably 75 μL or more.

  The number of sprays per day can be administered once per day, twice, or divided into multiple times. An appropriate number of times can be selected as necessary.

  When nasal administration is performed using the formulation of the present invention, it can be administered from one nose in one administration, or from both noses to administer the desired amount.

  The powder of the preparation for transmucosal administration of the present invention can be obtained by a usual method, and is prepared by adding an excipient or the like to the active ingredient. The excipient is not particularly limited as long as it is usually used as an excipient, and may be one or more kinds, for example, carmellose sodium, croscarmellose sodium, crospovidone, Magnesium aluminate, calcium silicate, magnesium silicate, light anhydrous silicic acid, crystalline cellulose, synthetic aluminum silicate, synthetic hydrotalcite, wheat starch, rice starch, sucrose fatty acid ester, low substituted sodium carboxymethyl starch, Low substituted hydroxypropyl cellulose, dextran 40, dextrin, natural aluminum silicate, corn starch, silicon dioxide, lactose, hydroxypropyl cellulose, phenacetin, partially pregelatinized starch or macrogol 4000 Croscarmellose sodium, crospovidone, magnesium aluminate silicate, calcium silicate, magnesium silicate, light anhydrous silicic acid, crystalline cellulose, synthetic aluminum silicate, synthetic hydrotalcite, wheat starch, rice starch, starch Preferred examples include sugar fatty acid esters, low-substituted sodium carboxymethyl starch, low-substituted hydroxypropylcellulose, dextran 40, dextrin, natural aluminum silicate, corn starch, silicon dioxide, or partially pregelatinized starch. There is also another embodiment in which carmellose sodium, crystalline cellulose, lactose, hydroxypropyl cellulose, or macrogol 4000 is preferred.

  In the present invention, the bioavailability (F) (hereinafter sometimes referred to as absorption rate (F)) refers to the percentage of the amount of drug absorbed relative to the amount of drug administered. Shows the total amount of milnacipran or its salt appearing in the blood.

  The lower limit of the bioavailability (F) of the nasal preparation in the present invention is preferably 90% or more, more preferably 93% or more, further preferably 95% or more, particularly preferably 97% or more, 99% The above is most preferable. Further, the lower limit is preferably 40% or more, more preferably 50% or more, further preferably 60% or more, particularly preferably 70% or more, and most preferably 80% or more. Further, the lower limit is preferably 1% or more, more preferably 5% or more, further preferably 10% or more, particularly preferably 20% or more, and most preferably 30% or more. The upper limit of F is not particularly limited as long as it is 100% or less, but 99% or less is preferable.

  In the present invention, the maximum blood concentration arrival time (Tmax) refers to the time until the maximum blood concentration is reached after administration when the maximum blood concentration is observed after drug administration. It is used for the evaluation of the absorption rate.

  The maximum blood concentration arrival time (Tmax) of the nasal preparation in the present invention is preferably within 60 minutes, more preferably within 40 minutes, further preferably within 30 minutes, particularly preferably within 25 minutes, most preferably within 20 minutes. preferable. In addition, this range is much shorter than 120 minutes, which is publicly known data for oral administration to humans, and it can be seen that the use of milnacipran or a salt thereof as an intranasal administration is effective. .

  As long as the preparation for transmucosal administration of the present invention does not affect the effect of the active ingredient other than the mixture according to the above-mentioned use form, the one used for normal preparation for nasal administration should be added. Can do.

  The preparation for transmucosal administration of the present invention can be used for patients who have been administered conventional oral milnacipran, and particularly for patients who cannot be administered orally, Effective for patients who need it. In addition, the preparation of the present invention can be used for the prevention, treatment, etc. of appropriate disease states in anticipation of the medicinal effects of the main component contained in this drug. Specifically, it is used as a preparation for transmucosal administration as an antidepressant or analgesic, but is not limited thereto. For example, it can be used for treatment of stress urinary incontinence, fibromyalgia (FMS) and the like. More preferably, it is used as a known antidepressant. In addition, other drugs having a known medicinal effect are also preferable, and among them, use as an analgesic (Obata, H. et al., Anesth Analg 2005; 100: 1406-10) is a more preferable example. Pain includes pain, among which chronic pain, neuropathic pain, headache, migraine, tension headache, chronic pelvic pain, muscle pain, joint pain, or fibromyalgia are preferred, and chronic pain, nerve pain Neuropathic pain or fibromyalgia is more preferable, and neuropathic pain or fibromyalgia is a more preferable example.

  In addition, the preparation of the present invention can be used for the treatment of chronic fatigue syndrome (CFS). The formulations of the present invention can also be used to treat neurogenic bladder, overactive bladder (OAB), or interstitial cystitis.

  Whether the preparation of the present invention has a good analgesic effect can be examined, for example, by the method described in Obata, H. et al., Anesth Analg 2005; 100: 1406-10.

  In addition, the present invention provides a method of administering SNRI from a mucosa in combination with a thickening agent, and particularly provides a method of administering SNRI by nasal drop in combination with a thickening agent. Furthermore, a method is provided in which milnacipran or a salt thereof is administered nasally in combination with a thickening agent. Milnacipran or a salt thereof has a high absorbability from the mucous membrane, and can be accelerated by, for example, nasal administration in combination with a thickening agent, and further enhanced.

  As a method of administering milnacipran or a salt thereof in combination with a thickening agent by nasal nose, in the case of a solid preparation, a capsule filled with powder is set in a special spray device equipped with a needle and the needle is inserted. For example, a method may be used in which fine holes are formed above and below the capsule, and then air is blown into the nasal cavity by feeding air with rubber balls.

  In addition, when the dosage form is a solution exemplified by a solution, suspension, or emulsion, the solution is put into a nasal container, a spray container, or a similar container suitable for applying such a solution into the nasal cavity. And a method of dropping or spraying into the nasal cavity. For example, it can be administered as an aerosol.

  In the case of a semi-solid preparation such as cream or ointment, the preparation is filled into a tube and an applicator is attached to the mouth of the tube at the time of administration, and it is administered directly into the nasal cavity, or a prescribed amount of the preparation is taken into the nasal cavity using an intranasal insertion tool. And a method of administering it internally.

  Examples of patients to whom milnacipran or a salt thereof can be administered include patients suffering from the above-mentioned diseases for which the preparation of the present invention can be used. Specific examples include patients suffering from depression or pain. It can also be administered to patients suffering from stress urinary incontinence and fibromyalgia (FMS). More preferably, it is administered to a depressed patient. In addition, other patients are preferable, and administration to patients suffering from pain is a more preferable example. Pain includes pain, among which chronic pain, neuropathic pain, headache, migraine, tension headache, chronic pelvic pain, muscle pain, joint pain, or fibromyalgia are preferred, and chronic pain, nerve pain Neuropathic pain or fibromyalgia is more preferable, and neuropathic pain or fibromyalgia is a more preferable example.

The preparation containing the SNRI of the present invention can also be used as a preparation for transdermal administration.
The preparation for transdermal administration of the present invention preferably contains an absorption enhancer. The absorption promoter is not particularly limited as long as it has an absorption promotion effect. For example, alcohols, higher alkanes, higher fatty acids, higher fatty acid esters, terpenes, alkyl sulfate esters, alkylamine oxides Pyrrolidones, inclusion-forming compounds, bile salts, saponins, or polyhydric alcohols. Examples of alcohols include ethanol, isopropanol, decanol, and stearyl alcohol. As the absorption accelerator, those described in JP-A-2006-335714 can also be used.

The dosage form of the preparation for transdermal administration of the present invention is not particularly limited as long as it is a dosage form capable of supplying a drug for a period required for treatment, but a patch, an ointment, a gel, a cream, a liquid, etc. Is exemplified. A patch is a preferred example of a dosage form that can supply an effective amount of the drug for a long time. Examples of the patch include a poultice, a tape, a patch, a plaster, and the like. In the case of a patch, a known base and support described in JP-A-2006-335714 can be used as the patch.
In addition, about the formulation of the form common to the formulation for transmucosal administration, it can prepare similarly to the preparation method of the formulation for transmucosal administration mentioned above.

  The present invention also provides a method of using milnacipran or a salt thereof for the manufacture of a preparation for transmucosal administration or a preparation for transdermal administration. Among others, a method for using milnacipran or a salt thereof for producing a preparation for nasal administration is provided.

  EXAMPLES The present invention will be specifically described below with reference to examples and test examples, but the present invention is not limited to these.

[Formulation Example 1]
After dissolving 10 g of milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) in an appropriate amount of purified water, further purified water is added to make a total of 50 mL, transmucosal containing 200 mg of milnacipran hydrochloride in 1 mL Manufacture preparations for administration. The transmucosal preparation has a pH of 4.55 and an osmotic pressure ratio of 3.81.

[Formulation Example 2]
After dissolving 3500 mg of milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) in an appropriate amount of purified water, the purified water is further added to make a total of 50 mL, and 1 mL contains 70 mg of milnacipran hydrochloride. Manufacture preparations for mucosal administration. The transmucosal preparation has a pH of 4.81 and an osmotic pressure ratio of 1.53.

[Formulation Example 3]
After dissolving 3250 mg of milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) in an appropriate amount of purified water, further add purified water to make 50 mL, transmucosal containing 65 mg of milnacipran hydrochloride in 1 mL Manufacture preparations for administration. The transmucosal preparation has a pH of 4.81 and an osmotic pressure ratio of 1.43.

[Formulation Example 4]
After dissolving 3000 mg of milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) in an appropriate amount of purified water, further purified water is added to make a total of 50 mL, transmucosal containing 60 mg of milnacipran hydrochloride in 1 mL Manufacture preparations for administration. The transmucosal preparation has a pH of 4.79 and an osmotic pressure ratio of 1.33.

[Formulation Example 5]
After dissolving 2500 mg of milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) in an appropriate amount of purified water, further purified water is added to make a total of 50 mL, transmucosal containing 50 mg of milnacipran hydrochloride in 1 mL Manufacture preparations for administration. The transmucosal preparation has a pH of 4.97 and an osmotic pressure ratio of 1.09.

[Formulation Example 6]
Milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) 2500 mg, hydroxypropyl methylcellulose (Nippon Soda; HPC-L) 50 mg, potassium dihydrogen phosphate (Wako Pure Chemicals; reagent special grade) 2.27 mg, water Sodium oxide (manufactured by Wako Pure Chemicals; reagent grade) 0.7 mg and methyl parahydroxybenzoate (made by Wako Pure Chemicals; reagent special grade) 25 mg are dissolved in purified water, the whole is made 50 mL, and milnacipran hydrochloride is added to 1 mL. A preparation for transmucosal administration containing 50 mg is produced. The transmucosal preparation has a pH of 6.22 and an osmotic pressure ratio of 1.13.

[Formulation Example 7]
Milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) 3500 mg, hydroxypropylmethylcellulose (manufactured by Nippon Soda; HPC-L) 50 mg, potassium dihydrogen phosphate (made by Wako Pure Chemicals; reagent special grade) 22.7 mg, water Sodium oxide (made by Wako Pure Chemical; reagent special grade) 7 mg and methyl parahydroxybenzoate (made by Wako Pure Chemical; reagent special grade) 25 mg are dissolved in purified water, the whole is 50 mL, and 70 mg of milnacipran hydrochloride is contained in 1 mL. To produce a preparation for transmucosal administration. This transmucosal preparation has a pH of 6.85 and an osmotic pressure ratio of 1.57.

[Formulation Example 8]
Milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) 5000 mg, hydroxypropylmethylcellulose (manufactured by Nippon Soda; HPC-L) 50 mg, potassium dihydrogen phosphate (manufactured by Wako Pure Chemicals; reagent special grade) 22.7 mg, water 7 mg of sodium oxide (made by Wako Pure Chemicals; reagent special grade) and 25 mg of methyl parahydroxybenzoate (made by Wako Pure Chemicals; reagent special grade) are dissolved in purified water, the whole is 50 mL, and 100 mg of milnacipran hydrochloride is contained in 1 mL. To produce a preparation for transmucosal administration. The transmucosal preparation has a pH of 5.91 and an osmotic pressure ratio of 2.13.

[Example 1]
The preparation for transmucosal administration containing chitosan of the present invention is obtained by adding chitosan to a desired content in the preparation for transmucosal administration containing milnacipran hydrochloride obtained in Formulation Examples 1 to 8 above. Obtainable.

[Example 2]
By dissolving 1 g of milnacipran hydrochloride (synthesized with reference to Patent Documents 1 to 3) in 50 mL of 0.5% chitosan aqueous solution, 20 mg of milnacipran hydrochloride is contained in 1 mL, and the chitosan concentration is 0.5%. A formulation requiring transmucosal administration can be obtained.

[Test Example 1] Effects of serotonin and noradrenaline reuptake selective inhibitor in combination with chitosan <Serotonin and noradrenaline reuptake selective inhibitor>
Milnacipran hydrochloride: A synthetic product was used (synthesized with reference to Patent Documents 1 to 3)
<Thickening agent>
Chitosan: Sigma Chemical Co. <Reagent>
In this test example, the following reagents were used.
Milnacipran hydrochloride: A synthetic product was used (synthesized with reference to Patent Documents 1 to 3)
Urethane: SIGMA (St Louis, MO, USA)
Acetonitrile for HPLC: chloroform, 2-propanol, n-heptane for HPLC, Kanto Chemical Co., Ltd .: Wako Pure Chemical Industries, Ltd.
Sodium hydroxide, potassium dihydrogen phosphate (KH ₂ PO ₄ ), 85% phosphoric acid (H ₃ PO ₄ ) and other reagents: Wako Pure Chemical Industries, Ltd., special grade Nembutal (registered trademark, pentobarbital sodium): Made by Sumitomo Dainippon Pharma Co., Ltd. (Osaka)
<Experimental animals>
Wistar male rats (250-300 g, 8 weeks old) were purchased from Saitama Experimental Animals (Saitama). Rats were allowed free access to food and water at 3 / cage. Used for experiments after 1 week of normal breeding.
<Quantitative method of milnacipran hydrochloride>
1) Extraction method Add 300 μL of NH ₄ C1 (pH 9.5) to 100 μL of plasma, stir for 30 seconds, add 500 μL of chloroform / 2-isopropanol / n-heptane (60/14/26), and shake for 2 minutes. Then, centrifugation (4 ° C., 15000 rpm, 5 min) was performed.
The chloroform layer (lower layer) obtained by centrifugation was taken in another microtube, and the solvent was removed under an inflow of nitrogen. After all the solvent was removed, 100 μL of HPLC mobile phase buffer was added to the extract to dissolve it, and then taken out into a glass tube and injected into HPLC by 30 μL, and the concentration of milnacipran hydrochloride was measured.
2) HPLC apparatus The following HPLC apparatus manufactured by Shimadzu Corporation was used.
Pump: LC-9A
Detector: SPO-6A
System controller: SCL-6B
Autoinjector: SIL-6B
Column open: CTO-6A
Chromatopack: C-R6A
3) HPLC conditions Mobile phase: Acetonitrile / 0.05M phosphate buffer (pH 2.8) prepared at 30:70 and degassed Elution: Flow rate 1 mL / min, 40 ° C.
Measurement wavelength: 200 nm
Table 1 shows the HPLC measurement conditions of milnacipran hydrochloride.

<Dynamic analysis>
The maximum plasma concentration in the vein (C _max ), the time to reach the maximum plasma concentration (T _max ), the area under the plasma concentration-time curve (AUC), and the absorption rate (F) were determined. The area under the plasma concentration-time curve (AUC) was calculated from the trapezoidal formula. AUC indicates the cumulative concentration of milnacipran in plasma that has been absorbed and transferred into the blood.
The obtained data was analyzed by a non-linear least squares method program (algorithm; Damping Gauss-Newton method). AUC, MRT, and MAT were calculated by moment analysis. Moreover, the relative retention in the nasal cavity was evaluated from the following formula (1).

<Forced swimming test>
According to the method of Porsolt et al. (Nature. 266: 730-732 (1977)), an acrylic transparent water tank (diameter 18 cm, height 40 cm) was filled with water to a height of 18 cm, and the water temperature was 25 ± 1 ° C. The test was loaded with forced swimming in two sessions, a conditioning session (15 minutes) and a test session (5 minutes). After completion of the conditioning session and 1 hour before the start of the test session, anesthesia was performed with diethyl ether, physiological saline was used as a control group, and milnacipran hydrochloride physiological saline was orally and nasally administered. The experimental protocol is shown in FIG.

<Closed nasal administration experiment>
Wistar male rats were anesthetized by intraperitoneal administration of urethane physiological saline (dosage 1.0 g / kg, 25 w / v%). After fixing the rat to the dorsal position on the fixed base, surgery was performed on the respiratory tract and esophagus according to the method of Hirai et al. (J. Pharm. Sci. 69: 1411-1413 (1980)) to expose the left and right jugular veins. The prepared physiological saline containing milnacipran hydrochloride was administered into the left nasal cavity with a microsyringe having a silicone tube attached to the tip (dose 20 mg / kg, concentration 100 mg / mL). Using a syringe pretreated with heparin, blood was collected from the right jugular vein over time. Blood samples were collected at 0.2 mL each at 0 minutes before nasal administration and at 5, 10, 20, 30, 60, 90, 120, 180, 240, 300, 360 minutes after administration. The blood sample was immediately centrifuged at 15,000 rpm (17,860 g) at 4 ° C. for 5 minutes to obtain a 0.1 mL plasma sample.

<Oral administration experiment>
1. Neural Butal (registered trademark, dosage 50 mg / kg, concentration 50 mg / mL) was intraperitoneally administered to Wistar male rats and anesthetized. After the rat was fixed on the dorsal position, the right jugular vein was exposed and a catheter was inserted. After the tip of the catheter was placed in the right atrium, the opened right jugular vein site was sutured using a suture with a medical needle (17 mm, square ½ black nylon 5-0, Matsusturures). After a sufficient recovery period, it was used for experiments.
2. Oral administration The prepared milnacipran hydrochloride physiological saline (dose 20 mg / kg, concentration 20 mg / mL) was administered to a rat subjected to jugular vein catheterization placement using an oral sonde under diethyl ether anesthesia. Using a syringe pretreated with heparin, blood was collected over time via a catheter. Blood samples were collected at 0.2 mL each at 0 minutes before nasal administration and at 5, 10, 20, 30, 60, 90, 120, 180, 240, 300, 360 minutes after administration. The blood sample was immediately centrifuged at 15,000 rpm (17,860 g) at 4 ° C. for 5 minutes to obtain a 0.1 mL plasma sample. In addition, after diethyl ether anesthesia awakening, it put in the gauge.

<Open nasal administration experiment>
Of the above oral administration experiment 1. The milnacipran hydrochloride saline solution (dose 20 mg / kg, concentration 100 mg / mL) prepared with a microsyringe with a silicone tube attached to the tip under anesthesia with diethyl ether ) Was administered into the left nasal cavity. Using a syringe pretreated with heparin, blood was collected over time via a catheter. Blood samples were collected at 0.2 mL each at 0 minutes before nasal administration and at 5, 10, 20, 30, 60, 90, 120, 180, 240, 300, 360 minutes after administration. The blood sample was immediately centrifuged at 15,000 rpm (17,860 g) at 4 ° C. for 5 minutes to obtain a 0.1 mL plasma sample. In addition, after diethyl ether anesthesia awakening, it was put in the gauge.

<Experimental result>
1. Effect of chitosan combination on nasal absorbability of milnacipran hydrochloride Whether absorption or retention in the nasal cavity is improved by combined use of chitosan with nasal administration of milnacipran hydrochloride, plasma concentration-time curve It evaluated by comparing.
A milnacipran hydrochloride solution supplemented with 0.5% chitosan was administered nasally in a closed system, and the improvement of nasal absorbability by using chitosan was evaluated. FIG. 1 shows the plasma concentration-time curve of milnacipran hydrochloride when chitosan is administered in combination, and Table 2 shows the pharmacokinetic parameters obtained. By coadministration of milnacipran hydrochloride and chitosan, C _max is 7090.7 ng / mL, F is 90.0%, and there is almost no difference in absorbability, but T _max is 10 minutes and MAT is 11. Absorption that was quicker than 4 minutes and control (Control) which is a case where chitosan was not added was obtained.

This is thought to be because drug penetration from the paracellular route was promoted in addition to the transcellular route by temporarily opening tight junctions of nasal mucosal epithelial cells with chitosan.
Fig. 2 shows plasma concentration-time curves of milnacipran hydrochloride in closed and open nasal administration when milnacipran hydrochloride solution supplemented with 0.5% chitosan is administered, and Table 3 shows pharmacokinetics. Indicates a parameter.
In the open nasal administration, when chitosan was used in combination, C _max was 5798.9 ng / mL and bioavailability (F) was 75.3%, which was higher than the control. The relative nasal retention rate (F ₀ / F _C ) calculated from the formula (1) was 72.8% in the control, but was improved to 83.8% by the combined use with chitosan. This is thought to be the result of the combined use of chitosan to increase the mucoadhesiveness of the drug solution, slowing the removal of the drug from the nasal cavity by mucociliary clearance, and leaving the drug in the nasal cavity for a longer time. This suggests that the amount transferred to the CNS via the systemic circulatory system also increased, and as a result of the drug staying longer in the nasal cavity, the amount transferred directly to the CNS was also increased.
2 and Table 3, Closed indicates a closed system, and Opened system indicates an open system.

<Influence of milnacipran hydrochloride on the pharmacological effects of chitosan combination>
It was found that the combined use of chitosan improved nasal retention of milnacipran hydrochloride and increased nasal absorption. Therefore, the forced swimming test was used for the pharmacological effect, and the shortening of the immobility time of the rat, which is one of the indicators of the antidepressant effect, was investigated and compared with the oral administration.
Fig. 3 shows the effects of oral administration of milnacipran hydrochloride (designated as po in the figure) and nasal administration (designated as in in the figure) when chitosan is used in combination during the immobility time in the forced swimming test. When chitosan was used in combination, dose-dependent and significant shortening of immobility time was observed as in the case of nasal administration of milnacipran hydrochloride physiological saline. Furthermore, nasal administration of milnacipran hydrochloride physiological saline showed a significant difference in the combination of chitosan compared with the dominant difference observed compared to oral administration of the same dose. Furthermore, since the antidepressant effect was almost equivalent in 60 mg / kg oral administration and 10 mg / kg nasal administration, it was found that a stronger antidepressant effect was obtained at a lower dose than oral administration.
This is because the combined use of chitosan improved the retention of the drug in the nasal cavity and increased its absorption into the systemic circulation, and improved the retention in the olfactory nerve region and improved the direct transfer to the CNS. There is a possibility.
Therefore, it was evaluated whether the strong antidepressant effect due to the combined use of chitosan was due to the improved absorption to the systemic circulation or because the direct transfer to the CNS was improved.
It is considered that the pharmacological effect of milnacipran hydrochloride appears strongly as the amount of transfer to CNS increases. The amount transferred from the systemic circulatory system to the CNS is related to the amount of drug absorbed into the systemic circulatory system. Therefore, the antidepressant effect was obtained as an antistatic effect from the following equation (2), and the relationship between AUC and the antidepressant effect was examined (FIG. 4).

Within the dose range used this time, the antidepressant effect became stronger with the increase of AUC in oral administration (indicated by ▲ in the figure), whereas oral administration in nasal administration (indicated by ◇ in the figure). It was found that a stronger antidepressant effect was shown at the same AUC as the administration. The antidepressant effect of milnacipran hydrochloride exerts its action by entering the brain. Since the transition to CNS is considered to be only transport through the systemic circulation in oral administration, the antidepressant effect is thought to correlate with the concentration of milnacipran hydrochloride in CNS.
Furthermore, by using 0.5% chitosan in combination with nasal administration (indicated by a circle in the figure), a stronger antidepressant effect was exhibited at a lower AUC. This is thought to be due to the large amount of drug transferred directly to the CNS due to improved retention in the olfactory nerve region.
Based on the above results, combined use of chitosan not only improved retention in the nasal cavity, resulting in higher bioavailability, but also improved retention of drugs in the olfactory nerve region, leading directly to CNS This suggests the possibility of facilitating the transition and enhancing the selectivity to the CNS. In addition, it was revealed that the combined use of chitosan showed a strong antidepressant effect compared to oral and nasal administration, which showed similar AUC.
As described above, combined use of chitosan as a base can improve retention in the nasal cavity and increase the absorption of the drug into the systemic circulatory system, as well as to the direct CNS of the drug from the olfactory nerve region It can be considered that the transition was promoted. The increased pharmacological effect of milnacipran hydrochloride may also be related to the transient opening action of chitosan on olfactory epithelial cells tight junction. As described above, a preparation using chitosan is considered to be useful as a transnasal mucosa delivery system because it exhibits a strong absorbency of milnacipran hydrochloride and a strong antidepressant effect at a low dose.

[Reference Example 1] Blood kinetic observation test when serotonin and noradrenaline reuptake selective inhibitor was administered intranasally <Serotonin and noradrenaline reuptake selective inhibitor>
Milnacipran hydrochloride <reagent>
In this test example, the following reagents were used.
Milnacipran hydrochloride: A synthetic product was used (synthesized with reference to Patent Documents 1 to 3).
Urethane: SIGMA (St Louis, MO, USA)
Acetonitrile for HPLC: chloroform, 2-propanol, n-heptane for HPLC, Kanto Chemical Co., Ltd .: Wako Pure Chemical Industries, Ltd.
Sodium hydroxide, potassium dihydrogen phosphate (KH ₂ PO ₄ ), 85% phosphoric acid (H ₃ PO ₄ ) and other reagents: Wako Pure Chemical Industries, Ltd.
Wistar male rats (200 to 250 g) were purchased from Saitama Experimental Animals (Saitama).

<Reference Experimental Example 1> In vivo intranasal administration test of milnacipran hydrochloride Urethane physiological saline was intraperitoneally administered to male male rats (n = 3) (dose 1 g / kg, 25 w / v%) and anesthesia was performed. did. After the rat was fixed on the dorsal position on the fixed base, the airway and the esophagus were operated to expose the left and right jugular veins to achieve the same physiological conditions as in the intravenous administration test. The prepared physiological saline containing milnacipran hydrochloride was administered into the left nasal cavity with a microsyringe with a silicon tube attached to the tip (dose 10 mg / kg, concentration 50 mg / mL (Example 5)). Using a syringe pretreated with heparin, blood was collected from the right jugular vein over time. The amount of blood collected at one time was 0.2 mL, and the blood sample was immediately centrifuged at 4 ° C. and 15000 rpm for 5 minutes to obtain plasma.

Reference Experimental Example 2 In vivo intravenous administration test of milnacipran hydrochloride Urethane physiological saline was intraperitoneally administered to Wistar male rats (n = 3) (dose 1 g / kg, 25 w / v%) and anesthesia was performed. did. The rat was fixed to the dorsal position on the fixed base, and then the airway and esophagus were operated to expose the left and right jugular veins. The prepared physiological saline containing milnacipran hydrochloride was administered from the right jugular vein (dosage 20 mg / kg, concentration 20 mg / mL), and blood was collected from the left jugular vein over time using a syringe pretreated with heparin. . The amount of blood collected at one time was 0.2 mL, and the blood sample was immediately centrifuged at 4 ° C. and 15000 rpm for 5 minutes to obtain plasma.

<Quantitative method of milnacipran hydrochloride>
1) Extraction method Add 300 μL of NH ₄ C1 (pH 9.5) to 100 μL of plasma, stir for 30 seconds, add 500 μL of chloroform / 2-isopropanol / n-heptane (60/14/26), and shake for 2 minutes. Then, centrifugation (4 ° C., 15000 rpm, 5 min) was performed.
The chloroform layer (lower layer) obtained by centrifugation was taken in another microtube, and the solvent was removed under an inflow of nitrogen. After all the solvent was removed, 100 μL of HPLC mobile phase buffer was added to the extract to dissolve it, and then taken out into a glass tube and injected into HPLC by 30 μL, and the concentration of milnacipran hydrochloride was measured.
2) HPLC apparatus The following HPLC apparatus manufactured by Shimadzu Corporation was used.
Pump: LC-9A
Detector: SPO-6A
System controller: SCL-6B
Autoinjector: SIL-6B
Column open: CTO-6A
Chromatopack: C-R6A
3) HPLC conditions Mobile phase: Acetonitrile / 0.05M phosphate buffer (pH 3.8) prepared at 30:70 and degassed Elution: Flow rate 1 mL / min, 30 ° C.
Measurement wavelength: 200 nm

<Data analysis>
The obtained data was analyzed by a non-linear least square method program (algorithm; DampingGauss-Newton method). The area under the plasma concentration-time curve (AUC) was calculated from the trapezoidal formula. AUC indicates the cumulative concentration of milnacipran in plasma that has been absorbed and transferred into the blood. The cumulative absorption profile of milnacipran hydrochloride was determined by the deconvolution method using the kinetic parameters obtained from the intravenous administration test as input functions and the plasma concentration after nasal administration as the output function.

<Result>
The logarithm-time curve of the plasma concentration of milnacipran hydrochloride in the intranasal administration test (Reference Experiment Example 1) is shown in FIG. 6, and the logarithm of the plasma concentration of milnacipran hydrochloride in the intravenous administration test (Reference Experiment Example 2) is shown in FIG. The time curve is shown in FIG. 7 and the pharmacokinetic parameters of milnacipran are shown in Table 4.
Further, the absorption profile of milnacipran hydrochloride was determined by the deconvolution method from the kinetic parameters obtained from the intravenous administration test and the plasma concentration-time curve of milnacipran hydrochloride in the intranasal administration test, and is shown in FIG.
Further, Table 5 shows the maximum plasma concentration (Cmax), maximum plasma concentration arrival time (Tmax), AUC, and bioavailability (F) in intravenous administration (iv) and intranasal administration (in).
From FIG. 6 and Table 5, milnacipran hydrochloride reached the maximum plasma concentration quickly after intranasal administration, Cmax was 5265.98 ng / mL, and Tmax was 20 min. Further, F is almost 100%, and it can be seen that milnacipran hydrochloride was well absorbed by intranasal administration. This result shows that the absorption rate of nasal administration of milnacipran hydrochloride is remarkably large and Tmax is significantly shortened compared with the known data by oral administration of Tmax = 120 minutes. ing.
Similarly, it can be seen from FIG. 8 that the absorption of milnacipran hydrochloride is very fast and almost complete in about 60 minutes.
In Table 5, “AUC _0-7 ” and “F _0-7 ” indicate “AUC” and “F” at 0 to 7 hours, that is, 0 to 420 minutes, respectively. “AUC _∞ ” and “F” “ _∞ ” indicates “AUC” and “F” up to infinity time, respectively. As described above, when a time regulation is provided for F, F means a value calculated based on the AUC up to that time. In the present invention, when there is no time regulation in F, a value calculated mainly based on AUC up to infinite time may be shown.

[Reference Example 2] In vivo mucosal absorbability test of serotonin and noradrenaline reuptake selective inhibitor <Selective inhibitor of serotonin and noradrenaline reuptake>
Milnacipran hydrochloride <reagent>
The same reagent as that used in Reference Example 1 was used.
<Experimental animals>
Wistar male rats (8 weeks old, 250-300 g) were purchased from Saitama experimental animals (Saitama).

<Reference Experimental Example 3> In vivo intranasal administration experiment of milnacipran hydrochloride Urethane physiological saline (dose 1 g / kg, 25 w / v%) was intraperitoneally administered to Wistar male rats (n = 4) for anesthesia. did. After the rat was fixed on the dorsal position, the left and right jugular veins were exposed for blood collection. Prepared milnacipran hydrochloride-containing physiological saline (dosage 20 mg / kg, concentration 200 mg / mL (Formulation Example 1)) prepared in the left nasal cavity with a microsyringe that was operated on the respiratory tract and esophagus and was attached with a silicone tube at the tip. Administered. Using a syringe pretreated with heparin, the blood sample was taken as 0 minutes at the time of intranasal administration, and thereafter 200 μL of blood was collected over time. The blood sample was centrifuged immediately after collection at 4 ° C. and 15000 rpm (17860 G) for 5 minutes to obtain 100 μL of a plasma sample.

Reference Experiment Example 4 In vivo intravenous administration experiment of milnacipran hydrochloride Urethane physiological saline (dose 1 g / kg, 25 w / v%) was intraperitoneally administered to Wistar male rats (n = 4), and anesthesia was performed. did. After the rat was fixed on the dorsal position, the left and right jugular veins were exposed for blood collection. Surgery to the respiratory tract and esophagus to achieve the same physiological conditions as in the intranasal administration experiment, and the prepared physiological saline containing milnacipran hydrochloride (dose 20 mg / kg, concentration 20 mg / mL) was administered from the right jugular vein Using a syringe pretreated with heparin, 200 μL of blood was collected over time from the left jugular vein. The blood sample was centrifuged immediately after collection at 4 ° C. and 15000 rpm (17860 G) for 5 minutes to obtain 100 μL of a plasma sample.

Reference Experimental Example 5 In vivo duodenal administration experiment of milnacipran hydrochloride Urethane physiological saline (dose 1 g / kg, 25 w / v%) was intraperitoneally administered to Wistar male rats (n = 4), and anesthesia was performed. did. After the rat was fixed on the dorsal position, the left and right jugular veins were exposed for blood collection. The abdominal cavity was incised, the duodenum was taken out, the downstream of the duodenum was ligated, and milnacipran hydrochloride-containing physiological saline solution (dose 20 mg / kg, concentration 20 mg / mL) prepared from the upstream was directly administered to the duodenum. Using a syringe pretreated with heparin, a blood sample was taken as 0 minutes at the time of administration to the duodenum, and thereafter 200 μL of blood was collected over time. The blood sample was centrifuged immediately after collection at 4 ° C. and 15000 rpm (17860 G) for 5 minutes to obtain 100 μL of a plasma sample.

<Quantitative method of milnacipran hydrochloride>
1) Extraction Method The same method as in Reference Example 1 was used.
2) HPLC apparatus The same apparatus as in Reference Example 1 was used.
3) HPLC conditions Mobile phase: Acetonitrile / 0.05M phosphate buffer (pH 2.8) prepared at 30:70 and degassed Elution: Flow rate 1 mL / min, 40 ° C.
Measurement wavelength: 200 nm

<Data analysis>
From the obtained data, the area under the plasma concentration-time curve (AUC), average residence time (MRT), and average absorption time (MAT) were calculated from moment analysis. In addition, the cumulative absorption profile of milnacipran hydrochloride was calculated by the deconvolution method using the kinetic parameters obtained in the intravenous administration test as input functions and the plasma concentration after intraduodenal or intranasal administration as the output function. .

<Result>
The logarithm-time curve of the plasma concentration of milnacipran hydrochloride after administration from each administration route is shown in FIG. 9, and the absorption profile obtained by the deconvolution method is shown in FIG. In FIG. 9, ● represents the result of intravenous administration, x represents the result of intraduodenal administration, and Δ represents the result of intranasal administration. Moreover, in FIG. 9, the broken line shows the result of intraduodenal administration, and the solid line shows the result of intranasal administration. Furthermore, the maximum plasma concentration (Cmax), the maximum plasma concentration arrival time (Tmax), the area under the plasma concentration time curve (AUC) in intravenous administration (iv), intraduodenal administration (id), and intranasal administration (in), Table 6 shows the bioavailability (F).
As shown in FIG. 9 and Table 6, Cmax for intraduodenal administration was 3074.8 ng / mL and Tmax was 60 minutes, whereas for intranasal administration, Cmax was 5124.8 ng / mL and Tmax was 20 minutes. Thus, milnacipran hydrochloride quickly reached Cmax by intranasal administration. Further, F was 70.8% in intraduodenal administration, whereas it was 84.9% in intranasal administration, and was absorbed better. Furthermore, as shown in FIG. 10, the absorption of milnacipran hydrochloride after intranasal administration was very fast, and the absorption was almost completed in about 30 minutes. The absorption rate of milnacipran hydrochloride from the nasal mucosa is also indicated by the fact that MAT is absorbed in 32.9 minutes in the duodenum, and in 16.9 minutes in the nasal administration. Is significantly larger.

[Reference Example 3] Confirmation of transition to the central nervous system after intranasal administration of serotonin and noradrenaline reuptake selective inhibitor <Serotonin and noradrenaline reuptake selective inhibitor>
Milnacipran hydrochloride <Reagents and experimental animals>
The same reagents and experimental animals as those used in Reference Example 2 were used.

<Reference Experimental Example 6> Evaluation of transferability of milnacipran hydrochloride to the central nervous system The drug concentration in cerebrospinal fluid (CSF) was measured as an index of transferability to the central nervous system. For intravenous administration, duodenal administration, and intranasal administration, the same operation and administration as in the in vivo mucosal absorbability experiment of Reference Example 2 were performed (n = 3), and blood was collected from the jugular vein over time. CSF was collected after a certain period of time. A pre-cut needle is bonded to a silicone tube, and a syringe is connected to the other end. After a certain period of time has elapsed since drug administration, the tip of the needle is punctured 5-6 mm ventrally from the back of the rat's occipital crest. The syringe was pulled and about 200 μL of CSF was collected in the silicon tube. After puncturing, the content of red blood cells was examined with an optical microscope in order to confirm the mixing of blood into the CSF, and it was confirmed that the red blood cell content was 500 cells / μL or less. The blood sample was centrifuged immediately at 4 ° C. and 15000 rpm (17860 G) for 5 minutes to obtain 100 μL of a CSF sample.

<Quantitative method of milnacipran hydrochloride>
Measurement was performed by the same extraction method, HPLC apparatus, and HPLC conditions as in Reference Example 2.

<Data analysis>
The area under the cerebrospinal fluid concentration-time curve (AUC _CSF ) was calculated from the obtained data by moment analysis. AUC _CSF indicates the total concentration of milnacipran in CFS absorbed and transferred into the brain. As a method for evaluating intracerebral transferability, since the transfer of a drug from the systemic circulation into the CSF is controlled by permeation of the blood brain barrier, the drug concentration in the blood has a great influence. Therefore, in order to consider the influence of permeation through the blood-brain barrier, comparison was made using the ratio of the concentration in CSF to the concentration of protein non-binding drug in plasma at the time of CSF collection. Further, the brain migration rate (K _pu ) was calculated from the area under the CSF concentration time curve, the area under the plasma concentration time curve, and the plasma protein non-binding rate (the following formula (3)). A significant difference test was performed using the Tukey-Kramer method of multiple comparison. In addition, AUC _Plasma shows the integration | accumulation of the plasma milnacipran density | concentration which was absorbed and moved into the blood.

<Result>
The log-time curve of CSF concentration of milnacipran hydrochloride after administration from each administration route is shown in FIG. 11, the ratio of plasma concentration to CSF concentration is shown in FIG. 12, the highest CSF concentration (Cmax), and the highest CSF concentration. Table 7 shows the concentration arrival time (Tmax), the area under the CSF concentration time curve (AUC _CSF ), the area under the blood concentration time curve (AUC _Plasma ), and the brain migration rate (K _pu ). In FIG. 11, ● represents the result of intravenous administration, x represents the result of intraduodenal administration, and Δ represents the result of intranasal administration. In FIG. 12, hatched lines indicate results of intravenous administration, white lines indicate results of intraduodenal administration, and black lines indicate results of intranasal administration. As shown in Table 7, Cmax was 2216.2 ng / mL for intravenous administration and 1005.5 ng / mL for intraduodenal administration, and 4019.1 ng / mL for intranasal administration. The value was doubled for administration and quadrupled for intraduodenal administration. Tmax also moved into the brain in a short time of 20 minutes for intranasal administration compared to 60 minutes for intraduodenal administration. Furthermore, the ratio of blood concentration to CSF concentration was substantially constant for other routes of administration other than intranasal administration, whereas it increased significantly up to 30 minutes after intranasal administration.

[Reference Example 4] Pharmacological evaluation test after nasal administration of serotonin and noradrenaline reuptake selective inhibitor <Serotonin and noradrenaline reuptake selective inhibitor>
Milnacipran hydrochloride <reagent>
In this test example, the following reagents were used.
Milnacipran hydrochloride: A synthetic product was used (synthesized with reference to Patent Documents 1 to 3).
Diethyl ether: Wako Pure Chemical Industries, Ltd.
<Experimental animals>
Experimental animals similar to those used in Reference Example 2 were used.
<Aquarium for swimming>
An acrylic cylinder with a diameter of 18 cm and a height of 40 cm was used.

Reference Experiment Example 7 Forced Swimming Experiment Wistar male rats were preliminarily raised for 6 days after purchase, and a 15-minute habituation test was conducted on the day before this test, and this test was performed for 5 minutes. A water tank kept at 25 ° C. was filled in a swimming tank to a depth of 18 cm. Rats were allowed to swim in this aquarium, and the behavior change at that time was captured by a web camera installed directly above the aquarium, and the immobility time was measured.
Anesthesia with diethyl ether was performed after the habituation study and 60 minutes before the start of this study, and serotonin and noradrenaline reuptake selective inhibitor-containing saline (saline containing milnacipran hydrochloride) was administered from each administration route. (10 mg / kg, 30 mg / kg, 60 mg / kg for oral administration, 10 mg / kg, 30 mg / kg for nasal administration). For oral administration, a gastric sonde was used, and for nasal administration, a microsyringe connected to a silicon tube was used. In addition, physiological saline was administered as a control drug.

<Statistical analysis>
A significant difference test was performed using the Tukey-Kramer method of multiple comparison.

<Result>
FIG. 13 shows the immobility time in the forced swimming test when milnacipran hydrochloride is administered by the following administration routes and doses a to g. In FIG. 13, a to g are displayed in parentheses.
a: Oral saline (Control (po))
b: Oral administration of milnacipran hydrochloride 10 mg / kg (10 mg / kg (po))
c: Oral administration of milnacipran hydrochloride 30 mg / kg (30 mg / kg (po))
d: Oral administration of milnacipran hydrochloride 60 mg / kg (60 mg / kg (po))
e: Nasal administration of saline (Control (in))
f: Milnacipran hydrochloride 10 mg / kg nasally (10 mg / kg (in))
g: Milnacipran hydrochloride 30 mg / kg nasally (30 mg / kg (in))
By administering milnacipran hydrochloride regardless of the route of administration, a significant dose-dependent and significant reduction in immobility time was observed. In addition, in the saline administration group (a and e) used as a control drug, there is no difference in immobility time between oral administration and nasal administration, so there is no effect due to the difference in administration route. Conceivable. The effects of oral administration 30 mg / kg (c) and nasal administration 10 mg / kg (f) are comparable, and oral administration 60 mg / kg (d) and nasal administration 30 mg / kg (e) are comparable. As a result, a stronger immobility time shortening effect was observed in the nasal administration group than in the oral administration group.

  In the transmucosal administration of SNRI, especially nasal administration according to the present invention, retention in the nasal cavity can be improved by using a thickening agent in combination, and the absorption of the drug to the systemic circulation system can be increased. Thus, administration to patients who are inappropriate for oral administration and ideal high-dose administration are possible. In addition, transmucosal administration of milnacipran formulation, especially nasal administration, is possible, administration to patients who are inappropriate for oral administration, and administration of ideal high doses. Treatment that is more effective than oral administration is possible. Furthermore, SNRI-containing preparations for transdermal administration, particularly milnacipran-containing preparations for transdermal administration, are provided.

It is a figure which shows the plasma concentration-time curve of the milnacipran hydrochloride when chitosan is administered together in closed nasal administration. It is a figure which shows the plasma concentration-time curve of the milnacipran hydrochloride when chitosan is used together in closed system and open system nasal administration. It is a figure which shows the immobility time in the oral administration of milnacipran hydrochloride and the nasal administration combined with chitosan. It is a figure which shows the relationship between an antidepressant effect and AUC in oral administration of milnacipran hydrochloride, nasal administration, and nasal administration with chitosan combination. It is a figure which shows the experiment protocol of a forced swimming test. It is a figure which shows the logarithm-time curve of the plasma concentration of the milnacipran hydrochloride in an intranasal administration test. It is a figure which shows the logarithm-time curve of the plasma concentration of the milnacipran hydrochloride in an intravenous administration test. It is a figure which shows the absorption profile of the milnacipran hydrochloride in nasal administration. It is a figure which shows the logarithm-time curve of the plasma concentration of the milnacipran hydrochloride in the intravenous administration, the duodenal administration, and the intranasal administration test. It is a figure which shows the absorption profile of the milnacipran hydrochloride in the duodenum administration and nasal administration. It is a figure which shows the logarithm-time curve of the concentration in the cerebrospinal fluid of the milnacipran hydrochloride in the intravenous administration, the duodenal administration, and the intranasal administration test. It is a figure which shows the ratio of the cerebrospinal fluid concentration with respect to the plasma concentration of milnacipran hydrochloride. It is a figure which shows the immobility time in oral administration and nasal administration of milnacipran hydrochloride.

Claims (16)

A preparation for transmucosal administration comprising a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent. The preparation according to claim 1, wherein the preparation for transmucosal administration is a preparation for nasal administration. The preparation according to claim 1 or 2, wherein the selective serotonin / noradrenaline reuptake inhibitor is milnacipran or a salt thereof. The preparation according to any one of claims 1 to 3, wherein the thickening agent is chitosan or chitin. The preparation according to any one of claims 1 to 4, wherein the preparation is a solution. The preparation according to any one of claims 1 to 4, wherein the preparation is a suspension. The preparation according to any one of claims 1 to 4, wherein the preparation is an emulsion. The preparation according to any one of claims 5 to 7, wherein the osmotic pressure ratio of the solution, suspension or emulsion is 0.5 to 5.0. The preparation according to any one of claims 1 to 8, wherein the preparation is an aerosol. The preparation according to any one of claims 1 to 4, wherein the preparation is a powder. The preparation according to any one of claims 1 to 10, comprising one or more preservatives selected from quaternary ammonium salts and parabens. The preparation according to any one of claims 1 to 11, wherein the preparation is an antidepressant. The preparation according to any one of claims 1 to 11, wherein the preparation is an analgesic. A preparation for transdermal administration containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent. Use of milnacipran or a salt thereof for the manufacture of a transmucosal preparation or a transdermal preparation containing a selective serotonin / noradrenaline reuptake inhibitor and a thickening agent. A method of administering a selective serotonin / noradrenaline reuptake inhibitor in combination with a thickening agent transmucosally or transdermally.