WO2002094238A1 - Apport de composes anti-migraine par voie d'inhalation - Google Patents

Apport de composes anti-migraine par voie d'inhalation Download PDF

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Publication number
WO2002094238A1
WO2002094238A1 PCT/US2002/016129 US0216129W WO02094238A1 WO 2002094238 A1 WO2002094238 A1 WO 2002094238A1 US 0216129 W US0216129 W US 0216129W WO 02094238 A1 WO02094238 A1 WO 02094238A1
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WIPO (PCT)
Prior art keywords
aerosol
lidocaine
lisuride
diltiazem
verapamil
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Application number
PCT/US2002/016129
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English (en)
Inventor
Joshua D. Rabinowitz
Alejandro C. Zaffaroni
Original Assignee
Alexza Molecular Delivery Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Alexza Molecular Delivery Corporation filed Critical Alexza Molecular Delivery Corporation
Priority to PCT/US2002/016129 priority Critical patent/WO2002094238A1/fr
Publication of WO2002094238A1 publication Critical patent/WO2002094238A1/fr

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/007Pulmonary tract; Aromatherapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/13Amines
    • A61K31/135Amines having aromatic rings, e.g. ketamine, nortriptyline
    • A61K31/137Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/13Amines
    • A61K31/135Amines having aromatic rings, e.g. ketamine, nortriptyline
    • A61K31/138Aryloxyalkylamines, e.g. propranolol, tamoxifen, phenoxybenzamine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/16Amides, e.g. hydroxamic acids
    • A61K31/165Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/192Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/216Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acids having aromatic rings, e.g. benactizyne, clofibrate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/27Esters, e.g. nitroglycerine, selenocyanates of carbamic or thiocarbamic acids, meprobamate, carbachol, neostigmine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404Indoles, e.g. pindolol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404Indoles, e.g. pindolol
    • A61K31/405Indole-alkanecarboxylic acids; Derivatives thereof, e.g. tryptophan, indomethacin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/407Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41961,2,4-Triazoles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/42Oxazoles
    • A61K31/422Oxazoles not condensed and containing further heterocyclic rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/42Oxazoles
    • A61K31/423Oxazoles condensed with carbocyclic rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/473Quinolines; Isoquinolines ortho- or peri-condensed with carbocyclic ring systems, e.g. acridines, phenanthridines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/49Cinchonan derivatives, e.g. quinine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A61K31/551Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
    • A61K31/55131,4-Benzodiazepines, e.g. diazepam or clozapine
    • A61K31/55171,4-Benzodiazepines, e.g. diazepam or clozapine condensed with five-membered rings having nitrogen as a ring hetero atom, e.g. imidazobenzodiazepines, triazolam
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/007Pulmonary tract; Aromatherapy
    • A61K9/0073Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/10Dispersions; Emulsions
    • A61K9/12Aerosols; Foams
    • FMECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F24HEATING; RANGES; VENTILATING
    • F24VCOLLECTION, PRODUCTION OR USE OF HEAT NOT OTHERWISE PROVIDED FOR
    • F24V30/00Apparatus or devices using heat produced by exothermal chemical reactions other than combustion

Definitions

  • the present invention relates to the delivery of anti-migraine compounds through an inhalation route. Specifically, it relates to aerosols containing lidocaine, verapamil, diltiazem, isometheptene, or lisuride that are used in inhalation therapy.
  • compositions currently marketed for the treatment of migraine headaches contain at least one active ingredient that provides for observed therapeutic effects.
  • active ingredients given in such anti-migraine compositions are lidocaine, verapamil, diltiazem, isometheptene, and lisuride.
  • lidocaine, verapamil, diltiazem, isometheptene, and lisuride It is desirable to provide a new route of administration for lidocaine, verapamil, diltiazem, isometheptene, and lisuride that rapidly produces peak plasma concentrations of the compounds. The provision of such a route is an object of the present invention.
  • the present invention relates to the delivery of anti-migraine compounds through an inhalation route. Specifically, it relates to aerosols containing lidocaine, verapamil, diltiazem, isometheptene, or lisuride that are used in inhalation therapy.
  • the aerosol comprises particles comprising at least 5 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the particles comprise at least 10 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the particles comprise at least 20 percent, 30 percent, 40 percent, 50 percent, 60 percent, 70 percent, 80 percent, 90 percent, 95 percent, 97 percent, 99 percent, 99.5 percent or 99.97 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the aerosol has a mass of at least 10 ⁇ g.
  • the aerosol has a mass of at least 100 ⁇ g. More preferably, the aerosol has a mass of at least 200 ⁇ g.
  • the particles comprise less than 10 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride degradation products.
  • the particles comprise less than 5 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride degradation products. More preferably, the particles comprise less than 2.5, 1, 0.5, 0.1 or 0.03 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the particles comprise less than 90 percent by weight of water.
  • the particles comprise less than 80 percent by weight of water. More preferably, the particles comprise less than 70 percent, 60 percent, 50 percent, 40 percent, 30 percent, 20 percent, 10 percent, or 5 percent by weight of water.
  • at least 50 percent by weight of the aerosol is amorphous in form, wherein crystalline forms make up less than 50 percent by weight of the total aerosol weight, regardless of the nature of individual particles.
  • at least 75 percent by weight of the aerosol is amorphous in form. More preferably, at least 90 percent by weight of the aerosol is amorphous in form.
  • the aerosol has an inhalable aerosol drug mass density of between 5 mg/L and 100 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 10 mg/L and 60 mg/L. More preferably, the aerosol has an inhalable aerosol drug mass density of between 20 mg/L and 40 mg/L.
  • the aerosol comprises verapamil
  • the aerosol has an inhalable aerosol drug mass density of between 0.5 mg/L and 50 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 1 mg/L and 20 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 2 mg/L and 10 mg/L.
  • the aerosol comprises diltiazem
  • the aerosol has an inhalable aerosol drug mass density of between 2 mg/L and 50 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 5 mg/L and 45 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 10 mg/L and 40 mg/L.
  • the aerosol comprises isometheptene
  • the aerosol has an inhalable aerosol drug mass density of between 5 mg/L and 200 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 10 mg/L and 120 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 20 mg/L and 100 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 0.01 mg/L and 1.0 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 0.05 mg/L and 0.7 mg/L. More preferably, the aerosol has an inhalable aerosol drug mass density of between 0.1 mg/L and
  • the aerosol has an inhalable aerosol particle density greater than 10 6 particles/mL.
  • the aerosol has an inhalable aerosol particle density greater than
  • the aerosol particles have a mass median aerodynamic diameter of less than 5 microns.
  • the particles have a mass median aerodynamic diameter of less than 3 microns. More preferably, the particles have a mass median aerodynamic diameter of less than 2 or 1 micron(s).
  • the geometric standard deviation around the mass median aerodynamic diameter of the aerosol particles is less than 3.0.
  • the geometric standard deviation is less than 2.5. More preferably, the geometric standard deviation is less than 2.2.
  • the aerosol is formed by heating a composition containing lidocaine, verapamil, diltiazem, isometheptene, or lisuride to form a vapor and subsequently allowing the vapor to condense into an aerosol.
  • one of lidocaine, verapamil, diltiazem, isometheptene, or lisuride is delivered to a mammal through an inhalation route.
  • the method comprises: a) heating a composition, wherein the composition comprises at least 5 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride, to form a vapor; and, b) allowing the vapor to cool, thereby forming a condensation aerosol comprising particles, which is inhaled by the mammal.
  • the composition that is heated comprises at least 10 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride. More preferably, the composition comprises at least 20 percent,
  • lidocaine a lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the particles comprise at least 5 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the particles comprise at least
  • lidocaine 10 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride. More preferably, the particles comprise at least 20 percent, 30 percent, 40 percent, 50 percent, 60 percent, 70 percent, 80 percent, 90 percent, 95 percent, 97 percent, 99 percent, 99.5 percent, 99.9 percent or 99.97 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the condensation aerosol has a mass of at least 10 ⁇ g.
  • the aerosol has a mass of at least 100 ⁇ g. More preferably, the aerosol has a mass of at least
  • the particles comprise less than 10 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride degradation products.
  • the particles comprise less than 5 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride degradation products. More preferably, the particles comprise
  • lidocaine 2.5, 1, 0.5, 0.1 or 0.03 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride degradation products.
  • the particles comprise less than 90 percent by weight of water.
  • the particles comprise less than 80 percent by weight of water. More preferably, the particles comprise less than 70 percent, 60 percent, 50 percent, 40 percent,
  • At least 50 percent by weight of the aerosol is amorphous in form, wherein crystalline forms make up less than 50 percent by weight of the total aerosol weight, regardless of the nature of individual particles.
  • at least 75 percent by weight of the aerosol is amorphous in form. More preferably, at least 90 percent by weight of the aerosol is amorphous in form.
  • the particles of the delivered condensation aerosol have a mass median aerodynamic diameter of less than 5 microns.
  • the particles have a mass median aerodynamic diameter of less than 3 microns. More preferably, the particles have a mass median aerodynamic diameter of less than 2 or 1 micron(s).
  • the geometric standard deviation around the mass median aerodynamic diameter of the aerosol particles is less than 3.0.
  • the geometric standard deviation is less than 2.5. More preferably, the geometric standard deviation is less than 2.2.
  • the delivered aerosol has an inhalable aerosol drug mass density of between 5 mg/L and 100 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 10 mg/L and 60 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 20 mg/L and 40 mg L.
  • the delivered aerosol has an inhalable aerosol drug mass density of between 0.5 mg/L and 50 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 1.0 mg/L and 20 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 2 mg/L and 10 mg/L.
  • the delivered aerosol has an inhalable aerosol drug mass density of between 2 mg/L and 50 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 5 mg/L and 45 mg/L. More preferably, the aerosol has an inhalable aerosol drug mass density of between 10 mg/L and
  • the delivered aerosol has an inhalable aerosol drug mass density of between 5 mg/L and 200 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 10 mg/L and 120 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 20 mg/L and 100 mg/L.
  • the delivered aerosol has an inhalable aerosol drug mass density of between 0.01 mg/L and 1.0 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 0.05 mg/L and 0.7 mg/L.
  • the aerosol has an inhalable aerosol drug mass density of between 0.1 mg/L and 0.5 mg/L.
  • the delivered aerosol has an inhalable aerosol particle density greater than 10 6 particles/mL.
  • the aerosol has an inhalable aerosol particle density greater than 10 7 particles/mL or 10 8 particles/mL.
  • the rate of inhalable aerosol particle formation of the delivered p condensation aerosol is greater than 10 particles per second.
  • the aerosol is formed at a rate greater than 10 9 inhalable particles per second. More preferably, the aerosol is formed at a rate greater than 10 10 inhalable particles per second.
  • the delivered condensation aerosol is formed at a rate greater than 0.5 mg/second.
  • the aerosol is formed at a rate greater than 0.75 mg/second. More preferably, the aerosol is formed at a rate greater than 1 mg/second, 1.5 mg/second or 2 mg/second.
  • the condensation aerosol comprises lidocaine
  • between 5 mg and 100 mg of lidocaine are delivered to the mammal in a single inspiration.
  • lidocaine More preferably, between 20 mg and 40 mg of lidocaine are delivered in a single inspiration.
  • the condensation aerosol comprises verapamil
  • between 0.5 mg and 50 mg of verapamil are delivered to the mammal in a single inspiration.
  • verapamil Preferably, between 1.0 mg and 20 mg of verapamil are delivered to the mammal in a single inspiration. More preferably, between 2.0 mg and 10 mg of verapamil are delivered in a single inspiration.
  • the condensation aerosol comprises diltiazem
  • between 2.0 mg and 50 mg of diltiazem are delivered to the mammal in a single inspiration.
  • diltiazem More preferably, between 10 mg and 40 mg of diltiazem are delivered in a single inspiration.
  • condensation aerosol comprises isometheptene
  • between 5 mg and 200 mg of isometheptene are delivered to the mammal in a single inspiration.
  • the condensation aerosol comprises lisuride
  • between 0.1 mg and 1.0 mg of lisuride are delivered to the mammal in a single inspiration.
  • between 0.05 mg and 0.7 mg of lisuride are delivered to the mammal in a single inspiration.
  • More preferably, between 0.1 mg and 0.5 mg of lisuride are delivered in a single inspiration.
  • the delivered condensation aerosol results in a peak plasma concentration of lidocaine, verapamil, diltiazem, isometheptene, or lisuride in the mammal in less than 1 h.
  • the peak plasma concentration is reached in less than 0.5 h. More preferably, the peak plasma concentration is reached in less than 0.2, 0.1, 0.05, 0.02, 0.01, or 0.005 h (arterial measurement).
  • a kit for delivering lidocaine, verapamil, diltiazem, isometheptene, or lisuride through an inhalation route to a mammal which comprises: a) a composition comprising at least 5 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride; and, b) a device that forms a lidocaine, verapamil, diltiazem, isometheptene, or lisuride aerosol from the composition, for inhalation by the mammal.
  • the composition comprises at least 20 percent, 30 percent, 40 percent, 50 percent, 60 percent, 70 percent, 80 percent, 90 percent, 95 percent, 97 percent, 99 percent, 99.5 percent, 99.9 percent or 99.97 percent by weight of lidocaine, verapamil, diltiazem, isometheptene, or lisuride.
  • the device contained in the kit comprises: a) an element for heating the lidocaine, verapamil, diltiazem, isometheptene, or lisuride composition to form a vapor; b) an element allowing the vapor to cool to form an aerosol; and, c) an element permitting the mammal to inhale the aerosol.
  • Fig. 1 shows a cross-sectional view of a device used to deliver lidocaine, verapamil, diltiazem, isometheptene, or lisuride aerosols to a mammal through an inhalation route.
  • Aerodynamic diameter of a given particle refers to the diameter of a spherical droplet with a density of 1 g/mL (the density of water) that has the same settling velocity as the given particle.
  • Aerosol refers to a suspension of solid or liquid particles in a gas.
  • Aerosol drug mass density refers to the mass of lidocaine, verapamil, diltiazem, isometheptene, or lisuride per unit volume of aerosol.
  • Aerosol mass density refers to the mass of particulate matter per unit volume of aerosol.
  • Aerosol particle density refers to the number of particles per unit volume of aerosol.
  • Amorphous particle refers to a particle that does not contain more than 50 percent by weight of a crystalline form. Preferably, the particle does not contain more than 25 percent by weight of a crystalline form. More preferably, the particle does not contain more than 10 percent by weight of a crystalline form.
  • Condensation aerosol refers to an aerosol formed by vaporization of a substance followed by condensation of the substance into an aerosol.
  • “Diltiazem” refers to 3-(acetyloxy)-5-[2-(dimethylamino)-ethyl]-2,3-dihydro-2- (4-methoxyphenyl)- 1 ,5-benzothiazepin-4(5H)-one.
  • Diazem degradation product refers to a compound resulting from a chemical modification of diltiazem.
  • the modification for example, can be the result of a thermally or photochemically induced reaction.
  • Such reactions include, without limitation, oxidation and hydrolysis.
  • Inhalable aerosol drug mass density refers to the aerosol drug mass density produced by an inhalation device and delivered into a typical patient tidal volume.
  • “Inhalable aerosol mass density” refers to the aerosol mass density produced by an inhalation device and delivered into a typical patient tidal volume.
  • “Inhalable aerosol particle density” refers to the aerosol particle density of particles of size between 100 n and 5 microns produced by an inhalation device and delivered into a typical patient tidal volume.
  • Isometheptene refers to 6-methylamino-2-methylheptene.
  • isometheptene degradation product refers to a compound resulting from a chemical modification of isometheptene.
  • the modification for example, can be the result of a thermally or photochemically induced reaction. Such reactions include, without limitation, oxidation and hydrolysis.
  • Lidocaine refers to 2-(diethylamino)-N-(2,6-dimethyl-phenyl)acetamide.
  • Lidocaine degradation product refers to a compound resulting from a chemical modification of lidocaine.
  • the modification for example, can be the result of a thermally or photochemically induced reaction. Such reactions include, without limitation, oxidation and hydrolysis.
  • An example of a degradation product is 2,6-dimethylaniline
  • Liuride refers to N'-[(8 ⁇ )-9, 10-didehydro-6-methylergolin-8-yl]-N,N- diethylurea.
  • Liuride degradation product refers to a compound resulting from a chemical modification of lisuride.
  • the modification for example, can be the result of a thermally or photochemically induced reaction. Such reactions include, without limitation, oxidation and hydrolysis.
  • Mass median aerodynamic diameter or "MMAD” of an aerosol refers to the aerodynamic diameter for which half the particulate mass of the aerosol is contributed by particles with an aerodynamic diameter larger than the MMAD and half by particles with an aerodynamic diameter smaller than the MMAD.
  • Rate of aerosol formation refers to the mass of aerosolized particulate matter produced by an inhalation device per unit time.
  • Rate of inhalable aerosol particle formation refers to the number of particles of size between 100 nm and 5 microns produced by an inhalation device per unit time.
  • Rate of drug aerosol formation refers to the mass of aerosolized lidocaine, verapamil, diltiazem, isometheptene, or lisuride produced by an inhalation device per unit time.
  • Settling velocity refers to the terminal velocity of an aerosol particle undergoing gravitational settling in air.
  • Typical patient tidal volume refers to 1 L for an adult patient and 15 mL/kg for a pediatric patient.
  • Vapor refers to a gas
  • vapor phase refers to a gas phase
  • thermal vapor refers to a vapor phase, aerosol, or mixture of aerosol-vapor phases, formed preferably by heating.
  • Verapamil degradation product refers to a compound resulting from a chemical modification of verapamil.
  • the modification for example, can be the result of a thermally or photochemically induced reaction. Such reactions include, without limitation, oxidation and hydrolysis.
  • any suitable method is used to form the aerosols of the present invention.
  • a preferred method involves heating a composition comprising lidocaine, verapamil, diltiazem, isometheptene, or lisuride to form a vapor, followed by cooling of the vapor such that it condenses to provide a lidocaine, verapamil, diltiazem, isometheptene, or lisuride comprising aerosol (condensation aerosol).
  • composition is heated in one of four forms: as pure active compound (i.e., pure lidocaine, verapamil, diltiazem, isometheptene, or lisuride); as a mixture of active compound and a pharmaceutically acceptable excipient; as a salt form of the pure active compound; and, as a mixture of active compound salt form and a pharmaceutically acceptable excipient.
  • pure active compound i.e., pure lidocaine, verapamil, diltiazem, isometheptene, or lisuride
  • pure active compound i.e., pure lidocaine, verapamil, diltiazem, isometheptene, or lisuride
  • pure active compound i.e., pure lidocaine, verapamil, diltiazem, isometheptene, or lisuride
  • a mixture of active compound and a pharmaceutically acceptable excipient as a
  • Salt forms of lidocaine, verapamil, diltiazem, isometheptene, or lisuride are either commercially available or are obtained from the corresponding free base using well known methods in the art.
  • a variety of pharmaceutically acceptable salts are suitable for aerosolization. Such salts include, without limitation, the following: hydrochloric acid, hydrobromic acid, acetic acid, maleic acid, formic acid, and fumaric acid salts.
  • compositions may be volatile or nonvolatile. Volatile excipients, when heated, are concurrently volatilized, aerosolized and inhaled with lidocaine, verapamil, diltiazem, isometheptene, or lisuride. Classes of such excipients are known in the art and include, without limitation, gaseous, supercritical fluid, liquid and solid solvents. The following is a list of exemplary carriers within the classes: water; terpenes, such as menthol; alcohols, such as ethanol, propylene glycol, glycerol and other similar alcohols; dimethylformamide; dimethylacetamide; wax; supercritical carbon dioxide; dry ice; and mixtures thereof.
  • Solid supports on which the composition is heated are of a variety of shapes. Examples of such shapes include, without limitation, cylinders of less than 1.0 mm in diameter, boxes of less than 1.0 mm thickness and virtually any shape permeated by small (e.g., less than 1.0 mm-sized) pores.
  • solid supports provide a large surface to volume ratio (e.g., greater than 100 per meter) and a large surface to mass ratio (e.g., greater than 1 cm per gram).
  • a solid support of one shape can also be transformed into another shape with different properties.
  • a flat sheet of 0.25 mm thickness has a surface to volume ratio of approximately 8,000 per meter. Rolling the sheet into a hollow cylinder of 1 cm diameter produces a support that retains the high surface to mass ratio of the original sheet but has a lower surface to volume ratio (about 400 per meter).
  • a number of different materials are used to construct the solid supports. Classes of such materials include, without limitation, metals, inorganic materials, carbonaceous materials and polymers. The following are examples of the material classes: aluminum, silver, gold, stainless steel, copper and tungsten; silica, glass, silicon and alumina; graphite, porous carbons, carbon yarns and carbon felts; polytetrafluoroethylene and polyethylene glycol. Combinations of materials and coated variants of materials are used as well. [0078] Where aluminum is used as a solid support, aluminum foil is a suitable material. Examples of silica, alumina and silicon based materials include amphorous silica S-5631 (Sigma, St.
  • the heating of the lidocaine, verapamil, diltiazem, isometheptene, or lisuride compositions is performed using any suitable method.
  • methods by which heat can be generated include the following: passage of current through an electrical resistance element; absorption of electromagnetic radiation, such as microwave or laser light; and, exothermic chemical reactions, such as exothermic solvation, hydration of pyrophoric materials and oxidation of combustible materials.
  • Lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosols of the present invention are delivered to a mammal using an inhalation device.
  • the device has at least three elements: an element for heating a lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing composition to form a vapor; an element allowing the vapor to cool, thereby providing a condensation aerosol; and, an element permitting the mammal to inhale the aerosol.
  • Various suitable heating methods are described above.
  • the element that allows cooling is, in it simplest form, an inert passageway linking the heating means to the inhalation means.
  • the element permitting inhalation is an aerosol exit portal that forms a connection between the cooling element and the mammal's respiratory system.
  • Delivery device 100 has a proximal end 102 and a distal end 104, a heating module 106, a power source 108, and a mouthpiece 110.
  • a lidocaine, verapamil, diltiazem, isometheptene, or lisuride composition is deposited on a surface 112 of heating module 106.
  • power source 108 Upon activation of a user activated switch 114, power source 108 initiates heating of heating module 106 (e.g, through ignition of combustible fuel or passage of current through a resistive heating element).
  • the lidocaine, verapamil, diltiazem, isometheptene, or lisuride composition volatilizes due to the heating of heating module 106 and condenses to form a condensation aerosol prior to reaching the mouthpiece 110 at the proximal end of the device 102.
  • Air flow traveling from the device distal end 104 to the mouthpiece 1 10 carries the condensation aerosol to the mouthpiece 110, where it is inhaled by the mammal.
  • Devices if desired, contain a variety of components to facilitate the delivery of lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosols.
  • the device may include any component known in the art to control the timing of drug aerosolization relative to inhalation (e.g., breath-actuation), to provide feedback to patients on the rate and/or volume of inhalation, to prevent excessive use (i.e., "lock-out” feature), to prevent use by unauthorized individuals, and/or to record dosing histories.
  • Lidocaine, verapamil, diltiazem, isometheptene, or lisuride are given at strengths of 30 mg, 40 mg, 30 mg, 65 mg, and 0.2 mg respectively for the treatment of migraine headaches.
  • 10 mg to 50 mg of lidocaine, 10 mg to 60 mg of verapamil, 10 mg to 50 mg of diltiazem, 5 mg to 200 mg of isometheptene, and 0.05 mg to 0.4 mg lisuride are generally provided for the same indication.
  • a typical dosage of a lidocaine, verapamil, diltiazem, isometheptene, or lisuride aerosol is either administered as a single inhalation or as a series of inhalations taken within an hour or less (dosage equals sum of inhaled amounts). Where the drug is administered as a series of inhalations, a different amount may be delivered in each inhalation.
  • the dosage amount of lidocaine, verapamil, diltiazem, isometheptene, or lisuride in aerosol form is generally no greater than twice the standard dose of the drug given orally.
  • lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosols to treat a particular condition using methods such as animal experiments and a dose-finding (Phase I/II) clinical trial.
  • One animal experiment involves measuring plasma concentrations of drug in an animal after its exposure to the aerosol. Mammals such as dogs or primates are typically used in such studies, since their respiratory systems are similar to that of a human.
  • Initial dose levels for testing in humans is generally less than or equal to the dose in the mammal model that resulted in plasma drug levels associated with a therapeutic effect in humans. Dose escalation in humans is then performed, until either an optimal therapeutic response is obtained or a dose-limiting toxicity is encountered.
  • a lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosol is determined using a number of methods, examples of which are described in Sekine et al, Journal of Forensic Science 32:1271-1280 (1987) and Martin et al, Journal of Analytic Toxicology 13:158-162 (1989).
  • One method involves forming the aerosol in a device through which a gas flow (e.g., air flow) is maintained, generally at a rate between 0.4 and 60 L/min. The gas flow carries the aerosol into one or more traps.
  • a gas flow e.g., air flow
  • traps are used for aerosol collection.
  • the following list contains examples of such traps: filters; glass wool; impingers; solvent traps, such as dry ice-cooled ethanol, methanol, acetone and dichloromethane traps at various pH values; syringes that sample the aerosol; empty, low-pressure (e.g., vacuum) containers into which the aerosol is drawn; and, empty containers that fully surround and enclose the aerosol generating device.
  • solvent e.g., vacuum
  • a solid such as glass wool
  • it is typically extracted with a solvent such as ethanol.
  • the solvent extract is subjected to analysis rather than the solid (i.e., glass wool) itself.
  • a syringe or container is used, the container is similarly extracted with a solvent.
  • the gas or liquid chromatograph discussed above contains a detection system (i.e., detector).
  • detection systems are well known in the art and include, for example, flame ionization, photon absorption and mass spectrometry detectors.
  • An advantage of a mass spectrometry detector is that it can be used to determine the structure of lidocaine, verapamil, diltiazem, isometheptene, or lisuride degradation products.
  • Particle size distribution of a lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosol is determined using any suitable method in the art (e.g., cascade impaction).
  • Inhalable aerosol mass density is determined, for example, by delivering a drug- containing aerosol into a confined chamber via an inhalation device and measuring the mass collected in the chamber.
  • the aerosol is drawn into the chamber by having a pressure gradient between the device and the chamber, wherein the chamber is at lower pressure than the device.
  • the volume of the chamber should approximate the tidal volume of an inhaling patient.
  • Inhalable aerosol drug mass density is determined, for example, by delivering a drug-containing aerosol into a confined chamber via an inhalation device and measuring the amount of active drug compound collected in the chamber.
  • the aerosol is drawn into the chamber by having a pressure gradient between the device and the chamber, wherein the chamber is at lower pressure than the device.
  • the volume of the chamber should approximate the tidal volume of an inhaling patient.
  • the amount of active drug compound collected in the chamber is determined by extracting the chamber, conducting chromatographic analysis of the extract and comparing the results of the chromatographic analysis to those of a standard containing known amounts of drug.
  • Inhalable aerosol particle density is determined, for example, by delivering aerosol phase drug into a confined chamber via an inhalation device and measuring the number of particles of given size collected in the chamber.
  • the number of particles of a given size may be directly measured based on the light-scattering properties of the particles.
  • Number of particles in a given size range Mass in the size range/Mass of a typical particle in the size range.
  • Rate of inhalable aerosol particle formation is determined, for example, by delivering aerosol phase drug into a confined chamber via an inhalation device. The delivery is for a set period of time (e.g., 3 s), and the number of particles of a given size collected in the chamber is determined as outlined above. The rate of particle formation is equal to the number of 100 nm to 5 micron particles collected divided by the duration of the collection time.
  • Rate of aerosol formation is determined, for example, by delivering aerosol phase drug into a confined chamber via an inhalation device.
  • the delivery is for a set period of time (e.g., 3 s), and the mass of particulate matter collected is determined by weighing the confined chamber before and after the delivery of the particulate matter.
  • the rate of aerosol formation is equal to the increase in mass in the chamber divided by the duration of the collection time.
  • the mass of particulate matter may be equated with the mass lost from the device or component during the delivery of the aerosol.
  • the rate of aerosol formation is equal to the decrease in mass of the device or component during the delivery event divided by the duration of the delivery event.
  • Rate of drug aerosol formation is determined, for example, by delivering a lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosol into a confined chamber via an inhalation device over a set period of time (e.g., 3 s).
  • a lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosol into a confined chamber via an inhalation device over a set period of time (e.g., 3 s).
  • the aerosol is pure lidocaine, verapamil, diltiazem, isometheptene, or lisuride
  • the amount of drug collected in the chamber is measured as described above.
  • the rate of drug aerosol formation is equal to the amount of lidocaine, verapamil, diltiazem, isometheptene, or lisuride collected in the chamber divided by the duration of the collection time.
  • the lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosol comprises a pharmaceutically acceptable excipient
  • multiplying the rate of aerosol formation by the percentage of lidocaine, verapamil, diltiazem, isometheptene, or lisuride in the aerosol provides the rate of drug aerosol formation.
  • the lidocaine, verapamil, diltiazem, isometheptene, or lisuride containing aerosols of the present invention are typically used for the treatment of migraine headaches.
  • Lidocaine, verapamil hydrochloride, diltiazem hydrochloride, and lisuride are commercially available from Sigma (www.sigma-aldrich.com). The preparation of isometheptene is described in U.S. Pat. Nos. 2,230,753 and 2,230,754.
  • EXAMPLE 1 General Procedure for Obtaining Free Base of a Compound Salt
  • salt e.g., mono hydrochloride
  • deionized water ⁇ 30 mL
  • sodium hydroxide (1 N NaOH aq ) is added dropwise to the solution, and the pH is checked to ensure it is basic.
  • the aqueous solution is extracted four times with dichloromethane (-50 mL), and the extracts are combined, dried (Na 2 SO ) and filtered.
  • the filtered organic solution is concentrated using a rotary evaporator to provide the desired free base. If necessary, purification of the free base is performed using standard methods such as chromatography or recrystallization.
  • Reverse-phase HPLC analysis with detection by absorption of 225 nm light is used to determine the purity of the aerosol. (When desired, the system is flushed through with argon prior to volatilization.) To obtain higher purity aerosols, one can coat a lesser amount of drug, yielding a thinner film to heat. A linear decrease in film thickness is associated with a linear decrease in impurities. [0100] The following aerosols were obtained using this procedure: lidocaine aerosol (7.3 mg, 99.5% purity); verapamil aerosol (1.41 mg, 96.2 % purity); diltiazem aerosol (1.91 mg, 97.1% purity); and, lisuride aerosol (0.2 mg, 100% purity).
  • Aerosol A solution of 12.2 mg lidocaine in 100 ⁇ L dichloromethane was spread out in a thin layer on the central portion of a 3.5 cm x 7 cm sheet of aluminum foil. The dichloromethane was allowed to evaporate. The aluminum foil was wrapped around a 300 watt halogen tube, which was inserted into a T-shaped glass tube. Both of the openings of the tube were sealed with parafilm, which was punctured with fifteen needles for air flow. The third opening was connected to a 1 liter, 3 -neck glass flask. The glass flask was further connected to a large piston capable of drawing 1.1 liters of air through the flask.
  • Alternating current was run through the halogen bulb by application of 90 V using a variac connected to 110 V line power.
  • an aerosol appeared and was drawn into the 1 L flask by use of the piston, with collection of the aerosol terminated after 6 s.
  • the aerosol was analyzed by connecting the 1 L flask to an eight-stage Andersen non-viable cascade impactor. Results are shown in table 1.
  • MMAD of the collected aerosol was 2.4 microns with a geometric standard deviation of 2.1.
  • Also shown in table 1 is the number of particles collected on the various stages of the cascade impactor, given by the mass collected on the stage divided by the mass of a typical particle trapped on that stage.
  • the mass of a single particle of diameter D is given by the volume of the particle, ⁇ D 3 /6, multiplied by the density of the drug (taken to be 1 g/cm 3 ).
  • the inhalable aerosol particle density is the sum of the numbers of particles collected on impactor stages 3 to 8 divided by the collection volume of 1 L, giving an inhalable aerosol particle density of 4.2 x 10 6 particles/mL.
  • the rate of inhalable aerosol particle formation is the sum of the numbers of particles collected on impactor stages 3 through 8 divided by the formation time of 6 s, giving a rate of inhalable aerosol particle formation of 7.0 x 10 particles/second.
  • Table 1 Determination of the characteristics of a lidocaine condensation aerosol by cascade impaction using an Andersen 8-stage non-viable cascade impactor run at 1 cubic foot per minute air flow.
  • a solution of 10.4 mg lidocaine in 100 ⁇ L dichloromethane was spread out in a thin layer on the central portion of a 3.5 cm x 7 cm sheet of aluminum foil. The dichloromethane was allowed to evaporate. The aluminum foil was wrapped around a 300 watt halogen tube, which was inserted into a T-shaped glass tube. Both of the openings of the tube were sealed with parafilm, which was punctured with fifteen needles for air flow. The third opening was connected to a 1 liter, 3 -neck glass flask. The glass flask was further connected to a large piston capable of drawing 1.1 liters of air through the flask.
  • Alternating current was run through the halogen bulb by application of 90 V using a variac connected to 110 V line power.
  • an aerosol appeared and was drawn into the 1 L flask by use of the piston, with formation of the aerosol terminated after 6 s.
  • the aerosol was allowed to sediment onto the walls of the 1 L flask for approximately 30 minutes.
  • the flask was then extracted with acetonitrile and the extract analyzed by HPLC with detection by light absorption at 225 nm.
  • Comparison with standards containing known amounts of lidocaine revealed that 3.1 mg of > 99% pure lidocaine had been collected in the flask, resulting in an aerosol drug mass density of 3.1 mg/L.
  • the aluminum foil upon which the lidocaine had previously been coated was weighed following the experiment. Of the 10.4 mg originally coated on the aluminum, 10.2 mg of the material was found to have aerosolized in the 6 s time period, implying a rate of drug aerosol formation of 1.7 mg/s.

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Abstract

La présente invention concerne l'apport de composés anti-migraine par voie d'inhalation. Plus particulièrement, cette invention concerne des aérosols contenant de la lidocaïne, du verapamil, du diltiazem, de l'isometheptène ou du lisuride utilisés dans une thérapie par inhalation. Dans une composition de cette invention, l'aérosol inclut des particules comprenant au moins 5 % en poids de lidocaïne, de verapamil, de diltiazem, d'isometheptène ou de lisuride. Dans une technique de cette invention, l'un des composés précités est distribué à un mammifère par voie d'inhalation. Cette technique consiste: (a) à chauffer une composition, cette dernière comprenant au moins 5 % en poids de lidocaïne, de verapamil, de diltiazem, d'isometheptène ou de lisuride, de façon à former une vapeur et, (b) à laisser cette vapeur refroidir, formant ainsi un aérosol de condensation comprenant des particules, lequel est inhalé par le mammifère. Dans un de ses aspects, cette invention concerne un kit permettant de distribuer la lidocaïne, le vérapamil, le diltiazem, l'isometheptène ou le lisuride par voie d'inhalation à un mammifère. Ce kit inclut (a) une composition comprenant au moins 5 % en poids de lidocaïne, de verapamil, de diltiazem, d'isometheptène ou de lisuride et, (b) un dispositif qui forme un aérosol contenant la lidocaïne, le verapamil, le diltiazem, l'isometheptène ou le lisuride de la composition que le mammifère doit inhaler.
PCT/US2002/016129 2001-05-24 2002-05-20 Apport de composes anti-migraine par voie d'inhalation WO2002094238A1 (fr)

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CN106511273A (zh) * 2009-05-15 2017-03-22 瑞克欧制药有限公司 舌下右美托咪定组合物及其使用方法
CN105722817A (zh) * 2013-01-18 2016-06-29 通尼克斯制药有限公司 异美汀异构体
WO2015188005A1 (fr) * 2014-06-04 2015-12-10 Seth Lederman Nouvelles compositions de (r)-isometheptène et utilisations
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US11351180B2 (en) 2015-03-19 2022-06-07 Universite Claude Bernard Lyon 1 Antiviral compositions for treating the flu
WO2019224489A1 (fr) 2018-05-23 2019-11-28 Universite Claude Bernard Lyon 1 Diltiazem pour son utilisation dans le traitement des infections microbiennes
FR3106055A1 (fr) 2020-01-13 2021-07-16 Centre National De La Recherche Scientifique (Cnrs) Combinaison de diltiazem et autres agents antiviraux
WO2021144528A1 (fr) 2020-01-13 2021-07-22 Universite Claude Bernard Lyon 1 Combinaison de diltiazem et des inhibiteurs de polymerase(s) virale(s)
WO2021181044A1 (fr) 2020-03-10 2021-09-16 Universite Claude Bernard Lyon 1 Composition comprenant du diltiazem pour traiter l'infection virale par les virus sars-cov-2
FR3108033A1 (fr) 2020-03-10 2021-09-17 Universite Claude Bernard Lyon 1 COMPOSES ANTIVIRAUX ET LEURS COMBINAISONS POUR TRAITER L’INFECTION VIRALE PAR LE SARS-CoV-2

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