Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/16—Amides, e.g. hydroxamic acids
  • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
  • A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
  • A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
  • A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
  • A61K47/34—Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/44—Oils, fats or waxes according to two or more groups of A61K47/02-A61K47/42; Natural or modified natural oils, fats or waxes, e.g. castor oil, polyethoxylated castor oil, montan wax, lignite, shellac, rosin, beeswax or lanolin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0034—Urogenital system, e.g. vagina, uterus, cervix, penis, scrotum, urethra, bladder; Personal lubricants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/08—Solutions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/107—Emulsions ; Emulsion preconcentrates; Micelles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/107—Emulsions ; Emulsion preconcentrates; Micelles
  • A61K9/1075—Microemulsions or submicron emulsions; Preconcentrates or solids thereof; Micelles, e.g. made of phospholipids or block copolymers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
  • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
  • A61L15/42—Use of materials characterised by their function or physical properties
  • A61L15/44—Medicaments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P23/00—Anaesthetics
  • A61P23/02—Local anaesthetics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0014—Skin, i.e. galenical aspects of topical compositions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
  • A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
  • A61L2300/402—Anaestetics, analgesics, e.g. lidocaine

Definitions

• the present invention relates to new pharmaceutical compositions comprising local anaesthetics for topical administration.
• the compositions can be used for reducing pain in connection with clinical conditions and clinical procedures.
• Local anaesthetics are commonly used to inhibit nociceptive pain, and are usually administered by local injection.
• Pharmaceutical compositions for local injection normally contain local anaesthetics at a concentration of 1 to 2 %. In the preparation of pharmaceutical compositions for topical administration it is preferred to have the local anaesthetic present at a higher concentration.
• Local anaesthetics of the amide type, ATC code N01 BB are weak bases with a pK a of around 8. Consequently, in an aqueous solution at neutral pH these local anaesthetics are mostly present in their acid form. However, the acid form is charged and therefore less suitable to pass through biological membranes. In pharmaceutical compositions for topical administration it is therefore preferred to have the local anaesthetic present in its base form which can readily pass through biological membranes. This can be achieved by adjusting the pH of the
• compositions to a pH around or even preferably above the pK a of the local anaesthetic, i.e. to a pH above 8 or higher.
• EP 0833612 discloses a pharmaceutical composition
• a pharmaceutical composition comprising an eutectic mixture of lidocaine base and prilocaine base.
• This mixture is in oil form at room temperature and can therefore be formulated as an emulsion.
• This eutectic mixture can only be obtained with a few local anaesthetic mixtures with suitable melting points, exemplified by lidocaine base and prilocaine base.
• EP 1629852 describes a system where the local anaesthetic is kept in a solution at acidic pH and only mixed with a buffering solution with high pH shortly prior to use, providing a solution of the local anaesthetic at a pH between 5.5 and 7. In this pH interval only a small portion of the local anaesthetic is present in the base form, the form that readily penetrates membranes.
• thermogelling agents for this purpose, studied different thermogelling agents together with local anaesthetics of the amide type at a basic pH. The results indicated difficulties to find stability and to settle stable conditions even with suitable candidates of such thermogelling agents.
• the present invention aims at providing such stable sterilizable thermogelling pharmaceutical compositions comprising one or more local anaesthetics and at a concentration sufficiently high and at a sufficiently high pH to be able to provide effective pain relief following topical administration, while being easy to administer with conventional tools and sufficiently cohesive at the administration site to exert the anaesthetic effect in a safe, controlled and predetermined manner. Description of the invention
• the term "about” is used to indicate a deviation of +/- 2 % of the given value, preferably +/- 5 %, and most preferably +/- 10 % of the numeric values, where applicable.
• the present invention relates to a stabilized
• thernnogelling pharmaceutical composition comprising an anaesthetically effective amount of one or more local anaesthetics; a polyoxyethylene castor oil in an amount of between about 10 and about 30 % by weight; and one or more surfactants in an amount of at least 15 % by weight to provide the composition with thernnogelling properties.
• surfactant refers to any agent that acts as an emulsifier and/or suspension stabilizer and/or as a thickening agent, preferably with thernnogelling properties most preferably with thermoreversible gelling properties. If only one surfactant is used in the composition, it must be selected with care and in suitable amounts so that it acts both as an emulsifier, as well as a thickening agent, preferably with thermoreversible gelling properties.
• thernnogelling has the meaning that the compositions are generally liquid with low viscosity at room (ambient) temperature of at about 20 to 25° C, but is a gel at body temperature at about 37 to 40°C.
• the transition between liquid and gel does not necessarily need to be at body temperature, but preferably the composition shall undergo transition in the interval about 30 to about 37°C. It is, however, important that the transition is sufficiently distinct at a defined temperature or at a fairly narrow temperature interval.
• the thernnogelling compositions generally are possible to eject from standard cannulas or other injection devices in preferred embodiments with a needle/tip as fine as having an inner diameter of about 1 mm, such as about 0.5 to about 2 mm at room temperature, while the compositions from a cohesive viscous gel at body temperature.
• a needle/tip as fine as having an inner diameter of about 1 mm, such as about 0.5 to about 2 mm at room temperature, while the compositions from a cohesive viscous gel at body temperature.
• Many materials with thermogelling characteristics are well known for topical drug delivery, such as different celluloses and surface active block copolymers.
• the compositions have an elasticity modulus (G') at room temperature of below about 20 Pa, more suitable about 1 Pa and in certain embodiments as low as 0.001 to 0.1 Pa, while the elasticity modulus at body temperature in within the approximate range of 50 to 10 000 Pa, such as about 10 4 Pa at body temperature.
• the viscosity at room temperature is preferably less than about 20 Pas, more preferably from about 0.4 to about 10 Pas, preferably less than about 20 Pas.
• Inventive compositions including thermogelling components suitable to meet such requirements are embodied in the following sections. Thermoreversible has the meaning that the rheological characteristics should be possible to repeat after warming and cooling the compositions.
• the compositions does not precipitate, degrade or in other terms change their appearance or usefulness during storage and/or heat sterilization including their thermogelling and preferably thermoreversible gelling properties.
• the pharmaceutical composition of the invention further comprises a solubilizer in an amount of between about 0 and about 10 % by weight, more preferably in an amount of between 1 and 5 % by weight.
• the Pharmaceutical composition comprises local anaesthetics present in an amount of between 1 and 10 % by weight, preferably in an amount of between 1 and 7 % by weight. Most suitable concentrations to include depend on the solubility limits achievable with the inventive composition systems. Finding such effective concentrations is within the general knowledge of the experienced with formulating local anaesthetics.
• compositions which is adjusted to a value where sufficient amounts of the local anaesthetic(s) are present in the uncharged base form.
• This feature is important to promote the penetration of the local anaesthetic into the tissue and consequently be able to exert the anaesthetic effect. That the pH is high enough so that a sufficient amount of the local anaesthetic is in its base form (close to or higher than the pK a of the local anaesthetics) is an advantage over a physiological pH (7.4) due to the promoted penetration of the uncharged base form.
• the pH-value of the pharmaceutical composition is adjusted with suitable acid or base in such a way that the final pH-value for the composition is higher or equal to the pK a of the local anaesthetic minus 1 .0, preferably the final pH-value for the composition is higher or equal to the pK a of the local anaesthetic minus 0.5, even more preferably the final pH-value for the composition is higher or equal to the pK a of the local anaesthetic.
• the final pH-value for the composition is adjusted in relation to the pK a of the local anaesthetic with the lowest pK a value.
• the pharmaceutical compositions of the invention include the base form of one or more local anaesthetics of the amide type ATC code N01 BB and have a pH of at least 8.0, Suitable such local anaesthetics of the amide type is selected from the group consisting of lidocaine, prilocaine, mepivacaine, ropivacaine, bupivacaine, and levobupivacaine.
• the local anaesthetic is the base form of lidocaine present in an amount of 1 to 7 % by weight, preferably from 2 to 6 % by weight.
• the polyoxyethylene castor oil acting as a primary solubilizer is present in an amount of between 10 and 30 % by weight, preferably the polyoxyethylene castor oil is selected from polyoxyethylene 35 castor oils, and most preferably the
• polyoxyethylene castor oil is Cremophor EL.
• Polyoxyethylene castor oil derivatives are a series of materials obtained by
• polyethoxylated hydrogenated castor oils are analogous to polyethoxylated castor oils with the exception that the double bond in the fatty chain has been saturated by hydrogenation.
• the PhEur 2005 states that polyoxyl castor oil contains mainly ricinoleyl glycerol ethoxylated with 30-50 molecules of ethylene oxide with small amounts of macrogol ricinoleate, and of the
• hydrogenated castor oil contains mainly trihydroxystearyl glycerol ethoxylated with 7-60 molecules of ethylene oxide.
• polyoxyl 35 castor oil (Cremophor EL) the relatively hydrophobic constituents comprise about 83% of the total mixture, the main component being glycerol polyethylene glycol ricinoleate.
• Other hydrophobic constituents include fatty acid esters of polyethylene glycol along with some unchanged castor oil.
• the hydrophilic part (17%) consists of polyethylene glycols and glycerol ethoxylates.
• Cremophor ELP a purified grade of Cremophor EL is also a polyoxyl 35 castor oil, it has a lower content of water, potassium, and free fatty acids and hence is claimed to have improved stability.
• polyethoxylated castor oil polyoxyethylene 35 castor oil.
• polyoxyethylene 40 hydrogenated castor oil Lipocol HC0 40; Lipocol LAV HCO 40; Nikkol HCO 40 Pharma; Nonionic GRH- 40; Protachem CAH-40.
• castor oil hydrogenated castor oil.
• the surfactant can be a non-ionic or ionic surfactant, preferably the surfactant is a non-ionic surfactant present in amount of about 15 to about 25% by weight and in certain embodiments between about 18 to22 % by weight. It is possible to use at least one surfactant having thermoreversible gelling properties. By choosing surfactant(s) with hydrophobic and hydrophilic domains in appropriate amounts, it is possible to obtain pharmaceutical compositions with local anaesthetics with thermoreversible gelling properties. This enables the pharmaceutical composition to be less viscous at room temperature and when applied at the targeted site the viscosity of the composition is increased. Thereby, the composition can safely remain at site where it is administered and deliver the active ingredient in a controlled manner.
• the surfactants with thermoreversible gelling properties are non-ionic block copolymers of polyoxy(ethylene) and
• poly(oxyproylene) conforming to the general formula HO-[C2H 4 O] a -[C3H 6 O]p- [C2H O] a -H, a and ⁇ representing the number of hydrophilic ethylene oxide and hydrophobic propylene oxide chains respectively. They are generally referred to as poloxamers.
• the pharmaceutical compositions comprise non-ionic block copolymers of the poly(oxyethylene) and poly(oxypropylene) type present in an amount of at least 15 % by weight, preferably from about 18 to about 25 % by weight, exemplified by 20 to 22 % by weight.
• block copolymers comprise a higher molecular weight poloxamer and a lower molecular weight poloxamer, and wherein the higher molecular weight poloxamer is present in excess to the lower molecular weight poloxamer.
• the poloxamers comprise a mixture of poloxamer 188 and poloxamer 407, suitably the two poloxamer are present in equal amounts or close to equal amounts.
• the weight ratio of poloxamer 407 to poloxamer 188 is from about 1 .5 to about 1 .3.
• the additional solubilizer of the inventive compositions preferably is selected from the group consisting of suitable lower alcohols such as ethanol, propanol, isopropanol, propylene glycol and benzyl alcohol; glycerol formal, glycofural, polysorbates such as polysorbate 80 and ethyl acetate. Most preferably, the solubilizer is selected among ethanol and benzylalcohol.
• compositions of the present invention further comprise water adding up to 100 % by weight.
• Certain preferred embodiments of the invention are pharmaceutical compositions comprise a local anaesthetic selected from lidocaine and prilocaine in an amount of between 2 to 6 % by weight; a polyoxyethylene castor oil in an amount of between 15 to 30 % by weight; one or more block copolymers of ethylene oxide and propylene oxide in an amount of between 15 to 30 % by weight; and benzyl alcohol in an amount of between 0 to 2 % by weight.
• inventions of the inventive pharmaceutical comprise a local anaesthetic selected from lidocaine and prilocaine in an amount of between 2 to 6 % by weight; a polyoxyethylene castor oil in an amount of between 10 to 30 % by weight; one or more block copolymers of ethylene oxide and propylene oxide in an amount of between 20 to 30 % by weight; and ethanol in an amount of between 2 to 5 % by weight.
• Still other embodiments comprise 2 to 6 % by weight of lidocaine in base form; about 20 to 30 % by weight of a polyoxyethylene castor oil; about 15 to 25 % by weight of poloxamers; and no cosolubilzer.
• Special embodiments of the composition according to the present invention comprise about 2 to 6 % by weight of lidocaine in base form; about 10 to 30 % by weight of a polyoxyethylene castor oil; about 15 to 25 % by weight of poloxamers; about 1 to 5 % by weigh of ethanol as cosolubilizer; and are adjusted to a pH- value of about 8.0 to 8.5.
• compositions comprising about 4 % lidocaine in base form; about 20 to 30 % by weight of a polyoxyethylene castor oil; about 20 to 25 % by weight of poloxamers; about 2 to 4 % by weigh of ethanol as cosolubilizer adjusted to a pH-value of about 8.0 to 8.5.
• the polyoxyethylene castor oil is selected from polyoxyethylene 35 castor oils, preferable Chremophor EL and the poloxamers are selected among poloxamer 188 and 407 according to embodiments disclosed in the earlier general context.
• the compositions have pH of about 8,0 to 8.5
• composition according to the invention can be formulated for topical administration on any mucosal tissue, such as but not limited to, oral, nasal, ocular, intravaginal, intracervical, pericervical, intrauteral, intrarectal administration.
• composition according to the invention can be formulated for dermal administration on healthy, diseased and/or injured skin.
• administration can be made directly from the container, by hand, or by means of or together with patches, bandages and wound dressings.
• the pharmaceutical composition can be administrated by means of a syringe.
• the syringe can be further provided with an applicator.
• the applicator can be in the form of a tube.
• compositions according to the present invention can be used for reducing pain in connection with various clinical conditions and clinical procedures.
• the present invention provides methods for reducing pain in connection with clinical conditions and clinical procedures comprising the administration of a pharmaceutical composition according to the invention.
• Such clinical conditions are exemplified by, but not limited to, wound healing, especially burn wounds, skin ulcers, hemorrhoids, anal fissures, herpes zoster, herpes simplex infections, especially, herpes labialis, and herpes genitalis.
• wound healing especially burn wounds, skin ulcers, hemorrhoids, anal fissures, herpes zoster, herpes simplex infections, especially, herpes labialis, and herpes genitalis.
• gynaecological procedures such as, abortions and application of intra uterine devices (IUD), hysteroscopy, in vitro fertilization, spontaneous and legal abortions, and general vaginal examination, dental procedures, surgical procedures, such as skin grafting.
• IUD intra uterine devices
• compositions on any mucosal tissue are possible, such as but not limited to, oral, nasal, intravaginal, intracervical, pericervical, intrauteral, intrarectal administration.
• the pharmaceutical composition can also be dermally administered on healthy, diseased and/or injured skin. Dermal administration can be made directly from the container, by hand, or by means of or together with patches, bandages and wound dressings.
• the administration can be made by means of a syringe.
• the syringe can be further provided with an applicator.
• the applicator can be in the form of a tube.
• the invention relates to a method of manufacturing a local anaesthetics product comprising the steps of providing a composition of a local anaesthetic of the amide type in a concentration of between 1 to 10 % by weight and solubilized with at least 10 % by weight of a polyoxyethylene castor oil and an additional solubilizer in amount of 0 to 5 % by weight.
• the composition further comprises at one or more surfactants in an amount of between of at least 15 % by weight to provide the composition with thermo-reversible gelling
• a sealed container which comprises the composition.
• the method further comprises the step of subjecting the container with the composition to heat sterilization (autoclavation) below 120°C, preferably between about 1 10 to 120°C and a period of about 10 minutes, preferably at about 1 15° C for about 10 minutes.
• autoclavation heat sterilization
• a stable product with maintained thermo-reversible gel-forming and with so low level of viable microorganisms is obtain so that the product is suitable for topical administration to an internal body site. Any of the earlier disclosed compositions can be employed with this production method.
• compositions of the present invention can be sterilized to an acceptable product at less harsh conditions than at autoclavation at 121° C during 15 minutes, as otherwise expected/required by clinical authorities as it significantly reduces the risk for potentially harmful degradation products. It is contemplated that the systems components may synergistically contribute to an antimicrobial effect under the conditions of the method.
• compositions of the present invention so far generally disclosed and
• the inventive composition surprisingly well meet the difficult requirements of a high, controlled anaesthetic effect at site inside the body, excellent compliance when administer and suitable stability also after final heat sterilization and storage.
• Figure 1 is a graph illustrating in-vitro release of local anaesthetics from
• compositions - ⁇ - 5 % prilocaine HCI in 20 % Chremophor, 1 % benzyl alcohol; - ⁇ - 5 % lidocaine in 23 % Chremophor, 1 % benzyl alcohol; -A- 4 % lidocaine in 23 % Chremophor, 1 % benzyl alcohol; - ⁇ - 3 % lidocaine in 23 % Chremophor, 1 % benzyl alcohol; - ⁇ - 2 % lidocaine in 23 % Chremophor, 1 % benzyl alcohol. Examples.
• Poloxamer 188 - BASF (technical grade)
• Poloxamer 407 - BASF (technical grade)
• compositions comprising the components according to Table 3 were prepared as described below.
• Step 1 Component I is dissolved in II or, in applicable cases, in II and III under gentle warming.
• Step 2 Components IV and V are dissolved in VI over night in a refrigerator, resulting into a clear slightly viscous solution.
• Step 3 The solution from step 2 is put to the solution from step 1 followed by a thorough mixing, resulting into an opalescent thick gel.
• the gel can be made slightly thinner with an appropriate amount of VI, which is compensated with a reduction of the amount VIII.
• Step 4 The pH of the gel is adjusted to 8 with VII.
• Step 5 Remaining amount of VIII is put to the mixture from step 4 in order to reach the final amount of preparation.
• a pharmaceutical composition comprising the components according to Table 4 was prepared as described below.
• Step 1 Components I and II are dissolved in III over night in a refrigerator, resulting in a clear slightly viscous solution.
• Step 2 Component IV is dissolved in the solution from step 1 .
• Step 3 Components V and VI are added to the solution from step 2 followed by a thorough mixing, resulting in an opalescent mixture.
• Step 4 The pH of the composition is adjusted to 8 with VII.
• the formulation has thermoreversible gelling properties as a result of the presence of the poloxamers. No precipitation of the prilocaine was observed at the desired pH of 8 where prilocaine is mainly present in its active base form.
• Example 3 In-vitro release of local anaesthetics from pharmaceutical compositions.
• Example 4 Lidocaine compositions with 40 mg/g and different amounts of poloxamers and cosolvents
• compositions comprising the components according to Table 5 were prepared as described below
• Cremophor EL, lidocaine and ethanol are mixed separately by heating to 55 °C. The solution is cooled down to room temperature.
• pH is measured in the total solution and pH is adjusted to pH 8.0-8.3 with 0.2-1 .0 M HCI if necessary.
• Cremophor EL, lidocaine and ethanol are mixed separately by heating to 55 °C. The solution is cooled down to room temperature.
• pH is measured in the total solution. pH is adjusted with 1 M NaOH or HCI to reach pH 8.0-8.3 The rheology of the prepared compositions was tested by dynamic oscillation and viscosity measurements. A TA Instruments AR-2000 was used at the following conditions:
• Lidocaine formulations with 40 mg/g lidocaine and pH is adjusted with 1 M HCl. The samples are not autoclaved.
• Table 4 demonstrates a number of compositions useful within the specifications of the invention.
• Example 5 Sterilization of the compositions Spores of Geobacillus searothermophilus was added in different amounts to the composition (120 mg/g poloxamer 188, 90 mg/g poloxamer 407, 270 mg/g Cremophor EL, 50 mg/g lidocaine, water up to 1 g). 0.15 ml of spore suspension with different amount of spores in accordance with Table 5 were added to 30 ml product before autoclaving and incubation at 55-60° for 5 days.
• composition including 1 10 mg/g poloxamer 188, 100 mg/g

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