WO2012023077A1 - Crème médicamenteuse à base d'acide fusidique préparée avec du fusidate de sodium et comprenant un biopolymère, un corticostéroïde - propionate de clobétasol, et un agent antifongique - nitrate d'oxiconazole, et procédé de préparation correspondant - Google Patents

Crème médicamenteuse à base d'acide fusidique préparée avec du fusidate de sodium et comprenant un biopolymère, un corticostéroïde - propionate de clobétasol, et un agent antifongique - nitrate d'oxiconazole, et procédé de préparation correspondant Download PDF

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WO2012023077A1
WO2012023077A1 PCT/IB2011/053402 IB2011053402W WO2012023077A1 WO 2012023077 A1 WO2012023077 A1 WO 2012023077A1 IB 2011053402 W IB2011053402 W IB 2011053402W WO 2012023077 A1 WO2012023077 A1 WO 2012023077A1
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amount
vessel
cream
mixture
added
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PCT/IB2011/053402
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English (en)
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Sulur Subramaniam Vanangamudi
Madhavan Srinivasan
Neelakandan Narayanan Chulliel
Kausik Ghosh
Sankar Haridas
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Sulur Subramaniam Vanangamudi
Madhavan Srinivasan
Neelakandan Narayanan Chulliel
Kausik Ghosh
Sankar Haridas
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Publication of WO2012023077A1 publication Critical patent/WO2012023077A1/fr

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    • 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
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic 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
    • A61K31/4164—1,3-Diazoles
    • 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
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
    • A61K31/573—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
    • 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
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/575—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of three or more carbon atoms, e.g. cholane, cholestane, ergosterol, sitosterol
    • 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
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
    • A61K31/716—Glucans
    • A61K31/722—Chitin, chitosan
    • 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
    • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
    • 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

Definitions

  • the present invention relates to primary and secondary bacterial skin infections, skin inflammations, fungal skin infections and wounds including burn wounds.
  • a cream incorporating Fusidic Acid and a biopolymer in the form of Chitosan, a corticosteroid in the form of Clobetasol Propionate, and an antifungal agent in the form of Oxiconazole Nitrate, and the process of making it and using it in treating these infections, inflammations and wounds.
  • Fusidic Acid in the said cream has been created in situ using Sodium Fusidate as the starting Active Pharmaceutical Ingredient (API).
  • Topical and systemic bacterial infection treatment compositions typically employ at least one active pharmaceutical ingredient (API) in combination with a base component.
  • the APIs typically comprise an antibiotic/antibacterial such as Fusidic Acid and a corticosteroid such as Clobetasol Propionate, and an antifungal agent such as Oxiconazole Nitrate and biopolymer such as Chitosan, and the like.
  • Fusidic Acid in fine powder form is used as source API.
  • the small particle size enhances its dermal contact by providing a large specific surface area and penetration, and provides a smooth feel on application to skin.
  • a serious shortcoming of the fine size of Fusidic Acid particles is that it presents an enormous surface area for contact and reaction with molecular Oxygen during manufacture, handling, and processing of the cream. This has serious implications to its chemical stability and results in rapid reduction in potency of the API (Fusidic Acid) in the final cream formulation.
  • Sodium Fusidate is known to have been used to make dermaceutical medicaments for topical application.
  • these are in the form of ointment rather than cream.
  • Drawbacks of ointments over creams are well known and it's generally preferable to use creams rather than ointments for topical application.
  • Stabilization of medicaments containing Fusidic Acid against oxidation involves observing a number of stringent precautionary procedures during manufacture and storage. These include: • replacing Oxygen in pharmaceutical containers with inert gases such as Nitrogen, Carbon dioxide, Helium and the like
  • Fusidic Acid cream in which Fusidic Acid will be of greater stability than the stability of the Fusidic Acid in the conventional creams, particularly at the time of the manufacture of the cream, and which will sustain its stability at an acceptable level throughout its shelf life.
  • Antifungal or antibacterial compositions are traditionally applied as lotions, creams or ointments. Furthermore in many instances, it is difficult to ascertain whether the skin condition is due to a bacterial agent or a fungus.
  • One approach to treating skin disorder is through elimination by trial and error.
  • Antibacterial or antifungal compositions are applied in turn and response monitored and treatment modified.
  • a major disadvantage of this approach is that treatment needs to be applied many times a day during the treatment period. This is greatly inconvenient and also not cost effective for a majority of human population, particularly in the under-developed countries.
  • compositions use steroids, antibacterial agents or antifungal agents, (or a fixed dose combination of these) and focus on these pharmaceutically active ingredients.
  • the composition of such formulations is such as to enhance their physical/chemical/bio-release profile.
  • Many skin disorders caused by inflammation and fungal/bacterial attacks lead to itching and subsequent scratching, which, among other causes, can in turn lead to serious and complicated secondary infections.
  • the conventionally available treatments do not focus on skin healing or rejuvenation; normally these two aspects are left to heal naturally.
  • the word healing as related to compromised skin conditions are not only about prevention, control, elimination of the source cause such as bacteria or fungi but also to restore the skin to its pre-infection state.
  • the word healing as related to compromised skin conditions are not only about prevention, control, elimination of the source cause such as bacteria or fungi but also to restore the skin to its pre-infection state.
  • the current approaches of skin treatment can be broadly categorized into two stages, a. healing b. restoration of skin to pre-ailment state.
  • the healing part comprises elimination, to the best possible extent, of the root cause of the disorder. This may be elimination of bacteria or fungi causing the infection through a suitable treatment of antibacterial or antifungal agents or reducing the inflammation through steroid treatment. While this treatment is under way, the ongoing compromised condition of the skin continues to be susceptible to secondary infections which can be of quite serious nature. In the case of scratched or wounded skin, it is important for blood clotting to occur quickly as it reduces chances of secondary infections.
  • the focus of such treatments, which are administered through creams, lotions, ointments is on the action of active pharmaceutical ingredients. Cream bases or ointment bases are merely viewed as carriers to take APIs to the sites of disorder.
  • Topical skin formulations can deliver skin healing or regeneration beyond the activity of the main APIs such that the therapeutic outcome of the main APIs are enhanced.
  • biopolymers biologically active polymers
  • the PCT application WO 2009063493 discloses a combination therapy of a topical antibiotic and a topical steroid for the treatment of inflammatory dermatoses associated with secondary bacterial infections.
  • topical pharmaceutical compositions comprising a combination of Fusidic Acid and corticosteroid such as Clobetasol Propionate useful in treatment of infected eczema's such as secondarily infected dermatitis, including secondarily infected contact dermatitis, psoriasis, allergic contact dermatitis and atopic dermatitis with secondary bacterial infections of skin.
  • topical pharmaceutical compositions comprising a combination of Fusidic Acid and corticosteroid such as Clobetasol Propionate useful in prevention of infection in cases of dermatitis, especially atopic dermatitis sufferers who are at risk of getting secondary bacterial infection.
  • WO 2009063493 also apparently surprisingly found that antibiotic action of Fusidic Acid and the anti-inflammatory effect of a corticosteroid such as Halobetasol, both play important roles in prevention of secondary bacterial infections in patients with non-infected dermatoses and in treatment of infected steroid responsive dermatoses such as secondarily infected dermatoses including secondarily infected contact dermatitis, allergic contact dermatitis, atopic dermatitis, psoriasis and other corticosteroid responsive dermatoses (CRD) with secondary bacterial infections of skin.
  • infected steroid responsive dermatoses such as secondarily infected dermatitis including secondarily infected contact dermatitis, allergic contact dermatitis, atopic dermatitis, psoriasis and other corticosteroid responsive dermatoses (CRD) with secondary bacterial infections of skin.
  • CCD corticosteroid responsive dermatoses
  • the invention disclosed in WO 2009063493 relates to a combination therapy of a topical antibiotic and a topical steroid for the treatment of inflammatory dermatoses associated with secondary bacterial infections.
  • topical pharmaceutical compositions comprising a combination of Fusidic Acid and corticosteroid such as Clobetasol Propionate useful in treatment of infected eczema's such as secondarily infected dermatitis, including secondarily infected contact dermatitis, psoriasis, allergic contact dermatitis and atopic dermatitis with secondary bacterial infections of skin.
  • the present invention also relates to topical pharmaceutical compositions comprising a combination of Fusidic Acid and corticosteroid such as Clobetasol Propionate useful in prevention of infection in cases of dermatitis, especially atopic dermatitis sufferers who are at risk of getting secondary bacterial infection
  • EP1787652 relates to a composition with antifungal properties, against foot fungus.
  • the invention comprises the use of Melaleuca Alternifolia essential oil in combination with at least one component chosen from the group consisting of Miconazole Nitrate, benzoic acid and sodium benzoate.
  • EP1787652 claims novelty on the assertion that the composition according to this invention has an improved antifungal effect and can be used for both preventive and therapeutic applications.
  • the composition comprises 2 to 8% by weight of Melaleuca Alternifolia essential oil and 0.5 to 1% by weight of a benzoate compound relative to the total composition. At this concentration an optimum level is achieved between antifungal activity and economic use of Melaleuca Alternifolia essential oil and benzoate compound.
  • US 20020009422 relates to a tanning product that treat tinea versicolor and promote tanning.
  • the product includes the active ingredients tolnaftate and Miconazole Nitrate.
  • US 20020009422 claims novelty on the assertion that the product manages to overcome few problem faced by conventionally used therapeutic like unpleasant smell, dry and rough skin caused by the conventional treatment.
  • the applicant has devices a system for treating tinea versicolor which consists of three systems; a body wash having a mixture of a shampoo, an exfoliate and tolnaftate cream; a tanning lotion and anti-fungal topical having mixture of a lotion, a tanning bronzer and a Miconazole Nitrate; and body spray having a mixture of a liquid tan enhancing body spray and tolnaftate cream.
  • US 4911932 describes a skin care composition having improved effectiveness in preventing and treating acute inflammatory skin conditions.
  • the composition consists of Miconazole Nitrate and zinc oxide.
  • US 4911932 claims novelty on the assertion that the formulation is an improved skin care compositions, which can be used for the prevention and treatment of diaper rash. According to the applicant, the improvement in the formulation is achieved because of the synergistic combination of active ingredients, 0.25% of Miconazole Nitrate and zinc oxide.
  • the composition of the invention may be added in either aqueous or oleaginous media. A thickener or stabilizer is added to prevent settling of the synergistic combinations and the resulting non-uniformity of the finished product upon standing.
  • CN 1931164 deals with the nanometer Miconazole Nitrate emulsion medicine which consist of surfactant, oil, Miconazole Nitrate and distilled water.
  • US 5,461,068 pertains to improved formulations for topical treatment of fungal diseases, and more particularly to solutions of imidazole derivatives such as Miconazole Nitrate of sufficient strength and stability for pharmaceutical use.
  • the said composition can accommodate a therapeutically significant concentration of the antifungal agents; thereby increasing the stability of the antifungal agents in solution for extended periods of time.
  • the solvent system comprises a primary carboxylic acid, a polar solvent, a solubilizer, a non-ionic or amphoteric surfactant, and water, in which imidazole derivatives can be dissolved.
  • cream base matrix as a functional element of the cream rather than a mere carrier for the main APIs
  • cream base which cream base provides therapeutical value complementary to that provided by the main APIs and serves the purpose over and above that of being a mere carrier or delivery mechanism.
  • Another object of the present invention is to provide a medicinal cream that is effective in treatment of skin inflammations, bacterial/fungal skin infections, wounds including burn wounds.
  • biopolymers Contain biologically active polymers (the so-called biopolymers) without compromising the stability of the formulations. If the right biopolymer is not selected stability of the formulations could be affected. Incorporate a functionally bio-active excipient polymer in cream matrix while retaining the functional stability of the API in a single dose format.
  • the present invention is directed to a medicinal composition for treating skin inflammations, fungal/bacterial skin infections and related wounds, and also other skin wounds including those caused by burns.
  • the cream also causes skin rejuvenation through an epithelisation process.
  • the cream comprises:
  • Active Pharmaceutical Ingredients in the form of Fusidic Acid that has been generated in situ from Sodium Fusidate, Clobetasol Propionate & Oxiconazole Nitrate c) a cream base containing primary and secondary emulsifiers, waxy materials, co- solvents, acids, preservatives, buffering agents, anti oxidants, chelating agents, and humectants.
  • the active ingredients namely Chitosan, Clobetasol Propionate, Oxiconazole Nitrate and Fusidic Acid, are incorporated in cream base for use in treating skin inflammations, fungal/ bacterial skin infections with allergy & itching, & wounds on human skin involving contacting human skin with the above identified composition.
  • the invention also discloses a process to make the medicinal cream containing Fusidic Acid which is formed in situ from Sodium Fusidate as the starting raw material, wherein Sodium Fusidate is converted into Fusidic Acid under oxygen-free environment created using inert gas, preferably nitrogen, and Chitosan.
  • the cream produced by the process of the present invention has greater shelf-life stability and the finer particle size of the API than the conventional creams containing Fusidic Acid.
  • the cream produced by the process of the present invention contains Fusidic Acid as the API that has been formed in situ from Sodium Fusidate, Clobetasol Propionate, & Oxiconazole Nitrate in a cream base comprising a preservative, an acid, a co-solvent, an emulsifier and a waxy material along with water, preferably purified water.
  • the cream produced by the process of the present invention further optionally contains an ingredient selected from a group comprising, a buffering agent, an anti oxidant, a chelating agent, and a humectant, or any combination thereof.
  • Creams containing Fusidic Acid that are made using Sodium Fusidate as starting API along with Clobetasol Propionate as a steroid, and Oxiconazole Nitrate as antifungal are not commercially available.
  • Sodium Fusidate is not considered to be inherently more stable as an API than Fusidic Acid.
  • Creams containing Chitosan and Fusidic Acid which has been created in situ from Sodium Fusidate , Clobetasol Propionate as a steroid, and Oxiconazole Nitrate as antifungal is not commercially available.
  • fusidic acid has very labile trans, sys, trans arrangement of these rings which forces ring B into a boat conformation.
  • fusidic acid readily undergoes acid mediated dehydration of C-l l hydroxy group to generate a C9-C11 double bond which on further isomerization followed by oxidization in the presence of oxygen leads to a mixture of biologically inactive fusidic acid derivatives.
  • carboxylic acid functional group present in the fusidic acid facilitates the above process more readily upon storage.
  • carboxylic acid promoted decomposition is not feasible.
  • sodium fusidate has superior solid state stability when compared to fusidic acid. This discovery of the inventor has also been corroborated through stability assessment of sodium fusidate and fusidic acid.
  • Tables 1 and 2 also show the comparison between the stability of the Fusidic Acid and Sodium Fusidate as raw APIs.
  • the study was carried out using an in-house HPLC method developed by the applicant, which the applicant believes is a true stability-indicating method as opposed to the titration method suggested in British Pharmacopoeia (BP). This is because the BP method does not differentiate between the intact API and the degraded form.
  • a dermaceutical cream that uses Sodium Fusidate would exploit the benefit of the fact that Sodium Fusidate is more stable than Fusidic Acid and it would also provide a cream formulation which is far superior in its application qualities than an ointment. It would thus fill an existing need for a cream that has better stability than currently available creams containing Fusidic Acid.
  • Sodium Fusidate rather than Fusidic Acid may be used as the starting API during the cream's manufacture.
  • Sodium Fusidate as starting material eliminates the drawback associated with the manufacture and storage of existing Fusidic Acid creams.
  • the applicant has also discovered that the Fusidic Acid cream prepared using Sodium Fusidate as the starting API and Clobetasol Propionate as a steroid, and Oxiconazole Nitrate as an antifungal showed good chemical stability and efficacy.
  • the application discloses a process of making a cream containing a biopolymer - Chitosan, Clobetasol Propionate as a steroid, and Oxiconazole Nitrate as an antifungal, and Fusidic Acid (the API) that has been prepared using Sodium Fusidate as the starting API, in which Fusidic Acid forms in-situ under totally oxygen-free environment created using inert gas, preferably nitrogen, by slow addition of an acid, into a molecular dispersion form (due to the presence of a co-solvent) at the intermediate stage, and which Fusidic Acid regenerates as an extremely fine dispersion when added to a final cream base, thereby resulting in a finely and homogeneously dispersed Fusidic Acid in the final cream. All these operations are performed in an environment free of atmospheric oxygen created using inert gas, preferably nitrogen.
  • the cream made using the process of the present invention contains Fusidic Acid as the API that has been formed in situ from Sodium Fusidate, a biopolymer - Chitosan, Clobetasol Propionate as a steroid, and Oxiconazole Nitrate as an antifungal in a cream base comprising a preservative, an acid, a co-solvent, an emulsifier and a waxy material along with water, preferably purified water.
  • the active compounds Sodium Fusidate, Clobetasol Propionate & Oxiconazole Nitrate which may be employed in the process of the present invention as starting APIs are well known in the art of treating bacterial primary & secondary bacterial skin infections, skin inflammations and fungal skin infections.
  • the active compounds Sodium Fusidate Clobetasol Propionate & Oxiconazole Nitrate require a base component to be used in the pharmaceutical composition that uses the compound, since the compound cannot, by themselves, be deposited directly on to human skin due to their harshness.
  • the base component usually contains a biopolymer, primary and secondary emulsifiers, waxy materials, co-solvents, acids, preservatives, purified water and the like.
  • the cream base of the cream made using the process of the present invention optionally further comprises an ingredient selected from a group comprising a buffering agent, an anti oxidant, a chelating agent, and a humectant, or any combination thereof.
  • the present invention provides a process to make a novel cream that has been produced using Sodium Fusidate as the starting raw material, and which cream contains Fusidic Acid of high therapeutic efficacy and of chemical stability that is generally superior to the commercially available creams containing Fusidic Acid.
  • the Fusidic Acid cream made using the process of the present invention has been manufactured in a totally oxygen free environment under purging with inert gas and applying vacuum, the inert gas being preferably nitrogen. Under these conditions, the Sodium Fusidate is converted in situ into Fusidic Acid and to which Clobetasol Propionate as a steroid, and Oxiconazole Nitrate as an antifungal are added.
  • the cream of the present invention is used in the treatment of bacterial skin infections fungal infections and inflammations.
  • Topical skin formulations can deliver skin healing or regeneration beyond the activity of the main APIs such that the therapeutic outcomes of the main APIs are enhanced.
  • the addition of biologically active polymers is a complex process in which the stability of the formulations could be affected, if the right biopolymer is not selected.
  • Incorporation of a functionally bio-active excipient polymer in cream matrix while retaining the functional stability of the API in a single dose format of dermaceutical cream involves resolution of problems specific to the physical stability of cream matrix.
  • topical antibacterial agents include, but are not limited to, Sodium Fusidate, Neomycin Sulphate Calcium Mupirocin, Gentamycin, Silver Sulphadiazine, Ciprofloxacin, Framycetin Sulphate, Quinidochlor, Povidone-Iodine, Sisomicin, Nitrofural and the like.
  • Corticosteroids which may be used, include, but are not limited to Clobetasol Propionate, Betamethasone Valerate, Fluticasone Propionate, Mometasone Furoate, Dexamethasone Acetate, Hydrocortisone Acetate, Clobetasone Butyrate, Beclomethasone Dipropionate, Betamethasone Dipropionate and the like.
  • Antifungals which may be used, include, but are not limited to Oxiconazole Nitrate, Terbinafine Hydrochloride, Ketoconazole, Clotrimazole, Miconazole Nitrate and the like.
  • suitable biopolymer which may be used, include, but are not limited to Chitosan and the like. Chitosan
  • Chitosan is a linear polysaccharide composed of randomly distributed -(l-4)-linked D-glucosamine (deacetylated unit) and N-acetyl-D-glucosamine (acetylated unit). It is known to have a number of commercial uses in agriculture and horticulture, water treatment, chemical industry, pharmaceuticals and biomedics.
  • Chitosan generally absorbs moisture from the atmosphere / environment and the amount absorbed depends upon the initial moisture content, temperature and relative humidity of the environment. It is regarded as a non-toxic and non-irritant material. It is biocompatible with both healthy and infected skin and has been shown to be biodegradable as it is derived from shrimps, squids and crabs. Chitosan due to its unique physical property accelerates wound healing and wound repair. It is positively charged and soluble in acidic to neutral solution. Chitosan is bioadhesive and readily binds to negatively charged surfaces such as mucosal membranes. Chitosan enhances the transport of polar drugs across epithelial surfaces. Chitosan's properties allow it to rapidly clot blood, and it has recently gained approval in the USA for use in bandages and other hemostatic agents.
  • Chitosan is nonallergenic, and has natural anti-bacterial properties, further supporting its use. As a micro-film forming biomaterial, Chitosan helps in reducing the width of the wound, controls the oxygen permeability at the site, absorbs wound discharge and gets degraded by tissue enzymes which are very much required for healing at a faster rate. It also reduces the itching by providing a soothing effect. It also acts like a moisturizer. It is also useful in treatment of routine minor cuts and wounds, burns, keloids, diabetic ulcers and venous ulcers. Chitosan used in the present invention comes in various molecular weights ranging from lkdal to 5000kdal.
  • Chitosan is discussed in the US Pharmacopoeia forum with regard to its functional excipient category and has been published in the official monograph (USP 34) NF. Since Chitosan is basically a polymer, it is available in various grades depending upon the molecular weight. The various grades of Chitosan include Chitosan long chain, Chitosan medium chain & Chitosan short chain. The grades long, medium & short chain directly corresponds to the molecular weight of the Chitosan.
  • the long chain grade has a molecular weight in the range of 500,000- 5,000,000 Da
  • the medium chain grade has a molecular weight in the range of 1,00,000-2,000,000 Da
  • the short chain grade has a molecular weight in the range of 50,000-1,000,000 Da.
  • the molecular weight of the Chitosan plays an important role in the formulation. Higher molecular weight Chitosan imparts a higher viscosity to the system and lower molecular weight Chitosan imparts a lower viscosity to the system. However the medium chain grade Chitosan delivered an optimum level of viscosity to the formulation. Since the dosage form is a cream, appropriate levels of viscosity is required to achieve a good spreadability over the skin.
  • the inventors finalized the Chitosan medium chain grade for the present invention since it imparted the required rheologic properties to the cream without compromising the therapeutic activity of the actives, ie Sodium Fusidate, Clobetasol Propionate & Oxiconazole Nitrate as the starting actives and Chitosan.
  • the concentration of Chitosan medium chain grade was carefully arrived based on several in house trials and Preclinical animal studies for efficacy.
  • Topical anti-fungals are intended to target skin for fungal infections caused by Tinea pedis, Tinea cruris, Tinea corporis etc. These include drugs like Clotrimazole, Ketoconazole, Miconazole Nitrate, Terbinafine HC1, Oxiconazole Nitrate, etc.
  • Oxiconazole Nitrate is an antifungal agent. Chemically, oxiconazole nitrate is 2',4'- dichloro-2-imidazol-l-ylacetophenone (Z)-[0-(2,4-dichlorobenzyl)oxime], mononitrate. The compound has the empirical formula C 18 H 13 ON 3 CI 4 HNO 3 , a molecular weight of 492.15.
  • Oxiconazole nitrate is an imidazole derivative whose antifungal activity is derived primarily from the inhibition of ergosterol biosynthesis, which is critical for cellular membrane integrity. It has in vitro activity against a wide range of pathogenic fungi. Oxiconazole has been shown to be active against most strains of the following organisms both in vitro and in clinical infections at indicated body sites:
  • Topical Oxiconazole nitrate is indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, or Epider-mophyton floccosum. It is also indicated for the topical treatment of tinea (pityriasis) versicolor due to Malassezia furfur. It may also be used in pediatric patients for tinea corporis, tinea cruris, tinea pedis, and tinea (pityriasis) versicolor;
  • Topical corticosteroids are a powerful tool for treating skin diseases.
  • Corticosteroids include drugs such as Clobetasol Propionate, Betamethasone dipropionate, Beclomethasone dipropionate, Clobetasone butyrate, Halobetasol propionate, Mometasone furoate, Halcinonide, Fluocinonide, Triamcinolone acetonide, Fluticasone propionate, Amcinonide, Hydrocortisone acetate, Diflorasone diacetate, Prednicarbate, etc.
  • drugs such as Clobetasol Propionate, Betamethasone dipropionate, Beclomethasone dipropionate, Clobetasone butyrate, Halobetasol propionate, Mometasone furoate, Halcinonide, Fluocinonide, Triamcinolone acetonide, Fluticasone propionate, Amcinonide, Hydrocortisone acetate,
  • Topical corticosteroids are classified by their potency, ranging from weak to extremely potent. They include weak potent steroids, moderate potent steroids, potent steroids, very potent steroids and extremely potent steroids.
  • the high potency steroids include Betamethasone Dipropionate, Betamethasone Valerate, Diflorasone Diacetate, Clobetasol Propionate, Halobetasol Propionate, Desoximetasone, Diflorasone Diacetate, Fluocinonide, Mometasone Furoate, Triamcinolone Acetonide, etc.
  • Low potency topical steroids include Desonide, Fluocinolone acetate, and Hydrocortisone acetate, etc.
  • Topical corticosteroid is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses.
  • Clobetasol propionate is a topically active corticosteroid which provides an exceptional combination of activity and safety having the chemical name (11 ⁇ , 16 ⁇ )-21 -chloro-9-fluoro- 11 -hydroxy- 16-methyl- 17-( 1 -oxopropoxy)-pregna- 1 ,4- diene-3,20-dione. Pharmacology
  • corticosteroids are a class of compounds comprising steroid hormones secreted by the adrenal cortex and their synthetic analogs. In pharmacologic doses, corticosteroids are used primarily for their anti-inflammatory and/or
  • Topical corticosteroids such as Clobetasol propionate are effective in the treatment of corticosteroid-responsive dermatoses primarily because of their anti-inflammatory, anti-pruritic, and vasoconstrictive actions.
  • Clobetasol propionate are effective in the treatment of corticosteroid-responsive dermatoses primarily because of their anti-inflammatory, anti-pruritic, and vasoconstrictive actions.
  • the physiologic, pharmacologic and clinical effects of the corticosteroids are well known, the exact mechanisms of their actions in each disease are uncertain.
  • Clobetasol propionate has been shown to have topical and systemic pharmacologic and metabolic effects characteristic of the corticosteroid class of drugs.
  • corticosteroids The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phosphohpase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes.
  • the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.
  • Topical corticosteroids can be absorbed through normal intact skin. Inflammation and/or other disease processes in the skin may increase percutaneous absorption. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids.
  • topical corticosteroids Once absorbed through the skin, topical corticosteroids enter pharmacokinetic pathways similar to systemically administered corticosteroids. Corticosteroids are bound to plasma proteins in varying degrees, are metabolized primarily in the liver and excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted into the bile.
  • Clobetasol Propionate is super-high potency corticosteroid formulations indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses. Treatment beyond 2 consecutive weeks is not recommended, and the total dosage should not exceed 50 g per week because of the potential for the drug to suppress the hypothalamic -pituitary-adrenal (HPA) axis. Use in children under 12 years of age is not recommended.
  • HPA hypothalamic -pituitary-adrenal
  • Topical Anti-bacterial are intended to target skin for bacterial infections caused by Staphylococcus aureus, Staphylococcus epidermidis, Methicillin Resistance Staphylococcus aureus (MRSA) etc.
  • Anti-bacterial act by inhibiting cell wall synthesis by combining with bacterial ribosomes and interfering with mRNA ribosome combination.
  • anti-bacterials induce ribosomes to manufacture peptide chains with wrong amino acids, which ultimately destroy the bacterial cell.
  • Sodium Fusidate belongs to the group of medicines known as antibiotics. It is used to treat bacterial infections, such as infections of the joints and bones by killing or stopping the growth of the bacteria responsible.
  • the molecular formula of Sodium Fusidate is Csi L ⁇ NaOe.
  • the chemical name is 3 ⁇ 11 ⁇ 16B-Trihydroxy 29- ⁇ -8 ⁇ , 9B, 13 ⁇ , 14B-dammara-17(20) [10,21-cis], 24- dien-21-oic acid 16-acetate, sodium salt. It is a white colour crystalline powder soluble in one part of water at 20°C.
  • Sodium Fusidate inhibits bacterial protein synthesis by interfering with amino acid transfer from aminoacyl-sRNA to protein on the ribosomes.
  • Sodium Fusidate may be bacteriostatic or bactericidal depending on inoculum size. Although bacterial cells stop dividing almost within 2 minutes after contact with the antibiotic in vitro, DNA and RNA synthesis continue for 45 minutes and 1 to 2 hours, respectively.
  • Sodium Fusidate is virtually inactive against gram-negative bacteria. The differences in activity against gram-negative and gram-positive organisms are believed to be due to a difference in cell wall permeability.
  • Mammalian cells are much less susceptible to inhibition of protein synthesis by Sodium Fusidate than sensitive bacterial cells. These differences are believed to be due primarily to a difference in cell wall permeability.
  • Sodium Fusidate is indicated for the treatment of primary and secondary skin infections caused by sensitive strains of S. aureus, Streptococcus species and C. minutissimum.
  • Primary skin infections that may be expected to respond to treatment with Sodium Fusidate topical include: impetigo contagiosa, erythrasma and secondary skin infections such as infected wounds and infected burns.
  • Creams are semi-solid emulsions which are mixtures of oil and water in which APIs (Active Pharmaceutical Ingredients) are incorporated. They are divided into two types: oil-in-water (O/W) creams which compose of small droplets of oil dispersed in a continuous water phase, and water-in-oil (W/O) creams which compose of small droplets of water dispersed in a continuous oily phase. Oil-in-water creams are user-friendly and hence cosmetically acceptable as they are less greasy and more easily washed with water.
  • An ointment is a viscous semisolid preparation containing APIs, which are used topically on a variety of body surfaces. The vehicle of an ointment is known as ointment base
  • ointment bases The choice of a base depends upon the clinical indication of the ointment, and the different types of ointment bases normally used are:
  • Hydrocarbon bases e.g. hard paraffin, soft paraffin
  • cream formulations are available as creams. Active compounds in cream formulations are available in ionized state, whereas in case of ointments these are present in non -ionized state.
  • the cream formulations are the first choice of the formulators in design and development of topical dosage forms, as the cream formulations are cosmetically elegant, and also as the active compound is available in ionized state, and the drug can penetrate the skin layer fast which makes the formulation totally patient friendly.
  • the pH of the Chitosan Cream with antibacterial agent - Sodium Fusidate, Clobetasol Propionate as a steroid, Oxiconazole Nitrate as an antifungal of the present invention is from about 3 to 6.
  • ointments that are commercially available are greasy and cosmetically non elegant.
  • the penetration of skin is slow. It is essential that the active drug penetrates the skin for the optimum bio-dermal efficacy.
  • the particle size of the active drug plays an important role here. It is necessary that the active drug is available in colloidal or molecular dispersed state for the product being highly efficacious form.
  • the product of the present invention is highly efficacious due to the pronounced antibacterial & wound healing activity of the active ingredients, which are available in ultra micro-size, colloidal form, which enhances skin penetration.
  • Topical Sodium Fusidate & Oxiconazole Nitrate have profound efficacy in primary & secondary bacterial/fungal skin infections of varied etiology due to their antibacterial/antifungal properties.
  • a drawback of the monotherapy with any topical antibacterial/antifungal has been the relatively slow onset of the effect.
  • Chitosan By employing Fusidic Acid along with Clobetasol Propionate and Oxiconazole Nitrate & Chitosan in a formulation, the properties of antibacterial, antifungal, and anti-inflammatory agents as well as Chitosan are optimized.
  • Chitosan is film forming, biocompatible, non-allergenic material it helps in protecting the skin by acting as a barrier. It further controls the superficial bleeding caused by scratching and also arrests the mobility of pathogens due to its cationic charge.
  • Chitosan in the formulation takes care of many attributes, which are considered to be very much essential in treating skin ailments.
  • the combination of Chitosan with Sodium Fusidate, Clobetasol Propionate, and Oxiconazole Nitrate is unique and novel since this is not available commercially across the globe. The concept of the combination is justified by considering the physical, chemical and therapeutic properties of Chitosan used in combination with Fusidic Acid made in situ from Sodium Fusidate, Clobetasol Propionate and Oxiconazole Nitrate.
  • Another inventive aspect of the present invention is that the addition of a functional excipient in the cream base is not a straight forward process of mere addition.
  • the inventor has found that the compatibility of the functional excipient such as Chitosan with other agents in the cream is of critical importance. This is because incompatibility would compromise the stability of the final product.
  • the inventors have found that well known excipients such as Xanthan Gum and carbomer which have been variously used as stabilizing agents, cannot be used in combination with functional biopolymers such as Chitosan.
  • Excipients for topical dosage forms include Polymers, Surfactants, Waxy Materials, and Emulsifiers etc. Polymers are used as gelling agents, suspending agents, viscosity builders, release modifiers, diluents, etc. Surfactants are used as wetting agents, emulsifiers, solubilising agents, release enhancers, etc. Generally polymers & surfactants may or may not possess ionic charge. They may be anionic or cationic or non-ionic in nature. If anionic excipients are included in the formulation they interact with cationic formulation excipients and produce products which are not homogenous, aesthetically not appealing and give rise to unwanted by products, possible allergens, impurities, toxic substances etc due to incompatibility. Since the dosage is for the treatment of ailing patients, these incompatibilities in the products cannot be accepted and these add more complication to the patients.
  • the inventors carefully screened the excipients which included the polymers and surfactants for developing a formulation. A thorough study was performed after screening the short listed excipients. The possible interactions between the excipients were given much focus and detailed experiments were done.
  • Fusidic Acid provides relief against bacterial infections
  • Clobetasol Propionate provides relief against skin inflammations
  • Oxiconazole Nitrate provides relief against fungal infections
  • the aspects such as like skin protection, bleeding at the site, mobility of pathogens from one site to another, etc are not addressed so far in a single dose therapy that includes Fusidic Acid generated in situ from Sodium Fusidate.
  • This present invention with its single-dose application fills this gap by incorporating Chitosan and tapping the required benefits of skin protection (by way of film forming property), stopping the bleeding (by way of blood clotting property) and immobilization of pathogenic microbes (due to its cationic electrostatic property).
  • Therapeutic value addition by incorporation of a functional excipient in the form of a Chitosan which is a biopolymer in the cream matrix is an integrated sub-set of the following functional attributes of the biopolymer:
  • the present invention with its single-dose therapy reduces the overall treatment time of a serious skin disorder significantly.
  • Preferred embodiment no. 1 A medicinal cream for topical treatment of bacterial skin infections, fungal skin infections, inflammations and for related wound healing including burns wound, wherein said cream comprises an antibacterial agent Sodium Fusidate, an antifungal agent Oxiconazole Nitrate, a corticosteroid Clobetasol
  • Propionate and a biopolymer provided in a cream base, said cream base comprising at least one of each of a preservative, a primary and a secondary emulsifier, a waxy material, a co-solvent, an acid, and water, preferably purified water.
  • Embodiment no. 1 A medicinal cream as disclosed in the preferred embodiment no 1, wherein said cream further comprising any of a group comprising a buffering agent, an antioxidant, a chelating agent, a humectant, or any combination thereof.
  • Embodiment no. 2 A medicinal cream as disclosed in the preferred embodiment no 1 and the embodiment no. 1 , wherein
  • said Fusidic Acid is present in an amount from about 0.1% (w/w) to about
  • the topical corticosteroid is from about 0.001% (w/w) to about 5% (w/w) by weight, preferably from about 0.01% to about 1% by weight and most preferably about 0.05% (w/w) by weight, of Clobetasol Propionate, and, - said antifungal is added from about 0.5% to about 5.0% by weight, preferably from about 0.5% to about 3.0% by weight, and most preferably about 1.0% by weight; said antifungal preferably being Oxiconazole Nitrate, and - said biopolymer is in the form of Chitosan, added in an amount between about 0.01% and about 10% by weight, preferably from about 0.01% w/w to about 1.0% w/w and most preferably about 0.1% w/w, the molecular weight of said chitosan is between lkDal and 5000kDal,
  • said primary and secondary emulsifiers are selected from a group comprising Cetostearyl alcohol, Cetomacrogol-1000, Polysorbate-80, Span-80 and the like and added in an amount from about 1% (w/w) to 20% (w/w), and said waxy materials is selected from a group comprising white soft paraffin, liquid paraffin, hard paraffin and the like, or any combination thereof, added in an amount from about 5% (w/w) to 30% (w/w), said co-solvent is selected from a group comprising Propylene Glycol, Hexylene Glycol, PolyEthylene Glycol-400, Isopropyl Myristate and the like, or any combination thereof, and added in an amount from about 5% (w/w) to 50% (w/w), said acid is selected from a group comprising HC1, H 2 SO 4 , HNO 3 , Lactic acid and the like, or any combination thereof, and added in an amount from about 0.005% (w/w) to
  • Embodiment no.3 A medicinal cream as disclosed in the preferred embodiment no 1 and embodiment 2 further comprising a buffering agent which is selected from a group comprising Di Sodium Hydrogen Ortho Phosphate, Sodium Hydrogen Ortho Phosphate and the like, or any combination thereof, and added in an amount from about 0.001% (w/w) to 10.0% (w/w),
  • Embodiment no. 4 A medicinal cream as disclosed in the preferred embodiment no 1 and embodiments 2 and 3 further comprising an antioxidant which is selected from a group comprising Butylated Hydroxy Anisole, Butylated Hydroxy Toluene and the like, or any combination thereof, and added in an amount from about 0.001% (w/w) to 1 % (w/w).
  • an antioxidant which is selected from a group comprising Butylated Hydroxy Anisole, Butylated Hydroxy Toluene and the like, or any combination thereof, and added in an amount from about 0.001% (w/w) to 1 % (w/w).
  • Embodiment no. 5 A medicinal cream as disclosed in the preferred embodiment no 1 and embodiments nos.2 to 4 further comprising a chelating agent which is selected from a group comprising Disodium EDTA and the like, or any combination thereof, and added in an amount from about 0.05% (w/w) to 1% (w/w).
  • a chelating agent which is selected from a group comprising Disodium EDTA and the like, or any combination thereof, and added in an amount from about 0.05% (w/w) to 1% (w/w).
  • Embodiment no. 6 A medicinal cream as disclosed in the preferred embodiment no 1, and embodiments nos. 2 to 5 further comprising a humectant which is selected from a group comprising Glycerin, Sorbitol, Propylene Glycol and the like, or any combination thereof, and added in an amount from about 5% (w/w) to 50% (w/w).
  • Embodiment no. 7 A medicinal cream as described in the preferred embodiment 1 and embodiments nos.
  • Embodiment no. 8 A medicinal cream as described in the preferred embodiment 1 and embodiments no. 1 to 7 wherein said conversion of Sodium Fusidate into said Fusidic Acid and the following formation of said Fusidic Acid in a finely dispersed form in the final cream base take place in an oxygen-free environment.
  • Embodiment no. 9 A medicinal cream as described in the preferred embodiment 1 and embodiments no. 7 and 8 wherein said oxygen-free environment comprises a gaseous environment formed of inert gas selected from a group comprising carbon dioxide, nitrogen, helium and the like.
  • Preferred embodiment 2 The preferred embodiment of the invention discloses a process to make a dermaceutical cream containing Fusidic Acid, said process comprising the step of using Sodium Fusidate as the raw API and converting it in situ into Fusidic Acid under oxygen-free environment in a cream base.
  • Embodiment No. 10 In an embodiment of the present invention the process of making the composition is disclosed, wherein the step of converting the Sodium Fusidate in situ into Fusidic Acid of the preferred embodiment no. 2 comprises the steps of:
  • heating purified water in the range from 20% (w/w) to 75% (w/w), preferably 25% (w/w) to 50% (w/w), more preferably 25% (w/w) to 40% (w/w), most preferably 27 % (w/w) in a water-phase vessel to 70 0 C to 80 0 C,
  • a preservative selected from a group comprising Methylparaben, Propylparaben, Chlorocresol, Potassium sorbate, Benzoic acid and the like, either singly or any combination thereof, in an amount between 0.05% (w/w) and 0.5% (w/w), preferably 0.25% (w/w), more preferably 0.2% (w/w), more preferably Benzoic acid,
  • waxy materials selected from a group comprising white soft paraffin, liquid paraffin, hard paraffin and the like, either singly or any combination thereof, in an amount between 5% (w/w) and 30% (w/w), preferably 15% (w/w), more preferably 12.5% (w/w), to an oil-phase vessel and melting said wax by heating to 70 0 C to 80 0 C,
  • a primary emulsifier preferably in the form of a non ionic surfactant, selected from a group comprising Cetostearyl alcohol, Cetomacrogol-1000, either singly or any combination thereof, wherein Cetostearyl alcohol is added, in an amount between 1% (w/w) and 20% (w/w), preferably 15% (w/w), more preferably 12.5% (w/w), and Cetomacrogol-1000 is added in an amount between 0.1% (w/w) and 5% (w/w), preferably 1% (w/w), more preferably 0.5% (w/w), and optionally a secondary emulsifier selected from a group comprising Polysorbate-80, Span- 80 and the like, preferably Polysorbate-80, in an amount between 1 and 5% w/w, preferably 1% (w/w) to 3% (w/w), more preferably 2% w/w and mixing the mixture thoroughly, preferably using an agitator, at 10
  • a co-solvent selected from a group comprising Propylene Glycol, Hexylene Glycol, PolyEthylene Glycol-400 and the like, either singly or any combination thereof, in an amount between 5% (w/w) and 50% (w/w), preferably 30% (w/w), more preferably 25% (w/w), preferably propylene glycol, subjecting the contents of said API-vessel to inert gas flushing, said inert gas being preferably nitrogen, and adding Sodium Fusidate to the mixture, said Sodium Fusidate added in an amount between 0.1% (w/w) and about 25% (w/w), preferably from about 0.5% (w/w) to about 5% (w/w) and more preferably about 2.08 % (w/w), and dissolving said Sodium Fusidate to the mixture, said Sodium Fusidate added in an amount between 0.1% (w/w) and about 25% (w/w), preferably from about 0.5% (w/w) to about 5% (w/
  • an acid selected from a group comprising acids such as HC1, H 2 SO 4 , HNO 3 , Lactic acid and the like, either singly or any combination thereof, preferably Nitric acid in an amount from about 0.005% (w/w) to 0.5% (w/w), preferably 0.3% (w/w), more preferably 0.25% (w/w),
  • Clobetasol Propionate added in an amount between 0.001% (w/w) and about 5% (w/w), preferably from about 0.01% (w/w) to about 1% (w/w) and more preferably about 0.05 % (w/w), k.
  • a third API- vessel propylene glycol in an amount between 1 % (w/w) to 10% (w/w), preferably 5% (w/w), more preferably 4% (w/w) and dispersing Oxiconazole Nitrate in it by continuous mixing to form a dispersion, followed by passing said dispersion through a colloid mill, said Oxiconazole Nitrate added in an amount between 0.5% (w/w) and about 5% (w/w), preferably from about
  • a biopolymer-mixing vessel adding an acid, selected from a group comprising acids such as HC1, H 2 SO 4 , HNO 3 , Lactic acid and the like, either singly or any combination thereof, preferably Lactic acid from about 0.005% (w/w) to 0.5% (w/w), preferably 0.3% (w/w), more preferably 0.05% (w/w), and purified water from about 0.1% (w/w) to 10% (w/w), preferably 8% (w/w), more preferably 5% (w/w) to form a mixture and dissolving a biopolymer, preferably Chitosan in an amount between about 0.01% w/w and about 10% w/w, preferably from about 0.01% w/w to about 1.0% w/w, and most preferably about 0.1% w/w, the molecular weight of said chitosan being between lkDal and 5000kDal,
  • step p transferring the contents of the biopolymer-mixing vessel of step o to the mixing vessel of step g with continuous stirring at 10 to 50 RPM and homogenizing the mixture at 1000 to 3000 RPM under inert gas flushing and under vacuum of minus 1000 to minus 300 mm of mercury, said inert gas being preferably nitrogen,
  • Embodiment No. 11 In another embodiment of the present invention the process described in embodiment no. 10 further incorporates adding a buffering agent, after the step of adding a preservative, selected from a group comprising Disodium Hydrogen Orthophosphate and the like, either singly or any combination thereof, from about 0.001% (w/w) to 10% (w/w).
  • a buffering agent selected from a group comprising Disodium Hydrogen Orthophosphate and the like, either singly or any combination thereof, from about 0.001% (w/w) to 10% (w/w).
  • a preservative selected from a group comprising Disodium Hydrogen Orthophosphate and the like, either singly or any combination thereof, from about 0.001% (w/w) to 10% (w/w).
  • the co-solvent of step h of the embodiment no. 11 above also serves as a humectant.
  • an additional humectant may be added, in the step a of embodiment 7,selected from a group comprising Glycerin, Sorbitol, Propylene glycol and the like, either singly or any combination thereof, from about 5% (w/w) to 50% (w/w).
  • Embodiment No. 13 In another embodiment of the present invention the process described in embodiments no. 11 & 12 further incorporates adding a chelating agent, after the step of adding a preservative, selected from a group comprising Disodium EDTA and the like, either singly or any combination thereof, from about 0.05% (w/w) to 1% (w/w).
  • a chelating agent selected from a group comprising Disodium EDTA and the like, either singly or any combination thereof, from about 0.05% (w/w) to 1% (w/w).
  • Embodiment No. 14 In a further embodiment of the present invention the process described in embodiments no. 11 to 13 further incorporate an anti oxidants in the step h of embodiment 10 selected from a group comprising Butylated Hydroxy Anisole, Butylated Hydroxy Toluene and the like from about 0.001% (w/w) to 1% (w/w).
  • Embodiment No. 15 Yet another process of making the composition as per the said earlier preferred embodiments & embodiments is disclosed, said process comprises the steps of a.
  • heating purified water in the range from 20% (w/w) to 75% (w/w), preferably 25% (w/w) to 50% (w/w), more preferably 25% (w/w) to 40% (w/w) most preferably 27 % (w/w) in a water-phase vessel to 70 0 C to 80 0 C,
  • a preservative selected from a group comprising Methylparaben, Propylparaben, Chlorocresol, Potassium sorbate, Benzoic acid and the like, either singly or any combination thereof, added in an amount between 0.05% (w/w) and 0.5% (w/w), preferably 0.25% (w/w), more preferably 0.2% (w/w), the preferred preservative being Benzoic acid, c.
  • a chelating agent is preferably Disodium edetate, added in an amount between 0.05% and 1 % (w/w), preferably 0.5% (w/w), more preferably 0.1% (w/w)
  • said buffering agent is preferably Di Sodium Hydrogen Ortho Phosphate, added in an amount from 0.001% (w/w) to 10.00% (w/w), preferably 0.01% (w/w) to 1.0% (w/w), more preferably 0.5% (w/w)
  • said humectant is preferably Propylene Glycol, added in an amount 5% (w/w) to 50% (w/w), preferably 35% (w/w), more preferably 32% (w/w),
  • step d mixing the mixture of said water-phase vessel of step c using an agitator at 10 to 50 RPM while maintaining the temperature of the mixture at 70°C to 80°C, adding to an oil-phase vessel an emulsifying wax, preferably Cetostearyl alcohol, in an amount between 1% (w/w) and 20 %(w/w), preferably 15% (w/w), more preferably 12.5 %(w/w) and a waxy material, preferably white soft paraffin, in an amount between 5% (w/w) and 30 %(w/w), preferably 15% (w/w), more preferably 12.5 %(w/w), and melting them by heating to 70°C to 80°C, adding to said oil phase vessel a non ionic surfactant or emulsifier, in an amount between 1% and 5 % (w/w), preferably 1% to 3% (w/w) more preferably 2 % (w/w) of Polysorbate 80 and in an amount between 0.1% and 5 % (w/
  • a co-solvent selected from a group comprising Propylene Glycol, Hexylene Glycol, PolyEthylene Glycol-400 adding propylene glycol, or any mixture thereof, in an amount between 5% (w/w) and 50% (w/w), preferably 30% (w/w), more preferably 25% (w/w), and optionally adding and dissolving an antioxidant, selected from a group comprising Butylated Hydroxy Anisole, Butylated Hydroxy Toluene and the like, or any combination thereof, added in an amount between 0.001% (w/w) and 1.0 % (w/w), preferably 0.1%(w/w), more preferably 0.01 % (w/w) Butylated Hydroxy Toluene in it by continuous mixing,
  • said inert gas preferably being nitrogen and adding Sodium Fusidate to the mixture and dissolving it in the mixture, said Sodium Fusidate being added in an amount between 0.1% (w/w) and about 25% (w/w), preferably between 0.5% (w/w) and about 5% (w/w) and more preferably about 2.08% (w/w),
  • an acid selected from a group comprising acids such as HCL, H 2 SO 4 , HNO 3 , lactic acid and the like, either singly or any combination thereof, preferably Nitric acid in an amount preferably between 0.005% (w/w) and 0.5 % (w/w), preferably 0.3 % (w/w), more preferably 0.25% (w/w),
  • Clobetasol Propionate added in an amount between 0.001% (w/w) and about 5% (w/w), preferably from about 0.01% (w/w) to about 1% (w/w) and more preferably about 0.05 % (w/w),
  • an acid selected from a group comprising acids such as HC1, H 2 S0 4 , HNO 3 , Lactic acid and the like, either singly or any combination thereof, preferably Lactic acid from about 0.005% (w/w) to 0.5% (w/w), preferably 0.3% (w/w), more preferably 0.05% (w/w), and purified water from about 0.1% (w/w) to 10% (w/w), preferably 8% (w/w), more preferably 5% (w/w) to form a mixture and dissolving the said biopolymer, Chitosan in an amount between about 0.01% and about 10% by weight, preferably from about 0.01% w/w to about 1% w/w and more preferably about 0.1% w/w, the molecular weight of said chitosan being between lkDal and 5000kDal,
  • step h transferring the contents of the biopolymer mixture of step q to the mixing vessel of step h with continuous stirring at 10 to 50 RPM and homogenizing the mixture at 1000 to 3000 RPM under inert gas flushing and under vacuum of minus 1000 to minus 300 mm of mercury, said inert gas being preferably nitrogen, cooling the contents of said mixing vessel of step h to 30 0 C to 37 0 C using circulation of cooled water from cooling tower at 8 0 C to 15 0 C into the jacket of mixing vessel,
  • step i also serve as a humectant.
  • an additional humectant may be added, selected from a group comprising Glycerin, Sorbitol, Propylene glycol and the like, either singly or any combination thereof, from about 5% (w/w) to 50% (w/w), preferably 35% (w/w), more preferably 32% (w/w).
  • Embodiment no. 16 A method of treating primary & secondary bacterial & fungal skin infections and inflammations said method comprising applying of a cream containing at least one corticosteroid Clobetasol Propionate, one antifungal Oxiconazole Nitrate and Fusidic Acid which is made in situ under oxygen-free environment using Sodium Fusidate, wherein said cream comprises Fusidic Acid made using Sodium Fusidate, a cream base containing a preservative, primary and secondary emulsifiers, waxy materials, co-solvents, acids, and water.
  • Embodiment no. 17 A method of treating primary & secondary bacterial & fungal skin infections and inflammations said method comprising applying of a cream as described in the preferred embodiment 1 and any of embodiments 1 to 9.
  • the cream obtained using the process of the present invention is homogenous and white to off white in colour and viscous in consistency.
  • the pH of the product made using the process of the present invention is from about 3 to 6.
  • Sodium Fusidate ointments that are commercially available are greasy and cosmetically non elegant.
  • the active drug penetrates the skin for the optimum bio-dermal efficacy.
  • the particle size of the active drug plays an important role here. It is necessary that the active drug is available in a finely dispersed form for the product to be being efficacious. Also this is to be achieved in the safe pH compatible environment of skin (4.0 to 6.0). To achieve all these, it is essential to choose proper vehicles or co-solvents for the dissolution or dispersion of the drug.
  • Particle size analysis was carried out on the cream made using the process of the present invention and on some commercially available product samples (samples A, C, D, F, G, and K). An optical microscope by Carl Zeiss (Axio Star Plus 2x to lOOx magnification) was used for this purpose. Maximum and minimum particle sizes, mean particle size and standard deviation and the coefficient of variation were assessed. Table 8: Particle size analysis
  • the particle size distribution analysis results indicated in table 8 clearly indicate the presence of Fusidic Acid of fine particle size in the product of the present invention, the size that is advantageously much reduced than the conventional products.
  • the maximum particle size observed for fusidic acid of the present invention is less than 6 ⁇
  • the maximum particle size observed for existing creams varies between 19 ⁇ to 40 ⁇ , with a majority of them having the maximum particle size between 30 ⁇ and 40 ⁇ .
  • the average size of the fusidic acid particles in the present invention has been found to be approximately 3 ⁇ whereas that for the existing creams varies between 14 ⁇ to 19 ⁇ .
  • the minimum particle size observed was approx. 0.83 ⁇ whereas the minimum particle size observed for existing creams ranged between 5 ⁇ and 10 ⁇ .
  • the cream of the present invention is therefore physically distinct from any of the existing creams and easily distinguishable. This is attributed to the fact that the instant product is made using Sodium Fusidate using in situ conversion of Sodium Fusidate to Fusidic Acid in a finely dispersed form. All of the measured parameters are better than those found for the commercially available creams containing Fusidic Acid. This is another clear advantage of the product disclosed herein over the commercially available products.
  • the product of the present invention is efficacious due to the pronounced antibacterial activity of the regenerated Fusidic Acid, antifungal activity of the Oxiconazole Nitrate, anti-inflammatory activity of the Clobetasol Propionate which is available in reduced particle size than the conventional products, and in a finely dispersed form.
  • the inventor has screened different co-solvents such as Propylene Glycol, Hexylene Glycol, PolyEthyleneGlycol-400 & the like and dissolved the Sodium Fusidate in one of above co-solvents varying from about 5% (w/w) to 50% (w/w) under inert gas purging and under vacuum and converted to Fusidic Acid in-situ by adding an acid such as HC1, H 2 S0 4 , HN0 3 , Lactic acid and the like from about 0.005% (w/w) to about 0.5% (w/w) under stirring and obtained Fusidic Acid in more stabilized and solution form, which makes our final product in a cream base which easily penetrates the skin and highly efficacious, and also highly derma compatible by having a pH of about 3.0 to about 6.0.
  • the stability of the product is confirmed by the stability studies performed for 6 months as per ICH guidelines and a comparison of stress studies done for in-house product with those on samples of commercially available comparable products.
  • API-stability experiments were carried out (see tables 10 - 12) using the product of the present invention and products currently commercially available. Tests were carried out to observe (or measure as appropriate) the physical appearance of the product, the pH value and assay of the API over a period of time. Tests were also carried out to assess the stability by subjecting the product to stress studies such as autoclave test and oxydative degradation test. Further, in vitro antimicrobial zone of inhibition studies and preclinical studies such as blood clotting studies & burns wound healing studies were also carried out over a period of time.
  • Each gram of product of the present invention used for the tests contained Sodium Fusidate as the starting raw material in the amount required to produce approximately 2% (w/w) Fusidic Acid, 0.05% (w/w) Clobetasol Propionate & l%(w/w) Oxiconazole Nitrate in the finished product.
  • the product used for the Stability Studies tests contained approximately 10% extra API (overages).
  • the product of the present invention used for studies contained Fusidic Acid cream prepared using Sodium Fusidate as starting material. It was packaged in an aluminum collapsible tube and each gram of the product contained 20.8 mg of Sodium Fusidate (in conformance with BP), which is equivalent to 20 mg of Fusidic Acid (BP conformant) and appropriate amount of steroids and antifungals as mentioned below.
  • composition of the final cream is given in the table 9 below.
  • PRODUCT Sodium Fusidate + Clobetasol Propionate + Oxiconazole Nitrate Cream
  • PACK Aluminum Collapsible tube
  • composition i) Sodium Fusidate IP equivalent to Fusidic Acid IP
  • product of the present invention is quite stable at ambient conditions and also at elevated temperature & humid conditions of storage. This is a major advantage over the currently available Fusidic Acid creams.
  • the stability of the product is further ascertained by the shelf-life prediction of the formulation using arrhenius plot of degradation employing Nova-LIMS software.
  • the antimicrobial/antibacterial activity of the product is confirmed by the in vitro Zone of Inhibition studies for the product. The results obtained clearly indicate the statistical significance.
  • the cream is applied after thorough cleansing and drying the affected area. Sufficient cream should be applied to cover the affected skin and surrounding area. The cream should be applied two - four times a day depending upon the skin conditions for the full treatment period, even though symptoms may have improved.
  • A. Wound Contraction Excision wound healing activity of the cream of the present invention was determined through animal testing. An excision wound 2.5 cm in diameter was inflicted by cutting away full thickness of the skin. The amount of contraction of the wound observed over a period indicated that the cream of present invention provides significantly improved wound contraction than a control (untreated wound).
  • B. Period Of Epithelisation Epithelisation of the wound occurred within shorter number of days using the cream of the present invention as compared to the days taken for epithelisation using the conventional cream. Therefore one benefit of the cream of the present invention is that it facilitates significantly faster epithelisation of the skin than a control (untreated wound).
  • Blood Clotting time was observed in both groups of animals, untreated control group and the test group of animals treated with the product of the present invention. Statistically significant decrease in the blood clotting time in treated group animals was observed when compared with that of the control group animals. The mean percent reduction of 50-60% was observed for the blood clotting time using the product of the present invention.
  • the therapeutic efficacy of topically applied cream of the present invention is due to the pronounced antibacterial / antifungal activity of the Sodium Fusidate & Oxiconazole Nitrate against the organisms responsible for skin infections, pronounced antiinflammatory activity of the Clobetasol Propionate against inflammations, the unique ability of actives to penetrate intact skin and wound healing & soothing properties of Chitosan.
  • the cream of the present invention incorporates a skin-friendly biopolymer in the form of Chitosan provides enhanced therapeutic outcomes. This is evident from the reduced blood clotting time, increased epithelial effect, and faster relief from infection and inflammation and wound contraction.
  • the cream of the present invention incorporates a biopolymer without compromising the stability of the cream matrix and without adversely affecting the functioning of known active pharmaceutical ingredients. This has been achieved through a careful selection of functional excipients to bypass undesirable aspects of physio-chemical compatibility/stability and bio-release.
  • the cream of the present invention provides an integrated uni-dose or a single-dose therapy hitherto unavailable in prescription dermaceutical formulations.
  • the novel cream of the present invention is adequately stable/efficacious at ambient conditions and does not need special temperature control during transportation/storage - hence will go a long way in achieving these social objectives.

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Abstract

La présente invention concerne une composition médicamenteuse permettant de traiter des inflammations cutanées, des infections cutanées fongiques/bactériennes et des plaies associées, ainsi que d'autres plaies cutanées comprenant celles causées par des brûlures. Ladite crème induit également une réjuvénation cutanée par le biais d'un processus d'épithélisation. Ladite crème comprend du chitosane, du propionate de clobétasol, du nitrate d'oxiconazole et de l'acide fusidique. L'invention concerne également un procédé de préparation de ladite crème médicamenteuse contenant de l'acide fusidique préparé in situ avec du fusidate de sodium comme matière première de départ, lequel fusidate de sodium est transformé en acide fusidique dans un environnement exempt d'oxygène créé à l'aide d'un gaz inerte, de préférence de l'azote, et du chitosane. La crème produite selon le procédé présente une meilleure stabilité à la conservation et une taille particulaire de la substance pharmaceutique active plus fine que les crèmes classiques contenant de l'acide fusidique. La crème produite selon le procédé contient de l'acide fusidique comme substance pharmaceutique active, lequel acide fusidique est produit in situ à partir de fusidate de sodium, du propionate de clobétasol et du nitrate d'oxiconazole, dans une base de crème renfermant un conservateur, un acide, un co-solvant, un émulsifiant et un matériau cireux, ainsi que de l'eau, de préférence de l'eau purifiée.
PCT/IB2011/053402 2010-08-17 2011-08-01 Crème médicamenteuse à base d'acide fusidique préparée avec du fusidate de sodium et comprenant un biopolymère, un corticostéroïde - propionate de clobétasol, et un agent antifongique - nitrate d'oxiconazole, et procédé de préparation correspondant WO2012023077A1 (fr)

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WO1992014472A1 (fr) * 1991-02-22 1992-09-03 Glaxo Group Limited Compositions a administration locale contenant du proprionate de fluticasone ainsi que de l'oxiconazole ou ses sels
US5461068A (en) 1993-09-29 1995-10-24 Corwood Laboratories, Inc. Imidazole derivative tincture and method of manufacture
US6001864A (en) 1995-06-07 1999-12-14 Taisho Pharmaceutical Co., Ltd. Antifungal agent
US20020009422A1 (en) 2000-07-24 2002-01-24 Hauan Diana L. Combination tanning and antifungal topical system for treating tinea versicolor
CN1931164A (zh) 2006-09-20 2007-03-21 西北农林科技大学 一种硝酸咪康唑纳米乳液药物及其制备方法
EP1787652A1 (fr) 2005-11-16 2007-05-23 Happy Foot Composition avec une propriété antifungale et son utilisation
WO2009063493A2 (fr) 2007-09-10 2009-05-22 Glenmark Pharmaceuticals Limited Composition pharmaceutique topique pour la combinaison de l'acide fusidique avec un corticostéroïde
WO2010084458A1 (fr) * 2009-01-21 2010-07-29 Sulur Subramaniam Vanangamudi Nouvelle crème dermaceutique fabriquée à partir de fusidate de sodium, d'antifongiques et de stéroïdes
WO2010084457A1 (fr) * 2009-01-21 2010-07-29 Sulur Subramaniam Vanangamudi Nouvelle crème dermaceutique fabriquée à partir de fusidate de sodium et de stéroïdes

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4911932A (en) 1984-01-18 1990-03-27 Johnson And Johnson Consumer Products, Inc. Skin care compositions
WO1992014472A1 (fr) * 1991-02-22 1992-09-03 Glaxo Group Limited Compositions a administration locale contenant du proprionate de fluticasone ainsi que de l'oxiconazole ou ses sels
US5461068A (en) 1993-09-29 1995-10-24 Corwood Laboratories, Inc. Imidazole derivative tincture and method of manufacture
US6001864A (en) 1995-06-07 1999-12-14 Taisho Pharmaceutical Co., Ltd. Antifungal agent
US20020009422A1 (en) 2000-07-24 2002-01-24 Hauan Diana L. Combination tanning and antifungal topical system for treating tinea versicolor
EP1787652A1 (fr) 2005-11-16 2007-05-23 Happy Foot Composition avec une propriété antifungale et son utilisation
CN1931164A (zh) 2006-09-20 2007-03-21 西北农林科技大学 一种硝酸咪康唑纳米乳液药物及其制备方法
WO2009063493A2 (fr) 2007-09-10 2009-05-22 Glenmark Pharmaceuticals Limited Composition pharmaceutique topique pour la combinaison de l'acide fusidique avec un corticostéroïde
WO2010084458A1 (fr) * 2009-01-21 2010-07-29 Sulur Subramaniam Vanangamudi Nouvelle crème dermaceutique fabriquée à partir de fusidate de sodium, d'antifongiques et de stéroïdes
WO2010084457A1 (fr) * 2009-01-21 2010-07-29 Sulur Subramaniam Vanangamudi Nouvelle crème dermaceutique fabriquée à partir de fusidate de sodium et de stéroïdes

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ANONYMOUS: "Fucicort-Creme", INTERNET CITATION, 14 October 2004 (2004-10-14), pages 1, XP002582673, Retrieved from the Internet <URL:http://www.pharmazie.com/graphic/A/64/1-25564.pdf> [retrieved on 20100518] *
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