WO2022130337A1 - An aqueous sterile solution of atropine for ophthalmic use - Google Patents
An aqueous sterile solution of atropine for ophthalmic use Download PDFInfo
- Publication number
- WO2022130337A1 WO2022130337A1 PCT/IB2021/061961 IB2021061961W WO2022130337A1 WO 2022130337 A1 WO2022130337 A1 WO 2022130337A1 IB 2021061961 W IB2021061961 W IB 2021061961W WO 2022130337 A1 WO2022130337 A1 WO 2022130337A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- solution
- aqueous sterile
- sterile solution
- present
- atropine
- Prior art date
Links
- 239000008174 sterile solution Substances 0.000 title claims abstract description 61
- 229930003347 Atropine Natural products 0.000 title claims description 33
- RKUNBYITZUJHSG-UHFFFAOYSA-N Hyosciamin-hydrochlorid Natural products CN1C(C2)CCC1CC2OC(=O)C(CO)C1=CC=CC=C1 RKUNBYITZUJHSG-UHFFFAOYSA-N 0.000 title claims description 33
- 229960000396 atropine Drugs 0.000 title claims description 33
- RKUNBYITZUJHSG-SPUOUPEWSA-N atropine Chemical compound O([C@H]1C[C@H]2CC[C@@H](C1)N2C)C(=O)C(CO)C1=CC=CC=C1 RKUNBYITZUJHSG-SPUOUPEWSA-N 0.000 title claims description 33
- 239000000243 solution Substances 0.000 claims abstract description 82
- KRKNYBCHXYNGOX-UHFFFAOYSA-N citric acid Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O KRKNYBCHXYNGOX-UHFFFAOYSA-N 0.000 claims abstract description 51
- 239000000872 buffer Substances 0.000 claims abstract description 37
- HOBWAPHTEJGALG-JKCMADFCSA-N [(1r,5s)-8-methyl-8-azoniabicyclo[3.2.1]octan-3-yl] 3-hydroxy-2-phenylpropanoate;sulfate Chemical compound [O-]S([O-])(=O)=O.C([C@H]1CC[C@@H](C2)[NH+]1C)C2OC(=O)C(CO)C1=CC=CC=C1.C([C@H]1CC[C@@H](C2)[NH+]1C)C2OC(=O)C(CO)C1=CC=CC=C1 HOBWAPHTEJGALG-JKCMADFCSA-N 0.000 claims abstract description 25
- 229960002028 atropine sulfate Drugs 0.000 claims abstract description 25
- 230000001681 protective effect Effects 0.000 claims abstract description 24
- 238000010790 dilution Methods 0.000 claims abstract description 17
- 239000012895 dilution Substances 0.000 claims abstract description 17
- NLJMYIDDQXHKNR-UHFFFAOYSA-K sodium citrate Chemical compound O.O.[Na+].[Na+].[Na+].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O NLJMYIDDQXHKNR-UHFFFAOYSA-K 0.000 claims abstract description 17
- 239000001509 sodium citrate Substances 0.000 claims abstract description 17
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Chemical compound O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 21
- VBSTXRUAXCTZBQ-UHFFFAOYSA-N 1-hexyl-4-phenylpiperazine Chemical compound C1CN(CCCCCC)CCN1C1=CC=CC=C1 VBSTXRUAXCTZBQ-UHFFFAOYSA-N 0.000 claims description 18
- JACRWUWPXAESPB-QMMMGPOBSA-N Tropic acid Natural products OC[C@H](C(O)=O)C1=CC=CC=C1 JACRWUWPXAESPB-QMMMGPOBSA-N 0.000 claims description 18
- 229920002413 Polyhexanide Polymers 0.000 claims description 17
- VAZJLPXFVQHDFB-UHFFFAOYSA-N 1-(diaminomethylidene)-2-hexylguanidine Polymers CCCCCCN=C(N)N=C(N)N VAZJLPXFVQHDFB-UHFFFAOYSA-N 0.000 claims description 16
- 229960004106 citric acid Drugs 0.000 claims description 16
- 239000003755 preservative agent Substances 0.000 claims description 16
- 239000003795 chemical substances by application Substances 0.000 claims description 14
- 230000002335 preservative effect Effects 0.000 claims description 13
- 239000008213 purified water Substances 0.000 claims description 12
- ONPJWQSDZCGSQM-UHFFFAOYSA-N 2-phenylprop-2-enoic acid Chemical compound OC(=O)C(=C)C1=CC=CC=C1 ONPJWQSDZCGSQM-UHFFFAOYSA-N 0.000 claims description 10
- 230000004379 myopia Effects 0.000 claims description 10
- 208000001491 myopia Diseases 0.000 claims description 10
- -1 polyethylene Polymers 0.000 claims description 10
- YASYEJJMZJALEJ-UHFFFAOYSA-N Citric acid monohydrate Chemical compound O.OC(=O)CC(O)(C(O)=O)CC(O)=O YASYEJJMZJALEJ-UHFFFAOYSA-N 0.000 claims description 9
- 229960002303 citric acid monohydrate Drugs 0.000 claims description 9
- 229960000999 sodium citrate dihydrate Drugs 0.000 claims description 9
- HRXKRNGNAMMEHJ-UHFFFAOYSA-K trisodium citrate Chemical compound [Na+].[Na+].[Na+].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O HRXKRNGNAMMEHJ-UHFFFAOYSA-K 0.000 claims description 9
- 238000000034 method Methods 0.000 claims description 8
- 239000004698 Polyethylene Substances 0.000 claims description 7
- 229920000573 polyethylene Polymers 0.000 claims description 7
- 229960000686 benzalkonium chloride Drugs 0.000 claims description 6
- CADWTSSKOVRVJC-UHFFFAOYSA-N benzyl(dimethyl)azanium;chloride Chemical compound [Cl-].C[NH+](C)CC1=CC=CC=C1 CADWTSSKOVRVJC-UHFFFAOYSA-N 0.000 claims description 6
- 229920003023 plastic Polymers 0.000 claims description 5
- 239000004033 plastic Substances 0.000 claims description 5
- XLYOFNOQVPJJNP-ZSJDYOACSA-N Heavy water Chemical compound [2H]O[2H] XLYOFNOQVPJJNP-ZSJDYOACSA-N 0.000 claims description 4
- 239000002997 ophthalmic solution Substances 0.000 abstract description 8
- 229940054534 ophthalmic solution Drugs 0.000 abstract description 7
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 22
- 239000000203 mixture Substances 0.000 description 18
- 239000007864 aqueous solution Substances 0.000 description 11
- 239000011780 sodium chloride Substances 0.000 description 11
- 239000012535 impurity Substances 0.000 description 9
- 230000000694 effects Effects 0.000 description 7
- HEMHJVSKTPXQMS-UHFFFAOYSA-M Sodium hydroxide Chemical compound [OH-].[Na+] HEMHJVSKTPXQMS-UHFFFAOYSA-M 0.000 description 6
- 230000000052 comparative effect Effects 0.000 description 6
- 239000007853 buffer solution Substances 0.000 description 5
- 239000007979 citrate buffer Substances 0.000 description 5
- 239000003889 eye drop Substances 0.000 description 5
- 229940012356 eye drops Drugs 0.000 description 5
- 239000003002 pH adjusting agent Substances 0.000 description 5
- 239000008215 water for injection Substances 0.000 description 5
- 230000015556 catabolic process Effects 0.000 description 4
- 239000007857 degradation product Substances 0.000 description 4
- 238000006731 degradation reaction Methods 0.000 description 4
- 238000002360 preparation method Methods 0.000 description 4
- 239000008223 sterile water Substances 0.000 description 4
- QTBSBXVTEAMEQO-UHFFFAOYSA-M Acetate Chemical compound CC([O-])=O QTBSBXVTEAMEQO-UHFFFAOYSA-M 0.000 description 3
- BTBUEUYNUDRHOZ-UHFFFAOYSA-N Borate Chemical compound [O-]B([O-])[O-] BTBUEUYNUDRHOZ-UHFFFAOYSA-N 0.000 description 3
- KCXVZYZYPLLWCC-UHFFFAOYSA-N EDTA Chemical compound OC(=O)CN(CC(O)=O)CCN(CC(O)=O)CC(O)=O KCXVZYZYPLLWCC-UHFFFAOYSA-N 0.000 description 3
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 3
- DNIAPMSPPWPWGF-UHFFFAOYSA-N Propylene glycol Chemical compound CC(O)CO DNIAPMSPPWPWGF-UHFFFAOYSA-N 0.000 description 3
- 229940079593 drug Drugs 0.000 description 3
- 239000003814 drug Substances 0.000 description 3
- 238000012494 forced degradation Methods 0.000 description 3
- 239000012528 membrane Substances 0.000 description 3
- 235000011121 sodium hydroxide Nutrition 0.000 description 3
- 238000003756 stirring Methods 0.000 description 3
- JLVSRWOIZZXQAD-UHFFFAOYSA-N 2,3-disulfanylpropane-1-sulfonic acid Chemical compound OS(=O)(=O)CC(S)CS JLVSRWOIZZXQAD-UHFFFAOYSA-N 0.000 description 2
- URDCARMUOSMFFI-UHFFFAOYSA-N 2-[2-[bis(carboxymethyl)amino]ethyl-(2-hydroxyethyl)amino]acetic acid Chemical compound OCCN(CC(O)=O)CCN(CC(O)=O)CC(O)=O URDCARMUOSMFFI-UHFFFAOYSA-N 0.000 description 2
- RNMCCPMYXUKHAZ-UHFFFAOYSA-N 2-[3,3-diamino-1,2,2-tris(carboxymethyl)cyclohexyl]acetic acid Chemical compound NC1(N)CCCC(CC(O)=O)(CC(O)=O)C1(CC(O)=O)CC(O)=O RNMCCPMYXUKHAZ-UHFFFAOYSA-N 0.000 description 2
- WRMNZCZEMHIOCP-UHFFFAOYSA-N 2-phenylethanol Chemical compound OCCC1=CC=CC=C1 WRMNZCZEMHIOCP-UHFFFAOYSA-N 0.000 description 2
- QFOHBWFCKVYLES-UHFFFAOYSA-N Butylparaben Chemical compound CCCCOC(=O)C1=CC=C(O)C=C1 QFOHBWFCKVYLES-UHFFFAOYSA-N 0.000 description 2
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 2
- VEXZGXHMUGYJMC-UHFFFAOYSA-N Hydrochloric acid Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 2
- 229930195725 Mannitol Natural products 0.000 description 2
- WCUXLLCKKVVCTQ-UHFFFAOYSA-M Potassium chloride Chemical compound [Cl-].[K+] WCUXLLCKKVVCTQ-UHFFFAOYSA-M 0.000 description 2
- 239000004480 active ingredient Substances 0.000 description 2
- 238000003556 assay Methods 0.000 description 2
- OSASVXMJTNOKOY-UHFFFAOYSA-N chlorobutanol Chemical compound CC(C)(O)C(Cl)(Cl)Cl OSASVXMJTNOKOY-UHFFFAOYSA-N 0.000 description 2
- 238000009472 formulation Methods 0.000 description 2
- 150000004677 hydrates Chemical class 0.000 description 2
- 230000036512 infertility Effects 0.000 description 2
- 229920001684 low density polyethylene Polymers 0.000 description 2
- 239000004702 low-density polyethylene Substances 0.000 description 2
- 239000000594 mannitol Substances 0.000 description 2
- 235000010355 mannitol Nutrition 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 230000002911 mydriatic effect Effects 0.000 description 2
- 239000008363 phosphate buffer Substances 0.000 description 2
- 230000004515 progressive myopia Effects 0.000 description 2
- 239000011253 protective coating Substances 0.000 description 2
- 150000003839 salts Chemical class 0.000 description 2
- JHJLBTNAGRQEKS-UHFFFAOYSA-M sodium bromide Chemical compound [Na+].[Br-] JHJLBTNAGRQEKS-UHFFFAOYSA-M 0.000 description 2
- 238000012430 stability testing Methods 0.000 description 2
- 230000001954 sterilising effect Effects 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 229920003169 water-soluble polymer Polymers 0.000 description 2
- JCIIKRHCWVHVFF-UHFFFAOYSA-N 1,2,4-thiadiazol-5-amine;hydrochloride Chemical compound Cl.NC1=NC=NS1 JCIIKRHCWVHVFF-UHFFFAOYSA-N 0.000 description 1
- CHHHXKFHOYLYRE-UHFFFAOYSA-M 2,4-Hexadienoic acid, potassium salt (1:1), (2E,4E)- Chemical compound [K+].CC=CC=CC([O-])=O CHHHXKFHOYLYRE-UHFFFAOYSA-M 0.000 description 1
- QCQCHGYLTSGIGX-GHXANHINSA-N 4-[[(3ar,5ar,5br,7ar,9s,11ar,11br,13as)-5a,5b,8,8,11a-pentamethyl-3a-[(5-methylpyridine-3-carbonyl)amino]-2-oxo-1-propan-2-yl-4,5,6,7,7a,9,10,11,11b,12,13,13a-dodecahydro-3h-cyclopenta[a]chrysen-9-yl]oxy]-2,2-dimethyl-4-oxobutanoic acid Chemical compound N([C@@]12CC[C@@]3(C)[C@]4(C)CC[C@H]5C(C)(C)[C@@H](OC(=O)CC(C)(C)C(O)=O)CC[C@]5(C)[C@H]4CC[C@@H]3C1=C(C(C2)=O)C(C)C)C(=O)C1=CN=CC(C)=C1 QCQCHGYLTSGIGX-GHXANHINSA-N 0.000 description 1
- 241001465356 Atropa belladonna Species 0.000 description 1
- UXVMQQNJUSDDNG-UHFFFAOYSA-L Calcium chloride Chemical compound [Cl-].[Cl-].[Ca+2] UXVMQQNJUSDDNG-UHFFFAOYSA-L 0.000 description 1
- LZZYPRNAOMGNLH-UHFFFAOYSA-M Cetrimonium bromide Chemical compound [Br-].CCCCCCCCCCCCCCCC[N+](C)(C)C LZZYPRNAOMGNLH-UHFFFAOYSA-M 0.000 description 1
- 108010009685 Cholinergic Receptors Proteins 0.000 description 1
- FBPFZTCFMRRESA-FSIIMWSLSA-N D-Glucitol Natural products OC[C@H](O)[C@H](O)[C@@H](O)[C@H](O)CO FBPFZTCFMRRESA-FSIIMWSLSA-N 0.000 description 1
- FBPFZTCFMRRESA-JGWLITMVSA-N D-glucitol Chemical compound OC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-JGWLITMVSA-N 0.000 description 1
- WQZGKKKJIJFFOK-QTVWNMPRSA-N D-mannopyranose Chemical compound OC[C@H]1OC(O)[C@@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-QTVWNMPRSA-N 0.000 description 1
- VGGSQFUCUMXWEO-UHFFFAOYSA-N Ethene Chemical compound C=C VGGSQFUCUMXWEO-UHFFFAOYSA-N 0.000 description 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- 239000004354 Hydroxyethyl cellulose Substances 0.000 description 1
- 229920000663 Hydroxyethyl cellulose Polymers 0.000 description 1
- 229920002153 Hydroxypropyl cellulose Polymers 0.000 description 1
- 208000006550 Mydriasis Diseases 0.000 description 1
- QPCDCPDFJACHGM-UHFFFAOYSA-N N,N-bis{2-[bis(carboxymethyl)amino]ethyl}glycine Chemical compound OC(=O)CN(CC(O)=O)CCN(CC(=O)O)CCN(CC(O)=O)CC(O)=O QPCDCPDFJACHGM-UHFFFAOYSA-N 0.000 description 1
- 229910019142 PO4 Inorganic materials 0.000 description 1
- 239000002202 Polyethylene glycol Substances 0.000 description 1
- 239000004743 Polypropylene Substances 0.000 description 1
- CZMRCDWAGMRECN-UGDNZRGBSA-N Sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 description 1
- 229930006000 Sucrose Natural products 0.000 description 1
- QAOWNCQODCNURD-UHFFFAOYSA-L Sulfate Chemical compound [O-]S([O-])(=O)=O QAOWNCQODCNURD-UHFFFAOYSA-L 0.000 description 1
- YDONNITUKPKTIG-UHFFFAOYSA-N [Nitrilotris(methylene)]trisphosphonic acid Chemical compound OP(O)(=O)CN(CP(O)(O)=O)CP(O)(O)=O YDONNITUKPKTIG-UHFFFAOYSA-N 0.000 description 1
- 102000034337 acetylcholine receptors Human genes 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 229930013930 alkaloid Natural products 0.000 description 1
- 150000003797 alkaloid derivatives Chemical class 0.000 description 1
- 239000005557 antagonist Substances 0.000 description 1
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 description 1
- KGBXLFKZBHKPEV-UHFFFAOYSA-N boric acid Chemical compound OB(O)O KGBXLFKZBHKPEV-UHFFFAOYSA-N 0.000 description 1
- 239000004327 boric acid Substances 0.000 description 1
- 150000001642 boronic acid derivatives Chemical class 0.000 description 1
- 229940067596 butylparaben Drugs 0.000 description 1
- 239000001110 calcium chloride Substances 0.000 description 1
- 229910001628 calcium chloride Inorganic materials 0.000 description 1
- 229960002798 cetrimide Drugs 0.000 description 1
- 239000002738 chelating agent Substances 0.000 description 1
- 229960004926 chlorobutanol Drugs 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 230000002860 competitive effect Effects 0.000 description 1
- 238000013329 compounding Methods 0.000 description 1
- 230000001010 compromised effect Effects 0.000 description 1
- 201000000255 cycloplegia Diseases 0.000 description 1
- 239000008121 dextrose Substances 0.000 description 1
- 229940124274 edetate disodium Drugs 0.000 description 1
- 229960001484 edetic acid Drugs 0.000 description 1
- BEFDCLMNVWHSGT-UHFFFAOYSA-N ethenylcyclopentane Chemical compound C=CC1CCCC1 BEFDCLMNVWHSGT-UHFFFAOYSA-N 0.000 description 1
- 238000011049 filling Methods 0.000 description 1
- 238000001914 filtration Methods 0.000 description 1
- 230000007062 hydrolysis Effects 0.000 description 1
- 238000006460 hydrolysis reaction Methods 0.000 description 1
- 235000019447 hydroxyethyl cellulose Nutrition 0.000 description 1
- 239000001863 hydroxypropyl cellulose Substances 0.000 description 1
- 235000010977 hydroxypropyl cellulose Nutrition 0.000 description 1
- 239000001866 hydroxypropyl methyl cellulose Substances 0.000 description 1
- 229920003088 hydroxypropyl methyl cellulose Polymers 0.000 description 1
- 235000010979 hydroxypropyl methyl cellulose Nutrition 0.000 description 1
- UFVKGYZPFZQRLF-UHFFFAOYSA-N hydroxypropyl methyl cellulose Chemical compound OC1C(O)C(OC)OC(CO)C1OC1C(O)C(O)C(OC2C(C(O)C(OC3C(C(O)C(O)C(CO)O3)O)C(CO)O2)O)C(CO)O1 UFVKGYZPFZQRLF-UHFFFAOYSA-N 0.000 description 1
- 239000005414 inactive ingredient Substances 0.000 description 1
- 125000001449 isopropyl group Chemical group [H]C([H])([H])C([H])(*)C([H])([H])[H] 0.000 description 1
- 229940113094 isopropylparaben Drugs 0.000 description 1
- 229910021645 metal ion Inorganic materials 0.000 description 1
- 238000011169 microbiological contamination Methods 0.000 description 1
- 230000003551 muscarinic effect Effects 0.000 description 1
- 125000005430 oxychloro group Chemical group 0.000 description 1
- 238000010979 pH adjustment Methods 0.000 description 1
- 230000001734 parasympathetic effect Effects 0.000 description 1
- 239000013618 particulate matter Substances 0.000 description 1
- 229960003330 pentetic acid Drugs 0.000 description 1
- 150000002978 peroxides Chemical class 0.000 description 1
- 239000000546 pharmaceutical excipient Substances 0.000 description 1
- WVDDGKGOMKODPV-ZQBYOMGUSA-N phenyl(114C)methanol Chemical compound O[14CH2]C1=CC=CC=C1 WVDDGKGOMKODPV-ZQBYOMGUSA-N 0.000 description 1
- 229940067107 phenylethyl alcohol Drugs 0.000 description 1
- 229940096826 phenylmercuric acetate Drugs 0.000 description 1
- PDTFCHSETJBPTR-UHFFFAOYSA-N phenylmercuric nitrate Chemical compound [O-][N+](=O)O[Hg]C1=CC=CC=C1 PDTFCHSETJBPTR-UHFFFAOYSA-N 0.000 description 1
- NBIIXXVUZAFLBC-UHFFFAOYSA-K phosphate Chemical compound [O-]P([O-])([O-])=O NBIIXXVUZAFLBC-UHFFFAOYSA-K 0.000 description 1
- 239000010452 phosphate Substances 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 239000001267 polyvinylpyrrolidone Substances 0.000 description 1
- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 1
- 235000013855 polyvinylpyrrolidone Nutrition 0.000 description 1
- 239000001103 potassium chloride Substances 0.000 description 1
- 235000011164 potassium chloride Nutrition 0.000 description 1
- 239000004302 potassium sorbate Substances 0.000 description 1
- 235000010241 potassium sorbate Nutrition 0.000 description 1
- 229940069338 potassium sorbate Drugs 0.000 description 1
- 210000001747 pupil Anatomy 0.000 description 1
- 150000004728 pyruvic acid derivatives Chemical class 0.000 description 1
- 239000004334 sorbic acid Substances 0.000 description 1
- 235000010199 sorbic acid Nutrition 0.000 description 1
- 229940075582 sorbic acid Drugs 0.000 description 1
- 239000000600 sorbitol Substances 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 230000000638 stimulation Effects 0.000 description 1
- 239000005720 sucrose Substances 0.000 description 1
- 150000003467 sulfuric acid derivatives Chemical class 0.000 description 1
- 230000002889 sympathetic effect Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- RTKIYNMVFMVABJ-UHFFFAOYSA-L thimerosal Chemical compound [Na+].CC[Hg]SC1=CC=CC=C1C([O-])=O RTKIYNMVFMVABJ-UHFFFAOYSA-L 0.000 description 1
- 229940033663 thimerosal Drugs 0.000 description 1
- 238000011200 topical administration Methods 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
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
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0048—Eye, e.g. artificial tears
-
- 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
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/46—8-Azabicyclo [3.2.1] octane; Derivatives thereof, e.g. atropine, cocaine
-
- 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
- A61K47/02—Inorganic compounds
-
- 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
- A61K47/12—Carboxylic acids; Salts or anhydrides thereof
-
- 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
- A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
- A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
-
- 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
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
Definitions
- the present invention relates to an aqueous sterile solution of atropine or its pharmaceutically acceptable salts for ophthalmic use, wherein the solution is filled in a light protective container.
- Myopia is an ophthalmic condition affecting more than l/5 th of the world population, especially children.
- Atropine is currently the most effective therapy for myopia control.
- Berton et al “Stability of Ophthalmic Atropine Solutions for Child Myopia Control” teaches that 1% concentration atropine eye drops is effective in controlling myopic progression but causes important visual side effects resulting from cycloplegia and mydriasis.
- Several clinical trials have evaluated the safety and efficiency of atropine eye drops at lower concentrations and demonstrated that low-dose atropine eye drops such as 0.01% resulted in retardation of myopia progression, with significantly less side effects compared to higher concentration preparation.
- Atropine Sulfate is the sulfate salt of atropine, a naturally -occurring alkaloid isolated from the plant Atropa belladonna. It functions as a sympathetic, competitive antagonist of muscarinic cholinergic receptors, thereby abolishing the effects of parasympathetic stimulation.
- atropine eye drops Several clinical trials have evaluated the safety and efficacy of atropine eye drops and have demonstrated that atropine eye drops helped in retardation of myopia progression, with significantly less side effects compared to higher concentration preparation.
- the present invention provides an aqueous sterile solution for ophthalmic use filled in a light protective container said solution comprising: a. atropine sulfate at a concentration ranging from 0.001 % to 0.05 % w/v, b. buffer consisting of sodium citrate and citric acid, and c. purified sterile water, wherein the pH of the solution ranges from 4.5 to 5.8, and the solution is to be instilled in the eye without dilution or reconstitution.
- the present invention provides an aqueous sterile solution for ophthalmic use filled in a light protective container said solution comprising: a. atropine sulfate at a concentration ranging from 0.01 % w/v, b. buffer consisting of sodium citrate and citric acid, c. polyhexamethylene biguanide hydrochloride, and d. punned sterile water, wherein the pH of the solution ranges is about 5.5, and the solution is to be instilled in the eye without dilution or reconstitution.
- sterile as used in the context of the invention means a solution that has been brought to a state of sterility and has not been subsequently exposed to microbiological contamination, i.e. the sterility of the aqueous solution present in the container has not been compromised.
- light protective container means a container that protects the contents from the effects of light by virtue of the specific properties of the material of which it is composed, including any coating applied to it, such as, for example, an opaque container or amber coloured container or a container coated with a light protective coating and the like.
- the solution is to be instilled in the eye without dilution or reconstitution” as used herein refers to direct topical administration of the aqueous drug solution to the eye of patient without involving any intermediate steps of manipulation, dilution, reconstitution, dispensing, sterilization, transfer, handling or compounding before administration of the drug solution.
- the aqueous drug solution is ready to use or ready to administer, which is meant for direct administration topically from the container to the eye of patient in need thereof, without dilution or reconstitution.
- stable means that the aqueous solution filled in the container is physically as well as chemically stable when stored at room temperature for a period of at least 6 months, preferably 12 months, more preferably 18 months, or more.
- the aqueous solution has been also found to be stable when stored at forced degradation conditions such as 60°C for 28 days.
- the aqueous solution is stable upon storage at the accelerated stability condition of 40°C/25% relative humidity (RH) for at least 1 month, preferably 3 months, more preferably, 6 months.
- RH relative humidity
- physical stability it means that the solution remains clear and colourless and free of any visible particulate matter upon storage.
- tropic acid is not generated and the levels are not detected upon storage.
- the level of tropic acid upon storage at room temperature (25 °C and 60 % relative humidity) for a period of 6 months is not more than 0.5 % by weight of atropine, preferably not more than 0.2 % by weight of atropine.
- the level of tropic acid upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 7.0 % by weight of atropine.
- the level of atropic acid upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 1.0 % by weight of atropine.
- the level of apotropine upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months is not more than 1.0 % by weight of atropine.
- the level of total impurities upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 7.0 % by weight of atropine.
- the assay of atropine remains within 93.0 % - 107.0 %, upon storage at room temperature for at least 3 months, preferably 6 months, more preferably 12 months.
- the present invention provides an aqueous sterile solution for ophthalmic use fdled in a light protective container said solution comprising: a. atropine sulfate at a concentration ranging from 0.001 to 0.05 % w/v, b. buffer consisting essentially of sodium citrate and citric acid, and c. purified sterile water, wherein the pH of the solution ranges from 4.5 to 5.8, and the solution is to be instilled in the eye without dilution or reconstitution.
- aqueous solution of the present invention contains a buffer having mainly sodium citrate and citric acid or hydrates thereof.
- the aqueous sterile solution for ophthalmic use according to the present invention comprises atropine sulfate as a sole therapeutically active ingredient. It is present in an amount ranging from about 0.001 % to 0.05 % w/v, preferably from about 0.005 % to 0.015 % w/v, more preferably, 0.006, 0.065, 0.007, 00075, 0.008, 0.0085, 0.009, 0.0095, 0.01, and/or 0.015 % w/v. In one preferred embodiment, atropine sulfate is present in the ophthalmic solution in an amount of 0.01 % w/v.
- the aqueous sterile solution for ophthalmic use according to the present invention comprises other pharmaceutically acceptable excipients, which may include, but are not limited to, pH adjusting agent/s, buffers, tonicity adjusting agents and preservatives.
- the vehicle used for formulating the aqueous sterile solution of the present invention is purified/sterile water.
- the active and inactive ingredients are dissolved in purified water to form a clear and colorless aqueous solution.
- the aqueous sterile solution of the present invention is free of deuterated water.
- the aqueous sterile solution for ophthalmic use according to the present invention has a pH in the range of about 3.5 to 6.0, preferably, from about 4.5 to 5.8, more preferably, 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7 or 5.8, or intermediate values thereof.
- the pH of the solution is 4.8 ⁇ 0.2, more preferably 4.89 ⁇ 0.2.
- the pH of the solution is 5.5 ⁇ 0.2.
- the pH of the solution may be adjusted using a pH adjusting agent/s and/or a buffer.
- the pH adjusting agents that may be used in the ophthalmic solution according to the present invention include, but are not limited to, hydrochloric acid, sodium hydroxide or mixtures thereof.
- the aqueous sterile solution for ophthalmic use according to the present invention comprises a buffer.
- the buffer that is preferably used is a citrate buffer, which consists of a mixture of citric acid and sodium citrate or hydrates thereof.
- the citrate buffer is present in the aqueous solution at a concentration ranging from 0.01 to 1.5 % w/v, for example, 0.01% w/v, 0.02% w/v, 0.03% w/v, 0.04% w/v, 0.05% w/v, 0.055% w/v, 0.06% w/v, 0.065% w/v, 0.07% w/v, 0.075% w/v, 0.08% w/v, 0.085% w/v, 0.09% w/v, 0.095% w/v, 0.1% w/v, 0.2% w/v, 0.3% w/v, 0.4% w/v, 0.5% w/v, 0.6% w/v, 0.7%
- the citrate buffer consists of citric acid monohydrate and sodium citrate dihydrate.
- Citric acid monohydrate may be present at a concentration ranging from 0.005 to 0.5 % w/v, preferably, at a concentration of 0.01 % to 0.3 % w/v, for example, 0.01 % w/v, 0.02% w/v, 0.03% w/v, 0.04% w/v, 0.05% w/v, 0.06% w/v, 0.07% w/v, 0.08% w/v, 0.09% w/v, 0.1% w/v, 0.2% w/v, or 0.3% w/v, and sodium citrate dihydrate may be present at a concentration ranging from 0.02 % to 1.0 % w/v, preferably, 0.03 % to 0.8 % w/v, more preferably, , more preferably,
- the aqueous sterile solution for ophthalmic use according to the present invention comprises a tonicity adjusting agent.
- the tonicity adjusting agent that may be used in the ophthalmic solution according to the present invention includes, but is not limited to, polyethylene glycol, propylene glycol, glycerol, sodium chloride, potassium chloride, sodium bromide, calcium chloride, mannitol, sorbitol, dextrose, sucrose, mannose and the like and mixtures thereof.
- the tonicity adjusting agent used in the ophthalmic solution according to the present invention is sodium chloride.
- Sodium chloride may be present in the solution at a concentration ranging from about 0.3 % to 0.9 % w/v.
- a combination of sodium chloride and mannitol may be used as tonicity adjusting agent.
- only sodium chloride is used as a tonicity adjusting agent at a concentration ranging from 0.7 to 0.9 % w/v.
- the aqueous sterile solution of the present invention is characterized by osmolalities of 250 to 350 mOsm/kg, preferably, 270-350 mOsm/kg, more preferably, 275, 280, 285, 290, 295, 300, 305, 310, 315, 320, 325, 330, 335, 340 or 345 mOsm/kg.
- the aqueous sterile solution for ophthalmic use according to the present invention further comprises a preservative such as polyhexamethylene biguanide or its salt like hydrochloride salt, benzyl alcohol, cetrimide, chlorobutanol, mercurial preservatives like phenylmercuric nitrate, phenylmercuric acetate, thimerosal, phenylethyl alcohol, polyquad®, stabilized peroxides and perborates, stabilized oxychloro compounds, edetate disodium, boric acid, borates, parabens (such as methyl-propyl, isopropyl and butylparaben), pyruvates, sorbic acid/potassium sorbate, metal ions, and the like and mixtures thereof.
- a preservative such as polyhexamethylene biguanide or its salt like hydrochloride salt, benzyl alcohol, cetrimide, chlorobutanol
- the ophthalmic solution according to the present invention contains polyhexamethylene biguanide.
- the polyhexamethylene biguanide may be present at a concentration ranging from 0.001 % to 0.5 % w/v, preferably, at a concentration ranging from 0.002 % to 0.5 % w/v, more preferably, 0.005 % w/v ,0.01% w/v, 0.015% w/v, 0.02% w/v, 0.025% w/v, 0.03% w/v, 0.035% w/v, 0.04 % w/v, 0.045% w/v , 0.05% w/v, 0.1% w/v, 0.15% w/v, 0.2% w/v, 0.25% w/v, 0.30% w/v, 0.35% w/v, 0.40% w/v, 0.45% w/v or 0.5 % w/v.
- polyhexamethylene biguanide as a preservative has been found to be advantageous over other widely used preservatives like benzalkonium chloride because an aqueous solution comprising polyhexamethylene biguanide shows lower mydriatic action than a solution which comprises benzalkonium chloride. It is noteworthy that mydriatic action, which leads to dilatation of pupil, is undesirable for the treatment of myopia.
- the aqueous sterile solution for ophthalmic use according to the present invention is free of chelating agents, such as, ethylenediamine tetraacetic acid (EDTA), cyclohexanediamine tetraacetic acid (CDTA), hydroxyethylethylenediamine triacetic acid (HEDTA), diethylenetriamine pentaacetic acid (DTP A), dimercaptopropane sulfonic acid (DMPS), dimercaptosuccmic acid (DMSA), and aminotrimethylene phosphonic acid (ATP A).
- chelating agents such as, ethylenediamine tetraacetic acid (EDTA), cyclohexanediamine tetraacetic acid (CDTA), hydroxyethylethylenediamine triacetic acid (HEDTA), diethylenetriamine pentaacetic acid (DTP A), dimercaptopropane sulfonic acid (DMPS), dimercaptosuccmic acid (DMSA), and aminotrimethylene
- the aqueous sterile solution for ophthalmic use according to the present invention is free of water soluble polymers, for example, hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyvinylpyrrolidone and the like.
- the aqueous sterile solution for ophthalmic use according to the present invention is filled into a light protective container which protects the aqueous solution contained therein from the effects of light by virtue of the specific properties of the material of which it is composed, for example, a container being opaque or amber coloured or a container coated with a light protective coating.
- Light protective containers that may be used include, but are not limited to, opaque polyethylene, polypropylene or low-density polyethylene containers.
- the aqueous stable solution for ophthalmic use according to the present invention is filled into a light protective opaque polyethylene plastic bottle.
- the light protective container may be in single-use format or multi -dose format.
- the aqueous sterile solution for ophthalmic use according to the present invention comprises a low concentration of atropine sulfate (0.005 to 0.015 % w/v), citrate buffer to maintain the pH of the solution in the range of 4.5 to 5.8, polyhexamethylene biguanide as a preservative, a tonicity adjusting agent and a pH adjusting agent, wherein the solution is free of benzalkonium chloride, deuterated water and water soluble polymers.
- the aqueous sterile solution for ophthalmic use is filled in a light protective container and comprises: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, and c. purified water, wherein the pH of the solution is 4.8 ⁇ 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
- an aqueous sterile solution for ophthalmic use filled in a light protective container comprising: a. atropine sulfate at a concentration of about 0.01 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, c. polyhexamethylene biguanide, and d. purified water, wherein the pH of the solution ranges from 4.5 to 5.8 and the solution is to be instilled in the eye without dilution or reconstitution.
- an aqueous sterile solution for ophthalmic use filled in a light protective container said solution consisting essentially of: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, c. polyhexamethylene biguanide at a concentration ranging from 0.001 % to 0.5 % w/v, d. a tonicity adjusting agent consisting essentially of sodium chloride, and e. purified water; wherein the pH of the solution is 4.8 ⁇ 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
- an aqueous sterile solution for ophthalmic use filled in a light protective container said solution consisting essentially of: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting essentially of sodium citrate at a concentration ranging from 0.03 % to 0.8 % w/v and citric acid at a concentration ranging from 0.005 % to 0.5 w/v, c. polyhexamethylene biguanide at a concentration ranging from 0.001 % to 0.5 % w/v, d. a tonicity adjusting agent consisting essentially of sodium chloride, and e. purified water, wherein the pH of the solution is 4.8 ⁇ 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
- the aqueous sterile solution for ophthalmic use is filled in a light protective container, said solution consisting of: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting of sodium citrate dihydrate at concentration of about 0.055 %w/v and citric acid monohydrate at the concentration of about 0.01% w/v, c. polyhexamethylene biguanide at a concentration of 0.005 % w/v, d. sodium chloride, and e. purified water, wherein the pH of the solution is 4.8 ⁇ 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
- a method of treating myopia comprising administering to a patient in need thereof an aqueous sterile solution for ophthalmic use filled in a light protective container, said solution comprising: a. atropine sulfate at a concentration ranging from 0.001 % to 0.05 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, and c. purified water, wherein the pH of the solution ranges from 4.5 to 5.5 and the solution is to be instilled in the eye without dilution or reconstitution.
- a method of treating myopia comprising administering to a patient in need thereof an aqueous sterile solution as disclosed in any one of the preceding embodiments.
- the present invention provides a process of preparing an aqueous sterile solution for ophthalmic use involving the steps of:
- Sterilizing the solution preferably by filtering it through membrane filter to get sterile solution; and filling the solution in an opaque container like a light protective polyethylene plastic bottle.
- Table 1 below gives composition details of an ophthalmic solution according to one preferred embodiment of the present invention.
- Table 1 Composition details q.s.: quantity sufficient, # Only if required for pH adjustment.
- Method of preparation of Composition A The dispensed quantity of the sodium citrate dihydrate and citric acid monohydrate were dissolved in water for injection. To this buffer solution, the dispensed quantity of polyhexamethylene biguanide was added under stirring and dissolved. The dispensed quantity of atropine sulfate was added to the solution containing the buffer and preservative. After that, the dispensed quantity of sodium chloride was added to the solution containing the buffer, preservative and atropine. The pH of the solution was 4.8. The volume was made up to 100 % with water for injection. The formulation was filtered through a membrane filter to get the sterile solution. The above solution was filled in opaque light protective polyethylene plastic bottles.
- Method of preparation of Composition B The dispensed quantity of the sodium citrate dihydrate and citric acid monohydrate were dissolved in water for injection. To this buffer solution, the dispensed quantity of polyhexamethylene biguanide was added under stirring and dissolved. The dispensed quantity of atropine sulfate was added to the solution containing the buffer and preservative. After that, the dispensed quantity of sodium chloride was added to the solution containing the buffer, preservative and atropine. The pH was adjusted to 5.5 using sodium hydroxide. The volume was made up to 100 % with water for injection. The formulation was filtered through a membrane filter to get the sterile solution. The above solution was filled in an opaque light protective polyethylene plastic bottles.
- composition A was tested for storage stability at room temperature (25°C and 60 % relative humidity) and was found to be physically and chemically stable upon storage. Stability results upon storage at room temperature are given below in Table 2.
- composition B was tested for storage stability at 20°C and 35% relative humidity and at the accelerated stability condition of 40°C/25%RH. Composition B was found to be physically and chemically stable upon storage. The assay of atropine sulfate was found within the specified limit of 93.0 % - 107.0 %. Further, the levels of impurities (tropic acid, atropic acid, and apotropine) and total impurities were found within the specified limit. Stability results upon storage at room temperature for Composition B are given below in Table 4.
- Ophthalmic solutions of atropine sulfate were prepared using the same procedure as explained in Example I.
- the compositions were prepared using different buffer systems such as acetate, borate and phosphate as described in comparative Examples II, III and IV and without use of buffers as per comparative Example la.
- Table 4 Compositions of Atropine with different buffer system. q.s.: quantity sufficient.
- the above compositions of comparative examples were filled in opaque light protective polyethylene bottles. Stability testing was carried out at forced degradation condition of 60°C at different time points. The stability study was also carried out at the accelerated stability condition of 40°C/25%RH. The stability results upon storage are disclosed in Table 5 below.
- Table 5 Stability Results for comparative Examples la to IV From the stability data set forth in Tables 2, 3 and 5, it was surprisingly found that when a citrate buffer consisting of citric acid and sodium citrate was used, there occurs no increase in the tropic acid impurity levels and no levels were detected. In contrast, other buffers as described in comparative Examples II, III and IV surprisingly caused increase in the tropic acid levels. The atropine solution prepared without using any buffer also showed an increased tropic acid level.
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Abstract
The present invention relates to an aqueous, sterile ophthalmic solution of low strength atropine sulfate, which is storage stable. Particularly, the present invention provides a stable, aqueous, sterile solution of atropine sulfate for ophthalmic use, filled in a light protective container, said solution comprising atropine sulfate and a buffer of sodium citrate and citric acid, wherein the pH of the solution ranges from 4.5 to 5.8 and the solution is to be instilled in the eye without dilution or reconstitution.
Description
AN AQUEOUS STERIUE SOEUTION OF ATROPINE FOR OPHTHAEMIC USE FIELD OF THE INVENTION
The present invention relates to an aqueous sterile solution of atropine or its pharmaceutically acceptable salts for ophthalmic use, wherein the solution is filled in a light protective container.
BACKGROUND OF THE INVENTION
Myopia is an ophthalmic condition affecting more than l/5th of the world population, especially children. Atropine is currently the most effective therapy for myopia control. Berton et al, “Stability of Ophthalmic Atropine Solutions for Child Myopia Control” teaches that 1% concentration atropine eye drops is effective in controlling myopic progression but causes important visual side effects resulting from cycloplegia and mydriasis. Several clinical trials have evaluated the safety and efficiency of atropine eye drops at lower concentrations and demonstrated that low-dose atropine eye drops such as 0.01% resulted in retardation of myopia progression, with significantly less side effects compared to higher concentration preparation.
Atropine Sulfate is the sulfate salt of atropine, a naturally -occurring alkaloid isolated from the plant Atropa belladonna. It functions as a sympathetic, competitive antagonist of muscarinic cholinergic receptors, thereby abolishing the effects of parasympathetic stimulation. Several clinical trials have evaluated the safety and efficacy of atropine eye drops and have demonstrated that atropine eye drops helped in retardation of myopia progression, with significantly less side effects compared to higher concentration preparation.
Till date, however, there appears to be a need of an improved, stable aqueous solution of atropine that is robust in terms of chemical stability. In fact, the inventors of the present invention while developing a robust aqueous sterile solution of atropine that can be directly instilled into the eyes without any further need of dilution or reconstitution, faced with a problem of generation of unwanted degradation product of atropine, particularly tropic acid, atropic acid and apotropine. Tropic acid is generated as a result of hydrolysis of atropine. The structure of the tropic acid is given in Formula I below:
Formula I
It is surprisingly found by the present inventors that when sodium citrate and citric acid are used as a buffer, there occurs no substantial increase in the level of these degradation products upon storage. For example, tropic acid, atropic acid and apotropine were found to be within the specified limit of NMT 7.0%, NMT 1.0% and NMT 1.0%, respectively, upon storage. Surprisingly, other buffers, such as acetate, borate and phosphate buffer, were less effective at controlling these degradation products, particularly tropic acid generation. Also, atropine solution prepared without using any buffer was similarly less effective at controlling generation of these degradation products.
SUMMARY OF THE INVENTION
The present invention provides an aqueous sterile solution for ophthalmic use filled in a light protective container said solution comprising: a. atropine sulfate at a concentration ranging from 0.001 % to 0.05 % w/v, b. buffer consisting of sodium citrate and citric acid, and c. purified sterile water, wherein the pH of the solution ranges from 4.5 to 5.8, and the solution is to be instilled in the eye without dilution or reconstitution.
In another embodiment, the present invention provides an aqueous sterile solution for ophthalmic use filled in a light protective container said solution comprising: a. atropine sulfate at a concentration ranging from 0.01 % w/v, b. buffer consisting of sodium citrate and citric acid, c. polyhexamethylene biguanide hydrochloride, and
d. punned sterile water, wherein the pH of the solution ranges is about 5.5, and the solution is to be instilled in the eye without dilution or reconstitution.
DETAILED DESCRIPTION OF THE INVENTION
The term “sterile” as used in the context of the invention means a solution that has been brought to a state of sterility and has not been subsequently exposed to microbiological contamination, i.e. the sterility of the aqueous solution present in the container has not been compromised.
The term “light protective container” as used herein means a container that protects the contents from the effects of light by virtue of the specific properties of the material of which it is composed, including any coating applied to it, such as, for example, an opaque container or amber coloured container or a container coated with a light protective coating and the like.
The phrase “the solution is to be instilled in the eye without dilution or reconstitution” as used herein refers to direct topical administration of the aqueous drug solution to the eye of patient without involving any intermediate steps of manipulation, dilution, reconstitution, dispensing, sterilization, transfer, handling or compounding before administration of the drug solution. The aqueous drug solution is ready to use or ready to administer, which is meant for direct administration topically from the container to the eye of patient in need thereof, without dilution or reconstitution.
The term ‘stable’ as used herein means that the aqueous solution filled in the container is physically as well as chemically stable when stored at room temperature for a period of at least 6 months, preferably 12 months, more preferably 18 months, or more. The aqueous solution has been also found to be stable when stored at forced degradation conditions such as 60°C for 28 days. Also, the aqueous solution is stable upon storage at the accelerated stability condition of 40°C/25% relative humidity (RH) for at least 1 month, preferably 3 months, more preferably, 6 months. By the term “physical stability”, it means that the solution remains clear and colourless and free of any visible particulate matter upon storage. By the term “chemical stability”, it means that generation of degradation impurities, such as tropic acid, atropic acid and apotropine, are controlled. In preferred embodiments, tropic acid is not generated and the levels are not detected upon storage. The level of tropic acid upon storage at room temperature (25 °C and 60 % relative humidity) for a period of 6
months is not more than 0.5 % by weight of atropine, preferably not more than 0.2 % by weight of atropine. Further, the level of tropic acid upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 7.0 % by weight of atropine. Similarly, the level of atropic acid upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 1.0 % by weight of atropine. Further, the level of apotropine upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 1.0 % by weight of atropine. In another aspect, the level of total impurities upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months, preferably 6 months, more preferably 12 months, is not more than 7.0 % by weight of atropine. Also, the assay of atropine remains within 93.0 % - 107.0 %, upon storage at room temperature for at least 3 months, preferably 6 months, more preferably 12 months.
The present invention provides an aqueous sterile solution for ophthalmic use fdled in a light protective container said solution comprising: a. atropine sulfate at a concentration ranging from 0.001 to 0.05 % w/v, b. buffer consisting essentially of sodium citrate and citric acid, and c. purified sterile water, wherein the pH of the solution ranges from 4.5 to 5.8, and the solution is to be instilled in the eye without dilution or reconstitution.
The term ‘consisting essentially of as used herein means that the aqueous solution of the present invention contains a buffer having mainly sodium citrate and citric acid or hydrates thereof.
The aqueous sterile solution for ophthalmic use according to the present invention comprises atropine sulfate as a sole therapeutically active ingredient. It is present in an amount ranging from about 0.001 % to 0.05 % w/v, preferably from about 0.005 % to 0.015 % w/v, more preferably, 0.006, 0.065, 0.007, 00075, 0.008, 0.0085, 0.009, 0.0095, 0.01, and/or 0.015 % w/v. In one preferred embodiment, atropine sulfate is present in the ophthalmic solution in an amount of 0.01 % w/v.
The aqueous sterile solution for ophthalmic use according to the present invention comprises other pharmaceutically acceptable excipients, which may include, but are not limited to, pH adjusting agent/s, buffers, tonicity adjusting agents and preservatives.
The vehicle used for formulating the aqueous sterile solution of the present invention is purified/sterile water. The active and inactive ingredients are dissolved in purified water to form a clear and colorless aqueous solution.
The aqueous sterile solution of the present invention is free of deuterated water.
The aqueous sterile solution for ophthalmic use according to the present invention has a pH in the range of about 3.5 to 6.0, preferably, from about 4.5 to 5.8, more preferably, 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7 or 5.8, or intermediate values thereof. According to preferred embodiments, the pH of the solution is 4.8 ± 0.2, more preferably 4.89 ± 0.2. In another preferred embodiment, the pH of the solution is 5.5 ± 0.2. The pH of the solution may be adjusted using a pH adjusting agent/s and/or a buffer. The pH adjusting agents that may be used in the ophthalmic solution according to the present invention include, but are not limited to, hydrochloric acid, sodium hydroxide or mixtures thereof.
The aqueous sterile solution for ophthalmic use according to the present invention comprises a buffer. The buffer that is preferably used is a citrate buffer, which consists of a mixture of citric acid and sodium citrate or hydrates thereof. In preferred embodiments, the citrate buffer is present in the aqueous solution at a concentration ranging from 0.01 to 1.5 % w/v, for example, 0.01% w/v, 0.02% w/v, 0.03% w/v, 0.04% w/v, 0.05% w/v, 0.055% w/v, 0.06% w/v, 0.065% w/v, 0.07% w/v, 0.075% w/v, 0.08% w/v, 0.085% w/v, 0.09% w/v, 0.095% w/v, 0.1% w/v, 0.2% w/v, 0.3% w/v, 0.4% w/v, 0.5% w/v, 0.6% w/v, 0.7% w/v, 0.8% w/v, 0.9% w/v, 1.0% w/v, 1.1% w/v, 1.2% w/v, 1.3% w/v, 1.4 % w/v or 1.5 % w/v. Preferably, at a concentration ranging from 0.05% w/v to 1.0% w/v. Preferably, the citrate buffer consists of citric acid monohydrate and sodium citrate dihydrate. Citric acid monohydrate may be present at a concentration ranging from 0.005 to 0.5 % w/v, preferably, at a concentration of 0.01 % to 0.3 % w/v, for example, 0.01 % w/v, 0.02% w/v, 0.03% w/v, 0.04% w/v, 0.05% w/v, 0.06% w/v, 0.07% w/v, 0.08% w/v, 0.09% w/v, 0.1% w/v, 0.2% w/v, or 0.3% w/v, and sodium citrate dihydrate may be present at a concentration ranging from 0.02 % to 1.0 % w/v, preferably, 0.03 % to 0.8 % w/v, more preferably, , more preferably, 0.03% to 0.5% w/v, for example, 0.03% w/v, 0.035% w/v, 0.04% w/v, 0.045%
w/v, 0.05% w/v, 0.055% w/v, 0.06% w/v, 0.065% w/v, 0.07% w/v, 0.075% w/v, 0.08 % w/v, 0.09 % w/v, 0.1% w/v, 0.2% w/v, 0.3% w/v, 0.4% w/v or 0.5% w/v.
It has been surprisingly found by the present inventors that when sodium citrate and citric acid are used as a buffer, the generation of degradation impurities, such as tropic acid, atropic acid and apotropine, is effectively controlled and there occurs no substantial increase in the level of tropic acid, atropic acid or apotropine impurities generated upon storage. Surprisingly, other buffers, such as acetate, borate and phosphate buffers, fail to control these degradation impurities, such as, tropic acid, atropic acid, apotropine, generation. Also, an atropine solution prepared without using any kind of buffer failed to control such degradation impurities.
The aqueous sterile solution for ophthalmic use according to the present invention comprises a tonicity adjusting agent. The tonicity adjusting agent that may be used in the ophthalmic solution according to the present invention includes, but is not limited to, polyethylene glycol, propylene glycol, glycerol, sodium chloride, potassium chloride, sodium bromide, calcium chloride, mannitol, sorbitol, dextrose, sucrose, mannose and the like and mixtures thereof. In one preferred embodiment, the tonicity adjusting agent used in the ophthalmic solution according to the present invention is sodium chloride. Sodium chloride may be present in the solution at a concentration ranging from about 0.3 % to 0.9 % w/v. In some embodiments, a combination of sodium chloride and mannitol may be used as tonicity adjusting agent. In preferred embodiments, only sodium chloride is used as a tonicity adjusting agent at a concentration ranging from 0.7 to 0.9 % w/v. The aqueous sterile solution of the present invention is characterized by osmolalities of 250 to 350 mOsm/kg, preferably, 270-350 mOsm/kg, more preferably, 275, 280, 285, 290, 295, 300, 305, 310, 315, 320, 325, 330, 335, 340 or 345 mOsm/kg.
The aqueous sterile solution for ophthalmic use according to the present invention further comprises a preservative such as polyhexamethylene biguanide or its salt like hydrochloride salt, benzyl alcohol, cetrimide, chlorobutanol, mercurial preservatives like phenylmercuric nitrate, phenylmercuric acetate, thimerosal, phenylethyl alcohol, polyquad®, stabilized peroxides and perborates, stabilized oxychloro compounds, edetate disodium, boric acid, borates, parabens (such as methyl-propyl, isopropyl and butylparaben), pyruvates, sorbic acid/potassium sorbate, metal ions, and the like and mixtures thereof. In preferred embodiments, the ophthalmic solution according to the present invention contains polyhexamethylene biguanide. The polyhexamethylene biguanide may
be present at a concentration ranging from 0.001 % to 0.5 % w/v, preferably, at a concentration ranging from 0.002 % to 0.5 % w/v, more preferably, 0.005 % w/v ,0.01% w/v, 0.015% w/v, 0.02% w/v, 0.025% w/v, 0.03% w/v, 0.035% w/v, 0.04 % w/v, 0.045% w/v , 0.05% w/v, 0.1% w/v, 0.15% w/v, 0.2% w/v, 0.25% w/v, 0.30% w/v, 0.35% w/v, 0.40% w/v, 0.45% w/v or 0.5 % w/v. In preferred embodiments, the aqueous solution according to the present invention is devoid of benzalkonium chloride.
The use of polyhexamethylene biguanide as a preservative has been found to be advantageous over other widely used preservatives like benzalkonium chloride because an aqueous solution comprising polyhexamethylene biguanide shows lower mydriatic action than a solution which comprises benzalkonium chloride. It is noteworthy that mydriatic action, which leads to dilatation of pupil, is undesirable for the treatment of myopia.
In preferred embodiments, the aqueous sterile solution for ophthalmic use according to the present invention is free of chelating agents, such as, ethylenediamine tetraacetic acid (EDTA), cyclohexanediamine tetraacetic acid (CDTA), hydroxyethylethylenediamine triacetic acid (HEDTA), diethylenetriamine pentaacetic acid (DTP A), dimercaptopropane sulfonic acid (DMPS), dimercaptosuccmic acid (DMSA), and aminotrimethylene phosphonic acid (ATP A).
In preferred embodiments, the aqueous sterile solution for ophthalmic use according to the present invention is free of water soluble polymers, for example, hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyvinylpyrrolidone and the like.
The aqueous sterile solution for ophthalmic use according to the present invention is filled into a light protective container which protects the aqueous solution contained therein from the effects of light by virtue of the specific properties of the material of which it is composed, for example, a container being opaque or amber coloured or a container coated with a light protective coating. Light protective containers that may be used include, but are not limited to, opaque polyethylene, polypropylene or low-density polyethylene containers. In a preferred embodiment, the aqueous stable solution for ophthalmic use according to the present invention is filled into a light protective opaque polyethylene plastic bottle. The light protective container may be in single-use format or multi -dose format.
In one preferred embodiment, the aqueous sterile solution for ophthalmic use according to the present invention comprises a low concentration of atropine sulfate (0.005
to 0.015 % w/v), citrate buffer to maintain the pH of the solution in the range of 4.5 to 5.8, polyhexamethylene biguanide as a preservative, a tonicity adjusting agent and a pH adjusting agent, wherein the solution is free of benzalkonium chloride, deuterated water and water soluble polymers.
In another preferred embodiment, the aqueous sterile solution for ophthalmic use is filled in a light protective container and comprises: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, and c. purified water, wherein the pH of the solution is 4.8 ± 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
In yet another embodiment, there is provided an aqueous sterile solution for ophthalmic use filled in a light protective container, said solution comprising: a. atropine sulfate at a concentration of about 0.01 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, c. polyhexamethylene biguanide, and d. purified water, wherein the pH of the solution ranges from 4.5 to 5.8 and the solution is to be instilled in the eye without dilution or reconstitution.
In another preferred embodiment, there is provided an aqueous sterile solution for ophthalmic use filled in a light protective container, said solution consisting essentially of: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, c. polyhexamethylene biguanide at a concentration ranging from 0.001 % to 0.5 % w/v, d. a tonicity adjusting agent consisting essentially of sodium chloride, and e. purified water; wherein the pH of the solution is 4.8 ± 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
In another preferred embodiment, there is provided an aqueous sterile solution for ophthalmic use filled in a light protective container, said solution consisting essentially of: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting essentially of sodium citrate at a concentration ranging from 0.03 % to 0.8 % w/v and citric acid at a concentration ranging from 0.005 % to 0.5 w/v, c. polyhexamethylene biguanide at a concentration ranging from 0.001 % to 0.5 % w/v, d. a tonicity adjusting agent consisting essentially of sodium chloride, and e. purified water, wherein the pH of the solution is 4.8 ± 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
In another preferred embodiment, the aqueous sterile solution for ophthalmic use is filled in a light protective container, said solution consisting of: a. atropine sulfate at a concentration of 0.01 % w/v, b. a buffer consisting of sodium citrate dihydrate at concentration of about 0.055 %w/v and citric acid monohydrate at the concentration of about 0.01% w/v, c. polyhexamethylene biguanide at a concentration of 0.005 % w/v, d. sodium chloride, and e. purified water, wherein the pH of the solution is 4.8 ± 0.2, and the solution is to be instilled in the eye without dilution or reconstitution.
In another embodiment, there is provided a method of treating myopia comprising administering to a patient in need thereof an aqueous sterile solution for ophthalmic use filled in a light protective container, said solution comprising: a. atropine sulfate at a concentration ranging from 0.001 % to 0.05 % w/v, b. a buffer consisting essentially of sodium citrate and citric acid, and c. purified water, wherein the pH of the solution ranges from 4.5 to 5.5 and the solution is to be instilled in the eye without dilution or reconstitution.
In yet another embodiment, there is provided a method of treating myopia comprising administering to a patient in need thereof an aqueous sterile solution as disclosed in any one of the preceding embodiments.
In yet another embodiment, there is provided use of the aqueous sterile solution as disclosed in any one of the preceding embodiments for the treatment of myopia.
In one embodiment, the present invention provides a process of preparing an aqueous sterile solution for ophthalmic use involving the steps of:
1. Dispensing and dissolving specified quantity of the sodium citrate dihydrate and citric acid monohydrate in water for injection to prepare a buffer solution;
2. Dispensing specified quantity of preservative such as polyhexamethylene biguanide, and adding it to the above buffer solution under stirring, until it is dissolved;
3. Dispensing specified quantity of atropine sulfate and adding in solution containing buffer and preservative;
4. Dispensing specified quantity of tonicity adjusting agent like sodium chloride and adding it to the solution containing buffer, preservative and atropine;
5. Adjusting the pH of the solution to 5.5±0.2 using pH adjusting agent/s if required and making the volume to 100 % with purified water;
6. Sterilizing the solution, preferably by filtering it through membrane filter to get sterile solution; and filling the solution in an opaque container like a light protective polyethylene plastic bottle.
While the present invention is disclosed generally above, additional aspects are further discussed and illustrated with reference to the examples set forth below. However, the examples are presented merely to illustrate the invention and should not be considered as limitations thereto.
EXAMPLE I
Table 1 below gives composition details of an ophthalmic solution according to one preferred embodiment of the present invention.
Method of preparation of Composition A: The dispensed quantity of the sodium citrate dihydrate and citric acid monohydrate were dissolved in water for injection. To this buffer solution, the dispensed quantity of polyhexamethylene biguanide was added under stirring and dissolved. The dispensed quantity of atropine sulfate was added to the solution containing the buffer and preservative. After that, the dispensed quantity of sodium chloride was added to the solution containing the buffer, preservative and atropine. The pH of the solution was 4.8. The volume was made up to 100 % with water for injection. The formulation was filtered through a membrane filter to get the sterile solution. The above solution was filled in opaque light protective polyethylene plastic bottles.
Method of preparation of Composition B: The dispensed quantity of the sodium citrate dihydrate and citric acid monohydrate were dissolved in water for injection. To this buffer solution, the dispensed quantity of polyhexamethylene biguanide was added under stirring and dissolved. The dispensed quantity of atropine sulfate was added to the solution containing the buffer and preservative. After that, the dispensed quantity of sodium chloride was added to the solution containing the buffer, preservative and atropine. The pH was adjusted to 5.5 using sodium hydroxide. The volume was made up to 100 % with water for injection. The formulation was filtered through a membrane filter to get the sterile solution. The above solution was filled in an opaque light protective polyethylene plastic bottles.
The solution prepared as per Example I, Composition A was tested for storage stability at room temperature (25°C and 60 % relative humidity) and was found to be physically and chemically stable upon storage. Stability results upon storage at room temperature are given below in Table 2.
Stability testing of the solution of Example I, Composition A was also carried out at forced degradation condition of 60°C at different time points. The stability study was also carried out at the accelerated stability condition of 40°C/25%RH. Stability results upon storage at different conditions are given below in Table 3. Table 3: Results of Stability:
Similarly, the solution prepared as per Example I, Composition B was tested for storage stability at 20°C and 35% relative humidity and at the accelerated stability condition of 40°C/25%RH. Composition B was found to be physically and chemically stable upon storage. The assay of atropine sulfate was found within the specified limit of 93.0 % - 107.0 %. Further, the levels of impurities (tropic acid, atropic acid, and apotropine) and total impurities were found within the specified limit. Stability results upon storage at room temperature for Composition B are given below in Table 4.
* Clear, colorless solution, filled in LDPE botle, NA: Not Available, ND: Not Detected
COMPARATIVE EXAMPLES (la to IV)
Effect of various buffers on the stability of an aqueous sterile solution of Atropine
Sulfate
Ophthalmic solutions of atropine sulfate were prepared using the same procedure as explained in Example I. The compositions were prepared using different buffer systems such as acetate, borate and phosphate as described in comparative Examples II, III and IV and without use of buffers as per comparative Example la.
Table 4: Compositions of Atropine with different buffer system.
q.s.: quantity sufficient. The above compositions of comparative examples were filled in opaque light protective polyethylene bottles. Stability testing was carried out at forced degradation condition of 60°C at different time points. The stability study was also carried out at the accelerated stability condition of 40°C/25%RH. The stability results upon storage are disclosed in Table 5 below. Table 5: Stability Results for comparative Examples la to IV
From the stability data set forth in Tables 2, 3 and 5, it was surprisingly found that when a citrate buffer consisting of citric acid and sodium citrate was used, there occurs no increase in the tropic acid impurity levels and no levels were detected. In contrast, other buffers as described in comparative Examples II, III and IV surprisingly caused increase in the tropic acid levels. The atropine solution prepared without using any buffer also showed an increased tropic acid level.
Claims
1. An aqueous sterile solution for ophthalmic use filled in a light protective container, said solution comprising:
1. atropine sulfate at a concentration ranging from 0.001 % to 0.05 % w/v, ii. a buffer consisting essentially of sodium citrate and citric acid, and iii. purified water, wherein the pH of the solution ranges from 4.5 to 5.8 and the solution is to be instilled in the eye without dilution or reconstitution.
2. The aqueous sterile solution as claimed in claim 1 , wherein atropine sulfate is present at a concentration of 0.01 % w/v.
3. The aqueous sterile solution as claimed in claim 1, wherein the buffer is present at a concentration ranging from 0.01 % to 1.5 % w/v.
4. The aqueous sterile solution as claimed in claim 1, wherein the buffer consists of citric acid monohydrate and sodium citrate dihydrate.
5. The aqueous sterile solution as claimed in claim 4, wherein citric acid monohydrate is present at a concentration ranging from 0.005 % to 0.5 % w/v and sodium citrate dihydrate is present at a concentration ranging from 0.03 % to 0.8 % w/v.
6. The aqueous sterile solution as claimed in claim 5, wherein citric acid monohydrate is present at a concentration of about 0.01 % w/v and sodium citrate dihydrate is present at a concentration of about 0.055 % w/v.
7. The aqueous sterile solution as claimed in claim 1, wherein the pH of the solution is 5.5 ± 0.2.
8. The aqueous sterile solution as claimed in claim 1, wherein the light protective container is an opaque polyethylene plastic bottle.
9. The aqueous sterile solution as claimed in claim 1, wherein the solution further comprises a preservative.
10. The aqueous sterile solution as claimed in claim 9, wherein the preservative is polyhexamethylene biguanide.
11. The aqueous sterile solution as claimed in claim 9, wherein the preservative is present at a concentration ranging from 0.002 % to 0.5 % w/v.
12. The aqueous sterile solution as claimed in claim 1, wherein the solution is free of benzalkonium chloride and deuterated water.
13. The aqueous sterile solution as claimed in claim 1, wherein the solution further comprises a tonicity adjusting agent.
14. The aqueous sterile solution as claimed in claim 13, wherein the tonicity adjusting agent is present at a concentration ranging from 0.3 % to 0.9 % w/v.
15. An aqueous sterile solution for ophthalmic use filled in a light protective container, said solution comprising: i. atropine sulfate at a concentration of about 0.01 % w/v, ii. a buffer consisting essentially of sodium citrate and citric acid, iii. polyhexamethylene biguanide, and iv. purified water, wherein the pH of the solution ranges from 4.5 to 5.8 and the solution is to be instilled in the eye without dilution or reconstitution.
16. The aqueous sterile solution as claimed in claim 15, wherein the solution is free of benzalkonium chloride and deuterated water.
17. The aqueous sterile solution as claimed in claim 15, wherein the solution further comprises a tonicity adjusting agent.
18. The aqueous sterile solution as claimed in claim 17, wherein the tonicity adjusting agent is present at a concentration ranging from 0.3 % to 0.9 % w/v.
19. The aqueous sterile solution as claimed in claim 15, wherein polyhexamethylene biguanide is present at a concentration of about 0.005% w/v.
20. The aqueous sterile solution as claimed in any one of claims 1 to 19, wherein the solution has no substantial increase in the level of tropic acid upon storage.
21. The aqueous sterile solution as claimed in claim 20, wherein the level of tropic acid upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and
25% relative humidity for a period of at least 3 months is not more than 7.0% by weight of atropine.
22. The aqueous sterile solution as claimed in any one of claims 1 to 19, wherein the solution has no substantial increase in the level of atropic acid upon storage.
23. The aqueous sterile solution as claimed in claim 22, wherein the level of atropic acid upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months is not more than 1.0% by weight of atropine.
24. The aqueous sterile solution as claimed in any one of claims 1 to 19, wherein the solution has no substantial increase in the level of apotropine upon storage.
25. The aqueous sterile solution as claimed in claim 24, wherein the level of apotropine upon storage at 30°C and 35% relative humidity or at accelerated condition of 40°C and 25% relative humidity for a period of at least 3 months is not more than 1.0% by weight of atropine.
26. A method of treating myopia comprising administering to a patient in need thereof an aqueous sterile solution for ophthalmic use filled in a light protective container, said solution comprising: i. atropine sulfate at a concentration ranging from 0.001 % to 0.05 % w/v, ii. a buffer consisting essentially of sodium citrate and citric acid, and iii. purified water; wherein the pH of the solution ranges from 4.5 to 5.5 and the solution is to be instilled in the eye without dilution or reconstitution.
27. A method of treating myopia comprising administering to a patient in need thereof an aqueous sterile solution of any one of claims 1 to 25.
28. Use of the aqueous sterile solution of any one of claims 1 to 25 for the treatment of myopia.
17
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WO2017204262A1 (en) * | 2016-05-25 | 2017-11-30 | Singapore Health Services Pte Ltd | Atropine-containing aqueous composition |
CN110917133A (en) * | 2019-12-23 | 2020-03-27 | 河北科技大学 | Eye drops for treating myopia and preparation method thereof |
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WO2017204262A1 (en) * | 2016-05-25 | 2017-11-30 | Singapore Health Services Pte Ltd | Atropine-containing aqueous composition |
CN110917133A (en) * | 2019-12-23 | 2020-03-27 | 河北科技大学 | Eye drops for treating myopia and preparation method thereof |
Non-Patent Citations (1)
Title |
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BOUATTOUR YASSINE ET AL: "Stability of an ophthalmic formulation of polyhexamethylene biguanide in gamma-sterilized and ethylene oxide sterilized low density polyethylene multidose eyedroppers", PEERJ, vol. 6, 18 April 2018 (2018-04-18), pages e4549, XP055820215, Retrieved from the Internet <URL:https://peerj.com/articles/4549.html> DOI: 10.7717/peerj.4549 * |
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