Pharmaceutical formulations that form gel in situ
11576973 · 2023-02-14
Assignee
Inventors
Cpc classification
A61P31/00
HUMAN NECESSITIES
A61K9/06
HUMAN NECESSITIES
A61K47/10
HUMAN NECESSITIES
A61K31/155
HUMAN NECESSITIES
A61K9/0014
HUMAN NECESSITIES
A61K47/36
HUMAN NECESSITIES
A61K47/26
HUMAN NECESSITIES
International classification
A61K47/36
HUMAN NECESSITIES
A61K47/32
HUMAN NECESSITIES
A61K47/10
HUMAN NECESSITIES
A61K9/00
HUMAN NECESSITIES
A61K47/26
HUMAN NECESSITIES
A61K9/06
HUMAN NECESSITIES
A61K31/155
HUMAN NECESSITIES
Abstract
The present invention provides aqueous formulations containing an anti-infection agent, a biocompatible polysaccharide, an osmotic pressure regulator, a pH regulator, and water, wherein a gel containing the therapeutic agent is formed in situ upon instillation of the formulations onto the skin and a body cavity of a subject. The formulations of this invention are useful for treating infectious diseases of skin or a body cavity (e.g., eye, nose, or vagina) of a subject.
Claims
1. An aqueous formulation comprising povidone-iodine as an antiseptic agent, a biocompatible polysaccharide, an osmotic pressure regulator, a pH regulator, and water, wherein the antiseptic agent is contained in the formulation at 0.1% to 5.0% weight/weight or weight/volume, the biocompatible polysaccharide comprises deacetylated gellan gum which is contained in the formulation at the concentration ranging from 0.1% to 1.0% weight/weight, and a gel containing the antiseptic agent is formed in situ at physiological temperature with instant viscosity increase upon instillation of the formulation onto a body cavity of a subject.
2. The aqueous formulation of claim 1, wherein the antiseptic agent is contained in the formulation at 0.1% to 1.0% weight/weight or weight/volume.
3. The aqueous formulation of claim 2, wherein the antiseptic agent is contained in the formulation at 0.3% to 1.0% weight/weight or weight/volume.
4. The aqueous formulation of claim 1, wherein the polysaccharide is contained in the formation at 0.1% to 0.5% weight/weight.
5. The aqueous formulation of claim 4, wherein the polysaccharide is contained in the formation at 0.3% to 0.4% weight/weight.
6. The aqueous formulation of claim 1, wherein the polysaccharide further comprises xanthan, sodium alginate, carrageenan, or any mixture thereof.
7. The aqueous formulation of claim 1, wherein the osmotic pressure regulator comprises sodium chloride, glycerol, polyethylene glycol 400, mannitol, or boric acid.
8. The aqueous formulation of claim 1, wherein the osmotic pressure regulator comprises sodium chloride and mannitol.
9. The aqueous formulation of claim 1, wherein the osmotic pressure regulator is contained in the formulation at 0.1 to 0.5% weight/volume.
10. The aqueous formulation of claim 1, wherein the osmotic pressure regulator is contained in the formulation at 0.2 to 0.4% weight/volume.
11. The aqueous formulation of claim 1, wherein the pH regulator comprises sodium hydroxide, tris(hydroxymethyl)aminomethane, tris(hydroxymethyl)aminomethane HCI, phosphoric acid, or any mixture thereof.
12. The aqueous formulation of claim 11, wherein the pH regulator comprises tris(hydroxymethyl)aminomethane.
13. The aqueous formulation of claim 1, wherein the formulation has a pH value in the range of 4.0 to 7.0.
14. The aqueous formulation of claim 12, wherein the formulation has a pH value in the range of 4.0 to 6.0.
15. The aqueous formulation of claim 1, wherein the body cavity of a subject is the eye, nose, or vagina, has infection, and is in need of a treatment.
16. The aqueous formulation of claim 15, wherein the infection is conjunctivitis, corneal abrasion, ulcerative infectious keratitis, epithelial keratitis, stromal keratitis, herpes virus-related keratitis, chronic rhinosinusitis, acute rhinosinusitis, or vaginitis.
17. A method for treating an ocular infectious disease, comprising administering a therapeutically effective amount of an aqueous ophthalmic formulation of claim 1 to a person in need thereof, wherein the ocular infectious disease is conjunctivitis, corneal abrasion, ulcerative infectious keratitis, epithelial keratitis, stromal keratitis, or herpes virus-related keratitis.
Description
BRIEF DESCRIPTIONS OF THE FIGURES
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DETAILED DESCRIPTION OF THE INVENTION
(20) The aqueous formulations in this invention contain a therapeutic agent against an infectious disease of skin or cavity of a subject (i.e., a mammal), a biocompatible (and environmentally sensitive) polysaccharide, an osmotic pressure regulator, a pH regulator, water, and optionally other pharmaceutically acceptable excipient or vehicles. The cavity can be eye, nose, or vagina.
(21) The ocular infection disease may be conjunctivitis, corneal abrasion, ulcerative infectious keratitis, epithelial keratitis, stromal keratitis, or herpes virus-related keratitis; whereas the infection disease in the nose can be chronic rhinosinusitis or acute rhinosinusitis; and the vaginal infection can be vaginitis. The polysaccharide contained in the formulations of this invention may include deacetylated gellan gum (DGG), xanthan, sodium alginate and carrageenan, or a mixture of these materials. Deacetylated gellan gum may be preferred, with a concentration ranging from 0.1% to 1% (w/w)—e.g., from 0.3% to 0.5% (w/w)—in the formulations.
(22) The therapeutic agent contained in the formulations may be PVP-I or chlorhexidine. The concentration of the PVP-I may range from 0.1% to 5% (w/w or w/v), from 0.3% to 1% (w/w or w/v), or from 0.3% to 0.6% (w/w or w/v). An example of chlorhexidine suitable for the formulations of this invention is chlorhexidine digluconate, with its concentration in the formulations ranging from 0.02% to 2% (w/w or w/v), from 0.02% to 0.5% (w/w or w/v), or from 0.02% to 0.2% (w/w or w/v).
(23) The osmotic pressure regulator contained in the formulations of this invention may include sodium chloride, glycerol, polyethylene glycol 400 (PEG400), mannitol, or borate, with a concentration ranging from 0.1 to 0.9% (w/v) or from 0.2 to 0.4% (w/v).
(24) The pH regulator contained in the formulations of this invention can include sodium hydroxide, trishydroxymethylaminomethane (Tris), or phosphoric acid, resulting in a pH of 5 to 9 or 5.0 to 6.0.
(25) The invention is further elucidated with specific examples. It is understood that these examples are only used to describe the invention but not to intend to limit the scope of invention. The experimental methods with no specific conditions in the following examples, are usually prepared under conventional conditions in the literature or according to the conditions suggested by the excipient manufacturer. Unless specifically stated, all percentages, ratios, proportions or fractions in this invention are calculated by weight by weight. Unless specifically defined in this invention, all professional and scientific terms used herein have the same meaning as well-trained personnel may be familiar with. In addition, any methods and materials similar or equivalent to those recorded in this invention can be applied to this invention. The preferred embodiments and materials described herein are used only for exemplary purposes.
Example 1
(26) Preparation of solution of deacetylated gellan gum (DGG) (Kelcogel-Cg-La gellan gum, food grade gellan gum, CAS: 71010-52-1: E418, particle size: ˜42 mesh (355 μm), purchased from CPKelco): DGG was dissolved in deionized water and the solution was stirred in an 80° C. water bath for 1 hour, cooled to the room temperature, allowed to stand until the material is fully swollen, and used to prepared solutions of 0.1% to 1.0% (w/w) concentrations.
(27) Preparation of simulated tear fluid (STF): NaHCO.sub.3 2.18 g; NaCl 6.78 g; CaCl.sub.2.2H.sub.2O 0.084 g; KCl 1.38 g; dissolve in 1000 mL deionized water: DGG solution and simulated tear fluid were mixed at the 40:7 ratio, and the viscosity of the DGG solution was measured before and after mixing with stimulated tear fluid with a rotary rheometer at 25° C. and at 34° C., respectively. The viscosity change was shown in
Example 2
(28) DGG-Xanthan mixed solution: DGG and xanthan were weighed and used at a certain proportion and added into deionized water. The mixture was stirred in an 80° C. water bath for 1 hour after the dispersion of DGG and xanthan in the water, cooled to the room temperature, and allowed to stand until fully swollen. The morphological scoring of the deacetylated gellan gum-xanthan mixed solution before and after adding simulated tear fluid was evaluated according to the following criteria: (1) thin liquid: 1-3 points; (2) thick gelatinous form: 4-6 points; (3) gel state: 7-9 points.
(29) TABLE-US-00001 TABLE 1 Morphological scoring of the DGG-xanthan solutions before and after adding STF. Scoring Scoring DGG Xanthan Scoring D + X + STF D + X + STF (%, w/w) (%, w/w) D + X25° C. (25° C.) 34° C. Δ 0.3 0.1 1 2 1 0.2 1 3 2 0.3 2 3 1 0.4 3 5 2 0.5 3 6 3 0.6 3 7 4 0.4 0.1 2 3 1 0.2 2 3 1 0.3 2 4 2 0.4 5 6 1 0.5 0.1 2 3 1 0.2 2 4 2 0.3 3 4 1 0.6 0 2 4 2 0.1 3 3 0 0.2 4 4 0 0.3 5 5 0 0.4 5 5 0
(30) As shown in Table 1 and
Example 3
(31) DGG-Kappa-Carrageenan compound solution: DGG and carrageenan were weighed and used at a certain proportion, added into deionized water, and the mixture was slowly stirring in an 80° C. water bath for 1 hour after being well-dispersed. It was then cooled to the room temperature and allowed to stand until fully swollen. The morphological scoring of the DGG-kappa-carrageenan mixed solutions before and after adding tear fluid was evaluated according to the above-mentioned criteria.
(32) TABLE-US-00002 TABLE 2 The morphological scoring of the DGG-kappa-carrageenan mixed solution before and after adding STF. Kappa- DGG Carrageenan 25° C.- D + K + STF (%, w/w) (%, w/w) D + K D + K + STF 34° C. Δ 0.2 0.1 1 1 0 0.2 1 1 0 0.3 2 2 0 0.4 2 5 3 0.3 0.1 1 1 0 0.2 1 2 1 0.3 2 7 5 0.4 3 8 5 0.4 0.1 2 2 0 0.2 2 6 4 0.3 3 6 3 0.5 0.1 3 3 0 0.6 0.1 4 6 2 0.2 4 6 2 0.3 7 8 1 0.4 8 9 1
(33) As the result shown in Table 2 and
Example 4
(34) DGG-Sodium alginate mixed solution: DGG and sodium alginate were weighed and used at a certain proportion. DGG was added into deionized water slowly under stirring in an 80° C. water bath for 1 hour after well-dispersed, cooled to room temperature, before sodium alginate was added to the solution by stirring. The mixture was allowed to stand for 24 hours until fully swollen. The morphological scoring of the resultant DGG-sodium alginate mixed solution before and after adding tear fluid was evaluated according to the above-mentioned criteria.
(35) TABLE-US-00003 TABLE 3 Morphological scoring of the DGG-sodium alginate mixed solution before and after adding STF. Alginate 25° C.- D + A + STF DGG (%, w/w) (%, w/w) D + A D + A + STF 34° C. Δ 0.2 0.1 1 1 0 0.2 1 1 0 0.3 1 1 0 0.4 2 2 0 0.5 2 2 0 0.6 2 2 0 0.8 2 2 0 0.3 0.1 1 1 0 0.2 2 2 0 0.3 2 2 0 0.4 2 2 0 0.5 2 2 0 0.6 3 2 1 0.8 4 2 2 0.4 0.1 1 1 0 0.2 2 2 0 0.3 2 2 0 0.4 3 3 0 0.6 4 3 1 0.8 5 3 2 0.5 0.2 3 3 0 0.4 4 3 1 0.6 5 3 2 0.8 6 4 2 0.6 0.1 4 3 1 0.2 5 3 2
(36) As the result shown in Table 3 and
(37) The above results indicated that addition of other macromolecule excipients to the DGG solution did not improve the gel-formation ability of DGG under simulated physiological conditions. PVP-I is a polymeric drug, and its effect on gel-formation ability when added to DGG solution was completely unknown.
Example 5
(38) The effect of povidone iodine and osmotic pressure regulator mannitol on gel formation ability of deacetylated gellan gum solution was investigated. Prepare deacetylated gellan gum solutions, containing povidone iodine and osmotic pressure regulator mannitol, according to the formulation set out in Table 4 (referred as Formulation (G)). Evaluate physicochemical properties and viscosity of all formulations under room temperature (25° C.) and simulated physiological condition (Formulation: simulated tear fluid STF=40:7, 34° C.).
(39) TABLE-US-00004 TABLE 4 The physicochemical properties of deacetylated gellan gum solutions, containing povidone iodine and mannitol. PVP-I D- Concentration Osmotic (%, mannitol of DGG pressure w/w) (%, w/w) (%, w/w) pH (mOsm/kg) Formulation 0.6% 5% 0.30 5.31 292 (G) 0.35 5.08 301 0.40 5.22 291 0.45 5.15 287 0.5 5.18 279 0.55 5.11 300 0.6 5.69 303
(40) As shown in Table 4 and
Example 6
(41) The effect of povidone iodine and osmotic pressure regulator mannitol on gel-formation ability of xanthan solutions: Xanthan solutions, containing povidone iodine and osmotic pressure regulator mannitol, were prepared according to formulations set out in Table 5 (referred as Formulation (X)). The physicochemical properties and viscosity of all formulations were evaluated at the room temperature (25° C.) and under simulated physiological condition (formulation: simulated tear fluid STF=40:7, 34° C.).
(42) TABLE-US-00005 TABLE 5 Physicochemical properties of xanthan solutions, containing PVP-I and mannitol. PVP-I D- Concentration Osmotic (%, mannitol of xanthan pressure w/w) (%, w/w) (%, w/w) pH (mOsm/kg) Formulation 0.6% 5% 0.3 5.04 279 (X) 0.35 5.01 289 0.4 5.53 292 0.45 5.62 285 0.5 5.04 280
(43) As shown in Table 5 and
Example 7
(44) The effect of povidone iodine and osmotic pressure regulator mannitol on gel-formation ability of deacetylated gellan gum-carrageenan mixed solutions: prepare deacetylated gellan gum-carrageenan mixed solutions, containing povidone iodine and osmotic pressure regulator mannitol, according to the formulation set out in Table 6 (referred as Formulation (G+K)). Evaluate physicochemical properties and viscosity of all formulations under room temperature (25° C.) and simulated physiological condition (formulation: simulated tear fluid STF=40:7, 34° C.).
(45) TABLE-US-00006 TABLE 6 Physicochemical properties of DGG-carrageenan mixed solutions, containing PVP-I and mannitol. Osmotic PVP-I D-mannitol Total polymer Concentration pressure (%, w/w) (%, w/w) (%, w/w) (%, w/w) pH (mOsm/kg) Formulation 0.6% 5% 0.2 0.1G + 0.1K 5.6 298 (G + K) 0.3 0.1G + 0.2K 5.24 299 0.2G + 0.1K 5.41 293 0.4 0.1G + 0.3K 5.21 308 0.2G + 0.2K 5.86 296 0.3G + 0.1K 5.24 287 0.5 0.1G + 0.4K 5.11 311 0.2G + 0.3K 5.05 300 0.3G + 0.2K 5.38 296 0.4G + 0.1K 5.17 294 0.6 0.1G + 0.5K 5.26 290 0.2G + 0.4K 5.15 300 0.3G + 0.3K 5.25 295 0.4G + 0.2K 5.06 292 0.5G + 0.1K 5.34 296
(46) As the result shown in Table 6 and
Example 8
(47) The effect of povidone iodine and osmotic pressure regulator mannitol on gel-formation ability of DGG-sodium alginate mixed solutions: A mixed solution of DGG and sodium alginate was prepared, containing PVP-I and an osmotic pressure regulator mannitol, according to the formulation set out in Table 6 (referred as Formulation (G+A)).
(48) The physicochemical properties and viscosity of all formulations were evaluated at the room temperature (25° C.) and under simulated physiological conditions (prescription: simulated tear fluid STF=40:7, 34° C.).
(49) TABLE-US-00007 TABLE 7 Physicochemical properties of DGG-sodium alginate mixed solution, containing povidone iodine and mannitol. PVP-I D- Osmotic (%, mannitol Concentration pressure w/w) (%, w/w) (%, w/w) pH (mOsm/kg) Formulation 0.6% 5% 0.2G + 0.2A 5.06 298 (G + A) 0.2G + 0.4A 5.22 296 0.2G + 0.6A 5.17 311 0.3G + 0.3A 5.11 303 0.4G + 0.2A 5.03 295
(50) As the result shown in Table 7 and
Example 9
(51) Simulation of viscosity change of formulations containing PVP-I caused by changes of temperature, shear stress, and tear flush after the formulations were dropped into conjunctival sac. Formulations of this invention containing PVP-I were prepared according to the formulations set out in Table 8. 5 mL of the formulations was taken and mixed with 1, 2, 3, 4, 5 parts of simulated tear fluid, respectively. 1 part simulated tear fluid equaled to 0.875 mL, and the calculation was based on the ratio of 40:7 between the formulations of this invention and simulated tear fluid. Viscosity of the formulations of this invention containing PVP-I and different concentrations of deacetylated gellan gum was measured, and diluted by different proportions of simulated tear fluid respectively.
(52) TABLE-US-00008 TABLE 8 The formulations of povidone iodine in situ gel eye drops. Gellan gum D-mannitol Concentration PVP-I Concentration Osmotic pressure (w/w %) (w/w %) (w/w %) (mOsm/kg) pH 0.3 0.6% 5% 294 6.2 0.35 298 6.52 0.4 291 6.47
(53) 5 ml of formulation of this invention containing PVP-I was taken. Added to the formulation was 0.875 mL simulated tear fluid and the mixture was well shaken before 1.5 mL sample was taken for viscosity determination. 0.875 mL simulated tear fluid was then added into the remaining solution, and another 1.5 mL of the resultant sample was taken out for viscosity determination. These steps were repeated 6 times, until the formulations were finished.
(54)
Example 10
(55) Screening of osmotic pressure regulators: The effect of osmotic pressure regulator on the stability of povidone iodine solution under was evaluated at the room temperature (25° C.). 0.6 g povidone iodine was added into 100 mL deionized water, followed by adding an osmotic pressure regulator according to Table 9. The pH of the resultant mixture was adjusted to 5.0-5.5 with NaOH, and their stability was evaluated at 25° C. PVP-I concentration was determined by sodium thiosulfate titration (n=3).
(56) TABLE-US-00009 TABLE 9 Formulations containing PVP-I, containing different osmotic pressure regulator Formulation Osmotic pressure regulator Amount (w/w) 1 Glycerol 2.5% 2 PEG 400 5% 3 Mannitol 5% 4 NaCl 0.9% 5 Borate 1.9%
(57) TABLE-US-00010 TABLE 10 Available iodine content (%) in PVP-I solutions. Assuming available iodine content at 0 day as 100% to calculate the remaining available iodine content after 5, 10 days. Available Iodine (%) Example 10 0 day Avg. 5 day Avg. Remaining PVP-I 9.04 9.04 9.04 9.04 7.68 8.14 8.59 8.14 90.01% PVP-I + Glyerol 9.89 9.89 9.44 9.74 8.54 8.54 8.54 8.54 87.68% PVP-I + PEG 400 10.38 10.38 10.38 10.38 8.13 8.58 8.58 8.43 81.21% PVP-I + Mannitol 9.54 9.54 9.54 9.54 8.63 8.63 8.63 8.63 90.46% PVP-I + NaCl 10.09 9.63 10.09 9.94 9.63 9.63 9.63 9.63 96.91% PVP-I + Borate 8.99 9.44 8.99 9.14 7.64 8.54 8.54 8.24 90.15% Available Iodine (%) Example 10 10 day Avg. Remaining PVP-I 4.23 4.65 4.65 4.51 49.89% PVP-I + Glyerol 5.56 5.56 5.56 5.56 57.08% PVP-I + PEG 400 4.64 5.16 4.64 4.81 46.37% PVP-I + Mannitol 5.61 6.08 5.14 5.61 58.81% PVP-I + NaCl 6.14 6.14 6.14 6.14 61.79% PVP-I + Borate 5.55 5.09 5.55 5.40 59.04%
(58) As the result shown in Table 10 and
(59) Screening of NaCl concentrations: NaCl was selected as osmotic pressure regulator. As DGG had an ionic sensitivity characteristic, we considered adding a small amount of NaCl in the formulation, so it did not form a gel while under storage condition, but gel formation would be triggered by mixing with a small amount of tear fluid in conjunctival sac. Formulations of this invention containing PVP-I and NaCl of different concentrations were prepared according to Table 10. Surprisingly, the formulations containing PVP-I and 0.3% NaCl showed a weak gel state after standing for a period of time. The formulations would become liquid of low viscosity immediately after shaking slightly, making them idea candidates for gelling.
(60) TABLE-US-00011 TABLE 11 Gel-forming observation of the formulations of PVP-I in situ gel eye drops, containing different concentrations of NaCl Concentration of NaCl (%, w/w) Characteristics 0.1 Liquid, no particles 0.2 Liquid, no particles 0.3 Weak gel state after 24 hours, become low viscosity liquid immediately after gentle shaking, no particles 0.4 Become hard gel after standing, partial broken gel particles after shaking 0.5 Become hard gel after standing, partial broken gel particles after repeatedly shaking 0.6 Become hard gel after standing, partial broken gel particles after repeatedly shaking 0.7 Become hard gel, partial broken gel particles after vigorously shaking 0.8 Become hard gel immediately, partial broken gel particles after vigorously shaking 0.9 Become hard gel immediately, hard to shake
Example 11
(61) Screening of pH regulators: The effect of pH regulator on the stability of povidone iodine solution was evaluated at the room temperature (25° C.). 0.9% normal saline (NS) was used as solvent, and 0.3% (w/w) DGG was used as gel matrix. NaOH, Tris, disodium hydrogen phosphate (DHP) and disodium hydrogen phosphate (DHP)-sodium dihydrogen phosphate+NaOH as pH regulator, was added respectively, to prepare PVP-I eye drops and formulations of this invention containing PVP-I at pH of 5.0-5.5. Their stability was evaluated at 25° C. Available iodine concentration was determined by sodium thiosulfate titration (n=3).
(62) TABLE-US-00012 TABLE 12 PVP-I Formulations NaCl Gellan gum Formulation (w/w) (w/w) pH regulator NS 0.9 — — DGG 0.3 0.3 — NS-NaOH 0.9 — NaOH DGG-NaOH 0.3 0.3 NaOH NS-Tris 0.9 — Tris DGG-Tris 0.3 0.3 Tris NS-Disodium 0.9 — Disodium hydrogen hydrogen phosphate phosphate DGG-Disodium 0.3 0.3 Disodium hydrogen hydrogen phosphate phosphate NS-Phosphate buffer- 0.9 — Phosphate buffer and NaOH NaOH DGG-Phosphate 0.3 0.3 Phosphate buffer and buffer-NaOH NaOH
(63) TABLE-US-00013 TABLE 13 Available Iodine concentration (%) after 5, 10, 20, 30 days. Available Iodine (%) Example 11 0 day Avg. 5 day Avg. Remaining 0.9% Normal 11.61 11.61 11.61 11.61 11.47 11.06 11.06 11.20 96.44% Saline (NS) 0.3% DGG 11.61 11.15 11.61 11.46 11.06 11.06 11.06 11.06 96.54% NS-NaOH 11.16 11.16 10.69 11.00 10.6 11.06 11.06 10.91 99.12% DGG-NaOH 11.17 11.17 11.17 11.17 10.62 10.62 10.62 10.62 95.08% NS-Tris 11.63 11.16 11.16 11.32 11.07 11.07 11.07 11.07 97.82% DGG-Tris 11.13 10.66 10.66 10.82 10.58 10.58 10.58 10.58 97.81% NS-disodium 11.64 11.64 11.17 11.48 11.08 11.08 11.08 11.08 96.49% hydrogen phosphate DGG-disodium 11.63 11.63 11.17 11.48 11.08 11.08 11.08 11.08 96.54% hydrogen phosphate NS-phosphate 11.65 11.19 11.19 11.34 11.1 10.63 10.63 10.79 95.09% buffer + NaOH DGG- 11.66 11.2 11.2 11.35 11.11 11.11 11.11 11.11 97.86% phosphate buffer + NaOH Available Iodine (%) Example 11 10 day Avg. Remaining 0.9% Normal 11.09 11.09 11.09 11.09 95.52% Saline (NS) 0.3% DGG 10.64 10.64 10.64 10.64 92.87% NS-NaOH 10.65 10.65 10.65 10.65 96.79% DGG-NaOH 10.22 10.22 10.67 10.37 92.84% NS-Tris 11.1 10.66 10.66 10.81 95.49% DGG-Tris 10.18 10.18 10.18 10.18 94.11% NS-disodium 10.67 10.67 10.67 10.67 92.92% hydrogen phosphate DGG-disodium 10.66 10.66 10.22 10.51 91.61% hydrogen phosphate NS-phosphate 10.68 10.68 10.68 10.68 94.15% buffer + NaOH DGG-phosphate 10.25 10.25 10.25 10.25 90.28% buffer + NaOH Available Iodine (%) Example 11 20 day Average Remaining 30 day Average Remaining 0.9% Normal 10.3 10.3 10.74 10.45 89.98% 9.37 10.71 9.82 9.97 85.85% Saline (NS) 0.3% DGG 9.85 9.85 9.85 9.85 85.98% 9.37 9.37 10.26 9.67 84.38% NS-NaOH 9.41 9.85 9.85 9.70 88.19% 9.38 9.38 9.82 9.53 86.58% DGG-NaOH 8.97 9.42 9.42 9.27 82.99% 9.39 9.39 8.94 9.24 82.72% NS-Tris 9.86 9.86 8.97 9.56 84.51% 9.38 9.38 9.38 9.38 82.89% DGG-Tris 9.83 8.94 9.38 9.38 86.75% 8.91 8.91 8.91 8.91 82.37% NS-disodium 9.87 9.87 9.87 9.87 85.95% 9.84 9.84 8.94 9.54 83.08% hydrogen phosphate DGG- 9.87 9.87 9.87 9.87 86.00% 9.39 9.39 9.39 9.39 81.82% disodium hydrogen phosphate NS- 10.17 9.71 9.25 9.71 85.60% 9.83 9.39 9.39 9.54 84.07% phosphate buffer + NaOH DGG- 9.89 8.99 8.99 9.29 81.83% 9.41 9.41 9.41 9.41 82.88% phosphate buffer + NaOH
(64) As the result shown in able 13 and
Example 12
(65) Screening of pH range: The effect of pH range on the stability of PVP-I solution at the room temperature (25° C.) was evaluated. 0.9% normal saline (NS) was used as solvent, 0.3% (w/w) DGG was used as gel matrix, and NaOH was used to adjust the pH to 4-5, 5-6, 6-7, 7-8, 8-9, respectively, to give rise to formulations of this invention. The stability of these formulations was evaluate at 25° C., and the available iodine concentration was determined by sodium thiosulfate titration (n=3).
(66) TABLE-US-00014 TABLE 14 pH changes of PVP-I solution and formulations of this invention containing PVP-I in different pH range 0 Day 5 Day 10 Day 20 Day 30 Day Solution-no pH adjust 2.78 2.77 2.67 2.94 2.55 In situ gel-no pH adjust 3.28 3.3 3.19 3.45 3.08 Solution-pH 4-5 4.47 4.3 4.1 4.23 3.56 In situ gel-pH 4-5 4.47 4.53 4.11 4.33 3.81 Solution-pH 5-6 5.38 4.53 4.32 4.45 4.06 In situ gel-pH 5-6 5.21 4.65 4.39 4.5 4.19 Solution-pH 6-7 6.42 4.84 4.58 4.65 4.01 In situ gel-pH 6-7 6.56 4.96 4.61 4.64 4.24 Solution-pH 7-8 7.31 4.98 4.71 4.74 4.28 In situ gel-pH 7-8 7.61 5.03 4.67 4.57 4.2 Solution-pH 8-9 8.47 5.05 4.76 4.89 4.42 In situ gel-pH 8-9 8.58 5.14 4.77 5.07 4.52
(67) TABLE-US-00015 TABLE 15 The stability of povidone iodine solution (Available iodine) and povidone iodine in situ gel formulation in different pH range Available Iodine (%) Example 12 0 day Average 5 day Average Remaining NS-(2~4) 10.62 10.62 10.62 10.62 10.23 10.23 10.23 10.23 96.33% DGG-(2~4) 10.63 10.63 11.09 10.78 10.68 10.68 10.68 10.68 99.04% NS(4~5) 11.1 11.1 10.63 10.94 10.68 10.68 10.24 10.53 96.25% DGG(4~5) 10.62 10.62 10.62 10.62 10.18 10.23 10.18 10.20 96.01% NS(5~6) 11.09 11.09 10.63 10.94 10.24 10.24 10.24 10.24 93.63% DGG(5~6) 10.16 10.62 10.62 10.47 10.22 10.22 9.33 9.92 94.81% NS(6~7) 10.63 10.63 10.17 10.48 9.35 9.79 9.35 9.50 90.65% DGG(6~7) 10.61 11.07 10.15 10.61 9.33 10.22 9.77 9.77 92.11% NS(7~8) 11.07 11.07 11.07 11.07 10.66 10.66 10.66 10.66 96.30% DGG(7~8) 11.09 10.63 10.63 10.78 10.23 10.23 10.23 10.23 94.87% NS(8~9) 10.61 10.15 10.15 10.30 9.77 10.21 10.21 10.06 97.67% DGG(8~9) 10.63 10.63 10.63 10.63 10.23 10.23 10.23 10.23 96.24% Available Iodine (%) Example 12 10 day Average Remaining NS-(2~4) 10.29 10.29 10.29 10.29 96.89% DGG-(2~4) 10.75 10.3 10.75 10.60 98.30% NS(4~5) 10.3 10.75 10.3 10.45 95.49% DGG(4~5) 9.85 10.3 10.3 10.15 95.57% NS(5~6) 10.3 10.3 10.3 10.30 94.18% DGG(5~6) 9.84 9.84 9.84 9.84 94.01% NS(6~7) 9.85 9.85 9.41 9.70 92.62% DGG(6~7) 9.84 9.84 9.84 9.84 92.74% NS(7~8) 10.73 10.73 10.73 10.73 96.93% DGG(7~8) 10.3 10.3 9.85 10.15 94.13% NS(8~9) 9.83 10.28 10.28 10.13 98.32% DGG(8~9) 10.3 9.85 9.85 10.00 94.07% Available Iodine Example12 20 day Average Remaining 30 day Average Remaining NS-(2~4) 10.29 10.65 10.21 10.38 97.77% 9.32 9.3 9.3 9.31 87.63% DGG-(2~4) 9.33 9.77 9.77 9.62 89.24% 8.87 9.31 9.31 9.16 84.98% NS(4~5) 9.77 9.77 9.77 9.77 89.28% 9.76 9.31 10.2 9.76 89.16% DGG(4~5) 9.77 9.77 9.77 9.77 92.00% 9.75 9.31 9.75 9.60 90.43% NS(5~6) 9.77 9.77 9.77 9.77 89.33% 9.76 9.76 9.76 9.76 89.24% DGG(5~6) 9.76 9.76 9.76 9.76 93.25% 9.74 8.86 9.3 9.30 88.85% NS(6~7) 8.88 9.33 9.77 9.33 89.02% 8.87 8.87 8.87 8.87 84.66% DGG(6~7) 9.31 8.87 9.31 9.16 86.37% 9.29 8.85 8.85 9.00 84.79% NS(7~8) 9.75 9.75 9.75 9.75 88.08% 9.73 9.29 9.29 9.44 85.25% DGG(7~8) 9.33 9.33 8.88 9.18 85.13% 9.31 8.87 8.87 9.02 83.62% NS(8~9) 9.31 9.31 9.75 9.46 91.78% 9.29 9.29 9.29 9.29 90.16% DGG(8~9) 9.33 9.33 9.33 9.33 87.77% 9.75 9.31 8.87 9.31 87.58%
(68) As the result shown in Table 15 and
Example 13
(69) Evaluation of the stability of low-concentration povidone-iodine eye drops. The stability of low-concentration PVP-I solutions in two different formulations was investigated. Formulations of this invention containing PVP-I and PVP-I solution were prepared according to Table 16. Their pH was adjusted to 5.0-5.5 with NaOH, and the stability was evaluated at 25° C. The concentration of povidone-iodine was determined by sodium thiosulfate titration (n=3).
(70) TABLE-US-00016 TABLE 16 Formulations of two formulations containing low-concentration PVP-I 0.3% in situ gel 0.3% solution Ingredient Formulation (0.3% F.) Control (0.3% C.) DGG 0.30 g — PVP-I 0.30 g 0.30 g NaCl 0.30 g 0.35 g Dexamethasone — 0.10 g EDTA — 0.01 g Tyloxapol — 0.05 g Anhydrous sodium sulfate — 1.20 g Hydroxylethyl cellulose — 0.25 g Distilled water 100 mL 100 mL pH 5.5 5.5
(71) TABLE-US-00017 TABLE 17 Stability of two low-concentration of PVP-I solutions (Available Iodine) Available Iodine (%) 0 day Avg 7 day Avg Remaining % F 0.3% 11.00 11.46 10.95 11.14 11.01 10.80 10.86 10.89 98% C 0.3% 10.93 13.16 12.79 12.29 11.09 10.72 10.84 10.88 89% 14 day Avg Remaining % 21 day Avg Remaining % F 0.3% 10.64 10.72 8.82 10.06 90% 10.95 8.67 10.67 10.10 91% C 0.3% 12.46 10.73 8.78 10.66 87% 12.20 10.46 10.43 11.03 90%
(72) As the results shown in Table 17 and
Example 14 In Vitro Dissolution Experiment
(73) Formulations of this invention containing PVP-I was prepared according to the formulations set out in Table 18. 2 g sample was measured precisely (about 2 m|) and then added into a vial of 22 mm outer diameter, followed by addition of 350 μL simulated tear fluid (STF) and mixing quickly. The mixture was covered with a stopper and weighed precisely and recorded. Placed samples into an air shaker (34.5° C., 120 r/min), balanced for 10 min, and added simulated tear fluid (pre-heated to 34.5° C., 2 ml) along the side-wall slowly, took out all of the release medium at a different point in time, weighed quickly and recorded. 10 minute rebalance was needed after each shaking; took out the release medium before adding fresh STF (pre-heated to 34.5° C.); repeated this process until gel was dissolved completely. Draw gel dissolution time curve (n=3) by plotting the total amount of gel dissolution vs time.
(74) TABLE-US-00018 TABLE 18 Formulations of this invention containing PVP-I DGG (w/w) PVP-I (w/w) NaCl (w/w) pH Formulation (G) 0.2% 0.6% 0.3% 5.0~5.5 0.3% 0.4%
(75) As the results shown in Table 18 and
Example 15 Evaluate Irritation of Formulations of this Invention Containing PVP-I
(76) Evaluate eye damage severity according to eye irritation test (Draize test); criteria: 10 adult New Zealand white rabbits was taken (body weight 2.0-2.5 kg) and administered with 30 μL drug into intraocular capsule. Closed the rabbit eyes for 5-10 seconds passively after administration. According to scoring criteria, added all scores of the stimulus response of cornea, iris, and conjunctiva of each animal; the total score was a test animal eye irritation response. The final score of formulations of this invention containing PVP-I against ocular irritation was the total score of every animal stimulus response divided by the number of animals. The degree of ocular irritation was determined by the criteria.
(77) The test results showed that the rabbit's eyes were natural and comfortable after administering formulations of this invention containing PVP-I; it had small amount of secretions, making eyelids and eyelashes moist or sticky; however, it was regarded as minimum irritation according to eye injury severity scoring criteria (Draize test).
(78) Rabbit eye blinking test: Adult New Zealand rabbit (body weight ranging from 2.0 to 2.5 kg) werr administrated with 304 drug into left and right eye conjunctival sac respectively, closed rabbit eye for 5-10 seconds passively after administration. Recorded the numbers of blinks within 90 seconds after administration (n=10). The test groups were as follows: 1) normal saline group (NS); 2) 0.4% DGG blank matrix group (Control); 3) povidone iodine eye drop solution group (PVP-I+NS); 4) povidone iodine in situ gel eye drop formulation with DGG concentration of 0.2%, 0.3%, 0.4% (PVP-I in situ gel).
(79) TABLE-US-00019 TABLE 19 The formulation of povidone iodine compositions PVP-I 0.3% Gellan Eye Formulation- Formulation- Formulation- No. NS gum blank drop −0.2% G −0.3% G −0.4% G 1 2 2 10 11 7 5 2 3 3 11 11 7 5 3 2 3 5 4 8 3 4 2 4 8 4 8 4 5 2 4 5 5 5 6 6 2 3 5 5 7 6 7 2 3 9 5 5 4 8 3 3 10 6 6 4 9 2 1 6 4 3 8 10 2 2 7 4 3 8 Average 2.2 2.8 7.6 5.9 5.9 5.3 SD 0.4216 0.9189 2.3190 2.7669 1.8529 1.7029 p 0.077 0.043 0.010
(80) As the results shown in Table 19 and
Example 16 In Vitro Release Test
(81) Took 2 mL formulations of this invention containing PVP-I or 2 mL PVP-I normal saline solution, placed in a 14 KDa dialysis bag, added into 50 mL simulated tear fluid with pre-warmed to 34.5° C., shook samples via air shaker at 120 rpm, took out the release medium STF every 30 minutes, and added fresh release medium (pre-warmed to 34.5° C.) quickly. Determined available iodine concentration by sodium thiosulfate titration (n=3), and calculated its accumulative release amount.
(82) As the results shown in
Example 17 Evaluate Ophthalmic Retention Ability
(83) Placed 1 ml normal saline and formulations of this invention containing PVP-I in brown EP tube, added 0.5% fluorescein sodium respectively. Chose a healthy New Zealand rabbit, and made its head fixed. Dropped 50 μL fluorescent labeled PVP-I normal saline solution into its left eye and made it close passively for 10 s. Observed fluorescence condition of left eyes at 0 min, 2 min, 4 min, 6 min, 8 min and 10 min via slit lamp; dropped 50 μl formulations of this invention containing PVP-I into its right eye and made it close passively for 10 seconds. Observed fluorescence conditions of the right eyes at 0 min, 2 min, 5 min, 10 min, 20 min 30 min, 40 min, 50 min and 60 min with slit lamp.
(84) As the results shown in
Example 18 Chlorhexidine extended release in situ ophthalmic formulations
(85) In another embodiment, the in situ gel forming materials are not limited to polysaccharides described in the examples. The in-situ gel forming chlorhexidine digluconate compositions can be formulated with one or more ion-activated in-situ gel forming materials. The polymeric in-situ gel forming agents may include but not limited to dextrans, polyethylene glycols, polyvinylpyrolidone, polysaccharide gels, Gelrite®, alginate, sodium alginate, sodium hyaluronate, hyaluronic acid, cellulosic polymers like hydroxypropyl methylcellulose, and carboxy-containing polymers such as polymers or copolymers of acrylic acid, as well as other polymeric demulcents. One or more in-situ gel formation agents can be selected in the compositions. Preferred polymeric in-situ gel forming agents can be Deacetylated gellan gum (Gelrite®).
Example 19. Formulations of this Invention Containing PVP-I for Skin and Vaginal Disinfection
(86) Formulations of this invention containing PVP-I can be studied for their extended release of PVP-I on infected skin and in the infected vagina in the same manner as described above and are expected to have much longer lasting effect than the PVP-I solutions without the gelling effect.
(87) The above-mentioned compositions can be further combined with an artificial tear-based lubricant to improve the comfort of the povidone-iodine solution. The povidone-iodine is prepared in the abovementioned sustained release formulation and combined with artificial-tear based lubricants that may include but are not limited to Propylene glycol, glycerin, propylene glycol, blended polyvinyl alcohols, Polyvinyl Alcohol, Polyethylene Glycol 400, light mineral oil, hydroxypropyl methylcellulose, hypromellose, Carbopol 980, White petrolatum, Soy lecithin, sodium carboxyl methylcellulose, hydroxypropyl methylcellulose, hypromellose.
(88) In a preferred embodiment, the povidone-iodine (PVP-I) is between 0.1% and 2.5%, between 0.3 and 2%, between 0.3 and 1.5%, or between 0.3% and 1.0%.
(89) The ophthalmic compositions may further comprise (1) a topical anesthetic which relieves pain (2) a penetration enhancer which enhances the penetration of povidone-iodine into the tissues of the eye, for example, Azone (laurocapram) a glucan sulfate such as dextran sulfate, cyclodextrin sulfate, and -1,3-glucan sulfate (3) an antimicrobial preservative, which, for example, may be at a concentration of about 0.001% to 1.0% by weight; (4) a co-solvent or a nonionic surface agent—surfactant, which, for example, may be about 0.01% to 2% by weight; (5) viscosity increasing agent, which, for example, may be about 0.01% to 2% by weight; (6) a cooling agent such as menthol, menthol derivatives including methane glycerin acetyl and methyl esters, carboxamides, methane glycerol ketals, alkylsubstituted ureas, sulfonamides, terpene analogs, furanones, and phosphine oxides; or camphor, and borneol, which can provide coolness sensation on the eye; and (7) other medicaments such as anti-inflammatories, steroids, and NSAIDs.
(90) The compositions are useful in the treatment of infections of the conjunctiva and cornea. In another embodiment, the invention is directed to a method for treating and/or prophylaxis of an eye disorder or a microorganism infection of at least one tissue of the eye comprising the step of administering one of more doses of an ophthalmic composition, discussed above, to the eye. The eye disorder may be, for example, a microorganism infection of at least one tissue of the eye, conjunctivitis, corneal abrasion, ulcerative infectious keratitis, epithelial keratitis, stromal keratitis and herpesvirus-related keratitis. The microorganism may be bacteria (e.g., mycobacteria), virus, fungi, or amoebae.
(91) One embodiment of the invention is directed to an ophthalmic composition suitable for topical administration to an eye, effective for treatment and/or prophylaxis of a microorganism infection or a disorder of at least one tissue of the eye. Prophylaxis may be, for example, prophylaxis from infection following surgery, prophylaxis from infection after birth for the newborn, or prophylaxis from accidental contact with contaminating material. Accidental contact with contaminating material may occur, for example, during surgery or during food processing.
(92) In the method, the treatment may comprise administering a formulation of the invention where the weight of the PVP-I is between 0.001 mg to 5 mg per dose. Further, the dose volume may be between 10 microliters to 200 microliters or between 50 microliters to 80 microliters; about one drop per eye. Administration may be between 1 to 24 times a day, between 2 to 4 times a day or between 2 to 24 times a day.
(93) Suitable topical anesthetics for the compositions and methods of the invention include, at least, proparacaine, lidocaine, tetracaine or a derivative or combination thereof.
(94) In any of the compositions of this disclosure for topical administration, such as topical administration to the eye, the mixtures are preferably formulated as 0.01 to 2.0 percent by weight solutions in water at a pH of 5.0 to 8.0. This pH range may be achieved by the addition of acids/bases or buffers to the solution. While the precise regimen is left to the discretion of the clinician, it is recommended that the resulting solution be topically applied by placing one drop in each eye 1 to 24 times daily. For example, the solution may be applied 1, 2, 4, 6, 8, 12, 18 or 24 times a day.
(95) Antimicrobial Preservative
(96) As an optional ingredient, suitable antimicrobial preservatives may be added to prevent multi-dose package contamination, though povidone-iodine will serve as self-preservative. Such agents may include benzalkonium chloride, thimerosal, chlorobutanol, methyl paraben, propyl paraben, phenylethyl alcohol, EDTA, sorbic acid, Onamer M, other agents known to those skilled in the art, or a combination thereof. Typically such preservatives are employed at a level of from 0.001% to 1.0% by weight.
(97) Co-Solvents/Surfactants
(98) The compositions of the invention may contain an optional co-solvent. The solubility of the components of the present compositions may be enhanced by a surfactant or other appropriate co-solvent in the composition. Such co-solvents/surfactants include polysorbate 20, 60, and 80, polyoxyethylene/polyoxypropylene surfactants (e.g. Pluronic F-68, F-84 and P-103), cyclodextrin, tyloxapol, other agents known to those skilled in the art, or a combination thereof. Typically such co-solvents are employed at a level of from 0.01% to 2% by weight.
(99) Viscosity Agents
(100) The compositions of the invention may contain an optional viscosity agent—that is, an agent that can increase viscosity. Viscosity increased above that of simple aqueous solutions may be desirable to increase ocular absorption of the active compound, to decrease variability in dispensing the formulation, to decrease physical separation of components of a suspension or emulsion of the formulation and/or to otherwise improve the ophthalmic formulation. Such viscosity builder agents include as examples polyvinyl alcohol, polyvinyl pyrrolidone, methyl cellulose, hydroxy propyl methylcellulose, hydroxyethyl cellulose, carboxymethyl cellulose, hydroxy propyl cellulose, other agents known to those skilled in the art, or a combination thereof. Such agents are typically employed at a level of from 0.01% to 2% by weight.
(101) The invention has been described herein by reference to certain preferred embodiments. However, as obvious variations thereof will become apparent to those skilled in the art, the invention is not to be considered as limited thereto. All patents, patent applications, and references cited anywhere is hereby incorporated by reference in their entirety.