Magnesium compositions for modulating the pharmacokinetics and injection site pain of insulin
Compositions and methods for modulating injection site pain associated with rapid acting injectable insulin formulations have been developed for subcutaneous injection. The formulations contain insulin in combination with a zinc chelator such as ethylenediaminetetraacetic acid (“EDTA”), a dissolution/stabilization agent such as citric acid, a magnesium salt, and, optionally, additional excipients. New presentations include rapid acting concentrated insulin formulations and a way to enhance the absorption of commercially available rapid acting analog formulations by mixing them with a vial containing dry powder excipients that accelerate their absorption. Devices for mixing excipient and insulin together at the time of administration, while minimizing residence time of the mixture, are also described.
1. An injectable insulin formulation comprising
(a) monomeric insulin, dimeric insulin, or both,
(b) an effective amount of a dissolution/stabilizing agent to stabilize the monomeric and dimeric insulin,
(c) an effective amount of a chelator to chelate the zinc in the insulin, and
(d) an effective amount of one or more magnesium compounds to decrease injection site pain, compared to the same formulation with sodium EDTA that does not include the one or more magnesium compounds, and
wherein the formulation does not significantly alter the rate of uptake of the insulin, compared to the same formulation with sodium EDTA, which does not include the one or more magnesium compounds.
2. The formulation of claim 1 wherein the insulin is human recombinant insulin.
3. The formulation claim 1 where the insulin is an insulin analog.
4. The formulation of claim 1 wherein the insulin concentration is 100, 200, 400 or 500 U/mL.
5. The formulation of claim 1 , wherein the one or more magnesium compounds are selected from the group consisting of inorganic magnesium salts, organic magnesium salts, and combinations thereof.
6. The formulation of claim 5 , wherein the inorganic magnesium salts are selected from the group consisting of magnesium hydroxide (Mg(OH) 2 ), magnesium sulfate (Mg(SO 4 ) 2 ), magnesium pyrophosphate, magnesium sulfate heptahydrate, magnesium oxide (MgO 2 ), and combinations thereof.
7. The formulation of claim 5 , wherein the organic magnesium salts are selected from the group consisting of magnesium EDTA, magnesium lactate, magnesium acetate, magnesium carbonate (Mg(CO 3 ) 2 ), magnesium citrate, and magnesium gluconate.
8. The formulation of claim 1 , wherein the one or more magnesium compounds are Mg(OH) 2 , MgSO 4 , magnesium EDTA, or combinations thereof.
9. The formulation of claim 1 , wherein the concentration of the one or magnesium compounds is between about 0.1 and about 10 mg/ml.
10. The formulation of claim 1 , wherein the formulation contains about 0.2-0.3 mg/ml Mg(OH) 2 , about 1.7-2.0 magnesium EDTA, about 0.4-0.5 magnesium sulfate, or combinations thereof.
11. The formulation of claim 1 wherein the dissolution/stabilization agent is selected from the group consisting of acetic acid, ascorbic acid, citric acid, glutamic, succinic, aspartic, maleic, fumaric, adipic acid, and salts thereof.
12. The formulation of claim 1 wherein the dissolution/stabilization agent forms citric ions and the pH is about 7.
13. The formulation of claim 11 wherein the dissolution/stabilization agent is citric acid or sodium citrate.
14. The formulation of claim 11 wherein the dissolution/stabilization agent is citric acid or sodium citrate in a range between 2.0×10 −4 M and 4.5×10 −3 M.
15. The formulation of claim 1 wherein the dissolution/stabilization agent is citric acid or sodium citrate in a range between 7×10 −3 M and 2×10 ×2 M.
16. The formulation of claim 1 wherein the dissolution/stabilization agent is citric acid or sodium citrate at about 9.37×10 −3 M or about 1.4×10 −2 M.
17. The formulation of claim 1 further comprising calcium chloride.
18. The formulation of claim 1 further comprising glycerine and m-cresol.
19. The formulation of claim 1 , wherein the chelator is sodium EDTA.
20. The formulation of claim 5 , wherein the inorganic magnesium salts are magnesium halides, selected from the group consisting of magnesium chloride (MgCl 2 ), magnesium bromide (MgBr 2 ), magnesium iodide (MgI 2 ) and combinations thereof.
21. The formulation of claim 5 , wherein the organic magnesium salts are magnesium amino acid chelates.
22. The formulation of claim 21 , wherein the magnesium amino acid chelate is magnesium aspartate.
23. The formulation of claim 9 , wherein the concentration of the one or magnesium compounds is between about 0.1 and about 5 mg/ml, between about 0.1 and about 2 mg/ml, or between about 0.2 and about 2 mg/ml.