Devices and methods for sustained treatment of bladder pain and irritative voiding
Devices and methods are provided for treating a patient having bladder pain and/or irritative voiding symptoms. The method includes administering to the patient's bladder lidocaine or another anesthetic agent continuously over a treatment period of 24 hours or more in an amount effective to achieve a therapeutic effect which is sustained beyond the end of the treatment period.
1. A device for administering lidocaine continuously to a patient's bladder, the device comprising:
an elastic device body which comprises a tube which comprises a water-permeable material and defines a reservoir, the tube having a single aperture having a diameter between 100 μm and 200 μm;
a plurality of solid tablets disposed in the reservoir, wherein the plurality of solid tablets comprises from 150 mg to 1000 mg lidocaine, in a water-soluble salt form,
wherein the device body is configured to permit water to enter the reservoir through the water permeable material and solubilize the lidocaine and to provide continuous controlled release of the lidocaine from the device body, driven by osmotic pressure, over a treatment period of 48 hours or more in an amount effective to achieve a therapeutic effect which is sustained beyond the end of the treatment period, and
wherein the device body is configured to release over the treatment period a mean average amount of from about 5 mg to about 30 mg lidocaine Free Base Equivalent (FBE) per day through the single aperture.
2. The device of claim 1 , which is configured to release the lidocaine at a rate in a range from 15 mg to 30 mg lidocaine (FBE) per day over a first 1 to 4 days of the treatment period and at a rate in a range from 15 mg to 3 mg lidocaine (FBE) per day over a remainder of the treatment period.
3. The device of claim 1 , which is configured to release the lidocaine at a rate in a range from 25 mg to 60 mg lidocaine (FBE) per day over a first 1 to 6 days of the treatment period and at a rate in a range from 25 mg to 10 mg lidocaine (FBE) per day over a remainder of the treatment period.
4. The device of claim 1 , which is configured to release a cumulative amount of from 200 mg to about 400 mg lidocaine (FBE).
5. The device of claim 1 , which is configured to release the lidocaine continuously from 2 to 28 days.
6. The device of claim 5 , which is configured to release a mean average amount of from about 10 mg to about 30 mg lidocaine (FBE) per day over the treatment period.
7. The device of claim 1 , which is configured to release the lidocaine continuously from 3 to 21 days.
8. The device of claim 1 , which is configured to release the lidocaine continuously from 10 to 14 days.
9. The device of claim 1 , which is configured to release the lidocaine at a rate in a range from 20 mg to 70 mg lidocaine (FBE) per day over a first 1 to 6 days of the treatment period and at a rate in a range from 25 mg to 10 mg lidocaine (FBE) per day over a remainder of the treatment period.
10. The device of claim 1 , wherein the plurality of solid tablets comprises lidocaine hydrochloride monohydrate.
11. The device of claim 10 , wherein the tube is a silicone elastomer tube and the plurality of tablets are disposed in a lumen in the silicone elastomer tube.
12. The device of claim 11 , which comprises from 246 mg to 801 mg of lidocaine hydrochloride monohydrate.
13. The device of claim 12 , which is configured to release the lidocaine hydrochloride monohydrate continuously from 2 to 28 days, at a mean average amount of from about 5 mg to about 30 mg lidocaine (FBE) per day over the treatment period.
14. The device of claim 1 , wherein:
the plurality of tablets comprises at least 80 wt % lidocaine hydrochloride;
the device body is configured to permit the tablets to contact urine in the bladder of a human patient, solubilizing the lidocaine hydrochloride within the device body;
the device body is configured to permit the solubilized lidocaine hydrochloride to be released, through an aperture in the tube, from the device body continuously over a treatment period that is from 7 days to 21 days; and
a cumulative amount of the lidocaine released over the treatment period is from about 200 mg to about 600 mg.
15. The device of claim 14 , which is configured to release about 400 mg lidocaine over a treatment period of 14 days.
16. A device for administering lidocaine continuously to a patient's bladder, the device comprising:
a silicone elastomer tube which comprises an annulus defining a reservoir;
a plurality of solid tablets disposed in the reservoir, the tablets comprising at least 80 wt % lidocaine hydrochloride,
wherein the tube is configured to permit water to enter the reservoir through a water permeable wall and solubilize the tablets and to release of the solubilized lidocaine from a single aperture in the wall, driven by osmotic pressure, and
wherein the device is configured to release a cumulative amount of the lidocaine from about 200 mg to about 600 mg and to release the lidocaine at an average amount from 5 mg to about 30 mg lidocaine (FBE) per day over a period in which the device is deployed in the patient's bladder, wherein the single aperture has a diameter between 100 μm and 200 μm.