Vaginal inserted estradiol pharmaceutical compositions and methods
Disclosed herein is, among other things, a soft gel vaginal pharmaceutical composition and dosage form containing solubilized estradiol for the treatment of vulvovaginal atrophy (VVA) and female sexual dysfunction (FSD).
1. A method for treating the symptoms of vulvo-vaginal atrophy (VVA) comprising:
administering to a human subject having VVA a vaginal suppository comprising a liquid composition containing 4 μg to 25 μg of estradiol,
wherein the viscosity of the liquid composition is from about 50 cps to about 1000 cps at 25° C.,
wherein the administration is conducted daily for two weeks, and twice weekly thereafter, and
wherein the treatment is effective at or within two weeks after administering the first vaginal suppository.
2. The method of claim 1 , wherein adverse events associated with administering the estradiol, other than headaches, do not differ significantly from adverse events associated with administering a placebo.
3. The method of claim 1 , wherein the symptoms of VVA comprise one or more symptoms selected from vaginal dryness, dyspareunia, vaginal or vulvar irritation, burning, or itching, dysuria, and vaginal bleeding associated with sexual activity.
4. The method of claim 1 , comprising increasing the level of vaginal secretions in a subject, as assessed by visual examination.
5. The method of claim 1 , comprising increasing the number of vaginal rugae in the subject, as assessed by visual examination.
6. The method of claim 1 , comprising decreasing vaginal bleeding or petechiae in the subject, as assessed by visual examination.
7. The method of claim 1 , comprising changing the color of the vaginal mucosa in the subject from transparent to pink, or from pale pink to pink, as assessed by visual examination.
8. The method of claim 1 , wherein the treatment decreases the severity of at least one symptom selected from the group consisting of vaginal dryness, vulvar or vaginal itching, and dyspareunia at or within two weeks after administering the first vaginal suppository.
9. The method of claim 8 , wherein the severity is measured on a scale of 0 to 3, where 0 is none, 1 is mild, 2 is moderate, and 3 is severe.
10. The method of claim 1 , wherein the liquid composition further includes a solubilizing agent, wherein the solubilizing agent includes at least one C6-C12 fatty acid or a glycol, monoglyceride, diglyceride, or triglyceride ester thereof.
11. The method of claim 1 , wherein the liquid composition contains 4 μg estradiol.
12. The method of claim 1 , wherein the vaginal liquid composition contains 10 μg estradiol.
13. The method of claim 1 , wherein the vaginal liquid composition contains 25 μg estradiol.
14. The method of claim 1 , wherein the vaginal suppository does not include a hydrophilic gel-forming bioadhesive agent in the liquid composition.
15. The method of claim 1 , wherein estradiol is the only active hormone in the vaginal suppository.
16. The method of claim 1 , wherein the subject remains ambulatory for a period of time beginning about 5 minutes after administering the vaginal suppository and ending about 4 hours after administering the vaginal suppository.
17. A method for treating female sexual dysfunction, the method comprising administering to a human female subject in need thereof, a vaginal suppository comprising: (a) a liquid composition comprising: a therapeutically effective amount of estradiol; a caprylic/capric triglyceride; a non-ionic surfactant comprising PEG-6 stearate and ethylene glycol palmitostearate; and (b) a soft gelatin capsule; wherein the liquid composition contains from about 1 microgram to about 25 micrograms of estradiol; wherein the viscosity of the liquid composition is from about 50 cps to about 1000 cps at 25° C.; wherein estradiol is the only active hormone in the vaginal suppository; and wherein the administration is conducted daily for two weeks, and twice weekly thereafter.
18. The method of claim 17 , wherein the suppository includes about 4 μg of estradiol, about 10 μg of estradiol, or about 25 μg of estradiol.