Safe desmopressin administration
Disclosed is a family of intranasal spray dispensers for administering uniform low doses of desmopressin so as to achieve safe antidiuresis in human patients. The dispensers of the invention may be used in the treatment of nocturia, primary nocturnal enuresis, incontinence, urinary frequency, diabetes insipidus, or any disease or syndrome where desmopressin therapy is useful or where safe temporary suppression of urine production may lead to beneficial health effects or increased convenience in voiding control.
1. A method of inducing an antidiuretic effect in a patient, the method comprising intranasally administering to the patient a composition of matter comprising an intranasal desmopressin dose in the form of a plume ejected over a time interval from the nozzle of a metered dose spray device, the plume comprising a volume of moving droplets together defining a conical volume having a central axis and an apex at the nozzle of the spray device, wherein the droplet density (number of droplets per unit volume) within the conical volume increases in a direction normal to the axis, the droplets together comprising between about 0.05 μg and 5.0 μg desmopressin, the plume serving to increase contact of the droplets with intranasal luminal mucosal surfaces.
2. The method of claim 1 , wherein the administering produces a desmopressin concentration no greater than 15+/−3 pg/ml in the bloodstream of the patient.
3. The method of claim 1 , wherein the administering produces a desmopressin concentration no greater than 10+/−3 pg/ml in the bloodstream of the patient.
4. The method of claim 1 , wherein the administering produces a desmopressin concentration no greater than 7+/−3 pg/ml in the bloodstream of the patient.
5. The method of claim 1 , wherein the administering induces antidiuresis for less than about six hours.
6. The method of claim 5 , wherein the administering induces antidiuresis for between about 2 and 4 hours.
7. The method of claim 1 , wherein the plume is effective to deliver transmucosally sufficient desmopressin to the bloodstream of a patient weighing 70 kg or 35 kg to produce a desmopressin blood concentration less than 18 pg/ml.
8. The method of claim 1 , wherein the plume is effective to produce a desmopressin blood concentration less than 15 pg/ml.
9. The method of claim 1 , wherein the plume is effective to produce a desmopressin blood concentration less than 10 pg/ml.
10. The method of claim 1 , wherein the droplets together comprise between about 0.2 μg and 5.0 μg desmopressin.
11. The method of claim 1 , wherein the droplets together comprise about 1.5 μg desmopressin.
12. The method of claim 1 , wherein the droplets together comprise about 0.75 μg desmopressin.
13. The method of claim 1 , wherein the droplets together comprise about 2 μg desmopressin.
14. The method of claim 1 , wherein the droplets further comprise a permeation enhancer.
15. The method of claim 14 , wherein the permeation enhancer comprises cyclopentadecanolide.
16. The method of claim 1 , wherein the droplets together comprise 1.5 μg desmopressin.
17. The method of claim 1 , wherein the droplets together comprise 0.75 μg desmopressin.
18. The method of claim 15 , wherein the droplets together comprise 1.5 μg desmopressin.
19. The method of claim 15 , wherein the droplets together comprise 0.75 μg desmopressin.