Intranasal delivery of olanzapine by precision olfactory device
Methods are provided for acute treatment of agitation, including agitation in patients with schizophrenia or bipolar disorder, comprising administering to a subject with agitation an effective dose of a dry pharmaceutical composition comprising olanzapine, wherein the dose is administered by an intranasal delivery device that provides, following intranasal administration, (a) a mean peak plasma olanzapine concentration (C max ) of at least 30 ng/mL, with (b) a mean time to C max (T max ) of olanzapine of less than 0.5 hours. Dry pharmaceutical compositions and devices suitable for intranasal delivery of olanzapine are provided.
1. A method for acutely treating agitation in a human subject, comprising:
intranasally administering a single dose of a dry pharmaceutical composition comprising 2-20 mg of olanzapine to the human subject exhibiting agitation by an intranasal delivery device, thereby reducing agitation within 30 minutes,
wherein the median diameter of the olanzapine particle size distribution (D50) in the dry pharmaceutical composition is between 1 μm and 100 μm,
wherein the intranasal delivery device comprises a compound chamber containing the dry pharmaceutical composition, a separate propellant canister containing propellant and a narrow, targeted delivery plume, wherein the propellant released from the canister contacts and propels the dry pharmaceutical composition through the narrow, targeted delivery plume to an upper nasal cavity;
wherein the intranasal administration provides a shorter median T max compared to intramuscular or oral administration of the single dose of olanzapine, and
wherein the intranasal administration provides a mean peak plasma olanzapine concentration (C max ) of at least 25 ng/ml.
2. The method of claim 1 , wherein the dry pharmaceutical composition is a powder.
3. The method of claim 2 , wherein the powder comprises olanzapine (i) in a crystalline form, (ii) in an amorphous form, optionally wherein the amorphous form is obtained by spray-drying, or (iii) in a partially crystalline and partially amorphous form.
4. The method of claim 2 , wherein the median diameter of the olanzapine particle size distribution (D50) in the powder is between 1 μm and 50 μm.
5. The method of claim 1 , wherein the dry pharmaceutical composition comprises no more than 70 wt% olanzapine, no more than 60 wt% olanzapine, 10-60% wt% olanzapine, 25-55 wt% olanzapine, 30-50 wt% olanzapine, or 40-50 wt% olanzapine.
6. The method of claim 1 , wherein the dry pharmaceutical composition comprises less than 3 wt% water, less than 2 wt% water, less than 1.5 wt% water, less than 1 wt% water, or less than 0.5 wt% water.
7. The method of claim 5 , wherein the dry pharmaceutical composition consists essentially of:
50 wt% olanzapine;
42 wt% hydroxypropylmethylcellulose (HPMC); and
8 wt% 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC).
8. The method of claim 1 , wherein the intranasal delivery device is (i) a handheld, manually actuated, metered-dose intranasal administration device or (ii) a handheld, manually actuated, propellant-driven, metered-dose intranasal administration device.
9. The method of claim 1 , wherein the dry pharmaceutical composition is, prior to device actuation, (i) encapsulated within a capsule positioned within the device or (ii) stored within a dose container that is removably coupled to the device.
10. The method of claim 1 , wherein the effective dose of dry pharmaceutical composition comprises 5-15 mg of olanzapine, 5 mg of olanzapine, 10 mg of olanzapine, or 15 mg of olanzapine.
11. The method of claim 1 , wherein the subject has schizophrenia, bipolar disorder, autism, dementia, post traumatic stress disorder (PTSD), intoxication, or a drug-induced psychotic state.
12. The method of claim 1 , wherein the intranasal administration provides: a mean peak plasma olanzapine concentration (C max ) of at least 30 ng/mL, at least 40 ng/mL, at least 50 ng/mL, at least 60 ng/mL, at least 70 ng/mL or at least 80 ng/mL.
13. A kit for acutely treating agitation in a human subject, comprising:
a dry pharmaceutical composition in a unit dosage form suitable for intranasal administration, comprising:
2-20 mg of olanzapine as a single dose, and at least one excipient, wherein the median diameter of the olanzapine particle size distribution (D50) in the dry pharmaceutical composition is between 1 μm and 100 μm, and,
an intranasal delivery device comprising a compound chamber containing the dry pharmaceutical composition, a propellant canister containing the propellant, and a narrow, targeted delivery plume, wherein the propellant released from the propellant canister propels the dry pharmaceutical composition through the narrow, targeted delivery plume to the upper nasal cavity, thereby providing (1) a median T max which is shorter compared to intramuscular or oral administration of the unit dose of olanzapine, (2) a mean peak plasma olanzapine concentration (C max ) of at least 25ng/m1 and (3) reducing agitation within 30 minutes.
14. The kit of claim 13 , wherein the dry pharmaceutical composition is a powder.
15. The kit of claim 14 , wherein the dry pharmaceutical composition comprises olanzapine (i) in a crystalline form, (ii) in an amorphous form, optionally wherein the amorphous olanzapine is obtained by spray-drying or (iii) in a partially crystalline and partially amorphous form.
16. The kit of claim 14 , wherein the median diameter of the olanzapine particle size distribution (D50) in the powder is between 1 μm and 50 μm.
17. The kit of claim 13 , wherein the dry pharmaceutical composition comprises no more than 70 wt% olanzapine, no more than 60 wt% olanzapine, 10-60 wt% olanzapine, 25-55 wt% olanzapine, 30-50 wt% olanzapine, 30-40 wt% olanzapine, or 40-50 wt% olanzapine.
18. The kit of claim 13 , wherein the dry pharmaceutical composition further comprises a stabilizer, wherein the stabilizer is selected from the group consisting of:
HPMC, polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft co-polymer (Soluplus), vinyl pyrrolinone-vinyl acetate copolymer (Kollidon VA64), polyvinyl pyrrolinone K30 (Kollidon K30), polyvinyl pyrrolidine K90 (Kollidon K90), hydroxypropylcellulose (HPC), hydroxypropyl betacyclodextrin (HPBCD), mannitol, and lactose monohydrate.
19. The kit of claim 13 , wherein the dry pharmaceutical composition further comprises a permeation enhancer, wherein the permeation enhancer is selected from the group consisting of n-tridecyl-B-D-maltoside, n-dodecyl-β-D-maltoside, 1,2-distearoyl-sn-glycero-3-phosphocholine DSPC, 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC), 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), propylene glycol, disodium EDTA, PEG400 monostearate, polysorbate 80, and macrogol (15)-hydroxystearate.
20. The kit of claim 13 , wherein the dry pharmaceutical composition further comprises an antioxidant, wherein the antioxidant is selected from the group consisting of alpha tocopherol, ascorbic acid, ascorbyl palmitate, bronopol butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), citric acid monohydrate, sodium ascorbate, ethylene diainetetraacetic acid, fumaric acid, malic acid, methionine, propionic acid, sodium metabisulfite, sodium sulfite, sodium thiosulfate, thymol, and vitamin E polyethylene glycol succinate.
21. The kit of claim 13 , wherein the dry pharmaceutical composition comprises less than 3 wt% water, less than 2 wt% water, less than 1.5 wt% water, less than 1 wt% water, or less than 0.5 wt% water.
22. The kit of claim 13 , wherein the dry pharmaceutical composition consists essentially of:
50 wt% olanzapine;
42 wt% hydroxypropylmethylcellulose (HPMC); and
8 wt% 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC).
23. The kit of claim 13 , wherein the dry pharmaceutical composition contains 5-15 mg of olanzapine, 5 mg of olanzapine, 10 mg of olanzapine, or 15 mg of olanzapine.
24. The kit of claim 13 , further comprising a capsule that encapsulates the dry pharmaceutical composition or a dose container that stores the dry pharmaceutical composition, wherein the dose container is configured to removably couple to the device.