Intranasal epinephrine formulations and methods for the treatment of disease
Drug products adapted for nasal delivery comprising formulations with epinephrine and devices comprising such formulations are provided. Methods of treating anaphylaxis with epinephrine products are also provided.
1. A method of treatment of a type-1 hypersensitivity reaction in a mammal comprising administering intranasally to the mammal in need thereof an aqueous nasal spray pharmaceutical formulation; wherein the aqueous nasal spray pharmaceutical formulation comprises:
an anaphylaxis active ingredient, wherein the anaphylaxis active ingredient consists of between about 0.1 mg and about 2.4 mg of epinephrine, or a salt thereof in a single dose.
2. The method of claim 1 , wherein:
the type-1 hypersensitivity reaction is chosen from allergic asthma, allergic conjunctivitis, allergic rhinitis, anaphylaxis, angioedema, urticaria, eosinophilia, drug allergy or food allergy; and
the aqueous nasal spray pharmaceutical formulation comprises the anaphylaxis active ingredient consisting of between about 0.4 mg and about 2.4 mg of epinephrine, or a salt thereof, in a single dose.
3. The method of claim 1 , wherein:
intranasal administration of the single dose of the aqueous nasal spray pharmaceutical formulation to the mammal provides a plasma epinephrine concentration that is efficacious for the treatment of anaphylaxis.
4. The method of claim 3 , wherein:
about 100 μL of the aqueous nasal spray pharmaceutical formulation is delivered to the mammal in one actuation of a nasal spray device.
5. The method of claim 3 , wherein:
the single dose of the aqueous nasal spray pharmaceutical formulation comprises the anaphylaxis active ingredient consisting of between about 0.5 mg and about 1.5 mg of epinephrine, or a salt thereof.
6. The method of claim 3 , wherein:
the single dose of the aqueous nasal spray pharmaceutical formulation comprises the anaphylaxis active ingredient consisting of between about 0.5 mg and about 0.7 mg of epinephrine, or a salt thereof; about 1.0 mg of epinephrine, or a salt thereof; or between about 1.3 mg and about 1.5 mg of epinephrine, or a salt thereof.
7. The method of claim 1 , wherein the aqueous nasal spray pharmaceutical formulation comprises: the anaphylaxis active ingredient consisting of
between about 0.5 mg and about 1.5 mg of epinephrine, or a salt thereof;
one or more absorption enhancement agents; and
optionally one or more of other agents comprising the following: an isotonicity agent; a stabilizing agent; an antioxidant; a preservative; or pH adjustment agents.
8. The method of claim 7 , wherein the one or more absorption enhancers are selected from the group consisting of dodecyl maltoside, benzalkonium chloride, a fatty acid, or salt thereof, polysorbate 20, polysorbate 80, and sodium lauryl sulfate.
9. The method of claim 7 , wherein the one or more absorption enhancement agents are selected from the group consisting of:
dodecyl maltoside;
benzalkonium chloride;
oleic acid, or salt thereof;
a combination of dodecyl maltoside and benzalkonium chloride;
a combination of dodecyl maltoside and oleic acid, or salt thereof; and
a combination of benzalkonium chloride and oleic acid, or salt thereof.
10. The method of claim 7 , wherein the one or more absorption enhancement agents are selected from the group consisting of:
about 0.005% (w/v) to about 2.5% (w/v) dodecyl maltoside;
about 0.001 (w/v) to about 1% (w/v) benzalkonium chloride;
about 0.001 (w/v) to about 1% (w/v) oleic acid, or salt thereof;
a combination of about about 0.005% (w/v) to about 2.5% (w/v) dodecyl maltoside and about 0.001 (w/v) to about 1% (w/v) benzalkonium chloride;
a combination of about about 0.005% (w/v) to about 2.5% (w/v) dodecyl maltoside and about 0.001 (w/v) to about 1% (w/v) oleic acid, or salt thereof; and
a combination of about 0.001 (w/v) to about 1% (w/v) benzalkonium chloride and about 0.001 (w/v) to about 1% (w/v) oleic acid, or salt thereof.
11. The method of claim 7 , wherein the one or more absorption enhancement agents are selected from:
about 0.005% (w/v) to about 0.08% (w/v) benzalkonium chloride;
about 0.01% (w/v) to about 0.06% (w/v) benzalkonium chloride; or
about 0.01% (w/v) to about 0.04% (w/v) benzalkonium chloride;
wherein the benzalkonium chloride is the sole absorption enhancement agent in the formulation or is present in the formulation with one or more other absorption enhancement agents.
12. The method of claim 7 , wherein the isotonicity agent is sodium chloride.
13. The method of claim 7 , wherein the stabilizing agent is ethylenediaminetetraacetic acid (EDTA) or a salt thereof.
14. The method of claim 13 , wherein the formulation comprises from about 0.001% (w/v) to about 1% (w/v) of disodium EDTA.
15. The method of claim 7 , wherein the preservative is benzalkonium chloride.
16. The method of claim 7 , wherein the aqueous nasal spray pharmaceutical formulation comprises pH adjustment agents and the aqueous nasal spray pharmaceutical formulation has a pH between about 2.0 and about 6.0.
17. The method of claim 7 , wherein the pH adjustment agent is an acid, a base, a buffer, or a combination thereof.
18. The method of claim 5 , wherein the aqueous nasal spray pharmaceutical formulation further comprises:
dodecyl maltoside, benzalkonium chloride, or a combination of dodecyl maltoside and benzalkonium chloride;
dextrose, glycerin, mannitol, potassium chloride, or sodium chloride;
ethylenediaminetetraacetic acid (EDTA) or a salt thereof; and
optional pH adjustment agents to adjust the pH of the aqueous nasal spray pharmaceutical formulation to a pH between about 2.0 and about 6.0.
19. The method of claim 3 , wherein the single dose of the aqueous nasal spray pharmaceutical formulation comprises: the anaphylaxis active ingredient consisting of
between about 0.5 mg and about 1.5 mg of epinephrine;
dodecyl maltoside;
benzalkonium chloride;
ethylenediaminetetraacetic acid (EDTA) or a salt thereof;
sodium chloride;
water; and
optional pH adjustment agents to adjust the pH of the aqueous nasal spray pharmaceutical formulation to a pH between about 2.0 and about 6.0.
20. The method of claim 4 , wherein the single dose of the aqueous nasal spray pharmaceutical formulation comprises: the anaphylaxis active ingredient consisting of
between about 0.4 mg and about 2.0 mg of epinephrine;
dodecyl maltoside;
benzalkonium chloride;
ethylenediaminetetraacetic acid (EDTA) or a salt thereof;
sodium chloride; and
optional pH adjustment agents to adjust the pH of the aqueous nasal spray pharmaceutical formulation to a pH between about 3.0 and about 5.0.