KIT FOR PREPARING INJECTABLE CARMUSTINE SOLUTIONS
The present invention relates to an improved kit for preparing injectable carmustine solutions, methods of preparing and administering such solutions, and methods of treatment with such solutions. The kit includes a product vial containing lyophilised carmustine and a diluent vial containing an ethanol-free non-aqueous diluent. Reconstitution of the lyophilised carmustine in the ethanol-free non-aqueous diluent results in a carmustine solution with improved solubility and stability.
1 . A method for administering carmustine to a patient in need thereof comprising administering by intravenous infusion an administrable solution of carmustine, wherein the administrable solution is prepared by:
(a) dissolving 50-200 mg of lyophilized carmustine in 2-6 mL of sterile propylene glycol to form a reconstituted solution, and
(b) diluting the reconstituted solution with an aqueous 0.9% sodium chloride solution or an aqueous 5% dextrose solution to obtain the administrable solution.
2 . The method of claim 1 , wherein step (a) comprises dissolving 100 mg of lyophilized carmustine in 3 mL of sterile propylene glycol to form a reconstituted solution.
3 . The method of claim 1 , wherein prior to dissolving the lyophilized carmustine in the propylene glycol, (i) the lyophilized carmustine and propylene glycol are stored in separate vials at 2-8° C. and (ii) the propylene glycol is allowed to attain room temperature just prior to dissolving the lyophilized carmustine in the propylene glycol.
4 . The method of claim 1 , wherein prior to dissolving the lyophilized carmustine in the propylene glycol, (i) the lyophilized carmustine and propylene glycol are stored in separate vials at 2-8° C. and (ii) the vials are allowed to attain room temperature just prior to dissolving the lyophilized carmustine in the propylene glycol.
5 . The method of claim 3 , wherein the propylene glycol is aseptically removed from its vial with a sterile syringe having a needle below 22 gauge and injected into the vial containing the lyophilized carmustine.
6 . The method of claim 1 , wherein the reconstituted solution contains at least 90% of the initial carmustine after storage at 2-8° C. for up to 480 hours.
7 . The method of claim 1 , wherein
the reconstituted solution is stored at 2-8° C. for up to 480 hours prior to step (b), and
after storage at 2-8° C. and prior to performing step (b), the reconstituted solution is examined for crystal formation and if crystals are observed, they are re-dissolved by warming the re-constituted solution to room temperature with agitation.
8 . The method of claim 1 , wherein step (b) comprises diluting the reconstituted solution up to 500 mL with an aqueous 0.9% sodium chloride solution or 500 mL of an aqueous 5% dextrose solution to obtain the administrable solution.
9 . The method of claim 1 , wherein step (b) is performed within 48 hours of the reconstituted solution being prepared.
10 . The method of claim 1 , wherein step (b) is performed more than 24 hours but less than 48 hours after the reconstituted solution is prepared.
11 . The method of claim 1 , wherein the administrable solution of carmustine is administered by intravenous infusion over at least two hours.
12 . The method of claim 1 , wherein the concentration of carmustine in the administrable solution is 0.2 mg/mL.
13 . The method of claim 1 , wherein administrable solution has a pH in the range of 6 to 7 and an osmolality in the range of 330-390 mOsmol/L.
14 . A method for administering carmustine to a patient in need thereof comprising administering by intravenous infusion an administrable solution of carmustine, wherein
the administrable solution is prepared from a kit comprising a product vial containing 100 mg of lyophilized carmustine and a diluent vial containing 3 mL of sterile propylene glycol, the kit being stored at 2-8° C., and
the administrable solution is prepared by:
(a) allowing the diluent vial to attain room temperature,
(b) aseptically removing the 3 mL of propylene glycol from the diluent vial, injecting it into the product vial containing 100 mg of lyophilized carmustine, and shaking the product vial to dissolve the lyophilized carmustine to form a reconstituted solution,
(c) optionally, storing the reconstituted solution and prior to performing step (d), the stored reconstituted solution is examined for crystal formation and if crystals are observed, they are re-dissolved by warming the reconstituted solution to room temperature with agitation, and
(d) diluting the reconstituted solution up to 500 mL with an aqueous 0.9% sodium chloride solution or an aqueous 5% dextrose solution to obtain the administrable solution.
15 . The method of claim 14 , wherein the propylene glycol is removed from the diluent vial in step (b) with a below 22 gauge needle.
16 . A kit for preparing an injectable carmustine solution, the kit comprising a product vial containing lyophilized carmustine and a diluent vial containing sterile propylene glycol, wherein, upon dissolving the lyophilized carmustine in the propylene glycol, the resulting solution contains at least 90% of the initial carmustine after storage at 2-8° C. for up to 720 hours or at 25° C.±2° C. for up to 48 hours.
17 . The kit according to claim 16 , wherein the concentration of lyophilized carmustine in product vial is from about 2 mg/vial to about 500 mg/vial.
18 . The kit according to claim 16 , wherein the amount of propylene glycol in the diluent vial is between 1 ml and 20 ml.
19 . The kit according to claim 16 , wherein in a single-step reconstitution procedure, the lyophilized carmustine from the product vial is reconstituted with specified amount of propylene glycol from the diluent vial.
20 . The kit according to claim 16 , wherein the product vial contains 50-200 mg of lyophilized carmustine and the diluent vial contains 2-4 mL of sterile propylene glycol.