Epinephrine spray formulations

1. A bi-dose nasal delivery device adapted for delivery of a pharmaceutical composition into a nostril of a human subject, comprising:

(a) the pharmaceutical composition configured as an aqueous pharmaceutical nasal spray formulation comprising

i) from about 1% to about 10% (w/w) of epinephrine, or a pharmaceutically acceptable salt thereof, in water;

ii) about 1% (w/w) of diethylene glycol monoethyl ether;

iii) from about 0.01% to about 0.2% (w/w) of hypromellose;

iv) from about 0.01% to about 0.1% (w/w) of sodium bisulfite or sodium metabisulfite;

v) from about 0.1% to about 1.0% (w/w) of chlorobutanol or chlorobutanol hemihydrate;

vi) from about 0.1% to about 1% (w/w) of citric acid or citric acid monohydrate; and

vii) from about 0.1% to about 1.0% (w/w) of sodium chloride; and

(b) a reservoir containing from about 125 uL to about 250 uL of the pharmaceutical composition,

wherein the bi-dose device is configured to administer the pharmaceutical composition into the nostril of the human subject as one or two nasal sprays.

2. The device of claim 1 , wherein the device is a pre-primed device that is configured to be actuatable with one hand.

3. The device of claim 1 , wherein the device is configured to deliver about 100 uL of the pharmaceutical composition from the reservoir upon each actuation of the device.

4. The device of claim 1 , wherein the pharmaceutical composition has a pH from about 4.0 to about 6.5.

5. The device of claim 1 , wherein one or more sprays take a shape of a round plume with an ovality ratio less than about 2.0.

6. The device of claim 1 , wherein the pharmaceutical composition comprises about 2% or about 5% (w/w) of epinephrine, or a pharmaceutically acceptable salt thereof.

7. The device of claim 1 , wherein the pharmaceutical composition is stable for a period of at least about three months at a temperature of at least about 20° C.

8. The device of claim 1 , wherein the pharmaceutical composition is stable for a period of at least one month at a temperature of at least about 40° C.

9. The device of claim 1 , wherein the pharmaceutical composition comprises no more than 2% total impurities after storage for a period of at least one month at a temperature of at least about 40° C.

10. A method for treating at least one symptom of anaphylaxis or anaphylactic shock, comprising administering a spray of a pharmaceutical spray composition from a bi-dose nasal delivery device according to claim 1 into at least one nostril of subject in need thereof.

11. The method of claim 10 , wherein the subject is suffering from a severe allergic reaction from exposure or suspected exposure to an allergen.

12. The method of claim 11 , wherein the allergen is food, medication, or an insect bite or sting.

13. The method of claim 10 , wherein the subject exhibits one or more symptoms chosen from: respiratory depression or distress, airway constriction, wheezing, tingling hands, feet, mouth, or scalp, shortness of breath, swelling or inflammation of the face, eyes, lips, tongue, or throat, hives, central nervous system depression, cardiovascular depression, altered level consciousness, mydriatic pupils, hypoxemia, hypotension, unresponsiveness to stimulus, unconsciousness, stopped breathing, erratic or stopped pulse, and vomiting.

14. The method of claim 13 , wherein the subject exhibits respiratory depression or distress, or cardiovascular depression.

15. The method of claim 14 , wherein the subject is free from respiratory depression or distress for at least about 1 hour following delivery of the pharmaceutical spray composition.

16. The method of claim 10 , wherein the pharmaceutical spray composition comprises about 2% or about 5% (w/w) of epinephrine, or a pharmaceutically acceptable salt thereof.

17. A pre-primed device adapted for delivery of an aqueous pharmaceutical composition into one or both nostrils of a human subject, comprising a reservoir containing from about 125 uL to about 250 uL of the pharmaceutical composition, wherein the pharmaceutical composition comprises:

a) from about 1% to about 10% (w/w) of epinephrine, or a pharmaceutically acceptable salt thereof, in water;

b) about 1% (w/w) of diethylene glycol monoethyl ether;

c) from about 0.01% to about 0.2% (w/w) of hypromellose;

d) from about 0.01% to about 0.1% (w/w) of sodium bisulfite or sodium metabisulfite;

e) from about 0.1% to about 1.0% (w/w) of chlorobutanol or chlorobutanol hemihydrate;

f) from about 0.1% to about 1% (w/w) of citric acid or citric acid monohydrate; and

g) from about 0.1% to about 1.0% (w/w) of sodium chloride,

wherein the pre-primed device is configured to administer the pharmaceutical composition as one or more sprays into one or both nostrils of the human subject.