Intranasal delivery of dihydroergotamine by precision olfactory device
Methods are provided for acutely treating migraine headache with or without aura. The methods comprise administering to a subject with migraine headache an effective dose of a liquid pharmaceutical composition comprising dihydroergotamine (DHE) or a salt thereof, wherein the dose is administered by an intranasal delivery device that provides, following intranasal administration, (a) a mean peak plasma DHE concentration (C max ) of at least 750 pg/ml, (b) with a mean time to C max (T max ) of DHE of less than 45 minutes, and (c) a mean plasma AUC 0-inf of DHE of at least 2500 pg*hr/ml. Also provided are kits for acutely treating migraine with or without aura in which a liquid pharmaceutical composition comprising DHE or DHE salt is contained within a sealed vial that is attachable to a precision intranasal olfactory delivery device packaged therewith.
1. A method of acutely treating migraine headache with or without aura, comprising:
administering, via a manually actuated, metered-dose, propellant-driven intranasal delivery device, to a subject with migraine headache an effective dose of a liquid pharmaceutical composition comprising 4 mg/mL of dihydroergotamine (DHE) mesylate,
wherein the effective dose comprises 1.45 mg of DHE mesylate administered as two divided doses of one spray per each nostril without requiring a timed wait between the two divided doses, and
wherein the manually actuated, metered-dose, propellant-driven intranasal delivery device is configured to sequentially release the liquid pharmaceutical composition followed by propellant, and wherein, following administration of the dose, the mean DHE C max in plasma is at least 750 pg/ml; the time to C max (T max ) of DHE in plasma is less than 45 minutes; and the mean plasma AUC 0-inf of DHE is at least 2500 pg*hr/ml.
2. The method of claim 1 , wherein, following administration of the dose, the mean plasma AUC 0-inf of DHE is at least 6000 pg*hr/ml.
3. The method of claim 1 , wherein, prior to first manual actuation, the liquid pharmaceutical composition and propellant are not in contact within the device.
4. The method of claim 1 , wherein each manual actuation brings a metered volume of liquid pharmaceutical composition and a separately metered volume of propellant into contact within a dose chamber of the device.
5. The method of claim 4 , wherein contact of propellant with liquid pharmaceutical composition within the dose chamber of the device creates a spray of liquid pharmaceutical composition as the formulation is expelled through a nozzle of the device.