Dry powder compositions for intranasal delivery
A pharmaceutical composition in a form of dry powder for intranasal administration includes solid particles of at least one opioid receptor antagonist as active ingredient and two types of solid particles. A naloxone pharmaceutical composition in the form of dry powder for intranasal administration, including as active agent naloxone or a pharmaceutically acceptable salt thereof. A kit for intranasal administration of naloxone. A method of treating opioid overdose/intoxication and/or a symptom thereof in a patient in need thereof by intranasally administering a therapeutically effective amount of a composition including solid particles of at least one opioid receptor antagonist as active ingredient and two types of solid particles.
1. A pharmaceutical composition in a form of dry powder for intranasal administration, comprising (1) a first type of solid particles and (2) a second type of solid particles, wherein the first type particles consist of at least one opioid receptor antagonist as active ingredient, and the second type of solid particles comprise a pharmaceutically acceptable disaggregating agent, wherein at least 90% of said first type particles are of a mean particle size of about 10 to about 30 microns, and less than about 10% of said first type particles are of a mean particle size equal to or below about 10 microns and said second type particles are of a mean particle size greater than that of said first type particles.
2. The pharmaceutical composition according to claim 1 , wherein less than about 5% of said first type particles are of a mean particle size of or below 5 microns.
3. The pharmaceutical composition of claim 1 , wherein said second type particles are of a mean size of about 50 to about 200 microns.
4. The pharmaceutical composition of claim 1 , wherein said second type particles are of a mean size of about 50 to about 150 microns.
5. The pharmaceutical composition of claim 1 , wherein said first type particles are of a substantially spherical form and said second type particle are of an irregular shape.
6. The pharmaceutical composition of claim 1 , comprising said disaggregating agent as the only excipient for preventing aggregation of the solid particles of the active ingredient and preserving their original size and shape in said composition.
7. The pharmaceutical composition of claim 1 , wherein said at least one opioid receptor antagonist any one of naloxone, naltrexone, almivopan, methylnaltrexone, naloxegon or naldemidine and pharmaceutically acceptable salts thereof and solvates or hydrates thereof, wherein said salt is any of chloride, bromide, oxalate, chloride, tosylates or tosylate.
8. The pharmaceutical composition of claim 1 , wherein said at least one opioid receptor antagonist is naloxone or naloxone hydrochloride, or solvate or hydrate thereof.
9. The pharmaceutical composition of claim 1 , wherein said disaggregating agent is any one of lactose monohydrate, lactose, a lactose functional analogue, or any mixture of at least two thereof.
10. The pharmaceutical composition of claim 1 , wherein said disaggregating is any one of dextrose, sorbitol, mannitol, maltitol and xylitol, a cellulose or cellulose derivative, or starch or starch derivative, or any mixture of at least two thereof.
11. The pharmaceutical composition of claim 1 , wherein the weight ratio between said first type particles and said second type particles is between about 1:9 to about 9:1.
12. The pharmaceutical composition of claim 11 , wherein the weight ratio between said first type particles and said second type particles is from about 1:9 to about 4:6.
13. A naloxone pharmaceutical composition in the form of dry powder for intranasal administration, comprising (1) a first type of solid particles and (2) a second type of solid particles, wherein the first type particles consist of as active agent naloxone or a pharmaceutically acceptable salt thereof as active agent, and the second type of solid particles comprise lactose monohydrate as disaggregation agent, wherein at least about 90% of said first type particles are of a mean particle size of about 10-30 microns and less than about 10% of said first type particles are of a mean particle size equal to or below about 10 microns and said second type particles are of a mean particle size greater than that of said first type particles, providing a metered therapeutically effective nominal dose of said naloxone or pharmaceutically acceptable salt thereof.
14. The naloxone pharmaceutical composition of claim 13 , wherein the weight ratio between said first type particles and said second type particles is from about 1:9 to about 4:6.
15. The naloxone pharmaceutical composition of claim 13 , comprising about 20% w/w, about 15% w/w, about 10% w/w, about 8% w/w or about 5% w/w naloxone or said pharmaceutically acceptable salt thereof or solvate or hydrate thereof.
16. The naloxone pharmaceutical composition of claim 13 , wherein said therapeutically nominal dose of naloxone is about 4 mg.
17. A disposable dose unit form for single intranasal administration to a subject of a pharmaceutical composition according to claim 1 , wherein said dose unit is loaded with a predetermined dose of the composition and provides the subject with a therapeutically effective metered dose of said active opioid receptor antagonist.
18. A disposable dose unit form for single intranasal administration to a subject of a pharmaceutical composition according to claim 13 , wherein said dose unit is loaded with a predetermined dose of the composition and provides the subject with a therapeutically effective metered dose naloxone or said pharmaceutically acceptable salt thereof.
19. The disposable unit of claim 18 , wherein said therapeutically effective metered dose naloxone or said pharmaceutically acceptable salt thereof is 4 mg per said single administration.
20. A kit for intranasal administration of naloxone comprising:
a. at least one dose unit for single intranasal administration comprising a pharmaceutical composition as defined in claim 17 ; and
b. instructions for use.
21. A method of treating opioid overdose/intoxication and/or a symptom thereof in a patient in need thereof, said method comprising intranasally administering to said patient a therapeutically effective amount of a composition as defined in claim 1 .
22. The method of claim 21 , wherein said symptom associated with opioid overdose/intoxication is any one of respiratory depression, central nervous system depression, cardiovascular depression, altered level consciousness, miotic pupils, hypoxemia, acute lung injury, aspiration pneumonia, sedation, hypotension, unresponsiveness to stimulus, unconsciousness, stopped breathing; erratic or stopped pulse, choking or gurgling sounds, blue or purple fingernails or lips, slack or limp muscle tone, contracted pupils, and vomiting.
23. A method of treating opioid overdose/intoxication and/or a symptom thereof in a patient in need thereof, said method comprising intranasally administering to said patient a therapeutically effective amount of a composition as defined in claim 13 .
24. The method of claim 23 , wherein a single intranasal administration provides said patient with a dose unit of 1.5, 2, 3 or 4 mg naloxone or said pharmaceutically acceptable salt thereof.
25. The method of claim 23 , wherein said symptom associated with opioid overdose/intoxication is any one of respiratory depression, central nervous system depression, cardiovascular depression, altered level consciousness, miotic pupils, hypoxemia, acute lung injury, aspiration pneumonia, sedation, hypotension, unresponsiveness to stimulus, unconsciousness, stopped breathing, erratic or stopped pulse, choking or gurgling sounds, blue or purple fingernails or lips, slack or limp muscle tone, contracted pupils, and vomiting.
26. The method of claim 23 , wherein said patient is not breathing.
27. The method of claim 24 , wherein administration said dose unit can be repeated at 2 to 3 minute intervals, up to a cumulative dose of from about 8 mg to about 10 mg and up to about 15 mg of naloxone.
28. The method of claim 24 , the method further comprising administration of an opioid, wherein said opioid is administered simultaneously with said dose unit of naloxone or separately.
29. The method of claim 24 , wherein by said dose unit intranasal administration the major part of over 50% of the said first type solid particles reach turbinates region in the intranasal cavity, and less than 1% of said first type solid particles reach the lungs of said patient.
30. The method of claim 24 , wherein by said dose unit intranasal administration is at least 85% of the said first type solid particles reach turbinates region in the intranasal cavity, less than about 10% of said first type solid particles reach another region of the intranasal cavity, and less than 1% of said first type solid particles reach the lungs of said patient.
31. The pharmaceutical composition of claim 11 , wherein the weight ratio between said first type particles and said second type particles is about 2:8.