Methods and compositions for treatment of pulmonary hypertension and other lung disorders
Provided herein are methods for treating pulmonary hypertension. The methods include administering to a subject in need thereof an effective amount of a vasodilator, wherein the vasodilator is administered to the subject via inhalation pro re nata using a portable inhaler. In some embodiments, the vasodilator is a PDE5 inhibitor. Pharmaceutical compositions for pro re nata administration of vasodilators are also described.
1. A method of treating pulmonary hypertension, the method comprising administering to a subject in need thereof an effective amount of a pharmaceutical carrier-based composition comprising:
a) about 0.1% to about 10% vardenafil, or salts or hydrates thereof, by weight relative to the total weight of the composition, and
b) a powder base;
wherein the vasodilator is administered to the subject via inhalation pro re nata at least 2-30 minutes before physical exertion using a portable inhaler.
2. The method of claim 1 , comprising vardenafil hydrochloride or hydrates thereof in the form of micronized drug particles.
3. The method of claim 2 , wherein the Dv50 of the micronized drug particles is less than 2.5 μm.
4. The method of claim 2 , wherein the powder base comprises one or more members selected from the group consisting of lactose, mannitol, trehalose, and starch.
5. The method of claim 4 , wherein the powder base comprises coarse crystalline lactose monohydrate particles.
6. The method of claim 5 , wherein the Dv50 of the coarse crystalline lactose monohydrate particles ranges from 50 μm to 100 μm.
7. The method of claim 5 , wherein the powder base further comprises fine crystalline lactose monohydrate carrier particles.
8. The method of claim 7 , wherein the Dv50 of the fine crystalline lactose monohydrate carrier particles is less than 10 μm.
9. The method of claim 7 , wherein the ratio of the fine crystalline lactose monohydrate particles to coarse crystalline lactose monohydrate particles ranges from about 5:95 to about 10:90 by weight.
10. The method of claim 1 , wherein the carrier-based composition further comprises a force control agent.
11. The method of claim 10 , wherein force control agent is selected from the group consisting of calcium stearate, magnesium stearate, leucine, a leucine derivative, lecithin, human serum albumin, polylysine, polyarginine, and combinations thereof.
12. The method of claim 1 , further comprising a second drug.
13. The method of claim 12 , wherein the second drug is a soluble guanylate cyclase (sGC) stimulator.
14. The method of claim 13 , wherein the sGC stimulator is riociguat.
15. The method of claim 12 , wherein the vardenafil hydrochloride or hydrates thereof and the second drug are separate formulations or are combined in one formulation.
16. The method of claim 1 , wherein the composition has a FPF s4-F of greater than 25% of the pharmaceutical carrier-based composition emitted by a portable inhaler.
17. The method of claim 1 , wherein the portable inhaler is a dry powder inhaler.
18. The method of claim 1 , wherein the pharmaceutical carrier-based composition comprises about 1% to about 2.4% vardenafil hydrochloride trihydrate, by weight relative to the total weight of the composition; and
wherein the powder base comprises i) coarse crystalline lactose particles having a Dv50 ranging from 50 μm to 100 μm and ii) fine crystalline lactose particles having a Dv50 less than 10 μm, wherein the amount of fine crystalline lactose particles ranges from about 5% to about 9% based on the total weight of lactose in the composition.
19. The method of claim 18 , wherein the pharmaceutical carrier-based composition is administered up to 8 times per day.
20. The method of claim 1 , wherein the pharmaceutical carrier-based composition is administered up to 8 times per day.