N-acetylcysteine compositions and methods
Storage stable sterile ready-to-administer formulations comprising N-acetylcysteine are presented with desirable stability characteristics. In preferred aspects, formulations comprise low quantities of one or more chelating agents, contain N-acetylcysteine at a concentration of 25 mg/mL or 50 mg/mL, and are packaged in a suitable format, such as a polymeric bag with a metalized overwrap and a non-contact oxygen scavenger.
1. A method of administering N-acetylcysteine to a subject in need thereof, comprising:
providing a sterile and ready-to-administer composition comprising N-acetylcysteine containing N-acetylcysteine at a fixed concentration of between 1 and 50 mg/mL, wherein the ready-to-administer composition has a pH of between 6.0 and 7.5;
infusing, without prior dilution, the ready-to-administer composition to a subject in need thereof in three distinct doses, wherein the fixed concentration of the N-acetylcysteine is the same in each of the three doses; and
wherein the ready-to-administer composition contains, after storage over at least three weeks at 80° C., equal or less than 7% total impurities generated from degradation of the N-acetylcysteine.
2. The method of claim 1 wherein the fixed concentration is 25 mg/mL or 50 mg/mL.
3. The method of claim 1 wherein the ready-to-administer composition comprises a metal chelator and has a pH of between 7.0 and 7.5, and optionally further comprises an antioxidant and/or a tonicity agent.
4. The method of claim 1 wherein administration of a first dose and at least part of a second dose of the three doses is done from a single container containing the ready-to-administer composition.
5. The method of claim 1 wherein administration of each of the three doses is done from respective separate containers, each containing the ready-to-administer composition.
6. The method of claim 4 wherein the container has a volume of between 200 and 300 mL.
7. The method of claim 3 wherein the metal chelator is ethylenediamine tetraacetic acid and is present at a concentration of between 1 and 60 mcg/mL.
8. The method of claim 1 wherein a first of the three doses is administered over 1 hour, wherein a second of the three doses is administered over 4 hours, and wherein a third of the three doses is administered over 16 hours.
9. The method of claim 1 wherein administering the ready-to-administer composition is performed using an infusion pump.
10. The method of claim 1 wherein the tonicity agent is sodium chloride, dextrose, and/or mannitol, and wherein the composition is filter sterilized.
11. The method of claim 1 wherein the infusion is performed according to a schedule in which
the fixed concentration is 50 mg/mL, and in which a first dose of 15 mL is administered over 1 hour, a second dose of 5 mL is administered over 4 hours, and a third dose of 10 mL is administered over 16 hours when the body weight of the subject is 5 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 30 mL is administered over 1 hour, a second dose of 10 mL is administered over 4 hours, and a third dose of 20 mL is administered over 16 hours when the body weight of the subject is 10 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 45 mL is administered over 1 hour, a second dose of 15 mL is administered over 4 hours, and a third dose of 30 mL is administered over 16 hours when the body weight of the subject is 15 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 60 mL is administered over 1 hour, a second dose of 20 mL is administered over 4 hours, and a third dose of 40 mL is administered over 16 hours when the body weight of the subject is 20 kg; or
the fixed concentration is 25 mg/mL, and in which a first dose of 126 mL is administered over 1 hour, a second dose of 42 mL is administered over 4 hours, and a third dose of 84 mL is administered over 16 hours when the body weight of the subject is 21 kg; or
the fixed concentration is 25 mg/mL, and in which a first dose of 180 mL is administered over 1 hour, a second dose of 60 mL is administered over 4 hours, and a third dose of 120 mL is administered over 16 hours when the body weight of the subject is 30 kg; or
the fixed concentration is 25 mg/mL, and in which a first dose of 240 mL is administered over 1 hour, a second dose of 80 mL is administered over 4 hours, and a third dose of 160 mL is administered over 16 hours when the body weight of the subject is 40 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 123 mL is administered over 1 hour, a second dose of 41 mL is administered over 4 hours, and a third dose of 82 mL is administered over 16 hours when the body weight of the subject is 41 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 150 mL is administered over 1 hour, a second dose of 50 mL is administered over 4 hours, and a third dose of 100 mL is administered over 16 hours when the body weight of the subject is 50 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 180 mL is administered over 1 hour, a second dose of 60 mL is administered over 4 hours, and a third dose of 120 mL is administered over 16 hours when the body weight of the subject is 60 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 210 mL is administered over 1 hour, a second dose of 70 mL is administered over 4 hours, and a third dose of 140 mL is administered over 16 hours when the body weight of the subject is 70 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 240 mL is administered over 1 hour, a second dose of 80 mL is administered over 4 hours, and a third dose of 160 mL is administered over 16 hours when the body weight of the subject is 80 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 270 mL is administered over 1 hour, a second dose of 90 mL is administered over 4 hours, and a third dose of 180 mL is administered over 16 hours when the body weight of the subject is 90 kg; or
the fixed concentration is 50 mg/mL, and in which a first dose of 300 mL is administered over 1 hour, a second dose of 100 mL is administered over 4 hours, and a third dose of 200 mL is administered over 16 hours when the body weight of the subject is 100 kg or heavier.
12. The method of claim 1 wherein the ready-to-administer composition contains, after storage over at least three weeks at 80° C., equal or less than 6% total impurities generated from degradation of the N-acetylcysteine.