Concentrated, inhalable ciprofloxacin formulation
A concentrated inhalable formulation of an antibiotic drug such as ciprofloxacin is disclosed. The antibiotic is formulated with sodium acetate and liposomes which incorporate antibiotic. The formulation is aerosolized and inhaled for treatment of respiratory tract infections and other medical conditions.
1. A pharmaceutical formulation, comprising:
a pharmaceutically acceptable carrier for aerosolized delivery to human lungs, the carrier comprising sodium acetate in a solution; and
a free, unencapsulated ciprofloxacin dissolved at a concentration of 10 mg/ml or more;
wherein the formulation has a pH of 4.0 or less.
2. The formulation of claim 1 , wherein the ciprofloxacin is dissolved at a concentration of 15 mg/ml or more.
3. The formulation of claim 1 , wherein the ciprofloxacin is dissolved at a concentration of 20 mg/ml or more.
4. The formulation of claim 1 , wherein the ciprofloxacin is dissolved at a concentration of 25 mg/ml or more.
5. The formulation of claim 1 , wherein the ciprofloxacin is dissolved at a concentration of 30 mg/ml or more.
6. The formulation of claim 1 , wherein the formulation has a pH of 3.3.
7. The formulation of claim 1 , further comprising:
an additional pharmaceutically active drug chosen from a bronchodilator and an anti-inflammatory drug.
8. The formulation of claim 7 , wherein the additional pharmaceutically active drug is a bronchodilator chosen from β-adrenergic receptor agonists, antimuscarinics and combinations thereof.
9. The formulation of claim 7 , wherein the additional pharmaceutically active drug is an anti-inflammatory selected from the group consisting of a corticosteroid, a leukotriene receptor antagonist, a leukotriene synthesis inhibitor, and a cyclooxygenase inhibitor.
10. The formulation of claim 1 , further comprising:
liposome-encapsulated ciprofloxacin wherein the liposomes are comprised of a phospholipid selected from the groups consisting of phosphatidylcholines, lysophosphatidylcholines, phosphatidylethanolamines, phosphatidylinositols, phosphatidylglycerols, phosphatidic acid, phosphatidylserines, and mixtures thereof;
wherein said phospholipid is provided in admixtures with a modifying agent selected from the group consisting of cholesterols, stearyl amines, stearic acid, tocopherols, and mixtures thereof; and
wherein the liposomes are unilamellar or multilamellar.
11. The formulation of claim 10 , wherein the ciprofloxacin is present at 24 mg/mL.
12. A method for treating a patient, comprising:
aerosolizing a formulation as claimed in claim 1 ; and
inhaling the aerosol into the patient's lungs and allowing the pH to adjust to 7.4±20%, wherein the free drug comprises from 10% to 70% of a total of both free drug and encapsulated drug in the formulation.
13. The method of claim 12 , wherein aerosolized formulation has a pH of 3.3.
14. The method of claim 12 , wherein the aerosolized formulation has a pH of 4.0.
15. The method of claim 12 , wherein the formulation is further comprised of liposome encapsulated ciprofloxacin and the liposomes have a diameter within a range of from about 10 nm to about 10 μm and wherein said liposomes further comprise a lipid selected from the group consisting of fatty acids; lysolipids; sphingolipids; phosphatidylcholines; phosphatidylethanolamines; sphingomyelin; glycolipids; glucolipids; glycosphingolipids; phosphatidic acid; palmitic acid; stearic acid; arachidonic acid; oleic acid; lipids bearing sulfonated mono-, di-, oligo- or polysaccharides; lipids with ether and ester-linked fatty acids, polymerized lipids, diacetyl phosphate, stearylamine, cardiolipin, phospholipids with short chain fatty acids of 6 to 8 carbons in length, synthetic phospholipids with asymmetric acyl chains; and lipids bearing a covalently bound polymer.
16. The method of claim 12 , wherein aerosolizing the formulation creates particles having a diameter of 0.5 to 12 μm.
17. The method of claim 12 , wherein the encapsulated ciprofloxacin is released at a rate of between about 0.1% to 100% per hour with substantially complete release of ciprofloxacin occurring after about 1 to 24 hours.
18. The method of claim 12 , wherein the encapsulated ciprofloxacin is released at a rate of between about 0.5% to 20% per hour with substantially complete release of ciprofloxacin occurring after about 1 to 12 hours.
19. The method of claim 12 , wherein the encapsulated ciprofloxacin is released at a rate of between about 2% to 10% per hour with substantially complete release of ciprofloxacin occurring after about 1 to 6 hours.
20. The method of claim 12 , further comprising administering a therapeutic agent selected from the group consisting of DNase, a mucoregulatory agent, chemicals that up-regulate the chloride ion channel or increase flow of ions across the epithelial surface of cells, including lantibiotics such as duramycin, agents to promote hydration or mucociliary clearance including epithelial sodium channel (ENaC) inhibitors or P2Y2 agonists such as denufosol, a bronchodilator, a steroid, an elastase inhibitor such as Alpha-1 antitryp sin (AAT), N-acetylcysteine, agents that enhance the activity of an anti-infective against biofilm bacteria such as sodium salicylate, gamma interferon, alpha interferon, a fluoroquinolone, an antibiotic, or a fluoroquinolone selected from the group consisting of amifloxacin, cinoxacin, ciprofloxacin, danofloxacin, difloxacin, enoxacin, enrofloxacin, fleroxacin, irloxacin, lomefloxacin, miloxacin, norfloxacin, ofloxacin, pefloxacin, rosoxacin, rufloxacin, sarafloxacin, sparfloxacin, temafloxacin and tosufloxacin or an antibiotic selected from the group of tobramycin, colistin, azithromycin, amikacin, cefaclor (Ceclor), aztreonam, amoxicillin, ceftazidime, cephalexin (Keflex), gentamicin, vancomycin, imipenem, doripenem, piperacillin, minocycline, or erythromycin.
21. An aerosolized composition of particles, comprising:
particles of formulation as claimed in claim 1 ,
wherein the aerosol is comprised of particles wherein 80% or more of the particles have a diameter of 2 μm to 6 μm.
22. The aerosolized composition of claim 21 , wherein the pH of the formulation is 3.3.
23. The aerosolized composition of claim 22 , wherein the pH of the formulation is 4.0.
24. The aerosolized composition of claim 19 , wherein the particles of the aerosol have a diameter in a range from about 2 microns to about 4 microns.