CA2309033C - Lacrimal gland specific emulsions for topical application to ocular tissue - Google Patents
Lacrimal gland specific emulsions for topical application to ocular tissue Download PDFInfo
- Publication number
- CA2309033C CA2309033C CA002309033A CA2309033A CA2309033C CA 2309033 C CA2309033 C CA 2309033C CA 002309033 A CA002309033 A CA 002309033A CA 2309033 A CA2309033 A CA 2309033A CA 2309033 C CA2309033 C CA 2309033C
- Authority
- CA
- Canada
- Prior art keywords
- cyclosporin
- emulsion
- polysorbate
- castor oil
- pharmaceutical composition
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 210000001519 tissue Anatomy 0.000 title claims abstract description 31
- 239000000839 emulsion Substances 0.000 title claims abstract description 27
- 210000004561 lacrimal apparatus Anatomy 0.000 title claims abstract description 23
- 230000000699 topical effect Effects 0.000 title claims description 12
- PMATZTZNYRCHOR-CGLBZJNRSA-N Cyclosporin A Chemical compound CC[C@@H]1NC(=O)[C@H]([C@H](O)[C@H](C)C\C=C\C)N(C)C(=O)[C@H](C(C)C)N(C)C(=O)[C@H](CC(C)C)N(C)C(=O)[C@H](CC(C)C)N(C)C(=O)[C@@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CC(C)C)N(C)C(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)N(C)C(=O)CN(C)C1=O PMATZTZNYRCHOR-CGLBZJNRSA-N 0.000 claims abstract description 92
- 229960001265 ciclosporin Drugs 0.000 claims abstract description 92
- 108010036949 Cyclosporine Proteins 0.000 claims abstract description 91
- 229930105110 Cyclosporin A Natural products 0.000 claims abstract description 90
- 229930182912 cyclosporin Natural products 0.000 claims abstract description 69
- 239000000203 mixture Substances 0.000 claims abstract description 56
- 239000004359 castor oil Substances 0.000 claims abstract description 34
- 235000019438 castor oil Nutrition 0.000 claims abstract description 34
- ZEMPKEQAKRGZGQ-XOQCFJPHSA-N glycerol triricinoleate Natural products CCCCCC[C@@H](O)CC=CCCCCCCCC(=O)OC[C@@H](COC(=O)CCCCCCCC=CC[C@@H](O)CCCCCC)OC(=O)CCCCCCCC=CC[C@H](O)CCCCCC ZEMPKEQAKRGZGQ-XOQCFJPHSA-N 0.000 claims abstract description 34
- 239000000244 polyoxyethylene sorbitan monooleate Substances 0.000 claims abstract description 22
- 235000010482 polyoxyethylene sorbitan monooleate Nutrition 0.000 claims abstract description 22
- 229940068968 polysorbate 80 Drugs 0.000 claims abstract description 22
- 229920000053 polysorbate 80 Polymers 0.000 claims abstract description 22
- 239000008194 pharmaceutical composition Substances 0.000 claims abstract description 17
- 235000014113 dietary fatty acids Nutrition 0.000 claims abstract description 13
- 239000000194 fatty acid Substances 0.000 claims abstract description 13
- 229930195729 fatty acid Natural products 0.000 claims abstract description 13
- 238000010521 absorption reaction Methods 0.000 claims abstract description 11
- 229940079593 drug Drugs 0.000 claims abstract description 10
- 239000003814 drug Substances 0.000 claims abstract description 10
- 231100000344 non-irritating Toxicity 0.000 claims abstract description 7
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 17
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 claims description 11
- CGIGDMFJXJATDK-UHFFFAOYSA-N indomethacin Chemical compound CC1=C(CC(O)=O)C2=CC(OC)=CC=C2N1C(=O)C1=CC=C(Cl)C=C1 CGIGDMFJXJATDK-UHFFFAOYSA-N 0.000 claims description 6
- 235000011187 glycerol Nutrition 0.000 claims description 5
- 229960000905 indomethacin Drugs 0.000 claims description 3
- 150000003431 steroids Chemical class 0.000 claims description 3
- 230000001804 emulsifying effect Effects 0.000 claims description 2
- 239000008251 pharmaceutical emulsion Substances 0.000 claims 4
- 125000005456 glyceride group Chemical group 0.000 claims 1
- 230000000087 stabilizing effect Effects 0.000 claims 1
- 230000007794 irritation Effects 0.000 abstract description 7
- 238000002425 crystallisation Methods 0.000 abstract description 5
- 230000008025 crystallization Effects 0.000 abstract description 4
- 238000002483 medication Methods 0.000 abstract description 3
- 238000009472 formulation Methods 0.000 description 40
- 210000001508 eye Anatomy 0.000 description 19
- HEMHJVSKTPXQMS-UHFFFAOYSA-M Sodium hydroxide Chemical compound [OH-].[Na+] HEMHJVSKTPXQMS-UHFFFAOYSA-M 0.000 description 15
- 241000283973 Oryctolagus cuniculus Species 0.000 description 12
- 230000000694 effects Effects 0.000 description 11
- 239000003921 oil Substances 0.000 description 10
- 235000019198 oils Nutrition 0.000 description 10
- 108010036941 Cyclosporins Proteins 0.000 description 8
- 239000000243 solution Substances 0.000 description 8
- 208000003556 Dry Eye Syndromes Diseases 0.000 description 6
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 6
- 241001465754 Metazoa Species 0.000 description 6
- 238000002360 preparation method Methods 0.000 description 6
- 238000012360 testing method Methods 0.000 description 6
- 210000001742 aqueous humor Anatomy 0.000 description 5
- 239000003995 emulsifying agent Substances 0.000 description 5
- 238000011282 treatment Methods 0.000 description 5
- 206010013774 Dry eye Diseases 0.000 description 4
- 229920002125 Sokalan® Polymers 0.000 description 4
- 239000003125 aqueous solvent Substances 0.000 description 4
- 210000004087 cornea Anatomy 0.000 description 4
- -1 for example Substances 0.000 description 4
- 238000005567 liquid scintillation counting Methods 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- WEVYAHXRMPXWCK-UHFFFAOYSA-N Acetonitrile Chemical compound CC#N WEVYAHXRMPXWCK-UHFFFAOYSA-N 0.000 description 3
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 3
- YXFVVABEGXRONW-UHFFFAOYSA-N Toluene Chemical compound CC1=CC=CC=C1 YXFVVABEGXRONW-UHFFFAOYSA-N 0.000 description 3
- 238000002485 combustion reaction Methods 0.000 description 3
- 210000000795 conjunctiva Anatomy 0.000 description 3
- 239000004006 olive oil Substances 0.000 description 3
- 235000008390 olive oil Nutrition 0.000 description 3
- 229920000136 polysorbate Polymers 0.000 description 3
- 239000000126 substance Substances 0.000 description 3
- 208000024891 symptom Diseases 0.000 description 3
- UCOQITKXMNKTKF-MXGZYYNMSA-N (3s,6s,9s,12r,15s,18s,21s,24s,30s,33s)-33-[(e,1r,2r)-1-hydroxy-2-methylhex-4-enyl]-1,4,7,10,12,15,19,25,28,30-decamethyl-6,9,18,24-tetrakis(2-methylpropyl)-3,21-di(propan-2-yl)-1,4,7,10,13,16,19,22,25,28,31-undecazacyclotritriacontane-2,5,8,11,14,17,20,23 Chemical compound C\C=C\C[C@@H](C)[C@@H](O)[C@@H]1N(C)C(=O)[C@H](C(C)C)N(C)C(=O)[C@H](CC(C)C)N(C)C(=O)[C@H](CC(C)C)N(C)C(=O)[C@@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CC(C)C)N(C)C(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)N(C)C(=O)CN(C)C(=O)[C@H](C)NC1=O UCOQITKXMNKTKF-MXGZYYNMSA-N 0.000 description 2
- NIXOWILDQLNWCW-UHFFFAOYSA-N Acrylic acid Chemical compound OC(=O)C=C NIXOWILDQLNWCW-UHFFFAOYSA-N 0.000 description 2
- IAZDPXIOMUYVGZ-UHFFFAOYSA-N Dimethylsulphoxide Chemical compound CS(C)=O IAZDPXIOMUYVGZ-UHFFFAOYSA-N 0.000 description 2
- KCXVZYZYPLLWCC-UHFFFAOYSA-N EDTA Chemical compound OC(=O)CN(CC(O)=O)CCN(CC(O)=O)CC(O)=O KCXVZYZYPLLWCC-UHFFFAOYSA-N 0.000 description 2
- 208000009319 Keratoconjunctivitis Sicca Diseases 0.000 description 2
- 108010038807 Oligopeptides Proteins 0.000 description 2
- 102000015636 Oligopeptides Human genes 0.000 description 2
- 235000019483 Peanut oil Nutrition 0.000 description 2
- 229920002675 Polyoxyl Polymers 0.000 description 2
- 238000004458 analytical method Methods 0.000 description 2
- 239000012736 aqueous medium Substances 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000001124 body fluid Anatomy 0.000 description 2
- 239000010839 body fluid Substances 0.000 description 2
- 229960001631 carbomer Drugs 0.000 description 2
- 125000004122 cyclic group Chemical group 0.000 description 2
- 238000007405 data analysis Methods 0.000 description 2
- 239000002270 dispersing agent Substances 0.000 description 2
- 239000013583 drug formulation Substances 0.000 description 2
- 210000000744 eyelid Anatomy 0.000 description 2
- 238000004128 high performance liquid chromatography Methods 0.000 description 2
- 230000001861 immunosuppressant effect Effects 0.000 description 2
- 239000004615 ingredient Substances 0.000 description 2
- 238000001990 intravenous administration Methods 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- 239000003960 organic solvent Substances 0.000 description 2
- 239000000312 peanut oil Substances 0.000 description 2
- 230000035515 penetration Effects 0.000 description 2
- 239000000546 pharmaceutical excipient Substances 0.000 description 2
- 229950008882 polysorbate Drugs 0.000 description 2
- 238000001556 precipitation Methods 0.000 description 2
- 239000000047 product Substances 0.000 description 2
- 239000008213 purified water Substances 0.000 description 2
- 230000035807 sensation Effects 0.000 description 2
- 239000002904 solvent Substances 0.000 description 2
- 239000004094 surface-active agent Substances 0.000 description 2
- 208000011580 syndromic disease Diseases 0.000 description 2
- 230000001988 toxicity Effects 0.000 description 2
- 231100000419 toxicity Toxicity 0.000 description 2
- 239000003643 water by type Substances 0.000 description 2
- ZMKGDQSIRSGUDJ-VSROPUKISA-N (3s,6s,9s,12r,15s,18s,21s,24s,30s,33s)-33-[(e,1r,2r)-1-hydroxy-2-methylhex-4-enyl]-1,4,7,10,12,15,19,25,28-nonamethyl-6,9,18,24-tetrakis(2-methylpropyl)-3,21-di(propan-2-yl)-30-propyl-1,4,7,10,13,16,19,22,25,28,31-undecazacyclotritriacontane-2,5,8,11,14,1 Chemical compound CCC[C@@H]1NC(=O)[C@H]([C@H](O)[C@H](C)C\C=C\C)N(C)C(=O)[C@H](C(C)C)N(C)C(=O)[C@H](CC(C)C)N(C)C(=O)[C@H](CC(C)C)N(C)C(=O)[C@@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CC(C)C)N(C)C(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)N(C)C(=O)CN(C)C1=O ZMKGDQSIRSGUDJ-VSROPUKISA-N 0.000 description 1
- WSWCOQWTEOXDQX-MQQKCMAXSA-M (E,E)-sorbate Chemical compound C\C=C\C=C\C([O-])=O WSWCOQWTEOXDQX-MQQKCMAXSA-M 0.000 description 1
- LSIXBBPOJBJQHN-UHFFFAOYSA-N 2,3-Dimethylbicyclo[2.2.1]hept-2-ene Chemical class C1CC2C(C)=C(C)C1C2 LSIXBBPOJBJQHN-UHFFFAOYSA-N 0.000 description 1
- 206010067484 Adverse reaction Diseases 0.000 description 1
- 235000003911 Arachis Nutrition 0.000 description 1
- 244000105624 Arachis hypogaea Species 0.000 description 1
- 208000027496 Behcet disease Diseases 0.000 description 1
- 208000009137 Behcet syndrome Diseases 0.000 description 1
- DSEKYWAQQVUQTP-UHFFFAOYSA-N Cerin Natural products CC12CCC3(C)C4CC(C)(C)CCC4(C)CCC3(C)C2CCC2(C)C1CC(O)C(=O)C2C DSEKYWAQQVUQTP-UHFFFAOYSA-N 0.000 description 1
- 108010069514 Cyclic Peptides Proteins 0.000 description 1
- 102000001189 Cyclic Peptides Human genes 0.000 description 1
- FBPFZTCFMRRESA-FSIIMWSLSA-N D-Glucitol Natural products OC[C@H](O)[C@H](O)[C@@H](O)[C@H](O)CO FBPFZTCFMRRESA-FSIIMWSLSA-N 0.000 description 1
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 1
- FBPFZTCFMRRESA-JGWLITMVSA-N D-glucitol Chemical compound OC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-JGWLITMVSA-N 0.000 description 1
- 208000005100 Herpetic Keratitis Diseases 0.000 description 1
- 206010020565 Hyperaemia Diseases 0.000 description 1
- 206010020864 Hypertrichosis Diseases 0.000 description 1
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 1
- 229930195725 Mannitol Natural products 0.000 description 1
- ZMKGDQSIRSGUDJ-UHFFFAOYSA-N NVa2 cyclosporine Natural products CCCC1NC(=O)C(C(O)C(C)CC=CC)N(C)C(=O)C(C(C)C)N(C)C(=O)C(CC(C)C)N(C)C(=O)C(CC(C)C)N(C)C(=O)C(C)NC(=O)C(C)NC(=O)C(CC(C)C)N(C)C(=O)C(C(C)C)NC(=O)C(CC(C)C)N(C)C(=O)CN(C)C1=O ZMKGDQSIRSGUDJ-UHFFFAOYSA-N 0.000 description 1
- 206010052143 Ocular discomfort Diseases 0.000 description 1
- 208000023715 Ocular surface disease Diseases 0.000 description 1
- 206010073938 Ophthalmic herpes simplex Diseases 0.000 description 1
- 229910019142 PO4 Inorganic materials 0.000 description 1
- LRJOMUJRLNCICJ-JZYPGELDSA-N Prednisolone acetate Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@@](C(=O)COC(=O)C)(O)[C@@]1(C)C[C@@H]2O LRJOMUJRLNCICJ-JZYPGELDSA-N 0.000 description 1
- 150000001242 acetic acid derivatives Chemical class 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 230000006838 adverse reaction Effects 0.000 description 1
- 125000005250 alkyl acrylate group Chemical group 0.000 description 1
- 125000000539 amino acid group Chemical group 0.000 description 1
- 150000001413 amino acids Chemical class 0.000 description 1
- 238000000540 analysis of variance Methods 0.000 description 1
- 239000003098 androgen Substances 0.000 description 1
- 229940030486 androgens Drugs 0.000 description 1
- 239000010775 animal oil Substances 0.000 description 1
- 230000003466 anti-cipated effect Effects 0.000 description 1
- 239000013011 aqueous formulation Substances 0.000 description 1
- 239000000607 artificial tear Substances 0.000 description 1
- 239000012496 blank sample Substances 0.000 description 1
- 150000001642 boronic acid derivatives Chemical class 0.000 description 1
- 239000000872 buffer Substances 0.000 description 1
- 239000006172 buffering agent Substances 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 239000003153 chemical reaction reagent Substances 0.000 description 1
- 210000004240 ciliary body Anatomy 0.000 description 1
- 150000001860 citric acid derivatives Chemical class 0.000 description 1
- 239000002285 corn oil Substances 0.000 description 1
- 235000005687 corn oil Nutrition 0.000 description 1
- 231100000478 corneal permeability Toxicity 0.000 description 1
- 229920006037 cross link polymer Polymers 0.000 description 1
- 108010019249 cyclosporin G Proteins 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 238000009792 diffusion process Methods 0.000 description 1
- 238000010790 dilution Methods 0.000 description 1
- 239000012895 dilution Substances 0.000 description 1
- 210000003717 douglas' pouch Anatomy 0.000 description 1
- 229940009662 edetate Drugs 0.000 description 1
- 230000005713 exacerbation Effects 0.000 description 1
- 150000004665 fatty acids Chemical class 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 229960001048 fluorometholone Drugs 0.000 description 1
- FAOZLTXFLGPHNG-KNAQIMQKSA-N fluorometholone Chemical compound C([C@@]12C)=CC(=O)C=C1[C@@H](C)C[C@@H]1[C@]2(F)[C@@H](O)C[C@]2(C)[C@@](O)(C(C)=O)CC[C@H]21 FAOZLTXFLGPHNG-KNAQIMQKSA-N 0.000 description 1
- 235000013305 food Nutrition 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 201000010884 herpes simplex virus keratitis Diseases 0.000 description 1
- 229960003444 immunosuppressant agent Drugs 0.000 description 1
- 239000003018 immunosuppressive agent Substances 0.000 description 1
- 238000010253 intravenous injection Methods 0.000 description 1
- 239000002502 liposome Substances 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 239000000594 mannitol Substances 0.000 description 1
- 235000010355 mannitol Nutrition 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 229940057917 medium chain triglycerides Drugs 0.000 description 1
- 210000004379 membrane Anatomy 0.000 description 1
- 239000012528 membrane Substances 0.000 description 1
- 239000002207 metabolite Substances 0.000 description 1
- 239000002480 mineral oil Substances 0.000 description 1
- 235000010446 mineral oil Nutrition 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 235000019271 petrolatum Nutrition 0.000 description 1
- 235000021317 phosphate Nutrition 0.000 description 1
- 150000003013 phosphoric acid derivatives Chemical class 0.000 description 1
- 239000002504 physiological saline solution Substances 0.000 description 1
- 229920001983 poloxamer Polymers 0.000 description 1
- 229920000867 polyelectrolyte Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 229960002800 prednisolone acetate Drugs 0.000 description 1
- 230000002285 radioactive effect Effects 0.000 description 1
- 230000008085 renal dysfunction Effects 0.000 description 1
- 238000004007 reversed phase HPLC Methods 0.000 description 1
- 238000005070 sampling Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 239000011734 sodium Substances 0.000 description 1
- 229910052708 sodium Inorganic materials 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 229940075554 sorbate Drugs 0.000 description 1
- 239000000600 sorbitol Substances 0.000 description 1
- 235000010356 sorbitol Nutrition 0.000 description 1
- 229960002920 sorbitol Drugs 0.000 description 1
- 238000010561 standard procedure Methods 0.000 description 1
- 230000000638 stimulation Effects 0.000 description 1
- 125000001424 substituent group Chemical group 0.000 description 1
- 230000001839 systemic circulation Effects 0.000 description 1
- 235000020679 tap water Nutrition 0.000 description 1
- 239000008399 tap water Substances 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 229960001005 tuberculin Drugs 0.000 description 1
- 235000015112 vegetable and seed oil Nutrition 0.000 description 1
- 239000008158 vegetable oil Substances 0.000 description 1
- 239000003981 vehicle Substances 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
- 208000018464 vernal keratoconjunctivitis Diseases 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Landscapes
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
- Medicinal Preparation (AREA)
Abstract
A pharmaceutical composition is disclosed in the form of a nonirritating emulsion which includes at least one cyclosporin in admixture with a higher fatty acid glyceride and polysorbate 80. More particularly, the cyclosporin may be cyclosporin A and the higher fatty acid glyceride may be castor oil. Composition has been found to be of a high comfort level and low irritation potential suitable for delivery of medications to sensitive areas such as ocular tissues with enhanced absorption in the lacrimal gland. In addition, the composition has stability for up to nine months without crystallization of cyclosporin.
Description
'1~
LACRIMAL GLAND SPECIFIC EMULSIONS FOR TOPICAL
APPLICATION TO OCULAR TISSUE
The present invention generally relates to novel pharmaceutical compositions incorporating chemicals ZO Which are poorly soluble in water and is more particu larly related to a novel ophthalmic emulsion including cyclosporin in admixture with castor oil and polysor bate 80 with high comfort level and low irritation . potential.
Cyclosporins are a group of nonpolar cyclic oligopeptides with known immunosuppressant activity..
In addition, as set forth in U.S. Patent No.
4,839,342, cyclosporin (sometimes referred to in the literature as "cyclosporine") has been found as effective in treating immune medicated :keratoconjune-tivitis sicca (KCS or dry eye disease) in a patient suffering therefrom.
.As hereinabove noted, cyclosporin comprises a group of cyclic oligopeptides and the major component thereof is cyclosporin A (C~2H111N11012)Whzch has been identified along with several other minor metabolites, cyclosporin B through I. In addition, a number of ,30 synthetic analogs have been prepared.
In general, commercially available cyclosporins . may contain a mixture of several individual cyclo-sporins which all share a cyclic peptide structure consisting of eleven amino acid residues with a total molecular weight of about 1,200, but with different' substituents or configurations of some of the amino acids.
It should be appreciated that reference to the term "cyclosporin" or "cyclosporins" is used through-out the present specification in order to designate the cyclosporin component in the composition of the present invention.
However, this specific reference is intended to include any individual member of the cyclosporin group as well as admixtures of two or more individual cyclo-sporins, whether natural or synthetic.
The activity of cyclosporins, as hereinabove noted, is as an immunosuppressant and in the enhance-ment or restoring of lacrimal gland tearing.
This activity can be enhanced if it is possible to enhance the absorption of the cyclosporin in the lacrimal gland. The present invention provides for a formulation and method that produces optimal cyclo-sporin A concentrations in the lacrimal gland and other ocular surface tissues.
Unfortunately, the solubility of cyclosporin in water is extremely low and as elaborated in U.S.
Patent No. 5,051,402, it has been considered not merely difficult but practically impossible to prepare -30 a pharmaceutical composition containing cyclosporin dissolved in an aqueous medium.
As reported, the solubility of cyclosporin in water is between about 20 ug/ml to 30 ~g/ml for cyclosporin A. Hence, heretofore prepared formula-tions incorporating cyclosporin have been prepared as oily solutions containing ethanol. However, these preparations limit the bioavailability to oral prep arations and this is believed to be due to the separ ation of cyclosporin as a solid immediately after it comes into contact with water, such as in the mouth or eye of a patient.
In the case of injectable preparations of cyclo-sporin, they first must be diluted with physiological saline before intravenous administration but this is likely to result in the precipitation of cyclosporin and therefore may be considered undesirable for intravenous administration.
Surface active agents such as polyoxyethylated castor oil have been utilized as solubilizers to in-ject preparations in order to prevent cyclosporin from separating. However, this also may give rise to safety problems (see U.S: Patent No. 5,051,402).
The practical usefulness of cyclosporin would be greatly enhanced if administration thereof could be effective; for example, cyclosporin's effectiveness in the treatment of ocular symptoms of Behcet's Syndrome.
However, if it is administered orally for the treat-ment of these symptoms, the accompanying side effects due to systemic circulation may cause adverse reac-tions such as hypertrichosis or renal dysfunction.
On the other hand, if oily preparations contain-- 30 ing cyclosporin are applied directly to the eyes, ir ritation or a clouding of visual field may result.
This plus the difficulty in formulating cyclosporin limits its use in formulations that would be useful during keratoplasty as well in the treatment of herpetic keratitis and spring catarrh.
LACRIMAL GLAND SPECIFIC EMULSIONS FOR TOPICAL
APPLICATION TO OCULAR TISSUE
The present invention generally relates to novel pharmaceutical compositions incorporating chemicals ZO Which are poorly soluble in water and is more particu larly related to a novel ophthalmic emulsion including cyclosporin in admixture with castor oil and polysor bate 80 with high comfort level and low irritation . potential.
Cyclosporins are a group of nonpolar cyclic oligopeptides with known immunosuppressant activity..
In addition, as set forth in U.S. Patent No.
4,839,342, cyclosporin (sometimes referred to in the literature as "cyclosporine") has been found as effective in treating immune medicated :keratoconjune-tivitis sicca (KCS or dry eye disease) in a patient suffering therefrom.
.As hereinabove noted, cyclosporin comprises a group of cyclic oligopeptides and the major component thereof is cyclosporin A (C~2H111N11012)Whzch has been identified along with several other minor metabolites, cyclosporin B through I. In addition, a number of ,30 synthetic analogs have been prepared.
In general, commercially available cyclosporins . may contain a mixture of several individual cyclo-sporins which all share a cyclic peptide structure consisting of eleven amino acid residues with a total molecular weight of about 1,200, but with different' substituents or configurations of some of the amino acids.
It should be appreciated that reference to the term "cyclosporin" or "cyclosporins" is used through-out the present specification in order to designate the cyclosporin component in the composition of the present invention.
However, this specific reference is intended to include any individual member of the cyclosporin group as well as admixtures of two or more individual cyclo-sporins, whether natural or synthetic.
The activity of cyclosporins, as hereinabove noted, is as an immunosuppressant and in the enhance-ment or restoring of lacrimal gland tearing.
This activity can be enhanced if it is possible to enhance the absorption of the cyclosporin in the lacrimal gland. The present invention provides for a formulation and method that produces optimal cyclo-sporin A concentrations in the lacrimal gland and other ocular surface tissues.
Unfortunately, the solubility of cyclosporin in water is extremely low and as elaborated in U.S.
Patent No. 5,051,402, it has been considered not merely difficult but practically impossible to prepare -30 a pharmaceutical composition containing cyclosporin dissolved in an aqueous medium.
As reported, the solubility of cyclosporin in water is between about 20 ug/ml to 30 ~g/ml for cyclosporin A. Hence, heretofore prepared formula-tions incorporating cyclosporin have been prepared as oily solutions containing ethanol. However, these preparations limit the bioavailability to oral prep arations and this is believed to be due to the separ ation of cyclosporin as a solid immediately after it comes into contact with water, such as in the mouth or eye of a patient.
In the case of injectable preparations of cyclo-sporin, they first must be diluted with physiological saline before intravenous administration but this is likely to result in the precipitation of cyclosporin and therefore may be considered undesirable for intravenous administration.
Surface active agents such as polyoxyethylated castor oil have been utilized as solubilizers to in-ject preparations in order to prevent cyclosporin from separating. However, this also may give rise to safety problems (see U.S: Patent No. 5,051,402).
The practical usefulness of cyclosporin would be greatly enhanced if administration thereof could be effective; for example, cyclosporin's effectiveness in the treatment of ocular symptoms of Behcet's Syndrome.
However, if it is administered orally for the treat-ment of these symptoms, the accompanying side effects due to systemic circulation may cause adverse reac-tions such as hypertrichosis or renal dysfunction.
On the other hand, if oily preparations contain-- 30 ing cyclosporin are applied directly to the eyes, ir ritation or a clouding of visual field may result.
This plus the difficulty in formulating cyclosporin limits its use in formulations that would be useful during keratoplasty as well in the treatment of herpetic keratitis and spring catarrh.
Heretofore, as for example in U.S. Patent No.
5,051,402, attempts have been made to dissolve suffi-cient cyclosporin in an aqueous solvent system so as to reach an effective concentration for treatment.
Importantly, this solvent system does not contain any surface active agent such as polyoxyethylated castor oil.
Conceptually, the purpose of dissolving the cyclosporin in an aqueous solvent system is to enable contact with body fluids which would merely constitute dilution of the aqueous solvent system which hopefully would eliminate the immediate precipitation of cyclo sporin when contacted with the water content of the body fluids.
For direct use in the eye, cyclosporin has been formulated with a number- of pharmaceutically accept-able excipients, for example, animal oil, vegetable oil, an appropriate organic or aqueous solvent, an artificial tear solution, a natural or synthetic poly-mer or an appropriate membrane.
Specific examples of these pharmaceutically acceptable excipients, which may be used solely or in combination, are olive oil, arachis oil, castor oil, mineral oil, petroleum jelly, dimethyl sulfoxide, chremophor, liposomes, or liposome-like products or a silicone fluid, among others.
In summary, a great deal of effort has been ex-pended in order to prepare a pharmaceutical composi-tion containing cyclosporin dissolved in an aqueous medium or cyclosporin prepared as an oily solution.
However, successful formulations have yet to be accom-plished as evidenced by the lack of commercial prod-ucts.
As hereinabove noted, it has been reported that cyclosporin has demonstrated some solubility in oily preparations containing higher fatty acid glycerides such as olive oil, peanut oil, and/or castor oil.
These formulations frequently produce an unpleasant sensation when applied to the eye because of stimula-tion or the viscousness which is characteristic of these oils.
Another drawback of these formulations is that they contain a high concentration of oils, and oils exacerbate the symptoms of certain ocular surface diseases such as dry eyes, indicated by cyclosporin.
Therefore, these oily formulations may not be clini-cally acceptable. Additionally, these formulations often suffer from physical instability due to cyclo-sporin°~ propensity to undergo conformational change and cr;~~stallize out. The-crystallization problem has been noticed in formulations containing corn oil or medium chain triglycerides. Lastly, these formula-tions often have a low thermodynamic activity (degree of saturation) of cyclosporin which leads to a poorer drug bioavailability.
It may be possible to minimize the problems related to unpleasant sensation and syndrome exacerba-tion by reducing the oil content and dispersing the oil phase in water into an emulsion. However, it is not an easy task to formulate an ophthalmic emulsion because one indispensable class of ingredients in an emulsion system is emulsifiers, and the majority of emulsifiers is highly irritating to the eyes.
The present invention is directed to an emulsion system which utilizes higher fatty acid glycerides but in combination with polysorbate 80 which results in an emulsion with a high comfort level and low irritation potential suitable for delivery of medications to sen-sitive areas such as ocular tissues. Further, the present invention provides a pharmaceutical composi-tion and method for causing preferential absorption of cyclosporin in the lacrimal gland. That is, for a given instillation of the composition into an eye, a greater amount of absorption occurs in the lacrimal gland for formulations made in accordance with the present invention than heretofore utilized formula tions.
SUMMARY OF THE INVENTION
In accordance with the present invention, a non-irritating pharmaceutical composition with high com-fort level and low irritation potential suitable for delivery to sensitive areas such as ocular tissues comprises cyclosporin in admixture with an emulsifying amount of a higher fatty acid glycerol and polysorbate 80. More particularly, the composition may comprise cyclosporin A and the higher fatty acid glyceride may comprise castor oil.
Preferably, the weight ratio of the castor oil to the polysorbate 80 is between about 0.3 to about 30 and a weight ratio of the cyclosporin to castor oil is below 0.16. More preferably, the weight ratio of castor oil to polysorbate 80 is between 0.5 and 12.5, and the weight ratio of cyclosporin to castor oil is between 0.12 and 0.02.
When cyclosporin is dissolved in the oil phase in accordance with the present invention, the emulsion is found to be physically stable upon long term storage.
No crystallization of cyclosporin was noticed after nine months at room temperature. Moreover, the cyclosporin emulsion is formulated in such a way that the drug has reasonably high thermodynamic activity, yet without the crystallization problem.
Importantly, the composition of the present in-vention provides for enhanced absorption of the cyclo-sporin in the lacrimal gland of the eye. In this manner, the activity of the cyclosporin in restoring lacrimal gland tearing is increased. That is, since a greater amount of cyclosporin is absorbed into the lacrimal gland, more of the cyclosporin is effective in producing lacrimal gland tearing than heretofore possible.
BRIEF DESCRIPTION OF THE DRAWINGS
The advantages and features of the present inven-tion will be better understood by the following description when consideYed in conjunction with the accompanying drawings in which:
Figure 1 is a bar chart of conjunctival concen-tration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye;
Figure 2 is a bar chart of cornea concentration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye;
Figure 3 is a bar chart of ciliary body concen-tration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye;
and Figure 4 is a bar chart of lacrimal gland concen-tration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye.
DETAILED DESCRIPTION
As hereinabove noted, cyclosporin is available as a mixture in which the principal ingredient is cyclo-_g_ sporin A with significant, but smaller, quantities of other cyclosporins such as cyclosporin B through I.
However, as also hereinabove noted, the present inven tion may be applied to either a pure cyclosporin or to a mixture of individual cyclosporins.
The discovery on which the present invention is founded relates to a combination of a higher fatty acid glyceride and an emulsifier and dispersing agent, polysorbate 80. The selection of these components could not have been anticipated on the basis of con-ventional thinking.
For example, although it is well known that cyclosporin may be used in combination with castor oil, this combination is irritating to sensitive tissues such as the eye. Thus, conventional teaching in the art is away from a formulation which utilizes a higher fatty acid glyceride, such as castor oil, and cyclosporin.
Stated another way, there is no way of deducing that the use of an emulsifier and dispersing agent such as polysorbate 80 will reduce the irritation po-tential of an emulsion utilizing castor oil. There are no examples of polysorbate in combination with castor oil which, when admixed to cyclosporin, pro-duces an emulsion with a high comfort level and low irritation potential suitable for the delivery of -30 medication to sensitive areas such as ocular tissues.
The present invention achieves a stable solution state of cyclosporin. This stable solution state is another important performance characteristic differ-entiating the present invention from the conventional oil systems. Cyclosporin is notorious for its ten-WO 95131211 P~.TfUS95/06302 _g_ dency to precipitate out in conventional oil systems in which it is fully dissolved initially.
In accordance with the present invention, the emulsions can be further stabilized using a polyelec-trolyte, or polyelectrolytes if more than one, from the family of cross-linked p.olyacrylates, such as carbomers and Pemulen~.
Pemulen~ is a polymeric emulsifier having a CTFA
name of Acryl~tes/C10-30 Alkyl Acrylate Cross-Polymer and is described in the "Garbomer 1342" monograph in the United States Pharmacopeial National Formuiary, United States Pharmacopeial Gonvention inc., 2002. ._ In addition, the tonicity of the emulsions can be further adjusted usincr a.lvcerine, mannitol, or sorbi-tol if desired. The pH of the emulsions can be ad-justed in a conventional manner using sodium hydroxide to a near physiological pH level and while buffering agents are not required, suitable buffers may include phosphates, citrates, acetates and borates.
While the preferable medications in accordance with the present invention include cyclosporin; other chemicals which are poorly soluble in water such as indomethacin and steroids such as androgens, predniso .lone, prednisolone acetate, fluorometholone, and dexamethasones, may be emulsified with castor oil and polysorbate 80 resulting in a composition with similar -30 low irritation potential.
The invention is further illustrated by the following =xamples with all parts and percentages expressed .by weight. The cyclosporin used in the examples was supplied by Sandoz.
WO 95/31211 PCTlUS95106302 Example 1 A B C D E
Cyclosporin 0.40% 0.20% 0.20% 0.10% 0.05%
A
Castor oil 5.00% 5.00% 2.50% 1.25% 0.625%
Polysorbate 1.00% 1.00% 1.00% 1.00% 1.00%
Pemulenm 0.05% 0.05% 0.05% 0.05% 0.05%
G1 cerine 2.20% 2.20% 2.20% 2.20% 2.20%
NaOH qs qs s s qs Purified waterqs qs qs qs qs pH 7.2-7.67.2-7.67.2-7.6 7.2-7.67.2-7.6'.
Example 2 A B C D
Castor oil 5.00% 2.50% 1.25% 0.625%
Pol sorbate 1.00% 1.00% 1.00% 1.00%
Pemulenm 0.05% 0.05% 0.05% 0.05%
Glycerine 2.20 2.20% 2.20% 2.20%
NaOH s s s s 2 0 Purified waters s s s pH 7.2-7.67.2-7.67.2-7.67.2-?.6' Example 3 A
Castor oil 2.50%
Polysorbate 80 0.75%
Carbomer 1382 0.05%
Glycerine 2.20%
3 0 NaOH qs Purified water qs pH 7.2-7.6 WO 95/31211 PC'TIUS95/06302 Example 4 A
Castor oil 5.00%
Polysorbate 80 0.75%
Carbomer 981 0.05%
G1 cerine 2.20%
NaOH s Purified water qs pH 7.2-7.6 The formulations set forth in Examples 1-4 were made for treatment of keratoconjunctivitis sicca (dry eye) syndrome with Examples 2, 3 and 4 without the active ingredient cyclosporin utilized to determine the toxicity of the emulsified components.
The formulations in Examples 1-4 were applied to rabbit eyes eight times a day for seven days and were found to cause only slight to mild discomfort and slight hyperemia in the rabbit eyes. Slit lamp exam-ination revealed no changes in the surface tissue. In addition, the cyclosporin containing castor oil emul-sion, as hereinabove set forth in Examples lA-1D, was also tested for ocular bioavailability in rabbits; and the therapeutic level of cyclosporin was found in the tissues of interest after dosage. This substantiates that cyclosporin in an ophthalmic delivery system is useful for treating dry eye as set forth in U.S.
'30 Patent No. 4,839,342.
In addition, no difference in toxicity was found between formulations with cyclosporin (Examples lA-1D) and formulations without cyclosporin (Examples 2-4).
The formulations set forth in Examples 1-4 were found to be physically stable upon long term storage.
pGTIUS95/06302 With regard to formulations lA-1D, no crystallization of cyclosporin was noticed after nine months at room temperature.
Further, other higher fatty acid glycerides such as olive oil, peanut oil and the like may also be utilized with the polysorbate 80 with similar results regarding biotoxicity.
The following examples demonstrate the activity of the composition in accordance with the present invention for enhanced absorption of cyclosporin A in the lacrimal gland.
Materials The [Mebmt-3H]-cyclosporin-A (lot #TRQ6553) was prepared by Amersham International (Buckinghamshire, England) with radiochemical purity of -98% (by reversed phase HPLC) and specific activity of 2.6 Ci/mmol (2.16 mCi/mg). The 3H-label is a metabolic-ally stable position as shown by the asterisk. The radiolabeled CsA was supplied as an ethanol solution (1 mCi/ml). All organic solvents used in the procedures described in this study were "HPLC grade".
all other chemicals and reagents were analytical grade unless otherwise noted.
The compositions of the six formulations tested - - 30 are listed in Table A.
WO 95/31211 . PCTfi3S9510G302 TABLE A
Castor Miglyol Aqueous- Polyoxyl ngredients astor Oil-in- ~ Cyclo-Oil-in.-olyoxyl40 with Oil Water dextrinWater 40 Edetate j Emulsion Emulsion C clos orin-A 0.20 0.20 0.10 0.20 0.05 0.05 C clodextrin 14 Castor Oil 99.8 1.25 Miglyoi* OiI
Pluronic* i_121 0.75 ~- P123 Tween* 80 I . 00 Gl cerin 2.20 2.20 Pemulen~ TR-2 0.05 Carbopol* 981 0 . 05' Polyoxyl 40 20 20 Steavate (mg) FiPMC 0.3 0.3 Butylated H drox toluene 0.001 0.001 Ethanol(9200 rood) 0.1 Sodium Chloride 0.73 0.73 Sodium Mono hos hate 0.2 0.2 Disodium Edetate 0.1 ~~
Water QS QS QS QS QS
Batch Size 1 g 5 g 1 g 5 g 1 g 1 g The radiolabeled formulations were formulated to ensure that the radioactivity was homogeneous throughout the vehicle. The, expected radioactivity concentrations of the radiolabeled drug formulations were 1-2 mCi/ml. The expected specific activity of radiolabeled cyclosporin A (CsA) formulations was 0.5-2 mCi/mg. All test articles were stored at ambient temperature.
* Trade mark Analysis of Test Drug Formulations The test formulations were analyzed in triplicate by HPLC to determine the concentration of CsA and radiochemical purity of the CsA dosing solutions (>93%) before dosing. The radioactive concentrations of the test formulations were quantified by liquid scintillation counting (LSC).
l0 Chromatographic Conditions Pump: Beckman Model 126 (Beckman Instruments, San Ramon, CA) Mobile phase: Acetonitrile: 0.03a H3POq in water, pH 3 (65:35 v/v) Flow rate: 1.0 ml/min Column: Supercosil C8, 7.5 cm x 4.6 mm, 3 ~cm (Supelco, Bellefonte, PA) Superguard LC-8 (Supelco) Column heater (Bio-rad, Richmond, CA) at 60-70C
Injector: WISP 712B (Waters Associates, Milford, MA) 1aC detector: Radio Isotope 171 Detector (Beckman Instruments) Scintillant: Ready Flow III (Beckman Instruments), Flow Rate of '4 ml/min W detector: Model 166 (Beckman Instruments), 2 0 2 nm - Data processor: Beckman System Gold (Beckman Instruments) Run Time: 15 min Retention Time: 6 min (cyclosporin A) Animals Female New Zealand albino rabbits were obtained and quarantined for at least five days before procedures. Animals were housed in temperature- and humidity-controlled rooms. Food and tap water were provided ad libitum. Fifty-eight rabbits (2-3 kg) were selected Pram the colony to minimize bias. They were individually identified by ear tags and appeared to be healthy.
Dos inct The animals were divided into six groups of nine I5 rabbits; each group was treated with one of the six CsA formulations. During dosing, the lower eyelid of each rabbit was gently pulled away from the eye and 35 ~cl of the formulation were administered in the lower conjunctival cul-de-sac of each eye. After dosing, the upper and lower eyelid were handheld closed for '5 seconds and released. The animals were observed visually for any signs of tearing or ocular discomfort.
Samr~li,ng Tissues were collected at 20-min., 6-hr. and 24-hr. post-dose for each group. Three rabbits (six eyes) were used at each time point. At the specific sampling times, the animals were euthanized by an intravenous injection of 0.5-1 ml Eutha-6 (Western Supply Co., Arcadia, California) via marginal ear vein. Each eye was then rinsed with normal saline.
The aqueous humor ('200 ~1) was removed by means of a 0.5~m1 tuberculin syringe. The orbital lacrimal gland ('400 mg) , upper and lower bulbar conjunctivae ('S0 mg each), corneal ('50 mg) and iris-ciliary body ('S0 mg) were dissected. The tissues dissected were blotted dry and weighed. Ocular tissue and aqueous humor samples from both eyes were collected from four untreated animals to be used as blank samples.
Analysis of Radioactivity An aliquot of aqueous humor (50-175 ~.1) was counted directly in 10 ml of Ready-Solv HP by LSC.
Tissue and blood samples were weighed into combustion cones prior to combustion in a Model 307 Packard Tissue Oxuduzer (Packard Co., Downers Grove, Illinois). After combustion of the tissue samples, 3H20 was trapped in the Monophase-S solution (Packard) and the radioactivity of the samples was determined by LSC in a Beckman Model 1801 or 3801 scintillation counter (Beckman Instruments, San Ramon, California).
Data Analyses Excel software (version 4.0, Microsoft Corp, Redmond, Washington) was used for data analysis.
concentrations of total radioactivity in the tissue samples were expressed as dpm/g or dpm/ml and converted to ng equivalents (eq) of CsA/g or ml, using the specific activity of the dosing formulations.
Mean, standard deviation (SD) or standard error of the mean (SEM) was calculated according to standard methods. Radioactivity levels were not considered - -30 significant unless the dpm was greater than twice that of background b=(blanks).
Comparisons of tissue drug concentrations at each time point for the formulations were determined by one-factor ANOVA. All statistical comparisons were made using StatView~ (version 1.03, Abacus Concepts, Inc., Berkeley, California). the Fisher and Scheffe F tests were used to determine significant differences between formulations at the 95% level (a = 0.05). The rejection criteria for excluding any outlier data was based on standard outlier tests. No mere than one outlier was eliminated from any data set.
results aid ~i~scuss~on The radioactivity concentrations in ocular tissues at 20 minutes, 6 hours, and 24 hours after a single topical application of various formulations are depicted in Figures 1-4. In general, the concentra-tions in the ocular tissues were greatest at the earl-iest time point of 20 minutes as reported in~previous single dose studies, The radioactivity concen tration was highest in the conjunctiva and cornea for each formulation. The relatively low aqueous humor and iris-ciliary body concentrations suggest low in traocular absorption of CsA, consistent with the low 2o CsA corneal permeability of -1.0 x 10'6 cm/sec., The decline of radioactivity concentrations from the cornea was slower than those from the conjunctiva, lacrimal gland, and aqueous humor. The obse~~-ved blood radioactivity concentrations (<3 ng-eq/ml) were much , lower than trough plasma CsA concentrations of 80-250 ng/ml observed after oral dosing to humans, The dependence of CsA corneal and conjunctival penetration on the formulation was interpreted in -30 terms of CsA concentration in formulation and the release rate of CsA from formulation into tear film.
The aqueous formulations demonstrated a greater propensity to release CsA for diffusion across. the surface tissue epithelia. The 0.2% straight castor oil was formulated below the CsA solubility and therefore the release rate could be hampered by the less than maximal CsA thermodynamic activity, The ocular surface tissues contained a higher fraction of the CsA dose than the other tissues and was used to discriminate among the aqueous, emulsion and the straight castor oil formulations. The poly-oxyl 4o formulation produced higher ocular surface tissue concentrations than the emulsions and straight castor oil. The emulsions were also effective in delivery of CsA to the tissues of interest, lacrimal gland, cornea, and conjunctiva. The castor oil emul-lo sion showed higher lacrimal gland concentrations than the modified Santen and the miglyol* ~ emulsion. The straight castor oil showed the lowest concentrations in surface ocular tissues. Apparently, the factors influencing CsA penetration into the lacrimal gland and the surface tissues are different.
Although there has been hereinabove described a particular pharmaceutical composition in the form of a nonirritating emulsion for the purpose of illustrat-ing the manner in which the invention may be used to advantage, it should be appreciated that the invention is not limited thereto. Accordingly, any and all mod-ifications, variations, or equivalent arrangements, which may occur,to those skilled in the art, should be considered to be within the scope of the present in-vention as defined in the appended claims.
* Trade mark
Importantly, this solvent system does not contain any surface active agent such as polyoxyethylated castor oil.
Conceptually, the purpose of dissolving the cyclosporin in an aqueous solvent system is to enable contact with body fluids which would merely constitute dilution of the aqueous solvent system which hopefully would eliminate the immediate precipitation of cyclo sporin when contacted with the water content of the body fluids.
For direct use in the eye, cyclosporin has been formulated with a number- of pharmaceutically accept-able excipients, for example, animal oil, vegetable oil, an appropriate organic or aqueous solvent, an artificial tear solution, a natural or synthetic poly-mer or an appropriate membrane.
Specific examples of these pharmaceutically acceptable excipients, which may be used solely or in combination, are olive oil, arachis oil, castor oil, mineral oil, petroleum jelly, dimethyl sulfoxide, chremophor, liposomes, or liposome-like products or a silicone fluid, among others.
In summary, a great deal of effort has been ex-pended in order to prepare a pharmaceutical composi-tion containing cyclosporin dissolved in an aqueous medium or cyclosporin prepared as an oily solution.
However, successful formulations have yet to be accom-plished as evidenced by the lack of commercial prod-ucts.
As hereinabove noted, it has been reported that cyclosporin has demonstrated some solubility in oily preparations containing higher fatty acid glycerides such as olive oil, peanut oil, and/or castor oil.
These formulations frequently produce an unpleasant sensation when applied to the eye because of stimula-tion or the viscousness which is characteristic of these oils.
Another drawback of these formulations is that they contain a high concentration of oils, and oils exacerbate the symptoms of certain ocular surface diseases such as dry eyes, indicated by cyclosporin.
Therefore, these oily formulations may not be clini-cally acceptable. Additionally, these formulations often suffer from physical instability due to cyclo-sporin°~ propensity to undergo conformational change and cr;~~stallize out. The-crystallization problem has been noticed in formulations containing corn oil or medium chain triglycerides. Lastly, these formula-tions often have a low thermodynamic activity (degree of saturation) of cyclosporin which leads to a poorer drug bioavailability.
It may be possible to minimize the problems related to unpleasant sensation and syndrome exacerba-tion by reducing the oil content and dispersing the oil phase in water into an emulsion. However, it is not an easy task to formulate an ophthalmic emulsion because one indispensable class of ingredients in an emulsion system is emulsifiers, and the majority of emulsifiers is highly irritating to the eyes.
The present invention is directed to an emulsion system which utilizes higher fatty acid glycerides but in combination with polysorbate 80 which results in an emulsion with a high comfort level and low irritation potential suitable for delivery of medications to sen-sitive areas such as ocular tissues. Further, the present invention provides a pharmaceutical composi-tion and method for causing preferential absorption of cyclosporin in the lacrimal gland. That is, for a given instillation of the composition into an eye, a greater amount of absorption occurs in the lacrimal gland for formulations made in accordance with the present invention than heretofore utilized formula tions.
SUMMARY OF THE INVENTION
In accordance with the present invention, a non-irritating pharmaceutical composition with high com-fort level and low irritation potential suitable for delivery to sensitive areas such as ocular tissues comprises cyclosporin in admixture with an emulsifying amount of a higher fatty acid glycerol and polysorbate 80. More particularly, the composition may comprise cyclosporin A and the higher fatty acid glyceride may comprise castor oil.
Preferably, the weight ratio of the castor oil to the polysorbate 80 is between about 0.3 to about 30 and a weight ratio of the cyclosporin to castor oil is below 0.16. More preferably, the weight ratio of castor oil to polysorbate 80 is between 0.5 and 12.5, and the weight ratio of cyclosporin to castor oil is between 0.12 and 0.02.
When cyclosporin is dissolved in the oil phase in accordance with the present invention, the emulsion is found to be physically stable upon long term storage.
No crystallization of cyclosporin was noticed after nine months at room temperature. Moreover, the cyclosporin emulsion is formulated in such a way that the drug has reasonably high thermodynamic activity, yet without the crystallization problem.
Importantly, the composition of the present in-vention provides for enhanced absorption of the cyclo-sporin in the lacrimal gland of the eye. In this manner, the activity of the cyclosporin in restoring lacrimal gland tearing is increased. That is, since a greater amount of cyclosporin is absorbed into the lacrimal gland, more of the cyclosporin is effective in producing lacrimal gland tearing than heretofore possible.
BRIEF DESCRIPTION OF THE DRAWINGS
The advantages and features of the present inven-tion will be better understood by the following description when consideYed in conjunction with the accompanying drawings in which:
Figure 1 is a bar chart of conjunctival concen-tration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye;
Figure 2 is a bar chart of cornea concentration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye;
Figure 3 is a bar chart of ciliary body concen-tration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye;
and Figure 4 is a bar chart of lacrimal gland concen-tration of cyclosporin A after a single topical instillation of various formulations in a rabbit eye.
DETAILED DESCRIPTION
As hereinabove noted, cyclosporin is available as a mixture in which the principal ingredient is cyclo-_g_ sporin A with significant, but smaller, quantities of other cyclosporins such as cyclosporin B through I.
However, as also hereinabove noted, the present inven tion may be applied to either a pure cyclosporin or to a mixture of individual cyclosporins.
The discovery on which the present invention is founded relates to a combination of a higher fatty acid glyceride and an emulsifier and dispersing agent, polysorbate 80. The selection of these components could not have been anticipated on the basis of con-ventional thinking.
For example, although it is well known that cyclosporin may be used in combination with castor oil, this combination is irritating to sensitive tissues such as the eye. Thus, conventional teaching in the art is away from a formulation which utilizes a higher fatty acid glyceride, such as castor oil, and cyclosporin.
Stated another way, there is no way of deducing that the use of an emulsifier and dispersing agent such as polysorbate 80 will reduce the irritation po-tential of an emulsion utilizing castor oil. There are no examples of polysorbate in combination with castor oil which, when admixed to cyclosporin, pro-duces an emulsion with a high comfort level and low irritation potential suitable for the delivery of -30 medication to sensitive areas such as ocular tissues.
The present invention achieves a stable solution state of cyclosporin. This stable solution state is another important performance characteristic differ-entiating the present invention from the conventional oil systems. Cyclosporin is notorious for its ten-WO 95131211 P~.TfUS95/06302 _g_ dency to precipitate out in conventional oil systems in which it is fully dissolved initially.
In accordance with the present invention, the emulsions can be further stabilized using a polyelec-trolyte, or polyelectrolytes if more than one, from the family of cross-linked p.olyacrylates, such as carbomers and Pemulen~.
Pemulen~ is a polymeric emulsifier having a CTFA
name of Acryl~tes/C10-30 Alkyl Acrylate Cross-Polymer and is described in the "Garbomer 1342" monograph in the United States Pharmacopeial National Formuiary, United States Pharmacopeial Gonvention inc., 2002. ._ In addition, the tonicity of the emulsions can be further adjusted usincr a.lvcerine, mannitol, or sorbi-tol if desired. The pH of the emulsions can be ad-justed in a conventional manner using sodium hydroxide to a near physiological pH level and while buffering agents are not required, suitable buffers may include phosphates, citrates, acetates and borates.
While the preferable medications in accordance with the present invention include cyclosporin; other chemicals which are poorly soluble in water such as indomethacin and steroids such as androgens, predniso .lone, prednisolone acetate, fluorometholone, and dexamethasones, may be emulsified with castor oil and polysorbate 80 resulting in a composition with similar -30 low irritation potential.
The invention is further illustrated by the following =xamples with all parts and percentages expressed .by weight. The cyclosporin used in the examples was supplied by Sandoz.
WO 95/31211 PCTlUS95106302 Example 1 A B C D E
Cyclosporin 0.40% 0.20% 0.20% 0.10% 0.05%
A
Castor oil 5.00% 5.00% 2.50% 1.25% 0.625%
Polysorbate 1.00% 1.00% 1.00% 1.00% 1.00%
Pemulenm 0.05% 0.05% 0.05% 0.05% 0.05%
G1 cerine 2.20% 2.20% 2.20% 2.20% 2.20%
NaOH qs qs s s qs Purified waterqs qs qs qs qs pH 7.2-7.67.2-7.67.2-7.6 7.2-7.67.2-7.6'.
Example 2 A B C D
Castor oil 5.00% 2.50% 1.25% 0.625%
Pol sorbate 1.00% 1.00% 1.00% 1.00%
Pemulenm 0.05% 0.05% 0.05% 0.05%
Glycerine 2.20 2.20% 2.20% 2.20%
NaOH s s s s 2 0 Purified waters s s s pH 7.2-7.67.2-7.67.2-7.67.2-?.6' Example 3 A
Castor oil 2.50%
Polysorbate 80 0.75%
Carbomer 1382 0.05%
Glycerine 2.20%
3 0 NaOH qs Purified water qs pH 7.2-7.6 WO 95/31211 PC'TIUS95/06302 Example 4 A
Castor oil 5.00%
Polysorbate 80 0.75%
Carbomer 981 0.05%
G1 cerine 2.20%
NaOH s Purified water qs pH 7.2-7.6 The formulations set forth in Examples 1-4 were made for treatment of keratoconjunctivitis sicca (dry eye) syndrome with Examples 2, 3 and 4 without the active ingredient cyclosporin utilized to determine the toxicity of the emulsified components.
The formulations in Examples 1-4 were applied to rabbit eyes eight times a day for seven days and were found to cause only slight to mild discomfort and slight hyperemia in the rabbit eyes. Slit lamp exam-ination revealed no changes in the surface tissue. In addition, the cyclosporin containing castor oil emul-sion, as hereinabove set forth in Examples lA-1D, was also tested for ocular bioavailability in rabbits; and the therapeutic level of cyclosporin was found in the tissues of interest after dosage. This substantiates that cyclosporin in an ophthalmic delivery system is useful for treating dry eye as set forth in U.S.
'30 Patent No. 4,839,342.
In addition, no difference in toxicity was found between formulations with cyclosporin (Examples lA-1D) and formulations without cyclosporin (Examples 2-4).
The formulations set forth in Examples 1-4 were found to be physically stable upon long term storage.
pGTIUS95/06302 With regard to formulations lA-1D, no crystallization of cyclosporin was noticed after nine months at room temperature.
Further, other higher fatty acid glycerides such as olive oil, peanut oil and the like may also be utilized with the polysorbate 80 with similar results regarding biotoxicity.
The following examples demonstrate the activity of the composition in accordance with the present invention for enhanced absorption of cyclosporin A in the lacrimal gland.
Materials The [Mebmt-3H]-cyclosporin-A (lot #TRQ6553) was prepared by Amersham International (Buckinghamshire, England) with radiochemical purity of -98% (by reversed phase HPLC) and specific activity of 2.6 Ci/mmol (2.16 mCi/mg). The 3H-label is a metabolic-ally stable position as shown by the asterisk. The radiolabeled CsA was supplied as an ethanol solution (1 mCi/ml). All organic solvents used in the procedures described in this study were "HPLC grade".
all other chemicals and reagents were analytical grade unless otherwise noted.
The compositions of the six formulations tested - - 30 are listed in Table A.
WO 95/31211 . PCTfi3S9510G302 TABLE A
Castor Miglyol Aqueous- Polyoxyl ngredients astor Oil-in- ~ Cyclo-Oil-in.-olyoxyl40 with Oil Water dextrinWater 40 Edetate j Emulsion Emulsion C clos orin-A 0.20 0.20 0.10 0.20 0.05 0.05 C clodextrin 14 Castor Oil 99.8 1.25 Miglyoi* OiI
Pluronic* i_121 0.75 ~- P123 Tween* 80 I . 00 Gl cerin 2.20 2.20 Pemulen~ TR-2 0.05 Carbopol* 981 0 . 05' Polyoxyl 40 20 20 Steavate (mg) FiPMC 0.3 0.3 Butylated H drox toluene 0.001 0.001 Ethanol(9200 rood) 0.1 Sodium Chloride 0.73 0.73 Sodium Mono hos hate 0.2 0.2 Disodium Edetate 0.1 ~~
Water QS QS QS QS QS
Batch Size 1 g 5 g 1 g 5 g 1 g 1 g The radiolabeled formulations were formulated to ensure that the radioactivity was homogeneous throughout the vehicle. The, expected radioactivity concentrations of the radiolabeled drug formulations were 1-2 mCi/ml. The expected specific activity of radiolabeled cyclosporin A (CsA) formulations was 0.5-2 mCi/mg. All test articles were stored at ambient temperature.
* Trade mark Analysis of Test Drug Formulations The test formulations were analyzed in triplicate by HPLC to determine the concentration of CsA and radiochemical purity of the CsA dosing solutions (>93%) before dosing. The radioactive concentrations of the test formulations were quantified by liquid scintillation counting (LSC).
l0 Chromatographic Conditions Pump: Beckman Model 126 (Beckman Instruments, San Ramon, CA) Mobile phase: Acetonitrile: 0.03a H3POq in water, pH 3 (65:35 v/v) Flow rate: 1.0 ml/min Column: Supercosil C8, 7.5 cm x 4.6 mm, 3 ~cm (Supelco, Bellefonte, PA) Superguard LC-8 (Supelco) Column heater (Bio-rad, Richmond, CA) at 60-70C
Injector: WISP 712B (Waters Associates, Milford, MA) 1aC detector: Radio Isotope 171 Detector (Beckman Instruments) Scintillant: Ready Flow III (Beckman Instruments), Flow Rate of '4 ml/min W detector: Model 166 (Beckman Instruments), 2 0 2 nm - Data processor: Beckman System Gold (Beckman Instruments) Run Time: 15 min Retention Time: 6 min (cyclosporin A) Animals Female New Zealand albino rabbits were obtained and quarantined for at least five days before procedures. Animals were housed in temperature- and humidity-controlled rooms. Food and tap water were provided ad libitum. Fifty-eight rabbits (2-3 kg) were selected Pram the colony to minimize bias. They were individually identified by ear tags and appeared to be healthy.
Dos inct The animals were divided into six groups of nine I5 rabbits; each group was treated with one of the six CsA formulations. During dosing, the lower eyelid of each rabbit was gently pulled away from the eye and 35 ~cl of the formulation were administered in the lower conjunctival cul-de-sac of each eye. After dosing, the upper and lower eyelid were handheld closed for '5 seconds and released. The animals were observed visually for any signs of tearing or ocular discomfort.
Samr~li,ng Tissues were collected at 20-min., 6-hr. and 24-hr. post-dose for each group. Three rabbits (six eyes) were used at each time point. At the specific sampling times, the animals were euthanized by an intravenous injection of 0.5-1 ml Eutha-6 (Western Supply Co., Arcadia, California) via marginal ear vein. Each eye was then rinsed with normal saline.
The aqueous humor ('200 ~1) was removed by means of a 0.5~m1 tuberculin syringe. The orbital lacrimal gland ('400 mg) , upper and lower bulbar conjunctivae ('S0 mg each), corneal ('50 mg) and iris-ciliary body ('S0 mg) were dissected. The tissues dissected were blotted dry and weighed. Ocular tissue and aqueous humor samples from both eyes were collected from four untreated animals to be used as blank samples.
Analysis of Radioactivity An aliquot of aqueous humor (50-175 ~.1) was counted directly in 10 ml of Ready-Solv HP by LSC.
Tissue and blood samples were weighed into combustion cones prior to combustion in a Model 307 Packard Tissue Oxuduzer (Packard Co., Downers Grove, Illinois). After combustion of the tissue samples, 3H20 was trapped in the Monophase-S solution (Packard) and the radioactivity of the samples was determined by LSC in a Beckman Model 1801 or 3801 scintillation counter (Beckman Instruments, San Ramon, California).
Data Analyses Excel software (version 4.0, Microsoft Corp, Redmond, Washington) was used for data analysis.
concentrations of total radioactivity in the tissue samples were expressed as dpm/g or dpm/ml and converted to ng equivalents (eq) of CsA/g or ml, using the specific activity of the dosing formulations.
Mean, standard deviation (SD) or standard error of the mean (SEM) was calculated according to standard methods. Radioactivity levels were not considered - -30 significant unless the dpm was greater than twice that of background b=(blanks).
Comparisons of tissue drug concentrations at each time point for the formulations were determined by one-factor ANOVA. All statistical comparisons were made using StatView~ (version 1.03, Abacus Concepts, Inc., Berkeley, California). the Fisher and Scheffe F tests were used to determine significant differences between formulations at the 95% level (a = 0.05). The rejection criteria for excluding any outlier data was based on standard outlier tests. No mere than one outlier was eliminated from any data set.
results aid ~i~scuss~on The radioactivity concentrations in ocular tissues at 20 minutes, 6 hours, and 24 hours after a single topical application of various formulations are depicted in Figures 1-4. In general, the concentra-tions in the ocular tissues were greatest at the earl-iest time point of 20 minutes as reported in~previous single dose studies, The radioactivity concen tration was highest in the conjunctiva and cornea for each formulation. The relatively low aqueous humor and iris-ciliary body concentrations suggest low in traocular absorption of CsA, consistent with the low 2o CsA corneal permeability of -1.0 x 10'6 cm/sec., The decline of radioactivity concentrations from the cornea was slower than those from the conjunctiva, lacrimal gland, and aqueous humor. The obse~~-ved blood radioactivity concentrations (<3 ng-eq/ml) were much , lower than trough plasma CsA concentrations of 80-250 ng/ml observed after oral dosing to humans, The dependence of CsA corneal and conjunctival penetration on the formulation was interpreted in -30 terms of CsA concentration in formulation and the release rate of CsA from formulation into tear film.
The aqueous formulations demonstrated a greater propensity to release CsA for diffusion across. the surface tissue epithelia. The 0.2% straight castor oil was formulated below the CsA solubility and therefore the release rate could be hampered by the less than maximal CsA thermodynamic activity, The ocular surface tissues contained a higher fraction of the CsA dose than the other tissues and was used to discriminate among the aqueous, emulsion and the straight castor oil formulations. The poly-oxyl 4o formulation produced higher ocular surface tissue concentrations than the emulsions and straight castor oil. The emulsions were also effective in delivery of CsA to the tissues of interest, lacrimal gland, cornea, and conjunctiva. The castor oil emul-lo sion showed higher lacrimal gland concentrations than the modified Santen and the miglyol* ~ emulsion. The straight castor oil showed the lowest concentrations in surface ocular tissues. Apparently, the factors influencing CsA penetration into the lacrimal gland and the surface tissues are different.
Although there has been hereinabove described a particular pharmaceutical composition in the form of a nonirritating emulsion for the purpose of illustrat-ing the manner in which the invention may be used to advantage, it should be appreciated that the invention is not limited thereto. Accordingly, any and all mod-ifications, variations, or equivalent arrangements, which may occur,to those skilled in the art, should be considered to be within the scope of the present in-vention as defined in the appended claims.
* Trade mark
Claims (15)
PROPERTY OR PRIVILEGE IS CLAIMED ARE AS FOLLOWS:
1. A composition comprising a nonirritating emulsion of a higher fatty acid glyceride, polysorbate 80 and an emulsion stabilizing amount of Pemulen® in water suitable for topical application to ocular tissue.
2. The pharmaceutical composition according to claim 1 wherein the weight ratio of the higher fatty acid glyceride to the polysorbate 80 is between about 0.3 and about 30.
3. A pharmaceutical composition comprising castor oil, polysorbate 80 and an emulsion-stabilizing amount of Pemulen® in water suitable for topical application to ocular tissue.
4. The pharmaceutical composition according to claim 3 wherein the weight ratio of castor oil to the polysorbate 80 is between about 0.3 and about 30.
5. A stable, nonirritating ophthalmic composition comprising an emulsifying amount of a higher fatty acid glyceride, polysorbate 80 and an emulsion-stabilizing amount of Pemulen®.
6. A pharmaceutical emulsion comprising castor oil, Pemulen®, a higher fatty acid glyceride , polysorbate 80 and water, said pharmaceutical emulsion being suitable for topical application to ocular tissue.
7. A pharmaceutical emulsion according to claim 6 wherein the castor oil is present in an amount of between about 0.625% and about 5.0% by weight, the polysorbate 80 is present in an amount of about 1.0%
by weight, Pemulen® is present in an amount of about 0.05% by weight and the glyceride is present in an amount of about 2.2% by weight.
by weight, Pemulen® is present in an amount of about 0.05% by weight and the glyceride is present in an amount of about 2.2% by weight.
8. A pharmaceutical emulsion consisting of between about 0.625%
and about 5.0% by weight of castor oil, about 1.0% by weight .of polysorbate 80, about 0.05% by weight of Pemulen® and about 2.2% by weight of glycerine in water with a pH of between about 7.2 and 7.6 suitable for topical application to ocular tissue.
and about 5.0% by weight of castor oil, about 1.0% by weight .of polysorbate 80, about 0.05% by weight of Pemulen® and about 2.2% by weight of glycerine in water with a pH of between about 7.2 and 7.6 suitable for topical application to ocular tissue.
9. A pharmaceutical composition suitable for instillation into an eye, said pharmaceutical composition comprising a non-irritating emulsion of a drug selected from cyclosporin, an indomethacin and a steroid drug, polysorbate 80, Pemulen®
and castor oil in an amount causing enhanced lacrimal gland absorption.
and castor oil in an amount causing enhanced lacrimal gland absorption.
10. The pharmaceutical composition according to claim 9 wherein the drug is selected from the group consisting of indomethacin and steroids.
11. The pharmaceutical composition according to claim 10 further comprising an emulsion-stabilizing amount of Pemulen® in water suitable for topical application in the eye.
12. The pharmaceutical composition according to claim 11 further comprising glycerin.
13. A nonirritating pharmaceutical composition suitable for instillation into an eye, said pharmaceutical composition comprising an emulsion-stabilizing amount of Pemulen®, polysorbate 80 and castor oil in an amount causing enhanced lacrimal gland absorption.
14. Use of a composition according to claim 13 for instillation into the eye for causing enhanced absorption in the lacrimal gland of an eye.
15. Use of a composition according to claim 11 for instillation into the eye for causing enhanced absorption in the lacrimal gland of an eye.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/243,279 US5474979A (en) | 1994-05-17 | 1994-05-17 | Nonirritating emulsions for sensitive tissue |
| US08/243,279 | 1994-05-17 | ||
| CA002190485A CA2190485C (en) | 1994-05-17 | 1995-05-17 | Lacrimal gland specific emulsions for topical application to ocular tissue |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002190485A Division CA2190485C (en) | 1994-05-17 | 1995-05-17 | Lacrimal gland specific emulsions for topical application to ocular tissue |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2309033A1 CA2309033A1 (en) | 1995-11-23 |
| CA2309033C true CA2309033C (en) | 2003-08-26 |
Family
ID=25678827
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002309033A Expired - Lifetime CA2309033C (en) | 1994-05-17 | 1995-05-17 | Lacrimal gland specific emulsions for topical application to ocular tissue |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA2309033C (en) |
-
1995
- 1995-05-17 CA CA002309033A patent/CA2309033C/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| CA2309033A1 (en) | 1995-11-23 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CA2190485C (en) | Lacrimal gland specific emulsions for topical application to ocular tissue | |
| US5182258A (en) | Systemic delivery of polypeptides through the eye | |
| US4990337A (en) | Cyclosporin formulations of mono or diglyceride fatty acid | |
| RU2331423C2 (en) | Delivery system with controlled release for intranasal applying | |
| US5951971A (en) | Ophthalmic compositions | |
| KR20100107462A (en) | Stable aqueous cyclosporin compositions | |
| KR20090053797A (en) | Cyclosporine composition | |
| SK282714B6 (en) | Hydrophilic binary systems for the administration of cyclosporin | |
| US5278142A (en) | Systemic delivery of polypeptides through the eye | |
| US20150045309A1 (en) | Cyclosporin emulsions | |
| AU2003247976A1 (en) | Ophthalmic compositions containing loratadine | |
| CA2309033C (en) | Lacrimal gland specific emulsions for topical application to ocular tissue | |
| MXPA96005599A (en) | Specific emulsions for the lagrimal gland, for the topic application to the ocu tissue | |
| Tsuji et al. | Hydrolysis of prednisolone succinate by esterase in rabbit ocular tissue | |
| JP2632010B2 (en) | Cyclosporine preparation | |
| US6225332B1 (en) | Compositions containing histamine H2 agonists and methods of use in treating allergy and inflammation | |
| HK1034190B (en) | Lacrimal gland specific emulsions for topical application to ocular tissue | |
| RU2634267C2 (en) | Aqueous ophthalmic solution based on cyclosporin a | |
| HK1183443B (en) | Cyclosporin emulsions | |
| MXPA06005325A (en) | Controlled release delivery system for nasal applications |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKEX | Expiry |
Effective date: 20150519 |