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Title: Nasal melatonin composition
United States Patent: 6,007,834
Inventors: Merkus; Franciscus W. H. M. (Kasterlee, BE)
Assignee: Merkus, Franciscus W.H.M. (Kasterlee, BE)
Appl. No.: 048465
Filed: March 26, 1998
Abstract
A pharmaceutical composition for intranasal administration, comprising
melatonin and a pharmaceutically acceptable excipient, which is effective
to cause the blood plasma melatonin concentration in a human adult,
receiving an amount of melatonin in the range of 50-1000 .mu.g and in a
single or simultaneous intranasal administration of said composition, to
reach at least X pg/ml, within 30 minutes of said administration, wherein
X is equal to 5 times the amount of melatonin, expressed in .mu.g, in said
single or simultaneous administration.
DESCRIPTION OF THE INVENTION
This invention relates to a pharmaceutical composition for
intranasal administration of melatonin. The invention further relates to
doses or dosage units for intranasal administration, and the use of the
same for the preparation of an intranasal dosage form.
Melatonin (N-acetyl-5-methoxytryptamine) is a neurohormone secreted from
the pineal gland. It has been disclosed in numerous references that
melatonin induces sleep when administered to a patient. The sleep-inducing
effects of melatonin have advantages over conventional hypnotics, since
not being a hypnotic drug itself, it only induces a state of sleepiness
without having the adverse side-effects of conventional hypnotics.
Melatonin is usually administered orally but, as with most oral
preparations, it takes over an hour after administration for the blood
plasma concentration of the active agent (melatonin) to reach its peak.
Other routes of administration, in particular nasal administration have
been considered. However, because of inherent problems, inter alia due to
the low solubility of melatonin in water, melatonin compositions suitable
for nasal administration have yet to be prepared.
In an early attempt to develop such a composition, Vollrath et ala, Adv.
Bioscience, 29 (1981), pp. 327-329 described the nasal administration of
1.7 mg of melatonin in ethanol. Due to serious local irritation and
painful administration, this composition was found to be unsuitable for
use in man. In 1980, intranasal compositions containing reduced quantities
of ethanol were disclosed in Japanese patent application J55057563
(Hoechst AG). A composition of 100 mg of melatonin in 10 ml of a 5%
solution of ethanol in water was proposed, but even this still causes an
unacceptable degree of adverse side-effects. This patent application also
disclosed a composition in which propylene glycol was used in place of
ethanol.
Although this second composition would not cause the acute problems
associated with ethanol, it is not suitable for nasal use because of the
toxicity of propylene glycol, which adversely affects the nasal mucosa.
Therefore, up until the present time, a pharmaceutically acceptable
melatonin composition, capable of providing a fast onset time, has yet to
be developed.
This problem has now been solved in accordance with the present invention
which provides, in a first aspect, a pharmaceutical composition for
intranasal administration, comprising melatonin and a pharmaceutically
acceptable excipient, characterized by being effective to cause the blood
plasma melatonin concentration in a human adult, receiving an amount of
melatonin in the range of 50-1000 .mu.g and in a single or simultaneous
intranasal administration of said composition, to reach at least X pg/ml
within 30 minutes of said administration, wherein X is equal to 5 times
the amount of melatonin, expressed in jig, in said single or simultaneous
administration.
X is preferably equal to 10, 15, 20 or 25 times the quantity of melatonin,
expressed in .mu.g, in said single or simultaneous administration and the
amount of melatonin in said administration can be in the range of 100-800
or 200-400 mg. Preferably, a composition in accordance with the invention
is effective to cause the blood plasma melatonin concentration in a human
adult, receiving 200 .mu.g of melatonin in a single or simultaneous
intranasal administration of said composition, to reach at least 1000
pg/ml and, preferably, at least 2000, 3000, 4000, or 5000 pg/ml, within 30
minutes of administration.
In preferred embodiments, said melatonin concentrations are reached within
15, 10, 8, 7, 6 or 5 minutes of administration. Compositions in accordance
with this aspect of the invention can also comprise a saccharide, a
polysaccharide or a triol.
In further preferred embodiments, compositions in accordance with the
present invention, when intranasally administered, are effective to cause
a peak blood plasma melatonin concentration, or tmax within 30
minutes of administration and, preferably, within 15 or 10 minutes of
administration.
Preferably, compositions in accordance with this aspect of the invention
comprise less than 5-1% by volume of ethanol and less than 20-5% by weight
of propylene glycol.
The "blood plasma melatonin concentration" can be a mean value
measured in a study of the type described in Example 4 below. Such studies
or trials are well known to those skilled in the art.
When used in this specification, the term "single or simultaneous
intranasal administration" encompasses both the administration of a
single dose or dose form, such as a single insulation of a powder, or a
single application of a spray, and the contemporaneous administration of a
plurality of such doses or dose forms, (for example, the administration of
two squirts of a spray or powder insufflations, one in each nostril).
It has also been found that glycerol and cyclodextrin, when employed in
nasal compositions containing melatonin, do not exhibit the unwanted toxic
and adverse effects previously noted with the use of (poly)alcohols. It
has further been found that cyclodextrin accelerates the absorption of
melatonin in the nasal mucosa.
Thus, in a second aspect, the present invention provides a pharmaceutical
composition for intranasal administration, comprising melatonin and an
additive, wherein the additive comprises cyclodextrin or glycerol. Such
pharmaceutical compositions can be in accordance with the first aspect of
the invention and can be in the form of an aqueous or a powdered
composition. When the composition is aqueous, the additive can be a
cyclodextrin, optionally in admixture with glycerol. When the composition
is powdered, the additive is preferably a cyclodextrin. The preferred
cyclodextrin is .beta.-cyclodextrin. Such compositions are
pharmaceutically acceptable because they do not cause the serious local
irritation, pain and toxic side effects caused by the (poly)alcohols used
in previously proposed compositions.
Nasal compositions in accordance with the invention can be administered as
a nasal spray, drop, solution, suspension, gel, ointment, cream, or
powder. The composition may also be administered using a nasal tampon or a
nasal sponge. As previously stated, the composition is preferably
administered in the form of an aqueous composition or a dry powder. The
aqueous composition is preferably an aqueous solution, but can be a
suspension, or a gel.
When taken as an aqueous composition suitable compositions can be obtained
with or without glycerol as an additive. Glycerol allows aqueous
compositions containing relatively high amounts of melatonin, does not
exert toxicity towards the epithelial membrane, and does not lead to
irritation of the nasal mucosa. An additional advantage of the use of
glycerol is the preservative properties thereof, leading to stable
solutions.
When taken as a powder, the composition preferably contains cyclodextrin
and more preferably a melatonin-cyclodextrin complex to obtain optimum
onset times.
Melatonin-cyclodextrin complexes, however, can be employed in any
embodiment of the present invention.
The term cyclodextrin refers to cyclodextrins such as .alpha.-cyclodextrin,
.beta.-cyclodextrin, .gamma.-cyclodextrin, and derivatives thereof, such
as methylated or alkylated cyclodextrins. Examples are methylated .beta.-cyclodextrin,
hydroxypropyl- and hydroxyethyl-cyclodextrin (di)glucosyl- or (di)maltosyl-cyclodextrins
carboxymethyl- or sulfoalkylether cyclodextrins, such as sulfobutylether-.beta.-cyclodextrin.
The preferred cyclodextrin is methylated .beta.-cyclodextrin, or more
preferred .beta.-cyclodextrin.
When a complex of melatonin and cyclodextrin is used, and additionally
glycerol is used as a further additive, the ratio of glycerol:cyclodextrin
may vary between 1:5 and 500:1 by weight, and preferably between 1:1 and
50:1 by weight.
Pharmaceutical compositions in accordance with the present invention can
be formulated to provide a single melatonin dose of between 10 .mu.g and 1
mg and, preferably, of between 0.8, 0.6, 0.5 or 0.4 mg and 0.2, 0.15, 0.1
or 0.05 mg. When used in such low doses, compositions in accordance with
the invention will still provide a sufficiently high peak melatonin blood
plasma concentration (tmax) sufficiently soon after
administration to be effective in the treatment of human disease,
particularly insomnia, or in causing drowsiness or sleep in humans. Thus,
the present invention allows effective melatonin blood plasma
concentrations to be achieved even when using extremely low melatonin
doses.
In preferred embodiments, pharmaceutical compositions in accordance with
the invention comprise aqueous compositions of 0.1 to 10 mg/ml of
melatonin, and one or more of 1 to 250 mg/ml of cyclodextrin and 5 to 50%
by volume of glycerol, or powdered compositions of 0.5 to 50% by weight of
melatonin, and 2.5 to 90% by weight of a cyclodextrin. Such a nasal powder
can comprise daily doses or dosage units of 0.01 to 1 mg of melatonin, and
preferably of about 0.1 to 0.8 mg of melatonin, for sleep induction in
man.
In a third aspect, the present invention provides a pharmaceutical dose or
dose form comprising sufficient of a pharmaceutical composition in
accordance with the first or second aspect of the invention to contain up
to 1 mg, 0.8 mg, 0.6 mg, 0.5 mg or 0.4 mg of melatonin and, preferably, at
least 0.01 mg, 0.05 mg, 0.1 mg, 0.15 mg or 0.2 mg of melatonin. Said
pharmaceutical dose can be in any of the aforementioned forms, including a
measured quantity of a liquid for application as a spray or in drops, a
spray or drop of liquid, or a powder.
A pharmaceutical dose or dose unit in accordance with the invention
preferably contains an additive selected from glycerol, cyclodextrin, and
mixtures thereof, and will give effective sleep-induction in man.
In a further aspect, the present invention provides a pharmaceutical
product, comprising apparatus for intranasally administering a
pharmaceutical dose or dose form in accordance with the third aspect of
the invention, and a pharmaceutical composition in accordance with the
first or second aspect of the invention. The apparatus can comprise a
reservoir and means for expelling the pharmaceutical dose in the form of a
spray, wherein a quantity of the pharmaceutical composition is contained
within the reservoir. In an embodiment, the apparatus comprises a pump
spray device in which the means for expelling a dose comprises a metering
pump. In an alternative embodiment, the apparatus comprises a pressurized
spray device, in which the means for expelling a dose comprises a metering
valve and the pharmaceutical composition further comprises a conventional
propellant. Suitable propellants include one or mixture of
chlorofluorocarbons, such as dichlorodifluoromethane, and the more recent
and preferred hydrofluorocarbons, such as 1,1,1,2-tetrafluoroethane
(HFC-134a) and 1,1,1,2,3,3,3 -heptafluoropropane (HFC-227). Suitable
pressurized spray devices are well known in the art and include those
disclosed in, inter alia, WO92/11190, U.S. Pat. No. 4,819,834, U.S. Pat.
No. 4,407,481 and WO97/09034, when adapted for producing a nasal spray,
rather than an aerosol for inhalation, or a sublingual spray. Suitable
nasal pump spray devices include the VP50, VP70 and VP100 models available
from Valois S.A. in Marly Le Roi, France and the 50, 70 and 100 .mu.l
nasal pump sprays available from Pfeiffer GmbH in Radolfzell, Germany,
although other models and sizes can be employed. In the aforementioned
embodiments, a pharmaceutical dose or dose unit in accordance with the
invention can be present within the metering chamber of the metering pump
or valve.
Pharmaceutical compositions, doses or products in accordance with the
present invention are useful in the treatment of human diseases known to
be responsive to melatonin, including insomnia, and for inducing
drowsiness or sleep in human subjects. They also provide a fast onset time
and are suitable for intranasal use. Although not wishing to be bound by
any particular theory, it is considered that the capacity of compositions
in accordance with the present invention for providing high blood plasma
melatonin concentrations very rapidly after administration, on the basis
of significantly reduced doses of melatonin, leads to their enhanced
efficacy and reduces the likelihood of any unwanted side-effects being
caused.
In a yet further aspect of the present invention, there is provided the
use of melatonin for the preparation of a pharmaceutical composition, dose
or product in accordance with any previously described aspect of the
invention, for treating insomnia, or inducing sleep or drowsiness. Use of
a pharmaceutical composition, dose or product in accordance with any
previous aspect of the invention, for the preparation of a medicament for
treating insomnia, or inducing sleep or drowsiness, is also encompassed by
the present invention.
The invention also comprises methods for treating disease, including
insomnia, and for inducing sleep in humans by intranasally administering a
pharmaceutical composition in accordance with the first or second aspect
of the invention or a pharmaceutical dose in accordance with the third
aspect of the invention. The preferred unit dose is 0.01 to 1 mg of
melatonin, and more preferably is 0.1 to 0.8 mg of melatonin.
Pharmaceutically suitable auxiliaries and liquids, such as those described
in the standard reference, Gennaro et al., Remington's Pharmaceutical
Sciences, (18th ed., Mack Publishing Company, 1990, see especially Part 8:
Pharmaceutical Preparations and Their Manufacture) can be included in
compositions of the present invention. Such compositions can be processed
into vials or containers, for instance, to provide a spray as aforesaid.
For making dose units, any pharmaceutically acceptable additives or
excipients which do not interfere with the function of the active compound
can be used.
To further improve the absorption of melatonin from the nasal composition,
nasal absorption enhancers, which are known in the art, may be added. Also
viscosity enhancers may be added, for example natural gums, cellulose
derivatives such as hydroxypropylmethyl cellulose or methyl cellulose,
acrylic polymers (carbopol), and vinyl polymers (polyvinylpyrrolidone).
Other conventional pharmaceutically acceptable excipients may also be
added, such as preservatives, surfactants, colorants, co-solvents,
adhesives, anti-oxidants, buffers, and agents to adjust the pH and
cosmolarity.
Nasal powder compositions can be made by mixing the active ingredients and
the excipients, both possessing the desired particle size. Other methods
to make a suitable powder formulation are the preparation of a solution of
active ingredients and excipients, followed by precipitation, filtration,
and pulverization, or followed by removal of the solvent by freeze-drying,
followed by pulverization of the powder to the desired particle size. The
final step can be sieving to obtain particles with a size of less than 100
.mu.m in diameter, preferably between 50 and 100 .mu.m in diameter.
Powders can be administered using a nasal insufflator, a jet-spray, or any
other conventional device known in the art.
Claim 1 of 94 Claims
1. A pharmaceutical composition for intranasal
administration, comprising melatonin and a pharmaceutically acceptable
excipient, said composition being effective to cause the blood plasma
melatonin concentration in a human adult, receiving an amount of melatonin
in the range of 50-1000 .mu.g and in a single or simultaneous intranasal
administration of said composition, to reach at least X pg/ml, within 30
minutes of said administration, wherein X is equal to 5 times the amount
of melatonin, expressed in .mu.g, in said single or simultaneous
administration.
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