EPINEPHRINE SPRAY FORMULATIONS

Abstract
The present invention is directed to epinephrine spray formulations. The present invention is further directed to methods of treating anaphylaxis by administering epinephrine spray formulations to subjects in need of such treatments.
Description
FIELD OF THE INVENTION

The present invention is directed to epinephrine spray formulations. The present invention is further directed to methods of treating anaphylaxis by administering epinephrine spray formulations to subjects in need of such treatments.


BACKGROUND OF THE INVENTION

Epinephrine (i.e. adrenaline) is a catecholamine with the following chemical structure:




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Epinephrine stimulates the alpha- and beta-adrenergic receptors of the sympathetic nervous system. Epinephrine binds to these adrenergic receptors leading to relief of many life-threatening symptoms of anaphylaxis including: relaxation of the smooth muscle in the bronchi of the lungs opening up the constricted airways; constriction of the blood vessels leading to decreased swelling of the tongue and throat and increased blood pressure; and finally, increased heart rate preventing or reversing cardiovascular collapse.


Epinephrine is commercially available as an injection (Adrenalin® a trademark of and available from Par Sterile Products, LLC) and an auto-injector (EpiPen® a trademark of and available from Mylan, Inc. and AuviQ® a trademark of and available from Sanofi Corporation). Epinephrine was previously available as a nasal spray (Adrenalin®) and an aerosol spray (Primatene® Mist trademark of Armstrong Pharmaceuticals, Inc.). Racepinephrine is commercially available as a 2.25% oral inhalation solution for use in nebulizers (S2® is available from Nephron Pharmaceuticals, Inc.). Epinephrine differs from racepinephrine in that epinephrine consists of only the L-isomer and racepinephrine is a 50/50 mixture of both the L- and D-isomers.


U.S. Pat. No. 8,628,805 is directed to a stable liquid adrenaline/bisulfite composition wherein the molar ratio of adrenaline to bisulfite is 1.31-2.20:1. U.S. Patent Application Publication No. 2012/0322884 Al is directed to epinephrine nanoparticles, which can be incorporated into sublingual tablets. U.S. Patent Application Publication No. 2007/0202163 A1 is directed to epinephrine tablets for sublingual administration, which contain between 12% and 48% epinephrine. World Intellectual Property Organization (“W.I.P.O.”) Publication No. 2014/127018 A1 is directed to a stable aqueous epinephrine formulation that requires cyclodextrin. W.I.P.O. Publication No. 2014/057365 A1 is directed to an injectable epinephrine formulation.


While there are various epinephrine formulations currently available, there remains a need in the art for a quick-onset spray formulation.


SUMMARY OF THE INVENTION

In one aspect, the present invention is directed to epinephrine spray formulations comprising:

  • from about 0.1% w/w to about 15% w/w epinephrine or a salt thereof, preferably the salt is selected from the group consisting of citrate, hydrochloride, halide, sulfate, phosphate, acetate, maleate, succinate, ascorbate, carbonate, mesylate and lactate;
  • from about 1% w/w to about 80% w/w water, preferably from about 5% to about 77% w/w, more preferably from about 10% to about 65% w/w or from about 15% to about 80% w/w; optionally, from about 1% w/w to about 99% w/w of a solvent selected from the group consisting of ethanol, glycerin, propylene glycol, polyethylene glycol 400 and a combination thereof; and
  • optionally, from about 0.1% w/w to about 60% w/w of at least one acid, wherein the formulation has a pH from about 2 to about 5.5.


In one aspect, the present invention is directed to epinephrine spray formulations comprising:

    • from about 0.1% w/w to about 15% w/w epinephrine or a salt thereof, preferably the salt is selected from the group consisting of citrate, hydrochloride, halide, sulfate, phosphate, acetate, maleate, succinate, ascorbate, carbonate, mesylate and lactate;
    • from about 1% w/w to about 99% w/w of a solvent selected from the group consisting of water, ethanol, glycerin, propylene glycol, polyethylene glycol 400 and a combination thereof, preferably the solvent is a combination of water, ethanol and propylene glycol or water;
    • from about 0.1% w/w to about 60% w/w of at least one acid, preferably the at least one acid is diluted hydrochloric acid,


      wherein the formulation has a pH from about 2 to about 5.5.


In another aspect, the present invention is directed to epinephrine spray formulations, wherein the formulation is free of a propellant.


In another aspect, the present invention is directed to epinephrine spray formulations, wherein the formulation does not contain sorbitol.


In another aspect, the solvent of the present invention comprises from about 1% w/w to about 30% w/w glycerin.


In another aspect, the epinephrine spray formulations of the present invention further comprise a permeation enhancer comprising caprylic acid, preferably the caprylic acid is at a concentration from about 0.1% w/w to about 10% w/w, more preferably from about 0.1% w/w to about 5% w/w.


In another aspect, the permeation enhancer of the present invention further comprises a second compound selected from the group consisting of menthol, limonene, carvone, methyl chitosan, polysorbates, sodium lauryl sulfate, glyceryl oleate, caproic acid, enanthic acid, pelargonic acid, capric acid, undecylenic acid, lauric acid, myristic acid, palmitic acid, oleic acid, stearic acid, linolenic acid, arachidonic acid, benzethonium chloride, benzethonium bromide, benzalkonium chloride (BKC), cetylpyridium chloride, edetate disodium dihydrate (EDTA), sodium desoxycholate, sodium deoxyglycolate, sodium glycocholate, sodium caprate, sodium taurocholate, sodium hydroxybenzoyal amino caprylate, dodecyl dimethyl aminopropionate, L-lysine, glycerol oleate, glyceryl monostearate, citric acid, peppermint oil and a combination thereof, preferably menthol, preferably the menthol is at a concentration from about 0.1% to about 5% w/w, more preferably from about 0.1% to about 1% w/w.


In another aspect, the epinephrine spray formulations of the present invention contain no permeation enhancer.


In another aspect, the epinephrine spray formulations of the present invention further comprise an isotonicity agent comprising sodium chloride.


In another aspect, the epinephrine spray formulations of the present invention further comprise a stabilizer selected from the group consisting of butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), ascorbic acid, methionine, sodium ascorbate, sodium thiosulfate, sodium bisulfite, sodium metabisulfite, ascorbyl palmitate, thioglycerol, alpha tocopherol (vitamin E), cysteine hydrochloride, benzalkonium chloride (“BKC”), citric acid, ethylenediaminetetraacetic acid (EDTA), sodium citrate, propyl gallate, 8-hydroxyquinoline, boric acid, histidine and combinations thereof, preferably the stabilizer comprises EDTA at a concentration from about 0.005% w/w to about 0.5% w/w, preferably the stabilizer comprises sodium bisulfite, sodium metabisulfite or a combination thereof at a concentration from about 0.005% w/w to about 5% w/w and preferably the stabilizer comprises BKC at a concentration from about 0.005% to about 0.5% w/w.


In another aspect, the epinephrine spray formulations of the present invention further comprise a preservative selected from the group consisting of butyl paraben, methyl paraben, ethyl paraben, propyl paraben, sodium benzoate, chlorobutanol, benzalkonium chloride (BKC), benzoic acid and combinations thereof, preferably BKC at a concentration from about 0.005% w/w to about 0.5% w/w.


In another aspect, the present invention is directed to epinephrine spray formulations comprising:

    • from about 0.1% to about 15% w/w epinephrine, or a salt thereof;
    • from about 1% to about 65% w/w hydrochloric acid with a normality from about 0.1 to 12N;
    • from about 2% to about 60% w/w ethanol;
    • from about 2% to about 98% w/w water;
    • from about 1% to about 20% w/w propylene glycol;
    • from about 0.001% to about 1% w/w sodium bisulfite;
    • from about 0.001% to about 1% w/w sodium metabisulfite;
    • from about 0.005% to about 1% w/w EDTA;
    • optionally, a permeation enhancer selected from the group consisting of from about 0.5% to about 15% w/w caprylic acid, from about 0.1% to about 10% w/w menthol and a combination thereof; and
    • optionally, benzalkonium chloride at a concentration from about 0.001% to about 0.1% w/w, wherein the formulation optionally has a pH from about 3 to about 5.5.


In another aspect, the present invention is directed to epinephrine spray formulations comprising:

    • from about 0.1% to about 15% w/w epinephrine, or a salt thereof;
    • from about 1% to about 65% w/w hydrochloric acid with a normality from about 0.1 to 12N;
    • from about 2% to about 98% w/w water;
    • from about 0.001% to about 7.5% w/w sodium bisulfite;
    • from about 0.001% to about 7.5% w/w sodium metabisulfite;
    • from about 0.005% to about 1% w/w EDTA;
    • from about 0.1% to about 1% sodium chloride;
    • optionally, benzalkonium chloride at a concentration from about 0.001% to about 0.1% w/w, wherein the formulation optionally has a pH from about 3 to about 5.5.


In another aspect, the present invention is directed to epinephrine spray formulations comprising:

    • from about 0.1% to about 15% w/w epinephrine, or a salt thereof;
    • from about 1% to about 65% w/w hydrochloric acid with a normality from about 0.1 to 12N;
    • from about 2% to about 98% w/w water, preferably from about 10% to about 65% w/w;
    • from about 0.005% to about 1% w/w sodium bisulfite;
    • from about 0.005% to about 1% w/w EDTA;
    • from about 0.005% to about 0.5% w/w BKC;
    • optionally, from about 2% to about 60% w/w ethanol;
    • optionally, from about 1% to about 20% w/w propylene glycol;
    • optionally, from about 0.05% to about 5% w/w sodium chloride;
    • optionally, benzalkonium chloride at a concentration from about 0.001% to about 0.1% w/w,


      wherein the formulation optionally has a pH from about 3 to about 5.5.


In another aspect, the present invention is directed to a method of treating anaphylaxis comprising administering to a subject in need thereof an epinephrine spray formulation of the present invention, preferably administration occurs via the intranasal route or sublingual route and wherein, optionally, the subject is suffering from seasonal allergies.


In another aspect, the present invention is directed to a method of treating anaphylaxis comprising administering to a subject in need thereof an epinephrine spray formulation of the present invention via unit dose or a multi-dose device that delivers more than one dose of the formulation, preferably via a bi-dose device that delivers two doses of the formulation.


In another aspect the present invention is directed to a method of treating anaphylaxis comprising administering via an assembled device an epinephrine formulation of the present invention.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1. Epinephrine plasma concentrations over first 6 hours post administration.



FIG. 2. Epinephrine plasma concentrations over first 30 minutes post administration.



FIG. 3. Semi-log plot of epinephrine plasma concentrations over first 6 hours post administration.





DETAILED DESCRIPTION OF THE INVENTION
Definitions

Applicants discovered epinephrine spray formulations that have improved bioavailability, a more rapid onset of action, and improved storage stability.


As used herein, “epinephrine” refers to the base.


As used herein, “free of propellant” refers to a formulation that is not administered using compressed gas.


As used herein, all numerical values relating to amounts, weights, and the like, that are defined as “about” each particular value is plus or minus 10%. For example, the phrase “about 10% w/w” is to be understood as “9% w/w to 11% w/w.” Therefore, amounts within 10% of the claimed value are encompassed by the scope of the claims.


As used herein “% w/w” and “percent w/w” refer to the percent weight of the total formulation.


As used herein the term “effective amount” refers to the amount necessary to treat a patient in need thereof.


As used herein the term “treat”, “treating” or “treatment” refers to ameliorating or inhibiting symptoms of type I allergies including anaphylaxis.


As used herein the term “subject” refers, but is not limited to, a person that is experiencing type I allergies including anaphylaxis.


As used herein the term “anaphylaxis” refers to an allergic reaction involving multiple organ systems in a subject upon contact with an allergen rather or not that allergen is identifiable.


As used herein the term “allergen” refers to any chemical capable of causing an immune system response in a subject including, but not limited to, chemicals found in drugs, food, plants, insect bites, and insect stings.


As used herein the term “seasonal allergies” refers to an allergic rhinitis. Seasonal allergies symptoms include, but are not limited to, itchy, watery eyes, sneezing, runny or stuffy nose, swollen nasal turbinates, itchy sinuses, throat or ear canals, ear congestion and postnasal drainage.


As used herein “nasal congestion” refers to a symptom of swollen nasal turbinates.


As used herein the term “pharmaceutically acceptable” refers to ingredients that are not biologically or otherwise undesirable for administration to a living subject.


“Sublingual” refers to administration of a substance via the mouth in such a way that the substance is rapidly absorbed via the blood vessels under the tongue.


“Intranasal” refers to administration of the composition to any portion of the nasal epithelium.


In one embodiment, the present invention is directed to epinephrine spray formulations comprising epinephrine, or a salt thereof.


Preferred epinephrine salts include citrate, hydrochloride, halide, sulfate, bitartrate, tartrate, phosphate, acetate, malate, maleate, succinate, ascorbate, carbonate, mesylate and lactate. One of skill in the art could use other pharmaceutically acceptable epinephrine salts in the formulations of the present invention. In a preferred embodiment, the formulations contain epinephrine or the pharmaceutically acceptable salt equivalent to from about 0.1% to about 15% w/w epinephrine. In a more preferred embodiment, the formulation contains epinephrine or the pharmaceutically acceptable salt equivalent to from about 0.1% to about 10% w/w of epinephrine. Other most preferred embodiments include formulations which contain epinephrine or the pharmaceutically acceptable salt equivalent to from about 0.1% w/w to about 10% w/w. In a most preferred embodiment, the epinephrine concentration between 3% and 10% w/w.


In another embodiment, the present invention is directed to epinephrine spray formulations comprising epinephrine, or a salt thereof, wherein the formulation is free of a propellant.


In another embodiment, the present invention is directed to epinephrine spray formulations comprising epinephrine, or a salt thereof, and one or more excipients selected from acids, solvents, stabilizers, permeation enhancers, viscosity modifiers, sweeteners, sweetness enhancers, pH modifiers, isotonicity agents and flavoring agents.


In a preferred embodiment, the formulations of the present invention contain from about 1% to about 65% w/w of an acid, more preferably from about 1% to about 45% w/w. Acids suitable for use in the present invention include, but are not limited to, hydrochloric acid, malic acid, tartaric acid, citric acid, succinic acid and combinations thereof. In a preferred embodiment, the acid is hydrochloric acid or malic acid, even more preferably from about 0.1N to about 12N hydrochloric acid, even more preferably from about 0.5 to about 6 N hydrochloric acid, even more preferably from about 0.5 N to about 3 N hydrochloric acid and most preferably 0.5 N or 3 N hydrochloric acid.


In a preferred embodiment, the formulations of the present invention contain from about 1% to 99% w/w of a solvent preferably from about 30% to about 99% w/w of the solvent.


Solvents suitable for use in the present invention include, but are not limited to, water, ethanol, glycerin, propylene glycol, polyethylene glycol 400 and combinations thereof, more preferably water.


In a preferred embodiment, the formulations of the present invention contain from about 0.001% to about 10% w/w of a stabilizer, preferably from about 0.005% to about 7.5% w/w, and even more preferably from about 0.01% to about 5% w/w. Stabilizers suitable for use in the present invention include, but are not limited to, butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), ascorbic acid, methionine, sodium ascorbate, sodium thiosulfate, sodium bisulfite, sodium metabisulfite, ascorbyl palmitate, thioglycerol, alpha tocopherol (vitamin E), cysteine hydrochloride, citric acid, ethylenediaminetetraacetic acid (“EDTA”), sodium citrate, propyl gallate, 8-hydroxyquinoline, boric acid, histidine and combinations thereof. In a preferred embodiment, the stabilizer is selected from sodium metabisulfite, sodium bisulfite, disodium EDTA, 8-hydroxyquinoline and combinations thereof. In an even more preferred embodiment the stabilizer is a combination of sodium bisulfite, sodium metabisulfite, 8-Hydroxyquinoline and EDTA. In a further preferred embodiment, the formulations of the present invention contain from about 0.005% to 0.5% w/w EDTA as the stabilizer. In a more preferred embodiment, the formulations of the present invention contain from about 0.01% to 0.1% EDTA as the stabilizer. In a most preferred embodiment, the formulations of the present invention contain about 0.05% EDTA as the stabilizer. In a further preferred embodiment, the formulations of the present invention contain sodium bisulfite and sodium metabisulfite as the anti-oxidants at a concentration from about from about 0.005% to 5% w/w. In a more preferred embodiment, the formulations of the present invention contain sodium bisulfite or sodium metabisulfite or a combination thereof as the anti-oxidants at a concentration from about from about 0.05% to 1% w/w. In a more preferred embodiment, the formulations of the present invention contain sodium bisulfite or sodium metabisulfite combination thereof as the anti-oxidants at a concentration from about from about 0.05% to about 1% w/w, more preferably from about 0.1% to about 0.75% w/w. In a most preferred embodiment, the formulations of the present invention contain sodium bisulfite as the anti-oxidant at a concentration at about 0.15% or 0.3% or 0.5% or 0.75% w/w.


In some embodiments, the formulations of the present invention contain from about 0.001% w/w to about 15% w/w of a permeation enhancer, preferably from about 0.03% w/w to about 12% w/w, and even more preferably from about 0.05% to 10% w/w.


Permeation enhancers suitable for use in the present invention include, but are not limited to, caprylic acid, oleic acid, polysorbate 80, menthol, EDTA, disodium edetate, cetylpyridinium chloride, sodium lauryl sulfate, citric acid, sodium desoxycholate, sodium deoxyglycolate, glyceryl oleate, L-lysine and combinations thereof. Preferred permeation enhancers are caprylic acid, menthol or a combination thereof.


Viscosity modifiers suitable for the present invention include, but are not limited to, polyvinylpyrrolidone, carboxymethyl cellulose, hydroxypropylmethyl cellulose (“HPMC”), methyl cellulose, hydroxyethyl cellulose, glycerin, polyvinyl alcohol and combinations thereof. In a preferred embodiment, the viscosity modifier is HPMC.


Sweeteners suitable for the present invention include, but are not limited to, sucralose, sucrose, aspartame, saccharin, dextrose, mannitol, glycerin, xylitol and combinations thereof. In a preferred embodiment, the sweetener is sucralose.


In some embodiments, the formulations of the present invention contain from about 0.001% to about 1% of a sweetness enhancer. Sweetness enhancers suitable for the present invention include, but are not limited to, the ammonium salt forms of crude and refined Glycyrrhizic Acid. Magnasweet® products (available from Mafco Worldwide Corporation, Magnasweet is a registered trademark of Mafco Worldwide Corporation) use the ammonium salt forms of crude and refined Glycyrrhizic Acid. Glycyrrhizic Acid is also available as a pure derivative in the sodium and potassium salt forms.


In a preferred embodiment, the formulations of the present invention are at a pH from about 2.0 to about 5.5. In a more preferred embodiment the formulations of the present invention are at a pH from about 3.0 to about 5.0. In a further preferred embodiment, the formulations of the present invention are at a pH from about 4.0 to about 5.0. In a most preferred embodiment the formulations of the present invention are at a pH of 4.5. pH modifiers suitable for the present invention include, but are not limited to, hydrochloric acid, citric acid, fumaric acid, lactic acid, sodium hydroxide, sodium citrate, sodium bicarbonate, sodium carbonate, ammonium carbonate and combinations thereof.


Preservatives suitable for the present invention include, but are not limited to, butyl paraben, methyl paraben, ethyl paraben, propyl paraben, sodium benzoate, chlorobutanol, benzalkonium chloride, benzoic acid and combinations thereof. In a preferred embodiment, the preservative is benzalkonium chloride. In a more preferred embodiment the benzalkonium chloride is at a concentration from about 0.01% to about 0.02% w/w, more preferably 0.01% or 0.02% w/w.


Flavoring agents suitable for the present invention include, but are not limited to, peppermint oil, menthol, spearmint oil, citrus oil, cinnamon oil, strawberry flavor, cherry flavor, raspberry flavor, orange oil and a combination thereof.


In preferred embodiment, the present invention is directed to epinephrine spray formulations comprising:

    • from about 2.8% to about 4% w/w epinephrine, or a salt thereof;
    • from about 32% to about 38% w/w hydrochloric acid with a normality from 0.5 to 3N;
    • from about 10% to about 65% w/w ethanol;
    • from about 2% to about 38% w/w water;
    • about 5% w/w propylene glycol;
    • from about 0.1% to about 0.75% w/w sodium bisulfite;
    • about 0.05% w/w disodium EDTA;
    • optionally, a permeation enhancer selected from the group consisting of from about 2% to about 10% w/w caprylic acid, from about 0.5% to about 1.0% w/w menthol and a combination thereof; and
    • optionally, benzalkonium chloride at a concentration from about 0.01% to about 0.02% w/w, wherein the formulation optionally has a pH of about 4.5.


In another preferred embodiment, the present invention is directed to epinephrine spray formulations comprising:

    • about 3.24% w/w epinephrine, or a salt thereof;
    • about 36.2% w/w hydrochloric acid with a normality of 0.5;
    • about 40% w/w ethanol;
    • about 14.84% w/w water;
    • about 5% w/w propylene glycol;
    • about 0.01% w/w benzalkonium chloride; and
    • from about 0.15% to about 0.3% w/w sodium bisulfite,
    • wherein the formulation has a pH at about 4.5.


In another preferred embodiment, the present invention is directed to intranasal epinephrine spray formulations comprising:

    • about 3.117% w/w epinephrine, or a salt thereof;
    • about 34.8% w/w hydrochloric acid with a normality of 0.5;
    • about 20% w/w ethanol;
    • about 36.87% w/w water;
    • about 5% w/w propylene glycol;
    • about 0.01% w/w benzalkonium chloride;
    • from about 0.15% w/w sodium bisulfite to about 0.3% w/w sodium bisulfite,
    • wherein the formulation has a pH at about 4.5.


In another preferred embodiment, the present invention is directed to intranasal epinephrine spray formulations comprising:

    • about 3.04% w/w epinephrine, or a salt thereof;
    • about 33.8% w/w hydrochloric acid with a normality of 0.5;
    • about 62.35% w/w water;
    • about 0.01% w/w benzalkonium chloride;
    • from about 0.15% w/w sodium bisulfite to about 0.3% w/w sodium bisulfite,


      wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 2.96% w/w epinephrine base;
    • about 32.93% w/w hydrochloric acid with a normality of about 0.5N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 0.6% w/w sodium chloride; and
    • about 63.30% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 3.18% w/w epinephrine base;
    • about 35.47% w/w hydrochloric acid with a normality of about 0.5N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 5% w/w propylene glycol;
    • about 40.0% w/w ethanol; and
    • about 16.14% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 5.923% w/w epinephrine base;
    • about 16.46% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 0.6% w/w sodium chloride; and
    • about 76.81% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 5.923% w/w epinephrine base;
    • about 16.46% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.30% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 0.6% w/w sodium chloride; and
    • about 76.66% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 6.356% w/w epinephrine base;
    • about 17.74% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 40.0% w/w ethanol;
    • about 5% w/w propylene glycol
    • about 30.70% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 6.356% w/w epinephrine base;
    • about 17.74% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.30% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 40.0% w/w ethanol;
    • about 5% w/w propylene glycol
    • about 30.55% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 8.885% w/w epinephrine base;
    • about 24.70% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 0.6% w/w sodium chloride; and
    • about 65.61% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 8.885% w/w epinephrine base;
    • about 24.70% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.45% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 0.6% w/w sodium chloride; and
    • about 65.31% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 9.534% w/w epinephrine base;
    • about 26.60% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 40.0% w/w ethanol;
    • about 5% w/w propylene glycol
    • about 18.65% w/w water, wherein the formulation has a pH at about 4.5.


An epinephrine spray formulation comprising:

    • about 9.534% w/w epinephrine base;
    • about 26.60% w/w hydrochloric acid with a normality of about 2N;
    • about 0.05% w/w edetate disodium dihydrate;
    • about 0.15% w/w sodium bisulfite;
    • about 0.01% w/w benzalkonium chloride;
    • about 40.0% w/w ethanol;
    • about 5% w/w propylene glycol
    • about 18.35% w/w water, wherein the formulation has a pH at about 4.5.


In another embodiment, administration to a human exposed to an allergen of 6 milligrams of epinephrine in the formulation #C1 of Table 62 below produced an epinephrine plasma concentration more than 100 picograms per milliliter at about 1-minute post administration.


In another embodiment, administration to a human not exposed to an allergen of 6 milligrams of epinephrine in the formulation #C1 of Table 62 below produced an epinephrine plasma concentration more than 100 picograms per milliliter at about 3-minutes post administration.


In another embodiment, administration to a human exposed to an allergen of 6 milligrams of epinephrine in the formulation #C2 of Table 62 below produced an epinephrine plasma concentration more than 100 picograms per milliliter at about 1-minute post administration.


In another embodiment, administration to a human exposed to an allergen of 6 milligrams of epinephrine in the formulation #C2 of Table 62 below produced an epinephrine plasma concentration more than 290 picograms per milliliter at about 1-minute post administration.


In another embodiment, administration to a human not exposed to an allergen of 6 milligrams of epinephrine in the formulation #C2 of Table 62 below produced an epinephrine plasma concentration more than 100 picograms per milliliter at about 3-minutes post administration.


In another embodiment, the formulations of the present invention are capable of producing a droplet size distribution at 3 cm wherein the mean DV (10) is from about 15 to about 18 microns during administration.


In another embodiment, the formulations of the present invention are capable of producing a droplet size distribution at 3 cm wherein the mean DV (50) is from about 30 to about 34 microns during administration.


In another embodiment, the formulations of the present invention are capable of producing a droplet size distribution at 3 cm wherein the mean DV (90) is from about 120 to about 230 microns during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray span ((Dv90-Dv10)/Dv50) at 3 cm of from about 3 to about 7.


In another embodiment, the formulations of the present invention are capable of producing a droplet size distribution at 6 cm wherein the mean DV (10) is from about 22 to about 25 microns during administration.


In another embodiment, the formulations of the present invention are capable of producing a droplet size distribution at 6 cm wherein the mean DV (50) is from about 36 to about 41 microns during administration.


In another embodiment, the formulations of the present invention are capable of producing a droplet size distribution at 6 cm wherein the mean DV (90) is from about 59 to about 231 microns during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray span ((Dv90-Dv10)/Dv50) at 6 cm of from about 1 to about 6.


In another embodiment, the formulations of the present invention are capable of producing a spray pattern at 3 cm wherein the Dmin is from about 18 to about 23 millimeters during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray pattern at 3 cm wherein the Dmax is from about 29 to about 33 millimeters during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray pattern at 3 cm wherein the ovality ratio is from about 1.4 to about 1.7 during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray pattern at 6 cm wherein the Dmin is from about 26 to about 33 millimeters during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray pattern at 6 cm wherein the Dmax is from about 47 to about 52 millimeters during administration.


In another embodiment, the formulations of the present invention are capable of producing a spray pattern at 6 cm wherein the ovality ratio is from about 1.6 to about 1.9 during administration.


In another embodiment, the formulations of the present invention are capable of producing a plume geometry at 3 cm wherein the angle is from about 49° to about 64°.


In another embodiment, the formulations of the present invention are capable of producing a plume geometry at 3 cm wherein the width is from about 27 to about 38 millimeters.


In another embodiment, the formulations of the present invention are capable of producing a plume geometry at 3 cm wherein the angle is from about 37° to about 44°.


In another embodiment, the formulations of the present invention are capable of producing a plume geometry at 3 cm wherein the width is from about 37 to about 44 millimeters.


In one embodiment, the present invention is directed to a method of treating anaphylaxis comprising administering via an assembled device an epinephrine formulation comprising from about 0.1% w/w to about 15% w/w epinephrine or a salt thereof and from about 1% to about 80% w/w water, wherein the formulation has a pH from about 2 to about 5.5.


In a preferred embodiment, the assembled device comprises a reservoir, a plunger, a cannula, a spray pin, a reservoir holder and an actuator or a reservoir, a piston and a swirl chamber.


In another preferred embodiment, the assembled device delivers one or more doses of the epinephrine formulation.


In another preferred embodiment, the assembled device is a unit-dose device that delivers one dose of the epinephrine formulation upon a single actuation and comprises a single reservoir containing not more than 250 μL of the epinephrine formulation, preferably about 237 μL or not more than 140 μL, preferably about 127 μL.


In another preferred embodiment, the assembled device is a unit-dose device that delivers about 200 μL or about 100 μL of the pharmaceutical formulation upon a single actuation.


In another preferred embodiment, the assembled device is a bi-dose device that delivers two doses of the epinephrine formulation upon two actuations and delivers about 100 μL of the epinephrine formulation per actuation.


In another preferred embodiment, the assembled device is a multi-dose device that delivers multiple doses of the epinephrine formulation upon multiple actuations and delivers about 100 μL of the pharmaceutical solution per actuation.


The disclosed embodiments are simply exemplary embodiments of the inventive concepts disclosed herein and should not be considered as limiting, unless the claims expressly state otherwise.


The following examples are intended to illustrate the present invention and to teach one of ordinary skill in the art how to use the formulations of the invention. They are not intended to be limiting in any way.


EXAMPLES
Example 1

An epinephrine spray was prepared as follows using the components and amounts listed in Table 1 below. All of the solvents were purged with nitrogen prior to use. Excipients including 0.5 N hydrochloric acid (“HCl”), malic acid, ethanol and propylene glycol, EDTA, sodium chloride, sodium bisulfate, sodium metabisulfite, and 8-hydroxyquinoline were dissolved in water while stirring at room temperature. Epinephrine base was then added to the excipient solution. Finally, sodium hydroxide (“NaOH”)/hydrochloric acid (HCl)) was used to adjust final pH.









TABLE 1







Epinephrine Formulations


















% w/w
#1
#2
#3
#4
#5
#6
#7
#8
#9
#10
#11





















Epinephrine base
1.0
1.0
1.0
1.0
1.0
7.5
1
3.0
3.0
3.0
3.0


HCl (0.5N)
10.66
10.66
10.66
10.66
10.66

11.35

32.6
32.6
32.6


EDTA
0.05
0.05
0.05
0.05
0.05



0.05
0.05
0.05


Sodium
0.01
0.015
0.02
0.025
0.025
0.25
0.025
0.04





metabisulfite


sodium bisulfite
0.01
0.015
0.02
0.025
0.025

0.025

0.05
0.2
0.2


Propylene Glycol










5


Menthol










5


Chlorobutanol









0.5



Sucralose









0.5
0.5


8-Hydroxyquinoline




0.02








Ethanol





15




50


Malic Acid





2.0

1.65





Water
88.27
88.26
88.25
88.24
88.22
79.75
87.6
95.31
64.3
63.15
4.15



100
100
100
100
100
100
100
100
100
100
100


pH adjusted with
pH
pH
pH
pH
pH
pH
pH
pH
pH
pH
pH


NaOH
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5









Example 2

The formulations listed in Table 1 were subjected to stability at 40° C.±2° C./75% ±5% relative humidity and 25° C.±2° C./60%±5% relative humidity. The stability of the formulations was analyzed at specified time points by evaluating their potency (assay value) and impurity levels. Assay and impurities were detected using high-performance liquid chromatography with an ultraviolet detector. The assay was performed at 280 nm and indicated as a % of initial concentration. For all impurities, analysis was performed at 210 nm and 280nm and expressed as a % area. Amounts of particular impurities are listed in Tables 2 to 20 as a percentage of area of each formulation along with amount of total impurities. Relative retention time (“RRT”) is given for each impurity. “ND” indicates that the impurity was not detected. “BQL” indicates purity is below quantification limit.









TABLE 2







Stability Data for Epinephrine Spray Formulation #1 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity











40° C. Formulation #1
RRT
0 Week
2 Weeks
4 Weeks





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
97.94 
95.80 


% Racemization

0.60
0.93
1.54


pH

4.50
3.52
3.29


% Impurity F
0.19
0.13
1.07
1.51


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.10
0.15



0.23
ND
ND
0.02



3.11
ND
BQL
0.03



3.26
ND
BQL
0.02


% Total Impurities

0.20
1.24
1.80
















TABLE 3







Stability Data for Epinephrine Spray Formulation #2 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity











40° C. Formulation #2
RRT
0 Week
2 Weeks
4 Weeks





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
96.02 
97.32 


% Racemization

0.60
0.91
1.77


pH

4.50
3.39
3.14


% Impurity F
0.19
0.14
1.27
1.91


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.38
ND
ND
BQL


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.10
0.11



0.23
ND
ND
BQL



3.26
ND
ND
ND


% Total Impurities

0.21
1.44
2.09
















TABLE 4







Stability Data for Epinephrine Spray Formulation #3 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













40° C. Formulation #3
RRT
0 Week
2 Weeks
4 Weeks
8 Weeks
3 Months





Appearance

Clear
Clear
Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
98.22 
96.87 
94.56 
93.27 


% Racemization

0.60
1.01
1.48
3.67
4.23


pH

4.50
3.37
3.14
3.01



% Impurity F
0.19
0.13
1.27
2.19
3.05
3.18


% Synephrine
1.26
ND
ND
ND
ND
ND


% Epinephrone
1.36
ND
ND
BQL
BQL
BQL


% Methoxy
1.88
0.07
0.07
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.08
0.07
0.08
0.24



3.11
ND
ND
BQL
BQL
BQL



3.26
ND
ND
BQL
BQL
BQL


% Total Impurities

0.20
1.42
2.33
3.20
3.49
















TABLE 5







Stability Data for Epinephrine Spray Formulation #4 stored at 40° C. ± 2° C./75% ± 5% Relative Humidity
















40° C. Formulation #4
RRT
0 Week
1 Week
2 Weeks
4 Weeks
6 Weeks
8 Weeks
3 Months
4 Months





Appearance

Clear
Clear
Clear
Clear
Clear
Clear
Clear
Clear


Assay (% of initial conc.)

100.0  
100.7  
98.54 
98.35 
96.02 
94.44 
92.60 
89.34 


% Racemization

0.60
0.68


3.41
3.46
5.75
9.20


% Impurity F
0.19
0.15
0.78
1.29
2.33
3.16
3.83
4.36
4.65


% Synephrine
1.26
ND
ND
ND
ND
ND
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND
BQL
BQL
BQL
BQL
BQL


% Methoxy
1.88
0.08
0.08
0.08
0.08
0.08
0.08
0.08
0.09


% Unknown Impurity
0.21
ND
ND
0.05
0.08
0.07
0.09
0.22
0.23



3.11
ND
ND
ND
BQL
BQL
BQL
BQL
0.05



3.26
ND
ND
ND
BQL
BQL
BQL
BQL
BQL


% Total Impurities

0.23
0.86
1.42
2.49
3.31
4.00
4.66
5.02
















TABLE 6







Stability Data for Epinephrine Spray Formulation #5 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













40° C. Formulation #5
RRT
0 Week
2 Weeks
4 Weeks
8 Weeks
3 Months





Appearance

Clear
Clear
Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
98.36 
96.88 
95.35 
93.34 


% Racemization

0.60
0.85
1.08
2.63
4.23


pH

4.50
3.64
3.37
3.20



% Impurity F
0.19
0.15
1.48
2.50
3.50
3.75


% Synephrine
1.26
ND
ND
ND
ND
ND


% Epinephrone
1.36
ND
ND
BQL
BQL
BQL


% Methoxy
1.88
0.07
0.07
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.10
0.11
0.15
0.35



0.88
ND
ND
ND
ND
BQL



3.11
ND
ND
BQL
BQL
BQL



3.26
ND
ND
BQL
BQL
BQL


% Total Impurities

0.22
1.65
2.68
3.72
4.17
















TABLE 7







Stability Data for Epinephrine Spray Formulation #6 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity











40° C. Formulation #6
RRT
0 Week
2 Weeks
1 Month





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
97.75 
95.95 


% Impurity F
0.19
0.15
2.38
4.04


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
BQL
BQL


% Methoxy
1.88
BQL
BQL
BQL


% Unknown Impurity
0.21
ND
0.05
0.08


% Total Impurities

0.15
2.43
4.08
















TABLE 8







Stability Data for Epinephrine Spray Formulation #7 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity











40° C. Formulation #7
RRT
0 Week
2 Weeks
4 Weeks





Appearance

Clear
Clear
Clear


% Impurity F
0.19
0.32
1.85
2.75


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
0.17
0.36
0.44


% Total Impurities

0.56
2.28
3.26
















TABLE 9







Stability Data for Epinephrine Spray Formulation #8 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity












40° C. Formulation #8
RRT
0 Week
2 Weeks







Appearance

Clear
Light Brown



Assay (% of initial conc.)

100.00 
95.55 



% Racemization

0.63
0.62



% Impurity F
0.19
0.22
1.56



% Synephrine
1.26
ND
ND



% Epinephrone
1.36
ND
ND



% Methoxy
1.88
0.07
0.07



% Unknown Impurity
0.21
ND
0.12




0.26
ND
BQL




0.88
ND
BQL




3.11
ND
BQL




3.26
ND
BQL



% Total Impurities

0.29
1.75

















TABLE 10







Stability Data for Epinephrine Spray Formulation #9 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity











40° C. Formulation #9
RRT
0 Week
1 Week
4 Weeks





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
100.76 
99.73 


% Racemization

0.60
0.68



% Impurity F
0.19
0.15
0.84
1.86


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
ND
0.06



3.11
ND
BQL
0.09



3.26
ND
BQL
0.08


% Total Impurities

0.22
0.91
2.16
















TABLE 11







Stability Data for Epinephrine Spray Formulation #10 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity












40° C. Formulation #10
RRT
0 Week
1 Week







Appearance

Clear
Clear



Assay (% of initial conc.)

100.00 
100.76 



% Racemization

0.60
0.68



% Impurity F
0.19
0.12
2.89



% Synephrine
1.26
ND
ND



% Epinephrone
1.36
ND
ND



% Methoxy
1.88
0.07
0.07



% Unknown Impurity
0.21
ND
BQL




3.11
ND
BQL




3.26
ND
BQL



% Total Impurities

0.19
2.96

















TABLE 12







Stability Data for Epinephrine Spray Formulation #11 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity












40° C. Formulation #11
RRT
0 Week
1 Week







Appearance

Clear
Clear



Assay (% of initial conc.)

100.00 
100.76 



% Racemization

0.60
0.68



% Impurity F
0.19
0.12
0.90



% Synephrine
1.26
ND
ND



% Epinephrone
1.36
ND
ND



% Methoxy
1.88
0.07
0.07



% Unknown Impurity
0.21
ND
BQL




3.11
ND
BQL




3.26
ND
BQL



% Total Impurities

0.19
0.97

















TABLE 13







Stability Data for Epinephrine Spray Formulation #1 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











25° C. Formulation #1
RRT
0 Week
1 Month
3 Months





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
97.91 
97.32 


% Racemization

0.60
0.76
0.93


% Impurity F
0.19
0.13
0.53
1.04


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.05
0.19



3.11
ND
ND
BQL



3.26
ND
ND
BQL


% Total Impurities

0.20
0.65
1.30
















TABLE 14







Stability Data for Epinephrine Spray Formulation #2 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











25° C. Formulation #2
RRT
0 Week
1 Month
3 Months





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
97.56 
96.88 


% Racemization

0.60
0.78
1.01


% Impurity F
0.19
0.14
0.55
1.25


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.08
0.18



3.11
ND
ND
BQL



3.26
ND
ND
BQL


% Total Impurities

0.21
0.70
1.50
















TABLE 15







Stability Data for Epinephrine Spray Formulation #3 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











25° C. Formulation #3
RRT
0 Week
1 Month
3 Months





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
99.32 
98.16 


% Racemization

0.60
0.75
0.84


% Impurity F
0.19
0.13
0.52
1.29


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
BQL
0.09



3.11
ND
ND
BQL



3.26
ND
ND
BQL


% Total Impurities

0.20
0.59
1.45
















TABLE 16







Stability Data for Epinephrine Spray Formulation #4 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity














25° C. Formulation #4
RRT
0 Week
3 Weeks
4 Weeks
8 Weeks
3 Months
6 Months





Appearance

Clear
Clear
Clear
Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
100.76 
99.79 
99.31 
99.09 
98.69 


% Racemization

0.60
0.68

0.91
0.97



% Impurity F
0.19
0.15
0.41
0.50
1.01
1.46
2.39


% Synephrine
1.26
ND
ND
ND
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND
ND
BQL
BQL


% Methoxy
1.88
0.08
0.08
0.08
0.08
0.08
0.08


% Unknown Impurity
0.21
ND
0.05
0.06
0.06
0.11
0.10



3.02
ND
ND
ND
ND
ND
0.12



3.11
ND
ND
ND
ND
ND
0.12



3.26
ND
ND
ND
ND
ND
0.10


% Total Impurities

0.23
0.54
0.64
1.15
1.65
2.91
















TABLE 17







Stability Data for Epinephrine Spray Formulation #5 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











25° C. Formulation #5
RRT
0 Week
1 Month
3 Months





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
98.40 
97.29 


% Racemization

0.60
0.77
0.84


% Impurity F
0.19
0.15
0.67
1.41


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.07
0.07
0.07


% Unknown Impurity
0.21
ND
0.05
0.18



3.11
ND
ND
BQL



3.26
ND
ND
BQL


% Total Impurities

0.22
0.79
1.66
















TABLE 18







Stability Data for Epinephrine Spray Formulation #6 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity












25° C. Formulation #6
RRT
0 Week
2 Weeks
1 Month
6 Months





Appearance

Clear
Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
100.25 
99.75 
94.80 


% Impurity F
0.19
0.15
0.45
0.76
2.93


% Synephrine
1.26
ND
ND
ND
ND


% Epinephrone
1.36
ND
BQL
BQL
BQL


% Methoxy
1.88
BQL
BQL
BQL
BQL


% Unknown Impurity
0.21
ND
ND
BQL
0.30



0.26
ND
ND
ND
0.13



0.88
ND
ND
ND
0.15



2.58
ND
ND
ND
0.10



3.11
ND
ND
ND
0.24



3.26
ND
ND
ND
0.17


% Total Impurities

0.15
0.45
0.76
4.02
















TABLE 19







Stability Data for Epinephrine Spray Formulation #8 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity












25° C. Formulation #8
RRT
0 Week
1 Month







Appearance

Clear
Clear



Assay (% of initial conc.)

100.00 
99.21 



% Racemization

0.63
0.66



% Impurity F
0.19
0.22
0.64



% Synephrine
1.26
ND
ND



% Epinephrone
1.36
ND
ND



% Methoxy
1.88
0.07
0.07



% Unknown Impurity
0.21
ND
0.06




3.11
ND
BQL




3.26
ND
BQL



% Total Impurities

0.29
0.77

















TABLE 20







Stability Data for Epinephrine Spray Formulation #9 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











25° C. Formulation #9
RRT
0 Week
1 Month
6 Months





Appearance

Clear
Clear
Clear


Assay (% of initial conc.)

100.00 
99.64 
98.88 


% Impurity F
0.19
0.15
0.52
1.71


% Synephrine
1.26
ND
ND
ND


% Epinephrone
1.36
ND
ND
ND


% Methoxy
1.88
0.08
0.07
0.07


% Unknown Impurity
0.21
ND
0.05
0.07



3.11
ND
BQL
0.09



3.26
ND
BQL
0.08


% Total Impurities

0.23
0.64
2.02









Formulations #1-#5 had less than 3% total impurities after 4 Weeks (1 Month) at 40° C.±2° C./75%±5% Relative Humidity and less than 1% total impurities after 4 Weeks (1 Month) at 25° C.±2° C./60%±5% relative humidity. Of Formulations #6-#8, only Formulation #8 was analyzed at 4 Weeks or later at 40° C. where 4.68% total impurities were found. Formulation #9 exhibited total impurities of 2.17% at 4 weeks 40° C. Formulation #11 exhibited total impurities of 1% at one week 40° C. The superior and surprising stability characteristics of the formulations of the present invention will allow the formulations to be effective when used by patients.


When compared with formulation 4, formulation 7 showed a faster generation of impurities and was not stable for more than a month at 40° C. Formulation 4 was stable for 4 months when stored at 40° C. which indicates that EDTA increases the stability of epinephrine formulations.


Example 3

Formulation #4 was further tested for stability during freeze-thaw cycling. Specifically, Formulation #4 was run through 3 cycles of −20° C. for 48 hours and then 25° C. for 48 hours, where the physical appearance of the formulation was recorded. The formulation remained clear and colorless throughout the entire freeze-thaw cycling indicating a stable formulation throughout.


Example 4

In order to determine the spray profile of Formulation #4, it was subjected to standardized droplet testing. A challenge of creating an epinephrine spray formulation is that it must be capable of producing spray droplets that are over 10 microns in diameter. Spray droplets of 10 microns or smaller could be inhaled into the lungs.


Droplet analysis was conducted using standard laser analysis procedures known by those of skill in the art. Droplet size distribution (Dv10, Dv50, Dv90, and Span) was tested at two distances, 3 cm and 6 cm. Dv10 refers to the droplet size at which 10% of the volume is smaller; Dv50 refers to the median droplet size; Dv90 refers to droplet size for which 90% of the total volume is smaller; Span refers to distribution span (Dv90-Dv10)/Dv50. %<10 μm refers to the percentage of the total volume that is made up of droplets less than 10 μm in diameter.


Spray pattern, specifically Dmin, Dmax, and ovality ratio were tested at two distances, 3 cm and 6 cm. Dmin refers to the shortest diameter of the spray pattern in mm, Dmax refers to the widest diameter of the spray pattern in mm, and ovality ratio refers to the ratio of Dmax to Dmin. The spay pattern is measured by shining a laser sheet perpendicular to the spray at a specific distance from the orifice. The ovality ratio is useful as it provides information regarding the shape and density of the spray pump plume.


The results of these tests can be seen below in Tables 17 to 22.









TABLE 21







Droplet size distribution of Epinephrine Spray Formulation at 3 cm












Droplet Size
DV10
DV50
DV90




Distribution 3 cm
(μm)
(μm)
(μm)
% < 10 μm
Span















Min
15.8
30.84
124
0.05
3.145


Max
17.23
33.96
228.7
0.89
6.283


Mean
16.34
32.88
177.9
0.473
4.93
















TABLE 22







Droplet size distribution of Epinephrine Spray Formulation at 6 cm












Droplet Size
DV10
DV50
DV90




Distribution 6 cm
(μm)
(μm)
(μm)
% < 10 μm
Span















Min
22.72
36.07
59.52
0
1.017


Max
24.05
40.35
230.9
0
5.127


Mean
23.2
38.48
121.5
0
2.49
















TABLE 23







Spray pattern of Epinephrine Spray Formulation at 3 cm













Dmin
Dmax
Ovality



Spray Pattern 3 cm
(mm)
(mm)
ratio
















Min
18.9
29.8
1.415



Max
22.2
32.1
1.696



Mean
20.4
31.1
1.53

















TABLE 24







Spray pattern of Epinephrine Spray Formulation at 6 cm













Dmin
Dmax
Ovality



Spray Pattern 6 cm
(mm)
(mm)
ratio
















Min
26.5
47
1.68



Max
32.2
54.2
1.852



Mean
29.1
51.4
1.768

















TABLE 25







Plume geometry of Epinephrine Spray Formulation at 3 cm











Plume Geometry 3 cm
Angle (°)
Width (mm)







Min
49.2
27.6



Max
63.4
37.8



Mean
55.4
32.2

















TABLE 26







Plume geometry of Epinephrine Spray Formulation at 6 cm











Plume Geometry 6 cm
Angle (°)
Width (mm)







Min
37.7
37.7



Max
43.5
43.5



Mean
40.7
40.7










Applicant found during testing that formulations of the present invention yielded desirable droplet sizes for spray administration. The testing also revealed that the formulation dose remains consistent when administered with a spray pump.


Example 5
Preparation of Additional Hydro-Alcoholic Epinephrine Spray Formulations

Additional epinephrine spray formulations were prepared using the components and amounts listed in Table 27 below. All solvents were purged with nitrogen prior to use. Excipients including 0.5 N hydrochloric acid (“HCl”), ethanol, propylene glycol, EDTA, sodium bisulfite, caprylic acid were dissolved in water while stirring at room temperature. Epinephrine base was then added to the excipient solution. Finally, sodium hydroxide (“NaOH”)/ hydrochloric acid (“HCl”) was used to adjust final pH.









TABLE 27







Additional Hydro-alcoholic Epinephrine Spray Formulations
















% w/w
#12
#13
#14
#15
#16
#17
#18
#19
#20



















Epinephrine base
3.2
3.2
3.2
3.2
3.2
3.38
3.38
3.24
3.12


Hydrochloric acid (0.5N)
34.6
34.6
34.6
34.6
34.6
37.7
37.7
36.2
34.8


EDTA
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05


Sodium bisulfite
0.1
0.15
0.20
0.25
0.30
0.15
0.15
0.15
0.15


Propylene Glycol
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0


Caprylic acid





2.0
10.0




Benzalkonium chloride





0.02
0.02
0.01
0.01


Menthol
1.0
1.0
1.0
1.0
1.0
0.5
0.5




Sucralose
0.5
0.5
0.5
0.5
0.5
0.5
0.5




Ethanol
40.0
40.0
40.0
40.0
40.0
40.0
40.0
40.0
20.0


Water
15.55
15.50
15.45
15.40
15.35
10.7
2.7
15.35
36.87


pH adjusted with
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5


2 NaOH/0.5N HCl
















TABLE 28







Additional Aqueous based Epinephrine Spray Formulation













% w/w
#21
#22
#23
#24
#25
#26
















Epinephrine base
3.040
3.040
3.040
3.040
3.040
3.040


Hydrochloric acid
33.80
33.80
33.80
33.80
33.80
33.80


(0.5N)


EDTA
0.05
0.05
0.05
0.05
0.05
0.05


Sodium bisulfite
0.150
0.250
0.5
1.00
2.00
5.00


Benzalkonium chloride
0.01
0.01
0.01
0.01
0.01
0.01


Sodium Chloride
0.6
0.6
0.6
0.6
0.6
0.6


Water
62.35
62.25
62.00
61.5
60.5
57.5


pH adjusted with
4.5
4.5
4.5
4.5
4.5
4.5


2 NaOH/0.5N HCl
















TABLE 29







Additional Epinephrine (6 mg/spray) Formulations












% w/w
Function
#27
#28
#29
#30















Epinephrine base
Active
5.923
6.356
5.923
6.356



Ingredient


Benzalkonium chloride
Preservative
0.010
0.010
0.010
0.010


Sodium Chloride
Tonicity
0.600

0.600




Agent


Sodium bisulfite
Anti-
0.150
0.150
0.300
0.300



Oxidant


Edetate Disodium
Chelating
0.050
0.050
0.050
0.050


Dihydrate (EDTA)
agent


Hydrochloric acid
pH modifier
16.462
17.736
16.462
17.736


(2N)


Purified Water
Vehicle
76.805
30.698
76.655
30.548


Dehydrated Alcohol
Co-Solvent

40.000

40.000


(Ethanol)


Propylene Glycol
Co-Solvent

5.000

5.000


Solution containing
pH
Adjust
Adjust
Adjust
Adjust


2.0N NaOH and
adjustment
to pH
to pH
to pH
to pH


0.5N HCl

4.5 ± 0.1
4.5 ± 0.1
4.5 ± 0.1
4.5 ± 0.1
















TABLE 30







Additional Epinephrine (9 mg/spray) Formulations












% w/w
Function
#31
#32
#33
#34















Epinephrine base
Active
8.885
9.534
8.885
9.534



Ingredient


Benzalkonium chloride
Preservative
0.010
0.010
0.010
0.010


Sodium Chloride
Tonicity
0.600

0.600




Agent


Sodium bisulfite
Anti-
0.150
0.150
0.45
0.45



Oxidant


Edetate Disodium
Chelating
0.050
0.050
0.050
0.050


Dihydrate (EDTA)
agent


Hydrochloric acid
pH modifier
24.695
26.603
24.695
26.603


(2N)


Purified Water
Vehicle
65.610
18.653
65.310
18.353


Dehydrated Alcohol
Co-Solvent

40.000

40.000


(Ethanol)


Propylene Glycol
Co-Solvent

5.000

5.000


Solution containing
pH
Adjust
Adjust
Adjust
Adjust


2.0N NaOH and
adjustment
to pH
to pH
to pH
to pH


0.5N HCl

4.5 ± 0.1
4.5 ± 0.1
4.5 ± 0.1
4.5 ± 0.1
















TABLE 31







Epinephrine (3 mg/spray) Formulations










% w/w
Function
#35
#36













Epinephrine base
Active
3.178
2.962



Ingredient


Benzalkonium chloride
Preservative
0.010
0.010


Sodium Chloride
Tonicity

0.6



Agent


Sodium bisulfite
Anti-
0.150
0.150



Oxidant


Edetate Disodium
Chelating
0.050
0.050


Dihydrate (EDTA)
agent


Hydrochloric acid
pH modifier
35.471
32.936


(0.5N)


Purified Water
Vehicle
16.141
63.298


Dehydrated Alcohol
Co-Solvent
40.000



(Ethanol)


Propylene Glycol
Co-Solvent
5.000



Solution containing
pH
Adjust
Adjust


2.0N NaOH and
adjustment
to pH
to pH


0.5N HCl

4.5 ± 0.1
4.5 ± 0.1









The formulations listed in Table 27 and Table 28 were filled in unit dose devices, packed into an oxygen impermeable pouches with oxygen scavengers, and then subjected to stability at 40° C.±2° C./75%±5% relative humidity and 25° C.±2° C./60%±5% relative humidity. The stability of the formulations was analyzed at specified time points by evaluating their potency (assay value) and impurity levels. Assay and impurities were detected using high-performance liquid chromatography with an ultraviolet detector. The assay was performed at 280 nm and indicated as a % of initial concentration. For all impurities, analysis was performed at 210 nm and 280nm and expressed as a % area. Amounts of particular impurities are listed in Tables 32 to 55 as a percentage of area of each formulation along with amount of total impurities. Relative retention time (“RRT”) is given for each impurity. “ND” indicates that the impurity was not detected. Any impurity which is less than 0.05% is indicated as BQL. NP refers to Not Performed.









TABLE 32







Stability Data for Epinephrine Spray Formulations # 12 to # 16 stored at


25° C. ± 2° C./60% ± 5% Relative Humidity









Stability @18 M 25° C./60% RH

















F # 12
F # 13
F # 14
F # 15
F # 16



RRT
0 Week
18 months
18 Months
18 Months
18 months
18 months


















Appearance

Clear
Clear
Clear
Clear
Clear
Clear


% Impurity F
0.19
0.11
1.91
2.53
3.27
3.57
 4.79*


% Synephrine
1.26
ND
ND
ND
ND
ND
ND


% Epinephrone
1.36
ND
BQL
BQL
BQL
BQL
BQL


% Methoxy
1.90
0.07
0.08
0.08
0.07
0.07
0.08


% Unknown Impurities
0.22
0.01
0.12
0.12
0.13
0.12
0.12



0.25
ND
0.09
BQL
BQL
ND
0.07



0.26
ND
ND
ND
ND
ND
ND



0.64
ND
ND
ND
ND
ND
BQL



0.88
ND
BQL
BQL
BQL
BQL
BQL



1.21
ND
0.09
0.09
0.08
BQL
0.06



1.34
ND
BQL
0.05
BQL
BQL
BQL



1.50
ND
ND
ND
0.07
BQL
BQL



1.51
ND
0.1 
0.07
ND
ND
ND



2.43
ND
ND
ND
ND
0.06
ND



2.44
ND
ND
0.07
0.08
ND
ND



2.45
ND
0.11
ND
ND
ND
ND



2.57
ND
ND
ND
ND
ND
0.06



2.71
ND
ND
ND
ND
ND
ND



2.90
ND
ND
ND
BQL
ND
ND



2.91
ND
ND
BQL
ND
ND
ND



2.93
ND
0.07
ND
ND
ND
ND



2.96
ND
ND
ND
ND
ND
ND



3.11
ND
0.05
BQL
BQL
BQL
BQL



3.26
ND
ND
BQL
ND
ND
ND


Total Impurities

0.19
2.62
3.01
3.70
3.82
5.18
















TABLE 33







Stability Data for Epinephrine Spray Formulation # 17 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











RRT
1 Month
2 Month
















Appearance

Clear
Clear



% Impurity F
0.19
0.50
0.72



% Epinephrone
1.36
ND
ND



% Methoxy
1.90
0.07
0.07



% Unknown
1.08
0.14
0.08



Impurities






% Total Impurities

0.71
0.87

















TABLE 34







Stability Data for Epinephrine Spray Formulation # 18 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity











RRT
1 Month
2 Months
















Appearance
Clear
Clear
Clear



% Impurity F
0.19
0.57
0.75



% Epinephrone
1.36
ND
ND



% Methoxy
1.90
0.07
0.07




1.08
0.08
0.14




1.12
BQL
0.07



% Total Impurities

0.72
1.03

















TABLE 35







Stability Data for Epinephrine Spray Formulations # 19 stored at 25° C. ±


2° C./60% ± 5% Relative Humidity
















TABLE 36







Stability Data for Epinephrine Spray Formulation # 20 stored at 25°


C. ± 2° C./60% ± 5% Relative Humidity












Epinephrine
RRT
T = 0
1 M
3 M
6 M





Assay (% LC)

103.9307
102.23 
99.07 
97.70 


Appearance

Clear,
Clear,
Clear,
Clear,




Colorless
Colorless
Colorless
Colorless


Imp-F
0.19
0.16
0.53
1.25
2.86


epinephrone
1.35
ND
BQL
BQL
BQL


Methoxy
1.78
0.06
0.06
0.06
0.06


Unknown
0.21
ND
ND
0.05
0.05


Impurities
0.26
ND
ND
ND
BQL



0.70
ND
BQL
BQL
BQL



0.83
ND
BQL
BQL
ND



0.88
BQL
BQL
BQL
ND



1.22
ND
ND
ND
BQL



1.41
ND
ND
BQL
BQL



1.49
ND
ND
ND
ND



1.51
BQL
ND
ND
ND



1.55
ND
BQL
BQL
ND



2.55
ND
BQL
BQL
ND



2.56
ND
BQL
BQL
ND



2.61
ND
BQL
BQL
ND



2.72
ND
ND
BQL
BQL



2.80
ND
ND
BQL
ND



2.87
ND
BQL
ND
ND



2.96
ND
BQL
ND
ND



3.09
BQL
BQL
ND
ND



3.22
ND
ND
BQL
ND



3.45
ND
ND
BQL
ND



3.73
ND
ND
ND
BQL


Total impurities

0.22
0.59
1.36
2.97


(%)
















TABLE 37







Stability Data for Epinephrine Spray Formulation # 21 stored at 25° C. ± 2° C./60% ± 5% Relative Humidity

















RRT
T = 0
1 M
2 M
3 M
4 M
6 M
8 M
12 M




















Assay

98.20 
101.02 
99.07 
100.13 
98.45 
98.45 
98.45 
95.12 


Appearance

Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,




Colorless
Colorless
Colorless
Colorless
Colorless
Colorless
Colorless
Colorless


% Impurity F
0.19
0.16
0.72
1.38
1.99
2.54
4.30
5.40
7.05


% Epinephrone
1.34
ND
BQL
BQL
BQL
BQL
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.06
0.06
0.06
0.05
0.05
0.05


Unknown
0.20
ND
ND
ND
ND
ND
ND
BQL
BQL


Impurities
0.66
ND
ND
ND
ND
ND
ND
ND
0.05


Total impurities (%)

0.22
0.78
1.44
2.05
2.60
4.35
5.45
7.15
















TABLE 38







Stability Data for Epinephrine Spray Formulations # 12 to 16 stored at


40° C. ± 2° C./75% ± 5% Relative Humidity

















F# 12
F# 13
F# 14
F# 15
F# 16


Epinephrine
RRT
0 Week
2 Months
2 Months
2 Months
2 Months
2 Months





Assay

100.00 
98.13 
94.51 
93.02 
93.26 
92.02 


Appearance

Clear
Clear
Clear
Clear
Clear
Clear


% Impurity F
0.19
0.11
3.22
5.64
7.42
9.7 
11.3 


% Synephrine
1.26
ND
ND
ND
ND
ND
ND


% Epinephrone
1.36
ND
BQL
BQL
BQL
BQL
BQL


% Methoxy
1.90
0.07
0.06
0.06
0.06
0.06
0.06


% Unknown
0.22
BQL
0.16
0.16
0.15
0.14
0.12


Impurities
0.25
ND
0.06
0.06
0.05
0.05
0.05



0.26
ND
ND
BQL
BQL
BQL
BQL



0.88
ND
ND
BQL
BQL
BQL
BQL



1.21
ND
0.06
0.06
0.05
BQL
BQL



1.34
ND
BQL
BQL
BQL
BQL
BQL



1.55
ND
BQL
BQL
BQL
BQL
BQL



2.57
ND
0.18
0.11
0.1 
0.08
0.07



3.11
ND
BQL
BQL
BQL
BQL
BQL



3.26
ND
BQL
BQL
BQL
BQL
ND


% Total Impurities

0.18
3.74
6.09
7.83
10.03
11.60
















TABLE 39







Stability Data for Epinephrine Spray Formulations # 17 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













RRT
2 Weeks
4 Weeks
6 Weeks
3 Months
















Physical

Clear
Clear
Clear
Clear


appearance


% Impurity F
0.19
1.02
2.03
3.01
5.11


% Epinephrone
1.36
ND
ND
BQL
BQL


% Methoxy
1.90
0.07
0.07
0.07
0.06



1.08
0.08
0.15
0.15
0.09



1.12
ND
ND
0.15
0.15



1.21
ND
BQL
0.06
0.13



2.53
BQL
BQL
0.05
0.15



2.58
ND
ND
BQL
0.06



3.04
ND
ND
BQL
0.06


% Total

1.17
2.25
3.49
5.81


Impurities
















TABLE 40







Stability Data for Epinephrine Spray Formulations # 18 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity












RRT
2 Weeks
1 Month
2 Months















Appearance

Clear
Clear
Clear


% Impurity F
0.19
0.93
2.16
3.71


% Epinephrone
1.36
ND
BQL
BQL


% Methoxy
1.90
0.07
0.07
0.07



1.08
0.09
0.09
0.10



1.12
BQL
0.06
0.14



1.21
ND
BQL
0.18



2.53
0.09
0.23
0.17



2.58
BQL
0.08
0.07



3.04
BQL
BQL
0.05


% Total Impurities

1.18
2.69
4.49
















TABLE 41







Stability Data for Epinephrine Spray Formulation # 19 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity
















Epinephrine
RRT
0 Month
1 M
2 M
3 M
4 M
5 M
6 M
10 M





Assay

101.32 
101.11 
97.06 
95.85 
96.08 
96.52 
95.58 
NP


Appearance

Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,




colorless
colorless
colorless
Light
Light
Light
Light
Light







Yellow
Yellow
Yellow
Yellow
Yellow


Imp-F
0.19
0.16
1.92
4.25
6.42
7.20
7.28
7.22
7.61


epinephrone
1.34
ND
BQL
BQL
BQL
BQL
BQL
BQL
BQL


Methoxy
1.77
0.07
0.06
0.06
0.06
0.06
0.06
0.06
0.06


Unknown
0.21
ND
0.09
0.19
0.11
0.3 
0.07
0.14
0.18


Impurities
0.26
ND
ND
0.14
0.21
0.31
0.32
0.31
0.52


(%)
0.52
ND
ND
ND
ND
BQL
BQL
BQL
BQL



0.64
ND
ND
ND
ND
BQL
ND
ND
ND



0.79
ND
ND
ND
BQL
ND
ND
BQL
BQL



0.88
ND
BQL
ND
ND
BQL
BQL
BQL
BQL



1.17
ND
0.06
0.07
0.05
0.09
0.08
ND
ND



1.25
ND
BQL
BQL
BQL
BQL
0.07
0.07
0.07



1.38
ND
BQL
BQL
BQL
BQL
BQL
BQL
BQL



1.55
ND
ND
ND
BQL
ND
ND
ND
ND



1.68
ND
ND
ND
BQL
BQL
ND
BQL
BQL



1.73
ND
ND
ND
BQL
BQL
BQL
BQL
BQL



1.99
ND
ND
ND
ND
BQL
BQL
BQL
BQL



2.07
ND
ND
ND
ND
BQL
BQL
BQL
BQL



2.38
ND
BQL
ND
ND
ND
BQL
ND
ND



2.22
ND
ND
ND
ND
ND
ND
BQL
BQL



2.44
ND
ND
ND
ND
ND
ND
BQL
BQL



2.60
ND
BQL
0.05
0.1 
0.19
0.33
0.76
0.99



2.80
ND
ND
ND
BQL
ND
ND
ND
ND



2.86
ND
BQL
ND
ND
ND
ND
ND
ND



2.98
ND
BQL
ND
ND
ND
BQL
ND
ND



3.13
ND
BQL
ND
ND
ND
ND
ND
ND



3.22
ND
ND
ND
BQL
ND
ND
ND
ND



2.82
ND
ND
ND
ND
0.07
0.12
0.13
0.21



3.38
ND
ND
ND
ND
BQL
ND
ND
ND



3.41
ND
ND
ND
ND
ND
BQL
ND
ND



3.44
ND
ND
ND
BQL
0.14
0.06
ND
ND



3.51
ND
ND
ND
ND
ND
ND
0.13
0.12



3.68
ND
ND
ND
BQL
BQL
BQL
0.07
0.06


Total impurities (%)

0.23
2.13
4.76
6.95
8.36
8.39
8.89
9.82
















TABLE 42







Stability Data for Epinephrine Spray Formulation # 20 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity















Epinephrine
RRT
T = 0
1 M
2 M
3 M
4 M
5 M
6 M





Assay (%)

103.93 
99.44 
96.16 
96.35 
96.38 
96.05 
93.96 


Appearance

Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,




colorless
colorless
colorless
Light
Light
Light
Light







Yellow
Yellow
Yellow
Yellow


% Impurity F
0.19
0.16
2.61
5.66
7.69
6.30
7.42
7.67


% Epinephrone
1.35
ND
BQL
BQL
BQL
BQL
BQL
BQL


% Methoxy
1.78
0.06
0.07
0.06
0.06
0.06
0.07
0.07


Unknown
0.21
ND
0.08
0.10
0.09
0.29
0.10
0.13


Impurities
0.26
ND
ND
0.06
0.12
0.17
0.18
0.19


(%)
0.70
ND
BQL
BQL
BQL
BQL
ND
BQL



0.88
BQL
BQL
BQL
BQL
BQL
BQL
BQL



1.13
ND
ND
ND
ND
ND
0.08
ND



1.18
ND
BQL
BQL
BQL
0.11
ND
ND



1.21
ND
ND
ND
ND
ND
ND
0.06



1.34
ND
ND
ND
ND
BQL
BQL
ND



1.36
ND
ND
ND
BQL
BQL
ND
BQL



1.49
ND
BQL
ND
ND
ND
ND
ND



1.42
ND
ND
ND
BQL
ND
ND
ND



1.51
BQL
ND
ND
ND
ND
ND
ND



1.55
ND
BQL
BQL
BQL
ND
ND
ND



1.58
ND
ND
ND
ND
0.09
ND
ND



1.64
ND
ND
ND
BQL
ND
ND
ND



1.73
ND
ND
ND
ND
ND
BQL
0.05



1.89
ND
ND
ND
BQL
ND
BQL
ND



2.00
ND
ND
ND
ND
BQL
0.05
0.08



2.09
ND
ND
ND
ND
ND
ND
0.08



2.21
ND
ND
ND
ND
ND
ND
0.08



2.39
ND
BQL
ND
ND
BQL
BQL
ND



2.44
ND
ND
ND
ND
ND
ND
0.05



2.56
ND
BQL
ND
ND
ND
BQL
BQL



2.61
ND
BQL
BQL
0.07
ND
ND
ND



2.71
ND
ND
ND
ND
0.39
0.54
1.10



2.87
ND
BQL
ND
BQL
BQL
ND
ND



2.96
ND
BQL
ND
ND
ND
ND
BQL



3.09
BQL
BQL
ND
ND
ND
ND
ND



3.14
ND
BQL
ND
ND
ND
ND
ND



3.36
ND
ND
ND
0.14
0.16
0.16
0.17



3.48
ND
ND
ND
ND
0.22
0.04
0.19



3.55
ND
ND
ND
BQL
BQL
ND
BQL



3.71
ND
ND
0.05
ND
ND
0.05
0.08



3.83
ND
ND
ND
ND
ND
ND
BQL



4.34
ND
ND
ND
ND
ND
ND
BQL


Total impurities (%)

0.22
2.76
5.93
8.17
7.79
8.69
10.00 
















TABLE 43







Stability Data for Epinephrine Spray Formulation # 21 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity
















Epinephrine
RRT
T = 0
1 M
2 M
3 M
4 M
5 M
8 M
12 M





Assay (%)

98.20 
94.84 
94.14 
95.37 
95.07 
95.87 
95.18 
96.1 


Appearance

Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,
Clear,




colorless
colorless
Light
Light
Light
Light
Light
Light






Yellow
Yellow
Yellow
Yellow
Yellow
Yellow


% Impurity F
0.19
0.16
4.43
7.96
8.20
8.31
7.93
8.47
8.36


% Epinephrone
1.34
ND
BQL
BQL
BQL
BQL
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.06
0.06
0.05
0.09
0.05
0.05


Unknown
0.20
ND
0.06
ND
ND
0.11
0.11
BQL
BQL


Impurities
0.66
ND
ND
ND
ND
ND
BQL
BQL
BQL


(%)
0.83
ND
ND
ND
ND
ND
ND
0.05
ND



1.67
ND
ND
ND
0.15
0.14
0.14
0.11
0.12



1.70
ND
ND
ND
ND
ND
ND
ND
0.08



1.73
ND
ND
ND
ND
ND
0.07
0.06
0.13



1.81
ND
ND
ND
ND
ND
ND
0.08
0.05



1.82
ND
ND
ND
ND
ND
ND
0.06
BQL



1.92
ND
ND
ND
ND
ND
ND
0.08
0.31



1.95
ND
ND
ND
ND
ND
ND
0.08
0.09



2.00
ND
ND
ND
ND
ND
ND
0.06
0.1 



2.09
ND
ND
ND
ND
ND
ND
0.09
0.27



2.27
ND
ND
ND
ND
ND
ND
ND
0.06



2.40
ND
ND
ND
ND
ND
ND
0.24
0.29



2.72
ND
ND
ND
BQL
BQL
BQL
BQL
0.08



2.79
ND
ND
ND
0.17
0.18
0.26
BQL
0.57



2.84
BQL
BQL
ND
0.05
ND
0.12
0.12
0.2 



2.87
ND
ND
ND
ND
0.2 
0.13
0.12
0.62



2.96
ND
ND
ND
ND
ND
ND
ND
0.08



2.98
ND
ND
ND
ND
ND
ND
ND
0.11



3.06
ND
ND
ND
ND
ND
ND
ND
0.14



3.15
ND
ND
ND
ND
ND
ND
ND
0.08



3.18
ND
ND
ND
ND
ND
ND
ND
0.06


Total impurities (%)

0.22
4.55
8.02
8.63
8.99
8.85
9.67
11.85 
















TABLE 44







Stability Data for Epinephrine Spray Formulation # 27 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













RRT
T = 0
1 M
3 M
4 M
















Appearance

Clear,
Clear,
Clear,
Clear,




colorless
colorless
Light
Light






Yellow
Yellow


Assay

101.98 
101.74 
NP
NP


% Impurity F
0.19
0.16
3.36
3.26
3.49


% Epinephrone
1.34
BQL
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.08
0.08


Unknown
0.20
ND
0.05
0.05
0.06


(%)Impurities
1.12
ND
ND
0.09
0.05



2.14
ND
ND
ND
0.05



2.34
ND
ND
ND
0.06



2.89
ND
ND
ND
0.16



2.96
ND
ND
0.50
0.48



2.99
ND
ND
0.10
0.19



3.05
ND
0.38
0.46
0.43


Total impurities

0.22
3.85
4.54
5.05


(%)
















TABLE 45







Stability Data for Epinephrine Spray Formulation # 28 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













RRT
T = 0
1 M
3 M
4 M
















Appearance

Clear,
Clear,
Clear,
Clear,




colorless
colorless
Light
Light






Yellow
Yellow


Assay

108.90 
107.20 
NP
NP


% Impurity F
0.19
0.16
1.75
3.15
3.61


% Epinephrone
1.34
BQL
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.08
0.08


Unknown
0.20
ND
0.24
0.24
0.33


Impurities (%)
0.25
ND
ND
0.09
0.09



2.50
ND
0.10
0.25
0.83



2.96
ND
ND
0.21
0.37



2.99
ND
ND
ND
0.05



3.05
ND
0.07
0.15
0.28



3.21
ND
ND
ND
0.27


Total impurities

0.22
2.22
4.17
5.91


(%)
















TABLE 46







Stability Data for Epinephrine Spray Formulation # 29 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













RRT
T = 0
1 M
3 M
4 M
















Appearance

Clear,
Clear,
Clear,
Clear,




colorless
colorless
Light
Light






Yellow
Yellow


Assay

101.08 
102.42 
NP
NP


% Impurity F
0.19
0.16
6.12
8.87
8.86


% Epinephrone
1.34
BQL
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.06
0.08


Unknown
0.20
ND
BQL
BQL
BQL


Impurities
0.25
ND
ND
ND
ND



1.06
ND
ND
ND
0.14



1.12
ND
ND
0.09
0.09



1.99
ND
ND
0.06
0.12



2.05
ND
ND
ND
0.14



2.15
ND
ND
ND
0.08



2.34
ND
ND
ND
0.08



2.89
ND
ND
0.11
0.23



2.96
ND
ND
0.45
0.47



2.99
ND
ND
0.13
0.27



3.05
BQL
BQL
0.40
0.43



3.20
ND
ND
0.15
0.23


Total impurities

0.22
6.18
10.32 
11.22 


(%)
















TABLE 47







Stability Data for Epinephrine Spray Formulation # 30 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity













RRT
T = 0
1 M
3 M
4 M
















Appearance

Clear,
Clear,
Clear,
Clear,




colorless
colorless
Light
Light






Yellow
Yellow


Assay

106.62 
107.37 
NP
NP


% Impurity F
0.19
0.16
5.00
8.76
8.41


% Epinephrone
1.34
BQL
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.09
0.08


Unknown
0.20
ND
BQL
0.07
0.07


Impurities
0.25
ND
ND
0.14
0.16



1.06
ND
ND
ND
0.14



1.12
ND
ND
0.05
BQL



2.50
ND
0.05
0.12
0.43



2.96
ND
ND
0.06
0.29



2.99
ND
ND
ND
0.07



3.05
ND
BQL
0.05
0.23



3.20
ND
BQL
0.05
0.16


Total impurities

0.22
5.11
9.39
10.04 


(%)
















TABLE 48







Stability Data for Epinephrine Spray Formulation # 31 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity












RRT
T = 0
1 M
3 M















Appearance

Clear,
Clear,
Clear,




colorless
colorless
Light






Yellow


Assay

101.23 
115.59 
NP


% Impurity F
0.19
0.16
2.75
2.35


% Epinephrone
1.34
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.09


Unknown
0.18
ND
BQL
BQL


Impurities (%)
1.12
ND
ND
0.05



2.03
ND
ND
0.05



2.79
ND
ND
BQL



2.86
ND
ND
0.12



2.92
ND
ND
0.82



2.99
ND
0.05
0.14



3.05
ND
0.92
0.72



3.16
ND
ND
0.08


Total impurities

0.22
3.78
4.42


(%)
















TABLE 49







Stability Data for Epinephrine Spray Formulation # 32 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity












RRT
T0
1 M
3 M















Appearance

Clear,
Clear,
Clear,




colorless
colorless
Light






Yellow


Assay

108.96 
103.80 
NP


% Impurity F
0.19
0.16
1.89
2.50


% Epinephrone
1.34
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.09


Unknown
0.18
ND
0.11
0.08


Impurities
0.25
ND
ND
BQL



1.12
ND
ND
0.07



1.19
ND
ND
0.05



2.48
ND
0.16
0.50



2.92
ND
ND
0.49



3.00
ND
0.16
0.37



3.16
ND
ND
0.16


Total impurities

0.22
2.38
4.31


(%)
















TABLE 50







Stability Data for Epinephrine Spray Formulation # 33 stored at 40°


C. ± 2° C./75% ± 5% Relative Humidity












RRT
T = 0
1 M
3 M















Appearance

Clear,
Clear,
Clear,




colorless
colorless
Light






Yellow


Assay

100.05 
99.36 
NP


% Impurity F
0.19
0.16
9.14
9.82


% Epinephrone
1.34
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.09


Unknown
0.18
ND
BQL
BQL


Impurities (%)
1.74
ND
ND
0.60



1.98
ND
ND
0.07



2.04
ND
ND
0.07



2.32
ND
ND
0.07



2.86
ND
ND
0.18



2.92
ND
ND
0.70



2.95
ND
ND
0.23



3.01
ND
ND
0.62



3.16
ND
ND
0.15



3.29
ND
ND
0.05


Total impurities

0.22
9.20
12.65 


(%)
















TABLE 51







Stability Data for Epinephrine Spray Formulation # 34 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity











Epinephrine
RRT
T = 0
1 M
3 M





Appearance

Clear,
Clear,
Clear,




colorless
colorless
Light






Yellow


Assay

113.33
112.55
NP


% Impurity F
0.19
0.16
6.30
9.61


% Epinephrone
1.34
BQL
BQL
BQL


% Methoxy
1.77
0.06
0.06
0.08


Unknown
0.18
ND
BQL
0.06


Impurities (%)
0.25
ND
ND
0.09



1.06
ND
ND
0.16



1.12
ND
ND
0.07



1.32
ND
ND
BQL



2.32
ND
ND
BQL



2.55
ND
0.07
0.23



2.93
ND
ND
0.34



2.96
ND
ND
0.07



2.98
ND
ND
0.08



3.02
ND
0.08
0.28



3.17
ND
ND
0.08


Total impurities

0.22
6.51
11.15


(%)
















TABLE 52







Stability Data for Epinephrine Spray Formulation # 35 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity













RRT
T = 0
2 M
3 M
6 M
















Assay

101.32 
83.12 
91.78 
100.20 


Appearance

Clear,
Clear,
Clear,
Clear,




colorless
colorless
colorless
colorless


% Impurity F
0.19
0.16
4.56
6.40
7.56


% Epinephrone
1.34
ND
BQL
BQL
BQL


% Methoxy
1.77
0.07
0.06
0.05
0.05


Unknown
0.20
ND
ND
ND
0.13


Impurities (%)
0.21
ND
0.26
0.05
0.08



0.26
ND
0.13
0.12
0.30



1.19
ND
0.06
BQL
BQL



1.71
ND
BQL
BQL
0.05



1.95
ND
ND
ND
0.07



2.45
ND
0.06
0.05
0.73



2.92
ND
ND
ND
0.19



2.95
ND
ND
ND
0.13



2.97
ND
ND
ND
0.16


Total Impurities

0.23
5.13
6.67
9.45


(%)
















TABLE 53







Stability Data for Epinephrine Spray Formulation # 36 stored


at 40° C. ± 2° C./75% ± 5% Relative Humidity












RRT
T = 0
2 M
6 M















Assay

101.32 
91.40 
103.10 


Appearance

Clear,
Clear,
Clear,




colorless
colorless
colorless


% Impurity F
0.19
0.16
6.81
6.90


% Epinephrone
1.34
ND
BQL
BQL


% Methoxy
1.77
0.07
0.06
0.05


Unknown
0.21
ND
0.09
0.07


Impurities (%)
0.70
ND
BQL
ND



1.71
ND
ND
0.07



1.92
ND
ND
0.07



1.95
ND
ND
0.05



2.00
ND
ND
0.05



2.09
ND
ND
0.06



2.27
ND
ND
0.05



2.41
ND
ND
0.08



2.84
ND
ND
0.19



2.90
ND
ND
0.29



2.93
ND
ND
0.31



2.98
ND
ND
0.25


Total Impurities

0.23
6.96
8.49


(%)
















TABLE 54







Stability Data for Epinephrine Spray Formulation # 35 stored


at 25° C. ± 2° C./60% ± 5% Relative Humidity












RRT
T = 0
3 M
6 M















Assay

101.32 
92.83 
101.79 


Appearance

Clear,
Clear,
Clear,




colorless
colorless
colorless


% Impurity F
0.19
0.16
1.08
2.32


% Epinephrone
1.34
ND
BQL
BQL


% Methoxy
1.77
0.07
0.05
0.06


Unknown
0.21
ND
BQL
0.07


Impurities (%)
0.26
ND
ND
ND



0.23
ND
ND
BQL



1.20
ND
ND
BQL



2.45
ND
ND
BQL


Total Impurities

0.23
1.13
2.45


(%)
















TABLE 55







Stability Data for Epinephrine Spray Formulation # 36 stored


at 25° C. ± 2° C./60% ± 5% Relative Humidity












RRT
T = 0
3 M
6 M















Assay

101.32 
103.80 
104.79 


Appearance

Clear,
Clear,
Clear,




colorless
colorless
colorless


% Impurity F
0.19
0.16
1.54
4.00


% Epinephrone
1.34
ND
BQL
BQL


% Methoxy
1.77
0.07
0.06
0.05


Unknown
0.21
ND
BQL
BQL


Impurities (%)
0.72
ND
BQL
BQL



0.83
ND
BQL
ND



3.09
ND
BQL
0.05


Total impurities

0.23
1.60
4.10


(%)









All formulas exemplified in Tables 27 to 31 above, remained clear throughout stability testing. Formulations were filled in to unit dose spray devices under nitrogen blanket, and then subjected to accelerated stability testing at 25° C.±2° C./60%±5% and 40° C.±2° C./75%±5% without pouching (Formulations 12 to 18), while formulations (F# 19 to 36) were subjected to accelerated stability testing under similar conditions with pouching containing oxygen scavenges. Formulation 13, un-pouched showed impurity F levels at 5.64% at 2M/40° C. However similar formulation 19, pouched, exhibited impurity F levels at 4.25% at 2M/40° C. Stability data suggest that epinephrine spray formulations which are pouched with oxygen scavenges are more stable compare to un-pouched formulations. Both hydro-alcoholic and aqueous formulations of present invention are stable at room temperature as well as 40° C.±2° C./75%±5.


For the Epinephrine 6 mg aqueous formulation in pouches, 3.49% and 8.86% of impurity F was observed after a period of 4 months at 40° C.±2° C./75% RH±5% RH for Formulations #27 and 29 respectively. Total impurities for Formulations #27 and 29 were found to be 5.05% and 11.22% after a period of 4 months at 40° C.±2° C./75% RH±5% RH, respectively. In the case of hydro-alcoholic formulations of the same strength in pouches, 3.61% and 8.41% of impurity F was observed after the same period for formulations #28 and 30, respectively. Total impurities for Formulations #28 and 30 were found to be 5.91% and 10.04% after a period of 4 months at 40° C.±2° C./75% RH±5% RH, respectively.


For the Epinephrine 9 mg aqueous formulation in pouches, 2.35% and 9.82% of impurity F was observed after a period of 4 months at 40° C.±2° C./75% RH±5% RH for Formulations #31 and 33 respectively. Total impurities for formulations #31 and 33 were found to be 4.42% and 12.65% after a period of 4 months at 40° C.±2° C./75% RH±5% RH, respectively. In the case of hydro-alcoholic formulations of the same strength in pouches, 2.50% and 9.61% of impurity F was observed after the same period for Formulations #32 and 34. Total impurities for Formulations #32 and 34 were found to be 4.31% and 11.15% after a period of 4 months at 40° C.±2° C./75% RH±5% RH, respectively.


Example 6
Mini-Pig Pharmacokinetic Data for Epinephrine Formulations

Protocol design was a single-dose crossover study. Five healthy male Yucatan mini-pigs weighing approximately eighty to ninety-five kilograms each were administered epinephrine formulations. The minipigs were fasted overnight till four hours' post administration. Each dosing was followed by a washout period of at least one-week. Blood samples were taken prior to administration and 2, 5, 10, 15, 20, 30, 45 min, 1, 1.5, 2, 4, and 24 hours' post dose. Minipig plasma samples were measured for epinephrine concentrations via liquid chromatography-tandem mass spectrometry.


The following pharmacokinetic parameters were calculated: peak concentration in plasma (Cmax), time to reach Cmax (Tmax), and area under the concentration-time curve from time-zero to 24 hours postdose (AUC0−24h).


The pharmacokinetic behavior of epinephrine formulations was evaluated. At 5 minutes after a single-dose intramuscular (IM) administration of epinephrine in minipigs, the geometric mean plasma concentration of epinephrine was 0.046 ng/mL. When epinephrine was formulated in #M1 and administered intranasally, a more rapid absorption of epinephrine was observed. Specifically, #M1 showed a geometric mean epinephrine plasma concentration of 0.26 ng/mL at 5 minutes postdose. It was also noted that a plasma concentration of 0.41 ng/mL was achieved as early as 2 minutes after an intranasal administration of #M1. In addition, #M1 showed a geometric mean Cmax of 1.01 ng/mL and a geometric mean AUC0−24h of 161.0 ng*min/L.









TABLE 56







Epinephrine Formulations for Minipig Dosing









Formulation



#M1














Epinephrine base
3.25



Dilute Hydrochloric acid 0.5N
36.2



Benzalkonium Chloride
0.01



Ethanol
40



Propylene Glycol
5



Sodium Bisulfite
0.15



EDTA
0.05



Water
15.34



Total
100







Components: % w/w













TABLE 57







Plasma concentrations for epinephrine after administration


to Yucatan minipigs under fasted conditions.










Formulation











IM solution
#M1















Route of administration
IM
Intranasal



Dose per animal (mg)
0.3
6



Concentration @ 2 min (ng/mL)
0.036
0.41



Concentration @ 5 min (ng/mL)
0.046
0.26



Concentration @ 10 min (ng/mL)
0.073
0.31



Concentration @ 15 min (ng/mL)
0.103
0.17



Concentration @ 30 min (ng/mL)
0.100
0.19



Tmax (min)
90
5



Cmax (ng/mL)
0.25
1.01



AUC0-24 h (ng * min/mL)
173.7
161.0







Plasma concentration: geometric mean



Tmax: median value



Cmax and AUC0-24 h: geometric mean






Example 7
Rabbit pharmacokinetic data for epinephrine formulations

Protocol design was a single-dose non-crossover study. Pharmacokinetics of a number of epinephrine formulations were evaluated in healthy male New Zealand white rabbits weighing approximately two to three kilograms. For dosing of each formulation, five or six rabbits were used. The rabbits were fasted overnight till four hours' post administration. Blood samples were taken prior to administration and 5, 10, 15, 20, 30, 40 min, 1, 1.5, 2, 4, and 5 hours' post dose. Rabbit plasma samples were measured for epinephrine concentrations via liquid chromatography-tandem mass spectrometry.


Formulation #R1-#R8 were provided in Table 43 and 44. Formulation #R9 existed as a spray-dried powder of epinephrine bitartrate salt. For the evaluation of #R9, approximately 21.83 mg of powder was dosed to each animal, as an equivalent dose of 12 mg epinephrine.


The following pharmacokinetic parameters were calculated: peak concentration in plasma (Cmax), time to reach Cmax (Tmax), and area under the concentration-time curve from time-zero to 24 hours postdose (AUC0−24h).


The pharmacokinetic behavior of epinephrine formulations was evaluated. At 5 minutes after a single-dose IM administration of epinephrine in rabbits, the mean plasma concentration of epinephrine was 0.988 ng/mL. In comparison, a sublingual administration of #R9 enabled a similar absorption of epinephrine in the early phase. Specifically, #R9 showed a mean epinephrine plasma concentration of 0.0.814 ng/mL at 5 minutes postdose. It was also noted that a plasma concentration of 0.713 ng/mL was achieved at 5 minutes after a sublingual administration of #R6. In addition, #R9 showed a geometric mean Cmax of 7.0 ng/mL and a geometric mean AUC0-24 h of 1050.1 ng*min/L.









TABLE 58







Epinephrine Formulations for Rabbit Dosing









Formulation













#R1
#R2
#R3
#R4
#R5
















Epinephrine base
0
0.006
3.025
3.243
3.243


Dilute Hydrochloric Acid
0.3
0.5
33.27
36.2
36.2


0.5N


Dehydrated Alcohol



40
40


Menthol



1
1


Sucralose
0.5

0.5
0.5
0.5


Propylene Glycol



5
5


Sodium Bisulfite
0.2
0.01
0.2
0.3
0.3


Edetate Disodium
0.05

0.05
0.05
0.05


(EDTA)


Water USP
98.45
98.584
62.455
13.707
13.707


Total
100
100
100
100
100





Components: % w/w













TABLE 59







Additional Epinephrine Formulations for Rabbit Dosing









Formulation











#R6
#R7
#R8














Epinephrine base
6.648
12.88
12.88


Dilute Hydrochloric Acid 1.5N
24.6


Dilute Hydrochloric Acid 3N

24.2
24.2


Dehydrated Alcohol
40
40
40


Menthol
0.5
0.5
0.5


Sucralose
0.5
0.5
0.5


Propylene Glycol
5
5
5


Sodium Bisulfite
0.6
0.6
0.6


Edetate Disodium (EDTA)
0.1
0.1
0.1


Water USP
21.552
15.72
15.72


Caprylic acid
0.5


Capric acid


0.5


Total
100
100
100





Components: % w/w













TABLE 60







Plasma concentrations for epinephrine after


administration to rabbits under fasted conditions.









Formulation













#R1
#R2
#R3
#R4
#R5
















Route of administration
SL
IM
SL
SL
SL


Dose per animal (mg)
0
0.03
3
3
6


Concentration @ 5 min
0.020
0.99
0.28
0.19
0.11


(ng/mL)


Concentration @ 10 min
0.011
0.83
0.24
0.32
0.35


(ng/mL)


Concentration @ 15 min
0.014
0.79
0.49
0.55
0.86


(ng/mL)


Concentration @ 30 min
0.012
0.73
0.44
1.24
1.94


(ng/mL)


Tmax (min)
300
15
240
90
90


Cmax (ng/mL)
0.05
1.1
1.3
2.9
6.3


AUC0-24 h (ng * min/mL)
6.7
96.7
217.0
537.1
956.8





Plasma concentration: mean


Tmax: median value


Cmax and AUC0-24 h: geometric mean


IM denotes intramuscular, SL denotes sublingual













TABLE 61







Plasma concentrations for epinephrine after


administration to rabbits under fasted conditions.









Formulation












#R6
#R7
#R8
#R9















Route of administration
SL
SL
SL
SL


Dose per animal (mg)
6
12
12
12


Concentration @ 5 min (ng/mL)
0.71
0.28
0.12
0.81


Concentration @ 10 min (ng/mL)
0.37
0.46
0.17
1.10


Concentration @ 15 min (ng/mL)
0.51
0.83
0.53
1.40


Concentration @ 30 min (ng/mL)
0.93
2.75
3.34
3.57


Tmax (min)
120
120
180
65


Cmax (ng/mL)
3.1
6.0
14.3
7.0


AUC0-24 h (ng * min/mL)
482.2
867.0
2145.1
1050.1





Plasma concentration: mean


Tmax: median value


Cmax and AUC0-24 h: geometric mean






Example 8
Intranasal Administration of Epinephrine Spray Formulations
Methods









TABLE 62







Clinical Formulations










Formulation











#C1
#C2















Epinephrine Base
2.962
3.178



Hydrochloric Acid 0.5N
32.93
35.471



Edetate Disodium Dihydrate
0.05
0.05



Sodium Bisulfite
0.15
0.15



Benzalkonium Chloride
0.01
0.01



Dehydrated alcohol

40



Sodium Chloride
0.6




Water
63.298
16.141







Components: % w/w






Protocol design was a Phase I, proof-of-concept, single-dose open-label, 5-treatment, crossover study to assess the bioavailability of intranasal formulations in adults with seasonal allergies. The study assessed the bioavailability of a single dose 3 milligrams and 6 milligrams dose of epinephrine in a formulation of the present invention to a single 0.3 milligram intramuscular dose of epinephrine. 50 subjects were randomly assigned to one of five groups including 3 milligram intranasal dose of an aqueous formulation of the present invention, 3 milligram intranasal dose of a hydro-alcoholic formulation of the present invention, 6 milligram intranasal dose of an aqueous formulation of the present invention, 6 milligram intranasal dose of a hydro-alcoholic formulation of the present invention and a 0.3 milligram intramuscular dose administered over 4 periods with periods 1 and 2 administered in the absence of allergen and periods 3 and 4 in the presence of an allergen that caused seasonal allergies in the subject. Plasma concentrations were taken at −60, −30, 0, 1, 3, 5, 10, 15, 20, 30, 40, 50, 60, 75, 90, 120, 180, 240 and 360 minutes post-dose.


Results









TABLE 63







Pharmacokinetic profile prior to allergen exposure











Formulation
Tmax (Mean)
Cmax (pg/mL)
AUClast (h * pg/mL)
AUCinf (h * pg/mL)





Aqueous
0.376 (0.05-1.25)
Mean 256 (23.4-1260)
Mean 231 (31.4-958)
Mean 377 (37.9-1860)




GeoMean 149
GeoMean 153
GeoMean 206


Hydro-alcoholic
 0.41 (0.05-2.0)
Mean 419 (77.6-1110)
Mean 596 (30.7-3520)
Mean 727 (31.2-4150)




GeoMean 314
GeoMean 317
GeoMean 385


Epipen ®
0.281 (0.05-0.833)
Mean 511 (148-1160)
Mean 307 (89.1-698)
Mean 329 (91.4-749)




GeoMean 429
GeoMean 255
GeoMean 273
















TABLE 64







Pharmacokinetic profile after allergen exposure











Formulation
Tmax (Mean)
Cmax (pg/mL)
AUClast (h * pg/mL)
AUCinf (h * pg/mL)





Aqueous
 0.13 (0.017-0.667)
Mean 418(78.5-1900).
Mean 231 (76.1-573).
Mean 273 (94.9-620).




GeoMean 268
GeoMean 197
GeoMean 237


Hydro-alcoholic
 0.12 (0.017-0.667)
Mean 639(60.6-3150).
Mean 429 (51.8-963).
Mean 497 (52-1100).




GeoMean 447
GeoMean -
GeoMean 376


Epipen ®
0.225 (0.05-0.667)
Mean 649(201-1750).
Mean 317(125-557).
Mean 362 (166-706).




GeoMean 517
GeoMean 286
GeoMean 326
















TABLE 65







Early Epinephrine plasma concentrations










Time (Minutes)
Mean (Min-Max) pg/ml
















Before Allergen






Exposure



Aqueous
1
47.8
(0-264)




3
154
(0-749)




5
171
(9.17-844)




10
198
(9.37-1260)



Hydro-alcoholic
1
84
(0-353)




3
244
(6.73-933)




5
250
(2.13-1030)




10
200
(34.5-718)



After Allergen



Exposure



Aqueous
1
174
(1.77-1390)




3
353
(28.2-1900)




5
288
(31.3-1040)




10
183
(36.2-461)



Hydro-alcoholic
1
290
(10.5-1300)




3
581
(42.3-3150)




5
398
(43.5-1340)




10
257
(20.6-692)










As seen in Tables 63-65 and FIGS. 1-3, subjects administered 6 milligrams of epinephrine in a hydroalcoholic formulation of the present invention in the presence of an allergen had a higher Cmax than all other cohorts. Further, as seen in FIGS. 1-3, subjects administered 0.3 milligrams of epinephrine as an intramuscular injection in absence of an allergen had a higher Cmax than all other cohorts in the absence of an allergen. Among subjects receiving either the aqueous or the hydroalcoholic formulations the subjects receiving the hydroalcoholic formulations had a higher Cmax across the entire sampling time than those receiving the aqueous formulation both in the absence and presence of an allergen. Epinephrine plasma concentrations were greater than 100 pg/mL up to 30 min post dose for all formulations. Further, epinephrine plasma concentration were greater than 100 pg/mL in less than 5 minutes post dose for all formulations of the present invention regardless of exposure to an allergen. Subjects administered the hydroalcoholic formulation had higher exposure in the entire sampling times for up to 6 hours compared to the aqueous formulation.


In conclusion, the bioavailability of intranasal formulations of the present invention is as good or better than that of the intramuscular injection both in subject that are and are not experiencing seasonal allergies.

Claims
  • 1. An epinephrine spray formulation comprising: from about 0.1% w/w to about 15% w/w epinephrine or a salt thereof; andfrom about 1% to about 80% w/w water,
  • 2. The formulation of claim 1, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax from about 256 to about 419 picograms per milliliter, a Tmax from about 0.376 to about 0.41 hours, an AUClast from about 231 to about 596 h*pg/mL, an AUCinf from about 377 to about 727 h*pg/mL and a combination thereof.
  • 3. The formulation of claim 1, wherein the human was exposed to an allergen prior to administration.
  • 4. The formulation of claim 3, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax from about 418 to about 639 picograms per milliliter, a Tmax from about 0.12 to about 0.13 hours, an AUClast from about 231 to about 429 h*pg/mL, an AUCinf from about 273 to about 497 h*pg/mL and a combination thereof.
  • 5. The formulation of claim 1 wherein the formulation comprises: about 2.96% w/w epinephrine base;about 32.93% w/w hydrochloric acid with a normality of about 0.5N;about 0.05% w/w edetate disodium dihydrate;about 0.15% w/w sodium bisulfate;about 0.01% w/w benzalkonium chloride;about 0.6% w/w sodium chloride; andabout 63.30% w/w water.
  • 6. The formulation of claim 5, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax from about 256 to about 418 picograms per milliliter, a Tmax from about 0.13 to about 0.376 hours, an AUClast of about 231 h*pg/mL, an AUCinf from about 273 to about 377 h*pg/mL and a combination thereof.
  • 7. The formulation of claim 5, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax of about 256 picograms per milliliter, a Tmax of about 0.376 hours, an AUClast of about 231 h*pg/mL, an AUCinf of about 377 h*pg/mL and a combination thereof.
  • 8. The formulation of claim 5, wherein the human was exposed to an allergen prior to administration.
  • 9. The formulation of claim 8, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax of about 418 picograms per milliliter, a Tmax of about 0.13 hours, an AUClast of about 231 h*pg/mL, an AUCinf of about 273 h*pg/mL and a combination thereof.
  • 10. The formulation of claim 1 wherein the formulation comprises: about 3.18% w/w epinephrine base;about 35.47% w/w hydrochloric acid with a normality of about 0.5N;about 0.05% w/w edetate disodium dihydrate;about 0.15% w/w sodium bisulfate;about 0.01% w/w benzalkonium chloride;about 40.0% w/w ethanol; andabout 16.14% w/w water.
  • 11. The formulation of claim 10, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax from about 419 to about 639 picograms per milliliter, a Tmax from about 0.12 to about 0.41 hours, an AUClast from about 429 to about 596 h*pg/mL, an AUCinf from about 497 to about 727 h*pg/mL and a combination thereof.
  • 12. The formulation of claim 10, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax of about 419 picograms per milliliter, a Tmax of about 0.41 hours, an AUClast of about 596 h*pg/mL, an AUCinf of about 727 h*pg/mL and a combination thereof.
  • 13. The formulation of claim 10, wherein the human was exposed to an allergen prior to administration.
  • 14. The formulation of claim 13, wherein the formulation provides a pharmacokinetic parameter selected from the group consisting of a Cmax of about 639 picograms per milliliter, a Tmax of about 0.12 hours, an AUClast of about 429 h*pg/mL, an AUCinf of about 497 h*pg/mL and a combination thereof.
  • 15. An epinephrine spray formulation comprising: from about 0.1% w/w to about 15% w/w epinephrine or a salt thereof; andfrom about 1% to about 80% w/w water,
  • 16. The formulation of claim 15, wherein the human was exposed to an allergen prior to administration.
  • 17. The formulation of claim 15, wherein the formulation comprises: about 2.96% w/w epinephrine base;about 32.93% w/w hydrochloric acid with a normality of about 0.5N;about 0.05% w/w edetate disodium dihydrate;about 0.15% w/w sodium bisulfite;about 0.01% w/w benzalkonium chloride;about 0.6% w/w sodium chloride; andabout 63.30% w/w water.
  • 18. The formulation of claim 15, wherein the formulation comprises: about 3.18% w/w epinephrine base;about 35.47% w/w hydrochloric acid with a normality of about 0.5N;about 0.05% w/w edetate disodium dihydrate;about 0.15% w/w sodium bisulfite;about 0.01% w/w benzalkonium chloride;about 40.0% w/w ethanol; andabout 16.14% w/w water.
Provisional Applications (1)
Number Date Country
62220320 Sep 2015 US
Continuations (2)
Number Date Country
Parent 16007998 Jun 2018 US
Child 16023313 US
Parent 16007999 Jun 2018 US
Child 16007998 US
Continuation in Parts (3)
Number Date Country
Parent 15488712 Apr 2017 US
Child 16007998 US
Parent 15488712 Apr 2017 US
Child 16007999 US
Parent 15264686 Sep 2016 US
Child 15488712 US