In order to increase the length of viability in storage for certain drugs, methods have been developed for freeze-drying or lyophilization of these compounds. These processes result in a dry powder cake sealed in a glass vial of appropriate size with a standard finish, or means of sealing. These means of sealing typically consist of a butyl rubber stopper crimped to the top rim of the glass vial with an aluminum cap. The most common of the standard sizes are 13 mm, 20 mm, and 28 mm, referring to the diameter of the crimped tops. In order to utilize these drugs, they must be reconstituted with an appropriate diluent and transferred from the vial to a syringe for injection. Traditionally a syringe was fitted with a needle which was used to pierce a vial containing the specified diluent and the correct volume of diluent was withdrawn. The syringe and needle was then used to pierce the butyl rubber stopper of the lyophilized drug vial, the diluent injected, and the drug reconstituted, usually by gently swirling the vial until the drug was completely dissolved. The syringe needle was then reinserted through the stopper and the reconstituted drug withdrawn by inverting the vial and pulling back on the plunger of the syringe. Additionally the vial becomes pressurized when the diluent is added with no means of venting out air to balance the change in volume, which can make fine control with the syringe difficult. Care had to be taken to position the needle tip such that the majority of the liquid drug was removed. With the reconstituted drug now in the syringe, the needle that had been used for transferring the diluent and drug, typically a larger diameter needle for ease of flow and now dulled by multiple piercings of the rubber stopper, would be removed and replaced with a needle for injection.
Risks inherent to this procedure include the possibility of needle-stick during the prolonged handling of multiple needles, potential for user error in the measuring of diluent and withdrawal of reconstituted drug, use of wrong needle for transfer or injection, and the potential contamination of the drug with particulate created by the steel needle penetrating the soft rubber seal. The present disclosure employing an adapter as described simplifies the process of reconstitution and reduces the user's exposure to needle handling.
In some embodiments, an adapter comprises an adapter body comprising a coupling member configured for coupling with a pre-fillable assembly and a spike having at least one conduit extending from a central body. At least one conduit extends through the spike, adapter body and the coupling member. A spike cover is sized to receive and seal the spike, the cover reversibly securable to the central body and receiving members configured to receive a vial shroud.
In another aspect of the embodiment, the at least one conduit includes a vent conduit. In another aspect, alone or in combination with any of the previous aspects, the adapter body is configured with generally cylindrical side walls. In another aspect, alone or in combination with any of the previous aspects, the adapter body is configured with generally cylindrical side walls extending longitudinally from the central body. In another aspect, alone or in combination with any of the previous aspects, the coupling member is generally cylindrical and configured to be slidably received within the cylindrical side walls of the adapter body.
In some embodiments, alone or in combination with any of the previous aspects, the adapter body further comprises an elastomeric plug positioned within the coupling member, the elastomeric plug secured between the coupling member and the central body. In another aspect, alone or in combination with any of the previous aspects, the adapter body further includes a penetrating cannula having one end coupled to the central body, the penetrating cannula fluidically coupled to the at least one conduit, and a second end extending at least partially into the coupling member, the adapter configured in a first state wherein the second end of the penetrating cannula is sealed by the elastomeric plug.
In another aspect, alone or in combination with any of the previous aspects, the penetrating cannula is configured in the first state to be aseptically sealed within the adapter by the elastomeric plug and the spike cover. In another aspect, alone or in combination with any of the previous aspects, the adapter is configured in the first state to seal contents of the prefill syringe device and/or control contact of the contents of the prefill syringe to the penetrating cannula, elastomeric plug, and the spike cover.
In another aspect, alone or in combination with any of the previous aspects, the adapter is configured to transition to a second state wherein the second end of the penetrating cannula penetrates the elastomeric plug. In another aspect, alone or in combination with any of the previous aspects, the coupling member is configurable to slidably traverse within the adapter body to urge the penetrating cannula to penetrate the elastomeric plug and provide fluidic communication between the coupling member and the at least one conduit of the spike in the second state. In another aspect, alone or in combination with any of the previous aspects, the adapter is configurable to transition from the first state to the second state upon coupling of the coupling member with a pre-fillable device.
In another aspect, alone or in combination with any of the previous aspects, the coupling member is configured with locking features receivable by complementary locking features of the adapter body in the second state so as to prevent return to the first state.
In some embodiments, alone or in combination with any of the previous aspects, the adapter body further includes a valve having a cracking pressure, the valve configured to control fluid flow between the at least one conduit of the spike and the coupling member. The valve is configured in a first state wherein fluid flow through the at least one conduit of the spike is prevented. In another aspect, alone or in combination with any of the previous aspects, the adapter is configured in the first state to seal contents of the prefill syringe device and/or control contact of the contents of the prefill syringe to the valve.
In another aspect, alone or in combination with any of the previous aspects, the valve is configurable to transition to a second state upon exceeding the cracking pressure wherein the valve opens and allows fluid flow between the at least one conduit of the spike. In another aspect, alone or in combination with any of the previous aspects, the coupling member is configurable to welding with the central body to contain the valve. In another aspect, alone or in combination with any of the previous aspects, the coupling member is configurable to snap-fit coupling with the central body to contain the valve.
In some embodiments, an adapter is provided configured for a prefilled diluent cartridge housed in a syringe-like housing is provided. This configuration allows the user to interface with the adapter as if it were a simple syringe and reduces the number of containers in the reconstitution process. The cartridge is typically a glass container or autoclavable plastic with butyl rubber stoppers that can preserve the diluent in a sterile condition for long periods. A break-away tab at the plunger rod and housing juncture prevents unintentional activation of the cartridge. A vial access device is attached to the luer of the syringe barrel, with a spike cover over the plastic vial access spike to preserve sterility.
In some embodiments, the pre-filled diluent cartridge is configured for being housed in a syringe-like housing as generally known in the art. This configuration allows the user to interface with the adapter as if it were a simple syringe and reduces the number of containers in the reconstitution process. The cartridge is typically a glass or autoclavable plastic container with butyl rubber stoppers that can allow for sterilization and/or preserve the diluent in a sterile condition for long periods. A break-away member 309 at the plunger rod 106 and syringe barrel 101 juncture is typically employed and prevents unintentional activation of the cartridge. A vial access device is attached to the luer of the syringe barrel, with a spike cover over the plastic vial access spike to preserve sterility.
In the figure descriptions, a cartridge consisting of a glass body, rubber seal with aluminum crimp and a butyl rubber stopper has been depicted. Various prefilled cartridges exist and could be used in this device concept. The cartridges may be filled with whatever diluent is required for a particular drug reconstitution.
The embodiments of the syringe housing described herein may be designed such that they are able to mate with standard and non-standard off-the-shelf needles and needle-less valves.
The vial adapter can be of any size required to match the drug vial finish, the standard 13 mm, 20 mm, and 28 mm or a custom size, and can be configured with or without a vent to relieve pressure build-up in the containers, or a fluid filter if required for a particular drug reconstitution. In addition the vial adapter may be configured in two parts that allow for the spike and cap to be assembled to the cartridge independently from the larger diameter shroud, facilitating high-volume handling of the cartridge in manufacturing and assembly. The shroud, which does not require sterility, could then be attached at a later stage.
The embodiments of the pre-fill syringe cartridge adapter described herein may alternately be equipped with other attachment means in place of the described shroud for securing the various containers such as but not limited to diluent bags and vials.
The embodiments of the pre-fill syringe cartridge adapter described herein may alternately be equipped with other access means for mating and sealably connecting to various containers such as but not limited to diluent bags and vials.
To reconstitute a lyophilized drug, the user would remove the spike cover of the vial access device and snap the adapter on to the top of the drug vial. The vial access device is configured for a low-force, permanent attachment. The user then removes the tab at the plunger of the syringe, which prevents unintentional activation, and depresses the plunger to inject the diluent into the vial. The initial movement of the plunger causes the internal diluent cartridge to be penetrated by a cannula so that it can be injected. The assembly can then be swirled normally to reconstitute the drug, with the vial adapter holding the syringe securely in place. When the drug is dissolved, the assembly can be inverted and the drug withdrawn into the syringe cartridge. A slot in the vial adapter allows the drug to be removed fully. The syringe can then be detached from the vial adapter at the luer lock connection, ready to be fitted with the appropriate needle for injection.
In some embodiments, an adapter configured for a prefilled diluent syringe is provided. In one aspect, the prefilled diluent syringe functions as the cartridge in the above embodiment.
In some of the figure descriptions, a syringe consisting of a glass body, elastomeric plug and elastomeric syringe stopper has been depicted. Various prefilled syringes exist and could be used in this device concept. Alternate materials for the syringe barrel with high barrier properties and syringe fill compatibility could be used, such as cyclic olefin copolymers COC or cycloolefin polymer COP. Alternate elastomeric materials with good barrier properties and syringe fill compatibility could be used for the butyl rubber plug and stopper, such as Polyisoprene or SANTOPRENE™. The syringes may be filled with whatever diluent or content is required for a particular drug reconstitution or delivery.
The embodiments of the adapters described herein may be designed such that they are able to mate with standard and non-standard off-the-shelf needles and needle-free valves. The shroud of the vial adapter can be of any size required to match the drug vial finish, the standard 13 mm, mm, and 28 mm or a custom size, and can be configured with or without a vent to relieve pressure build-up in the containers, or a fluid filter if required for a particular drug reconstitution. In addition the adapter may be configured in two parts that allow for the spike and spike cover to be assembled to the syringe independently from the larger diameter shroud which allows the assembly to stay within the diameter of the syringe barrel so that the syringe can be hung by the flange, facilitating high-volume handling of the syringe in manufacturing and assembly. This also accommodates ready-to-fill tub design. The shroud, which typically does not require sterility, could then be attached at a later stage so as to facilitate mechanical handling of the prefill devices without the added girth or diameter of the shroud.
In some embodiments, the present disclosure provides for a pre-filled syringe vial adapter, which couples to a prefilled syringe barrel, sealed on the distal end with a plug and on the proximal end with a stopper which may be butyl rubber or other elastomeric materials compatible with the long-term storage of the syringe's contents, the proximal stopper being configured as a sliding syringe plunger. A plunger rod, which may be removable, temporary, permanent or user attachable, is fixed to a stopper. The distal plug is captured in a luer connector by a cap and is attached to the prefilled syringe distal end by a luer lock collar. A vial adapter consisting of an adapter body, a spike, a central attachment means, an internal fluid path, and optionally a penetrating cannula or valve, is slidably attached to the cap by means of features on the outer diameter of the cap and flexible tabs on the body of the vial adapter with openings that interact with the adapter body features creating a first position and a second position. A spike cover on the spike and optionally a plug covering the penetrating cannula maintains the sterility of the fluid path. A vial adapter shroud, sized to attach to the required vial top, attaches to the central attachment means of the vial adapter with snap fingers or the like.
In some embodiments, the spike cover is removed and the spike is positioned above the drug vial septum, which can be assisted by the shroud. The adapter is then pressed down onto the drug vial to access the vial. As force is applied, the cap moves to the second position causing the penetrating cannula to pass through the plug. This movement is small and requires a low force compared to the force required to pierce the larger drug vial septum and snap on the vial adapter shroud.
An alternative configuration of the adapter is compatibility with a prefilled syringe barrel, sealed on the proximal end with a stopper which may be butyl rubber or other elastomeric materials compatible with the long-term storage of the syringe's contents, the proximal stopper being configured as a sliding syringe plunger. A plunger rod, which may be removable, temporary, permanent or user attachable, is fixed to the stopper. The adapter can be attached to the distal end of the syringe with a luer lock collar. A seal of butyl rubber or other elastomeric material or blend of materials is captured inside the luer fitting to ensure a complete seal. Alternately the seal may be made by a thermoplastic female luer against the syringe male luer, and thus integral to the adapter with no need for a separate elastomer component. A spike cover, also of a butyl or butyl-like elastomeric material, on the adapter spike maintains the storage life of the contents and the sterility of the fluid path. An adapter shroud, sized to attach to the required vial top, attaches to the central attachment means of the adapter with snap fingers.
In another alternate configuration of the pre-filled syringe vial adapter, a vent is added to the configuration with a vent lumen passing through the spike, co-axial and separate from the fluid lumen, in connection with a vent port, which is covered with a vent filter media. The vent filter media may be a hydrophobic material to prevent leaking of fluid from the adapter, and may have orifices of 0.2 microns or less in cross section providing a sterile barrier to the outside air. A filter configuration could be used with either of the presently described devices.
For all configurations of the adapter for pre-filled syringe devices, once the connection to the drug vial is made an open fluid path is created from the prefilled syringe to the drug vial and the diluent may be transferred into the drug vial by depressing the syringe plunger rod. The drug in the vial can be reconstituted and withdrawn into the prefilled syringe, which is then detached from the vial adapter luer connection for delivery. This configuration reduces the number of steps, containers and needles in the reconstitution process, simplifying reconstitution for the user and increasing safety.
The following is a description of the figures and associated features of each embodiment of the enclosed disclosure.
With reference to
Referring to the sectional views 2B and 2D, penetrating cannula 115 is incorporated into Luer adapter 59 for penetrating seal 55 of cartridge 50 upon activation of the device by translating plunger rod 106 and urging the contents of cartridge 50 through spike conduit 114. Prefilled syringe device can be assembled with adapter 199 without the shroud 121 so as to facilitate ease of adaptation with conventional filling and packaging machines. Adapter 199 with spike cover 120 provides a septic seal compatible with sterilization techniques. To use adapter 199, shroud 121 can be connected, spike cover 120 removed, spike 112 inserted into a vial containing reconstitutable medicament whereby shroud 121 will lock the vial in place. Removing locking tab 60 and urging plunger rod 106 releases contents of cartridge 50 by forcing penetrating cannula 115 through seal 55 allowing fluid communication with spike conduit 114. After reconstitution, the contents of the valve can be withdrawn back into the cartridge 50 by drawing back on plunger rod 106.
Referring now to
As shown in
In use, adapter 500 provides for valve 520 to open at flap 525 when cracking pressure is exceeded. This will happen when contents of prefilled syringe device are urged by pushing plunger rod 106. Likewise, cracking pressure will be exceeded and flap 525 will open when the contents of vial 124 and diluent of prefilled syringe device are withdrawn by reversing the direction of plunger rod 106, as shown in
Adapter 600 of
Modifications and Alternatives to the previously disclosed embodiments include, for example, alternate attachment and access means, among other things. The embodiments described herein may alternately be equipped with other attachment means in place of the described vial shroud, for example, for securing to various containers as well as being equipped with other access means in place of the septum spike to connect to various containers, such as but not limited to diluent bags, non-standard vials, or cartridges.
The attachment of adapter 500 with shroud 121 to vial 124 containing reconstitutable medicament 124a and the sequence of introducing diluent and the withdrawal of reconstituted medicament 124b, and the disconnection of reconstituted medicament contained in prefilled syringe device by the separation of Luer adapter 595 from detachable portion 596 is shown via sectional views of
In some embodiments, applicable to all of the adapter embodiments disclosed and described herein, to reconstitute a lyophilized drug or otherwise add fluid to a liquid or powdered drug, the spike cover coupled to the prefilled device comprising the present adapter embodiment is removed and the adapter is coupled (snapped on) to the accessible, penetrable top of the drug vial. During this attachment, in some embodiments, an internal cannula of the prefilled device penetrates an elastomeric plug, completing the fluid path between the prefilled device and the vial.
The present adapter is configured for a low-force, permanent attachment to the prefilled device and/or drug vial. A user can then depresses the plunger to inject the diluent into the vial. The assembly can then be swirled normally to reconstitute the drug, with the vial adapter holding the syringe securely in place. When the drug is dissolved, mixed, or in suspension, the assembly can be inverted and the drug withdrawn into the syringe. A slot in the adapter spike allows the drug to be removed fully. The syringe can then be detached from the adapter at the luer lock connection, ready to be fitted with the appropriate needle, IV connector, etc., or similar device for injection.
Filing Document | Filing Date | Country | Kind |
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PCT/US2015/019012 | 3/5/2015 | WO | 00 |
Number | Date | Country | |
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62071040 | Sep 2014 | US | |
61966872 | Mar 2014 | US |