The invention is in the field of topical formulations for treating herpes infections, such as genital herpes, oral herpes, and shingles.
Genital herpes is a sexually transmitted disease caused by herpes simplex 2 virus (HSV-2). Many can be infected yet have no or mild symptoms and not know they are infected. When symptoms do occur, they typically include small blisters that break open to form painful ulcers. Flu-like symptoms, such as fever, aching, or swollen lymph nodes, may also occur. Onset is typically around 4 days after exposure, with symptoms lasting up to 4 weeks. Once infected, further outbreaks may occur but are generally milder.
The disease is typically spread by direct genital contact with the skin surface or secretions of someone who is infected. This may occur during sex, including vaginal, anal, and oral sex. Sores are not required for transmission to occur. The risk of spread between a couple is about 7.5% over a year. HSV is classified into two types, HSV-1 and HSV-2. While historically most genital herpes infections are caused by HSV-2, genital HSV-1 has become more common in the developed world. HSV-1 is usually associated with oral herpes (e.g., cold sores).
Efforts to prevent infection include abstaining from sex, using condoms, and only having sex with someone not infected. Once infected, there is no known cure. Antiviral drugs can prevent, reduce, or shorten outbreaks when they occur. Long-term use of antivirals may decrease the risk of further spread.
In 2015, about 846 million people (12% of the world population) had genital herpes. In the United States, more than one in six people has HSV-2. Women are more commonly infected than men. Complications may include aseptic meningitis, increased risk of HIV/AIDS if exposed to HIV-positive individuals, and spread to a baby during childbirth, resulting in neonatal herpes.
In males, lesions usually occur on the glans penis, shaft of the penis, other parts of the genital region, inner thigh, buttocks, and/or anus. In females, lesions can appear on or near the vulva, clitoris, labia, buttocks, and/or anus.
Common symptoms include pain, itching, and burning. Less frequent yet still common symptoms include discharge from the penis or vagina, fever, headache, muscle pain (myalgia), swollen and enlarged lymph nodes, and malaise. Women often experience additional symptoms such as painful urination (dysuria) and cervicitis. Herpetic proctitis (inflammation of the anus and rectum) is common for individuals participating in anal intercourse.
After a first episode of herpes genitalis caused by HSV-2, there will be at least one recurrence in approximately 80% of people, while the recurrence rate for herpes genitalis caused by HSV-1 is approximately 50%. Herpes genitalis caused by HSV-2 recurs on average four to six times per year, while that of HSV-1 infection occurs only about once per year.
Antiviral medications, such as acyclovir, valacyclovir, famciclovir, and penciclovir, may prevent herpes outbreaks or shorten outbreaks if they occur.
Acyclovir is an antiviral medication and reduces the pain and the number of lesions in the initial case of genital herpes. Furthermore, it decreases the frequency and severity of recurrent infections. It comes in capsules, tablets, suspension, injection, powder for injection, and ointment. The ointment is used topically and decreases pain, reduces healing time, and limits the spread of the infection.
Valacyclovir is a prodrug that is converted to acyclovir once in the body. It helps relieve the pain and discomfort and speeds healing of sores. It only comes in caplets and has a longer duration of action than acyclovir. An example usage is by mouth twice per day for ten days for primary lesions, and twice per day for three days for a recurrent episode.
Famciclovir is another antiviral drug that belongs to the same class. Famciclovir is a prodrug that is converted to penciclovir in the body.
In view of the foregoing, there has been a long-felt but unmet need to find effective topical treatments for genital herpes and other herpetic lesions, such as oral herpes and shingles.
It has now been found that a topical composition comprising dimethyl sulfoxide (DMSO), a quaternary ammonium compound (QAC), and a diluent, such as water and/or polyol, is effective in treating herpes lesions when topically applied to the affected area.
In embodiments, the herpes lesions are related to genital herpes, oral herpes, or shingles. Application of the topical composition to herpes lesions has been found to reduce the time of healing.
Moreover, application of the topical compositions disclosed herein can prophylactically prevent or reduce the number of outbreaks normally experienced by a person with a herpetic infection.
In embodiments, the compositions may further include other agents that can sooth pain and discomfort associated with herpes, such as a cannabinoid (e.g., cannabidiol (CBD) and/or tetrahydrocannabinol (THC)).
Anti-viral agents that can be used in addition to the QAC include acyclovir, valacyclovir, famciclovir, and penciclovir.
Amino acids, such as lysine or salt thereof, have been found to enhance effectiveness of the topical composition.
Camphor, essential oils and/or one or more terpenes can be added to provide a soothing effect.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the embodiments claimed.
Disclosed are topical compositions comprising dimethyl sulfoxide (DMSO), a quaternary ammonium compound (QAC), and a diluent, such as water and/or polyol, which are highly effective in treating herpes lesions when topically applied to the affected area.
Herpes lesions that can be treated with the topical compositions include genital herpes, oral herpes, and shingles. Application of the topical composition to herpes lesions has been found to reduce the time of healing. In some cases, future outbreaks are prevented or greatly reduced in frequency and/or duration. Application of the topical compositions disclosed herein can prophylactically prevent or reduce the number of outbreaks normally experienced by a person with a herpetic infection.
In some embodiments, the compositions may further include other agents that can sooth pain and discomfort associated with herpes, such as a cannabinoid (e.g., cannabidiol (CBD) and/or tetrahydrocannabinol (THC)).
Amino acids, such as lysine or salt thereof, have been found to enhance effectiveness of the topical composition.
Camphor, essential oils and/or one or more terpenes can be added to provide a soothing effect.
In some embodiments, the topical composition includes a penetrating liquid carrier that comprises 10-90 wt % DMSO and 90-10 wt % diluent, or 20-85 wt % DMSO and 80-20 wt % diluent, or 30-80 wt % DMSO and 70-20 wt % diluent, or 40-75 wt % DMSO and 60-25 wt % diluent, or 50-70 wt % DMSO and 50-30 wt % diluent. In preferred embodiments, the amount of DMSO is at least 40 wt %, at least 50 wt %, at least 60 wt %, at least 70 wt %, or at least 80 wt % and less than 90 wt % (or ranges bounded by any of the foregoing), and the amount of diluent is less than 20 wt %, less than 30 wt %, less than 40 wt %, less than 50 wt %, or less than 60 wt %, and greater than 10 wt % (or ranges bounded by any of the foregoing).
In some embodiments, the amount of the quaternary ammonium compound can at 0.1 wt %, 0.13 wt %, 0.15 wt %, 0.175 wt %, 0.2 wt %, 0.25 wt %, 0.3 wt %, 0.4 wt %, or 0.5 wt %, or a range bounded by any of the foregoing values.
In some embodiments, the quaternary ammonium compound comprises at least one of the following: benzalkonium chloride, alkylbenzyldimethylammonium chloride, alkyldimethyl/ethylbenzylammonium chloride, n-alkyldimethylbenzylammonium chloride, diisobutyl-phenoxyethoxyethyldimethylbenzylammonium chloride, n-(C12C14C16) alkyl dimethylbenzylammonium chloride, didecyldimethylammonium chloride, dioctyldimethylammonium chloride, dialkyldimethylammonium chloride, dialkylmethyl-benzylammonium chloride, octyldecyldimethylammonium chloride, lauryldimethyl-benzylammonium chloride, o-benzyl-p-chlorophenol, dideryldimethyl-ammonium chloride, dioctyldimethylammonium chloride, alkyl (C14C12C16), dimethylbenzyl-ammonium chloride, cetylpyridinium chloride, or cetalalkonium chloride.
A topical treatment composition for treating genital herpes was made by combining the following components:
The treatment composition was a clear colorless liquid.
A person suffering from genital herpes applied the composition to the genital region during an outbreak. The person re-applied the composition once each day thereafter until the outbreak ceased. The outbreak was shortened by 3-5 days compared to the usual outbreak.
The person continued applying the composition to the affected area and went about 8 months without having a breakout, which normally occurred every few weeks unless an oral anti-viral composition (acyclovir) was taken. This was an unexpected and unpredictable result. It also shows the composition was effective as a prophylactic treatment to reduce, reduce or delay a breakout of lesions.
A topical treatment composition for treating genital herpes was made by combining the following components:
The treatment composition is a clear colorless liquid.
A person suffering from genital herpes applies the composition to the genital region during an outbreak. The person re-applies the composition once each day thereafter until the outbreak ceased. The outbreak is shortened by 1-2 days compared to the usual outbreak.
The person continues applying the composition to the affected area and goes several months without having a breakout, which shows the composition is effective as a prophylactic treatment to reduce, reduce or delay a breakout of lesions.
A topical treatment composition for treating genital herpes was made by combining the following components:
The treatment composition is a clear colorless liquid.
A person suffering from genital herpes applies the composition to the genital region during an outbreak. The person re-applies the composition once each day thereafter until the outbreak ceased. The outbreak is shortened by 2-3 days compared to the usual outbreak.
The person continues applying the composition to the affected area and goes several months without having a breakout, which shows the composition is effective as a prophylactic treatment to reduce, reduce or delay a breakout of lesions.
A topical treatment composition for treating genital herpes was made by combining the following components:
The treatment composition is a clear colorless liquid.
A person suffering from genital herpes applies the composition to the genital region during an outbreak. The person re-applies the composition once each day thereafter until the outbreak ceased. The outbreak is shortened by 2-4 days compared to the usual outbreak.
The person continues applying the composition to the affected area and goes several months without having a breakout, which shows the composition is effective as a prophylactic treatment to reduce, reduce or delay a breakout of lesions.
A topical treatment composition for treating genital herpes was made by combining the following components:
The treatment composition is a clear colorless liquid.
A person suffering from genital herpes applies the composition to the genital region during an outbreak. The person re-applies the composition once each day thereafter until the outbreak ceased. The outbreak is shortened by 3-5 days compared to the usual outbreak.
The person continues applying the composition to the affected area and goes several months without having a breakout, which shows the composition is effective as a prophylactic treatment to reduce, reduce or delay a breakout of lesions.
A topical treatment composition for treating genital herpes was made by combining the following components:
The treatment composition is a clear colorless liquid.
A person suffering from genital herpes applies the composition to the genital region during an outbreak. The person re-applies the composition once each day thereafter until the outbreak ceased. The outbreak is shortened by 3-5 days compared to the usual outbreak.
The person continues applying the composition to the affected area and goes several months without having a breakout, which shows the composition is effective as a prophylactic treatment to reduce, reduce or delay a breakout of lesions.
Any of the foregoing topical treatment compositions are modified by changing the relative amounts of liquid carrier and benzalkonium chloride in the following ways:
As the quantity of benzalkonium chloride is increased, the antiviral activity per unit dose is increased and less composition is required to achieve the same relative effectiveness in topically treating herpes infections, either therapeutically or prophylactically.
Any of the foregoing topical treatment compositions is modified by replacing at least a portion of benzalkonium chloride with one or more the following quaternary ammonium compounds: alkylbenzyldimethylammonium chloride, alkyldimethyl/ethylbenzylammonium chloride, n-alkyldimethylbenzylammonium chloride, diisobutyl-phenoxyethoxyethyldimethylbenzylammonium chloride, n-(C12C14C16) alkyl dimethylbenzylammonium chloride, didecyldimethylammonium chloride, dioctyldimethylammonium chloride, dialkyldimethylammonium chloride, dialkylmethylbenzylammonium chloride, octyldecyldimethylammonium chloride, lauryldimethylbenzylammonium chloride, o-benzyl-p-chlorophenol, dideryldimethylammonium chloride, dioctyldimethylammonium chloride, alkyl (C14C12C16), dimethylbenzylammonium chloride, cetylpyridinium chloride, or cetalalkonium chloride.
The amount of quaternary ammonium compound in the composition may be increased or decreased depending on its antiviral activity.
The treatment composition of Example 1 was modified by adding an amount of CBD oil to yield a composition having 0.25% of cannabidiol (CBD). The composition had the same outbreak shortening effect as in Example 1 but with reduced pain and inflammation.
The treatment composition of Example 1 was modified by adding an amount of lysine HCl to yield a composition containing 3% w/v of lysine HCl. The composition appeared to have the same or better outbreak shortening effect as in Example 1.
A topical treatment composition for treating genital herpes is made by combining the following components:
The treatment composition is a yellow tinted tincture and was found to be effective in treating genital herpes similar to the compositions of Examples 1 and 2.
A two-component topical treatment system for treating genital herpes is made that includes a first treatment composition for initial application and a second treatment composition or subsequent application.
The first treatment composition was applied by a subject when at the initial phase of an outbreak, including one application the first day and then re-applied one or more times during the outbreak.
The second treatment composition was applied for 1-3 days after applying the first treatment composition to reduce inflammation and pain.
A commercially available CBD hand and body lotion (CBD SFV/Klashnikova Migraine & Pain Terpenes) sold by Koodegras (Sandy, Utah), which contained 400 mg CBD in 6 fluid ounces of lotion, was mixed with DMSO, glycerin, and benzalkonium chloride to form a topical composition in the following amounts:
The CBD lotion contained the following: capric/caprillic triglycerides, sunflower seed oil, hemp CBD oil with terpenes, Moroccan organic argan oil, emulsifying wax, glyceryl monostearate, simmondsia (jojoba) oil, butyrospermum parkii (shea butter), stearic acid, cetyl alcohol, glyceryl distearate, and carbomer.
The resulting topical composition was a thin cream that remained as a stable emulsion.
A man suffering from genital herpes applied the composition to the genital region directly on the lesions and surrounding tissue and massaged it in gently. The composition was re-applied each day until the outbreak ceased. The lesions healed 3-5 days sooner than during the usual outbreak.
A woman suffering from genital herpes applies the composition to the genital region directly on the lesions and surrounding tissue and massages it in gently. The composition is re-applied each day until the outbreak ceases. The lesions heal 3-5 days sooner than during the usual outbreak.
A commercially available CBD black seed salve (Sacred Herbal Medicinal Remedies) sold by Koodegras, which contained 900 mg CBD in 6 fluid ounces of salve, was with DMSO, glycerin, and benzalkonium chloride to form a topical composition in the following amounts:
The CBD salve contained the following: organic olive oil, black seed (cumin) oil, coconut oil, jojoba oil, sweet almond oil, argan oil, nigella sativa oil, shea butter, beeswax, hemp CBD oil, skullcap charcoal, arnica, passionflower, Vitamin E, tocopherol, camphor, white willow oil, rosemary, turmeric lavender, frankincense, capsicum annum, and essential oils and herbal blends (proprietary).
The resulting topical composition was a thick emulsion that appeared to be relatively stable overnight.
A man suffering from genital herpes applies the composition to the genital region directly on the lesions and surrounding tissue and massages it in gently. The composition is re-applied each day until the outbreak ceases. The lesions heal 3-5 days sooner than during the usual outbreak.
A woman suffering from genital herpes applies the composition to the genital region directly on the lesions and surrounding tissue and massages it in gently. The composition is re-applied each day until the outbreak ceases. The lesions heal 3-5 days sooner than during the usual outbreak.
A commercially available CBD salve (No. 9 Time-Released Quick Relief Salve) sold by Koodegras, which contained 200 mg CBD in 2 fluid ounces of salve, is mixed with a liquid carrier comprising DMSO (70%) and vegetable glycerin (30%) at a ratio of 1:1 to form a topical composition. An amount of benzalkonium chloride is added to achieve a concentration of 0.13% by weight of the composition.
The CBD salve contained the following: argan oil, black seed oil, olive oil, organic beeswax, proprietary Asian herbal mix, Vitamin E oil, mixed tocopherols, anhydrous hemp oil, time release CBD oil, proprietary essential oil blend, melaleuca oil, eucalyptus oil, cayenne oil, and beta-caryophyllene.
The resulting topical composition is a thick emulsion that is relatively stable but may require occasional agitation to resuspend. Addition of vegetable glycerin may help stabilize the composition and reduce odor of the DMSO.
A person suffering from genital herpes applies the composition to the genital region directly on the lesions and surrounding tissue and massages it in gently. The composition is re-applied each day until the outbreak ceases. The lesions heal 3-5 days sooner than during the usual outbreak.
A commercially available CBD and THC infused balm (Energy Relief) sold by Planet 13, which contains 50 mg THC and 50 mg CBD in 50 grams of balm, is mixed with a liquid carrier comprising DMSO (70%) and vegetable glycerin (30%) at a ratio of 1:1 to form a topical composition. An amount of benzalkonium chloride is added to achieve a concentration of 0.13% by weight of the composition.
The CBD and THC infused balm contained the following: olive oil (extra virgin), lobelia olive oil, beeswax, castor oil, CBD isolate, cocoa butter, essential oil blend (proprietary), and THC. Total cannabinoid analysis in 100 mg of cannabinoids: 45.939 mg THC, 49.824 mg CBD, 0.0 mg CBG, 4.191 mg THCV, and 0.0 mg THCVa. Total terpenes: eucalyptol 13.546, camphene 9.220 mg, alpha-pinene 24.648 mg, and linalool 11.024 mg.
The resulting topical composition is a thin runny suspension that appears to be a relatively stable emulsion but may need agitation before use. The vegetable glycerin helps stabilize the composition and reduce odor of the DMSO.
A person suffering from genital herpes applies the composition to the genital region directly on the lesions and surrounding tissue and massages it in gently. The composition is re-applied each day until the outbreak ceases. The lesions heal 3-5 days sooner than during the usual outbreak.
A commercially available water-borne nanosized CBD dispersion (Angstrom PlexII phytocannabinoid complex) sold by Koodegras, which contained 250 mg CBD in 10 milliliters, is mixed with mixed with a liquid carrier comprising DMSO (70%) and vegetable glycerin (30%) at a ratio of 1:1 to form a topical composition. An amount of benzalkonium chloride is added to achieve a concentration of 0.13% by weight of the composition.
The CBD suspension contained the following: purified water, olive oil, sunflower lecithin, anhydrous hemp oil, potassium sorbate, Vitamin E, and citric acid.
The resulting topical composition is a thin non-viscous fluid suspension that is relatively stable but may require occasional agitation to resuspend. Addition of vegetable glycerin may help stabilize the suspension and reduce odor of the DMSO.
A person suffering from genital herpes applies the composition to the genital region directly on the lesions and surrounding tissue and massages it in gently. The composition is re-applied each day until the outbreak ceases. The lesions heal 3-5 days sooner than during the usual outbreak.
Any of the topical compositions of Examples 1-17 is modified by adding camphor, such as in a range of about 0.05% to about 1%, or about 0.075 to about 0.5%, or about 0.1% w/v.
Any of the topical compositions of Examples 1-18 is modified by adding a therapeutically effective amount of an anti-viral compound selected from acyclovir, valacyclovir, famciclovir, or penciclovir, optionally to replace at least some of the benzalkonium chloride.
A kit is made that contains any of the topical compositions of Examples 1-19 packaged together with an oral dosage form of lysine, such as lysine HCl. The oral dosage form is a tablet, capsule or liquid and provides from 1-3 g/day of lysine.
The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
This Application is a continuation-in-part of U.S. patent application Ser. No. 16/886,730, filed May 28, 2020, which claims the benefit of U.S. Provisional Application No. 62/853,712, filed May 28, 2019, which are incorporated by reference in their entirety.
Number | Date | Country | |
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62853712 | May 2019 | US |
Number | Date | Country | |
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Parent | 16886730 | May 2020 | US |
Child | 18608359 | US |