CA2202137C - Composition, device and method for enhanced electrotransport agent delivery - Google Patents

Abstract

An electrotransport composition comprises at least one C2-C4 lower alcohol, unsaturated derivatives thereof, or mixtures thereof, and at least one C8-C14 higher alcohol, unsaturated derivatives thereof, or mixtures thereof. An electrotransport device and a method of increasing transdermal electrotransport flux utilize the composition of the invention for delivering pharmaceutically-acceptable agents across a body surface such as skin.

Description

WO 96/14870 PCi'/US95/14175 COMPOSITION, DEVICE, AND METHOD FOR
ENHANCED ELECTROTRANSPORT AGENT DELIVERY
= BACKGROUND OF THE INVENTION
Technical Field This invention relates generally to permeation enhancers for electrotransport agent delivery. More particularly, this invention relates to compositions comprising different alcohols as permeation enhancers. These compositions may be incorporated into electrotransport devices for the delivery of agents, such as drugs and prodrugs, through a body surface.
Background Art Drugs are most conventionally administered either orally or by injection.
Unfortunately, many medicaments are completely ineffective or of radically reduced efficacy when orally administered since they either are not absorbed or are adversely affected before entering the blood stream and thus do not possess the desired activity. On the other hand, the direct injection of the medicament into the blood stream, while assuring no modification of the medicament in administration, is a difficult, inconvenient and uncomfortable procedure, sometimes resulting in poor patient compliance. Transdermal drug delivery offers improvements in these areas. The term "transdermal" is used hereiri in its broadest sense as the delivery of an agent through a body surface, such as the skin, mucosa, or nails. There are two major types of transdermal agent delivery, one driven by a concentration-gradient force (passive transdermal delivery), and the other driven, in addition, by a force created by applying an electrical =
potential (electrotransport delivery).

The term "passive" transdermal delivery, is used herein to describe the passage of an agent through a body surface, eg, skin, in the absence of an applied electrical current. Typically, passive delivery devices have a drug reservoir which contains a high concentration of a drug. The device is placed in contact with a body surface for an extended period of time, and is allowed to diffuse from the reservoir and into the body of the patient, which has a much lower concentration of drug. The primary driving force for passive drug delivery is the concentration gradient of the drug across the skin. In this type of delivery, the drug reaches the bloodstream by diffusion through the dermal layers of the body. The preferred agents for passive delivery are hydrophobic non-ionic agents, given that the drug must diffuse through the lipid layers of the skin.
The term "electrotransport" is used herein to describe the passage of a substance, eg, a drug or prodrug, through a body surface or membrane, such as the skin, mucous membranes, or nails, induced at least partially by the application of an electric field across the body surface (eg, skin). A widely used electrotransport process, iontophoresis, involves the electrically induced transport of therapeutic agents in the form of charged ions. Ionizable therapeutic agents, eg, in the form of a salt which when dissolved forms charged agent ions, are preferred for iontophoretic delivery because the charged agent ions move by electromigration within the applied eiectric field.
Electroosmosis, another type of electrotransport process, involves the movement of a liquid, which liquid contains a charged and/or uncharged therapeutic agent dissolved therein, through a biological membrane under the influence of an electric field.
= Another type of electrotransport, electroporation, involves the formation of' transiently-existing pores in a(iving biological membrane under the influerice of an electric field and delivery of a therapeutic agent therethrough. Howeve:r, in any given electrotransport process, more than one of these processes may be occurring simultaneously to some extent. Accordingly, the term "electrotransport" is used herein in its broadest possible interpretation to include the electrically induced or enhanced transport of at least one agent, which may be charged, ie, in the form of ions, or uncharged, or of mixtures thereof, regardless of the specific mechanisms by which the agent is actually transported.

A common goal in both passive and electrotransport delivery is to enhance the rate of delivery of the agent. A further goal in electrotransport delivery is to reduce the electrical resistance of the skin or other body surfaces, so that the power requirements for a given level of applied electric current or drug flux will be lowered. The term "permeation enhancer" is used herein to describe additives which cause an increase in drug delivery rates both in passive and electrotransport delivery, regardless of whether the enhancenient occurs by reduction of electrical or diffusional resistance.

Although there are similarities between electrotransport and passivE:
transdermal delivery, there are also substantial differences. One difference relates to the different pathways utilized for delivery through the skin by the passive and electrotransport induced processes. Transdermal electrotransport = delivery of an agent occurs within the hydrophilic pathways through the skin, ie, the sweat ducts, around hair follicles, and/or through pores, because these are the paths of least electrical resistance. On the other hand, passive transdermal delivery occurs primarily by direct diffusion through the lipid layers of the skin.
Accordingly, an ideal passive permeation enhancer will disrupt the lipid layers of the skin, while an ideal electrotransport enhancer will preferably decrease the electrical resistance of the existing "hydrophilic pathways in the skin. (See, Rolf, D., "Chemical and Physical Methods of Enhancing Transdermal Drug Delivery,"
Pharmaceutical Technology, pp 130-140 (Sept. 1988); Cullander, C., "What are the Pathways of lontophoretic Current Flow through Mammalian Skin?", Advanced Drug Delivery Reviews, 9:119-135 (1992)).
Thus, it is not surprising that many passive permeation enhancers do not enhance electrotransport delivery rates. For instance, Hirvonen et al indicate that N, N-dimethylamino acetate (DDAA) and azone increase the rate of passive permeation of the agent sotalol relative to that obtained with sotalol alone (control). (Hirvonen et al, 'Transdermal Permeation of Model Anions and Cations: Effect of Skin Charge, lontophoresis and Permeation Enhancers", Proceed. Intem. Symp. Control. Rel. Bioact. Mater., 19:452 (1992)). And the passage of an electric current was also shown to increase the rate of delivery of sotalol compared to that of its passive rate (control). However, the addition to solatol of either DDAA or Azone reduced the rate of electrotransport of solatol compared to its rate of electrotransport without DDAA or azone (control).
Clearly, DDAA and azone, both known passive permeation enhancers, were not only inoperative in electrotransport, but they actually reduced the rate of electrotransport delivery of the agent. Kontturi et al indicated that the aforementioned passive enhancers, in fact, increase skin resistivity, and advanced that passive enhancers such as those are inappropriate for use in electrotransport drug delivery. (Kontturi et al, "Electrochemical Characterization *Trade-mark of Human Skin by Impedance Spectroscopy: The Effect of Penetration Enhancers", Pharmaceutical Research 10(3):381-385 (1993)).

Other permeation enhancers have been disclosed to be useful in passive 5 transdermal delivery. For example, WIPO Laid Open Patent Application WO
91 /16930 to Ferber et al discloses that an aqueous solution of up to 40 v/v%
lower alcohol and higher alcohol in a saturating amount is suitable for enhancing passive transdermal delivery. Suitable passive transdermal delivery enhancers disclosed therein are lower C2-C4 alcohols such as ethanol, 1-propanol, 2-propanol, 1-butanol, and 2-butanol, and higher alcohols such as Cs-C14 alcohols including 1-hexanol, 1-octanol, 1-nonanol, 1-decanol, 1-undecanol, 1-dodecanol, 1-tridecanol, 1-tetradecanol, 4-methyl-1-pentanol, 5-methyl-1-heptanol, 3,3-dimethyl-1-octanol, 3-cyclopentyl-l-propanol, cis-3-hexen-l-ol, trans-3-hexen-1-ol, 9-decen-1-ol and 2-octanol.
The number of permeation enhancers disclosed as useful in electrotransport delivery is considerably more limited. Ethanol, for instance, has been used as a permeation enhancer for the electrotransport delivery of polypeptides is discussed by Srinivasan et al (Srinivasan et al, "lontophoresis of Polypeptides: Effect of Ethanol Pretreatment of Human Skin," J. Pharm. Sci.
79(7):588 (July 1990)). Surfactant (eg, sodium lauryl sulfate) permeation enhancers for electrotransport drug delivery are disclosed in Sanderson et al, US Patent 4,722,726 and fatty acid (eg, oleic acid) permeation enhancers -For electrotransport drug delivery are disclosed in Francoeur et al, US Patent 5,023,085.

Thus, in general, there is still a need for compositions which reduce the electrical resistance of the skin and, thus, increase agent electrotransport therethrough, producing an enhancement of the delivery rate of the agent while reducing the power requirements of the electrotransport device and/or the area of contact between the device and the body surface.

DISCLOSURE OF THE INVENTION
According to one broad aspect of the present invention, there is provided a formulation comprising: (a) an agent in a form suitable for electrotransport delivery;
and (b) a transdermal electrotransport composition comprising: (i) at least one C8-C14 linear, branched or cyclic alcohol or unsaturated derivatives thereof, or mixtures thereof; and (ii) at least one C2-C4 alcohol or unsaturated derivatives thereof, or mixtures thereof;
wherein the C8-C14 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 0.01 to 100 mM; and the C2-C4 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 0.5 to 30 % (v/v).

According to another broad aspect of the present invention, there is provided an electrotransport delivery device comprising donor and counter electrodes electrically connected to a power source; at least one of the electrodes having a reservoir comprising a formulation as described herein.

According to another broad aspect of the present invention, there is provided use of a composition for enhancing electrotransport flux of a pharmaceutically 6a acceptable agent in a form suitable for electrotransport delivery through a body surface, the composition comprising;
at least one C8-C14 linear, branched or cyclic alcohol or unsaturated derivatives thereof, or mixtures thereof; and at least one C2-C4 alcohol or unsaturated derivatives thereof, wherein the CB-C14 alcohol, unsaturated derivative thereof, or mixture thereof, is present in an amount of about 0.01 to 100 mM.

6b This invention arose from a desire to improve on prior art technology in the field of transdermal electrotransport delivery. This invention provides a composition that enhances the electrotransport flux of a drug or prodrug through a body surface such as skin. The permeation enhancing composition comprises in combination (1) at least one lower alcohol and (2) at least one higher alcohol, both of which may be linear branched, aromatic, and/or cyclic. The lower alcohol is preferably a C2-C4 alkanol or unsaturated derivatives thereof, and more preferably ethanol. The higher alcohol is preferably a C8-C14 alkanol or unsaturated derivatives thereof, more preferably a C,o-C,2 alkanol or unsaturated derivatives thereof. Of these higher alcohols, dodecanol and 1-dodecanol are most preferred.

The composition of the invention reduces the electrical resistance of body surfaces, such as the skin, mucosa, and nails, during electrotransport. agent delivery, and permits a reduction in the size of the delivery device and/or the power (ie, voltage) required to maintain a particular level of electrotransport current and rate of electrotransport agent delivery.

The present composition is suitable for use in reducing the electrical resistance of the body surface (eg, skin) site adjacent the donor electrode of an electrotransport delivery device, the skin site adjacent the counter electrode of the device, or both body surface sites. The permeation enhancer composition may be applied to the body surface prior to or during agent delivery, but the composition is preferably placed in the donor and/or counter reservoir of an electrotransport delivery device and is delivered to the body surface simultaneously with the agent.

Also provided herein is an electrotransport delivery device comprising.
donor and counter electrodes, at least one of the electrodes having a reservoir comprising the lower/higher alcohol composition, an electrical power source which is electrically connected to the donor and counter electrodes, and optionally electronic control circuitry.
The composition of the present invention may be used with different electrotransport devices for the delivery of a variety of pharmaceutically .acceptable agents, including those specifically disclosed herein. One particular application for which the composition is most suitable is the electrotransport 7a delivery of amine and amino acid containing agents. Other exemplary pharmaceutically acceptable agents include, without limitation, analgesics (e.g., opioids, fentanyl or a pharmaceutically acceptable analog thereof, including pharmaceutically acceptable fentanyl salts such as fentanyl hydrochloride, fentanyl esters, and sufentanil or a pharmaceutically acceptable salt thereof); proteins, peptides and polypeptides (e.g., insulin or analogs or mimics thereof or insulinotropin). Uses of the formulations and compositions of the invention are also provided, including, the use of analgesics for treating pain, and insulin, insulinotropin and related macromolecules for treating diabetes mellitus.

This invention will now be described in further detail with reference to the accompanying drawing.

BRIEF DESCRIPTION OF THE DRAWING

Figure 1 is a sectional view of one embodiment of an electrotransport device suitable for use with the permeation enhancing composition of the 5 present invention.

MODES FOR CARRYING OUT THE INVENTION

This invention arose form a desire to improve on prior art technology for the transdermal deiivery of pharmaceutically-acceptable agents, such as drugs or prodrugs, suitable for the prevention or treatment of disease in humans.
The present technology has particular application in the field of electrotransport delivery of pharmaceutically-acceptable agents (eg, drugs) and particularly agents containing amine groups and/or peptide groups.
This present invention, thus, provides a transdermal electrotransport permeation enhancing composition, comprising at least one lower alcohol, preferably a C2-C4 alkanol or unsaturated derivatives thereof, or mixtures thereof, and at least one higher alcohol, preferably a Cs-C14 alkanol or unsaturated derivative thereof, or mixtures thereof. An alcohol, as used herein, is defined as an alkyl compound having at least one hydroxyl (-OH) group, which may be saturated or unsaturated, linear, branched, cyclic and/or aromatic.
This definition also includes polyhydric alcohols having more than one hydroxyl group, such as glycols or diols. A "higher alcohol", as used herein, refers to a straight or branched chain or cyclic C8-C14 alcohol. The higher alcohol may be a primary, secondary or tertiary alcohol. Examples of higher alcohols include, without limitation, 1-dodecanol, 3-dodecanol, 1-decanol, 1-undecanol, 3-butyl-octanol, 4-pentyl-1-hexanol, and 5-propyl-2-decanol. The higher alcohol is ' preferably a straight chain alcohol having 10 to 12, and more preferably 12, carbon atoms. Preferred as a higher alcohol is dodecanol, and still more preferred is 1-dodecanol. A "lower alcohol", as used herein, encompasses an alcohol preferably having 2 to 4 carbon atoms. The lower alcohol may be a primary, secondary or tertiary alcohol including, without limitation, ethanol, propanol, 2-propanol, 1-butanol, 2-butanol, t-butyl alcohol, and unsaturated derivatives thereof. More preferably, the lower alcohol is ethanol or propanol, and still more preferably it is ethanol. The alcohols of the composition of this invention may have other substituents which do not interfere with the electrotransport delivery enhancing characteristics of the composition. The combination of the lower and higher alcohols in an electrotransport composition produces an unexpected enhancement of the transdermal electrotransport drug flux, which is accompanied by an unexpected reduction in skin resistance during electrotransport drug delivery, when compared with the drug flux and skin resistance when electrotransporting drug in the presence of either the lower alcohol or the higher alcohol alone.

An increase in the delivery rate of the agent and a decrease in the electrical resistance of the body surface are achieved by contacting the agent (eg, drug) to be delivered and the composition with the body surface while applying an electrical current through the composition, the agent, and the Ibody surface. More preferably, the composition of the invention is added directly to the donor reservoir, counter reservoir, or both reservoirs of an electrotransport delivery device. However, the body surface may also be treated with the lower/higher alcohol composition prior to the electrotransport delivery of ttie drug. In addition, it is possible to apply the lower/higher alcohol composition to the body surface after electrotransport delivery of the agent has been initiated.

The concentration of the higher alcohol in the fully hydrated donor 5 reservoir, ie, under reservoir conditions immediately prior to use, is preferably about 0.01 to 100 millimolar (mM). More preferably, the higher alcohol concentration is about 1 to about 50 mM, and still more preferabiy greater than 10 mM. The concentration of the lower alcohol in the donor reservoir is preferably about 0.5 to 30% (v/v), more preferably less than about 25% (v/v), 10 and still more preferably, 10 to 25% (v/v). I.none embodiment, the concentration of the lower alcohol is about 1 to 20% (v/v). In one particular preferred form of the device, the composition present in the donor reservoir preferabiy contains sufficient water to achieve greater than 50% ionization of the agent to be delivered. The concentration of the pharmaceutically-acceptable agent to be delivered may vary substantially, depending on the type of drug, its potency, and the like. The concentration of the agent in the fully hydrated donor.reservoir is generally about 1 microgram/mL ( g/mL) to 100,000 g/mL, and more preferably about 1000 g/mL to about 50,000 g/mL. Furthermore, the donor reservoir may contain other chemical species such as buffering agents, antioxidants, antimicrobial agents and agents that further increase the conductivity of the body surface or its permeability, and the like. Other suitable additives may be chosen to increase drug solubility and/or increase charged ion concentration. The donor reservoir may also contain additives which inhibit microbial growth or perform other functions unrelated to the delivery of the agent.

This invention is useful in the delivery of drugs or prodrugs within a broad class that are deliverabie through body surfaces and membranes, including the skin, mucosa and nails. As used herein, the expressions "agent", "drug" and "prodrug" are used interchangeably, and are intended in their broadest interpretation as any pharmaceutically-acceptable substance which may be delivered to a living organism to produce a desired, usually beneficial, effect. In general, this includes therapeutic agents in all of the major therapeutic fieldls including, but not limited to, anti-infectives such as antibiotics and antiviral agents; analgesics such as fentanyl, sufentanil, and buprenorphine, and analgesic combinations; anesthetics; anorexics; antiarthritics; antiasthmatic agents such as terbutaline; anticonvulsants; antidepressants; antidiabetics agents; antidiarrheals; antihistamines; anti-inflammatory agents;
antimigrairie preparations; antimotion sickness preparations such as scopolamine and ondansetron; antinauseants; antineoplastics; antiparkinsonism drugs;
antipruritics; antipsychotics; antipyretics; antispasmodics including gastrointestinal and urinary; anticholinergics; sympathomimetrics; xanthine derivatives; cardiovascular preparations including calcium channel blockers such as nifedipine; beta-agonists such as dobutamine and ritodrine; beta blockers; antiarrythmics; antihypertensives such as atenolol; ACE inhibitors such as ranitidine; diuretics; vasodilators including general, coronary, peripheral and cerebral; central nervous systems stimulants; cough and cold preparations;
decongestants; diagnostics; hormones such as parathyroid hormones;
hypnotics; immunosuppressives; muscle relaxants; parasympatholytics;
parasympathomimetrics; prostagiandins; proteins; peptides; psychostimularits;
sedatives and tranquilizers.

More specifically, this invention is useful for the controlled delivery of baclofen, beclomethasone, betamethasone, buspirone, cromolyn sodium, diltiazem, doxazosin, droperidol, encainide, fentanyl, hydrocortisone, indomethacin, ketoprofen, lidocaine, methotrexate, metoclopramide, micon<azole, midazolam, nicardipine, piroxicam, prazosin, scopolamine, sufentanil, terbutaline, testosterone, tetracaine, and verapamil, among other drugs.

The invention is particularly useful in the controlled delivery of peptides, polypeptides, proteins, or other macromolecules difficult to deliver transdermally or transmucosally because of their size. These macromolecular substances typically have a molecular weight of at least about 300 Daltons, and more typically, in the range of about 300 to 40,000 Daltons. Examples of peptides and proteins which may be delivered in accordance with the present invention include, without limitation, LHRH, LHRH analogs such as buserelin, gonadorelin, naphrelin and leuprolide, GHRH, GHRF, insulin, insulinotropin, heparin, calcitonin, octreotide, endorphin, TRH, NT-36 (chemical name: N-[[(s)-4-oxo-2-azetidinyl]carbonyl]-L-histidyl-L-prolinamide], liprecin, pituitary hormones (eg, HGH, HMG, HCG, desmopressin acetate), follicle luteoids, a-ANF, growth factor releasing factor (GFRF), f3-MSH, somatostatin, bradykinin, somatotropin, platelet-derived growth factor, asparaginase, bleomycin sulfate, chymopapain, cholecystokinin, chorionic gonadotropin, corticotropin (ACTH), erythropoietin, epoprostenol (platelet aggregation inhibitor), glucagon, hirudin and hirudin analogs such as hirulog, hyaluronidase, interferon, interieukin-2, menotropins (urofollitropin (FSH) and LH), oxytocin, streptokinase, tissue plasminogen activator, urokinase, vasopressin, desmopressin, ACTH analogs, ANP, ANP
clearance inhibitors, angiotensin II antagonists, antidiuretic hormone agonists, antidiuretic hormone antagonists, bradykinin antagonists, CD4, ceredase, CSF's, enkephalins, FAB fragments, IgE peptide.suppressors, IGF-1, neurotrophic factors, colony stimulating factors, parathyroid hormone and agonists, parathyroid hormone antagonists, prostagiandin antagonists, pentigetide, protein C, protein S, renin inhibitors, thymosin alpha-1, thrombolytics, TNF, vaccines, -vasopressin antagonist analogs, alpha-1 antitrypsin (recombinant), and TGF-beta.

One example of an electrotransport device suitable for use with the present invention is illustrated in Figure 1. Device 10 has two current distributing members or electrodes, comprised of electrically conductive materials, referred to herein as donor electrode 12 and counter electrode 14.
The electrodes may be composed of any materials which are sufficiently electrically conductive, including without limitation, silver, silver chloride, zinc, carbon, and stainless steel. The electrodes may be present in a variety of forms including a metal foil or screen, a polymer film having an electrically conductive coating or a polymer matrix containing an electrically conductive filler, eg, powdered carbon or metal, formed by conventional processes such as exl:ruding, calendering, film evaporation, or spray coating. In Figure 1, the donor and counter electrodes 12 and 14 are positioned adjacent to, and in electrical contact with, donor reservoir 16 and counter reservoir 18, respectively. Tlhe donor reservoir 16 contains a solution of the beneficial agent (eg, a drug) to be delivered, while the counter reservoir 18 contains a solution of a biocompatible electrolytic salt such as sodium chloride or optionally another beneficial agent to be delivered. The reservoirs 16 and 18 are formed of any material adapted to absorb and hold a sufficient quantity of liquid therein in order to permit the:
passage of the agent therethrough by electrotransport. Since water is the preferred liquid solvent for forming the solutions contained in reservoirs 1 13 and 18, the reservoirs preferably contain one or more hydrophilic polymers such as polyvinylpyrrolidone, polyvinyl alcohol, or polyethylene glycols, optionally mixed with a hydrophobic polymer such as polyisobutylene, polyethylene, and/or polypropylene. An electrical insulator 20 is positioned between (i) the donor electrode 12 and the donor reservoir 16, and (ii) the counter electrode 14 and the counter reservoir 18. The insulator 20, may be an air gap or a material which conducts neither electrons nor ions to a substantial extent, and prevents the device 10 from short-circuiting through a path which does not include the body surface 40, to which the device 10 is applied. The device 10 optionally includes a backing layer 22 composed of a liquid-impermeable non-conducting material.

The device 10 has an electronic circuit, illustrated schematically in Figure 1 as layer 24, having an electric power source, eg, one or more batteries, therein. Typically, the electronic circuit layer 24 is relatively thin and is preferably comprised of electronically conductive pathways, which are printed, painted or otherwise deposited on a thin, flexible substrate such as, for example, a film or polymeric web. The electronic circuit layer 24 is, for example, a printed flexible circuit. In addition to the power source, the electronic circuit layer 24 may also include one or more electronic components which control the level, waveform shape, polarity, timing, etc, of the electric current applied by the device 10. For example, the circuit layer 24 may contain one or more elements of control circuitry such as a current controller, eg, a resistor or a transistor-based current control circuit, an on/off switch, and/or a microprocessor adapted to control the current output of the power source over time. The outputs of the circuit layer 24 are electrically connected to the electrodes 12 and 14, so that at any one time each electrode is in electrical contact with an opposite pole of the power source within the circuit layer 24.

WO 96/14870 PCTlUS95/14175 In this embodiment, the device 10 adheres to the body surface by imeans of a peripheral adhesive layer 28. The device may optionally contain an in-line adhesive layer, ie an ion-conducting adhesive layer positioned between reservoirs 16, 18 and the body surface, eg, the skin surface. An in-line adlhesive 5 must be composed of an ion-transmitting material, ie beneficial agent ions must be capable of passing through the adhesive layer to reach the body surface.
Optional flux control membranes 30 and 32, such as those disclosed in Theeuwes et al, US Patents 5,080,646; 5,147,296; and 5,169,382, are positioned between the donor reservoir 16 and the body surface 40 and between 10 the counter reservoir 18 and the body surface 40, respectively, in order to limit or control the amount of passive, ie non-electrically assisted, flux of agent to the body surface 40.

The invention will be further described by reference to the following 15 examples, wherein human cadaver skin electrical resistivity and drug flux were measured for various permeation enhancer compositions.

EXAMPLES
Preparation of Human Cadaver Skin Skin strips having a thickness of 1 mm were removed from a human cadaver with an electric dermatome. These skin strips were placed in polyethylene bags, sealed and placed in a. refrigerator at 4 C for temporanl storage. Prior to use in an electrotransport cell, the skin strips were placed in 1 liter beakers containing water at 60 C for about 90 seconds, and gently stirred.
The skin strips were then removed, and placed onto the absorbent side of a piece of BENCHKOTE fabric with their dermis side down. The epidermis was removed from each strip with a round-tip spatula, and flat tipped tweezers to retain the dermis. Each epidermis, stratum comeum side up, was then transferred to a 5 cm deep PYREX*glass tray filled with water. Each floating epidermis was stretched essentially flat, and then removed from the water, and 2.2 cm diameter disks of each epidermis were punched out of areas having no observable surface damage. The disks were stored at 4 C in a sealed container with water drop!ets to maintain their moisture.

Experimental Set-up for Electrotransport The disks were mounted between the donor and receptor compartments, with the stratum comeum side facing the donor compartment, of'a 2-compartment polycarbonate electrotransport permeation cell. The volume of each compartment was about 2 mL and the area between the two compartments, ie, the exposed area for transport, was about 1.26 cm2.

An aqueous solution of the drug being transdermally delivered and the selected permeation enhancer composition, if any, was placed in the donor compartment. Dulbecco's phosphate buffered saline (approximately 0.15 N
NaCI, pH 7.0) was placed in the receptor compartment.

The rate of transport of drug and the electrical resistance of the skin were monitored throughout the experiments while applying an electric current.
The cell was maintained at 32 C by a Haake Model Dl heating block/water bath. The electrodes were connected to a galvanostat, which *Trade-mark applied a constant current of 126 A (current density of 100 A/cm2) and monitored the voltage drop across the skin by placing two Ag/AgCl junctian reference electrodes, one each in the donor and receptor solutions, and measuring the voltage difference (AV) between the electrodes.
The resistance of the skin (R) was obtained from Ohm's law:
R=AV/i where i equals the applied current (ie, 126 A).
Example 1: Enhanced Effect of Composition of the Invention Over Either Component Alone on Agent Flux and Skin Resistance The following experiments were conducted to assess the effect of one composition of the invention, containing ethanol and dodecanol, on the transdermal delivery of sodium ketoprofen (ketoprofen anions) by electrotransport from a cathodic electrode. The electrotransport delivery cif ketoprofen in the presence of various enhancers was assessed side-by-side for comparative purposes. The enhancers used were as follows: (i) ethanol alone;
(ii) dodecanol alone; (iii) no enhancer; (iv) ethanol and dodecanol. The in;itial concentration of ketoprofen in the donor compartment was 100 mg/mL, and the donor solution had a pH (unbuffered) of 5.0 to 5.5. A silver chloride composite polymer electrode (cathode) was placed in the donor compartment, and a silver foil electrode (anode) was placed in the receptor compartment.
Each experiment was started by connecting the power source to the electrodes, and samples were automatically taken from the receptor compartment every one to two hours, except for overnight experimentatiori, using an Isco Model 2230 autosampler and a metering pump. The concentration of ketoprofen in the samples was determined by high performance liquid chromatography (HPLC) using a Shimadzu Model SCL-6B chromatograph.
Each run was conducted in triplicate, including the control, to minimize errors.
All cells were set-up with tissue from the same cadaver. The seiected permeation enhancer composition was placed in the donor compartment, while the control cell's donor compartment contained no enhancer.

Flux and voltage measurements generally reached steady state after about 4 hours of cell operation. The steady state flux values and calculated skin resistances are shown in Table 1 in normalized form, ie, all values are divided by their respective control value.

Table 1: Comparison of Effect on Agent Flux and Skin Resistance of Lower or Higher Alcohol Alone, and Composition of Invention Permeation Enhancer(s) Normalized Normalized Skin Ketoprofen Resistance Flux Control 1.00 1.00 (No Enhancer) Ethanol 1.24 0.47 (25% v/v) Dodecanol 1.93 0.39 (<100mM) Dodecanol (< 100 mM) 10.15 0.06 and Ethanol (20% v/v) *Trade-mark As Table 1 above illustrates, the addition of ethanol alone produced a reduction in skin resistance to 0.47 with respect to 1 for the control (more than a 50% reduction in skin resistance), while the addition of dodecanol alone produced a reduction in skin resistance to 0.39 with respect to the value of 1 for the control (almost a 60% reduction in skin resistance).

The composition containing both dodecanol and ethanol, however, produced an unexpectedly greater reduction in skin resistance to only 0.06 with respect to the value of 1 for the control (a reduction in skin resistance of greater than 94%). In addition, ethanol alone increased the rate of delivery of ketoprofen by only 24%, and dodecanol alone increased it by 93%. The ethanol/dodecanol composition, representative of the invention, produced ein unexpected enhancement of ketoprofen electrotransport flux, which was more than 10 times greater than the control.

Although ethanol is present in slightly different amounts when tested alone (25% v/v) and with dodecanol (ethanol 20%v/v) as an enhancer, this difference in its concentration does not significantly alter its effect. This is confirmed in Example 2.

Example 2: Measurement of Metoclopramide Flux with Ethanol/Dodecanol as Enhancer in Comparison with Ethanol Alone as Enhancer (Comparison of Invention with Prior Art) The experimental conditions were identical to those described in Example 1, except an aqueous solution of metoclopramide HCI, instead of sodium ketoprofen, was placed in the donor compartment. In addition, the silver chloride cathode was placed in the receptor compartment and the silver foil anode was placed in the donor compartment since metoclopramide ions are cationic as opposed to ketoprofen ions which are anionic. The concentration of metoclopramide in the donor solution was about 100 mg metoclopramide/mL, and saiine pH 7 was placed in the receptor compartment. The system was =
5 maintained at 32 C and a constant electric current of 100 A/cm2 was applied throughout the procedure.

All runs had the same concentration of agent and other conditions, except for the following shown in Table 2.
Table 2: Content of Enhancer (Ethanol), Metoclopramide Flux and Cell Voltage Enhancer Normalized Metoclopramide Normalized # Type Amt n Mass Flux Skin Resistance (wt%) (after 5 hrs) (after 5 hrs) I None 0 1 1.00 1.00 2 Ethanol 10 3 0.86 1.32 3 Ethanol 20 3 0.73 1.13 4 Ethanol 30 3 0.93 1.26 5 Dodecanol 2 Ethanol 30 3 1.55 0.50 The mass flux and skin resistance values were normalized versus the control. The second column from the right shows the normalized values versus the electrotransport fiux of metoclopramide in the absence of any permeation enhancer (first line). The skin resistance (which was calculated from the measured cell voltage AV using Ohm's law, R=i/AV) was also normalized with respect to the value obtained by electrotransport of metoclopramide in the absence of any permeation enhancer (rightmost column). These values hEive been provided to permit a comparison with the values for the permeation enhancing compositions shown in Table 1. For example, when dodecanol was utilized in the presence of 30 wt% ethanol, the electrotransport mass flux of metoclopramide was enhanced by over 50% and the skin resistance was lowered to one-half the resistance of the control. However, the use of ethanol alone as a flux enhancer is shown in Table 2 not to enhance, but to actually decrease, the mass flux of metoclopramide and increase the resistance of 1the skin during electrotransport delivery of metoclopramide.

Having thus generally described the invention, and described in detiail certain preferred embodiments thereof, it will be readily apparent that various modifications to the invention may be made by those skilled in the art withciut departing from the scope of this invention, which is limited only by the followving claims.

~

Claims (33)

CLAIMS:

1. A formulation comprising:

(a) an agent in a form suitable for electrotransport delivery; and (b) a transdermal electrotransport composition comprising:

(i) at least one C8-C14 linear, branched or cyclic alcohol or unsaturated derivatives thereof, or mixtures thereof; and (ii) at least one C2-C4 alcohol or unsaturated derivatives thereof, or mixtures thereof;

wherein the C8-C14 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 0.01 to 100 mM; and the C2-C4 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 0.5 to 30 % (v/v).

2. The formulation of claim 1, wherein the composition further comprises an aqueous solvent.

3. The formulation of claim 1 or 2, wherein the C8-C14 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 1 to 50 mM; and the C2-C4 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 1 to 20 % (v/v).

4. The formulation of any one of claims 1 to 3, wherein the C2-C4 alcohol is ethanol.

5. The formulation of any one of claims 1 to 4, wherein the C8-C19 alcohol is dodecanol.

6. The formulation of claim 5, wherein the dodecanol is 1-dodecanol.

7. The formulation of any one of claims 1 to 6, wherein the agent suitable for electrotransport delivery is a beneficial pharmaceutically acceptable agent.

8. The formulation of any one of claims 1 to 6, wherein the agent is an analgesic.

9. The formulation of claim 8, wherein the agent is an opioid.

10. The formulation of any one of claims 1 to 6, wherein the agent is fentanyl or a pharmaceutically acceptable analog thereof.

11. The formulation of claim 10, wherein the agent is fentanyl or a pharmaceutically acceptable salt or ester thereof.

12. The formulation of claim 11, wherein the agent is fentanyl.

13. The formulation of claim 11, wherein the agent is fentanyl hydrochloride.

14. The formulation of claim 10, wherein the agent is sufentanil or a pharmaceutically acceptable salt thereof.

15. The formulation of any one of claims 8 to 14 for treating pain.

16. The formulation of any one of claims 1 to 6, wherein the agent is a protein.

17. The formulation of any one of claims 1 to 6, wherein the agent is a polypeptide.

18. The formulation of any one of claims 1 to 6, wherein the agent is a peptide.

19. The formulation of any one of claims 1 to 6, wherein the agent is insulin or an analog or mimic thereof.

20. The formulation of claim 21, wherein the agent is insulin.

21. The formulation of any one of claims 1 to 6, wherein the agent is insulinotropin.

22. The formulation of any one of claims 19 to 21 for treating diabetes mellitus.

23. An electrotransport delivery device comprising donor and counter electrodes electrically connected to a power source;

at least one of the electrodes having a reservoir comprising the formulation of any one of claims 1 to 22.

24. The device of claim 23, wherein the donor electrode contains the formulation of any one of claims 1 to 22.

25. Use of the formulation of claim 8, 9, 10, 11, 12, 13 or 14 for treating pain in a human patient in need thereof.

26. Use of the formulation of claim 19, 20 or 21 for treating diabetes mellitus.

27. Use of a composition for enhancing electrotransport flux of a pharmaceutically acceptable agent in a form suitable for electrotransport delivery through a body surface, the composition comprising;

at least one C8-C14 linear, branched or cyclic alcohol or unsaturated derivatives thereof, or mixtures thereof; and at least one C2-C4 alcohol or unsaturated derivatives thereof, wherein the C8-C14 alcohol, unsaturated derivative thereof, or mixture thereof, is present in an amount of about 0.01 to 100 mM.

28. The use of claim 27, wherein the pharmaceutically acceptable agent is dissolved in an aqueous solvent.

29. The use of claim 27 or 28, wherein the C2-C4 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 0.5 to 30 % (v/v).

30. The use of claim 27 or 28, wherein the C8-C14 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 1 to 50 mM; and the C2-C4 alcohol, unsaturated derivative thereof, or mixture thereof, is present in the composition in an amount of about 1 to 20 %(v/v).

31. The use of any one of claims 27 to 30, wherein the C2-C4 alcohol is ethanol.

32. The use of any one of claims 27 to 31, wherein the C8-C14 alcohol is dodecanol.

33. The use of claim 32, wherein the dodecanol is 1-dodecanol.