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ENHANCED DRUG DELIVERY IN tion, there are some applications where it is desirable to have
TRANSDERMAL SYSTEMS a greater crystal inhibiting effect.
This application is a continuation of application Ser. No. SUMMARY OF THE INVENTION
09/948,107, filed Sep. 7, 2001, which claims priority to U.S. 5
Provisional Application No. 60/298,381, filed Jun. 18,2001. P1 . . . , ,. ,
One object ol the invention is to overcome the disadvan
BACKGROUND OF THE INVENTION tages of the known art described above. Another object of the
invention is to provide a transdermal drug delivery system
1 Field of the Invention 10 that has an improved flux of steroid compared to a system of
The present invention relates to transdermal drug delivery equal size. Still another object of the invention is to provide a
systems. In particular, the present invention relates to trans- composition that has reduced, or no, crystal formation in the
dermal drug delivery systems for delivering steroids, and to transdermal drug delivery system.
methods of making and using the same. ^ In accomplishing the foregoing and other objects, there has
2. Description of the Related Art been provided according to one aspect of the present inven
The use of a transdermal drug delivery system, for example tion a composition5 preferably a dermal composition, result
a pressure-sensitive adhesive containing a medicament, j from an admixture that includes: a therapeutically effec
namely, a drug, as a means lor administering therapeutically ^. ^ „ , ^. ^1 ^- 1 1
„ J '„^ ,. ^ . ,, , „ , tive amount oi a pharmaceuticals active agent that includes a
effective amounts oi the medicament is well known. Such .
known delivery systems involve incorporation of a medica- 20 sterold ^ a corresponding steroid derivative that provides a ment into a carrier such as a polymeric and/or a pressure- source of therapeutically active steroid; and a carrier for the sensitive adhesive formulation or other forms of carriers. The pharmaceutically active agent, wherein the steroid and stepressure-sensitive adhesive must adhere effectively to the roid derivative are present in a weight ratio of 10:1 to 1:10 skin and permit migration of the medicament from the carrier steroid: steroid derivative. In a preferred embodiment, the through the skin and into the bloodstream of the patient. steroid derivative is a steroid ester. In another preferred Steroids such as estradiol and norethindrone are especially embodiment the carrier is a polymer that includes a pressurewell known for use in transdermal drug delivery systems, in sensitive adhesive.
particular, as hormone replacement therapy. These steroids . ,. ^, ^ „ ^, . ^. ^, ,
, i • • ^ i-ii 1 J; ^ v i ^ According to another aspect oi the invention, there has
may be administered singularly, such as the estradiol trans- . . .
dermal drug delivery system sold under the trademark 3° been provided a method of making a composition described
Vivelle® and Vivelle-DotTMmanufactured by Noven Pharma- above that includes forming a mixture of the steroid, corre
ceuticals, Inc. of Miami, Fla. See also U.S. Pat. No. 6,221, sponding steroid derivative and carrier. Preferably, the carrier
383. Alternatively, two or more steroids may be administered is a polymer and the method further includes: forming the
together, such as the estradiol/norethindrone acetate transder- 35 blend into a polymer matrix; and drying the polymer matrix to
mal drug delivery system sold under the trademark Combi- remove volatile solvents to form the composition.
Patch® also manufactured by Noven Pharmaceuticals. See » . . f ■ .
TT^„ „T ^ ,„„„^ , TT^„ „T r- . According to another aspect oi the invention, there has
also U.S. Pat. No. 6,221,383. See also U.S. Pat. No. 5,474, , .,6, t, , ,t F . , . , V1
been provided a method oi treating a human or an animal with
....... ^ ^ a therapeutically effective amount of a pharmaceutically
transdermal drug delivery systems with more than one d(] . . . .
drug are generally more difficult to formulate in view of active agent, that includes the steps of: applying to the skin of
different interactions with each drug and the carrier, excipi- an ammal or human belng'the composition descnbed above;
ents, etc., even the other drug present. In addition, govern- and maintaining the composition in contact with the skin for
ment agencies that regulate pharmaceutical products, such as a predetermined length of time sufficient to administer the
the FDA in the United States, require more testing of multiple 45 therapeutically amount of the active agent,
drugs, individually as well as together to establish efficacy. Further ... features aad advantages of the present
Thus, when a steroid is administered, it is generally admin- invention will become apparent from the detailed description
istered in one form only (e.g., norethindrone or norethindrone „ „ , ... ^ i-i.ru
iiX„ TTo T^ixt ^1 .in n-n- oi preferred embodiments which follows,
acetate). See, e.g., U.S. Pat. No. 6,149,935. F
The use of a steroid as an additive to act as a crystallization 50 inhibitor in transdermal drug delivery devices where the drug is a hormone is described in WO 99/15156. WO 99/15156
teaches the steroid is present in the device in an amount FIG. 1 is a graph illustrating the drug flux from a compo
insufficient to provide significant pharmaceutical or physi- sition containing norethindrone acetate and estradiol, and a
ological effect. Other patents include U.S. Pat. Nos. 5,633, 55 composition containing combined norethindrone/norethin
242; 4,906,169; 5,711,962; 6,153,216; 5,898,032; 5,811,117; drone acetate wd estradiol.
''' FIG. 2 is a graph illustrating the flux of norethindrone
One problem in the delivery of steroids from transdermal ... from a osition containing norethindrone acetate
drug delivery systems lies in the rate oi drug release (com- JtJ-i 1 • j *i • j / *i • j
, ,, . „n r , , and estradiol, combined norethindrone/norethindrone acetate
monly called flux or permeation rate ) from the transder- 60 „ ^ . . ^ . , , ^ . ,
, . „ -r- 1,r +1 1- +■ ■ irom a composition contaimng norethindrone/norethindrone
mal system. Specifically, there are many applications in , r
,. , ., ,,, j-11-1 . a J- * -j acetate and estradiol, and norethindrone from a composition
which it would be desirable to have a greater flux 01 steroid . . . r
from the system. Another problem in the delivery of steroids containing norethindrone and estradiol, is the tendency for steroids to crystallize in the carrier of the FIG. 3 is a graph illustrating the drug flux of combined transdermal system. This results in less steroid being avail- 65 testosterone/testosterone acetate from a composition containable for transdermal administration. Although the addition of ing testosterone/testosterone acetate, the flux of testosterone solublilzing agents, such as PVP, help to inhibit crystalliza- acetate from the same composition, the flux of testosterone
BRIEF DESCRIPTION OF THE FIGURES
from the same composition and the flux of testosterone from a transdermal drug delivery system called Testoderm® sold by Alza, Inc.
DETAILED DESCRIPTION OF PREFERRED 5
The present invention provides, inter alia, a transdermal drug delivery composition for administration of a therapeutically effective amount of a steroid, particularly transdermal 10 compositions having a greater flux than known compositions.
As used herein, "transdermal" delivery is intended both transdermal (or "percutaneous" or "dermal") and transmucosal administration, i.e., delivery by passage of a drug through the skin or mucosal tissue and into the bloodstream. 15
As used herein, the term, "flux" (also called "permeation rate") is defined as the absorption of the drug through the skin or mucosa, and is described by Fick's first law of diffusion:
where J is the flux in g/cm2/sec, D is the diffusion coefficient of the drug through the skin or mucosa in cm2/sec and dCm/ dx is the concentration gradient of the drug across the skin or mucosa.
As used herein, a steroid is defined as a family of lipid compounds that includes the sterols, bile acids, cardiac glycosides, saponins, corticoid steroids andhormones. The basic structure of the steroid is a well known 4 ring fused structure.
Useful for this invention are steroids having a free hydroxy 30 group at a position on the steroid ring, such as the 17-position, the 3-position, or at the 11 -postion on the fused ring. Particularly preferred are hormones such as estrogens, progestins, and androgens. The corresponding steroid derivative is defined as a corresponding structure to the steroid where the 35 free hydroxy at the 3, 11 or 17 postion has been reacted with an alcohol reactive moiety. Particularly preferred are steroid derivatives reacted at the 17 position. Regardless of whether the steroid or the corresponding steroid derivative is incorporated in the carrier composition as the dominant drug, each 40 provides a source of steroid in the bloodstream to achieve the intended physiological effect which, in the case of the corresponding steroid derivative, occurs through metabolic conversion of the derivative.
A steroid ester is the corresponding structure to the steroid 45 where the free hydroxy group on the ring has been esterified. Examples of a steroid and its corresponding ester include estradiol and estradiol benzoate, estradiol 17-beta cypionate, estradiol 17 propionate, estradiol hemisuccinate (eutocol), estradiol enanthate, estradiol undecylate, etc. Another 50 example is testosterone and its corresponding ester of testosterone such as 17 beta-cypionate, testosterone enanthate, testosterone nicotinate, testosterone phenylacetate, testosterone propionate, etc. Also included are non-esters that have groups on the 17 position such as testosterone 17-chloral 55 hemiacetal, or ethers that have groups on the 3-position such as estradiol 3-methyl ether.
Other steroids that can be used include progestins such as allylestrenol, anagestone, desogestrel, dimethisterone, dydrogesterone, ethisterone, ethynodiol, gestodene, halo- 60 progesterone, 17-hydroxy-16-methylene-progesterone, 17.alpha. -hydroxyprogesterone, lynestrenol, medroxyprogesterone, melengestrol, norethindrone, norethynodrel, norgesterone, norgestimate, norgestrel, norgestrienone, norvinisterone, pentagestrone, and trimigestone. 65
Anabolic steroids can include androisoxazole, androstenediol, bolandiol, bolasterone, clostebol, ethylestrenol. formyl
dienolone, 4-hydroxy-19-nortestosterone, methandriol, methenolone, methyltrienolone, nandrolone, norbolethone, oxymesterone, stenbolone and trenbolone. Androgenic steroids can include boldenone, fluoxymesterone, mestanolone, mesterolone, methandrostenolone, 17-methyltestosterone, 17.alpha, -methyltestosterone 3-cyclopentyl enol ether, norethandrolone, normethandrone, oxandrolone, oxymesterone, oxymetholone, prasterone, stanlolone, stanozolol, testosterone, testosterone 17-chloral hemiacetal and tiomesterone.
Estrogens can include conjugated estrogenic hormones, equilenin, equilin, estradiol, estradiol benzoate, estradiol 17.beta.-cypionate, estriol, estrone, ethinyl estradiol and mixtures thereof.
Further steroids can include glucocorticoids such as 21-Acetoxyprefnenolone, Aalclometasone, Algestone, Amicinonide, Beclomethasone, Betamethasone, Budesonide, Chloroprednisone, Clobetasol, Blovetasone, Clocortolone, Cloprednol, Corticosterone, Cortisone, Cortivazol, Deflazacort, Desonide, Desoximetasone, Dexamethasone, Diflorasone, Diflucortolone, Difluprednate, Enoxolone, Fluazacort, Flucloronide, Flumehtasone, Flunisolide, Fluocinolone Acetonide, Fluocinonide, Fluocortin Butyl, Fluocortolone, Fluorometholone, Fluperolone, Fluprednidene, Fluprednisolone, Flurandrenolide, Formocortal, Halcinonide, Halometasone, Halopredone, Hydrocortamate, Hydrocortisone, Maziprednone, Medrysone, Meprednisone, Methyolprednisolone, Mometasone Furoate, Paramethasone, Prednicarbate, Prednisolone, Prednisone, Prednival, Prednylidene, Tixocortal, and Triamcinolone,
Also included are mineralcorticoids such as Aldosterone, Deoxycorticosterone and Fludrocortisone.
In typical known devices the corresponding steroid derivative is administered in view of crystallizations problems that occur with the use of the non-derivative steroid. The present inventors have discovered that when the steroid is administered together with its corresponding steroid derivative, a synergism in flux is observed as well as a reduction in crystallization. That is, the flux from the combination of steroid and steroid derivative is greater than the flux of an equal amount of steroid or steroid derivative alone. For example, in a system that contains estradiol and norethindrone acetate, the addition of norethindrone and a reduction in the amount of norethindrone acetate such that the combined amount equals the original amount of norethindrone acetate results in increased delivery of norethindrone/norethindrone acetate.
Another unexpected advantage of the present invention is that the total amount of steroid/corresponding steroid derivative delivered from the system is significantly greater than the amount drug from a composition containing the steroid or corresponding steroid derivative alone. For example, applicants have found that for compositions containing both norethindrone acetate and norethindrone, the total amount of steroid delivered from the system was 65% greater than a system containing a comparable amount of norethindrone acetate alone.
In order to achieve this synergistic effect, the weight ratio of steroid/corresponding steroid derivative is important. The ratio is preferably in the range of 10:1 to 1:10 steroidxorresponding steroid derivative. A more preferred ratio is in the range of 6:1 to 1:6 steroidxorresponding steroid derivative. The ratios providing the greatest synergism depend on the pharmaceutically active agents in the system. For example, for the administration of the corresponding steroid and steroid derivative alone, a greater amount of steroid relative to corresponding steroid derivative produces the greatest synergy. In this embodiment, a preferred ratio is 1:1 to 3:1, more preferably 3:2 to 5:2, even more preferably about 2:1. How5
ever, when an additional steroid is present (such as estradiol) the opposite ratio gives the greatest synergy. In this embodiment, a preferred ratio is 1:1 to 1:3, more preferably 2:3 to 2:5, even more preferably 1:2 steroidxorresponding steroid derivative. Any ratio that provides a synergistic flux is within 5 the scope of the present invention.
The inventors have also discovered that the combination of a steroid and its corresponding steroid derivative can assist in inhibiting crystallization of the steroid/corresponding steroid derivative in the transdermal composition. This is particularly 10 important for the next generation of transdermal drug delivery systems (particularly for hormone replacement therapy) that will be required to deliver a therapeutically effective amount of the steroid over the course of up to one week or more. To achieve an extended delivery, the steroid must often 15 be incorporated into the composition in a supersaturated state. However, supersaturation often leads to problems of crystallization. The inventors believe that that inclusion of both the steroid and steroid corresponding derivative into the carrier matrix (particularly the polymer matrix) functions to disrupt 20 each entities (i.e., steroid or its corresponding derivative) crystal lattice structure, thus inhibiting crystal formation. Some corresponding derivatives will work better than others in providing this disruption. For example, it has been found that testosterone propionate does not work as well as other 25 testosterone esters. Likewise, estradiol enanthate and propionate work much better than estradiol acetate in combination with estradiol.
Moreover, it further has been found that combinations of steroid derivatives also result in inhibiting crystallization of 30 the drug species in the transdermal carrier compositions, with certain derivatives again working better than others. As shown in Table I, the addition of estradiol methyl ether to estradiol acetate in a transdermal carrier composition significantly improves crystal inhibition, whereas the combination 35 of estradiol acetate and estradiol propionate shows no improvement, at the concentrations tested. The examples were observed through a microscope for crystal formation after two weeks maintained at 25° C. and a relative humidity of 65% to 70%, using a viewing field of 38.5 mm2.
effect, etc. The minimum amount of steroid/corresponding steroid derivative in the system is selected based on the amount of steroid/corresponding steroid derivative which passes through the skin in the time span for which the composition is to provide therapy. Normally, the amount of steroid/corresponding steroid derivative in the composition can vary from about 0.1% to about 50% by weight, and preferably, for the lower steroid/corresponding steroid derivative doses permitted by this invention, from about 0.3% to about 20%. Other possible ranges can include 0.1% to 10%, or 0.1% to 6% by weight.
The steroid is present in a carrier. "Carrier" or "vehicle" as used herein refers to carrier materials suitable for transdermal drug administration, and include any such materials known in the art, e.g., any liquid, gel, solvent, liquid diluent, solubilizer, polymer or the like, which is nontoxic and which does not significantly interact with other components of the composition or the skin in a deleterious manner. The carrier is present in an amount sufficient to achieve its function of carrying the steroid/corresponding steroid derivative. Preferably, the carrier is present in an amount ranging from 2 to 99 wt %, more preferably 30 to 90 wt %, even more preferably 40 to 80 wt %. The carrier is preferably substantially free of water and more preferably contains no water.
Particularly preferred carriers are flexible, finite compositions . The phrase "flexible, finite system" is intended to mean a solid form capable of conforming to the surface with which it comes into contact, and which is capable of maintaining the contact in such solid form so as to facilitate topical application without adverse physiological response, and without being appreciably decomposed by aqueous contact during administration to a patient. Particularly preferred flexible, finite systems are polymer carriers such as pressure-sensitive adhesive matrix type in which the steroid/corresponding steroid derivative is dispersed directly in the pressure-sensitive adhesive or reservoir type carriers.
Illustrative examples of suitable adhesives as matrix type flexible, finite delivery systems include those described in U.S. Pat. Nos. 5,474,783, and 5,656,386 both assigned to
derivative is solubilized or contained in a reservoir or depot separate form the adhesive which attaches directly to the skin or mucosa.
As noted above, particularly preferred carriers are pressure-sensitive adhesive flexible, finite carriers. These can 5 include any viscoelastic material which adheres instantaneously to most substrates with the application of very slight pressure and remains permanently tacky. A polymer is a pressure-sensitive adhesive within the meaning of the term as used herein if it has the properties of a pressure-sensitive 10 adhesive per se or functions as a pressure-sensitive adhesive by admixture with tackifiers, plasticizers or other additives. The term pressure-sensitive adhesive also includes mixtures of different polymers and mixtures of polymers, such as polyisobutylenes (PIB), of different molecular weights, wherein 15 each resultant mixture is a pressure-sensitive. Other useful rubber based pressure-sensitive adhesives include hydrocarbon polymers such as natural and synthetic polyisoprene, polybutylene and polyisobutylene, styrene/butadiene polymers styrene-isoprene-styrene block copolymers, hydrocar- 20 bon polymers such as butyl rubber, halogen-containing polymers such as polyacrylic-nitrile, polytetrafluoroethylene, polyvinylchloride, polyvinylidene chloride, and polychlorodiene, and other copolymers thereof.
Other useful pressure-sensitive adhesives ("PSA") can 25 include acrylic-based pressure-sensitive adhesives and silicone-based pressure-sensitive adhesives as described in U.S. Pat. Nos. 5,474,783, and 5,656,386. Suitable commercially available acrylic-based polymers can include adhesives are commercially available and include the polyacrylate adhe- 30 sives sold under the trademarks Duro-Tak by National Starch and Chemical Corporation, Bridgewater, N.J., such as DuroTak 87-2194, Duro-Tak 87-2196, Duro-Tak 87-1197, 87-4194, 87-2510, 87-2097 and 87-2852. Other suitable acrylic-based adhesives are those sold under the trademarks 35 Gelva-Multipolymer Solution (GMS) (Monsanto; St. Louis, Mo.), such as GMS 737, 788, 1151, 3087 and 7882.
Suitable silicone-based pressure-sensitive adhesives can include those described in Sobieski, et al., "Silicone Pressure Sensitive Adhesives," Handbook of Pressure-Sensitive Adhe- 40 sive Technology, 2nd ed., pp. 508-517 (D. Satas, ed.), Van Nostrand Reinhold, New York (1989), incorporated by reference in its entirety. Other useful silicone-based pressure sensitive adhesives are described in the following U.S. Patents: U.S. Pat. Nos. 4,591,622; 4,584,355; 4,585,836; and 4,655, 45 767. Suitable silicone-based pressure-sensitive adhesives are commercially available and include the silicone adhesives sold under the trademarks BIO-PSA 7-4503, BIO-PSA 7-4603, BIO-PSA 7-4301,7-4202,7-4102,7-4106, andBIOPSA 7-4303 by Dow Corning Corporation, Medical Prod- 50 ucts, Midland, Mich.
The amount of the polymer carrier can range from 2 to 99 wt %, preferably, 30 to 90 wt %, even more preferably 40 to 80 wt %.
The pressure-sensitive adhesives can be blended to modu- 55 late the solubility of the steroid in the carrier system such as described in the '783 patent. In a particularly preferred embodiment of the invention, the multiple polymer adhesive system comprises a pressure-sensitive adhesive blend of an acrylic-based polymer, a silicone-based polymer, and a 60 soluble PVP (described below). The acrylic-based polymer and silicone-based polymer are preferably in a ratio by weight, respectively, from about 2:98 to about 96:4, more preferably from about 2:98 to about 90:10, and even more preferably about 2:98 to about 86:14. The amount of acrylic- 65 based (also referred to broadly as a polyacrylate) polymer and silicone-based polymer (also referred to broadly as a polysi
loxane) is adjusted so as to modify the saturation concentration of the steroid/corresponding steroid derivative in the ternary multiple polymer adhesive system in order to affect the rate of delivery of the steroid/corresponding steroid derivative from the system and through the skin. Other useful ranges include about 5-85% by weight of the acrylate-based polymer, 10-90% by weight of polyisobutylene and 5-95% by weight of silicone-based polymer.
The transdermal drug delivery system can also contain agents known to accelerate the delivery of the steroid/corresponding steroid derivative through the skin. These agents have been referred to as skin-penetration enhancers, accelerants, adjuvants, and sorption promoters, and are collectively referred to herein as "enhancers" and are described in U.S. Pat. No. 6,221,383. They can include polyhydric alcohols such as dipropylene glycol, propylene glycol, and polyethylene glycol which enhance steroid/steroid derivative solubility; oils such as olive oil, squalene, and lanolin; fatty ethers such as cetyl ether and oleyl ether; fatty acid esters such as isopropyl myristate which enhance steroid/corresponding steroid derivative diffusibility; urea and urea derivatives such as allantoin which affect the ability of keratin to retain moisture; polar solvents such as dimethyldecylphosphoxide, methyloctylsulfoxide, dimethyllaurylamide, dodecylpyrrolidone, isosorbitol, dimethylacetonide, dimethylsulfoxide, decylmethylsulfoxide, and dimethylformamide which affect keratin permeability; salicylic acid which softens the keratin; amino acids which are penetration assistants; benzyl nicotinate which is a hair follicle opener; and higher molecular weight aliphatic surfactants such as lauryl sulfate salts which change the surface state of the skin and drugs administered. Other agents include oleic and linoleic acids, ascorbic acid, panthenol, butylated hydroxytoluene, tocopherol, tocopheryl acetate, tocopheryl linoleate, propyl oleate, and isopropyl palmitate. Particularly preferred are combinations of polyhydric alcohols such as glycerine, dipropylene glycol, butylene glycol, propylene glycol and one or more of oleyl alcohol and oleic acid.
In some embodiments, the invention can also include a plasticizer or tackifying agent is incorporated into the formulation to improve the adhesive characteristics of the pressuresensitive adhesive composition. Such plasticizers or tackifying agents include: (1) aliphatic hydrocarbons; (2) mixed aliphatic and aromatic hydrocarbons; (3) aromatic hydrocarbons; (4) substituted aromatic hydrocarbons; (5) hydrogenated esters; (6) polyterpenes; and (7) hydrogenated wood rosins.
The tackifying agent employed is preferably compatible with the blend of polymers. In preferred embodiments, the tackifying agent is silicone fluid (e.g., 360 Medical Fluid, available from Dow Corning Corporation, Midland, Mich.) or mineral oil. Silicone fluid is useful for blends comprising polysiloxane as a major component. In other embodiments, where a synthetic rubber, for example, is a major component, mineral oil is a preferred tackifying agent.
For steroid/corresponding steroid derivative molecules which are not readily soluble in the polymer system, a cosolvent for the steroid/corresponding steroid derivative and polymer can be added. Co-solvents, such as lecithin, retinal derivatives, tocopherol, dipropylene glycol, triacetin, propylene glycol, saturated and unsaturated fatty acids, mineral oil, silicone fluid, alcohols, butyl benzyl phthalate, and the like are useful in the practice of the instant invention depending on the solubility of the steroid/corresponding steroid derivative in the multiple polymer adhesive system.
In addition to the use of the steroid/steroid derivative combinations to inhibit crystallization, other crystallization inhib