CA2132865C - Transdermal administration of oxybutynin - Google Patents
Transdermal administration of oxybutynin Download PDFInfo
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- CA2132865C CA2132865C CA002132865A CA2132865A CA2132865C CA 2132865 C CA2132865 C CA 2132865C CA 002132865 A CA002132865 A CA 002132865A CA 2132865 A CA2132865 A CA 2132865A CA 2132865 C CA2132865 C CA 2132865C
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- A—HUMAN NECESSITIES
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
- A61K9/7023—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms
- A61K9/703—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms characterised by shape or structure; Details concerning release liner or backing; Refillable patches; User-activated patches
- A61K9/7038—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer
- A61K9/7046—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds
- A61K9/7053—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds obtained by reactions only involving carbon to carbon unsaturated bonds, e.g. polyvinyl, polyisobutylene, polystyrene
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- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
- A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
- A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
- A61K31/216—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acids having aromatic rings, e.g. benactizyne, clofibrate
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
- A61K47/14—Esters of carboxylic acids, e.g. fatty acid monoglycerides, medium-chain triglycerides, parabens or PEG fatty acid esters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0014—Skin, i.e. galenical aspects of topical compositions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
- A61K9/7023—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms
- A61K9/703—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms characterised by shape or structure; Details concerning release liner or backing; Refillable patches; User-activated patches
- A61K9/7084—Transdermal patches having a drug layer or reservoir, and one or more separate drug-free skin-adhesive layers, e.g. between drug reservoir and skin, or surrounding the drug reservoir; Liquid-filled reservoir patches
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- A61P13/00—Drugs for disorders of the urinary system
- A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P15/00—Drugs for genital or sexual disorders; Contraceptives
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
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Abstract
The present invention is directed to the transdermal administration of oxybutynin together with a suitable permeation en-hancer. The invention includes a transdermal drug delivery device comprising a matrix adapted to be placed in oxybutynin- and permeation enhancer-transmitting relation with the skin site. The matrix contains sufficient amounts of a permeation enhancer and of oxybutynin, in combination, to continuously administer to the skin for a predetermined period of time the oxybutynin to provide an effective therapeutic result. The invention is also directed to a method for the transdermal administration of a thera-peutically effective amount of oxybutynin together with a skin permeation-enhancing amount of a suitable permeation enhancer.
Description
,..
WO 93/23025 ~ ~ ~ ~' ~~ ~ ~ PCT/US93/04518 TRANSDERMAL ADMINISTRATION OF OXYBUTYNIN
FIELD OF THE INVENTION
This invention relates the efficacious and safe, controlled transdermal administration of oxybutynin and related compounds for s ~ the treatment of neurogenic bladder disorders.
BACKGROUND OF THE INYEION
Neurogenic bladder disease is.a disorder involving loss of control of urination. The major symptoms of this disease are urinary frequency, urinary retention or incontinence. There are two types of ~o lesions that cause a neurogenic bladder. The first, upper motoneuron lesion, leads to hypertonia and hyperreflexia of the bladder, a spastic condition, giving rise to symptoms of urinary frequency and incontinence. The second lesion, a lower motoneuron lesion, involves hypotonia and hyporeflexia of the bladder. The major symptoms in is this condition are urinary retention, since the voiding reflex has been lost, and incontinence, which occurs when the bladder "leaks", being foil to overflowing.
The majority of neurogenic bladder patients have the spastic or hypertonic bladder. The clinician usually attempts to convert the Zo condition of hyperreflexia and hypertoni.a to hypotonia, thereby treating the primary problem of incontinence. When the condition has .been converted to hypotonia, it can be managed by intermittent catheterization. However, there is a significant population of patients who cannot be converted completely from the hypertonic to z5 the hypotonic condition, and who still find they have to urinate every hour or are incontinent. For these patients, treatment with an anticholinergic drug is necessary. The drug of choice is oxybutynin (4-diethyiamino-2-butynylphenylcyclohexylglycolate).
The use of oxybutynin chloride, as approved by the FDA in the ao United States, is described in the 1992 Physician's Desk Reference, pages 1332 through 1333 with reference to the drug Ditropan~
manufactured by Marion Merrell Dow. Oxybutynin is normally administered to human beings orally at relatively high doses (5 mg Z
tablets taken two to four times a day). Oxybutynin has been incorporated into tablets, capsules, granules or.pilis containing 1-5 mg, preferably 5 mg, of oxybutynin chloride, syrups containing 1-5 mg, preferably 5 mg, of oxybutynin chloride per 5 ml and s transdermai compositions (creams or ointments) containing 1-10 weight percent ("wt %") oxybutynin chloride. See, 8E 902605.
In U.S. Patent No. 4,747,845, oxybutynin was listed as an agent that could be incorporated into a transdermai synthetic resin matrix system for extended duration drug release, but oxybutynin was not io . used in the device. In U.S. Patent No~. 4,928,680 oxybutynin was given as a pharmacologically active agent suitable for transdermai delivery, but as with the above reference, oxybutynin was not incorporated into the device.
Oxybutynin has been incorporated into a device having a water i5 impermeable barrier layer, a reservoir containing oxybutynin in contact with the inner surface of the barrier layer and a removable protector layer in contact with the other surface of the reservoir.
The reservoir is a polyurethane fiber mat impregnated with an aqueous solution containing 25 mg/ml of oxybutynin. The device was placed on zo a 20 um thick polybutadiene film. The non-device carrying surface was in contact with 0.05 M isotonic phosphate buffer solution. The in vitro release rate measured was approximately 12 mg over 24 hours through a 49 cm2 area or l0 ug/cm2/hr. (U.S. Patent No. 4,784,857 and EP 0 250 125).
is In Pharm Res, "Development of Transdermal'Deiivery Systems of Oxybutynin: In-Yivo Bioavailability", P. Keshary et al., (NY)8 (10 Supp) 1991, p. S205 three types of transdermal delivery systems, using matrix-diffusion controlled and membrane-permeation controlled technologies were discussed. The in vitro permeation rate of about ~0 9, 12 and 12 ug/cmZ/hr and in vitro release rates (sink condition) of .
about 1160, 402 and 57.2 ug/cm2/hr were obtained from Silastic~
monolithic, acrylic pressure sensitive adhesive matrix and reservoir type delivery systems, respectively. In humans, steady state plasma concentrations of about 1.86 ng/ml were obtained after 6 hours of *Trade-mark application of a single 20 cm2 patch of the acrylic pressure sensitive adhesive matrix type.
The transdermal route of administrateon for drugs and other biologically active agents ("agents") has been proposed for a wide s variety of systemically acting and locally acting agents on either a rate-controlled or non. rate-controlled basis and is described in numerous technical publications and patents, such as U..S. Patents 3,598,122; 3,598,123; 3,731,683; 3,797,494; 4,031,894; 4,201,211;
4,286,592; 4,314,557; 4,379,454; 4,435,180; 4,588,580; 4,645,502;
io 4,704,282; 4,788,062; 4,816,258; 4,908,027; 4,943,435; and 5,004,610.
Just as certain drugs can irritate, sensitize or be otherwise toxic, so can permeation enhancers. The use of permeation enhancers for transdermal administration is described in numerous technical is publications and patents, such as U.S. Patents Nos. 4,940,586;
4,863,738; 4,820,720; 4,746,515; 4,568,343; 4,405,616;
4,379,454; 4,343,798; 4,335,115; 4,299,826; 4,130,667;
4,130,643; 4,046,886; British Patent No. 1,001,949 and Idson, Percutaneous Absorption, J. Phar. Sci., Uol. 64, No. 66, June 1975, zo pp. 901-924.
Permeation enhancers that are not normally toxic at the concentrations employed in cosmetic or medical compositions may exhibit toxic effects at the higher concentrations required to produce adequate permeation enhancement. No "universal" permeation is enhancer has been identified. Instead, the behavior of permeation enhancers is highly idiosyncratic; a permeation enhancer effective for one drug may not be effective with other drugs, including closely related drugs.
Often, a permeation enhancer will exacerbate irritation and .3o sensitization problems by allowing high transdermal permeation rates of the drug or permeation enhancer or permitting otherwise impermeable components of the transdermai device to enter the skin.
Many potential permeation enhancers interact adversely with other components of transdermal devices. One major problem is that many ~1 s~~
potential permeation enhancers are not compatible with medically acceptable contact adhesives. Enhancers may improve the transdermal permeation rate adequately, but not adequately reduce the lag time.
The use of a permeation enhancer in any transdermal drug s delivery device necessarily complicates the design and development of the device. Permeation enhancers cause compatibility problems throughout the delivery system. Instead of having to characterize the properties of the reservoir compositions, adhesives, and release-controlling materials with respect to just the drug, these materials io must now have the proper characteristics with respect to bath the drug and the permeation enhancer. Typically, drugs and permeation enhancers have very different physical and chemical properties, and, in most cases, the properties of mixtures of the drug with the permeation enhancer are unknown. For example, permeation enhancers is can cause, among other problems, cohesive failure of adhesives and can partition through other components in the system.
As used herein, the term "oxybutynin" is used to designate oxybutynin, acid addition salts of oxybutynin and the related compounds thereof. The preferred active agent according to the Za present invention is oxybutynin itself. Oxybutynin is a base capable of forming acid addition salts with organic and mineral acids, for example, with hydrochloric acid to form oxybutynin chloride.
Preferably, the device of this invention contains oxybutynin as the free base.
Zs As used herein, the term "transdermal" delivery or application refers to the delivery or application of oxybutynin by passage through skin, mucosa and/or other body surfaces by topical application.
As used herein, the term "therapeutically effective" amount or so rate refers to the amount or rate of oxybutynin needed to effect the desired therapeutic result.
As used herein, the term "monoesters" refers to those nwnoesters having from 10 to 20 carbon atoms.
'CVO 93/23025 ~' PCT/US93/04518 As used herein, the term "glycerol monooleate" refers to glycerol monooleate itself or a mixture of monoglycerides wherein glycerol monooleate is present in the greatest amount.
As used herein, the term "glycerol manoiaurate" refers to s glycerol monolaurate itself or a mixture of monoglycerides wherein glycerol monolaurate is present in the greatest amount.
As used herein, the term "glycerol monoiinoleate" refers to glycerol monolinoleate itself or a mixture of monoglycerides wherein glycerol monolinoieate is present in the greatest amount.
io The above summarizes the primary characteristics recognized to date that affect suitability of oxybutynin and a permeation enhancer for transdermal administration. There are undoubtedly others, some of which have not yet been recognized. In order for oxybutynin and a permeation enhancer to be suitable for transdermal administration i5 they must possess the right combination of all of these characteristics, a combination which is quite rare and unpredictable.
SUMMARY OF THE INVENTION
According to the present invention, it has been discovered that oxybutynin may be safely and efficaciously administered Zo transdermally, together with a suitable permeation enhancer, preferably a monoglyceride or mixture of monoglycerides of fatty acids with a total monoester content of at least 519'x. The invention includes a transdermal drug delivery device containing sufficient amounts of permeation enhancer and of oxybutynin, in combination, to provide systemic administration of oxybutynin through the skin for a predetermined period of time for the oxybutynin to provide an effective therapeutic result.
The invention is also directed to a method for the transdermal administration of a therapeutically effective amount of oxybutynin 3o together with a skin permeation-enhancing amount of a suitable permeation enhancer.
5a In one device aspect, the invention provides a device for th.e; transde:rrnal administrat=ion, at a therapeutically effect:ivre rate, of oxybutynin, which device comprises : (a) a :reservrcair comprising a therapeutically effective amount of oxyrbrrtynin and a skin permeation-enhancing amount of a ,r.orroglycerid~~ or- a mixture of monoglycerides of a fal:ty acid witi~ a tc:ta:1 monoesters content of at least 51'>; (b) a bacl~ing on the skin-distal surface of th~~ re:~ervo:i.rw; and (c.) rnearis for maintaining the reservoir in oxybutyniru- and monog=Lyceride or monoglyceride mixture-transmitting rE:~lation with the skin.
In a further device aspect, the invention provides a device for t:.lze transc.3ermal admins_stration, at a therapeutical~.y effective rate, of oxybutynin, which device comprises: (a) a first reservoir comprising a therapeuticall.;r effective amount of oxybutynin and a skin permeation-enhancing amount of a mcnog:lyceride or a mixture of monoglycerides of a fatty acid with a total monoester content of a least 51%; (b) a second reservoir comprising an excess of the monoglyce:r;_c~e or monoglyceride mixture of_ part (a) and substantially free of oxybutynin; (c) a membrane between the first reser~ro.ir and the second. reservoir, wherein said membrane cc,~mprises polyethylene, polyvinyl acetate or ethylene vinyr=i copolymers; ~',d) a backing on the skin-distal surface of the second reservoir; and (e) means for maintaining the first arid second reservoirs in oxybutynin- and monogly~:~eride or monoglyceride mixture-transmitting relation w.:i.th the skin.
In a use aspec.~t, the invention provides a use of a monoglyceride c:~r a mixtm:Y-e of monog-iycerides of a fatty acid with a total mo:noesters content of at least 51~ for increasing the permeabiw..ity of skin to oxybutynin.
b BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a cross-section through a schematic perspective view of one emoodiment of transdermai therapeutic devices according to this invention.
s FIG. 2 is a cross-section through another embodiment of a transdermal therapeutic device according to this invention.
FIG. 3 is a cross-section through another embodiment of a transdermal therapeutic device according to this invention.
FIG. 4 is a cross-section through yet another embodiment of a lo transdermai therapeutic device according to this invention.
FIG. 5 shows the oxybutynin permeation rate through the epidermis at 35'C with various permeation enhancers.
DETAILED DESCRIPTION OF THE INVENTION
AND PREFERR~p EMBODIMENTS
is According to the present invention, it has been found that oxybutynin may be administered to the human body in a therapeutically effective amount via the transdermal route when it is co-administered with a suitable permeation enhancer. Therapeutic blood levels from a~~ut 0.5 ng/ml to about 3.0 ng/ml can be obtained from 2o administration rates in the range of 0.08 mg/hr to 0.5 mg/hr.
Representative skin permeation rates of oxybutynin through living human skin are in the range of about 12 ~g/cm2/hr to about 40 ug/cmZ/hr, depending on the permeation enhancer. Therapeutic blood levels can be achieved within approximately 1-5 hours, and peak is blood concentrations are achieved at about 3 hours when the system is worn for 24 hours. The range of desired and achievable system permeation rates of oxybutynin, arriving through the skin from a limited area, is 1-20 mg over a period of 24 hours. The system application is easily adapted for shorter or longer duration ao treatments, but generally 24 hours is the nominal duration for' treatment.
Typical transdermal delivery devices are described in U.S.
patent numbers 3,598.122; 3,598.123; 4,286,592; 4,314,557; 4,379,454;
4,559,222; 4,573,995; and 4,849.,226, for example.
__ The co-administration of VO 93/23025 ~ ~ ~ f' ~~ ~ '' PGT/US93/04518 J
oxybutynin and a permeation enhancer as disclosed herein can be accomplished by using transdermal devices of these kinds.
Because of the wide variation in skin permeability from individual and from site to site on the same body, it may be preferable that oxybutynin and the permeation enhancer be administered from a rate-controlled transdermal delivery device.
Rate control can be obtained either through a rate-controlling membrane or adhesive or through the other means disclosed in the patents noted above.
io A certain amount of oxybutynin will bind to the skin, and it is accordingly preferred that the skin-contacting layer of the device include this amount of the agent as a loading dose.
Examples of suitable transdermal delivery devices are illustrated in FIGS. 1, 2 and 3. In the drawings, the same reference rs numbers are used throughout the different figures to designate the same or similar components. The figures are not drawn to scale.
In FIG. 1, transdermal delivery device 10 comprises a reservoir 12 containing both oxybutynin and a suitable permeation enhancer. Reservoir 12 is preferably in the form of a matrix zo 4ontaining oxybutynin and enhancer dispersed therein. Reservoir is sandwiched between a backing layer 14, which is permeable to water vapor, and an in-line contact adhesive layer 16. Preferably, the backing is a spun-laced polyester, such as Sontara~, a nylon reinforced polyurethane, such as NRU-100-C Flexcona or a multilaminate film layer, such as EVA/EVA/polyvinyldienefluoride /EVA/EVA film layer Saranex~ Type 52. The device 10 adheres to the surface of the skin 18 by means of the adhesive layer 16. The adhesive layer 16 may optionally contain enhancer and/or oxybutynin.
A strippable release liner (not shown in FIG. 1) is normally provided ;o along the exposed surface of adhesive layer 16 and is removed prior to application of device 10 to the skin 18. Optionally, a rate-controlling membrane (not shown) may be present between the reservoir 12 and the adhesive layer 16.
Alternatively, as shown in FIG. 2, transdermal therapeutic device 20 may be attached to the skin or mucosa of a patient by means WO 93/23025 ~ ~ ~ ~ ~j ~ ~ PCT/US93/04518 of an adhesive overlay 22. Device 20 is comprised of a oxybutynin-and permeation enhancer-containing reservoir 12 which is preferably in the form of a matrix containing oxybutynin and the enhancer dispersed therein. A backing layer 14, which is impermeable to s oxybutynin, the permeation enhancer and water vapor, is provided adjacent one surface of reservoir 12. Adhesive overlay 22 maintains the device on the skin and may be fabricated together with, or provided separately from, the remaining elements of the device. With certain formulations, the adhesive overlay 22 may be preferable to ~o the in-line contact adhesive 16 as shown in FIG. 1. This is true, for example, where the oxybutynin/enhancer reservoir contains a material which adversely affects the adhesive properties of the in-line contact adhesive layer 16. Backing layer 14 is preferably slightly larger than reservoir 12, and in this manner prevents the is materials in reservoir 12 from adversely interacting with the adhesive in overlay 22. Optionally, a rate-controlling membrane (not shown in FIG. 2) may be provided on the skin-proximal side of reservoir 12. A strippable release liner 24 is also provided with device 20 and 's removed just prior to application of device 20 to zo the skin.
In FIG. 3, transdermai delivery device 30 comprises a oxybutynin and permeation enhancer containing reservoir ("oxybutynin reservoir") 12 substantially as described with respect to FIG. 1.
Permeation enhancer reservoir ("enhancer reservoir") 26 comprises is permeation enhancer dispersed throughout and is substantially free of any undissolved oxybutynin, Enhancer reservoir 26 is preferably made from substantially the same matrix as is used to form oxybutynin reservoir 12. A rate-controlling membrane 28 for controlling the release rate of the permeation enhancer from enhancer reservoir 26 to 30 oxybutynin reservoir 12 is placed between the two reservoirs. A
rate-controlling membrane (not shown in FIG. 3) for controlling the release rate of the enhancer from oxybutynin reservoir 12 to the skin may also optionally be utilized and would be present between adhesive layer 16 and reservoir 12.
VO 93/23025 ~ ~ '~ ~~ ~~ ~ ~ PCT/US93/04518 The rate-controlling membrane may be fabricated from permeable, semipermeable or microporous materials which are known in the art to control the rate of agents into and out of delivery devices and having a permeability to the permeation enhancer lower than that of s oxybutynin reservoir 12. Suitable materials include, but are not limited to, polyethylene, polyvinyl acetate and ethylene vinyl acetate copolymers.
Superimposed over the permeation enhancer reservoir 26 of device 30 is a backing 14 that is permeable to water vapor. On the lo skin-proximal side of reservoir 12 are an adhesive layer lfi and a strippable liner 24 which would be removed prior to application of the device 30 to the skin.
In the embodiments of FIGS. 1, 2 and 3, the carrier or matrix material of the reservoirs has sufficient viscosity to maintain its is shape without oozing or flowing. If, however, the matrix or carrier is a low viscosity flowable material such as a liquid or a gel, the composition can be fully enclosed in a pouch or pocket, as known to the art from U.S. Pat. No. 4,379,454 (noted above), for example, and as illustrated in FIG. 4.
zo Device 40 shown in FIG. 4 comprises a backing member 14 which serves as a protective cover for the device, imparts structural support, and substantially keeps components in device 40 from escaping the device. Device 40 also includes reservoir 12 which contains the oxybutynin and permeation enhancer and bears on its z5 surface distant from backing member 14 a rate-controlling membrane 28 for controlling the release of oxybutynin and/or permeat ion enhancer from device 40. The outer edges of backing member 14 overlay the edges of reservoir 12 and are joined along the perimeter with the outer edges of the rate-controlling membrane 28 in a fluid-tight ;o arrangement. This sealed reservoir may be effected by pressure, fusion, adhesion, an adhesive applied to the edges, or other methods known in the art. In this manner, reservoir 12 is contained wholly between backing member 14 and rate-controlling membrane 28. On the skin-proximal side of rate-controlling membrane 28 are an adhesive WO 93123025 ~ ~ ~ ~ ~ ~ PGT/US93/04518 layer 16 and a strippable liner 24 which would be removed prior to application of the device 40 to the skin, In an alternative embodiment of device 40 of FIG. 4, reservoir 12 contains the permeation enhancer only and is substantially free of oxybutynin. The oxybutynin and an additional amount of permeation enhancer are present in adhesive layer 16 which acts as a separate reservoir.
The oxybutynin and the permeation enhancer can be co-extensively administered to human skin or mucosa by direct application to the skin or mucosa in the form of an ointment, gel, cream or lotion, for example, but are preferably administered from a skin patch or other known transdermal delivery device which contains a saturated or unsaturated formulation of oxybutynin and the enhancer.
's The formulation may be aqueous or non-aqueous based. The formulation should be designed to deliver the oxybutynin and the permeation enhancer at the necessary release rates. Aqueous formulations typically comprise water or water/ethanol and about 1-2 wt f. of a gelling agent, an example being a hydrophilic polymer ao such as hydroxyethylcellulose or hydroxypropylcellulose. Typical non-aqueous gels are comprised of silicone fluid or mineral oil.
Mineral oil-based gels also typically contain 1-2 wt % of a gelling agent such as colloidal silicon dioxide. The suitability of a particular gel depends upon the compatibility of its constituents .: with both the oxybutynin and the permeation enhancer and any other components in the formulation.
The reservoir matrix should be compatible with oxybutynin, the permeation enhancer and any carrier therefor. The term "matrix" as used herein refers to a well-mixed composite of ingredients fixed into shape. When using an aqueous-based formulation, the reservoir matrix is preferably a hydrophilic polymer, e.g., a hydrogel. When using a non-aqueous-based formulation, the reservoir matrix is preferably composed of a hydrophobic polymer. Suitable polymeric matrices are well known in the transdermal drug delivery art, and examples are listed in the above-named patents.
A typical laminated system would comprise a polymeric membrane and/or matrix such as ethylene vinyl acetate (EVA) copolymers, such as those described in U.S. Pat. No. 4,144,317, preferably having a vinyl acetate (VA) content in the. range of from about 9%. up to about 60'x and more preferably about 28%. to about 60%. VA.
Polyisobutylene/oil polymers containing from 4-25y high molecular weight polyisobutylene and 20-81%. low molecular weight io polyisobutylene with the balance being~an oil such as mineral oil or poiybutynes may also be used as the matrix material.
The aforementioned patents describe a wide variety of materials which can be used for fabricating the various layers or components of the transdermal oxybutynin delivery devices according to th is is invention. This invention therefore contemplates the use of materials other than those specifically disclosed herein, including those which may hereafter become known to the art to be capable of performing the necessary functions.
The amount of oxybutynin present in the therapeutic device and zo required to achieve an effective therapeutic result depends on many factors, such as the minimum necessary dosage of oxybutynin for the particular indication being treated; the solubility and permeability of the matrix, of the adhesive layer and of the rate-controlling membrane, if present; and the period of time for which the device zs will be fixed to the skin. The minimum amount of oxybutynin is determined by the requirement that sufficient quantities of oxybutynin must be present in the device to maintain the desired rate of release over the given period of application. The maximum amount for safety purposes is determined by the requirement that the 30 ' quantity of oxybutynin present cannot exceed a rate of release, that reaches toxic levels. The oral lethal dose discovered for rats is 1220 mg/kg.
When a constant oxybutynin delivery rate is desired, the oxybutynin is normally present in the matrix or carrier at a a concentration in excess of saturation, the amount of excess being a z~~3z~s~
function of the desired length of the oxybutynin delivery period of the system. The oxybutynin may, however, be present at a level below saturation without departing from this invention as long as oxybutynin is continuously administered to the same skin or mucosa s site in an amount and for a period of time sufficient to provide the desired therapeutic rate and delivery profile of oxybutynin delivery.
The permeation enhancer is dispersed through the matrix or carrier, preferably at a concentration sufficient to provide permeation-enhancing amounts of enhancer in the reservoir throughout io the anticipated administration period. Where there is an additional, separate permeation enhancer matrix layer as well, as in FIGS. 3 and 4, the permeation enhancer normally is present in the separate reservoir in excess of saturation, The preferred permeation enhancers of the present invention are is a monoglyceride or a mixture of monoglycerides of fatty acids with a total monoester content of at least 51x. Fatty acids may be saturated or unsaturated and straight or chained, and include, for example, lauric acid, myristic acid, steari~ acid, oleic acid, linoleic acid and palmitic acid. Monoglycerides are generally Zo available as a mixture of monoglycerides, with the mixture deriving its name from the monoglyceride present in the greatest amount.
Monoglyceride permeation enhancers include, for example, glycerol monooleate, glycerol monolaurate and glycerol monolinoleate. In a more preferred embodiment, the permeation enhancer is glycerol zs monooleate.
In addition to oxybutynin and a suitable permeation~enhancer, which are essential to the invention, the matrix or carrier may also contain dyes, pigments, inert fillers, excipients and other conventional components of pharmaceutical products or transdermal 3o devices known to the art.
In the present invention, oxybutynin is delivered at a therapeutically effective rate (that is, a rate that provides a desired therapeutic effect) and the permeation enhancer is delivered at a permeation-enhancing rate (that is, a rate that provides 2I~~ ~~~
increased permeability of the application site to the oxybutynin) for a predetermined time period and in the required delivery pattern.
A preferred embodiment of the present invention comprises a method of treating any disorder in which it is therapeutic to administer a therapeutically effective amount of one or more of the compounds of the present invention to a patient suffering from such disorder.
Another preferred embodiment of the present invention comprises a method of treating neurogenic bladder disorders, e.g., urinary o frequency or incontinence. To be useful in treating a neurogenic bladder disorder. oxybutynin should be present in plasma at levels above about 0.5 ng/ml, preferably at levels above about 1.0 ng/ml and most preferably at levels of about 2.0 ng/ml. To achieve this result, oxybutynin is delivered at a therapeutic rate of at least :s about 40-200 ug per hour, but typically of at least 80 ug/hr, and more typically at about 80-160 ug/hr, for the treatment period, usually about 24 hours to 7 days.
The administration rate through the skin should be sufficient to minimize the size of the device. The size of the device of this zo invention can vary from less than 1 cmz to greater than 200 cm2. A
typical device, however, will have a size within the range of 5-50 cmZ. The delivery device containing the oxybutynin and a permeation enhancer is placed on a user such that the device is delivering oxybutynin in a therapeutically effective amount to the zs user to treat a neurogenic bladder disorder.
The length of time of oxybutynin presence and the total amount of oxybutynin in the plasma can be changed following the teachings of this invention to provide different treatment regimens. Thus, they can be controlled by the amount of time during which exogenous ~o oxybutynin is delivered transdermally to an individual or animal.
The devices of this invention can be designed to effectively deliver oxybutynin for an extended time period of from several hours up to 7 days or longer. Seven days is generally the maximum time limit for application of a single device because the adverse affect _. of occlusion of a skin site increases with time and the normal cycle 213~~ ~~
WO 93/23025 ' PCT/US93/04518 or sloughing and replacement or the skin cells occurs in about 7 days. The transdermal therapeutic devices of the present invention are prepared in a manner known in the art, such as by those procedures, for example, described in the transdermal device patents s listed previously herein. Having thus generally described the invention, the following specific examples describe preferred embodiments thereof.
DETAILED DESCRIPTION OF EXAMPLES
The devices for Example 1 were prepared as follows:
;o ~ A. Formulation without a Permeation Enhancer A formulation containing 30 wt o oxybutynin base in a matrix of EVA 40 (U.S.I. Chemicals, Illinois) was prepared by dissolving the oxybutynin base and EVA 40 in methylene chloride. The solution was poured onto a sheet of fluorocarbon diacrylate ("FCO")/polyester i5 release liner to dry. The dried material was pressed to 5 mil (a.
0.1 mm) thickness between two sheets of FCD/polyester release liner at 75'C. The resulting film was laminated to a flexible cloth backing (spun laced polyester, 1.3 oz/ydZ), and 2.0 cm= discs were cut from the laminate, ~o B. Formulations with Permeation Enhancers Formulations containing oxybutynin base at 30 wt °o, and various permeation enhancers glycerol monolaurate, glycerol monooleate, and glycerol monolinoleate) at 25 wt o in a matrix of EVA 40 were prepared by dissolving the oxybutynin base, permeation enhancer and is EVA 40 in methylene chloride. The same procedure as described above was then used to make the device.
The glycerol monooleate (GMO) used was Myverol~ 18-99K glycerol monooleate (Eastman Kodak Chemicals), which has a glycerol monooleate content of 61x and a total monoester content of 93x, the glycerol ~o monolinoieate (GMLO) used was Myverolm 18-92K glycerol monolinoleate.
which has a glycerol monolinoleate content of 68X and a minimum total monoester content of 90x, and the glycerol monolaurate (GML) used was Grindtek~ ML 90 glycerol monolaurate, which has a glycerol monolaurate content of 90%. and a minimum total monoester content of 90%.
C. Device with In-line Adhesive Each of the oxybutynin matriX/cloth backing laminates were.
divided in half, and one half of each was laminated to 3M'~acyiate transfer adhesive MSP 32589 (1.6 mil, an acrylate adhesive with 2-5%
acid functionality). Before testing, each final laminate was . equilibrated format least 5 days to allow the enhancer and oxybutynin to partition into the contact adhesive'. The edges of the devices with in-line adhesive were masked with polyester tape so that the oxybutynin reservoir edges were not exposed to the epidermis or solutions when they were tested.
The devices for Examples 2. 4 and 5 are prepared as follows:
A. Formulation containing GMO
i3 A formulation containing 27 wt 9. oxybutynin base and 27 wt y.
GMO (Myverol~ 18-99K glycerol monooleate) in a matrix of EYA 40 was prepared using a Brabender~''Mixer and a 50 cc mixing bowl. The EVA 40 was added to the mixing bowl and mixed until pellets were no longer visible. The oxybutynin base was slowly added to the mixing bowl.
?o Mixing was continued for an additional 10 minutes after addition was complete. GMO was heated to 40'C and added very slowly to the mixing bowl. Addition time was approximately 45 minutes. The bowl was then closed and mixing continued for at least 20 minutes before removing the completed oxybutynin mix from the bowl.
The oxybutynin mix was calendared to 5 mil thickness between release liners (FCD/polyesterj. Five one-foot sections of the oxybutynin film were heat laminated to Medparo backing (medium .
density polyethylene layer/aluminum polyester layer/EVA layer).
Three of the oxybutynin film/backing laminates were laminated to 3M
3o acrylate transfer adhesive MSP 1006 P.
*Trade-mark ~1 ~~,{~~5 WO 93123025 PCI'/US93/04518 1b EXAMPLE I
The in vitro transdermal oxybutynin permeation rates through the epidermis of two human skin donors from devices described above were determined. For each device tested, the release liner was s removed and the oxybutynin-releasing surface was placed against the stratum corneum side of a disc of human epidermis which had been blotted dry just prior to use. The excess epidermis was wrapped around the device so that none of the device edge was exposed to the receptor solution. The device covered with epidermis was attached to io the flat side of the TeflonA holder of a release rate rod using nylon mesh and metal string. The rods were reciprocated in a fixed volume of receptor solution 0.05 M phosphate buffer, pH 6.5. The entire receptor solution was changed at each sampling time. The temperature of the receptor solution in the water bath was maintained at 35'C.
is Results are summarized in the following table:
Average Transdermal Oxybutynin (Base) Permeation Enhancer Permeation Rate Zo ua/cm2/hr for 0-96 hrs With adhesive None (control) 1.21 GML 3.74 Myverol~ 18-99K 3.09 Myverol~ 18-92K 2.40 2s Without adhesive None Control 1.13 GML 4.24 Myverola 18-99K 3.59 Myverol~ 18-92K 2.47 EXAMPLE ,~
3o The in vitro transdermal oxybutynin permeation rates through the epidermis of five human skin donors from devices described above were determined as described in Example 1. The control formulation contained 30 wt y. oxybutynin base (no permeation enhancer) in an EVA
40 matrix. No in-line adhesive was present. The other formulation 2~ ~~8~
.V0 93/2302, PCT/US93/04518 contained 28 wt °~° oxybutynin base and 28 wt °.o Myveroi~ 18-99K
glycerol monooleate in an EVA 40 matrix. There was a 3M acrylate in-line adhesive present. This same device was used in the in vivo testing described in Examples 3 and 4. The results are summarized in s the following table:
TA_ BLE 2 Control Without With Permeation Sk~-n, Donor Permeation ~nhancer Enhancer a4/cm ~hr u4/cm2/hr io 1 4.7 15.4 2 3.1 6,8 ' 3 2.6 9.4 4 2.5 4.7 2.6 5.4 a AMP
This experiment was carried out using standard glass diffusion cells which consist of a donor compartment with a 4 ml capacity, and a receptor compartment with a 22 ml capacity. A circular piece of epidermis was placed in each diffusion cell (permeation area -zo 1.13 cm2) in a horizontal position between a lower capped receptor compartment and an upper capped donor compartment. The receptor compartment has both a venting tube (uncapped) and a sampling port (capped). The stratum corneum side of the epidermis faced the donor compartment. An 0-ring was positioned between the epidermis and the zs .donor compartment, and a clamp held the compartments together. The receptor solution, 22 ml of 0.05 M phosphate buffer solution, pH 6.5, was added to each receptor compartment. The cells were placed in a temperature controlled water bath shaker at 35'C and allowed to come to temperature before the donor solution was added.
A total of five donor solutions were tested, and the donor volume was 0,2 ml in each case. The donor solutions tested were oxybutynin saturated in 0.05 M phosphate buffer solution, pH 6.5, oxybutynin saturated in mineral oil, oxybutynin saturated in a solution of 3096 ethanol in phosphate buffer, oxybutynin saturated in _. a solution of 10.69: Myverol 18-99K glycerol monooleate in mineral ~~~~i~~~
oil, and oxybutynin saturated in a solution of 10.6Yo glycerol monolaurate in mineral oil. All donor solutions were at pH 6.5.
At each time interval, the receptor solution was removed from the test cell and replaced with an equal volume of fresh receptor solution previously equilibrated at 35'C. The receptor solutions for each time interval were then assayed for oxybutynin, by HPL~C (Zorbax Rx-C8, 15 cm x 4.6 mm ID, 5 ~cm, 30x acetonitrile/water, 0.06x dimethyloctylamine, 0.03 H3P04, 220 nm, 1.0 ml/min), to calculate the permeation rate of oxybutynin through epidermis from the donor io solution.
As can be seen in Figure 5, glycerol monolaurate and glycerol monolinoleate increased the permeation rate of oxybutynin, whereas ethanol showed the same permeation rate as the donor solution containing no permeation enhancer.
is AMP 4 The in vivo plasma levels of oxybutynin were measured for two body sites. A 10 cm2 device was worn on the penis for 10~ hours and two 10 cmZ devices were worn on the inner thigh for 24 hours. A
control sample was drawn before applying the systems. The device 2o worn on the penis produced a plasma oxybutynin level of 2.0 ng/mL
within 4 hours, and the levels varied between 1.4 and 2.1 ng/ml during the following 6~ hours of wearing. The systems worn on the inner thigh produced a plasma oxybutynin concentration of 0.9 ng/mL
after 12 hours of wearing, and after 24 hours of wearing ,the level 25 had reached 1.1 ng/mL.
The in vivo plasma oxybutynin concentration were also measured in two additional subjects who each wore two 10 cm~ systems on the inner thigh. One subject achieved a plasma oxybutynin concentration of 2.0 ng/mL after 9 hours, and the plasma level was 1.7 ng/ml after so 24 hours of wearing. The other subject achieved a plasma level of 0.7 ng/ml after 12 hours, and the plasma level was 0.8 ng/mL after 24 hours.
2~1~~F5a The residual oxybutynin in devices which had been worn by subjects was measured and compared to the oxybutynin content of devices which had not been worn. The results are summarized in the following table:
TABLE 3, Measured Drug Loss Subiect ~ Site (ma/20 cm2LaYj 1 inner thigh 5.8 :0 2 inner thigh 8.6 3 chest 6.7 . 4 abdomen 7.2 pen l s 19 . 2 Having thus generally described the present invention and :s described certain specific embodiments thereof including the embodiments that the applicants consider the best mode of practicing their invention, it will be readily apparent that various modifications to the invention may be made by workers skilled in the art without departing from the scope of this invention which is limited only by the following claims,
WO 93/23025 ~ ~ ~ ~' ~~ ~ ~ PCT/US93/04518 TRANSDERMAL ADMINISTRATION OF OXYBUTYNIN
FIELD OF THE INVENTION
This invention relates the efficacious and safe, controlled transdermal administration of oxybutynin and related compounds for s ~ the treatment of neurogenic bladder disorders.
BACKGROUND OF THE INYEION
Neurogenic bladder disease is.a disorder involving loss of control of urination. The major symptoms of this disease are urinary frequency, urinary retention or incontinence. There are two types of ~o lesions that cause a neurogenic bladder. The first, upper motoneuron lesion, leads to hypertonia and hyperreflexia of the bladder, a spastic condition, giving rise to symptoms of urinary frequency and incontinence. The second lesion, a lower motoneuron lesion, involves hypotonia and hyporeflexia of the bladder. The major symptoms in is this condition are urinary retention, since the voiding reflex has been lost, and incontinence, which occurs when the bladder "leaks", being foil to overflowing.
The majority of neurogenic bladder patients have the spastic or hypertonic bladder. The clinician usually attempts to convert the Zo condition of hyperreflexia and hypertoni.a to hypotonia, thereby treating the primary problem of incontinence. When the condition has .been converted to hypotonia, it can be managed by intermittent catheterization. However, there is a significant population of patients who cannot be converted completely from the hypertonic to z5 the hypotonic condition, and who still find they have to urinate every hour or are incontinent. For these patients, treatment with an anticholinergic drug is necessary. The drug of choice is oxybutynin (4-diethyiamino-2-butynylphenylcyclohexylglycolate).
The use of oxybutynin chloride, as approved by the FDA in the ao United States, is described in the 1992 Physician's Desk Reference, pages 1332 through 1333 with reference to the drug Ditropan~
manufactured by Marion Merrell Dow. Oxybutynin is normally administered to human beings orally at relatively high doses (5 mg Z
tablets taken two to four times a day). Oxybutynin has been incorporated into tablets, capsules, granules or.pilis containing 1-5 mg, preferably 5 mg, of oxybutynin chloride, syrups containing 1-5 mg, preferably 5 mg, of oxybutynin chloride per 5 ml and s transdermai compositions (creams or ointments) containing 1-10 weight percent ("wt %") oxybutynin chloride. See, 8E 902605.
In U.S. Patent No. 4,747,845, oxybutynin was listed as an agent that could be incorporated into a transdermai synthetic resin matrix system for extended duration drug release, but oxybutynin was not io . used in the device. In U.S. Patent No~. 4,928,680 oxybutynin was given as a pharmacologically active agent suitable for transdermai delivery, but as with the above reference, oxybutynin was not incorporated into the device.
Oxybutynin has been incorporated into a device having a water i5 impermeable barrier layer, a reservoir containing oxybutynin in contact with the inner surface of the barrier layer and a removable protector layer in contact with the other surface of the reservoir.
The reservoir is a polyurethane fiber mat impregnated with an aqueous solution containing 25 mg/ml of oxybutynin. The device was placed on zo a 20 um thick polybutadiene film. The non-device carrying surface was in contact with 0.05 M isotonic phosphate buffer solution. The in vitro release rate measured was approximately 12 mg over 24 hours through a 49 cm2 area or l0 ug/cm2/hr. (U.S. Patent No. 4,784,857 and EP 0 250 125).
is In Pharm Res, "Development of Transdermal'Deiivery Systems of Oxybutynin: In-Yivo Bioavailability", P. Keshary et al., (NY)8 (10 Supp) 1991, p. S205 three types of transdermal delivery systems, using matrix-diffusion controlled and membrane-permeation controlled technologies were discussed. The in vitro permeation rate of about ~0 9, 12 and 12 ug/cmZ/hr and in vitro release rates (sink condition) of .
about 1160, 402 and 57.2 ug/cm2/hr were obtained from Silastic~
monolithic, acrylic pressure sensitive adhesive matrix and reservoir type delivery systems, respectively. In humans, steady state plasma concentrations of about 1.86 ng/ml were obtained after 6 hours of *Trade-mark application of a single 20 cm2 patch of the acrylic pressure sensitive adhesive matrix type.
The transdermal route of administrateon for drugs and other biologically active agents ("agents") has been proposed for a wide s variety of systemically acting and locally acting agents on either a rate-controlled or non. rate-controlled basis and is described in numerous technical publications and patents, such as U..S. Patents 3,598,122; 3,598,123; 3,731,683; 3,797,494; 4,031,894; 4,201,211;
4,286,592; 4,314,557; 4,379,454; 4,435,180; 4,588,580; 4,645,502;
io 4,704,282; 4,788,062; 4,816,258; 4,908,027; 4,943,435; and 5,004,610.
Just as certain drugs can irritate, sensitize or be otherwise toxic, so can permeation enhancers. The use of permeation enhancers for transdermal administration is described in numerous technical is publications and patents, such as U.S. Patents Nos. 4,940,586;
4,863,738; 4,820,720; 4,746,515; 4,568,343; 4,405,616;
4,379,454; 4,343,798; 4,335,115; 4,299,826; 4,130,667;
4,130,643; 4,046,886; British Patent No. 1,001,949 and Idson, Percutaneous Absorption, J. Phar. Sci., Uol. 64, No. 66, June 1975, zo pp. 901-924.
Permeation enhancers that are not normally toxic at the concentrations employed in cosmetic or medical compositions may exhibit toxic effects at the higher concentrations required to produce adequate permeation enhancement. No "universal" permeation is enhancer has been identified. Instead, the behavior of permeation enhancers is highly idiosyncratic; a permeation enhancer effective for one drug may not be effective with other drugs, including closely related drugs.
Often, a permeation enhancer will exacerbate irritation and .3o sensitization problems by allowing high transdermal permeation rates of the drug or permeation enhancer or permitting otherwise impermeable components of the transdermai device to enter the skin.
Many potential permeation enhancers interact adversely with other components of transdermal devices. One major problem is that many ~1 s~~
potential permeation enhancers are not compatible with medically acceptable contact adhesives. Enhancers may improve the transdermal permeation rate adequately, but not adequately reduce the lag time.
The use of a permeation enhancer in any transdermal drug s delivery device necessarily complicates the design and development of the device. Permeation enhancers cause compatibility problems throughout the delivery system. Instead of having to characterize the properties of the reservoir compositions, adhesives, and release-controlling materials with respect to just the drug, these materials io must now have the proper characteristics with respect to bath the drug and the permeation enhancer. Typically, drugs and permeation enhancers have very different physical and chemical properties, and, in most cases, the properties of mixtures of the drug with the permeation enhancer are unknown. For example, permeation enhancers is can cause, among other problems, cohesive failure of adhesives and can partition through other components in the system.
As used herein, the term "oxybutynin" is used to designate oxybutynin, acid addition salts of oxybutynin and the related compounds thereof. The preferred active agent according to the Za present invention is oxybutynin itself. Oxybutynin is a base capable of forming acid addition salts with organic and mineral acids, for example, with hydrochloric acid to form oxybutynin chloride.
Preferably, the device of this invention contains oxybutynin as the free base.
Zs As used herein, the term "transdermal" delivery or application refers to the delivery or application of oxybutynin by passage through skin, mucosa and/or other body surfaces by topical application.
As used herein, the term "therapeutically effective" amount or so rate refers to the amount or rate of oxybutynin needed to effect the desired therapeutic result.
As used herein, the term "monoesters" refers to those nwnoesters having from 10 to 20 carbon atoms.
'CVO 93/23025 ~' PCT/US93/04518 As used herein, the term "glycerol monooleate" refers to glycerol monooleate itself or a mixture of monoglycerides wherein glycerol monooleate is present in the greatest amount.
As used herein, the term "glycerol manoiaurate" refers to s glycerol monolaurate itself or a mixture of monoglycerides wherein glycerol monolaurate is present in the greatest amount.
As used herein, the term "glycerol monoiinoleate" refers to glycerol monolinoleate itself or a mixture of monoglycerides wherein glycerol monolinoieate is present in the greatest amount.
io The above summarizes the primary characteristics recognized to date that affect suitability of oxybutynin and a permeation enhancer for transdermal administration. There are undoubtedly others, some of which have not yet been recognized. In order for oxybutynin and a permeation enhancer to be suitable for transdermal administration i5 they must possess the right combination of all of these characteristics, a combination which is quite rare and unpredictable.
SUMMARY OF THE INVENTION
According to the present invention, it has been discovered that oxybutynin may be safely and efficaciously administered Zo transdermally, together with a suitable permeation enhancer, preferably a monoglyceride or mixture of monoglycerides of fatty acids with a total monoester content of at least 519'x. The invention includes a transdermal drug delivery device containing sufficient amounts of permeation enhancer and of oxybutynin, in combination, to provide systemic administration of oxybutynin through the skin for a predetermined period of time for the oxybutynin to provide an effective therapeutic result.
The invention is also directed to a method for the transdermal administration of a therapeutically effective amount of oxybutynin 3o together with a skin permeation-enhancing amount of a suitable permeation enhancer.
5a In one device aspect, the invention provides a device for th.e; transde:rrnal administrat=ion, at a therapeutically effect:ivre rate, of oxybutynin, which device comprises : (a) a :reservrcair comprising a therapeutically effective amount of oxyrbrrtynin and a skin permeation-enhancing amount of a ,r.orroglycerid~~ or- a mixture of monoglycerides of a fal:ty acid witi~ a tc:ta:1 monoesters content of at least 51'>; (b) a bacl~ing on the skin-distal surface of th~~ re:~ervo:i.rw; and (c.) rnearis for maintaining the reservoir in oxybutyniru- and monog=Lyceride or monoglyceride mixture-transmitting rE:~lation with the skin.
In a further device aspect, the invention provides a device for t:.lze transc.3ermal admins_stration, at a therapeutical~.y effective rate, of oxybutynin, which device comprises: (a) a first reservoir comprising a therapeuticall.;r effective amount of oxybutynin and a skin permeation-enhancing amount of a mcnog:lyceride or a mixture of monoglycerides of a fatty acid with a total monoester content of a least 51%; (b) a second reservoir comprising an excess of the monoglyce:r;_c~e or monoglyceride mixture of_ part (a) and substantially free of oxybutynin; (c) a membrane between the first reser~ro.ir and the second. reservoir, wherein said membrane cc,~mprises polyethylene, polyvinyl acetate or ethylene vinyr=i copolymers; ~',d) a backing on the skin-distal surface of the second reservoir; and (e) means for maintaining the first arid second reservoirs in oxybutynin- and monogly~:~eride or monoglyceride mixture-transmitting relation w.:i.th the skin.
In a use aspec.~t, the invention provides a use of a monoglyceride c:~r a mixtm:Y-e of monog-iycerides of a fatty acid with a total mo:noesters content of at least 51~ for increasing the permeabiw..ity of skin to oxybutynin.
b BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a cross-section through a schematic perspective view of one emoodiment of transdermai therapeutic devices according to this invention.
s FIG. 2 is a cross-section through another embodiment of a transdermal therapeutic device according to this invention.
FIG. 3 is a cross-section through another embodiment of a transdermal therapeutic device according to this invention.
FIG. 4 is a cross-section through yet another embodiment of a lo transdermai therapeutic device according to this invention.
FIG. 5 shows the oxybutynin permeation rate through the epidermis at 35'C with various permeation enhancers.
DETAILED DESCRIPTION OF THE INVENTION
AND PREFERR~p EMBODIMENTS
is According to the present invention, it has been found that oxybutynin may be administered to the human body in a therapeutically effective amount via the transdermal route when it is co-administered with a suitable permeation enhancer. Therapeutic blood levels from a~~ut 0.5 ng/ml to about 3.0 ng/ml can be obtained from 2o administration rates in the range of 0.08 mg/hr to 0.5 mg/hr.
Representative skin permeation rates of oxybutynin through living human skin are in the range of about 12 ~g/cm2/hr to about 40 ug/cmZ/hr, depending on the permeation enhancer. Therapeutic blood levels can be achieved within approximately 1-5 hours, and peak is blood concentrations are achieved at about 3 hours when the system is worn for 24 hours. The range of desired and achievable system permeation rates of oxybutynin, arriving through the skin from a limited area, is 1-20 mg over a period of 24 hours. The system application is easily adapted for shorter or longer duration ao treatments, but generally 24 hours is the nominal duration for' treatment.
Typical transdermal delivery devices are described in U.S.
patent numbers 3,598.122; 3,598.123; 4,286,592; 4,314,557; 4,379,454;
4,559,222; 4,573,995; and 4,849.,226, for example.
__ The co-administration of VO 93/23025 ~ ~ ~ f' ~~ ~ '' PGT/US93/04518 J
oxybutynin and a permeation enhancer as disclosed herein can be accomplished by using transdermal devices of these kinds.
Because of the wide variation in skin permeability from individual and from site to site on the same body, it may be preferable that oxybutynin and the permeation enhancer be administered from a rate-controlled transdermal delivery device.
Rate control can be obtained either through a rate-controlling membrane or adhesive or through the other means disclosed in the patents noted above.
io A certain amount of oxybutynin will bind to the skin, and it is accordingly preferred that the skin-contacting layer of the device include this amount of the agent as a loading dose.
Examples of suitable transdermal delivery devices are illustrated in FIGS. 1, 2 and 3. In the drawings, the same reference rs numbers are used throughout the different figures to designate the same or similar components. The figures are not drawn to scale.
In FIG. 1, transdermal delivery device 10 comprises a reservoir 12 containing both oxybutynin and a suitable permeation enhancer. Reservoir 12 is preferably in the form of a matrix zo 4ontaining oxybutynin and enhancer dispersed therein. Reservoir is sandwiched between a backing layer 14, which is permeable to water vapor, and an in-line contact adhesive layer 16. Preferably, the backing is a spun-laced polyester, such as Sontara~, a nylon reinforced polyurethane, such as NRU-100-C Flexcona or a multilaminate film layer, such as EVA/EVA/polyvinyldienefluoride /EVA/EVA film layer Saranex~ Type 52. The device 10 adheres to the surface of the skin 18 by means of the adhesive layer 16. The adhesive layer 16 may optionally contain enhancer and/or oxybutynin.
A strippable release liner (not shown in FIG. 1) is normally provided ;o along the exposed surface of adhesive layer 16 and is removed prior to application of device 10 to the skin 18. Optionally, a rate-controlling membrane (not shown) may be present between the reservoir 12 and the adhesive layer 16.
Alternatively, as shown in FIG. 2, transdermal therapeutic device 20 may be attached to the skin or mucosa of a patient by means WO 93/23025 ~ ~ ~ ~ ~j ~ ~ PCT/US93/04518 of an adhesive overlay 22. Device 20 is comprised of a oxybutynin-and permeation enhancer-containing reservoir 12 which is preferably in the form of a matrix containing oxybutynin and the enhancer dispersed therein. A backing layer 14, which is impermeable to s oxybutynin, the permeation enhancer and water vapor, is provided adjacent one surface of reservoir 12. Adhesive overlay 22 maintains the device on the skin and may be fabricated together with, or provided separately from, the remaining elements of the device. With certain formulations, the adhesive overlay 22 may be preferable to ~o the in-line contact adhesive 16 as shown in FIG. 1. This is true, for example, where the oxybutynin/enhancer reservoir contains a material which adversely affects the adhesive properties of the in-line contact adhesive layer 16. Backing layer 14 is preferably slightly larger than reservoir 12, and in this manner prevents the is materials in reservoir 12 from adversely interacting with the adhesive in overlay 22. Optionally, a rate-controlling membrane (not shown in FIG. 2) may be provided on the skin-proximal side of reservoir 12. A strippable release liner 24 is also provided with device 20 and 's removed just prior to application of device 20 to zo the skin.
In FIG. 3, transdermai delivery device 30 comprises a oxybutynin and permeation enhancer containing reservoir ("oxybutynin reservoir") 12 substantially as described with respect to FIG. 1.
Permeation enhancer reservoir ("enhancer reservoir") 26 comprises is permeation enhancer dispersed throughout and is substantially free of any undissolved oxybutynin, Enhancer reservoir 26 is preferably made from substantially the same matrix as is used to form oxybutynin reservoir 12. A rate-controlling membrane 28 for controlling the release rate of the permeation enhancer from enhancer reservoir 26 to 30 oxybutynin reservoir 12 is placed between the two reservoirs. A
rate-controlling membrane (not shown in FIG. 3) for controlling the release rate of the enhancer from oxybutynin reservoir 12 to the skin may also optionally be utilized and would be present between adhesive layer 16 and reservoir 12.
VO 93/23025 ~ ~ '~ ~~ ~~ ~ ~ PCT/US93/04518 The rate-controlling membrane may be fabricated from permeable, semipermeable or microporous materials which are known in the art to control the rate of agents into and out of delivery devices and having a permeability to the permeation enhancer lower than that of s oxybutynin reservoir 12. Suitable materials include, but are not limited to, polyethylene, polyvinyl acetate and ethylene vinyl acetate copolymers.
Superimposed over the permeation enhancer reservoir 26 of device 30 is a backing 14 that is permeable to water vapor. On the lo skin-proximal side of reservoir 12 are an adhesive layer lfi and a strippable liner 24 which would be removed prior to application of the device 30 to the skin.
In the embodiments of FIGS. 1, 2 and 3, the carrier or matrix material of the reservoirs has sufficient viscosity to maintain its is shape without oozing or flowing. If, however, the matrix or carrier is a low viscosity flowable material such as a liquid or a gel, the composition can be fully enclosed in a pouch or pocket, as known to the art from U.S. Pat. No. 4,379,454 (noted above), for example, and as illustrated in FIG. 4.
zo Device 40 shown in FIG. 4 comprises a backing member 14 which serves as a protective cover for the device, imparts structural support, and substantially keeps components in device 40 from escaping the device. Device 40 also includes reservoir 12 which contains the oxybutynin and permeation enhancer and bears on its z5 surface distant from backing member 14 a rate-controlling membrane 28 for controlling the release of oxybutynin and/or permeat ion enhancer from device 40. The outer edges of backing member 14 overlay the edges of reservoir 12 and are joined along the perimeter with the outer edges of the rate-controlling membrane 28 in a fluid-tight ;o arrangement. This sealed reservoir may be effected by pressure, fusion, adhesion, an adhesive applied to the edges, or other methods known in the art. In this manner, reservoir 12 is contained wholly between backing member 14 and rate-controlling membrane 28. On the skin-proximal side of rate-controlling membrane 28 are an adhesive WO 93123025 ~ ~ ~ ~ ~ ~ PGT/US93/04518 layer 16 and a strippable liner 24 which would be removed prior to application of the device 40 to the skin, In an alternative embodiment of device 40 of FIG. 4, reservoir 12 contains the permeation enhancer only and is substantially free of oxybutynin. The oxybutynin and an additional amount of permeation enhancer are present in adhesive layer 16 which acts as a separate reservoir.
The oxybutynin and the permeation enhancer can be co-extensively administered to human skin or mucosa by direct application to the skin or mucosa in the form of an ointment, gel, cream or lotion, for example, but are preferably administered from a skin patch or other known transdermal delivery device which contains a saturated or unsaturated formulation of oxybutynin and the enhancer.
's The formulation may be aqueous or non-aqueous based. The formulation should be designed to deliver the oxybutynin and the permeation enhancer at the necessary release rates. Aqueous formulations typically comprise water or water/ethanol and about 1-2 wt f. of a gelling agent, an example being a hydrophilic polymer ao such as hydroxyethylcellulose or hydroxypropylcellulose. Typical non-aqueous gels are comprised of silicone fluid or mineral oil.
Mineral oil-based gels also typically contain 1-2 wt % of a gelling agent such as colloidal silicon dioxide. The suitability of a particular gel depends upon the compatibility of its constituents .: with both the oxybutynin and the permeation enhancer and any other components in the formulation.
The reservoir matrix should be compatible with oxybutynin, the permeation enhancer and any carrier therefor. The term "matrix" as used herein refers to a well-mixed composite of ingredients fixed into shape. When using an aqueous-based formulation, the reservoir matrix is preferably a hydrophilic polymer, e.g., a hydrogel. When using a non-aqueous-based formulation, the reservoir matrix is preferably composed of a hydrophobic polymer. Suitable polymeric matrices are well known in the transdermal drug delivery art, and examples are listed in the above-named patents.
A typical laminated system would comprise a polymeric membrane and/or matrix such as ethylene vinyl acetate (EVA) copolymers, such as those described in U.S. Pat. No. 4,144,317, preferably having a vinyl acetate (VA) content in the. range of from about 9%. up to about 60'x and more preferably about 28%. to about 60%. VA.
Polyisobutylene/oil polymers containing from 4-25y high molecular weight polyisobutylene and 20-81%. low molecular weight io polyisobutylene with the balance being~an oil such as mineral oil or poiybutynes may also be used as the matrix material.
The aforementioned patents describe a wide variety of materials which can be used for fabricating the various layers or components of the transdermal oxybutynin delivery devices according to th is is invention. This invention therefore contemplates the use of materials other than those specifically disclosed herein, including those which may hereafter become known to the art to be capable of performing the necessary functions.
The amount of oxybutynin present in the therapeutic device and zo required to achieve an effective therapeutic result depends on many factors, such as the minimum necessary dosage of oxybutynin for the particular indication being treated; the solubility and permeability of the matrix, of the adhesive layer and of the rate-controlling membrane, if present; and the period of time for which the device zs will be fixed to the skin. The minimum amount of oxybutynin is determined by the requirement that sufficient quantities of oxybutynin must be present in the device to maintain the desired rate of release over the given period of application. The maximum amount for safety purposes is determined by the requirement that the 30 ' quantity of oxybutynin present cannot exceed a rate of release, that reaches toxic levels. The oral lethal dose discovered for rats is 1220 mg/kg.
When a constant oxybutynin delivery rate is desired, the oxybutynin is normally present in the matrix or carrier at a a concentration in excess of saturation, the amount of excess being a z~~3z~s~
function of the desired length of the oxybutynin delivery period of the system. The oxybutynin may, however, be present at a level below saturation without departing from this invention as long as oxybutynin is continuously administered to the same skin or mucosa s site in an amount and for a period of time sufficient to provide the desired therapeutic rate and delivery profile of oxybutynin delivery.
The permeation enhancer is dispersed through the matrix or carrier, preferably at a concentration sufficient to provide permeation-enhancing amounts of enhancer in the reservoir throughout io the anticipated administration period. Where there is an additional, separate permeation enhancer matrix layer as well, as in FIGS. 3 and 4, the permeation enhancer normally is present in the separate reservoir in excess of saturation, The preferred permeation enhancers of the present invention are is a monoglyceride or a mixture of monoglycerides of fatty acids with a total monoester content of at least 51x. Fatty acids may be saturated or unsaturated and straight or chained, and include, for example, lauric acid, myristic acid, steari~ acid, oleic acid, linoleic acid and palmitic acid. Monoglycerides are generally Zo available as a mixture of monoglycerides, with the mixture deriving its name from the monoglyceride present in the greatest amount.
Monoglyceride permeation enhancers include, for example, glycerol monooleate, glycerol monolaurate and glycerol monolinoleate. In a more preferred embodiment, the permeation enhancer is glycerol zs monooleate.
In addition to oxybutynin and a suitable permeation~enhancer, which are essential to the invention, the matrix or carrier may also contain dyes, pigments, inert fillers, excipients and other conventional components of pharmaceutical products or transdermal 3o devices known to the art.
In the present invention, oxybutynin is delivered at a therapeutically effective rate (that is, a rate that provides a desired therapeutic effect) and the permeation enhancer is delivered at a permeation-enhancing rate (that is, a rate that provides 2I~~ ~~~
increased permeability of the application site to the oxybutynin) for a predetermined time period and in the required delivery pattern.
A preferred embodiment of the present invention comprises a method of treating any disorder in which it is therapeutic to administer a therapeutically effective amount of one or more of the compounds of the present invention to a patient suffering from such disorder.
Another preferred embodiment of the present invention comprises a method of treating neurogenic bladder disorders, e.g., urinary o frequency or incontinence. To be useful in treating a neurogenic bladder disorder. oxybutynin should be present in plasma at levels above about 0.5 ng/ml, preferably at levels above about 1.0 ng/ml and most preferably at levels of about 2.0 ng/ml. To achieve this result, oxybutynin is delivered at a therapeutic rate of at least :s about 40-200 ug per hour, but typically of at least 80 ug/hr, and more typically at about 80-160 ug/hr, for the treatment period, usually about 24 hours to 7 days.
The administration rate through the skin should be sufficient to minimize the size of the device. The size of the device of this zo invention can vary from less than 1 cmz to greater than 200 cm2. A
typical device, however, will have a size within the range of 5-50 cmZ. The delivery device containing the oxybutynin and a permeation enhancer is placed on a user such that the device is delivering oxybutynin in a therapeutically effective amount to the zs user to treat a neurogenic bladder disorder.
The length of time of oxybutynin presence and the total amount of oxybutynin in the plasma can be changed following the teachings of this invention to provide different treatment regimens. Thus, they can be controlled by the amount of time during which exogenous ~o oxybutynin is delivered transdermally to an individual or animal.
The devices of this invention can be designed to effectively deliver oxybutynin for an extended time period of from several hours up to 7 days or longer. Seven days is generally the maximum time limit for application of a single device because the adverse affect _. of occlusion of a skin site increases with time and the normal cycle 213~~ ~~
WO 93/23025 ' PCT/US93/04518 or sloughing and replacement or the skin cells occurs in about 7 days. The transdermal therapeutic devices of the present invention are prepared in a manner known in the art, such as by those procedures, for example, described in the transdermal device patents s listed previously herein. Having thus generally described the invention, the following specific examples describe preferred embodiments thereof.
DETAILED DESCRIPTION OF EXAMPLES
The devices for Example 1 were prepared as follows:
;o ~ A. Formulation without a Permeation Enhancer A formulation containing 30 wt o oxybutynin base in a matrix of EVA 40 (U.S.I. Chemicals, Illinois) was prepared by dissolving the oxybutynin base and EVA 40 in methylene chloride. The solution was poured onto a sheet of fluorocarbon diacrylate ("FCO")/polyester i5 release liner to dry. The dried material was pressed to 5 mil (a.
0.1 mm) thickness between two sheets of FCD/polyester release liner at 75'C. The resulting film was laminated to a flexible cloth backing (spun laced polyester, 1.3 oz/ydZ), and 2.0 cm= discs were cut from the laminate, ~o B. Formulations with Permeation Enhancers Formulations containing oxybutynin base at 30 wt °o, and various permeation enhancers glycerol monolaurate, glycerol monooleate, and glycerol monolinoleate) at 25 wt o in a matrix of EVA 40 were prepared by dissolving the oxybutynin base, permeation enhancer and is EVA 40 in methylene chloride. The same procedure as described above was then used to make the device.
The glycerol monooleate (GMO) used was Myverol~ 18-99K glycerol monooleate (Eastman Kodak Chemicals), which has a glycerol monooleate content of 61x and a total monoester content of 93x, the glycerol ~o monolinoieate (GMLO) used was Myverolm 18-92K glycerol monolinoleate.
which has a glycerol monolinoleate content of 68X and a minimum total monoester content of 90x, and the glycerol monolaurate (GML) used was Grindtek~ ML 90 glycerol monolaurate, which has a glycerol monolaurate content of 90%. and a minimum total monoester content of 90%.
C. Device with In-line Adhesive Each of the oxybutynin matriX/cloth backing laminates were.
divided in half, and one half of each was laminated to 3M'~acyiate transfer adhesive MSP 32589 (1.6 mil, an acrylate adhesive with 2-5%
acid functionality). Before testing, each final laminate was . equilibrated format least 5 days to allow the enhancer and oxybutynin to partition into the contact adhesive'. The edges of the devices with in-line adhesive were masked with polyester tape so that the oxybutynin reservoir edges were not exposed to the epidermis or solutions when they were tested.
The devices for Examples 2. 4 and 5 are prepared as follows:
A. Formulation containing GMO
i3 A formulation containing 27 wt 9. oxybutynin base and 27 wt y.
GMO (Myverol~ 18-99K glycerol monooleate) in a matrix of EYA 40 was prepared using a Brabender~''Mixer and a 50 cc mixing bowl. The EVA 40 was added to the mixing bowl and mixed until pellets were no longer visible. The oxybutynin base was slowly added to the mixing bowl.
?o Mixing was continued for an additional 10 minutes after addition was complete. GMO was heated to 40'C and added very slowly to the mixing bowl. Addition time was approximately 45 minutes. The bowl was then closed and mixing continued for at least 20 minutes before removing the completed oxybutynin mix from the bowl.
The oxybutynin mix was calendared to 5 mil thickness between release liners (FCD/polyesterj. Five one-foot sections of the oxybutynin film were heat laminated to Medparo backing (medium .
density polyethylene layer/aluminum polyester layer/EVA layer).
Three of the oxybutynin film/backing laminates were laminated to 3M
3o acrylate transfer adhesive MSP 1006 P.
*Trade-mark ~1 ~~,{~~5 WO 93123025 PCI'/US93/04518 1b EXAMPLE I
The in vitro transdermal oxybutynin permeation rates through the epidermis of two human skin donors from devices described above were determined. For each device tested, the release liner was s removed and the oxybutynin-releasing surface was placed against the stratum corneum side of a disc of human epidermis which had been blotted dry just prior to use. The excess epidermis was wrapped around the device so that none of the device edge was exposed to the receptor solution. The device covered with epidermis was attached to io the flat side of the TeflonA holder of a release rate rod using nylon mesh and metal string. The rods were reciprocated in a fixed volume of receptor solution 0.05 M phosphate buffer, pH 6.5. The entire receptor solution was changed at each sampling time. The temperature of the receptor solution in the water bath was maintained at 35'C.
is Results are summarized in the following table:
Average Transdermal Oxybutynin (Base) Permeation Enhancer Permeation Rate Zo ua/cm2/hr for 0-96 hrs With adhesive None (control) 1.21 GML 3.74 Myverol~ 18-99K 3.09 Myverol~ 18-92K 2.40 2s Without adhesive None Control 1.13 GML 4.24 Myverola 18-99K 3.59 Myverol~ 18-92K 2.47 EXAMPLE ,~
3o The in vitro transdermal oxybutynin permeation rates through the epidermis of five human skin donors from devices described above were determined as described in Example 1. The control formulation contained 30 wt y. oxybutynin base (no permeation enhancer) in an EVA
40 matrix. No in-line adhesive was present. The other formulation 2~ ~~8~
.V0 93/2302, PCT/US93/04518 contained 28 wt °~° oxybutynin base and 28 wt °.o Myveroi~ 18-99K
glycerol monooleate in an EVA 40 matrix. There was a 3M acrylate in-line adhesive present. This same device was used in the in vivo testing described in Examples 3 and 4. The results are summarized in s the following table:
TA_ BLE 2 Control Without With Permeation Sk~-n, Donor Permeation ~nhancer Enhancer a4/cm ~hr u4/cm2/hr io 1 4.7 15.4 2 3.1 6,8 ' 3 2.6 9.4 4 2.5 4.7 2.6 5.4 a AMP
This experiment was carried out using standard glass diffusion cells which consist of a donor compartment with a 4 ml capacity, and a receptor compartment with a 22 ml capacity. A circular piece of epidermis was placed in each diffusion cell (permeation area -zo 1.13 cm2) in a horizontal position between a lower capped receptor compartment and an upper capped donor compartment. The receptor compartment has both a venting tube (uncapped) and a sampling port (capped). The stratum corneum side of the epidermis faced the donor compartment. An 0-ring was positioned between the epidermis and the zs .donor compartment, and a clamp held the compartments together. The receptor solution, 22 ml of 0.05 M phosphate buffer solution, pH 6.5, was added to each receptor compartment. The cells were placed in a temperature controlled water bath shaker at 35'C and allowed to come to temperature before the donor solution was added.
A total of five donor solutions were tested, and the donor volume was 0,2 ml in each case. The donor solutions tested were oxybutynin saturated in 0.05 M phosphate buffer solution, pH 6.5, oxybutynin saturated in mineral oil, oxybutynin saturated in a solution of 3096 ethanol in phosphate buffer, oxybutynin saturated in _. a solution of 10.69: Myverol 18-99K glycerol monooleate in mineral ~~~~i~~~
oil, and oxybutynin saturated in a solution of 10.6Yo glycerol monolaurate in mineral oil. All donor solutions were at pH 6.5.
At each time interval, the receptor solution was removed from the test cell and replaced with an equal volume of fresh receptor solution previously equilibrated at 35'C. The receptor solutions for each time interval were then assayed for oxybutynin, by HPL~C (Zorbax Rx-C8, 15 cm x 4.6 mm ID, 5 ~cm, 30x acetonitrile/water, 0.06x dimethyloctylamine, 0.03 H3P04, 220 nm, 1.0 ml/min), to calculate the permeation rate of oxybutynin through epidermis from the donor io solution.
As can be seen in Figure 5, glycerol monolaurate and glycerol monolinoleate increased the permeation rate of oxybutynin, whereas ethanol showed the same permeation rate as the donor solution containing no permeation enhancer.
is AMP 4 The in vivo plasma levels of oxybutynin were measured for two body sites. A 10 cm2 device was worn on the penis for 10~ hours and two 10 cmZ devices were worn on the inner thigh for 24 hours. A
control sample was drawn before applying the systems. The device 2o worn on the penis produced a plasma oxybutynin level of 2.0 ng/mL
within 4 hours, and the levels varied between 1.4 and 2.1 ng/ml during the following 6~ hours of wearing. The systems worn on the inner thigh produced a plasma oxybutynin concentration of 0.9 ng/mL
after 12 hours of wearing, and after 24 hours of wearing ,the level 25 had reached 1.1 ng/mL.
The in vivo plasma oxybutynin concentration were also measured in two additional subjects who each wore two 10 cm~ systems on the inner thigh. One subject achieved a plasma oxybutynin concentration of 2.0 ng/mL after 9 hours, and the plasma level was 1.7 ng/ml after so 24 hours of wearing. The other subject achieved a plasma level of 0.7 ng/ml after 12 hours, and the plasma level was 0.8 ng/mL after 24 hours.
2~1~~F5a The residual oxybutynin in devices which had been worn by subjects was measured and compared to the oxybutynin content of devices which had not been worn. The results are summarized in the following table:
TABLE 3, Measured Drug Loss Subiect ~ Site (ma/20 cm2LaYj 1 inner thigh 5.8 :0 2 inner thigh 8.6 3 chest 6.7 . 4 abdomen 7.2 pen l s 19 . 2 Having thus generally described the present invention and :s described certain specific embodiments thereof including the embodiments that the applicants consider the best mode of practicing their invention, it will be readily apparent that various modifications to the invention may be made by workers skilled in the art without departing from the scope of this invention which is limited only by the following claims,
Claims (13)
1. A device for the transdermal administration, at a therapeutically effective rate, of oxybutynin, which device comprises:
(a) a reservoir comprising a therapeutically effective amount of oxybutynin and a skin permeation-enhancing amount of a monoglyceride or a mixture of monoglycerides of a fatty acid with a total monoesters content of at least 51%;
(b) a backing on the skin-distal surface of the reservoir; and (c) means for maintaining the reservoir in oxybutynin- and monoglyceride or monoglyceride mixture-transmitting relation with the skin.
(a) a reservoir comprising a therapeutically effective amount of oxybutynin and a skin permeation-enhancing amount of a monoglyceride or a mixture of monoglycerides of a fatty acid with a total monoesters content of at least 51%;
(b) a backing on the skin-distal surface of the reservoir; and (c) means for maintaining the reservoir in oxybutynin- and monoglyceride or monoglyceride mixture-transmitting relation with the skin.
2. A device for the transdermal administration, at a therapeutically effective rate, of oxybutynin, which device comprises:
(a) a first reservoir comprising a therapeutically effective amount of oxybutynin and a skin permeation-enhancing amount of a monoglyceride or a mixture of monoglycerides of a fatty acid with a total monoester content of a least 51%;
(b) a second reservoir comprising an excess of the monoglyceride or monoglyceride mixture of part (a) and substantially free of oxybutynin;
(c) a membrane between the first reservoir and the second reservoir, wherein said membrane comprises polyethylene, polyvinyl acetate or ethylene vinyl copolymers;
(d) a backing on the skin-distal surface of the second reservoir; and (e) means for maintaining the first and second reservoirs in oxybutynin- and monoglyceride or monoglyceride mixture-transmitting relation with the skin.
(a) a first reservoir comprising a therapeutically effective amount of oxybutynin and a skin permeation-enhancing amount of a monoglyceride or a mixture of monoglycerides of a fatty acid with a total monoester content of a least 51%;
(b) a second reservoir comprising an excess of the monoglyceride or monoglyceride mixture of part (a) and substantially free of oxybutynin;
(c) a membrane between the first reservoir and the second reservoir, wherein said membrane comprises polyethylene, polyvinyl acetate or ethylene vinyl copolymers;
(d) a backing on the skin-distal surface of the second reservoir; and (e) means for maintaining the first and second reservoirs in oxybutynin- and monoglyceride or monoglyceride mixture-transmitting relation with the skin.
3. A device according to claim 1 or claim 2 wherein the monoglyceride or monoglyceride mixture comprises glycerol monooleate, glycerol monolaurate or glycerol monolinoleate.
4. A device according to any one of claims 1 to 3 adapted for an administration rate of the oxybutynin to the skin of at least 0.08 mg/hour for a predetermined period of time.
5. A device according to any one of claims 1 to 4 adapted for a permeation rate of the oxybutynin through the skin of at least 12 µg/cm2/hr for a predetermined period of time.
6. A device according to any one of claims 1 to 5 wherein the backing is permeable to water vapor.
7. A device according to any one of claims 1 to 6 wherein the monoglyceride is glycerol monooleate and the reservoir further comprises a matrix containing ethylene vinyl acetate copolymer having from about 9% to 60% vinyl acetate.
8. A device according to any one of claims 1 to 7 wherein the means for maintaining the reservoir in relation with the skin comprises an in-line adhesive layer on the skin-proximal surface of the reservoir.
9. A device according to claim 2 wherein the first reservoir also is an adhesive layer which functions as the means for maintaining the reservoirs in relation with the skin.
10. A use for treating neurogenic bladder disorders of the oxybutynin transdermal delivery device according to any one of claims 1 to 9.
11. A use of the device according to any one of claims 1 to 9 to enhance transdermal flux of oxybutynin.
12. A use of a monoglyceride or a mixture of monoglycerides of a fatty acid with a total monoesters content of at least 51% for increasing the permeability of skin to oxybutynin.
13. The use according to claim 12 wherein the monoglyceride or monoglyceride mixture comprises glycerol monooleate, glycerol monolaurate or glycerol monolinoleate.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US88265292A | 1992-05-13 | 1992-05-13 | |
| US07/882,652 | 1992-05-13 | ||
| PCT/US1993/004518 WO1993023025A1 (en) | 1992-05-13 | 1993-05-13 | Transdermal administration of oxybutynin |
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|---|---|
| CA2132865A1 CA2132865A1 (en) | 1993-11-25 |
| CA2132865C true CA2132865C (en) | 2003-12-02 |
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ID=25381055
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002132865A Expired - Fee Related CA2132865C (en) | 1992-05-13 | 1993-05-13 | Transdermal administration of oxybutynin |
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|---|---|
| US (2) | US5411740A (en) |
| EP (1) | EP0767659B1 (en) |
| JP (1) | JP3786684B2 (en) |
| KR (1) | KR950701516A (en) |
| AT (1) | ATE185694T1 (en) |
| AU (1) | AU666735B2 (en) |
| CA (1) | CA2132865C (en) |
| DE (1) | DE69326848T2 (en) |
| ES (1) | ES2137261T3 (en) |
| FI (1) | FI945311A (en) |
| MX (1) | MX9302812A (en) |
| NO (1) | NO944249L (en) |
| NZ (1) | NZ252598A (en) |
| WO (1) | WO1993023025A1 (en) |
| ZA (1) | ZA933349B (en) |
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| KR960704579A (en) * | 1993-09-29 | 1996-10-09 | 에드워드 엘. 만델 | Monoglyceride / lactate Ester Permeation Enhancer for Oxybutynin |
| US5399359A (en) * | 1994-03-04 | 1995-03-21 | Edward Mendell Co., Inc. | Controlled release oxybutynin formulations |
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| EP0800384B1 (en) * | 1994-12-14 | 2001-03-07 | Enbalt Trading Limited | Pharmaceutical tablet formulations for direct compression |
| US5532278A (en) * | 1995-01-31 | 1996-07-02 | Sepracor, Inc. | Methods and compositions for treating urinary incontinence using optically pure (S)-oxybutynin |
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| US5968547A (en) | 1997-02-24 | 1999-10-19 | Euro-Celtique, S.A. | Method of providing sustained analgesia with buprenorphine |
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| WO1999032153A1 (en) * | 1997-12-22 | 1999-07-01 | Alza Corporation | Monoglyceride and ethyl palmitate permeation enhancer compositions |
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1993
- 1993-05-13 DE DE69326848T patent/DE69326848T2/en not_active Expired - Fee Related
- 1993-05-13 CA CA002132865A patent/CA2132865C/en not_active Expired - Fee Related
- 1993-05-13 WO PCT/US1993/004518 patent/WO1993023025A1/en active IP Right Grant
- 1993-05-13 EP EP93911284A patent/EP0767659B1/en not_active Expired - Lifetime
- 1993-05-13 MX MX9302812A patent/MX9302812A/en unknown
- 1993-05-13 JP JP50372594A patent/JP3786684B2/en not_active Expired - Fee Related
- 1993-05-13 KR KR1019940704052A patent/KR950701516A/en not_active IP Right Cessation
- 1993-05-13 ZA ZA933349A patent/ZA933349B/en unknown
- 1993-05-13 AU AU42473/93A patent/AU666735B2/en not_active Ceased
- 1993-05-13 ES ES93911284T patent/ES2137261T3/en not_active Expired - Lifetime
- 1993-05-13 AT AT93911284T patent/ATE185694T1/en not_active IP Right Cessation
- 1993-05-13 NZ NZ252598A patent/NZ252598A/en not_active IP Right Cessation
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1994
- 1994-02-08 US US08/193,661 patent/US5411740A/en not_active Expired - Lifetime
- 1994-11-08 NO NO944249A patent/NO944249L/en unknown
- 1994-11-11 FI FI945311A patent/FI945311A/en not_active Application Discontinuation
-
1995
- 1995-02-15 US US08/388,767 patent/US5500222A/en not_active Expired - Lifetime
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| NZ252598A (en) | 1997-01-29 |
| US5500222A (en) | 1996-03-19 |
| ES2137261T3 (en) | 1999-12-16 |
| FI945311A0 (en) | 1994-11-11 |
| DE69326848D1 (en) | 1999-11-25 |
| CA2132865A1 (en) | 1993-11-25 |
| NO944249L (en) | 1994-11-14 |
| US5411740A (en) | 1995-05-02 |
| ZA933349B (en) | 1994-06-15 |
| NO944249D0 (en) | 1994-11-08 |
| WO1993023025A1 (en) | 1993-11-25 |
| EP0767659A1 (en) | 1997-04-16 |
| DE69326848T2 (en) | 2000-01-27 |
| JP3786684B2 (en) | 2006-06-14 |
| KR950701516A (en) | 1995-04-28 |
| EP0767659B1 (en) | 1999-10-20 |
| FI945311A (en) | 1994-11-11 |
| JPH08502952A (en) | 1996-04-02 |
| MX9302812A (en) | 1993-11-01 |
| ATE185694T1 (en) | 1999-11-15 |
| AU666735B2 (en) | 1996-02-22 |
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