| (84) |
Designated Contracting States: |
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AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO
PL PT RO SE SI SK SM TR |
| (43) |
Date of publication of application: |
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29.06.2011 Bulletin 2011/26 |
| (73) |
Proprietor: MDM S.p.A. |
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I-20123 Milano (IT) |
|
| (72) |
Inventor: |
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- Borsa, Massimiliano
20190 Vimodrone/ MI (IT)
|
| (74) |
Representative: Beneduce, Gianna |
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Via Poggibonsi 7 20146 Milano 20146 Milano (IT) |
| (56) |
References cited: :
EP-A1- 2 135 601
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WO-A1-2004/043431
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| |
|
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- YURIKA KINO ET AL: "Involvement of Supraspinal Imidazoline Receptors and Descending
Monoaminergic Pathways in Tizanidine-Induced Inhibition of Rat Spinal Reflexes" JOURNAL
OF PHARMACOLOGICAL SCIENCES, JAPANESE PHARMACOLOGICAL SOCIETY, TOKYO, JP LNKD- DOI:10.1254/JPHS.FP0050520,
vol. 99, no. 1, 1 January 2005 (2005-01-01), pages 52-60, XP008122407 ISSN: 1347-8613
[retrieved on 2005-08-26]
- DATABASE CA [Online] CHEMICAL ABSTRACTS SERVICE, COLUMBUS, OHIO, US; 15 September
2009 (2009-09-15), CHEN, GANG ET AL: "Tizanidine hydrochloride and tandospirone citrate
combined medicine for treating headache" XP002582463 retrieved from STN Database accession
no. 151:389366 & CN 101 530 413 A (CHENGDU LUKAI PHARMACEUTICAL SCIENCE AND TECHNOLOGY
CO., LTD., PEOP. R) 16 September 2009 (2009-09-16)
- KAWAMATA TOMOYUKI ET AL: "Antihyperalgesic and Side Effects of Intrathecal Clonidine
and Tizanidine in a Rat Model of Neuropathic Pain" ANESTHESIOLOGY, AMERICAN SOCIETY
OF ANESTHESIOLOGISTS, PHILADELPHIA, PA, US, vol. 98, no. 6, 1 June 2003 (2003-06-01),
pages 1480-1483, XP008122410 ISSN: 0003-3022
- DATABASE CA [Online] CHEMICAL ABSTRACTS SERVICE, COLUMBUS, OHIO, US; 27 November 2008
(2008-11-27), NIMISHA, M. BAJPAI ET AL: "Formulation and evaluation of bioadhesive
microspheres of tizanidine hydrochloride for nasal drug delivery" XP002582464 retrieved
from STN Database accession no. 149:518832 & INDIAN PHARMACIST (NEW DELHI, INDIA)
, 7(74), 71-72, 75-77 CODEN: IPNHA9; ISSN: 0972-7914, 2008,
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State of the art
[0001] Tizanidine, 5-chloro-N-(4,5-dihydro-1H-imidazol-2-yl)-2,1,3-benzothia-diazol-4-amine,
is a α
2-adrenergic agonist structurally related to clonidine. It is a centrally acting skeletal
muscle relaxant that acts mainly at spinal and supraspinal levels to inhibit excitatory
interneurones. It is indicated for the symptomatic relief of spasticity associated
with multiple sclerosis or spinal cord injury or disease or painful muscle spasm.
[0002] The compound tizanidine, as hydrochloride, is included in Japan and US Pharmacopoeias
and it is approved and marketed worldwide, as base, in the form of 2 or 4 mg tablets.
As such, tizanidine is usually well and rapidly absorbed by oral route, but it undergoes
extensive first-pass effect which inactivates metabolites. The pharmacokinetic profile
of tizanidine, T
max 1-2h, T
1/2z 1-2h, suggested to perform slow-release dosage forms as in
US 2008 0214629A1 or
WO 2008 047208A1, but, on the other hand, the entity of the first-pass effect, suggested to replace
oral absorption with different routes of administration.
[0003] Are known in the art patent documents which describe pharmaceutical formulations
containing tizanidine: trans-dermal formulations are described in
DK 175982B1, buccal spray formulations are described in
WO 2004 019905A1, buccal and sublingual formulations are described in
WO 2004 043431A1 and in
US 2004 0122065A1. The aim of these documents is to increase the onset of action of tizanidine as well
as its bioavailability and to reduce the relative hepatic first-pass effect.
[0005] In
EP-2014305 liquid intranasal compositions are suggested with muscle relaxant in a long list
of actives.
Description of the invention
[0006] It is the object of the present invention a pharmaceutical composition in liquid
dosage form which contains as active principle the α
2-adrenergic agonist compound Tizanidine.
[0007] According to the invention it has been found that tizanidine, in the form of the
corresponding hydrochloride, is soluble in water at concentrations and pH suitable
for systemic administration, specifically for intranasal administration, and that
these aqueous solutions of tizanidine hydrochloride may be normally stored and, in
addition, easily sterilized by heat so that the use of preservative agents can be,
when preferred, avoided.
[0008] Pharmaceutical compositions of tizanidine in liquid form, such as the aqueous solutions
of the present invention, offer different advantages: they can be administered by
intranasal route (IN) to increase the bioavailability overcoming the hepatic first-pass
effect and/or to shorten the time to peak. The transmucosal nasal delivery, represents
a delivery option for drugs with limited oral bioavailability due to the degradation
in the intestinal tract, such as proteins, or hepatic first-pass metabolism, and is
also a convenient alternative to intravenous or intramuscular drug administration.
The considerable blood flow, actually responsible for breath conditioning, benefits
from the efficient systemic drug uptake and provides direct access to the systemic
circulation for transmucosal adsorbed drug.
[0009] In accordance with the administration route used, the composition of the invention
may also contain suitable, commonly used agents such as pH buffer, preservative, flavouring,
absorption enhancer and hyperbaric agents.
[0010] Among commonly used suitable pH buffer agents, aqueous buffer acetate and aqueous
buffer phosphate solutions are preferred. Among the commonly used preservative agents,
benzyl alcohol, methyl-, ethyl- and propylparahydroxybenzoate are preferred. Among
commonly used water soluble flavouring agents citrus, preferably orange, eucalyptol,
eucalyptus oil and peppermint are preferred. Among commonly used absorption enhancer
agents chitosan, methylpyrrolidone and cholic acid are preferred. Suitable tonicity
of solutions may be obtained by addition of saline or salt solutions.
[0011] The amount of tizanidine, as base, contained in the composition of the invention,
which can be daily administered to a patient, may vary in a large range and depends
on various factors, such as the pathology to be treated, the intranasal administration
relative bioavailability, the age and conditions of the patient.
[0012] The daily dose of tizanidine, as base, is generally in the range 6.00 -12.00 mg/day.
The pH value of the intranasal aqueous pharmaceutical composition may vary from 4.8
to 7.4. Tizanidine intranasal administrations may contain absorption enhancer agents
such as chitosan, methylpyrrolidone or cholic acid and preservative agents such as
benzyl alcohol, methyl-, ethyl- and propylparahydroxybenzoate or similar products
and flavouring compounds as citrus, preferably orange, eucalyptol, eucalyptus oil
or peppermint aroma and similar products.
[0013] The compositions containing tizanidine hydrochloride aqueous solutions of the present
invention, that is the compositions suitable for intranasal administration, proved
to be well tolerated at the administration site, and showed themselves to be effective
for relief both of muscle spasm and of multiple sclerosis and neuronal spasticity.
They can be administered over a wide range of doses according to the pathology, bioavailability,
and peak time.
[0014] Detailed formulations and physico-chemical properties are hereinafter provided.
Intranasal solutions
[0015] Aqueous solutions, with or without flavour, at 22.90 mg/mL suitable to be dispensed
as two 50 µL puff by 0.05 mL snap-on pump, equal to 2 mg of tizanidine base. Aqueous
solutions, with or without flavour, at 45.80 mg/mL suitable to be dispensed as two
50 µL puff by 0.05 mL snap-on pump, equal to 4.00 mg of tizanidine base.
Preparation of composition of intranasal spray solutions
[0016] An aqueous solution of tizanidine.HCl at high concentration, 45.00 mg/mL, and pH
4.8 is tolerated by the nasal mucosa without any local side effect, i.e. redness or
pain. The proposed formulations are calculated for a single puff of 50 µL/nostril.
Example 1
[0017]
| Tizanidine.HCl |
22.90 mg |
| Methyl p-hydroxybenzoate |
1.00 mg |
| Eucalyptol |
4.00 mg |
| 95% Ethanol |
0.40 mL |
| Water to |
1.00 mL |
Yellow, clear solution, pH 4.8
[0018] The formulation allows administering 1.00 or 2.00 mg of tizanidine base with 1 or
2 puffs.
Example 2
[0019]
| Tizanidine.HCl |
45.80 mg |
| Methyl p-hydroxybenzoate |
1.00 mg |
| Eucalyptol |
4.00 mg |
| 95% Ethanol |
0.40 mL |
| Water to |
1.00 mL |
Yellow, clear solution, pH 4.8
[0020] The formulation allows administering 2.00 or 4.00 mg of tizanidine base with 1 or
2 puffs.
Example 3
[0021]
| Tizanidine.HCl |
22.90 mg |
| Benzyl alcohol |
10.00 mg |
| Eucalyptol |
4.00 mg |
| Phosphate buffer pH 7.4 (0.03M) to |
1.00 mL |
Yellow, clear solution, pH 7.4
[0022] The formulation allows administering 1.00 or 2.00 mg of tizanidine base with 1 or
2 puffs.
Example 4
[0023]
| Tizanidine.HCl |
22.90 mg |
| Benzyl alcohol |
10.00 mg |
| Eucalyptol |
4.00 mg |
| Chitosan.HCl |
10.00 mg |
| Phosphate buffer pH 7.4(0.03M) to |
1.00 mL |
Yellow, clear solution, pH 7.4
[0024] The formulation allows administering 1.00 or 2.00 mg of tizanidine base with 1 or
2 puffs.
Example 5
[0025]
| Tizanidine.HCl |
22.90 mg |
| Benzyl alcohol |
10.00 mg |
| Eucalyptol |
4.00 mg |
| Cholic acid |
14.00 mg |
| Phosphate buffer pH 7.4(0.03M) to |
1.00 mL |
Yellow, clear solution, pH 7.4.
[0026] The formulation allows administering 1.00 or 2.00 mg of tizanidine base with 1 or
2 puffs.
Pharmacokinetics of tizanidine solutions
[0027] Preliminary pharmacokinetic data in rabbits at the dose of 3.00 mg/kg of tizanidine
hydrochloride by intranasal (IN), intramuscular (IM), and oral route (PO) were performed
to test the intranasal absorption without any enhancer. Tizanidine (IN) is rapidly
absorbed with a bioavailability close to that of intramuscular route (IM).
1. A pharmaceutical composition of tizanidine in liquid form for use in therapy by intranasal
administration, characterized by the fact that it contains the active ingredient, in its hydrocloride form, dissolved
in an aqueous solution and buffer solution at a pH value selected in the range from
4.8 to 7.4, that the obtained solution, duly sterilized by a heat treatment or added
with a suitable preservative agent, may be administered as such or, optionally, be
added with one or more suitable commonly used flavouring, tonicity, hyperbaric and
absorption enhancer agents.
2. The pharmaceutical composition of tizanidine in liquid form according to claim 1,
characterized by the fact that the sterilization is carried out by a heat treatment.
3. The pharmaceutical composition of tizanidine in liquid form according to claim 1 or
2, characterized by the fact that the preservative agent is selected in the group consisting of benzyl
alcohol, methylparahydroxybenzoate, ethylparahydroxybenzoate and propylparahydroxybenzoate,
that the flavouring agent is selected from the group of aroma consisting of citrus,
eucalyptol, eucalyptus oil and peppermint optionally in the presence of a tonicity
agent and/ or hyperbaric agent.
4. The pharmaceutical composition of tizanidine in liquid form for intranasal spray administration
according to any of claim 1 to 3, characterized by the fact that it contains tizanidine at the concentration from 20.00 to 40.00 mg/mL
in the presence of an absorption enhancer agent selected in the group consisting of
chitosan, methylpyrrolidone and cholic acid.
5. The pharmaceutical composition of tizanidine in liquid form according to claim 4,
characterized by the fact that the absorption enhancer agent is chitosan.
1. Pharmazeutische Zusammensetzung aus Tizanidin in flüssiger Form zur Verwendung in
der Therapie durch intranasale Verabreichung, dadurch gekennzeichnet, dass sie den Wirkstoff in seiner hydrochloriden Form in einer wässrigen Lösung und Pufferlösung
mit einem pH-Wert im Bereich zwischen 4,8 und 7,4 gelöst enthält, dass die erhaltene
Lösung, die ordnungsgemäß durch eine Erhitzung oder ein Hinzufügen eines geeigneten
Konservierungsmittels sterilisiert ist, als solche verabreicht oder wahlweise mit
einem oder mehreren geeigneten, üblicherweise verwendete Geschmacks-, Tonizitäts-
hyperbaren und absorptionsverbessernden Mitteln versehen werden kann.
2. Pharmazeutische Zusammensetzung aus Tizanidin in flüssiger Form nach Anspruch 1, dadurch gekennzeichnet, dass die Sterilisierung durch eine Erhitzung durchgeführt wird.
3. Pharmazeutische Zusammensetzung aus Tizanidin in flüssiger Form nach Anspruch 1 oder
2, dadurch gekennzeichnet, dass das Konservierungsmittel aus der Gruppe ausgewählt wird, die aus Benzylakohol, Methylparahydroxybenzoat,
Äthylparahydroxybenzoat und Propylparahydroxybenzoat besteht, und dass das Geschmacksmittel
aus der Gruppe von Aromen ausgewählt wird, die aus Zitrus, Eukalyptus, Eukalyptusöl
und Pfefferminze besteht; wobei wahlweise ein Tonizitätsmittel und/oder hyperbares
Mittel beigegeben ist.
4. Pharmazeutische Zusammensetzung aus Tizanidin in flüssiger Form zur intranasalen Verabreichung
durch Sprühen nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass sie Tizanidin in einer Konzentration zwischen 20,00 bis 40,00 mg/mL enthält, wobei
ein absorptionsverbesserndes Mittel beigegeben ist, das aus der Gruppe ausgewählt
wird, die aus Chitosan, Methylpyrrolidon und Cholsäure besteht.
5. Pharmazeutische Zusammensetzung aus Tizanidin in flüssiger Form nach Anspruch 4, dadurch gekennzeichnet, dass das absorptionsverbessernde Mittel Chitosan ist.
1. Composition pharmaceutique de tizanidine en forme liquide pour l'usage en thérapie
par administration intranasal, caractérisée par le fait qu'elle contient l'ingrédient actif, en sa forme hydrochlorydrate, dissous dans une solution
aqueuse et une solution tampon à une valeur de pH choisi entre 4,8 et 7,4, que la
solution obtenue, dûment stérilisée par traitement thermique ou par addition d'un
ou plusieurs aptes agents conservatifs, peut être administrée telle quelle ou, facultativement,
avec l'addition d'un ou plusieurs aptes agents communément utilisés pour aromatiser,
donner tonicité, augmenter l'hyperbaricité et l'absorption.
2. Composition pharmaceutique de tizanidine en forme liquide selon la revendication 1,
charactérisée par le fait que la stérilisation a lieu par traitement termique.
3. Composition pharmaceutique de tizanidine en forme liquide selon la revendication 1
ou 2, charactérisée par le fait que l'agent conservatif est choisi dans le groupe
consistant de alcool benzylique, méthylparahydroxybenzoate, éthylparahydroxybenzoate
et propylparahydroxybenzoate, que l'agent aromatisant est choisi dans le groupe d'arômes
consistants des agrumes, eucalyptol, huile d'eucaliptol et menthol facultativement
en présence d'un agent de tonicité et/ou d'un agent d'hyperbaricité.
4. Composition pharmaceutique de tizanidine en forme liquide pour administration de spray
nasal selon une quelconque des revendications 1 à 3, charactérisée par le fait qu'elle
contient tizanidine à la concentration de 20,00 à 40,00 mg/mL en présence d'un agent
augmentatif de l'absorption choisi dans le groupe consistant en chitosane, méthylpyrrholidon
et acide cholique.
5. Composition pharmaceutique de tizanidine en forme liquide selon la revendication 4,
charactérisée par le fait que l'agent augmentatif de l'absorption est chitosane.