Antiparasitic formulations.

ANTIPARASITIC FORMULATIONS

This invention relates to antiparasitic formulations, particularly antiparasitic formulations containing avermectins or milbemycins, including derivatives thereof, suitable for topical application to mammals, including humans and domestic animals such as cats and dogs, and which are useful in the treatment of conditions caused by endo- and/or ectoparasites. Especially of interest are formulations of substances active against fleas and/or heartworms.

Antiparasitic avermectins, milbemycins and their derivatives have been described in numerous publications, see for example European Patent Applications publication nos. 0 214 731,0 284 176,0 317 148,0 308 145,0 340 832,0 335 541,0 350 187, 0 170 006,

254 583, 0 334 484, 0 410 615, British Patent Application numbers 1 573 955, 1 390 336, International Patent Applications publication nos. WO 94/15944 and WO

95/22552, “Ivermectin and Abamectin”, WC Campbell, Springer Verlag, New York (1989), and “Doramectin - a potent novel endectocide”, AC Goudie et al, Vet.Parasitol. ® 49(1993)5. 2;

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A number of such substances have been developed for commercialisation, for example ivermectin (Ivomec™), doramectin (Dectomax™), moxidectin and abamectin (Avomec™).

International Patent Application publication no. WO 94/15944, the teaching of which is herein incorporated by reference in its entirety, describes a family of 5-oximino

5 derivatives of avermectin 13-monosaccharides having activity in the treatment of a number of conditions caused by endo- and/or ectoparasites, including 5-oximino-22,23dihydro-25-cyclohexylavermectin BI monosaccharide (selamectin, Example 5).

We describe herein long-acting formulations suitable for topical application that are

0 capable of delivering avermectins and milbemycins with activity against endo- and/or ecto-parasites. These formulations have good cosmetic profiles, stability on storage, cutaneous tolerability, and transdermal delivery characteristics.

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According to one aspect of the invention there is provided a long-acting antiparasitic formulation suitable for topical application including:

(a) about 0.1-50% w/v an avermectin or milbemycin having activity against endoandz'or ectoparasites;

(b) about 1-50% v/v a di(C₂^, glycol) mono(C_M alkyl) ether;

(c) an optional antioxidant; and (d) an optional skin acceptable volatile solvent q.s. v/v.

[By w/v is meant weight/volume, i.e. 1% w/v means lg in 100ml of the 10 formulation.]

The formulations of the invention have a good cosmetic profile. For instance when applied topically to the fur of a domestic animal such as a cat or dog, they spread well giving good skin contact across a wide range of temperatures. They do not leave an unsightly oily patch, of the type associated with some commercial avermectin or milbemycin formulations in fatty excipients.

Certain of the formulations according to the invention are effective enough to enable long periods, e.g. a several weeks or a month, between treatments.

Preferably the active compound has activity against both endo- and ectoparasites.

Preferably the active compound is selected from ivermectin, doramectin, abamectin, moxidectin, and the avermectin 13-monosaccharide 5-oximes generically and

5 specifically disclosed in International Patent Application publication no. WO 94/15944.

Most preferably the active compound is 5-oximino-22,23-dihydro-25cyclohexylavermectin BI monosaccharide (selamectin).

0 Preferably the di(C₂₄ glycol) mono(C_M alkyl) ether is diethylene glycol monomethyl ether (DEGMME) or dipropylene glycol monomethyl ether (DPGMME).

More preferably the glycol monomethyl ether is DPGMME.

Any source of phamaceutical/veterinary quality di(C₂_„ glycol) mono(C_M alkyl) ethers

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1^^* 3 may be used. For instance, an acceptable commercial source of DPGMME is Dow Coming, whose product “Dowanol DPM™” has the following characteristics: B.pt. 74.6°C at 13mbar; freezing point -83°C, density 0.948g/cm³ at 25°C, viscosity 3.72 mPas at 25°C and refractive index of 1.421 at 25°C.

Preferably the di(C₂^, glycol) mono(C_lut alkyl) ether is present in the formulation at a level of up to about 20% v/v, yet more preferably in the range about 2-16% v/v, further more preferably in the range about 4-12% v/v, and most preferably in the range about 612% v/v.

Preferably the skin acceptable volatile solvent is present and is ethanol or isopropanol (IPA).

More preferably the skin acceptable solvent is IP A.

Preferably the w/v to v/v ratio of active compound to the glycol monomethyl ether is in the range about (0.5 to 2) to 1.

More preferably the w/v to v/v ratio of active compound to the glycol monomethyl ether is about (0.7 to 1.4) to 1.

Yet more preferably the w/v to v/v ratio of active compound to the glycol monomethyl 2 0 ether is about (0.9 to 1.1) to 1.

Most preferably the w/v to v/v ratio of active compound to the glycol monomethyl ether is about 1:1.

Preferably the level of active avermectin or milbemycin in the total formulation is in the

5 range about 1% to about 16% w/v, more preferably about 4% to about 12% w/v, yet more preferably about 6 to about 12% w/v.

Optionally the formulation can further include an antioxidant, such as propylgallate,

BHA (2-t-butyl-4-methoxyphenol), or BHT (2,6-di-z-butyl-4-methylphenol).

0 Preferably, the antioxidant, if present, is BHT.

Preferably, the antioxidant, if present, is at a level of less than 0.2% w/v, more preferably less than 0.1% w/v.

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Preferably the formulation consists of:

(a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide (selamectin, at a level of 1% to 16% w/v);

(b) DEGMME or DPGMME at 1 to 16% v/v, and at a w/v to v/v ratio of active compound to DEGMME/DPGMME of about 1:1;

(c) isopropanol q.s. 100% v/v;

and, optionally (d) BHT (at less than 0.1% w/v).

More preferably the formulation consists of:

(a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide (selamectin, at a level of 6% to 12% w/v);

(b) DEGMME or DPGMME 6 to 12% v/v, and at a w/v to v/v ratio of active compound to or DEGMME/DPGMME of about 1:1;

(c) isopropanol q.s. 100% v/v;

and, optionally (d) BHT (at less than 0.1% w/v).

A preferred group of formulations consists of the formulations mentioned in the Examples below.

Another aspect of the invention is a method of treatment of a condition caused by an endo- or ectoparasite by administration of an effective amount of a formulation according to the invention.

Another aspect of the invention is a formulation according to the invention for use in medicine.

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Another aspect of the invention is the use of a formulation according to the invention in the manufacture of a medicament for the treatment of conditions caused by endo- and/or ecto-parasites:

Formulations according to the invention can be made by standard methods, for example by dissolution of the avermectin and/or milbemycin and optional antioxidant in the solvent or solvents, in accordance with standard pharmaceutical or veterinary practice,

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e.g. by agitation of a mixture of the ingredients, if necessary with concurrent warming.

The invention is illustrated by the following examples, in which (i) the BHT antioxidant (if present) was dissolved in a mixture of DPGMME or DEGMME and IP A, (ii) the drug substance was added, and the mixture stirred until dissolution took place, (iii) any residue was filtered off prior to filling into appropriate containers.

Example 1

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavennectin BI monosaccharide at 6% w/v (b) DPGMME at 6% v/v (c) BHT at 0.08% w/v (d) IP A q.s. 100% v/v.

Example 2

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 6% w/v (b) DPGMME at 6% v/v (c) IPA q.s. 100% v/v.

Example 3

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 8% w/v (b) DPGMME at 16% v/v (c) BELA 0.1 % w/v (d) IPA q.s. 100% v/v.

Example 4

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A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 12% w/v (b) DPGMME at 12% v/v (c) BHT at 0.08% w/v (d) IPA q.s. 100% v/v.

Example 5

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 12% w/v 10 (b) DPGMME at 12% v/v (c) IPA q.s. 100% v/v.

Example 6

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 16% w/v (b) DPGMME at 16% v/v (c) BHA 0.1 % w/v (d) IPA q.s. 100% v/v.

Example 7

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 16% w/v (b) DEGMME at 16% v/v (c) IPA q.s. 100% v/v.

Example 8

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin BI monosaccharide at 16% w/v 3 0 (b) DPGMME at 8% v/v (c) IPA q.s. 100% v/v.

Example 9

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A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin Bl monosaccharide at 16% w/v (b) DPGMME at 16% v/v (c) IPA q.s. 100% v/v.

Example 10

A formulation consisting of (a) 5-oximino-22,23-dihydro-25-cyclohexylaverrnectinBl monosaccharide at 16% w/v (b) DEGMME at 8% v/v (c) IPA q.s. 100% v/v.

Example 11

A formulation with the following ingredients (in mg/ml):

(a) 5-oximino-22,23-dihydro-25-cyclohexylavermectinBl monosaccharide (60);

(b) DPGMME (56.28);

(c) BHT (0.8); and (d) IPA (697.92).

Example 12

A formulation with the following ingredients (in mg/ml):

(a) 5-oximino-22,23-dihydro-25-cyclohexylavermectin Bl monosaccharide (120);

(b) DPGMME (112.56);

(c) BHT (0.8); and (d) IPA (613.64).

The amount of antiparasitic avermectin I milbemycin material in a unit dose of the formulation can of course vary depending on the efficacy of the avermectin / milbemycin in treating the condition of interest, the desired frequency of application, etc., according to standard veterinary and pharmaceutical practice.

The formulations of the invention can be administered in a way appropriate to the specific use envisaged, the particular species and weight of host animal being treated, the parasite or parasites involved, degree of infestation, etc., according to standard

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medical and veterinary' practice.

For example, for dogs and cats, a dose of 5-oximino-22,23-dihydro-25cyclohexylavermectin Β1 monosaccharide (selamectin) of between 4 mg/kg and 12 mg/kg, preferably about 9 mg/kg body weight of the host animal as a single dose once per month will be satisfactory for flea control and heartworm prophylaxis, but of course there will be instances where higher or lower dosage ranges are indicated and such are within the scope of this invention. A typical dosage regime for a'6mg/kg dose, to a domestic animal such as a typical domestic cat or dog, would be 0.25ml to 2ml of the formulation of Example 1 per dose per month.

The formulations according to the invention are especially suitable to be administered topically. For topical application, dip, spray, pour-on, spot-on, jetting fluid, shampoos, collar, tag or harness may be used. Particularly preferred is a spot-on formulation.

It is to be understood that reference to treatment includes prevention, alleviation and cure of the condition or conditions caused by the parasite or parasites.

The efficacy of the formulations according to the invention is illustrated by the following. Three formulations of selamectin were administered as a single topical dose of 8 mg/kg, and evaluated over time against induced infestations of the flea (Ctenocephalides felis) on dogs. The three formulations each contained 160 mg/mL of selamectin and, respectively, 16% w/v diethylene glycol monomethyl ether (DEGMME), 8% w/v dipropylene glycol monomethyl ether (DPGMME) or 16% w/v DPGMME, with isopropanol to volume. Thirty-six dogs (16 males and 20 females) previously infested with 100 unfed viable adult fleas were allocated randomly by flea count to one of four groups which subsequently received saline (negative control, Tl), selamectin in 16% w/v DEGMME (T2), selamectin in 8% w/v DPGMME (T3), and selamectin in 16% w/v DPGMME (T4). Treatment was administered topically at the base of the neck in front of the shoulder blades on day 0. Efficacy was assessed by comb counts of viable fleas present on each dog. Each dog was infested with approximately 100 unfed viable adult C. felis on days 1,4, 11, 18, 23, 27, 32, and 39, and comb counts were conducted approximately 72 hours after each infestation, on days

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4, 7, 14, 21, 26, 30, 35 and 42. There were no adverse drug reactions and no mortalities during the study. Geometric mean flea comb counts for each of the three selamectin formulations were significantly lower (P &lt; 0.05) than those of the saline control on each post-treatment flea counting day. Efficacies (percentage reductions in geometric mean flea comb counts) on day 30 were 98.6%, 98.2% and 99.4% for T2, T3 and T4, respectively. On day 35, efficacies for T2, T3 and T4 were 93.5%, 95.9% and 97.7%, respectively. Efficacies on day 42 were 67.3%, 82.3% and 88.1% for T2, T3, and T4, respectively.

The efficacy of a selamectin formulation, administered topically at dosages of 3 mg/kg, mg/kg and 9 mg/kg, was evaluated against induced infestations of Ctenocephalides felis on dogs for the determination of an appropriate dose. The formulation contained 12% (120 mg/mL) of selamectin and 11.26% w/v dipropylene glycol monomethyl ether (DPGMME) in isopropanol. Forty-eight dogs (24 males and 24 females) were allocated randomly by flea counts within sex to one of four groups: placebo (negative control,

Tl) or selamectin at 3 mg/kg (T2), 6 mg/kg (T3) or 9 mg/kg (T4). On day 0, treatments were administered topically on the animal’s back at the base of the neck in front of the shoulder blades. Efficacy was assessed by comb counts of live fleas present on each dog. Each dog was infested with approximately 100 unfed viable adult C. felis on days

0 4, 11, 18 and 27, and comb counts were conducted approximately 72 hours after each infestation, on days 7, 14, 21 and 30, respectively. There were no adverse drug reactions and no mortalities during the study. Percentage reductions in geometric mean flea comb counts for the three selamectin treatments ranged from 94.6% to 100% on days 7, bland 21. On day 30, percentage reductions were 81.5%, 94.7%, and 90.8% for T2, T3,

5 and T4, respectively. Analysis of variance showed that day 30 flea comb counts for the treated groups (T2, T3 and T4 combined) were significantly lower (P &lt; 0.05) than for placebo (Tl), and that counts for the 3 mg/kg treatment (T2) were significantly higher (P &lt; 0.05) than for the 6 mg/kg and 9 mg/kg treatments (T3 and T4 combined), which were not statistically different (P &gt; 0.10).