Administration of benzodiazepine

<Cross-reference to related applications> This application has priority over US provisional application 61 / 497,017 filed on June 14, 2011 and US provisional application 61 / 570,110 filed on December 13, 2011. Alleged, each incorporated herein by reference in its entirety.

The application relates to nasal administration of benzodiazepine drugs and combinations thereof.

By one example, the benzodiazepine family consists of drugs such as diazepam, lorazepam and midazolam. Drugs within this family have been observed to possess sedative, tranquilizing and muscle relaxant properties. They are often classified as anxiolytics and skeletal muscle relaxants. They prevent anxiety, insomnia, agitation, seizures (such as those caused by epilepsy), symptoms of muscle spasticity and stiffness, withdrawal and exposure to nerve gas associated with continued abuse of central nervous system depressants. , Treatment, or improvement.

Benzodiazepines are GABA in nerve cells_AIt is said to act by binding to the receptor, altering the shape of the receptor and making it more accessible to gamma-aminobutyric acid (GABA).

GABA is GABA_AWhen bound to a receptor, Cl flows into the nerve cell to which the receptor binds.^-It is an inhibitory neurotransmitter that promotes ions. Cl^-The increase in ions hyperpolarizes the membrane of nerve cells. This completely or substantially reduces the ability of nerve cells to carry action potentials. Targeting this receptor is particularly useful in treating many disorders, such as tetanus and epilepsy, which can result from too many action potentials passing through the nervous system.

Current formulations of benzodiazepine drugs can be administered orally, rectally, or parenterally. The ability to utilize these and other types of formulations is often severely limited by solubility challenges.

The oral route of administration may be considered non-optimal due to some drawbacks. For example, the time required for an orally administered benzodiazepine drug to reach a therapeutically relevant concentration in plasma can be one hour or longer. Moreover, significant amounts of the drug can be metabolized as a benzodiazepine drug that passes through the liver. Therefore, high doses may be required to achieve therapeutic plasma levels. Furthermore, the nature of seizures and muscle spasticity can make it difficult for patients or caregivers to administer benzodiazepine drugs orally, and caregivers may hesitate to touch the patient's mouth.

Intravenous administration probably provides a faster route of administration. However, intravenous administration is generally limited to trained healthcare professionals in a tightly controlled clinical setting. In addition, sterility must be maintained. In addition, intravenous administration of any drug may be painful and is probably impractical for patients suffering from needle phobia. In addition, intravenous administration of benzodiazepines is associated with respiratory depression. Therefore, the use of intravenous benzodiazepines is limited to professional health environments.

Anal suppository compositions of benzodiazepine drugs can have a rapid onset of action. However, rectal drug inconvenience is their apparent disorder being administered by someone other than a very small population of close acquaintances of the patient and professional care donors of the patient.

<p> In some embodiments, (a) a benzodiazepine drug, (b) about 30% to about 95% (w / w) in a pharmaceutically acceptable solution for administration to one or more nasal mucosa of a patient. ), One or more natural or synthetic tocopherols or tocotrienols, or a combination thereof, (c) one or more alcohols or glycols in an amount of about 10% to about 70% (w / w), or a combination thereof. A (non-aqueous) drug solution for nasal administration, consisting of any combination and (d) alkyl glycosides, is provided. In some embodiments, the benzodiazepine drug is one or more natural or synthetic tocopherols or tocotrienols in an amount of about 30% to about 95% (w / w), or any combination thereof; And dissolved in one or more alcohols or glycols, or any combination, in an amount of about 10% to about 70% (w / w). In embodiments, the benzodiazepine drug is alprazolam, brothizolam, chlordiazepoxide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, furlazepam, harazepam, midazolam, nordazepam, medazepam, medazolam, nordazepam, medazepam, nitrazepam, medazepam, nitrazepam. It is selected from the group consisting of loprazoram, any pharmaceutically acceptable salt thereof, and any combination thereof. In some embodiments, the benzodiazepine drug is diazepam, or a pharmaceutically acceptable salt thereof. In some embodiments, the solution contains from about 1 to about 20% (w / v) of benzodiazepines, eg, about 1 to about 20% (w / v) of diazepam. In some embodiments, the one or more natural or synthetic tocopherols or tocotrienols are α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, δ-tocotrienols. , Tocophersolan, any isomer thereof, any ester thereof, any analog or derivative thereof, and any combination thereof. In some embodiments, the one or more alcohols are selected from the group consisting of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, or any combination thereof. In some embodiments, the solution is ethanol (1-25% (w / v)) and benzyl alcohol (1-25% (w / v)), or ethanol (10-22.5% (w / v)). And benzyl alcohol (7.5-12. Contains two or more alcohols, such as 5% (w / v)). In some embodiments, the benzodiazepine is present in the pharmaceutical composition at a concentration of about 20 mg / mL to about 200 mg / mL. In some embodiments, one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 45% to about 85% (w / w). In some embodiments, one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, is in an amount of about 50% to about 75% (w / w). In some embodiments, one or more alcohols or glycols, or any combination thereof, is about 15% to about 55% (w / w), eg, about 25% to about 40% (w / w). Is the amount of. In some embodiments, the solution is diazepam (5-15% (w / v)), alkylglycoside (0.01-1% (w / v)), vitamin E (45-65% (w / v)). , Ethanol (10-25% (w / v)) and benzyl alcohol (5-15% (w / v)). In some embodiments, the solution comprises at least about 0.01% (w / w) of an alkyl glycoside such as dodecyl maltoside, eg, about 0.01% to 1% (w / w) of an alkyl glycoside. In some embodiments, the solution is diazepam (5-15% (w / v)), dodecyl maltoside (0.01-1% (w / v)), vitamin E (45-65% (w / v)). ), Ethanol (10-25% (w / v)), and benzyl alcohol (5-15% (w / v)), in particular the solution is diazepam (9-11% (w / v)), Dodecyl maltoside (0.1-0.5% (w / v)), vitamin E (50-60% (w / v)), ethanol (15-22.5% (w / v)) and benzyl alcohol (7.5-12.5% (7.5-12.5%) It can consist of w / v)), and more particularly the solution is diazepam (10% (w / v)), dodecyl maltoside (0.15-0.</p><p> Some embodiments described herein provide a method of treating a patient with a disorder that may be treatable by a benzodiazepine drug, the method of which is a benzodiazepine drug, from about 30% to about 95% ( One or more natural or synthetic tocopherols or tocotrienols in an amount of w / w), or any combination, one or more alcohols or glycols in an amount of about 10% to about 70% (w / w), or It comprises the step of administering to one or more nasal mucosa of a patient a drug solution for nasal administration consisting of any combination thereof and alkyl glycosides. In some embodiments, the benzodiazepine drug is in an amount of about 30% to about 95% (w / w), one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, and about 10%. Dissolved in an amount of to about 70% (w / w) of one or more alcohols or glycols, or any combination thereof. In some embodiments, the benzodiazepine drug is alprazolam, brothizolam, chlordiazepoxide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, flurazepam, harazepam, midazolam, nordazepam, medazepam, medazolam, nitrazepam, medazepam, nitrazepam, medazepam. , Temazepam, loprazolam, any pharmaceutically acceptable salt thereof, and any combination thereof. In some embodiments, the benzodiazepine drug is diazepam, or a pharmaceutically acceptable salt thereof. In some embodiments, the solution contains about 1-20% (w / v) of benzodiazepines, such as about 1-20% (w / v) of diazepam. In some embodiments, the one or more natural or synthetic tocopherols or tocotrienols are α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, δ-tocotrienols. , Toco It is selected from the group consisting of fersolane, any isomer thereof, any ester thereof, any analog or derivative thereof, and any combination thereof. In some embodiments, the one or more alcohols are selected from the group consisting of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, or any combination thereof. In some embodiments, the solution is ethanol (1-25% (w / v)) and benzyl alcohol (1-25% (w / v)), or ethanol (10-22.5% (w / v)). And contains two or more alcohols, such as benzyl alcohol (7.5-12.5% (w / v)). In some embodiments, the benzodiazepine is present in the pharmaceutical composition at a concentration of about 20 mg / mL to about 200 mg / mL. In some embodiments, one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, is in an amount of about 45% to about 85% (w / w). In some embodiments, one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, is in an amount of about 50% to about 75% (w / w). In some embodiments, one or more alcohols or glycols, or any combination thereof, is about 15% to about 55% (w / w), such as about 25% to about 40% (w / w). The amount. In some embodiments, the solution is diazepam (5-15% (w / v)), alkylglycoside (0.01-1% (w / v)), vitamin E (45-65% (w / v)). , Ethanol (10-25% (w / v)) and benzyl alcohol (5-15% (w / v)). In some embodiments, the solution is at least about 0.01% (w / w) of an alkyl glycoside, such as dodecyl maltoside, eg, about 0. Contains 01% to 1% (w / w) alkyl glycosides. In some embodiments, the solution is diazepam (5-15% (w / v)), dodecyl maltoside (0.01-1% (w / v)), vitamin E (45-65% (w / v)). ), Ethanol (10-25% (w / v)) and benzyl alcohol (5-15% (w / v)), in particular the solution is diazepam (9-11% (w / v)), dodecyl Mass concentration (0.1-0.5% (w / v)), vitamin E (50-60% (w / v)), ethanol (15-22.5% (w / v)) and benzyl alcohol (7.5-12.5% (w)) It can consist of / v)), and more particularly the solution is diazepam (10% (w / v)), dodecyl maltoside (0.15-0. From 3% (w / v)), Vitamin E (50-60% (w / v)), Ethanol (17-20% (w / v)) and Benzyl Alcohol (10-12% (w / v)) Can be. In some embodiments, the patient is human. In some embodiments, the benzodiazepine is administered in a therapeutically effective amount of about 1 mg to about 20 mg. In some embodiments, the benzodiazepine is administered in a dosage of about 10 μL to about 200 μL. In some embodiments, administration of the pharmaceutical composition comprises spraying at least a portion of a therapeutically effective amount of benzodiazepine into at least one nostril. In some embodiments, administration of the pharmaceutical composition comprises spraying at least a portion of a therapeutically effective amount of benzodiazepine into each nostril. In some embodiments, administration of the pharmaceutical composition involves spraying the first nostril with a first amount of the pharmaceutical composition, spraying the second nostril with a second amount of the pharmaceutical composition, and the like. And optionally, after a preselected time delay, it comprises spraying a third amount of the pharmaceutical composition into the first nostril. In some embodiments, the method comprises administering at least a fourth amount of the pharmaceutical composition to the second nostril after an optionally preselected time delay. In some embodiments, nasal administration of the pharmaceutical composition begins at any time before or after the onset of symptoms of the disorder that may be treatable by the pharmaceutical composition. In some embodiments, treatment is achieved with the same benzodiazepine administered intravenously, about 80-125% (eg, about 90-110%, or, above all, about 92.5-107.). Achieve 5%) bioavailability. For example, in this context, bioavailability is intended to be measured by appropriate pharmacokinetic methods, such as comparing areas under the plasma concentration curve (AUC) for drugs administered nasally and intravenously. The percent bioavailability of benzodiazepines given nasally is in the area under the plasma concentration curve obtained with one dose of benzodiazepines (eg, 10 mg nasal diazepam) and another dose of the same benzodiazepine given intravenously. It can be measured by comparison with (eg, 5 mg iv diazepam) and it is further understood that dose differences are taken into account. Therefore, for illustration purposes, a dose of 10 mg nasal diazepam that achieves an AUC of exactly half the AUC obtained at 5 mg iv would have 100% bioavailability. In some embodiments, the disorder being treated is a seizure such as an epileptic seizure, an uncontrollable seizure, or another seizure. In some embodiments, solution and treatment with solution are substantially non-irritating and well tolerated.</p><p> In some embodiments, the pharmaceutical composition for nasal administration is a benzodiazepine drug in a pharmaceutically acceptable formulation for administration to one or more nasal mucosa of a patient; about 30% to about 95%. One or more natural or synthetic tocopherols or tocotrienols in an amount of (w / w), or any combination thereof; and about 5% to about 70% (w / w), preferably 10% to about 70%. Includes one or more alcohols or glycols in an amount of (w / w), or any combination thereof. In some embodiments, the benzodiazepine drug is one or more natural or synthetic tocopherols or tocotrienols in an amount of about 30% to about 95% (w / w), or any combination thereof; and about 5% to about. It is dissolved in one or more alcohols or glycols in an amount of 70% (w / w), preferably about 10% to about 70% (w / w), or any combination thereof. In some embodiments, the benzodiazepine drug is a carrier system. Dissolved in system). In some embodiments, at least some of the benzodiazepine drugs are in the form of containing benzodiazepine microparticles, nanoparticles or a combination thereof. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles, or a combination thereof.</p><p> In some embodiments, the benzodiazepine drug is alprazolam, brothizolam, chlordiazepoxide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, flurazepam, harazepam, midazolam, nordazepam, medazepam, medazolam, nitrazepam, medazepam, medazepam. , Temazepam, loprazolam, any pharmaceutically acceptable salt thereof, and any combination thereof. In some embodiments, the benzodiazepine drug is diazepam, or a pharmaceutically acceptable salt thereof. In some embodiments, the benzodiazepine drug is a benzodiazepine microparticle, nanoparticles, or a combination thereof. In some embodiments, the benzodiazepine nanoparticles have an effective average particle size of less than about 5000 nm. In some embodiments, the benzodiazepine drug is substantially free of benzodiazepine microparticles, nanoparticles or combinations thereof.</p><p> In some embodiments, the one or more natural or synthetic tocopherols or tocotrienols are α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, δ-tocotrienols. , Tocophersolan, any isomer thereof, any ester thereof, any analog or derivative thereof, and any combination thereof. In some embodiments, the synthetic tocopherol can include vitamin E TPGS (vitamin E polyethylene glycol succinate). On the other hand, in some embodiments, synthetic tocopherols exclude tocopherols that are covalently attached or linked to a glycol polymer (eg, by a diacidic linking group), such as polyethylene glycol. Therefore, in some embodiments, the compositions described herein exclude Vitamin E TPGS.</p><p> In some embodiments, the one or more alcohols are selected from the group consisting of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, or any combination thereof. In some embodiments, the one or more glycols are selected from groups consisting of ethylene glycol, propylene glycol, butylene glycol, pentylene glycol, any isomer thereof, and any combination thereof. In some preferred embodiments, the glycol excludes the glycol polymer. In some preferred embodiments, glycols exclude glycol polymers having an average molecular weight of greater than 200. In some embodiments, glycols exclude polyethylene glycols having an average molecular weight greater than about 200.</p><p> In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 1 mg / mL to about 600 mg / mL. In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 10 mg / mL to about 250 mg / mL. In some embodiments, the benzodiazepine is present in the carrier system at a concentration of about 20 mg / mL to about 50 mg / mL.</p><p> In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 45% to about 85% (w / w). In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 60% to about 75% (w / w). In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 70% (w / w).</p><p> In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 10% to about 70% (w / w). In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 15% to about 55% (w / w). In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 25% to about 40% (w / w). In some embodiments, the carrier system comprises an amount of about 30% (w / w) of one or more alcohols or glycols, or any combination thereof.</p><p> In some embodiments, the composition is a pharmaceutical active ingredient; enhancer; excipient; and to regulate pH, buffer the composition, prevent decomposition and improve appearance, aroma, or taste. Contains at least one additional ingredient selected from the group consisting of the agents used.</p><p> In some embodiments, the composition comprises one or more paraoxybenzoic acid esters, one or more povidone, and / or one or more additional excipients such as one or more alkyl glycosides.</p><p> The present invention also discloses methods of treating patients with disorders that may be treatable by benzodiazepine drugs. In some embodiments, the patient is human. In some embodiments, the method is a benzodiazepine drug; one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 30% to about 95% (w / w); and about. A pharmaceutical composition for nasal administration comprising one or more alcohols or glycols, or any combination thereof, in an amount of 5% to about 70%, preferably about 10% to about 70% (w / w). Includes the step of administering to one or more nasal mucosa of a patient. In some embodiments, the benzodiazepine is in an amount of about 30% to about 95% (w / w), one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof; and about 5% to about. It is dissolved in one or more alcohols or glycols, or any combination thereof, in an amount of 70%, preferably about 10% to about 70% (w / w). In some embodiments, the benzodiazepine drug is dissolved in a carrier system. In some embodiments, the benzodiazepine drug is a benzodiazepine microparticle, nanoparticles, or a combination thereof. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles or combinations thereof.</p><p>In some embodiments, the benzodiazepine drug is alprazolam, brothizolam, chlordiazepoxide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, furlazepam, harazepam, midazolam, nordazepam, medazepam, nitrazepam, medazepam, nitrazepam, medazepam. , Temazepam, loprazolam, or any pharmaceutically acceptable salt thereof, and any combination thereof. In some embodiments, the benzodiazepine drug is diazepam, or a pharmaceutically acceptable salt thereof. In some embodiments, the benzodiazepine drug is well dissolved in a single phase containing one or more natural or synthetic one or more tocopherols or tocotrienols and one or more alcohols or glycols. In some embodiments, the benzodiazepine drug comprises benzodiazepine microparticles, nanoparticles, or a combination thereof. In some embodiments, the composition further comprises water. In some embodiments, the benzodiazepine nanoparticles have an effective average particle size of less than about 5000 nm. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles or combinations thereof.</p><p> In some embodiments, the one or more natural or synthetic tocopherols or tocotrienols are α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, δ-tocotrienols. , Tocophersolan, any isomer thereof, any ester thereof, any analog or derivative thereof, and any combination thereof.</p><p>In some embodiments, the one or more alcohols are selected from the group consisting of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, and any combination thereof. In some embodiments, the one or more glycols are selected from the group consisting of ethylene glycol, propylene glycol, butylene glycol, pentylene glycol, any isomer thereof, and any combination thereof. In some embodiments, the alcohol or glycol is water-free (dehydrated, USP). In some embodiments, the alcohol is ethanol (dehydration, USP).</p><p> In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 1 mg / mL to about 600 mg / mL. In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 10 mg / mL to about 250 mg / mL. In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 20 mg / mL to about 50 mg / mL.</p><p> In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 45% to about 85% (w / w). In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 60% to about 75% (w / w). In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 70% (w / w).</p><p> In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 15% to about 55% (w / w). In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 25% to about 40% (w / w). In some embodiments, the carrier system comprises an amount of about 30% (w / w) of one or more alcohols or glycols, or any combination thereof.</p><p> In some embodiments, the composition is a pharmaceutical active ingredient; enhancer; excipient; and to regulate pH, buffer the composition, prevent decomposition and improve appearance, aroma, or taste. Contains at least one additional ingredient selected from the group consisting of the agents used.</p><p> In some embodiments, the composition is in a pharmaceutically acceptable spray formulation, further comprising administering the composition to one or more nasal mucosa of the patient. In some embodiments, the therapeutically effective amount is from about 1 mg to about 20 mg of benzodiazepines. In some embodiments, the pharmaceutical composition is in a pharmaceutically acceptable spray formulation having a volume of about 10 μL to 200 μL.</p><p> In some embodiments, administration of the composition comprises spraying at least one nostril with a portion of the composition in a therapeutically effective amount. In some embodiments, administration of the pharmaceutical composition comprises spraying at least a therapeutically effective amount of at least a portion of the benzodiazepine into each nostril. In some embodiments, administration of the pharmaceutical composition involves spraying the first nostril with a first amount of the pharmaceutical composition, spraying the second nostril with a second amount of the pharmaceutical composition, and the like. And optionally, after a preselected time delay, it comprises spraying a third amount of the pharmaceutical composition into the first nostril. In some embodiments, the method comprises administering at least a fourth amount of the pharmaceutical composition to the second nostril after an optionally preselected time delay.</p><p> In some embodiments, administration of the composition begins before or at any time after the onset of symptoms of the disorder that may be treatable by the composition.</p><p> Additional embodiments, uses, and advantages of the present invention will become apparent to those skilled in the art in light of the disclosures described herein.</p><p>&lt;Incorporation by Citation&gt; All gazettes, patents, and patent applications referred to herein are clearly and individually indicated so that each gazette, patent, or patent application is incorporated by citation, respectively. To the same extent as incorporated herein by reference.</p>

Some embodiments of the invention may be further recognized in the discussion of the accompanying drawings:

<figref num="1">Arithmetic of diazepam after intranasal administration of 10 mg diazepam as a suspension in Table 11-2, after nasal administration of 10 mg diazepam as a solution in Table 11-1, and after 5 mg diazepam as an intravenous infusion. Draw a 240-hour linear plot of mean plasma concentration.</figref><figref num="2">Of diazepam after intranasal administration of 10 mg diazepam as a suspension in Table 11-2, after intranasal administration of 10 mg diazepam as a solution in Table 11-1, and after 5 mg diazepam as intravenous infusion. Draw a 240-hour half-log plot of arithmetic mean plasma concentration.</figref><figref num="3">After intranasal administration of 10 mg diazepam as a suspension of 11-2, intranasal administration of 10 mg diazepam as a solution in Table 11-1, and 5 mg diazepam as an intravenous administration of diazepam. Draw a 24-hour linear plot of arithmetic mean plasma concentration.</figref><figref num="4">It is a flow chart which concerns on one Embodiment of the process of manufacturing the diazepam solution by this invention.</figref><figref num="5">It is a flow chart concerning one embodiment of the process of manufacturing the diazepam suspension according to the present invention.</figref>

Pharmaceutical compositions of one or more benzodiazepine drugs, and methods of using such pharmaceutical compositions, are provided herein. Such pharmaceutical compositions are administered nasally.

In some embodiments, the pharmaceutical composition is a benzodiazepine drug; one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 30% to about 95% (w / w); And one or more alcohols or glycols, or any combination, in an amount of about 10% to about 70% (w / w) in a pharmaceutically acceptable formulation for administration to one or more nasal mucosa of a patient. including. In some embodiments, the benzodiazepine drug is in an amount of about 30% to about 95% (w / w), one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof; and about 10% to. Dissolved in an amount of about 70% (w / w) of one or more alcohols or glycols, or any combination thereof. In some embodiments, the benzodiazepine drug is dissolved in a carrier system. In some embodiments, at least some of the benzodiazepine drugs are in the form of microparticles, nanoparticles, or a combination thereof. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles, or a combination thereof.

In some embodiments, the pharmaceutical composition for nasal administration is a benzodiazepine drug; one or more natural or synthetic tocopherols or tocotrienols in an amount of about 30% to about 95% (w / w), or Any combination thereof; and one or more alcohols in an amount of about 5% to about 70% (w / w) in a pharmaceutically acceptable formulation for administration to one or more nasal mucosa of a patient. Or glycol, or any combination thereof. In some embodiments, the benzodiazepine drug is in an amount of about 30% to about 95% (w / w), one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof; and about 5% to. Dissolved in an amount of about 70% (w / w) of one or more alcohols or glycols, or any combination thereof. In some embodiments, the benzodiazepine drug is dissolved in a carrier system. In some embodiments, at least some of the benzodiazepine drugs are in the form of microparticles, nanoparticles, or a combination thereof. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles, or a combination thereof.

In some embodiments, the benzodiazepine drug is alprazolam, brothizolam, chlordiazepoxide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, furlazepam, harazepam, midazolam, nordazepam, medazepam, nitrazepam, medazepam, nitrazepam, medazepam. , Temazepam, loprazolam, any pharmaceutically acceptable salt thereof, and any combination selected from the group. In some embodiments, the benzodiazepine drug is diazepam, or a pharmaceutically acceptable salt thereof. In some embodiments, the benzodiazepine drug comprises benzodiazepine microparticles, nanoparticles, or a combination thereof. In some embodiments, the benzodiazepine nanoparticles have an effective average particle size of less than about 5000 nm. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles or combinations thereof.

In some embodiments, the one or more natural or synthetic tocopherols or tocotrienols are α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, δ-tocotrienols. , Tocophersolan, any isomer thereof, any ester thereof, any analog or derivative thereof, and any combination thereof. In some embodiments, the carrier system comprises one or more synthetic tocopherols having a polymeric glycol covalently attached or linked to a tocopherol core such as Vitamin E TPGS, which is described in US Pat. No. 6,193,985. And incorporated herein by reference in its entirety. In particular, within some particulate suspensions of benzodiazepine, where benzodiazepine is not dissolved in the tocopherol phase, Vitamin E TPGS is a desirable addition to stabilize particulate (fine particles, nanoparticles or combinations) suspensions. Can be a formant. On the other hand, in some embodiments, the carrier system is vitamin E. Except specifically for synthetic tocopherols, which have a polymeric glycol covalently attached or linked to a tocopherol core such as TPGS, which is described in US Pat. No. 6,193,985 and incorporated herein by reference in its entirety. Is done.

In some embodiments, the one or more alcohols are selected from the group consisting of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, or any combination thereof. In some embodiments, the alcohol is ethanol (dehydration, USP). In some embodiments, the one or more glycols are selected from groups consisting of ethylene glycol, propylene glycol, butylene glycol, pentylene glycol, any isomer thereof, and any combination thereof. In some embodiments, the glycol is propylene glycol USP. In some embodiments, the synthetic tocopherol can include vitamin E TPGS (vitamin E polyethylene glycol succinate). On the other hand, in some embodiments, synthetic tocopherols exclude tocopherols that are covalently attached or linked to a glycol polymer such as polyethylene glycol (eg, by a diacid linking group). Therefore, in some embodiments, the compositions described herein exclude Vitamin E TPGS.

In some embodiments, the benzodiazepine drug is present in a carrier system at a concentration of about 1 mg / mL to about 600 mg / mL. In some embodiments, the benzodiazepine drug is present in a carrier system at a concentration of about 10 mg / mL to about 250 mg / mL. In some embodiments, the benzodiazepine is present in the carrier system at a concentration of about 20 mg / mL to about 50 mg / mL.

In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 45% to about 85% (w / w). In some embodiments, the amount of carrier system about 60% to about 75% (w / w), 1 or more natural or synthetic tocopherols or Tokotorieno including Lumpur, or any combination thereof. In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 70% (w / w). In some embodiments, the synthetic tocopherol can include vitamin E TPGS (vitamin E polyethylene glycol succinate). On the other hand, in some embodiments, synthetic tocopherols exclude tocopherols that are covalently attached or linked to a glycol polymer (eg, by a diacid linking group), such as polyethylene glycol. Therefore, in some embodiments, the compositions described herein exclude Vitamin E TPGS.

In some embodiments, the carrier system is about 10% to about 55%, about 10% to about 40%, about 10% to about 35%, about 12% to about 55%, about 12% to about 40%. , About 12% to about 35% About 15% to about 55%, About 15% to about 40%, About 15% to about 35%, About 10%, About 12.5%, About 15%, About 17.5%, About 20 %, Approximately 22.5%, Approximately 25%, Approximately 27.5%, Approximately 30%, Approximately 32.5%, Approximately 35%, Approximately 37.5%, Approximately 40%, Approximately 42.5%, Approximately 45%, Approximately 47.5%, Approximately 50%, Includes one or more alcohols or glycols, or any combination thereof, in an amount of about 52.5%, or about 55% (w / w). In some embodiments, the carrier system comprises one or more alcohols or glycols in an amount of about 25% to about 40% (w / w), or any combination thereof. In some embodiments, the carrier system comprises one or more alcohols or glycols in an amount of about 30% (w / w), or any combination thereof. In some embodiments, the alcohol is ethanol or comprises ethanol. In some preferred embodiments, the glycol excludes the glycol polymer. In some preferred embodiments, glycols exclude glycol polymers having an average molecular weight of greater than 200. In some embodiments, glycols exclude polyethylene glycols having an average molecular weight greater than about 200.

In some embodiments, the carrier system comprises one or more alcohols or glycols in an amount of about 15% to about 55% (w / w), or any combination thereof. In some embodiments, the carrier system comprises one or more alcohols or glycols in an amount of about 25% to about 40% (w / w), or any combination thereof. In some embodiments, the carrier system comprises one or more alcohols or glycols in an amount of about 30% (w / w), or any combination thereof.

In some embodiments, the composition is a pharmaceutical active ingredient; enhancer; excipient; and to regulate pH, buffer the composition, prevent decomposition and improve appearance, aroma, or taste. Contains at least one additional ingredient selected from the group consisting of the agents used.

In some embodiments, the composition comprises at least one alkyl glycoside. In some embodiments, at least one alkyl glycoside is described in US Pat. No. 5,661,130 and is incorporated herein by reference.

In some embodiments, the composition comprises natural or synthetic tocopherols or tocotrienols, and benzodiazepine drugs that are well soluble in alcohols or glycols. In some embodiments, the composition comprises a benzodiazepine drug that is well dissolved in a solvent containing natural or synthetic tocopherols or tocotrienols, and alcohols or glycols, where the solution is at least substantially free of water. .. (In some embodiments, "substantially absent" means that the solution contains less than about 1%, less than about 0.5%, about 0.25%, or less than about 0.1% water.) Some In the embodiment, the composition consists essentially of one or more natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. In some embodiments, the composition is sufficient with one or more natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and optionally one or more alkyl glycosides in which the solution is at least substantially free of water. It consists essentially of a benzodiazepine drug that is dissolved in. (In some embodiments, "substantially absent" means that the solution contains less than about 1%, less than about 0.5%, about 0.25%, or less than about 0.1% water.) In one embodiment, the composition is composed of benzodiazepine dissolved in a solvent consisting of one or more natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. .. In some embodiments, the composition is composed of benzodiazepine dissolved in a solvent consisting of one or more natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. , Here the solution is at least virtually free of water. (In some embodiments, "substantially water-free" means that the solution is less than about 1%, less than about 0.5%, about 0.25%, or about 0. Indicates that it contains less than 1% water. )

In some embodiments, the composition comprises a benzodiazepine drug that is well dissolved in a solvent that includes natural or synthetic tocopherols or tocotrienols, and alcohol or. Therefore, in some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles or combinations thereof. In some embodiments, the composition comprises a benzodiazepine drug that is well dissolved in a solvent containing natural or synthetic tocopherols or tocotrienols, and alcohols or glycols, where the solution is at least substantially free of water. (In some embodiments, "substantially absent" means that the solution contains less than about 1%, less than about 0.5%, about 0.25%, or less than about 0.1% water.) Some In the embodiment of, the composition is essentially from benzodiazepine fully dissolved in a solvent consisting of one or more natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. It is composed. In some embodiments, the composition is essentially from a benzodiazepine drug that is well soluble in one or more natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. Here the solution is, at least, virtually free of water. (In some embodiments, "substantially water-free" means that the solution is less than about 1%, less than about 0.5%, about 0.25%, or about 0. Indicates that it contains less than 1% water. ) In some embodiments, the composition comprises benzodiazepines dissolved in a solvent consisting of one or more natural or synthetic tocopherols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. .. In some embodiments, the composition is dissolved in becoming soluble in one or more natural or synthetic tocopherols, one or more alcohols or glycols, and optionally one or more alkyl glycosides. , The solution is at least virtually free of water. (In some embodiments, "substantially absent" means that the solution contains less than about 1%, less than about 0.5%, about 0.25%, or less than about 0.1% water.)

In some embodiments, the composition contains at least less of the benzodiazepine drug in the form of particulates suspended in a carrier system or glycol that partially contain natural or synthetic tocopherols or tocotrienols and one or more alcohols. doing. In some embodiments, substantially all benzodiazepine drugs are in the form of particulates. In some embodiments, at least some of the benzodiazepine drugs are in the form of microparticles or nanoparticles. In the carrier system, the amount of at least one benzodiazepine present in the composition exceeds its solubility in the carrier system. In some embodiments, the carrier system in such a composition comprises water. In some embodiments, such a liquid carrier system contains water and one or more excipients. In some embodiments, one or more excipients are dissolved or suspended in a carrier system. In some embodiments, at least one such excipient stabilizes the suspension of benzodiazepine particulates in the carrier system. In some embodiments, the carrier system may comprise different concentrations of paraoxybenzoic acid esters (eg, methylparaben, propylparaben, etc.) and / also varying amounts of one or more surfactants, such as povidone (polyvinyl). .. In some embodiments, the particulate suspension of benzodiazepines specifically removes one or more polymeric glycols, such as polyethylene glycol. In some embodiments, the particulate suspension of benzodiazepines specifically excludes one or more polymeric glycols having a molecular weight greater than about 200 g / mol. In some embodiments, the composition is suspended in a carrier system comprising synthetic tocopherols, one or more paraoxybenzoic acid esters, one or more alcohols or glycols, one or more surfactants and water. Benzodiazepines Includes benzodiazepine drugs in the form of particulates and / or nanoparticles. In some embodiments, the composition is Vitamin E. Includes benzodiazepine drugs in the form of benzodiazepine microparticles or nanoparticles suspended in a carrier system containing TPGS, one or both of methylparaben and propylparaben, at least one glycol, povidone and water. In some embodiments, the composition comprises a benzodiazepine drug in the form of benzodiazepine microparticles and / or nanoparticles suspended in a carrier system containing vitamin E TPGS, methylparaben, propylparaben, propylene glycol, povidone and water. .. In some embodiments, the composition is suspended in a carrier system consisting essentially of synthetic tocopherols, one or more paraoxybenzoic acid esters, one or more alcohols or glycols, one or more surfactants and water. It is essentially composed of a benzodiazepine drug in a form comprising benzodiazepine microparticles and / or nanoparticles. In some embodiments, the composition is a benzodiazepine microparticle or nanoparticle suspended in a carrier system consisting essentially of vitamin E TPGS, one or both of methylparaben and propylparaben, at least one glycol, povidone and water. Consistently composed of benzodiazepine drugs in the form containing. In some embodiments, the composition comprises benzodiazepine microparticles and / or nanoparticles suspended in a carrier system consisting essentially of vitamin E TPGS, methylparaben, propylparaben, propylene glycol, povidone and water. Essentially from the drug. In some embodiments, the composition is a benzodiazepine suspended in a carrier system consisting of synthetic tocopherols, one or more paraoxybenzoic acid esters, one or more alcohols or glycols, one or more surfactants and water. It consists of a benzodiazepine drug in the form of microparticles and / or nanoparticles. In some embodiments, the composition is Vitamin E. It consists of a benzodiazepine drug in the form of benzodiazepine microparticles or nanoparticles suspended in a carrier system consisting of TPGS, one or both of methylparaben and propylparaben, at least one glycol, povidone and water. In some embodiments, the composition comprises a benzodiazepine drug in a form comprising benzodiazepine microparticles and / or nanoparticles suspended in a carrier system consisting of vitamin E TPGS, methylparaben, propylparaben, propylene glycol, povidone and water. ..

In some embodiments, the composition is a benzodiazepine drug in at least partially particulate form suspended in a carrier system containing natural or synthetic tocopherols or tocotrienols, one or more alcohols or glycols, and alkyl glycosides. Contains. In some embodiments, substantially all benzodiazepine drugs are in the form of particulates. In some embodiments, at least some of the benzodiazepine drugs are in particulate or nanoparticulate form. In the carrier system, the amount of at least one benzodiazepine present in the composition exceeds its solubility in the carrier system. In some embodiments, the carrier system in such a composition comprises water. In some embodiments, such a liquid carrier system contains water and one or more excipients. In some embodiments, one or more excipients are dissolved or suspended in the carrier system. In some embodiments, at least one such excipient stabilizes a suspension of benzodiazepine particulates in a carrier system. In some embodiments, the carrier system contains different concentrations of paraoxybenzoic acid esters (eg, methylparaben, propylparaben, etc.) and / or different amounts of one or more surfactants, such as povidone (polyvinylpyrrolidone). obtain. In some embodiments, the particulate suspension of benzodiazepines specifically removes one or more polymeric glycols, such as polyethylene glycol. In some embodiments, the particulate suspension of benzodiazepines specifically excludes one or more polymeric glycols having a molecular weight greater than about 200 g / mol. In some embodiments, the composition is a benzodiazepine microparticle and / or suspended in a carrier system containing synthetic tocopherols, one or more paraoxybenzoic acid esters, one or more alcohols or glycols, alkyl glucosides and water. Contains benzodiazepine drugs in the form of nanoparticles. In some embodiments, the composition is Vitamin E. Includes benzodiazepine drugs in the form of benzodiazepine microparticles or nanoparticles suspended in a carrier system containing TPGS, one or both of methylparaben and propylparaben, at least one glycol, alkylglycoside and water. In some embodiments, the composition comprises a benzodiazepine drug in a form comprising benzodiazepine microparticles and / or nanoparticles suspended in a carrier system comprising vitamin E TPGS, methylparaben, propylparaben, propylene glycol, alkylglycosides and water. Including. In some embodiments, the composition is a carrier system consisting essentially of synthetic tocopherols, one or more paraoxybenzoic acid esters, one or more alcohols or glycols, alkyl glycosides, optionally surfactants, and water. It consists essentially of a suspended benzodiazepine drug in the form of containing benzodiazepine microparticles and / or nanoparticles. In some embodiments, the composition was suspended in a carrier system consisting essentially of vitamin E TPGS, one or both of methylparaben and propylparaben, at least one glycol, alkylglycoside, optionally povidone and water. , Benzodiazepines essentially consist of benzodiazepine drugs in the form of microparticles or nanoparticles. In some embodiments, the composition is a benzodiazepine microparticle and / or suspended in a carrier system consisting essentially of vitamin E TPGS, methylparaben, propylparaben, propylene glycol, alkylglycoside, optionally povidone, and water. It consists essentially of a benzodiazepine drug in a nanoparticle-containing form. In some embodiments, the composition is a carrier system consisting of synthetic tocopherols, one or more paraoxybenzoic acid esters, one or more alcohols or glycols, alkyl glycosides, optionally one or more surfactants and water. It consists of a suspended benzodiazepine drug in the form of containing benzodiazepine microparticles and / or nanoparticles. In some embodiments, the composition is Vitamin E. It consists of a benzodiazepine drug in the form of benzodiazepine microparticles or nanoparticles suspended in a carrier system consisting of TPGS, one or both of methylparaben and propylparaben, at least one glycol, an alkylglycoside, optionally povidone and water. In some embodiments, the composition comprises benzodiazepine microparticles and / or nanoparticles suspended in a carrier system consisting of vitamin E TPGS methylparaben, propylparaben, propylene glycol, alkylglycoside, optionally povidone and water. Consists of benzodiazepine drugs.

The present invention discloses a method of treating a patient with a disorder that may be treatable by a benzodiazepine drug. In some embodiments, the patient is human. In some embodiments, the method is a benzodiazepine drug; one or more natural or synthetic tocopherols or tocotrienols in an amount of about 30% to about 95% (w / w), or any combination thereof; and about 5 A pharmaceutical for nasal administration containing one or more alcohols or glycols in an amount of% to about 70% (w / w), preferably about 10% to about 70% (w / w), or any combination thereof. The composition comprises administering to one or more nasal mucosa of a patient. In some embodiments, the benzodiazepine is in an amount of about 30% to about 95% (w / w), one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof; and about 5% to about. It is dissolved in one or more alcohols or glycols in an amount of 70% (w / w), preferably in an amount of about 10% to about 70% (w / w), or any combination thereof. In some embodiments, the benzodiazepine drug is dissolved in a carrier system. In other embodiments, at least some of the benzodiazepine drugs are in the form of microparticles, nanoparticles or a combination thereof. In some embodiments, the composition is substantially free of benzodiazepine microparticles, nanoparticles, or a combination thereof.

In some embodiments, the benzodiazepine drug is alprazolam, brothizolam, chlordiazepoxide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, furlazepam, harazepam, midazolam, nordazepam, medazepam, nitrazepam, medazepam, nitrazepam, medazepam. , Temazepam, loprazolam, or any pharmaceutically acceptable salt thereof, and any combination selected from the army. In some embodiments, the benzodiazepine drug is diazepam, or a pharmaceutically acceptable salt thereof. In some embodiments, the benzodiazepine drug is a benzodiazepine microparticle, nanoparticles, or a combination thereof. In some embodiments, the benzodiazepine nanoparticles have an effective average particle size of less than about 5000 nm.

In some embodiments, the one or more natural or synthetic tocopherols or tocotrienols are α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, δ-tocotrienols. , Tocophersolan, any isomer thereof, any ester thereof, any analog or derivative thereof, and any combination thereof. Synthetic tocopherols may include tocopherols that are covalently attached to tocopherols by a covalent linking group such as diacid or modified to contain hydrophilic groups such as polyethylene glycol groups that can be linked to tocopherols. Those skilled in the art can envision other synthetic tocopherols with similar diacidic and / or hydrophilic groups, but exemplary synthetic tocopherols of this type are vitamin E polyethylene glycol succinate (vitamin E TPGS). ).

In some embodiments, the one or more alcohols are selected from the group consisting of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, and any combination thereof. In some embodiments, the one or more glycols are selected from the group consisting of ethylene glycol, propylene glycol, butylene glycol, pentylene glycol, any isomer thereof, and any combination thereof. In some embodiments, the one or more glycols specifically exclude polymer glycols such as polyethylene glycol. In some embodiments, the one or more glycols specifically exclude polymeric glycols having a molecular weight greater than about 200 g / mol.

In some embodiments, the benzodiazepine drug is present in a carrier system at a concentration of about 1 mg / mL to about 600 mg / mL. In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 10 mg / mL to about 250 mg / mL. In some embodiments, the benzodiazepine drug is present in the carrier system at a concentration of about 20 mg / mL to about 50 mg / mL.

In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 45% to about 85% (w / w). In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 60% to about 75% (w / w). In some embodiments, the carrier system comprises one or more natural or synthetic tocopherols or tocotrienols, or any combination thereof, in an amount of about 70% (w / w). In some embodiments, suspensions of fine particles of benzodiazepine drugs are particularly considered, and the composition may include tocopherols, in particular synthetic tocopherols having hydrophilic groups that are covalently linked to tocopherols. In other embodiments, solutions of benzodiazepine drugs are specifically considered, and tocopherols are substantially or completely free of vitamin E TPGS.

In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 10% to about 55% (w / w). In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount of about 25% to about 40% (w / w). In some embodiments, the carrier system comprises one or more alcohols or glycols, or any combination thereof, in an amount from about 30% (w / w). In some embodiments, the amount of one or more alcohols or glycols in the carrier system is 10% to about 55%, about 10% to about 40%, about 10% to about 35%, about 12% to about. 55%, about 12% to about 40%, about 12% to about 35%, about 15% to about 55%, about 15% to about 40%, about 15% to about 35%, about 10%, about 12.5% , About 15%, about 17.5%, about 20%, about 22.5%, about 25%, about 27.5%, about 30%, about 32.5%, about 35%, about 37.5%, about 40%, about 42.5%, about 45%, about 47.5%, about 50%, about 52.5% or about 55% (w / w).

In some embodiments, the composition is a pharmaceutical active ingredient; enhancer; excipient; and to regulate pH, buffer the composition, prevent decomposition and improve appearance, aroma, or taste. Contains at least one additional ingredient selected from the group consisting of the agents used.

In some embodiments, the composition comprises at least one permeation enhancer in addition to the benzodiazepine drug, natural or synthetic tocopherols or tocotrienols, alcohols or glycols. In some embodiments, the permeation enhancer is an alkyl glycoside. In some embodiments, alkyl glycosides refer to any sugar bound to any hydrophobic alkyl, as described in US Pat. No. 5,661,130, which is incorporated herein by reference in its entirety. The hydrophobic alkyl can be of any suitable length, eg, carbon of about 9 to about 24 in length, in particular carbon of length 10 to about 14. Hydrophobic alkyls can be branched and / or partially or totally unsaturated. Alkyl can be a saccharide core, for example by a carbonyl group. It can be attached to the core), thereby forming an ester group. Suitable alkyl glycosides have the property of being non-toxic, non-ionic, and can increase the absorption of benzodiazepines when administered nasally as described herein. Exemplary sugars that can be covalently attached to the alkyl according to the invention include glucose, maltose, maltotriose, maltotetrose, sucrose and trehalose. Exemplary alkyl glycosides that can be used include octyl-, nonyl-, decyl-, undecylic-, dodecyl, tridecylic, tetradecyl, pentadecyl, octadecyl α- or β-D-maltoside, -glucoside or sucroside. In some embodiments, preferred glycosides include maltose, sucrose or glycosides linked by glycosidic bonds to the alkyl chains of 9, 10, 12, 14, 16, 18 or 20 carbon atoms. When possessed, the amount of alkyl glycoside in the composition is sufficient to enhance the absorption of the benzodiazepine drug administered by the intranasal route. In some embodiments, the amount of alkyl glycoside in the composition is selected to enhance the absorption of the benzodiazepine drug, but at the same time does not significantly irritate the nasal mucosa. In some embodiments, the amount of alkyl glycoside in the composition ranges from about 0.01% (w / v) to about 1% (w / v). In some embodiments, the amount of alkyl glycoside in the composition is from about 0.05% (w / v) to about 0.5% (w / v), or from about 0.125% (w / v) to about 0.05% (w). It is in the range of / v).

In some embodiments, the composition is in a pharmaceutically acceptable spray formulation, further comprising administering the composition to one or more nasal mucosa of the patient. In some embodiments, the therapeutically effective amount is from about 1 mg to about 20 mg of benzodiazepines. In some embodiments, the pharmaceutical composition is a pharmaceutically acceptable spray formulation having a volume of about 10 μL to 200 μL.

In some embodiments, administration of the composition comprises spraying at least one nostril with at least a therapeutically effective amount of a portion of the composition. In some embodiments, administration of the composition comprises spraying at least a therapeutically effective amount of a portion of the composition into at least each nostril. In some embodiments, administration of the composition is to spray the first nostril with a first amount of composition, to spray a second nostril with a second amount of composition, and optionally. Includes spraying a third amount of composition into the first nostril after a preselected time delay. Some embodiments further comprise administering at least a fourth amount of the composition to the second nostril after an optionally preselected time delay.

In some embodiments, administration of the composition begins at any time before or after the onset of symptoms of the disorder that may be treatable by the composition.

&lt;Definition&gt; As used herein, the phrase "therapeutically effective amount" (more simply, "effective amount") is administered to a patient in which the drug requires a particular treatment. Includes an amount sufficient to provide a specific therapeutic response. Skilled clinicians recognize that the therapeutically effective amount of drug depends on the patient, efficacy and specific drug administered.

As used herein, the modifier "about" is intended to have a regularly recognized general meaning. In some embodiments, the term can be more accurately interpreted as meaning within a particular percentage of the value to be modified, eg, "about" is ± 20%, ± 10% in some embodiments. , ± 5%, ± 2%, or ± 1% or less.

As used herein, the phrase "analog or derivative" includes molecules that differ from each other by one or more atoms or functional groups that have been exchanged for different atoms or functional groups. This can result in molecules with similar chemical formulas but different chemicals and / or biological properties.

As used herein, the term "isomer" includes molecules that have the same chemical formula but may differ in molecular arrangement between them. These different sequences can result in molecules with the same chemical formula but different chemistries. As an unrestricted example, propanol has the formula C.₃H₇Has OH. It can be found as propano-1-ol, where -OH is found attached to the end carbon. Alternatively, it can be found as propano-2-ol, where -OH is found attached to the second carbon.

<chemistry num="1"><img file="JP6523397B2_D0001.tif" /></chemistry>

As used herein, the term "seizure" refers to commonly recognized types of seizures, including absence seizures, myoclonic seizures, clonic seizures, tonic seizures, tonic-clonic seizures, and weakness seizures. Including. Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more auras familiar to the patient or those close to the patient. Each patient generally experiences a different kind of aura, which is specific to that patient, but the aura is usually or at least often preceded by the seizures that the patient experiences, auditory, visual, olfactory or tactile. Can be categorized as a sensation. (Not all patients suffering from seizures experience aura, but it is not uncommon among those who suffer from the worst types of seizures, especially tonic-clonic seizures.)

As used herein, the term "prevention" refers to prevention, including temporary prevention of the onset of a disorder. In the case of seizures, this can occur with or without the benefit of warning omen.

As used herein, the term "treatment" refers to a reduction in the intensity and / or duration of a disorder, or a similar effect. The term also includes the side effects of such "treatment".

As used herein, "a" and "an" can mean one or more, unless otherwise limited.

As used herein, the term "including" in all variants is used to indicate that the invention includes or contains, but is not limited to, a specifically described claim element. , A transitional clause used in the claims.

As used herein, the phrase "being essentially from" means that the list of ingredients, parts or procedural steps described below must be in the claimed composition, machine or procedure. As shown, used in the claims to show that the claims also apply to unlisted components, parts or procedural steps that do not materially affect the basic and novel properties of the invention. It is a transitional phrase.

As used herein, the term "consisting of" is a transitional phrase used in a claim to indicate that the claimed invention comprises only the elements stated in the claim. is there.

&lt;Benzodiazepine Drugs&gt; In the context of the present invention, the term "benzodiazepine drug" includes any therapeutically effective benzodiazepine compound, or a pharmaceutically acceptable salt, or a combination thereof. In some embodiments, benzodiazepines include members of the group consisting of alprazolam, diazepam, flurazepam, lorazepam, medazepam, mexazolam, midazolam, temazepam and pharmaceutically acceptable salts, and combinations thereof.

Additional that have previously been considered less significant or of little therapeutic benefit, either due to poor bioavailability, poor pharmacokinetic properties, or poor pharmacological properties. Benzodiazepine compounds have been found to be used by the present invention, which include improved bioavailability of benzodiazepine drugs, delivery of high concentrations of benzodiazepine drugs via the nasal pathway, rapid arrival of therapeutic levels of benzodiazepines in plasma, first pass effect. It will be appreciated by those skilled in the art that it may result in avoidance and concomitant avoidance of the hepatic portal vein and / or improved rapid presentation of benzodiazepine drugs to the brain.

For example, most benzodiazepines are so soluble in water very little that therapeutically effective amounts cannot be dissolved in an amount of aqueous solvent suitable for mucosal application. In some embodiments, by using a carrier system of the invention that provides improved ability to dissolve a benzodiazepine drug, the invention administers the benzodiazepine drug to one or more mucosa, including the nasal mucosa. Allows you to This can make it possible to administer the drug without hospitalization or unnecessary discomfort. In addition, in some embodiments of the invention, such as nasal administration, most of the digestive system can be avoided. This later improvement can result in improved bioavailability, faster arrival of therapeutic levels of benzodiazepines in plasma, avoidance of the hepatic portal vein, and / or concomitant avoidance of first-pass effects.

Nasal administration of the composition can result in faster presentation of one or more benzodiazepine drugs to the brain by the cell membrane-brain adjacency. Patients who develop seizures suffer, for example, stiff muscles and uncontrollable luck. This can make oral and / or intravenous administration difficult or inconvenient. However, the nasal passages remain open and readily available, which is a useful route of administration for the present invention.

In some embodiments, the pharmaceutical composition is used to treat a patient suffering from a disorder applicable to treatment or prevention with an effective amount of one or more benzodiazepine drugs. By one example, such disorders include symptoms of insomnia, anxiety, seizures, muscle spasticity and stiffness, and withdrawal.

In some embodiments, one or more benzodiazepine drugs are used to treat seizures, protect against seizures, reduce or improve seizure intensity, reduce or improve seizure frequency, and / Or used alone or in combination with other anticonvulsants to prevent the occurrence or recurrence of seizures.

Alprazolam (8-chloro-6-phenyl-1-methyl-4H-1,2,4-triazolo [4,3-a] [1,4] benzodiazepines)

<chemistry num="2"><img file="JP6523397B2_D0002.tif" /></chemistry>

Alprazolam is a benzodiazepine drug with sedative, tranquilizing and muscle relaxant properties. It is classified as an anxiety relieving agent. Alprazolam has also been shown to be useful in the treatment of panic disorder. The dose of alprazolam depends on the indication, but the therapeutic dose is about 0.5 to about 4, preferably about 1 to about 2 mg per dose, 1 to 8, preferably 2 to 8, and in some preferred embodiments 1 Expected to be in the range of about 4-6 hours per day. Alprazolam may be manufactured using the procedure disclosed in US Pat. No. 3,987,052, which is incorporated herein by reference in its entirety.

In some embodiments, alprazolam alone or in combination with other drugs to provide anxiolytic, anticonvulsant, sedative, skeletal muscle relaxant, amnesiac, or a combination of the aforementioned effects. Is used.

In some embodiments, alprazolam is used to treat seizures, protect against seizures, reduce or improve seizure intensity, reduce or improve seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. Alprazolam can be administered by the patient or another person (such as a healthcare professional) while the patient is in a non-seizure state to protect against seizures. Administration of alprazolam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even when protection from seizures is not absolute. In some embodiments, administration of alprazolam can prevent the development of seizures. In some embodiments, administration of alprazolam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with alprazolam to provide anticonvulsant or synergistic anticonvulsant effects.

While the patient is in a seizure state, alprazolam may also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall muscle relaxation, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the alprazolam preparations of the present invention and in certain nasal preparations are less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The alprazolam preparations of the present invention and in certain nasal preparations also provide the favorable administration of therapeutically beneficial drugs to patients who do not require the administration of intravenous drugs or rectal drugs.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Diazepam (7-chloro-1-methyl-5-phenyl-1,3-dihydro-2H-1,4-benzodiazepine-2-one)

<chemistry num="3"><img file="JP6523397B2_D0003.tif" /></chemistry>

Diazepam is a benzodiazepine drug with sedative, tranquilizing and muscle relaxant properties. It is classified as anxiolytic and skeletal muscle relaxant. It has the properties of anxiety relief, anticonvulsants, sedation, skeletal muscle relaxation and amnesia. The dose of diazepam can vary depending on efficacy, but therapeutic doses range from about 1 to about 20, preferably about 2 to about 10 mg per dose, 1 to 8, preferably 2 to 8, and some per day. In a preferred embodiment of, it is expected to be about 4 to about 6 times. Diazepam uses the procedure disclosed in one of U.S. Pat. Nos. 3,371,085, 3,109,843, 3,136,815 or 3,102,116, each of which is incorporated herein by reference in its entirety. Can be manufactured.

In some embodiments, diazepam alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnesiac or a combination of the aforementioned effects. used.

In some embodiments, diazepam treats seizures, protects them from seizures, reduces or improves seizure intensity, reduces or improves seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, diazepam can be administered by the patient or another person (such as a healthcare professional) while the patient is in a non-seizure state. Administration of diazepam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even when protection from seizures is not absolute. In some embodiments, administration of diazepam can prevent the development of seizures. In some embodiments, administration of diazepam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with diazepam to provide antispasmodic or synergistic antispasmodic effects.

While the patient is in a seizure state, diazepam may also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall muscle relaxation, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the diazepam preparations of the present invention and in certain nasal preparations are less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The diazepam preparations of the present invention and in certain nasal preparations also provide the favorable administration of therapeutically beneficial drugs to patients who do not require the administration of intravenous drugs or rectal drugs.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Flurazepam (7-chloro-5- (2-fluorophenyl) -2,3-dihydro-1-(2- (diethylamino) ethyl) -1H-1,4-benzodiazepine-2-one

<chemistry num="4"><img file="JP6523397B2_D0004.tif" /></chemistry>

Flurazepam is a benzodiazepine drug with sedative (particularly sleep and hypnosis), anxiolytic, anticonvulsant, and muscle relaxant properties. It is classified as sedative, hypnotic. Fluzepam has been shown to be useful in the treatment of insomnia. The dose of fluzepam can vary depending on the indication, but the therapeutic dose ranges from about 5 to about 40, preferably about 20 to about 35 mg per dose, 1 to 8, preferably 2 to 8, and some per day. In a preferred embodiment of, it is expected to be about 4 to about 6 times. Flurazepam can be manufactured using the procedures disclosed in US Pat. Nos. 3,567,710 and 3,299,053, each of which is incorporated herein by reference in its entirety.

In some embodiments, flurazepam alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnestic or a combination of the aforementioned effects. used.

In some embodiments, flurazepam treats seizures, protects them from seizures, reduces or improves seizure intensity, reduces or improves seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, flurazepam can be administered by the patient or another person (such as a healthcare professional) while the patient is in a non-seizure state. Administration of flurazepam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even if protection from seizures is not absolute. In some embodiments, administration of flurazepam can prevent the development of seizures. In some embodiments, administration of flurazepam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with flurazepam to provide anticonvulsant or synergistic anticonvulsant effects.

Flurazepam can also be administered to a patient by another person (eg, acquaintance or companion, family member or healthcare professional) while the patient is in a seizure state. Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall muscle relaxation, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the flurazepam formulation of the present invention and in certain nasal formulations is less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The flurazepam preparations of the present invention and in certain nasal preparations also provide a favorable administration of a therapeutically beneficial drug to a patient who does not require the administration of a drug for intravenous injection or a drug for the rectum.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Lorazepam (7-chloro-5- (2-chlorophenyl) -3-hydroxy-1,3-dihydro-2H-1,4-benzodiazepine-2-one)

<chemistry num="5"><img file="JP6523397B2_D0005.tif" /></chemistry>

Lorazepam is a benzodiazepine drug with sedative, tranquilizing, anticonvulsant, amnesia, and muscle relaxant properties. It is classified as an anxiolytic. Lorazepam has been shown to be useful in the treatment of nausea. The dose of lorazepam may vary depending on efficacy, but therapeutic doses range from about 0.1 to about 10, preferably about 0.2 to about 1 mg per dose, from 1 to 8, preferably 2 to 8, and some per day. In a preferred embodiment of, it is expected to be about 4 to about 6 times. Lorazepam may be manufactured using the procedure disclosed in US Pat. No. 3,296,249, which is incorporated herein by reference in its entirety.

In some embodiments, lorazepam alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnesiac or a combination of the aforementioned effects. used.

In some embodiments, lorazepam treats seizures, protects them from seizures, reduces or improves seizure intensity, reduces or improves seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, lorazepam can be administered by the patient or another person (such as a healthcare professional) while the patient is in a non-seizure state. Administration of lorazepam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even if protection from seizures is not absolute. In some embodiments, administration of lorazepam can prevent the development of seizures. In some embodiments, administration of lorazepam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with lorazepam to provide anticonvulsant or synergistic anticonvulsant effects.

While the patient is in a seizure state, lorazepam may also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall muscle relaxation, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the lorazepam preparations of the present invention and in certain nasal preparations are less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The lorazepam preparations of the present invention and in certain nasal preparations also provide the favorable administration of therapeutically beneficial drugs to patients who do not require the administration of intravenous drugs or rectal drugs.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Medazepam ((7-Chloro-1-methyl-5-phenyl-2,3-dihydro-1H-1,4-benzodiazepine)

<chemistry num="6"><img file="JP6523397B2_D0006.tif" /></chemistry>

Medazepam is a benzodiazepine drug with sedative, tranquilizing, anticonvulsant, amnesia, and muscle relaxant properties. It is classified as an anxiolytic. Medazepam has been shown to be useful in the treatment of nausea. The dose of medazepam can vary depending on efficacy, but therapeutic doses range from about 0.1 to about 10, preferably about 0.2 to about 1 mg per dose, 1 to 8, preferably 2 to 8, and some per day. In the preferred embodiment of, it is expected to be about 4 to about 6 times. Medazepam may be manufactured using the procedure disclosed in US Pat. No. 3,243,427, which is incorporated herein by reference in its entirety.

In some embodiments, medazepam alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnestic or a combination of the aforementioned effects. used.

In some embodiments, medazepam treats seizures, protects them from seizures, reduces or improves seizure intensity, reduces or improves seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, medazepam can be administered by the patient or another person (such as a healthcare professional) while the patient is not having a seizure. Administration of medazepam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even if protection from seizures is not absolute. In some embodiments, administration of medazepam can prevent the development of seizures. In some embodiments, administration of medazepam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with medazepam to provide anticonvulsant or synergistic anticonvulsant effects.

While the patient is in a seizure state, medazepam may also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall relaxation of muscles, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the medazepam preparations of the present invention and in certain nasal preparations are less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The medazepam preparations of the present invention and in certain nasal preparations also provide the favorable administration of therapeutically beneficial drugs to patients who do not require the administration of intravenous drugs or rectal drugs.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Mexazolam (10-chloro-11b- (2-chlorophenyl) -1,3,7,11b-tetrahydro-3-methyloxazolo [3,2-d] [1,4] benzodiazepine-6 (5H) -on)

<chemistry num="7"><img file="JP6523397B2_D0007.tif" /></chemistry>

Mexazolam is a benzodiazepine drug with sedative, tranquilizing, anticonvulsant, amnesia, and muscle relaxant properties. It is classified as an anxiolytic. Mexazolam has been shown to be useful in the treatment of nausea. Mexazolam doses may vary depending on efficacy, but therapeutic doses range from about 0.1 to about 10, preferably about 0.2 to about 1 mg per dose, from 1 to 8, preferably 2 to 8, and some per day. In the preferred embodiment of, it is expected to be about 4 to about 6 times. Mexazolam may be manufactured using the procedure disclosed in US Pat. No. 3,722,371, which is incorporated herein by reference in its entirety.

In some embodiments, mexazolam is used alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnesiac, or a combination of the aforementioned effects. used.

In some embodiments, the mexazolam is used to treat seizures, protect against seizures, reduce or improve seizure intensity, reduce or improve seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, mexazolam can be administered by the patient or another person (such as a healthcare professional) while the patient is not having a seizure. Administration of mexazolam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even if protection from seizures is not absolute. In some embodiments, administration of mexazolam can prevent the development of seizures. In some embodiments, administration of mexazolam can help disrupt the seizure cycle, and thus prevent recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with medazepam to provide anticonvulsant or synergistic anticonvulsant effects.

While the patient is in a seizure state, mexazolam may also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall relaxation of muscles, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the mexazolam preparations of the present invention and in certain nasal preparations are less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The mexazolam preparations of the present invention and in certain nasal preparations also provide the favorable administration of therapeutically beneficial drugs to patients who do not require the administration of intravenous drugs or rectal drugs.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Midazolam (8-chloro-6- (2-fluorophenyl) -1-methyl-4H-imidazole (1,5-a) benzodiazepine)

<chemistry num="8"><img file="JP6523397B2_D0008.tif" /></chemistry>

Midazolam is a tricyclic benzodiazepine drug with anxiolytic, amnesia, hypnosis, anticonvulsant, and skeletal muscle relaxant and sedative properties. Midazolam is thought to be soluble in water at pH lower than about 4, but is relatively insoluble in most aqueous solutions at neutral pH (eg, about 6-8). Therefore, in some embodiments, it is desirable for a water-soluble nasal formulation of midazolam having a pH of about 5.5 or higher, preferably about 6.0 or higher, or about 6.5 or higher. In some preferred embodiments, the pH is between about 6-9 and about 6-8. It is considered that the preparation of midazolam is particularly suitable for nasal administration, as lipid-soluble (nearly neutral pH) midazolam is rapidly absorbed across the nasal mucosa, resulting in efficient uptake of midazolam. It is further considered that midazolam can be formulated with non-aqueous delivery means such as hydrofluorocarbon propellants, hydrocarbon propellants and the like known in aerosol administration techniques.

The dose of midazolam can vary depending on efficacy, but therapeutic doses range from about 0.1 to about 20, preferably about 0.2 to about 10 mg per dose, 1 to 8, preferably 2 to 8, and some per day. In the preferred embodiment of, it is expected to be about 4 to about 6 times. Midazolam may be manufactured using the procedure disclosed in one of US Pat. Nos. 4,280,957, 5,831,089, each of which is incorporated herein by reference in its entirety.

In some embodiments, midazolam is used alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnesiac, or a combination of the aforementioned effects. used.

In some embodiments, midazolam is used to treat seizures, protect against seizures, reduce or improve seizure intensity, reduce or improve seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, midazolam can be administered by the patient or another person (such as a healthcare professional) while the patient is not having a seizure. Even if protection from seizures is not absolute, administration of midazolam can reduce or improve seizure intensity and / or reduce or improve seizure frequency. In some embodiments, administration of midazolam can prevent the development of seizures. In some embodiments, administration of midazolam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with medazepam to provide synergistic anticonvulsant effects.

While the patient is in a seizure state, midazolam can also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall relaxation of muscles, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the midazolam formulation of the present invention and in certain nasal formulations is less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The midazolam preparations of the present invention and in certain nasal preparations also provide the favorable administration of therapeutically beneficial drugs to patients who do not require the administration of intravenous drugs or rectal drugs.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

Temazepam (7-chloro-1-methyl-5-phenyl-3-hydroxy-1,3-dihydro-2H-1,4-benzodiazepine-2-one)

<chemistry num="9"><img file="JP6523397B2_D0009.tif" /></chemistry>

Temazepam is a benzodiazepine drug with sedative, tranquilizing, anticonvulsant, amnesia, hypnosis, anticonvulsant, and muscle relaxant properties. It is classified as an anxiolytic. Temazepam has been shown to be useful in the treatment of nausea. The dose of temazepam can vary depending on efficacy, but therapeutic doses range from about 1 to about 50, preferably about 5 to about 30 mg per dose, 1 to 8, preferably 2 to 8, and some per day. In the preferred embodiment of, it is expected to be about 4 to about 6 times. Temazepam may be manufactured using the procedures disclosed in US Pat. Nos. 3,340,253 and 3,374,225, each of which is incorporated herein by reference in its entirety.

In some embodiments, temazepam alone or in combination with other drugs to provide anxiolytic, antispasmodic, sedative, skeletal muscle relaxant, amnestic or a combination of the aforementioned effects. used.

In some embodiments, temazepam treats seizures, protects them from seizures, reduces or improves seizure intensity, reduces or improves seizure frequency, and / or of seizures. Used alone or in combination with other anticonvulsants to prevent seizures or recurrence. To protect against seizures, temazepam may be administered by the patient or another person (such as a healthcare professional) while the patient is not having a seizure. Administration of temazepam can reduce or improve the intensity of seizures and / or reduce or improve the frequency of seizures, even if protection from seizures is not absolute. In some embodiments, administration of temazepam can prevent the development of seizures. In some embodiments, administration of temazepam can help interrupt the seizure cycle, thus preventing recurrence of seizures, especially if the patient is prone to continuous seizures or status epilepticus. .. In addition to benzodiazepines (such as diazepam), other anticonvulsant drugs can be combined with temazepam to provide synergistic anticonvulsant effects.

While the patient is in a seizure state, temazepam may also be administered to the patient by another person (eg, acquaintance or companion, family member or healthcare professional). Therefore, one of the advantages of the formulations according to the invention is the ability to administer, for example, nasally, in an emergency therapeutic environment for treating seizure victims. Some of the beneficial therapeutic effects that can be provided by emergency administration of benzodiazepine anticonvulsants, such as nasal administration, are reduction of seizure severity (eg, overall relaxation of muscles, seizure-induced anxiety experienced by patients). (And overall transmission of well-being to the patient), reduced duration of seizures, reduced likelihood of patients experiencing repeated seizures, increased interval between current and next seizures. Therefore, the temazepam preparations of the present invention and in certain nasal preparations are less than about 30 minutes, less than about 15 minutes, less than about 10 minutes in some cases, and less than about 5 minutes in some cases. Provides an earlier onset of therapeutic effect. The temazepam preparations of the present invention and in certain nasal preparations also provide a favorable administration of a therapeutically beneficial drug to a patient who does not require administration of a drug for intravenous injection or a drug for the rectum.

Often, seizures, especially severe tonic or clonic seizures, are predicted by one or more aura events familiar to the patient or those close to the patient. These auras are actually unique to each patient, but can generally or typically be classified as auditory, visual, olfactory or tactile sensations that precede the patient's seizure experience. In some embodiments of the invention, the method comprises rapid administration of a preparation of a benzodiazepine drug according to the invention during the precursors. In some embodiments, administration during the precursor of such a benzodiazepine drug, eg, by nasal administration, prevents or at least ameliorate the effects of an imminent seizure (intensity, duration, or both). Thus, in the context of the present invention, seizure prophylaxis refers to the temporary proactive prevention of seizures with or without warning aura.

&lt;Pharmaceutically acceptable salts&gt; Benzodiazepines generally have the basic structure of formula I:

<chemistry num="10"><img file="JP6523397B2_D0010.tif" /></chemistry>

Where R₁-R₅Is a substituent. In certain embodiments, R₁Is an optionally substituted alkyl or R₄Form a ring with R₂Is a halogen (eg Cl, Br) and R₃Is an optionally substituted aryl (eg 2-chloro or 2-fluorophenyl), R₅Is H or OH, R₄And R₄'Forms a carbonyl (C = O) with the carbon to which they are attached, or R₄And R₁Form a optionally substituted heterocycle with the diazepam ring atoms to which they are attached, R₃'And R₆Form double bonds together or form optionally substituted heterocycles along the diazepam ring atoms to which they are attached. Such basic compounds can form acid addition salts with pharmaceutically acceptable acids such as pharmaceutically acceptable mineral acids and pharmaceutically acceptable organic acids.

Pharmaceutically acceptable mineral acids are those recognized by those skilled in the art, HCl, H.₂SO₄, H₂SO₃, H₃PO₄, H₃PO₃And others. Pharmaceutically acceptable organic acids include acetic acid, benzoic acid, tartaric acid, citric acid, oxalic acid, maleic acid, malonic acid and the like. Therefore, in some embodiments, the pharmaceutically acceptable acids are 1-hydroxy-2-naphthoic acid, 2,2-dichloroacetic acid, 2-hydroxyethanesulfonic acid, 2-oxoglutaric acid, 4-. Acetamide benzoic acid, 4-aminosalicylic acid, acetic acid, adipic acid ascorbic acid (L), aspartic acid (L), benzenesulfonic acid, benzoic acid, camphoric acid (+), camphor-10 -Sulphonic acid (+), capric acid (decanoic acid), caproic acid (hexanoic acid), capric acid (octanoic acid), carbonic acid, cinnamic acid, citric acid, cyclamic acid, dodecyl sulfate, ethane-1,2-disulfone Acid, ethanesulfonic acid, fumaric acid (formic acid fumaric) acid), galactal acid, gentidic acid, glucoheptonic acid (D), gluconic acid (D), glucuronic acid (D), glutamic acid, glutaric acid, glycerophosphate, glycolic acid, horse uric acid, hydrobromic acid, hydrochloride, Isobutyric acid, lactic acid (DL), lactobionic acid, lauric acid, maleic acid, malic acid (-L), malonic acid, mandelic acid (DL), methanesulfonic acid, benzenesulfonic acid (besylic) acid), naphthalene-1,5-disulfonic acid, naphthalene-2-sulfonic acid, nicotinic acid, nitrate, oleic acid, oxalic acid, palmitic acid, pamonic acid, phosphoric acid, propionic acid, pyroglutamic acid (-L), salicylic acid , Sevacinic acid, stearic acid, succinic acid, sulfuric acid, tartaric acid (+ L), thiocyan acid, toluenesulfonic acid (p) and undecyleneic acid. Other pharmaceutically acceptable acids can be pharmaceutically acceptable acidic (nonionic) polymers or pharmaceutically acceptable amphoteric polymers. Those skilled in the art will recognize that other basic pharmaceutical active ingredients may be combined with the aforementioned acids to produce acid addition salts. Similarly, those skilled in the art will recognize that, in some embodiments, it may be an advantage that some or all of the added acids are the active ingredients of the drug on their own.

In some embodiments, the invention provides a nasal composition comprising one or more acidic pharmaceutical active ingredients. It is fully considered within conventional techniques to determine which of the compounds set up for the above is acidic. Such compounds may include, for example, one or more mineral bases (eg, NaOH, KOH, LVDS).₃, Na₂CO₃, NH₃) Or by the addition of an organic base, it can be prepared as a base addition salt. It is considered within the art to select pharmaceutically acceptable bases.

Known benzodiazepine compounds have anxiolytic, anticonvulsant, sedative and / or skeletal muscle relaxant effects. The term "anticonvulsant" includes treatment of seizures, protection from seizures, reduction or improvement of seizure intensity, reduction or improvement of seizure frequency, and / or prevention of seizure occurrence or recurrence. In this regard, seizure treatment includes discontinuing an ongoing seizure, reducing the severity of an ongoing seizure, and reducing the duration of an ongoing seizure. Protection from seizures involves preventing oncoming seizures.

&lt;Carrier system&gt; Vitamin E is a class of fat-soluble methylated phenols. There are at least eight naturally occurring compounds in this class: α-tocopherols, β-tocopherols, γ-tocopherols, δ-tocopherols, α-tocotrienols, β-tocotrienols, γ-tocotrienols, and δ-tocotrienols. All can be used in the compositions and methods of the invention. There are multiple isomers of each of these compounds, all of which can be used in the compositions and methods of the invention. There are also multiple esters of each of these compounds, including tocophersolan, all of which can be used in the compositions and methods of the invention. As used herein, Vitamin E is either natural or synthetic tocopherols, tocotrienols, any isomer thereof, any ester thereof, any analog or derivative thereof, or any combination thereof. Point to.

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&lt;α-tocopherol&gt; Vitamin E-containing compounds are antioxidants. There is also evidence that heart disease, cancer, cataracts, macular degeneration, glaucoma, Alzheimer's disease, and Parkinson's disease can be prevented, their onset delayed, or their symptoms ameliorated. The inventor has found that Vitamin E can provide an effective carrier for benzodiazepine drugs. In some embodiments, the benzodiazepine is soluble or partially soluble in Vitamin E. In some embodiments, Vitamin E may be present as microparticles, nanoparticles, or any combination thereof. In addition, the use of Vitamin E has the additional benefit of avoiding irritation of sensitive mucosa and / or relieving irritation of mucosa.

Vitamin E is generally classified as hydrophobic and may be limited to the formulation as an emulsion when used as a carrier. However, emulsions can have some drawbacks. For example, they can be difficult to produce and can be quite unstable. In addition, they can leave an oily film on the surface of the skin. Therefore, in order to avoid the drawbacks of emulsions, some embodiments of the invention include a solution of one or more benzodiazepine drugs and one or more lower alkyl alcohols or one or more lower alkyl glycols in vitamin E. Alternatively, it includes any combination thereof.

Lower alkyl alcohols are alkyl alcohols with 6 or less carbon atoms. Therefore, any one of ethanol, propyl alcohol, butyl alcohol, pentanol, benzyl alcohol, any isomer thereof, or any combination thereof can be used.

Lower alkyl glycols are alkyl glycols with 6 or less carbon atoms. Therefore, any one of ethylene glycol, propylene glycol, butylene glycol, pentylene glycol, any isomer thereof, or any combination thereof can be used.

&lt;Additional excipients&gt; In some embodiments, the composition comprises at least one permeation enhancer in addition to the benzodiazepine drug, natural or synthetic tocopherols or tocotrienols, and alcohols or glycols. In some embodiments, the permeation enhancer is at least one alkyl glycoside. In some embodiments, alkyl glycosides are incorporated herein by reference in their entirety, U.S. Pat. No. 5,661, As described in No. 130, it refers to any sugar bound to any hydrophobic alkyl. The hydrophobic alkyl can be of any suitable length, eg, about 9 to about 24 carbon lengths, in particular about 10 to about 14 carbon lengths. Hydrophobic alkyl can be branched and / or partially or totally unsaturated. The alkyl can be attached to the saccharide core, for example via a carbonyl group, thereby forming an ester group. Suitable alkyl glycosides, when administered intranasally as described herein, will have properties that are non-toxic, non-ionic, and capable of increasing the absorption of benzodiazepines. Typical sugars that can be covalently attached to the alkyl according to the invention include glucose, maltose, maltotriose, maltotetrose, sucrose and trehalose. Typical alkyl glycosides that may be used include octyl-, nonyl-, decyl-, undecylic-, dodecyl, tridecylic, tetradecyl, pentadecyl, octadecyl α- or β-D-maltoside, -glucoside or scroside. In some embodiments, preferred glycosides include maltose, sucrose or glucose linked by glycosidic bonds to the alkyl chains of 9, 10, 12, 14, 16, 18 or 20 carbon atoms. Specific excipients that may be used in the nasal compositions according to the invention are alkyl saccharides, dodecyl maltoside, tetradecyl maltoside, sucrose dodecanoate, sucrose monosteer alert, sucrose diste alert, and /. Or includes a combination of two or more thereof. Alkyl glycosides that are considered particularly useful in embodiments of the present invention are Aegis Therapeutics, LLC, San Diego, et al. Includes those marketed by CA under the name Intravail®. Other alkyl glycosides can be selected from those having a hydrophilic lipophilicity ratio (HLB) value of about 10-20, in particular about 11-15. HLB values may be determined as specified in Gazette US2009 / 0047347, published February 19, 2009, the whole of which, and in particular paragraphs [0075]-[0079], are cited herein by reference. Incorporated into the book. If present, the amount of alkyl glycoside in the composition is sufficient to enhance the absorption of the benzodiazepine drug administered by the intranasal route. In some embodiments, the amount of alkyl glycoside in the composition is selected to enhance the absorption of the benzodiazepine drug, but at the same time does not significantly irritate the nasal mucosa. In some embodiments, the amount of alkyl glycoside in the composition ranges from about 0.01% (w / v) to about 1% (w / v). In some embodiments, the amount of alkyl glycoside in the composition is within about 0.05% (w / v) to about 0.5% (w / v), or about 0.125% (w / v) to about 0.5% ( It is in the range of w / v).

The term "penetration enhancer" means any substance that acts to increase absorption across the mucosa and / or increase bioavailability. In some embodiments, such substances include mucolytic agents, degrading enzyme inhibitors and compounds that increase the permeability of mucosal cell membranes. Whether a given compound is an "enhancer" can be determined in vivo or in a good model study by comparing two formulations containing small polar molecules that are unrelated as a drug, with or without an enhancer. And can be determined by measuring whether the absorption of the drug is increased to a clinically significant degree. Enhancers do not pose a problem with chronic toxicity, because in vivo, enhancers should be non-irritating and / or rapidly metabolized into normal cell constituents with no severe irritating effects. Because it is.

In some embodiments, the preferred accelerator is lysophospholipid, such as lysophosphatidylcholine available from eggs or soy lecithin. Used by other lysophosphatidylcholines that have similar membrane-modifying properties, but also have phosphatidylethanolamine and lyso compounds produced from phosphatidyl acid, in addition to the different acyl groups. Can be done. Acylcarnitine (eg palmitoyl group-dl-carnitine chloride) is an alternative. In some embodiments, the appropriate concentration is 0.02 to 20% (w / v).

In some embodiments, suitable accelerators are chelators (EGTA, EDTA, alginate), surfactants (particularly nonionic substances), acylglycerols, fatty acids and salts (SIGMA Catalog, 1988, page 316-321). This includes tyroxapole and biological cleaning agents listed in (incorporated herein by reference), and agents that alter the fluidity and permeability of the membrane are enamines (eg, ethyl acetoacetate). Phenylalanine enamin), malonate (eg diethyleneoxymethylene malonate), salicylate, bile salt, and suitable agents such as analog and fusidic acid. Suitable concentrations are 20% (v / v). Up to.

Accordingly, in some embodiments, the invention provides a pharmaceutical composition for nasal administration in a pharmaceutically acceptable formulation for administration to one or more nasal mucosa of a patient. The pharmaceutical composition is a benzodiazepine drug, one or more natural or synthetic tocopherols or tocotrienols in an amount of about 30% to about 95% (w / w), or any combination thereof; one or more alkyl glycosides; and , Includes one or more alcohols or glycols, or any combination thereof, in an amount of about 10% to about 70% (w / w). In some embodiments, the alkyl glycoside is a trademark alkyl glycoside of Intravail®. In some embodiments, the alkyl glycoside is dodecyl maltoside, tetradecyl maltoside, sucrose dodecanoate, sucrose monosteer alert, sucrose distea alert, and / or a combination of two or more thereof. In some embodiments, the alkyl glycoside is a dodecyl maltoside. In some embodiments, the alkyl glycoside is a tetradecylmaltoside. In some embodiments, the alkyl glycoside is sucrose decanoart. In some embodiments, the alkyl glycoside is a sucrose monosteer alert. In some embodiments, the alkyl glycoside is a sucrose diste alert. In some embodiments, the alkyl glycoside is a combination of two or more of dodecyl maltoside, tetradecyl maltoside, sucrose dodecanoate, sucrose monosteer alert, or sucrose diste alert.

Accordingly, in some embodiments, the present invention provides a pharmaceutical composition for nasal administration in a pharmaceutically acceptable formulation for administration to one or more nasal mucosa of a patient. The pharmaceutical composition is a benzodiazepine drug containing microparticles, nanoparticles or both, one or more natural or synthetic tocopherols or tocotrienols in an amount of about 30% to about 95% (w / w), or any combination thereof. Includes one or more alkyl glycosides; and one or more alcohols or glycols in an amount of about 10% to about 70% (w / w), or any combination thereof. In some embodiments, the alkyl glycoside is a trademark alkyl glycoside of Intravail®. In some embodiments, the alkyl glycoside is dodecyl maltoside, tetradecyl maltoside, sucrose dodecanoate, sucrose monosteer alert, sucrose distea alert, and / or a combination of two or more thereof. In some embodiments, the alkyl glycoside is a dodecyl maltoside. In some embodiments, the alkyl glycoside is a tetradecylmaltoside. In some embodiments, the alkyl glycoside is sucrose decanoart. In some embodiments, the alkyl glycoside is a sucrose monosteer alert. In some embodiments, the alkyl glycoside is a sucrose diste alert. In some embodiments, the alkyl glycoside is a combination of two or more of dodecyl maltoside, tetradecyl maltoside, sucrose dodecanoate, sucrose monosteer alert, or sucrose diste alert.

&lt;Mucosal Membrane Preparations&gt; Mucosal preparations are generally administered in a fixed amount of spray with a dose of less than 250 μL, preferably less than 150 μL, and ideally 25-100 μL. Although not prohibited in the present invention, doses greater than about 300 μL per dose usually exceed the absorption capacity of the membrane. This results in the loss of most of the pharmaceutically active ingredients.

The dosage of the preparation, especially the nasal preparation, is preferably in the range of 25-100 μL. Dosees that exceed the aforementioned range bypass the sinuses and flow down the back of the throat, where the excess volume is swallowed.

&lt;Alprazolam&gt; The dose of alprazolam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, one dose. It is expected to be in the range of about 0.5 to about 4, preferably about 1 to about 2 mg. Alprazolam may be manufactured using the process disclosed in US Pat. No. 3,987,052, which is incorporated herein by reference in its entirety.

As a nasal preparation, alprazolam may be administered in a fixed amount of 25 to 250 μL of the spray. In some preferred embodiments, alprazolam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Diazepam&gt; The dose of diazepam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, one dose. It is expected to be in the range of about 1 to about 20, preferably about 2 to about 10 mg per hit. Diazepam may be manufactured using the process disclosed in one of U.S. Pat. Nos. 3,371,085, 3,109,843, 3,136,815 or 3,102,116, each of which is hereby incorporated by reference in its entirety. Be incorporated.

As a nasal preparation, diazepam may be administered in a fixed amount of 25 to 250 μL of the spray. In some preferred embodiments, diazepam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Flurazepam&gt; The dose of flurazepam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, one dose. It is expected to be in the range of about 5-40, preferably about 20-35 mg. Flurazepam may be manufactured using the processes disclosed in US Pat. No. 3,567,710 or 3,299,053, each of which is incorporated herein by reference in its entirety.

As a nasal preparation, flurazepam may be administered in a fixed amount of 25-250 μL spray. In some preferred embodiments, flurazepam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Lorazepam&gt; The dose of lorazepam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, once. It is expected to be in the range of about 0.1 to about 10, preferably about 0.2 to about 1 mg. Lorazepam may be manufactured using the process disclosed in US Pat. No. 3,296,249, which is incorporated herein by reference in its entirety.

As a nasal preparation, lorazepam may be administered in a fixed amount of 25-250 μL spray. In some preferred embodiments, lorazepam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Medazepam&gt; The dose of medazepam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, once. It is expected to be in the range of about 0.1 to about 10, preferably about 0.2 to about 1 mg. Medazepam may be manufactured using the process disclosed in US Pat. No. 3,243,427, which is incorporated herein by reference in its entirety.

As a nasal preparation, medazepam may be administered in a fixed amount of 25-250 μL spray. In some preferred embodiments, medazepam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Mexazolam&gt; The dose of mexazolam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, one dose. It is expected to be in the range of about 0.1 to about 10, preferably about 0.2 to about 1 mg. Mexazolam may be manufactured using the process disclosed in US Pat. No. 3,722,371, which is incorporated herein by reference in its entirety.

As a nasal preparation, mexazolam may be administered in a fixed amount of 25 to 250 μL of the spray. In some preferred embodiments, the mexazolam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Midazolam&gt; The dose of midazolam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, one dose. It is expected to be in the range of about 0.1 to about 20, preferably about 0.2 to about 10 mg. Midazolam may be manufactured using the process disclosed in one of US Pat. Nos. 4,280,957 or 5,831,089, each of which is incorporated herein by reference in its entirety.

As a nasal preparation, midazolam may be administered in a fixed amount of 25-250 μL spray. In some preferred embodiments, midazolam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Temazepam&gt; The dose of temazepam varies depending on the indication, but the therapeutic dose is 1 to 8, preferably 2 to 8, and in some preferred embodiments, about 4 to about 6 times, one dose. It is expected to be in the range of about 1 to about 50, preferably about 5 to about 30 mg. Temazepam may be manufactured using the processes disclosed in US Pat. No. 3,340,253 or 3,374,225, each of which is incorporated herein by reference in its entirety.

As a nasal preparation, temazepam may be administered in a fixed amount of 25-250 μL spray. In some preferred embodiments, temazepam is administered in a fixed amount of spray, 50-150 μL, especially about 100 μL.

&lt;Formulation&gt; Some embodiments include the step of administering a therapeutically effective amount of one or more benzodiazepine drugs, or a pharmaceutically acceptable salt thereof, to one or more mucosa of a patient. Some embodiments of the composition disclose a composition comprising one or more benzodiazepine drugs or pharmaceutically acceptable salts thereof at concentrations up to about 600 mg / mL. Other compositions disclose compositions containing one or more benzodiazepine drugs or pharmaceutically acceptable salts thereof at concentrations from about 10 mg / mL to about 250 mg / mL. In addition, some embodiments disclose compositions comprising one or more benzodiazepine drugs or pharmaceutically acceptable salts thereof at concentrations from about 20 mg / mL to about 50 mg / mL.

In some embodiments, about 50% to about 90% (w / w) of Vitamin E and about 10% to about 50% (w / w) of lower alcohol or lower alkyl glycol, or any combination thereof. A carrier system is disclosed. In some embodiments, about 65% to about 75% (w / w) of Vitamin E and about 25% to about 35% (w / w) of lower alkyl alcohols or lower alkyl glycols, or any combination thereof. The carrier system is disclosed. In addition, some embodiments include carrier systems, which are about 70% (w / w) of Vitamin E and about 30% (w / w) of lower alkyl alcohols or lower alkyl glycols, or any combination thereof. Disclose.

Some embodiments of the invention provide a method of administering a composition of a benzodiazepine drug to a patient. Preferred embodiments include the use of diazepam. Some embodiments of the method disclose dose levels of about 1.0 mg to about 20.0 mg of diazepam until the desired result is achieved. Other dose levels disclose dose levels of about 2.0 mg to about 15.0 mg until the desired result is achieved. Some embodiments disclose dose levels of about 5.0 mg to about 10.0 mg until the desired result is achieved.

In some embodiments of the method, the dose ranges from about 10 μL to about 200 μL. In some embodiments, the dose ranges from about 20 μL to about 180 μL. In addition, some embodiments disclose doses of about 50 μl to about 140 μl. In some embodiments, the dose is 50 μL, 75 μL or 100 μL per nostril.

&lt;Pharmaceutical Process&gt; In some embodiments, the composition for nasal administration is substantially free of benzodiazepine microparticles, nanoparticles or combinations thereof. In some embodiments, the composition is made by slowly warming and heating Vitamin E until it is liquefied. Then one or more benzodiazepine drugs are added. The mixture is agitated and heated until one or more benzodiazepine drugs are dissolved or substantially dissolved. One or more alcohols or glycols, or any combination thereof, are then added to the composition. The composition is stirred until a less sticky composition is achieved.

The formulation process may be adjusted to take into account changes in the formulation. For example, as depicted in FIG. 4, a formulation containing both benzyl alcohol and ethanol first combines vitamin E, benzyl alcohol and ethanol (eg, anhydrous alcohol, USP) and mixes until the ingredients are homogeneous. Then heat the mixture to 45 ° C (± 2 ° C), add the alkyl glycoside, and mix until the alkyl glycoside is dissolved and the solution is homogeneous, benzodiazepine while maintaining the mixture at about 45 ° C. Add (eg diazepam), cool the solution to 25 ° C (± 2 ° C), add ethanol (sufficient amount) to achieve the final target weight of the solution, to ensure homogeneity It can be formulated by mixing well. The solutions produced by this process can be formulated with different concentrations of diazepam. For example, some embodiments of the present invention include diazepam formulations summarized in the table below. Diazepam is used as an illustration in Figure 4 and the table below, but any benzodiazepine is also alprazolam, brothizolam, chlordiazepamide, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, furlazepam, harazepam, midazom. It may be used in combination with medazepam, nitrazepam, oxazepam, lorazepam, placepam, quazepam, triazolam, temazepam, loprazolum, any pharmaceutically acceptable salt thereof, and any combination thereof.

NRL-1 Quantitative composition. In some embodiments, the pharmaceutical formulation is a formulation for nasal administration.

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In some embodiments, the above-mentioned formulation is a sterile solution having a bacterial count of 10 below acceptable levels on a per mL basis. Moreover, the pathogen is preferably absent. In some embodiments, the solution is self-preserving, self-sterile, or both.

In some embodiments, the benzodiazepine drug is formulated as a suspension of benzodiazepine microparticles and / or nanoparticles. Preparation of fine particles and nanoparticles of benzodiazepines can be achieved by methods such as milling. Such methods are known to those of skill in the art.

FIG. 5 illustrates one embodiment of the process of producing a benzodiazepine suspension according to the present invention. First, benzodiazepines (eg, diazepam) are sifted to produce micronized benzodiazepines (eg, diazepam). The micronized benzodiazepines (eg, diazepam) are then split into two intermediate products, i.e. diazepam A (high pressure) has a small particle size (average particle size &lt;2000 nm) and diazepam B (low pressure). ) Is a large particle size (average particle size&gt; 2000nm). After testing during the process, the two intermediate products provide a suspending agent for bimodal particles with a preselected average particle diameter, which is greater than 2000 nm in some embodiments. Combined with one or more excipients in the correct proportions. In some embodiments, the excipient is, for example, first combining propylene glycol, water and polyethylene glycol succinate of vitamin E to form a mixture, heating the mixture until the ingredients are dissolved, and then heating the mixture. Methylparaben, propylparaben and Intravail (alkylglycoside) are added to the mixture, mixed until the newly added ingredients are dissolved, and finally the mixture is cooled to, for example, 25 ° C ± 2 ° C. By doing so, it is adjusted according to the second column in FIG. The excipient is then combined with the micronized diazepam A and the micronized diazepam B and actively mixed to disperse the micronized diazepam to form a suspension. Povidone is then added to the mixture and mixed until fully dissolved. Finally, the suspension is up to its final target weight with purified water, mixed well and homogeneity is achieved. The final product can then be filled into a suitable container. In some embodiments, 3 mL is PTFE lined phenolic. It can be filled into 4 mL amber glass vials with closures), but other containers are of course possible and will be considered within the scope of the present invention. Alprazolam, brothizolam, chlordiazepam, clobazam, clonazepam, chlorazepam, demoxazepam, diazepam, flumazenil, fluramazenil, harazepam, midazolam, nordazepam, medazolam, nordazepam, as diazepam is depicted in Figure 5 as a typical benzodiazepine. , Prazepam, quazepam, triazolam, temazepam, lorazepam, any benzodiazepine, and any combination thereof, such as any pharmaceutically acceptable salt thereof.

In some embodiments, the above-mentioned formulation is a sterile suspension having a total number of 10 bacteria below an acceptable level per ml. In addition, pathogens are preferably not included. In some embodiments, the suspension is self-preserving, self-sterile, or both.

In some embodiments, the benzodiazepine drug is formulated as a solution. Utilization of particulate and / or nanoparticles of benzodiazepine drugs during the process of preparing a formulation, which is considered an aspect of the present invention, can improve the overall solubility of benzodiazepine drugs in a solvent system.

&lt;Additional active and inactive ingredients&gt; In addition, some embodiments of the composition and methods of using the composition include additional ingredients in the composition selected from the active ingredients. As a non-limiting example, such active ingredients include insulin, calciumtonin (eg, pig, human, salmon, chicken, or eel) and synthetic modifications thereof, enkephaline, LHRH and analogs (nafarelin, buserelin, Zolidex). )), GHRH (Growth Hormone Release Hormone), Nifedipine, THF (Chest Gland Fluid Factor), CGRP (Calcitonin Gene Related Peptide), Atrial Sodium Diuretic Peptide, Antibiotics, Metoclopramid, Ergotamine, Pizotizin, Nasal Vaccine (Especially HIV vaccine, measles, rhinovirus type 13, and respiratory syncitial virus), pentamidin, CCK (Cholecystikinine), DDVAP, interferon, growth hormone (solatotropir) Polypeptides or derivatives thereof (preferably having a molecular weight of 1000 to 300,000), secretin, brazikinin antagonist, GRF (growth hormone-releasing factor), THF, TRH (thyroid stimulating hormone-releasing hormone), ACTH analog, IGF (insulin) Growth factor)), CGRP (peptide associated with the Calcitorin gene) atrial sodium diuretic peptide, vasopressin and analog (DDAVP, lipresin), metoclopramide, treatment of migraine (dihydroergotamine, ergomethrin, ergotamine, pizotidin), Nasal vaccines (particularly AIDS vaccines) Factor VIII, colony stimulators, G-colony stimulators (granulocyte colony stimulators), EPO (Erythropoitin) PTH (parathyroid hormone) or pharmaceutically acceptable thereof Includes salt or combination.

In addition, some embodiments of the composition and the method of using the composition include additional ingredients in the composition selected from other anticonvulsants. As an unrestricted example, such active ingredients are paraaldehydes; aromatic allyl alcohols (such as stillipentol); barbitur (eg, phenobarbitol, primidone, methylphenobarbital, metalbital and barbexacron); bromides ( Potassium bromide, etc.); Carbamate (ferbamate, etc.); Carboxamide (carbamazepine and oxcarbazepine, etc.); Fatty acids (valproic acid, sodium valproate and divalproex sodium, bigabatrin, progavid, thiagabin, etc.); Analogs (eg gabapentin and pregavalin); Hydantin (eg etotoin, phenytoin, mephenytoin, and phosphenytoin); Oxazolidinedione (parameterdione, trimedadion, etadion, etc.); Primidone), pyrrolidine (eg, bribalacetam, levetyracetam, and seletracetam); succinimide (eg, ethosuccimid, phenytoin, and mesuximide); Zonisamide); Triazine (such as lamotridin); Urea (such as phenytoin, phenytoin); Valproylamides (such as valproylamide and valnoctamide); and other anticonvulsants or pharmaceutically acceptable salts or combinations thereof. ..

In addition, some embodiments of the composition and the method of using the composition include additional ingredients in the composition selected from other anticonvulsants. As a non-limiting example, such active ingredients include tetracycline hydrochloride, leucomycin, penicillin, penicillin derivatives, erythromycin, gentamycin, sulfatiazole, and antibiotics and anti-inflammatory agents such as nitroflazone; local anesthetics such as benzocaine. Vascular contractors such as phenilefurin hydrochloride, tetracycline hydrochloride, nafazoline nitrate, oxymethasone hydrochloride and tramazoline hydrochloride; cardiotonics such as digitalis and digoxin; vasodilators such as nitroglycerin and papaverin hydrochloride; chlorhexidine hydrochloride, hexyl resorcinol, decalinium chloride, And disinfectants such as acrinol; enzymes such as lysozyme chloride and dexamethasone; bone metabolism regulators such as vitamin D, active vitamin D and vitamin C; sex hormones; antihypertensive agents; sedatives; anti-tumor agents, hydrocortisone, prednisolone , Fruticazone, prednisolone, triamcinolone, triamcinolone acetonide, dexamethasone, betamethasone, bechromethasone and bechrometazone dipropionate and other steroidal anti-inflammatory agents; Non-steroidal anti-inflammatory agents such as indomethacin, corhitin, and probenocid, anti-inflammatory agents of enzymes such as chymotrypsin and seratiopeptidase; salt chain diphenhydramine, chloropheniramine Anti-histamines such as maleate and cremastine;

In addition, some embodiments of the composition and methods of using the composition include an additional inert ingredient in the composition. As non-limiting examples, small amounts of components such as stabilizers, colorants, pH regulators, buffers, preservatives such as agents that may avoid decomposition, wetting agents and flavors may also be present. Examples of colorants include β-carotene, Red No. 2, and Blue No. 1. Examples of preservatives include stearic acid, ascorbic acid stearic acid ester salt and ascorbic acid. Examples of flavoring agents include menthol and citrus perfume.

In some embodiments, the drug delivery system of the present invention may conveniently include an absorption enhancer. The term "enhancer" means any material that acts to increase absorption and / or increase bioavailability throughout the mucosa. In some embodiments, such materials include mucolytic agents, degradable enzyme inhibitors and compounds that enhance the permeability of mucosal cell membranes. Whether a given compound is an "enhancer" is determined by comparing two formulations with or without an enhancer containing small unrelated polar molecules as a drug in an in vivo test or a good model test. , And by measuring whether the absorption of the drug is enhanced to a clinically significant degree. Enhancers create any problems in terms of chronic toxicity, as in vivo enhancers should be rapidly metabolized to normal cell components that are non-irritating and / or have no stimulating effect. Must not be.

In some embodiments, the preferred fortifying material is lysophospholipids, such as lysophosphatidylcholine available from eggs or soy lecithin. Other lysophosphatidylcholines with different acyl groups may be used, as well as lyso compounds produced from phosphatidylethanolamine and phosphatidic acid with similar membranes that modify their properties. Acylcarnitine (eg palmitoyl-di-carnitine-chloride) is an alternative. In some embodiments, the appropriate concentration is 0.02 to 20% (w / v).

In some embodiments, suitable accelerators are chelating agents (EGTA, EDTA, alginate), surfactants (particularly nonionic materials), acylglycerols, fatty acids and salts, SIGMA Catalog, 1988, 316-321. Includes tyroxapols and biological detergents listed on page (incorporated herein by reference). Membrane fluidity and permeability of enamine (eg, phenylalanine enamine of ethyl acetoacetate), malonic acid (eg, diethyleneoxymethylene malonate), salicylic acid, bile acids, and analog and fusidic acid. The drug to be modified is appropriate. Suitable concentrations are up to 20% (v / v).

In some embodiments, the invention together with additional pharmaceutical adjuvants applied to systems containing active drugs and mucolytics, peptidase inhibitors or non-drug polypeptide substrates alone or in combination. Utilize the delivery of drugs that are incorporated into bioadhesive microspheres. Suitable, the mucolytic agent is a thiol-containing compound such as N-acetylcysteine and its derivatives. Peptide inhibitors include actinonin, amastatin, bestatin, chloroacetyl-HOLeu-Ala-Gly-NH.sub.2 diprotin A and B, ebelactone A and B, E-64, leupeptin, pepstatin. Includes A, phisphoramidon, H-Thr- (tBu) -Phe-Pro-OH, aprotinin, kallikrein, amastatin, benzamidine, chymotrypsin and trypsin. Suitable concentrations are 0.01 to 10% (w / v). One of ordinary skill in the art can easily determine whether an enhancer should be included.

&lt;Administration&gt; In some embodiments, administration of the composition comprises administering to at least one mucosa at least a portion of the composition in a therapeutically effective amount. In some embodiments, administration of the composition comprises spraying at least one nostril with at least a portion of a therapeutically effective amount of the composition. In some embodiments, administration of the composition comprises spraying each nostril with at least a portion of a therapeutically effective amount of the composition. In some embodiments, administration of the composition involves spraying the first nostril with a first amount of the composition, spraying the second nostril with a second amount of the composition, and optionally. Includes spraying a third amount of composition into the first nostril after a preselected time delay. Some embodiments further comprise administering at least a fourth amount of the composition to the second nostril after an optionally preselected time delay.

&lt;Alprazolam&gt; The dose of alprazolam depends on the sign, however, the therapeutic dose is from about 0.5 to about 4 mg per dose, preferably from 1 to about 2 mg per dose, from 1 to 8 times per day, preferably 1 It is expected to range from 2 to 8 times per day, and in some preferred embodiments, from about 4 to 6 times per day. Alprazolam may be manufactured using the process disclosed in US Pat. No. 3,987,052, which is incorporated herein by reference in its entirety.

As a nasal formulation, alprazolam is metered in 25-250 μL. It may be administered by sprays). In a preferred embodiment, alprazolam is administered in 50-150 μL, especially about 100 μL of quantitative spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, the third quantitative spray is applied to the first nostril. In some embodiments, the fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably 10 seconds to about 1 minute, between applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Diazepam&gt; The dose of diazepam may vary depending on the symptoms, but the therapeutic dose is from about 1 to about 20 mg per dose, preferably from 2 to about 10 mg per dose, preferably from 1 to 8 times per day. It is expected to range from 2 to 8 times per day, and in some preferred embodiments, from about 4 to 6 times per day. Diazepam may be manufactured using the process disclosed in one of US Pat. Nos. 3,371,085, 3,109,843, 3,136,815, or 3,102,116, which is incorporated herein by reference in its entirety.

As a nasal preparation, diazepam may be administered in 25 to 250 μL of a metered dose spray. In some preferred embodiments, diazepam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, while applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Flurazepam&gt; The dose of flurazepam varies depending on the symptoms, but the therapeutic dose is from about 5 to about 40 mg per dose, preferably from 20 to about 35 mg per dose, from 1 to 8 times per day, preferably per day. It is expected to range from 2 to 8 times and, in some preferred embodiments, about 4 to 6 times per day. Flurazepam may be manufactured using the process disclosed in US Pat. No. 3,567,710 or 3,299,053, which is incorporated herein by reference in its entirety.

As a nasal preparation, flurazepam may be administered in 25 to 250 μL of a metered dose spray. In some preferred embodiments, flurazepam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, while applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Lorazepam&gt; The dose of lorazepam varies depending on the symptoms, but the therapeutic dose is from about 0.1 to about 10 mg per dose, preferably from 0.2 to about 1 mg per dose, from 1 to 8 times per day, preferably per day. It is expected to range from 2 to 8 times, and in some preferred embodiments, from about 4 to 6 times per day. Lorazepam may be manufactured using the process disclosed in US Pat. No. 3,296,249, which is incorporated herein by reference in its entirety.

As a nasal formulation, lorazepam may be administered in 25-250 μL quantitative spray. In some preferred embodiments, lorazepam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, between applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Medazepam&gt; The dose of medazepam varies depending on the symptoms, but the therapeutic dose is from about 0.1 to about 10 mg per dose, preferably from 0.2 to about 1 mg per dose, from 1 to 8 times per day, preferably per day. It is expected to range from 2 to 8 times and, in some preferred embodiments, about 4 to 6 times per day. Medazepam may be manufactured using the process disclosed in US Pat. No. 3,243,427, which is incorporated herein by reference in its entirety.

As a nasal preparation, medazepam may be administered in 25 to 250 μL of a metered dose spray. In some preferred embodiments, medazepam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, while applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Mexazolam&gt; The dose of mexazolam varies depending on the symptoms, but the therapeutic dose is from about 0.1 to about 10 mg per dose, preferably from 0.2 to about 1 mg per dose, from 1 to 8 times per day, preferably per day. It is expected to range from 2 to 8 times and, in some preferred embodiments, about 4 to 6 times per day. Mexazolam may be manufactured using the process disclosed in US Pat. No. 3,722,371, which is incorporated herein by reference in its entirety.

As a nasal formulation, mexazolam may be administered in 25-250 μL quantitative spray. In some preferred embodiments, the mexazolam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, while applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Midazolam&gt; The dose of midazolam varies depending on the symptoms, but the therapeutic dose is from about 0.1 to about 20 mg per dose, preferably from 0.2 to about 10 mg per dose, from 1 to 8 times per day, preferably per day. It is expected to range from 2 to 8 times and, in some preferred embodiments, about 4 to 6 times per day. Midazolam may be manufactured using the process disclosed in one of US Pat. Nos. 4,280,957 or 5,831,089, which is incorporated herein by reference in its entirety.

As a nasal preparation, midazolam may be administered in 25 to 250 μL of a metered dose spray. In some preferred embodiments, midazolam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In an optional embodiment, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, while applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

&lt;Temazepam&gt; The dose of temazepam varies depending on the symptoms, but the therapeutic dose is from about 1 to about 50 mg per dose, preferably from about 5 to about 30 mg per dose, from 1 to 8 times per day, preferably 1 It is expected to range from 2 to 8 times per day, and in some preferred embodiments, from about 4 to 6 times per day. Temazepam may be manufactured using the process disclosed in one of US Pat. Nos. 3,340,253 or 3,374,225, which is incorporated herein by reference in its entirety.

As a nasal preparation, temazepam may be administered in 25 to 250 μL of a metered dose spray. In some preferred embodiments, temazepam is administered in 50-150 μL, especially 100 μL of metered dose spray. In some embodiments, the first quantitative spray is applied to the first nostril and, if necessary, the second quantitative spray is applied to the second nostril. In some optional embodiments, a third quantitative spray is applied to the first nostril. In some embodiments, a fourth quantitative spray is applied to the second nostril. In some embodiments, additional quantitative sprays are applied alternately to the nostrils until a sufficient targeted therapeutic dose has been administered to the patient. In some embodiments, there is a time increment of a few seconds to 5 minutes, preferably about 10 seconds to about 1 minute, while applying the benzodiazepine drug to the same nostril. This allows time for the drug to cross the nasal mucosa and enter the bloodstream. Multiple application of a metered spray to each nostril, optionally separated by time intervals, allows complete absorption of the benzodiazepine drug into the bloodstream and prevents the drug from running out in the back of the throat. A total therapeutic dose can be administered with a sufficiently small increase.

Those skilled in the art say that systematic and therapeutically effective amounts of benzodiazepine drugs for treating the aforementioned diseases vary depending on the patient's age, size, weight and general health and severity of the disease. You will notice that. The frequency of administration also depends on the formulation of the composition, and the frequency can be adjusted so that an appropriate number of administrations per day is used.

&lt;Examples&gt; The present invention is illustrated herein in the context of the following exemplary, non-limiting examples.

&lt;Example 1&gt; A pharmaceutical composition containing diazepam is prepared. It is prescribed as a solution delivered by a nasal delivery device. The composition is used to treat or prevent seizures associated with epilepsy in adults. Treatment is administered before or after the onset of seizures. If the patient has a seizure, puff with any nasal delivery device (5.0 mg / puff (5.0 mg / 0.1 puff and 0.1 mL / puff) every 5 minutes until the seizure subsides) ) Is administered as a blow. However, it can be given as one blow per nostril (2 blows of 2.5 mg / puff (5.0 mg / 0.1 mL and 0.05 mL / puff)) every 5 minutes until the seizure subsides. it can. The compositions according to this example are described in the table below.

<tables num="2"><img file="JP6523397B2_D0013.tif" /></tables>

&lt;Example 2&gt; A pharmaceutical composition containing diazepam is prepared. It is prescribed as a solution delivered by a nasal delivery device. The composition is used to treat or prevent epilepsy-related seizures in children. Treatment is administered before or after the onset of seizures. When the patient is suffering from a seizure, it is administered in a single blow from any nasal delivery device (2.0 mg / puff (2.0 mg / 0.1 mL and 0.1 mL / puff). The seizure did not stop. If so, another dose may be administered after 5 minutes, however, it can be given as a blow per nasal passage in each nasal passage (1.0 mg / puff (2.0 mg / 0.1 mL and 0.05 mL / puff). ). 2 blows). If the seizure does not stop, another dose may be administered after 5 minutes. The composition according to this example is described in the table below.

<tables num="3"><img file="JP6523397B2_D0014.tif" /></tables>

&lt;Formulation of Example 3-Diazepam Solution&gt; In general, a benzodiazepine solution is prepared by combining one or more natural or synthetic tocopherols or tocotrienols with one or more lower alcohols or glycols and mixing until a homogeneous mixture is formed. To add the benzodiazepine drug to the homogeneous mixture, to heat and mix the ingredients until the benzodiazepine is completely dissolved in the homogeneous mixture, to cool the mixture, and to make the mixture contain lower alcohol or glycol. It may be formulated by its final mass or volume.

Two different diazepam solutions are formulated by the process described above. Vitamin E USP and absolute ethanol USP are combined and mixed in the amounts described in the table below to form a homogeneous mixture. The amounts of diazepam specified in the table below were then added to the homogeneous mixture. The ingredients were mixed and heated to 40-45 ° C until the diazepam was fully dissolved. The solution was cooled to 20-25 ° C, then the solution was brought to its final target weight with absolute ethanol USP and the solution was mixed thoroughly to ensure homogeneity. A sample of the solution was then taken for ongoing testing and placed in a 3 mL amber glass vial.

<tables num="4"><img file="JP6523397B2_D0015.tif" /></tables>

By varying the amount of diazepam and the relative amount of vitamin E and ethanol, additional solutions of diazepam of various concentrations are made in a similar manner. Other benzodiazepine solutions are made by using one or more benzodiazepines instead of diazepam. Other components, such as alkyl glycosides, can be added at appropriate steps in the process (eg, before or at the same time as the addition of benzodiazepines).

&lt;Example 4&gt; --Formulation of diazepam suspension Generally, a benzodiazepine suspension is formulated by pulverizing a benzodiazepine and combining a carrier and a benzodiazepine. The carrier is to combine one or more lower alcohols or glycols with water, add natural or synthetic tocopherols or tocotrienols, heat the mixture until the tocopherols or tocotrienols are dissolved, add one or more parabens. , And by mixing until the parabens are dissolved, and by cooling the carrier. Once the benzodiazepine is added to the carrier, additional excipients such as surfactants can optionally be added and dissolved in the carrier. The suspension is then made into its final mass or volume with water.

Two different diazepam suspensions are formulated by the general process described above. Two different diazepam particle sizes were prepared-A: small particle size prepared by high pressure micronization and B: large particle size prepared by low pressure micronization. The carrier was prepared by combining propylene glycol USP and purified water USP, then adding Vitamin E polyethylene glycol succinate NF, then mixing the combined components and heating to about 45 ° C. Mixing was continued until the Vitamin E polyethylene glycol succinate was fully dissolved. The carrier was then cooled to 20-25 ° C. Finely divided diazepam (A and B) was added to the carrier with vigorous mixing until the diazepam was well dispersed in the carrier. Then polyvinylpyrrolidone povidone USP / NF was added to the mixture and mixed until fully dissolved. The suspension was then weighed to include purified water USP. The suspension was then mixed until homogeneous, sampled for ongoing testing and placed in a 3 mL amber glass bottle.

<tables num="5"><img file="JP6523397B2_D0016.tif" /></tables>

Additional suspensions of diazepam at various concentrations are made in a similar manner by varying the amount of diazepam and optionally other excipients. Other benzodiazepine suspensions are made by using one or more benzodiazepines in place of diazepam. Other ingredients, such as alkyl glycosides, can be added at the appropriate step during the process. For example, alkyl glycosides may be added to the carrier while mixing the carriers, or may be added to the suspension mixture at the same time as or after the addition of povidone.

&lt;Example 5&gt; --Stability of diazepam solution and suspension Solutions 00 and 02 (&lt;Example 3&gt;) and suspensions 01 and 03 (&lt;Example 4&gt;) are 25 ° C / 60%. Stability at RH, 30 ° C / 65% RH, and 40 ° C / 75% RH was set. In addition to the corresponding actuators, one batch of each of the four different formulations in a 3 ml vial with a sealed container with a screw cap was set up with three storage conditions. They are listed in Table 1 with the first sample control number of the corresponding particle science.

<tables num="6"><img file="JP6523397B2_D0017.tif" /></tables>

Samples were tested for spray content uniformity, spray volume, diazepam contents, diazepam-related substances, and methylparaben and propylparaben assays (suspension samples only). The unit weight was determined according to USP &lt;755&gt;.

A summary of the mean analysis and all other results is given in Tables 5-4, 5-5, 5-6 and 5-7. Results at early 1 and 3 months are also shown for comparison. Results of individual spray content uniformity are given in Tables 5-8, 5-9, 5-10, 5-11, 5-12, 5-13, 5-14, and 5-15. ..

In general, all assays and other results are similar to the initial data, with the exception of diazepam-related compounds A and B.

Related compound A also did not meet the specification of 0.01% (NMT) at best for some samples (see Table 2). Related compound A increased with time and temperature.

<tables num="7"><img file="JP6523397B2_D0018.tif" /></tables>

Related compound B also increases with time and temperature, failing to specify NMT 0.1% at 40 ° C for both suspension and one solution formulation. Only formulation 2602 meets all impurity specifications.

<tables num="8"><img file="JP6523397B2_D0019.tif" /></tables>

<tables num="9"><img file="JP6523397B2_D0020.tif" /></tables>

<tables num="10"><img file="JP6523397B2_D0021.tif" /></tables>

<tables num="11"><img file="JP6523397B2_D0022.tif" /></tables>

<tables num="12"><img file="JP6523397B2_D0023.tif" /></tables>

<tables num="13"><img file="JP6523397B2_D0024.tif" /></tables>

<tables num="14"><img file="JP6523397B2_D0025.tif" /></tables>

<tables num="15"><img file="JP6523397B2_D0026.tif" /></tables>

<tables num="16"><img file="JP6523397B2_D0027.tif" /></tables>

<tables num="17"><img file="JP6523397B2_D0028.tif" /></tables>

<tables num="18"><img file="JP6523397B2_D0029.tif" /></tables>

<tables num="19"><img file="JP6523397B2_D0030.tif" /></tables>

<tables num="20"><img file="JP6523397B2_D0031.tif" /></tables>

&lt;Example 6&gt; All the solutions and suspensions described in Examples 3 and 4 are dodecyl maltoside, tetradecyl maltoside, sucrose dodecanoate, sucrose monostearate, sucrose distearate, and / or. Add the appropriate amount of alkyl glycoside, as described herein, such as a combination of two or more of them, or as sold as Intravail® by Aegis Therapeutics in San Diego, CA. , Formulated as described in Examples 3 and 4. Subsequent solutions and suspensions containing the added alkyl glycosides may then be set to stability as described in Example 5.

&lt;Example 7&gt; The solutions and suspensions of Examples 3, 4 and 6 are evaluated for pharmacokinetics in a suitable animal model such as mouse, rat, rabbit or dog. First, each animal (eg, rabbit) is given a benzodiazepine drug dose intravenously. The amount of benzodiazepine drug administered intravenously is selected to be less than the amount considered to be an effective amount administered nasally (eg, approximately half). For example, the intravenous dose of diazepam administered to a rabbit is from about 0.05 to about 0.2 mg / kg, for example about 0.1 mg / kg. Blood is collected immediately prior to administration and at specific time points after administration. Plasma blood levels of the drug are assayed for each of the blood samples. After a washout period of at least one day, each animal is administered an amount of solution or suspension as described in Examples 3, 4 and 6 intranasally. Blood is collected immediately prior to administration and at about the same specific time points as after administration of IV administration. Pharmacokinetic curves (drug-to-time plasma concentration) are constructed for the intravenous route of administration and for solutions and suspensions administered by the nasal route, respectively.

Toxicity is assessed by known means. In particular, histological samples are collected especially from the nasal mucosal tissue of test animals. Similarly, other toxological methods are optionally used.

&lt;Example 8&gt; The solutions and suspensions of Examples 3, 4 and 6 are evaluated for their ability to deliver drugs across the blood-brain barrier in suitable animal models such as mice, rats, rabbits or dogs. Each animal is administered intranasally in an amount of solution or suspension as described in Examples 3, 4 and 6, where the solution or suspension is optionally the ability of the drug to cross the blood-brain barrier. Includes contrast agents such as dyes that may be used as a surrogate for measuring. The drug or contrast agent is detected at a selected time point after administration of the suspension or solution to measure how much the suspension or solution crosses the blood-brain barrier. These results may be compared to similar results obtained with intravenous solutions containing drugs or contrast media.

&lt;Example 9&gt; The above solutions and / or suspensions can be evaluated for human pharmacokinetics. Normal and healthy human subjects receive the drug dose intravenously. The amount chosen for intravenous administration may be any amount, but it is preferably the dose that is believed to be effective in treating human seizures. For example, the IV dose of diazepam administered to humans ranges from 1 to 15 mg and may be, for example, about 7.5 mg. Blood is collected immediately prior to administration and at selected time points after administration. Plasma blood levels of the drug are assayed for each of the blood samples. After a washout period of at least one day, each subject is administered an amount of solution or suspension as described herein intranasally. Blood is collected shortly before and substantially at the same time as intravenous administration after administration. Pharmacokinetic curves (drug-to-time plasma concentration) are constructed for intravenous and intranasal routes of administration.

&lt;Example 10&gt; The above solutions and / or suspensions can be evaluated for efficacy in a suitable animal model. Briefly, for each dose of suspension or solution tested, the test animal is stimulated by a seizure-inducing stimulus. The stimulus may be a light, sound, chemical stimulus, or other stimulus that is effective in inducing a seizure in the model animal. Once the animal begins to suffer from seizures, a solution or suspension as described herein is administered to the animal intranasally. Efficacy of solutions and / or suspension doses is assessed based on the animal's response to the test dose. This procedure is repeated with sufficient repeats and with a sufficient number of doses to ascertain the doses that may be effective in treating the seizures by intranasal administration of the drug.

&lt;Example 11&gt; The pharmaceutical composition containing diazepam was prepared as a composition formulated as a solution delivered by a nasal delivery device. The solution was prepared according to the procedure outlined in the flowchart of FIG. The ingredients used in a 100 mg / mL diazepam solution are described in Table 11-1 below.

<tables num="21"><img file="JP6523397B2_D0032.tif" /></tables>

A single solution in Table 11-1 was prepared and exposed to stability testing at 25 ° C / 60% RH for 12 months. The table below measures stability for this dose at the initial, 3 months, 6 months, and 12 months.

<tables num="22"><img file="JP6523397B2_D0033.tif" /></tables>

A single solution in Table 11-1 was prepared and exposed to a stability test (early condition) at 30 ° C / 65% RH for 12 months. The table below measures stability for this dose at the initial, 1-month, and 12-month points.

<tables num="23"><img file="JP6523397B2_D0034.tif" /></tables>

A single solution in Table 11-1 was prepared and exposed to a stability test (early condition) at 40 ° C / 75% RH for 12 months. The table below measures stability for this dose at the initial, 3 months, 6 months, and 12 months.

<tables num="24"><img file="JP6523397B2_D0035.tif" /></tables>

Suspension formulations are described in Table 11-2 below.

<tables num="25"><img file="JP6523397B2_D0036.tif" /></tables>

A single suspension in Table 11-2 was prepared and exposed to stability testing at 25 ° C / 60% RH for 3 months. The table below measures stability for this dose at the initial stage and at 3 months.

<tables num="26"><img file="JP6523397B2_D0037.tif" /></tables>

A single suspension in Table 11-2 was prepared and exposed to a stability test (early condition) at 30 ° C / 65% RH for 1 month. The table below measures the stability of this batch at the initial stage and at 1 month.

<tables num="27"><img file="JP6523397B2_D0038.tif" /></tables>

A single suspension in Table 11-2 was prepared and exposed to a stability test (early condition) at 40 ° C / 75% RH for 3 months. The table below measures stability for this dose at the initial, 1-month and 3-month points.

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Three periods, three treatments, six sequences, and a randomized crossover study were performed in healthy volunteers. For each dose, each volunteer settled for 12 hours prior to each dose and up to 24 hours after the pharmacokinetic sample was collected. The 100 μL single dose pharmaceutical compositions listed in Tables 11-1 and 11-2 were administered to each volunteer as a single spray of 100 μL into the left nostril per spray. Pharmacokinetic samples were collected at 22 time points over a 10-day period (PK time points: 2.5, 5, 10, 15, 20, 30, and 45 minutes, 1, 1.5, 2, 4 after each dosing). , 12, 24, 36, 48, 72, 96, 144, 192, and 240 hours) No serious adverse events were observed. PK data were compared to those obtained with 5 mg diazepam administered intravenously. PK data is summarized in Table 11-3 and Figure 1-3.

The solutions in Table 11-1 and the suspensions in Table 11-2 were found to be sufficiently resistant only to the reported mild adverse events. The solutions in Table 11-1 were further found to have similar bioavailability to intravenous administration of diazepam (96% of iv). The nasal preparations in Table 11-1 showed a Tmax of 1.5 hours and a Cmax of approximately 272 nanograms / mL. These results are comparable to those reported in the literature for commercially available diazepam gel (Diastat®).

Solutions similar to the solutions described in Table 11-1 are diazepam (5-15% (w / v)), dodecylmaltoside (0.01-1% (w / v)), vitamin E (45-65%). (w / v)), ethanol (10-25% (w / v)), and benzyl alcohol (5-15% (w / v)); diazepam (9-11% (w / v)), dodecyl Mass concentration (0.1-0.5% (w / v)), vitamin E (50-60% (w / v)), ethanol (15-22.5% (w / v)), and benzyl alcohol (7.5-12.5%) (w / v)); Alternatively, diazepam (10% (w / v)), dodecylmaltoside (0.15-0.3% (w / v)), vitamin E (50-60% (w / v)), ethanol It can be prepared to consist of (17-20% (w / v)) and benzyl alcohol (10-12% (w / v)).

Solutions similar to the solutions described in Table 11-1 are bioavailability that is approximately 80-125% of the bioavailability achieved with the same benzodiazepine administered intravenously, eg, the same benzodiazepine administered intravenously. Achieve bioavailability that is approximately 90-110% of the bioavailability achieved by, or approximately 92.5-107.5% of the bioavailability achieved by the same benzodiazepine administered intravenously. Such solutions may be used in methods of treating patients with diseases that can be treated with benzodiazepine drugs, such as seizures, epileptic seizures and / or sudden seizures. In some embodiments, the solutions described herein may be used to treat diseases such as those treated with Diastat® diazepam gel.

A summary of the pharmacokinetic data obtained for the forms of diazepam solutions and suspensions is shown below in Table 11-3.

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The data collected in the study are further illustrated in Figure 1-3. Table 1 shows 10 mg as the solution of Table 11-1 compared to the intranasal (IN) administration of 10 mg diazepam as the suspension of Table 11-2 and the intravenous (IV) administration of 5 mg diazepam. It is a uniform scale plot of the arithmetic mean of the plasma concentration of diazepam after IN administration of diazepam. FIG. 2 is a semi-logarithmic scale plot of the same data shown in FIG. FIG. 3 shows the first 24 hours of data from FIG. 1 on a uniform scale.

Preferred embodiments of the present invention are shown and described herein, but it will be apparent to those skilled in the art that such embodiments are provided by way of example only. It will be appreciated by those skilled in the art that numerous changes, changes and substitutions will be made herein without departing from the present invention. It should be understood that various alternatives to the embodiments of the invention described herein may be utilized in carrying out the invention. The following claims define the scope of the invention, by which methods and structures within the scope of these claims and their equivalents are intended to be included.