Insulin administration using methyl and propyl paraben

A therapeutic composition for trans-mucosal administration in the treatment of diabetes including insulin, as an adjuvant a water-soluble fusidic acid salt and as a co-adjuvant methylparaben and/or propylparaben.

BACKGROUND OF THE INVENTION 
(a) Field of the Invention 
This invention relates to a novel therapeutic composition for the treatment 
of diabetes, preferably by nasal administration. More particularly, this 
invention relates to a therapeutic composition for the treatment of 
diabetes which includes, in admixture, insulin and two adjuvants, the 
first adjuvant being an ionized or partially ionized water-soluble alkali 
salt of fusidic acid or a derivative thereof, and the co-adjuvant being at 
least one or a mixture of methylparaben and propylparaben. 
(b) Prior Art 
U.S. Pat. No. 4,548,922 describes a therapeutic composition for the 
treatment of diabetes by nasal administration which includes, in 
admixture, insulin and, as an adjuvant, an ionized or partially ionized 
water-soluble alkali salt of fusidic acid or a derivative thereof. The 
adjuvants described in U.S. Pat. No. 4,548,922 are useful in the present 
invention. In addition, British Pat. No. 1,527,605 and U.S. Pat. No. 
4,153,689 have described the use of various bile salts to enhance 
absorption of insulin by the nasal mucosa. 
SUMMARY OF THE INVENTION 
According to this invention, a novel therapeutic composition for the 
treatment of diabetes by nasal administration is provided which includes, 
in admixture, insulin and two adjuvants, the first adjuvant being an 
ionized or partially ionized water-soluble alkali salt of fusidic acid or 
a derivative thereof, and the co-adjuvant being at least one or a mixture 
of methylparaben and propylparaben. 
The ionized or partially ionized water-soluble alkali salt of fusidic acid 
or a derivative thereof useful in this invention are those described in 
U.S. Pat. No. 4,548,922 at column 2, line 20 through column 3, line 35, 
which U.S. Pat. No. 4,548,922 is incorporated by reference herein in its 
entirety. 
Preferred steroids are fusidic acid; 24,25 dihydrofusidic acid, 17-20,24-25 
tetrahydrofusidic acid; 3-acetoxyl-fusidic acid; cephalosporin P.sub.1 ; 
and C.sub.21 conjugates of these. 
Methylparaben and propylparaben are articles of commerce and have been used 
extensively as preservatives in pharmaceutical preparations. The 
methylparaben and/or propylparaben are used in adjuvent amounts effective 
to increase the permeability of the mucosal surface to the drug. 
The therapeutic compositions of the invention are preferably administered 
nasally in the form of aqueous solutions.

The following examples illustrate the formulation and the efficacy of the 
novel therapeutic compositions of the invention. 
EXAMPLE I 
A sufficient quantity of sodium tauro-24,25-dihydrofusidate was dissolved 
in 0.02M sodium phosphate, pH 7.4, to form a 1% final solution, weight by 
volume. Commercially available porcine regular insulin was then mixed in 
to give a final concentration of 270 U/mL. The m-cresol, benzyl alcohol 
and/or methylparaben and propylparaben were added to give final 
concentrations in the four compositions as shown below: 
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Solution 
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A 270 U/mL porcine regular insulin 
1.00% w/v sodium tauro-24,25-dihydrofusidate 
0.31% w/v m-cresol 
B 270 U/mL porcine regular insulin 
0.99% w/v sodium tauro-24,25-dihydrofusidate 
0.14% w/v methylparaben 
0.07% w/v propylparaben 
C 270 U/mL porcine regular insulin 
0.99% w/v sodium tauro-24,25-dihydrofusidate 
0.76% w/v benzyl alcohol 
D 270 U/mL porcine regular insulin 
0.99% w/v sodium tauro-24,25-dihydrofusidate 
0.26% w/v benzyl alcohol 
0.06% w/v methylparaben 
0.03% w/v propylparaben 
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Twelve normal human subjects received approximately 0.70 U/kg of insulin 
from each of the above formulations. This was administered intranasally 
with 2 equal sprays, one to each nostril. The areas under the curve for 
mean plasma insulin concentrations resulting from each formulation are 
given below. 
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Solution AUC(uU .times. min/mL) 
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A 4233 
B 4741 
C 2876 
D 4899 
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The formulation containing methylparaben, propylparaben and benzyl alcohol 
(Formulation D) resulted in a 70% increase in AUC when compared to a 
similar formula containing benzyl alcohol with no parabens (Formulation C) 
and a 16% increase in AUC when compared to that containing m-cresol 
(Formulation A). Formulation B, containing methylparaben and propylparaben 
showed a 65% increase over the one containing benzyl alcohol (Formulation 
C) and a 12% increase over the m-cresol containing one (Formulation A). 
Mean plasma levels resulting from treatment with each of the four 
solutions are shown in FIG. 1. The AUCs resulting from the treatments with 
paraben-containing formulae were statistically significantly greater than 
that from the other treatments (p=0.06). 
These results are shown in FIG. 1 of the attached drawing.