TOPICAL PHARMACEUTICAL COMPOSITION COMPRISING PSEUDOMONIC ACID OR A SALT OR ESTER THEREOF AND A CORTICOSTEROID

Abstract: Pharmaceutical compositions for topical application to the skin are disclosed comprising pseudomonic acid or a pharmaceutically acceptable salt or ester thereof, and a corticosteroid intimately mixed therewith. The compositions are useful for the treatment of skin disorders in humans and domestic mammals.

Description: The present invention relates to pharmaceutical compositions of pseudomonic acid, its salts and esters, for topical application. Pseudomonic acid, its salts and esters, are known antibiotics and are described in UK Patent No. 1,395,907. Topical formulations comprising pseudomonic acid or a salt or ester thereof and a polyethylene glycol or polyethylene glycol analogue or derivative are described in EP-A-0 095 897 and EP-A-0 128 338. The term 'pseudomonic acid' as used herein includes all of the four antibacterially active metabolites of Pseudomonas fluorescens , i.e . pseudomonic acids A, B, C and D, the structures of which are given by P.J. Baines et al . in 'Mupirocin: a novel topical antibiotic', Royal Society of Medicine (London) International Congress and Symposium Series (Editor-in-Chief: H.J.C.J. L'Etang), No. 80 (1984), pages 13-22. The term 'mupirocin' has recently been adopted as the approved name for the major metabolite, pseudomonic acid A. Although pseudomonic acid, its salts and esters, are useful antibiotics, it has been found that compositions for topical administration comprising pseudomonic acid or a pharmaceutically acceptable salt or ester thereof and a corticosteroid are especially valuable for treating skin and other disorders in certain cases. Accordingly the present invention provides a pharmaceutical composition for topical application to humans or domestic mammals comprising the hydrated crystalline calcium salt of mupirocin and a corticosteroid intimately mixed therewith. As used herein the term pharmaceutically acceptable includes 'veterinarily acceptable'. It will be understood that the pharmaceutical composition of the invention is prepared by intimately mixing the said components before the composition is applied topically. It will be further understood that the intimate mixture prepared by the above procedure may include a mixture of the said components in a solid form and/or a solution or suspension of one of the said components in the other said component. The pharmaceutical composition of the invention may comprise a solution and/or a suspension of the said components in a suitable carrier. Suitably the composition comprises from 0.01 to 50% of the hydrated crystalline calcium salt of mupirocin, preferably from 0.1 to 25%, more preferably from 0.5 to 10%, and especially from 1 to 3%. All percentages mentioned herein are by weight and based on the total weight of the composition. The percentage of the hydrated crystalline calcium salt of mupirocin given is calculated as the free acid. Suitably the composition comprises up to 5%, advantageously from 0.001 to 5%, preferably from 0.05 to 3%, more preferably from 0.1 to 2%, of the corticosteroid. In a preferred aspect of the invention, the composition comprises from 1 to 3% of mupirocin as the hydrated crystalline calcium salt. Suitably the hydrated crystalline calcium salt contains 1.8 to 2.2 moles of water per mole. Normally, the hydrated calcium salt contains from 1.9 to 2.1 moles of water per mole. Suitable corticosteroids include hydrocortisone, betamethasone or betamethasone valerate. Preferably the hydrated crystalline calcium salt of mupirocin and the corticosteroid are incorporated in the formulation in the form of fine particles. Normally such particles will have an average size of less than 50 µm. The composition may also comprise additional therepeutic agents such as antimicrobial, antibiotic, antibacterial, antifungal, and antiviral agents, for instance chlortetracycline, miconazole, and idoxuridine, provided that these are compatible with the mupirocin or salt or ester thereof. Pseudomonic acid and salts and esters thereof show a tendency to undergo a rearrangement reaction in the presence of acid (that is to say below about pH4) and accordingly acidic agents are unlikely to be compatible with pseudomonic acid and its salts and esters. Similarly, pseudomonic acid and salts and esters thereof are not stable in strongly basic media, that is to say above about pH9. The compositions of the present invention may be made up in any conventional carriers suitable for the topical administration of antibiotics and corticosteroids, for example paraffins and alcohols. They may be presented as, for instance, ointments, creams or lotions, eye and ear ointments, gels, impregnated dressings and aerosols. The compositions may also contain appropriate conventional additives, for example preservatives, solvents to assist drug penetration, and emollients. A particularly suitable composition according to the present invention comprises from 1 to 3% of hydrated crystalline calcium salt of mupirocin and up to 5% of a corticosteroid. Such a composition may suitably be presented as a cream or ointment for topical application. A suitable ointment base may conveniently comprise from 65 to 100% (preferably 75 to 96%) of white soft paraffin, from 0 to 15% of liquid paraffin, and from 0 to 7% (preferably 3 to 7%) of lanolin or a derivative or synthetic equivalent thereof. Another suitable ointment base may conveniently comprise a polyethylene - liquid paraffin matrix, for example that available from Squibb under the trade mark 'Plastibase'. A suitable cream base may conveniently comprise an emulsifying system, for example from 2 to 10% of polyoxyethylene alcohols ( e.g . the mixture available under the trade mark 'Cetomacrogol 1000'), from 10 to 25% of stearyl alcohol, from 20 to 60% of liquid paraffin, and from 10 to 65% of water; together with one or more preservatives, for example from 0.1 to 1% of N , N ''-methylenebis[ N '-(3-(hydroxymethyl)-2,5-dioxo-4-imidazo lidinyl]urea] (available under the name 'Imidurea USNF'), from 0.1 to 1% of alkyl 4-hydroxybenzoates (for example the mixture available from Nipa Laboratories under the trade mark 'Nipastat'), from 0.01 to 0.1% of sodium butyl 4-hydroxybenzoate (available from Nipa Laboratories under the trade mark 'Nipabutyl sodium'), and from 0.1 to 2% of phenoxyethanol. A suitable gel base may conveniently comprise a semi-solid system in which a liquid phase is constrained within a three dimensional polymeric matrix with a high degree of cross-linking. The liquid phase may conveniently comprise water, together with from 0 to 20% of water-miscible additives, for example glycerol, polyethylene glycol, or propylene glycol, and from 0.1 to 10%, preferably from 0.5 to 2%, of a thickening agent, which may be a natural product, for example tragacanth, pectin, carrageen, agar and alginic acid, or a synthetic or semi-synthetic compound, for example methylcellulose and carboxypolymethylene ('carbopol'); together with one or more preservatives, for example from 0.1 to 2% of methyl 4-hydroxybenzoate ('methyl parabenz') or phenoxyethanol. Another suitable base may comprise from 70 to 90% of polyethylene glycol (for example, polyethylene glycol ointment containing 40% of polyethylene glycol 3350 and 60% of polyethylene glycol 400, prepared in accordance with the United States National Formulary (USNF)), from 5 to 20% of water, from 0.02 to 0.25% of an anti-oxidant (for example butylated hydroxytoluene), and from 0.005 to 0.1% of a chelating agent (for example ethylenediamine tetraacetic acid (EDTA)). The term 'soft paraffin' as used above encompasses the cream or ointment bases white soft paraffin and yellow soft paraffin. The term 'lanolin' encompasses native wool fat and purified wool fat. Derivatives of lanolin include in particular lanolins which have been chemically modified in order to alter their physical or chemical properties and synthetic equivalents of lanolin include in particular synthetic or semisynthetic compounds and mixtures which are known and used in the pharmaceutical and cosmetic arts as alternatives to lanolin and may, for example, be referred to as 'lanolin substitutes'. One suitable synthetic equivalent of lanolin that may be used is the material available under the trade mark 'Softisan' known as 'Softisan 649'. Softisan 649, available from Dynamit Nobel Aktiengesellschaft, is a glycerine ester of natural vegetable fatty acids, of isostearic acid and of adipic acid; its properties are discussed by H. Hermsdorf in Fette, Seifen, Anstrichmittel, Issue No. 84, No.3 (1982),p.p. 3-6. The other substances mentioned hereinabove as constituents of suitable ointment or cream bases and their properties are discussed in standard reference works, for example pharmacopoeia. 'Cetomacrogol 1000'has the formula CH₃(CH₂) m (OCH₂CH₂) n OH wherein m may be 15 or 17 and n may be 20 to 24. Butylated hydroxytoluene is 2,6-di-tert-butyl-p-cresol. 'Nipastat' is a mixture of methyl, ethyl, propyl and butyl 4-hydroxybenzoates. The compositions of the invention may be produced by conventional pharmaceutical techniques. Thus the aforementioned composition, for example, may conveniently be prepared by mixing together at an elevated temperature, preferably 60-70°C, the soft paraffin, liquid paraffin if present, and lanolin or derivative or synthetic equivalent thereof. The mixture may then be cooled to room temperature, and, after addition of the hydrated crystalline calcium salt of mupirocin with the corticosteroid and any other ingredients, stirred to ensure adequate dispersion. If necessary the composition may be milled at any suitable stage of the process. A suitable sterilisation procedure may also be included if necessary. Alternatively raw materials are obtained in sterile condition and the compositions are produced aseptically. The composition of the invention may be applied topically both to the outer skin and to other parts of the human or animal body, for example the eyes and inside the nose. The composition of the invention may also be applied topically to areas in which the skin is missing or damaged, as found, for example, in burns and wounds. Thus, the present invention further provides a method of treating skin disorders in human or domestic mammals, which method comprises applying topically to a human or domestic mammal in need thereof the composition of the invention. The invention will now be illustrated by the following Examples: Example 1 Ointment % w/w Mupirocin, crystalline calcium salt, dihydrate 2.0 (calculated as mupirocin) Hydrocortisone 1.0 Ointment base to 100% The ointment base contains: % w/w White soft paraffin 95 'Softisan 649' 5 An ointment formulation was prepared from the above ingredients by the following method. Appropriate proportions of white soft paraffin and 'Softisan 649' were heated together until molten (60 - 70°C) and mixed thoroughly. The mixture was allowed to cool down, with stirring, to room temperature and the hydrocortisone and micronised calcium mupirocin were incorporated using a suitable mixer. The ointment was finally triple-roller-milled. Example 2 Ointment % w/w Mupirocin, crystalline calcium salt, dihydrate 2.0 (calculated as mupirocin) Betamethasone valerate 0.1 (calculated as betamethasone) Ointment base to 100% The ointment base contains: % w/w White soft paraffin 95 'Softisan 649' 5 An ointment formulation was prepared from the above ingredients by the following method. Appropriate proportions of white soft paraffin and 'Softisan 649' were heated together until molten (60 - 70°C) and mixed thoroughly. The mixture was allowed to cool down, with stirring, to room temperature and the betamethasone valerate and micronised calcium mupirocin were incorporated using a suitable mixer. The ointment was finally triple-roller-milled. Example 3 Ointment % w/w Mupirocin, crystalline calcium salt, dihydrat 2.0 (calculated as mupirocin) Hydrocortisone 1.0 Ointment base to 100% The ointment base contains: % w/w White soft paraffin 100 An ointment formulation may be prepared from the above ingredients by the following method. White soft paraffin is heated until molten (60-70°C) and the micronised calcium mupirocin and micronised hydrocortisone are incorporated using a suitable mixer. The ointment is then allowed to cool. Example 4 Cream % w/w Mupirocin, crystalline calcium salt, dihydrate 2.0 (calculated as mupirocin) Hydrocortisone 1.0 Cream base to 100% The cream base contains: % w/w Cetomacrogol 1000 3.6 Stearyl alcohol USNF 14.4 Liquid Paraffin 42.0 Imidurea USNF 0.3072 Nipastat 0.2048 Nipabutyl Sodium 0.0205 Water to 100% A cream formulation may be prepared from the above ingredients by the following method. Appropriate proportions of Cetomacrogol 1000, stearyl alcohol and liquid paraffin are heated until molten (60-70°C). Micronised calcium mupirocin, micronised hydrocortisone, Nipastat, and Nipabutyl Sodium are added at 60-70°C and dispersed. An appropriate quantity of water is then mixed with the oil phase after being heated to a similar temperature. The mixture is homogenised and stirred and allowed to cool to 40°C. Imidurea is then added and dispersed and the cream is allowed to cool to room temperature. Example 5 Cream % w/w Mupirocin 2.0 Hydrocortisone 1.0 Cream base to 100% The cream base contains: % w/w Butylated hydroxytoluene 0.05 EDTA 0.01 Water 10.31 Polyethylene glycol ointment to 100% (The polyethylene glycol ointment contains 40% of polyethylene glycol 3350 and 60% of polyethylene glycol 400, prepared in accordance with the United States National Formulary.) A cream formulation may be prepared from the above ingredients by the following method. The butylated hydroxytoluene, EDTA, water, and polyethylene glycol ointment are heated at 50-60°C and mixed thoroughly. The micronised mupirocin and micronised hydrocortisone are incorporated using a suitable mixer and the cream is allowed to cool. Example 6 Ointment % w/w Mupirocin 2.0 Hydrocortisone 1.0 Ointment base to 100% The ointment base contains: % w/w Plastibase 100 An ointment formulation may be prepared from the above ingredients by the following method. Appropriate proportions of micronised mupirocin and micronised hydrocortisone are dispersed in Plastibase at room temperature using a suitable mixer. Example 7 Ointment % w/w Mupirocin, crystalline calcium salt, dihydrate 2.0 (calculated as mupirocin) Hydrocortisone 1.0 Ointment base to 100% The ointment base contains: % w/w Plastibase 100 An ointment formulation may be prepared from the above ingredients by a method analogous to that described in Example 6. Example 8 Cream % w/w Mupirocin, crystalline calcium salt, dihydrate 2.0 (calculated as mupirocin Hydrocortisone 1.0 Cream base to 100% The cream base contains: % w/w Cetomacrogol 1000 3.6 Stearyl alcohol USNF 14.4 Liquid Paraffin 42.0 Phenoxyethanol 1.0 Water to 100% A cream formulation may be prepared from the above ingredients by the following method. Appropriate proportions of Cetomacrogol 1000, stearyl alcohol and liquid paraffin are heated until molten (60-70°C). Micronised calcium mupirocin, micronised hydrocortisone, and phenoxyethanol are added and dispersed. An appropriate quantity of water is then mixed with the oil phase after being heated to a similar temperature. The mixture is homogenised and stirred and allowed to cool to room temperature. Example 9 Gel % w/w Mupirocin, crystalline calcium salt, dihydrate 2.0 (calculated as mupirocin) Hydrocortisone 1.0 Gel base to 100% The gel base contains: % w/w Water 98.0 Methylcellulose 2.0 As gel formulation may be prepared from the above ingredients by the following method. The gel base is prepared by adding the methylcellulose to the water and mixing thoroughly. The micronised calcium mupirocin and micronised hydrocortisone are then added at room temperature and dispersed using a suitable mixer.

Claims: A pharmaceutical composition for topical application to humans or domestic mammals comprising the hydrated crystalline calcium salt of mupirocin, and a corticosteroid intimately mixed therewith. A composition according to Claim 1, which composition comprises 0.01 to 50% of the hydrated crystalline calcium salt of mupirocin. A composition according to Claim 1 or Claim 2, which composition comprises from 0.001 to 5% of the corticosteroid. A composition according to Claim 1, which composition comprises from 1 to 3% of the hydrated crystalline salt of mupirocin and from 0.1 to 2% of the corticosteroid. A composition according to any one of Claims 1 to 4, wherein the corticosteroid is hydrocortisone. A composition according to Claim 1 containing 2% of mupirocin crystalline calcium salt dihydrate (calculated as mupirocin), and 1% of hydrocortisone in an ointment base, the ointment base containing 95% of white soft paraffin and 5% of 'Softisan 649'. A method for preparing a composition as claimed in claim 1 which method comprises intimately mixing the hydrated crystalline calcium salt of mupirocin and a corticosteroid. A method as claimed in Claim 7 wherein the corticosteroid is hydrocortisone. A pharmaceutical composition as defined in any one of claims 1 to 6 for use in therapy. The use of the hydrated crystalline salt of mupirocin and a corticosteroid for the manufacture of a medicament for treating skin disorders.

Inventors: GREENWAY, MICHAEL JOHN, ORR, NORMAN ANDREW
Applicants: BEECHAM GROUP PLC
Application year: 1986
Main classification: A61K31
IPC codes: C07D407, A61K31, A61P17