Patent Publication Number: US-4096271-A

Title: Slow release injectable formulations of tetramisole and derivatives in benzyl benzoate

Description:
Compounds of formula (I) ##STR1## wherein R is hydrogen, amino, i-butyrylamino, trimethylacetylamino or benzoylamino; and the compounds are the racemic mixtures and the optically active isomers thereof are highly effective for the control of helminths infecting homothermic farm and companion animals such as sheep, goats, horses and swine, and dogs and cats. The anthelmintics may be administered to the animals in, or with their feed or drinking water; or may be administered orally in the form of pills, boluses, tablets and the like. The formula (I) anthelmintics may also be formulated as drenches, pour-ons, implants and injectables. 
     Injectable formulations are one of the preferred modes of administration, since they allow the introduction and delivery of the above anthelmintics into the circulatory system of the animal via subcutaneous and/or intramuscular injections in precisely calculated dosages. Propylene glycol is a commonly used solvent for such formulations. Unfortunately, the compounds of formula (I) and their salts are quite toxic to certain farm and domestic animals such as swine, dogs and cats, and the margin of safety between the maximum effective and minimum toxic dose in the homothermic farm and companion animals is small. Thus an accidentally administered overdose could poison, and might even kill the animal it was supposed to protect. Slow-release injectable formulations of formula (I) compounds possessing a wider margin of safety in homothermic farm and companion animals are highly desirable. 
     Pharmaceutically acceptable salts of formula (I) compounds administered as conventional aqueous buffered subcutaneous (and/or intramuscular) injections to homothermic farm and companion animals are rapidly absorbed from the site of the injection, and will reach the circulatory system of the animals in a relatively short period of time. Anthelmintically effective amounts of the above formula (I) compounds will appear in the animals circulatory system, if the formula (I) compounds are administered at or below the recommended maximum dosage of about 8 mg levamisole hydrochloride equivalent/kg body weight for farm animals and about 4 mg levamisole hydrochloride equivalent/kg for companion animals. The level thus attained is maintained only for a relatively short period of time, and then the active compound is rapidly eliminated from the animals circulatory system. 
     As stated above, it would be advantageous and highly desirable to find slow release injectable formulations of formula (I) compounds, which would possess a wider margin of safety in homothermic farm and companion animals, and thus would make possible, if desired, the administration of larger than the hitherto recommended maximum dosages of 4 to 8 mg levamisole hydrochloride equivalent/kg body weight to the animals. 
     I have found that injectable formulations comprising an anthelmintic compound represented by formula (I) ##STR2## wherein R is hydrogen, amino, i-butyrylamino, trimethylacetylamino or benzoylamino; and the compounds which are the racemic mixtures and the optical isomers thereof dissolved in benzyl benzoate, are slow release anthelmintic injectable formulations when administered subcutaneously (or intramuscularly) to homothermic farm and companion animals. Additionally, overdosages up to five times the recommended maximum level are well-tolerated by the recipient animals, with only transient, short lived, toxic symptoms accompanying such overdosages. 
     It is essential, that the benzyl benzoate utilized in the formulations be free of hydrohalo acids (e.g. hydrochloric acid) and/or halogen containing organic compounds (e.g. benzylchloride), which in the presence of, or when brought in contact with, water would react with same to form the hydrohalo acids. The presence of the hydrohalo acids in the formulation would be detrimental since the formula (I) bases would be rapidly precipitated from their solutions as the corresponding salts. 
     The most preferred compound of the group represented by formula (I) is dl-6-phenyl-2,3,5,6-tetrahydroimidazo[1,2-b]-thiazole (tetramisole) and especially its l isomer, also known as levamisole. Among the optically active isomers of formula (I) compounds, the l isomers are generally preferred since they appear to be biologically more active than are the corresponding d isomers. 
     Conventional aqueous buffered injectable formulations utilize water soluble salts of formula (I) anthelmintics, prepared from the corresponding formula (I) bases and a pharmaceutically acceptable acid. These salts will migrate rapidly from the site of the injection into the animals circulatory system. Thus, an accidentally administered overdose may rapidly reach a toxic and possibly lethal drug level in the recipient animals circulatory system. An additional disadvantage of the aqueous injectables is the relative instability of the above-referred-to salts of formula (I) compounds in these solutions. 
     Advantageously, we now find that the migration of formula (I) bases from the site of the injection is in general, much slower than that of their corresponding salts. Consequently, when administered to homothermic farm and companion animals, even in larger than the recommended dosages, these compounds will reach in the animals circulatory system an anthelmintically effective level and will maintain the anthelmintically effective level for a prolonged period of time with only mild toxic symptoms from which the recipient animals rapidly recover. 
     The slow release injectable formulations of the invention comprising the solution of a compound of formula (I) ##STR3## wherein R is hydrogen, amino, i-butylrylamino, trimethylacetylamino or benzoylamino and the racemic mixtures and the optical isomers thereof in benzyl benzoate in amounts corresponding to 5% to 20% w/v levamisole hydrochloride equivalent, and preferably 6% to 18.2% w/v levamisole hydrochloride equivalent are inherently safer than conventional aqueous formulations and are well tolerated even when administered at the rate of five times the recommended maximum dosage, and the storage stability of the sterilized injectables is improved. 
     In the examples below levamisole hydrochloride is used as a standard. Free base equivalents of the compounds of this invention are reported in the table below: 
     
         ______________________________________                                    
 ##STR4##                                                                 
                Free Base Equivalents (in mg)                             
R               of 1 mg levamisole · HCl                         
______________________________________                                    
H               0.8486                                                    
amino           0.9109                                                    
i-butyrylamino  1.2020                                                    
trimethylacetylamino                                                      
                1.2603                                                    
benzoylamino    1.3433                                                    
______________________________________                                    
 
    
     The most preferred slow-release formulation comprises a solution of levamisole, l-6-phenyl-2,3,5,6-tetrahydroimidazo[2,1-b]thiazole in benzyl benzoate containing the compound in amounts equivalent to 6% to 18.2 % levamisole hydrochloride. 
     For the control of helminths infecting homothermic farm and companion animals such as sheep, goats, horses and swine, and dogs and cats, the above novel slow-release formulations are administered to the animals as one or more subcutaneous (or intramuscular) injection(s), designed to deliver 5 mg to 40 mg and preferably 6 mg to 16 mg levamisole hydrochloride equivalent/kg body weight. 
     The following non-limiting examples are provided to further illustrate the invention. 
     EXAMPLE 1 
     Evaluation of the safety of 18.2% levamisole aqueous injectable formulation in pigs at 8, 16, 24, 32, 48 and 64 mg/kg levamisole hydrochloride equivalent 
     
         ______________________________________                                    
Composition of formulation                                                
       Ingredients*  %                                                    
______________________________________                                    
Levamisole . HCl equivalent                                               
as levamisole phosphate                                                   
                     18.2                                                 
 Propyl paraben      0.0205                                               
 Methyl paraben      0.162                                                
 Sodium hydroxide    0.047                                                
Sodium metabisulfite 0.2                                                  
 Disodium edetate    0.13                                                 
 Citric acid . H.sub.2 O                                                  
                     3.47                                                 
Sodium citrate . 2 H.sub.2 O                                              
                     2.08                                                 
Distilled water q.s. ad                                                   
                     100.00                                               
______________________________________                                    
 *In grams except for water                                               
 
    
     Procedure 
     Thirty Yorkshire-Hampshire crossbred pigs are weighed, and are allocated to 6 groups of 5 pigs each. Water and swine grower ration are provided ad libitum (the composition of the swine grower ration is given at the end of this example). 
     At 4 days after weighing, each pig in groups A,B, C,D,E and F is injected subcutaneously in the right axillary space with the above injectable formulation at dosages of 8, 16, 24, 32, 48 and 64 mg levamisole hydrochloride equivalent/kg body weight. 
     The animals are under close observation on the day of medication and once daily for 7 days postinjection. Any toxic symptoms or mortality are recorded. The data obtained are summarized in Table I below. 
     
                       Table I                                                     
______________________________________                                    
Evaluation of the Safety of Regular Aqueous Buffered                      
Levamisole Injectable Solution Containing the Equivalent of               
18.2% w/v Levamisole Hydrochloride at 8, 16, 24, 32, 48 and               
64 mg/kg body Weight Level, in Pigs                                       
      mg/kg                                                               
      Levamisole          Duration                                        
                                  Sur-                                    
      Hydro-              of      vivors                                  
                                        Percent                           
      chloride  Toxic     Treatment                                       
                                  per   Mortal-                           
      Equivalent                                                          
                Symptoms  Effects Total ity                               
______________________________________                                    
A      8        none       --     5/5   0                                 
B     16        T;F;E     1 hour  5/5   0                                 
C     24        T;F;E;A   1 hour  5/5   0                                 
D     32        S;T;E;L;  2.5 hours                                       
                                  2/5   60                                
                D                                                         
E     48        S;T;E;L;  4 hours 1/5   80                                
                D                                                         
F     64        E;L;D             0/5   100                               
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 A = Ataxia; D = Death; E = Emesis; F = Foamy muzzle; L = Lateral         
 recumbency; S = Salivation; T = Tremors                                  
 
    
     
         ______________________________________                                    
Composition of Swine Grower Ration                                        
Ingredients          %                                                    
______________________________________                                    
Ground Corn          78.00                                                
Soybean Oil Meal, 49% Protein                                             
                     17.50                                                
Fat, and Bone Meal, 50% Protein                                           
                     2.50                                                 
Dicalcium Phosphate (18.5%P)                                              
                     0.75                                                 
Iodized Salt         0.50                                                 
Limestone (38% Ca)   0.60                                                 
Mineral Premix.sup.a 0.075                                                
Vitamin Premix.sup.b 0.075                                                
                     100.00                                               
a) Minerals provided per ton of feed (ppm)                                
Iron                 75 ppm                                               
Copper               75 ppm                                               
Manganese            45 ppm                                               
Zinc                 75 ppm                                               
b) Vitamins provided per ton of feed                                      
Vitamin A            3,000,000 I.U.                                       
Vitamin D              600,000 I.U.                                       
Riboflavin            6 g                                                 
Pantothenic acid     15 g                                                 
Niacin               30 g                                                 
Vitamin B.sub.12     15 mg                                                
Menadione             3 g                                                 
Vitamin E            7,500 I.U.                                           
Choline              150 g                                                
______________________________________                                    
 
    
     EXAMPLE 2 
     Evaluation of the safety of regular 9.1% levamisole injectable vs. an aqueous propylene glycol formulation containing 9.1% levamisole 
     
         ______________________________________                                    
Composition of the Formulations                                           
                 Regular  Aqueous Propylene                               
Ingredients*     9.1%     Glycol 9.1%                                     
______________________________________                                    
Levamisole . HCl equivalent                                               
as levamisole phosphate                                                   
                 9.1      9.1                                             
Propyl paraben   0.0205   0.0205                                          
Methyl paraben   0.162    0.162                                           
Sodium hydroxide 0.047                                                    
                 0.047                                                    
Sodium metabisulfite                                                      
                 0.2      0.2                                             
Disodium edetate 0.13     0.13                                            
Citric acid . H.sub.2 O                                                   
                 3.47     3.47                                            
Sodium citrate . 2 H.sub.2 O                                              
                 2.08     2.08                                            
Propylene glycol 0        50.0                                            
Dist. water q.s. ad                                                       
                 100.0    100.0                                           
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 *In grams, except for water                                              
 
    
     Preparation of the Formulations 
     The ingredients listed in the above table are dissolved in a portion of distilled water and the volume of the solution is then adjusted to 100 ml with distilled water, to yield formulations containing the equivalent of 9.1% w/v levamisole hydrochloride. 
     Procedure 
     Forty Yorkshire-Hampshire crossbred pigs, having an average weight of 65 lb, are used for the experiment. The pigs are separated in groups of 5 per pen. Water and Swine Grower Feed are provided ad libitum. 
     Individual pig weights are measured at 1 to 2 days before treatment for calculation of individual drug dosages. 
     
         ______________________________________                                    
Treatment Groups                                                          
                                   No. of Pigs                            
Group  9.1% w/v Formulation                                               
                      Dosage* mg/kg                                       
                                   per Group                              
______________________________________                                    
A     Regular         16           10                                     
B     aq. propylene glycol                                                
                      16           10                                     
C     Regular         32           5                                      
D     aq. propylene glycol                                                
                      32           5                                      
E     Regular         40           5                                      
F     aq. propylene glycol                                                
                      40           5                                      
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 *Standard dosage is 8 mg/kg body weight                                  
 
    
     The experiment is conducted in two phases. In phase I, 5 male and 5 female pigs in group A are injected subcutaneously in the right axillary space with the regular 9.1% w/v levamisole injectable at 16 mg levamisole hydrochloride equivalent/kg body weight (2 times the recommended level). 
     Similarly, 5 male and 5 female pigs in group B are injected with the experimental 9.1% w/v levamisole in aqueous propylene glycol at 16 mg levamisole hydrochloride equivalent/kg body weight (2 times the recommended dosage). The animals are under close observation on the injection day and the following morning. Any symptons of toxicity, mortality and onset and duration of the toxic symptoms are recorded. 
     Phase II is conducted 1 day after the phase I treatment. Pigs in groups C and D are injected subcutaneously with the regular 9.1% w/v levamisole injectable and the experimental 9.1% w/v levamisole in aqueous propylene glycol at 32 mg levamisole hydrochloride equivalent/kg body weight (4 times the recommended level). Pigs in groups E and F are injected subcutaneously with the respective formulations at 40 mg levamisole hydrochloride equivalent/kg body weight (5 times the recommended level). The animals are under close observation, and mortality and toxic symptoms are recorded. The data obtained are summarized in Table II below. 
     
                                           Table II                                
__________________________________________________________________________
Evaluation of the safety of regular aqueous buffered levamisole           
injectable compared to a similar                                          
formulation containing propylene glycol; wherein both injectables contain 
9.1% w/v levamisole                                                       
hydrochloride equivalent, in pigs.                                        
                           No. of Pigs                                    
           mg/kg levamisole                                               
                    Clinical                                              
                           Showing at least                               
                                      Time became                         
                                              Survivors                   
Group                                                                     
   Formulation                                                            
           . HCl Equivalent                                               
                    Observation                                           
                           one of the Symptoms                            
                                      Normal (Hrs)                        
                                              Per Total                   
__________________________________________________________________________
A  Regular 16       T;F;V;l                                               
                            9/10      1-2     10/10                       
B  aq. propylene                                                          
           16       T/F/V/L                                               
                            6/10      0.5-2   10/10                       
   glycol                                                                 
C  Regular 32       T;F;S;A;                                              
                           5/5          1-1.5 2/5                         
                    C;R;L;D                                               
D  aq. propylene                                                          
           32       T;F;S;A;                                              
                           4/5        1-2     5/5                         
   glycol           C;R;L;D                                               
E  Regular 40       T;A;F;C;                                              
                           5/5                0/5                         
                    R;D                                                   
F  aq. propylene                                                          
           40       T;A;F;S;                                              
                           5/5          2-2.5 2/5                         
   glycol           R;D                                                   
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 A = Ataxia; D = -Death; F = Foamy muzzle; C = Convulsions; L = Lethargy; 
 = Recumbency; T = Tremors; V = Vomiting: S = Salivation                  
 
    
     EXAMPLE 3 
     The Safety of Levamisole Base-Benzyl Benzoate Injectable Formulation in Pigs 
     Formulation 
     Levamisole base is dissolved in benzyl benzoate (levamisole base 7.72 g real, benzyl benzoate q.s. ad 100 ml) to provide an injectable formulation containing the equivalent of 9.1% w/v levamisole hydrochloride. 
     Test animals 
     Twenty-four Yorkshire-Hampshire crossbred pigs (12 males and 12 females), having an average weight of 14.7 kg, are randomly distributed in 4 groups of 6 pigs each (3 males and 3 females). Water and a basal swine starter ration are offered ad libitum. 
     Procedure 
     Phase I 
     Individual pig weights are determined the same day of treatment for calculation of individual drug dosages. No more than 4 ml of injectable is placed subcutaneously at any injection site in the axillary region when administering the corresponding drug dosages. Pigs in group 1 serve as unmedicated controls, and receive 1 ml of normal saline per 11.34 kg body weight. Animals in groups 2, 3 and 4 are injected with the above formulations providing the equivalent of 8, 24 and 40 mg levamisole hydrochloride/kg body weight, respectively. Animals are observed after treatment continuously for 3 hours and at least once a day thereafter. 
     Phase II 
     The procedure is essentially the same as the one used in phase I. There is a 14 days interval between the beginning of this phase and phase I. The average weight of the pigs is 19.9 kg. The data obtained in phases I and II are summarized Table III below. 
     
                                           Table III                               
__________________________________________________________________________
Evaluation of the safety of a novel levamisole base/benzyl benzoate       
injectable,                                                               
containing the equivalent of 9.1% w/v levamisole hydrochloride, in pigs.  
             Clinical observation                                         
                         No. of Pigs Showing at                           
    mg/kg levamisole                                                      
             and Symptoms                                                 
                         Least One of the Symptoms                        
                                       Survivors per Total                
Group*                                                                    
    . HCl Equivalent                                                      
             Phate I                                                      
                   Phase II                                               
                         Phase I                                          
                                Phase II                                  
                                       Phase I                            
                                            Phase II                      
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1   Unmedicated                                                           
             normal                                                       
                   normal                                                 
                         0/6    0/6    6/6  4/4                           
    Controls                                                              
2    8       normal                                                       
                   normal                                                 
                         0/6    0/6    6/6  4/4                           
3   24       E;S;T;A;F;                                                   
                   E;L;D 5/6    4/6    6/6  4/4                           
             L;P                                                          
4   40       E;S;T;A;F;                                                   
                   E;S;D;F;                                               
                         6/6    6/6    6/6  4/4                           
             L;P   T;L;A                                                  
__________________________________________________________________________
 E = Emesis; S = Salivation; T = Tremors; A = Ataxia; F = Foamy muzzle; L 
 Lethargy; P = Polypnea; D = -Diarrhea                                    
 *Two pigs of each group are sacrificed in phase II, one hour after the   
 administration of the corresponding drug dose.                           
 
    
     It can be seen from Table III that no toxic symptoms are observed at the recommended dose level. Toxic symptoms at the 24 and 40 mg/kg dosages include emesis, foamy muzzle, salivation, depression, accelerated respiration, slight ataxia and slight tremors. All pigs given the exaggerated dosages return to normal within 2.5 hours. Toxic symptoms observed after the first and second treatments are similar. 
     EXAMPLE 4 
     In this example, the survivors per total, and mortality data obtained in Examples 1, 2 and 3 are combined in Table IV for comparison. The data displayed in Table IV clearly show that the levamisole base/benzyl benzoate injectable solution, containing the equivalent of 9.1% w/v levamisole hydrochloride is much safer at the 40 mg/kg body weight level than the corresponding regular and aqueous propylene glycol formulations containing the equivalent of 9.1% w/v levamisole hydrochloride. 
     
                                           Table IV                                
__________________________________________________________________________
Combined data from Examples 1,2 and 3 for purposes of comparison          
Dosage: mg/kg                                                             
          Survivors per Total* Percent Mortality*                         
levamisole . HCl                                                          
          Regular                                                         
                aq. prop.                                                 
                       base/benzyl                                        
                               Regular aq. propyl                         
                                              base/benzyl                 
Equivalent                                                                
          9.1%                                                            
             18.2%                                                        
                glycol 9.1%                                               
                       benzoate, 9.1%                                     
                               9.1%                                       
                                   18.2%                                  
                                       glycol 9.1%                        
                                              benzoate;                   
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                                              9.1%                        
 8           5/5       6/6;4/4     0          0                           
16        10/10                                                           
             5/5                                                          
                10/10          0   0   0                                  
24           5/5       6/6;4/4     0          0                           
32        2/5                                                             
             2/5                                                          
                5/5            60  60  0                                  
40        0/5   2/5    6/6;4/4 100     60     0                           
48           1/5                   80                                     
64           0/5                   100                                    
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 *Formulations containing % levamisole . HCl Equivalent, as indicated?