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United States Patent (19) 11 4,244,949 Gupta 45) Jan

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United States Patent (19) 11 4,244,949 Gupta 45) Jan United States Patent (19) 11 4,244,949 Gupta 45) Jan. 13, 1981 (54) MANUFACTURE OF LONG TERM Steroid-Induced Sterility in Mice, Nature, vol. 190, pp. CONTRACEPTIVE IMPLANT 174-175 (1961). (75) Inventor: Gopi N. Gupta, Blauvelt, N.Y. Primary Examiner-Henry R. Jiles Assistant Examiner-Robert C. Whittenbaugh 73) Assignee: The Population Council, Inc., New Attorney, Agent, or Firm-Brumbaugh, Graves, York, N.Y. Donohue & Raymond 21 Appl. No.: 894,088 (57) ABSTRACT Apr. 6, 1978 (22 Filed: This invention relates to a bioabsorbable fused implant (51) Int. C.’.............................................. A61K 31/56 for subcutaneous administration in mammals of a con 52 U.S.C. .................................................... 424/243 stant and effective amount of a steroid over a prolonged 58 Field of Search ......................................... 424/243 period comprising a solid dispersion of an effective 56) References Cited amount of a steriod uniformly dispersed in a matrix of a lipoid carrier the weight of steroid to lipoid carrier PUBLICATIONS being within the approximate range of 99:1 to 80:20, Shimkin and White, Absorption Rate of Hormone respectively, and to the method of manufacturing the Cholesterol Pellets, Endrocrinology, 29:1020, 1941. P. M. F. Bishop, et al, Absorption of Hormone Implants fused implants. in Man, Lancet, Aug. 11, 1951, pp. 229-232. Lipschutz, et al., Recovery of Fertility After Protracted 12 Claims, 4 Drawing Figures U.S. Patent Jan. 13, 1981 Sheet 1 of 3 4,244,949 ATMOSPHERE 0 I6, - St \ - VACUUM A/6. / U.S. Patent 4,244,949 Q S Juva45th SD passeudxa AlAuod l3N-(H) U.S. Patent Jan. 13, 1981 Sheet 3 of 3 4,244,949 3H-d-Norge stre dissolution rate in rot In vivo, release of H-d-NG radioactivity from o fused microimplant (4.45mm long; 2.38mm O.D Ond 41.8mm surface-area, 21.7Omg mass, A/6. 3. 80% H- d -NG + 20% chol, w/w) into urine O o and feces x - - -x of rot (H)-Norethindrone acetate (NETA) dissolution-rote from a 25O IOO% bioobsorbable and erodible fused micro implant s in monkey 20O 3 s S. W. 5O X CN Implant S. removed e - OO > -8 5o: d to 20 3o 4o so so 7o so go too to 2030 DAYS -a- In vivo, release of H-NETA radioactivity from a bioobsorboble fused microimplant (size - 2.4X 5.8mm surface-area and 36.5 mg mass, 80% H-NETA + A/G. 4. 20% chol., w/ w ) into urine o-o, x---x in monkey 4,244,949 1. 2 mal end of a Pyrex glass tube of a desired length and MANUFACTURE OF LONG TERM bore is fitted with a rubber cap and a tightly fitting steel CONTRACEPTIVE IMPLANT wire is inserted into the tube through the rubber cap to act as a plunger. In order to prevent adhering of the BACKGROUND OF THE INVENTION 5 implants to the walls, the glass is lightly oiled with The present invention relates to bioabsorbable fused liquid petrolatum. The desired quantity of the active implants which are effective in administering hormones chemical and other ingredients are mixed and melted in subcutaneously in mammals over a protracted time an oil bath. The resulting solution is drawn up into the period, and to the method of manufacturing the fused lubricated glass tube by means of the wire plunger. As implants. 10 soon as the material solidifies in the tube, it is extruded Steroids are currently used for treating a variety of by the plunger. The solid rod thus formed is divided conditions in mammals, including cancer, endocrine into implants of desired size by means of a razor blade. and gynecological problems and the control of fertility. The implants are then washed in ether and again in A variety of methods and apparatus have been known alcohol to remove the oil on the surface and to smooth as aids in controlling fertility in mammals, including 15 the rough edges. humans. Some approaches of current interest are con The implants are introduced into the subcutaneous doms, IUCD's, diaphrams, spermidical creams, jellies tissue of the subject by means of a trocar fitted with a and foams, and tablets and pills containing various ste plunger. The implants fit into the trocar, and no prepar roids to be administered orallyl. Many of these ap atory skin incision is necessary. proaches to fertility control are not completely effec 20 The glass tubing method of making fused implants tive and some cause undesirable side effects as a result has several major disadvantages. The fused implants of administering sex hormones such as estrogen and tend to adhere to the glass wall and the glass must be progesterone, normally associated with pregnancy, to lubricated to allow for removal of the implants. The use non-pregnant females. These side effects range from. of lubrication is a serious drawback in preparing im migraine headaches, vomiting, fatigue, nausea, and hy 25 plants for human use. Implants for use in humans must pertension to a higher risk of heart attacks. be highly purified, and the use of oils and petrolatum on The administration of steroid sex hormones such as 19-norprogesterone derivatives is known to prevent the glass tubing wall introduces an unwanted and trou luteinization, that is, the production of the corpus lu blesome impurity which must be scrupulously removed teum, as well as preventing ovulation, that is, the release 30 before the implant is suitable for human use. of an egg from the ovary. The anti-luteinizing and anti The glass tubing method of the prior art has addi ovulation effects of these hormones have been used for tional problems when used specifically for producing several years to induce reversible protracted sterility in steroid implants such as are used for fertility control. mammals, including humans. Pincus, G., Chang, M. C. According to this method, the steroid mixture is melted et al. Endocrinol. 59, 694 (1956) Rock, J., Garcia, C. R. 35 in a system that is open to the atmosphere. Since in most et al. Amer. J. Obst, and Gynecol. 79, 758 (1960). steroid mixtures melting occurs at a temperature above One of the experimental methods of administering 100°C., there is danger of thermal decomposition of the steroid sex hormones has been through subcutaneous hormone. The presence of oxygen from the atmosphere implants. See, for example, U.S. Pat. No. 3,800,038 to quickly activates undesirable oxidation changes in the Rudel; Kincl, Acta Endocrinologica 64 (1970). 253-264 steroid. In addition, if the mixture is heated above 500 and Kochakian, American J. Physiol, 145 549 (1945). C., the Pyrex glass begins to soften and may impart The implantation of pellets under the skin is a well further impurities to the molten steroid mixture. established method of administering steroids and other The problem of thermal decomposition of the compo compositions. In 1936, M.J. Shear, American Journal of nents of an implant must also be considered during Cancer, 26:322-332 (1936), reported the use of fused 45 sterilization. Sterilization is often accomplished by heat implants of cholesterol and a carcinogen to induce tu ing the object to 100° C. for 60 minutes. The glass tube mors in animals. P. M. Bishop, in Lancet, Aug. 11, 1951, method of manufacturing implants is carried out open pp. 229-232, in an article entitled "Absorption of Hor to the atmosphere and heating the components of the mone Implants in Man' summarizes the use of implants implant in contact with the oxygen in the atmosphere and reports that in 1938 he recorded the effects of in 50 causes further decomposition products which seriously planting a 14 mg. pellet of oestrone in an ovariecto impair the purity of the implant. mised woman; in 1939, Salmon et al. treated menopausal A further disadvantage of the glass-tubing method is women with oestrodiol-benzoate implants; Thorn and that it generally produces a cylindrical implant. Studies Firor in 1940 treated Addison's disease by implanting have shown that an implant of ellipsoidal shape in cross pellets of deoxycortone and found that their effect 55 section is preferred for many reasons. Since glass is rigid lasted 9 to 12 months; in 1943, Greenblatt studied the and non-pliable, it is difficult to form glass tubing in an effect of androgen implants in women with functional elliptical shape. The inability to easily produce an ellip menstrual disorders; in 1947, Zondek suggested the soidal implant is a serious drawback of the glass tubing introduction of pellets deep in the vaginal mucosa to system. avoid undesirable general systemic effects from hor In the past, the use of the fused implants as a means of mone treatment; and, in 1949, Vargas treated diabetics administering medication, especially sex hormones, has by the implantation of pellets of protamine-zinc insulin met with the problem of controlling the release of the and cholesterol. drug to obtain constant long-term release of the thera The implants used in these early experiments were peutic agent. In some pellet compositions, the dissolu made according to a method developed by, among 65 tion rate was too slow and not enough of the therapeu others, Shear, supra; Organon Laboratories Ltd., En tic compound was released to the patient's system or, on gland, and M. B. Shimkin and J. White, Endocrinology, the contrary, the dissolution rate was too rapid, which 29:1020-25 (1941). According to this method, the proxi resulted in overdosing and insufficient length of drug 4,244,949 3 4. release. It has been reported by M. B. Shimkin and J. It has now been found that a fused ellipsoidal shaped White, Endocrinology, supra, and others that by combin pharmaceutical implant comprising a solid dispersion of ing cholesterol with the active ingredients in the pellet an effective amount of a steroid uniformly dispersed in a long-acting implant can be produced.
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