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ANESTHETIC PHARMACOLOGY

Pharmacokinetics and Pharmacodynamics of a New Intranasal Midazolam Formulation in Healthy Volunteers

Daniel P. Wermeling, PharmD, FASHP^*, Kenneth A. Record, PharmD^*, Thomas H. Kelly, PhD, Sanford M. Archer, MD, Thomas Clinch, and Anita C. Rudy, PhD

From the *University of Kentucky College of Pharmacy; University of Kentucky College of Medicine; Division of Otolaryngology – Head & Neck Surgery, University of Kentucky A. B. Chandler Medical Center; Intranasal Therapeutics, Inc., Lexington, Kentucky.

Address correspondence and reprint requests to Daniel P. Wermeling, Pharm.D., University of Kentucky College of Pharmacy, 725 Rose Street, Lexington, Kentucky 40536. Address e-mail to dwermel{at}uky.edu.

We evaluated the pharmacokinetics and pharmacodynamics of single 5-mg doses of midazolam after administration of a novel intranasal (IN) formula, IM, and IV midazolam in an open-label, randomized, 3-way cross-over study in 12 healthy volunteers. IN doses were delivered as 0.1-mL unit-dose sprays of a novel formulation into both naris. Blood samples were taken serially from 0 to 12 h after each dose. Plasma midazolam concentrations were determined by liquid chromatography/mass spectrometry/mass spectrometry. Noncompartmental analysis was used to estimate pharmacokinetic parameters. The mean midazolam bioavailabilities and % coefficient of variation were 72.5 (12) and 93.4 (12) after the IN and IM doses, respectively. Median time to maximum concentration was 10 min for IN doses. Adverse events were minimal with all routes of administration, but nasopharyngeal irritation, eyes watering, and a bad taste were reported after IN doses. Our results support further development of this novel midazolam nasal spray.