WO1998014768A2 - Transdermal chemical monitoring device - Google Patents
Transdermal chemical monitoring device Download PDFInfo
- Publication number
- WO1998014768A2 WO1998014768A2 PCT/US1997/017856 US9717856W WO9814768A2 WO 1998014768 A2 WO1998014768 A2 WO 1998014768A2 US 9717856 W US9717856 W US 9717856W WO 9814768 A2 WO9814768 A2 WO 9814768A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- monitoring device
- transdermal
- collection
- chemical
- medium
- Prior art date
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Classifications
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/483—Physical analysis of biological material
- G01N33/497—Physical analysis of biological material of gaseous biological material, e.g. breath
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N1/00—Sampling; Preparing specimens for investigation
- G01N1/28—Preparing specimens for investigation including physical details of (bio-)chemical methods covered elsewhere, e.g. G01N33/50, C12Q
- G01N1/40—Concentrating samples
- G01N1/4005—Concentrating samples by transferring a selected component through a membrane
- G01N2001/4016—Concentrating samples by transferring a selected component through a membrane being a selective membrane, e.g. dialysis or osmosis
Definitions
- the invention relates to a non-invasive chemical monitoring device that is placed on the surface of the skin and collects ana measures the concentration of various chemicals within ne body by outward diffusion of the chemicals from the interior of the body, through the skin and into the device.
- Environmental/Occupational Exposure Monitoring Monitoring m the workplace for chemical exposure has taken on a number of different of different forms, mostly all of them appliea to those workplaces where the normal course of occupational activity involves chemicals (as opposed to office buildings, for example, where employees may be exposed to pesticides used by the building management) .
- This monitoring includes the periodic use of instruments to sample the air and the use of personal monitoring badges, which also monitor the air. This results in data presumptive of certain exposures, but not fully indicative of personal exposure.
- the most accurate representation of personal exposure is biological monitoring. Biological monitoring involves a measurement of the chemical or its surrogate in biological fluid or tissue. The most commonly used monitoring site is urine. This involves taking a urine sample at some specified time.
- the problem with this method is mat, because of pharmacokinetic factors, it does not give a full picture of exposure. It would be necessary to collect urine for 12 to ⁇ 2 hours or longer to overcome this limitation. Such a procedure creates compliance problems.
- Another monitoring site is blood. It has tne ⁇ isadvantage of being invasive. It also has the same pharmacokinetic limitations that would make repeated sampling necessary to acnieve a full exposure picture. This presents obvious disadvantages and risks.
- the TCMD overcomes the aforementioned problems. It does not present compliance or risk problems, and tne collection period can be specifically tuned to the pharmacokinetic behavior of the chemicals under surveillance. Of course, the TCy will work only for chemicals that are transdermally transporte ⁇ . Based on physical chemical requirements, this includes a large fraction of the chemicals of interest such as therapeutic drugs, hormones, environmental toxins, pesticides, drugs of abuse and xenooiotics found in occupational settings.
- U.S. Pat. No. 3,552,929 to Fields, et a_. discloses a Dand-aid-type test patch suited for determining the cnloride ion concentration in perspiration as a method of diagnosing cystic fibrosis.
- the apparatus disclosed in Fields comprises an absorptive sweat collecting pad with an impermeable overlying layer for the purpose of preventing evaporation.
- the patch When the absorptive pad is saturated, the patch is removed from the skin and exposed to a series of strips impregnated with incremental quantities of silver chromate or silver nitrate, the color of which undergoes a well known change upon conversion to the chloride salt.
- the Phillips U.S. Pat. No. 4,329,999 discloses a dermal patch for collecting sweat from a patient which includes a collecting pad for aDsorbmg sweat.
- 4,595,011 d ⁇ sc_.cses a transoermal dosimeter device including a dermal contact bridge, a fluid collecting component for collecting and storing fluids collected from the skin and a process component for bmdin ⁇ or chemically converting the stored substances.
- a transoermal dosimeter device including a dermal contact bridge, a fluid collecting component for collecting and storing fluids collected from the skin and a process component for bmdin ⁇ or chemically converting the stored substances.
- Phillips patent suggests that chemical conversion of collected substances to produce an observable color change in the device may be effected.
- the Fogt et . al . U.S. Pat. No. 4,444,193 discloses an absoroent patch device for absorbing sweat, which patch device includes a chemical composition capable of reacting with chloride contained in the sweat.
- the Pugliese U.S. Pat. No. 4,071,020 discloses an apparatus and metnoos for performing m-vivo measurements of enzyme activity wherem one or more reactants are placed directly on a predetermined area c: the skin surface and are free to migrate into the skin. ⁇ hile the apparatus and methods of Pugliese are not dependent on collection of a substance such as sweat or interstitial fluid, they may be dangerous to the subject if the reactants have toxic effects upon m ⁇ grat_on into the skin of the sub ect.
- U.S. Pat. No. 4,706,676 to Peck discloses a dermal collection device which comprises a binder to prevent reverse migration of an ana yte, a liquid transfer medium which permits transfer of an analyte from the dermal surface to the binder and an occlusive cover across the top of the liquid transfer medium and binder.
- Other U.S patents issued to Peck include No. 4,819,645, No. 4,960,467, No. 4,909,256 and No. 4,821,733.
- Clark, Jr. U.S. Pat. Nos. 4,401,122 and 4,458,686 disclose apparatus and methods for measuring substances, particularly gases, which diffuse through the skin or are present underneath the skin in the blood or tissue using polarographic electrodes or enzyme electrodes.
- the v'esterager et al U.S. Pat. No. 4,274,418 discloses an apparatus for measuring gases, for example oxygen and carbon dioxide, whicn diffuse from blood vessels and through skin tissue wherein the gas is directed to a measuring chamber in wnich the partial pressure is measured.
- the Peck devices are composed of a detector means including at least one detector chemical in solution and capable of chemically reacting with the analyte as the analyte migrates to the skin surface.
- the transdermal chemical monitoring device s a patch applied to the skin and capable of providing data on the levels of specific drugs and/or chemicals in the blood.
- Transcutaneous chemical collection represents a relatively novel approach to the non-invasive sampling of certain blood components.
- the same principles that apply to the inward movement of drugs from transdermal dosing patches through the skin into the blood also apply to the outward movement to the skin surface.
- This outward movement of chemicals from blood to the s ⁇ n provides the basis for transcutaneous monitoring of chemicals in the blood by use of a TCMD.
- Figure 1 shows a cross sectional view of the copo ymer paten
- Figure 2 shows a bottom section view of the copoiymer patch shown in figure 1;
- Figure 3 shows a cross sectional view of the copoiymer patch with me oil dispersion m the matrix;
- Figure 4 shows a cross sectional view of the copoiymer patch consisting of several components, an outside copoiymer snell, an inner reservoir of uptake material, an inner binding compound and an adhesive attachment.
- the inner reservoir material can consist of polymers, oils, fats, fatty acids, fatty acid esters, waxes, and rubbers whicn act to trap the absorbed analyte in the transderma_. collection monitoring device;
- Figure 5 shows a bottom sectional view of the copoiymer oatch device snown in figure 4;
- F_gure 6 shows the forward flux through hairless rat skin and accumulation of estradiol in the receptor compartment.
- the axes show cumulative amount in disintegrations per minute on the Y-axis vs time in hours on the x-axis.
- Figure ⁇ shows the reverse flux through hairless rat skin ana accumulation of estradiol in the receptor compartment.
- the axes snow cumulative amount in disintegrations per minute on the Y-axis vs time in hours on the x-axis.;
- Figure 8 shows the forward flux through LSE and accumulation of estra ⁇ iol in the receptor compartment.
- the axes show cumulative amount in disintegrations per minute on the Y-axis vs time in hours
- Figure 9 shows the forward flux through LSE and accumulation of estradiol in the receptor compartment sampled every hour out to 24 hours .
- the axes show cumulative amount in disintegrations per minute in the receptor solution and remaining quantity of material in the donor solution on the Y-axis vs time in hours on the x-axis.
- Figure 10 shows the rorward flux through SFLS LSE and accumulation of estradiol in the receptor compartment. The axes show cumulative amount m disintegrations per minute on the Y-axis vs time in hours on the x-axis.
- Figure 11 shows the flux through CoTran #9270 polyethylene film membrane and accumulation of estradiol in the receptor compartment. The axes show cumulative amount in disintegrations per minute on the Y-axis vs time in hours on the x-axis.;
- Figure 12 shows the forward flux through hairless rat skin and accumulation of progesterone in the receptor compartment.
- the axes show cumulative amount in disintegrations per minute on the Y-axis vs time m hours on the x-axis.;
- Figure 13 shows the forward flux through LSE and accumulation of progesterone in the receptor compartment.
- the axes snow cumulative amount in disintegrations per minute on the .-axis "s time in hours on the x-axis.;
- Figure 14 shows the forward flux through SFLS LSE and accumulation of progesterone in the receptor compartment.
- the axes show cumulative amount in disintegrations per minute on the Y-axis vs time in hours on the x-axis.;
- Figure 15 shows the forward flux througn LSE and accumulation of tritiated water in the receptor compartment.
- the axes show cumulative amount in disintegrations per minute in the receptor compartment and the remaining disintegrations per minute for the donor compartment on the Y-axis vs time in hours on the x-axis.;
- Figure 16 shows the forward flux through SFLS LSE and accumulation of tritiated water in the receptor compartment.
- the axes show cumulative amount in disintegrations per minute on the Y- axis vs time in hours on tne x-axis .
- TCMDs when placed on the skin, collect a chemical by accumulating the chemical through thermodynamic factors. The patch is then analyzed to produce quantitative results on the accumulated chemical.
- the device can be designed to accumulate a number of different molecules, which can be used as an advantage such as in the simultaneous monitoring of different chemicals.
- TCMDs can be designed according to the methods described m a variety of ways so as to accommodate various detection techniques and application configurations.
- FIG. 1 An embodiment of the device are shown in Figure 1.
- the device shown is comprised of a single-piece of molded polymer (1) .
- the molded polymer is treated on its skin contact surface with a tacky material that serves as the skm-to-patch transfer link (SPTL) (2).
- SPTL skm-to-patch transfer link
- the components of the SPTL can vary, depending upon the physical chemical properties of the compounds for which monitoring is oeing done.
- the components of the polymer are specifically dictated by physical chemical properties needed for transferring the analyte from the skin into the collection medium.
- the polymer can be formulated in a tacky consistency such that it provides its own SPTL.
- This active unit can then be attached to the outer anchoring adhesive (3) .
- the bottom view of this embodiment is shown in Figure 2.
- the TCMD can be provided with a thermodynamic sink in the form of an area within the molded polymer in which an additional substance is provided wnicn nas a difference nydrophilicity or lipophilicity from tne molded polymer.
- the additional substance can also be a polymeric material which has been selected and formulated for it physical chemical properties.
- Figure 3 shows such an embodiment in which ⁇ roplets of oil (4) are added to the poiymer in order to enhance tne tnermodynamic sink for certain lipophilic chemicals.
- Figure 4 shows the fabrication of an embodiment that contains a center well that can be used for reagents that will react with the analyte such that the patch can consist of a self-contained analytical system to quantify the amount of analyte.
- the pre-pc_ —e ⁇ zed mixture is poured into a mold so that it polymerizes in a forTM containing a well (1).
- the reagent material is then a ⁇ deo to the veil (5).
- the well can contain material to further concentrate the analyte, e.g., mineral oil.
- a film material such as commercially available paraffin film (6) is then placed over the e__, and a layer of pre polymerized mixture poured over that cover, .'.nen the added mixture polymerizes (7), a single piece device (8) results.
- the SPTL material is added (2) and the unit attached to the outer anchoring adhesive.
- F_gure 5 shows the bottom view of this embodiment of the TCMD: the tac ⁇ y polymeric surface (shown as a section) (2) for bonding tne patch tc the skin; an outline of the reservoir (5) can oe seen trough the translucent polymer (8); the anchoring outer adhesive (3).
- PVP Polyvmylpyrrolidone PLASDONE K-90 is 2-pyrrol ⁇ d ⁇ none, 1- ethenyl-, homopolymer (ISP Technologies, Wayne NJ) witn a molecular formula of (C 6 H 9 NO, x Also known as Polyvmylpyrrolidone. CAS#9003-39-8.
- PVA Poly Vinyl Alcohol (Sigma Chemical Company, St. Louis MO) with molecular weight of 70,000-100,000 Daltons . Also known as vinyl alcohol polymer. CAS#9002-89-5.
- GANEX P-904 2-pyrrol ⁇ d ⁇ none, 1-ethenyl-, polymer with 1-butene (ISP Technologies, Wayne NJ) with a molecular weight of 16000 Daltons. Also known as Butylated polyvmylpyrrolidone. CAS#26160-96- 3.
- Desmophen 1800 Polyester Polyol (Polydiethylene Adipate) . (Bayer, Pittsburgh PA)
- Desmophen 2200B Polyester Polyol CAS#28183-09-7 Comprises acrylic acid/ethenediol repeats (Bayer, Leverkusen, Germany) .
- Multranol 9111 Bayer, Pittsburgh PA. Polyether Polyol (Poly- oxyalkylene) Polyol) .
- Isonate 181 Dow, Midland MI. Pre-polymer diphenylmethylenedi- isocyanate.
- Isonate M301 Dow Benelux, 4 , 4-d ⁇ phenyl, methyl-diisocyanate prepolymer .
- Isonate M342 Dow Benelux, 4, 4-d ⁇ phenyl, methyl-diisocyanate prepolymer
- Bayflex 0549B Polyester Polyol Bayer, Leverkusen, Germany
- Bayflex 0681 Polyester Polyol CAS#26570-73-0' Bayer, Leverkusen, Germany
- Voranate M580 Polymeric methylene oiphenyl dusocyanate, Dow, Beneiix
- PEG 1300 Carbowax Sentry Polyethylene Glycol 1000NF, FCC Grace (Union Carbide, Danbury CT) .
- PEG 3350 Carbowax Sentry Polyethylene Glycol 3350 Flake NF, FCC Grace 'Union Carbide, Danbury CT) .
- Polyethylene Glycol an oxya ⁇ .lene polymer with tne formula H0 ICH , CH 0ln_H with a molecular weigr range of 3000-3600 Daltons. Also known as polyoxyethylene 3350 and poly (oxy-1, 2ethaned ⁇ yl) a-nydro-w-nydroxy- . CAS#25322-68-3
- PEG 4600 Carbowax Sentry Polyethylene Glycol 4600 Flake NF, FCC Gra ⁇ e (Union Caroide, DanDury CT) .
- Polyethylene Glycoi an oxyai-c/lene polymer with the formula H0"ICH 2 CH 2 01n_H with a molecular weight range of 4400-4800 Daltons. Also known as polyoxyethylene 4600 and poly(oxy-l,2ethaned ⁇ yl) , 1-hydro-w-hydroxy- . CAS#25322-68-3
- PEG 8000 Carbowax Sentry Polyethylene Glycol 8000 Flake NF, FCC Grade (Union Carbide, Danbury CT) .
- Polyethylene Glycol an oxyalkylene polymer with the formula H0 ⁇ ,CH 2 CH 2 01 "-" with a molecular weight range of 7000-9000 Daltons. Also known as polyoxyethylene 8000 and poly ⁇ oxy-l,2ethaned ⁇ yl) , 1-hydro-w-hydroxy- . CAS#25322-68-3. Proce ⁇ ures for the preparation of me polymer formulations are described below: PVP/PVA
- Polymers were prepared in 100 gram batches. 4g of Polyvmylalcohol (PVA) and 24g of glycerol were added to 85mL of solvent consisting of a 50/50 mixture of absolute ethanol and H20 contained in a stainless steel beaker. The mixture was stirre ⁇ on low speed setting #2 using a Caframo RZR1 stirrer (Wharton Ontario Canada). 28grams of PVP K-90 is placed in a beaker with 115mL of a 50/50 ethanol/H20 solvent mixture. When the oil bath reached 90°C the PVP solution mentioned previously was added to the PVA/Glycerol mixture. The mixture was boiled at 130°C with stirring and heat continued for five minutes beyond this point.
- PVA Polyvmylalcohol
- glycerol glycerol
- the beaker was removed from the heat (oil bath) and 3 grams of the copoiymer was poure ⁇ into each of 10 wells of a nonstick mold. Approximately 48 hours later, a good film had formed. The disks removed from the mold had a weignt of 1.1-1.3 grams each
- PVA/GANEX 4g of PVA was mixed with 85mL of 50% Ethanol at 90°C (in an oil bath) . 12 grams of glycerol was added and this mixture was heated to 110 degrees Celsius. At that point 14.5 grams of GA EX V516(ISP Technologies, Wayne NJ) was added to the mixture. The GANEX was not dissolved in any solvent prior to its addition to the PVA/Glycerol/Ethanol mixture. The final solution was mixed and heated to 130°C. The mixture was then poured into a nonstick mold and a non-stick sheet. The film took approximately 48 hours to form.
- Isonate M342 & Bavflex 0681 17 grams of Bayfl ⁇ x 0681 (Bayer, Leverkusen, Germany) was combined with 3 grams of Isonate M342 (Dow, Benelux) and 4 ml of heavy mineral oil (source as above) and heated with stirring unt_l a homogeneous mixture was obtained. The mixture was then poured into nonstick molds and placed in an oven overnight at 60°C.
- Voranate M580 & Multranol 9111 These components were combined in a 3:17 ratio and heated with stirring until a homogenous mixture was obtained. The mixture was then poured into a nonstick mold and polymerized in a dry oven at 60 degrees centigrade overnight.
- Hairless rat skin was cut using a Padgett Dermatome (Padgett Instruments, Kansas City MO) to a thickness of between 200 and 250 microns.
- the skin was mounted on a franz cell containing HBSS as the donor solution facing the papillary dermis .
- the HBSS was stirred and maintained at a temperature of 32°C using a circulating water batn.
- the skin was equilibrated with the HBSS prior to dosing for a period of 24 hours. After the equilibration period, [4- 1 C] -Estradiol was introduced into the donor solution and a polymer collection patch applied using CoTran #9871 Pharmaceutical Grade Transfer Adhesive (3M, St. Paul MN) .
- the skin and the patch were removed and the donor solution collected for counting along with two rinses of tne Franz cell.
- the skin was solubilized using the tissue solubilizer TS-2 (RPI, Mount Prospect IL) .
- the resulting material was brought to a neutral pH using 0.01 N sooiurr hydroxide.
- the patch was extracted using ethanol (95%) for a period of 24 hours.
- the donor solution and aforementioned patch materials and solubilized skin were quenched using scintillation cocktail and counted by scintillation counting.
- the flux of parathion, chlorpyrifos, estradiol and progesterone a variety of membranes including dermatome cut hairless rat skin, CoTran f9270 (3M, St. Paul MN) , Living Skin Equivalent iLSE), ana serum free lipid supplemented living skin equivalent (SFLS LSE) .
- the Kp values describing tne movement of these comooun ⁇ s are shoii r Table 1 .
- Table 1 Kp values for the Movement of test compounds tnrough various membranes. (All values are listed as the Mean ⁇ Standard Deviation of the Kp, units are cm/hr) .
- the forward flux of progesterone through hairless rat skin is shown in figure 12. This figure shows the cumulative amount of progesterone taken up on the receptor side. It also appears that the steady state is approached much faster in this case - by 3 hours it appears that there is a constant flux across the membrane from that point on to eight hours. The receptor fluid was sampled hourly out to eight hours and then again at 18,20,22 and 24 hours. The reverse flux of progesterone through hairless rat skin is similar to the forward flux shown m figure 12. Once again, there appears to be a steady state condition approached at 3 - 4 hours. The forward flux of progesterone through living skin equivalent is shown m figure 13.
- the movement of tritiated water was also assessed through the LSE and SFLS LSE membrane.
- the data for LSE is represented in plots whicn snow the cumulative amount of tritiated water that has moved across the membrane and into the receptor solution as well as the amount of t ⁇ tiate ⁇ water remaining in the donor solution compartment.
- the forward movement through LSE is shown in figure 15.
- the ⁇ ata for the SFLS LSE is shown in a plot of cumulative amount in receptor fluid vs time in figure 16 for forward flux.
- the reverse flux in the two previous cases was very similar to the forward flux.
- PGTA Pharmaceutical Grade Transfer Adhesive applied in these experiments .
- acousto-optic tunable filter near infrared spectroscopy (AOTF-NIR) .
- AOTF-NIR acousto-optic tunable filter near infrared spectroscopy
- concentration of the analyte can be measured nondestructively from directly within the TCMD.
- AOTF-NIR measurements with the TCMD are typically sensitive enough to measure subnanogram quantities of estradiol and other analytes.
- Other methods of detection that can be utilized include laser desorption mass spectrometry as well as techniques sucn as liquid chromatography and gas chromatography of extracted TCMDs.
- An advantage of the TCMD is that it can be cast as a solid one piece device and can incorporate chemical sensors directly into the body of the TCMD.
- the sensors may also be quite specialized and include sensitive and selective detectors for specific volatile or nonvolatile chemical or biological compounds such pesticides or otner anti-acetylcholmesterase compounds.
- the TCMD may also incorporate several types of sensors into one integrated device and the sensors may oe used to perform quantitative analyte measurements while tne device is still attached to the skin or after it has been removed.
- the sensors can be integrated into the structure of the TCMD.
- Such sensors can utilize different methods of detection.
- miniaturized detectors such as electrochemical sensors including chemical selective electrodes, immunosensors and biosensors which may contain specific antibodies or other ligands that will selectively bind the chemical compound of interest.
- Biosensors utilizing specific antibodies or ligands typically are bound to piezo crystals or electrodes or optical waveguides for fluorescent, photometric, or surface plasmon spectroscopy. Miniature photoacoustic detectors may also be employed. Because it is possible to produce TCMDs which are transparent or near transparent, any method of optical analytical measurement technique utilizing visible, infrared, or ultraviolet light my be utilized. Waveguides can be cast into the body of the TCMD with optically active ligands bound to the surface of the wave guide for the detection and measurement of collected analyte.
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PCT/US1997/017856 WO1998014768A2 (en) | 1997-10-06 | 1997-10-06 | Transdermal chemical monitoring device |
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PCT/US1997/017856 WO1998014768A2 (en) | 1997-10-06 | 1997-10-06 | Transdermal chemical monitoring device |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2003030951A3 (en) * | 2001-10-09 | 2003-08-21 | Kimberly Clark Co | Sampling article for determining quantitative and qualitative drug transfer to skin |
US8946276B2 (en) | 2011-06-28 | 2015-02-03 | Watson Laboratories, Inc. | High dosage mucoadhesive metronidazole aqueous-based gel formulations and their use to treat bacterial vaginosis |
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ATE196741T1 (en) * | 1994-06-24 | 2000-10-15 | Cygnus Therapeutic Systems | IONTOPHORETIC SAMPLING DEVICE |
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Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2003030951A3 (en) * | 2001-10-09 | 2003-08-21 | Kimberly Clark Co | Sampling article for determining quantitative and qualitative drug transfer to skin |
US8946276B2 (en) | 2011-06-28 | 2015-02-03 | Watson Laboratories, Inc. | High dosage mucoadhesive metronidazole aqueous-based gel formulations and their use to treat bacterial vaginosis |
US9198858B2 (en) | 2011-06-28 | 2015-12-01 | Watson Pharmaceuticals, Inc. | Methods of treating bacterial vaginosis with aqueous-based metronidazole gel formulations |
US10238634B2 (en) | 2011-06-28 | 2019-03-26 | Chemo Research, S.L. | Aqueous-based metronidazole gel formulations |
US10596155B2 (en) | 2011-06-28 | 2020-03-24 | Chemo Research, S.L. | Aqueous-based metronidazole gel formulations |
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