CA2495527C - New sexual-dysfunction-compound-containing rapid-onset pharmaceutical formulations comprising cocoa powder and use thereof - Google Patents
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Abstract
A sexual-dysfunction-compound-containing rapid-onset pharmaceutical composition that comprises cocoa powder, process for manufacturing the composition and use of the composition in sexual dysfunction therapy.</SDOAB >
Description
2 PCT/SE2003/001022 New sexual-dysfunction-compound-containing rapid-onset pharmaceutical formulations comprising cocoa powder and use thereof Field of the Invention This invention relates to novel rapid-onset orally administered pharmaceutical compositions of sexual dysfunction (SD) compounds and use thereof. More particularly, the present invention relates to compositions comprising SD compounds and cocoa powder, methods to prepare said compositions, and to methods for using said compo-sitions in sexual dysfunction therapy, including enhancement of sexual desire, and interest or performance.
Bacl~round and Prior Art Orally administered therapies for sexual dysfunction, in particular for male erectile disorder, are well known. See for example Gingell ~ Lockyer (1999), "Emerging pharmacological therapies for erectile dysfunction", Expert Opinion on Therapeutic Patents 9, 1659-1696. Drugs in use or in development include phospho-diesterase type 5 (PDES) inhibitors, e.g., sildenafil citrate, available under the trademark Viagra0 of Pfizer, cyclic AMP activators, a-adrenergic antagonists, e.g., yohimbine, and dopaminergic agonists, e.g., apomorphine.
International Patent Publication No. WO 00/40226 discloses compounds useful in treating sexual dysfunction in men and women, these compounds being of formula (I) N\R~
(I) or pharmaceutically acceptable salts thereof, wherein R1, RZ and R3 are the same or different and are H, C1_6 alkyl (optionally phenyl substituted), C3_5 alkenyl or alkynyl or C3_lo cycloalkyl, or where R3 is as above and Rl and RZ are cyclized with the attached N atom to form pyrrolidinyl, piperidinyl; morpholinyl, 4-methylpiperazinyl or imidazolyl groups;
X is H, F, Cl, Br, I, OH, Cl_6 alkyl or alkoxy, CN, carboxamide, carboxyl or (Cl_6 alkyl)carbonyl;
A is CH, CH2, CHF, CHCI, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, S02 or N;
B is CH, CH2, CHF, CHCI, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1;
and D is CH, CH2, CHF, CHC1, CHBr, CHI, C=O, O, N, NH or NCH3;
with various provisos indicated therein. WO 00/40226 further contemplates prescription of the drug (R)-5,6-dihydro-5-(methylamino)-4H-imidazo[4,5-ij]-quinolin-2(1H)-one (~-2-butenedioate (1:1) to male and female subjects at a dose of 1-3 mg, to be taken 0.5-1 h before engaging in sexual activity, and indicates that at such a dose and timing of administration the drug is therapeutically effective. No information is provided as to the route of administration or nature of dosage form.
The class of compounds proposed for treatment of sexual dysfunction in WO
00/40226 was earlier disclosed in U.S. Patent No. 5,273,975 to Moon et al. to have therapeutically useful central nervous system activity. Certain compounds of the above class are the subject of a paper by Heier et al. (1997), "Synthesis and biological activi-ties of (R)-5,6-dihydro-N,N-dimethyl-4H-imidazo[4,5,1-ij]quinolin-5-amine and its metabolites", J. Med. Chem. 40, 639-646.
In spite of the availability of sildenafil citrate, apomorphine and other drugs in orally deliverable form, there remains a need for dosage forms of a therapeutic agent for treating sexual dysfunction in men and women, having one or more of the following benefits:
(a) rapid absorption leading to rapid onset of therapeutic effect;
(b) reduced unpleasantness of taste;
(c) no requirement to be taken with water;
(d) high bioavailability for substances with high first pass metabolism;
(e) provision for an association of pleasure; and (f) no immediate patient-perceived association with medicines.
In one aspect, sexual dysfunction as addressed herein comprises sexual disorders including, without limitation, hypoactive sexual desire disorder, female sexual arousal disorder, male erectile disorder, female orgasmic disorder and male orgasmic disorder, all as defined in Dia~,nostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (1994), and DSM-IV Guidebook (1995), both published by American Psychiatric Press, Inc., Washington, DC.
In another aspect, sexual dysfunction as addressed herein comprises diminish-
Bacl~round and Prior Art Orally administered therapies for sexual dysfunction, in particular for male erectile disorder, are well known. See for example Gingell ~ Lockyer (1999), "Emerging pharmacological therapies for erectile dysfunction", Expert Opinion on Therapeutic Patents 9, 1659-1696. Drugs in use or in development include phospho-diesterase type 5 (PDES) inhibitors, e.g., sildenafil citrate, available under the trademark Viagra0 of Pfizer, cyclic AMP activators, a-adrenergic antagonists, e.g., yohimbine, and dopaminergic agonists, e.g., apomorphine.
International Patent Publication No. WO 00/40226 discloses compounds useful in treating sexual dysfunction in men and women, these compounds being of formula (I) N\R~
(I) or pharmaceutically acceptable salts thereof, wherein R1, RZ and R3 are the same or different and are H, C1_6 alkyl (optionally phenyl substituted), C3_5 alkenyl or alkynyl or C3_lo cycloalkyl, or where R3 is as above and Rl and RZ are cyclized with the attached N atom to form pyrrolidinyl, piperidinyl; morpholinyl, 4-methylpiperazinyl or imidazolyl groups;
X is H, F, Cl, Br, I, OH, Cl_6 alkyl or alkoxy, CN, carboxamide, carboxyl or (Cl_6 alkyl)carbonyl;
A is CH, CH2, CHF, CHCI, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, S02 or N;
B is CH, CH2, CHF, CHCI, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1;
and D is CH, CH2, CHF, CHC1, CHBr, CHI, C=O, O, N, NH or NCH3;
with various provisos indicated therein. WO 00/40226 further contemplates prescription of the drug (R)-5,6-dihydro-5-(methylamino)-4H-imidazo[4,5-ij]-quinolin-2(1H)-one (~-2-butenedioate (1:1) to male and female subjects at a dose of 1-3 mg, to be taken 0.5-1 h before engaging in sexual activity, and indicates that at such a dose and timing of administration the drug is therapeutically effective. No information is provided as to the route of administration or nature of dosage form.
The class of compounds proposed for treatment of sexual dysfunction in WO
00/40226 was earlier disclosed in U.S. Patent No. 5,273,975 to Moon et al. to have therapeutically useful central nervous system activity. Certain compounds of the above class are the subject of a paper by Heier et al. (1997), "Synthesis and biological activi-ties of (R)-5,6-dihydro-N,N-dimethyl-4H-imidazo[4,5,1-ij]quinolin-5-amine and its metabolites", J. Med. Chem. 40, 639-646.
In spite of the availability of sildenafil citrate, apomorphine and other drugs in orally deliverable form, there remains a need for dosage forms of a therapeutic agent for treating sexual dysfunction in men and women, having one or more of the following benefits:
(a) rapid absorption leading to rapid onset of therapeutic effect;
(b) reduced unpleasantness of taste;
(c) no requirement to be taken with water;
(d) high bioavailability for substances with high first pass metabolism;
(e) provision for an association of pleasure; and (f) no immediate patient-perceived association with medicines.
In one aspect, sexual dysfunction as addressed herein comprises sexual disorders including, without limitation, hypoactive sexual desire disorder, female sexual arousal disorder, male erectile disorder, female orgasmic disorder and male orgasmic disorder, all as defined in Dia~,nostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (1994), and DSM-IV Guidebook (1995), both published by American Psychiatric Press, Inc., Washington, DC.
In another aspect, sexual dysfunction as addressed herein comprises diminish-
3 meat of sexual desire, interest and/or function arising from primary diseases or condi-tions that are not sexual disorders in a strict sense. Such diseases and conditions include, without limitation; epilepsy, eraniopharyngioma, hypogonadism and general psychiatric disorders such as depression. Sexual dysfunction as addressed herein additionally com-prises sexual deficiencies following hysterectomy and/or oophorectomy as well as those arising as side effects of medication.
European Patent Application No. 0 960 621 discloses that sildenafil citrate has an unpleasant taste that cannot be completely masked by flavoring agents, and proposes rapidly disintegrating oral dosage forms of sildenafil in the form of its free base, which has extremely low solubility in water and is virtually tasteless.
International Patent Publication No. WO 99/66933 proposes intranasal admini-stration of sildenafil, illustratively in the form of salts such as the hydrochloride salt, for treatment of erectile dysfunction. Dosage forms proposed include a nasal spray and an aqueous nasal gel. Aqueous solutions are said to be preferred. Rapid onset of therapeu-tic effect is contemplated; however, no solution is suggested to the problem of unplea-sant taste arising from drainage of the drug into the mouth. Further, intranasal admini-stration is not a sufficiently discreet way of administering SD compounds.
Dosage rates are contemplated in WO 99/66933 to be lower than are required when the drug is orally administered; a 30 mg dose of sildenafil hydrochloride in the form of a nasal spray is exemplified. Also exemplified is a nasal spray formulation delivering 30 mg of sildena-fil hydrochloride and 1 mg of apomorphine hydrochloride.
European Patent Application No. 0 992 240 discloses cGMP-PDE inhibitory compounds said to be useful in treatment of male erectile dysfunction and proposes transmucomembranous administration, for example in the form of sublingual prepa-rations, of such compounds.
International Patent Publication No. WO 00/76509 also proposes nasal admini-stration of apornorphine, illustratively as its hydrochloride salt.
Heaton (1996), "Buccal apomorphine", J. Urol. 155, 49, reports efficacy of a sublingual formulation of apomorphine in treatment of male non-organic erectile dys-function.
U.S. Patent No. 5,985,889 to El-Rashidy et al. proposes sublingual administra-Lion of apomorphine for treatment of male psychogenic erectile dysfunction.
Various sublingual tablet formulations of apomorphine hydrochloride are disclosed therein.
International Patent Publication No. WO 00/35457 proposes use of apomorphine
European Patent Application No. 0 960 621 discloses that sildenafil citrate has an unpleasant taste that cannot be completely masked by flavoring agents, and proposes rapidly disintegrating oral dosage forms of sildenafil in the form of its free base, which has extremely low solubility in water and is virtually tasteless.
International Patent Publication No. WO 99/66933 proposes intranasal admini-stration of sildenafil, illustratively in the form of salts such as the hydrochloride salt, for treatment of erectile dysfunction. Dosage forms proposed include a nasal spray and an aqueous nasal gel. Aqueous solutions are said to be preferred. Rapid onset of therapeu-tic effect is contemplated; however, no solution is suggested to the problem of unplea-sant taste arising from drainage of the drug into the mouth. Further, intranasal admini-stration is not a sufficiently discreet way of administering SD compounds.
Dosage rates are contemplated in WO 99/66933 to be lower than are required when the drug is orally administered; a 30 mg dose of sildenafil hydrochloride in the form of a nasal spray is exemplified. Also exemplified is a nasal spray formulation delivering 30 mg of sildena-fil hydrochloride and 1 mg of apomorphine hydrochloride.
European Patent Application No. 0 992 240 discloses cGMP-PDE inhibitory compounds said to be useful in treatment of male erectile dysfunction and proposes transmucomembranous administration, for example in the form of sublingual prepa-rations, of such compounds.
International Patent Publication No. WO 00/76509 also proposes nasal admini-stration of apornorphine, illustratively as its hydrochloride salt.
Heaton (1996), "Buccal apomorphine", J. Urol. 155, 49, reports efficacy of a sublingual formulation of apomorphine in treatment of male non-organic erectile dys-function.
U.S. Patent No. 5,985,889 to El-Rashidy et al. proposes sublingual administra-Lion of apomorphine for treatment of male psychogenic erectile dysfunction.
Various sublingual tablet formulations of apomorphine hydrochloride are disclosed therein.
International Patent Publication No. WO 00/35457 proposes use of apomorphine
4 for treatment of male organic, e.g., vasculogenic, erectile dysfunction, and exemplifies use of a sublingual tablet formulation of apomorphine hydrochloride. WO
further suggests that nausea, a common side effect of apomorphine, can be controlled by inclusion of an anti-emetic agent such as nicotine in the formulation.
U.S. Patent No. 6,121,276 to El-Rashidy & Ronsen discloses flavored sublingual tablets containing apomorphine hydrochloride and nicotine.
International Patent Publication No. WO 01/49292 discloses sublingual tablets of apomorphine providing prolonged release of the drug, said to be useful in treatment of Parkinson's disease.
International Patent Publication No. WO 00/42992 discloses a dosage unit com-prising a water-soluble hydrocolloid and sildenafil citrate in a mucoadhesive film said to be suitable for application to the oral mucosa. Pharmacokinetic data presented in WO
00/42992 indicate no faster absorption into the bloodstream with sublingual application of such a film than with a commercial tablet formulation of sildenafil citrate (Viagra~) at the same dosage.
International Patent Publication No. WO 01/10406 discloses compositions said to be suitable for a wide range of routes of administration of sildenafil citrate, including buccal and sublingual routes. Preferred compositions disclosed are said to comprise a solution, gel, semisolid, suspension, metered dose device, transdermal patch or film.
International Patent Publication No. WO 02/05820 discloses film dosage forms comprising sildenafil citrate. These dosage forms are prepared by mixing a solid dis-persion of sildenafil citrate and a water soluble sugar with a hydrocolloid and optionally other ingredients, and are said, upon placement on a mucosal surface, to form a coating that subsequently disintegrates and dissolves to release sildenafil.
International Patent Publication No. WO 02/041840 discloses the use of cocoa powder as a flavorant, though not a taste-masker, in chewing gums for sildenafil citrate.
International Patent Publication No. WO 00/30641 discloses the use of cocoa powder as a flavorant in oral compositions containing nicotine.
International Patent Publication No. WO 99/66916 discloses the use of chocolate flavor in oral compositions containing apornorphine.
Chocolate, which is very different from cocoa powder as such, has very rarely been used as an ingredient in pharmaceutical products on the market, hitherto only in laxatives. One example is Ex-Lax~ being chocolated laxative pieces marketed by S
Novartis comprising sennosides. Purex, a laxative wherein phenolphthalein was formulated with chocolate, was marketed in the 1950s.
It has now surprisingly been found that a rapid onset of orally administered pharmaceutical compositions of SD compounds is achieved concomitantly with suffi-cient taste masking of badly tasting ingredients, such as buffering agents, through the use of SD-compound-containing formulations comprising cocoa powder as filler/diluent and taste masking or flavoring agent and agent for providing a smooth texture.
No similar formulations have been disclosed hitherto.
Summary of the invention The present invention provides an orally administered rapid-onset pharmaceu-tical composition useful for treatment of sexual dysfunction, stimulation of sexual activity and enhancement of sexual desire, interest and performance in men and women.
The composition is a dosage form comprising a therapeutically or sexual-stimulatorily effective amount of one or more SD compounds. A "therapeutically effective amount"
herein is an amount sufficient to improve sexual desire, interest or performance in a subject having a sexual dysfunction condition. A "sexual-stimulatorily effective amount" herein is an amount sufficient to improve sexual desire, and interest or per-formance in a subject whether or not the subject has a sexual dysfunction condition.
Suitable such SD compounds are chosen from the below agents, but are not limited thereto:
A compound of formula (I) '~~R2 (I) or a pharmaceutically acceptable salt thereof, wherein R1, R~' and R3 are the same or different and are H, C1_6 alkyl (optionally phenyl substituted), C3_5 alkenyl or alkynyl or C3_1o cycloalkyl, or where R3 is as above and R1 and RZ are cyclized with the attached N atom to form pyrrolidinyl, piperidinyl, morpholinyl, 4-methylpiperazinyl or imidazolyl groups;
X is H, F, Cl, Br, I, OH, C1_6 alkyl or alkoxy, CN, carboxamide, carboxyl or (Cl_ 6 alkyl)carbonyl;
A is CH, CH2, CHF, CHCI, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, S02 or N;
B is CH, CHI, CHF, CHCI, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1;
and D is CH, CHI, CHF, CHC1, CHBr, CHI, C=O, O, N, NH or NCH3;
said compound of formula (I) or salt thereof being water-soluble. A suitable dosing is from around 0.1 mg to around 10 mg per dose.
A compound of formula (II) HN
~~X (II) wherein X is O or S, and pharmaceutically acceptable salts thereof. A suitable dosing is from around 0.05 mg to around 10 mg per dose.
A compound chosen from phosphodiesterase type 5 (PDES) inhibitors, such as sildenafil in base form and pharmaceutically acceptable salts thereof, including sildena-fil citrate marketed under the trademark Viagra~, vardenafil marketed as Nuviva and tadalafil marketed as Cialis~. Suitable dosing is from around 5 mg to around 100 mg per dose.
A compound chosen from dopaminergic agonists, such as apomorphine, with or without addition of anti-emetic agents. Suitable dosing is from 0.5 mg to around 10 rng per dose.
A compound chosen from noradrenergic alpha antagonists or a-adrenergie anta-gonists, such as phentolamine mesylate marketed as Vasomax, yohimbine and prazosin.
A compound chosen from cyclic AMP activators.
Pharmaceutically acceptable salts, complexes and mixtures of the above com-pounds are also useful.
It is preferred that the amount of the SD compound, salt, complex or mixture thereof be lower than an amount causing significant side effects.
A particularly useful dosage form of the present invention is a formulation that disintegrates or melts in the mouth without need for drinking water or other fluid.
Preferred dosage forms are tablets, sublingual tablets and lozenges. Chewing gums are not preferred dosage forms.
The invention is adapted for discreet self administration. By "dis~eet self administration" herein is meant self-administration shortly prior to sexual activity in a way that does not draw attention of a sexual partner to, or emphasize, the e~tence of a sexual dysfunction, a need for therapy or a need or desire for enhancement of sexual performance. The combination of discxeetness and rapid onset that is peamittb~
by the present invention provides a benefit in spontaneity; by contrast, prior art compositions for treating sexual dysfunction can be seriously compromised in their effeess if their self administration requires premeditation and/or cannot be done discreetly, such self administration being thereby not conducive to spontaneity.
Also provided by the present imrention are methods of use of compositions of the present invention for treatment of sexual dysfunction and for enhancement of swmal desire, and interest or performance, and a method of use of a c~position of the inven-tion for preparing a medicament. Other:features of this invention w~l be in pa=t apparent and in part pointed out hereinafter.
Compositions for the therapeutic delivery of SD compounds are provided. Said compositions comprising SD compounds provide rapid h~ansnaucosal ~ in the oral cavity. Compositions of the invention may be contained in a commercial package, together with instructions for the use thereof as herein described.
The SD vompomnds of the print invention rude ttm paz>~ as all as salts and ~ of tlae parea>t fonnas.
Aa object of the invention is to provide new pharmaceutical notions of SD
compounds for uptake buocaly or by other mncosa in the oral cavity, specially such compositions comprising a large percentage of cocoa powdor.
A second object of the invention is to pmvide methods for preparing said oom-positions.
A third object of the invention is methods for using said formulations in sexual dysfunction therapy, including enhancement of sexual desire, and inherest or perfor-30 ice. .
Further objects of the invention will become apparent to one skilled in t~
art;
and still other objects will become apparent hereinafter fiom the specification and claims.
The main advantages provided by a composition according to the present im~en-tion are:
1) It allows for rapid onset of the pharmacological effect;
2) It provides for good taste masking properties due to the presence of cocoa powder;
3) It does not require any water for swallowing;
4) It provides for possible high bioavailability for substances with high first pass meta-bolism;
further suggests that nausea, a common side effect of apomorphine, can be controlled by inclusion of an anti-emetic agent such as nicotine in the formulation.
U.S. Patent No. 6,121,276 to El-Rashidy & Ronsen discloses flavored sublingual tablets containing apomorphine hydrochloride and nicotine.
International Patent Publication No. WO 01/49292 discloses sublingual tablets of apomorphine providing prolonged release of the drug, said to be useful in treatment of Parkinson's disease.
International Patent Publication No. WO 00/42992 discloses a dosage unit com-prising a water-soluble hydrocolloid and sildenafil citrate in a mucoadhesive film said to be suitable for application to the oral mucosa. Pharmacokinetic data presented in WO
00/42992 indicate no faster absorption into the bloodstream with sublingual application of such a film than with a commercial tablet formulation of sildenafil citrate (Viagra~) at the same dosage.
International Patent Publication No. WO 01/10406 discloses compositions said to be suitable for a wide range of routes of administration of sildenafil citrate, including buccal and sublingual routes. Preferred compositions disclosed are said to comprise a solution, gel, semisolid, suspension, metered dose device, transdermal patch or film.
International Patent Publication No. WO 02/05820 discloses film dosage forms comprising sildenafil citrate. These dosage forms are prepared by mixing a solid dis-persion of sildenafil citrate and a water soluble sugar with a hydrocolloid and optionally other ingredients, and are said, upon placement on a mucosal surface, to form a coating that subsequently disintegrates and dissolves to release sildenafil.
International Patent Publication No. WO 02/041840 discloses the use of cocoa powder as a flavorant, though not a taste-masker, in chewing gums for sildenafil citrate.
International Patent Publication No. WO 00/30641 discloses the use of cocoa powder as a flavorant in oral compositions containing nicotine.
International Patent Publication No. WO 99/66916 discloses the use of chocolate flavor in oral compositions containing apornorphine.
Chocolate, which is very different from cocoa powder as such, has very rarely been used as an ingredient in pharmaceutical products on the market, hitherto only in laxatives. One example is Ex-Lax~ being chocolated laxative pieces marketed by S
Novartis comprising sennosides. Purex, a laxative wherein phenolphthalein was formulated with chocolate, was marketed in the 1950s.
It has now surprisingly been found that a rapid onset of orally administered pharmaceutical compositions of SD compounds is achieved concomitantly with suffi-cient taste masking of badly tasting ingredients, such as buffering agents, through the use of SD-compound-containing formulations comprising cocoa powder as filler/diluent and taste masking or flavoring agent and agent for providing a smooth texture.
No similar formulations have been disclosed hitherto.
Summary of the invention The present invention provides an orally administered rapid-onset pharmaceu-tical composition useful for treatment of sexual dysfunction, stimulation of sexual activity and enhancement of sexual desire, interest and performance in men and women.
The composition is a dosage form comprising a therapeutically or sexual-stimulatorily effective amount of one or more SD compounds. A "therapeutically effective amount"
herein is an amount sufficient to improve sexual desire, interest or performance in a subject having a sexual dysfunction condition. A "sexual-stimulatorily effective amount" herein is an amount sufficient to improve sexual desire, and interest or per-formance in a subject whether or not the subject has a sexual dysfunction condition.
Suitable such SD compounds are chosen from the below agents, but are not limited thereto:
A compound of formula (I) '~~R2 (I) or a pharmaceutically acceptable salt thereof, wherein R1, R~' and R3 are the same or different and are H, C1_6 alkyl (optionally phenyl substituted), C3_5 alkenyl or alkynyl or C3_1o cycloalkyl, or where R3 is as above and R1 and RZ are cyclized with the attached N atom to form pyrrolidinyl, piperidinyl, morpholinyl, 4-methylpiperazinyl or imidazolyl groups;
X is H, F, Cl, Br, I, OH, C1_6 alkyl or alkoxy, CN, carboxamide, carboxyl or (Cl_ 6 alkyl)carbonyl;
A is CH, CH2, CHF, CHCI, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, S02 or N;
B is CH, CHI, CHF, CHCI, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1;
and D is CH, CHI, CHF, CHC1, CHBr, CHI, C=O, O, N, NH or NCH3;
said compound of formula (I) or salt thereof being water-soluble. A suitable dosing is from around 0.1 mg to around 10 mg per dose.
A compound of formula (II) HN
~~X (II) wherein X is O or S, and pharmaceutically acceptable salts thereof. A suitable dosing is from around 0.05 mg to around 10 mg per dose.
A compound chosen from phosphodiesterase type 5 (PDES) inhibitors, such as sildenafil in base form and pharmaceutically acceptable salts thereof, including sildena-fil citrate marketed under the trademark Viagra~, vardenafil marketed as Nuviva and tadalafil marketed as Cialis~. Suitable dosing is from around 5 mg to around 100 mg per dose.
A compound chosen from dopaminergic agonists, such as apomorphine, with or without addition of anti-emetic agents. Suitable dosing is from 0.5 mg to around 10 rng per dose.
A compound chosen from noradrenergic alpha antagonists or a-adrenergie anta-gonists, such as phentolamine mesylate marketed as Vasomax, yohimbine and prazosin.
A compound chosen from cyclic AMP activators.
Pharmaceutically acceptable salts, complexes and mixtures of the above com-pounds are also useful.
It is preferred that the amount of the SD compound, salt, complex or mixture thereof be lower than an amount causing significant side effects.
A particularly useful dosage form of the present invention is a formulation that disintegrates or melts in the mouth without need for drinking water or other fluid.
Preferred dosage forms are tablets, sublingual tablets and lozenges. Chewing gums are not preferred dosage forms.
The invention is adapted for discreet self administration. By "dis~eet self administration" herein is meant self-administration shortly prior to sexual activity in a way that does not draw attention of a sexual partner to, or emphasize, the e~tence of a sexual dysfunction, a need for therapy or a need or desire for enhancement of sexual performance. The combination of discxeetness and rapid onset that is peamittb~
by the present invention provides a benefit in spontaneity; by contrast, prior art compositions for treating sexual dysfunction can be seriously compromised in their effeess if their self administration requires premeditation and/or cannot be done discreetly, such self administration being thereby not conducive to spontaneity.
Also provided by the present imrention are methods of use of compositions of the present invention for treatment of sexual dysfunction and for enhancement of swmal desire, and interest or performance, and a method of use of a c~position of the inven-tion for preparing a medicament. Other:features of this invention w~l be in pa=t apparent and in part pointed out hereinafter.
Compositions for the therapeutic delivery of SD compounds are provided. Said compositions comprising SD compounds provide rapid h~ansnaucosal ~ in the oral cavity. Compositions of the invention may be contained in a commercial package, together with instructions for the use thereof as herein described.
The SD vompomnds of the print invention rude ttm paz>~ as all as salts and ~ of tlae parea>t fonnas.
Aa object of the invention is to provide new pharmaceutical notions of SD
compounds for uptake buocaly or by other mncosa in the oral cavity, specially such compositions comprising a large percentage of cocoa powdor.
A second object of the invention is to pmvide methods for preparing said oom-positions.
A third object of the invention is methods for using said formulations in sexual dysfunction therapy, including enhancement of sexual desire, and inherest or perfor-30 ice. .
Further objects of the invention will become apparent to one skilled in t~
art;
and still other objects will become apparent hereinafter fiom the specification and claims.
The main advantages provided by a composition according to the present im~en-tion are:
1) It allows for rapid onset of the pharmacological effect;
2) It provides for good taste masking properties due to the presence of cocoa powder;
3) It does not require any water for swallowing;
4) It provides for possible high bioavailability for substances with high first pass meta-bolism;
5) It provides for an association of pleasure;
6) It does not give an immediate patient-perceived association with medicines (traditional tablets).
Detailed Description of the Invention It is the primary object of the present invention to provide rapid-onset pharma-ceutical compositions useful for treatment of sexual dysfunction, stimulation of sexual activity and enhancement of sexual desire, interest or performance in men and women.
The term "rapid-onset" means that a therapeutic effect is achieved within a short period of time, for example less than about 1 hour, preferably less than 30 minutes, following administration.
More specifically it is the object of the invention to provide such a SD-compound-containing composition, for transmucosal, preferably buccal, delivery, that disintegrates and/or melts at body temperature .with or without the aid of salivary fluid or mechanical erosion, or a combination thereof after which the formulation preferably shows adhesiveness towards the tissues in the oral cavity.
The addition of buffering agents provides for a transient change in local pH
of the saliva. Thereby a higher fraction of the active agent is transformed into its less ionized form. Thereupon the transmucousal permeation is facilitated, which enhances the absorption of the active agent. For those skilled in the art it is evident that the choice of the buffering system is dependent on the one or more pI~s of the active agent.
It has surprisingly been found that a rapid buccal absorption of SD compounds concomitantly with sufficient taste masking of badly tasting ingredients, such as the active compound and/or buffering agents, is achieved through the use of cocoa powder.
The cocoa powder acts as filler/diluent as well as taste masking or flavoring agent and agent for providing a smooth texture. No similar formulations have been disclosed hitherto.
A preferred formulation is a composition, weighing around 400 mg - 500 mg, having the following ingredients:
A therapeutically efficient amount of a SD compound, cocoa powder around 200 mg, fatty components around 180 mg, aspartame around 2.5 rng, sodium carbonate around 15 mg, lecithin around 4 mg.
Preferably the composition should comprise at least 15 % by weight of cocoa powder.
Cocoa powder is defined as cocoa nib with some fat removed and ground into a powder. Cocoa nib is defined as cocoa beans with the shell removed. Cocoa butter is defined as fat expelled from the center (kernels or nib) of cocoa beans.
Cocoa powder is prepared from roasted cocoa beans. It is a complex compound, which consists of starch, cocoa butter, amino acids, proteins, xanthines, amines, rnono-and polysaccharides, phospholipids, flavonoids, pyrazines, etc.
Preferred fatty components are fats/lipids chosen from tempering fats, including cocoa butter equivalents (CBE) and cocoa butter improvers (CBI), and non-tempering fats, including cocoa butter replacers (CBR) and cocoa butter substitutes (CBS).
According to Industrial Chocolate Manufacture ahd Use, S. T. Beckett, ed., 2na edition, Blackier Academic & Professional, London, 1994, p 382, chocolate is defined as a product obtained from cocoa nib, cocoa mass powder and sucrose with or without added cocoa butter, having a minimum dry cocoa solids content of 35%, at least 14% of dry non-fat cocoa solids and 18% cocoa butter. Chocolate has two major distinguishing characteristics: its flavor and its texture. A primary feature of the texture is that the chocolate must be solid at a temperature of 20 - 25°C and yet melt rapidly in the mouth at 37°C thereby being transferred to a liquid, which appears smooth to the tongue. The processing of chocolate is related to obtaining these two criteria (ibad. p 2).
Neither milk chocolate nor light cooking chocolate or dark cooking chocolate may mask the disagreeable taste of most buffering agents. The cocoa content of milk chocolate is comparatively low (a cocoa mass content of 10 -16%, corresponding to approximately 5 - 8% cocoa powder). The beans'/cocoa mass' content of dark, bitter-sweet chocolate is 55 - 70% (Beckett, pp. 276 - 277), corresponding to approximately 28 - 35% cocoa powder. By making a vehicle with a high proportion of cocoa powder (30 - 70%) and fatty components (30 -50%), as per the present invention, an effective masking is though obtained. The higher the cocoa powder concentration the better the taste masking.
Examples Belowfollows non-limiting examples on preparation of certain embodiments of the present invention.
Example 1: Preparation of a preferred embodiment 5 A composition, weighing around 400 mg, having the following preferred composition (w/w):
Active: A SD compound according to above formula (I) in an amount from around 0.25 mg to around 10 rng.
Diluent/filler and 10 flavoring/taste-masking agent and agent for pro-viding a smooth texture: cocoa powder around 50%
Lipid ingredient: cocoa butter equivalents (CBE) around 44%
Buffering agent: sodium carbonate around 4%
Sweetener: aspartame around 0,6%
Emulsifier/solubilizer: lecithin around 1%
Flavoring agent: mint or vanilla flavor 0,5 %
is prepared in the following way:
A part of the CBE is melted. The solid components, i a the SD compound, cocoa powder, aspartame, sodium carbonate and the flavoring agent if solid, are added and mixed. A reduction of particle size of the solid components is performed by milling in a roll-refiner. If the solid components have already got the required particle size, a g by milling before the mixing with the fatty components, roll refining is dispensed with.
After treatment in the roll-refiner the mixture is mixed with the rest of the melted fatty components or remelted (if solidified) and mixed with the rest of the melted CBE. A
mixing of the melt is performed in a suitable mixer. The liquid components, i a lecithin and the flavoring agent if liquid, are added. Tablets or other solid dosage forms are subsequently made using suitable techniques, such as molding, extrusion or congealing, including pastillation, when necessary after suitable preconditioning. Also other suitable manufacturing methods may be used.
Example 2: Preparation of a further embodiment In essentially the same way as in Example 1 is manufactured a composition with a weight from around 400 mg to around 500 mg having the below ingredients:
from 0.25 mg to around 10 mg thereof of a compound of above formula (II), around 50% (w/w) cocoa powder, around 44% (w/w) cocoa butter equivalents (CBE), around 4% (w/w) sodium carbonate, around 0,6% (w/w) aspartame and/or acesulfame potassium, and around 1% (w/w) lecithin.
Example 3: Preparation of a still further embodiment In essentially the same way as in Example 1 is manufactured a composition with the below contents:
Active: A SD-compound in a therapeutically sufficient amount.
Diluent/filler and Cocoa powder and optionally a small amount of a flavoring/taste- substance/substances chosen from one or more of the masking agent compounds fructose, glucose, galactose, and invert sugar, agent for providing a pharmaceutically acceptable polyol a such as xylitol, smooth texture: sorbitol, maltitol, rnannitol, isomalt and glycerol, or polydextrose, or any mixture thereof, from around 30% to around 70% (w/w), Lipid ingredient: from around 30% to around 50% (w/w), Buffering agent: from 0 % to around 10% (w/w), Sweetener: from around 0.3% to around 3% (w/w), Emulsifier/solubilizer: from around 0.3% to around 5% (w/w), Flavoring agent: from 0 % to around 4% (w/w).
Example 4: Preparation of alternative embodiments Useful embodiments are obtained by exchanging some of the excipients in the embodiments of the above examples for equivalently functioning alternative com-pounds.
A small part of the cocoa powder may be exchanged for one or more of the compounds fructose, glucose, galactose, lactose, maltose, invert sugar, a pharmaceu-tically acceptable polyol such as xylitol, sorbitol, maltitol, mannitol, isomalt and glycerol, or polydextrose, or any mixture thereof, but only to such an extent that the taste-mashing effect of the cocoa-powder remains sufficient.
The lipid ingredient, being fatty components, may be chosen from one or more of the following compounds:
cocoa butter and cocoa butter alternatives, including cocoa butter equivalents (CBE), cocoa butter substitutes (CBS), cocoa butter replacers (CBR) and cocoa butter irnprovers (CSI), - coconut, palmkernel oil and other similar oils characterized by being predomi-nantly based on lauric and myristic acids, - palm oil, shea butter, karite butter, illipe butter, mango kernel oil, sal fat and other similar fats characterized by being predominantly based on palinitic, oleic and stearic acids, - corn oil, sunflower oil, hybrid sunflower oil, soybean oil, rapeseed oil, canola oil, olive oil, ricebran oil, cottonseed oil, arachis (peanut, groundnut) oil and other oils characterized by being predominantly based on oleic, linoleic and linolenic acids and hydrogenated to a suitable melting point, - fish oil, tallow, lard, butterfat and other animal derived fats, and - synthetic fats, reesterified fats, hard fats obtained by a chemical reaction of fatty acids with glycerol using no, acidic, alkaline or enzymatic catalysis, whereby said compounds) is/are used as a single component or mixed with each other, being either crude or refined using physical or alkaline refining, or being subject-fed to further processing including catalytic hydrogenation, interesterification, trans-esterification and fractionation.
The buffer sodium carbonate may be exchanged for carbonates, bicarbonates, acetates, gluconates, glycerophosphates, phosphates or glycinates of sodium, potassium or ammonium, or mixtures thereof. Most phosphates are though less suitable because their taste usually is disagreeable and difficult to mask.
The sweetener aspartame may entirely or in part be exchanged for one or more other artificial sweeteners, such as acesulfame potassium, saccharine, sodium saccha-rine, cyclamate and glycyrrhizine and/or salts thereof.
The emulsifier lecithin is preferably soy lecithin and/or egg lecithin, but may be exchanged for - a nonionic surfactant, such as poloxamer, polyoxyethylene alkyl ether, poly-oxyethylene castor oil derivative, polyoxyethylene sorbitan fatty acid ester, monoglyce-ride, diglyceride and esther thereof, polyoxyethylene stearate, polyglycerolester of fatty acids (including polyglycerolpolyricinoleic acid (PGPR)), sorbitan fatty acid ester, - an anionic surfactant, such as fatty acid, soap of fatty acid, lactylate, especially sodium and/or calcium stearoyllactylate, sodium lauryl sulfate and latanol, - a zwitterionic surfactant, such as zwitterionic phospholipid, such as phosphati-dylcholine and phosphatidylethanolamine, or mixtures, fractions or derivatives thereof or with lecithin.
In principally the same way as in the above examples compositions comprising other SD compounds may be manufactured. The dose range and the percentages of the excipients should in such cases be accordingly adjusted.
Detailed Description of the Invention It is the primary object of the present invention to provide rapid-onset pharma-ceutical compositions useful for treatment of sexual dysfunction, stimulation of sexual activity and enhancement of sexual desire, interest or performance in men and women.
The term "rapid-onset" means that a therapeutic effect is achieved within a short period of time, for example less than about 1 hour, preferably less than 30 minutes, following administration.
More specifically it is the object of the invention to provide such a SD-compound-containing composition, for transmucosal, preferably buccal, delivery, that disintegrates and/or melts at body temperature .with or without the aid of salivary fluid or mechanical erosion, or a combination thereof after which the formulation preferably shows adhesiveness towards the tissues in the oral cavity.
The addition of buffering agents provides for a transient change in local pH
of the saliva. Thereby a higher fraction of the active agent is transformed into its less ionized form. Thereupon the transmucousal permeation is facilitated, which enhances the absorption of the active agent. For those skilled in the art it is evident that the choice of the buffering system is dependent on the one or more pI~s of the active agent.
It has surprisingly been found that a rapid buccal absorption of SD compounds concomitantly with sufficient taste masking of badly tasting ingredients, such as the active compound and/or buffering agents, is achieved through the use of cocoa powder.
The cocoa powder acts as filler/diluent as well as taste masking or flavoring agent and agent for providing a smooth texture. No similar formulations have been disclosed hitherto.
A preferred formulation is a composition, weighing around 400 mg - 500 mg, having the following ingredients:
A therapeutically efficient amount of a SD compound, cocoa powder around 200 mg, fatty components around 180 mg, aspartame around 2.5 rng, sodium carbonate around 15 mg, lecithin around 4 mg.
Preferably the composition should comprise at least 15 % by weight of cocoa powder.
Cocoa powder is defined as cocoa nib with some fat removed and ground into a powder. Cocoa nib is defined as cocoa beans with the shell removed. Cocoa butter is defined as fat expelled from the center (kernels or nib) of cocoa beans.
Cocoa powder is prepared from roasted cocoa beans. It is a complex compound, which consists of starch, cocoa butter, amino acids, proteins, xanthines, amines, rnono-and polysaccharides, phospholipids, flavonoids, pyrazines, etc.
Preferred fatty components are fats/lipids chosen from tempering fats, including cocoa butter equivalents (CBE) and cocoa butter improvers (CBI), and non-tempering fats, including cocoa butter replacers (CBR) and cocoa butter substitutes (CBS).
According to Industrial Chocolate Manufacture ahd Use, S. T. Beckett, ed., 2na edition, Blackier Academic & Professional, London, 1994, p 382, chocolate is defined as a product obtained from cocoa nib, cocoa mass powder and sucrose with or without added cocoa butter, having a minimum dry cocoa solids content of 35%, at least 14% of dry non-fat cocoa solids and 18% cocoa butter. Chocolate has two major distinguishing characteristics: its flavor and its texture. A primary feature of the texture is that the chocolate must be solid at a temperature of 20 - 25°C and yet melt rapidly in the mouth at 37°C thereby being transferred to a liquid, which appears smooth to the tongue. The processing of chocolate is related to obtaining these two criteria (ibad. p 2).
Neither milk chocolate nor light cooking chocolate or dark cooking chocolate may mask the disagreeable taste of most buffering agents. The cocoa content of milk chocolate is comparatively low (a cocoa mass content of 10 -16%, corresponding to approximately 5 - 8% cocoa powder). The beans'/cocoa mass' content of dark, bitter-sweet chocolate is 55 - 70% (Beckett, pp. 276 - 277), corresponding to approximately 28 - 35% cocoa powder. By making a vehicle with a high proportion of cocoa powder (30 - 70%) and fatty components (30 -50%), as per the present invention, an effective masking is though obtained. The higher the cocoa powder concentration the better the taste masking.
Examples Belowfollows non-limiting examples on preparation of certain embodiments of the present invention.
Example 1: Preparation of a preferred embodiment 5 A composition, weighing around 400 mg, having the following preferred composition (w/w):
Active: A SD compound according to above formula (I) in an amount from around 0.25 mg to around 10 rng.
Diluent/filler and 10 flavoring/taste-masking agent and agent for pro-viding a smooth texture: cocoa powder around 50%
Lipid ingredient: cocoa butter equivalents (CBE) around 44%
Buffering agent: sodium carbonate around 4%
Sweetener: aspartame around 0,6%
Emulsifier/solubilizer: lecithin around 1%
Flavoring agent: mint or vanilla flavor 0,5 %
is prepared in the following way:
A part of the CBE is melted. The solid components, i a the SD compound, cocoa powder, aspartame, sodium carbonate and the flavoring agent if solid, are added and mixed. A reduction of particle size of the solid components is performed by milling in a roll-refiner. If the solid components have already got the required particle size, a g by milling before the mixing with the fatty components, roll refining is dispensed with.
After treatment in the roll-refiner the mixture is mixed with the rest of the melted fatty components or remelted (if solidified) and mixed with the rest of the melted CBE. A
mixing of the melt is performed in a suitable mixer. The liquid components, i a lecithin and the flavoring agent if liquid, are added. Tablets or other solid dosage forms are subsequently made using suitable techniques, such as molding, extrusion or congealing, including pastillation, when necessary after suitable preconditioning. Also other suitable manufacturing methods may be used.
Example 2: Preparation of a further embodiment In essentially the same way as in Example 1 is manufactured a composition with a weight from around 400 mg to around 500 mg having the below ingredients:
from 0.25 mg to around 10 mg thereof of a compound of above formula (II), around 50% (w/w) cocoa powder, around 44% (w/w) cocoa butter equivalents (CBE), around 4% (w/w) sodium carbonate, around 0,6% (w/w) aspartame and/or acesulfame potassium, and around 1% (w/w) lecithin.
Example 3: Preparation of a still further embodiment In essentially the same way as in Example 1 is manufactured a composition with the below contents:
Active: A SD-compound in a therapeutically sufficient amount.
Diluent/filler and Cocoa powder and optionally a small amount of a flavoring/taste- substance/substances chosen from one or more of the masking agent compounds fructose, glucose, galactose, and invert sugar, agent for providing a pharmaceutically acceptable polyol a such as xylitol, smooth texture: sorbitol, maltitol, rnannitol, isomalt and glycerol, or polydextrose, or any mixture thereof, from around 30% to around 70% (w/w), Lipid ingredient: from around 30% to around 50% (w/w), Buffering agent: from 0 % to around 10% (w/w), Sweetener: from around 0.3% to around 3% (w/w), Emulsifier/solubilizer: from around 0.3% to around 5% (w/w), Flavoring agent: from 0 % to around 4% (w/w).
Example 4: Preparation of alternative embodiments Useful embodiments are obtained by exchanging some of the excipients in the embodiments of the above examples for equivalently functioning alternative com-pounds.
A small part of the cocoa powder may be exchanged for one or more of the compounds fructose, glucose, galactose, lactose, maltose, invert sugar, a pharmaceu-tically acceptable polyol such as xylitol, sorbitol, maltitol, mannitol, isomalt and glycerol, or polydextrose, or any mixture thereof, but only to such an extent that the taste-mashing effect of the cocoa-powder remains sufficient.
The lipid ingredient, being fatty components, may be chosen from one or more of the following compounds:
cocoa butter and cocoa butter alternatives, including cocoa butter equivalents (CBE), cocoa butter substitutes (CBS), cocoa butter replacers (CBR) and cocoa butter irnprovers (CSI), - coconut, palmkernel oil and other similar oils characterized by being predomi-nantly based on lauric and myristic acids, - palm oil, shea butter, karite butter, illipe butter, mango kernel oil, sal fat and other similar fats characterized by being predominantly based on palinitic, oleic and stearic acids, - corn oil, sunflower oil, hybrid sunflower oil, soybean oil, rapeseed oil, canola oil, olive oil, ricebran oil, cottonseed oil, arachis (peanut, groundnut) oil and other oils characterized by being predominantly based on oleic, linoleic and linolenic acids and hydrogenated to a suitable melting point, - fish oil, tallow, lard, butterfat and other animal derived fats, and - synthetic fats, reesterified fats, hard fats obtained by a chemical reaction of fatty acids with glycerol using no, acidic, alkaline or enzymatic catalysis, whereby said compounds) is/are used as a single component or mixed with each other, being either crude or refined using physical or alkaline refining, or being subject-fed to further processing including catalytic hydrogenation, interesterification, trans-esterification and fractionation.
The buffer sodium carbonate may be exchanged for carbonates, bicarbonates, acetates, gluconates, glycerophosphates, phosphates or glycinates of sodium, potassium or ammonium, or mixtures thereof. Most phosphates are though less suitable because their taste usually is disagreeable and difficult to mask.
The sweetener aspartame may entirely or in part be exchanged for one or more other artificial sweeteners, such as acesulfame potassium, saccharine, sodium saccha-rine, cyclamate and glycyrrhizine and/or salts thereof.
The emulsifier lecithin is preferably soy lecithin and/or egg lecithin, but may be exchanged for - a nonionic surfactant, such as poloxamer, polyoxyethylene alkyl ether, poly-oxyethylene castor oil derivative, polyoxyethylene sorbitan fatty acid ester, monoglyce-ride, diglyceride and esther thereof, polyoxyethylene stearate, polyglycerolester of fatty acids (including polyglycerolpolyricinoleic acid (PGPR)), sorbitan fatty acid ester, - an anionic surfactant, such as fatty acid, soap of fatty acid, lactylate, especially sodium and/or calcium stearoyllactylate, sodium lauryl sulfate and latanol, - a zwitterionic surfactant, such as zwitterionic phospholipid, such as phosphati-dylcholine and phosphatidylethanolamine, or mixtures, fractions or derivatives thereof or with lecithin.
In principally the same way as in the above examples compositions comprising other SD compounds may be manufactured. The dose range and the percentages of the excipients should in such cases be accordingly adjusted.
Claims (35)
1. A rapid-onset pharmaceutical composition, comprising a sexual-dysfunction-compound and cocoa powder, wherein the cocoa powder is not part of chocolate, and which composition is an oral dosage form other than a chewing gum.
2. The composition according to claim 1, which comprises at least 15% cocoa powder.
3. The composition according to claim 1 or 2, which further comprises one or more lipid ingredients.
4. A composition according to claim 3, wherein the one or more lipid ingredients are chosen from - cocoa butter, cocoa butter equivalents (CBE), cocoa butter substitutes (CBS), cocoa butter replacers (CBR), cocoa butter improvers (CBI) and other cocoa butter alternatives, - coconut, palmkernel oil and other similar oils characterized by being predominantly based on lauric and myristic acids, - palm oil, shea butter, karite butter, illipe butter, mango kernel oil, sal fat and other similar fats characterized by being predominantly based on palmitic, oleic and stearic acids, - corn oil, sunflower oil, hybrid sunflower oil, soybean oil, rapeseed oil, canola oil, olive oil, ricebran oil, cottonseed oil, arachis oil based on peanut or ground nut and other oils characterized by being predominantly based on oleic, linoleic and linolenic acids and hydrogenated to a suitable melting point, - fish oil, tallow, lard, butterfat and other animal derived fats, and - synthetic fats, reesterified fats, hard fats obtained by a chemical reaction of fatty acids with glycerol using no, acidic, alkaline or enzymatic catalysis, wherein the one or more lipid ingredients are used as a single component or mixed with each other, being either crude or refined using physical or alkaline refining, or being subjected to catalytic hydrogenation, interesterification, transesterification, fractionation or other further processing.
5. The composition according to claim 4, wherein the one or more lipid ingredients are chosen from cocoa butter equivalents (CBE), cocoa butter substitutes (CBS) and cocoa butter replacers (CBR).
6. The composition according to any one of claims 1 to 5, wherein the sexual-dysfunction-compound is:
a compound of formula (I) or a pharmaceutically acceptable salt thereof, wherein R1, R2 and R3 are the same or different and are H, C1-6 alkyl optionally substituted with phenyl, C3-5 alkenyl, C3-5 alkynyl or C3-10 cycloalkyl, or where R3 is as above and R1 and R2 are cyclized with the attached N atom to form a pyrrolidinyl, piperidinyl, morpholinyl, 4-methylpiperazinyl or imidazolyl group;
X is H, F, Cl, Br, I, OH, C1-6 alkyl, C1-6 alkoxy, CN, carboxamide, carboxyl or (C1-6 alkyl)carbonyl;
A is CH, CH2, CHF, CHC1, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, SO2 or N;
B is CH, CH2, CHF, CHC1, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1; and D is CH, CH2r CHF, CHC1, CHBr, CHI, C=O, O, N, NH
or NCH3;
the compound of formula (I) or salt thereof being water-soluble;
a compound of formula (II) or a pharmaceutically acceptable salt thereof, wherein X is O or S;
a compound or pharmaceutically acceptable salt which is a phosphodiesterase type 5 (PDE5) inhibitor;
a compound or pharmaceutically acceptable salt which is a dopaminergic agonist, optionally in combination with an anti-emetic agent;
a compound or pharmaceutically acceptable salt which is a noradrenergic alpha antagonist or an .alpha.-adrenergic antagonist;
a compound or pharmaceutically acceptable salt which is a cyclic AMP activator;
or a complex or a mixture thereof.
a compound of formula (I) or a pharmaceutically acceptable salt thereof, wherein R1, R2 and R3 are the same or different and are H, C1-6 alkyl optionally substituted with phenyl, C3-5 alkenyl, C3-5 alkynyl or C3-10 cycloalkyl, or where R3 is as above and R1 and R2 are cyclized with the attached N atom to form a pyrrolidinyl, piperidinyl, morpholinyl, 4-methylpiperazinyl or imidazolyl group;
X is H, F, Cl, Br, I, OH, C1-6 alkyl, C1-6 alkoxy, CN, carboxamide, carboxyl or (C1-6 alkyl)carbonyl;
A is CH, CH2, CHF, CHC1, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, SO2 or N;
B is CH, CH2, CHF, CHC1, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1; and D is CH, CH2r CHF, CHC1, CHBr, CHI, C=O, O, N, NH
or NCH3;
the compound of formula (I) or salt thereof being water-soluble;
a compound of formula (II) or a pharmaceutically acceptable salt thereof, wherein X is O or S;
a compound or pharmaceutically acceptable salt which is a phosphodiesterase type 5 (PDE5) inhibitor;
a compound or pharmaceutically acceptable salt which is a dopaminergic agonist, optionally in combination with an anti-emetic agent;
a compound or pharmaceutically acceptable salt which is a noradrenergic alpha antagonist or an .alpha.-adrenergic antagonist;
a compound or pharmaceutically acceptable salt which is a cyclic AMP activator;
or a complex or a mixture thereof.
7. The composition according to claim 6, wherein:
the PDE5 inhibitor is sildenafil, vardenafil or tadalafil, or a pharmaceutically acceptable salt thereof;
the dopaminergic agonist is apomorphine or a pharmaceutically acceptable salt thereof; and the noradrenergic alpha antagonist or .alpha.-adrenergic antagonist is phentolamine, yohimbine or prazosin, or a pharmaceutically acceptable salt thereof.
the PDE5 inhibitor is sildenafil, vardenafil or tadalafil, or a pharmaceutically acceptable salt thereof;
the dopaminergic agonist is apomorphine or a pharmaceutically acceptable salt thereof; and the noradrenergic alpha antagonist or .alpha.-adrenergic antagonist is phentolamine, yohimbine or prazosin, or a pharmaceutically acceptable salt thereof.
8. The pharmaceutical composition according to any one of claims 1 to 7, wherein the sexual-dysfunction compound is sildenafil citrate.
9. The pharmaceutical composition according to any one of claims 1 t 7, wherein the sexual-dysfunction compound is phentolamine mesylate.
10. The composition according to any one of claims 1 to 9, which further comprises one or more buffering agents.
11. The composition according to claim 10, wherein the one or more buffering agents are one or more carbonates, one or more bicarbonates, one or more acetates, one or more gluconates, one or more glycerophosphates, one or more phosphates or one or more glycinates of sodium, potassium or ammonium, or mixtures thereof.
12. The composition according to any one of claims 1 to 11, which further comprises one or more sweeteners and optionally one or more flavoring agents.
13. The composition according to claim 12, wherein the one or more sweeteners are aspartame, acesulfame potassium, saccharine, sodium saccharine, cyclamate and/or glycyrrhizine and/or salts of glycyrrhizine.
14. The composition according to any one of claims 1 to 13, which further comprises one or more emulsifiers/solubilisers.
15. The composition according to claim 14, wherein the one or more emulsifiers/solubilisers are one or more lecithin, one or more nonionic surfactant, one or more anionic surfactant, or one or more zwitterionic surfactant, or a mixture, fraction or derivative thereof.
16. The composition according to claim 15, wherein:
- the lecithin is soy lecithin or egg lecithin, or a mixture thereof;
- the nonionic surfactant is a poloxamer, polyoxyethylene alkyl ether, polyoxyethylene castor oil derivative, polyoxyethylene sorbitan fatty acid ester;
monoglyceride, diglyceride or an ester thereof;
polyoxyethylene stearate, polyglycerolester of a fatty acid or sorbitan fatty acid ester, or a mixture thereof;
- the anionic surfactant is a fatty acid, soap of fatty acid, lactylate, sodium lauryl sulfate or latanol, or a mixture thereof; and - the zwitterionic surfactant is a zwitterionic phospholipid.
- the lecithin is soy lecithin or egg lecithin, or a mixture thereof;
- the nonionic surfactant is a poloxamer, polyoxyethylene alkyl ether, polyoxyethylene castor oil derivative, polyoxyethylene sorbitan fatty acid ester;
monoglyceride, diglyceride or an ester thereof;
polyoxyethylene stearate, polyglycerolester of a fatty acid or sorbitan fatty acid ester, or a mixture thereof;
- the anionic surfactant is a fatty acid, soap of fatty acid, lactylate, sodium lauryl sulfate or latanol, or a mixture thereof; and - the zwitterionic surfactant is a zwitterionic phospholipid.
17. The composition according to claim 16, wherein the polyglycerolester of a fatty acid is polyglycerolpolyricinoleic acid, the lactylate is sodium or calcium stearoyllactylate or a mixture thereof, and the zwitterionic phospholipid is phophatidylcholine or phosphatidylethanolamine or a mixture thereof.
18. The composition according to claim 15, which comprises lecithin.
19. The composition according to claim 18, which comprises soy lecithin and/or egg lecithin.
20. The composition according to any one of claims 1 to 18, which further comprises fructose, glucose, galactose, lactose, maltose, invert sugar, a pharmaceutically acceptable polyol, or polydextrose, or any mixture thereof.
21. The composition according to claim 20, wherein the pharmaceutically acceptable polyol is xylitol, sorbitol, maltitol, mannitol, isomalt, or glycerol, or a mixture thereof.
22. A rapid-onset pharmaceutical composition, comprising:
in a unit dosage form, which is an oral dosage form other than a chewing gum, and wherein the cocoa powder is not part of chocolate.
in a unit dosage form, which is an oral dosage form other than a chewing gum, and wherein the cocoa powder is not part of chocolate.
23. The composition according to claim 22, wherein the pharmaceutically acceptable polyol is xylitol, sorbitol, maltitol, mannitol, isomalt, or glycerol, or a mixture thereof.
24. A sexual-dysfunction-compound-containing rapid-onset pharmaceutical composition, comprising from 0.25 mg to around 10 mg thereof of a sexual-dysfunction-compound of formula (II) wherein X is O or S, or a pharmaceutically acceptable salt thereof, around 50% (w/w) cocoa powder, around 44% (w/w) cocoa butter equivalents (CBE), around 4% (w/w) sodium carbonate, around 0.6% (w/w) aspartame and/or acesulfame potassium, and around 1% (w/w) lecithin, in a unit dosage form, which is an oral dosage form other than a chewing gum, and wherein the cocoa powder is not part of chocolate.
25. A rapid-onset pharmaceutical composition, comprising:
Active: a sexual-dysfunction compound according to formula (I) or a pharmaceutically acceptable salt thereof, wherein R1, R2 and R3 are the same or different and are H, C1-6 alkyl optionally substituted by phenyl, C3-5 alkenyl, C3-5 alkynyl or C3-10 cycloalkyl, or where R3 is as above and R1 and R2 are cyclized with the attached N atom to form a pyrrolidinyl, piperidinyl, morpholinyl, 4-methylpiperazinyl or imidazolyl group;
X is H, F, Cl, Br, I, OH, C1-6 alkyl, C1-6 alkoxy, CN, carboxamide, carboxyl or (C1-6 alkyl)carbonyl;
A is CH, CH2, CHF, CHCl, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, SO2 or N;
B is CH, CH2, CHF, CHCl, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1; and D is CH, CH2, CHF, CHCl, CHBr, CHI, C=O, O, N, NH
or NCH3;
in an amount from around 0.25 mg to around 10 mg, Diluent/filler and flavoring/taste-masking agent and agent for providing a smooth texture: cocoa powder around 50%, Lipid ingredient: cocoa butter equivalents (CBE) around 44%, Buffering agent: sodium carbonate around 4%, Sweetener: aspartame around 0.6%, Emulsifier/solubilizer: lecithin around 1%, and Flavoring agent: mint or vanilla flavor 0.5%, in a unit dosage form, which is an oral dosage form other than a chewing gum, and wherein the cocoa powder is not part of chocolate.
Active: a sexual-dysfunction compound according to formula (I) or a pharmaceutically acceptable salt thereof, wherein R1, R2 and R3 are the same or different and are H, C1-6 alkyl optionally substituted by phenyl, C3-5 alkenyl, C3-5 alkynyl or C3-10 cycloalkyl, or where R3 is as above and R1 and R2 are cyclized with the attached N atom to form a pyrrolidinyl, piperidinyl, morpholinyl, 4-methylpiperazinyl or imidazolyl group;
X is H, F, Cl, Br, I, OH, C1-6 alkyl, C1-6 alkoxy, CN, carboxamide, carboxyl or (C1-6 alkyl)carbonyl;
A is CH, CH2, CHF, CHCl, CHBr, CHI, CHCH3, C=O, C=S, CSCH3, C=NH, CNH2, CNHCH3, CNHCOOCH3, CNHCN, SO2 or N;
B is CH, CH2, CHF, CHCl, CHBr, CHI, C=O, N, NH or NCH3, and n is 0 or 1; and D is CH, CH2, CHF, CHCl, CHBr, CHI, C=O, O, N, NH
or NCH3;
in an amount from around 0.25 mg to around 10 mg, Diluent/filler and flavoring/taste-masking agent and agent for providing a smooth texture: cocoa powder around 50%, Lipid ingredient: cocoa butter equivalents (CBE) around 44%, Buffering agent: sodium carbonate around 4%, Sweetener: aspartame around 0.6%, Emulsifier/solubilizer: lecithin around 1%, and Flavoring agent: mint or vanilla flavor 0.5%, in a unit dosage form, which is an oral dosage form other than a chewing gum, and wherein the cocoa powder is not part of chocolate.
26. The composition according to any one of claims 1 to 25, which provides for delivery of the sexual-dysfunction-compound through the buccal mucosa and/or other mucosa of the oral cavity.
27. The composition according to any one of claims 1 to 26, which is formulated as a tablet, as a sublingual tablet or as a lozenge.
28. Use of a composition as defined in any one of claims 1 to 25 for the manufacture of a medicament useful for treatment of sexual dysfunction, stimulation of sexual activity and/or enhancement of sexual desire and/or interest or performance.
29. Use of a composition as defined in any one of claims 1 to 27 for treatment of sexual dysfunction, stimulation of sexual activity and/or enhancement of sexual desire and/or interest or performance.
30. The pharmaceutical composition according to any one of claims 1 to 27 for treating sexual dysfunction in a subject.
31. Use of the pharmaceutical composition as defined in any one of claims 1 to 27 orally by a subject less than 1 hour prior to sexual activity.
32. Use of the pharmaceutical composition as defined in any one of claims 1 to 27 orally by a subject less than 30 minutes prior to sexual activity.
33. A commercial package comprising the pharmaceutical composition as defined in any one of claims 1 to 27, and instructions for the use thereof for treating sexual dysfunction.
34. The commercial package of claim 33, wherein the instructions describe the use of the composition less than 1 hour prior to sexual activity.
35. The commercial package of claim 33, wherein the instructions describe the use of the composition less than 30 minutes prior to sexual activity.
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| SE0202365A SE0202365D0 (en) | 2002-08-05 | 2002-08-05 | New formulation and use thereof |
| SE0202365-3 | 2002-08-05 | ||
| PCT/SE2003/001022 WO2004012702A1 (en) | 2002-08-05 | 2003-06-18 | New sexual-dysfunction-compound-containing rapid-onset pharmaceutical formulations comprising cocoa powder and use thereof |
Publications (2)
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| CA2495527A1 CA2495527A1 (en) | 2004-02-12 |
| CA2495527C true CA2495527C (en) | 2008-12-30 |
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| CA002495527A Expired - Fee Related CA2495527C (en) | 2002-08-05 | 2003-06-18 | New sexual-dysfunction-compound-containing rapid-onset pharmaceutical formulations comprising cocoa powder and use thereof |
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| JP (1) | JP2005539008A (en) |
| CN (1) | CN1674866B (en) |
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| BR (1) | BR0313224A (en) |
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| DE10232113A1 (en) | 2002-07-16 | 2004-01-29 | Bayer Ag | Medicinal products containing vardenafil hydrochloride trihydrate |
| DE102005009241A1 (en) * | 2005-03-01 | 2006-09-07 | Bayer Healthcare Ag | Dosage forms with controlled bioavailability |
| DE102005009240A1 (en) | 2005-03-01 | 2006-09-07 | Bayer Healthcare Ag | Dosage forms with improved pharmacokinetic properties |
| GB0509317D0 (en) * | 2005-05-06 | 2005-06-15 | Clarke Anthony | Pharmaceutical formulation of apomorphine |
| DE102010024866A1 (en) * | 2010-06-24 | 2011-12-29 | Pharmatech Gmbh | Formulation for taste masking |
| EP3299010B1 (en) | 2016-09-21 | 2022-11-09 | LTS Lohmann Therapie-Systeme AG | Oral dosage form |
| BR112020017468A2 (en) | 2018-03-01 | 2020-12-22 | Lts Lohmann Therapie-Systeme Ag | ORAL DOSAGE FORM WITH THEOBROMINE FREE COCOA |
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| US4755180A (en) * | 1986-06-16 | 1988-07-05 | Alza Corporation | Dosage form comprising solubility regulating member |
| FR2717387B1 (en) * | 1994-03-17 | 1996-10-18 | Hi Pharmtech | Process for the production of chewable tablets based on troxerutin, calcium carbonate, calcium phosphate, arginine aspartate, amoxicillin arginine glutamate. |
| US6121276A (en) | 1994-04-22 | 2000-09-19 | Pentech Pharmaceuticals, Inc. | Apomorphine-containing dosage forms for ameliorating male erectile dysfunction |
| ES2105970B1 (en) * | 1995-08-02 | 1998-07-01 | S A L V A T Lab Sa | ORAL PHARMACEUTICAL COMPOSITION OF CIPROFLOXACINO, NON-AQUEOUS, STABLE AND WITH IMPROVED ORGANOLEPTIC CHARACTERISTICS. |
| CA2178021C (en) * | 1996-04-19 | 1999-09-28 | Theodore H. Stanley | Tobacco substitute |
| ID21806A (en) * | 1997-01-06 | 1999-07-29 | Pfizer | FORM OF PHARMACEUTICAL QUARTERING THAT WAS QUICKLY REMOVED AND THAT COVERED |
| GT199900061A (en) * | 1998-05-15 | 2000-10-14 | Pfizer | PHARMACEUTICAL FORMULATIONS. |
| JP2000095710A (en) * | 1998-09-21 | 2000-04-04 | Taisho Pharmaceut Co Ltd | Oral solid preparation mixed with cacao powder |
| JP2000119198A (en) * | 1998-10-16 | 2000-04-25 | Eisai Co Ltd | Phosphodiesterase inhibitor-containing peroral preparation hiding bitterness or the like |
| US6060094A (en) * | 1998-10-30 | 2000-05-09 | Nestec S.A. | Method of reducing fat in fat-based coating for confectionery products |
| SE9803986D0 (en) | 1998-11-23 | 1998-11-23 | Pharmacia & Upjohn Ab | New compositions |
| US6531114B1 (en) * | 1999-04-06 | 2003-03-11 | Wm. Wrigley Jr. Company | Sildenafil citrate chewing gum formulations and methods of using the same |
| SI20109A (en) * | 1998-12-16 | 2000-06-30 | LEK, tovarna farmacevtskih in kemi�nih izdelkov, d.d. | Stable pharmaceutical formulation |
| US6291471B1 (en) | 1998-12-17 | 2001-09-18 | Abb Holdings, Inc. | Use of apomorphine for the treatment of organic erectile dysfunction in males |
| US6455564B1 (en) * | 1999-01-06 | 2002-09-24 | Pharmacia & Upjohn Company | Method of treating sexual disturbances |
| US6552024B1 (en) | 1999-01-21 | 2003-04-22 | Lavipharm Laboratories Inc. | Compositions and methods for mucosal delivery |
| JP2003506394A (en) | 1999-08-10 | 2003-02-18 | ボード オブ リージェンツ， ザ ユニバーシティ オブ テキサス システム | Method for increasing optic nerve, choroid and retinal blood flow to facilitate retention of vision |
| JP2001114668A (en) * | 1999-10-13 | 2001-04-24 | Meiji Seika Kaisha Ltd | Chocolate preparation |
| BR0012822A (en) | 1999-12-30 | 2004-03-09 | Tap Holdings Inc | Pharmaceutical Formulation and Tablet Dosage Form |
| AU2001273545A1 (en) | 2000-07-19 | 2002-01-30 | Lavipharm Laboratories, Inc. | Sildenafil citrate solid dispersions having high water solubility |
| JP2002193839A (en) * | 2000-12-27 | 2002-07-10 | Meiji Seika Kaisha Ltd | Cocoa pharmaceutical preparation |
| JP2004520389A (en) * | 2001-02-08 | 2004-07-08 | ファルマシア・コーポレーション | Early-effect drugs for the treatment of sexual dysfunction |
| US20020172732A1 (en) * | 2001-03-21 | 2002-11-21 | Wies Ter Laak | Composition comprising cocoa |
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| RU2005102835A (en) | 2005-08-10 |
| AU2003239038B2 (en) | 2008-01-03 |
| BR0313224A (en) | 2005-07-05 |
| MXPA05000978A (en) | 2005-12-12 |
| JP2005539008A (en) | 2005-12-22 |
| SE0202365D0 (en) | 2002-08-05 |
| CN1674866A (en) | 2005-09-28 |
| AR040797A1 (en) | 2005-04-20 |
| RU2312665C2 (en) | 2007-12-20 |
| EP1539096A1 (en) | 2005-06-15 |
| AU2003239038A1 (en) | 2004-02-23 |
| IL166031A0 (en) | 2006-01-15 |
| ZA200500051B (en) | 2006-12-27 |
| WO2004012702A1 (en) | 2004-02-12 |
| NZ537520A (en) | 2006-11-30 |
| TW200418470A (en) | 2004-10-01 |
| CN1674866B (en) | 2012-09-26 |
| CA2495527A1 (en) | 2004-02-12 |
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