Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
  • A61K31/525—Isoalloxazines, e.g. riboflavins, vitamin B2
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/04—Centrally acting analgesics, e.g. opioids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/06—Antimigraine agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• This invention relates to compositions and methods useful in the treatment of migraine headaches and related illnesses.
• migraine migraine including cluster headaches
• Treatment for many patients having the occasional migraine involves simple analgesics with or without sedatives. Approximately 10% of migraine sufferers have three or more attacks per month and warrant prophylactic treatment. Twenty-five to fifty percent of this group benefit from treatment with beta-adrenoreceptor blocking agents, clonidine or, in the female sufferer, gestagen hormones.
• beta-adrenoreceptor blocking agents clonidine
• Feverfew rich in sesquiterpene lactones, principally parthenolide
• sixty-eight percent of migraine sufferers displayed improvement when treated prophylactically with riboflavin.
• Non-selective antagonist drugs will, therefore, not only reduce the smooth muscular spasm (of intracranial blood vessels in the case of migraine, or bronchial smooth muscle in the case of asthma) but also the pain
• Sesquiterpene lactones are known to be present in many plants, for example in Asteracea, Magnoliaceae, and in particular in Tanacetum parthenium
• a sesquiterpene lactone or a source of sesquiterpene lactones, such as sesquiterpene lactone-containing plants and plant extracts, is used in combination with a B-complex vitamin, such as riboflavin.
• Preparations comprising such a combination are also provided that have pharmaceutical use, particularly in the treatment of migraine, including cluster, headaches and various arthritic and bronchial conditions, such as asthma.
• the B-complex vitamin that is useful in accordance with the present invention includes riboflavin, riboflavin phosphate, flavin adenine dinucleotide, nicotinic acid, folic acid, cyanocobalmin, para-amino benzoic acid, thiamine, py ⁇ ' doxine, pantothenic acid, biotin, choline inositol, and carnitine.
• the sesquiterpene lactone that is useful in accordance with the present invention includes germacranolides, guaianolides, and pseudoguaianolides, in particular those sesquiterpene lactones having an ⁇ -methylene substituent in the lactone ring, such as parthenolide.
• Parthenolide and sesquiterpene lactone- containing plant materials, such as feverfew leaf or extracts from such plant materials are preferred.
• These natural-sources of actives are preferred because they deliver many active components, not only a single chemical entity.
• the variety of active components and active chemical species present results in preparations with a broader spectrum of activity compared to pure sesquterpine lactones.
• both sesquiterpene lactones and B-complex vitamins have been found, individually, to be effective for treatment or prophylaxis of migraine
• the combination of the two types of actives leads to synergistic effects.
• a combination of feverfew or other source of parthenolide with a B-vitamin additive leads to a further decrease in the frequency of the attacks and causes the attacks to be less painful.
• An increased percentage of migraine sufferers should therefore display an improvement in frequency, severity, or both, when treated prophylactically with the combinational drug.
• the combinational drug has low toxicity, surprisingly few side-effects and may be taken for the extended periods required for effective prophylaxis, without adverse reactions.
• the dosage of active ingredients will, of course, vary from individual to individual and will depend upon many factors, including body weight, metabolism, and the like. In general, however, it is believed that, in both treatment and prophylaxis, a given individual should receive from about 50 to about 10,000 micrograms, preferably from about 250 to about 1000 micrograms, and most preferably about 250 micrograms of sesquiterpene lactone, such as parthenolide, per day. In general, it is also believed that a given individual should receive from about 0.1 to about 5,000 milligrams, preferably from about 100 to about 500 milligrams, and most preferably about 400 milligrams of B- complex vitamin, especially riboflavin, per day. More, however, may be need in the case of acute attacks.
• pharmaceutical dosage forms contain from about 50 to about 10,000 micrograms, preferably from about 250 to about 1000 micrograms, and most preferably about 250 micrograms of sesquiterpene lactone, such as parthenolide, in combination with about 0.1 to about 5,000 milligrams, preferably from about 100 to about 500 milligrams, and most preferably about 400 milligrams of B-complex vitamin, especially riboflavin, per day.
• such pharmaceutical dosage forms may comprise from about 5 to 300 mg, especially 50 to 200 mg, of feverfew leaf, containing about 250 micrograms of parthenolide, in combination with from about 0.1 to 400 mg of riboflavin per day.
• the feverfew dosage may be adjusted to accommodate the naturally variable levels of sesquiterpene lactones, such as parthenolide.
• a particularly preferred capsule contains about 125 mg of high-parthenolide feverfew and 400 mg of riboflavin.
• composition of the present invention be administered as two tablets daily; each tablet containing 125 mg feverfew (containing 250 mg of sesquiterpene lactone) and 200 mg riboflavin or other B-complex vitamin.
• the combination of actives may also be administered by independent dosage forms. For example, two tablets of feverfew, each containing 250 ⁇ grams of parthenolide may be taken daily in addition to two tablets of B complex vitamin, each containing 200 mgrams of riboflavin.
• the preparations may be administered orally, or parenterally and conveniently take the form of a tablet, caplet, capsule, lozenge, injectable solution, liquid suspension or elixir. Circumstances may arise wherein the dose is best administered by suppository, inhalation, slow release implant, slow release patch or other topical vehicle.
• the combination of active ingredients are usually best given in an oral form made up as a tablet, caplet, capsule, or as a liquid suspension or elixir one or two times daily.
• oral administration the preparation may be admixed with any conventional tableting or capsuling carrier, or as a suspension or solution in any orally acceptable non-toxic liquid carrier.
• the drug may be provided in encapsulated form for sustained release over a period of time.
• parenteral administration the drug may be provided as a suspension or solution in any suitable, sterile injection medium, e.g. sterile aqueous saline solution
• the pharmaceutical formulations may additionally include, in addition to the aforementioned active agents, other known anti-migraine preparations, sedatives and relaxants, analgesics and antiemetics such as:
• Excellent efficacy of a preparation in accordance with this invention is likely in all forms of migraine including the treatment of classical and common migraine, migrainous neuralgia (cluster headache), and premenstrual and menstrual migraine and other headaches.
• compositions of the present invention may be used in the prevention of the aforementioned types of headache by reducing the frequency, severity and duration of the attacks and by reducing the nausea and vomiting symptoms.
• the compositions may also be used to treat acute attacks of the aforementioned types of headache, by reducing their duration, severity and the intensity of associated symptoms.
• preparations in accordance with the invention may be administered orally, or parenterally and conveniently take the form of a tablet, capsule, injectable, liquid suspension or elixir. Circumstances may arise where it is best administered by suppository, inhalation, slow release implant, slow release patch, or other topical vehicle. Dosage and administration are as indicated above.
• a preparation in accordance with the invention may additionally include other anti-arthritis agents including non-steroidal anti-inflammatory drugs, analgesics, skeletal muscle relaxants, steroids, gold and penicillamine.
• agents examples include aspirin, indomethacin, piroxicam, benorylate, ibuprofen, paracetamol, salicylamine, diflunizal, ethoheptazine, fenoprofen (calcium fenoprofate) flufenamic acid, mefenamic acid, naproxen sodium, ketoprofen, phenylbutazone, sulindac, penicillamine, salicylate, fenclofenac, flurbiprofen, fenbufen, feprazone, sodium aurothiomalate, naproxen, benoxaprofen, aloxipria, hydroxychloroquine sulphate, azapropazone, tolemtin, choline magnesium trisalicylate, diclofenac, adrenal steroids such as prednisone or prednisolone, white willowbark and its extracts, other non-steroidal anti-inflammatory agents of
• compositions of the present invention may be used in the treatment of rheumatoid arthritis, osteoarthritis, arthritis associated with Felty's syndrome,
• Still's disease systemic lupus erythematosus, polyarteritis nodosa, scleroderma, gout, achalasia of the cardia, Crohn's disease, chronic brucellosis, ankylosing spondylitis, sarcoidosis, psoriasis and gonorrhoea.
• the preparations are believed to be useful in the prevention of the above arthritides, being effective in reducing the frequency, severity and duration of the symptoms.
• the preparations can also be used to treat the acute attacks of the above arthritides reducing their duration, severity and associated symptoms.
• compositions of the present invention can be enhanced by the presence of gamma linoleic acid.
• the compositions may comprise, in addition to a sesquiterpene lactone and a B- complex vitamin, gamma linoleic acid or a source thereof.
• the linoleic acid source may be, for example, evening primrose oil or borage oil.
• preparations in accordance with the invention may be administered orally, or parenterally and conveniently take the form of a tablet, capsule, injectable, liquid suspension or elixir. Circumstances may arise where it is best administered by suppository, inhalation, slow release implant, slow release patch or other topical vehicle. Dosage and administration are as indicated above.
• a preparation in accordance with the invention may be co-administered with or additionally include other ingredients such as bronchodilator, antihistamine and anti-infective agents, examples of which agents are: isoprenaline sulphate, orciprenaline, adrenaline, terbutaline sulphate, theophylline, brazilian cocoa choline theophyllinate, aminophylline, ephedrine hydrochloride, papaverine hydrochloride, ipratropium bromide, atropine methonitrate, beclomethasone dipropionate, fenoterol hydrobromide, betamethasone, isoetharine mesylate or hydrochloride, phenylephrine hydrochloride or bitartrate, thenyldiamine hydrochloride, reproterol hydrochloride, deptropine citrate, butethamate citrate, acepifylline, diphenylpyraline hydrochloride, sodium
• H1 -receptor antagonists diprophylline, methoxyphenamine hydrochloride, rimiterol hydrobromide, hyoscine hydrobromide, salbutamol sulphate, ketotifen hydrogen fumarate, pseudo-ephedrine hydrochloride, bromhexine hydrochloride, and antifungal, antibacterial and antiviral agents.
• the composition in accordance with the present invention is believed to be useful in the treatment of bronchial asthma, bronchoconstriction associated with chronic bronchitis, and symptoms associated with histamine release in allergic hypersensitivity phenomena such as hay fever and anaphylaxis.
• Compositions in accordance with the invention will now be illustrated in more detail with reference to the following Examples:
• Powdered feverfew leaf and riboflavin are mixed in the following proportions:
• the mixture is encapsulated into a soft shell capsule or hard shell capsule or two piece hard shell gelatin capsules.
• the capsules may be treated to retard disintegration or absorption by the use of gastro-resistant coatings, such as hydroxymethyl propyl cellulose, or the content may be mixed with polymeric matrix materials as those known to the pharmaceutical industry, to release the active ingredients at a controlled rate.
• gastro-resistant coatings such as hydroxymethyl propyl cellulose
• the soft shell or two piece hard shell gelatin capsule may be used via the oral or rectal route.
• the pH is adjusted to between 2 and 6.5, using HCI.
• the injectable may be administered by intramuscular, subcutaneous, or intravenous injection.
• the preparation should be stored in tight, light-resistant containers, preferably between 15-25° C.
• Caplets may be enteric coated, sugar coated, film coated or prepared as a laminated tablet.
• the dry solids are triturated and the purified water is slowly added with trituration.
• the pH is adjusted to between 3 and 6.5 using HCI as required.
• the suspension may be administered by ingestion.
• the preparation should be stored in tight, light-resistant containers, preferably between 15-25°C.

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• Health & Medical Sciences (AREA)
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• Pharmacology & Pharmacy (AREA)
• Animal Behavior & Ethology (AREA)
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• Chemical & Material Sciences (AREA)
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• Engineering & Computer Science (AREA)
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• Biomedical Technology (AREA)
• Pain & Pain Management (AREA)
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• Epidemiology (AREA)
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• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
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• 1995
  • 1995-01-26 CA CA002141126A patent/CA2141126A1/en not_active Abandoned
• 1996
  • 1996-01-25 EP EP96900799A patent/EP0805680A2/en not_active Withdrawn
  • 1996-01-25 WO PCT/CA1996/000052 patent/WO1996022774A2/en not_active Application Discontinuation
  • 1996-01-25 JP JP8522519A patent/JPH10512573A/ja active Pending
  • 1996-01-25 KR KR1019970705116A patent/KR19980701720A/ko not_active Application Discontinuation
  • 1996-01-25 AU AU44780/96A patent/AU4478096A/en not_active Abandoned

Non-Patent Citations (1)

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