EP1309331A2

EP1309331A2 - Medicine for fighting against sexual dysfunction

Info

Publication number: EP1309331A2
Application number: EP01963079A
Authority: EP
Inventors: Philippe Gorny; Catherine Pons-Himbert; Olivier STÜCKER
Original assignee: Adenomed BV
Current assignee: Adenomed BV
Priority date: 2000-08-08
Filing date: 2001-08-08
Publication date: 2003-05-14
Also published as: ZA200300967B; FR2812812B1; BR0112830A; US20030139368A1; JP2004505897A; RU2003105600A; IL154215A0; IL154216A0; CA2419042A1; EP1311273A2; ZA200300966B; BR0112908A; US20030139371A1; CN1496265A; WO2002011735A3; WO2002011665A3; AU2001284126A1; RU2003105601A; CA2420066A1; JP2004505921A

Abstract

The invention concerns in combination, in a pharmaceutical excipient and/or carrier, a purine and a nonsteroidal anti-inflammatory drug. The nonsteroidal anti-inflammatory drugs potentiate the action of purines in the prevention or the treatment of male or female sexual dysfunction.

Description

Medication intended in particular to combat sexual dysfunctions

The invention relates to a medicament intended in particular for preventing or treating sexual dysfunctions in men or women. The invention relates in particular to obtaining a medicament capable of combating disorders of the physiological and / or anatomical response to sexual stimulation in humans. Such a drug contains, in combination, a purine and a non-steroidal anti-inflammatory agent.

We know that, in humans, the erection process is schematically that indicated below. The erectile tissue of the penis, called the corpora cavernosa, is a spongy tissue capable of filling with blood. At rest, the arteries of the penis are under the dependence of the adrenergic tone which keeps them spasmed, so that no notable blood flow comes to fill the cavernous body. When properly stimulated, the erection nerves inhibit the adrenergic tone, releasing certain mediators promoting the dilation of the arteries of the penis, which leads to an accumulation of blood in the corpora cavernosa. The latter grows, while the increase in its internal pressure causes it to become rigid. When magnifying, it crushes the cavernous veins against the envelope of the erectile body, preventing the evacuation of the blood it contains, which ensures the maintenance of rigidity. After ejaculation, norepinephrine is again released locally, the arterial blood supply immediately decreases, the pressure in the corpora cavernosa decreases and the blood accumulated in it can be evacuated by the veins which are no longer compressed , which results in the loss of rigidity, with return to the state of rest.

In women, sexual arousal results in particular in the vasodilation of the blood vessels supplying the genitals. This vasodilation leads in particular to swelling and an erectile response of the clitoris, as well as vasocongestion of the vaginal wall with exudation of vaginal fluids. It is known that a fairly large proportion of men (between 10 and 50% depending on the populations studied and according to the age groups) suffer from permanent or temporary erectile dysfunction. These disorders can be of organic origin, in which case they require specific treatments adapted to each cause. But we also observe a majority of non-organic erectile dysfunctions, often of psychogenic origin; see for example Feldman H.A. et al, J. Urol. 151; 54-61 (1994).

Also in women, the physiological response to sexual stimulation, and its anatomical manifestations, can be altered temporarily, and sometimes durably, even without detectable organic cause. The most frequently observed disorders include the absence of sexual desire even after stimulation, the difficulty of obtaining an orgasm, the low intensity of sexual pleasure and the decrease in natural vaginal lubrication or even its absence. These disorders often result in a lack of interest in sexual activity. It is these disorders of the physiological and / or anatomical response to sexual stimulation that are called, in the present application, "female sexual dysfunctions". According to some estimates, the frequency of temporary or chronic sexual dysfunction in women is equivalent to that of erectile dysfunction in men; see for example Laumann EO, JAMA 281; 537-544 (1999).

It is therefore desirable to have treatments which make it possible to reduce the severity and / or the duration of these disorders, or to prevent their occurrence, to restore the capacity for accomplishing satisfactory sexual intercourse, in subjects, men or women. , who have these disorders, or who fear their occurrence.

The physiology of erection, and more generally the phenomenon of turgor of the erectile bodies (penis, clitoris), is a complex phenomenon which associates neuronal and vascular mediators. The erection is maintained by the relaxation of the arteries afferent to the cavernous body and the smooth muscles of this cavernous body. Among the molecules inducing relaxation, we find nitric oxide

(NO) released by the vascular endothelium and by NANC type nerve fibers (non-adrenergic non-cholinergic).

Nitric oxide has been shown to stimulate the synthesis of cyclic guanosine monophosphate (or cGMP) which is the effective agent for muscle relaxation in the arteries. We also know that nitrogen monoxide is the main physiological neurotransmitter involved by non-adrenergic and non-cholinergic peripheral neurons innervating the corpora cavernosa and its arteries, and that its release at the level of the effector synapse is an important factor in the 'induction of erection; see in particular BURNETT et al, Science 257: 401-403 (1992), and FAJFER et al, New Engl. J. Med. 326: 90-94 (1992).

We know that prostaglandins have a regulatory effect on the tone of the cavernous muscle, either by inducing vasolidation (prostaglandin 12, prostaglandin E2), or by causing vasoconstriction (prostaglandin F2alpha).

In addition, purines also play an important role in vascular control of erection. They intervene in particular through specific receptors. It has been shown in rabbits that purines are capable of inducing relaxation of the corpora cavernosa; see WU H-Y et al. Int. J. Impotence Res. 5, 161-167 (1993). It has also been shown that intravenous injection of adenosine triphosphate induces erection in dogs; see TAKAHASHI Y. et al. Int. J. Impotence Res. 4, 27-34 (1992).

The authors of the present invention have attempted to investigate whether other mediators have a regulatory effect on the action of purines.

The in vitro model used was that of the rabbit cavernous body isolated in organ chambers. A good response analogy has been shown with the human cavernous body. It is indeed in rabbits that the best correlations with the results obtained in humans have been observed; see for example Bush P.A., Aronson WJ, Buga GM, Rajfer J., Ignarro LJ J. Urol. 147-6); 1650-1655 (1992); Knispel HH., Goessel C, Bechman R, Urol. Res 20 (4); 253-257 (1992); Holmquist F, Hedlund H, Andersson KE, J. Physiol. (London) 449; 295-311 (1992); and Cellek S., Moncada S- Proc Natl Acad Sci USA, 94 (15); 8226-8231 (1997).

In this model, the relaxing action of purines was studied, either with purines alone, or with an inhibitor of NO synthesis (N-omega-nitro-L-arginine, or L-NNA), in order to study if the regulation by purines of the production of NO is a component of the relaxing effect of purines.

These studies have shown that the presence of an inhibitor of NO synthesis decreases slightly, by only 15%, the effects observed with purine alone. Similarly, it was investigated whether the presence of an inhibitor of prostaglandin synthesis (cyclooxygenase inhibitor) modifies the effects of purine. If the action of purine could be explained in part by an indirect effect via prostaglandins, we should expect a decrease in the effect of purine in the presence of the cyclooxygenase inhibitor. However, the authors of the invention have found that, on the contrary, and surprisingly, cyclooxygenase inhibitors strongly potentiate the relaxing effect of purine and reduce the vasoconstrictor effect of catecholamines. This discovery is all the more surprising since the cyclooxygenase inhibitor alone has no relaxing effect on smooth muscle at rest.

Non-steroidal anti-inflammatory drugs (NSAIDs) have in common various properties, and in particular an activity of inhibition of cyclooxygenase. It was with a well-known non-steroidal anti-inflammatory drug, aspirin, that the above study was first conducted. The results have been confirmed with other NSAIDs, including salicylic acid, mefenamic acid and indomethacin.

Thus, the combination of a purine activity and a non-steroidal anti-inflammatory agent activity makes it possible to obtain favorable results in the prevention and treatment of disorders of the physiological and anatomical response to sexual stimulation in humans ( man or woman), and therefore to combat said disorders, thanks to a synergistic effect.

The subject of the invention is therefore a medicament combining a purine activity and an NSAID activity, and further comprising a pharmaceutical excipient or vehicle. The medicament of the invention generally contains at least one purine and at least one NSAID.

In the present application, the term "purine" is intended to mean purine bases, in particular adenine, nucleosides based on purine and in particular adenosine as well as the corresponding phosphates, in particular AMP, ADP and ATP, or still guanine, guanosine, GMP, GDP, GTP and their derivatives, in particular their pharmaceutically acceptable salts (for example adenosine or adenosine hydrochloride, or sodium salts of adenosine-phosphates). More generally, “purine” is also understood to mean any substance capable of acting on purine receptors (PI receptors sensitive to AMP and adenosine, or P2 receptors, sensitive to ADP and ATP). Such substances are known or can be sought according to known methods. A purine activity is an activity obtained by the presence of a purine as it has just been defined.

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a known class of anti-inflammatory drugs; see, for example, THE MERCK INDEX, 12 ^th edition, the content of which concerning NSAIDs (including data and references) is incorporated into this description by reference. NSAIDs have several properties in common, and in the first place an activity of inhibition of cyclooxygenase which gives them the capacity to inhibit the synthesis of prostaglandins. NSAIDs have other properties in common, and in particular the decoupling of oxidative phosphorylation, modifications of the intracellular movements of calcium ions, activation of the synthesis of inducible NO synthase, action on the nuclear factors kappa, etc. It is possible that one of these properties is responsible for the potentiating effect of NSAIDs on purines, but it is also possible that other properties, known or unknown, are involved. An NSAID activity is an activity obtained by the presence of a product having at least one of the properties common to NSAIDs.

Among the NSAIDs that can be used, there may be mentioned in particular:

- salicylic derivatives such as acetylsalicylic acid (aspirin), methyl salicylate, salicylic acid, 2- (2-nitroxy) -butyl 2-acetoxybenzoate and 2 (2-nitroxymethyl) 2-acetoxybenzoate phenyl;

- pyrazole derivatives such as phenylbutazone, tolmetin, antipyrine, noramidopyrine, dipyrone, oxyphenbutazone, azapropazone, bumadizone, clofezone, kébuzone, mofébutazone, proxifézone, pyrazinophenazone ;

- anthranilic acid derivatives (also called fenamates) such as mefenamic acid, flufenamic acid, niflumic acid, tolfenamic acid, meclofenamic acid, etofenamic acid;

- propionic acid derivatives, such as: ibuprofen, ketoprofen, maproxen, fenoprofen, flurbiprofen, tiaprofenic acid, naproxen;

- phenothiazinic derivatives such as methiazinic acid or protizinic acid;

- other derivatives of organic acids such as bucloxic acid, diclof enac or piroxicam; - indole derivatives such as indomethacin or sulindac;

- NSAIDs selectively or preferentially inhibiting cyclooxygenase-2 (or Cox-2) such as rofecoxib, celecoxib or nabumetone;

- as well as donors of nitric oxide derived from NSAIDs, in particular nitric esters and nitro and nitroso derivatives of NSAIDs such as those described in the patents and patent applications EP 0 670 825, US 5,700,947, WO 95/30641, US 5 703 073, US 6 043 232 and US 6 043 233, the content of which is incorporated into the present description by reference. It is of course possible to use all other NSAIDs (having the capacity to potentiate the action of purines) such as the NSAIDs described in THE MERCK INDEX, 12 ^th edition.

In the present application, in general terms, "derivatives" are any products which are obtained by the modification of a chemical function or of an atom or group of atoms of an active product, and which have a physiological activity of same type as the active product. By way of examples, the derivatives of active products having acid functions can be in particular the salts (for example sodium salts or salts of other alkali metals, or amine salts such as piperazine or lysine salts), or esters formed by said acids with alcohols, or amides formed by these acids with amines; the derivatives of active products having amino functions are in particular the amides and the addition salts formed by these amines with acids; the derivatives of active products having alcohol functions are in particular the esters formed by said alcohols with acids.

To study the effects of agents intended to combat disorders of the physiological and anatomical response to sexual stimulation in men and in women, it is possible to use known methods described in the literature, for example those described by Boolell M. and al., Intern. Journal of impotence Research 8; 47-52 (1996) and by Goldstein L, New England J. of Medicine 338; 20, 1397-1404 (1998), or the organ chamber techniques which are mentioned in the remainder of this description.

The medicament of the invention is used in such a way as to administer to the treated person effective doses which can be determined by simple routine experiments, using for example the tests which have just been mentioned. It should also be noted that the active doses of several purines are known. It is also easy to determine the effective doses using such tests. The doses of NSAIDs can be easily determined by routine tests, including tests such as those described below, on isolated rabbit organs.

The subject of the invention is therefore the use in combination of a purine activity and an NSAID activity, in the preparation of a medicament intended for combating male or female sexual dysfunctions, including disorders of the physiological and / or anatomical response to sexual stimulation, and in particular to prevent or treat non-organic erectile dysfunctions. This medication can be administered to curative or preventive title, to subjects who need it, that is to say to people who have experienced or feared such disorders.

The active ingredients of a medicament obtained in accordance with the invention may be presented separately, each in an appropriate pharmaceutical form, and combined in the same package.

However, to facilitate the simultaneous administration of the active ingredients, it is generally preferred to prepare the medicament in a single pharmaceutical form containing the two active ingredients, as well as optionally an appropriate pharmaceutical excipient.

Of course, a compound having both a purine activity and an NSAID activity must be considered as constituting on its own a combination having the two types of activity, and can therefore be used in accordance with the invention as active ingredient unique. For example, a purine and an NSAID can be combined by establishing a chemical bond between the two molecules. One can in particular amidify an amino function of the purine base with an acid group present in an NSAID such as for example acetylsalicylic acid or mefenamic acid. An amidification product can thus be obtained which has both purine activity and NSAID activity.

It is therefore possible to replace the combination of a purine and an NSAID with a single product in which a purine, or a purine analog, is covalently linked to an NSAID, possibly via at least one arm spacer. These products are in particular those which correspond to formula I

(A-) _ra (X) _p (-B) _π (I) in which A is the rest of the molecule of an NSAID, B is the rest of a purine and X represents either a covalent bond between A and B , or a spacer arm connecting at least one remainder A to at least one remainder B, m is an integer which can range from 1 to 3, n is an integer which can range from 1 to 3, and p represents zero or an integer at most equal to the largest of the numbers m and n. We can indeed, depending on the case, either graft one or more residues A and / or B on a single spacer arm, or graft one or more groups A- X- on a residue B (and then m = p and n = 1 ), or graft one or more -XB groups on a remainder A (and then n = p and m = 1). When p = zero, either one or more remainders A are linked to a remainder B (and n = 1), or one or more remainders B are linked to a remainder A (and m = 1).

The products of formula I can be used in the form of salts, in particular in the form of alkali metal salts such as sodium or potassium salts; these salts are for example those of phosphate groups, if they are present, phenolic groups (case of salicylic acid), etc. The products of formula I can also be used, where appropriate, in the form of addition salts (for example in the form of the hydrochloride) when these products contain an amino group.

The bonds between the spacer arm and the remains A and B are covalent bonds. The chemical groups making the connection between A and B (when p = zero), or between A and X or between X and B (when p is other than zero), are for example groups carboxylic ester, carboxylic amide, thiocarboxylic ester or thiocarboxylic amide. In formula I, A can represent in particular the acyl residue of an NSAID having a carboxylic group (the NSAID therefore has the formula A-OH) and B can represent the residue of a purine-based nucleoside or nucleotide linked to X , or connected to A (in the absence of a spacer arm), via the nitrogen of a primary amine of the purine base and / or via the oxygen of a hydroxyl group of said purine-based nucleoside or nucleotide; for example one or more groups A or AX- can be linked to B via the oxygen of the primary alcohol of said nucleoside and / or via the oxygen of at least one secondary alcohol of said nucleotide . In these cases, the purine from which B derives obviously has the formula BH.

In formula I, said nucleoside or nucleotide is in particular a ribonucleoside or ribonucleotide. The purine can be chosen from adenosine, guanosine and inosine, as well as the corresponding 5 '-monophosphates, -diphosphates and -triphosphates.

The spacer arms may in particular be bivalent residues of bi-functional aliphatic compounds (that is to say compounds having reactive functional groups at each of their ends, each making it possible to form covalent bonds with A and with B). These compounds may for example be compounds which have both an amino group and a carboxylic (or thiocarboxylic) group, or alternatively compounds which have both an amino group and a hydroxyl group.

In formula I, group X (disregarding its end functional groups) represents in particular a divalent aliphatic group possibly interrupted by one or more heteroatoms - O - or - S - or by one or more heteroatomic groups - NH - or - CO - NH -. The spacing agents, that is to say the compounds capable of giving, after reaction with purine and the NSAID, products of formula I in which A and B are linked by spacer arms, are for example alpha acids -, beta- or gamma-amino alkanecarboxylic acids, in particular natural alpha-amino acids such as glycine, alanine, valine or leucine, or even peptides, in particular dipeptides or tripeptides.

The spacing agents can also be hydroxycarboxylic acids such as lactic, glycolic acids, aldonic acids (gluconic, mannonic, galactonic, ribonic, arabinonic, xylonic and erythronic) and the corresponding lactones or dilactones (for example lactide, glycolide, delta-glucolonactone, delta-valeronactone), or aldaric acids.

The functional groups optionally present on the spacer arm and not involved in the binding with an element A or B can be used to graft other residues A and / or B so as to obtain compounds of formula I for which m and / or n are greater than 1. This is the case, for example, of the hydroxyl groups of the hydroxy acids, of the second carboxylic group of the amino acids dicarboxylic acids, of the second amino group of the amino diamines, of the hydroxyl group of the hydroxy amino acids, etc.

To prepare the compounds of formula I, the conventional methods of organic synthesis are used. For example, to prepare amides or esters, a carboxylic compound (NSAID or spacer agent) can be reacted in the form of a carboxylic acid (or thiocarboxylic) halide, or in the form of a mixed anhydride, or in the form of an activated ester, for example a p-nitrophenyl ester. The acid can also be activated using a coupling agent such as dicyclohexylcarbodiimide.

As the compounds of formula I include residues of nucleosides or nucleotides, they can be prepared using in particular the methods known in the chemistry of nucleic acids, described for example in the work by Kochetkoc and

Budovskii, Organic Chemistry of Nucleic Acids, Plenum Press, 1971 (2 volumes), the content of which is incorporated in the present description by reference.

Of course, when the compounds from which A, B or X of formula I derive, comprise several functions capable of reacting, it is advisable to operate either by using the reagents in stoichiometric proportions (according to the number of precursor products of A and / or of B that we want to react), either by temporarily protecting the functions reactive which we do not want to react. The methods of temporary protection of said reactive functions are used for this. These temporary protection methods are well known, in particular those which have been developed during research concerning the synthesis of peptides. For example, the -NH ₂ groups can be protected by carbobenzoxy, phthaloyl, t-butoxycarbonyl, trifluoroacetyl, toluenesulfonyl groups; the carboxylic groups can be protected in the form of benzyl esters, tetrahydropyranyl esters or t-butyl esters; the alcohols can be protected in the form of esters (for example acetates), in the form of tetrahydropyranyl ethers, of benzyl ethers or of trityl ethers, or also in the form of acetals (including under the form of acetonides in the case of vicinal glycols). Protection and possible deprotection reactions of various chemical groups are known and described for example in the book Advances in Organic Chemistry, Methods and Results, Vol. 3, Interscience Publishers (1963), pages 159 et seq. And pages 191 et seq., As well as in TW Green, Protective Groups in Organic Synthesis, Wiley-Interscience Publication (1991). The content of these works is incorporated into this description by reference.

The phosphating or dephosphating reactions of the primary alcohol of the nucleotides or nucleosides can be carried out using natural enzymes (for example phosphatases, phosphokinases). Among the products of formula I, mention will be made in particular of those which correspond to formula la:

A- B (la), in which A and B are defined as above. A represents in particular the acyl residue of an NSAID having a carboxylic group, the bond with B taking place for example by the formation of an amide or of an ester with an amino or alcohol function, respectively, of the purine of which the formula is BH.

Among the products of formula I or la, there may be mentioned in particular the amides and esters formed with the acyl residues A of salicylic acid, acetylsalicylic acid, diclofenac, ibuprofen, naproxen or sulindac, and with B residues derived from adenosine or AMP.

Of course, it is particularly interesting to choose, among the products of formula I, those which have a potentiating synergistic effect compared to their constituents purine and NSAIDs. Such products can be selected by simple routine experiments.

It has also been noted that the products of formula I or la generally have an improved gastric tolerance, compared to the NSAID from which they are derived. Among the products of formula I, there may be mentioned in particular the amidation product of AMP by salicylic acid or acetylsalicylic acid, and the amidation product of adenosine with salicylic acid.

The medicament obtained in accordance with the invention can be administered by oral, sublingual, nasal, pulmonary, vaginal, rectal or transdermal route, or also by intracavernous injection.

For this purpose, it can be presented in any form allowing oral administration (in particular in the form of capsules, oral solutions or emulsions, powders, gels, granules, tablets or tablets), by nasal route (for example solutions to be administered in the form of drops or sprays), by pulmonary way (solutions in pressurized bottle for aerosols), by rectal way (suppositories), by cutaneous way (for example ointments or transdermal devices, also called patches or patches), or by the transmucosal route, for example by the sublingual route (solutions in a pressurized bottle, or tablets with oral disintegration) or by the vaginal route (in particular gynecological creams or ova), or even by the intracavernous route (suspensions or injectable solutions) .

These pharmaceutical forms are prepared in the usual manner and may contain suitable conventional excipients and vehicles.

The medicament of the invention makes it possible to obtain favorable results in men suffering from transient erectile dysfunctions, and also in subjects suffering from chronic erectile dysfunctions. In women, improvements can be noted in particular for at least one of the following disorders: loss or reduction of sexual desire, absence of orgasm or difficulty in obtaining orgasm, vaginal dryness, reduction in the intensity of sexual pleasure, etc.

The medicament obtained in accordance with the invention can be used either for long periods in the case of chronic erectile dysfunctions (for example cures lasting several weeks, several times a year), or in episodic cures in the treatment of temporary erectile dysfunctions and / or recent, or again on an ad hoc basis. Such a medicament can be prepared for example in a pharmaceutical form allowing the administration of 50 to 1000 mg of AMP in one or two doses, or an equivalent dose of another purine, and also allowing the administration of a a sufficient dose of NSAIDs, for example a dose of 50 to 500 mg per day of aspirin, in one or two doses, or an equivalent dose of another NSAID.

For example, a dose of 50 to 1000 mg of AMP and

50 to 500 mg per day of aspirin, in adults, for a treatment which should last from 2 to 4 weeks. In the case of a punctual use, one can administer, for example by oral or sublingual route, from 200 to 1000 mg of AMP, and from 100 to 300 mg of aspirin in a single dose, approximately 30 minutes to 2 hours before contemplating intercourse.

AMP can be replaced in particular by equivalent amounts of ATP.

If one wishes to substitute another purine for AMP and / or another NSAID for aspirin, one can easily adapt the ranges of doses mentioned above by replacing a given dose of AMP by an equivalent dose of another purine and / or by replacing a given dose of aspirin with an equivalent dose of another NSAID. A dose of purine equivalent to a given dose of AMP is for example a dose of purine capable of inducing relaxation of the smooth muscles of the corpora cavernosa (previously contracted with phenylephrine), isolated from rabbits, in an organ chamber, this relaxation being comparable to that obtained with said given dose of AMP, in a test using the known techniques described in particular by HOLMQUIST et al, J. Urol. 144, 146-151 (1990); BRODERICK et al, Neuro. Urol. Urodyn 10,507-515 (1991); BUSH et al, 147, 1650-55 (1992); HSI Yang Yu. Int J. Tax. Res. 5, 161-167 (1993); SAENZ DE TEJADA et al, J. Pharmacol. Exp. Treat 290 (1), 1-8 (1999). A dose of NSAID equivalent to a given dose of aspirin is for example a dose which, in combination with a purine, is capable of inducing relaxation of the smooth muscles of the corpora cavernosa which is comparable to the relaxation obtained with said dose of aspirin combined with the same purine, in a test using one of the techniques just mentioned.

The invention also relates to a method of preventing or treating male or female sexual dysfunctions, in which a medicament as defined above is administered.

The invention also relates to a non-therapeutic method for increasing sexual desire and / or sexual capacities and / or promoting sexual activity and / or improving the intensity of the sexual pleasure and / or favor the achievement of satisfactory sexual intercourse, in the people who wish it, although not suffering from sexual dysfunctions as defined above. This method comprises administering to such persons a purine and an NSAID (or a composition combining a purine activity and an NSAID activity), in particular AMP and aspirin, for example between two hours and one half an hour before a planned sexual activity. The doses administered can be chosen from the dose ranges indicated above.

The following example illustrates the invention. EXAMPLE: Powder sachet for oral suspensions Powder sachets containing:

- AMP: 400 mg

- Aspirin: 250 mg

- Flavored excipient: 500 mg

AMP can be replaced by an equivalent amount of ATP, and aspirin can be replaced by an equivalent dose of mefenamic acid, salicylic acid, diclofenac, dibuprofen, naproxen, sulindac or indometacin.

It is recommended to ingest the contents of a sachet every day, after being suspended in water. You can also ingest the content of an additional sachet 30 minutes to 2 hours before a planned sexual activity. PHARMACOLOGICAL STUDY:

This study was carried out in vitro on the smooth muscles of the corpora cavernosa of male and female rabbits. The technique is that of organ chambers.

The objective of this study is the search for an effect of purines (AMP and ATP) on the relaxation of the corpora cavernosa after a pre-contraction to phenylephrine and the search for a possible modification of this effect of purines by aspirin. The study was done in male and female rabbits.

In this experimental test, AMP induced a significant relaxation of the smooth muscle of the body of male rabbit cavernous since it reached 70% to 10 ^"3 M. Aspirin ^10" ^3M potentiates the effect of AMP since thanks to the association, we achieve 92% relaxation. This potentiating effect cannot be explained by the addition of the response to AMP and the response to aspirin, since the latter has no vasoactive effect in itself on this model. Aspirin also potentiates the effect of ATP, on the same test, in the male rabbit, but the effect of ATP was found to be weaker than that of AMP (35% relaxation with ATP 10 ^" 3M, reaching 57% in the presence of 10 ^" 3M aspirin).

In female rabbits, AMP (10 ^" 3M) induces relaxation of 20%, reaching 36% in the presence of aspirin. ATP (10 ^" 3M) seems to cause slightly greater relaxation , by 31%, reaching 50% in the presence of aspirin.

In all cases, aspirin amplifies the relaxing response of the purines studied (AMP or ATP). This amplification is by a factor ranging from 1.5 to 2.

Similar potentiating effects have been observed by replacing aspirin with mefenamic acid, salicylic acid and indomethacin.

Claims

1. Medicinal product combining purine activity and NSAID activity, and also containing an excipient and / or a pharmaceutical vehicle.

2. Medicament according to claim 1, having at least one of the following characteristics: it comprises in combination at least one purine and at least one NSAID; - the purine is chosen from adenine, adenosine, guanine, guanosine, AMP, ADP, ATP, GMP, GDP and GTP; the NSAID is chosen from the following anti-inflammatory drugs: derivatives of salicylic acid, pyrazole derivatives, derivatives of anthranilic acid, derivatives of propionic acid, phenothiazine derivatives and indole derivatives and other derivatives of organic acids such as bucloxic acid, diclofenac or piroxicam; said medicine contains said active ingredients, separately, in the same package; - said drug is in a unique pharmaceutical form containing the two active ingredients; said medicament is in the form of capsules, oral solutions or emulsions, granules, gels, creams, powders, tablets, tablets, ointments, transdermal devices, gynecological ova, suppositories, or solutions, possibly in pressurized vials, for administration by nasal or pulmonary route, or solutions or suspensions injectable by intracavernous route.

3. The medicament according to claim 1 or 2, wherein said purine is chosen from adenosine, AMP, ADP and ATP.

4. Medicament according to any one of the preceding claims, in which said purine is AMP or ATP.

5. Medicament according to any one of the preceding claims, in a pharmaceutical form allowing the administration of a dose of 50 to 1000 mg of purine, in one or two doses.

6. Medicament according to any one of the preceding claims, in a pharmaceutical form allowing the administration of 50 to 500 mg of aspirin, in one or two doses, or an equivalent dose of another NSAID.

7. Use, in combination, of a purine activity and an NSAID activity in the preparation of a medicament intended to combat male or female sexual dysfunctions.

8. Use according to claim 7, having at least one of the following characteristics:

- The composition contains at least one purine and at least one NSAID;

- the purine is chosen from adenine, adenosine, AMP, ADP, ATP, guanine, guanosine, GMP, GDP and GTP, or their derivatives;

- Said purine is AMP or ATP; - the purine is administered at a dose equivalent to a dose of 50 to

1000 mg of AMP, in one or two daily doses;

- the NSAID is chosen from the following anti-inflammatory drugs: salicylic acid derivatives, pyrazole derivatives, anthranilic acid derivatives, propionic acid derivatives, phenothiazinic derivatives and indole derivatives; - the NSAID is administered at a dose equivalent to a dose of 50 to 500 mg of aspirin, in one or two daily doses.

9. Non-therapeutic method to increase sexual desire and / or promote sexual activity and / or increase sexual capacity and / or promote sexual activity and / or improve the intensity of sexual pleasure and / or promote fulfillment satisfactory sexual intercourse, in persons not suffering from sexual dysfunction, in which said persons are administered a composition combining purine activity and NSAID activity.

10. Method according to claim 9, having at least one of the following characteristics: the composition contains at least one purine and at least one NSAID;

- Said purine is AMP or ATP;

- the purine is administered at a dose equivalent to a dose of 50 to 1000 mg of AMP, in one or two daily doses; - the NSAID is chosen from the following anti-inflammatory drugs: salicylic acid derivatives, pyrazole derivatives, anthranilic acid derivatives, propionic acid derivatives, phenothiazinic derivatives and indole derivatives;

- the NSAID is administered at a dose equivalent to a dose of 50 to 500 mg of aspirin, in one or two daily doses.