EP1755678A2 - Zusammensetzung aus aktiva mit einer carbinolverbindung und einem opioid - Google Patents

Zusammensetzung aus aktiva mit einer carbinolverbindung und einem opioid

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Publication number
EP1755678A2
EP1755678A2 EP05732430A EP05732430A EP1755678A2 EP 1755678 A2 EP1755678 A2 EP 1755678A2 EP 05732430 A EP05732430 A EP 05732430A EP 05732430 A EP05732430 A EP 05732430A EP 1755678 A2 EP1755678 A2 EP 1755678A2
Authority
EP
European Patent Office
Prior art keywords
methyl
radical
imidazole
dimethylamino
benzyl
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP05732430A
Other languages
English (en)
French (fr)
Inventor
Helmut Heinrich Buschmann
Bonifacio Gutierrez Silva
Jörg Holenz
Antonio Farre Gomis
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Esteve Pharmaceuticals SA
Original Assignee
Laboratorios del Dr Esteve SA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from ES200400836A external-priority patent/ES2245226B1/es
Priority claimed from US10/953,432 external-priority patent/US20050222135A1/en
Application filed by Laboratorios del Dr Esteve SA filed Critical Laboratorios del Dr Esteve SA
Publication of EP1755678A2 publication Critical patent/EP1755678A2/de
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • 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
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/415—1,2-Diazoles
    • 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
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4164—1,3-Diazoles
    • 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
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/485—Morphinan derivatives, e.g. morphine, codeine
    • 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
    • A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A61K31/551—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
    • A61K31/5513—1,4-Benzodiazepines, e.g. diazepam or clozapine
    • A61K31/5517—1,4-Benzodiazepines, e.g. diazepam or clozapine condensed with five-membered rings having nitrogen as a ring hetero atom, e.g. imidazobenzodiazepines, triazolam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
    • 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
    • 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
    • A61P25/02—Drugs for disorders of the nervous system for peripheral neuropathies
    • 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
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • the present invention relates to an active substance combination comprising at least one substituted carbinol compound and at least one opioid, a medicament comprising said active substance combination, a pharmaceutical formulation comprising said active substance combination and the use of said active substance combination for the manufacture of a medicament.
  • Opioids such as morphine, which belong to the class of centrally acting analgesics, are key compounds for the treatment of moderate to very severe pain.
  • these opioid analgesics show a multifaceted spectrum of undesired side effects, when administered to the patient in need of treatment, ranging from unpleasant effects such as emesis, inhibition of gastrointestinal function, sedation or dizziness to severe, often life-threatening effects such as respiratory depression.
  • Further problems associated with the administration of opioids are the development of tolerance, the risk of addiction as well as the illicit use of such substances.
  • WO 03/099268 discloses the use of an active substance combination comprising at least one compound selected from a group comprising among others opioids and at least one compound selected from a group comprising among others cizolirtine for the preparation of a drug for the treatment of urinary urgency or urinary incontinence, whereby said active substance combination is not to have an analgesic effect.
  • the present invention relates to an active substance combination comprising
  • R 1 represents a hydrogen atom, a linear or branched alkyl radical, a linear or branched alkenyl radical, an optionally at least mono-substituted cycloaliphatic radical, which may contain at least one nitrogen atom as ring member, or a phenyl radical,
  • R 2 represents a hydrogen atom, an optionally at least one nitrogen atom as ring member containing cycloaliphatic radical, which may be at least ono-substituted by a linear or branched alkyl radical and/or which may be bound via a linear or branched alkylene group, a NR 3 R 4 -moiety, which is bound via a linear or branched alkylene group, or a NR 5 R 6 -moiety, which is bound via a linear or branched alkylene group,
  • R 3 and R 4 identical or different, represent a linear or branched alkyl radical or an unsubstituted benzyl radical
  • R 5 and R 6 together with the bridging nitrogen atom represent a saturated, unsubstituted, optionally at least one further heteroatom as ring member containing heterocyclic radical
  • X represents an optionally at least mono-substituted phenyl radical or an optionally at least mono-substituted thienyl radical, wherein in each case the substituents are selected from the group consisting of a linear or branched alkyl radical, a linear or branched alkoxy group, a linear or branched alkyl radical, which is at least partially halogenated or a halogen atom,
  • Y represents a heteroaryl radical, which contains one or more nitrogen atoms as ring members and which is unsubstituted or at least mono-substituted by one or more substitutents independently from one another selected from the group consisting of a halogen atom, a linear or branched alkyl radical, an unsubstituted benzyl radical, a ciano group bound via a linear or branched d -4 -alkylene group, a carboxy group bound via a linear or branched C ⁇ -4 -alkylene group, a methoxy carbonyl group bound via a linear or branched C ⁇ - 4 -alkylene group, a hydroxy group bound via a linear or branched C ⁇ - -alkylene group, an amino group bound via a linear or branched C ⁇ - - alkylene group, a (C ⁇ - ) dialkylamino group bound via a linear or branched C 1 - 4 - alkylene group
  • the inventive active substance combination comprises one or more substituted carbinol compounds of general formula I given above, wherein R 3 and R 4 , identical or different, independently from one another represent a linear or branched C ⁇ -4 alkyl radical or an unsubstituted benzyl radical, preferably a linear or branched d -4 alkyl radical, and the remaining substituents R 1 , R 2 , R 5 , R 6 , X and Y have the meaning given above, optionally in form of one of its stereoisomers, preferably enantiomers or diastereomers, its racemate or in form of a mixture of at least two of its stereoisomers, preferably enantiomers and/or diastereomers, in any mixing ratio, or a corresponding salt thereof, or a corresponding solvate.
  • R 3 and R 4 identical or different, independently from one another represent a linear or branched C ⁇ -4 alkyl radical or an unsubstituted benzyl radical, preferably
  • the active substance combination according to the present invention comprises one or more substituted carbinol compounds of general formula I given above, wherein R 5 and R 6 together with the bridging nitrogen atom represent a saturated, unsubstituted, optionally at least one oxygen atom as ring member containing, 5- or 6-membered heterocyclic radical, and the remaining substituents R 1 - R 4 , X and Y have the meaning given above, optionally in form of one of its stereoisomers, preferably enantiomers or diastereomers, its racemate or in form of a mixture of at least two of its stereoisomers, preferably enantiomers and/or diastereomers, in any mixing ratio, or a corresponding salt thereof, or a corresponding solvate.
  • the active substance combination according to the present invention comprises one or more substituted carbinol compounds of general formula I given above, wherein X represents an optionally at least mono-substituted phenyl radical or an optionally at least mono-substituted thienyl radical, wherein in each case the substituents are independently selected from the group consisting of a linear or branched C ⁇ - alkyl radical, a linear or branched C 1 - 4 alkoxy radical, a linear or branched C 1 - 4 alkyl radical, which is at least partially fluorinated, a fluorine atom, a chlorine atom and a bromine atom, preferably an optionally at least mono-substituted phenyl radical or an optionally at least mono-substituted thienyl radical, wherein in each case the substituents are independently selected from the group consisting of a methyl radical, a methoxy radical, a trifluoromethyl radical, a fluorine atom
  • the active substance combination according to the present invention comprises one or more substituted carbinol compounds of general formula I, wherein Y represents an azole radical selected from the group consisting of
  • R 7 represents a linear or branched C- ⁇ - 12 alkyl radical, a benzyl radical or a radical of the type:
  • n 1 or 2
  • R 8 represents a hydrogen atom, a methyl radical or a halogen atom, preferably a hydrogen atom, a methyl radical, a bromine atom or a chlorine atom,
  • R 9 represents a hydrogen atom, a C 1 - 1 2 alkyl radical, a benzyl radical or a radical of the general formula (b1 ): 10 -(CH 2 ) n -
  • R 10 represents a piperidinyl radical, a phenyl radical, a cyano group, a hydroxyl radical, a carboxy radical, an amino group, a dimethylamino group or a methyl ester group,
  • R 1 -R 6 and X have the meaning given above, optionally in form of one of its stereoisomers, preferably enantiomers or diastereomers, its racemate or in form of a mixture of at least two of its stereoisomers, preferably enantiomers and/or diastereomers, in any mixing ratio, or a corresponding salt thereof, or a corresponding solvate.
  • inventive active substance combination comprises one or more substituted carbinol compounds of general formula I given above, wherein
  • R 1 represents a hydrogen atom; a linear or branched C 1 - 4 alkyl radical; a linear or branched C 2-4 alkenyl radical; a 5-or 6-membered cycloaliphatic radical, which may contain 1 or 2 nitrogen atoms as ring member(s) and/or which may be substituted by 1 , 2, 3 or 4 linear or branched C ⁇ -4 alkyl radicals that may be identical or different; or a phenyl radical;
  • R 2 represents a hydrogen atom; an optionally 1 , 2 or 3 nitrogen atom(s) as ring member(s) containing, 5- or 6-membered cycloaliphatic radical, which may be substituted by 1 , 2, 3 or 4 linear or branched C ⁇ -4 -alkyl radical that may be identical or different and/or which may be bound via a linear or branched d -4 -alkyl radical; a NR 3 R 4 -moiety, which is bound via a linear or branched d -4 alkylene group; or a NR 5 R 6 -moiety, which is bound via a linear or branched C ⁇ -4 alkylene group;
  • R 3 and R 4 identical or different, independently from one another represent a linear or branched C 1 - 4 alkyl radical; or an unsubstituted benzyl radical;
  • R 5 and R 6 together with the bridging nitrogen atom represent a saturated, unsubstituted, optionally one oxygen atom as ring member containing, 5- or 6- membered heterocyclic radical;
  • X represents a phenyl radical, which may be substituted with 1 , 2, 3, 4 or 5 substituents or a thienyl radical, which may be substituted with 1 , 2 or 3 substituents, wherein in each case the substituents may be independently selected from the group consisting of a linear or branched C ⁇ -4 alkyl radical, a linear or branched C ⁇ -4 alkoxy radical, a linear or branched C 1 -4 alkyl radical, which is at least partially fluorinated, a fluorine atom, a chlorine atom and a bromine atom; and
  • Y represents an azole radical selected from the group consisting of
  • R 7 represents a linear or branched C 1 - 12 alkyl radical, a benzyl radical or a radical of the type:
  • n 1 or 2
  • R 8 represents a hydrogen atom, a methyl radical or a halogen atom, preferably a hydrogen atom, a methyl radical, a bromine atom or a chlorine atom, 9 b) an imidazole of the general formula
  • R 9 represents a hydrogen atom, a C 1 - 12 alkyl radical, a benzyl radical or a radical of the general formula (b1 ):
  • R 10 represents a piperidinyl radical, a phenyl radical, a cyano group, a hydroxyl radical, a carboxy radical, an amino group, a dimethylamino group or a methyl ester group,
  • the inventive active substance combination comprises one or more substituted carbinol compounds of general formula 1 given above, wherein
  • R 1 represents a hydrogen atom; a linear or branched C 1 - 4 alkyl radical; a vinyl group; a cyclohexyl radical; an N-Methyl-piperidyl radical; or a phenyl radical;
  • R 2 represents a hydrogen atom; an optionally 1 , 2 or 3 nitrogen atom(s) as ring member(s) containing, 5- or 6-membered cycloaliphatic radical, which may be substituted by 1 , 2, 3 or 4 linear or branched C ⁇ _ 4 -alkyl radicals that may be identical or different and/or which may be bound via a linear or branched C ⁇ - 4 -alkyl radical; a NR 3 R 4 -moiety, which is bound via a linear or branched C 1 - 4 alkylene group; or a NR 5 R 6 -moiety, which is bound via a linear or branched d- 4 alkylene group;
  • R 3 and R 4 identical or different, independently from one another represent a linear or branched C 1 - 4 alkyl radical
  • R 5 and R 6 together with the bridging nitrogen atom represent a saturated, unsubstituted, optionally one oxygen atom as ring member containing, 5- or 6- membered heterocyclic radical;
  • X represents a phenyl radical that may be substituted with 1 , 2, 3, 4 or 5 substituents or a thienyl radical that may be substituted with 1 , 2 or 3 substituents, wherein in each case the substituents may be independently selected from the group consisting of a methyl radical, a methoxy radical, a trifluoromethyl radical, a fluorine atom, a chlorine atom and a bromine atom;
  • Y represents an azole radical selected from the group consisting of
  • R 7 represents a linear or branched d- 12 alkyl radical, a benzyl radical or a radical of the type:
  • n 1 or 2
  • R 8 represents a hydrogen atom, a methyl radical or a halogen atom, preferably a hydrogen atom, a methyl radical, a bromine atom or a chlorine atom,
  • R 9 represents a hydrogen atom, a C 1 - 12 alkyl radical, a benzyl radical or a radical of the general formula (b1):
  • R 10 represents a piperidinyl radical, a phenyl radical, a cyano group, a hydroxyl radical, a carboxy radical, an amino group, a dimethylamino group or a methyl ester group,
  • R 1 represents a hydrogen atom, a methyl radical, an ethyl radical, an n-propyl radical, an iso-propyl radical, a sec-butyl radical, a tert-butyl radical, an n-butyl radical, a vinyl radical, a cyclohexyl radical, an N-methyl-piperidinyl group, or a phenyl group,
  • R 2 represents a hydrogen atom, a dimethylaminoethyl group, a pyrrolidin lethyl group, a piperidinylethyl group, a methyl-benzyl-aminoethyl group, a morpholinylethyl group, a diisopropylaminoethyl group, a dimethylaminopropyl group, a piperidinylpropyl group, a pyrrolidinylpropyl group, a morpholinylpropyl group, an N- methyl-2-piperidyl group, an N-ethyl-2-piperidyl group, an N-propyl-2-piperidyl group, an N-methyl-2-pyrrolidinyl group, an N-ethyl-2-pyrrolidinyl group, an N-propyl-2- pyrrolidinyl group, or a 2-dimethylaminoethyl-1 -methyl group,
  • X represents a phenyl radical, a 2-methyl-phenyl radical, a 3-methyl-phenyl radical, a 4-methyl phenyl radical, a 2-chloro-phenyl radical, a 3-chloro-phenyl radical, a 4- chloro-phenyl radical, a 2-fluoro-phenyl radical, a 3-fluoro-phenyl radical, a 4-fluoro- phenyl radical, a 2-trifluoromethyl-phenyl radical, a 3-trifluoromethyl-phenyl radical, a 4-trifluoromethyl-phenyl radical, a 2-methoxy-phenyI radical, a 3-methoxy-phenyl radical, a 4-methoxy-phenyl radical, a 3,4,5-tris-methoxy-phenyl radical, a 3,4- dichloro-phenyl radical, a 2,4-dichloro-phenyIradical, a thien-2-yl radical, a thien
  • Y represents an azole radical selected from the group consisting of
  • R 7 represents a methyl radical, an ethyl radical, an n-propyl radical, an iso-propyl radical, an n-butyl radical, a sec-butyl radical or a tert-butyl radical,
  • R 8 represents a hydrogen atom, a methyl radical, a bromine atom or a chlorine atom
  • R 9 represents a hydrogen atom, a methyl radical, an ethyl radical, an n- propyl radical, an iso-butyl radical, an n-butyl radical, a sec-butyl radical a tert-butyl radical, an n-pentyl radical, an n-hexyl radical, an n-heptyl radical, an n-octyl radical, an n-nonyl radical, an n-decyl radical, an n-undecyl radical an n-dodecyl radical, a benzyl radical, or a radical of the general formula (b1 ):
  • R 10 represents a piperidinyl radical, a phenyl radical, a cyano group, a hydroxyl radical, a carboxy radical, an amino group, a dimethylamino group, or a methyl ester group,
  • the compounds [204], [205], [206] and [207] may be excluded from the afore mentioned group of compounds as component (A).
  • Physiologically acceptable salts of the substituted carbinol compounds of general formula I given above may be obtained by conventional methods known to those skilled in the art.
  • Preferred pharmaceutically acceptable salts of these substituted carbinol compounds of general formula I given above are the citrate salts or the ditoluyltartrate salts.
  • Generally included are also addition salts of mineral acids or of organic acids such as oxalate, tartrate, citrate and hydroquinonesulfate.
  • the term “salt” is to be understood as including any form of an active compound of the inventive active substance combination in which this is present in ionic or charged form and is coupled with a corresponding counter-ion (a cation or anion) or is in solution.
  • the term “salt” further comprises complexes of an active compound of the inventive active substance combination with other ions or molecules, in particular complexes, which are complexed via ionic interactions.
  • physiologically acceptable salt is understood in particular as including a salt that is formed either with a physiologically tolerated acid, that is to say salts of the particular active compound with inorganic or organic acids which are physiologically tolerated - especially if used on humans and/or mammals - or with at least one, preferably inorganic, ion, preferably cation, which are physiologically tolerated, especially if used on humans and/or mammals.
  • physiologically tolerated salts of particular acids are salts of hydrochloric acid, hydrobromic acid, sulfuric acid, methanesulfonic acid, formic acid, acetic acid, oxalic acid, succinic acid, malic acid, tartaric acid, mandelic acid, fumaric acid, lactic acid, citric acid, glutamic acid, 1 ,1-dioxo-1 ,2-dihydro-6-benzo[d]isothiazol-3-one (saccharin acid), monomethylsebacic acid, 5-oxo-proline, hexane-1-sulfonic acid, nicotinic acid, 2-,3- or 4-aminobenzoic acid, 2,4,6-trimethyl-benzoic acid, alpha-lipoic acid, acetylglycine, acetylsalicylic acid, hippuric acid and/or aspartic acid.
  • physiologically tolerated salts of particular bases are salts of alkali and alkaline earth metals and/or with ⁇ NH x R 4 - x ] + -ions, wherein x is 0, 1 , 2, 3 or 4 and R represents a linear or branched d- 4 alkyl radical.
  • salts that are preferred are salts of physiologically tolerated acids.
  • the salt, which is particularly preferred for the particular compound of component A is the citrate.
  • opioid includes substances having affinity for one or more of the opioid receptors such as the ⁇ -opioid receptors, the ⁇ - opioid receptors and/or the ⁇ -opioid receptors.
  • opioids which act as agonists or partial agonists on these receptors as well as mixed agonists/antagonists.
  • Suitable opioids according to component (B) of the inventive pharmacologically active substance combination as well as methods for their preparation are well known to those skilled in the art, e.g. from E. Friderichs, T. Christoph and H. Buschmann, "Analgesics and Antipyretics", UNmann's Encyclopedia of Industrial Chemistry, Sixth Edition, Wiley-VCH Verlag GmbH, Weinheim 2000, pages 27-45.
  • the opioid 14- Methoxymetopon is for example described in the publication of M.A. King et al., Eur. J. of Pharmacology, 459 (2003), 203-209. The respective descriptions are hereby incorporated by reference and form part of the present disclosure, especially as sources for the election of the opioids according to component B of the inventive active substance combination.
  • the inventive active substance combination comprises as component (B) at least one opoid with weak analgesic efficacy, which may preferably be selected from the group consisting of codeine, dextropropoxyphene, dihydrocodeine, diphenoxylate, ethylmorphine, loperamide, meptazinol, nalbuphine, pethidine, tilidine, tramadol, viminol and corresponding physiologically acceptable salts of these compounds.
  • weak analgesic efficacy which may preferably be selected from the group consisting of codeine, dextropropoxyphene, dihydrocodeine, diphenoxylate, ethylmorphine, loperamide, meptazinol, nalbuphine, pethidine, tilidine, tramadol, viminol and corresponding physiologically acceptable salts of these compounds.
  • the active substance combination of the present invention comprises as component (B) an opioid with weak analgesic efficacy
  • the molar ratio of component (B) to component (A) is preferably in the range of 1 :1 to 1 :20, preferably 1 :1 to 1 :10, more preferably 1 :1 to 1 :5.
  • the inventive active substance combination comprises one or more opioid analgesics with medium to strong analgesic efficacy, which may preferably be selected from the group consisting of alfentanil, buprenorphine, butorphanol, dextromoramide, dezocine, diacetylmorphine (heroine), etorphine, fentanyl, hydrocodone, hydromorphone, ketobemidone, levomethadone, levomethadyl acetate, levorphanol, morphine, nalorphine, oxycodone, oxymorphone, pentazocine, piritramide, remifentanil, sufentanil and corresponding physiologically acceptable salts thereof.
  • opioid analgesics with medium to strong analgesic efficacy which may preferably be selected from the group consisting of alfentanil, buprenorphine, butorphanol, dextromoramide, dezocine, diacetyl
  • the active substance combination of the present invention comprises as component (B) an opioid with medium to strong analgesic efficacy
  • the molar ratio of component (B) to component (A) is in the range of 1 :1 to 1 :400, preferably 1 :1 to 1 :200, more preferably 1 :1 to 1 :10, most preferably 1 :1 to 1 :5.
  • Physiologically acceptable salts of the opioid analgesics according to component (B) of the inventive active substance combination are also well known to those skilled in the art and may preferably be selected from the group consisting of hydrochloride, hydrobromide, sulfate, phosphate, tartrate, citrate and acetate. Generally included are addition salts of mineral acids or of organic acids such as oxalate, tartrate, citrate and hydroquinonesulfate. Additionally, the term “salt” is to be understood as including any form of an active compound of the inventive active substance combination in which this is present in ionic or charged form and is coupled with a corresponding counter-ion (a cation or anion) or is in solution. The term “salt” further comprises complexes of an active compound of the inventive active substance combination with other ions or molecules, in particular complexes, which are complexed via ionic interactions.
  • physiologically acceptable salt is understood in particular as including a salt that is formed either with a physiologically tolerated acid, that is to say salts of the particular active compound with inorganic or organic acids which are physiologically tolerated - especially if used on humans and/or mammals - or with at least one, preferably inorganic, ion, preferably cation, which are physiologically tolerated, especially if used on humans and/or mammals.
  • physiologically tolerated salts of particular acids are salts of hydrochloric acid, hydrobromic acid, sulfuric acid, methanesulfonic acid, formic acid, acetic acid, oxalic acid, succinic acid, malic acid, tartaric acid, mandelic acid, fumaric acid, lactic acid, citric acid, glutamic acid, 1 ,1-dioxo-1 ,2-dihydro-6-benzo[d]isothiazol-3-one (saccharin acid), monomethylsebacic acid, 5-oxo-proline, hexane-1 -sulfonic acid, nicotinic acid, 2-,3- or 4-aminobenzoic acid, 2,4,6-trimethyl-benzoic acid, alpha-lipoic acid, acetylglycine, acetylsalicylic acid, hippuric acid and/or aspartic acid.
  • physiologically tolerated salts of particular bases are salts of alkali and alkaline earth metals and/or with ⁇ NH x R 4 - ⁇ ] + -ions, wherein x is 0, 1 , 2, 3 or 4 and R represents a linear or branched d- 4 alkyl radical.
  • the active substance according to component (B) and/or the active substance according to component (A) of the inventive active substance combination may each also be present in form of mixture of two or more different salts.
  • both components may at least partially form a salt with one another.
  • These salts may be prepared according to conventional methods well known to those skilled in the art, e.g. by dissolution of both components in a suitable solvent and subsequent evaporation of the solvent.
  • component (A) and component (B) are at least partially present in form of a salt formed between these two components.
  • the inventive active substance combination is suitable for the administration to humans, including infants, children and grown-ups, as well as animals.
  • the total amount of the active substance(s) according to component (A), calculated as the free compound(s), to be administered to the patient in a 24 hours period does not exceed 800 mg.
  • the total amount of the active substance(s) according to component (B), calculated as the free compound(s), to be administered to the patient in a 24 hours period does not exceed 200 mg.
  • the inventive active substance combination comprises components (A) and (B) in the above defined molar ratios and within the afore given limits for the maximum dosis to be administered per day.
  • Pharmaceutically active substances may be the subject of abuse.
  • a certain dose of an opioid active substance is usually more potent when administered parenterally, particularly intravenously, compared to the same dose being administered orally. Consequently, a common mode of abuse for an oral pharmaceutical formulation comprising an opioid active substance includes the extraction of the opioid from the formulation with subsequent intravenous injection.
  • the active substance combination further comprises as component (C) one or more agents that are suitable to reduce or even prevent abuse of the active substances of component (A) and/or component (B).
  • anti-abuse agents are present in the inventive active substance combination, they are included in such a form that they are either not liberated at all or in such a way that they do not develop their anti-abuse effect if the active substance combination is administered to the patient according to its intended route of administration.
  • inventive active substance combination or - after separation - one of its components alone is administered via a route other than the intended route of administration, said anti-abuse agent will exert its effect and therefore reduce or even prevent abuse.
  • Agents that are particularly suitable for the reduction or prevention of opioid abuse are, for example, opioid antagonists, which have little or no effect if taken orally, but which will block the effect of the opioid if administered parenterally together with the opioid after extraction.
  • Suitable opioid antagonists may preferably be selected from the group consisting of levallorphan, naloxone, naltrexone and corresponding physiologically acceptable salts thereof.
  • anti-abuse agents include aversive agents such as bittering agents, irritants, emetics and/or nauseants as well as gelli ng agents.
  • the kinds and amounts of the anti-abuse agents used as component (C) in the inventive active substance combination as well as their mode of formulation together with components (A) and/or (B) depend on the kind of abuse that is to be reduced or prevented, e.g. parenteral, intranasal or oral misuse.
  • Different modes of formulations and/or different anti-abuse agents from the same class or from different classes may be used to reduce or eliminate more than one kind of abuse, e.g. the inventive active substance combination may comprise one agent suitable for the reduction or prevention of parenteral abuse and one agent suitable for the reduction or prevention of nasal abuse.
  • Suitable opioid antagonists according to component (C) of the inventive substance combination as well as methods for their preparation are well known to those skilled in the art, e.g. from E. Friderichs, T. Christoph and H. Buschmann, "Analgesics and Antipyretics", UNmann's Encyclopedia of Industrial Chemistry, Sixth Edition, Wiley- VCH Verlag GmbH, Weinheim 2000, pages 45-47.
  • Opioid antagonists as well as other anti-abuse agents suitable for reduction or prevention of different ways of abuse of active substances, suitable amounts and methods for their incorporation into pharmaceutical formulations are also known to those skilled in the art from EP 1 201 233, WO03/013476 and WO 99/32120.
  • the present invention relates to a medicament comprising an inventive active substance combination and optionally at least one further active substance and/or optionally at least one auxiliary substance.
  • the inventive medicament is suitable for the treatment of pain, particularly for the treatment of pain selected from the g roup consisting of neuropathic pain, acute pain, chronic pain, post-operative pain, chronic lower back pain, cluster headaches, herpes neuralgia, phantom limb pain, central pain, dental pain, resistant pain, visceral pain, surgical pain, bone injury pain, pain during labor and delivery, pain resulting from burns, pain resulting from sunburns, post partum pains, migraine, angina pain, genitourinary tract-related pain . pain from cystitis and nociceptive pain.
  • the inventive medicament is suitable for the prophylaxis and/or treatment of urinary incontinence.
  • the inventive medicament is also suitable for the prophylaxis and/or treatment of neurogenic inflammation.
  • components (A) and (B) of the active substance combination according to the present invention may be administered simultaneously or sequentially to one another, whereby in each case components (A) and (B) may be administerd via the same or different administration pathways, e.g. orally or parenterally. preferably both components (A) and (B) are administered simultaneously in one and the same administration form.
  • Another aspect of the present invention relates to the use of an inventive pharmacologically active substance combin ation for the preparation of a medicament for the treatment of pain, preferably for the treatment of pain selected from the group consisting of neuropathic pain, acute pain, chronic pain, post-operative pain, chronic lower back pain, cluster headaches, herpes neuralgia, phantom limb pain, central pain, dental pain, resistant pain, visceral pa in, surgical pain, bone injury pain, pain during labor and delivery, pain resulting from burns, pain resulting from sunburns, post partum pains, migraine, angina pain, genitourinary tract-related pain, pain from cystitis and nociceptive pain.
  • a further aspect of the present invention is the use of an inventive active substance combination for the preparation of a medicament for the prophylaxis and/or treatment of urinary incontinence.
  • Yet another aspect of the present invention is the use of an inventive active substance combination for the
  • a further aspect of the present invention relates to pharmaceutical formulations in different pharmaceutical forms comprising an inventive active substance combination and optionally at least one further active substance and/or optionally at least one auxiliary substance.
  • inventive pharmaceutical formulation is suitable for oral or parenteral administration, more preferably for oral, intravenous, intraperitoneal, intramuscular, subcutaneous, intrathekal, rectal, transdermal, transmucosal or nasal administration.
  • Inventive pharmaceutical formulation for oral administration are preferably selected from the group consisting of tablets, dragees, capsules, drops, gels, juices, sirups, solutions and suspensions.
  • the pharmaceutical formulation of the present invention for oral administration may also be in the form of multiparticulates, preferably pellets or granules, optionally compressed into a tablet, filled into a capsule or suspended in a suitable liquid. Suitable liquids are known to those skilled in the art.
  • the respective pharmaceutical formulations may - depending on their route of administration - also contain one or more auxiliary substances known to those skilled in the art.
  • the pharmaceutical formulations according to the present invention may be produced according to standard procedures known to those skilled in the art, e.g. from the tables of contents from ..Pharmaceutics: the Science of Dosage Forms", Second Edition, Aulton, M.E. (Ed.) Churchill Livingstone, Edinburgh (2002); Encyclopedia of Pharmaceutical Technology", Second Edition, Swarbrick, J. and Boylan J.C. (Eds.), Marcel Dekker, Inc. New York (2002); constructiveModern Pharmaceutics", Fourth Edition, Banker G.S. and Rhodes C.T. (Eds.) Marcel Dekker, Inc. New York 2002 and prevalentThe Theory and Practice of Industrial Pharmacy", Lachman L, Lieberman H. and Kanig J. (Eds.), Lea & Febiger, Philadelphia (1986).
  • the respective descriptions are incorporated by reference and are part of the present disclosure.
  • the pharmaceutical formulation comprises one or both of the components (A) and (B) at least partially in a sustained- release form.
  • the inventive pharmaceutical formulation comprises component (B) at least partially in a sustained-release form.
  • Suitable sustained-release forms as well as materials and methods for their preparation are known to those skilled in the art, e.g. from the tables of contents from legitimateModified-Release Drug Delivery Technology", Rathbone, M.J. Hadgraft, J. and Roberts, M.S. (Eds.), Marcel Dekker, Inc., New York (2002); dominantHandbook of Pharmaceutical Controlled Release Technology", Wise, D.L. (Ed.), Marcel Dekker, Inc. New York, (2000);”Controlled Drug Delivery", Vol. I, Basic Concepts, Bruck, S.D. (Ed.), CRC Press Inc., Boca Raton (1983) and from Takada, K.
  • the pharmaceutical formulation according to the present invention comprises at least one of the components (A) and (B) at least partially in a sustained-release form
  • said sustained release may preferably be achieved by the application of at least one coating or provision of a matrix comprising at least one sustained-release material.
  • the sustained-release material is preferably based on an optionally modified, water- insoluble, natural, semisynthetic or synthetic polymer, or a natural, semisynthetic or synthetic wax or fat or fatty alcohol or fatty acid, or on a mixture of at least two of these afore mentioned components.
  • the water-insoluble polymers used to produce a sustained-release material are preferably based on an acrylic resin, which is preferably selected fro the group of poly(meth)acrylates, particularly preferably poly(C ⁇ - 4 )alkyl (meth)acrylates, poly(C ⁇ - 4 )dialkylamino(C ⁇ - 4 )alkyl (meth)acrylates and/or copolymers or mixtures thereof, and very particularly preferably copolymers of ethyl acrylate and methyl methacrylate with a monomer molar ratio of 2:1 (Eudragit NE30D ® ), copolymers of ethyl acrylate, methyl methacrylate and trimethylammonium ethyl methacrylate- chloride with a monomer molar ratio of 1 :2:0.1 (Eudragit RS ® ), copolymers of ethyl acrylate, methyl methacrylate and trimethylammonium ethyl methacryl
  • coating materials are commercially available as 30 wt.% aqueous latex dispersions, i.e. as Eudragit RS30D ® , Eudragit NE30D ® or Eudragit RL30D ® , and may also be used as such for coating purposes.
  • the sustained-release material is based on water-insoluble cellulose derivatives, preferably alkyl celluloses, particularly preferably ethyl cellulose, or cellulose esters, e.g. cellulose acetate.
  • alkyl celluloses particularly preferably ethyl cellulose, or cellulose esters, e.g. cellulose acetate.
  • Aqueous ethyl cellulose dispersions are commercially available, for example, under the trademarks Aquacoat ® or Surelease ® .
  • the sustained- release material may be based on carnauba wax, beeswax, glycerol monostearate, glycerol monobehenate, glycerol ditripalmitostearate, microcrystalline wax, cetyl alcohol, cetylstearyl alcohol or a mixture of at least two of these com ponents.
  • the afore mentioned polymers of the sustained-release material may also comprise a conventional, physiologically acceptable plasticizer in amounts know n to those skilled in the art.
  • plasticizers are lipophilic diesters of a C 6 -C 40 aliphatic or aromatic dicarboxylic acid and a Ci-Cs aliphatic alcohol, e.g. dibutyl phthalate, diethyl phthalate, dibutyl sebacate or diethyl sebacate, hydrophilic or lipop ilic citric acid esters, e.g. triethyl citrate, tri butyl citrate, acetyltri butyl citrate or acetyltriethyl citrate, polyethylene glycols, propylene glycol, glycerol esters, e.g. triacetin, Myvacet ®
  • Aqueous dispersions of Eudragit RS ® and optionally Eudragit RL ® preferably contain triethyl citrate.
  • the sustained-release material may comprise one or more plasticisers in amounts of, for example, 5 to 50 wt.% based on the amount of polymer(s) used.
  • the sustained-release material may also contain other conventional auxiliary substances known to those skilled in the art, e.g. lubricants, coloured pigments or surfactants.
  • the pharmaceutical formulation of the present invention may also comprise at least one of the components (A) and (B) covered by an enteric coating form which dissolves as a function of pH. Because of this coating, part or all of the pharmaceutical formulation can pass through the stomach undissolved and the components (A) and/or (B) are only released in the intestinal tract.
  • the enteric coating preferably dissolves at a pH of between 5 and 7.5.
  • the enteric coating may be based on any enteric material known to those skilled in the art, e.g. on methacrylic acid/methyl methacrylate copolymers with a monomer molar ratio of 1 :1 (Eudragit L ® ), methacrylic acid/methyl methacrylate copolymers with a monomer molar ratio of 1 :2 (Eudragit S ® ), methacrylic acid/ethyl acrylate copolymers with a monomer molar ratio of 1 :1 (Eudragit L30D-55 ® ), methacrylic acid/methyl acrylate/methyl methacrylate copolymers with a monomer molar ratio of 7:3:1 (Eudragit FS ® ), shellac, hydroxypropyl methyl cellulose acetate-succinates, cellulose acetate-phthalates or a mixture of at least two of these components, which can optionally also be used in combination with the above-mentione
  • the coatings of the pharmaceutical formulations of the present invention may be applied by the conventional processes known to those skilled in the art, e.g. from Johnson, J.L., ..Pharmaceutical tablet coating", Coatings Technology Handbook (Second Edition), Satas, D. and Tracton, A.A. (Eds), Marcel Dekker, Inc. New York, (2001 ), 863-866; Carstensen, T., possiblyCoating Tablets in Advanced Pharmaceutical
  • the pharmaceutical formulation of the present invention contains one or both of components (A) and (B) not only in sustained-release form, but also in non-retarded form.
  • a high initial dose can be achieved for the rapid onset of the beneficial effect.
  • the slow release from the sustained release form then prevents the beneficial effect from diminishing.
  • Such a pharmaceutical formulation is particularly useful for the treatment of acute health problems.
  • a pharmaceutical formulation having at least one immediate-release coating comprising at least one of the components (A) and (B) to provide for rapid onset of the beneficial effect after administration to the patient.
  • the pharmacological efficacy of the opioid component is enhanced by their administration in combination with one or more substituted carbinol compounds of general formula I given above.
  • the dose of the opioid may be reduced and fewer, less pronounced to none undesired side effects occur and the risk of tolerance development is reduced, while the analgesic efficacy is at least maintained.
  • the analgesic activity of the inventive active substance combination is determined in male Swiss mice (weight 20-25 g, Harlan Iberica, S. Feliu de Codinas, Barcelona, Spain) as described in the publication of G. Woolfe and A. D. MacDonald, J. Pharm. Exp. Ther. 1944, 80, pages 300-307. The respective description of this publication is incorporated by reference and forms part of the present disclosure.
  • mice are put onto a plate, which is heated to 55 °C and the time is determined until the mice show signs of pain such as vigorous and repeated licking of the paws, jumping or pulling back the paws.
  • the mice are kept on the hot plate for no longer than 40 seconds in order to avoid the development of cutaneous lesions.
  • the untreated mice are subjected to the hot-plate test to determine a baseline for their pain induced behaviour.
  • the active substances and the inventive active substance combination to be tested are administered to different groups of mice. 0.5 hours, 1 hour and 2 hours after the administration the animals are put onto the hot plate and the time is measured until they show signs of pain.
  • the analgesic efficacy of the active substances or active substance combination is calculated on the basis of the values obtained for the comparison group of mice which is only administered the vehicle.
  • Opioid dependency is delevoped in the mice by intraperitoneal administration of the opioid in a suitable dose known to those skilled in the art, e.g. 5 mg/kg/day for 4 consecutive days for morphine. Withdrawal symptoms are then induced by the intravenous administration of a suitable opioid antagonist in a dose known to those skilled in the art, for example, 2 mg/kg naloxone in case of morphine, 30 minutes after the administration of the final dose of the opioid is completed.
  • mice show typical withdrawal symptoms, namely jumps and shakes (of the wet dog shake type), which are counted and registered.
  • the active substance comination is also administered to the mice for 4 consecutive days. After the administration of 2 mg/kg naloxone 30 minutes after the administration of the final dose of the active substance combination has been completed, the mice are closely watched for withdrawal symptoms, namely jumps and shakes (of the wet dog shake type), which are then counted and registered.
  • analgesic efficacy of an inventive active substance combination comprising as component (A) the compound (+)-5-[ ⁇ -[2-(Dimethylamino)ethoxy]benzyl]-1-methyl- 1 H-pyrazole citrate (hereinafter Cizolirtine Citrate) and as component (B) Morphine in mice has been determined as described above and compared to the administration of vehicle, Cizolirtine Citrate and Morphine alone.

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EP05732430A 2004-04-05 2005-04-05 Zusammensetzung aus aktiva mit einer carbinolverbindung und einem opioid Withdrawn EP1755678A2 (de)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
ES200400836A ES2245226B1 (es) 2004-04-05 2004-04-05 Combinacion de substancias activas.
ES200402102 2004-08-27
US10/953,432 US20050222135A1 (en) 2004-04-04 2004-09-29 Active substance combination
PCT/EP2005/003862 WO2005097192A2 (en) 2004-04-05 2005-04-05 Active substance combination of a carbinol compound and an opioid

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WO2007017127A2 (en) * 2005-07-29 2007-02-15 Laboratorios Del Dr. Esteve, S.A Controlled realease dosage form of pirazole compounds to treat urinary incontinence
WO2009005460A1 (en) * 2007-06-29 2009-01-08 Astrazeneca Ab Small molecule inhibitors of navl.7 sodium channels for the treatment of pain disorders
EP2014288A1 (de) * 2007-07-10 2009-01-14 Laboratorios del Dr. Esteve S.A. Kombination aus einem Benzyl-4,5-Dihydro-1H-Imidazol-Derivat und einem Opioid-Rezeptorliganden
ES2350439B1 (es) * 2007-07-10 2011-10-17 Laboratorios Del Dr. Esteve, S.A. Combinacion de un derivado del bencil-4,5-dihidro 1h-imidazol y un receptor opioide.

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GB850298A (en) * 1956-10-30 1960-10-05 Maggioni & C Societa Per Azion ª‡,ª‡[(p-chlorophenyl)-(4-pyridyl)] carbinols and method of preparing same
FR2613720B1 (fr) * 1987-04-10 1990-01-19 Esteve Labor Dr Derives d'aryl-heteroaryl carbinols avec activite analgesique
ES2130083B1 (es) * 1997-08-04 2000-01-16 Esteve Labor Dr Procedimiento para la obtencion de los enantiomeros de cizolirtina.
DE10224107A1 (de) * 2002-05-29 2003-12-11 Gruenenthal Gmbh Kombination ausgewählter Opioide mit anderen Wirkstoffen zur Therapie der Harninkontinenz

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