IE56451B1 - Pharmaceutical compositions for treating androgen-related disorders in humans - Google Patents

Abstract

A method of treating androgen-related disorders in an animal which comprises administering to the animal dihydrotestosterone level decreasing amounts of a compound of formula (I): wherein R is H or F; R1 is selected from the group consisting of -H; straight or branched chain lower alkyl hydroxyl; -OCOR3; and O~(C^-Cg alkyl); wherein R3 is -H, cl*c10 straight or branched chain alkyl group, phenyl, phenyl alkylene having straight or branched chain C|-Cg alkylene, cycloalkyl or C^-Cxq cycloalkyl' alkylene; R2 is h2/ methylene, ethylidene, a-CH3(H), βCH3(H), a-(OH)(H) or the acetonide derived from the 16a,17a-dihydroxy derivative, and n is 1 or 2.

Description

This invention relates to pharmaceutical compositions useful for the treatment of androgen-related disorders in humans.

Considerable experimental evidence exists supporting the conclusion that the 5a-reduced metabolite of testosterone (II), 5a-dihydrotestosterone (III) is the active form of the androgenic hormone responsible for eliciting somatic androgenic effects, and that testosterone (II) is, de facto, a prohormone tcG for fe& V* -3example, Gloyna, R.E. and Wilson, J.D., J. Clin.

Endocrinol. 29:970(1969); Mainwaring, W.I.P., Mangan, F.R., Wilce, P.A. and Melroy, E.G.P., Advances in Experimental Medicine and Biology, 36:197(1973); Liao, S., International Review of Cytology, 41:87(1975)3« It is consequently generally accepted that androgen-related disorders stem from excessive production of dihydrotestosterone in the body. Such androgen-related disorders include acne oily skin seborrhea androgenic alopecia hirsutism androgen-dependent prostatic cancer prostatic hypertrophy and virilism.

It follows that treatment, or palliative treatment in the case of prostatic carcinoma, of these disorders may be effected by inhibiting the conversion of (II) into (III).

The conversion of testosterone (II) into dihydrotestosterone (III) in the body is effected by the NADPH-dependent enzyme 5a-reductase. Treatment of androgen-related disorders may thus be achieved by inhibiting the enzyme 5«-reductase. This fact is welldocumented in the literature (cf. for example, U.S.P. 3,917,029; U.S.P. 4,008,760). Progesterone appears to be a preferred substrate for the enzyme (cf. for example, Voight, W., Fernandez, E.P. and Hsia, S.L*, J. Biol. -4Chem. 245:5594(1970)), and is well-known to be a reversible and competitive inhibitor of the enzyme. It is therefore not surprising that progesterone has been used to counteract excessive dihydrotestosterone production. Thus topical administration of a 0o5% solution of progesterone in aqueous ethanol caused an important decrease in sebum secretion in 45/53 males with acne (cf. Vermorken, a.j.m. and Jouben, Drug.

Intel, Clin. Pharm., 12:151-157(1978)1. A pro-drug form of progesterone is claimed in Bodor, N.S. and Sloan, K.B., U.S.P. 4,213,978/1980, as useful in the treatment of acne and seborrhea. Progesterone strongly inhibits the enzyme in cell-culture preparations of human prostate thereby inhibiting growth of the tissue [Sandberg, A., U.I.C.C. Technical Report Series 48:165(1979), see also Massa, R. and Martini, L., Gynec. Invest. 2:253(1971/2)]. Inhibition of the conversion of testosterone to dihydrotestosterone by progesterone in preparations of human benign prostatic hypertrophic tissue has been reported by Tau, S.Y., Antonpillai, I. and Pearson Murphy, B.E. [J. Clin. Endocrinol. Metab. 39:936(1974)]. However, the value of progesterone as an inhibitor of Sa^reductase, and hence as a therapeutic agent in the treatment of androgen-related disorders, is limited by the following:(i) It is a competitive (reversible) inhibitor of a -5the enzyme. It is now widely recognized that an irreversible inhibitor offers a distinct advantage over a reversible inhibitor in that it can induce prolonged inactivation of the enzyme and combat the effects of physiological dilution (cf- for example, Shaw, E-, in Enzyme Inhibitors as Drugs, Ed. Sandler, M-, MacMillan Press, pe 25, 1980]; (ii) It undergoes metabolism in the body to androstenedione and other androgenic metabolites and is thus unsuitable for systemic administration.

A need therefore exists for progesterone derivatives which are irreversible inhibitors of the enzyme 5areductase.

It is therefore an object of the invention to provide pharmaceutical compositions for the treatment of androgenrelated disorders, in humans which comprises 5a-testosterone decreasing amounts of a compound of the Formula (I) wherein R is H or F R' is selected from the group consisting of -H; straight or branched chain lower alkyl; hydroxyl; -OCOR^ and O-CC^-Cg alkyl); wherein is -H, C^-C^q straight or branched chain alkyl group, phenyl, phenyl alkylene having straight or branched chain C^-Cg alkylene, Cg* c10 cycloalkyl or Cg-C10 cycloalkylalkylene; R2 is H2' methylene, ethylidene, a-CH3(H), 0a(OH)H, or the acetonide derived from the 16a*17a-dihydroxy derivative, and n is 1 or 2 together with an inert pharmaceutically acceptable carrier. -7FIGURE I shows the time course of inactivation of 5a-reductase following incubation of the enzyme with NADPH and 17a-acetoxy-6-methyleneprogesterone; see Example 2.

FIGURE 2 demonstrates that the inactivation of the enzyme 5a-reductase follows saturation kinetics, since the plot of the rate constants (as Tb 's) versus 1/[Inhibitor] is linear; see Example 2.

As used herein the term androgen-related disorder is intended to mean any disease or condition resulting from overproduction of dihydrotestosterone in the body including acne, oily skin, seborrhea, androgenic alopecia, hirsutism, virilism, androgen-dependent prostatic carcinoma and benign prostatic hypertrophy.

For a more detailed description of these conditions, see for example Harrison's Principles of Internal Medicine, 9th Edition, McGraw Hill, 1980, Volume 1, pp. 227-229 (hirsutism, virilism), volume 1, pages 242-243 (acne), volume 2, pages 1771-1772 (cancer of the prostate ).

It is the object of this invention to provide pharmaceutical preparations of the steroids ot' formula -8(I) which can be administered to a patient suffering from an androgen-related disorder; this novel method of treatment offers considerable advantages over prior art, for example over estrogen therapy, in that it is free from deleterious side effects such as estrogenizationThe compounds used in the invention have the formula (I): wherein R is H or F; R’ is H; lower alkyl containing from 1 to 6 carbon atoms, which may be straight or branched chain such as for example methyl, ethyl, n-propyl, butyl, isobutyl and the like; hydroxyl; OCOR^ wherein R^ may be H, an alkyl moiety containing from 1 to 10 carbon atoms and may be straight or branched chain, such as for example methyl, ethyl, n-propyl, isopropyl, nbutyl, sec-butyl, tert-butyl, n-pentyl, neopentyl, pivalyl, hexyl, heptyl and octyl; phenyl; phenylalkyl (Ph-alkyl-) wherein the alkyl moiety ( ( -9(which may also be referred to as an alkylene moiety) has from 1 to 6 carbon atoms and can be straight or branched chain; cycloalkyl wherein the cycloalkyl moiety has from 5 to 10 carbon atoms such as cyclopentyl-, cyclohexyl-, cycloheptyl, cyclooctyland their alkylene derivatives containing from 6 to 16 carbon atoms such as cyclopentylmethylene ; 0-lower alkyl, wherein the alkyl group has from 1 to 6 carbon atoms and may be straight or branched chain such for example as methyl-, ethyl-, propyl-, iso-propyl-, iso-pentyl, butyl, isobutyl, pentyl? R2 is H2? methylene, ethylidene, a-Me(H), g-Me(H), a(OH)H, and the acetonide derived from the 16a,17adihydroxy derivative? is 1 or 2.

Preferred embodiments of this invention include the following derivatives of 6-Methyleneprogesterone: 17a-acetoxy17a-acetoxy-D-homo17a-acetoxy-21-fluoro17a-acetoxy-21-fluoro-D-homo 17a-caproyloxy17a-caproyloxy-D-homo 17a-caproyloxy-21-f luoro17a-caproyloxy-21-fluoro-D-homo; the 16a-methyl-r 16β-methyl- and 16-methylone and ethylidene derivatives t -XUof the above (when n = 1), 17a-methyl17a-methy 1-D-homo17 α-methy1-21-fluoro17 a-methy1-21-fluoro-D-homo-; the 17a-ethyl analogues of the above and their 16a- and 163-methylderivatives (when n = 1)/ 17a-methoxy17a-methoxy-D-homo17a-methyl -21-fluoro17a-methyl -21-fluoro-D-homo-; the 17a-ethyl analogues of the above and their 16a- and 160-methyl-derivatives (when n=l), 17«-methoxy17a-me thoxy - D-homo17a-methoxy-21-f1uoro17a-methoxy-21-fluoro-D-homo17a-ethoxy17a-ethoxy-D-homo17 α-e thoxy-21-fluoro17a-ethoxy-21-fluoro-D-homo-; the 16a-methyl, 163methyl and 16-methylene and ethylidene derivatives of the above (when n = 1), acetonide from 16a,17a-dihydroxy derivative (when n = 1) acetonide from the 21-fluoro-16a,17a-dihydroxy derivative (when n = 1) and the D-homo analogs of the above 6-methylene progesterone and its 21-fluoro16a-methyl-1121-fluoro-16α-methyl16 3-methyl 21-fluoro-163-methyl and D-homo analogues of the above.

Most of the compounds claimed in this invention are already known in the art. Those that are not known can be readily prepared from the known and appropriate » progesterone derivatives by the Vilsmeier or analogous processes as reported, for example, in the following publications: D. Burn et al, Tetrahedron 20:597(1964) F. Schneider et al, Helv, Chim. Acta 56:2396(1973) M. Muller et al, Helv, Chim. Acta 63:1857(1980) D. Burn et al. Tetrahedron 21:569(1965) D. N. Kirk and V. Petrow, U.S.P. 3,112,305 F. B. Colton, U.S.P. 2,980,711 The Upjohn Co. B.P. 1,271,207.

V. Petron, et al, in Steroids, Vol. 38, No. 2 (08/1981), Pages 121-141, described preliminary IN VITRO experiments to assess the potential activity of the compounds of the present invention as irreversible inhibitors of rat prostatic Δ - 3 - ketosteroid 5a- reductase. No mention is made in said paper of the actual possibility of utilizing the compounds in human therapy, particularly in topical formulations, nor is any useful information given about useful dosages and toxicity.

The compounds employed in the present invention can be administered in various manners to achieve the desired dihydrotestosterone-decreasing effect. The compounds can be administered alone or in the form of pharmaceutical preparations to the patient being treated orally, parenterally or topically.

Topical administration is preferred for acne and seborrhea. The amount of compound administered will vary ( ( -12with the severity of the condition being treated. For oraL and parenteral administration the daily dose will generally be from 0.1 to 50 mg/Kg and preferably from 1 to 30 mg/Kg. Unit dosages for oral or parenteral administration may contain, for example, from 5 to 500 mg of the active ingredient.

For topical administration effective amounts of the compounds of general formula (I) on a percent basis may vary from 0.001% to 5% and preferably from 0.005% to 1%. For topical administration the formulated active ingredient, that is a compound of general formula I, can be applied directly to the site requiring treatment or can be applied to the oral or nasal mucosa. Applicator sticks carrying the formulation can be, for example, in the form of a solution, suspension, emulsion, gel or cream of either the oil-in-water or water-in-oil type, ointment, paste, jelly, paint or powder. Suitable bases for the topical preparation may be of any conventional type such as oleaginous bases, for example, olive oil, cottonseed oil, petrolatum, white petrolatum, mineral oils, silicones, such as dimethyIpolysiloxane, or methylphenyIpolysiloxane, lanolins, polyethyleneglycol, glyceryl monostea rate, me thyIcel lulose and hydroxymethy Ice 1lulose. The topical formulation may contain pharmaceutically acceptable (. -13surfactants, wetting agents, dispersing agents, emulsifiers, penetrants, emollients, detergents, hardeners, preservatives, fillers, antioxidants, perfumes, cooling agents, such as methnol soothing agents, such as camphor, or coloring agents, such as zinc oxide. Aerosol preparations of a solution, suspension or emulsion containing the active ingredient in the form of a finely ground powder can also be employed for topical administration. The aerosol container together with a gaseous or liquified propellant, for example, dichlorofluoromethane, dichlorodifluoromethane with dichlorodifluoroethane, carbon dioxide, nitrogen, or propane with the usual adjuvant such as cosolvent and wetting agents as may be necessary or desirable. The compounds may also be administered in a nonpressurized form such as in a nebulizer or atomizer.

For oral administration the compounds can be formulated into solid or liquid preparations, such as capsules, pills, tablets, troches, powders, solutions, suspensions or emulsions. The compounds can be applied in the form of an aerosol containing finely divided particles of the active ingredient. The solid unit dosage forms can be a capsule which can be of the ordinary gelatin type containing a compound of general formula I and a carrier, for example, lubricants and ( ( -14inert filler such as lactose, sucrose, and corn starch.

In another embodiment the compounds of the general formula I can be tableted with conventional tablet bases such as lactose, sucrose and corn starch in combination with binders such as acacia, corn starch or gelatin, disintegrating agents such as potato starch or aliginic acids and a lubricant such as stearic acid or magnesium stearate.

For parenteral administration the compounds may be administered as injectable dosages of a solution or suspension of the compound in a physiologically acceptable diluent with a pharmaceutical carrier which can be a sterile liquid such a water-in-oil with or without the addition of a surfactant and other pharmaceutically acceptable adjuvants. Illustrative of oils which can be employed in these preparations are those of petroleum, animal, vegetable or synthetic origin, for example, peanut oil, soybean oil and mineral oil. In general, water, saline, aqueous dextrose and related sugar solutions, ethanols and glycols, such as propylene glycol or polyethylene glycol are preferred liquid carriers particularly for injectable solutions.

The compounds can be administered in the form of a depot injection or implant preparation which can be formulated in such a manner as to permit a sustained release of the active ingredient. The active ingredient ( ( 15can be compressed into pellets or small cylinders and implanted subcutaneously or intramuscularly as depot injections or implants. Implants may employ inert materials such as biodegradable polymers and synthetic silicones. For example, Silastic, silicone rubber * manufactured by the Dow-Corning Corporations The compounds of general Formula I in treating acne * and oily skin conditions may be used in combination with other anti-acne preparations, antiseptics, anti-infective agents, keratolytic agents* for example, benzoic acid, resorcinol or salicylic acid, and comedolytic agents, such as, retinoic acid or agents having a retinoic acidlike action, corticoids or other antiinflammatory agents, thioglycolates, ethyl lactate or benzoyl peroxide.

In using the products of this invention, topical administration is preferred for acne and seborrhea. The remaining conditions are preferably treated by sytemic administration. In treating benign prostatic hypertrophy and prostatic carcinoma, improved results are obtained by administering the products of the invention concurrently with megestrol acetate, chlormadinonc acetate, medrogestone or cyproterone acetate at therapeutic dose levels.

Having now generally described this invention, the same will be better understood by reference to certain specific examples ( ( -16Example 1 The compounds of the present invention represent an important advance over progesterone and derivatives thereof since they are irreversible inhibitors of the enzyme 5a-reductase. Employing the assay of IL J. Moore and J. D. Wilson [Methods in Enzymology, Vol. XXXVI, Academic Press, N.Y., Ed. W. O'Malley and G. Hardman, p. 466-474(1975)], it is found that 6-methyleneprogesterone and 17a-acetoxy-6-methyleneprogesterone, for example are equipotent with progesterone as inhibitors of the enzyme. On preincubating the enzyme with 17a-acetoxy-6inethyleneprogesterone and NADPH, diluting tenfold and assaying for 5a-reductase activity, it is surprisingly found, however, that 75% of the enzyme activity is lost. Similar preincubation of the enzyme with progesterone, in striking contrast, does not result in enzyme inactivation. These results are tabulated below, in Tables 1 and 2. Φ c c 0 ••Η u φ z Φ jj ω 4J o w 0} 0 4J a + v> σ» c Φ 6-h e*\e Ό •rt Φ in 0 O ε □ 0 *G C φ Φ -rt •Η CM lu KO ko KO KO w II II II II II II c co c c £ c c •rt \O σ* CO •v o o CM © Ή CM CM • • • • • e o c o, © © e, + 1 + 1 + | + 1 + 1 +1 •rt n o KO r* o 00 KD (*> ^u • • • e • β o n CM CM I φ c Mu MU W «j c ω ω ♦rd w c 4 0 E ♦H in υ jj ♦W ·Η «Τ Ε Ό 1 >1 C Φ N 0 6 c o •rt ω &- c 0 £ to •rt •P C ε K3 0 Ώ •rt in □ +> •rt U • rt £ t; ·· •rt c Φ Φ 0 e M o CM E- **· ’T «φ «φ ffi 1 I 1 1 1 1 A o o o © o o O ι—1 •rt •rt Ή •rt •rt 4 X X X X X X z in in in in in in Φ CO co 00 co co oo X» | 1 1 1 1 | (0 o o o o o O 0 »—t •rt •rt rrt •rt «rt •P X X X X X X (0 m in in in in in Φ o •H X2 ♦H x: c rc CM Q z u 4J X) co co ι l o o X X m in in in I I co co ι I o o <—I ·—I X X m m co o © o •rt <-i £ c X X 0 o KO KO o o •rt •rt 4J 4-» IQ jQ X) □ □ υ υ £ c *rM »» r* Φ Φ 1 1 h tl o © a C4 •rt X X 0 0 m o o m z z 4 ω C ω [u w u c ω E •»u U Φ 0m X Φ uu o Φ A E □ C II £ ( a 18fM ω j cn < φ c o u Φ P (0 Φ σ» o >1 ij u CU -P > 4= ·Η P P •ρ υ 5 < φ >< 4J ν o C 3 ω ό φ p a O I C iA o •P c P o (0 Ό X 3 CU O Q d < •H z Φ Ui Ό cu c f0 υ Φ MJ MJ ω Φ c c 0 •P Ui Φ Φ P P 0 c w Ui P 0 P CU 6 co CTLIA Φ E Ό C P ο ·ρ 0 υ E 3 0 Ό u Φ p cu to (0 ω io υ •P E f—< P θ'» «Τ <*» m ρ os r* o m oo LA LA Φ C Ρ CO 00 00 00 00 00 Φ 1 1 1 1 1 1 Ρ ο ο ο ο Ο ο (0 Ρ Ή Ρ Ρ Ρ Ρ 0 X X X X X X Ρ ιΛ ιΛ ιΑ ιΛ ΙΑ ΙΑ (0 Φ l·· >1 *3* *4· rf *3· Ν 2 1 1 1 1 1 1 C 04 ο ο ο ο ο ο φ d Q »-Μ Ρ Ρ Ρ Ρ •Ρ tf X X X X X X CP Ε 2 ΙΛ ΙΑ ΙΑ ΙΑ ΙΑ ιΑ C LA I © P X LA •P ·— Ui *O (0 c •P P •P •D C o υ φ c o u Φ oo co 00 CO Ρ 1 1 1 1 ω ο ο Ο ο φ Ρ Ρ Ρ Ρ σ> X X X X 0 LA ΙΛ LA LA M CU kO P* k£> LA CO ro oo I © P X LA ' o P X tn T3 c c o P υ E C LA O -p P P ·· Φ U cu rc cu Q tf lA iA in tn II II o P X LO Φ C Ui Φ P w Φ CP u cu X X C C C LO <£> ο ο ο •Ρ ·Ρ •Ρ Ρ Ρ Ρ nJ <0 η) Χ3 Ώ £2 3 3 3 υ υ Ο c C C •Ρ ·Ρ Ρ Γ* ί Φ Φ Φ 1 1 Ui Ui Ui ο ο Οι Οι CU Ρ ρ X X 0 0 Ο ιΛ ΙΑ 2 2 ΓΜ m •O’ No preincubation 5xl0“8 5xl0“4 5x10“ ( ( -19These observations reveal that 17a-acetoxy-6methyleneprogesterone, in striking contrast to progesterone, combines with the enzyme in the presence of the co-factor I4ADPH in an irreversible manner, whilst progesterone inactivation of the enzyme is competitive and reversible.

Example 2 The time course of inactivation of 5a-reductase following incubation of the enzyme with NADPH and 17aacetoxy-6-methyleneprogesterone is shown in Fig. 1.

This time course of inactivation of the enzyme can be seen to follow pseudo first-order kinetics, which is in accord with the postulate that the inhibition invoked by such preincubation exposure is irreversible. When these rate constants are plotted (as the *s) against the reciprocal of the inhibitor concentrations, a straight line is obtained with a positive intercept on the y-axis, indicating a saturation phenomenon (Fig. 2). These data are in accord with the conclusion that the interaction of the inhibitor with the enzyme shows two phases. The first is a reversible combination of the enzyme and inhibitor with a Ki of 1.25 x 10^M. The enzyme-inhibitor complex then undergoes irreversible combination rendering the enzyme inactive. The rate constant for this step (kcaU is 4,8 x 10^ sec1. -20Following are illustrative topical pharmaceutical formulations which may be employed in practicing the present invention: Example 3 Solution 17a-Acetoxy-6-methyleneprogesterone Alcohol Isopropyl Myristate Polyethylene Glycol 400 Purified Water qs ad 0.85 g 78.9 ml .0 g 10.0 g 100. ml Combine the alcohol, isopropyl myristate and polyethylene glycol 400 and dissolve the drug substance therein. Add sufficient purified water to give 100 ml.

Example 4 A Gel 17a-Acetoxy-6-methyleneprogesterone Alcohol Isopropyl Myristate Polyethylene Glycol 400 Carbopol 940 (Carboxypolymethylene) Triethylamine Purified Water qs ad 0.85 g 78.9 ml 5.0 g .0 g 0.75 g qs g Disperse the Carbopol 940 in the isopropyl myristate. To ml of alcohol add 7 ml of purified water and the polyethylene glycol 400 and mix. Combine the two phases and mix until well dispersed. Add sufficient -21triethylamine to give a neutral pH· Dissolve the drug substance in the balance of the alcohol and mix well into the batch. Add and mix sufficiently purified water to provide 85 g of finished product.

Example 5 Applicator Stick 17a-Acetoxy-6-methyleneprogesterone Absolute Alcohol Polyethylene Glycol 400 Isopropy1 Myr i s tate Stearic Acid Sodium Hydroxide Purified Water qs ad 0.85 g 75® ml 10.0 g .0 g 4.3 g 0. 55 g 85. g Combine the absolute alcohol, polyethylene glycol 400 and isopropyl myristate and dissolve the drug substance therein. Add the stearic acid and heat the mixture to about 65°C. Dissolve the sodium hydroxide in a small amount of water, add and mix. Add sufficient water to provide .85 g of finished product. Pour into suitable molds and allow to solidify.

Example 6 Aerosol Foam «-Acetoxy-6-methyleneprogesterone Propylene Glycol Emulsifying Wax NE XIV Dichlorodi f luo route thane: cryfluorane 1.0 96.0 3.0 (20:80) 6.9 g -22Dissolve the drug substance in the propylene glycol. Add the emulsifying wax and heat to approximately 70°C. Stir while cooling to room temperature. Charge a suitable aerosol unit with this concentrate and 6.9 g of dichlorod ifluoromethane:cryofluorane (20:80 ).

Example 7 Topical Cream, Vanishing, o/w 17a-Acetoxy-6-methyleneprogesterone 1.

Stearic Acid 15.

Sorbitan Monostearate 2.

Polyoxyethylene Sorbitan Monostearate 2.3 Propylene Glycol 5.

Methylparaben 0.025% Propylparaben 0.015% Purified Water qs Example 8 Buccal or Sublingual Tablet 17a-Acetoxy-6-methyleneproge sterone 1% Calcium Stearate 1% Calcium Saccharin 0.02% Granular Mannitol qs Mix and compress on a suitable tablet machine to a weight of 0.115 g/tablet.

Example 9 Powder 17tt-Acetoxy-6-methyleneprogesterone, rnicronized 1 Silicon dioxide, anhydrous _ 0.5 Corn starch, Lactose, fine powder aa qs -23Example 10 Oleaginous Ointment 17a-Acetoxy-6-methyleneprogesterone 1 White wax 5 White petrolatum qs 100 Example 11 Absorption Ointment Base 17a-Acetoxy-6-methyleneprogesterone 1 Cholesterol 3 Stearyl alcohol 3 White wax 8 White petrolatum qs 100 Example 12 Water Soluble Ointment Base 17a-Acetoxy-6~methyleneprogesterone 1 Polyethylene glycol 4000 40 Polyethylene glycol 400 qs 100 Example 13 Paste 17a-Acetoxy-6-ine; thyleneprogesterone 1 Starch 25 Zinc oxide 25 White petrolatum qs 100 -24Example 14 Aerosol Foam 17a-Acetoxy-6-methyleneprogesterone Emulsifying wax Stearic acid Stearyl alcohol Diglycol stearate Propylene glycol The following are illustrative pharmaceutical formulations suitable for oral or parenteral administration which may be employed in practicing the present invention: Example 15 Tablet For 15,000 17a-Acetoxy-6-methyleneprogesterone 75. g Lactose 1.216 Kg Corn Starch 0.3 Kg Mix the active ingredient, the lactose and corn starch uniformly. Granulate with 10¾ starch paste. Dry to a moisture content of about 2.5%. Screen through a No. 12 mesh screen. Add and mix the following: Magnesium Stearate 0.015 Kg Corn Starch qs ad 1.725 Kg Compress on a suitable tablet machine to a weight to 0.L15 g/tablet. (' -25Example 16 Soft Gelatin Capsule a-Acetoxy-6-methyleneprogesterone 0.25 Kg Polysorbate 30 0.25 Kg Corn Oil qs ad 25.0 Kg Mix and fill into 50,000 soft gelatin capsules.

Example 17 IM Depot Injection Each 1 ml contains the following: 17a-Acetoxy-6-methyleneprogesterone Anhydrous Chlorobutanol Aluminum Monostearate Peanut Oil qs ad .0 mg 5.0 mg 50.0 mg 1.0 ml Dissolve or disperse the ingredients in the peanut oil.

Example 13 Depot-Implant 17a-Acetoxy-6-methyleneprogesterone 5. mg Dimethylsiloxane 240. mg Catalyst qs Disperse the drug substance in the fluid dimethylsiloxane. Add the catalyst and cast into a suitable monolytic structure.

Alternatively, the drug substance may be enclosed by a precast polydimethylsiloxane envelope.

Alternatively, the drug substance may be dispersed 1 in a suitable amount of hydroxyethyL acrylate ( ( -26subsequently polymerized and cross-linked by the addition of ethylenedimethacrylate, and an oxidizing agent, to yield a 3-dimensional ethylene glycomethacrylate mouldable gel (Hydron).

Example 19 IM Injections A. Oil Type: 17a-Acetoxy-6-methyleneprogesterone BHA, BHT aa Peanut Oil or Sesame Oil qs B. Suspension Type: 17a-Acetoxy-6-methyleneprogesterone Sodium Carboxymethylcellulose Sodium Bisulfite Water for Injection, qs « θ mg 0.01% w/v 1.0 ml . 0 mg 0.5% w/v 0.02% w/v 1.0 ml Example 20 Buccal or Sublingual Tablet a-Acetoxy-6-methyleneprogesterone 1% Calciun Stearate 1% Calcium Saccharin 0.02% Granular Mannitol qs Mix and compress on a suitable tablet machine to a weight of 0.115 g/tablet.

The following formulations are illustrative of pharmaceutical preparations for topical application comprising a compound of general Formula 1 in combination with a keratolytic agent. ( ( -27Dissolve the druy substance in the propylene glycol. Add the emulsifying wax and heat to about 70°C. Stir while cooling to room temperature. Charge a suitable aerosol unit with the concentrate and 6.9 g of dichlorodifluoromcthane: cryfluorane (20:80).

Example 21 AEROSOL FOAM «-Acetoxy-6-methyleneprogesterone Resorcinol Alcohol Isopropyl myristate Polyethylene glycol 400 Carbopol 940 (carboxypolymethylene) Triethylamine Purified water qs ad % yj/w 0.85 g 0.85 g 78.9 ml 5.0 g .0 g 0.75 g qs Disperse the Carbopol 940 in the isopropyl myristate. To 38 ml of alcohol add 7 ml of purified water and the polyethylene glycol 400 and mix. Combine the two phases and mix until well dispersed. Adil sufficient triethylamine to give a neutral pH. Dissolve the drug ( ( -28substance and the resorcinol in the balance of the alcohol and mix well into the batch. Add and mix sufficient purified water to provide 35 g of finished product.

Having now fully described this invention, it will be understood that the same can be practiced within a wide range of equivalent composition and administration values without affecting the scope or spirit of the invention or any embodiment thereof.

Claims (5)

1. 2 12. The pharmaceutical composition of Claim 1 wherein R=H, R =0Ac, R is fj-Me(H) and n=l. 13. The pharmaceutical composition of Claim 1 wherein R=H, R^OAc, R 2 is =H2 and n=2. 14. The pharmaceutical composition of Claim 1 wherein R=R^=H, R 2 is =H 2 and n=2. 15. A pharmaceutical composition for topical application to the skin of a patient suffering from an androgen-related disorder which comprises 5adihydrotestosterone level decreasing amounts of a compound of the formula: wherein R is H or F; is selected from the group consisting of -H; straight (' -32or branched chain lower alkyl; hydroxyl; -QCOR^ and O-(C^-C£ alkyl); wherein R^ is -H, c l“^io straight or branched chain alkyl group, phenyl, phenyl alkylene having straight or branched chain C|-C 10 straight or branched chain alkyl group, phenyl, phenyl alkylene having straight or branched chain C^-Cg alkylene, C5 c io cycloalkyl or C 6 -C 1Q cycloalkyl alkylene; R 2 is H 2 , methylene, ethylidene, a-CH^(H), βCH-j(H), a(OH)(H) or the acetonide derived from the 16a,17a-dihydroxy derivative, and n is 1 or 2; together with an inert topical pharmaceutical carrier. 16. The composition of Claim 15 wherein said carrier is selected from oleaginous bases, silicones, lanolines, polyethylene glycol, glyceryl monostearate, methylcellulose and hydroxymethylcellulose. 17. A pharmaceutical composition substantially as hereinbefore described with reference to the Examples. Dated this the 29th day of July, 1983. NS & CO., (cant’s Agents, (Signed)

1. A pharmaceutical composition for treating androgen-related disorders in humans, which comprises 5«-hydrotestosterone decreasing amounts of a compound of formula (I) wherein R is H or F; Ri is selected from -H; straight or branched chain lower alkyl; hydroxyl; -OCOR 3 ; and alkyl); wherein R 3 is -H, C|-C^q straight or branched chain alkyl group, phenyl, phenyl alkylene having straight or branched chain C^-Cg alkylene, C5C10 cycloalkyl or C 6 -C 10 cycloalkyl alkylene; R 2 is H 2 , methylene, ethylidene, a-Ctlj(ll), β-CUj(ll), a(O1I)H or the acetonide derived from the 16a,17a( (. -30dihydroxy derivative, and n is 1 or 2, together with an inert pharmaceutically acceptable carrier.

2. The pharmaceutical composition of Claim 1 wherein the androgenrelated disorder is selected from the group consisting of acne, seborrhea, and androgenic alopecia.

3. The pharmaceutical composition of Claim 2 wherein the compound is * administered as a topical preparation containing from 0.001% to 5% of the compound.

4. The pharmaceutical composition of Claim 1 wherein the androgen 1 related disorder is selected from the group consisting of oily skin, hirsutism, benign prostatic hypertrophy and androgen dependent prostatic adenocarcinoma, 5. The pharmaceutical composition of Claim 4 wherein the compound is administered orally in an amount ot from 0.1 to 50 mg/Kg. 6. The pharmaceutical composition of Claim 4 wherein the compound is administered parenterally in an amount of from 0,1 to 50 mg/Kg. 7. The pharmaceutical composition of Claim 4 wherein said disorder is androgen dependent prostatic adenocarcinoma and the compound is administered together with a compound selected from tlie group consisting of megestrol acetate medrogerstone and cyproterone acetate. 8. The pharmaceutical composition of Claim 1 wherein R=R 1 =H, R 2 is and n=l. 9. The pharmaceutical composition of Claim 1 wherein R=H, R^OAc, r2 is and n«l. -3110. The pharmaceutical composition of Claim 1 wherein R=H, R^OAc, R 2 is =CH£ and n=l. 11. The pharmaceutical composition of Claim 1 wherein R=H, R^=0Ac, R 2 is a-Me(H) and n=l.

5. , D&tmouth Road, DUBLIN 6. -33ABSTRACT OF THE DISCLOSURE A method of treating androgen-related disorders in an animal which comprises administering to the animal dihydrotestosterone level decreasing amounts of a compound of formula (I): wherein R is H or F; R 1 is selected from the group consisting of -H; straight or branched chain lower alkyl hydroxyl; -OCOR 3 ; and O~(C^-Cg alkyl); wherein R 3 is -H, c l* c 10 straight or branched chain alkyl group, phenyl, phenyl alkylene having straight or branched chain C|-Cg alkylene, cycloalkyl or C^-Cxq cycloalkyl' alkylene; R 2 i s h 2 / methylene, ethylidene, a-CH3(H), βCH3(H), a-(OH)(H) or the acetonide derived from the 16a,17a-dihydroxy derivative, and n is 1 or 2.