IE882603L - Pharmaceutical compositions - Google Patents

Abstract

A medicament contains a combination of N-alkylscopolaminium salt, preferably N-butylscopolaminium bromide, and nitroglycerin. This medicament can be administered, for example, in the form of soft gelatine capsules, rectal capsules, ointments, plasters, coated tablets, tablets or pills. It is particularly suitable for the treatment of colic in the urinary tract, the gall bladder and the biliary tract. The effect of the medicament is thoroughly comparable with that of combination products based on metamizole and can accordingly be used as substitute for these combination products which are objectionable because of their side effects.

Description

61 4 50 - 2 - The invention relates to a medicament which contains N-alkylscopolaminium salts preferably M-Butylscopolaminium bromide as active ingredient as we 11 as s optionally,, conventional adjuvants and carriers., a process for its 05 manufacture and the use thereof* For the treatment of colic pains9 especially in the region of the urinary tracts the gall bladder and the bile duet „ combination preparations based on Dipyrone have been successfully applied in previous times. The active 10 ingredient combination in such preparations consisted for example of IM-Buty IscopoTamin ium bromide and Dipyrone. It has been shown,, however* that combination preparations containing Dipyrone exhibit worrying side effects,, so that, for example, permission for these preparat ions has been 15 withdrawn in the Federal Republic of Germany. There is therefore a considerable demand for a replacement for the (9 combination preparations on the basis of Dipyrone which are no longer allowed.

Accordingly the problem which the invention seeks to solve is to provide a medicament which is just as suitable for the therapy of the above-mentioned colic pains, as the no-longer-permissible combination prepa rations on the basis of Dipyrone.

For the solution of this problem, a medicament of the type mentioned in the introduction is proposed,, which is characterized in that it con tains Nitroglycerin as a further active ingredient.

The subject matter of the invention is, furthermore, a process for the manufacture of the medicament according to the invention, which is characterized in that la) an aqueous solution of N-alkylscopolaminium salt, preferably N-Butylscopolaminium bromide, and Nitroglycerin is prepared,, by taking about 90% of the total intended amount of water,, acidifying it to a pH value of 3„0 to 5.5, heating it to 90 - 95°C, carefully introducing into it with stirring Nitroglycerin as such, as a solution or deposited on an inert carrier material, adding in N-alkylscopolaminium salt to the solution after the Nitroglycerin has completely dissolved,, and, when the N-alkylscopolaminium salt has been dissolved,, cooling the solution to room temperature and making it up with water to the desired final volume, or lb) preparing an organic solution or suspension of N-alkylscopolaminiutn salt, preferably N-ButyIscopol-arniniuni bromide, by taking the N-a Iky 1 scopo 1 am i n i um salt and reacting it with 1 to 200 times the amount of an organic solvent with gentle warming in a water bath, and adding a solution of Nitroglycerin in alcohol or medium chain-length triglycerides to the resulting solution which has been cooled down to room temperature9 and, if desired 2) working up the obtained solution of M-a1ky1scopo1 - aminium salt and Nitroglycerin , which has been cooled down to room temperature in a manner known par se, to the desired form for administration of the med i cament.

A further provision of the invention is the use of the medicament in accordance of the invention as a spasmolytic for the treatment of colic painss especially in the region of the urinary tract, the gall bladder and the bile duct.

The alkyl residue in the N-alkylscopolaminium salt used in accordance with the invention can have 1 to 10 carbon atoms* Preferred are alkyl residues with 2 to 6 carbon atoms and especially those with 4 carbon atoms* Both N-alkylscopolaminium salts9 especially N-Buty 1 scopo lam 3 n i urn bromi de9 and Nitroglycerin are substances obtainable in commerce and/or described in the literature (cf for example Martin Negwer "Organisch-Chemische Arzneimittel und ihre Synonyma", fifth edition,, Volume I!„ 1978, No 4751 on page 875 and Volume I, Wo 91 on page 15s Arzneimittel Forschung 18a page 1132 ff 1968 etc)s so that a detailed description of the manufacture and properties thereof is redundant.

The manufacture of the active substance combination contained in the medicament according to the invention takes place for preference in such a way that an aqueous solution of the active ingredient combination is first prepared. To this about 90% of the necessary amount of water is added and the pH value is adjusted to 3.0 to 5..51. preferably with dilute hydrochloric acid". The solution is then heated to 90 to 95°C. The necessary amount of Nitroglycerin is carefully introduced with stirring. For this purpose the Nitroglycerin can be used as such, as a solution or on an inert carrier material, preferably as Nitroglycerin rubbed into sugar (compare in this connection for example European Patent Application 0 108 248 and the publications named therein). After complete dissolution of the Nitroglycerin, the intended amount of N-alkylscopol-aminium salt, preferably N-Buty 1 scopo1 aminium bromide, is added* As soon as the latter has dissolved, the solution is cooled to room temperature. After that the batch is made up to the desired final volume.

Alternatively,, an organic solution or suspension of N-a1ky1scopolaminium salt can be prepared, by taking the E*! = a Iky 1 scopo 1 amin i um salt, preferably M = Buty1scopo1 aminium bromide, and mixing it with 1 to 200 times the amount of an organic solvent, preferably ethanol, polyethylene glycol, propylene glycol or glycerin, with gentle warming in a water bath. A solution of Nitroglycerin in alcohol or medium chain-length triglycerides is then added to the solution obtained, after cooling it to room temperature* The concept "medium chain-length triglycerides" designates triglycerides in which the fatty acids have from 4 to 12 carbon atoms* The aqueous solution of the active ingredient combination in accordance with the invention., thus obtained;, can be used as such, or after further working-up in manner known per se. The per se known working-up can consist of sterile filtering, filling and sterilizing of the solution when it is intended eg for parenteral application* A further working-up possibility for the aqueous or organic solution consists in mixing the solution with suitable adjuvants and filling it into a spray bottle or spray can, so that the medicament can be used as a pump spray. If in addition a propellant is used, the medicament can also be used as a pressurised aerosol* Furthermore the solution of the active ingredient combination according to the invention can be worked up with the addition of suitable adjuvants to give a medicament in the form of a soft gelatine capsule or a recta 1 capsule. - 6 - The proportion by weight of N-alkylscopolaminium salt to Nitroglycerin in the medicament according to the invention is preferably 50:1 to 2:1 and especially 2:1 to 7:1. In the use of M-buty 1 scopo 1 aminium salt, particularly good 05 results have been achieved with a weight proportion of 8.3:1. A unit dose of the medicament according to the invention contains for preference 10 - 30 mgs especially 18 - 22 mg of N-aIkyIscopolaminium salt and preferably 0.4 - 4 mg«, especially 1 - 3 mg of Nitroglycerin. 10 Particularly good results have been achieved with a unit dose which contained 20 mg N-Butylscopolaminium bromide and 2.4 mg Ni troglycer i n.

As already mentioned above., the medicament according to the invention can be applied parenterally in the form of an 15 aqueous solution, and in particular can be applied intravenously. Further forms of administration which may be considered include sprays 8 capsules, rectal capsules9 ointments., plasters, tablets,, dragees and pills.

It is surprising to the expert that the combination of 20 N-alkylscopolaminium salt and Nitroglycerin should correspond to the known combination preparations based on Dipyrone in its spasmolytic effectivenesss and that it shows fewer undesired effects than the Dipyrone combination preparations* Neither N-alkylscopolaminium salt nor 25 Nitroglycerin alone has such a pronounced spasmo lytic effect. In addition, they offer the advantage compared with medicaments in the form of opiates,, which can also serve as a substitute for the previously used combination preparations on the basis of Dipyrone,, that they permit a 30 short-term clinical examination afterwarids9 whereas opiates mask the clinical picture and have a bad effect on short term control investigations and their reliability* - 7 - Examp le Dose units which contained 20 mg of M-ButylscopolaminSum bromide and 2.4 mg of Nitroglycerin, were applied intravenously to patients having colic of the urinary tract, who 05 demanded a strong spasmolytic and had already evaluated various medicaments as ineffective. After 20 to 35 minutes a distinct spasmolysis and relief of pain were achieved in all ten patients™ In this, there was no appearance of clinical complications such as stone perforation or urinary 10 seps i s. - 8 -

Claims (4)

1. CLAIMS 1. Medicament which contains as active ingredient N-alkvlscopolaminium salt with 1 to 10 carbon atoms in the alkyl 5 residue, preferably N-butylscopolaminium bromide, as well as, optionally, conventional adjuvants and carriers, wherein it contains, t, as a further active ingredient, nitroglycerin.

2. Medicament according to claim 1, wherein it contains 10 N-alkvlscopolaminium salt and nitroglycerin in a proportion by weight of 50*1 to 2 = 1 and preferably 10:1 to 7:1.;

3. Medicament according to claim 1 or 2, wherein one dose unit contains 10 to 30 mg and preferably 18 to 22 mg of N-alkvlscopolaminium;15 salt and 0.4 to 4 mg and preferably 1 to 3 mg of nitroglycerin.;

4. Process for preparing a medicament according to one of claims 1 to 3, wherein;20 la) an aqueous solution of N-alkvlscopolaminium salt with 1 to 10 carbon atoms in the alkyl residue, preferably N-butylscopolaminium bromide, and nitroglycerin is prepared by introducing first approximately 90% of the total intended amount of water, acidifying it to a pH value of 3.0 to 6.5, heating it to 90 to 95°C, carefully 25 introducing, whilst stirring, nitroglycerin as such, as a solution or deposited on an inert carrier material, adding N-alkvlscopolaminium salt to the solution after the nitroglycerin has completely dissolved and, when the N-alkvlscopolaminium salt has been dissolved, cooling the solution to room temperature and making it up with water to the desired 30 final volume, or lb) preparing an organic solution of N-alkylscopolaminium salt,;preferably N-butylscopolaminium bromide, by introducing first the t;N-alkvlscopolaminium salt and reacting it with 1 to 200 times the 35 amount of an organic solvent with gentle warming in a water bath and adding to the resulting solution cooled to room temperature, a solution of nitroglycerin in alcohol or medium-chain-length triglycerides, and, optionally;_ 9 -;2) processing in a manner known per se the obtained solution of N-alkylscopo1 aminium salt and nitroglycerin, which has been cooled to room temperature, to the desired form for administering the medicament.;5 5* Process according to claim 4, wherein, in step la), instead of water an isotonic solution is used as the solvent. 6. Process according to claim 4, wherein the step lb) ethanol, polyethylene glycol, propylene glycol or glycerin is used as the 10 organic solvent. 7. Process according to one of claims 4 to 6, wherein the further processing in step 2) is carried out by 15 a) sterile filtering, packing and sterilising the solution, b) mixing the solution with suitable adjuvants, packing it into a spray bottle or a spray can and, optionally, providing it with a propel 1 ant, or 20 c) reacting the solution with suitable adjuvants and processing it further to give a medicament in the form of soft gelatine capsules, rectal capsules, ointments, plasters, dragees, tablets or pills. 25 8. Use of N-alkylscopo1aminium salt with 1 to 10 carbon atoms in the alkyl residue, preferably N-butylscopolaminium bromide, together with nitroglcerin for preparing a medicament according to one of claims 1 to 3. 30 Dated this 26th day of August, 1988. BY: TOMKINSaCO., Applicants' Agents, (Signed) 35 5, Dartmouth Road, DUBLIN 6.