MX2012006624A - Therapeutic combinations of theobromine and an antihistamine. - Google Patents

Abstract

An agent comprises theobromine and an antihistamine, as a combined preparation for simultaneous, sequential or separate use in therapy, particularly in the therapy of cough.

Description

THERAPEUTIC COMBINATION OF THEOBROMINE AND AN ANTIHISTAMINIC Field of the Invention This invention relates to a combination of drugs, their composition and their use in therapy, particularly in cough therapy.

Background of the Invention Cough is a protective reflex. The persistent cough can be exhausting. Free sale remedies are available but their effectiveness is doubtful.

W098 / 42322 discloses the use of theobromine for the treatment of cough, to be administered orally.

Usmeni et al., FASEB J. express article 10.1096, reveals that theobromine inhibits the action of the sensory nerve and cough. Data are provided, which show effects following oral dosing in cough induced by citric acid in guinea pigs, and the challenge of coughing by capsaicin in humans, and after bathing with vagus nerve preparations in guinea pigs isolated Antihistamines namely diphenhydramine has been shown to be effective in the cough model induced by citric acid in healthy human volunteers (Packman et al., Int.J. Clin.Pharmacol.Ther.Toxicol., 1991). However, a recent review article, Bjórnsdóttir et al. 2007 December, 29 (6): 577-83 reports that the Ref: 231178 Assumptions about the efficacy of diphenhydramine against cough in humans are not uniquely justified in the literature. In other words, there is no strong evidence that antihistamines have any efficacy in coughing.

Brief Description of the Invention The invention is based at least in part on the data showing a synergistic antitussive effect of theobromine combined with the antihistamine of chlorpheniramine, in a cough model induced by citric acid. Since recent literature suggests that antihistamines have no efficacy in coughing, it was surprisingly found that a combination of theobromine and chlorpheniramine has an improved antitussive effect, compared to theobromine alone.

Accordingly, when theobromine is used in combination with an antihistamine, a considerably reduced dose of theobromine can be provided for an equivalent antitussive effect for theobromine alone, in order to reduce the side effects and the burden of theobromine. drugs.

Therefore, according to a first aspect of the present invention, an agent comprises theobromine and an antihistamine, as a combined preparation for simultaneous, sequential or separate use in therapy.

According to a second aspect, a pharmaceutical composition comprises theobromine and an antihistamine.

It is believed that this synergistic relationship will be exhibited with all antihistamines. Without wanting to relate to the theory, this may be due to the structural similarity of members of the class of drugs that are antihistamines.

Brief Description of the Figures Figure 1 shows the effect of theobromine, and a combination of theobromine and chlorpheniramine, on cough induced by citric acid in guinea pigs.

Detailed description of the invention As used herein, the term "antihistamine" means an agent that inhibits the action of histamiha by means of histamine receptors. This term represents a well-defined class of drug that is well known to people with experience. In a preferred embodiment, the antihistamine is an antihistamine receptor. Any suitable form of the antihistamine agent can be chosen. This includes the salts, pro-drugs and active metabolites.

As used herein, the treatment of cough means any therapy that reduces the number and / or the severity of the cough. Preferably, it means a reduction in the number of episodes of cough, that is, a direct antitussive effect that reduces the body's urge to cough. Therefore, according to a preferred embodiment of the invention, an agent comprises theobromine and an antihistamine, which is used as an antitussive pharmaceutical composition. An agent of the invention is useful as an antitussive in the control of cough. Preferably, it is used in the control of unprovoked cough.

The antihistamine can be used in an amount that is readily known for use, although the combination according to this invention means that a reduced dose can be effective. The dose of the antihistamine that is administered with the theobromine will of course depend on the usual factors, including its potency, but is preferably at least 0.1, eg, at least 5, and may be up to 50 mg / kg / day. Preferably, it is dosed in a range of 0.1 to 30 mg / kg / day.

Any suitable form of theobromine can be chosen.

This includes salts, pro-drugs and active metabolites. Theobromine can also be in the form of cocoa or chocolate. Suitable ranges of theobromine doses are known in the art and will depend on the usual factors (age, etc.); although the synergistic effect of the combination means that the effective dose can be reduced.

A combination according to the invention can be provided in a simple formulation or in separate formulations, for combined, simultaneous or sequential administration.

This antihistamine can. be chosen from the following drugs: diphenhydramine, loratadine, desloratadine, alimemazine, dimenhydrinate, doxylamine, meclizine, quetiapine, fexofenadine, feniramine, cetirizine, promethazine, clemastine, chlorpheniramine, dexchlorpheniramine, levocetrizine, hydroxyzine, alimemazine, acrivastine, cyproheptadine, astemizole, fexofenadine, loratadine, cetirizine, levocetirizine, brompheniramine, dextrobromfeniramine, promethazine, mizolastine, and tripolidine. Preferably, the antihistamine is chlorpheniramine.

The compounds of the invention can be administered by any suitable route, such as by oral, inhaled, intranasal, sublingual, intravenous, rectal and vaginal routes.

The compounds of the invention are preferably combinations that are administered orally, for example, tablets, troches, lozenges, aqueous or oily suspensions, powders or granules that can be dispersed. The preferred pharmaceutical compositions of the invention are tablets and capsules. Liquid dispersions for oral administration may be syrups, emulsions and suspensions. More preferably, the pharmaceutical composition of the combination is a compressed tablet or capsule with conventional excipients, examples of which are given below.

The compositions intended for oral administration can be prepared according to any method known in the art for the production of pharmaceutical compositions, and these compositions can contain one or more agents selected from the group consisting of sweetening agents, flavoring agents, coloring agents and agents. The tablets contain the active ingredients combined in admixture with pharmaceutically acceptable non-toxic excipients which are suitable for the production of tablets These excipients may be, for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example corn starch or alginic acid; binding agents, for example starch gelatin, acacia, microcrystalline cellulose or polyvinyl pyrrolidone; and lubricating agents, for example magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a long period. For example, a material for time delay such as glyceryl monostearate or glyceryl distearate can be used.

The aqueous suspensions contain the active materials combined in admixture with excipients suitable for the production of aqueous suspensions. These excipients are suspending agents, for example sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinyl pyrrolidone, tragacanth gum and acacia gum.; dispersing agents or humectants can be a naturally occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example polyoxyethylene stearate, or condensation products of ethylene acid with aliphatic alcohols of long chain, for example heptadecaethylene oxide ethanol, condensation products of ethylene oxide with partial esters derived from fatty acids, for example polyoxyethylene sorbitan monooleate. The aqueous suspensions may also contain one or more preservatives, for example ethyl p-hydroxybenzoate or n-propyl, one or more coloring agents, one or more seasoning agents and one or more sweetening agents, such as sucrose or saccharin.

Oily suspensions may be formulated by suspending the active ingredient in a vegetable oil, for example, peanut oil, olive oil, sesame oil or > oil. coconut, hydrogenated polyoxyethylene castor oil, fatty acids such as oleic acid, or in a mineral oil such as liquid paraffin or in other surfactants or detergents. The oily suspensions may contain a thickening agent, for example beeswax, solid paraffin or cetyl alcohol. Sweetening agents, such as those set forth above, and seasoning agents can be added to provide a pleasant oral preparation. These compositions can be preserved by the addition of an antioxidant such as ascorbic acid.

Dispersible powders and granules suitable for the preparation of an aqueous suspension by the addition of water provide the combined active ingredients in admixture with a dispersing or wetting agent, suspending agent and one or more preservatives. Suitable sweetening agents, seasonings and colorants may also be present.

The combined pharmaceutical compositions of the invention may also be in the form of oil-in-water emulsions. The oil phase can be a vegetable oil, for example olive oil or peanut oil, or a mineral oil, for example liquid paraffin, or mixtures thereof. Suitable emulsifying agents can be gums that occur in nature, for example acacia gum or tragacanth gum, phosphatides that occur in nature, for example, soybean seed, lecithin and partial esters or esters derived from fatty acids and anhydrides. of hexitol, for example sorbitan monooleate and condensation products of the partial esters with ethylene oxide, for example polyoxyethyl sorbitan monooleate. The emulsions may also contain sweetening agents and condiments.

The syrups and elixirs can be formulated with sweetening agents, for example, glycerol, propylene glycol, sorbitol or sucrose. These formulations may also contain an emollient, a preservative, seasoning and coloring agents.

The suspensions and emulsions may contain a carrier, for example a natural gum, agar, sodium alginate, pectin, methylcellulose, carboxymethylcellulose, or polyvinyl alcohol.

Combined compositions according to the invention can be produced using conventional formulation techniques. In particular, spray drying can be used to produce microparticles comprising the active agent dispersed or suspended within a material that provides the controlled release properties.

The grinding process, for example jet grinding, can also be used to formulate the therapeutic composition. This applies particularly to particles intended for administration by inhalation. The manufacture of fine particles by grinding can be achieved using conventional techniques. The term "milling" is used herein to refer to any mechanical process that applies sufficient force to the particles of active material to break or crush the particles into fine particles. The different grinding conditions and devices are suitable for use in the production of the compositions of the invention.

The selection of the appropriate grinding conditions, for example, milling intensity and duration, to provide the required degree of strength, will be within the capability of the experienced person. Ball milling is a preferred method. Alternatively, a high pressure homogenizer may be used, wherein a fluid containing the particles is forced through a valve with high pressure, producing conditions of high shear and turbulence. The shear forces in the particles, the impacts between the particles and surfaces of the machine or other particles, in cavitation due to the acceleration of the fluid, can also contribute to the fracture of the particles.

Suitable homogenizers include the high pressure ElmsiFlex homogenizer, Niro Soavi high pressure homogenizer and the Microfluidific Microfluidizer. The milling process can be used to provide mass microparticles with average aerodynamic diameters.

If it is hygroscopic the active agent can be ground with a hydrophobic material, as described above.

If required, the particulates produced by the grinding step can then be formulated with an additional excipient. This can be achieved by means of a spray drying process, eg, complementary spray drying. In this embodiment, the particles are suspended in a solvent and dried by complementary spray with a solution or suspension of the additional excipient. Additional preferred excipients include polysaccharides. Other pharmaceutically effective excipients may also be used.

Composition compositions intended for administration by inhalation, topical, intranasal, sublingual, intravenous, rectal and vaginal can be prepared according to any method known in the art for the production of pharmaceutical composition.

The therapy according to the invention can be conducted in a generally known manner, depending on several factors, such as the sex, age or condition of the patient, and the existence or otherwise of one or more concomitant therapies. The patient population can be important.

The present invention is based at least in part on the following studies. study Coughing was induced in guinea pigs by the use of citric acid. It was administered to a group of guinea pigs with 10 mg / kg of theobromine, and two groups were administered with theobromine in combination with 10 or 30 mg / kg of chlorpheniramine. As a control, a fourth group received only the vehicle. The administration was through the oral route.

The results are shown in Figure 1. The data show that the combinations of theobromine and chlorpheniramine have a significant, improved efficacy in cough therapy when compared to theobromine monotherapy.

It is noted that in relation to this date, the best method known to the applicant to carry out the aforementioned invention, is that which is clear from the present description of the invention.

Claims (6)

CLAIMS Having described the invention as above, the content of the following claims is claimed as property:

1. Agent comprising theobromine and an antihistaminic, characterized in that it is a preparation that is used as a therapy simultaneously, sequentially or separately.

2. Agent according to claim 1, characterized in that the therapy is for cough.

3. Pharmaceutical composition characterized in that it comprises theobromine and an antihistamine.

4. Agent or composition according to any preceding claim, characterized in that the antihistamine is selected from diphenhydramine, loratadine, deslaratadine, alimemazine, dimenhydrinate, doxylamine, meclizine, quetiapine, fexofenadine, feniramine, cetirizine, promethazine, clemastine, chlorpheniramine, dexchlorpheniramine, levocetrizine, hydroxyzine , alimemazine, acrivastine, cyproheptadine, asthemizole, fexofenadine, loratadine, cetirizine, levocetirizine, brompheniramine, dextrobromfeniramine, promethazine, mizolastine, and tripolidine.

5. Agent or composition according to claim 4, characterized in that the antihistamine is chlorpheniramine.

6. Agent or composition according to any of the preceding claims, characterized in that the antihistamine is such that it is administered in a dose of 0.1 to 30 mg / kg / day.