NZ613401B2 - Polyethylene Glycol Solutions for Use in the Treatment of Constipation - Google Patents
Polyethylene Glycol Solutions for Use in the Treatment of Constipation Download PDFInfo
- Publication number
- NZ613401B2 NZ613401B2 NZ613401A NZ61340112A NZ613401B2 NZ 613401 B2 NZ613401 B2 NZ 613401B2 NZ 613401 A NZ613401 A NZ 613401A NZ 61340112 A NZ61340112 A NZ 61340112A NZ 613401 B2 NZ613401 B2 NZ 613401B2
- Authority
- NZ
- New Zealand
- Prior art keywords
- aqueous solution
- per litre
- solution
- peg
- paraben
- Prior art date
Links
- 229920001223 polyethylene glycol Polymers 0.000 title claims abstract description 80
- 206010010774 Constipation Diseases 0.000 title claims abstract description 40
- 239000002202 Polyethylene glycol Substances 0.000 title abstract description 74
- 239000000243 solution Substances 0.000 claims abstract description 160
- WCUXLLCKKVVCTQ-UHFFFAOYSA-M potassium chloride Chemical compound [Cl-].[K+] WCUXLLCKKVVCTQ-UHFFFAOYSA-M 0.000 claims abstract description 124
- FAPWRFPIFSIZLT-UHFFFAOYSA-M sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims abstract description 124
- UIIMBOGNXHQVGW-UHFFFAOYSA-M NaHCO3 Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 claims abstract description 115
- 230000002335 preservative Effects 0.000 claims abstract description 97
- 239000003755 preservative agent Substances 0.000 claims abstract description 97
- 239000007864 aqueous solution Substances 0.000 claims abstract description 90
- 239000011780 sodium chloride Substances 0.000 claims abstract description 69
- 239000001103 potassium chloride Substances 0.000 claims abstract description 62
- 235000011164 potassium chloride Nutrition 0.000 claims abstract description 62
- 235000017557 sodium bicarbonate Nutrition 0.000 claims abstract description 55
- 229910000030 sodium bicarbonate Inorganic materials 0.000 claims abstract description 55
- 206010056325 Faecaloma Diseases 0.000 claims abstract description 25
- 238000010790 dilution Methods 0.000 claims abstract description 19
- LXCFILQKKLGQFO-UHFFFAOYSA-N Methylparaben Chemical compound COC(=O)C1=CC=C(O)C=C1 LXCFILQKKLGQFO-UHFFFAOYSA-N 0.000 claims description 93
- 235000002639 sodium chloride Nutrition 0.000 claims description 68
- 235000003599 food sweetener Nutrition 0.000 claims description 52
- 239000003765 sweetening agent Substances 0.000 claims description 52
- 235000010270 methyl p-hydroxybenzoate Nutrition 0.000 claims description 45
- 239000004292 methyl p-hydroxybenzoate Substances 0.000 claims description 44
- 229960002216 methylparaben Drugs 0.000 claims description 44
- WVDDGKGOMKODPV-UHFFFAOYSA-N benzyl alcohol Chemical compound OCC1=CC=CC=C1 WVDDGKGOMKODPV-UHFFFAOYSA-N 0.000 claims description 42
- 235000010228 ethyl p-hydroxybenzoate Nutrition 0.000 claims description 42
- NUVBSKCKDOMJSU-UHFFFAOYSA-N Ethylparaben Chemical compound CCOC(=O)C1=CC=C(O)C=C1 NUVBSKCKDOMJSU-UHFFFAOYSA-N 0.000 claims description 41
- 229960001617 ethyl hydroxybenzoate Drugs 0.000 claims description 41
- 239000004403 ethyl p-hydroxybenzoate Substances 0.000 claims description 41
- 239000000203 mixture Substances 0.000 claims description 40
- QELSKZZBTMNZEB-UHFFFAOYSA-N Propylparaben Chemical compound CCCOC(=O)C1=CC=C(O)C=C1 QELSKZZBTMNZEB-UHFFFAOYSA-N 0.000 claims description 24
- 239000004405 propyl p-hydroxybenzoate Substances 0.000 claims description 24
- 235000010232 propyl p-hydroxybenzoate Nutrition 0.000 claims description 24
- 229960003415 propylparaben Drugs 0.000 claims description 24
- BAQAVOSOZGMPRM-JVFSCRHWSA-N (2R,3R,4R,5R,6R)-2-[(2S,3R,4R,5R)-2,5-bis(chloromethyl)-3,4-dihydroxyoxolan-2-yl]oxy-5-chloro-6-(hydroxymethyl)oxane-3,4-diol Chemical compound O[C@@H]1[C@@H](O)[C@@H](Cl)[C@@H](CO)O[C@@H]1O[C@]1(CCl)[C@H](O)[C@@H](O)[C@H](CCl)O1 BAQAVOSOZGMPRM-JVFSCRHWSA-N 0.000 claims description 22
- 239000004376 Sucralose Substances 0.000 claims description 22
- 235000019408 sucralose Nutrition 0.000 claims description 22
- 239000000619 acesulfame-K Substances 0.000 claims description 20
- QCDWFXQBSFUVSP-UHFFFAOYSA-N Phenoxyethanol Chemical compound OCCOC1=CC=CC=C1 QCDWFXQBSFUVSP-UHFFFAOYSA-N 0.000 claims description 19
- 229960005323 Phenoxyethanol Drugs 0.000 claims description 19
- DNIAPMSPPWPWGF-UHFFFAOYSA-N propylene glycol Chemical compound CC(O)CO DNIAPMSPPWPWGF-UHFFFAOYSA-N 0.000 claims description 16
- 235000019445 benzyl alcohol Nutrition 0.000 claims description 14
- 229960004217 benzyl alcohol Drugs 0.000 claims description 14
- 229920002562 Polyethylene Glycol 3350 Polymers 0.000 claims description 13
- QAOWNCQODCNURD-UHFFFAOYSA-L sulfate Chemical compound [O-]S([O-])(=O)=O QAOWNCQODCNURD-UHFFFAOYSA-L 0.000 claims description 11
- WPYMKLBDIGXBTP-UHFFFAOYSA-N Benzoic acid Chemical compound OC(=O)C1=CC=CC=C1 WPYMKLBDIGXBTP-UHFFFAOYSA-N 0.000 claims description 10
- 229960004063 Propylene glycol Drugs 0.000 claims description 7
- 150000003839 salts Chemical class 0.000 claims description 7
- IXMINYBUNCWGER-UHFFFAOYSA-M sodium;4-propoxycarbonylphenolate Chemical compound [Na+].CCCOC(=O)C1=CC=C([O-])C=C1 IXMINYBUNCWGER-UHFFFAOYSA-M 0.000 claims description 7
- URAYPUMNDPQOKB-UHFFFAOYSA-N Triacetin Chemical compound CC(=O)OCC(OC(C)=O)COC(C)=O URAYPUMNDPQOKB-UHFFFAOYSA-N 0.000 claims description 6
- 229960002622 Triacetin Drugs 0.000 claims description 6
- 239000003814 drug Substances 0.000 claims description 6
- 239000001087 glyceryl triacetate Substances 0.000 claims description 6
- 235000013773 glyceryl triacetate Nutrition 0.000 claims description 6
- PGRHXDWITVMQBC-UHFFFAOYSA-N 3-acetyl-6-methylpyran-2,4-dione Chemical compound CC(=O)C1C(=O)OC(C)=CC1=O PGRHXDWITVMQBC-UHFFFAOYSA-N 0.000 claims description 5
- 239000005711 Benzoic acid Substances 0.000 claims description 5
- LVDKZNITIUWNER-UHFFFAOYSA-N Bronopol Chemical compound OCC(Br)(CO)[N+]([O-])=O LVDKZNITIUWNER-UHFFFAOYSA-N 0.000 claims description 5
- 239000004287 Dehydroacetic acid Substances 0.000 claims description 5
- 229940075582 Sorbic Acid Drugs 0.000 claims description 5
- 150000001298 alcohols Chemical class 0.000 claims description 5
- 235000010233 benzoic acid Nutrition 0.000 claims description 5
- 229960004365 benzoic acid Drugs 0.000 claims description 5
- 229960003168 bronopol Drugs 0.000 claims description 5
- 235000019258 dehydroacetic acid Nutrition 0.000 claims description 5
- 229940061632 dehydroacetic acid Drugs 0.000 claims description 5
- 235000010199 sorbic acid Nutrition 0.000 claims description 5
- WSWCOQWTEOXDQX-UHFFFAOYSA-N sorbic acid Chemical compound CC=CC=CC(O)=O WSWCOQWTEOXDQX-UHFFFAOYSA-N 0.000 claims description 5
- 239000004334 sorbic acid Substances 0.000 claims description 5
- 229960004998 Acesulfame potassium Drugs 0.000 claims description 3
- 235000010358 acesulfame potassium Nutrition 0.000 claims description 3
- 238000004519 manufacturing process Methods 0.000 claims description 3
- IAOZJIPTCAWIRG-QWRGUYRKSA-N Aspartame Chemical compound OC(=O)C[C@H](N)C(=O)N[C@H](C(=O)OC)CC1=CC=CC=C1 IAOZJIPTCAWIRG-QWRGUYRKSA-N 0.000 claims description 2
- 229960003438 Aspartame Drugs 0.000 claims description 2
- 108010011485 Aspartame Proteins 0.000 claims description 2
- 229920001030 Polyethylene Glycol 4000 Polymers 0.000 claims description 2
- CVHZOJJKTDOEJC-UHFFFAOYSA-N Saccharin Chemical compound C1=CC=C2C(=O)NS(=O)(=O)C2=C1 CVHZOJJKTDOEJC-UHFFFAOYSA-N 0.000 claims description 2
- 239000000605 aspartame Substances 0.000 claims description 2
- 235000010357 aspartame Nutrition 0.000 claims description 2
- WBZFUFAFFUEMEI-UHFFFAOYSA-N Acesulfame potassium Chemical compound [K+].CC1=CC(=O)NS(=O)(=O)O1 WBZFUFAFFUEMEI-UHFFFAOYSA-N 0.000 claims 1
- 239000003792 electrolyte Substances 0.000 abstract description 6
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 29
- 239000000796 flavoring agent Substances 0.000 description 20
- WBZFUFAFFUEMEI-UHFFFAOYSA-M potassium;6-methyl-2,2-dioxooxathiazin-4-olate Chemical compound [K+].CC1=CC(=O)[N-]S(=O)(=O)O1 WBZFUFAFFUEMEI-UHFFFAOYSA-M 0.000 description 20
- 235000019634 flavors Nutrition 0.000 description 15
- JBXKSUUBAYVELX-UHFFFAOYSA-N (3-ethylphenyl)methanol Chemical compound CCC1=CC=CC(CO)=C1 JBXKSUUBAYVELX-UHFFFAOYSA-N 0.000 description 14
- 239000011734 sodium Substances 0.000 description 13
- -1 acesulfame ions Chemical class 0.000 description 11
- 244000005700 microbiome Species 0.000 description 10
- 238000002360 preparation method Methods 0.000 description 10
- KRKNYBCHXYNGOX-UHFFFAOYSA-N citric acid Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O KRKNYBCHXYNGOX-UHFFFAOYSA-N 0.000 description 9
- 230000001629 suppression Effects 0.000 description 9
- 241001331781 Aspergillus brasiliensis Species 0.000 description 8
- 235000013399 edible fruits Nutrition 0.000 description 8
- 239000003826 tablet Substances 0.000 description 8
- 241000222122 Candida albicans Species 0.000 description 7
- 229940095731 Candida albicans Drugs 0.000 description 7
- 229940055023 Pseudomonas aeruginosa Drugs 0.000 description 7
- 241000589517 Pseudomonas aeruginosa Species 0.000 description 7
- 241000191967 Staphylococcus aureus Species 0.000 description 7
- 229940076185 Staphylococcus aureus Drugs 0.000 description 7
- 230000002475 laxative Effects 0.000 description 7
- 239000008141 laxative Substances 0.000 description 7
- 239000007788 liquid Substances 0.000 description 7
- ZLMJMSJWJFRBEC-UHFFFAOYSA-N potassium Chemical compound [K] ZLMJMSJWJFRBEC-UHFFFAOYSA-N 0.000 description 7
- 239000011591 potassium Substances 0.000 description 7
- 229910052700 potassium Inorganic materials 0.000 description 7
- 239000007787 solid Substances 0.000 description 7
- 229960005164 ACESULFAME Drugs 0.000 description 6
- 238000005259 measurement Methods 0.000 description 6
- 229920000139 polyethylene terephthalate Polymers 0.000 description 6
- 239000005020 polyethylene terephthalate Substances 0.000 description 6
- 229910001414 potassium ion Inorganic materials 0.000 description 6
- 239000000843 powder Substances 0.000 description 6
- 239000003795 chemical substances by application Substances 0.000 description 5
- LYCAIKOWRPUZTN-UHFFFAOYSA-N glycol Chemical compound OCCO LYCAIKOWRPUZTN-UHFFFAOYSA-N 0.000 description 5
- 235000019223 lemon-lime Nutrition 0.000 description 5
- 230000001264 neutralization Effects 0.000 description 5
- 229910052708 sodium Inorganic materials 0.000 description 5
- BVKZGUZCCUSVTD-UHFFFAOYSA-M Bicarbonate Chemical compound OC([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-M 0.000 description 4
- 235000005979 Citrus limon Nutrition 0.000 description 4
- 240000002268 Citrus limon Species 0.000 description 4
- 239000002775 capsule Substances 0.000 description 4
- VEXZGXHMUGYJMC-UHFFFAOYSA-M chloride anion Chemical compound [Cl-] VEXZGXHMUGYJMC-UHFFFAOYSA-M 0.000 description 4
- 229960003511 macrogol Drugs 0.000 description 4
- 238000004806 packaging method and process Methods 0.000 description 4
- KEAYESYHFKHZAL-UHFFFAOYSA-N sodium Chemical compound [Na] KEAYESYHFKHZAL-UHFFFAOYSA-N 0.000 description 4
- 159000000000 sodium salts Chemical class 0.000 description 4
- 235000008733 Citrus aurantifolia Nutrition 0.000 description 3
- 210000001072 Colon Anatomy 0.000 description 3
- 240000004808 Saccharomyces cerevisiae Species 0.000 description 3
- 235000015450 Tilia cordata Nutrition 0.000 description 3
- 235000011941 Tilia x europaea Nutrition 0.000 description 3
- 125000001495 ethyl group Chemical group [H]C([H])([H])C([H])([H])* 0.000 description 3
- 238000009472 formulation Methods 0.000 description 3
- 239000011521 glass Substances 0.000 description 3
- 239000004571 lime Substances 0.000 description 3
- 230000003204 osmotic Effects 0.000 description 3
- 229910001415 sodium ion Inorganic materials 0.000 description 3
- 231100000716 Acceptable daily intake Toxicity 0.000 description 2
- 241000894006 Bacteria Species 0.000 description 2
- 241000207199 Citrus Species 0.000 description 2
- 229940093915 Gynecological Organic acids Drugs 0.000 description 2
- VEXZGXHMUGYJMC-UHFFFAOYSA-N HCl Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 2
- 210000000664 Rectum Anatomy 0.000 description 2
- VVWRPGSYRSSUID-UHFFFAOYSA-K [Cl-].C([O-])([O-])=O.Cl Chemical compound [Cl-].C([O-])([O-])=O.Cl VVWRPGSYRSSUID-UHFFFAOYSA-K 0.000 description 2
- 229910052782 aluminium Inorganic materials 0.000 description 2
- 239000004411 aluminium Substances 0.000 description 2
- XAGFODPZIPBFFR-UHFFFAOYSA-N aluminum Chemical compound [Al] XAGFODPZIPBFFR-UHFFFAOYSA-N 0.000 description 2
- 235000020971 citrus fruits Nutrition 0.000 description 2
- 239000000470 constituent Substances 0.000 description 2
- 235000005911 diet Nutrition 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 238000004090 dissolution Methods 0.000 description 2
- 239000007941 film coated tablet Substances 0.000 description 2
- 235000013305 food Nutrition 0.000 description 2
- 150000002500 ions Chemical class 0.000 description 2
- 229920001684 low density polyethylene Polymers 0.000 description 2
- 239000004702 low-density polyethylene Substances 0.000 description 2
- HQKMJHAJHXVSDF-UHFFFAOYSA-L magnesium stearate Chemical compound [Mg+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O HQKMJHAJHXVSDF-UHFFFAOYSA-L 0.000 description 2
- 230000000813 microbial Effects 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000006011 modification reaction Methods 0.000 description 2
- 201000006417 multiple sclerosis Diseases 0.000 description 2
- PMZURENOXWZQFD-UHFFFAOYSA-L na2so4 Chemical compound [Na+].[Na+].[O-]S([O-])(=O)=O PMZURENOXWZQFD-UHFFFAOYSA-L 0.000 description 2
- 235000015205 orange juice Nutrition 0.000 description 2
- 150000007524 organic acids Chemical class 0.000 description 2
- 235000005985 organic acids Nutrition 0.000 description 2
- 239000000123 paper Substances 0.000 description 2
- 241000894007 species Species 0.000 description 2
- 244000144927 Aloe barbadensis Species 0.000 description 1
- 235000002961 Aloe barbadensis Nutrition 0.000 description 1
- 240000002254 Ananas comosus Species 0.000 description 1
- 235000007119 Ananas comosus Nutrition 0.000 description 1
- 241000228245 Aspergillus niger Species 0.000 description 1
- 241000228257 Aspergillus sp. Species 0.000 description 1
- 240000000560 Citrus x paradisi Species 0.000 description 1
- 206010051244 Dyschezia Diseases 0.000 description 1
- 241000792859 Enema Species 0.000 description 1
- 229940079360 Enema for Constipation Drugs 0.000 description 1
- 241000588724 Escherichia coli Species 0.000 description 1
- 229940023064 Escherichia coli Drugs 0.000 description 1
- 206010056988 Faecalith Diseases 0.000 description 1
- 210000003608 Feces Anatomy 0.000 description 1
- 235000016623 Fragaria vesca Nutrition 0.000 description 1
- 240000009088 Fragaria x ananassa Species 0.000 description 1
- 235000011363 Fragaria x ananassa Nutrition 0.000 description 1
- 206010019233 Headache Diseases 0.000 description 1
- 206010025482 Malaise Diseases 0.000 description 1
- BQJCRHHNABKAKU-KBQPJGBKSA-N Morphine Chemical compound O([C@H]1[C@H](C=C[C@H]23)O)C4=C5[C@@]12CCN(C)[C@@H]3CC5=CC=C4O BQJCRHHNABKAKU-KBQPJGBKSA-N 0.000 description 1
- 229940005483 OPIOID ANALGESICS Drugs 0.000 description 1
- 229940100688 Oral Solution Drugs 0.000 description 1
- 206010061536 Parkinson's disease Diseases 0.000 description 1
- XCRBXWCUXJNEFX-UHFFFAOYSA-N Peroxybenzoic acid Chemical compound OOC(=O)C1=CC=CC=C1 XCRBXWCUXJNEFX-UHFFFAOYSA-N 0.000 description 1
- 229940037179 Potassium Ion Drugs 0.000 description 1
- 240000001890 Ribes hudsonianum Species 0.000 description 1
- 235000016954 Ribes hudsonianum Nutrition 0.000 description 1
- 235000001466 Ribes nigrum Nutrition 0.000 description 1
- 210000003296 Saliva Anatomy 0.000 description 1
- 244000269722 Thea sinensis Species 0.000 description 1
- 240000000280 Theobroma cacao Species 0.000 description 1
- HRXKRNGNAMMEHJ-UHFFFAOYSA-K Trisodium citrate Chemical compound [Na+].[Na+].[Na+].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O HRXKRNGNAMMEHJ-UHFFFAOYSA-K 0.000 description 1
- 244000290333 Vanilla fragrans Species 0.000 description 1
- 235000009499 Vanilla fragrans Nutrition 0.000 description 1
- 235000012036 Vanilla tahitensis Nutrition 0.000 description 1
- CIWBSHSKHKDKBQ-JLAZNSOCSA-N Vitamin C Chemical compound OC[C@H](O)[C@H]1OC(=O)C(O)=C1O CIWBSHSKHKDKBQ-JLAZNSOCSA-N 0.000 description 1
- YGCFIWIQZPHFLU-UHFFFAOYSA-N acesulfame Chemical compound CC1=CC(=O)NS(=O)(=O)O1 YGCFIWIQZPHFLU-UHFFFAOYSA-N 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 235000011399 aloe vera Nutrition 0.000 description 1
- 229920002892 amber Polymers 0.000 description 1
- 230000000845 anti-microbial Effects 0.000 description 1
- 235000010323 ascorbic acid Nutrition 0.000 description 1
- 239000011668 ascorbic acid Substances 0.000 description 1
- 229960005070 ascorbic acid Drugs 0.000 description 1
- 235000019219 chocolate Nutrition 0.000 description 1
- 230000001684 chronic Effects 0.000 description 1
- 230000000112 colonic Effects 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 235000009508 confectionery Nutrition 0.000 description 1
- 230000001186 cumulative Effects 0.000 description 1
- 238000000354 decomposition reaction Methods 0.000 description 1
- 230000013872 defecation Effects 0.000 description 1
- 238000006297 dehydration reaction Methods 0.000 description 1
- 230000037213 diet Effects 0.000 description 1
- 230000000378 dietary Effects 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 230000035622 drinking Effects 0.000 description 1
- 235000021271 drinking Nutrition 0.000 description 1
- 229940079593 drugs Drugs 0.000 description 1
- 239000007920 enema Substances 0.000 description 1
- 230000004634 feeding behavior Effects 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 230000037406 food intake Effects 0.000 description 1
- 239000003205 fragrance Substances 0.000 description 1
- 239000008369 fruit flavor Substances 0.000 description 1
- 231100000869 headache Toxicity 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 239000001257 hydrogen Substances 0.000 description 1
- 229910052739 hydrogen Inorganic materials 0.000 description 1
- 230000000670 limiting Effects 0.000 description 1
- 239000000314 lubricant Substances 0.000 description 1
- 235000019359 magnesium stearate Nutrition 0.000 description 1
- 150000007522 mineralic acids Chemical class 0.000 description 1
- 229960005181 morphine Drugs 0.000 description 1
- 229930014694 morphine Natural products 0.000 description 1
- 230000003364 opioid Effects 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- NPYPAHLBTDXSSS-UHFFFAOYSA-N potassium ion Chemical compound [K+] NPYPAHLBTDXSSS-UHFFFAOYSA-N 0.000 description 1
- 159000000001 potassium salts Chemical class 0.000 description 1
- 230000002035 prolonged Effects 0.000 description 1
- 230000001105 regulatory Effects 0.000 description 1
- 230000000717 retained Effects 0.000 description 1
- 239000001509 sodium citrate Substances 0.000 description 1
- 229910052938 sodium sulfate Inorganic materials 0.000 description 1
- 235000011152 sodium sulphate Nutrition 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 238000003860 storage Methods 0.000 description 1
- 150000003467 sulfuric acid derivatives Chemical class 0.000 description 1
- 235000013616 tea Nutrition 0.000 description 1
- 239000011778 trisodium citrate Substances 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/02—Inorganic compounds
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
- A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
- A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/08—Solutions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/10—Laxatives
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
Abstract
Provided are aqueous solutions comprising polyethylene glycol (PEG) and electrolytes. A preferred aqueous solution comprises: (a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da; (b) 8.0 to 20 g/L sodium chloride; (c) 1.0 to 3.0 g/L potassium chloride and (d) 3.0 to 11 g/L sodium bicarbonate. The solution may be substantially free of preservative. The solutions are useful for treating constipation and/or faecal impaction without requiring further dilution. g/L sodium bicarbonate. The solution may be substantially free of preservative. The solutions are useful for treating constipation and/or faecal impaction without requiring further dilution.
Description
Polyethylene Glycol Solutions for Use in the Treatment of Constipation
The present invention relates to solutions for the treatment of constipation and/or faecal
impaction. In particular, it relates to ready-to-use solutions comprising polyethylene glycol
(PEG) and electrolytes for the treatment of constipation and/or faecal impaction.
Constipation is a widespread condition which generally gives rise to discomfort. The physical
presence of faeces retained in the colon and/or the rectum gives rise to a feeling of malaise and
headaches. In extreme cases of prolonged constipation, dyschezia may result from the presence
of scybala or faecaliths in the rectum.
Numerous treatments for constipation have been developed, including dietary manipulation (e.g.
increasing the fibre content of the diet and removing foods considered to cause constipation),
laxatives and enemas. Laxatives are agents that promote and assist defecation. Osmotic
laxatives act to retain water in the colonic lumen, thereby counteracting the normal dehydrating
action of the colon. By suppressing the dehydration action of the colon, the osmotic laxative
produces a faecal stream which is softer, bulkier and easier to expel.
A number of osmotic laxative treatments currently in use comprise polyethylene glycol (PEG)
and electrolytes. Various such PEG / electrolyte products are on the market in many countries.
An example of such a product is MOVICOL (registered trademark of Edra AG, exclusively
licensed to the Norgine group of companies, and marketed in the UK by Norgine Limited,
Chaplin House, Widewater Place, Moorhall Road, Harefield, Uxbridge, Middlesex UB9 6NS,
United Kingdom). MOVICOL is provided in a sachet containing 13.8g powder for making up
into an oral solution. Each sachet contains: 13.1250g Macrogol 3350, 0.3507g sodium chloride,
0.1785g sodium bicarbonate and 0.0466g potassium chloride. This is the standard dose of
MOVICOL. It also contains flavouring and sweetener. MOVICOL has been on the market
since 1995. MOVICOL PLAIN is essentially the same as MOVICOL but it does not contain
flavouring or sweetener, so to adjust for the potassium content of the sweetener, it contains
slightly more potassium chloride. Each sachet of MOVICOL PLAIN contains: 13.1250g
Macrogol 3350, 0.3508g sodium chloride, 0.1786g sodium bicarbonate and 0.0502g potassium
chloride. When MOVICOL or MOVICOL PLAIN is made into a drink with water to a volume
of 125 millilitres, each sachet gives the equivalent of: 65 millimoles/litre sodium, 53
millimoles/litre chloride, 17 millimoles/litre bicarbonate and 5.4 millimoles/litre potassium.
One standard dose of MOVICOL is provided as a unit treatment in powder form in one sachet.
Patients are advised to combine the powder contents of a sachet with water to make up a drink of
125ml. It is found that dissolution can, in practice, take some time. It is important with a
solution of the MOVICOL type that the patient does not to attempt to speed the dissolution by
heating as that will lead to decomposition of the bicarbonate component. The time taken for the
powder to dissolve causes inefficiency in the care-home or hospital setting where solutions are
prepared by professional care-providers. In the self-administration domestic setting, it can cause
frustration in the patient and risks the patient taking an incompletely dissolved preparation,
which would reduce the efficacy of the treatment. The sachets are made of a laminate consisting
of four layers: low density polyethylene, aluminium, low density polyethylene and paper. Some
patients have difficulties manipulating and tearing open the sachets. The sachets are not re-
usable.
For the treatment of constipation, patients are advised to take one sachet dissolved to 125ml 1-3
times a day, according to the severity of the constipation. Treatment with MOVICOL usually
lasts about 2 weeks. There are various situations in which MOVICOL is recommended for
longer treatments than 2 weeks, particularly in patients who take drugs that cause constipation
(e.g. opioids, such as morphine) or have a disease that has associated constipation (for example
Parkinson's disease or multiple sclerosis (MS)). Usually, for long term treatment in such chronic
treatment situations, the number of doses per day can be adjusted down to either one or two.
For the treatment of faecal impaction, the recommended treatment is 8 sachets a day (each
dissolved to 125ml), taken within 6 hours. That number of doses may be needed for up to 3
days.
Therefore, MOVICOL and other PEG-based laxatives generally require the user to make up a
solution for consumption by combining a dry powder with water. This is generally inconvenient,
particularly for the elderly, time consuming and increases the possibility that the instructions,
typically provided with such products, are not followed as directed. In addition, it requires the
user to have drinkable water or other aqueous solution available.
It is an object of the present invention to provide a PEG-based laxative product that is easy and
convenient to take, is efficacious, has an acceptable taste and an acceptable shelf-life.
In one aspect of the invention, there is provided an aqueous solution comprising the following
components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride; and
(d) 3.0 to 11 g/L sodium bicarbonate,
the solution being substantially free from added preservative selected from the group consisting
of: sodium propyl paraben, methyl paraben, ethyl paraben, propyl paraben, benzyl alcohol,
phenoxyethanol, benzoic acid, dehydroacetic acid, sorbic acid, Bronopol, propylene glycol,
glyceryl triacetate, alcohols, and salts thereof,
for use in a method of treating constipation and/or faecal impaction in a mammalian subject,
such as a human, comprising orally administering the aqueous solution without further dilution.
In some embodiments, the aqueous solution consists essentially of the following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) optional sweetener; and
(f) optional flavouring
the solution being substantially free from added preservative selected from the group consisting
of: sodium propyl paraben, methyl paraben, ethyl paraben, propyl paraben, benzyl alcohol,
phenoxyethanol, benzoic acid, dehydroacetic acid, sorbic acid, Bronopol, propylene glycol,
glyceryl triacetate, alcohols, and salts thereof,
for use in a method of treating constipation and/or faecal impaction in a mammalian subject,
such as a human, comprising orally administering the aquous solution without further dilution.
In one aspect of the invention, there is provided a method of treating constipation and/or faecal
impaction in a mammalian subject, such as a human, comprising orally administering, without
further dilution, an aqueous solution, preferably substantially free of sulphate, comprising (or
consisting essentially of) the following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) optional preservative;
(f) optional sweetener; and
(g) optional flavouring.
The invention provides, in particular, a method of treating constipation comprising orally
administering an aqueous solution as described supra. In another aspect of the present invention,
there is provided an aqueous solution as described supra for oral administration, without further
dilution, for the treatment of constipation and/or faecal impaction. The solution is especially
suitable for the treatment of constipation.
By “without further dilution” is meant that the aqueous solutions of the present invention are
“ready-to-use”, that is, neither do they require the combination of a dry powder with water nor
do they require combination with water or any other liquid (i.e. they do not require any dilution)
prior to consumption. It is to be understood that there may be an insubstantial amount of dilution
by the saliva or dregs of liquid (e.g. from rinsing a glass or other drinking vessel) upon
administration/consumption, but this is not to be taken as “further dilution” within the context of
this invention. In particular, “without further dilution” means that the solutions of the invention
are used/administered without being combined with added liquid, such as water.
As such, solutions of the invention are particularly convenient to administer/consume. This is
particularly advantageous for subjects that are frail (for example the geriatric population) where
it is generally inconvenient to have to follow preparation instructions prior to consuming a
product.
Solutions of the invention are preferably substantially free from any sulphate component. In
particular, solutions of the invention are preferably substantially free from sodium sulphate. In
this context, “substantially free from any sulphate component” is taken to mean free from any
added sulphate component. Negligible amounts of sulphate salts may be present in other added
components, or in the water that is used in the solutions. Such amounts are not substantial in this
context.
In accordance with the present invention, there is further provided an aqueous solution for use in
the treatment of constipation and/or faecal impaction by oral administration without further
dilution, preferably substantially free of sulphate, comprising (or consisting essentially of) the
following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 1.0 to 5.9 g/L (for example 3.0 to 5.9 g/L) of preservative;
(f) optional sweetener; and
(g) optional flavouring.
In accordance with the present invention, there is further provided an aqueous solution for
use in the treatment of constipation and/or faecal impaction by oral administration without
further dilution, comprising the following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate; and
(e) 1.0 to 5.9 g/L of preservative.
In accordance with the present invention, there is further provided an aqueous solution,
preferably substantially free of sulphate, comprising the following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride; and
(d) 3.0 to 11 g/L sodium bicarbonate
for use in a method of treating constipation and/or faecal impaction in a mammalian subject,
such as a human, comprising orally administering the solution without further dilution.
In accordance with the present invention there is preferably provided an aqueous solution,
preferably substantially free of sulphate, comprising (or consisting essentially of) the
following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 1.0 to 5.9 g/L (for example 3.0 to 5.9 g/L) of preservative;
(f) 0.1 to 1.5 g/L sweetener; and
(g) optional flavouring.
In accordance with the present invention there is more preferably provided an aqueous
solution, preferably substantially free of sulphate, comprising (or consisting essentially of)
the following components:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 1.0 to 5.9 g/L (for example 3.0 to 5.9 g/L) of preservative;
(f) 0.1 to 1.5 g/L sweetener; and
(g) 1.0 to 10.0 g/L flavouring.
Preservatives.
Various national and regional pharmacopoeias set criteria that oral preparations, particularly
those comprising multiple dosage unit amounts of solutions, must fulfil regarding their
propensity to support micro-organism growth. For example, in order to meet the criteria of the
European Pharmacopoeia for an oral preparation, a solution must satisfy the following: 3 log
units drop in number of viable micro-organisms for bacteria over 14 days (typically assessed
using Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus, the drop being
required for each), and 1 log unit drop for yeasts and moulds over 14 days (typically assessed
using Candida albicans and Aspergillus sp.for example, Aspergillus niger or Aspergillus
brasiliensis ). Also, for bacteria and yeasts/moulds, there must then be no increase from 14 days
to 28 days.
Various preservatives are known for use in liquid oral preparations. Examples of such
preservatives include sodium propyl paraben, methyl paraben, ethyl paraben, propyl paraben,
benzyl alcohol and phenoxyethanol. Further preservatives that are known for use in liquid oral
preparations (including foods) include benzoic acid, dehydroacetic acid, sorbic acid, Bronopol,
propylene glycol and glyceryl triacetate. Alcohols are used as preservatives in some
preparations.
In some cases, liquid oral preparations do not require the inclusion of a preservative in order to
be able to fulfil criteria regarding propensity to support micro-organism growth, particularly in
the case where the liquid oral preparation is provided in a form containing a single unit dose
amount. Thus the invention also encompasses aqueous solutions that are substantially free from
added preservative. In that case, the aqueous solution is preferably in a form containing a single
unit dose amount.
If the aqueous solution of the invention does include a preservative, the preservative component
may comprise one, two or more preservatives. The preservative may be (i) a separate component
from the other components of the solution and mixed therewith, (ii) a constituent part of a
flavouring component (f), sweetener component (g) or other component of a solution of the
invention, or (iii) both (i) and (ii).
Particularly preferred preservatives are those that are efficacious in suppressing microbial growth
and/or do not degrade over time at neutral or preferably alkaline pH. Preferably, the preservative
is efficacious at a pH of 7.1 to 10, preferably 8 to 10 (e.g. 8.2 to 8.6) more preferably 9 to 10 e.g.
pH 9.5 or thereabout Preferred preservatives include sodium propyl paraben, methyl paraben,
ethyl paraben, propyl paraben, benzyl alcohol, phenoxyethanol, propylene glycol, glyceryl
triacetate and blends of two or more of those. Methyl paraben, ethyl paraben, propyl paraben,
benzyl alcohol and phenoxyethanol and blends of two or more of those are particularly preferred.
Appropriate preservatives may be provided as salts, for example sodium salts. In solutions of the
invention, a preservative is preferably not provided as a salt; if a preservative is provided as a
salt, then the electrolyte components (b) to (d) may need to be adjusted so that the total
concentration of each electrolyte remains at the required level. For example, if a preservative is
used in the form of a sodium salt, it may be necessary to reduce the amount of sodium chloride
present.
It is important that the level of preservative in any oral formulation does not exceed
recommended safe levels for oral use. For an oral preparation that will be given to a patient
several times per day, it is important that the cumulative level of preservative is sufficiently low
not to exceed recommended daily intake levels. Preferred preservatives have ADI (acceptable
daily intake) levels that have been confirmed by suitable regulatory bodies, for example the
EFSA. Methyl paraben, ethyl paraben, propyl paraben, benzyl alcohol and blends of two or
more of those are particularly preferred.
For the solutions of the present invention, it has been found that the preservative may be present
at a level of from 1.0 to 5.9g, for example 3.0 to 5.9g per litre of solution (i.e. 0.30 to 0.59w/v
%), for example 3.3 to 5.7g per litre of solution (i.e. 0.33 to 0.57 w/v %). For example, a
preservative may be present at a level of from 3.5 to 5.5g per litre of solution (i.e. 0.35 to 0.55
w/v %). For example, a preservative may be present at a level of 3.5g/L, 4.0g/L, 4.5g/L or
.5g/L or thereabout. For example, a preservative may be present at a level of from 3.0 to 3.9 g
per litre of solution.
The term “thereabout” used throughout this specification is intended to convey that strict
compliance with the indicated amount is not necessary and is intended to encompass
insignificant variations e.g. due to manufacturing tolerances.
Certain preservatives have limited solubility in water. The effectiveness of a preservative can be
improved by the inclusion of a solubilising agent. Examples of solubilising agents include
benzyl alcohol, phenoxyethanol and propylene glycol. A solubilising agent may be (i) a separate
component from the other components of the solution and mixed therewith, (ii) a constituent part
of a preservative component (e), a flavouring component (f), sweetener component (g) or other
component of a solution of the invention, or (iii) both (i) and (ii). It is important that the level of
a solubilising agent in any oral formulation does not exceed recommended safe levels.
In a preferred embodiment, a preservative comprises 20-30% by weight (relative to the weight of
the preservative) paraben (which may be a single paraben or a mixture of parabens), and 70-80%
by weight solubiliser. It is thus preferred that, in one embodiment, a solution of the invention
includes one or both of methyl paraben and ethyl paraben, and benzyl alcohol, optionally further
comprising propyl paraben. In an embodiment, a solution of the invention includes one or both
of methyl paraben and ethyl paraben, and phenoxyethanol, optionally further comprising propyl
paraben.
Therefore, suitable preservatives should fulfill multiple criteria: they should be efficacious in
suppressing microbial growth and/or not degrade over time at neutral or preferably alkaline pH,
and be sufficiently effective to fulfill national and regional pharmacopoeia criteria regarding
micro-organism growth when used in an amount that is safe for human consumption.
Preferably, a solution of the invention includes all three of methyl paraben, ethyl paraben and
benzyl alcohol. For example, they may be present in a weight ratio methyl paraben: ethyl
paraben: benzyl alcohol of 1 to 3: 1: 5 to 12, for example 1.5 to 2.5: 1: 7 to 9. For example, in
the ratio 18: 9: 73.
Preferably, a blend of methyl paraben, ethyl paraben and benzyl alcohol is present at a level of
3.0 to 4.9g per litre of solution (ie 0.30 to 0.49w/v %), for example 3.3 to 4.7g per litre of
solution (i.e. 0.33 to 0.47w/v %). For example, a preservative may be present at a level of from
3.5 to 4.5g per litre of solution (ie 0.35 to 0.45w/v %). For example, a preservative may be
present at a level of 3.5g/L, 4.0g/L or 4.5g/L. A preferred solution comprises 3.5g or 4.0.g of a
blend of methyl paraben, ethyl paraben and benzyl alcohol per litre, for example 3.5g or 4.0g per
litre of a blend of methyl paraben (18%), ethyl paraben (9%) and benzyl alcohol (73%), the
weight % being based on the weight of the preservative component. Henceforth, this blend of
methyl paraben (18%), ethyl paraben (9%) and benzyl alcohol (73%) is referred to as “MEB”.
For example, a blend of methyl paraben and ethyl paraben (and no further added preservative) is
present at a level of 1.0 to 2.0 g per litre of solution (ie 0.1 to 0.2w/v %). The methyl and ethyl
parabens may be present in a weight ratio of methyl paraben : ethyl paraben of from 3:1 to 1:3,
for example 2:1.
In one embodiment therefore, the aqueous solution of the invention comprises (or consists
essentially of) the following components at the following concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 4.9 g/L for example 3.3 to 4.7g/L or 3.5 to 4.5g/L, e.g. 3.5g/L, 4.0g/L or
4.5g/L of preservative comprising or consisting essentially of methyl paraben,
ethyl paraben or benzyl alcohol, or a mixture of two or more of them (e.g. MEB at
a concentration for example of 3.5 to 4.5g/L such as 3.5 or 4.5 g/L);
(f) optional sweetener; and
(g) optional flavouring.
In an alternative embodiment, the preservative comprises a blend of MEB and propyl paraben.
In some embodiments, the ratio of MEB:propyl paraben is 1.2:1 to 4.5:1, e.g. 1.5:1 to 4.0:1,
1.75:1 to 3.5:1. In one embodiment, the MEB:propyl paraben is 1.75:1 or 3.5:1. Thus in some
embodiments, MEB is present at a level of from 3.0g to 4.0g per liter of solution (0.3 to 0.4w/v
%) and propyl paraben is also present at a level of from 0.8 to 2.5g per liter of solution (0.08 to
0.25 w/v %). In one embodiment, MEB is present at a level of 3.5g per litre or thereabout
(0.35w/v %) and propyl paraben is present at a level of 1g per litre of solution or thereabout
(0.1w/v %). In another embodiment, MEB is present at a level of 3.5g per litre or thereabout
(0.35w/v %) and propyl paraben is present at a level of 2g per litre of solution or thereabout
(0.2w/v %).
Accordingly therefore the present invention further provides an aqueous solution comprising (or
consisting essentially of) the following components at the following concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L for example 4.5 to 5.5 g/L, of preservative comprising or consisting
essentially of methyl paraben, ethyl paraben, benzyl alcohol, or a mixture of two
or more of them (e.g. MEB at a concentration for example of 3.0 to 4.0g/L such as
3.5g/L) and propyl paraben (at a concentration of e.g. 0.08g/L to 0.25g/L such as
0.1g/L or 0.2g/L).
(f) optional sweetener; and
(g) optional flavouring.
In other embodiments of the invention, the preservative is a blend of methyl paraben, ethyl
paraben and phenoxyethanol. For example, a solution of the invention includes all three of
methyl paraben, ethyl paraben and phenoxyethanol. For example, they may be present in a
weight ratio methyl paraben : ethyl paraben : phenoxyethanol of 1 to 3 : 1 : 5 to 12, for example
1.2 to 2.5 : 1 : 7 to 9. For example, in the ratio 18: 9: 73, or 15: 10: 75. This blend therefore
maybe a blend of methyl paraben (18%), ethyl paraben (9%) and phenoxyethanol (73%), the
weight % being based on the weight of the preservative component.
A blend of methyl paraben, ethyl paraben and phenoxyethanol may be present at a level of from
3.1 to 5.9g per litre of solution (ie 0.31 to 0.59w/v %), for example 3.3 to 5.7g per litre of
solution (i.e. 0.33 to 0.57 w/v %). For example, a blend of methyl paraben, ethyl paraben and
phenoxyethanol may be present at a level of from 3.5 to 5.5g per litre of solution (ie 0.35 to 0.55
w/v %). For example, a blend of methyl paraben, ethyl paraben and phenoxyethanol may be
present at a level of 3.5g/L, 4.0g/L, 4.5g/L or 5.5g/L.
The present invention further provides an aqueous solution for use in the treatment of
constipation and/or faecal impaction by oral administration without further dilution, comprising;
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da; and
(b) 1.0 to 5.9g per litre of aqueous solution of preservative wherein the preservative is acceptable
for human consumption and efficacious in the aqueous solution at alkaline pH in suppressing the
growth of one or more of the following microorganisms:
Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and Aspergillus
brasiliensis.
The present invention also further provides an aqueous solution, preferably substantially free of
sulphate, comprising (or consisting essentially of);
(a) 350 to 600g/L PEG (or a sub-range thereof, as described infra) having an average molecular
weight of 2500 to 4500 Da; and
(b) 1.0 to 5.9g, for example 3.0 to 5.9g, per litre of solution (i.e. 0.30 to 0.59w/v %), for example
3.3 to 5.7g per litre of solution (i.e. 0.33 to 0.57 w/v %) of preservative wherein the preservative
(such as those described supra) is acceptable for human consumption and efficacious in the
aqueous solution at neutral or preferably alkaline pH (preferably at a pH of 7.1 to 10, preferably
8 to 10, more preferably 9 to 10 e.g. 9.5 or thereabout) in suppressing the growth of one or more
(preferably all) of the following microorganisms:
Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and Aspergillus
brasiliensis.
Preferably, solutions of this embodiment of the invention further comprise (or further consist
essentially of);
(b) 8.0 to 20 g/L (or a sub-range thereof as set forth infra) sodium chloride;
(c) 1.0 to 3.0 g/L (or a sub-range thereof as set forth infra) potassium chloride;
(d) 3.0 to 11 g/L (or a sub-range thereof as set forth infra) sodium bicarbonate;
(e) optional sweetener, when present, at a concentration as set forth infra;
(f) optional flavouring, when present, at a concentration as set forth infra.
Alternatively, components (b), (c) and (d) maybe administered or consumed separately from the
aqueous solution and are preferably in a solid form such as a capsule or tablet. Preferably, in this
embodiment, these components are in the form of a film coated tablet. In this embodiment, the
tablet may comprise sodium chloride in a range of 0.1 to 3.0g, preferably, 0.3g. to 1.5g, even
more preferably, 0.3g to 1.0g, e.g. 0.3g to 0.4g. In this embodiment, the tablet may further
comprise potassium chloride in a range of 0.01g to 0.1g, preferably, 0.3g to 0.6g, more
preferably, 0.4g to 0.5g. In this embodiment, the tablet may further comprise, in addition to
sodium chloride and potassium chloride, sodium bicarbonate, which if present, is in the range of
0.1g to 0.3g, preferably, 0.15g to 0.2g, more preferably, 0.17g to 0.18g. The tablet may further
contain typical excipients such as lubricants (e.g. magnesium stearate) as known and called for
by acceptable galenic practice.
The sweetener and flavouring in this embodiment may be contained within either the aqueous
solution and/or on or within the solid form. In one embodiment, both the aqueous solution
comprising components (a) and (b), and solid form comprising or consisting essentially of
components (b) to (d), comprise either a flavouring and/or a sweetener. The flavouring used
with the aqueous solution maybe the same or different as that used with the solid form. If
different, preferably the flavouring is complimentary in taste to that flavouring used in the
aqueous solution. The flavouring in the solid form may contrast with that used in the aqueous
solution (e.g. sweet versus sour).
In a further embodiment, there is provided the use of a preservative (such as those described
supra) that is acceptable for human consumption and efficacious in an aqueous solution at
neutral but preferably alkaline pH in suppressing the growth of one or more (preferably all) of
the following microorganisms:
Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and Aspergillus
brasiliensis
in preserving an aqueous solution comprising 350 to 600g/L PEG (or a sub-range thereof, as
described infra) having an average molecular weight of 2500 to 4500 Da., and optionally further
comprising (b) to (f) as set forth immediately supra.
The present invention further provides a kit comprising:
(A) an aqueous solution comprising (a) 350 to 600g/L PEG having an average molecular
weight of 2500 to 4500 Da; and (b) 1.0 to 5.9g per litre of aqueous solution of preservative
wherein the preservative is acceptable for human consumption and efficacious in the aqueous
solution at alkaline pH in suppressing the growth of one or more of the following
microorganisms: Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and
Aspergillus brasiliensis; and
(B) a composition in a solid form such as a capsule or tablet (e.g. film coated tablet)
comprising;
(c) sodium chloride in a range of 0.1 to 3.0g;
(d) potassium chloride in a range of 0.01g to 0.1g; and
(e) sodium bicarbonate, in the range of 0.1g to 0.3g.
In one embodiment there is provided a kit comprising:
(A) an aqueous solution, preferably substantially free of sulphate, comprising (or consisting
essentially of);
(a) 350 to 600g/L PEG (or a sub-range thereof, as described infra) having an average
molecular weight of 2500 to 4500 Da; and
(b) 1.0 to 5.9g, for example 3.0 to 5.9g, per litre of solution (i.e. 0.30 to 0.59w/v %), for
example 3.3 to 5.7g per litre of solution (i.e. 0.33 to 0.57 w/v %) of preservative wherein
the preservative (such as those described supra) is acceptable for human consumption
and efficacious in the aqueous solution at alkaline pH (preferably at a pH of 7 to 10,
preferably 8 to 10, more preferably 9 to 10 e.g. 9.5 or thereabout) in suppressing the
growth of one or more (preferably all) of the following microorganisms:
Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and Aspergillus
brasiliensis; and
(B) a composition in a solid form such as a capsule or tablet comprising;
(c) sodium chloride in a range of 0.1 to 3.0g, preferably, 0.3g. to 1.5g, even more
preferably, 0.3g to 1.0g, e.g. 0.3g to 0.4g;
(d) potassium chloride in a range of 0.01g to 0.1g, preferably, 0.3g to 0.6g, more
preferably, 0.4g to 0.5g;
(e) sodium bicarbonate, in the range of 0.1g to 0.3g, preferably, 0.15g to 0.2g, more
preferably, 0.17g to 0.18g.
In one particular embodiment there is provided a kit comprising:
(A) an aqueous solution comprising;
(i) 525g/L or thereabout of PEG having an average molecular weight of 2500 to 4500 Da
(particularly PEG3350);
(ii) 1.0 to 5.9g, for example 3.0 to 5.9g, per litre of solution (i.e. 0.30 to 0.59w/v %), for
example 3.3 to 5.7g per litre of solution (i.e. 0.33 to 0.57 w/v %) of preservative wherein
the preservative (such as those described supra) is acceptable for human consumption
and efficacious in the aqueous solution at neutral or preferably alkaline pH (preferably at
a pH of 7 to 10, preferably 8 to 10, preferably 9 to 10 e.g. 9.5 or thereabout) in
suppressing the growth of one or more (preferably all) of the following microorganisms:
Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and Aspergillus
brasiliensis; and
(B) a tablet or capsule comprising:
sodium chloride in a range of 0.1 to 3.0g, preferably, 0.3g. to 1.5g, even more preferably,
0.3g to 1.0g, e.g. 0.3g to 0.4g;
potassium chloride in a range of 0.01g to 0.1g, preferably, 0.3g to 0.6g, more preferably,
0.4g to 0.5g; and
sodium bicarbonate, in the range of 0.1g to 0.3g, preferably, 0.15g to 0.2g, more
preferably, 0.17g to 0.18g.
In accordance with the present invention, there is further provided use of the aqueous solution of
the invention, and optionally a second aqueous solution, for the manufacture of a medicament for
the treatment of constipation and/or faecal impaction in a human subject.
In one embodiment, the treatment of constipation and/or faecal impaction in a human subject
comprises the steps of;
(a) administering or consuming the aqueous solution of the invention; and
(b) optionally administering or consuming a second aqueous solution.
In one embodiment, the second aqueous solution is administered or consumed following
administration or consumption of the aqueous solution of step (a).
In one embodiment, a portion (e.g. approximately half) of the aqueous solution of step (a) is
administered or consumed followed by the second aqueous solution of step (b) followed by
administering or consuming the remaining portion of the aqueous solution of step (a).
Polyethylene glycol
The polyethylene glycol (PEG) used in solutions of the invention has an average molecular
weight (for example a weight average molecular weight), of 2500Da to 4500Da. The PEG may
have an average molecular weight of 3000 to 4000. For example, the PEG may be PEG 3350 or
PEG 4000 as defined in national pharmacopoeias. Further examples of suitable PEGs
recognized in some national pharmacopoeias include Macrogols, for example Macrogol 4000.
Optionally, the PEG used in compositions of the invention may comprise two or more different
PEG compounds.
Depending on the molecular weight of the PEG in a solution of the invention, the upper limit of
concentration of the PEG may be limited by the water solubility of the PEG. Solutions of the
invention therefore comprise PEG in an amount of 350 to 600 g per litre, preferably within a
range wherein the lower limit is 400, 450 or 500 g per litre and the upper limit is, independently,
600, 575 or 550 g per litre; for example 500 to 550 g per litre. For example a solution of the
invention may comprise 525 g of PEG per litre, for example 525 g of PEG 3350 per litre.
Sodium Chloride
Solutions of the invention preferably comprise sodium chloride in an amount of 8.0 to 20g per
litre of solution, preferably within a range wherein the lower limit is 10, 11, 12 or 13 g per litre
and the upper limit is, independently, 18, 17, 16 or 15 g per litre; for example 13 to 15 g per litre.
For example a solution of the invention may comprise approximately 14g of sodium chloride per
litre, for example 14.028g per litre.
Potassium Chloride
Solutions of the invention preferably comprise potassium chloride in an amount of 1.0 to 3.0 g
per litre, preferably within a range wherein the lower limit is 1.2, 1.4, 1.6, 1.7 or 1.8 g per litre
and the upper limit is, independently, 2.7, 2.5, 2.3, 2.1 or 2.0 g per litre; for example 1.6 to 2.1 g
per litre, for example 1.8 to 1.9g per litre. For example a solution of the invention may
comprise 1.864 g of potassium chloride per litre. An alternative solution of the invention may
comprise 1.268g or 2.008 g of potassium chloride per litre. In an embodiment, the potassium ion
content may be provided by a potassium salt other than potassium chloride.
Sodium bicarbonate
Solutions of the invention preferably comprise sodium bicarbonate (also known as sodium
hydrogen carbonate) in an amount of 3.0 to 11g per litre, preferably within a range wherein the
lower limit is 5.0, 6.0, 6.5 or 7.0g per litre and the upper limit is, independently, 10, 9.0, 8.0 or
7.5g per litre; for example 6.5 to 8.0 g per litre. For example a solution of the invention may
comprise approximately 7.1 g per litre, for example 7.140g per litre.
In a solution of the invention, the weight ratio of the components PEG, sodium chloride,
potassium chloride and sodium bicarbonate is preferably approximately 13.125(PEG) : 0.3507
(NaCl) : 0.0466 (KCl) : 0.1785 (NaHCO ), ie approximately 282 (PEG) : 7.5 (NaCl) : 1 (KCl) :
3.8 (NaHCO ). For example it may be within the ranges 250 to 450 (PEG) : 5 to 15 (NaCl) : 1
(KCl) : 3 to 7.5 (NaHCO ), for example 250 to 300 (PEG) : 5 to 10 (NaCl) : 1 (KCl) : 3 to 5
(NaHCO ), for example within the ranges 275 to 285 (PEG) : 7 to 8 (NaCl) : 1 (KCl) : 3.6 to 4.0
(NaHCO ).
In another embodiment of a solution of the invention, the molar ratio of the individual ions in the
components sodium chloride, potassium chloride and sodium bicarbonate is preferably
+ - + - + -
approximately 65(Na ) : 53 (Cl ) : 5.0 (K ) : 17 (HCO ), ie approximately 13 (Na ) :10.6 (Cl ) :
+ - + -
1 (K ) : 3.4 (HCO ), For example it may be within the ranges 11 to 15 (Na ) : 8 to 13 (Cl ) : 1
+ - + - +
(K ) : 2.8 to 4.0 (HCO ), for example within the ranges 12 to 14 (Na ) : 9 to 11 (Cl ) : 1 (K ) :
3.2 to 3.6 (HCO ).
Solutions of the invention preferably comprise sodium present as sodium ions in an amount of
173 to 473 mmol per litre, preferably within a range wherein the lower limit is 231, 259, 282 or
305 mmol per litre and the upper limit is, independently, 427, 398, 369 or 345 mmol per litre; for
example 305 to 345 mmol per litre. For example, a solution of the invention may comprise
approximately 325 mmol sodium present as sodium ions per litre.
In one embodiment, solutions of the invention preferably comprise potassium present as
potassium ions in an amount of 14 to 43 mmol per litre, preferably within a range wherein the
lower limit is 17, 23 or 26 mmol per litre and the upper limit is, independently, 39, 34 or 29
mmol per litre; for example from 26 to 29 mmol per litre. For example a solution of the
invention may comprise approximately 27 mmol potassium present as potassium ions per litre.
In another embodiment, solutions of the invention preferably comprise potassium present as
potassium ions in an amount of 13 to 40 mmol per litre, preferably within a range wherein the
lower limit is 16, 19, 21, 23 or 24 mmol per litre and the upper limit is, independently, 36, 34,
31, 28 or 27 mmol per litre; for example 21 to 28 mmol per litre, for example from 24 to 25
mmol per litre. For example a solution of the invention may comprise approximately 25 mmol
potassium present as potassium ions per litre.
Solutions of the invention preferably comprise chloride ions in an amount of 150 to 382 mmol
per litre, preferably within a range wherein the lower limit is 187, 207, 226 or 245 mmol per litre
and the upper limit is, independently, 344, 325, 305 or 284 mmol per litre; for example from 246
to 281 mmol per litre. For example a solution of the invention may comprise approximately 265
mmol chloride ions per litre.
Solutions of the invention preferably comprise bicarbonate ions in an amount of 36 to 131 mmol
per litre, preferably within a range wherein the lower limit is 60, 71, 77 or 83 mmol per litre and
the upper limit is, independently, 119, 107, 95 or 89 mmol per litre; for example 77 to 95 mmol
per litre. For example a solution of the invention may comprise approximately 85 mmol per
litre.
Sweeteners
Solutions of the invention may comprise one or more sweeteners. Preferred sweeteners include
aspartame, acesulfame potassium (acesulfame K), sucralose and saccharine and combinations
thereof. For example, solutions of the invention may comprise one or both of sucralose and
acesulfame potassium (acesulfame K). Typically, a sweetener may be present at a level of for
example 0.1 to 1.5g per litre such as 0.3 to 1.2g per litre, e.g. 0.5g to 1g per litre. Solutions of the
invention may include a sweetener at a level of 0.7 to 1.5g per litre. Solutions of the invention
may include a sweetener, for example at a level of 0.6 to 0.9g per litre, for example 0.70 to 0.95g
per litre, for example 0.80 to 0.95g per litre. In one embodiment, the sweetener is at a level of
1.0g or thereabout per litre. In another embodiment, the sweetener is at a level of 0.85g or
thereabout per litre.
In an embodiment, acesulfame K is present in an amount of, 0.20 to 0.60 g per litre, preferably
within in a range in which the lower limit is 0.20, 0.30 or 0.35 g per litre and the upper limit is,
independently, 0.60, 0.50 or 0.45 g per litre. For example, a solution of the invention may
comprise 0.40 g acesulfame K per litre.
In one embodiment, solutions of the invention preferably comprise acesulfame ions in an amount
of 1.0 to 3.0 mmol per litre, preferably within a range in which the lower limit is 1.0, 1.5 or 1.7
mmol per litre and the upper limit is, independently, 3.0, 2.5 or 2.2 mmol per litre. For example,
a solution of the invention may comprise approximately 2.0 mmol acesulfame ions per litre.
For example, in one embodiment, the invention provides an aqueous solution, comprising the
following components at the following concentrations:
(a) 78 to 240 mmol/L PEG having an average molecular weight of 2500 to 4500 Da;
(b1) 173 to 473 mmol/L sodium present as sodium ions;
(c) 14 to 43 mmol/L potassium present as potassium ions;
(b2) 150 to 382 mmol/L chloride ions;
(d) 36 to 131 mmol/L bicarbonate ions;
(e) preservative;
(f1) 1.0 to 3.0 mmol/L acesulfame ions;
(f2) optional additional sweetener; and
(g) optional flavouring.
In one embodiment of a solution of the invention, the molar ratio of the individual ions in the
components sodium chloride, potassium chloride, sodium bicarbonate and acesulfame K is
+ - + - +
preferably approximately 65(Na ) : 53 (Cl ) : 5.4 (K ) : 17 (HCO ), ie approximately 12 (Na )
- + - +
:10 (Cl ) : 1 (K ) : 3 (HCO ), For example it may be within the ranges 10 to 14 (Na ) : 8 to 12
- + - + -
(Cl ) : 1 (K ) : 2.5 to 3.7 (HCO ), for example within the ranges 11 to 13 (Na ) : 9 to 11 (Cl ) : 1
(K ) : 2.9 to 3.3 (HCO ).
In an embodiment, sucralose is present in an amount of 0.2 to 1.0g per litre, more preferably
within in a range in which the lower limit is , 0.2 or 0.4 g per litre and the upper limit is,
independently, 1.0, 0.8, 0.6, 0.5, 0.45, 0.3g per litre. For example, sucralose may be present in
an amount of from 0.20 to 0.55g per litre, for example 0.30 to 0.55g per litre, for example 0.40 to
0.50g per litre. For example, a solution of the invention may comprise 0.6 g or 0.45g sucralose
per litre.
In a preferred embodiment, the preservative and sweetener are present in a weight ratio of
preservative: sweetener of 1:1 to 7:1, preferably 1:1 to 5:1, more preferably 1:1 to 2:1.
In one embodiment, the invention provides an aqueous solution comprising (or consisting
essentially of) the following components at the following concentrations:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L of preservative;
(f) 0.7 to 1.5 g/L (for example 0.7 to 0.9 g/L) sweetener; and
(g) optional flavouring,
In one embodiment, the invention provides an aqueous solution comprising (or consisting
essentially of) the following components at the following concentrations:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 3.9 g/L of preservative;
(f) 0.7 to 1.5 g/L (for example 0.7 to 0.9 g/L) sweetener; and
(g) optional flavouring.
In one embodiment, the solution of the invention comprises both sucralose (as the optional
additional sweetener) and acesulfame K. In this embodiment, acesulfame K is present in an
amount of, 0.20 to 0.60 g per litre, preferably within a range in which the lower limit is 0.20,
0.30 or 0.35 g per litre and the upper limit is, independently, 0.60, 0.50 or 0.45 g per litre. For
example, a solution of the invention may comprise 0.40 g acesulfame K per litre. In this
embodiment, sucralose is present in an amount of 0.2 to 1.0 g per litre, preferably within a range
in which the lower limit is 0.2 or 0.4 g per litre and the upper limit is, independently, 1.0, 0.8,
0.6, 0.5, 0.45, 0.3 g per litre. For example, a solution of the invention may comprise 0.6 g or
0.45 g sucralose per litre.
Thus, in one embodiment of the present invention, the solution of the invention comprises 0.6g
or thereabout sucralose per litre and 0.4g or thereabout acesulfame K per litre. In another
embodiment, the solution of the invention comprises 0.45g or thereabout sucralose per litre and
0.4g or thereabout acesulfame K per litre. Preferably, sucralose and acesulfame K are present in
a weight ratio of sucralose : acesulfame K of from 2:1 to 1:2, more preferably from 1.25:1 to 1:1.
In one embodiment, the invention provides an aqueous solution comprising (or consisting
essentially of) the following components at the following concentrations:
(a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L of preservative;
(f) 0.7 to 1.5 g/L (for example 0.7 to 0.9 g/L) sweetener comprising sucralose and
acesulfame K; and
(g) optional flavouring,
In accordance therefore with the present invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 4.9 g/L (for example 3.3 to 4.7g/L or 3.5 to 4.5g/L, e.g. 3.5g/L, 4.0g/L or
4.5g/L) of preservative comprising or consisting essentially of methyl paraben,
ethyl paraben or benzyl alcohol, or a mixture of two or more of them (e.g. MEB at
a concentration for example of 3.5 to 4.5g/L, such as 3.5 or 4.5 g/L);
(f) 0.1 to 1.5g per litre (such as 0.3 to 1.2g per litre, e.g. 0.5g to 1g per litre, such as
1.0g or thereabout per litre, or 0.85g or thereabout per litre) of sweetener; and
(g) optional flavouring.
In accordance therefore with the present invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L (for example 4.5 to 5.5 g/L) of preservative comprising or
consisting essentially of, methyl paraben, ethyl paraben, benzyl alcohol, or a
mixture of two or more of them (e.g. MEB at a concentration for example of 3.5
to 4.0g/L, such as 3.5g/L) and propyl paraben (at a concentration of e.g. 0.08g/L
to 0.25g/L, such as 0.1g/L or 0.2g/L) and;
(f) 0.1 to 1.5g per litre (such as 0.3 to 1.2g per litre, e.g. 0.5g to 1g per litre, such as
1.0g or thereabout per litre, or 0.85g or thereabout per litre) of sweetener; and
(g) optional flavouring.
In accordance with a further aspect of the invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 4.9 g/L (for example 3.3 to 4.7g/L or 3.5 to 4.5g/L, e.g. 3.5g/L, 4.0g/L or
4.5g/L) of preservative comprising or consisting essentially of methyl paraben,
ethyl paraben or benzyl alcohol, or a mixture of two or more of them (e.g. MEB at
a concentration for example of 3.5 to 4.5g/L, such as 3.5 or 4.5 g/L);
(f1) 0.2 to 0.6g/L (for example 0.2 to 0.5g/L or 0.3 to 0.45g/L, e.g. 0.4g/L of
acesulfame K);
(f2) 0.2 to 1.0g/L (for example 0.2 to 0.8g/L or 0.3 to 0.6g/L or 0.4 to 0.6g/L, such as
0.45g/L or thereabout, or 0.6g/L or thereabout) of sucralose; and
(g) optional flavouring.
In accordance therefore with the present invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L (for example 4.5 or 5.5 g/L) of preservative comprising or
consisting essentially of, methyl paraben, ethyl paraben, benzyl alcohol, or a
mixture of two or more of them (e.g. MEB at a concentration for example of 3.0
to 4.0g/L) and propyl paraben (at a concentration of e.g. 0.08g/L to 0.25g/L, such
as 0.1g/L or thereabout or 0.2g/L or thereabout);
(f1) 0.2 to 0.6g/L (for example 0.2 to 0.5g/L or 0.3 to 0.4g/L, e.g. 0.4g/L) of
acesulfame K;
(f2) 0.2 to 1.0g/L (for example 0.2 to 0.8g/L or 0.3 to 0.6g/L or 0.4 to 0.6g/L, such as
0.45g/L or thereabout, or 0.6g/L or thereabout) of sucralose; and
(g) optional flavouring.
Flavouring
Solutions of the invention optionally comprise one or more flavourings. Flavourings assist in
making the solutions for ingestion more palatable to certain patients. The exact level of
flavouring required depends on the intensity of flavour desired, and the nature and strength of the
flavour in question. Typically, a flavouring may be present at a level of 1 to 10g per litre, for
example from 1 to 5g per litre, especially from 1.2 to 4.3g per litre, such as 1.5 to 3.7g per litre,
for example 1.5g, 2.0g, 2.5g, 3.2g, 3.7g or 4.0g per litre.
Examples of flavours that can be used include orange, lemon-lime, lemon, citrus, chocolate,
tropical fruit, aloe vera, tea, strawberry, grapefruit, blackcurrant, pineapple and vanilla.
Preferred flavours are orange juice flavour, lemon and lime and tropical fruit flavour. Citrus
flavour may also be used.
Those and further suitable flavourings are available from various flavour manufacturers and
suppliers, for example International Flavours and Fragrances Inc. (Duddery Hill, Haverhill,
Suffolk, CB9 8LG, England), Ungerer & Company (Sealand Road, Chester, England CH1 4LP),
Firmenich (Firmenich UK Ltd., Hayes Road, Southall, Middlesex UB2 5NN) or S. Black Ltd
(Foxholes Business Park, John Tate Road, Hertford, Herts, SG13 7YH, United Kingdom)
In accordance therefore the invention provides an aqueous solution comprising (or consisting
essentially of) the following components at the following concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 4.9 g/L (for example 3.3 to 4.7g/L or 3.5 to 4.5g/L, e.g. 3.5g/L, 4.0g/L or
4.5g/L) of preservative comprising or consisting essentially of methyl paraben,
ethyl paraben or benzyl alcohol, or a mixture of two or more of them (e.g. MEB at
a concentration for example of 3.5 to 4.5g/L, such as 3.5 or 4.5 g/L);
(f) 0.1 to 1.5g per litre (such as 0.3 to 1.2g per litre, e.g. 0.5g to 1g per litre, such as
1.0g or thereabout per litre or 0.85g or thereabout per litre) of sweetener; and
(g) 1 to 10g per litre (for example, 1 to 5g or 1.2 to 4.3g or 1.5 to 4.0g, e.g. 1.5, 2.0,
2.5, 3.2, 3.7 or 4.0g per litre) of flavouring (which may be orange, lemon-lime or
tropical fruit.
In accordance therefore with the present invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L (for example 4.5 or 5.5 g/L) of preservative comprising or
consisting essentially of, methyl paraben, ethyl paraben, benzyl alcohol, or a
mixture of two or more of them (e.g. MEB at a concentration for example of 3.0
to 4.5g/L, such as 3.5g/L) and propyl paraben (at a concentration of e.g. 0.8g/L or
0.25g/L, such as 0.1g/L or thereabout, or 0.2g/L or thereabout) and;
(f) 0.1 to 1.5g per litre (such as 0.3 to 1.2g per litre, e.g. 0.5g to 1g per litre, such as
1.0g or thereabout per litre, or 0.85g or thereabout per litre) of sweetener; and
(g) 1 to 10g (for example, 1 to 5g or 1.2 to 4.3g or 1.5 to 4.0g, e.g. 1.5,2.0,2.5,3.2,3.7
or 4.0g per litre) of flavouring (which may be orange, lemon-lime or tropical
fruit).
In accordance with a further aspect of the invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 4.9 g/L (for example 3.3 to 4.7g/L or 3.5 to 4.5g/L, e.g. 3.5g/L, 4.0g/L or
4.5g/L) of preservative comprising or consisting essentially of methyl paraben,
ethyl paraben or benzyl alcohol, or a mixture of two or more of them (e.g. MEB at
a concentration for example of 3.5 to 4.5g/L such as 3.5 or 4.5 g/L);
(f1) 0.2 to 0.6g/L (for example 0.2 to 0.5g/L or 0.3 to 0.4g/L e.g. 0.4g/L) of
acesulfame K;
(f2) 0.2 to 1.0g/L (for example 0.2 to 0.8g/L or 0.3 to 0.6g/L or 0.4 to 0.6g/L such as
0.45g/L or 0.6g/L) of sucralose; and
(g) 1 to 10g/L (for example, 1 to 5g or 1.2 to 4.3g or 1.5 to 4.0g , e.g.1.5, 2.0, 2.5, 3.2,
3.7 or 4.0g per litre) of flavouring (which may be orange, Lemon-Lime or tropical
fruit).
In accordance therefore with the present invention there is provided an aqueous solution
comprising (or consisting essentially of) the following components at the following
concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L (for example 4.5 or 5.5 g/L) of preservative comprising or
consisting essentially of, methyl paraben, ethyl paraben, benzyl alcohol, or a
mixture of two or more of them (e.g. MEB at a concentration for example of 3.5
to 4.0g/L) and propyl paraben (at a concentration of e.g. 0..08g/L or 0.25g/L);
(f1) 0.2 to 0.6g/L (for example 0.2 to 0.5g/L or 0.3 to 0.4g/L e.g. 0.4g/L) of acesulfame
(f2) 0.2 to 1.0g/L (for example 0.2 to 0.8g/L or 0.3 to 0.6g/L or 0.4 to 0.6g/L such as
0.45g/L or 0.6g/L) of sucralose; and
(g) 1 to 10g/L (for example, 1 to 5g or 1.2 to 4.3g or 1.5 to 4.0g (e.g. 1.5, 2.0, 2.5,
3.2, 3.7 or 4.0g per litre) of flavouring (which may be orange, lemon-lime or
tropical fruit).
Solutions of the invention are preferably substantially free from added citrate ions. Citrate ions
are provided for example by citric acid and sodium citrate. Some fruit flavourings may
intrinsically contain a small amount of citric acid. Those amounts are not considered substantial
in this context. Solutions of the invention are preferably substantially free from added acid.
Hydrogen ions are provided for example by organic acids (for example citric acid or ascorbic
acid) or inorganic acids (for example hydrochloric acid). Some fruit flavourings may
intrinsically contain small amounts of organic acids. Those amounts are not considered
substantial in this context. Solutions of the invention preferably have a pH of 8.0 to 11.0,
preferably 8.0 to 10.5, for example 8.4 to 9.0. Measurements of pH may, for example, be carried
out with a Hanna Instruments “pH ep” temperature compensating pH meter.
In another embodiment of the invention, an aqueous solution has the following components at
the following concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(f) optional flavouring; and
(g) optional sweetener.
In all respects other than in relation to the added preservative component, the solution has the
preferred features described elsewhere herein. Containers and kits comprising such solutions,
methods of preparing such solutions are also provided.
A preferred embodiment of an aqueous solution of the invention comprises (or consists
essentially of) the following components at the following concentrations:
(a) 525 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 14.028 g/L sodium chloride;
(c) 1.864 g/L potassium chloride;
(d) 7.140 g/L sodium bicarbonate;
(e) optional preservative (but where present in an amount of 3.5g/L or 4.0g/L or
5.4g/L) ;
(f) optional flavouring (but where present in an amount of 1.5g/L or 2.0g/L or 2.5g/L
or 3.2g/L or 4.0g/L); and
(g) optional sweetener (but where present in an amount of 0.85g/L or thereabout
(e.g.0.848g/L) or 1.0g/L).
The invention further provides a unit treatment of a solution of the invention, the unit treatment
having the volume necessary to provide 11 to 15g of PEG. An alternative unit treatment of a
solution of the invention has the volume necessary to provide 5.5 to 7.5g of PEG (for use in mild
cases of constipation or the paediatric population).
For example, a unit treatment may be from 10 to 50ml of the solution of the invention. For
example, if a solution of the invention comprises 525 g of PEG 3350 per litre, then 25ml are
required to provide the amount of PEG shown above. A unit treatment is thus preferably from
to 40ml, for example 25 to 30ml, especially 25 ml. Accordingly, the invention further
provides a unit treatment of from 10 to 50ml of the solution of the invention. Preferably, a unit
treatment is from 20 to 40ml, for example 25 to 30ml, especially 25 ml. For use in an alternative
setting (for example for paediatric use or in patients with mild constipation) mentioned above, all
of the quantities in a unit treatment are halved.
For example, a unit treatment may comprise 10 to 50ml of a solution in water comprising the
following components at the following concentrations:
(a) 350 to 600 g/L PEG having an average molecular weight of 2500 to 4500 Da;
(b) 8.0 to 20 g/L sodium chloride;
(c) 1.0 to 3.0 g/L potassium chloride;
(d) 3.0 to 11 g/L sodium bicarbonate;
(e) 3.0 to 5.9 g/L preservative;
(f) optional flavouring; (but where present is in an amount of from 1.0 to 10.0 g/L);
(g) optional sweetener (but when present is in an amount of from 0.7 g to 0.9g/L).
A unit treatment may comprise 7.8 to 62.5ml, for example 10 to 50ml of a solution in water
comprising the following components in the following weights:
(a) 3.50 to 30 g PEG having an average molecular weight of 2500 to 4500 Da;
(b) 0.08 to 1.0 g sodium chloride;
(c) 0.01 to 0.15 g potassium chloride;
(d) 0.03 to 0.55 g sodium bicarbonate;
(e) 0.03 to 0.295 g preservative;
(f) optional flavouring (but where present in an amount of from 0.01g to 0.5g); and
(g) sweetener in an amount of from 0.007g to 0.045g.
A preferred unit treatment comprises 10 to 50ml of a solution in water comprising the following
components in the following weights:
(a) 11 to 15 g PEG having an average molecular weight of 2500 to 4500 Da;
(b) 0.3 to 0.4 g sodium chloride;
(c) 0.035 to 0.055 g potassium chloride;
(d) 0.15 to 0.25 g sodium bicarbonate;
(e) 0.03 to 0.12g preservative;
(f) optional flavouring; and
(g) 0.010g to 0.030g sweetener.
A preferred unit treatment comprises 20 to 50ml of a solution in water comprising the following
components in the following weights:
(a) 13.125 g PEG having an average molecular weight of 3350;
(b) 0.3507 g sodium chloride;
(c) 0.0466 g potassium chloride;
(d) 0.1785 g sodium bicarbonate;
(e) 0.03 to 0.12g preservative;
(f) 0.02 to 0.5g flavouring; and
(g) 0.010g to 0.030g sweetener.
For use in an alternative setting (for example for paediatric use or in patients with mild
constipation) mentioned above, all of the quantities in a unit treatment are halved. Thus, an
alternative preferred unit treatment comprises 10 to 25ml of a solution in water comprising the
following components in the following weights:
(a) 6.563 g PEG having an average molecular weight of 3350;
(b) 0.01754 g sodium chloride;
(c) 0.0233 g potassium chloride;
(d) 0.0893 g sodium bicarbonate;
(e) 0.05 to 0.075g preservative;
(f) optional flavouring; and
(g) optional sweetener.
The invention also provides a container containing a solution of the invention. For example, a
container may contain:
(a) x x 262.50g polyethylene glycol (PEG) 3350;
(b) x x 7.014 g sodium chloride;
(c) x x 0.932g potassium chloride;
(d) x x 3.570g sodium bicarbonate;
(e) optionally x x an amount of preservative;
(f) optionally x x an amount of flavouring;
(g) optionally x x an amount of sweetener; and
(h) water to x x 500ml;
where x is 0.5 to 2, for example x is 0.5 or 1.
The invention also provides a container containing:
(a) y x 13.125g polyethylene glycol (PEG) 3350;
(b) y x 0.3507g sodium chloride;
(c) y x 0.0466g potassium chloride;
(d) y x 0.1785g sodium bicarbonate;
(e) optionally y x an amount of preservative;
(f) optionally y x an amount of flavouring;
(g) optionally y x an amount of sweetener; and
(h) water to y x 25 ml;
where y is 0.5 to 40, for example y is 0.5 or 1 or 2 or 4 or 10.
Such a container may, for example, contain:
(a) 262.50g PEG 3350;
(b) 7.014 g sodium chloride;
(c) 0.932g potassium chloride;
(d) 3.570g sodium bicarbonate;
(e) optional preservative (but where present in an amount of from 1.5 to 2.95g) ;
(f) optional flavouring (but where present in an amount of from 0.5 to 5.0 g);
(g) optional sweetener (but where present in an amount of from 0.05 to 0.75g); and
(h) water to 500ml.
An alternative container may contain:
(a) 131.25g PEG 3350;
(b) 3.507g sodium chloride;
(c) 0.466g potassium chloride;
(d) 1.785g sodium bicarbonate;
(e) optional preservative (but where present in an amount of from 0.75 to 1.475g) ;
(f) optional flavouring (but where present in an amount of from 0.25 to 2.5g);
(g) optional sweetener (but where present in an amount of from 0.025 to 0.375g); and
(h) water to 250ml.
An alternative container may contain:
(a) 78.75g PEG 3350;
(b) 2.1042 g sodium chloride;
(c) 0.2796g potassium chloride;
(d) 1.071g sodium bicarbonate;
(e) optional preservative (but where present in an amount of from 0.45 to 0.88g);
(f) optional flavouring (but where present in an amount of from 0.15 to 1.5g);
(g) optional sweetener (but where present in an amount of from 0.015 to 0.225g); and
(h) water to 150ml.
An alternative container may contain:
(a) 52.5g PEG 3350;
(b) 1.4028g sodium chloride;
(c) 0.1864g potassium chloride;
(d) 0.714g sodium bicarbonate;
(e) optional preservative (but where present in an amount of from 0.3 to 0.59g);
(f) optional flavouring (but where present in an amount of from 0.1 to 1.0g);
(g) optional sweetener (but where present in an amount of from 0.01 to 0.15g); and
(h) water to 100ml.
An alternative container may contain:
(a) 13.125g PEG 3350;
(b) 0.3507g sodium chloride;
(c) 0.0466g potassium chloride;
(d) 0.1785g sodium bicarbonate;
(e) optional preservative (but where present in an amount of from 0.075 to 0.1475g);
(f) optional flavouring (but where present in an amount of from 0.025 to 0.25g);
(g) optional sweetener (but where present in an amount of from 0.0025 to 0.0375 g);
(h) water to 25ml.
The solutions of the present invention, optionally presented in a container comprising single or
multiple treatment units, are preferably provided with instructions for use. The invention further
provides a kit comprising a container containing a solution of the invention together with
instructions to consume a unit amount of the invention. The instructions may also state what
disorders (such as constipation or faecal impaction), the solution of the invention is indicated for.
The invention further provides a kit comprising a container containing a solution of the invention
together with a measuring accessory for measuring out a defined volume of the solution.
Examples of measuring accessories include measuring cups, measuring spoons, measuring tubes,
and syringes. If 25ml is the unit measurement, the measuring accessory preferably enables the
measurement of a 25ml unit treatment out of the bottle or container.
The measuring accessory may be adapted to attach to the container, for example it may be in the
form of a cap that fits over and grips onto the closure of the container in storage and can be held
separately from the container for measuring out a required volume of solution. The measuring
accessory may have a measurement volume such that several measurement accessories provide
the required unit treatment volume. For example, for the provision of a 25ml unit treatment
volume, a measuring accessory might provide for measuring a volume of 25ml, 12.5ml (two
needed), 8.333ml (three needed), 6.25ml (4 needed) or 5ml (5 needed). A suitable measuring
accessory may have the required volume as its total capacity, or it may be provided with one or
more gradation lines to indicate the required volume. In one embodiment, the measuring
accessory is a cap that provides for the measurement of a 25ml unit volume. For use in an
alternative setting (for example for paediatric use or in patients with mild constipation)
mentioned above, the volumes mentioned here are all halved. For distribution and sale, a
container may be provided in an outer packaging, such as a carton. Instructions may be provided
on a medium, for example paper, inside the outer packaging. Instructions may be printed onto
the outer packaging, or onto the container itself. A carton may contain the container, a
measuring accessory and instructions. Alternatively or additionally, instructions may direct the
user to a website where information such as background information on approved indications,
recommended dose, composition of the solution, frequency of recommended use, and the like are
displayed.
Solutions of the invention are suitable for use in the treatment of constipation and/or faecal
impaction. Accordingly, the present invention also provides a method of treating constipation or
faecal impaction comprising administering orally, without further dilution, to a subject an
effective amount of the solution of the invention. The invention also provides a solution of the
invention for use as a medicament; for example the medicament can be for use in the treatment
of constipation or faecal impaction. A solution for use in a method of the invention has the
preferred features described above in respect of the solutions of the invention.
The solution of the invention may be provided in a container having a volume that is for multiple
unit treatments. The invention thus further provides a container that contains sufficient solution
for any convenient number of unit treatments. For example, the container might provide 1, 2, 4,
, 8, 10, 12, 15, 20, 25, 30, 35, 40, 50, 60, 70, 75, 80 or 100 unit treatments. For example, if a
solution of the invention comprises 525 g of PEG 3350 per litre, and 25ml are required to
provide the 13.125g of PEG in a standard dose, then a container may provide 25ml, 50ml,
100ml, 125ml, 150ml, 200ml, 250ml, 300ml, 375ml, 500ml, 625ml, 750ml, 875ml or 1l of
solution. For example a container may contain one or more unit treatments of solution, each unit
treatment having a volume of 20 to 50ml, for example 25ml, or each unit treatment having a
volume of 7.5 to 25ml, for example 12.5ml. For example, a container (for example a bottle) of
the invention provides 100ml, 150ml, 250ml or 500ml of solution of the invention.
Suitable containers include bottles, for example with a re-closable closure. A re-closable closure
may be child-proof. A re-closable closure may be tamper-evident. Containers may for example
be made of plastic or glass, for example polyethylene terephthalate (PET). They may be circular
in cross-section, for example they may be a right circular cylinder. They may be transparent,
translucent or opaque; containers may be coloured, for example amber.
In another embodiment of the invention, the solution of the invention is provided as a single unit
amount which may be particularly convenient when access to safe drinkable water is not readily
available, for instance, when the user is travelling. This embodiment is also more readily
portable and avoids the need to carry more units than are needed. The single unit amount of
solution of the invention maybe disposed within a container of suitable, preferably minimal,
volume such as a bottle, pouch, stickpack, sachet or can. Since this embodiment encompasses a
single dose unit amount of solution of the invention, a preservative may not be needed in order to
achieve an acceptable shelf-life. A plurality of single unit dose containers may be in a box, for
example to provide a course of treatment. It is preferred that packaging used in the present
invention, particularly those parts in direct contact with the aqueous solution of PEG, are
substantially free (preferably entirely free) of aluminium.
Accordingly, therefore the present invention also provides a container such as a bottle, pouch,
sachet, stickpack or can comprising a single unit amount of the following components;
(a) 13.125g PEG 3350;
(b) 0.3507g sodium chloride;
(c) 0.0466g potassium chloride;
(d) 0.1785g sodium bicarbonate;
(e) optional preservative (but where present in an amount of from 0.075 to 0.1475g);
(f) optional flavouring (but where present in an amount of from 0.025 to 0.25g);
(g) optional sweetener (but where present in an amount of from 0.0025 to 0.0375 g);
and
(h) water to 25ml.
The following solutions in Table 1 (Tables 1a to 1c) are disclosed herein. These solutions are
specifically disclaimed as per se solutions in this application. Some of the solutions may find
use in the methods and uses of the current invention. Solutions specifically disclosed in
international patent application are specifically disclaimed from per se
solution claims in this application. Some of the solutions disclosed in that application may find
use in the methods and uses of the current invention.
Table 1a: Common components of the solutions of the solutions in Tables 1b and 1c
Component Quantity/g
PEG 3350 13.1250
Sodium Chloride 0.3507
Potassium Chloride 0.0466*
Sodium Bicarbonate 0.1785
Acesulfame K 0.0100
Optional Preservative As indicated
Optional Flavour As indicated
Optional Additional Sweetener As indicated
Water As indicated
In Tables 1b and 1c, the flavour “TF” is Tropical Fruit and the flavor “OJ” is Orange Juice.
They are available from Firmenich UK Ltd (Hayes Road, Southall, Middlesex, UB2 5NN).
Table 1b:
Component 2A 2B 2C 2D 2E 2F 2G 2H
Flavour NoneNone0.0375gTF0.0375gTF0.0375gTF0.0375gTF0.0375gTF0.0375gTF
Sucralose NoneNone0.0150g0.0150g 0.0150g0.0150g0.0150g0.0150g
Sodium propyl paraben (sodium propyl 4- 0.05% 0.1%
hydroxybenzoate) [0.01625g] [0.0325g]
Blend of methyl paraben (18%), ethyl 0.3% 0.5% 0.7%
paraben (9%) and benzyl alcohol (73%) [0.075g] [0.125g] [0.175g]
Phenoxyethanol 0.7%
[0.175g]
Methyl paraben (as sodium salt) 0.15%
[0.0375g]
Ethyl paraben (as sodium salt) 0.10%
[0.025g]
Blend of methyl paraben (18%), ethyl 0.5%
paraben (9%) and phenoxyethanol (73%) [0.125g]
to 32.5ml to 32.5ml to 25ml to 25ml to 25ml to 25ml to 25ml to 25ml
Water
Table 1c:
Component 2I 2J 2K 2L 2M 2N 2P 2Q
Flavour 0.0375gTF0.0375gTF0.0800gOJ0.0800gOJ 0.0800gOJ 0.0800gOJ 0.0800gOJ 0.0800gOJ
Sucralose 0.0150g0.0150g0.003g0.003g0.003g0.003g0.003g0.003g
Methyl paraben 0.18% 0.225% 0.0675% 0.0675%
[0.045g] [0.05625g] [0.0169g] [0.0169g]
Propyl paraben 0.02% 0.025%
[0.005g] [0.00625g]
Ethyl paraben 0.0338% 0.0338%
[0.0084g] [0.0084g]
Benzyl alcohol 0.1825% 0.2163%
[0.0456g] [0.05406g]
Propylene glycol 3.75g 3.75g
Blend of methyl paraben (15%), ethyl 0.5% 0.8%
paraben (10%) and phenoxyethanol (75%) [0.125g] [0.200g]
to 25ml to 25ml to 25ml to 25ml to 25ml to 25ml to 25ml to 25ml
Water
Examples
The following non-limiting Examples illustrate the invention.
Example 1: Solutions of the invention
Solutions 1A to 1N were prepared. The solutions contained the components shown in
Table 2, and each solution was made up with water to a total volume of 25 ml.
Table 2:
Solution Flavouring Macrogol Sodium Sodium Potassium Acesulfame Sucralose Flavour Preservative
No. 3350 (g) Chloride Bicarbonate Chloride K (g) (g) type and
(g) (g) (g) (g) (g)
1A Lemon- 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0925 Iscaguard MEB
Lime 0.0875g
1B Tropical 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0375 Iscaguard MEB
0.1000g
1C Orange 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0800 Iscaguard
0.0875g
1D Orange 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0800 Iscaguard
0.1000g
1E Lemon- 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0625 Iscaguard
Lime MEB
0.0875g
1F Lemon- 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0500 Iscaguard
Lime MEB
0.0875g
1G Tropical 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0375 Iscaguard
0.1000g
1H Tropical 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.1000 Iscaguard
0.1000g
1I Lemon- 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0925 Methyl Paraben
Lime 0.0200g
Ethyl Paraben
0.0100g
Table 2 continued:
Solution Flavouring Macrogol Sodium Sodium Potassium Acesulfame Sucralose Flavour Preservative
No. 3350 (g) Chloride Bicarbonate Chloride K (g) (g) type and
(g) (g) (g) (g) (g)
1J Lemon- 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0925 Methyl Paraben
Lime 0.0250g
Ethyl Paraben
0.0130g
1K Tropical 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0375 Methyl Paraben
0.0200g
Ethyl Paraben
0.0100g
1L Tropical 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0375 Methyl Paraben
0.0250g
Ethyl Paraben
0.0130g
1M Lemon 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0925 Iscaguard MEB
Lime 0.0875g
Propyl Paraben
0.025g
1N Lemon 13.125 0.3507 0.1785 0.0466 0.0100 0.0112 0.0925 Iscaguard MEB
Lime 0.0875g
Propyl Paraben
0.050g
Example 2 : Efficacy of antimicrobial preservative.
Five 20g portions of each sample were transferred to sterile glass bottles and inoculated
separately with 0.2mL culture of the test species as detailed below. The test species used
include the following shown in Table 3.
Table 3:
Species
Pseudomonas aeruginosa
Escherichia coli
Staphylococcus aureus
Candida albicans
Aspergillus brasiliensis
The inoculated sample portions were mixed using sterile implements and stored at room
temperature. The challenge test protocol as set forth in 5.1.3 of the European
Pharmacopoeia, version 7.2 was then followed.
Results:
Samples of formulation 1A and 1B were tested for efficacy of the preservative at time (T)
T=4 weeks, T=9 weeks and T=12 weeks and passed the acceptance criteria (Table
5.1.3.3, European Pharmacopoeia, 7.2) at all measured time points. Specifically, the
combined CFU count for yeast and mould was determined to be less than 10 CFU/ml at
all measured time points.
Example 3: Container containing a solution of the invention
Bottle 2a: A 500ml polyethylene terephthalate (PET) bottle contains 500ml of a solution
1A to 1N described in Example 1 above. The bottle is provided with a re-closable
closure, and a cap that fits over and grips onto the closure. The cap is suitable for
measuring a 25ml unit treatment volume. The bottle is provided in a carton with
instructions for use. The instructions include the instruction that 25ml of the solution
should be measured out and taken neat as a treatment dose.
Bottle 2b is a 250ml polyethylene terephthalate (PET) bottle containing 250ml of a
solution 1A to 1N described in Example 1 above.
Bottles 2c and 2d are the same as bottles 2a and 2b respectively, but with a cap that is
suitable for measuring a 12.5ml unit treatment volume, and instructions that include
instruction that 12.5ml of the solution should be measured out and taken neat as a
treatment dose.
Pouch 2e contains 25ml of a solution 1A to 1N described in Example 1 above. Single use
container 2f contains 25ml of a solution 1A to 1N described in Example 1 above.
Stickpack 2g contains 25ml of a solution 1A to 1N described in Example 1 above. Each
of pouch 2e, single use container 2f and stickpack 2g is provided with instructions for
use. The instructions include the instruction that 25ml of the solution should be taken
neat as a treatment dose. A plurality of pouches 2e, single use containers 2f or stickpacks
2g are provided in a carton.
It will be understood that the term “comprise” and any of its derivatives (eg. comprises,
comprising) as used in this specification is to be taken to be inclusive of features to which
it refers, and is not meant to exclude the presence of any additional features unless
otherwise stated or implied.
The reference to any prior art in this specification is not, and should not be taken as, an
acknowledgement of any form of suggestion that such prior art forms part of the common
general knowledge.
It will be appreciated by those skilled in the art that the invention is not restricted in its
use to the particular application described. Neither is the present invention restricted in its
preferred embodiment with regard to the particular elements and/or features described or
depicted herein. It will be appreciated that various modifications can be made without
departing from the principles of the invention. Therefore, the invention should be
understood to include all such modifications in its scope.
Claims (19)
1. An aqueous solution comprising the following components: (a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da; 5 (b) 8.0 to 20 g/L sodium chloride; (c) 1.0 to 3.0 g/L potassium chloride; and (d) 3.0 to 11 g/L sodium bicarbonate, the solution being substantially free from added preservative selected from the group consisting of: sodium propyl paraben, methyl paraben, ethyl paraben, propyl paraben, 10 benzyl alcohol, phenoxyethanol, benzoic acid, dehydroacetic acid, sorbic acid, Bronopol, propylene glycol, glyceryl triacetate, alcohols, and salts thereof, for use in a method of treating constipation and/or faecal impaction in a mammalian subject, such as a human, comprising orally administering the aqueous solution without further dilution.
2. The aqueous solution of claim 1, consisting essentially of the following components: (a) 350 to 600g/L PEG having an average molecular weight of 2500 to 4500 Da; (b) 8.0 to 20 g/L sodium chloride; (c) 1.0 to 3.0 g/L potassium chloride; 20 (d) 3.0 to 11 g/L sodium bicarbonate; (e) optional sweetener; and (f) optional flavouring the solution being substantially free from added preservative selected from the group consisting of: sodium propyl paraben, methyl paraben, ethyl paraben, propyl paraben, 25 benzyl alcohol, phenoxyethanol, benzoic acid, dehydroacetic acid, sorbic acid, Bronopol, propylene glycol, glyceryl triacetate, alcohols, and salts thereof, for use in a method of treating constipation and/or faecal impaction in a mammalian subject, such as a human, comprising orally administering the aquous solution without further dilution.
3. The aqueous solution of claim 1 or claim 2, wherein sodium chloride is within a range wherein the lower limit is 10, 11, 12 or 13g per litre and the upper limit is, independently, 18, 17, 16 or 15g per litre. 5
4. The aqueous solution of claim 3, wherein sodium chloride is within a range of 13 to 15g per litre.
5. The aqueous solution of any one of the preceding claims, wherein the sodium bicarbonate is in an amount of approximately 7.1 g per litre.
6. The aqueous solution of any preceding claim comprising 0.1 to 1.5 g/L of sweetener selected from the group consisting of: aspartame, acesulfame potassium, sucralose, saccharine and combinations thereof. 15
7. The aqueous solution of any one of the preceding claims comprising a 1.0 to 10.0g/L of flavouring.
8. The aqueous solution of claim 7, comprising 1 to 5g per litre of flavouring. 20
9. The aqueous solution of any one of the preceding claims comprising PEG in a range wherein the lower limit is 400, 450 or 500 g per litre and the upper limit is, independently, 600, 575 or 550 g per litre.
10. The aqueous solution of claim 9, comprising PEG in a range of 500 to 550 g per litre.
11. The aqueous solution of claim 9 or 10, wherein the PEG is PEG 3350 or PEG4000.
12. The aqueous solution of any one of the preceding claims, wherein the aqueous solution is substantially free of sulphate.
13. The aqueous solution as claimed in any preceding claim for use as a medicament.
14. The aqueous solution as claimed in claim 13, for use in the treatment of constipation and/or faecal impaction. 5
15. The aqueous solution as claimed in claim 14, for use in the treatment of constipation and/or faecal impaction by oral administration without further dilution.
16. The use of the aqueous solution of any one of claims 1 to 12, and optionally a second aqueous solution, for the manufacture of a medicament for the treatment of constipation 10 and/or faecal impaction in a human subject.
17. The use of claim 16, wherein the treatment of constipation and/or faecal impaction in a human subject comprises the steps of; (a) administering or consuming the aqueous solution of any one of claims 1 to 15; and 15 (b) optionally administering or consuming a second aqueous solution.
18. The use of claim 17, wherein the second aqueous solution is to be administered or consumed following administration or consumption of the aqueous solution of step (a). 20
19. The use of claim 17 wherein a portion (e.g. approximately half) of the aqueous solution of step (a) is to be administered or consumed followed by the second aqueous solution of step (b) followed by the remaining portion of the aqueous solution of step (a).
Applications Claiming Priority (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB1101666.4 | 2011-01-31 | ||
GBGB1101666.4A GB201101666D0 (en) | 2011-01-31 | 2011-01-31 | Improvements in and relating to compositions |
GBGB1101738.1A GB201101738D0 (en) | 2011-02-01 | 2011-02-01 | Improvements in and relating to compositions |
GB1101738.1 | 2011-02-01 | ||
GBGB1200637.5A GB201200637D0 (en) | 2012-01-13 | 2012-01-13 | Improvements in and relating to compositions |
GB1200637.5 | 2012-01-13 | ||
PCT/GB2012/050195 WO2012104617A1 (en) | 2011-01-31 | 2012-01-31 | Improvements in and relating to compositions |
Publications (2)
Publication Number | Publication Date |
---|---|
NZ613401A NZ613401A (en) | 2016-03-31 |
NZ613401B2 true NZ613401B2 (en) | 2016-07-01 |
Family
ID=
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