US20100190852A1 - Short acting phenylalkylamine calcium channel blockers and uses thereof - Google Patents

Short acting phenylalkylamine calcium channel blockers and uses thereof Download PDF

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US20100190852A1
US20100190852A1 US12/664,026 US66402608A US2010190852A1 US 20100190852 A1 US20100190852 A1 US 20100190852A1 US 66402608 A US66402608 A US 66402608A US 2010190852 A1 US2010190852 A1 US 2010190852A1
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lower alkyl
substituted
alkoxyalkyl
lower alkoxyalkyl
methyl
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Martin P. Maguire
Elise Rioux
Harry J. Leighton
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Milestone Pharmaceuticals Inc
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Milestone Pharmaceuticals Inc
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Assigned to MILESTONE PHARMACEUTICALS INC. reassignment MILESTONE PHARMACEUTICALS INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: MAGUIRE, MARTIN P., LEIGHTON, HARRY J., RIOUX, ELISE
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/275Nitriles; Isonitriles
    • A61K31/277Nitriles; Isonitriles having a ring, e.g. verapamil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/216Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acids having aromatic rings, e.g. benactizyne, clofibrate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/26Cyanate or isocyanate esters; Thiocyanate or isothiocyanate esters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/275Nitriles; Isonitriles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00Drugs for disorders of the muscular or neuromuscular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/06Antiarrhythmics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/10Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/12Antihypertensives
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C229/00Compounds containing amino and carboxyl groups bound to the same carbon skeleton
    • C07C229/02Compounds containing amino and carboxyl groups bound to the same carbon skeleton having amino and carboxyl groups bound to acyclic carbon atoms of the same carbon skeleton
    • C07C229/34Compounds containing amino and carboxyl groups bound to the same carbon skeleton having amino and carboxyl groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton containing six-membered aromatic rings
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C229/00Compounds containing amino and carboxyl groups bound to the same carbon skeleton
    • C07C229/38Compounds containing amino and carboxyl groups bound to the same carbon skeleton having amino groups bound to acyclic carbon atoms and carboxyl groups bound to carbon atoms of six-membered aromatic rings of the same carbon skeleton
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C255/00Carboxylic acid nitriles
    • C07C255/01Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms
    • C07C255/32Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms having cyano groups bound to acyclic carbon atoms of a carbon skeleton containing at least one six-membered aromatic ring
    • C07C255/42Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms having cyano groups bound to acyclic carbon atoms of a carbon skeleton containing at least one six-membered aromatic ring the carbon skeleton being further substituted by singly-bound nitrogen atoms, not being further bound to other hetero atoms
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C255/00Carboxylic acid nitriles
    • C07C255/01Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms
    • C07C255/32Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms having cyano groups bound to acyclic carbon atoms of a carbon skeleton containing at least one six-membered aromatic ring
    • C07C255/42Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms having cyano groups bound to acyclic carbon atoms of a carbon skeleton containing at least one six-membered aromatic ring the carbon skeleton being further substituted by singly-bound nitrogen atoms, not being further bound to other hetero atoms
    • C07C255/43Carboxylic acid nitriles having cyano groups bound to acyclic carbon atoms having cyano groups bound to acyclic carbon atoms of a carbon skeleton containing at least one six-membered aromatic ring the carbon skeleton being further substituted by singly-bound nitrogen atoms, not being further bound to other hetero atoms the carbon skeleton being further substituted by singly-bound oxygen atoms

Definitions

  • the invention relates to the use of phenylalkylamine compounds which block L-type calcium channels to treat cardiovascular disorders.
  • CBs Calcium channel blockers
  • cardiovascular disorders such as hypertension, angina, and cardiac arrhythmias
  • Calcium influx through these channels initiates a process of electromechanical coupling that ultimately leads to muscle contraction.
  • the ability to regulate the entry of calcium into cardiac and vascular smooth muscle cells is a powerful therapeutic approach to the treatment of angina and hypertension, respectively.
  • blocking calcium influx into cardiac tissues and conduction systems provides a useful approach to control certain types of arrhythmia.
  • Serum esterases play an important role in the hydrolytic biotransformation of a vast number of structurally diverse drugs. These enzymes are major determinants of the pharmacokinetic behavior of most therapeutic agents containing ester bonds. Serum esterases are classified into three groups, A-, B-, and C-esterases, based on their interaction with organophosphates (De Vriese et al., Endocrinology (2004) 145, No. 11, 4997-5005).
  • A-esterases including arylesterase/paraoxonase, rapidly hydrolyze organophosphates.
  • B-esterases including acetylcholinesterase, butyrylcholinesterase, and nonspecific carboxylesterase, are inhibited by organophosphates.
  • C-esterases such as acetylesterase, do not interact with organophosphates.
  • Angina is a symptom of insufficient blood oxygen supply to an area of the heart due to an imbalance of the oxygen supply-demand ratio.
  • Angina is usually precipitated following exertion or emotional stress in susceptible patients due to an inability of the coronary vasculature to provide sufficient cardiac oxygen perfusion.
  • a narrowing of the coronary arteries is often an underlying cause as a result of arteriosclerosis or vasospastic narrowing of blood vessels.
  • Angina usually lasts less than 15 minutes and is typically treated by sublingual administration of nitroglycerin to relieve symptoms. Nitroglycerin and other nitrates induce vasodilation through release of nitric oxide (NO) thereby causing a lowering of blood pressure.
  • NO nitric oxide
  • Angina can be classified as stable angina whose principal underlying cause is arteriosclerosis, vasospastic angina (also called variant angina or Prinzmetal angina) whose underlying cause is due to transient vasospasm of the coronary arteries, or unstable angina cause by platelet clotting at sites of ruptured arteriosclerotic plaques.
  • Stable angina usually occurs as a result of exertion or stress whereas vasospastic angina can also be felt during periods of rest or in the early morning hours. Unstable angina is felt even during periods of rest and can signal imminent myocardial infarction.
  • Sustained reduced blood flow (ischemia) to the heart can cause permanent damage to the heart due to the death of cardiac muscle.
  • coronary arteries are severely narrowed by more than 50-70%, the blood vessels can no longer supply the oxygen demands of the heart and angina is felt symptomatically as chest pain.
  • Arrhythmia or abnormal heart rhythms, is caused by abnormal excitation and conduction to the heart.
  • the mechanism of the onset of arrhythmia is categorized into three groups: (1) abnormal excitation, (2) abnormal conduction of excitation, and (3) a combination of abnormal excitation and abnormal conduction of excitation.
  • Atrial fibrillation is arrhythmia arising from abnormalities in the intrinsic pacemaker conductive potential of the heart.
  • the electrical discharges are rapid and irregular, resulting in an irregular rhythm of heart contraction.
  • electrical discharges are generated in the sino-atrial node.
  • electrical discharges are not generated exclusively in the sino-atrial node and come from other parts of the atria.
  • Paroxysmal supraventricular tachycardia presents as episodes of regular and paroxysmal palpitations with sudden onset and termination (Blomstrom-Lundqvist et al., 2003, J Am Coll Cardiol, 42:1493-531).
  • Atrial flutter is characterized by acute symptoms of palpitations, dyspnea, fatigue, or chest pain. In most instances, patients with atrial flutter have a two-to-one atrio-ventricular node (AV) conduction pattern.
  • AV atrio-ventricular node
  • the flutter rate of the atria can be 300 per minute with a ventricular rate of 150 beats per minute (Blomstrom-Lundqvist et al., 2003, J Am Coll Cardiol, 42:1493-531).
  • Hypertension is defined as high blood pressure, usually above 140 (systolic)/90 (diastolic). Hypertensive conditions can occur in relation to the conduction of surgical procedures. For example, blood pressure control is critical before, during, and after surgery. Hypertensive crisis arising from high blood pressure is subdivided into two categories: urgent and emergency. The symptoms of an emergency hypertensive crisis are more severe and may include brain swelling, stroke, pulmonary edema, heart attack or other symptoms. Both urgent and emergency categories hypertensive crisis involve a severe increase in blood pressure and require immediate treatment to prevent potential complications (i.e., stroke or damage to organs and tissues).
  • Raynaud's phenomenon is a disorder associated with restricted blood flow to body extremities such as the fingers, toes, ears and nose, and reflects an aberration of the normal response to cold involving peripheral vasoconstriction and restriction of blood flow to the extremities in order to protect the core body temperature. Attacks may be brought on by exposure to cold or emotional stress. Up to 5 to 10% of the population of the United States is affected, to some degree, by Raynaud's phenomenon.
  • Intermittent claudication is a condition that involves discomfort in the legs and occasionally the arms. It is due to a narrowing of the arteries and a resulting decrease in blood flow, particularly to muscles during physical exertion. The condition most commonly occurs in the calf muscle but may also affect the foot, hip or buttocks.
  • No-reflow phenomenon is a condition following reperfusion in which excessive or abnormal vasoconstriction occurs.
  • the no-reflow phenomenon that occurs in about 2-5% of patients undergoing percutaneous transluminal coronary angioplasty (PTCA) is believed to be due to aggregation of platelets and neutrophils, which causes a blockage of blood flow within the vessels and vasoconstriction from substances released from the platelets.
  • the condition is characterized by abnormal tissue perfusion. Persistent no-reflow is associated with higher clinical complication rates (Eeckhout, E. and Kern, M. J., European Heart Journal (2001) 22, 729-739).
  • cardiovascular disorders including ischemic heart conditions and cardiac arrhythmias.
  • the invention relates to the use of a pharmaceutically effective amount of a short-acting calcium channel blocking compounds for use in treating ischemic heart conditions such as angina pectoris and cardiac arrythmias such as paroxysmal supraventricular tachycardia, atrial flutter and atrial fibrillation in humans.
  • ischemic heart conditions such as angina pectoris and cardiac arrythmias
  • the compounds may also be used to treat other cardiovascular disorders and conditions involving hypertension and blood flow.
  • the first aspect of the invention features a method of treating an ischemic heart condition or cardiac arrhythmia, where the method includes administering to a patient in need thereof a therapeutically effective amount of a compound having the formula
  • the ischemic heart condition is stable or unstable angina or vasospastic angina.
  • the cardiac arrhythmia is atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), premature atrial, nodal, or ventricular depolarizations, atrial tachycardia, ventricular tachycardia, ventricular fibrillation, or Torsades de Pointes.
  • administering includes sublingual, buccal, transdermal, intranasal or inhalation administration and the patient desirably is a human patient.
  • the invention features a method of treating a hypertensive crisis in an emergency room setting, where the method includes administering to a patient in need thereof a therapeutically effective amount of a compound having the formula
  • administering includes sublingual, buccal, intranasal, inhalation, or parenteral administration.
  • parenteral administration is intravenous administration.
  • the patient is a human patient.
  • the invention features a method of treating hypertension before, during, or after surgery, or no-reflow phenomenon following reperfusion, where the method includes administering to a patient in need thereof a therapeutically effective amount of a compound having the formula
  • administering involves parenteral administration.
  • the parenteral administration is intravenous administration.
  • the patient is a human patient.
  • the disease associated with decreased skeletal muscle blood flow is Raynaud's phenomenon or intermittent claudication.
  • administering includes sublingual, buccal, transdermal, intranasal, inhalation or topical administration.
  • the invention features a pharmaceutical composition including a compound having the following structure:
  • the pharmaceutical composition is formulated for treating a condition selected from the group consisting of:
  • the invention features a kit including
  • the compound used in the invention can exclude any of the following compounds:
  • the compound used in the invention may be stereochemically pure or may be used as a mixture of stereochemical isomers.
  • the compound is racemic.
  • the compound is a single enantiomer or a single diastereomer.
  • the compound is a mixture of diastereomers or a mixture of enantiomers.
  • compositions, or kits of the invention include a compound where:
  • the compound is not verapamil, gallopamil, emopamil, mepamil, or devapamil.
  • some embodiments include a compound where at least one of R 11 , R 12 , R 13 , R 14 , R 15 , R 16 , R 17 , R 18 , and R 20 is CO 2 R 10 , lower alkyl substituted by —CO 2 (lower alkyl), lower alkyl substituted with —CO 2 (lower alkoxyalkyl), a lower alkoxyalkyl substituted with —CO 2 (lower alkyl), or lower alkoxyalkyl substituted with —CO 2 (lower alkoxyalkyl).
  • R 19 is H
  • g is a single bond
  • R 20 is H.
  • R 19 is H, g is a single bond, R 20 is CO 2 R 10 , and -d-R 14 and -e-R 15 are not both —O-(lower alkyl) or —O-(lower alkoxyalkyl).
  • compositions, or kits of the invention include a compound where
  • R 17 is lower alkyl
  • R 18 is CN or CO 2 R 10 ;
  • At least one of -d-R 14 , -e-R 15 , -f-R 16 , or -g-R 20 is, independently,
  • At least one of R 11 , R 12 , R 13 , R 14 , R 15 , R 16 , R 17 , R 18 , or R 20 is CO 2 R 10 , lower alkyl substituted by —CO 2 (lower alkyl), lower alkyl substituted with —CO 2 (lower alkoxyalkyl), lower alkoxyalkyl substituted with —CO 2 (lower alkyl), or lower alkoxyalkyl substituted with —CO 2 (lower alkoxyalkyl).
  • R 19 is H
  • g is a single bond
  • R 20 is H.
  • g is a single bond
  • R 20 is CO 2 R 10
  • -d-R 14 and -e-R 15 are not both —O-(lower alkyl) or —O-(lower alkoxyalkyl).
  • a lower alkyl may be: methyl, ethyl, propyl, isopropyl, n-butyl, s-butyl, i-butyl, t-butyl, pentyl, isoamyl, hexyl, heptyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclobutylmethyl, or cycloheptyl.
  • a lower alkyl is methyl, ethyl, propyl, isopropyl, n-butyl, t-butyl, or cyclopropyl.
  • a lower alkyl substituted with —CO 2 may be: —CH 2 CO 2 R 21 , —CH 2 CH 2 CO 2 R 21 , —CH(CO 2 R 21 )CH 3 , —CH 2 CH 2 CH 2 CO 2 R 21 , —CH(CO 2 R 21 )CH 2 CH 3 , —CH 2 CH(CO 2 R 21 )CH 3 , —CH(CH 3 )CH 2 CO 2 R 21 , —C(CH 3 ) 2 CO 2 R 21 , —CH 2 CH 2 CH 2 CH 2 CO 2 R 21 , —CH 2 CH 2 CH 2 CH 2 CO 2 R 21 , —CH 2 CH 2 CH 2 CH 2 CH 2 CO 2 R 21 , or —CH 2 CH 2 CH 2 CH 2 CH 2 CH 2 CO 2 R 21 , where R 21 is a lower alkyl.
  • R 21 is methyl, ethyl, propyl, isopropyl, t-butyl, or cyclopropyl.
  • a lower alkyl substituted with —CO 2 (lower alkyl) is: —CH 2 CO 2 CH 3 , —CH 2 CO 2 CH 2 CH 3 , —CH 2 CH 2 CO 2 CH 3 , or —CH 2 CH 2 CO 2 CH 2 CH 3 .
  • a lower alkoxyalkyl may be: —CH 2 OR 22 , —CH 2 CH 2 OR 22 , —CH(OR 22 )CH 3 , —CH 2 CH 2 CH 2 OR 22 , —CH(OR 22 )CH 2 CH 3 , —CH 2 CH(OR 22 )CH 3 , —CH(CH 3 )CH 2 OR 22 , —C(CH 3 ) 2 OR 22 , —CH 2 CH 2 CH 2 CH 2 COR 22 , —CH 2 CH 2 CH 2 CH 2 CH 2 OR 22 , —CH 2 CH 2 CH 2 CH 2 CH 2 OR 22 , or —CH 2 CH 2 CH 2 CH 2 CH 2 CH(OR 22 ), where R 22 is a lower alkyl.
  • R 22 is methyl, ethyl, propyl, isopropyl, n-butyl, t-butyl, or cyclopropyl.
  • a lower alkoxyalkyl is —CH 2 OCH 3 , —CH 2 OCH 2 CH 3 , —CH 2 CH 2 OCH 3 , or —CH 2 CH 2 OCH 2 CH 3 .
  • a lower alkyl substituted with —CO 2 may be: —CH 2 CO 2 R 23 , —CH 2 CH 2 CO 2 R 23 , —CH(CO 2 R 23 )CH 3 , —CH 2 CH 2 CH 2 CO 2 R 23 , —CH(CO 2 R 23 )CH 2 CH 3 , —CH 2 CH(CO 2 R 23 )CH 3 , —CH(CH 3 )CH 2 CO 2 R 23 , —C(CH 3 ) 2 CO 2 R 23 , —CH 2 CH 2 CH 2 CH 2 CO 2 R 23 , —CH 2 CH 2 CH 2 CH 2 CO 2 R 23 , —CH 2 CH 2 CH 2 CH 2 CH 2 CO 2 R 23 , or —CH 2 CH 2 CH 2 CH 2 CH 2 CH 2 (CO 2 R 23 ), where R 23 is a lower alkoxyalkyl.
  • R 23 is CH 2 CH 2 OCH 3 or CH 2 CH 2 OCH 2 CH 3 .
  • a lower alkyl substituted with —CO 2 (lower alkoxyalkyl) is: —CH 2 CO 2 (CH 2 CH 2 OCH 3 ), —CH 2 CO 2 (CH 2 CH 2 OCH 2 CH 3 ), —CH 2 CH 2 CO 2 (CH 2 CH 2 OCH 3 ), or —CH 2 CH 2 CO 2 (CH 2 CH 2 OCH 2 CH 3 ).
  • a lower alkyl substituted with fluorine or chlorine may be: —CH 2 X, —CHX 2 , —CX 3 , —CH 2 CX 3 , —CX 2 CX 3 , or —CH(CX 3 ) 2 , where X is —F or —Cl.
  • a lower alkyl substituted with fluorine or chlorine is —CF 3 , —CCl 3 , —CF 2 CF 3 , or —CH(CF 3 ) 2 .
  • a lower alkoxyalkyl substituted with —CO 2 may be: —CH 2 CH(CO 2 R 24 )OR 25 , —CH(CO 2 R 24 )CH 2 OR 25 , —CH 2 CH 2 OCH 2 CH 2 (CO 2 R 24 ), or —CH 2 CH 2 OCH(CO 2 R 24 )CH 3 , where R 24 and R 25 are each, independently, lower alkyl.
  • R 24 is methyl, ethyl, propyl, isopropyl, t-butyl, or cyclopropyl.
  • R 25 is methyl, ethyl, propyl, isopropyl, n-butyl, t-butyl, or cyclopropyl.
  • a lower alkoxyalkyl substituted with —CO 2 may be: —CH 2 CH(CO 2 R 26 )OR 27 , —CH(CO 2 R 26 )CH 2 OR 27 , —CH 2 CH 2 OCH 2 CH 2 (CO 2 R 26 ), or —CH 2 CH 2 OCH(CO 2 R 26 )CH 3 , where, independently, R 26 is a lower alkoxyalkyl and R 27 is a lower alkyl.
  • R 26 is CH 2 CH 2 OCH 3 or CH 2 CH 2 OCH 2 CH 3 .
  • R 27 is methyl, ethyl, propyl, isopropyl, n-butyl, t-butyl, or cyclopropyl.
  • a lower alkoxyalkyl substituted with fluorine or chlorine may be: —CX 2 CX 2 OCH 2 CH 3 , —CH 2 CH 2 OCH 2 CX 3 , —CH 2 CH 2 OCX 2 CX 3 , or —CH 2 CH 2 OCH(CX 3 ) 2 , where X is —F or —Cl.
  • CO 2 R 10 may be: CO 2 CH 3 , CO 2 CH 2 CH 3 , CO 2 CH(CH 3 ) 2 , CO 2 C(CH 3 ) 3 , CO 2 CH 2 CH 2 OCH 3 , or CO 2 CH 2 CH 2 OCH 2 CH 3 .
  • the compound used in the invention desirably is any of the following compounds:
  • angina refers to the chest discomfort felt due to ischemic heart disease.
  • Angina can be classified as stable angina whose principal underlying cause is arteriosclerosis, vasospastic angina (also called variant angina or Prinzmetal angina) whose underlying cause is due to transient vasospasm of the coronary arteries, or unstable angina cause by platelet clotting at sites of ruptured arteriosclerotic plaques.
  • the term “buccal administration” means absorption of a compound or a pharmaceutically acceptable formulation of a compound by administering between the cheek and gum.
  • the compound is a compound of Formula I.
  • Cardiac arrhythmia refers to a condition characterized by abnormal heart rhythms that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart.
  • Arrhythmias can be divided into ventricular arrhythmias occurring in the lower chambers of the heart (ventricles) and into supraventricular arrhythmias occurring in the upper chambers of the heart (aorta).
  • Cardiac arrhythmias include atrial fibrillation and atrial flutter that are characterized by abnormally fast electrical discharge patterns that cause the atria to contract very rapidly thereby impairing efficient pumping of the blood into the ventricles.
  • Cardiac arrhythmias also include paroxysmal supraventricular tachycardia (PSVT) that is characterized by a regular and fast heart rate originating in heart tissue above the ventricles.
  • PSVT paroxysmal supraventricular tachycardia
  • Other exemplary cardiac arrhythmias are premature atrial, nodal, or ventricular depolarization, atrial tachycardia, ventricular tachycardia, ventricular fibrillation, and Torsades de Pointes.
  • a “disease associated with decreased skeletal muscle blood flow” as used herein refers to a condition where a narrowing of the arteries that perfuse the skeletal muscle results in reduced perfusion and oxygen delivery. Such conditions include, but are not limited to, Raynaud's phenomenon and intermittent claudication.
  • excipient is used herein to describe any ingredient other than an active compound (e.g., those having Formula I) described herein.
  • Excipients may include, for example: antiadherents, antioxidants, binders, coatings, compression aids, disintegrants, dyes (colors), emollients, emulsifiers, fillers (diluents), film formers or coatings, flavors, fragrances, glidants (flow enhancers), lubricants, preservatives, printing inks, sorbents, suspensing or dispersing agents, sweeteners, or waters of hydration.
  • excipients include, but are not limited to: butylated hydroxytoluene (BHT), calcium carbonate, calcium phosphate (dibasic), calcium stearate, croscarmellose, crosslinked polyvinyl pyrrolidone, citric acid, crospovidone, cysteine, ethylcellulose, gelatin, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, maltitol, mannitol, methionine, methylcellulose, methyl paraben, microcrystalline cellulose, polyethylene glycol, polyvinyl pyrrolidone, povidone, pregelatinized starch, propyl paraben, retinyl palmitate, shellac, silicon dioxide, sodium carboxymethyl cellulose, sodium citrate, sodium starch glycolate, sorbitol, starch (corn), stearic acid, stearic acid, sucrose, talc, titanium dioxide, vitamin A, B
  • “Hypertension before, during or after surgery” as used herein refers to perioperative hypertension, i.e., a sustained elevated blood pressure (systolic/diastolic ⁇ 140/90 mm Hg in the USA, or ⁇ 160/95 mm Hg in many other countries) that occurs immediately prior to, during, or after a surgical procedure.
  • perioperative hypertension i.e., a sustained elevated blood pressure (systolic/diastolic ⁇ 140/90 mm Hg in the USA, or ⁇ 160/95 mm Hg in many other countries) that occurs immediately prior to, during, or after a surgical procedure.
  • hypotensive crisis in an emergency room setting refers to a sudden increase in systolic and diastolic blood pressures that requires immediate management in a hospital or hospital emergency room environment.
  • the sudden acute and severe increase in blood pressure may or may not be associated with acute end-organ damage (i.e. cardiovascular, renal, central nervous system).
  • “Inhalation administration” or “administration by inhalation” as used herein refers to delivering a drug for absorption to the body in the form of a liquid aerosol mist, solid aerosol particulates or a gaseous substance by inhalation into the lungs.
  • the compound is a compound of Formula I.
  • intranasal administration or “nasal administration” means absorption of a compound or a pharmaceutically acceptable formulation of a compound by administering to the nose or nasal cavity.
  • the compound is a compound of Formula I.
  • intravenous administration means injection of a pharmaceutically acceptable formulation of a compound directly into a vein.
  • the compound is a compound of Formula I.
  • ischemic heart disease or “ischemic heart condition” as used herein refers to a condition characterized by narrowed heart arteries that results in restricted blood flow and reduced oxygen delivery to the heart muscle.
  • lower alkoxyalkyl as used herein means a lower alkyl group having an ether-containing substituent such as, for example, ethoxyethyl, methoxyethyl, and methoxypropyl, among others, where the ether-containing substituent may be at any position of the lower alkyl.
  • a lower alkoxyalkyl may be, for example: —CH 2 OR 22 , —CH 2 CH 2 OR 22 , —CH(OR 22 )CH 3 , —CH 2 CH 2 CH 2 OR 22 , —CH(OR 22 )CH 2 CH 3 , —CH 2 CH(OR 22 )CH 3 , —CH(CH 3 )CH 2 OR 22 , —C(CH 3 ) 2 OR 22 , —CH 2 CH 2 CH 2 CH 2 COR 22 , —CH 2 CH 2 CH 2 CH 2 CH 2 OR 22 , —CH 2 CH 2 CH 2 CH 2 CH 2 OR 22 , or —CH 2 CH 2 CH 2 CH 2 CH 2 CH(OR 22 ), where R 22 is a lower alkyl.
  • R 22 is methyl, ethyl, propyl, isopropyl, n-butyl, t-butyl, or cyclopropyl.
  • exemplary, non-limiting lower alkoxyalkyls include —CH 2 OCH 3 , —CH 2 OCH 2 CH 3 , —CH 2 CH 2 OCH 3 , and —CH 2 CH 2 OCH 2 CH 3 .
  • a lower alkoxyalkyl may be optionally substituted.
  • a substituted lower alkoxyalkyl may be optionally substituted, for example, with CO 2 R 10 at any carbon position on either the lower alkyl group or at any carbon position on the ether containing substituent.
  • lower alkyl as used herein means alkyl groups of from 1 to 7 carbon atoms that consist of a straight, branched or cyclic configuration. Lower alkyls may include 1, 2, 3, 4, 5, 6, or 7 carbon atoms. Examples of lower alkyl groups include, but are not limited to: methyl, ethyl, propyl, isopropyl, butyl, s-, i- and t-butyl, pentyl, isoamyl, hexyl, heptyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclobutylmethyl, and cycloheptyl, among others.
  • a lower alkyl is methyl, ethyl, propyl, isopropyl, n-butyl, t-butyl, or cyclopropyl.
  • a lower alkyl may be optionally substituted.
  • a substituted lower alkyl may be optionally substituted with, for example, CO 2 R 10 at any carbon position.
  • No-reflow phenomenon following reperfusion refers to the inability of myocardial tissue to reperfuse after prolonged ischemia despite reopening of the occluded artery related to the ischemic condition.
  • parenteral administration means administration of a compound or a pharmaceutically acceptable formulation of a compound by a route that bypasses the gastrointestinal tract.
  • parenteral administration is intravenous administration, injection of a pharmaceutically acceptable formulation of a compound below the skin's cutaneous layer (subcutaneous), within the dermis (intradermal), or into the muscle (intramuscular).
  • the compound is a compound of Formula I.
  • a “pharmaceutically acceptable acid addition salt” is derived from a basic active compound and an organic acid or an inorganic acid.
  • exemplary pharmaceutically acceptable acid addition salts derived from organic acids include, but are not limited to, acetate, adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptonate, glycerophosphate, heptonate, hexanoate, 2-hydroxy-ethanesulfonate, isethionate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate (mesylate), 2-naphthalenesulfonate,
  • Exemplary pharmaceutically acceptable acid addition salts derived from inorganic acids include bisulfate, sulfate, borate, hydrobromide, hydrochloride, hydroiodide, hemisulfate, nitrate, phosphate salts and the like.
  • a “pharmaceutically acceptable acid addition salt” is oxalate, hydrochloride, hydrobromide, methanesulfonate, sulfate, hemisulfate or bisulfate.
  • a “pharmaceutically acceptable carrier” as used herein refers to a vehicle capable of suspending or dissolving the active compound, and having the properties of being nontoxic and non-inflammatory in a patient.
  • a pharmaceutically acceptable carrier may include a pharmaceutically acceptable additive, such as a preservative, antioxidant, fragrance, emulsifier, dye, or excipient known or used in the field of drug formulation and that does not significantly interfere with the therapeutic effectiveness of the biological activity of the active agent, and that is non-toxic to the patient.
  • pharmaceutically acceptable formulation refers to a composition including a pharmaceutically acceptable carrier and an active compound.
  • the active compound is a compound of Formula I.
  • the term “pharmaceutical patch” refers to a pad containing an embedded active compound to be placed on the exterior surface of a patient for absorption of the active compound into the bloodstream, skin or underlying tissue. Desirably, patch is placed on the skin and the compound is released gradually from the patch over time. Further, the patch desirably is an adhesive patch.
  • the term “sublingual administration” means absorption of a compound or a pharmaceutically acceptable formulation of a compound by administering under the tongue.
  • the compound is a compound of Formula I.
  • a therapeutically effective amount refers to an amount of an active compound that, when administered to a patient, reduces, eliminates or prevents an ischemic heart condition, cardiac arrhythmia, hypertensive crisis in an emergency room setting, hypertension before, during or after surgery, no-reflow phenomenon following reperfusion, or a disease associated with decreased skeletal muscle bloodflow.
  • a therapeutically effective amount of a pharmaceutical formulation contains a compound of the invention (e.g., a compound having Formula I) in a concentration range of about 0.000001 to 10 percent weight/volume (“% w/v”).
  • Topical administration or “topically administering” as used herein refers to the application of a pharmaceutical acceptable formulation of a compound to the external surface of a patient, such that the active compound enters the underlying tissue.
  • the external surface is the skin and topical administration desirably involves application of a pharmaceutically acceptable formulation to intact skin, to broken skin, to raw skin or to an open skin wound.
  • the compound is a compound of Formula I.
  • Transdermal administration or “transdermally administering” as used herein refers to the diffusion of an agent across the barrier of the skin resulting from topical administration or other application of a compound or a pharmaceutically acceptable formulation of a compound.
  • the compound is a compound of Formula I.
  • optional substituents include, but are not limited to: halogen (i.e., —F, —Cl, —Br, or —I), —CO 2 H, —CO 2 (lower alkyl), —CO 2 (lower alkoxyalkyl), -(lower alkyl), -(lower alkoxyalkyl), —O(lower alkyl), —O(lower alkoxyalkyl), —NH(lower alkyl), —NH(lower alkoxyalkyl), —N(lower alkyl) 2 , and —N(lower alkoxyalkyl) 2 .
  • halogen i.e., —F, —Cl, —Br, or —I
  • —CO 2 H i.e., —CO 2 (lower alkyl), —CO 2 (lower alkoxyalkyl), -(lower alkyl), -(lower alkoxyalky
  • the present invention relates to the use of a pharmaceutically effective amount of a short-acting calcium channel blocking compound to treat ischemic heart conditions, cardiac arrhythmias, hypertensive crisis in an emergency room setting, hypertension before, during, or after surgery, no-reflow phenomenon following reperfusion, and diseases associated with decreased skeletal muscle blood flow.
  • the compounds used in the compositions, kits, and methods of the present invention are rendered short-acting by covalent attachment of esterase sensitive groups to molecules derived from the phenylalkylamine (e.g., verapamil) class of calcium channel blockers and may be formulated for sublingual, buccal, transdermal, intranasal, inhalation, topical, and parenteral (e.g., intravenous) routes of administration.
  • Pharmaceutical compositions containing the compounds disclosed herein may be included in a kit with instructions for administration according to the methods of the invention.
  • a short acting calcium channel blocking compound is meant to infer a compound that produces the desired effect and is then rapidly inactivated metabolically.
  • a short acting CCB is meant to have a duration of action of from less than 1 minute to less than 60 minutes. Preferably the compound's duration of action will be from 1 minute to 30 minutes.
  • the compounds defined by Formula I may exist as free bases or as pharmaceutically acceptable acid addition salts.
  • the short-acting calcium channel blockers of the invention may be used to treat disorders in which the regulation of calcium plays a role in normal hemostasis.
  • disorders include, for example, pulmonary hypertension, peripheral vascular disease, mild congestive heart failure, hypertrophic subaortic stenosis, protection against ischemic injury, stroke, migraine, tumor resistance to anti-neoplastic drugs, achalasia, esophageal spasms, bronchial asthma, premature labor, dysmenorrhea, and enhancement of success in renal transplantation.
  • Pharmaceutical agents such as a calcium channel-blocking compound, can be made with relatively short durations of therapeutic action, ranging from the ultra-short to medium-range, through non-hepatic means of inactivation. Such agents may be subject to extensive metabolism in blood by serum esterases, as well as potential metabolism in the liver. Rapid elimination or biotransformation to inactive or less active products minimizes accumulation with prolonged or repeated administration.
  • a calcium channel-blocking compound that is rendered sensitive to serum esterases is expected to undergo rapid degradation to inactive or less active metabolites in the blood. This may be considered analogous to the rapid degradation experienced by succinylcholine (Stanski, D. R. and Hug, C. C., Jr. Anesthesiology 57: 435-438 (1982)) and enables a more predictable correlation of dose with the duration of pharmacologic effect.
  • Anti-anginal drugs relieve or prevent coronary ischemia by increasing oxygen supply to the heart or by decreasing myocardial oxygen demand.
  • organic nitrates e.g., glyceryl trinitrate, nitroglycerin
  • beta-blockers e.g., beta-adrenergic antagonists also known as beta-blockers.
  • Organic nitrates e.g., glyceryl trinitrate, nitroglycerin
  • NO nitric oxide
  • a major limitation of the use of organic nitrates is the development of nitrate tolerance.
  • Calcium channel blockers e.g., verapamil, nicardipine, nifedipine, clevidipine, diltiazem, bepredil
  • Calcium channel blockers are generally well tolerated with minor adverse effects including hypotension, dizziness, edema, nausea, and vomiting, and are contraindicated for patients with hypertrophic obstructive cardiomyopathies.
  • Medications used to treat atrial fibrillation and slow down the abnormal and rapid heart rate include calcium channel blockers (e.g., verapamil, diltiazem), digoxin (e.g., digitalis), and beta-blockers (e.g., propranolol, atenolol, esmolol). These pharmaceutical agents slow the heart rate by retarding conduction of the electrical discharges through the atrio-ventricular node, but do not usually convert atrial fibrillation back into a normal rhythm. Other drugs or treatments are necessary to achieve a normal heart rhythm but these are generally associated with greater toxicity.
  • calcium channel blockers e.g., verapamil, diltiazem
  • digoxin e.g., digitalis
  • beta-blockers e.g., propranolol, atenolol, esmolol.
  • Calcium channel blockers and beta-blockers are often prescribed for acute pharmacological treatment of atrial flutter as well as traditional antiarrhythmic medications such as amiodarone.
  • Nitrate containing drugs such as nitroglycerin or sodium nitroprusside
  • drugs can be used to address these disorders involving blood flow and pressure regulation, but these drugs can produce rebound tachycardia and other adverse effects.
  • Other traditional hypotensive agents such as the calcium channel blocker nicardipine, are generally too long acting to effectively address blood pressure regulation surrounding surgery.
  • the compounds of the invention are short acting and thus overcome the undesirable characteristics and effects noted above in connection with existing therapies for cardiovascular disorders.
  • Desirable routes of administration of the compounds (e.g., the compounds having Formula I) used in the present invention include sublingual, buccal, transdermal, intranasal, inhalation, topical, and parenteral (e.g., intravenous) administration.
  • the compounds desirably are administered with a pharmaceutically acceptable carrier.
  • Pharmaceutical formulations of the compounds described herein formulated for treatment of the disorders described herein are also part of the present invention.
  • the administration of a therapeutic dose will, of course, be continuous rather than intermittent throughout the dosage regimen.
  • Dosages for buccal or sublingual administration typically are 0.1 to 500 mg per single dose as required.
  • the physician determines the actual dosing regimen which is most suitable for an individual patient, and the dosage varies with the age, weight, and response of the particular patient.
  • the above dosages are exemplary of the average case, but individual instances exist wherein higher or lower dosages are merited, and such are within the scope of this invention.
  • compositions may take the form of tablets, lozenges, etc. formulated in a conventional manner.
  • Liquid drug formulations suitable for use with nebulizers and liquid spray devices and electrohydrodynamic (EHD) aerosol devices will typically include a compound of the invention with a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier is a liquid such as alcohol, water, polyethylene glycol or a perfluorocarbon.
  • another material may be added to alter the aerosol properties of the solution or suspension of compounds of the invention. Desirably, this material is liquid such as an alcohol, glycol, polyglycol or a fatty acid.
  • the compounds may also be formulated for nasal administration.
  • the solutions or suspensions are applied directly to the nasal cavity by conventional means, for example, with a dropper, pipette or spray.
  • the formulations may be provided in a single or multidose form.
  • dosing may be achieved by the patient administering an appropriate, predetermined volume of the solution or suspension.
  • this may be achieved, for example, by means of a metering atomizing spray pump.
  • the compounds may further be formulated for aerosol administration, particularly to the respiratory tract by inhalation and including intranasal administration.
  • the compound will generally have a small particle size for example on the order of five (5) microns or less. Such a particle size may be obtained by means known in the art, for example by micronization.
  • the active ingredient is provided in a pressurized pack with a suitable propellant such as a chlorofluorocarbon (CFC), for example, dichlorodifluoromethane, trichlorofluoromethane, or dichlorotetrafluoroethane, or carbon dioxide or other suitable gas.
  • CFC chlorofluorocarbon
  • the aerosol may conveniently also contain a surfactant such as lecithin.
  • the dose of drug may be controlled by a metered valve.
  • the active ingredients may be provided in a form of a dry powder, for example, a powder mix of the compound in a suitable powder base such as lactose, starch, and starch derivatives such as hydroxypropylmethyl cellulose, and polyvinylpyrrolidine (PVP).
  • a powder mix of the compound in a suitable powder base such as lactose, starch, and starch derivatives such as hydroxypropylmethyl cellulose, and polyvinylpyrrolidine (PVP).
  • the powder carrier will form a gel in the nasal cavity.
  • the powder composition may be presented in unit dose form for example in capsules or cartridges of e.g., gelatin or blister packs from which the powder may be administered by means of an inhaler.
  • a compound of the invention can be administered alone, but generally is administered in admixture with a pharmaceutical carrier selected with regard to the intended route of administration and standard pharmaceutical practice.
  • Pharmaceutical compositions for use in accordance with the present invention thus can be formulated in a conventional manner using one or more physiologically acceptable carriers comprising excipients and auxiliaries that facilitate processing of compounds of Formula I into preparations which can be used pharmaceutically.
  • compositions can be manufactured in a conventional manner, e.g., by conventional mixing, dissolving, granulating, dragee-making, levigating, emulsifying, encapsulating, entrapping, or lyophilizing processes. Proper formulation is dependent upon the route of administration chosen. The formulation and preparation of such compositions is well-known to those skilled in the art of pharmaceutical formulation.
  • compounds of in the invention are conveniently delivered in the form of an aerosol spray presentation from pressurized packs or a nebulizer, with the use of a suitable propellant.
  • the dosage unit can be determined by providing a valve to deliver a metered amount.
  • the pharmaceutical formulation may also be administered parenterally (intravenous, intramuscular, subcutaneous or the like) in dosage forms or formulations containing conventional, non-toxic pharmaceutically acceptable carriers and adjuvants.
  • formulations suitable for parenteral administration include aqueous and non-aqueous sterile injection solutions which may contain anti-oxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
  • the compounds of the invention may be dissolved or suspended in a parenterally acceptable liquid vehicle.
  • acceptable vehicles and solvents that may be employed are water, water adjusted to a suitable pH by addition of an appropriate amount of hydrochloric acid, sodium hydroxide or a suitable buffer, 1,3-butanediol, Ringer's solution and isotonic sodium chloride solution.
  • the aqueous formulation may also contain one or more preservatives, for example, methyl, ethyl or n-propyl p-hydroxybenzoate.
  • the formulations for parenteral administration may be presented in unit-dose or multi-dose containers, for example, sealed ampules and vials, and may be stored in a freeze-dried (lyophilized) conditions requiring only the addition of the sterile liquid carrier, for example, water for injections, immediately prior to use.
  • sterile liquid carrier for example, water for injections, immediately prior to use.
  • Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets.
  • compositions for use in accordance with the present invention can be formulated in conventional manner using one or more physiologically acceptable carriers comprising excipients and auxiliaries that facilitate processing of the compounds of the invention (e.g., a compound of Formula I) into preparations that can be used pharmaceutically. Proper formulation is dependent upon the desired product chosen. Non-limiting exemplary formulations are provided below.
  • the topical formulations useful in the subject invention can be made into a wide variety of product types. These include, but are not limited to, lotions, creams, gels, sticks, sprays, ointments, pastes, mousses, and cosmetics.
  • the product types can include several types of carrier systems including, but not limited to solutions, emulsions, gels, solids, and liposomes. Techniques for formulation and administration are standard in the art and can be found, for example, in “Remington: The Science and Practice of Pharmacy 20 th edition” Lippincott Williams & Wilkins, Philadelphia, Pa. Eds Gennaro A. R. et al, 2000.
  • the formulation can be selected to maximize delivery to a desired target site in the body such as the skin.
  • Lotions which are preparations that are to be applied to the skin surface without friction, are typically liquid or semi-liquid preparations. Lotions may be formulated with an aqueous or oily base and will in general also contain one or more emulsifying agents, stabilizing agents, dispersing agents, suspending agents, thickening agents, or coloring agents.
  • Creams containing the active agent for delivery according to the present invention are viscous liquid or semisolid emulsions, either oil-in-water or water-in-oil.
  • Cream bases are water-washable, and contain an oil phase, an emulsifier and an aqueous phase.
  • the oil phase also sometimes called the “internal” phase, generally contains petrolatum and a fatty alcohol such as cetyl or stearyl alcohol; the aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant.
  • the emulsifier in a cream formulation as described in “Remington: The Science and Practice of Pharmacy 20 th edition” Lippincott Williams & Wilkins, Philadelphia, Pa. Eds Gennaro A. R. et al, 2000, is generally a nonionic, anionic, cationic or amphoteric surfactant.
  • Gel formulations can also be used in connection with the present invention.
  • gels are semisolid, suspension-type systems.
  • Single-phase gels contain organic macromolecules distributed substantially uniformly throughout the carrier liquid, which is typically aqueous, but also, preferably, contain an alcohol and, optionally, an oil.
  • Ointments which are semisolid preparations, are typically based on petrolatum or other petroleum derivatives.
  • the specific ointment base to be used is one that provides for optimum delivery for the active agent chosen for a given formulation, and, preferably, provides for other desired characteristics as well, e.g., emolliency or the like.
  • an ointment base should be inert, stable, nonirritating and non-sensitizing. As described, for example, in Remington: The Science and Practice of Pharmacy 20 th edition” Lippincott Williams & Wilkins, Philadelphia, Pa. Eds Gennaro A. R.
  • ointment bases may be grouped in four classes: oleaginous bases; absorption bases; water-removable bases; and water-soluble bases.
  • Oleaginous ointment bases include, for example, vegetable oils, fats obtained from animals, and semisolid hydrocarbons obtained from petroleum.
  • Absorption bases are either water-in-oil (W/O) emulsions or oil-in-water (O/W) emulsions, and include, for example, cetyl alcohol, glyceryl monostearate, lanolin and stearic acid.
  • Preferred water-soluble ointment bases are prepared from polyethylene glycols of varying molecular weight.
  • Sprays generally provide the active agent in an aqueous and/or alcoholic solution which can be misted onto the skin for delivery.
  • Such sprays include those formulated to provide for concentration of the active agent solution at the site of administration following delivery, e.g., the spray solution can be primarily composed of alcohol or other like volatile liquid in which the drug or active agent can be dissolved.
  • the carrier evaporates, leaving concentrated active agent at the site of administration.
  • a topical pharmaceutical formulation for use in the present invention may also include suitable solid or gel phase carriers.
  • suitable solid or gel phase carriers include, but are not limited to, calcium carbonate, calcium phosphate, various sugars, starches, cellulose derivatives, gelatin, and polymers such as polyethylene glycols.
  • a topical pharmaceutical formulation may include a suitable emulsifier, i.e., an agent that enhances or facilitates mixing and suspending oil-in-water or water-in-oil.
  • a suitable emulsifier i.e., an agent that enhances or facilitates mixing and suspending oil-in-water or water-in-oil.
  • An emulsifying agent for use in the invention may consist of a single emulsifying agent or may be a blend of emulsifying agents and may be a nonionic, anionic or cationic surfactant or a blend of two or more such surfactants.
  • Such surface-active agents are described, for example, in “McCutcheon's Detergent and Emulsifiers,” North American Edition, 1980 Annual published by the McCutcheon Division, MC Publishing Company, 175 Rock Road, Glen Rock, N.J. 07452, USA.
  • HLB hydrophile-lipophile balance
  • nonionic emulsifiers include, but are not limited to, “BRIJ 72,” the trade name for a polyoxyethylene (2) stearyl ether having an HLB of 4.9; “BRIJ 721,” the trade name for a polyoxyethylene (21) stearyl ether having an HLB of 15.5.
  • a topical pharmaceutical formulation may also contain suitable emollients.
  • Emollients are materials that may be used for the prevention or relief of dryness, as well as for the protection of the skin.
  • Useful emollients include, but are not limited to, cetyl alcohol, isopropyl myristate, stearyl alcohol, and the like.
  • suitable emollients are known in the art and can be used in the formulations encompassed by the invention. See e.g., Sagarin, Cosmetics, Science and Technology, 2nd Edition, Vol. 1, pp. 32-43 (1972), and U.S. Pat. No. 4,919,934, to Deckner et al., issued Apr. 24, 1990, both of which are incorporated herein by reference in their entirety.
  • a topical pharmaceutical formulation for use in the methods of the invention may also include suitable antioxidants, i.e., substances that inhibit oxidation.
  • Antioxidants suitable for use in accordance with the present invention include, but are not limited to, butylated hydroxytoluene, ascorbic acid, sodium ascorbate, calcium ascorbate, ascorbic palmitate, butylated hydroxyanisole, 2,4,5-trihydroxybutyrophenone, 4-hydroxymethyl-2,6-di-tert-butylphenol, erythorbic acid, gum guaiac, propyl gallate, thiodipropionic acid, dilauryl thiodipropionate, tert-butylhydroquinone and tocopherols such as vitamin E, and the like, including pharmaceutically acceptable salts and esters of these compounds.
  • the antioxidant is butylated hydroxytoluene, butylated hydroxyanisole, propyl gallate, ascorbic acid, pharmaceutically acceptable salts or esters thereof, or mixtures thereof.
  • the antioxidant is butylated hydroxytoluene.
  • topical pharmaceutical formulations for use in the present invention may also include suitable preservatives.
  • Preservatives are compounds added to a pharmaceutical formulation to act as an anti-microbial agent.
  • preservatives known in the art as being effective and acceptable in parenteral formulations are benzalkonium chloride, benzethonium, chlorohexidine, phenol, m-cresol, benzyl alcohol, methylparaben, propylparaben, chlorobutanol, o-cresol, p-cresol, chlorocresol, phenylmercuric nitrate, thimerosal, benzoic acid, and various mixtures thereof. See, e.g., Wall Later, K.-H., Develop. Biol. Standard, 24:9-28 (1974) (S. Krager, Basel).
  • a topical pharmaceutical formulation for use in the present invention may further contain suitable chelating agents to form complexes with metal cations which do not cross a lipid bilayer.
  • suitable chelating agents include ethylene diamine tetraacetic acid (EDTA), ethylene glycol-bis(beta-aminoethyl ether)-N,N,N′,N′-tetraacetic acid (EGTA) and 8-Amino-2-[(2-amino-5-methylphenoxy)methyl]-6-methoxyquinoline-N,N,N′,N′-tetraacetic acid, tetrapotassium salt (QUIN-2).
  • EDTA ethylene diamine tetraacetic acid
  • EGTA ethylene glycol-bis(beta-aminoethyl ether)-N,N,N′,N′-tetraacetic acid
  • QUIN-2 8-Amino-2-[(2-amino-5-methylphenoxy)methyl]-6-me
  • Topical pharmaceutical formulations useful for the methods of the invention may also include suitable neutralizing agents used to adjust the pH of the formulation to within a pharmaceutically acceptable range.
  • pH range desirably is 4.5-7.1. Most desirably, the pH range is 4.5-6.5.
  • a topical pharmaceutical formulation may include suitable hydrophilic gelling agents.
  • suitable hydrophilic gelling agents are, for example, diffusable compounds capable of increasing the viscosity of a polymer-containing solution through the interaction of the agent with the polymer.
  • hydrophilic gelling agents such as the acrylic acid/ethyl acrylate copolymers and the carboxyvinyl polymers sold by the B. F. Goodrich Company under the trademark of Carbopol® resins. These resins consist essentially of a colloidally water-soluble polyalkenyl polyether crosslinked polymer of acrylic acid crosslinked with from 0.75% to 2.00% of a crosslinking agent such as polyallyl sucrose or polyallyl pentaerythritol.
  • a desirable viscosity increasing agent is for example Carbopol® Ultrez 10.
  • a topical pharmaceutical formulation may also contain one or more suitable solvents.
  • suitable solvents include ethanol, propylene glycol, glycerin, dipropylene glycol and polyethylene glycol.
  • Non-lipophilic drugs typically display very low solubility in pharmaceutically acceptable solvents and/or carriers.
  • a topical pharmaceutical formulation for use in the present invention may include one or more suitable skin penetration enhancers.
  • suitable excipients are known in the art to be skin penetration enhancers (as described, for example, in Osborne D. W. and Henke J. J., “Skin penetration enhancers cited in the technical literature” Pharm. Tech. 21:58-66, 1997).
  • Examples of skin penetration enhancers include water, ethanol, propylene glycol, oleic acid, oleyl alcohol, sodium lauryl sulfate, dimethylsulfoxide, 1-dodecylazacycloheptan-2-one (trade name Azone®), N-methyl-2-pyrrolidinone, 2-pyrrolidinone, D-limonene, 1,8-cineole, urea, and menthol are just a few of the known penetration enhancers.
  • Diethylene glycol monoethyl ether NF (CAS number 111-90-0, INCI name ethoxydiglycol, trade name TRANSCUTOL®) (see, for example, Watkinson A. C.
  • DGME Diethylene glycol monoethyl ether NF
  • Liquid forms such as lotions suitable for topical administration or suitable for cosmetic application, may include a suitable aqueous or non-aqueous vehicle with buffers, suspending and dispensing agents, thickeners, penetration enhancers, and the like.
  • Solid forms such as creams or pastes or the like may include, for example, any of the following ingredients, water, oil, alcohol or grease as a substrate with surfactant, polymers such as polyethylene glycol, thickeners, solids and the like.
  • Liquid or solid formulations may include enhanced delivery technologies such as liposomes, microsomes, microsponges, patches, and the like.
  • Topical treatment regimens can include applying the composition directly to the skin at the application site, from one to several times daily. Also included are delivery methods in the form of pharmaceutical patches.
  • formulations may include a pharmaceutically acceptable carrier such as water, oils (including vegetable and mineral oils), cream bases, lotion bases, ointment bases, and the like. These bases include suspending agents, thickeners, penetration enhancers, and the like.
  • Topical and transdermal formulations are well known to those in the art of cosmetics and topical pharmaceuticals and are described, for example, in Chapter 44 of “Remington: The Science and Practice of Pharmacy 20 th edition” Lippincott Williams & Wilkins, Philadelphia, Pa. Eds Gennaro A. R. et al, 2000, which is incorporated herein by reference.
  • Topical (e.g., transdermal) formulations may also include pharmaceutically acceptable vehicles.
  • Additives for topical formulations are well-known in the art, and may be added to the topical composition, as long as they are pharmaceutically acceptable and not deleterious to the epithelial cells or their function. Further, the additives should not cause deterioration in the stability of the formulation, in particular, of the active compound.
  • inert fillers for example, inert fillers, anti-irritants, tackifiers, excipients, fragrances, opacifiers, antioxidants, gelling agents, stabilizers, surfactants, emollients, coloring agents, preservatives, buffering agents, other permeation enhancers, and other conventional components of transdermal delivery devices as are known in the art.
  • Excipients generally are carriers, diluents and/or vehicles used in formulating drug compositions. Excipients are standard in the art and examples of excipients and their application can be found, for instance, in Katz, M. ( Drug Design 4:93-148, 1973).
  • Penetration or permeation through the skin of an active compound may be enhanced by an agent (e.g., p20 solvents) or a mixture of agents which, alone or in combination, act to increase the permeability of the skin to a drug.
  • agent e.g., p20 solvents
  • the enhanced permeation effected through the use of such enhancers can be observed, for example, by measuring the rate of diffusion of the drug through animal or human skin using a diffusion cell apparatus.
  • a diffusion cell is described by Merritt et al. “Diffusion Apparatus for Skin Penetration,” J. of Controlled Release, 1:161-162, 1984.
  • Topical administration of a pharmaceutical agent can result in a limited distribution of the agent to the skin and surrounding tissues or, when the agent is removed from the treatment area by the bloodstream, can result in systemic distribution of the agent.
  • transdermal administration desirably results in the diffusion of an agent across the barrier of the skin resulting from topical administration or other application of a pharmaceutically acceptable formulation.
  • the stratum corneum acts as a barrier and few pharmaceutical agents are able to penetrate intact skin.
  • the epidermis and dermis are permeable to many solutes and absorption of drugs therefore occurs more readily through skin that is abraded or otherwise stripped of the stratum corneum to expose the epidermis.
  • Transdermal delivery includes injection or other delivery through any portion of the skin or mucous membrane and absorption or permeation through the remaining portion. Absorption through intact skin can be enhanced by placing the active agent in an appropriate pharmaceutically acceptable vehicle before application to the skin. Passive topical administration may consist of applying the active agent directly to the treatment site in combination with emollients or penetration enhancers.
  • a topically (e.g., transdermally) administrable pharmaceutical formulation may also include an amount of a form of hyaluronic acid sufficient to transport the composition through the skin of a patient into the epidermis or dermis where the composition remains until discharged via the lymphatic system.
  • the active compound is 1-5% by weight of the formulation and hyaluronic acid is 1-3% by weight of the formulation.
  • Desirable forms of hyaluronic acid have a molecular weight greater than about 150,000 daltons and less than 750,000 daltons. Salts of hyaluronic acid are also desirable for use in the methods encompassed by the present invention.
  • Such pharmaceutically acceptable acid addition salts are those salts that retain the biological effectiveness and properties of the free bases.
  • the sensitivity of the CCB analogs to hydrolysis by esterase enzymes can be inferred by measuring their stability in human plasma. This measure provides a qualitative in-vitro method of ranking the compounds in order of relative stability and provides a useful comparison to CCBs with longer half-lives (i.e. diltiazem, verapamil and nifedipine).
  • Such assays are available from commercial service providers such as MDS Pharma Services. The assay is conducted in the following manner:
  • Compounds of the invention may be prepared as described herein.
  • the method depicted in Scheme 1 may be used for the synthesis of compounds having Formula I.
  • the compounds may be prepared by heating a halogen substituted compound of general structure A with an amine of general structure B.
  • the reaction may be conducted by heating the reactants together neat or in the presence of a solvent such as dichloromethane or tetrahydrofuran.
  • a catalyst such as sodium iodide may or may not be added.
  • Step 1 To a solution of 9.99 g (56.4 mmol) of (3,4-Dimethoxyphenyl)acetonitrile in 141 mL of tetrahydrofuran (THF) at ⁇ 30° C., was slowly added 56.4 mL (56.4 mmol) of sodium bis(trimethylsilyl)amide (NaHMDS, 1.0 M in THF). The mixture was stirred at ⁇ 30° C. for 10 minutes and 10.6 mL (113.0 mmol) of 2-bromopropane was added. The mixture was heated to reflux for 2 hours (h) then left at 22° C. for about 16 h.
  • THF tetrahydrofuran
  • Step 2 To a solution of 11.21 g (51.1 mmol) of 2-(3,4-dimethoxyphenyl)-3-methylbutanenitrile in 126 mL of tetrahydrofuran (THF) at ⁇ 30° C., was slowly added 46.0 mL (46.0 mmol) of sodium bis(trimethylsilyl)amide (NaHMDS, 1.0 M in THF). The mixture was stirred at ⁇ 30° C. for 10 minutes and 9.40 mL (256 mmol) of 1,3-dibromopropane was added dropwise. The mixture was warmed to 22° C. and stirred for about 16 h.
  • THF tetrahydrofuran
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile, dimethyl carbonate was substituted for 2-bromopropane and sodium hydride was substituted for NaHMDS.
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 dimethyl carbonate was substituted for 2-bromopropane and sodium hydride was substituted for NaHMDS.
  • Step 1 diethyl carbonate was substituted for 2-bromopropane and sodium hydride was substituted for NaHMDS.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile, 2-iodopropane was substituted for 2-bromopropane and KHMDS was substituted for NaHMDS.
  • Step 2 1-bromo-3-chloropropane was substituted for 1,3-dibromopropane.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile, ethyl chloroformate was substituted for 2-bromopropane and lithium diisopropylamide (LDA) was substituted for NaHMDS.
  • LDA lithium diisopropylamide
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid ethyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile, ethyl chloroformate was substituted for 2-bromopropane and lithium diisopropylamide (LDA) was substituted for NaHMDS.
  • LDA lithium diisopropylamide
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile, di-tert-butyl dicarbonate was substituted for 2-bromopropane and LDA was substituted for NaHMDS.
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile, isopropyl chloroformate was substituted for 2-bromopropane and LDA was substituted for NaHMDS.
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile and dimethyl sulfate was substituted for 2-bromopropane.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid ethyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile and dimethyl sulfate was substituted for 2-bromopropane.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid methyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile and diethyl sulfate was substituted for 2-bromopropane.
  • Step 1 methyl 4-(cyanomethyl)benzoate was substituted for (3,4-Dimethoxyphenyl)acetonitrile.
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid ethyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile and diethyl sulfate was substituted for 2-bromopropane.
  • Step 1 (3,4-dimethoxy-phenyl)-acetic acid isopropyl ester was substituted for (3,4-Dimethoxyphenyl)acetonitrile and dimethyl sulfate was substituted for 2-bromopropane.
  • Step 1 methyl 4-(cyanomethyl)benzoate was substituted for (3,4-Dimethoxyphenyl)acetonitrile and dimethyl carbonate was substituted for 2-bromopropane.
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 methyl 3-(cyanomethyl)benzoate was substituted for (3,4-Dimethoxyphenyl)acetonitrile and sodium hydride was substituted for NaHMDS.
  • Step 2 sodium hydride was substituted for NaHMDS.
  • Step 1 methyl 3-(cyanomethyl)benzoate was substituted for (3,4-Dimethoxyphenyl)acetonitrile and dimethyl carbonate was substituted for 2-bromopropane.
  • Ethyl 4-(1-cyano-2-methylpropyl)benzoate was obtained by NaOH hydrolysis of methyl 4-(1-cyano-2-methylpropyl)benzoate (obtained as an intermediate in the transformations described in Example 14) and subsequent esterification by heating in ethanol and catalytic H 2 SO 4 .
  • the ethyl ester was then subjected to the procedure of Method A, Step 2.
  • Isopropyl 4-(1-cyano-2-methylpropyl)benzoate was obtained by NaOH hydrolysis of methyl 4-(1-cyano-2-methylpropyl)benzoate (obtained as an intermediate in the transformations described in Example 14) and subsequent esterification by heating in 2-propanol and catalytic H 2 SO 4 .
  • the isopropyl ester was then subjected to the procedure of Method A, Step 2.
  • aqueous solution was back-extracted with 30 mL of DCM and the combined organic extracts were dried (Na 2 SO 4 ) and evaporated to give methyl 4-(2-(2,2,2-trifluoroacetamido)ethyl)benzoate as a solid.
  • the material was further purified by flash chromatography on silica gel, eluting first with hexane and then gradually increasing to 20% ethyl acetate/hexane.
  • Step 1 To a solution of 1.25 g (4.26 mmol) of ethyl 4-(2-(tert-butoxycarbonylamino)ethyl)benzoate in 40 mL of dry THF under a nitrogen atmosphere was added dropwise, 4.7 mL (4.7 mmol) of NaHMDS (1.0 M in THF) at 0° C. After stirring for 10 min, 0.50 mL (5.3 mmol) of dimethyl sulfate was added and the reaction was warmed to 22° C. and stirred for about 16 h. The reaction was quenched by adding 25 mL of saturated NaHCO 3 and the mixture was extracted with DCM (2 ⁇ 25 mL).
  • Method D To a solution of 1.00 g (5.75 mmol) of 4-(2-aminoethyl)phenol in 5 mL of dioxane at 22° C. was added 2 mL of 1 N NaOH followed by 1.88 g (8.62 mmol) of BOC 2 O dissolved in 2 mL of dioxane. The mixture was stirred at 22° C. for 2 h and then neutralized by adding 25 mL of saturated NaHCO 3 which resulted in a pH of about 7.5-8. The aqueous layer was separated and extracted with DCM (3 ⁇ 50 mL). The organics were combined, dried (Na 2 SO 4 ) and evaporated.
  • Method E To a solution of 1.11 g (4.70 mmol) of tert-butyl 4-hydroxyphenethylcarbamate in 20 mL of DMF at 22° C. was added 1.3 g (9.4 mmol) of potassium carbonate and 0.700 mL (5.87 mmol) of benzyl bromide. The mixture was stirred for about 16 h at 22° C., diluted with 100 mL of water and extracted with ethyl acetate (3 ⁇ 75 mL). The organic layers were combined, washed with 100 mL of 1 N HCl, dried (Na 2 SO 4 ), and evaporated.
  • tert-butyl 4-(benzyloxy)phenethylcarbamate as an oil which later solidified under vacuum. Transformation of tert-butyl 4-(benzyloxy)phenethylcarbamate to tert-butyl 4-(benzyloxy)phenethyl(methyl)carbamate was accomplished in a manner analogous to Method B Step 1.
  • Transformation of 3-(2-(tert-butoxycarbonyl (methyl)amino)ethyl)benzoic acid to butyl 3-(2-(tert-butoxycarbonyl(methyl)amino)ethyl)benzoate was accomplished with 1-iodobutane and potassium carbonate in a manner analogous to that described in Example 23. Transformation of butyl 3-(2-(tert-butoxycarbonyl(methyl)amino)ethyl)benzoate to 2m was accomplished in a manner analogous to that described in Method B Step 2.
  • Method F Preparation of compounds of Formula 1 exemplified in this invention was accomplished by the general procedure of Method F.
  • the conditions of Method F are suitable for the synthesis of the compounds described in the below Examples.
  • the reaction was conducted without evaporation of THF or other suitable non-reactive organic solvents were used instead.
  • a few crystals of sodium iodide were added to help accelerate the reaction or a base such as DIEA was added. These variations did not significantly alter the outcome of the general procedure.
  • Method F A solution of 0.326 g (0.961 mmol) of 1f in 1 mL of THF and a separate solution of 0.292 g (1.41 mmol) of 2c in 1 mL of THF were combined. The resulting solution was heated in a 90° C. oil bath and the THF was evaporated under a slow stream of nitrogen. The resulting mixture was stirred under nitrogen at 85° C. for 18 h, cooled to 22° C. and partitioned between saturated NaHCO 3 and ethyl acetate.
  • the oxalate salt of 3r was recrystallized from ethyl acetate; mp 112-113.5° C.
  • the K i values were calculated using the equation of Cheng and Prusoff (Cheng, Y. et al. Biochem. Pharmacol. (1973) 22, 3099-3018) using the observed IC 50 of the tested compound, the concentration of the radioligand employed in the assay, and the historical values for the K d of the ligand (obtained experimentally at MDS Pharma Services).

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EP3283067B1 (en) * 2015-04-14 2020-01-01 Milestone Pharmaceuticals Inc. Highly water-soluble salts of a short acting phenylalkylamine calcium channel blocker and uses thereof
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