US20110301214A1 - Pharmaceutical compositions comprising (3-(1-(1h-imidazol-4-yl)ethyl)-2-methylphenyl)methanol - Google Patents

Pharmaceutical compositions comprising (3-(1-(1h-imidazol-4-yl)ethyl)-2-methylphenyl)methanol Download PDF

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US20110301214A1
US20110301214A1 US13/147,760 US201013147760A US2011301214A1 US 20110301214 A1 US20110301214 A1 US 20110301214A1 US 201013147760 A US201013147760 A US 201013147760A US 2011301214 A1 US2011301214 A1 US 2011301214A1
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pain
compounds
compound
mixture
chronic pain
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Daniel W. Gil
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Allergan Inc
ALLEGRAN Inc
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ALLEGRAN Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4164—1,3-Diazoles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4164—1,3-Diazoles
    • A61K31/4174—Arylalkylimidazoles, e.g. oxymetazolin, naphazoline, miconazole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P23/00—Anaesthetics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/04—Centrally acting analgesics, e.g. opioids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/06—Antimigraine agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D233/00—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, not condensed with other rings
    • C07D233/54—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, not condensed with other rings having two double bonds between ring members or between ring members and non-ring members
    • C07D233/64—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, not condensed with other rings having two double bonds between ring members or between ring members and non-ring members with substituted hydrocarbon radicals attached to ring carbon atoms, e.g. histidine

Definitions

  • Compound I is (3-(1-(1H-imidazol-4-yl)ethyl)-2-methylphenyl)methanol. It occurs as two enantiomers:
  • Compound II is (R)-(3-(1-(1H-imidazol-4-yl)ethyl)-2-methylphenyl)methanol;
  • Compound III is (S)-(3-(1-(1H-imidazol-4-yl)ethyl)-2-methylphenyl)methanol.
  • medetomidine 5-(1-(2,3-dimethylphenyl)ethyl)-1H-imidazole):
  • Medetomidine is well known in the art.
  • the hydrochloride salt of the (S) enantiomer of medetomidine is sold in the United States under the brand name Precedex® for the sedation of initially intubated and mechanically ventilated patients during treatment in an intensive care setting.
  • the racemic mixture (medetomidine) is sold in the United States for use in the sedation of animals.
  • Metabolites of medetomidine and dexmedetomidine are known, and are described in I. Stoilov, et al., Synthesis of detomidine and medetomidine metabolites: 1,2,3-trisubstituted arenes with 4′(5′)-imidazolylmethyl groups, J. Heterocyclic Chem. 30:6, 1645-51 (1993); P. V. Kavanagh et al., Synthesis of possible metabolites of medetomidine ⁇ 1-(2,3-dimethylphenyl)-1-[imidazol-4(5)-yl]ethane ⁇ , J. Chem. Res. Synopses 4, 152-3 (1993); J. S. Salonen and M.
  • the inventors have discovered that, whereas medetomidine is sedating—indeed, whereas the compounds is marketed for its sedative properties—the compounds of the invention may be used to treat chronic pain without sedation.
  • the reaction was quenched by drop wise addition of saturated aq NH 4 Cl (1.0 L, prepared from 835 g of NH 4 Cl and 2.5 L of tap water) to the mixture while keeping the internal temperature below 20° C. After this addition was complete, the layers were separated. The organic layer was washed with a 1:2 mixture of tap water (500 mL) and brine (1000 mL, prepared from 1 kg of NaCl and 2 L of tap water), and the layers were separated. The organic layer was washed with brine (300 mL, as above), separated, and dried over MgSO 4 (100 g). After filtration, it was concentrated under reduced pressure. The residue was dried under the high vacuum to give 162.8 g of 5 as a brown foam.
  • saturated aq NH 4 Cl 1.0 L, prepared from 835 g of NH 4 Cl and 2.5 L of tap water
  • the batch was diluted with tap water (25 mL) and the resulting cloudy solution was extracted with EtOAc (3 ⁇ 100 mL). HPLC assay indicated that only the first two extracts contained product. All organic extracts were combined and dried over anhydrous MgSO 4 (16.2 g). The batch was filtered through a filter paper and the filter cake rinsed with EtOAc (100 mL). Filtrate and rinses were concentrated under reduced pressure. The residue was swished with EtOAc (50 mL) for 10 min while cooling with an ice-water bath, and then the solids were collected on a filter. The filter cake was rinsed with cold EtOAc (20 mL) and dried under high vacuum (1.18 g).
  • the compounds of the invention may be used to treat chronic pain.
  • To “treat,” as used here, means to deal with medically. It includes administering a compound of the invention to prevent pain as well as to alleviate its severity.
  • Pain is of two types: chronic and acute.
  • An “acute pain” is a pain of short duration having a sudden onset.
  • One type of acute pain for example, is cutaneous pain felt on injury to the skin or other superficial tissues, such as caused by a cut or a burn. Cutaneous nociceptors terminate just below the skin, and due to the high concentration of nerve endings, produce a well-defined, localized pain of short duration.
  • Chronic pain is a pain other than an acute pain.
  • the compounds of the invention may be used to treat chronic pain.
  • Chronic pain includes neuropathic pain, inflammatory pain, headache pain, somatic pain, visceral pain and referred pain.
  • the compounds of the invention may be used to treat neuropathic pain.
  • Neuropathic pain includes pain associated with neuralgia, differentiation, complex regional pain syndromes, and neuropathy.
  • Neuralgia is a pain that radiates along the course of one or more specific nerves usually without any demonstrable pathological change in the nerve structure.
  • the causes of neuralgia are varied. Chemical irritation, inflammation, trauma (including surgery), compression by nearby structures (for instance, tumors), and infections may all lead to neuralgia. In many cases, however, the cause is unknown or unidentifiable.
  • Neuralgia is most common in elderly persons, but it may occur at any age. Neuralgia includes, for example, trigeminal neuralgia, spinal stenosis, postherpetic neuralgia, glossopharyngeal neuralgia, pain associated with nerve entrapment disorders, sciatica, and atypical facial pain.
  • Deafferentation indicates a loss of the sensory input from a portion of the body, and can be caused by interruption of either peripheral sensory fibres or nerves from the central nervous system.
  • Deafferentation pain syndrome includes, for example, post-stroke pain, phantom pain, and paraplegia.
  • CRPS is a chronic pain syndrome with two forms.
  • CRPS1 currently replaces the term “reflex sympathetic dystrophy syndrome.” It is a chronic nerve disorder that occurs most often in the arms or legs after a minor or major injury.
  • CRPS1 is associated with severe pain; changes in the nails, bone, and skin; and an increased sensitivity to touch in the affected limb.
  • CRPS 2 replaces the term causalgia, and results from an identified injury to the nerve.
  • Neuropathy is a functional or pathological change in a nerve and is characterized clinically by sensory or motor neuron abnormalities.
  • Central neuropathy is a functional or pathological change in the central nervous system.
  • Peripheral neuropathy is a functional or pathological change in one or more peripheral nerves. Either condition can lead to pain which may be treated by the compounds of the invention.
  • neuropathy Some causes of neuropathy include heredity disorders, such as Charcot-Marie-Tooth disease, Friedreich's ataxia; systemic or metabolic conditions, such as diabetes, dietary deficiencies (especially vitamin B-12 deficiency), excessive alcohol use, uremia, and cancer; and infectious conditions, such as AIDS, hepatitis, and diphtheria; exposure to toxic compounds, such as the solvents used in industrial processes, heavy metals (lead, arsenic, mercury, etc.); and chemotherapy.
  • heredity disorders such as Charcot-Marie-Tooth disease, Friedreich's ataxia
  • systemic or metabolic conditions such as diabetes, dietary deficiencies (especially vitamin B-12 deficiency), excessive alcohol use, uremia, and cancer
  • infectious conditions such as AIDS, hepatitis, and diphtheria
  • exposure to toxic compounds such as the solvents used in industrial processes, heavy metals (lead, arsenic, mercury, etc.); and chemotherapy.
  • Neuropathy may involve a function or pathological change to a single nerve or nerve group (monneuropathy) or a function or pathological change affecting multiple nerves (polyneuropathy).
  • Other types of neuropathy includes generalized peripheral neuropathies, distal axonopathies, myelinopathies, neuronopathies, and focal entrapment neuropathies, all of which can lead to chronic pain which may be treated by the compounds of the invention.
  • the compounds of the invention may be used to treat chronic pain associated with any of the following conditions: arthritis, such as rheumatoid arthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus (SLE), gouty arthritis, scleroderma, osteoarthritis, psoriatic arthritis, and ankylosing spondylitis; connective tissue disorders, such as spondyloarthritis and dermatomyositis; injury, such as stretching of a tissue or joint, that results in chronic inflammatory pain; infection; neuritis, such as brachial neuritis and retrobulbar neuropathy; vestibular neuritis; and inflammation of the joints, such as that caused by bursitis or tendonitis.
  • arthritis such as rheumatoid arthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus (SLE), gouty arthritis, scleroderma, osteoarthritis,
  • a headache is a condition of mild to severe pain in the head. It may indicate an underlying local or systemic disease or be a disorder in itself. Examples of headaches include muscular/myogenic headache, such as tension headache; vascular headache, such as migraine, cluster headaches, and headaches resulting from high blood pressure; traction and inflammatory headaches resulting from other disorders such as stroke or sinus infection; hormone headache; rebound headache (medication overuse headaches); chronic sinusitis headache; organic headache; and ictal headaches.
  • the compounds of the invention may be used to treat chronic pain associated with any of the following somatic pain conditions: excessive muscle tension, such as that caused by sprains or strains; repetitive motion disorders, such as those resulting from overuse of the hands, wrists, elbows, and shoulder; muscle disorders such as polymyositis, dermatomyositis, lupus, fibromyalgia, myalgia, polymyalgia rheumatica, macrophagic myofasciitis, and rhabdomyolysis; and muscle pain secondary to neurological and neuromuscular disorders;
  • somatic pain conditions such as that caused by sprains or strains
  • repetitive motion disorders such as those resulting from overuse of the hands, wrists, elbows, and shoulder
  • muscle disorders such as polymyositis, dermatomyositis, lupus, fibromyalgia, myalgia, polymyalgia rheumatica, macrophagic myof
  • the compounds of the invention may be used to treat chronic pain associated with any of the following visceral pain conditions.
  • Visceral pain originates from body's viscera, or organs.
  • Examples of visceral pain include the following: functional visceral pain, such as pain associated with functional irritable bowel syndrome, functional abdominal pain, functional constipation, functional dyspepsia, functional gastroesophageal reflux disease, and non-cardiac chest pain; pain associated with chronic gastrointestinal inflammation, such as gastritis, inflammatory bowel disease, Crohn's disease, ulcerative colitis, diverticulitis and gastroenteritis; pain associated with interstitial cystitis, urinary tract infections, pancreatitis and hernia.
  • functional visceral pain such as pain associated with functional irritable bowel syndrome, functional abdominal pain, functional constipation, functional dyspepsia, functional gastroesophageal reflux disease, and non-cardiac chest pain
  • pain associated with chronic gastrointestinal inflammation such as gastritis, inflammatory bowel
  • the A afferent fibers can be stimulated at a lower threshold than C fibers, and appear to be involved in the sensation of chronic pain. Under normal conditions, low threshold stimulation of these fibers (such as a light brush or tickling) is not painful. Under certain conditions such as those following nerve injury or in the herpes virus-mediated condition known as shingles the application of even such a light touch or the brush of clothing can be very painful. This condition is termed allodynia and appears to be mediated at least in part by A-beta afferent nerves.
  • C fibers may also be involved in the sensation of chronic pain, but if so it appears clear that persistent firing of the neurons over time brings about some sort of change which now results in the sensation of chronic pain.
  • the chronic pain associated with allodynia may be treated with the compounds of the invention.
  • compositions are formulated as pharmaceutical compositions.
  • a “pharmaceutically acceptable salt” is any salt that retains the activity of the parent compound and does not impart any additional deleterious or untoward effects on the subject to which it is administered and in the context in which it is administered compared to the parent compound.
  • a pharmaceutically acceptable salt also refers to any salt which may form in vivo as a result of administration of an acid, another salt, or a prodrug which is converted into an acid or salt.
  • Pharmaceutically acceptable salts of acidic functional groups may be derived from organic or inorganic bases.
  • the salt may comprise a mono or polyvalent ion. Of particular interest are the inorganic ions lithium, sodium, potassium, calcium, and magnesium.
  • Organic salts may be made with amines, particularly ammonium salts such as mono-, di- and trialkyl amines or ethanol amines. Salts may also be formed with caffeine, tromethamine and similar molecules. Hydrochloric acid or some other pharmaceutically acceptable acid may form a salt with a compound that includes a basic group, such as an amine or a pyridine ring.
  • prodrugs may also be formulated as prodrugs.
  • a “prodrug” is a compound which is converted to a therapeutically active compound after administration, and the term should be interpreted as broadly herein as is generally understood in the art. While not intending to limit the scope of the invention, conversion may occur by hydrolysis of an ester group or some other biologically labile group. Generally, but not necessarily, a prodrug is inactive or less active than the therapeutically active compound to which it is converted. Ester prodrugs of the compounds disclosed herein are specifically contemplated. While not intending to be limiting, an ester may be an alkyl ester, an aryl ester, or a heteroaryl ester.
  • alkyl has the meaning generally understood by those skilled in the art and refers to linear, branched, or cyclic alkyl moieties.
  • C 1-6 alkyl esters are particularly useful, where alkyl part of the ester has from 1 to 6 carbon atoms and includes, but is not limited to, methyl, ethyl, propyl, isopropyl, n-butyl, sec-butyl, iso-butyl, t-butyl, pentyl isomers, hexyl isomers, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, and combinations thereof having from 1-6 carbon atoms, etc.
  • Compounds of the invention may be administered orally, transdermally, topically, intraperitoneally, parenterally, subcutaneously, intranasally, intrathecally, intramuscularly, intravenously and intrarectally.
  • “Pharmaceutically acceptable excipients” refers to those ingredients comprising the vehicle in which the compounds of the invention are administered. Excipients are usually inert. Their selection depends on how the drug is to be administered. Compounds of the invention may be connected as a powder, pill, tablet or the like, or as a solution, emulsion, suspension, aerosol, syrup or elixir suitable for oral or parenteral administration or inhalation.
  • non-toxic solid carriers include, but are not limited to, pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharin, the polyalkylene glycols, talcum, cellulose, glucose, sucrose and magnesium carbonate.
  • the solid dosage forms may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period.
  • a time delay material such as glyceryl monostearate or glyceryl distearate may be employed. They may also be coated by the technique described in U.S. Pat. Nos. 4,256,108, 4,166,452, and 4,265,874, the contents of which are incorporated herein by reference, to form osmotic therapeutic tablets for control release.
  • Liquid pharmaceutically administrable dosage forms can, for example, comprise a solution or suspension of one or more of the presently useful compounds and optional pharmaceutical adjutants in a carrier, such as for example, water, saline, aqueous dextrose, glycerol, ethanol and the like, to thereby form a solution or suspension.
  • a carrier such as for example, water, saline, aqueous dextrose, glycerol, ethanol and the like
  • the pharmaceutical composition to be administered may also contain minor amounts of nontoxic auxiliary substances such as wetting or emulsifying agents, pH buffering agents and the like. Typical examples of such auxiliary agents are sodium acetate, sorbitan monolaurate, triethanolamine, sodium acetate, triethanolamine oleate, etc.
  • composition of the formulation to be administered contains a quantity of one or more of the presently useful compounds in an amount effective to provide the desired therapeutic effect.
  • the compounds of the invention may be administered at pharmaceutically effective doses.
  • dosages are usually the minimum dose necessary to achieve the desired therapeutic effect; in the treatment of chronic pain, this amount would be roughly that necessary to reduce the discomfort caused by the pain to tolerable levels.
  • doses generally will be in the range of about 0.01-50 mg/kg/day, and often in the range of 0.05-25 mg/kg/day.
  • the actual amount of the compound to be administered in any given case will be determined by a physician taking into account the relevant circumstances, such as the severity of the pain, the age and weight of the patient, the patient's general physical condition, the cause of the pain, and the route of administration.
  • the most effective pain-relieving drugs are also the most heavily sedating.
  • the compounds of the invention in contrast, can effectively relieve pain at doses that are non-sedating or only minimally sedating.
  • “Sedating,” as used here, means causing that level of sedation which would be described by a score of three or greater on the Stanford Sleepiness Scale.
  • “Non-sedating” or “minimally sedating” means causing no more sedation than would be described by a score of 3 or less on the Stanford Sleepiness Scale. In this widely used measurement of alertness, a patient sits quietly with his eyes closed for one minute and then describes his current state of alertness using one of eight descriptions, as set forth below:
  • Compound I (or one or both of its enantiomers) is administered to a patient to treat chronic pain at a dose that results in a sleepiness score of no more than 1 on the Stanford Sleepiness Scale. In another embodiment, Compound I (or one or both of its enantiomers) is administered to a patient to treat chronic pain at a dose that results in a sleepiness score of no more than 2 on the Stanford Sleepiness Scale. In another embodiment, Compound I (or one or both of its enantiomers) is administered to a patient to treat chronic pain at a dose that results in a sleepiness score of no more than 3 on the Stanford Sleepiness Scale.
  • Compound I (or one or both of its enantiomers) is administered to a patient to treat chronic pain at a dose that results in a sleepiness score of four or greater on the Stanford Sleepiness Scale.
  • Compound I (racemic mixture) was assayed for its ability to alleviate sulprostone-induced tactile hypersensitivity and for sedating activity at various doses.
  • the tactile hypersensitivity of 5-6 mice (weighing approx. 25 g) per group was scored every five minutes between 15 and 50 minutes following intraperitoneal dosing with 300 ng/kg (in a 1 mL/kg volume) sulprostone (Cayman Chemical Company, Ann Arbor, Mich.).
  • Compound I or vehicle was administered intraperitoneally 15 minutes prior to sulprostone.
  • Tactile hypersensitivity was quantified by scoring the response of mice to light stroking of their flanks with a small paintbrush, which is not normally painful. The mice were rated on the following scale: a score of “2” was given to animals showing aggressive escape responses along with squeaking and biting at the brush; a score of “1” was given to animals exhibiting mild squeaking with attempts to escape; and a score of “0” was given if the animal showed no response to the light stroking of the paintbrush. The scores were summed to generate a cumulative score of 0 to 16 as described in Minami et al., Pain 57:217-223 (1994).
  • Sulprostone-treated mice typically have a score of 14 and vehicle-treated mice typically have a score of 5-6.
  • Chronic pain compounds including gabapentin and amitriptyline are active in this model consistent with effects in other chronic pain models and chronic pain patients, as described in Gil D W, Cheevers C V and Donello J E, Br J Pharmacol 153: 769-74 (2008).
  • locomotor activity of 5-6 mice per group was measured in a five minute period 30 minutes following intraperitoneal dosing with compound I.
  • the activity is determined automatically by placing the mice in an exploratory chamber (Omnitech Electronic) that has photocell beams criss-crossing the box that are interrupted as the animal moves around.
  • the computer analyses this movement and records total activity.
  • Locomotor activity relative to vehicle-treated animals was expressed as a percentage; percentage sedation was calculated as 100% minus the percent locomotor activity.
  • Statistical calculations of significance for in vivo studies were done using a two-tailed Student's t-test.
  • the FLIPR assay measures release of intracellular calcium in response to receptor activation.
  • Cells are preloaded with a calcium sensitive dye that fluoresces in response to calcium.
  • Receptors that activate the G protein, Gq elicit the response.
  • Alpha adrenergic receptors, which normally couple to Gi trigger the increase in intracellular calcium when coexpressed with a hybrid Gq protein containing a Gi receptor recognition domain, designated Gq/i5 (Conklin et al., Nature 363:274-6 (1993)) or with the promiscuous G protein G a16 .
  • the assay was performed essentially as follows. HEK 293 cells stably expressing an alpha-2 receptor and either the chimeric G-protein Gqi5 or the promiscuous G protein G16 were plated in poly-D-lysine coated 384-well plates at 20,000-25,000 cells per well and grown overnight in DMEM supplemented with 10% FBS. Cells were washed twice with HBSS/HEPES Buffer (1 ⁇ Hanks Buffered Salt Solution, 20 mM HEPES, pH 7.4) prior to the addition of Fluo-4-AM (4 ⁇ M Fluo-4-AM, 0.04% pluronic acid in HBSS/HEPES Buffer), a calcium-sensitive dye.
  • HBSS/HEPES Buffer 1 ⁇ Hanks Buffered Salt Solution, 20 mM HEPES, pH 7.4
  • Table 2 shows agonist and antagonist activity at the alpha-1A, alpha-1B, alpha-2A, alpha-2B, and alpha-2C adrenergic receptors.
  • Data in the first line in each column shows agonism; the first number is the EC 50 , with the relative efficacy as compared to norepinephrine in parenthesis.
  • Data in the second line when present, shows antagonism; the first number is the IC 50 , with the percent antagonism in parenthesis.
  • the (R) enantiomer of Compound 1 is an alpha-2A and alpha-2B agonist, and an alpha-2A antagonist.
  • the (S) enantiomer is a an alpha-2 pan agonist having some alpha-1A antagonist activity.
  • the racemate (Compound I) is an alpha-2 pan agonist having some alpha-1A agonist activity.

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EP3241553A1 (en) 2017-11-08
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JP2012518007A (ja) 2012-08-09
CA2752148A1 (en) 2010-08-19
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US9193690B2 (en) 2015-11-24
EP3241553B1 (en) 2019-04-10
US9555021B2 (en) 2017-01-31
ES2733905T3 (es) 2019-12-03
WO2010093930A1 (en) 2010-08-19
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