Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K33/00—Medicinal preparations containing inorganic active ingredients
  • A61K33/06—Aluminium, calcium or magnesium; Compounds thereof, e.g. clay
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
  • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
• • 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
  • A61K31/38—Heterocyclic compounds having sulfur as a ring hetero atom
  • A61K31/385—Heterocyclic compounds having sulfur as a ring hetero atom having two or more sulfur atoms in the same ring
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/02—Nutrients, e.g. vitamins, minerals
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
  • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs

Definitions

• the present invention relates to oral nutritional and therapeutic products which are useful for preventing or treating compensated and decompensated insulin resistance and associated diseases and sequelae, or diabetes mellitus and its sequelae, complications, and co-morbidities.
• the pharmaceutical products and methods of the present invention are particularly useful in preventing or treating diabetes mellitus and its sequelae, complications, and co-morbidities in humans.
• Diabetes mellitus (commonly referred to as "diabetes”) is a syndrome of disordered metabolism resulting in abnormally high blood sugar levels.
• Type 2 diabetes mellitus non-insulin dependent diabetes mellitus
• Late diagnosis, coupled with poor disease management, can result in long-term complications such as microvascular damage and diseases of the eye, nervous system, and kidney. These complications lead to cataracts and blindness, nerve damage (neuropathy), kidney failure, cardiovascular disease, and death.
• Oxidative stress is defined in general as excess formation and/or insufficient removal of highly reactive inflammatory species such as reactive oxygen species (ROS; including, by way of example, superoxide radical anion, hydroxyl radical, peroxyl radicals, hydroperoxyl radicals, hydrogen peroxide, and hypochlorous acid) and reactive nitrogen species (RNS; including, by way of example, nitric oxide, nitrogen dioxide, peroxynitrite, nitrous oxide, and alkyl peroxynitrates).
• ROS reactive oxygen species
• RNS reactive nitrogen species
• Both ROS and RNS are generated under physiological conditions; many of these species have physiological activity as signaling molecules and defense mechanisms. However, excess generation of these reactive species, particularly when the excess continues over time, causes damage to proteins, lipids, and DNA.
• oxidative stress in diabetes is based on studies in which markers of oxidative stress, such as plasma and urinary F2-isoprostane, plasma and tissue levels of nitrotyrosine and superoxide radical anion, and imbalances in physiological anti-oxidants, were measured. In diabetes, these markers are generated via non-enzymatic, enzymatic and mitochondrial pathways.
• ALADIN III a randomized multicenter double-blind placebo controlled study, showed that in a cohort of 509 patients, 600 mg ⁇ -lipoic acid administered daily for 6 months improved neuropathy impairment score as early as 19 days, which was maintained up to 7 months.
• the DEKAN Deutsche kardialed neurpathie
• the SYDNEY trial investigated the effect of ⁇ -lipoic acid treatment on sensory symptoms of diabetic polyneuropathy as assessed by the Total Symptom Score.
• ⁇ -Lipoic acid is the common name for the chiral compound 1 ,2-dithiocyclopentane-3- valeric acid.
• ⁇ -Lipoic acid is available commercially as both the racemic mixture, RS-a- lipoic acid (also commonly known as thioctic acid), and as the single enantiomer, R-(+)-a- lipoic acid. All of the clinical studies presented above used RS- ⁇ -lipoic acid.
• R-(+)- ⁇ -lipoic acid is the form of ⁇ -lipoic acid found in the body. Lysine-bound R-(+)-a- lipoate is a coenzyme of ⁇ -ketoacid dehydrogenases (pyruvate dehydrogenase, ⁇ - ketoglutarate dehydrogenase, etc.) and acts at a key site in the sugar and energy metabolism of the cell.
• R-(+)- ⁇ -lipoate functions as a physiological redox system and is reduced intracellular ⁇ to its corresponding R-(+)- ⁇ -dihydrolipoate, which is subsequently re-oxidized, both intra- and extra-cellularly, to R-(+)- ⁇ -lipoate. Dihydrolipoate is able to regenerate other anti-oxidants such as vitamin C, vitamin E, and reduced glutathione through redox cycling.
• the water-soluble salts disclosed by Wessel include salts of organic amines, such as ⁇ -methylbenzylamine, diphenylamine, trometamol, and 2-amino-2-hydroxymethyl-1 ,3-propylene glycol.
• organic amines such as ⁇ -methylbenzylamine, diphenylamine, trometamol, and 2-amino-2-hydroxymethyl-1 ,3-propylene glycol.
• glucose assimilation was stimulated by the R-enantiomer of lipoic acid by a factor greater than 2, comparable to the effect of 200 nM insulin, whereas the S-enantiomer effected little or no change.
• R-(+)- ⁇ -lipoate stimulated the translocation of glucose transporters (GLUT 1 and GLUT 4) from the cytosol to the plasma membrane; S-(-)- ⁇ -lipoate had no effect or has an inhibiting effect and appeared to lower the total content of glucose transporters. Further, the activity of a key enzyme involved in glucose metabolism, pyruvate dehydrogenase, was increased by R-(+)- ⁇ -lipoate but inhibited by S-(-)- ⁇ - lipoate.
• RS- ⁇ -lipoic acid is more stable than R-(+)- ⁇ -lipoic acid.
• RS- ⁇ -Lipoic acid may be stored in a closed and sealed amber container at room temperature for a year or longer.
• R-(+)- ⁇ -lipoic acid must be stored in a closed and sealed amber container at refrigerated temperatures and must be used within a few months, since it gradually polymerizes to intractable polymers and degrades to physiologically and therapeutically inactive compounds by loss of sulfur-containing compounds.
• adequate magnesium is essential for glycolysis, formation of adenosine-3",5"-cyclic monophosphate, energy-dependent membrane transport, and over
• Magnesium plays the role of a second messenger for insulin action. Conditions associated with insulin resistance (i.e., reduced sensitivity to the activity of insulin), such as diabetes, hypertension or aging, are also associated with low intracellular magnesium contents. In diabetes mellitus, low intracellular magnesium levels have been reported, likely as a result from both increased urinary losses and insulin resistance. Chronic magnesium supplementation can contribute to an improvement in both islet beta-cell response and insulin action in non-insulin-dependent diabetic subjects.
• the present invention is an oral nutritional and therapeutic composition useful for preventing or treating diabetes mellitus and its sequelae, complications, and comorbidities, comprising a unit dosage or serving of magnesium R-(+)-alpha-lipoate.
• a method of preventing or treating diabetes mellitus, its sequelae, complications, and comorbidities in a human, comprising administering to said human a safe and effective amount of a supplement comprising magnesium R-(+)-alpha-lipoate, is also disclosed.
• a method of preventing and treating diabetes mellitus, its sequelae, complications, and co-morbidities in a warm-blooded animal with a therapeutically effective amount of a pharmaceutical composition comprising magnesium R-(+)-alpha- lipoate is disclosed.
• a method of preparing magnesium R-(+)-alpha-lipoate is also provided.
• the present invention comprises use of magnesium R- (+)-alpha-lipoate in the manufacture of a medicament for the prevention or treatment of compensated and decompensated insulin resistance and associated diseases and sequelae, or diabetes mellitus and its sequelae, complications, and co-morbidities.
• Figure 1 is a graph showing the percentage of bioavailable magnesium in magnesium R- (+)-alpha-lipoate (Mg RALA) at each value of pH in the range from pH 4 to pH 8, the pH range of the human gastrointestinal tract.
• Figure 2 is a chromatogram showing the relative retention times of R-(+)-alpha-lipoate of the invention and S-(-)-alpha-lipoate. The relative peak heights confirm that R-(+)-alpha- lipoate of the invention has at least 95% chiral purity.
• the present invention is an oral nutritional and therapeutic composition useful for the treatment of diabetes mellitus and its sequelae, co-morbidities, and complications, comprising a unit dosage or serving of magnesium R-(+)-alpha-lipoate.
• This agent promotes the assimilation of blood sugar in the tissue.
• This activity is of clinical relevance in the case of pathological disorders of the control of blood sugar adjustment, as in the case of diabetes mellitus types I and II, or in the case of disorders in insulin sensitivity of the tissue (insulin resistance).
• complications, sequelae, or co-morbidities of diabetes mellitus or of insulin resistance can also be affected therapeutically by the treatment of the basic diseases with the stable drug of this invention.
• the composition is useful in men and women.
• the present invention also relates to a method of treating compensated and decompensated insulin resistance and, with that, of associated diseases and sequelae, or of diabetes mellitus and its sequelae and complications in a human, comprising administering to said human a safe and effective amount of a supplement comprising an effective amount of magnesium R-(+)-alpha-lipoate.
• the present invention relates to a method of preventing and treating compensated and decompensated insulin resistance and, with that, of associated diseases and sequelae, or of diabetes mellitus and its sequelae and complications in a warm-blooded animal with a therapeutically effective amount of a pharmaceutical composition comprising pharmaceutical quality magnesium R-(+)-alpha-lipoate.
• a pharmaceutical composition comprising pharmaceutical quality magnesium R-(+)-alpha-lipoate.
• Magnesium R-(+)-alpha-lipoate is the magnesium salt of R-(+)- ⁇ -lipoic acid.
• Magnesium R-(+)- ⁇ -lipoate is a stable, non-hygroscopic, light yellow powder having a molecular formula of Mg(C 8 H 13 O 2 S 2 ⁇ , the general formula and a molecular weight of 434.94.
• Pharmaceutical quality magnesium R-(+)-alpha-lipoate of this invention has at least about 95% chiral purity. In other words, pharmaceutical quality magnesium R-(+)-alpha-lipoate of the invention contains less than about 5% of magnesium S-(-)-alpha-lipoate.
• R-(+)- ⁇ -lipoate has been selected because this stable salt provides both magnesium and R-(+)-alpha-lipoate, the anion of R-(+)-alpha-lipoic acid.
• R-(+)- ⁇ -Lipoate is the form of alpha-lipoic acid naturally found in the human body.
• R-(+)-alpha- lipoate is a widely distributed physiological antioxidant that combines free radical scavenging properties with an ability, after intracellular reduction to dihydrolipoic acid, to regenerate the levels of other nonenzymatic and enzymatic antioxidants, including glutathione (GSH), ascorbate, ⁇ -tocopherol, catalase and GSH peroxidase.
• GSH glutathione
• R-(+)- ⁇ -lipoate the R-(+)-enantiomer
• R-(+)- ⁇ -Lipoate has demonstrated safety and an absence of toxicity when administered chronically to humans.
• Magnesium is the fourth most prevalent element in the body and the second most abundant intracellular ion. Since magnesium is a cofactor in over 300 enzyme systems, adequate magnesium is essential for many biosynthetic processes, including, by way of example, glycolysis, formation of adenosine- 3",5"-cyclic monophosphate, energy-dependent membrane transport, and transmission of the genetic code.
• the relationship between insulin and magnesium has been recently studied by Paolisso et al. [G.
• a reduced intracellular magnesium content has been reported to contribute to the impaired insulin response and action which occurs in Type 2 (non-insulin- dependent) diabetes mellitus.
• Chronic magnesium supplementation contributes to an improvement in both islet beta-cell response and insulin action in non-insulin-dependent diabetic subjects.
• compensated insulin resistance implies long-standing and adequate control of blood glucose levels as manifested by glycosylated hemoglobin (HbAI c) levels (a simple and routine blood test) within normal levels, i.e., ⁇ about 7.0%.
• HbAI c glycosylated hemoglobin
• This is an index of metabolic control over several months that doctors use as an index of how well a patient is balancing diet, medications (insulin, etc.), exercise and other variables, i.e., how well "compensated” they are with their diabetes.
• Poorly compensated insulin resistance levels of HbIAc higher than about 7.0%) is associated with retinopathy, nephropathy, neuropathy, vasculopathy, etc.
• bioavailability refers to the amount of a substance that is absorbed in the intestines and ultimately available for biological activity in a subject's cells and tissues.
• excipient material is intended to mean any compound forming a part of the formulation which is not intended to have biological activity itself and which is added to a formulation to provide specific characteristics to the dosage form, including by way of example, providing protection to the active ingredient from chemical degradation, facilitating release of a tablet or caplet from equipment in which it is formed, and so forth.
• treating and “treatment” and the like are used herein to generally mean obtaining a desired pharmacological and physiological effect.
• the effect may be prophylactic in terms of preventing or partially preventing a disease, symptom or condition thereof and/or may be therapeutic in terms of a partial or complete cure of a disease, condition, symptom or adverse effect attributed to the disease.
• treatment encompasses any treatment of a disease in a mammal, particularly a human and includes: (a) preventing the disease from occurring in a subject which may be predisposed to the disease but has not yet been diagnosed as having it; (b) inhibiting the disease or arresting its development; (c) relieving the disease, causing regression of the disease and/or its symptoms or conditions; or (d) returning a clinical value to the concentration range normally found in a subject.
• magnesium R-(+)-alpha-lipoate has a purity of at least about 90% and a chiral purity of at least about 90%.
• magnesium R-(+)-alpha-lipoate contains at most low part per million quantities of contaminating metals having known toxicities in humans. Examples of such metals include aluminum, lead, thallium, arsenic, barium, cadmium, and so forth.
• the phrase "therapeutically effective” is intended to qualify the amount of magnesium R- (+)-alpha-lipoate for use in the orally administered composition of this invention which will achieve the goal of providing the quantity of R-(+)-alpha-lipoate and magnesium that are needed to prevent and treat compensated and decompensated insulin resistance and, with that, of associated diseases and sequelae, or of diabetes mellitus and its sequelae and complications in a warm-blooded animal.
• a warm-blooded animal is a member of the animal kingdom which includes but is not limited to mammals and birds.
• the most preferred mammal of this invention is human.
• Magnesium R-(+)-alpha-lipoate is not commercially available. In order to obtain sufficient quantities of this salt for use in this invention, a method of preparing pharmaceutical quality magnesium R-(+)-alpha-lipoate was required.
• a method of preparing magnesium alpha-lipoate was disclosed by Pearson and Richardson in U.S. Patent No. 6,288,106 B1.
• Pearson and Richardson disclose that a solution of alpha-lipoic acid in anhydrous ethanol was added with stirring to a solution of magnesium ethoxide in anhydrous ethanol. After stirring the reaction mixture for 30 minutes, the solvent was evaporated under reduced pressure to afford the magnesium salt of alpha-lipoic acid.
• Attempts to prepare pharmaceutical quality magnesium R-(+)-alpha-lipoate by the method of Pearson and Richardson failed. After evaporation of the solvents, as required by the method of Pearson and Richardson, a stringy, intractable polymer was obtained; no pharmaceutical quality magnesium /?-(+)- alpha-lipoate was isolated.
• R-(+)- ⁇ -Lipoic acid is a hydrophobic fatty acid that is known to undergo self- polymerization by heat- or light-induced cleavage of the sulfur-sulfur bond on one molecule to an unstable diradical that can interact with a second lipoic acid molecule at its sulfur-sulfur bond to generate a new ring-opened dimer of lipoic acid.
• This polymerization process can be repeated multiple times to generate polylipoates (i.e., polymers of ring- opened lipoic acid) of varying sizes and molecular weights.
• Monomeric R-(+)-alpha-lipoic acid is a yellow powder which is soluble in organic solvents such as alcohols, alkanes, etc.
• the polylipoates are intractable, "gummy" yellow solids which adhere to the surfaces of containers and are essentially insoluble in aqueous or organic solvents.
• R-(+)-alpha-lipoate a synthesis of pharmaceutical quality magnesium R-(+)-alpha-lipoate which provided a powdery solid at room temperature without a requirement for evaporation of solvents or lengthy exposure to heating, wherein the solid had a purity of at least about 90% and a chiral purity of at least about 90% and within ⁇ 5% of the chiral purity of the R-(+)-alpha-lipoic acid starting material used for its preparation.
• R-(+)-alpha- Lipoic acid is an acid; a magnesium salt of an acid is obtained by reaction of the acid with a magnesium-containing base.
• the acid-base reaction must occur under conditions which are non-racemizing.
• Magnesium hydroxide and magnesium oxide are commercially available bases containing magnesium. Both of these bases are insoluble in water or organic solvents. Because of this lack of solubility, reaction of magnesium hydroxide or magnesium oxide with /?-(+)- alpha-lipoic acid does not occur under commercially useful conditions.
• Magnesium methoxide, magnesium ethoxide, magnesium f-butoxide, and magnesium acetylacetonate are bases containing magnesium.
• a solution of magnesium methoxide in methanol is commercially available.
• a solution of magnesium ethoxide in ethanol can be prepared if 70 ml. or more of ethanol per gram of magnesium ethoxide is heated.
• the inventors discovered that solutions of magnesium f-butoxide or magnesium acetylacetonate can be prepared in methanol or acetonitrile at room temperature.
• Lipoic acid in solution is known to be susceptible to undesirable oxidation reactions.
• R- (+)-alpha-Lipoic acid in solution is very susceptible to oxidation by oxygen in air, particularly in the presence of a base.
• the inventors discovered that oxidation is prevented by preparing solutions of R-(+)-alpha-Lipoic acid in an inert atmosphere of nitrogen or argon and completing subsequent reactions under these conditions.
• magnesium ethoxide in methanol When a solution of magnesium ethoxide in methanol was added to a solution of R-(+)-alpha-lipoic acid in methanol or ethanol, the desired product, magnesium R-(+)-alpha-lipoate failed to precipitate from solution.
• magnesium methoxide in methanol was added to a solution of R-(+)-alpha-lipoic acid in methanol or ethanol
• magnesium R-(+)-alpha-lipoate failed to precipitate from solution. If acetone was then added to induce precipitation, a glassy green solid was obtained that was not magnesium R-(+)-alpha-lipoate.
• magnesium acetylacetonate in methanol When a solution of magnesium acetylacetonate in methanol was added to a solution of R- (+)-alpha-lipoic acid in isopropanol, acetonitrile, or methanol/isopropanol, the desired product, magnesium R-(+)-alpha-lipoate was not obtained. Instead, a mixed salt, magnesium (R-(+)-alpha-lipoate)(acetylacetonate), was obtained.
• magnesium R-(+)-alpha-lipoate a powdery yellow solid.
• a solution of magnesium methoxide in methanol was added to a solution of R-(+)-alpha-lipoic acid in isopropanol, acetonitrile, or methanol/isopropanol, the desired product, magnesium R-(+)-alpha-lipoate was obtained.
• the inventors discovered that the dropwise addition of a solution of magnesium methoxide in methanol to a clear solution of R-(+)-alpha-lipoic acid in methanol-isopropyl alcohol solution maintained under an inert atmosphere of nitrogen or argon and shielded from light provided magnesium R-(+)-alpha-lipoate as a solid, pale yellow precipitate.
• the volume ratios of solvent that were used in this preparation were from 25-35 milliliters isopropyl alcohol for each gram of R-(+)-alpha-lipoic acid and from 5- 15 milliliters methanol for each gram of R-(+)-alpha-lipoic acid.
• Magnesium R-(+)- ⁇ -lipoate was isolated by filtration and purified from contaminants by washing with fresh isopropyl alcohol. Magnesium R-(+)- ⁇ -lipoate did not melt at temperatures below 300 0 C. Analysis for magnesium content by titration showed that the magnesium content was about 5.6% by weight, as expected. Analysis for /?-(+)- ⁇ -lipoate content by HPLC showed that the R-(+)- ⁇ -lipoate was about 95% by weight, as expected.
• this newly discovered method of preparing pharmaceutical quality magnesium R-(+)- ⁇ -lipoate uses inexpensive, commercially available reagents, reaction conditions that are easily scaled to commercial quantities, comprises reaction conditions that are non-racemizing, and provides greater than 65% yields of magnesium R-(+)- ⁇ -lipoate of greater than 95% purity and greater than 95% chiral purity.
• magnesium R-(+)- ⁇ -lipoate that is prepared in the manner disclosed above is a stable magnesium salt of R-(+)- ⁇ -lipoic acid.
• the salt was not hygroscopic. This pale yellow salt had no characteristic odor or taste.
• Magnesium R-(+)-alpha-lipoate is insoluble in water, a property that conventionally indicates that this salt has poor bioavailability.
• the inventor has found that both magnesium and R-(+)- ⁇ -lipoate ions are available from suspensions of the salt in aqueous solutions having a pH in the range from about 4 to about 8. This is the pH range that is found in parts of the human gastrointestinal system, where a pH of 4 is found in the stomach after food has been ingested, a pH of 6-7 is found in the upper intestine, and a pH of 8 is found in the lower intestine.
• R-(+)- ⁇ -Lipoate has both hydrophilic and lipophilic properties.
• R-(+)- ⁇ -lipoate binds to lipophilic membranes, as are found on cells throughout the body, and is taken up, at least in part, by absorption of magnesium-bound lipoate from the gastrointestinal tract.
• R-(+)- ⁇ -lipoate binds to lipophilic membranes, as are found on cells throughout the body, and is taken up, at least in part, by absorption of magnesium-bound lipoate from the gastrointestinal tract.
• its bioavailability is unexpectedly high, as compared to conventional, water-insoluble magnesium salts.
• a unit dose or serving of a composition of the invention provides from 5 mg to about 100 mg magnesium, on an elemental basis, and from 95 mg to about 1 ,900 mg of R-(+)-a- lipoate in the form of pharmaceutical quality magnesium R-(+)-alpha-lipoate.
• a clinician has the training and expertise to determine which dose level and related dosage regimen are most appropriate for a patient.
• compositions of this invention can be administered by any means that effects contact of the active ingredients with the site of action in the body of a warm-blooded animal.
• a most preferred means of administration is by the oral route (i.e., ingestion).
• the compositions of this invention can be administered one or more times each day, so as to facilitate and enhance compliance with dosage regimens.
• the active ingredients can be administered by the oral route in solid dosage forms, such as tablets, capsules, and powders, or in liquid dosage forms, such as elixirs, syrups, and suspensions.
• the pharmaceutical composition is preferably made in the form of a dosage unit containing a particular amount of each active ingredient.
• One most preferred oral dosage form of a composition of the present invention is an admixture of powders contained within a sachet. Because a composition of the present invention is not hygroscopic and has no repugnant taste or odor, the admixture of powders comprising a composition of the present invention can be sprinkled on food or stirred into beverages to enhance ease of use and support high levels of compliance with daily dosage regimens.
• compositions of this invention can be prepared by conventional techniques, as are described in Remington's Pharmaceutical Sciences, a standard reference in this field [Gennaro AR, Ed. Remington: The Science and Practice of Pharmacy. 20 th Edition. Baltimore: Lippincott, Williams & Williams, 2000].
• the active components of this combination therapy invention are ordinarily combined with one or more adjuvants appropriate to the indicated route of administration.
• the components may be admixed with lactose, sucrose, starch powder, cellulose esters of alkanoic acids, cellulose alkyl esters, talc, stearic acid, magnesium stearate, gelatin, acacia gum, sodium alginate, polyvinylpyrrolidone, and/or polyvinyl alcohol, and then tabletted or encapsulated for convenient administration.
• Such capsules or tablets may contain a controlled-release formulation as may be provided in a dispersion of active compound in hydroxypropyl methylcellulose.
• Solid dosage forms can be manufactured as sustained release products to provide for continuous release of medication over a period of hours.
• Compressed tablets can be sugar coated or film coated to mask any unpleasant taste and protect the tablet from the atmosphere, or enteric coated for selective disintegration in the gastrointestinal tract. Both the solid and liquid oral dosage forms can contain coloring and flavoring to increase patient acceptance. Other adjuvants and modes of administration are well and widely known in the pharmaceutical art.
• Dosing for oral administration may be with a regimen calling for single daily dose, or for a single dose every other day, or for multiple, spaced doses throughout the day.
• the active agents which make up the therapy may be administered simultaneously, either in a combined dosage form or in separate dosage forms intended for substantially simultaneous oral administration.
• the active agents which make up the therapy may also be administered sequentially, with either active component being administered by a regimen calling for two-step ingestion.
• a regimen may call for sequential administration of the active agents with spaced-apart ingestion of the separate, active agents.
• the time period between the multiple ingestion steps may range from a few minutes to several hours, depending upon the properties of each active agent such a potency, solubility, bioavailability, plasma half-life and kinetic profile of the agent, as well as depending upon the age and condition of the patient.
• the active agents of the therapy may involve a regimen calling for administration of one active agent by oral route and the other active agent by intravenous route. Whether the active agents of the therapy are administered by oral or intravenous route, separately or together, each such active agent will be contained in a suitable pharmaceutical formulation of pharmaceutically-acceptable excipients, diluents or other formulations components.
• Example 1 Preparation and analysis of pharmaceutical quality magnesium /?-(+)- alpha-lipoate.
• B Method of preparation of pharmaceutical quality magnesium ft-(+)-alpha-lipoate of this invention. Dropwise addition of 485 ml. of a solution of magnesium methoxide in methanol (a volume equivalent to about one mole of magnesium methoxide) to a clear solution of about 100 g of R-(+)-alpha-lipoic acid (2 mole equivalents) having a chiral purity of about 96% in 3,500 ml. of methanol-isopropyl alcohol solution maintained under an inert gas and shielded from light provided magnesium R-(+)-alpha-lipoate as a solid, pale yellow precipitate.
• Magnesium R-(+)- ⁇ -lipoate was isolated by filtration and purified from contaminants by washing with fresh isopropyl alcohol. Magnesium R-(+)- ⁇ -lipoate did not melt at temperatures below 300 0 C. Analysis for magnesium content by titration showed that the magnesium content was 5.6% by weight, as expected. Analysis for R- (+)- ⁇ -lipoate content by HPLC showed that the R-(+)- ⁇ -lipoate was 94.4% by weight, as expected. HPLC analysis by a method useful for the determination of chiral purity confirmed that the magnesium R-(+)-alpha-lipoate obtained therefrom had at least about 95% chiral purity; thus, no racemization occurred during its preparation.
• magnesium /?-(+)- ⁇ -lipoate contained only very low parts per million levels of toxic metals, such as aluminum, tin, arsenic, barium, lead, and thallium.
• toxic metals such as aluminum, tin, arsenic, barium, lead, and thallium.
• pharmaceutical quality magnesium R-(+)- ⁇ -lipoate was obtained in greater than 65% yields and had greater than 95% purity and greater than 95% chiral purity.
• Test samples of magnesium R-(+)- ⁇ -lipoate were exposed to ambient environments with relative humidities as high as 75% for a period of a week. The physical appearance and properties of the compound did not change during storage. The data indicated that the compound was not hygroscopic and was stable during storage under these conditions. Test samples of magnesium R-(+)- ⁇ -lipoate were stored at ambient temperatures for two years. The physical appearance and properties of the compound did not change. Magnesium R-(+)- ⁇ -lipoate was a light yellow powder throughout the storage period and showed no visible signs of polymerization or degradation. Chemical analyses indicated that its chemical composition, purity, and chiral purity did not change during storage under these conditions.
• Example 3 Bioavailability of magnesium /?-(+)-alpha-lipoate of this invention. The percentage of bioavailable magnesium was determined as the percentage of phosphorous bound from a solution of phosphate. Materials. Materials other than magnesium R-(+)- ⁇ -lipoate were obtained from commercial suppliers (e.g., Sigma Aldrich Chemical Co., Inc., VWR, Alfa Aesar Chemical

Landscapes

• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Chemical & Material Sciences (AREA)
• Medicinal Chemistry (AREA)
• Animal Behavior & Ethology (AREA)
• Veterinary Medicine (AREA)
• General Health & Medical Sciences (AREA)
• Pharmacology & Pharmacy (AREA)
• Public Health (AREA)
• Engineering & Computer Science (AREA)
• Diabetes (AREA)
• General Chemical & Material Sciences (AREA)
• Chemical Kinetics & Catalysis (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Organic Chemistry (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Epidemiology (AREA)
• Obesity (AREA)
• Hematology (AREA)
• Nutrition Science (AREA)
• Mycology (AREA)
• Food Science & Technology (AREA)
• Polymers & Plastics (AREA)
• Inorganic Chemistry (AREA)
• Endocrinology (AREA)
• Emergency Medicine (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Priority Applications (6)

Applications Claiming Priority (1)

Related Child Applications (1)

Publications (1)

Family

ID=42119567

Family Applications (1)

Country Status (5)

Cited By (1)

Families Citing this family (6)

Citations (3)

Family Cites Families (10)

• 2008
  • 2008-10-24 US US13/125,724 patent/US8222432B2/en not_active Expired - Fee Related
  • 2008-10-24 WO PCT/US2008/081128 patent/WO2010047717A1/en not_active Ceased
  • 2008-10-24 CA CA2741700A patent/CA2741700A1/en not_active Abandoned
  • 2008-10-24 EP EP08877632A patent/EP2349322A4/en not_active Withdrawn
  • 2008-10-24 JP JP2011533151A patent/JP2012506429A/ja active Pending
• 2012
  • 2012-07-13 US US13/548,929 patent/US20120283320A1/en not_active Abandoned

Patent Citations (3)

Also Published As

Similar Documents

Legal Events