WO2011073646A1 - Combination of theobromine with a decongestant and its use for the treatment of cough - Google Patents

Combination of theobromine with a decongestant and its use for the treatment of cough Download PDF

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Publication number
WO2011073646A1
WO2011073646A1 PCT/GB2010/052085 GB2010052085W WO2011073646A1 WO 2011073646 A1 WO2011073646 A1 WO 2011073646A1 GB 2010052085 W GB2010052085 W GB 2010052085W WO 2011073646 A1 WO2011073646 A1 WO 2011073646A1
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WO
WIPO (PCT)
Prior art keywords
decongestant
theobromine
cough
agent
pseudoephedrine
Prior art date
Application number
PCT/GB2010/052085
Other languages
French (fr)
Inventor
John Brew
Robin Mark Bannister
Original Assignee
Biocopea Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to NZ600243A priority Critical patent/NZ600243A/en
Priority to AU2010332494A priority patent/AU2010332494B2/en
Priority to UAA201208706A priority patent/UA105944C2/en
Priority to EP10795446A priority patent/EP2512464A1/en
Priority to MX2012006625A priority patent/MX343222B/en
Priority to CN2010800570306A priority patent/CN102740843A/en
Priority to CA2784214A priority patent/CA2784214C/en
Priority to JP2012543902A priority patent/JP2013513651A/en
Application filed by Biocopea Limited filed Critical Biocopea Limited
Priority to RU2012129839/15A priority patent/RU2564904C2/en
Priority to NZ600267A priority patent/NZ600267A/en
Priority to BR112012014161A priority patent/BR112012014161A2/en
Priority to SG2012043642A priority patent/SG181686A1/en
Publication of WO2011073646A1 publication Critical patent/WO2011073646A1/en
Priority to US13/446,217 priority patent/US20120252824A1/en
Priority to ECSP12012132 priority patent/ECSP12012132A/en
Priority to ZA2012/04293A priority patent/ZA201204293B/en
Priority to IL220383A priority patent/IL220383A/en
Priority to US14/287,014 priority patent/US9314465B2/en
Priority to US14/287,017 priority patent/US10016437B2/en
Priority to US14/287,015 priority patent/US9308211B2/en
Priority to US14/488,215 priority patent/US20150005325A1/en
Priority to US14/687,393 priority patent/US20150216869A1/en
Priority to US14/991,892 priority patent/US20160120899A1/en
Priority to US15/061,656 priority patent/US9700561B2/en
Priority to US15/063,465 priority patent/US9675618B2/en
Priority to US15/144,800 priority patent/US20160271197A1/en
Priority to US15/144,798 priority patent/US20160271136A1/en
Priority to US16/042,670 priority patent/US10420812B2/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • 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
    • A61K31/13—Amines
    • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
    • A61K31/137—Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
    • 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
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • A61K31/52—Purines, e.g. adenine
    • A61K31/522—Purines, e.g. adenine having oxo groups directly attached to the heterocyclic ring, e.g. hypoxanthine, guanine, acyclovir
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A61P11/14—Antitussive agents
    • 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

Definitions

  • This invention relates to a drug combination, its composition and its use in therapy, particularly in the therapy of cough.
  • Cough is a protective reflex. Persistent cough can be distressing. Over- the-counter remedies are available but their effectiveness is doubtful.
  • W098/42322 discloses the use of theobromine for the treatment of cough, to be given orally.
  • the invention is based at least in part on data showing a synergistic antitussive effect for theobromine combined with the decongestant pseudoephedrine, in a citric acid-induced cough model.
  • the data show that when theobromine is combined with pseudoephedrine, the effect is surprisingly potent and greater than the sum of the individual drugs, revealing that the combination has a substantially improved effect. This is particularly surprising given that it is doubtful that pseudoephedrine has an antitussive effect at all.
  • an agent comprises theobromine and a decongestant, as a combined preparation for simultaneous, sequential or separate use in therapy.
  • a pharmaceutical composition comprises theobromine and a decongestant.
  • Figure 1 shows the effect of theobromine, and of a combination of theobromine and pseudoephedrine, on citric acid-induced cough in guinea-pig.
  • the term "decongestant” is a defined class of drugs, which is well known to the skilled person.
  • the decongestant is a a-adrenergic receptor agonist.
  • Any suitable form of the decongestant agent may be chosen. These include salts, prodrugs and active metabolites.
  • the treatment of cough means any therapy that reduces the number and/or the severity of cough. Preferably, it means a reduction in the number of coughs, i.e. a direct antitussive effect that reduces the body's urge to cough. Therefore, according to a preferred embodiment of the invention, an agent comprises theobromine and a decongestant, for use as an antitussive pharmaceutical composition.
  • An agent of the invention is useful as an antitussive in the control of cough. Preferably, it is used in the control of nonproductive cough.
  • the decongestant may be used in an amount that is already known for its use, although combination according to this invention means that a reduced dose may be effective.
  • the dose of the decongestant that is administered with the theobromine will of course depend on the usual factors, including its potency, but is preferably at least 0.1 , e.g. at least 5, and may be up to 50 mg/kg/day.
  • the decongestant is dosed in a range of 0.1 to 30 mg/kg/day.
  • any suitable form of theobromine can be chosen. These include salts, prodrugs and active metabolites.
  • Theobromine may also be in the form of cocoa or chocolate.
  • Suitable dose ranges for theobromine are known in the art and will depend on the usual factors (age etc); although the synergistic effect of the combination means that the effective dose may be reduced.
  • a combination according to the invention may be provided in a single formulation or in separate formulations, for combined, simultaneous or sequential administration.
  • This decongestant is preferably chosen from the following drugs: ephedrine, levmetamfetamine, naphazoline, oxymetazoline, phenylephrine, phenylpropanolamine, propylhexedrine, pseudoephedrine, synephrine and tetrahydrozoline. More preferably, the decongestant is pseudoephedrine.
  • the compounds of the invention may be administered by any available route, such as via the oral, inhaled, intranasal, sublingual, intravenous, rectal and vaginal routes.
  • the compounds of the invention are preferably as combinations to be administered orally, for example as tables, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules.
  • Preferred pharmaceutical compositions of the invention are tablets and capsules. Liquid dispersions for oral administration may be syrups, emulsions and suspensions. More preferably, the pharmaceutical composition of the combination is a pressed tablet or capsule with conventional excipients, examples of which are given below.
  • compositions intended for oral use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions, and such compositions may contain one or more agents selected from the group consisting of sweetening agents, flavouring agents, colouring agents and preserving agents in order to provide pharmaceutically elegant and palatable preparations.
  • Tablets contain the combined active ingredients in admixture with non-toxic pharmaceutically acceptable excipients which are suitable for the manufacture of tablets.
  • excipients may be, for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example corn starch or alginic acid; binding agents, for example starch gelatin, acacia, microcrystalline cellulose or polyvinyl pyrrolidone; and lubricating agents, for example magnesium stearate, stearic acid or talc.
  • the tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period.
  • a time delay material such as glyceryl monostearate or glyceryl distearate may be employed.
  • Aqueous suspensions contain the combined active materials in admixture with excipients suitable for the manufacture of aqueous suspensions.
  • excipients are suspending agents, for example sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinyl pyrrolidone, gum tragacanth and gum acacia; dispersing or wetting agents may be a naturally occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example polyoxyethylene stearate, or condensation products of ethylene oxide with long-chain aliphatic alcohols, for example heptadecaethyleneoxycetanol, or condensation products of ethylene oxide with partial esters derived from fatty acids, for example polyoxyethylene sorbitan monooleate.
  • suspending agents for example sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinyl pyrrolidone, gum tragacanth and gum
  • the aqueous suspensions may also contain one or more preservatives, for example ethyl or n-propyl p- hydroxybenzoate, one or more colouring agents, one or more flavouring agents, and one or more sweetening agents, such as sucrose or saccharin.
  • preservatives for example ethyl or n-propyl p- hydroxybenzoate
  • colouring agents for example ethyl or n-propyl p- hydroxybenzoate
  • flavouring agents such as sucrose or saccharin.
  • sweetening agents such as sucrose or saccharin.
  • Oily suspensions may be formulated by suspending the active ingredient in a vegetable oil, for example arachis oil, olive oil, sesame oil or coconut oil, polyoxyethylene hydrogenated castor oil, fatty acids such as oleic acid, or in a mineral oil such as liquid paraffin or in other surfactants or detergents.
  • the oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol.
  • Sweetening agents, such as those set forth above, and flavouring agents may be added to provide a palatable oral preparation. These compositions may be preserved by the addition of an antioxidant such as ascorbic acid.
  • Dispersible powders and granules suitable for preparation of an aqueous suspension by the addition of water provide the combined active ingredients in admixture with a dispersing or wetting agent, suspending agent and one or more preservatives. Suitable sweetening, flavouring and colouring agents may also be present.
  • the combined pharmaceutical compositions of the invention may also be in the form of oil-in-water emulsions.
  • the oily phase may be a vegetable oil, for example olive oil or arachis oil, or a mineral oil, for example liquid paraffin, or mixtures of these.
  • Suitable emulsifying agents may be naturally occurring gums, for example gum acacia or gum tragacanth, naturally occurring phosphatides, for example soya bean, lecithin, and esters or partial esters derived from fatty acids and hexitol anhydrides, for example sorbitan monooleate and condensation products of the said partial esters with ethylene oxide, for example polyoxyethylene sorbitan monooleate.
  • the emulsions may also contain sweetening and flavouring agents.
  • Syrups and elixirs may be formulated with sweetening agents, for example glycerol, propylene glycol, sorbitol or sucrose. Such formulations may also contain a demulcent, a preservative, flavouring and colouring agents.
  • sweetening agents for example glycerol, propylene glycol, sorbitol or sucrose.
  • Such formulations may also contain a demulcent, a preservative, flavouring and colouring agents.
  • Suspensions and emulsions may contain a carrier, for example a natural gum, agar, sodium alginate, pectin, methylcellulose, carboxymethylcellulose, or polyvinyl alcohol.
  • a carrier for example a natural gum, agar, sodium alginate, pectin, methylcellulose, carboxymethylcellulose, or polyvinyl alcohol.
  • compositions according to the invention may be produced using conventional formulation techniques.
  • spray-drying may be used to produce micro particles comprising the active agent dispersed or suspended within a material that provides the controlled release properties.
  • milling for example jet milling
  • the process of milling may also be used to formulate the therapeutic composition. This applies particularly to particles intended for administration by inhalation.
  • manufacture of fine particles by milling can be achieved using conventional techniques.
  • milling is used herein to refer to any mechanical process which applies sufficient force to the particles of active material to break or grind the particles down into fine particles.
  • Various milling devices and conditions are suitable for use in the production of the compositions of the invention.
  • Suitable homogenisers include the EmulsiFlex high pressure homogeniser, the Niro Soavi high pressure homogeniser and the Microfluidics Microfluidiser.
  • the milling process can be used to provide the microparticles with mass median aerodynamic diameters as specified above. If hygroscopic, the active agent may be milled with a hydrophobic material, as stated above.
  • the microparticles produced by the milling step can then be formulated with an additional excipient.
  • an additional excipient This may be achieved by a spray- drying process, e.g. co-spray-drying.
  • the particles are suspended in a solvent and co-spray-dried with a solution or suspension of the additional excipient.
  • Preferred additional excipients include polysaccharides. Additional pharmaceutically effective excipients may also be used.
  • compositions of the combination intended for inhaled, topical, intranasal, sublingual, intravenous, rectal and vaginal use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions.
  • Therapy according to the invention may be conducted in generally known manner, depending on various factors, such as the sex, age or condition of the patient, and the existence or otherwise of one or more concomitant therapies.
  • the patient population may be important.
  • the present invention is based at least in part on the following study.
  • Guinea pigs were dosed via oral gavage (dose volume 2 mL/kg) with theobromine dosed 2 hours prior to citric acid exposure. Pseudoephedrine was dosed 30 min prior to citric acid exposure and vehicle control animals were dosed both at 2 hours and 30 minutes prior to citric acid exposure.

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Abstract

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

Description

COMBINATION OF THEOBROMINE WITH A DECONGESTANT AND ITS USE FOR
THE TREATMENT OF COUGH
Field of the Invention
This invention relates to a drug combination, its composition and its use in therapy, particularly in the therapy of cough.
Background of the Invention
Cough is a protective reflex. Persistent cough can be distressing. Over- the-counter remedies are available but their effectiveness is doubtful.
W098/42322 discloses the use of theobromine for the treatment of cough, to be given orally.
Usmeni et al., FASEB J. express article 10.1096, discloses that theobromine inhibits sensory nerve action and cough. Data are provided, showing effects following oral dosing in citric-acid induced cough in the guinea pig, and in the capsaicin cough challenge in humans, and following bathing of isolated guinea pig vagus nerve preparations.
The decongestant pseudoephedrine has been to shown to have very limited efficacy in the citric acid induced cough model in guinea-pigs (Minamizawa et. al., J Pharmacol Sci, 2006). However, most of the literature fails to demonstrate that pseudoephedrine has an antitussive effect. A number of papers describe effects on "cough and cold" (which has little meaning in the medical field), but none describes or even examines direct antitussive effect.
Summary of the Invention
The invention is based at least in part on data showing a synergistic antitussive effect for theobromine combined with the decongestant pseudoephedrine, in a citric acid-induced cough model. The data show that when theobromine is combined with pseudoephedrine, the effect is surprisingly potent and greater than the sum of the individual drugs, revealing that the combination has a substantially improved effect. This is particularly surprising given that it is doubtful that pseudoephedrine has an antitussive effect at all.
Consequently, a considerably reduced dose of both drugs can be given for an equivalent effect for each individual drug, so reducing side -effects and drug burden.
Therefore, according to a first aspect of, the present invention, an agent comprises theobromine and a decongestant, as a combined preparation for simultaneous, sequential or separate use in therapy. According to a second aspect, a pharmaceutical composition comprises theobromine and a decongestant.
It is believed that this synergistic relationship will be exhibited by all decongestants. Without wishing to be bound by theory, this may be due to the structural similarity of the members of the decongestant class of drugs.
Description of the Drawing
Figure 1 shows the effect of theobromine, and of a combination of theobromine and pseudoephedrine, on citric acid-induced cough in guinea-pig. Description of the Invention
As used herein, the term "decongestant" is a defined class of drugs, which is well known to the skilled person. Preferably, the decongestant is a a-adrenergic receptor agonist. Any suitable form of the decongestant agent may be chosen. These include salts, prodrugs and active metabolites.
As used herein, the treatment of cough means any therapy that reduces the number and/or the severity of cough. Preferably, it means a reduction in the number of coughs, i.e. a direct antitussive effect that reduces the body's urge to cough. Therefore, according to a preferred embodiment of the invention, an agent comprises theobromine and a decongestant, for use as an antitussive pharmaceutical composition. An agent of the invention is useful as an antitussive in the control of cough. Preferably, it is used in the control of nonproductive cough.
The decongestant may be used in an amount that is already known for its use, although combination according to this invention means that a reduced dose may be effective. The dose of the decongestant that is administered with the theobromine will of course depend on the usual factors, including its potency, but is preferably at least 0.1 , e.g. at least 5, and may be up to 50 mg/kg/day.
Preferably, the decongestant is dosed in a range of 0.1 to 30 mg/kg/day.
Any suitable form of theobromine can be chosen. These include salts, prodrugs and active metabolites. Theobromine may also be in the form of cocoa or chocolate. Suitable dose ranges for theobromine are known in the art and will depend on the usual factors (age etc); although the synergistic effect of the combination means that the effective dose may be reduced. A combination according to the invention may be provided in a single formulation or in separate formulations, for combined, simultaneous or sequential administration.
This decongestant is preferably chosen from the following drugs: ephedrine, levmetamfetamine, naphazoline, oxymetazoline, phenylephrine, phenylpropanolamine, propylhexedrine, pseudoephedrine, synephrine and tetrahydrozoline. More preferably, the decongestant is pseudoephedrine.
The compounds of the invention may be administered by any available route, such as via the oral, inhaled, intranasal, sublingual, intravenous, rectal and vaginal routes.
The compounds of the invention are preferably as combinations to be administered orally, for example as tables, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules. Preferred pharmaceutical compositions of the invention are tablets and capsules. Liquid dispersions for oral administration may be syrups, emulsions and suspensions. More preferably, the pharmaceutical composition of the combination is a pressed tablet or capsule with conventional excipients, examples of which are given below.
Compositions intended for oral use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions, and such compositions may contain one or more agents selected from the group consisting of sweetening agents, flavouring agents, colouring agents and preserving agents in order to provide pharmaceutically elegant and palatable preparations. Tablets contain the combined active ingredients in admixture with non-toxic pharmaceutically acceptable excipients which are suitable for the manufacture of tablets. These excipients may be, for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example corn starch or alginic acid; binding agents, for example starch gelatin, acacia, microcrystalline cellulose or polyvinyl pyrrolidone; and lubricating agents, for example magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate may be employed.
Aqueous suspensions contain the combined active materials in admixture with excipients suitable for the manufacture of aqueous suspensions. Such excipients are suspending agents, for example sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinyl pyrrolidone, gum tragacanth and gum acacia; dispersing or wetting agents may be a naturally occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example polyoxyethylene stearate, or condensation products of ethylene oxide with long-chain aliphatic alcohols, for example heptadecaethyleneoxycetanol, or condensation products of ethylene oxide with partial esters derived from fatty acids, for example polyoxyethylene sorbitan monooleate. The aqueous suspensions may also contain one or more preservatives, for example ethyl or n-propyl p- hydroxybenzoate, one or more colouring agents, one or more flavouring agents, and one or more sweetening agents, such as sucrose or saccharin.
Oily suspensions may be formulated by suspending the active ingredient in a vegetable oil, for example arachis oil, olive oil, sesame oil or coconut oil, polyoxyethylene hydrogenated castor oil, fatty acids such as oleic acid, or in a mineral oil such as liquid paraffin or in other surfactants or detergents. The oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening agents, such as those set forth above, and flavouring agents may be added to provide a palatable oral preparation. These compositions may be preserved by the addition of an antioxidant such as ascorbic acid.
Dispersible powders and granules suitable for preparation of an aqueous suspension by the addition of water provide the combined active ingredients in admixture with a dispersing or wetting agent, suspending agent and one or more preservatives. Suitable sweetening, flavouring and colouring agents may also be present.
The combined pharmaceutical compositions of the invention may also be in the form of oil-in-water emulsions. The oily phase may be a vegetable oil, for example olive oil or arachis oil, or a mineral oil, for example liquid paraffin, or mixtures of these. Suitable emulsifying agents may be naturally occurring gums, for example gum acacia or gum tragacanth, naturally occurring phosphatides, for example soya bean, lecithin, and esters or partial esters derived from fatty acids and hexitol anhydrides, for example sorbitan monooleate and condensation products of the said partial esters with ethylene oxide, for example polyoxyethylene sorbitan monooleate. The emulsions may also contain sweetening and flavouring agents.
Syrups and elixirs may be formulated with sweetening agents, for example glycerol, propylene glycol, sorbitol or sucrose. Such formulations may also contain a demulcent, a preservative, flavouring and colouring agents.
Suspensions and emulsions may contain a carrier, for example a natural gum, agar, sodium alginate, pectin, methylcellulose, carboxymethylcellulose, or polyvinyl alcohol.
Combined compositions according to the invention may be produced using conventional formulation techniques. In particular, spray-drying may be used to produce micro particles comprising the active agent dispersed or suspended within a material that provides the controlled release properties.
The process of milling, for example jet milling, may also be used to formulate the therapeutic composition. This applies particularly to particles intended for administration by inhalation. The manufacture of fine particles by milling can be achieved using conventional techniques. The term "milling" is used herein to refer to any mechanical process which applies sufficient force to the particles of active material to break or grind the particles down into fine particles. Various milling devices and conditions are suitable for use in the production of the compositions of the invention.
The selection of appropriate milling conditions, for example, intensity of milling and duration, to provide the required degree of force, will be within the ability of the skilled person. Ball milling is a preferred method. Alternatively, a high pressure homogeniser may be used, in which a fluid containing the particles is forced through a valve at high pressure, producing conditions of high shear and turbulence. Shear forces on the particles, impacts between the particles and machine surfaces or other particles, and cavitation due to acceleration of the fluid, may all contribute to the fracture of the particles. Suitable homogenisers include the EmulsiFlex high pressure homogeniser, the Niro Soavi high pressure homogeniser and the Microfluidics Microfluidiser. The milling process can be used to provide the microparticles with mass median aerodynamic diameters as specified above. If hygroscopic, the active agent may be milled with a hydrophobic material, as stated above.
If it is required, the microparticles produced by the milling step can then be formulated with an additional excipient. This may be achieved by a spray- drying process, e.g. co-spray-drying. In this embodiment, the particles are suspended in a solvent and co-spray-dried with a solution or suspension of the additional excipient. Preferred additional excipients include polysaccharides. Additional pharmaceutically effective excipients may also be used.
Compositions of the combination intended for inhaled, topical, intranasal, sublingual, intravenous, rectal and vaginal use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions.
Therapy according to the invention may be conducted in generally known manner, depending on various factors, such as the sex, age or condition of the patient, and the existence or otherwise of one or more concomitant therapies. The patient population may be important.
The present invention is based at least in part on the following study.
Study
A study was designed to investigate the antitussive activity of theobromine in combination with two different doses of pseudoephedrine, on citric acid-induced cough in conscious guinea pigs.
Test Doses
1 - vehicle control
2 - theobromine (10 mg/kg. p.o.)
3 - theobromine (10 mg/kg, p.o.) + pseudoephedrine (10 mg/kg. p.o.)
4 - theobromine (10 mg/kg, p.o.) + pseudoephedrine (30 mg/kg. p.o.)
Method
Male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) were used throughout the study. Thirty guinea pigs were randomly allocated to one of the four treatment groups according to the blinding code. The blinding code was not revealed to the investigator until coughs from all of the animals had been tallied.
Guinea pigs were dosed via oral gavage (dose volume 2 mL/kg) with theobromine dosed 2 hours prior to citric acid exposure. Pseudoephedrine was dosed 30 min prior to citric acid exposure and vehicle control animals were dosed both at 2 hours and 30 minutes prior to citric acid exposure.
Individual guinea pigs were placed in an exposure chamber with airflow of 2 L/min at t -10 min prior to citric acid exposure to acclimatise. At t = 0 min, cough responses were induced by exposure to citric acid aerosol (1 M) generated by an ultrasonic nebuliser at a nebulisation rate of 0.6 mL/min for 10 min.
Coughs were counted throughout the 10 min citric acid exposure and for a further 5 min post exposure.
Results
The results show that pre-treatment with theobromine ( 10 mg/kg, p.o.) caused a significant reduction to the number of citric acid induced coughs (13 ± 3) (see Figure 1 ), as well as to the onset to the first cough (156 ± 15s) (data not shown). In combination with pseudoephedrine (10 mg/kg and 30 mg/kg), the inhibitory response of theobromine on the citric acid-induced tussive activity, was potentiated with the highest dose, both in respect of total number of coughs (9 ± 2 c.f. 13 ± 3) (Figure 1 ) and onset time to the first cough (170 ± 15s c.f. 156 ± 15s) (data not shown).

Claims

1. An agent comprising theobromine and a decongestant, as a combined preparation for simultaneous, sequential or separate use in therapy.
2. An agent according to claim 1 , wherein the therapy is of cough.
3. A pharmaceutical composition comprising theobromine and a decongestant.
4. An agent or composition according to any preceding claim, wherein the decongestant is selected from ephedrine, levmetamfetamine, naphazoline, oxymetazoline, phenylephrine, phenylpropanolamine, propylhexedrine, pseudoephedrine, synephrine and tetrahydrozoline.
5. An agent or composition according to claim 4, wherein the decongestant is pseudoephedrine.
6. An agent or composition according to any preceding claim, wherein the decongestant is to be administered in a dose of 0.1 to 30 mg/kg/day.
PCT/GB2010/052085 2009-06-16 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough WO2011073646A1 (en)

Priority Applications (27)

Application Number Priority Date Filing Date Title
CA2784214A CA2784214C (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough
UAA201208706A UA105944C2 (en) 2009-12-14 2010-12-14 Drug formulation with theobromine and decongestant for treatment of cough
EP10795446A EP2512464A1 (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough
MX2012006625A MX343222B (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough.
CN2010800570306A CN102740843A (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough
NZ600243A NZ600243A (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough
JP2012543902A JP2013513651A (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use to treat cough
AU2010332494A AU2010332494B2 (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough
RU2012129839/15A RU2564904C2 (en) 2009-12-14 2010-12-14 Theobromine-decongestant combination and application thereof for treating cough
NZ600267A NZ600267A (en) 2009-12-14 2010-12-14 Combined oral preparation of theobromine and a decongestant for cough therapy
BR112012014161A BR112012014161A2 (en) 2009-12-14 2010-12-14 theobromine-based pharmaceutical composition and a decongestant and its use in the treatment of cough
SG2012043642A SG181686A1 (en) 2009-12-14 2010-12-14 Combination of theobromine with a decongestant and its use for the treatment of cough
US13/446,217 US20120252824A1 (en) 2009-06-16 2012-04-13 Drug Combinations and Uses in Treating a Coughing Condition
ECSP12012132 ECSP12012132A (en) 2009-12-14 2012-06-12 COMBINATION OF THEOBROMINE WITH A DESCONGESTIVE AND ITS USE FOR THE TOS TREATMENT
ZA2012/04293A ZA201204293B (en) 2009-12-14 2012-06-12 Combination of theobromine with a decongestant and its use for the treatment of cough
IL220383A IL220383A (en) 2009-12-14 2012-06-13 Combination of theobromine with a decongestant for the treatment of cough
US14/287,014 US9314465B2 (en) 2009-06-16 2014-05-24 Drug combinations and uses in treating a coughing condition
US14/287,017 US10016437B2 (en) 2009-06-16 2014-05-24 Drug combinations and uses in treating a coughing condition
US14/287,015 US9308211B2 (en) 2009-06-16 2014-05-24 Drug combinations and uses in treating a coughing condition
US14/488,215 US20150005325A1 (en) 2009-06-16 2014-09-16 Drug Combinations and Uses in Treating a Coughing Condition
US14/687,393 US20150216869A1 (en) 2009-06-16 2015-04-15 Drug Combinations and Uses in Treating a Coughing Condition
US14/991,892 US20160120899A1 (en) 2009-06-16 2016-01-08 Drug Combinations and Uses in Treating a Coughing Condition
US15/061,656 US9700561B2 (en) 2009-06-16 2016-03-04 Drug combinations and uses in treating a coughing condition
US15/063,465 US9675618B2 (en) 2009-06-16 2016-03-07 Drug combinations and uses in treating a coughing condition
US15/144,800 US20160271197A1 (en) 2009-06-16 2016-05-02 Drug Combinations and Uses in Treating a Coughing Condition
US15/144,798 US20160271136A1 (en) 2009-06-16 2016-05-02 Drug Combinations and Uses in Treating a Coughing Condition
US16/042,670 US10420812B2 (en) 2009-06-16 2018-07-23 Drug combinations and uses in treating a coughing condition

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GBGB0921805.8A GB0921805D0 (en) 2009-12-14 2009-12-14 Drug composition and its use in therapy
GB0921805.8 2009-12-14

Related Parent Applications (3)

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PCT/GB2010/051896 Continuation-In-Part WO2011058374A1 (en) 2009-06-16 2010-11-12 Drug combination with theobromine and its use in therapy
PCT/GB2010/052056 Continuation-In-Part WO2011070363A1 (en) 2009-06-16 2010-12-09 Carbon and its use in blood cleansing applications
PCT/GB2010/052086 Continuation-In-Part WO2011073647A1 (en) 2009-06-16 2010-12-14 Therapeutic combinations of theobromine and an antihistamine

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PCT/GB2010/052086 Continuation-In-Part WO2011073647A1 (en) 2009-06-16 2010-12-14 Therapeutic combinations of theobromine and an antihistamine
PCT/GB2011/051610 Continuation-In-Part WO2012025761A1 (en) 2009-06-16 2011-08-25 Theobromine in combination with an expectorant or a mucolytic for use in therapy

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JP (2) JP2013513651A (en)
CN (2) CN102740843A (en)
AU (1) AU2010332494B2 (en)
BR (1) BR112012014161A2 (en)
CA (1) CA2784214C (en)
CO (1) CO6541630A2 (en)
EC (1) ECSP12012132A (en)
GB (1) GB0921805D0 (en)
IL (1) IL220383A (en)
MX (1) MX343222B (en)
NZ (1) NZ600243A (en)
PE (1) PE20121537A1 (en)
RU (1) RU2564904C2 (en)
SG (2) SG181686A1 (en)
UA (1) UA105944C2 (en)
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ZA (1) ZA201204293B (en)

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US9308211B2 (en) 2009-06-16 2016-04-12 Infirst Healthcare Limited Drug combinations and uses in treating a coughing condition
US9314465B2 (en) 2009-06-16 2016-04-19 Infirst Healthcare Limited Drug combinations and uses in treating a coughing condition
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MX343222B (en) 2016-10-28
ECSP12012132A (en) 2012-09-28
PE20121537A1 (en) 2012-12-21
AU2010332494B2 (en) 2015-01-15
IL220383A0 (en) 2012-08-30
JP2016040279A (en) 2016-03-24
JP2013513651A (en) 2013-04-22
CN105816462A (en) 2016-08-03
SG181686A1 (en) 2012-07-30
NZ600243A (en) 2013-07-26
UA105944C2 (en) 2014-07-10
CA2784214A1 (en) 2011-06-23
AU2010332494A1 (en) 2012-06-14
RU2564904C2 (en) 2015-10-10
ZA201204293B (en) 2013-02-27
MX2012006625A (en) 2012-10-05
RU2012129839A (en) 2014-01-27
CN102740843A (en) 2012-10-17
CA2784214C (en) 2018-01-09
EP2512464A1 (en) 2012-10-24
IL220383A (en) 2017-01-31
GB0921805D0 (en) 2010-01-27

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