U.S. patent application number 16/124816 was filed with the patent office on 2019-01-03 for compounds for treatment of pain.
The applicant listed for this patent is BioPharma Works LLC. Invention is credited to Peter Cornelius, Anton Franz Joseph Fliri, Anthony Marfat, Fredrick Raymond Nelson, Robert Volkmann, Panayiotis Zagouras.
Application Number | 20190002473 16/124816 |
Document ID | / |
Family ID | 51731831 |
Filed Date | 2019-01-03 |
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United States Patent
Application |
20190002473 |
Kind Code |
A1 |
Volkmann; Robert ; et
al. |
January 3, 2019 |
COMPOUNDS FOR TREATMENT OF PAIN
Abstract
The aspects of the disclosed embodiments are directed to novel
compounds, formulations containing said compounds or
pharmaceutically acceptable salts thereof which are suitable for
administration to a patient.
Inventors: |
Volkmann; Robert; (Mystic,
CT) ; Marfat; Anthony; (Old Lyme, CT) ;
Cornelius; Peter; (Old Lyme, CT) ; Zagouras;
Panayiotis; (Old Saybrook, CT) ; Nelson; Fredrick
Raymond; (Groton, CT) ; Fliri; Anton Franz
Joseph; (Stonington, CT) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
BioPharma Works LLC |
Groton |
CT |
US |
|
|
Family ID: |
51731831 |
Appl. No.: |
16/124816 |
Filed: |
September 7, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14785545 |
Oct 19, 2015 |
10072018 |
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PCT/US2014/034398 |
Apr 16, 2014 |
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16124816 |
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61813143 |
Apr 17, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61P 25/04 20180101;
C07D 489/04 20130101 |
International
Class: |
C07D 489/04 20060101
C07D489/04 |
Claims
1. A compound of the formula ##STR00016## wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)OR.sup.5, CHR.sup.4O(C.dbd.O)R.sup.6,
CHR.sup.4O(C.dbd.O)NR.sup.6R.sup.7,
CHR.sup.4O(C.dbd.O)CHR.sup.8NR.sup.6R.sup.7,
CHR.sup.4O(C.dbd.O)CHR.sup.8NH(COCHR.sup.8NH).sub.nH,
CHR.sup.4R.sup.9, CHR.sup.4O(C.dbd.O)CR.sup.5R.sup.6OR.sup.7,
CHR.sup.4O(C.dbd.O)O(CH.sub.2).sub.nNR.sup.5R.sup.6,
CHR.sup.4O(C.dbd.O)O(CH.sub.2).sub.nCO.sub.2R.sup.5,
CHR.sup.4O(C.dbd.O)(CH.sub.2).sub.nNR.sup.5R.sup.6,
CHR.sup.4O(C.dbd.O)(CH.sub.2).sub.nCO.sub.2R.sup.5, ##STR00017##
R.sup.2 is H; R.sup.3 is H, CH.sub.3, or (C.dbd.O)CH.sub.3; R.sup.4
is H or optionally substituted alkyl; wherein said substituents are
independently selected from the group OR.sup.3 and
(C.dbd.O)OR.sup.5; R.sup.5 is optionally substituted alkyl,
cycloalkyl, phenylalkyl, heteroalkyl, heterocycloalkyl, aryl, or
heteroaryl; wherein said substituents are independently
(CH.sub.2).sub.nCO.sub.2alkyl; R.sup.6 is H or R.sup.5; R.sup.7 is
H or R.sup.5; R.sup.8 is H or R.sup.5; R.sup.9 is 4-isoxazoyl;
wherein each n is independently an integer from 1-12; and A is an
anion selected from the group consisting of: Br.sup.-, Cl.sup.-,
I.sup.-, R.sup.7CO.sub.2.sup.-, H.sub.2PO.sub.4.sup.-,
NO.sub.3.sup.-, Etodolate, Mefenamate, Urosodeoxycholate and
R.sup.6SO.sub.3.
2. A compound according to claim 1 wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)OR.sup.5.
3. A compound according to claim 1 wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)R.sup.6.
4-16. (canceled)
17. A compound according to claim 1 wherein R.sup.3 is H.
18. A compound according to claim 1 wherein R.sup.3 is Methyl.
19. (canceled)
20. A compound according to claim 1 wherein R.sup.4 is H.
21. (canceled)
22. (canceled)
23. A compound according to claim 1 wherein R.sup.5 is alkyl
selected from methyl, ethyl, isopropyl, n-butyl, or n-pentyl.
24. (canceled)
25. A compound according to claim 1 wherein R.sup.5 is
cyclohexyl.
26. (canceled)
27. A compound according to claim 1 wherein R.sup.6 is H.
28. A compound according to claim 1 wherein R.sup.6 is methyl.
29. A compound according to claim 1 wherein R.sup.6 is
cyclohexyl.
30. A compound according to claim 1 wherein R.sup.6 is t-butyl.
31. A compound according to claim 1 wherein R.sup.6 is
i-propyl.
32. (canceled)
33. (canceled)
34. (canceled)
35. A compound according to claim 1 wherein A is Br.sup.-.
36. A compound according to claim 1 wherein A is Cl.sup.-.
37. A compound according to claim 1 wherein A is I.sup.-.
38-45. (canceled)
46. A composition according to claim 1 wherein said composition is
in tablet, capsule, oral solution, or oral suspension dosage
form.
47-52. (canceled)
Description
FIELD
[0001] The aspects of the disclosed embodiments are directed to
novel compounds, formulations containing said compounds or
pharmaceutically acceptable salts thereof which are suitable for
administration to a patient.
BACKGROUND
[0002] This disclosure is directed to quaternary oxycodone,
oxymorphone, hydrocodone and hydromorphone ammonium compounds
described in general Formula I and to compositions and uses of said
compounds for treating pain associated with a variety of chronic
human disorders including for example neuropathic pain and pain
associated with cancer, surgeries or injuries.
[0003] The compounds of the disclosure may be generically
categorized within the class of compounds known as opioids. It is
well known that opioid drugs target three types of endogenous
opioid receptors (i.e., mu, delta and kappa receptors) in
biological systems. Most opioids, such as morphine, are mu opioid
agonists that are often used as analgesics for the treatment of
severe pain due to their activation of mu opioid receptors in the
brain and central nervous system (CNS). Opioid receptors are,
however, not limited to the CNS, and have been found in other
tissues throughout the body. A number of side effects of opioid
drugs may be caused by activation of these peripheral receptors
including nausea, vomiting and inhibition of normal propulsive
gastrointestinal function resulting in side effects such as, for
example, constipation, drowsiness, respiratory depression, changes
in mood, and mental clouding without a resulting loss of
consciousness. Thus, it is widely recognized that opioid treatment
induced constipation is sometimes even more difficult to treat than
the underlying pain. Towards this end, several ameliorating
strategies have been developed which include, for example, the
administration of opioid receptor antagonist such as for example,
Naltrexon to patients for reversing opioid induced constipation.
However, since central acting opioid receptor antagonists also
reverse analgesia and precipitate opioid withdrawal symptoms, non
CNS penetrant quaternary ammonium derivatives of opioid antagonist
such as for example, Methyl Naltrexone have been developed and
these derivatives have been shown to reverse peripheral side
effects of opioids without inducing CNS mediated withdrawal
symptoms or reversing analgesia. However, since use of opioid
antagonists targets the amelioration of already manifested side
effects, these treatment regimens add cost and burden to the
treatment of pain. Accordingly there is a need for developing
opioid derivatives that would exhibit reduced peripheral
side-effects while maintaining central analgesic properties.
[0004] Moreover, prescription opioid use is also the subject of
extensive "substance abuse" which is increasing and exacts a high
toll on patients, physicians, and society. Nonmedical users of
prescription pain relievers quadrupled from 1990 to 2000, with
abuse of oxycodone and hydrocodone products particularly common.
Extracting a societal toll, this prescription drug abuse is
associated with higher rates of comorbidities and drug-related
mortality.
[0005] Chronic pain and prescription opioid abuse are both highly
prevalent. Chronic pain affects approximately 50 million Americans
each year, and an additional 48 million Americans 12 years or older
have used prescription drugs for nonmedical reasons in their
lifetimes. Among the most potent analgesics available, opioids have
a recognized role in the treatment of cancer- and
non-cancer-related chronic pain conditions. Yet many physicians,
concerned that their patients will become addicted, are reluctant
to prescribe these agents, contributing to the widespread
undertreatment of chronic pain.
[0006] One strategy for reducing the potential for abuse is
development of tamper resistant opioid formulations designed to
create barriers to manipulations of prescription drug formulations.
Additionally, opioid formulations incorporating pharmacological
strategies have also been designed to deter or resist misuse and
abuse by making it difficult to achieve euphoria through opioid
use. As pharmacologically proactive tools, these formulations use
either pharmacodynamic or physical mechanisms to make opioids
unattractive to individuals who abuse them, as well as present
barriers to unintentional or deliberate misuse. Such formulations
are currently available and have had mixed epidemiological results.
New compounds and formulations that obviate the limitations of
existing therapeutics are thus needed.
[0007] Pharmaceutical strategies have been developed as either
agonist-antagonist or agonist-additional active ingredient
combinations. Agonist-antagonist formulations can be considered
pharmacodynamic strategies because they act to reduce reward at the
receptor level. An example of such a strategy is Embeda.TM.
(Pfizer.TM.), which combines morphine with an antagonist such as
naltrexone. If this formulation is ingested normally, the
naltrexone remains latent; if it is crushed, the naltrexone is
released and reduces the effects of the morphine Other
agonist-antagonist combinations include Talwin.TM. containing
pentazocine hydrochloride and naloxone hydrochloride equivalent;
Valoron.TM., a combination of tilidine and naloxone; and Terngesic,
a combination of buprenorphine and naloxone. These strategies
cause, in some instances, opioid withdrawal symptoms.
[0008] Opioids with a reduced side effect and abuse potential are
one of the most important unmet needs in the management of chronic
pain and help physicians to better balance optimal analgesia with
reduced risk of having to treat either opioid induced side effects
or worry about prescription misuse and abuse.
[0009] Compounds of the present disclosure combine
agonist/antagonist activity at opioid receptors in a single
molecular entity and exploit (as principle of their pharmacological
action) relative drug distribution/partitioning differences between
agonist and quaternary ammonium antagonist in peripheral and
central nervous system compartments, thereby reducing peripheral
side effects associated with opioid receptor agonist use (such asGI
effects, or respiratory depression and pruritis). In addition, by
controlling the delivery of a centrally acting analgesic opioid
through the rate of enzymatic conversion of a peripheral quaternary
ammonium opioid antagonist, compounds of the present invention are
abuse-resistant while maintaining analgesic properties of the
parent opioid.
[0010] The invention relates to a compound of Formula I:
##STR00001##
wherein R.sup.1 is CHR.sup.4O(C.dbd.O)OR.sup.5,
CHR.sup.4O(C.dbd.O)R.sup.6, CHR.sup.4O(C.dbd.O)NR.sup.6R.sup.7,
CHR.sup.4O(C.dbd.O)CHR.sup.8NR.sup.6R.sup.7,
CHR.sup.4O(C.dbd.O)CHR.sup.8NH(COCHR.sup.8NH).sub.nH,
CHR.sup.4R.sup.9, CHR.sup.4O(C.dbd.O)CR.sup.5R.sup.6OR.sup.7,
CHR.sup.4O(C.dbd.O)O(CH.sub.2).sub.nNR.sup.5R.sup.6,
CHR.sup.4O(C.dbd.O)O(CH.sub.2).sub.nCO.sub.2R.sup.5,
CHR.sup.4O(C.dbd.O)(CH.sub.2).sub.nNR.sup.5R.sup.6,
CHR.sup.4O(C.dbd.O)(CH.sub.2).sub.nCO.sub.2R.sup.5,
##STR00002##
R.sup.2 is H, OH, or O(C.dbd.O)CH.sub.3; R.sup.3 is H, CH.sub.3, or
(C.dbd.O)CH.sub.3; R.sup.4 is H or optionally substituted alkyl;
wherein said substituents are independently selected from the group
OR.sup.3 and (C.dbd.O)OR.sup.5; R.sup.5 is optionally substituted
alkyl, cycloalkyl, phenylalkyl, heteroalkyl, heterocycloalkyl,
aryl, or heteroaryl; wherein said substituents are independently
(CH.sub.2).sub.nCO.sub.2alkyl; R.sup.6 is H or R.sup.5; R.sup.7 is
H or R.sup.5; R.sup.8 is H or R.sup.5; R.sup.9 is 4-isoxazoyl;
wherein n is an integer from 1-12; and A is an anion selected from
the group consisting of: Br.sup.-, Cl.sup.-, I.sup.-,
R.sup.7CO.sub.2.sup.-, H.sub.2PO.sub.4.sup.-, NO.sub.3.sup.-,
Etodolate, Mefenamate, Urosodeoxycholate and R.sup.6SO.sub.3.
[0011] Alkyl means unsubstituted and substituted, straight-chain
and branched-chain alkyls having from 1 to 20 carbon atoms; alkyl
may also contain one or multiple numbers of unsaturation including
double and/or triple bonds; straight chain alkyl includes methyl,
ethyl, propyl, butyl group, pentyl (to be also referred to as an
amyl group) hexyl, decyl), branched chain alkyl group includes
isopropyl, diethylmethyl, isobutyl, sec-butyl, t-butyl, isopentyl,
t-pentyl, 2-ethylhexyl and the like; alkyl is also optionally
substituted with 1 or more substituents independently selected from
the group consisting of halo, hydroxy, alkoxy(alkoxy)x,
hydroxyalkoxy(alkoxy)x, amino, monoalkylamino, dialkylamino, nitro,
carboxyl, alkoxycarbonyl, and cyano, wherein x is an integer from 0
to 3 and the alkoxy contains from 1 to 5 carbon atoms.
[0012] Cycloalkyl means cyclopropyl, cyclobutyl, cyclopentyl and
cyclohexyl; and said cyclic alkyl is optionally substituted with 1
or 2 substituents independently selected from the group consisting
of halo, hydroxy, alkoxy(alkoxy)x, hydroxyalkoxy(alkoxy)x, amino,
monoalkylamino, dialkylamino, nitro, carboxyl, alkoxycarbonyl, and
cyano, wherein x is an integer from 0 to 3 and the alkoxy portion
of the alkoxycarbonyl contains from 1 to 5 carbon atoms.
[0013] Phenylalkyl is selected from the group consisting of benzyl,
phenylethyl and phenylpropyl; and the phenyl portion of the
phenylalkyl is optionally substituted with 1 to 3 substituents
independently selected from the group consisting of alkyl, hydroxy,
alkoxy, halo, amino, monoalkylamino, dialkylamino, nitro, carboxyl,
alkoxycarbonyl and cyano, wherein the phenyl portion of the
phenylalkyl is unsubstituted or substituted.
[0014] Heteroalkyl means a straight or branched-chain having from
one to 20 carbon atoms and one or more heteroatoms selected from
nitrogen, oxygen, or sulphur, wherein the nitrogen and sulphur
atoms may optionally be oxidized, i.e., in the form of an N-oxide
or an S-oxide.
[0015] Heterocycloalkyl means a monocyclic or multicyclic ring
system (which may be saturated or partially unsaturated), including
fused and spiro rings, of about five to about 10 elements wherein
one or more of the elements in the ring system is an element other
than carbon and is selected from nitrogen, oxygen, silicon, or
sulphur atoms.
[0016] Aryl means phenyl or napthyl wherein the phenyl or napthyl
moiety is optionally substituted with 1 to 3 substituents
independently selected from the group consisting of alkyl, hydroxy,
alkoxy, halo, amino, monoalkylamino, dialkylamino, nitro, carboxyl,
alkoxycarbonyl and cyano groups.
[0017] Heteroaryl means a five to about a 14-membered aromatic
monocyclic or multicyclic hydrocarbon ring system, including fused
and spiro rings, in which one or more of the elements in the ring
system is an element other than carbon and is selected from
nitrogen, oxygen, silicon, or sulphur and wherein an N atom may be
in the form of an N-oxide.
[0018] Natural, synthetic, racemic, L-, or D-amino acid group as
used herein refers to a substituent containing 1 to 20 amino acid.
When two or more amino acids are linked together the group is known
as a polypeptide. The polypeptide may be (i) an oligopeptide, (ii)
a homopolymer of one of the twenty naturally occurring amino acids,
(iii) a heteropolymer of two or more naturally occurring amino
acids, (iv) a homopolymer of a synthetic amino acid, (v) a
heteropolymer of two or more synthetic amino acids or (vi) a
heteropolymer of one or more naturally occurring amino acids and
one or more synthetic amino acids. Polypeptides include the twenty
naturally occurring amino acids. Specific polypeptides include one
or more amino acids selected from glutamic acid, aspartic acid,
arginine, asparagine, cysteine, lysine, threonine, or serine. Such
peptides may be attached through the C-terminus or the
N-terminus.
[0019] Selection of the particular amino acids will depend on the
physical properties desired. For instance, properties such as bulk,
lipophilicity, and hydrophilicity may be optimized according to
selection parameters known to those skilled in the art.
[0020] Sugar or saccharide as used herein refers to a
monosaccharide, a disaccharide, polysaccharide or sugar alcohol.
Saccharide includes galactose, fructose, glucose, maltose,
cellobiose, gentiobiose, melibiose, lactose, turanose, sophorose,
trehalose, isotrehalose, isosaccharose, white sugar, mannitol,
sorbitol, xylitol or inositol.
[0021] Compounds of Formula I exist in the form of quaternary
ammonium cations ionically complexed with pharmaceutically
acceptable anions derived from acids to form addition salts of the
compounds of Formula I. The phrase "pharmaceutically acceptable
salt(s)", as used herein, unless otherwise indicated, includes
salts of quaternary ammonium compounds of Formula I.
[0022] Suitable salts are formed from acids which form non-toxic
salts and may include acids that are known to enhance the
pharmacologic utility of opioids. Examples include the acetate,
adipate, aspartate, benzoate, besylate, bicarbonate/carbonate,
bisulphate/sulphate, borate, camsylate, chenodeoxycholate, citrate,
cyclamate, edisylate, Etodolate, esylate, formate, fumarate,
gluceptate, gluconate, glucuronate, hexafluorophosphate, hibenzate,
hydrochloride/chloride, hydrobromide/bromide, hydroiodide/iodide,
isethionate, lactate, malate, maleate, malonate, mefenamate,
mesylate, methylsulphate, naphthylate, 2-napsylate, nicotinate,
nitrate, orotate, oxalate, palmitate, pamoate, phosphate/hydrogen
phosphate/dihydrogen phosphate, pyroglutamate, salycilate,
saccharate, stearate, succinate, tannate, tartrate, tosylate,
trifluoroacetate, Ursodexoycholate and xinofoate salts. Suitable
anions include Br.sup.-, Cl.sup.-, I.sup.-, R.sup.7CO.sub.2.sup.-,
H.sub.2PO.sub.4.sup.-, NO.sub.3.sup.-, and R.sup.6SO.sub.3.
Hemisalts may also be formed, for example, hemisulphate. For a
review on suitable salts, see Handbook of Pharmaceutical Salts:
Properties, Selection, and Use by Stahl and Wermuth (Wiley-VCH,
2002).
[0023] As used herein the term "Formula I" is defined to include
all forms of the compounds of Formula I, including hydrates,
solvates, isomers, crystalline and non-crystalline forms,
isomorphs, polymorphs, and metabolites thereof.
[0024] The compounds of the present disclosure may exist in a
continuum of solid states ranging from fully amorphous to fully
crystalline. The term `amorphous` refers to a state in which the
material lacks long range order at the molecular level and,
depending upon temperature, may exhibit the physical properties of
a solid or a liquid. Typically such materials do not give
distinctive X-ray diffraction patterns and, while exhibiting the
properties of a solid, are more formally described as a liquid.
Upon heating, a change from solid to liquid properties occurs which
is characterized by a change of state, typically second order
(`glass transition`). The term `crystalline` refers to a solid
phase in which the material has a regular ordered internal
structure at the molecular level and gives a distinctive X-ray
diffraction pattern with defined peaks. Such materials when heated
sufficiently will also exhibit the properties of a liquid, but the
change from solid to liquid is characterized by a phase change,
typically first order (`melting point`).
[0025] The compounds of the present disclosure may also exist in
unsolvated and solvated forms. The term `solvate` is used herein to
describe a molecular complex comprising the compound according to
the present disclosure and one or more pharmaceutically acceptable
solvent molecules, for example, ethanol. The term `hydrate` is
employed when said solvent is water.
[0026] A currently accepted classification system for organic
hydrates is one that defines isolated site, channel, or metal-ion
coordinated hydrates--see Polymorphism in Pharmaceutical Solids by
K. R. Morris (Ed. H. G. Brittain, Marcel Dekker, 1995). Isolated
site hydrates are ones in which the water molecules are isolated
from direct contact with each other by intervening organic
molecules. In channel hydrates, the water molecules lie in lattice
channels where they are next to other water molecules. In metal-ion
coordinated hydrates, the water molecules are bonded to the metal
ion.
[0027] When the solvent or water is tightly bound, the complex will
have a well-defined stoichiometry independent of humidity. When,
however, the solvent or water is weakly bound, as in channel
solvates and hygroscopic compounds, the water/solvent content will
be dependent on humidity and drying conditions. In such cases,
non-stoichiometry will be the norm.
[0028] Also included within the aspects of the disclosed
embodiments are multi-component complexes (other than salts and
solvates) wherein the drug and at least one other component are
present in stoichiometric or non-stoichiometric amounts. Complexes
of this type include clathrates (drug-host inclusion complexes) and
co-crystals. The latter are typically defined as crystalline
complexes of neutral molecular constituents which are bound
together through non-covalent interactions, but could also be a
complex of a neutral molecule with a salt. Co-crystals may be
prepared by melt crystallisation, by recrystallisation from
solvents, or by physically grinding the components together--see
Chem Commun, 17, 1889-1896, by O. Almarsson and M. J. Zaworotko
(2004). For a general review of multi-component complexes, see J
Pharm Sci, 64 (8), 1269-1288, by Haleblian (August 1975).
[0029] The compounds according to the disclosed embodiments may
also exist in a mesomorphic state (mesophase or liquid crystal)
when subjected to suitable conditions. The mesomorphic state is
intermediate between the true crystalline state and the true liquid
state (either melt or solution). Mesomorphism arising as the result
of a change in temperature is described as `thermotropic` and that
resulting from the addition of a second component, such as water or
another solvent, is described as `lyotropic`. Compounds that have
the potential to form lyotropic mesophases are described as
`amphiphilic` and consist of molecules which possess an ionic (such
as --COO.sup.-Na.sup.+, --COO.sup.-K.sup.+, or
--SO.sub.3.sup.-Na.sup.+) or non-ionic (such as
--N.sup.-N.sup.+(CH.sub.3).sub.3) polar head group. For more
information, see Crystals and the Polarizing Microscope by N. H.
Hartshorne and A. Stuart, 4.sup.th Edition (Edward Arnold,
1970).
[0030] Hereinafter all references to compounds of Formula I include
references to salts, solvates, multi-component complexes and liquid
crystals thereof and to solvates, multi-component complexes and
liquid crystals of salts thereof.
[0031] The compounds of the present disclosure include compounds of
Formula I as hereinbefore defined, including all polymorphs and
crystal habits thereof, and isomers thereof (including optical,
geometric and tautomeric isomers) as hereinafter defined and
isotopically-labeled compounds of Formula I.
[0032] The compounds of Formula I have asymmetric carbon and
nitrogen atoms and exist as two or more stereoisomers. The bonds of
the compounds of Formula I may be depicted herein using a solid
line (), a solid wedge (), or a dotted wedge (). The use of a solid
line to depict bonds to asymmetric carbon atoms is meant to
indicate that all possible stereoisomers (e.g. specific
enantiomers, racemic mixtures, etc.) at that atom are included. The
use of either a solid or dotted wedge to depict bonds to asymmetric
atoms is meant to indicate that only the stereoisomer shown is
meant to be included. It is possible that compounds of Formula I
may contain more than one asymmetric atom. In those compounds, the
use of a solid line to depict bonds to asymmetric atoms is meant to
indicate that all possible stereoisomers are meant to be included.
For example, unless stated otherwise, it is intended that the
compounds of Formula I can exist as enantiomers and diastereomers
or as racemates and mixtures thereof. The use of a solid line to
depict bonds to one or more asymmetric atoms in a compound of
Formula I and the use of a solid or dotted wedge to depict bonds to
other asymmetric atoms in the same compound is meant to indicate
that a mixture of diastereomers is present.
[0033] Stereoisomers of Formula I include cis and trans isomers,
optical isomers such as R and S enantiomers, diastereomers,
geometric isomers, rotational isomers, conformational isomers, and
tautomers of the compounds of Formula I, including compounds
exhibiting more than one type of isomerism; and mixtures thereof
(such as racemates and diastereomeric pairs).
[0034] When any racemate crystallizes, crystals of two different
types are possible. The first type is the racemic compound (true
racemate) referred to above wherein one homogeneous form of crystal
is produced containing both enantiomers in equimolar amounts. The
second type is the racemic mixture or conglomerate wherein two
forms of crystal are produced in equimolar amounts each comprising
a single enantiomer.
[0035] The compounds of the Formula I may exhibit the phenomena of
tautomerism and structural isomerism. For example, the compounds of
Formula I may exist in several tautomeric forms, including the enol
and imine form, and the keto and enamine form and geometric isomers
and mixtures thereof. All such tautomeric forms are included within
the scope of compounds of Formula I. Tautomers exist as mixtures of
a tautomeric set in solution. In solid form, usually one tautomer
predominates. Even though one tautomer may be described, the
disclosed embodiments include all tautomers of the compounds of
Formula I.
[0036] The present invention includes all pharmaceutically
acceptable isotopically-labelled compounds of Formula I wherein one
or more atoms are replaced by atoms having the same atomic number,
but an atomic mass or mass number different from the atomic mass or
mass number which predominates in nature.
[0037] Examples of isotopes suitable for inclusion in the compounds
of the present disclosure include isotopes of hydrogen, such as
.sup.2H and .sup.3H, carbon, such as .sup.11C, .sup.13C and
.sup.14C, chlorine, such as .sup.36Cl, fluorine, such as .sup.18F,
iodine, such as .sup.123I and .sup.125I, nitrogen, such as .sup.13N
and .sup.15N, oxygen, such as .sup.15O, .sup.17O and .sup.18O,
phosphorus, such as .sup.32P, and sulphur, such as .sup.35S.
[0038] Certain isotopically-labelled compounds of Formula I, for
example, those incorporating a radioactive isotope, are useful in
drug and/or substrate tissue distribution studies. The radioactive
isotopes tritium, i.e. .sup.3H, and carbon-14, i.e. .sup.14C, are
particularly useful for this purpose in view of their ease of
incorporation and ready means of detection.
[0039] Substitution with heavier isotopes such as deuterium, i.e.
.sup.2H, may afford certain therapeutic advantages resulting from
greater metabolic stability, for example, increased in vivo
half-life or reduced dosage requirements, and hence may be
preferred in some circumstances.
[0040] Substitution with positron emitting isotopes, such as
.sup.11C, .sup.18F, .sup.15O and .sup.13N, can be useful in
Positron Emission Topography (PET) studies for examining substrate
receptor occupancy.
[0041] Isotopically-labeled compounds of Formula I can generally be
prepared by conventional techniques known to those skilled in the
art or by processes analogous to those described in the
accompanying Examples and Preparations using an appropriate
isotopically-labeled reagent in place of the non-labeled reagent
previously employed.
[0042] Another embodiment relates to compounds of Formula I,
wherein the stereochemistry about the quaternary nitrogen center is
in the "S" configuration.
[0043] Another embodiment relates to compounds of Formula I,
wherein the stereochemistry about the quaternary nitrogen center is
in the "R" configuration.
[0044] Compounds of Formula I of particular interest can be
segregated according to established opioid skeletons (wherein
R.sup.2 and R.sup.3 groups have been replaced) as described
below:
##STR00003## ##STR00004##
[0045] Another embodiment of the present disclosure refers to
compounds of Formula I wherein the R.sup.1 groups (taken together
with the R.sup.4, R.sup.5 and R.sup.6 functionality) have the
formulae:
##STR00005##
[0046] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is CHR.sup.4O(C.dbd.O)OR.sup.5.
[0047] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is CHR.sup.4O(C.dbd.O)R.sup.6.
[0048] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is CHR.sup.4O(C.dbd.O)NR.sup.6R.sup.7.
[0049] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is CHR.sup.4O(C.dbd.O)CHR.sup.8NR.sup.6R.sup.7.
[0050] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)CHR.sup.8NH(COCHR.sup.8NH).sub.nH.
[0051] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is CHR.sup.4R.sup.9.
[0052] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is CHR.sup.4O(C.dbd.O)CR.sup.5R.sup.6OR.sup.7.
[0053] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)O(CH.sub.2).sub.nNR.sup.5R.sup.6.
[0054] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)O(CH.sub.2).sub.nCO.sub.2R.sup.5.
[0055] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)(CH.sub.2).sub.nNR.sup.5R.sup.6.
[0056] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is
CHR.sup.4O(C.dbd.O)(CH.sub.2).sub.nCO.sub.2R.sup.5.
[0057] Another embodiment relates to compounds of Formula I,
wherein R.sup.1 is
##STR00006##
Another embodiment relates to compounds of Formula I, wherein
R.sup.1 is
##STR00007##
[0058] Another embodiment relates to compounds of Formula I,
wherein R.sup.2 is H. Other embodiments relate to compounds of
Formula I, wherein R.sup.2 is H and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1.
[0059] Another embodiment relates to compounds of Formula I,
wherein R.sup.2 is OH. Other embodiments relate to compounds of
Formula I, wherein R.sup.2 is OH and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1.
[0060] Another embodiment relates to compounds of Formula I,
wherein R.sup.2 is O(C.dbd.O)CH.sub.3. Other embodiments relate to
compounds of Formula I, wherein R.sup.2 is O(C.dbd.O)CH.sub.3 and
R.sup.1 is one of the aforesaid embodiments relating to
R.sup.1.
[0061] Another embodiment relates to compounds of Formula I,
wherein R.sup.3 is H. Other embodiments relate to compounds of
Formula I, wherein R.sup.3 is H and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.3 is H and R.sup.1 is one of
the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is one
of the aforesaid embodiments relating to R.sup.2.
[0062] Another embodiment relates to compounds of Formula I,
wherein R.sup.3 is Methyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.3 is methyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, wherein R.sup.3 is methyl and R.sup.1 is
one of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2
is one of the aforesaid embodiments relating to R.sup.2.
[0063] Another embodiment relates to compounds of Formula I,
wherein R.sup.3 is (C.dbd.O)CH.sub.3. Other embodiments relate to
compounds of Formula I, wherein R.sup.3 is (C.dbd.O)CH.sub.3 and
R.sup.1 is one of the aforesaid embodiments relating to R.sup.1.
Other embodiments relate to compounds of Formula I, wherein R.sup.3
is (C.dbd.O)CH.sub.3 and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1 and/or R.sup.2 is one of the
aforesaid embodiments relating to R.sup.2.
[0064] Another embodiment relates to compounds of Formula I,
wherein R.sup.4 is H. Other embodiments relate to compounds of
Formula I, wherein R.sup.4 is H and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.4 is H and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3.
[0065] Another embodiment relates to compounds of Formula I,
wherein R.sup.4 is methyl, ethyl, isopropyl, t-butyl,
diethylmethyl, or pentyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.4 is methyl, ethyl, isopropyl, t-butyl,
diethylmethyl, or pentyl and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.4 is methyl, ethyl,
isopropyl, t-butyl, diethylmethyl, or pentyl and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3.
[0066] Another embodiment relates to compounds of Formula I,
wherein R.sup.4 is alkyl optionally substituted with one or more
substituents independently selected from the group OR.sup.3 and
(C.dbd.O)OR.sup.5. Other embodiments relate to compounds of Formula
I, wherein R.sup.4 is alkyl optionally substituted with one or more
substituents independently selected from the group OR.sup.3 and
(C.dbd.O)OR.sup.5 and R.sup.1 is one of the aforesaid embodiments
relating to R.sup.1. Other embodiments relate to compounds of
Formula I, wherein R.sup.4 is alkyl optionally substituted with one
or more substituents independently selected from the group OR.sup.3
and (C.dbd.O)OR.sup.5 and/or R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1 and/or R.sup.2 is one of the
aforesaid embodiments relating to R.sup.2 and/or R.sup.3 is one of
the aforesaid embodiments relating to R.sup.3.
[0067] Another embodiment relates to compounds of Formula I,
wherein R.sup.5 is alkyl selected from methyl, ethyl, isopropyl,
n-butyl, or n-pentyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.5 is alkyl selected from methyl, ethyl,
isopropyl, n-butyl, or n-pentyl and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.5 is alkyl selected from
methyl, ethyl, isopropyl, n-butyl, or n-pentyl and/or R.sup.1 is
one of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2
is one of the aforesaid embodiments relating to R.sup.2 and/or
R.sup.3 is one of the aforesaid embodiments relating to R.sup.3
and/or R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0068] Another embodiment relates to compounds of Formula I,
wherein R.sup.5 is optionally substituted alkyl, wherein said
substituent(s) is (CH.sub.2).sub.nCO.sub.2alkyl; and wherein n is
an integer from 1-12. Other embodiments relate to compounds of
Formula I, wherein R.sup.5 is optionally substituted alkyl, wherein
said substituent(s) is (CH.sub.2).sub.nCO.sub.2alkyl; and wherein n
is an integer from 1-12 and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.5 is optionally substituted
alkyl, wherein said substituent(s) is
(CH.sub.2).sub.nCO.sub.2alkyl; and wherein n is an integer from
1-12 and/or R.sup.1 is one of the aforesaid embodiments relating to
R.sup.1 and/or R.sup.2 is one of the aforesaid embodiments relating
to R.sup.2 and/or R.sup.3 is one of the aforesaid embodiments
relating to R.sup.3 and/or R.sup.4 is one of the aforesaid
embodiments relating to R.sup.4.
[0069] Another embodiment relates to compounds of Formula I,
wherein R.sup.5 is cyclohexyl. Other embodiments relate to
compounds of Formula I, wherein R.sup.5 is cyclohexyl and R.sup.1
is one of the aforesaid embodiments relating to R.sup.1. Other
embodiments relate to compounds of Formula I, R.sup.5 is cyclohexyl
and/or R.sup.1 is one of the aforesaid embodiments relating to
R.sup.1 and/or R.sup.2 is one of the aforesaid embodiments relating
to R.sup.2 and/or R.sup.3 is one of the aforesaid embodiments
relating to R.sup.3 and/or R.sup.4 is one of the aforesaid
embodiments relating to R.sup.4.
[0070] Another embodiment relates to compounds of Formula I,
wherein R.sup.5 is benzyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.5 is benzyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, R.sup.5 is benzyl and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3 and/or
R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0071] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is H. Other embodiments relate to compounds of
Formula I, wherein R.sup.6 is H and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.6 is H and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3 and/or
R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0072] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is methyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.6 is methyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, R.sup.6 is methyl and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3 and/or
R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0073] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is t-butyl. Other embodiments relate to compounds
of Formula I, wherein R.sup.6 is t-butyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, wherein R.sup.6 is t-butyl and/or
R.sup.1 is one of the aforesaid embodiments relating to R.sup.1
and/or R.sup.2 is one of the aforesaid embodiments relating to
R.sup.2 and/or R.sup.3 is one of the aforesaid embodiments relating
to R.sup.3 and/or R.sup.4 is one of the aforesaid embodiments
relating to R.sup.4.
[0074] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is i-propyl. Other embodiments relate to compounds
of Formula I, wherein R.sup.6 is i-propyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, R.sup.6 is i-propyl and/or R.sup.1 is
one of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2
is one of the aforesaid embodiments relating to R.sup.2 and/or
R.sup.3 is one of the aforesaid embodiments relating to R.sup.3
and/or R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0075] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is cyclohexyl. Other embodiments relate to
compounds of Formula I, wherein R.sup.6 is cyclohexyl and R.sup.1
is one of the aforesaid embodiments relating to R.sup.1. Other
embodiments relate to compounds of Formula I, wherein R.sup.6 is
cyclohexyl and/or R.sup.1 is one of the aforesaid embodiments
relating to R.sup.1 and/or R.sup.2 is one of the aforesaid
embodiments relating to R.sup.2 and/or R.sup.3 is one of the
aforesaid embodiments relating to R.sup.3 and/or R.sup.4 is one of
the aforesaid embodiments relating to R.sup.4.
[0076] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is benzyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.6 is benzyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, R.sup.6 is benzyl and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3 and/or
R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0077] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is phenyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.6 is phenyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, wherein R.sup.6 is phenyl and/or R.sup.1
is one of the aforesaid embodiments relating to R.sup.1 and/or
R.sup.2 is one of the aforesaid embodiments relating to R.sup.2
and/or R.sup.3 is one of the aforesaid embodiments relating to
R.sup.3 and/or R.sup.4 is one of the aforesaid embodiments relating
to R.sup.4.
[0078] Another embodiment relates to compounds of Formula I,
wherein R.sup.7 is H. Other embodiments relate to compounds of
Formula I, wherein R.sup.7 is H and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.7 is H and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3 and/or
R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0079] Another embodiment relates to compounds of Formula I,
wherein R.sup.7 is methyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.7 is methyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, wherein R.sup.7 is methyl and/or R.sup.1
is one of the aforesaid embodiments relating to R.sup.1 and/or
R.sup.2 is one of the aforesaid embodiments relating to R.sup.2
and/or R.sup.3 is one of the aforesaid embodiments relating to
R.sup.3 and/or R.sup.4 is one of the aforesaid embodiments relating
to R.sup.4.
[0080] Another embodiment relates to compounds of Formula I,
wherein R.sup.6 is H. Other embodiments relate to compounds of
Formula I, wherein R.sup.8 is H and R.sup.1 is one of the aforesaid
embodiments relating to R.sup.1. Other embodiments relate to
compounds of Formula I, wherein R.sup.8 is H and/or R.sup.1 is one
of the aforesaid embodiments relating to R.sup.1 and/or R.sup.2 is
one of the aforesaid embodiments relating to R.sup.2 and/or R.sup.3
is one of the aforesaid embodiments relating to R.sup.3 and/or
R.sup.4 is one of the aforesaid embodiments relating to
R.sup.4.
[0081] Another embodiment relates to compounds of Formula I,
wherein R.sup.8 is methyl. Other embodiments relate to compounds of
Formula I, wherein R.sup.8 is methyl and R.sup.1 is one of the
aforesaid embodiments relating to R.sup.1. Other embodiments relate
to compounds of Formula I, wherein R.sup.8 is methyl and/or R.sup.1
is one of the aforesaid embodiments relating to R.sup.1 and/or
R.sup.2 is one of the aforesaid embodiments relating to R.sup.2
and/or R.sup.3 is one of the aforesaid embodiments relating to
R.sup.3 and/or R.sup.4 is one of the aforesaid embodiments relating
to R.sup.4.
[0082] Another embodiment relates to compounds of Formula I,
wherein R.sup.9 is 4-isoxazoyl. Other embodiments relate to said
R.sup.9 4-isoxazoyl embodiments taken in combination with the
R.sup.1, R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments
described herein above.
[0083] Another embodiment relates to compounds of Formula I,
wherein A is Br.sup.-. Other embodiments relate to said A as
Br.sup.- embodiments taken in combination with the other R.sup.1,
R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments described
herein above.
[0084] Another embodiment relates to compounds of Formula I,
wherein A is Cl.sup.-. Other embodiments relate to said A is
Cl.sup.- embodiments taken in combination with the other R.sup.1,
R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments described
herein above.
[0085] Another embodiment relates to compounds of Formula I,
wherein A is I.sup.-. Other embodiments relate to said A is I.sup.-
embodiments taken in combination with the other R.sup.1, R.sup.2,
R.sup.3, R.sup.4 and/or R.sup.5 embodiments described herein
above.
[0086] Another embodiment relates to compounds of Formula I,
wherein A is R.sup.7CO.sub.2.sup.-, more specifically lactate,
acetate, tartrate, and valerate. Other embodiments relate to said A
is R.sup.7CO.sub.2.sup.- embodiments taken in combination with the
other R.sup.1, R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5
embodiments. described herein above.
[0087] Another embodiment relates to compounds of Formula I,
wherein A is H.sub.2PO.sub.4.sup.-. Other embodiments relate to
said A as H.sub.2PO.sub.4.sup.- embodiments taken in combination
with the other R.sup.1, R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5
embodiments described herein above.
[0088] Another embodiment relates to compounds of Formula I,
wherein A is NO.sub.3.sup.-. Other embodiments relate to said A as
NO.sub.3.sup.- embodiments taken in combination with the other
R.sup.1, R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments
described herein above.
[0089] Another embodiment relates to compounds of Formula I,
wherein A is R.sup.6SO.sub.3. Other embodiments relate to said A as
R.sup.6SO.sub.3 embodiments taken in combination with the other
R.sup.1, R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments
described herein above.
[0090] Another embodiment relates to compounds of Formula I,
wherein A is Ursodeoxycholate. Other embodiments relate to said A
as Ursodeoxycholate embodiments taken in combination with the other
R.sup.1, R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments
described herein above.
[0091] Another embodiment relates to compounds of Formula I,
wherein A is Etodolate. Other embodiments relate to said A as
Etodolate embodiments taken in combination with the other R.sup.1,
R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments described
herein above.
[0092] Another embodiment relates to compounds of Formula I,
wherein A is Mefanamate. Other embodiments relate to said A as
Mefanamate embodiments taken in combination with the other R.sup.1,
R.sup.2, R.sup.3, R.sup.4 and/or R.sup.5 embodiments described
herein above.
[0093] Another embodiment of the invention relates to the following
specific compounds of the invention:
##STR00008## ##STR00009## ##STR00010## ##STR00011## ##STR00012##
##STR00013##
[0094] The compounds of Formula I (and the other embodiments above)
are useful in the treatment of pain, particularly neuropathic,
nociceptive and inflammatory pain.
[0095] Another embodiment relates to a method of treating acute or
chronic pain comprising administering to a patient an effective
amount of a compound of Formula I.
[0096] The aspects of the disclosed embodiments also relate to
compositions comprising a compound of Formula I. Accordingly one
embodiment relates to a pharmaceutical composition comprising a
pharmaceutically effective amount of a compound of Formula I, a
pharmaceutically acceptable carrier and, optionally, at least one
additional medicinal or pharmaceutical agent.
[0097] Another embodiment relates to a composition of any of the
aforesaid embodiments of compounds of Formula I wherein said
composition is in tablet, capsule, oral solution, or oral
suspension dosage form.
[0098] Another embodiment relates to a composition of a compound of
Formula I wherein said composition is in tablet or capsule dosage
form.
[0099] Another embodiment relates to an oral pharmaceutical
preparation containing a therapeutically effective amount of a
compound of Formula I for once daily administration.
[0100] Another embodiment relates to a sustained release
composition containing a compound of Formula I.
[0101] In yet further embodiments, the pharmaceutical composition
in addition to the compound of Formula I may further include a
non-opioid drug. Such non-opioid drugs would preferably provide
additional analgesia, and include, for example, aspirin;
acetaminophen; non-steroidal anti-inflammatory drugs ("NSAIDS"),
e.g., ibuprofen, ketoprofen, etc.; N-methyl-D-aspartate (NMDA)
receptor antagonists, e.g., a morphinan such as dextromethorphan or
dextrorphan, or ketamine; cyclooxygenase-II inhibitors ("COX-II
inhibitors"); and/or glycine receptor antagonists.
[0102] Suitable non-steroidal anti-inflammatory agents, include
ibuprofen, diclofenac, naproxen, benoxaprofen, flurbiprofen,
fenoprofen, flubufen, ketoprofen, indoprofen, piroprofen,
carprofen, oxaprozin, pramoprofen, muroprofen, trioxaprofen,
suprofen, aminoprofen, tiaprofenic acid, fluprofen, bucloxic acid,
indomethacin, sulindac, tolmetin, zomepirac, tiopinac, zidometacin,
acemetacin, fentiazac, clidanac, oxpinac, mefenamic acid,
meclofenamic acid, flufenamic acid, niflumic acid, tolfenamic acid,
diflurisal, flufenisal, piroxicam, sudoxicam, isoxicam,
pharmaceutically acceptable salts thereof, mixtures thereof, and
the like. Useful dosages of these drugs are well known to those
skilled in the art.
[0103] N-methyl-D-aspartate (NMDA) receptor antagonists are well
known in the art, and encompass, for example, morphinans such as
dextromethorphan or dextrorphan, ketamine, or pharmaceutically
acceptable salts thereof. For purposes of the present disclosure,
the term "NMDA antagonist" is also deemed to encompass drugs that
at least partially inhibit a major intracellular consequence of
NMDA-receptor activation, e.g. a ganglioside such as GM.sub.1 or
GT.sub.1 b, a phenothiazine such as trifluoperazine or a
naphthalenesulfonamide such as
N-(6-aminothexyl)-5-chloro-1-naphthalenesulfonamide. These drugs
are stated to inhibit the development of tolerance to and/or
dependence on addictive drugs, e.g., narcotic analgesics such as
morphine, codeine, etc. in U.S. Pat. Nos. 5,321,012 and 5,556,838
(both to Mayer, et al.), and to treat chronic pain in U.S. Pat. No.
5,502,058 (Mayer, et al.). The NMDA antagonist may be included
alone, or in combination with a local anesthetic such as lidocaine,
as described in these Mayer, et al. patents.
[0104] The treatment of chronic pain via the use of glycine
receptor antagonists and the identification of such drugs is
described in U.S. Pat. No. 5,514,680 (Weber, et al.).
[0105] COX-2 inhibitors have been reported in the art and many
chemical structures are known to produce inhibition of
cyclooxygenase-2. COX-2 inhibitors are described, for example, in
U.S. Pat. Nos. 5,616,601; 5,604,260; 5,593,994; 5,550,142;
5,536,752; 5,521,213; 5,475,995; 5,639,780; 5,604,253; 5,552,422;
5,510,368; 5,436,265; 5,409,944; and 5,130,311. Certain preferred
COX-2 inhibitors include celecoxib, flosulide, meloxicam,
6-methoxy-2 naphthylacetic acid (6-MNA), nabumetone (prodrug for
6-MNA), nimesulide, or combinations thereof. Dosage levels of COX-2
inhibitor on the order of from about 0.005 mg to about 140 mg per
kilogram of body weight per day are therapeutically effective in
combination with the compounds of Formula I. Alternatively, about
0.25 mg to about 7 g per patient per day of a COX-2 inhibitor is
administered in a combination.
[0106] In yet further embodiments, a non-opioid drug can be
included which provides a desired effect other than analgesia,
e.g., antitussive, expectorant, decongestant, antihistamine drugs,
local anesthetics, and the like.
[0107] The pharmaceutically acceptable carrier may comprise any
conventional pharmaceutical carrier or excipient. Suitable
pharmaceutical carriers include inert diluents or fillers, water
and various organic solvents (such as hydrates and solvates). The
pharmaceutical compositions may, if desired, contain additional
ingredients such as flavorings, binders, excipients and the like.
Thus for oral administration, tablets containing various
excipients, such as citric acid may be employed together with
various disintegrants such as starch, alginic acid and certain
complex silicates and with binding agents such as sucrose, gelatin
and acacia. Additionally, lubricating agents such as magnesium
stearate, sodium lauryl sulfate and talc are often useful for
tableting purposes. Solid compositions of a similar type may also
be employed in soft and hard filled gelatin capsules. Non-limiting
examples of materials, therefore, include lactose or milk sugar and
high molecular weight polyethylene glycols.
[0108] The pharmaceutical composition may, for example, be in a
form suitable for oral administration as a tablet, capsule, pill,
powder, sustained release formulations, solution suspension, for
parenteral injection as a sterile solution, suspension or emulsion,
for topical administration as an ointment or cream or for rectal
administration as a suppository.
[0109] Physiological pain is an important protective mechanism
designed to warn of danger from potentially injurious stimuli from
the external environment. The system operates through a specific
set of primary sensory neurons and is activated by noxious stimuli
via peripheral transducing mechanisms (see Millan, 1999, Prog.
Neurobiol., 57, 1-164 for a review). These sensory fibers are known
as nociceptors and are characteristically small diameter axons with
slow conduction velocities. Nociceptors encode the intensity,
duration and quality of noxious stimulus and by virtue of their
topographically organized projection to the spinal cord, the
location of the stimulus. The nociceptors are found on nociceptive
nerve fibers of which there are two main types, A-delta fibres
(myelinated) and C fibres (non-myelinated). The activity generated
by nociceptor input is transferred, after complex processing in the
dorsal horn, either directly, or via brain stem relay nuclei, to
the ventrobasal thalamus and then on to the cortex, where the
sensation of pain is generated.
[0110] Pain may generally be classified as acute or chronic. Acute
pain begins suddenly and is short-lived (usually twelve weeks or
less). It is usually associated with a specific cause such as a
specific injury and is often sharp and severe. It is the kind of
pain that can occur after specific injuries resulting from surgery,
dental work, a strain or a sprain. Acute pain does not generally
result in any persistent psychological response. In contrast,
chronic pain is long-term pain, typically persisting for more than
three months and leading to significant psychological and emotional
problems. Common examples of chronic pain are neuropathic pain
(e.g. painful diabetic neuropathy, post herpetic neuralgia), carpal
tunnel syndrome, back pain, headache, cancer pain, arthritic pain
and chronic post-surgical pain.
[0111] When a substantial injury occurs to body tissue, via disease
or trauma, the characteristics of nociceptor activation are altered
and there is sensitization in the periphery, locally around the
injury and centrally where the nociceptors terminate. These effects
lead to a heightened sensation of pain. In acute pain these
mechanisms can be useful, in promoting protective behaviors which
may better enable repair processes to take place. The normal
expectation would be that sensitivity returns to normal once the
injury has healed. However, in many chronic pain states, the
hypersensitivity far outlasts the healing process and is often due
to nervous system injury. This injury often leads to abnormalities
in sensory nerve fibers associated with maladaptation and aberrant
activity (Woolf & Salter, 2000, Science, 288, 1765-1768).
[0112] Clinical pain is present when discomfort and abnormal
sensitivity feature among the patient's symptoms. Patients tend to
be quite heterogeneous and may present with various pain symptoms.
Such symptoms include: 1) spontaneous pain which may be dull,
burning, or stabbing; 2) exaggerated pain responses to noxious
stimuli (hyperalgesia); and 3) pain produced by normally innocuous
stimuli (allodynia--Meyer et al., 1994, Textbook of Pain, 13-44).
Although patients suffering from various forms of acute and chronic
pain may have similar symptoms, the underlying mechanisms may be
different and may, therefore, require different treatment
strategies. Pain can also therefore be divided into a number of
different subtypes according to differing pathophysiology,
including nociceptive, inflammatory and neuropathic pain.
[0113] Nociceptive pain is induced by tissue injury or by intense
stimuli with the potential to cause injury. Pain afferents are
activated by transduction of stimuli by nociceptors at the site of
injury and activate neurons in the spinal cord at the level of
their termination. This is then relayed up the spinal tracts to the
brain where pain is perceived (Meyer et al., 1994, Textbook of
Pain, 13-44). The activation of nociceptors activates two types of
afferent nerve fibers. Myelinated A-delta fibers transmit rapidly
and are responsible for sharp and stabbing pain sensations, whilst
unmyelinated C fibers transmit at a slower rate and convey a dull
or aching pain. Moderate to severe acute nociceptive pain is a
prominent feature of pain from central nervous system trauma,
strains/sprains, burns, myocardial infarction and acute
pancreatitis, post-operative pain (pain following any type of
surgical procedure), posttraumatic pain, renal colic, cancer pain
and back pain. Cancer pain may be chronic pain such as tumor
related pain (e.g. bone pain, headache, facial pain or visceral
pain) or pain associated with cancer therapy (e.g. post
chemotherapy syndrome, chronic postsurgical pain syndrome or post
radiation syndrome). Cancer pain may also occur in response to
chemotherapy, immunotherapy, hormonal therapy or radiotherapy. Back
pain may be due to herniated or ruptured intervertebral discs or
abnormalities of the lumber facet joints, sacroiliac joints,
paraspinal muscles or the posterior longitudinal ligament. Back
pain may resolve naturally but in some patients, where it lasts
over 12 weeks, it becomes a chronic condition which can be
particularly debilitating.
[0114] Neuropathic pain is currently defined as pain initiated or
caused by a primary lesion or dysfunction in the nervous system.
Nerve damage can be caused by trauma and disease and thus the term
`neuropathic pain` encompasses many disorders with diverse
etiologies. These include, but are not limited to, peripheral
neuropathy, diabetic neuropathy, post herpetic neuralgia,
trigeminal neuralgia, back pain, cancer neuropathy, HIV neuropathy,
phantom limb pain, carpal tunnel syndrome, central post-stroke pain
and pain associated with chronic alcoholism, hypothyroidism,
uremia, multiple sclerosis, spinal cord injury, Parkinson's
disease, epilepsy and vitamin deficiency. Neuropathic pain is
pathological as it has no protective role. It is often present well
after the original cause has dissipated, commonly lasting for
years, significantly decreasing a patient's quality of life (Woolf
and Mannion, 1999, Lancet, 353, 1959-1964). The symptoms of
neuropathic pain are difficult to treat, as they are often
heterogeneous even between patients with the same disease (Woolf
& Decosterd, 1999, Pain Supp., 6, S141-S147; Woolf and Mannion,
1999, Lancet, 353, 1959-1964). They include spontaneous pain, which
can be continuous, and paroxysmal or abnormal evoked pain, such as
hyperalgesia (increased sensitivity to a noxious stimulus) and
allodynia (sensitivity to a normally innocuous stimulus).
[0115] The inflammatory process is a complex series of biochemical
and cellular events, activated in response to tissue injury or the
presence of foreign substances, which results in swelling and pain
(Levine and Taiwo, 1994, Textbook of Pain, 45-56). Arthritic pain
is the most common inflammatory pain. Rheumatoid disease is one of
the commonest chronic inflammatory conditions in developed
countries and rheumatoid arthritis is a common cause of disability.
The exact etiology of rheumatoid arthritis is unknown, but current
hypotheses suggest that both genetic and microbiological factors
may be important (Grennan & Jayson, 1994, Textbook of Pain,
397-407). It has been estimated that almost 16 million Americans
have symptomatic osteoarthritis (OA) or degenerative joint disease,
most of whom are over 60 years of age, and this is expected to
increase to 40 million as the age of the population increases,
making this a public health problem of enormous magnitude (Houge
& Mersfelder, 2002, Ann Pharmacother., 36, 679-686; McCarthy et
al., 1994, Textbook of Pain, 387-395). Most patients with
osteoarthritis seek medical attention because of the associated
pain. Arthritis has a significant impact on psychosocial and
physical function and is known to be the leading cause of
disability in later life. Ankylosing spondylitis is also a
rheumatic disease that causes arthritis of the spine and sacroiliac
joints. It varies from intermittent episodes of back pain that
occur throughout life to a severe chronic disease that attacks the
spine, peripheral joints and other body organs.
[0116] Another type of inflammatory pain is visceral pain which
includes pain associated with inflammatory bowel disease (IBD).
Visceral pain is pain associated with the viscera, which encompass
the organs of the abdominal cavity. These organs include the sex
organs, spleen and part of the digestive system. Pain associated
with the viscera can be divided into digestive visceral pain and
non-digestive visceral pain. Commonly encountered gastrointestinal
(GI) disorders that cause pain include functional bowel disorder
(FBD) and inflammatory bowel disease (IBD). These GI disorders
include a wide range of disease states that are currently only
moderately controlled, including, in respect of FBD,
gastro-esophageal reflux, dyspepsia, irritable bowel syndrome (IBS)
and functional abdominal pain syndrome (FAPS), and, in respect of
IBD, Crohn's disease, ileitis and ulcerative colitis, all of which
regularly produce visceral pain. Other types of visceral pain
include the pain associated with dysmenorrhea, cystitis and
pancreatitis and pelvic pain.
[0117] It should be noted that some types of pain have multiple
etiologies and thus can be classified in more than one area, e.g.
back pain and cancer pain have both nociceptive and neuropathic
components.
[0118] Other types of pain include: pain resulting from
muscular-skeletal disorders, including myalgia, fibromyalgia,
spondylitis, sero-negative (non-rheumatoid) arthropathies,
non-articular rheumatism, dystrophinopathy, glycogenolysis,
polymyositis and pyomyositis; heart and vascular pain, including
pain caused by angina, myocardical infarction, mitral stenosis,
pericarditis, Raynaud's phenomenon, scleredoma and skeletal muscle
ischemia; head pain, such as migraine (including migraine with aura
and migraine without aura), cluster headache, tension-type headache
mixed headache and headache associated with vascular disorders;
erythermalgia; and orofacial pain, including dental pain, otic
pain, burning mouth syndrome and temporomandibular myofascial
pain.
[0119] The term "treating", as used herein, unless otherwise
indicated, means reversing, alleviating, inhibiting the progress
of, or preventing the disorder or condition to which such term
applies, or one or more symptoms of such disorder or condition. The
term "treatment", as used herein, unless otherwise indicated,
refers to the act of treating as "treating" is defined immediately
above. The term "treating" also includes adjuvant and neo-adjuvant
treatment of a subject.
[0120] Administration of the compounds of Formula I may be effected
by any method that enables delivery of the compounds to the site of
action. These methods include oral routes, intraduodenal routes,
parenteral injection (including intravenous, subcutaneous,
intramuscular, intravascular or infusion), topical, and rectal
administration.
The aspects of the disclosed embodiments also relate to altering
the pharmacokinetic and pharmacological properties of opioids,
particularly oxycodone, oxymorphone, hydrocodone and hydromorphone,
through quaternization of the bicyclic tertiary amine embedded in
the opioid structure. It is well known to those skilled in the art
that quaternization can change the rate and extent of absorption,
metabolism, distribution, and elimination of a drug. Moreover,
preferred quaternary ammonium compounds of the present disclosure
possess opioid antagonist activity. Furthermore, the quaternary
ammonium compounds of the disclosure, when ingested or administered
to a patient by any other means, are converted to free base opioid
possessing agonist activity at opioid receptors. Thus, these
compounds inherently possess both antagonist and agonist
properties. When the quaternary ammonium compound is first orally
administered it may bind to opioid receptors. More specifically, if
a quaternary ammonium compound of the disclosure is orally
ingested, the compound upon reaching the intestinal tract binds to
the mu or delta opioid receptor acting as an antagonist.
Simultaneously, quaternary ammonium opioid compound is subject to
the action of intestinal metabolic action and uptake and further
metabolism by intestinal wall transmission processes. These
processes are responsible for converting the quaternary ammonium
opioid into the tertiary amine parent compound (i.e. oxycodone,
oxymorphone and hydromorphone). Although the opioid is now free to
act in the intestinal tract as an agonist the receptors have
already been blocked by prior saturation with the antagonistic
quaternary compound. This localized inactivation of opioid
receptors reduces local side effects such as constipation, a major
side effect of agonists. When administered at a normal therapeutic
dose the bioavailability (the time-versus-concentration curve; area
under the curve; AUC) of the opioid may be similar to that observed
with slow or extended release formulations of the parent free base
opioid compound. However, since the uptake (systemic
bioavailability) of the quaternary ammonium opioid derivative into
the circulation is generally much lower when compared with the
uptake of the parent opioid compounds, this differential uptake
property causes a relative decline of the parent opioid agonist
concentration in intestinal compartments and maintains the
potential of the antagonist to reduce agonist induced constipation.
In contrast, the parent opioid agonist derived from the quaternary
ammonium precursor through the action of metabolic enzymes is
readily taken up into the circulation, enters the central nervous
system where it exerts its analgesic activity. Moreover, the
quaternary ammonium antagonist is restricted from crossing the
blood brain barrier and thus has negligible penetration into the
central nervous system. Furthermore, since means for generating
euphoria aim at very rapid delivery of relatively large amounts of
an opioid into the central nervous system; compounds embraced in
general formula 1 are abuse resistant because enzymes control the
amounts of opioid available for CNS uptake and the speed of release
from a quaternary ammonium precursor cannot be altered even if
compounds are taken above doses intended in the prescription or in
deviation of the recommended route of administration. Likewise, the
active principal in opioid abuse cannot be easily obtained from
quaternary ammonium precursors adding a second barrier to drug
abuse. This in turn diminishes the abuse potential, whether
unintended or intentionally sought.
[0121] Persons that abuse opioids such as hydrocodone or oxycodone
commonly seek to increase their euphoria by snorting or injecting
the drugs. These routes of administration increase the rate and
extent of drug absorption and provide a faster, nearly
instantaneous, effect. This increases the amount of drug that
reaches the central nervous system where it has its effect. In a
particular aspect of the disclosed embodiments, the bioavailability
of the covalently modified opioid is substantially decreased by the
intranasal and intravenous routes as compared to the parent opioid
compound. Thus the illicit practice of snorting and shooting the
drug loses its advantage.
[0122] Dosage regimens may be adjusted to provide the optimum
desired response. For example, a single bolus may be administered,
several divided doses may be administered over time or the dose may
be proportionally reduced or increased as indicated by the
exigencies of the therapeutic situation. It is especially
advantageous to formulate parenteral compositions in dosage unit
form for ease of administration and uniformity of dosage. Dosage
unit form, as used herein, refers to physically discrete units
suited as unitary dosages for the mammalian subjects to be treated;
each unit containing a predetermined quantity of active compound
calculated to produce the desired therapeutic effect in association
with the required pharmaceutical carrier.
[0123] Thus, the skilled artisan would appreciate, based upon the
disclosure provided herein, that the dose and dosing regimen is
adjusted in accordance with methods well-known in the therapeutic
arts. That is, the maximum tolerable dose can be readily
established, and the effective amount providing a detectable
therapeutic benefit to a patient may also be determined, as can the
temporal requirements for administering each agent to provide a
detectable therapeutic benefit to the patient. Accordingly, while
certain dose and administration regimens are exemplified herein,
these examples in no way limit the dose and administration regimen
that may be provided to a patient in practicing the aspects of the
disclosed embodiments.
[0124] It is to be noted that dosage values may vary with the type
and severity of the condition to be alleviated, and may include
single or multiple doses. It is to be further understood that for
any particular subject, specific dosage regimens should be adjusted
over time according to the individual need and the professional
judgment of the person administering or supervising the
administration of the compositions, and that dosage ranges set
forth herein are exemplary only and are not intended to limit the
scope or practice of the claimed composition. For example, doses
may be adjusted based on pharmacokinetic or pharmacodynamic
parameters, which may include clinical effects such as toxic
effects and/or laboratory values. Thus, the aspects of the
disclosed embodiments encompass intra-patient dose-escalation as
determined by the skilled artisan. Determining appropriate dosages
and regimens for administration of the active agent are well-known
in the relevant art and would be understood to be encompassed by
the skilled artisan once provided the teachings disclosed
herein.
[0125] The amount of the compound of Formula I administered will be
dependent on the subject being treated, the severity of the
disorder or condition, the rate of administration, the disposition
of the compound and the discretion of the prescribing physician.
However, an effective dosage is in the range of about 0.001 to
about 100 mg per kg body weight per day, preferably about 1 to
about 35 mg/kg/day, in single or divided doses. For a 70 kg human,
this would amount to about 0.05 to about 7 g/day, preferably about
0.1 to about 2.5 g/day. In some instances, dosage levels below the
lower limit of the aforesaid range may be more than adequate, while
in other cases still larger doses may be employed without causing
any harmful side effect, provided that such larger doses are first
divided into several small doses for administration throughout the
day.
[0126] As used herein, the term "combination therapy" refers to the
administration of a compound of Formula I together with an at least
one additional pharmaceutical or medicinal agent, either
sequentially or simultaneously.
[0127] The aspects of the disclosed embodiments include the use of
a combination of a compound as provided in Formula I and one or
more additional pharmaceutically active agent(s). If a combination
of active agents is administered, then they may be administered
sequentially or simultaneously, in separate dosage forms or
combined in a single dosage form. Accordingly, the present
disclosure also includes pharmaceutical compositions comprising an
amount of: (a) a first agent comprising a compound of Formula I;
(b) a second pharmaceutically active agent; and (c) a
pharmaceutically acceptable carrier, vehicle or diluent.
[0128] Various pharmaceutically active agents may be selected for
use in conjunction with the compounds of Formula I, depending on
the disease, disorder, or condition to be treated.
DETAILED DESCRIPTION
[0129] In the reaction schemes and Formulae that follow R.sup.1
through R.sup.9, n, and A are as defined above.
##STR00014## ##STR00015##
[0130] Compounds of the Formula I may be subcategorized into
recognized individual opioid skeletons including oxycodone,
hydrocodone, oxymorphone and hydromorphone as described above. Each
of these skeletons is associated with copious synthetic methods
well known to those skilled in the art. Thus starting materials of
the Formula IV and V are commercially available or can be made by
methods well known to those skilled in the art. See for example
U.S. Pat. No. 8,183,376, U.S. Pat. Nos. 2,628,962, 2,654,756 and
2,649,454 (hydromorphone and others); U.S. Pat. No. 2,715,626
(hydrocodone and others); U.S. Pat. No. 2,806,033 (oxymorphone and
others); Freund et al. (1916) J. Prak. Chemie 94:135-178
(oxycodone).
[0131] In general the compounds of the disclosed embodiments may be
made by processes which include processes analogous to those known
in the chemical arts, particularly in light of the description
contained herein. The compounds of the disclosed embodiments also
have asymmetric nitrogen atoms and exist as two stereoisomers
around the quaternary ammonium nitrogen. Other asymmetric carbon
atoms exist in these compounds enlarging the number of possible
stereoisomers.
[0132] Scheme 1 refers to the preparation of compounds of Formula I
having the "S" stereochemistry about the quaternary ammonium
nitrogen. Referring to Scheme 1, compounds of Formula IV may be
produced by reaction of free base des-methyl opioid of Formula V,
such as Norhydromorphone, Noroxymorphone, Noroxycodone,
Norhydrocodone, with a halomethyl acetate, carbonate, carbamate, or
isoxazolylate, such as chloromethyl acetate, in the presence of a
strong base, such as for example, NaH, LDA and KO.sup.tBu.
[0133] The alpha methyl acetate, carbonate, carbamate, or
isoxazolylate (including derivatives of Formula II or III when
using appropriate activated reagents) compound of Formula IV may be
reacted with a methylating agent such as methyl iodide in the
presence of a base to form the "S" enantiomeric quaternary ammonium
compound of Formula I.
[0134] Scheme 2 refers to the preparation of compounds of Formula I
having the "R" stereochemistry about the quaternary ammonium
nitrogen. Referring to Scheme 2, free base opioid compounds of
Formula IV may be reacted with a halomethyl acetate, carbonate,
carbamate, or isoxazolylate, such as chloromethyl acetate, in the
presence of a strong base such as for example, NaH, LDA, KO.sup.tBu
to form a compound of Formula I.
[0135] As an initial note, in the preparation of the Formula I
compounds it is noted that some of the preparation methods useful
for the preparation of the compounds described herein may require
protection of remote functionality (e.g., primary amine, secondary
amine, carboxyl in Formula I precursors). The need for such
protection will vary depending on the nature of the remote
functionality and the conditions of the preparation methods. The
need for such protection is readily determined by one skilled in
the art. The use of such protection/deprotection methods is also
within the skill in the art. For a general description of
protecting groups and their use, see T. W. Greene, Protective
Groups in Organic Synthesis, John Wiley & Sons, New York,
1991.
[0136] Compounds of Formula I that have chiral centers may exist as
stereoisomers, such as racemates, enantiomers, or diastereomers.
Conventional techniques for the preparation/isolation of individual
enantiomers include chiral synthesis from a suitable optically pure
precursor or resolution of the racemate using, for example, chiral
high pressure liquid chromatography (HPLC). Alternatively, the
racemate (or a racemic precursor) may be reacted with a suitable
optically active compound, for example, an alcohol, or, in the case
where the compound contains an acidic or basic moiety, an acid or
base such as tartaric acid or 1-phenylethylamine. The resulting
diastereomeric mixture may be separated by chromatography and/or
fractional crystallization and one or both of the diastereoisomers
converted to the corresponding pure enantiomer(s) by means well
known to one skilled in the art. Chiral compounds of Formula I (and
chiral precursors thereof) may be obtained in
enantiomerically-enriched form using chromatography, typically
HPLC, on an asymmetric resin with a mobile phase consisting of a
hydrocarbon, typically heptane or hexane, containing from 0 to 50%
isopropanol, typically from 2 to 20%, and from 0 to 5% of an
alkylamine, typically 0.1% diethylamine. Concentration of the
eluate affords the enriched mixture. Stereoisomeric conglomerates
may be separated by conventional techniques known to those skilled
in the art. See, e.g. "Stereochemistry of Organic Compounds" by E.
L. Eliel (Wiley, New York, 1994), the disclosure of which is
incorporated herein by reference in its entirety.
[0137] Where a compound of Formula I contains an alkenyl or
alkenylene group, geometric cis/trans (or Z/E) isomers are
possible. Cis/trans isomers may be separated by conventional
techniques well known to those skilled in the art, for example,
chromatography and fractional crystallization. Salts of the present
disclosure can be prepared according to methods known to those of
skill in the art.
[0138] Polymorphs can be prepared according to techniques
well-known to those skilled in the art.
[0139] Cis/trans isomers may be separated by conventional
techniques well known to those skilled in the art, for example,
chromatography and fractional crystallisation.
[0140] Conventional techniques for the preparation/isolation of
individual enantiomers include chiral synthesis from a suitable
optically pure precursor or resolution of the racemate (or the
racemate of a salt or derivative) using, for example, chiral high
pressure liquid chromatography (HPLC).
[0141] Chiral compounds of the disclosed embodiments (and chiral
precursors thereof) may be obtained in enantiomerically-enriched
form using chromatography, typically HPLC, on an asymmetric resin
with a mobile phase consisting of a hydrocarbon, typically heptane
or hexane, containing from 0 to 50% by volume of isopropanol,
typically from 2% to 20%, and from 0 to 5% by volume of an
alkylamine, typically 0.1% diethylamine. Concentration of the
eluate affords the enriched mixture.
[0142] When any racemate crystallises, crystals of two different
types are possible. The first type is the racemic compound (true
racemate) referred to above wherein one homogeneous form of crystal
is produced containing both enantiomers in equimolar amounts. The
second type is the racemic mixture or conglomerate wherein two
forms of crystal are produced in equimolar amounts each comprising
a single enantiomer.
[0143] While both of the crystal forms present in a racemic mixture
have identical physical properties, they may have different
physical properties compared to the true racemate. Racemic mixtures
may be separated by conventional techniques known to those skilled
in the art--see, for example, Stereochemistry of Organic Compounds
by E. L. Eliel and S. H. Wilen (Wiley, 1994).
[0144] The aspects of the disclosed embodiments also include
isotopically-labeled compounds of Formula I, wherein one or more
atoms is replaced by an atom having the same atomic number, but an
atomic mass or mass number different from the atomic mass or mass
number usually found in nature. Isotopically-labeled compounds of
Formula I can generally be prepared by conventional techniques
known to those skilled in the art or by processes analogous to
those described herein, using an appropriate isotopically-labeled
reagent in place of the non-labeled reagent otherwise employed.
[0145] Compounds of the disclosed embodiments intended for
pharmaceutical use may be administered as crystalline or amorphous
products. They may be obtained, for example, as solid plugs,
powders, or films by methods such as precipitation,
crystallization, freeze drying, spray drying, or evaporative
drying. Microwave or radio frequency drying may be used for this
purpose.
[0146] They may be administered alone or in combination with one or
more other compounds of the disclosed embodiments or in combination
with one or more other drugs (or as any combination thereof).
Generally, they will be administered as a formulation in
association with one or more pharmaceutically acceptable
excipients. The term `excipient` is used herein to describe any
ingredient other than the compound(s) of the disclosed embodiments.
The choice of excipient will to a large extent depend on factors
such as the particular mode of administration, the effect of the
excipient on solubility and stability, and the nature of the dosage
form.
[0147] Pharmaceutical compositions suitable for the delivery of
compounds of the disclosed embodiments and methods for their
preparation will be readily apparent to those skilled in the art.
Such compositions and methods for their preparation may be found,
for example, in Remington's Pharmaceutical Sciences, 19th Edition
(Mack Publishing Company, 1995).
[0148] The compounds of the disclosed embodiments may be
administered orally. Oral administration may involve swallowing, so
that the compound enters the gastrointestinal tract, and/or buccal,
lingual, or sublingual administration by which the compound enters
the blood stream directly from the mouth.
[0149] Formulations suitable for oral administration include solid,
semi-solid and liquid systems such as tablets; soft or hard
capsules containing multi- or nano-particulates, liquids, or
powders; lozenges (including liquid-filled); chews; gels; fast
dispersing dosage forms; films; ovules; sprays; and
buccal/mucoadhesive patches.
[0150] Liquid formulations include suspensions, solutions, syrups
and elixirs. Such formulations may be employed as fillers in soft
or hard capsules (made, for example, from gelatin or
hydroxypropylmethylcellulose) and typically comprise a carrier, for
example, water, ethanol, polyethylene glycol, propylene glycol,
methylcellulose, or a suitable oil, and one or more emulsifying
agents and/or suspending agents. Liquid formulations may also be
prepared by the reconstitution of a solid, for example, from a
sachet.
[0151] The compounds of the disclosed embodiments may also be used
in fast-dissolving, fast-disintegrating dosage forms such as those
described in Expert Opinion in Therapeutic Patents, 11 (6),
981-986, by Liang and Chen (2001).
[0152] For tablet dosage forms, depending on dose, the drug may
make up from 1 weight % to 80 weight % of the dosage form, more
typically from 5 weight % to 60 weight % of the dosage form. In
addition to the drug, tablets generally contain a disintegrant.
Examples of disintegrants include sodium starch glycolate, sodium
carboxymethyl cellulose, calcium carboxymethyl cellulose,
croscarmellose sodium, crospovidone, polyvinylpyrrolidone, methyl
cellulose, microcrystalline cellulose, lower alkyl-substituted
hydroxypropyl cellulose, starch, pregelatinised starch and sodium
alginate. Generally, the disintegrant will comprise from 1 weight %
to 25 weight %, preferably from 5 weight % to 20 weight % of the
dosage form.
[0153] Binders are generally used to impart cohesive qualities to a
tablet formulation. Suitable binders include microcrystalline
cellulose, gelatin, sugars, polyethylene glycol, natural and
synthetic gums, polyvinylpyrrolidone, pregelatinised starch,
hydroxypropyl cellulose and hydroxypropyl methylcellulose. Tablets
may also contain diluents, such as lactose (monohydrate,
spray-dried monohydrate, anhydrous and the like), mannitol,
xylitol, dextrose, sucrose, sorbitol, microcrystalline cellulose,
starch and dibasic calcium phosphate dihydrate.
[0154] Tablets may also optionally comprise surface active agents,
such as sodium lauryl sulfate and polysorbate 80, and glidants such
as silicon dioxide and talc. When present, surface active agents
may comprise from 0.2 weight % to 5 weight % of the tablet, and
glidants may comprise from 0.2 weight % to 1 weight % of the
tablet.
[0155] Tablets also generally contain lubricants such as magnesium
stearate, calcium stearate, zinc stearate, sodium stearyl fumarate,
and mixtures of magnesium stearate with sodium lauryl sulphate.
Lubricants generally comprise from 0.25 weight % to 10 weight %,
preferably from 0.5 weight % to 3 weight % of the tablet.
[0156] Other possible ingredients include anti-oxidants,
colourants, flavouring agents, preservatives and taste-masking
agents.
[0157] Exemplary tablets contain up to about 80% drug, from about
10 weight % to about 90 weight % binder, from about 0 weight % to
about 85 weight % diluent, from about 2 weight % to about 10 weight
% disintegrant, and from about 0.25 weight % to about 10 weight %
lubricant.
[0158] Tablet blends may be compressed directly or by roller to
form tablets. Tablet blends or portions of blends may alternatively
be wet-, dry-, or melt-granulated, melt congealed, or extruded
before tabletting. The final formulation may comprise one or more
layers and may be coated or uncoated; it may even be
encapsulated.
[0159] The formulation of tablets is discussed in Pharmaceutical
Dosage Forms: Tablets, Vol. 1, by H. Lieberman and L. Lachman
(Marcel Dekker, New York, 1980).
[0160] Consumable oral films for human or veterinary use are
typically pliable water-soluble or water-swellable thin film dosage
forms which may be rapidly dissolving or mucoadhesive and typically
comprise a compound of formula I, a film-forming polymer, a binder,
a solvent, a humectant, a plasticiser, a stabiliser or emulsifier,
a viscosity-modifying agent and a solvent. Some components of the
formulation may perform more than one function.
[0161] The compound of formula I may be water-soluble or insoluble.
A water-soluble compound typically comprises from 1 weight % to 80
weight %, more typically from 20 weight % to 50 weight %, of the
solutes. Less soluble compounds may comprise a greater proportion
of the composition, typically up to 88 weight % of the solutes.
Alternatively, the compound of formula I may be in the form of
multiparticulate beads.
[0162] The film-forming polymer may be selected from natural
polysaccharides, proteins, or synthetic hydrocolloids and is
typically present in the range 0.01 to 99 weight %, more typically
in the range 30 to 80 weight %.
[0163] Other possible ingredients include anti-oxidants, colorants,
flavourings and flavour enhancers, preservatives, salivary
stimulating agents, cooling agents, co-solvents (including oils),
emollients, bulking agents, anti-foaming agents, surfactants and
taste-masking agents.
[0164] Films in accordance with the disclosed embodiments are
typically prepared by evaporative drying of thin aqueous films
coated onto a peelable backing support or paper. This may be done
in a drying oven or tunnel, typically a combined coater dryer, or
by freeze-drying or vacuuming.
[0165] Solid formulations for oral administration may be formulated
to be immediate and/or modified release. Modified release
formulations including delayed-, sustained-, pulsed-, controlled-,
targeted and programmed release are of particular interest.
Suitable modified release formulations for the purposes of the
disclosed embodiments are described in U.S. Pat. No. 6,106,864.
Details of other suitable release technologies such as high energy
dispersions and osmotic and coated particles are to be found in
Pharmaceutical Technology On-line, 25(2), 1-14, by Verma et al
(2001). The use of chewing gum to achieve controlled release is
described in WO 00/35298.
[0166] The compounds of the disclosed embodiments may also be
administered directly into the blood stream, into muscle, or into
an internal organ. Suitable means for parenteral administration
include intravenous, intraarterial, intraperitoneal, intrathecal,
intraventricular, intraurethral, intrasternal, intracranial,
intramuscular, intrasynovial and subcutaneous. Suitable devices for
parenteral administration include needle (including microneedle)
injectors, needle-free injectors and infusion techniques.
[0167] Capsules (made, for example, from gelatin or
hydroxypropylmethylcellulose), blisters and cartridges for use in
an inhaler or insufflator may be formulated to contain a powder mix
of the compound of the disclosed embodiments, a suitable powder
base such as lactose or starch and a performance modifier such as
I-leucine, mannitol, or magnesium stearate. The lactose may be
anhydrous or in the form of the monohydrate, preferably the latter.
Other suitable excipients include dextran, glucose, maltose,
sorbitol, xylitol, fructose, sucrose and trehalose.
[0168] The compounds of the disclosed embodiments can also be
formulated as Drug-cyclodextrin complexes. Both inclusion and
non-inclusion complexes may be used. As an alternative to direct
complexation with the drug, the cyclodextrin may be used as an
auxiliary additive, i.e. as a carrier, diluent, or solubiliser.
Most commonly used for these purposes are alpha-, beta- and
gamma-cyclodextrins, examples of which may be found in
International Patent Applications Nos. WO 91/11172, WO 94/02518 and
WO 98/55148.
[0169] Since the aspects of the disclosed embodiments may relate to
the treatment of the disease/conditions described herein with a
combination of active ingredients which may be administered
separately, they also relate to combining separate pharmaceutical
compositions in kit form. The kit comprises two separate
pharmaceutical compositions: a compound of Formula I or a salt of
such compound and a second compound as described above. The kit
comprises means for containing the separate compositions such as a
container, a divided bottle or a divided foil packet. Typically the
kit comprises directions for the administration of the separate
components.
[0170] An example of such a kit is a so-called blister pack.
Blister packs are well known in the packaging industry and are
being widely used for the packaging of pharmaceutical unit dosage
forms (tablets, capsules, and the like). Blister packs generally
consist of a sheet of relatively stiff material covered with a foil
of a preferably transparent plastic material. During the packaging
process recesses are formed in the plastic foil. The recesses have
the size and shape of the tablets or capsules to be packed. Next,
the tablets or capsules are placed in the recesses and the sheet of
relatively stiff material is sealed against the plastic foil at the
face of the foil which is opposite from the direction in which the
recesses were formed. As a result, the tablets or capsules are
sealed in the recesses between the plastic foil and the sheet.
Preferably the strength of the sheet is such that the tablets or
capsules can be removed from the blister pack by manually applying
pressure on the recesses whereby an opening is formed in the sheet
at the place of the recess. The tablet or capsule can then be
removed via said opening.
Summary of Pharmacokinetic Parameters for Compounds of Formula
I
[0171] Binding to Opioid Receptors (Binding Assay)
[0172] Membrane preparations (from either rodent brain or from
cells transfected with plasmids engineered to express an opioid
receptor) are rapidly thawed and diluted in binding buffer (50 mM
HEPES, 5 mM MgCl2, 1 mM CaCl2, 0.2% BSA, pH 7.4) to a concentration
of 0.1 mg/mL. The radioligand and unlabeled compounds are diluted
in binding buffer to achieve the desired final concentration in
each well. The assays are performed in microtiter plates using 40
ul of binding buffer or unlabeled ligand, 10 ul of radioligand
(final concentration of (3H)-DAMGO=2 nM), and 50 ul of diluted
membranes with three wells per group. The plates are then incubated
at room temperature for two hours. Unlabeled test compounds are
added at one third-log increments with 5 log separation between
highest and lowest concentrations. The binding incubation is
terminated by the addition of 100 ul cold binding buffer to each
well. The glass fiber filter plates are presoaked for 30-45 min
with 0.33% polyethylenimine (PE)I buffer. The PEI solution is
removed from the filter plate with a vacuum manifold (Millipore)
and the filters washed with 200 ul priming buffer (50 mM HEPES,
0.5% BSA, pH 7.4) per well. The binding reaction is transferred to
the filter plate and washed with 200 ul washing buffer (50 mM HEPES
with 500 mM NaCl and 0.1% BSA, pH 7.4). The plate is dried and the
filters removed using a cell harvester and punch assembly
(MultiScreen HTS, Millipore) for analysis in a scintillation
counter (Beckman Coulter, Fullerton, Calif.). For the competitive
binding experiments with test compounds, the Ki value was
calculated from the IC50 value by GraphPad Prism, using the
equation of Cheng and Prusoff (1973).
[0173] Activation of Opioid Receptors (Functional Assay)
[0174] Opioid receptors belong to the seven transmembrane
superfamily of heterotrimeric guanine nucleotide-binding protein-(G
protein) coupled receptors, and are linked to the adenylyl
cyclase-inhibitory G proteins Gi and Go (Carter and Medzihradsky,
1993). Thus a variety of in vitro assays may be used to establish
agonist or antagonist properties of novel opioid receptor ligands,
including GTP binding (using the non-hydrolyzable GTP analog
GTP.gamma.S) and inhibition of cAMP accumulation.
[0175] The binding of the nonhydrolyzable GTP analog
[.sup.35S]GTP.gamma.S is often used to provide a measure of G
protein activation by agonists (e.g., Lorenzen et al., 1993; Tian
et al., 1994). Because G-protein activation is the first
biochemical step after opioid receptor activation and is not
limited by downstream effector systems, this assay provides a very
direct measurement of efficacy, and the utility of this assay for
determining the relative efficacies of mu opioid agonists in vitro
has been demonstrated (Traynor and Nahorski 1995; Emmerson et al,
1996). The correlation between the intrinsic activity of a drug in
this assay and its efficacy in vivo makes it an appropriate system
for measuring the relative efficacies of opioid receptor
agonists.
[0176] Cell culture. C6(m) rat glioma cells (which lack endogenous
opioid receptors) which had been stably transfected with an opioid
receptor-expressing plasmid (Emmerson et al., 1996) are grown under
5% CO2 in Dulbecco's modified Eagle's medium containing 10% fetal
bovine serum. Stock flasks are maintained in the presence of 1
mg/ml Geneticin to select for the presence of the transfected
plasmid, which codes for both the opioid receptor and antibiotic
resistance. Cells used for experiments are split from the stock
flasks and grown to confluence in the absence of Geneticin.
[0177] Membrane preparation. Cells are rinsed twice with ice-cold
phosphate-buffered saline (0.9% NaCl, 0.61 mM Na2HPO4, 0.38 mM
KH2PO4, pH 7.4) and detached from dishes by incubation with lifting
buffer (5.6 mM glucose, 5 mM KCl, 5 mM HEPES, 137 mM NaCl, 1 mM
EGTA, pH 7.4). The cells are then pelleted by centrifugation,
resuspended in ice-cold lysis buffer (0.2 mM MgSO4, 0.38 mM KH2PO4,
0.61 mM Na2HPO4, pH 7.4) and homogenized using a glass-glass Dounce
homogenizer. Membranes are then isolated by centrifugation for 20
min at 20,000.times.g at 4.degree. C. The resulting membrane
pellets are resuspended in 50 mM Tris buffer (pH 7.4) and stored at
-80.degree. C. in 1-ml aliquots (approximately 1 mg
protein/ml).
[0178] Protein determination. Protein concentration in membrane
samples is determined by the method of Lowry et al. (1951), using
bovine serum albumin as a standard. Samples are solubilized by
incubation at room temperature in 0.5 N NaOH for 30 min before
protein determination.
[0179] [35S]GTP.gamma.S binding assay. Varying concentrations of
ligand are preincubated with membranes (15 mg membrane
protein/tube) for 2 hr at 25.degree. C. in binding cocktail [30 mM
GDP, 1 mM dithiothreitol, I mM EDTA, 5 mM MgCl2, 100 mM NaCl and 47
mM Tris (pH 7.4)] in a 200 ml final assay volume. Experiments are
initiated by the addition of [35S]GTP.gamma.S (final concentration
40 pM), which is added in a volume of 10 ul H.sub.2O, to minimize
any dilution of ligand and other reagents. After 1 min the reaction
is terminated by the addition of 2 ml ice-cold washing buffer (50
mM Tris, 5 mM MgCl2, 100 mM NaCl) and the contents of the tubes are
rapidly filtered through glass fiber filters (Schleicher &
Schuell no. 32, Keene, N.H.). The tubes and filters are then rinsed
with 2 ml washing buffer an additional three times. Filters are
placed in scintillation vials containing 400 ml ethanol and 4-ml
scintillation cocktail for liquid scintillation counting.
Nonspecific counts are determined from tubes which contained 100 nM
unlabeled GTP.gamma.S.
[0180] Inhibition of cAMP Accumulation. In this assay, cells
expressing opioid receptors (either endogenous or recombinant) are
first treated with agents which elevate intracellular cAMP (eg,
PGE1 or forskolin) after which test compounds are added to the
culture medium and intracellular cAMP is measured by
radioimmunoassay or ELISA (Yu et al, 1990, Blake, 1997).
Specifically, cell monolayers are treated for approximately 30 min
at 37.degree. C. with culture medium containing 0.5 mM
isobutylmethylxanthine. After treatment, the medium is replaced
with medium containing test compound at several different
concentrations (eg, 10-11 to 10-6 M) and incubated at 37.degree. C.
for 5 min. The medium is then aspirated, and 1 ml of 0.1 N HCl was
added; the cells are sonicated and the monolayers were frozen at
-20.degree. C. For determination of the cAMP content of each well,
the monolayers are thawed, placed on ice, sonicated, and the
intracellular cAMP levels measured by radioimmunoassay (Amersham
plc, Buckinghamshire, UK). Data obtained from the dose-response
curves is then analyzed by nonlinear regression (using GraphPad
Prism 2.01 from GraphPad Software, Inc., San Diego, Calif.) to
calculate agonist potency.
[0181] In Vivo Measurement of Analgesic Activity and Opioid Side
Effects
[0182] Determination of analgesic activity is well known to those
skilled in the art. Several methods recognized as characterizing
activity are listed below.
[0183] Tail Flick Test.
[0184] The method, which detects analgesic activity, follows that
described by D'Amour and Smith (1941). Briefly, a mouse's tail is
heated by means of a thermal light source or by immersion in hot
water. The latency before the animal withdraws its tail is measured
(with a maximum time of exposure to heat of 15 seconds). Opioids
are well known to significantly increase the latency to tail
withdrawal in this assay. In this assay the parent opioid is used
as the reference substance (eg, hydrocodone, oxycodone etc), and
the dose and pretreatment time for a test agent (eg, a quaternary
ammonium derivative) is dependent on the route of administration of
the test agent (could be oral, subcutaneous, intraperitoneal or
intrathecal).
[0185] Formalin Test
[0186] As described by Shibata et al (1989), 25 ul of 0.5% sterile
formalin was administered into the right hind paw of a mouse, which
elicits a characteristic, biphasic behavioral response. Each animal
was then returned to the chamber and pain response was recorded for
a period of 30 min. The summation of time (in seconds) spent
licking and biting the injected paw during each 5 minute block was
measured as an indicator of pain response. Test agents are
administered at various times and doses prior to formalin injection
via oral, subcutaneous, intraperitoneal or intrathecal routes. In
this assay, the parent opioid is used as the reference substance
(eg, hydrocodone, oxycodone etc), and the dose and pretreatment
time for a test agent (eg, a quaternary ammonium derivative of the
parent opioid) to exert analgesic activity is calculated relative
to the parent opioid.
[0187] An important side effect of chronic opioid use is
constipation. The method below describes how a compound of the
disclosed embodiments can be demonstrated to exhibit reduced
activity on gastrointestinal motility relative to the parent
opioid.
[0188] Gastrointestinal (GI) Transit.
[0189] For measurements of GI transit (Green, 1959), rats were fed
by oral gavage with 2 ml of a test meal consisting of 10% vegetable
charcoal in water. Five minutes afterwards animals were euthanized,
their small intestine was removed, its length was measured (from
the pyloric sphincter to the ileocecal junction) and the distance
traveled by the test meal was recorded as a percentage of the total
length (percentage of GI transit). The effect of test agents (eg,
quaternary ammonium derivative of parent opioid) on GI motility is
measured relative to the parent opioid as a reference, with either
substance being administered at various times prior to oral gavage
with the charcoal meal.
[0190] All publications, including but not limited to, issued
patents, patent applications, and journal articles, cited in this
application are each herein incorporated by reference in their
entirety.
[0191] Although the invention has been described above with
reference to the disclosed embodiments, those skilled in the art
will readily appreciate that the specific experiments detailed
below are only illustrative of the invention. It should be
understood that various modifications can be made without departing
from the spirit of the invention. Accordingly, the invention is
limited only by the claims.
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