Note: Descriptions are shown in the official language in which they were submitted.
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81271 pct.211
Novel pharmaceutical compositions comprising novel anticholinergic
agents and NK~ receptor antagonists
The present invention relates to novel pharmaceutical compositions based on
new anticholinergics and NK~ receptor antagonists, processes for preparing
them and their use in the treatment of respiratory complaints.
Description of the invention
The present invention relates to novel pharmaceutical compositions based on
new anticholinergics and NK~ receptor antagonists, processes for preparing
them and their use in the treatment of respiratory complaints.
Surprisingly, an unexpectedly beneficial therapeutic effect, particularly a
synergistic effect can be observed in the treatment of inflammatory andlor
obstructive diseases of the respiratory tract if one or more, preferably one,
new anticholinergic of formula 1 is used with one or more, preferably one, NK~
receptor antagonist 2. In view of this synergistic effect the pharmaceutical
combinations according to the invention can be used in smaller doses than
would be the case with the individual compounds used in monotherapy in the
usual way.
The combinations of active substances according to the invention are
surprisingly characterised both by a rapid onset of activity and also by a
long-
lasting duration of activity. This is very important to the patient's feeling
of
well-being, as on the one hand they experience a rapid improvement in their
condition once the combination has been administered and on the other hand
the drug need only be taken once a day, thanks to its long-lasting effects.
These effects are observed both when the active substances are
administered simultaneously within a single active substance formulation and
also when the two active substances are administered successively in
separate formulations. It is preferable according to the invention to
administer
the two active ingredients simultaneously in a single formulation.
Within the scope of the present invention the anticholinergics used are the
salts of formula 1
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Men+~Me
N
O H
O O
Me
1
wherein
X - denotes an anion with a single negative charge, preferably an
anion selected from the group consisting of chloride, bromide,
iodide, sulphate, phosphate, methanesulphonate, nitrate,
maleate, acetate, citrate, fumarate, tartrate, oxalate, succinate,
benzoate and p-toluenesulphonate.
Preferably, the salts of formula 1 are used wherein
X - denotes an anion with a single negative charge selected from
the group consisting of chloride, bromide, 4-toluenesulphonate
and methanesulphonate, preferably bromide.
Most preferably, the salts of formula 1 are used wherein
X - denotes an anion with a single negative charge selected from
the group consisting of chloride, bromide and
methanesulphonate, preferably bromide.
Particularly preferred according to the invention is the salt of formula 1
wherein
X - denotes bromide.
The salts of formula 1 are known from International Patent Application WO
02/32899.
Within the scope of the present patent application, an explicit reference to
the
pharmacologically active cation of formula
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can be recognised by the use of the designation 1'. Any reference to
compounds 1 naturally includes a reference to the cation 1'.
Any reference within the scope of the present invention to the salts 1 which
may be used according to the invention also includes any hydrates and
solvates of these compounds which may be obtainable.
Within the scope of the present invention the term NK~ receptor antagonists
(hereinafter 2) preferably denotes those compounds which are selected from
among N-[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-{4-cyclopropylmethyl-
piperazin-1-yl}-N-methyl-2-phenyl-acetamide (BIIF 1149), CP-122721, FK-
888, NKP 608C, NKP 608A, CGP 60829, SR 48968(Saredutant), SR 140333
(Nolpitantium besilatelchloride), LY 303 870 (Lanepitant), MEN-11420
(Nepadutant), SB 223412, MDL-105172A, MDL-103896, MEN-11149, MEN-
11467, DNK 333A, SR-144190, YM-49244, YM-44778, ZM-274773, MEN-
10930, S-19752, Neuronorm, YM-35375, DA-5018, Aprepitant (MK-869), L-
754030, CJ-11974, L-758298, DNK-33A, 6b-I, CJ-11974, TAK-637, GR
205171 and the arylglycinamide derivatives of general formula 3
CF3
R' p I \
R2~N N ~ CF3
Me
3
wherein
R1 and R2 together with the N to which they are bound form a
ring of formula
Men+~Me
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/(CH2)2 \
Rs-N~ N_
(CH2)r ~
R \ / (CH2)2 \
C N_
R$ / ~ (CH2)S i
wherein r and s are 2 or 3;
R6 denotes H, -C~-C5-alkyl, Cg-C5-alkenyl, propynyl,
hydroxy(C2-C4)alkyl, methoxy(C2-C4)alkyl,
di(C~-C3)alkylamino(C2-C4)alkyl, amino(C2-Cq.)alkyl, amino,
di(C~-C3)alkylamino, monofluoro- to perfluoro(C~-C2)alkyl,
N-methylpiperidinyl, pyridyl, pyrimidinyl, pyrazinyl or pyridazinyl,
R7 has one of the meanings (a) to (d),
(a) hydroxy
(b) 4-piperidinopiperidyl,
(c)
R~s
-N
~R~7
wherein R~ 6 and R~ 7 independently of each other denote H,
(C~-C4)alkyl, (Cg-Cg)cycloalkyl, hydroxy(C2-C4)alkyl,
dihydroxy(C2-C4)alkyl, (C~-C3)alkoxy(C2-Cq.)alkyl,
phenyl(C~-Cq.)alkyl or di(C~-C3)alkylamino(C2-Cq,)alkyl,
R$ denotes H,
optionally in the form of the enantiomers and mixtures of
enantiomers thereof, optionally in the form of the racemates
thereof.
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The abovementioned compounds of formula 3 are known for example from
International Patent Applications WO 96/32386, WO 97/32865 and WO
02132865, to which reference is hereby made in their entirety.
Preferably, the compound 2 is selected from among BIIF 1149, CP-122721,
CGP 60829, MK-869, CJ-11974, GR 205171 and the arylglycinamide
derivatives of general formula 3, wherein
R1 and R2 together with the N to which they are bound form a
ring of formula
/ (CH2)2 \
C N_
R$ / ~ (CH2)S i
wherein s is 2 or 3;
R7 denotes a group
R~ s
-N
~R~7
wherein R16 and R17 independently of each other denote H,
(C1-C4)alkyl, (C3-Cg)cycloalkyl, hydroxy(C2-C4)alkyl,
dihydroxy(C2-C4)alkyl, (C1-C3)alkoxy(C2-C4~Ikyl,
phenyl(C1-C4)alkyl or di(C1-C3)alkylamino(C2-C4)alkyl,
R8 denotes H,
optionally in the form of the enantiomers and mixtures of
enantiomers thereof and optionally in the form of the racemates
thereof.
Particularly preferably, the compound 2 is selected from among BIIF1149 and
the arylglycinamide derivatives of general formula 3, wherein
R1 and R2 together with the N to which they are bound form a
ring of formula
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/ (CH2)2 \
C N_
R8 / ~ (CH2)S i
wherein s is 2 and
R7 denotes a group
R~s
-N
~R~7
wherein R16 and R1 ~ independently of each other denote H,
(C1-C4)alkyl, (C3-C6)cycloalkyl, hydroxy(C2-C4)alkyl or
dihydroxy(C2-C4)alkyl,
R$ denotes H,
optionally in the form of the enantiomers and mixtures of
enantiomers thereof and optionally in the form of the racemates
thereof.
Most particularly preferred as compounds of formula 2 are N-[2-
(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-(4-[(3-hydroxy-propyl)-
methyl-amino]-piperidin-1-yl}-N-methyl-2-phenyl-acetamide, N-
[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-[4-(2-hydroxy-1-
hydroxymethyl-ethylamino)-piperidin-1-yl]-N-methyl-2-
phenylacetamide, N-[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-
[4-(cyclopropylmethyl-methyl-amino)-piperidin-1-yl]-N-methyl-2-
phenyl-acetamide, N-[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-
{4-[(2-hydroxy-ethyl)-(3-hydroxy-propyl)-amino]-piperidin-1-yl}-
N-methyl-2-phenyl-acetamide and N-[2-(3,5-bis-trifluoromethyl-
phenyl)-ethyl]-2-(4-[cyclopropylmethyl-(3-hydroxy-propyl)-
amino]-piperidin-1-yl}-N-methyl-2-phenyl-acetamide,
optionally in the form of the enantiomers and mixtures of
enantiomers thereof and optionally in the form of the racemates
thereof.
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Of particular importance is N-[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-[4-
(2-
hydroxy-1-hydroxymethyl-ethylamino)-piperidin-1-yl]-N -methyl-2-
phenylacetamide, optionally in the form of its enantiomers, preferably in the
form of its (S)-enantiomer, optionally in the form of the mixtures of
enantiomers thereof, and optionally in the form of the racemates thereof.
Examples of alkyl groups (including those which are part of other groups),
unless otherwise defined, are branched and unbranched alkyl groups with 1 to
carbon atoms, such as, for example: methyl, ethyl, propyl, 1-methylethyl
(isopropyl), n-butyl, 1-methylpropyl, 2-methylpropyl, 1,1-dimethylethyl
(tert.butyl), etc. The definitions propyl, butyl and pentyl always include the
associated isomeric groups. Hydroxy or dihydroxyalkyl groups are alkyl
groups substituted by one or two hydroxy groups.
Examples of alkenyl groups (including those which are part of other groups)
are branched and unbranched alkenyl groups with 3 to 5 carbon atoms,
provided that they have at least one double bond, such as, for example,
propenyl, isopropenyl, butenyl, etc.
Cycloalkyl generally denotes a saturated cyclic hydrocarbon group having 3 to
6 carbon atoms. Examples include cyclopropyl, cyclobutyl, cyclopentyl,
cyclohexyl, cyclopropylmethyl, cyclobutylmethyl, cyclopentylmethyl,
cyclopropylethyl, cyclobutylethyl, etc.
Alkyloxy, which may optionally also be referred to as alkoxy, denotes a
straight-chain or branched alkyl group bound via an oxygen atom. The
methoxy group is particularly preferred.
Any reference to the abovementioned NK1-receptor antagonists 2 within the
scope of the present invention includes a reference to any pharmacologically
acceptable acid addition salts thereof which may exist.
By the physiologically acceptable acid addition salts which may be formed
from 2 are meant, for example, pharmaceutically acceptable salts selected
from the salts of hydrochloric acid, hydrobromic acid, sulphuric acid,
phosphoric acid, methanesulphonic acid, acetic acid, fumaric acid, succinic
acid, lactic acid, citric acid, tartaric acid or malefic acid. Particularly
preferred
salts of the compounds 2 according to the invention are those selected from
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among the acetate, hydrochloride, hydrobromide, sulphate, phosphate and
methanesulphonate.
The pharmaceutical combinations of 1 and 2 according to the invention are
preferably administered by inhalation. Suitable inhalable powders packed into
suitable capsules (inhalettes) may be administered using suitable powder
inhalers. Alternatively, the drug may be inhaled by the application of
suitable
inhalation aerosols. These also include powdered inhalation aerosols which
contain for example HFA134a, HFA227 or a mixture thereof as propellant gas.
The drug may also be inhaled using suitable solutions of the pharmaceutical
combination consisting of 1 and 2.
In one aspect, therefore, the invention relates to a pharmaceutical
composition which contains a combination of 1 and 2.
In another aspect the present invention relates to a pharmaceutical
composition which contains one or more salts 1 and one or more compounds
2, optionally in the form of their solvates or hydrates. The active substances
may be combined in a single preparation or contained in two separate
formulations. Pharmaceutical compositions which contain the active
substances 1 and 2 in a single preparation are preferred according to the
invention.
In another aspect the present invention relates to a pharmaceutical
composition which contains, in addition to therapeutically effective
quantities
of 1 and 2, a pharmaceutically acceptable carrier or excipient. In another
aspect the present invention relates to a pharmaceutical composition which
does not contain any pharmaceutically acceptable excipient in addition to
therapeutically effective quantities of 1 and 2.
The present invention also relates to the use of 1 and 2 for preparing a
pharmaceutical composition containing therapeutically effective quantities of
1
and 2 for treating inflammatory or obstructive diseases of the respiratory
tract,
particularly asthma or chronic obstructive pulmonary disease (COPD), as well
as complications thereof such as pulmonary hypertension, as well as allergic
and non-allergic rhinitis, provided that treatment with NK~ receptor
antagonists
is not contraindicated from a therapeutic point of view, by simultaneous or
successive administration.
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The present invention also relates to the simultaneous or successive use of
therapeutically effective doses of the combination of the above
pharmaceutical compositions 1 and 2 for treating inflammatory and/or
obstructive diseases of the respiratory tract, particularly asthma or chronic
obstructive pulmonary disease (COPD), as well as complications thereof such
as pulmonary hypertension, as well as allergic and non-allergic rhinitis,
provided that treatment with NK~ receptor antagonists is not contraindicated
from a therapeutic point of view, by simultaneous or successive
administration.
In the active substance combinations of 1 and 2 according to the invention,
ingredients 1 and 2 may be present in the form of their enantiomers, mixtures
of enantiomers or in the form of racemates.
The proportions in which the two active substances 1 and 2 may be used in
the active substance combinations according to the invention are variable.
Active substances 1 and 2 may possibly be present in the form of their
solvates or hydrates. Depending on the choice of the compounds 1 and 2,
the weight ratios which may be used within the scope of the present invention
vary on the basis of the different molecular weights of the various compounds
and their different potencies. As a rule, the pharmaceutical combinations
according to the invention may contain compounds 1 and 2 in ratios by weight
ranging from 1:100 to 100:1, preferably from 1:80 to 80:1.
In the particularly preferred pharmaceutical combinations which contain in
addition to a compound of formula 1 a compound selected from among BIIF
1149, CGP 60829, MK-869, CJ-11974, GR 205171, N-[2-(3,5-bis-
trifluoromethyl-phenyl)-ethyl]-2-{4-[(3-hydroxy-propyl)-methyl-amino]-
piperidin-
1-yl}-N-methyl-2-phenyl-acetamide, N-[2-(3,5-bis-trifluoromethyl-phenyl)-
ethyl]-2-[4-(2-hydroxy-1-hydroxymethyl-ethylamino)-piperidin-1-yl]-N-methyl-2-
phenylacetamide, N-[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-[4-
(cyclopropylmethyl-methyl-amino)-piperidin-1-yl]-N-methyl-2-phenyl-
acetamide, N-[2-(3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-{4-[(2-hydroxy-
ethyl)-
(3-hydroxy-propyl)-amino]-piperidin-1-yl}-N-methyl-2-phenyl-acetamide and N-
[2-{3,5-bis-trifluoromethyl-phenyl)-ethyl]-2-(4-[cyclopropylmethyl-(3-hydroxy-
propyl)-amino]-piperidin-1-yl}-N-methyl-2-phenyl-acetamide as well as the
arylglycinamide derivatives of formula 3 as NK~ receptor antagonists 2, the
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weight ratios of 1 to 2 are preferably in a range wherein 1' and 2 are present
in proportions ranging from 1:50 to 50:1, more preferably from 1:20 to 20:1.
For example, without restricting the scope of the invention thereto, preferred
combinations of 1 and 2 according to the invention may contain the cation 1'
and NK1 receptor antagonists 2 in the following weight ratios:
1:50; 1:49; 1:48; 1:47; 1:46; 1:45; 1:44; 1:43; 1:42; 1:41; 1:40; 1:39; 1:38;
1:37; 1:36; 1:35; 1:34; 1:33; 1:32; 1:31; 1:30; 1:29; 1:28; 1:27; 1:26; 1:25;
1:24; 1:23; 1:22; 1:21; 1:20; 1:19; 1:18; 1:17; 1:16; 1:15; 1:14; 1:13; 1:12;
1:11;1:10;1:9;1:8;1:7;1:6;1:5;1:4;1:3;1:2;1:1;2:1;3:1;4:1;5:1;6:1;7:1;
8:1; 9:1; 10:1; 11:1; 12:1; 13:1; 14:1; 15:1; 16:1; 17:1; 18:1; 19:1; 20:1.
The pharmaceutical compositions according to the invention containing the
combinations of 1 and 2 are normally used so that 1 and 2 are present
together in doses from 0.01 bis 10000pg, preferably from 0.1 to 2000Ng, more
preferably from 1 to 1500Ng, most preferably from 50 to 1200Ng per single
dose. For example, combinations of 1 and 2 according to the invention
contain an amount of 1' and NK~ receptor antagonist 2 such that the total
dosage per single dose is 100Ng, 105Ng, 11 ONg, 115Ng, 120pg, 125pg,
130Ng, 135pg, 140Ng, 145pg, 150Ng, 155pg, 160~g, 165Ng, 170Ng, 175Ng,
180Ng, 185pg, 190Ng, 195pg, 200Ng, 205Ng, 210pg, 215Ng, 220Ng, 225pg,
230Ng, 235Ng, 240Ng, 245Ng, 250Ng, 255pg, 260pg, 265Ng, 270pg, 275pg,
280Ng, 285~g, 290Ng, 295Ng, 300Ng, 305Ng, 310Ng, 315Ng, 320Ng, 325Ng,
330Ng, 335Ng, 340Ng, 345Ng, 350pg, 355~g, 360pg, 365pg, 370pg, 375Ng,
380pg, 385pg, 390Ng, 395Ng, 400~g, 405pg, 410Ng, 415~g, 420Ng, 425Ng,
430Ng, 435Ng, 440Ng, 445~g, 450pg, 455pg, 460Ng, 465pg, 470Ng, 475pg,
480Ng, 485Ng, 490Ng, 495~g, 500pg, 505ug, 510Ng, 515pg, 520Ng, 525Ng,
530pg, 535pg, 540pg, 545~g, 550Ng, 555Ng, 560Ng, 565pg, 570pg, 575Ng,
580pg, 585~g, 590Ng, 595pg, 600Ng, 605Ng, 610Ng, 615Ng, 620pg, 625pg,
630Ng, 635pg, 640Ng, 645pg, 650Ng, 655Ng, 660pg, 665Ng, 670pg, 675pg,
680Ng, 685ug, 690Ng, 695Ng, 700pg, 705pg, 710pg, 715pg, 720~g, 725pg,
730~g, 735Ng, 740Ng, 745Ng, 750pg, 755Ng, 760Ng, 765pg, 770Ng, 775Ng,
780pg, 785pg, 790Ng, 795pg, 800~g, 805pg, 810pg, 815~g, 820Ng, 825pg,
830pg, 835Ng, 840Ng, 845~g, 850pg, 855pg, 860Ng, 865pg, 870Ng, 875Ng,
880Ng, 885pg, 890Ng, 895Ng, 900pg, 905Ng, 910~g, 915pg, 920Ng, 925pg,
930pg, 935Ng, 940Ng, 945Ng, 950pg, 955Ng, 960Ng, 965Ng, 970~g, 975Ng,
980pg, 985Ng, 990Ng, 995Ng, 1000Ng, 1005Ng, 1010Ng, 1015~g, 1020Ng,
1025pg, 1030Ng, 1035Ng, 1040pg, 1045pg, 1050Ng, 1055~g, 1060Ng,
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1065pg, 1070Ng, 1075~g, 1080Ng, 1085Ng, 1090pg, 1095pg, 1100pg or the
like. These proposed dosages per single dose are not to be regarded as
being restricted to the numerical values explicitly mentioned but are merely
disclosed by way of example. Obviously, dosages which fluctuate around
these values within a range of about +I- 2.5Ng are also covered by the values
mentioned by way of example. In these dosage ranges the active substances
1' and 2 may be present in the weight ratios described above.
For example and without restricting the scope of the invention thereto, the
combinations of 1 and 2 according to the invention may contain an amount of
1' and NK~ receptor antagonist 2 such that 16.5Ng of 1' and 25pg of 2, 16.5Ng
of 1' and 25pg of 2, 16.5Ng of 1' and 50pg of 2, 16.5~g of 1' and 100Ng of 2,
16.5Ng of 1' and 200~g of 2, 16.5pg of 1' and 300pg of 2, 16.5pg of 1' and
400Ng of 2, 16.5Ng of 1' and 500Ng of 2, 16.5Ng of 1' and 600Ng of 2, 16.5Ng
of 1' and 700Ng of 2, 16.5Ng of 1' and 800Ng of 2, 16.5Ng of 1' and 900Ng of
2, 16.5Ng of 1' and 1000pg of 2, 33.1 ~g of 1' and 25Ng of 2, 33.1 Ng of 1'
and
50pg of 2, 33.1 erg of 1' and 100pg of 2, 33.1 Ng of 1' and 200pg of 2, 33.1
Ng of
1' and 300Ng of 2, 33.1 Ng of 1' and 400~g of 2, 33.1 Ng of 1' and 500~g of 2,
33.1 pg of 1' and 600pg of 2, 33.1 pg of 1' and 700~g of 2, 33.1 ~g of 1' and
800pg of 2, 33.1 Ng of 1' and 900~g of 2, 33.1 Ng of 1' and 1000pg of 2,
49.5Ng
of 1' and 25Ng of 2, 49.5Ng of 1' and 50pg of 2, 49.5~g of 1' and 100Ng of 2,
49.5ug of 1' and 200Ng of 2, 49.5pg of 1' and 300Ng of 2, 49.5Ng of 1' and
400pg of 2, 49.5Ng of 1' and 500Ng of 2, 49.5pg of 1' and 600pg of 2, 49.5Ng
of 1' and 700Ng of 2, 49.5Ng of 1' and 800pg of 2, 49.5Ng of 1' and 900pg of
2, 49.5pg of 1' and 1000pg of 2, 82.6Ng of 1' and 25Ng of 2, 82.6Ng of 1' and
50Ng of 2, 82.6Ng of 1' and 1 OOUg of 2, 82.6Ng of 1' and 200pg of 2, 82.6Ng
of
1' and 300pg of 2, 82.6Ng of 1' and 400pg of 2, 82.6Ng of 1' and 500pg of 2,
82.6~g of 1' and 600Ng of 2, 82.6~g of 1' and 700~g of 2, 82.6pg of 1' and
800Ng of 2, 82.6pg of 1' and 900pg of 2, 82.6~g of 1' and 1000pg of 2,
165.1 Ng of 1' and 25pg of 2, 165.1 Ng of 1' and 50pg of 2, 165.1 Ng of 1' and
100Ng of 2, 165.1 pg of 1' and 200~g of 2, 165.1 pg of 1' and 300Ng of 2,
165.1 Ng of 1' and 400ug of 2, 165.1 pg of 1' and 500~g of 2, 165.1 Ng of 1'
and
600~g of 2, 165.1 Ng of 1' and 700Ng of 2, 165.1 Ng of 1' and 800Ng of 2,
165.1 Ng of 1' and 900pg of 2, 165.1 Ng of 1' and 1 OOOpg of 2, 206.4~g of 1'
and 25Ng of 2, 206.4Ng of 1' and 50Ng of 2, 206.4Ng of 1' and 100Ng of 2,
206.4Ng of 1' and 200Ng of 2, 206.4Ng of 1' and 300Ng of 2, 206.4Ng of 1' and
400Ng of 2, 206.4Ng of 1' and 500pg of 2 or 206.4pg of 1' and 600Ng of 2,
206.4Ng of 1' and 700pg of 2, 206.4Ng of 1' and 800Ng of 2, 206.4Ng of 1' and
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900pg of 2, 206.4Ng of 1' and 1000Ng of 2, 412.8Ng of 1' and 25pg of 2,
412.8Ng of 1' and 50Ng of 2, 412.8pg of 1' and 100pg of 2, 412.8Ng of 1' and
200pg of 2, 412.8pg of 1' and 300pg of 2, 412.8Ng of 1' and 400pg of 2,
412.8Ng of 1' and 500pg of 2 or 412.8Ng of 1' and 600Ng of 2, 412.8pg of 1'
and 700Ng of 2, 412.8Ng of 1' and 800pg of 2, 412.8pg of 1' and 900pg of 2,
412.8Ng of 1' and 1000pg of 2 are administered per single dose.
If the active substance combination wherein 1 denotes the bromide is used as
the preferred combination of 1 and 2 according to the invention, the
quantities
of active substances 1' and 2 administered per single dose as specified by
way of example correspond to the following quantities of 1 and 2 administered
per single dose: 20pg of 1 and 25Ng of 2, 20Ng of 1 and 50ug of 2, 20ug of 1
and 100Ng of 2, 20pg of 1 and 200pg of 2, 20Ng of 1 and 300Ng of 2, 20pg of
1 and 400pg of 2, 20pg of 1 and 500Ng of 2, 20pg of 1 and 600pg of 2, 20Ng
of 1 and 700Ng of 2, 20pg of 1 and 800Ng of 2, 20Ng of 1 and 900Ng of 2,
20Ng of 1 and 1000Ng of 2, 40Ng of 1 and 25pg of 2, 40Ng of 1 and 50pg of 2,
40pg of 1 and 100Ng of 2, 40pg of 1 and 200Ng of 2, 40pg of 1 and 300Ng of
2, 40Ng of 1 and 400pg of 2, 40pg of 1 and 500pg of 2, 40Ng of 1 and 600Ng
of 2, 40ug of 1 and 700pg of 2, 40Ng of 1 and 800pg of 2, 40pg of 1 and
900pg of 2, 40Ng of 1 and 1000ug of 2, 60Ng of 1 and 25Ng of 2, 60pg of 1
and 50pg of 2, 60Ng of 1 and 100pg of 2, 60pg of 1 and 200Ng of 2, 60pg of 1
and 300pg of 2, 60Ng of 1 and 400pg of 2, 60pg of 1 and 500pg of 2, 60Ng of
1 and 600Ng of 2, 60pg of 1 and 700pg of 2, 60ug of 1 and 800Ng of 2, 60pg
of 1 and 900Ng of 2, 60pg of 1 and 1 OOONg of 2, 100ug of 1 and 25pg of 2,
100pg of 1 and 50Ng of 2, 100pg of 1 and 100pg of 2, 100pg of 1 and 200Ng
of 2, 100Ng of 1 and 300Ng of 2, 100pg of 1 and 400pg of 2, 100Ng of 1 and
500pg of 2, 100pg of 1 and 600Ng of 2, 100Ng of 1 and 700Ng of 2, 1 OONg of 1
and 800Ng of 2, 100pg of 1 and 900pg of 2, 100Ng of 1 and 1000Ng of 2,
200pg of 1 and 25Ng of 2, 200pg of 1 and 50Ng of 2, 200Ng of 1 and 100pg of
2, 200Ng of 1 and 200Ng of 2, 200Ng of 1 and 300pg of 2, 200Ng of 1 and
400pg of 2, 200Ng of 1 and 500Ng of 2, 200pg of 1 and 600Ng of 2, 200Ng of 1
and 700pg of 2, 200Ng of 1 and 800Ng of 2, 200pg of 1 and 900pg of 2, 200Ng
of 1 and 1000pg of 2, 250pg of 1 and 25pg of 2, 250pg of 1 and 50pg of 2,
250Ng of 1 and 100Ng of 2, 250pg of 1 and 200Ng of 2, 250Ng of 1 and 300pg
of 2, 250pg of 1 and 400Ng of 2, 250Ng of 1 and 500Ng of 2, 250Ng of 1 and
600Ng of 2, 250pg of 1 and 700pg of 2, 250Ng of 1 and 800Ng of 2, 250pg of 1
and 900Ng of 2, 250pg of 1 and 1000Ng of 2, 500Ng of 1 and 25pg of 2, 500pg
of 1 and 50pg of 2, 500~rg of 1 and 100Ng of 2, 500Ng of 1 and 200Ng of 2,
CA 02491451 2004-12-31
W0.20041004724 13 PCTlEP20031006667
500pg of 1 and 300Ng of 2, 500Ng of 1 and 400Ng of 2, 500pg of 1 and 500Ng
of 2, 500pg of 1 and 600Ng of 2, 500Ng of 1 and 700pg of 2, 500pg of 1 and
800pg of 2, 500pg of 1 and 900Ng of 2 or 500Ng of 1 and 1000pg of 2.
The active substance combinations of 1 and 2 according to the invention are
preferably administered by inhalation. For this purpose, ingredients 1 and 2
have to be made available in forms suitable for inhalation. Inhalable
preparations include inhalable powders, propellant-containing metering
aerosols or propellant-free inhalable solutions. Inhalable powders according
to the invention containing the combination of active substances 1 and 2 may
consist of the active substances on their own or of a mixture of the active
substances with physiologically acceptable excipients. Within the scope of
the present invention, the term propellant-free inhalable solutions also
includes concentrates or sterile inhalable solutions ready for use. The
preparations according to the invention may contain the combination of active
substances 1 and 2 either together in one formulation or in two or three
separate formulations. These formulations which may be used within the
scope of the present invention are described in more detail in the next part
of
the specification.
A) Inhalable powder containing the combinations of active substances 1
and 2 according to the invention:
The inhalable powders according to the invention may contain 1 and 2 either
on their own or in admixture with suitable physiologically acceptable
excipients.
If the active substances 1 and 2 are present in admixture with physiologically
acceptable excipients, the following physiologically acceptable excipients may
be used to prepare these inhalable powders according to the invention:
monosaccharides (e.g. glucose or arabinose), disaccharides (e.g. lactose,
saccharose, maltose, trehalose), oligo- and polysaccharides (e.g. dextran),
polyalcohols (e.g. sorbitol, mannitol, xylitol), salts (e.g. sodium chloride,
calcium carbonate) or mixtures of these excipients. Preferably, mono- or
disaccharides are used, while the use of lactose or glucose is preferred,
particularly, but not exclusively, in the form of their hydrates. For the
purposes
of the invention, lactose is the particularly preferred excipient, while
lactose
monohydrate is most particularly preferred.
CA 02491451 2004-12-31
WO X0041004724 14 PCTIEP2003/006667
Within the scope of the inhalable powders according to the invention the
excipients have a maximum average particle size of up to 250~rm, preferably
between 10 and 150Nm, most preferably between 15 and 80Nm. It may
sometimes seem appropriate to add finer excipient fractions with an average
particle size of 1 to 9pm to the excipient mentioned above. These finer
excipients are also selected from the group of possible excipients listed
hereinbefore. Finally, in order to prepare the inhalable powders according to
the invention, micronised active substance 1 and 2, preferably with an
average particle size of 0.5 to 1 O~m, more preferably from 1 to 6~,m, is
added
to the excipient mixture. Processes for producing the inhalable powders
according to the invention by grinding and micronising and by finally mixing
the ingredients together are known from the prior art. The inhalable powders
according to the invention may be prepared and administered either in the
form of a single powder mixture which contains both 1 and 2 or in the form of
separate inhalable powders which contain only 1 or 2.
The inhalable powders according to the invention may be administered using
inhalers known from the prior art. Inhalable powders according to the
invention which contain a physiologically acceptable excipient in addition to
1
and 2 may be administered, for example, by means of inhalers which deliver a
single dose from a supply using a measuring chamber as described in
US 4570630A, or by other means as described in DE 36 25 685 A. Preferably,
the inhalable powders according to the invention which contain physiologically
acceptable excipients in addition to 1 and 2 are packed into capsules (to
produce so-called inhalettes) which are used in inhalers as described, for
example, in WO 94/28958.
A particularly preferred inhaler for using the pharmaceutical combination
according to the invention in inhalettes is shown in Figure 1.
This inhaler (Handyhaler) for inhaling powdered pharmaceutical compositions
from capsules is characterised by a housing 1 containing two windows 2, a
deck 3 in which there are air inlet ports and which is provided with a screen
5
secured via a screen housing 4, an inhalation chamber 6 connected to the
deck 3 on which there is a push button 9 provided with two sharpened pins 7
and movable counter to a spring 8, and a mouthpiece 12 which is connected
to the housing 1, the deck 3 and a cover 11 via a spindle 10 to enable it to
be
~
CA 02491451 2004-12-31
WO 20041004724 15 PCTIEP20031006667
flipped open or shut, as well as air through-holes 13 for adjusting the flow
resistance.
If the inhalable powders according to the invention are to be packed into
capsules (inhalettes) for the preferred use described above, the quantities
packed into each capsule should be 1 to 30mg, preferably 3 to 20mg, more
particularly 5 to 10mg of inhalable powder per capsule. These capsules
contain, according to the invention, either together or separately, the doses
of
1' and 2 mentioned hereinbefore for each single dose.
B) Propellant gas-driven inhalation aerosols containing the
combinations of active substances 1 and 2 according to the invention:
Inhalation aerosols containing propellant gas according to the invention may
contain 1 and 2 dissolved in the propellant gas or in dispersed form. 1 and 2
may be present in separate formulations or in a single preparation, in which 1
and 2 are either both dissolved, both dispersed or only one component is
dissolved and the other is dispersed. The propellant gases which may be
used to prepare the inhalation aerosols according to the invention are known
from the prior art. Suitable propellant gases are selected from among
hydrocarbons such as n-propane, n-butane or isobutane and
halohydrocarbons such as chlorinated andlor fluorinated derivatives of
methane, ethane, propane, butane, cyclopropane or cyclobutane. The
propellant gases mentioned above may be used on their own or in mixtures
thereof. Particularly preferred propellant gases are halogenated alkane
derivatives selected from TG11, TG12, TG134a and TG227. Of the
abovementioned halogenated hydrocarbons, TG 134a (1,1,1,2-
tetrafluoroethane) and TG227 (1,1,1,2,3,3,3-heptafluoropropane) and
mixtures thereof are preferred according to the invention.
The propellant-driven inhalation aerosols according to the invention may also
contain other ingredients such as co-solvents, stabilisers, surfactants,
antioxidants, lubricants and pH adjusters. All these ingredients are known in
the art.
The inhalation aerosols containing propellant gas according to the invention
may contain up to 5 wt.-% of active substance 1 andlor 2. Aerosols
according to the invention contain, for example, 0.002 to 5 wt.-%, 0.01 to
CA 02491451 2004-12-31
WO 20041004724 16 PCTlEP20031006667
3 wt.-%, 0.015 t0 2 wt.-%, 0.1 to 2 wt.-%, 0.5 to 2 wt.-% or 0.5 to 1 wt.-% of
active substance 1 and/or 2.
If the active substances 1 andlor 2 are present in dispersed form, the
particles of active substance preferably have an average particle size of up
to
1 O~.m, preferably from 0.1 to 5wm, more preferably from 1 to 5~,m.
The propellant-driven inhalation aerosols according to the invention
mentioned above may be administered using inhalers known in the art (MDIs
= metered dose inhalers). Accordingly, in another aspect, the present
invention relates to pharmaceutical compositions in the form of propellant-
driven aerosols as hereinbefore described combined with one or more
inhalers suitable for administering these aerosols. In addition, the present
invention relates to inhalers which are characterised in that they contain the
propellant gas-containing aerosols described above according to the
invention. The present invention also relates to cartridges which are fitted
with a suitable valve and can be used in a suitable inhaler and which contain
one of the above-mentioned propellant gas-containing inhalation aerosols
according to the invention. Suitable cartridges and methods of filling these
cartridges with the inhalable aerosols containing propellant gas according to
the invention are known from the prior art.
C~ Propellant-free inhalable solutions or suspensions containing the
combinations of active substances 1 and 2 according to the invention:
It is particularly preferred to use the active substance combination according
to the invention in the form of propellant-free inhalable solutions and
suspensions. The solvent used may be an aqueous or alcoholic, preferably
an ethanolic solution. The solvent may be water on its own or a mixture of
water and ethanol. The relative proportion of ethanol compared with water is
not limited but the maximum is up to 70 percent by volume, more particularly
up to 60 percent by volume and most preferably up to 30 percent by volume.
The remainder of the volume is made up of water. The solutions or
suspensions containing 1 and 2, separately or together, are adjusted to a pH
of 2 to 7, preferably 2 to 5, using suitable acids. The pH may be adjusted
using acids selected from inorganic or organic acids. Examples of particularly
suitable inorganic acids include hydrochloric acid, hydrobromic acid, nitric
acid, sulphuric acid andlor phosphoric acid. Examples of particularly suitable
organic acids include ascorbic acid, citric acid, malic acid, tartaric acid,
malefic
CA 02491451 2004-12-31
WO 2004!004724 17 PCTJEP20031006667
acid, succinic acid, fumaric acid, acetic acid, formic acid and/or propionic
acid
etc. Preferred inorganic acids are hydrochloric and sulphuric acids. It is
also
possible to use the acids which have already formed an acid addition salt with
one of the active substances. Of the organic acids, ascorbic acid, fumaric
acid and citric acid are preferred. If desired, mixtures of the above acids
may
be used, particularly in the case of acids which have other properties in
addition to their acidifying qualities, e.g. as flavourings, antioxidants or
complexing agents, such as citric acid or ascorbic acid, for example.
According to the invention, it is particularly preferred to use hydrochloric
acid
to adjust the pH.
According to the invention, the addition of editic acid (EDTA) or one of the
known salts thereof, sodium edetate, as stabiliser or complexing agent is
unnecessary in the present formulation. Other embodiments may contain this
compound or these compounds. In a preferred embodiment the content
based on sodium edetate is less than 100 mg/100m1, preferably less than
50mg1100m1, more preferably less than 20mg/100m1. Generally, inhalable
solutions in which the content of sodium edetate is from 0 to 10mg1100m1 are
preferred.
Co-solvents andlor other excipients may be added to the propellant-free
inhalable solutions according to the invention. Preferred co-solvents are
those which contain hydroxyl groups or other polar groups, e.g. alcohols -
particularly isopropyl alcohol, glycols - particularly propyleneglycol,
polyethyleneglycol, polypropyleneglycol, glycolether, glycerol,
polyoxyethylene alcohols and polyoxyethylene fatty acid esters. The terms
excipients and additives in this context denote any pharmacologically
acceptable substance which is not an active substance but which can be
formulated with the active substance or substances in the pharmacologically
suitable solvent in order to improve the qualitative properties of the active
substance formulation. Preferably, these substances have no
pharmacological effect or, in connection with the desired therapy, no
appreciable or at least no undesirable pharmacological effect. The excipients
and additives include, for example, surfactants such as soya lecithin, oleic
acid, sorbitan esters, such as polysorbates, polyvinylpyrrolidone, other
stabilisers, complexing agents, antioxidants andlor preservatives which
guarantee or prolong the shelf life of the finished pharmaceutical
formulation,
flavourings, vitamins and/or other additives known in the art. The additives
CA 02491451 2004-12-31
WO 20041004724 1 8 PCT/EP20031006667
also include physiologically acceptable salts such as sodium chloride as
isotonic agents.
The preferred excipients include antioxidants such as ascorbic acid, for
example, provided that it has not already been used to adjust the pH, vitamin
A, vitamin E, tocopherols and similar vitamins and provitamins occurring in
the
human body.
Preservatives may be used to protect the formulation from contamination with
pathogens. Suitable preservatives are those which are known in the art,
particularly cetyl pyridinium chloride, benzalkonium chloride or benzoic acid
or
benzoates such as sodium benzoate in the concentration known from the
prior art. The preservatives mentioned above are preferably present in
concentrations of up to 50mgI100m1, more preferably between 5 and
20mgI100m1.
Preferred formulations contain, in addition to the solvent water and the
combination of active substances 1 and 2, only benzalkonium chloride and
sodium edetate. In another preferred embodiment, no sodium edetate is
present.
The propellant-free inhalable solutions according to the invention are
administered in particular using inhalers of the kind which are capable of
nebulising a small amount of a liquid formulation in the required therapeutic
dose within a few seconds to produce an aerosol suitable for therapeutic
inhalation. Within the scope of the present invention, preferred nebulisers
are
those in which a quantity of less than 100~.L, preferably less than 50~,L,
more
preferably between 20 and 30~L of active substance solution can be
nebulised in preferably one spray action to form an aerosol with an average
particle size of less than 20~,m, preferably less than 10~m, in such a way
that
the inhalable part of the aerosol corresponds to the therapeutically effective
quantity.
An apparatus of this kind for propellant-free delivery of a metered quantity
of a
liquid pharmaceutical composition for inhalation is described for example in
International Patent Application WO 91114468 and also in WO 97112687 (cf. in
particular Figures 6a and 6b). The nebulisers (devices) described therein are
known by the name Respimat~.
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W0,2004/004724 1 9 PCTIEP20031006667
This nebuliser (Respimat~) can advantageously be used to produce the
inhalable aerosols according to the invention containing the combination of
active substances 1 and 2. Because of its cylindrical shape and handy size of
less than 9 to 15 cm long and 2 to 4 cm wide, this device can be carried at
all
times by the patient. The nebuliser sprays a defined volume of the
pharmaceutical formulation at high pressures through small nozzles so as to
produce inhalable aerosols.
The preferred atomiser essentially consists of an upper housing part, a pump
housing, a nozzle, a locking mechanism, a spring housing, a spring and a
storage container, characterised by
- a pump housing which is secured in the upper housing part and which
comprises at one end a nozzle body with the nozzle or nozzle
arrangement,
- a hollow plunger with valve body,
- a power takeoff flange in which the hollow plunger is secured and
which is located in the upper housing part,
- a locking mechanism situated in the upper housing part,
- a spring housing with the spring contained therein, which is rotatably
mounted on the upper housing part by means of a rotary bearing,
- a lower housing part which is fitted onto the spring housing in the axial
direction.
The hollow plunger with valve body corresponds to a device disclosed in
WO 97112687. It projects partially into the cylinder of the pump housing and
is axially movable within the cylinder. Reference is made in particular to
Figures 1 to 4, especially Figure 3, and the relevant parts of the
description.
The hollow plunger with valve body exerts a pressure of 5 to 60 Mpa (about
50 to 600 bar), preferably 10 to 60 Mpa (about 100 to 600 bar) on the fluid,
the measured amount of active substance solution, at its high pressure end at
the moment when the spring is actuated. Volumes of 10 to 50 microlitres are
preferred, while volumes of 10 to 20 microlitres are particularly preferred
and
a volume of 15 microlitres per spray is most particularly preferred.
The valve body is preferably mounted at the end of the hollow plunger facing
the valve body.
CA 02491451 2004-12-31
WO 2004!004724 2~ PCTlEP2003/006667
The nozzle in the nozzle body is preferably microstructured, i.e. produced by
microtechnology. Microstructured valve bodies are disclosed for example in
WO-94107607; reference is hereby made to the contents of this specification,
particularly Figure 1 therein and the associated description.
The nozzle body consists for example of two sheets of glass and/or silicon
firmly joined together, at least one of which has one or more microstructured
channels which connect the nozzle inlet end to the nozzle outlet end. At the
nozzle outlet end there is at least one round or non-round opening 2 to 10
microns deep and 5 to 15 microns wide, the depth preferably being 4.5 to 6.5
microns while the length is preferably 7 to 9 microns.
In the case of a plurality of nozzle openings, preferably two, the directions
of
spraying of the nozzles in the nozzle body may extend parallel to one another
or may be inclined relative to one another in the direction of the nozzle
opening. In a nozzle body with at least two nozzle openings at the outlet end
the directions of spraying may be at an angle of 20 to 160° to one
another,
preferably 60 to 150°, most preferably 80 to 100°. The nozzle
openings are
preferably arranged at a spacing of 10 to 200 microns, more preferably at a
spacing of 10 to 100 microns, most preferably 30 to 70 microns. Spacings of
50 microns are most preferred. The directions of spraying will therefore meet
in the vicinity of the nozzle openings.
The liquid pharmaceutical preparation strikes the nozzle body with an entry
pressure of up to 600 bar, preferably 200 to 300 bar, and is atomised into an
inhalable aerosol through the nozzle openings. The preferred particle or
droplet sizes of the aerosol are up to 20 microns, preferably 3 to 10 microns.
The locking mechanism contains a spring, preferably a cylindrical helical
compression spring, as a store for the mechanical energy. The spring acts on
the power takeoff flange as an actuating member the movement of which is
determined by the position of a locking member. The travel of the power
takeoff flange is precisely limited by an upper and lower stop. The spring is
preferably biased, via a power step-up gear, e.g. a helical thrust gear, by an
external torque which is produced when the upper housing part is rotated
counter to the spring housing in the lower housing part. In this case, the
upper housing part and the power takeoff flange have a single or multiple
V-shaped gear.
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W O, 2004/004724 2 ~ PCTIEP2003/006667
The locking member with engaging locking surtaces is arranged in a ring
around the power takeoff flange. It consists, for example, of a ring of
plastic
or metal which is inherently radially elastically deformable. The ring is
arranged in a plane at right angles to the atomiser axis. After the biasing of
the spring, the locking surfaces of the locking member move into the path of
the power takeoff flange and prevent the spring from relaxing. The locking
member is actuated by means of a button. The actuating button is connected
or coupled to the locking member. In order to actuate the locking mechanism,
the actuating button is moved parallel to the annular plane, preferably into
the
atomiser; this causes the deformable ring to deform in the annular plane.
Details of the construction of the locking mechanism are given in
WO 97/20590.
The lower housing part is pushed axially over the spring housing and covers
the mounting, the drive of the spindle and the storage container for the
fluid.
When the atomiser is actuated the upper housing part is rotated relative to
the
lower housing part, the lower housing part taking the spring housing with it.
The spring is thereby compressed and biased by means of the helical thrust
gear and the locking mechanism engages automatically. The angle of
rotation is preferably a whole-number fraction of 360 degrees, e.g. 180
degrees. At the same time as the spring is biased, the power takeoff part in
the upper housing part is moved along by a given distance, the hollow plunger
is withdrawn inside the cylinder in the pump housing, as a result of which
some of the fluid is sucked out of the storage container and into the high
pressure chamber in front of the nozzle.
If desired, a number of exchangeable storage containers which contain the
fluid to be atomised may be pushed into the atomiser one after another and
used in succession. The storage container contains the aqueous aerosol
preparation according to the invention.
The atomising process is initiated by pressing gently on the actuating button.
As a result, the locking mechanism opens up the path for the power takeoff
member. The biased spring pushes the plunger into the cylinder of the pump
housing. The fluid leaves the nozzle of the atomiser in atomised form.
' CA 02491451 2004-12-31
WO 20041004724 22 PCTIEP20031006667
Further details of construction are disclosed in PCT Applications
WO 97112683 and WO 97/20590, to which reference is hereby made.
The components of the atomiser (nebuliser) are made of a material which is
suitable for its purpose. The housing of the atomiser and, if its operation
permits, other parts as well, are preferably made of plastics, e.g. by
injection
moulding. For medicinal purposes, physiologically safe materials are used.
Figures 6alb of WO 97/12687, to which reference is explicitly made at this
point, show the nebuliser (Respimat~) which can advantageously be used for
inhaling the aqueous aerosol preparations according to the invention. Figure
6a of WO 97/12687 shows a longitudinal section through the atomiser with the
spring biased while Figure 6b of WO 97112687shows a longitudinal section
through the atomiser with the spring relaxed. The upper housing part (51 )
contains the pump housing (52) on the end of which is mounted the holder
(53) for the atomiser nozzle. In the holder is the nozzle body (54) and a
filter
(55). The hollow plunger (57) fixed in the power takeoff flange (56) of the
locking mechanism projects partially into the cylinder of the pump housing. At
its end the hollow plunger carries the valve body (58). The hollow plunger is
sealed off by means of the seal (59). Inside the upper housing part is the
stop
{60) on which the power takeoff flange abuts when the spring is relaxed. On
the power takeoff flange is the stop (61 ) on which the power takeoff flange
abuts when the spring is biased. After the biasing of the spring the locking
member (62) moves between the stop (61 ) and a support (63) in the upper
housing part. The actuating button (64) is connected to the locking member.
The upper housing part ends in the mouthpiece (65) and is sealed off by
means of the protective cover (66) which can be placed thereon.
The spring housing (67) with compression spring {68) is rotatably mounted on
the upper housing part by means of the snap-in lugs (69) and rotary bearing.
The lower housing part (70) is pushed over the spring housing. Inside the
spring housing is the exchangeable storage container (71 ) for the fluid (72)
which is to be atomised. The storage container is sealed off by the stopper
(73) through which the hollow plunger projects into the storage container and
is immersed at its end in the fluid (supply of active substance solution).
CA 02491451 2004-12-31
W O 20041004724 23 PCTIEP20031006667
The spindle (74) for the mechanical counter is mounted in the covering of the
spring housing. At the end of the spindle facing the upper housing part is the
drive pinion (75). The slider (76) sits on the spindle.
The nebuliser described above is suitable for nebulising the aerosol
preparations according to the invention to produce an aerosol suitable for
inhalation.
If the formulation according to the invention is nebulised using the
technology
described above (Respimat~) the quantity delivered should correspond to a
defined quantity with a tolerance of not more than 25%, preferably 20% of this
amount in at least 97%, preferably at least 98% of all operations of the
inhaler
(spray actuations). Preferably, between 5 and 30 mg of formulation, most
preferably between 5 and 20 mg of formulation are delivered as a defined
mass on each actuation.
However, the formulation according to the invention may also be nebulised by
means of inhalers other than those described above, e.g. jet stream inhalers.
Accordingly, in a further aspect, the invention relates to pharmaceutical
formulations in the form of propellant-free inhalable solutions or suspensions
as described above combined with a device suitable for administering these
formulations, preferably in conjunction with the Respimat~. Preferably, the
invention relates to propellant-free inhalable solutions or suspensions
characterised by the combination of active substances 1 and 2 according to
the invention in conjunction with the device known by the name Respimat~.
In addition, the present invention relates to the above-mentioned devices for
inhalation, preferably the Respimat~, characterised in that they contain the
propellant-free inhalable solutions or suspensions according to the invention
as described hereinbefore.
The propellant-free inhalable solutions or suspensions according to the
invention may take the form of concentrates or sterile inhalable solutions or
suspensions ready for use, as well as the above-mentioned solutions and
suspensions designed for use in a Respimat~. Formulations ready for use
may be produced from the concentrates, for example, by the addition of
isotonic saline solutions. Sterile formulations ready for use may be
administered using energy-operated fixed or portable nebulisers which
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WO 2004/004724 24 PCTIEP2003I006667
produce inhalable aerosols by means of ultrasound or compressed air by the
Venturi principle or other principles.
Accordingly, in another aspect, the present invention relates to
pharmaceutical compositions in the form of propellant-free inhalable solutions
or suspensions as described hereinbefore which take the form of
concentrates or sterile formulations ready for use, combined with a device
suitable for administering these solutions, characterised in that the device
is
an energy-operated free-standing or portable nebuliser which produces
inhalable aerosols by means of ultrasound or compressed air by the Venturi
principle or other methods.
The Examples which follow serve to illustrate the present invention in more
detail without restricting the scope of the invention to the following
embodiments by way of example.
Formulation Examples
Inhalable powders:
1)
Ingredients pg per capsule
1'-Bromide 200
N-[2-(3,5-Bis-trifluoromethyl- 150
phenyl)-ethyl]-2-{4-[(3-hydroxy-
propyl)-methyl-amino]-
piperidin-1-yl}-N-methyl-2-
phenyl-acetamide
Lactose 12150
Total 12500
2)
Ingredients Ng per capsule
1'-Bromide 100
N-[2-(3,5-Bis-trifluoromethyl-125
phenyl)-ethyl]-2-[4-(2-hydroxy-
1-hydroxymethyl-ethylamino)-
piperidin-1-yl]-N-methyl-2-
phenylacetamide
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WO 20041004724 25 PCTIEP20031006667
Lactose 12350
Total 12500
3)
4)
Ingredients Ng per capsule
1'-Bromide 200
N-[2-(3,5-Bis-trifluoromethyl- 250
phenyl)-ethyl]-2-{4-[(3-hydroxy-
propyl)-methyl-amino]-
piperidin-1-yl}-N-methyl-2-
phenyl-acetamide
Lactose 12250
Total 12500
Ingredients pg per capsule
1'-Bromide 200
N-[2-(3,5-Bis-trifluoromethyl- 400
phenyl)-ethyl]-2-[4-
(cyclopropylmethyl-methyl-
amino)-piperidin-1-yl]-N-
methyl-2-phenyl-acetamide
Lactose 24776
Total 25000
