Title of Invention

COMPOUNDS CAPABLE OF RELEASING PHENOLIC OPIOIDS THROUGH INTRA-MOLECULAR CYCLIZATION

Abstract A method of providing a patient with controlled release of a phenolic opioid using a prodrug capable, upon enzymalic activation, of releasing the phenolic opioid through intra-molecular cyclization leading to formation of a cyclic urea, carbamate or thiocarbamate.
Full Text CONTROLLED RELEASE OF PHENOLIC OPIOIDS
The present application claims the benefit of United States provisional patent
application number 60/809,082 filed on May 26, 2006 and United States provisional patent
application number 60/901,795 filed on February 16, 2007, the contents of which are
incorporated herein in their entirety.
The present invention relates to controlled release of phenolic opioids. More
particularly it relates to a method of providing patients with controlled release of phenolic
opioids using prodrugs having a particular substituent on the phenolic hydrogen atom, to
prodrugs of phenolic opioids and to pharmaceutical compositions comprising the prodrugs.
Delivery systems are often essential in safely administering active agents such as
drugs. Often delivery systems can optimize bioavailability, improve dosage consistency and
improve patient compliance (e.g., by reducing dosing frequency). Solutions to drug delivery
and/or bioavailability issues in pharmaceutical development include converting known drugs
to prodrugs. Typically, in a prodrug, a polar functional group (e.g., a carboxylic acid, an
amino group, phenol group, a sulfhydryl group, etc.) of the active agent is masked by a
promoiety, which is labile under physiological conditions. Accordingly, prodrugs are usually
transported through hydrophobic biological barriers such as membranes and may possess
superior physicochemical properties in comparison to the parent drug. Prodrugs are usually
non-toxic and are ideally electively cleaved at the locus of drug action. Preferably, cleavage
of the promoiety occurs rapidly and quantitatively with the formation of non-toxic
by-products (i.e., the hydrolyzed promoiety).
Prodrugs as described above are capable of providing patients with safe and effective
treatment if the patients follow the directions given by the attending physician. Unfortunately
human patients do not always follow the directions that they have been given. They may
accidentally take an overdose of the prodrug, or deliberately abuse it, for example by taking
an overdose, by injecting or inhaling it, or by using readily available household chemicals
(like vinegar or baking soda) to obtain the active drug from the prodrug. Abuse is a particular
concern with prodrugs of opioids, which are properly used for the treatment of pain.
It would be desirable to have a prodrug of an opioid that has built-in control, so that it
is difficult to use the prodrug other than in the way it is intended.
A way has now been found for configuring prodrugs of phenolic opioids that affords
controlled release of the drugs.
Phenolic opioids form a sub-group of the opioids, and include the widely prescribed
drugs hydromorphone, oxymorphone, and morphine.
According to one aspect, the present invention provides a method of providing a
patient with post administration-activated, controlled release of a phenolic opioid, which
comprises administering to said patient a corresponding compound in which the phenolic
hydrogen atom has been substituted with a spacer leaving group bearing a nitrogen
nucleophile that is protected with an enzymatically-cleavable moiety, the configuration of the
spacer leaving group and nitrogen nucleophile being such that, upon enzymatic cleavage of
the cleavable moiety, the nitrogen nucleophile is capable of forming a cyclic urea, carbamate
or thiocarbamate, liberating the compound from the spacer leaving group so as to provide the
patient with controlled release of the phenolic opioid.
In another aspect, the present invention provides the use in the manufacture of a
medicament for providing a patient with post administration-activated, controlled release of a
phenolic opioid, of a corresponding compound in which the phenolic hydrogen atom has been
substituted with a spacer leaving group bearing a nitrogen nucleophile that is protected with
an enzymatically-cleavable moiety, the configuration of the spacer leaving group and nitrogen
nucleophile being such that, upon enzymatic cleavage of the cleavable moiety, the nitrogen
nucleophile is capable of forming a cyclic urea, carbamate or thiocarbamate, liberating the
compound from the spacer leaving group so as to provide the patient with controlled release
of the phenolic opioid.
The corresponding compound (prodrug in accordance with the present invention)
provides post administration-activated, controlled release of the phenolic opioid, because it
requires enzymatic cleavage to initiate release of the compound, and because the rate of
release of the opioid depends upon both the rate of enzymatic cleavage and the rate of
cyclisation. Accordingly, the prodrug has reduced susceptibility to accidental overdosing or
abuse, whether by deliberate overdosing, administration through an inappropriate route, such
as by injection, or by chemical modification using readily available household chemicals.
The prodrug is configured so that it will not provide excessively high plasma levels of the
active drug if it is administered inappropriately, and cannot readily be decomposed to afford
the active drug other than by enzymatic-cleavage.
The enzyme capable of cleaving the enzymatically-cleavable moiety may be a
peptidase - the enzymatically-cleavable moiety being linked to the nucleophilic nitrogen
through an amide (e.g. a peptide: -NHCO-) bond. In some embodiments, the enzyme is a
digestive enzyme such as, for example, pepsin, trypsin, chymotrypsin, colipase, elastase,
aminopeptidase N, aminopeptidase A, dipeptidylaminopeptidase IV, tripeptidase or
enteropeptidase. Accordingly, in one embodiment of the method, the corresponding
compound is administered orally to the patient.
The enzyme-cleavable moiety linked to the nitrogen nucleophile through an amide
bond may be, for example, a residue of an amino acid or a peptide, or an (alpha) N-acyl
derivative of an amino acid or peptide (for example an N-acyl derivative of a
pharmaceutically acceptable carboxylic acid, such as an N-acetyl derivative). The peptide
may contain, for example, up to 10 amino acid residues. For example, it may be a dipeptide
or tripeptide. Each amino acid may advantageously be a naturally occurring D or L-amino
acid (such as an L-amino acid). Examples of naturally occurring amino acids are alanine,
arginine, asparagine, aspartic acid, cysteine, glycine, glutamine, glutamic acid, histidine,
isoleucine, leucine, methionine, phenylalanine, proline, serine, threonine, tryptophan,
tyrosine, lysine and valine. Accordingly, examples of enzyme-cleavable moieties include
residues of the L-amino acids listed hereinabove and the N-acetyl derivatives thereof, and
dipeptides and tripeptides formed from two or three of the L-amino acids listed hereinabove,
and the N-acetyl derivatives thereof.
The cyclic group formed when the phenolic opioid is released is conveniently
pharmaceutically acceptable, in particular a pharmaceutically acceptable cyclic urea,
carbamate or thiocarbamate. It will be appreciated that cyclic ureas in particular are generally
very stable and have low toxicity.
In one specific example of the invention, the spacer leaving group bearing a
nucleophile that is protected with a cleavable moiety is a group of formula
-C(O)-N(CH3)-(CH2)2-NH(R4) wherein R4 is an enzyme-cleavable moiety linked to the NH
group through an amide bond. When the N-R4 amide bond is cleaved enzymatically, a
nitrogen nucleophile (-NH2) is freed, and this cyclises back onto the carbonyl group, forming
a cyclic urea and releasing the phenolic opioid.
Generally, the spacer group may be any group capable of forming a cyclic urea,
carbamate or thiocarbamate when the phenolic opioid is displaced by the nitrogen
nucleophile. Accordingly, the spacer group may be, for example, a group of formula -C(O)-
Y-L-N-(R3)(R4); in which:-
Y is -NR5-, -O- or -S-;
L is an unsubstituted or substituted alkyl, alkenyl, alkynyl, carbocyclic or heterocyclic
group, or a combination of two or more such groups linked together by a single bond, a spiro
linkage, a single or double bond or by a C=0, O, S, SO, SO2, CONH, NHCO or NH linkage;
each of R3 and R5 is independently is hydrogen, alkyl, substituted alkyl, aryl or
substituted aryl; and
R4 is an enzyme-cleavable moiety linked to the nitrogen of the N(R3) group through
an amide bond.
In one embodiment, R4 is a group of formula
wherein:
each R6 is independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted
heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with
the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl
ring;
R7 is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, alkoxycarbonyl,
substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl;
p is an integer from 1 to 5;
each W is independently -NR8-, -O- or -S-; and
each R8 is independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl, or
optionally, each R6 and R8 independently together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
It will be appreciated that when W is NH and R7 is H or acyl, then R4 is a residue of
an amino acid or peptide, or an N-acyl derivative thereof. When W is NR8, R7 is H or acyl
and R6 and R8 together with the atoms to which they are bonded form a pyrrolidine ring, then
R4 is a residue of proline or an N-acyl derivative thereof.
Accordingly, in another embodiment, R4 is a residue of a D or L-amino acid (such as
an L-amino acid) selected from alanine, arginine, asparagine, aspartic acid, cysteine, glycine,
glutamine, glutamic acid, histidine, isoleucine, leucine, methionine, phenylalanine, proline,
serine, threonine, tryptophan, tyrosine, lysine and valine; a residue of a dipeptide or tripeptide
composed of two or three D or L amino acid residues (such as L-amino acid residues) selected
independently from alanine, arginine, asparagine, aspartic acid, cysteine, glycine, glutamine,
glutamic acid, histidine, isoleucine, leucine, methionine, phenylalanine, proline, serine,
threonine, tryptophan, tyrosine, lysine and valine; or a residue of an N-acyl derivative thereof,
such as an N-acetyl derivative.
In one embodiment, L is an unsubstituted or substituted 1,2-phenylene group. For
example, Y-L-NR3 together may form a 1,2-diaminophenylene group which is unsubstituted
or substituted on the phenylene moiety with one or two substituents selected from a halogen
atom, (l-4C)alkyl and (l-4C)alkoxy.
In another embodiment, L is a divalent group of formula
in which:-
n is an integer from 1 to 10; and
each of R1 and R2 is independently hydrogen, alkyl, substituted alkyl, aryl or
substituted aryl, or R1 and R2 together with the carbon to which they are attached form a
cycloalkyl or substituted cycloalkyl group, or two R1 or R2 groups on adjacent carbon atoms
may, together with the carbon atoms to which they are attached, form a cycloalkyl or
substituted cycloalkyl group.
Accordingly, in one embodiment, the spacer leaving group bearing a nucleophile that
is protected with a cleavable moiety is of formula -C(O)-Y-(C(R1)(R2))n-N-(R3)(R4); the
spacer leaving group corresponding with the group -C(O)-Y-(C(R1)(R2))n-, the nucleophilic
nitrogen atom that is protected with a cleavable moiety corresponding with the group -N-
(R3)(R4) and the cleavable moiety corresponding with the group R4; in which:
Y is -NR5-, -O- or -S-;
n is an integer from 1 to 10;
each R1, R2, R3 and R5 is independently hydrogen, alkyl, substituted alkyl, aryl or
substituted aryl, or R1 and R2 together with the carbon to which they are attached form a
cycloalkyl or substituted cycloalkyl group, or two R1 or R2 groups on adjacent carbon atoms
may, together with the carbon atoms to which they are attached, form a cycloalkyl or
substituted cycloalkyl group;

each R6 is independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted
heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with
the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl
ring;
R is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, alkoxycarbonyl,
substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl;
p is an integer from 1 to 5;
each W is independently -NR8-, -O- or -S-; and
each R8 is independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl, or
optionally, each R6 and R8 independently together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
Thus, if XH represents the phenolic opioid that is released, then the corresponding
compound may be represented by the general formula (I)

and the cyclic urea, carbamate or thiocarbamate may be presented by the formula

In one embodiment, each of R1, R2, R3 and R5 is independently hydrogen, alkyl,
substituted alkyl, aryl or substituted aryl.
In another embodiment, R6 is a side atom or group of a natural amino acid, such as H
(from glycine), -CH2(CH2)3NH2 (from leucine), -CH2CH2CH2NHC(NH)NH2 (from arginine),
4-hydroxybenzyl (from tyrosine), CH2COOH (from aspartic acid) or CH2CH2COOH (from
glutamic acid).
In another embodiment, R7 is a hydrogen atom, or an unsubstituted of substituted acyl
group, for example (l-6C)alkanoyl, such as acetyl or t-butanoyl; benzoyl unsubstituted or
substituted by methylenedioxy or one or two substituents selected from (l-4C)alkyl, (1-
4C)alkoxy or halogen, such as benzoyl or piperonyl; CONRxRy in which Rx and Ry are each
independently hydrogen or (l-4C)alkyl, such as CONH2), or a hemiacid or hemiester, such as
CH2CH2COOH or CH2CH2COOEt. The unsubstituted of substituted acyl group is
conveniently the residue of a pharmaceutically acceptable carboxylic acid.
Examples of particular values are:-
forY: -NR5;
for R5: (l-4C)alkyl, such as -CH3;
forL: -CH2CH2-
for R1 and R2: hydrogen or (l-4C)alkyl, such as CH3; more particularly hydrogen;
forn: 2 or 3;
for R3: hydrogen or (l-4C)alkyl, such as -CH3;
for W: NH;
for R6: H, -CH2(CH2)3NH2, -CH2CH2CH2NHC(NH)NH2, 4-hydroxybenzyl, CH2COOH or
CH2CH2COOH;
for R7: hydrogen, (l-6C)alkanoyl, such as acetyl or t-butanoyl, or optionally substituted
benzoyl, for example benzoyl unsubstituted or substituted by methylenedioxy or one or two
substituents selected from (l-4C)alkyl, (l-4C)alkoxy or halogen, such as benzoyl or
piperonyl; in particular hydrogen or acetyl;
for a cycloheteroalkyl or substituted cycloheteroalkyl ring formed by R6 and R8 together with
the atoms to which they are bonded: pyrrolidinyl;
for p: 1 or 2;
for R4: arginine, N-acetylarginine, N-t-butanoylarginine, N-benzoylarginine, N-
piperonylarginine, N-glycinylarginine, lysine, glutamic acid, aspartic acid, tyrosine, proline
and N-glycinylproline.
Generally the corresponding compound (the prodrug in accordance with the invention)
is administered orally. However, in certain embodiments it is envisaged that it could be
administered by another route.
Each corresponding compound may have a different release profile, the rate of release
of the phenolic opioid depending upon the rate at which the cleavable moiety is cleaved, and
the rate in which the nitrogen nucleophile can undergo an intramolecular cyclization - release
reaction thus displacing the phenolic opioid. Accordingly, one embodiment of the method
comprises administering a plurality of corresponding compounds to the patient, each
corresponding compound having a different spacer leaving group and/or a different cleavable
moiety so as to provide the patient with a different controlled release of the phenolic opioid.
Specific examples of phenolic opioids include oxymorphone, hydromorphone,
morphine and derivatives thereof. Particular mention is made of oxymorphone,
hydromorphone and morphine. Other examples of phenolic opioids are buprenorphine,
dihydroetorphine, diprenorphine, etorphine and levorphanol.
The prodrugs may be administered alone or may be co-administered with one or more
other active agents. In one embodiment, they may be co-administered with a peripheral
opioid antagonist, such as (R)-N-methylnaltrexone (N-MTX), or a pro-drug thereof. It will be
appreciated by those skilled in the art that (R)-N-methylnaltrexone antagonizes the actions of
opioids such as hydromorphone, oxymorphone and morphine, but is incapable of crossing the
blood brain barrier. It therefore antagonizes only their peripheral actions, which are
undesirable, not their actions on the central nervous system, such as pain relief, which are
desirable. In one embodiment, the pro-drug of (R)-N-methylnaltrexone is a compound of
formula (I) in which X represents the phenolic residue of (R)-N-methylnaltrexone, Y, R1, R ,
n, R3 have any of the meanings given hereinabove, and R4 is hydrogen or has any of the
meanings given hereinabove. Such a pro-drug may be administered orally. Compounds in
which R4 has any of the meanings given above desirably release (R)-N-methylnaltrexone in
the way that the pro-drug of the opioid releases the opioid it is being used to antagonize.
Such compounds may be formulated for co-administration with a pro-drug of an opioid
according to the present invention, for example in a pharmaceutical composition comprising
both compounds and a pharmaceutically acceptable carrier. It will be appreciated that the
parent drug, (R)-N-methylnaltrexone has poor oral bioavailability, and generally needs to be
administered parenterally. Thus, the pro-drugs of (R)-N-methylnaltrexone in accordance with
the present invention are useful whenever oral (R)-N-methylnaltrexone therapy is desired.
In another aspect, the present invention provides a prodrug of oxymorphone,
hydromorphone or morphine that is capable of providing post administration-activated
controlled release of oxymorphone, hydromorphone or morphine. Accordingly, the present
invention provides a compound of structural Formula (I):

or a salt, hydrate or solvate thereof wherein:
X is oxymorphone, hydromorphone or morphine, wherein the hydrogen atom of the
phenolic hydroxyl group is replaced by a covalent bond to -C(O)-Y-(C(R1)(R2)m-N-(R3)(R4);
Y is-NR5-,-0-or-S-;
n is an integer from 1 to 4;
each R1, R2, R3 and R5 is independently hydrogen, alkyl, substituted alkyl, aryl or
substituted aryl, or R1 and R2 together with the carbon to which they are attached form a
cycloalkyl or substituted cycloalkyl group, or two R1 or R2 groups on adjacent carbon atoms
may, together with the carbon atoms to which they are attached, form a cycloalkyl or
substituted cycloalkyl group;

each R6 is independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted
heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with
the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl
ring;
R7 is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, alkoxycarbonyl,
substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl;
p is an integer from 1 to 10;
each W is independently -NR8-, -O- or -S-; and

each R8 is independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl, or
optionally, each R6 and R8 independently together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
For example, when X is a residue of hydromorphone, the compound of formula (I) has
the structure
In one embodiment, X is hydromorphone or oxymorphone. In another embodiment, X
is morphine.
In another aspect the present invention provides a compound of formula I

or a salt, hydrate or solvate thereof wherein:
X is (R)-N-methylnaltrexone, wherein the hydrogen atom of the phenolic hydroxyl
group is replaced by a covalent bond to -C(O)-Y-(C(R1)(R2))„-N-(R3)(R4); and Y, R1, R2, n,
R3 and R4 have any of the meanings given hereinabove.
In another aspect, pharmaceutical compositions are provided which generally
comprise one or more compounds of Formula (I), salts, hydrates or solvates thereof and a
pharmaceutically acceptable vehicle such as a diluent, carrier, excipient or adjuvant. The
choice of diluent, carrier, excipient and adjuvant will depend upon, among other factors, the
desired mode of administration.
In still another aspect, methods for treating or preventing various diseases or disorders
are provided. The methods generally involve administering to a patient in need of such
treatment or prevention a therapeutically effective amount of a compound Formula (I) and/or
a pharmaceutical composition thereof.
Brief Description of the Drawings
Figure 1 shows the plasma concentration time course of the production of N-MTX
following oral (PO) dosing in rats.
Figure 2 shows the plasma concentration time course of the production of
hydromorphone and N-MTX following PO dosing of prodrugs in rats.
As used herein, the term "alkyl" by itself or as part of another substituent refers to a
saturated branched or straight-chain monovalent hydrocarbon radical derived by the removal
of one hydrogen atom from a single carbon atom of a parent alkane. Typical alkyl groups
include, but are not limited to, methyl; ethyl, propyls such as propan-1-yl or propan-2-yl; and
butyls such as butan-1-yl, butan-2-yl, 2-methyl-propan-l-yl or 2-methyl-propan-2-yl.
In some embodiments, an alkyl group comprises from 1 to 20 carbon atoms. In other
embodiments, an alkyl group comprises from 1 to 10 carbon atoms. In still other
embodiments, an alkyl group comprises from 1 to 6 carbon atoms, such as from 1 to 4 carbon
atoms.
"AlkenyJ" by itself or as part of another substituent refers to an unsaturated branched,
straight-chain or cyclic alkyl radical having at least one carbon-carbon double bond derived
by the removal of one hydrogen atom from a single carbon atom of a parent alkene. The
group may be in either the cis or trans conformation about the double bond(s). Typical
alkenyl groups include, but are not limited to, ethenyl; propenyls such as prop-1-en-l-yl,
prop-l-en-2-yl, prop-2-en-l-yl (allyl), prop-2-en-2-yl, cycloprop-1-en-l-yl;
cycloprop-2-en-l-yl; butenyls such as but-l-en-l-yl, but-l-en-2-yl, 2-methyl-prop-l-en-l-yl,
but-2-en-l-yl, but-2-en-l-yl, but-2-en-2-yl, buta-l,3-dien-l-yl, buta-l,3-dien-2-yl,
cyclobut-1-en-l-yl, cyclobut-l-en-3-yl, cyclobuta-l,3-dien-l-yl, etc.; and the like.
"Alkynyl" by itself or as part of another substituent refers to an unsaturated branched,
straight-chain or cyclic alkyl radical having at least one carbon-carbon triple bond derived by
the removal of one hydrogen atom from a single carbon atom of a parent alkyne. Typical
alkynyl groups include, but are not limited to, ethynyl; propynyls such as prop-1-yn-l-yl,
prop-2-yn-l-yl, etc.; butynyls such as but-1-yn-l-yl, but-l-yn-3-yl, but-3-yn-l-yl, etc.; and
the like.
"Acyl" by itself or as part of another substituent refers to a radical -C(O)R30, where
R30 is hydrogen, alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl,
heteroarylalkyl as defined herein. Representative examples include, but are not limited to
formyl, acetyl, t-butanoyl, cyclohexylcarbonyl, cyclohexylmethylcarbonyl, benzoyl,
piperonyl, benzylcarbonyl and the like.
"Alkoxy" by itself or as part of another substituent refers to a radical -OR31 where R31
represents an alkyl or cycloalkyl group as defined herein. Representative examples include,
but are not limited to, methoxy, ethoxy, propoxy, butoxy, cyclohexyloxy and the like.
"Alkoxycarbonyl" by itself or as part of another substituent refers to a radical
-C(O)OR where R31 represents an alkyl or cycloalkyl group as defined herein.
Representative examples include, but are not limited to, methoxycarbonyl, ethoxycarbonyl,
propoxycarbonyl, butoxycarbonyl, cyclohexyloxycarbonyl and the like.
"Aryl" by itself or as part of another substituent refers to a monovalent aromatic
hydrocarbon radical derived by the removal of one hydrogen atom from a single carbon atom
of a parent aromatic ring system. Typical aryl groups include, but are not limited to, groups
derived from aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene,
benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene,
as-indacene, 5-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene,
penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene,
picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, trinaphthalene and the like. In
some embodiments, an aryl group comprises from 6 to 20 carbon atoms. In other
embodiments, an aryl group comprises from 6 to 12 carbon atoms. Examples of an aryl group
are phenyl and naphthyl.
"Arylalkyl" by itself or as part of another substituent refers to an acyclic alkyl radical
in which one of the hydrogen atoms bonded to a carbon atom, typically a terminal or sp
carbon atom, is replaced with an aryl group. Typical arylalkyl groups include, but are not
limited to, benzyl, 2-phenyleth-l-yl, naphthylmethyl, 2-naphtbyleth-l-yl, naphthobenzyl,
2-naphthophenyleth-l-yl and the like. In some embodiments, an arylalkyl group is (C7*-C30*)
arylalkyl, e.g., the alkyl moiety of the arylalkyl group is (C1*-C10*) and the aryl moiety is
(C6*-C20). In other embodiments, an arylalkyl group is (C7*-C20*) arylalkyl, e.g., the alkyl
moiety of the arylalkyl group is (C1*-C8*) and the aryl moiety is (C6*-C12*).
Compounds may be identified either by their chemical structure and/or chemical
name. The compounds described herein may contain one or more chiral centers and/or
double bonds and therefore, may exist as stereoisomers, such as double-bond isomers (i.e.,
geometric isomers), enantiomers or diastereomers. Accordingly, all possible enantiomers and
stereoisomers of the compounds including the stereoisomerically pure form (e.g.,
geometrically pure, enantiomerically pure or diastereomerically pure) and enantiomeric and
stereoisomeric mixtures are included in the description of the compounds herein.
Enantiomeric and stereoisomeric mixtures can be resolved into their component enantiomers
or stereoisomers using separation techniques or chiral synthesis techniques well known to the
skilled artisan. The compounds may also exist in several tautomeric forms including the enol
form, the keto form and mixtures thereof. Accordingly, the chemical structures depicted
herein encompass all possible tautomeric forms of the illustrated compounds. The
compounds described also include isotopically labeled compounds where one or more atoms
have an atomic mass different from the atomic mass conventionally found in nature.
Examples of isotopes that may be incorporated into the compounds disclosed herein include,
but are not limited to, 2H, 3H, 11C, 13C, 14C, 15N, 180,170, etc. Compounds may exist in
unsolvated forms as well as solvated forms, including hydrated forms. Certain compounds
may exist in multiple crystalline or amorphous forms. In general, all physical forms are
equivalent for the uses contemplated herein and are intended to be within the scope of the
present disclosure.
"Cycloalkvl" by itself or as part of another substituent refers to a saturated cyclic alkyl
radical. Typical cycloalkyl groups include, but are not limited to, groups derived from
cyclopropane, cyclobutane, cyclopentane, cyclohexane and the like. In some embodiments,
the cycloalkyl group is (C3-C10) cycloalkyl. In other embodiments, the cycloalkyl group is
(C3-C7) cycloalkyl.
"Cycloheteroalkvl" by itself or as part of another substituent, refers to a saturated
cyclic alkyl radical in which one or more carbon atoms (and any associated hydrogen atoms)
are independently replaced with the same or different heteroatom. Typical heteroatoms to
replace the carbon atom(s) include, but are not limited to, N, P, O, S, Si, etc. Typical
cycloheteroalkyl groups include, but are not limited to, groups derived from epoxides,
azirines, thiiranes, imidazolidine, morpholine, piperazine, piperidine, pyrazolidine,
pyrrolidine, quinuclidine and the like.
"Heteroalkyl, Heteroalkenyl and Heteroalkynyl" by themselves or as part of another
substituent refer to alkyl, alkenyl and alkynyl groups, respectively, in which one or more of
the carbon atoms (and any associated hydrogen atoms) are independently replaced with the
same or different heteroatomic groups. Typical heteroatomic groups which can be included in
these groups include, but are not limited to, -0-, -S-, -O-O-, -S-S-, -0-S-, -NR37R38-, =N-N=,
-N=N-, -N=N-NR39R40, -PR41-, -P(O)2-, -POR42-, -0-P(O)2-, -SO-, -SO2-, -SnR43R44- and the
like, where R37, R38, R39, R40, R41, R42, R43 and R44 are independently hydrogen, alkyl,
substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted
cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted
heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl or substituted heteroarylalkyl.
"Heteroaryl" by itself or as part of another substituent, refers to a monovalent
heteroaromatic radical derived by the removal of one hydrogen atom from a single atom of a
parent heteroaromatic ring system. Typical heteroaryl groups include, but are not limited to,
groups derived from acridine, arsindole, carbazole, p-carboline, chromane, chromene,
cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran,
isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine,
oxadiazole, oxazole, perimidine, phenanthridine, phenanthroline, phenazine, phthalazine,
pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole,
pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole,
thiophene, triazole, xanthene, and the like. In some embodiments, the heteroaryl group is
from 5-20 membered heteroaryl. In other embodiments, the heteroaryl group is from 5-10
membered heteroaryl. In still other embodiments, heteroaryl groups are those derived from
thiophene, pyrrole, benzothiophene, benzofuran, indole, pyridine, quinoline, imidazole,
oxazole and pyrazine.
"Heteroarylalkyl" by itself or as part of another substituent, refers to an acyclic alkyl
radical in which one of the hydrogen atoms bonded to a carbon atom, typically a terminal or
sp3 carbon atom, is replaced with a heteroaryl group. In some embodiments, the
heteroarylalkyl group is a 6-30 membered heteroarylalkyl, e.g., the alkyl moiety of the
heteroarylalkyl is 1-10 membered and the heteroaryl moiety is a 5-20-membered heteroaryl.
In other embodiments, the heteroarylalkyl group is 6-20 membered heteroarylalkyl, e.g., the
alkyl moiety of the heteroarylalkyl is 1-8 membered and the heteroaryl moiety is a
5-12-membered heteroaryl.
"Opioid" refers to a chemical substance that exerts its pharmacological action by
interaction at opioid receptors, providing patients with relief from pain. "Phenolic opioid"
refers to a subset of the opioids that contains a phenol group. Examples of phenolic opioids
include buprenorphine, dihydroetorphine, diprenorphine, etorphine, hydromorphone,
levorphanol, morphine, and oxymorphone. An "opioid antagonist" is a compound that
antagonizes the pharmacological action of an opioid. The term includes phenolic opioid
antagonists. Examples of phenolic opioid antagonists include naltrexone, naloxone, and (R)-
N-methylnaltrexone. A "peripheral opioid antagonist" is a compound that is not capable of
penetrating the blood/brain barrier, and hence is capable of antagonizing the (undesired)
action of an opioid outside the central nervous system. An example of a peripheral phenolic
opioid antagonist is (R)-N-methylnaltrexone.
"Parent Aromatic Ring System" by itself or as part of another substituent, refers to an
unsaturated cyclic or polycyclic ring system having a conjugated % electron system.
Specifically included within the definition of "parent aromatic ring system" are fused ring
systems in which one or more of the rings are aromatic and one or more of the rings are
saturated or unsaturated, such as, for example, fiuorene, indane, indene, phenalene, etc.
Typical parent aromatic ring systems include, but are not limited to, aceanthrylene,
acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene,
fluoranthene, fiuorene, hexacene, hexaphene, hexalene, as-indacene, s-indacene, indane,
indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene,
pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene,
pyranthrene, rubicene, triphenylene, trinaphthalene and the like.
"Parent Heteroaromatic Ring System" by itself or as part of another substituent, refers
to a parent aromatic ring system in which one or more carbon atoms (and any associated
hydrogen atoms) are independently replaced with the same or different heteroatom. Typical
heteroatoms to replace the carbon atoms include, but are not limited to, N, P, O, S, Si, etc.
Specifically included within the definition of "parent heteroaromatic ring systems" are fused
ring systems in which one or more of the rings are aromatic and one or more of the rings are
saturated or unsaturated, such as, for example, arsindole, benzodioxan, benzofuran, chromane,
chromene, indole, indoline, xanthene, etc. Typical parent heteroaromatic ring systems
include, but are not limited to, arsindole, carbazole, (3-carboline, chromane, chromene,
cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran,
isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine,
oxadiazole, oxazole, perimidine, phenanthridine, phenanthroline, phenazine, phthalazine,
pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole,
pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole,
thiophene, triazole, xanthene and the like.
"Pharmaceutical composition" refers to at least one compound and a pharmaceutically
acceptable vehicle, with which the compound is administered to a patient.
"Pharmaceutically acceptable salt" refers to a salt of a compound, which possesses the
desired pharmacological activity of the parent compound. Such salts include: (1) acid
addition salts, formed with inorganic acids such as hydrochloric acid, hydrobromic acid,
sulfuric acid, nitric acid, phosphoric acid, and the like; or formed with organic acids such as
acetic acid, propionic acid, hexanoic acid, cyclopentanepropionic acid, glycolic acid, pyruvic
acid, lactic acid, malonic acid, succinic acid, malic acid, maleic acid, fumaric acid, tartaric
acid, citric acid, benzoic acid, 3-(4-hydroxybenzoyl) benzoic acid, cinnamic acid, mandelic
acid, methanesulfonic acid, ethanesulfonic acid, 1,2-ethane-disulfonic acid,
2-hydroxyethanesulfonic acid, benzenesulfonic acid. 4-chlorobenzenesulfonic acid,
2-naphthalenesulfonic acid, 4-toluenesulfonic acid, camphorsulfonic acid,
4-methylbicyclo[2.2.2]-oct-2-ene-l-carboxylic acid, glucoheptonic acid, 3-phenylpropionic
acid, trimethylacetic acid, tertiary butylacetic acid, lauryl sulfuric acid, gluconic acid,
glutamic acid, hydroxynaphthoic acid, salicylic acid, stearic acid, muconic acid, and the like;
or (2) salts formed when an acidic proton present in the parent compound is replaced by a
metal ion, e.g., an alkali metal ion, an alkaline earth ion, or an aluminum ion; or coordinates
with an organic base such as ethanolamine, diethanolamine, triethanolamine,
N-methylglucamine and the like.
"Pharmaceutically acceptable vehicle" refers to a diluent, adjuvant, excipient or carrier
with, or in which a compound is administered.
"Patient" includes mammal humans. The terms "human" and "patient" are used
interchangeably herein.
"Preventing" or "prevention" refers to a reduction in risk of acquiring a disease or
disorder (i.e., causing at least one of the clinical symptoms of the disease not to develop in a
patient that may be exposed to or predisposed to the disease but does not yet experience or
display symptoms of the disease).
"Prodrug" refers to a derivative of an active agent that requires a transformation
within the body to release the active agent. Prodrugs are frequently, although not necessarily,
pharmacologically inactive until converted to the active agent.
"Promoiety" refers to a form of protecting group that when used to mask a functional
group within an active agent converts the active agent into a prodrug. Typically, the
promoiety will be attached to the drug via bond(s) that are cleaved by enzymatic or
non-enzymatic means in vivo.
"Protecting group" refers to a grouping of atoms that when attached to a reactive
functional group in a molecule masks, reduces or prevents reactivity of the functional group.
Examples of protecting groups can be found in Green et al., "Protective Groups in Organic
Chemistry," (Wiley, 2nd ed. 1991) and Harrison et al, "Compendium of Synthetic Organic
Methods," Vols. 1-8 (John Wiley and Sons, 1971-1996). Representative amino protecting
groups include, but are not limited to, formyl, acetyl, trifluoroacetyl, benzyl,
benzyloxycarbonyl ("CBZ"), tert-butoxycarbonyl ("Boc"), trimethylsilyl ("TMS"),
2-trimethylsilyl-ethanesulfonyl ("SES"), trityl and substituted trityl groups, allyloxycarbonyl,
9-fluorenylmethyloxycarbonyl ("FMOC"), nitro-veratryloxycarbonyl ("NVOC") and the like.
Representative hydroxy protecting groups include, but are not limited to, those where the
hydroxy group is either acylated or alkylated such as benzyl, and trityl ethers as well as alkyl
ethers, tetrahydropyranyl ethers, trialkylsilyl ethers and allyl ethers.
"Substituted" refers to a group in which one or more hydrogen atoms are
independently replaced with the same or different substituent(s). Typical substituents include,
but are not limited to, alkylenedioxy (such as methylenedioxy), -M, -R60, -O", =0, -OR60,
-SR60, -S\ =S, -NR^R61, =NR60, -CF3, -CN, -OCN, -SCN, -NO, -N02, =N2, -N3, -S(O)20-S(O)20H, -S(O)2R60, -OS(O)20\ -OS(O)2R6°, -P(O)(0')2, -P(O)(OR60)(O"),
-OP(O)(OR60)(OR61), -C^R60, -C(S)R60, -C(O)OR60, -C(O)NR60R6,,-C(O)O\ -C(S)OR60,
-NR62C(O)NR60R61, -NR62C(S)NR60R61, -NR62C(NR63)NR60R61 and -C(NR62)NR60R61 where
M is halogen; R60, R61, R62 and R63 are independently hydrogen, alkyl, substituted alkyl,
alkoxy, substituted alkoxy, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted
cycloheteroalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, or optionally R
and R61 together with the nitrogen atom to which they are bonded form a cycloheteroalkyl or
substituted cycloheteroalkyl ring; and R6* and R65 are independently hydrogen, alkyl,
substituted alkyl, aryl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted
cycloheteroalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, or optionally R
and R65 together with the nitrogen atom to which they are bonded form a cycloheteroalkyl or
substituted cycloheteroalkyl ring. In some embodiments, substituents include -M, -R , =0,
-OR60, -SR60, -S", =S, -NR60R61, =NR60, -CF3, -CN, -OCN, -SCN, -NO, -N02, =N2, -N3,
-SOW60, -0S(O)20-, -OS(O)2R6°, -P(O)(0-)2, -P(O)(OR60)(O"), -OP(O)(OR60)(OR61),
-C(O)R60, -C(S)R60, -C(O)OR60, -C(O)NR60R6,,-C(O)O", -NR62C(O)NR60R61. In other
embodiments, substituents include -M, -R60, =0, -OR60, -SR60, -NR^R61, -CF3, -CN, -N02,
-S(O)2R60, -P(O)(OR60)(O-), -OP(O)(OR60)(OR61), -C(O)R60, -C(O)OR60,
-C(O)NR60R61,-C(O)0 . In still other embodiments, substiruents include -M, -R60, =0, -OR60,
-SR60, -NR60V, -CF3, -CN, -N02, -S(O)2R60, -OP(O)(OR60)(OR61), -C(O)R50. -C(O)OR60
,-C(O)O, where R , R61 and R62 are as defined above. For example, a substituted group may
bear a methylenedioxy substiruent or one, two, or three substituents selected from a halogen
atom, a (1 -4C)alkyl group and a (1 ~4C)alkoxy group.
"Treating" or 'treatment" of any disease or disorder refers, in some embodiments, to
ameliorating the disease or disorder (i.e., arresting or reducing the development of the disease
or at least one of the clinical symptoms thereof). In otheT embodiments "treating" or
"treatment" refers to ameliorating at least one physical parameter, which may not be
discernible by the patient. In yet other embodiments, "treating" or "treatment" refers to
inhibiting the disease or disorder, either physically, (e.g., stabilization of a discernible
symptom), physiologically, (e.g., stabilization of a physical parameter), or both. In still other
embodiments, "treating" or "treatment" refers to delaying the onset of the disease or disorder.
"Therapeutically effective amount" means the amount of a compound that, when
administered to a patient for treating a disease, is sufficient to effect such treatment for the
disease. The 'therapeutically effective amount" will vary depending on the compound, the
disease and its severity and the age, weight, etc., of the patient to be treated.
Reference will now be made in detail to various embodiments. It will be understood
that the invention is not limited to these embodiments. To the contrary, it is intended to cover
alternatives, modifications, and equivalents as may be included within the spirit and scope of
the allowed claims.
Disclosed herein arc prodrugs of phenolic opioids. The promoiety of the prodrug
includes a spacer group and a cleavable moiety where the spacer group, inter alia, physically
separates the drug from the cleavable moiety Accordingly, a prodrug disclosed herein
comprises a phenol attached through the phenolic oxygen to a spacer, which is further
attached to a cleavable moiety. Cleavage of the cleavable moiety reveals a nucleophilic
nitrogen resulting in the "activation" of the prodrug The controlled release of the parent drug
can now be mediated by the nucleophilic nitrogen undergoing an intramolecular cyclization-
release reaction.
The cleavable moiety may comprise an amide. Generally, the cleavable moiety can be
cleaved under physiological conditions. The cleavable moiety is cleaved enzymatically.
In some embodiments, a compound of structural Formula (I) or salts, solvates or
hydrates thereof is provided
wherein:
X is a phenolic opioid, wherein the hydrogen atom of the hydroxyl group is replaced by a
covalent bond to -C(O)-Y-(C(R1)(R2))n-N-(R3)(R4);
Y is -NR5-, -O- or -S-;
n is an integer from 1 to 4;
each R1, R2, R3 and R5 is independently hydrogen, alkyl, substituted alkyl, aryl or substituted
aryl, or R1 and R2 together with the carbon to which they are attached form a cycloalkyl or
substituted cycloalkyl group;

each R6 is independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, aryialkyl,
substituted aryialkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl,
heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with the atoms
to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;
R7 is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, alkoxycarbonyl, substituted
alkoxycarbonyl, aryl, substituted aryl, aryialkyl or substituted aryialkyl;
p is an integer from 1 to 10;
each W is independently -NR8-, -O- or -S-; and
each R is independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl, or
optionally, each R6 and R8 independently together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
In some embodiments, each of R1, R7, R3 and R5 is independently hydrogen, alkyl,
substituted alkyl, aryl or substituted aryl.
In some embodiments, X is hydromorphone, morphine or oxymorphone. In other
embodiments, X is buprenorphinc, dihydroetorphine, diprcnorphine, etorphine or levorphanol.
In some embodiments, R7 is hydrogen, alkyl, acyl or alkoxycarbonyl. In other
embodiments, R is vhere R9 is hydrogen or alkyl and x is an integer
between 1 and 2000. In other embodiments, R7 is a commercially available PEG derivative
such as, for example, PEG-200, PEG-400, PEG-1550, PEG-3350, PEG-6000, PEG-20,000 or
PEG-40,000.
In some embodiments, Y is NR5 and R5 is hydrogen or alkyl. In other embodiments, n
is 2 or 3. In other embodiments, n is 1. In still other embodiments, R1, R2, R3, R5 and R* are
independently hydrogen or alkyl.
In some embodiments, each R6 is independently, hydrogen, alkyl, substituted alkyl,
aryl, arylalkyl, cycloalkyl, substituted cycloalkyl, substituted arylalkyl or heteroarylalkyl or
optionally, R6 and R7 together with the atoms to which they are attached form a
cycloheteroalkyl or substituted cycloheteroalkyl ring. In other embodiments, R is
independently hydrogen, alkyl, substituted alkyl, aryl, arylalkyl, substituted arylalkyl,
heteroalkyl, heteroarylalkyl, substituted heteroarylalkyl, or optionally, R and R together
with the atoms to which they are bonded form a cycloheteroalkyl or substituted
cycloheteroalkyl ring. In still other embodiments, each R6 is independently, hydrogen,
methyl, isopropyl, isobutyl, sec-butyl, t-butyl, cyclopentyl, cyclohexyl, -CH2OH,
-CH(OH)CH3, -CH2CO2H, -CH2CH2C02H, -CH2CONH2, -CH2CH2CONH2, -CH:CH2SCH3,
-CH2SH, -CH2(CH2)3NH2, -CH2CH2CH2NHC(NH)NH2, phenyl, benzyl, homobenzyl,
4-hydroxybenzyl, 4-bromobenzyl, 4-imidazolylmethyl, 3-indoIyImethyl,
3-[5-hydroxyindolyl]-methyl, 9-anthranylmethyl, 3-ben20thienylmethyl, cyclohexylmethyl,
diphenylmethyl, 2-fury 1 methyl, iodomethyl, 1 -napthylmethyl, 2-napthylmcthyl,
2-pyridylmethyl, 3-pyridylmethyl, 4-pyridylmethyl, 3-styrylmethyl, 2-thienylmethyl,
vinylmethyl. cyclohexyl, acetylenomethyl, 2-trifluoromethylbenzyl, 2-chlorobenzyl,
2-cyanobenzyl, 2-fluorobenzyl, 2-methylbenzyl, 3-trifluoromethylbcnzyl, 3-chlorobenzyl,
3-cyanobenzyl, 3-fluorobenzyl, 3-mcthylbcnzyl, 4-benzoylbenzyl,
3,5-dibromo-4-hydroxybcnzyl, 3-trifluoromethylbenzyl, 4-chlorobcnzyl, 4-cyanobenzyl,
4-fluorobenzyl, 4-iodobenzyl, 4-methylbenzyl, 4-nitrobenzyl, 3,4-dihydroxybenzyI,
2,4-dichlorobcnzyl, 3,4 dichlorobenzyl, 3,4 difluorobenzyl, 3,5 diiodo-4-hydroxylbenzyl,
3-nitro-4-hydroxybenzyl, aminomethyl,

or optionally R6 and R7 together with the atoms to which they are attached form an azetidine,
pyrrolidine or piperidine ring.
In some embodiments, W is -NR8 and each R7 is independently hydrogen or alkyl,
aryl or arylalkyl.
In some embodiments, R7 is hydrogen, alkyl, acyl or alkoxycarbonyl.
In other embodiments, each R6 is independently -CI 12(CH2)3NH2 or
-CH2CH2CH2NHC(NH)NH2. In still other embodiments, p is 1 and R6 is -CH2(CH2)3NH2 or
-CH2CH2CH2NHC(NH)NH2. In still other embodiments, each W is -NR8-, each R8 is
hydrogen and R7 is hydrogen, acyl, substituted acyl, alkoxycarbonyl or substituted
alkoxycarbonyl.
In some embodiments, each R6 is independently phenyl, benzyl, 4-hydroxybenzyl,
4-bromobenzyl, 4-imidazolylmethyl, 3-indolylmethyl, isobutyl, -CH2CH2SCH3,
-CH2CH2CONH2, -CH2CH2CONH2 or -CH2CO2H. In still other embodiments, each R6 is
independently benzyl, 4-hydroxybenzyl, 4-bromobenzyl or 3-indolylmethyl. In still other
embodiments, n is 1 and R6 is phenyl, benzyl, 4-hydroxybenzyl, 4-bromobenzyl,
4-imidazolylmethyl, 3-indolylmethyl, isobutyl, -CH2CH2SCH3, -CH2CH2CONH2,
-CH2CH2CONH2 or -CH2CO2H. In still other embodiments, n is I and R6 is benzyl,
4-hydroxybenzyl, 4-bromobenzyl or 3-indolylmethyl. In some of any of the above
embodiments, each W is -NR8-, each R8 is hydrogen and R7 is acyl, substituted acyl,
alkoxycarbonyl or substituted alkoxycarbonyl.
In some embodiments, p is greater than 1 and R7 is hydrogen. In any of the above
embodiments, each W is -NR8-, each R8 is hydrogen and R7 is acyl, substituted acyl,
alkoxycarbonyl or substituted alkoxycarbonyl.
In some embodiments, p is 3 and R7 is hydrogen. In other embodiments, each W is
-NR8- and each R8 is hydrogen.
In some embodiments, each R6 is independently hydrogen, methyl, isopropyl,
isobutyl, sec-butyl, -CH2OH or -CH2SH. In other embodiments, p is 1 and R6 is hydrogen,
methyl, isopropyl, isobutyl or sec-butyl, each W is -NR8-, each R8 is hydrogen and R7 is acyl,
substituted acyl, alkoxycarbonyl or substituted alkoxycarbonyl.
In some embodiments, each R6 is independently hydrogen, methyl, isopropyl,
isobutyl, sec-butyl, r-butyl, cyclopentyl, cyclohexyl, -CH2OH, -CH(OH)CH3, -CH2CONH2,
-CH2CH2SCH3, -CH2SH, phenyl, benzyl, 4-hydroxybenzyl, 4-bromobenzyl or
3-indolylmethyl. In other embodiments, each R6 is independently hydrogen, methyl,
isopropyl, isobutyl, sec-butyl, r-butyl, cyclopentyl, cyclohexyl, phenyl, benzyl,
4-bromobenzyl, 3-indolylmethyl or optionally R6 and R7 together with the atoms to which
they are attached form an azetidine, pyrrolidine or piperidine ring. In some of the above
embodiments, each W is -NR8-, each R8 is hydrogen or optionally each R6 and R8,
independently together with the atoms to which they are attached form an azetidine,
pyrrolidine or piperidine ring and R7 is acyl, substituted acyl, alkoxycarbonyl or substituted
alkoxycarbonyl.
In some embodiments, each R6 is independently benzyl, 4-hydroxybenzyl or isobutyl.
In other embodiments, each W is -NR8-, each R8 is hydrogen and R7 is acyl, substituted acyl,
alkoxycarbonyl or substituted alkoxycarbonyl.
In some embodiments, each R6 is independently -CH2CO2H or -CH2CH2CO2H. In
other embodiments, each W is -NR8-, each R8 is hydrogen and R7 is acyl, substituted acyl,
alkoxycarbonyl or substituted alkoxycarbonyl.
In some embodiments, p is 2 and the R6 group adjacent to the N-terminal nitrogen
atom is independently, hydrogen, methyl, isopropyl, isobutyl, sec-butyl, /-butyl, cyclopentyl,
cyclohexyl, -CH2OH, -CH(OH)CH3, -CH2CO2H, -CH2CH2CO2H, -CH2CONH2,
-CH2CH2CONH2, -CH2CH2SCH3, -CH2SH, -CH2(CH2)3NH2, -CH2CH2CH2NHC(NH)NH2,
phenyl, benzyl, homobenzyl (phenethyl), 4-hydroxybenzyl, 4-bromobenzyl,
4-imidazolylmethyl, 3-indolylmethyl, 3-[5-hydroxyindoIyl]-methyI, 9-anthranylmethyl,
3-benzothienylmethyI, cyclohexylmethyl, diphenylmethyl, 2-furylrnethyl, iodomethyl,
1-napthylmethyl, 2-napthylmethyl, 2-pyridylmethyl, 3-pyridylmethyl, 4-pyridylmethyl,
3-styrylmethyl, 2-thienylmethyl, vinylmethyl, cyclohexyl, acetylenomethyl,
2-trifluoromethylbenzyI, 2-chlorobenzyl, 2-cyanobenzyl, 2-fluorobenzyl, 2-methylbenzyl,
3-trifluoromethylben2yl, 3-chlorobenzyl, 3-cyanobenzyl, 3-fluorobenzyl, 3-methylbenzyl,
4-benzoylbenzyl, 3,5-dibromo-4-hydroxybenzyl, 3-trifluoromethylbenzyl, 4-chlorobenzyl,
4-cyanobenzyl, 4-fluorobenzyl, 4-iodobenzyl, 4-methylbenzyl, 4-nitrobenzyl,
3,4-dihydroxybenzyl, 2,4-dichlorobenzyI, 3,4 dichlorobenzyl, 3,4 difluorobenzyl, 3,5
diiodo-4-hydroxylbenzyl, 3-nitro-4-hydroxybenzyl, aminomethyl,

or optionally each R6 and R8, independently together with the atoms to which they are
attached form an azetidine, pyrrolidine or piperidine ring and the other R group is methyl or
R6 and R8, independently together with the atoms to which they are attached form a
pyrrolidine ring. In other embodiments, each W is -NR8-, each R8 is hydrogen or optionally
each R6 and R8, independently together with the atoms to which they are attached form a
pyrrolidine ring and R7 is acyl, substituted acyl, alkoxycarbonyl or substituted
alkoxycarbonyl.
In some of the above embodiments, p is 1, and R6 is hydrogen. In some of the above
embodiments, p is 1, R6 is hydrogen and W is NH. In some of the above embodiments, p is 1,
R6 is hydrogen, W is NH and R7 is hydrogen. In other embodiments, each R6 is hydrogen and
W is NH. In still other embodiments, each R6 is hydrogen, W is NH and R7 is hydrogen.
In some embodiments, Y is NR5, n is 2 or 3, p is 1 or 2, R1, R2, R3, R5 and R7 are
independently hydrogen or alkyl, each R6 is independently hydrogen, alkyl, substituted alkyl,
aryl, arylalkyl, substituted arylalkyl, heteroalkyl, heteroarylalkyl, substituted heteroarylalkyl
or optionally, R6 and R7 together with the atoms to which they are bonded form a
cycloheteroalkyl or substituted cycloheteroalkyl ring. In other embodiments, Y is NR , n is 2,
p is 1, R1 and R2 are hydrogen, R3 and R5 are methyl or hydrogen and R6 is independently
hydrogen, alkyl, substituted alkyl, aryl, arylalkyl, substituted arylalkyl, heteroalkyl,
heteroarylalkyl, substituted heteroarylalkyl or optionally, R6 and R7 together with the atoms to
which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring or
optionally R7 is hydrogen. In still other embodiments, Y is NR5, n is 2, R1 and R2 are
hydrogen, R3 and R5 are methyl or hydrogen, R7 is hydrogen and R6 is -CH2(CH2)3NH2 or
-CH2CH2CH2NHC(NH)NH2. In some of the above embodiments, X is oxymorphone or
hydromorphone.
The compounds described herein may be obtained via the routes generically illustrated
in Schemes 1-4.
The promoieties described herein, may be prepared and attached to drugs containing
phenols by procedures known to those of skill in the art (See e.g., Green et al., "Protective
Groups in Organic Chemistry," (Wiley, 2nd ed. 1991); Harrison et al, "Compendium of
Synthetic Organic Methods," Vols. 1-8 (John Wiley and Sons, 1971-1996); "Beilstein
Handbook of Organic Chemistry," Beilstein Institute of Organic Chemistry, Frankfurt,
Germany; Feiser et al, "Reagents for Organic Synthesis," Volumes 1-17, (Wiley
Interscience); Trost et al., "Comprehensive Organic Synthesis," (Pergamon Press, 1991);
"Theilheimer's Synthetic Methods of Organic Chemistry," Volumes 1-45, (Karger, 1991);
March, "Advanced Organic Chemistry," (Wiley Interscience), 1991; Larock "Comprehensive
Organic Transformations," (VCH Publishers, 1989); Paquette, "Encyclopedia of Reagents for
Organic Synthesis," (John Wiley & Sons, 1995), Bodanzsky, "Principles of Peptide
Synthesis," (Springer Verlag, 1984); Bodanzsky, "Practice of Peptide Synthesis," (Springer
Verlag, 1984). Further, starting materials may be obtained from commercial sources or via
well established synthetic procedures, supra.
Referring now to Scheme 1 and formula I, supra, where for illustrative purposes T is -
0-, -S- or NR\ Y is NR5, -O- or -S-, W is NR8, -O- or -S-, n is 2, R1 and R2 are hydrogen, p,
R3, R5, R6, R7 and R8 are as previously defined, X is a phenolic opioid, P is a protecting
group, and M is a leaving group, compound 1 may be acylated with an appropriate carboxylic
acid or carboxylic acid equivalent to provide compound 2 which then may be deprotected to
yield compound 3. Compound 3 is then reacted with an activated carbonic acid equivalent 4
to provide desired compound 5.
Referring now to Scheme 2 and formula I, supra, where for illustrative purposes T is -
0-, -S- or NR3, Y is NCH3, W is NR8, -O- or -S-, n is 2, R1 and R2 are hydrogen, p, R3, R6, R7
and R8 are as previously defined, X is a phenolic opioid, P is a protecting group, and M is a
leaving group, compound 6 is acylated with an appropriate carboxylic acid or carboxylic acid
equivalent to provide compound 7. Compound 7 is then deprotected and reacted with
activated carbonic acid equivalent 4 to provide desired compound 9.

Referring now to Scheme 3 and formula I, supra, where for illustrative purposes T is
NCH3, Y is NR5, -O- or -S-, W is NR8, -O- or -S-, n is 2, R1 and R2 are hydrogen, p, R5, R6,
R and R are as previously defined, X is a phenolic opioid, P is a protecting group, and M is
a leaving group, compound 10 is acylated with an appropriate carboxylic acid or carboxylic
acid equivalent to provide compound 11 which after deprotection and functional group
intraconversion, if necessary, is converted to compound 12. Reaction of compound 12 with
activated carbonic acid equivalent 4 provides desired compound 13.

Referring now to Scheme 4 and formula I, supra, where for illustrative purposes T and
Y are NCH3, W is NR8, -O- or -S-, n is 2, R1 and R2 are hydrogen, p, R6, R7 and R8 are as
previously defined, X is a phenolic opioid, P is a protecting group, and M is a leaving group,
compound 14 is acylated with an appropriate carboxylic acid or carboxylic acid equivalent to
provide compound 15. Reaction of compound 15 with activated carbonic acid equivalent 4
provides desired compound 16.
A compound of formula (I) so prepared in which R7 represents a hydrogen atom may
then be further acylated to afford a corresponding compound of formula (I) in which the value
of p has been increased, or in which R7 represents an acyl group.
According to another aspect, therefore, the present invention provides a process for the
preparation of a compound of formula (I) or a pharmaceutically acceptable salt thereof, which
comprises reacting a compound of formula (III)

or a protected derivative thereof, with a compound of formula (IV)

in which M represents a leaving atom or group, such as an activated aryloxycarbonyl group,
for example p-nitrophenoxycarbonyl;
followed by removing any protecting groups and, if desired, acylating a compound of
formula (I) in which R (in the group R4 as defined hereinabove) represents a hydrogen atom
and/or forming a pharmaceutically acceptable salt.
Compounds of formula (I) in which X represents a residue of (R)-N-methylnaltrexone
can also be prepared by methylating a corresponding compound of formula (I) in which X is a
residue of naltrexone, or a protected derivative thereof.
Selection of appropriate protecting groups, reagents and reaction conditions for any of
the steps in the above Schemes is well within the ambit of those of skilled in the art. Other
methods for synthesis of the prodrugs described herein will be readily apparent to the skilled
artisan and may be used to synthesize the compounds described herein. Accordingly, the
methods presented in the Schemes herein are illustrative rather than comprehensive.
The invention further provides all the novel intermediates described herein.
In general, the prodrugs disclosed herein may be used to treat and/or prevent the same
disease(s) and/or conditions as the parent drug which are well known in the art (see, e.g.,
Physicians Desk Reference, 2000 54th Edition and the Merck Index, 13th Edition). Phenolic
opioids are useful in the treatment of pain.
For example, a prodrug of a phenolic opioid such as hydromorphone could be used,
inter alia, to treat or prevent pain including, but not limited to include, acute pain, chronic
pain, neuropathic pain, acute traumatic pain, arthritic pain, osteoarthritic pain, rheumatoid
arthritic pain, muscular skeletal pain, post-dental surgical pain, dental pain, myofascial pain,
cancer pain, visceral pain, diabetic pain, muscular pain, post-herpetic neuralgic pain, chronic
pelvic pain, endometriosis pain, pelvic inflammatory pain and child birth related pain. Acute
pain includes, but is not limited to, acute traumatic pain or post-surgical pain. Chronic pain
includes, but is not limited to, neuropathic pain, arthritic pain, osteoarthritic pain, rheumatoid
arthritic pain, muscular skeletal pain, dental pain, myofascial pain, cancer pain, diabetic pain,
visceral pain, muscular pain, post-herpetic neuralgic pain, chronic pelvic pain, endometriosis
pain, pelvic inflammatory pain and back pain.
The pharmaceutical compositions disclosed herein comprise a prodrug disclosed
herein with a suitable amount of a pharmaceutically acceptable vehicle, so as to provide a
form for proper administration to a subject.
Suitable pharmaceutical vehicles include excipients such as starch, glucose, lactose,
sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate,
talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol and the
like. The present pharmaceutical compositions, if desired, can also contain minor amounts of
wetting or emulsifying agents, or pH buffering agents. In addition, auxiliary, stabilizing,
thickening, lubricating and coloring agents may be used.
Pharmaceutical compositions may be manufactured by means of conventional mixing,
dissolving, granulating, dragee-making, levigating, emulsifying, encapsulating, entrapping or
lyophilizing processes. Pharmaceutical compositions may be formulated in a conventional
manner using one or more physiologically acceptable carriers, diluents, excipients or
auxiliaries, which facilitate processing of compositions and compounds disclosed herein into
preparations which can be used pharmaceutically. Proper formulation is dependent upon the
route of administration chosen.
The present pharmaceutical compositions can take the form of solutions, suspensions,
emulsion, tablets, pills, pellets, capsules, capsules containing liquids, powders,
sustained-release formulations, suppositories, emulsions, aerosols, sprays, suspensions or any
other form suitable for use known to the skilled artisan. In some embodiments, the
pharmaceutically acceptable vehicle is a capsule (see e.g., Grosswald et al, United States
Patent No. 5,698,155). Other examples of suitable pharmaceutical vehicles have been
described in the art (see Remington's Pharmaceutical Sciences, Philadelphia College of
Pharmacy and Science, 19th Edition, 1995).
Pharmaceutical compositions for oral delivery may be in the form of tablets, lozenges,
aqueous or oily suspensions, granules, powders, emulsions, capsules, syrups, slurries,
suspensions or elixirs, for example. Orally administered compositions may contain one or
more optional agents, for example, sweetening agents such as fructose, aspartame or
saccharin, flavoring agents such as peppermint, oil of wintergreen, or cherry coloring agents
and preserving agents, to provide a pharmaceutically palatable preparation. Moreover, when
in tablet or pill form, the compositions may be coated to delay disintegration and absorption
in the gastrointestinal tract, thereby providing a sustained action over an extended period of
time. Oral compositions can include standard vehicles such as mannitol, lactose, starch,
magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, sucrose, sorbitol,
maize starch, wheat starch, rice starch, potato starch, gelatin, gum tragacanth, methyl
cellulose, hydroxypropylmethyl-cellulose, sodium carboxymethylcellulose, and/or
polyvinylpyrrolidone (PVP), granulating agents, binding agents and disintegrating agents
such as the cross-linked polyvinylpyrrolidone, agar, or alginic acid or a salt thereof such as
sodium alginate etc.
In some embodiments, pharmaceutical compositions are in the form of lozenges or
lollipops where dissolution and release of the active ingredients occurs in the oral cavity,
generally through the oral mucosa. For these embodiments, buffering agents may also be
used to provide an optimum environment for delivery of the agents or compositions.
Additional components may include, for example, sweeteners, binders, diluents,
disintegrating agents, lubricating agents, etc.
In still other embodiments, the pharmaceutical composition is a dissolving sublingual
tablet, where dissolution and release of the active ingredients occurs under the tongue, and the
compositions and/or compounds disclosed herein are absorbed through the oral mucosa. In
these embodiments, buffering agents may also be used to provide an optimum environment
for delivery of each of the agents. Additional components may include, for example,
sweeteners, binders, diluents, disintegrating agents, etc.
The methods that involve oral administration of compounds disclosed herein of can
also be practiced with a number of different dosage forms, which provide sustained release.
In some embodiments, the dosage form is comprised of beads that on dissolution or
diffusion release compositions and/or compounds disclosed herein over an extended period of
hours, preferably, over a period of at least 6 hours, more preferably, over a period of at least 8
hours and even more preferably, over a period of at least 12 hours and most preferably, over a
period of at least 24 hours. The beads may have a central composition or core comprising
compounds disclosed herein and pharmaceutically acceptable vehicles, including optional
lubricants, antioxidants and buffers. The beads may be medical preparations with a diameter
of about 1 to about 2 mm. Individual beads may comprise doses of the compounds disclosed
herein. The beads, in some embodiments, are formed of non-cross-linked materials to
enhance their discharge from the gastrointestinal tract. The beads may be coated with a
release rate-controlling polymer that gives a timed-release profile.
The time-release beads may be manufactured into a tablet for therapeutically effective
administration. The beads can be made into matrix tablets by direct compression of a
plurality of beads coated with, for example, an acrylic resin and blended with excipients such
as hydroxypropyhnethyl cellulose. The manufacture of beads has been disclosed in the art
(Lu, Int. J. Pharm. 1994, 112, 117-124; Pharmaceutical Sciences by Remington, 14th ed, pp
1626-1628 (1970); Fincher, J. Pharm. Sci. 1968, 57,1825-1835; Benedikt, United States
Patent No. 4,083,949) as has the manufacture of tablets (Pharmaceutical Sciences, by
Remington, 17th Ed, Ch. 90, pp 1603-1625 (1985).
In other embodiments, an oral sustained release pump may be used (Langer, supra;
Sefton, 1987, CRC Crit Ref Biomed. Eng. 14:201; Saudek etal, 1989, N. Engl J Med.
321:574).
In still other embodiments, polymeric materials can be used (See "Medical
Applications of Controlled Release," Langer and Wise (eds.), CRC Press., Boca Raton,
Florida (1974); "Controlled Drug Bioavailability," Drug Product Design and Performance,
Smolen and Ball (eds.), Wiley, New York (1984); Langer et at, 1983, JMacromol. Sci. Rev.
Macromol Chem. 23:61; Levy et al, 1985, Science 228: 190; During et al., 1989, Ann.
Neurol. 25:351; Howard et al., 1989, J. Neurosurg. 71:105). In some embodiments,
polymeric materials are used for oral sustained release delivery. Such polymers include, for
example, sodium carboxymethylcellulose, hydroxypropylcellulose,
hydroxypropylmethylcellulose and hydroxyethylcellulose (most preferred,
hydroxypropylmethylcellulose). Other cellulose ethers have been described (Alderman, Int.
J. Pharm. Tech. & Prod. Mfr. 1984, 5(3) 1-9). Factors affecting drug release are well known
to the skilled artisan and have been described in the art (Bamba et al, Int. J. Pharm. 1979, 2,
307).
In still other embodiments, enteric-coated preparations can be used for oral sustained
release administration. Coating materials include, for example, polymers with a
pH-dependent solubility {i.e., pH-controlled release), polymers with a slow or pH-dependent
rate of swelling, dissolution or erosion (i.e., time-controlled release), polymers that are
degraded by enzymes {i.e., enzyme-controlled release) and polymers that form firm layers
that are destroyed by an increase in pressure {i.e., pressure-controlled release).
In yet other embodiments, drug-releasing lipid matrices can be used for oral sustained
release administration. For example, solid microparticles of compositions and/or compounds
disclosed herein may be coated with a thin controlled release layer of a lipid {e.g., glyceryl
behenate and/or glyceryl palmitostearate) as disclosed in Farah et al, United States Patent No.
6,375,987 and Joachim et al, United States Patent No. 6,379,700. The lipid-coated particles
can optionally be compressed to form a tablet Another controlled release lipid-based matrix
material which is suitable for sustained release oral administration comprises polyglycolized
glycerides as disclosed in Roussin et al, United States Patent No. 6,171,615.
In yet other embodiments, waxes can be used for oral sustained release administration.
Examples of suitable sustained releasing waxes are disclosed in Cain et al, United States
Patent No. 3,402,240 (carnauba wax, candedilla wax, esparto wax and ouricury wax);
Shtohryn et al, United States Patent No. 4,820,523 (hydrogenated vegetable oil, bees wax,
caranuba wax, paraffin, candelillia, ozokerite and mixtures thereof); and Walters, United
States Patent No. 4,421,736 (mixture of paraffin and castor wax).
In still other embodiments, osmotic delivery systems are used for oral sustained
release administration (Verma et al, Drug Dev. Ind. Pharm. 2000,26:695-708). In some
embodiments, OROS® systems made by Alza Corporation, Mountain View, CA are used for
oral sustained release delivery devices (Theeuwes et al, United States Patent No. 3,845,770;
Theeuwes et al, United States Patent No. 3,916,899).
In yet other embodiments, a controlled-release system can be placed in proximity of
the target of the compositions and/or compounds disclosed herein thus requiring only a
fraction of the systemic dose (See, e.g., Goodson, in "Medical Applications of Controlled
Release," supra, vol. 2, pp. 115-138 (1984)). Other controlled-release systems are discussed
in Langer, 1990, Science 249:1527-1533 may also be used.
In still other embodiments, the dosage form comprises compounds disclosed herein
coated on a polymer substrate. The polymer can be an erodible or a nonerodible polymer. The
coated substrate may be folded onto itself to provide a bilayer polymer drug dosage form. For example, compounds disclosed herein can be coated onto a polymer such as a polypeptide,
collagen, gelatin, polyvinyl alcohol, polyorthoester, polyacetyl, or apolyorthocarbonate and the
coated polymer folded onto itself to provide a bilaminated dosage form. In operation, the
bioerodible dosage form erodes at a controlled rate to dispense the compounds over a
sustained release period. Representative biodegradable polymers comprise a member selected from the group consisting of biodegradable poly(amides), poly (amino acids), poly(esters),
poly(lactic acid), poly(glycolic acid), poly(carbohydrate), poly(orthoester), poly
(orthocarbonate), poly(acetyl), poly(anhydrides), biodegradable poly(dihydropyrans), and
poly(dioxinones) which are known in the art (Rosoff, Controlled Release of Drugs, Chap. 2,
pp. 53-95 (1989); Heller et al., United States Patent No. 3,811,444; Michaels, United States
Patent No. 3,962,414; Capozza, United States Patent No. 4,066,747; Schmitt, United States
Patent No. 4,070,347; Choi et al, United States Patent No. 4,079,038; Choi et al, United
States Patent No. 4,093,709).
In other embodiments, the dosage form comprises compounds disclosed herein loaded
into a polymer that releases the drug(s) by diffusion through a polymer, or by flux through
pores or by rupture of a polymer matrix. The drug delivery polymeric dosage form comprises
a concentration of 10 mg to 2500 mg homogenously contained in or on a polymer. The
dosage form comprises at least one exposed surface at the beginning of dose delivery. The
non-exposed surface, when present, is coated with a pharmaceutically acceptable material
impermeable to the passage of the drug(s). The dosage form may be manufactured by
procedures known in the art. An example of providing a dosage form comprises blending a
pharmaceutically acceptable carrier like polyethylene glycol, with a known dose of
compositions and/or compounds disclosed herein at an elevated temperature, (e.g., 37 °C),
and adding it to a silastic medical grade elastomer with a cross-linking agent, for example,
octanoate, followed by casting in a mold. The step is repeated for each optional successive
layer. The system is allowed to set for about 1 hour, to provide the dosage form.
Representative polymers for manufacturing the dosage form comprise a member selected
from the group consisting of olefin, and vinyl polymers, addition polymers, condensation
polymers, carbohydrate polymers, and silicone polymers as represented by polyethylene,
polypropylene, polyvinyl acetate, polymethylacrylate, polyisobutylmethacrylate, poly
alginate, polyamide and polysilicone. The polymers and procedures for manufacturing them
have been described in the art (Coleman et al., Polymers 1990, 31,1187-1231; Roerdink et
al., Drug Carrier Systems 1989, 9,57-10; Leong et al., Adv. Drug Delivery Rev. 1987, 1,
199-233; Roff et al., Handbook of Common Polymers 1971, CRC Press; Chien et al, United
States Patent No. 3,992,518).
In other embodiments, the dosage form comprises a plurality of tiny pills. The tiny
time-release pills provide a number of individual doses for providing various time doses for
achieving a sustained-release drug delivery profile over an extended period of time up to 24
hours. The matrix comprises a hydrophilic polymer selected from the group consisting of a
polysaccharide, agar, agarose, natural gum, alkali alginate including sodium alginate,
carrageenan, fucoidan, furcellaran, laminaran, hypnea, gum arabic, gum ghatti, gum karaya,
gum tragacanth, locust bean gum, pectin, amylopectin, gelatin, and a hydrophilic colloid. The
hydrophilic matrix comprises a plurality of 4 to 50 tiny pills, each tiny pill comprises a dose
population of from 10ng,0.5mg, 1 mg, 1.2 mg, 1.4mg, 1.6 mg, 5.0 mg, etc. The tiny pills
comprise a release rate-controlling wall of 0.001 mm up to 10 mm thickness to provide for the
timed release of drug(s). Representative wall forming materials include a triglyceryl ester
selected from the group consisting of glyceryl tristearate, glyceryl monostearate, glyceryl
dipalmitate, glyceryl laureate, glyceryl didecenoate and glyceryl tridenoate. Other wall
forming materials comprise polyvinyl acetate, phthalate, methylcellulose phthalate and
microporous olefins. Procedures for manufacturing tiny pills are disclosed in Urquhart et ah,
United States Patent No. 4,434,153; Urquhart eta!., United States Patent No. 4,721,613;
Theeuwes, United States Patent No. 4,853,229; Barry, United States Patent No. 2,996,431;
Neville, United States Patent No. 3,139,383; Mehta, United States Patent No. 4,752,470.
In other embodiments, the dosage form comprises an osmotic dosage form, which
comprises a semipermeable wall that surrounds a therapeutic composition comprising
compounds disclosed herein. In use within a subject, the osmotic dosage form comprising a
homogenous composition, imbibes fluid through the semipermeable wall into the dosage form
in response to the concentration gradient across the semipermeable wall. The therapeutic
composition in the dosage form develops osmotic pressure differential that causes the
therapeutic composition to be administered through an exit from the dosage form over a
prolonged period of time up to 24 hours (or even in some cases up to 30 hours) to provide
controlled and sustained release. These delivery platforms can provide an essentially zero
order delivery profile as opposed to the spiked profiles of immediate release formulations.
In other embodiments, the dosage form comprises another osmotic dosage form
comprising a wall surrounding a compartment, the wall comprising a semipermeable
polymeric composition permeable to the passage of fluid and substantially impermeable to the
passage of compounds disclosed herein present in the compartment, a drug-containing layer
composition in the compartment, a hydrogel push layer composition in the compartment
comprising an osmotic formulation for imbibing and absorbing fluid for expanding in size for
pushing the drug composition layer from the dosage form, and at least one passageway in the
wall for releasing the composition. The method delivers compounds disclosed herein by
imbibing fluid through the semipermeable wall at a fluid imbibing rate determined by the
permeability of the semipermeable wall and the osmotic pressure across the semipermeable
wall causing the push layer to expand, thereby delivering the compounds disclosed herein
from the dosage form through the exit passageway to a subject over a prolonged period of
time (up to 24 or even 30 hours). The hydrogel layer composition may comprise 10 mg to
1000 mg of a hydrogel such as a member selected from the group consisting of a polyalkylene
oxide of 1,000,000 to 8,000,000 weight-average molecular weight which are selected from the
group consisting of a polyethylene oxide of 1,000,000 weight-average molecular weight, a polyethylene oxide of 2,000,000 molecular weight, a polyethylene oxide of 4,000,000
molecular weight, a polyethylene oxide of 5,000,000 molecular weight, a polyethylene oxide
of 7,000,000 molecular weight and a polypropylene oxide of the 1,000,000 to 8,000,000
weight-average molecular weight; or 10 mg to 1000 mg of an alkali carboxymethylcellulose of
10,000 to 6,000,000 weight average molecular weight, such as sodium carboxymethylcellulose
or potassium carboxymethylcellulose. The hydrogel expansion layer comprises 0.0 mg to 350
mg, in present manufacture; 0.1 mg to 250 mg of a hydroxyalkylcellulose of 7,500 to 4,500,00
weight-average molecular weight (e.g., hydroxymethylcellulose,
hydroxyethylcellulose, hydroxypropylcellulose, hydroxybutylcellulose or
hydroxypentylcellulose) in present manufacture; 1 mg to 50 mg of an osmagent selected
from the group consisting of sodium chloride, potassium chloride, potassium acid
phosphate, tartaric acid, citric acid, raffinose, magnesium sulfate, magnesium chloride, urea,
inositol, sucrose, glucose and sorbitol; 0 to 5 mg of a colorant, such as ferric oxide; 0 mg to 30
mg, in a present manufacture, 0.1 mg to 30 mg of a hydroxypropylalkylcellulose of 9,000 to
225,000 average-number molecular weight, selected from the group consisting of
hydroxypropylethylcellulose, hydroxypropypentylcellulose,
hydroxypropylmethylcellulose, and hydropropylbutylcellulose; 0.00 to 1.5 mg of an
antioxidant selected from the group consisting of ascorbic acid, butylated hydroxyanisole,
butylated hydroxyquinone, butylhydroxyanisole, hydroxycoumarin, butylated
hydroxytoluene, cephalm, ethyl gallate, propyl gallate, octyl gallate, lauryl gallate,
propyl-hydroxybenzoate, trihydroxybutyrophenone, dimethylphenol, dibutylphenol,
vitamin E, lecithin and ethanolamine; and 0.0 mg to 7 mg of a lubricant selected from the
group consisting of calcium stearate, magnesium stearate, zinc stearate, magnesium oleate,
calcium palmitate, sodium suberate, potassium laurate, salts of fatty acids, salts of alicyclic
acids, salts of aromatic acids, stearic acid, oleic acid, palmitic acid, a mixture of a salt of a
fatty, alicyclic or aromatic acid and a fatty, alicyclic or aromatic acid.
In the osmotic dosage forms, the semipermeable wall comprises a composition that is
permeable to the passage of fluid and impermeable to the passage of compounds disclosed
herein. The wall is non-toxic and comprises a polymer selected from the group consisting of a
cellulose acylate, cellulose diacylate, cellulose triacylate, cellulose acetate, cellulose diacetate
and cellulose triacetate. The wall comprises 75 wt % (weight percent) to 100 wt % of the
cellulosic wall-forming polymer; or, the wall can comprise additionally 0.01 wt % to 80 wt %
of polyethylene glycol, or 1 wt % to 25 wt % of a cellulose ether selected from the group
consisting of hydroxypropylcellulose or a hydroxypropylalkylcellulose such as
hydroxypropylmethylcellulose. The total weight percent of all components comprising the
wall is equal to 100 wt %. The internal compartment comprises the drug-containing
composition alone or in layered position with an expandable hydrogel composition. The
expandable hydrogel composition in the compartment increases in dimension by imbibing the
fluid through the semipermeable wall, causing the hydrogel to expand and occupy space in
the compartment, whereby the drug composition is pushed from the dosage form. The
therapeutic layer and the expandable layer act together during the operation of the dosage
form for the release of compounds disclosed herein to a subject over time. The dosage form
comprises a passageway in the wall that connects the exterior of the dosage form with the
internal compartment The osmotic powered dosage form can be made to deliver drug from
the dosage form to the subject at a zero order rate of release over a period of up to about 24
hours.
The expression "passageway" as used herein comprises means and methods suitable
for the metered release of the compounds disclosed herein from the compartment of the
dosage form. The exit means comprises at least one passageway, including orifice, bore,
aperture, pore, porous element, hollow fiber, capillary tube, channel, porous overlay, or
porous element that provides for the osmotic controlled release of the compounds disclosed
herein. The passageway includes a material that erodes or is leached from the wall in a
fluid environment of use to produce at least one controlled-release dimensioned
passageway. Representative materials suitable for forming a passageway, or a multiplicity
of passageways comprise a leachable poly(glycolic) acid or poly(lactic) acid polymer in the
wall, a gelatinous filament, poly(vinyl alcohol), leach-able polysaccharides, salts, and
oxides. A pore passageway, or more than one pore passageway, can be formed by
leaching a leachable compound, such as sorbitol, from the wall. The passageway
possesses controlled-release dimensions, such as round, triangular, square and elliptical, for
the metered release of compositions and/or drugs from the dosage form. The dosage form
can be constructed with one or more passageways in spaced apart relationship on a single
surface or on more than one surface of the wall. The expression "fluid environment"
denotes an aqueous or biological fluid as in a human patient, including the gastrointestinal
tract. Passageways and equipment for forming passageways are disclosed in Theeuwes et al,
United States Patent No. 3,845,770; Theeuwes et al, United States Patent No. 3,916,899;
Saunders et al., United States Patent No. 4,063,064; Theeuwes et al, United States Patent No.
4,088,864 and Ayer et al, United States Patent No. 4,816,263. Passageways formed by
leaching are disclosed in Ayer et al, United States Patent No. 4,200,098 and Ayer et al,
United States Patent No. 4,285,987.
In order to decrease dosing frequency and augment the convenience to the subject and
increase subject compliance, the sustained release oral dosage form (regardless of the specific
form of the sustained release dosage form) preferably, provides therapeutic concentrations of
the compounds disclosed herein in the patient's blood over a period of at least about 6 hours,
more preferably, over a period of at least about 8 hours, even preferably, over a period of at
least about 12 hours and most preferably, over a period of at least 24 hours.
For oral liquid preparations such as, for example, suspensions, elixirs and solutions,
suitable carriers, excipients or diluents include water, saline, alkyleneglycols {e.g., propylene
glycol), polyalkylene glycols {e.g., polyethylene glycol) oils, alcohols, slightly acidic buffers
between pH 4 and pH 6 {e.g., acetate, citrate, ascorbate at between about 5 mM to about 50
mM), etc. Additionally, flavoring agents, preservatives, coloring agents, bile salts,
acylcarnitines and the like may be added.
Liquid drug formulations suitable for use with nebulizers and liquid spray devices and
EHD aerosol devices will typically include compounds disclosed herein with a
pharmaceutically acceptable carrier such as, for example, a liquid {e.g., alcohol, water,
polyethylene glycol or a perfluorocarbon). Optionally, another material may be added to alter
the aerosol properties of the solution or suspension of compositions and/or compounds
disclosed herein. In some embodiments, this material is liquid such as an alcohol, glycol,
polyglycol or a fatty acid. Other methods of formulating liquid drug solutions or suspension
suitable for use in aerosol devices are known to those of skill in the art (Biesalski, United
States Patent No. 5,112,598; Biesalski, United States Patent No. 5,556,611).
For topical administration a compound disclosed herein may be formulated as
solutions, gels, ointments, creams, suspensions, etc. as are well-known in the art.
For buccal administration, the compounds disclosed herein may take the form of
tablets, lozenges, lollipops, etc. formulated in a conventional manner.
Compounds disclosed herein may also be formulated in rectal or vaginal compositions
such as suppositories or retention enemas, e.g., containing conventional suppository bases
such as cocoa butter or other glycerides.
Systemic formulations include those designed for administration by injection, e.g.,
subcutaneous, intravenous, intramuscular, intrathecal or intraperitoneal injection, as well as
those designed for transdermal, transmucosal, oral or pulmonary administration. Systemic
formulations may be made in combination with a further active agent that improves
mucociliary clearance of airway mucus or reduces mucous viscosity. These active agents
include but are not limited to sodium channel blockers, antibiotics, N-acetyl cysteine,
homocysteine and phospholipids.
For injection, compounds disclosed herein may be formulated in aqueous solutions,
such as physiologically compatible buffers such as Hanks' solution, Ringer's solution,
physiological saline buffer or in association with a surface-active agent (or wetting agent or
surfactant) or in the form of an emulsion (as a water-in-oil or oil-in-water emulsion). Suitable
surface-active agents include, in particular, non-ionic agents, such as
polyoxyethylenesorbitans (e.g., Tween™ 20,40, 60, 80 or 85) and other sorbitans (e.g.,
Span™ 20, 40, 60, 80 or 85). Compositions with a surface-active agent may comprise
between 0.05 and 5% surface-active agent or between 0.1 and 2.5% surface-active agent. The
solution may contain formulatory agents such as suspending, stabilizing and/or dispersing
agents. Alternatively, compounds disclosed herein may be in powder form for constitution
with a suitable vehicle, e.g., sterile pyrogen-free water, before use.
Suitable emulsions may be prepared using commercially available fat emulsions. The
combination (or single components) may be either dissolved in a pre-mixed emulsion
composition or alternatively it may be dissolved in an oil (e.g., soybean oil, safflower oil,
cottonseed oil, sesame oil, corn oil or almond oil) and an emulsion formed upon mixing with
a phospholipid (e.g., egg phospholipids, soybean phospholipids or soybean lecithin) and
water. It will be appreciated that other ingredients may be added, for example glycerol or
glucose, to adjust the tonicity of the emulsion. Suitable emulsions will typically contain up to
20% oil, for example, between 5 and 20%. In some embodiments, EDTA is added as a
preservative.
In addition to the formulations described previously, compounds disclosed herein may
also be formulated as a depot preparation. Such long acting formulations may be
administered by implantation (for example, subcutaneously or intramuscularly) or by
intramuscular injection. Thus, for example, compounds disclosed herein may be formulated
with suitable polymeric or hydrophobic materials (for example, as an emulsion in an
acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a
sparingly soluble salt.
When used to treat and/or prevent diseases the compounds disclosed herein and/or
pharmaceutical compositions thereof may be administered alone or in combination with other
pharmaceutical agents including compounds disclosed herein and/or pharmaceutical
compositions thereof. The compounds disclosed herein may be administered or applied per
se or as pharmaceutical compositions. The specific pharmaceutical composition depends on
the desired mode of administration, as is well known to the skilled artisan.
Compounds disclosed herein and/or pharmaceutical compositions thereof may be
administered to a subject by intravenous bolus injection, continuous intravenous infusion, oral
tablet, oral capsule, oral solution, intramuscular injection, subcutaneous injection, transdermal
absorption, buccal absorption, intranasal absorption, inhalation, sublingual, intracerebrally,
intravaginally, rectally, topically, particularly to the ears, nose, eyes, or skin or any other
convenient method known to those of skill in the art. In some embodiments, compounds
disclosed herein and/or pharmaceutical compositions thereof are delivered via sustained
release dosage forms, including oral sustained release dosage forms. Administration can be
systemic or local. Various delivery systems are known, (e.g., encapsulation in liposomes,
microparticles, microcapsules, capsules, "patient controlled analgesia" drug delivery systems,
etc.) that can be used to deliver compounds disclosed herein and/or pharmaceutical
compositions thereof.
Compounds disclosed herein and/or pharmaceutical compositions thereof may also be
administered directly to the lung by inhalation. For administration by inhalation, the
compounds disclosed herein and/or pharmaceutical compositions thereof may be conveniently
delivered to the lung by a number of different devices. For example, a Metered Dose Inhaler
("MDI") which utilizes canisters that contain a suitable low boiling propellant, e.g.,
dichlorodifluoromethane, trichlorofluoromemane, dichlorotetrafluoroethane, carbon dioxide
or other suitable gas may be used to deliver the compounds disclosed herein and/or
pharmaceutical compositions thereof.
Alternatively, a Dry Powder Inhaler ("DPI") device may be used to administer
compounds disclosed herein and/or pharmaceutical compositions thereof (See, e.g., Raleigh et
ah, Proc. Amer. Assoc. Cancer Research Annual Meeting, 1999, 40, 397). DPI devices
typically use a mechanism such as a burst of gas to create a cloud of dry powder inside a
container, which may then be inhaled by the patient. A popular variation is the multiple dose
DPI ("MDDPI") system, which allows for the delivery of more than one therapeutic dose.
For example, capsules and cartridges of gelatin for use in an inhaler or insufflator may be
formulated containing a powder mix of the compositions and/or compounds disclosed herein
and a suitable powder base such as lactose or starch for these systems.
Another type of device that may be used to deliver the compounds disclosed herein
and/or pharmaceutical compositions thereof is a liquid spray device supplied, for example, by
Aradigm Corporation, Hayward, CA. Liquid spray systems use extremely small nozzle holes
to aerosolize liquid drug formulations that may then be directly inhaled.
In some embodiments, a nebulizer device is used to deliver compounds and/or
pharmaceutical compositions thereof disclosed herein. Nebulizers create aerosols from liquid
drug formulations by using, for example, ultrasonic energy to form fine particles that may be
readily inhaled (e.g., Verschoyle et al, British J. Cancer, 1999, 80, Suppl. 2, 96; Armer et al,
United States Patent No. 5,954,047; van der Linden et al, United States Patent No.
5,950,619; van der Linden et al, United States Patent No. 5,970,974).
In still other embodiments, an electrohydrodynamic ("EHD") aerosol device is used to
deliver the compounds disclosed herein and/or pharmaceutical compositions thereof. EHD
aerosol devices use electrical energy to aerosolize liquid drug solutions or suspensions (see
e.g., Noakes et al, United States Patent No. 4,765,539; Coffee, United States Patent No.
4,962,885; Coffee, International Publication No. WO 94/12285; Coffee, International
Publication No. WO 94/14543; Coffee, International Publication No. WO 95/26234; Coffee,
International Publication No. WO 95/26235; Coffee, International Publication No. WO
95/32807). Other methods of intra-pulmonary delivery of a compound disclosed herein
and/or pharmaceutical composition thereof are known to the skilled artisan and are within the
scope of the present disclosure.
Transdermal devices can also be used to deliver the compounds disclosed herein
and/or pharmaceutical compositions thereof. In some embodiments, the transdermal device is
a matrix type transdermal device (Miller et al, International Publication No. WO
2004/041324). In other embodiments, the transdermal device is a multi-laminate transdermal
device (Miller, United States Patent Application Publication No. 2005/0037059).
The amount of compounds disclosed herein and/or pharmaceutical compositions
thereof that will be effective in the treatment or prevention of diseases in a patient will depend
on the specific nature of the condition and can be determined by standard clinical techniques
known in the art. The amount of compounds disclosed herein and/or pharmaceutical
compositions thereof administered will, of course, be dependent on, among other factors, the
subject being treated, the weight of the subject, the severity of the affliction, the manner of
administration and the judgment of the prescribing physician.
In certain embodiments, compounds disclosed herein and/or pharmaceutical
compositions thereof can be used in combination therapy with at least one other therapeutic
agent. The compounds disclosed herein and/or pharmaceutical compositions thereof and the
therapeutic agent can act additively or, more preferably, synergistically. In some
embodiments, compounds disclosed herein and/or pharmaceutical compositions thereof are
administered concurrently with the administration of another therapeutic agent. For example,
compounds disclosed herein and/or pharmaceutical compositions thereof may be administered
together with another therapeutic agent (e.g. including, but not limited to, peripheral opioid
antagonists, laxatives, non-opioid analgesics and the like). In other embodiments, compounds
disclosed herein and/or pharmaceutical compositions thereof are administered prior or
subsequent to administration of other therapeutic agents.
In one embodiment, the present invention provides a pharmaceutical composition
comprising a compound of Formula (I), or a salt, hydrate of solvate thereof, in which X is
(R)-N-methylnaltrexone and a compound of Formula (I), or a salt, hydrate of solvate thereof,
in which X is a phenolic opioid, such as oxymorphone, hydromorphone or morphine, and a
pharmaceutically acceptable carrier.
It will be apparent to those skilled in the art that many modifications, both to materials
and methods, may be practiced without departing from the scope of this disclosure.
Accordingly, the present embodiments are to be considered as illustrative and not restrictive,
and the invention is not to be limited to the details given herein, but may be modified within
the scope and equivalents of the allowed claims.
All publications and patents cited herein are incorporated by reference in their
entirety.
The following examples illustrate the invention.
In the examples, the following abbreviations are used:-
HOBt: 1-Hydroxybenzotriazole; PyBOP: Benzotriazole-1-yl-oxy-tris-pyrrolidino-
phosphonium hexafluorophosphate; DIEA: diisopropylethylamine; and BocGlyOSu:
N-(N-alpha-glycinyloxy)succinimide.
Preparation 1

BocArg(diBoc)OH (Bachem, 0.47 g, 1.0 mmol) was dissolved in dimethylformamide (5 ml)
and mixed with HOBt (0.15 g (1.15 mmol) and PyBOP (0.6 g, 1.15 mmol).
Diisopropylethylamine (0.4 ml, 2.3 mmol) was added to the mixture, then the resulting
solution was stirred for 10 minutes and added to a solution of H2NCH2CH2N(CH3)CBz (0.28
g, 1.15 mmol) in dimethylformamide (3 ml). The basicity was adjusted by addition of DIE A
(0.4 ml (2.3 mmol). The mixture was stirred for 2 hours and then poured into 40 ml of 5%
aqueous citric acid. The product was extracted with a 20 ml of ethyl ether and ethyl acetate
(5:1). The organic layer was washed with water, two times with 10 ml of 1M aqueous sodium
carbonate, water and brine, and then dried over magnesium sulfate. The solvents were
removed by evaporation to afford 0.65 g (98%) of depicted product.
Preparation 2
The product of Preparation 1 (0.65 g, 0.98 mmol) was dissolved in ethanol (10 ml).
Pearlman's catalyst (0.32 g) was then added and the mixture was subjected to hydrogenation
(1 atm, 24 h). The resultant mixture was then filtered from the catalyst and the solvent was
removed by evaporation. The residue was further dried under high vacuum for 2 hours to
afford 0.525 g (99%) of the depicted product.
Preparation 3

Hydromorphone (0.21 g (0.74 mmol) was suspended in dichloromethane (3 ml), p-
Nitrophenylchlorocarbonate (0.16 g (0.79 mmol) in dichloromethane (3 ml) was then added
dropwise over a period of 5 minutes. The reaction mixture was then sonicated for 2 hours to
afford a stock solution of the depicted product that was used in the next step.
Preparation 4

The product of Preparation 2 (0.21 g, 0.38 mmol) was added to the product of Preparation 3
(stock solution, 3 ml, 0.38 mmol). The pH was then adjusted by adding triethylamine (0.056
ml, 0.4 mmol). The reaction mixture was then stirred for 6 hours. The solvent was then
evaporated under a vacuum, and the residue was dissolved in a diethyl ether-ethyl acetate
mixture (3:1,10 ml) and washed four times with 5 ml of 1M aqueous sodium carbonate. The
organic layer was then washed three times with water (10 ml) and once with brine (10 ml),
then dried over magnesium sulfate. The solvent was then removed by evaporation to afford
the depicted product 0.28g (87.5%).
Example 1
Hydromorphone3-(N-methyl-N-(2-arginylamino))ethylcarbamate

The product of Preparation 4 (0.28 g, 0.33 mmol) was dissolved in a 1:1 mixture of
dichloromethane and trifluoroacetic acid (6 ml). The reaction mixture was then stirred for 6
hours. The solvent was then removed by evaporation under a vacuum, and the residue was
triturated with ethyl ether (10 ml). A precipitate formed, and this was filtered off, washed with
diethyl ether (10 ml) four times and dried in a stream of dry nitrogen gas to afford a crude
product (0.26 g). A portion of the crude product (0.14 g) was purified by reverse phase
preparative HPLC (acetonitrile gradient) to afford the depicted compound (0.031 g, 29%).
Mass spec: Calculated 541.3. Observed 542.4
Preparation 5
BocGlyOSu (0.037 g, 0.136 mmol) was added to a stirred solution of the product of Example
1 (0.12 g, 0.136 mmol) in dimethylformamide (3 ml). Triethylamine (0.048 ml, 0.272) mmol)
was then added to the reaction mixture and the resulting solution was stirred for 2 hours. The
solvent was then removed by evaporation under a high vacuum, and the residue was triturated
with diethyl ether (3 ml) to afford the depicted compound (0.125 g, 100%).
Example 2
Hydromorphone 3-(N-methyl-N-(2-N'-glycinylarginylamino))ethylcarbamate

The product of Preparation 5 was deprotected following the method of Example 1 to afford a
crude product, which was purified by reverse phase preparative HPLC to afford the depicted
product (0.015 g, 16%). Mass spec: Calculated 598.3. Observed 599.1
Example 3
Hydromorphone3-(N-methyl-N-(2-N,-acetylarginylamino))ethylcarbamate

Prepared following the method of Preparation 5 and Example 2, but using acetic anhydride
instead of BocGlyOSu. Mass spec: Calculated 583.3. Observed 584.4.
Example 4
Hydromorphone3-(N-methyl-N-(2-N'-t-butanoylarginylamino))ethylcarbamate

Prepared following the method of Preparation 5 and Example 2, but using t-butanoyl chloride
instead of BocGlyOSu. Mass spec: Calculated 625.4. Observed 626.8.
Example 5

Prepared following the method of Preparation 5 and Example 2, but using benzoyl chloride
instead of BocGlyOSu. Mass spec: Calculated 645.3. Observed 646.7.
Example 6
Hydromorphone 3-(N-methyl-N-(N'-piperonyl-2-arginylamino))ethylcarbamate
(
Prepared following the method of Preparation 5 and Example 2, but using piperonyl chloride
instead of BocGlyOSu. Mass spec: Calculated 689.3. Observed 690.4.
Example 7

Prepared following the method of Preparations 1 to 4 and Example 1, but using
BocLys(Boc)OH instead of BocArg(diBoc)OH. Mass spec: Calculated 513.3. Observed
514.2.
Example 8
Hydromorphone 3-(N-methyl-N-(2-Iysinyl(methyl)amino))ethylcarbamate

Prepared following the method of Example 7, but using CH3NHCH2CH2N(CH3)CBz instead
of H2NCH2CH2N(CH3)CBz. Mass spec: Calculated 527.3. Observed 528.2.
Example 9

Prepared following the method of Preparations 1 to 4 and Example 1, but using
CH3NHCH2CH2N(CH3)CBz instead of H2NCH2CH2N(CH3)CBz. Mass spec: Calculated
555.3. Observed 556.3.
Example 10

Prepared following the method of Preparations 1 to 4 and Example 1, but using
BocGlu(OBu1)OH instead of BocArg(diBoc)OH. Mass spec: Calculated 514.2. Observed
515.3.
]
]
Prepared following the method of Preparations 1 to 4 and Example 1, but using
BocAsp(OtBu)OSu instead of BocArg(diBoc)OH. Mass spec: Calculated 500.23. Observed
501.5.

)
Prepared following the method of Preparations 1 to 4 and Example 1, but using
BocTyr(OtBu)OH instead of BocArg(diBoc)OH. Mass spec: Calculated 548.26. Observed
549.3
Reference Example 1

Prepared following the method of Preparations 1 to 4 and Example 1, but using
CBzpiperidine instead of H2NCH2CH2N(CH3)CBz. Mass spec: Calculated 553.3. Observed
554.5.
Preparation 6
Oxymorphone (0.15 g, 0.5 mmol) was suspended in dichloromethane (3 ml), p-
Nitrophenylchlorocarbonate (0.105 g (0.52 mmol) in dichloromethane (5 ml) was then added
dropwise over a period of 5 minutes. The reaction mixture was then sonicated for 2 hours to
afford a stock solution of the depicted product that was used in the next step.
Preparation 7
The product of Preparation 2, previously described, (0.265 g, 0.5 mmol) was added to the
product of Preparation 6 (stock solution, 8 ml, 0.5 mmol). The pH was then adjusted by
adding triethylamine (0.14 ml, 1.0 mmol). The reaction mixture was then stirred for 4 hours.
The solvent was then evaporated under a vacuum, and the residue was dissolved in a diethyl
ether-ethyl acetate mixture (3:1, 10 ml) and washed four times with 5 ml of 1M aqueous
sodium carbonate. The organic layer was then washed three times with water (10 ml) and
once with brine (10 ml), then dried over magnesium sulfate. The solvent was then removed by
evaporation to afford the depicted product 0.39 g (90%).

The product of Preparation 7 (0.39 g, 0.46 mmol) was dissolved in a 1:1 mixture of
dichloromethane and trifluoroacetic acid (6 ml). The reaction mixture was then stirred for 6
hours. The solvent was then removed by evaporation under a vacuum, and the residue was
triturated with ethyl ether (10 ml). A precipitate formed, and this was filtered off, washed with
diethyl ether (10 ml) four times and dried in a stream of dry nitrogen gas to afford a crude
product (0.46 g). A portion of the crude product (0.06 g) was purified by reverse phase
preparative HPLC (acetonitrile gradient) to afford the depicted compound (0.035 g, 90%).
Mass spec: Calculated 557.3. Observed 558.0
Preparation 8

BocGlyOSu. (0.065 g, 0.24 mmol) was added to a stirred solution of the crude product of
Example 13 (0.2 g, 0.22 mmol) in dimethylformamide (3 ml). Triethylamine (0.066 ml, 0.48)
mmol) was then added to the reaction mixture and the resulting solution was stirred for 2
hours. The solvent was then removed by evaporation under a high vacuum, and the residue
was trifurated with diethyl ether (three times by 3 ml) to afford the depicted compound
(0.164 g, 79%).


The product of Preparation 8 was deprotected following the method of Example 13 to afford a
crude product, which was purified by reverse phase preparative HPLC to afford the depicted
product (0.055 g, 44%). Mass spec: Calculated 614.3. Observed 615.4.
Example 15
Oxyroorphone 3-(N-methyl-N-(2-N '-acetylarginylamino))ethylcarbamate

Prepared and purified following the method of Preparation 8 and Example 14, but using acetic
anhydride instead of BocGlyOSu. Mass spec: Calculated 599.3. Observed 600.4.
Preparation 9
The product of Preparation 9 was synthesized following the method of Preparation 7,
substituting morphine for oxymorphone, to afford a stock solution of the depicted product that
was used in preparation 10.
Preparation 10

The product of Preparation 10 was synthesized following the method of Preparation 12 to
afford the depicted product 0.85 g (92%).
Example 16
MMorphine 3-(N-methyl-N-(2~arginylamino))ethylcarbamate

The product of Example 16 was synthesized following the method of Example 13 to
afford a crude product (0.93 g). A portion of the crude product (0.08 g) was purified by
reverse phase preparative HPLC (acetonitrile gradient) to afford the depicted compound
(0.043 g, 45%). Mass spec: Calculated 541.6 Observed 542.6
Preparation 11

The product of Preparation 11 was synthesized following the method of Preparation 13 to
afford the depicted compound (0.18 g, 84%).
]
The product of Preparation 11 was deprotected following the method of Example 13 to afford
a crude product, which was purified by reverse phase preparative HPLC to afford the depicted
product (0.036 g, 40%). Mass spec: Calculated 598.7. Observed 599.6.

Prepared and purified following the method of Preparation 8 and Example 14, but using acetic
anhydride instead of BocGlyOSu. Mass spec: Calculated 583.7. Observed 584.5.

Naltrexone (0.34 g (1.0 mmol) was dissolved in dichloromethane (10 ml), p-
Nitrophenylchlorocarbonate (0.212 g (1.1 mmol) in dichloromethane (5 ml) was then added
dropwise over a period of 5 minutes. The reaction mixture was then sonicated for 2 hours to
afford a stock solution of the depicted product that was used in the next step.
Preparation 13

The product of Preparation 12 (stock solution, 15 ml, 1.0 mmol) was added to the solution of
0.265 g (1.05 mmol) of benzyl 2-(methylamino)ethylcarbamate hydrochloride in 10 ml of
dimethylformamide. The pH was then adjusted by adding triethylamine (0.28 ml, 2.0 mmol).
The reaction mixture was then stirred for 2 hours. The solvent was then evaporated under a
vacuum, and the residue was dissolved in ethyl acetate (20 ml) and washed four times with 10
ml of 1M aqueous sodium carbonate. The organic layer was then washed three times with
water (10 ml) and once with brine (10 ml), then dried over magnesium sulfate. The solvent
was then removed by evaporation to afford the depicted product 0.425 g (74%). Mass spec:
Calculated 575.26 Observed 576.4.
Preparation 14

The product of Preparation 13 (0.425 g, 0.74 mmol) was dissolved in 5 ml of dry acetone.
Methyl iodide (1.42 g, 10 mmol) was added and the mixture was heated in a capped tube at
85°C for 3 days. The solvent was then removed by evaporation. The residue was then
dissolved in 10 ml of methanol and loaded onto a column with 4 g of anion-exchange resin,
chloride form (DOWEX 1x2-200). The chloride salt was eluted from the column using 50 ml
of methanol. The solution was then evaporated to 10 ml volume and mixed with 2 g of silica
gel. The remaining solvent was then evaporated and the residual dry powder was loaded onto
a silica gel column. Remaining starting compound was then eluted with dichloromethane/lM
solution of ammonia in methanol (95:5). The product was then eluted with
dichloromethane/lM solution of ammonia in methanol (70:30) to afford the depicted
compound 0.125 g (27%).
Example 19
The product of Preparation 14 (0.125 g, 0.2 mmol) was dissolved in trifluoroacetic acid (3
ml). AIM solution of boron tribromide in dichloromethane (0.4 ml, 0.4 mmol) was added at
0-5°C. The mixture was then stirred for 2 hours. The solvent was removed in vacuum. 10 ml
of 3 N aqueous hydrogen chloride were mixed with the residue and the mixture was stirred
for 16 hours. After evaporation of water under a vacuum, the crude product was purified by
reverse phase preparative HPLC (acetonitrile gradient) to afford the depicted compound
(0.032 g, 30%). Mass spec: Calculated 456.25. Observed 456.4.
Preparation 15
The product of Preparation 15 was prepared following the method of Preparation 1, but using
BocLys(Boc)OH to afford depicted product with 74% yield.
Preparation 16

The product of Preparation 16 was prepared following the method of Preparation 2 using the
product of Preparation 15 to afford depicted product with 95% yield.
Preparation 17

The product of Preparation 17 was prepared following the method of Preparation 12, but
using the product of Preparation 16 a to afford the depicted product with 66% yield.
Preparation 18

Prepared following the method of Preparation 14. Yield 16%.


Prepared following the method of Example 1. The crude product was purified by reverse
phase preparative HPLC (acetonitrile gradient) to afford the depicted compound (33%).
Mass spec: Calculated 584.3. Observed 584.5.
Protocols for Evaluating Test Compounds
la. "Kitchen" Test
The stability of a test compound in the presence of the readily available household chemicals,
acetic acid (vinegar) and sodium bicarbonate (baking soda) may be demonstrated in the
following "Kitchen" Test.
0.5 mg of a test compound is dissolved in 1 ml of each of the following solutions
corresponding with possible household chemicals: 30% aqueous acetic acid; 50% aqueous
ethanol and saturated aqueous solution of sodium bicarbonate (baking soda). Each solution is
kept at room temperature for 20-24 hours and then heated at 85°C for 20-24 hours.
Hydromorphone release and general stability are monitored by analytical HPLC. A compound
is considered as having passed this test if after 20 hours the hydromorphone concentration
does not exceed 10% of the starting material or other product of degradation.
The compounds exemplified herein have passed this test.
lb. Demonstration of the controlled release of parent drug from "activated" prodrugs.
IN VITRO DEMONSTRATION
The controlled release of parent drug (e.g. hydromorphone) from the prodrug was
demonstrated by the synthesis, and in vitro testing of several compounds depicted in Table 1.
Compounds A, and C are examples of "activated" prodrugs whereby the enzyme-cleavable
activating group has been omitted to enable specific evaluation of the kinetics attending the
intramolecular cyclization-release sequence. As previously described, the intramolecular
cyclization-release sequence results in the concomitant formation of a cyclic urea with the
release of the parent drug.
These release kinetics of these compounds were evaluated in aqueous solutions at increasing
pH. The liberation of hydromorphone during the course of these reactions was confirmed by
LC-MS analysis. Compound D is an interesting example of a molecule that bears a
nucleophilic nitrogen atom, yet it is rendered incapable of undergoing the intramolecular
cyclization-release reaction due to the conformational restrictions imposed by the cyclic
piperazine ring (i.e it cannot adopt the conformation required for the nucleophilic addition of
the lone pair of electrons on nitrogen into the carbonyl carbon of the carbamate moiety). A
further example of the structural features required for the intramolecular cyclization-release
reaction is provided by compound B representing a molecule is in its "unactivated" form (i.e.
the lone pair of electrons on the now acylated nitrogen atom are unavailable for nucleophilic
attack on the carbamate). It is interesting to note that the intramolecular cyclization-release
reactions can be suppressed at low pH by deactivation of the nucleophilic nitrogen atom via
protonation.
These data confirm the functional roles of the spacer and the "activated" nucleophilic
nitrogen in the intramolecular cyclization-release of the parent drug molecule.
Table 1. The liberation of hydromorphone from prodrug in aqueous solutions.
IN VIVO DEMONSTRATION
In order to investigate the formation of parent drug form prodrug in vivo, compounds
depicted in Table 2 were synthesized and administered intravenously to rats. Subsequent to
dosing, plasma levels of hydromorphone were measured as described in the experimental
section. Compounds A, and B are examples of "activated" prodrugs whereby the enzyme-
cleavable activating group has been omitted to enable specific evaluation of the kinetics
attending the intramolecular cyclization-release sequence As previously described, the
intramolecular cyclization-release sequence results in the concomitant formation of a cyclic
urea with the release of the parent drug.
When these drugs are administered to rats, hydromorphone is liberated. Compound C is an
interesting example of a molecule that bears a nucleophilic nitrogen atom, yet it is rendered
incapable of undergoing the intramolecular cyclization-release reaction due to the
conformational restrictions imposed by the cyclic piperazine ring (i.e it cannot adopt the
conformation required for the nucleophilic addition of the lone pair of electrons on nitrogen
into the carbonyl carbon of the carbamate moiety). When this compound is administered to
rats, no hydromorphone is detected. Compound D is an example of a prodrug whereby the
enzyme-cleavable protecting group has been attached to a piperazine nitrogen. This molecule
was studied to assess the possibility of a direct enzyme-mediated hydrolysis of the carbamate
moiety. The data indicates that this process does not occur in vivo. Interestingly, when
Compound D is administered to rats Compound C is formed and no hydromorphone is
liberated, thus also providing further evidence for the in vivo "activation" of the described
produgs.
Table 3. The liberation of hydromorphone from prodrugs following TV administration
in rats.
2. In vitro human µ-opioid receptor binding assay.
This test measures the affinity of test compounds for the µ-opioid receptor relative to
hydromorphone.
General procedure:
The general procedure follows the protocol described by Wang, J.-B., Johnson, P.S., Perscio,
A.M., Hawkins, A.L., Griffin, C.A. and Uhl, G.R. (1994). FEBS Lett., 338: 217-222.
Assay: µ-opioid receptor
Origin: human recombinant (HEK-293 cells)
Reference compound: [d-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAMGO)
Radioligand: [3H]DAMGO (0.5 nM)
Non-specific ligand: naloxone (lOuM)
Incubation: 120 min @ 22°C
Method of detection: scintillation counting
Analysis and expression of results: The specific binding to the receptors is defined as the
difference between the total binding and the non-specific binding determined in the presence
of an excess of unlabelled ligand. The results are expressed as a percent of control of specific
binding and as a present inhibition of control specific binding obtained in the presence of test
compounds. The IC50 values (molar concentration causing a half-maximal inhibition of
control specific binding), and Hill coefficients (nH) were determined by non-linear regression
analysis of competition curves using Hill equation curve fitting.
The above results are consistent with the structure activity relationships for opioids obtained
in the literature, obtained from screening of these representative molecules, demonstrate the
deactivation of opioid potency when the promoiety is appended to the phenol residue of
hydromorphone.
3. Pharmacokinetic Data
Plasma timecourse of hydromorphone following IV administration to rat
IV dosing: Test compound is dissolved in saline (2mg/ml) and injected into the tail vein of
jugular vein cannulated male Sprague-Dawley rats. Hydromorphone (HM) at 1 mg/kg,
oxyydromorphone (OM) at 0.5 mg/kg, morphine (MR) at 1 mg/kg, and N-methylnaltrexone
(N-MTX) at 2 mg/kg are used as positive controls, and the test compounds are dosed at a
parent opioid equivalent dose (e.g. equal to 1 mg/kg , 0.5 mg/kg or 2 mg/kg). At specified
time points, blood is withdrawn, quenched into methanol, centrifuged at 14000 rpm @ 4°C,
and stored at -80°C until analysis. Samples are quantified via LC/MS/MS using an ABI 3000
triple-quad mass spectrometer.
Oral dosing: The test compound is dissolved in saline (20mg/ml) and dosed via oral gavage
into jugular vein cannulated male Sprague-Dawley rats. HM, OM, MR and 10 mg/kg, and N-
MTX at 20 mg/kg are used positive controls and the test compound is dosed at an
approximate parent opioid equivalent dose (e.g. equal to 10 or 20 mg/kg). At specified time
points, blood is withdrawn, quenched into methanol, centrifuged at 14000 rpm @ 4°C, and
stored at -80°C until analysis. Samples are quantified via LC/MS/MS using an ABI 3000
triple-quad mass spectrometer.
Compared to hydromorphone, compounds according to the invention afford a lower Cmax
of hydromorphone when administered IV, but demonstrate similar Cmax values to
hydromorphone when administered orally.
Compared to oxymorphone, compounds according to the invention afford a lower Cmax of
oxymorphone when administered IV, but demonstrate similar Cmax values to oxymorphone
when administered orally.
Compared to morphine, compounds according to the invention afford a lower Cmax of
morphine when administered IV, but demonstrate similar Cmax values to morphine when
administered orally.
The compound of Example 19, which is a secondary carbamate prodrug of (R)-N-
Methylnaltexone, describes one aspect of the invention which embodies a method of
providing a patient with post administration-activated, controlled release of a phenolic opioid
antagonist, in this case a peripherally active opioid antagonist. Compared to (R)-N-
methylnaltrexone, the compound affords a superior Cmax value compared to (R)-N-
methylnaltrexone when administered orally.
Figure 1. Plasma concentration time course of the production of N-MTX following oral (PO)
dosing in rats. The solid line represents the plasma concentration of N-MTX following PO
dosing of N-MTX at 20 mg/kg. The dashed line represents the plasma concentration of N-
MTX produced following oral dosing of Example 19 at 20 mg/kg.
Figure 2. Plasma concentration time course of the production of hydromorphone and N-MTX
following PO dosing of prodrugs in rats. The solid line represents the plasma concentration
of hydromorphone following PO dosing of Example 3 at 10 mg/kg. The dashed line
represents the plasma concentration of N-MTX following oral dosing of Example 19 at 20
mg/kg.
By examining the plasma time course represented by figure 1 it is clear that the utility of (R)-
N-methylnaltrexone may be limited by its poor pharmacokinetic profile (e.g. oral
bioavailability). This limitation can be overcome by the prodrug represented by the
compound of Example 19 which provides an improved pharmacokinetic profile (e.g.
increased oral bioavailabilty). Furthermore figure 2 demonstrates that the prodrug approach
represented by the compounds of Examples 3 and 19 allows for higher, and perhaps
complimentary, plasma levels of opioid agonist and antagonist to be obtained when prodrugs
thereof are dosed orally.
Plasma timecourse of hydromorphone following IV administration in dog.
Fifteen male beagle dogs were selected from the Test Facility's colony of non-naïve animals
and placed into five groups of three animals per group. The animals were assigned to the
study based on acceptable health as determined by a staff veterinarian following a pre-study
health status check. The animals were fasted overnight prior to each dosing session and food
was returned to the animals approximately 4 hours post-dose for each dose session. All
substances were stored at 22±5°C prior to dosing under desiccate conditions.
Intravenous administration.
The test compounds were prepared in 0.9% NaCl at a target concentration of 0.4 mg/mL (0.4
mg/kg final dose) for intravenous administration. Hydromorphone was prepared in 0.9%
NaCl at a target concentration of 0.2 and 0.1 mg/m (0.1 and 0.2 mg/kg final dose) for
intravenous administration.
A dose formulation sample (0.15 mL) was collected from each intravenous formulation, prior
to dosing, pre- and post-filtration. All dose formulation samples were stored at -20±5°C until
analyzed.
Test compounds were administered through a temporary percutaneous catheter placed in a
peripheral vein at a target dose level of 0.4 mg/kg and a dose volume of 1 mL/kg. The
Animals received a slow intravenous bolus push over a 1.5 minute period. Hydromorphone
was administered similarly at a target dose level of 0.2 mg/kg and a dose volume of 1 mL/kg.
The animals received a slow intravenous bolus push over a 2 minute period. Immediately
following intravenous dosing, the catheters were flushed with 3 mL of saline prior to removal.
Blood samples (0.5 mL, whole blood, Li-Heparin anticoagulant) were collected prior to
dosing and at timepoints up to 24 hours following intravenous dosing. All samples were
collected via direct venipuncture of a peripheral vein, quenched into methanol, centrifuged at
14000 rpm @ 4°C, and stored at -80°C until analysis. Samples are quantified via LC/MS/MS
using an ABI 3000 triple-quad mass spectrometer.
Oral administration.
The test compounds were prepared in 0.9% NaCl at a target concentration of 4 mg/mL (4
mg/kg final dose) for oral administration. Hydromorphone, was prepared in 0.9% NaCl at a
target concentration of 2 mg/mL (2 mg/kg final dose) for oral administration. The oral
formulations were mixed by swirling and sonicated as needed to aid in complete dissolution.
A dose formulation sample (0.15 mL) was collected from each oral formulation prior to
dosing. All dose formulation samples were stored at -20±5°C until analyzed.
Test compounds were administered via oral gavage at a target dose level 4 mg/kg and at a
dose volume of 1 mL/kg. Hydromorphone was administered via oral gavage at a target dose
level 2 mg/kg and at a dose volume of 1 mL/kg. Immediately following oral dosing the
gavage tubes were flushed with 10 mL of water prior to removal. Blood samples (0.5 mL,
whole blood, Li-Heparin anticoagulant) were collected prior to dosing and at timepoints up to
24 hours following oral dosing.. All samples were collected via direct venipuncture of a
peripheral vein, quenched into methanol, centrifuged at 14000 rpm @ 4°C, and stored at
-80°C until analysis. Samples are quantified via LC/MS/MS using an ABI 3000 triple-quad
mass spectrometer.
Results:
Table 12. Maximum concentration (Cmax) of hydromorphone (HM) found in blood
after IV dosing in dogs.
Compared to hydromorphone, compounds according to the invention afford a lower Cmax
of hydromorphone when administered IV, but demonstrate similar Cmax values to
hydromorphone when administered orally.
Taken together, these test data demonstrate that compounds according to the invention are
capable of providing patients with post administration-activated, controlled release of a
phenolic opioid. In particular, the data demonstrate that the pro-drugs release opioid when
administered orally, but resist release of opioid when subjected to conditions commonly used
by those who wish to abuse the drug.
CLAIMS
1. A method of providing a patient with post administration-activated, controlled release
of a phenolic opioid, which comprises administering to said patient a corresponding
compound in which the phenolic hydrogen atom has been substituted with a spacer leaving
group bearing a nitrogen nucleophile that is protected with an enzymatically-cleavable
moiety, the configuration of the spacer leaving group and nitrogen nucleophile being such
that, upon enzymatic cleavage of the cleavable moiety, the nitrogen nucleophile is capable of
forming a cyclic urea, carbamate or thiocarbamate, liberating the compound from the spacer
leaving group so as to provide the patient with controlled release of the phenolic opioid.
2. A method as claimed in Claim 1, in which the configuration is such that the nitrogen
nucleophile is capable of forming a cyclic urea.
3. A method as claimed in Claim 1, in which the enzymatically-cleavable moiety is
linked to the nitrogen nucleophile through an amide bond.
4. A method as claimed in Claim 3, in which the amide bond is a peptide bond.
5. A method as claimed in Claim 4, in which the cleavable moiety is a residue of an
amino acid or a peptide, or an N-acyl derivative of an amino acid or peptide.
6. A method as claimed in Claim 5, in which the cleavable moiety is a residue of a D or
L-amino acid selected from alanine, arginine, asparagine, aspartic acid, cysteine, glycine,
glutamine, glutamic acid, histidine, isoleucine, leucine, methionine, phenylalanine, proline,
serine, threonine, tryptophan, tyrosine, lysine and valine; a residue of a dipeptide or tripeptide
composed of two or three D or L-amino acid residues selected independently from alanine,
arginine, asparagine, aspartic acid, cysteine, glycine, glutamine, glutamic acid, histidine,
isoleucine, leucine, methionine, phenylalanine, proline, serine, threonine, tryptophan,
tyrosine, lysine and valine; or a residue of an N-acyl derivative thereof.
7. A method as claimed in Claim 1, in which the corresponding compound is
administered orally to the patient.
8. A method as claimed in Claim 1, in which the phenolic opioid is hydromorphone,
oxymorphone or morphine.
5 9. Use in the manufacture of a medicament for providing a patient with post
administration-activated, controlled release of a phenolic opioid, of a corresponding
compound in which the phenolic hydrogen atom has been substituted with a spacer leaving
group bearing a nitrogen nucleophile that is protected with an enzymatically-cleavable
moiety, the configuration of the spacer leaving group and nitrogen nucleophile being such
10 that, upon enzymatic cleavage of the cleavable moiety, the nitrogen nucleophile is capable of
forming a cyclic urea, carbamate or thiocarbamate, liberating the compound from the spacer
leaving group so as to provide the patient with controlled release of the phenolic opioid.
10. Use as claimed in Claim 9, in which the configuration is such that the nitrogen
15 nucleophile is capable of forming a cyclic urea.
11. Use as claimed in Claim 9 or Claim 10, in which the enzymatically-cleavable moiety
is linked to the nitrogen nucleophile through an amide bond.
20 12. Use as claimed in Claim 11, in which the amide bond is a peptide bond.
13. Use as claimed in any one of Claims 9 to 12, in which the cleavable moiety is a
residue of an amino acid or a peptide, or an N-acyl derivative of an amino acid or peptide.
25 14. Use as claimed in Claim 13, in which the cleavable moiety is a residue of a D or L-
amino acid selected from alanine, arginine, asparagine, aspartic acid, cysteine, glycine,
glutamine, glutamic acid, histidine, isoleucine, leucine, methionine, phenylalanine, proline,
serine, threonine, tryptophan, tyrosine, lysine and valine; a residue of a dipeptide or tripeptide
composed of two or three D or L-amino acid residues selected independently from alanine,
30 arginine, asparagine, aspartic acid, cysteine, glycine, glutamine, glutamic acid, histidine,
isoleucine, leucine, methionine, phenylalanine, proline, serine, threonine, tryptophan,
tyrosine, lysine and valine; or a residue of an N-acyl derivative thereof.
15. Use as claimed in any one of Claims 9 to 14, in which the corresponding compound is
for oral administration to the patient.
16. Use as claimed in any one of Claims 9 to 15, in which the phenolic opioid is
hydromorphone, oxymorphone or morphine.
17. A compound of structural Formula (I):

or a salt, hydrate or solvate thereof wherein:
X is oxymorphone, hydromorphone or morphine, wherein the hydrogen atom of the phenolic
hydroxyl group is replaced by a covalent bond to -C(0)-Y-(C(R1)(R2))n-N-(R3)(R4);
Y is -NR5-, -O- or -S-;
n is an integer from 1 to 10;
each R1, R2, R3 and Rs is independently hydrogen, alkyl, substituted alkyl, aryl or substituted
aryl, or R1 and R2 together with the carbon to which they are attached form a cycloalkyl or
substituted cycloalkyl group, or two R1 or R2 groups on adjacent carbon atoms, together with
the carbon atoms to which they are attached, form a cycloalkyl or substituted cycloalkyl
group;

each R6 is independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl,
substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl,
heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with the atoms
to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;
R is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, alkoxycarbonyl, substituted
alkoxycarbonyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl;
p is an integer from 1 to 5;
each W is independently -NR8-, -O- or -S-; and
each R8 is independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl, or
optionally, each R6 and R8 independently together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
18. The compound of Claim 17 in which each of R1, R2, R3 and Rs is independently
hydrogen, alkyl, substituted alkyl, aryl or substituted aryl.
19. The compound of Claim 17 or Claim 18 in which Y is NR5 and R5 is hydrogen or
alkyl.
20. The compound of Claim 19, in which R5 is (1 -4C)alkyl.
21. The compound of Claim 20, in which R5 is methyl.
22. The compound of one of Claims 17 to 21 in which n is 2 or 3.
23. The compound of any one of Claims 17 to 22 in which each of R1, K2, R3, Rs and R8 is
independently hydrogen or alkyl.
24. The compound of any one of Claims 17 to 23, in which R1 and R2 are each hydrogen.
25. The compound of any one of Claims 17 to 24, in which R3 is hydrogen or (l-4C)alkyl.
26. The compound of Claim 25, in which R3 is hydrogen or methyl.
27. The compound of any one of Claims 17 to 26 in which each R6 is independently
hydrogen, alkyl, substituted alkyl, aryl, arylalkyl, substituted arylalkyl, heteroalkyl,
heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with the atoms
to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
28. The compound of any one of Claims 17 to 27 in which R7 is hydrogen, alkyl, acyl or
alkoxycarbonyl.
29. The compound of any one of Claims 17 to 21 in which n is 1
30. The compound of any one of Claims 17 to 26 in which Y is NR5, n is 2 or 3, p is 1 or
2,R1,R2,R3,R5 and R7 are independently hydrogen or alkyl, each R6 is independently
hydrogen, alkyl, substituted alkyl, aryl, arylalkyl, substituted arylalkyl, heteroalkyl,
heteroarylalkyl, substituted heteroarylalkyl or optionally, R6 and R7 together with the atoms to
which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
31. The compound of any one of Claims 17 to 26 in which Y is NR5, n is 2, p is 1, R1 and
R2 are hydrogen, R3 and R5 are methyl or hydrogen and R6 is independently hydrogen, alkyl,
substituted alkyl, aryl, arylalkyl, substituted arylalkyl, heteroalkyl, heteroarylalkyl, substituted
heteroarylalkyl or optionally, R6 and R7 together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring or optionally R is hydrogen.
32. The compound of any one of Claims 17 to 26 in which Y is NR5, n is 2, R1 and R2 are
hydrogen, R3 and R5 are methyl or hydrogen, R7 is hydrogen and R6 is -CH2(CH2)3NH2 or
-CH2CH2CH2NHC(NH)NH2.
33. The compound of any one of claims 17 to 26, in which R4 is a residue of a
D or L-amino acid selected from alanine, arginine, asparagine, aspartic acid, cysteine, glycine,
glutamine, glutamic acid, histidine, isoleucine, leucine, methionine, phenylalanine, proline,
serine, threonine, tryptophan, tyrosine, lysine and valine; a residue of a dipeptide or tripeptide
composed of two or three D or L-amino acid residues selected independently from alanine,
arginine, asparagine, aspartic acid, cysteine, glycine, glutamine, glutamic acid, histidine,
isoleucine, leucine, methionine, phenylalanine, proline, serine, threonine, tryptophan,
tyrosine, lysine and valine; or a residue of an N-acyl derivative thereof.
34. The compound of claim 33, which is a residue of an L-amino acid.
35. The compound of claim 17, in which Y is -NR5; R5 is (1 -4C)alkyl;
R1 and R2 axe each hydrogen; n is 2 or 3; R3 is hydrogen or (l-4C)alkyl; W is NH;
R6 is hydrogen, -CH2(CH2)3NH2, -CH2CH2CH2NHC(NH)NH2, 4-hydroxybenzyl, CH2COOH
or CH2CH2COOH; R7 is hydrogen, (l-6C)alkanoyl or benzoyl unsubstituted or substituted by
methylenedioxy or one or two substituents selected from (l-4C)alkyl, (l-4C)alkoxy and
halogen; and p is 1 or 2.
36. The compound of claim 35, in which Y is -NR5; R5 is (1-4C)alkyl;
R1 and R2 are each hydrogen; n is 2 or 3; R3 is hydrogen or (1-4C)alkyl; W is NH;
R6 is hydrogen, -CH2(CH2)3NH2, -CH2CH2CH2NHC(NH)NH2 or CH2CH2COOH;
R7 is hydrogen, (1-6C)alkanoyl or benzoyl unsubstituted or substituted by methylenedioxy or
one or two substituents selected from (l-4C)alkyl, (l-4C)alkoxy and halogen; and p is 1 or 2.
37. The compound of claim 33, in which R4 is arginine, N-acetylarginine, N-t-
butanoylarginine, N-benzoylarginine, N-piperonylarginine, N-glycinylarginine, lysine,
glutamic acid, aspartic acid, tyrosine, proline or N-glycinylproline.
38. The compound of claim 37, in which R4 is arginine, N-acetylarginine, N-t-
butanoylarginine, N-benzoylarginine, N-piperonylarginine, N-glycinylarginine, lysine,
glutamic acid, proline or N-glycinylproline.
39. A process for the preparation of a compound of formula (I) or a pharmaceutically
acceptable salt thereof as defined in any one of Claims 17 to 38, which comprises reacting a
compound of formula (III)

or a protected derivative thereof, with a compound of formula (IV)

in which M represents a leaving atom or group;
followed by removing any protecting groups and, if desired, acylating a compound of
formula (I) and/or forming a pharmaceutically acceptable salt.
40. A pharmaceutical composition, which comprises a compound as claimed in any one of
Claims 17 to 38 and a pharmaceutically acceptable carrier.
41. A method of treating pain in a patient in need of treatment, which comprises
administering an effective amount of a compound as claimed in Claim 17.
42. A compound as claimed in any one of Claims 17 to 38, for use in therapy.
43. Use of a compound as claimed in any one of Claims 17 to 38 in the manufacture of a
medicament for the treatment of pain.
44. A compound of structural Formula (I):

or a salt, hydrate or solvate thereof wherein:
X is (R)-N-methylnaltrexone, wherein the hydrogen atom of the phenolic hydroxyl group is
replaced by a covalent bond to -C(O)-Y-(C(R1)(R2))n-N-(R3)(R4);
Y is -NR5-, -O- or -S-;
n is an integer from 1 to 10;
each R , R , R and R is independently hydrogen, alkyl, substituted alkyl, aryl or substituted
aryl, or R1 and R2 together with the carbon to which they are attached form a cycloalkyl or
substituted cycloalkyl group, or two R1 or R2 groups on adjacent carbon atoms, together with
the carbon atoms to which they are attached, form a cycloalkyl or substituted cycloalkyl
group;

each R6 is independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl,
substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl,
heteroarylalkyl, substituted heteroarylalkyl, or optionally, R6 and R7 together with the atoms
to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;
R7 is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, alkoxycarbonyl, substituted
alkoxycarbonyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl;
p is an integer from 1 to 5;
each W is independently -NR8-, -O- or -S-; and
each R8 is independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl, or
optionally, each R6 and R8 independently together with the atoms to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring.
45. A compound as claimed in Claim 44, in which Y is NR5 and R5 is hydrogen or (1-
4C)alkyl.
46. A compound as claimed in Claim 45, in which R5 is methyl.
47. A compound as claimed in any one of Claims 44 to 46, in which n is 2 or 3.
48. A compound as claimed in any one of Claims 44 to 47, in which R1 and R2 are each
hydrogen.
49. A compound as claimed in any one of Claims 44 to 48, in which R3 is hydrogen or (1-
4C)alkyl.
50. A compound as claimed in any one of Claims 44 to 49, in which R4 is hydrogen or a
residue of a D or L-amino acid selected from alanine, arginine, asparagine, aspartic acid,
cysteine, glycine, glutamine, glutamic acid, histidine, isoleucine, leucine, methionine,
phenylalanine, proline, serine, threonine, tryptophan, tyrosine, lysine and valine; a residue of
a dipeptide or tripeptide composed of two or three D or L-amino acid residues selected
independently from alanine, arginine, asparagine, aspartic acid, cysteine, glycine, glutamine,
glutamic acid, histidine, isoleucine, leucine, methionine, phenylalanine, proline, serine,
threonine, tryptophan, tyrosine, lysine and valine; or a residue of an N-acyl derivative thereof.
51. A compound as claimed in Claim 50, in which R4 is a residue of arginine, N-
acetylarginine, N-t-butanoylarginine, N-benzoylarginine, N-piperonylarginine, N-
glycinylarginine, lysine, glutamic acid, aspartic acid, tyrosine, proline or N-glycinylproline.
52. A compound as claimed in Claim 50, in which R4 is hydrogen.
53. A process for the preparation of a compound of formula (I) or a pharmaceutically
acceptable salt thereof as defined in any one of Claims 44 to 52, which comprises
(a) reacting a compound of formula (HI)

or a protected derivative thereof, with a compound of formula (IV)

in which M represents a leaving atom or group; or
(b) methylating a corresponding compound of formula (I) in which X is a residue
of naltrexone, or a protected derivative thereof;
followed by removing any protecting groups and, if desired, acylating a compound oi
formula (I) and/or forming a pharmaceutically acceptable salt.
54. A pharmaceutical composition, which comprises a compound as claimed in any one oJ
Claims 44 to 53 and a pharmaceutically acceptable carrier.
55. A pharmaceutical composition as claimed in Claim 54, which further comprises &
compound as claimed in any one of Claims 17 to 38.
56. Use of a compound as claimed in any one of claims 44 to 53 in the manufacture of a
medicament for use as a pro-drug for (R)-N-methylnaltrexone.
57. Use as claimed in claim 56, in which the medicament is for oral administration.
A method of providing a patient with controlled release of a phenolic opioid using a prodrug capable, upon enzymalic
activation, of releasing the phenolic opioid through intra-molecular cyclization leading to formation of a cyclic urea, carbamate or
thiocarbamate.

Documents:

4837-KOLNP-2008-(09-09-2014)-ABSTRACT.pdf

4837-KOLNP-2008-(09-09-2014)-ANNEXURE TO FORM 3.pdf

4837-KOLNP-2008-(09-09-2014)-CLAIMS.pdf

4837-KOLNP-2008-(09-09-2014)-EXAMINATION REPORT REPLY RECEIVED.pdf

4837-KOLNP-2008-(09-09-2014)-FORM-13.pdf

4837-KOLNP-2008-(09-09-2014)-PETITION UNDER RULE 137-1.pdf

4837-KOLNP-2008-(09-09-2014)-PETITION UNDER RULE 137.pdf

4837-KOLNP-2008-(09-10-2014)-CORRESPONDENCE.pdf

4837-KOLNP-2008-(09-10-2014)-FORM-1.pdf

4837-KOLNP-2008-(09-10-2014)-FORM-13-1.1.pdf

4837-KOLNP-2008-(09-10-2014)-FORM-13.pdf

4837-KOLNP-2008-(09-10-2014)-FORM-2.pdf

4837-KOLNP-2008-(09-10-2014)-FORM-3.pdf

4837-KOLNP-2008-(09-10-2014)-FORM-5.pdf

4837-KOLNP-2008-(09-10-2014)-OTHERS.pdf

4837-KOLNP-2008-(09-10-2014)-PA.pdf

4837-kolnp-2008-abstract.pdf

4837-KOLNP-2008-AMENDED CLAIMS.pdf

4837-KOLNP-2008-ASSIGNMENT.pdf

4837-kolnp-2008-claims.pdf

4837-KOLNP-2008-CORRESPONDENCE-1.1.pdf

4837-KOLNP-2008-CORRESPONDENCE-1.2.pdf

4837-KOLNP-2008-CORRESPONDENCE-1.3.pdf

4837-kolnp-2008-correspondence.pdf

4837-kolnp-2008-description (complete).pdf

4837-kolnp-2008-form 1.pdf

4837-KOLNP-2008-FORM 13.pdf

4837-KOLNP-2008-FORM 18.pdf

4837-KOLNP-2008-FORM 3-1.1.pdf

4837-kolnp-2008-form 3.pdf

4837-kolnp-2008-form 5.pdf

4837-KOLNP-2008-GPA.pdf

4837-kolnp-2008-international preliminary examination report.pdf

4837-kolnp-2008-international publication.pdf

4837-kolnp-2008-international search report.pdf

4837-kolnp-2008-others.pdf

4837-kolnp-2008-pct request form.pdf

4837-kolnp-2008-specification.pdf


Patent Number 264370
Indian Patent Application Number 4837/KOLNP/2008
PG Journal Number 52/2014
Publication Date 26-Dec-2014
Grant Date 24-Dec-2014
Date of Filing 28-Nov-2008
Name of Patentee SIGNATURE THERAPEUTICS, INC.
Applicant Address 1731 EMBARCADERO ROAD, SUITE 220, PALO ALTO, CA 94303 UNITED STATES OF AMERICA
Inventors:
# Inventor's Name Inventor's Address
1 KOLESINIKOV, ALEKSANDR 623 38TH AVENUE, SAN FRANSISCO, CALIFORNIA 94121
2 JENKINS, THOMAS E. 101 SPYGLASS LANE, HALF MOON BAY, CA 94019
PCT International Classification Number A61K 47/48
PCT International Application Number PCT/US2007/069683
PCT International Filing date 2007-05-24
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/901,795 2007-02-16 U.S.A.
2 60/809,082 2006-05-26 U.S.A.