(12) Patent Application Publication (10) Pub. N0.: US 2014/0221426 A1 Gerk Et Al
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US 20140221426A1 (19) United States (12) Patent Application Publication (10) Pub. N0.: US 2014/0221426 A1 Gerk et al. (43) Pub. Date: Aug. 7, 2014 (54) SELECTIVE METABOLIC APPROACH TO A61K 31/216 (2006.01) INCREASING ORAL BIOAVAILABILITY OF A61K 31/09 (2006.01) PHENYLEPHRINE AND OTHER PHENOLIC A61K 31/05 (2006.01) BIOACTIVITIES A61K 31/353 (2006.01) A61K 31/4525 (2006.01) (71) Applicant: VIRGINIA COMMONWEALTH A61 K 31/3 75 (2006.01) UNIVERSITY, Richmond, VA (US) A61K 31/121 (2006.01) _ _ _ (52) US. Cl. (72) Inventorsl Ph_lll_lP M- Gerk’ Rthmond, VA (Us); CPC ........... .. A61K 31/137 (2013.01); A61K 31/3 75 Wllllam H- Fa", R10hm°nda VA (Us); (2013.01); A61K 31/235 (2013.01); A61K J"sellh K- thter’ Rlchmond, VA (Us) 31/11 (2013.01); A61K 31/085 (2013.01); _ A61K 31/121 (2013.01); A61K 31/09 (21) APP1~ NO" 14/345,689 (2013.01); A61K31/05 (2013.01); A61K . _ 31/353 (2013.01);A61K31/4525 (2013.01); (22) PCT Filed. Sep. 27, 2012 A61K31/216 (201301) USPC ......... .. 514/321' 514/653' 514/474' 514/544' ( 86 ) PCT N 0 .: PCT/U52012/057588 ’ ’ 514/456;’ 514/532’ § 371 (0X1), Related US“ Application Data Presystemic metabolism in intestine of bioactives such as (60) Provisional application No. 61/539,530, ?led on Sep. phenylephrine 1? avoided by administering a Sllbject (human 27, 2011, provisional application No. 61/544,396, 0r 21111111211) the bloactlve(e-g-,Pheny1ephr1ne)1n comblnatlon ?led on Oct 7, 201 1_ With one or more inhibitors of sulfation (e.g., sulfotransferase enzymes aka SULTs). This can also be enhanced be co Publication Classi?cation administering inhibitors of monoamine oxidases aka, MAOs, and uridine diphosphate glucoronysl transferases, aka UGTs. (51) Int. Cl. Preferably the inhibitors are GRAS compounds. The one or A61K 31/137 (2006.01) more inhibitor compounds inhibit the enzymes responsible A61K 31/235 (2006.01) for rapid presystemic metabolism, thus allowing the bioac A61K 31/11 (2006.01) tives (e. g., phenylephrine) to be more readily absorbed intact A61K 31/085 (2006.01) into the circulatory system. Patent Application Publication Aug. 7, 2014 Sheet 1 0f 4 US 2014/0221426 A1 Synthesis of Phenyiephrine 3-O-Sulfate OH F NHCH a i F o 3 1.TFA20,20C,15mm. ff 0 F O >+F OH N F \ phenylephrine CH3 2‘ 803*Py1‘; pyridine OH 90cc, 130mm F NOF 0 F OH 0 HF 3. aq. 1M KHco3 NHCH3 N\ F 25 0C,0vernighl CH3 0 /O K 28% \s // Q(3 phenylephrine 3-O-suifate, potassium salt FIGURE 1 Patent Application Publication Aug. 7, 2014 Sheet 2 0f4 US 2014/0221426 A1 Figure 2A. Inhibition of 4-Methylumbellifer0ne Metabolism . 4-Methylumbelliferone A 4-Methylumbelliferonemetabolized (as%ofsolutionwithoutcells) Figure 28. Inhibition of 1-Naphthol Metabolism. 1-Naphthol 1~Naphtholmetabolized (as%ofsolutionwithoutcells) Patent Application Publication Aug. 7, 2014 Sheet 3 of4 US 2014/0221426 A1 Figure 2C. Inhibition of Raspberry Ketone Metabolism. Rasketone (raspberry ketone) 1 239.mewo~=on§wE x.mi:oréow*0305.?3:00 Figure 2D. Inhibition of Pinoresinol Metabolism. Pinoresinoi w8642 moooéoo Q Patent Application Publication Aug. 7, 2014 Sheet 4 of 4 US 2014/0221426 A1 Figure 2E. inhibition of Magnoiol Metabolism. Magnolol 80- ~1— 60 Magnololmetabollzed (as%ofsolutionwithoutcells) 40 ii 1* 2 Figure 2F. Inhibition of a-Mangostin Metabolism. a-Mangostin A a-Mangostmmetaboilzed (as%ofsolutionwithoutcells) US 2014/0221426 A1 Aug. 7, 2014 SELECTIVE METABOLIC APPROACH TO inhibiting or reducing the rate of biotransforrnation of drugs INCREASING ORAL BIOAVAILABILITY OF in the liver or intestines. Qazi does not identify the extract as PHENYLEPHRINE AND OTHER PHENOLIC including GRAS compounds. BIOAC TIVITIES [0010] US. Pat. No. 6,180,666 to Wacher et al. describes [0001] Portions of this invention were made using funding orally co-administering a compound of interest with a gallic from the National Institutes of Health (NIH/NCMHD Grant acid ester such as octyl gallate, propyl gallate, lauryl gallate, and methyl gallate. Gallic acid is a trihydroxybenzoic acid, a No. 1P60-MD002256), and the US. Government has certain rights in this invention. type of organic phenolic acid found in plants such as gallnuts, sumac, witch hazel, tea leaves, and oak bark. The gallic acid BACKGROUND ester is purportedly present in order to inhibit biotransforma tions of drugs that are carried out e.g. by cytochromes P450. [0002] 1. Field of the Invention The esters are described as GRAS compounds. [0003] The invention is generally related to increasing the [0011] US. Pat. No. 6,121,234 to Benet et al., describes a bioavailability of bioactive compounds which are adminis method for purportedly increasing bioavailability and reduc tered or taken orally, and more particularly, to using com ing inter- and intra-individual variability of an orally admin pounds which are generally regarded as safe (GRAS), par istered hydrophobic pharmaceutical compound. In Benet, the ticularly certain phenolic compounds, to prevent or decrease pharmaceutical compound is orally co-administered with an pre-systemic or systemic metabolism or clearance of the bio essential oil or essential oil component. Benet suggests that active compounds. the role of the essential oil may be to inhibit drug biotrans [0004] 2. Description of the PriorArt formation in the gut. Essential oils are described as GRAS [0005] Increasing the bioavailablity of compounds pro compounds. vided to a subject to treat various diseases has been a subject [0012] US patent application 2003/0215462 to Wacher et of intense investigation for a number of years. Furthermore, al. describes using UDP-glucuronosyltrasnsferase (UGT) there have been a number of approaches that have employed inhibitors to increase the bioavailability orally administered compositions that include a drug in combination with sub drugs. Wacher suggests the formulation may be used with stances that are Generally Regarded As Safe (GRAS) com 2-methoxyestradiol, raloxifene, irinotecan, SN-38, estradiol, pounds. labetalol, dilevalol, zidovudine (AZT) and morphine. The [0006] US. Pat. No. 5,972,382 to Majeed et al. teaches UDP-inhibitors are generally natural products and include compositions and methods for the improvement of gas epicatechin gallate, epigallocatechin gallate, octyl gallate, trointestinal absorption and systemic utilization of nutrients propyl gallate, quercetin, tannic acid, benzoin gum, capsai and nutritional supplements by combining them with pip cin, dihydrocapsaicin, eugenol, gallocatechin gallate, erine, an alkaloid derived from black pepper. Maj eed does not geraniol, menthol, menthyl acetate, naringenin, allspice berry discuss the delivery of drugs per se, and piperine is not a oil, N-vanillylnonanamide, clovebud oil, peppermint oil, sili GRAS compound. binin, and silymarin. Wacher does not list resveratrol and [0007] US. Pat. No. 7,576,124 to Harris describes “?rst phenylephrine as exemplary drugs, nor are the GRAS sub pass” inhibiting furocoumarin compounds that are purport stances propyl paraben, vanillin, vitamin C and curcumin edly safe and effective. The furocoumarins are citrus-derived identi?ed as being useful in Wacher. The objective of the substances prepared from, e.g., grapefruit. Harris does not Wacher technology appears to be the identi?cation of speci?c identify which components of pre-systemic metabolism are combinations of drugs and inhibitors that work well together. inhibited, but the cytochrome P450 family of enzymes is Wacher notes that “ . a compound that inhibits the glucu referenced. The furocoumarins are not described as GRAS. ronidation of one substrate does not necessarily prevent the [0008] US. Pat. No. 7,125,564 to Chen et al. discusses glucuronidation of all UGT substrates . ”. problems associated with ?rst-pass degradation of bioactive [0013] US patent applications 2006/0040875 and 2009/ treatment compounds, and teaches the use of water-soluble 0093467 to Oliver et al. describe UGT2B inhibitors that can complexes with glycyrrhizin, which is the main sweet-tasting increase the bio-availability of drugs. Speci?cally named compounds from licorice root. Glycyrrhizin is described as inhibitors are natural products such as capillarisin, isorham GRAS. Chen does not indicate that glycyrrhizin can inhibit netin, [3-naphtho?avone, (x-naphtho?avone, hesperetin, terpi ?rst pass metabolism; rather, Chen discusses having the com neol, (+)-limonene, [3-myrcene, swertiamarin, eriodictyol, positions parenterally administered to avoid the ?rst-pass cineole, apigenin, baicalin, ursolic acid, isovitexin, lauryl effect. alcohol, puerarin, trans-cinnamaldehyde, 3-phenylpropyl [0009] US. Pat. No. 7,070,814 to Qazi et al. teaches com acetate, isoliquritigenin, paeoni?orin, gallic acid, genistein, positions which are purportedly bioenhancing/bioavailabil glycyrrhizin, protocatechuic acid, ethyl myristate, and ity-facilitating. These compositions include an extract and/or umbelliferone. Suggested drugs for which bioavailability can at least one bioactive fraction from the Cuminum cyminum be increased include morphine, naloxone, nalorphine, oxy plant (i.e., the plant from which the spice cumin is derived). morphone, hydromorphone, dihydromorphine, codeine, nal This extract is combined with drugs, nutrients, vitamins, trexone, naltrindole, nalbuphine and buprenorphine. The nutraceuticals, herbal drugs/products, micro nutrients, and focus of Oliver is on the delivery of analgesics. antioxidants, along with pharmaceutically acceptable addi [0014] US patent application 2010/0087493 to Kaivosaari tives/excipients. Similar to the Majeed patent, Qazi