USOO6469.065B1 (12) United States Patent (10) Patent No.: US 6,469,065 B1 Garvey et al. (45) Date of Patent: Oct. 22, 2002 (54) NITROSATED AND NITROSYLATED 5,612,314 A 3/1997 Stamler et al. C-ADRENERGIC RECEPTOR ANTAGONIST, 5,635,204 A 6/1997 Gevirtz et al. .............. 424/449 COMPOSITIONS AND METHODS OF USE 5,646,181 A 7/1997 Fung et al. 5,648,393 A 7/1997 Stamler et al. 5,698,589 A 12/1997 Allen (75) Inventors: David S. Garvey, Dover; Joseph D. 5,731,339 A 3/1998 Lowrey Schroeder, Dedham, both of MA (US); 5,767,160 A 6/1998 Kaesemeyer Inigo Saenez de Tejada, Madrid (ES); 5,773,457 A 6/1998 Nahoum Ricky D. Gaston, Malden, MA (US); 5,789.442 A 8/1998 Garfield et al. Tatiana E. Shelekhin, Acton, MA 5,877,216 A 3/1999 Place et al. (US); Tiansheng Wang, Concord, MA (US) FOREIGN PATENT DOCUMENTS EP O346297 12/1989 (73) Assignee: NitroMed, Inc., Bedford, MA (US) EP O357581 3/1990 EP O432199 6/1991 (*) Notice: Subject to any disclaimer, the term of this FR 2547SO1 12/1984 patent is extended or adjusted under 35 JP 8O26962 1/1998 U.S.C. 154(b) by 0 days. WO 97/27749 * 8/1997 WO 97.27749 8/1997 WO 97.42.946 11/1997 (21) Appl. No.: 09/387,724 WO 9852569 11/1998 Filed: Sep. 1, 1999 WO 99.01132 1/1999 (22) WO 9907353 2/1999 WO 99.07695 2/1999 Related U.S. Application Data WO 992S345 5/1999 (63) Continuation-in-part of application No. 09/145,143, filed on WO 9930697 6/1999 Sep. 1, 1998, now Pat. No. 6.294,517, which is a continu ation-in-part of application No. 08/714,313, filed on Sep. 18, OTHER PUBLICATIONS 1996, now Pat. No. 5,994,294, which is a continuation-in part of application No. 08/595,732, filed on Feb. 2, 1996, Buvat et al, The Journal of Urology, 141 (6): 1364–1367 now Pat. No. 5,932,538. (1989). (51) Int. Cl........................ A61K31/135; A61K 31/21 Costa et al, The Journal of Urology, 149:301-305 (1993). (52) U.S. Cl. ....................... 514/546; 514/506; 514/617; Burnett, The Journal of Urology, 157:320-324 (1997). 514/651; 536/103; 540/1; 540/147; 540/155; (List continued on next page.) 548/500; 564/45 (58) Field of Search ................................. 514/546, 506, Primary Examiner Bennett Celsa 514/617, 651; 536/103; 540/1; 560/147, (74) Attorney, Agent, or Firm-Hale and Dorr LLP 155; 548/500; 564/45 (57) ABSTRACT (56) References Cited The present invention describes novel nitrosated and/or U.S. PATENT DOCUMENTS nitrosylated C.-adrenergic receptor antagonists, and novel compositions containing at least one nitrosated and/or 4,127,118 A 11/1978 Latorre nitrosylated C.-adrenergic receptor antagonist, and, 4,590,202 A 5/1986 Remy ......................... 514/392 4,801,587 A 1/1989 Voss et al. optionally, one or more compounds that donate, transfer or 4.885,173 A 12/1989 Stanley et al. release nitric oxide, elevate endogenous levels of 5,059,603 A 10/1991 Rubin endothelium-derived relaxing factor, Stimulate endogenous 5,145,852 A 9/1992 Virag Synthesis of nitric oxide or are a Substrate for nitric oxide 5,190,967 A 3/1993 Riley Synthase, and/or one or more vasoactive agents. The present 5,236,904 A 8/1993 Gerstenberg et al. invention also provides novel compositions containing at 5,256,652 A 10/1993 El-Rashidy least one O-adrenergic receptor antagonist, and one or more 5,281,607 A 1/1994 Stone et al. ................ 514/280 compounds that donate, transfer or release nitric oxide, 5,380,758 A 1/1995 Stamler et al. elevate endogenous levels of endothelium-derived relaxing 5,399,581 A 3/1995 Laragh 5,403,847. A 4/1995 Gluchowski et al. ....... 514/318 factor, Stimulate endogenous Synthesis of nitric oxide or is a 5.439,938 A 8/1995 Snyder et al. Substrate for nitric oxide Synthase and/or one or more 5,447.912 A 9/1995 Gerstenberg et al. vasoactive agents. The present invention also provides 5,451,609 A 9/1995 Bellamy et al. ............ 514/651 methods for treating or preventing Sexual dysfunctions in 5,474,535 A 12/1995 Place et al. males and females, for enhancing Sexual responses in males 5.492.911 A 2/1996 Stief and females, and for treating or preventing benign prostatic 5,498.623 A 3/1996 Karjalainen et al. ........ 514/396 hyperplasia, hypertension, congestive heart failure, variant 5,543,430 A 8/1996 Kaesemeyer (Print Zmetal) angina, glaucoma, neurodegenerative 5,565,466 A 10/1996 Gioco et al. disorders, vasospastic diseases, cognitive disorders, urge 5,567,706 A 10/1996 Gavras 5,574,068 A 11/1996 Stamler et al. incontinence, or overactive bladder, and for reversing the 5,578,611 A 11/1996 Gluchowski et al. ....... 514/318 State of anesthesia. 5,583,144. A 12/1996 Kral 5,593.876 A 1/1997 Stamler et al. 19 Claims, 11 Drawing Sheets US 6,469,065 B1 Page 2 OTHER PUBLICATIONS Physicians Desk Reference, 48th Edition, pp. 1146-1147 Buvat et al, The Journal of Urology, 159:116-119 (Jan. (1994). 1998). Zorgniotti et al, Int. J. Impotence Res., 6:33-36 (1994). Saenz de Tejada et al, The Journal of Pharmacology and Trigo-Rocha et al., Neuroulogy and Urodynamics, 13:71-80 Experimental Therapeutics, 290(1):121-128 (1999). (1994). Mathers et al., European Urology, 35(suppl 2):67 (abstract Sonda et al., Journal of Sex & Marital Therapy, 16(1):15-21 266) (1999). (1990). RBI/Sigma Catalog, p. 354 (1999). Marquer et al., Fundam Clin Pharmacol, 12:377–387 (1998). The Merck Index, 12th Edition, pp. 132, 1727 and 1728 (1996). * cited by examiner U.S. Patent Oct. 22, 2002 Sheet 1 of 11 US 6,469,065 B1 Figure I 12O — -rurummittanowawm-w 1 OO 8O 60 40 O -- Example 1 Example 1 Yohimbine Yohimbine (500 ug) (500 ug) (150 ug) (500 ug) -- Yohimbine (150 ug) U.S. Patent Oct. 22, 2002 Sheet 2 of 11 US 6,469,065 B1 Figure 2 Yohimbine (150 lug) Yohimbine (500 ug) Example (500 Lug) Example 1 + Yohimbine (500 ug) (150 ug) O 10 20 30 40 5O (Duration (min) U.S. Patent Oct. 22, 2002 Sheet 3 of 11 US 6,469,065 B1 Figure 3 4O -area 12O OO 68 OO 4. O O -T- Example 2 Example 2 Yohimbine Yohimbine Yohimbine (500 ug) (1 mg) (150 lug) (500 ug) (1 mg) U.S. Patent Oct. 22, 2002 Sheet 4 of 11 US 6,469,065 B1 Figure 4 Yohimbine (1 mg) Yohimbine (500 g) Yohimbine (150 ug) Example 2 (1 mg) (500 ug) - 15 20 25 30 35 Duration (min) U.S. Patent Oct. 22, 2002 Sheet 5 of 11 US 6,469,065 B1 L. Ot D C?) C T2 E LILLIrish I III-III a LL EXAMPLE 2 H.-- (500pg) MINUTE FIG.5A O O S. EEE H. O. O. O. 2 l PAP/PHENT/PGE s -- MINUTE FIG.5B U.S. Patent Oct. 22, 2002 Sheet 6 of 11 US 6,469,065 B1 Figure 6 1 OO racareer 468OOO 2 O Example 6 Moxisylyte (1 mg) (1 mg) U.S. Patent Oct. 22, 2002 Sheet 7 of 11 US 6,469,065 B1 Figure 7 Moxisylyte (1 mg) Moxisylyte (2 mg) Example 6 (1 mg) Example 6 (2 mg) O 1o 20 30 40 Duration (min) U.S. Patent Oct. 22, 2002 Sheet 8 of 11 US 6,469,065 B1 Figure 8 12 O --- GS 8 1 OO 8. I o -------a -- C) 8 O CC s is 60 On C 4 O 2 O O --- O.2 mg 0.4 mg 0.8 mg 1.6mg Dose (Example 9) U.S. Patent Oct. 22, 2002 Sheet 9 of 11 US 6,469,065 B1 Figure 9 1 OO --- 9 O ara 8 O 85 7 O C E 6 O Z 5 O O CC 4 O D 3 O O 2O | 1 O O --- 0.2 mg 0.4 mg O.8 mg 1.6mg Dose (Example 9) U.S. Patent Oct. 22, 2002 Sheet 10 of 11 US 6,469,065 B1 Figure 10 1 OO --- 9 O 80 7 O 6 O 5 O 4 O 3 C. -T- 20 : 1 O O -- 0.64 mg 1.07 mg 2.13 mg 4.26 mg Dose (Example 10) U.S. Patent Oct. 22, 2002 Sheet 11 of 11 US 6,469,065 B1 Figure 11 1 4 O -------- 12 O 16 SB 100 CS . 5 80 s 6 O H C 4 O ?h 2O O --- 0.64 mg 1.07 mg 2.13 mg 4.26 mg Dose (Example 10) US 6,469,065 B1 1 2 NITROSATED AND NITROSYLATED Sexual response is the erectile response. The erectile C-ADRENERGIC RECEPTOR ANTAGONIST, response in both males and females is the result of engorge COMPOSITIONS AND METHODS OF USE ment of the erectile tissues of the genitalia with blood which is caused by the relaxation of Smooth muscles in the arteries RELATED APPLICATIONS Serving the genitalia. In both pre-menopausal and menopausal females, Sexual This application is a continuation-in-part of U.S. appli dysfunction can include, for example, Sexual pain disorders, cation Ser. No. 09/145,143, filed Sep. 1, 1998, now U.S.