WO1999063977A2 - Pharmaceutical combination comprising a tricyclic compound and at least one of zolpidem, zopiclone, triazolam and brotizolam for treating or preventing sleep disorders - Google Patents

Pharmaceutical combination comprising a tricyclic compound and at least one of zolpidem, zopiclone, triazolam and brotizolam for treating or preventing sleep disorders Download PDF

Info

Publication number
WO1999063977A2
WO1999063977A2 PCT/JP1999/003057 JP9903057W WO9963977A2 WO 1999063977 A2 WO1999063977 A2 WO 1999063977A2 JP 9903057 W JP9903057 W JP 9903057W WO 9963977 A2 WO9963977 A2 WO 9963977A2
Authority
WO
WIPO (PCT)
Prior art keywords
triazolam
treating
zopiclone
zolpidem
brotizolam
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP1999/003057
Other languages
French (fr)
Other versions
WO1999063977A3 (en
Inventor
Shigenori Ohkawa
Masaomi Miyamoto
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Takeda Pharmaceutical Co Ltd
Original Assignee
Takeda Chemical Industries Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Takeda Chemical Industries Ltd filed Critical Takeda Chemical Industries Ltd
Priority to EP99923960A priority Critical patent/EP1100508B8/en
Priority to DE69910795T priority patent/DE69910795T2/en
Priority to AT99923960T priority patent/ATE247967T1/en
Priority to CA002332521A priority patent/CA2332521C/en
Priority to AU40605/99A priority patent/AU4060599A/en
Priority to US09/700,405 priority patent/US6348485B1/en
Publication of WO1999063977A2 publication Critical patent/WO1999063977A2/en
Anticipated expiration legal-status Critical
Publication of WO1999063977A3 publication Critical patent/WO1999063977A3/en
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/557—Eicosanoids, e.g. leukotrienes or prostaglandins
    • A61K31/558—Eicosanoids, e.g. leukotrienes or prostaglandins having heterocyclic rings containing oxygen as the only ring hetero atom, e.g. thromboxanes
    • A61K31/5585—Eicosanoids, e.g. leukotrienes or prostaglandins having heterocyclic rings containing oxygen as the only ring hetero atom, e.g. thromboxanes having five-membered rings containing oxygen as the only ring hetero atom, e.g. prostacyclin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/20—Hypnotics; Sedatives

Definitions

  • the present invention relates to a pharmaceutical composition for treating or preventing sleep disorders which comprises (S) -N- [ 2- ( 1, 6 , 7 , 8-tetrahydro-2H- indeno[5, 4-b]furan-8-yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.
  • Benzodiazepines can be classified into about 90 different types based on features of symptoms, cause of disease, etc. (International Classification of Sleep Disorders (ICSD) : In diagnostic and Coding Manual; American Sleep Disorder Association; Allen Press Inc.: Lawrence, Kansas, 1990). Most of medicines for treating these disorders at present are benzodiazepines and their derivatives. Non-benzodiazepines such as zolpidem, zopiclone, etc. , which are comparatively new hypnotics , are structurally different from benzodiazepines, but exhibit the same activities as benzodiazepines through benzodiazepine receptors. It is believed that benzodiazepines lower the activity of information proceeding by sedating the limbic system and hypothalamus and induce sleep. Further, it is known that benzodiazepines do not increase REM (rapid eye movement) sleep and increase non-REM sleep only.
  • REM rapid eye movement
  • the present invention provides a pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam, a method for reducing amounts and(or) side effects of benzodiazepines administered to a mammal which comprises administering to such mammal an effective amount of melatonin agonists in combination with benzodiazepines, a method for reducing amounts and(or) side effects of benzodiazepines administered to a mammal which comprises administering to such mammal an effective amount of compound A in combination with benzodiazepines , a method for reducing amounts and(or) side effects of active component (s) (zolpidem, zopiclone, triazolam and/or brotizolam) administered to a mammal for treating or preventing sleep disorders which comprises administering to such mammal an effective amount of compound A in combination with at least one active component selected from zolpi
  • Compound A used in the present invention can be produced by the methods disclosed in Example 11 of WO 97/32871 or analogous methods thereto.
  • Zolpidem is N,N, 6-trimethyl-2- (4-methylpheny) - imidazo[l,2-a]pyridine-3-acetamide and can be produced by the methods disclosed in Japanese Patent Unexamined
  • Zopiclone is 4-methyl-1-piperazinecarboxylic acid 6- (5-chloro-2-pyridinyl) -6 , 7-dihydro-7-oxo-5H- pyrrolo[3 , 4-b]pyrazin-5-yl ester and can be produced in the methods disclosed in Japanese Patent Unexamined Publication No.76892/1973( S48) (USP 3862149) or analogous methods thereto.
  • Triazolam (halcion) is 8-chloro-6- ( 2- chlorophenyl)-l-methyl-4H- [1,2, 4 ] riazolo[4 , 3- a] [ 1 , 4]benzodiazepine and can be produced by the methods disclosed in Japanese Patent Unexamined Publication No. 76892/1973(S48) (USP 3987052) or analogous methods thereto .
  • Brotizolam (lendormin) is 8-bromo-6- (o- chlorophenyl) -1-methyl-4H-s- triazolo[3,4c]thieno[2,3e] 1 , 4-diazepine and can be produced by the methods disclosed in Japanese Patent Unexamined Publication No. 80899/1976(S51) (USP 4094984) or analogous methods thereto .
  • the pharmaceutical composition for treating or preventing sleep disorders in the present invention comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam as active components.
  • This composition can be used orally in the form of a dosage form available on each of the above components or mixing each of the above components with a pharmacologically acceptable carrier or excipient and then combining them.
  • the pharmaceutical composition for treating or preventing sleep disorders in the present invention can be provided with compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam, for example, in the alternative forms prepared by the following procedures .
  • the above components are mixed optionally with a pharmaceutically acceptable excipient or the like by the known pharmaceutical technology to provide one dosage form, (2) the respective components are independently processed, optionally together with a pharmaceutically acceptable excipient or the like, to use in combination with independent dosage forms, at the same time or at staggered times, or (3) the respective components are independently processed, optionally together with a pharmaceutically acceptable excipient or the like, to provide independently prepared dosage forms as a set (kit) .
  • the respective components in case that the respective components are independently processed to provide independently prepared dosage forms, they can be administered to one patient at the same time or at staggered times, and the numbers of dosing of the respective dosage forms may or may not be equal.
  • the pharmaceutical composition for treating or preventing sleep disorders in the present invention can be provided in one dosage form containing all of the active components or in dosage forms in which the respective active components or part of them are independently prepared .
  • the amount of active components is from about 0.01 to about 100% by weight of the total weight of the composition.
  • This composition can be administered to patients by the oral route, such as tablets, fine granules, capsules and granules , among others . Preferred are tablets , fine granules , and capsules .
  • the pharmaceutical compositions in the present invention can be formulated in any per se known manner or analogous methods thereof available with pharmaceutically acceptable carriers used in any per se known manner.
  • the said carriers include any ordinary organic and inorganic carrier substances that are usable as formulating medicines.
  • excipients for formulating solid preparations
  • solvents solubilizers , suspending agents, isotonizing agents, buffers, soothing agents, etc. for formulating liquid preparations.
  • further employable are other additives such as ordinary preservatives, antioxidants , colorants, sweeteners, adsorbents, wetting agents, etc.
  • the excipients include, for example, lactose, white sugar, D-mannitol, starch, corn starch, crystalline cellulose, light silicic anhydride, etc.
  • the lubricants include, for example, magnesium stearate, calcium stearate, talc, colloidal silica, etc.
  • the binders include, for example, crystalline cellulose, white sugar, D-mannitol, dextrin, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, polyvinyl pyrrolidone, starch, sucrose, gelatin, methyl cellulose, carboxymethyl cellulose sodium, etc.
  • the disintegrators include, for example, starch, carboxymethyl cellulose, carboxymethyl cellulose calcium, croscarmellose sodium, carboxymethyl starch sodium, L- hydroxypropyl cellulose, etc.
  • the solvents include, for example, water for injections, alcohol, propylene glycol, macrogol, sesame oil, corn oil, olive oil, etc.
  • the solubilizers include, for example, polyethylene glycol, propylene glycol, D-mannitol, benzyl benzoate. ethanol, trisaminomethane, cholesterol, triethanola ine, sodium carbonate, sodium citrate, etc.
  • the suspending agents include, for example, surfactants such as stearyl triethanolamine, sodium lauryl sulfate, lauryl aminopropionic acid, lecithin, benzalkonium chloride, benzethonium chloride, glycerin monostearate, etc. ; hydrophilic polymers such as polyvinyl alcohol, polyvinyl pyrrolidone, carboxymethyl cellulose sodium, methyl cellulose, hydroxymethyl cellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, etc.
  • surfactants such as stearyl triethanolamine, sodium lauryl sulfate, lauryl aminopropionic acid, lecithin, benzalkonium chloride, benzethonium chloride, glycerin monostearate, etc.
  • hydrophilic polymers such as polyvinyl alcohol, polyvinyl pyrrolidone, carboxymethyl cellulose sodium, methyl cellulose, hydroxymethyl cellulose, hydroxyeth
  • the isotonizing agents include, for example, glucose, D-sorbitol, sodium chloride, glycerin, D-mannitol, etc.
  • the buffers include, for example, liquid buffers of phosphates, acetates, carbonates, citrates, etc.
  • the soothing agents include, for example, benzyl alcohol, etc.
  • the preservatives include, for example, parahydroxybenzoates , chlorobutanol, benzyl alcohol, phenethyl alcohol, dehydroacetic acid, sorbic acid, etc.
  • the antioxidants include, for example, sulfites, ascorbic acid, etc.
  • the stabilizers for light include, for example, titanium oxide, etc.
  • the pharmaceutical composition containing compound A used in the present invention can be provided in various dosage forms, for example, as tablets (including sugar- coated tablets, film-coated tablets), powders, granules, capsules (including soft capsules), liquids, injections, suppositories, sustained release preparations, plasters and also as chewing gum, etc. , in accordance with the per se known methods, for example, the methods disclosed in WO 97/32871 or analogous methods thereto.
  • the pharmaceutical composition which comprises at least one components selected from zolpidem, zopiclone, triazolam and brotizolam can be prepared in the same manners used in the above pharmaceutical composition containing compound A.
  • the pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam can reduce the amount (dose) of active component(s) required compared to the case with the monotherapy using any of the above-mentioned active components .
  • zolpidem, zopiclone, triazolam and brotizolam in a lower amount than the case with monotherapy using their active components for treating or preventing sleep disorders.
  • a combination of active component(s) in the respective amount of which separately cannot produce beneficial effects exhibits an action for sleep and reduces problematic side effects (e.g. rebound insomnia, dysmnesia, ataxia after sleep-awake and somnolence) .
  • the amount of zolpidem, zopiclone, triazolam and/or brotizolam can be reduced to an amount which do not produce side effects and an effect for sleep can be produced with the lower amount .
  • Compound A does not produce side effects in a monotherapy dose.
  • the pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam is useful for treating and/or preventing, for example, sleep disorders [e.g., primary insomnia, sleep-awake rhythm disorders (e.g., work-shift syndrome, time-zone syndrome( jet-lag) , seasonal melancholia, genital disorder, neuroendocrine disorder, senile dementia, Alzheimer's disease, various disorders accompanied by aging, cerebrovascular disorders (e.g., cerebral hemorrhage, etc.), cranial injury, spinal injury, epilepsy, anxiety, depression, manic-depressive psychosis, schizophrenia, alchoholism, Parkinson's disease, hypertension, arteriosclerosis, arrhythmia, premenstrual tension syndrome, glaucoma, cancer, aids and diabetes in mammals (e.g., human, cat, dog, monkey, etc.).
  • sleep disorders e.g.
  • Compound A is independently useful for treating and/or preventing, for example, sleep disorders [e. g. , primary insomnia, sleep-awake rhythm disorders (e. g.
  • the pharmaceutical composition for treating or preventing sleep disorders in the present invention is of low toxicity and can be used safely for human with oral administration .
  • the dose of the pharmaceutical composition of the present invention varies, depending on the subject to which the composition is administered, the administration route employed, the disorder of the subject, the kinds of active components used, etc., for example, as the respective active components dose for adults (body weight about 60 kg) with sleep disorders, the following amount may be administered once or several times a day, at the same time or at an interval of 30 minutes or 3 hours.
  • the dose of compound A may be from about 0.05 to about 10 mg of body weight, preferably from about 0.1 to about 3 mg of body weight for one administration.
  • the dose of zolpidem may be from about 0.2 to about 10 mg of body weight, preferably from about 0.5 to about 5 mg of body weight for one administration.
  • the dose of zopiclone may be from about 0.2 to about
  • the dose of triazolam may be from about 0.01 to about 0.5 mg/kg of body weight or so, preferably from about 0.02 to about 0.3 mg/kg of body weight for one administration.
  • the dose of brotizolam may be from about 0.01 to about 1 mg of body weight or so, preferably from about 0.05 to about 0.3 mg of body weight for one administration.
  • the ratio in combination of compound A with at least one selected from zolpidem, zopiclone, triazolam and brotizolam is 0.1 to 30 part by weight per 1 part by weight of compound A.
  • the pharmaceutical composition for treating or preventing sleep disorders in the present invention may be used with other active components (e.g., benzodiazepine-type medicines comprising benzodiazepine compounds such as diazepam, alprazolam, estazolam, etc.; agents for regulating sleep rhythm comprising fatty acid derivatives such as butoctamide and its salt, etc.; sleep reducing substances comprising cis-9 , 10-octadecenamide, etc.
  • Such other active components and the compound A and at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam may be mixed by means of per se known methods to give pharmaceutical compositions
  • the reaction system was depressurized to normal, followed by determination of the conversion and the optical purity of the product, (S)-2-(l,6,7,8- tetrahydro-2H-indeno[5,4-b]furan-8-yl) ethylamine), by means of high performance liquid chromatography.
  • the conversion was 100% and the optical purity was 88.8%e.e.
  • Toluene (10 mL) was added to the residue (1.02 g) obtained by concentration under reduced pressure.
  • the mixture was cooled on an ice-bath, to which was added, while stirring, 2% hydrochloric acid (10 mL).
  • the reaction mixture was stirred for 30 minutes, which was concentrated under reduced pressure to leave the residue (1.21 g) .
  • the concentrate was dissolved in methanol (5 mL) , to which was added acetone ( 10 mL) .
  • the mixture was cooled to 0°C, which was then subjected to filtration to collect the title compound (0.64 g) . Further, the filtrate was concentrated under reduced pressure.
  • the concentrate (0.34 g) was recrystallized from a mixture of methanol (1.5 mL) and acetone (3.0 mL) to give the title compound (0.17 g, total yield 0.81 g, yield 68%) .
  • This hydrochloride was processed with a 5% aqueous solution of sodium hydroxide to give (S)-2-(l,6,7, 8-tetrahydro-2H-indeno[ 5 , 4-b]furan-8- yl) ethylamine.
  • the optical purity of the product was determined by means of high performance liquid chromatography, which was 100 %e.e.
  • the uncoated-tablets were sugar-coated with a fluid containing cane sugar, titanium dioxide, talc and arable gum and polished with beeswax to give 1000 coated tablets .
  • Magnnesium stearate 3.0g Compound A (10-Og) and magnesium stearate (3.0g) were granulated with 70mL of aqueous solution dissolving soluble starch (7.0g of soluble starch). The granules were dried and mixed with lactose (70.0g) and corn starch (50.0g) . The mixtures were compressed to give 1000 tablets .
  • Treatment with compound A had no significant effects on the latency of any sleep stages.
  • Triazolam (0.03 mg/kg, p.o.) alone also produced no significant effects on the sleep latencies.
  • Treatment with triazolam (0.03 mg/kg) did not affect general behavior and it did not cause ataxia and sedation as such were seen when high doses of triazolam are given.
  • the effects of co-administration of compound A and triazolam on the sleep latency are shown in Fig.1.
  • Co-administration of Compound A and triazolam shortened the latencies of deep slow wave sleep, stage 3 and stage 4, and it significantly shortend the latency of the stage 4 sleep.
  • the co-administration also had no significant effects on general behavior of monkeys . It is clear that compound A in combination with triazolam has an excellent effect on the sleep disorders without the side effects.
  • composition for treating or preventing sleep disorders which comprises (S)-N-[2-
  • Compound A is independently useful for treating and/or preventing, for example, sleep disorders[e. g. , primary insomnia, sleep-awake rhythm disorders(e. g.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Epidemiology (AREA)
  • Neurosurgery (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Neurology (AREA)
  • Biomedical Technology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

The present invention provides a pharmaceutical composition for treating or preventing sleep disorders which comprises (S)-N-[2-(1,6,7,8-tetrahydro-2H-indeno[5,4-b]furan-8-yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.

Description

Description Pharmaceutical Composition for Treating or Preventing Sleep Disorders
Technical field
The present invention relates to a pharmaceutical composition for treating or preventing sleep disorders which comprises (S) -N- [ 2- ( 1, 6 , 7 , 8-tetrahydro-2H- indeno[5, 4-b]furan-8-yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.
Background art
Sleep disorders can be classified into about 90 different types based on features of symptoms, cause of disease, etc. (International Classification of Sleep Disorders (ICSD) : In diagnostic and Coding Manual; American Sleep Disorder Association; Allen Press Inc.: Lawrence, Kansas, 1990). Most of medicines for treating these disorders at present are benzodiazepines and their derivatives. Non-benzodiazepines such as zolpidem, zopiclone, etc. , which are comparatively new hypnotics , are structurally different from benzodiazepines, but exhibit the same activities as benzodiazepines through benzodiazepine receptors. It is believed that benzodiazepines lower the activity of information proceeding by sedating the limbic system and hypothalamus and induce sleep. Further, it is known that benzodiazepines do not increase REM (rapid eye movement) sleep and increase non-REM sleep only.
On the other hand, it is disclosed in WO 97/32871 that various tricyclic compounds including (S)-N-[2- (1,6,7,8-tetrahydro-2H-indeno[ 5 , 4-b]furan-8- yl)ethyl]propionamide, have an excellent activity as melatonin agonists and are useful for treating or preventing sleep disorders, etc.
Brief description of drawings
Effects of compound A and triazolam on sleep latencies at nighttime in monkeys . Each value shows the mean latency to appear each sleep stages (SEM) . S1+S2 : stage 1 and stage 2; S3: stage 3; S4 : stage 4 and REM: rapid eye movement. *P<0.05 compared with control group (paired t-test) .
Disclosure of the invention
It is indicated that known hypnotics have many problems such as transient insomnia (rebound insomnia) [Science, Vol.201, pages 1039-1041, 1978], dysmnesia such as anterograde amnesia [Psychopharmacology, Vol.70, pages 231-237, 1980, Neuroscience and Biobehavior Review, Vol.9, Pages 87-94, 1985], ataxia after sleep-awake and somnolence . Therefore, it is desired to develop a hypnotic without these problems .
The inventors of the present invention made intensive studies and as a result, they found that (S)-N-[2- (1,6,7 , 8-tetrahydro-2H-indeno[ 5 , 4-b]furan-8- yl)ethyl]propionamide (hereinafter referred to as compound A) in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam (as a pharmaceutical mixture, combination dosage form or concomitant pharmacotherapy) produces clinically beneficial effects as a medication exhibiting remarkable efficacy in the therapy (treating) and prophylaxis (preventing) of sleep disorders with substantially no risk for side effects such as recoil insomnia, dysmnesia, ataxia after sleep-awake and somnolence and hence is safe than monotherapy using any of the above-mentioned active components. The present invention has been developed on the basis of the above finding .
Namely, the present invention provides a pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam, a method for reducing amounts and(or) side effects of benzodiazepines administered to a mammal which comprises administering to such mammal an effective amount of melatonin agonists in combination with benzodiazepines, a method for reducing amounts and(or) side effects of benzodiazepines administered to a mammal which comprises administering to such mammal an effective amount of compound A in combination with benzodiazepines , a method for reducing amounts and(or) side effects of active component (s) (zolpidem, zopiclone, triazolam and/or brotizolam) administered to a mammal for treating or preventing sleep disorders which comprises administering to such mammal an effective amount of compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam, and a pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from non-benzodiazepines, etc.
Compound A used in the present invention can be produced by the methods disclosed in Example 11 of WO 97/32871 or analogous methods thereto. Zolpidem is N,N, 6-trimethyl-2- (4-methylpheny) - imidazo[l,2-a]pyridine-3-acetamide and can be produced by the methods disclosed in Japanese Patent Unexamined
Publication No. 8384/1988 (S63 ) (USP 4794185) or analogous methods thereto .
Zopiclone is 4-methyl-1-piperazinecarboxylic acid 6- (5-chloro-2-pyridinyl) -6 , 7-dihydro-7-oxo-5H- pyrrolo[3 , 4-b]pyrazin-5-yl ester and can be produced in the methods disclosed in Japanese Patent Unexamined Publication No.76892/1973( S48) (USP 3862149) or analogous methods thereto.
Triazolam (halcion) is 8-chloro-6- ( 2- chlorophenyl)-l-methyl-4H- [1,2, 4 ] riazolo[4 , 3- a] [ 1 , 4]benzodiazepine and can be produced by the methods disclosed in Japanese Patent Unexamined Publication No. 76892/1973(S48) (USP 3987052) or analogous methods thereto .
Brotizolam (lendormin) is 8-bromo-6- (o- chlorophenyl) -1-methyl-4H-s- triazolo[3,4c]thieno[2,3e] 1 , 4-diazepine and can be produced by the methods disclosed in Japanese Patent Unexamined Publication No. 80899/1976(S51) (USP 4094984) or analogous methods thereto .
The pharmaceutical composition for treating or preventing sleep disorders in the present invention comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam as active components. This composition can be used orally in the form of a dosage form available on each of the above components or mixing each of the above components with a pharmacologically acceptable carrier or excipient and then combining them. The pharmaceutical composition for treating or preventing sleep disorders in the present invention can be provided with compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam, for example, in the alternative forms prepared by the following procedures . ( 1 ) the above components are mixed optionally with a pharmaceutically acceptable excipient or the like by the known pharmaceutical technology to provide one dosage form, (2) the respective components are independently processed, optionally together with a pharmaceutically acceptable excipient or the like, to use in combination with independent dosage forms, at the same time or at staggered times, or (3) the respective components are independently processed, optionally together with a pharmaceutically acceptable excipient or the like, to provide independently prepared dosage forms as a set (kit) . In the pharmaceutical composition of the present invention, in case that the respective components are independently processed to provide independently prepared dosage forms, they can be administered to one patient at the same time or at staggered times, and the numbers of dosing of the respective dosage forms may or may not be equal.
The pharmaceutical composition for treating or preventing sleep disorders in the present invention can be provided in one dosage form containing all of the active components or in dosage forms in which the respective active components or part of them are independently prepared . The amount of active components is from about 0.01 to about 100% by weight of the total weight of the composition. This composition can be administered to patients by the oral route, such as tablets, fine granules, capsules and granules , among others . Preferred are tablets , fine granules , and capsules . The pharmaceutical compositions in the present invention can be formulated in any per se known manner or analogous methods thereof available with pharmaceutically acceptable carriers used in any per se known manner. The said carriers include any ordinary organic and inorganic carrier substances that are usable as formulating medicines. For example, employable are excipients, lubricants, binders, disintegrators, etc. for formulating solid preparations; and solvents, solubilizers , suspending agents, isotonizing agents, buffers, soothing agents, etc. for formulating liquid preparations. If desired, further employable are other additives such as ordinary preservatives, antioxidants , colorants, sweeteners, adsorbents, wetting agents, etc. The excipients include, for example, lactose, white sugar, D-mannitol, starch, corn starch, crystalline cellulose, light silicic anhydride, etc.
The lubricants include, for example, magnesium stearate, calcium stearate, talc, colloidal silica, etc. The binders include, for example, crystalline cellulose, white sugar, D-mannitol, dextrin, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, polyvinyl pyrrolidone, starch, sucrose, gelatin, methyl cellulose, carboxymethyl cellulose sodium, etc. The disintegrators include, for example, starch, carboxymethyl cellulose, carboxymethyl cellulose calcium, croscarmellose sodium, carboxymethyl starch sodium, L- hydroxypropyl cellulose, etc.
The solvents include, for example, water for injections, alcohol, propylene glycol, macrogol, sesame oil, corn oil, olive oil, etc.
The solubilizers include, for example, polyethylene glycol, propylene glycol, D-mannitol, benzyl benzoate. ethanol, trisaminomethane, cholesterol, triethanola ine, sodium carbonate, sodium citrate, etc.
The suspending agents include, for example, surfactants such as stearyl triethanolamine, sodium lauryl sulfate, lauryl aminopropionic acid, lecithin, benzalkonium chloride, benzethonium chloride, glycerin monostearate, etc. ; hydrophilic polymers such as polyvinyl alcohol, polyvinyl pyrrolidone, carboxymethyl cellulose sodium, methyl cellulose, hydroxymethyl cellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, etc.
The isotonizing agents include, for example, glucose, D-sorbitol, sodium chloride, glycerin, D-mannitol, etc.
The buffers include, for example, liquid buffers of phosphates, acetates, carbonates, citrates, etc. The soothing agents include, for example, benzyl alcohol, etc.
The preservatives include, for example, parahydroxybenzoates , chlorobutanol, benzyl alcohol, phenethyl alcohol, dehydroacetic acid, sorbic acid, etc. The antioxidants include, for example, sulfites, ascorbic acid, etc.
The stabilizers for light include, for example, titanium oxide, etc.
The pharmaceutical composition containing compound A used in the present invention can be provided in various dosage forms, for example, as tablets (including sugar- coated tablets, film-coated tablets), powders, granules, capsules (including soft capsules), liquids, injections, suppositories, sustained release preparations, plasters and also as chewing gum, etc. , in accordance with the per se known methods, for example, the methods disclosed in WO 97/32871 or analogous methods thereto.
The pharmaceutical composition which comprises at least one components selected from zolpidem, zopiclone, triazolam and brotizolam can be prepared in the same manners used in the above pharmaceutical composition containing compound A. The pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam can reduce the amount (dose) of active component(s) required compared to the case with the monotherapy using any of the above-mentioned active components . Namely, in the present invention, it is preferred to use zolpidem, zopiclone, triazolam and brotizolam in a lower amount than the case with monotherapy using their active components for treating or preventing sleep disorders. In the present invention, for example, a combination of active component(s) in the respective amount of which separately cannot produce beneficial effects exhibits an action for sleep and reduces problematic side effects (e.g. rebound insomnia, dysmnesia, ataxia after sleep-awake and somnolence) . In other words, in the present invention, the amount of zolpidem, zopiclone, triazolam and/or brotizolam can be reduced to an amount which do not produce side effects and an effect for sleep can be produced with the lower amount . Compound A does not produce side effects in a monotherapy dose.
The pharmaceutical composition for treating or preventing sleep disorders which comprises compound A in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam is useful for treating and/or preventing, for example, sleep disorders [e.g., primary insomnia, sleep-awake rhythm disorders (e.g., work-shift syndrome, time-zone syndrome( jet-lag) , seasonal melancholia, genital disorder, neuroendocrine disorder, senile dementia, Alzheimer's disease, various disorders accompanied by aging, cerebrovascular disorders (e.g., cerebral hemorrhage, etc.), cranial injury, spinal injury, epilepsy, anxiety, depression, manic-depressive psychosis, schizophrenia, alchoholism, Parkinson's disease, hypertension, arteriosclerosis, arrhythmia, premenstrual tension syndrome, glaucoma, cancer, aids and diabetes in mammals (e.g., human, cat, dog, monkey, etc.). In addition, it is also effective for protection against aging, immunoregulation, and ovulatory regulation (e.g., contraception) . Compound A is independently useful for treating and/or preventing, for example, sleep disorders [e. g. , primary insomnia, sleep-awake rhythm disorders (e. g. , work-shift syndrome, time-zone syndrome( jet-lag) , seasonal melancholia, genital disorder, neuroendocrine disorder, senile dementia, Alzheimer's disease, various disorders accompanied by aging, cerebrovascular disorders (e.g., cerebral hemorrhage, etc.), cranial injury, spinal injury, epilepsy, anxiety, depression, manic-depressive psychosis, schizophrenia, alchoholism, Parkinson's disease, hypertension, arteriosclerosis, arrhythmia, premenstrual tension syndrome, glaucoma, cancer, aids and diabetes in mammals (e.g., human, cat, dog, monkey, etc.), in addition protection against aging, immunoregulation, and ovulatory regulation (e.g., contraception).
The pharmaceutical composition for treating or preventing sleep disorders in the present invention is of low toxicity and can be used safely for human with oral administration .
Though the dose of the pharmaceutical composition of the present invention varies, depending on the subject to which the composition is administered, the administration route employed, the disorder of the subject, the kinds of active components used, etc., for example, as the respective active components dose for adults (body weight about 60 kg) with sleep disorders, the following amount may be administered once or several times a day, at the same time or at an interval of 30 minutes or 3 hours.
The dose of compound A may be from about 0.05 to about 10 mg of body weight, preferably from about 0.1 to about 3 mg of body weight for one administration.
The dose of zolpidem may be from about 0.2 to about 10 mg of body weight, preferably from about 0.5 to about 5 mg of body weight for one administration. The dose of zopiclone may be from about 0.2 to about
10 mg of body weight, preferably from about 0.5 to about 5 mg of body weight for one administration.
The dose of triazolam may be from about 0.01 to about 0.5 mg/kg of body weight or so, preferably from about 0.02 to about 0.3 mg/kg of body weight for one administration. The dose of brotizolam may be from about 0.01 to about 1 mg of body weight or so, preferably from about 0.05 to about 0.3 mg of body weight for one administration.
In the pharmaceutical composition for treating or preventing sleep disorders in the present invention, the ratio in combination of compound A with at least one selected from zolpidem, zopiclone, triazolam and brotizolam (relative dosage) is 0.1 to 30 part by weight per 1 part by weight of compound A. The pharmaceutical composition for treating or preventing sleep disorders in the present invention may be used with other active components (e.g., benzodiazepine-type medicines comprising benzodiazepine compounds such as diazepam, alprazolam, estazolam, etc.; agents for regulating sleep rhythm comprising fatty acid derivatives such as butoctamide and its salt, etc.; sleep reducing substances comprising cis-9 , 10-octadecenamide, etc. Such other active components and the compound A and at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam may be mixed by means of per se known methods to give pharmaceutical compositions
(e.g. , tablets, powders, granules, capsules including soft capsules, liquids, injections, suppositories, sustained release preparations, etc.); or they may be separately formulated into different preparations , which may be administered to one and the same subject either simultaneously or at different times.
Best mode for carrying out the invention
The invention will be described in more detail hereinafter, with reference to the following Reference
Examples , Preparation Examples and Experimental Examples , which, however, are to concretely illustrate some embodiments of the invention and are not intended to restrict the scope of the invention. Various changes and modifications can be made within the range that does not deviate from the scope of the invention.
Examples
Reference Example 1
2 , 3-Dihydrobenzofuran-5-carbaldehyde
To a solution of 2, 3-dihydrobenzofuran (lOO.Og, 832 mmols) in N,N-dimethylformamide (134.0g, 1.83mols) was added dropwise phosphorus oxychloride (255. lg, 1.66mols) , then the mixture was stirred at 80-90° C for 7.5 hours. The mixture was cooled to room temperature, poured into water ( 1L) , and stirred for 15 hours. The product was extracted with toluene (1.5L). The extract was washed with water (500mL) followed by saturated aqueous solution of sodium bicarbonate (500mL) and concentrated under reduced pressure to obtain 115.9g (yield : 94%) of the title compoun .
Reference Example 2
Ethyl (E) -3- ( 2 , 3-dihydrobenzofuran-5-yl) -2-propenoate To an ice-cooled suspension of sodium t-buthoxide
(90.4g, 941mmols) in toluene (1L) was added dropwise triethyl phosphonoacetate (211. Og, 941mmols) followed by 2, 3-dihydrobenzofuran-5-carbaldehyde (115.9g, 782mmols). The mixture was stirred for 1 hour and then acetic acid ( 12g, 200mmols) and water (604mL) was added. The separated organic layer was washed with water (525mL) followed by saturated aqueous solution of sodium bicarbonate (263mL) and concentrated under reduced pressure. Methanol (525mL) and water (525mL) was added to the residue and the mixture was stirred for 30 min. Crystals precipitated were collected by filtration to obtain 161.2g (yield : 94%) of the title compound.
Reference Example 3 Ethyl 3- ( 2 , 3-Dihydrobenzofuran-5-yl)propionate
To a solution of ethyl (E)-3-(2,3- dihydrobenzofuran-5-yl) -2-propenoate (160. Og, 733mmols) in acetic acid (960mL) was added 5% palladium on activated carbon (32.0g, 50% hydrous). The mixture was stirred at 50° C for 3.5 hours under hydrogen atmosphere (ambient pressure) . The catalyst was filtered off and the filtrate containing 156.7g (yield : 97%) of the title compound was obtained which was provided to the next step. Reference Example 4
3- ( 6 , 7-Dibromo-2 , 3-dihydrobenzofuran-5-yl)propionic acid Sodium acetate (59.2g, 722mmols) was dissolved in a solution of ethyl 3- (2 , 3-dihydrobenzofuran-5- yl)propionate (156.7g, 711mmols) in acetic acid, which was obtained in Reference Example 3. To the solution was added dropwise bromine (708g, 4.43mols). The reaction mixture was stirred at room temperature for 4 hours and then added to a precooled 15% aqueous solution of sodium sulfite (2527g) followed by refluxing with acetonitrile (480mL) for 2 hours. After cooling, crystals were collected by filtration and washed with water to obtain 179.3g (yield: 72%) of the title compound.
Reference Example 5
4, 5-Dibromo-l,2 ,6, 7-tetrahydro-8H-indeno[ 5 , 4-b]furan-8- one A mixture of 3- ( 6 , 7-dibromo-2 , 3- dihydrobenzofuran-5-yl)propionic acid (lO.Og, 28.6mmols) , dichloromethane (35mL), thionyl chloride (5.11g, 40.8mmols) and N,N-dimethylformamide (30mg) was heated to reflux for 1 hour . After cooling, aluminum chloride ( 4.66g, 43.3mmols) was added to the reaction mixture blow 0° C and then the mixture was stirred for 30 min. The reaction mixture was poured into precooled methanol (200mL), then stirred for 30 min. Crystals precipitated were collected by filtration, washed with water (500mL) followed by methanol (500mL) to obtain 7.9g (yield : 89%) of the title compound.
Reference Example 6 1,2,6 , 7-Tetrahydro-8H-indeno[ 5 , 4-b]furan-8-one
To a suspension of 4, 5-dibromo-l , 2 , 6 , 7- tetrahydro-8H-indeno[5,4-b]furan-8-one (18.4 g, 55.4 mmols) in methanol (400mL) was added 10% Palladium on activated carbon (2.0 g, 50% hydrous) followed by sodium acetate (12.6 g, 154mmols). The mixture was stirred at 40° C for 1.5 hours under hydrogen atmosphere (4kgf/cm2). The catalyst was filtered off and the filtrate was concentrated under reduced pressure. Crystals were collected by filtration, washed with water and recrystallized successively with methanol : water = 5 : 1 to obtain 8.0 g (yield : 83%) of the title compound.
Reference Example 7 (E)-(l,6,7, 8-Tetrahydro-2H-indeno[ 5 , 4-b]furan-8- ylidene)acetonitrile
To a solution of 1, 2 , 6 , 7-tetrahydro-8H-indeno[ 5 , 4-b]furan-8-one (250. Og, 1.44mols) and diethyl (cyanomethyl) phosphonate (304.8g, 1.72mols) in toluene( 6.25L) was added dropwise 28% sodium methoxide in methanol (332.8g, 1.72mols). After stirring for 2 hours under the same temperature, water (2.5L) was added to the reaction mixture to separate organic layer which was washed with water (1L) and concentrated under reduced pressure. Crystals were collected by filtration to obtain 250.4g (yield : 88%) of the title compound.
Reference Example 8
(E)-2-(l,6,7, 8-Tetrahydro-2H-indeno[ 5 , 4-b]furan-8- indene)ethylamine hydrochloride
To a solution of (E) - ( 1 , 6 , 7 , 8-tetrahydro-2H- indeno [ 5 , 4-b]furan-8-ylidene) acetonitrile ( 30. Og, 152mmols) in toluene (500mL) were added methanol (lOOmL), 14.4% aqueous solution of sodium hydroxide (10.5g) and Raney cobalt (44g) . The mixture was stirred at 35°C for 5.5 hours under hydrogen atmosphere (2kgf/cm2). After the catalyst was filtered off, water (160mL) and 1N-HC1 (150mL) were added to the filtrate, then the mixture was stirred at 40° C for 30 min. Aqueous layer was separated and saturated aqueous solution of sodium chloride (320mL) was added. The precipitated crystals were collected by filtration to obtain 30. Og (yield: 83%) of the title compound.
Reference Example 9
(S)-2-(l,6,7,8-tetrahydro-2H-indeno [ 5 , 4-b] furan-8-yl] ethylamine hydrochloride A Hastelloy autoclave (200 mL) was charged with
(E)-2-(l,6,7,8-tetrahydro-2H-indeno[ 5 , 4-b]furan-8- ylidene) ethylamine (1.00 g, 5.00 mmol.), Ru2Cl4[(R)- BINAP]2NEt3 (21.0 mg) and methanol (10 mL) under nitrogen atmosphere. Into the vessel, hydrogen gas was introduced up to 100 atmospheric pressure. The mixture was stirred for 20 hours at 50°C. The reaction system was depressurized to normal, followed by determination of the conversion and the optical purity of the product, (S)-2-(l,6,7,8- tetrahydro-2H-indeno[5,4-b]furan-8-yl) ethylamine), by means of high performance liquid chromatography. The conversion was 100% and the optical purity was 88.8%e.e.
Toluene (10 mL) was added to the residue (1.02 g) obtained by concentration under reduced pressure. The mixture was cooled on an ice-bath, to which was added, while stirring, 2% hydrochloric acid (10 mL). The reaction mixture was stirred for 30 minutes, which was concentrated under reduced pressure to leave the residue (1.21 g) . The concentrate was dissolved in methanol (5 mL) , to which was added acetone ( 10 mL) . The mixture was cooled to 0°C, which was then subjected to filtration to collect the title compound (0.64 g) . Further, the filtrate was concentrated under reduced pressure. The concentrate (0.34 g) was recrystallized from a mixture of methanol (1.5 mL) and acetone (3.0 mL) to give the title compound (0.17 g, total yield 0.81 g, yield 68%) . This hydrochloride was processed with a 5% aqueous solution of sodium hydroxide to give (S)-2-(l,6,7, 8-tetrahydro-2H-indeno[ 5 , 4-b]furan-8- yl) ethylamine. The optical purity of the product was determined by means of high performance liquid chromatography, which was 100 %e.e.
Reference Example 10
( S) -N- [ 2- ( 1 , 6 , 7 , 8-Tetrahydro-2H-indeno[ 5 , 4-b] furan-8- yl)ethyl]propionamide (compound A)
To a suspension of (S) -2- ( 1 , 6 , 7 , 8-tetrahydro-2H- indeno[5, 4-b]furan-8-yl) ethylamine hydrochloride (lOO.Og, 417mmol) in tetrahydrofuran (250mL) at 15° C was added dropwise 7.1% aqueous solution of sodium hydroxide ( 538mL) . Propionyl chloride (44.4g, 480mmol) was added dropwise to the reaction mixture. Stirring was continued at room temperature for 30 min. Water (800mL) was added and crystals precipitated were collected by filtration followed by recrystallization from ethanol : water = 1: 2 to obtain 99.5g (yield : 92%) of the title compound.
Preparation Example 1
(l)compound A 10. Og
(2)lactose 60. Og (3)com starch 35. Og
(4)gelatin 3.0g
(5)magnesium stearate 2.0g
Compound A (10.0 g) , lactose (60.0 g) and corn starch
(35.0 g) were mixed and the mixture was granulated with 10%(w/v) aqueous solution dissolving gelatin (gelatin 3.0 g) by using a screen with 1mm mesh, and was dried at 40° C and screened. Thus-obtained granules were mixed with magnesium stearate (2.0g) and compressed to give uncoated-tablets . The uncoated-tablets were sugar-coated with a fluid containing cane sugar, titanium dioxide, talc and arable gum and polished with beeswax to give 1000 coated tablets .
Preparation Example 2 (l)compound A 10. Og
(2)lactose 70. Og
(3)corn starch 50. Og
(4)soluble starch 7.0g
(5)magnesium stearate 3.0g Compound A (10-Og) and magnesium stearate (3.0g) were granulated with 70mL of aqueous solution dissolving soluble starch (7.0g of soluble starch). The granules were dried and mixed with lactose (70.0g) and corn starch (50.0g) . The mixtures were compressed to give 1000 tablets .
Preparation Example 3
(l)compound A l.Og
(2)lactose 60. Og
(3)corn starch 35. Og (4)soluble starch 3.0g
(5)magnesium stearate 2.0g
Compound A (l.Og), lactose (60.0g) and corn starch
( 35. Og) were mixed and the mixture was granulated with 30mL of 10%(w/v) aqueous solution dissolving gelatin (gelatin 3.0g) by using a screen with 1mm mesh, and was dried at 40° C and screened. The thus-obtained granules were mixed with magnesium stearate (2.0g) and compressed to give uncoated-tablets . The uncoated-tablets were sugar-coated with a fluid containing cane sugar, titanium dioxide, talc and arable gum and polished with beeswax to give 1000 coated tablets.
Experimental Example Methods
Six female crab-eating macaques (Macaca fascicularis) , weighing 2.8-4.2 kg, housed individually in a room maintained at 24±1° C with a 12-h light/dark cycle (light on 6:00). Under sodium pentobarbital anesthesia, stainless steel screw and bipolar electrodes for electroencephalogram (EEG) , electromyogram (EMG) and electro-oculogram (EOG) were implanted. After recovery from surgery, the monkeys were well habituated to the recording chamber (60x60*80 cm) located in a sound-proof and electrically shielded room. Compound A (0.003 mg/kg) and/or triazolam (0.03 mg/kg) were given orally 17: 50-17:55. Compound A and triazoilam were suspened in 0.5% metylcellulose solution. The control monkey was given 0.5% MC. The behaviors of subjects were observed using a video camera with infrared light sensitivity. The EEG, EMG and EOG were recorded on a MO disk with an electroencephalograph (EE5518, NEC Medical Systems , Tokyo, Japan). All recordings were carried out from 18:00 until 6:00. The EEG power spectral analysis was also performed continuously by means of a fast Fourier transform (FFT) system equipped with a personal computer. Based on these EEG, EMG and EOG data and on behavior, visually judged in each 20-sec epoch, we classified the sleep-wake stages according to Rechtshaffen and Kales ( 1968 ) essentially (i.e. stage W, stage 1+2, stage 3, stage 4 and stage rapid eye movement (REM)). Latencies of each sleep stage (the time until the first appearance of each sleep stage) were determined from 18:00. The occurrence of each sleep stage at nighttime and other sleep parameters were also determined.
Results
Treatment with compound A (0.003 mg/kg, p.o. ) had no significant effects on the latency of any sleep stages. Triazolam (0.03 mg/kg, p.o.) alone also produced no significant effects on the sleep latencies. Treatment with triazolam (0.03 mg/kg) did not affect general behavior and it did not cause ataxia and sedation as such were seen when high doses of triazolam are given. The effects of co-administration of compound A and triazolam on the sleep latency are shown in Fig.1. Co-administration of Compound A and triazolam shortened the latencies of deep slow wave sleep, stage 3 and stage 4, and it significantly shortend the latency of the stage 4 sleep. The co-administration also had no significant effects on general behavior of monkeys . It is clear that compound A in combination with triazolam has an excellent effect on the sleep disorders without the side effects.
(Rechtschaffen, A. and Kales, A.A. : A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Bethersda, M.D., US Department of Health, Education and Welfare, 1968.)
Industrial Applicability
The pharmaceutical composition for treating or preventing sleep disorders which comprises (S)-N-[2-
(1,6,7,8-tetrahydro-2H-indeno[ 5 , 4-b]f ran-8- yl)ethyl]propionamide (compound A) in combination with at least one active component selected from zolpidem. zopiclone, triazolam and brotizolam in one dosage form or independent dosage forms and the method for treating or preventing which comprises administering the composition to a mammal is useful for treating and/or preventing, for example, sleep disorders [e.g., primary insomnia, sleep-awake rhythm disorders (e.g., work-shift syndrome, time-zone syndrome( et-lag) , seasonal melancholia, genital disorder, neuroendocrine disorder, senile dementia, Alzheimer's disease, various disorders accompanied by aging, cerebrovascular disorders (e.g., cerebral hemorrhage, etc. ) , cranial injury, spinal injury, epilepsy, anxiety, depression, manic-depressive psychosis, schizophrenia, alchoholism, Parkinson's disease, hypertension, arteriosclerosis, arrhythmia, premenstrual tension syndrome, glaucoma, cancer, aids and diabetes in mammals (e.g. , human, cat, dog, monkey, etc. ) . In addition, it is also effective for protection against aging, immunoregulation, and ovulatory regulation (e.g., contraception) . Compound A is independently useful for treating and/or preventing, for example, sleep disorders[e. g. , primary insomnia, sleep-awake rhythm disorders(e. g. , work-shift syndrome, time-zone syndrome(jet-lag) , seasonal melancholia, genital disorder, neuroendocrine disorder, senile dementia, Alzheimer's disease, various disorders accompanied by aging, cerebrovascular disorders (e.g., cerebral hemorrhage, etc.), cranial injury, spinal injury, epilepsy, anxiety, depression, manic-depressive psychosis, schiaophrenia, alchoholism, Parkinson's disease, hypertension, arteriosclerosis, arrhythmia, premenstrual tension syndrome, glaucoma, cancer, aids and diabetes in mammals (e.g., human, cat, dog, monkey, etc.), in addition protection against aging, immunoregulation, and ovulatory regulation (e.g., contraception).

Claims

Claims
1. A pharmaceutical composition for treating or preventing sleep disorders which comprises (S) -N- [2- ( 1, 6, 7 ,8- tetrahydro-2H-indeno[ 5, 4-b]furan-8- yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.
2. A pharmaceutical composition for treating or preventing sleep disorders which comprises (S) -N- [2- ( 1, 6 , 7 ,8- tetrahydro-2H-indeno[ 5 , 4-b]furan-8- yl)ethyl] ropionamide in combination with at least one active component selected from zolpidem, zopiclone and triazolam.
3. Use of (S)-N-[2-(l,6.7,8-tetrahydro-2H-indeno[5,4- b]f ran-8-yl)ethyl] ropionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam for treating or preventing sleep disorders. 4. Use of combination of (S) -N- [2- (1, 6, 7 ,8-tetrahydro- 2H-indeno[ 5,
4-b]furan-8-yl)ethyl]propionamide with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam for the production of a pharmaceutical composition for treating or preventing sleep disorders.
5. A method for treating or preventing sleep disorders in a mammal in need thereof, which comprises administering to such mammal an effective amount of (S)-N-[2- (1,6,7 , 8-tetrahydro-2H-indeno[ 5, 4-b]f ran-8- yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.
6. A method for reducing the amount of active component ( s ) administered to a mammal for treating or preventing sleep disorders, which comprises administering to such mammal an effective amount of (S) -N- [2- ( 1 , 6 , 7 , 8- tetrahydro-2H-indeno[ 5 , 4-b]furan-8- yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.
7. A method for reducing the side effects of active component (s) administered to a mammal for treating or preventing sleep disorders, which comprises administering to such mammal an effective amount of (S)-N- [2-(l,6,7,8-tetraydro-2H-indeno[5,4-b]furan-8- yl)ethyl]propionamide in combination with at least one active component selected from zolpidem, zopiclone, triazolam and brotizolam.
PCT/JP1999/003057 1998-06-09 1999-06-08 Pharmaceutical combination comprising a tricyclic compound and at least one of zolpidem, zopiclone, triazolam and brotizolam for treating or preventing sleep disorders Ceased WO1999063977A2 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
EP99923960A EP1100508B8 (en) 1998-06-09 1999-06-08 Pharmaceutical combination comprising a tricyclic compound and at least one of zolpidem, zopiclone and brotizolam for treating or preventing sleep disorders
DE69910795T DE69910795T2 (en) 1998-06-09 1999-06-08 PHARMACEUTICAL COMBINATION WITH A TRIZYCLIC COMPOUND AND AT LEAST ONE OF ZOLPIDEM, ZOPICLONE AND BROTIZOLAM, FOR TREATING OR PREVENTING SLEEP DISORDERS
AT99923960T ATE247967T1 (en) 1998-06-09 1999-06-08 PHARMACEUTICAL COMBINATION CONTAINING A TRICYCLIC COMPONENT AND AT LEAST ONE OF ZOLPIDEM, ZOPICLONE AND BROTIZOLAM, FOR THE TREATMENT OF SLEEP DISORDERS
CA002332521A CA2332521C (en) 1998-06-09 1999-06-08 Pharmaceutical composition for treating or preventing sleep disorders
AU40605/99A AU4060599A (en) 1998-06-09 1999-06-08 Pharmaceutical composition for treating or preventing sleep disorders
US09/700,405 US6348485B1 (en) 1998-06-09 1999-06-08 Method for treating or preventing sleep disorders

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP10/160270 1998-06-09
JP16027098 1998-06-09

Publications (2)

Publication Number Publication Date
WO1999063977A2 true WO1999063977A2 (en) 1999-12-16
WO1999063977A3 WO1999063977A3 (en) 2001-03-29

Family

ID=15711379

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP1999/003057 Ceased WO1999063977A2 (en) 1998-06-09 1999-06-08 Pharmaceutical combination comprising a tricyclic compound and at least one of zolpidem, zopiclone, triazolam and brotizolam for treating or preventing sleep disorders

Country Status (10)

Country Link
US (1) US6348485B1 (en)
EP (1) EP1100508B8 (en)
KR (1) KR100642024B1 (en)
CN (1) CN1206996C (en)
AR (1) AR019639A1 (en)
AT (1) ATE247967T1 (en)
AU (1) AU4060599A (en)
CA (1) CA2332521C (en)
DE (1) DE69910795T2 (en)
WO (1) WO1999063977A2 (en)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004100948A1 (en) * 2003-05-19 2004-11-25 Sciencom Ltd Further therapeutic use of zolpidem
EP1494650A4 (en) * 2002-04-28 2006-07-12 Neurim Pharma 1991 Pharmaceutical formulation comprising melatonin
WO2008151170A3 (en) * 2007-05-31 2009-04-23 Teva Pharma Process for the synthesis of ramelteon and its intermediates
EP1832286A4 (en) * 2004-12-13 2009-11-18 Takeda Pharmaceutical PROPHYLACTIC OR THERAPEUTIC AGENT FOR THE TREATMENT OF SLEEP DISORDERS
WO2009060318A3 (en) * 2007-07-12 2009-12-10 Teva Pharmaceutical Industries Ltd. Polymorphic forms of ramelteon and processes for preparation thereof
EP1792899A4 (en) * 2004-09-13 2009-12-16 Takeda Pharmaceutical PROCESS FOR THE PREPARATION OF OPTICALLY ACTIVE AMINE DERIVATIVES
EP1867641A4 (en) * 2005-04-04 2010-01-13 Takeda Pharmaceutical A PROPHYLACTIC OR THERAPEUTIC MEDICINE AGAINST AQUEOUS DEPRESSION OR NEUROSIS
WO2025155789A1 (en) * 2024-01-17 2025-07-24 Rivo Bio, Inc. Indane-, indene-, azaindane-, and azaindene-amines as activators of serotonin receptors

Families Citing this family (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU2002214305A1 (en) * 2000-11-17 2002-05-27 Takeda Chemical Industries Ltd. Pharmaceutical preparation containing copolyvidone
AU2003285012A1 (en) * 2002-10-24 2004-05-13 Sepracor, Inc. Compositions comprising zopiclone derivatives and methods of making and using the same
JP3735668B2 (en) * 2002-11-27 2006-01-18 独立行政法人情報通信研究機構 Brain function measuring device and brain function measuring method
PL1691811T3 (en) * 2003-12-11 2014-12-31 Sunovion Pharmaceuticals Inc Combination of a sedative and a neurotransmitter modulator, and methods for improving sleep quality and treating depression
US20050215521A1 (en) * 2003-12-22 2005-09-29 Karim Lalji Modafinil combination therapy for improving sleep quality
EP1696959A2 (en) * 2003-12-24 2006-09-06 Sepracor, Inc. Melatonin combination therapy for improving sleep quality
EP1715853A4 (en) * 2004-02-17 2012-07-18 Transcept Pharmaceuticals Inc Compositions for delivering hypnotic agents across the oral mucosa and methods of use thereof
DK1742624T3 (en) * 2004-02-18 2010-03-08 Sepracor Inc Dopamine agonist combination therapy with sedatives to improve sleep quality
EP3216445A1 (en) * 2004-05-28 2017-09-13 Imaginot Pty Ltd. Oral therapeutic compound delivery system
US8216610B2 (en) * 2004-05-28 2012-07-10 Imaginot Pty Ltd. Oral paracetamol formulations
GT200600042A (en) * 2005-02-10 2006-09-27 Aventis Pharma Inc BIS ARILO AND HETEROARILO COMPOUNDS REPLACED AS SELECTIVE ANTAGONISTS OF 5HT2A
US20070287740A1 (en) * 2005-05-25 2007-12-13 Transcept Pharmaceuticals, Inc. Compositions and methods of treating middle-of-the night insomnia
US20070225322A1 (en) * 2005-05-25 2007-09-27 Transoral Pharmaceuticals, Inc. Compositions and methods for treating middle-of-the night insomnia
US20070123562A1 (en) * 2005-05-25 2007-05-31 Transoral Pharmaceuticals, Inc. Compositions and methods for treating middle-of-the-night insomnia
JP5220408B2 (en) * 2005-06-22 2013-06-26 武田薬品工業株式会社 Tablets containing poorly soluble active ingredients
FR2889811B1 (en) * 2005-08-19 2009-10-09 Sanofi Aventis Sa ASSOCIATION OF A HYPNOTIC AGENT HAS LONG LASTING ACTION AND A SHORT-ACTING HYPNOTIC AGENT, A PHARMACEUTICAL COMPOSITION CONTAINING THE SAME AND ITS THERAPEUTIC USE.
CA2629904C (en) * 2005-11-28 2018-07-10 Imaginot Pty Ltd. Oral therapeutic compound delivery system
AU2007228087A1 (en) * 2006-03-20 2007-09-27 Takeda Pharmaceutical Company Limited Agent for prevention/treatment of irritable bowel syndrome
US7960436B2 (en) * 2006-06-05 2011-06-14 Valeant Pharmaceuticals International Substituted arylamino-1,2,3,4-tetrahydro naphthalenes and-2,3-dihydro-1H-indenes as potassium channel modulators
US20090082432A1 (en) * 2007-09-26 2009-03-26 Protia, Llc Deuterium-enriched ramelteon
BRPI0914068A2 (en) * 2008-11-14 2015-10-13 Watson Pharma Private Ltd n- [2- (1,6,7,8-tetrahydro-2h-indeno [5,4-b] furan-8-yl)] ethylamine and ramelteon resolution process
US20100196286A1 (en) * 2008-12-01 2010-08-05 Armer Thomas A Inhalation delivery methods and devices
US8555875B2 (en) 2008-12-23 2013-10-15 Map Pharmaceuticals, Inc. Inhalation devices and related methods for administration of sedative hypnotic compounds
EP2483258A1 (en) * 2009-09-29 2012-08-08 Lonza Ltd. Process for preparing 1,2,6,7-tetrahydro-8h-indeno[5,4-b]furan-8-one
KR102593047B1 (en) 2012-01-26 2023-10-24 반다 파마슈티칼즈, 인코퍼레이티드. Treatment of circadian rhythm disorders
US11918557B2 (en) 2012-01-26 2024-03-05 Vanda Pharmaceuticals Inc. Treatment of circadian rhythm disorders
WO2014100292A1 (en) 2012-12-18 2014-06-26 Vanda Pharmaceuticals Inc. Treatment of circadian rhythm disorders
US11090285B2 (en) 2013-11-12 2021-08-17 Vanda Pharmaceuticals Inc Treatment of circadian rhythm disorders
US10376487B2 (en) 2013-11-12 2019-08-13 Vanda Pharmaceuticals Inc. Method of treatment

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3987052A (en) 1969-03-17 1976-10-19 The Upjohn Company 6-Phenyl-4H-s-triazolo[4,3-a][1,4]benzodiazepines
OA04285A (en) 1972-01-07 1979-12-31 Rhone Poulenc Sa New derivatives of pyrrolo (3,4-b) pyrazine and their preparation.
AT338799B (en) 1974-03-02 1977-09-12 Boehringer Sohn Ingelheim PROCESS FOR PREPARING NEW SUBSTITUTED 6-ARYL-4H-S-TRIAZOLO- (3,4C) -THIENO- (2,3E) -1,4-DIAZEPINE AND THEIR SALTS
FR2600650B1 (en) 1986-06-27 1988-09-09 Synthelabo PROCESS FOR THE PREPARATION OF IMIDAZOPYRIDINES AND INTERMEDIATE COMPOUNDS
IT1251544B (en) 1991-05-13 1995-05-17 Gabriele Biella PHARMACEUTICAL COMPOSITIONS ACTIVE IN THE THERAPY OF SLEEP DISORDERS INCLUDING MELATONIN OR A DERIVATIVE IN ASSOCIATION WITH A BENZODIAZEPINE DERIVATIVE
US5786357A (en) * 1991-12-02 1998-07-28 Sepracor Inc. Methods and compositions for treating sleep disorders, convulsive seizures and other disorders using optically pure (+) zopiclone
ES2175350T5 (en) * 1996-03-08 2008-12-16 Takeda Pharmaceutical Company Limited TRICYCLE COMPOUNDS THAT HAVE AFFINITY OF UNION TO MELATONINE RECEPTORS, THEIR PRODUCTION AND USE.
US6034239A (en) * 1996-03-08 2000-03-07 Takeda Chemical Industries, Ltd. Tricyclic compounds, their production and use
GB9613969D0 (en) * 1996-07-03 1996-09-04 Merck Sharp & Dohme Therapeutic agents

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1494650A4 (en) * 2002-04-28 2006-07-12 Neurim Pharma 1991 Pharmaceutical formulation comprising melatonin
WO2004100948A1 (en) * 2003-05-19 2004-11-25 Sciencom Ltd Further therapeutic use of zolpidem
US8097737B2 (en) 2004-09-13 2012-01-17 Takeda Pharmaceutical Company Limited Process for production of optically active amine derivatives
US8609871B2 (en) 2004-09-13 2013-12-17 Takeda Pharmaceutical Company Limited Process for production of optically active amine derivatives
EP2537842A1 (en) * 2004-09-13 2012-12-26 Takeda Pharmaceutical Company Limited Crystals of (S)-N-[2-(2,6,7,8-Tetrahydro-1H-indeno[5,4-b]furan-8-yl)ethyl]propionamide
EP1792899A4 (en) * 2004-09-13 2009-12-16 Takeda Pharmaceutical PROCESS FOR THE PREPARATION OF OPTICALLY ACTIVE AMINE DERIVATIVES
RU2385318C2 (en) * 2004-09-13 2010-03-27 Такеда Фармасьютикал Компани Лимитед Method of producing optically active amine derivatives
AU2005283521B2 (en) * 2004-09-13 2011-10-13 Takeda Pharmaceutical Company Limited Process for production of optically active amine derivatives
EP1832286A4 (en) * 2004-12-13 2009-11-18 Takeda Pharmaceutical PROPHYLACTIC OR THERAPEUTIC AGENT FOR THE TREATMENT OF SLEEP DISORDERS
EP1867641A4 (en) * 2005-04-04 2010-01-13 Takeda Pharmaceutical A PROPHYLACTIC OR THERAPEUTIC MEDICINE AGAINST AQUEOUS DEPRESSION OR NEUROSIS
US8084630B2 (en) 2007-05-31 2011-12-27 Teva Pharmaceutical Industries Ltd. Process for the synthesis of ramelteon and its intermediates
WO2008151170A3 (en) * 2007-05-31 2009-04-23 Teva Pharma Process for the synthesis of ramelteon and its intermediates
WO2009060318A3 (en) * 2007-07-12 2009-12-10 Teva Pharmaceutical Industries Ltd. Polymorphic forms of ramelteon and processes for preparation thereof
WO2025155789A1 (en) * 2024-01-17 2025-07-24 Rivo Bio, Inc. Indane-, indene-, azaindane-, and azaindene-amines as activators of serotonin receptors

Also Published As

Publication number Publication date
EP1100508B8 (en) 2004-01-07
US6348485B1 (en) 2002-02-19
CN1309565A (en) 2001-08-22
CA2332521C (en) 2009-02-10
CN1206996C (en) 2005-06-22
EP1100508A2 (en) 2001-05-23
WO1999063977A3 (en) 2001-03-29
ATE247967T1 (en) 2003-09-15
AR019639A1 (en) 2002-02-27
EP1100508B1 (en) 2003-08-27
KR100642024B1 (en) 2006-11-06
AU4060599A (en) 1999-12-30
CA2332521A1 (en) 1999-12-16
DE69910795T2 (en) 2004-06-17
KR20010052676A (en) 2001-06-25
DE69910795D1 (en) 2003-10-02

Similar Documents

Publication Publication Date Title
CA2332521C (en) Pharmaceutical composition for treating or preventing sleep disorders
US12029742B2 (en) Compositions and methods for the repair of myelin
US7273884B2 (en) Method of treating tremors
KR20010052503A (en) N-linked sulfonamides of n-heterocyclic carboxylic acids or carboxylic acid isosteres
US12291528B2 (en) Crystalline imidazo[4,5-b]pyridine compound, pharmaceutical compositions, and their use in treating medical conditions
JP3509637B2 (en) Sleep disorder prevention / treatment agent
IL291332B2 (en) Compound as potassium channel regulator and preparation and use thereof
US20080242682A1 (en) Preventive or Therapeutic Agent for Sleep Disorder
DK168441B1 (en) [R- (E)] - 4- (3-phosphono-2-propenyl) -2-piperazine carboxylic acid, process for its preparation, pharmaceutical composition containing the compound and use thereof
EP0532553B1 (en) Use of compounds for the treatment of age-related memory impairment and other cognitive disorders
EP0694299B1 (en) The use of( a) bicycloheptane derivative(s)
JP7709202B2 (en) Treatment of CNS disorders associated with sleep disorders
CN119384406A (en) Compound
CN116987091B (en) Medicine for treating epileptic seizure disease and preparation method thereof
WO2002007727A1 (en) Use of pyridazino(4,5-)indole-1-acetamide derivatives for preparing medicines for treating pathologies related to the dysfunction of peripheral benzodiazepin receptors
US20240383892A1 (en) PARTICLES OF IMIDAZO[4,5-b]PYRIDINE COMPOUND, PHARMACEUTICAL COMPOSITIONS, AND THEIR USE IN TREATING MEDICAL CONDITIONS
De Kozak et al. Ginkgo biloba extract (EGb 761) and a platelet-activating factor antagonist protect the retina in experimental autoimmune uveoretinitis
CN113491680A (en) Application of catechol and derivatives in preparation of drugs for treating sleep disorders
JP2002128773A (en) Tricyclic compound and medicinal composition containing the compound
WO2002016337A1 (en) Tricyclic compounds and pharmaceutical compositions containing the same
WO2003087091A1 (en) Novel crystal of quinoxalinedione derivative anhydride
HK1111597A (en) Preventive or therapeutic agent for sleep disorder

Legal Events

Date Code Title Description
WWE Wipo information: entry into national phase

Ref document number: 99807166.8

Country of ref document: CN

AK Designated states

Kind code of ref document: A2

Designated state(s): AE AL AM AU AZ BA BB BG BR BY CA CN CU CZ EE GD GE HR HU ID IL IN IS JP KG KR KZ LC LK LR LT LV MD MG MK MN MX NO NZ PL RO RU SG SI SK SL TJ TM TR TT UA US UZ VN YU ZA

AL Designated countries for regional patents

Kind code of ref document: A2

Designated state(s): GH GM KE LS MW SD SL SZ UG ZW AM AZ BY KG KZ MD RU TJ TM AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN GW ML MR NE SN TD TG

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
WWE Wipo information: entry into national phase

Ref document number: 1999923960

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 09700405

Country of ref document: US

ENP Entry into the national phase

Ref document number: 2332521

Country of ref document: CA

WWE Wipo information: entry into national phase

Ref document number: 1020007013921

Country of ref document: KR

AK Designated states

Kind code of ref document: A3

Designated state(s): AE AL AM AU AZ BA BB BG BR BY CA CN CU CZ EE GD GE HR HU ID IL IN IS JP KG KR KZ LC LK LR LT LV MD MG MK MN MX NO NZ PL RO RU SG SI SK SL TJ TM TR TT UA US UZ VN YU ZA

AL Designated countries for regional patents

Kind code of ref document: A3

Designated state(s): GH GM KE LS MW SD SL SZ UG ZW AM AZ BY KG KZ MD RU TJ TM AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN GW ML MR NE SN TD TG

WWP Wipo information: published in national office

Ref document number: 1999923960

Country of ref document: EP

WWP Wipo information: published in national office

Ref document number: 1020007013921

Country of ref document: KR

WWG Wipo information: grant in national office

Ref document number: 1999923960

Country of ref document: EP

WWW Wipo information: withdrawn in national office

Ref document number: 1020007013921

Country of ref document: KR

WWR Wipo information: refused in national office

Ref document number: 1020007013921

Country of ref document: KR