# Patent

## Title
Dermatological and cosmetic compositions

## Abstract

The use of nor- and homo-bile acids derivatives as absorption enhancers for medicaments is described. Said derivatives show the advantage of improving the absorption of medicaments through mucosae without being metabolized by the intestinal flora, thus allowing a fast excretion. Moreover, the derivatives of the invention have a negligible toxicity.

## Background
The present invention relates to the use of nor- and homo-bile acids derivatives (hereinafter named NORAB and HOMOAB, respectively) as absorption enhancers for medicaments.

Particularly, the invention relates to the use of nor- and homo-bile acids derivatives having respectively the following formulae: ##STR1## wherein: R.sub.1 R.sub.2   R.sub.3   R.sub.4 ______________________________________ a)       .alpha.-OH .alpha.-OH H       H b)       .alpha.-OH .beta.-OH H       H c)       .alpha.-OH H         .alpha.-OH H d)       .alpha.-OH H         .beta.-OH H e)       .alpha.-OH H         H       .beta.-OH ______________________________________

corresponding to: ##STR2## wherein: R.sub.1 R.sub.2     R.sub.3 R.sub.4 ______________________________________ f)       .alpha.-OH .alpha.-OH  H     H g)       .alpha.-OH .beta.-OH   H     H h)       .alpha.-OH H           .alpha.-OH H i)       .alpha.-OH H           .beta.-OH H l)       .alpha.-OH H           H     .beta.-OH ______________________________________

corresponding to:

It is also an object of the invention the use of the corresponding NORAB and HOMOAB conjugated respectively in C.sub.23 and C.sub.25 with taurine, glycine and alanine.

The present trend for pharmacological therapy, particularly in the case of slight disorders or of treatments involving multiple administrations repeated in time, and therapies for conscious patients, is the self-administration by the patient itself. From this point of view, the preferred administration routes are the enteral, i.e. buccal, rectal and intranasal ones.

The medicament administered through these routes, once released from the pharmaceutic form containing it (tablet, suppository, aerosol, and the like), must cross the different mucosae coating the gastrointestinal tract and the nasal cavity, in order to enter the circulatory stream and be distributed in the various body districts thus reaching the action site.

Due to the complex nature of the mucosae and the different chemical structure of the medicaments, the crossing of the mucosae involves different difficulties, depending on the kind of medicament and the type of mucosa.

One of the main problems involved in the design of medicaments consists in the need to give the pharmacologically active compound those hydrophilic characteristics which are generally required to have the active principle dissolved in the biological liquids (serum, interstitial liquid) and sometimes also lipophilic characteristics to cross the mucosa, which generally consists of a more or less complex cell barrier.

This approach finds a number of difficulties from the viewpoint of the medicament design, both in the synthesis and in the pharmacokinetic expectation.

A different approach to this problem consists in combining the active principle with a compound enhancing the absorption of the medicament through the mucosa.

Due to the single chemico-physical peculiarities of the different medicaments, up to now it was necessary to look for absorption enhancers suitable for both the considered medicament and the involved mucosa.

Bile acids (BA) are natural detergents capable of forming, with other poorly water-soluble medicaments, mixed micells with phospholipids and cholesterol at a relatively low concentration (1-4 mM).

Moreover, thanks to the structure thereof, they are also relatively lipophilic (log p=2.div.4) and therefore they can passively cross the biologic membranes. The bile acids crossing and partitioning in the lipidic domain exert their activity in this microenvironment modifying the cholesterol content and therefore increasing the permeability to other substances.

A bile acid designed to be an enhancer, moreover, must be: P.gtoreq.1; .ltoreq.7.+-.2 mM; 7-dehydroxylated and oxidized to potentially toxic or inactive compounds.

Now it has been found that bile acids derivatives in which the side chain has one carbon atom more (NOR) or one less (HOMO) proved remarkable properties as absorption enhancers for medicaments by the enteral route and other not-parenteral routes (intranasal, buccal, sublingual).

Particularly, the best results were obtained with derivatives of the dehydroxylated bile acids above reported with two OH at the 3.alpha.7.alpha., 3.alpha.7.beta., 3.alpha.6.alpha., 3.alpha.12.alpha. and 3.alpha.12.beta. positions. The choice of one of the above reported epimers will depend on the substance to carry. Compared with the natural derivatives, the nor- and homo-derivatives show the advantage that they are not metabolized by the intestinal bacterial flora and have a very high stability in anaerobic and aerobic fecal culture.

The change in the side chain can prevent a 7 dehydroxylation of the 3.alpha.7.alpha. and 3.alpha.7.beta. derivatives with an enormous advantage compared with the natural components which are quickly metabolized.

The glycine- or taurine-amidated compounds also show a high stability to bacterial flora compared with physiological bile acids (BA) which are quickly deconjugated.

The derivatives of the invention are useful as absorption enhancers for medicaments administered by the enteral route or by other routes (intranasal, buccal, sublingual).

One of the most preferred administration routes is the rectal one, since these compounds are absorbed by the rectal mucosa and, once in circulation, the are immediately transformed into glucuronide derivatives at the hepatic level and excreted through the feces (even though they are not metabolized by the bacteria in the last intestinal tract, as already mentioned).

The general toxicity thereof is negligible even at doses 100 times higher than the envisaged ones.

The compounds of the invention can be obtained semisynthetically according to known methods.

The medicaments which can be advantageously combined with iodeoxycholic acid belong in various chemical and/or therapeutical classes, such as peptides, not steroidal antiinflammatories, steroids, diuretics, cardiovasculars, hormones, local anaesthetics, antihistaminics, rhinologic and anticolinergic agents.

NORAB and HOMOAB, compared with the up to now known enhancers, particularly with other bile acids previously used (cholic and taurocholic acids) show the following advantages: biotransformations, such as the conversion of taurocholic acid into deoxycholic acid; the capability of forming reverse micells inside which a part of membrane cholesterol dissolves, thereby the membrane becoming more permeable;

Examples of rectal formulations according to the invention comprise suppositories, microclysmas, soft gelatin rectal capsules.

For the intranasal administration, sterile solutions or powders are suitable, whereas oral or buccal forms comprise capsules, tablets, bioadhesive tablets and the like.

The preparation techniques and the excipients used for the preparation of said pharmaceutical forms are the conventional ones known, for example, from Remington's Pharmaceutical Sciences, Mack Pub., Co. N.Y., USA, XVII Ed.

For the oral use, the presence of NORAB and/or HOMOAB enhances the absorption of some active principles such as NSADs, diuretics and the like.

For the oral administration, the action of the derivatives of the invention takes place mainly at the duodenal and intestinal levels, therefore, in order to optimize the absorption, gastroresistant forms or controlled-release forms are preferably used, allowing the tablet to disintegrate at well-controlled pH values which are characteristic of a particular portion of the intestinal tract.

According to the invention, NORABs and HOMOABs are used in amounts from 0.1 to 100 mg per unitary dose. Preferably, for the oral, buccal and rectal forms, they are present in amounts from 10 to 40 mg per unitary dose, whereas for intranasal forms they range from 0.5 to 10 mg per unitary dose .

The following examples further illustrate the invention. In said examples, Enhancer HOMOAB1, Enhancer NORAB1, Enhancer HOMOAB2, Enhancer NORAB2, Enhancer HOMOAB3, Enhancer NORAB4, Enhancer HOMOAB5 and Enhancer NORAB5 means, respectively, the following acids: homochenodeoxycholic, norchenodeoxycholic, homoursodeoxycholic, norursodeoxycholic, homodeoxycholic, 24-nor-[3.alpha.,12.beta.-dihydroxy-5.beta.-cholan-23-oic], 24-homo-[3.alpha.-6.beta.-dihydroxy-5.beta.-cholan-23-oic] and 24-nor[3.alpha.-6.beta.-dihydroxy-5.beta.-cholan-23-oic]. Diclofenac suppositories ______________________________________ One suppository contains: Sodium diclofenac  100         mg Enhancer HOMOAB1   20          mg Whitepsol H 15 q.s. to 2,5 g ______________________________________ Calcitonin rectal capsules ______________________________________ One soft gelatin capsule for rectal use contains: Synthetic salmon calcitonin 100     I.U. Enhancer NORAB1          20      mg Vaseline oil q.s. to     700     mg ______________________________________ Dipyrone coated tablets ______________________________________ One coated tablet contains: Dipyrone           250        mg Starch             125        mg Enhancer HOMOAB2   100        mg Microcrystalline cellulose 150        mg Talc               30         mg Magnesium stearate 20         mg PVP K30            30         mg Methacrylic acid polymer 10         mg Diethyl phthalate  0,5        mg ______________________________________ Furosemide tablets ______________________________________ One tablet contains: Furosemide        20         mg Enhancer NORAB2   20         mg Starch            50         mg Lactose           50         mg PVP K30           3          mg Talc              1          mg Magnesium stearate 1          mg Croscaramellose   5          mg ______________________________________ Metronidazole tablets ______________________________________ One tablet contains: Metronidazole      250         mg Microcrystalline cellulose 200         mg Starch             130         mg Enhancer HOMOAB3   100         mg Talc               10          mg Sodium amidoglycolate 100         mg ______________________________________ LHRH for buccal use: ______________________________________ One administration unit contains: LHRH                 50        mcg Starch               80        mg Carboxyvinyl polymer 100       mg Enhancer NORAB4      20        mg ______________________________________ LHRH for intranasal administration: ______________________________________ One administration unit contains: LHRH                     50    mcg Enhancer HOMOAB5         5     mg Mannite q.s. to          20    mg ______________________________________ GRH for intranasal administration: ______________________________________ One administration unit contains: GRH                     50    mcg Enhancer NORAB5         2,5   mg Mannite q.s. to         20    mg ______________________________________

## Claims

1. A method of enhancing the absorption of a medicament by an animal, comprising adminstering to an animal the medicament in conjunction with a component selected from the group consisting of nor- and homo-bile acids derivatives of the following respective formulae: ##STR3## wherein: R.sub.1 R.sub.2   R.sub.3   R.sub.4 ______________________________________ a)       .alpha.-OH .alpha.-OH H       H b)       .alpha.-OH .beta.-OH H       H c)       .alpha.-OH H         .alpha.-OH H d)       .alpha.-OH H         .beta.-OH H e)       .alpha.-OH H         H       .beta.-OH ______________________________________ ##STR4## wherein: R.sub.1 R.sub.2   R.sub.3   R.sub.4 ______________________________________ a)       .alpha.-OH .alpha.-OH H       H b)       .alpha.-OH .beta.-OH H       H c)       .alpha.-OH H         .alpha.-OH H d)       .alpha.-OH H         .beta.-OH H e)       .alpha.-OH H         H       .beta.-OH ______________________________________ and conjugates of the above derivatives at positions C.sub.23 or C.sub.25 with taurine, glycine or alanine.

2. The method of claim 1, wherein the absorption takes place in the gastrointestinal tract.

3. The method of claim 1, wherein the absorption takes place at the buccal mucosa.

4. The method of claim 1, wherein the absorption takes place in the duodenal tract.

5. The method of claim 1, wherein the absorption takes place in the intestinal tract.

6. The method of claim 1, wherein the absorption takes place in the rectal tract.

7. The method of claim 1, wherein the absorption takes place in the nasal cavity.

8. The method of claim 1, wherein the medicaments are selected from the group consisting of peptides, not steroidal antiinflammatories, steroids, diuretics, cardiovasculars, hormones, local anaesthetics, antihistaminics, and anticolinergics.

9. The method of claim 1, wherein the administration is by a pharmaceutical form selected from the group consisting of a suppository, solution, powder, capsule, and tablet.

10. The method of claim 1, wherein said nor- and homo-bile acid derivative or conjugate is administered in amounts of between 0.1 and 100 mg per unitary dose.

11. The method of claim 10, wherein said amount is from 10 to 40 mg.

12. The method of claim 10, wherein said amount is 0.5 to 10 mg.

13. The method of claim 1, wherein said medicament and said nor and homo-bile acid derivative or conjugate are separately administered.

14. The method of claim 1, wherein said medicament and said nor- and homo-bile acid derivative or conjugate are co-administered.

15. The method of claim 14, wherein the said medicament and said nor- and homo-bile acid derivative or conjugate are both present in and co-administered by a pharmaceutical form selected from the group consisting of a suppository, solution, powder, capsule, tablet and bioadhesive.