# Patent

## Title
Meldonium salts, method of their preparation and pharmaceutical composition on their basis

## Abstract

New salts of Meldonium, the method of their preparation, and pharmaceutical formulation on their basis have been described. The general formula of these salts is X−(CH3)3N+NHCH2CH2COOH where X− is an acid anion selected from the group of pharmaceutically acceptable acids. Practically non-hygroscopic and/or increased thermal stability and/or lasting action Meldonium hydrogen salts of fumaric acid, phosphoric acid, oxalic acid, maleic acid, and pamoic acid as well as Meldonium orotate and galactarate are especially suitable. Novel pharmaceutical formulations containing non-hygroscopic and/or increased thermal stability and/or and/or lasting action 3-(2,2,2-trimethylhydrazinium) propionate salts for oral parenteral, rectal, and transdermal introduction are concurrently described.

## Background
TECHNICAL FIELD
The present invention relates to 3-(2,2,2-trimethylhydrazinium)propionate salts of the general formula X−(CH3)3N+NHCH2CH2COOH where X− is an acid anion selected from the group of acid phosphate, acid fumarate, acid oxalate, acid maleate and/or acid pamoate, orotate, galactarate, sulfate, dichloroacetate, acid galactarate, fumarate, taurate, maleate, acid aspartate, creatinate, acid sulfate, magnesium succinate, acid citrate, citrate, succinate, acid succinate, adipinate, acid tartrate and lactate, which distinguish from 3-(2,2,2-trimethylhydrazinium) propionate dihydrate by low hygroscopicity and/or increased thermal stability and/or lasting action. This invention relates also to the method of such salt preparation and to pharmaceutical formulations containing the said salts.
BACKGROUND OF THE INVENTION
3-(2,2,2-Trimethylhydrazinium) propionate is disclosed in U.S. Pat. No. 4,481,218.
It is well known that 3-(2,2,2-trimethylhydrazinium) propionate as dihydrate (this substance being known under its International Nonproprietary Name of Meldonium) is widely used for controlling carnitine and gamma-butyrobetaine concentration ratio and consequently the speed of fatty acid beta-oxidation in the body (Dambrova M., Liepinsh E., Kalvinsh I. Mildronate: cardioprotective action through carnitine-lowering effect. Review.//Trends Cardiovasc. Med.-2002.-Vol. 12, N.6. -P. 275–279. Rupp H., Zarain-Herzberg A., Maisch B. The use of partial fatty acid oxidation inhibitors for metabolic therapy of angina pectoris and heart failure//Herz, 2002-Vol. 27, N.7.-P. 621–636. Mildronate, Met-88. Drugs Fut. 2001, 26(1), p. 82).
Due to these properties, Meldonium (registered with the trade mark of “MILDRONĀTS®”, “MILDRONATE®”, “MPOHAT®”) is extensively applied in medicine as an anti-ischemic un stress-protective drug in treating various cardio-vascular diseases and other pathologies involving tissue ischemia (R. S. Karpov, O. A. Koshelskaya, A. V. Vrublevsky, A. A. Sokolov, A. T. Teplyakov, I. Skarda, V. Dzerve, D. Klintsare; A. Vitols, I. Kalvinsh, L. Matveyeva, D. Urbane. Clinical efficacy and safety of Mildronate in patients with ischemic heart disease and chronic heart failure. Kardiologiya, 2000, Vol. 6, -P. 69–74.)
However, Meldonium as dihydrate has essential drawbacks, the first of which consists in its rather high hygroscopicity. Already after 24 hours maintenance at 100% air humidity, Meldonium mass is increased by 10% because of water absorption, the substance being transformed into a syrup.
Other essential drawback of Meldonium is caused by the half-elimination period equalling 4–10 hours for humans while this drug must be used 2–4 times daily in the clinic (V. Dzērve. Mildronāts. PAS “Grindeks”, 1999, p. 1), though it is longer in trials on rats (K. Yoshisue, Y. Yamomoto, K. Yoshida, M. Saeki, Y. Minami, Y. Esumi, Y. Kawaguchi. Pharmacokinetics and biological fate of 3-(2,2,2-trimethylhydrazinium)propionate (MET-88), a novel cardioprotective agent, in rats. Drug Metabolism and Disposition, vol. 28, No 6, 687–694).
As Meldonium dihydrate is unsuitable for single daily oral introduction, it was one of the aims of the present invention to find other pharmacologically acceptable Meldonium forms which would be applicable for single daily use. It is generally known that amino acid betaine salts usually have good solubility in water. If pharmacologically acceptable acids are selected, resorption and elimination pharmacokinetics and biological activity of these salts normally does not much differ from the parameters of the initial compound.
Besides, Meldonium is not very stable: while heated, it fast loses the water of the crystal hydrate. In turn, the anhydrous form of Meldonium is unstable and extremely hygroscopic. In such form, this compound soon becomes coloured and gets a specific annoying odour. Thus, the hygroscopicity and thermal non-stability of Meldonium dihydrate are significant disadvantages restricting the possibilities of preparing different oral and external drug dosage forms from this compound. Furthermore, Meldonium dihydrate is actively dehydrated at temperatures so low as 40–45° C. This means that sure storage of Meldonium dosage forms containing crystal hydrate is rather embarrassing in countries with hot climate.
Because Meldonium dihydrate is not readily applicable for producing drug oral dosage forms, it was a further object of this invention to find other pharmacologically acceptable salts of Meldonium which would lack hygroscopicity or/and, be thermally stable and could be stored in any climatic zone for a long time.


DETAILED DESCRIPTION OF THE INVENTION
For most Meldonium salts, their pharmacokinetic properties practically do not differ from those described for Meldonium. Therefore the use of these salts for preparing pharmaceutical compositions seemingly have no advantage as compared to Meldonium.
To our surprise, we suddenly found that Meldonium salts of some pharmaceutically acceptable polybasic acids are an exception in this respect; although readily soluble in water, they essentially differ from Meldonium by their pharmacokinetic and pharmacodynamic properties.
It was an astonishing discovery since no theoretical argument exists why Meldonium salts, which are easily soluble in water should have resorption and elimination speed different from that of Meldonium.
Nevertheless, we succeeded in finding among the above salts some specific Meldonium salts with appropriate pharmacokinetics and pharmacodynamics allowing their single daily use; they are: X−(CH3)3N+NHCH2CH2COOH where X− is the anion of acids is selected from the group of mono-substituted fumaric acid, mono-substituted phosphoric acid, mono-substituted oxalic acid, mono-substituted maleic acid un mono- and/or di-substituted galactaric, pamoic acids and orotic acid.
It is common knowledge that betaines of amino acids are commonly relatively stable substances. It is well known that these compounds are readily soluble in water and the biological activity of their pharmacologically acceptable salts usually does not differ from that of the initial compound.
However, Meldonium and monobasic, dibasic as well as tribasic pharmaceutically acceptable acid salts have equal or even higher hygroscopicity than Meldonium itself. Moreover, many of them cannot be prepared in crystalline form at all because they form syrups containing variable quantity of water.
The salts of both strong and weak acids, viz. Meldonium sulfate, hydrogen chloride, acetate, lactate, citrate as well as salts of many other pharmaceutically acceptable acids are hygroscopic. Consequently, using these salts for preparation of pharmaceutical compositions for oral use is deemed lacking preference to that of Meldonium.
We noticed completely unexpectedly that Meldonium salts of some pharmaceutically acceptable polybasic acids are exceptional in this regard; they proved to be practically non-hygroscopic though easily soluble in water. We observed that these compounds are also very stable while maintained at both room temperature and temperatures up to at least 50 centigrade over a long period of time. Similarly we gained the unanticipitated result that such specific monobasic acid as orotic acid forms a non-hygroscopic Meldonium salt, too. All of the claimed salts proved more stable thermally than Meldonium.
Orally administered Meldonium is easily bioavailable also from these salts, therefore these salts are much more suitable for preparing various drug dosage forms than the hygroscopic and thermally unstable Meldonium. It was an astounding discovery because no theoretical underpinning suggests any difference of Meldonium orotate or polybasic acid salts, which are also readily soluble in water, from other salts as to hygroscopicity.
Since they are not hygroscopic and/or have increased thermal stability, these salts can be easily handled and are favourably suitable for manufacturing solid administration forms. Their aqueous solutions are less acid than those of the corresponding chlorides: consequently these salts are also more suitable for manufacturing injectable administration forms.
The following non-limiting examples illustrate the preparation of salts according to the present invention.
EXAMPLE 1
The following methods may be applied for the preparation of these salts. Meldonium is dissolved in water or other appropriate solvent, an equimolar quantity of a polybasic acid selected from the group of fumaric acid, phosphoric acid, aspartic acid, citric acid, lactic acid, maleic acid, oxalic acid, or orotic acid (the latter is taken in semi-molar quantity) is added, and the mixture is stirred at temperature from 20 to 50° C. till the corresponding salt is formed. At the second technological stage, Meldonium salts are evaporated to dryness if necessary. At the third technological stage, in case of need the obtained salts are recrystallised from a suitable solvent.
EXAMPLE 2
The said salts can also be prepared from the corresponding salts of Meldonium production intermediates, viz. methyl- or ethyl-esters of 3(2,2,2,-trimethylhydrazinium) propionate, the latter being heated together with the corresponding acids in aqueous or aqueous-alcoholic solutions, and subsequent treatment, eduction and purification being performed by analogy with the first method of preparation.
EXAMPLE 3
Method of salt preparation from meldonium dihydrate. Meldonium and the corresponding acid are dissolved in a small quantity of water at 40–50° C. under stirring. The obtained solution is evaporated in vacuum at 40–50° C. Acetone or acetonitrile is added to the formed mass (what predominantly is viscous syrup), and the mixture is grated. The precipitated crystalline mass is stirred in acetone or acetonitrile during several hours, filtered off, washed with acetone or acetonitrile, dried in vacuum at room temperature.
Sample hygroscopicity was tested by H2O content determination before the test and after 24 hours maintenance at 100% humidity (keeping in a closed vessel over water). On such conditions, Meldonium absorbs 10% water (as to mass increase) during 24 hours. Water content was determined by titration by Fischer's method; in cases of syrup formation water content is determined by sample mass increase.
The claimed invention is illustrated by, but not restricted to the following examples of salts obtained by the above method:
EXAMPLE 4
Meldonium orotate (1:1). Mp. 211–214° C. 1H NMR spectrum (D2O), δ, ppm: 2.56 (2H, t, CH2COO−); 3.29 (2H, t, CH2N); 3.35 (9H, s, Me3N+); 6.18 (1H, s, —CH═). Found, %: C, 43.78; H, 6.01; N, 18.48. Calculated, %: C, 43.71; H, 6.00; N, 18.53. Initially H2O content in the sample was 0.3919%; during 24 hours at 100% humidity it remains unchanged.
EXAMPLE 5
Meldonium phosphate (1:1). Mp. 158–160° C. 1H NMR spectrum (D2O), δ, ppm: 2.60 (2H, t, CH2COO−); 3.31 (2H, t, CH2N); 3.35 (9H, s, Me3N+). Found, %: C, 29.64; H, 7.05; N, 11.33 Calculated, %: C, 29.51; H, 7.02; N, 11.47. Initially H2O content in the sample was 0.0762%; during 24 hours at 100% humidity it remains unchanged.
EXAMPLE 6
Meldonium fumarate (1:1). Mp. 140–142° C. 1H NMR spectrum, δ, ppm: 2.57 (2H, t, CH2); 3.29 (2H, t, CH2); 3.35 (9H, s, Me3N+); 6.72 (2H, s, —CH═CH—). Found, %: C, 45.46; H, 6.94; N, 10.72. Calculated, %: C, 45.80, H, 6.92; N, 10.68. Initially H2O content in the sample was 0.18%; during 24 hours at 100% humidity it remains unchanged.
EXAMPLE 7
Meldonium oxalate (1:1). Mp. 123–125° C. 1H NMR spectrum (D2O), δ, ppm: 2.61 (2H, t, CH2COO−); 3.30 (2H, t, CH2N); 3.35 (9H, s, Me3N+). Found, %: C, 40.86; H, 6.82; N, 11.78 Calculated, %: C, 40.68; H, 6.83; N, 11.86. Initially H2O content in the sample was 0.1661%; after 24 hours maintenance at 100% humidity it was 3.1211%.
EXAMPLE 8
Meldoniuma maleate (1:1). Mp. 98–100° C. 1H NMR spectrum (D2O), δ, ppm: 2.60 (2H, t, CH2COO−); 3.31 (2H, t, NCH2); 3.35 (9H, s, Me3N+); 6.35 (2H, s, —CH═CH—). Found, %: C, 45.93; H, 6.95; N, 10.65. Computational, %: C, 45.80; H, 6.92; N, 10.68. Initially H2O content in the sample was 0.387%; after 24 hours maintenance at 100% humidity it was 4.6844%.
EXAMPLE 9
Meldonium mucate (galactarate; 2:1; ×H2O). Mp. 152–154° C. 1H NMR spectrum (D2O), δ, ppm: 2.46 (4H, t, 2×CH2COO−); 3.26 (4H, t, 2×NCH2); 3.35 (18H, s, 2×Me3N+); 3.98 un 4.31—two singlets of low intensity, protons of mucic acid. Found, %: C, 42.13; H, 7.58; N, 10.77. Calculated, %: C, 41.53; H, 7.75; N, 10.76. Initially H2O content in the sample was 3.0414%; after 24 hours maintenance at 100% humidity it was 7.6830%.
EXAMPLE 10
Meldonium pamoate (1:1; ×H2O). Meldonium (5.46 g, 30 mmol) and pamoic acid (5.82 g, 15 mmol) are mixed with water and acetone (15+15 ml), the formed suspension is evaporated, 30–40 ml toluene is added to the residual viscous mass, it is grated, and evaporation is repeated. If the residue is insufficiently dry, treatment with toluene is repeated. Mp. 128–133° C. (decomp.). 1H NMR spectrum (DMSO-d6), δ, ppm: 2.41 (2H, t, CH2COO−); 3.14 (2H, t, CH2N); 3.25 (9H, s, Me3N+); 4.75 (2H, s, —CH2—(pam.)); 7.12 (2H, t, Harom); 7.26 (2H, td, Harom); 7.77 (2H, d, Harom); 8.18 (2H, s, Harom); 8.35 (2H, s, Harom). Found, %: C, 62.90; H, 5.83; N, 4.98. Calculated, %: C, 63.07; H, 5.84; N, 5.07. Initially H2O content in the sample was 1.71%; after 24 hours maintenance at 100% humidity sample mass increased by 9% due to absorbed water.
EXAMPLE 11
Meldonium sulfate (2:1). Tm 80–182° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.60 (4H, t, 2×CH2COO−); 3.30 (4H, t, 2×CH2N); 3.35 (18H, s, 2×Me3N+). Found, %: C, 37.08; H, 7.73, N, 14.29; S, 8.20. Calculated, %: C, 36.91; H, 7.74; N, 14.35; S, 8.21. Initially H2O content in the sample was 0.313%; after 24 hours maintenance at 100% humidity sample mass increased by 11.8% due to absorbed water.
EXAMPLE 12
Meldonium dichloroacetate (1:1). Mp. 86–88° C. 1H NMR spectrum (D2O), δ, ppm: 2.61 (2H, t, CH2COO−); 3.31 (2H, t, CH2N); 3.35 (9H, s, Me3N+); 6.05 (1H, s, —CHCl2). Found, %: C, 35.13; H, 5.85; N, 10.10. Calculated, %: C, 34.92; H, 5.86; N, 10.18. Initially H2O content in the sample was 1.17%; after 24 hours maintenance at 100% humidity sample mass increased by 12% due to absorbed water.
EXAMPLE 13
Meldonium mucate (galactarate; 1:1). Mp. 152–154° C. 1H NMR spectrum (D2O), δ, ppm: 2.47 (2H, t, CH2COO−); 3.26 (2H, t, CH2N); 3.35 (9H, s, Me3N+); 3.71 and 3.98—two singlets of low intensity, protons of the slightly soluble mucic acid. Found, %: C, 40.22; H, 6.75; N, 7.75%. Calculated, %: C, 40.22; H, 6.79; N, 7.86. Initially H2O content in the sample was 1.98%; after 24 hours maintenance at 100% humidity it was 12.8%.
EXAMPLE 14
Meldonium fumarate (2:1). Mp. 156–158° C. 1H NMR spectrum (D2O), δ, ppm: 2.53 (4H, t, 2×CH2(meld)); 3.29 (4H, t, 2×CH2(meld)); 3.35 (18H, s, 2×Me3N+); 6.65 (2H, s, —CH═CH—(fum.ac.)). Found, %: C, 46.68; H, 7.91; N, 13.69. Calculated, %: C, 47.05; H, 7.90; N, 13.72. Initially H2O content in the sample was 1.5136%; after 24 hours maintenance at 100% humidity it was 13.4707%.
EXAMPLE 15
Meldonium 2-aminoethane sulfonate (taurate; 1:1; ×1.5H2O). Mp. 190–193° C. (with decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.38 (2H, t, CH2COO−); 3.18–3.30 (4H, m, NCH2(meld.)+CH2(taur.)); 3.34 (9H, s, Me3N+); 3.42 (2H, t, CH2(taur.)). Found %: C, 32.40; H, 8.16; N, 13.98; S, 10.60. Calculated, %: C, 32.21; H, 8.11; N, 14.08; S, 10.75. Initially H2O content in the sample was 9,4824%; after 24 hours maintenance at 100% humidity it was 17.0854%.
EXAMPLE 16
Meldonium maleate (2:1). Mp. 104–106° C. 1H NMR spectrum (D2O), δ, ppm: 2.54 (4H, t, CH2COO−); 3.30 (4H, t, CH2N); 3.35 (18H, s, Me3N+); 6.42 (2H, s, —CH═CH—). Found, %: C, 46.59; H, 7.88; N, 13.50. Calculated: C, 47.05; H, 7.90; N, 13.72. Initially H2O content in the sample was 1.3595%; after 24 hours maintenance at 100% humidity sample mass increased by 18% due to absorbed water.
EXAMPLE 17
Meldonium L-(+)-aspartate (1:1; ×2H2O). Mp. 146–148° C. 1H NMR spectrum (D2O), δ, ppm: 2.49 (2H, t, CH2COO−); 2.70–2.99 (2H, m, CH2(asp.)) 3.27 (2H, t, CH2N); 3.35 (9H, s, Me3N+); 3.95 (1H, dd, CHNH2). Found, %: C, 37.71; H, 7.85; N, 13.03. Calculated, %: C, 38.09; H, 7.99; N, 13.33. Initially H2O content in the sample was 12.5%; after 24 hours maintenance at 100% humidity sample mass increased by 18% due to absorbed water.
EXAMPLE 18
Meldonium creatinate (1:1; ×3H2O). Mp. 227–228° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.38 (2H, t, CH2COO−); 3.03 (3H, s, NMe(creatine)); 3.22 (2H, t, CH2N); 3.35 (9H, s, Me3N+); 3.92 (2H, s, NCH2(creatine)). Initially H2O content in the sample was 15.8%; after 24 hours maintenance at 100% humidity sample mass increased by 18% due to absorbed water.
EXAMPLE 19 
Meldonium sulfate (1:1). Tm 98–100° C. 1H NMR spectrum (D2O), δ, ppm: 2.62 (2H, t, CH2COO−); 3.31 (2H, t, CH2N); 3.35 (9H, s, Me3N+). Found, % C: C, 29.23; H, 6.57; N, 11.17; S, 13.10. Calculated: C, 29.50; H, 6.60; N, 11.47; S, 13.13. Initially H2O content in the sample was 1.4189%; after 24 hours maintenance at 100% humidity sample mass increased by 20% due to absorbed water.
EXAMPLE 20
Meldonium magnesium succinate (1:1:1; ×2H2O). (see Meldonium-magnesium tartrate). Mp. 135–140° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.39 (2H, t, CH2COO−); 2.46 (4H, s, —CH2—CH2—(succin.ac,)); 3.22 (2H, t, CH2N); 3.35 (9H, s, Me3N+). Found, %: C, 36.66; H, 7.28; N, 8.37. Calculated: C, 37.23; H, 6.87; N, 8.68. Initially H2O content in the sample was 10.1215%; after 24 hours maintenance at 100% humidity sample mass increased by 20% due to absorbed water.
EXAMPLE 21
Meldonium magnesium citrate (1:1:1; ×2H2O) (see Meldonium-magnesium tartrate). Mp. 195–200° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.48 (2H, t, CH2COO−); 2.75 (4H, dd, 2×CH2(citr.)); 3.26 (2H, t, CH2N); 3.34 (9H, s, Me3N+). Found, %: C, 36.58; H, 6.09; N, 6.96. Calculated: C, 36.34; H, 6.10; N, 7.06. Initially H2O content in the sample was 9.45%; after 24 hours maintenance at 100% humidity the sample diffused.
EXAMPLE 22
Meldonium citrate (1:1). Mp. 90–95° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.56 (2H, t, CH2COO−); 2.85 (4H, dd, 2×CH2(citr.)); 3.28 (2H, t, CH2N); 3.35 (9H, s, Me3N+).
EXAMPLE 23
Meldonium citrate (2:1). Mp. 101–107° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.51 (4H, t, 2×CH2COO−); 2.81 (4H, dd, 2×CH2(Citr.)); 3.26 (4H, t, 2×CH2N); 3.35 (18H, s, 2×Me3N+).
EXAMPLE 24
Meldonium succinate (1:1). Mp. 95–100° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.51 (2H, t, CH2(meldon.)); 2.60 (4H, s, —CH2—CH2—(succin.ac.)); 3.27 (2H, t, CH2(meldon.)); 3.35 (9H, s, Me3N+).
EXAMPLE 25
Meldonium succinate (2:1). Mp. 103–107° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.47 (4H, t, 2×CH2(meldon.)); 2.59 (4H, s, —CH2—CH2—(succin.ac.)); 3.29 (4H, t, 2×CH2(meldon.)); 3.35 (18H, s, 2×Me3N−).).
EXAMPLE 26
Meldonium adipinate (2:1). Mp. 110–114° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 1.55–1.70 (4H, m, 2×CH2(adip.)); 2.28–2.39 (4H, m, 2×CH2(adip.)); 2.45 (4H, t, 2×CH2(meldon.)); 3.24 (4H, t, 2×CH2(meldon.)); 3.34 (18H, s, 2×Me3N+).
EXAMPLE 27
Meldonium tartrate (1:1). Mp. 100–107° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 2.57 (2H, t, CH2COO−); 3.29 (2H, t, CH2(meldon.)); 3.35 (9H, s, Me3N+); 4.55 (2H, s, CH(tart.ac.)).
EXAMPLE 28
Meldonium lactate (1:1). Mp. 110–114° C. (decomp.). 1H NMR spectrum (D2O), δ, ppm: 1.33–1.48 (3H, m, Me(lac.ac,)); 2.50 (2H, t, CH2COO−); 3.26 (2H, t, CH2(mildr.)); 3.35 (9H, s, Me3N+); 4.21 (1H, q, CH(lac.ac.)).
This invention relates also to pharmaceutical formulations containing at least one of the Meldonium salts described herein as pharmaceutical active and pharmaceutically acceptable solid or liquid excipients used in drug dosage form production. Solid formulations suitable for producing dosage forms of oral introduction as well as syrups and solutions containing the claimed salts and excipients are preferable.
In case when the active substance(s) is (are) inserted into tablets, caplets, pills, granules, powders, or capsules, they shall contain a Meldonium salt from 0,5 to 5 gr. per tablet, caplet, pill, capsule or one portion of powder or granules.
The following non-limiting examples illustrate the pharmaceutical formulation of salts for solid formulation
EXAMPLE 29
Formulation for Manufacturing Tablets

















A Meldonium salt according to the invention
500
mg



Starch
20
mg



Talc
10
mg



Ca-stearate
1
mg



Total
531
mg










The following non-limiting examples illustrate composition suitable for producing capsules is the following:
EXAMPLE 30

















A Meldonium salt according to the invention
500
mg



Starch
66
mg



Talc
26
mg



Ca-stearate
3
mg



Total
602
mg










In case if the active(s) are introduced by injections or orally by means of drops, a syrup or beverage, the pharmaceutical formulation shall contain a Meldonium salt according to this invention in a ratio of 0,5 to 60% by weight and a pharmaceutically admissible solvent, e.g. distilled water, an isotonic, glucose or buffer solution or mixtures of them.
The following non-limiting examples illustrate the pharmaceutical formulation of salts for injectable administration or/and orally administration:
EXAMPLE 31
Injection Formulation:

















A Meldonium salt according to the invention
500
mg



Water for injections
5
ml










EXAMPLE 32
A Syrup Formulation:














A Meldonium salt according to the invention
25.00
mg


Methyl-p-hydroxybenzoate
0.20–0.60
g


Propyl-p-hydroxybenzoate
0.01–0.1
g


Propylene glycol
6.15–8.30
g


Sorbit
120.00–150.50
g


Glycerine
10.00–15.00
g


Purified water
108
ml


Total
250
ml









In case of trans-dermal application of the active(s), it's (their) content in an cream, gel, solution, ointment or plaster shall be 0.5–40% by weight.
The following non-limiting examples illustrate the pharmaceutical formulation of salts for trans-dermal (local/topical) administration:
EXAMPLE 33
Gel Formulation:
















A Meldonium salt according to the invention
10.00%



Sodium starch glycollate type C,
4.00



Propylene glycol
2.00



Fumaric acid
0.40



Purified vater
83.40










In the case the salt are administered rectally their content in a suppository or microenema accounts for 0.5 to 40% by weight.

## Claims

1. A meldonium salt selected from those of general formula:


X(CH3)3N+NHCH2CH2COOH


wherein X− is an anion selected from dihydrogen phosphate, hydrogen fumarate, hydrogen oxalate, hydrogen maleate, hydrogen pamoate, orotate, galactarate, sulfate, dichloroacetate, hydrogen galactarate, fumarate, taurate, maleate, hydrogen aspartate, creatinate, hydrogen sulfate, magnesium succinate, hydrogen citrate, citrate, succinate, hydrogen succinate, adipinate, hydrogen tartrate, and lactate anions.

2. A salt of claim 1, which is meldonium dihydrogen phosphate.

3. A salt of claim 1, which is meldonium hydrogen fumarate.

4. A salt of claim 1, which is meldonium orotate.

5. A process for producing a meldonium salt of claim 1, comprising:
(a) dissolving meldonium having the formula (CH3)3NNHCH2CH2COOH in water or another appropriate solvent;
(b) adding an equimolar quantity of a polybasic acid selected from fumaric acid, phosphoric acid, aspartic acid, citric acid, lactic acid, maleic acid, oxalic acid, and orotic acid;
(c) stirring the mixture at a temperature of from 20 to 50° C. until the corresponding salt is formed; and
(d) evaporating the meldonium salt formed in step (c) to dryness, if necessary; and, optionally, recrystallizing the meldonium salt from a suitable solvent.

6. A pharmaceutical composition for oral or sublingual administration, comprising as active ingredient a salt of claim 1, together with one or more pharmaceutically acceptable carries, wherein the composition is in a solid or liquid form selected from a tablet, with or without coating, a capsule, a caplet, dragees, granules, a powder, a solution, and a syrup, wherein the composition contains from 0.5 to 5 g of the active ingredient in every tablet, capsule, dragee, granule or powder dose, or from 0.5–40% by weight of the active ingredient in a solution or syrup dose.

7. The pharmaceutical composition of claim 6, wherein the pharmaceutically acceptable carrier is selected from one or more of the following: stearic acid and its salts, lactose, glucose, saccharose, starch, talc, vegetable oils, polyethylene glycols, microcrystalline cellulose, aerosil, aromatizers, flavoring agents, colorants, ethyl alcohol, and water.

8. A pharmaceutical composition for parenteral administration, comprising as active ingredient a salt of claim 1, together with a pharmaceutically acceptable solvent, wherein the composition is in the form of a solution for injection, and wherein the composition contains from 0.5 to 40% by weight of the active ingredient.

9. The pharmaceutical composition of claim 8, wherein the pharmaceutically acceptable solvent is selected from one or more of the following: distilled water, isotonic solution, buffer solution, and glucose solution.

10. A pharmaceutical composition for transcutaneous administration comprising as active ingredient a salt of claim 1, together with a pharmaceutically acceptable carrier, wherein the composition is in the form of an ointment, cream, gel, solution or plaster, and wherein the composition contains from 0.5 to 40% by weight of the active ingredient.

11. The pharmaceutical composition of claim 10, wherein the pharmaceutically acceptable carrier is selected from one or more of the following: water, polyethylene glycols 400, 1500 and 4000, vegetable oils, fats, glycerine, preservants, emulgators, stabilizers, porous polymer material, dimethylsulphoxide, alcohol, and water.

12. A pharmaceutical composition for rectal administration comprising as active ingredient a salt of claim 1, together with a pharmaceutically acceptable carrier, wherein the composition is in the form of a suppository or microenema, and wherein the composition contains from 0.5 to 40% by weight of the active ingredient.

13. The pharmaceutical composition of claim 12, wherein the pharmaceutically acceptable carrier is selected from one or more of the following: water, polyethylene glycols 400, 1500 and 4000, vegetable oils, fats, glycerine, preservants, emulgators, and stabilizers.

14. A pharmaceutical composition suitable for once per day administration, comprising as active ingredient a salt of claim 1 together with one or more pharmaceutically acceptable carriers.