ANTIDIABETIC COMPOSITIONS

Abstract: Certain novel oral antidiabetic compositions are dis­ closed. These pharmaceutical compositions involve the concomitant use of two different organic chemical com­ pounds each chosen from a separate class of known hypoglycemic agents. One class of agents involves certain known oxazolidine-2,4-dione compounds (A), while the other class is primarily concerned with a series of known hypog­ lycemic sulfonylureas (B). Preferred embodiments involve the use of 5-(3-thienyl)oxazolidine-2,4-dione, 5-(4-ethoxy-3-­ thienyl)oxazolidine-2,4-dione, 5-(2-methoxy-6-­ fluorophenyl)oxazolidine-2,4-dione, 5-(2-methoxy-6-­ chlorophenyl)oxazolidine-2,4-dione or 5-(2-ethoxy-5-chloro-­ 3-pyridyl)oxazolidine-2,4-dione as compound (A) in conjunc­ tion with either chlorpropamide or glipizide as compound (B). Various methods for administering these compounds in combination and/or in a concomitant manner are provided.

Description: ANTIDIABETIC COMPOSITIONS This invention relates to new pharmaceutical compositions which are of therapeutic value in the treatment of diabetes. More particularly, it is concerned with the concomitant use of two different chemical compounds each chosen from a different class of known organic hypoglycemic agents, but whose concomitant use in this connection has not been previously known. One of the two known groups of chemical compounds is a series of 5-substituted-oxazolidine-2,4-dione compounds (A) disclosed in Belgian Patents nos. 889757 and 889758 and U.K. published Patent Applications GB 2080803A and 2083810A. This group includes such compounds as 5- (2-methoxy-6-fluorophenyl) oxazolidine-2, 4-dione, 5- (2-methoxy-6-chlorophenyl)oxazolidine-2, 4-dione, 5(3- thienyl)-oxazolidine-2,4-dione, 5- (4-ethoxy-3-thienyl)oxa- zolidine-2,4-dione and 5-(2-ethoxy-5-chloro-3-pyridyl)oxazolidine-2,4-dione, respectively. The other known group of compounds useful in this connection involves several known hypoglycemic sulfonylureas (B) that are thoroughly discussed in a review article appearing in the Chemical & Engineering News, Vol. 59, No. 9, p. 30 (1981) dealing with clinically useful oral antidiabetic agents. Included among this group are such compounds as chlorpropamide, tolbutamide, glipizide and glibenclamide, etc. According to the present invention, there are provided new oral antidiabetic compositions comprising a compound (A) of the formula: EMI2.1 wherein R is a member selected from the group consisting of 3-thienyl, 4-ethoxy-3-thienyl, 2-fluorophenyl, 2-methoxyphenyl, 2-ethoxyphenyl, 2-methyl- 5-fluorophenyl, 2-methoxy-5-fluorophenyl, 2-methoxy-6-fluorophenyl, 2-methoxy-5-chlorophenyl, 2-methoxy-6-chlorophenyl, 2-methoxy-5-chloro-3-pyridyl and 2-ethoxy-5-chloro3-pyridyl, or a pharmaceutically acceptable.cationic base salt thereof; and a compound (B) of the class of hypoglycemic sulfonylureas selected from the group consisting of chlorpropamide, tolbutamide, acetohexamide, tolazamide, glipizide and glibenclamide, or a pharmaceutically acceptable cationic base salt thereof, with or without a pharmaceutically acceptable carrier or diluent. Pharmaceutically acceptable cationic base salts of the compounds of formula (I) include the alkali metal salts (e.g., sodium and potassium), alkaline-earth metal salts (e.g., calcium and magnesium), aluminum salts, ammonium salts and salts with organic amines such as benzathine (N,N'-dibenzylethylenediamine), choline, diethanolamine, ethylenediamine, meglumine (N-methylg lucamine), benethamine (N-benzylphenethylamine) diethylamine, piperazlne, tromethamine (2-amino-2 hydroxymethyl-1,3-propanediol), procaine, etc. More specifically, it has been found that the concomitant use of a compound (A) of the formula (I) with a compound (B) as previously discussed is particularly and unexpectedly valuable in the treatment of diabetes via the oral route of administration. In view of this unexpected synergism, the concomitant oral use of these two compounds in the treatment of diabetes is much more effective than the use of either compound alone when given by the same route of administration. Thus, a further aspect of this invention provides a method for lowering blood sugar in the treatment of a diabetic host, which comprises orally administering in a concomitant manner to said host an effective blood sugar lowering amount of a compound (A) of the formula (I), or a pharmaceutically acceptable cationic base salt thereof, and a compound (B) of the hypoglycemic sulfonylurea class previously described or a pharmaceutically acceptable cationic base salt thereof. Preferably, the compounds are administered orally in a ratio of about one part by weight of compound (A) of the formula (I) to about 0.02-5.0 parts by weight of compound (B). The preferred weight ratio of compound (A) oxazolidinedione to compound (B) sulfonylurea is in the range of about 1.0:0.2 to about 1.0:2.0, respectively. Preferred embodiments involve the use of 5-(2-methoxy-6-chloro phenyl)oxazolidine-2,4-dione (A) in conjunction with either chlorpropamide or glipizide (B); 5-(3-thienyl) oxazolidine-2,4-dione (A) in conjunction with either chlorpropamide or glipizide (B), 5-(2-ethoxy-5-chloro 3-pyridyl)oxazolidine-2,4-dione (A) in conjunction with either chlorpropamide or glipizide (B); 5-(4 ethoxy-2-thienyl)oxazolidine-2,4-dione (A) in conjunc tion with either chlorpropamide or glipizide (B); and 5-(2-methoxy-6-fluorophenyl)oxazolidine-2,4-dione (A) in conjunction with either chlorpropamide or glipizide (B). In general, the herein described compounds (A) and (B) can be administered as oral antidiabetic agents in the dose ratios, by weight, indicated above, viz., from about one part by weight of the free acid of compound (A) to about 0.02-5.0 parts by weight of compound (B). In this way, they may be administered simultaneously, i.e., in single or separate tablets, capsules, syrups or other oral dosage forms, or sequentially in separate oral dosage forms. The daily oral dosage levels of the compounds (A) and (B) will depend on the age and weight of the subject being treated, but (expressed as the non-salt form of each compound) will generally be in the respective -ranges of approximately 0.5-25 mg/kg of body weight per day of compound (A) of the formula (I) and from -about 0.06-25 mg/kg of body weight 'of compound (B) of the hypoglycemic sulfonylurea class previously described. Thus, for an average adult (70 kg) subject, from approximately 35-1750 mg of compound (A) oxazolidinedione and from approximately 4.0-1750 mg of compound (B) sulfonylurea will be administered per day in either a single oral dose or up to four divided doses. Preferably, the compounds will be administered together in the form of a pharmaceutical composition comprising a compound (A) of the formula (I), or a pharmaceutically acceptable cationic base salt thereof, and a compound (B) of the hypoglycemic sulfonylurea class previously described, or a pharmaceutically acceptable cationic base salt thereof, with the weight ratio (expressed as the non-salt form of each compound) of compound (A) oxazolidinedione to compound (B) sulfonylurea being from about 1.0:0.02 up to about 1.0:5.0, respectively, and the composition will usually also comprise a pharmaceutically acceptable carrier or diluent. The compositions will necessarily be present in a form suitable for oral administration, e.g., in the form of tablets, capsules, emulsions, syrups or elixirs, etc. Suitable compositions can contain from about 35-250 mg of compound (A) of the formula (I) and from about 7.0-250 mg of compound (B) of the hypoglycemic sulfonylurea class previously described, with the weight ratio of compound (A) oxazolidinedione to compound (B) sulfonylurea being in the range of from about 1.0:0.02 to about 1.0:5.0, as aforesaid, and preferably in the range of 1.0:0.2 to about 1.0:2.0, respectively. Compositions in forms suitable for oral administration may be prepared by methods which are well known to those skilled in the art. For instance, the novel oral antidiabetic compositions of this invention can be administered in a wide variety of different dosage forms, e.g., they may be combined with various pharmaceutically acceptable inert carriers in the form of tablets, capsules, lozenges, troches, hard candies, powders, aqueous suspensions or emulsions, elixirs, syrups and the like. Such carriers include solid diluents or fillers, sterile aqueous media and various non-toxic organic solvents, etc. Moreover, such oral pharmaceutical compositions can be suitably sweetened and/or flavored by means of various commonlyknown agents. In general, the therapeutically-effective compounds (A) and (B) of this invention are present in such oral dosage forms at concentration levels ranging from about 0.5% to about 90% by weight of the total composition, i.e., in amounts which are sufficient to provide the desired unit dosage. For oral administration, tablets containing various excipients such as sodium citrate, calcium carbonate and dicalcium phosphate may be employed along with various disintegrants such as starch and preferably potato or tapioca starch, alginic acid and certain complex silicates, together with binding agents such polyvinylpyrrolidone, gelatin and acacia. Additionally, lubricating agents such as magnesium stearate, sodium lauryl sulfate and talc are often very useful for tabletting purposes. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules; preferred materials in this connection would also include the high molecular weight polyethylene glycols. When aqueous suspensions and/or elixirs are desired for oral administration, the essential - wactive ingredient therein may be combined with various sweetening or flavoring agents, coloring matter or dyes and, if so desired, emulsifying and/or suspending agents as well, together with such diluents as water, ethanol, propylene glycol, glycerin and various like combinations thereof. EXAMPLE 1 The following combinations of 5-(3-thienyl)oxazolidine 2,4-dione (Compound No. 1) in conjunction with chlorpropamide, tolbutamide, glibenclamide or glipizide were respectively tested for hypoglycemic activity in terms of their ability to exhibit enhanced glucose control in groups of intact male albino rats that had been fasted for 18 hours prior to use. No anesthetic was used in this study. After the rats had been fasted, different groups were then treated orally with either water (controls) or the aforesaid oxazolidine-2,4-dione compound (as the sodium salt) at the 25 mg./kg. dose level. Thirty minutes later, the groups of rats were dosed intraperitoneally with either saline alone (controls) or one of the aforesaid sul fonylurea compounds (dissolved as the sodium.salt.in C.98 saline) at a dose level ranging from 0.6 mg./kg. to 25 mg./kg., respectively (see table). Blood samples were then taken from the tail vein of each animal thirty minutes following the intraperitoneal dosing. The samples were immediately diluted 1:10 (by volume) with 1.0% heparin in 0.98 saline. Blood glucose concentrations (mg./dl.) were then determined by adapting the method of W. S. Boffman [Journal of Bioloqical Chemistry, Vol. 120, p. 51 (1937)) to the Autoanalyzer instrument produced by Technicon Instruments Corporation of Chauncey, N.Y. On this basis, the following results were obtained in terms of blood glucose levels (with standard error of the mean) at the 0.5-hour mark for each combination listed in the table below: Hypoglycemic Combination Blood Glucose (mg./dl.) Control (water plus 0.9% saline) 72 + 3.2 Cpd. No. 1 plus saline (0.98) 69 + 2.7 Water plus chlorpropamide (25 mg./kg.) 63 + 1.5 Cpd. No. 1 plus chlorpropamide (25 mg./kg.) 55 + 0.9 Water plus tolbutamide (25 mg./kg.) 57 + 1.6 Cpd. No. 1 plus tolbutamide (25 mg./kg.) 48 + 0.9 Water plus glibenclamide (0.6 mg./kg.) 60 + 1.4 Cpd. No. 1 plus glibenclamide (0.6 mg./kg.) 48 + 1.3 Water plus glipizide (0.6 mg./kg.) 68 + 3.2 Cpd. No. 1 plus glipizide (0.6 mg./kg.) 55 + 2.1 From the data presented in the above table, it is obvious that combinations of 5-(3-thienyl)oxazolidine 2,4-dione (Cpd. No. 1) and the appropriate sulfonylurea produce better therapeutic effects than either. compound alone, as attested to by the statistically significant -enhancement - enhancement of the hypoglycemic activity of the sulfony- lurea in the presence of the specifically selected oxazolidine-2,4-dione compound. EXAMPLE 2 The following combinations of 5-(2-methoxy-6-chloro phenyl)-oxazolidine-2,4-dione (Compound No. 2) with chlorpropamide, tolbutamide, glibenclamide or glipizide were respectively tested for hypoglycemic activity in terms of their ability to exhibit enhanced blood glucose control in groups of intact male albino rats according to the procedure described in Example 1 for the corre sponding 5-(3-thienyl) compound. In this particular case, the oxazolidine-2,4-dione compound (i.e., Compound No. 2) was tested at the 5.0 mg./kg. dose level (orally), while the sulfonylurea compound was thereafter administered in the same manner as before (i.e., intra peritoneally) at a dose level ranging from 0.3 mg./kg. to 25 mg./kg., as indicated in the table below, where the results obtained are again reported in terms of blood glucose levels (with standard error of the mean) at the 0.5-hour mark for each of the combinations so specified: Hypoglycemic Combination Blood Glucose (m./dl.) Control (water plus 0.98 saline) 78 + 4.3 Cpd. No. 2 plus saline (0.98) 73 + 1.5 Water plus chlorpropamide (25 mg./kg.) 69 + 1.4 Cpd. No. 2 plus chlorpropamide (25 mg./kg.) SB + 0.8 Water plus tolbutamide (25 mg./kg.) 64 + 1.1 Cpd. No. 2 plus tolbutamide (25 mg./kg.) 56 + 3.0 Water plus glibenclamide (0.6 mg./kg.) 63 + 2.1 Cpd. No. 2 plus glibenclamide (0.6 mg./kg.) 54 * 0.95 Water plus glipizide (0.3 mg./kg.) 71 * 3.7 Cpd. No. 2 plus glipizide (0.3 mg./kg.) 64 + 2.5 From the data presented in the above table, it can be seen that combinations of 5-(2-methoxy-6-chlorophenyl)- oxazolidine-2,4-dione (Cpd. No. 2) and the appropriate sulfonylurea produce better therapeutic effects than either compound alone, as attested to by the substantially enhanced hypoglycemic activity of the sulfonylurea in the presence of the specifically selected oxazolidine-2, 4-dione compound. EXAMPLE 3 The following oral antidiabetic compositions are prepared by combining the active ingredients listed below (oxazolidinedione plus hypoglycemic sulfonylurea) in the amounts indicated in parenthesis, together with standard pharmaceutical excipients (if so desired): 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus chlorpropamide (250 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus chlorpropamide (100 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (250 mg.) plus chlorpropamide (100 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (250 mg.) plus chlorpropamide (250 mg.) 5-(2-methoxy-6-chlorophenyl)oxazolidine-2,4-dione (100 mg.) plus chlorpropamide (250 mg.) 5- ( 2-methoxy-6-chlorophenyl )oxazolidine-2, 4-dione (50 mg.) plus chlorpropamide (250 mg.) 5-( 2-methoxy-6-chlorophenyl )oxazolidine-2, 4-dione (100 mg.) plus chlorpropamide (100 mg.) 5-(2-methoxy-6-chlorophenyl)oxazolidine-2,4-dione (50 mg.) plus chlorpropamide (100 mg.) 5-(2-ethoxy-5-chloro-3-pyridyl)oxazolidine-2,4- -dione ¯ dione (50 mg.) plus chlorpropamide (100 mg.) 5-(2-e.hoxy-5-chloro-3-pyridyl)oxazolidine-2,4- dione (100 mg.) plus .chlorpropamide (100 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus tolbutamide (250 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus tolazamide (250 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus acetohexamide (250 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus glibenclamide (50 mg.) 5-(3-thienyl)oxazolidine-2,4-dione (100 mg.) plus glibenclamide (10 mg.) 5-(2-methoxy-6-chlorophenyl)oxazolidine-2,4-dione (100 mg.) plus glipizide (25 mg.) 5- ( 2-methoxy-6-chlorophenyl )oxazolidine-2, 4-dione (100 mg.) plus glibenclamide (10 mg.) 5-(2-ethoxy-5-chloro-3-pyridyl)oxazolidine-2,4- dione (100 mg.) plus glipizide (25 mg.). EXAMPLE 4 The following combinations of 5-(4-ethoxy-3thienyl)oxazolidine-2,4-dione (Compound No. 3) with chlorpropamide or glipizide were respectively tested for hypoglycemic activity in terms of their ability to exhibit enhanced blood glucose control in groups of intact male albino rats according to the procedure described in Example 1 for the corresponding 5-(3thienyl) compound. In this particular case the oxazolidine-2,4-dione compound (i.e., Compound No. 3) was tested at the 10 mg./kg. dose level (orally), while the sulfonylurea compound was thereafter administered in the same manner as before (i.e., intraperitoneally at a dose level ranging from 0.3 mg./kg. to 25 mg./kg., as indicated in the table below, where the results obtained are again reported in terms of blood glucose levels (with standard error of the mean) at the 0.5-hour mark for each of the combinations so specified: Hvpooiycemic Combination Blood Glucose (mg./dl.) Control (water plus 0.98 saline) 67 + 2.2 Cpd. No. 3 plus saline (0.98) 62.5 + 1.2 Water plus chlorpropamide (25 mg./kg.) 62.9 - 3.1 Cpd. No. 3 plus chlorpropamide (25 mg./kg.) 45.9 + 3.1 Water plus glipizide (0.3 mg./kg.) 61.2 T 2.5 Cpd. No. 3 plus glipizide (03 mg./kg.) 49.9 * 2.0 From the data presented in the above table, it can be seen that combinations of 5-(4-ethoxy-3-thienyl) oxazolidine-2,4-dione (Cpd. No. 3) and the appropriate sulfonylurea produce better therapeutic effects than either compound alone, as attested to by the substantially enhanced hypoglycemic activity of the sulfonylurea in the presence of the specifically selected oxazolidine-2, 4-dione compound. EXAMPLE 5 The following combination of 5-(2-methoxy-6-fluorophenyl)oxazolidine-2,4-dione (Compound No. 4) with chlorpropamide or glipizide were respectively tested for hypoglycemic activity in terms of their ability to exhibit enhanced blood glucose control in groups of intact male albino rats according to the procedure described in Example 1 for the corresponding 5-(3thienyl) compound. In this particular case, the 'oxazolidine-2,4-dione compound (i.e., Cpd. No. 4) was tested at the 10 mg./kg. dose level (orally), while the sulfonylurea compound was thereafter administered in the same manner as before (i.e., intraperitoneally) at a dose level ranging from 0.3 mg./kg. to 25 mg./kg., zs indicated in the table below, where the results . obtained are again reported in terms of blood glucose levels (with standard error of the mean) at the 0.5-hour mark for each of the combinations so specified: Bypoqlvcemic Combination' Blood Glucose (ms./dl.) Control (water + 0.9% saline) 64.7 + 2.7 Cpd. No. 4 plus saline (0.9%) 58.8 + 1.2 Water plus chlorpropamide (25 mg./kg.) 56.6 + 1.9 Cpd. No. 4 plus chlorpropamide (25 mg./kg.) 45.3 + 3.0 Water plus glipizide (0.3 ing./kg.) 54.7 + 2.2 Cpd. No. 4 plus glipizide (0.3 mg./kg.) . 43.7 + 3.0 From the data presented in the above table, it can be seen that combinations of 5-(2-methoxy-6-fluorophenyl) oxazolidine-2,4-dione (Cpd. No. 4) and the appropriate sulfonylurea produce better therapeutic effects than either compound alone, as attested to by the substantially enhanced hypoglycemic activity of the sulfonylurea in the presence of the specifically selected oxazolidine 2,4-dione compound.

Claims: CLAIMS 1. An oral antidiabetic composition comprising a compound (A) of the formula: EMI13.1 wherein R is a member selected from the group consisting of 3-thienyl, 4-ethoxy-3-thienyl, 2-fluorophenyl, 2-methoxyphenyl, 2-ethoxyphenyl, 2-methyl-S-f 1uorQhenyl, 2-methoxy-5-fluorophenyl, 2-methoxy-6-fluorophenyl, 2-methoxy-5-chlorophenyl, 2-methoxy-6-chlorophenyl, 2-methoxy-5-chloro-3-pyridyl and 2-ethoxy-5-chloro-3- pyridyl, or a pharmaceutically acceptable cationic base salt thereof; and a compound (B) of the class of hypoglycemic sulfonylureas selected from the group consisting of chlorpropamide, tolbutamide, acetohexamide, tolazamide, glipizide and glibenclamide, or a pharmaceutically acceptable cationic base salt thereof. 2. A composition as claimed in claim 1 wherein compound (A) is an oxazolidinedione of the formula (I) wherein R is 3-thienyl and compound (B) is chlorpropamide or glipizide. 3. A composition as claimed in claim 1 wherein compound (A) is an oxazolidinedione of the formula (I) wherein R is 4-ethoxy-3-thienyl and compound (B) is chlorpropamide or glipizide. 4. A composition as claimed in claim 1 wherein compound (A) is an oxazolidinedione of the formula (I) wherein R is 2-methoxy-6-fluorophenyl and compound (B) is chlorpropamide or glipizide. 5. A composition as claimed in claim 1 wherein compound (A) is an oxazolidinedione of the formula (I) wherein R is 2-methoxy-6-chlorophenyl and compound (B) is chlorpropamide or glipizide. 6. A pharmaceutical composition comprising an oral antidiabetic composition as claimed in any preceding claim, together with a pharmaceutically acceptable carrier or diluent. 7. A composition as claimed in any preceding claim wherein the weight ratio of the compound (A) to the compound (B) is in the range of from about 1.0:0.02 to about 1.0:5.0. 8. A composition as claimed in claim 7 wherein the ratio is in the range from about 1.0:0.2 to about 1.0:2.0. CLAIMS FOR AUSTRIA 1. A process for preparing an oral diabetic composition which comprises mixing a compound (A) of the formula: EMI15.1 wherein R is a member selected from the group consisting of 3-thienyl, 4-ethoxy-3-thienyl, 2-fluorophenyl, 2-methoxyphenyl, 2-ethoxyphenyl, 2-methyl-5-fluorophenyl, 2-methoxy-5-fluorophenyl, 2-methoxy- 6-f luorophenyl, 2-methoxy-5-chlorophenyl, 2-methoxy- 6-chlorophenyl, 2-methoxy-5-chloro-3-pyridyl and 2-ethoxy-5-chloro-3- pyridyl, or a pharmaceutically acceptable cationic base salt thereof, with a compound (B) of the class of hypoglycemic sulfonylureas selected from the group consisting of chiorpropamide, tolbutamide, acetohexamide, tolazamide, glipizide and glibenclamide, or a pharmaceuti cally acceptable cationic base salt thereof, to form a composition in which the compounds (A) and (B) have a synergistic effect in lowering blood sugar when administered orally. 2. A process as claimed in claim 1, in which the compounds (A) and (B) are mixed together with a pharma ceutically acceptable carrier material or diluent. 3. A process as claimed in claim 1 or claim 2 in which the compounds (A) and (B) are mixed in a weight ratio in the range from about 1.0:0.02 to about 1.0:5.0. 4. A process as claimed in claim 3, in which the ratio is in the range from about 1.0:0.2 to about 1.0:2.0. 5. A process as claimed in any preceding claim wherein the compound (A) oxazolidinedione is of the formula (I) wherein R is 3-thienyl and the compound (B) sulfonylurea is chlorpropamide or glipizide. 6. A process as claimed in any of claims 1 to 4 wherein the compound (A) oxazolidinedione is of the formula (I) wherein R is 4-ethoxy-3-thienyl and the compound (B) sulfonylurea is chlorpropamide or glipizide. 7. A process as claimed in any of claims 1 to 4 wherein the compound (A) oxazolidinedione is of the formula (I) wherein R is 2-methoxy-6-fluorophenyl and the compound (B) sulfonylurea is chlorpropamide or glipizide. 8. A process as claimed in any of claims 1 to 4 wherein the compound (A) oxazolidinedione is of the formula (I) wherein R is 2-methoxy-6-chlorphenyl and the compound (B) sulfonylurea is chlorpropamide or glipizide.

Inventors: MORVILLE, MALCOLM, PAGE, MICHAEL GARTH, SCHNUR, RODNEY CAUGHREN
Applicants: PFIZER INC.
Application year: 1983
Main classification: A61K31
IPC codes: A61K31