IBUPROFEN-CAFFEINE COMBINATIONS

Abstract: This invention relates to pharmaceutical compositions for use in the treatment of pain and inflammation in mammals, including humans, by administering compositions comprising (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)-lysine; and (ii) an amount effective in the enhancement of pain relief of caffeine.

Description: TITLE OF THE INVENTION IBUPROFEN-CAFFEINE COMBINATIONS BACKGROUND OF THE INVENTION The non-steroidal anti-inflammatory drugs (NSAID) have been utilized in the treatment of pain/inflammation and a number of other symptoms including stiffness that are associated with painful conditions affecting muscles, bones, and joints. NSAIDs have been prescribed to relieve back pain, gout, menstrual pain, headaches, mild pain following surgery, and pain from soft tissue injuries such as sprains and strains. NSAIDs are within the broader class of non- narcotic analgesics which also includes acetylsahcyclic acid (aspirin) and acetaminophen. NSAIDs, except for acetaminophen, are generally considered to exert their effect by blocking the production of prostaglandins at the site of pain, irritation or injury so that the pain signal does not reach the brain. Ibuprofen (2-(4-isobutylphenyl)propionic acid) is a well known and commonly employed NSAID. Amino acid salts of racemic ibuprofen Including the lysine or arginine salt are also known pain relievers. See U.S. Pat. No. 4,279,926. Recently, it has been found that a faster onset of pain relief and an enhanced analgesic response can be obtained by utilizing the single enantiomer (S)-ibuprofen (also known as (-f-)-ibuprofen or dexibuprofen) rather than the racemic mixture of ibuprofen. See U.S. Patent 4,877,620. Caffeine is a well known xanthine alkaloid and is used in a number of foods and medicines. The Xanthines, including caffeine, are known to stimulate the central nervous system, induce relaxation of smooth muscle constrictions of the smaller bronchi and other smooth muscles, cause dilation of the small pulmonary arteries, and induce stimulation of cardiac muscle with increased cardiac output and the promotion of mild diuresis. It has been postulated that these actions may be related to the antagonism of adenosine receptors. Combinations of ibuprofen with caffeine have been disclosed. See U.S. Pat. No. 4,851,444 which broadly discloses the combination of (S)-ibuprofen and several additional active ingredients including caffeine; 4,587,249 discloses the combination of ibuprofen and caffeine; See also 4,567,183; 4,558,051; 4,486,436; 4,464,376; 4,656,177; 4,777,174. There is a need to employ a compound with faster acting and enhanced analgesic capability as well as enhanced solubility such as (S)-ibuprofen-(S)-lysine substantially free of (R)- ibuprofen in combination with a xanthine derivative such as caffeine to more effectively treat and prevent the pain and discomfort associated with headaches or other aches and pains. The present invention provides both faster onset and enhanced relief of aches and pains associated with the head and body. DETAILED DESCRIPTION OF THE INVENTION This invention claims pharmaceutical compositions for use in the treatment of pain and inflammation. The composition comprises: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in enhancement of pain relief of caffeine. This invention is also directed to a method of treating pain and inflammation in mammals, including humans, in need thereof, comprising administering to such organism: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and(ii) an amount effective in enhancement of pain relief of caffeine. This invention is further directed to a method of eliciting an onset hastened and enhanced response for the treatment of pain and inflammation in mammals, including humans, in need thereof, comprising administering to such organism: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in enhancement of pain relief of caffeine. Substantially free of (R)-ibuprofen means that the ratio of (S)-ibuprofen to (R)-ibuprofen is at least 90:10. Salts of (S)-ibuprofen include pharmaceutically acceptable salts such as alkali metals (sodium or potassium), alkaline earth metals (calcium), or salts with other metals such as magnesium, aluminum, iron, zinc, copper, nickel or cobalt. Pharmaceutically acceptable salts of (S)-ibuprofen further include the amino acid salts, particularly the basic amino acids such as lysine or arginine. Specifically included within the composition of the instant invention is (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine. The term mammals or mammalian organism includes but is not limited to man, dog, cat, horse and cow. The term treatment encompasses the complete range of therapeutically positive effects associated with pharmaceutical medication including reduction of, alleviation of and relief from the symptoms or illness which affect the organism. (S)-ibuprofen may be prepared following the procedures disclosed in U.S. Patent 4,877,620. Metal salts of ibuprofen may be obtained by contacting a hydroxide, or carbonate with ibuprofen. Amino acid salts of ibuprofen may be obtained by contacting an amino acid in solution with ibuprofen. U.S. Patent No. 4,994,604 describes a process for the formation and resolution of (S)-ibuprofen-(S)-lysine that employs preferential crystallization to separate a pair of diastereomeric salts, (S)-ibuprofen-(S)-lysine and (R)-ibuprofen-(S)-lysine. The basic procedure involves (a) contacting (R),(S)-ibuprofen and (S)-lysine in an aqueous-organic solvent mixture; (b) separating any suspended solid from the mixture; and (c) cooling the clear mixture until the mixture is supersaturated with respect to each of the (S)-ibuprofen-(S)-lysine and (R)-ibuprofen-(S)-lysine salts; (d) contacting the supersaturated mixture with a slurry of (S)-ibuprofen-(S)-lysine in an aqueous-organic solvent; and (e) separating the formed crystalline (S)-ibuprofen-(S)-lysine. Specifically, the racemic ibuprofen starting material is mixed with an organic solvent that is miscible with water. The (S)- lysine is mixed with water and the ibuprofen and lysine solutions are combined. The mixture is agitated for a time period sufficient to crystallize all the salts, if any, in excess of the solubility limit. The suspended salts are separated to obtain a clear mother liquor which is generally saturated with respect to the diastereomeric salts (S)- ibuprofen-(S)-lysine and (R)-ibuprofen-(S)-lysine. Filtration may be employed to effect the separation. The liquor is then cooled to a temperature at which it is supersaturated with respect to each of the diastereomeric salts. It is preferred that the liquor be cooled to the point at which maximum supersaturation is obtained with respect to each salt without nucleation of either crystallizable species. Typically the temperature of the mother liquor must be lowered by about 5° C to reach maximum supersaturation without precipitation of either salt. However, the degree of cooling will depend on the particular solvent composition. The supersaturated liquor is then passed into a vessel containing a slurry of (S)-ibuprofen-(S)-lysine, hereafter referred to as the (S,S) salt, in the same solvent system employed above for the mixture of racemic ibuprofen and (S)-lysine. In the presence of the (S,S) salt crystals acting as a seed, the supersaturation of the (S,S)-salt in the feed liquor is released by the growth of further crystals of the (S,S)- salt. Conversely, there is little or no change in the (R)-ibuprofen-(S)- lysine supersaturation because the growth rate of the (R,S) crystals is essentially zero in the absence of any initial (R,S) salt seed. The (S,S) crystals are then separated by filtration or centrifugation and washed with aqueous-organic solvent to yield (S)-ibuprofen-(S)-lysine of purity approximating 98%. The pharmaceutical compositions of the present invention are useful in the rapid and enhanced treatment of pain and inflammation. In particular, the (S)-ibuprofen-(S)-lysine combined with caffeine is useful for the treatment of pain, and inflammation. The utilization of (S)-ibuprofen and in particular (S)-ibuprofen-(S)-lysine in an analgesic/caffeine combination offers significant advantages over the combination of racemic ibuprofen and caffeine or (S)-ibuprofen and caffeine. (S)-ibuprofen and in particular the lysine salt of (S)- ibuprofen provides a faster onset of pain and inflammation relief and an enhanced degree of relief compared to racemic ibuprofen. These benefits contribute to overall enhanced and faster relief of symptoms associated with headaches and other aches and pains when the (S)- ibuprofen -(S)-lysine is combined with a xanthine derivative such as caffeine. The absence or reduction of (R)-ibuprofen also provides significant benefits. The allergic contraindications sometimes associated with ibuprofen administration are absent or reduced in a (R)-ibuprofen- free or substantially -free composition. An additional advantage may be that less metabolic energy will be used to convert the inactive (R)- ibuprofen to the active (S)-ibuprofen. In addition, a reduced burden may be placed on the urogenital system since administration of the pure (S)-ibuprofen eliminates the need to excrete the (R)-ibuprofen or its metabolites. The absence of the (R)-enantiomer also reduces or eliminates the incorporation of this molecule into fatty tissue. The renal burden and renal toxicities sometimes associated with racemic ibuprofen therapy may be reduced or eliminated in a (S)-ibuprofen composition that is substantially free of the (R) enantiomer. Caffeine and xanthine alkaloids are known in the art and may be used in combination with (S)-ibuprofen (S)-lysine. Caffeine is well tolerated and has minimal side effects and thus advantageously may be used in the present invention in combination with (S)-ibuprofen (S)- lysine. The composition of (S)-ibuprofen-(S)-lysine with caffeine provides a combination which simultaneously and selectively provides enhanced relief from headaches, pain, and inflammation. This combination also has an advantage under circumstances where a mammalian organism requires enhanced pain relief and wakefulness or mental altertness. The absence of inactive enantiomers, particularly (R)- ibuprofen provides for significant size and weight advantages in a combination dosage form, particularly a sustained release dosage form. Where a sustained release dosage of ibuprofen may have required 800 to 1000 mg, the employment of (S)-ibuprofen-(S)-lysine reduces the weight to 400 to 500 mg, and provides for a more practical size tablet for an ibuprofen/caffeine combination. An effective amount of (S)-ibuprofen, or a salt thereof, for use in a unit dose composition of this invention may range from 50-800 mg of (S)-ibuprofen. The preferred amount of (S)-ibuprofen is about 100 to 400 mg. The amount of a salt such as (S)-ibuprofen-(S)-lysine is determined based on the amount of (S)-ibuprofen contained therein. Caffeine is advantageously used in the present invention in combination with (S)-ibuprofen-(S)-lysine. The amount of caffeine used in the present invention in humans may range from 20 to 400 milligrams (mg). Advantageously, 32 to 65 mg is administered in combination with 100 to 400 mg of (S)-ibuprofen (S)-lysine. The combination claimed in the instant invention is advantageously admimstered orally. However, in patients with hypersecretory conditions, intractable ulcers, or in patients who are unable to take oral medication, the claimed combination may be administered intravenously in a suitable dosage within the limits described for oral treatment. The present composition may be administered in the form of tablets, caplets, gelcaps, capsules, elixirs, syrups, or suspensions. For oral administration, the active ingredients may be admixed with a pharmaceutically acceptable diluent such as lactose, sucrose, cellulose, dicalcium phosphate, calcium sulfate, mannitol, and, in a liquid composition, ethyl alcohol. Acceptable emulsifying or suspending agents such as PVP, gelatin, natural sugars, corn sweeteners, natural and synthetic gums such as acacia, sodium alginate, guar gum, agar, bentonite, carboxymethylcellulose sodium, polyethylene glycol and waxes, may also be admixed with the active components. Where necessary, lubricants such as magnesium stearic acid talc or magnesium stearate, and disintegrators or superdisintegrators such as starch, sodium starch glycolate or cross-linked PVP may also be included. Electrolytes such as dicalcium phosphate, sodium benzoate, sodium acetate and sodium chloride may also be used. The active components may also be formulated in sustained release or effervescent formulations. These formulations depending upon whether they are sustained release or effervescent may be employed in oral, dermal, rectal or vaginal administrations. The sustained release formulations also include layered formulations which provide for distinct release ratio and thus may be more effective in allowing for short and long term relief. The following examples illustrate the compositions of the present invention which may be readily prepared and as such are not to be considered as limiting the invention set forth in the claims. EXAMPLE 1 (SVIbuprofen lvsine/caffeine Tablet (S)-ibuprofen-(S)-lysine 342 mg caffeine 65 mg PVP 15 mg Avicel PHlOl 40 mg Magnesium Stearate 4 mg EXAMPLE 2 (SVIbuprofen lvsine/caffeine Tablet (S)-ibuprofen-(S)-lysine 342 mg caffeine 20 mg PVP 15 mg Avicel PHlOl 40 mg Magnesium Stearate 4 mg EXAMPLE 3 (SVIbuprofen lvsine/caffeine Sustained Release (S)-ibuprofen-(S)-lysine 400 mg caffeine 65 mg PVP 30 mg Avicel PH101 80 mg Magnesium Stearate 8 mg Methocel E10MCR 66 mg Methocel K100MLV 200 mg EXAMPLE 4 (SVIbuprofen (S Vlvsine/caffeine Sustained Release (S)-ibuprofen-(S)-lysine 400 mg caffeine 200 mg PVP 30 mg Avicel PHlOl 80 mg Magnesium Stearate 8 mg Methocel E10MCR 66 mg Methocel K100MLV 200mg EXAMPLE 5 (SVIbuprofen-fSVlvsine/caffeine Solution (S)-ibuprofen-(S)-lysine 342 mg caffeine 65mg g.s. syrup 5 ml EXAMPLE 6 (SVIbuprofen-CSVlvsine/caffeine Solution (S)-ibuprofen-(S)-lysine 342 mg caffeine 200 mg g.s. syrup 5 ml

Claims: WHAT IS CLAIMED IS: 1. A pharmaceutical composition for use in the treatment of pain and inflammation and the enhancement of pain relief in mammals, including humans comprising: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in the enhancement of pain relief of caffeine. 2. The composition of Claim 1 comprising at least 50 mg of (S)-ibuprofen-(S)-lysine. 3. The composition of Claim 1 comprising between 20-400 mg of caffeine. 4. The composition of Claim 1 comprising 100-400 mg of (S)-ibuprofen-(S)-lysine and 32-65 mg of caffeine. 5. A method of treating pain and inflammation and enhancing pain relief in a mammalian organism in need of such treatment, comprising administering to such organism: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in the enhancement of pain relief of caffeine. 6. A method according to Claim 5 wherein the composition administered to a mammalian organism in need thereof comprises: (i) an analgesically and anti-inflammatory effective amount of (S)-ibuprofen-(S)-lysine substantially free of (R)-ibuprofen ; and (ii) an amount effective in the enhancement of pain relief of caffeine. 7. A method of eliciting an onset enhanced and hastened response or the treatment of pain and inflammation and the enhancement of pain relief in a mammalian organism in need of such treatment, comprising administering to such organism: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in the enhancement of pain relief of caffeine. 8. A method according to Claim 7 wherein the composition administered to a mammalian organism in need thereof comprises: (i) an analgesically and anti-inflammatory effective amount of (S)-ibuprofen-(S)-lysine substantially free of (R)-ibuprofen ; and (ii) an amount effective in the enhancement of pain relief of caffeine. 9. A method of reducing the side effects associated with the administration of a racemic ibuprofen/caffeine combination which comprises the administration of: (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in the enhancement of pain relief of caffeine. 10. A method according to Claim 9 wherein the composition administered to a mammalian organism in need thereof comprises: (i) an analgesically and anti-inflammatory effective amount of (S)-ibuprofen-(S)-lysine substantially free of (R)-ibuprofen; and (ii) an amount effective in the enhancement of pain relief of caffeine. 11. A method of reducing the size and weight of a pharmaceutically effective amount of an ibuprofen/caffeine combination dosage form which comprises combining (i) an analgesically and anti-inflammatory effective amount of a salt of (S)-ibuprofen substantially free of (R)-ibuprofen wherein the salt is selected from (S)-ibuprofen-(S)-lysine and (S)-ibuprofen-(R)- lysine; and (ii) an amount effective in the enhancement of pain relief of caffeine. 12. A method according to Claim 11 wherein the composition administered to a mammalian organism in need thereof comprises: (i) an analgesically and anti-inflammatory effective amount of (S)-ibuprofen-(S)-lysine substantially free of (R)-ibuprofen ; and (ii) an amount effective in the enhancement of pain relief of caffeine.

Inventors: MCMAHON ROBERT, SIMS ROBERT T, SLIVKA WILLIAM, MCMAHON, ROBERT, SIMS, ROBERT, T., SLIVKA, WILLIAM
Applicants: MCMAHON ROBERT, MCNEIL PPC INC, MERCK & CO INC, SIMS ROBERT T, SLIVKA WILLIAM, MCNEIL-PPC, INC., MERCK & CO., INC.
Application year: 1993
Main classification: A61K9
IPC codes: A61K31, A61P25, A61P29