FIELD OF THE INVENTION
[0001] This invention provides for improved paste formulations suitable for pharmaceutical
and veterinary use as well as the use of these formulations in the preparation of
a medicament for treating various disease states. This invention also provides for
an improved method for manufacturing paste formulations.
BRIEF DESCRIPTION OF THE DRAWINGS
[0002]
Fig. 1 depicts the change of viscosity as a function of increased CAB.O.SIL content
wherein no viscosity modifier was added.
Fig. 2 depicts the impact of the viscosity modifier, PEG 300, on the paste viscosity
of initial and after storage for 6 days at 60°C.
Fig. 3 depicts the schematic representation of the competition of excess PEG molecules
with the crosslinking PEG molecules.
Fig. 4 depicts the sheer sensitivity study of the intermediate product at low sheer.
Fig. 5 depicts the sheer sensitivity study of the end product at high sheer.
Fig. 6 depicts the powder X-ray diffraction (XRPD) pattern of form A.
Fig. 7 depicts the XRPD pattern of form B.
BACKGROUND OF THE INVENTION
[0003] Therapeutic agents are administered to animals and humans by a variety of routes.
These routes include, for example, oral ingestion, topical application or parental
administration. The particular route selected by the practitioner depends upon factor
such as the physiochemical properties of the therapeutic agent, the condition of the
host, and economics.
[0004] One method of formulating a therapeutic agent for oral, topical, dermal or subdermal
administration is to formulate the therapeutic agent as a paste.
[0005] EP 0181525 relates to antelminthic paste compositions containing resonated L-tetramisole or
resonated DL-tetramisole, heavy mineral oil, a non-ionic surfactant, a second active
ingredient, an agent to increase the density of the composition and fumed or participated
silica.
US 5,122,377 relates to a veterinary drug delivery system suitable for oral administration which
comprises a therapeutic agent, a non-volatile oil, silicon dioxide, capric/caprylic
triglyceride and/or capric/caprylic stearic triglyceride.
US 3,746,490 relates to a veterinary paste for horses comprising dimethyldichlorovinylphosphate.
US 5,708,017 relates to an oral paste composition suitable for the delivery of a proton pump inhibitor
to horses. The paste comprises a thickening agent, a basifying agent and a hydrophobic
oily liquid vehicle.
US 4,891,211 relates to a stable, palatable and safe hydrogen peroxide releasing toothpaste or
gel dentrifrice comprising sodium bicarbonate and sodium percabonate in a polyethylene
glycol base. Thickening agents, surfactants, flavouring agents, sweeteners, fluoridating
agents and other conventional adjuvants may also be included in the formulation.
US 4,605,563 relates to compositions comprising 0.1% to 10% by weight of a high melting glyceride
of saturated fatty acids melting above 50°C and 0.2% to 10% by weight of a highly
dispersed pyrogenic silica. The ratio of component is adjusted to obtain a paste consistency.
US 6,017,520 relates to topical compositions containing vitamin E as a penetration enhancing agent
and a solvent selected from the group consisting of mineral oil, water, ethanol, triacetin,
glycerin and propylene glycol, together with a cohesion agent selected from polyisobutylene,
polyvinyl acetate and polyvinyl alcohol. The composition further comprises a thickening
agent. Finally,
WO 00/56346 relates to a stable oil in glycerin emulsion containing at least one oil, at least
one emulsifier and glycerin.
[0006] Pastes have the advantage of being relatively easy to use. The disadvantage associated
with their use is that often these products typically do not retain good chemical
and physical stability over the shelf-life of the product. Hence, there is a need
for improved paste formulations which do not exhibit these undesirable properties.
[0007] One of the causes of these disadvantages is the inclusion of fumed silica as a viscosity
agent. Fumed silica is commercially available and sold, for example, under the trade
names of CAB-O-SIL (Cabot, TD11) and AEROSIL (Degussa, Technical Bulletin Pigments,
No. 11 and No. 49). Fumed silica is an extremely light material (density 0.04 g/ml),
which makes its handling and processing difficult. Moreover, because of its light
density, fumed silica, when mixed with a vehicle, introduces a significant amount
of air into the product. This occurs even at the relatively small amounts (6 to 8%)
typically used to make pastes (6 to 8%). Unless the paste is processed under vacuum
or a deareation step is added at the end of the process, it is not possible to remove
such large amounts of air bubbles from the paste.
[0008] In order to demonstrate the problems associated with using fumed silica such as CAB-O-SIL,
the viscosity of a paste as a function of CAB-O-SIL, content was measured. Fig. 1
depicts the change of viscosity of the paste where no viscosity modifier was added.
Triacetin was used as the vehicle in this study. When the CAB-O-SIT content was less
than 5%, the paste remained thin as a free flow liquid and entrapped air could easily
escape. After 5%, the viscosity increased dramatically and the additional air brought
into the paste by the CAB-O-SIL could not escape and stayed in the paste. When about
7% of CAB-O-SIL was added, the paste had a penetration value of 35 mm. This amount
is comparable with the initial penetration value of other commercially known pastes
such as GASTROGARD (20-40 mm). Hence, in the absence of a viscosity modifier, at least
7% of CAB-O-SIL was needed to make pastes with useful viscosity. Because of the low
density of CAB-O-SIL (0.04 g/ml), the amount of entrapped air is significant. Thus,
unless processing under vacuum or adding a deaeration step at the end, it is impossible
to remove such large amounts of air in the paste and cannot control the accuracy of
the dose.
[0009] Viscosity modifiers include compounds that have two or more functional groups which
are capable of forming hydrogen bonds with the silanols on the surface of the fumed
silica particles. Compounds which function as viscosity modifiers include, for example,
the polyethylene glycols ("PEGs"). These compounds are liquid and solid polymers which
correspond to the general formula H(OCH
2CH
2)
nOH, where n is greater than or equal to 4, and are described in "
The Merck Index", 10th ed., M. Windholz and S. Budavari eds., p. 1092, Merck & Co.,
Inc., Rahway, NJ (1983).
[0010] While not wishing to be bound by theory, in order to understand the mechanism of
the viscosity modifiers, it is necessary to understand how CAB-O-SIL thickens a formulation.
The hydrogen bonds between the silanol groups on the surface of the CAB-O-SIL particles
are responsible for its thickening effect. CAB-O-SIL particles are connected through
these hydrogen bonds to form a three-dimension network. The viscosity modifiers have
two or more functional groups (e.g., -OH or -NH
2). These groups form hydrogen bonds with the silanols on the surface of CAB-O-SIL
particles. These viscosity modifiers act as crosslinkers to extend the network structure
and also increase the crosslinking density. This is why the addition of a small amount
of the viscosity modifiers dramatically increased the viscosity of the pastes.
[0011] In order to demonstrate this, placebo pastes containing 4% CAB-O-SIL and 0.1-3.0%
polyethylene glycol ("PEG") 300 in triacetin were prepared and their viscosity values
were measured using penetrometer (Fig. 2). Before the addition of PEG 300, the viscosity
was too low to be tested on penetrometer (>65 mm). The viscosity jumped dramatically
with just the addition of only 0.1% PEG 300. The viscosity increased further when
more PEG 300 was added. After the PEG level reached 0.5%, the viscosity increase plateaued.
From 0.5-3.0%, the viscosity remained about the same, although a slight decrease in
viscosity was seen when more than 2% PEG was added.
[0012] Fig. 3 depicts what is believed to be happening at the molecular level. Fig. 3 depicts
the competition of excess PEG molecules with the crosslinking PEG molecules at the
molecular level. The figure indicates that the silanol groups on the surface of CAB-O-SIL
particles were saturated when more than 0.5% PEG was added. The extra PEG molecules
could no longer increase the viscosity because it could not find two free silanol
groups on two different particles to increase further the viscosity. On the contrary,
the free PEG molecules actually compete with the bonded PEG molecules that crosslinks
two particles (Fig. 3). As a result, some of the crosslinks dissociate and the viscosity
decreases slightly. Based on Fig. 2, the ideal range of PEG 300 is about 0.2% to about
1.5% for this particular paste.
[0013] Thus, as depicted in Fig. 1, the prior pastes use a relatively high amount of fumed
silica to achieve the proper viscosity. The effect of this is that a large amount
of air will be entrapped into the paste, which causes, for example, dose inaccuracy,
shrinkage, liquid separation (whipping) and discoloration of the paste. Further, the
therapeutic agent may also oxidize. Moreover, when a large amount of fumed silica
is used in an oral paste, the paste imparts a sandy feel to the mouth. This sandy
feel causes the product to be less palatable. Furthermore, the manufacturing costs
to prepare the pastes are expensive because the process must occur under vacuum or
a subsequent deaeration step at the end of the process is required. Additional manufacturing
costs are incurred because fumed silica is relatively expensive and very difficult
to handle due to its extremely low density. The present invention overcomes these
as well as other disadvantages.
SUMMARY OF THE INVENTION
[0014] The present invention provides for a stable paste formulation for a wide range of
veterinary and pharmaceutical products. The present invention also provides for an
improved process to make the inventive paste products. The formulations of the present
invention exhibit good chemical and physical stability over the shelf life and maintain
the chemical integrity, texture, consistency and viscosity over a wide temperature
range. The inventive manufacturing process provides for a simple, fast and economical
process for preparing the inventive paste formulations that avoids heating and cooling
during manufacturing and entrapment of air, a common problem in the manufacturing
of paste dosage forms.
[0015] These and other embodiments are disclosed or are obvious, from and encompassed by,
the following Detailed Description.
DETAILED DESCRIPTION
[0016] The present invention provides for a pharmaceutical or veterinary paste formulation
comprising:
- (a) an effective amount of a therapeutic agent selected from an 8a-azalide, azithromycin
or erythromycin;
- (b) fumed silica;
- (c) a viscosity modifier selected from PEG 200, PEG 300, PEG 400, PEG 600, monoethanolamine,
triethanolamine, glycerol, propylene glycol, polyoxylene sorbitan monoleate and poloxamers;
- (d) a carrier;
- (e) optionally, an absorbent selected from magnesium carbonate, calcium carbonate,
starch and cellulose and its derivatives; and
- (f) optionally, a stabilizer, surfactant, preservative or colorant selected from titanium
dioxide, dye and lake;
wherein the 8a-azalide is of formula I

wherein
- R1
- is hydrogen;
hydroxy;
C1-4 alkoxy;
formyl;
C1-10 alkylcarbonyl, C1-10 alkoxycarbonyl, aryloxycarbonyl, C1-10 aralkoxycarbonyl, C1-10 alkylsulfonyl, or arylsulfonyl wherein said C1-10 alkyl group or aryl group is unsubstituted or substituted by 1-3 halo (F, Cl, Br),
hydroxy, amino, C1-5 acylamino or C1-4 alkyl groups; or
unsubstituted or substituted C1-10 alkyl, C2-10 alkenyl or C2-10 alkynyl wherein said substituents are independently 1-3 of
(a) aryl or heteroaryl optionally substituted by 1-3 halo (F, Cl, Br, I), C1-4 alkyl, C1-3 alkoxy, amino, C1-4 alkylamino, di(C1-4 alkyl) amino or hydroxy,
(b) heterocyclyl optionally substituted by hydroxy, amino, C1-4 alkylamino, di(C1-4 alkyl)amino, C1-4 alkylcarbonyloxy or C1-4 alkylcarbonylamino,
(c) halo (F, Cl, Br or I),
(d) hydroxy optionally, acylated by a group

wherein
R2 is hydrogen, C1-6 alkyl, aryl, heteroaryl, aralkyl, or heteroaralkyl and
Rb is C1-6 alkyl or aryl,
(e) C1-10 alkoxy.
(f) aryloxy or heterocaryloxy optionally substituted by 1-3 halo, hydroxy, amino or
C1-4 alkyl group,
(g) amino or C1-10 alkylamino optionally acylared by a group

or RbSO2, wherein
R2 and
Rb are as defined above,
(g) di(C1-10 alkyl)amino,
(h) arylamino, heteroarylamino, aralkylamino or heteroarylakylamino wherein said aryl
or heteroaryl groups is optionally substituted by 1-3 halo, hydroxy, amino or C1-4 alkyl groups,
(i) mercapto,
(j) C1-10 alkylthio, alkylsulfinyl or alkylsulfonyl, arylthio, arylsulfinyl or arylsulfonyl
wherein said aryl group is optionally substituted by 1-3 halo, hydroxy, amino or C1-4 alkyl groups,
(k) formyl,
(l) C1-10 alkylcarbonyl,
(m)arylcarbonyl, heteroarylcarbonyl, aralkylcarbonyl or heteroarylalkylcarbonyl wherein
said aryl or heteroaryl group is optionally substituted by 1-3 halo, hydroxy, amino
or C1-4 alkyl groups,
(n) carboy,
(o) C1-10 alkoxycarbonyl,
(p) aryloxycarbonyl, heteroaryloxycarbonyl, aralkoxycarbonyl or heteroarylalkoxycarbonyl
wherein said aryl or heteroaryl group is optionally substituted by 1-3 halo, hydroxy,
amino or C1-4 alkyl groups,
(q) carbamoyl or sulfamoyl wherein the N-atom is optionally substituted by 1-2 C1-6 alkyl groups or by a C4-6 alkylene chain,
(r) cyano,
(s) isonitrilo,
(t) nitro,
(u) azido,
(v) iminomethyl optionally substituted on nitrogen or carbon with C1-10 alkyl,
(w) oxo, or
(x) thiono;
wherein said alkyl chain, if more than two carbons in length, can be optionally interrupted
by 1-2 oxa, thia or aza (-NR-wherein R is hydrogen or C1-3 alkyl) groups.
- R10
- is hydrogen or
- R1 and R10
- together are C1-C3 alkylene optionally substituted by an oxo group;
- R1 and R4
- together are C1-C3 alkylene optionally, substituted by an oxo, group
- R2 and R3
- are hydrogen, C1-10 alkyl, aryl
- R2 and R3
- together are oxo and thiono;
- R4 and R5
- are independently hydrogen and alkylcarbonyl;
- R4 and R5
- are together carbonyl;
- R6 and R7
- are both hydrogen or one of R6 and R7 is hydrogen and the other is hydroxy, an acyloxy derivative taken from the group
consisting of formyloxy, C1-10 alkylcarbonyloxy, arylcarbonyloxy and aralkylcarbonyloxy, or
-NHR12 wherein R13 is hydrogen, arylsulfonyl or heteroarylsulfonyl optionally substituted by is halo
or C1-3 alkyl groups, alkylsulfonyl, or

where
X is a connecting bond, O or NH,
A is connecting bond or C1-C3 alkylene
- R13
- is hydrogen, C1-C10 alkyl, aryl, aralkyl, heteroaryl, heterocyclyl, or C3-C7 cycloalkyl, any of which R13 groups other than hydrogen can be substituted by one or more of halogen, hydroxyl,
C1-C3 alkoxy, cyano, isonitrilo, nitro, amino, mono- or di-(C1-C3)alkylamino, mercapto, C1-C3 alkylthio, C1-C3 alkylsulfinyl, C1-C3 alkylsulfonyl, arylthio, arylsulfinyl, sulfamoyl, arylsulfonyl, carboxy, carbamoyl,
C1-C3 alkylcarbonyl, or C1-C3 alkoxycarbonyl;
- R6 and R7
- are together oxo, hydroxyimino, alkoxyimino, aralkoxyimino or aminoimino;
- R8
- is methyl, aralkoxycarbonyl, and arylsulfonyl;
- R9
- is hydrogen, formyl, C1-10 alkylcabonyl, C1-10 alkoxycarbonyl, and arylalkoxycarbonyl;
m and n are independently integers of zero or one; and said metal complex is taken
from the group consisting of copper, zinc, cobalt, nickel and cadmium or a pharmaceutically
acceptable salt, ester or metal complex thereof.
[0017] The invention further relates to the use of a paste as described above in the preparation
of a medicament for treating a bacterial infection in a host in need thereof.
[0018] Additionally, the compounds can be administered in combination with other insecticides,
parasiticides, and acaricides. Such combinations include anthelmintic agents, which
include ivermectin, avermectin, and emamectin, as well as other agents such as thiabendazole,
febantel or morantel; phenylpyrazoles such as fipronil; and insect growth regulators
such as lufenuron. Such combinations are also contemplated in the present invention.
[0019] In one preferred embodiment, the therapeutic agent is erythromycin.
[0020] Erythromycin (MW 733.94 daltons) is the common name for a macrolide antibiotic produced
by the growth of a strain of Streptomyces erythreous. It is a mixture of three erythromycins.
A. B and C consisting largely of erythromycin A which is represented by the formula:

[0021] Its chemical name is (3R*,4S*,5S*,6R*,7R*,9R*,11R*,12R*, 13S*,14R*)-4-[(2,6-dideoxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyranosyl)-oxy]-14-ethyl-7,12,13-trihydroxy-3,5,7,9,11,13-hexamethyl-6[[3,4,6-trideoxy-3-(dimethylamino)-β-D-xylo-hexapyranosyl]oxy]oxacyclotetradecane-2,10-dione,
(C
37H
67NO
13).
[0022] Erythromycin has a broad and essentially bacteriostatic action against many Gram-positive
and some Gram-negative bacteria as well as other organisms including mycoplasmas,
spirochetes, chlamydiae and rickettsiae. In humans, it finds usefulness in the treatment
of a wide variety of infections. It finds wide application in veterinary practice
in the treatment of infectious diseases such as pneumonias, mastitis, metritis, rhinitis,
and bronchitis in, for example, cattle, swine and sheep.
[0023] Other derivatives of erythromycins include carbomycin, clarithromycin, josamycin,
leucomycins, midecamycins, mikamycin, miokamycin, oleandomycin, pristinamycin, rokitamycin,
rosaramicin, roxithromycin, spiramycin, tylosin, troleandomycin, and virginiamycin.
As with the erythromycins, many of these derivatives exist as component mixtures.
For example, carbomycin is a mixture of carbomycin A and carbomycin B. Leucomycin
exists as a mixture of components A
1, A
2, A
3, A
9, B
1-B
4, U and V in various proportions. Component A
3 is also known as josamycin and leucomycin V is also known as miokomycin. The major
components of the midecamycins is midecamycin A and the minor components are midecamycins
A
2, A
3 and A
4. Likewise, mikamycin is a mixture of several components, mikamycin A and B. Mikamycin
A is also known as virginiamycin M
1. Pristinamycin is composed of pristinamycins I
A, I
B, and I
C, which are identical to virginiamycins B
2, B
13 and B
2 respectively, and pristinamycin II
A and II
B, which are identical to virginiamycin M
1 and 26,27-dihydrovirginiamycin M
1. Spiramycin consists of three components, spiromycin I, II, and III. Virginiamycin
is composed of virginiamycin S
1 and virginiamycin M
1. All these components may be used in this invention. Sources of these macrolides
are well known to the practitioner and are described in the literature in references
such as "The Merck Index," 12th ed., S. Budarari, ed., Merck & Co., Inc., Whitehouse
Station, NJ (1996).
[0024] These compounds are disclosed in
EP 568 699. Azalides as a class of components is well-known in the art and further derivatives
are described, for example, in
U.S. Patent Nos. 5,869,629;
5,629,296;
5,434,140;
5,332,807;
U.S. 5,250,518;
5,215,890; and
5,210,235, all incorporated herein by reference.
[0025] In one preferred embodiment, the therapeutic agent is azithromycin. The structure
of azithromycin is

[0026] In another preferred embodiment, the therapeutic agent is an 8a-azalide selected
from a compound of formula I,

wherein Des is desosomine and Clad is cladinose, and a compound of formula II,

[0027] The compound of formula II are also known as 8a-azalide. These compounds are disclosed
in
EP 508 699. The corresponding basic and acid addition salts and ester derivatives of the macrolides,
including the azalides compounds, are also contemplated. These salts are formed from
the corresponding organic or inorganic acids or bases. These derivatives include the
customary hydrochloride and phosphate salts as well as the acetate, propionate and
butyrate esters. These derivatives may have different names. For example, the phosphate
salt of oleandomycin is matromycin and the triaceyl derivative is troleandomycin.
Rokitamycin is leucomycin V 4-B-butanoate, 3B-propionate.
[0028] The term "therapeutic agent," also includes the pharmaceutically or veterinary acceptable
acid or base salts, where applicable, of these compounds. The term "acid" contemplates
all pharmaceutically or veterinary acceptable inorganic or organic acids. Inorganic
acids include mineral acids such as hydrohalic acids, such as hydrobromic and hydrochloric
acids, sulfuric acids, phosphoric acids and nitric acids. Organic acids include all
pharmaceutically or veterinary acceptable aliphatic, alicyclic and aromatic carboxylic
acids, dicarboxylic acids tricarboxylic acids and fatty acids. Preferred acids are
straight chain or branched, saturated or unsaturated C
1-C
20 aliphatic carboxylic acids, which are optionally substituted by halogen or by hydroxyl
groups, or C
6-C
12 aromatic carboxylic acids. Examples of such acids are carbonic acid, formic acid,
fumaric acid, acetic acid, propionic acid, isopropionic acid, valeric acid, α-hydroxy
acids, such as glycolic acid and lactic acid, chloroacetic acid, benzoic acid, methane
sulfonic acid, and salicylic acid. Examples of dicarboxylic acids include oxalic acid,
malic acid, succinic acid, tataric acid and maleic acid An example of a tricarboxylic
acid is citric acid. Fatty acids include all pharmaceutically or veterinary acceptable
saturated or unsaturated aliphatic or aromatic carboxylic acids having 4 to 24 carbon
atoms. Example include butyric acid, isobutyric acid, see-butyric acid, lauric acid,
palmitic acid, stearic acid, oleic acid, linoleic acid, linolenic acid, and phenylsteric
acid, Other acids include gluconic acid, glycoheptonic acid and lactobionic acid.
[0029] The term "base" contemplates all pharmaceutically or veterinary acceptable inorganic
or organic bases. Such bases include, for example, the alkali metal and alkaline earth
metal salts, such as the lithium, sodium, potassium, magnesium or calcium salts. Organic
bases include the common hydrocarbyl and heterocyclic amine salts, which include,
for example, the morpholine and piperidine salts.
[0030] The ester and amide derivatives of these compounds, where applicable, are also contemplated.
Specific compounds which belong to these classes of therapeutic agents are well known
to the practitioner of this art.
[0031] An important feature of the present invention is the combustion of a viscosity modifier
to the formulation. The addition of the viscosity modifier provides for a paste formulation
which contains less fumed silica than the amount normally used in a conventional paste.
The inventive formulation allows for all the air that is introduced into the formulation
by the fumed silica to escape when the viscosity is low. The viscosity modifier is
then added to bring the viscosity of the paste to the desired level without the introduction
of more air into the final product. While not wishing to be bound by theory, it is
believed that because of their functional groups, the viscosity modifiers act as crosslinkers
and extend the three-dimensional network formed by the interaction of the silica and
the hydrophobic carrier. The viscosity modifiers also extend the crosslinking density
in the formulation.
[0032] Especially preferred hydroxy-containing viscosity modifiers include PEG 200, PEG
300, PEG 400, and PEG 600. Other hydroxyl-containing viscosity modifiers include block
copolymer mixtures of polyoxyalkylene compounds, i.e., poloxamers including ethylene
oxide and propylene oxide poloxamer mixtures, such as those described in
U.S. Patent Nos. 4,343,785;
4,465,663;
4,511,563; and
4,476,107. Commercial versions of these nonionic poloxamer surfactants are available from BASF
- Wyandotte Co., Wyandotte, Mich. and include various Pluronics such as Pluronic L81,
Pluronic F108, and F127 and those Pluronics described in "
Pluronic & Tetronic Surfactants", BASF Corp., 1987, as well as in "
The Merck Index", 10th ed. on page 1090 and in Remington Pharmaceutical Science. Other suitable density modifiers useful
as of the present invention include: polyoxyethylene sorbit in monoleate (Polysorbate
80); polyethylene glycols (Pluracols); nonylphenol ethoxylates (Surfonics); and linear
alcohol ethoxylates polyethyleneglycol paraisooctyphenyl/ethers (Tritons's).
[0033] Propylene glycol mono- and di-fatty acid esters are also provided for in the inventive
formulations. These esters include for example, propylene glycol dicaprylate; propylene
glycol dilaurate, propylene glycol hydroxystearate, propylene glycol isostearate,
propylene glycol laurate, propylene glycol ricinoleate, and propylene glycol stearate,
most preferably propylene glycol caprylic-capric acid diester as is available under
the Trade Name MIGLYOL 840.
[0034] Other compounds which function as viscosity modifiers are those which contain both
hydroxy and amino function groups. Such compounds include, for example, monoethanolamine,
diethanolamine and triethanolamine. These compounds, as well as their use, are well
known to a practitioner in the pharmaceutical and veterinary arts.
[0035] The amount of viscosity modifier varies from formulation to formulation and the determination
of the amount required is well within the routine skill of a practitioner in the formulation
an. Preferred is about 0.01 to about 20% of viscosity modifier, based upon total weight
of the composition. An especially preferred amount is about 0.05 to about 5%, with
about 0.1 to about 2% being most preferred.
[0036] Fumed silica is used as the thickening agent. In the pastes according to this invention,
the amount of fumed silica is very low. This allows an intermediate with a low viscosity,
which in turn allows for a quick escape of the air by buoyancy. After letting the
intermediate settle for about 10 minute, no air was detected in the intermediate.
Preferred pastes comprise from about 1 to about 20%, based upon total weight of solution,
with from about 1% to about 6% being preferred. Amounts of about 0.02% to about 20%,
about 1% to 6.5% or about 1 to about 4% or 5% are also preferred. A paste where the
amount of silica is about 4.25% is especially preferred.
[0037] The carrier is another important component of the formulation. It is the liquid phase
that dissolves the active drug to give an excellent content uniformity and bioavailability.
Compounds which act as carriers include solvents that are suitable for pharmaceutical
applications, such as triacetin, short to medium chain mono-, di-, or tri-glycerides,
glycerin, water, propylene glycol, N-methyl pyrrolidinone, glycerol formal, polyethylene
glycol, polyethylene glycol-polypropylene glycol polyethylene glycol tri-block copolymers,
vegetable oil, sesame oil, soybean oil, corn oil, mineral oil, peanut oil, castor
oil, cotton oil, transcutol, benzyl alcohol, N,N-dimethylformamide, dimethylsulfoxide,
or the like. These compounds may be used alone or as mixtures. Triacetin is especially
preferred as it has some water solubility that allows an easy cleaning of the manufacturing
equipment. Unlike some aqueous based pastes, triacetin does not support microbial
growth, which eliminates the need for a preservative. Mixtures of other carriers with
triacetin are also preferred. The amount and type of hydrophobic carrier for a particular
formulation is well within the skill level of the practitioner.
[0038] When present, any of the conventional pharmaceutical or veterinary colorants may
be used. Such colorants include, for example, dyes, aluminum lakes, colorants based
upon iron oxide, caramel or combinations of various colorants. Preferably up to about
20%, by weight of total composition, may be present with about 0.001 or 0.01% to about
10% and 0.001 to about 4% being most preferred.
[0039] Absorbents may also be added to the paste formulation. Such compounds are well known
in the art to the practitioner as well as their use in pastes. These compounds effectively
prevent or alleviate the phase separation of the product during storage. Preferred
absorbents include magnesium carbonate, calcium carbonate, starch, cellulose and its
derivatives, or mixtures of absorbents with magnesium carbonate being especially preferred.
The inclusion of these compounds is optional with amounts of 0% to about 30%, 0 to
about 15% or about 1% to about 15% or about 1% to about 10%, based on total weight
of the composition being especially preferred.
[0040] In addition to the therapeutic agent, the viscosity modifier, and the carrier, the
formulation can contain other inert ingredients such as antioxidants, preservatives,
stabilizers or surfactants. These compounds are well known in the formulation art.
Antioxidants such as an alpha tocopheral, ascorbic acid, ascrobyl palmitate, fumeric
acid, malic acid, sodium ascorbate, sodium metabisulfate, n-propyl gallate, BHA (butylated
hydroxy anisole), BHT (butylated hydroxy toluene) monothioglycerol and the like, may
be added to the present formulation. The antioxidants are generally added to the formulation
in amounts of from about 0.01 to about 2.0%, based upon total weight of the formulation.
Preservatives such as the parabens (methylparaben and/or propylparaben) are suitably
used in the formulation in amounts ranging from about 0.01 to about 2.0%. Other preservatives
include benzalkonium chloride, benzethonium chloride, benzoic acid, benzyl alcohol,
bronopol, butylparaben, cetrimide, chlorhexidine, chlorobutanol, chlorocresol, cresol,
ethylparaben, imidurea, methylparaben, phenol, phenoxyethanol, phenylethyl alcohol,
phenylmercuric acetate, phenylmercuric borate, phenylmercuric nitrate, potassium sorbate,
sodium benzoate, sodium propionate, sorbic acid, thimerosal, and the like.
[0041] Surfactants can also be added to help solubilize the active drug, to prevent crystallization,
and to prevent phase separation. Some examples of the surfactants are: glyceryl monooleate,
polyoxyethylene sorbitan fatty acid esters, sorbitan esters, polyvinyl alcohol, Pluronics,
sodium lauryl sulfate, etc. Again, these compounds, as well as their amounts are well
known in the art.
[0042] In one highly preferred embodiment, the paste formulation of the invention, based
upon total weight of composition, comprises:
- (a) about 0.01 to about 50% of the therapeutic agent;
- (b) about 0.02 to about 20% of fumed silica;
- (c) about 0.01 to about 20% of a viscosity modifier;
- (d) 0% to about 30% of an absorbent;
- (e) 0% to about 20% of a colorant; and
- (f) Q.S. a carrier.
[0043] The instant formulation is equally applicable to other compounds used for pastes
as long as such compounds are soluble in the carrier. Additional compounds that can
be used in this formulation are other antiparasitic agents and antibiotics, therapeutic
vitamin and mineral supplements, and other agents that are assisted in their therapeutic
effect by having improved stability over a prolonged period of time. Again, such compounds
would be well know to the practitioner.
[0044] The pastes are administered to warm-blooded animals, such as humans, cattle, sheep,
pigs, cats, dogs, horses, and the like, by oral, topical, dermal and subdermal administration.
The inventive pastes may also be administered to humans. The amount of therapeutic
agent depends on the individual therapeutic agent, the animal being treated, the disease
state, and the severity of the disease state. The determination of those factors is
well within the skill level of the practitioner. Generally, such preparation normally
contain about 0.0005 to about 50% of therapeutic agent by total weight of composition.
Preferred formulations are those containing about 0.01 to 10% of therapeutic agent
and especially preferred 2.5 to about 5% w/v. However depending upon the activity
of the compound and the animal being treated, doses as low as about 0.3% of the active
ingredient are usable. For nodulisporic acid and its derivatives, a formulation containing
about 0.0005 to about 5% of the active compound is preferred.
[0045] The present invention also provides for a process to prepare paste formulations which
is easier and relatively inexpensive. Because fumed silica is a relatively expensive
and difficult to handle material, the use of a density modifier reduces the overall
cost of the product and minimizes the material handling issue. The manufacturing process
is described as follows:
- 1. In a proper mixer, charge all or a portion of the carrier. Add the active drug
and mix it until all of the drug is dissolved.
- 2. Add the colorant and magnesium carbonate, if necessary. Apply appropriate mixing
action to uniformly disperse the titanium dioxide and magnesium carbonate.
- 3. Add fumed silica to the mixer in a single charge or in portions. Apply appropriate
mixing action to uniformly disperse the fumed silica.
- 4. Add the remaining portion of the triacetin to the mixer. Apply appropriate mixing
action to produce a uniform intermediate.
- 5. Let the intermediate settle for a proper amount of time to let the air that was
entrapped with the addition of fumed silica to escape.
- 6. Add the viscosity modifier and mix until a uniform paste product is produced.
[0046] In comparison, with the process to prepare prior paste products, such as EQVALAN
paste and GASTROGARD paste, which are manufactured using different formulations and
processes, this invention has the following advantages - First, the process is much
simpler. A 300 kg batch can be made in less than 2 hours, while 5 hours or more are
needed for EQVALAN and GASTROGARD pastes. Second, no heating or cooling is required
during the manufacturing of this product, which lowers the equipment demand and cost.
Many other paste products require heating and/or cooling. Third, this product is not
very shear-sensitive. During manufacturing, over mixing of the inventive pastes, to
a certain extent, has little effect on the final consistency of the product. This
robustness provides for a forgiving manufacturing process. Many other paste products
are shear sensitive and careful manufacturing parameter must be maintained to assure
product quality. Fourth, the inventive pastes exhibit little temperature sensitivity.
Extended storage under accelerated storage condition showed little physical or chemical
change. While many other paste products change the viscosity, and/or dry out, and/or
separate significantly when stored under high (e.g. 60°C)/or low (e.g. -20°C) temperature
conditions.
[0047] The inventive paste formulations may be used to treat a number of disease states
by administering to the host in need thereof an effective amount of the paste containing
the therapeutic agent. The determining of a treatment protocol of a specific indication
would he well within the skill level of a practitioner in the pharmaceutical or veterinary
arts. Disease states which may be treated by the inventive formulations include, for
example, treating inflammation, treating osteoarthritis and rheumatoid arthritis pain
or fever, treating or preventing insect or parasitic infestations, treating or preventing
bacterial infections: or inhibiting excess acid secretions in the stomach for treating
stomach ulcers. The hosts include all animals. e.g. cats, dogs, cattle, sheep, horses,
pigs, and humans.
EXAMPLES
[0048] A better understanding of the present invention and of its many advantages will be
had from the following examples, given by way of illustration.
Example 1
[0049] The penetration value of placebo pastes were determined in order to demonstrate the
ability of the viscosity modifier to increase the viscosity of the paste at low values
of fumed silica. Penetration pastes containing 4% CAB-O-SIL and 0.25% to 2% of a viscosity
modifier were prepared in a mixed vehicle (triacetin: miglyol 840). The penetration
values of the resulting composition are listed below.
Table 4 Penetration value of placebo paste (mm)
| Viscosity modifier |
Initial |
10 days at 50°C |
1 month at 50°C |
| MEA 0.25% |
23.4 |
22.7 |
23.7 |
| MEA 0.5% |
25.2 |
25.8 |
25.3 |
| MEA 1.0% |
24.3 |
22.7 |
21.9 |
| MEA 1.5% |
28.1 |
23.8 |
26.2 |
| TEA 0.5% |
25.6 |
21.9 |
20.7 |
| Tween 80 1% |
32.0 |
20.5 |
21.2 |
| PEG 300 1% |
33.4 |
26.6 |
26.5 |
| PEG 300 2% |
38.4 |
26.1 |
29.1 |
| Pluronic L81 1% |
43.9 |
27.0 |
27.0 |
| None |
Too thin to be tested (>65) |
38.9 |
42.2 |
| After two months storage at room temperature pastes changed to pale yellow when MEA
was added. Degree of yellowish: MEA 1.5%> MEA 1.0%> MEA 0.5%> MEA 0.25%. No significant
color change in pastes with other additives. Also paste with MEA had an acidic small,
while other pastes did not have. |
[0050] In the table. MEA is the abbreviation for monoethanolamine and TEA is the abbreviation
for triethanolamine. The results demonstrate that the viscosity modifiers have the
ability to increase dramatically the viscosity of the placebo paste at low CAB-O-SIL
levels. The results in Table 6 also demonstrate that the viscosity of all the pastes
increased slightly over time. This result is consistent with the data presented in
Fig. 2 which demonstrate that after storage for 6 days at 60°C the viscosity increased
slightly. From this data, one would expect that this increase would stop after a few
days.
Example 2
[0051] The physical stabilities of three pastes according to the present invention were
prepared and placed into a 6.1 ml white syringe. The formulations were as fellows:
Table 5 Paste formulation containing the COX-2 inhibitor, formula III (not within
the scope of the claims)
| |
Formula A |
Formula B |
Formula C |
| Cox-2 inhibitora |
1.16% |
11.16% |
1.16% |
| CAB-O-SIL |
3.5% |
4.0% |
4.0% |
| PEG 300 |
---- |
1.0% |
1.0% |
| Monoethanolamine |
0.2%% |
---- |
---- |
| Titanium Dioxide |
---- |
2.0% |
---- |
| Triacetin |
QS |
QS |
QS |
| a 3-(cyclopropylmethoxy)-5,5-dimethyl-4-(4-methylsulfonyl)phenyl)-5H-furan-2-one. |
a. Chemical Stability
[0052] The chemical stability of these formulations was tested over accelerated storage
conditions. The results of these tests are provided below in Table 4.
Table 6 Chemical stability of paste formulation containing the Cox-2 inhibitor. 3-(cyclopropylmethoxy)-5,5-dimethyl-4-(4-methylsulfonyl)phenyl)-5H-furan-2-one.
| |
% of initial after 10 days at 60°C |
% of initial after 4 weeks at 60°C |
% of initial after 4 weeks at 40°C |
% of initial after 4 weeks at 40°C/75% RH |
| Formula A |
99.3% |
101% |
|
|
| Formula B |
98.3% |
99.4% |
99.0% |
99.0% |
| Formula C |
99.4% |
99.4% |
|
|
From these data one may conclude that the inventive formulations would be stable for
a shelf life of two years.
b. Viscosity
[0053] Most semi-solie products change viscosity over storage. A useful product viscosity
needs to be maintained throughout the shelf-life of a product to ensure animal acceptance
and ease of use. Since the viscosity usually changes more and faster under higher
temperature, the viscosity change of Formulation A and B was studied at 60°C (Table
7).
Table 7 Viscosity change of Formulation A and B under accelerated storage conditions.
| |
Initial |
1 wk 60°C |
4 wk 60°C |
4 wk 40°C |
4 wk 40°C/75% RH |
| Formulation A |
22.8 |
22.9 |
22.9 |
|
|
| Formulation B |
23.7 |
17.7 |
15.2 |
18.5 |
18.7 |
[0054] Formulation A used MEA as the viscosity modifier and showed almost no change in viscosity
after even 4 weeks at 60°C. Formulation B used PEG 300 as the viscosity modifier and
had a slight increase in viscosity after 4 weeks at 60°C and this increase is expected
to stop after longer storage. The viscosity change under 40°C/75% RH was similar to
that of 40°C. indicating that the humidity had no impact on paste viscosity. In contrast
to Eqvalan or Gastrogard pastes, where Thixcin R was used as the thickener and their
viscosity increased from 20-40 mm to 6 mm after 4 weeks at 60°C. the viscosity increase
in these formulations is insignificant.
[0055] The viscosity of these pastes at extreme use temperature has not been measured. But
based on visual observation, these pastes had good consistency at a wide temperature
range.
c. Whipping
[0056] Slight phase separation: comparable to that of GASTROGARD, was observed in all three
formulations, with Formulation B having slightly less separation.
d. Shrinkage and Discoloration
[0057] Discoloration was not seen in pastes except those using MEA as the viscosity modifier.
Formulation A (containing 0.20% MEA) changed to slightly yellow but still clear. This
slight discoloration is known for MEA and it has no impact on the drug.
[0058] No shrinkage occurred to all three formulations.
e. Air Entrapment
[0059] No air entrapment was noticed in the pastes.
Example 3.
[0060] Table 8 lists the concentrations of placebo pastes prepared in order to investigate
whipping:
Table 8 Placebo Pastes
| Formula D |
Formula E |
Formula F |
| 4% CAB-O-SIL |
4.5% CAB-O-SIL |
5% CAB-O-SIL |
| 1% PEG 300 |
1% PEG 300 |
1% PEG |
| 1% MgCO2 |
-- |
-- |
| 94% Triacetin |
94.5% Triacetin |
94% Triacetin |
Whipping (phase separation) in all these pastes was reduced with whipping almost unnoticeable
in formula D.
Example 4
[0061] The viscosity change of these two pastes under accelerated conditions is shown in
Table 9
Table 9 Viscosity change of placebo pastes containing 1% PEG 300 and different amounts
of CAB-O-SIL under accelerated storage condition.
| Formulation |
CAB-O-SIL content |
Initial (mm) |
6 days at 60°C |
14 days at 60°C |
| D |
4.0% |
34.2 |
27.4 |
---- |
| E |
4.5% |
23.9 |
18.4 |
18.8 |
| F |
5.0% |
21.1 |
13.0 |
11.9 |
The paste of Formula F with 5% CAB-O-SIL seemed to be unnecessarily over-thickened.
The paste of Formula E with 4.5% CAB-O-SIL was better balanced with respect to viscosity
and whipping. Moreover, Formula E seemed to provide the best viscosity over storage.
Example 5
[0062] The following paste was prepared according to the process of the present invention.
Table 10 formulation example with a COX-2 inhibitor (not within the scope of the claims)
| Ingredient |
Composition in the specific example |
| COX-2 inhibitora |
0.82% |
| Titanium dioxide |
10.2% |
| Magnesium carbonate |
12% |
| Fumed silica |
4.25% |
| Polyethylene Glycol (PEG) 300 |
0.4% |
| Triacetin |
QS |
| a 3-(cyclopropylmethoxy)-5,5-dimethyl-4-(4-methylsulfonyl)phenyl)-5H-furan-2-one. |
[0063] A portion of the triacetin was charged into a mixer followed by the addition of the
COX-2 inhibitor. The compounds were mixed until all the drug was dissolved. Next,
titanium dioxide and magnesium carbonate were added. Mixing continued until the titanium
dioxide and magnesium carbonate were uniformly dispersed. Subsequent to this fumed
silica was added to the mixer and mixing occurred until the fumed silica was uniformly
dispersed. The remaining portion of the triacetin to the mixer. Mixing occurred until
a uniform intermediate was obtained. The intermediate was allowed to settle for 10
minutes until the air that was entrapped with the addition of fumed silica escaped.
PEG was added and mixing occurred until a uniform paste product was produced.
Example 6
[0064] The following paste was prepared using a process similar to that of Example 5. A
uniform paste was obtained.
Table 11 Formulation example with a COX-2 inhibitor (not within the scope of the claims)
| Ingredient |
Composition in the specific example |
| COX-2 Inhibitora |
1.64% |
| FD&C Blue #1. aluminum lake |
0.005% |
| Magnesium carbonate |
2% |
| Fumed silica |
4.25% |
| Polyethylene Glycol (PEG) 300 |
0.4% |
| Triacetin |
QS |
| a3-(cyclopropylmethoxy)-3,5-dimethyl-4-(4-methylsulfonyl)phenyl)-5H-furan-2-one. |
Example 7
[0065] The following paste was prepared using a process similar to that in Example 6. A
uniform paste was obtained.
Table 12 Formulation example with a COX-2 inhibitor (not within the scope of the claims)
| Ingredient |
Composition in the specific example |
| COX-2 inhibitora |
2.5% |
| Titanium dioxide |
1% |
| Fumed silica |
4% |
| Monoethanolamine |
1.0% |
| Triacetin |
50% |
| Miglyol 840 |
QS. |
| a 3-(cyclopropylmethoxy)-5,5-dimethyl-4-(4-methylsulfonyl)phenyl)-5H-furan-2-one. |
Example 8
[0066] In order to test the robustness of the paste obtained by the inventive process a
placebo paste was prepared by the following process:
- 1. Charge triacetin. Turn on the mixing screw and chopper until the drug is completely
dissolved.
- 2. Stop mixer, add titanium dioxide and turn on the chopper to disperse.
- 3. Stop the mixer, add CAB-O-SIL in several portions to the mixer. After each portion
is added, turn on the mixer to wet the powder.
- 4. After all CAB-O-SIL is added, mix until uniform.
- 5. Stop mixer and wait for 10 minutes to let air escape.
- 6. Add magnesium carbonate. Add the remaining triacetin and PEG 300 to the mixer.
Turn on mixing screw to mix until uniform.
[0067] To determine the robustness of the paste obtained by the inventive process, the intermediate
sample (4% CAB-O-SIL in triacetin) at step 5 was tested with Brookfield viscometer
(Fig. 4). Its viscosity seems to be not very sensitive to the low shear testing condition.
As shown in Fig. 4, the viscosity remained almost constant throughout the course of
a 5 minute measuring in the testing container. To evaluate the shear sensitivity of
the end product, the final paste at step 6 was subjected to high shear using a homogenizer
at 2500 rpm. Samples were collected at different time intervals and tested using Brookfield
viscometer and penetrometer (Fig. 5). Both the Brookfield testing and penetrometer
testing of the initial end product and the aged end product at 60°C demonstrated that
the paste at step 6 were only a little sensitive to shear. Based on these data, we
conclude that over-mixing during production should not have much impact on the paste
viscosity.
Example 9 : Conversion of polymorph A to polymorph B by stirring in methanol without seeding
[0068] To a 5 ml flask was added 1 g of methanol and 1.5 g of polymorph A.
[0069] The agitation was maintained at room temperature for 50 minutes. All polymorph A
had converted to polymorph B after this time. The results on the polymorphic form
were confirmed by X-Ray diffraction.
[0070] The polymorphic B form may be formulated as described in examples 5-7.
[0071] The above description of the invention is intended to be illustrative and not limiting.
Various changes or modifications in the embodiment described may occur to those skilled
in the art. These can be made without departing from the scope of the claims.
1. A pharmaceutical or veterinary paste formulation comprising:
(a) an effective amount of a therapeutic agent selected from an 8a-azalide, azithromycin
or erythromycin;
(b) fumed silica;
(c) a viscosity modifier selected from PEG 200, PEG 300, PEG 400, PEG 600, monoethanolamine,
triethanolamine, glycerol, propylene glycol, polyoxylene sorbitan monoleate and poloxamers;
(d) a carrier;
(e) optionally, an absorbent selected from magnesium carbonate, calcium carbonate,
starch and cellulose and its derivatives; and
(f) optionally, a stabilizer, surfactant, preservative or colorant selected from titanium
dioxide, dye and lake;
wherein the 8a-azalide is of formula I

wherein
R1 is hydrogen;
hydroxy;
C1-4 alkoxy;
formyl;
C1-10 alkylcarbonyl, C1-10 alkoxycarbonyl, aryloxycarbonyl, C1-10 aralkoxycarbonyl, C1-10 alkylsulfonyl, or arylsulfonyl wherein said C1-10 alkyl group or aryl group is unsubstituted or substituted by 1-3 halo (F, Cl, Br),
hydroxy, amino, C1-5 acylamino or C1-4 alkyl groups; or
unsubstituted or substituted C1-10 alkyl, C2-10 alkenyl or C2-10 alkynyl wherein said substituents are independently 1-3 of
(a) aryl or heteroaryl optionally substituted by 1-3 halo (F, Cl, Br, I), C1-4 alkyl, C1-3 alkoxy, amino, C1-4 alkylamino, di(C1-4 alkyl) amino or hydroxy,
(b) heterocyclyl optionally substituted by hydroxy, amino, C1-4 alkylamino, di(C1-4 alkyl)amino, C1-4 alkylcarbonyloxy or C1-4 alkylcarbonylamino,
(c) halo (F, Cl, Br or I),
(d) hydroxy optionally, acylated by a group

wherein
Ra is hydrogen, C1-6 alkyl, aryl, heteroaryl, aralkyl, or heteroaralkyl and
Rb is C1-6 alkyl or aryl,
(e) C1-10 alkoxy.
(f) aryloxy or heteroaryloxy optionally substituted by 1-3 halo, hydroxy, amino or
C1-4 alkyl group,
(g) amino or C1-10 alkylamino optionally acylared by a group

or RbSO2, wherein
Ra and
Rb are as defined above,
(g) di(C1-10 alkyl)amino,
(h) arylamino, heteroarylamino, aralkylamino or heteroarylalkylamino wherein said
aryl or heteroaryl groups is optionally substituted by 1-3 halo, hydroxy, amino or
C1-4 alkyl groups,
(i) mercapto,
(j) C1-10 alkylthio, alkylsulfinyl or alkylsulfonyl, arylthio, arylsulfinyl or arylsulfonyl
wherein said aryl group is optionally substituted by 1-3 halo, hydroxy, amino or C1-4 alkyl groups,
(k) formyl,
(l) C1-10 alkylcarbonyl,
(m)arylcarbonyl, heteroarylcarbonyl, aralkylcarbonyl or heteroarylalkylcarbonyl wherein
said aryl or heteroaryl group is optionally substituted by 1-3 halo, hydroxy, amino
or C1-4 alkyl groups,
(n) carboxy,
(o) C1-10 alkoxycarbonyl,
(p) aryloxycarbonyl, heteroaryloxycarbonyl, aralkoxycarbonyl or heteroarylalkoxycarbonyl
wherein said aryl or heteroaryl group is optionally substituted by 1-3 halo, hydroxy,
amino or C1-4 alkyl groups,
(q) carbamoyl or sulfamoyl wherein the N-atom is optionally substituted by 1-2 C1-6 alkyl groups or by a C4-6 alkylene chain,
(r) cyano,
(s) isonitrilo,
(t) nitro,
(u) azido,
(v) iminomethyl optionally substituted on nitrogen or carbon with C1-10 alkyl,
(w) oxo, or
(x) thiono;
wherein said alkyl chain, if more than two carbons in length, can be optionally interrupted
by 1-2 oxa, thia or aza (-NR- wherein R is hydrogen or C
1-3 alkyl) groups.
R10 is hydrogen or
R1 and R10 together are C1-C3 alkylene optionally substituted by an oxo group;
R1 and R4 together are C1-C3 alkylene optionally, substituted by an oxo, group
R2 and R3 are hydrogen, C1-10 alkyl, aryl
R2 and R3 together are oxo and thiono;
R4 and R5 are independently hydrogen and alkylcarbonyl;
R4 and R5 are together carbonyl;
R6 and R7 are both hydrogen or one of R6 and R7 is hydrogen and the other is hydroxy, an acylox y derivative taken from the group
consisting of formyloxy, C1-10 alkylcarbonyloxy, arylcarbonyloxy and aralkylcarbonyloxy, or
-NHR12 wherein R12 is hydrogen, arylsulfonyl or heteroarylsulfonyl optionally substituted by 1-3 halo
or C1-3 alkyl groups, alkylsulfonyl, or

where
X is a connecting bond, O or NH,
A is a connecting bond or C1-C3 alkylene
R6 and R7 are together oxo, hydroxyimino, alkoxyimino, aralkoxyimino or aminoimino;
R8 is methyl, aralkoxycarbonyl, and arylsulfonyl;
R9 is hydrogen, formyl, C1-10 alkylcarbonyl, C1-10 alkoxycarbonyl, and arylalkoxycarbonyl;
m and n are independently integers of zero or one; and said metal complex is taken
from the group consisting of copper, zinc, cobalt, nickel and cadmium or a pharmaceutically
acceptable salt, ester or metal complex thereof.
2. A paste according to claim 1 wherein the therapeutic agent is azithromycin.
3. A paste according to claim 1 wherein the therapeutic agent is erythromycin.
4. A paste according to claim 1 wherein the 8a-azalide is selected from a compound of
formula I

wherein Des is desosomine and Clad is cladinose
and a compound of formula II
5. The paste formulation according to claim 1, which based upon total weight of composition,
comprises:
(a) about 0.01 to about 50% of the therapeutic agent;
(b) about 0.02 to about 20% of fumed silica;
(c) about 0.01 to about 20% of a viscosity modifier;
(d) 0% to about 30% of an absorbent;
(e) 0% to about 20% of a colorant; and
(f) Q.S. a carrier.
6. The paste formulation according to claim 1, wherein the formulation is for oral administration.
7. The paste formulation according to claim 1, wherein the formulation is for topical,
dermal or transdermal administration.
8. The paste formulation according to claim 1, which comprises an antioxidant and the
antioxidant is selected from the group consisting of alpha tocopherol, ascorbic acid,
ascrobyl palmitate, fumeric acid, malic acid, sodium ascorbate, sodium metabisulfate,
n-propyl gallate, BHA, BHT and monothioglycerol.
9. The paste formulation according to claim 1 which comprises a preservative and the
preservative is selected from the group consisting of the parabens, benzalkonium chloride,
benzethonium chloride, benzoic acid, benzyl alcohol, bronopol, cetrimide, chlorhexidine,
chlorobutanol, chlorocresol, cresol, imidurea, phenol, phenoxyethanol, phenylethyl
alcohol, phenylmercuric acetate, phenylmercuric borate, phenylmercuric nitrate, potassium
sorbate, sodium benzoate, sodium propionate, sorbic acid and thimerosal.
10. The paste formulation according to claim 1 wherein the carrier is selected from triacetin,
short to medium chain mono-, di-, or tri-glycerides, glycerin, water, propylene glycol,
N-methyl pyrrolidinone, glycerol formal, polyethylene glycol, polyethylene glycol-polypropylene
glycol-polyethylene glycol tri-block copolymers, vegetable oil, sesame oil, soybean
oil, corn oil, mineral oil, peanut oil, castor oil, cotton oil, transcutol, benzyl
alcohol, N, N-dimethylformamide and dimethylsulfoxide.
11. Use of a paste according to claim 1 in the preparation of a medicament for treating
a bacterial infection in a host in need thereof.
1. Formulation pâteuse pharmaceutique ou vétérinaire, comprenant :
(a) une quantité efficace d'un agent thérapeutique choisi parmi un 8a-azalide, l'azithromycine,
ou l'érythromycine,
(b) de la silice fumée ;
(c) un modificateur de viscosité choisi parmi le PEG 200, le PEG 300, le PEG 400,
le PEG 600, la monoéthanolamine, la triéthanolamine, le glycérol, le propylène glycol,
le polyoxylène sorbitane monoléate et les poloxamères ;
(d) un excipient ;
(e) éventuellement, un agent absorbant choisi parmi le carbonate de magnésium, le
carbonate de calcium, l'amidon et la cellulose et ses dérivés ; et
(f) éventuellement, un stabilisateur, un tensio-actif, un conservateur ou un colorant
choisi parmi le dioxyde de titane, une teinture et une laque ;
dans laquelle le 8a-azalide est de formule 1

dans laquelle
R
1 est un hydrogène ;
un hydroxy ;
un alcoxy en C
1-4 ;
un formyle ;
un alkylcarbonyle en C
1-10, un alcoxycarbonyle en C
1-10, un aryloxycarbonyle, un aralcoxycarbonyle en C
1-10, un alkylsulfonyle ou un arylsulfonyle en C
1-10 dans lequel ledit groupe alkyle ou groupe aryle en C
1-10 est non substitué ou substitué par des groupes 1-3 halo (F, Cl, Br), hydroxy, amino,
acylamino en C
1-5 ou alkyle en C
1-4 ; ou
un alkyle en C
1-10 non substitué ou substitué, un alcényle en C
2-10 ou un alcynyle en C
2-
10 dans lequel lesdits substituants sont indépendamment 1-3 groupes parmi
(a) aryle ou hétéroaryle éventuellement substitué par 1-3 halo (F, Cl, Br, I), un
alkyle en C1-4, un alcoxy en C1-3, un amino, un alkylamino en C1-4, un di(alkyle en C1-4) amino ou hydroxy,
(b) hétérocyclyle éventuellement substitué par un hydroxy, un amino, un alkylamino
en C1-4, un di(alkyle en C1-4)amino, un alkylcarbonyloxy en C1-4, ou un alkylcarbonylamino en C1-4,
(c) halo (F, Cl, Br ou I),
(d) hydroxy éventuellement acylé par un groupe

dans laquelle Ra est un hydrogène, un alkyle en C1-6, un aryle, un hétéroaryle, un aralkyle ou un hétéroaralkyle,
et
Rb est un alkyle en C1-6 ou aryle,
(e) un alcoxy en C1-10
(f) un aryloxy ou hétéroaryloxy éventuellement substitué par un groupe halo 1-3, hydroxy,
amino ou alkyle en C1-4;
(g) amino ou alkylamino en C1-10 éventuellement acylé par un groupe

ou RbSO2, dans lequel
Ra et
Rb sont comme définis ci-dessus,
(g) di(alkyle en C1-10) amino,
(h) arylamino, hétéroarylamino, aralkylamino ou hétéroarylalkylamino dans lesquels
ledit groupe aryle ou hétéroaryle est éventuellement substitué par des groupes 1-3
halo, hydroxy, amino ou alkyle en C1-4 ;
(i) mercapto,
(j) alkylthio en C1-10, alkylsulfinyle ou alkylsulfonyle, arylthio, arylsulfinyle ou arylsulfonyle dans
lesquels ledit groupe aryle est éventuellement substitué par des groupes 1-3 halo,
hydroxy, amino ou alkyle en C1-4,
(k) formyle,
(l) alkylcarbonyle en C1-10,
(m) arylcarbonyle, hétéroarylcarbonyle, aralkylcarbonyle ou hétéroarylalkylcarbonyle
dans lesquels ledit groupe aryle ou hétéroaryle est éventuellement substitué par des
groupes 1-3 halo, hydroxy, amino ou alkyle en C1-4 ;
(n) carboxy ;
(o) alcoxycarbonyle en C1-10 ;
(p) aryloxycarbonyle, hétéroaryloxycarbonyle, aralcoxycarbonyle ou hétéroarylalcoxycarbonyle
dans lesquels ledit groupe aryle ou hétéroaryle est éventuellement substitué par des
groupes 1-3 halo, hydroxy, amino ou alkyle en C1-4 ;
(q) carbamoyle ou sulfamoyle dans lequel l'atome N est éventuellement substitué par
1-2 groupes alkyle en C1-6 ou par une chaîne d'alcylène en C4-6 ;
(r) cyano
(s) isonitrile,
(t) nitro,
(u) azido,
(v) iminométhyle éventuellement substitué sur l'azote ou le carbone avec un alkyle
en C1-10,
(w) oxo ou
(x) thiono ;
dans lesquels ladite chaîne alkyle, si elle dépasse deux atomes de carbone en longueur,
peut être éventuellement interrompue par des groupes 1-2 oxa, thia ou aza (-NR dans
lesquels R est un hydrogène ou alkyle en C
1-3).
R
10 est un hydrogène ou
R
1 et R
10 sont ensemble un alcylène en C
1-C
3 éventuellement substitué par un groupe oxo ;
R
1 et R
4 sont ensemble un alcylène C
1-C
3 éventuellement substitué par un groupe oxo ;
R
2 et R
3 sont un hydrogène, un alkyl, en C
1-C
10, un aryl
R
2 et R
3 sont ensemble un oxo et thiono ;
R
4 et R
5 sont indépendamment un hydrogène et un alkylcarbonyle ;
R
4 et R
5 sont ensemble un carbonyle ;
R
6 et R
7 sont tous deux un hydrogène ou l'un de R
6 et R
7 est un hydrogène et l'autre est un hydroxy, un dérivé acyloxy pris dans le groupe
constitué de formyloxy, d'alkylcarbonyloxy en C
1-10, un arylcarbonyloxy en C
1-C
10 et un aralkylcarbonyloxy en C
1-10 ou
-NHR
12 dans lequel R
12 est un hydrogène, un arylsulfonyle ou un hétéroarylsulfonyle éventuellement substitué
par des groupes 1-3 halo ou alkyle en C
1-3, un alkylsulfonyle ou

où
X est une liaison de connexion, O ou NH,
A est une liaison de connexion ou un alcylène en C
1-C
3
R
13 est un hydrogène, un alkyle en C
1-C
10, un aryle, un aralkyle, un hétéroaryle, un hétérocyclyle, ou un cycloalkyle en C
3-C
7, dont l'un quelconque des groupes R
13 autre que l'hydrogène peut être substitué par un ou plusieurs des groupes parmi un
halogène, hydroxyle, alcoxy en C
1-C
3, cyano, isonitrilo, nitro, amino, mono- ou di-alkylamino (C
1-C
3), mercapto, alkylthio en C
1-C
3, alkylsulfinyle en C
1-C
3, arylthio, arylsulfinyle, sulfamoyle, arylsulfonyle, carboxy, carbamoyle, alkylcarbonyle
en C
1-C
3 ou alcoxycarbonyle en C
1-C
3;
R
6 et R
7 sont ensemble un oxo, un hydroxyimino, alcoxyimino, aralcoxyimino ou aminoimino ;
R
8 est un méthyle, aralcoxycarbonyle et arylsulfonyle ;
R
9 est un hydrogène, formyle, alkylcarbonyle en C
1-10, alcoxycarbonyle en C
1-10 et arylalcoxycarbonyle ;
m et n sont indépendamment des nombres entiers de zéro ou un ; et ledit complexe métallique
est pris dans le groupe constitué de cuivre, zinc, cobalt, nickel et cadmium ou un
sel, ester ou complexe métallique pharmaceutiquement acceptable de celui-ci.
2. Pâte selon la revendication 1, dans laquelle l'agent thérapeutique est l'azithromycine.
3. Pâte selon la revendication 1 dans laquelle l'agent thérapeutique est l'érythromycine.
4. Pâte selon la revendication 1, dans laquelle le 8a-azalide est choisi à partir d'un
composé de formule I

dans laquelle Des est la désosomine et Clad est la cladinose
et un composé de formule II
5. Formulation pâteuse selon la revendication 1, basée sur le poids total de la composition,
comprenant :
(a) environ 0,01 à environ 50% de l'agent thérapeutique ;
(b) environ 0,02 à environ 20% de silice fumée ;
(c) environ 0,01 à environ 20% d'un modificateur de viscosité ;
(d) 0% à environ 30% d'un agent absorbant ;
(e) 0% à environ 20% d'un colorant ; et
(f) Q.S un excipient
6. Formulation pâteuse selon la revendication 1, dans laquelle la formulation est destinée
à une administration par voie orale.
7. Formulation pâteuse selon la revendication 1, dans laquelle la formulation est destinée
à une administration par voie topique, dermique ou transdermique.
8. Formulation pâteuse selon la revendication 1, qui comprend un antioxydant et l'antioxydant
est choisi dans le groupe constitué d'alpha-tocophérol, d'acide ascorbique, de palmitate
d'ascorbyle, d'acide fumarique, d'acide malique, d'ascorbate de sodium, de métobisulfate
de sodium, de n-propyl gallate, de BHA, de BHT et de monothioglycérol.
9. Formulation pâteuse selon la revendication 1 qui comprend un agent conservateur et
l'agent conservateur est choisi dans le groupe constitué de parabènes, de chlorure
de benzalkonium, de chlorure de benzéthonium, d'acide benzoïque, d'alcool de benzyle,
de bronopol, de cétrimide, de chlorhexidine, de chlorobutanol, de chlorocrésol, de
crésol, d'imidurée, de phénol, de phénoxyéthanol, d'alcool phényléthylique, d'acétate
phénylmercurique, de borate phénylmercurique, de nitrate phénylmercurique, de sorbate
de potassium, de benzoate de sodium, de propionate de sodium, d'acide sorbique et
de thimérosal.
10. Formulation pâteuse selon la revendication 1, dans laquelle l'excipient est choisi
dans le groupe constitué de triacétine, de mono-, di- ou triglycérides à chaîne courte
à moyenne, de glycérine, d'eau, de propylène glycol, de N-méthyl pyrrolidinone, de
glycérol formal, de polyéthylène glycol, de copolymères tri-blocs polyéthylène glycol-polypropylène
glycol-polyéthylène glycol, d'huile végétale, d'huile de sésame, d'huile de soja,
d'huile de maïs, d'huile minérale, d'huile d'arachide, d'huile de ricin, d'huile de
coton, de transcutol, d'alcool benzylique, de N,N-diméthylformamide et de diméthylsulfoxyde.
11. Utilisation d'une pâte selon la revendication 1, dans la préparation d'un médicament
pour traiter une infection bactérienne sur un hôte en ayant besoin.
1. Pharmazeutische oder veterinärmedizinische Pastenformulierung, umfassend:
(a) eine wirksame Menge eines therapeutischen Mittels, ausgewählt aus einem 8a-Azalid,
Azithromycin oder Erythromycin;
(b) Quarzstaub;
(c) einen Viskositätsmodifikator, ausgewählt aus PEG 200, PEG 300, PEG 400, PEG 600,
Monoethanolamin, Triethanolamin, Glycerin, Propylenglycol, Polyoxylensorbitanmonooleat
und Poloxameren;
(d) einen Träger;
(e) gegebenenfalls ein Absorbens, ausgewählt aus Magnesiumcarbonat, Calciumcarbonat,
Stärke und Cellulose und ihren Derivaten; und
(f) gegebenenfalls einen Stabilisator, ein grenzflächenaktives Mittel, Konservierungsmittel
oder ein Färbemittel, ausgewählt aus Titandioxid, Farbstoff und Pigmentfarbe,
wobei das 8a-Azalid eines der Formel I ist

wobei
R1 Wasserstoff;
Hydroxy;
C1-4-Alkoxy;
Formyl,
C1-10-Alkylcarbonyl, C1-10-Alkoxycarbonyl, Aryloxycarbonyl, C1-10-Aralkoxycarbonyl, C1-10-Alkylsulfonyl oder Arylsulfonyl, wobei der C1-10-Alkylrest oder Arylrest unsubstituiert oder mit 1 bis 3 Halogenatomen (F, Cl, Br),
Hydroxy, Amino, C1-5-Acylamino oder C1-4-Alkylresten substituiert ist; oder
unsubstituiertes oder substituiertes C1-10-Alkyl, C2-10-Alkenyl oder C3-10-Alkinyl ist, wobei die Substituenten unabhängig 1 bis 3 von
(a) Aryl oder Heteroaryl, gegebenenfalls substituiert mit 1 bis 3 Halogenatomen (F,
Cl, Br, I), C1-4-Alkyl, C1-3-Alkoxy, Amino, C1-4-Alkylamino, Di-(C1-4-alkyl)amino oder Hydroxy,
(b) Heterocyclyl, gegebenenfalls substituiert mit Hydroxy, Amino, C1-4-Alkylamino, Di-(C1-4-alkyl)amino, C1-4-Alkylcarbonyloxy oder C1-4-Alkylcarbonylamino,
(c) Halogen (F, Cl, Br oder I),
(d) Hydroxy, gegebenenfalls acyliert mit einem Rest

wobei
Ra Wasserstoff, C1-6-Alkyl, Aryl, Heteroaryl, Aralkyl oder Heteroaralkyl ist
und
Rb C1-6-Alkyl oder Aryl ist,
(e) C1-10-Alkoxy,
(f) Aryloxy oder Heteroaryloxy, gegebenenfalls substituiert mit 1 bis 3 Halogenatomen,
Hydroxy, Amino oder C1-4-Alkylresten,
(g) Amino oder C1-10-Alkylamino, gegebenenfalls acyliert mit einem Rest

oder RbSO2, wobei
Ra und
Rb wie vorstehend definiert sind,
(g) Di-(C1-10-alkyl)amino,
(h) Arylamino, Heteroarylamino, Aralkylamino oder Heteroarylalkylamino, wobei der
Aryl- oder Heteroarylrest gegebenenfalls mit 1 bis 3 Halogenatomen, Hydroxy, Amino
oder C1-4-Alkylresten substituiert ist,
(i) Mercapto,
(j) C1-10-Alkylthio, Alkylsulfinyl oder Alkylsulfonyl, Arylthio, Arylsulfinyl oder Arylsulfonyl,
wobei der Arylrest gegebenenfalls mit 1 bis 3 Halogenatomen, Hydroxy, Amino oder C1-4-Alkylresten substituiert ist,
(k) Formyl,
(l) C1-10-Alkylcarbonyl,
(m) Arylcarbonyl, Heteroarylcarbonyl, Aralkylcarbonyl oder Heteroarylalkylcarbonyl,
wobei der Aryl- oder Heteroarylrest gegebenenfalls mit 1 bis 3 Halogenatomen, Hydroxy,
Amino oder C1-4-Alkylresten substituiert ist,
(n) Carboxy,
(o) C1-10-Alkoxycarbonyl;
(p) Aryloxycarbonyl, Heteroaryloxycarbonyl, Aralkoxycarbonyl oder Heteroarylalkoxycarbonyl,
wobei der Aryl- oder Heteroarylrest gegebenenfalls mit 1 bis 3 Halogenatomen, Hydroxy,
Amino oder C1-4-Alkylresten substituiert ist,
(q) Carbamoyl oder Sulfamoyl, wobei das N-Atom gegebenenfalls mit 1 bis 2 C1-6-Alkylresten oder mit einer C4-6-Alkylenkette substituiert ist,
(r) Cyano,
(s) Isonitrilo,
(t) Nitro,
(u) Azido,
(v) Iminomethyl, gegebenenfalls an einem Stickstoff- oder Kohlenstoffatom mit C1-10-Alkyl substituiert,
(w) Oxo, oder
(x) Thiono sind;
wobei die Alkylkette, wenn sie mehr als zwei Kohlenstoffatome in der Länge aufweist,
gegebenenfalls durch 1 bis 2 Oxa-, Thia- oder Aza-(-NR-, wobei R Wasserstoff oder
C
1-3-Alkyl ist)-Reste unterbrochen sein kann,
R
10 Wasserstoff ist, oder
R
1 und R
10 zusammen C
1-C
3-Alkylen, gegebenenfalls substituiert mit einem Oxorest, sind;
R
1 und R
4 zusammen C
1-C
3-Alkylen, gegebenenfalls substituiert mit einem Oxorest, sind;
R
2 und R
3 Wasserstoff, C
1-10-Alkyl, Aryl sind;
R
2 und R
3 zusammen Oxo und Thiono sind;
R
4 und R
5 unabhängig Wasserstoff und Alkylcarbonyl sind;
R
4 und R
5 zusammen Carbonyl sind;
R
6 und R
7 beide Wasserstoff sind oder eines von R
6 und R
7 Wasserstoff ist und das andere Hydroxy, ein Acyloxyderivat aus Formyloxy, C
1-10-Alkylcarbonyloxy, Arylcarbonyloxy und Aralkylcarbonyloxy ist, oder
-NHR
12, wobei R
12 Wasserstoff, Arylsulfonyl oder Heteroarylsulfonyl, gegebenenfalls substituiert mit
1 bis 3 Halogenatomen oder C
1-3-Alkylresten, Alkylsulfonyl oder

wobei
X eine verknüpfende Bindung, O oder NH ist,
A eine verknüpfende Bindung oder C
1-C
3-Alkylen ist,
R
13 Wasserstoff, C
1-C
10-Alkyl, Aryl, Aralkyl, Heteroaryl, Heterocyclyl oder C
3-C
7-Cycloalkyl ist, wobei die Reste R
13, die von Wasserstoff verschieden sind, jeweils mit einem oder mehreren Halogenatomen,
Hydroxyl, C
1-C
3-Alkoxy, Cyano, Isonitrilo, Nitro, Amino, Mono- oder Di-(C
1-C
3)-alkylamino, Mercapto, C
1-C
3-Alkylthio, C
1-C
3-Alkylsulfinyl, C
1-C
3-Alkylsulfonyl, Arylthio, Arylsulfinyl, Sulfamoyl, Arylsulfonyl, Carboxy, Carbamoyl,
C
1-C
3-Alkylcarbonyl oder C
1-C
3-Alkoxycarbonyl substituiert sein können;
R
6 und R
7 zusammen Oxo, Hydroxyimino, Alkoxyimino, Aralkoxyimino oder Aminoimino sind;
R
8 Methyl, Aralkoxycarbonyl und Arylsulfonyl ist;
R
9 Wasserstoff, Formyl, C
1-10-Alkylcarbonyl, C
1-10-Alkoxycarbonyl und Arylalkoxycarbonyl ist;
m und n unabhängig ganze Zahlen von null oder eins sind; und der Metallkomplex ausgewählt
ist aus Kupfer, Zink, Kobalt, Nickel und Cadmium; oder ein pharmazeutisch verträgliches/verträglicher
Salz, Ester oder Metallkomplex davon.
2. Paste gemäß Anspruch 1, wobei das therapeutische Mittel Azithromycin ist.
3. Paste gemäß Anspruch 1, wobei das therapeutische Mittel Erythromycin ist.
4. Paste gemäß Anspruch 1, wobei das 8a-Azalid ausgewählt ist aus einer Verbindung der
Formel I

wobei Des Desosomin und Clad Cladinose ist,
und einer Verbindung der Formel II
5. Pastenformulierung nach Anspruch 1, welche, bezogen auf das Gesamtgewicht der Zusammensetzung:
(a) etwa 0,01 bis etwa 50% des therapeutischen Mittels;
(b) etwa 0,02 bis etwa 20% Quarzstaub;
(c) etwa 0,01 bis etwa 20% eines Viskositätsmodifikators;
(d) 0% bis etwa 30% eines Absorbens;
(e) 0% bis etwa 20% eines Färbemittels; und
(f) q.s. einen Träger,
umfasst.
6. Pastenformulierung gemäß Anspruch 1, wobei die Formulierung zur oralen Verabreichung
bestimmt ist.
7. Pastenformulierung gemäß Anspruch 1, wobei die Formulierung zur topischen, dermalen
oder transdermalen Verabreichung bestimmt ist.
8. Pastenformulierung gemäß Anspruch 1, welche ein Antioxidationsmittel umfasst und wobei
das Antioxidationsmittel ausgewählt ist aus α-Tocopherol, Ascorbinsäure, Ascorbylpalmitat,
Fumarsäure, Maleinsäure, Natriumascorbat, Natriummetabisulfat, n-Propylgallat, BHA,
BHT und Monothioglycerin.
9. Pastenformulierung gemäß Anspruch 1, welche ein Konservierungsmittel umfasst und wobei
das Konservierungsmittel ausgewählt ist aus Parabenen, Benzalkoniumchlorid, Benzethoniumchlorid,
Benzoesäure, Benzylalkohol, Bronopol, Cetrimid, Chlorhexidin, Chlorbutanol, Chlorcresol,
Cresol, Imidharnstoff, Phenol, Phenoxyethanol, Phenylethylalkohol, Phenylquecksilberacetat,
Phenylquecksilberborat, Phenylquecksilbemitrat, Kaliumsorbat, Natriumbenzoat, Natriumpropionat,
Sorbinsäure und Thimerosal.
10. Pastenformulierung gemäß Anspruch 1, wobei der Träger ausgewählt ist aus Triacetin,
Mono-, Di- oder Triglyceriden mit kurzer bis mittlerer Kettenlänge, Glycerin, Wasser,
Propylenglycol, N-Methylpyrrolidinon, Glycerinformal, Polyethylenglycol, Polyethylenglycol-Polypropylenglycol-Polyethylenglycol-Triblockcopolymeren,
Pflanzenöl, Sesamöl, Sojaöl, Maisöl, Mineralöl, Erdnussöl, Rizinusöl, Baumwollöl,
Transkutol, Benzylalkohol, N,N-Dimethylformamid und Dimethylsulfoxid.
11. Verwendung einer Paste gemäß Anspruch 1 bei der Herstellung eines Medikaments zur
Behandlung einer bakteriellen Infektion in einem Wirt, der diese benötigt.