Use of a cytochrome oxidase inhibitor to increase the cough-suppressing activity of dextromorphan
Patent 5350756 Issued on September 27, 1994. Estimated Expiration Date: May 28, 2012. Estimated Expiration Date is calculated based on simple USPTO term provisions. It does not account for terminal disclaimers, term adjustments, failure to pay maintenance fees, or other factors which might affect the term of a patent.
514/289, Two of the cyclos share at least three ring members (i.e., bridged) (e.g., morphinans, etc.)514/295, Two of the cyclos share at least three ring carbons (i.e., bridged) (e.g., benzomorphans, etc.)514/305Quinuclidines (including unsaturation)
This invention discloses a method for increasing the effectiveness of dextromethorphan (DM) as an antitussive agent (i.e., as a cough suppressant). This method involves the concurrent administration of DM and a second agent which inhibits the oxidative activity of debrisoquin hydroxylase, a cytochrome P450 oxidase enzyme. Effective anti-oxidant compounds include quinidine, yohimbine, and fluoxetine.
Other References
Koppel, C., et al, "Urinary metabolism of dextromethorphan in man," Arzneim.-Forsch./Drug Research 37: 1304-1306 (1987)
Guttendorf, R. J., et al, "Simplified phenotyping with dextromethorphan by thin-layer chromatography," Ther. Drug. Monit. 10: 490-498 (1988)
Kupfer, A., et al "Dextromethorphan as a safe probe for debrisoquine hydroxylation polymorphism," Lancet ii: 517-518 (1984)
Inaba, T., et al, "In vitro inhibition studies of two isozymes of human liver cytochrome P-450," Drug Metabolism and Disposition 13: 443-447 (1985)
Inaba, T., et al, "Quinidine: Potent inhibition of sparteine and debrisoquin oxidation in vivo," Br. J. Clin. Pharmacol. 22: 199-200 (1986)
Broly, F., et al, "Effect of quinidine on the dextromethorphan O-methylase activity of microsomal fractions from human liver," Br. J. Clin. Pharmacol. 28: 29-36 (1989)
Broly, F., et al, "Inhibitory studies of mexiletine and dextromethorphan oxidation in human liver microsomes," Biochem. Pharmacol. 39: 1045-1053 (1990)
Brinn, R., et al, "Sparteine oxidation is practically abolished in quinidine-treated patients," Br. J. Clin. Pharmacol. 22: 194-197 (1986)
Brosen, K., et al, "Extensive metabolizers of debrisoquin become poor metabolizers during quinidine treatment," Pharmacol. Toxicol. 60: 312-314 (1987)
Nielsen, M. D., et al, "A dose-effect study of the in vivo inhibitory effect of quinidine on sparteine oxidation in man," Br. J. Clin. Pharmacol. 29: 299-304 (1990)
Walker, E. O., and Hunt, V. P., "An open label trial of dextromethorphan in Huntington's Disease," Clin. Neuropharmacol. 12: 322-330 (1989)
Albers, G. W., et al, "Safety and tolerance of oral dextromethorphan in patients at risk for brain ischemia," Stroke 22: 1075-1077 (1991)
Applebaum, J. S., et al, "Dextromethorphan in the treatment of ALS: A pilot study," Abstract No. 960S (p. 393) in Neurology 41 (Suppl. 1), Mar. 199