Weight loss abstract
A method for producing or maintaining weight loss by administering
to a human a composition containing an effective amount of each
of caffine, aspirin and ephedrine. The pharmaceutical composition
can be administered concurrently with caloric restriction or in
the absence of caloric restriction, for the purpose of reducing
weight or maintaining body weight.
Weight loss claims
What is claimed as new and desired to be secured by Letters Patent
of the United States is:
1. A method for producing weight loss in a human in need thereof,
comprising administering thereto an effective amount of a composition
comprising aspirin, caffeine and ephedrine or pharmaceutically acceptable
salts thereof.
2. The method of claim 1, wherein about 30-2500 mg/day aspirin,
about 10-500 mg/day caffeine and about 25-350 mg/day ephedrine are
administered.
3. The method of claim 1, wherein about 200-1000 mg/day aspirin,
about 30-200 mg/day caffeine and about 50-100 mg/day ephedrine are
administered.
4. The method of claim 1, wherein about 300 mg/day aspirin, about
120 mg/day caffeine and about 150 mg/day ephedrine are administered.
5. The method of claim 1, wherein the amount of aspirin, caffeine
and ephedrine administered is in a relative ratio of about 2.0:1.0:0.5
to about 3.5:1.0:2.0.
6. The method of claim 5, wherein said ratio is about 2.75:1.0:1.25.
7. The method of claim 1, wherein said composition is administered
orally.
8. The method of claim 1, wherein said composition is in unit dose
form.
9. The method of claim 8, wherein said unit dose comprises about
30-2500 mg aspirin, 10-500 mg caffeine and 25-350 mg ephedrine.
10. The method of claim 8, wherein said unit dose comprises about
200-1000 mg aspirin, 30-200 mg caffeine and 50-100 mg ephedrine.
11. The method of claim 8, wherein said unit dose comprises about
300 mg aspirin, 120 mg caffeine and 150 mg ephedrine.
12. The method of claim 1, wherein said composition is administered
with a pharmaceutically acceptable carrier or excipient.
13. The method of claim 1, wherein said human is overweight or
obese.
14. The method of claim 1, wherein said human is low energy adapted.
15. The method of clam 1, further comprising calorically restricting
said human during said administering step.
16. A method for producing weight loss in a calorically restricted
human in need thereof, comprising administering to the human a composition
comprising an effective amount of each of aspirin, caffeine and
ephedrine or pharmaceutically acceptable salts thereof.
17. The method of claim 16, wherein about 30-2500 mg/day aspirin,
about 10-500 mg/day caffeine and about 25-350 mg/day ephedrine are
administered.
18. The method of claim 16, wherein about 200-1000 mg/day aspirin,
about 30-200 mg/day caffeine and about 50-100 mg/day ephedrine are
administered.
19. The method of claim 16, wherein about 300 mg/day aspirin, about
120 mg/day caffeine and about 150 mg/day ephedrine are administered.
20. The method of claim 16, wherein the amount of aspirin, caffeine
and ephedrine administered is in a relative ratio of about 2.0:1.0:0.5
to about 3.5:1.0:2.0.
21. The method of claim 16, wherein said ratio is about 2.75:1.0:1.25.
22. The method of claim 16, wherein said composition is administered
orally.
23. The method of claim 16, wherein said composition is in unit
dose form.
24. The method of claim 16, wherein said unit dose comprises about
30-2500 mg aspirin, 10-500 mg caffeine and 25-350 mg ephedrine.
25. The method of claim 16, wherein said unit dose comprises about
200-1000 mg aspirin, 30-200 mg caffeine and 50-100 mg ephedrine.
26. The method of claim 16, wherein said unit dose comprises about
300 mg aspirin, 120 mg caffeine and 150 mg ephedrine.
27. The method of claim 16, wherein said composition is administered
with a pharmaceutically acceptable carrier or excipient.
28. The method of claim 16, wherein said human is low energy adapted.
Weight loss description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to a composition which is useful
for inducing weight loss in humans and to a treatment for obesity.
More specifically, the invention is directed to a composition containing
aspirin, caffeine and ephedrine and use of this composition for
producing weight loss.
2. Description of the Background
Western society is increasingly concerned with personal weight
and appearance. Diets and weight loss programs are extensively advertised
and utilized by a large segment of Western society with varying
degrees of effectiveness. There is a continuing search for new and
effective means to facilitate weight loss.
Obesity, originally presumed to result from simple overeating or
the combination of overeating with inactivity, has more recently
been attributed to a genetic predisposition in combination with
poor diet and exercise habits. It has been suggested that predisposition
to obesity is associated with a defect in the sympathetic nervous
system. This defect is manifested as a high efficiency in food utilization
and a reduced thermogenic response to food intake. In normal persons,
food intake results in a thermogenic response, that is, an increase
in body temperature in which the caloric content of food is expended
as heat. Some studies suggest that persons with a genetic predisposition
to obesity are metabolically more efficient than lean persons, storing
excess caloric energy as body fat. In obese persons, thermogenic
defects may make a significant contribution to weight gain in the
absence of controlled food intake. Calories not expended as heat
are stored as excess weight. See Dulloo, A. G. and Miller, D. S.,
Wld. Rev. Nutr. Diet., vol. 50, pp. 1-56, 1987.
Pharmaceutical compositions have been developed with the purpose
of stimulating thermogenesis and thereby inducing weight loss. Ephedrine
stimulates thermogenesis in laboratory animals, presumably by stimulating
brown adipose tissue. In theory, catecholamines activate thermogenesis
in brown adipose tissue in animals by binding adrenergic receptors
(Buckowiecki, L., Jahjah, L., and Follea, N., International Journal
of Obesity, vol. 6, pp. 343-350, 1982). Numerous studies have been
published on the thermogenic response of humans and mammals to ephedrine
treatment (See for example Morgan, J. B., York, D. A., Wasilewska,
A. and Portman, J., Br. J. Nutr., vol. 47, pp. 21-32, 1982; Dulloo,
A. G. and Miller, D. S., Br. J. Nutr., vol. 52, pp. 179-196, 1984;
Himms-Hagen, J., Seminars in Medicine of the Beth-Israel Hospital,
Boston, vol. 311, no. 24, pp. 1549-1558, 1984; Pasquali, R., Cesari,
M. P. Melchionda, N., Stefanini, C., Raitano, A. and Labo, G., International
Journal of Obesity, vol. 11, pp. 163-168, 1987; Astrup, A., Lundsgaard,
C., Madsen, J. and Christensen, N. J., The American Journal of Clinical
Nutrition, vol. 42, pp. 83-94, 1985 and Astrup, A., Bulow, J., Madsen,
J. and Christensen, N. J., Journal of the American Physiological
Society, pp. E507-E515, 1985). The anorectic effect of ephedrine
has also been investigated in rats (Zarrindast, M. R., Hosseini-Nia,
T. and Farnoodi, F., Gen. Pharmac., vol. 18, no. 5, pages 559-561,
1967). Ephedrine, used alone, results in increased thermogenesis,
but also undesirable side effects in man, such as elevated blood
pressure and tremors.
The thermogenic response to ephedrine in animals varies with the
type of animal model studied. Dulloo and Miller (British Journal
of Nutrition, loc. cit.) have studied the thermogenic properties
of six sympathomimetic drugs in both mice and rats. The six drugs
studied were ephedrine, methoxyphenamine, yohimbine, tranylcypromine,
amitriptyline, iprindole and theophylline. The metabolic response
of various mice and rat models differed with the respective drugs.
For example, in mice made obese by chemical lesioning in the hypothalamus,
all of the drugs with the exception of theophylline caused a reduction
in body fat without loss of body protein. Similarly, all six drugs
with the exception of theophylline resulted in a state of negative
energy balance by means of a thermogenic effect. In contrast, in
mice made obese by feeding a high protein, high fat diet, all seven
drugs caused a negative energy imbalance. In genetically obese mice
only ephedrine and tranylcypromine were found to have thermogenic
activity. A similar variability in physiological effect was seen
in the rat models.
The activity of thermogenic drugs in humans has been postulated
to involve brown adipose tissue. However, this proposed mechanism
of action has never been verified in humans.
Studies have also been reported investigating combinations of ephedrine
with additional compounds such as caffeine. In 1972, a composition
containing ephedrine, caffeine and phenobarbitol was noted as inducing
loss of appetite and weight loss in humans. This composition, popularly
known as the "Elsinore pill" was widely prescribed. However,
serious side effects such as cutaneous reactions (tremors) were
reported with this composition. Ephedrine/caffeine compositions
without the presence of phenobarbitol were also been investigated
in attempts to reduce the side effects of the Elsinore pill. However,
patients receiving this "modified Elsinore pill" continue
to suffer from tremors similar to the effects seen with the Elsinore
pill (Malchow-Moller, A., Larsen, S., Hey, H., Stokholm, K. H.,
Juhl, E. and Quaade, F., International Journal of Obesity, vol.
5, pp. 183-187, 1981).
More recent studies of the thermogenic effects in humans of mixtures
of ephedrine and methylxanthines, such as caffeine and theophylline,
have been reported by Dulloo and Miller (American Journal of Clinical
Nutrition, vol. 43, pp. 388-394, 1986 and International Journal
of Obesity, vol. 10, pp. 467-481, 1986). These studies suggest that
ephedrine/methylxanthine mixtures are more effective than ephedrine
given alone. Methylxanthines are reported as potentiating the thermogenic
anti-obesity effect of ephedrine leading to normalization of body
weight and body composition. However, reports have also been published
suggesting that caffeine has no potentiating effect on the action
of ephedrine (Cesari, M. P., Pasquali, R., Casimirri, F., Melchionda,
N., Stefanini, C. and Raitano, A., Ist. Clin. Med. and Gastroenterol.,
Univ. Alma Mater, S. Orsola Hospital, Bologna, Italy).
Studies reporting the thermogenic effect of ephedrine/etilefrine
(Pasquali, R., Cesari, M.P., Besteghi, L., Melchionda, N. and Balestra,
V., International Journal of Obesity, vol. 11, Supplement 3, pp.
23-26, 1987) and ephedrine/aspirin (Dulloo, A. G. and Miller, D.
S., Am. J. Clin. Nutr., vol. 45, pp. 564-569, 1987) have also been
reported. Results obtained with ephedrine/etilefrin were inconclusive.
Aspirin appears to potentiate the thermogenic effects of ephedrine.
A need continues to exist for improved weight loss compositions
which are safe, effective and exhibit reduced side effects in humans.
Studies on the thermogenic and physiological effects of ephedrine
and other compounds in rats and mice give varying results which
cannot be directly applied to the use of these compounds in humans.
The function of brown adipose tissues in humans is only speculative.
The thermogenic effect demonstrated in animals has been postulated
to proceed by means of brown adipose tissue in animals, an effect
which cannot be directly applied to human treatment in view of the
variable effects seen with sympathimometic drugs in animal studies.
A new approach to weight loss composition and methods for use in
humans is needed.
SUMMARY OF THE INVENTION
Accordingly, one object of the present invention is to provide
a weight loss composition which produces significant weight loss.
A further object is a weight loss composition which can be administered
both in conjunction with caloric restriction (diet) and the absence
of caloric restriction. A further object of the invention is to
provide a weight loss composition and method producing weight loss
which is effective in promoting additional weight loss in low energy
adapted obese persons who have difficulty losing weight with conventional
caloric restriction. Still a further object of the invention is
to provide a method for maintaining weight loss which is achieved
using commercial caloric restriction programs.
These and other objects which will become apparent from the following
specification have been achieved by the present method for producing
weight loss which comprises administering to a human a composition
comprising an effective amount of each of aspirin, caffeine and
ephedrine into pharmaceutical weight loss compositions containing
an effective amount of these compounds.
BRIEF DESCRIPTION OF THE DRAWINGS
A more complete appreciation of the invention and many of the attendant
advantages thereof will be readily obtained from the drawings, wherein
FIG. 1 shows the weight loss results for an eight-week treatment
period comparing use of the composition of the present invention
and a placebo, and
FIG. 2 shows a follow-up crossover study where the group receiving
a placebo in the first phase of the study received the composition
of the present invention in the crossover phase.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The composition of the present invention is useful for producing
weight loss in humans in a clinically obese condition. A person
is "overweight", whose body weight (kg) is 15% above acceptable
weight for that persons height (cm). Obesity has been defined using
these measurements, as having a weight greater than 40% above acceptable
weight (Dulloo, A.G. and Miller, D. S., Wld Rev. Nutr. Diet., vol.
50, pp.1-56, 1987). However, the composition of the present invention
is also useful for inducing weight loss in humans of relatively
normal weight where additional weight loss is desirable. The composition
can be formulated in any convenient pharmaceutical form and administered
for the purpose of treating obesity, inducing weight loss, suppressing
appetite, or maintaining weight control while on a diet or caloric
restriction. In a particularly interesting application, the present
composition can be used to induce weight loss in the person who
has become low energy adapted following a regime of dieting. In
such persons, initial weight loss due to caloric restriction is
seen followed by a plateau phase in which additional weight loss
is difficult as the dieting person's metabolic rate becomes low
energy adapted. Administration of the present composition induces
additional weight loss in such low energy adapted persons allowing
additional weight loss.
Surprisingly, weight loss is effected using the present composition
whether or not caloric restriction is employed concurrently. That
is, there is no restriction with regard to caloric intake when using
the present composition, and yet weight loss is induced. Obviously,
when administered in conjunction with a commercial diet program,
improved weight loss is observed and can be maintained.
In its broadest sense, the present invention is directed to a method
for producing weight loss in a human by administering a composition
containing a weight loss effective amount of aspirin, caffeine and
ephedrine, all administered concurrently. In general, the amount
of aspirin administered is about 30-2500 mg/day, preferably about
200-1000 mg/day. Caffeine is generally administered in amounts of
about 10-500 mg/day, preferably about 30-200 mg/day. Ephedrine is
administered in amounts of about 25-350 mg/day, preferably about
50-100 mg/day Most preferably, aspirin, caffeine and ephedrine are
administered in amounts of about 300 mg/day, 120 mg/day and 150
mg/day, respectively. Obviously, amounts slightly above or below
these general ranges may be used as long as a weight loss effective
amount of each compound is present.
Each of aspirin, caffeine and ephedrine are commercially available.
Aspirin (acetylsalicyclic acid) is well known and available as a
white crystalline powder. Caffeine (1,3,7-trimethylxanthine) is
also available as a white crystalline powder in both technical and
pharmaceutical grades. Ephedrine possesses two assymetric carbon
atoms and is therefore available in four different stereoisomers,
that is, (-)-ephedrine, (+)-ephedrine, (-)-.psi.-ephedrine and (+)-.psi.-ephedrine,
as well as two racemic mixtures. The stereoisomer (-)-ephedrine
is much more effective and is therefore the preferred ephedrine
stereoisomer for use in the present invention. However, the other
stereoisomers of ephedrine are active in stimulating a thermogenic
response and may be used in the present invention if desired. Ephedrine
is also available as a white powder in technical and pharmaceutical
grades.
In the method and composition of the present invention, the relative
proportions of aspirin, caffeine and ephedrine are generally in
the range of about 2.0:1.0:0.5 to about 3.5:1.0:2.0 for optimum
effectiveness. Most preferably, aspirin, caffeine and ephedrine
are present in relative amounts of about 2.75:1.0:1.25.
Administration of these general amounts of aspirin, caffeine and
ephedrine, concurrently, produces onset of weight loss with substantially
no increase in blood pressure, tremors or other side effects seen
with conventional weight loss compositions and methods. Maintenance
administration of the present composition allows one to maintain
weight loss at the desired level after the initial amount of weight
has been reduced. After weight loss, persons generally have more
energy for daily activities and exhibit fewer undesirable side effects.
Surprisingly, the concurrent administration of aspirin, caffeine
and ephedrine does not result in an increase in blood pressure.
In contrast, other sympathomimetic drugs such as nicotine and propanolamine
give rise to an increase in blood pressure. The present method results
in larger increases in weight reduction with reduced side effects
and lower dosages.
The composition of the invention is usually administered in the
form of a pharmaceutical formulation or composition comprising the
compounds of the invention together with a pharmaceutically acceptable
carrier therefor.
The carrier must be "acceptable" in the sense of being
compatible with the other ingredients of the formulation and not
deleterious to the patient. Such carriers may be solid, liquid or
gaseous materials suitable for the purpose of administering the
medicament by the desired route.
These pharmaceutical compositions may be administered orally or
parenterally (including subcutaneous, intramuscular and intraveneous
injection) or as a suppository or pessary. In general the compositions
are administered orally.
For parenteral administration the active compounds may be presented
in sterile solutions or suspensions in aqueous or oleaginous vehicles,
which may also contain preservatives and material for rendering
the solution or suspension isotonic with the blood of the patient.
The formulations are conveniently presented in unit-dose or multi-dose
sealed containers.
For oral administration the pharmaceutical compositions may be
formulated as a draught in water or in a syrup, in capsules, cachets,
boluses or tablets, as an aqueous or oleaginous solution or suspension
or in suspension in a syrup, such suspensions optionally including
suspending agents, or as an oil-in-water or water-in-oil emulsion.
Flavouring, sweetening, preserving, thickening or emulsifying agents
may also be included in the formulation.
Tablets may contain the active compounds as a powder or granules
optionally mixed with binders, lubricants, inert diluents or surface-active
or dispersing agents and may be formed by compression or by molding
in inert liquid diluent. Such tablets may be scored and/or coated.
Capsules and cachets may contain the active compounds alone as
admixture or in a mixture with one or more other ingredients. Capsules
may also contain the active compounds in aqueous or oleaginous solution
suspension or emulsion optionally in association with other ingredients.
For administration as a suppository or pessary the active compounds
may be presented in admixture with a suitable carrier such as cocoa
butter and other material commonly used in the art, and are conveniently
shaped by molding. For administration in discrete unit dosage forms
such as tablets, capsules, suppositories and pessaries as described
above, the active compound is preferably present in the mg/day amounts
discussed above, per tablet, capsule, suppository or pessary.
All the above formulations may be produced by standard processes
comprising bringing the active compounds into association with one
or more pharmaceutically acceptable carriers.
A unit dose of the composition of the present invention, preferably
contains from 30-2500 mg aspirin, 10-500 mg caffeine and 25-350
mg ephedrine. More preferably, the unit dose comprises about 200-1000
mg aspirin, 30-200 mg caffeine and 50-100 mg ephedrine. A particularly
preferred unit dose is about 300 mg aspirin, 120 mg caffeine and
150 mg ephedrine. Such unit dose compositions may be administered
from 1 to 6 times per day such that the total daily dose is in the
ranges mentioned above for the effective treatment.
The aspirin, caffeine and ephedrine used in the present invention
may also be present as pharmaceutically acceptable salts if desired.
Typical salts include hydrochloride, hydrobromide and maleate salts,
although any pharmaceutically acceptable salt may be used.
Other features of the invention will become apparent in the course
of the following descriptions of exemplary embodiments which are
given for illustration of the invention and are not intended to
be limiting thereof.
EXAMPLES
The safety and efficacy of a composition containing aspirin, caffeine
and ephedrine (ECA) were studied in 24 obese human subjects. A total
daily dosage of ephedrine (75 mg), caffeine (150 mg) and aspirin
(300 mg) or a placebo was given in three pre-meal doses over an
eight-week period in a double blind experiment. After four weeks,
the ephedrine dose was increased to 150 mg/day. The subjects were
not calorically restricted.
The overall weight loss with the composition was 2.2 kg versus
0.67 kg in subjects taking the placebo. When the initial and final
weights were compared, significant differences were found in the
test group taking the composition of the present invention at week
6 (p<0.005) and at week 8 (p<0.001), but not in the placebo
group. Additionally, the rate of weight loss for the group of subjects
taking the present composition was significantly greater than for
the placebo (p.ltoreq.0.05).
Neither the group taking the active composition nor the group taking
the placebo showed significant changes in heart rate, blood pressure,
serum glucose, insulin or cholesterol. There was no statistically
significant difference in the frequency of reported side effects.
FIG. 1 shows the weight loss results for the eight-week treatment
period in both the placebo group and the group taking the ECA composition.
The untreated group weighed on the average about 8 kg more at the
beginning of the study than the treated group. As can be seen from
FIG. 1, the untreated group showed no trend toward weight loss,
just random variation between about 100 and 101 kg over the course
of the eight-week period. In contrast, the treatment group showed
significant weight loss between week 0 and week 4 and a greater
tendency toward weight loss after week 4 when the administered dose
of ephedrine was doubled.
In a follow-up crossover study, the group of subjects receiving
the placebo in the first phase of the study, now received the ECA
composition (ephedrine-75 mg, caffeine 150 mg, aspirin-300 mg).
At the beginning of the second phase study, the average weight of
the subjects had increased by approximately 1 kg in the interval
between the end of the first phase of the study and the beginning
of the second phase as can be seen from FIG. 2. Over the four weeks
of the second phase study, the average weight loss for participants
in the second phase was approximately 2 kg. In contrast, this same
group of subjects lost an average of only 0.6 kg during the entire
eight-week period of the first phase study.
The crossover study clearly shows the efficacy of the ECA composition
of the present invention for weight loss in humans, even without
caloric restriction.
Obviously, numerous modifications and variations of the present
invention are possible in light of the above teachings. Therefore,
it is to be understood that the invention may be practiced other
than as specifically described herein. |