Main > NEPHROLOGY > Dialysis. Peritoneal > HyperPhosphatemia > Treatment > Sevelamer.HCl (Polymer) > Patent. > Literature. > Poly(AllylAmine) > CrossLinked with Epichlorohydrin > Patent Assignee

Product USA. G. No. 4

PATENT NUMBER This data is not available for free
PATENT GRANT DATE January 21, 2003
PATENT TITLE Method of making phosphate-binding polymers for oral administration

PATENT ABSTRACT Phosphate-binding polymers are provided for removing phosphate from the gastrointestinal tract. The polymers are orally administered, and are useful for the treatment of hyperphosphatemia
PATENT INVENTORS This data is not available for free
PATENT ASSIGNEE This data is not available for free
PATENT FILE DATE April 4, 2000
PATENT REFERENCES CITED McGary, T.J. et al., "Polycation As an Alternative Osmotic Agent and Phosphate Binder in Peritoneal Dialysis," Uremia Investigation, 8(2):79-84 (1984-1985).
Physicians' Desk Reference, Consult 1992 Supplements for Revisions "Phoslo.RTM.", Calcium Acetate Tablets.
Physicians' Desk Reference, Consult 1992 Supplements for Revisions "Amphojel.RTM.", Suspension Tablets.
Burt et al., "Ion-Exchange Resins as Potential Phosphate-Binding Agents for Renal Failure Patients: Effect of the Physicochemical Properties of Resins on Phosphate and Bile Salt Binding," Journal of Pharmaceutical Sciences, 76(5):379-383 (1987).
Delmez, James A. et al., "Hyperphosphatemia: Its Consequences and Treatment in Patients with Chronic Renal Disease," American Journal of Kidney Diseases, XIX(4):303-317 (1992).
Emmett, Michael et al., "Calcium Acetate Control of Serum Phosphorus in Hemodialysis Patients," American Journal of Kidney Diseases, XVII(5):544-550 (1991).
Ghosh, J.P. et al., "Preparation and Properties of a New Chelating Resin Containing 2-Nitroso-1-naphthol," Talanta, 28:957-959 (1981).
Mai, Martin L. et al., "Calcium acetate, an effective phosphorus binder in patients with renal failure," Kidney International, 36:690-695 (1989).
Munson, Paul L., "Studies on the Role of the Parathyroids in Calcium and Phosphorus Metabolism," Annals New York Academy of Sciences, pp. 776-795 (Jun. 1993).
Slausky, I.B. et al., "Aluminum Accumulation During Treatment with Aluminum Hydroxide and Dialysis in Children and Young Adults with Chronic Renal Disease," The New England Journal of Medicine, 324(8):537-531 (1991).
Slatopolsky, Eduardo et al., "Calcium Carbonate as a Phosphate Binder in Patients with Chronic Renal Failure Undergoing Dialysis," The New England Journal of Medicine, 315(3):157-161 (1986).
Warshawsky, A., in Ion Exchange and Sorption Processes in Hydrometallurgy Critical Reports on Applied Chemistry, vol. 15, Chapter 4: Chelating ion exchangers, pp. 166-225 M. Streat & D. Naden (Eds.), John Wiley & Sons, (1987).
Winston, Anthony and Kirchner, Darrell, "Hydroxamic Acid Polymers. Effect of Structure of the Selective Chelation of Iron in Water," Macromolecules, 11(3):597-603 (1978).
Winston, Anthony and McLaughline, Glenn R., "Hydroxamic Acid Polymers. II. Design of a Polymeric Chelating Agent for Iron," Journal of Polymer Science, 14:2155-2165 (1976).
PATENT PARENT CASE TEXT This data is not available for free
PATENT CLAIMS What is claimed is:

1. A pharmaceutical composition consisting essentially of a carrier and at least one water insoluble, crosslinked polymer characterized by a repeat unit having the formula ##STR28##

or a copolymer thereof, wherein each n is an integer, each R, independently, is H or an alkyl, alkylamino, or aryl group optionally substituted with a quaternary ammonium, primary alkyl amine, secondary alkyl amine, primary aryl amine, secondary aryl amine, hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl, aryl, hydrazine, guanidine, urea, or carboxylic acid ester group, or a combination thereof.

2. The pharmaceutical composition of claim 1 wherein said polymer is crosslinked with a crosslinking agent, wherein said agent is present in said composition from about 0.5% to about 75% by weight.

3. The pharmaceutical composition of claim 2 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin, 1,4 butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

4. The pharmaceutical composition of claim 2 wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

5. The pharmaceutical composition of claim 1 wherein the polymer is a copolymer comprising a second repeat unit having the formula ##STR29##

wherein each n, independently, is an integer and each R, independently, is H or a substituted or unsubstituted alkyl, alkylamino, or aryl group and each X.sup.- is an exchangeable negatively charged counterion.

6. The pharmaceutical composition of claim 5 wherein said polymer is crosslinked with a crosslinking agent wherein said crosslinking agent is present in said composition from about 0.5% to about 75% by weight.

7. The pharmaceutical composition of claim 6 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin, 1,4 butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

8. The pharmaceutical composition of claim 6 wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

9. A pharmaceutical composition comprising a carrier and at least one water insoluble, crosslinked polymer characterized by a repeat unit having the formula ##STR30##

or a copolymer thereof, wherein n is an integer, each R, independently, is H or an alkyl, alkylamino, or aryl group optionally substituted with a quaternary ammonium, primary alkyl amine, secondary alkyl amine, primary aryl amine, secondary aryl amine, hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl; aryl, hydrazine, guanidine, urea, or carboxylic acid ester group, or a combination thereof.

10. The pharmaceutical composition of claim 9 wherein said polymer is crosslinked with a crosslinking agent, wherein said agent is present in said composition from about 0.5% to about 75% by weight.

11. The pharmaceutical composition of claim 10 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin, 1,4 butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

12. The pharmaceutical composition of claim 10 wherein said polymer is crosslinked with a crosslinking agent, wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

13. The pharmaceutical composition of claim 9 wherein the polymer is a copolymer comprising a second repeat unit having the formula ##STR31##

wherein each n, independently, is an integer and R is a substituted or unsubstituted alkyl, alkylamino, or aryl group and each X.sup.- is an exchangeable negatively charged counterion.

14. The pharmaceutical composition of claim 13 wherein said polymer is crosslinked with a crosslinking agent wherein said crosslinking agent is present in said composition from about 1% to about 75% by weight.

15. The pharmaceutical composition of claim 14 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin, 1,4 butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

16. The pharmaceutical composition of claim 14 wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

17. A pharmaceutical composition comprising a carrier and at least one water insoluble, crosslinked polymer characterized by a repeat unit having the formula ##STR32##

or a copolymer thereof, wherein n is an integer, and each R.sub.1 and R.sub.2, independently, is H or an alkyl, alkylamino, or aryl group optionally substituted with a quaternary ammonium, primary alkyl amine, secondary alkyl amine, primary aryl amine, secondary aryl amine, hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl, aryl, hydrazine, guanidine, urea, or carboxylic acid ester group, or a combination thereof, and each X.sup.- is an exchangeable negatively charged counterion.

18. The pharmaceutical composition of claim 17 wherein at least one of said R groups is a hydrogen group.

19. The pharmaceutical composition of claim 17 wherein said polymer is crosslinked with a crosslinking agent, wherein said agent is present in said composition from about 0.5% to about 75% weight.

20. The pharmaceutical composition of claim 19 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin 1,4-butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

21. The pharmaceutical composition of claim 19 wherein said polymer is crosslinked with a crosslinking agent, wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

22. A pharmaceutical composition comprising a carrier and at least one water insoluble, crosslinked polymer characterized by a repeat unit having the formula ##STR33##

or a copolymer thereof, wherein n is an integer, each R.sub.1 and R.sub.2, independently, is H or an alkyl group containing 1 to 20 carbon atoms optionally substituted with a quaternary ammonium, primary alkyl amine, secondary alkyl amine, primary aryl amine, secondary aryl amine, hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl, aryl, hydrazine, guanidine, urea, or carboxylic acid ester group, or a combination thereof.

23. The pharmaceutical composition of claim 22 wherein said polymer is crosslinked with a crosslinking agent, wherein said agent is present in said composition from about 0.5% to about 75% by weight.

24. The pharmaceutical composition of claim 23 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin 1,4-butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

25. The pharmaceutical composition of claim 23 wherein said polymer is crosslinked with a crosslinking agent, wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

26. A pharmaceutical composition comprising a carrier and at least one water insoluble, crosslinked polymer characterized by a repeat unit having the formula ##STR34##

or a copolymer thereof, wherein n is an integer, each R.sub.1, R.sub.2 and R.sub.3, independently, is H, an alkyl group containing 1 to 20 carbon atoms, an aminoalkyl group, or an aryl group containing 1 to 12 atoms, each of which are optionally substituted with a quaternary ammonium, primary alkyl amine, secondary alkyl amine, primary aryl amine, secondary aryl amine, hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl, aryl, hydrazine, guanidine, urea, or carboxylic acid ester group, or a combination thereof, and each X.sup.- is an exchangeable negatively charged counterion.

27. The pharmaceutical composition of claim 16 wherein said polymer is crosslinked with a crosslinking agent, wherein said agent is present in said composition from about 0.5% to about 75% by weight.

28. The pharmaceutical composition of claim 19 wherein said crosslinking agent is selected from the group consisting of epichlorohydrin 1,4-butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence duisocyanate, acryloyl chloride, and pyromellitic dianhydride.

29. The pharmaceutical composition of claim 27 wherein said polymer is crosslinked with a crosslinking agent, wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

30. A pharmaceutical composition comprising at least one hydrophilic, water insoluble, cross-linked aliphatic amine polymer and a pharmaceutically acceptable carrier or diluent.

31. A pharmaceutical composition consisting essentially of a carrier and at least one crosslinked, water insoluble polymer characterized by a repeat unit having the formula ##STR35##

or a copolymer thereof, wherein each n is an integer, each R, independently, is H or a alkyl, alkylamino, or aryl group optionally substituted with a quaternary ammonium, primary alkyl amine, secondary alkyl amine, primary aryl amine, secondary aryl amine, hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl, aryl, hydrazine, guanidine, urea, or carboxylic acid ester group, or a combination thereof, and each X.sup.- is an exchangeable negatively charged counterion.

32. The pharmaceutical composition of claim 31 wherein said polymer is crosslinked with a crosslinking agent, wherein said agent is present in said composition from about 0.5% to about 75% by weight.

33. The pharmaceutical composition of claim 32 wherein said crosslinking agent is selected from the group consisting of epichlofohydrin, 1,4 butanedioldiglycidyl ether, 1,2-ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluence diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

34. The pharmaceutical composition of claim 32 wherein said crosslinking agent is present in said composition from about 2% to about 20% by weight.

35. A pharmaceutical composition consisting essentially of a carrier and a crosslinked, water insoluble, polyallylamine polymer.

36. The pharmaceutical composition of claim 35 wherein the polyallylamine polymer is a homopolymer.

37. The pharmaceutical composition of claim 35 wherein the polyallylamine polymer is crosslinked with epichlorohydrin.

38. A pharmaceutical composition comprising a crosslinked, water insoluble polyallylamine homopolymer, wherein the polyallylamine homopolymer comprises repeat units represented by the structural formula: ##STR36##

wherein n is an integer.
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PATENT DESCRIPTION BACKGROUND OF THE INVENTION

Hyperphosphatemia frequently accompanies diseases associated with inadequate renal function, hypoparathyroidism, and certain other medical conditions. Hyperphosphatemia is typically defined as possessing a serum phosphate levels of over about 6 mg/dL. The condition, especially if present over extended periods of time, leads to severe abnormalities in calcium and phosphorus metabolism and can be manifested by aberrant calcification in joints, lungs, and eyes.

Therapeutic efforts to reduce serum phosphate include dialysis, reduction in dietary phosphate, and oral administration of insoluble phosphate binders to reduce gastrointestinal absorption. Dialysis and reduced dietary phosphate are generally unsuccessful in adequately reversing hyperphosphatemia. Further difficulties in these therapeutic regimens include the invasive nature of dialysis and the difficulties in modifying dietary habits in the latter therapy.

The oral administration of certain phosphate binders has also been suggested. Phosphate binders include calcium or aluminum salts. Calcium salts have been widely used to bind intestinal phosphate and prevent absorption. The ingested calcium combines with phosphate to form insoluble calcium phosphate salts such as Ca.sub.3 (PO.sub.4).sub.2, CaHPO.sub.4, or Ca(H.sub.2 PO.sub.4).sub.2. Different types of calcium salts, including calcium carbonate, acetate (such as PhosLo.RTM. calcium acetate tablets), citrate, alginate, and ketoacid salts have been utilized for phosphate binding. This class of therapeutics generally results in hypercalcemia due from absorption of high amounts of ingested calcium. Hypercalcemia has been indicated in many serious side effects, such as cardiac arrhythmias, renal failure, and skin and visceral calcification. Frequent monitoring of serum calcium levels is required during therapy with calcium-based phosphate binders.

Aluminum-based phosphate binders, such as Amphojel.RTM. aluminum hydroxide gel, have also been used for treating hyperphosphatemia. These compounds complex with intestinal phosphate to form highly insoluble aluminum phosphate; the bound phosphate is unavailable for absorption by the patient. Prolonged use of aluminum gels leads to accumulations of aluminum, and often to aluminum toxicity, accompanied by such symptoms as encephalopathy, osteomalacia, and myopathy.

Selected ion exchange resins have also been suggested for use in binding phosphate. Those tested include Dowex.RTM. anion-exchange resins in the chloride form, such as XF 43311, XY 40013, XF 43254, XY 40011, and XY 40012. These resins have several drawbacks for treatment of hyperphosphatemia, including poor binding efficiency, necessitating use of high dosages for significant reduction of absorbed phosphate.

Thus a need exists for improved phosphate binders which can be administered orally in acceptable dosage levels without resulting in many of the serious side effects discussed above.

SUMMARY OF THE INVENTION

The invention relates to the discovery that a class of anion exchange polymers have improved phosphate binding properties. In general, the invention features a method of removing phosphate from a patient by ion exchange, which involves oral administration of a therapeutically effective amount of a composition containing at least one phosphate-binding polymer. The polymers of the invention may be crosslinked with a crosslinking agent.

The invention provides an effective treatment for decreasing the serum level of phosphate by binding phosphate in the gastrointestinal tract, without comcomittantly increasing the absorption of any clinically undesirable materials, particularly calcium or aluminum.

Other features and advantages will be apparent from the following description of the preferred embodiments and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an illustration of the bound phosphate relevant to solution phosphate concentration after a phosphate solution is treated with poly(dimethylaminopropylacrylamide).

FIG. 2 is a graphic illustration of the phosphate concentration in fecal samples taken from rats fed with a dietary supplement of a crosslinked polyallylamine and micro-crystalline cellulose (placebo).

FIG. 3 is a graphic illustration of the urinary phosphate concentration in rats similarly given a dietary supplement of a crosslinked polyallylamine and microcrystalline cellulose (placebo).

DETAILED DESCRIPTION OF THE INVENTION

A description of preferred embodiments of the invention follows.

The polymers of the invention generally include hydrophilic anion exchange resins, particularly aliphatic amine polymers. The "amine" group can be present in the form of a primary, secondary or tertiary amine, quaternary ammonium salt, amidine, guanadine, hydrazine, or combinations thereof. The amine can be within the linear structure of the polymer (such as in polyethylenimine or a condensation polymer of a polyaminoalkane, e.g. diethylenetriamine, and a crosslinking agent, such as epichlorohydrin) or as a functional group pendant from the polymer backbone (such as in polyallylamine, polyvinylamine or poly(aminoethyl)acrylate).

In one aspect, the polymer is characterized by a repeating unit having the formula ##STR1##

or a copolymer thereof, wherein n is an integer and each R, independently, is H or a substituted or unsubstituted alkyl, such as a lower alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl (e.g., phenyl) group.

In a second aspect, the polymer is characterized by a repeating unit having the formula ##STR2##

or a copolymer thereof, wherein n is an integer, each R, independently, is H or a substituted or unsubstituted alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl (e.g., phenyl) group, and each X.sup.- is an exchangeable negatively charged counterion.

One example of a copolymer according to the second aspect of the invention is characterized by a first repeating unit having the formula ##STR3##

wherein n is an integer, each R, independently, is H or a substituted or unsubstituted alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl group (e.g., phenyl), and each X.sup.- is an exchangeable negatively charged counterion; and further characterized by a second repeating unit having the formula ##STR4##

wherein each n, independently, is an integer and each R, independently, is 11 or a substituted or unsubstituted alkyl (e g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl group (e.g., phenyl).

In a fourth aspect, the polymer is characterized by a repeating unit having the formula ##STR5##

or a copolymer thereof, wherein n is an integer, and R is H or a substituted or unsubstituted alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl group (e.g., phenyl).

One example of a copolymer according to the second aspect of the invention is characterized by a first repeating unit having the formula ##STR6##

wherein n is an integer, and R is H or a substituted or unsubstituted alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl group (e.g., phenyl); and further characterized by a second repeating unit having the formula ##STR7##

wherein each n, independently, is an integer and R is H or a substituted or unsubstituted alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), alkylamino (e.g., having between 1 and 5 carbon atoms, inclusive, such as ethylamino) or aryl group (e.g., phenyl).

In a fifth aspect, the polymer is characterized by a repeating group having the formula ##STR8##

or a copolymer thereof, wherein n is an integer, and each R.sub.1 and R.sub.2, independently, is H or a substituted or unsubstituted alkyl (e.g., having between 1 and 5 carbon atoms, inclusive), and alkylamino (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino) or aryl group (e.g., phenyl), and each X.sup.- is an exchangeable negatively charged counterion.

In one preferred polymer according to the fifth aspect of the invention, at least one of the R groups is a hydrogen atom.

In a sixth aspect, the polymer is characterized by a repeat unit having the formula ##STR9##

or a copolymer thereof, where n is an integer, each R.sub.1 and R.sub.2, independently, is H, a substituted or unsubstituted alkyl group containing 1 to 20 carbon atoms, an alkylamino group (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino), or an aryl group containing 6 to 12 atoms (e.g., phenyl).

In a seventh aspect, the polymer is characterized by a repeat unit having the formula ##STR10##

or a copolymer thereof, wherein n is an integer, each R.sub.1, R.sub.2 and R.sub.3, independently, is H, a substituted or unsubstituted alkyl group containing 1 to 20 carbon atoms, an alkylamino group (e.g., having between 1 and 5 carbons atoms, inclusive, such as ethylamino), or an aryl group containing 6 to 12 atoms (e.g., phenyl), and each X.sup.- is an exchangeable negatively charged counterion.

In each case, the R groups can carry one or more substituents, Suitable substituents include therapeutic anionic groups, e.g., quaternary ammonium groups, or amine groups, e.g., primary and secondary alkyl or aryl amines. Examples of other suitable substituents include hydroxy, alkoxy, carboxamide, sulfonamide, halogen, alkyl, aryl, hydrazine, guanadine, urea, and carboxylic acid esters, for example.

The polymers are preferably crosslinked, in some cases by adding a crosslinking agent to the reaction mixture during or after polymerization. Examples of suitable crosslinking agents are diacrylates and dimethacrylates (e.g., ethylene glycol diacrylate, propylene glycol diacrylate, butylene glycol diacrylate, ethylene glycol dimethacrylate, propylene glycol dimethacrylate, butylene glycol dimethacrylate, polyethyleneglycol dimethacrylate, polyethyleneglycol diacrylate), methylene bisacrylamide, methylene bismethacrylamide, ethylene bisacrylamide, epichlorohydrin, epibromohydrin, toluene diisocyanate, ethylenebismethacrylamide, ethylidene bisacrylamide, divinyl benzene, bisphenol A dimethacrylate, bisphenol A diacrylate, 1,4 butanedioldiglycidyl ether, 1,2 ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, acryloyl chloride, or pyromellitic dianhydride.

The amount of crosslinking agent is typically between about 0.5 and about 75 weight %, and preferably between about 1 and about 25% by weight, based upon the combined weight of crosslinking and monomer. In another embodiment, the crosslinking agent is present between about 2 and about 20% by weight of polymer.

In some cases the polymers are crosslinked after polymerization. One method of obtaining such crosslinking involves reaction of the polymer with difunctional crosslinkers, such as epichlorohydrin, succinyl dichloride, the diglycidyl ether of bisphenol A, pyromellitic dianhydride, toluence diisocyanate, and ethylenediamine. A typical example is the reaction of poly(ethyleneimine) with epichlorohydrin. In this example the epichlorohydrin (1 to 100 parts) is added to a solution containing polyethyleneimine (100 parts) and heated to promote reaction. Other methods of inducing crosslinking on already polymerized materials include, but are not limited to, exposure to ionizing radiation, ultraviolet radiation, electron beams, radicals, and pyrolysis.

Examples of preferred crosslinking agents include epichlorohydrin, 1,4 butanedioldiglycidyl ether, 1,2 ethanedioldiglycidyl ether, 1,3-dichloropropane, 1,2-dichloroethane, 1,3-dibromopropane, 1,2-dibromoethane, succinyl dichloride, dimethylsuccinate, toluene diisocyanate, acryloyl chloride, and pyromellitic dianhydride.

The negatively charged counterions, X.sup.-, can be organic ions, inorganic ions, or a combination thereof. The inorganic ions suitable for use in this invention include halide (especially chloride), carbonate, bicarbonate, sulfate, bisulfate, hydroxide, nitrate, persulfate and sulfite. Suitable organic ions include acetate, ascorbate, benzoate, citrate, dihydrogen citrate, hydrogen citrate, oxalate, succinate, tartrate, taurocholate, glycocholate, and cholate.

In a preferred embodiment, the counterion does not have a detrimental side effect to the patient but rather is selected to have a therapeutic or nutritional benefit to the patient
PATENT EXAMPLES Available on request
PATENT PHOTOCOPY Available on request

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