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Page 2 of 2 Publication Images ‘APPENDIX 1. United States Patent p] [II] Fw% [as] Inventrx: Sen-Maw Fang, North Salt Lake, Utah [73] Assignee: $M$’ Labs, Ine, North Salt Lake City, [U] Appl. No.: 09/036,854 [22] Filed: Mar. 9,199s [51] Int. Cl.6 .... ..... ..... ........ .. ..-.v.................... CO% 229126 [SZ] . U.S. Cl . . . . .. ....‘ ..... .. ... ... _......." . ...." S62/560; SW567 [SS] PIeId of Search ...Al._l_.l..._._.l....,...562/560,567; 514/554,556 References Cited WI 5,994,581 Nov. 30,1999 T Ka&kaws et al., “EZec!s of L-Camitine on Exercise Tolerant in Patientswith StableAngina Pectmis,”Japu- [S4] CARNlTINE CRE4TINATE [75] Patent Number: Date of Patent: U.S. PATENTDOCUMENTS 5,030,657 7/1991 Burtle et&. OTHEik PUBLJC/‘JlONS DatabaseCAPLUS on STN, Act. No. 1970:404187.Nordmann et al, ‘Antiiatigue phosphocrcatiw salts. GB 1185882 (abstract),1970. P R Bomm, “Camitine,”Ana R& Nun. 3:233-259.1983. G Brevctti,et al. %oreasesin WaIkingDistancein Patients with PeripheralVascularDiseaseTreatedwith L.-Camitine: A Double-Blind, Cros.QJver Shaiy,” Circulation, 77(4): nese HearrJoumd, 25: 587~597,1984. S &&in, A Seven, M Mert, F Akalp, F YurdaIwl, and G Ckdan, “Gould L-Carnitine be an Acute EnergyInduar in Calabdic ChxIitions?“, Dev Mcd Ckifd New02 39(3): 174-177, 1997. K Lint, S Cboi, Y S Cha, and D S Sachan,“Caruitine and Ca&ine&mi&tration IncreasesFat Oxidationand EndurancePerfo&ancein Athletes: FASEBJ, ll(3): 2174,1997. CM&i, K Iriyama,B K GUIISOII, H Suzuki andP MoMaster, “PlasmaCam&c Kinetics during Ortbotqpic Liver Traasplantation;’&and 3 GaslmMterol, 3x4): 357-362.1997. U Rebouciie,DJ Paulson,“Camitioe Metabolismand Function in Humans,”AmRey Ntm 6:41-66,198G. A A-Shukaji et al., “On the- Interrelationship between Hepatic Qrnitiue, Fatty Acid Oxidation, rind TrigIycctide Biosynthesjs$ Nephcosis:’Lip&, 32(8) 847-852‘1997. L Vecchiel‘etaI., ‘Influence of L-CamItine Administration on Maximal Physical Exercise,”Eur J&pi Physio7,61: 486-494%990~ Sigma-Taq PbarmacenticaIs,Inc., “Camitor,” Pkysicians Desk Reference,pp. 2623-2625,1997. Primary E+r-Gary G&l Assistant Exuminer-Brian J. Davis 76%773,1988. Attoq, H P Broquist, “Camitint: A %entieth Century Study,” FMEB .7ou,t, ll(3): 2088,1997. P Cerrcteltiand C Marconi,“L-Camitine S~@mentatian in Humans.The Effects on PhysicalPerformance:’Iti. 3. Sponr Med. 11: l-4, 1990. R N Cortrigbt, D M Muoio, and G L Dohm, “Skeletal MuscleLipid Metabolism:A Frontierfor New Insights into Fuel Homeostasis,” NucritionrtlBiochemistry,8: 228-245, 1997. I R Dipalma, ‘Lcamitioe: Its Therapeutic Potential,’ AmericanFamiiy Physician,34(9:17.7~l30, 1986. 1 R Dipalma, “Camitiue Deficiency,”American Family ABSTRACT kv The present invention relates to the formation of a Sal! betweencar&w and creatincwhich has unique and us&l attributesaver creatine mowbydratc or carritine base.An acid-baseran&ionbetweencam&e and neatiac causesthe formation of the salt composition.Further, the inventioo provides a%aIt form of camitioe which is very stable and non-hygrovopic, The camitine cnatioate product of the presentinvention is representedby the following: Physkkm,38(1):243-251, *en& or Firm-Thorpe North & Western,LLP 1988. R Fenari, F Cwchini and 0 Visioli, “The Metabolical EffccC of L-camitine in Angina Pcctozis?I&Z J of Cardi&gy,5: 2s2X,1984. J D Felts,AL Shug,J R K&e, N Bittar, “Ptotecfion of the Is&&c Dog Myocardiumwith Camitine,”AmaricunJ. of CQdfOfO~, 443120%i214,1978. E M Gorostiaga,C A Mawr, J P Eclacha,“Decreasein Respiratory Quotient @ring Exercise FoIIowing L-Carnitinc SuppIementaticm,” Int. J. Sporrs&fed, 10: 169-174, 1989. S Hirose, et al., “Car&&e DepletionduringTotal ParenteraI Ac Nukition DcspitcOral L-Camitiae SupplementaIion,” PQedia~~~aJa~~ca,3~1~2~,~9~. wherein X is an integer behveenabout 0 and 5. 6 Claims, No Drawings http://patimg2.uspto.gov/.piw?DocidOS9945~l&homeurl=http%3AP2F%2~p~~t.uspto.go,,. ’ 5/6/2004 Page 2 of 2 Publication Images 5,994,581 1 2 by the anaerobic degradationof phosphocreatic (PCR) and glycngen(<man E. et aL;Energymer*rbolirmandfatigue. BRIEF DESCRlPTlON OF THE INVENTION In: Taylor A, Gollnick P, GreenH, et al., eds.Biocb~m~*~ This invention relatesto the formation of a salt between of.&&& VII. Champaign,III: Human Kinetic Publishers, camitincand creatinewhich hasuniqueand useful attributes 5 1990: vol. 21, 73-92). Greenhaffet al. proposedthat the observeddeclinein force production during intensecontracover creatioe monohydrate or carnitine base. More specifically,tb6 invention relatesto a carnitinc creatinate tion may be relatedto the availability of musclePCR stores (Grcahaff P. C., CaseyA., ShortA H., Harris R., Soderhmd salt that provides a significantly improved taste over carnitine salts,such as tartrateand citrate,heretoforeavailable. K., Hnlimab E.; i@uence of oral creatine supprementaiion volunAdditionally, it provides a salt form of camitine which is IO of mu& mque during repented bouts of m&l very stableand non-hygroscopic.The combinedcompound my exercisrin man; Clinical Science(1993) 84,565-571). The deplet@nof these PCR storeslimits the rephosphoryis an excellent choice in diet formulations because it lation of ADP, therebylimiting the ATP availablefor energy improvesmetabolicfat burning andprovidesan extraenergy production. Greenhaff et al. further proposed that any boost. IS mechahismcapable of increasing the intramusculartotal BACKGROUND OF THE INVENTION creatine store ,might arrest PCR depletion during intense muscularcontractionand offset or even prevent the decline Creatine, also known as N-(Aminoiminomelhyl)-Nmethylglycine, methylglycoamine or N-methyl-guanido in the rate of ADP rephosphorylation during exercise. Grcenhaff et al. did not document means whereby the amtic acid is listed in the MERCK INDlX, an accepted chemical encyclopediaand may be representedby the 20 effectiveiount of creatincwitbin the musclecellscould be increased.indeed, Grcenhaffei al. relied upon work previfollowing depiction: ously publishedby Harris et al. where it was demonstrated that the creatine content of skeletal muscles may be increased,howeverby only 2@-$046,through standardoral z pathways.,ImportanUy,in order to achieve this mediocre increasein the.creatinecontentof musclecells the subjects of the study were required to ingest 20 grams of creatinc monohydrate,much of which was washed out through the urine inste+dof being assimilatedand metabolized(Harris (The Merck Index Tenth Edition, No. 2551). Perhaps, 30 RC, Soderhmd K, Hultman E.; Elevation of crealine in becauseof thepositioningof the-NH, group gamma to the resting and exercised muscle ofnormal subjects by creative carboxylic acid, creatine is labile to acid hydrolysis. supplemen&tion.,Clin. Sci., 1992; 83: 367-74). Regardless,however,of any purportedrational, creatineis Creatine’ can be found biologically in many forms and in susceptibleto cyclization under acid conditions to form diverseportionsof the body. Walkerreportscreatineto exist crealinincwhich may be representedby the following depic- 35 mainly in the nerves and muscle (Walker J.B.; Crea~ine: Biosynthesis.rcgulurion,andfuncfionAdr! Enzymologyand tion: RelaredA&as of Moiecular Biology (1979) 50: 177442). Creatinehasa normal turnoverrateof about2 gramsper day. The biochemicalprocesswhich uses creatinefor the regenF NH 4c eration of +TP fFomADP irreversibly transformscreatineto creatinine which is eliminated through the urine. Because Ycreatinei&irreversibly used, the body must either produce creatinebiochemicallyor securean adequateoutsidesource. I0 “\E Biochczncally creatineis synthesizedin the human liver 4s and pancreaswhereascreatineis synthesizedexclusivelyin In acidicaqueoussolutionsthe formationof creatininefrom the,liver by membersof the poultry family. The humanliver creatine is nearly quantitative and irreversible (Cannan, and pancreasuse the amino acids glycine, serine,arginina and methjonine to synthesizecreatine. However, where Shore,Biochem. J. 22,92& 1928).Creatinineis, aswell, one sufficient creatine is made bioavailable through ingestion by-productof normalmetabolic useof crearineandhasbeen used as a diagnostic marker of such use. Moreover the 50 such biosynthesiswould seemunnecessary.Although aniexposureof creatine to the acidic environmentof the gut ma1 musqlc contains approximately 0.5% creatine by weight, m&t of this is degradedby cooking thereby prewould be expectedto causethe irreversible formation of creatinine precluding further biological use of ingested eluding cqoked meat from the potential list of external creatine. Furthermore,the ingestion of crealine has been sourcesOCingestile bioavailablecreatine.Moreover,neiassociatedwith markedstomachand gastricupset.Althotigh 5s ther plant nor vegetablematterprovidesa sourceof creatioe. the ingestionof creatincand gastic upset are perhapsonly Creatina has been a componentin several recent U.S. linked by empiricalobservation,the acid stability of crealine patents.US. Pat. No. 5397,786 entitled REHYDRATION and subsequentformation of creatinineprovide potentia1 DRINK dbclnscs and claims a rehydration drink for the treatment$nd preventionof the lossof essentialelectrolytes IWEOIlS. Muscle contractionand relaxationare fueled by the free 60 becauseof Buid loss. This patent teachesthat creatine,B energy liberated by the dcphosphorylationof adenosine vitamihs,pantothenicacid andcholineareenergyenhancers. Additionally, tbii invention suggeststhe addition of numertriphosphate(ATP). ‘Ihe AI’P stored within ceI1.sis rapidly depleted during even normal activity. For normal tissue ous salts such as MgC4, CaCO, and magnesiumaspartate function to continue, Xl? must be rapidly resynthesized assupplementswhich containessentialnutrientsfor healthy from its breakdown products, one of which is adenosine6s metabolism.However,the useof ionic&s such as MgCO, is less effective than desiredbecausemost of the ingested diphosphate(ADP). During maximal exercise of a short durationthis resynthesisis accomplishedalmostexctusively element is lost in the acidic environmentof the gut. CARNITINE CREATINATE ‘-‘----‘, http://patimg2.uspto.gov/.piw?docid=USOO599458l&SectionNum=2&~Key=~l4EBEB... 12/2/2003 Page 2 of 2 Publication Images $994,581 4 3 U.S. Pat. No. 5,576,316entitled METHOD FORINHIBITING TUMOR GROWTH RATE USING CREXI’INE OR CREATINEANALOGS issuedNo?. 19, 1996. This patent teachestbe use of creatine and creaiine analogs for the treatmentof tumors.Specificallythis invention.teacbesthat 5 the administrationof creatinein the form of a saIt can reduce a tumor’s growth rate. Importantly, this pat&t also teaches that significant portions of orally administeredcreatine are lost through the urine without having been used by the host Although the potential causesfor this observanceare not stated,one reasoncould be the low solubility of creatinein IO water to account for the observed preclusion of ingested creatinefrom biological use. Carnitine (3.Carboxy-Z-bydroxypropyl) trimathylammnoniumhydroxide inner salt (CAR) may be represented graphically according to the depiction of 15 GraphicI. LCamitine may improve exercise tolerancein patients with effori angha (Efffecisof L-Cartiine on Exercise Tolerance in @i&t.s with Slable At&a Pecloris. Japanese Heart Journal 25: 587, Karikawa T. et al., 1984). L-Carnit@+converted lactate production to extraction and increasedthe percentageof free fatty acid extraction,suggating a qse to improvethe metabolismof coronaryartery disease patients (The Mefabolical Ej$ects of L-Cardtim in Angina P&%ori.s.Ferrari R., Cuccbini F., Visloli O., laternarional Journal of Cardiology 5(1984): 213-216). L-Car&m has also improved the walking capacity of patientswith intermittentclaudication (mCreu.se~ in WaIking Distance &I Patients with Peripheral Vascular Dtiease Treated v$th L-Camitine. A Double-Blind, Cross-Over S&y. Breyetti G., Jancelli V. G., et al. Circulation Vol. 77, No. 4,76%-7X$ April 1988). L-Camitine may benefit the ischemicmyocardinmby maintaining tissue levels of free cardine Ompbic I 20 (Protection of the Ischetic Dog Myocardium wilh Camitine..Folts J. D., Shug A. L., Koke 3. R., Bittar N., American Journal of Cardiology 41: 1209, 1978). Pat&& wifh type II or type IV hy+ipoprotcinemia, when treatedwith 3 grams of oral camitine per day, had a marked reduction in serumcholesterol and serumtriglyceridc (Car&&e. Bornm, P. R. Ann Rev Nutr 1983. 3: 233-259). Carnit$e may be an essentialnutrient for the newborn (Car@inqc Bmum, P. R. Ann Rev Nun 1983. 3: 233-259). L-Camitine has promisein reducing the fat accumulationin certain types of fatty Iivers (L-Car&tie: its Therapeutic PotentiaL Dipalma J. R. Amer Fan Phys 34(6): 127-l30, 1986). The use of L-Car&& in dialysis patients may be important’iu individual cases L-Camnitine: Its Therapedc Poren~ial. ,Dipalma J.R. Amer Fam Phys 34(6): 12%l30, There are two chemical forms of CAR, L-CAR and D-CAR, OCwhich LCAR is biologically active and is 25 pharmaceutically available for medicinal indications. Biologically, a portion of CAR binds fatty acids forming acyl (A) CAR while the restexistsas free (F) CAR. The sum of thesetwo fractions &referred to as total (T) CAR Some of its physiological roles in fatty acid oxidation and in the 30 excretionof organic acids have been well investigated. LCamitine functions as a carrier moleculein the transport of long chain fatty acidsacrossthe inner mitocbondrial membrane.It delivers substratefor oxidation and subse- 1986). quent energyproduction. Meat and dairy productsarethe major sourcesof carnitioe Camitine’s essentialrole is to transport fatty acids of 35 in the United States.Cereal,fruits, and vegetablescontain 12-18 carbonsacrossthe outer and inner membranesof tbe little or no carnitine (Carniiine. Borum, I? R. Ann Rev Nutr mitocboodria.Camitine palmitoyltransferasecatalyzestbe 1983. 3: 233-259). transfer of the fatty acid or acyl group to camitine at the Individuals on enteral nutrition for long of time outer surfaceof the mitochondrialmembrane.The acylcar, periods mxare, caseIn, or egg nitine then goes acrossthe outer membraneof the inner 40 WhOSo pIOteln SOuTCe 1s sOy pmeln white protein get low amounts of carnitine (4 nmoliml surfaceof the mitocboodrialmembrane.Here the acyl group camitioe br Iess) (Carni~ine. Bornm, P. R. Ann Rev Nurr is transferredback to coenzymeA under the inlinen- 01 cam&e paimitoyltransferase II (Carnirinu Deficiency 1983. 3: p3-2.59). DipalmaJ. R.,AmericanFamifyPhysician, 38(I): 243-251, There is evidence of increasedVO, max with carnitine 1988). 45 suppleme@ation. This is probably through the removal of L-Carnitioe is used in the treatmentof primary systemic part of the short-chain acyl-CoA by L-Camnitine in the carnitioedeficiency.CIinicaI presentationcan include recurmuscles heavily involved in exercise with a concnrreot rent epis&es of Reye-like encepbalopathy,bypoketotic releaseof free CoA. This would stimulate pyruvate debyhypoglycemia, and/or cardiomyopathy.Other associated drogenasqand enhanceflux in the Krebs Cycle(L-Carnitine symptomsincludedhypotonia,muscleweakness, andfailure SO Supplemwtafion in Humans. The Effects on Physical Perto thrive (Physicians Desk Rq%wnce, 1997, p. 2624). formance, Cerretelli P., Marconi C., Int J. Sports Med 11 L-Carnitine may also alIeviate the metabolic abnormali- (1990) 1114). ties of patientswith Inborn errors of metabolismthat result L-&&tine could be advantageous to exercising in the accumulationof toxic organic acids(Physicians Desk individuais, as prolonged exercise increasesthe urinary 55 excretion, of camitioe (L-Carnifine Supplementasion in Reference, 1997, ~2623). Camitine’simportancein cardiac metabolismand funcHumans.!t?zEffects on PhysicalPerformance. Cerretelll P., tion hasbeenemphasizedby a numberof studiesshowing a Marconi C., Int J. Sporfs Med ll(1 990) l-14). close associationbetweensystemicand myopathiccamitine A positive effect of L-Camitine is au increaseof muscles’ deficiencyand both bypertropbicand congestivecardiomyo- anaerobiccapacity. Carnitine, by fnoctiomug as an acetyl patbies (Cam&e Metabolism and Fun&n in Humans. 60 group buffer, 1) Maintsios a viable pool of CoA even when ReboucheC. I., PaulsonD. J., Ann Rev 1986. 6: 41-66). the rate cif acetyl-CoAformation exceedsthat of condensaReportsindicate L-Camitine therapy converts abnormal tion of the above metabolitewith oxaloacetate,2) Prevent fatty acid metabolismto normal, increasesthe concentration ‘%oodin$’oftbe mitochondrialmatrix by acetyl-CoAesters, of LCamifine in cardiacmuscleaod in blood, and improves 3) Act as an additionalsink for pyruvare,and 4) Improve the cardiacoutput and blood pressure(L-Cam&e: Its Thera- 65 transport pf adeoiaermcleotides(L-Carnitiw Supplementapeuric Potential. Dipalma J. R. Amer Pam Phys 34(6): tion in Humans. The Effects on Physicul Pe$ormance. 127-130,1986). Cenetelli P., Marconi C., InlJ. SpowMed 11 (1990) l-14). http://patimg2.uspto.gov/.piw?docid=USOO59945Sl&PageNum=3&IDKe~=X;F14EBEBB... 12/2/2003 Page 2 of 2 j Publication Images 5,994,581 5 L-Camitine may increaselipid utilization by muscleduring exe&e. (Decrease in Respiratory Quotient During Exercise Following L-Camitine Supplementation. GorostkagaE. M., Maurer C. A., E&&e J. P.,Inr J. Sporrs Med. 6 properties of the salt comprising creatine and car&me, namelycacnitinecreatinate,areunexpectedin that the salt is more stab)r:than the two organic moieties of which it is made and has a distinct yet pleasant taste. 5 Furthermore,carnitinecreatinate salt of the presentinvention is a u&me chemicalcomposition as evidencedby the designationof a ChemicalAbstracts Serviceunique identifer. This unique identifer is given to new chemicalcompositions by the Chemical Abstracts Service (CAS). The 10 uniqueCAS numberassignedthe unique camitinecreatmate chemical compositionof the present invention is 20179031-O. 10 (1989) 169-174. LCarnicine has been showy to increaseboth maximal oxygen uptake and power output (InjJnenceof E-Carnirine Adminisrrationon Maximal PhysicalExerc&e.VecchietL., et al. European Jounuzl @Applied Physiology (1990) 61: 486-490). In the supplementationof L-CAR for patients on longterm total parenteralnutrition, especiallyfor patients with shortbowel syndrome,a morepracticalproblemarises.Oral supplementationof L-CAR of the type known cannot propREFERREDEMBODIMENT AND EXAMPLES vide a sufficientamountof CAR when patientshave severe 15 A preferredembodimentof lhe present invention would malabsorption, because it is not easily absorbed.For this population, intravenous supplementationis considered. be preparedaccordingto the following: However,the availability of L-CAR 601ihtravenousadminEXAMPLE 1 i&ration is limited becauseof a lack of metabolicallyacceptable salts of car&me. One mole of camiline (161.20 grams) is mixed with one 20 Camitine possessesan unpleasantsmell and is hygromole of cmatinemonohydrate(149.15 grams)in a 4:l w:w scopicas a solid. The hygroscopicitymakesit very difficult mixture of isopropanol(40 g):water (10 g). The mixture is lo store camitine,especiallyas a solid. Tbe creaturesalt of heatedIO 70-72 C. until the mixture becomesa soft mass. carnitineof the presentinventionovercomestheseproblems Continued,mixing for an additional 5 minuteswith subseand possessesa distinct yet pleasanttasteand is not hygro- 2s quent coolingto 15-20’ C. resultsin a solid material.The solid ia further dried at reducedpressure(400-500 mm Hg) scopic. at no higher than 45” C. The resultant &n&e creatinale OBJECTSCtFTHE INVENTION monohydr&esalt has a molecularweight of 310.35 with a decompositionmelting point of 184-188’ C. and is a nonIt is thereforean object of the presentinventionto provide 30 hygrosco$c solid with a distinct yet agreeabletaste. a salt of carnitine with crealine. The salt synthesizedaccording to this example can be It is ao additional object of the invention to provide a caraitine salt having improved palatability and decreased administeredin daily dosagesofbehveen about50 and2,000 mg/day.Such dosagescan be in a single doseor m divided, hygroscopicity. It is still another object of tbe invention to provide a 35 multiple doses.The salt can be pressedinto tablets,placed in capsules,formulated as a syrup or elixir, or preparedby creatinesalt of camitinewhich hasimprovedpalatabilityand anv other conventional mechanism for oral dosane. metabolicavailability. Preferably,becauseof its improved palatability, the salcm Theseand other objects may be accomplishedby means oowder form can be administeredbv disnersineor dissolvof an organicsalt formed of crcatineand camitine and their &g it in a drink such as fruit juice. 1; ma; alsogc combined attendant salts and ananalogue.As used herein&e term 40 with protein powders or other food sourcesdesignedto “camitine analogue”will connote a salt or derivative of improve metabolicperformance. carnitine such as a memberselectedfrom tie group consistingof carnitinehydrochloride,carnitineesters,camitine EXAMPLE 2 amides,camitineimides and mixmresthereof.Similarly,the Apanelspf ten people were given samplesof a mixture of term “creatine analogne”will connotea substancewhich is 4s 100 mg of creatinemonohydrateand 100 mg of carnitinein made from chemicalmanipulationof creatine. 250 ml of applejuice. The samepanel was given 200 mg carnitinecreatinateformed in Example 1 in 250 ml of apple DETAILED DESCRIPTIONOF THE juice. The sampleswere merely labeled A and B and each INVEN’IlON Both creatineand camitine are bimorphic,each contain- 50 memberof the panel was free to elect which sampleto taste first. In ail instancesthe sample containing the carnitine ing an acidicand a basicmoiety.This somewhatunique dual oreatinatesaltwas judged to have the better taste. charactercreatesa natural analogy between creatine and carnitine,the correspondingsalt formed,and analogoussalts EXAMPLE 3 of ammo acids.Amino acids also possessboth acidic and basic moietieswithin one molecularstructure.Becauseof 55 The resultantcarnitine creatinatesalt, in solid form from Example 1, in dosagesof from about 50 to 2000 mg, can be this dual nature,aminoacids,creatine,and carnitincmay be mixed with 8 oz. water or juice and taken as an exercise either the anionic or the cationic portion of a salt which supplement This supplement can be taken in single or includes them. Specifically these dual functionality comdivided dosessuch that pounds can-be used as either the. . acid or the base in the . between50 . mg. to _ 2000 mg of the ^ . . . . tormabonat a salt throughan acid-Lme reaCtlOd. MOreOVer, 60 camitine creatinatesail 1smgestedeach 24 hour period. these dual functionality organic compounds often form While me above example shows a 1:l molar ratio of interior, intramolecularsalts, e.g. a.salt formed of its own creatineto camitine to form a salt, the molar ratio may vary from bet&en aboutO.l:l to 1:O.l creatureto camitine. This acidic and basic portions. Carnitine is an a-hydroxy carboxylic acid and creatine is an a-N(aminoiminomethy1) may be accomplishedbecausecreatine and camitine form carboxylic acid and the acid-basereaction between these 6s stable salts internaIly. Indeed,one of skill in the art would utxbrsttm@the various ratios and mannersin which these two causesthe formation of the salt compositionwhich is one embodimentof the presentinvention. Importantly the two organic compoundsmay be advantageouslycombined. http://patimg2.uspto.gov/.piw?docid=USOO599458l&PageNum=4&TDKe~=~l4EBEBB... 12/2/2003 Page 2 of 2 Publication Ima,ges 5,994581 7 8 What js‘clsimed is: In summary,it ia to be noted that creatineis an important 1. A salt of a creatine member and a camitine member factor in the regenerationof ATE Camitine is an essential wherein the molar ratio between the creatine memberand cofactor far many metabolic interactionsin the body parthe carnitine memberis between about 0.13. to 1:O.l. titularly in the role of fatty acid oxidatron and in the 2. The salt according to claim 1 wherein the creatine excretionof organic acids.Both creatineand camitine have s member i$ selectedfrom the group consisting of creatine, a characteristicunpleasanttastewhen administeredorally. cmatine esters,cnatine amides,creatine imides, and mmMoreover, creatine monohydrate is only slightly water tures thereof. soluble.Additionally inorganicand internal saltsof cam&e 3. The salt according to claim 2 wherein the carnitine areunstableandhygroscopic.The camitinecreatinatesalt of 1n member is’selectedfrom the group consisting of camitine, carnitine esters,camitine amides,camitine itnides,camitine the presentinventiongreatly nnprovespalatability andoveranmoniq s&s, and mixtures thereof. all stability and enabiesthe optimal biofnnctionality of both 4. The salt according to claim 2 wherein the creatine creatine and camitine in enhancingenergy and metabolic member is creatine. rates. 5. The salt according to claim 4 wherein the carnitine Furthermore,significant publications and researchhave 15 member is camitine. &The salt accordingto claim 5 being representedby the concluded that nitrogen metabolismand growth are proformula: mated by CAR ingestion,with somestudiesconcluding that CAR injection should be a part of normal TPN, especially for pediatric patients. However, the instability and marked bygroscopicityof camitine hasmadesuch use digicult The 20 present invention amelioratesthis and other concernsby providing a camitine salt which is stable and non hygroscopic. Moreoverthe salt of the present invention accom+X Hz0 plishesthis benefitwhile providing the unexpectedadditive 25 advantageof assistingin muscleenergy stores. Therefore, the salt of the present invention is more beneficial than a simple mixture of inorganic salts of carnitine and creatinebecausethe camitinecreatinatesaltof the present invention is nonhygroscopic. Furthermore, the present invention provides for improved palatability and 3o wherein X is an integer between about 0 and 5. I * * * * would be better acceptid by the user. http://patimg2.uspto.gov/.piw?docid=USOO59945Sl&PageNum=5&IDKey=FFl4EBEBB... 12/2/2003