Title of Invention	ACYLOXYALKYL CARBAMATE OF TRANEXAMIC ACID AND COMPOSITIONS THEREOF
Abstract	Acyloxyalkyl carbamate prodrugs of tranexamic acid of Formula (I) wherein R1 is selected from C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3- 7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl, R2 and R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, R4 is selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl, and wherein each substituent group is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino and compositions thereof.

Title of Invention

ACYLOXYALKYL CARBAMATE OF TRANEXAMIC ACID AND COMPOSITIONS THEREOF

Abstract

Acyloxyalkyl carbamate prodrugs of tranexamic acid of Formula (I) wherein R1 is selected from C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3- 7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl, R2 and R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, R4 is selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl, and wherein each substituent group is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino and compositions thereof.

Full Text	Technical Field [002] The disclosure relates to prodrugs of acyloxyalkyl carbamate trans-4- (aminomethyl)-cyclohexanecarboxylic acid, pharmaceutical compositions thereof, methods of making prodrugs of trans-4-(aminomethyl)-cyclohexane-carboxylic acid, and methods of using prodrugs of trans-4-(aminomethyl)-cyclohexanecarboxylic acid and pharmaceutical compositions thereof to treat various diseases or disorders. The disclosure also relates to such prodrugs suitable for oral and topical administration including for oral administration using sustained release dosage forms. Background [003] Tranexamic acid (1) (trans-4-aminomethyl)-cyclohexanecarboxylic acid, Cyklokapron®): is an antifibrinolytic agent that reversibly blocks lysine binding sites on plasminogen and plasmin, and acts to prevent proteolytic degradation of fibrin clots which form in the normal physiologic process of hemostasis. Both plasminogen and plasmin are activators of fibrinolysis and active clot-lysing agents. Tranexamic acid thus helps to stabilize fibrin clots, which in turn maintains coagulation and helps to control bleeding. [004] Tranexamic acid is used clinically to control excess bleeding, for example, heavy bleeding associated with cardiac surgery, upper gastrointestinal hemorrhage, blood loss in patients with advanced cancer (both acute hemorrhagic events and low-volume chronic bleeding), excessive bleeding that occurs during dental procedures in hemophiliacs, and for heavy bleeding during menstruation,i.e.,menorrhagia {see Wellington and Wagstaff, Drugs, 2003, 63,1417- 1433; Dunn and Goa, Drugs, 1999,57,1005-1032; Pereira and Phan, The Oncologist, 2004,9, 561-570). [005] The importance of the plasminogen / plasmin proteolytic cascade in epidermal biology and pathophysiology is also well appreciated (Kramer et al, Biol. Chem. Hoppe-Seylar, 1995,3,131-141). Disruption of the stratum corneumby mechanical or chemical injury induces epidermal proteolytic activity. Topical treatment of human or rodent skin with tranexamic acid significantly accelerates barrier recovery and greatly decreases epidermal hyperplasia, suggesting a role for plasmin inhibitory compounds in promoting epidermal wound healing (Denda et al, J. Invest. Dermatol, 1997,109,84-90; Kitamura et al, J. Soc. Cosmet. Chem., 1995, 29,133-145). Exposure of human skin to ultraviolet radiation causes erythema and pigmentation, with pigmentation resulting from increased melanin production. A role for plasmin in contributing to increased production of arachidonic acid and prostaglandin metabolites in skin following U.V. exposure has also been demonstrated. Topical application of tranexamic acid prevents U.V.-induced pigmentation in vivo through dose-dependent reduction in prostaglandin production (Maeda and Naganuma,/. Photochem. Photobiol. B, 1998,47,136-141; Manosroi et al, J. Cosmet. Sci., 2002,53, 375-386; Suetsugu et al, U.S. Patent No. 5,690,914). [006] The plasminogen activation system is also a predominant protease pathway responsible for extracellular matrix (ECM) degradation. Cancer dissemination and metastasis is synonymous with invasive cell migration, a process in which the ECM plays the dual role of the substratum on which the cells move as well as the physical obstacle that the cells have to surpass. To degrade the physical obstacle that the ECM poses in the direction of migration, cells use proteolytic enzymes such as plasminogen and plasmin capable of hydrolyzing the ECM components (Stonelake et al, Br. J. Cancer, 1997, 75, 951-959; Dunbar et al, Expert Opin. Investig. Drugs, 2000,9,2085-2092; Sidenius andBlasi, Cancer Metastasis Rev., 2003,22,205-222). Plasmin inhibitory compounds such as tranexamic acid, therefore, show utility as anti-metastatic agents either alone or in combination with cytotoxic anticancer agents (Tsutsumi and Konisbi, Jpn. Kokai Tokkyo Koho, 2002114673). [007] Menorrhagia is defined as blood loss >80 mL per menstrual cycle and affects many women and represents a significant health problem. Prevalence rates are believed to be similar across the Western world, and in the U.K. at least one in 20 women aged between 34 and 49 years will consult their general practitioners because of menstrual disorders. Menorrhagia accounts for 60% of primary-care consultations for menstrual problems and 12% of all gynecology referrals (Peto et al, Fain. Pract., 1993,10,207-211; McPherson and Andersson, eds., Women's problems in general practice, Oxford: Oxford University Press, 1983, pp 21-41; Bradlow et al, Patterns of referral, Oxford: Oxford Health Services Research Unit, 1992). While various pathological mechanisms may contribute to the cause of menorrhagia, approximately 50% of women with heavy menstrual blood loss have no underlying anatomical or endocrinological abnormality. In such women fibrinolytic activity in utero is higher than in women with normal menstrual blood loss, with this increased fibrinolysis resulting from elevated levels of endometrium-derived plasmin and plasminogen activators (Gleeson, Am. J. Obstet. Gynecol, 1994,171,178-183; Dockeray et al, Eur. J. Obstet. Gynecol. Reprod. Biol, 1987,24,309-318). [008] Despite the availability of clinically effective antifibrinolytic agents such as tranexamic acid (which has been shown to reduce menstrual blood loss by ~50%), approximately 60% of women with menorrhagia undergo hysterectomy within 5 years of referral to a gynecologist (Coulter et al, Br. J. Obstet. Gynaecol, 1991,98, 789-796). Women suffering from menorrhagia are typically treated orally with tranexamic acid concurrently with menstruation (4-7 days). Doses of 500-1500 mg tranexamic acid tablets administered three or four times daily are typical. Intravenous dosage formulations are also available for use as a continuous infusion in the surgical setting. The requirement for frequent daily oral administration results from the suboptimal pharmacokinetic properties of tranexamic acid, which includes modest oral bioavailability (~30%) and a rapid terminal elimination half-life of ~2 hours. [009] Sustained released oral dosage formulations are a conventional solution to the problem of rapid systemic drug clearance, as is well known in the art (See, e.g., "Remington's Pharmaceutical Sciences," Philadelphia College of Pharmacy and Science, 19th Edition, 1995). Osmotic delivery systems are also recognized methods for sustained drug delivery (see e.g., Verma et al, DrugDev. Ind. Pharm., 2000,26,695-708). Successful application of these technologies depends on the drug of interest having an effective level of absorption from the large intestine (also referred to herein as the colon), where the dosage form spends a majority of its time during its passage through the gastrointestinal tract. Tranexamic acid is poorly absorbed following rectal administration in humans (Aimer et al., J. Clin. Pharm., 1992,32,49-54), consistent with limited permeability of the drug across the colonic mucosa. Development of an oral controlled release formulation for tranexamic acid should considerably improve the convenience, efficacy and side effect profile of tranexamic acid therapy. However, the rapid passage of conventional dosage forms through the proximal absorptive region of the small intestine has thus far prevented the successful application of sustained release technologies to this drug. Heasley et al. have described delayed release oral formulations of tranexamic acid based on the use of enteric polymer coatings that are designed to retard the dissolution of the drug by 1-2 hours until the dosage form has passed from the stomach to the small intestine (U.S. Patent Application No. 2005/002825). Such formulations are said to reduce the adverse gastrointestinal reactions that may accompany oral tranexamic acid therapy (including nausea, vomiting, diarrhea, dyspepsia and cramping). However these formulations would not be expected to substantially alter the elimination half-life of the drug, and hence overcome the requirement for frequent daily dosing. [0010] There is a significant need for new prodrugs of tranexamic acid that are well absorbed in the large intestine and hence suitable for oral sustained release formulations, thus improving the convenience, efficacy and side effect profile of antifibrinolytic therapy. Moreover, since the zwitterionic character of tranexamic acid limits the permeability of the compound across the epidermal barrier, there is also a need for more lipophilic prodrug derivatives of tranexamic acid which would provide for more effective topical administration in the treatment of skin disorders such as wound healing, epidermal hyperplasia, skin roughening, unwanted skin pigmentation, etc. [0011] One solution to the incomplete gastrointestinal absorption of tranexamic acid is through design of prodrug derivatives (see Svahn et al., J. Med. Chem., 1986,29,448-453; Svahn et al., European Patent No. 0 079 872 Bl; Svahn et al., U.S. Patent No. 4,483,867; Jonsson, International Publication No. WO94/15904; Svahn et al, Arzneim-Forsch., 1988,38,735-738; Edlund et al., Br. J. Obstet. Gynaecol, 1995,102,913-917). The prodrug l-(ethoxycarbonyl)oxyethyl trans-4- (aminomethyl)-cyclohexanecarboxylate (i.e.,Kabi 2161) showed markedly improved oral bioavailability of tranexamic acid in human patients, and was effective in reducing menstrual blood loss in women suffering from idiopathic menorrhagja. Summary [0012] The needs described above, among other needs, can be satisfied by the disclosure herein of acyloxyalkyl carbamate prodrugs of tranexamic acid, pharmaceutical compositions of acyloxyalkyl carbamate prodrugs of tranexamic acid, methods of making acyloxyalkyl carbamate prodrugs of tranexamic acid, and methods of using acyloxyalkyl carbamate prodrugs of tranexamic acid and/or pharmaceutical compositions thereof to treat various medical pathologies. The disclosure also provides prodrugs suitable for oral and topical administration including for oral administration using sustained release dosage forms. [0013] In one aspect, compounds of Formula (I) are provided, pharmaceutically acceptable salts thereof, and pharmaceuticaUy acceptable solvates of any of the foregoing, wherein: R1 is selected from acyl, substituted acyl, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl; R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon atom to which they are bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted cycloheteroalkyl ring; and R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl. [0014] In another aspect, compounds of Formula (IT) are provided, pharmaceutically acceptable salts thereof and pharmaceutically acceptable solvates of any of the foregoing, wherein: X is selected from fluoro, chloro, bromo, iodo, and R20SO3- wherein R20 is selected from C1-6 alkyl, C5-7 aryl, and substituted C5-7 aryi; and R2, R3 and R4 are as defined above. [0015] m another aspect, methods of synthesizing a compound of Formula (I) are provided, comprising: contacting a compound of Formula (II), a compound of Formula (HI) and at least one equivalent of a reactant selected from an organic base, an inorganic base, and combinations thereof, to provide a compound of Formula (I), pharmaceutically acceptable salts thereof and pharmaceutically acceptable solvates of any of the foregoing, wherein: X, R1, R2, R3 and R4 are as defined above. [0016] In another aspect, methods of synthesizing a compound of Formula (I) are provided, comprising: contacting a compound of Formula (TV) with a compound of Formula (V) to provide a compound of Formula (I), pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable solvate of any of the foregoing, wherein: R5 and R6 are independently selected from hydrogen, acylamino, acyloxy, alkoxycarbonylamino, alkoxycarbonyloxy, alkyl, substituted alkyl, alkoxy, substituted alkoxy, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyloxy, dialkylamino, heteroaryl, substituted heteroaryl, hydroxy, and sulfonamido, or R5 and R6 together with the atoms to which they are bonded form a substituted cycloalkyl, substituted cycloheteroalkyl, or substituted aryl ring; and R1,R2,R3andR4 are as defined above. [0017] In another aspect, methods of synthesizing a compound of Formula (I) are provided, comprising contacting a compound of Formula (XV) with an oxidant, to provide a compound of Formula (I), or pharmaceutically acceptable salts thereof, or pharmaceutically acceptable solvates of any of the foregoing, wherein R1, R2, R3 and R4 are as defined above. [0018] In another aspect, pharmaceutical compositions comprising at least one phaimaceutically acceptable vehicle and a therapeutically effective amount of at least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable solvate of any of the foregoing, are provided. [0019] In another aspect, oral dosage forms, comprising at least one tranexamic acid prodrug of Formula (D, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable solvate of any of the foregoing, are provided. [0020] In another aspect, sustained release oral dosage forms, comprising at least one prodrug of Formula (I), a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable solvate of any of the foregoing, are provided. [0021] In another aspect, topical dosage forms are provided, comprising at least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable solvate of any of the foregoing, formulated in a pharmaceutically acceptable topical vehicle. [0022] In another aspect, methods of topically administering to a patient at least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable solvate of any of the foregoing, are provided, the methods comprising applying the at least one compound of Formula (I) onto a surface area of the patient. [0023] In another aspect, methods are provided for treating excessive bleeding, including heavy bleeding associated with cardiac surgery, upper gastrointestinal hemorrhage, blood loss in patients with advanced cancer, excessive bleeding that occurs during dental procedures, for example in hemophiliacs, and heavy bleeding during menstruation, i.e., menorrhagia. The methods include adrninistering to a patient in need of such treatment a therapeutically effective amount of at least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a solvate of any of the foregoing and/or a pharmaceutical composition thereof. [0024] In another aspect, methods are provided for treating skin disorders such as wound healing, epidermal hyperplasia, skin roughening and unwanted skin pigmentation. The methods include topically administering to a patient in need of such treatment a therapeutically effective amount of at least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a solvate of any of the foregoing, and/or a pharmaceutical composition thereof. [0025] In another aspect, methods are provided for treating tumor metastasis in a patient suffering from a disorder, such as a malignant disorder. These methods include administering to a patient in need of such treatment a therapeutically effective amount of at least one compound of Formula (I), a phannaceutically acceptable salt thereof, or a solvate of any of the foregoing and/or a pharmaceutical composition thereof, either alone or in combination with one or more cytotoxic agents. [0026] In another aspect, methods are provided for achieving a sustained therapeutic or prophylactic concentration of tranexamic acid in the systemic circulation of a patient comprising orally administering at least one compound of Formula (T), a pharmaceutically acceptable salt thereof, or a solvate of any of the foregoing to the patient Brief Description of the Drawings [0027] The skilled artisan will understand that the drawings, described herein, are for illustration purposes only. The drawings are not intended to limit the scope of the present disclosure. [0028] Figure 1 shows the pharmacokinetics profile of released tranexamic acid (- • -) and remaining tranexamic acid prodrug 13 (- v -) following intracolonic administration of tranexamic acid prodrug 13. [0029] Figure 2 shows the pharmacokinetics profile of tranexamic acid following oral administration of tranexamic acid prodrug 13. The levels of prodrug 13 following oral gavage administration were below the level of detection. Detailed Description Definitions [0030] Unless otherwise indicated, all numbers expressing quantities of ingredients, reaction conditions, and so forth used in the specification and claims are to be understood as being modified in all instances by the term "about." Accordingly, unless indicated to the contrary, the numerical parameters set forth in the following specification and attached claims are approximations that may vary depending upon the properties sought to be obtained. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques. [0031] Notwithstanding that the numerical ranges and parameters setting forth the broad scope of the embodiments are approximations, the numerical values set forth in the specific examples are reported as precisely as possible. Any numerical values, however, inherently contain certain errors necessarily resulting from in the error inherent in measurements. [0032] The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter disclosed. [0033] To the extent the definitions of terms in the publications, patents, and patent applications incorporated herein by reference are not the same as the definitions set forth in this specification, the definitions in this specification control for the entire specification, including the claims. Any other definitions in the publications, patents, and patent applications incorporated herein by reference that are not explicitly provided in this specification apply only to the embodiments discussed in the publications, patents, and patent applications incorporated herein by reference. [0034] A dash ("-") mat is not between two letters or symbols is used to indicate a point of attachment for a substituent. For example, -CONEfe is attached through the carbon atom. [0035] "Acyl" by itself or as part of another substituent refers to a radical - C(0)R30, where R30 is hydrogen, alkyl, heteroalkyl, cycloalkyl, cycloheteroalkyl, cycloalkylalkyL cycloheteroalkylalkyl, aryl, heteroaryl, arylalkyl, or heteroarylalkyl, which may be substituted, as defined herein. Examples of acyl groups include, but are not limited to, formyl, acetyl, cyclohexylcafbonyl, cyclohexyhnethylcarbonyl, benzoyl, benzylcarbonyl. In certain embodiments, an acyl group is C1-3 acyl. [0036] "Acylamino" by itself or as part of another substituent refers to a radical -NR31C(0)R32, where R31 and R32 are independently hydrogen, alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, which may be substituted as defined herein. Examples of acylamino groups include, but are not limited to, formamido, acetamido and benzamido. [0037] "1-Acyloxy-Alkyl Carbamate" refers to an N-l-(acyloxy)alkoxycarbonyl derivative of tranexamic acid as encompassed by compounds of Formula (I) disclosed herein. [0038] "Alkyl" by itself or as part of another substituent refers to a saturated or unsaturated, branched or straight-chain monovalent hydrocarbon radical derived by the removal of one hydrogen atom from a single carbon atom of a parent alkane, alkene, or alkyne. Examples of alkyl groups include, but are not limited to, methyl; ethyls such as ethanyl, ethenyl, and ethynyl; propyls such as propan-1-yl, propan-2-yl, prop-1-en-l-yl, prop-l-en-2-yl, prop-2-en-l-yl (allyl), prop-1-yn-l-yl, prop-2-yn-l-yl, etc.; butyls such as butan-1-yl, butan-2-yl, 2-methyl-propan-l-yl, 2-methyl-propan-2-yl, but-1-en-l-yl, but-l-en-2-yl, 2-methyl-prop-l-en-l-yl, but-2-en-l-yl, but-2-en-2-yl, buta-l,3-dien-l-yl, buta-l,3-dien-2-yl, but-1-yn-l-yl, but-l-yn-3-yl, but-3-yn-l-yl, etc.; and the like. [0039] The term "alkyl" is specifically intended to include groups having any degree or level of saturation, Le., groups having exclusively single carbon-carbon bonds, groups having one or more double carbon-carbon bonds, groups having one or more triple carbon-carbon bondsjand groups having mixtures of single, double and triple carbon-carbon bonds. Wbiire a specific level of saturation is intended, the expressions "alkanyl," "alkenyl," and "alkynyl" are used. In certain embodiments, an alkyl group comprises from 1 to 20 carbon atoms, in certain embodiments, from 1 to 6 carbon atoms, and in certain embodiments, from 1 to 3 carbon atoms. In certain embodiments, alkyl is Ci^ alkyl, Ci^ alkyl, C1-3 alkyl, methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, terf-butyl, or allyl. [0040] "Alkanyl" by itself or as part of another substituent refers to a saturated branched or straight-chain alkyl radical derived by the removal of one hydrogen atom from a single carbon atom of a parent alkane. Examples of alkanyl groups include, but are not limited to, methanyl, ethanyl, propanyls such as propan-1-yl, propan-2-yl (isopropyl), etc.; butanyls such as butan-1-yl butan-2-yl (sec-butyl), 2-methyl-propan-l-yl (isobutyl), 2-methyl-propan-2-yl (t-butyl), etc.; and the like. [0041] "Alkenyl" by itself or as part of another substituent refers to an unsaturated branched or straight-chain alkyl radical having at least one carbon-carbon double bond derived by the removal of one hydrogen atom from a single carbon atom of a parent alkene. The group may be in either the cis or trans conformation about the double bond(s). Examples of alkenyl groups include, but are not limited to, ethenyl; propenyls such as prop-1-en-l-yl, prop-l-en-2-yl, prop-2-en-l-yl (allyl), prop-2-en-2-yl; butenyls such as but-1-en-l-yl, but-l-en-2-yl, 2-methyl-prop-l-en-l-yl, but-2-en-l-yl but-2-en-l-yl but-2-en-2-yl, buta-l,3-dien-l-yl, buta-l,3-dien-2-yl, etc.; and the like. [0042] "Alkynyl" by itself or as part of another substituent refers to an unsaturated branched or straight-chain alkyl radical having at least one carbon-carbon triple bond derived by the removal of one hydrogen atom from a single carbon atom of a parent alkyne. Examples of alkynyl groups include, but are not limited to, ethynyl; propynyls such as prop-1-yn-l-yl, prop-2-yn-l-yl, etc.; butynyls such as but-1-yn-l-yl, but-l-yn-3-yl, but-3-yn-l-yl, etc.; and the like. [0043] "Acyloxy" by itself or as part of another substituent refers to a radical -OC(O)R33, where R33 is alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, which may be substituted, as defined herein. Examples of acyloxy groups include, but are not limited to, acetoxy, isobutyroyloxy, benzoyloxy, phenylacetoxy. [0044] "Alkoxy" by itself or as part of another substituent refers to a radical - OR34 where R34 is alkyl, cycloalkyl, cycloalkylalkyl, aryl, or arylalkyl, which may be substituted, as defined herein. Examples of alkoxy groups include, but are not limited to, methoxy, ethoxy, propoxy, butoxy, cyclohexyloxy. [0045] "Alkoxycarbonyl" by itself or as part of another substituent refers to a radical -C(O)OR35 where R3S is an alkyl or substituted alkyl group, as defined herein. Examples of alkoxycarbonyl groups include, but are not limited to, methoxycarbonyl, ethoxycarbonyl, propoxycarbonyl, butoxycarbonyl. In certain embodiments, an alkoxycarbonyl group is C1-3 alkoxycarbonyl. [0046] "Alkoxycarbonylamino" by itself or as part of another substituent refers to a radical -NR36C(O)-OR37 where R36 represents an alkyl, substituted alkyl, cycloalkyl, or substituted cycloalkyl group and R37 is alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, which may be substituted, as defined herein. Examples of alkoxycarbonylamino groups include, but are not limited to, methoxycarbonylamino, tert-butoxycarbonylamino, and benzyloxycarbonylamino. [0047] "Alkoxycarbonyloxy" by itself or as part of another substituent refers to a radical -OC(O)-OR38 where R38 is an alkyl, substituted alkyl, cycloalkyl, or substituted cycloalkyl group, as defined herein. Examples of alkoxyarbonyloxy groups include, but are not limited to, methoxycarbonyloxy, ethoxycarbonyloxy, and cyclohexyloxycarbonyloxy. [0048] "Alkylamino" by itself or as part of another substituent refers to a radical -NHR39 where R39 is an alkyl, substituted alkyl, cycloalkyl, or substituted cycloalkyl group, as defined herein. In certain embodiments, an alkylamino group is C1-3 alkylamino. [0049] "Aryl" by itself or as part of another substituent refers to a monovalent aromatic hydrocarbon radical derived by the removal of one hydrogen atom from a single carbon atom of a parent aromatic ring system. Aryl encompasses 5- and 6- membered carbocyclic aromatic rings, for example, benzene; bicyclic ring systems wherein at least one ring is carbocyclic and aromatic, for example, naphthalene, indane, and tetralin; and tricyclic ring systems wherein at least one ring is carbocyclic and aromatic, for example, fluorene. Aryl encompasses multiple ring systems having at least one carbocyclic aromatic ring fused to at least one carbocylic aromatic ring, cycloalkyl ring, or heterocycloalkyl ring. For example, aryl includes 5- and 6- membered carbocyclic aromatic rings fused to a 5- to 7-membered heterocycloalkyl ring containing one or more heteroatoms chosen from N, O, and S. For such fused, bicyclic ring systems wherein only one of the rings is a carbocyclic aromatic ring, the point of attachment may be at the carbocyclic aromatic ring or the heterocycloalkyl ring. Examples of aryl groups include, but are not limited to, groups derived from aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene, as- indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, trinaphthalene. In certain embodiments, an aryl group may have from 5 to 20 carbon atoms, and in certain embodiments, from 5 to 12 carbon atoms. Aryl, however, does not encompass or overlap in any way with heteroaryl, separately defined herein. Hence, a multiple ring system in which one or more carbocyclic aromatic rings is fused to a heterocycloalkyl aromatic ring, is heteroaryl, not aryl, as defined herein. In certain embodiments, aryl is C6-10 aryl or phenyl. [0050] "Arylalkyl" by itself or as part of another substituent refers to an acyclic alkyl radical in which one of the hydrogen atoms bonded to a carbon atom, typically a terminal or sp3 carbon atom, is replaced with an aryl group. Examples of arylalkyl groups include, but are not limited to, benzyl, 2-phenylethan-l-yl, 2-phenylethen-l-yl, naphthylmethyl, 2-naphthylethan-l-yl, 2-naphthylefhen-l-yl, naphthobenzyl, 2-naphthophenylethan-l-yl. Where specific alkyl moieties are intended, the nomenclature arylalkanyl, arylalkenyl, or arylalkynyl is used. In certain embodiments, an arylalkyl group is C7-30 arylalkyl, e.g., the alkanyl alkenyl, or alkynyl moiety of the arylalkyl group is C1-10 and the aryl moiety is C6-20, and in certain embodiments, an arylalkyl group is C7-20 arylalkyl, e.g., the alkanyl, alkenyl, or alkynyl moiety of the arylalkyl group is C1-8 and the aryl moiety is C6-12. In certain embodiments, arylalkyl is C7-16 arylalkyl or benzyl. [0051] "Aryldialkylsilyr by itself or as part of another substituent refers to the radical -SiR40'R41R42 where one of R40, R41, and R42 is aryl or substituted aryl as defined herein and the other two of R40, R41, and R42 are alkyl or substituted alkyl, as defined herein. In certain embodiments, an aryldialkylsilyl group is C7-14 aryldialkylsilyl. [0052] "AUC" is the area under the plasma drug concentration-versus-time curve extrapolated from zero time to infinity. [0053] "Cmax" is the highest drug concentration observed in plasma following an extravascular dose of drug. [0054] "Carbamoyl" by itself or as part of another substituent refers to the radical -C(O)NR43R44 where R43 and R44 are independently hydrogen, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, aryl, or substituted aryl, as defined herein. [0055] "Carbamoyloxy" by itself or as part of another substituent refers to a radical -OC^aNR4^46 where R45 and R46 are independently selected from hydrogen, alkyl, cycloalkyl, cycloheteroalkyL aryl, arylalkyl, heteroalkyl, heteroaryl, and heteroarylalkyl, which may be substituted, as defined herein, or R45 and R46 together with the atoms to which they are bonded form a cycloheteroalkyl or heteroaryl ring. [0056] "Cleave" refers to breakage of chemical bonds and is not limited to chemical or enzymatic reactions or mechanisms unless clearly intended by the context [0057] "Compounds" refers to compounds encompassed by structural Formulae (I) - (XIX) disclosed herein and includes any specific compounds within these formulae whose structure is disclosed herein. Compounds may be identified either by their chemical structure and/or chemical name. When the chemical structure and chemical name conflict, the chemical structure is determinative of the identity of the compound. The compounds described herein may contain one or more chiral centers and/or double bonds and therefore, may exist as stereoisomers, such as double-bond isomers, i.e., geometric isomers, enantiomers and diastereomers. Accordingly, the chemical structures depicted herein encompass all possible enantiomers and stereoisomers of the illustrated compounds including the stereoisomerically pure form (e.g., geometrically pure, enantiomerically pure or diastereomerically pure) and enantiomeric and other stereoisomeric mixtures. Enantiomeric and stereoisomeric mixtures may be resolved into their component enantiomers or stereoisomers using separation techniques or stereocontrolled synthesis techniques well known to the skilled artisan. The compounds may also exist in several tautomeric forms including the enol form, the keto form and mixtures thereof Accordingly, the chemical structures depicted herein encompass all possible tautomeric forms of the illustrated compounds. The compounds described also include isotopically labeled compounds where one or more atoms have an atomic mass different from the atomic mass found in nature. Examples of isotopes that may be incorporated into the compounds disclosed herein include, but are not limited to, 2H, EL, nC, ,3C, 14C, 15N, ,70,180, etc. Compounds may exist in unsolvated forms as well as solvated forms, including hydrated forms and as N-oxides. In general, compounds may be hydrated, solvated, or N-oxides. Certain compounds may exist in multiple crystalline or amorphous forms. In general, all physical forms are equivalent for the uses contemplated herein and are intended to be within the scope of the present disclosure. Further, it should be understood, when partial structures of the compounds are illustrated, an asterisk () indicates the point of attachment of the partial structure to the rest of the molecule. [0058] "Cycloalkoxycarbonyl" by itself or as part of another substituent refers to a radical -C(O)OR47 where R47 represents an cycloalkyl or substituted cycloalkyl group as defined herein. Examples of cycloalkoxycarbonyl groups include, but are not limited to, cyclobutyloxycarbonyl, cyclohexyloxycarbonyl. [0059] "Cycloalkyl" by itself or as part of another substituent refers to a partially saturated or unsaturated cyclic alkyl radical. Where a specific level of saturation is intended, the nomenclature "cycloalkanyl" or "cycloalkenyl" is used. Examples of cycloalkyl groups include, but are not limited to, groups derived from cyclopropane, cyclobutane, cyclopentane, cyclohexane. m certain embodiments, a cycloalkyl group is C3.15 cycioalkyl, and in certain embodiments, C5.12 cycloalkyl. In certain embodiments, a cycloalkyl group is C3-7 cycloalkyl or cyclohexyl. [0060] "Cycloheteroalkyl" by itself or as part of another substituent refers to a partially saturated or unsaturated cyclic alkyl radical in which one or more carbon atoms (and any associated hydrogen atoms) are independently replaced with the same or different heteroatom. Examples of heteroatoms to replace the carbon atom(s) include, but are not limited to, N, P, O, S and Si. Where a specific level of saturation is intended, the nomenclature "cycloheteroalkanyl" or "cycloheteroalkenyl" is used. Examples of cycloheteroalkyl groups include, but are not limited to, groups derived from epoxides, azirines, tbiiranes, irnidazolidine, morpholine, piperazine, piperidine, pyrazolidine, pyrrolidine, quinuclidine. [0061] "Dialkylamino" by itself or as part of another substituent refers to the radical -NR^R49 where R48 and R49 are independently alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, arylalkyl, substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroarylalkyl, or substituted heteroarylalkyl, or R48 and R49 together with the nitrogen to which they are attached form a cycloheteroalkyl or substituted cycloheteroalkyl ring. In certain embodiments, a dialkylamino group is C1-3 dialkylamino. [0062] "1-Haloalkyl carbamate" refers to an JV-1-haloalkoxycarbonyl derivative of tranexamic acid as encompassed by compounds of Formula (II) disclosed herein. [0063] "Heteroalkyl" by itself or as part of another substituent refer to an alkyl group in which one or more of the carbon atoms (and any associated hydrogen atoms) are independently replaced with the same or different heteroatomic groups. Examples of heteroatomic groups include, but are not limited to, -0-, -S-, -O-O-, -S-S-, -O- S-, -NR50R51-, =N-N=, -N=N-, -N=N-NR52R53, -PR54-, -P(O)2~, -POR55-, -O- P(O)2- -SO-, -SO2-, -SnR5^57- Where R50, R51, RS2, R53, R54, R55, R56, and R57 are independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, or substituted heteroarylalkyl. Where a specific level of saturation is intended, the nomenclature "heteroalkanyl," "heteroalkenyl," or "heteroalkynyl" is used. [0064] "Heteroaryl" by itself or as part of another substituent refers to a monovalent heteroaromatic radical derived by the removal of one hydrogen atom from a single atom of a parent heteroaromatic ring system. Heteroaryl encompasses multiple ring systems having at least one aromatic ring fused to at least one other ring, which may be aromatic or non-aromatic in which at least one ring atom is a heteroatom. Heteroaryl encompasses 5- to 7-membered aromatic, monocyclic rings containing one or more, for example, from 1 to 4, or in certain embodiments, from 1 to 3, heteroatoms chosen from N, O, and S, with the remaining ring atoms being carbon; and bicyclic heterocycloalkyl rings containing one or more, for example, from 1 to 4, or in certain embodiments, from 1 to 3, heteroatoms chosen from N, O, and S, with the remaining ring atoms being carbon and wherein at least one heteroatom is present in an aromatic ring. For example, heteroaryl includes a 5- to 7-membered heterocycloalkyl, aromatic ring fused to a 5- to 7-membered cycloalkyl ring. For such fused, bicyclic heteroaryl ring systems wherein only one of the rings contains one or more heteroatoms, the point of attachment maybe at the heteroaromatic ring or the cycloalkyl ring. In certain embodiments, when the total number of N, S, and O atoms in the heteroaryl group exceeds one, the heteroatoms are not adjacent to one another. In certain embodiments, the total number of N, S, and O atoms in the heteroaryl group is not more than two. In certain embodiments, the total number of N, S, and O atoms in the aromatic heterocycle is not more than one. Heteroaryl does not encompass or overlap with aryl as defined herein. [0065] Examples of heteroaryl groups include, but are not limited to, groups derived from acridine, arsindole, carbazole, fl-carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine, phenanttiridine, phenanthroline, phenazine, phthalazine, pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole, thiophene, triazole, xanthene. In certain embodiments, a heteroaryl group is from 5- to 20-membered heteroaryl, and in certain embodiments from 5- to 10-membered heteroaryl. In certain embodiments heteroaryl groups are those derived from thiophene, pyrrole, benzothiophene, benzofuran, indole, pyridine, quinoline, imidazole, oxazole, and pyrazine. [0066] "Heteroarylalkyl" by itself or as part of another substituent refers to an acyclic alkyl radical in which one of the hydrogen atoms bonded to a carbon atom, typically a terminal or sp3 carbon atom, is replaced with a heteroaryl group. Where specific alkyl moieties are intended, the nomenclature heteroarylalkanyl, heteroarylalkenyl, or heteroarylalkynyl is used. In certain embodiments, a heteroarylalkyl group is a 6- to 30-membered heteroarylalkyl, e.g., the alkanyl, alkenyl, or alkynyl moiety of the heteroarylalkyl is 1- to 10-membered and the heteroaryl moiety is a 5- to 20-membered heteroaryl, and in certain embodiments, 6- to 20-membered heteroarylalkyl, e.g., the alkanyl, alkenyl, or alkynyl moiety of the heteroarylalkyl is 1- to 8-membered and the heteroaryl moiety is a 5- to 12-membered heteroaryl. [0067] "Immediately preceding embodiments" means the embodiments disclosed in the same paragraph. [0068] "Parent aromatic ring system" refers to an unsaturated cyclic or polycyclic ring system having a conjugated 7t electron system. Included within the definition of "parent aromatic ring system" are fused ring systems in which one or more of the rings are aromatic and one or more of the rings are saturated or unsaturated, such as, fluorene, indane, indene, phenalene, etc. Examples of parent aromatic ring systems include, but are not limited to, aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, trinaphthalene. [0069] 'Tarent heteroaromatic ring system" refers to a parent aromatic ring system in which one or more carbon atoms (and any associated hydrogen atoms) are independently replaced with the same or different heteroatom. Examples of heteroatoms to replace the carbon atoms include, but are not limited to, N, P, O, S, Si, etc. Specifically included within the definition of "parent heteroaromatic ring systems" are fused ring systems in which one or more of the rings are aromatic and one or more of the rings are saturated or unsaturated, such as, arsindole, benzodioxan, benzofuran, chromane, chromene, indole, indoline, xanthene, etc. Examples of parent heteroaromatic ring systems include, but are not limited to, arsindole, carbazole, P-carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoqwnoline, isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine, phenanthridine, phenanihroline, phenazine, phthalazine, pteridine, puiine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole, thiophene, triazole, xanthene. [0070] 'Tatienf' includes mammals, such as for example, humans. [0071] 'Tharmaceutical composition" refers to at least one compound and a pharmaceutically acceptable vehicle, with which the compound is administered to a patient. [0072] "Pharmaceutically acceptable" refers to approved or approvable by a regulatory agency of the Federal or a state government or listed in the U.S. Pharmacopoeia or other generally recognized pharmacopoeia for use in animals, including humans. [0073] "Pharmaceutically acceptable salt" refers to a salt of a compound which possesses the desired pharmacological activity of the parent compound. Such salts include: (1) acid addition salts, formed with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, and the like; or formed with organic acids such as acetic acid, propionic acid, hexanoic acid, cyclopentanepropionic acid, glycolic acid, pyruvic acid, lactic acid, malonic acid, succinic acid, malic acid, maleic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, 3-(4-hydroxybenzoyl) benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, 1,2-ethane-disulfonic acid, 2-hydroxyethanesulfonic acid, benzenesulfonic acid, 4-chlorobenzenesulfonic acid, 2-naphthalenesulfonic acid, 4-toluenesulfonic acid, camphorsulfonic acid, 4-methylbicyclo[2.2.2]-oct-2-ene-l-carboxylic acid, glucoheptonic acid, 3-phenylpropionic acid, trimethylacetic acid, tertiary butylacetic acid, lauryl sulfuric acid, gluconic acid, glutamic acid, hydroxynaphthoic acid, salicylic acid, stearic acid, muconic acid, and the like; or (2) salts formed when an acidic proton present in the parent compound is replaced by a metal ion, e.g, an alkali metal ion, an alkaline earth ion, or an aluminum ion; or coordinates with an organic base such as ethanolamine, diethanolarnine, triethanolamine, TV-me&ylglucamine and the like. [0074] "Phannaceutically acceptable vehicle" refers to a phannaceutically acceptable diluent, a phannaceutically acceptable adjuvant, a phannaceutically acceptable excipient, a phannaceutically acceptable carrier, or a combination of any of the foregoing with which a compound of the present disclosure may be administered to a patient and which does not destroy the pharmacological activity thereof and which is nontoxic when administered in doses sufficient to provide a therapeutically effective amount of the compound. [0075] "Preventing" or "prevention" refers to a reduction in risk of acquiring a disease or disorder, i.e., causing at least one of the clinical symptoms of the disease not to develop in a patient that may be exposed to or predisposed to the disease but does not yet experience or display symptoms of the disease. [0076] "Prodrug" refers to a derivative of a drug molecule that requires a transformation within the body to release the active drug. Prodrugs can be, although not necessarily, pharmacologically inactive until converted to the parent drug. [0077] "Promoiety" refers to a form of protecting group that when used to mask a functional group within a drug molecule converts the drug into a prodrug. For example, the promoiety may be attached to the drug via bond(s) that are cleaved by enzymatic or non-enzymatic means in vivo. [0078] "Protecting group" refers to a grouping of atoms, which when attached to a reactive group in a molecule masks, reduces, or prevents that reactivity. Examples of protecting groups can be found in Green et al, "Protective Groups in Organic Chemistry," (Wiley, 2nd ed. 1991) and Harrison et al, "Compendium of Synthetic Organic Methods," Vols. 1-8 (John Wiley and Sons, 1971-1996). Examples of amino protecting groups include, but are not limited to, formyl, acetyl, trifluoroacetyl, benzyl, benzyloxycarbonyl (CBZ), tert-butoxycarbonyl (Boc), trimethylsilyl (IMS), 2-trimethylsilyl-ethanesulfonyl (SES), trityl and substituted trityl groups, allyloxycarbonyl, 9-fluorenylmethyloxycarbonyl (FMOC), nitro-veratryloxycarbonyl (NVOC). Examples of hydroxy protecting groups include, but are not limited to, those in which the hydroxy group is either acylated or alkylated such as benzyl, and trityl ethers as well as alkyl ethers, tetrahydropyranyl ethers, trialkylsilyl ethers, and allyl ethers. [0079] "Solvate" refers to a molecular complex of a compound with one or more solvent molecules in a stoichiometric or non-stoichiometric amount. Such solvent molecules are those commonly used in the pharmaceutical art, which are known to be innocuous to the recipient, e.g., water, ethanol, and the like. A molecular complex of a compound or moiety of a compound and a solvent can be stabilized by non-covalent intra-molecular forces such as, electrostatic forces, van der Waals forces, or hydrogen bonds. The term' ihydrate" refers to a complex where the one or more solvent molecules are water including monohydrates and hemi-hydrates. [0080] "Substantially one enantiomer" refers to a compound containing 1 or more stereogenic centers such mat the enantiomeric excess (e.e.) of the compound is at least about 90%, in certain embodiments greater than about 95%, in certain embodiments greater than about 98%, and in certain embodiments greater than about 99%. [0081 ] "Substituted" refers to a group in which one or more hydrogen atoms are independently replaced with the same or different substituent(s). Example of substituents include, but are not limited to, -M, -R60, -O" (-OH), =0, -OR60, -SR60, - S' (-SH), =S, -NR^R61, =NR60, -CF3, r-CN, -OCN, -SCN, -NO, -N02, =N2) -N3, - S(O)20", -S(O)2OH, -S^R60, -OS(02)0", -OSCOfcR.", -P(O)(0")2, - PCOXOR^XO"), -OPCOXOR^OR61), -CiOyR.60, -C(S)R60, -C^OR60, - CCOJNR^R61, -C(O)0_, -C(S)OR60, -NRfi2C(OJNR60Rw, -NR62C(S)NR60R61, - NR^CCNR^NR6^61 and -CCNR^NR^R61 where M is a halogen; R60, R61, R62, and R63 are independently selected from hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, aryl, substituted aryl, heterdaryl, and substituted heteroaryl, or when bonded to a nitrogen atom, R60 and R61 together with the nitrogen atom to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring; and R62 and R63 are independently selected from hydrogen, alkyl, substituted alkyl, aryl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, aryl, substituted aryl, heteroaryl, and substituted heteroaryl, or when bonded to a nitrogen atom, R62 and R63 together with the nitrogen atom to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring. In certain embodiments, substituents include -M, -R60, =0, -OR60, -SR60, -S", ?=S, -NR^R61, =NR60, -CF3, - CN, -OCN, -SCN, -NO, -N02, =N2, -N3, -SCO)^60, -OS(02)0', -OS(O)2R60, - P(O)((r)2, -PCOXOR^XO-), -OP(O)(OR60)(OR61), -C^R60, -C(S)R60, -C^OR60, -C^NR6^61, -C(O)0", and -NR62C(D)NR60R61, where R60, R61, and R62 are as defined above. In other embodiments, substituents may be chosen from -M, -R60, =0, -OR60, -SR60, -NRV1, -CF3, -CN, -N02, -S^R60, -P(O)(OR60)(O"), - OPCOXOR^COR61), -aCQR60, -qOpR60, -CCONR^R61, -€(O)0-, where R60 and Rfil are as defined above. In yet other embodiments, substituents include -M, -R60, =0, -OR60, -SR60, -NR6^61, -CF3, -CN, -NO2, SiP^R.60, -OP^XOR^XOR61), - C^R60, -CCOPR60, and -C(O)0", where R60 and R61 are as defined above. In certain embodiments, each substituent is independently selected from C1-3 alkyl, -OH, -NH2,-SH, C1-3 alkoxy, C1-3 acyl, C1-3 tbioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino, as defined herein. [0082] "Sulfonamido" by itself or as part of anouier substituent refers to a radical -NR65S(O)2R66, where R65 is alkyl, substituted alkyl, cycloalkyl, cycloheteroalkyl, aryl, substituted aryl, arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, and R66 is hydrogen, alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, which may be substituted, as defined herein. Examples of sulfonamido groups include, but are not limited to, methanesulfonamido, benzenesulfonamido, and p-toluenesulfonamido. [0083] "Tbioalkyl" by itself or as part of another substituent refers to a radical -SR67 where R67 is alkyl or substituted alkyl, as defined herein. In certain embodiments, a tbioalkyl group is C1-3 tbioalkyl. [0084] "Treating" or "treatment" of any disease or disorder refers to arresting or ameliorating a disease, disorder, or at least one of the clinical symptoms of a disease or disorder, reducing the risk of acquiring a disease, disorder, or at least one of the clinical symptoms of a disease or disorder, reducing the development of a disease, disorder or at least one of the clinical symptoms of the disease or disorder, or reducing the risk of developing a disease or disorder or at least one of the clinical symptoms of a disease or disorder. "Treating" or "treatment" also refers to inhibiting the disease or disorder, either physically, (e.g., stabilization of a discernible symptom), physiologically, (e.g., stabilization of a physical parameter), or both, and to inhibiting . at least one physical parameter which may or may not be discernible to the patient. In certain embodiments, "treating" or "treatment" refers to delaylng the onset of the disease or disorder or at least one or more symptoms thereof in a patient which may be exposed to or predisposed to a disease or disorder even though that patient does not yet experience or display symptoms of the disease or disorder. [0085] "Therapeutically effective amount" refers to the amount of a compound that, when administered to a subject for treating a disease or disorder, or at least one of the clinical symptoms of a disease or disorder, is sufficient to affect such treatment of the disease, disorder, or symptom. The "therapeutically effective amount" may vary depending, for example, on the compound, the disease, disorder, and/or symptoms of the disease or disorder, severity of the disease, disorder, and/or symptoms of the disease or disorder, the age, weight, and/or health of the patient to be treated, and the judgment of the prescribing physician. An appropriate amount in any given instance may be readily ascertained by those skilled in the art or capable of determination by routine experimentation. [0086] "Trialkylsilyl" by itself or as part of another substituent refers to a radical -SiR^R6^70 where R68, R69, and R70 are independently selected from alkyl and substituted alkyl, as defined herein. In certain embodiments, a trialkylsilyl group is C3-12 trialkylsilyl. [0087] Reference is now be made in detail to embodiments of the present disclosure. While certain embodiments of the present disclosure are described, it will be understood that it is not intended to limit the embodiments of the present disclosure to the disclosed embodiments. To the contrary, reference to embodiments of the present disclosure is intended to cover alternatives, modifications, and equivalents as may be included within the spirit and scope of the embodiments of the present disclosure as defined by the appended claims. Compounds [0088] Certain embodiments of the present disclosure provide a compound of Formula (I)" a pharmaceutically acceptable salt thereof, or solvate of any of the foregoing, wherein: R1 is selected from acyl, substituted acyl, alkyL substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl; R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon atom to which they are bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted cycloheteroalkyl ring; and R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl. [0089] In certain embodiments of a compound of Formula (I), the compound, which when administered in the intestinal lumen of a patient is absorbed to a sufficient extent so as to achieve a bioavailability of ra/w-4-(aminomethyl)- cyclohexanecarboxylic acid at least 2-fold greater than the bioavailability of trans-4- (aminomethyl)-cyclohexanecarboxyUc acid achieved when trans-4-(ammomethyl)- cyclohexanecarboxylic acid itself is administered in the intestinal lumen of the patient. [0090] In certain embodiments of a compound of Formula (I), R1 is selected from Ci.6 alkyl, substituted CM alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl. In certain of the immediately preceding embodiments, the substituent group of Rl is selected from at least one of C1-3 alkyl, -OH, -NH2> -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [0091] In certain embodiments of a compound of Formula (I), R1 is selected from CM alkyl, substituted CM alkyl, phenyl, substituted phenyl, cyclohexyl, and substituted cyclohexyl. In certain of the immediately preceding embodiments, each substituent group of R1 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [0092] In certain embodiments of a compound of Formula (I), each substituent group of R1 is independently selected from at least one of Cu alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C(.3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [0093] la certain embodiments of a compound of Formula (I), Rl is selected from methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyl, and cyclohexyl. [0094] In certain embodiments of a compound of Formula (I), R4 is selected from hydrogen, CM alkyl, substituted C\^ alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C^io aryl. substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl. In certain of the immediately preceding embodiments, each substituent group of R4 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, Q-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [0095] In certain embodiments of a compound of Formula (I), R4 is selected from hydrogen, methyl, ethyl, terf-butyl, allyl, benzyl, 4-methoxybenzyl, diphenylmethyl, triphenylmethyl, trimethylsilyl, triethylsilyl, triisopropylsilyl, tert-butyldimethylsilyl, and phenyldimethylsilyl. [0096] In certain embodiments of a compound of Formula (I), R4 is selected from hydrogen, allyl, benzyl, and trimethylsilyl. [0097] In certain embodiments of a compound of Formula (I), R4 is hydrogen. [0098] In certain embodiments of a compound of Formula (I), R2 and R3 are independently selected from hydrogen, Ci.6 alkyl, substituted Ci^ alkyl, C6-10 aryl, substituted C6.10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl. In certain of the immediately preceding embodiments, each substituent group of R2 and/or R3 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [0099] In certain embodiments of a compound of Formula (I), R2 and R3 are independently selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. [00100] In certain embodiments of a compound of Formula (I), R2 is hydrogen, and R is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. In certain embodiments of a compound of Formula (£), R2 is hydrogen, and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. [00101] In certain embodiments of a compound of Formula (I), R1 is selected from C1-6 alkyl, substituted Cu alkyl, Cwo aryl, substituted Cwo aryl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-i6 substituted arylalkyl, and R2 and R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6.10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl. In certain of the immediately preceding embodiments, each substituent group of R1 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [00102] In certain embodiments of a compound of Formula (I), R1 is selected from methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, terf-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, and R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. In certain embodiments of a compound of Formula (I), R1 is selected from methyl, ethyl, n-propyl, isopropyl, n- butyl, isobutyl, sec-butyl, fert-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. [00103] In certain embodiments of a compound of Formula (T), R4 is hydrogen. [00104] In certain embodiments of a compound of Formula (T), each of R2 and R3 is other than hydrogen. When each of R2 and R3 is hydrogen, a metabolite of certain acyloxyalkylcarbamate promoieties may be formaldehyde. In some embodiments for methods of treatment comprising administering large amounts of a compound of Formula (I) it may be desireable that the amount of toxic metabolites of the promoiety such as formaldehyde be minimized or eliminated. [00105] In certain embodiments of a compound of Formula (I), the compound is selected from: trans-4- {[(2-Methylpropanoyloxy)methoxycarbonyl]aminomethyl} - cyclohexanecarboxylic acid; rrflfty-4-{[(2,2-Dimethylpropanoyloxy)methoxycarbonyl]- aminomethyl} -cyclohexanecarboxylic acid; franj-4-{[(3-Memylbutanoyloxy)memoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; franj-4-{[(Benzoyloxy)memoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; /ranjr^{[l-(2-Methylpropanoyloxy)ethoxycarbonyl]amuiomethyl}- cyclohexanecarboxylic acid; fran5^{[l-(2-Methylpropanoyloxy)propoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; fnww-4-{[l-(2-Methylpropanoyloxy)-2- methylpropoxycaibonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4- {[ l-(B6DZoyloxy)-2-methylpropoxycarbonyl]aminoinethyl} - cyclohexanecaiboxylic acid; /raiw-4-{[l-(Cyclohexylcaibonyloxy)-2- methylpropoxycarbonyl]aminomethyl} cyclohexanecarboxylic acid; /rans^{[l-(PentaQoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; ^a/w^{[l-(Propanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; fra/w^{[l^utanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; /ra?w^{[l-(Pentanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; /ra7u-4-{[l-(3-Mediylbutanoyloxy)edioxycarbonyl]aminoniethyl}- cyclohexanecarboxylic acid; rra/w-4-{[l-(2,2- Dimethylpropanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; fra«^-{[l-(Cyclohexylcarbonyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; /rfl7W^{[l-(Benzoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; rra7w^{[l-(2-Methylbenzoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4- {[ 1 -(Butanoyloxy)butoxycarbonyl]aminomethyl} - cyclohexanecarboxylic acid; trans-4- {[1 -(2-Methylprppanoyloxy)butoxycarbonyl] aminomethyl} - cyclohexanecarboxylic acid; fra«5^{[H3-Metiiyltfutano3^oxy)butoxycaibonyl]aininometbyl}- cyclohexanecarboxylic acid; /raw-4-{[l-(2^- Dimethylpiopanoyloxy)butoxyx:arbonyl]aiiunomethyl}-cyclohexanecarboxylic acid; /rfln5^{[l^en2oyloxy)butoxycaibonyl]aminomethyl}- cyclohexanecarboxylic acid; fran^{[l-(Propanoylpxy)propoxycarbonyl]ammometliyl}- cyclohexanecarboxylic acid; fraw-^{[l-(Butanoyloxy)propoxycaibonyl]anaiiiomethyl}- cyclohexanecarboxylic acid; /rfl/w-4-{[l-(2,2- Dimethylpropanoyloxy)propoxycaibonyl]atninomethyl}- cyclohexanecarboxylic acid; frfl/w^{[l-(Benzoyloxy)propoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; /ranj,-4-{[l-(Butanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4- {[l-(Butanoyloxy)-l- cyclohexylmethoxycarbonyljaminomethyl} -cyclohexanecarboxylic acid; /ra/w-4-{[l-(2-Methylpropanoyloxy)-l- cyclohexylmethoxycarbonyl]aminometb.yl}-cyclohexanecarboxylic acid; trans-4- {[l-(Acetoxy)butoxycarbonyl]aininomethyl} - cyclohexanecarboxylic acid; /raas-4-{[l-(Propanoyloxy)butoxycarbonyl3aminom6thyl}- cyclobexanecarboxylic acid; /ra7w^{[l-(Acetoxy)-2-methylpropoxycarbonyl]arninomethyl}- cyclobexanecarboxylic acid; trans-4- {[1 -(3-Methylbutanoyloxy)-2- methylpropoxycarbonyl]aminornethyl}-cyclohexanecarboxylic acid; trans-4- {[ 1 -(2,2-Dimethylpropanoyloxy)-2- methylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; /ra7w^{[l-(Acetoxy)ellioxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; and frfl7ts-4-{[l-(Propanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; including pharmaceutically acceptable salts thereof and pharmaceutically acceptable solvates of any of the foregoing. [00106] Certain embodiments of the present disclosure provide a compound of Formula (II): a pharmaceutically acceptable salt thereof, or solvate of any of the foregoing, wherein: X is selected from fluoro, chloro, bromo, and R20SO3- wherein R20 is selected from C1-6 alkyl, C5-7 aryl, and substituted C5-7 aryl; and R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon atom to which they are bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted cycloheteroalkyl ring; and R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl. [00107] In certain embodiments of a compound of Formula (II), at least one of R2, R3, and R4 is substituted with a substituent group selected from at least one of Cu alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, Ct_3 thioalkyl, C1-3 alkoxycarbonyl, Ci_ 3 alkylamino, and C1-3 dialkylamino. [00108] In certain embodiments of a compound of Formula (II), X is chloro. [00109] In certain embodiments of a compound of Formula (IT), R4 is selected from hydrogen, C1-6 alkyl, substituted CM alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C,s-io aryl, substituted C5.10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl. In certain of the immediately preceding embodiments, each substituent group of R4 is independently selected from at least one of d-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyL C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [00110] In certain embodiments of a compound of Formula (XT), R4 is selected from hydrogen, methyl, ethyl, tert-butyl, allyl, benzyl, 4-methoxybenzyl, diphenylmethyl, triphenylmethyl, trimethylsilyl, triethylsilyL triisopropylsilyl, fert-butyldimethylsilyl, and phenyldimethylsilyl. [00111] In certain embodiments of a compound of Formula (H), R4 is selected from hydrogen, allyl, benzyl, and trimethylsilyl. [00112] In certain embodiments of a compound of Formula (II), R4 is hydrogen. [00113] In certain embodiments of a compound of Formula (II), R2 and R3 are independently selected from hydrogen, Ci^ alkyl, substituted Q-e alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl. In certain of the immediately preceding embodiments, each substituent group of R2 and/or R3 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [00114] In certain embodiments of a compound of Formula (II), R2 and R3 are independently selected from hydrogen, methyl, ethyl, M-propyl, isopropyl, phenyl, and cyclohexyl. [00115] In certain embodiments of a compound of Formula (H), R2 is hydrogen, and R3 is selected from hydrogen, methyL ethyl, 7j-propyl, isopropyl, phenyl, and cyclohexyl. [00116] In certain embodiments of a compound of Formula (II), R2 and R3 are independently selected from hydrogen, Ci^ alkyL substituted C^ alkyl C6.10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, and R4 is selected from hydrogen, Q-6 alkyL substituted Ci^ alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl. In certain of the immediately preceding embodiments, each substituent group of R2 and/or R3 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH» C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [00117] In certain embodiments of a compound of Formula (H), R2 is hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl, and R4 is hydrogen. [00118] In certain embodiments of a compound of Formula (II), X is chloro, R2 is hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl, and R4 is hydrogen. [00119] Compounds of Formula (II) are useful intermediates in the synthesis of compounds of Formula (I) as described below. Synthesis [00120] Compounds of the present disclosure may be obtained via the synthetic methods illustrated in Schemes 1-9. Those of ordinary skill in the art will appreciate that a synthetic route to the disclosed compounds consists of attaching promoieties to tranexamic acid. [00121] A variety of methods for synthesis of acyloxyalkyl carbamate derivatives of amines are known in the art (for example, see Alexander et ah, U.S. Patent No. 4,426,391; Alexander, U.S. Patent No. 4,760,057; Lund, U.S. Patent No. 5,401,868; Saari etah, European Patent No. 0416689B1; Mulvihill et ah, Tetrahedron LeU., 2001,7751-7754; Sxmetah, Bioorg. Med. Chem. Lett., 2001,11,1875-1879; Sun et ah, Bioorg. Med. Chem. Lett., 2001,11,3055-3059;'Chen et ah, International Publication No. WO 01/05813; Mulvihill et ah, Synthesis, 2002,3, 365-370; Gallop et ah, U.S. Patent No. 6,927,036; Raillard et ah, U.S. Patent Application Publication No. 2004/0014940; Bhat et ah, U.S. Patent Application Publication No. 2005/0070715; Gallop et ah, U.S. Patent Application Publication No. 2005/0222431). [00122] General synthetic methods useful in the synthesis of the compounds described herein are available in the art (e.g., Green et ah, "Protective Groups in Organic Chemistry," (Wiley, 2nd ed. 1991); Harrison et ah, "Compendium of Synthetic Organic Methods," Vols. 1-8 (John Wiley and Sons, 1971-1996; Larock, "Comprehensive Organic Transformations," VCH Publishers, 1989; andPaquette, "Encyclopedia of Reagents for Organic Synthesis," John Wiley & Sons, 1995). [00123] Accordingly, starting materials useful for preparing compounds and intermediates thereof, and/or for practicing methods described herein are commercially available or may be prepared by well-known synthetic methods. Other methods for synthesis of the prodrugs of the present disclosure are either described in the art or will be readily apparent to the skilled artisan in view of the references provided above and may be used to synthesize the compounds described herein. Accordingly, the methods presented in the Schemes herein are illustrative rather than comprehensive. [00124] Intermediate (V), useful in the preparation of 1-haloalkyl carbamates of Formula (DQ, may be generated according to the reactions detailed in Scheme 1: [00125] The amino group of tranexamic acid is protected under standard conditions with a protecting group (Pg) to afford compound (VII). The carboxylic acid moiety of compound (VII) is esterified to yleld compound (Vm), either via alkylation or silylation wiui R4-X, where X is selected from fiuoro, chloro, bromo, iodo, and R20SO3- wherein R20 is selected from Q-6 alkyl, C5.7 aryl, and substituted C5.7 aryl, or any other suitable leaving group, or via condensation with alcohol R4-OH under standard acylation conditions (e.g., in the presence of a coupling agent such as a carbodiimide, via an acyl halide, acid anhydride, or other activated ester intermediate). Removal of the protecting group from compound (Vlll) under standard deprotection conditions affords compound (V). [00126] In certain embodiments, a compound of Formula (H) is prepared by acylation of compound (V) with compound (IX) (see Scheme 2), where X is a halide and Z is a leaving group (e.g, halide, jp-nitrophenolate, imidazolyl, etc.). In certain embodiments, X is F, CI, Br, or L In some of these embodiments, Z is CI. In certain embodiments, X and Z are each CI. The acylation reaction may be performed in the presence of an inorganic base or an organic base (e.g, tertiary amine bases, such as triethylamine, tributylamine, diisopropylethylamine, dimemylisopropylamine, JV-methylmorpholine, iV-methylpyrrolidine, JV-methylpiperidine, pyridine, 2-methylpyridine, 2,6-dimemylpyridine, 4-dimemylaminopyridine, 1, 4-diazabicyclo[2.2.2]octane, 1, 8-diazabicyclo[5.4.0]undec-7-ene or l,5-diazabicyclo[4.3.0]undec-7-ene), and combinations of any of the foregoing. Suitable solvents for acylation include, but are not limited to, dichloromethane, dichloroethane, chloroform, toluene, dimethylformamide, dimethylacetamide, i^-methylpyrrolidinone, dimethyl sulfoxide, pyridine, ethyl acetate, isopropyl acetate, acetonitrile, acetone, 2-butanone, methyl /erf-butyl ether, and combinations of any of the foregoing. Alternatively, biphasic solvent mixtures comprising water and including one or more of dichloromethane, dichloroethane, chloroform, toluene, ethyl acetate, isopropyl acetate, or methyl tert-butyl ether, can be utilized. Temperatures for performing the reaction of Scheme 2 can range from about -20 °C to about 50 °C, and in certain embodiments can range from about -20 °C to about 25 °C. [00127] In certain embodiments, a compound of Formula (IT), where R4 is triaikylsilyl or aryldialkylsilyl, can be prepared directly from tranexamic acid by silylation (e.g., using a silyl halide or silylamide reagent) followed by acylation of the resulting intermediate with compound (EX) (see Scheme 3). Suitable solvents for performing mis reaction include, but are not limited to, dichloromethane, dichloroethane, chloroform, toluene, pyridine, acetonitrile, and combinations of any of the foregoing. Suitable bases for performing this reaction include but are not limited to, triethylamine, tributylamine, diisopropylethylamine, dimethylisopropylamine, //-methylmorpholine, i^-methylpyrrolidine, iV-methylpiperidine, pyridine, 2-methylpyridine, 2,6-dimethylpyridine, 4-dimethylaminopyridine, l,4-diazabicyclo[2.2J2]octane, 1, 8-diazabicyclo[5.4.0]undec-7-ene, l,5-diazabicyclo[4.3.0]undec-7-ene, and combinations of any of the foregoing. Temperatures for performing the reaction of Scheme 3 can range from about -78 °C to about 50 °C, and in certain embodiments can range from about -20 °C to about 25 °C. [00128] In certain embodiments, iV-1-acyloxylalkyl carbamates of Formula (I) can be prepared from compounds of Formula (EQ by treatment with carboxylic acids of Formula (Ed) in the presence of an organic or inorganic base, or other metal salt, as illustrated in Scheme 4. Scheme 4 In certain embodiments of a compound of Formula (II) in the method of Scheme 4, X is selected from fluoro, chloro, bromo, and R20SQr- wherein R20 is selected from Ci.6 alkyl, C5.7 aryl, and substituted C5.7 aryL In certain embodiments of compounds of Formulae (I) and (EH) in the method of Scheme 4, R1 is selected from acyl, substituted acyl, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl. In certain embodiments of compounds of Formulae (I) and (U) in the method of Scheme 4, R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon atom to which they are bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted cycloheteroalkyl ring. In certain embodiments of compounds of Formulae (I) and (II) in the method of Scheme 4, R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl. In certain of the immediately preceding embodiments, each substituent group of R1, R2, R3, and/or R4 is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [00129] In certain embodiments of compounds of Formulae (I), (II), and (III) in the method of Scheme 4, X is chloro, R1 is selected from methyl, ethyl, «-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyL and cyclohexyl, R2 is hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl, and R4 is hydrogen. [00130] In certain embodiments of the method of Scheme 4, the ratio of a compound of Formula (H) to a compound of Formula (HI) can range from about 1:1 to about 1:20. In certain embodiments, the ratio of a compound of Formula (II) to a compound of Formula (ill) can range from about 1:1 to about 1:5. In certain embodiments, the ratio of a compound of Formula (II) to a compound of Formula (HI) is about 1:1. [00131] In certain embodiments of the method of Scheme 4, compounds of Formulae (II) and (HI) and a metal salt are contacted with a solvent. In certain embodiments in which a compound of Formula (I), a compound of Formula (H) and a metal salt are contacted with a solvent, the ratio of a compound of Formula (II) to a compound of Formula (HI) can range from about 1:1 to about 1:20, in certain embodiments, from about 1:1 to about 1:5, and in certain embodiments, the ratio of a compound of Formula (II) to a compound of Formula (HI) is about 1:1. In certain embodiments, the solvent can be dichloromethane, dichloroethane, chloroform, toluene, dimethylformamide, dimethylacetamide, AT-methylpyrrolidinone, dimethyl sulfoxide, pyridine, ethyl acetate, acetonitrile, acetone, 2-butanone, methyl tert-butyl ether, methanol, ethanol, isopropanol, tert-butanol, water, hexamethylphosphoramide, and combinations of any of the foregoing. In certain embodiments, the metal salt can be a salt of Ag, Hg, Na, K, Li, Cs, Ca, Mg, Zn, and combinations of any of the foregoing. [00132] In certain embodiments of the method of Scheme 4, compounds of Formulae (II) and (IDT) and an organic base are contacted with a solvent. In certain embodiments in which a compound of Formula (II), a compound of Formula (HI) and an organic base are contacted with a solvent, the ratio of a compound of Formula (H) to a compound of Formula (HI) can range from about 1:1 to about 1:20, in certain embodiments, from about 1:15 to about 1:20, and in certain embodiments, can range from about 1:1 to about 1:5. In certain embodiments in which a compound of Formula (H), a compound of Formula (HI) and an organic base are contacted with a solvent, the ratio of a compound of Formula (II) to a compound of Formula (HI) is about 1:1, and in certain embodiments, is about 1:10. In some embodiments, the solvent can be dichloromethane, dichloroethane, chloroform, toluene, dimethylfonnamide, dimethylacetamide, ivnnemylpyrroudinone, dimethyl sulfoxide, pyridine, ethyl acetate, acetonitrile, acetone, 2-butanone, methyl tert-butyl ether, methanol, ethanol, isopropanol, tert-butanol, water, hexamethylphosphoramide, and combinations of any of the foregoing. In certain embodiments, the organic base can be triethylamine, tributylamine, diisopropylethylamine, dimethylisopropylamine, iNT-memylmorpholine, iV-methylpyrrolidine, W-memylpiperidine, pyridine, 2-methylpyridine, 2,6-dimetb.ylpyridine, 4-a^emylatninopyridine, l,4-diazabicyclo[2.2.2]octane, l,8-diazabicyclo[5.4.0]undec-7-ene, l,5-diazabicyclo[4.3.0]undec-7-ene, and combinations of any of the foregoing. [00133] In some embodiments of the method of Scheme 4, a compound of Formula (ID) is a liquid under the conditions of contacting with a compound of Formula (II), and the compound of Formula (HI) further serves as a solvent for the reaction with a compound of Formula (H). m certain embodiments, a compound of Formula (IB) can be acetic acid, methoxyacetic acid, ethoxyacetic acid, propionic acid, butyric acid, isobutyric acid, pivalic acid, valeric acid, isovaleric acid, 2-methylbutyric acid, cyclobutanecarboxylic acid, cyclopentanecarboxylic acid, or cyclohexanecarboxylic acid. [00134] In some embodiments of the method of Scheme 4, a compound of Formula (H), a compound of Formula (HI), and a metal salt can be contacted at a temperature ranging from about -25 °C to about 120 °C. In certain embodiments, the temperature can range from about 0 °C to about 25 °C. [00135] In certain other embodiments of the method of Scheme 4, a compound of Formula (H), a compound of Formula (HI), and#an organic base can be contacted at a temperature ranging from about -25 °C to about 120 °C. In certain embodiments, the temperature can range from about 0 °C to about 25 °C. [00136] In some embodiments of the method of Scheme 4, a compound of Formula (II), a compound of Formula (Til), and an organic base can be contacted with a catalytic amount of an iodide salt. In certain embodiments, the iodide salt can be sodium iodide, potassium iodide, tetramethylammonium iodide, tetraethylammonium iodide, or tetrabutylammonium iodide. [00137] In some embodiments of the method of Scheme 4, R4 can be a carboxylic acid protecting group that can be removed under mild conditions to provide a compound of Formula (I) where R4 is hydrogen. Carboxylic acid protecting groups removable via mild acidic hydrolysis, fluoride ion-promoted hydrolysis, catalytic hydrogenolysis, transfer hydrogenolysis, or other transition metal-mediated deprotection reactions can be used. In some embodiments, R4 can be trimethylsilyl, allyl, or benzyl. [00138] In certain embodiments, a compound of Formula (I) can be prepared as illustrated in Scheme 5. [00139] Chloroformate (X) is treated with an aromatic leaving group such as p-nitrophenol in the presence of base to provide/i-nitrophenylcarbonate (XI). Halide interchange provides iodide (Xn), which is reacted with a metal or tetraalkylammonium salt of a carboxylic acid to afford compound (XUI). Treatment of (XEQ) with tranexamic acid derivative (V), optionally in the presence of trimethylsilyl chloride, affords a compound of Formula (I). Methods for making related acyloxyalkyl carbamate compounds are described in the art (e.g., Alexander, U.S. Patent No. 4,760,057; Alexander, U.S. Patent No. 4,916,230; Alexander, U.S. Patent No. 5,466,811; Alexander, U.S. Patent No. 5,684,018). [00140] Another method for synthesis of compounds of Formula (I) proceeds via carbonylation of tranexamic acid derivative (V) to an intermediate carbamic acid species, which is captured by an in situ alkylation reaction in an adaptation of methods disclosed in the art (Butcher, Synlett, 1994, 825-6; Ferres et al., U.S. Patent 4,036,829). Carbon dioxide gas is bubbled into a solution containing tranexamic acid derivative (V) and a base (e.g., CS2CQ3, Ag2C03, or AgO) in a solvent such as DMF or NMP. An activated halide is added, optionally, in the presence of iodide ion as a catalyst, and the carbonylation continued until the reaction is completed. This method is illustrated in Scheme 6 for the preparation of a compound of Formula (I) from halide (XIV). [00141] Yet another method for synthesis of a compound of Formula upon oxidation of ketocarbamate derivatives of tranexamic acid (e.g., Gallop et al, U.S. Patent No. 6,927,036; and Bhat et al, U.S. Application Publication No. 2005/0070715). As illustrated in Scheme 7, oxidation of ketocarbamate (XV) affords a compound of Formula (I). Methods for synthesis of a compound of Formula (XV) are disclosed in U.S. Patent No. 6,927,036 and U.S. Application Publication No. 2005/0070715. Examples of oxidants useful in the method of Scheme 6 include those successfully used in Baeyer-Villager oxidations of ketones to esters or lactones (Strukul, Angew. Chem. Int. Ed., 1998,37,1198; Renz., Eur. J. Org. Chem., 1999, 4, 737-50; Beller et al, in "Transition Metals in Organic Synthesis" Chapter 2, Wiley VCH; Stewart, Current Organic Chemistry, 1998,2, 195; Kayser et al, Synlett, 1999, 153). The use of anhydrous oxidants can be beneficial since prodrugs of Formula (I) may be labile. Thus, performing the oxidation under anhydrous reaction conditions can avoid hydrolysis of the reactive products. Scheme 7 In certain embodiments of compounds of Formulae (I) and (XV) in the method of Scheme 7, R1 is selected from acyl, substituted acyl, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl. In certain embodiments of compounds of Formulae (I) and (XV), R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the atom to which they are bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkylor substituted cycloheteroalkyl ring. In certain embodiments of compounds of Formulae (I) and (XV), R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl. In certain embodiments of compounds of Formulae (I) and (XV), each substituent group of R1, R2, R3, and/or R4 is independently selected from at least one of C1-3 alkyl, -OH, - NH2, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylarnino. [00142] In certain embodiments of compounds of Formulae (I) and (XV) in the method of Scheme 7, R1 is selected from methyl, ethyl, /i-propyl, isopropyl, ra-butyl, isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, R3 is selected from hydrogen, methyl, ethyl, w-propyl, isopropyl, phenyl, and cyclohexyl, and R4 is hydrogen. [00143] In the method of Scheme 7 oxidation can be performed in the liquid phase, and in certain embodiments, in the presence of a solvent. Choosing a solvent for oxidation of a compound of Formula (XV) is well within the ambit of one of skill in the art Generally, a useful solvent will dissolve, at least partially, both the oxidant and a compound of Formula (XV) and will be inert to the reaction conditions. Useful solvents can be anhydrous and include, but are not limited to, dichloromethane, dichloroethane, chloroform, ethyl acetate, isopropyl acetate, toluene, chlorobenzene, xylene, acetonitrile, diethyl ether, methyl terf-butyl ether, acetic acid, cyclohexane, and hexanes. Combinations of the above solvents can also be used in the oxidation of a compound of Formula (XV) to a compound of Formula (I). [00144] In some embodiments, the anhydrous oxidant is an anhydrous peroxyacid generated in situ by reaction of a urea-hydrogen peroxide complex (UHP) with a carboxylic acid anhydride. In certain embodiments, the anhydrous oxidant is an anhydrous peroxysulfonic acid generated in situ by reaction of a urea-hydrogen peroxide complex with a sulfonic acid anhydride. The UHP complex serves as a source of anhydrous hydrogen peroxide and has been used in a variety of oxidative transformations, in anhydrous organic solvents (Cooper et al, Synlett., 1990, 533-535; Balicki era/., Synth. Commun., 1993,23,3149; AstadiUo et al.,Heterocycles, 1993, 36,1075-1080; Varmaete/a/., Org. Lett., 1999, /, 189-191). However, other suitable sources of anhydrous hydrogen peroxide can also be used in the reaction instead of the UHP-complex (e.g., the l,4-diazabicyclo[2.2.2]octane-hydrogen peroxide complex). [00145] A useful oxidant is anhydrous peroxytrifluoroacetic acid, generated in situ by reacting the UHP-complex with trifiuoroacetic anhydride (Cooper et al, Synlett., 1990,533-535; Benjamin, et al, J. Am. Chem. Soc, 2002,124, 827-833). Anhydrous peroxycarboxylic acids (XVII) can be prepared by treating carboxylic acid anhydrides (XVI) with anhydrous hydrogen peroxide, and in certain embodiments, with the UHP-complex. Similarly, anhydrous peroxysulfonic acids (XIX) can be prepared by reacting sulfonic acid anhydrides (XVIII) with anhydrous hydrogen peroxide, and in certain embodiments, with the UHP-complex. Preparation of anhydrous peroxycarboxylic acids (XVII) and peroxysulfonic acids (XIX) is illustrated in Scheme 8. [00146] The UHP-complex and a carboxylic acid anhydride (XVI) or a sulfonic acid anhydride (XVIII) can be reacted in dichloromethane or other suitable solvent at temperatures ranging from about -25 °C to about 100 °C to generate the corresponding anhydrous peroxyacid oxidant. The peroxyacid oxidant can be generated first and subsequently reacted with a ketocarbamate (XV). In some embodiments, a carboxylic acid anhydride (XVI) is added to a stirred suspension or solution containing the UHP-complex and a ketocarbamate (XV) to generate the peroxycarboxylic acid, which reacts in situ with the ketocarbamate (XV) to give compound (I). In certain embodiments^ the molar ratio of UHP-complex and carboxylic acid anhydride (XVI) is about 6:1. In certain embodiments, the molar ratio of UHP-complex and carboxylic acid anhydride (XVI) can range from about 5:1 to about 1:1. In certain embodiments, the molar ratio of UHP-complex and acid anhydride (XVI) can range from about 2:1 to about 1:1. [00147] In some embodiments of the method of Scheme 8, the molar ratio of the peroxyacid oxidant to a compound of Formula (XV) can range from about 8:1 to about 1:1. In certain embodiments, the molar ratio of the peroxyacid oxidant to a compound of Formula (XV) can range from about 4:1 to about 1:1. In certain embodiments, the molar ratio of the peroxyacid oxidant to a compound of Formula (XV) can range from about 2:1 to about 1:1. In certain embodiments, when the oxidant is peroxytrifluoroacetic acid or another substituted peroxyacetic acid, the molar ratio of the peroxyacid oxidant to a compound of Formula (XV) is about 2:1. [00148] Further, in the method of Scheme 8 the use of additives in the oxidation of a compound of Formula (XV) to a compound of Formula (I) is also contemplated. For example, additives can either catalyze the reaction or stabilize the final product or botii. In some embodiments, a Lewis acid or a protic acid or any combination of Lewis acid or protic acid can be used in the oxidation of a compound of Formula (XV) and in certain embodiments, in the presence of a solvent Examples of Lewis acids include, but are not limited to, BF3, SeC>2, MeRe03, MuC^, SnCLt, Sc(OTf)3, Ti(0-iPr)4, AI2O3, and Fe23. Examples of protic acids include, but are not limited to, trifluoroacetic acid, acetic acid,p-toluenesulfonic acid, methanesulfonic acid, trifluoromethanesulfonic acid, hydrochloric acid, and sulfuric acid. In certain embodiments, the Lewis acid and/or protic acid can catalyze oxidation by increasing the electrophilicity of the carbonyl group in Formula (XV). [00149] In certain embodiments of the method of Scheme 8, the oxidation can be conducted in the presence of an anhydrous base. In certain embodiments, the base can stabilize acid sensitive products by reacting with acidic by-products formed during oxidation. [00150] Generally, in the method of Scheme 8 the temperature of the reaction can be optimized by methods known to those of ordinary skill in the art. In certain embodiments, the oxidation of a compound of Formula (XV) can be carried out at a temperature ranging from about -25 °C to about 100 °C, and in certain embodiments, from about 0 °C to about 25 CC. [00151] A feature of this method of synthesis of a compound of Formula (I) is that oxidation of a ketocarbamate derivative (XV) proceeds stereospecifically, with retention of configuration at the carbon atom initially adjacent to the carbonyl group in the ketocarbamate derivative (XV). This stereospecificity can be exploited in a stereoselective synthesis of prodrug derivatives of Formula (I). [00152] Another method for synthesis of a compound of Formula (I), illustrated in Scheme 9, relies upon reaction of tranexamic acid, or a compound of Formula (V), with a l-(acyloxy)-alkyl N-hydtoxysuccinimidyl carbonate compound of Formula (TV), as described in the co-pending application Gallop et al, U.S. Application Publication No. 2005/0222431: wherein R1, R2, R3 and R4 are as defined herein, and R5 and R6 are independently selected from hydrogen, acylamino, acyloxy, alkoxycarbonylamino, alkoxycarbonyloxy, alkyl, substituted alkyl, alkoxy, substituted alkoxy, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyloxy, dialkylamino, heteroaryl, substituted heteroaryl, hydroxy, and sulfonamido, or R5 and R6 together with the atoms to which they are bonded form a substituted cycloalkyl, substituted cycloheteroalkyl, or substituted aryl ring. In certain of the immediately preceding embodiments, the substituent group of R1, R2, R3, R4, R5, and/or R6 is selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. [00153] In certain embodiments of compounds of Formula (J), (TV), and (V) of the method of Scheme 9, R1 is selected from methyl, ethyl, »-propyl, isopropyl, n- butyl, isobutyl, sec-butyl, fert-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl, R4 is hydrogen, and R5 and R* are each hydrogen. [00154] In some embodiments, the method of Scheme 9 can be carried out in a solvent. Useful solvents include, but are not limited to, acetone, acetonitrile, dichloromethane, dichloroethane, chloroform, toluene, tetrahydrofuran, dioxane, dimemylformamide, dimethylacetamide, JV-methylpyrrolidinone, dimethyl sulfoxide, pyridine, ethyl acetate, methyl tert-butyl ether, methanol, ethanol, isopropanol, tert-butanol, water, and combinations of any of the foregoing. In certain embodiments, the solvent can be acetone, acetonitrile, dichloromethane, toluene, tetrahydrofuran, pyridine, methyl tert-butyl ether, methanol, ethanol, isopropanol, water, and combinations of any of the foregoing. In certain embodiments, the solvent can be a combination of acetonitrile and water. In certain embodiments, the solvent can be a combination of acetonitrile and water, with a volume ratio of acetonitrile to water ranging from about 1:5 to about 5:1. In certain embodiments, the solvent can be a combination of methyl tert-butyl ether and water. In certain embodiments, the solvent can be a combination of methyl tert-butyl ether and water, with a volume ratio of methyl tert-butyl ether to water ranging from about 2:1 to about 20:1. In certain embodiments, the solvent can be a combination of methyl tert-butyl ether and water, wherein the methyl tert-butyl ether contains from about 10% to about 50% acetone by volume. In certain embodiments, the solvent can be dichlorometiiane, water, or a combination thereof. In certain embodiments, the solvent is a biphasic combination of dichloromethane and water. In certain embodiments, the solvent can be a biphasic combination of dichloromethane and water containing from about 0.001 equivalents to about 0.1 equivalents of a phase transfer catalyst. In certain embodiments, the phase transfer catalyst is a tetraalkylammonium salt, and in certain embodiments, the phase transfer catalyst is a tetrabutylammonium salt. [00155] The method of Scheme 9 can be carried out a temperature ranging from about -20 °C to about 40 °C. In certain embodiments, the temperature can range from about -20 °C to about 25 °C. In certain embodiments, the temperature can range from about 0 °C to about 25 °C. In certain embodiments, the temperature can range from about 25 °C to about 40 °C. [00156] In certain embodiments of the method of Scheme 9, the reaction can be performed in the absence of a base. [00157] In certain embodiments of the method of Scheme 9, the reaction can be performed in the presence of an inorganic base. In some embodiments, the reaction can be performed in the presence of an alkali metal bicarbonate or alkali metal carbonate salt. In certain embodiments, the reaction can be performed in the presence of sodium bicarbonate. [00158] In certain embodiments of the method of Scheme 9, the reaction can be performed in the presence of an organic base. In certain embodiments, the reaction can be performed in the presence of triethylamine, tributylamine, diisopropylethylamine, dimemylisopropylamine, //-methylmorpholine, iV-methylpyrrolidine, i^-methylpiperidijie, pyridine, 2-methylpyridine, 2,6-dimethylpyridine, 4-dimemylarninopyridine, l,4-diazabicyclo[2.2.2]octane, l,8-diazabicyclo[5.4.0]undec-7-ene, l,5-diazabicyclo[4.3.0]undec-7-ene, or a combination of any of the foregoing. In certain embodiments, the reaction can be performed in the presence of triethylamine, diisopropylethylaroine, i\A-methylmorpholine, or pyridine. Pharmaceutical Compositions [00159] Pharmaceutical compositions comprising a therapeutically effective amount of one or more tranexamic acid prodrug compounds of Formula (I), optionally in purified form, together with a suitable amount of a pharmaceutically acceptable vehicle, so as to provide a form for proper administration to a patient are provided herein. Suitable pharmaceutical vehicles include excipients such as starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol, and the like. Compositions of the present disclosure, if desired, can also contain minor amounts of wetting agents, emulsifylng agents, or pH buffering agents. In addition, auxiliary, stabilizing, thickening, lubricating, and coloring agents can be included. [00160] Pharmaceutical compositions can be manufactured, for example, by means of conventional mixing, dissolving, granulating, dragee-making, levigating, emulsifylng, encapsulating, entrapping, and lyophilizing processes. Pharmaceutical compositions can be formulated in a conventional manner using one or more physiologically acceptable carriers, diluents, excipients, and auxiliaries, which facilitate processing of compounds disclosed herein into preparations, which can be used pharmaceutically. Proper formulation can be dependent upon the route of administration chosen. [00161] The present pharmaceutical compositions can take the form of, for example, solutions, suspensions, emulsion, tablets, pills, pellets, capsules, capsules containing liquids, powders, sustained-release formulations, suppositories, emulsions, aerosols, sprays, suspensions, or any other form suitable for use. In some embodiments, a pharmaceutically acceptable vehicle can be a capsule (see e.g., Grosswald et al, U.S. Patent No. 5,6981,155). Other examples of suitable pharmaceutical vehicles have been described in the art (see Remington's Pharmaceutical Sciences, Philadelphia College of Pharmacy and Science, 19th Edition, 1995). In some embodiments, compositions can be formulated for oral delivery, for example, oral sustained release admimstratiori. In certain embodiments, compositions can be formulated for topical delivery, and in certain embodiments, for topical sustained release administration. [00162] Pharmaceutical compositions for oral delivery can be in the form of, for example, tablets, lozenges, aqueous or oily suspensions, granules, powders, emulsions, capsules, syrups, or elixirs, for example. Orally administered compositions can contain one or more optional agents, sweetening agents such as fructose, aspartame or saccharin, flavoring agents such as peppermint, oil of wintergreen, cherry coloring agents, and preserving agents, to provide a palatable preparation. Moreover, when in tablet or pill form, the compositions can be coated to delay disintegration and absorption in the gastrointestinal tract, thereby providing a sustained action over an extended period of time. Oral compositions can include standard vehicles such as roannitol, lactose, starch, magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, etc. Such vehicles may be of pharmaceutical grade. [00163] For oral liquid preparations for example, suspensions, elixirs and solutions, suitable carriers, excipients or diluents include water, saline, alkyleneglycols (e.g., propylene glycol), polyalkylene glycols (e.g., polyethylene glycol), oils, alcohols, slightly acidic buffers between about pH 4 and about pH 6 (e.g., acetate, citrate, ascorbate at between about 5 mM to about 50 mM), etc. Additionally, flavoring agents, preservatives, coloring agents, bile salts, acylcarnitines, and the like can be added. [00164] For topical formulations of tranexamic acid prodrug compounds of Formula (I) in the form of creams, gels, viscous lotions, transdermal patches, and/or sprays can be used as appropriate delivery forms. Such formulations can comprise one or more tranexamic acid prodrug compounds of Formula (I), optionally in purified form, together with a suitable amount of any pharmaceutically acceptable topical excipients including, but not limited to, gels, patches, lotions, creams, ointments, and liquids. [00165] Compositions for topical administration include those for delivery via the mouth (buccal), nose (nasal), the rectum (rectal), the vagina (vaginal), and through the skin (dermal). Topical delivery systems also include transdermal patches containing at least one compound of Formula (I) to be administered. Delivery through the skin can be achieved by diffusion or by more active energy sources such as iontophoresis or electrotransport. [00166] Compositions suitable for topical administration in the mouth include lozenges comprising a compound of Formula (I) optionally in a flavored basis such as sucrose and acacia or tragacanth, pastilles comprising a compound of Formula (I) in an inert basis such as gelatin and glycerin, or sucrose and acacia; and mouthwashes comprising a compound of Formula (I) administered in a suitable liquid vehicle. [00167] Compositions suitable for topical administration to the skin include ointments, creams, gels, patches, pastes and sprays comprising a compound of Formula (I) to be administered in a pharmaceutical acceptable vehicle. Formulations of a compound of Formula (I) for topical use, such as in creams, ointments and gels, can include an oleaginous or water-soluble ointment base. For example, topical compositions can include vegetable oils, animal fats, and in certain embodiments, semisolid hydrocarbons obtained from petroleum. Topical compositions can further include white ointment, yellow ointment, cetyl esters wax, oleic acid, olive oil, paraffin, petrolatum, white petrolatum, spermaceti, starch glycerite, white wax, yellow wax, lanolin, anhydrous lanolin, and glyceryl monostearate. Various water- soluble ointment bases can also be used, including glycol ethers and derivatives, polyethylene glycols, polyoxyl 40 stearate, and polysorbates. [00168] Compositions for rectal administration can be in the form of a suppository with a suitable base comprising, for example, cocoa butter or a salicylate. Compositions suitable for vaginal administration can be provided as pessaries, tampons, creams, gels, pastes, foams, or spray formulations containing in addition to a compound of Formula (I) such vehicles as are known in the art to be appropriate. Compositions for nasal administration can be in the form of, for example, nasal solutions, sprays, aerosols, or inhalants, and can include in addition to at least one compound of Formula (I), vehicles suitable for nasal adrninistration. [00169] When a compound of Formula (I), is acidic, it can be included in any of the above-described formulations as the free acid, a pharmaceutically acceptable salt, a solvate, or a hydrate. Pharmaceutically acceptable salts can substantially retain the activity of the free acid, can be prepared by reaction with bases, and can be more soluble in aqueous and other protic solvents than the corresponding free acid form. m some embodiments, sodium salts of a compound of Formula 00 can be used in the above described formulations. Sustained Release Oral Dosage Forms [00170] The disclosed compounds may be used with a number of different dosage forms, which can be adapted to provide sustained release of a compound of Formula (I) upon oral administration. [00171] In some embodiments, a dosage form can comprise beads that on dissolution or diffusion release a compound disclosed herein over an extended period of hours, in certain embodiments, over a period of at least 4 hours, in certain embodiments, over a period of at least 8 hours and in certain embodiments, over a period of at least 12 hours. The beads can have a central composition or core comprising a compound disclosed herein and pharmaceutically acceptable vehicles, including an optional lubricant, antioxidant, and buffer. The beads can be medical preparations with a diameter ranging from about 0.05 mm to about 2 mm. Individual beads can comprise doses of a compound disclosed herein, for example, doses of up to about 40 mg of the compound. The beads, in some embodiments, can be formed of non-cross-linked materials to enhance their discharge from the gastrointestinal tract. The beads can be coated with a release rate-controlling polymer that gives a timed- release profile. [00172] The time-release beads can be manufactured into a tablet for therapeutically effective administration. The beads can be made into matrix tablets by the direct compression of a plurality of beads coated with, for example, an acrylic resin and blended with excipients such as hydroxypropylmethyl cellulose. The manufacture of beads has been disclosed in the art (Lu, Int. J. Pharm., 1994,112, 117-124; 'Tharmaceutical Sciences" by Remington, 14th Ed, pp. 1626-1628 (1970); Fincher, J. Pharm. ScL, 1968, 57,1825-1835; and U.S. Patent No. 4,083,949) as has the manufacture of tablets ('Tharmaceutical Sciences," by Remington, 17th Ed, Ch. 90, pp 1603-1625(1985)). [00173] One type of sustained release oral dosage formulation that can be used with the disclosed compounds comprises an inert core, such as a sugar sphere, coated with an inner drug-containing layer and an outer membrane layer controlling drug release from the inner layer. A "sealcoat" can be provided between the inert core and the layer containing the active ingredient When the core is of a water-soluble or water-swellable inert material, the sealcoat can be in the form of a relatively thick layer of a water-insoluble polymer. Such a controlled release bead an thus comprise: (i) a core unit of a substantially water-soluble or water-swellable inert material; (ii) a first layer on the core unit of a substantially water-insoluble polymer; (iii) a second layer covering the first layer and containing an active ingredient; and (iv) a third layer on the second layer of polymer effective for controlled release of the active ingredient, wherein the first layer is adapted to control water penetration into the core. [00174] In certain embodiments, the first layer (ii) above can constitute more than about 2% (w/w) of the final bead composition, and in certain embodiments, more than about 3% (w/w), e.g., from about 3% to about 80% (w/w). The amount of the second layer (ii) above can constitute from about 0.05% to about 60% (w/w), and in certain embodiments from about 0.1% to about 30% (w/w) of the final bead composition. The amount of the third layer (iv) above can constitute from about 1% to about 50% (w/w), in certain embodiments, from about 2% to about 25% (w/w) of the final bead composition. The core unit can have a size ranging from about 0.05 to about 2 mm. The controlled release beads can be provided in a multiple unit formulation, such as a capsule or a tablet. [00175] The cores can comprise a water-soluble or swellable material and can be any such material that is conventionally used as cores or any other pharmaceutically acceptable water-soluble or water-swellable material made into beads or pellets. The cores can be spheres of materials such as sucrose/starch (Sugar Spheres NF), sucrose crystals, or extruded and dried spheres typically comprised of excipients such as microcrystalline cellulose and lactose. The substantially water-insoluble material in the first, or sealcoat layer can be a "GI insoluble" or "GI partially insoluble" film forming polymer (dispersed or dissolved in a solvent). Examples include, but are not limited to, ethyl cellulose, cellulose acetate, cellulose acetate butyrate, polymethacrylates such as ethyl acrylate/methyl methacrylate copolymer (Eudragit NE-30-D) and ammonio methacrylate copolymer types A and B (Eudragit RL30D and RS30D), and silicone elastomers, ha certain embodiments, a plastieizer can be used together with, the polymer. Examples of plasticizers include, but are not limited to, dibutylsebacate, propylene glycol, triethylcitrate, tributylcitrate, castor oil, acetylated monoglycerides, acetyl triethylcitrate, acetyl butylcitrate, diethyl phthalate, dibutyl phthalate, triacetin, and fractionated coconut oil (medium-chain triglycerides). The second layer containing the active ingredient can comprise an active ingredient with or without a polymer as a binder. The binder, when used, can be hydrophilic, and in certain embodiments can be water-soluble or water-insoluble. Examples of polymers that can be used in the second layer containing the active drug include hydrophilic polymers such as, polyvinylpyrrolidone (PVP), polyalkylene glycol such as polyethylene glycol, gelatine, polyvinyl alcohol, starch and derivatives thereof, cellulose derivatives, such as hydroxypropylmethyl cellulose (HPMC), hydroxypropyl cellulose, carboxymethyl cellulose, methyl cellulose, ethyl cellulose, hydroxyethyl cellulose, carboxyethyl cellulose, carboxymethylhydroxyethyl cellulose, acrylic acid polymers, polymethacrylates, or any other pharmaceutically acceptable polymer. The ratio of drug to hydrophilic polymer in the second layer can range from about 1:100 to about 100:1 (w/w). Suitable polymers for use in the third layer, or membrane, for controlling the drug release can be selected from water-insoluble, polymers or polymers withpH-dependent solubility, such as, ethyl cellulose, hydroxypropylmethyl cellulose phthalate, cellulose acetate phthalate, cellulose acetate trimellitate, polymethacrylates, or mixtures thereof, optionally combined with plasticizers, such as those mentioned above. Optionally, the controlled release layer comprises, in addition to the polymers above, other substance(s) with different solubility characteristics, to adjust the permeability and thereby the release rate, of the controlled release layer. Example of polymers that can be used as a modifier together with, for example, ethyl cellulose include, but are not limited to, HPMC, hydroxyethyl cellulose, hydroxypropyl cellulose, methylcellulose, carboxymethylcellulose, polyethylene glycol, polyvinylpyrroUdone (PVP), polyvinyl alcohol, polymers with pH-dependent solubility, such as cellulose acetate phthalate or ammonio methacrylate copolymer, methacrylic acid copolymer, and combinations of any of the foregoing. Additives such as sucrose, lactose and pharmaceutical grade surfactants can also be included in the controlled release layer, if desired. [00176] The preparation of the multiple unit formulation can comprise the additional step of tramforming the prepared beads into a pharmaceutical formulation, such as by filling a predetermined amount of the beads into a capsule, or compressing the beads into tablets. Examples of multi-particulate sustained release oral dosage forms are described in, for example, U.S. Patent Nos. 6,627,223 and 5,229,135. [00177] In certain embodiments, polymeric materials can be used (See "Medical Applications of Controlled Release," Laager and Wise (eds.), CRC Press, Boca Raton, Florida (1974); "Controlled Drug Bioavailability, Drug Product Design and Performance," Smolen and Ball (eds.), Wiley, New York (1984); Langer et al, J Macromol. Sci. Rev. Macromol Chem., 1983,23,61; see also Levy et al., Science, 1985,228,190; During et al, Ann. Neurol, 1989,25,351; Howard et al, J. Neurosurg., 1989, 71,105). In some embodiments, polymeric materials can be used for oral sustained release delivery. Polymers include, but are not limited to, sodium carboxymethylcellulose, hydroxypropylcellulose, hydroxypropylmetnylcellulose, and hydroxyethylcellulose (especially, hydroxypropylmethylcellulose). Ottier cellulose ethers have been described (Alderman, Int. J. Pharm. Tech. & Prod. Mfr., 1984,5(3), 1-9). Factors affecting drug release are well known to the skilled artisan and have been described in the art (Bamba et al, Int. J. Pharm., 1979,2,307). [00178] In certain embodiments, enteric-coated preparations can be used for oral sustained release administration. Examples of useful coating materials include polymers with apH-dependent solubility (i.e., pH-controlled release), polymers with a slow or pH-dependent rate of swelling, dissolution or erosion (i.e., time-controlled release), polymers that are degraded by enzymes (i.e., enzyme-controlled release), and polymers that form firm layers that are destroyed by an increase in pressure (i.e., ' pressure-controlled release). [00179] In certain embodiments, drug-releasing lipid matrices can be used for oral sustained release administration. An example is when solid microparticles of a compound disclosed herein are coated with a thin controlled release layer of a lipid (e.g., glyceryl behenate and/or glyceryl palmitostearate) as disclosed in Farah et al, U.S. Patent No. 6,375,987 and Joachim^ al, U.S. Patent No. 6,379,700. The lipid-coated particles can optionally be compressed to form a tablet. Another controlled release lipid-based matrix material that is suitable for sustained release oral administration comprises polyglycolized glycerides as disclosed in Roussin et al, U.S. Patent No. 6,171,615. [00180] In certain embodiments, waxes can be used for oral sustained release administration. Examples of suitable sustained compound-releasing waxes are disclosed in Cain et al, U.S. Patent No. 3,402,240 (camauba wax, candelilla wax, esparto wax and ouricury wax); Shtohryn et al, U.S. Patent No. 4,820,523 (hydrogenated vegetable oil, bees wax, camauba wax, paraffin, candelilla, ozokerite and combinations of any of the foregoing); and Walters, U.S. Patent No. 4,421,736 (mixture of paraffin and castor wax). [00181] In certain embodiments, osmotic delivery systems can be used for oral sustained release administration (Verma et al, Drug Dev. Ind. Pharm., 2000,26, 695-708). In some embodiments, OROS® systems made by Alza Corporation, Mountain View, CA can be used for oral sustained release delivery devices (Theeuwes et al, U.S. Patent No. 3,845,770; Theeuwes et al, U.S. Patent No. 3,916,899). [00182] In certain embodiments, a controlled-release system can be placed in proximity of the target of a compound disclosed herein (e.g., within the spinal cord), thus requiring only a fraction of the systemic dose (See, e.g., Goodson, in "Medical Applications of Controlled Release," supra, vol. 2, pp. 115-138 (1984)). Other controlled-release systems discussed in Langer, Science, 1990,249,1527-1533 can also be used. [00183] In certain embodiments, a dosage form can comprise a compound disclosed herein coated on a polymer substrate. The polymer can be an erodible, or a nonerodible polymer. The coated substrate can be folded onto itself to provide a bilayer polymer drug dosage form. For example, a compound disclosed herein can be coated onto a polymer such as a polypeptide, collagen, gelatin, polyvinyl alcohol, polyorthoester, polyacetyl, or apolyorthocarbonate and the coated polymer folded onto itself to provide a bilaminated dosage form. In operation, a bioerodible dosage form erodes at a controlled rate to dispense a compound disclosed herein over a sustained release period. Representative biodegradable polymers include biodegradable poly(amides), poly (amino acids), poly(esters), poly(lactic acid), poly(glycolic acid), poly(carbohydrate), poly(orthoester), poly(orthocarbonate), poly(acetyl), poly(anhydrides), biodegradable poly(dihydropyrans), and poly(dioxinones) which are known in the art (Rosoff, Controlled Release of Drugs Chap. 2, pp. 53-95 (1989); and in U.S. Patent Nos. 3,811,444; 3,962,414; 4,066,747,4,070,347; 4,079,038; and 4,093,709). [00184] In certain embodiments, a dosage form can comprise a compound of Formula (I) loaded into a polymer that releases the compound by diffusion through a polymer, or by flux through pores or by rupture of a polymer matrix. The drug delivery polymeric dosage form can comprise from about 10 mg to about 500 mg of the compound homogenously contained in or on a polymer. The dosage form can comprise at least one exposed surface at the beginning of dose delivery. The non-exposed surface, when present, can be coated with a pharmaceutically acceptable material impermeable to the passage of the compound. The dosage form can be manufactured by procedures known in the art An example of providing a dosage form comprises blending a pharmaceutically acceptable carrier such as polyethylene glycol, with a known dose of a compound at an elevated temperature, (e.g., 37 °C), and adding the blended composition to a silastic medical grade elastomer with a cross-linking agent, for example, octanoate, followed by casting in a mold. The step can be repeated for each optional successive layer. The system can be allowed to set for about 1 hour, to provide the dosage form. Representative polymers for .manufacturing the dosage include olefinic polymers, vinyl polymers, addition polymers, condensation polymers, carbohydrate polymer and silicone polymers as represented by polyethylene, polypropylene, polyvinyl acetate, polymethylacrylate, polylsobutylmethacrylate, poly alginate, polyamide and polysilicone. The polymers and procedures for manufacturing the polymers have been described in the art (Coleman et al, Polymers, 1990,31,1187-1231; Roerdink et al, Drug Carrier Systems, 1989,9,57-10; Leong et al, Adv. Drug Delivery Rev., 1987,1,199-233; Roff etal, Handbook of Common Polymers, 1971, CRC Press; and U.S. Patent No. 3,992,518). [00185] In certain embodiments, a dosage form can comprise a plurality of pills. The time-release pills can provide a number of individual doses for providing various time doses for achieving a sustained-release prodrug delivery profile over an extended period of time up to about 24 hours. The matrix can comprise a hydrophilic polymer such as, a polysaccharide, agar, agarose, natural gum, alkali alginate including sodium alginate, carrageenan, fucoidan, furcellaran, laminaran, hypnea, gum arabic, gum ghatti, gum karaya, gum tragacanth, locust bean gum, pectin, amylopectin, gelatin, or a hydrophilic colloid. The hydrophilic matrix can comprise a plurality of 4 to 50 time release pills, each time release pill comprising a dose population of from about 10 ng, about 0.5 mg, 1 mg, about 1.2 mg, about 1.4 mg, about 1.6 mg, about 5.0 mg, etc. The pills can comprise a release rate-controlling wall ranging from about 0.001 mm to about 10 mm thick to provide for the timed release of a compound of Formula (S). Representative wall forming materials include a triglyceryl ester such as glyceryl tristearate, glyceryl monostearate, glyceryl dipalmitate, glyceryl laureate, glyceryl didecenoate and glyceryl tridenoate. Other wall forming materials include polyvinyl acetate, phthalate, methylcellulose phthalate, and microporous olefins. Procedures for rnanufacturing pills are disclosed in U.S. Patent Nos. 4,434,153; 4,721,613; 4,853,229; 2,996,431; 3,139,383; and 4,752,470. [00186] In certain embodiments, a dosage form can comprise an osmotic dosage form, which comprises a semipermeable wall that surrounds a therapeutic composition comprising the compound. In use within a patient, an osmotic dosage form comprising a homogenous composition, imbibes fluid through the semipermeable wall into the dosage form in response to the concentration gradient across the semipermeable wall The therapeutic composition in the dosage form develops osmotic pressure differential that causes the therapeutic composition to be administered through an exit from the dosage form over a prolonged period of time up to about 24 hours (or even in some cases up to about 30 hours) to provide controlled and sustained compound release. These delivery platforms can provide an essentially zero order delivery profile as opposed to the spiked profiles of immediate release formulations. [00187] In certain embodiments, the dosage form can comprise another osmotic dosage form comprising a wall surrounding a compartment, the wall comprising a semipermeable polymeric composition permeable to the passage of fluid and substantially impermeable to the passage of compound present in the compartment, a compound-containing layer composition in the compartment, a hydrogel push layer composition in the compartment comprising an osmotic formulation for imbibing and absorbing fluid for expanding in size for pushing the compound composition layer from the dosage form, and at least one passageway in the wall for releasing the prodrug composition. The method delivers the compound by imbibing fluid through the semipermeable wall at a fluid imbibing rate determined by the permeability of the semipermeable wall and the osmotic pressure across the semipermeable wall causing the push layer to expand, thereby delivering the compound from the dosage form through the exit passageway to a patient over a prolonged period of time (up to about 24 or even about 30 hours). The hydrogel layer composition can comprise from about 10 mg to about 1000 mg of a hydrogel such as a member selected from the group consisting of a polyalkylene oxide of about 1,000,000 to about 8,000,000 weight-average molecular weight, which are selected from the group consisting of a polyethylene oxide of about 1,000,000 weight-average molecular weight, a polyethylene oxide of about 2,000,000 molecular weight, a polyethylene oxide of about 4,000,000 molecular weight, a polyethylene oxide of about 5,000,000 molecular weight, a polyethylene oxide of about 7,000,000 molecular weight and a polypropylene oxide of the about 1,000,000 to about 8,000,000 weight-average molecular weight; or about 10 mg to about 1000 mg of an alkali carboxymethylcellulose of about 10,000 to about 6,000,000 weight average molecular weight, such as sodium carboxymethylcellulose or potassium carboxymethylcellulose. The hydrogel expansion layer comprises about 0 mg to about 350 mg, in present manufacture; about 0.1 mg to about 250 mg of a hydroxyalkylcellulose of about 7,500 to about 4,500,00 weight-average molecular weight (e.g., hydroxymethylcellulose, hydroxyethylcellulose, hydroxypropylcellulose, hydroxybutylcellulose or hydroxypentylcellulose) in present manufacture; about 1 mg to about 50 mg of an agent selected from the group consisting of sodium chloride, potassium chloride, potassium acid phosphate, tartaric acid, citric acid, raffinose, magnesium sulfate, magnesium chloride, urea, inositol, sucrose, glucose and sorbitol; 0 to about 5 mg of a colorant, such as ferric oxide; about 0 mg to about 30 mg, in a present manufacture, 0.1 mg to 30 mg of a hydroxypropylalkylcellulose of about 9,000 to about 225,000 average-number molecular weight, selected from the group consisting of hydroxypropylelhylcellulose, hydroxypropypentylcellulose, hydroxypropylmethylcellulose, and hydropropylbutylcellulose; about 0.00 to about 1.5 mg of an antioxidant selected from the group consisting of ascorbic acid, butylated hydroxyanisole, butylated hydroxyquinone, butylhydroxyanisol, hydroxycoumarin, butylated hydroxytoluene, cephalm, ethyl gallate, propyl gallate, octyl gallate, lauryl gallate, propyl-hydroxybenzoate, trihydroxybutylrophenone, dimethylphenol, dibutylphenol, vitamin E, lecithin, and emanolarnine; and about 0.0 mg to about 7 mg of a lubricant selected from the group consisting of calcium stearate, magnesium stearate, zinc stearate, magnesium oleate, calcium palmitate, sodium suberate, potassium laurate, salts of fatty acids, salts of alicyclic acids, salts of aromatic acids, stearic acid, oleic acid, palmitic acid, a mixture of a salt of a fatty, alicyclic or aromatic acid, and a fatty, alicyclic, or aromatic acid. [00188] In the osmotic dosage forms, the semipermeable wall can comprise a composition that is permeable to the passage of fluid and impermeable to the passage of prodrug. The wall is nontoxic and comprises a polymer selected from the group consisting of a cellulose acylate, cellulose diacylate, cellulose triacylate, cellulose acetate, cellulose diacetate and cellulose triacetate. The wall comprises about from 75 wt % (weight percent) to about 100 wt % of the cellulosic waU-forming polymer or, the wall can comprise additionally about 0.01 wt % to about 80 wt % of polyethylene glycol, or about from 1 wt % to about 25 wt % of a cellulose ether selected from the group consisting of hydroxypropylcellulose and a hydroxypropylalkycellulose such as hydroxypropylmethylcellulose. The total weight percent of all components comprising the wall is equal to about 100 wt %. The internal compartment comprises the compoimd-cxmtainmg composition alone or in layered position with an expandable hydrogel composition. The expandable hydrogel composition in the compartment increases in dimension by imbibing the fluid through the semipermeable wall, causing the hydrogel to expand and occupy space in the compartment, whereby the drug composition is pushed from the dosage form. The therapeutic layer and the expandable layer act together during the operation of the dosage form for the release of prodrug to a patient over time. The dosage form comprises a passageway in the wall that connects the exterior of the dosage form with the internal compartment. The osmotic powered dosage form can be made to deliver prodrug from the dosage form to the patient at a zero order rate of release over a period of up to about 24 hours. [00189] The expression "passageway" as used herein comprises means and methods suitable for the metered release of the compound from the compartment of the dosage form. The exit means comprises at least one passageway, including an orifice, bore, aperture, pore, porous element, hollow fiber, capillary tube, channel, porous overlay, or porous element that provides for the osmotic controlled release of compound. The passageway includes a material that erodes or is leached from the wall in a fluid environment of use to produce at least one controlled-release dimensioned passageway. Representative materials suitable for forming a passageway, or a multiplicity of passageways comprise a leachable poly(glycolic) acid or poly(lactic) acid polymer in the wall, a gelatinous filament, polyvinyl alcohol), leach-able polysaccharides, salts, and oxides. A pore passageway, or more than one pore passageway, can be formed by leaching a leachable compound, such as sorbitol, from the wall. The passageway possesses controlled-release dimensions, such as round, triangular, square, or elliptical, for the metered release of prodrug from the dosage form. The dosage form can be constructed with one or more passageways in spaced apart relationship on a single surface or on more than one surface of the wall. The expression "fluid environment" denotes an aqueous or biological fluid as in a human patient, including the gastrointestinal tract Passageways and equipment for forming passageways are disclosed in U.S. Patent Nos. 3,845,770; 3,916,899; 4,063,064; 4,088,864; and 4,816,263. Passageways formed by leaching are disclosed in U.S. Patents Nos. 4,200,098 and 4,285,987. [00190] Regardless of the specific form of sustained release oral dosage form used, compounds of Formula (I) can be released from the dosage form over a period of at least about 4 hours, for example, over a period of at least about 8 hours or at least about 12 hours. Further, in certain embodiments, the dosage form can release from about 0% to about 30% of the prodrug in from 0 to about 2 hours, from about 20% to about 50% of die prodrug in from about 2 to about 12 hours, from about 50% to about 85% of the prodrug in from about 3 to about 20 hours and greater than about 75% of the prodrug in from about 5 to about 18 hours, m certain embodiments, a sustained release oral dosage form can provide a concentration of tranexamic acid in the blood plasma of a patient over time, which curve has an area under the curve (Cmax) that is proportional to the dose of the prodrug of tranexamic acid administered, and a maximum concentration Cmax. [00191] Jh certain embodiments, dosage forms are administered once or twice per day, and in certain embodiments, once per day. Therapeutic Uses of Compounds. Compositions and Dosage Forms [00192] In some embodiments, a therapeutically effective amount of one or more compounds of Formula (I) can be administered to a patient, such as a human, suffering from excessive bleeding, including heavy bleeding associated with cardiac surgery, upper gastrointestinal hemorrhage, blood loss inpatients with advanced cancer, excess bleeding that occurs during dental procedures in hemophiliacs, and heavy bleeding during menstruation, i.e.,menorrhagia. In certain embodiments, bleeding associated with these and other indications, can be considered heavy or excessive when the bleeding is greater than normal and will depend, at least in part, on the particular pathology and the judgment of the treating physician. [00193] In certain embodiments, a therapeutically effective amount of one or more compounds of Formula (I) can be administered to a patient, such as a human, suffering from skin diseases or disorders such as wound healing, epidermal hyperplasia, skin roughening and unwanted skin pigmentation. In certain embodiments, a therapeutically effective amount of one or more compounds of Formula (I) can be administered to a patient, such as a human, suffering from cancer to treat or prevent tumor metastasis. In some of the above embodiments, sustained release oral dosage forms can be administered to the patient In certain embodiments, topical formulations of one or more compounds of Formula (I) can be administered to the patient [00194] Further, in certain embodiments, a therapeutically effective amount of one or more compounds of Formula 00 can be administered to a patient, such as a human, as a preventative measure against various diseases or disorders. Thus, the therapeutically effective amount of one or more compounds of Formula (I) can be administered as a preventative measure to a patient having a predisposition for excessive bleeding, including, but not limited to, excessive bleeding associated with cardiac surgery, upper gastrointestinal hemorrhage, blood loss in patients with advanced cancer, excessive bleeding that occurs during dental procedures, for example in hemophiliacs, and excessive bleeding during menstruation,i.e.^nenorrhagia. In certain embodiments, the therapeutically effective amount of one or more compounds of Formula (T) can be administered as a preventive measure to a patient having a predisposition for skin disease and disorder including, but not limited to, wound healing, epidermal hyperplasia, skin roughening, and unwanted skin pigmentation. In certain embodiments, the therapeutically effective amount of one or more compounds of Formula (I) can be administered as a preventive measure to a patient having a predisposition for tumor metastasis. [00195] When used to treat or prevent the above diseases or disorders a therapeutically effective amount of one or more compounds of Formula (I) can be administered or applied singly, or in combination with other agents. The therapeutically effective amount of one or more compounds of Formula (I) can also deliver a compound of Formula (I) in combination with another pharmaceutically active agent, including another compound of Formula (I). For example, in the treatment of a patient suffering from cancer, a dosage form comprising a compound of Formula (I) can be administered in conjunction with an anti-cancer agent, such as adriamycin, Alkeran, Aredia, Arirnidex, Avastin, BiCNU, Bleomycin, Blenoxane, Camptosar, carboplatin, Casodex, Celestone, Cerubidine, cisplatin, Cosmegan, CytosarU, Cytoxan, daunorubricin, DaunoXome, Didronel, diethylstilbestrol, Diflucan, Doxil, doxorubicin, Elspar, Emcyt, Epogen, ergamisol, EthyoL Etopophos, \ Etoposide, Eulexin, Femara, Fludara, Fluorouracil, Gemzar, Gleevec, Gliade, Herceptin, Hexalen, Hycamtin, Hydrea; hydroxyurea, idamycin, Iflex, Intron A, Kytril, Leucovorin calcium, Leukeran, Leukine, Leustatin, Lupron, Lysodren, Marinol, Matulane, Mesnex, methotrexate, Mithracin, Mitoxantrosc, Mustargen, Mutamycin, Myleran, Navelbine, Neupogen, Nilandron, Nipent, Nolvadex, Novantrone, Oncaspar, Oncovin, oxaliplatin, Faraplatin, Photofrin, Platinol, Procrit, Proleukin, Purinethol, Rituxan, Roferon A, Rubex, Salagen, Sandostatin, squalamine, Tarcvea, Taxol, Taxotere, tirioguanine, Thioplex, Tice BCG, TNP 470, Velban, Vesanoid, VePesid, Vitaxin, Vumon, Zanosar, Zinecard, Zofran, Zoladex, and Zyloprim. [00196] In certain embodiments, in the treatment of a patient suffering from excessive bleeding, such as for example menorrhagia, a dosage form comprising a compound of Formula (T) can be administered in conjunction with an agent known or believed to be effective in treating excessive bleeding, including oral synthetic progestins such as medroxyprogesterone, norethindrone acetate, and norgestrel; natural progestins such as progesterone; gonadatrophin inhibitors such as danazol; or nonsteroidal anti-inflammatory agent such as aspirin, salsalate, diflunisal, ibuprofen, detaprofen, nabumetone, piroxicam, mefenamic acid, naproxen, diclofenac, indomethacin, sulindac, tolmetin, etodolac, ketorolac, oxaprozdn, and COX-2 inhibitors such as celecoxib, meloxicam, and rofecoxib. [00197] In certain embodiments, a compound of Formula (I) can be administered to a patient in combination with another antifibrinolytic agent such as desmopressin, aprotinin, e-aminocaproic acid, a plasmin inhibitor, or another compound used to treat patients having excessive bleeding such as aluminum hydroxide, ranitidine, or goserelin. [00198] In certain embodiments, compounds of Formula (I) are prodrugs of both tranexamic acid and a second therapeutic agent. The moiety having the structure: can comprise a second therapeutic agent having a -COOH group. In certain embodiments, the second therapeutic agent can be a compound effective treating a symptom associated with excessive bleeding. For example, in certain embodiments such as for treating menorrhagia, the second therapeutic agent can be a non-steroidal mti-inflammatory agent having a -COOH group such as aspirin, salsalate, diflunisal, ibuprofen, ketaprofen, mefenamic acid, naproxen, diclofenac, indomethacin, sulindac, tolmetin, etodolac, ketorolac, or oxaprozin. In certain embodiments, a compound of Formula (I) is a prodrug of tranexamic acid and a non-steroidal anti-inflammatory agent such as ibuprofen or naproxen. [00199] Dosage forms, upon releasing a tranexamic acid prodrug of Formula (I), can provide tranexamic acid upon in vivo administration to a patient. The promoiety or promoieties of the prodrug of Formula (f) can be cleaved either chemically and/or enzymatically. One or more enzymes present in the stomacb, intestinal lumen, intestinal tissue, blood, liver, brain or any other suitable tissue of a mammal can enzymatically cleave the promoiety or promoieties of the prodrug. If the promoiety or promoieties are cleaved after absorption by the gastrointestinal tract, tranexamic acid prodrugs of Formula (I) can be absorbed into the systemic circulation from the large intestine. In certain embodiments, the promoiety or promoieties are cleaved after absorption by the gastrointestinal tract. In certain embodiments, the promoiety or promoieties are cleaved in the gastrointestinal tract and tranexamic acid is absorbed into the systemic circulation form the large intestine. La certain embodiments, the tranexamic acid prodrug is absorbed into the systemic circulation from the gastrointestinal tract, and the promoiety or promoieties are cleaved in the systemic circulation, after absorption of the tranexamic acid prodrug from the gastrointestinal tract [00200] In certain embodiments, a tranexamic prodrug of Formula (I) can be provided to a patient by topical administration. For example, a pharmaceutical composition comprising at least on compound of Formula (I) and at least one pharmaceutically acceptable topical vehicle can be formulated in the form of a cream, lotion, ointment, solution, aerosol, spray and the like. The topical formulation can be applied to a surface area of a patient to be treated, for example, by spreading or spraylng. The surface area of a patient to be treated can be an area exhibiting excessive or heavy bleeding such as a wound, oral mucosa, buccal mucosa, rectal mucosa, vaginal mucosa, nasal mucosa, surfaces exposed during surgery, or an area of the skin exhibiting a skin disease or disorder. In prophylactic applications, the surface area of a patient to be treated can be, for example, an area of a mucosa or the skin having a predisposition for a skin disease or disorder including, but not limited to, bleeding, epidermal hyperplasia, skin roughening, and unwanted skin pigmentation. Doses [00201] The amount of tranexamic acid prodrug that will be effective in the treatment of a particular disorder or condition disclosed herein can depend on the nature of the disorder or condition, and can be determined by standard clinical techniques known in the art m addition, in vitro or in vivo assays can optionally be employed to help identify optimal dosage ranges. The amount of a compound administered can depend on, among other factors, the subject being treated, the weight of the subject, the severity of the affliction, the manner of administration, and the judgment of the prescribing physician. [00202] In certain embodiments, a dosage form are adapted to be administered to a patient no more than twice per day, and in certain embodiments, only once per day. Dosing can be provided alone or in combination with other drugs and can continue as long as required for effective treatment of the disease state or disorder. When used to treat or prevent menorrhagia, a therapeutically effective amount of one or more compounds of Formula CO can be administered concurrently with menstruation (typically for 4 to 7 days). [00203] Suitable daily dosage ranges for oral administration can range from about 2 mg to about 50 mg of tranexamic acid equivalents per kilogram body weight. Suitable drug concentrations in formulations for topical administration can range from about 1% to about 10% (on a weight basis). Appropriate dosage ranges can be readily determined by methods known to the skilled artisan. Examples [00204] The following examples describe in detail preparation of compounds and compositions disclosed herein and assays for using compounds and compositions disclosed herein. It will be apparent to those of ordinary skill in the art that many modifications, both to materials and methods, may be practiced. [00205] In the examples below, the following abbreviations have the following meanings. If an abbreviation is not defined, it has its generally accepted meaning. DMSO = dimethylsulfoxide g = gram h = hour HPLC = high pressure liquid chromatography LC/MS = liquid chromatography/mass spectroscopy M = molar mg = milligram Tnin = minute mL = milliliter mmol = millimoles MTBE = methyl tert-butyl ether NMM = ^-methylmorpholine nM = nanomolar jiL = microliter um =. micrometer uM = micromolar v/v = volume to volume w/v = weight to volume General Experimental Protocols [00206] fra7w^^Arnmomemyl)-cyclohexanecarboxylic acid (tranexamic acid) was purchased from Sigma-Aldrich, Inc. and was used without further manipulation. O-(l-Acyloxyalkyl) S-alkylthiocarbonates were previously synthesized according to the procedures disclosed in Gallop et al, U.S. Application Publication No. 2005/0222431 and converted to the corresponding acyloxyalkyl N- hyd^oxysuccinimide carbonic acid esters as described therein, or according to the general procedure given below. All other reagents and solvents were purchased from commercial suppliers and used without further purification or manipulation. [00207] Proton NMR spectra (400 MHz) were recorded on a Varian AS 400 NMR spectrometer equipped with an autosampler and data processing computation. DMSO-d6 (99.9% D) or CDC13 (99.8 % D) were used as solvents unless otherwise noted. The DMSO or chloroform solvent signal was used for calibration of the individual spectra (H. E. Gottlieb et al., J. Org. Chem., 1997, 62,7512). Analytical LC/MS was performed on a Waters 2790 separation module equipped with a Waters Micromass QZ mass spectrometer, a Waters 996 photodiode detector, and a Merck Chromolith UM2072-027 or Phenomenex Luna C-18 analytical column. Mass- guided preparative HPLC purification of final compounds was performed on an instrument equipped with a Waters 600 controller, ZMD Micromass spectrometer, a Waters 2996 photodiode array detector, and a Waters 2700 Sample Manager. Acetonitrile/water gradients containing 0.05% formic acid were used as eluents in both analytical and preparative HPLC experiments. General Procedure for the Synthesis of Acvloxvalkvi JV-hvdroxvsuccinimide Carbonic Acid Esters [00208] A 250 mL round-bottomed flask equipped with a magnetic stir bar and a pressure-equilibrating dropping funnel was charged with the 1-acyloxyalkyl alkyltbiocarbonate (10 mmol) and Jv"-hydroxysuccinimide (20-40 mmol). Dichloromethane (20-40 mL) was added and the reaction mixture cooled to ca. 0 °C in an ice-bath. Peracetic acid (32 wt.%) in a 40-45% aqueous acetic acid solution (30 mmol) was added dropwise with stirring over a period of ca. one hour to the cooled solution. After addition was complete, stirring was continued for additional three to five hours at this temperature, the reaction being monitored by 'H NMR. spectroscopy. After complete consumption of the starting material, the reaction mixture was diluted with additional dichloromethane, and the organic solution was washed successively with water (three times) and once with a 10% aqueous solution of sodium metabisulfite or sodium thiosulfate to quench any remaining oxidant. The combined organic extracts were dried over MgSO^ filtered, and the solvent removed under reduced pressure with a rotary evaporator. Compound identity, integrity, and purity were checked by 'H NMR spectroscopy. The crude material was used directly in the next step, or could be further purified by commonly employed techniques well-known to those skilled in the art. Example 1: l-f(2.5-Dioxopvrrolidinyl)oxycarbonvloxy1-propvl2- methvlpropanoate (2) [00209] Following the above general procedure, l-(ethylthiocarbonyloxy)- propyl 2-methylpropanoate (2.3 g, 9.82 mmol) and iV'-hydroxysuccinirnide (4.6 g, 40 mmol) were reacted in dichloromethane (20 mL) with peracetic acid (32 wt.%, 6.13 mL). After aqueous workup, isolation and removal of residual solvents in vacuo, the crude product 2 (1.76 g, 61%) was obtained as a yellow oil. The material was used in the next step without further purification. lK NMR (400 MHz, CDC13): 8 = 1.02 (t, J = 7.6 Hz, 3H), 1.20 (d, J= 6.8 Hz, 3H); 1.21 (d, J= 7.2 Hz, 3H), 1.88-2.00 (m, 2H), 2.61 (hept, J= 7.2 Hz, 1H), 2.84 (s, 4H), 6.71 (t, J= 5.2 Hz, 1H). Example 2: l-K2,5-Dioxopvrrolidinvl)oivcarbonvloxvl-2-methvlpropvl2- methylpropanoate (3) [00210] Following the above general procedure, 2-mefhyl-l- (methylthiocarbonyloxy)-propyl 2-methylpropanoate (2.34 g, 10.0 mmol) andiV- hydroxysuccinimide (5.76 g, 50 mmol) were reacted in dichloromethane (30 mL) with peracetic acid (32 wt%, 8.17 mL). After aqueous workup, isolation and removal of residual solvents in vacuo, the crude product 3 (2.12 g, 70%) was obtained as a pale yellow oil. The material was used in the next step without further purification. H NMR (400 MHz, CDCI3): 8 = 1.04 (d, J=7.2 Hz, 6H), 1.21 (d, J= 6.8 Hz, 3H), 1.22 (d, y- 6.8 Hz, 3H), 2.15-2.21 (m, 1H), 2.63 (hept, J= 7.2 Hz, 1H), 2.84 (s, 4H), 6.59 (d, J= 5.2 Hz, 1H). MS (ESI) m/z 324.10 (M+Na)+. General Nucleophilic Carbamovlation Procednre for Synthesis of Acyloxyalkvl Carbamates of Tranexamic Acid [00211] A screw-capped 40 mL glass vial equipped with a magnetic stir bar was charged with fran5-4-(aminomethyl)cyclohexanecarboxylic (tranexamic) acid (472 mg, 3.0 mmol). The appropriate acyloxyalkyl N-hydroxysucciriimide carbonic acid ester (2.0 mmol) was added either as a solid or was dissolved in a small volume of solvent (for oily materials). A mixture of methyl tert-butyl ether (MTBE), acetone, and water (v/v/v = 4:3:1) (15-20 mL) was added, and the reaction mixture stirred for ca. 12 hours at room temperature. Upon completion of the reaction, the mixture was diluted with ethyl acetate and 1 N aqueous hydrochloric acid (ca. 10 mL) was added. After vigorous mixing followed by phase separation, the aqueous layer was extracted once more with EtOAc, and the combined organic extracts were washed with brine. The solvents were evaporated under reduced pressure, the dry residue was dissolved in a mixture of 60% (v/v) acetonitrile/water, and the solution filtered through a 0.2 yaa nylon syringe filter. Final purification was achieved by mass-guided preparative HPLC. After lyophilization of the solvents, the pure compounds were obtained as white powders. General Procedure for One Pot Synthesis of Acvloxvalkvl Carbamates of Tranexamic Acid [00212] Under an atmosphere of nitrogen, a dry 100 mL round-bottomed flask equipped with a magnetic stir bar and a rubber septum was charged with trans-4- (arninomethyl)cyclohexanecarboxylic (tranexamic) acid (786.1 mg, 5.0 mmol). Anhydrous dichloromethane (10-15 mL) was added, and the reaction mixture was cooled to ca. 0 °C with an icebath. CMorotrimethylsilane (1.396 mL, 1.195 g, 11.0 mmol) was added neat at this temperature, followed by slow addition ofN- methylmorpholine (1.374 mL, 1.264 g, 12.5 mmol). The reaction mixture was stirred at this temperature for ca. 30 min, when an appropriately substituted chloroalkylchloroformate (7.5 mmol) was added dropwise and in neat form. The reaction mixture was stirred at this temperature for an additional 30 min when a premixed mixture of NMM (2.75 mL, 2.53 g, 25 mmol) and an appropriately substituted carboxylic acid (50 mmol) was added at ca. 0 °C. The reaction mixture was stirred overnight with warming to room temperature. The dichloromethane was removed in vacuo from the dark brownish reaction mixture using a rotary evaporator. The crude reaction product was diluted with methyl ter/-butyl ether (MTBE), and the solution washed three times with water. The organic layer was dried over MgSC>4, and the filtrate evaporated in vacuo using a rotary evaporator. The crude dry residue was dissolved in a small amount of a mixture of 60% (v/v) acetonitrile/water (ca. 5 mL), and the solution filtered through a 0.2 nm nylon syringe filter. Final purification was achieved by mass-guided preparative HPLC. After lyophilization of the solvents, the pure compounds were generally obtained as white powders. General Procedure for the Synthesis of Sodium Salts of Acvloxvalkvl Carbamates of Tranexamic Acid [00213] A screw-capped 40 mL vial equipped with a magnetic stir bar was charged with an appropriately substituted acyloxyalkyl carbamate of tranexamic acid (5.0 mmol). The material was dissolved in ca. 10 mL of acetonitrile. A solution of sodium bicarbonate (NaHCOs) (420.1 mg, 5.0 mmol) in ca. 20 mL of water was added at room temperature and the mixture was stored one hour after the evolution of carbon dioxide subsided. The clear solution was frozen at -78 °C and the solvents were lyophilized. After lyophilization of the solvents, the pure compounds were obtained as white powders. Example 3: Cvclohexanecarboxvlic Acid (4) [00214] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)ox3TOarbonyloxy]methyl 2-methylpropanoate (518 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 4 (397 mg, 66% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 5 = 0.82-0.95 (br. m, 2H), 1.08 (d, 7= 7.2 Hz, 6H), 1.17-1.39 (br. m, 3H), 1.64-1.73 (br. m, 2H), 1.82-1.91 (br. m, 2H), 2.10 (tt, 7= 11.8,3.8 Hz, 1H), 2.55 (hept, 7= 7.2 Hz, 1H), 2.78-2.88 (br. m, 2H), 5.61 (s, 2H), 7.55 (t, J= 5.6 Hz, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 302.09 (M+H)+; 299.99 (M-H)". Example 4: /ra«5-4-lfr3-Methvlbntanoyloxv)niethoxvcarbonvnaminomethvl)- Cyclohexanecarboxylic Acid (5) [00215] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyn:oUdinyl)oxycarbonyloxy]meuiyl 3-methylbutanoate (547 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 5 (310 mg, 49% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. !H NMR (400 MHz, DMSO-d6): 8 = 0.86-0.94 (br. m, 8H), 1.17- 1.38 (br. m, 3H), 1.64-1.72 (br. m, 2H), 1.83-1.91 (br. m, 2H), 1.96 (hept, J= 7.2 Hz, 1H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.21 (d, /= 6.8 Hz, 2H), 2.78-2.86 (br. m, 2H), 5.61 (s, 2H), 7.55 (t, /= 5.6 Hz, 1H), 11.99 (br. s, 1H). MS (ESI) m/z 316.11 (M+H)+; 314.07 (M-H)". Example 5: fraity-4"(f(2,2-DimethYlpropanovtoxv^methoxvcarbonyM- aminomethyD-Cyclohexanecarboxvlic Acid (6) [00216] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]methyl 2,2-dimethylpropanoate (547 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 6 (476 mg, 76% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H), 1.13 (s, 9H), 1.17-1.38 (br. m, 3H), 1.64-1.72 (br. m, 2H), 1.82-1.91 (br. m, 2H), 2.09 (tt, J= 12.0,3.6 Hz, 1H), 2.78-2.87 (br. m, 2H), 5.61 (s, 2H), 7.54 (t, /= 5.6 Hz, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 316.11 (M+H)+; 314.01 (M-H)-. Example 6: frgfts^fffltenzoytoxY^methoxvcarbonvflamfaomethvU- Cvclohexanecarborvlic Acid (7) [00217] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]methyl benzoate (587 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 7 (445 mg, 66% yleld) a white powder after work-up and mass-guided preparative HPLC purification. ^NMR (400 MHz, DMSO-d6): 8 = 0.83-0.95 (br. m, 2H), 1.16-1.39 (br. m, 3H), 1.65-1.72 (br. M, 2H), 1.82-1.91 (br. m, 2H), 2.09 (tt, J= 12.4, 3.6 Hz, 1H), 2.81-2.88 (br. m, 2H), 5.88 (s, 2H), 7.50-7.57 (m, 2H), 7.61 (t, J= 6.0 Hz, 1H), 7.65-7.70 (m, 1H), 7.93-7.97 (m, 2H), 11.96 (br. s, 1H). MS (ESI) m/z 336.01 Example 7: trans-4-{fl-(Acetoxv)ethoxvcarbonvllaminomethvU- Cvclohexanecarboxvlic Acid f8) [00218] Following the general procedure for the one pot synthesis, tranexamic acid (786 mg, 5.0 mmol) was reacted with chlorotrimethylsilane (1.396 mL, 1.195 g, 11.0 mmol) in anhydrous dichloromethane (10 mL) and in the presence of N- methylmorphohne (1.374 mL, 1.264 g, 12.5 mmol). Subsequent reaction of the intermediate with 1-chloroethylchloroformate (0.82 mL, 1.07 g, 7.5 mmol) followed by a mixture of NMM (2.75 mL, 2.53 g, 25 mmol) and acetic acid (2.86 mL, 3.00 g, 50 mmol) ylelded the title compound 8 (320 mg, 22% yleld) as a very slightly orange- colored oil after aqueous work-up and mass-guided preparative HPLC purification. !H NMR (400 MHz, DMSO-d6): 5 = 0.82-0.94 (br. m, 2H), 1.17-1.35 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.66-1.73 (br. m, 2H), 1.84-1.91 (br. m, 2H), 1.99 (s, 3H), 2.10 (tt, /= 12.0,3.6 Hz, 1H), 2.74-2.88 (m, 2H), 6.62 (q, /= 5.2 Hz, 1H), 7.44 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 310.12 (M+Na)+; 286.08 (M-H)-. Example 8: trans-4- { fl-flPropanovIoxytethoxvcarbonvn aminomethvU- Cvclohexanecarboxvlic Acid (9) [00219] Following the general procedure for the one pot synthesis, tranexamic acid (786 mg, 5.0 mmol) was reacted with chlorotrimethylsilane (1.396 mL, 1.195 g, 11.0 mmol) in anhydrous dichloromethane (10 mL) and in the presence of N- methyhnorpholine (1.374 mL, 1.264 g, 12.5 mmol). Subsequent reaction of the intermediate with chloroethylchloroformate (0.82 mL, 1.07 g, 7.5 mmol) followed by a mixture of NMM (2.75 mL, 2.53 g, 25 mmol) and propionic acid (3.73 mL, 3.70 g, 50 mmol) ylelded the title compound 9 (103 mg, 7% yleld) as colorless, very viscous oil after aqueous work-up and two mass-guided preparative HPLC purifications. 'H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H), 1.03 (t, J= 7.6 Hz, 3H), 1.17-1.35 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.65-1.73 (br. m, 2H), 1.83-1.91 (br. m, 2H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.26-2.33 (m, 2H), 2.74-2.90 (m, 2H), 6.64 (q, J= 5.6 Hz, 1H), 7.44 (t, J= 5.6 Hz, 1H), 11.99 (br. s, 1H). MS (ESI) m/z 324.14 (M+Na)+; 300.10 (M-H)-. Example 9: fra»5-4-(fl-rButanovloxv)ethoxvcarbonvilaminomethvl)- Cyclohexanecarboxvlic Acid (10) [00220] Following the general nucleophilic carbamoylation procedure, tranexamic acid (800 mg, 5 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]ethyl butanoate (700 mg, 2.6 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 10 (200 mg, 28% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.89-0.97 (m, 5H), 1.22-1.36 (br. m, 3H), 1.42 (d, J= 5.6 Hz, 3H), 1.51-1.60 (m, 2H), 1.72-1.73 (br. m, 2H), 1.90-1.93 (m, 2H), 2.13 (tt, /= 12,3.6 Hz, 1H), 2.29 (t, / = 6.8 Hz, 2H), 2.85 (t, J= 6.4 Hz, 2H), 6.69 (q, J= 5.6 Hz, 1H), 7.48 (t, J = 6.0 Hz, 1H), 12.03 (br. s, 1H). MS (ESI) tn/z 338.15 (M+Na)+; 314.12 (M-H)~. Example 10: Sodium frg«^-4-{ri-(BntanovIoxv)ethoxvcarbonvl]aminomethvI>- Cvcloheianecarboxvlate (11) [00221] Following the general procedure for the formation of the corresponding sodium carboxylates of acyloxyaliyl carbamates of tranexamic acid. 946 mg (3.0 mmol) of fran^-{[l-(butanoyloxy)ethoxycarbonyl]aminornethyl}- cyclohexanecarboxylic acid 10 was reacted with 252 mg (3.0 mmol) of sodium bicarbonate (NaHCOs) in 20 mL of a mixture of acetonitrile and water (1:1) to yleld 1.02 g (quant.) of the title compound 11 as a colorless powder. H NMR (400 MHz, DMSO-d6): 8 = 0.73-0.84 (m, 2H), 0.87 (t, J= 6.8 hz, 3H) 1.08-120 (m, 2H), 1.20- 1.32 (m, IB), 1.38 (d, /= 5.2 Hz, 3H), 1.46-1.56 (m, 2H), 1.60-1.74 (br. m, 3H), 1.76-1.83 (br. m, 2H), 2.25 (t, /= 7.2 Hz, 2H), 2.78 (t, J= 6.0 Hz, 2H), 6.65 (q, J= 5.2 Hz, 1H), 7.41 (t, J= 5.6 Hz, 1H). MS (ESI) mlz 338.16 (M+Na)+; 314.18 (M-H)-. Example 11: frg«5-4-{fl-(TentanovIoxv)ethoxvcarbonyllanmiomethvl>- Cvclohexanecarboxvlic Acid (12) [00222] Following the general nucleophilic carbamoylation procedure, tranexamic acid (1.1 g, 7.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy] ethyl pentanoate (800 mg, 2.8 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 12 (150 mg, 16% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 5 = 0.88-0.97 (m, 5H), 1.22-1.38 (br. m, 5H), 1.42 (d, /= 5.2 Hz, 3H), 1.44-1.56 (m, 2H), 1.72-1.74 (m, 2H), 1.90-1.93 (m, 2H), 2.13 (tt, J= 12, 3.6 Hz, 1H), 2.30 (t, /= 7.2 Hz, 2H)5 2.85 (t, J= 6.4 Hz, 2H), 6.68 (q, J= 5.6 Hz, 1H): 7.47 (t J= 6.0 Hz, 1H), 12.01 (br. s, 1H). MS (EST) mlz 352.18 (M+Na)+: 328.14 (M-H)-. Example 12: frg«y-4-{ri-(2-MethYlpropanovIoxv0ethoxvcarbonvI1-aminomethvI}- Cvclohexanecarboxvlic Acid (13) 00223] Following the general nucleophilic carbamoylation procedure, tranexamic acid and 1-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]ethyl 2-methylpropanoate were reacted to yleld the title compound 13 (333 mg, 53% yleld) as a colorless powder after work-up and mass-guided preparative HPLC purification. 1H NMR (400 MHz, DMSO- ds): 6 = 0.82-0.94 (br. m, 2H), 1.058 (d, J = 6.4 Hz, 3H), 1.062 (d, J= 6.8 Hz, 3H), 1.17- 1.36 (br. m, 3H), 1.38 (d, J= 5.6 Hz, 3H), 1.65-1.73 (br. m, 2H), 1.83-1.91 (br. m, 2H), 2.10 (tt, J= 12.0, 3.6 Hz, 1H), 2.49 (hept., J = 6.8 Hz, 1H), 2.77-2.85 (br. m, 2H), 6.62 (q, J= 5.2 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.08 (M+Na)+; 314.01 (M-H)". Example 13: Sodium frg«y-4-iri- aminomethvU-CvcIohexanecarboxvIate(14) [00224] Following the general procedure for the formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid, 5.03 g (15.94 mmol) of iran5-4-{[l-(2-methylpropanoyloxy)ethoxycarbonyl]- aminomethyl}-cyclohexanecarboxylic acid 13 was reacted with 1.34 g (15.94 mmol) of sodium bicarbonate (NaHCOs) in 40 mL of a mixture of acetonitrile and water (1:1) to yleld 5.38 g (quant.) of the title compound 14 as a colorless powder. JH NMR (400 MHz, DMSO-d6): 5 = 0.72-0.84 (br. m, 2H), 1.057 (d, J= 6.4 Hz, 3H), 1.059 (d, J= 6.8 Hz, 3H), 1.20-1.32 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.59-1.73 (br. m, 3H), 1.75-1.83 (m, 2H), 2.43-2.53 (m, 1H), 2.72-2.84 (br. m, 2H), 6.62 (q, J= 5.6 Hz, 1H), 7.42 (t, J= 5.6 Hz, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)~. Example 14; (-J-)-frc?f5-4-((rqJy)-l-(2- MethvIpropanoyloxv')ethox\1carbonvlaminolmethvIVCvclohexanecarborsrIic Acid (15) [00225] The enantiomers of frcms-4-{[l-(2- methylprop ano>4oxy)emoxycaxbon>4]-aminomethyl} -cyclohexanecarboxylic acid 13 were resolved by means of a Waters mass-guided preparative HPLC using a ChiralPak AD-RH 250 x 20 mm column, an isocratic eluent of 30% acetonitrile/70% water/0.05% formic acid, and a flowrate of 15 rnL/min. The enantiomeric excesses were determined with an analytical Waters 2690/ZQ LC/MS apparatus using a ChiralPak AD-RH column, an isocratic ement consisting of 30% acetonitrile/70% water/0.05% formic acid, and a flowrate of 60 ^Urnin. 529 mg of the title compound 15 was obtained as a colorless powder after lyophilization [J?f = 12.2 min; e.e. = 98.3%; [afo25-8 = +18.64, c (19.97, MeOH)]. The assignment of the absolute configuration was accomplished by comparison with material obtained from an independent synthesis. lH NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H), 1.057 (d, J= 6.8 Hz, 3H), 1.061 (d, J=6.8 Hz, 3H), 1.17-1.36 (br. m, 3H), 1.38 (d, J = 5.6 Hz, 3H), 1.65-1.73 (br. m, 2H), L83-1.91 (br. m, 2H), 2.10 (tt, J= 12.0,3.6 Hz, 1H), 2.49 (hept, /= 6.8 Hz, 1H), 2.77-2.85 (br. m, 2H), 6.62 (q, J- 5.2 Hz, 1H), 7.45 (t,7= 6.0Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)~. Example 15: Sodium trans-4-(f UlS)-l-{2- methvlpropanovloxv)ethorylcarbonylamino>methyl)-CvcIohexanecarboxvlate 061 [00226] Following the general procedure for the formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid, 90.0 mg (0.2854 mmol) of (+>/raay-4-({[(15)-l-(2- memylpropanoyloxy)emoxy]carbonylammo}methyl)-cyclohexanecarboxylic acidl5 was reacted with 24.0 mg (0.2854 mmol) of sodium bicarbonate (NaHCOa) in 4 mL of a mixture of acetonitrile and water (1:1) to yleld 96.3 mg (quant) of the title compound 16 as a colorless powder. The enantiomeric excesses were determined with an analytical Waters 2690/ZQ LC/MS apparatus using a ChiralPak AD-RH column, an isocratic eluent consisting of 30% acetonitrile/70% water/0.05% formic acid, and a flowrate of 60 ^iL/xnin (R{ = 12.1 min; e.e. = 98.5%). JH NMR (400 MHz, DMSO-d6): S = 0.72-0.84 (br. m, 2H), 1.057 (d, 7= 6.4 Hz, 3H), 1.059 (d, /= 6.8 Hz, 3H), 1.20-1.32 (br. m, 3H), 1.38 (d,/= 5.2 Hz, 3H), 1.59-1.73 (br. m, 3H), 1.75-1.83 (m, 2H), 2.43-2.53 (m, 1H), 2.72-2.84 (br. m, 2H), 6.62 (q, /= 5.6 Hz, 1H), 7.42 (t, J = 5.6 Hz, 1H). MS (EST) m/z 338.16 (M+Na)+; 314.12 (M-H)-. Example 16; f-^Wm«5-4-f(raj;)-l-f2- MethYlpropanoYloxv)ethoxvkarbonylainino)methvlVCvcIohexanecarboxvlic Acid (lTi [00227] The enantiomers of fra«5-4-{[l-(2- memylpropanoyloxy)emoxycarbonyl]-aminomethyl}-cyclohexanecarboxylic acidl3 were resolved by means of a Waters mass-guided preparative HPLC using a ChiralPak AD-RH 250 x 20 mm column, an isocratic eluent of 30% acetonitrile/70% water/0.05% formic acid, and a flowrate of 15 mL/min. The enantiomeric excesses were determined with an analytical Waters 2690/ZQ LC/MS apparatus using a ChiralPak AD-RH column, an isocratic eluent consisting of 30% acetonitrile/70% water/0.05% formic acid, and a flowrate of 60 uL/min. 310 mgofthe title compound 17 was obtained as a colorless powder after lyophilization [Rf= 15.1 min; e.e. = 97.6 %; WD M-5 = -14.94, c (24.30, MeOH)]. The assignment of the absolute configuration was accomplished by comparison with material obtained from an independent synthesis. H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H), 1.057 (d, J= 6.8 Hz, 3H), 1.061 (d, J= 6.8 Hz, 3H), 1.17-1.36 (br. m, 3H), 1.38 (d, J = 5.6 Hz, 3H), 1.65-1.73 (br. m, 2H), 1.83-1.91 (br. m, 2H), 2.10 (tt, J= 12.0,3.6 Hz, 1H), 2.49 (hept, /= 6.8 Hz, 1H), 2.77-2.85 (br. m, 2H), 6.62 (q, /= 5.2 Hz, 1H), 7.45 (t,/=6.0Hz, 1H), 11.97 (br.s, 1H). MS (ESI) m/z338.16 (M+Na)+; 314.12 (M-H)-. Example 17: Sodium ft-a«^-4-((raJg)-l-(2- MethvIpropanovloxv)ethorvlcarboavlamino)rnethvl)-Cvclohexanecarboxylate 081 [00228] Following the general procedure for the formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid, 90.0 mg (0.2854 mmol) of (-)-fra/w-4-({[(li?)-l-(2- methylpropanoyloxy)ethoxy]carbonylarnino}methyl)-cyclohexanecarboxylic acidl7 was reacted with 24.0 mg (0.2854 mmol) of sodium bicarbonate (NaHCOj) in 4 mL of a mixture of acetonitrile and water (1:1) to yleld 96.3 mg (quant.) of the title compound 18 as a colorless powder. The enantiomeric excesses were determined with an analytical Waters 2690/ZQ LC/MS apparatus using a ChiralPak AD-RH column, an isocratic eluent consisting of 30% acetonitrile/70% water/0.05% formic acid, and a flowrate of 60 uL/min (Rt = 15.0 min; e.e. = 97.7 %). JH NMR (400 MHz, DMSO-d6): 5 = 0.72-0.84 (br. m, 2H), 1.057 (d, J= 6.4 Hz, 3H), 1.059 (d, /= 6.8 Hz, 3H), 1.20-1.32 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.59-1.73 (br. m, 3H), 1.75-1.83 (m, 2H), 2.43-2.53 (m, 1H), 2.72-2.84 (br. m, 2H), 6.62 (q, /= 5.6 Hz, 1H), 7.42 (t, J = 5.6 Hz, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)". Example 18: Cvclohexanecarboxylic Acid (19) [00229] Following the general nucleophilic carbamoylation procedure, tranexamic acid (900 mg, 6 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]ethyl 3-methylbutanoate (800 mg, 2.8 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 19 (200 mg, 21% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 5 = 0.88-0.97 (m, 8H), 1.22- 1.38 (br. m, 3H), 1.42 (d, J= 5.2 Hz, 3H), 1.71-1.74 (m, 2H), 1.90-2.02 (br. m, 3H), 2.1-2.2 (br. m, 3H), 2.85 (t, J= 6.4 Hz, 2H), 6.69 (q, J= 5.6 Hz, 1H), 7.48 (t, 7= 6.0 Hz, 1H), 12.01 (br. s, 1H). MS (ESI) m/z 352.15 (M+Na)+; 328.14 (M-H)". Example 19: Sodium frg»s-4-IFl-(3- Methvlbutanovloxv')ethoyycarbonvl]aininomethvU-CYclohexanecarboxvlate(20) [00230] Following the general procedure for the formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid, 1.976 g (6.0 mmol) of/ra7M-4-{[l-(3- memylbutanoyloxy)emoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid 19 was reacted with 504.1 mg (6.0 mmol) of sodium bicarbonate (NaHCOa) in 20 mL of a mixture of acetonitrile and water (1:1) to yleld 2.11 g (quant) of the title compound 20 as a colorless powder. !H NMR (400 MHz, DMSO-d6): 8 = 0.72-0.84 (m, 2H), 0.89 (d, /= 6.4 Hz, 6H), 1.07-1.21 (m, 2H), 1.22-1.32 (m, 1H), 1.38 (d, /= 5.2 Hz, 3H), 1.58-1.74 (br. m, 3H), 1.76-1.84 (br. m, 2H), 1.88-2.01 (m, 1H), 2.08-2.20 (m, 2H), 2.74-2.85 (m, 2H), 6.66 (q, 7= 5.6 Hz, 1H), 7.42 (t, /= 6.4 Hz, 1H). MS (ESI) m/z 352.18 (M+Na)+; 328.14 (M-H)~. Example 20: fra/ig-4-(Hr(2,2-DimethvlpropanoyloxY)- ethoxycarbonvllaminomethvil-Cvclohexanecarboxylic Acid (21) [00231] Following the general nucleophilic carbamoylation procedure, tranexamic acid (1.1 g, 7 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]ethyl 2,2-dimethylpropanoate (1.1 g, 3.8 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 21 (200 mg, 16% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. [H NMR (400 MHz, DMSO-d6): 5 = 0.86-0.99 (m, 2H), 1.14 (s, 9H), 1.21-1.39 (br. m, 3H), 1.42 (d, J= 5.2 Hz, 3H), 1.71-1.74 (m, 2H), 1.89-1.91 (m, 2H), 2.13 (tt, J= 12,3.6 Hz, 1H), 2.81-2.89 (m, 2H), 6.64 (q, J= 5.6 Hz, IH), 7.49 (t, J= 6.0 Hz, 1H), 12.01 (br. s, 1H). MS (ESI) /M/Z 352.16 (M+Na)+; 328.14 (M-H)' Example 21: frgHjr-4-(fl-(CvclohexvIcarbonviorv)ethoivcarbonvnamiiiomethvU- Cvclohexanecarboxvlic Acid (22) [00232] Following the general nucleophilic carbamoylation procedure, tranexamic acid (780 mg, 5.0 mmol) and l-[(2,5- dioxopyrrohdmyl)oxycarbonyloxy]ethyl cyclohexanecarboxylate (700 mg, 2.2 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 22 (200 mg, 26% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. 'H NMR (400 MHz, DMSO-d6): 5 = 0.87-0.99 (m, 2H), 1.20- 1.44(br. m, 11H), 1.58-1.81 (m, 7H), 1.89-1.92 (m, 2H),2.13 (11,7= 12,3.6 Hz, 1H), 2.27-2.35 (m, 1H), 2.79-2.90 (m, 2H), 6.66 (q, J=5.6 Hz, 1H), 7.48 (t, /= 6.0 Hz, 1H), 12.05 (br. s, 1H). MS (ESI) m/z 378.13 (M+Na)+; 354.15 (M-H)". Example 22: fra/is-4-ffl-(BenzoYloxv)ethoxvcarbonvllaminomethvU- Cvclohexanecarboxvlic Acid (23) [00233] Following the general nucleophilic carbamoylation procedure, tranexamic acid (1.1 g, 7.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]ethyl benzoate (800 mg, 2.6 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 23 (160 mg, 18% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 5 = 0.87-0.96 (m, 2H), 1.21-1.38 (br. m, 3H), 1.57 (d, /= 5.6 Hz, 3H), 1.71-1.74 (m, 2H), 1.88-1.91 (m, 2H), 2.1-2.2 (m, 1H), 2.84-2.88 (m, 2H), 6.92 (q, J= 5.6 Hz, 1H), 7.54-7.58 (m, 3H), 7.70 (m, 1H), 7.94-7.96 (m, 2H), 12.05 (br. s, 1H). MS (ESI) m/z 372.10 (M+Na)+; 348.05 (M-H)". Example 23: Sodium trans-4-{fl-(BenzovIoxv)ethoxvcarbonyllairiinomethvU- Cvclohexanecarboxvlate (24) [00234] Following the general nucleophilic carbamoylation procedure for the formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid, 2.096 g (6.0 mmol) of trans A- {[1- (benzoyloxy)ethoxycaibonyl]aniinomethyl}-cyclohexanecarboxylic acid 23 was reacted with. 504.1 mg (6.0 mmol) of sodium bicarbonate (NaHCCb) in 20 mL of a mixture of acetonitrtte and water (1:1) to yleld 2.23 g (quant.) of the title compound 24 as a colorless powder. JH NMR (400 MHz, DMSO-d6): 8 = 0.72-0.86 (m, 2H), 1.08-1.21 (m, 2H), 1.22-1.32 (m, 1H), 1.53 (d, J= 5.6 Hz, 3H), 1.59-1.84 (br. m, 5H), 2.73-2.86 (m, 2H), 6.88 (q, /= 5.6 Hz, 1H), 7.47-7.56 (m, 3H), 7.64-7.70 (m, 1H), 7.89-7.94 (m, 2H). MS (ESI) m/z 372.10 (M+Na)+; 348.12 (M-H)~ Example 24: Methvlbenzovloxy)ethoxvcarbonvllaminomethvl>-CYclohexanecarboxylic Acid (25) [00235] Following the general nucleophilic carbamoylation procedure, tranexamic acid (780 mg, 5.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]ethyl 2-methylbenzoate (700 mg, 2.2 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 25 (290 mg, 36% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.88-0.97 (m, 2H), 1.22- 1.38 (br. m, 3H), 1.57 (d, /= 5.6 Hz, 3H), 1.72-1.76 (m, 2H), 1.89-1.92 (m, 2H), 2.13 (tt, J = 12,3.6 Hz, 1H), 2.50 (s, 3H), 2.87 (t, /= 2.8 Hz, 2H), 6.89 (q, J= 5.6 Hz, 1H), 7.32-7.37 (m, 2H), 7.50-7.59 (m, 2H), 7.77 (dd, J= 7.2,1.2 Hz, 1H), 12.00 (s, 1H). MS (ESI) m/z 386.12 (M+Na)+; 362.07 (M-H)-. Example 25: frg/iy-4-(f({2-f4-(2- MethYlpropvl)phenvIlpropanoyloxY}ethoxy)carbonylamino1methvl) Cyclohexanecarboxvlic Acid (26) [00236] Following the general nucleophilic carbamoylation procedure, tranexamic acid (629 mg, 4.0 mmol) and l-[(2,5- dioxopyrrohdinyl)oxycarbonyloxy]ethyl2-[4-(2-methylpropyl)phenyl]propanoate (665 mg, 1.7 mmol) were reacted in the MTBE/acetone/water mixture (32 mL) to yleld the title compound 26 (344 mg, 47% yleld) as a colorless powder after work-up and mass-guided preparative HPLC purification. :H NMR (400 MHz, DMSO-d6): 8 = 0.79-0.95 (m, 8H), 1.16-1.39 (m, 9H), 1.60-1.92 (m, 5H), 2.02-2.15 (m, 1H), 2.38- 2.44 (m, 2H), 2.70-2.86 (m, 2H), 3.68-3.76 (m, 1H), 6.62-6.72 (m, 1H), 7.04-7.18 (m, 4H), 7.32-7.50 (m, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 456.24 (M+Na)+; 432.19 (M-H)". Example 26: fraiiy-4-f(fr(2^-2-(6-Methoxv(2- naphthvn)propanoyloxylethory>cart>onvlamfao)methyll Cvclohexanecarboxylic Acid (27) [00237] Following the general nucleophilic carbamoylation procedure, tranexamic acid (6.9 g, 43.9 mmol) and l-[(2,5- dioxop>TToUdinyl)oxycarbonyloxy]ethyl(2iS)-2-[6-methoxy(2-naphthyl)]propanoate (ca. 6.2 g, 14.9 mmol) were reacted in the MTBE/acetone/water mixture (160 mL) to yleld the title compound 27 (579 mg, 9% yleld) as a colorless powder after work-up, purification by silica gel column chromatography using ethyl acetate/hexane mixtures from 2:1 to 4:1 as eluent, and subsequent mass-guided preparative HPLC. lH NMR (400 MHz, DMSO-d6): 5 = 0.76-0.94 (m, 2H), 1.10-1.92 (m, 13H), 1.98-2.14 (m, 1H), 2.66-2.86 (m, 2H), 3.82-3.95 (m, 4H), 6.64-6.76 (m, 1H), 7.10-7.17 (m, 1H), 7.24- 7.50 (m, 3H), 7.63-7.80 (m, 3H), 11.99 (br.s, 1H). MS (ESI) m/z 480.16 (M+Na)+; 456.18 (M-H)". Example 27: /rg/M-^IH-fPropanovloxvlpropoxvcarbonvnaminomethvU- Cvclohexanecarboxvlic Acid (28) [00238] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]propylpropanoate (281 mg, 1.03 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 28 (173 mg, 53% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lB NMR (400 MHz, DMSO-d6): 5 = 0.82-0.94 (br. m, 5H), 1.01 (t, J= 7.2 Hz, 3H), 1.17-1.37 (br. m, 3H), 1.64-1.75 (m, 4H), 1.83-1.91 (br. m, 2H), 2.10 (tt, J= 12.0,3.6 Hz, 1H), 2.23-2.38 (m, 2H), 2.76-2.87 (br. m, 2H), 6.54 (t, J= 6.0 Hz, 1H), 7.42 (t, 7=6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)-. Example 28: fraHSMt-ffl-fButanovtoxvlpropoxvcarfaonvlTaminomethYU- Cvclohexanecarboxylic Acid (29) [00239] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]propyl butanoate (575 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 29 (408 mg, 62% yleld) as a white powder after work-up and mass-guided preparative HPLC purification lH NMR (400 MHz, DMSO-d6): 5 = 0.81-0.94 (or. m, 8H), 1.17-1.38 (br. m, 3H), 1.47-1.58 (m, 2H), 1.64-1.75 (m, 4H), 1.83-1.92 (br. m, 2H), 2.10 (tt, J= 12.0, 3.6 Hz, 1H), 2.26 (t, J= 7.2 Hz, 2H), 2.75-2.88 (m, 2H), 6.55 (t, /= 5.2 Hz, 1H), 7.42 (t, 7= 5.6 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 352.18 (M+Na)+; 328.14 (M-H)-. Example 29: Methvlpropanovloxv)propoxvcarbonvnaminomethYl)-Cyclohexanecarboxylic Acid (30) [00240] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrohdinyl)oxycarbonyloxy]propyl 2-methylpropanoate (575 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 30 (651 mg, 99% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 5H), 1.06 (d, /= 6.8 Hz, 3H), 1.07 (d, J= 6.8 Hz, 3H), 1.17-1.39 (br. m, 3H), 1.64-1.76 (br. m, 4H), 1.83-1.91 (br. m, 2H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.50 (hept., .7= 6.8 Hz, 1H), 2.77-2.84 (br. m, 2H), 6.52 (t, /= 5.6 Hz, 1H), 7.43 (t, /= 6.0 Hz, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 352.06 (M+Na)+; 328.02 (M-H)". Example 30: fm«a-4-(ri-(2J- Dimethvlpropanovloxv)propoxvcarbonvnamipomethYU-CvcIohexanecarboxvlic Acid (31) [00241] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrohdinyl)oxycarbonyloxy]propyl 2,2-dimethylpropanoate (290 mg, 0.96 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 31 (147 mg, 45% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 5H), 1.12 (s, 9H), 1.16-1.38 (m, 3H), 1.64-1.76 (m, 4H), 1.82-1.91 (br. m, 2H), 2.09 (tt, J= 12.0,3.2 Hz, 1H), 2.72-2.90 (m, 2H), 6.51 (t, J= 5.6 Hz, 1H), 7.44 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 366.21 (M+Na)+; 342.16 (M-H)-. Example 31: fraws-4-(fl^enzoYlory)propoxvcarbonvllaDmiomethvU- Cvdohexanecarboxvlic Acid (32) [00242] Following the general nucleopbilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]propyl benzoate (602 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 32 (679 mg, 93% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.80-0.95 (br. m, 2H), 0.96 (t, J= 7.6 Hz, 3H), 1.15-1.38 (br. m., 3H), 1.60-1.74 (m, 2H), 1.82-1.91 (m, 4H), 2.08 (tt, J = 12.0,3.2 Hz, 1H), 2.76-2.87 (br. m, 2H), 6.78 (t, J= 5.6 Hz, 1H), 7.48-7.56 (br. m, 3H), 7.67 (tt, /= 7.6,1.2 Hz, 1H), 7.90-7.95 (m, 2H), 11.96 (br. s, 1H). MS (ESI) /«/z 386.12 (M+Na)+; 362.14 (M-H)". Example 32: fra/i$-4-lfl-fAcetoxv)butoxvcarbonvl1ammomethyl)- Cvclohexanecarboxvlic Acid (33) [00243] Following the general nucleopbilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl acetate (620 mg, 2.27 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 33 (174 mg, 24% yleld) as a waxy white solid after work-up and mass-guided preparative HPLC purification. 'H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 5H), 1.17-1.38 (br. m, 5H), 1.63-1.73 (br. m, 4H), 1.83-1.91 (br. m, 2H), 2.05 (s, 3H), 2.10 (tt, J= 11.6, 3.6 Hz, 1H), 2.74-2.88 (m, 2H), 6.58 (t, J= 5.6 Hz, IE), 7.42 (t, J=> 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m£ 338.16 (M+Na)+; 314.12 (M-H)". Example 33: Cvclohexanecarboxylic Acid (34) [00244] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl propanoate (686 mg, 2.38 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 34 (144 mg, 18% yleld) as a brittle off-white solid after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 5H), 1.01 (t, J= 7.2 Hz, 3H), 1.17-1.38 (br. m, 5H), 1.63-1.73 (br. m, 4H), 1.84- 1.92 (br. m, 2H), 2.10 (tt, /= 12.0,3.6 Hz, 1H), 2.22-2.38 (m, 2H), 2.75-2.87 (m, 2H), 6.60 (t, J= 6.0 Hz, 1H), 7.42 (t, 7= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) mJz 352.18 (M+Na)+; 328.14 (M-Hf. Example 34: transAA fl-(BiitanovIoxv>butoxvcarbonvl] aminomethyl)- Cvclohexanecarboxvlic Acid (35) [00245] Following the general nucleophilic carbamoylation procedure, tranexamic acid (800 mg, 5 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl butanoate (700 mg, 2.3 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 35 (210 mg, 27% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.87-0.95 (m, 8H), 1.22-1.41 (br. m, 5H), 1.56 (m, 2H), 1.68-1.73 (m, 4H), 1.89-1.92 (m, 2H), 2.13 (tt, J= 12,3.2 Hz, 1H), 2.30 (t, J= 7.2 Hz, 2H), 6.65 (t, /= 5.6 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H). MS (ESI) m/z 366.21 (M+Na)+; 342.16 (M-H)". Example 35: frq«s-4-(fl-(2-MethvlpropanovIoxY)butoxvcarbonvnaininomethvI}- Cvclohexanecarboxvlic Acid (36) [00246] Following the general nucleophilic carbamoylation procedure, tranexamic acid (800 mg, 5 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl 2-meth'ylpropanoate (700 mg, 2.3 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 36 (100 mg, 13% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lE NMR (400 MHz, DMSO-d6): 8 = 0.87-0.95 (m, 8H), 1.08 (d, y=4.0Hz, 3H), 1.10 (d, .7=4.0 Hz, 3H), 1.21-1.41 (br. m, 5H), 1.68-1.73 (m, 4H), 1.89-1.91 (m, 2H), 2.13 (tt, /= 12,3.2 Hz, 1H), 2.79-2.88 (m, 3H), 6.65 (t, /= 5.6 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H). MS (ESI) m/z 366.21 (M+Na)+; 342.16 (M-H)"". Example 36: frawy-4-(ri-(3-Methylbutanovloxv)butoxycarboavHaminomethYU- Cyclohexanecarboxylic Acid (37) [00247] Following the general nucleophilic carbamoylation procedure, tranexamic acid (800 mg, 5.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl 3-methylbutanoate (700 mg, 2.2 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 37 (120 mg, 15% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.87-0.95 (m, 11H), 1.21- 1.41 (br. m, 5H), 1.68-1.73 (m, 4H), 1.89-2.02 (m, 3H), 2.10-2.22 (m, 3H), 2.80-2.89 (m, 2H), 6.65 (t, J= 5.6 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H). MS (ESI) m/z 380.23 (M+Na)+; 356.18 (M-H)'. Example 37: trans-4-{fl-(2^- PimethvlpropanovloxY>butoxvcarbonyllaminomethyl}-CvctohexanecarboxYlic Acid (38) [00248] Following the general nucleophilic carbamoylation procedure, tranexamic acid (800 mg, 5.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl 2,2-dimethylpropanoate (700 mg, 2.2 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 38 (90 mg, 12% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. !H NMR (400 MHz, DMSO-d5): 5 = 0.87-0.99 (m, 5H), 1.12- 1.38 (br. m, 14H), 1.69-1.74 (m, 4H), 1.89-1.92 (m, 2H), 2.13 (tt, J= 12,3.2 Hz, 1H), 2.78-2.91 (m, 2H), 6.61 (t, J= 5.6 Hz, 1H), 7.47 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H). MS (ESI) m/z 380.22 (M+Na)+; 356.18 (M-H)~. Example 38: fm/ Cyclohexanecarboxvlic Acid (39) [00249] Following the general nucleophilic carbamoylation procedure, tranexamic acid (800 mg, 5 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]butyl benzoate (700 mg, 2.1 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 39 (150 mg, 19% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 5 = 0.84-0.99 (m, 5H), 1.20-1.38 (br. m, 3H), 1.41-1.51 (m, 2H), 1.70-1.73 (m, 2H), 1.84-1.89 (m, 4H), 2.11 (tt, J= 12,3.2 Hz, 1H), 2.82-2.91 (m, 2H), 6.61 (t, J= 5.6 Hz, 1H), 7.52-7.58 (m, 3H), 7.47 (t, J= 6.0 Hz, 1H), 7.95-7.97 (m, 2H), 12.04 (s, 1H). MS (ESI) m/z 400.15 (M+Na)+; 376.16 (M-H)". Example 39: fraws-4-{fl-(AcetoryV2-methvIpropoxycarbonvl1amuiomethvU- Cyclohexanecarboxvlic Acid (40) [00250] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-methylpropyl acetate (306 mg, 1.12 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 40 (89 mg, 28% yleld) as an oily solid after work-up and mass-guided preparative HPLC purification. 'HNMR (400 MHz, DMSO-d6): 8 = 0.83-0.95 (br. m, 8H), 1.18-1.37 (m, 3H), 1.65- 1.73 (br. m, 2H), 1.84-1.97 (br. m, 3H), 2.02 (s, 3H), 2.10 (tt, /= 12.0, 3.6 Hz, 1H), 2.78-2.84 (m, 2H), 6.41 (d, J= 5.2 Hz, 1H), 7.39 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)-. Example 40: frg«$-4-{H-fPropanovIoxv)-2- methvlpropoxvcarbonvHaminomethvU-Cvclohexanecarboxvlic Acid (41) [00251] Following the general nucleophilic carbamoylation procedure, tranexamic acid (250 mg, 1.6 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-methylpropyl propanoate (230 mg, 0.80 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 41 (70 mg, 21% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. !H NMR (400 MHz, DMSO-d6): 8 = 0.85-0.92 (rn, 8H), 1.08 (t, J== 7.2 Hz, 3H), 1.17-1.32 (br. m, 3H), 1.68 (d, J= 12 Hz, 2H), 1.85-1.96 (br. m, 3H), 2.05- 2.12 (m, 1H), 2.25-2.36 (br. m, 2H), 2.80 (t, J= 6.4 Hz, 2H), 6.42 (d, J= 5.2 Hz, 1H), 7.38 (t, /= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 352.12 (M+Na)+; 328.14 (M-H)". Example 41: frg«5-4-{[l-(PentanovIoxv')-2- methvIpropoxycarbonvraminomethvl>-CvcIoIiexanecarborylic Acid (42) [00252] Following the general nucleophilic carbamoylation procedure, tranexamic acid (700 mg, 4.5 mmol) and 1-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-2-methylpropyl pentanoate (500 mg, 1.6 mmol) were reacted in the MTBE/acetone/water mixture (16 ml_) to yleld the title compound 42 as a white powder after work-up and mass-guided preparative HPLC purification. 1H NMR (400 MHz, DMSO-d6): 5 = 0.83-0.92 (br. m, 11H), 1.17-1.32 (br. m, 5H), 1.45-1.52 (m, 2H), 1.68 (d, J= 12 Hz, 2H), 1.85-1.94 (br. m, 3H), 2.04-2.12 (m, 1H), 2.27-2.32 (br. m, 1H), 2.83 (td, J = 7.2, 1.6 Hz, 2H), 2.78-2.82 (m, 2H), 6.42 (d, J = 5.2 Hz, 1H), 7.38 (t, J = 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) mJ z 380.16 (M+Naf; 356.17 (M-H)". Example 42: ^gK5-4-{fl-rBatanovIoxy)-2-methvIproporycarbonYllammomethYl}- Cvclohexanecarboxvlic Acid (43) [00253] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-meth.ylpropyl butanoate (602 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 43 (513 mg. 75% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 5 = 0.83-0.95 (br.m, 11H), 1.17-1.38 (br. m, 3H), 1.48-1.5S (m, 2H), 1,65-1.73 (br. m, 2H), 1.83-1.98 (br. m, 3H), 2.10 (tt, J= 12.0, 3.2 Hz, 1H), 2.21-2.32 (br. m, 2H), 2.75-2.87 (br. m, 2H), 6.44 (d, J= 5.6 Hz, 1H), 7.40 (t, /= 6.0 Hz), 11.97 (br. s, 1H). MS (ESI) m/z 366.21 (M+Na)+; 342.16 (M-H)~. Example 43: frgfls-4-(fl-(2-MethvIpropanovloxv)-2- methvIpropoxvcarbonvl]ammomethvI}-Cvclohexanecarborylic Acid (44) [00254] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-methylpropyl 2-methylpropanoate (603 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 44 (486 mg, 71% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 8H), 1.06 (d, J= 6.8 Hz, 3H), 1.08 (d, J= 7.2 Hz, 3H), 1.16-1.38 (br. m, 3H), 1.64-1.73 (br. m, 2H), 1.82-1.92 (br. m, 3H), 2.10 (tt, J= 12.0,3.6 Hz, 1H), 2.52 (hept, /= 6.8 Hz, 1H), 2.74-2.87 (br. m, 2H), 6.42 (d, J= 5.2 Hz, 1H), 7.40 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) /n/z 366.08 (M+Na)+; 342.04 (M-H)". Example 44: Sodium trans-4-{fl-(2-Methvlpropanovloxv)-2- methvIpropoxvcarbonvllaminomethvU-Cvclohexanecarboxvlate(45) [00255] Following the general nucleophilic carbamoylation procedure for the formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid, 3.434 g (10.0 mmol) of Zra7W-4-{[l-(2-methylpropanoyloxy)-2- memylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid 44 was reacted with 840.1 mg (10.0 mmol) of sodium bicarbonate (NaHCOs) in 60 mL of a mixture of acetonitrile and water (1:2) to yleld 3.654 g (quant) of the title compound 45 as a colorless powder. JH NMR (400 MHz, DMSO-d6): 8 = 0.72-0.84 (m, 2H), 0.87-0.92 (m, 6H), 1.04-1.20 (m, 8H), 1.20-1.32 (m, 1H), 1.59-1.73 (m, 3H), 1.74-1.83 (m, 2H), 1.88-1.98 (m, 1H), 2.46-2.56 (m, 1H), 2.72-2.84 (br. m, 2H), 6.42 (d, J= 5.6 Hz, 1H), 7.37 (t, J= 5.6 Hz, 1H). MS (ESI) m/z 366.14 (M+Na)+; 342.16 (M-H)". Example 45: fr methvlpropoxvcarbonYllaminomethvU-Cvclohexanecarborylic Acid (46) [00256] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-methylpropyl 3-methylbutanoate (558 mg, 1.77 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 46 (75 mg, 12% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 14H), 1.17-1.37 (m, 3H), 1.65-1.73 (br. m, 2H), 1.83-2.01 (br. m, 4H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.17 (d, J= 6.6 Hz, 2H), 2.74-2.87 (br. m, 2H), 6.45 (d, J = 4.8 Hz, 1H), 7.40 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) w/z 380.23 (M+Na)+; 356.18 (M-H)". Example 46: fra/ig-4-(fl-(2,2-Dimethvlpropanoyloxy)-2- methvlpropoxvcarbonyllaminomethyll-Cvclohexanecarboxvlic Acid (47) [00257] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-methylpropyl 2,2-dimethylpropanoate (631 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 ml) to yleld the title compound 47 (23 mg, 3% yleld) as an off-white powder after work-up and mass-guided preparative HPLC purification. H NMR (400 MHz, DMSO-d6): 8 = 0.81-0.94 (br. m, 8H), 1.12 (s, 9H), 1.17-1.38 (m, 3H), 1.64-1.72 (br. m, 2H), 1.82-2.00 (br. m, 3H), 2.09 (tt, J= 12.4,3.2 Hz, 1H), 2.72-2.89 (br. m, 2H), 6.40 (d, J" 4.8 Hz, 1H), 7.41 (t, /= 5.6 Hz, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 380.23 (M+Na)+; 356.18 (M-H)-. Example 47: /ra»a-4-(fl-(CvclohexvlcarbonYloxv>-2- methvlpropoxvcarbonvllaminomethvU-Cyclohexanecarboxvlic Acid (48) [00258] Following the general nucleophilic carbamoylation procedure, tranexamic acid (1.4 g, 8.0 mmol) and l-[(2,5-dioxopyrroUdinyl)oxycarbonyloxy]-2- methylpropyl cyclohexanecarboxylate (1.0 g, 2.9 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 48 (300 mg, 27% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. !H NMR (400 MHz, DMSO-d6): 5 = 0-83-0.92 (br. m, 8H), 1.15-1.35 (br. m, 8H), 1.54-1.95 (br. m, 10H), 2.08 (tt, 7= 12.0,3.6 Hz, 1H), 2.27-2.32 (br. m, 1H), 2.74-2.83 (br. m, 2H), 6.41 (d, J= 5.2 Hz, 1H), 7.39 (t, /== 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 406.14 (M+Na)+; 382.17 (M-H)-. Example 48: fra«g-4-(fl-fBenzovloxY)-2-methvlpropoxvcarbonvllaminometh.vl}- Cvclohexanecarboxvlic Acid (49) [00259] Following the general nucleophilic carbamoylation procedure, tranexamic acid (630 mg, 4.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]- 2-methylpropyl benzoate (500 mg, 1.5 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 49 (200 mg, 35% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. :H NMR (400 MHz, DMSO-d6): 5 = 0.84-0.91 (br. m, 2H), 0.99 (d, J= 6.8 Hz, 6H), 1.16-1.31 (br. m, 3H), 1.66-1.68 (br. m, 2H), 1.82-1.85 (m, 2H), 2.03- 2.12 (br. m, 2H), 2.80 (t, J = 6.4 Hz, 2H), 6.11 (d, /= 4.4 Hz, 1H), 7.51 (t, J= 6.0 Hz, 1H), 7.57 (t, /= 6.0 Hz, 2H), 7.71 (t, 7= 7.2 Hz, 1H), 7.96 (dd, J= 8.4,1.6 Hz, 2H), 11.97 (br. s, 1H). MS (ESI) m/z 400.08 (M+Na)+; 376.10 (M-H)-. Example 49: fra«5-4-(F14ButanovloxvVl- cvclohexvlmethorycarbonvnamipoiiiethvU-Cvclohexanecarboxvlic Acid (50) [00260] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]cyclohexylrnethyl butanoate (683 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 50 (329 mg, 43% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. 'H NMR (400 MHz, DMSO-d6): 5 = 0.83-0.95 (br. m, 5H), 0.96- 1.37 (br. m, 8H), 1.47-1.57 (m, 2H), 1.58-1.74 (br. m, 8H), 1.83-1.92 (br. m, 2H), 2.09 (tt, J= 12.0,3.6 Hz, 1H), 2.26 (td, J= 7.6,0.8 Hz, 2H), 2.74-2.86 (m, 2H), 6.44 (d, J= 5.6 Hz, 1H), 7.39 (t, /= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) TK/Z 406.24 (M+Na)+; 382.23 (M-H)~. Example 50: fra«y-4-(\|fl-(2-MethvlpropapoYloxy)-l- cvclohexYlmethoxvcarbonvnaminomethvU-Cyclohexanecarboxvlic Acid (51) [00261] Following the general nucleophilic carbamoylation procedure, tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5- dioxopyrrolidinyl)oxycarbonyloxy]cyclohexylmethyl 2-methylpropanoate (683 mg, 2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 51 (327 mg, 43% yleld) as a white powder after work-up and mass-guided preparative HPLC purification. •H NMR (400 MHz, DMSO-d6): 5 = 0.81-0.94 (br. m, 2H), 1.00-1.36 (br. m, 14H), 1.58-1.74 (br. m, 8H), 1.83-1.91 (br. m, 2H), 2.09 (tt, J= 12.0, 3.6 Hz, 1H), 2.51 (hept, J= 6.8 Hz, 1H), 2.74-2.86 (m, 2H), 6.41 (d, /= 5.2 Hz, 1H), 7.40 (br. t, /= 5.6 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 406.18 (M+Na)+; 382.19 (M-H)". Example 51: Standard Methods for Determination of Enzymatic Cleavage of Prodrugs in Vitro [00262] The stabilities of prodrugs were evaluated in one or more in vitro systems using a variety of tissue preparations following methods known in the art. The chemical stability of prodrugs in aqueous buffers at a pH of 2.0,7.4, and 8.0 were also measured. Tissues were obtained from commercial sources (e.g., Pel-Freez Biologicals, Rogers, AR, or GenTest Corporation, Woburn, MA). Experimental conditions used for the in vitro studies are described in Table 1. Each preparation was incubated with test compound at 37 °C for one hour. Aliquots (50 uL) were removed at 0,30, and 60 min and quenched with 0.1% trifluoroacetic acid in acetonitrile. Samples were then centrifuged and analyzed by LC/MS/MS. Stability of prodrugs towards specific enzymes (e.g., peptidases, etc.) was also assessed in vitro by incubation with the purified enzyme. [00263] Pancreatin Stability: Stability studies were conducted by incubating prodrug (5 uM) with 1% (w/v) pancreatin (Sigma, P-1625, from porcine pancreas) in 0.025 M Tris buffer containing 0.5 M NaCl (pH 7.5) at 37 °C for 60 min. The reaction was stopped by addition of 2 volumes of methanol. After centrifugation at 14,000 rpm for 10 min, the supernatant was removed and analyzed by LC/MS/MS. [00264] Caco-2 Homogenate S9 Stability: Caco-2 cells were grown for 21 days prior to harvesting. Culture medium was removed and cell monolayers were rinsed and scraped off into ice-cold 10 mM sodium phosphate/0.15 M potassium chloride, pH 7.4. Cells were lysed by sonication at 4 °C using a probe sonicator. Lysed cells were then transferred into 1.5 mL centrifuge vials and centrifuged at 9,000 g for 20 min at 4 °C. The resulting supernatant (Caco-2 cell homogenate S9 fraction) was aliquoted into 0.5 mL vials and stored at -80 °C until used. [00265] For stability studies, prodrug (5 JJM) was incubated in Caco-2 homogenate S9 fraction (0.5 mg protein per mL) for 60 min at 37 °C. Concentrations of intact prodrug and released tranexamic acid were determined at zero time and 60 min using LC/MS/MS. [00266] pH-Dependent Stability: The long-term pH-dependent stability of tranexamic acid prodrug at 37 °C was measured by LC/MS/MS at five different representative pH values from pH 2.0 to pH 8.0 was determined. The test concentration was 5 uM. The amount of remaining prodrug and the amount of tranexamic acid released from the prodrug was determined at 0 hour and after 24 hours. [00267] Compounds 13,15-19,32-34,44,46,48-49, and 51, for example, showed good stability from pH 2 to pH 8, are stable in the presence of pancreatin and colonic wash (> 40% intact prodrug remaining after 60 min incubation) and are extensively hydrolyzed to liberate tranexamic acid in the presence of human liver S9( Example 52: In Vitro Determination of Caco-2 Cellular Permeability of Prodrugs [00268] The passive permeability of the prodrugs of the present disclosure can be assessed in vitro using standard methods well known in the art (See, e.g., Stewart, et al, Pharm. Res., 1995,12,693). For example, passive permeability can be evaluated by examining the flux of a prodrug across a cultured polarized cell monolayer (e.g., Caco-2 cells). [00269] Caco-2 cells obtained from continuous culture (passage less than 28) were seeded at high density onto Transwell polycarbonate filters. Cells were maintained with DMEM/10% fetal bovine serum, 1 mM nonessential amino acids, and 6 mM L-Gln, 5% C02/ 95% O* at 37 °C until the day of the experiment. Permeability studies were conducted at pH 6.5 apically (in 50 mM MES buffer containing 1 mM CaCl2, ImM MgCl2,150 mM NaCl, 3 mM KC1,1 mM NaH2P04,5 mM glucose) and pH 7.4 basolaterally (in Hanks' balanced salt solution containing 10 mM HEPES) in the presence of efflux pump inhibitors (250 uM MK-571 and 250 ^M Verapamil). Inserts were placed in 12 or 24 well plates containing buffer and incubated for 30 min at 37 °C. Prodrug (200 uM) was added to the apical or basolateral compartment (donor) and concentrations of prodrug and/or released parent drug in the opposite compartment (receiver) were determined at intervals over 1 hour using LC/MS/MS. Values of apparent permeability (Papp) were calculated using the equation: where Vr is the volume of the receiver compartment in mL; dC/dt is the total flux of prodrug and parent drug (uM/sec), determined from the slope of the plot of concentration in the receiver compartment versus time; Co is the initial concentration of prodrug in uM; and A is the surface area of the membrane in cm2. Prodrugs with significant transcellular permeability may demonstrate a value of Papp of £ 1 x 10"6 cm/sec, for example, a value of Papp of > 1 x 10"5 cm/sec, or even a value of Papp of > 5 x 10"5 cm/sec. Typical values of Papp obtained for prodrugs of the present disclosure are shown in Table 2. [00270] The data in Table 2 shows that the prodrugs disclosed herein have high cellular permeability and should be well absorbed from the intestine. The apical-to- basolateral permeabilities of these prodrugs exceed their basolateral-to-apical permeabilities. This suggests that these compounds are substrates for active transport mechanisms present in the apical membrane of Caco-2 cells (although some component of this transcellular permeability may also be mediated by passive diffusion). Example 53: Pharmacokinetics of Tranexamic Acid Following Administration of Tranexamic Acid or Tranexamic Acid Prodrug to Rats [00271] Tranexamic acid or a tranexamic acid prodrug of the present disclosure was administered as an intravenous bolus injection (i.v.), by oral gavage (p.o.), or by intracolonic (i.e.) administration via an indwelling catheter in the ascending colon to groups of four to six adult male Sprague-Dawley rats (weight approximately 250 g). Animals were fasted overnight before the study and for 4 hours post-dosing and were conscious at the time of the experiment When administered intravenously, tranexamic acid was administered as a solution in water at a dose equivalent to 16 mg (0.1 mmol) of tranexamic acid per kg body weight Prodrugs were orally or intracolonically administered as a suspension in 0.5 % methyl cellulose in 0.1 % Tween 80 at a dose equivalent to 16 mg (0.1 mmol) of tranexamic acid per kg body weight. Blood samples (300 \iL) were obtained via a jugular vein cannula at intervals over 8 hours after oral dosing. Blood was quenched immediately using methanol and then was frozen at -80 °C until analyzed. [00272] The following procedure was used to prepared blood samples for analysis: [00273] 1. Rat blood (100 uL) was collected at different times into K2EDTA tubes, 300 uL of methanol, and the mixture was vortexed to mix the ingredients. [00274] 2. Blank rat blood (90 uL) was quenched with 300 uL of methanol. Then ten uL of a standard stock solution (0.04,0.2,1,5,25, and 100 ug/mL) were added to the tube individually. Then 20 uL of p-chlorophenylalanine (5 jag/mL in 50% methanol) was added to each tube to make up a final calibration standard (0.004, 0.02, 0.1, 0.5,2.5, and 10 ug/mL). The samples were vortexed and centrifuged at 14,000 ipm for 20 min. [00275] 3. To the quenched blood samples were added 20 uL ofp- cblorophenylalanine (5 jag/mL in 50% methanol), the samples were vortexed and centrifuged at 14,000 rpm for 20 min. [00276] 4. The supernatant was analyzed by LC/MS/MS. [00277] The following method was used for LC/MS/MS Analysis of the prepared blood samples. An API 4000 or 2000 LC/MS/MS spectrometer equipped with Agilent 1100 binary pumps and a CTC HTS-PAL autosampler were used in the analysis. A ThermoHypersil-BetaSil CI 8,100 x 4.6 mm, 5 um column was used during the analysis. The mobile phase for the analysis of tranexamic acid and prodrug was (A) 0.1 % formic acid in water, and (B) 0.1 % formic acid in acetonitrile. The gradient condition was: 2 % eluent-B to 95 % eluent-B for 2.5 min, then to 98 % eluent-B to 4.0 min. At 4.1 min, it was returned to 2 % eluent-B and maintained at 2 % eluent-B till 6.0 min. The flow rate was 1 rnL/min. An ESI source was used on the API 4000. The analysis of tranexamic acid was performed in positive ion mode for and negative ion mode was used for analysis of tranexamic acid prodrugs. [00278] The MRM transition for each analyte was optimized using standard solutions. 20 uL of the sample was injected. Non-compartmental analysis was performed using WinNonlin (v.3.1 Professional Version, Pharsight Corporation, Mountain View, California) on individual animal profiles. Summary statistics on major parameter estimates was performed for Cmax (peak observed concentration following dosing), Tmax (time to maximum concentration is the time at which the peak concentration was observed), AUC( curve from time zero to last collection time, estimated using the log-linear trapezoidal method), AUC(o-»), (area under the serum concentration time curve from time zero to infinity, estimated using the log-linear trapezoidal method to the last collection time with extrapolation to infinity), and t\a (terminal half-life). [00279] The oral or intracolonic bioavailability (F) of tranexamic acid was determined by comparing the area under the tranexamic acid concentration vs. time curve (AUC) following oral or intracolonic administration of tranexamic acid or prodrug with the AUC of the tranexamic acid concentration vs. time curve following intravenous administration of tranexamic acid on a dose normalized basis. An AUCinf of 22.2 hr*(4.g/mL for the intravenously administered tranexamic acid (dosed at 16 mg/kg) was used for the calculations of the bioavailability of tranexamic acid released from prodrugs post absorption. The results for tranexamic acid and tranexamic prodrug 13 are shown in Table 3, Figure 1, and Figure 2. In Table 3, the values represent the mean ± 1SD. When administered intracolonically, each of compounds 13-20,23-24, and 44-45, for example, showed greater than 8-fold higher bioavailability of tranexamic acid compared to the bioavailability of tranexamic acid when tranexamic acid itself was administered intracolonically. [00280] While some embodiments have been shown and described, various modifications and substitutions may be made thereto without departing from the spirit and scope of the invention. For example, for claim construction purposes, it is not intended that the claims set forth hereinafter be construed in any way narrower than the literal language thereof, and it is thus not intended that exemplary embodiments from the specification be read into the claims. Accordingly, it is to be understood that the present invention has been described by way of illustration and not as a limitation on the scope of the claims. i We Claim: 1. A compound of Formula (I): a pharmaceutically acceptable salt thereof such as herein described, or a pharmaceutically acceptable solvate of any of the foregoing such as herein described, wherein: R1 is selected from C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl; R2 and R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl; R4 is selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl; and wherein each substituent group is independently selected from at least one of C1-3 alkyl, - OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino. 2. The compound as claimed in claim 1, wherein R1 is selected from C1-4 alkyl, phenyl, substituted phenyl, cyclohexyl, and substituted cyclohexyl. 3. The compound as claimed in claim 1, wherein R1 is selected from methyl, ethyl, n- propyl, isopropyl, n-butyl, isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyl, and cyclohexyl. 4. The compound as claimed in claim 1, wherein R4 is selected from hydrogen, methyl, ethyl, fert-butyl, allyl, benzyl, 4-methoxybenzyl, diphenylmethyl, triphenylmethyl, trimethylsilyl, triethylsilyl, triisopropylsilyl, tert-butyldimethylsilyl, and phenyldimethylsilyl. 5. The compound as claimed in claim 1, wherein R4 is selected from hydrogen, allyl, benzyl, and trimethylsilyl. 6. The compound as claimed in claim 1, wherein R4 is hydrogen. 7. The compound as claimed in claim 1, wherein R2 and R3 are independently selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. 8. The compound as claimed in claim 1, wherein R2 is hydrogen, and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. 9. The compound as claimed in claim 1, wherein R1 is selected from methyl, ethyl, n- propyl, isopropyl, n-butyl, isobutyl, sec-butyl, terf-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. 10. The compound as claimed in claim 9, wherein R4 is hydrogen. 11. The compound as claimed in claim 1, which is selected from: trans-4-{[(2-methylpropanoyloxy)methoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[(2,2-dimethylpropanoyloxy)methoxycarbonyl]-aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[(3-methylbutanoyloxy)methoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[(benzoyloxy)methoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1 -(2-methylpropanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(2-methylpropanoyloxy)propoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(2-methylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(benzoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(cyclohexylcarbonyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(pentanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(propanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(butanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(pentanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(3-methylbutanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(2,2-dimethylpropanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-({1 -(cyclohexylcarbonyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(2-methylbenzoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(butanoyloxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(2-methylpropanoyloxy)butoxycarbonyl]aminomethyl)- cyclohexanecarboxylic acid; trans-4-{[1-(3-methylbutanoyloxy)butoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(2,2-dimethylpropanoyloxy)butoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(benzoyloxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(propanoyloxy)propoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(butanoyloxy)propoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(2,2-dimethylpropanoyloxy)propoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(benzoyloxy)propoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(butanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[ 1-(butanoyloxy)-1-cyclohexylmethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(2-methylpropanoyloxy)-1-cyclohexylmethoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(acetoxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(propanoyloxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(acetoxy)-2-methylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; trans-4-{[1-(3-methylbutanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1-(2,2-dimethylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; trans-4-{[1 -(acetoxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; and trans-4-{[1-(propanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; pharmaceutically acceptable salts such as herein described thereof, and pharmaceutically acceptable solvates such as herein described of any of the foregoing. 12. A pharmaceutical composition formulated for oral administration comprising at least one compound as claimed in any one of claims 1 to 11 and a pharmaceutically acceptable vehicle such as herein described, wherein the composition comprises from 2 mg-equivalents to 50 mg- equivalents of tranexamic acid of formula (I) per kg of body weight of a patient. 13. A pharmaceutical composition formulated for topical administration comprising from 1 weight% to 10 weight% of at least one compound as claimed in any one of claims 1 to 11 and a pharmaceutically acceptable vehicle such as herein described. 14. The pharmaceutical composition as claimed in any one of claims 12 or 13, which is a sustained release formulation. 15. The compound as claimed in claim 1, wherein: R1 is selected from C1-4 alkyl, phenyl, o-tolyl, and cyclohexyl; R2 is hydrogen; R3 is selected from d1-3 alkyl, phenyl, and cyclohexyl; and R4 is selected from hydrogen, C1-4 alkyl, benzyl, 4-methoxybenzyl, diphenylmethyl, triphenylmethyl, trimethylsilyl, triethylsilyl, triisopropylsilyl, ferf-butyldimethylsilyl, and phenyldimethylsilyl. 16. The compound as claimed in claim 15, wherein: R1 is selected from isopropyl, isobutyl and phenyl; R3 is selected from methyl and isopropyl; and R4 is hydrogen. 17. The compound as claimed in claim 16, which is trans-4-{[1-(2-methylpropanoyloxy)- 2-methylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid or a pharmaceutically acceptable salt such as herein described thereof. 18. The compound as claimed in claim 16, which is trans-4-{[1- (benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid or a pharmaceutically acceptable salt such as herein described thereof. 19. The compound as claimed in claim 1, wherein R1 is isopropyl; one of R2 and R3 is hydrogen and the other of R2 and R3 is methyl; and R4 is hydrogen. 20. The compound as claimed in claim 19, which is chosen from: (+)-trans-4-({[(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylic acid; (-)-trans-4-({[(1R)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylic acid; and mixtures thereof. 21. The compound as claimed in claim 19, which is chosen from: sodiumtrans-4-({t(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylate; sodiumtrans-4-({[(1R)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylate; and mixtures thereof. 22. The compound as claimed in claim 19, which is trans-4-{[1-(2- methylpropanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid. 23. The compound as claimed in claim 19, which is sodium trans-4-{[1-(2- methylpropanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid. 24. The compound as claimed in claim 1, which is selected from: trans-4-{[1-(2-methylpropanoyloxy)ethoxycarbonyl]-aminomethyl}-cyclohexanecarboxylic acid; sodiumtrans-4-{[1-(2-methylpropanoyloxy)ethoxycarbonyl]-aminomethyl}- cyclohexanecarboxylate; (+)-trans-4-({[(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylic acid; sodiumtrans-4-({[(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylate; (-)-trans-4-({[(1 R)-1 -(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylic acid; sodiumtrans-4-({[(1R)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)- cyclohexanecarboxylate; trans-4-{[1-(3-methylbutanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; sodiumtrans-4-{[1-(3-methylbutanoyloxy)ethoxycarbonyl]aminomethyl}- cyclohexanecarboxylate; trans-4-{[1-(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; sodiumtrans-4-{[1-(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylate; trans-4-{[1-(2-methylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylic acid; and sodiumtrans-4-{[1-(2-methylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}- cyclohexanecarboxylate; a pharmaceutically acceptable salt thereof such as herein described, or a pharmaceutically acceptable solvate of any of the foregoing such as herein described. 25. A pharmaceutical composition formulated for oral administration comprising at least one compound as claimed in any one of claims 15 to 24 and a pharmaceutically acceptable vehicle such as herein described, wherein the composition comprises from 2 mg-equivalents to 50 mg- equivalents of tranexamic acid of formula (I) per kg of body weight of a patient. 26. A pharmaceutical composition formulated for topical administration comprising from 1 weight% to 10 weight% of at least one compound as claimed in any one of claims 15 to 24 and a pharmaceutically acceptable vehicle such as herein described. 27. The pharmaceutical composition as claimed in any one of claims 25 and 26, which is a sustained release formulation. substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, R4 is selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl, and wherein each substituent group is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino and compositions thereof. 28. The pharmaceutical composition as claimed in any one of claims 25 and 26, having at least one cytotoxic agent such as herein described. 28. The pharmaceutical composition as claimed in any one of claims 25 and 26, having at least one cytotoxic agent such as herein described. ABSTRACT ACYLOXYALKYL CARBAMATE OF TRANEXAMIC ACID AND COMPOSITIONS THEREOF Acyloxyalkyl carbamate prodrugs of tranexamic acid of Formula (I) wherein R1 is selected from C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3- 7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl, R2 and R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, R4 is selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl, and wherein each substituent group is independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino and compositions thereof.

Full Text

Technical Field
[002] The disclosure relates to prodrugs of acyloxyalkyl carbamate trans-4-
(aminomethyl)-cyclohexanecarboxylic acid, pharmaceutical compositions thereof,
methods of making prodrugs of trans-4-(aminomethyl)-cyclohexane-carboxylic acid,
and methods of using prodrugs of trans-4-(aminomethyl)-cyclohexanecarboxylic acid
and pharmaceutical compositions thereof to treat various diseases or disorders. The
disclosure also relates to such prodrugs suitable for oral and topical administration
including for oral administration using sustained release dosage forms.
Background
[003] Tranexamic acid (1) (trans-4-aminomethyl)-cyclohexanecarboxylic
acid, Cyklokapron®):

is an antifibrinolytic agent that reversibly blocks lysine binding sites on plasminogen
and plasmin, and acts to prevent proteolytic degradation of fibrin clots which form in
the normal physiologic process of hemostasis. Both plasminogen and plasmin are
activators of fibrinolysis and active clot-lysing agents. Tranexamic acid thus helps to

stabilize fibrin clots, which in turn maintains coagulation and helps to control
bleeding.
[004] Tranexamic acid is used clinically to control excess bleeding, for
example, heavy bleeding associated with cardiac surgery, upper gastrointestinal
hemorrhage, blood loss in patients with advanced cancer (both acute hemorrhagic

events and low-volume chronic bleeding), excessive bleeding that occurs during
dental procedures in hemophiliacs, and for heavy bleeding during
menstruation,i.e.,menorrhagia {see Wellington and Wagstaff, Drugs, 2003, 63,1417-
1433; Dunn and Goa, Drugs, 1999,57,1005-1032; Pereira and Phan, The Oncologist,
2004,9, 561-570).
[005] The importance of the plasminogen / plasmin proteolytic cascade in
epidermal biology and pathophysiology is also well appreciated (Kramer et al, Biol.
Chem. Hoppe-Seylar, 1995,3,131-141). Disruption of the stratum corneumby
mechanical or chemical injury induces epidermal proteolytic activity. Topical
treatment of human or rodent skin with tranexamic acid significantly accelerates
barrier recovery and greatly decreases epidermal hyperplasia, suggesting a role for
plasmin inhibitory compounds in promoting epidermal wound healing (Denda et al,
J. Invest. Dermatol, 1997,109,84-90; Kitamura et al, J. Soc. Cosmet. Chem., 1995,
29,133-145). Exposure of human skin to ultraviolet radiation causes erythema and
pigmentation, with pigmentation resulting from increased melanin production. A role
for plasmin in contributing to increased production of arachidonic acid and
prostaglandin metabolites in skin following U.V. exposure has also been
demonstrated. Topical application of tranexamic acid prevents U.V.-induced
pigmentation in vivo through dose-dependent reduction in prostaglandin production
(Maeda and Naganuma,/. Photochem. Photobiol. B, 1998,47,136-141; Manosroi et
al, J. Cosmet. Sci., 2002,53, 375-386; Suetsugu et al, U.S. Patent No. 5,690,914).
[006] The plasminogen activation system is also a predominant protease
pathway responsible for extracellular matrix (ECM) degradation. Cancer
dissemination and metastasis is synonymous with invasive cell migration, a process in
which the ECM plays the dual role of the substratum on which the cells move as well
as the physical obstacle that the cells have to surpass. To degrade the physical
obstacle that the ECM poses in the direction of migration, cells use proteolytic
enzymes such as plasminogen and plasmin capable of hydrolyzing the ECM
components (Stonelake et al, Br. J. Cancer, 1997, 75, 951-959; Dunbar et al, Expert
Opin. Investig. Drugs, 2000,9,2085-2092; Sidenius andBlasi, Cancer Metastasis
Rev., 2003,22,205-222). Plasmin inhibitory compounds such as tranexamic acid,
therefore, show utility as anti-metastatic agents either alone or in combination with
cytotoxic anticancer agents (Tsutsumi and Konisbi, Jpn. Kokai Tokkyo Koho,
2002114673).

[007] Menorrhagia is defined as blood loss >80 mL per menstrual cycle and
affects many women and represents a significant health problem. Prevalence rates are
believed to be similar across the Western world, and in the U.K. at least one in 20
women aged between 34 and 49 years will consult their general practitioners because
of menstrual disorders. Menorrhagia accounts for 60% of primary-care consultations
for menstrual problems and 12% of all gynecology referrals (Peto et al, Fain. Pract.,
1993,10,207-211; McPherson and Andersson, eds., Women's problems in general
practice, Oxford: Oxford University Press, 1983, pp 21-41; Bradlow et al, Patterns
of referral, Oxford: Oxford Health Services Research Unit, 1992). While various
pathological mechanisms may contribute to the cause of menorrhagia, approximately
50% of women with heavy menstrual blood loss have no underlying anatomical or
endocrinological abnormality. In such women fibrinolytic activity in utero is higher
than in women with normal menstrual blood loss, with this increased fibrinolysis
resulting from elevated levels of endometrium-derived plasmin and plasminogen
activators (Gleeson, Am. J. Obstet. Gynecol, 1994,171,178-183; Dockeray et al,
Eur. J. Obstet. Gynecol. Reprod. Biol, 1987,24,309-318).
[008] Despite the availability of clinically effective antifibrinolytic agents
such as tranexamic acid (which has been shown to reduce menstrual blood loss by
~50%), approximately 60% of women with menorrhagia undergo hysterectomy
within 5 years of referral to a gynecologist (Coulter et al, Br. J. Obstet. Gynaecol,
1991,98, 789-796). Women suffering from menorrhagia are typically treated orally
with tranexamic acid concurrently with menstruation (4-7 days). Doses of 500-1500
mg tranexamic acid tablets administered three or four times daily are typical.
Intravenous dosage formulations are also available for use as a continuous infusion in
the surgical setting. The requirement for frequent daily oral administration results
from the suboptimal pharmacokinetic properties of tranexamic acid, which includes
modest oral bioavailability (~30%) and a rapid terminal elimination half-life of ~2
hours.
[009] Sustained released oral dosage formulations are a conventional
solution to the problem of rapid systemic drug clearance, as is well known in the art
(See, e.g., "Remington's Pharmaceutical Sciences," Philadelphia College of Pharmacy
and Science, 19th Edition, 1995). Osmotic delivery systems are also recognized
methods for sustained drug delivery (see e.g., Verma et al, DrugDev. Ind. Pharm.,
2000,26,695-708). Successful application of these technologies depends on the drug

of interest having an effective level of absorption from the large intestine (also
referred to herein as the colon), where the dosage form spends a majority of its time
during its passage through the gastrointestinal tract. Tranexamic acid is poorly
absorbed following rectal administration in humans (Aimer et al., J. Clin. Pharm.,
1992,32,49-54), consistent with limited permeability of the drug across the colonic
mucosa. Development of an oral controlled release formulation for tranexamic acid
should considerably improve the convenience, efficacy and side effect profile of
tranexamic acid therapy. However, the rapid passage of conventional dosage forms
through the proximal absorptive region of the small intestine has thus far prevented
the successful application of sustained release technologies to this drug. Heasley et
al. have described delayed release oral formulations of tranexamic acid based on the
use of enteric polymer coatings that are designed to retard the dissolution of the drug
by 1-2 hours until the dosage form has passed from the stomach to the small intestine
(U.S. Patent Application No. 2005/002825). Such formulations are said to reduce the
adverse gastrointestinal reactions that may accompany oral tranexamic acid therapy
(including nausea, vomiting, diarrhea, dyspepsia and cramping). However these
formulations would not be expected to substantially alter the elimination half-life of
the drug, and hence overcome the requirement for frequent daily dosing.
[0010] There is a significant need for new prodrugs of tranexamic acid that are
well absorbed in the large intestine and hence suitable for oral sustained release
formulations, thus improving the convenience, efficacy and side effect profile of
antifibrinolytic therapy. Moreover, since the zwitterionic character of tranexamic acid
limits the permeability of the compound across the epidermal barrier, there is also a
need for more lipophilic prodrug derivatives of tranexamic acid which would provide
for more effective topical administration in the treatment of skin disorders such as
wound healing, epidermal hyperplasia, skin roughening, unwanted skin pigmentation,
etc.
[0011] One solution to the incomplete gastrointestinal absorption of
tranexamic acid is through design of prodrug derivatives (see Svahn et al., J. Med.
Chem., 1986,29,448-453; Svahn et al., European Patent No. 0 079 872 Bl; Svahn et
al., U.S. Patent No. 4,483,867; Jonsson, International Publication No. WO94/15904;
Svahn et al, Arzneim-Forsch., 1988,38,735-738; Edlund et al., Br. J. Obstet.
Gynaecol, 1995,102,913-917). The prodrug l-(ethoxycarbonyl)oxyethyl trans-4-
(aminomethyl)-cyclohexanecarboxylate (i.e.,Kabi 2161) showed markedly improved

oral bioavailability of tranexamic acid in human patients, and was effective in
reducing menstrual blood loss in women suffering from idiopathic menorrhagja.
Summary
[0012] The needs described above, among other needs, can be satisfied by the
disclosure herein of acyloxyalkyl carbamate prodrugs of tranexamic acid,
pharmaceutical compositions of acyloxyalkyl carbamate prodrugs of tranexamic acid,
methods of making acyloxyalkyl carbamate prodrugs of tranexamic acid, and methods
of using acyloxyalkyl carbamate prodrugs of tranexamic acid and/or pharmaceutical
compositions thereof to treat various medical pathologies. The disclosure also
provides prodrugs suitable for oral and topical administration including for oral
administration using sustained release dosage forms.
[0013] In one aspect, compounds of Formula (I) are provided,

pharmaceutically acceptable salts thereof, and pharmaceuticaUy acceptable solvates
of any of the foregoing, wherein:
R1 is selected from acyl, substituted acyl, alkyl, substituted alkyl, aryl,
substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl,
cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl,
heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl;
R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl,
alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl,
substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted
cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl,
heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon
atom to which they are bonded form a cycloalkyl, substituted cycloalkyl,
cycloheteroalkyl, or substituted cycloheteroalkyl ring; and
R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl,

cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl,
heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl,
substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl.
[0014] In another aspect, compounds of Formula (IT) are provided,

pharmaceutically acceptable salts thereof and pharmaceutically acceptable solvates of
any of the foregoing, wherein:
X is selected from fluoro, chloro, bromo, iodo, and R20SO3- wherein R20 is
selected from C1-6 alkyl, C5-7 aryl, and substituted C5-7 aryi; and
R2, R3 and R4 are as defined above.
[0015] m another aspect, methods of synthesizing a compound of Formula (I)
are provided, comprising:

contacting a compound of Formula (II), a compound of Formula (HI) and at least one
equivalent of a reactant selected from an organic base, an inorganic base, and
combinations thereof, to provide a compound of Formula (I), pharmaceutically

acceptable salts thereof and pharmaceutically acceptable solvates of any of the
foregoing, wherein:
X, R1, R2, R3 and R4 are as defined above.
[0016] In another aspect, methods of synthesizing a compound of Formula (I)
are provided, comprising:

contacting a compound of Formula (TV) with a compound of Formula (V) to provide
a compound of Formula (I), pharmaceutically acceptable salt thereof, or a
pharmaceutically acceptable solvate of any of the foregoing, wherein:
R5 and R6 are independently selected from hydrogen, acylamino, acyloxy,
alkoxycarbonylamino, alkoxycarbonyloxy, alkyl, substituted alkyl, alkoxy, substituted
alkoxy, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyloxy,
dialkylamino, heteroaryl, substituted heteroaryl, hydroxy, and sulfonamido, or R5 and
R6 together with the atoms to which they are bonded form a substituted cycloalkyl,
substituted cycloheteroalkyl, or substituted aryl ring; and
R1,R2,R3andR4 are as defined above.
[0017] In another aspect, methods of synthesizing a compound of Formula (I)
are provided, comprising contacting a compound of Formula (XV) with an oxidant, to
provide a compound of Formula (I), or pharmaceutically acceptable salts thereof, or
pharmaceutically acceptable solvates of any of the foregoing,

wherein R1, R2, R3 and R4 are as defined above.

[0018] In another aspect, pharmaceutical compositions comprising at least one
phaimaceutically acceptable vehicle and a therapeutically effective amount of at least
one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a
pharmaceutically acceptable solvate of any of the foregoing, are provided.
[0019] In another aspect, oral dosage forms, comprising at least one
tranexamic acid prodrug of Formula (D, a pharmaceutically acceptable salt thereof, or
a pharmaceutically acceptable solvate of any of the foregoing, are provided.
[0020] In another aspect, sustained release oral dosage forms, comprising at
least one prodrug of Formula (I), a pharmaceutically acceptable salt thereof, or a
pharmaceutically acceptable solvate of any of the foregoing, are provided.
[0021] In another aspect, topical dosage forms are provided, comprising at
least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a
pharmaceutically acceptable solvate of any of the foregoing, formulated in a
pharmaceutically acceptable topical vehicle.
[0022] In another aspect, methods of topically administering to a patient at
least one compound of Formula (I), a pharmaceutically acceptable salt thereof, or a
pharmaceutically acceptable solvate of any of the foregoing, are provided, the
methods comprising applying the at least one compound of Formula (I) onto a surface
area of the patient.
[0023] In another aspect, methods are provided for treating excessive
bleeding, including heavy bleeding associated with cardiac surgery, upper
gastrointestinal hemorrhage, blood loss in patients with advanced cancer, excessive
bleeding that occurs during dental procedures, for example in hemophiliacs, and
heavy bleeding during menstruation, i.e., menorrhagia. The methods include
adrninistering to a patient in need of such treatment a therapeutically effective amount
of at least one compound of Formula (I), a pharmaceutically acceptable salt thereof,
or a solvate of any of the foregoing and/or a pharmaceutical composition thereof.
[0024] In another aspect, methods are provided for treating skin disorders
such as wound healing, epidermal hyperplasia, skin roughening and unwanted skin
pigmentation. The methods include topically administering to a patient in need of
such treatment a therapeutically effective amount of at least one compound of
Formula (I), a pharmaceutically acceptable salt thereof, or a solvate of any of the
foregoing, and/or a pharmaceutical composition thereof.

[0025] In another aspect, methods are provided for treating tumor metastasis
in a patient suffering from a disorder, such as a malignant disorder. These methods
include administering to a patient in need of such treatment a therapeutically effective
amount of at least one compound of Formula (I), a phannaceutically acceptable salt
thereof, or a solvate of any of the foregoing and/or a pharmaceutical composition
thereof, either alone or in combination with one or more cytotoxic agents.
[0026] In another aspect, methods are provided for achieving a sustained
therapeutic or prophylactic concentration of tranexamic acid in the systemic
circulation of a patient comprising orally administering at least one compound of
Formula (T), a pharmaceutically acceptable salt thereof, or a solvate of any of the
foregoing to the patient
Brief Description of the Drawings
[0027] The skilled artisan will understand that the drawings, described herein,
are for illustration purposes only. The drawings are not intended to limit the scope of
the present disclosure.
[0028] Figure 1 shows the pharmacokinetics profile of released tranexamic
acid (- • -) and remaining tranexamic acid prodrug 13 (- v -) following intracolonic
administration of tranexamic acid prodrug 13.
[0029] Figure 2 shows the pharmacokinetics profile of tranexamic acid
following oral administration of tranexamic acid prodrug 13. The levels of prodrug
13 following oral gavage administration were below the level of detection.
Detailed Description
Definitions
[0030] Unless otherwise indicated, all numbers expressing quantities of
ingredients, reaction conditions, and so forth used in the specification and claims are
to be understood as being modified in all instances by the term "about." Accordingly,
unless indicated to the contrary, the numerical parameters set forth in the following
specification and attached claims are approximations that may vary depending upon
the properties sought to be obtained. At the very least, and not as an attempt to limit
the application of the doctrine of equivalents to the scope of the claims, each

numerical parameter should at least be construed in light of the number of reported
significant digits and by applying ordinary rounding techniques.
[0031] Notwithstanding that the numerical ranges and parameters setting forth
the broad scope of the embodiments are approximations, the numerical values set
forth in the specific examples are reported as precisely as possible. Any numerical
values, however, inherently contain certain errors necessarily resulting from in the
error inherent in measurements.
[0032] The section headings used herein are for organizational purposes only
and are not to be construed as limiting the subject matter disclosed.
[0033] To the extent the definitions of terms in the publications, patents, and
patent applications incorporated herein by reference are not the same as the
definitions set forth in this specification, the definitions in this specification control
for the entire specification, including the claims. Any other definitions in the
publications, patents, and patent applications incorporated herein by reference that are
not explicitly provided in this specification apply only to the embodiments discussed
in the publications, patents, and patent applications incorporated herein by reference.
[0034] A dash ("-") mat is not between two letters or symbols is used to
indicate a point of attachment for a substituent. For example, -CONEfe is attached
through the carbon atom.
[0035] "Acyl" by itself or as part of another substituent refers to a radical -
C(0)R30, where R30 is hydrogen, alkyl, heteroalkyl, cycloalkyl, cycloheteroalkyl,
cycloalkylalkyL cycloheteroalkylalkyl, aryl, heteroaryl, arylalkyl, or heteroarylalkyl,
which may be substituted, as defined herein. Examples of acyl groups include, but
are not limited to, formyl, acetyl, cyclohexylcafbonyl, cyclohexyhnethylcarbonyl,
benzoyl, benzylcarbonyl. In certain embodiments, an acyl group is C1-3 acyl.
[0036] "Acylamino" by itself or as part of another substituent refers to a
radical -NR31C(0)R32, where R31 and R32 are independently hydrogen, alkyl,
cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, or
heteroarylalkyl, which may be substituted as defined herein. Examples of acylamino
groups include, but are not limited to, formamido, acetamido and benzamido.
[0037] "1-Acyloxy-Alkyl Carbamate" refers to an
N-l-(acyloxy)alkoxycarbonyl derivative of tranexamic acid as encompassed by
compounds of Formula (I) disclosed herein.

[0038] "Alkyl" by itself or as part of another substituent refers to a saturated
or unsaturated, branched or straight-chain monovalent hydrocarbon radical derived by
the removal of one hydrogen atom from a single carbon atom of a parent alkane,
alkene, or alkyne. Examples of alkyl groups include, but are not limited to, methyl;
ethyls such as ethanyl, ethenyl, and ethynyl; propyls such as propan-1-yl, propan-2-yl,
prop-1-en-l-yl, prop-l-en-2-yl, prop-2-en-l-yl (allyl), prop-1-yn-l-yl, prop-2-yn-l-yl,
etc.; butyls such as butan-1-yl, butan-2-yl, 2-methyl-propan-l-yl,
2-methyl-propan-2-yl, but-1-en-l-yl, but-l-en-2-yl, 2-methyl-prop-l-en-l-yl,
but-2-en-l-yl, but-2-en-2-yl, buta-l,3-dien-l-yl, buta-l,3-dien-2-yl, but-1-yn-l-yl,
but-l-yn-3-yl, but-3-yn-l-yl, etc.; and the like.
[0039] The term "alkyl" is specifically intended to include groups having any
degree or level of saturation, Le., groups having exclusively single carbon-carbon
bonds, groups having one or more double carbon-carbon bonds, groups having one or
more triple carbon-carbon bondsjand groups having mixtures of single, double and
triple carbon-carbon bonds. Wbiire a specific level of saturation is intended, the
expressions "alkanyl," "alkenyl," and "alkynyl" are used. In certain embodiments, an
alkyl group comprises from 1 to 20 carbon atoms, in certain embodiments, from 1 to 6
carbon atoms, and in certain embodiments, from 1 to 3 carbon atoms. In certain
embodiments, alkyl is Ci^ alkyl, Ci^ alkyl, C1-3 alkyl, methyl, ethyl, n-propyl,
isopropyl, n-butyl, isobutyl, sec-butyl, terf-butyl, or allyl.
[0040] "Alkanyl" by itself or as part of another substituent refers to a saturated
branched or straight-chain alkyl radical derived by the removal of one hydrogen atom
from a single carbon atom of a parent alkane. Examples of alkanyl groups include,
but are not limited to, methanyl, ethanyl, propanyls such as propan-1-yl, propan-2-yl
(isopropyl), etc.; butanyls such as butan-1-yl butan-2-yl (sec-butyl),
2-methyl-propan-l-yl (isobutyl), 2-methyl-propan-2-yl (t-butyl), etc.; and the like.
[0041] "Alkenyl" by itself or as part of another substituent refers to an
unsaturated branched or straight-chain alkyl radical having at least one carbon-carbon
double bond derived by the removal of one hydrogen atom from a single carbon atom
of a parent alkene. The group may be in either the cis or trans conformation about the
double bond(s). Examples of alkenyl groups include, but are not limited to, ethenyl;
propenyls such as prop-1-en-l-yl, prop-l-en-2-yl, prop-2-en-l-yl (allyl),
prop-2-en-2-yl; butenyls such as but-1-en-l-yl, but-l-en-2-yl,

2-methyl-prop-l-en-l-yl, but-2-en-l-yl but-2-en-l-yl but-2-en-2-yl,
buta-l,3-dien-l-yl, buta-l,3-dien-2-yl, etc.; and the like.
[0042] "Alkynyl" by itself or as part of another substituent refers to an
unsaturated branched or straight-chain alkyl radical having at least one carbon-carbon
triple bond derived by the removal of one hydrogen atom from a single carbon atom
of a parent alkyne. Examples of alkynyl groups include, but are not limited to,
ethynyl; propynyls such as prop-1-yn-l-yl, prop-2-yn-l-yl, etc.; butynyls such as
but-1-yn-l-yl, but-l-yn-3-yl, but-3-yn-l-yl, etc.; and the like.
[0043] "Acyloxy" by itself or as part of another substituent refers to a radical
-OC(O)R33, where R33 is alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl,
heteroalkyl, heteroaryl, or heteroarylalkyl, which may be substituted, as defined
herein. Examples of acyloxy groups include, but are not limited to, acetoxy,
isobutyroyloxy, benzoyloxy, phenylacetoxy.
[0044] "Alkoxy" by itself or as part of another substituent refers to a radical -
OR34 where R34 is alkyl, cycloalkyl, cycloalkylalkyl, aryl, or arylalkyl, which may be
substituted, as defined herein. Examples of alkoxy groups include, but are not limited
to, methoxy, ethoxy, propoxy, butoxy, cyclohexyloxy.
[0045] "Alkoxycarbonyl" by itself or as part of another substituent refers to a
radical -C(O)OR35 where R3S is an alkyl or substituted alkyl group, as defined herein.
Examples of alkoxycarbonyl groups include, but are not limited to, methoxycarbonyl,
ethoxycarbonyl, propoxycarbonyl, butoxycarbonyl. In certain embodiments, an
alkoxycarbonyl group is C1-3 alkoxycarbonyl.
[0046] "Alkoxycarbonylamino" by itself or as part of another substituent
refers to a radical -NR36C(O)-OR37 where R36 represents an alkyl, substituted alkyl,
cycloalkyl, or substituted cycloalkyl group and R37 is alkyl, cycloalkyl,
cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, which
may be substituted, as defined herein. Examples of alkoxycarbonylamino groups
include, but are not limited to, methoxycarbonylamino, tert-butoxycarbonylamino,
and benzyloxycarbonylamino.
[0047] "Alkoxycarbonyloxy" by itself or as part of another substituent refers
to a radical -OC(O)-OR38 where R38 is an alkyl, substituted alkyl, cycloalkyl, or
substituted cycloalkyl group, as defined herein. Examples of alkoxyarbonyloxy
groups include, but are not limited to, methoxycarbonyloxy, ethoxycarbonyloxy, and
cyclohexyloxycarbonyloxy.

[0048] "Alkylamino" by itself or as part of another substituent refers to a
radical -NHR39 where R39 is an alkyl, substituted alkyl, cycloalkyl, or substituted
cycloalkyl group, as defined herein. In certain embodiments, an alkylamino group is
C1-3 alkylamino.
[0049] "Aryl" by itself or as part of another substituent refers to a monovalent
aromatic hydrocarbon radical derived by the removal of one hydrogen atom from a
single carbon atom of a parent aromatic ring system. Aryl encompasses 5- and 6-
membered carbocyclic aromatic rings, for example, benzene; bicyclic ring systems
wherein at least one ring is carbocyclic and aromatic, for example, naphthalene,
indane, and tetralin; and tricyclic ring systems wherein at least one ring is carbocyclic
and aromatic, for example, fluorene. Aryl encompasses multiple ring systems having
at least one carbocyclic aromatic ring fused to at least one carbocylic aromatic ring,
cycloalkyl ring, or heterocycloalkyl ring. For example, aryl includes 5- and 6-
membered carbocyclic aromatic rings fused to a 5- to 7-membered heterocycloalkyl
ring containing one or more heteroatoms chosen from N, O, and S. For such fused,
bicyclic ring systems wherein only one of the rings is a carbocyclic aromatic ring, the
point of attachment may be at the carbocyclic aromatic ring or the heterocycloalkyl
ring. Examples of aryl groups include, but are not limited to, groups derived from
aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene,
chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene, as-
indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene,
ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene,
phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene,
trinaphthalene. In certain embodiments, an aryl group may have from 5 to 20 carbon
atoms, and in certain embodiments, from 5 to 12 carbon atoms. Aryl, however, does
not encompass or overlap in any way with heteroaryl, separately defined herein.
Hence, a multiple ring system in which one or more carbocyclic aromatic rings is
fused to a heterocycloalkyl aromatic ring, is heteroaryl, not aryl, as defined herein. In
certain embodiments, aryl is C6-10 aryl or phenyl.
[0050] "Arylalkyl" by itself or as part of another substituent refers to an
acyclic alkyl radical in which one of the hydrogen atoms bonded to a carbon atom,
typically a terminal or sp3 carbon atom, is replaced with an aryl group. Examples of
arylalkyl groups include, but are not limited to, benzyl, 2-phenylethan-l-yl,
2-phenylethen-l-yl, naphthylmethyl, 2-naphthylethan-l-yl, 2-naphthylefhen-l-yl,

naphthobenzyl, 2-naphthophenylethan-l-yl. Where specific alkyl moieties are
intended, the nomenclature arylalkanyl, arylalkenyl, or arylalkynyl is used. In certain
embodiments, an arylalkyl group is C7-30 arylalkyl, e.g., the alkanyl alkenyl, or
alkynyl moiety of the arylalkyl group is C1-10 and the aryl moiety is C6-20, and in
certain embodiments, an arylalkyl group is C7-20 arylalkyl, e.g., the alkanyl, alkenyl,
or alkynyl moiety of the arylalkyl group is C1-8 and the aryl moiety is C6-12. In certain
embodiments, arylalkyl is C7-16 arylalkyl or benzyl.
[0051] "Aryldialkylsilyr by itself or as part of another substituent refers to
the radical -SiR40'R41R42 where one of R40, R41, and R42 is aryl or substituted aryl as
defined herein and the other two of R40, R41, and R42 are alkyl or substituted alkyl, as
defined herein. In certain embodiments, an aryldialkylsilyl group is C7-14
aryldialkylsilyl.
[0052] "AUC" is the area under the plasma drug concentration-versus-time
curve extrapolated from zero time to infinity.
[0053] "Cmax" is the highest drug concentration observed in plasma following
an extravascular dose of drug.
[0054] "Carbamoyl" by itself or as part of another substituent refers to the
radical -C(O)NR43R44 where R43 and R44 are independently hydrogen, alkyl,
substituted alkyl, cycloalkyl, substituted cycloalkyl, aryl, or substituted aryl, as
defined herein.
[0055] "Carbamoyloxy" by itself or as part of another substituent refers to a
radical -OC^aNR4^46 where R45 and R46 are independently selected from
hydrogen, alkyl, cycloalkyl, cycloheteroalkyL aryl, arylalkyl, heteroalkyl, heteroaryl,
and heteroarylalkyl, which may be substituted, as defined herein, or R45 and R46
together with the atoms to which they are bonded form a cycloheteroalkyl or
heteroaryl ring.
[0056] "Cleave" refers to breakage of chemical bonds and is not limited to
chemical or enzymatic reactions or mechanisms unless clearly intended by the
context
[0057] "Compounds" refers to compounds encompassed by structural
Formulae (I) - (XIX) disclosed herein and includes any specific compounds within
these formulae whose structure is disclosed herein. Compounds may be identified
either by their chemical structure and/or chemical name. When the chemical structure
and chemical name conflict, the chemical structure is determinative of the identity of

the compound. The compounds described herein may contain one or more chiral
centers and/or double bonds and therefore, may exist as stereoisomers, such as
double-bond isomers, i.e., geometric isomers, enantiomers and diastereomers.
Accordingly, the chemical structures depicted herein encompass all possible
enantiomers and stereoisomers of the illustrated compounds including the
stereoisomerically pure form (e.g., geometrically pure, enantiomerically pure or
diastereomerically pure) and enantiomeric and other stereoisomeric mixtures.
Enantiomeric and stereoisomeric mixtures may be resolved into their component
enantiomers or stereoisomers using separation techniques or stereocontrolled
synthesis techniques well known to the skilled artisan. The compounds may also exist
in several tautomeric forms including the enol form, the keto form and mixtures
thereof Accordingly, the chemical structures depicted herein encompass all possible
tautomeric forms of the illustrated compounds. The compounds described also
include isotopically labeled compounds where one or more atoms have an atomic
mass different from the atomic mass found in nature. Examples of isotopes that may
be incorporated into the compounds disclosed herein include, but are not limited to,
2H, *EL, nC, ,3C, 14C, 15N, ,70,180, etc. Compounds may exist in unsolvated forms as
well as solvated forms, including hydrated forms and as N-oxides. In general,
compounds may be hydrated, solvated, or N-oxides. Certain compounds may exist in
multiple crystalline or amorphous forms. In general, all physical forms are equivalent
for the uses contemplated herein and are intended to be within the scope of the present
disclosure. Further, it should be understood, when partial structures of the
compounds are illustrated, an asterisk (*) indicates the point of attachment of the
partial structure to the rest of the molecule.
[0058] "Cycloalkoxycarbonyl" by itself or as part of another substituent refers
to a radical -C(O)OR47 where R47 represents an cycloalkyl or substituted cycloalkyl
group as defined herein. Examples of cycloalkoxycarbonyl groups include, but are
not limited to, cyclobutyloxycarbonyl, cyclohexyloxycarbonyl.
[0059] "Cycloalkyl" by itself or as part of another substituent refers to a
partially saturated or unsaturated cyclic alkyl radical. Where a specific level of
saturation is intended, the nomenclature "cycloalkanyl" or "cycloalkenyl" is used.
Examples of cycloalkyl groups include, but are not limited to, groups derived from
cyclopropane, cyclobutane, cyclopentane, cyclohexane. m certain embodiments, a

cycloalkyl group is C3.15 cycioalkyl, and in certain embodiments, C5.12 cycloalkyl. In
certain embodiments, a cycloalkyl group is C3-7 cycloalkyl or cyclohexyl.
[0060] "Cycloheteroalkyl" by itself or as part of another substituent refers to
a partially saturated or unsaturated cyclic alkyl radical in which one or more carbon
atoms (and any associated hydrogen atoms) are independently replaced with the same
or different heteroatom. Examples of heteroatoms to replace the carbon atom(s)
include, but are not limited to, N, P, O, S and Si. Where a specific level of saturation
is intended, the nomenclature "cycloheteroalkanyl" or "cycloheteroalkenyl" is used.
Examples of cycloheteroalkyl groups include, but are not limited to, groups derived
from epoxides, azirines, tbiiranes, irnidazolidine, morpholine, piperazine, piperidine,
pyrazolidine, pyrrolidine, quinuclidine.
[0061] "Dialkylamino" by itself or as part of another substituent refers to the
radical -NR^R49 where R48 and R49 are independently alkyl, substituted alkyl,
cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl,
arylalkyl, substituted arylalkyl, heteroalkyl, substituted heteroalkyl, heteroarylalkyl,
or substituted heteroarylalkyl, or R48 and R49 together with the nitrogen to which they
are attached form a cycloheteroalkyl or substituted cycloheteroalkyl ring. In certain
embodiments, a dialkylamino group is C1-3 dialkylamino.
[0062] "1-Haloalkyl carbamate" refers to an JV-1-haloalkoxycarbonyl
derivative of tranexamic acid as encompassed by compounds of Formula (II)
disclosed herein.
[0063] "Heteroalkyl" by itself or as part of another substituent refer to an alkyl
group in which one or more of the carbon atoms (and any associated hydrogen atoms)
are independently replaced with the same or different heteroatomic groups. Examples
of heteroatomic groups include, but are not limited to, -0-, -S-, -O-O-, -S-S-, -O-
S-, -NR50R51-, =N-N=, -N=N-, -N=N-NR52R53, -PR54-, -P(O)2~, -POR55-, -O-
P(O)2- -SO-, -SO2-, -SnR5^57- Where R50, R51, RS2, R53, R54, R55, R56, and R57 are
independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl,
substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted
cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted
heteroaryl, heteroarylalkyl, or substituted heteroarylalkyl. Where a specific level of
saturation is intended, the nomenclature "heteroalkanyl," "heteroalkenyl," or
"heteroalkynyl" is used.

[0064] "Heteroaryl" by itself or as part of another substituent refers to a
monovalent heteroaromatic radical derived by the removal of one hydrogen atom
from a single atom of a parent heteroaromatic ring system. Heteroaryl encompasses
multiple ring systems having at least one aromatic ring fused to at least one other ring,
which may be aromatic or non-aromatic in which at least one ring atom is a
heteroatom. Heteroaryl encompasses 5- to 7-membered aromatic, monocyclic rings
containing one or more, for example, from 1 to 4, or in certain embodiments, from 1
to 3, heteroatoms chosen from N, O, and S, with the remaining ring atoms being
carbon; and bicyclic heterocycloalkyl rings containing one or more, for example, from
1 to 4, or in certain embodiments, from 1 to 3, heteroatoms chosen from N, O, and S,
with the remaining ring atoms being carbon and wherein at least one heteroatom is
present in an aromatic ring. For example, heteroaryl includes a 5- to 7-membered
heterocycloalkyl, aromatic ring fused to a 5- to 7-membered cycloalkyl ring. For such
fused, bicyclic heteroaryl ring systems wherein only one of the rings contains one or
more heteroatoms, the point of attachment maybe at the heteroaromatic ring or the
cycloalkyl ring. In certain embodiments, when the total number of N, S, and O atoms
in the heteroaryl group exceeds one, the heteroatoms are not adjacent to one another.
In certain embodiments, the total number of N, S, and O atoms in the heteroaryl group
is not more than two. In certain embodiments, the total number of N, S, and O atoms
in the aromatic heterocycle is not more than one. Heteroaryl does not encompass or
overlap with aryl as defined herein.
[0065] Examples of heteroaryl groups include, but are not limited to, groups
derived from acridine, arsindole, carbazole, fl-carboline, chromane, chromene,
cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran,
isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole,
naphthyridine, oxadiazole, oxazole, perimidine, phenanttiridine, phenanthroline,
phenazine, phthalazine, pteridine, purine, pyran, pyrazine, pyrazole, pyridazine,
pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine,
quinoxaline, tetrazole, thiadiazole, thiazole, thiophene, triazole, xanthene. In certain
embodiments, a heteroaryl group is from 5- to 20-membered heteroaryl, and in certain
embodiments from 5- to 10-membered heteroaryl. In certain embodiments heteroaryl
groups are those derived from thiophene, pyrrole, benzothiophene, benzofuran,
indole, pyridine, quinoline, imidazole, oxazole, and pyrazine.

[0066] "Heteroarylalkyl" by itself or as part of another substituent refers to an
acyclic alkyl radical in which one of the hydrogen atoms bonded to a carbon atom,
typically a terminal or sp3 carbon atom, is replaced with a heteroaryl group. Where
specific alkyl moieties are intended, the nomenclature heteroarylalkanyl,
heteroarylalkenyl, or heteroarylalkynyl is used. In certain embodiments, a
heteroarylalkyl group is a 6- to 30-membered heteroarylalkyl, e.g., the alkanyl,
alkenyl, or alkynyl moiety of the heteroarylalkyl is 1- to 10-membered and the
heteroaryl moiety is a 5- to 20-membered heteroaryl, and in certain embodiments, 6-
to 20-membered heteroarylalkyl, e.g., the alkanyl, alkenyl, or alkynyl moiety of the
heteroarylalkyl is 1- to 8-membered and the heteroaryl moiety is a 5- to 12-membered
heteroaryl.
[0067] "Immediately preceding embodiments" means the embodiments
disclosed in the same paragraph.
[0068] "Parent aromatic ring system" refers to an unsaturated cyclic or
polycyclic ring system having a conjugated 7t electron system. Included within the
definition of "parent aromatic ring system" are fused ring systems in which one or
more of the rings are aromatic and one or more of the rings are saturated or
unsaturated, such as, fluorene, indane, indene, phenalene, etc. Examples of parent
aromatic ring systems include, but are not limited to, aceanthrylene, acenaphthylene,
acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene,
fluorene, hexacene, hexaphene, hexalene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene,
pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene,
pyranthrene, rubicene, triphenylene, trinaphthalene.
[0069] 'Tarent heteroaromatic ring system" refers to a parent aromatic ring
system in which one or more carbon atoms (and any associated hydrogen atoms) are
independently replaced with the same or different heteroatom. Examples of
heteroatoms to replace the carbon atoms include, but are not limited to, N, P, O, S, Si,
etc. Specifically included within the definition of "parent heteroaromatic ring
systems" are fused ring systems in which one or more of the rings are aromatic and
one or more of the rings are saturated or unsaturated, such as, arsindole, benzodioxan,
benzofuran, chromane, chromene, indole, indoline, xanthene, etc. Examples of parent
heteroaromatic ring systems include, but are not limited to, arsindole, carbazole,

P-carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole,
indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoqwnoline,
isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine,
phenanthridine, phenanihroline, phenazine, phthalazine, pteridine, puiine, pyran,
pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline,
quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole, thiophene,
triazole, xanthene.
[0070] 'Tatienf' includes mammals, such as for example, humans.
[0071] 'Tharmaceutical composition" refers to at least one compound and a
pharmaceutically acceptable vehicle, with which the compound is administered to a
patient.
[0072] "Pharmaceutically acceptable" refers to approved or approvable by a
regulatory agency of the Federal or a state government or listed in the U.S.
Pharmacopoeia or other generally recognized pharmacopoeia for use in animals,
including humans.
[0073] "Pharmaceutically acceptable salt" refers to a salt of a compound
which possesses the desired pharmacological activity of the parent compound. Such
salts include: (1) acid addition salts, formed with inorganic acids such as hydrochloric
acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, and the like; or
formed with organic acids such as acetic acid, propionic acid, hexanoic acid,
cyclopentanepropionic acid, glycolic acid, pyruvic acid, lactic acid, malonic acid,
succinic acid, malic acid, maleic acid, fumaric acid, tartaric acid, citric acid, benzoic
acid, 3-(4-hydroxybenzoyl) benzoic acid, cinnamic acid, mandelic acid,
methanesulfonic acid, ethanesulfonic acid, 1,2-ethane-disulfonic acid,
2-hydroxyethanesulfonic acid, benzenesulfonic acid, 4-chlorobenzenesulfonic acid,
2-naphthalenesulfonic acid, 4-toluenesulfonic acid, camphorsulfonic acid,
4-methylbicyclo[2.2.2]-oct-2-ene-l-carboxylic acid, glucoheptonic acid,
3-phenylpropionic acid, trimethylacetic acid, tertiary butylacetic acid, lauryl sulfuric
acid, gluconic acid, glutamic acid, hydroxynaphthoic acid, salicylic acid, stearic acid,
muconic acid, and the like; or (2) salts formed when an acidic proton present in the
parent compound is replaced by a metal ion, e.g, an alkali metal ion, an alkaline earth
ion, or an aluminum ion; or coordinates with an organic base such as ethanolamine,
diethanolarnine, triethanolamine, TV-me&ylglucamine and the like.

[0074] "Phannaceutically acceptable vehicle" refers to a phannaceutically
acceptable diluent, a phannaceutically acceptable adjuvant, a phannaceutically
acceptable excipient, a phannaceutically acceptable carrier, or a combination of any
of the foregoing with which a compound of the present disclosure may be
administered to a patient and which does not destroy the pharmacological activity
thereof and which is nontoxic when administered in doses sufficient to provide a
therapeutically effective amount of the compound.
[0075] "Preventing" or "prevention" refers to a reduction in risk of acquiring a
disease or disorder, i.e., causing at least one of the clinical symptoms of the disease
not to develop in a patient that may be exposed to or predisposed to the disease but
does not yet experience or display symptoms of the disease.
[0076] "Prodrug" refers to a derivative of a drug molecule that requires a
transformation within the body to release the active drug. Prodrugs can be, although
not necessarily, pharmacologically inactive until converted to the parent drug.
[0077] "Promoiety" refers to a form of protecting group that when used to
mask a functional group within a drug molecule converts the drug into a prodrug. For
example, the promoiety may be attached to the drug via bond(s) that are cleaved by
enzymatic or non-enzymatic means in vivo.
[0078] "Protecting group" refers to a grouping of atoms, which when attached
to a reactive group in a molecule masks, reduces, or prevents that reactivity.
Examples of protecting groups can be found in Green et al, "Protective Groups in
Organic Chemistry," (Wiley, 2nd ed. 1991) and Harrison et al, "Compendium of
Synthetic Organic Methods," Vols. 1-8 (John Wiley and Sons, 1971-1996). Examples
of amino protecting groups include, but are not limited to, formyl, acetyl,
trifluoroacetyl, benzyl, benzyloxycarbonyl (CBZ), tert-butoxycarbonyl (Boc),
trimethylsilyl (IMS), 2-trimethylsilyl-ethanesulfonyl (SES), trityl and substituted
trityl groups, allyloxycarbonyl, 9-fluorenylmethyloxycarbonyl (FMOC),
nitro-veratryloxycarbonyl (NVOC). Examples of hydroxy protecting groups include,
but are not limited to, those in which the hydroxy group is either acylated or alkylated
such as benzyl, and trityl ethers as well as alkyl ethers, tetrahydropyranyl ethers,
trialkylsilyl ethers, and allyl ethers.
[0079] "Solvate" refers to a molecular complex of a compound with one or
more solvent molecules in a stoichiometric or non-stoichiometric amount. Such
solvent molecules are those commonly used in the pharmaceutical art, which are

known to be innocuous to the recipient, e.g., water, ethanol, and the like. A molecular
complex of a compound or moiety of a compound and a solvent can be stabilized by
non-covalent intra-molecular forces such as, electrostatic forces, van der Waals
forces, or hydrogen bonds. The term' ihydrate" refers to a complex where the one or
more solvent molecules are water including monohydrates and hemi-hydrates.
[0080] "Substantially one enantiomer" refers to a compound containing 1 or
more stereogenic centers such mat the enantiomeric excess (e.e.) of the compound is
at least about 90%, in certain embodiments greater than about 95%, in certain
embodiments greater than about 98%, and in certain embodiments greater than about
99%.
[0081 ] "Substituted" refers to a group in which one or more hydrogen atoms
are independently replaced with the same or different substituent(s). Example of
substituents include, but are not limited to, -M, -R60, -O" (-OH), =0, -OR60, -SR60, -
S' (-SH), =S, -NR^R61, =NR60, -CF3, r-CN, -OCN, -SCN, -NO, -N02, =N2) -N3, -
S(O)20", -S(O)2OH, -S^R60, -OS(02)0", -OSCOfcR.", -P(O)(0")2, -
PCOXOR^XO"), -OPCOXOR^OR61), -CiOyR.60, -C(S)R60, -C^OR60, -
CCOJNR^R61, -C(O)0_, -C(S)OR60, -NRfi2C(OJNR60Rw, -NR62C(S)NR60R61, -
NR^CCNR^NR6^61 and -CCNR^NR^R61 where M is a halogen; R60, R61, R62, and
R63
are independently selected from hydrogen, alkyl, substituted alkyl, alkoxy,
substituted alkoxy, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted
cycloheteroalkyl, aryl, substituted aryl, heterdaryl, and substituted heteroaryl, or when
bonded to a nitrogen atom, R60 and R61 together with the nitrogen atom to which they
are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring; and R62 and
R63 are independently selected from hydrogen, alkyl, substituted alkyl, aryl,
cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl,
aryl, substituted aryl, heteroaryl, and substituted heteroaryl, or when bonded to a
nitrogen atom, R62 and R63 together with the nitrogen atom to which they are bonded
form a cycloheteroalkyl or substituted cycloheteroalkyl ring. In certain embodiments,
substituents include -M, -R60, =0, -OR60, -SR60, -S", ?=S, -NR^R61, =NR60, -CF3, -
CN, -OCN, -SCN, -NO, -N02, =N2, -N3, -SCO)^60, -OS(02)0', -OS(O)2R60, -
P(O)((r)2, -PCOXOR^XO-), -OP(O)(OR60)(OR61), -C^R60, -C(S)R60, -C^OR60,
-C^NR6^61, -C(O)0", and -NR62C(D)NR60R61, where R60, R61, and R62 are as
defined above. In other embodiments, substituents may be chosen from -M, -R60,
=0, -OR60, -SR60, -NRV1, -CF3, -CN, -N02, -S^R60, -P(O)(OR60)(O"), -

OPCOXOR^COR61), -aCQR60, -qOpR60, -CCONR^R61, -€(O)0-, where R60 and
Rfil are as defined above. In yet other embodiments, substituents include -M, -R60,
=0, -OR60, -SR60, -NR6^61, -CF3, -CN, -NO2, SiP^R.60, -OP^XOR^XOR61), -
C^R60, -CCOPR60, and -C(O)0", where R60 and R61 are as defined above. In
certain embodiments, each substituent is independently selected from C1-3 alkyl, -OH,
-NH2,-SH, C1-3 alkoxy, C1-3 acyl, C1-3 tbioalkyl, C1-3 alkoxycarbonyl, C1-3
alkylamino, and C1-3 dialkylamino, as defined herein.
[0082] "Sulfonamido" by itself or as part of anouier substituent refers to a
radical -NR65S(O)2R66, where R65 is alkyl, substituted alkyl, cycloalkyl,
cycloheteroalkyl, aryl, substituted aryl, arylalkyl, heteroalkyl, heteroaryl, or
heteroarylalkyl, and R66 is hydrogen, alkyl, cycloalkyl, cycloheteroalkyl, aryl,
arylalkyl, heteroalkyl, heteroaryl, or heteroarylalkyl, which may be substituted, as
defined herein. Examples of sulfonamido groups include, but are not limited to,
methanesulfonamido, benzenesulfonamido, and p-toluenesulfonamido.
[0083] "Tbioalkyl" by itself or as part of another substituent refers to a radical
-SR67 where R67 is alkyl or substituted alkyl, as defined herein. In certain
embodiments, a tbioalkyl group is C1-3 tbioalkyl.
[0084] "Treating" or "treatment" of any disease or disorder refers to arresting
or ameliorating a disease, disorder, or at least one of the clinical symptoms of a
disease or disorder, reducing the risk of acquiring a disease, disorder, or at least one of
the clinical symptoms of a disease or disorder, reducing the development of a disease,
disorder or at least one of the clinical symptoms of the disease or disorder, or reducing
the risk of developing a disease or disorder or at least one of the clinical symptoms of
a disease or disorder. "Treating" or "treatment" also refers to inhibiting the disease or
disorder, either physically, (e.g., stabilization of a discernible symptom),
physiologically, (e.g., stabilization of a physical parameter), or both, and to inhibiting
. at least one physical parameter which may or may not be discernible to the patient. In
certain embodiments, "treating" or "treatment" refers to delaylng the onset of the
disease or disorder or at least one or more symptoms thereof in a patient which may
be exposed to or predisposed to a disease or disorder even though that patient does not
yet experience or display symptoms of the disease or disorder.
[0085] "Therapeutically effective amount" refers to the amount of a
compound that, when administered to a subject for treating a disease or disorder, or at
least one of the clinical symptoms of a disease or disorder, is sufficient to affect such

treatment of the disease, disorder, or symptom. The "therapeutically effective
amount" may vary depending, for example, on the compound, the disease, disorder,
and/or symptoms of the disease or disorder, severity of the disease, disorder, and/or
symptoms of the disease or disorder, the age, weight, and/or health of the patient to be
treated, and the judgment of the prescribing physician. An appropriate amount in any
given instance may be readily ascertained by those skilled in the art or capable of
determination by routine experimentation.
[0086] "Trialkylsilyl" by itself or as part of another substituent refers to a
radical
-SiR^R6^70 where R68, R69, and R70 are independently selected from alkyl and
substituted alkyl, as defined herein. In certain embodiments, a trialkylsilyl group is
C3-12 trialkylsilyl.
[0087] Reference is now be made in detail to embodiments of the present
disclosure. While certain embodiments of the present disclosure are described, it will
be understood that it is not intended to limit the embodiments of the present disclosure
to the disclosed embodiments. To the contrary, reference to embodiments of the
present disclosure is intended to cover alternatives, modifications, and equivalents as
may be included within the spirit and scope of the embodiments of the present
disclosure as defined by the appended claims.
Compounds
[0088] Certain embodiments of the present disclosure provide a compound of
Formula (I)"

a pharmaceutically acceptable salt thereof, or solvate of any of the foregoing,
wherein:

R1 is selected from acyl, substituted acyl, alkyL substituted alkyl, aryl,
substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl,
cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl,
heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl;
R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl,
alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl,
substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted
cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl,
heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon
atom to which they are bonded form a cycloalkyl, substituted cycloalkyl,
cycloheteroalkyl, or substituted cycloheteroalkyl ring; and
R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl,
cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl,
heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl,
substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl.
[0089] In certain embodiments of a compound of Formula (I), the compound,
which when administered in the intestinal lumen of a patient is absorbed to a
sufficient extent so as to achieve a bioavailability of *ra/w-4-(aminomethyl)-
cyclohexanecarboxylic acid at least 2-fold greater than the bioavailability of trans-4-
(aminomethyl)-cyclohexanecarboxyUc acid achieved when trans-4-(ammomethyl)-
cyclohexanecarboxylic acid itself is administered in the intestinal lumen of the
patient.
[0090] In certain embodiments of a compound of Formula (I), R1 is selected
from Ci.6 alkyl, substituted CM alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7 cycloalkyl,
substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl. In certain
of the immediately preceding embodiments, the substituent group of Rl is selected
from at least one of C1-3 alkyl, -OH, -NH2> -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl,
C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[0091] In certain embodiments of a compound of Formula (I), R1 is selected
from CM alkyl, substituted CM alkyl, phenyl, substituted phenyl, cyclohexyl, and
substituted cyclohexyl. In certain of the immediately preceding embodiments, each
substituent group of R1 is independently selected from at least one of C1-3 alkyl, -OH,

-NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3
alkylamino, and C1-3 dialkylamino.
[0092] In certain embodiments of a compound of Formula (I), each
substituent group of R1 is independently selected from at least one of Cu alkyl, -OH,
-NH2, -SH, C1-3 alkoxy, C(.3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3
alkylamino, and C1-3 dialkylamino.
[0093] la certain embodiments of a compound of Formula (I), Rl is selected
from methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, tert-butyl,
phenyl, o-tolyl, and cyclohexyl.
[0094] In certain embodiments of a compound of Formula (I), R4 is selected
from hydrogen, CM alkyl, substituted C\^ alkyl, C3-7 cycloalkyl, substituted C3-7
cycloalkyl, C^io aryl. substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl,
C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl. In certain of the immediately preceding
embodiments, each substituent group of R4 is independently selected from at least one
of C1-3 alkyl, -OH, -NH2, -SH, Q-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3
alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[0095] In certain embodiments of a compound of Formula (I), R4 is selected
from hydrogen, methyl, ethyl, terf-butyl, allyl, benzyl, 4-methoxybenzyl,
diphenylmethyl, triphenylmethyl, trimethylsilyl, triethylsilyl, triisopropylsilyl,
tert-butyldimethylsilyl, and phenyldimethylsilyl.
[0096] In certain embodiments of a compound of Formula (I), R4 is selected
from hydrogen, allyl, benzyl, and trimethylsilyl.
[0097] In certain embodiments of a compound of Formula (I), R4 is hydrogen.
[0098] In certain embodiments of a compound of Formula (I), R2 and R3 are
independently selected from hydrogen, Ci.6 alkyl, substituted Ci^ alkyl, C6-10 aryl,
substituted C6.10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl. In certain of the
immediately preceding embodiments, each substituent group of R2 and/or R3 is
independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy,
C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[0099] In certain embodiments of a compound of Formula (I), R2 and R3 are
independently selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and
cyclohexyl.
[00100] In certain embodiments of a compound of Formula (I), R2 is hydrogen,
and R is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and

cyclohexyl. In certain embodiments of a compound of Formula (£), R2 is hydrogen,
and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl.
[00101] In certain embodiments of a compound of Formula (I), R1 is selected
from C1-6 alkyl, substituted Cu alkyl, Cwo aryl, substituted Cwo aryl, C3-7 cycloalkyl,
substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-i6 substituted arylalkyl, and R2 and
R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10
aryl, substituted C6.10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl. In certain
of the immediately preceding embodiments, each substituent group of R1 is
independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy,
C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[00102] In certain embodiments of a compound of Formula (I), R1 is selected
from methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, terf-butyl,
phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, and R3 is selected from hydrogen,
methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl. In certain embodiments of
a compound of Formula (I), R1 is selected from methyl, ethyl, n-propyl, isopropyl, n-
butyl, isobutyl, sec-butyl, fert-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen,
and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl.
[00103] In certain embodiments of a compound of Formula (T), R4 is hydrogen.
[00104] In certain embodiments of a compound of Formula (T), each of R2 and
R3 is other than hydrogen. When each of R2 and R3 is hydrogen, a metabolite of
certain acyloxyalkylcarbamate promoieties may be formaldehyde. In some
embodiments for methods of treatment comprising administering large amounts of a
compound of Formula (I) it may be desireable that the amount of toxic metabolites of
the promoiety such as formaldehyde be minimized or eliminated.
[00105] In certain embodiments of a compound of Formula (I), the compound
is selected from:
trans-4- {[(2-Methylpropanoyloxy)methoxycarbonyl]aminomethyl} -
cyclohexanecarboxylic acid;
rrflfty-4-{[(2,2-Dimethylpropanoyloxy)methoxycarbonyl]-
aminomethyl} -cyclohexanecarboxylic acid;
franj-4-{[(3-Memylbutanoyloxy)memoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
franj-4-{[(Benzoyloxy)memoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;

/ranjr^{[l-(2-Methylpropanoyloxy)ethoxycarbonyl]amuiomethyl}-
cyclohexanecarboxylic acid;
fran5^{[l-(2-Methylpropanoyloxy)propoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
fnww-4-{[l-(2-Methylpropanoyloxy)-2-
methylpropoxycaibonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4- {[ l-(B6DZoyloxy)-2-methylpropoxycarbonyl]aminoinethyl} -
cyclohexanecaiboxylic acid;
/raiw-4-{[l-(Cyclohexylcaibonyloxy)-2-
methylpropoxycarbonyl]aminomethyl} cyclohexanecarboxylic acid;
/rans^{[l-(PentaQoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
^a/w^{[l-(Propanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
fra/w^{[l^utanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
/ra?w^{[l-(Pentanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
/ra7u-4-{[l-(3-Mediylbutanoyloxy)edioxycarbonyl]aminoniethyl}-
cyclohexanecarboxylic acid;
rra/w-4-{[l-(2,2-
Dimethylpropanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic
acid;
fra«^-{[l-(Cyclohexylcarbonyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
/rfl7W^{[l-(Benzoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
rra7w^{[l-(2-Methylbenzoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4- {[ 1 -(Butanoyloxy)butoxycarbonyl]aminomethyl} -
cyclohexanecarboxylic acid;
trans-4- {[1 -(2-Methylprppanoyloxy)butoxycarbonyl] aminomethyl} -
cyclohexanecarboxylic acid;

fra«5^{[H3-Metiiyltfutano3^oxy)butoxycaibonyl]aininometbyl}-
cyclohexanecarboxylic acid;
/raw-4-{[l-(2^-
Dimethylpiopanoyloxy)butoxyx:arbonyl]aiiunomethyl}-cyclohexanecarboxylic
acid;
/rfln5^{[l^en2oyloxy)butoxycaibonyl]aminomethyl}-
cyclohexanecarboxylic acid;
fran*^{[l-(Propanoylpxy)propoxycarbonyl]ammometliyl}-
cyclohexanecarboxylic acid;
fraw-^{[l-(Butanoyloxy)propoxycaibonyl]anaiiiomethyl}-
cyclohexanecarboxylic acid;
/rfl/w-4-{[l-(2,2-
Dimethylpropanoyloxy)propoxycaibonyl]atninomethyl}-
cyclohexanecarboxylic acid;
frfl/w^{[l-(Benzoyloxy)propoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
/ranj,-4-{[l-(Butanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4- {[l-(Butanoyloxy)-l-
cyclohexylmethoxycarbonyljaminomethyl} -cyclohexanecarboxylic acid;
/ra/w-4-{[l-(2-Methylpropanoyloxy)-l-
cyclohexylmethoxycarbonyl]aminometb.yl}-cyclohexanecarboxylic acid;
trans-4- {[l-(Acetoxy)butoxycarbonyl]aininomethyl} -
cyclohexanecarboxylic acid;
/raas-4-{[l-(Propanoyloxy)butoxycarbonyl3aminom6thyl}-
cyclobexanecarboxylic acid;
/ra7w^{[l-(Acetoxy)-2-methylpropoxycarbonyl]arninomethyl}-
cyclobexanecarboxylic acid;
trans-4- {[1 -(3-Methylbutanoyloxy)-2-
methylpropoxycarbonyl]aminornethyl}-cyclohexanecarboxylic acid;
trans-4- {[ 1 -(2,2-Dimethylpropanoyloxy)-2-
methylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
/ra7w^{[l-(Acetoxy)ellioxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid; and

frfl7ts-4-{[l-(Propanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
including pharmaceutically acceptable salts thereof and pharmaceutically acceptable
solvates of any of the foregoing.
[00106] Certain embodiments of the present disclosure provide a compound of
Formula (II):

a pharmaceutically acceptable salt thereof, or solvate of any of the foregoing,
wherein:
X is selected from fluoro, chloro, bromo, and R20SO3- wherein R20 is selected
from C1-6 alkyl, C5-7 aryl, and substituted C5-7 aryl; and
R2 and R3 are independently selected from hydrogen, alkyl, substituted alkyl,
alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl,
substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted
cycloalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl,
heteroarylalkyl, and substituted heteroarylalkyl, or R2 and R3 together with the carbon
atom to which they are bonded form a cycloalkyl, substituted cycloalkyl,
cycloheteroalkyl, or substituted cycloheteroalkyl ring; and
R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl,
cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl,
heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl,
substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl.
[00107] In certain embodiments of a compound of Formula (II), at least one of
R2, R3, and R4 is substituted with a substituent group selected from at least one of Cu
alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, Ct_3 thioalkyl, C1-3 alkoxycarbonyl, Ci_
3 alkylamino, and C1-3 dialkylamino.
[00108] In certain embodiments of a compound of Formula (II), X is chloro.

[00109] In certain embodiments of a compound of Formula (IT), R4 is selected
from hydrogen, C1-6 alkyl, substituted CM alkyl, C3-7 cycloalkyl, substituted C3-7
cycloalkyl, C,s-io aryl, substituted C5.10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl,
C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl. In certain of the immediately preceding
embodiments, each substituent group of R4 is independently selected from at least one
of d-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyL C1-3 thioalkyl, C1-3
alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[00110] In certain embodiments of a compound of Formula (XT), R4 is selected
from hydrogen, methyl, ethyl, tert-butyl, allyl, benzyl, 4-methoxybenzyl,
diphenylmethyl, triphenylmethyl, trimethylsilyl, triethylsilyL triisopropylsilyl,
fert-butyldimethylsilyl, and phenyldimethylsilyl.
[00111] In certain embodiments of a compound of Formula (H), R4 is selected
from hydrogen, allyl, benzyl, and trimethylsilyl.
[00112] In certain embodiments of a compound of Formula (II), R4 is
hydrogen.
[00113] In certain embodiments of a compound of Formula (II), R2 and R3 are
independently selected from hydrogen, Ci^ alkyl, substituted Q-e alkyl, C6-10 aryl,
substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl. In certain of the
immediately preceding embodiments, each substituent group of R2 and/or R3 is
independently selected from at least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy,
C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[00114] In certain embodiments of a compound of Formula (II), R2 and R3 are
independently selected from hydrogen, methyl, ethyl, M-propyl, isopropyl, phenyl, and
cyclohexyl.
[00115] In certain embodiments of a compound of Formula (H), R2 is
hydrogen, and R3 is selected from hydrogen, methyL ethyl, 7j-propyl, isopropyl,
phenyl, and cyclohexyl.
[00116] In certain embodiments of a compound of Formula (II), R2 and R3 are
independently selected from hydrogen, Ci^ alkyL substituted C^ alkyl C6.10 aryl,
substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, and R4 is
selected from hydrogen, Q-6 alkyL substituted Ci^ alkyl, C3-7 cycloalkyl, substituted
C3-7 cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16
arylalkyl, C3-12 trialkylsilyl, and C7-14 aryldialkylsilyl. In certain of the immediately
preceding embodiments, each substituent group of R2 and/or R3 is independently

selected from at least one of C1-3 alkyl, -OH, -NH2, -SH» C1-3 alkoxy, C1-3 acyl, C1-3
thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[00117] In certain embodiments of a compound of Formula (H), R2 is
hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl,
and cyclohexyl, and R4 is hydrogen.
[00118] In certain embodiments of a compound of Formula (II), X is chloro, R2
is hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl,
and cyclohexyl, and R4 is hydrogen.
[00119] Compounds of Formula (II) are useful intermediates in the synthesis of
compounds of Formula (I) as described below.
Synthesis
[00120] Compounds of the present disclosure may be obtained via the synthetic
methods illustrated in Schemes 1-9. Those of ordinary skill in the art will appreciate
that a synthetic route to the disclosed compounds consists of attaching promoieties to
tranexamic acid.
[00121] A variety of methods for synthesis of acyloxyalkyl carbamate
derivatives of amines are known in the art (for example, see Alexander et ah, U.S.
Patent No. 4,426,391; Alexander, U.S. Patent No. 4,760,057; Lund, U.S. Patent No.
5,401,868; Saari etah, European Patent No. 0416689B1; Mulvihill et ah, Tetrahedron
LeU., 2001,7751-7754; Sxmetah, Bioorg. Med. Chem. Lett., 2001,11,1875-1879;
Sun et ah, Bioorg. Med. Chem. Lett., 2001,11,3055-3059;'Chen et ah, International
Publication No. WO 01/05813; Mulvihill et ah, Synthesis, 2002,3, 365-370; Gallop et
ah, U.S. Patent No. 6,927,036; Raillard et ah, U.S. Patent Application Publication No.
2004/0014940; Bhat et ah, U.S. Patent Application Publication No. 2005/0070715;
Gallop et ah, U.S. Patent Application Publication No. 2005/0222431).
[00122] General synthetic methods useful in the synthesis of the compounds
described herein are available in the art (e.g., Green et ah, "Protective Groups in
Organic Chemistry," (Wiley, 2nd ed. 1991); Harrison et ah, "Compendium of
Synthetic Organic Methods," Vols. 1-8 (John Wiley and Sons, 1971-1996; Larock,
"Comprehensive Organic Transformations," VCH Publishers, 1989; andPaquette,
"Encyclopedia of Reagents for Organic Synthesis," John Wiley & Sons, 1995).
[00123] Accordingly, starting materials useful for preparing compounds and
intermediates thereof, and/or for practicing methods described herein are

commercially available or may be prepared by well-known synthetic methods. Other
methods for synthesis of the prodrugs of the present disclosure are either described in
the art or will be readily apparent to the skilled artisan in view of the references
provided above and may be used to synthesize the compounds described herein.
Accordingly, the methods presented in the Schemes herein are illustrative rather than
comprehensive.
[00124] Intermediate (V), useful in the preparation of 1-haloalkyl carbamates
of Formula (DQ, may be generated according to the reactions detailed in Scheme 1:

[00125] The amino group of tranexamic acid is protected under standard
conditions with a protecting group (Pg) to afford compound (VII). The carboxylic
acid moiety of compound (VII) is esterified to yleld compound (Vm), either via
alkylation or silylation wiui R4-X, where X is selected from fiuoro, chloro, bromo,
iodo, and R20SO3- wherein R20 is selected from Q-6 alkyl, C5.7 aryl, and substituted
C5.7 aryl, or any other suitable leaving group, or via condensation with alcohol R4-OH

under standard acylation conditions (e.g., in the presence of a coupling agent such as a
carbodiimide, via an acyl halide, acid anhydride, or other activated ester
intermediate). Removal of the protecting group from compound (Vlll) under
standard deprotection conditions affords compound (V).
[00126] In certain embodiments, a compound of Formula (H) is prepared by
acylation of compound (V) with compound (IX) (see Scheme 2), where X is a halide
and Z is a leaving group (e.g, halide, jp-nitrophenolate, imidazolyl, etc.). In certain
embodiments, X is F, CI, Br, or L In some of these embodiments, Z is CI. In certain
embodiments, X and Z are each CI. The acylation reaction may be performed in the
presence of an inorganic base or an organic base (e.g, tertiary amine bases, such as
triethylamine, tributylamine, diisopropylethylamine, dimemylisopropylamine,
JV-methylmorpholine, iV-methylpyrrolidine, JV-methylpiperidine, pyridine,
2-methylpyridine, 2,6-dimemylpyridine, 4-dimemylaminopyridine, 1,
4-diazabicyclo[2.2.2]octane, 1, 8-diazabicyclo[5.4.0]undec-7-ene or
l,5-diazabicyclo[4.3.0]undec-7-ene), and combinations of any of the foregoing.
Suitable solvents for acylation include, but are not limited to, dichloromethane,
dichloroethane, chloroform, toluene, dimethylformamide, dimethylacetamide,
i^-methylpyrrolidinone, dimethyl sulfoxide, pyridine, ethyl acetate, isopropyl acetate,
acetonitrile, acetone, 2-butanone, methyl /erf-butyl ether, and combinations of any of
the foregoing. Alternatively, biphasic solvent mixtures comprising water and
including one or more of dichloromethane, dichloroethane, chloroform, toluene, ethyl
acetate, isopropyl acetate, or methyl tert-butyl ether, can be utilized. Temperatures
for performing the reaction of Scheme 2 can range from about -20 °C to about 50 °C,
and in certain embodiments can range from about -20 °C to about 25 °C.

[00127] In certain embodiments, a compound of Formula (IT), where R4 is
triaikylsilyl or aryldialkylsilyl, can be prepared directly from tranexamic acid by

silylation (e.g., using a silyl halide or silylamide reagent) followed by acylation of the
resulting intermediate with compound (EX) (see Scheme 3). Suitable solvents for
performing mis reaction include, but are not limited to, dichloromethane,
dichloroethane, chloroform, toluene, pyridine, acetonitrile, and combinations of any
of the foregoing. Suitable bases for performing this reaction include but are not
limited to, triethylamine, tributylamine, diisopropylethylamine,
dimethylisopropylamine, //-methylmorpholine, i^-methylpyrrolidine,
iV-methylpiperidine, pyridine, 2-methylpyridine, 2,6-dimethylpyridine,
4-dimethylaminopyridine, l,4-diazabicyclo[2.2J2]octane, 1,
8-diazabicyclo[5.4.0]undec-7-ene, l,5-diazabicyclo[4.3.0]undec-7-ene, and
combinations of any of the foregoing. Temperatures for performing the reaction of
Scheme 3 can range from about -78 °C to about 50 °C, and in certain embodiments
can range from about -20 °C to about 25 °C.

[00128] In certain embodiments, iV-1-acyloxylalkyl carbamates of Formula (I)
can be prepared from compounds of Formula (EQ by treatment with carboxylic acids
of Formula (Ed) in the presence of an organic or inorganic base, or other metal salt, as
illustrated in Scheme 4.
Scheme 4

In certain embodiments of a compound of Formula (II) in the method of Scheme 4, X
is selected from fluoro, chloro, bromo, and R20SQr- wherein R20 is selected from Ci.6
alkyl, C5.7 aryl, and substituted C5.7 aryL In certain embodiments of compounds of
Formulae (I) and (EH) in the method of Scheme 4, R1 is selected from acyl,
substituted acyl, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted
arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted
cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted
heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl. In certain embodiments
of compounds of Formulae (I) and (U) in the method of Scheme 4, R2 and R3 are
independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl,
substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl,
carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl,
substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and
substituted heteroarylalkyl, or R2 and R3 together with the carbon atom to which they
are bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted
cycloheteroalkyl ring. In certain embodiments of compounds of Formulae (I) and (II)
in the method of Scheme 4, R4 is selected from hydrogen, alkyl, substituted alkyl,
aryl, substituted aryl, arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted
aryldialkylsilyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted
cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted
heteroaryl, heteroarylalkyl, substituted heteroarylalkyl, trialkylsilyl, and substituted
trialkylsilyl. In certain of the immediately preceding embodiments, each substituent
group of R1, R2, R3, and/or R4 is independently selected from at least one of C1-3 alkyl,
-OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3
alkylamino, and C1-3 dialkylamino.
[00129] In certain embodiments of compounds of Formulae (I), (II), and (III)
in the method of Scheme 4, X is chloro, R1 is selected from methyl, ethyl, «-propyl,

isopropyl, n-butyl, isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyL and cyclohexyl, R2
is hydrogen, R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl,
and cyclohexyl, and R4 is hydrogen.
[00130] In certain embodiments of the method of Scheme 4, the ratio of a
compound of Formula (H) to a compound of Formula (HI) can range from about 1:1
to about 1:20. In certain embodiments, the ratio of a compound of Formula (II) to a
compound of Formula (ill) can range from about 1:1 to about 1:5. In certain
embodiments, the ratio of a compound of Formula (II) to a compound of Formula
(HI) is about 1:1.
[00131] In certain embodiments of the method of Scheme 4, compounds of
Formulae (II) and (HI) and a metal salt are contacted with a solvent. In certain
embodiments in which a compound of Formula (I), a compound of Formula (H) and a
metal salt are contacted with a solvent, the ratio of a compound of Formula (II) to a
compound of Formula (HI) can range from about 1:1 to about 1:20, in certain
embodiments, from about 1:1 to about 1:5, and in certain embodiments, the ratio of a
compound of Formula (II) to a compound of Formula (HI) is about 1:1. In certain
embodiments, the solvent can be dichloromethane, dichloroethane, chloroform,
toluene, dimethylformamide, dimethylacetamide, AT-methylpyrrolidinone, dimethyl
sulfoxide, pyridine, ethyl acetate, acetonitrile, acetone, 2-butanone, methyl tert-butyl
ether, methanol, ethanol, isopropanol, tert-butanol, water, hexamethylphosphoramide,
and combinations of any of the foregoing. In certain embodiments, the metal salt can
be a salt of Ag, Hg, Na, K, Li, Cs, Ca, Mg, Zn, and combinations of any of the
foregoing.
[00132] In certain embodiments of the method of Scheme 4, compounds of
Formulae (II) and (IDT) and an organic base are contacted with a solvent. In certain
embodiments in which a compound of Formula (II), a compound of Formula (HI) and
an organic base are contacted with a solvent, the ratio of a compound of Formula (H)
to a compound of Formula (HI) can range from about 1:1 to about 1:20, in certain
embodiments, from about 1:15 to about 1:20, and in certain embodiments, can range
from about 1:1 to about 1:5. In certain embodiments in which a compound of
Formula (H), a compound of Formula (HI) and an organic base are contacted with a
solvent, the ratio of a compound of Formula (II) to a compound of Formula (HI) is
about 1:1, and in certain embodiments, is about 1:10. In some embodiments, the
solvent can be dichloromethane, dichloroethane, chloroform, toluene,

dimethylfonnamide, dimethylacetamide, ivnnemylpyrroudinone, dimethyl sulfoxide,
pyridine, ethyl acetate, acetonitrile, acetone, 2-butanone, methyl tert-butyl ether,
methanol, ethanol, isopropanol, tert-butanol, water, hexamethylphosphoramide, and
combinations of any of the foregoing. In certain embodiments, the organic base can
be triethylamine, tributylamine, diisopropylethylamine, dimethylisopropylamine,
iNT-memylmorpholine, iV-methylpyrrolidine, W-memylpiperidine, pyridine,
2-methylpyridine, 2,6-dimetb.ylpyridine, 4-a^emylatninopyridine,
l,4-diazabicyclo[2.2.2]octane, l,8-diazabicyclo[5.4.0]undec-7-ene,
l,5-diazabicyclo[4.3.0]undec-7-ene, and combinations of any of the foregoing.
[00133] In some embodiments of the method of Scheme 4, a compound of
Formula (ID) is a liquid under the conditions of contacting with a compound of
Formula (II), and the compound of Formula (HI) further serves as a solvent for the
reaction with a compound of Formula (H). m certain embodiments, a compound of
Formula (IB) can be acetic acid, methoxyacetic acid, ethoxyacetic acid, propionic
acid, butyric acid, isobutyric acid, pivalic acid, valeric acid, isovaleric acid,
2-methylbutyric acid, cyclobutanecarboxylic acid, cyclopentanecarboxylic acid, or
cyclohexanecarboxylic acid.
[00134] In some embodiments of the method of Scheme 4, a compound of
Formula (H), a compound of Formula (HI), and a metal salt can be contacted at a
temperature ranging from about -25 °C to about 120 °C. In certain embodiments, the
temperature can range from about 0 °C to about 25 °C.
[00135] In certain other embodiments of the method of Scheme 4, a compound
of Formula (H), a compound of Formula (HI), and#an organic base can be contacted
at a temperature ranging from about -25 °C to about 120 °C. In certain embodiments,
the temperature can range from about 0 °C to about 25 °C.
[00136] In some embodiments of the method of Scheme 4, a compound of
Formula (II), a compound of Formula (Til), and an organic base can be contacted
with a catalytic amount of an iodide salt. In certain embodiments, the iodide salt can
be sodium iodide, potassium iodide, tetramethylammonium iodide,
tetraethylammonium iodide, or tetrabutylammonium iodide.
[00137] In some embodiments of the method of Scheme 4, R4 can be a
carboxylic acid protecting group that can be removed under mild conditions to
provide a compound of Formula (I) where R4 is hydrogen. Carboxylic acid protecting

groups removable via mild acidic hydrolysis, fluoride ion-promoted hydrolysis,
catalytic hydrogenolysis, transfer hydrogenolysis, or other transition metal-mediated
deprotection reactions can be used. In some embodiments, R4 can be trimethylsilyl,
allyl, or benzyl.
[00138] In certain embodiments, a compound of Formula (I) can be prepared as
illustrated in Scheme 5.

[00139] Chloroformate (X) is treated with an aromatic leaving group such as
p-nitrophenol in the presence of base to provide/i-nitrophenylcarbonate (XI). Halide
interchange provides iodide (Xn), which is reacted with a metal or
tetraalkylammonium salt of a carboxylic acid to afford compound (XUI). Treatment
of (XEQ) with tranexamic acid derivative (V), optionally in the presence of
trimethylsilyl chloride, affords a compound of Formula (I). Methods for making
related acyloxyalkyl carbamate compounds are described in the art (e.g., Alexander,
U.S. Patent No. 4,760,057; Alexander, U.S. Patent No. 4,916,230; Alexander, U.S.
Patent No. 5,466,811; Alexander, U.S. Patent No. 5,684,018).
[00140] Another method for synthesis of compounds of Formula (I) proceeds
via carbonylation of tranexamic acid derivative (V) to an intermediate carbamic acid
species, which is captured by an in situ alkylation reaction in an adaptation of
methods disclosed in the art (Butcher, Synlett, 1994, 825-6; Ferres et al., U.S. Patent

4,036,829). Carbon dioxide gas is bubbled into a solution containing tranexamic acid
derivative (V) and a base (e.g., CS2CQ3, Ag2C03, or AgO) in a solvent such as DMF
or NMP. An activated halide is added, optionally, in the presence of iodide ion as a
catalyst, and the carbonylation continued until the reaction is completed. This method
is illustrated in Scheme 6 for the preparation of a compound of Formula (I) from
halide (XIV).

[00141] Yet another method for synthesis of a compound of Formula upon oxidation of ketocarbamate derivatives of tranexamic acid (e.g., Gallop et al,
U.S. Patent No. 6,927,036; and Bhat et al, U.S. Application Publication No.
2005/0070715). As illustrated in Scheme 7, oxidation of ketocarbamate (XV) affords
a compound of Formula (I). Methods for synthesis of a compound of Formula (XV)
are disclosed in U.S. Patent No. 6,927,036 and U.S. Application Publication No.
2005/0070715. Examples of oxidants useful in the method of Scheme 6 include those
successfully used in Baeyer-Villager oxidations of ketones to esters or lactones
(Strukul, Angew. Chem. Int. Ed., 1998,37,1198; Renz., Eur. J. Org. Chem., 1999, 4,
737-50; Beller et al, in "Transition Metals in Organic Synthesis" Chapter 2, Wiley
VCH; Stewart, Current Organic Chemistry, 1998,2, 195; Kayser et al, Synlett, 1999,
153). The use of anhydrous oxidants can be beneficial since prodrugs of Formula (I)
may be labile. Thus, performing the oxidation under anhydrous reaction conditions
can avoid hydrolysis of the reactive products.
Scheme 7

In certain embodiments of compounds of Formulae (I) and (XV) in the method of
Scheme 7, R1 is selected from acyl, substituted acyl, alkyl, substituted alkyl, aryl,
substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl,
cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl,
heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl. In
certain embodiments of compounds of Formulae (I) and (XV), R2 and R3 are
independently selected from hydrogen, alkyl, substituted alkyl, alkoxycarbonyl,
substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl,
carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, heteroalkyl,
substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and
substituted heteroarylalkyl, or R2 and R3 together with the atom to which they are
bonded form a cycloalkyl, substituted cycloalkyl, cycloheteroalkylor substituted
cycloheteroalkyl ring. In certain embodiments of compounds of Formulae (I) and
(XV), R4 is selected from hydrogen, alkyl, substituted alkyl, aryl, substituted aryl,
arylalkyl, substituted arylalkyl, aryldialkylsilyl, substituted aryldialkylsilyl,
cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl,
heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl,
substituted heteroarylalkyl, trialkylsilyl, and substituted trialkylsilyl. In certain
embodiments of compounds of Formulae (I) and (XV), each substituent group of R1,
R2, R3, and/or R4 is independently selected from at least one of C1-3 alkyl, -OH, -
NH2, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and
C1-3 dialkylarnino.
[00142] In certain embodiments of compounds of Formulae (I) and (XV) in the
method of Scheme 7, R1 is selected from methyl, ethyl, /i-propyl, isopropyl, ra-butyl,
isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen, R3 is
selected from hydrogen, methyl, ethyl, w-propyl, isopropyl, phenyl, and cyclohexyl,
and R4 is hydrogen.

[00143] In the method of Scheme 7 oxidation can be performed in the liquid
phase, and in certain embodiments, in the presence of a solvent. Choosing a solvent
for oxidation of a compound of Formula (XV) is well within the ambit of one of skill
in the art Generally, a useful solvent will dissolve, at least partially, both the oxidant
and a compound of Formula (XV) and will be inert to the reaction conditions. Useful
solvents can be anhydrous and include, but are not limited to, dichloromethane,
dichloroethane, chloroform, ethyl acetate, isopropyl acetate, toluene, chlorobenzene,
xylene, acetonitrile, diethyl ether, methyl terf-butyl ether, acetic acid, cyclohexane,
and hexanes. Combinations of the above solvents can also be used in the oxidation of
a compound of Formula (XV) to a compound of Formula (I).
[00144] In some embodiments, the anhydrous oxidant is an anhydrous
peroxyacid generated in situ by reaction of a urea-hydrogen peroxide complex (UHP)
with a carboxylic acid anhydride. In certain embodiments, the anhydrous oxidant is
an anhydrous peroxysulfonic acid generated in situ by reaction of a urea-hydrogen
peroxide complex with a sulfonic acid anhydride. The UHP complex serves as a
source of anhydrous hydrogen peroxide and has been used in a variety of oxidative
transformations, in anhydrous organic solvents (Cooper et al, Synlett., 1990, 533-535;
Balicki era/., Synth. Commun., 1993,23,3149; AstadiUo et al.,Heterocycles, 1993,
36,1075-1080; Varmaete/a/., Org. Lett., 1999, /, 189-191). However, other suitable
sources of anhydrous hydrogen peroxide can also be used in the reaction instead of
the UHP-complex (e.g., the l,4-diazabicyclo[2.2.2]octane-hydrogen peroxide
complex).
[00145] A useful oxidant is anhydrous peroxytrifluoroacetic acid, generated in
situ by reacting the UHP-complex with trifiuoroacetic anhydride (Cooper et al,
Synlett., 1990,533-535; Benjamin, et al, J. Am. Chem. Soc, 2002,124, 827-833).
Anhydrous peroxycarboxylic acids (XVII) can be prepared by treating carboxylic
acid anhydrides (XVI) with anhydrous hydrogen peroxide, and in certain
embodiments, with the UHP-complex. Similarly, anhydrous peroxysulfonic acids
(XIX) can be prepared by reacting sulfonic acid anhydrides (XVIII) with anhydrous
hydrogen peroxide, and in certain embodiments, with the UHP-complex. Preparation
of anhydrous peroxycarboxylic acids (XVII) and peroxysulfonic acids (XIX) is
illustrated in Scheme 8.

[00146] The UHP-complex and a carboxylic acid anhydride (XVI) or a sulfonic
acid anhydride (XVIII) can be reacted in dichloromethane or other suitable solvent at
temperatures ranging from about -25 °C to about 100 °C to generate the
corresponding anhydrous peroxyacid oxidant. The peroxyacid oxidant can be
generated first and subsequently reacted with a ketocarbamate (XV). In some
embodiments, a carboxylic acid anhydride (XVI) is added to a stirred suspension or
solution containing the UHP-complex and a ketocarbamate (XV) to generate the
peroxycarboxylic acid, which reacts in situ with the ketocarbamate (XV) to give
compound (I). In certain embodiments^ the molar ratio of UHP-complex and
carboxylic acid anhydride (XVI) is about 6:1. In certain embodiments, the molar
ratio of UHP-complex and carboxylic acid anhydride (XVI) can range from about 5:1

to about 1:1. In certain embodiments, the molar ratio of UHP-complex and acid
anhydride (XVI) can range from about 2:1 to about 1:1.
[00147] In some embodiments of the method of Scheme 8, the molar ratio of
the peroxyacid oxidant to a compound of Formula (XV) can range from about 8:1 to
about 1:1. In certain embodiments, the molar ratio of the peroxyacid oxidant to a
compound of Formula (XV) can range from about 4:1 to about 1:1. In certain
embodiments, the molar ratio of the peroxyacid oxidant to a compound of Formula
(XV) can range from about 2:1 to about 1:1. In certain embodiments, when the
oxidant is peroxytrifluoroacetic acid or another substituted peroxyacetic acid, the
molar ratio of the peroxyacid oxidant to a compound of Formula (XV) is about 2:1.
[00148] Further, in the method of Scheme 8 the use of additives in the
oxidation of a compound of Formula (XV) to a compound of Formula (I) is also
contemplated. For example, additives can either catalyze the reaction or stabilize the
final product or botii. In some embodiments, a Lewis acid or a protic acid or any
combination of Lewis acid or protic acid can be used in the oxidation of a compound
of Formula (XV) and in certain embodiments, in the presence of a solvent Examples
of Lewis acids include, but are not limited to, BF3, SeC>2, MeRe03, MuC^, SnCLt,
Sc(OTf)3, Ti(0-iPr)4, AI2O3, and Fe23. Examples of protic acids include, but are not
limited to, trifluoroacetic acid, acetic acid,p-toluenesulfonic acid, methanesulfonic
acid, trifluoromethanesulfonic acid, hydrochloric acid, and sulfuric acid. In certain
embodiments, the Lewis acid and/or protic acid can catalyze oxidation by increasing
the electrophilicity of the carbonyl group in Formula (XV).
[00149] In certain embodiments of the method of Scheme 8, the oxidation can
be conducted in the presence of an anhydrous base. In certain embodiments, the base
can stabilize acid sensitive products by reacting with acidic by-products formed
during oxidation.
[00150] Generally, in the method of Scheme 8 the temperature of the reaction
can be optimized by methods known to those of ordinary skill in the art. In certain
embodiments, the oxidation of a compound of Formula (XV) can be carried out at a
temperature ranging from about -25 °C to about 100 °C, and in certain embodiments,
from about 0 °C to about 25 CC.
[00151] A feature of this method of synthesis of a compound of Formula (I) is
that oxidation of a ketocarbamate derivative (XV) proceeds stereospecifically, with

retention of configuration at the carbon atom initially adjacent to the carbonyl group
in the ketocarbamate derivative (XV). This stereospecificity can be exploited in a
stereoselective synthesis of prodrug derivatives of Formula (I).
[00152] Another method for synthesis of a compound of Formula (I),
illustrated in Scheme 9, relies upon reaction of tranexamic acid, or a compound of
Formula (V), with a l-(acyloxy)-alkyl N-hydtoxysuccinimidyl carbonate compound
of Formula (TV), as described in the co-pending application Gallop et al, U.S.
Application Publication No. 2005/0222431:

wherein R1, R2, R3 and R4 are as defined herein, and R5 and R6 are independently
selected from hydrogen, acylamino, acyloxy, alkoxycarbonylamino,
alkoxycarbonyloxy, alkyl, substituted alkyl, alkoxy, substituted alkoxy, aryl,
substituted aryl, arylalkyl, substituted arylalkyl, carbamoyloxy, dialkylamino,
heteroaryl, substituted heteroaryl, hydroxy, and sulfonamido, or R5 and R6 together
with the atoms to which they are bonded form a substituted cycloalkyl, substituted
cycloheteroalkyl, or substituted aryl ring. In certain of the immediately preceding
embodiments, the substituent group of R1, R2, R3, R4, R5, and/or R6 is selected from at
least one of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3
alkoxycarbonyl, C1-3 alkylamino, and C1-3 dialkylamino.
[00153] In certain embodiments of compounds of Formula (J), (TV), and (V) of
the method of Scheme 9, R1 is selected from methyl, ethyl, »-propyl, isopropyl, n-
butyl, isobutyl, sec-butyl, fert-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is hydrogen,
R3 is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and
cyclohexyl, R4 is hydrogen, and R5 and R* are each hydrogen.
[00154] In some embodiments, the method of Scheme 9 can be carried out in a
solvent. Useful solvents include, but are not limited to, acetone, acetonitrile,
dichloromethane, dichloroethane, chloroform, toluene, tetrahydrofuran, dioxane,

dimemylformamide, dimethylacetamide, JV-methylpyrrolidinone, dimethyl sulfoxide,
pyridine, ethyl acetate, methyl tert-butyl ether, methanol, ethanol, isopropanol,
tert-butanol, water, and combinations of any of the foregoing. In certain
embodiments, the solvent can be acetone, acetonitrile, dichloromethane, toluene,
tetrahydrofuran, pyridine, methyl tert-butyl ether, methanol, ethanol, isopropanol,
water, and combinations of any of the foregoing. In certain embodiments, the solvent
can be a combination of acetonitrile and water. In certain embodiments, the solvent
can be a combination of acetonitrile and water, with a volume ratio of acetonitrile to
water ranging from about 1:5 to about 5:1. In certain embodiments, the solvent can
be a combination of methyl tert-butyl ether and water. In certain embodiments, the
solvent can be a combination of methyl tert-butyl ether and water, with a volume ratio
of methyl tert-butyl ether to water ranging from about 2:1 to about 20:1. In certain
embodiments, the solvent can be a combination of methyl tert-butyl ether and water,
wherein the methyl tert-butyl ether contains from about 10% to about 50% acetone by
volume. In certain embodiments, the solvent can be dichlorometiiane, water, or a
combination thereof. In certain embodiments, the solvent is a biphasic combination
of dichloromethane and water. In certain embodiments, the solvent can be a biphasic
combination of dichloromethane and water containing from about 0.001 equivalents
to about 0.1 equivalents of a phase transfer catalyst. In certain embodiments, the
phase transfer catalyst is a tetraalkylammonium salt, and in certain embodiments, the
phase transfer catalyst is a tetrabutylammonium salt.
[00155] The method of Scheme 9 can be carried out a temperature ranging
from about -20 °C to about 40 °C. In certain embodiments, the temperature can range
from about -20 °C to about 25 °C. In certain embodiments, the temperature can range
from about 0 °C to about 25 °C. In certain embodiments, the temperature can range
from about 25 °C to about 40 °C.
[00156] In certain embodiments of the method of Scheme 9, the reaction can be
performed in the absence of a base.
[00157] In certain embodiments of the method of Scheme 9, the reaction can be
performed in the presence of an inorganic base. In some embodiments, the reaction
can be performed in the presence of an alkali metal bicarbonate or alkali metal
carbonate salt. In certain embodiments, the reaction can be performed in the presence
of sodium bicarbonate.

[00158] In certain embodiments of the method of Scheme 9, the reaction can be
performed in the presence of an organic base. In certain embodiments, the reaction
can be performed in the presence of triethylamine, tributylamine,
diisopropylethylamine, dimemylisopropylamine, //-methylmorpholine,
iV-methylpyrrolidine, i^-methylpiperidijie, pyridine, 2-methylpyridine,
2,6-dimethylpyridine, 4-dimemylarninopyridine, l,4-diazabicyclo[2.2.2]octane,
l,8-diazabicyclo[5.4.0]undec-7-ene, l,5-diazabicyclo[4.3.0]undec-7-ene, or a
combination of any of the foregoing. In certain embodiments, the reaction can be
performed in the presence of triethylamine, diisopropylethylaroine,
i\A-methylmorpholine, or pyridine.
Pharmaceutical Compositions
[00159] Pharmaceutical compositions comprising a therapeutically effective
amount of one or more tranexamic acid prodrug compounds of Formula (I),
optionally in purified form, together with a suitable amount of a pharmaceutically
acceptable vehicle, so as to provide a form for proper administration to a patient are
provided herein. Suitable pharmaceutical vehicles include excipients such as starch,
glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate,
glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene,
glycol, water, ethanol, and the like. Compositions of the present disclosure, if
desired, can also contain minor amounts of wetting agents, emulsifylng agents, or pH
buffering agents. In addition, auxiliary, stabilizing, thickening, lubricating, and
coloring agents can be included.
[00160] Pharmaceutical compositions can be manufactured, for example, by
means of conventional mixing, dissolving, granulating, dragee-making, levigating,
emulsifylng, encapsulating, entrapping, and lyophilizing processes. Pharmaceutical
compositions can be formulated in a conventional manner using one or more
physiologically acceptable carriers, diluents, excipients, and auxiliaries, which
facilitate processing of compounds disclosed herein into preparations, which can be
used pharmaceutically. Proper formulation can be dependent upon the route of
administration chosen.
[00161] The present pharmaceutical compositions can take the form of, for
example, solutions, suspensions, emulsion, tablets, pills, pellets, capsules, capsules
containing liquids, powders, sustained-release formulations, suppositories, emulsions,

aerosols, sprays, suspensions, or any other form suitable for use. In some
embodiments, a pharmaceutically acceptable vehicle can be a capsule (see e.g.,
Grosswald et al, U.S. Patent No. 5,6981,155). Other examples of suitable
pharmaceutical vehicles have been described in the art (see Remington's
Pharmaceutical Sciences, Philadelphia College of Pharmacy and Science, 19th
Edition, 1995). In some embodiments, compositions can be formulated for oral
delivery, for example, oral sustained release admimstratiori. In certain embodiments,
compositions can be formulated for topical delivery, and in certain embodiments, for
topical sustained release administration.
[00162] Pharmaceutical compositions for oral delivery can be in the form of,
for example, tablets, lozenges, aqueous or oily suspensions, granules, powders,
emulsions, capsules, syrups, or elixirs, for example. Orally administered
compositions can contain one or more optional agents, sweetening agents such as
fructose, aspartame or saccharin, flavoring agents such as peppermint, oil of
wintergreen, cherry coloring agents, and preserving agents, to provide a palatable
preparation. Moreover, when in tablet or pill form, the compositions can be coated to
delay disintegration and absorption in the gastrointestinal tract, thereby providing a
sustained action over an extended period of time. Oral compositions can include
standard vehicles such as roannitol, lactose, starch, magnesium stearate, sodium
saccharine, cellulose, magnesium carbonate, etc. Such vehicles may be of
pharmaceutical grade.
[00163] For oral liquid preparations for example, suspensions, elixirs and
solutions, suitable carriers, excipients or diluents include water, saline,
alkyleneglycols (e.g., propylene glycol), polyalkylene glycols (e.g., polyethylene
glycol), oils, alcohols, slightly acidic buffers between about pH 4 and about pH 6
(e.g., acetate, citrate, ascorbate at between about 5 mM to about 50 mM), etc.
Additionally, flavoring agents, preservatives, coloring agents, bile salts,
acylcarnitines, and the like can be added.
[00164] For topical formulations of tranexamic acid prodrug compounds of
Formula (I) in the form of creams, gels, viscous lotions, transdermal patches, and/or
sprays can be used as appropriate delivery forms. Such formulations can comprise
one or more tranexamic acid prodrug compounds of Formula (I), optionally in
purified form, together with a suitable amount of any pharmaceutically acceptable

topical excipients including, but not limited to, gels, patches, lotions, creams,
ointments, and liquids.
[00165] Compositions for topical administration include those for delivery via
the mouth (buccal), nose (nasal), the rectum (rectal), the vagina (vaginal), and through
the skin (dermal). Topical delivery systems also include transdermal patches
containing at least one compound of Formula (I) to be administered. Delivery
through the skin can be achieved by diffusion or by more active energy sources such
as iontophoresis or electrotransport.
[00166] Compositions suitable for topical administration in the mouth include
lozenges comprising a compound of Formula (I) optionally in a flavored basis such as
sucrose and acacia or tragacanth, pastilles comprising a compound of Formula (I) in
an inert basis such as gelatin and glycerin, or sucrose and acacia; and mouthwashes
comprising a compound of Formula (I) administered in a suitable liquid vehicle.
[00167] Compositions suitable for topical administration to the skin include
ointments, creams, gels, patches, pastes and sprays comprising a compound of
Formula (I) to be administered in a pharmaceutical acceptable vehicle. Formulations
of a compound of Formula (I) for topical use, such as in creams, ointments and gels,
can include an oleaginous or water-soluble ointment base. For example, topical
compositions can include vegetable oils, animal fats, and in certain embodiments,
semisolid hydrocarbons obtained from petroleum. Topical compositions can further
include white ointment, yellow ointment, cetyl esters wax, oleic acid, olive oil,
paraffin, petrolatum, white petrolatum, spermaceti, starch glycerite, white wax,
yellow wax, lanolin, anhydrous lanolin, and glyceryl monostearate. Various water-
soluble ointment bases can also be used, including glycol ethers and derivatives,
polyethylene glycols, polyoxyl 40 stearate, and polysorbates.
[00168] Compositions for rectal administration can be in the form of a
suppository with a suitable base comprising, for example, cocoa butter or a salicylate.
Compositions suitable for vaginal administration can be provided as pessaries,
tampons, creams, gels, pastes, foams, or spray formulations containing in addition to a
compound of Formula (I) such vehicles as are known in the art to be appropriate.
Compositions for nasal administration can be in the form of, for example, nasal
solutions, sprays, aerosols, or inhalants, and can include in addition to at least one
compound of Formula (I), vehicles suitable for nasal adrninistration.

[00169] When a compound of Formula (I), is acidic, it can be included in any
of the above-described formulations as the free acid, a pharmaceutically acceptable
salt, a solvate, or a hydrate. Pharmaceutically acceptable salts can substantially retain
the activity of the free acid, can be prepared by reaction with bases, and can be more
soluble in aqueous and other protic solvents than the corresponding free acid form.
m some embodiments, sodium salts of a compound of Formula 00 can be used in the
above described formulations.
Sustained Release Oral Dosage Forms
[00170] The disclosed compounds may be used with a number of different
dosage forms, which can be adapted to provide sustained release of a compound of
Formula (I) upon oral administration.
[00171] In some embodiments, a dosage form can comprise beads that on
dissolution or diffusion release a compound disclosed herein over an extended period
of hours, in certain embodiments, over a period of at least 4 hours, in certain
embodiments, over a period of at least 8 hours and in certain embodiments, over a
period of at least 12 hours. The beads can have a central composition or core
comprising a compound disclosed herein and pharmaceutically acceptable vehicles,
including an optional lubricant, antioxidant, and buffer. The beads can be medical
preparations with a diameter ranging from about 0.05 mm to about 2 mm. Individual
beads can comprise doses of a compound disclosed herein, for example, doses of up
to about 40 mg of the compound. The beads, in some embodiments, can be formed of
non-cross-linked materials to enhance their discharge from the gastrointestinal tract.
The beads can be coated with a release rate-controlling polymer that gives a timed-
release profile.
[00172] The time-release beads can be manufactured into a tablet for
therapeutically effective administration. The beads can be made into matrix tablets by
the direct compression of a plurality of beads coated with, for example, an acrylic
resin and blended with excipients such as hydroxypropylmethyl cellulose. The
manufacture of beads has been disclosed in the art (Lu, Int. J. Pharm., 1994,112,
117-124; 'Tharmaceutical Sciences" by Remington, 14th Ed, pp. 1626-1628 (1970);
Fincher, J. Pharm. ScL, 1968, 57,1825-1835; and U.S. Patent No. 4,083,949) as has
the manufacture of tablets ('Tharmaceutical Sciences," by Remington, 17th Ed, Ch.
90, pp 1603-1625(1985)).

[00173] One type of sustained release oral dosage formulation that can be used
with the disclosed compounds comprises an inert core, such as a sugar sphere, coated
with an inner drug-containing layer and an outer membrane layer controlling drug
release from the inner layer. A "sealcoat" can be provided between the inert core and
the layer containing the active ingredient When the core is of a water-soluble or
water-swellable inert material, the sealcoat can be in the form of a relatively thick
layer of a water-insoluble polymer. Such a controlled release bead an thus comprise:
(i) a core unit of a substantially water-soluble or water-swellable inert material; (ii) a
first layer on the core unit of a substantially water-insoluble polymer; (iii) a second
layer covering the first layer and containing an active ingredient; and (iv) a third layer
on the second layer of polymer effective for controlled release of the active
ingredient, wherein the first layer is adapted to control water penetration into the core.
[00174] In certain embodiments, the first layer (ii) above can constitute more
than about 2% (w/w) of the final bead composition, and in certain embodiments, more
than about 3% (w/w), e.g., from about 3% to about 80% (w/w). The amount of the
second layer (ii) above can constitute from about 0.05% to about 60% (w/w), and in
certain embodiments from about 0.1% to about 30% (w/w) of the final bead
composition. The amount of the third layer (iv) above can constitute from about 1%
to about 50% (w/w), in certain embodiments, from about 2% to about 25% (w/w) of
the final bead composition. The core unit can have a size ranging from about 0.05 to
about 2 mm. The controlled release beads can be provided in a multiple unit
formulation, such as a capsule or a tablet.
[00175] The cores can comprise a water-soluble or swellable material and can
be any such material that is conventionally used as cores or any other
pharmaceutically acceptable water-soluble or water-swellable material made into
beads or pellets. The cores can be spheres of materials such as sucrose/starch (Sugar
Spheres NF), sucrose crystals, or extruded and dried spheres typically comprised of
excipients such as microcrystalline cellulose and lactose. The substantially
water-insoluble material in the first, or sealcoat layer can be a "GI insoluble" or "GI
partially insoluble" film forming polymer (dispersed or dissolved in a solvent).
Examples include, but are not limited to, ethyl cellulose, cellulose acetate, cellulose
acetate butyrate, polymethacrylates such as ethyl acrylate/methyl methacrylate
copolymer (Eudragit NE-30-D) and ammonio methacrylate copolymer types A and B
(Eudragit RL30D and RS30D), and silicone elastomers, ha certain embodiments, a

plastieizer can be used together with, the polymer. Examples of plasticizers include,
but are not limited to, dibutylsebacate, propylene glycol, triethylcitrate, tributylcitrate,
castor oil, acetylated monoglycerides, acetyl triethylcitrate, acetyl butylcitrate, diethyl
phthalate, dibutyl phthalate, triacetin, and fractionated coconut oil (medium-chain
triglycerides). The second layer containing the active ingredient can comprise an
active ingredient with or without a polymer as a binder. The binder, when used, can
be hydrophilic, and in certain embodiments can be water-soluble or water-insoluble.
Examples of polymers that can be used in the second layer containing the active drug
include hydrophilic polymers such as, polyvinylpyrrolidone (PVP), polyalkylene
glycol such as polyethylene glycol, gelatine, polyvinyl alcohol, starch and derivatives
thereof, cellulose derivatives, such as hydroxypropylmethyl cellulose (HPMC),
hydroxypropyl cellulose, carboxymethyl cellulose, methyl cellulose, ethyl cellulose,
hydroxyethyl cellulose, carboxyethyl cellulose, carboxymethylhydroxyethyl cellulose,
acrylic acid polymers, polymethacrylates, or any other pharmaceutically acceptable
polymer. The ratio of drug to hydrophilic polymer in the second layer can range from
about 1:100 to about 100:1 (w/w). Suitable polymers for use in the third layer, or
membrane, for controlling the drug release can be selected from water-insoluble,
polymers or polymers withpH-dependent solubility, such as, ethyl cellulose,
hydroxypropylmethyl cellulose phthalate, cellulose acetate phthalate, cellulose acetate
trimellitate, polymethacrylates, or mixtures thereof, optionally combined with
plasticizers, such as those mentioned above. Optionally, the controlled release layer
comprises, in addition to the polymers above, other substance(s) with different
solubility characteristics, to adjust the permeability and thereby the release rate, of the
controlled release layer. Example of polymers that can be used as a modifier together
with, for example, ethyl cellulose include, but are not limited to, HPMC,
hydroxyethyl cellulose, hydroxypropyl cellulose, methylcellulose,
carboxymethylcellulose, polyethylene glycol, polyvinylpyrroUdone (PVP), polyvinyl
alcohol, polymers with pH-dependent solubility, such as cellulose acetate phthalate or
ammonio methacrylate copolymer, methacrylic acid copolymer, and combinations of
any of the foregoing. Additives such as sucrose, lactose and pharmaceutical grade
surfactants can also be included in the controlled release layer, if desired.
[00176] The preparation of the multiple unit formulation can comprise the
additional step of tramforming the prepared beads into a pharmaceutical formulation,
such as by filling a predetermined amount of the beads into a capsule, or compressing

the beads into tablets. Examples of multi-particulate sustained release oral dosage
forms are described in, for example, U.S. Patent Nos. 6,627,223 and 5,229,135.
[00177] In certain embodiments, polymeric materials can be used (See
"Medical Applications of Controlled Release," Laager and Wise (eds.), CRC Press,
Boca Raton, Florida (1974); "Controlled Drug Bioavailability, Drug Product Design
and Performance," Smolen and Ball (eds.), Wiley, New York (1984); Langer et al, J
Macromol. Sci. Rev. Macromol Chem., 1983,23,61; see also Levy et al., Science,
1985,228,190; During et al, Ann. Neurol, 1989,25,351; Howard et al, J.
Neurosurg., 1989, 71,105). In some embodiments, polymeric materials can be used
for oral sustained release delivery. Polymers include, but are not limited to, sodium
carboxymethylcellulose, hydroxypropylcellulose, hydroxypropylmetnylcellulose, and
hydroxyethylcellulose (especially, hydroxypropylmethylcellulose). Ottier cellulose
ethers have been described (Alderman, Int. J. Pharm. Tech. & Prod. Mfr., 1984,5(3),
1-9). Factors affecting drug release are well known to the skilled artisan and have
been described in the art (Bamba et al, Int. J. Pharm., 1979,2,307).
[00178] In certain embodiments, enteric-coated preparations can be used for
oral sustained release administration. Examples of useful coating materials include
polymers with apH-dependent solubility (i.e., pH-controlled release), polymers with a
slow or pH-dependent rate of swelling, dissolution or erosion (i.e., time-controlled
release), polymers that are degraded by enzymes (i.e., enzyme-controlled release), and
polymers that form firm layers that are destroyed by an increase in pressure (i.e.,
' pressure-controlled release).
[00179] In certain embodiments, drug-releasing lipid matrices can be used for
oral sustained release administration. An example is when solid microparticles of a
compound disclosed herein are coated with a thin controlled release layer of a lipid
(e.g., glyceryl behenate and/or glyceryl palmitostearate) as disclosed in Farah et al,
U.S. Patent No. 6,375,987 and Joachim^ al, U.S. Patent No. 6,379,700. The
lipid-coated particles can optionally be compressed to form a tablet. Another
controlled release lipid-based matrix material that is suitable for sustained release oral
administration comprises polyglycolized glycerides as disclosed in Roussin et al,
U.S. Patent No. 6,171,615.
[00180] In certain embodiments, waxes can be used for oral sustained release
administration. Examples of suitable sustained compound-releasing waxes are
disclosed in Cain et al, U.S. Patent No. 3,402,240 (camauba wax, candelilla wax,

esparto wax and ouricury wax); Shtohryn et al, U.S. Patent No. 4,820,523
(hydrogenated vegetable oil, bees wax, camauba wax, paraffin, candelilla, ozokerite
and combinations of any of the foregoing); and Walters, U.S. Patent No. 4,421,736
(mixture of paraffin and castor wax).
[00181] In certain embodiments, osmotic delivery systems can be used for oral
sustained release administration (Verma et al, Drug Dev. Ind. Pharm., 2000,26,
695-708). In some embodiments, OROS® systems made by Alza Corporation,
Mountain View, CA can be used for oral sustained release delivery devices
(Theeuwes et al, U.S. Patent No. 3,845,770; Theeuwes et al, U.S. Patent No.
3,916,899).
[00182] In certain embodiments, a controlled-release system can be placed in
proximity of the target of a compound disclosed herein (e.g., within the spinal cord),
thus requiring only a fraction of the systemic dose (See, e.g., Goodson, in "Medical
Applications of Controlled Release," supra, vol. 2, pp. 115-138 (1984)). Other
controlled-release systems discussed in Langer, Science, 1990,249,1527-1533 can
also be used.
[00183] In certain embodiments, a dosage form can comprise a compound
disclosed herein coated on a polymer substrate. The polymer can be an erodible, or a
nonerodible polymer. The coated substrate can be folded onto itself to provide a
bilayer polymer drug dosage form. For example, a compound disclosed herein can be
coated onto a polymer such as a polypeptide, collagen, gelatin, polyvinyl alcohol,
polyorthoester, polyacetyl, or apolyorthocarbonate and the coated polymer folded onto
itself to provide a bilaminated dosage form. In operation, a bioerodible dosage form
erodes at a controlled rate to dispense a compound disclosed herein over a sustained
release period. Representative biodegradable polymers include biodegradable
poly(amides), poly (amino acids), poly(esters), poly(lactic acid), poly(glycolic acid),
poly(carbohydrate), poly(orthoester), poly(orthocarbonate), poly(acetyl),
poly(anhydrides), biodegradable poly(dihydropyrans), and poly(dioxinones) which
are known in the art (Rosoff, Controlled Release of Drugs Chap. 2, pp. 53-95 (1989);
and in U.S. Patent Nos. 3,811,444; 3,962,414; 4,066,747,4,070,347; 4,079,038; and
4,093,709).
[00184] In certain embodiments, a dosage form can comprise a compound of
Formula (I) loaded into a polymer that releases the compound by diffusion through a

polymer, or by flux through pores or by rupture of a polymer matrix. The drug
delivery polymeric dosage form can comprise from about 10 mg to about 500 mg of
the compound homogenously contained in or on a polymer. The dosage form can
comprise at least one exposed surface at the beginning of dose delivery. The
non-exposed surface, when present, can be coated with a pharmaceutically acceptable
material impermeable to the passage of the compound. The dosage form can be
manufactured by procedures known in the art An example of providing a dosage
form comprises blending a pharmaceutically acceptable carrier such as polyethylene
glycol, with a known dose of a compound at an elevated temperature, (e.g., 37 °C),
and adding the blended composition to a silastic medical grade elastomer with a
cross-linking agent, for example, octanoate, followed by casting in a mold. The step
can be repeated for each optional successive layer. The system can be allowed to set
for about 1 hour, to provide the dosage form. Representative polymers for
.manufacturing the dosage include olefinic polymers, vinyl polymers, addition
polymers, condensation polymers, carbohydrate polymer and silicone polymers as
represented by polyethylene, polypropylene, polyvinyl acetate, polymethylacrylate,
polylsobutylmethacrylate, poly alginate, polyamide and polysilicone. The polymers
and procedures for manufacturing the polymers have been described in the art
(Coleman et al, Polymers, 1990,31,1187-1231; Roerdink et al, Drug Carrier
Systems, 1989,9,57-10; Leong et al, Adv. Drug Delivery Rev., 1987,1,199-233;
Roff etal, Handbook of Common Polymers, 1971, CRC Press; and U.S. Patent No.
3,992,518).
[00185] In certain embodiments, a dosage form can comprise a plurality of
pills. The time-release pills can provide a number of individual doses for providing
various time doses for achieving a sustained-release prodrug delivery profile over an
extended period of time up to about 24 hours. The matrix can comprise a hydrophilic
polymer such as, a polysaccharide, agar, agarose, natural gum, alkali alginate
including sodium alginate, carrageenan, fucoidan, furcellaran, laminaran, hypnea,
gum arabic, gum ghatti, gum karaya, gum tragacanth, locust bean gum, pectin,
amylopectin, gelatin, or a hydrophilic colloid. The hydrophilic matrix can comprise a
plurality of 4 to 50 time release pills, each time release pill comprising a dose
population of from about 10 ng, about 0.5 mg, 1 mg, about 1.2 mg, about 1.4 mg,
about 1.6 mg, about 5.0 mg, etc. The pills can comprise a release rate-controlling
wall ranging from about 0.001 mm to about 10 mm thick to provide for the timed

release of a compound of Formula (S). Representative wall forming materials include
a triglyceryl ester such as glyceryl tristearate, glyceryl monostearate, glyceryl
dipalmitate, glyceryl laureate, glyceryl didecenoate and glyceryl tridenoate. Other
wall forming materials include polyvinyl acetate, phthalate, methylcellulose phthalate,
and microporous olefins. Procedures for rnanufacturing pills are disclosed in U.S.
Patent Nos. 4,434,153; 4,721,613; 4,853,229; 2,996,431; 3,139,383; and 4,752,470.
[00186] In certain embodiments, a dosage form can comprise an osmotic
dosage form, which comprises a semipermeable wall that surrounds a therapeutic
composition comprising the compound. In use within a patient, an osmotic dosage
form comprising a homogenous composition, imbibes fluid through the
semipermeable wall into the dosage form in response to the concentration gradient
across the semipermeable wall The therapeutic composition in the dosage form
develops osmotic pressure differential that causes the therapeutic composition to be
administered through an exit from the dosage form over a prolonged period of time up
to about 24 hours (or even in some cases up to about 30 hours) to provide controlled
and sustained compound release. These delivery platforms can provide an essentially
zero order delivery profile as opposed to the spiked profiles of immediate release
formulations.
[00187] In certain embodiments, the dosage form can comprise another osmotic
dosage form comprising a wall surrounding a compartment, the wall comprising a
semipermeable polymeric composition permeable to the passage of fluid and
substantially impermeable to the passage of compound present in the compartment, a
compound-containing layer composition in the compartment, a hydrogel push layer
composition in the compartment comprising an osmotic formulation for imbibing and
absorbing fluid for expanding in size for pushing the compound composition layer
from the dosage form, and at least one passageway in the wall for releasing the
prodrug composition. The method delivers the compound by imbibing fluid through
the semipermeable wall at a fluid imbibing rate determined by the permeability of the
semipermeable wall and the osmotic pressure across the semipermeable wall causing
the push layer to expand, thereby delivering the compound from the dosage form
through the exit passageway to a patient over a prolonged period of time (up to about
24 or even about 30 hours). The hydrogel layer composition can comprise from about
10 mg to about 1000 mg of a hydrogel such as a member selected from the group
consisting of a polyalkylene oxide of about 1,000,000 to about 8,000,000

weight-average molecular weight, which are selected from the group consisting of a
polyethylene oxide of about 1,000,000 weight-average molecular weight, a
polyethylene oxide of about 2,000,000 molecular weight, a polyethylene oxide of
about 4,000,000 molecular weight, a polyethylene oxide of about 5,000,000 molecular
weight, a polyethylene oxide of about 7,000,000 molecular weight and a
polypropylene oxide of the about 1,000,000 to about 8,000,000 weight-average
molecular weight; or about 10 mg to about 1000 mg of an alkali
carboxymethylcellulose of about 10,000 to about 6,000,000 weight average molecular
weight, such as sodium carboxymethylcellulose or potassium carboxymethylcellulose.
The hydrogel expansion layer comprises about 0 mg to about 350 mg, in present
manufacture; about 0.1 mg to about 250 mg of a hydroxyalkylcellulose of about 7,500
to about 4,500,00 weight-average molecular weight (e.g., hydroxymethylcellulose,
hydroxyethylcellulose, hydroxypropylcellulose, hydroxybutylcellulose or
hydroxypentylcellulose) in present manufacture; about 1 mg to about 50 mg of an
agent selected from the group consisting of sodium chloride, potassium chloride,
potassium acid phosphate, tartaric acid, citric acid, raffinose, magnesium sulfate,
magnesium chloride, urea, inositol, sucrose, glucose and sorbitol; 0 to about 5 mg of a
colorant, such as ferric oxide; about 0 mg to about 30 mg, in a present manufacture,
0.1 mg to 30 mg of a hydroxypropylalkylcellulose of about 9,000 to about 225,000
average-number molecular weight, selected from the group consisting of
hydroxypropylelhylcellulose, hydroxypropypentylcellulose,
hydroxypropylmethylcellulose, and hydropropylbutylcellulose; about 0.00 to about
1.5 mg of an antioxidant selected from the group consisting of ascorbic acid,
butylated hydroxyanisole, butylated hydroxyquinone, butylhydroxyanisol,
hydroxycoumarin, butylated hydroxytoluene, cephalm, ethyl gallate, propyl gallate,
octyl gallate, lauryl gallate, propyl-hydroxybenzoate, trihydroxybutylrophenone,
dimethylphenol, dibutylphenol, vitamin E, lecithin, and emanolarnine; and about 0.0
mg to about 7 mg of a lubricant selected from the group consisting of calcium
stearate, magnesium stearate, zinc stearate, magnesium oleate, calcium palmitate,
sodium suberate, potassium laurate, salts of fatty acids, salts of alicyclic acids, salts of
aromatic acids, stearic acid, oleic acid, palmitic acid, a mixture of a salt of a fatty,
alicyclic or aromatic acid, and a fatty, alicyclic, or aromatic acid.
[00188] In the osmotic dosage forms, the semipermeable wall can comprise a
composition that is permeable to the passage of fluid and impermeable to the passage

of prodrug. The wall is nontoxic and comprises a polymer selected from the group
consisting of a cellulose acylate, cellulose diacylate, cellulose triacylate, cellulose
acetate, cellulose diacetate and cellulose triacetate. The wall comprises about from 75
wt % (weight percent) to about 100 wt % of the cellulosic waU-forming polymer or,
the wall can comprise additionally about 0.01 wt % to about 80 wt % of polyethylene
glycol, or about from 1 wt % to about 25 wt % of a cellulose ether selected from the
group consisting of hydroxypropylcellulose and a hydroxypropylalkycellulose such as
hydroxypropylmethylcellulose. The total weight percent of all components
comprising the wall is equal to about 100 wt %. The internal compartment comprises
the compoimd-cxmtainmg composition alone or in layered position with an
expandable hydrogel composition. The expandable hydrogel composition in the
compartment increases in dimension by imbibing the fluid through the semipermeable
wall, causing the hydrogel to expand and occupy space in the compartment, whereby
the drug composition is pushed from the dosage form. The therapeutic layer and the
expandable layer act together during the operation of the dosage form for the release
of prodrug to a patient over time. The dosage form comprises a passageway in the
wall that connects the exterior of the dosage form with the internal compartment. The
osmotic powered dosage form can be made to deliver prodrug from the dosage form
to the patient at a zero order rate of release over a period of up to about 24 hours.
[00189] The expression "passageway" as used herein comprises means and
methods suitable for the metered release of the compound from the compartment of
the dosage form. The exit means comprises at least one passageway, including an
orifice, bore, aperture, pore, porous element, hollow fiber, capillary tube, channel,
porous overlay, or porous element that provides for the osmotic controlled release of
compound. The passageway includes a material that erodes or is leached from the
wall in a fluid environment of use to produce at least one controlled-release
dimensioned passageway. Representative materials suitable for forming a
passageway, or a multiplicity of passageways comprise a leachable poly(glycolic)
acid or poly(lactic) acid polymer in the wall, a gelatinous filament, polyvinyl
alcohol), leach-able polysaccharides, salts, and oxides. A pore passageway, or more
than one pore passageway, can be formed by leaching a leachable compound, such as
sorbitol, from the wall. The passageway possesses controlled-release dimensions,
such as round, triangular, square, or elliptical, for the metered release of prodrug from
the dosage form. The dosage form can be constructed with one or more passageways

in spaced apart relationship on a single surface or on more than one surface of the
wall. The expression "fluid environment" denotes an aqueous or biological fluid as in
a human patient, including the gastrointestinal tract Passageways and equipment for
forming passageways are disclosed in U.S. Patent Nos. 3,845,770; 3,916,899;
4,063,064; 4,088,864; and 4,816,263. Passageways formed by leaching are disclosed
in U.S. Patents Nos. 4,200,098 and 4,285,987.
[00190] Regardless of the specific form of sustained release oral dosage form
used, compounds of Formula (I) can be released from the dosage form over a period
of at least about 4 hours, for example, over a period of at least about 8 hours or at
least about 12 hours. Further, in certain embodiments, the dosage form can release
from about 0% to about 30% of the prodrug in from 0 to about 2 hours, from about
20% to about 50% of die prodrug in from about 2 to about 12 hours, from about 50%
to about 85% of the prodrug in from about 3 to about 20 hours and greater than about
75% of the prodrug in from about 5 to about 18 hours, m certain embodiments, a
sustained release oral dosage form can provide a concentration of tranexamic acid in
the blood plasma of a patient over time, which curve has an area under the curve
(Cmax) that is proportional to the dose of the prodrug of tranexamic acid administered,
and a maximum concentration Cmax.
[00191] Jh certain embodiments, dosage forms are administered once or twice
per day, and in certain embodiments, once per day.
Therapeutic Uses of Compounds. Compositions and Dosage Forms
[00192] In some embodiments, a therapeutically effective amount of one or
more compounds of Formula (I) can be administered to a patient, such as a human,
suffering from excessive bleeding, including heavy bleeding associated with cardiac
surgery, upper gastrointestinal hemorrhage, blood loss inpatients with advanced
cancer, excess bleeding that occurs during dental procedures in hemophiliacs, and
heavy bleeding during menstruation, i.e.,menorrhagia. In certain embodiments,
bleeding associated with these and other indications, can be considered heavy or
excessive when the bleeding is greater than normal and will depend, at least in part,
on the particular pathology and the judgment of the treating physician.
[00193] In certain embodiments, a therapeutically effective amount of one or
more compounds of Formula (I) can be administered to a patient, such as a human,
suffering from skin diseases or disorders such as wound healing, epidermal

hyperplasia, skin roughening and unwanted skin pigmentation. In certain
embodiments, a therapeutically effective amount of one or more compounds of
Formula (I) can be administered to a patient, such as a human, suffering from cancer
to treat or prevent tumor metastasis. In some of the above embodiments, sustained
release oral dosage forms can be administered to the patient In certain embodiments,
topical formulations of one or more compounds of Formula (I) can be administered to
the patient
[00194] Further, in certain embodiments, a therapeutically effective amount of
one or more compounds of Formula 00 can be administered to a patient, such as a
human, as a preventative measure against various diseases or disorders. Thus, the
therapeutically effective amount of one or more compounds of Formula (I) can be
administered as a preventative measure to a patient having a predisposition for
excessive bleeding, including, but not limited to, excessive bleeding associated with
cardiac surgery, upper gastrointestinal hemorrhage, blood loss in patients with
advanced cancer, excessive bleeding that occurs during dental procedures, for
example in hemophiliacs, and excessive bleeding during
menstruation,i.e.^nenorrhagia. In certain embodiments, the therapeutically effective
amount of one or more compounds of Formula (T) can be administered as a preventive
measure to a patient having a predisposition for skin disease and disorder including,
but not limited to, wound healing, epidermal hyperplasia, skin roughening, and
unwanted skin pigmentation. In certain embodiments, the therapeutically effective
amount of one or more compounds of Formula (I) can be administered as a preventive
measure to a patient having a predisposition for tumor metastasis.
[00195] When used to treat or prevent the above diseases or disorders a
therapeutically effective amount of one or more compounds of Formula (I) can be
administered or applied singly, or in combination with other agents. The
therapeutically effective amount of one or more compounds of Formula (I) can also
deliver a compound of Formula (I) in combination with another pharmaceutically
active agent, including another compound of Formula (I). For example, in the
treatment of a patient suffering from cancer, a dosage form comprising a compound of
Formula (I) can be administered in conjunction with an anti-cancer agent, such as
adriamycin, Alkeran, Aredia, Arirnidex, Avastin, BiCNU, Bleomycin, Blenoxane,
Camptosar, carboplatin, Casodex, Celestone, Cerubidine, cisplatin, Cosmegan,
CytosarU, Cytoxan, daunorubricin, DaunoXome, Didronel, diethylstilbestrol,

Diflucan, Doxil, doxorubicin, Elspar, Emcyt, Epogen, ergamisol, EthyoL Etopophos,
\ Etoposide, Eulexin, Femara, Fludara, Fluorouracil, Gemzar, Gleevec, Gliade,
Herceptin, Hexalen, Hycamtin, Hydrea; hydroxyurea, idamycin, Iflex, Intron A,
Kytril, Leucovorin calcium, Leukeran, Leukine, Leustatin, Lupron, Lysodren,
Marinol, Matulane, Mesnex, methotrexate, Mithracin, Mitoxantrosc, Mustargen,
Mutamycin, Myleran, Navelbine, Neupogen, Nilandron, Nipent, Nolvadex,
Novantrone, Oncaspar, Oncovin, oxaliplatin, Faraplatin, Photofrin, Platinol, Procrit,
Proleukin, Purinethol, Rituxan, Roferon A, Rubex, Salagen, Sandostatin, squalamine,
Tarcvea, Taxol, Taxotere, tirioguanine, Thioplex, Tice BCG, TNP 470, Velban,
Vesanoid, VePesid, Vitaxin, Vumon, Zanosar, Zinecard, Zofran, Zoladex, and
Zyloprim.
[00196] In certain embodiments, in the treatment of a patient suffering from
excessive bleeding, such as for example menorrhagia, a dosage form comprising a
compound of Formula (T) can be administered in conjunction with an agent known or
believed to be effective in treating excessive bleeding, including oral synthetic
progestins such as medroxyprogesterone, norethindrone acetate, and norgestrel;
natural progestins such as progesterone; gonadatrophin inhibitors such as danazol; or
nonsteroidal anti-inflammatory agent such as aspirin, salsalate, diflunisal, ibuprofen,
detaprofen, nabumetone, piroxicam, mefenamic acid, naproxen, diclofenac,
indomethacin, sulindac, tolmetin, etodolac, ketorolac, oxaprozdn, and COX-2
inhibitors such as celecoxib, meloxicam, and rofecoxib.
[00197] In certain embodiments, a compound of Formula (I) can be
administered to a patient in combination with another antifibrinolytic agent such as
desmopressin, aprotinin, e-aminocaproic acid, a plasmin inhibitor, or another
compound used to treat patients having excessive bleeding such as aluminum
hydroxide, ranitidine, or goserelin.
[00198] In certain embodiments, compounds of Formula (I) are prodrugs of
both tranexamic acid and a second therapeutic agent. The moiety having the
structure:

can comprise a second therapeutic agent having a -COOH group. In certain
embodiments, the second therapeutic agent can be a compound effective treating a

symptom associated with excessive bleeding. For example, in certain embodiments
such as for treating menorrhagia, the second therapeutic agent can be a non-steroidal
mti-inflammatory agent having a -COOH group such as aspirin, salsalate, diflunisal,
ibuprofen, ketaprofen, mefenamic acid, naproxen, diclofenac, indomethacin, sulindac,
tolmetin, etodolac, ketorolac, or oxaprozin. In certain embodiments, a compound of
Formula (I) is a prodrug of tranexamic acid and a non-steroidal anti-inflammatory
agent such as ibuprofen or naproxen.
[00199] Dosage forms, upon releasing a tranexamic acid prodrug of Formula
(I), can provide tranexamic acid upon in vivo administration to a patient. The
promoiety or promoieties of the prodrug of Formula (f) can be cleaved either
chemically and/or enzymatically. One or more enzymes present in the stomacb,
intestinal lumen, intestinal tissue, blood, liver, brain or any other suitable tissue of a
mammal can enzymatically cleave the promoiety or promoieties of the prodrug. If the
promoiety or promoieties are cleaved after absorption by the gastrointestinal tract,
tranexamic acid prodrugs of Formula (I) can be absorbed into the systemic circulation
from the large intestine. In certain embodiments, the promoiety or promoieties are
cleaved after absorption by the gastrointestinal tract. In certain embodiments, the
promoiety or promoieties are cleaved in the gastrointestinal tract and tranexamic acid
is absorbed into the systemic circulation form the large intestine. La certain
embodiments, the tranexamic acid prodrug is absorbed into the systemic circulation
from the gastrointestinal tract, and the promoiety or promoieties are cleaved in the
systemic circulation, after absorption of the tranexamic acid prodrug from the
gastrointestinal tract
[00200] In certain embodiments, a tranexamic prodrug of Formula (I) can be
provided to a patient by topical administration. For example, a pharmaceutical
composition comprising at least on compound of Formula (I) and at least one
pharmaceutically acceptable topical vehicle can be formulated in the form of a cream,
lotion, ointment, solution, aerosol, spray and the like. The topical formulation can be
applied to a surface area of a patient to be treated, for example, by spreading or
spraylng. The surface area of a patient to be treated can be an area exhibiting
excessive or heavy bleeding such as a wound, oral mucosa, buccal mucosa, rectal
mucosa, vaginal mucosa, nasal mucosa, surfaces exposed during surgery, or an area of
the skin exhibiting a skin disease or disorder. In prophylactic applications, the surface
area of a patient to be treated can be, for example, an area of a mucosa or the skin

having a predisposition for a skin disease or disorder including, but not limited to,
bleeding, epidermal hyperplasia, skin roughening, and unwanted skin pigmentation.
Doses
[00201] The amount of tranexamic acid prodrug that will be effective in the
treatment of a particular disorder or condition disclosed herein can depend on the
nature of the disorder or condition, and can be determined by standard clinical
techniques known in the art m addition, in vitro or in vivo assays can optionally be
employed to help identify optimal dosage ranges. The amount of a compound
administered can depend on, among other factors, the subject being treated, the
weight of the subject, the severity of the affliction, the manner of administration, and
the judgment of the prescribing physician.
[00202] In certain embodiments, a dosage form are adapted to be administered
to a patient no more than twice per day, and in certain embodiments, only once per
day. Dosing can be provided alone or in combination with other drugs and can
continue as long as required for effective treatment of the disease state or disorder.
When used to treat or prevent menorrhagia, a therapeutically effective amount of one
or more compounds of Formula CO can be administered concurrently with
menstruation (typically for 4 to 7 days).
[00203] Suitable daily dosage ranges for oral administration can range from
about 2 mg to about 50 mg of tranexamic acid equivalents per kilogram body weight.
Suitable drug concentrations in formulations for topical administration can range from
about 1% to about 10% (on a weight basis). Appropriate dosage ranges can be readily
determined by methods known to the skilled artisan.
Examples
[00204] The following examples describe in detail preparation of compounds
and compositions disclosed herein and assays for using compounds and compositions
disclosed herein. It will be apparent to those of ordinary skill in the art that many
modifications, both to materials and methods, may be practiced.
[00205] In the examples below, the following abbreviations have the following
meanings. If an abbreviation is not defined, it has its generally accepted meaning.
DMSO = dimethylsulfoxide
g = gram

h = hour
HPLC = high pressure liquid chromatography
LC/MS = liquid chromatography/mass
spectroscopy
M = molar
mg = milligram
Tnin = minute
mL = milliliter
mmol = millimoles
MTBE = methyl tert-butyl ether
NMM = ^-methylmorpholine
nM = nanomolar
jiL = microliter
um =. micrometer
uM = micromolar
v/v = volume to volume
w/v = weight to volume
General Experimental Protocols
[00206] fra7w^^Arnmomemyl)-cyclohexanecarboxylic acid (tranexamic acid)
was purchased from Sigma-Aldrich, Inc. and was used without further manipulation.
O-(l-Acyloxyalkyl) S-alkylthiocarbonates were previously synthesized according to
the procedures disclosed in Gallop et al, U.S. Application Publication No.
2005/0222431 and converted to the corresponding acyloxyalkyl N-
hyd^oxysuccinimide carbonic acid esters as described therein, or according to the
general procedure given below. All other reagents and solvents were purchased from
commercial suppliers and used without further purification or manipulation.
[00207] Proton NMR spectra (400 MHz) were recorded on a Varian AS 400
NMR spectrometer equipped with an autosampler and data processing computation.
DMSO-d6 (99.9% D) or CDC13 (99.8 % D) were used as solvents unless otherwise
noted. The DMSO or chloroform solvent signal was used for calibration of the
individual spectra (H. E. Gottlieb et al., J. Org. Chem., 1997, 62,7512). Analytical
LC/MS was performed on a Waters 2790 separation module equipped with a Waters

Micromass QZ mass spectrometer, a Waters 996 photodiode detector, and a Merck
Chromolith UM2072-027 or Phenomenex Luna C-18 analytical column. Mass-
guided preparative HPLC purification of final compounds was performed on an
instrument equipped with a Waters 600 controller, ZMD Micromass spectrometer, a
Waters 2996 photodiode array detector, and a Waters 2700 Sample Manager.
Acetonitrile/water gradients containing 0.05% formic acid were used as eluents in
both analytical and preparative HPLC experiments.
General Procedure for the Synthesis of Acvloxvalkvi JV-hvdroxvsuccinimide
Carbonic Acid Esters
[00208] A 250 mL round-bottomed flask equipped with a magnetic stir bar and
a pressure-equilibrating dropping funnel was charged with the 1-acyloxyalkyl
alkyltbiocarbonate (10 mmol) and Jv"-hydroxysuccinimide (20-40 mmol).
Dichloromethane (20-40 mL) was added and the reaction mixture cooled to ca. 0 °C
in an ice-bath. Peracetic acid (32 wt.%) in a 40-45% aqueous acetic acid solution (30
mmol) was added dropwise with stirring over a period of ca. one hour to the cooled
solution. After addition was complete, stirring was continued for additional three to
five hours at this temperature, the reaction being monitored by 'H NMR. spectroscopy.
After complete consumption of the starting material, the reaction mixture was diluted
with additional dichloromethane, and the organic solution was washed successively
with water (three times) and once with a 10% aqueous solution of sodium
metabisulfite or sodium thiosulfate to quench any remaining oxidant. The combined
organic extracts were dried over MgSO^ filtered, and the solvent removed under
reduced pressure with a rotary evaporator. Compound identity, integrity, and purity
were checked by 'H NMR spectroscopy. The crude material was used directly in the
next step, or could be further purified by commonly employed techniques well-known
to those skilled in the art.
Example 1: l-f(2.5-Dioxopvrrolidinyl)oxycarbonvloxy1-propvl2-
methvlpropanoate (2)
[00209] Following the above general procedure, l-(ethylthiocarbonyloxy)-
propyl 2-methylpropanoate (2.3 g, 9.82 mmol) and iV'-hydroxysuccinirnide (4.6 g, 40
mmol) were reacted in dichloromethane (20 mL) with peracetic acid (32 wt.%, 6.13

mL). After aqueous workup, isolation and removal of residual solvents in vacuo, the
crude product 2 (1.76 g, 61%) was obtained as a yellow oil. The material was used in
the next step without further purification. lK NMR (400 MHz, CDC13): 8 = 1.02 (t, J
= 7.6 Hz, 3H), 1.20 (d, J= 6.8 Hz, 3H); 1.21 (d, J= 7.2 Hz, 3H), 1.88-2.00 (m, 2H),
2.61 (hept, J= 7.2 Hz, 1H), 2.84 (s, 4H), 6.71 (t, J= 5.2 Hz, 1H).
Example 2: l-K2,5-Dioxopvrrolidinvl)oivcarbonvloxvl-2-methvlpropvl2-
methylpropanoate (3)
[00210] Following the above general procedure, 2-mefhyl-l-
(methylthiocarbonyloxy)-propyl 2-methylpropanoate (2.34 g, 10.0 mmol) andiV-
hydroxysuccinimide (5.76 g, 50 mmol) were reacted in dichloromethane (30 mL) with
peracetic acid (32 wt%, 8.17 mL). After aqueous workup, isolation and removal of
residual solvents in vacuo, the crude product 3 (2.12 g, 70%) was obtained as a pale
yellow oil. The material was used in the next step without further purification. *H
NMR (400 MHz, CDCI3): 8 = 1.04 (d, J=7.2 Hz, 6H), 1.21 (d, J= 6.8 Hz, 3H), 1.22
(d, y- 6.8 Hz, 3H), 2.15-2.21 (m, 1H), 2.63 (hept, J= 7.2 Hz, 1H), 2.84 (s, 4H), 6.59
(d, J= 5.2 Hz, 1H). MS (ESI) m/z 324.10 (M+Na)+.
General Nucleophilic Carbamovlation Procednre for Synthesis of Acyloxyalkvl
Carbamates of Tranexamic Acid
[00211] A screw-capped 40 mL glass vial equipped with a magnetic stir bar
was charged with fran5-4-(aminomethyl)cyclohexanecarboxylic (tranexamic) acid
(472 mg, 3.0 mmol). The appropriate acyloxyalkyl N-hydroxysucciriimide carbonic
acid ester (2.0 mmol) was added either as a solid or was dissolved in a small volume
of solvent (for oily materials). A mixture of methyl tert-butyl ether (MTBE), acetone,
and water (v/v/v = 4:3:1) (15-20 mL) was added, and the reaction mixture stirred for
ca. 12 hours at room temperature. Upon completion of the reaction, the mixture was
diluted with ethyl acetate and 1 N aqueous hydrochloric acid (ca. 10 mL) was added.
After vigorous mixing followed by phase separation, the aqueous layer was extracted
once more with EtOAc, and the combined organic extracts were washed with brine.
The solvents were evaporated under reduced pressure, the dry residue was dissolved
in a mixture of 60% (v/v) acetonitrile/water, and the solution filtered through a 0.2
yaa nylon syringe filter. Final purification was achieved by mass-guided preparative

HPLC. After lyophilization of the solvents, the pure compounds were obtained as
white powders.
General Procedure for One Pot Synthesis of Acvloxvalkvl Carbamates of
Tranexamic Acid
[00212] Under an atmosphere of nitrogen, a dry 100 mL round-bottomed flask
equipped with a magnetic stir bar and a rubber septum was charged with trans-4-
(arninomethyl)cyclohexanecarboxylic (tranexamic) acid (786.1 mg, 5.0 mmol).
Anhydrous dichloromethane (10-15 mL) was added, and the reaction mixture was
cooled to ca. 0 °C with an icebath. CMorotrimethylsilane (1.396 mL, 1.195 g, 11.0
mmol) was added neat at this temperature, followed by slow addition ofN-
methylmorpholine (1.374 mL, 1.264 g, 12.5 mmol). The reaction mixture was stirred
at this temperature for ca. 30 min, when an appropriately substituted
chloroalkylchloroformate (7.5 mmol) was added dropwise and in neat form. The
reaction mixture was stirred at this temperature for an additional 30 min when a
premixed mixture of NMM (2.75 mL, 2.53 g, 25 mmol) and an appropriately
substituted carboxylic acid (50 mmol) was added at ca. 0 °C. The reaction mixture
was stirred overnight with warming to room temperature. The dichloromethane was
removed in vacuo from the dark brownish reaction mixture using a rotary evaporator.
The crude reaction product was diluted with methyl ter/-butyl ether (MTBE), and the
solution washed three times with water. The organic layer was dried over MgSC>4,
and the filtrate evaporated in vacuo using a rotary evaporator. The crude dry residue
was dissolved in a small amount of a mixture of 60% (v/v) acetonitrile/water (ca. 5
mL), and the solution filtered through a 0.2 nm nylon syringe filter. Final purification
was achieved by mass-guided preparative HPLC. After lyophilization of the solvents,
the pure compounds were generally obtained as white powders.
General Procedure for the Synthesis of Sodium Salts of Acvloxvalkvl
Carbamates of Tranexamic Acid
[00213] A screw-capped 40 mL vial equipped with a magnetic stir bar was
charged with an appropriately substituted acyloxyalkyl carbamate of tranexamic acid
(5.0 mmol). The material was dissolved in ca. 10 mL of acetonitrile. A solution of
sodium bicarbonate (NaHCOs) (420.1 mg, 5.0 mmol) in ca. 20 mL of water was

added at room temperature and the mixture was stored one hour after the evolution of
carbon dioxide subsided. The clear solution was frozen at -78 °C and the solvents
were lyophilized. After lyophilization of the solvents, the pure compounds were
obtained as white powders.
Example 3: Cvclohexanecarboxvlic Acid (4)
[00214] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)ox3TOarbonyloxy]methyl 2-methylpropanoate (518 mg, 2.0 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
4 (397 mg, 66% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. *H NMR (400 MHz, DMSO-d6): 5 = 0.82-0.95 (br. m, 2H), 1.08
(d, 7= 7.2 Hz, 6H), 1.17-1.39 (br. m, 3H), 1.64-1.73 (br. m, 2H), 1.82-1.91 (br. m,
2H), 2.10 (tt, 7= 11.8,3.8 Hz, 1H), 2.55 (hept, 7= 7.2 Hz, 1H), 2.78-2.88 (br. m,
2H), 5.61 (s, 2H), 7.55 (t, J= 5.6 Hz, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 302.09
(M+H)+; 299.99 (M-H)".
Example 4: /ra«5-4-lfr3-Methvlbntanoyloxv)niethoxvcarbonvnaminomethvl)-
Cyclohexanecarboxylic Acid (5)
[00215] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyn:oUdinyl)oxycarbonyloxy]meuiyl 3-methylbutanoate (547 mg, 2.0 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
5 (310 mg, 49% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. !H NMR (400 MHz, DMSO-d6): 8 = 0.86-0.94 (br. m, 8H), 1.17-
1.38 (br. m, 3H), 1.64-1.72 (br. m, 2H), 1.83-1.91 (br. m, 2H), 1.96 (hept, J= 7.2 Hz,
1H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.21 (d, /= 6.8 Hz, 2H), 2.78-2.86 (br. m, 2H),
5.61 (s, 2H), 7.55 (t, /= 5.6 Hz, 1H), 11.99 (br. s, 1H). MS (ESI) m/z 316.11
(M+H)+; 314.07 (M-H)".
Example 5: fraity-4"(f(2,2-DimethYlpropanovtoxv^methoxvcarbonyM-
aminomethyD-Cyclohexanecarboxvlic Acid (6)

[00216] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]methyl 2,2-dimethylpropanoate (547 mg, 2.0
mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title
compound 6 (476 mg, 76% yleld) as a white powder after work-up and mass-guided
preparative HPLC purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br.
m, 2H), 1.13 (s, 9H), 1.17-1.38 (br. m, 3H), 1.64-1.72 (br. m, 2H), 1.82-1.91 (br. m,
2H), 2.09 (tt, J= 12.0,3.6 Hz, 1H), 2.78-2.87 (br. m, 2H), 5.61 (s, 2H), 7.54 (t, /=
5.6 Hz, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 316.11 (M+H)+; 314.01 (M-H)-.
Example 6: frgfts^fffltenzoytoxY^methoxvcarbonvflamfaomethvU-
Cvclohexanecarborvlic Acid (7)
[00217] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]methyl benzoate (587 mg, 2.0 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 7 (445 mg,
66% yleld) a white powder after work-up and mass-guided preparative HPLC
purification. ^NMR (400 MHz, DMSO-d6): 8 = 0.83-0.95 (br. m, 2H), 1.16-1.39
(br. m, 3H), 1.65-1.72 (br. M, 2H), 1.82-1.91 (br. m, 2H), 2.09 (tt, J= 12.4, 3.6 Hz,
1H), 2.81-2.88 (br. m, 2H), 5.88 (s, 2H), 7.50-7.57 (m, 2H), 7.61 (t, J= 6.0 Hz, 1H),
7.65-7.70 (m, 1H), 7.93-7.97 (m, 2H), 11.96 (br. s, 1H). MS (ESI) m/z 336.01
Example 7: trans-4-{fl-(Acetoxv)ethoxvcarbonvllaminomethvU-
Cvclohexanecarboxvlic Acid f8)
[00218] Following the general procedure for the one pot synthesis, tranexamic
acid (786 mg, 5.0 mmol) was reacted with chlorotrimethylsilane (1.396 mL, 1.195 g,
11.0 mmol) in anhydrous dichloromethane (10 mL) and in the presence of N-
methylmorphohne (1.374 mL, 1.264 g, 12.5 mmol). Subsequent reaction of the
intermediate with 1-chloroethylchloroformate (0.82 mL, 1.07 g, 7.5 mmol) followed
by a mixture of NMM (2.75 mL, 2.53 g, 25 mmol) and acetic acid (2.86 mL, 3.00 g,
50 mmol) ylelded the title compound 8 (320 mg, 22% yleld) as a very slightly orange-
colored oil after aqueous work-up and mass-guided preparative HPLC purification.

!H NMR (400 MHz, DMSO-d6): 5 = 0.82-0.94 (br. m, 2H), 1.17-1.35 (br. m, 3H),
1.38 (d, J= 5.2 Hz, 3H), 1.66-1.73 (br. m, 2H), 1.84-1.91 (br. m, 2H), 1.99 (s, 3H),
2.10 (tt, /= 12.0,3.6 Hz, 1H), 2.74-2.88 (m, 2H), 6.62 (q, /= 5.2 Hz, 1H), 7.44 (t, J=
6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 310.12 (M+Na)+; 286.08 (M-H)-.
Example 8: trans-4- { fl-flPropanovIoxytethoxvcarbonvn aminomethvU-
Cvclohexanecarboxvlic Acid (9)
[00219] Following the general procedure for the one pot synthesis, tranexamic
acid (786 mg, 5.0 mmol) was reacted with chlorotrimethylsilane (1.396 mL, 1.195 g,
11.0 mmol) in anhydrous dichloromethane (10 mL) and in the presence of N-
methyhnorpholine (1.374 mL, 1.264 g, 12.5 mmol). Subsequent reaction of the
intermediate with chloroethylchloroformate (0.82 mL, 1.07 g, 7.5 mmol) followed by
a mixture of NMM (2.75 mL, 2.53 g, 25 mmol) and propionic acid (3.73 mL, 3.70 g,
50 mmol) ylelded the title compound 9 (103 mg, 7% yleld) as colorless, very viscous
oil after aqueous work-up and two mass-guided preparative HPLC purifications. 'H
NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H), 1.03 (t, J= 7.6 Hz, 3H),
1.17-1.35 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.65-1.73 (br. m, 2H), 1.83-1.91 (br.
m, 2H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.26-2.33 (m, 2H), 2.74-2.90 (m, 2H), 6.64 (q,
J= 5.6 Hz, 1H), 7.44 (t, J= 5.6 Hz, 1H), 11.99 (br. s, 1H). MS (ESI) m/z 324.14
(M+Na)+; 300.10 (M-H)-.
Example 9: fra»5-4-(fl-rButanovloxv)ethoxvcarbonvilaminomethvl)-
Cyclohexanecarboxvlic Acid (10)
[00220] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (800 mg, 5 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]ethyl butanoate (700 mg, 2.6 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 10 (200 mg,
28% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.89-0.97 (m, 5H), 1.22-1.36 (br.
m, 3H), 1.42 (d, J= 5.6 Hz, 3H), 1.51-1.60 (m, 2H), 1.72-1.73 (br. m, 2H), 1.90-1.93
(m, 2H), 2.13 (tt, /= 12,3.6 Hz, 1H), 2.29 (t, / = 6.8 Hz, 2H), 2.85 (t, J= 6.4 Hz,
2H), 6.69 (q, J= 5.6 Hz, 1H), 7.48 (t, J = 6.0 Hz, 1H), 12.03 (br. s, 1H). MS (ESI)
tn/z 338.15 (M+Na)+; 314.12 (M-H)~.

Example 10: Sodium frg«^-4-{ri-(BntanovIoxv)ethoxvcarbonvl]aminomethvI>-
Cvcloheianecarboxvlate (11)
[00221] Following the general procedure for the formation of the
corresponding sodium carboxylates of acyloxyaliyl carbamates of tranexamic acid.
946 mg (3.0 mmol) of fran^-{[l-(butanoyloxy)ethoxycarbonyl]aminornethyl}-
cyclohexanecarboxylic acid 10 was reacted with 252 mg (3.0 mmol) of sodium
bicarbonate (NaHCOs) in 20 mL of a mixture of acetonitrile and water (1:1) to yleld
1.02 g (quant.) of the title compound 11 as a colorless powder. *H NMR (400 MHz,
DMSO-d6): 8 = 0.73-0.84 (m, 2H), 0.87 (t, J= 6.8 hz, 3H) 1.08-120 (m, 2H), 1.20-
1.32 (m, IB), 1.38 (d, /= 5.2 Hz, 3H), 1.46-1.56 (m, 2H), 1.60-1.74 (br. m, 3H),
1.76-1.83 (br. m, 2H), 2.25 (t, /= 7.2 Hz, 2H), 2.78 (t, J= 6.0 Hz, 2H), 6.65 (q, J=
5.2 Hz, 1H), 7.41 (t, J= 5.6 Hz, 1H). MS (ESI) mlz 338.16 (M+Na)+; 314.18
(M-H)-.
Example 11: frg«5-4-{fl-(TentanovIoxv)ethoxvcarbonyllanmiomethvl>-
Cvclohexanecarboxvlic Acid (12)
[00222] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (1.1 g, 7.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy] ethyl pentanoate (800 mg, 2.8 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 12 (150 mg,
16% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. *H NMR (400 MHz, DMSO-d6): 5 = 0.88-0.97 (m, 5H), 1.22-1.38 (br.
m, 5H), 1.42 (d, /= 5.2 Hz, 3H), 1.44-1.56 (m, 2H), 1.72-1.74 (m, 2H), 1.90-1.93 (m,
2H), 2.13 (tt, J= 12, 3.6 Hz, 1H), 2.30 (t, /= 7.2 Hz, 2H)5 2.85 (t, J= 6.4 Hz, 2H),
6.68 (q, J= 5.6 Hz, 1H): 7.47 (t J= 6.0 Hz, 1H), 12.01 (br. s, 1H). MS (EST) mlz
352.18 (M+Na)+: 328.14 (M-H)-.
Example 12: frg«y-4-{ri-(2-MethYlpropanovIoxv0ethoxvcarbonvI1-aminomethvI}-
Cvclohexanecarboxvlic Acid (13)
00223] Following the general nucleophilic carbamoylation procedure, tranexamic
acid and 1-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]ethyl 2-methylpropanoate were

reacted to yleld the title compound 13 (333 mg, 53% yleld) as a colorless powder after
work-up and mass-guided preparative HPLC purification. 1H NMR (400 MHz, DMSO-
ds): 6 = 0.82-0.94 (br. m, 2H), 1.058 (d, J = 6.4 Hz, 3H), 1.062 (d, J= 6.8 Hz, 3H), 1.17-
1.36 (br. m, 3H), 1.38 (d, J= 5.6 Hz, 3H), 1.65-1.73 (br. m, 2H), 1.83-1.91 (br. m, 2H),
2.10 (tt, J= 12.0, 3.6 Hz, 1H), 2.49 (hept., J = 6.8 Hz, 1H), 2.77-2.85 (br. m, 2H), 6.62
(q, J= 5.2 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.08
(M+Na)+; 314.01 (M-H)".
Example 13: Sodium frg«y-4-iri- aminomethvU-CvcIohexanecarboxvIate(14)
[00224] Following the general procedure for the formation of the
corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid,
5.03 g (15.94 mmol) of iran5-4-{[l-(2-methylpropanoyloxy)ethoxycarbonyl]-
aminomethyl}-cyclohexanecarboxylic acid 13 was reacted with 1.34 g (15.94 mmol)
of sodium bicarbonate (NaHCOs) in 40 mL of a mixture of acetonitrile and water
(1:1) to yleld 5.38 g (quant.) of the title compound 14 as a colorless powder. JH NMR
(400 MHz, DMSO-d6): 5 = 0.72-0.84 (br. m, 2H), 1.057 (d, J= 6.4 Hz, 3H), 1.059 (d,
J= 6.8 Hz, 3H), 1.20-1.32 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.59-1.73 (br. m,
3H), 1.75-1.83 (m, 2H), 2.43-2.53 (m, 1H), 2.72-2.84 (br. m, 2H), 6.62 (q, J= 5.6 Hz,
1H), 7.42 (t, J= 5.6 Hz, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)~.
Example 14; (-J-)-frc?f5-4-((rqJy)-l-(2-
MethvIpropanoyloxv')ethox\1carbonvlaminolmethvIVCvclohexanecarborsrIic
Acid (15)
[00225] The enantiomers of frcms-4-{[l-(2-
methylprop ano>4oxy)emoxycaxbon>4]-aminomethyl} -cyclohexanecarboxylic acid 13
were resolved by means of a Waters mass-guided preparative HPLC using a
ChiralPak AD-RH 250 x 20 mm column, an isocratic eluent of 30% acetonitrile/70%
water/0.05% formic acid, and a flowrate of 15 rnL/min. The enantiomeric excesses
were determined with an analytical Waters 2690/ZQ LC/MS apparatus using a
ChiralPak AD-RH column, an isocratic ement consisting of 30% acetonitrile/70%
water/0.05% formic acid, and a flowrate of 60 ^Urnin. 529 mg of the title compound

15 was obtained as a colorless powder after lyophilization [J?f = 12.2 min; e.e. =
98.3%; [afo25-8 = +18.64, c (19.97, MeOH)]. The assignment of the absolute
configuration was accomplished by comparison with material obtained from an
independent synthesis. lH NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H),
1.057 (d, J= 6.8 Hz, 3H), 1.061 (d, J=6.8 Hz, 3H), 1.17-1.36 (br. m, 3H), 1.38 (d, J
= 5.6 Hz, 3H), 1.65-1.73 (br. m, 2H), L83-1.91 (br. m, 2H), 2.10 (tt, J= 12.0,3.6 Hz,
1H), 2.49 (hept, /= 6.8 Hz, 1H), 2.77-2.85 (br. m, 2H), 6.62 (q, J- 5.2 Hz, 1H), 7.45
(t,7= 6.0Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)~.
Example 15: Sodium trans-4-(f UlS)-l-{2-
methvlpropanovloxv)ethorylcarbonylamino>methyl)-CvcIohexanecarboxvlate
061
[00226] Following the general procedure for the formation of the
corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid,
90.0 mg (0.2854 mmol) of (+>/raay-4-({[(15)-l-(2-
memylpropanoyloxy)emoxy]carbonylammo}methyl)-cyclohexanecarboxylic acidl5
was reacted with 24.0 mg (0.2854 mmol) of sodium bicarbonate (NaHCOa) in 4 mL
of a mixture of acetonitrile and water (1:1) to yleld 96.3 mg (quant) of the title
compound 16 as a colorless powder. The enantiomeric excesses were determined
with an analytical Waters 2690/ZQ LC/MS apparatus using a ChiralPak AD-RH
column, an isocratic eluent consisting of 30% acetonitrile/70% water/0.05% formic
acid, and a flowrate of 60 ^iL/xnin (R{ = 12.1 min; e.e. = 98.5%). JH NMR (400 MHz,
DMSO-d6): S = 0.72-0.84 (br. m, 2H), 1.057 (d, 7= 6.4 Hz, 3H), 1.059 (d, /= 6.8 Hz,
3H), 1.20-1.32 (br. m, 3H), 1.38 (d,/= 5.2 Hz, 3H), 1.59-1.73 (br. m, 3H), 1.75-1.83
(m, 2H), 2.43-2.53 (m, 1H), 2.72-2.84 (br. m, 2H), 6.62 (q, /= 5.6 Hz, 1H), 7.42 (t, J
= 5.6 Hz, 1H). MS (EST) m/z 338.16 (M+Na)+; 314.12 (M-H)-.
Example 16; f-^Wm«5-4-f(raj;)-l-f2-
MethYlpropanoYloxv)ethoxvkarbonylainino)methvlVCvcIohexanecarboxvlic
Acid (lTi
[00227] The enantiomers of fra«5-4-{[l-(2-
memylpropanoyloxy)emoxycarbonyl]-aminomethyl}-cyclohexanecarboxylic acidl3
were resolved by means of a Waters mass-guided preparative HPLC using a

ChiralPak AD-RH 250 x 20 mm column, an isocratic eluent of 30% acetonitrile/70%
water/0.05% formic acid, and a flowrate of 15 mL/min. The enantiomeric excesses
were determined with an analytical Waters 2690/ZQ LC/MS apparatus using a
ChiralPak AD-RH column, an isocratic eluent consisting of 30% acetonitrile/70%
water/0.05% formic acid, and a flowrate of 60 uL/min. 310 mgofthe title compound
17 was obtained as a colorless powder after lyophilization [Rf= 15.1 min; e.e. = 97.6
%; WD M-5 = -14.94, c (24.30, MeOH)]. The assignment of the absolute
configuration was accomplished by comparison with material obtained from an
independent synthesis. *H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 2H),
1.057 (d, J= 6.8 Hz, 3H), 1.061 (d, J= 6.8 Hz, 3H), 1.17-1.36 (br. m, 3H), 1.38 (d, J
= 5.6 Hz, 3H), 1.65-1.73 (br. m, 2H), 1.83-1.91 (br. m, 2H), 2.10 (tt, J= 12.0,3.6 Hz,
1H), 2.49 (hept, /= 6.8 Hz, 1H), 2.77-2.85 (br. m, 2H), 6.62 (q, /= 5.2 Hz, 1H), 7.45
(t,/=6.0Hz, 1H), 11.97 (br.s, 1H). MS (ESI) m/z338.16 (M+Na)+; 314.12 (M-H)-.
Example 17: Sodium ft-a«^-4-((raJg)-l-(2-
MethvIpropanovloxv)ethorvlcarboavlamino)rnethvl)-Cvclohexanecarboxylate
081
[00228] Following the general procedure for the formation of the
corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid,
90.0 mg (0.2854 mmol) of (-)-fra/w-4-({[(li?)-l-(2-
methylpropanoyloxy)ethoxy]carbonylarnino}methyl)-cyclohexanecarboxylic acidl7
was reacted with 24.0 mg (0.2854 mmol) of sodium bicarbonate (NaHCOj) in 4 mL
of a mixture of acetonitrile and water (1:1) to yleld 96.3 mg (quant.) of the title
compound 18 as a colorless powder. The enantiomeric excesses were determined
with an analytical Waters 2690/ZQ LC/MS apparatus using a ChiralPak AD-RH
column, an isocratic eluent consisting of 30% acetonitrile/70% water/0.05% formic
acid, and a flowrate of 60 uL/min (Rt = 15.0 min; e.e. = 97.7 %). JH NMR (400 MHz,
DMSO-d6): 5 = 0.72-0.84 (br. m, 2H), 1.057 (d, J= 6.4 Hz, 3H), 1.059 (d, /= 6.8 Hz,
3H), 1.20-1.32 (br. m, 3H), 1.38 (d, J= 5.2 Hz, 3H), 1.59-1.73 (br. m, 3H), 1.75-1.83
(m, 2H), 2.43-2.53 (m, 1H), 2.72-2.84 (br. m, 2H), 6.62 (q, /= 5.6 Hz, 1H), 7.42 (t, J
= 5.6 Hz, 1H). MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)".

Example 18: Cvclohexanecarboxylic Acid (19)
[00229] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (900 mg, 6 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]ethyl 3-methylbutanoate (800 mg, 2.8 mmol) were
reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 19
(200 mg, 21% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. lH NMR (400 MHz, DMSO-d6): 5 = 0.88-0.97 (m, 8H), 1.22-
1.38 (br. m, 3H), 1.42 (d, J= 5.2 Hz, 3H), 1.71-1.74 (m, 2H), 1.90-2.02 (br. m, 3H),
2.1-2.2 (br. m, 3H), 2.85 (t, J= 6.4 Hz, 2H), 6.69 (q, J= 5.6 Hz, 1H), 7.48 (t, 7= 6.0
Hz, 1H), 12.01 (br. s, 1H). MS (ESI) m/z 352.15 (M+Na)+; 328.14 (M-H)".
Example 19: Sodium frg»s-4-IFl-(3-
Methvlbutanovloxv')ethoyycarbonvl]aininomethvU-CYclohexanecarboxvlate(20)
[00230] Following the general procedure for the formation of the
corresponding sodium carboxylates of acyloxyalkyl carbamates of tranexamic acid,
1.976 g (6.0 mmol) of/ra7M-4-{[l-(3-
memylbutanoyloxy)emoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid 19
was reacted with 504.1 mg (6.0 mmol) of sodium bicarbonate (NaHCOa) in 20 mL of
a mixture of acetonitrile and water (1:1) to yleld 2.11 g (quant) of the title compound
20 as a colorless powder. !H NMR (400 MHz, DMSO-d6): 8 = 0.72-0.84 (m, 2H),
0.89 (d, /= 6.4 Hz, 6H), 1.07-1.21 (m, 2H), 1.22-1.32 (m, 1H), 1.38 (d, /= 5.2 Hz,
3H), 1.58-1.74 (br. m, 3H), 1.76-1.84 (br. m, 2H), 1.88-2.01 (m, 1H), 2.08-2.20 (m,
2H), 2.74-2.85 (m, 2H), 6.66 (q, 7= 5.6 Hz, 1H), 7.42 (t, /= 6.4 Hz, 1H). MS (ESI)
m/z 352.18 (M+Na)+; 328.14 (M-H)~.
Example 20: fra/ig-4-(Hr(2,2-DimethvlpropanoyloxY)-
ethoxycarbonvllaminomethvil-Cvclohexanecarboxylic Acid (21)
[00231] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (1.1 g, 7 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]ethyl
2,2-dimethylpropanoate (1.1 g, 3.8 mmol) were reacted in the MTBE/acetone/water
mixture (16 mL) to yleld the title compound 21 (200 mg, 16% yleld) as a white
powder after work-up and mass-guided preparative HPLC purification. [H NMR (400

MHz, DMSO-d6): 5 = 0.86-0.99 (m, 2H), 1.14 (s, 9H), 1.21-1.39 (br. m, 3H), 1.42 (d,
J= 5.2 Hz, 3H), 1.71-1.74 (m, 2H), 1.89-1.91 (m, 2H), 2.13 (tt, J= 12,3.6 Hz, 1H),
2.81-2.89 (m, 2H), 6.64 (q, J= 5.6 Hz, IH), 7.49 (t, J= 6.0 Hz, 1H), 12.01 (br. s, 1H).
MS (ESI) /M/Z 352.16 (M+Na)+; 328.14 (M-H)'
Example 21: frgHjr-4-(fl-(CvclohexvIcarbonviorv)ethoivcarbonvnamiiiomethvU-
Cvclohexanecarboxvlic Acid (22)
[00232] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (780 mg, 5.0 mmol) and l-[(2,5-
dioxopyrrohdmyl)oxycarbonyloxy]ethyl cyclohexanecarboxylate (700 mg, 2.2 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
22 (200 mg, 26% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. 'H NMR (400 MHz, DMSO-d6): 5 = 0.87-0.99 (m, 2H), 1.20-
1.44(br. m, 11H), 1.58-1.81 (m, 7H), 1.89-1.92 (m, 2H),2.13 (11,7= 12,3.6 Hz, 1H),
2.27-2.35 (m, 1H), 2.79-2.90 (m, 2H), 6.66 (q, J=5.6 Hz, 1H), 7.48 (t, /= 6.0 Hz,
1H), 12.05 (br. s, 1H). MS (ESI) m/z 378.13 (M+Na)+; 354.15 (M-H)".
Example 22: fra/is-4-ffl-(BenzoYloxv)ethoxvcarbonvllaminomethvU-
Cvclohexanecarboxvlic Acid (23)
[00233] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (1.1 g, 7.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]ethyl benzoate (800 mg, 2.6 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 23 (160 mg,
18% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. lH NMR (400 MHz, DMSO-d6): 5 = 0.87-0.96 (m, 2H), 1.21-1.38 (br.
m, 3H), 1.57 (d, /= 5.6 Hz, 3H), 1.71-1.74 (m, 2H), 1.88-1.91 (m, 2H), 2.1-2.2 (m,
1H), 2.84-2.88 (m, 2H), 6.92 (q, J= 5.6 Hz, 1H), 7.54-7.58 (m, 3H), 7.70 (m, 1H),
7.94-7.96 (m, 2H), 12.05 (br. s, 1H). MS (ESI) m/z 372.10 (M+Na)+; 348.05 (M-H)".
Example 23: Sodium trans-4-{fl-(BenzovIoxv)ethoxvcarbonyllairiinomethvU-
Cvclohexanecarboxvlate (24)
[00234] Following the general nucleophilic carbamoylation procedure for the
formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of

tranexamic acid, 2.096 g (6.0 mmol) of trans A- {[1-
(benzoyloxy)ethoxycaibonyl]aniinomethyl}-cyclohexanecarboxylic acid 23 was
reacted with. 504.1 mg (6.0 mmol) of sodium bicarbonate (NaHCCb) in 20 mL of a
mixture of acetonitrtte and water (1:1) to yleld 2.23 g (quant.) of the title compound
24 as a colorless powder. JH NMR (400 MHz, DMSO-d6): 8 = 0.72-0.86 (m, 2H),
1.08-1.21 (m, 2H), 1.22-1.32 (m, 1H), 1.53 (d, J= 5.6 Hz, 3H), 1.59-1.84 (br. m, 5H),
2.73-2.86 (m, 2H), 6.88 (q, /= 5.6 Hz, 1H), 7.47-7.56 (m, 3H), 7.64-7.70 (m, 1H),
7.89-7.94 (m, 2H). MS (ESI) m/z 372.10 (M+Na)+; 348.12 (M-H)~
Example 24: Methvlbenzovloxy)ethoxvcarbonvllaminomethvl>-CYclohexanecarboxylic Acid
(25)
[00235] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (780 mg, 5.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]ethyl 2-methylbenzoate (700 mg, 2.2 mmol) were
reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 25
(290 mg, 36% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.88-0.97 (m, 2H), 1.22-
1.38 (br. m, 3H), 1.57 (d, /= 5.6 Hz, 3H), 1.72-1.76 (m, 2H), 1.89-1.92 (m, 2H), 2.13
(tt, J = 12,3.6 Hz, 1H), 2.50 (s, 3H), 2.87 (t, /= 2.8 Hz, 2H), 6.89 (q, J= 5.6 Hz, 1H),
7.32-7.37 (m, 2H), 7.50-7.59 (m, 2H), 7.77 (dd, J= 7.2,1.2 Hz, 1H), 12.00 (s, 1H).
MS (ESI) m/z 386.12 (M+Na)+; 362.07 (M-H)-.
Example 25: frg/iy-4-(f({2-f4-(2-
MethYlpropvl)phenvIlpropanoyloxY}ethoxy)carbonylamino1methvl)
Cyclohexanecarboxvlic Acid (26)
[00236] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (629 mg, 4.0 mmol) and l-[(2,5-
dioxopyrrohdinyl)oxycarbonyloxy]ethyl2-[4-(2-methylpropyl)phenyl]propanoate
(665 mg, 1.7 mmol) were reacted in the MTBE/acetone/water mixture (32 mL) to
yleld the title compound 26 (344 mg, 47% yleld) as a colorless powder after work-up
and mass-guided preparative HPLC purification. :H NMR (400 MHz, DMSO-d6): 8
= 0.79-0.95 (m, 8H), 1.16-1.39 (m, 9H), 1.60-1.92 (m, 5H), 2.02-2.15 (m, 1H), 2.38-

2.44 (m, 2H), 2.70-2.86 (m, 2H), 3.68-3.76 (m, 1H), 6.62-6.72 (m, 1H), 7.04-7.18 (m,
4H), 7.32-7.50 (m, 1H), 11.98 (br. s, 1H). MS (ESI) m/z 456.24 (M+Na)+; 432.19
(M-H)".
Example 26: fraiiy-4-f(fr(2^-2-(6-Methoxv(2-
naphthvn)propanoyloxylethory>cart>onvlamfao)methyll Cvclohexanecarboxylic
Acid (27)
[00237] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (6.9 g, 43.9 mmol) and l-[(2,5-
dioxop>TToUdinyl)oxycarbonyloxy]ethyl(2iS)-2-[6-methoxy(2-naphthyl)]propanoate
(ca. 6.2 g, 14.9 mmol) were reacted in the MTBE/acetone/water mixture (160 mL) to
yleld the title compound 27 (579 mg, 9% yleld) as a colorless powder after work-up,
purification by silica gel column chromatography using ethyl acetate/hexane mixtures
from 2:1 to 4:1 as eluent, and subsequent mass-guided preparative HPLC. lH NMR
(400 MHz, DMSO-d6): 5 = 0.76-0.94 (m, 2H), 1.10-1.92 (m, 13H), 1.98-2.14 (m, 1H),
2.66-2.86 (m, 2H), 3.82-3.95 (m, 4H), 6.64-6.76 (m, 1H), 7.10-7.17 (m, 1H), 7.24-
7.50 (m, 3H), 7.63-7.80 (m, 3H), 11.99 (br.s, 1H). MS (ESI) m/z 480.16 (M+Na)+;
456.18 (M-H)".
Example 27: /rg/M-^IH-fPropanovloxvlpropoxvcarbonvnaminomethvU-
Cvclohexanecarboxvlic Acid (28)
[00238] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]propylpropanoate (281 mg, 1.03 mmol) were
reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 28
(173 mg, 53% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. lB NMR (400 MHz, DMSO-d6): 5 = 0.82-0.94 (br. m, 5H), 1.01
(t, J= 7.2 Hz, 3H), 1.17-1.37 (br. m, 3H), 1.64-1.75 (m, 4H), 1.83-1.91 (br. m, 2H),
2.10 (tt, J= 12.0,3.6 Hz, 1H), 2.23-2.38 (m, 2H), 2.76-2.87 (br. m, 2H), 6.54 (t, J=
6.0 Hz, 1H), 7.42 (t, 7=6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 338.16
(M+Na)+; 314.12 (M-H)-.

Example 28: fraHSMt-ffl-fButanovtoxvlpropoxvcarfaonvlTaminomethYU-
Cvclohexanecarboxylic Acid (29)
[00239] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]propyl butanoate (575 mg, 2.0 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 29 (408 mg,
62% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification lH NMR (400 MHz, DMSO-d6): 5 = 0.81-0.94 (or. m, 8H), 1.17-1.38
(br. m, 3H), 1.47-1.58 (m, 2H), 1.64-1.75 (m, 4H), 1.83-1.92 (br. m, 2H), 2.10 (tt, J=
12.0, 3.6 Hz, 1H), 2.26 (t, J= 7.2 Hz, 2H), 2.75-2.88 (m, 2H), 6.55 (t, /= 5.2 Hz,
1H), 7.42 (t, 7= 5.6 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 352.18 (M+Na)+;
328.14 (M-H)-.
Example 29: Methvlpropanovloxv)propoxvcarbonvnaminomethYl)-Cyclohexanecarboxylic
Acid (30)
[00240] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrohdinyl)oxycarbonyloxy]propyl 2-methylpropanoate (575 mg, 2.0 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
30 (651 mg, 99% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 5H), 1.06
(d, /= 6.8 Hz, 3H), 1.07 (d, J= 6.8 Hz, 3H), 1.17-1.39 (br. m, 3H), 1.64-1.76 (br. m,
4H), 1.83-1.91 (br. m, 2H), 2.09 (tt, J= 12.4,3.6 Hz, 1H), 2.50 (hept., .7= 6.8 Hz,
1H), 2.77-2.84 (br. m, 2H), 6.52 (t, /= 5.6 Hz, 1H), 7.43 (t, /= 6.0 Hz, 1H), 11.98
(br. s, 1H). MS (ESI) m/z 352.06 (M+Na)+; 328.02 (M-H)".
Example 30: fm«a-4-(ri-(2J-
Dimethvlpropanovloxv)propoxvcarbonvnamipomethYU-CvcIohexanecarboxvlic
Acid (31)
[00241] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrohdinyl)oxycarbonyloxy]propyl 2,2-dimethylpropanoate (290 mg, 0.96
mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title

compound 31 (147 mg, 45% yleld) as a white powder after work-up and mass-guided
preparative HPLC purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br.
m, 5H), 1.12 (s, 9H), 1.16-1.38 (m, 3H), 1.64-1.76 (m, 4H), 1.82-1.91 (br. m, 2H),
2.09 (tt, J= 12.0,3.2 Hz, 1H), 2.72-2.90 (m, 2H), 6.51 (t, J= 5.6 Hz, 1H), 7.44 (t, J=
6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 366.21 (M+Na)+; 342.16 (M-H)-.
Example 31: fraws-4-(fl^enzoYlory)propoxvcarbonvllaDmiomethvU-
Cvdohexanecarboxvlic Acid (32)
[00242] Following the general nucleopbilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]propyl benzoate (602 mg, 2.0 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 32 (679 mg,
93% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.80-0.95 (br. m, 2H), 0.96 (t, J=
7.6 Hz, 3H), 1.15-1.38 (br. m., 3H), 1.60-1.74 (m, 2H), 1.82-1.91 (m, 4H), 2.08 (tt, J
= 12.0,3.2 Hz, 1H), 2.76-2.87 (br. m, 2H), 6.78 (t, J= 5.6 Hz, 1H), 7.48-7.56 (br. m,
3H), 7.67 (tt, /= 7.6,1.2 Hz, 1H), 7.90-7.95 (m, 2H), 11.96 (br. s, 1H). MS (ESI) /«/z
386.12 (M+Na)+; 362.14 (M-H)".
Example 32: fra/i$-4-lfl-fAcetoxv)butoxvcarbonvl1ammomethyl)-
Cvclohexanecarboxvlic Acid (33)
[00243] Following the general nucleopbilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl acetate (620 mg, 2.27 mmol) were reacted in
the MTBE/acetone/water mixture (16 mL) to yleld the title compound 33 (174 mg,
24% yleld) as a waxy white solid after work-up and mass-guided preparative HPLC
purification. 'H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 5H), 1.17-1.38
(br. m, 5H), 1.63-1.73 (br. m, 4H), 1.83-1.91 (br. m, 2H), 2.05 (s, 3H), 2.10 (tt, J=
11.6, 3.6 Hz, 1H), 2.74-2.88 (m, 2H), 6.58 (t, J= 5.6 Hz, IE), 7.42 (t, J=> 6.0 Hz,
1H), 11.97 (br. s, 1H). MS (ESI) m£ 338.16 (M+Na)+; 314.12 (M-H)".
Example 33: Cvclohexanecarboxylic Acid (34)

[00244] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl propanoate (686 mg, 2.38 mmol) were
reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 34
(144 mg, 18% yleld) as a brittle off-white solid after work-up and mass-guided
preparative HPLC purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br.
m, 5H), 1.01 (t, J= 7.2 Hz, 3H), 1.17-1.38 (br. m, 5H), 1.63-1.73 (br. m, 4H), 1.84-
1.92 (br. m, 2H), 2.10 (tt, /= 12.0,3.6 Hz, 1H), 2.22-2.38 (m, 2H), 2.75-2.87 (m, 2H),
6.60 (t, J= 6.0 Hz, 1H), 7.42 (t, 7= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) mJz
352.18 (M+Na)+; 328.14 (M-Hf.
Example 34: transAA fl-(BiitanovIoxv>butoxvcarbonvl] aminomethyl)-
Cvclohexanecarboxvlic Acid (35)
[00245] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (800 mg, 5 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl butanoate (700 mg, 2.3 mmol) were reacted
in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 35 (210 mg,
27% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.87-0.95 (m, 8H), 1.22-1.41 (br.
m, 5H), 1.56 (m, 2H), 1.68-1.73 (m, 4H), 1.89-1.92 (m, 2H), 2.13 (tt, J= 12,3.2 Hz,
1H), 2.30 (t, J= 7.2 Hz, 2H), 6.65 (t, /= 5.6 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 12.04
(s, 1H). MS (ESI) m/z 366.21 (M+Na)+; 342.16 (M-H)".
Example 35: frq«s-4-(fl-(2-MethvlpropanovIoxY)butoxvcarbonvnaininomethvI}-
Cvclohexanecarboxvlic Acid (36)
[00246] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (800 mg, 5 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl 2-meth'ylpropanoate (700 mg, 2.3 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
36 (100 mg, 13% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. lE NMR (400 MHz, DMSO-d6): 8 = 0.87-0.95 (m, 8H), 1.08 (d,
y=4.0Hz, 3H), 1.10 (d, .7=4.0 Hz, 3H), 1.21-1.41 (br. m, 5H), 1.68-1.73 (m, 4H),
1.89-1.91 (m, 2H), 2.13 (tt, /= 12,3.2 Hz, 1H), 2.79-2.88 (m, 3H), 6.65 (t, /= 5.6

Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H). MS (ESI) m/z 366.21 (M+Na)+;
342.16 (M-H)"".
Example 36: frawy-4-(ri-(3-Methylbutanovloxv)butoxycarboavHaminomethYU-
Cyclohexanecarboxylic Acid (37)
[00247] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (800 mg, 5.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl 3-methylbutanoate (700 mg, 2.2 mmol) were
reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 37
(120 mg, 15% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.87-0.95 (m, 11H), 1.21-
1.41 (br. m, 5H), 1.68-1.73 (m, 4H), 1.89-2.02 (m, 3H), 2.10-2.22 (m, 3H), 2.80-2.89
(m, 2H), 6.65 (t, J= 5.6 Hz, 1H), 7.45 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H). MS (ESI)
m/z 380.23 (M+Na)+; 356.18 (M-H)'.
Example 37: trans-4-{fl-(2^-
PimethvlpropanovloxY>butoxvcarbonyllaminomethyl}-CvctohexanecarboxYlic
Acid (38)
[00248] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (800 mg, 5.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl 2,2-dimethylpropanoate (700 mg, 2.2 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
38 (90 mg, 12% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. !H NMR (400 MHz, DMSO-d5): 5 = 0.87-0.99 (m, 5H), 1.12-
1.38 (br. m, 14H), 1.69-1.74 (m, 4H), 1.89-1.92 (m, 2H), 2.13 (tt, J= 12,3.2 Hz, 1H),
2.78-2.91 (m, 2H), 6.61 (t, J= 5.6 Hz, 1H), 7.47 (t, J= 6.0 Hz, 1H), 12.04 (s, 1H).
MS (ESI) m/z 380.22 (M+Na)+; 356.18 (M-H)~.
Example 38: fm/ Cyclohexanecarboxvlic Acid (39)
[00249] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (800 mg, 5 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]butyl benzoate (700 mg, 2.1 mmol) were reacted

in the MTBE/acetone/water mixture (16 mL) to yleld the title compound 39 (150 mg,
19% yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. lH NMR (400 MHz, DMSO-d6): 5 = 0.84-0.99 (m, 5H), 1.20-1.38 (br.
m, 3H), 1.41-1.51 (m, 2H), 1.70-1.73 (m, 2H), 1.84-1.89 (m, 4H), 2.11 (tt, J= 12,3.2
Hz, 1H), 2.82-2.91 (m, 2H), 6.61 (t, J= 5.6 Hz, 1H), 7.52-7.58 (m, 3H), 7.47 (t, J=
6.0 Hz, 1H), 7.95-7.97 (m, 2H), 12.04 (s, 1H). MS (ESI) m/z 400.15 (M+Na)+;
376.16 (M-H)".
Example 39: fraws-4-{fl-(AcetoryV2-methvIpropoxycarbonvl1amuiomethvU-
Cyclohexanecarboxvlic Acid (40)
[00250] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-methylpropyl acetate (306 mg, 1.12 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 40 (89 mg, 28%
yleld) as an oily solid after work-up and mass-guided preparative HPLC purification.
'HNMR (400 MHz, DMSO-d6): 8 = 0.83-0.95 (br. m, 8H), 1.18-1.37 (m, 3H), 1.65-
1.73 (br. m, 2H), 1.84-1.97 (br. m, 3H), 2.02 (s, 3H), 2.10 (tt, /= 12.0, 3.6 Hz, 1H),
2.78-2.84 (m, 2H), 6.41 (d, J= 5.2 Hz, 1H), 7.39 (t, J= 6.0 Hz, 1H), 11.97 (br. s, 1H).
MS (ESI) m/z 338.16 (M+Na)+; 314.12 (M-H)-.
Example 40: frg«$-4-{H-fPropanovIoxv)-2-
methvlpropoxvcarbonvHaminomethvU-Cvclohexanecarboxvlic Acid (41)
[00251] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (250 mg, 1.6 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-methylpropyl propanoate (230 mg, 0.80 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 41 (70 mg, 21%
yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. !H NMR (400 MHz, DMSO-d6): 8 = 0.85-0.92 (rn, 8H), 1.08 (t, J== 7.2
Hz, 3H), 1.17-1.32 (br. m, 3H), 1.68 (d, J= 12 Hz, 2H), 1.85-1.96 (br. m, 3H), 2.05-
2.12 (m, 1H), 2.25-2.36 (br. m, 2H), 2.80 (t, J= 6.4 Hz, 2H), 6.42 (d, J= 5.2 Hz, 1H),
7.38 (t, /= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 352.12 (M+Na)+; 328.14
(M-H)".

Example 41: frg«5-4-{[l-(PentanovIoxv')-2-
methvIpropoxycarbonvraminomethvl>-CvcIoIiexanecarborylic Acid (42)
[00252] Following the general nucleophilic carbamoylation procedure, tranexamic
acid (700 mg, 4.5 mmol) and 1-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-2-methylpropyl
pentanoate (500 mg, 1.6 mmol) were reacted in the MTBE/acetone/water mixture (16
ml_) to yleld the title compound 42 as a white powder after work-up and mass-guided
preparative HPLC purification. 1H NMR (400 MHz, DMSO-d6): 5 = 0.83-0.92 (br. m,
11H), 1.17-1.32 (br. m, 5H), 1.45-1.52 (m, 2H), 1.68 (d, J= 12 Hz, 2H), 1.85-1.94 (br. m,
3H), 2.04-2.12 (m, 1H), 2.27-2.32 (br. m, 1H), 2.83 (td, J = 7.2, 1.6 Hz, 2H), 2.78-2.82
(m, 2H), 6.42 (d, J = 5.2 Hz, 1H), 7.38 (t, J = 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) mJ
z 380.16 (M+Naf; 356.17 (M-H)".
Example 42: ^gK5-4-{fl-rBatanovIoxy)-2-methvIproporycarbonYllammomethYl}-
Cvclohexanecarboxvlic Acid (43)
[00253] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-meth.ylpropyl butanoate (602 mg, 2.0 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 43 (513 mg. 75%
yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. *H NMR (400 MHz, DMSO-d6): 5 = 0.83-0.95 (br.m, 11H), 1.17-1.38
(br. m, 3H), 1.48-1.5S (m, 2H), 1,65-1.73 (br. m, 2H), 1.83-1.98 (br. m, 3H), 2.10 (tt,
J= 12.0, 3.2 Hz, 1H), 2.21-2.32 (br. m, 2H), 2.75-2.87 (br. m, 2H), 6.44 (d, J= 5.6
Hz, 1H), 7.40 (t, /= 6.0 Hz), 11.97 (br. s, 1H). MS (ESI) m/z 366.21 (M+Na)+;
342.16 (M-H)~.
Example 43: frgfls-4-(fl-(2-MethvIpropanovloxv)-2-
methvIpropoxvcarbonvl]ammomethvI}-Cvclohexanecarborylic Acid (44)
[00254] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-methylpropyl 2-methylpropanoate (603 mg, 2.0 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 44 (486 mg, 71%
yleld) as a white powder after work-up and mass-guided preparative HPLC

purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 8H), 1.06 (d, J=
6.8 Hz, 3H), 1.08 (d, J= 7.2 Hz, 3H), 1.16-1.38 (br. m, 3H), 1.64-1.73 (br. m, 2H),
1.82-1.92 (br. m, 3H), 2.10 (tt, J= 12.0,3.6 Hz, 1H), 2.52 (hept, /= 6.8 Hz, 1H),
2.74-2.87 (br. m, 2H), 6.42 (d, J= 5.2 Hz, 1H), 7.40 (t, J= 6.0 Hz, 1H), 11.97 (br. s,
1H). MS (ESI) /n/z 366.08 (M+Na)+; 342.04 (M-H)".
Example 44: Sodium trans-4-{fl-(2-Methvlpropanovloxv)-2-
methvIpropoxvcarbonvllaminomethvU-Cvclohexanecarboxvlate(45)
[00255] Following the general nucleophilic carbamoylation procedure for the
formation of the corresponding sodium carboxylates of acyloxyalkyl carbamates of
tranexamic acid, 3.434 g (10.0 mmol) of Zra7W-4-{[l-(2-methylpropanoyloxy)-2-
memylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid 44 was reacted
with 840.1 mg (10.0 mmol) of sodium bicarbonate (NaHCOs) in 60 mL of a mixture
of acetonitrile and water (1:2) to yleld 3.654 g (quant) of the title compound 45 as a
colorless powder. JH NMR (400 MHz, DMSO-d6): 8 = 0.72-0.84 (m, 2H), 0.87-0.92
(m, 6H), 1.04-1.20 (m, 8H), 1.20-1.32 (m, 1H), 1.59-1.73 (m, 3H), 1.74-1.83 (m, 2H),
1.88-1.98 (m, 1H), 2.46-2.56 (m, 1H), 2.72-2.84 (br. m, 2H), 6.42 (d, J= 5.6 Hz, 1H),
7.37 (t, J= 5.6 Hz, 1H). MS (ESI) m/z 366.14 (M+Na)+; 342.16 (M-H)".
Example 45: fr methvlpropoxvcarbonYllaminomethvU-Cvclohexanecarborylic Acid (46)
[00256] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-methylpropyl 3-methylbutanoate (558 mg, 1.77 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 46 (75 mg, 12%
yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. lH NMR (400 MHz, DMSO-d6): 8 = 0.82-0.94 (br. m, 14H), 1.17-1.37
(m, 3H), 1.65-1.73 (br. m, 2H), 1.83-2.01 (br. m, 4H), 2.09 (tt, J= 12.4,3.6 Hz, 1H),
2.17 (d, J= 6.6 Hz, 2H), 2.74-2.87 (br. m, 2H), 6.45 (d, J = 4.8 Hz, 1H), 7.40 (t, J=
6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) w/z 380.23 (M+Na)+; 356.18 (M-H)".
Example 46: fra/ig-4-(fl-(2,2-Dimethvlpropanoyloxy)-2-
methvlpropoxvcarbonyllaminomethyll-Cvclohexanecarboxvlic Acid (47)

[00257] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-methylpropyl 2,2-dimethylpropanoate (631 mg, 2.0 mmol) were reacted in the
MTBE/acetone/water mixture (16 ml) to yleld the title compound 47 (23 mg, 3%
yleld) as an off-white powder after work-up and mass-guided preparative HPLC
purification. *H NMR (400 MHz, DMSO-d6): 8 = 0.81-0.94 (br. m, 8H), 1.12 (s, 9H),
1.17-1.38 (m, 3H), 1.64-1.72 (br. m, 2H), 1.82-2.00 (br. m, 3H), 2.09 (tt, J= 12.4,3.2
Hz, 1H), 2.72-2.89 (br. m, 2H), 6.40 (d, J" 4.8 Hz, 1H), 7.41 (t, /= 5.6 Hz, 1H),
11.98 (br. s, 1H). MS (ESI) m/z 380.23 (M+Na)+; 356.18 (M-H)-.
Example 47: /ra»a-4-(fl-(CvclohexvlcarbonYloxv>-2-
methvlpropoxvcarbonvllaminomethvU-Cyclohexanecarboxvlic Acid (48)
[00258] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (1.4 g, 8.0 mmol) and l-[(2,5-dioxopyrroUdinyl)oxycarbonyloxy]-2-
methylpropyl cyclohexanecarboxylate (1.0 g, 2.9 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 48 (300 mg, 27%
yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. !H NMR (400 MHz, DMSO-d6): 5 = 0-83-0.92 (br. m, 8H), 1.15-1.35
(br. m, 8H), 1.54-1.95 (br. m, 10H), 2.08 (tt, 7= 12.0,3.6 Hz, 1H), 2.27-2.32 (br. m,
1H), 2.74-2.83 (br. m, 2H), 6.41 (d, J= 5.2 Hz, 1H), 7.39 (t, /== 6.0 Hz, 1H), 11.97
(br. s, 1H). MS (ESI) m/z 406.14 (M+Na)+; 382.17 (M-H)-.
Example 48: fra«g-4-(fl-fBenzovloxY)-2-methvlpropoxvcarbonvllaminometh.vl}-
Cvclohexanecarboxvlic Acid (49)
[00259] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (630 mg, 4.0 mmol) and l-[(2,5-dioxopyrrolidinyl)oxycarbonyloxy]-
2-methylpropyl benzoate (500 mg, 1.5 mmol) were reacted in the
MTBE/acetone/water mixture (16 mL) to yleld the title compound 49 (200 mg, 35%
yleld) as a white powder after work-up and mass-guided preparative HPLC
purification. :H NMR (400 MHz, DMSO-d6): 5 = 0.84-0.91 (br. m, 2H), 0.99 (d, J=
6.8 Hz, 6H), 1.16-1.31 (br. m, 3H), 1.66-1.68 (br. m, 2H), 1.82-1.85 (m, 2H), 2.03-
2.12 (br. m, 2H), 2.80 (t, J = 6.4 Hz, 2H), 6.11 (d, /= 4.4 Hz, 1H), 7.51 (t, J= 6.0 Hz,

1H), 7.57 (t, /= 6.0 Hz, 2H), 7.71 (t, 7= 7.2 Hz, 1H), 7.96 (dd, J= 8.4,1.6 Hz, 2H),
11.97 (br. s, 1H). MS (ESI) m/z 400.08 (M+Na)+; 376.10 (M-H)-.
Example 49: fra«5-4-(F14ButanovloxvVl-
cvclohexvlmethorycarbonvnamipoiiiethvU-Cvclohexanecarboxvlic Acid (50)
[00260] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]cyclohexylrnethyl butanoate (683 mg, 2.0 mmol)
were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title compound
50 (329 mg, 43% yleld) as a white powder after work-up and mass-guided preparative
HPLC purification. 'H NMR (400 MHz, DMSO-d6): 5 = 0.83-0.95 (br. m, 5H), 0.96-
1.37 (br. m, 8H), 1.47-1.57 (m, 2H), 1.58-1.74 (br. m, 8H), 1.83-1.92 (br. m, 2H),
2.09 (tt, J= 12.0,3.6 Hz, 1H), 2.26 (td, J= 7.6,0.8 Hz, 2H), 2.74-2.86 (m, 2H), 6.44
(d, J= 5.6 Hz, 1H), 7.39 (t, /= 6.0 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) TK/Z 406.24
(M+Na)+; 382.23 (M-H)~.
Example 50: fra«y-4-(|fl-(2-MethvlpropapoYloxy)-l-
cvclohexYlmethoxvcarbonvnaminomethvU-Cyclohexanecarboxvlic Acid (51)
[00261] Following the general nucleophilic carbamoylation procedure,
tranexamic acid (472 mg, 3.0 mmol) and l-[(2,5-
dioxopyrrolidinyl)oxycarbonyloxy]cyclohexylmethyl 2-methylpropanoate (683 mg,
2.0 mmol) were reacted in the MTBE/acetone/water mixture (16 mL) to yleld the title
compound 51 (327 mg, 43% yleld) as a white powder after work-up and mass-guided
preparative HPLC purification. •H NMR (400 MHz, DMSO-d6): 5 = 0.81-0.94 (br.
m, 2H), 1.00-1.36 (br. m, 14H), 1.58-1.74 (br. m, 8H), 1.83-1.91 (br. m, 2H), 2.09 (tt,
J= 12.0, 3.6 Hz, 1H), 2.51 (hept, J= 6.8 Hz, 1H), 2.74-2.86 (m, 2H), 6.41 (d, /= 5.2
Hz, 1H), 7.40 (br. t, /= 5.6 Hz, 1H), 11.97 (br. s, 1H). MS (ESI) m/z 406.18
(M+Na)+; 382.19 (M-H)".
Example 51: Standard Methods for Determination of Enzymatic Cleavage of
Prodrugs in Vitro
[00262] The stabilities of prodrugs were evaluated in one or more in vitro
systems using a variety of tissue preparations following methods known in the art.

The chemical stability of prodrugs in aqueous buffers at a pH of 2.0,7.4, and 8.0 were
also measured. Tissues were obtained from commercial sources (e.g., Pel-Freez
Biologicals, Rogers, AR, or GenTest Corporation, Woburn, MA). Experimental
conditions used for the in vitro studies are described in Table 1. Each preparation
was incubated with test compound at 37 °C for one hour. Aliquots (50 uL) were
removed at 0,30, and 60 min and quenched with 0.1% trifluoroacetic acid in
acetonitrile. Samples were then centrifuged and analyzed by LC/MS/MS. Stability of
prodrugs towards specific enzymes (e.g., peptidases, etc.) was also assessed in vitro
by incubation with the purified enzyme.
[00263] Pancreatin Stability: Stability studies were conducted by incubating
prodrug (5 uM) with 1% (w/v) pancreatin (Sigma, P-1625, from porcine pancreas) in
0.025 M Tris buffer containing 0.5 M NaCl (pH 7.5) at 37 °C for 60 min. The
reaction was stopped by addition of 2 volumes of methanol. After centrifugation at
14,000 rpm for 10 min, the supernatant was removed and analyzed by LC/MS/MS.
[00264] Caco-2 Homogenate S9 Stability: Caco-2 cells were grown for 21 days
prior to harvesting. Culture medium was removed and cell monolayers were rinsed
and scraped off into ice-cold 10 mM sodium phosphate/0.15 M potassium chloride,
pH 7.4. Cells were lysed by sonication at 4 °C using a probe sonicator. Lysed cells
were then transferred into 1.5 mL centrifuge vials and centrifuged at 9,000 g for 20
min at 4 °C. The resulting supernatant (Caco-2 cell homogenate S9 fraction) was
aliquoted into 0.5 mL vials and stored at -80 °C until used.

[00265] For stability studies, prodrug (5 JJM) was incubated in Caco-2
homogenate S9 fraction (0.5 mg protein per mL) for 60 min at 37 °C. Concentrations
of intact prodrug and released tranexamic acid were determined at zero time and 60
min using LC/MS/MS.
[00266] pH-Dependent Stability: The long-term pH-dependent stability of
tranexamic acid prodrug at 37 °C was measured by LC/MS/MS at five different
representative pH values from pH 2.0 to pH 8.0 was determined. The test
concentration was 5 uM. The amount of remaining prodrug and the amount of
tranexamic acid released from the prodrug was determined at 0 hour and after 24
hours.
[00267] Compounds 13,15-19,32-34,44,46,48-49, and 51, for example,
showed good stability from pH 2 to pH 8, are stable in the presence of pancreatin and
colonic wash (> 40% intact prodrug remaining after 60 min incubation) and are
extensively hydrolyzed to liberate tranexamic acid in the presence of human liver
S9( Example 52: In Vitro Determination of Caco-2 Cellular Permeability of Prodrugs
[00268] The passive permeability of the prodrugs of the present disclosure can
be assessed in vitro using standard methods well known in the art (See, e.g., Stewart,
et al, Pharm. Res., 1995,12,693). For example, passive permeability can be
evaluated by examining the flux of a prodrug across a cultured polarized cell
monolayer (e.g., Caco-2 cells).

[00269] Caco-2 cells obtained from continuous culture (passage less than 28)
were seeded at high density onto Transwell polycarbonate filters. Cells were
maintained with DMEM/10% fetal bovine serum, 1 mM nonessential amino acids,
and 6 mM L-Gln, 5% C02/ 95% O* at 37 °C until the day of the experiment.
Permeability studies were conducted at pH 6.5 apically (in 50 mM MES buffer
containing 1 mM CaCl2, ImM MgCl2,150 mM NaCl, 3 mM KC1,1 mM NaH2P04,5
mM glucose) and pH 7.4 basolaterally (in Hanks' balanced salt solution containing 10
mM HEPES) in the presence of efflux pump inhibitors (250 uM MK-571 and 250 ^M
Verapamil). Inserts were placed in 12 or 24 well plates containing buffer and
incubated for 30 min at 37 °C. Prodrug (200 uM) was added to the apical or
basolateral compartment (donor) and concentrations of prodrug and/or released parent
drug in the opposite compartment (receiver) were determined at intervals over 1 hour
using LC/MS/MS. Values of apparent permeability (Papp) were calculated using the
equation:

where Vr is the volume of the receiver compartment in mL; dC/dt is the total flux of
prodrug and parent drug (uM/sec), determined from the slope of the plot of
concentration in the receiver compartment versus time; Co is the initial concentration
of prodrug in uM; and A is the surface area of the membrane in cm2. Prodrugs with
significant transcellular permeability may demonstrate a value of Papp of £ 1 x 10"6
cm/sec, for example, a value of Papp of > 1 x 10"5 cm/sec, or even a value of Papp of > 5
x 10"5 cm/sec. Typical values of Papp obtained for prodrugs of the present disclosure
are shown in Table 2.

[00270] The data in Table 2 shows that the prodrugs disclosed herein have high
cellular permeability and should be well absorbed from the intestine. The apical-to-
basolateral permeabilities of these prodrugs exceed their basolateral-to-apical
permeabilities. This suggests that these compounds are substrates for active transport
mechanisms present in the apical membrane of Caco-2 cells (although some
component of this transcellular permeability may also be mediated by passive
diffusion).

Example 53: Pharmacokinetics of Tranexamic Acid Following Administration of
Tranexamic Acid or Tranexamic Acid Prodrug to Rats
[00271] Tranexamic acid or a tranexamic acid prodrug of the present disclosure
was administered as an intravenous bolus injection (i.v.), by oral gavage (p.o.), or by
intracolonic (i.e.) administration via an indwelling catheter in the ascending colon to
groups of four to six adult male Sprague-Dawley rats (weight approximately 250 g).
Animals were fasted overnight before the study and for 4 hours post-dosing and were
conscious at the time of the experiment When administered intravenously,
tranexamic acid was administered as a solution in water at a dose equivalent to 16 mg
(0.1 mmol) of tranexamic acid per kg body weight Prodrugs were orally or
intracolonically administered as a suspension in 0.5 % methyl cellulose in 0.1 %
Tween 80 at a dose equivalent to 16 mg (0.1 mmol) of tranexamic acid per kg body
weight. Blood samples (300 \iL) were obtained via a jugular vein cannula at intervals
over 8 hours after oral dosing. Blood was quenched immediately using methanol and
then was frozen at -80 °C until analyzed.
[00272] The following procedure was used to prepared blood samples for
analysis:
[00273] 1. Rat blood (100 uL) was collected at different times into K2EDTA
tubes, 300 uL of methanol, and the mixture was vortexed to mix the ingredients.
[00274] 2. Blank rat blood (90 uL) was quenched with 300 uL of methanol.
Then ten uL of a standard stock solution (0.04,0.2,1,5,25, and 100 ug/mL) were
added to the tube individually. Then 20 uL of p-chlorophenylalanine (5 jag/mL in
50% methanol) was added to each tube to make up a final calibration standard (0.004,
0.02, 0.1, 0.5,2.5, and 10 ug/mL). The samples were vortexed and centrifuged at
14,000 ipm for 20 min.
[00275] 3. To the quenched blood samples were added 20 uL ofp-
cblorophenylalanine (5 jag/mL in 50% methanol), the samples were vortexed and
centrifuged at 14,000 rpm for 20 min.
[00276] 4. The supernatant was analyzed by LC/MS/MS.
[00277] The following method was used for LC/MS/MS Analysis of the
prepared blood samples. An API 4000 or 2000 LC/MS/MS spectrometer equipped
with Agilent 1100 binary pumps and a CTC HTS-PAL autosampler were used in the
analysis. A ThermoHypersil-BetaSil CI 8,100 x 4.6 mm, 5 um column was used

during the analysis. The mobile phase for the analysis of tranexamic acid and prodrug
was (A) 0.1 % formic acid in water, and (B) 0.1 % formic acid in acetonitrile. The
gradient condition was: 2 % eluent-B to 95 % eluent-B for 2.5 min, then to 98 %
eluent-B to 4.0 min. At 4.1 min, it was returned to 2 % eluent-B and maintained at 2
% eluent-B till 6.0 min. The flow rate was 1 rnL/min. An ESI source was used on the
API 4000. The analysis of tranexamic acid was performed in positive ion mode for
and negative ion mode was used for analysis of tranexamic acid prodrugs.
[00278] The MRM transition for each analyte was optimized using standard
solutions. 20 uL of the sample was injected. Non-compartmental analysis was
performed using WinNonlin (v.3.1 Professional Version, Pharsight Corporation,
Mountain View, California) on individual animal profiles. Summary statistics on
major parameter estimates was performed for Cmax (peak observed concentration
following dosing), Tmax (time to maximum concentration is the time at which the
peak concentration was observed), AUC( curve from time zero to last collection time, estimated using the log-linear trapezoidal
method), AUC(o-»), (area under the serum concentration time curve from time zero to
infinity, estimated using the log-linear trapezoidal method to the last collection time
with extrapolation to infinity), and t\a (terminal half-life).
[00279] The oral or intracolonic bioavailability (F) of tranexamic acid was
determined by comparing the area under the tranexamic acid concentration vs. time
curve (AUC) following oral or intracolonic administration of tranexamic acid or
prodrug with the AUC of the tranexamic acid concentration vs. time curve following
intravenous administration of tranexamic acid on a dose normalized basis. An AUCinf
of 22.2 hr*(4.g/mL for the intravenously administered tranexamic acid (dosed at 16
mg/kg) was used for the calculations of the bioavailability of tranexamic acid released
from prodrugs post absorption. The results for tranexamic acid and tranexamic
prodrug 13 are shown in Table 3, Figure 1, and Figure 2. In Table 3, the values
represent the mean ± 1SD. When administered intracolonically, each of compounds
13-20,23-24, and 44-45, for example, showed greater than 8-fold higher
bioavailability of tranexamic acid compared to the bioavailability of tranexamic acid
when tranexamic acid itself was administered intracolonically.

[00280] While some embodiments have been shown and described, various
modifications and substitutions may be made thereto without departing from the spirit
and scope of the invention. For example, for claim construction purposes, it is not
intended that the claims set forth hereinafter be construed in any way narrower than
the literal language thereof, and it is thus not intended that exemplary embodiments
from the specification be read into the claims. Accordingly, it is to be understood that
the present invention has been described by way of illustration and not as a limitation
on the scope of the claims. i

We Claim:
1. A compound of Formula (I):

a pharmaceutically acceptable salt thereof such as herein described, or a pharmaceutically
acceptable solvate of any of the foregoing such as herein described, wherein:
R1 is selected from C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-7
cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl;
R2 and R3 are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10
aryl, substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl;
R4 is selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7
cycloalkyl, C6-10 aryl, substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl,
and C7-14 aryldialkylsilyl; and
wherein each substituent group is independently selected from at least one of C1-3 alkyl, -
OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3 alkylamino, and C1-3
dialkylamino.
2. The compound as claimed in claim 1, wherein R1 is selected from C1-4 alkyl, phenyl,
substituted phenyl, cyclohexyl, and substituted cyclohexyl.
3. The compound as claimed in claim 1, wherein R1 is selected from methyl, ethyl, n-
propyl, isopropyl, n-butyl, isobutyl, sec-butyl, tert-butyl, phenyl, o-tolyl, and cyclohexyl.
4. The compound as claimed in claim 1, wherein R4 is selected from hydrogen, methyl,
ethyl, fert-butyl, allyl, benzyl, 4-methoxybenzyl, diphenylmethyl, triphenylmethyl, trimethylsilyl,
triethylsilyl, triisopropylsilyl, tert-butyldimethylsilyl, and phenyldimethylsilyl.
5. The compound as claimed in claim 1, wherein R4 is selected from hydrogen, allyl, benzyl,
and trimethylsilyl.

6. The compound as claimed in claim 1, wherein R4 is hydrogen.
7. The compound as claimed in claim 1, wherein R2 and R3 are independently selected
from hydrogen, methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl.
8. The compound as claimed in claim 1, wherein R2 is hydrogen, and R3 is selected
from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl.
9. The compound as claimed in claim 1, wherein R1 is selected from methyl, ethyl, n-
propyl, isopropyl, n-butyl, isobutyl, sec-butyl, terf-butyl, phenyl, o-tolyl, and cyclohexyl, R2 is
hydrogen, and R3 is selected from methyl, ethyl, n-propyl, isopropyl, phenyl, and cyclohexyl.
10. The compound as claimed in claim 9, wherein R4 is hydrogen.
11. The compound as claimed in claim 1, which is selected from:
trans-4-{[(2-methylpropanoyloxy)methoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[(2,2-dimethylpropanoyloxy)methoxycarbonyl]-aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[(3-methylbutanoyloxy)methoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[(benzoyloxy)methoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1 -(2-methylpropanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(2-methylpropanoyloxy)propoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(2-methylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(benzoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(cyclohexylcarbonyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(pentanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;

trans-4-{[1-(propanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(butanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(pentanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(3-methylbutanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(2,2-dimethylpropanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-({1 -(cyclohexylcarbonyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(2-methylbenzoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(butanoyloxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(2-methylpropanoyloxy)butoxycarbonyl]aminomethyl)-
cyclohexanecarboxylic acid;
trans-4-{[1-(3-methylbutanoyloxy)butoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(2,2-dimethylpropanoyloxy)butoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(benzoyloxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(propanoyloxy)propoxycarbonyl]aminomethyl}-cyclohexanecarboxylic
acid;
trans-4-{[1-(butanoyloxy)propoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(2,2-dimethylpropanoyloxy)propoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(benzoyloxy)propoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(butanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[ 1-(butanoyloxy)-1-cyclohexylmethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(2-methylpropanoyloxy)-1-cyclohexylmethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(acetoxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
trans-4-{[1-(propanoyloxy)butoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;

trans-4-{[1-(acetoxy)-2-methylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic
acid;
trans-4-{[1-(3-methylbutanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1-(2,2-dimethylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid;
trans-4-{[1 -(acetoxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid; and
trans-4-{[1-(propanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
pharmaceutically acceptable salts such as herein described thereof, and pharmaceutically
acceptable solvates such as herein described of any of the foregoing.
12. A pharmaceutical composition formulated for oral administration comprising at least
one compound as claimed in any one of claims 1 to 11 and a pharmaceutically acceptable vehicle
such as herein described, wherein the composition comprises from 2 mg-equivalents to 50 mg-
equivalents of tranexamic acid of formula (I) per kg of body weight of a patient.
13. A pharmaceutical composition formulated for topical administration comprising from 1
weight% to 10 weight% of at least one compound as claimed in any one of claims 1 to 11 and a
pharmaceutically acceptable vehicle such as herein described.
14. The pharmaceutical composition as claimed in any one of claims 12 or 13, which is a
sustained release formulation.
15. The compound as claimed in claim 1, wherein:
R1 is selected from C1-4 alkyl, phenyl, o-tolyl, and cyclohexyl;
R2 is hydrogen;
R3 is selected from d1-3 alkyl, phenyl, and cyclohexyl; and
R4 is selected from hydrogen, C1-4 alkyl, benzyl, 4-methoxybenzyl, diphenylmethyl,
triphenylmethyl, trimethylsilyl, triethylsilyl, triisopropylsilyl, ferf-butyldimethylsilyl, and
phenyldimethylsilyl.
16. The compound as claimed in claim 15, wherein:
R1 is selected from isopropyl, isobutyl and phenyl;
R3 is selected from methyl and isopropyl; and

R4 is hydrogen.
17. The compound as claimed in claim 16, which is trans-4-{[1-(2-methylpropanoyloxy)-
2-methylpropoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid or a pharmaceutically
acceptable salt such as herein described thereof.
18. The compound as claimed in claim 16, which is trans-4-{[1-
(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid or a pharmaceutically
acceptable salt such as herein described thereof.
19. The compound as claimed in claim 1, wherein R1 is isopropyl; one of R2 and R3 is
hydrogen and the other of R2 and R3 is methyl; and R4 is hydrogen.
20. The compound as claimed in claim 19, which is chosen from:
(+)-trans-4-({[(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylic acid;
(-)-trans-4-({[(1R)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylic acid; and
mixtures thereof.
21. The compound as claimed in claim 19, which is chosen from:
sodiumtrans-4-({t(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylate;
sodiumtrans-4-({[(1R)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylate; and
mixtures thereof.
22. The compound as claimed in claim 19, which is trans-4-{[1-(2-
methylpropanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid.
23. The compound as claimed in claim 19, which is sodium trans-4-{[1-(2-
methylpropanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid.
24. The compound as claimed in claim 1, which is selected from:

trans-4-{[1-(2-methylpropanoyloxy)ethoxycarbonyl]-aminomethyl}-cyclohexanecarboxylic
acid;
sodiumtrans-4-{[1-(2-methylpropanoyloxy)ethoxycarbonyl]-aminomethyl}-
cyclohexanecarboxylate;
(+)-trans-4-({[(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylic acid;
sodiumtrans-4-({[(1S)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylate;
(-)-trans-4-({[(1 R)-1 -(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylic acid;
sodiumtrans-4-({[(1R)-1-(2-methylpropanoyloxy)ethoxy]carbonylamino}methyl)-
cyclohexanecarboxylate;
trans-4-{[1-(3-methylbutanoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
sodiumtrans-4-{[1-(3-methylbutanoyloxy)ethoxycarbonyl]aminomethyl}-
cyclohexanecarboxylate;
trans-4-{[1-(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylic acid;
sodiumtrans-4-{[1-(benzoyloxy)ethoxycarbonyl]aminomethyl}-cyclohexanecarboxylate;
trans-4-{[1-(2-methylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylic acid; and
sodiumtrans-4-{[1-(2-methylpropanoyloxy)-2-methylpropoxycarbonyl]aminomethyl}-
cyclohexanecarboxylate;
a pharmaceutically acceptable salt thereof such as herein described, or a pharmaceutically
acceptable solvate of any of the foregoing such as herein described.
25. A pharmaceutical composition formulated for oral administration comprising at least
one compound as claimed in any one of claims 15 to 24 and a pharmaceutically acceptable vehicle
such as herein described, wherein the composition comprises from 2 mg-equivalents to 50 mg-
equivalents of tranexamic acid of formula (I) per kg of body weight of a patient.
26. A pharmaceutical composition formulated for topical administration comprising from 1
weight% to 10 weight% of at least one compound as claimed in any one of claims 15 to 24 and a
pharmaceutically acceptable vehicle such as herein described.
27. The pharmaceutical composition as claimed in any one of claims 25 and 26, which is
a sustained release formulation.

substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, R4 is selected from
hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl,
substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14
aryldialkylsilyl, and wherein each substituent group is independently selected from at least one
of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3
alkylamino, and C1-3 dialkylamino and compositions thereof.
28. The pharmaceutical composition as claimed in any one of claims 25 and 26, having
at least one cytotoxic agent such as herein described.

28. The pharmaceutical composition as claimed in any one of claims 25 and 26, having
at least one cytotoxic agent such as herein described.

ABSTRACT

ACYLOXYALKYL CARBAMATE OF TRANEXAMIC ACID AND COMPOSITIONS
THEREOF
Acyloxyalkyl carbamate prodrugs of tranexamic acid of Formula (I)

wherein R1 is selected from C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl, substituted C6-10 aryl, C3-
7 cycloalkyl, substituted C3-7 cycloalkyl, C7-16 arylalkyl, and C7-16 substituted arylalkyl, R2 and R3
are independently selected from hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C6-10 aryl,
substituted C6-10 aryl, C3-7 cycloalkyl, and substituted C3-7 cycloalkyl, R4 is selected from
hydrogen, C1-6 alkyl, substituted C1-6 alkyl, C3-7 cycloalkyl, substituted C3-7 cycloalkyl, C6-10 aryl,
substituted C6-10 aryl, C7-16 arylalkyl, substituted C7-16 arylalkyl, C3-12 trialkylsilyl, and C7-14
aryldialkylsilyl, and wherein each substituent group is independently selected from at least one
of C1-3 alkyl, -OH, -NH2, -SH, C1-3 alkoxy, C1-3 acyl, C1-3 thioalkyl, C1-3 alkoxycarbonyl, C1-3
alkylamino, and C1-3 dialkylamino and compositions thereof.

ACYLOXYALKYL CARBAMATE OF TRANEXAMIC ACID AND COMPOSITIONS THEREOF

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