Nitric oxide amino acid esters for improving vascular circulation, and prophylaxis or treatment of a condition associated with impaired blood circulation

1. A topical composition comprising:

an effective amount of a compound selected from the group consisting of (2-nitrooxy)-2-ethylamino-3-methylbutanoate

valine butylene glycol nitrate

2′-nitrooxyethyl 2-amino-pentanoate

and 4′-nitrooxybutyl 2-amino-pentanoate

or any pharmaceutically acceptable salts thereof; and

at least one topical antimicrobial,

in association with a pharmaceutically acceptable topical carrier.

2. The composition as claimed in claim 1 , wherein said topical antimicrobial is at least one of a topical antibiotic chosen from amikacin, gentamicin, kanamycin, neomycin, netilmicin, tobramycin, paromomycin, geldanamycin, herbimycin, loracarbef, ertapenem, doripenem, imipenem/cilastatin, meropenem, cefadroxil, cefazolin, cefalotin, cefalexin, cefaclor, cefamandole, cefoxitin, cefprozil, cefuroxime, cefixime, cefdinir, cefditoren, cefoperazone, cefotaxime, cefpodoxime, ceftazidime, ceftibuten, ceftizoxime, ceftriaxone, cefepime, ceftobiprole, teicoplanin, vancomycin, telavancin, clindamycin, lincomycin, azithromycin, clarithromycin, dirithromycin, erythromycin, roxithromycin, troleandomycin, telithromycin, spectinomycin, aztreonam, furazolidone, nitrofurantoin, amoxicillin, ampicillin, azlocillin, carbenicillin, cloxacillin, dicloxacillin, flucloxacillin, mezlocillin, methicillin, nafcillin, oxacillin, penicillin g, penicillin v, piperacillin, temocillin, ticarcillin, amoxicillin and clavulanate, ampicillin and sulbactam, piperacillin and tazobactam, ticarcillin and clavulanate, bacitracin, colistin, polymyxin b, ciprofloxacin, enoxacin, gatifloxacin, levofloxacin, lomefloxacin, moxifloxacin, nalidixic acid, norfloxacin, ofloxacin, trovafloxacin, grepafloxacin, sparfloxacin, temafloxacin, mafenide, sulfonamidochrysoidine, sulfacetamide, sulfadiazine, silver sulfadiazine, sulfamethizole, sulfamethoxazole, sulfanilimide, sulfasalazine, sulfisoxazole, trimethoprim, trimethoprim-sulfamethoxazole, demeclocycline, doxycycline, minocycline, oxytetracycline, tetracycline, clofazimine, dapsone, capreomycin, cycloserine, ethambutol, ethionamide, isoniazid, pyrazinamide, rifampicin, rifabutin, rifapentine, streptomycin, arsphenamine, chloramphenicol, fosfomycin, fusidic acid, linezolid, metronidazole, mupirocin, platensimycin, quinupristin/dalfopristin, rifaximin, thiamphenicol, and tinidazole,

a topical antifungal chosen from natamycin, rimocidin, filipin, nystatin, amphotericin b, candicin, hamycin, miconazole, ketoconazole, clotrimazole, econazole, bifonazole, butoconazole, fenticonazole, isoconazole, oxiconazole, sertaconazole, sulconazole, tioconazole, fluconazole, itraconazole, isavuconazole, ravuconazole, posaconazole, voriconazole, terconazole, abafungin, terbinafine, amorolfine, naftifine, butenafine, anidulafungin, caspofungin, micafungin, benzoic acid, ciclopirox, tolnaftate, undecylenic acid, 5 -fluorocytosine, griseofulvin, haloprogin, and sodium bicarbonate,

and combinations thereof.

3. The composition of claim 1 , further comprising a skin penetration enhancer chosen from a C 8 -C 22 fatty acid, a C 8 -C 22 fatty alcohol, a lower alkyl ester of a C 8 -C 22 fatty acid, a di(lower)alkyl ester of C 6 -C 22 diacid, a monoglyceride of C 8 -C 22 fatty acid, tetrahydrofurfuryl alcohol polyethylene glycol ether, polyethylene glycol, propylene glycol, 2-(2-ethoxyethoxy)ethanol (transcutol), diethylene glycol monomethyl ether, diethylene glycol monoethyl ether, an alkylaryl ether of polyethylene oxide, a polyethylene oxide monomethyl ether, a polyethylene oxide dimethyl ether; dimethyl sulfoxide (DMSO), glycerol, ethyl acetate, acetoacetic ester, N-alkylpyrrolidone, a terpenes, dimethyl formamide (DMF), N,N-dimethylacetamide (DMA), methyl laurate, glycerol monolaurate, a fatty acid ester of a C 2 to C 4 alkanediol having a fatty acid portion of said ester from about 8 to 22 carbon atoms, a fatty alcohol ether of a C 2 to C 4 alkanediols having a fatty acid portion of said ether from about 8 to 22 carbon atoms, triglycerides of coconut oil, isopropyl palmitate, isopropyl myristate, laurocapram, and combinations thereof.