AU2005211520A1 - Adding pharmaceutically active compounds to substrates - Google Patents

Adding pharmaceutically active compounds to substrates Download PDF

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Publication number
AU2005211520A1
AU2005211520A1 AU2005211520A AU2005211520A AU2005211520A1 AU 2005211520 A1 AU2005211520 A1 AU 2005211520A1 AU 2005211520 A AU2005211520 A AU 2005211520A AU 2005211520 A AU2005211520 A AU 2005211520A AU 2005211520 A1 AU2005211520 A1 AU 2005211520A1
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AU
Australia
Prior art keywords
solution
pharmaceutically active
aliphatic alcohol
active compound
substrates
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
AU2005211520A
Inventor
Ching-Yun Morris Yang
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Johnson and Johnson Consumer Inc
Original Assignee
McNeil PPC Inc
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Filing date
Publication date
Priority claimed from AU2003203497A external-priority patent/AU2003203497A1/en
Application filed by McNeil PPC Inc filed Critical McNeil PPC Inc
Priority to AU2005211520A priority Critical patent/AU2005211520A1/en
Publication of AU2005211520A1 publication Critical patent/AU2005211520A1/en
Priority to AU2008264163A priority patent/AU2008264163B2/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/42Use of materials characterised by their function or physical properties
    • A61L15/44Medicaments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/20Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing organic materials

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  • Health & Medical Sciences (AREA)
  • Hematology (AREA)
  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Materials Engineering (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Absorbent Articles And Supports Therefor (AREA)
  • Compositions Of Macromolecular Compounds (AREA)

Description

-1-
AUSTRALIA
PATENTS ACT 1990 COMPLETE SPECIFICATION FOR A STANDARD PATENT
ORIGINAL
Name of Applicant/s: Actual Inventor/s: Address for Service is: McNeil-PPC, Inc.
Ching-Yun Morris Yang SHELSTON IP Margaret Street SYDNEY NSW 2000 CCN: 3710000352 Attorney Code: SW Telephone No: Facsimile No.
(02) 9777 1111 (02) 9241 4666 Invention Title: ADDING PHARMACEUTICALLY
SUBSTRATES
ACTIVE COMPOUNDS Details of Original Application No. 2003203497 dated 31 Mar 2003 The following statement is a full description of this invention, including the best method of performing it known to me/us:- File: 38474AUP01 5006866271 .DOC/5844 la ADDING PH MACEUTICALY ACTIVE CCMPOUNDS TO SUBSRATES BackQround of the Invention The present invention relates to a process for adding pharmaceutically active compounds to substrates. The present invention is particularly useful for substrates used in the manufacture of disposable absorbent articles, specifically suited for substrates used in the manufacture of tampons.
There are several methods of delivering pharmaceutically active compounds to their intended targets, including but not limited to oral, topical, and transdermal.
Disposable absorbent articles can be used as vehicles for topical delivery to the vaginal canal, perineum, and related areas, as well as for treatment sites for the discharged fluids to come in contact with the pharmaceutically active compounds, as they are captured by the product.
Duchane, US Patent number 3,796,219 discloses a watersoluble, thermoplastic compound for hygienic and medical applications, such as for use as an insertion aid coating for tampons and as the matrix structure for suppositories. The coating is stable in temperatures up to 650 C, and it provides lubricity at temperatures 2 below 650 C when exposed to shear forces, as those present during insertion of the tampon. Duchane discloses the use of two olefinic diols, polyethylene glycol and propylene glycol in combination with hydroxypropyl cellulose (HPC) having a molecular weight of approximately 75,000. The resulting composition is stable at temperatures up to 650 C.
Von Bittera et al., US Patent number 4,582,717, discloses a process for producing vaginal tampons containing a pharmaceutical active compound. The process involves preparing a material containing the active compound and additional formulation auxiliaries, heating the material to a temperature in excess of 40° C, cooling the melt to 400 C, and then injecting the cooled material into pre-warmed tampons. One of the formulation auxiliaries disclosed in von Bittera is polyethylene glycol (PEG) having moderate molecular weight.
A common theme of the art shown above is the attempt to provide a coating that is stable above room temperature, but is liquid at or near body temperature (370 C).
Brown-Skrobot, US Patent number 5,679,369, discloses additives to tampons to inhibit the production of toxic shock syndrome toxin-1. The additives generally are not liquid at or near room temperature, and therefore, they require a carrier material, such as isopropyl alcohol.
This technology represents an important advance in the art, but the disclosed process of Sapplying the additive may require a recovery process to capture the volatile alcohol.
All of the art above requires either the use of significant energy or a volatile carrier material, to apply their respective coatings; thus a need still exists for a process for adding pharmaceutically active compounds to substrates or articles of manufacture, C without the limiting requirements as stated.
0 Any discussion of the prior art throughout the specification should in no way be considered as an admission that such prior art is widely known or forms part of common general knowledge in the field.
Summary of the Invention According to a first aspect the invention provides a low temperature process for the production of substrates containing pharmaceutically active compounds, comprising the following steps: a) preparing a solution of an olefinic diol and a pharmaceutically active compound, which is selected from the group consisting of: i) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its alilphatic alcohol residue; ii) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol residue; and iii) mixtures of said monoesters and diesters; wherein the solution is liquid at a temperature of less than about 35°C; and -3ab) applying the solution to the substrate at a temperature of less than 40 0
C.
According to a second aspect the invention provides a process for the production of a disposable absorbent article containing pharmaceutically active compounds, comprising the following steps: a) preparing a solution of an olefinic diol and a pharmaceutically active compound selected from the group consisting of: i) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its aliphatic alcohol residue; ii) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol reside; and iii) mixtures of said monesters and diesters; wherein the solution is liquid at a temperature of less than about 35°C; and b) applying said solution to the disposable absorbent article at a temperature of less than According to a third aspect the invention provides a process for the production of disposable absorbent article containing pharmaceutically active compounds, comprising the following steps: a) preparing a solution of an olefinic diol and a pharmaceutically active compound selected from the group consisting of: i) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its aliphatic alcohol residue; -3b ii) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol residue; and iii)mixtures of said monoesters and diesters; wherein the solution is liquid at a temperature of less than about b) applying said solution to a fluid permeable material at a temperature of less than 40°C; and c) encasing at least a portion of an absorbent material with the fluid permeable material.
According to a fourth aspect the invention provides a disposable absorbent article containing an additive, wherein the additive comprises a solution that is liquid at a temperature of less than about 35°C, the solution comprising an olefinic diol and a pharmaceutically active compound, which is selected from the group consisting of: a) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its aliphatic alcohol residue; b) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said diester has at least one hydroxyl group associate with its aliphatic alcohol residue; and c) mixtures of said monoesters and diesters.
According to a fifth aspect the invention provides a solution comprising an olefinic diol and a pharmaceutically active compound selected from the group consisting of: 3c a) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its aliphatic alcohol residue; b) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbons and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol residue; and c) mixtures of said monoesters and diesters; wherein the solution is liquid at a temperature of less than about Unless the context clearly requires otherwise, throughout the description and the claims, the words 'comprise' -'comprising', and the like are to be construed in an inclusive sense as opposed to an exclusive or exhaustive sense; that is to say, in the sense of "including, but not limited to".
The present invention relates to a solution of an olefinic diol and a pharmaceutically active compound that is liquid at a temperature of less than about 35 0 C, to the solution's preparation, and to its use. This solution is useful in low temperature addition of the pharmaceutically active compound to articles ofmanufacure. In accordance with one embodiment of the present invention, the solution is applied to the substrate at a temperature of less than 40 0 C. In another embodiment of the present invention the solution is applied to a disposable absorbent article at a temperature of less than A third embodiment involves applying the solution to a fluid permeable material at a temperature of less than 40 0 C and encasing at least a portion of an absorbent material with the 4 fluid permeable material. The invention also relates to a disposable absorbent article containing an additive, wherein the additive comprises the solution described above.
The pharmaceutically active compound of the present invention is selected from the group consisting of: i) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its aliphatic alcohol residue; ii) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol residue; and iii) mixtures of said monoesters and diesters.
Detailed Description.of the Invention The present invention relates to a low temperature process for adding pharmaceutically active compounds to substrates, specifically substrates used in the manufacture of disposable absorbent articles, to the articles during manufacture, or to the finished product.
The process incorporates the use of a liquid solution to apply the active compound to substrates. The solution of the present invention is liquid at a temperature of less than about 350 C, and it comprises an olefinic diol as the solvent, and a chosen pharmaceutically active compound as the solute.
One advantage the present invention provides is the ability to apply pharmaceutically active compounds to substrates at low temperatures. The advantage eliminates the need for applying significant energy to the active compound for application, resulting in energy cost savings; equipment cost savings, and other related items. The present invention also eliminates the need for a volatile carrier for the pharmaceutically active compound and a system to recover the carrier. As used in this specification and the appended claims, liquid is defined to be a substance that has a definite volume but no definite form except such as given by its container.
A solution is defined herein to be a homogeneous mixture of a-substance (solid, liquid, or gas) dissolved ina liquid, the solvent.
A second advantage provided by the present invention is the reduced volatility of the pharmaceutically active compound during processes at elevated temperatures. As energy is applied to a substrate containing the solution, the solution may begin to volatilize. During this volatilization, the vapor pressure of the solution is madeup of the partial pressures of each component in the solution. This is governed by Raoult's law, which 6 states that the partial pressure of any component in the vapor is equal to its mole fraction in the solution times the vapor pressure of the pure component at the same temperature. Therefore at a given temperature, the vapor driven off of a solution will contain less of the active compound than if it were exposed neat, without the solvent. Many substrates, such as through-air bonded or thermally bonded nonwovens, are subjected to thermal energy during their manufacture. If the fibers used to form such nonwovens have already been finished with the solution of the present invention, then less of the active compound will be lost during the formation of the nonwoven. More of the pharmaceutically active compoundwill be available for its intended purpose. As evidence of this phenomenon, glycerol monolaurate a preferred pharmaceutically active compound of the present invention, was added neat to Dish i, while a 50:50 ratio solution of GML and PEG-400 (polyethylene glycol, having an average molecular weight (number average) of 400) was added to Dish 2. Both dishes were heated at a temperature of about 1200 C for 20 minutes.
The results are shown in Table 1 below.
7 TABLE 1 Initial Final Weight loss GML* Weight Weight loss (g) (g) Dish 1 0.4204 0.4068 0.0136 3.23 Dish 2 0.8557 0.8476 0.0081 1.89 *Assuming all weight loss attributable to GML Assuming the worst case scenario, all of the loss was attributed to the GML, the results show that less of the pharmaceutically active compound will volatize from a solution than from the neat compound.
A third advantage is the improved adherence of the pharmaceutically active compound to a substrate. For example, a solution of GML in PEG-400 may be more compatible with a fibrous structure comprising polyolefin fibers than the GML alone. This is believed to occur due to the chemical structure of PEG-400.
This compound has similar structure to both the glycerol portion of GML or other of the polyhydric aliphatic alcohols and to the olefin fiber. It is believed that the olefinic diol, PEG-400, acts as a coupling agent from the pharmaceutically active compound and the substrate. Therefore, it is believed that the solution of the present invention is especially effective with substrates comprising polyolefins.
8 Yet another advantage of the present invention is that the solution creates a more wettable structure than a structure having a pharmaceutically active compound that is hydrophobic or only moderately hydrophilic. When these compounds are applied to a substrate, these properties are then transferred to the resulting structure. If a hydrophobic substrate is used as a liquid permeable cover material in a disposable absorbent article, then the product's performance may be reduced. That is, a hydrophobic or moderately hydrophilic cover may inhibit fluid transfer through it and into the absorbent material. The addition of the olefinic diol yields a more hydrophilic solution, and therefore, a more hydrophilic substrate.
A material is defined to be hydrophobic if a water droplet placed onto the surface of the material yields a contact angle of greater than 900, as measured according to a standard test method, such as ASTM D 5725: "Surface Wettability and Absorbency of Sheet. Materials Using on Automated Contact Angle Tester." A material is moderately hydrophilic if it yields a contact angle of between 30 and 900, and highly hydrophilic having a contact angle of less than 30 0 As used in this specification and in the appended claims, wettable is defined to be a material that is moderately or highly hydrophilic.
9 The olefinic diols of the present invention are highly hydrophilic and/or very miscible with water. Thus, O aqueous bodily fluids that may be absorbed by absorbent structures treated with the present solution will have a greater affinity for such structures than for structures treated with the neat pharmaceutically active compound.
SA representative, non-limiting list of olefinic diols Suseful in the present invention includes the following: 1o polyethylene glycol, polypropylene glycol, polybutylene glycol, propylene glycol, and the like. The olefinic diols of the present invention are liquid at a temperature of less than about 350 C. This weight is typically dictated by their molecular weight. As used is herein in the specification and claims, the term "molecular weight" refers to the number average molecular weight of a compound. Preferably, the olefinic diol is polyethylene glycol, having a molecular weight of less than about 600, or polypropylene glycol, having a molecular weight of less than about 4,000.
Most preferably, the solvent used in the present invention is polyethylene glycol, having an average molecular weight of less than about 600.
The pharmaceutically active compounds useful in the present invention used in the present invention are useful to inhibit the production of toxins by various bacteria as disclosed in Brown-Skrobot and Brown-Skrobot 10 Q et al., U.S. Patent Nos. 5,389,374; 5,547,985; 5,641,503; 5,679,369; and 5,705,182, all of which are incorporated by reference. These compounds are selected O from the group consisting of: monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has Sat least one hydroxyl group associated with its aliphatic alcohol residue; diesters of a polyhydric C aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol residue; and mixtures of said monoesters and diesters. Preferably, the active compound is glycerol monolaurate.
The solution of the present invention may be prepared by dissolving a suitable pharmaceutically active compound with a suitable olefinic diol. The order of adding the solvent and solute is not critical to the present o0 invention. Optionally, a slight amount of energy can be utilized for preparing the solution in an effort to decrease the amount of time needed to render a homogenous solution.
The solution ratio of low molecular weight olefinic diol to pharmaceutically active compound, useful in the present invention, is from about 5:95 to about 95:5; 11 preferably, from about 20:80 to about 80:20; and most preferably, from about 60:40 to about 70:30.
After the solution is prepared, in accordance to the description above, it is then applied to a substrate.
Useful substrates include, but are not limited to absorbent and non-absorbent fibers, such as cellulose, rayon, polyester, polyethylene, polypropylene, ethylene vinyl acetate, polyurethane, and the like; non-woven fabrics, such as spunbonded fabric, thermal bonded fabric, resin bonded fabric, and the like; apertured and non-apertured films; foams, such as polyurethane foams; and superabsorbent polymers, such as polyacrylic acid, and the like. Preferably, the solution is applied to a nonwoven fabric or its precursor fiber(s), wherein the nonwoven comprises thermally bonded synthetic fibers, such as polypropylene and polyester polyethylene bicomponent fibers. The solution provided by the present invention is especially compatible with substrates comprising olefinic materials. The process of applying the solution is by any number of methods known by one skilled in the art, such as roller transfer coating, spray, dip, and the like.
The amount of pharmaceutically active compound applied to a substrate, useful in the present invention, is from about 0.1 to about 2.0 weight percent; preferably, from about 0.1 to about 1.0.weight percent; and most 12 preferably, from about 0.2 to about 0.3 weight percent.
The amount of solution applied to the substrate, determined from the preferred solution ratios and amount of pharmaceutically active compound, is from about 0.2 s weight percent to about 40 weight percent; preferably, from about 0.2 weight percent to about 20 weight percent; and most preferably, from about 0.2 weight percent to about 6.0 weight percent.
The substrates of the present invention can be used independently, or as an element in the manufacture of disposable absorbent articles. Such articles can include patches for topical or transdermal applications, nasal pads (nasal tampons), diapers, incontinence products, sanitary protection products, body wipes, bedsheets and surgical gowns. Preferably, the substrates are elements in used in the manufacture of sanitary protection. The solutions can also be applied to finished disposable absorbent articles.
Typically, sanitary protection articles fall into two distinct categories, those worn externally in contact with the perineum, and those worn internally, partially or wholly contained within the vaginal canal. External sanitary protection products include, without limitation, pantiliners, full-size pads, and ultrathins.
Internal sanitary protection products can be defined as absorbing products, such as tampons, and the like; 13 collecting products, such as described in Contente et al., U.S. Patent Number 5,295,984 and the like; or a combination of the two. U.S. Patent Numbers 4,294,253 and 4,642,108, incorporated by reference herein, s disclose tampon constructions and processes of manufacture. The preferred disposable absorbent article of the present invention, for the solution to be applied to, is a sanitary tampon.
A process for producing disposable absorbent articles comprises encasing at least a portion of an absorbent material with a liquid permeable material, wherein the discharged fluids, contact and penetrate the liquid permeable material, and are drawn into the absorbent material for storage. The liquid permeable material may be a nonwoven fabric such as a spunbonded fabric, a thermal bonded fabric, a resin bonded fabric, and the like; a three-dimensional or two-dimensional apertured polymeric film; or any other suitable covering surface that is capable of allowing fluid to permeate and be comfortably worn against the perineum. A representative, non-limiting list of materials useful as the absorbent material includes cellulosic fibers, such as wood pulp and cotton pulp; synthetic fibers, such as polyesters and polyolefins; superabsorbent polymers, such as polyacrylic acid, and the like.
14 Optionally, the process can further comprise encasing a second portion of the absorbent material with a liquid impermeable material, to prevent the collected fluid from transferring completely through the article.
Useful liquid impermeable materials include, without limitation, polymeric films or coatings, such as polyolefins polyethylene and polypropylene), polyvinyls polyvinyl acetate, polyvinyl chloride, and polyvinylidene chloride), copolymers ethylene vinyl acetate), and blends or laminates of one or more of the above polymers; bodily fluid repellant structures such as nonwovens, apertured films, and repellant fiber layers integrated into the bottom layer of the absorbent materials.
The invention has been illustrated by, but is not intended to be limited to, the above description and examples. The scope of the invention is to be determined by the claims attached hereto.

Claims (2)

1. A solution comprising an olefinic diol and a pharmaceutically active compound selected from the group consisting of: a) monoesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbon atoms and wherein said monoester has at least one hydroxyl group associated with its aliphatic alcohol residue; b) diesters of a polyhydric aliphatic alcohol and a fatty acid containing from eight to eighteen carbons and wherein said diester has at least one hydroxyl group associated with its aliphatic alcohol residue; and c) mixtures of said monoesters and diesters; wherein the solution is liquid at a temperature of less than about 35 0 C.
2. A solution comprising an olefinic diol and a pharmaceutically active compound substantially as herein described with reference to any one of the embodiments of the invention illustrated in the accompanying examples. DATED this 14th day of September 2005 Shelston IP Attorneys for: McNeil-PPC, Inc.
AU2005211520A 1998-06-30 2005-09-14 Adding pharmaceutically active compounds to substrates Abandoned AU2005211520A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU2005211520A AU2005211520A1 (en) 1998-06-30 2005-09-14 Adding pharmaceutically active compounds to substrates
AU2008264163A AU2008264163B2 (en) 1998-06-30 2008-12-23 Adding pharmaceutically active compounds to substrates

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/109342 1998-06-30
AU2003203497A AU2003203497A1 (en) 1998-06-30 2003-03-28 Adding pharmaceutically active compounds to substrates
AU2005211520A AU2005211520A1 (en) 1998-06-30 2005-09-14 Adding pharmaceutically active compounds to substrates

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AU2003203497A Division AU2003203497A1 (en) 1998-06-30 2003-03-28 Adding pharmaceutically active compounds to substrates

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AU2008264163A Division AU2008264163B2 (en) 1998-06-30 2008-12-23 Adding pharmaceutically active compounds to substrates

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AU2005211520A1 true AU2005211520A1 (en) 2005-10-06

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AU2005211520A Abandoned AU2005211520A1 (en) 1998-06-30 2005-09-14 Adding pharmaceutically active compounds to substrates
AU2008264163A Ceased AU2008264163B2 (en) 1998-06-30 2008-12-23 Adding pharmaceutically active compounds to substrates

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NZ250714A (en) * 1990-10-30 1996-05-28 Mcneil Ppc Inc Liquid composition comprising esters of higher fatty acids for use as a vaginal douche and to prevent toxic shock toxin production

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AU2008264163A1 (en) 2009-01-29
AU2008264163B2 (en) 2011-07-07

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