CN110354125A - A kind of composition that treating helicobacter pylori infections and its preparation and purposes - Google Patents
A kind of composition that treating helicobacter pylori infections and its preparation and purposes Download PDFInfo
- Publication number
- CN110354125A CN110354125A CN201910747020.8A CN201910747020A CN110354125A CN 110354125 A CN110354125 A CN 110354125A CN 201910747020 A CN201910747020 A CN 201910747020A CN 110354125 A CN110354125 A CN 110354125A
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- China
- Prior art keywords
- capsule
- amoxicillin
- immediate
- sustained release
- helicobacter pylori
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
- A61K31/425—Thiazoles
- A61K31/429—Thiazoles condensed with heterocyclic ring systems
- A61K31/43—Compounds containing 4-thia-1-azabicyclo [3.2.0] heptane ring systems, i.e. compounds containing a ring system of the formula, e.g. penicillins, penems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/439—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom the ring forming part of a bridged ring system, e.g. quinuclidine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
- A61K31/4439—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. omeprazole
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
- A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
- A61K9/5005—Wall or coating material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
- A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
- A61K9/5084—Mixtures of one or more drugs in different galenical forms, at least one of which being granules, microcapsules or (coated) microparticles according to A61K9/16 or A61K9/50, e.g. for obtaining a specific release pattern or for combining different drugs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
Abstract
The present invention provides a kind of composition for treating helicobacter pylori infections and its preparation and purposes, and the composition includes Mycobutin, Amoxicillin and the Levpantoprazole Sodium that weight fraction ratio is 10-20:70-120:2.2-4;Two wires Triple Therapy cycle time 20% can be reduced patient's treatment cost by the composition.The present invention also provides a kind of for treating the capsule of helicobacter pylori infections, which can be improved the compliance of patient, and then improve the eradication rate to helicobacter pylori.
Description
Technical field
The invention belongs to field of medicinal compositions, in particular to a kind of composition for treating helicobacter pylori infections and its system
Agent and purposes.
Background technique
Helicobacter pylori (Helicobacter pylori, Hp) is Gram-negative, microaerophilic bacteria, survives in stomach
And in duodenum.The chronic inflammation that it can cause stomach lining slight, results even in gastric and duodenal ulcer and gastric cancer.?
China, the crowd of more than half have helicobacter pylori infections, and Eliminating H. pylori Infection by Means can cure gastritis and duodenum is burst
Ulcer, and the generation of gastric cancer can be prevented.The scheme for eradicating helicobacter pylori includes standard triple therapy, including proton pump inhibits
Agent, Amoxicillin and clarithromycin, however due to clarithromycin drug resistance, standard triple therapy is aobvious to the eradication rate of helicobacter pylori
Work drops to 80% or less.For the patient through the failure of standard triple therapy Anti-Helicobacter Pylori Therapy, using remedying scheme,
Using two wires triple therapy, specially Omeprazole 20mg/ Pantoprazole 40mg, 2 times a day, Mycobutin 150mg, daily 2
Secondary, Amoxicillin 1000mg treats 10d 2 times a day.The eradication rate of two wires triple therapy on Helicobacter pylori increases, but
Be the two wires triple therapy treatment cycle it is longer, Mycobutin price is somewhat expensive, increases the treatment cost of patient.And it should
When two wires triple therapy is taken, each medicine needs are individually taken, and patient compliance is poor, thereby reduces the elimination to helicobacter pylori
Rate.
Summary of the invention
The present invention provides a kind of new composition for being used to treat helicobacter pylori infections, and the composition can be by two wires three
Therapy treatment cycle shortens 20%, reduces patient's treatment cost.The present invention also provides one kind for treating Helicobacter pylori
The capsule of dye, which can be improved the compliance of patient, and then improve the eradication rate to helicobacter pylori.
The composition for the treatment helicobacter pylori infections that one aspect of the present invention provides, the composition includes that weight fraction ratio is
10-20:70-120:2.2-4 Mycobutin, Amoxicillin and Levpantoprazole Sodium.
In some embodiments, the composition includes Mycobutin, the A Moxi that weight fraction ratio is 15:100:2.7
Woods and Levpantoprazole Sodium.
Another aspect of the present invention provides a kind of capsule, and the capsule includes:
First sustained release unit, the first sustained release unit is enteric coated particles, including Pantoprazole Sodium and Amoxicillin;
Second immediate-release units, second immediate-release units are immediate-release granules, including Mycobutin and Amoxicillin;
The capsule shells of encapsulation the first sustained release unit and the second immediate-release units;
Wherein, the weight fraction ratio of Mycobutin, Amoxicillin and Levpantoprazole Sodium is 10-20:70-120:2.2-
4。
In some embodiments, in the first sustained release unit in Amoxicillin and the second immediate-release units Amoxicillin weight
Amount score ratio is 2:8.
In some embodiments, the first sustained release unit includes sustained release agent and enteric coating;The first sustained release unit
It further include one or both of filler, disintegrating agent, adhesive or lubricant with the second immediate-release units.
In some embodiments, the filler is selected from one of mannitol, microcrystalline cellulose, lactose or cornstarch
Or two kinds;The disintegrating agent is selected from one of crospovidone, low-substituted hydroxypropyl cellulose or sodium carboxymethyl starch or two
Kind;Described adhesive is selected from one of hydroxypropyl methylcellulose, sodium carboxymethylcellulose, PVP K30 or Macrogol 4000
Or two kinds;The lubricant is selected from one or both of magnesium stearate, titanium dioxide, talcum powder or superfine silica gel powder;It is described slow
It releases agent and is selected from one or both of chitosan, acrylic resin or polyvinyl acetate.
In some embodiments, the first sustained release unit further includes asparatate.
In some embodiments, second immediate-release units further include alanine.
Asparatate is separately added into the first sustained release unit and the second immediate-release units and alanine can be improved first
It is sustained the stability of unit and the second immediate-release units, reduces the degradation speed of left Pantoprazole Sodium, Amoxicillin and Mycobutin sum
Rate;The asparatate being added in the first sustained release unit simultaneously can also improve the dissolution rate of Amoxicillin, improve its biology
Availability.
In some embodiments, second immediate-release units further include triglycerol monolaurate.
Another aspect of the present invention provides a kind of preparation method of capsule, includes the following steps:
1) Pantoprazole Sodium, filler, disintegrating agent and sustained release agent are placed in wet granulator, are stirred evenly;It will bonding
Agent is dissolved in ethyl alcohol, softwood processed, and softwood is added in wet granulator, stirring granulation, and lubrication is added in whole grain for whole grain of being sieved
Agent and asparatate are uniformly mixed, sieving granulation;Enteric coating is carried out in coating pan;
2) Amoxicillin, filler, disintegrating agent, sustained release agent and asparatate are placed in wet granulator, stirring is equal
It is even;Adhesive is dissolved in ethyl alcohol, softwood processed, softwood is added in wet granulator, stirring granulation, whole grain of being sieved, side whole grain
Lubricant, asparatate and disintegrating agent is added in side, is uniformly mixed, sieving granulation;Enteric coating is carried out in coating pan;
3) Mycobutin, filler, disintegrating agent, alanine and triglycerol monolaurate are placed in wet granulator,
It stirs evenly;Adhesive is dissolved in ethyl alcohol, softwood processed, softwood is added in wet granulator, stirring granulation, whole grain of being sieved,
Lubricant and g alanine are added in whole grain, is uniformly mixed, sieving granulation;
4) Amoxicillin, filler, disintegrating agent, alanine and triglycerol monolaurate are placed in wet granulator,
It stirs evenly;Adhesive is dissolved in ethyl alcohol, softwood processed, softwood is added in wet granulator, stirring granulation, whole grain of being sieved,
Lubricant, alanine and disintegrating agent are added in whole grain, is uniformly mixed, sieving granulation;
5) step 1) and the particle of step 2) preparation form the first sustained release unit, the granulated of step 3) and step 4) preparation
At the second immediate-release units, the first sustained release unit and the second immediate-release units are packed into capsule shells, capsule is made.
The capsule prepared by above method has very high stability, and disintegration is fast in vivo, can reduce active constituent
Degradation speed.
It is glutinous to stomach that Amoxicillin and Mycobutin can be improved in addition triglycerol monolaurate in the second immediate-release units
Permeability of the membrane.
Another aspect of the present invention provides composition and capsule is used to treat the purposes of helicobacter pylori infections.
The composition for the treatment of helicobacter pylori infections provided by the invention can reduce the treatment cycle of anti-helicobacter pylori, phase
Than existing two wires Triple Therapy cycle time 20%, patient's treatment cost is reduced;Capsule provided by the invention can
To improve the compliance of patient, and then improve the eradication rate to helicobacter pylori.
Specific embodiment
Embodiment 1
A kind of composition for treating helicobacter pylori infections, the composition include:
Mycobutin 150mg
Amoxicillin 1000mg
Levpantoprazole Sodium 27mg.
Embodiment 2
A kind of composition for treating helicobacter pylori infections, the composition include:
Mycobutin 100mg
Amoxicillin 700mg
Levpantoprazole Sodium 22mg.
Embodiment 3
A kind of composition for treating helicobacter pylori infections, the composition include:
Mycobutin 200mg
Amoxicillin 1200mg
Levpantoprazole Sodium 40mg.
Embodiment 4
A kind of capsule, the capsule include:
First sustained release unit, the first sustained release unit is enteric coated particles, comprising:
Second immediate-release units, second immediate-release units are immediate-release granules, comprising:
The capsule shells of encapsulation the first sustained release unit and the second immediate-release units;
The capsule the preparation method comprises the following steps:
1) 27mg Levpantoprazole Sodium, 10mg microcrystalline cellulose, 5mg crospovidone and 5mg chitosan are placed in wet
In method granulator, stir evenly;5mg Macrogol 4000 is dissolved in ethyl alcohol, wet granulator is added in softwood by softwood processed
In, stirring granulation crosses 18 mesh sieves, 1mg magnesium stearate and 5mg asparatate is added in whole grain, be uniformly mixed, crosses 24
Mesh granulation;Enteric coating liquid coating weight gain is carried out in coating pan to 4%, and Levpantoprazole Sodium sustained release coating is made
Grain;
2) by the Amoxicillin 200mg, 30mg microcrystalline cellulose, 5mg crospovidone, 15mg chitosan and 5mg lucid asparagus
Propylhomoserin is placed in wet granulator, is stirred evenly;10mg Macrogol 4000 is dissolved in ethyl alcohol, softwood is added softwood processed
In wet granulator, stirring granulation crosses 18 mesh sieves, 4mg magnesium stearate, 5mg asparatate and 5mg is added in whole grain
Crospovidone is uniformly mixed, and crosses the granulation of 24 meshes;Enteric coating liquid coating weight gain is carried out in coating pan to 4%, be made Ah
Amdinocillin enteric-coated sustained release coated granule;
3) by 150mg Mycobutin, 15mg lactose, 10mg sodium carboxymethyl starch, 3mg alanine and 6mg triglycerin Dan Yue
Cinnamic acid ester is placed in wet granulator, is stirred evenly;6mg PVP K30 is dissolved in ethyl alcohol, softwood processed softwood is added wet
In method granulator, stirring granulation crosses 18 mesh sieves, 2mg talcum powder and 3mg alanine is added in whole grain, is uniformly mixed, mistake
The granulation of 24 meshes, is made rifamycin immediate-release granules;
4) by the Amoxicillin 800mg, 40mg lactose, 10mg sodium carboxymethyl starch, 6mg alanine and 14mg triglycerin Dan Yue
Cinnamic acid ester is placed in wet granulator, is stirred evenly;14mg PVP K30 is dissolved in ethyl alcohol, softwood processed softwood is added wet
In method granulator, stirring granulation crosses 18 mesh sieves, 5mg talcum powder, 6mg alanine and 10mg carboxymethyl is added in whole grain
Sodium starch is uniformly mixed, and crosses the granulation of 24 meshes, Amoxicillin immediate-release granules are made;
5) step 1) and the particle of step 2) preparation form the first sustained release unit, the granulated of step 3) and step 4) preparation
At the second immediate-release units, the first sustained release unit and the second immediate-release units are packed into capsule shells, capsule is made.
Embodiment 5
A kind of capsule, the capsule include:
First sustained release unit, the first sustained release unit is enteric coated particles, comprising:
Second immediate-release units, second immediate-release units are immediate-release granules, comprising:
The capsule shells of encapsulation the first sustained release unit and the second immediate-release units;
The preparation method of capsule is the same as embodiment 4.
The bacteriostatic experiment of 1 composition of experimental example and its capsule to helicobacter pylori
Helicobacter pylori Strains 26695 are inoculated in culture medium (Colombia's blood fine jade containing 7% de- fiber sheep blood
Rouge), it is cultivated.
The Helicobacter pylori Strains 26695 for collecting culture are configured to 3.0 × 108The bacteria suspension of CFU/mL, configuration is containing difference
The helicobacter pylori fluid nutrient medium and capsule containing various concentration of concentration combination object (composition of embodiment 1) be (embodiment 4
Capsule) helicobacter pylori fluid nutrient medium;Draw the helicobacter pylorus bacteria liquid that the composition containing various concentration is added in bacteria suspension
In the helicobacter pylori fluid nutrient medium of culture medium and the capsule containing various concentration, 37 DEG C of incubators are set, cultivate reading group after 72h
The minimal inhibitory concentration MIC for closing object and capsule, is 6.4 μ g/mL.
Show that the composition improved and its capsule of the invention have very strong inhibiting effect to helicobacter pylori.
The bacteriostatic experiment of 2 composition of experimental example and its capsule to the mouse of helicobacter pylori infections
Male C57BL/6 mouse, 60, be randomly divided into positive controls (Pantoprazole 40mg, 2 times a day, Mycobutin
150mg, 2 times a day, Amoxicillin 1000mg, 2 times a day), 10d is administered altogether;Treat 1 group of (composition of embodiment 1: left-handed
Pantoprazole Sodium 27mg, 2 times a day, Mycobutin 150mg, 2 times a day, Amoxicillin 1000mg, 2 times a day), it is administered altogether
7d;2 groups (capsules of embodiment 4,1 tablet each time, 2 times a day) are treated, 7d is administered altogether;Treat 3 groups (composition of embodiment 1:
Levpantoprazole Sodium 27mg, 2 times a day, Mycobutin 150mg, 2 times a day, Amoxicillin 1000mg, 2 times a day), it gives altogether
Medicine 10d;4 groups (capsules of embodiment 4,1 tablet each time, 2 times a day) are treated, 10d is administered altogether, 5 groups for the treatment of (dissolves Tuo La for left-handed
Enteric-coated sustained release coated granule is made in azoles sodium 27mg, and immediate-release granules are made in Mycobutin 150mg and Amoxicillin 1000mg, then will
Two kinds of particles are fitted into capsule shells, 1 tablet each time, 2 times a day), 10d is administered altogether.Mouse after being administered is put to death, and stomach is taken out
Tissue carries out RUT experiment and W-S dyeing, RUT and W-S coloration result is that negative patient then judges helicobacter pylori eradication success,
The eradication rate for calculating each group, the results are shown in Table 1.
Table 1 is bacteriostatic experiment result (n=10) of each group to mice with helicobacter pylori infection
As can be seen from the table, after composition treatment 10d provided by the invention, eradication rate is better than positive controls, provides
Capsule after treating 7d, curative effect is suitable with positive controls, treat 10d after, eradication rate is up to 100%.Thus this is obtained
Inventing the composition provided and capsule has good eradication rate to helicobacter pylori, and curative effect is better than two wires triple therapy.
3 capsule stability experiment of experimental example
Measure the stability that 4 kinds of particles prepared by embodiment 4 are packed into before capsule shells.
The stability of 4 kinds of particles is examined according to high temperature, high humidity and the strong illumination experiment in Chinese Pharmacopoeia 2015 editions
It examines, mainly investigates the related substance (total miscellaneous, %) and content (%) of each active constituent, the results are shown in Table 2.
In table, each group is expressed as follows:
Test 1 group -- the Levpantoprazole Sodium sustained release coating particle prepared in embodiment 4
Test the amoxicillin slow release enteric coating particle prepared in 2 groups-embodiment 4;
Test the rifamycin immediate-release granules prepared in 3 groups-embodiment 4;
Test the Amoxicillin immediate-release granules prepared in 4 groups-embodiment 4;
Test the 5 groups-Levpantoprazole Sodium sustained release coating particle without asparatate
Test the 6 groups-amoxicillin slow release enteric coating particle without asparatate;
Test the 7 groups-rifamycin immediate-release granules without alanine;
Test the 8 groups-Amoxicillin immediate-release granules without alanine.
2 stability experiment result of table
As can be seen from the table, various particles prepared by the present invention have extraordinary stability.
Claims (10)
1. a kind of composition for treating helicobacter pylori infections, which is characterized in that the composition includes that weight fraction ratio is 10-
20:70-120:2.2-4 Mycobutin, Amoxicillin and Levpantoprazole Sodium.
2. the composition for the treatment of helicobacter pylori infections as described in claim 1, which is characterized in that the composition includes weight
Measure Mycobutin, Amoxicillin and the Levpantoprazole Sodium that portion rate is 15:100:2.7.
3. a kind of capsule for treating helicobacter pylori infections, which is characterized in that the capsule includes: the first sustained release unit,
The first sustained release unit is enteric coated particles, including Pantoprazole Sodium and Amoxicillin;
Second immediate-release units, second immediate-release units are immediate-release granules, including Mycobutin and Amoxicillin;
The capsule shells of encapsulation the first sustained release unit and the second immediate-release units;
Wherein, the weight fraction ratio of Mycobutin, Amoxicillin and Levpantoprazole Sodium is 10-20:70-120:2.2-4.
4. capsule as claimed in claim 3, which is characterized in that Amoxicillin and the second quick-release in the first sustained release unit
The weight fraction ratio of Amoxicillin is 2:8 in unit.
5. capsule as claimed in claim 3, which is characterized in that the first sustained release unit includes sustained release agent and enteric packet
Clothing;It is described first sustained release unit and the second immediate-release units further include one of filler, disintegrating agent, adhesive or lubricant or
Two kinds.
6. capsule as claimed in claim 5, which is characterized in that the filler is selected from mannitol, microcrystalline cellulose, lactose
Or one or both of cornstarch;The disintegrating agent is selected from crospovidone, low-substituted hydroxypropyl cellulose or carboxymethyl
One or both of sodium starch;Described adhesive is selected from hydroxypropyl methylcellulose, sodium carboxymethylcellulose, PVP K30 or poly-
One or both of ethylene glycol 4000;The lubricant is in magnesium stearate, titanium dioxide, talcum powder or superfine silica gel powder
It is one or two kinds of;The sustained release agent is selected from one or both of chitosan, acrylic resin or polyvinyl acetate.
7. capsule as claimed in claim 5, which is characterized in that the first sustained release unit further includes asparatate.
8. capsule as claimed in claim 5, which is characterized in that second immediate-release units further include alanine.
9. capsule as claimed in claim 5, which is characterized in that second immediate-release units further include triglycerin mono laurate
Ester.
10. as the described in any item compositions of claim 1-2 or the described in any item capsules of claim 3-8 are used in preparation
Application in the drug for the treatment of helicobacter pylori infections.
Priority Applications (1)
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CN201910747020.8A CN110354125A (en) | 2019-08-12 | 2019-08-12 | A kind of composition that treating helicobacter pylori infections and its preparation and purposes |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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CN201910747020.8A CN110354125A (en) | 2019-08-12 | 2019-08-12 | A kind of composition that treating helicobacter pylori infections and its preparation and purposes |
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Publication Number | Publication Date |
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CN110354125A true CN110354125A (en) | 2019-10-22 |
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CN201910747020.8A Pending CN110354125A (en) | 2019-08-12 | 2019-08-12 | A kind of composition that treating helicobacter pylori infections and its preparation and purposes |
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Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102382103A (en) * | 2011-11-01 | 2012-03-21 | 陕西合成药业有限公司 | Method for preparing and purifying (L)-pantoprazole sodium |
CN109893516A (en) * | 2013-02-13 | 2019-06-18 | 红山生物医药有限公司 | For treating the pharmaceutical composition of helicobacter pylori |
-
2019
- 2019-08-12 CN CN201910747020.8A patent/CN110354125A/en active Pending
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102382103A (en) * | 2011-11-01 | 2012-03-21 | 陕西合成药业有限公司 | Method for preparing and purifying (L)-pantoprazole sodium |
CN109893516A (en) * | 2013-02-13 | 2019-06-18 | 红山生物医药有限公司 | For treating the pharmaceutical composition of helicobacter pylori |
Non-Patent Citations (1)
Title |
---|
CARRO等: "Efficacy of rifabutin-based triple therapy in Helicobacter pylori infected patients after two standard treatments", 《JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY》 * |
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