EP0000774B1 - Antithrombotic medicative combination and process for its preparation - Google Patents

Antithrombotic medicative combination and process for its preparation Download PDF

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Publication number
EP0000774B1
EP0000774B1 EP78100586A EP78100586A EP0000774B1 EP 0000774 B1 EP0000774 B1 EP 0000774B1 EP 78100586 A EP78100586 A EP 78100586A EP 78100586 A EP78100586 A EP 78100586A EP 0000774 B1 EP0000774 B1 EP 0000774B1
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Prior art keywords
antithrombotic
preparation
combination
medicative
pharmaceutical combination
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EP78100586A
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German (de)
French (fr)
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EP0000774A1 (en
Inventor
Laurence A. Prof. Harker
Hans Wolfgang Dr. Schröter
Walter Dr. Haarmann
Josef Dr. Dipl.-Chemiker Roch
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Boehringer Ingelheim Pharma GmbH and Co KG
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Dr Karl Thomae GmbH
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00Drugs for disorders of the blood or the extracellular fluid
    • A61P7/02Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors

Definitions

  • the invention relates to a new antithrombotic drug combination and a process for its preparation.
  • 2,6-bis (diethano) amino) -4,8-dipiperidino-pyrimido [5,4-d] pyrimidine (generic name: DIPYRIDAMOL) has long been used as a coronary-expanding remedy. It was first described in British patent 807 826.
  • 1,2-diphenyl-3,5-dioxo-4- (2-phenylsulfinylethyl) pyrazolidine (generic name: SULFINPYRAZON) has been on the market as an anti-gout agent for a long time, it was first used in Helv. Chim. Acta 44, 236 (1961). A good antithrombotic effect was subsequently found for both remedies, see for example Therapy Week 26, 8464-8489 (1976).
  • the substance to be tested is administered orally to the awake animals (mostly) 4 times a day over the test period of 4-5 days.
  • the table clearly shows that for the normalization of the shortened platelet lifetime 10 mg / kg / day dipyridamole or 100 mg / kg / day sulfinpyrazone is required, but with a combination of 2.5 mg / kg / day of the two active substances the same effect is achieved. It is known that the results on the normalization of platelet life can be transferred very well from monkeys to humans, for example in humans the same dose of dipyridamole per kilogram is required to achieve the same effect as in monkeys.
  • the Normalization of the platelet lifespan is of great therapeutic importance since the shortening of the platelet lifespan occurring in humans is an indication of a tendency to thrombosis. The new drug combination is therefore well suited for the prevention and healing of thromboembolic diseases.
  • a single dose for adults contains between 25 mg and 75 mg of the two active substances, preferably 50 mg dipyridamole and 50 mg sulfinpyrazone; the single dose is preferably administered 3 times a day, the mean daily dose is therefore 150 mg / kg of each of the two active compounds. Since both active ingredients have been on the market for many years, no information about the toxicity needs to be given, since this is low in both cases.
  • the invention further relates to a process for the preparation of the pharmaceutical combination according to the invention, which is characterized in that 2,6-bis (diethanolamino) -4,8-dipiperidino-pyrimido [5,4-d] pyrimidine and 1,2-diphenyl -3,5-dioxo-4- (2-phenylsulfinyläthyl) -pyrazolidine combined in the ratio of 10: 1 to 1:10 and the usual carriers and / or auxiliaries in the manufacture of medicines to tablets, dragees, powder for letters and Capsules is formulated.
  • the new preparations according to the invention are preferably administered orally in the doses mentioned above.
  • Tablets and dragees capsules are produced in a manner known per se, for example the tablets are produced by directly compressing a mixture of the active ingredients and auxiliaries and, if appropriate, subsequently coated with a film which is compatible with the gastrointestinal tract, the capsules being produced First the powder mixture and the core are coated separately and then filled on a commercially available capsule filling machine.
  • the active ingredients are mixed together with milk sugar and starch and the mixture is moistened evenly with an aqueous gelatin solution.
  • the moist mass is limited to max. Sieved 2 mm, dried and mixed with the lubricant after sieving again. Tablets of 400 mg were pressed from the mixture prepared in this way.
  • the kernels are coated with a conventional sugar-coating suspension to 500 mg and then with sugar syrup to 530 mg / coated tablet.

Description

Die Erfindung betrifft eine neue antithrombotisch wirkende Arzneimittelkombination sowie ein Verfahren zu ihrer Herstellung. 2,6-Bis(diäthano)amino)-4,8-dipiperidino-pyrimido[5,4-d]pyrimidin (generic name: DIPYRIDAMOL) wird bereits seit langem als koronarerweiterndes Heilmittel verwendet. Es wurde erstmals im bristischen Patent 807 826 beschrieben. Ebenso ist 1,2-Diphenyl-3,5-dioxo-4-(2-phenylsulfinyläthyl)-pyrazolidin (generic name: SULFINPYRAZON) bereits seit langem als Antigichtmittel im Handel, es wurde erstmals in der Helv. chim. Acta 44, 236 (1961) beschrieben. Bei beiden Heilmitteln wurde in der Folgezeit auch eine gute antithrombotische Wirkung gefunden, siehe beispielsweise Therapiewoche 26, 8464-8489 (1976).The invention relates to a new antithrombotic drug combination and a process for its preparation. 2,6-bis (diethano) amino) -4,8-dipiperidino-pyrimido [5,4-d] pyrimidine (generic name: DIPYRIDAMOL) has long been used as a coronary-expanding remedy. It was first described in British patent 807 826. Likewise, 1,2-diphenyl-3,5-dioxo-4- (2-phenylsulfinylethyl) pyrazolidine (generic name: SULFINPYRAZON) has been on the market as an anti-gout agent for a long time, it was first used in Helv. Chim. Acta 44, 236 (1961). A good antithrombotic effect was subsequently found for both remedies, see for example Therapy Week 26, 8464-8489 (1976).

Bei beiden Substanzen ist jedoch zur Erzielung einer antithrombotischen Wirkung eine relativ hohe Dosis erforderlich, wobei sich schon die Nebenwirkungen beider Verbindungen bemerkbar machen; beim Dipyridamol sind es gewisse Kreislaufwirkungen, die sich in Kopfschmerzen äußern, beim Sulfinpyrazon sind es Magenschmerzen wegen der in hohen Dosen ulcerogenen Wirkung dieser Substanz.For both substances, however, a relatively high dose is required to achieve an antithrombotic effect, with the side effects of both compounds already being noticeable; Dipyridamole has certain circulatory effects, which are expressed in headaches, and sulfinpyrazone causes stomach pains due to the fact that this substance is ulcerogenic in high doses.

Überraschenderweise wurde nun eine starke synergistische Wirkung der beiden Wirkstoffe festgestellt. Bei einer Kombination von Dipyridamol und Sulfinpyrazon können die erforderlichen Dosen zur Erreichung des gleichen antithrombotischen Effektes wesentlich gesenkt werden. Diese synergistische Wirkung wurde im folgenden Versuchsmodell an Pavianen festgestellt:

  • Männlichen Pavianen mit einem Gewicht von 8-12 kg wird unter Narkose ein A-V-Shunt zwischen Arteria und Vena femoralis angelegt. Dieser Shunt ist ca. 50 cm lang und besteht aus einem besonders präparierten Silastikschlauch. Durch den Fremdkörperreiz dieser körperfremden Oberfläche kommt es zu einem erhöhten Thrombozytenverbrauch (da der Organismus bestrebt ist, diesen "Defekt" abzudecken). Dieser läßt sich leicht messen, indem man dem Versuchstier mit Chrom 51 radioaktiv markierte Thrombozyten injiziert und deren Verschwinden aus der Blutbahn durch 2 x tägl. Messen verfolgt. Bei einem normalen Thrombozytenumsatz beträgt die Lebensdauer der Thrombozyten etwa 5 Tage, bei Tieren mit einem eingesetzten Shunt verkürzt sich die mittlere Thrombozytenlebenszeit (als Ausdruck eines erhöhten, Thrombozytenumsatzes) auf etwa 2-2,5 Tage.
Surprisingly, a strong synergistic effect of the two active ingredients has now been found. With a combination of dipyridamole and sulfinpyrazone, the doses required to achieve the same antithrombotic effect can be significantly reduced. This synergistic effect was found in the following test model on baboons:
  • Male baboons weighing 8-12 kg are placed under anesthesia under an AV shunt between the artery and femoral vein. This shunt is approx. 50 cm long and consists of a specially prepared silica tube. The foreign body stimulus of this foreign surface leads to increased platelet consumption (since the organism strives to cover this "defect"). This can be easily measured by injecting the test animal with 51 radio-labeled platelets with chromium and following their disappearance from the bloodstream by measuring it twice a day. With a normal platelet turnover, the lifespan of the platelets is about 5 days, in animals with an inserted shunt the mean platelet lifespan is shortened (as an expression of an increased platelet turnover) to about 2-2.5 days.

Bei der Substanzprüfung wird die zu prüfende Substanz über den Versuchszeitraum von 4-5 Tagen den wachen Tieren (meist) 4 mal täglich oral verabreicht.During the substance test, the substance to be tested is administered orally to the awake animals (mostly) 4 times a day over the test period of 4-5 days.

Die bei dieser Methode erzielten Ergebnisse sind in der nachstehenden Tabelle wiedergegeben:

Figure imgb0001
The results obtained with this method are shown in the table below:
Figure imgb0001

Aus der Tabelle geht klar hervor, daß für die Normalisierung der verkürzten Thrombozytenlebenszeit 10 mg/kg/Tag Dipyridamol oder 100 mg/kg/Tag Sulfinpyrazon erforderlich ist, daß jedoch mit einer Kombination von je 2,5 mg/kg/Tag der beiden Wirkstoffe der gleiche Effekt erreicht wird. Es ist bekannt, daß sich die Ergebnisse über die Normalisierung der Thrombozytenlebenszeit sehr gut vom Affen auf den Menschen übertragen lassen, beispielsweise ist beim Menschen zur Erzielung des gleichen Effektes die gleiche Dosis von Dipyridamol pro Kilogramm erforderlich, wie beim Affen. Die Normalisierung der Thrombozytenlebenszeit ist therapeutisch von sehr großer Bedeutung, da die beim Menschen auftretende Verkürzung der Thrombozytenlebenszeit ein Indiz für eine Neigung zu Thrombosen ist. Die neue Arzneimittelkombination ist daher zur Vorbeugung und Heilung von thromboembolischen Krankheiten gut geeignet.The table clearly shows that for the normalization of the shortened platelet lifetime 10 mg / kg / day dipyridamole or 100 mg / kg / day sulfinpyrazone is required, but with a combination of 2.5 mg / kg / day of the two active substances the same effect is achieved. It is known that the results on the normalization of platelet life can be transferred very well from monkeys to humans, for example in humans the same dose of dipyridamole per kilogram is required to achieve the same effect as in monkeys. The Normalization of the platelet lifespan is of great therapeutic importance since the shortening of the platelet lifespan occurring in humans is an indication of a tendency to thrombosis. The new drug combination is therefore well suited for the prevention and healing of thromboembolic diseases.

Eine Einzeldosis für Erwachsene enthält zwischen 25 mg und 75 mg der beiden Wirkstoffe, vorzugsweise 50 mg Dipyridamol und 50 mg Sulfinpyrazon; die Einzeldosis wird vorzugsweise 3 mal täglich verabreicht, die mittlere Tagesdosis beträgt somit 150 mg/kg von jedem der beiden Wirkstoffe. Da beide Wirkstoffe schon seit vielen Jahren im Handel sind, brauchen keine Angaben über die Toxizität gemacht werden, da diese in beiden Fällen gering ist.A single dose for adults contains between 25 mg and 75 mg of the two active substances, preferably 50 mg dipyridamole and 50 mg sulfinpyrazone; the single dose is preferably administered 3 times a day, the mean daily dose is therefore 150 mg / kg of each of the two active compounds. Since both active ingredients have been on the market for many years, no information about the toxicity needs to be given, since this is low in both cases.

Gegenstand der Erfindung ist des weiteren ein Verfahren zur Herstellung der erfindungsgemäßen Arzneimittelkombination, welches dadurch gekennzeichnet ist, daß 2,6-Bis(diäthanolamino)-4,8- dipiperidino-pyrimido[5,4-d]pyrimidin und 1,2-Diphenyl-3,5-dioxo-4-(2-phenylsulfinyläthyl)-pyrazolidin im Verhältnis von 10:1 bis 1:10 kombiniert und den bei der Herstellung von Arzneimitteln üblichen Träger- und/oder Hilfsstoffen zu Tabletten, Dragees, Pulver für Briefe und Kapseln formuliert wird. Die erfindungsgemäßen neuen Präparate werden vorzugsweise peroral in den oben angeführten Dosen verabreicht.The invention further relates to a process for the preparation of the pharmaceutical combination according to the invention, which is characterized in that 2,6-bis (diethanolamino) -4,8-dipiperidino-pyrimido [5,4-d] pyrimidine and 1,2-diphenyl -3,5-dioxo-4- (2-phenylsulfinyläthyl) -pyrazolidine combined in the ratio of 10: 1 to 1:10 and the usual carriers and / or auxiliaries in the manufacture of medicines to tablets, dragees, powder for letters and Capsules is formulated. The new preparations according to the invention are preferably administered orally in the doses mentioned above.

Die Herstellung von Tabletten und Dragees, Kapseln erfolgt in an sich bekannter Weise, beispielsweise werden die Tabletten durch unmittelbares Verpressen eines Gemisches der Wirk- und Hilfsstoffe hergestellt und gegebenenfalls nachträglich mit einem im Magen- und Darm verträglichen Film überzogen, bei der Herstellung der Kapseln wird erst die Pulvermischung und der Kern mit Uberzug getrennt hergestellt und dann auf einer handelsüblichen Kapselabfüllmaschine abgefüllt.Tablets and dragees, capsules are produced in a manner known per se, for example the tablets are produced by directly compressing a mixture of the active ingredients and auxiliaries and, if appropriate, subsequently coated with a film which is compatible with the gastrointestinal tract, the capsules being produced First the powder mixture and the core are coated separately and then filled on a commercially available capsule filling machine.

Die folgenden Beispiele erläutern die Erfindung ohne sie zu beschränken:

Figure imgb0002
The following examples illustrate the invention without restricting it:
Figure imgb0002

Die Wirkstoffe werden zusammen mit Milchzucker und Stärke gemischt und die Mischung gleichmäßig mit einer wäßrigen Gelatinelösung befeuchtet. Die feuchte Masse wird auf max. 2 mm gesiebt, getrocknet und nach nochmaligem Sieben mit dem Schmiermittel vermischt. Aus der so hergestellten preßfertigen Mischung wurden Tabletten von 400 mg gepreßt.The active ingredients are mixed together with milk sugar and starch and the mixture is moistened evenly with an aqueous gelatin solution. The moist mass is limited to max. Sieved 2 mm, dried and mixed with the lubricant after sieving again. Tablets of 400 mg were pressed from the mixture prepared in this way.

Drageekernmaße:Coated core dimensions:

Figure imgb0003
Figure imgb0003

Dragierung:Coating:

Die Kerne werden mit einer üblichen Zuckerdragiersuspension auf 500 mg und anschließend mit Zuckersirup auf 530 mg/Dragee dragiert.

Figure imgb0004
The kernels are coated with a conventional sugar-coating suspension to 500 mg and then with sugar syrup to 530 mg / coated tablet.
Figure imgb0004

Claims (4)

1. Antithrombotic pharmaceutical combination, characterised in that it contains as active ingredient 2,6 - bis(diethanolamino) - 4,8 - dipiperidino - pyrimido[5,4 - d]pyrimidine, 1,2 - diphenyl-3,5 - dioxo - 4 - (2 - phenylsulphinylethyl) - pyrazolidine and conventional carriers and/or excipients.
2. Pharmaceutical combination according to claim 1, characterised in that the weight ratio of 2,6 - bis(diethanolamino) - 4,8 - dipiperidino - pyrimido[5,4 - d] - pyrimidine to 1,2 - diphenyl - 3,5-dioxo - 4 - (2 - phenylsulphinylethyl) - pyrazolidine is 10:1 1 to 1:10.
3. Pharmaceutical combination according to claims 1 and 2, characterised in that the ratio of the two active substances is 1:1.
4. Process for the preparation of an antithrombotic pharmaceutical combination, characterised in that 2,6 - bis(diethanolamino) - 4,8 - dipiperidino - pyrimido[5,4 - d] - pyrimidine and 1,2 - diphenyl-3,5 - dioxo - 4 - (2 - phenylsulphinylethyl) - pyrazolidine are combined in a ratio of 10:1 to 1:10 and are formulated with conventional carriers and/or excipients into coated tablets, tablets, capsules or powder envelopes.
EP78100586A 1977-08-09 1978-08-03 Antithrombotic medicative combination and process for its preparation Expired EP0000774B1 (en)

Applications Claiming Priority (2)

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DE2735830 1977-08-09
DE19772735830 DE2735830A1 (en) 1977-08-09 1977-08-09 ANTITHROMBOTIC DRUG COMBINATION AND METHOD FOR THE PRODUCTION THEREOF

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EP0000774A1 EP0000774A1 (en) 1979-02-21
EP0000774B1 true EP0000774B1 (en) 1980-05-28

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US (1) US4206214A (en)
EP (1) EP0000774B1 (en)
JP (1) JPS5940134B2 (en)
AU (1) AU517484B2 (en)
BE (1) BE869614A (en)
DE (2) DE2735830A1 (en)
FR (1) FR2399841A1 (en)
GB (1) GB2002230A (en)
IE (1) IE47740B1 (en)
IL (1) IL55301A (en)
IT (1) IT1107571B (en)
LU (1) LU80083A1 (en)
NL (1) NL7807539A (en)
NZ (1) NZ188098A (en)
PH (1) PH14149A (en)
SE (1) SE7808489L (en)
ZA (1) ZA784470B (en)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2904736A1 (en) * 1979-02-08 1980-08-28 Thomae Gmbh Dr K ANTITHROMBOTIC DRUG COMBINATION
EP0019586A1 (en) * 1979-05-11 1980-11-26 Ciba-Geigy Ag Antithrombotic combination formulas
FR2470599A1 (en) * 1979-12-07 1981-06-12 Panoz Donald IMPROVEMENTS IN PROCESSES FOR THE PREPARATION OF GALENIC SHAPES WITH DELAYED ACTION AND PROGRAMMED RELEASE AND GALENIC FORMS OF MEDICAMENTS THUS OBTAINED
US4444777A (en) * 1981-07-30 1984-04-24 Bristol-Myers Company Pharmaceutical compositions of anagrelide and sulfinpyrazone
AT393962B (en) * 1987-10-22 1992-01-10 Thomae Gmbh Dr K Synergistic pharmaceutical combination with a content of a phosphodiesterase inhibitor and the use thereof
US6376242B1 (en) * 1999-09-21 2002-04-23 Emory University Methods and compositions for treating platelet-related disorders using MPL pathway inhibitory agents
EP1093814A1 (en) * 1999-10-22 2001-04-25 Boehringer Ingelheim Pharma KG Use of dipyridamole or mopidamol in the manufacture of a medicament for the treatment and prevention of fibrin-dependent microcirculation disorders
US7064130B2 (en) * 2001-04-20 2006-06-20 Boehringer Ingelheim Pharma Gmbh & Co. Kg Use of radical-scavenging compounds for treatment and prevention of NO-dependent microcirculation disorders
JP2006516593A (en) * 2003-02-07 2006-07-06 ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング Use of dipyridamole or mopidamol for the treatment and prevention of MMP-9 dependent diseases

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3031450A (en) * 1959-04-30 1962-04-24 Thomae Gmbh Dr K Substituted pyrimido-[5, 4-d]-pyrimidines
US3322755A (en) * 1964-03-10 1967-05-30 Boehringer Sohn Ingelheim Basic-substituted 1, 2, 3, 4-tetrahydropyrimido [5, 4-d]-pyrimidines
GB1190419A (en) * 1966-08-16 1970-05-06 Yamanouchi Pharma Co Ltd Substituted Pyrimido-Pyrimidines and a process for the preparation thereof

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Publication number Publication date
NZ188098A (en) 1984-07-06
PH14149A (en) 1981-03-06
EP0000774A1 (en) 1979-02-21
SE7808489L (en) 1979-02-10
FR2399841B1 (en) 1980-10-31
IE47740B1 (en) 1984-06-13
JPS5428829A (en) 1979-03-03
IT7850483A0 (en) 1978-07-26
JPS5940134B2 (en) 1984-09-28
GB2002230A (en) 1979-02-21
DE2860018D1 (en) 1980-10-16
IL55301A (en) 1983-05-15
ZA784470B (en) 1980-04-30
IT1107571B (en) 1985-11-25
FR2399841A1 (en) 1979-03-09
IE781610L (en) 1979-02-09
US4206214A (en) 1980-06-03
DE2735830A1 (en) 1979-03-01
LU80083A1 (en) 1979-09-06
BE869614A (en) 1979-02-08
AU517484B2 (en) 1981-08-06
AU3873578A (en) 1980-02-14
NL7807539A (en) 1979-02-13

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