GB2216413A

GB2216413A - Medicaments containing sufotidine

Info

Publication number: GB2216413A
Application number: GB8904879A
Authority: GB
Inventors: Roger Stables; Keith Thomas Bunce
Original assignee: Glaxo Group Ltd
Current assignee: Glaxo Group Ltd
Priority date: 1988-03-04
Filing date: 1989-03-03
Publication date: 1989-10-11
Also published as: DK104489D0; IT8947714A0; GB8805268D0; DE3906884A1; DK104489A; AU3098489A; ZA891640B; SE8900752D0; GB8904879D0; NL8900525A; JPH01316319A; BE1002256A3; SE8900752L; JP2834175B2; KR890014110A; FR2627985A1

Abstract

An anti-inflammatory pharmaceutical compositions comprises a systematic non-steroidal anti-inflammatory drug and sufotidine or a physiologically acceptable salt thereof. The two active ingredients, may be administered separately or may be combined in a single preparation. Suitable non- steroidal anti-inflammatory drugs are aspirin, indomethacin, ibuprofen, piroxicam, fenoprofen, ketoprofen, naproxen, meferamic acid, diflurisal, benorylate, azapropazone, diclofenac, fenbufen, feprazone, fenclofenac, flufenamic acid, flurbiprofen, oxyphenbutazone, phenylbutazone, sulindac and tolmetin.

Description

2 16 4 MEDICAMENTS This invention relates to improvements in the treatment

of inflammatocy conditions. More particularly it relates to the use of V a non-steroidal anti-inflammatory drug in conjunction with sufotidine in the treatment of such conditions, and to pharmaceutical compositions containing the two active ingredients.

Systemic non-steroidal anti-inflammatory drugs, such as aspirin, indomethacin, ibuprofen and piroxicam, are known to give rise to undesirable side effects. In particular, they are known to be ulcerogenic and can thus, for example, give rise to gastric Lo ulceration when administered orally. This side effect may be further enhanced in combination with other factors such as stress. Since in some treatments these compounds may have to be used for an extended period, such side effects can prove a serious disadvantage.

Sufotidine is the approved name for 1-methyl-3methylsulphonylmethyl-N-[3-[3-(I-pipp-pidinylmethyl/)phenoxylpropyll-lH-1, 2,4-triazole-5-amine which is described and claimed in British Patent Specification No. 2075007B. The compound is a potent and long-acting histamine H2-antagonist which may be used in the treatment of conditions where there is an advantage in lowering gastric acidity. Such conditions include duodenal and gastric ulceration, reflux oesophagitis and Zollinger-Ellison syndrome. Sufotidine may also be used prophylactically in surgical procedures, and in the treatment of allergic and inflammatory conditions where histamine is a known mediator.

It has now been discovered that mucosal lesions of the gastrointestinal tract caused by non-steroidal anti-inflammatopy drugs can be significantly reduced by co-administering sufotidine with the anti-inflammatory drug.

Such combination therapy may be used in the treatment of inflammatory conditions, particularly acute and chronic musculo-skeletal inflammatory conditions such as rheumatoid and osteo-arthritis and ankylosing spondylitis and for analgesia in conditions such as dysmenorrhoea, especially where the use of - 2 the anti-inflammatory drug is limited by gastro-intestinal side effects.

The present invention thus provides a method of treating inflammatory conditions which comprises administering to a human or animal subject a systemic non-steroidal anti-inflammatory drug and sufotidine or a physiologically acceptable salt thereof.

According to another aspect the invention provides for the use of a systemic non-steroidal anti-inflammatory drug for the manufacture of a medicament for administration in conjunction with sufotidine or a physiologically acceptable salt thereof, for the treatment of inflammatory conditions.

The systemic non-steroidal anti-inflammatory drug, and sufotidine or a physiologically acceptable salt thereof, may be administered as a single pharmaceutical composition comprising effective amounts of the two active ingredients. Alternatively the two active ingredients may be coadministered in the form of two separate pharmaceutical compositions for simultaneous or sequential use.

The systemic non-stecoidal anti-inflammatory drugs which may be employed in the invention generally also show analgesic activity and include, for example, aspirin, indomethacin, ibuprofen, piroxicam, fenoprofen, ketoprofen, naproxen, mefenamic acid, diflunisal, benorylate, azapropazone, diclofenac, fenbufen, feprazone, fenclofenac, flufenamic acid, flurbiprofen, oxyphenbutazone, phenylbutazone, sulindac and tolmetin. They may be used according to the invention in their usual dosage amounts, e.g. 50 mg - lg of aspirin. 10 - 100 mg of indomethecin, 5 - 50 mg of piroxicam and 100 - 500 mg of ibuprofen per dosage unit taken one or more times daily in accordance with the normal dosage regime for the drug in question. Particular non- steroidal anti-inflammatories for use according to the invention include indomethacin and., more preferably, piroxicam.

Sufotidine may be administered according to the invention in the form of either its free base or a physiologically acceptable salt. Such salts include salts of inorganic or organic acids such as the hydrochloride, hydrobromide, sulphate, methanesulphonate, - 3 acetate, maleate, succinate, citrate, tartrate, benzoate and fumarate salts. 5ufotidine in the form of its free base is particularly preferred. The amount of sufotidine employed in the invention will be an amount sufficient to reduce the gastrointestinal distress caused by the anti-inflammatory drug and will preferably be in the range of 50 to 600 mg per dosage unit, expressed as the weight of free base. The sufotidine is preferably administered once or twice daily.

The exact dose of the two active ingredients will depend on the route of administration and the condition being treated, and it will be appreciated that it may be necessary to make routine variations to the dosage depending on the age and weight of the patient as well. as the severity of the condition to be treated. A particularly useful form of administration is by the oral route.

According to a further aspect the invention provides a pharmaceutical composition, for use in human or veterinary medicine, comprising a systemic non-3teroidal anti-inflammatory drug, and sufotidine or a physiologically acceptable salt thereof.

Pharmaceutical compositions according to the invention may be presented in a conventional manner with the aid of at least one pharmaceutical carrier or excipient. The composition may take the form of, for example, tablets, capsules, powders, granules, solutions, syrups, suspensions or suppositories prepared by conventional means with acceptable excipients. The compositions may thus contain as excipients, for example, binding agents, compression aids, fillers, lubricants, disintegrants and wetting agents. If desired, other active ingredients may also be present in such compositions. Tablets may be coated in conventional manner, for example with a suitable film- forming material such as methyl cellulose, ethyl cellulose and/or hydroxypropylmethyl cellulose or with sugar. Liquid preparations may also contain, for example, edible oils such as peanut oil. Suppositories may contain, for example, fat-soluble or water miscible bases.

The pharmaceutical compositions of the invention may be prepared according to conventional techniques well known in the pharmaceutical industry. Thus, for example, the anti-inflamma-tory - 4 drug and sufotidine or its salt may be admixed together, if desired, with suitable excipients. Tablets may be prepared, for example, by direct compression of such a mixture. Capsules may be prepared by filling the blend along with suitable excipients into gelatin capsules, using a suitable filling machine.

Alternatively, the pharmaceutical compositions of the invention may be presented in a suitable controlled release form so that the sufotidine or its salt is rapidly made available for absorption and the non-steroidal anti-inflammatory drug is released more slowly.

Thus, for example, the pharmaceutical compositions may be presented for oral administration in a conventional manner associated with controlled release forms.

In order that the invention may be more fully understood, the following Examples are given by way of illustration only.

Example I - Tablets (a) mg/tablet

Sufotidine 300.00 Ibuprofen 400.00 Lactose 245.00 Hydroxpropyl methylcellulose 5.00 Sodium starch glycollate 40.00 Magnesium stearate 10.00 Compression weight 1000.00 The sufotidine and ibuprofen are sieved through a 250pm sieve and blended with the lactose. This mix is granulated with a solution of the hydroxypropyl methylcellulose. The granules are dried, screened and blended with the sodium starch glycollate and the magnesium stearate. The lubricated granules are compressed into tablets using suitable punches.

(b) mg/tablet

Sufotidine 300.00 Indomethacin 50.00 Microcrystalline cellulose 46.00 Magnesium stearate 4.00 Compression weight 400.00 The sufotidine and indomethacin are sieved through a 250pp sieve and blended with the microcrystalline cellulose and magnesium stearate and compressed using 10.Omm punches.

( c) mq/tablet Sufotidine 300.00 Piroxicam 20.00 Microcrystalline cellulose 76.00 Magnesium stearate 4.00 Compression weight 400.00 The sufotidine and piroxicam are sieved through a 250pm sieve and blended with the microcrystalline cellulose and magnesium stearate and compressed using IO.Omm punches.

Example 2 - Capsules (a) mg/capsule Sufotidine 300.00 Ibuprofen 400.00 Starch 1500 96.00 Magnesium stearate 4.00 Fill weight 800.00 A form of directly compressible starch supplied by Colorcon Ltd., Orpington, Kent. 25 The sufotidine and ibuprofen are sieved through a 250pm sieve and blended with the Starch 1500 and magnesium stearate. The resultant mix is filled into size 0 hard gelatin capsules using a suitable filling machine.

(b) mg/capsule Sufotidine 300.00 Indomethacin 50.00 Starch 1500 147.50 Magnesium stearate 2.5 Fill weight 500-00 - 6 The sufotidine and indomethacin are sieved through a 250pm sieve and blended with the Starch 1500 and magnesium stearate. The resultant mix is filled into size 1 hard gelatin capsules using a suitable filling machine.

(c) mg/capsule Sufotidine 300.00 Piroxicam 20.00 Starch 1500 177.50 Magnesium stearate 2.50 Fill weight 500.00 The sufotidine and piroxicam are sieved through a 250pm sieve and blended with the starch 1500 and magnesium stearate. The resultant mix is filled into size I hard gelatin capsules using a suitable filling machine.

Example 3 - Suppositories (a) mg/suppository Sufotidine 300.0 Piroxicam 10.0 Adeps Solidus 670.0 Colloidal silica 20.0 Fill weight 1000.0 The sufotidine and piroxicam are sieved through a 100pm sieve and blended with the molten Adeps Solidus containing the colloidal silica. The resultant mixture is filled into suppository cavities using a suitable filling machine.

0- 7 (b) mg/suppository Sufotidine 300.0 Indomethacin 100.0 Polyethylene glycol 400 80.0 Polyethylene glycol 4000 520.0 Fill weight 1000.0 The sufatidine and indomethacin are sieved through a 100pn sieve and blended with the molten polyethylene glycol mixture. The resultant mixture is filled into suppository cavities using a suitable filling machine.

8

Claims

1. A pharmaceutical composition for use in human or t veterinary medicine comprising a systemic non-steroidal anti- inflammatory drug and sufotidine or a physiologically acceptable salt thereof.

2. A pharmaceutical composition as claimed in claim 1 wherein the sufotidine is used in the form of the free base or as the hydrochloride, hydrobromide, sulphate, methanesulphonate, acetate, maleate, succinate, tartrate, benzoate or funarate salt.

3. A pharmaceutical composition as claimed in claim 2 wherein the suf otidine is used in the form of the f ree base.

4. A pharmaceutical composition as claimed in any of claims 1 to 3 in unit dose form and containing from 50 to 600mg of suf otidine per unit dose expressed as the weight of f ree base.

5. A pharmaceutical composition as claimed in any of claims 1 to 4 wherein the non-steroidal anti-inflammatory drug is selected from aspirin, indomethacin, ibuprofen, piroxicam, fenoprofen, ketoprofen, naproxen, mefenamic acid, diflunisal, benorylate, azapropazone, diclofenac, fenbufen, feprazone, fenclofenac, flufenamic acid, flurbiprofen, oxyphenbutazone, phenylbutazone, sulindac and tolmetin.

6. A pharmaceutical composition as claimed in claim 5 wherein the non-steroidal anti-inflammatory drug is piroxicam.

7. A pharmaceutical composition as claimed in claim 6 in unit dose form and containing 5 - 50mg of piroxican per 6056/1.1 9 unit dose.

8. A pharmaceutical composition as claimed in any of claims 1 to 7 in a form adapted for oral administration.

9. A pharmaceutical composition as claimed in any of claims 1 to 8 also containing at least one pharmaceutical carrier or excipient.

10. A method for the manufacture of a pharmaceutical composition as claimed in any of claims 1 to 9 which comprises processing the components by conventional techniques to form a pharmaceutical composition.

11. The use of sufotidine or a physiologically acceptable salt thereof for the manufacture of a medicament for administration in conjunction with a systemic nonsteroidal anti-inf lammatory drug in the treatment of an infla=atory condition.

12. The use as claimed in claim 11 wherein the sufotidine is used in the form of the free base or as the hydrochloride, hydrobromide, sulphate, mathanesulphonate, acetate, maleate, succinate, tartrate, benzoate or fumarate salt.

13. The use as claimed in claim 12 wherein the sufotidine is used in the form of the free base.

14. The use as claimed in any of claims 11 to 13 wherein the medicament is in unit dose form containing from 50 to 600mg of sufotidine per unit dose expressed as the weight of free base.

15. The use as claimed in any of claims 11 to 14 t wherein the non-steroidal anti-inflammatbry drug is 6056/1.1 selected from aspirin, indomethacin, ibuprof en, piroxicam, fenoprofen, ketoprofen, naproxen, mefenamic acid, diflunisal, benorylate, azapropazone, diclofenac, fenbufen, feprazone, fenclofenac, flufenamic acid, flurbiprofen, oxyphenbutazone, phenylbutazone, sulindac and tolmetin.

16. The use as claimed in claim 15 wherein the nonsteroidal antiinflammatory drug is piroxicam.

17. The use as claimed in ciaim 16 wherein the piroxicam is used in unit dose form containing 5 - 50mg of piroxicam per unit dose.

18. The use as claimed in any of claims 11 to 17 wherein the medicament is in a form adapted for oral administration.

19. The use as claimed in any of claims 11 to 18 wherein the medicament is for administration in conjunction with the non-steroidal antiinflanmatory but separately therefrom.

Published 1989 atThe Patent Oface.8tate House, 68.71 RLghHolbornlondonWClR4TP. Further copies maybe obtained from The Patentofftee. Sales Branch, St Marv Cray, Orpington, Kent BRS 3RD. Printed by Multiplex techniques ltd, St Mary Cray, Kent, Con. 1187