US20030055067A1 - Antifungal composition with enhanced bioavailability - Google Patents

Antifungal composition with enhanced bioavailability Download PDF

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US20030055067A1
US20030055067A1 US10/114,612 US11461202A US2003055067A1 US 20030055067 A1 US20030055067 A1 US 20030055067A1 US 11461202 A US11461202 A US 11461202A US 2003055067 A1 US2003055067 A1 US 2003055067A1
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liquid
suspension
sorbitan
effective amount
liquid suspension
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Stefan Sharpe
Joel Sequeira
David Harris
Shashank Mahashabde
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Merck Sharp and Dohme Corp
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Schering Corp
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Priority to US13/161,097 priority patent/US8263600B2/en
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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
    • A61K31/495—Heterocyclic 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
    • A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
    • A01N43/00—Biocides, pest repellants or attractants, or plant growth regulators containing heterocyclic compounds
    • A01N43/64—Biocides, pest repellants or attractants, or plant growth regulators containing heterocyclic compounds having rings with three nitrogen atoms as the only ring hetero atoms
    • A01N43/647—Triazoles; Hydrogenated triazoles
    • A01N43/653—1,2,4-Triazoles; Hydrogenated 1,2,4-triazoles
    • 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
    • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
    • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
    • 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
    • A61K9/10—Dispersions; Emulsions
    • 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
    • A61P31/10—Antimycotics

Definitions

  • This invention relates to stable, liquid suspensions containing an antifungally effective amount of the micronized compound represented by the chemical structural formula I:
  • At least one thickening agent, a non-ionic surfactant, and a pharmaceutically acceptable liquid carrier at least one thickening agent, a non-ionic surfactant, and a pharmaceutically acceptable liquid carrier, and methods of using the suspensions to treat or prevent fungal infections
  • U.S. Pat. No. 5,661,151 discloses the compound of formula I and its potent antifungal activity against a broad range of fungi such as Aspergillis, Candida, Cryptococcus, Fusarium, and other opportunistic fungi.
  • U.S. Pat. Nos. 5,834,472 and 5,846,971 disclose oral pharmaceutical capsule compositions of the compound of structural formula I coated onto inert beads together with a binder.
  • the compound of structural formula I is highly lipophilic, and has an extremely low water solubility.
  • aqueous compositions of the compound of structural formula I were found to have reduced anti-fungal activity and/or bioavailability, presumably due to the extremely low water solubility of the compound. Accordingly, a need exists for an oral pharmaceutical composition of the compound of structural formula I that has enhanced bioavailability and improved stability characteristics
  • compositions in the form of liquid suspension, suitable for oral administration comprising micronized particles of posaconazole, the compound having the chemical structural formula I
  • At least one thickening agent, a non-ionic surfactant, and a pharmaceutically acceptable liquid carrier that provides significant advantages over the prior art.
  • Advantages of the liquid suspensions of the present invention include improved homogeneity of the suspension and ease of dispersibility of the suspension.
  • the solids that settle in the liquid suspension of the present invention do not form a solid cake that is difficult to re-disperse. There is virtually no sedimentation of the solids in the unreconstituted liquid suspension of this invention for a period of at least three days.
  • This surprising feature ensures that a patient having a fungal infection taking the liquid suspensions of the present invention will receive an antifungally effective amount of posaconazole.
  • the liquid suspensions of the present invention have a longer shelf life. Additionally, the liquid suspension, upon reconstitution, provide substantially the same antifungally effective amount posaconazole as the initially prepared suspension.
  • the present invention provides a liquid suspension comprising micronized posaconazole, having the chemical structural formula I:
  • At least one thickening agent at least one thickening agent, a non-ionic surfactant, and a pharmaceutically acceptable liquid carrier.
  • This invention also provides a liquid suspension comprising an antifungally effective amount of micronized posaconazole having the chemical structural formula I:
  • an effective amount of at least one thickening agent an amount of a buffer system effective to maintain the pH of the system in the range of about 4.0 to about 6.0, an effective amount of a non-ionic surfactant, and a pharmaceutically acceptable liquid carrier.
  • This invention further provides a liquid suspension comprising an antifungally effective amount of micronized posaconazole having the chemical structural formula I:
  • the micronized compound has a mean particle size in the range of about 1200 nm to about 1600 nm, an effective amount of polyoxyethylene derivatives of sorbitan esters of saturated or unsaturated C 12 to C 18 acids, an effective amount of a buffer system sufficient to maintain a pH in the range of about 4.0 to about 6.0, an effective amount of a combination of two thickening agents, wherein one is a liquid sugar, and a pharmaceutically acceptable liquid carrier.
  • FIGS. I & 2 graphically display the mean plasma concentration time profiles of posaconazole tablets and of the liquid suspension of Example 1 of the present invention.
  • FIG. 1 is a linear:linear graphic profile of the plasma concentration (ng/ml)of the compound of formula I versus time (hours) after administration of the following four Treatments A- D: a single of 2 ⁇ 100 mg of the compound of formula I in the tablet co-precipitate formulation of U.S. Pat. No. 5,834,472 with a standardized high-fat breakfast- Treatment D and. symbol -•-; a 200 mg of the compound of formula I in the oral suspension of this invention (5 ml) following a 10-hr. fast -Treatment A and.
  • FIG. 2 is a log linear graphic profile of the plasma concentration (ng/ml)of the compound of formula I versus time in hours for the data presented in FIG. 1.
  • the present invention provides a stable suspension of micronized particles of the antifungal compound posaconazole in a pharmaceutically acceptable liquid carrier.
  • the suspension of the present invention is stable to settling without sedimentation when stored undisturbed for more than three days at 25° C. (See Table 1 below).
  • Table 2 below shows that the liquid suspension formulations of this invention are stable in that the concentration of posaconazole in the suspension is substantially the same ( ⁇ 2%) compared to the initial concentration (as measured by HPLC) for periods of up to 12 months.
  • the stable suspension of the present invention has a remarkably higher (23-36% increase) bioavailability compared to an optimized oral tablet of micronized particles of posaconazole when each is administered to subjects concurrently with a high fat breakfast. See Tables 3 and 4 and FIGS. 1 & 2
  • One aspect of the present invention is to provide a pharmaceutical composition that contains micronized particles of posaconazole in combination with a non-ionic surfactant, such as a sorbitan ester and at least one thickening agent, preferably a combination of xanthan gum and a liquid sugar, that are easily dispersible in a pharmaceutically acceptable liquid carrier such as purified water.
  • a pharmaceutically acceptable liquid carrier such as purified water.
  • the pharmaceutical composition provides a stabilized suspension that does not settle for at least three days, thus ensuring that patients will get an effective dose of posaconazole.
  • Another feature of the stabilized suspension of the present invention is that it is useful in treating patients with HIV-1 infections with oral thrush without posaconazole precipitating out of solution.
  • Another aspect of the present invention is that the suspension of the present invention avoids formation of solid cakes which are difficult to disperse.
  • Micron-sized particles of posaconazole preferably have a mean particle size range of about 1000 nanometers (nm) to about 1800 nm, preferably about 1200 nm to about 1600 nm, and most preferably about 1400 nm. This particle size can be obtained either by the final step during the manufacture of the antifungal compound of formula I or by the use of conventional micronizing techniques after the conventional crystallization procedure(s).
  • microfluidization is an alternative to traditional homogenization that utilizes the collision of two product streams at high pressures to produce a much more uniform particle size distribution (according to Microfluidics International Co.) and smaller average particle size of about 1200 nm to 1600 nm.
  • the process and equipment used in microfluidization are described in U.S. Pat. No. 4,533,254.
  • the micronized posaconazole of the present invention may also be present in crystalline form. It is preferably substantially chemically and optically pure, and it contains less than about 10% of its optical isomers, enantiomers or other diastereomers. It may be 99% of the optically pure the levorotatory or dextrarotatory isomer. This optically pure compound of chemical structure I should avoid many of the untoward side effects of a mixture of other optical isomers.
  • Posaconazole liquid suspension is employed in the composition in antifungally amounts effective to control the fungi of interest.
  • antifungally effective amounts can range from about 10 mg/ml to about 100 mg/ml concentration of the liquid suspension formulations of the present invention, more preferably from about 20 mg/ml to about 60 mg/ml, and most preferably about 40 mg/ml of the compound of formula I.
  • the present invention also provides for a method of treating and/or preventing fungal infection in a mammal comprising administering to the mammal an amount of the liquid suspension containing the micronized posaconazole in an amount effective for treating and/or preventing such fungal infection.
  • Antifungally effective amounts of liquid suspensions of present invention containing 40 mg/ml of the compound of formula I is administered orally in the doses of 5 ml—containing 200 mg of formula I—three times a day (TID) or four times a day (QID)—or 10 ml—containing 400 mg of the compound of formula 1—twice a day (BID).
  • TID three times a day
  • QID four times a day
  • 10 ml containing 400 mg of the compound of formula 1—twice a day
  • BID twice a day
  • the attending clinician may change the dose and dosing regimen in view of the age, health, and sex of the patient as well as the severity of the fungal infection.
  • Non-ionic surfactant refers to a surfactant which lacks a net ionic charge and does not dissociate to an appreciable extent in aqueous media.
  • the properties of non-ionic surfactants are largely dependent upon the proportions of the hydrophilic and hydrophobic groups in the molecule.
  • Hydrophilic groups include the oxyethylene group (—OCH 2 CH 2 —) and the hydroxy group. By varying the number of these groups in a hydrophobic molecule, such as an ester of a fatty acid, substances are obtained which range from strongly hydrophobic and water insoluble compounds, such as glyceryl monostearate, to strongly hydrophilic and water-soluble compounds, such as the macrogols.
  • hydrophilic and hydrophobic groups are more evenly balanced, such as the macrogol esters and ethers and sorbitan derivatives.
  • Suitable non-ionic surfactants may be found in Martindale, The Extra Pharmacopoeia, 28th Edition, 1982, The Pharmaceutical Press, London, Great Britain, pp. 370 to 379.
  • Such suitable non-ionic surfactants include block copolymers of ethylene oxide and propylene oxide, glycol or glyceryl esters of saturated or unsaturated C 8 to C 20 acids, preferably, polyoxyethylene esters of saturated or unsaturated C 8 to C 20 acids, polyoxyethylene ethers of saturated or unsaturated C 8 to C 20 acids, and polyvinylalcohols or sorbitan esters of saturated or unsaturated C 10 to C 20 acids.
  • the non-ionic surfactant is a sorbitan ester of a saturated or unsaturated C 10 to C 20 acid, and more preferably the sorbitan ester is a fatty acid ester of sorbitan selected from sorbitan monolaurate, sorbitan monooleate, sorbitan sesquioleate, sorbitan trioleate, sorbitan monopalmitate, sorbitan monostearate and sorbitan tristearate, or mixtures thereof.
  • Suitable sorbitan esters include, e.g. Polysorbate 20, Polysorbate 40, Polysorbate 60, Polysorbate 65, Polysorbate 80, Polysorbate 85, Sorbitan Monolaurate, Sorbitan Mono-oleate, Sorbitan Monopalmitate, Sorbitan Monostearate, Sorbitan Sesquioleate, Sorbitan Trioleate and Sorbitan Tristearate.
  • the most preferred non-ionic surfactant is Polysorbate 80, available from ICI Americas under the tradename Tween 80 which is a mixture of oleate esters of sorbitol and sorbitol anhydrides, consisting predominantly of the monoester, condensed with approximately 20 moles of ethylene oxide.
  • Suitable block copolymers of ethylene oxide and propylene oxide generically called “Poloxamers” and include those represented by the following chemical structure I:
  • a is an integer ranging from about 10 to about 110, preferably from about 12 to 101; more preferably from about 12 to 80; and
  • b is an integer ranging from about 20 to about 60, more preferably from about 20 to about 56; also from about 20 to 27.
  • Suitable glycol and glyceryl esters of fatty acids include glyceryl monooleate and similar water soluble derivatives
  • Suitable polyoxyethylene esters of fatty acids include polyoxyethylene castor oil and hydrogenated castor oil derivatives;
  • Suitable polyoxyethylene ethers of fatty acids include Cetomacrogel 1000, Lauromacrogols (a series of lauryl ethers of macrogols of differing chain lengths), e.g. Laureth 4 , Laureth 9 and Lauromacrogol 400.
  • the effective amount of non-ionic surfactant in the composition can range from about 5 mg/ml to about 50 mg/ml concentration of the formulation, more preferably from about 5 mg/ml to about 25 mg/ml, and most preferably 10 mg/ml.
  • Thickening agents found suitable in the present invention include any commercially available agent useful for such purpose.
  • Xanthan gum, liquid sugars, starches, celluloses and mixtures thereof are preferred thickening agents. More preferred is a combination of xanthan gum and a liquid sugar and, most preferred is a combination of xanthan gum, NF and glucose, NF.
  • the xanthan gum is present in an amount of about 1 mg/ml to about 5 mg/ml, and more preferably the xanthan gum is present in an amount of about 3 mg/ml.
  • the glucose NF is present in an amount of about 200 to about 500 mg/ml, and more preferably about 350 mg/ml.
  • the effective amount of thickening agent of the present invention may be about 1 to about 500 mg/ml, more preferably about 200 to about 500 mg/ml, most preferably about 353 mg/ml.
  • the thickening agents of the present invention facilitate suspension of the formulation after constitution with minimum agitation and prevent rapid settling and caking of the suspension over time.
  • Pharmaceutically acceptable carriers include those well known in the art, including purified water USP, liquid glucose, NF, and anhydrous glycerol. Most preferred is purified water USP and liquid glucose, NF.
  • the pharmaceutically acceptable carrier may be present in an amount of about 10 to about 500 mg/ml, more preferably about 200 mg/ml to about 400 mg/ml, most preferably about 350 mg/ml.
  • the buffer systems suitable for the formulations of the present invention are those which maintain the pH of the liquid suspension in the range of about 4 to about 6, preferably in the 4.5 to 5.0, and most preferably about 4.5.
  • Other suitable buffer systems may be used to maintain the desired pH range of 4 to 6.
  • the buffering agents may be present in a concentration of about 0.4 to about 1.5 mg/ml, more preferably about 0.7 to about 1.5 mg/ml, most preferably about 1.1 mg/ml.
  • Anti-foaming agents found suitable in the present invention include any commercially available agent useful for such purpose including the methylated linear siloxsane polymers end blocked with trimethylsiloxyl units such as dimethicone and simethicone, as well as mixtures of dimethicone with an average chain length of 200 to 250 dimethylsiloxane units and silica gel.
  • the effective amount of anti-foaming agents is an amount sufficient to provide a concentration of about 2 mg/ml to about 4 mg/ml, preferably about 3 mg/ml.
  • the water soluble preservatives found useful in present invention include sodium benzoate, sodium citrate and benzalkonium chloride as well as other pharmaceutically acceptable water soluble preservatives.
  • Use of sodium benzoate as a preservative is preferred.
  • the effective amount of the water soluble preservative is an amount sufficient to provide a concentration of about 0.5 mg/ml to about 3 mg/ml, most preferably about 2 mg/ml.
  • the opacifier agents found suitable in the present invention include pharmaceutically acceptable metal oxides, especially titanium dioxide.
  • the effective amount of the opacifier agent is an amount sufficient to provide a concentration of about 2 mg/ml to about 6 mg/ml, most preferably about 4 mg/ml.
  • Typical flavoring agents are those that are approved by FDA for use in sweetened pharmaceuticals, foods, candies, beverages and the like; these materials impart flavors such as grape, cherry, citrus, peach, strawberry, bubble gum, peppermint and many others.
  • the effective amount of the flavoring agents is an amount sufficient to provide a concentration of about 0.01 mg/ml to about 6 mg/ml, more preferably about 5 mg/ml.
  • compositions of the present invention containing posaconazole are not to be interpreted as limiting the scope of the claims.
  • Concentration Range Ingredient (mg/ml) Posaconazole (micronized) 10-100 Polysorbate 80 5-50 Sodium Citrate, USP, 0.4-0.8 Monohydrate Citric Acid, USP, Monohydrate 0.36-0.6 Simethicone, USP 2-4 Xanthan Gum, NF 1-5 Sodium Benzoate, NF 0.5-3 Liquid Glucose, NF 200-500 Glycerin, USP 50-150 Artificial Cherry Flavor 2-10 Titanium Dioxide 2-6 Purified Water, USP q.s. ad —
  • Concentration Ingredient (mg/ml) Posaconazole (micronized) 40 Polysorbate 80 10 Sodium Citrate, USP, 0.6 Monohydrate Citric Acid, USP, Monohydrate 0.48 Simethicone, USP 3 Xanthan Gum, NF 3 Sodium Benzoate, NF 2 Liquid Glucose, NF 350 Glycerin, USP 100 Artificial Cherry Flavor 5 Titanium Dioxide 4 Purified Water, USP q.s. ad 1 ml
  • This example is prepared as follows: charge approximately 5% of the final batch volume of purified water at 20 ⁇ 3° C. to a suitable vessel equipped with a mixer propeller. Add 40% of the polysorbate 80 to the purified water in step 1 and mix until dissolved. Add 40% of the simethicone and mix until it is dispersed. Recirculate the mixture in step 3 through a Microfluidizer, operating at about 30,000 ⁇ 5000 psi for approximately 5 passes. Add approximately 7% of the final batch volume of purified water at about 20 ⁇ 3° C., and mix for approximately five minutes. Add the Posaconazole to the vessel in step 5 with constant mixing. Continue mixing until it is fully dispersed.
  • Step 6 Recirculate the suspension portion from step 6 through a Microfluidizer, operating at a pressure of about 30,000 ⁇ 5,000 psi. Process the concentrate until the median of the particles shows a particle size of about 1.4 ⁇ 0.2 ⁇ m, when measured via laser diffraction techniques that are known in the art.
  • Example 2 is another example of a formulation within the scope of the present invention prepared using the procedure of Example 1 and has a pH of 4.5.
  • Concentration Ingredient (mg/ml) Posaconazole (micronized) 40 Polysorbate 80 10 Sodium Citrate, USP, 0.6 Monohydrate Citric Acid, USP, Monohydrate 1.5 Simethicone, USP 3 Xanthan Gum, NF 3 Sodium Benzoate, NF 2 Liquid Glucose, NF 350 Glycerin, USP 100 Artificial Cherry Flavor 5 Titanium Dioxide 4 Purified Water, USP q.s. ad 1 ml
  • the sodium benzoate was not expected to sediment. Surprisingly, the posaconazole was not sedimented after 3 days.
  • compositions of the present invention have both ease of dispersibility and homogeneity as is evidenced by the stability of the samples in Table 1.
  • Bioavailability is defined as the rate and extent to that the active drug ingredient or therapeutic moiety is absorbed into the systemic circulation from an administered dosage form as compared to a standard or control.
  • C max value is defined as the maximum concentration of the antifungal compound measured (i.e. “peak”) in the plasma serum.
  • Formulations of the present invention have the advantage that they have an increased bioavailability and lower variability than previous formulations.
  • the first objective was to determine the relative bioavailability of posaconazole given as an oral suspension compared to an oral solid formulation when administered with a high-fat breakfast.
  • the second objective was to determine the effect of high-fat and non-fat food relative to fasting conditions on the oral bioavailability of the compound of formula I when given as an oral suspension.
  • Treatment A 200 mg of the compound of formula I in the oral suspension of this invention (5 ml) following a 10-hr.
  • fast Treatment B 200 mg of the compound of formula I in the oral suspension of this invention (5 ml) with a standardized high-fat breakfast
  • Treatment C 200 mg of the compound of formula I in the oral suspension of this invention (5 ml) with a standardized non-fat breakfast
  • Treatment D 2 ⁇ 100 mg of the compound of formula I in the tablets (co-precipitate formulation of U.S. Pat. No. 5,834,472 with a standardized high-fat breakfast
  • Subjects were randomized to either remain fasted (Treatment A), to receive a standardized high fat breakfast (Treatment B or D) or a standardized non-fat breakfast (Treatment C). Meals were consumed in a 20-minute period prior to the morning drug administration and subjects received the appropriate treatment within 5 minute of completing the breakfast.
  • Blood samples (6 ml) were collected into heparinized tubes for each treatment immediately prior to dosing (0 hour) and at 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, 48 and 72 hours after dosing. Blood was centrifuged at 4° C. and plasma stored at or below ⁇ 20° C. until assayed. Plasma concentrations of posaconazole were assayed using a validated high performance liquid chromatographic assay with a LOQ of ng/ml.
  • C(tf) is the estimated concentration determined from linear regression at time, tf.
  • Vdarea/F The apparent volume of distribution (Vdarea/F) was calculated from the ratio of the total body clearance to the terminal phase rate constant (K).
  • suspension formulation of the present invention resulted in a 23% increase in Cmax and a 36% increase in AUC(tf) compared to the tablet of the prior art.
  • the secondary objective of the study was to evaluate the effect of high fat food (Treatment B) and non-fat food (Treatment C) compared to fasting (Treatment A) on the oral bioavailability of posaconazole administered as an oral suspension.
  • a high fat breakfast produced a 4-fold increase in the bioavailability of posaconazole given in a suspension. This was consistent with results from a previous study where food significantly increased the bioavailability of posaconazole by 3-5-fold for both tablet and capsule formulations. The effect of a non-fat breakfast (Treatment C) compared to fasting (Treatment A) was less, with a 2.5-3-fold increase in bioavailability.

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005117831A1 (en) * 2004-05-28 2005-12-15 Schering Corporation Injectable pharmaceutical suspension comprising posaconazole
US20060160823A1 (en) * 2004-05-28 2006-07-20 Leonore Witchey-Lakshmanan Particulate-stabilized injectable pharmaceutical compositions of Posaconazole
US20070065507A1 (en) * 2005-09-16 2007-03-22 Selamine Limited Bisphosphonate formulation
US20070281011A1 (en) * 2006-05-30 2007-12-06 Elan Pharma International Ltd. Nanoparticulate posaconazole formulations
US20080167364A1 (en) * 2006-12-01 2008-07-10 Selamine Limited Ramipril-amine salts
US20080171775A1 (en) * 2006-12-01 2008-07-17 Selamine Limited Ramipril-amlodipine salt
US20080188539A1 (en) * 2006-12-01 2008-08-07 Selamine Limited Ramipril-amino acid salts
WO2009129300A2 (en) * 2008-04-15 2009-10-22 Schering Corporation High density compositions containing posaconazole and formulations comprising the same
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BR0208626A (pt) 2004-03-09
AR033096A1 (es) 2003-12-03
JP4308902B2 (ja) 2009-08-05
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