Classifications

• • 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
  • A61K31/60—Salicylic acid; Derivatives thereof
• • 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
• • 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
  • A61K31/47—Quinolines; Isoquinolines
• • 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
• • 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
  • A61K31/54—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
  • A61K31/542—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with heterocyclic ring systems
  • A61K31/545—Compounds containing 5-thia-1-azabicyclo [4.2.0] octane ring systems, i.e. compounds containing a ring system of the formula:, e.g. cephalosporins, cefaclor, or cephalexine
• • 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
  • A61K31/555—Heterocyclic compounds containing heavy metals, e.g. hemin, hematin, melarsoprol
• • 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
  • A61K31/65—Tetracyclines
• • 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
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K33/00—Medicinal preparations containing inorganic active ingredients
  • A61K33/24—Heavy metals; Compounds thereof
  • A61K33/245—Bismuth; Compounds thereof
• • 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
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/28—Dragees; Coated pills or tablets, e.g. with film or compression coating
  • A61K9/2806—Coating materials
  • A61K9/2833—Organic macromolecular compounds
  • A61K9/284—Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone
• • 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
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/28—Dragees; Coated pills or tablets, e.g. with film or compression coating
  • A61K9/2806—Coating materials
  • A61K9/2833—Organic macromolecular compounds
  • A61K9/286—Polysaccharides, e.g. gums; Cyclodextrin
  • A61K9/2866—Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
• • 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
  • A61K9/5073—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 having two or more different coatings optionally including drug-containing subcoatings
  • A61K9/5078—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 having two or more different coatings optionally including drug-containing subcoatings with drug-free core
• • 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

Definitions

• the present invention relates to oral pharmaceutical compositions in pellet or tablet form for reversible proton pump inhibitors for combined use with antimicrobially-active ingredients for the treatment of disorders caused by Helicobacter.
• Control of the microbe Helicobacter pylori which is thought to be responsible for certain gastric disorders, by combined use of an antimicrobially-active ingredient which is active against Helicobacter pylori and of an agent which reduces gastric acid has been regarded as the method of choice for some time.
• Irreversible proton pump inhibitors are substances which covalently, and thus irreversibly, bind to the enzyme which i ⁇ responsible for acid secretion in the stomach, the H + /K + ATPase.
• irreversible proton pump inhibitors which essentially have a common basic chemical structure (pyridinylmethylsulfinylbenzimidazoles)
• irreversible proton pump inhibitors which essentially have a common basic chemical structure (pyridinylmethylsulfinylbenzimidazoles)
• reversible H + /K + ATPase inhibitors which have different basic chemical structures and which, as the name indicates, reversibly bind to the enzyme responsible for gastric acid secretion.
• reversible proton pump inhibitors in connection with the present invention.
• Reversible proton pump inhibitors are disclosed, for example, in the documents DE-A-3917232, EP-A-0399267, EP-A-0387821, JP-A-3031280, JP-A-2270873, EP-A-0308917, EP-A-0268989, EP-A-0228006 , EP-A-0204285, EP-A-0165545, EP-A-0125756, EP-A-0120589, EP-A-0509974, DE-A-3622036, EP-A-0537532, EP-A-0535529, JP-A-3284686, JP-A-3284622, US-P-4,833 ,149, EP-A-0261912, WO-A-9114677 , WO-A-9315055, O-A-9315071, O-A-9315056, O-A-9312090, O-A-9212969, O-A-9118887, EP-A-0393926, EP-
• the invention thus relates to an oral pharmaceutical compo ⁇ sition for treating a disorder caused by Helicobacter comprising a reversible proton pump inhibitor in combination with at least one antimicrobially-active ingredient, wherein at least part of the reversible proton pump inhibitor is in slow-release form.
• Reversible proton pump inhibitors are, for the purpose of the present invention, those active ingredients which reversibly bind to the enzyme responsible for gastric acid secretion, E*/K + ATPase. Examples of reversible proton pump inhibitors are enumerated in the previously-noted documents.
• Examples of reversible proton pump inhibitors are, e.g., 8-(2- methoxycarbonylamino-6-methylbenzylamino) -2 , 3-dimethyl- imidazo[l,2-a]pyridine (hereinafter B9401-011) , 3 -hydroxymethy 1- 8- (2 -methoxycarbonyl amino- 6 -methylbenzyl oxy) -2 methylimidazo[l, 2-a]pyridine, 3-hydroxymethyl-8- (2- methoxycarbonylamino-6-methylbenzyloxy ) -2-methylimidazo [ 1,2- a]pyridine, 8- (2-methoxycarbonylamino-6-methylbenzyloxy) -2 , 3-di- methylimidazo[ 1,2 -a] pyridine, 8-(2-tert-butoxycarbonylamino-6- methylbenzylamino)-2,3-dimethylimidazo[l,2-a]pyridine, 8-(2-tert-butoxy
• Reversible proton pump inhibitors can, in this connection, be present as such, in the form of their salts and/or their solvates (e.g. hydrates) , etc.
• Particularly suitable salts are (because all reversible proton pump inhibitors are substances with a basic reaction) all acid-addition salts.
• the pharmacologically-acceptable salts of inorganic and organic acids customarily used in pharmaceutical technology, including water-soluble and water-insoluble acid- addition salts with acids, ⁇ uch as hydrochloric acid, hydrobromic acid, phosphoric acid, nitric acid, sulfuric acid, acetic acid, citric acid, D-gluconic acid, benzoic acid, 2-(4- hydroxybenzoyl)benzoic acid, butyric acid, sulfo ⁇ alicylic acid, maleic acid, lauric acid, malic acid, fumaric acid, succinic acid, oxalic acid, tartaric acid, embonic acid, stearic acid, toluenesulfonic acid, methanesulfonic acid and 3-hydroxy-2- naphthoic acid, the acids being used in the preparation of the salt in a ratio of amounts which are equimolar or different therefrom - depending on whether the acid is mono- or polybasic and depending on the salt required
• suitable antimicrobially-active ingredients active against Helicobacter pylori
• active ingredients include, for example, bismuth salt ⁇ (such as bismuth subcitrate or bismuth subsalicylate) , sulfonamides, nitrofurans (such as nitrofurazone, nitrofurantoin or furazolidone) , metronidazole, tinidazole, nimorazole or antibiotics.
• antibiotics which may be mentioned in this connection are, arranged according to particular classes of active ingredient: aminoglycosides, such a ⁇ gentamicin, neomycin, kanamycin, amikacin or streptomycin; macrolides, such as erythromycin, azithromycin, clarithromycin, clindamycin or rifampicin; penicillins, ⁇ uch as penicillin G, penicillin V, ampicillin, ezlocillin or amoxicillin; polypeptides, such as bacitracin or polymyxin; tetracycline ⁇ , such as tetracyline, chlorotetracycline.
• aminoglycosides such as a ⁇ gentamicin, neomycin, kanamycin, amikacin or streptomycin
• macrolides such as erythromycin, azithromycin, clarithromycin, clindamycin or rifampicin
• penicillins ⁇ uch as penicillin G, penicillin V,
• oxytetracycline, inocycline or doxycycline carbapenems, such as imipenem, loracarbef, meropene or panipenem; cephalosporins, such as cefalexin, cefoxitin, cefuroxime axetil, cefotaxime, cefpodoxime proxetil, cefaclor, cefadroxil or cephalothin; gyrase inhibitor ⁇ , such as ciprofloxacin, norfloxacin, ofloxacin or pefloxacin; or other different antibiotics, such as chloramphenicol.
• carbapenems such as imipenem, loracarbef, meropene or panipenem
• cephalosporins such as cefalexin, cefoxitin, cefuroxime axetil, cefotaxime, cefpodoxime proxetil, cefaclor, cefadroxil or cephalothin
• a plurality of antimicrobially-active ingredients for example the combination of a bi ⁇ muth salt and/or tetracycline with metronidazole, or the combination of amoxicillin or clarithromycin with metronidazole.
• a reversible proton pump inhibitor together with a plurality of antimicrobially-active ingredients, for example with the combination of a bismuth salt and/or tetracycline with metronidazole, or with the combination of amoxicillin or clarithromycin or with metronidazole.
• the dosage of the active ingredients depends greatly on the nature of the reversible proton pump inhibitor u ⁇ ed and of the antimicrobially-active ingredient(s) u ⁇ ed.
• a typical do ⁇ age of a reversible proton pump inhibitor as disclosed, for example, in O-A-9418199 can be regarded as a daily dose of from about 0.01 to about 20, preferably from 0.05 to 5, and in particular from 0.1 to 1.5, mg/kg of body weight, where appropriate in the form of a plurality of ⁇ ingle do ⁇ e ⁇ .
• Penicillin ⁇ such as amoxicillin, are admini ⁇ tered in a daily do ⁇ e of from about 5 to 40, preferably from 10 to 20, mg/kg of body weight.
• Antimicrobially-active ingredients which may be emphasized are erythromycin, azithromycin, clarithromycin, clinda ycin, rifampicin, ampicillin, mezlocillin, amoxicillin, tetracycline, minocycline, doxycycline, imipenem, meropenem, cefalexin, cefuroxime axetil, cefpodoxime proxetil, cefaclor, cefadroxil, ciprofloxacin, norfloxacin, ofloxacin and pefloxacin.
• Clarithromycin and amoxicillin may be mentioned as antimicrobially-active ingredients which should be particularly emphasized.
• Combined administration means fixed and, in particular, free combinations, i.e. the slow-relea ⁇ e rever ⁇ ible proton pump inhibitor and the antimicrobially-active ingredient are present together in one dosage unit, or slow-release reversible proton pump inhibitor and antimicrobially-active ingredient, which are present in separate dosage units, are administered in direct succession or at a relatively large time interval; a relatively large time interval means within a time span of up to a maximum of 24 hours.
• the ⁇ e are preferably made available together in one pack.
• the two dosage units are packed together in blister packs which are designed with regard to the relative arrangement of the two dosage units with respect to one another, the inscription and/or coloring in a manner known per se so that the times for taking the individual components (dosage regimen) of the two dosage units are evident to a patient.
• a dosage unit means, in particular, those medicinal dosage forms in which slowing or extending of reversible proton pump inhibitor release is achieved with as few problems as possible.
• These include, in particular, tablets, coated tablets or pellets, and microtablets in capsule ⁇ , with the dosage form advantageously being designed so that the two active ingredient components (reversible proton pump inhibitor on the one hand and antimicrobially-active ingredient on the other hand) are released, or made available effectively for the body, in such a way that an optimal active-ingredient profile (and thus action profile) is achieved.
• various types and degrees of retarding release may be used to ensure a reversible proton pump inhibitor plasma level which persi ⁇ t ⁇ a ⁇ long as possible and is sufficient for raising pH.
• Thepharmaceutical formulation of the antimicrobially-active ingredient(s) is carried out in a manner which is familiar per se to the skilled worker for the individual active ingredients.
• the rapid release of part of the reversible proton pump inhibitor and retarding release of another part is optionally achieved, for example, by layered tablets or multilayer tablets, in which part of the reversible proton pump inhibitor is present in an outer coating in a form without slowing release; this is followed by another coating containing the antimicrobially-active ingredient and then the core with the reversible proton pump inhibitor who ⁇ e release is slowed in a suitable manner.
• the oral pharmaceutical composition ⁇ according to the invention are distinguished from the prior art by controlled release of active ingredients and increa ⁇ ed stability.
• Suitable binder is, in particular, polyvinylpyrrolidone in various degrees of polymerization.
• lubricants and nonstick agents are higher fatty acids and their alkali-metal and alkaline-earth-metal salts, such a ⁇ calcium stearate.
• Suitable tablet di ⁇ integrant ⁇ are, in particular, chemically-inert agent ⁇ .
• Preferred tablet di ⁇ integrant ⁇ include cro ⁇ s-linked polyvinylpyrrolidone, crosslinked sodium carboxymethylcelluloses and sodium starch glycolate.
• suitable film-forming polymers in respect of the water-insoluble release-slowing intermediate layer(s) to be applied to the pellet or tablet core, include ethylcellulose, polyvinyl acetate, ammonio methacrylate copolymer type A (e.g. Eudragit® RL) and type B (Eudragit® RS) etc.
• the release rate can be controlled not only by incorporating suitable water-soluble pore formers such as PEG, lactose, mannitol, sorbitol, HPMC, etc., but also by the thickness of the coating layer applied.
• the solvents or dispersants used for the release-controlling polymer dispersion are non-aqueous organic solvents, such as alcohols, ketones, halogenated hydrocarbons or mixtures of such solvents.
• Suitable polymers for the enteric coating are methacrylic acid/methyl methacrylate copolymer or methacrylic acid/ethyl methacrylate copolymer (Eudragit ® L) or cellulose derivatives, such as carboxymethylethylcellulo ⁇ e (CMEC, Duodcel) , cellulo ⁇ e acetate phthalate (CAP) , cellulo ⁇ e acetate trimellitate (CAT) , hydroxypropylmethylcellulo ⁇ e phthalate (HP50, HP55) , hydroxypropyimethylcellulose acetate ⁇ uccinate (HPMCAS) or polyvinyl acetate phthalate, to which it is also possible to add, if desired, pla ⁇ ticizer (such as propylene glycol) and/or other additives and ancillary sub ⁇ tance ⁇ (e.g. buffer; base, such as, preferably, aluminum hydroxide; or pigment) .
• pla ⁇ ticizer such as propylene glycol
• the combined u ⁇ e according to the invention of a slow- release reversible proton pump inhibitor with an antimicrobially- active ingredient meets all the requirements for a pharmaceutical product or combination pharmaceutical product for the treatment of gastric disorder ⁇ attributable to the microbe, Helicobacter pylori.
• the particular advantage ⁇ connected with the combined use of the slow-relea ⁇ e drug form with an antimicrobially-active ingredient which may be mentioned are: the rapid on ⁇ et of action with pH values as far a ⁇ neutral in the lumen of the ⁇ tomach and in the wall of the ⁇ tomach and an optimal displaying of the effect of the antimicrobially-active ingredient.
• the short duration of treatment which can be achieved increases the compliance, which is extremely important for antibiotic treatments.
• a) is mixed with b) , c) and part of d) .
• a paste is prepared with the remainder of d) .
• the latter i ⁇ used for granulation of the powder mixture in a suitable mixer.
• the granule ⁇ are dried in a drying oven or fluidized bed.
• the tablet cores obtained under I are coated to an adequate layer thickness with the suspension obtained above in suitable apparatus.
• a) is sprayed with an aqueous solution of b) and c) in a fluidized bed (Wurster method) .
• a release-slowing layer is applied in analogy to the procedure described for tablets in a pan or fluidized bed.
• release-slowing layer i ⁇ applied in analogy to the procedure described for tablets in a pan or fluidized bed.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Veterinary Medicine (AREA)
• Chemical & Material Sciences (AREA)
• Medicinal Chemistry (AREA)
• Pharmacology & Pharmacy (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
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• Bioinformatics & Cheminformatics (AREA)
• Engineering & Computer Science (AREA)
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• General Chemical & Material Sciences (AREA)
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• Chemical Kinetics & Catalysis (AREA)
• Communicable Diseases (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Organic Chemistry (AREA)
• Medicinal Preparation (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
• Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
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• 1995
  • 1995-07-05 US US08/498,391 patent/US6132768A/en not_active Expired - Fee Related
• 1996
  • 1996-07-02 ES ES96924850T patent/ES2192227T3/es not_active Expired - Lifetime
  • 1996-07-02 AU AU65175/96A patent/AU711577B2/en not_active Ceased
  • 1996-07-02 AT AT96924850T patent/ATE232091T1/de not_active IP Right Cessation
  • 1996-07-02 JP JP9504812A patent/JPH11508578A/ja active Pending
  • 1996-07-02 PT PT96924850T patent/PT841904E/pt unknown
  • 1996-07-02 DE DE69626117T patent/DE69626117T2/de not_active Expired - Fee Related
  • 1996-07-02 EP EP96924850A patent/EP0841904B1/en not_active Expired - Lifetime
  • 1996-07-02 DK DK96924850T patent/DK0841904T3/da active
  • 1996-07-02 WO PCT/EP1996/002893 patent/WO1997002021A1/en not_active Ceased
• 2004
  • 2004-06-11 CY CY0400048A patent/CY2460B1/xx unknown

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