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
  • A61K31/33—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
  • A61K31/4196—1,2,4-Triazoles
• • 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
  • A61K31/4164—1,3-Diazoles
  • A61K31/4178—1,3-Diazoles not condensed 1,3-diazoles and containing further heterocyclic rings, e.g. pilocarpine, nitrofurantoin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • 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
• • 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
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P33/00—Antiparasitic agents
  • A61P33/02—Antiprotozoals, e.g. for leishmaniasis, trichomoniasis, toxoplasmosis
  • A61P33/04—Amoebicides
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
  • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
  • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
  • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

• the present invention is related to the treatment of infectious diseases in the female reproductive system and more particularly with the use of an association of compounds comprising fluconazole and tinidazole associated in doses lower than the therapeutically used doses.
• the combination has been shown to have broad effectiveness and good tolerance.
• vaginal infections represent a frequent health problem since 95% of patients consult the doctor for vaginal discharge.
• these conditions in adolescents are among the first three causes of consultation, having a much higher incidence in those young people with active sexual life, although it has also been found among adolescents who do not have this condition.
• Normal vaginal secretions are characterized by being odorless, clear, viscous, with acidic pH less than 4.5, do not contain necrophiles and do not flow during speculum examination.
• vaginal infections are: poor genito-anal hygiene, new or multiple sexual partners, baths in swimming pools and tubs, pregnancy, diabetes, parasitosis, urinary or fecal incontinence, stress, congenital malformations, frequent use of antibiotics, hormones preparations contraceptive for oral or topical and vaginal use, immune deficiency, tight clothing, use of nylon clothing, use of non-hygienic vaginal applicators, etc. More frequent forms of presentation of vaginal infection are as shown in the following table:
• Vaginal infection or vaginal discharge syndrome is an infectious process of the vagina characterized by one or more of the following symptoms: discharge, vulvar itching, burning, irritation, dysuria, dyspareunia and vaginal fetus; During vaginal infection it is often found that more than one microorganism causes the presence of mixed vaginal infections.
• Vulvovaginitis, vulvitis and vaginitis are terms generally related to inflammation of the vagina and vulva, often caused by fungi, bacteria and parasites
• vulvovaginitis as the secretion of abnormal and irritating flow, smelly or not, that produces local discomfort (itching or burning) and that can be accompanied by dysuria and / or dyspareunia.
• Vulvovaginitis is the most frequent gynecological problem in primary care consultations. 90% of women with symptoms suffer from some kind of bacterial vaginosis (especially gardneris), candidiasis or trichomonas. The remaining 10% suffer from other disorders: STDs, vaginal atrophy, allergies and chemical irritation.
• Candidiasic vulvovaginitis (WC) is the most common cause of vaginitis in Europe. 85-90% of cases are Candida Albicans. In the initial treatment topical agents are used.
• topical agents are used in creams, vaginal tablets and ovules for periods ranging from approximately 7 to 10 days, with the ovules and cream a cure rate of no more than 75% is achieved.
• Some treatments may include the use of clotrimazole, miconazole, fenticonazole and nystatin.
• ketoconazole 100 mg per day is generally used for 6 months, cotrimazole, a vaginal ovum per month in the postmenstrual phase for 6 months or itraconazole 200 mg al Oral day for 3 days in 6 cycles. Bulletin Nov. 15 from 2002 Pharmacoepidemiology.
• Bacterial vaginosis represents an alteration in the bacterial flora of the vagina that is characterized by a decrease in the concentration of hydrogen peroxide produced by lactobacilli and an increase in the prevalence of Gardnerella vaginalis, and gram-negative anaerobic bacteria that lead to appearance of smelly secretion without presenting vulvo-vaginal inflammation.
• lactobacilli most of the lactobacilli disappear, the vaginal pH increases and there is a pathogenic proliferation of other anaerobic bacteria.
• Trichomonas vulvovaginitis is a process caused by the mobile, flagellated, and anaerobic protozoan, called Trichomona vaginalis, which is acquired through sexual contact. It is an important cause of vaginal infections. 50% of patients (both men and women) are asymptomatic at the time of diagnosis. A third of them will develop symptoms in the next 6 months if left untreated. The most recommended guideline for treatment is 2 grams of metronidazole orally in a single dose, either male or female. With this therapeutic regimen, and if the sexual partner is also involved, up to 85% effectiveness is achieved. If therapeutic failure persists, it can occur The alternative regimen consisting of metronidazole 500mg every 12 hours for 7 days.
• tinidazole or furazolidone will be used.
• the treatment should be focused in a syndromic way, on infections more frequently.
• vaginal fluid syndrome trichomoniasis, candidiasis and bacterial vaginosis since the vaginal infection is then mixed.
• rabies the commonly used tracans are summarized:
• Candidiasis Trichomoniasis Isoconazole 1%, cream - Metronidazole 250mg vaginally, for 7 to 14 days. oral, 3xd ⁇ a, 7 days. - Miconazole cream or ovules - Metronidazole 2.0g orally for 7 days. single dose. - Thioconazole 6.5%, topical - Tinidazole 2.0g orally single dose. single dose. - Terconazole 0.8% cream - Secnidazole 2.0g orally for 7 days. single dose. - Fluconazole 150mg orally, - Association Miconazol + one day. Tinidazole cream - Itraconazole 400mg -1 day or vaginal for 7 days. 200mg, 3 days - Cetoconazole 200mg, 2 tablets orally for 5 days.
• 6,416,779, 5,120,735, 6,705,270, 6,440,949 and 5,840,744 show different treatments, methods and compositions for delivering intravaginal or transvaginal dose of a pharmaceutical agent to the vagina, although it is important to note that vaginal application may not be well accepted by the patient.
• active agents with pharmaceutical qualities for use in the treatment of vaginal infections include fungicides. It has been difficult to achieve optimal and effective potential in these compounds. It has been found that when they are used as gels, foams, creams, ovules and tablets, they present a low bioadherence to the walls of the vagina. It is believed that this happens because of its miscibility with water and / or the loss of its physical stability at 37 ° C (body temperature).
• the buffer system is selected from the group consisting of gluconodeltactone, acetic acid, fumaric acid, lactic acid, citric acid, propionic acid, maleic acid, such is the case of the MX 188,752 patent, which describes a therapeutic method for the treatment of vaginal infections that includes the use of a combination of itraconazole-secnidazole.
• the treatment described in the aforementioned patent is long and includes 12 shots during the treatment for 3 days, not ensuring compliance with the treatment by the patient. An improvement percentage of 77.77% is described.
• the fluconazole-tinidazole pharmaceutical combination is described, characterized in that the doses used are 150 mg of fluconazole and 2 g of tinidazole for the treatment of diseases. Infectious in the female reproductive system.
• the association of fluconazole and tinidazole products in doses lower than those already known, and administered in a single day of treatment in one or two doses improves in all aspects the known treatments for mixed infections of the human reproductive system, which results in a very important advantage over the treatments of longer duration, since it ensures the patient's compliance with the greatest adherence to the treatment.
• the present invention is related to the treatment of infectious diseases in the human, male and female reproductive system through the use of a composition consisting of an association of two fluconazole and tinidazole chemicals, associated in smaller doses than those known. This combination has proven to be widely effective.
• the composition of the present invention is administered in one shot and maximum two, which results in a very important advantage over the treatments of longer duration, since there is greater acceptability for the treated patients, which ensures compliance of the patient with a greater attachment to treatment
• Fluconazole is a triazole derivative with a broad antifungal effect, whose melting point is between 138 and 140 ° C. Its molecular polarity allows to achieve a systemic action when administered both orally and parenterally.
• Tinidazole is a 5-nitroimidazole derivative with selective activity against anaerobic and protozoan bacteria. Tinidazole is completely adsorbed orally and is widely distributed throughout the body. It has low protein binding, this being around 12%.
• Tinidazole is known to be effective in the treatment of respiratory infections, intra-abdo inal sepsis, amebiasis, giardasis and gynecological infections caused by trichomone vaginallis. In the treatment of Bacterial Vaginosis, where we frequently find Gardnerella vaginalis associated, the use of 2 g of single dose tinidazole reported a cure rate.
• Secnidazole has an antiparasitic activity and acts against Entamoeba histolytica, Giardia lamblia, Trichomona vaginalis and Gardnerella vaginalis. After oral administration of a single dose of 2 g of secnidazole, maximum serum rates are obtained at the third hour. The plasma half-life is about 25 hours. The essentially urinary elimination is slow (50% of the ingested dose is excreted in 120 hours).
• the present composition comprising an association of two chemicals, such as the active ingredient, in doses lower than those usually known for the treatment of vaginal infections by its spectrum of activity, allows treating both vaginitis caused by Candida sp and Trichomona vaginallis, as Vaginosis caused by Gardnerella and anaerobic bacteria. Due to the proportions used in the new fluconazole-tinidazole composition, a greater or equal inhibition of microorganisms causing mixed vaginal infections is obtained with respect to conventional treatments and the doses of known use.
• the composition comprises an association of fluconazole and tinidazole.
• the weight ratio is 50mg to 150mg of fluconazole and 1000 to 2000mg of tinidazole.
• the weight ratio is 112.5 mg of fluconazole and 1500 mg of tinidazole. These last values represent a decrease in fluconazole from 150mg to 112.5mg, that is, 25% less and from 2000mg to 1500mg, that is, 25% less doses than reported in the literature. It is evident to an expert in the field that one could not expect but a decrease in the therapeutic effect of these medications by decreasing the doses in the magnitudes mentioned above, which, as shown below, does not occur.
• the pharmaceutical composition for the treatment of vaginal infections of the present invention is preferably applied orally in the wide variety of pharmaceutical forms such as capsules, tablets, dragees, effervescent tablets and sublingual tablets, not being limiting to each of them.
• the tablets used for the treatment of mixed vaginal infections comprise the association in lower doses than the therapeutically known fluconazole-tinidazole and at least one pharmaceutically acceptable carrier, it is considered that an alternative ingredient to tinidazole is secnidazole
• Pharmaceutically acceptable carriers include, but are not limited to silicon dioxide, varieties of glycolate, crospovidone, sodium lauryl sulfate PVP, magnesium stearate, isopropyl alcohol.
• they require an unconventional manufacturing process, given the use of the unusual proportions and so separated in quantity of fluconazole-tinidazole. The process must be controlled to obtain excellent product uniformity.
• fluconazole-tinidazole chemicals is carried out by forming a binder solution that includes the chemical in a smaller proportion and is subsequently used as the granulating solution, where the product in a smaller proportion is fluconazole.
• Tinidazole together with the other components are mixed in a fluid bed to which the binder solution is added to form the granulate.
• the following steps to this stage are those that are generally used for the tablet preparation, ie drying, sieving and compression.
• the following examples are intended to illustrate the present invention, not being limiting.
• Example 1 A pharmaceutical composition is prepared that includes the association fluconazol-tinidazole in the form of tablets with the following composition: INGREDIENT QUANTITY Tinidazole 500 mg Fluconazole 37.5 mg Microcrystalline cellulose 101 60.50 mg Sodium starch glycolate 6.50 mg Crospovidone 16.25 mg Lauryl sodium sulfate 6.50 mg Polyvinylpyrrolidone K-30 19.5 mg Magnesium stearate 3.25 mg Opadry white YS 7322 10.50 mg TOTAL 660.5 mg
• Example 2 A pharmaceutical composition is prepared which includes the association fluconazole-tinidazole in the form of tablets with the following composition:
• a pharmaceutical composition is prepared in accordance with the present invention that includes the association fluconazole-tinidazole in tablet form with the following composition:
• Example 4 A pharmaceutical composition is prepared including the association fluconazole-Secnidazole in the form of tablets with the following composition: INGREDIENT QUANTITY Secnidazole 500 mg Fluconazole 37.5 mg Microcrystalline cellulose 101 60.50 mg Sodium starch glycolate 6.50 mg Crospovidone 16.25 mg Sodium lauryl sulfate 6.50 mg Polyvinylpyrrolidone K-30 19.5 mg Magnesium stearate 3.25 mg Opadry white YS 7322 10.50 mg TOTAL 660.5 g
• Pharmacological Examples A longitudinal, comparative study with simple randomized blind assignment was performed. The study included 42 female patients over 18 years of age, not pregnant women who had vaginal infections. The patients were assigned in two groups; Group 1 received a dose of 150 mg of fluconazole and 2 g of tinidazole (standard dose), which is the dose reported in the co-pending application of the present application. In group 2 an association was administered with 112.5 mg of fluconazole and 1500 mg of tinidazole. It was to the second group that the dose of the present application was administered, which as is evident is a low dose and surprising results. The medicine was administered to both groups, in two doses during a single day.

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• General Chemical & Material Sciences (AREA)
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• 2004
  • 2004-01-22 US US10/762,616 patent/US8309103B2/en not_active Expired - Fee Related
  • 2004-12-17 JP JP2006550972A patent/JP2007518797A/ja active Pending
  • 2004-12-17 ES ES04808700T patent/ES2280150T3/es not_active Expired - Lifetime
  • 2004-12-17 DE DE602004021638T patent/DE602004021638D1/de not_active Expired - Fee Related
  • 2004-12-17 BR BRPI0418065-8A patent/BRPI0418065A/pt not_active Application Discontinuation
  • 2004-12-17 DE DE04808700T patent/DE04808700T1/de active Pending
  • 2004-12-17 EP EP04808700A patent/EP1712229B1/en not_active Expired - Lifetime
  • 2004-12-17 CA CA2553646A patent/CA2553646C/en not_active Expired - Fee Related
  • 2004-12-17 WO PCT/MX2004/000094 patent/WO2005070421A1/es not_active Ceased

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