WO2021107341A1 - Préparation pour absorption transdermique contenant de la rasagiline ou un sel pharmaceutiquement acceptable de celle-ci - Google Patents

Préparation pour absorption transdermique contenant de la rasagiline ou un sel pharmaceutiquement acceptable de celle-ci Download PDF

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Publication number
WO2021107341A1
WO2021107341A1 PCT/KR2020/011467 KR2020011467W WO2021107341A1 WO 2021107341 A1 WO2021107341 A1 WO 2021107341A1 KR 2020011467 W KR2020011467 W KR 2020011467W WO 2021107341 A1 WO2021107341 A1 WO 2021107341A1
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Prior art keywords
sensitive adhesive
drug
matrix layer
rasagiline
hydroxyl group
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PCT/KR2020/011467
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English (en)
Korean (ko)
Inventor
최후균
임다혜
남택수
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주식회사 우신라보타치
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Publication of WO2021107341A1 publication Critical patent/WO2021107341A1/fr

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/70Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
    • A61K9/7023Transdermal patches and similar drug-containing composite devices, e.g. cataplasms
    • A61K9/703Transdermal patches and similar drug-containing composite devices, e.g. cataplasms characterised by shape or structure; Details concerning release liner or backing; Refillable patches; User-activated patches
    • A61K9/7038Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer
    • A61K9/7046Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds
    • A61K9/7053Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds obtained by reactions only involving carbon to carbon unsaturated bonds, e.g. polyvinyl, polyisobutylene, polystyrene
    • A61K9/7061Polyacrylates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/13Amines
    • A61K31/135Amines having aromatic rings, e.g. ketamine, nortriptyline
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/14Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • A61P25/16Anti-Parkinson drugs

Definitions

  • the present invention relates to a transdermally absorbable preparation comprising rasagiline or a pharmaceutically acceptable salt thereof as an active ingredient. More particularly, the present invention relates to a transdermally absorbable preparation comprising a drug-containing matrix layer in which a matrix is formed with an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group, and a method for preparing the same .
  • Rasagiline has a chemical name of N-propargyl-1(R)-aminoindan, and has a structure of Formula 1 below.
  • Rasagiline is an irreversible inhibitor of monoamine oxidase-B, used as monotherapy to treat early symptoms of Parkinson's disease or as adjunct therapy in advanced Parkinson's disease. ; It is known to be particularly useful for treating non-motor symptoms such as fatigue (Stocchi F, Fossati C1 Torti M. Rasagiline for the treatment of Parkinson's disease: an update. Expert Opin Pharmacother. 2015;16(14):2231-41; Elbers RG et al. Interventions for fatigue in Parkinson's disease. Cochrane Database Syst Rev. 2015 Oct 8;10; Azilect Prescribing Information Label last revised May, 2014).
  • rasagiline By inhibiting the breakdown of dopamine in the synapse, rasagiline allows signaling neurons to reuptake more dopamine which is later released for reuse, which may compensate for the reduced quality of dopamine produced.
  • Azilect Tab which contains 1.56 mg of rasagiline mesylate (1 mg as rasagiline).
  • Rasagiline has disadvantages in that it is difficult to use as an oral preparation in patients with hepatic dysfunction, such as a twofold increase in plasma concentration in patients using CYP1A2 inhibitors, and a relatively low bioavailability.
  • a transdermally absorbable preparation containing rasagiline or a pharmaceutically acceptable salt thereof has been disclosed.
  • European Patent Publication No. EP2011488A1 discloses that a drug-carrying reservoir includes an organic or inorganic substance as a regulator, and a transdermally absorbable preparation containing a substance that enhances skin permeation of rasagiline has been disclosed.
  • US Patent Publication No. US2012/0265158A1 discloses a transdermally absorbable preparation in which a substrate layer includes a carrier material and a retaining agent.
  • Korean Patent Laid-Open No. 10-2017-0091791 discloses a transdermally absorbable preparation comprising a matrix including a functional group-free acrylic pressure-sensitive adhesive (ie, a functional group-free acrylate copolymer) and a cationic acrylic pressure-sensitive adhesive.
  • the transdermal absorption preparations disclosed in European Patent Publication No. EP2011488A1 and US Patent Publication No. US2012/0265158A1 include the use of substances such as modifiers, permeation enhancers, and retainers, and thus skin irritation caused by these ingredients and increased manufacturing cost
  • the transdermal absorbent preparation disclosed in Korean Patent Laid-Open No. 10-2017-0091791 has disadvantages such as complicated manufacturing and increased manufacturing cost because two types of acrylic pressure-sensitive adhesives must be used in combination.
  • the present inventors have found that as a transdermally absorbable preparation containing rasagiline or a pharmaceutically acceptable salt thereof as an active ingredient, the use of an adjuvant such as a permeation enhancer can be avoided and can be applied for a long period of time (eg, 48 hours) Various studies were carried out to develop transdermally absorbed formulations. As a result, when a drug-containing matrix layer is formed with rasagiline or a pharmaceutically acceptable salt thereof using a specific adhesive, the daily oral dose of rasagiline (about 1 mg/day) without the use of a permeation enhancer or the like It was found that it was possible to prepare a transdermally absorbable preparation applicable for 48 hours while exhibiting a skin permeability close to that of .
  • an object of the present invention is to provide a transdermally absorbable preparation comprising a drug-containing matrix layer comprising rasagiline or a pharmaceutically acceptable salt thereof and a specific adhesive as an active ingredient.
  • Another object of the present invention is to provide a method for preparing the transdermally absorbable preparation.
  • rasagiline or a pharmaceutically acceptable salt thereof as an active ingredient and a drug-containing matrix layer comprising an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group as the pressure-sensitive adhesive.
  • the transdermally absorbable preparation may be composed of a support layer, a drug-containing matrix layer, and a release layer.
  • the drug-containing matrix layer may include rasagiline or a pharmaceutically acceptable salt thereof; and an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group as the pressure-sensitive adhesive.
  • the transdermally absorbable preparation may be a transdermally absorbent preparation applied to the skin for 48 hours.
  • rasagiline or a pharmaceutically acceptable salt thereof may be present in an amount of 3 to 7% by weight based on the total weight of the drug-containing matrix layer, and the pressure-sensitive adhesive is the total weight of the drug-containing matrix layer. It may be present in the range of 93 to 97% by weight based on weight.
  • the pressure-sensitive adhesive may be an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group.
  • the organic solvent of step (a) may be one or more selected from the group consisting of ethyl acetate and ethanol.
  • step (b) may be performed by drying at 30-40 ° C. for 2 minutes to 8 minutes.
  • the solution obtained in step (a) is applied to a release paper, dried at room temperature for 15 to 25 minutes, and then dried at 30 to 40° C. for 2 to 8 minutes, the release paper It can be carried out by forming a drug-containing matrix layer thereon.
  • the solution obtained in step (a) is applied to a release paper, dried at room temperature for 15 to 25 minutes, and then dried at about 40° C. for about 5 minutes or less, on the release paper. by forming a drug-containing matrix layer.
  • the transdermally absorbable preparation of the present invention uses a specific adhesive, that is, an acrylic adhesive containing a hydroxyl group or an acrylic adhesive containing a hydroxyl group and a carboxyl group to form a drug-containing matrix layer, so that the daily oral dose of rasagiline ( It is applicable for 48 hours with skin permeability close to about 1 mg/day). Therefore, the transdermally absorbable preparation of the present invention can greatly improve patients' medication compliance.
  • the transdermally absorbable preparation of the present invention can avoid the use of additives such as permeation enhancers, regulators, and retainers, thereby preventing side effects (eg, skin irritation, etc.) caused by these components, and Since it is manufactured using an adhesive, it can be easily applied at the manufacturing site.
  • Example 1 shows the results of measuring the skin permeation amount per unit area of the transdermally absorbable preparations (Examples 2 and 3) and Comparative Examples 1 to 3 according to the present invention.
  • Example 2 shows the results of measuring the amount of skin permeation per unit area for 48 hours of the transdermally absorbable preparation (Example 1) according to the present invention.
  • FIG. 3 shows the appearance of a transdermally absorbed preparation prepared through direct drying without performing drying at room temperature.
  • the term "acrylic pressure sensitive adhesive containing a hydroxyl group” refers to an acrylic pressure sensitive adhesive having hydroxyl groups as functional groups.
  • "acrylic adhesive containing a hydroxyl group and a carboxyl group” refers to an acrylic adhesive having hydroxyl groups and carboxyl groups as functional groups.
  • the acrylic pressure-sensitive adhesive is referred to as an acrylates copolymer.
  • the hydroxyl group-containing acrylic pressure-sensitive adhesive is a commercially available pressure-sensitive adhesive, that is, Duro-Tak TM 87-2516 (Henkel Corporation, Bridgewater, New Jersey, USA), Duro-Tak TM 87-2510 (Henkel Corporation, Bridgewater, New Jersey, USA).
  • the acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group is a commercially available pressure-sensitive adhesive, that is, Duro-Tak TM 87-2074 (Henkel Corporation, Bridgewater, New Jersey, USA), Duro-Tak TM 87-2979 (Henkel Corporation, Bridgewater). , New Jersey, USA) and the like, preferably Duro-Tak TM 87-2074 (Henkel Corporation, Bridgewater, New Jersey, USA).
  • the present invention provides rasagiline or a pharmaceutically acceptable salt thereof as an active ingredient; and a drug-containing matrix layer comprising an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group as an adhesive.
  • the transdermally absorbable preparation may be composed of a support layer, a drug-containing matrix layer, and a release layer.
  • the drug-containing matrix layer comprises, as an active ingredient, rasagiline or a pharmaceutically acceptable salt thereof; and an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group as the pressure-sensitive adhesive.
  • the rasagiline or a pharmaceutically acceptable salt thereof may be used in an amount suitable to obtain a therapeutically effective blood concentration.
  • the rasagiline or a pharmaceutically acceptable salt thereof may be present in an amount of 3 to 7% by weight, preferably 4 to 6% by weight, based on the total weight of the drug-containing matrix layer.
  • the adhesive strength of the transdermally absorbable preparation may decrease or cold flow may occur.
  • the transdermally absorbable preparation according to the present invention contains, as an adhesive, an acrylic adhesive containing a hydroxyl group or an acrylic adhesive containing a hydroxyl group and a carboxyl group, and more preferably an acrylic adhesive containing a hydroxyl group and a carboxyl group.
  • the pressure-sensitive adhesive forms the matrix of the drug-containing matrix layer. That is, the drug-containing matrix layer is formed by uniformly dispersing rasagiline or a pharmaceutically acceptable salt thereof in the pressure-sensitive adhesive.
  • the transdermally absorbable preparation of the present invention may be a transdermally absorbable preparation applied to the skin for 48 hours.
  • the acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group may be used in an amount sufficient to form a matrix layer, for example, 93 to 97 weight based on the total weight of the drug-containing matrix layer. %, preferably in the range of 94 to 96% by weight.
  • the present invention also provides (a) rasagiline or a pharmaceutically acceptable salt thereof; and dissolving an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group in an organic solvent, (b) applying and drying the solution obtained in step (a) on a release paper and drying the drug on the release paper -Provides a method for preparing a transdermally absorbable preparation comprising: forming a matrix layer containing the drug; and (c) laminating a protective layer on the drug-containing matrix layer.
  • the preparation method of the present invention may be a method for preparing a transdermally absorbable preparation comprising a support layer, a drug-containing matrix layer, and a release layer.
  • the drug-containing matrix layer comprises, as an active ingredient, rasagiline or a pharmaceutically acceptable salt thereof; and an acrylic pressure-sensitive adhesive containing a hydroxyl group or an acrylic pressure-sensitive adhesive containing a hydroxyl group and a carboxyl group as the pressure-sensitive adhesive.
  • the transdermally absorbable preparation may be a transdermally absorbent preparation applied to the skin for 48 hours.
  • the organic solvent in step (a) may be one or more selected from the group consisting of ethyl acetate and ethanol, and preferably ethyl acetate.
  • step (b) may be carried out by drying at 30-40° C. for 2 minutes to 8 minutes, preferably at about 40° C. for 2 minutes to 5 minutes.
  • a process of drying at room temperature for 15 to 25 minutes, preferably for about 20 minutes may be additionally performed.
  • the solution obtained in step (a) is applied to a release paper, dried at room temperature for 15 minutes to 25 minutes, preferably for about 20 minutes, and then at 30-40° C. for 2 minutes to It can be carried out by drying for 8 minutes to form a drug-containing matrix layer on the release paper.
  • step (b) the solution obtained in step (a) is applied to a release paper, dried at room temperature for 15 to 25 minutes, and then at about 40° C. for about 5 minutes or less (eg, 2 minutes to 5 minutes) to form a drug-containing matrix layer on the release paper.
  • the release paper is peeled off before being attached to the skin, and may be a release paper or a laminate thereof commonly used in the field of transdermal absorption agents, for example, polyethylene, polyester, polyvinyl chloride, poly coated with silicone resin or fluorine resin. Films such as vinylidene chloride, paper, or laminates thereof can be used.
  • the protective layer may use a drug-non-absorbable and flexible film commonly used in the field of transdermal drug absorption, for example, a polyethylene film, a polyolefin film, a polyether film, a multilayer ethylene vinyl acetate film, A polyester film, a polyurethane film, etc. can be used.
  • a transdermally absorbable preparation was prepared according to the components and contents of Table 1 below.
  • the content in Table 1 indicates the weight % of each component with respect to the total weight of the drug-containing matrix layer of each transdermal absorption preparation.
  • Rasagiline was dissolved in ethyl acetate, and an adhesive (solid content: 0.7 g) was added thereto to uniformly dissolve.
  • the obtained solution was applied to a silicone-coated release paper, dried at room temperature for 20 minutes, and then dried at 40° C. for 5 minutes, and then a polyethylene film was laminated to form a protective layer, thereby preparing a transdermally absorbable preparation containing rasagiline. prepared.
  • transdermally absorbed preparations were prepared in the same manner as in Examples 1 to 4.
  • the content in Table 2 represents the weight % of each component relative to the total weight of the drug-containing matrix layer of each transdermal absorption preparation.
  • Test Example 1 Evaluation of drug content of transdermally absorbed formulations according to drying conditions
  • a transdermally absorbable preparation was prepared in the same manner as in Example 1, except that room temperature drying was not performed. Specifically, rasagiline was dissolved in ethyl acetate, and Duro-Tak TM 87-2074 (solid content 0.7 g) was added thereto to uniformly dissolve it. The obtained solution was applied to a silicone-coated release paper, dried at 40° C. for 5 minutes, and then a polyethylene film was laminated to form a protective layer, thereby preparing a transdermally absorbable preparation containing rasagiline.
  • the obtained transdermally absorbed preparation was placed in a 20 ml vial, 10 ml of methanol was added, sonication was performed for 30 minutes, and the mixture was stirred at 500 rpm for 24 hours.
  • the obtained sample was quantified using high performance liquid chromatography (HPLC) under the following analysis conditions.
  • the content of rasagiline in the transdermally absorbed formulation was 96.2 ⁇ 3.4%, indicating a significant decrease in the rasagiline content.
  • the appearance of the transdermally absorbable preparation obtained above is shown in FIG. 3 .
  • the organic solvent ethyl acetate
  • adhesion between the drug-containing matrix layer and the protective layer was insufficient, resulting in a cold flow phenomenon.
  • the drying process was dried at room temperature for 20 minutes and then carried out according to the conditions in Table 3 below to prepare the transdermally absorbable preparations, respectively.
  • Each of the transdermally absorbed formulations was placed in a 20 ml vial, 10 ml of methanol was added, sonication was performed for 30 minutes, and the mixture was stirred at 500 rpm for 24 hours.
  • the obtained sample was quantified using high performance liquid chromatography (HPLC) under the same analysis conditions as in (1) above. As described above, the results of measuring the content of rasagiline in the transdermally absorbed preparation are shown in Table 3 below.
  • the content of rasagiline in the transdermal absorption preparation obtained according to the drying conditions is significantly different.
  • the drying process at room temperature is additionally performed, the decrease in the content of rasagiline in the transdermally absorbed preparation can be significantly reduced.
  • the drying process is carried out at room temperature for 15 to 25 minutes, preferably for about 20 minutes, then at 30-40° C. for 2 minutes to 8 minutes, preferably at about 40° C. for about 5 minutes or less ( For example, 2 to 5 minutes) is more preferable.
  • the obtained sample was quantified using high performance liquid chromatography (HPLC) under the same analysis conditions as in Test Example 1.
  • HPLC high performance liquid chromatography
  • Example 2 a transdermally absorbable preparation prepared using an adhesive containing a carboxyl group/hydroxyl group as a functional group (Example 2) and a transdermally absorbed preparation using an adhesive containing a hydroxyl group as a functional group ( In Example 3), the skin permeability was 19.34 ⁇ g/cm 2 /h and 22.40 ⁇ g/cm 2 /h, respectively, indicating that the skin permeability was close to the daily oral dose of rasagiline. That is, the daily oral dose of rasagiline is about 1 mg/day, and the bioavailability is known to be 36%. Excluding the liver initial effect, the daily dose is calculated to be about 0.36 mg.
  • transdermal preparations of Examples 2 and 3 exhibited skin permeability close to the daily oral dose of rasagiline.
  • the transdermally absorbable preparation (Comparative Example 1) prepared using an adhesive containing only a carboxyl group as a functional group and a transdermally absorbable preparation using an adhesive that does not contain a functional group (Comparative Example 2) had too low skin permeability. Therefore, there are disadvantages in that the size (area) of the preparation applied to the skin must be increased and/or the amount of drug in the transdermally absorbed preparation must be greatly increased.
  • transdermally absorbable preparation (Comparative Example 3) prepared using the non-acrylic adhesive, styrene-butadiene-styrene, has too high skin permeability, so it is not suitable for preparing a transdermally absorbable preparation that can be applied for 48 hours.
  • the skin of 6-8-week-old hairless mice was extracted just before the test.
  • Each transdermally absorbable preparation was cut into a circle to have an area of 2 cm 2 and attached to the excised skin.
  • Each obtained skin was clamped to a Flow-Through Diffusion Cell.
  • An isotonic phosphate buffer (pH 6.0) was added to the receptor. While maintaining the diffusion cell at 37°C and stirring with a magnetic stirrer, samples were collected at 4 hour intervals for 48 hours. The obtained sample was quantified using high performance liquid chromatography under the same analysis conditions as in Test Example 1.
  • the transdermally absorbable preparation obtained according to the present invention exhibits skin permeability close to the daily oral dose (about 1 mg/day) of rasagiline, and can be applied for 48 hours. can be known
  • mice Seven hairless mice were anesthetized with zoletyl 50 and rumpun diluent, and a polyethylene tube was cannulated into the carotid artery, and the tip was passed under the skin to induce the back of the neck.
  • Each mouse was placed in an automated blood sampling system metabolic cage and allowed to fully recover from anesthesia. The test was started after 2-3 hours. Before attaching the patch (transdermally absorbed), the back of the mouse was wiped with alcohol swab and deionized water and dried well. The 0.6 mg/1.5 cm 2 dose of the transdermally absorbed formulation prepared in Example 4 was cut into a size of 1 X 1.5 cm 2 and attached.
  • Blood samples were collected immediately before drug administration (0, used as control) and after drug administration 1, 2, 4, 6, 8 using automated blood sampling (Raturn TM , BASi, West Lafayette, IN, USA). At 12, 18, and 24 hours, blood was collected through the carotid artery, and plasma was collected by centrifugation immediately and analyzed using LC-MS/MS under the following conditions.
  • CXP Collision Cell Potential
  • Standard curve range 0.5 - 500 ng/ml

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Abstract

La présente invention concerne une préparation pour absorption transdermique et un procédé de production de celle-ci, la préparation pour absorption transdermique comprenant une couche de matrice contenant un médicament comprenant : en tant que substance active, de la rasagiline ou un sel pharmaceutiquement acceptable de celle-ci ; et en tant qu'adhésif, un adhésif acrylique contenant un groupe hydroxyle, ou un adhésif acrylique contenant un groupe hydroxyle et un groupe carboxyle.
PCT/KR2020/011467 2019-11-27 2020-08-27 Préparation pour absorption transdermique contenant de la rasagiline ou un sel pharmaceutiquement acceptable de celle-ci WO2021107341A1 (fr)

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KR10-2019-0153916 2019-11-27
KR1020190153916A KR102155108B1 (ko) 2019-11-27 2019-11-27 라사길린 또는 그의 약학적으로 허용가능한 염을 함유하는 경피흡수제제

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013027052A1 (fr) * 2011-08-25 2013-02-28 Amarin Technologies S.A. Dispositif d'administration transdermique de composés alcalins qui sont susceptibles de dégradation sous leur forme de base libre
KR20140016293A (ko) * 2011-03-24 2014-02-07 테이코쿠 팔마 유에스에이, 인코포레이티드 활성제층 및 활성제 변환층을 포함하는 경피 조성물
JP5675225B2 (ja) * 2009-09-01 2015-02-25 久光製薬株式会社 貼付製剤
KR20150059177A (ko) * 2012-11-02 2015-05-29 테이코쿠 팔마 유에스에이, 인코포레이티드 프로피닐아미노인단 경피 조성물
WO2015200472A1 (fr) * 2014-06-24 2015-12-30 KAT Transdermals LLC Système d'administration transdermique

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP5675225B2 (ja) * 2009-09-01 2015-02-25 久光製薬株式会社 貼付製剤
KR20140016293A (ko) * 2011-03-24 2014-02-07 테이코쿠 팔마 유에스에이, 인코포레이티드 활성제층 및 활성제 변환층을 포함하는 경피 조성물
WO2013027052A1 (fr) * 2011-08-25 2013-02-28 Amarin Technologies S.A. Dispositif d'administration transdermique de composés alcalins qui sont susceptibles de dégradation sous leur forme de base libre
KR20150059177A (ko) * 2012-11-02 2015-05-29 테이코쿠 팔마 유에스에이, 인코포레이티드 프로피닐아미노인단 경피 조성물
WO2015200472A1 (fr) * 2014-06-24 2015-12-30 KAT Transdermals LLC Système d'administration transdermique

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