WO2000032558A1 - Therapeutic product and its use - Google Patents
Therapeutic product and its use Download PDFInfo
- Publication number
- WO2000032558A1 WO2000032558A1 PCT/GB1999/004021 GB9904021W WO0032558A1 WO 2000032558 A1 WO2000032558 A1 WO 2000032558A1 GB 9904021 W GB9904021 W GB 9904021W WO 0032558 A1 WO0032558 A1 WO 0032558A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- tramadol
- enantiomer
- product according
- treatment
- racemic
- Prior art date
Links
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
- A61K31/13—Amines
- A61K31/133—Amines having hydroxy groups, e.g. sphingosine
-
- 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
- A61K31/13—Amines
- A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/04—Centrally acting analgesics, e.g. opioids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/06—Antimigraine agents
-
- 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
- A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
- A61K9/2086—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
- A61K9/209—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat containing drug in at least two layers or in the core and in at least one outer layer
Definitions
- the present invention relates to a novel, non-racemic, form of tramadol, and its use in analgesia.
- Tramadol ( ⁇ is-2-dimethylaminomethyl-l- (3-methoxy- phenyl)-l-cyclohexanol) is a chiral drug substance which is used as a high-potency analgesic agent.
- tramadol is currently marketed as the racemate only, there has been considerable interest in the physiological properties associated with its individual enantiomers, namely 1S, 2S- (-) -tramadol and lR, 2R- ⁇ +) -tramadol, the latter being shown below (1) .
- the present invention is based on the discovery that, by employing certain, non-racemic, proportions of the respective enantiomers of tramadol, the most beneficial therapeutic index, in terms of analgesic efficacy and reduction of side effects (e.g. nausea, vomiting, dizziness, constipation, sedation and others) associated with administration of the racemate, may be achieved.
- a product comprises a non-racemic mixture of the single enantiomers of tramadol as a combined preparation (kit) for simultaneous, separate or sequential use in the treatment or prevention of pain.
- a non-racemic mixture of the single enantiomers of tramadol is used in the manufacture of a medicament for the treatment or prevention of pain, and is particularly useful for the treatment of patients disposed to side effects typically associated with the administration of racemic tramadol.
- the medicament is, however, useful in treating other patient types, as discussed below.
- a product comprises a non-racemic mixture of the single enantiomers of tramadol and a pharmaceutically-acceptable carrier.
- the non-racemic mixture for use in the present invention comprises at least 60 wt.% (-) -tramadol. While enantiomerically-pure (-) -tramadol may be useful in achieving analgesia, it is preferred that (-) -tramadol be formulated with at least some (+) -tramadol, as with both enantiomers present the optimal balance between analgesic efficacy and safety is achieved.
- weight ratios of the two enantiomers lie in the range 10- 40:90-60 (+) -tramadol: (-) -tramadol (+:-), more preferred ratios lie in the range 20-40:80-60 (+:-), and the most preferred ratios lie in the range 30-40:70-60 (+:-) .
- racemic tramadol preferred non-racemic mixtures are particularly useful in the treatment of patients who are disposed to side effects typically associated with the administration of racemic tramadol.
- side effects typically observed in the administration of racemic tramadol include blurred vision, drowsiness, somnolence, hallucinations, respiratory depression, and euphoria.
- the present invention is particularly useful in treating those patients prone to nausea and vomiting. This is because, as is explained in the Example below, (-) -tramadol is believed to modulate the emetic properties of (+)- tramadol, thereby reducing the overall emetic capability of racemic tramadol. This effect can be exploited for maximum benefit using different release profiles for the different enantiomers, as is discussed below.
- the present invention is also believed to be particularly suited to the treatment of patients exhibiting abnormal CYP2D6 liver enzyme activity.
- the CYP2D6 gene encoding sparteine oxygenase is highly polymorphic, and an ever-increasing number of mutations are being identified.
- the wild-type gene is CYP2D6*1A. Any person not having the wild-type gene can be categorised as exhibiting abnormal enzyme activity. The precise nature of any particular mutation determines the degree to which a patient exhibits abnormal enzyme activity. Thus, by applying simple laboratory genetic analysis techniques it is possible to ascertain the approximate rate at which (+) -tramadol will be metabolised by a particular patient, and therefore how rapid and effective analgesia will be.
- mixtures comprising a very high proportion of (-) -tramadol may be used, for example weight ratios in the range 0-10:100-90 (+:-), with patients particularly disposed to side effects associated with racemic tramadol.
- Another option is to employ a more even balance of the two enantiomers, with the more efficacious (+) -enantiomer in excess, for instance weight ratios in the range 60-80:40-20 (+:-), typically 60-70:40- 30 (+:-).
- Such ratios may be useful in treating patients not particularly disposed to side effects associated with racemic tramadol, or where analgesic efficacy is of primary importance.
- Administration of (-) -tramadol before or at a faster rate than (+) -tramadol would, however, still be beneficial in reducing side effects.
- a further aspect of the present invention is the use of a non-racemic mixture of the single enantiomers of tramadol in the manufacture of a medicament for the prevention or treatment of migraine.
- the amount of non-racemic tramadol administered to any particular patient will depend upon the patient and the conditions for which the non-racemic tramadol is administered, and on whether non-racemic tramadol is to be used in prophylaxis or in therapy.
- Suitable amounts for administration are readily derivable by the skilled person.
- the different enantiomers of tramadol may be administered simultaneously, separately or sequentially. They may be formulated for either immediate or controlled release, or a combination of the two, or for release at different rates, or at different times.
- Preferred modes of administration release (-) -tramadol before or at a faster rate than (+) -tramadol, so as to optimise the effect of (-) -tramadol on the emetic properties of (+) -tramadol.
- situations may be envisaged, where the reverse may be required, and it is desired to administer (+)- tramadol before or at a faster rate than (-) -tramadol.
- a particularly preferred mode of administration is with (-) -tramadol in immediate release form and (+)- tramadol in controlled release form, by employing a combination of immediate and controlled release technologies, as described in WO-A-9840053 , the contents of which are incorporated herein by way of reference. It is envisaged that a dosage form of this type may be particularly beneficial in achieving rapid analgesia without the concomitant side effects associated with administration of racemic tramadol.
- a number of different types of dosage form can be envisaged for the non-racemic mixtures of the present invention, for administration by a variety of routes, e.g. oral, rectal, transdermal, nasal, ophthalmic, pormonary and injectable (subcutaneous or intravenous) .
- Suitable dosage forms include, for example, tablets, suppositories, capsules, e.g. containing multiparticulates, patches, polymer implants, aerosols, liposomes or microparticulates for injection, and any other conventional dosage form. Particularly preferred dosage forms are described in WO-A-9840053.
- a bilayered tablet is particularly preferred, including (-) -tramadol for immediate release in one layer and (+) -tramadol for controlled release in another layer.
- the results upon which the present invention are based are reported in the following Example.
- the objective was to identify the optimal range of enantiomeric ratios capable of providing the most beneficial therapeutic index, in terms of both analgesic efficacy and reduction of the nausea and vomiting associated with racemic tramadol.
- test substances Different amounts of each of the test substances were orally administered to rats, using a constant dose volume of 10 ml/kg.
- 0.1 ml of a 20% w/v suspension of Brewer's yeast in saline was injected subcutaneously into the plantar surface of the right hand paw of each rat to induce hyper-algesia.
- the left hind paw was similarly injected with 0.1 ml saline, as a control.
- Measurements of pressure tolerated were taken from the left (non-inflamed) and right (inflamed) paws 30 minutes after administration of the test substance.
- (+) -tramadol is seen to be non-emetic at doses of up to 200 mg/kg.
- (+) -tramadol induces nausea in 75% of ferrets at 50 mg/kg, while the racemate causes nausea in 25% of animals at 100 mg/kg.
- the racemate is a 50:50 mixture of the two enantiomers it is seen to induce less nausea than would be expected based on its content of (+)- enantiomer. This disparity can be explained by the ability of the (-) -enantiomer to modulate emesis associated with the (+) -enantiomer.
Abstract
Description
Claims
Priority Applications (9)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
KR1020017005443A KR20010080364A (en) | 1998-12-02 | 1999-12-02 | Therapeutic Product and Its Use |
EP99973016A EP1135361A1 (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
PL99347542A PL347542A1 (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
AU14001/00A AU1400100A (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
CA002350635A CA2350635A1 (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
JP2000585200A JP2002531431A (en) | 1998-12-02 | 1999-12-02 | Therapeutic products and their use |
IL14277899A IL142778A0 (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
BR9915873-6A BR9915873A (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
NO20012738A NO20012738D0 (en) | 1998-12-02 | 2001-06-01 | Therapeutic products and their use |
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GBGB9826537.4A GB9826537D0 (en) | 1998-12-02 | 1998-12-02 | Therapeutic product and its use |
GBGB9826536.6A GB9826536D0 (en) | 1998-12-02 | 1998-12-02 | Therapeutic product and its use |
GB9826536.6 | 1998-12-02 | ||
GB9826537.4 | 1998-12-02 | ||
GB9826535.8 | 1998-12-02 | ||
GBGB9826535.8A GB9826535D0 (en) | 1998-12-02 | 1998-12-02 | Therapeutic product and its use |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2000032558A1 true WO2000032558A1 (en) | 2000-06-08 |
Family
ID=27269570
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/GB1999/004021 WO2000032558A1 (en) | 1998-12-02 | 1999-12-02 | Therapeutic product and its use |
Country Status (12)
Country | Link |
---|---|
EP (1) | EP1135361A1 (en) |
JP (1) | JP2002531431A (en) |
KR (1) | KR20010080364A (en) |
CN (1) | CN1329590A (en) |
AU (1) | AU1400100A (en) |
BR (1) | BR9915873A (en) |
CA (1) | CA2350635A1 (en) |
HU (1) | HUP0104420A2 (en) |
IL (1) | IL142778A0 (en) |
NO (1) | NO20012738D0 (en) |
PL (1) | PL347542A1 (en) |
WO (1) | WO2000032558A1 (en) |
Cited By (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2001034125A2 (en) * | 1999-11-09 | 2001-05-17 | Darwin Discovery Limited | Therapeutic use and formulation of (-)-tramadol |
WO2002028383A1 (en) * | 2000-10-03 | 2002-04-11 | Penwest Pharmaceuticals Company | Delivery system for multi-pharmaceutical active materials at various release rates |
WO2002066026A2 (en) * | 2001-02-21 | 2002-08-29 | Grünenthal GmbH | Tramadol-based medicament |
US6780891B2 (en) | 2001-11-30 | 2004-08-24 | Sepracor Inc. | Tramadol analogs and uses thereof |
WO2008100933A2 (en) | 2007-02-12 | 2008-08-21 | Dmi Biosciences, Inc. | Reducing side effects of tramadol |
US8962019B2 (en) | 2005-09-09 | 2015-02-24 | Angelini Pharma, Inc. | Sustained drug release composition |
WO2018219977A1 (en) * | 2017-05-31 | 2018-12-06 | Metys Pharmaceuticals AG | Synergistic compositions comprising (r)-dimiracetam (1) and (s)-dimiracetam (2) in a non-racemic ratio |
US10369134B2 (en) | 2017-12-05 | 2019-08-06 | Sunovion Pharmaceuticals Inc. | Nonracemic mixtures and uses thereof |
US10377708B2 (en) | 2017-12-05 | 2019-08-13 | Sunovion Pharmaceuticals Inc. | Crystal forms and production methods thereof |
US11160758B2 (en) | 2019-06-04 | 2021-11-02 | Sunovion Pharmaceuticals Inc. | Modified release formulations and uses thereof |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
BRPI0811639A2 (en) * | 2007-05-31 | 2014-09-30 | Sepracor Inc | FENY CYCLOAKILAMINES REPLACED AS MONOAMINE RECAPTATION INHIBITORS |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5204116A (en) * | 1991-05-01 | 1993-04-20 | Alza Corporation | Dosage form providing immediate therapy followed by prolonged therapy |
WO1998040053A1 (en) * | 1997-03-11 | 1998-09-17 | Darwin Discovery Limited | Dosage forms comprising separate portions of r- and s-enantiomers |
WO1999042095A1 (en) * | 1998-02-21 | 1999-08-26 | Asta Medica Ag | Pharmaceutical combinations containing tramadol |
-
1999
- 1999-12-02 PL PL99347542A patent/PL347542A1/en not_active Application Discontinuation
- 1999-12-02 CN CN99813934A patent/CN1329590A/en active Pending
- 1999-12-02 HU HU0104420A patent/HUP0104420A2/en unknown
- 1999-12-02 KR KR1020017005443A patent/KR20010080364A/en not_active Application Discontinuation
- 1999-12-02 WO PCT/GB1999/004021 patent/WO2000032558A1/en not_active Application Discontinuation
- 1999-12-02 JP JP2000585200A patent/JP2002531431A/en active Pending
- 1999-12-02 BR BR9915873-6A patent/BR9915873A/en not_active IP Right Cessation
- 1999-12-02 EP EP99973016A patent/EP1135361A1/en not_active Withdrawn
- 1999-12-02 CA CA002350635A patent/CA2350635A1/en not_active Abandoned
- 1999-12-02 AU AU14001/00A patent/AU1400100A/en not_active Abandoned
- 1999-12-02 IL IL14277899A patent/IL142778A0/en unknown
-
2001
- 2001-06-01 NO NO20012738A patent/NO20012738D0/en not_active Application Discontinuation
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5204116A (en) * | 1991-05-01 | 1993-04-20 | Alza Corporation | Dosage form providing immediate therapy followed by prolonged therapy |
WO1998040053A1 (en) * | 1997-03-11 | 1998-09-17 | Darwin Discovery Limited | Dosage forms comprising separate portions of r- and s-enantiomers |
WO1999042095A1 (en) * | 1998-02-21 | 1999-08-26 | Asta Medica Ag | Pharmaceutical combinations containing tramadol |
Non-Patent Citations (2)
Title |
---|
FRANKUS E ET AL: "UEBER DIE ISOMERENTRENNUNG, STRUKTURAUFKLAERUNG UND PHARMAKOLOGISCHE CHARAKTERISIERUNG VON 1-(M-METHOXYPHENYL)-2 -(DIMETHYLAMINOMETHYL)-CY CLOHEXAN-1-OL. ON SEPARARION OF ISOMERS, STRUCTURAL ELUCIDATION AND PHARMACOLOGICAL CHARACTERIZATION OF 1 -(M-METHOXYPHENYL)-2-(DIMETHYLA MINOMETHYL)-CYCLOHEXAN-", ARZNEIMITTEL FORSCHUNG. DRUG RESEARCH, vol. 28, no. 1A, 1 January 1978 (1978-01-01), pages 114 - 121, XP000644506, ISSN: 0004-4172 * |
POULSEN L ET AL: "THE HYPOALGESIC EFFECT OF TRAMADOL IN RELATION TO CYP2D6", CLINICAL PHARMACOLOGY & THERAPEUTICS,US,ST LOUIS, MO, vol. 60, no. 6, 1 December 1996 (1996-12-01), pages 636 - 644, XP000891863 * |
Cited By (32)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6297286B1 (en) | 1999-11-09 | 2001-10-02 | Darwin Discovery, Ltd. | Therapeutic use and formulation |
WO2001034125A3 (en) * | 1999-11-09 | 2002-07-11 | Darwin Discovery Ltd | Therapeutic use and formulation of (-)-tramadol |
WO2001034125A2 (en) * | 1999-11-09 | 2001-05-17 | Darwin Discovery Limited | Therapeutic use and formulation of (-)-tramadol |
JP2004513091A (en) * | 2000-10-03 | 2004-04-30 | ペンウェスト ファーマシューティカルズ カンパニー | Delivery systems for multiple pharmaceutically active ingredients at different rates |
WO2002028383A1 (en) * | 2000-10-03 | 2002-04-11 | Penwest Pharmaceuticals Company | Delivery system for multi-pharmaceutical active materials at various release rates |
AU2001294979B2 (en) * | 2000-10-03 | 2007-03-29 | Penwest Pharmaceuticals Company | Delivery system for multi-pharmaceutical active materials at various release rates |
US7611730B2 (en) | 2001-02-21 | 2009-11-03 | Grunenthal Gmbh | Tramadol-based medicament |
WO2002066026A3 (en) * | 2001-02-21 | 2002-11-07 | Gruenenthal Gmbh | Tramadol-based medicament |
WO2002066026A2 (en) * | 2001-02-21 | 2002-08-29 | Grünenthal GmbH | Tramadol-based medicament |
US6780891B2 (en) | 2001-11-30 | 2004-08-24 | Sepracor Inc. | Tramadol analogs and uses thereof |
US9439866B2 (en) | 2005-09-09 | 2016-09-13 | Angelini Pharma, Inc. | Trazodone composition for once a day administration |
US8962019B2 (en) | 2005-09-09 | 2015-02-24 | Angelini Pharma, Inc. | Sustained drug release composition |
EP2486921A1 (en) | 2007-02-12 | 2012-08-15 | DMI Biosciences, Inc. | Reducing Side Effects of Tramadol |
WO2008100933A2 (en) | 2007-02-12 | 2008-08-21 | Dmi Biosciences, Inc. | Reducing side effects of tramadol |
JP2020521816A (en) * | 2017-05-31 | 2020-07-27 | メティス ファーマシューティカルズ アクチェンゲゼルシャフト | Synergistic composition comprising (R)-dimiracetam (1) and (S)-dimiracetam (2) in non-racemic ratio |
WO2018219977A1 (en) * | 2017-05-31 | 2018-12-06 | Metys Pharmaceuticals AG | Synergistic compositions comprising (r)-dimiracetam (1) and (s)-dimiracetam (2) in a non-racemic ratio |
JP7157471B2 (en) | 2017-05-31 | 2022-10-20 | メティス ファーマシューティカルズ アクチェンゲゼルシャフト | Synergistic composition comprising (R)-dimiracetam (1) and (S)-dimiracetam (2) in a non-racemic ratio |
JP2021073171A (en) * | 2017-05-31 | 2021-05-13 | メティス ファーマシューティカルズ アクチェンゲゼルシャフト | Synergistic composition including (r)-dimiracetam(1) and (s)-dimiracetam(2) at non-racemic ratio |
EP3735971A1 (en) * | 2017-05-31 | 2020-11-11 | Metys Pharmaceuticals AG | Synergistic compositions comprising (r)-dimiracetam (1) and (s)-dimiracetam (2) in a non-racemic ratio |
US10738054B2 (en) | 2017-05-31 | 2020-08-11 | Metys Pharmaceuticals AG | Synergistic compositions comprising (R)-dimiracetam (1) and (S)-dimiracetam (2) in a non-racemic ratio |
US10377708B2 (en) | 2017-12-05 | 2019-08-13 | Sunovion Pharmaceuticals Inc. | Crystal forms and production methods thereof |
US10660875B1 (en) | 2017-12-05 | 2020-05-26 | Sunovion Pharmaceuticals Inc. | Nonracemic mixtures and uses thereof |
US10800738B2 (en) | 2017-12-05 | 2020-10-13 | Sunovion Pharmaceuticals Inc. | Crystal forms and production methods thereof |
US10576058B2 (en) | 2017-12-05 | 2020-03-03 | Sunovion Pharmaceuticals Inc. | Nonracemic mixtures and uses thereof |
US10874639B2 (en) | 2017-12-05 | 2020-12-29 | Sunovion Pharmaceuticals Inc. | Nonracemic mixtures and uses thereof |
US10577317B2 (en) | 2017-12-05 | 2020-03-03 | Sunovion Pharmaceuticals Inc. | Crystal forms and production methods thereof |
US11370753B2 (en) | 2017-12-05 | 2022-06-28 | Sunovion Pharmaceuticals Inc. | Crystal forms and production methods thereof |
US10369134B2 (en) | 2017-12-05 | 2019-08-06 | Sunovion Pharmaceuticals Inc. | Nonracemic mixtures and uses thereof |
US11517558B2 (en) | 2017-12-05 | 2022-12-06 | Sunovion Pharmaceuticals Inc. | Nonracemic mixtures and uses thereof |
US11767293B2 (en) | 2017-12-05 | 2023-09-26 | Sunovion Pharmaceuticals Inc. | Crystal forms and production methods thereof |
US11160758B2 (en) | 2019-06-04 | 2021-11-02 | Sunovion Pharmaceuticals Inc. | Modified release formulations and uses thereof |
US11654113B2 (en) | 2019-06-04 | 2023-05-23 | Sunovion Pharmaceuticals Inc. | Modified release formulations and uses thereof |
Also Published As
Publication number | Publication date |
---|---|
PL347542A1 (en) | 2002-04-08 |
IL142778A0 (en) | 2002-03-10 |
KR20010080364A (en) | 2001-08-22 |
EP1135361A1 (en) | 2001-09-26 |
CN1329590A (en) | 2002-01-02 |
NO20012738L (en) | 2001-06-01 |
NO20012738D0 (en) | 2001-06-01 |
JP2002531431A (en) | 2002-09-24 |
BR9915873A (en) | 2001-08-21 |
AU1400100A (en) | 2000-06-19 |
HUP0104420A2 (en) | 2002-08-28 |
CA2350635A1 (en) | 2000-06-08 |
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