Methods of Chromatographic Determination of Medicines Decreasing the Level of Cholesterol
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
FIELD Study Revealed Fenofibrate Reduced Need for Laser Treatment for Diabetic Retinopathy by Anthony C
Supplement to Supported by an unrestricted educational grant from Abbott Laboratories March/April 2008 FIELD Study Revealed Fenofibrate Reduced Need for Laser Treatment for Diabetic Retinopathy By Anthony C. Keech, MBBS, Msc Epid, FRANZCS, FRACP; and Paul Mitchell, MBBS(Hons), MD, PhD, FRANZCO, FRACS, FRCOphth, FAFPHM This agent’s mechanism of benefit in diabetic retinopathy appears to go beyond its effects on lipid concentration or blood pressure, and this potential mechanism of action operates even when glycemic control and blood pressure levels are within goal. ABSTRACT icant relative reduction was seen of almost one-third in PURPOSE the rate of first laser application for retinopathy after The FIELD (Fenofibrate Intervention and Event an average treatment duration of 5 years with fenofi- Lowering in Diabetes) study sought to investigate brate 200 mg/day. whether long-term lipid-lowering therapy with fenofi- In this report, we detail the effects of fenofibrate brate would reduce macro- and microvascular compli- administration on ophthalmic microvascular compli- cations among patients with type 2 diabetes. We previ- cations and attempt to clarify some of the underlying ously reported that in type 2 diabetes patients with pathologies being addressed among patients undergo- adequate glycemic and blood pressure control, a signif- ing laser treatment. Jointly sponsored by The Dulaney Foundation and Retina Today MARCH/APRIL 2008 I SUPPLEMENT TO RETINA TODAY I 1 FIELD Study Revealed Fenofibrate Reduced Need for Laser Treatment for Diabetic Retinopathy Jointly sponsored by The Dulaney Foundation and Retina Today. Release date: April 2008. Expiration date: April 2009. This continuing medical education activity is supported by an unrestricted educational grant from Abbott Laboratories. -
Profile Profile Uses and Administration Adverse Effects And
Etacrynic Acid/Ezetimibe 1379 unchanged and partly in the form of metabolites. It is Efortil; Etilefril; Chile: Elfortilt; Fin.: Elfortil; Fr.: Effortil; Ger.: over 10 years, may be given ezetimibe for the same indica extensively bound to plasma proteins. Bioflutin; Effortil; Etil; Pholdyston; Thomasin; Gr.: Effortil; tions and at the same doses as in adults (see above). ' Efortil; Ita/. : Elfortil; Jpn: Effortil; Mex.: Effortil; Quimtatil; Pol.: Effortil; Port.: Effortil; S.Afr.: Effortilt; Spain: Efortil; Swed.: Hyperlipidaemias. Ezetimibe inhibits the absorption of �:.�!?.�.��.!��-��--·········································································· Effortil; Switz. : Effortil; Thai.: Buracard; Circula; Circuman; dietary cholesterol' and, although there is a compensatory Proprietary Preparations (details are given in Volume B) Venez. : Elfortilt; Effrine; Efxine; Hyposia; Hyprosiat; Effontil. increase in cholesterol synthesis in the liver.' overall Single-ingredient Preparations. Austral.: Edecrin; Canad.: Multi-ingredient Preparations. Austria: Agilan; Amphodynt; plasma LDL-cholesterol concentrations are reduced.2 Ezeti Edecrin; Hung.: Uregyt; Ita!. : Reomax; Rus.: Uregyt (Ypei"HT); Effortil camp; Hypodynt; Influbenet; Ger.: Dibydergot plus; mibe may be used alone' in the management of hyperlipi Ukr.: Uregyt (YperHT); USA: Edecrin. Effortil plust; Switz.: Dibydergot plust; Elfortil plust. daentias (p. 1248.1) but use with lipid regulating drugs Phannacopoeial Preparations that act by reducing cholesterol synthesis may -
Joint Assessment Report Was Discussed by the Phvwp at Its Meeting in July 2007 and Finalised in September 2007
ASSESSMENT REPORT on the benefit:risk of fibrates EXECUTIVE SUMMARY 1. BACKGROUND In the light of the established role of statins in the primary and secondary prevention of cardiovascular disease (CVD) and safety concerns arising from the use of fibrates, the CHMP Pharmacovigilance Working Party (PhVWP) agreed to undertake a benefit:risk assessment of this class of medicines. The objective was to establish the current place of fibrates in the treatment of cardiovascular and dyslipidaemic diseases, and in diabetes mellitus; also to provide recommendations regarding amendments of the Summary of Product Characteristics (SPC), as necessary. Fibrates exert their effects mainly by activating the peroxisome proliferator-activated receptor-alpha (PPAR-alpha). Unique in this class, bezafibrate is an agonist for all three PPAR isoforms alpha, gamma, and delta. Fibrates have been shown to reduce plasma triglycerides by 30% to 50% and raise the level of high density lipoprotein cholesterol (HDL- C) by 2% to 20%. Their effect on low density lipoprotein cholesterol (LDL-C) is variable, ranging from no effect to a small decrease of the order of 10%. Today there are four licensed fibrates: bezafibrate, fenofibrate, gemfibrozil and ciprofibrate. Their currently approved indications are quite broad and in many cases still use the old Fredrickson classification for dyslipidaemias. 2. METHODOLOGY In February 2006 a List of Questions was agreed by the PhVWP for the Marketing Authorisation Holders (MAHs) of medicinal products containing one of the four currently licensed fibrates (Annex 1). Other clofibrate-containing medicinal products (e.g. etofibrate, etofyllinclofibrate) were excluded from this class review, since these are available only in a few member states via national marketing authorizations. -
Fenofibrate Capsules Apotex Standard 67 Mg and 200 Mg
PRODUCT MONOGRAPH PrAPO-FENO-MICRO Fenofibrate Capsules Apotex Standard 67 mg and 200 mg PrAPO-FENOFIBRATE Fenofibrate Capsules Apotex Standard 100 mg Lipid Metabolism Regulator APOTEX INC. 150 Signet Drive Toronto, Ontario DATE OF REVISION: M9L 1T9 October 7, 2014 Control No.: 169773 - 1 - PRODUCT MONOGRAPH PrAPO-FENO-MICRO Fenofibrate Capsules Apotex Standard 67 mg and 200 mg PrAPO-FENOFIBRATE Fenofibrate Capsules Apotex Standard 100 mg THERAPEUTIC CLASSIFICATION Lipid Metabolism Regulator ACTIONS AND CLINICAL PHARMACOLOGY Fenofibrate lowers elevated serum lipids by decreasing the low-density lipoprotein (LDL) fraction rich in cholesterol and the very low density lipoprotein (VLDL) fraction rich in triglycerides. In addition, fenofibrate increases the high density lipoprotein (HDL) cholesterol fraction. Fenofibrate appears to have a greater depressant effect on the VLDL than on the low density lipoproteins (LDL). Therapeutic doses of fenofibrate produce elevations of HDL cholesterol, a reduction in the content of the low density lipoproteins cholesterol, and a substantial reduction in the triglyceride content of VLDL. The mechanism of action of fenofibrate has not been definitively established. Work carried out to date suggests that fenofibrate: · enhances the liver elimination of cholesterol as bile salts; · inhibits the biosynthesis of triglycerides and enhances the catabolism of VLDL by increasing the activity of lipoprotein lipase; · has an inhibitory effect on the biosynthesis of cholesterol by modulating the activity of HMG- CoA reductase. Metabolism and Excretion After oral administration with food, fenofibrate is rapidly hydrolyzed to fenofibric acid, the active metabolite. In man it is mainly excreted through the kidney. Half-life is about 20 hours. In patients with severe renal failure, significant accumulation was observed with a large increase in half-life. -
PI Changes for Fibrates
Changes to Product Information as approved by the CHMP on 21 October 2010, pending endorsement by the European Commission 1 BEZAFIBRATE ANNEX I -SUMMARY OF PRODUCT CHARACTERISTICS 4.1 Therapeutic indications (to replace current text) [Product name] is indicated as an adjunct to diet and other non-pharmacological treatment (e.g. exercise, weight reduction) for the following: - Treatment of severe hypertriglyceridaemia with or without low HDL cholesterol. - Mixed hyperlipidaemia when a statin is contraindicated or not tolerated. 5.1 Pharmacodynamic properties (Additional text) There is evidence that treatment with fibrates may reduce coronary heart disease events but they have not been shown to decrease all cause mortality in the primary or secondary prevention of cardiovascular disease ANNEX III -LABELLING AND PACKAGE LEAFLET What [Product name] is and what it is used for [Product name] belongs to a group of medicines, commonly known as fibrates. These medicines are used to lower the level of fats (lipids) in the blood. For example the fats known as triglycerides. [Product name] is used, alongside a low fat diet and other non-medical treatments such as exercise and weight loss, to lower levels of fats in the blood. 2 CIPROFIBRATE ANNEX I -SUMMARY OF PRODUCT CHARACTERISTICS 4.1 Therapeutic indications (to replace current text) [Product name] is indicated as an adjunct to diet and other non-pharmacological treatment (e.g. exercise, weight reduction) for the following: - Treatment of severe hypertriglyceridaemia with or without low HDL cholesterol. - Mixed hyperlipidaemia when a statin is contraindicated or not tolerated. 5.1 Pharmacodynamic properties (Additional text) There is evidence that treatment with fibrates may reduce coronary heart disease events but they have not been shown to decrease all cause mortality in the primary or secondary prevention of cardiovascular disease ANNEX III -LABELLING AND PACKAGE LEAFLET What [Product name] is and what it is used for [Product name] belongs to a group of medicines, commonly known as fibrates. -
Fenofibrate, Bezafibrate, Ciprofibrate and Gemfibrozil Procedure Number
28 February 2011 EMA/CHMP/580013/2012 Assessment report for fenofibrate, bezafibrate, ciprofibrate, and gemfibrozil containing medicinal products pursuant to Article 31 of Directive 2001/83/EC, as amended INN: fenofibrate, bezafibrate, ciprofibrate and gemfibrozil Procedure number: EMEA/H/A-1238 Assessment Report as adopted by the CHMP with all information of a commercially confidential nature deleted. 7 Westferry Circus ● Canary Wharf ● London E14 4HB ● United Kingdom Telephone +44 (0)20 7418 8400 Facsimile +44 (0)20 7523 7051 E -mail [email protected] Website www.ema.europa.eu An agency of the European Union © European Medicines Agency, 2013. Reproduction is authorised provided the source is acknowledged. Table of contents 1. Background information on the procedure .............................................. 3 1.1. Referral of the matter to the CHMP ......................................................................... 3 2. Scientific discussion ................................................................................ 3 2.1. Introduction......................................................................................................... 3 2.2. Clinical aspects .................................................................................................... 4 2.2.1. PhVWP recommendation ..................................................................................... 4 2.2.2. CHMP review ..................................................................................................... 7 2.2.3. Discussion ..................................................................................................... -
Anatomical Classification Guidelines V2021 EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2021
EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2021 Anatomical Classification Guidelines V2021 "The Anatomical Classification of Pharmaceutical Products has been developed and maintained by the European Pharmaceutical Marketing Research Association (EphMRA) and is therefore the intellectual property of this Association. EphMRA's Classification Committee prepares the guidelines for this classification system and takes care for new entries, changes and improvements in consultation with the product's manufacturer. The contents of the Anatomical Classification of Pharmaceutical Products remain the copyright to EphMRA. Permission for use need not be sought and no fee is required. We would appreciate, however, the acknowledgement of EphMRA Copyright in publications etc. Users of this classification system should keep in mind that Pharmaceutical markets can be segmented according to numerous criteria." © EphMRA 2021 Anatomical Classification Guidelines V2021 CONTENTS PAGE INTRODUCTION A ALIMENTARY TRACT AND METABOLISM 1 B BLOOD AND BLOOD FORMING ORGANS 28 C CARDIOVASCULAR SYSTEM 36 D DERMATOLOGICALS 51 G GENITO-URINARY SYSTEM AND SEX HORMONES 58 H SYSTEMIC HORMONAL PREPARATIONS (EXCLUDING SEX HORMONES) 68 J GENERAL ANTI-INFECTIVES SYSTEMIC 72 K HOSPITAL SOLUTIONS 88 L ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS 96 M MUSCULO-SKELETAL SYSTEM 106 N NERVOUS SYSTEM 111 P PARASITOLOGY 122 R RESPIRATORY SYSTEM 124 S SENSORY ORGANS 136 T DIAGNOSTIC AGENTS 143 V VARIOUS 145 Anatomical Classification Guidelines V2021 INTRODUCTION The Anatomical Classification was initiated in 1971 by EphMRA. It has been developed jointly by Intellus/PBIRG and EphMRA. It is a subjective method of grouping certain pharmaceutical products and does not represent any particular market, as would be the case with any other classification system. -
2 12/ 35 74Al
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date 22 March 2012 (22.03.2012) 2 12/ 35 74 Al (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 9/16 (2006.01) A61K 9/51 (2006.01) kind of national protection available): AE, AG, AL, AM, A61K 9/14 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, (21) International Application Number: DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, PCT/EP201 1/065959 HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, (22) International Filing Date: KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, 14 September 201 1 (14.09.201 1) ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PE, PG, PH, PL, PT, QA, RO, RS, RU, (25) Filing Language: English RW, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, (26) Publication Language: English TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: 61/382,653 14 September 2010 (14.09.2010) US (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, (71) Applicant (for all designated States except US): GM, KE, LR, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, NANOLOGICA AB [SE/SE]; P.O Box 8182, S-104 20 ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, Stockholm (SE). -
Update of Comparative Effectiveness of Lipid-Modifying Agents
Evidence-based Practice Center Systematic Review Protocol Project Title: Update of Comparative Effectiveness of Lipid-Modifying Agents I. Background and Objectives for the Systematic Review Epidemiology and Practice Guidelines Cardiovascular disease (CVD) affects 83.6 million Americans.1 CVD includes a variety of conditions such as myocardial infarction, stroke, heart failure, arrhythmia, heart valve disease, and hypertension. In 2009, CVD contributed to 32.3 percent of U.S. deaths and is a leading cause of disability.1 Atherosclerosis plays a major role in the development of certain cardiovascular diseases—coronary heart disease (CHD) including myocardial infarction, angina, and heart failure and cerebrovascular accident. These atherosclerotic diseases affect 15.4 million Americans.1 Elevated blood lipids are a major risk factor for atherosclerotic CVD. Abnormal lipoprotein metabolism predisposes individuals to atherosclerosis, especially increased concentrations of apolipoprotein B (apo B)-100–containing low-density lipoprotein (LDL-c). Oxidized LDL is atherogenic, causing endothelial damage, alteration of vascular tone, and recruitment of monocytes and macrophages. Many studies have underscored the importance of LDL-c in development of atherosclerotic CVD.2,3 Due to the consistent and robust association of higher LDL-c levels with atherosclerotic CVD across experimental and epidemiologic studies, therapeutic strategies to decrease risk have focused on LDL-c reduction as the primary goal. The trial results are most compelling regarding the reduction of CHD by lowering LDL-c. 4,5 Based on this evidence, the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) report established three CHD risk strata together with guidelines regarding the initiation of treatment and therapeutic targets based on LDL-c cutoffs. -
Anatomical Classification Guidelines V2020 EPHMRA ANATOMICAL
EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2020 Anatomical Classification Guidelines V2020 "The Anatomical Classification of Pharmaceutical Products has been developed and maintained by the European Pharmaceutical Marketing Research Association (EphMRA) and is therefore the intellectual property of this Association. EphMRA's Classification Committee prepares the guidelines for this classification system and takes care for new entries, changes and improvements in consultation with the product's manufacturer. The contents of the Anatomical Classification of Pharmaceutical Products remain the copyright to EphMRA. Permission for use need not be sought and no fee is required. We would appreciate, however, the acknowledgement of EphMRA Copyright in publications etc. Users of this classification system should keep in mind that Pharmaceutical markets can be segmented according to numerous criteria." © EphMRA 2020 Anatomical Classification Guidelines V2020 CONTENTS PAGE INTRODUCTION A ALIMENTARY TRACT AND METABOLISM 1 B BLOOD AND BLOOD FORMING ORGANS 28 C CARDIOVASCULAR SYSTEM 35 D DERMATOLOGICALS 50 G GENITO-URINARY SYSTEM AND SEX HORMONES 57 H SYSTEMIC HORMONAL PREPARATIONS (EXCLUDING SEX HORMONES) 65 J GENERAL ANTI-INFECTIVES SYSTEMIC 69 K HOSPITAL SOLUTIONS 84 L ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS 92 M MUSCULO-SKELETAL SYSTEM 102 N NERVOUS SYSTEM 107 P PARASITOLOGY 118 R RESPIRATORY SYSTEM 120 S SENSORY ORGANS 132 T DIAGNOSTIC AGENTS 139 V VARIOUS 141 Anatomical Classification Guidelines V2020 INTRODUCTION The Anatomical Classification was initiated in 1971 by EphMRA. It has been developed jointly by Intellus/PBIRG and EphMRA. It is a subjective method of grouping certain pharmaceutical products and does not represent any particular market, as would be the case with any other classification system. -
Estonian Statistics on Medicines 2013 1/44
Estonian Statistics on Medicines 2013 DDD/1000/ ATC code ATC group / INN (rout of admin.) Quantity sold Unit DDD Unit day A ALIMENTARY TRACT AND METABOLISM 146,8152 A01 STOMATOLOGICAL PREPARATIONS 0,0760 A01A STOMATOLOGICAL PREPARATIONS 0,0760 A01AB Antiinfectives and antiseptics for local oral treatment 0,0760 A01AB09 Miconazole(O) 7139,2 g 0,2 g 0,0760 A01AB12 Hexetidine(O) 1541120 ml A01AB81 Neomycin+Benzocaine(C) 23900 pieces A01AC Corticosteroids for local oral treatment A01AC81 Dexamethasone+Thymol(dental) 2639 ml A01AD Other agents for local oral treatment A01AD80 Lidocaine+Cetylpyridinium chloride(gingival) 179340 g A01AD81 Lidocaine+Cetrimide(O) 23565 g A01AD82 Choline salicylate(O) 824240 pieces A01AD83 Lidocaine+Chamomille extract(O) 317140 g A01AD86 Lidocaine+Eugenol(gingival) 1128 g A02 DRUGS FOR ACID RELATED DISORDERS 35,6598 A02A ANTACIDS 0,9596 Combinations and complexes of aluminium, calcium and A02AD 0,9596 magnesium compounds A02AD81 Aluminium hydroxide+Magnesium hydroxide(O) 591680 pieces 10 pieces 0,1261 A02AD81 Aluminium hydroxide+Magnesium hydroxide(O) 1998558 ml 50 ml 0,0852 A02AD82 Aluminium aminoacetate+Magnesium oxide(O) 463540 pieces 10 pieces 0,0988 A02AD83 Calcium carbonate+Magnesium carbonate(O) 3049560 pieces 10 pieces 0,6497 A02AF Antacids with antiflatulents Aluminium hydroxide+Magnesium A02AF80 1000790 ml hydroxide+Simeticone(O) DRUGS FOR PEPTIC ULCER AND GASTRO- A02B 34,7001 OESOPHAGEAL REFLUX DISEASE (GORD) A02BA H2-receptor antagonists 3,5364 A02BA02 Ranitidine(O) 494352,3 g 0,3 g 3,5106 A02BA02 Ranitidine(P) -
Therapeutic Class Overview Fibric Acid Derivatives
Therapeutic Class Overview Fibric Acid Derivatives Therapeutic Class • Overview/Summary: The fibric acid derivatives are agonists of the peroxisome proliferator activated receptor α (PPARα). Activation of PPARα increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein CIII. The resulting decrease in triglycerides (TG) produces an alteration in the size and composition of low- density lipoprotein cholesterol (LDL-C) from small, dense particles to large buoyant particles. There is also an increase in the synthesis of high-density lipoprotein cholesterol (HDL-C), as well as apoprotein AI and AII.1-10 The major action of this class of medications is to reduce TG. The fibric acid derivatives can decrease TG by 20 to 50% and increase HDL-C by 10 to 35%. They also lower LDL- C by 5 to 20%; however, in patients with hypertriglyceridemia, LDL-C may increase with the use of fibric acid derivatives.11 Several fenofibrate products are currently available, including micronized and non-micronized formulations. The different fenofibrate formulations are not equivalent on a milligram-to-milligram basis. Micronized fenofibrate is more readily absorbed than non-micronized formulations, which allows for a lower daily dose. Fenofibrate (micronized and non-micronized formulations), fenofibric acid, and gemfibrozil are available generically in at least one dosage form and/or strength.12 Fenofibrate and fenofibric acid are Food and Drug Administration (FDA)-approved for the treatment of hypercholesterolemia and mixed dyslipidemias, as well as hypertriglyceridemia. Gemfibrozil is FDA- approved for the treatment of hypertriglyceridemia and to reduce the risk of developing coronary heart disease (CHD) in select patients.13 Gemfibrozil has demonstrated a reduction in the risk of fatal and nonfatal myocardial infarction (MI) for primary prevention, as well as a reduction in CHD death and nonfatal MI and stroke for secondary prevention.