HK1007105B - Diclofenac sodium plaster - Google Patents
Diclofenac sodium plaster Download PDFInfo
- Publication number
- HK1007105B HK1007105B HK98106294.3A HK98106294A HK1007105B HK 1007105 B HK1007105 B HK 1007105B HK 98106294 A HK98106294 A HK 98106294A HK 1007105 B HK1007105 B HK 1007105B
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- HK
- Hong Kong
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- paste
- diclofenac sodium
- backing material
- sodium
- plaster
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Description
The present invention relates to a diclofenac sodium plaster containing diclofenac sodium and having good percutaneous absorption.
Diclofenac sodium is a non-steroidal anti-inflammatory analgesic and is now available as oral preparations and suppositories on the market. However, oral or rectal administration involves the problem of various side effects, led by stomach troubles, while suppositories are accompanied by the problem of shock or the like which may be caused by an abrupt increase in the diclofenac concentration in blood. To overcome such problems, formulations for external use, such as ointments, creams and liquid preparations, have been proposed with a view to allowing diclofenac sodium to act locally or on the whole body. In practice, however, there is no external preparation with good percutaneous absorption.
US-A-4 543 251 discloses gel preparations comprising diclofenac sodium, a medium comprising water, a lower alkanol and a glycol (inter alia propylene glycol), a water soluble polymer (carboxyvinyl polymer) and optionally e.g. 1-menthol as a cooling agent. Plasters are not disclosed in this reference.
JP-A-59 227 819 relates to plasters comprising diclofenac sodium in a copolymer of (i) an alkyl (meth)acrylate, (ii) a (meth)acrylic acid ester having an ether group in the molecule, and (iii) a polar monomer.
The present inventors previously found that a gel-type ointment having excellent percutaneous absorption can be obtained by adding diclofenac or a salt thereof (and menthol) to a gel-form base which has been obtained by neutralizing a gelling agent with ammonia or an alkylamine, and filed a patent application thereon (Japanese Patent Application Laid-Open No. 49722/1990.
The gel-type ointment is however accompanied by the drawback that, even when a gel-type ointment excellent in percutaneous absorption as described above is used, its stable percutaneous absorption over a long period of time is difficult because the gel-type ointment is prone to separation, for example, due to contact between the skin of an applied part and clothing, washing, or the like. In addition, it is difficult to spread such an ointment in a predetermined constant amount and at a constant thickness on the skin, leading to the further drawback that it is difficult to maintain stable percutaneous absorption over a long time.
The present inventors therefore have proceeded with a further investigation. As a result, the use of a plaster has been found most suitable as a method for extended stable percutaneous absorption of diclofenac.
A paste for plasters, however, is required to have many functions and properties beyond that of carrying an effective ingredient. It is therefore impossible to divert, for example, gel-type ointments which have been employed conventionally. Functions and properties required for a paste for plasters include having suitable adhesiveness when applied to the skin, locational stability during long-term application, easy release from the skin when the plaster is removed, and stability of properties even when stored as a product for a long time. Numerous limitations are therefore imposed on the composition of a paste.
The present inventors have conducted a still further investigation with a view toward improving the percutaneous absorption of diclofenac from a paste for plaster on which many limitations are imposed as described above. As a result, it has been found that a plaster providing extremely good percutaneous absorption of diclofenac sodium can be obtained by using, as a penetration enhancer to be incorporated in a paste, 1-menthol and propylene glycol in combination and further employing a particular hydrophilic base, leading to the completion of the present invention.
The present invention therefore provides a diclofenac sodium plaster which comprises a backing material and a paste spread on the backing material. The paste comprises diclofenac sodium, a penetration enhancer composed of 1-menthol and propylene glycol, and a hydrophilic base composed principally of a water-soluble polymer.
The diclofenac sodium plaster according to the present invention are extremely good in skin penetration and percutaneous absorption, so that diclofenac sodium can be stably and continuously supplied to an affected part of the body.
- FIG. 1 diagrammatically shows time-dependent changes in the diclofenac concentration in plasma when the diclofenac sodium plasters prepared in Example 1 and Comparative Examples 1-3, respectively, were applied; and
- FIG. 2 diagrammatically illustrates time-dependent changes in the diclofenac concentration in plasma when the diclofenac sodium plasters prepared in Example 4 and Comparative Examples 4, respectively, were applied.
Examples of the water-soluble polymer employed as a base in the present invention include polyacrylic acid, sodium polyacrylate, carboxyvinyl polymer, sodium carboxymethylcellulose, polyvinyl pyrrolidone, polyvinyl alcohol, hydroxypropylcellulose, hydroxyethylcellulose, ethylcellulose, alginic acid, sodium alginate, and gelatin. Of these, preferred are those obtained by crosslinking polyacrylic acids and/or polyacrylate salts with multivalent metal compounds and that obtained by freezing and melting an aqueous solution of polyvinyl alcohol. They can be used either singly or in combination. These water-soluble polymers are preferably added in a total proportion of 0.5-40 wt.%, notably 1-20 wt.% based on a paste.
Propylene glycol added as a penetration enhancer is preferably added in a proportion of 0.1-60 wt.% based on the paste, with 0.5-20 wt.% being particularly preferred. 1-Menthol is preferably added in a proportion of 0.05-10 wt.%, especially 0.1-5 wt.% based on the paste.
According to the present invention, the combined use of propylene glycol and 1-menthol as a penetration enhancer can synergistically increase the percutaneous absorption of diclofenac sodium as will be demonstrated in examples to be set forth later. In addition to such a penetration enhancer, the plaster according to the present invention can also include one or more conventional absorption promoters such as oleic acid, oleyl alcohol, diisopropyl adipate, octyldodecanol, diethyl sebacate, benzyl alcohol, isopropyl myristate, crotamiton, lauryl alcohol, 2-octyldodecanol, ethyl 2-ethylhexanoate, calcium thioglycolate, capric monoglyceride, caprylate esters, caprate esters, decyl oleate, diethyl sebacate, squalane and/or D-limonene.
Besides the essential ingredients described above, the plaster according to the present invention may also include other additives incorporated in conventional hydrophilic-base-containing plasters, for example, polyhydric alcohols as moisturizing agents, such as glycerin and sorbitol; inorganic compounds as fillers, such as kaolin and titanium dioxide; and surfactants such as polyoxyethylene sorbitan monooleate, sorbitan monooleate, polyoxyethylene hydrogenated castor oil, polyoxyethylene lauryl ether and polyoxyethylene monolaurate; as well as, if necessary, perfumes, stabilizers, crosslinking agents, pH regulators, etc.
The plaster according to the present invention can be prepared, preferably, by formulating a paste from the above-described ingredients in a manner known per se in the art and then having the paste carried on a backing material.
The paste useful in the plaster of this invention preferably has a stress in a range of from 5 x 10-2 N (5 x 103 dyne)/cm2 to 5 N (5 x 105 dyne)/cm2, especially from 0.8 x 10-1 N (0.8 x 104 dyne)/cm2 to 1.0 N (1.0 x 105) dyne/cm2. Incidentally, the stress of a paste is measured, for example, in the following manner. After the formulation of the ointment, it is placed in a cylindrical vessel whose diameter and height are 40 mm and 20 mm, respectively. After sealing the vessel, the vessel with the paste placed therein is maintained at 25°C for at least 168 hours. The paste is then placed on a sample table of a compression tester (e.g., "SUN RHEO METER", trade mark; manufactured by K.K. Sun Kagaku), and its central part is pressed at a compression speed of 300 mm/min against a disk-shaped adapter having a diameter of 15 mm and mounted on a pressure-sensing shaft. The stress of the paste is measured in terms of the stress produced upon pressing the paste over a distance of 2 mm after the adapter has contacted the paste.
No particular limitation is imposed on the backing material as long as it is a woven fabric, non-woven fabric, film or sheet having flexibility. For example, a woven or non-woven fabric of rayon, polyester, polyolefin or polyurethane fibers, a polymer film, a foamed sheet, or the like can be used. They may be applied with an anchor coat, as needed.
No particular limitation is imposed on the preparation method of the plaster according to this invention. The plaster can be prepared by formulating a paste containing 0.5-20 wt.% of diclofenac sodium, spreading it on a backing material and then covering the surface of the paste with a protective film or, as an alternative, by formulating a paste containing 0.5-20 wt.% of diclofenac sodium and then sandwiching it between a backing material and a protective film.
The plaster obtained as described above may be stored in a tight container, envelope or the like, as needed.
The present invention will next be described by examples.
To 15 g of propylene glycol heated to 40°C in advance, 1 g of diclofenac sodium, 3 g of 1-menthol and 1 g of polyoxyethylene hydrogenated castor oil were added, followed by stirring into an intimate mixture (A). In 10 g of propylene glycol, 2.5 g of sodium carboxymethylcellulose, 6 g of sodium polyacrylate and 0.1 g of aluminum glycinate were uniformly dispersed (B). One gram of gelatin was dissolved in 27.68 g of purified water which had been heated to about 60°C (C). 0.12 g of tartaric acid, 3.6 g of agueous polyacrylic acid solution (10%), 30 g of D-sorbitol solution (70% aqueous solution), the mixture (A), the suspension (B) and the solution (C) were kneaded into an intimate paste, which was then spread at a rate of 0.1 g/cm2 on a non-woven fabric. The surface of the paste was covered with a polyester film, whereby a diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained. The stress of the paste of the diclofenac sodium plaster was 1.8 x 10-1 N (1.8 x 104 dyne)/cm2 when measured by the method described above.
To 10 g of propylene glycol heated to 40°C in advance, 1 g of diclofenac sodium, 2 g of benzyl alcohol, 1 g of 1-menthol and 1 g of polyoxyethylene hydrogenated castor oil were added, followed by stirring into an intimate mixture (A). In 10 g of propylene glycol, 3 g of sodium carboxymethylcellulose, 5 g of sodium polyacrylate and 0.1 g of dry aluminum ammonium sulfate were uniformly dispersed (B). Four grams of kaolin were evenly dispersed in 10 g of a D-sorbitol solution (70% aqueous solution) (C). 51.9 grams of purified water, 1 g of tartaric acid, the mixture (A), the dispersion (B) and the dispersion (C) were kneaded into an intimate paste, which was then spread at a rate of 0.1 g/cm2 on a non-woven fabric. The surface of the paste was covered with a polyester film, whereby a diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained. The stress of the paste of the diclofenac sodium plaster was 2.7 x 10-1 N (2.7 x 104 dyne)/cm2 when measured by the method described above.
Two grams of diisopropyl adipate, 1 g of 1-menthol and 1 g of polyoxyethylene monolaurate were mixed under stirring while being heated at 40°C. Further, 0.5 g of diclofenac sodium was added, followed by stirring into an intimate mixture (A). Two grams of sodium carboxymethylcellulose, 5 g of sodium polyacrylate and 0.15 g of dry aluminum ammonium sulfate were uniformly dispersed in 15 g of propylene glycol (B). One gram of gelatin was dissolved in 38.23 g of purified water which had been heated to about 60°C (C). 30 grams of a D-sorbitol solution (70% aqueous solution), 0.12 g of tartaric acid, 4 g of an aqueous polyacrylic acid solution (10%), the mixture (A), the dispersion (B), and the solution (C) were kneaded into an intimate paste, which was then spread at a rate of 0.1 g/cm2 on a non-woven fabric. The surface of the paste was covered with a polypropylene film, whereby a diclofenac sodium plaster containing 0.5 mg of diclofenac sodium per cm2 was obtained. The stress of the paste of the diclofenac sodium plaster was 0.8 N (0.8 x 105 dyne)/cm2 when measured by the method described above.
13.5 grams of polyvinyl alcohol was dissolved in 76.5 g of purified water which had been heated to 90°C. After the former was dissolved in the latter, the resultant solution was cooled to room temperature (A). While 5 g of propylene glycol was being heated to 40°C, 1 g of diclofenac sodium was dissolved therein, followed by the addition of 1 g of 1-menthol (B). The solutions (A) and (B) were combined and stirred into an intimate solution. The solution was then subjected to a centrifugator to deaerate the same. The solution so deaerated was poured at a rate of 0.1 g/cm2 into a mold and then hermetically sealed. The mold with the solution filled therein was stored for 24 hours in a freezer controlled at -20°C, whereby the solution was lyophilized. The lyophilizate so formed was thawed at 10°C and the resulting sheet was then taken out. The sheet was sandwiched between polyurethane sheets, whereby a diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained. The stress of the paste of the diclofenac sodium plaster was 1.6 x 10-1 N (1.6 x 104 dyne)/cm2 when measured by the method described above.
A diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained in a similar manner to Example 1 except for the addition of concentrated glycerin instead of propylene glycol.
A diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained in a similar manner to Example 1 except for the addition of purified water in place of 1-menthol.
A diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained in a similar manner to Example 1 except that concentrated glycerin and purified water were added in lieu of propylene glycol and 1-methanol, respectively, and 1 g of diclofenac sodium was uniformly dispersed.
A diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained in a similar manner to Example 4 except that purified water was added instead of propylene glycol and 1-menthol and 1 g of diclofenac sodium was uniformly dispersed.
A diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained in a similar manner to Example 4 except that purified water was added instead of propylene glycol and 1 g of diclofenac sodium was uniformly dispersed.
A diclofenac sodium plaster containing 1 mg of diclofenac sodium per cm2 was obtained in a similar manner to Example 4 except that purified water was added instead of 1-menthol.
The diclofenac sodium plasters prepared in Example 1 and Comparative Examples 1, 2 and 3, respectively, were each applied to the shaved backs (30 cm2 area) of three male guinea pigs (species: Hartley, age: 4 weeks old, body weight: 250-300 g). From each guinea pig, blood samples were collected through a cannula inserted in the carotid before the application of the plaster and upon elapsed times of 2, 4, 6 and 8 hours after the application of the plaster. The diclofenac concentrations in the plasmas of the respective blood samples were measured by HPLC, whereby changes in the diclofenac sodium concentration in plasma were observed. The results are diagrammatically shown in FIG. 1.
The diclofenac sodium plasters prepared in Example 4 and Comparative Example 4, respectively, were each applied to the shaved backs (30 cm2 area) of three male guinea pigs (species: Hartley, age: 4 weeks old, body weight: 250-300 g). From each guinea pig, blood samples were collected through a cannula inserted in the carotid before the application of the plaster and upon elapsed times of 2, 4, 6 and 8 hours after the application of the plaster. The diclofenac concentrations in the plasmas of the respective blood samples were measured by HPLC, whereby changes in the diclofenac sodium concentration in plasma were observed. The results are diagrammatically shown in FIG. 2.
As is evident from these results, excellent transdermal absorption is observed only when 1-methanol and propylene glycol are added in combination.
Claims (8)
- A process for producing a diclofenac sodium plaster comprising a backing material and a paste spread on the backing material, said paste comprising diclofenac sodium, a penetration enhancer composed of 1-menthol and propylene glycol, and a hydrophilic base composed principally of a water-soluble polymer, said process comprising the step of spreading the paste on the backing material or sandwiching the paste between a backing material and a protective film.
- The process of claim 1, wherein diclofenac sodium is contained in an amount of 0.5-20 wt.% based on the paste.
- The process of claim 1, wherein the water-soluble polymer is selected from the group consisting of polyacrylic acid, sodium polyacrylate, carboxyvinyl polymer, sodium carboxymethylcellulose, polyvinyl pyrrolidone, polyvinyl alcohol, hydroxypropylcellulose, hydroxyethylcellulose, ethylcellulose, alginic acid, sodium alginate, and gelatin.
- The process of claim 1, wherein the water-soluble polymer is used in an amount of 0.5-40 wt.% based on the paste.
- The process: of claim 1, wherein propylene glycol is used in an amount of 0.1-60 wt.% based on the paste.
- The process of claim 1, wherein 1-menthol is used in an amount of 0.05-10 wt.% based on the paste.
- The process of claim 1, wherein the stress of the paste ranges from 5 x 10-2 to 5 N (5 x 103 to 5 x 105 dyne)/cm2 as measured by a pressure-sensing shaft having a disk-shaped adapter having a diameter of 15 mm, against which a central part of a sample of the paste is pressed at a compression speed of 300 mm/min, when the paste has been pressed over a distance of 2 mm after having contacted the adapter.
- The process of claim 1, wherein the backing material is a woven or non-woven fabric of rayon, polyester, polyolefin or polyurethane fibers, a polymer film, or a foamed sheet.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP187532/91 | 1991-07-26 | ||
| JP03187532A JP3086290B2 (en) | 1991-07-26 | 1991-07-26 | Diclofenac sodium patch |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| HK1007105B true HK1007105B (en) | 1999-04-01 |
| HK1007105A1 HK1007105A1 (en) | 1999-04-01 |
Family
ID=16207737
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| HK98106294A HK1007105A1 (en) | 1991-07-26 | 1998-06-24 | Diclofenac sodium plaster |
Country Status (8)
| Country | Link |
|---|---|
| US (1) | US5208035A (en) |
| EP (1) | EP0524582B1 (en) |
| JP (1) | JP3086290B2 (en) |
| KR (1) | KR100199695B1 (en) |
| CA (1) | CA2074050C (en) |
| DE (2) | DE122004000002I1 (en) |
| ES (1) | ES2097837T3 (en) |
| HK (1) | HK1007105A1 (en) |
Families Citing this family (25)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5318960A (en) * | 1992-06-03 | 1994-06-07 | Frank Toppo | System for transdermal delivery of pain relieving substances |
| JP2523428B2 (en) * | 1992-12-04 | 1996-08-07 | エスエス製薬株式会社 | Anti-inflammatory analgesic gel formulation |
| WO1994013257A1 (en) * | 1992-12-16 | 1994-06-23 | Creative Products Resource Associates, Ltd. | Occlusive/semi-occlusive lotion for treatment of a skin disease or disorder |
| JPH06247846A (en) * | 1993-02-22 | 1994-09-06 | Toko Yakuhin Kogyo Kk | Composition for percutaneous absorption preparation of ritodrine hydrochloride |
| JP3526887B2 (en) * | 1993-04-23 | 2004-05-17 | 帝國製薬株式会社 | Anti-inflammatory analgesic external patch |
| US5554650A (en) * | 1994-07-28 | 1996-09-10 | Southern Research Institute | Antiphlogistic, analgesic, antipyretic injection preparation |
| KR100191062B1 (en) * | 1994-09-16 | 1999-06-15 | 나카토미 히로타카 | External patch |
| CN1210463A (en) * | 1996-02-07 | 1999-03-10 | 株式会社津村 | Transparent aqueous solution of diclofenac sodium and medicinal compositions with the use of the same |
| KR19990026792A (en) * | 1997-09-26 | 1999-04-15 | 김윤 | Matrix Patches Containing Diclofenac Diethylammonium Salt |
| US6193996B1 (en) | 1998-04-02 | 2001-02-27 | 3M Innovative Properties Company | Device for the transdermal delivery of diclofenac |
| GB0015617D0 (en) * | 2000-06-26 | 2000-08-16 | Vectura Ltd | Improved preparations for dermal delivery of active substances |
| KR100363476B1 (en) * | 2000-06-27 | 2002-12-05 | 대신제약주식회사 | Transdermal plaster comprising diclofenac or its salt |
| AU2003211297B2 (en) | 2002-02-19 | 2007-12-06 | Hisamitsu Pharmaceutical Co., Inc. | Percutaneous absorption type plaster |
| JP5300169B2 (en) * | 2002-03-29 | 2013-09-25 | 小林製薬株式会社 | Anti-inflammatory analgesic containing phenylacetic acid derivatives and menthol and method for enhancing anti-inflammatory analgesic action |
| WO2005094814A1 (en) * | 2004-03-31 | 2005-10-13 | Kowa Co., Ltd. | External preparation |
| EP1833471B1 (en) * | 2004-12-15 | 2015-03-25 | Teikoku Seiyaku Co., Ltd. | External patches containing etofenamate |
| RS50693B (en) * | 2005-06-14 | 2010-06-30 | Uni-Pharma Kleon Tsetis Pharmaceutical | STABLE PHARMACEUTICAL GEL DICLOFENAC SODIUM |
| WO2010103843A1 (en) * | 2009-03-11 | 2010-09-16 | 興和株式会社 | External preparation containing analgesic/anti-inflammatory agent |
| JP5421063B2 (en) | 2009-10-23 | 2014-02-19 | 帝國製薬株式会社 | Diclofenac sodium-containing aqueous patch |
| JP5358551B2 (en) * | 2010-12-07 | 2013-12-04 | 小林製薬株式会社 | Anti-inflammatory analgesic containing phenylacetic acid derivatives and menthol and method for enhancing anti-inflammatory analgesic action |
| ITMI20111355A1 (en) | 2011-07-20 | 2013-01-21 | Epifarma Srl | TRANSDERMIC PATCH CONTAINING DICLOFENAC AND TIOCOLCHICOSIDE |
| US11020356B2 (en) | 2016-12-28 | 2021-06-01 | Hisamitsu Pharmaceutical Co., Inc. | Drug-containing patch |
| CN110151685A (en) * | 2019-07-01 | 2019-08-23 | 李云昆 | A kind of externally-used pain-relieving composition and preparation method |
| US20220378729A1 (en) * | 2019-11-06 | 2022-12-01 | Smartech Topical, Inc. | Topical formulations of cyclooxygenase inhibitors and their use |
| US11872320B2 (en) | 2021-02-25 | 2024-01-16 | Hisamitsu Pharmaceutical Co., Inc. | Method for treating osteoarthritis |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2045618B (en) * | 1979-04-03 | 1983-05-11 | Hisamitsu Pharmaceutical Co | Adhesive plaster |
| JPS59227819A (en) | 1983-06-09 | 1984-12-21 | Nitto Electric Ind Co Ltd | Plaster for anti-inflammatory and analgesic use |
| US4543251A (en) * | 1983-12-09 | 1985-09-24 | Toko Yakuhin Industry Co., Ltd. | Gel preparations for external application |
| US4931283A (en) * | 1983-12-22 | 1990-06-05 | American Home Products Corp. (Del) | Menthol enhancement of transdermal drug delivery |
| US4933184A (en) * | 1983-12-22 | 1990-06-12 | American Home Products Corp. (Del) | Menthol enhancement of transdermal drug delivery |
| CA1248450A (en) * | 1984-04-05 | 1989-01-10 | Kazuo Kigasawa | Soft patch |
| JPS61293911A (en) * | 1985-06-24 | 1986-12-24 | Teisan Seiyaku Kk | Sustained release preparation |
| US4855142A (en) * | 1987-02-27 | 1989-08-08 | Ciba-Geigy Corporation | Pharmaceutical plaster |
| JP2677371B2 (en) * | 1988-01-30 | 1997-11-17 | 帝國製薬株式会社 | Hydrous smoking substitute patch |
| JPH07106982B2 (en) * | 1988-08-11 | 1995-11-15 | エスエス製薬株式会社 | Topical drug composition |
-
1991
- 1991-07-26 JP JP03187532A patent/JP3086290B2/en not_active Expired - Lifetime
- 1991-12-03 US US07/801,901 patent/US5208035A/en not_active Expired - Lifetime
-
1992
- 1992-07-08 KR KR1019920012116A patent/KR100199695B1/en not_active Expired - Lifetime
- 1992-07-16 CA CA002074050A patent/CA2074050C/en not_active Expired - Lifetime
- 1992-07-20 ES ES92112382T patent/ES2097837T3/en not_active Expired - Lifetime
- 1992-07-20 EP EP92112382A patent/EP0524582B1/en not_active Expired - Lifetime
- 1992-07-20 DE DE200412000002 patent/DE122004000002I1/en active Pending
- 1992-07-20 DE DE69217288T patent/DE69217288T8/en not_active Expired - Lifetime
-
1998
- 1998-06-24 HK HK98106294A patent/HK1007105A1/en not_active IP Right Cessation
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