multiple - unit tableted dosage form : the multiple - unit tableted dosage form of the invention illustrated in fig1 consists of a tablet body 1 optionally covered by a film layer 3 and small pellets 2 distributed at random in the tablet body 1 . the pellets 2 contain an acid - susceptible proton pump inhibitor in form of the racemate , an alkaline salt or one of its enantiomers . the individual units 2 ( small beads , granules or pellets ) containing the acid - susceptible proton pump inhibitor and optionally containing alkaline substances , are coated with a layer ( s ) possessing delayed release and / or extended release and optionally an additional enteric coating layer . the coated units , 2 are then mixed with the h2 receptor antagonist and conventional tablet excipients forming , in combination , the tablet body 1 . the h2 receptor antagonist and tablet excipients may be dry mixed or wet mixed into granules . the mixture of coated layered units , h2 receptor antagonist and excipients are compressed into the multiple unit tableted dosage forms . by the expression “ individual units ” is meant small beads , granules or pellets , in the following referred to as proton pump inhibitor pellets . in yet another embodiment of the invention , also the h2 receptor antagonist is coated onto the “ individual units ”. then the h2 receptor antagonist must be positioned in a peripheral position in relation to the coating layers for delayed and / or extended release and enteric release , in order to be rapidly released in the gastro - intestinal tract . in compressing the mixture into tablets , care must be taken not to significantly affect the acid resistance of the coated pellets . in regard of the core material for coating layered pellets comprising an acid - susceptible proton pump inhibitor reference is made to wo 97 / 25066 , page 13 , second to last paragraph , to page 15 , end of second paragraph , which are hereby incorporated by reference . in regard of the coating layer ( s ) exerting the delayed and / or extended release reference is made to u . s . pat . no . 6 , 274 , 173 , which are hereby incorporated as reference . reference is also made to “ pharmaceutics . the science of dosage form design .”, 1 st edition ; ed . m . e . aulton , churchill livingstone , edinburgh 1988 . reference is then especially made to pages 289 - 305 . in regard of the enteric coating layer ( s ) reference is made to wo 97 / 25066 , page 15 , second to last paragraph , to page 18 , end of second paragraph , which are hereby incorporated by reference . the acid - susceptible proton pump inhibitor pellets covered with layers for delayed and / or extended release and optionally an enteric coating layer ( s ) may be further covered with one or more over - coating layers . in regard of such over - coating layer ( s ) reference is made to wo 97 / 25066 , page 18 , last paragraph , to page 19 , end of first paragraph , which are hereby incorporated by reference . the h2 receptor antagonist is dry mixed with inactive excipients such as filler , binders , disintegrants , and other pharmaceutically acceptable additives . the mixture is wet massed with a granulation liquid . the wet mass is dried preferably to a loss on drying of less than 3 % by weight . then the dry mass is milled to a suitable size for granules , preferably smaller than 1 mm . suitable inactive excipients are , for instance , mannitol , corn starch , potato starch , low substituted hydroxypropyl cellulose , microcrystalline cellulose and crosslinked polyvinylpyrrolidone . the dry mixture comprising the h2 receptor antagonist may be mixed with a suitable granulation liquid comprising , for instance , hydroxypropylcellulose or polyvinyl - pyrrolidone dissolved in water or alcohol or their mixtures . alternatively the h2 receptor antagonist is dry mixed with pharmaceutically acceptable excipients ( see supra ). as mentioned above , in another embodiment of the invention the h2 receptor antagonist can be coated onto the small units , 2 , rather than mixed with excipients to form the tablet body , 1 . irrespective of how the h2 receptor antagonist is incorporated it should possess a rapid release . multi - unit tablets : the coated layered pellets comprising an acid - susceptible proton pump inhibitor are mixed with the h2 receptor antagonist granules or with the prepared dry mixture comprising the h2 receptor antagonist . the mixture is admixed with lubricant ( s ) and compressed into a multiple unit tableted dosage form . suitable lubricants for the tableting process are , for instance , sodium stearyl fumarate , magnesium stearate and talc . the compressed tablets are optionally covered with film - forming agent ( s ) to obtain a smooth surface . such a coating layer may further comprise additives such as anti - tacking agents , colorants and pigments or other additives . the fraction of coated pellets preferably constitutes less than 60 % by weight of the total tablet weight . the preferred multiple - unit table formulation thus consists of delayed and / or extended release coated layered pellets optionally coated with an enteric coating layer , comprising the acid - susceptible proton pump inhibitor , optionally in admixture with alkaline reacting compound ( s ), compressed into tablets with the prepared h2 receptor antagonist / excipient ( s ) mixture . the optional enteric coating layer ( s ) make ( s ) the pellets of the dosage form insoluble in acidic media but disintegrating / dissolving in near neutral to alkaline media , such as the gastric fluid present in the proximal part of the small intestine where the dissolution and uptake of the acid - susceptible proton pump inhibitor is desired . the delayed release coating layer , will then start to release the acid susceptible proton pump inhibitor after a certain time period in the gastrointestinal tract or at a certain ph , reached at some position in the intestine or colon . the extended release coating layer will extend the release of the proton pump inhibitor in order to result in drug absorption during several hours . the delayed and / or extended release coated proton pump inhibitor pellets may also be covered with an overcoating layer before being formulated into tablets , and they may also contain one or more separating layer ( s ) in between the core material and the other layers . process for making multi - unit tablets : the process for the manufacture of this dosage form represents a further aspect of the invention . after formulating the pellets by dry mixing ( ordered mixture ), spray coating or layering of the acid - susceptible proton pump inhibitor onto seeds , or by extrusion / spheronization or granulation , the pellets are first optionally covered with the separating layer ( s ) and then covered with the delayed and / or extended release layer ( s ) and then optionally covered with the enteric coating layer ( s ). the coating is carried out as described above and in the accompanying examples . the preparation of the h2 receptor antagonist mixture is also described in the examples . optionally the h2 receptor antagonist can be coated onto the already existing layers comprising delayed and / or extended release layer ( s ) and enteric coating layer . the coated pellets , with or without an overcoat , are mixed with the prepared h2 receptor antagonist granules or dry powder , tablet excipients and other pharmaceutically acceptable additives and compressed into tablets . alternatively , the coated proton pump inhibitor pellets may be covered by a second layer containing the h2 receptor antagonist as described in the following examples . furthermore , as illustrated in fig2 , the coated pellets 4 may be intimately mixed with excipients 5 and pre - compressed whereafter the h2 receptor antagonist preparation 7 is added and the entire tablet mass finally compressed into a tablet , optionally with film - forming agent ( s ) 6 to obtain a smooth surface . as a further alternative illustrated in fig3 , the acid - susceptible proton pump inhibitor in the form of a powder may be mixed with tablet excipients and compressed into a tablet 8 which is optionally covered with a separating layer and thereafter covered with delayed and / or extended release coating 9 . optionally , an enteric coating layer is applied . the thus produced tablet core is subsequently press - coated with the h2 receptor antagonist preparation 10 . finally the table may be covered with a tablet coat 11 to obtain a smooth surface . it is also possible to fill the acid - susceptible proton pump inhibitor in form of coated layered pellets in a sachet together with h2 receptor antagonist and optionally mixed with excipients . fig4 illustrates a hard gelatin capsule 16 filled with the uncompressed core material 14 , 15 of the embodiment of fig1 . in the examples given ( fig1 , 2 , 3 and 4 ) the terms coating , coating layer or layer have been used . these terms are exchangeable and also identical to the term membrane . irrespective of the nomenclature they have in common that they correspond to more or less continuous phases of excipient materials applied by e . g . spraying onto a core material . due to the nature of the processing these membranes are relatively thin with regard to thickness . suitable excipient materials for forming coatings layers ( or membranes ) for delayed and / or extended release are non - polymeric — or polymeric materials such as calcium phosphate , ethyl cellulose , methacrylate copolymer , polyamide , polyethylene , polyvinyl alcohol or polyvinyl acetate . further , the proton pump - containing part of the formulations ( 2 in fig1 , 4 in fig2 , 8 in fig3 and 15 in fig4 ) have above been described to exert their delayed and / or extended release effect by applying coatings to a core material of the proton pump inhibitor . however , another approach is instead to exchange the coating layer ( s ), i . e . the membrane system to a matrix system . the excipients are then chosen to form a lipid or water insoluble matrix . the function of the matrix is then to exert an extended release of the proton pump inhibitor . suitable matrix forming excipients are non - polymeric — or polymeric materials such as calcium phosphate , ethyl cellulose , methacrylate copolymer , polyamide , polyethylene or polyvinyl acetate , carnauba wax , cetyl alcohol , hydrogenated vegetable oils , microcrystalline waxes , mono - and triglycerides , polyethylene glycol or polyethylene glycol monostearate and most preferably carnauba wax , cetyl alcohol , hydrogenated vegetable oils , microcrystalline waxes , mono - and triglycerides , polyethylene glycol or polyethylene glycol monostearate . in order to obtain an optimal release rate , hydrophilic , pore - forming excipients can be optionally added . suitable hydrophilic , pore forming materials are alginates , carbopol , gelatin , hydroxypropyl cellulose , hydroxypropyl metylcellulose or metylcellulose . in general , the methods of wo 97 / 25066 for making oral pharmaceutical dosage forms comprising an acid susceptible proton pump inhibitor and an antacid agent or alginate can be adapted to suit the purpose of the present invention by firstly , adding the membrane — or matrix system to the part of the formulation that contains the proton pump inhibitor and secondly , by substituting part or the entire amount of antacid agent or alginate by a pharmacologically effective amount of an h2 receptor antagonist , the remainder of the antacid agent or alginate ( if substitution is not 1 : 1 by weight ) being omitted or substituted by excipients like microcrystalline cellulose , silica , lactose , mannitol , ant the like . the dosage forms according to the invention are especially advantageous in the treatment of dyspepsia and other gastrointestinal disorders related to the production of gastric acid to provide quick and lasting relief from symptoms . the dosage forms are administered once or several times a day . the typical daily dose of the acid - susceptible proton pump inhibitor and the h2 receptor antagonist will depend on various factors such as individual requirements of patients , the mode of administration , and the particular condition to be treated . in general each dosage form will comprise from 1 mg to 100 mg of acid - susceptible proton pump inhibitor and from 1 to 800 mg of the h2 receptor antagonist . preferably each dosage form will comprise from 5 to 50 mg of the acid - susceptible proton pump inhibitor and from 5 to 200 mg of the h2 receptor antagonist . the multiple unit tablet preparation is also suitable for dispersion in water , which has been made slightly acidic by the addition of citric acid . multiple - unit tableted dosage form comprising magnesium omeprazole and cimetidine hydrochloride ; batch size 400 tablets . for omeprazole mg - salt pellet production ( core material , separating layer , enteric coating layer and over - coating layer , see wo 97 / 25066 , p . 22 - 23 under respective headings ), see wo 97 / 25066 , first two paragraphs , all of which is hereby incorporated by reference . the extended release layer is applied , by a coating process , in between the separation layer and the enteric coating layer , in accordance with what is described in patent u . s . pat . no . 6 , 274 , 173 , example 1 - 4 , using ethyl cellulose or polyvinyl acetate as extended release forming excipients , the information under which is hereby incorporated as reference . a small amount of the potato starch is dissolved in purified hot water to form the granulation liquid . cimetidine hydrochloride , the rest of potato starch and microcrystalline cellulose are dry mixed . the granulation liquid is added to the dry mixture and the mass is wet mixed . the wet mass is dried in an oven at 50 ° c . the prepared granulation is milled through sieve 1 mm in an oscillating mill equipment . the coated pellets with an over - coating layer , the prepared h2 receptor antagonist granules , cross - linked polyvinylpyrrolidone and sodium stearyl fumarate are mixed and compressed into tablets using a tableting machine equipped with oval punches . the amount of omeprazole in each tablet is approx . 10 mg and the amount of cimetidine hydrochloride is approx . 100 mg . by a slight modification this multiple - unit tablet form can be made to comprise an antacid agent ( instead of microcrystalline cellulose , 300 mg : microcrystalline cellulose , 100 g ; calcium carbonate , 100 mg ; magnesium oxide , 100 mg ; all other constituents , except water , in the amounts given above ). the tablet comprises the acid - susceptible proton pump inhibitor omeprazole , a separating layer and a core layer comprising cimetidine hydrochloride . batch size 1000 tablets . the constituents of the first tablet layer are dry mixed and pre - compressed as a first layer in a tableting machine equipped with oval punches . microcrystalline cellulose is filled on the top of the first layer to form a separating layer to the next layer . the constituents of the second tablet layer are dry mixed and filled on top of the separating layer . the three layers are compressed into a three - layer tablet , which may be coated by a tablet coating layer . the amount of omeprazole is approx . 10 mg and that of cimetidine hydrochloride approx . 200 mg per tablet . no . 1 hard gelatin capsules ( 16 ) ( fig4 ; volume 0 . 48 ml ) were filled with extended release - coated omeprazole pellets ( 15 ) containing 20 mg omeprazole ( as prepared in example 1 ) and a dry mixture 14 of commercially available famotidine 20 mg and closed . extended release pellets containing 15 mg lansoprazole ( as prepared in analogy with example 1 ) and the famotidine preparation were dry mixed with citric acid . single dose portions thereof containing 10 mg each of lansoprazole and famotidine hydrochloride and 200 mg powderous citric acid were dry packed in plastic laminate . the composition is intended to be poured into 20 ml of water , stirred for a short time , and swallowed . the capsule comprises magnesium omeprazole and famotidine hydrochloride . for extended release coating layer , see u . s . pat . no . 6 , 274 , 173 , example 1 - 4 , the information under which is hereby incorporated as reference . for enteric coating layer and over - coating layer , see wo 97 / 25066 , page 22 - 23 under respective headings , the information under which is hereby incorporated by reference . magnesium omeprazole is mixed with microcrystalline cellulose spheres to an ordered mixture . the ordered mixture is coated with an extended release layer , consisting of polyvinyl acetate , micronised lactose , propylene glycol and ammonia ( 25 %) in a fluid bed apparatus . these extended release pellets were the coated with an enteric coating layer consisting of methacrylic acid copolymer , mono - and diglycerides , triethyl citrate and polysorbate in a fluid bed apparatus . the extended release / enteric coated ordered units is then over - coated with a water suspension containing famotidine hydrochloride , hydroxypropylmethyl cellulose and magnesium stearate in a fluid bed apparatus . the extended release / enteric coated ordered mixture with an over - coating layer was filled into hard gelatin capsules . the amount of omeprazole is approx . 10 mg and that of famotidine hydrochloride approx . 20 mg per capsule . the tablet comprises magnesium omeprazole and cimetidine hydrochloride . magnesium omeprazole is mixed with mannitol granules to an ordered mixture which is coated with both an extended release coating layer and an enteric coating layer as described in example 5 . cimetidine hydrochloride is granulated as described in example 1 . the coated ordered mixture comprising magnesium omeprazole , the cimetidine granules and excipients are dry mixed and compressed into tablets . the amount of omeprazole in each tablet is approx . 10 mg and that of cimetidine is approx . 100 mg . multiple - unit tableted dosage form for instant release of h2 receptor antagonist and colon extended release of proton pump inhibitor . the tablet comprises magnesium omeprazole and cimetidine hydrochloride . suspension layering was performed in a fluid bed apparatus . omeprazole magnesium salt was sprayed onto sugar sphere seeds from a water suspension containing the dissolved binder and polysorbate 80 . the size of sugar sphere seeds were in the range of 0 . 25 to 0 . 35 mm . the prepared core material was covered with both an extended release layer and a delayed release layer in a fluid bed apparatus with commercially available water - based suspensions , eudragit ® rtm and eudragit ® fs 30 d , respectively . the enteric coating layer consisting of methacrylic acid copolymer , mono - and diglycerides , triethyl citrate and polysorbate was sprayed onto the pellets covered with extended / delayed release layers in a fluid bed apparatus . the enteric coating layered pellets were classified by sieving . a small amount of the potato starch was dissolved in hot purified water to form the granulation liquid . cimetidine hydrochloride , calcium carbonate , magnesium hydroxide and potato starch were dry - mixed . the granulation liquid was added to the dry mixture and the mass was wet - mixed . the wet mass was dried in a steamoven at 40 deg c . the prepared granulation was milled through sieve 1 mm in an oscillating mill equipment . the multiple coated layered pellets , prepared granules , polyvidone crosslinked , microcrystalline cellulose and sodium stearyl fumarate were mixed and compressed into tablets using a tableting machine equipped with 9 . times . 20 mm oval punches . the amount of omeprazole in each tablet was approx . 20 mg and the same amount was used for cimetidine hydrochloride . optionally the obtained tablets were covered with a tablet coating layer .
an oral pharmaceutical dosage form comprises pharmacologically effective amounts of an acid - susceptible proton pump inhibitor and an h2 receptor antagonist in combination with at least on pharmacologically acceptable excipient which causes a delayed release and / or an extended release of the proton pump inhibitor . the h2 receptor antagonist is included in the dosage form in such a way that it is rapidly released after administration . this dosage form is suitable for the treatment of conditions associated with an excessive secretion of gastric acid and provides a suitable combination of a rapid onset and a long - lasting duration of the effect . the invention also relates to a method for manufacturing such a dosage form and to a method for the treatment of conditions associated with the secretion of gastric acid .