Levetiracetam+nonsteroidal anti-inflammatory drug binary systems: A contribution to the development of new solid dosage forms

Novel drug-drug salt crystals of metformin with ibuprofen or naproxen: Improved solubility, dissolution rate, and synergistic antinociceptive effects

As the monotherapy of available analgesics is usually accompanied by serious side effects or limited efficacy in the management of chronic pain, multimodal analgesia is widely used to achieve improved benefit-to-risk ratios in clinic. Drug-drug salts are extensively researched to optimize the physicochemical properties of active pharmaceutical ingredients (APIs) and achieve clinical benefits compared with individual APIs or their combination. New drug-drug salt crystals metformin-ibuprofen (MET-IBU) and metformin-naproxen (MET-NAP) were prepared from metformin (MET) and two poorly water-soluble anti-inflammatory drugs (IBU and NAP) by the solvent evaporation method. The structures of these crystals were confirmed by single crystal and powder X-ray diffraction, Hirshfeld surface, Fourier transform infrared spectroscopy and thermal analysis. Both MET-IBU and MET-NAP showed significantly improved solubility and intrinsic dissolution rate than the pure IBU or NAP. The stability test indicated that MET-IBU and MET-NAP have excellent physical stability under stressing test (10 days) and accelerated conditions (3 months). Moreover, isobolographic analysis suggested that MET-IBU and MET-NAP exerted potent and synergistic antinociceptive effects in λ-Carrageenan-induced inflammatory pain in mice, and both of them had an advantage in rapid pain relief. These results demonstrated the potential of MET-IBU and MET-NAP to achieve synergistic antinociceptive effects by developing drug-drug salt crystals.

Combination Drug Therapy for the Management of Chronic Neuropathic Pain

Chronic neuropathic pain (NP) is an increasingly prevalent disease and leading cause of disability which is challenging to treat. Several distinct classes of drugs are currently used for the treatment of chronic NP, but each drug targets only narrow components of the underlying pathophysiological mechanisms, bears limited efficacy, and comes with dose-limiting side effects. Multimodal therapies have been increasingly proposed as potential therapeutic approaches to target the multiple mechanisms underlying nociceptive transmission and modulation. However, while preclinical studies with combination therapies showed promise to improve efficacy over monotherapy, clinical trial data on their efficacy in specific populations are lacking and increased risk for adverse effects should be carefully considered. Drug-drug co-crystallization has emerged as an innovative pharmacological approach which can combine two or more different active pharmaceutical ingredients in a single crystal, optimizing pharmacokinetic and physicochemical characteristics of the native molecules, thus potentially capitalizing on the synergistic efficacy between classes of drugs while simplifying adherence and minimizing the risk of side effects by reducing the doses. In this work, we review the current pharmacological options for the treatment of chronic NP, focusing on combination therapies and their ongoing developing programs and highlighting the potential of co-crystals as novel approaches to chronic NP management.

Challenges and Progress in Nonsteroidal Anti-Inflammatory Drugs Co-Crystal Development

Co-crystal innovation is an opportunity in drug development for both scientists and industry. In line with the “green pharmacy” concept for obtaining safer methods and advanced pharmaceutical products, co-crystallization is one of the most promising approaches to find novel patent drugs, including non-steroidal anti-inflammatory drugs (NSAID). This kind of multi-component system improves previously poor physicochemical and mechanical properties through non-covalent interactions. Practically, there are many challenges to find commercially viable co-crystal drugs. The difficulty in selecting co-formers becomes the primary problem, followed by unexpected results, such as decreased solubility and dissolution, spring and parachute effect, microenvironment pH effects, changes in instability, and polymorphisms, which can occur during the co-crystal development. However, over time, NSAID co-crystals have been continuously updated regarding co-formers selection and methods development.

Enhanced Dissolution of Naproxen by Combining Cocrystallization and Eutectic Formation

Improving dissolution properties of active pharmaceutical ingredients (APIs) is a critical step in drug development with the increasing occurrence of sparingly soluble APIs. Cocrystal formation is one of the methods to alter the physicochemical properties of APIs, but its dissolution behavior in biorelevant media has been scrutinized only in recent years. We investigated the combined strategy of cocrystallization and eutectic formation in this regard and utilized the cocrystal model system of naproxen and three pyridinecarboxamide isomers. Binary melting diagrams were constructed to discover the eutectic compositions of the three cocrystals with excess amounts of pyridinecarboxamides. The melt-crystallized eutectics and cocrystals were compared in their dissolution behaviors with respect to neat naproxen. The eutectics enhanced the early dissolution rates of the cocrystals in both the absence and presence of biologically relevant bile salt and phospholipid components, whereas the cocrystal dissolution was expedited and delayed, respectively. The combined strategy in the present study will be advantageous in maximizing the utility of the pharmaceutical cocrystals.

Emerging Multi-Drug Eutectics: Opportunities and Challenges

Complexity and heterogeneous nature of most diseases have posed greater challenges in the modern healthcare system. Fixed-dose combination can offer an ideal way to improve patient compliance and higher therapeutic efficacy. However, biopharmaceutical issues associated with the drug combinations remain unaddressed. Multidrug eutectics (MDE) have demonstrated significant promise in improving the biopharmaceutical attributes with synergistic therapeutic action. Eutectic mixtures are the multicomponent solid forms that possess lesser melting point than the individual components at a fixed composition. Non-covalent linking of drug combinations as MDE is an innovative strategy with enhanced solubility, dissolution, and mechanical and potential therapeutic efficacy. This review provides a comprehensive overview of the design of MDE, rational selection of drugs, characterization tools, and their therapeutic potential. Besides, the futuristic perspective where MDE could make a significant impact on combination therapy is briefly outlined. Graphical Abstract.

Eutectic mixtures as an approach to enhance solubility, dissolution rate and oral bioavailability of poorly water-soluble drugs

Eutectic mixtures have been known for a long time in the pharmaceutical field. However, its potential as a system to improve the solubility and dissolution of poorly water-soluble drugs remains little explored. Studies involving the microstructural characterization and the preparation of solid dosage forms containing eutectic mixtures are also an issue to be developed. Recently, the number of studies involving the preparation of eutectic mixtures to improve the solubility and oral bioavailability of poorly soluble drugs has increased considerably, including drug-carrier and drug-drug mixtures. In this review is discussed the potential of eutectic mixtures as an alternative pharmaceutical solid system to enhance drugs solubility, dissolution rate or oral bioavailability. Different aspects like history, physico-chemical, microstructural properties, preparation methods, mechanisms involved in solubility/dissolution enhancement, techniques for solid state characterization, in vivo studies, advantages, limitations and formulation perspective are also discussed.

Systematic comparison of racemic and enantiopure multicomponent crystals of phenylsuccinic acid—the role of chirality

Comparison of binary cocrystals of chiral and racemic carboxylic acids showed that the introduction of chiral building blocks may lead to the formation of subclasses of multicomponent crystals with unique Z′′/Z^r values combined with complex protonation stages of the molecules.