Influence of Solid Oral Dosage Form Characteristics on Swallowability, Visual Perception, and Handling in Older Adults

A systemic approach to estimate and validate RP-HPLC assay method for remdesivir and favipiravir in capsule dosage form

The implementation of quality by design offer quality and safety product to patients, efficient processes for continuous improvements to manufacturers, negligible amount of batch failures and robust product quality attributes. This study was designed to establish a simple, specific, precise, and accurate reverse phase-high performance liquid chromatographic (RP-HPLC) method for the quantitative determination of remdesivir and favipiravir in Capsule dosage forms. The RP-HPLC method was performed on a Kromasil 100A C18 column (250 mm x 4.6 mm, 5 μm particle size) with a mobile phase containing (50 mL of acetonitrile, 350 mL methanol, 100ml of water and 0.5 mL of Phosphoric acid). The flow rate was 1.0 mL/min. The ultraviolet (UV) detection wavelength was 300 nm, and the column temperature was set at ambient. Linearity and range stock solutions were prepared as 50% to 150%. The calibration curves showed a good linear response ranged from 0.02 to 0.06 mg/ml (r=1.0000) for favipiravir and 0.022 to 0.066 mg/ml (r=1.0000) for remdesivir, and the average recoveries were 99.9% for favipiravir and 99.8% for remdesivir in assay test. The retention time of favipiravir was RT 11.5 minutes and remdesivir 20.95 minutes, tailing factor was not more than 1.5 and resolution of more than 2.0 respectively. The extended run time was supported by high concentration of favipiravir and uneven peak behavior of remdesivir in single run, which disturb resolution, retention times, injection repeatability. Reducing runtime on HPLC will lead to coelution of peaks, poor resolution, and loss of sensitivity during degradation profiling. This issue may be overcome with future UHPLC technique. The method was validated in accordance to International Council for Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) guidelines. The limit of detection (LOD) for Favipiravir was 0.104mg/ml and Remdesivir was 0.052mg/ml and limit of quantification (LOQ) for Favipiravir was 0.316mg/ml and Remdesivir was 0.158mg/ml respectively. In stress conditions, this product undergoes degradation and was considered sensitive to Acid, Alkali, Oxidation, reduction, hydrolysis, high temperature and humidity. The assay methods was simple, rapid, sensitive, repeatable, eco-friendly, stability indicating and can be used cost-effectively for the testing of these two drug substances in capsule dosage form. Due to the emergent need of antivirals for flu management, this coloaded combination was considered as dire need of society. Also, we reported that the product must be stored under ambient temperature, low humidity, and protected from light exposure.

Esophageal transit of solid oral dosage forms - impact of different surface materials characterized in vitro and in vivo by MRI in healthy volunteers

Acceptable swallowability and complete esophageal transit are decisive for the safe and effective administration of solid oral dosage forms. This applies in particular to the main user group of medicines, older adults, who often suffer from swallowing difficulties. It is well known that surface properties play an important role in this respect. In the past, this has led to the development of numerous coating formulations for tablets with improved swallowability. However, in vitro and especially in vivo data investigating a positive effect of different coating materials is limited. Therefore, we investigated coating materials being based on polyvinyl alcohol, hydroxypropyl methylcellulose, and a copolymer of methacrylate in respect to their influence on swallowability and esophageal transit of a tablet formulation. They were compared to uncoated tablets as well as to hard gelatin capsules. Three in vitro assays suitable for routine use in pharmaceutical development were performed: i.) Wettability test in artificial saliva; ii.) Swelling measurement in artificial saliva; iii.) Measurement of the adhesion between surface materials and a simulated mucosa surface. All three assays resulted in a differentiation of the surface materials. The coated tablets showed favorable behavior compared to uncoated tablets and hard gelatin capsules. To test the effect of the different materials in vivo, an intervention study was conducted. 36 adults were included and the likeliness of prolonged esophageal transit of (un-)coated tablets as well as a hard gelatin capsule of the same weight was objectively evaluated by means of magnetic resonance imaging. While hard gelatin capsules showed highest rates for prolonged esophageal transit, the tendency for adhesion was reduced for uncoated tablets, and least for coated tablets, i.e., prolonged esophageal transit in 22.2 %, 11.1 %, and ≤5.6 % of the cases, respectively. Further differentiation of the coating materials was not possible. Subjective evaluations of each participant with respect to subjective swallowability and esophageal transit did not correlate well with the objective measurements by means of magnetic resonance imaging. The use of coatings in general has a positive influence on esophageal transit. However, the selection of coating type seems to be of greater importance in respect to patients' oral perception of the dosage forms compared to their influence on the probability for prolonged esophageal transit.

VIDEOFLUOROSCOPIC EVALUATION OF THE IMPACT OF CAPSULE SIZE AND SUBJECT'S AGE AND GENDER ON CAPSULE SWALLOWING

BACKGROUND

People recurrently have difficulties swallowing solid medications, which can be associated with the size of the medication and the age and gender of individuals.

OBJECTIVE

To evaluate the impact of capsule size and adults' age and gender on oral and pharyngeal capsule transit during capsule swallows.

METHODS

Videofluoroscopy was used to measure capsule oral and pharyngeal transit during swallows in 49 healthy individuals (17 men and 32 women), with a mean age of 46 years (ranging from 23 to 88 years). Smaller capsules were filled with 0.50 mL of barium sulfate, and larger capsules were filled with 0.95 mL of barium sulfate; the volume of liquid ingested with the capsules was also quantified in each ingestion. The measurements included the oral preparation time, oral transit time, swallowing reaction time, time to laryngeal vestibule closure, laryngeal vestibule closure duration, pharyngeal transit time, and upper esophageal sphincter opening duration.

RESULTS

The capsule size did not influence either the oral or pharyngeal transit time. Increased liquid volume was ingested with larger capsules and by people older than 40 years. The oral transit time was shorter in older adults (60-88 years), and the time to laryngeal vestibule closure was longer in women.

CONCLUSION

The size of large capsules did not make a difference in oral or pharyngeal transit when compared with smaller capsules. The capsule size and the participant's age influenced the volume of liquid ingested - larger capsules and older individuals required a larger volume. The capsule oral transit was faster in individuals older than 60 years.

BACKGROUND

•Swallowing is influenced by the characteristics of what is being swallowed.

BACKGROUND

•There was no difference in swallowing capsules containing 0.50 mL or 0.95 mL.

BACKGROUND

•Larger capsules need more liquid ingestion to make swallowing easier.

BACKGROUND

•Individuals older than 40 years need a greater volume of liquid to swallow capsules than younger adults.