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Gaikwad SS, Morales JO, Lande NB, Catalán-Figueroa J, Laddha UD, Kshirsagar SJ. Exploring paediatric oral suspension development: Challenges, requirements, and formulation advancements. Int J Pharm 2024:124169. [PMID: 38688428 DOI: 10.1016/j.ijpharm.2024.124169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
Oral suspension is the most preferred dosage form for the paediatric population because of the difficulties related to solid medications, such as the swallowing limitations, bitter taste, and poor oral bioavailability, which can cause serious impairment to attain a successful treatment. Given the importance of successful therapies, there is a need for safe and effective commercially-available paediatric oral suspension and their characterization. For the latter, it is important to identify safe excipients and preservatives. The paediatric group is a diverse category which includes infants and teenagers, with major pharmacokinetics and pharmacodynamics differences, mainly because of physiological and behavioral variations. Therefore, finding a single formulation for paediatric population remains a challenge, as well asthe formulation of stable-in-time suspension. In addition, drug's dissolving characteristic and permeation, are the main determinants for oral absorption, which are closely related to drug release kinetics from the pharmaceutical form. In this context, drug release profile is an important and limiting step in oral bioavailability, particularly for BCS class II drugs; thus, it is possible to increase bioavailability and minimize adverse effects by changing the release rate of such drugs. This review covers all the aspects for paediatric oral suspension development, and analyses the considerations for excipients selection as a crucial task for effectively choosing a safe and effective pharmaceutical form and correctly dosing paediatric patients.
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Affiliation(s)
- Sachin S Gaikwad
- Department of Pharmaceutics, Sanjivani College of Pharmaceutical Education and Research, Savitribai Phule Pune University, At Sahajanandnagar, Post-Shinganapur, Tal-Kopargaon, Ahmednagar, Maharashtra 423603, India; Department of Pharmaceutics, MET's Institute of Pharmacy, Affiliated to Savitribai Phule Pune University, Bhujbal Knowledge City, Adgaon, Nashik 422003, India.
| | - Javier O Morales
- Department of Pharmaceutical Sciences and Technology, University of Chile. Santiago 8380494, Chile; Advanced Center for Chronic Diseases (ACCDiS), Chile; Center of New Drugs for Hypertension (CENDHY), Chile
| | - Narayan B Lande
- Department of Pharmaceutics, Sanjivani College of Pharmaceutical Education and Research, Savitribai Phule Pune University, At Sahajanandnagar, Post-Shinganapur, Tal-Kopargaon, Ahmednagar, Maharashtra 423603, India
| | - Johanna Catalán-Figueroa
- Departamento de Formación Transversal en Salud, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile
| | - Umesh D Laddha
- Department of Pharmaceutics, MET's Institute of Pharmacy, Affiliated to Savitribai Phule Pune University, Bhujbal Knowledge City, Adgaon, Nashik 422003, India; Regeron Inc., Chuncheon-si, Gangwon-do 24232, South Korea
| | - Sanjay J Kshirsagar
- Department of Pharmaceutics, MET's Institute of Pharmacy, Affiliated to Savitribai Phule Pune University, Bhujbal Knowledge City, Adgaon, Nashik 422003, India
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Wang L, Ding Z, Wang Z, Zhao Y, Wu H, Wei Q, Gao L, Han J. The Development of an Oral Solution Containing Nirmatrelvir and Ritonavir and Assessment of Its Pharmacokinetics and Stability. Pharmaceutics 2024; 16:109. [PMID: 38258119 PMCID: PMC10818454 DOI: 10.3390/pharmaceutics16010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/27/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Paxlovid®, a co-packaged medication comprised of separate tablets containing two active ingredients, nirmatrelvir (NRV) and ritonavir (RTV), exhibits good effectiveness against coronavirus disease 2019 (COVID-19). However, the size of the NRV/RTV tablets makes them difficult for some patients to swallow, especially the elderly and those with dysphagia. Therefore, an oral liquid formulation that can overcome this shortcoming and improve patient compliance is required. In this study, we developed a liquid formulation containing NRV and RTV by adopting strategies that used co-solvents and surfactants to enhance the solubility and inhibit possible recrystallization. The in vitro release results showed that NRV and RTV could be maintained at high concentrations in solution for a certain period in the investigated media. In vivo studies in rats showed that the oral bioavailability of NRV/RTV solution was significantly enhanced. Compared to Paxlovid® tablets, the AUC(0-t) of NRV and RTV increased by 6.1 and 3.8 times, respectively, while the Cmax increased by 5.5 times for both. Furthermore, the promoting effect of the absorption of RTV on the bioavailability of NRV was confirmed. Experiments with a beagle showed a similar trend. Stability studies were also conducted at 4 °C, 25 °C, and 40 °C for 90 days, indicating that the oral liquid formulation was physically and chemically stable. This study can be used as a valuable resource for developing and applying oral liquid NRV/RTV formulations in a clinical context.
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Affiliation(s)
- Lili Wang
- School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, China
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
| | - Zhuang Ding
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
| | - Zhengping Wang
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
| | - Yanna Zhao
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
| | - Hengqian Wu
- School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, China
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
| | - Qipeng Wei
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
| | - Lingfeng Gao
- School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, China
| | - Jun Han
- School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, China
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252000, China
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Chachlioutaki K, Iordanopoulou A, Bouropoulos N, Meikopoulos T, Gika H, Ritzoulis C, Andreadis D, Karavasili C, Fatouros DG. Pediatric and Geriatric-Friendly Buccal Foams: Enhancing Omeprazole Delivery for Patients Encountering Swallowing Difficulties. J Pharm Sci 2023; 112:2644-2654. [PMID: 37549845 DOI: 10.1016/j.xphs.2023.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
Buccal foams containing omeprazole (OME) have been developed as potential drug delivery systems for individuals encountering swallowing difficulties, particularly pediatric and geriatric patients. The buccal foams were formulated from lyophilized aqueous gels of maltodextrin, used as a sweetener, combined with various polymers (alginate, chitosan, gelatin, tragacanth) to fine tune their structural, mechanical, and physicochemical properties. Consistent with the requirements for efficient drug delivery across buccal epithelium, the foam comprised of hydroxypropyl methylcellulose and alginate (HPMC-Alg-OME), exhibited moderate hardness and high mucoadhesion resulting to prolonged residence and increased transport of the active across porcine epithelium. The HPMC-Alg-OME foam induced a 30-fold increase in the drug's apparent permeability across porcine buccal tissue, compared to the drug suspension. The developed buccal foams exhibited excellent stability, as evidenced by the unchanged omeprazole content even after six months of storage under ambient conditions (20 °C and 45% RH). Results indicate that buccal foams of omeprazole may address the stability and ease of administration issues related to oral administration of the drug, particularly for children and elderly patients who have difficulty swallowing solid dosage forms.
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Affiliation(s)
- Konstantina Chachlioutaki
- Department of Pharmacy Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece; Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
| | - Anastasia Iordanopoulou
- Department of Pharmacy Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Nikolaos Bouropoulos
- Department of Materials Science, University of Patras, Patras, Greece; Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature Chemical Processes, Patras, Greece
| | - Thomas Meikopoulos
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Helen Gika
- Laboratory of Forensic Medicine and Toxicology, Medical School, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Christos Ritzoulis
- Department of Food Science and Technology, International Hellenic University, Thessaloniki, Greece
| | - Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christina Karavasili
- Department of Pharmacy Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece; Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
| | - Dimitrios G Fatouros
- Department of Pharmacy Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece; Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece.
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Rouaz-El Hajoui K, Herrada-Manchón H, Rodríguez-González D, Fernández MA, Aguilar E, Suñé-Pou M, Nardi-Ricart A, Pérez-Lozano P, García-Montoya E. Pellets and gummies: Seeking a 3D printed gastro-resistant omeprazole dosage for paediatric administration. Int J Pharm 2023; 643:123289. [PMID: 37536640 DOI: 10.1016/j.ijpharm.2023.123289] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023]
Abstract
The production of 3D printed pharmaceuticals has thrived in recent years, as it allows the generation of customised medications in small batches. This is particularly helpful for patients who need specific doses or formulations, such as children. Compounding pharmacies seek alternatives to conventional solid oral doses, opting for oral liquid formulations. However, ensuring quality and stability, especially for pH-sensitive APIs like omeprazole, remains a challenge. This paper presents the application of semi-solid extrusion 3D printing technology to develop patient-tailored medicinal gummies, with an eye-catching appearances, serving as an innovative omeprazole pharmaceutical form for paediatric use. The study compares 3D printing hydrogels with dissolved omeprazole to hydrogels loaded with gastro-resistant omeprazole pellets, a ground-breaking approach.. Gastro-resistance and dissolution profiles were studied using different methods for better comparison and to emphasize the significance of the assay's methodology. Both developed formulas exhibit proper rheology, good printability, and meet content and mass uniformity standards. However, the high gastro-resistance and suitable release profile of 3D printed chewable semi-solid doses with enteric pellets highlight this as an effective strategy to address the challenge of paediatric medication.
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Affiliation(s)
- Khadija Rouaz-El Hajoui
- Departamento de Farmacia, Tecnología Farmacéutica y Físico Química, Facultad de Farmacia y Ciencias de la Alimentación. Universidad de Barcelona. Avda. Joan XXIII, 27-31. 08028 Barcelona, Spain
| | - Helena Herrada-Manchón
- Fundación Idonial. Parque Científico y Tecnológico de Gijón. Avda. Jardín Botánico, 1345. 33203 Gijón, Asturias, Spain
| | - David Rodríguez-González
- Fundación Idonial. Parque Científico y Tecnológico de Gijón. Avda. Jardín Botánico, 1345. 33203 Gijón, Asturias, Spain; Centro de Innovación en Química Avanzada (ORFEO-CINQA), Instituto Universitario de Química Organometálica "Enrique Moles", Departamento de Química Orgánica e Inorgánica. Universidad de Oviedo. C/ Julián Clavería, 8. 33006 Oviedo, Asturias, Spain
| | - Manuel Alejandro Fernández
- Fundación Idonial. Parque Científico y Tecnológico de Gijón. Avda. Jardín Botánico, 1345. 33203 Gijón, Asturias, Spain
| | - Enrique Aguilar
- Centro de Innovación en Química Avanzada (ORFEO-CINQA), Instituto Universitario de Química Organometálica "Enrique Moles", Departamento de Química Orgánica e Inorgánica. Universidad de Oviedo. C/ Julián Clavería, 8. 33006 Oviedo, Asturias, Spain
| | - Marc Suñé-Pou
- Departamento de Farmacia, Tecnología Farmacéutica y Físico Química, Facultad de Farmacia y Ciencias de la Alimentación. Universidad de Barcelona. Avda. Joan XXIII, 27-31. 08028 Barcelona, Spain; IDIBELL-UB Research Group, Pharmacotherapy, Pharmacogenomics and Pharmaceutical Technology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Nardi-Ricart
- Departamento de Farmacia, Tecnología Farmacéutica y Físico Química, Facultad de Farmacia y Ciencias de la Alimentación. Universidad de Barcelona. Avda. Joan XXIII, 27-31. 08028 Barcelona, Spain
| | - Pilar Pérez-Lozano
- Departamento de Farmacia, Tecnología Farmacéutica y Físico Química, Facultad de Farmacia y Ciencias de la Alimentación. Universidad de Barcelona. Avda. Joan XXIII, 27-31. 08028 Barcelona, Spain; IDIBELL-UB Research Group, Pharmacotherapy, Pharmacogenomics and Pharmaceutical Technology, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Encarna García-Montoya
- Departamento de Farmacia, Tecnología Farmacéutica y Físico Química, Facultad de Farmacia y Ciencias de la Alimentación. Universidad de Barcelona. Avda. Joan XXIII, 27-31. 08028 Barcelona, Spain; IDIBELL-UB Research Group, Pharmacotherapy, Pharmacogenomics and Pharmaceutical Technology, L'Hospitalet de Llobregat, Barcelona, Spain
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Low M, Singh S, Venkataya B, Pearson J, Ibrahim M, Jarouche M, Khoo C, Rowe J, Li CG. Stability of omeprazole in a commercial calcium carbonate based oral suspension at 2, 5 and 10 mg/mL stored under refrigeration (4°C) for 70 days. Pharmacy Practice and Res 2022. [DOI: 10.1002/jppr.1782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mitchell Low
- NICM Health Research Institute Western Sydney University Penrith Australia
| | - Simi Singh
- NICM Health Research Institute Western Sydney University Penrith Australia
| | - Beatrice Venkataya
- NICM Health Research Institute Western Sydney University Penrith Australia
| | - Jarryd Pearson
- NICM Health Research Institute Western Sydney University Penrith Australia
| | - Martha Ibrahim
- NICM Health Research Institute Western Sydney University Penrith Australia
| | - Mariam Jarouche
- NICM Health Research Institute Western Sydney University Penrith Australia
| | | | - James Rowe
- NICM Health Research Institute Western Sydney University Penrith Australia
| | - Chun G. Li
- NICM Health Research Institute Western Sydney University Penrith Australia
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Belayneh A, Tessema Z. A Systematic Review of the Stability of Extemporaneous Pediatric Oral Formulations. ScientificWorldJournal 2021; 2021:8523091. [PMID: 34955693 DOI: 10.1155/2021/8523091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/26/2021] [Accepted: 12/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Extemporaneous compounding is a pharmacy practice to produce suitable pharmaceutical preparations when there are no commercially available, licensed, and age-specific dosage forms. Compared to the use of authorized drugs, these preparations have significant risks. Stability issues are one of the major concerns during the preparation of extemporaneous formulations. Aim The aim of this work was to study the stability of pediatric extemporaneous formulations of commercially available conventional solid dosage forms by reviewing systematically the currently available stability studies. Method Articles were searched in the databases of the Web of Science, PubMed, Scopus, EMBASE, Cochrane Library, and Google Scholar. From all the searched articles, a total of 28 experimental studies reporting the stability of oral pediatric extemporaneous formulations were included based on the inclusion criteria. Oral extemporaneous formulations from commercially available dosage forms and pure drugs were considered. According to the United States and British Pharmacopeia (USP and BP), most extemporaneous formulations are accepted as chemically stable if they maintain ≥90% of the original drug amount, physically stable if there is no apparent change in physical property, and microbiologically stable if there is no growth of microorganisms in prepared formulations. Finding. In this study, most extemporaneous pediatric oral formulations were chemically, physically, and microbiologically stable and retained more than 90% of the initial content. Very few studies did not include either a physical stability test or a microbiological stability test. Conclusion According to this systematic review, the chemical and physical instabilities as well as microbial growth on pediatric oral extemporaneous formulations are very rare in published experimental studies. Most studies show that extemporaneous preparations are stable at the ICH recommended storage conditions and duration. Generally, extemporaneously prepared oral formulations will be the promising option for child medications.
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Pitchayajittipong C, Sriboon S, Kulmee S, Prachuabaree L, Srisawai K, Wattanawong W, Sripa S, Anderson C, Supapaan T. An Overview of Pharmaceutical Production in Thai Hospitals. Hosp Pharm 2019; 56:265-275. [PMID: 34381260 DOI: 10.1177/0018578719890090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this research was to provide an overview of pharmaceutical production in Thai hospitals. Methods: A cross-sectional survey was developed to study pharmaceutical production in the 1347 Thai hospitals. A representative sample was chosen using multistep selection arriving at a final total of 750 hospitals. Five experts in hospital pharmacy production were recruited to evaluate the content validity. The questionnaire consisted of 2 parts: (1) general details of the hospitals and (2) the type of pharmaceutical products. The latter classification were further divided into 6 types: (1) nonsterile products, (2) extemporaneous preparations, (3) total parenteral nutrition, (4) intravenous admixtures, (5) cytotoxic preparations, and (6) herbal medicine products. All data were analyzed via descriptive statistics. Results: From the 750 questionnaires sent out, 395 hospitals (52.67%) responded to the questionnaires. Regarding the 395 respondent sample group, approximately 60% of the hospitals were involved in pharmaceutical production. The top 3 pharmaceutical products were as follows: (1) cytotoxic preparations (315 items); (2) liquid nonsterile preparations (60 items), and (3) liquid extemporaneous preparations (52 items). The most frequently mentioned reasons for the production of each dosage form were as follows: (1) no commercially available product in appropriate dosage form or strength needed and (2) product was prepared following the hospital's policy. The support needs in hospital pharmacy production were revealed as follows: (1) master formula, (2) quality assurance and quality control processes, (3) equipment, (4) standard references, (5) buildings, (6) personnel, (7) budget, (8) raw material suppliers, and (9) the coordination between the faculties of pharmaceutical sciences and hospitals. Conclusions: Approximately 60% of the respondents had pharmaceutical production in their hospitals. The greatest need for support was for a master formula to inform hospital-based pharmaceutical production. These findings provide essential information, especially for stakeholders, to understand the professional challenges and likely pharmaceutically related health service changes in the future.
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