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Ruiz-Picazo A, Colón-Useche S, Gonzalez-Alvarez M, Gonzalez-Alvarez I, Bermejo M, Langguth P. Effect of thickener on disintegration, dissolution and permeability of common drug products for elderly patients. Eur J Pharm Biopharm 2020; 153:168-176. [PMID: 32561342 DOI: 10.1016/j.ejpb.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/27/2019] [Revised: 04/30/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022]
Abstract
Dysphagia is a very common problem suffered by elderly patients. The use of thickeners during administration in these patients helps to prevent difficulties with swallowing larger solid dosage forms. However, there are several indications when the thickeners may influence disintegration and dissolution processes of solid dosage forms, potentially affecting therapeutic efficacy. In this paper the effects of a commonly used thickener on tablet disintegration, dissolution and subsequent absorption of 6 formulated drugs frequently used in elderly patients (Aspirin, Atenolol, Acenocumarol, Candesartan, Ramipril and Valsartan) in two different administration conditions (intact tablet and crushed tablet) are reported. Disintegration times were determined using a modified disintegration test device. The presence of thickener leads to a pseudoplastic behavior with clearly increased viscosity values. The thickener was also shown to significantly affect the release processes (dissolution and disintegration), but not the permeability of the studied drugs. When tablets are crushed the effect of the thickener on drug dissolution is avoided. Consequently, crushing the tablets would be a recommendation for these drugs if the use of a thickener is necessary in patients with dysphagia.
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Affiliation(s)
- Alejandro Ruiz-Picazo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, Spain
| | - Sarin Colón-Useche
- Analysis and Control Department, University of Los Andes, Mérida 5101, Venezuela
| | - Marta Gonzalez-Alvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, Spain
| | - Isabel Gonzalez-Alvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, Spain.
| | - Marival Bermejo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, Spain
| | - Peter Langguth
- Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
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Ruiz Picazo A, Martinez-Martinez MT, Colón-Useche S, Iriarte R, Sánchez-Dengra B, González-Álvarez M, García-Arieta A, González-Álvarez I, Bermejo M. In Vitro Dissolution as a Tool for Formulation Selection: Telmisartan Two-Step IVIVC. Mol Pharm 2018; 15:2307-2315. [PMID: 29746133 DOI: 10.1021/acs.molpharmaceut.8b00153] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 02/08/2023]
Abstract
The purpose of this investigation was to develop an exploratory two-step level A IVIVC for three telmisartan oral immediate release formulations, the reference product Micardis, and two generic formulations (X1 and X2). Correlation was validated with a third test formulation, Y1. Experimental solubility and permeability data were obtained to confirm that telmisartan is a class II compound under the Biopharmaceutic Classification System. Bioequivalence (BE) studies plasma profiles were combined using a previously published reference scaling procedure. X2 demonstrated in vivo BE, while X1 and Y1 failed to show BE due to the lower boundary of the 90% confidence interval for Cmax being outside the acceptance limits. Average plasma profiles were deconvoluted by the Loo-Riegelman method to obtain the oral fractions absorbed ( fa). Fractions dissolved ( fdiss) were obtained in several conditions in USP II and USP IV apparatus, and later, the results were compared in order to find the most biopredictive model, calculating the f2 similarity factor. The apparatus and conditions showing the same rank order than in vivo data were selected for further refinement of conditions. A Levy plot was constructed to estimate the time scaling factor and to make both processes, dissolution and absorption, superimposable. The in vitro dissolution experiment that reflected more accurately the in vivo behavior of the different formulations of telmisartan employed the USP IV dissolution apparatus and a dissolution environment with a flow rate of 8 mL/min and a three-step pH change, from 1.2 to 4.5 and 6.8, with a 0.05% of Tween 80. Thus, these conditions gave rise to a biopredictive dissolution test. This new model is able to predict the formulation differences in dissolution that were previously observed in vivo, which could be used as a risk-analysis tool for formulation selection in future bioequivalence trials.
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Affiliation(s)
- Alejandro Ruiz Picazo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
| | - Ma Teresa Martinez-Martinez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
| | - Sarin Colón-Useche
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain.,Analysis and Control Department , University of Los Andes , Mérida 5101 , Venezuela
| | - Ramon Iriarte
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
| | - Bárbara Sánchez-Dengra
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
| | - Marta González-Álvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
| | - Alfredo García-Arieta
- Service on Pharmacokinetics and Generic Medicines, Division of Pharmacology and Clinical Evaluation, Department of Human Use Medicines , Spanish Agency for Medicines and Health Care Products , Madrid , Spain
| | - Isabel González-Álvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
| | - Marival Bermejo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area , Miguel Hernandez University , Alicante 03550 , Spain
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Colón-Useche S, González-Álvarez I, Mangas-Sanjuan V, González-Álvarez M, Pastoriza P, Molina-Martínez I, Bermejo M, García-Arieta A. Investigating the Discriminatory Power of BCS-Biowaiver in Vitro Methodology to Detect Bioavailability Differences between Immediate Release Products Containing a Class I Drug. Mol Pharm 2015; 12:3167-74. [PMID: 26287948 DOI: 10.1021/acs.molpharmaceut.5b00076] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 11/30/2022]
Abstract
The purpose of this work is to investigate the discriminatory power of the Biopharmaceutics Classification System (BCS)-biowaiver in vitro methodology, i.e., to investigate if a BCS-biowaiver approach would have detected the Cmax differences observed between two zolpidem tablets and to identify the cause of the in vivo difference. Several dissolution conditions were tested with three zolpidem formulations: the reference (Stilnox), a bioequivalent formulation (BE), and a nonbioequivalent formulation (N-BE). Zolpidem is highly soluble at pH 1.2, 4.5, and 6.8. Its permeability in Caco-2 cells is higher than that of metoprolol and its transport mechanism is passive diffusion. None of the excipients (alone or in combination) showed any effect on permeability. All formulations dissolved more than 85% in 15 min in the paddle apparatus at 50 rpm in all dissolution media. However, at 30 rpm the nonbioequivalent formulation exhibited a slower dissolution rate. A slower gastric emptying rate was also observed in rats for the nonbioequivalent formulation. A slower disintegration and dissolution or a delay in gastric emptying might explain the Cmax infra-bioavailability for a highly permeable drug with short half-life. The BCS-biowaiver approach would have declared bioequivalence, although the in vivo study was not conclusive but detected a 14% mean difference in Cmax that precluded the bioequivalence demonstration. Nonetheless, these findings suggest that a slower dissolution rate is more discriminatory and that rotation speeds higher than 50 rpm should not be used in BCS-biowaivers, even if a coning effect occurs.
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Affiliation(s)
- Sarin Colón-Useche
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University , 03550 Alicante, Spain.,Pharmacokinetics and Pharmaceutical Technology, Complutense University of Madrid , 28040 Madrid, Spain.,Analysis and Control Department, University of Los Andes , Mérida, Venezuela
| | - Isabel González-Álvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University , 03550 Alicante, Spain
| | - Victor Mangas-Sanjuan
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University , 03550 Alicante, Spain
| | - Marta González-Álvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University , 03550 Alicante, Spain
| | - Pilar Pastoriza
- Pharmacokinetics and Pharmaceutical Technology, Complutense University of Madrid , 28040 Madrid, Spain
| | - Irene Molina-Martínez
- Pharmacokinetics and Pharmaceutical Technology, Complutense University of Madrid , 28040 Madrid, Spain
| | - Marival Bermejo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University , 03550 Alicante, Spain
| | - Alfredo García-Arieta
- Service on Pharmacokinetics and Generic Medicines, Division of Pharmacology and Clinical Evaluation, Department of Human Use Medicines, Spanish Agency for Medicines and Health Care Products , 28022 Madrid, Spain
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