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Purohit TJ, Amirapu S, Wu Z, Hanning SM. Rectal Bioavailability of Amoxicillin from Hollow-Type Suppositories: Effect of Chemical Form of Amoxicillin. Pharmaceutics 2023; 15:1865. [PMID: 37514051 PMCID: PMC10383505 DOI: 10.3390/pharmaceutics15071865] [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: 05/03/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Rectal drug administration could offer advantages in the delivery of medicines for children by avoiding swallowability issues, improving stability and enabling administration by caregivers. This study aimed to evaluate the rectal bioavailability of hollow-type suppositories (HTS) and understand the effect of two chemical forms of amoxicillin: amoxicillin sodium (AS) or amoxicillin trihydrate (AMT). HTS were prepared by incorporating a lipophilic core containing the antibiotic with a polyethylene glycol (PEG) shell. Formulations were characterised in vitro, and the absolute bioavailability was determined in a rabbit model, while drug-base interactions were evaluated using X-ray diffraction crystallography (XRD), differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy. The in vitro amoxicillin release from AMT HTS was delayed, taking 27.3 ± 4.9 h to release 50% drug compared with 1.7 h for the AS HTS, likely due to solubility differences between AMT and AS. The presence of orthorhombic AMT and anhydrous AS crystals in respective HTS was confirmed via XRD and DSC. PEG shells were able to protect the drug chemical stability when stored at 25 °C/60% RH. Despite the difference in their in vitro release rates, a similar rectal bioavailability was found in both forms of amoxicillin (absolute bioavailability 68.2 ± 6.6% vs. 72.8 ± 32.2% for AMT HTS and AS HTS, respectively; p = 0.9682). Both HTS formulations showed little or no irritation to the rectal mucosa following a single dose.
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Affiliation(s)
- Trusha J Purohit
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Satya Amirapu
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Zimei Wu
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Sara M Hanning
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
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Rathi R, Sanshita, Kumar A, Vishvakarma V, Huanbutta K, Singh I, Sangnim T. Advancements in Rectal Drug Delivery Systems: Clinical Trials, and Patents Perspective. Pharmaceutics 2022; 14:2210. [PMID: 36297645 PMCID: PMC9609333 DOI: 10.3390/pharmaceutics14102210] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 09/10/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 07/30/2023] Open
Abstract
The rectal route is an effective route for the local and systemic delivery of active pharmaceutical ingredients. The environment of the rectum is relatively constant with low enzymatic activity and is favorable for drugs having poor oral absorption, extensive first-pass metabolism, gastric irritation, stability issues in the gastric environment, localized activity, and for drugs that cannot be administered by other routes. The present review addresses the rectal physiology, rectal diseases, and pharmaceutical factors influencing rectal delivery of drugs and discusses different rectal drug delivery systems including suppositories, suspensions, microspheres, nanoparticles, liposomes, tablets, and hydrogels. Clinical trials on various rectal drug delivery systems are presented in tabular form. Applications of different novel drug delivery carriers viz. nanoparticles, liposomes, solid lipid nanoparticles, microspheres, transferosomes, nano-niosomes, and nanomicelles have been discussed and demonstrated for their potential use in rectal administration. Various opportunities and challenges for rectal delivery including recent advancements and patented formulations for rectal drug delivery have also been included.
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Affiliation(s)
- Ritu Rathi
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Sanshita
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Alpesh Kumar
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | | | | | - Inderbir Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Tanikan Sangnim
- Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand
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Abstract
INTRODUCTION The field of neonatal, infant and toddler pharmaceutical development is constantly improving, however a lag still remains in comparison to older children and adults. Their rapid anatomical, physiological and behavioural developmental rates pose extra challenges in diagnosing, treating, or preventing their disease. In turn, this brings complexity in formulating truly age-appropriate medicinal products that suit this heterogeneous paediatric subset. Progress in the availability of such products has ensued following the introduction of the 2007 European Union Paediatric Regulation, and in recent years, oral multiparticulate and dispersible solid formulations have gained interest alongside liquid formulations. However, the need is still great for dosage forms that do not compromise on pharmaceutical efficacy, safety and global accessibility in those aged under 2. AREAS COVERED This article highlights some of the formulation challenges correlated with this age group and critically explores recent solid age-appropriate formulations and their administration devices for enteral drug delivery. EXPERT OPINION There are many formulation requirements to consider when formulating drug products for children aged under 2. Efforts are required into understanding acceptability in this age group and of their carers, and whether innovation or optimisation is required, to help guide formulators towards optimal approaches without impacting access.
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Affiliation(s)
- Nicole Sheena Kaneria
- University College London, School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London, WC1N 1AX UK
| | - Catherine Tuleu
- University College London, School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London, WC1N 1AX UK
| | - Terry Ernest
- GlaxoSmithKline, New Frontiers Science Park, Third Avenue Essex, Harlow, CM19 5AW UK.,GlaxoSmithKline, Hertfordshire, Park Road, Ware, UK, SG12 0DP
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Bialik M, Kuras M, Sobczak M, Oledzka E. Achievements in Thermosensitive Gelling Systems for Rectal Administration. Int J Mol Sci 2021; 22:ijms22115500. [PMID: 34071110 PMCID: PMC8197127 DOI: 10.3390/ijms22115500] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Rectal drug delivery is an effective alternative to oral and parenteral treatments. This route allows for both local and systemic drug therapy. Traditional rectal dosage formulations have historically been used for localised treatments, including laxatives, hemorrhoid therapy and antipyretics. However, this form of drug dosage often feels alien and uncomfortable to a patient, encouraging refusal. The limitations of conventional solid suppositories can be overcome by creating a thermosensitive liquid suppository. Unfortunately, there are currently only a few studies describing their use in therapy. However, recent trends indicate an increase in the development of this modern therapeutic system. This review introduces a novel rectal drug delivery system with the goal of summarising recent developments in thermosensitive liquid suppositories for analgesic, anticancer, antiemetic, antihypertensive, psychiatric, antiallergic, anaesthetic, antimalarial drugs and insulin. The report also presents the impact of various types of components and their concentration on the properties of this rectal dosage form. Further research into such formulations is certainly needed in order to meet the high demand for modern, efficient rectal gelling systems. Continued research and development in this field would undoubtedly further reveal the hidden potential of rectal drug delivery systems.
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Seoane-Viaño I, Gómez-Lado N, Lázare-Iglesias H, García-Otero X, Antúnez-López JR, Ruibal Á, Varela-Correa JJ, Aguiar P, Basit AW, Otero-Espinar FJ, González-Barcia M, Goyanes A, Luzardo-Álvarez A, Fernández-Ferreiro A. 3D Printed Tacrolimus Rectal Formulations Ameliorate Colitis in an Experimental Animal Model of Inflammatory Bowel Disease. Biomedicines 2020; 8:E563. [PMID: 33276641 PMCID: PMC7761558 DOI: 10.3390/biomedicines8120563] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to fabricate novel self-supporting tacrolimus suppositories using semisolid extrusion 3-dimensional printing (3DP) and to investigate their efficacy in an experimental model of inflammatory bowel disease. Blends of Gelucire 44/14 and coconut oil were employed as lipid excipients to obtain suppository formulations with self-emulsifying properties, which were then tested in a TNBS (2,4,6-trinitrobenzenesulfonic acid) induced rat colitis model. Disease activity was monitored using PET/CT medical imaging; maximum standardized uptake values (SUVmax), a measure of tissue radiotracer accumulation rate, together with body weight changes and histological assessments, were used as inflammatory indices to monitor treatment efficacy. Following tacrolimus treatment, a significant reduction in SUVmax was observed on days 7 and 10 in the rat colon sections compared to non-treated animals. Histological analysis using Nancy index confirmed disease remission. Moreover, statistical analysis showed a positive correlation (R2 = 71.48%) between SUVmax values and weight changes over time. Overall, this study demonstrates the effectiveness of 3D printed tacrolimus suppositories to ameliorate colitis and highlights the utility of non-invasive PET/CT imaging to evaluate new therapies in the preclinical area.
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Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - Héctor Lázare-Iglesias
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain; (H.L.-I.); (J.R.A.-L.)
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - José Ramón Antúnez-López
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain; (H.L.-I.); (J.R.A.-L.)
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
- Tejerina Foundation, José Abascal 40, 28003 Madrid, Spain
| | - Juan Jesús Varela-Correa
- Pharmacy Department, University Hospital Ourense (SERGAS), Calle Ramón Puga Noguerol 54, 32005 Ourense, Spain;
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - Abdul W. Basit
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK;
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Francisco J. Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain;
| | - Alvaro Goyanes
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK;
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain;
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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Peet MM, Agrahari V, Anderson SM, Hanif H, Singh ON, Thurman AR, Doncel GF, Clark MR. Topical Inserts: A Versatile Delivery Form for HIV Prevention. Pharmaceutics 2019; 11:E374. [PMID: 31374941 DOI: 10.3390/pharmaceutics11080374] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 11/16/2022] Open
Abstract
The development of topical inserts for the prevention of sexually transmitted infections (STIs), particularly human immunodeficiency virus (HIV), represents a promising alternative to oral and parenteral pre-exposure prophylaxis (PrEP) dosage forms. They may be used for vaginal and/or rectal administration of a variety of agents with antiviral activity. Topical inserts deliver drugs to the portal of viral entry, i.e., the genital or rectal mucosa, with low systemic exposure, and therefore are safer and have fewer side effects than systemic PrEP agents. They may dissolve fast, releasing the active drugs within minutes of insertion, or slowly for long-acting drug delivery. Furthermore, they are user-friendly being easy to administer, discreet and highly portable. They are also economical and easy to manufacture at scale and to distribute, with excellent stability and shelf-life. Altogether, topical inserts represent a particularly promising form of drug delivery for HIV and STI prevention. Highlighted within this review are end-user acceptability research dedicated to understanding preferred attributes for this form of drug delivery, advantages and disadvantages of the formulation platform options, considerations for their development, clinical assessment of select placebo prototypes, future directions, and the potential impact of this dosage form on the HIV prevention landscape.
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Nunes R, Araújo F, Barreiros L, Bártolo I, Segundo MA, Taveira N, Sarmento B, das Neves J. Noncovalent PEG Coating of Nanoparticle Drug Carriers Improves the Local Pharmacokinetics of Rectal Anti-HIV Microbicides. ACS Appl Mater Interfaces 2018; 10:34942-34953. [PMID: 30234288 DOI: 10.1021/acsami.8b12214] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Antiretroviral drug nanocarriers hold great promise for developing anti-human immunodeficiency virus (HIV) rectal microbicides. However, challenges remain, namely, concerning which properties are more suited for enhancing colorectal distribution and retention of microbicide compounds. In this work, we developed and assessed the in vitro and in vivo performance of poly(lactic- co-glycolic acid) (PLGA)-based nanoparticles (NPs) as carriers for the model drug efavirenz (EFV). We particularly focused on the effect of noncovalent poly(ethylene glycol) coating of PLGA NPs (PEG-PLGA NPs) conferring a mucus-diffusive behavior on the pharmacokinetics (PK) of EFV following rectal administration to mice. Drug-loaded PLGA NPs and PEG-PLGA NPs (200-225 nm) were obtained by nanoprecipitation. Both types of systems were able to retain native antiretroviral activity of EFV in vitro, while featuring lower cytotoxicity against different epithelial cell lines and HIV target cells. Also, PLGA NPs and PEG-PLGA NPs were readily taken up by colorectal cell lines and mildly reduced EFV permeation while increasing membrane retention in Caco-2 and Caco-2/HT29-MTX cell monolayer models. When administered intrarectally to CD-1 mice in phosphate-buffered saline (pH 7.4), EFV-loaded PEG-PLGA NPs consistently provided higher drug levels in colorectal tissues and lavages, as compared to free EFV or drug-loaded PLGA NPs. Mean values for the area-under-the-curve between 15 min and 12 h following administration were particularly higher for PEG-PLGA NPs in distal and middle colorectal tissues, with relative bioavailability values of 3.7 and 29, respectively, as compared to free EFV (2.2 and 6.0 over PLGA NPs, respectively). Systemic exposure to EFV was reduced for all treatments. NPs were further shown safe after once-daily administration for 14 days, as assessed by histological analysis of colorectal tissues and chemokine/cytokine assay of rectal lavages. Overall, PEG-PLGA NPs demonstrated to be safe carriers for rectal microbicide drug delivery and able to provide enhanced local PK that could be valuable in preventing rectal HIV transmission.
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Affiliation(s)
- Rute Nunes
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra 4585-116 , Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar Universidade do Porto, Porto 4050-313 , Portugal
| | | | - Luisa Barreiros
- LAQV, REQUIMTE, Departamento de Ciências Quı́micas, Faculdade de Farmácia , Universidade do Porto , Porto 4050-313 , Portugal
| | - Inês Bártolo
- HIV Evolution, Epidemiology and Prevention, Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia , Universidade de Lisboa , Lisboa 1649-003 , Portugal
| | - Marcela A Segundo
- LAQV, REQUIMTE, Departamento de Ciências Quı́micas, Faculdade de Farmácia , Universidade do Porto , Porto 4050-313 , Portugal
| | - Nuno Taveira
- HIV Evolution, Epidemiology and Prevention, Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia , Universidade de Lisboa , Lisboa 1649-003 , Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) , Instituto Universitário Egas Moniz , Monte de Caparica 2829-511 , Portugal
| | - Bruno Sarmento
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra 4585-116 , Portugal
| | - José das Neves
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra 4585-116 , Portugal
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Liu Y, Wang X, Liu Y, Di X. Thermosensitive In Situ Gel Based on Solid Dispersion for Rectal Delivery of Ibuprofen. AAPS PharmSciTech 2018; 19:338-347. [PMID: 28733828 DOI: 10.1208/s12249-017-0839-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/19/2017] [Indexed: 02/06/2023] Open
Abstract
The objective of this study was to develop a thermosensitive in situ gel based on solid dispersions (SDs) for rectal delivery of ibuprofen (IBU). Thermosensitive (poloxamer 407) and mucoadhesive (hydroxypropylmethyl cellulose E5 and sodium alginate) polymers were used to prepare the in situ gel and the sol-gel transition temperature (T sol-gel) and gel strength were optimized. The in vitro release performance and in vivo pharmacokinetic properties of the in situ gel after their rectal administration to rabbits were investigated. Compared with the solid suppository, the cumulative release of the IBU SDs loaded in situ gel was significantly increased. The in vivo pharmacokinetics indicated that in situ gel had a higher peak plasma concentration (C max) and area under the curve (AUC(0-∞)) in plasma than the solid suppositories. Histopathology results showed that the IBU in situ gel given at a dose of 15 mg/kg did not produce any irritation. In conclusion, this study suggested that the in situ gel could be an effective rectal formulation for IBU.
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