Amphotericin B (AmB) is a "life-saving" medicine for the treatment of invasive fungal infections and visceral leishmaniasis. To date, all marketed AmB formulations require parenteral administration, which causes high rates of acute infusion-related side effects and dose-dependent nephrotoxicity. The development of an oral AmB formulation will entail numerous advantages including increased patient compliance, eliminated infusion-related toxicities and reduced nephrotoxicity. Unfortunately, the gastrointestinal absorption of AmB is negligible due to its extremely low solubility in both aqueous and lipid solvents, and its poor gastrointestinal permeability. Drug-phospholipid complexation is an emerging strategy for oral delivery of poorly soluble drugs. In this study, monoacyl-phosphatidylcholine (MAPC) was complexed with AmB forming an AmB-MAPC complex (APC), to enhance the dissolution rate and aqueous solubility of AmB, in order to enable oral delivery of AmB. X-ray powder diffraction demonstrated that AmB was transformed to its amorphous form following complexation with MAPC, i.e. in the APC. Fourier-transform infrared spectroscopy suggested molecular interactions between AmB and MAPC. Dynamic light scattering indicated formation of colloidal structures after aqueous dispersion of APC; Cryogenic transmission electron microscopy showed that APC formed small round, "rod-like" and "worm-like" micellar structures and Small-angle neutron scattering provided three-dimensional micellar structures formed by APC upon aqueous dispersion, which indicated that AmB was inserted into the micellar mono-layer membrane formed by MAPC. Additionally, APC showed an increased dissolution rate and a higher amount of AmB solubilized in fasted state simulated intestinal fluid, compared to AmB/MAPC physical mixtures and crystalline AmB. In conclusion, an APC exhibiting amorphous properties was developed, the APC showed improved dissolution rate and increased apparent aqueous solubility compared to AmB, indicating that the application of APC could be a promising strategy to enable the oral delivery of AmB.

Bioavailability of weakly basic drugs may be disrupted by dramatic pH changes or unexpected pH alterations in the gastrointestinal tract. Conventional organic acids or enteric coating polymers cannot address this problem adequately because they leach out or dissolve prematurely, especially during controlled release applications. Thus, a non-leachable, multifunctional terpolymer nanoparticle (TPN) made of cross-linked poly(methacrylic acid) (PMAA)-polysorbate 80-grafted-starch (PMAA-PS 80-g-St) was proposed to provide pH transition-independent release of a weakly basic drug, verapamil HCl (VER), by a rationally designed bilayer-coated controlled release bead formulation. The pH-responsive PMAA and cross-linker content in the TPN was first optimized to achieve the largest possible increase in medium uptake alongside the smallest decrease in drug release rate at pH 6.8, relative to pH 1.2. Such TPNs maintained an acidic microenvironmental pH (pHm) when loaded in ethylcellulose (EC) films, as measured using pH-indicating dyes. Further studies of formulations revealed that with the 1:2 VER:TPN ratio and 19% coating weight gain, bilayer-coated beads maintained a constant release rate over the pH transition and exhibited extended release up to 18 h. These results demonstrated that the multifunctional TPN as a pHm modifier and pH-dependent pore former could overcome the severe pH-dependent solubility of weakly basic drugs.

To elucidate the critical parameters affecting drug dissolution in the human stomach, the intrinsic dissolution rate (IDR) of cinnarizine was determined in aspirated and simulated human gastric fluids (HGF). Fasted aspirated HGF (aspHGF) was collected from 23 healthy volunteers during a gastroscopic examination. Hydrochloric acid (HCl) pH 1.2, fasted state simulated gastric fluid (FaSSGF), and simulated human gastric fluid (simHGF) developed to have rheological, and physico-chemical properties similar to aspHGF, were used as simulated HGFs. The IDR of cinnarizine was significantly higher in HCl pH 1.2 (952 +/- 27 mu g/(cm2.min)) than in FaSSGF pH 1.6 (444 +/- 7 mu g/(cm2.min)), and simHGF pH 2.5 (49 +/- 5 mu g/(cm2.min)) due to the pH dependent drug solubility and viscosity differences of the three simulated HGFs. The shear thinning behavior of aspHGF had a significant impact on the IDR of cinnarizine, indicating that the use of FaSSGF, with viscosity similar to water, to evaluate gastric drug dissolution, might overestimate the IDR by a factor of 100-10.000, compared to the non-Newtonian, more viscous, fluids in the human stomach. The developed simHGF simulated the viscosity of the gastric fluids, as well as the IDR of the model drug, making it a very promising medium to study gastric drug dissolution in vitro.

Microcontainers, which are microfabricated cylindrical devices with a reservoir function, have shown promise as an oral drug delivery system for small molecular drug compounds. However, they have never been evaluated against a relevant control formulation. In the current study, we prepared microcrystalline cellulose (MCC) microspheres as a control for in vitro and in vivo testing of SU-8 microcontainers as an oral drug delivery system. Both dosage forms were loaded with paracetamol and coated with chitosan or polyethylene glycol (PEG) (12 kDa). These coatings were followed by an additional enteric coating of Eudragit (R) S100. In addition, a control dosage form was coated with Eudragit (R) alone. The dosage forms were evaluated in vitro, in a physiologically relevant two-step model simulating rat gastrointestinal fluids, and in vivo by oral administration to rats. In vitro, the microcontainers coated with PEG/Eudragit (R) resulted in a prolonged release of paracetamol compared to the respective microspheres, which was consistent with in vivo observations of a later time (T-max) for maximum plasma concentration (C-max) for the microcontainers. For microspheres and microcontainers coated with chitosan/Eudragit (R), the time for complete in vitro release of paracetamol was very similar, due to an earlier release from the microcontainers. This trend was supported by very similar T-max values in vivo. The in vitro in vivo relation was confirmed by a linear regression with R-2 = 0.9, when T-max for each dosage form was plotted as a function of time for 90% paracetamol release in vitro. From the in vivo study, the average plasma concentration of paracetamol 120 min after dosing was significantly higher for microcontainers than for microspheres (0.3 +/- 0.1 mu g/mL and 0.1 +/- <0.1 mu g/mL, respectively) - regardless of the coating applied.

Probiotics have become one of the most consumed food supplements worldwide. Many probiotic strains are sensitive to low pH and bile concentrations encountered in the gastrointestinal tract upon oral ingestion. This study aimed at developing gastro-resistant probiotic granulates releasing viable cells in the small intestine. Fatty alcohols were investigated as potential coating materials. Cetostearyl alcohol was selected and combined with different plasticizers to further optimize the coating properties. Combining cetostearyl alcohol with olive oil and beeswax in selected concentrations was found promising, and the coatings were applied to L. acidophilus LA3 and B. longum BB536, using hot-melt fluid bed coating. Viability in and release from the coated probiotic granulate was investigated, using a physiological relevant in vitro model simulating conditions in the human stomach, duodenum, jejunum and ileum. L. acidophilus LA3 coated with cetostearyl alcohol and olive oil in the ratio 95:5 (w/w) resulted in significantly higher viability after simulated gastrointestinal transit, compared to the uncoated probiotic powder. Furthermore, the coating showed no release of viable cells after simulated gastric transit. Released viable cells were detected after the remaining steps in the in vitro model, indicating that the coating system provides gastric protection and release during intestinal transit.

The purpose of this study was to investigate whole-dosage form UV-vis imaging as a potential tool for functional characterization of excipients used in solid oral dosage forms. To this end, tablets (average mass 260.0 mg, 224.5 mg and 222.1 mg) containing theophylline anhydrate (20 % w/w), 1% (w/w) magnesium stearate, and 79 % (w/w) of either microcrystalline cellulose (MCC, Avicel PH 101) or hydroxypropyl methylcellulose (HPMC, Methocel K15 M or K100 M) were prepared as model systems. Drug liberation from tablets was studied in 0.01 M HCl at 37 degrees C using a Sirius SDi2 equipped with a USP IV type flow cell comprising a UV-vis imaging detector operating at 255 nm and 520 nm. The effluent from the flow cell was passed through a downstream spectrophotometer, and UV-vis spectra in the wavelength range 200-800 nm were recorded every 2 min. The erosion and swelling behavior of the MCC tablets and HPMC K15 M and K100 M tablets were visualized in real time. The swelling of HPMC K15 M and K100 M containing tablets was assessed quantitatively as changes in tablet diameter measured at 520 nm, and was clearly distinguished from the swelling of the MCC tablets. Namely, an increment of 2.5 mm in diameter was determined for the HPMC tablets while the MCC tablets increased by 0.5-1 mm in diameter. Gel layers of variable thickness were observed only for the HPMC K15 M and K100 M tablets. In addition, a relatively high initial liberation rate of theophylline was found for the MCC tablets as compared to the HPMC tablets. UV-vis imaging revealed features of liberation not revealed by simply measuring drug concentration in the dissolution media or by visual assessment. It may be sufficiently sensitive to be further developed for functional characterization of excipients and provide insights into drug-excipient interactions likely to be useful in formulation development. (C) 2020 Elsevier B.V. All rights reserved.

Lipid based drug delivery systems (LbDDSs) present an effective solution for increasing the apparent solubility and eliminating the slow dissolution process of many poorly water-soluble compounds. Typically, an initial step in designing a LbDDS is to measure the equilibrium solubility of the compound in various LbDDS excipients, which often are viscous. Equilibrium solubility is usually measured by the classical saturation shake-flask (SSF) method with centrifugation for phase separation. The concentration of the compound in the supernatant is determined as the solubility. As complete phase separation is necessary to determine the equilibrium solubility, but difficult to achieve in viscous solvents, the aim of the present study was to evaluate the effect of centrifugation speed on the measured solubility. In the present study, the solubility of seven poorly water-soluble compounds: amphotericin B, nystatin, beta-carotene, curcumin, itraconazole, cinnarizine and fenofibrate was measured in five viscous solvents using the SSF method. For five out of the seven compounds (amphotericin B, nystatin, beta-carotene, curcumin and itraconazole) the centrifugation speed had a significant effect on the measured solubility, i.e. different centrifugation speeds led to differences in the measured solubility. The supernatants of all the tested samples, following 15 min of centrifugation at 900 x g (3K RPM), 4.7K x g (7K RPM) and 17K x g (13.3K RPM), were evaluated for particle presence by polarized light microscopy. Presence of particles in the supernatants of the five affected compounds indicated that complete phase separation was not obtained, and that the measured solubility did not represent the true equilibrium solubility. Studying the physicochemical properties of the tested compounds, it was found, that the compounds, for which the measured solubility was affected by the centrifugation speed, all display high melting points. In conclusion, to avoid overestimating the equilibrium solubility, especially for compounds with high melting points, it is recommended to use the highest possible centrifugation speed, and to evaluate the effect of centrifugation speed on the solubility measurement, when conducting solubility experiments in viscous solvents using centrifugation for phase separation.

Intake of probiotics is associated with many health benefits, which has generated an interest in formulating viable probiotic supplements. The present study had two aims. The first aim was to achieve gastrointestinal protection and delayed release of viable probiotics by pelletizing and coating freeze-dried probiotic strains, using riboflavin as a marker for release. The second aim was to set up a dynamic three-step in vitro model simulating the conditions in the human gastric, duodenum/jejunum and ileum compartments using physiologically relevant media to evaluate delayed release of the formulations. To simulate lowered bile acid concentrations in the ileum area of the gastrointestinal tract, a novel method using the bile acid sequestrant cholestyramine to lower bile acid concentrations in the small intestinal medium to physiologically relevant levels was attempted. Granulation, extrusion and spheronization was used to develop pellets containing viable probiotics using freeze-dried Lactobacullus reuteri as a model strain. Fluid bed coating the pellets with the pH-sensitive polymers Eudragit S100 or Eudragit FS30D resulted in targeted release in the ileum step of the three-step in vitro model based on release of the marker riboflavin.

The aim of this study was to investigate new porous flexible substrates, i.e., solid foams that would serve as a carrier with a high ink absorption potential for inkjet printable pharmaceuticals. Propranolol hydrochloride was used as a model active pharmaceutical ingredient (API). Pharmaceutically approved and edible cellulose derivatives and gums together with different additives were evaluated as a base for the substrate. Different methods for preparation of a solid foam such as freeze-drying, vacuum oven drying and drying at room temperature were explored. Only freeze-drying of the polymeric solutions resulted in the desired porous and flexible, but mechanically stable, soft sponge-like substrates with hydroxypropyl methylcellulose (HPMC)-based solid foams being the most suitable for the use in continuous inkjet printing. The plasticized HPMC foams had a superior absorption capacity and fast penetration speed for the different solvents due to the open cell pore structure and higher porosity as compared to nonplasticized additive-free foams, although, the latter were less hygroscopic. The produced solid foams were well suited for inkjet printing of high volumes of API-containing ink. The inkjet-printed API was immediately released from the dosage forms upon contact with the dissolution medium. This work demonstrates that the fabricated solid foams, based on plasticized HPMC, show a great potential as porous carriers in the fabrication of high dose dosage forms by inkjet printing.

The use of inkjet printing (IJP) technology enables the flexible manufacturing of personalized medicine with the doses tailored for each patient. In this study we demonstrate, for the first time, the applicability of IJP in the production of edible dosage forms in the pattern of a quick response (QR) code. This printed pattern contains the drug itself and encoded information relevant to the patient and/or healthcare professionals. IJP of the active pharmaceutical ingredient (API)-containing ink in the pattern of QR code was performed onto a newly developed porous and flexible, but mechanically stable substrate with a good absorption capacity. The printing did not affect the mechanical properties of the substrate. The actual drug content of the printed dosage forms was in accordance with the encoded drug content. The QR encoded dosage forms had a good print definition without significant edge bleeding. They were readable by a smartphone even after storage in harsh conditions. This approach of efficient data incorporation and data storage combined with the use of smart devices can lead to safer and more patient-friendly drug products in the future.

Printing technologies, both 2D and 3D, have gained considerable interest during the last years for manufacturing of personalized dosage forms, tailored to each patient. Here we review the research work on 2D printing techniques, mainly inkjet printing, for manufacturing of film-based oral dosage forms. We describe the different printing techniques and give an overview of film-based oral dosage forms produced using them. The main part of the review focuses on the non-destructive analytical methods used for evaluation of qualitative aspects of printed dosage forms, e.g., solid-state properties, as well as for quantification of the active pharmaceutical ingredient (API) in the printed dosage forms, with an emphasis on spectroscopic methods. Finally, the authors share their view on the future of printed dosage forms.

PURPOSE:The purpose of this study was to investigate the applicability of Raman spectroscopy for visualization and quantification of inkjet-printed pharmaceuticals.METHODS:Haloperidol was used as a model active pharmaceutical ingredient (API), and a printable ink base containing lactic acid and ethanol was developed. Inkjet printing technology was used to apply haloperidol ink onto three different substrates. Custom-made inorganic compacts and dry foam, as well as marketed paracetamol tablets were used as the substrates.RESULTS:Therapeutic personalized doses were printed by using one to ten printing rounds on the substrates. The haloperidol content in the finished dosage forms were determined by high-performance liquid chromatography (HPLC). The distribution of the haloperidol on the dosage forms were visualized using Raman chemical imaging combined with principal components analysis (PCA). Raman spectroscopy combined with modeling by partial least squares (PLS) regression was used for establishment of a quantitative model of the haloperidol content in the printed dosage forms. A good prediction of the haloperidol content was achieved for the inorganic compacts, while a slightly poorer prediction was observed for the paracetamol tablets. It was not possible to quantify haloperidol on the dry foam due to the low and varying density of the substrate.CONCLUSIONS:Raman spectroscopy is a useful tool for visualization and quality control of inkjet printed personalized medicine.

An aqueous gel composition comprising a) water, at least one polysaccharide and at least one high molecular weight polyethylene oxide, wherein the water content is at least 90 % by weight of the composition, and b) a local anaesthetic agent or an analgesic agent, for use as a local anaesthetic or analgesic. The aqueous gel shows transparency, lubricity, stringiness, elongation, extensiveness, and cohesiveness while being devoid of taste and smell and non-tacky or non-sticky.

L'invention concerne une composition aqueuse de gel comprenant a) de l'eau, au moins un polysaccharide et au moins un oxyde de polyethylene de poids moleculaire eleve, la teneur en eau s'elevant a au moins 90 % en poids de la composition, et b) un agent anesthesique local ou un agent antalgique, ladite composition etant destinee a etre utilisee comme anesthesique ou antalgique local. Le gel aqueux est transparent, lubrifiant, de nature filandreuse, et capable d'etirement, d'extensibilite et de cohesion, mais ne presente pas de gout, pas d'odeur, pas de caractere poisseux ou pas de caractere collant.

In an ideal world, doses of medicines would be tailored for the specific patient with the specific condition. If combinations are indicated, preferably, all drugs would be administered in one oral dosage form once or twice daily and the taste of the drugs would be concealed. The dosage form would resemble something children are used to intake. We are not there, but we might get there some day.For now, microencapsulation seems to be one path to conceal the taste of drugs, to prevent drug-drug and drug-excipient chemical incompatibilities and, if possible, for modified release. Fast-hydrating dry granulates which swell into pudding-like vehicles have been developed as carriers for the microencapsulated drugs. Robots can accurately dispense the prescribed drugs into appropriate packages, but US and EU registration procedures so far could not handle drug registration within the framework of automated compounding. This might be the challenge of coming years and decades.The technical challenges in producing the components are examined, analysis procedures evaluated and the regulatory aspects are tentatively discussed.

This commentary reviews the difficulties in formulating oral products for children. The significance of the fragmentation of the pediatric population in terms of development and ability to ingest different dosage formulations is examined. It is postulated that a flexible formulation, acceptable by all patient groups, is needed, and an automated compounding concept is proposed. The finishing of the formulation is done at the dispensing pharmacy using an automated process. The individual components (pudding-like carrier, microencapsulated drug, and the dispensing robot and its software) are reviewed. The involvement of different stakeholders is considered because new regulatory, clinical, and marketing thinking is required.

Pharmaceuticals do not fall from the sky. Before they are available, they must be developed. This historical framework has three aspects-the past without which we cannot understand the present, and the present which we have tried to make more understandable in all this book's chapters. And the future? Our crystal ball is a bit opaque. We can extrapolate some of today's technical developments into the near future, such as the technique of microencapsulation. Other dimensions are more difficult to predict, such as the future of US and EU pediatric legislation, which role patient advocacy groups will play in 10 or 20 years, towards which priorities the public opinion will swing during the next decades, and how politicians will channel it. And then there are the truly unknown unknowns, those surprises in science, social environment and any other aspect of life that most of us did not and do not expect (apart from the true prophets, which we are not).

PURPOSE:To develop a minimally-invasive method for direct visualization of drug delivery systems in the human stomach and to compare the obtained results with an established in vitro model. The method should provide the capsule rupture, dispersion characteristics, and knowledge regarding the surrounding physiological environment in the stomach.METHODS:A capsule endoscopic method was developed. The disintegration time, dispersion characteristics and the impact of the physiological environment on different lipid based delivery systems in different gelatin capsules in the fasted stomach of nine healthy volunteers were visualized. Biorelevant dissolution studies using a USP II apparatus and a droplet size analysis of the released SNEDDS were performed.RESULTS:Visualization of the behavior of both hard and soft gelatin capsules formulations was possible. The disintegration and dispersion of EP oil in a soft capsule and SNEDDS in a hard shell capsule were visualized. The in vitro release rates were different from the in vivo release rates of the soft capsule due to volume, fluid composition and motility differences but not for the hard capsule containing SNEDDS.CONCLUSIONS:A minimally-invasive capsule endoscopic method was developed for direct visualizing of drug delivery systems in the human stomach and maybe later, in the duodenum.