Optimization and Quest of HPMC loaded Stavudine Controlled Release Dosage Development by Central Composite Design utilizing Reduced Factorial Screening Technique

Abstract The current research focused on screening and finding the significant independent variables in stavudine loaded tablet, followed by optimizing the best formulation using central composite design. The objective of the study to develop stavudine loaded controlled release tablet utilizing reduced factorial design, followed by optimization technique as well as characterization of prepared tablets. Preliminary trial batches were prepared using different grades of hydroxypropyl methylcellulose. The resolution-IV reduced factorial design was selected to screen the significant independent variables in the dosage form design. A total number of eight runs were prepared and responses were recorded. The signified factors identified by half-normal and Pareto chart. The prepared tablets are evaluated for various physiochemical characterizations. Three dependent responses such as hardness, dissolution at 6 hour and 12 hours are considered in optimization process. Later on, drug-polymer interaction study was carried out. The principal of the study design based on finding the best formulation with prefixed set parameter values utilizing the concept of screening technique. It observed that HPMC K15M (57.18 %), HPMC K100 (66.32 %) and PVP K30 (7.97 %) as best composition in a formulation batch would fulfill the predetermined parameter with specific values.

Partição de Comprimidos Antineoplásicos Utilizados no Tratamento de Leucemias Agudas em Crianças e Adolescentes / Splitting of Antineoplastic Tablets Used in Acute Leukemias Treatment in Children and Adolescents / Partición de Comprimidos Antineoplásicos Empleados en el Tratamiento de Leucemias Agudas en Niños y Adolescentes

Introdução: A manipulação de antineoplásicos para ajuste de dose, como partição de comprimidos, é comum no tratamento de leucemias agudas de crianças e adolescentes. Objetivo: Identificar a frequência e descrever a prática da partição domiciliar de comprimidos antineoplásicos utilizados no tratamento oral de crianças e adolescentes com leucemias agudas na fase de manutenção. Método: Trata-se de um estudo transversal descritivo, realizado em um hospital pertencente à rede de saúde pública do Distrito Federal com assistência especializada em pediatria. Foram incluídos no estudo crianças e adolescentes entre 1 e 18 anos, diagnosticados com leucemias agudas e em fase de manutenção do tratamento no período de estudo. Foi aplicado um questionário semiestruturado ao responsável principal pela administração dos medicamentos quimioterápicos via oral, podendo ser o cuidador ou a própria criança/adolescente. Foram coletadas variáveis sociodemográficas dos pacientes e cuidadores e variáveis sobre a prática de partição de medicamentos antineoplásicos no domicílio. Resultados: Todos os 48 entrevistados no período do estudo relataram ter partido comprimidos antineoplásicos ao longo do tratamento de leucemias agudas, sendo estes mercaptopurina (n=45 [93,75%]) e tioguanina (n=3 [6,25%]). Conclusão: A partição de comprimidos antineoplásicos foi uma prática unânime em virtude da necessidade referida de ajuste de dose individual para o tratamento de leucemias agudas de crianças e adolescentes, considerando a indisponibilidade de formulações adequadas. Os resultados reforçam a necessidade de a partição ser uniformizada e realizada de maneira a minimizar os riscos e a garantir a segurança para as crianças e adolescentes e seus cuidadores.

Introduction: Antineoplastic drug manipulation for dose adjustment, such as tablet splitting, is standard in acute leukemia treatment for children and adolescents. Objective: To identify the frequency and describe the practice of household splitting of antineoplastic tablet for oral treatment of children and adolescents with acute leukemias in the maintenance phase. Method: Cross-sectional descriptive study performed in a public health system hospital from Distrito Federal (Brazil) with specialized pediatric assistance. Children and teenagers between 1 and 18 years old, diagnosed with acute leukemia and in treatment maintenance phase during the study period were included. A semi-structured questionnaire was applied to the main responsible for administering oral chemotherapy drugs, which could be the caregiver or the child/adolescent themselves. Sociodemographic variables of patients and caregivers and variables on the practice of splitting antineoplastic drugs at home were collected. Results: All 48 interviewees in the study period reported having split antineoplastic tablets during the treatment for acute leukemias, such as mercaptopurine (n = 45 [93.75%]) and thioguanine (n = 3 [6.25%]). Conclusion: The splitting of antineoplastic tablets was a unanimous practice due to the reported need to adjust the individual dose for acute leukemia treatment in children and adolescents, considering the unavailability of adequate formulations. The results reinforce the need for splitting to be standardized and performed in a way that minimizes risks and ensures safety for patients and their caregivers

Introducción: La manipulación de fármacos antineoplásicos para el ajuste de dosis, como las particiones de comprimidos, es frecuente en el tratamiento de las leucemias agudas en niños y jóvenes. Objetivo: Identificar la frecuencia y describir la práctica de la división domiciliaria de medicamentos antineoplásicos utilizados en el tratamiento oral de niños y adolescentes con leucemias agudas en la fase de mantenimiento. Método: Se trata de un estudio transversal descriptivo realizado en un hospital de la red de salud pública del Distrito Federal (Brasil) con asistencia especializada en pediatría. El estudio incluyó a niños y jóvenes de entre 1 y 18 años de edad diagnosticados con leucemia aguda y en fase de mantenimiento del tratamiento en el período del estudio. Se aplicó un cuestionario semiestructurado a la persona principal responsable de la administración de fármacos quimioterapéuticos por vía oral, que puede ser el cuidador o el propio niño/joven. Fueron colectadas variables sociodemográficas de los pacientes y cuidadores y variables sobre la práctica de la división de los medicamentos antineoplásicos en domicílios. Resultados: Los 48 entrevistados en el período de estudio informaron haber roto las pastillas antineoplásicas durante el tratamiento de la leucemia aguda, siendo éstas mercaptopurina (n=45 [93,75%]) y tioguanina (n=3 [6,25%]). Conclusión: La partición de comprimidos antineoplásicos fue una práctica unánime debido a la necesidad mencionada de ajustar la dosis individual para el tratamiento de las leucemias agudas de niños y adolescentes, considerando la falta de formulaciones apropiadas. Los resultados refuerzan la necesidad de estandarizar y realizar la partición para minimizar los riesgos y garantizar la seguridad de los niños, jóvenes y sus cuidadores.

Application of quality by design approach in RP-HPLC method development for simultaneous estimation of saxagliptin and dapagliflozin in tablet dosage form

A simple, sensitive, precise, accurate and robust high performance liquid chromatographic method has been developed for simultaneous estimation of saxagliptin (SAXA) and dapagliflozin (DAPA) in pharmaceutical formulation. Design of experiments (DoE) was applied for multivariate optimization of the experimental conditions of RP-HPLC method. Risk assessment was performed to identify the critical method parameters. Three independent factors; mobile phase composition, flow rate and column temperature were used to design mathematical models. Central composite design (CCD) was used to study the response surface methodology and to study in depth the effects of these independent factors. Desirability function was used to simultaneously optimize the retention time and resolution of SAXA and DAPA. The optimized and predicted data from contour diagram consisted of acetonitrile and ortho phosphoric acid (0.1%) in the ratio of 50:50 respectively, at a flow rate of 0.98 ml/min and column temperature 31.4 °C. Using these optimum conditions baseline separation of both drugs with good resolution and run time of less than 6 min were achieved. The optimized assay conditions were validated according to ICH guidelines. Hence, the results clearly showed that Quality by design approach could be successfully applied to optimize RP-HPLC method for simultaneous estimation of SAXA and DAPA.

Pharmacokinetics, safety and tolerability of L-3-n-butylphthalide tablet after single and multiple oral administrations in healthy Chinese volunteers

L-3-n-butylphthalide (L-NBP) is a naturally occurring antioxidant, which can be used for the treatment of acute ischemic stroke and vascular dementia. This study evaluated the safety, tolerability and pharmacokinetics of L-NBP tablets in healthy Chinese volunteers. This was a single-center, randomized, double-blind, placebo-controlled, single- and multiple-dose study. Subjects were assigned to receive a single dose of L-NBP tablet at either 80, 160, 320, or 480 mg (n=40), or multiple doses of 160 mg twice daily for 7 days (n=12). Plasma samples were analyzed with LC-MS/MS. Pharmacokinetic parameters of L-NBP were calculated using non-compartmental analysis with WinNonlin software. Statistical analysis was performed using SPSS software. All adverse events (AEs) were mild and of limited duration; AEs in this study occurred less frequently and more mildly than AEs listed for the DL-NBP soft capsule. No serious adverse event (SAE), death or withdrawal from the study was observed. In the single-dose study, Cmax was reached at about 1 h, and the mean t1/2 was approximately 13.76 h. Area under curve (AUC) and Cmax increased with dose escalation, but dose proportionality was not observed over the range of 160 to 480 mg. In the multiple-dose study, the steady-state was reached within 3 days with slight accumulation. In summary, the L-NBP tablet was well tolerated in healthy Chinese subjects. Slight accumulation appeared after repeated doses.

L-3-n-butilftalida (L-NMP) é um antioxidante natural, que pode ser utilizado para o tratamento do acidente isquêmico agudo e demência vascular. Este estudo avaliou segurança, tolerância e farmacocinética de comprimidos de L-NBP em chineses voluntários sadios. Este foi um estudo monocêntrico, randomizado, duplo cego, com controle por placebo e doses única e múltipla. Os indivíduos receberam dose única de comprimido de L-NBP de 80, 160, 320 ou 480 mg (n=40) e doses múltiplas de 160 mg duas vezes ao dia, por sete dias (n=12). Amostras de plasma foram analisadas com LC-MS/MS. Os parâmetros farmacocinéticos do L-NBP foram calculados utilizando análise não compartimental, com o programa WinNonlin. A análise estatística foi realizada utilizando-se o programa SPSS. Todos os eventos adversos (EAs) foram moderados e de duração limitada. EAs nesse estudo ocorreram menos frequentemente e mais moderadamente do que os EAs relacionados para cápsulas moles de DL-NBP. Não se observaram eventos adversos graves (EAG), morte ou abandono do estudo. Com dose única, atingiu-se o Cmax em cerca de 1 hora e o t1/2 médio foi de, aproximadamente, 13,76 h. A área sob a curva (ASC) e o Cmax aumentaram com o aumento da dose, mas não se observou proporcionalidade na faixa acima de 160 a 480 mg. No estudo de dose múltipla, o equilíbrio foi alcançado em três dias, com pequeno acúmulo. Em resumo, o comprimido de L-NMP foi bem tolerado em indivíduos chineses saudáveis. O acúmulo pequeno apareceu após doses repetidas.

Design and optimization of novel in situ gel of mercaptopurine for sustained drug delivery

Mercaptopurine is a purine antagonist, belonging to the class of antimetabolites. Its oral absorption is erratic and variable throughout GIT, with bioavailability of 5-37% and belongs to Biopharmaceutical Classification System (BCS) class IV. The focus of the present study was to improve solubility of mercaptopurine and to release the drug uniformly throughout the GIT by formulating into a novel in situ gel tablet. By in vitro swelling studies, xanthan gum was selected as the best gelling polymer and the tablets were prepared by direct compression. Sodium chloride was used as a release modifier to improve the release of drug from the tablet. A 32 full factorial design was applied to optimize the percentage of xanthan gum and sodium chloride to get desired swelling index and release profile. Tablets were evaluated for weight variation, hardness, friability, disintegration time, drug content, in vitro swelling studies and in vitro dissolution studies. The best optimized formulation showed good swelling index and extended the release up to 12 h, where as conventional tablet released the drug within 45 min. The results indicate that mercaptopurine loaded in situ gel tablet could be effective in sustaining drug release for a prolonged period of time throughout the GIT, which can possibly improve the oral bioavailability.

Mercaptopurine é um antagonista da purina, pertencente à a classe dos antimetabólitos. A sua absorção oral é errática e variável através do TGI, com biodisponibilidade de 5-37 % e pertence à classe IV, de acordo com o Sistema de Classificação Biofarmacêutica. O foco do presente estudo foi melhorar a solubilidade da mercaptopurina e liberar o fármaco uniformemente através do TGI, por meio da nova formulação de comprimidos que se tornam gel in situ. Por meio de estudos de inchamento, a goma xantana foi selecionada como o o melhor polímero gelificante e os comprimidos foram preparados por compressão direta. O cloreto de sódio também foi usado como agente modificador de liberação para aprimorar a liberação do fármaco do comprimido. Aplicou-se planejamento fatorial 32 para otimizar a porcentagem de goma xantana e de cloreto de sódio para se alcançar o índice de inchamento e o perfil de liberação desejáveis. Os comprimidos foram avaliados quanto à variação de peso, dureza, friabilidade, tempo de desintegração, conteúdo de fármaco, estudos in vitro de inchamento e de dissolução. A formulação mais bem otimizada mostrou bom índice de inchamento e liberação prolongada acima de 12 h, em comparação com um comprimido convencional, que libera o fármaco em 45 minutos. Os resultados indicam que a 6-mercaptopurina carregada no comprimido de gelificação in situ poderia ser eficaz para a liberação controlada por período de tempo prolongado através do TGI, o que pode, possivelmente, aprimorar a biodisponibilidade oral.

Organizadores e cortadores de comprimidos: riscos e restrições ao uso / Pill organizers and pill cutters: risks and limitations / Organizadores y cortadores de comprimidos: riesgos y restricciones del uso

Com base em análise documental, foram discutidas e problematizadas as limitações associadas à utilização de organizadores e cortadores de comprimidos, como questão de saúde pública. Os organizadores destinados ao armazenamento e transporte de comprimidos e cápsulas expõem essas formas farmacêuticas a fatores ambientais dos quais estariam protegidos em suas embalagens originais, comprometendo sua estabilidade, eficácia e segurança. Os cortadores oferecem risco adicional quanto a perda da eficácia, reações adversas e intoxicação. Por outro lado, o transporte de medicamentos pelo usuário é reflexo da conciliação entre autonomia e autocuidado e a partição de comprimidos é necessária para cumprir certos regimes posológicos. Conclui-se que cabe aos profissionais observar e orientar pacientes e cuidadores, visando à adequação dessas condutas e à prevenção dos riscos envolvidos.

In this essay, based on documental analysis, the limitations associated with the use of pill organizers and cutters are discussed and analyzed as a matter of public health. The use of the organizers for storing and carrying tablets and capsules exposes these medications to environmental factors from which their original packaging protected them, compromising their stability and safeness. Cutters also pose the additional risk of causing loss of efficacy, adverse reactions and overdose. On the other hand, the user carrying their own medication reflects the balance between autonomy and self-care, and splitting is sometimes required to comply with certain regimens. It can be concluded that healthcare professionals should observe and guide patients and caregivers in order to avoid risks.

Objetivo Con base en análisis documental, se discutieron y señalaron los problemas de las limitaciones asociadas a la utilización de organizadores y cortadores de comprimidos, con respecto a la salud pública. Los organizadores destinados al almacenamiento y transporte de comprimidos y cápsulas exponen las formas farmacéuticas a factores ambientales de los cuales estarían protegidos en sus embalajes originales, comprometiendo su estabilidad, eficacia y seguridad. Los cortadores ofrecen riesgo adicional con relación a la pérdida de la eficacia, reacciones adversas e intoxicación. Por otro lado, el transporte de medicamentos por el usuario es reflejo de la conciliación entre autonomía y autocuidado, y la partición de comprimidos es necesaria para cumplir ciertos regímenes posológicos. Se concluye que resta a los profesionales observar y orientar pacientes y cuidadores, buscando la adecuación de esas conductas y la prevención de los riesgos involucrados.

Modificación de formas farmacéuticas sólidas: relevamiento en un hospital de la Provincia de Córdoba / [Modification of solid dosage forms: survey in a hospital of the Province of Cordoba].

BACKGROUND: In the hospital setting is frequent to manipulate solid dosage forms (SDF, tablets 16 and capsules), which can affect their physicochemical and biopharmaceutical properties, the pharmacoloeffect and sometimes to cause the appearance of undesirable side effects. OBJECTIVES: To identify the medicines whose SDF is altered in a Hospital of Cordoba (Argentina), to determine how these modifications are made and to establish whether they were properly performed or not. METHODS: We retrospectively analyzed the prescriptions made between the 5th and the 11th of March of 2012 and identified impaired requesting SDF modifications. Open interviews were held with nurses and service visits to each hospital to determine how they manipulated the SDF. RESULTS: We analyzed 700 prescriptions for 113 patients, of which 61 (54

) had manipulations of the received SDF (49 for medical prescription, 7 because they had nasogastric tubes, 3 due to patient choice and 2 by nursing decision). Twenty three medicines were manipulated, but only 12 were correctly manipulated. The major changes were partition of tablets and grinding of tablets or microgranules and dispersible in water. CONCLUSION: The SDF of several medicines is altered in the analyzed hospital, many times without medical indication and scientific justification. It would be appropriate to conduct training courses and establish closer collaborations between pharmacy and nursing units in the investigated hospital.

Avaliação do processo de partição em comprimidos de hidroclorotiazida / Assessment of the splitting process in hydrochlorothiazide tablets

Um dos problemas mais comuns para a saúde da população é a hipertensão arterial, uma doença cardiovascular, cujas consequências podem ser fatais. Esta patologia requer tratamento posológico rigoroso para manutenção da concentração plasmática do fármaco em níveis terapêuticos desejados e constantes, para o devido controle da pressão arterial. Um dos fármacos mais utilizados para o controle da hipertensão é o diurético hidroclorotiazida. O presente estudo teve como objetivo avaliar o processo de partição (divisão em duas partes) em comprimidos de hidroclorotiazida, através de ensaios físico-químicos. Foram avaliadas as apresentações similar (S), genéricos (G) e referência (R) do fármaco estudado. Os resultados obtidos demonstraram que essa prática não se mostra segura, em função das grandes variações, na concentração de fármaco, encontrados em cada uma das partes do comprimido.

One of the commonest problems affecting the health of the population is arterial hypertension, a cardiovascular disease, whose consequences can be fatal. This condition requires strictly controlled drug dosage to maintain the plasma concentration of the drug at desirable and constant therapeutic levels, in order to control the blood pressure. One of the drugs most used for arterial hypertension control is the diuretic, hydrochlorothiazide. The aim of this study was to assess, by means of physicochemical tests, the process of splitting hydrochlorothiazide tablets into two parts. Similar (S), generic (G) and reference (R) forms of the drug were tested. The results showed that this practice appears not to be safe, according to the wide variations in the amount of drug found in each part of the tablet.

Avaliação do efeito da partição de comprimidos de furosemida sobre a uniformidade da dose / Influence of tablet splitting on dose uniformity

Buscando avaliar a uniformidade da dose unitária de comprimidos submetidos ao procedimento de partição, este trabalho avaliou a dureza, friabilidade, variação de peso e uniformidade de conteúdo em quatro amostras de comprimidos de furosemida de 40 mg, obtidas de diferentes fornecedores. Todas as amostras estudadas atendiam às especificações oficiais antes de serem submetidas ao procedimento de partição; porém, após serem partidas, o teor de fármaco nas metades apresentou excessiva variação, mostrando que esse procedimento pode ser terapeuticamente desaconselhável.

In order to assess the uniformity of the dose of active ingredient in the halves of tablets subjected to splitting, the hardness, friability, weight variability and uniformity of content were studied in four samples of 40 mg tablets of furosemide obtained on the Brazilian market, both whole and split into two parts. All the tablets complied with the official specifications before splitting, but, after this procedure, the drug content in the halves showed excessive variation, indicating that this procedure is inadvisable.

Formulation and evaluation of cetirizine dihydrochloride orodispersible tablet

Cetirizine orodispersible tablets were prepared to achieve quick onset of action and for maximum bioavailability. Tablets were prepared using cetirizine along with camphor and mannitol in the proportion of 1:1:1, 1:1:3, and 1:1:6. The flow property of granules was found to be good for the formulation CZ2 [1:1:3]. The hardness and friability of all the formulations were found to be within the standard limit for orodispersible tablets. Disintegration time was found to be rapid in formulation CZ2 [1:1:3].The in vitro dissolution time was found to be 100% in 11 minutes for the formulation CZ2 [1:1:3]