Scintigraphic evaluation of a novel colon-targeted delivery system (CODES) in healthy volunteers.

The purposes of this study are to investigate the gastrointestinal transit and release properties of a novel, colon-targeted delivery system (CODES) administered to healthy volunteers using gamma scintigraphy and to confirm that lactulose functions to promote disintegration in the colon. Two placebo formulations were studied: one was CODES, which consisted of a lactulose containing core overcoated with both Eudragit E and Eudragit L designed to rapidly disintegrate in the colon, the other was lactulose-free reference formulation (LFRF) that consisted of lactulose-free tablet core overcoated with the same materials. Transit and disintegration of the radiolabeled formulations were followed by gamma scintigraphy. In the fasted state, scintigraphic images indicated that CODES started to disintegrate in the ascending colon in the majority of subjects at 7.11 +/- 2.01 h post-dose. Disintegration was complete within 1 h following commencement of in vivo release. In contrast, LFRF presented with prolonged in vivo disintegration properties. In the fed state, the disintegration period of CODES was almost comparable to that observed in the fasted state. Gamma scintigraphic studies clearly showed that CODES provides for rapid target site release in the colon regardless of the ingestion of food.

Plasma carnitine concentrations in patients undergoing open heart surgery.

Carnitine is an essential cofactor for fatty acid (FA) metabolism, the predominant source of ATP in the normal aerobic heart. During myocardial ischemia, FA metabolism is impaired and tissue carnitine levels are depleted. Since the heart cannot synthesize carnitine, plasma carnitine could play an important role in maintaining myocardial carnitine levels during reperfusion. The purpose of this study was to determine the incidence of abnormal plasma carnitine concentrations in open heart surgery. Blood samples were obtained from eleven patients before, immediately after, and two hours after cardiopulmonary bypass (CPB). Total and free carnitine levels were significantly reduced immediately after CPB (p<0.01) and remained depressed until two hours after CPB (p<0.01 vs. pre CPB), while acyl carnitine levels were unchanged over the course of this study. These depressed free carnitine levels might affect cardiac metabolism in the heart after open heart surgery. Carnitine supplement might be a useful adjunct in the therapy after open heart surgery.

Potential use of cyclodextrins to enhance the solubility of YM466 in aqueous solution.

Various solubilizing agents for YM466, a new Factor Xa inhibitor, were investigated to begin designing the aqueous formulation for subcutaneous administration. The tentative target concentration was 5 mg/mL. First, three kinds of buffer solutions (glycine-HCl, citrate, and lactate) were examined for their solubilizing effects. The dissolution rate of YM466 in lactate buffer was the fastest, as determined by visual examination at room temperature. The dissolution rate of YM466 in lactate buffer was enhanced, without degradation, by heating at 40 degrees C, and YM466 solution at a concentration of 1 mg/mL became transparent 10 min after the start of heating. The solubility of YM466 increased along with lactate concentrations ranging from 50 mM to 200 mM and reached a high of 1.3 mg/mL after increasing lactate concentration to 200 mM at 5 degrees C. The addition of cyclodextrins beta-cyclodextrin (beta-CD), 2-hydroxypropyl-beta-cyclodextrin (HP-beta-CD), and gamma-cyclodextrin (gamma-CD), but not alpha-cyclodextrin (alpha-CD), had remarkable impact on its solubility, and 7-8 mg/mL of YM466 was dissolved by the addition of HP-beta-CD or gamma-CD. These results demonstrated that YM466 was included in cyclodextrins and that the inclusion formations required a cavity size larger than alpha-CD. Based on the calculation from the linear portion of the phase solubility diagrams, apparent stability constants of alpha-CD, beta-CD, HP-beta-CD, and gamma-CD at 5 degrees C were estimated to be 2M(-1), 206M(-1), 143M(-1), and 276M(-1), respectively. Therefore, we found that gamma-CD has the largest inclusion capacity.

Timed-release formulation to avoid drug-drug interaction between diltiazem and midazolam.

The purpose of this study was to investigate whether the use of a timed-release (TR) drug formulation can avoid unfavorable pharmacokinetic drug-drug interactions in vivo. First, the effects of the time interval between administration of midazolam and diltiazem on the known drug-drug interaction between these drugs were investigated in dogs. When dogs were given midazolam orally at the same time they were orally given an aqueous diltiazem solution, the area under the plasma concentration-time curves of midazolam increased significantly compared with that of midazolam given orally in the absence of diltiazem. However, there was no significant difference in pharmacokinetics of midazolam when the diltiazem solution was administered 1-2 h after midazolam. Tests on a TR formulation containing diltiazem demonstrated that the first appearance of diltiazem in plasma occurs at 2.6 +/- 0.5 h in dogs. Subsequent tests showed that the plasma concentration-time profile of midazolam after concurrent oral administration of the diltiazem TR formulation was almost the same as that of midazolam administered alone. These results demonstrate that a TR formulation of diltiazem can avoid the interaction between diltiazem and midazolam by creating a time interval between absorption of drugs in vivo, without the need for closely controlling the time of drug administration.

A new stressed test to predict the foreign matter formation of minodronic acid in solution.

A formulation containing 0.5 mg/ml minodronic acid, 40 mM citrate, pH 4.5, and sodium chloride, stored in regular flint glass ampoules, was stable without particulate increase under high temperature conditions, such as 40 degrees C for 6 months, or 50 or 60 degrees C for 3 months. However, when stored at 25 degrees C, there was an increase in >or=2 microm particles at the 5-month timepoint. This demonstrated that long-term stability cannot simply be predicted by the evaluation of samples just stored at higher temperatures. Therefore, a new stressed test was designed which is useful in the rapid selection of formulations that are stable and without particulate increase. Since the particulate matter is apparently a complex of minodronic acid and aluminum ions leaching from ampoules, samples were placed at 80 degrees C for up to 4 weeks to accelerate aluminum leaching. Although no particulate increase was observed directly after storage at 80 degrees C, 4 freeze-thaw cycles following the storage caused a drastic particulate increase. The evaluation of samples subjected to the freeze-thaw cycles indicated that the following formulation modifications have inhibitory effects on particulate generation: (1). addition of meglumine, diethanolamine, mannitol, or glycerol to the formulation; (2). increase of citric acid concentration; (3). decrease of minodronic acid concentration. These modifications also worked well for samples stored at 25 degrees C for 6 months, and particulate increase did not occur. This method is a powerful tool for predicting the stability of minodronic acid in solution.

Failure of stability prediction for minodronic acid injectable by accelerated stability testing.

A liquid formulation containing 0.5 mg/ml minodronic acid, 40 mM, pH 4.5, citrate, and sodium chloride added to adjust the osmolarity of the final formulation was stored in flint glass ampoules at 25, 40, 50, and 60 degrees C. At specified times, the drug potency and pH, and the tendency to generate particulate matter, were measured. Test samples stored at 40 degrees C for 6 months or at 50 and 60 degrees C for 3 months were stable with no potency loss and no particulate increase. However, despite the satisfactory stability at high temperatures, the amount of particulate matter increased when the formulation was stored at 25 degrees C. Scanning electron microscopy-energy dispersive X-ray analysis of the particulate matter revealed that it contains aluminum and phosphorus, the latter thought to be derived from minodronic acid. In contrast, the number of the particulate matter did not increase, when the formulation was stored in either plastic containers or in SiO(2)-treated glass ampoules(.) The spike of minodronic acid solution with aluminum ions led to the particulate generation. These results demonstrate that the particulate matter is a complex of minodronic acid molecules and aluminum ions, which apparently leached from the glass of regular ampoules. Since the particulate generation could not be observed at higher temperatures, it was suggested that the complex formation was exothermic and accelerated testing did not predict the stability in terms of particulate generation.