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Cotabarren I, Gallo L. 3D printing of PVA capsular devices for modified drug delivery: design and in vitro dissolution studies. Drug Dev Ind Pharm 2020; 46:1416-1426. [PMID: 32619117 DOI: 10.1080/03639045.2020.1791166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The fabrication through FDM 3D printing of hollow systems intended for oral drug delivery constitutes an attractive technology to change personalized medications in the compounding pharmacy. In this sense, this work studied the design and 3D printing of one compartment capsular devices filled of drugs that could require a delayed release mechanism. The optimization of printing parameters such as material flow rate and printing speed by means of simple gcode modifications, resulted critical to allow the production of PVA capsular devices in a single manufacturing process. In addition, the disintegration and dissolution studies of the obtained capsular device confirmed the existence of a delayed drug release compared to commercial hard-gelatin capsules. Furthermore, the use of sinkers in the dissolution tests resulted in similar dissolution profiles regardless the rotation speed. Finally, Gompertz and Weibull equations were the kinetic models that best fitted the experimental data corresponding to immediate release with lag time type profiles. Overall, this work provides insights to understand the effect of the printing parameters on the production of PVA capsular devices and suggests a simple design and single manufacturing process that can be adopted in the future compounding pharmacy.
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Affiliation(s)
- Ivana Cotabarren
- Departamento de Ingeniería Química, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina.,Planta Piloto de Ingeniería Química, PLAPIQUI (UNS-CONICET), Bahía Blanca, Argentina
| | - Loreana Gallo
- Planta Piloto de Ingeniería Química, PLAPIQUI (UNS-CONICET), Bahía Blanca, Argentina.,Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
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Pereira BC, Isreb A, Isreb M, Forbes RT, Oga EF, Alhnan MA. Additive Manufacturing of a Point-of-Care "Polypill:" Fabrication of Concept Capsules of Complex Geometry with Bespoke Release against Cardiovascular Disease. Adv Healthc Mater 2020; 9:e2000236. [PMID: 32510859 DOI: 10.1002/adhm.202000236] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/01/2020] [Indexed: 12/11/2022]
Abstract
Polypharmacy is often needed for the management of cardiovascular diseases and is associated with poor adherence to treatment. Hence, highly flexible and adaptable systems are in high demand to accommodate complex therapeutic regimens. A novel design approach is employed to fabricate highly modular 3D printed "polypill" capsules with bespoke release patterns for multiple drugs. Complex structures are devised using combined fused deposition modeling 3D printing aligned with hot-filling syringes. Two unibody highly modular capsule skeletons with four separate compartments are devised: i) concentric format: two external compartments for early release while two inner compartments for delayed release, or ii) parallel format: where nondissolving capsule shells with free-pass corridors and dissolution rate-limiting pores are used to achieve immediate and extended drug releases, respectively. Controlling drug release is achieved through digital manipulation of shell thickness in the concentric format or the size of the rate limiting pores in the parallel format. Target drug release profiles are achieved with variable orders and configurations, hence confirming the modular nature with capacity to accommodate therapeutics of different properties. Projection of the pharmacokinetic profile of this digital system capsules reveal how the developed approach can be applied in dose individualization and achieving multiple desired pharmacokinetic profiles.
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Affiliation(s)
- Beatriz C. Pereira
- School of Pharmacy and Biomedical SciencesUniversity of Central Lancashire Fylde road Preston PR1 2HE UK
| | - Abdullah Isreb
- School of Pharmacy and Biomedical SciencesUniversity of Central Lancashire Fylde road Preston PR1 2HE UK
| | - Mohammad Isreb
- School of PharmacyUniversity of Bradford Richmond Road Brardford BD7 1DP UK
| | - Robert T. Forbes
- School of Pharmacy and Biomedical SciencesUniversity of Central Lancashire Fylde road Preston PR1 2HE UK
| | - Enoche F. Oga
- School of Pharmacy and Biomedical SciencesUniversity of Central Lancashire Fylde road Preston PR1 2HE UK
| | - Mohamed A. Alhnan
- Institute of Pharmaceutical ScienceKing's College London 5.77 Franklin Wilkins Building, 150 Stamford Street London SE1 9NH UK
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Eleftheriadis GK, Katsiotis CS, Genina N, Boetker J, Rantanen J, Fatouros DG. Manufacturing of hybrid drug delivery systems by utilizing the fused filament fabrication (FFF) technology. Expert Opin Drug Deliv 2020; 17:1063-1068. [DOI: 10.1080/17425247.2020.1776260] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | | | - Natalja Genina
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Johan Boetker
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Jukka Rantanen
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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3D printing by fused deposition modeling of single- and multi-compartment hollow systems for oral delivery – A review. Int J Pharm 2020; 579:119155. [DOI: 10.1016/j.ijpharm.2020.119155] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 02/08/2023]
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55
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Aita IE, Breitkreutz J, Quodbach J. Investigation of semi-solid formulations for 3D printing of drugs after prolonged storage to mimic real-life applications. Eur J Pharm Sci 2020; 146:105266. [DOI: 10.1016/j.ejps.2020.105266] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/16/2020] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
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56
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Govender R, Abrahmsén-Alami S, Larsson A, Folestad S. Therapy for the individual: Towards patient integration into the manufacturing and provision of pharmaceuticals. Eur J Pharm Biopharm 2020; 149:58-76. [DOI: 10.1016/j.ejpb.2020.01.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/23/2019] [Accepted: 01/08/2020] [Indexed: 12/18/2022]
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Clark EA, Alexander MR, Irvine DJ, Roberts CJ, Wallace MJ, Yoo J, Wildman RD. Making tablets for delivery of poorly soluble drugs using photoinitiated 3D inkjet printing. Int J Pharm 2020; 578:118805. [DOI: 10.1016/j.ijpharm.2019.118805] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023]
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58
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Eleftheriadis GK, Katsiotis CS, Bouropoulos N, Koutsopoulos S, Fatouros DG. FDM-printed pH-responsive capsules for the oral delivery of a model macromolecular dye. Pharm Dev Technol 2020; 25:517-523. [PMID: 31903821 DOI: 10.1080/10837450.2019.1711396] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To this day, the oral delivery of biomacromolecules remains a major developmentally-oriented challenge. A combinatorial approach was followed at this study, to formulate an efficient carrier for the in vitro delivery of a model macromolecule, fluorescein isothiocyanate-dextran 4 kDa (FD4). The model macromolecule was formulated in a self-assembling peptide hydrogel (ac-(RADA)4-CONH2), prior to deposition in a hydroxypropyl methylcellulose-phthalate (HPMCP)-based 3D-printed capsule. Loading of FD4 was investigated for potential alterations on the structural (AFM) and gelling properties of the peptide carrier. Thermal analysis and morphological properties of the 3D-printed capsules were assessed by TGA, DSC and microscopy studies. For the peptide hydrogel, similar release profiles of FD4 were recorded in simulated gastric fluid pH 1.2 and phosphate buffer saline pH 7.4, indicating the need for a structural barrier, to protect the peptide carrier from the acidic environment of the stomach. The pH responsive character of the HPMCP-based capsule was evidenced in the release profiles of FD4 in a sequence of release media, i.e. simulated gastric fluid pH 1.2, simulated intestinal fluid pH 6.8 and phosphate buffer saline pH 7.4. The results supported the combinatorial formulation approach as a promising system for the efficient oral delivery of biomacromolecules.
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Affiliation(s)
- Georgios K Eleftheriadis
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos S Katsiotis
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Bouropoulos
- Department of Materials Science, University of Patras, Patras, Greece.,Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature Chemical Processes, Patras, Greece
| | - Sotirios Koutsopoulos
- Center for Biomedical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Dimitrios G Fatouros
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ehtezazi T, Algellay M, Hardy A. Next Steps in 3D Printing of Fast Dissolving Oral Films for Commercial Production. RECENT PATENTS ON DRUG DELIVERY & FORMULATION 2019; 14:5-20. [PMID: 31886755 DOI: 10.2174/1872211314666191230115851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 01/12/2023]
Abstract
3D printing technique has been utilised to develop novel and complex drug delivery systems that are almost impossible to produce by employing conventional formulation techniques. For example, this technique may be employed to produce tablets or Fast Dissolving oral Films (FDFs) with multilayers of active ingredients, which are personalised to patient's needs. In this article, we compared the production of FDFs by 3D printing to conventional methods such as solvent casting. Then, we evaluated the need for novel methods of producing fast dissolving oral films, and why 3D printing may be able to meet the shortfalls of FDF production. The challenges of producing 3D printed FDFs are identified at commercial scale by referring to the identification of suitable materials, hardware, qualitycontrol tests and Process Analytical Technology. In this paper, we discuss that the FDF market will grow to more than $1.3 billion per annum in the next few years and 3D printing of FDFs may share part of this market. Although companies are continuing to invest in technologies, which provide alternatives to standard drug delivery systems, the market for thin-film products is already well established. Market entry for a new technology such as 3D printing of FDFs will, therefore, be hard, unless, this technology proves to be a game changer. A few approaches are suggested in this paper.
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Affiliation(s)
- Touraj Ehtezazi
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Marwan Algellay
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Alison Hardy
- Knowledge Exchange and Commercialisation, Liverpool John Moores University, Liverpool, United Kingdom
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High Content Solid Dispersions for Dose Window Extension: A Basis for Design Flexibility in Fused Deposition Modelling. Pharm Res 2019; 37:9. [PMID: 31848730 PMCID: PMC6917630 DOI: 10.1007/s11095-019-2720-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/12/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE This study uses high drug content solid dispersions for dose window extension beyond current demonstrations using fused deposition modelling (FDM) to; i) accommodate pharmaceutically relevant doses of drugs of varying potencies at acceptable dosage form sizes and ii) enable enhanced dose flexibility via modular dosage form design concepts. METHODS FDM was used to generate ~0.5 mm thick discs of varying diameter (2-10 mm) from melt-extruded feedstocks based on 10% to 50% w/w felodipine in ethyl cellulose. Drug content was determined by UV spectroscopy and dispensing precision from printed disc mass. RESULTS Mean felodipine content was within ±5% of target values for all print volumes and compositions including contents as high as ~50% w/w. However, poor dispensing precision was evident at all print volumes. CONCLUSIONS In pursuit of dose flexibility, this successful demonstration of dose window extension using high content solid dispersions preserves FDM design flexibility by maintaining applicability to drugs of varying potencies. The achieved uniformity of content supports the application of varying content solid dispersions to modular dosage form concepts to enhance dose flexibility. However, poor dispensing precision impedes its utilisation until appropriate compatibility between FDM hardware and materials at varying drug contents can be attained.
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Elbl J, Gajdziok J, Kolarczyk J. 3D printing of multilayered orodispersible films with in-process drying. Int J Pharm 2019; 575:118883. [PMID: 31811925 DOI: 10.1016/j.ijpharm.2019.118883] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 11/24/2022]
Abstract
The aim of this study was to prepare benzydamine hydrochloride loaded orodispersible films using modified semisolid extrusion 3D printing method. An innovative approach was developed where thin layer of drug loaded dispersion is printed and dried before printing of subsequent layers. Layer-by-layer drying as the in process step improves mechanical properties of films, uniformity of drug content and allows faster preparation of films in compounding settings due to shortening of drying time. Orodispersible films consisted of film forming maltodextrin, sorbitol as a plasticizer and hydroxyethylcellulose as a thickening agent. The height of the digital model showed excellent correlation with the disintegration time, weight, thickness and mechanical properties of prepared films. Drug content, predefined by volume of digital model and concentration of drug in print dispersion, showed excellent uniformity. The modified printing method shows great promise in a compounding production of personalized film dosage forms, and brings in possibilities such as one step preparation of films with compartmented drugs and incorporation of taste masking or release control layers.
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Affiliation(s)
- Jan Elbl
- Department of Pharmaceutics, Faculty of Pharmacy, Veterinary and Pharmaceutical University Brno, Palackého tr. 1946/1, 612 42 Brno, Czech Republic
| | - Jan Gajdziok
- Department of Pharmaceutics, Faculty of Pharmacy, Veterinary and Pharmaceutical University Brno, Palackého tr. 1946/1, 612 42 Brno, Czech Republic.
| | - Jan Kolarczyk
- Department of Pharmaceutics, Faculty of Pharmacy, Veterinary and Pharmaceutical University Brno, Palackého tr. 1946/1, 612 42 Brno, Czech Republic
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62
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Dapivirine-releasing vaginal rings produced by plastic freeforming additive manufacturing. Int J Pharm 2019; 572:118725. [DOI: 10.1016/j.ijpharm.2019.118725] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/02/2019] [Accepted: 09/20/2019] [Indexed: 12/21/2022]
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63
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Jamróz W, Kurek M, Szafraniec-Szczęsny J, Czech A, Gawlak K, Knapik-Kowalczuk J, Leszczyński B, Wróbel A, Paluch M, Jachowicz R. Speed it up, slow it down…An issue of bicalutamide release from 3D printed tablets. Eur J Pharm Sci 2019; 143:105169. [PMID: 31785383 DOI: 10.1016/j.ejps.2019.105169] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/17/2019] [Accepted: 11/25/2019] [Indexed: 01/17/2023]
Abstract
The article describes the preparation and characterization of 3D-printed tablets with bicalutamide obtained using two-material co-extrusion-based fused deposition modeling (FDM). This method is a modification of typical two-material FDM where separate nozzles are used to print from two filaments. In this work we used a ZMorph® 3D printer with DualPro printhead which allows us to co-extrude two filaments through a single nozzle. This approach gives the opportunity to modify tablet properties in a wide range, especially the dissolution rate, by producing dosage forms with a complex design. The great advantage of this method is that switching between immediate dosage form and controlled release does not require any change in the 3D-printer set-up. We checked the accuracy of co-extrusion printing simply by weighing the amounts of soluble and insoluble material in the printed object as well as calculating the volumes of the printed objects from micro computed tomography (µ-CT) images. We printed several tablets with a different design including simple one-material tablets, two- and three-compartment tablets with various internal structure and composition of the printing path. The dissolution tests were conducted in sink and non-sink conditions. We obtained tablets with desired bicalutamide dissolution profiles, i.e. immediate, controlled, and combined. The formation of spatial matrix slows down the dissolution in controlled and combined release bicalutamide tablets what was confirmed by µ-CT analysis before and after dissolution.
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Affiliation(s)
- Witold Jamróz
- Chair and Department of Pharmaceutical Technology and Biopharmaceutics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland.
| | - Mateusz Kurek
- Chair and Department of Pharmaceutical Technology and Biopharmaceutics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
| | - Joanna Szafraniec-Szczęsny
- Chair and Department of Pharmaceutical Technology and Biopharmaceutics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland; Department of Physical Chemistry and Electrochemistry, Faculty of Chemistry, Jagiellonian University, 2 Gronostajowa str., 30-387 Krakow, Poland
| | - Anna Czech
- Chair and Department of Pharmaceutical Technology and Biopharmaceutics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
| | - Karolina Gawlak
- Department of Physical Chemistry and Electrochemistry, Faculty of Chemistry, Jagiellonian University, 2 Gronostajowa str., 30-387 Krakow, Poland
| | - Justyna Knapik-Kowalczuk
- Division of Biophysics and Molecular Physics, Institute of Physics, University of Silesia, Uniwersytecka 4, 40-007 Katowice, Poland; Silesian Center for Education and Interdisciplinary Research, 75 Pulku Piechoty 1a, 41-500 Chorzow, Poland
| | - Bartosz Leszczyński
- M. Smoluchowski Institute of Physics, Jagiellonian University, Łojasiewicza 11 30-348 Krakow, Poland
| | - Andrzej Wróbel
- M. Smoluchowski Institute of Physics, Jagiellonian University, Łojasiewicza 11 30-348 Krakow, Poland
| | - Marian Paluch
- Division of Biophysics and Molecular Physics, Institute of Physics, University of Silesia, Uniwersytecka 4, 40-007 Katowice, Poland; Silesian Center for Education and Interdisciplinary Research, 75 Pulku Piechoty 1a, 41-500 Chorzow, Poland
| | - Renata Jachowicz
- Chair and Department of Pharmaceutical Technology and Biopharmaceutics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
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Rycerz K, Stepien KA, Czapiewska M, Arafat BT, Habashy R, Isreb A, Peak M, Alhnan MA. Embedded 3D Printing of Novel Bespoke Soft Dosage Form Concept for Pediatrics. Pharmaceutics 2019; 11:pharmaceutics11120630. [PMID: 31779123 PMCID: PMC6956071 DOI: 10.3390/pharmaceutics11120630] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 11/16/2022] Open
Abstract
Embedded three-dimensional printing (e-3DP) is an emerging method for additive manufacturing where semi-solid materials are extruded within a solidifying liquid matrix. Here, we present the first example of employing e-3DP in the pharmaceutical field and demonstrate the fabrication of bespoke chewable dosage forms with dual drug loading for potential use in pediatrics. LegoTM-like chewable bricks made of edible soft material (gelatin-based matrix) were produced by directly extruding novel printing patterns of model drug ink (embedded phase) into a liquid gelatin-based matrix (embedding phase) at an elevated temperature (70 °C) to then solidify at room temperature. Dose titration of the two model drugs (paracetamol and ibuprofen) was possible by using specially designed printing patterns of the embedded phase to produce varying doses. A linearity [R2 = 0.9804 (paracetamol) and 0.9976 (ibuprofen)] was achieved between percentage of completion of printing patterns and achieved doses using a multi-step method. The impact of embedded phase rheological behavior, the printing speed and the needle size of the embedded phase were examined. Owning to their appearance, modular nature, ease of personalizing dose and geometry, and tailoring and potential inclusion of various materials, this new dosage form concept holds a substantial promise for novel dosage forms in pediatrics.
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Affiliation(s)
- Katarzyna Rycerz
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
- Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Krzysztof Adam Stepien
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
- Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Marta Czapiewska
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
- Faculty of Pharmacy, Department of Pharmaceutical Technology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Jurasza 2 St., 85-089 Bydgoszcz, Poland
| | - Basel T. Arafat
- Faculty of Medical Sciences and Public Health, Anglia Ruskin University, Chelmsford CM1 1SQ, UK;
| | - Rober Habashy
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
| | - Abdullah Isreb
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
| | - Matthew Peak
- Paediatric Medicines Research Unit, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK;
| | - Mohamed A. Alhnan
- Institute of Pharmaceutical Sciences, School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9NH, UK
- Correspondence: ; Tel.: +44-(0)20-7848-7265
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El Aita I, Ponsar H, Quodbach J. A Critical Review on 3D-printed Dosage Forms. Curr Pharm Des 2019; 24:4957-4978. [PMID: 30520369 DOI: 10.2174/1381612825666181206124206] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND In the last decades, 3D-printing has been investigated and used intensively in the field of tissue engineering, automotive and aerospace. With the first FDA approved printed medicinal product in 2015, the research on 3D-printing for pharmaceutical application has attracted the attention of pharmaceutical scientists. Due to its potential of fabricating complex structures and geometrics, it is a highly promising technology for manufacturing individualized dosage forms. In addition, it enables the fabrication of dosage forms with tailored drug release profiles. OBJECTIVE The aim of this review article is to give a comprehensive overview of the used 3D-printing techniques for pharmaceutical applications, including information about the required material, advantages and disadvantages of the respective technique. METHODS For the literature research, relevant keywords were identified and the literature was then thoroughly researched. CONCLUSION The current status of 3D-printing as a manufacturing process for pharmaceutical dosage forms was highlighted in this review article. Moreover, this article presents a critical evaluation of 3D-printing to control the dose and drug release of printed dosage forms.
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Affiliation(s)
- Ilias El Aita
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University Duesseldorf, Universitaetsstr. 1, 40225 Duesseldorf, Germany
| | - Hanna Ponsar
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University Duesseldorf, Universitaetsstr. 1, 40225 Duesseldorf, Germany.,INVITE GmbH, Drug Delivery Innovation Center (DDIC), Chempark Building W 32, 51368 Leverkusen, Germany
| | - Julian Quodbach
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University Duesseldorf, Universitaetsstr. 1, 40225 Duesseldorf, Germany
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66
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Tagami T, Hayashi N, Sakai N, Ozeki T. 3D printing of unique water-soluble polymer-based suppository shell for controlled drug release. Int J Pharm 2019; 568:118494. [DOI: 10.1016/j.ijpharm.2019.118494] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/11/2019] [Accepted: 07/01/2019] [Indexed: 12/26/2022]
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67
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The advent of a novel manufacturing technology in pharmaceutics: superiority of fused deposition modeling 3D printer. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2019. [DOI: 10.1007/s40005-019-00451-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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68
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An Effective Technology for the Development of Immediate Release Solid Dosage Forms Containing Low-Dose Drug: Fused Deposition Modeling 3D Printing. Pharm Res 2019; 36:128. [PMID: 31250313 DOI: 10.1007/s11095-019-2655-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Fabrication of immediate release (IR) tablet formulations with rapid release profile via fused deposition modeling 3D printing (FDM 3DP) is a challenge. The aims of this study were to prepare IR tablets with different dissolution profiles and to increase their in vitro dissolution rates by making physical modifications on them. Pramipexole was used as the model low-dose drug. METHODS Polymeric filaments were prepared with six different combinations of Eudragit EPO and poly(ethylene) oxide by hot melt extrusion and 3D tablets were produced using an FDM printer. Characterization studies for the filaments and tablets were carried out. The printability of the filaments was also evaluated using a novel mechanical characterization method. Tablet formulation with optimum dissolution profile was chosen and physical modifications (infill %, shape change and thickness) on this formulation were made. RESULTS Low-dose pramipexole loading filaments and 3D tablets were homogenously prepared. The printability of the filaments was related to their flexibility. With the physical modifications, the drug release completion time of the tablets reduced to 5 min. CONCLUSIONS The same rapid release profiles with conventional IR tablets can be reached by making only physical changes on 3D tablets without using any filling or disintegrating agents.
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Kallakunta VR, Sarabu S, Bandari S, Tiwari R, Patil H, Repka MA. An update on the contribution of hot-melt extrusion technology to novel drug delivery in the twenty-first century: part I. Expert Opin Drug Deliv 2019; 16:539-550. [PMID: 31007090 DOI: 10.1080/17425247.2019.1609448] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Currently, hot melt extrusion (HME) is a promising technology in the pharmaceutical industry, as evidenced by its application to manufacture various FDA-approved commercial products in the market. HME is extensively researched for enhancing the solubility and bioavailability of poor water-soluble drugs, taste masking, and modifying release in drug delivery systems. Additionally, its other novel opportunities or pharmaceutical applications, and capability for continuous manufacturing are being investigated. This efficient, industrially scalable, solvent-free, continuous process can be easily automated and coupled with other novel platforms for continuous manufacturing of pharmaceutical products. AREAS COVERED This review focuses on updates on solubility enhancement of poorly water-soluble drugs and process analytical tools such as UV/visible spectrophotometry; near-infrared spectroscopy; Raman spectroscopy; and rheometry for continuous manufacturing, with a special emphasis on fused deposition modeling 3D printing. EXPERT OPINION The strengths, weakness, opportunities, threats (SWOT) and availability of commercial products confirmed wide HME applicability in pharmaceutical research. Increased interest in continuous manufacturing processes makes HME a promising strategy for this application. However, there is a need for extensive research using process analytical tools to establish HME as a dependable continuous manufacturing process.
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Affiliation(s)
- Venkata Raman Kallakunta
- a Department of Pharmaceutics and Drug Delivery , The University of Mississippi , Oxford , MS , USA
| | - Sandeep Sarabu
- a Department of Pharmaceutics and Drug Delivery , The University of Mississippi , Oxford , MS , USA
| | - Suresh Bandari
- a Department of Pharmaceutics and Drug Delivery , The University of Mississippi , Oxford , MS , USA
| | - Roshan Tiwari
- a Department of Pharmaceutics and Drug Delivery , The University of Mississippi , Oxford , MS , USA
| | - Hemlata Patil
- a Department of Pharmaceutics and Drug Delivery , The University of Mississippi , Oxford , MS , USA
| | - Michael A Repka
- a Department of Pharmaceutics and Drug Delivery , The University of Mississippi , Oxford , MS , USA.,b Pii Center for Pharmaceutical Technology , The University of Mississippi , Oxford , MS , USA
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Elbadawi M. Rheological and Mechanical Investigation into the Effect of Different Molecular Weight Poly(ethylene glycol)s on Polycaprolactone-Ciprofloxacin Filaments. ACS OMEGA 2019; 4:5412-5423. [PMID: 31459706 PMCID: PMC6648292 DOI: 10.1021/acsomega.8b03057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/19/2019] [Indexed: 06/10/2023]
Abstract
Fused deposition fabrication (FDF) three-dimensional printing is a potentially transformative technology for fabricating pharmaceuticals. The state-of-the-art technology is still in its infancy and requires a concerted effort to realize its potential. One aspect includes the processing parameters of FDF and the effect of formulation thereto, which, to date, have not been thoroughly investigated. To progress understanding, the effect of different molecular weight poly(ethylene glycol)s (PEG) on polycaprolactone (PCL) loaded with ciprofloxacin (CIP) was investigated. A rheometer was used, and adapted accordingly, to analyze three processing aspects pertaining to FDF: viscosity, solidification, and adhesion. The results revealed that both CIP and PEG affected all three processing parameters. The salient findings were that the ternary blend with 10% w/w PEG 8000 exhibited rheological and adhesive properties ideal for FDF, as it provided a desirably shear-thinning filament that solidified rapidly, and improved the adhesion strength, in comparison to both the PCL-CIP binary blend and other ternary blends. In contrast, the ternary blend with 15% w/w PEG 200 was unfavorable; despite having a greater plasticizing effect, whereby the viscosity was markedly reduced, the sample provided no benefit to the solidification behavior of PCL-CIP and, in addition, failed to display adhesive behavior, which is a necessity for a successful print in FDF. The original findings herein set the precedent that the effect of drug and PEG on FDF processing should be considered beyond solely modifying the viscosity.
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Affiliation(s)
- Mohammed Elbadawi
- Control Engineering Group,
Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, SE-97187 Luleå, Sweden
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71
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Tian P, Yang F, Yu LP, Lin MM, Lin W, Lin QF, Lv ZF, Huang SY, Chen YZ. Applications of excipients in the field of 3D printed pharmaceuticals. Drug Dev Ind Pharm 2019; 45:905-913. [DOI: 10.1080/03639045.2019.1576723] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Pan Tian
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
| | - Fan Yang
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
- College of pharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Li-Ping Yu
- College of pharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Min-Mei Lin
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wei Lin
- College of pharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qi-Feng Lin
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhu-Fen Lv
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
| | - Si-Yu Huang
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yan-Zhong Chen
- Guangdong Key Laboratory of New Dosage Forms of Drugs, Guangdong Pharmaceutical University, Guangzhou, China
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72
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Araújo MRP, Sa-Barreto LL, Gratieri T, Gelfuso GM, Cunha-Filho M. The Digital Pharmacies Era: How 3D Printing Technology Using Fused Deposition Modeling Can Become a Reality. Pharmaceutics 2019; 11:pharmaceutics11030128. [PMID: 30893842 PMCID: PMC6471727 DOI: 10.3390/pharmaceutics11030128] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 01/08/2023] Open
Abstract
The pharmaceutical industry is set to join the fourth industrial revolution with the 3D printing of medicines. The application of 3D printers in compounding pharmacies will turn them into digital pharmacies, wrapping up the telemedicine care cycle and definitively modifying the pharmacotherapeutic treatment of patients. Fused deposition modeling 3D printing technology melts extruded drug-loaded filaments into any dosage form; and allows the obtainment of flexible dosages with different shapes, multiple active pharmaceutical ingredients and modulated drug release kinetics—in other words, offering customized medicine. This work aimed to present an update on this technology, discussing its challenges. The co-participation of the pharmaceutical industry and compounding pharmacies seems to be the best way to turn this technology into reality. The pharmaceutical industry can produce drug-loaded filaments on a large scale with the necessary quality and safety guarantees; while digital pharmacies can transform the filaments into personalized medicine according to specific prescriptions. For this to occur, adaptations in commercial 3D printers will need to meet health requirements for drug products preparation, and it will be necessary to make advances in regulatory gaps and discussions on patent protection. Thus, despite the conservatism of the sector, 3D drug printing has the potential to become the biggest technological leap ever seen in the pharmaceutical segment, and according to the most optimistic prognostics, it will soon be within reach.
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Affiliation(s)
- Maisa R P Araújo
- Laboratory of Food, Drugs and Cosmetics (LTMAC), University of Brasília (UnB), Brasília 70910-900, Brazil.
| | - Livia L Sa-Barreto
- Laboratory of Food, Drugs and Cosmetics (LTMAC), University of Brasília (UnB), Brasília 70910-900, Brazil.
| | - Tais Gratieri
- Laboratory of Food, Drugs and Cosmetics (LTMAC), University of Brasília (UnB), Brasília 70910-900, Brazil.
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs and Cosmetics (LTMAC), University of Brasília (UnB), Brasília 70910-900, Brazil.
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs and Cosmetics (LTMAC), University of Brasília (UnB), Brasília 70910-900, Brazil.
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Lamichhane S, Bashyal S, Keum T, Noh G, Seo JE, Bastola R, Choi J, Sohn DH, Lee S. Complex formulations, simple techniques: Can 3D printing technology be the Midas touch in pharmaceutical industry? Asian J Pharm Sci 2019; 14:465-479. [PMID: 32104475 PMCID: PMC7032174 DOI: 10.1016/j.ajps.2018.11.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/16/2018] [Accepted: 11/23/2018] [Indexed: 12/16/2022] Open
Abstract
3D printing is a method of rapid prototyping and manufacturing in which materials are deposited onto one another in layers to produce a three-dimensional object. Although 3D printing was developed in the 1980s and the technology has found widespread industrial applications for production from automotive parts to machine tools, its application in pharmaceutical area is still limited. However, the potential of 3D printing in the pharmaceutical industry is now being recognized. The ability of 3D printing to produce medications to exact specifications tailored to the needs of individual patients has indicated the possibility of developing personalized medicines. The technology allows dosage forms to be precisely printed in various shapes, sizes and textures that are difficult to produce using traditional techniques. However, there are various challenges associated with the proper application of 3D printing in the pharmaceutical sector which should be overcome to exploit the scope of this technology. In this review, an overview is provided on the various 3D printing technologies used in fabrication of complex dosage forms along with their feasibility and limitations.
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Affiliation(s)
| | - Santosh Bashyal
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Taekwang Keum
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Gyubin Noh
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Jo Eun Seo
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Rakesh Bastola
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Jaewoong Choi
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Dong Hwan Sohn
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Sangkil Lee
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
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Recent advances in pharmaceutical dosage forms and devices using additive manufacturing technologies. Drug Discov Today 2019; 24:636-643. [DOI: 10.1016/j.drudis.2018.11.019] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/16/2018] [Accepted: 11/24/2018] [Indexed: 12/20/2022]
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75
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Linares V, Casas M, Caraballo I. Printfills: 3D printed systems combining fused deposition modeling and injection volume filling. Application to colon-specific drug delivery. Eur J Pharm Biopharm 2019; 134:138-143. [DOI: 10.1016/j.ejpb.2018.11.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
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An Overview of 3D Printing Technologies for Soft Materials and Potential Opportunities for Lipid-based Drug Delivery Systems. Pharm Res 2018; 36:4. [PMID: 30406349 DOI: 10.1007/s11095-018-2531-1] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 10/21/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE Three-dimensional printing (3DP) is a rapidly growing additive manufacturing process and it is predicted that the technology will transform the production of goods across numerous fields. In the pharmaceutical sector, 3DP has been used to develop complex dosage forms of different sizes and structures, dose variations, dose combinations and release characteristics, not possible to produce using traditional manufacturing methods. However, the technology has mainly been focused on polymer-based systems and currently, limited information is available about the potential opportunities for the 3DP of soft materials such as lipids. METHODS This review paper emphasises the most commonly used 3DP technologies for soft materials such as inkjet printing, binder jetting, selective laser sintering (SLS), stereolithography (SLA), fused deposition modeling (FDM) and semi-solid extrusion, with the current status of these technologies for soft materials in biological, food and pharmaceutical applications. RESULT The advantages of 3DP, particularly in the pharmaceutical field, are highlighted and an insight is provided about the current studies for lipid-based drug delivery systems evaluating the potential of 3DP to fabricate innovative products. Additionally, the challenges of the 3DP technologies associated with technical processing, regulatory and material issues of lipids are discussed in detail. CONCLUSION The future utility of 3DP for printing soft materials, particularly for lipid-based drug delivery systems, offers great advantages and the technology will potentially support patient compliance and drug effectiveness via a personalised medicine approach.
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Advanced Pharmaceutical Applications of Hot-Melt Extrusion Coupled with Fused Deposition Modelling (FDM) 3D Printing for Personalised Drug Delivery. Pharmaceutics 2018; 10:pharmaceutics10040203. [PMID: 30356002 PMCID: PMC6321644 DOI: 10.3390/pharmaceutics10040203] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/12/2018] [Accepted: 10/21/2018] [Indexed: 12/14/2022] Open
Abstract
Three-dimensional printing, also known as additive manufacturing, is a fabrication process whereby a 3D object is created layer-by-layer by depositing a feedstock material such as thermoplastic polymer. The 3D printing technology has been widely used for rapid prototyping and its interest as a fabrication method has grown significantly across many disciplines. The most common 3D printing technology is called the Fused Deposition Modelling (FDM) which utilises thermoplastic filaments as a starting material, then extrudes the material in sequential layers above its melting temperature to create a 3D object. These filaments can be fabricated using the Hot-Melt Extrusion (HME) technology. The advantage of using HME to manufacture polymer filaments for FDM printing is that a homogenous solid dispersion of two or more pharmaceutical excipients i.e., polymers can be made and a thermostable drug can even be introduced in the filament composition, which is otherwise impractical with any other techniques. By introducing HME techniques for 3D printing filament development can improve the bioavailability and solubility of drugs as well as sustain the drug release for a prolonged period of time. The latter is of particular interest when medical implants are considered via 3D printing. In recent years, there has been increasing interest in implementing a continuous manufacturing method on pharmaceutical products development and manufacture, in order to ensure high quality and efficacy with less batch-to-batch variations of the pharmaceutical products. The HME and FDM technology can be combined into one integrated continuous processing platform. This article reviews the working principle of Hot Melt Extrusion and Fused Deposition Modelling, and how these two technologies can be combined for the use of advanced pharmaceutical applications.
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79
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3D printed capsules for quantitative regional absorption studies in the GI tract. Int J Pharm 2018; 550:418-428. [DOI: 10.1016/j.ijpharm.2018.08.055] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/21/2018] [Accepted: 08/28/2018] [Indexed: 12/14/2022]
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Fina F, Goyanes A, Madla CM, Awad A, Trenfield SJ, Kuek JM, Patel P, Gaisford S, Basit AW. 3D printing of drug-loaded gyroid lattices using selective laser sintering. Int J Pharm 2018; 547:44-52. [DOI: 10.1016/j.ijpharm.2018.05.044] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 02/08/2023]
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Awad A, Trenfield SJ, Gaisford S, Basit AW. 3D printed medicines: A new branch of digital healthcare. Int J Pharm 2018; 548:586-596. [PMID: 30033380 DOI: 10.1016/j.ijpharm.2018.07.024] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 12/11/2022]
Abstract
Three-dimensional printing (3DP) is a highly disruptive technology with the potential to change the way pharmaceuticals are designed, prescribed and produced. Owing to its low cost, diversity, portability and simplicity, fused deposition modeling (FDM) is well suited to a multitude of pharmaceutical applications in digital health. Favourably, through the combination of digital and genomic technologies, FDM enables the remote fabrication of drug delivery systems from 3D models having unique shapes, sizes and dosages, enabling greater control over the release characteristics and hence bioavailability of medications. In turn, this system could accelerate the digital healthcare revolution, enabling medicines to be tailored to the individual needs of each patient on demand. To date, a variety of FDM 3D printed medical products (e.g. implants) have been commercialised for clinical use. However, within pharmaceuticals, certain regulatory hurdles still remain. This article reviews the current state-of-the-art in FDM technology for medical and pharmaceutical research, including its use for personalised treatments and interconnection within digital health networks. The outstanding challenges are also discussed, with a focus on the future developments that are required to facilitate its integration within pharmacies and hospitals.
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Affiliation(s)
- Atheer Awad
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Sarah J Trenfield
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Simon Gaisford
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
| | - Abdul W Basit
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK.
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