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Henry S, Samaro A, Marchesini FH, Shaqour B, Macedo J, Vanhoorne V, Vervaet C. Extrusion-based 3D printing of oral solid dosage forms: Material requirements and equipment dependencies. Int J Pharm 2021; 598:120361. [PMID: 33571622 DOI: 10.1016/j.ijpharm.2021.120361] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 02/08/2023]
Abstract
Extrusion-based 3D printing is steadily gaining importance as a manufacturing technique due to its flexibility and wide range of possible end-products. In the medical field, the technique is being exploited for a variety of applications and one of these is the production of personalised medicines. However, despite many proof-of-concept studies, more thorough insights in the production technique itself and the required material properties are needed before 3D printing can be fully exploited in a hospital or pharmacy setting. This research aims at clarifying the complex interplay between material properties, process parameters and printer-dependent variables. A variety of different polymers and polymer-drug blends were extruded (diameter 1.75±0.05 mm) and characterised in terms of mechanical, thermal and rheological properties. These properties, together with the processing temperature, printing speeds and different nozzle diameters of the 3D printer were linked to the quality of the end-product. Different failure mechanisms (mechanical, thermal) were assessed. Decisive material parameters (e.g. cross-over point) for optimal printing behaviour and the importance of printer construction (nozzle diameter) were clarified. In general, this study offers insight into the 3D printing process and will help to speed up future pharmaceutical formulation development for printlets.
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Affiliation(s)
- S Henry
- Laboratory of Pharmaceutical Technology, Ghent University, 9000 Ghent, Belgium
| | - A Samaro
- Laboratory of Pharmaceutical Technology, Ghent University, 9000 Ghent, Belgium
| | - F H Marchesini
- Department of Materials, Textiles and Chemical Engineering, Ghent University, 9052 Zwijnaarde, Belgium
| | - B Shaqour
- Voxdale bv, Bijkhoevelaan 32C, 2110 Wijnegem, Belgium; Laboratory for Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1 S.7, 2610 Antwerp, Belgium
| | - J Macedo
- iMed.ULisboa, Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal
| | - V Vanhoorne
- Laboratory of Pharmaceutical Technology, Ghent University, 9000 Ghent, Belgium
| | - C Vervaet
- Laboratory of Pharmaceutical Technology, Ghent University, 9000 Ghent, Belgium.
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Chatzitaki AT, Tsongas K, Tzimtzimis EK, Tzetzis D, Bouropoulos N, Barmpalexis P, Eleftheriadis GK, Fatouros DG. 3D printing of patient-tailored SNEDDS-based suppositories of lidocaine. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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53
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Pressure-assisted microsyringe 3D printing of oral films based on pullulan and hydroxypropyl methylcellulose. Int J Pharm 2021; 595:120197. [PMID: 33486041 DOI: 10.1016/j.ijpharm.2021.120197] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
Oral films (OFs) continue to attract attention as drug delivery systems, particularly for pedatric and geriatric needs. However, immiscibility between different polymers limits the full potential of OFs from being explored. One example is pullulan (PUL), a novel biopolymer which often has to be blended with other polymers to reduce cost and alter its mechanical properties. In this study, the state-of-the-art in fabrication techniques, three-dimensional (3D) printing was used to produce hybrid film structures of PUL and hydroxypropyl methylcellulose (HPMC), which were loaded with caffeine as a model drug. 3D printing was used to control the spatial deposition of films. HPMC was found to increase the mean mechanical properties of PUL films, where the tensile strength, elastic modulus and elongation break increased from 8.9 to 14.5 MPa, 1.17 to 1.56 GPa and from 1.48% to 1.77%, respectively. In addition, the spatial orientation of the hybrid films was also explored to determine which orientation could maximize the mechanical properties of the hybrid films. The results revealed that 3D printing could modify the mechanical properties of PUL whilst circumventing the issues associated with immiscibility.
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54
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Vaz VM, Kumar L. 3D Printing as a Promising Tool in Personalized Medicine. AAPS PharmSciTech 2021; 22:49. [PMID: 33458797 PMCID: PMC7811988 DOI: 10.1208/s12249-020-01905-8] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/18/2020] [Indexed: 12/13/2022] Open
Abstract
Personalized medicine has the potential to revolutionize the healthcare sector, its goal being to tailor medication to a particular individual by taking into consideration the physiology, drug response, and genetic profile of that individual. There are many technologies emerging to cause this paradigm shift from the conventional "one size fits all" to personalized medicine, the major one being three-dimensional (3D) printing. 3D printing involves the establishment of a three-dimensional object, in a layer upon layer manner using various computer software. 3D printing can be used to construct a wide variety of pharmaceutical dosage forms varying in shape, release profile, and drug combination. The major technological platforms of 3D printing researched on in the pharmaceutical sector include inkjet printing, binder jetting, fused filament fabrication, selective laser sintering, stereolithography, and pressure-assisted microsyringe. A possible future application of this technology could be in a clinical setting, where prescriptions could be dispensed based on individual needs. This manuscript points out the various 3D printing technologies and their applications in research for fabricating pharmaceutical products, along with their pros and cons. It also presents its potential in personalized medicine by individualizing the dose, release profiles, and incorporating multiple drugs in a polypill. An insight on how it tends to various populations is also provided. An approach of how it can be used in a clinical setting is also highlighted. Also, various challenges faced are pointed out, which must be overcome for the success of this technology in personalized medicine.
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Macedo J, Samaro A, Vanhoorne V, Vervaet C, Pinto JF. Processability of poly(vinyl alcohol) Based Filaments With Paracetamol Prepared by Hot-Melt Extrusion for Additive Manufacturing. J Pharm Sci 2020; 109:3636-3644. [DOI: 10.1016/j.xphs.2020.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 01/04/2023]
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Deshkar S, Rathi M, Zambad S, Gandhi K. Hot Melt Extrusion and its Application in 3D Printing of Pharmaceuticals. Curr Drug Deliv 2020; 18:387-407. [PMID: 33176646 DOI: 10.2174/1567201817999201110193655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/10/2020] [Accepted: 09/29/2020] [Indexed: 11/22/2022]
Abstract
Hot Melt Extrusion (HME) is a continuous pharmaceutical manufacturing process that has been extensively investigated for solubility improvement and taste masking of active pharmaceutical ingredients. Recently, it is being explored for its application in 3D printing. 3D printing of pharmaceuticals allows flexibility of dosage form design, customization of dosage form for personalized therapy and the possibility of complex designs with the inclusion of multiple actives in a single unit dosage form. Fused Deposition Modeling (FDM) is a 3D printing technique with a variety of applications in pharmaceutical dosage form development. FDM process requires a polymer filament as the starting material that can be obtained by hot melt extrusion. Recent reports suggest enormous applications of a combination of hot melt extrusion and FDM technology in 3D printing of pharmaceuticals and need to be investigated further. This review in detail describes the HME process, along with its application in 3D printing. The review also summarizes the published reports on the application of HME coupled with 3D printing technology in drug delivery.
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Affiliation(s)
- Sanjeevani Deshkar
- Department of Pharmaceutics, Dr. D.Y. Patil Institute of Pharamceutical Sciences and Research, Pune, Maharashtra 411018, India
| | - Mrunali Rathi
- Department of Pharmaceutics, Dr. D.Y. Patil Institute of Pharamceutical Sciences and Research, Pune, Maharashtra 411018, India
| | - Shital Zambad
- ThinCR Technologies India Pvt Ltd, Rahatani, Pune, Maharashtra 411017, India
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Đuranović M, Obeid S, Madžarević M, Cvijić S, Ibrić S. Paracetamol extended release FDM 3D printlets: Evaluation of formulation variables on printability and drug release. Int J Pharm 2020; 592:120053. [PMID: 33161041 DOI: 10.1016/j.ijpharm.2020.120053] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023]
Abstract
Paracetamol printlets were prepared via hot-melt extrusion process and fused deposition modelling, using two types of backbone polymers. Polycaprolactone (PCL) and Polyethylene oxides (PEO) 100 K and 200 K were used, while Arabic gum was used as a plasticizer to facilitate the material flow and Gelucire® 44/14 as an enhancer of drug release. Different drug/polymer ratios were prepared. Extrusion temperature was adjusted according to the mixture/polymer types. It was possible to produce filaments with maximum of 60% w/w of drug. Mechanical properties of filaments were evaluated using three-point bend test, while obtained parameters were modelled using decision tree as a data mining method. Correlation between maximum displacement, maximum force and printability was obtained with accuracy of 84.85% and can be a useful tool for predicting printability of filaments. This study briefly demonstrated that backbone polymer in formulation plays crucial role in obtaining FDM printlets with desired properties. PEO-based filaments were more prone to be clogged in printcore, but their printlets showed much faster drug release. Drug release from all printlets was prolonged: from 50% in 8 h (PCL), to complete release in 4 h (PEO). Paracetamol release kinetics was guided by anomalous transport, attributed to the diffusion and erosion process.
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Affiliation(s)
- Marija Đuranović
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade - Faculty of Pharmacy, Serbia
| | - Samiha Obeid
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade - Faculty of Pharmacy, Serbia
| | - Marijana Madžarević
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade - Faculty of Pharmacy, Serbia
| | - Sandra Cvijić
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade - Faculty of Pharmacy, Serbia
| | - Svetlana Ibrić
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade - Faculty of Pharmacy, Serbia.
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58
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Durga Prasad Reddy R, Sharma V. Additive manufacturing in drug delivery applications: A review. Int J Pharm 2020; 589:119820. [DOI: 10.1016/j.ijpharm.2020.119820] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
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59
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Fused Deposition Modeling (FDM), the new asset for the production of tailored medicines. J Control Release 2020; 330:821-841. [PMID: 33130069 DOI: 10.1016/j.jconrel.2020.10.056] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
Over the last few years, conventional medicine has been increasingly moving towards precision medicine. Today, the production of oral pharmaceutical forms tailored to patients is not achievable by traditional industrial means. A promising solution to customize oral drug delivery has been found in the utilization of 3D Printing and in particular Fused Deposition Modeling (FDM). Thus, the aim of this systematic literature review is to provide a synthesis on the production of pharmaceutical solid oral forms using FDM technology. In total, 72 relevant articles have been identified via two well-known scientific databases (PubMed and ScienceDirect). Overall, three different FDM methods have been reported: "Impregnation-FDM", "Hot Melt Extrusion coupled with FDM" and "Print-fill", which yielded to the formulation of thermoplastic polymers used as main component, five families of other excipients playing different functional roles and 47 active ingredients. Solutions are underway to overcome the high printing temperatures, which was the initial brake on to use thermosensitive ingredients with this technology. Also, the moisture sensitivity shown by a large number of prints in preliminary storage studies is highlighted. FDM seems to be especially fitted for the treatment of rare diseases, and particular populations requiring tailored doses or release kinetics. For future use of FDM in clinical trials, an implication of health regulatory agencies would be necessary. Hence, further efforts would likely be oriented to the use of a quality approach such as "Quality by Design" which could facilitate its approval by the authorities, and also be an aid to the development of this technology for manufacturers.
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60
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Eleftheriadis GK, Fatouros DG. Haptic Evaluation of 3D-printed Braille-encoded Intraoral Films. Eur J Pharm Sci 2020; 157:105605. [PMID: 33091570 DOI: 10.1016/j.ejps.2020.105605] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/26/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Abstract
The three-dimensional (3D) printing technology has recently emerged in the pharmaceutical field, providing an array of applications for individualized dosing and elaborate formulation designs. However, an alternative asset of the 3D printing technology is the capability to imprint haptic identifiers directly onto the surface of the formulations. This approach can generate novel design concepts, that will serve specific populations for identifying the right treatment regimen, i.e., visually impaired people. Toward this direction, the fused deposition modelling (FDM) technique was investigated for manufacturing intraoral films and incorporating Braille characters on the available area. The films comprised a drug-loaded compartment and a backing layer, which are typical structural characteristics for buccal delivery. A hydrophilic polymer, i.e., hydroxypropyl methylcellulose, provided the polymer matrix for both compartments, whereas ketoprofen was incorporated in the study as model drug. The Braille-encoded texts were designed on top of the backing layer, complying with the Marburg Medium spacing convention for pharmaceutical Braille. Moreover, modifications on the standard spacing and dimension parameters were applied, to investigate the accuracy and repeatability of the FDM process. The fabricated films were subjected to a haptic evaluation study with the aid of visually impaired individuals, to assess the readability of the 3D-printed Braille-encoded text. The outcomes of the study highlighted the capacity of the FDM technology in combining novel manufacturing concepts for individualized therapies with customized services that can be provided to specific populations, as in the case of people with visual impairment.
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Affiliation(s)
- Georgios K Eleftheriadis
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Dimitrios G Fatouros
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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61
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Xu X, Awad A, Robles-Martinez P, Gaisford S, Goyanes A, Basit AW. Vat photopolymerization 3D printing for advanced drug delivery and medical device applications. J Control Release 2020; 329:743-757. [PMID: 33031881 DOI: 10.1016/j.jconrel.2020.10.008] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 12/17/2022]
Abstract
Three-dimensional (3D) printing is transforming manufacturing paradigms within healthcare. Vat photopolymerization 3D printing technology combines the benefits of high resolution and favourable printing speed, offering a sophisticated approach to fabricate bespoke medical devices and drug delivery systems. Herein, an overview of the vat polymerization techniques, their unique applications in the fields of drug delivery and medical device fabrication, material examples and the advantages they provide within healthcare, is provided. The challenges and drawbacks presented by this technology are also discussed. It is forecast that the adoption of 3D printing could pave the way for a personalised health system, advancing from traditional treatments pathways towards digital healthcare.
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Affiliation(s)
- Xiaoyan Xu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Atheer Awad
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Pamela Robles-Martinez
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Simon Gaisford
- Department of Pharmaceutics, 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
| | - Alvaro Goyanes
- Department of Pharmaceutics, 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; Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I + D Farma (GI-1645), Facultad de Farmacia, and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Abdul W Basit
- Department of Pharmaceutics, 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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Melocchi A, Uboldi M, Cerea M, Foppoli A, Maroni A, Moutaharrik S, Palugan L, Zema L, Gazzaniga A. A Graphical Review on the Escalation of Fused Deposition Modeling (FDM) 3D Printing in the Pharmaceutical Field. J Pharm Sci 2020; 109:2943-2957. [DOI: 10.1016/j.xphs.2020.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 01/02/2023]
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Chang SY, Li SW, Kowsari K, Shetty A, Sorrells L, Sen K, Nagapudi K, Chaudhuri B, Ma AW. Binder-Jet 3D Printing of Indomethacin-laden Pharmaceutical Dosage Forms. J Pharm Sci 2020; 109:3054-3063. [DOI: 10.1016/j.xphs.2020.06.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
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Polymer Selection for Hot-Melt Extrusion Coupled to Fused Deposition Modelling in Pharmaceutics. Pharmaceutics 2020; 12:pharmaceutics12090795. [PMID: 32842703 PMCID: PMC7558966 DOI: 10.3390/pharmaceutics12090795] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/16/2020] [Accepted: 08/18/2020] [Indexed: 12/31/2022] Open
Abstract
Three-dimensional (3D) printing offers the greatest potential to revolutionize the future of pharmaceutical manufacturing by overcoming challenges of conventional pharmaceutical operations and focusing design and production of dosage forms on the patient’s needs. Of the many technologies available, fusion deposition modelling (FDM) is considered of the lowest cost and higher reproducibility and accessibility, offering clear advantages in drug delivery. FDM requires in-house production of filaments of drug-containing thermoplastic polymers by hot-melt extrusion (HME), and the prospect of connecting the two technologies has been under investigation. The ability to integrate HME and FDM and predict and tailor the filaments’ properties will extend the range of printable polymers/formulations. Hence, this work revises the properties of the most common pharmaceutical-grade polymers used and their effect on extrudability, printability, and printing outcome, providing suitable processing windows for different raw materials. As a result, formulation selection will be more straightforward (considering the characteristics of drug and desired dosage form or release profile) and the processes setup will be more expedite (avoiding or mitigating typical processing issues), thus guaranteeing the success of both HME and FDM. Relevant techniques used to characterize filaments and 3D-printed dosage forms as an essential component for the evaluation of the quality output are also presented.
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65
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Lee J, Song C, Noh I, Song S, Rhee YS. Hot-Melt 3D Extrusion for the Fabrication of Customizable Modified-Release Solid Dosage Forms. Pharmaceutics 2020; 12:pharmaceutics12080738. [PMID: 32764499 PMCID: PMC7464107 DOI: 10.3390/pharmaceutics12080738] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/24/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022] Open
Abstract
In this work, modified-release solid dosage forms were fabricated by adjusting geometrical properties of solid dosage forms through hot-melt 3D extrusion (3D HME). Using a 3D printer with air pressure driving HME system, solid dosage forms containing ibuprofen (IBF), polyvinyl pyrrolidone (PVP), and polyethylene glycol (PEG) were printed by simultaneous HME and 3D deposition. Printed solid dosage forms were evaluated for their physicochemical properties, dissolution rates, and floatable behavior. Results revealed that IBF content in the solid dosage form could be individualized by adjusting the volume of solid dosage form. IBF was dispersed as amorphous state with enhanced solubility and dissolution rate in a polymer solid dosage form matrix. Due to absence of a disintegrant, sustained release of IBF from printed solid dosage forms was observed in phosphate buffer at pH 6.8. The dissolution rate of IBF was dependent on geometric properties of the solid dosage form. The dissolution rate of IBF could be modified by merging two different geometries into one solid dosage form. In this study, the 3D HME process showed high reproducibility and accuracy for preparing dosage forms. API dosage and release profile were found to be customizable by modifying or combining 3D modeling.
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66
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Jacob S, Nair AB, Patel V, Shah J. 3D Printing Technologies: Recent Development and Emerging Applications in Various Drug Delivery Systems. AAPS PharmSciTech 2020; 21:220. [PMID: 32748243 DOI: 10.1208/s12249-020-01771-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/22/2020] [Indexed: 02/06/2023] Open
Abstract
The 3D printing is considered as an emerging digitized technology that could act as a key driving factor for the future advancement and precise manufacturing of personalized dosage forms, regenerative medicine, prosthesis and implantable medical devices. Tailoring the size, shape and drug release profile from various drug delivery systems can be beneficial for special populations such as paediatrics, pregnant women and geriatrics with unique or changing medical needs. This review summarizes various types of 3D printing technologies with advantages and limitations particularly in the area of pharmaceutical research. The applications of 3D printing in tablets, films, liquids, gastroretentive, colon, transdermal and intrauterine drug delivery systems as well as medical devices have been briefed. Due to the novelty and distinct features, 3D printing has the inherent capacity to solve many formulation and drug delivery challenges, which are frequently associated with poorly aqueous soluble drugs. Recent approval of Spritam® and publication of USFDA technical guidance on additive manufacturing related to medical devices has led to an extensive research in various field of drug delivery systems and bioengineering. The 3D printing technology could be successfully implemented from pre-clinical phase to first-in-human trials as well as on-site production of customized formulation at the point of care having excellent dose flexibility. Advent of innovative 3D printing machineries with built-in flexibility and quality with the introduction of new regulatory guidelines would rapidly integrate and revolutionize conventional pharmaceutical manufacturing sector.
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67
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Andriotis EG, Monou PK, Louka A, Papaefstathiou E, Eleftheriadis GK, Fatouros DG. Development of food grade 3D printable ink based on pectin containing cannabidiol/cyclodextrin inclusion complexes. Drug Dev Ind Pharm 2020; 46:1569-1577. [DOI: 10.1080/03639045.2020.1791168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Eleftherios G. Andriotis
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paraskevi-Kyriaki Monou
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aristi Louka
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Papaefstathiou
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios K. Eleftheriadis
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G. Fatouros
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
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68
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Eleftheriadis GK, Katsiotis CS, Andreadis DA, Tzetzis D, Ritzoulis C, Bouropoulos N, Kanellopoulou D, Andriotis EG, Tsibouklis J, Fatouros DG. Inkjet printing of a thermolabile model drug onto FDM-printed substrates: formulation and evaluation. Drug Dev Ind Pharm 2020; 46:1253-1264. [PMID: 32597338 DOI: 10.1080/03639045.2020.1788062] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The inkjet printing (IP) and fused deposition modeling (FDM) technologies have emerged in the pharmaceutical field as novel and personalized formulation approaches. Specific manufacturing factors must be considered in each adopted methodology, i.e. the development of suitable substrates for IP and the incorporation of highly thermostable active pharmaceutical compounds (APIs) for FDM. In this study, IP and FDM printing technologies were investigated for the fabrication of hydroxypropyl methylcellulose-based mucoadhesive films for the buccal delivery of a thermolabile model drug. Significance: This proof-of-concept approach was expected to provide an alternative formulation methodology for personalized mucoadhesive buccal films. METHODS Mucoadhesive substrates were prepared by FDM and were subjected to sequential IP of an ibuprofen-loaded liquid ink. The interactions between these processes and the performance of the films were evaluated by various analytical and spectroscopic techniques, as well as by in vitro and ex vivo studies. RESULTS The model drug was efficiently deposited by sequential IP passes onto the FDM-printed substrates. Significant variations were revealed on the morphological, physicochemical and mechanical properties of the prepared films, and linked to the number of IP passes. The mechanism of drug release, the mucoadhesion and the permeation of the drug through the buccal epithelium were evaluated, in view of the extent of ink deposition onto the buccal films, as well as the distribution of the API. CONCLUSIONS The presented methodology provided a proof-of-concept formulation approach for the development of personalized mucoadhesive films.
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Affiliation(s)
| | - Christos S Katsiotis
- Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios A Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Tzetzis
- School of Science and Technology, International Hellenic University, Thermi, Greece
| | - Christos Ritzoulis
- Department of Food Science and Technology, International Hellenic University, 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
| | - Dimitra Kanellopoulou
- Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature Chemical Processes, Patras, Greece
| | | | - John Tsibouklis
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Dimitrios G Fatouros
- Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
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69
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Hsiao WK, Lorber B, Paudel A. Can 3D printing of oral drugs help fight the current COVID-19 pandemic (and similar crisis in the future)? Expert Opin Drug Deliv 2020; 17:899-902. [PMID: 32427004 DOI: 10.1080/17425247.2020.1772229] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The ongoing COVID-19 crisis has highlighted the importance of a robust drug supply chain which can be quickly and flexibly ramped up to produce life-saving drug treatments. 3D printing (3DP) of oral solid dosage forms (OSDF) could be a viable part of the emergency drug production response to support vulnerable patients in rural regions and other isolated locations. In the context of the current pandemic, the suitability of different 3DP technologies will depend on the physicochemical properties, unit dose strength and BCS classification of the repurposed drug compounds currently being trialed for COVID-19. Furthermore, the deployment strategy should focus on simplifying dosage forms and formulations, scaling down the size and complexity of the printing systems and real-time quality assurance via process analytical technologies (PAT).
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Affiliation(s)
- Wen-Kai Hsiao
- Research Center Pharmaceutical Engineering GmbH , Graz, Austria
| | - Barbara Lorber
- Faculty of Technical Chemistry, Chemical and Process Engineering and Biotechnology, Graz University of Technology , Graz, Austria
| | - Amrit Paudel
- Research Center Pharmaceutical Engineering GmbH , Graz, Austria.,Faculty of Technical Chemistry, Chemical and Process Engineering and Biotechnology, Graz University of Technology , Graz, Austria
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70
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Eleftheriadis GK, Monou PK, Bouropoulos N, Boetker J, Rantanen J, Jacobsen J, Vizirianakis IS, Fatouros DG. Fabrication of Mucoadhesive Buccal Films for Local Administration of Ketoprofen and Lidocaine Hydrochloride by Combining Fused Deposition Modeling and Inkjet Printing. J Pharm Sci 2020; 109:2757-2766. [PMID: 32497597 DOI: 10.1016/j.xphs.2020.05.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/28/2020] [Accepted: 05/19/2020] [Indexed: 12/17/2022]
Abstract
In the area of developing oromucosal drug delivery systems, mucoadhesive buccal films are the most promising formulations for either systemic or local drug delivery. The current study presents the fabrication of buccal films, by combining fused deposition modeling (FDM) and inkjet printing. Hydroxypropyl methylcellulose-based films were fabricated via FDM, containing the non-steroidal anti-inflammatory drug ketoprofen. Unidirectional release properties were achieved, by incorporating an ethyl cellulose-based backing layer. The local anesthetic lidocaine hydrochloride, combined with the permeation enhancer l-menthol, was deposited onto the film by inkjet printing. Physicochemical analysis showed alterations in the characteristics of the films, and the mucoadhesive and mechanical properties were effectively modified, due to the ink deposition on the substrates. The in vitro release data of the active pharmaceutical compounds, as well as the permeation profiles across ex vivo porcine buccal mucosa and filter-grown TR146 cells of human buccal origin, were associated with the presence of the permeation enhancer and the backing layer. The lack of any toxicity of the fabricated films was demonstrated by the MTT viability assay. This proof-of-concept study provides an alternative formulation approach of mucoadhesive buccal films, intended for the treatment of local oromucosal diseases or systemic drug delivery.
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Affiliation(s)
- Georgios K Eleftheriadis
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Paraskevi Kyriaki Monou
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Nikolaos Bouropoulos
- Department of Materials Science, University of Patras, 26504 Rio, Patras, Greece; Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature Chemical Processes, 26504 Patras, Greece
| | - Johan Boetker
- Department of Pharmacy, University of Copenhagen, Copenhagen DK-2100, Denmark
| | - Jukka Rantanen
- Department of Pharmacy, University of Copenhagen, Copenhagen DK-2100, Denmark
| | - Jette Jacobsen
- Department of Pharmacy, University of Copenhagen, Copenhagen DK-2100, Denmark
| | - Ioannis S Vizirianakis
- Laboratory of Pharmacology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios G Fatouros
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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71
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Tagami T, Yoshimura N, Goto E, Noda T, Ozeki T. Fabrication of Muco-Adhesive Oral Films by the 3D Printing of Hydroxypropyl Methylcellulose-Based Catechin-Loaded Formulations. Biol Pharm Bull 2020; 42:1898-1905. [PMID: 31685772 DOI: 10.1248/bpb.b19-00481] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pharmaceutical applications of three dimensional (3D) printing technology are increasing following the approval of 3D-printed tablets by the U.S. Food and Drug Administration. Semi-solid extrusion-type 3D printers are used to 3D print hydrogel- and paste-based materials. We previously developed tablet formulations for semi-solid extrusion-type 3D bioprinters. In the present study, we extended our study to the preparation of muco-adhesive oral film formulations to 3D bioprint mouth ulcer pharmaceuticals. We focused on hydroxypropyl methylcellulose (HPMC)-based catechin (model drug)-loaded hydrogel formulations and found that the viscosity of a hydrogel formulation is dependent on the HPMC concentration, and that viscosity is important for facile 3D printing. HPMC-based films were prepared using two different drying methods (air drying and freeze drying). The films exhibited different drug dissolution profiles, and increasing the amount of HPMC in the film delayed drug dissolution. The fabrication of HPMC-based catechin-loaded films with different shapes provides a model of individualized, on-demand pharmaceuticals. Our results support the flexible application of 3D bioprinters (semi-solid extrusion-type 3D printers) for preparing film formulations.
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Affiliation(s)
- Tatsuaki Tagami
- Drug Delivery and Nano Pharmaceutics, Graduate School of Pharmaceutical Sciences, Nagoya City University
| | - Natsumi Yoshimura
- Drug Delivery and Nano Pharmaceutics, Graduate School of Pharmaceutical Sciences, Nagoya City University
| | - Eiichi Goto
- Drug Delivery and Nano Pharmaceutics, Graduate School of Pharmaceutical Sciences, Nagoya City University
| | - Takehiro Noda
- Drug Delivery and Nano Pharmaceutics, Graduate School of Pharmaceutical Sciences, Nagoya City University
| | - Tetsuya Ozeki
- Drug Delivery and Nano Pharmaceutics, Graduate School of Pharmaceutical Sciences, Nagoya City University
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72
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Ghilan A, Chiriac AP, Nita LE, Rusu AG, Neamtu I, Chiriac VM. Trends in 3D Printing Processes for Biomedical Field: Opportunities and Challenges. JOURNAL OF POLYMERS AND THE ENVIRONMENT 2020; 28:1345-1367. [PMID: 32435165 PMCID: PMC7224028 DOI: 10.1007/s10924-020-01722-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Alina Ghilan
- “Petru Poni” Institute of Macromolecular Chemistry, Laboratory of Inorganic Polymers, 41-A Grigore Ghica Voda Alley, Iasi, 700487 Romania
| | - Aurica P. Chiriac
- “Petru Poni” Institute of Macromolecular Chemistry, Laboratory of Inorganic Polymers, 41-A Grigore Ghica Voda Alley, Iasi, 700487 Romania
| | - Loredana E. Nita
- “Petru Poni” Institute of Macromolecular Chemistry, Laboratory of Inorganic Polymers, 41-A Grigore Ghica Voda Alley, Iasi, 700487 Romania
| | - Alina G. Rusu
- “Petru Poni” Institute of Macromolecular Chemistry, Laboratory of Inorganic Polymers, 41-A Grigore Ghica Voda Alley, Iasi, 700487 Romania
| | - Iordana Neamtu
- “Petru Poni” Institute of Macromolecular Chemistry, Laboratory of Inorganic Polymers, 41-A Grigore Ghica Voda Alley, Iasi, 700487 Romania
| | - Vlad Mihai Chiriac
- “Gh. Asachi” Technical University, Faculty of Electronics, Telecommunications and Information Technology, Bd. Carol I, 11A, Iasi, 700506 Romania
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73
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Jennotte O, Koch N, Lechanteur A, Evrard B. Three-dimensional printing technology as a promising tool in bioavailability enhancement of poorly water-soluble molecules: A review. Int J Pharm 2020; 580:119200. [PMID: 32156531 DOI: 10.1016/j.ijpharm.2020.119200] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022]
Abstract
Poor aqueous solubility of active pharmaceutical ingredients (API) is nowadays a major issue in the pharmaceutical field. The combinatorial chemistry provides more and more API with a great therapeutic potential, but with a low aqueous solubility. Among the strategies to overcome this drawback, the use of amorphous solid dispersions (ASD), as well as the increase of surface area, is widely used. The three dimensional (3D) printing technologies appear to be innovative tools allowing the construction of any unconventional forms with different composition, structure or infill; especially by using ASD materials. This review aims to deliver notions about the different 3D printing techniques found in the literature to improve aqueous solubility of several API, namely nozzle-based method, inkjet methods and laser- based methods, as well as guide formulator in terms of formulation parameters that have to be optimized to allow the most suitable impression of innovative medicines.
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Affiliation(s)
- Olivier Jennotte
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liege, 4000 Liege, Belgium.
| | - Nathan Koch
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liege, 4000 Liege, Belgium.
| | - Anna Lechanteur
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liege, 4000 Liege, Belgium
| | - Brigitte Evrard
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liege, 4000 Liege, Belgium
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74
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Liu J, Guan J, Wan X, Shang R, Shi X, Fang L, Liu C. The Improved Cargo Loading and Physical Stability of Ibuprofen Orodispersible Film: Molecular Mechanism of Ion-Pair Complexes on Drug-Polymer Miscibility. J Pharm Sci 2020; 109:1356-1364. [DOI: 10.1016/j.xphs.2019.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 10/25/2022]
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Azad MA, Olawuni D, Kimbell G, Badruddoza AZM, Hossain MS, Sultana T. Polymers for Extrusion-Based 3D Printing of Pharmaceuticals: A Holistic Materials-Process Perspective. Pharmaceutics 2020; 12:E124. [PMID: 32028732 PMCID: PMC7076526 DOI: 10.3390/pharmaceutics12020124] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 01/27/2020] [Accepted: 01/30/2020] [Indexed: 11/16/2022] Open
Abstract
Three dimensional (3D) printing as an advanced manufacturing technology is progressing to be established in the pharmaceutical industry to overcome the traditional manufacturing regime of 'one size fits for all'. Using 3D printing, it is possible to design and develop complex dosage forms that can be suitable for tuning drug release. Polymers are the key materials that are necessary for 3D printing. Among all 3D printing processes, extrusion-based (both fused deposition modeling (FDM) and pressure-assisted microsyringe (PAM)) 3D printing is well researched for pharmaceutical manufacturing. It is important to understand which polymers are suitable for extrusion-based 3D printing of pharmaceuticals and how their properties, as well as the behavior of polymer-active pharmaceutical ingredient (API) combinations, impact the printing process. Especially, understanding the rheology of the polymer and API-polymer mixtures is necessary for successful 3D printing of dosage forms or printed structures. This review has summarized a holistic materials-process perspective for polymers on extrusion-based 3D printing. The main focus herein will be both FDM and PAM 3D printing processes. It elaborates the discussion on the comparison of 3D printing with the traditional direct compression process, the necessity of rheology, and the characterization techniques required for the printed structure, drug, and excipients. The current technological challenges, regulatory aspects, and the direction toward which the technology is moving, especially for personalized pharmaceuticals and multi-drug printing, are also briefly discussed.
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Affiliation(s)
- Mohammad A. Azad
- Department of Chemical, Biological and Bioengineering, North Carolina A&T State University, Greensboro, NC 27411, USA; (D.O.); (G.K.)
| | - Deborah Olawuni
- Department of Chemical, Biological and Bioengineering, North Carolina A&T State University, Greensboro, NC 27411, USA; (D.O.); (G.K.)
| | - Georgia Kimbell
- Department of Chemical, Biological and Bioengineering, North Carolina A&T State University, Greensboro, NC 27411, USA; (D.O.); (G.K.)
| | - Abu Zayed Md Badruddoza
- Department of Chemical and Life Sciences Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Md. Shahadat Hossain
- Department of Engineering Technology, Queensborough Community College, City University of New York (CUNY), Bayside, NY 11364, USA;
| | - Tasnim Sultana
- Department of Public Health, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences (MCPHS), Boston, MA 02115, USA;
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76
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Musazzi UM, Khalid GM, Selmin F, Minghetti P, Cilurzo F. Trends in the production methods of orodispersible films. Int J Pharm 2020; 576:118963. [DOI: 10.1016/j.ijpharm.2019.118963] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 12/15/2022]
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77
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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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78
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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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79
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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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80
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Khan FA, Narasimhan K, Swathi CSV, Mustak S, Mustafa G, Ahmad MZ, Akhter S. 3D Printing Technology in Customized Drug Delivery System: Current State of the Art, Prospective and the Challenges. Curr Pharm Des 2019; 24:5049-5061. [PMID: 30636582 DOI: 10.2174/1381612825666190110153742] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/24/2018] [Accepted: 12/31/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND 3D printing/Additive Manufacturing seems a pragmatic approach to realize the quest for a truly customized and personalized drug delivery. 3DP technology, with innovations in pharmaceutical development and an interdisciplinary approach to finding newer Drug Delivery Systems can usher a new era of treatments to various diseases. The true potential of this is yet to be realized, and the US-FDA is focusing on the regulatory science of 3D printed medical devices to help patients access this technology safely and effectively. The approval of the first 3D printed prescription medicine by FDA is a promising step in the translation of more research in this area. METHODS A web-search on PubMed, ScienceDirect, and Nature was performed with the keywords Customized 3D printing and Drug delivery, publications dealing with the aspects of drug delivery using 3D printing for personalized or customized delivery were further considered and analyzed and discussed. RESULTS We present the advantages offered by 3DP over conventional methods of formulation development and discuss the current state of 3DP in pharmaceutics and how it can be used to develop a truly customized drug delivery system, various 3DP technologies including Stereolithography (SLA), Selective Laser Sintering (SLS), Fused Deposition Modelling (FDM), Pressure Assisted Microsyringe (PAM) that have been used to develop pharmaceutical products have been discussed along with their limitations and also the regulatory considerations to help formulation scientists envisaging research in this area with the necessary information. CONCLUSION 3D printing has the potential to fabricate a customized drug delivery system. Presence of many drug formulation and the devices are already in the regulatory approval process indicating its success.
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Affiliation(s)
| | | | - C S V Swathi
- Sri Indu Institute of Pharmacy, Hyderabad, India
| | | | - Gulam Mustafa
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, AD-Dawadmi, Riyadh, Saudi Arabia
| | - Mohammad Zaki Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Sohail Akhter
- Nanomedicine Research Lab, Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, New Delhi 110062, India.,LE STUDIUM® Loire Valley Institute for Advanced Studies, Centre-Val de Loire Region, Orleans, France.,Centre de Biophysique Moléculaire (CBM)-CNRS UPR4301, Rue Charles Sadron, 45071 Orléans Cedex 2, France
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81
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Algahtani MS, Mohammed AA, Ahmad J. Extrusion-Based 3D Printing for Pharmaceuticals: Contemporary Research and Applications. Curr Pharm Des 2019; 24:4991-5008. [PMID: 30636584 DOI: 10.2174/1381612825666190110155931] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/24/2018] [Accepted: 12/31/2018] [Indexed: 01/19/2023]
Abstract
Three-dimensional printing (3DP) has a significant impact on organ transplant, cosmetic surgery, surgical planning, prosthetics and other medical fields. Recently, 3 DP attracted the attention as a promising method for the production of small-scale drug production. The knowledge expansion about the population differences in metabolism and genetics grows the need for personalised medicine substantially. In personalised medicine, the patient receives a tailored dose and the release profile is based on his pharmacokinetics data. 3 DP is expected to be one of the leading solutions for the personalisation of the drug dispensing. This technology can fabricate a drug-device with complicated geometries and fillings to obtain the needed drug release profile. The extrusionbased 3 DP is the most explored method for investigating the feasibility of the technology to produce a novel dosage form with properties that are difficult to achieve using the conventional industrial methods. Extrusionbased 3 DP is divided into two techniques, the semi-solid extrusion (SSE) and the fused deposition modeling (FDM). This review aims to explain the extrusion principles behind the two techniques and discuss their capabilities to fabricate novel dosage forms. The advantages and limitations observed through the application of SSE and FDM for fabrication of drug dosage forms were discussed in this review. Further exploration and development are required to implement this technology in the healthcare frontline for more effective and personalised treatment.
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Affiliation(s)
- Mohammed S Algahtani
- Department of Pharmaceutics, College of Pharmacy, Najran University, Saudi Arabia
| | - Abdul Aleem Mohammed
- Department of Pharmaceutics, College of Pharmacy, Najran University, Saudi Arabia
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Saudi Arabia
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82
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Rohani Shirvan A, Bashari A, Hemmatinejad N. New insight into the fabrication of smart mucoadhesive buccal patches as a novel controlled-drug delivery system. Eur Polym J 2019. [DOI: 10.1016/j.eurpolymj.2019.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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83
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Unidirectional drug release from 3D printed mucoadhesive buccal films using FDM technology: In vitro and ex vivo evaluation. Eur J Pharm Biopharm 2019; 144:180-192. [PMID: 31550525 DOI: 10.1016/j.ejpb.2019.09.018] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 12/22/2022]
Abstract
Oromucosal delivery of active pharmaceutical ingredients provides an attractive alternative route of administration, due to avoidance of the first pass effect and improved patient compliance. In the current work, fused deposition modelling (FDM) 3D printing was investigated as an additive manufacturing approach for poly(vinyl alcohol)-based mucoadhesive films, enabling unidirectional drug release. For this purpose, chitosan was incorporated as a permeation and mucoadhesion enhancer whereas ethylcellulose and commercial wafer sheets were evaluated as backing layers. The formulated films were initially assessed for structural integrity and dose uniformity. Solid-state characterization of the films, including thermal methods (DSC, TGA), diffraction (XRPD) and Raman spectroscopy, was implemented to characterize the physicochemical properties of the produced polymeric filaments and buccal films. The mechanical properties of the products were investigated by instrumented indentation and tensile tests. Evaluation of buccal films was assessed in vitro, to study the effect of backing-layer type on hydration capacity of the films, diffusion of the drug throughout the restricting layer and release profiles in simulated saliva. The ex vivo performance of the manufactured products, associated with the presence of chitosan, was investigated by textural analysis for mucoadhesion properties, whereas permeation studies and histological studies were performed across porcine buccal epithelium. The results demonstrated that FDM printing is a timesaving and versatile approach in the context of manufacturing multi-layered mucoadhesive buccal films, providing unidirectional release properties.
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84
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Tian Y, Orlu M, Woerdenbag HJ, Scarpa M, Kiefer O, Kottke D, Sjöholm E, Öblom H, Sandler N, Hinrichs WLJ, Frijlink HW, Breitkreutz J, Visser JC. Oromucosal films: from patient centricity to production by printing techniques. Expert Opin Drug Deliv 2019; 16:981-993. [DOI: 10.1080/17425247.2019.1652595] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yu Tian
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, AV, The Netherlands
| | - Mine Orlu
- School of Pharmacy, University College London, London, Bloomsbury, UK
| | - Herman J. Woerdenbag
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, AV, The Netherlands
| | | | - Olga Kiefer
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dina Kottke
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Erica Sjöholm
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Turku, FI, Finland
| | - Heidi Öblom
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Turku, FI, Finland
| | - Niklas Sandler
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Turku, FI, Finland
| | - Wouter L. J. Hinrichs
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, AV, The Netherlands
| | - Henderik W. Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, AV, The Netherlands
| | - Jörg Breitkreutz
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - J. Carolina Visser
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, AV, The Netherlands
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85
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Kjar A, Huang Y. Application of Micro-Scale 3D Printing in Pharmaceutics. Pharmaceutics 2019; 11:E390. [PMID: 31382565 PMCID: PMC6723578 DOI: 10.3390/pharmaceutics11080390] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/28/2019] [Accepted: 08/01/2019] [Indexed: 01/09/2023] Open
Abstract
3D printing, as one of the most rapidly-evolving fabrication technologies, has released a cascade of innovation in the last two decades. In the pharmaceutical field, the integration of 3D printing technology has offered unique advantages, especially at the micro-scale. When printed at a micro-scale, materials and devices can provide nuanced solutions to controlled release, minimally invasive delivery, high-precision targeting, biomimetic models for drug discovery and development, and future opportunities for personalized medicine. This review aims to cover the recent advances in this area. First, the 3D printing techniques are introduced with respect to the technical parameters and features that are uniquely related to each stage of pharmaceutical development. Then specific micro-sized pharmaceutical applications of 3D printing are summarized and grouped according to the provided benefits. Both advantages and challenges are discussed for each application. We believe that these technologies provide compelling future solutions for modern medicine, while challenges remain for scale-up and regulatory approval.
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Affiliation(s)
- Andrew Kjar
- Department of Biological Engineering, Utah State University, Logan, UT 84322, USA
| | - Yu Huang
- Department of Biological Engineering, Utah State University, Logan, UT 84322, USA.
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86
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3D printed oral theophylline doses with innovative ‘radiator-like’ design: Impact of polyethylene oxide (PEO) molecular weight. Int J Pharm 2019; 564:98-105. [DOI: 10.1016/j.ijpharm.2019.04.017] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/03/2019] [Accepted: 04/06/2019] [Indexed: 01/29/2023]
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87
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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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88
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Edinger M, Jacobsen J, Bar-Shalom D, Rantanen J, Genina N. Analytical aspects of printed oral dosage forms. Int J Pharm 2018; 553:97-108. [PMID: 30316794 DOI: 10.1016/j.ijpharm.2018.10.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/30/2018] [Accepted: 10/10/2018] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Magnus Edinger
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Denmark
| | - Jette Jacobsen
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Denmark
| | - Daniel Bar-Shalom
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Denmark
| | - Jukka Rantanen
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Denmark
| | - Natalja Genina
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Denmark.
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89
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Trenfield SJ, Goyanes A, Telford R, Wilsdon D, Rowland M, Gaisford S, Basit AW. 3D printed drug products: Non-destructive dose verification using a rapid point-and-shoot approach. Int J Pharm 2018; 549:283-292. [DOI: 10.1016/j.ijpharm.2018.08.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 12/26/2022]
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90
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Haring AP, Tong Y, Halper J, Johnson BN. Programming of Multicomponent Temporal Release Profiles in 3D Printed Polypills via Core-Shell, Multilayer, and Gradient Concentration Profiles. Adv Healthc Mater 2018; 7:e1800213. [PMID: 29888441 DOI: 10.1002/adhm.201800213] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/20/2018] [Indexed: 02/03/2023]
Abstract
Additive manufacturing (AM) appears poised to provide novel pharmaceutical technology and controlled release systems, yet understanding the effects of processing and post-processing operations on pill design, quality, and performance remains a significant barrier. This paper reports a study of the relationship between programmed concentration profile and resultant temporal release profile using a 3D printed polypill system consisting of a Food and Drug Administration (FDA) approved excipient (Pluronic F-127) and therapeutically relevant dosages of three commonly used oral agents for treatment of type 2 diabetes (300-500 mg per pill). A dual-extrusion hydrogel microextrusion process enables the programming of three unique concentration profiles, including core-shell, multilayer, and gradient structures. Experimental and computational studies of diffusive mass transfer processes reveal that programmed concentration profiles are dynamic throughout both pill 3D printing and solidification. Spectrophotometric assays show that the temporal release profiles could be selectively programmed to exhibit delayed, pulsed, or constant profiles over a 5 h release period by utilizing the core-shell, multilayer, and gradient distributions, respectively. Ultimately, this work provides new insights into the mass transfer processes that affect design, quality, and performance of spatially graded controlled release systems, as well as demonstrating the potential to create disease-specific polypill technology with programmable temporal release profiles.
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Affiliation(s)
- Alexander P. Haring
- Department of Industrial and Systems Engineering Macromolecules Innovation Institute Virginia Tech Blacksburg VA 24061 USA
| | - Yuxin Tong
- Department of Industrial and Systems Engineering Virginia Tech Blacksburg VA 24061 USA
| | - Justin Halper
- Department of Industrial and Systems Engineering Virginia Tech Blacksburg VA 24061 USA
| | - Blake N. Johnson
- Department of Industrial and Systems Engineering Department of Chemical Engineering Department of Materials Science and Engineering Macromolecules Innovation Institute, Virginia Tech Blacksburg VA 24061 USA
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91
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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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