‘In vivo’ disintegration of hard gelatin capsules in fasting and non-fasting subjects

Fasting before Intra-Gastric Dosing with Antigen Improves Intestinal Humoral Responses in Syrian Hamsters

Oral vaccines, unlike injected, induce intestinal secretory immunoglobulin A (sIgA) mimicking our natural defense against gut pathogens. We previously observed sIgA responses after administering the Clostridioides difficile colonisation factor CD0873 orally in enteric capsules to hamsters. Enteric-coated capsules are designed to resist dissolution in the stomach and disintegrate only at the higher pH of the small intestine. However, the variable responses between animals led us to speculate suboptimal transit of antigens to the small intestine. The rate of gastric emptying is a controlling factor in the passage of oral drugs for subsequent availability in the small intestine for absorption. Whilst in humans, food delays gastric emptying, in rats, capsules can empty quicker from fed stomachs than from fasted. To test in hamsters if fasting improves the delivery of antigens to the small intestine, as inferred from the immune responses generated, 24 animals were dosed intragastrically with enteric capsules containing recombinant CD0873. Twelve hamsters were fasted for 12 h prior to each dose and the other 12 fed. Significantly higher sIgA titres, with significantly greater bacterial-adherence-blocking activity, were detected in small intestinal lavages in the fasted group. We conclude that fasting in hamsters improves intestinal delivery leading to more robust responses.

Evaluation and Characterization of Hard-Shell Capsules Formulated by Using Goatskin Gelatin

Gelatin is used as an additive in medicine, food, and cosmetics. Gelatin from goatskin is a new excipient that has not been explored by researchers, including for hard-shell capsules. The aim of this study was to evaluate and characterize the hard-shell capsules produced from goatskin gelatin. The goatskin gelatin was extracted by an acid hydrolysis method, and the functional properties were investigated. Hard-shell capsules were then produced from goatskin gelatin, evaluated, and characterized. The gelatin extracted from goatskin had 56.9% ± 0.95 clarity and a pH of 5.11 ± 0.09, 97.51% ± 1.1 protein content, 9.23% ± 0.08 water content, 0.18% ± 0.07 ash content, 2.08% ± 0.35 fat content, gel strength of 298 ± 2.64 gbloom, and viscosity of 27.33 ± 2.07 mPs. The gelatin has met the requirements to be made into hard-shell capsules. The average weight of the hard-shell capsules produced was 96.9 mg with 8.69 standard deviation. The average size of the body and cap length was 18.84 ± 0.64 mm and 10.98 ± 0.30 mm, respectively. The results of capsule evaluation and characterization were as follows: the pH was 4.82 ± 1,27, water content was 10.03 ± 0.21, disintegration time was 4.02 ± 2.09 min, and there was no microbial growth. Thus, the capsules made have met the requirements and can be produced in a large quantity.

Fast-dissolving microparticles fail to show improved oral bioavailability

Oral dosage forms are the preferred means of delivering drugs for systemic absorption. However, development problems occur for drugs with poor water solubility and/or gastrointestinal permeability. It is generally believed that the in-vivo bioavailability of poorly water-soluble drugs from Class II of the Biopharmaceutics Classification System can be improved by increasing the dissolution rate. We have attempted to increase the in-vivo oral bioavailability of a model Class II drug (griseofulvin) by preparing rapidly-dissolving particles. The solvent-diffusion method was used to prepare particles with hydrophilic surfactants (Brij 76/Tween 80 surfactant blend) and in-vivo studies were conducted in rats. The griseofulvin particles produced were bipyramidal in habit with a particle size of 2.18 ± 0.12 mm; they contained crystalline drug and a relatively large proportion (12% w/w) of hydrophilic surfactant. The latter and the small particle size ensured rapid particle dispersion and dissolution in-vitro. Thus, within 30 min of the in-vitro dissolution test, the bipyramidal particles had released ∼70% of drug compared with ∼10% from the starting material (particle size 12.61 ± 1.11 μm). However, the rapid and increased drug dissolution in-vitro was not translated to rapid and enhanced absorption in-vivo, and the oral bioavailability of the model drug was found to be the same from the control and from the bipyramidal particles. The poor in-vivo performance of the bipyramidal particles showed that although the dissolution rate of a Class II drug is thought to be a good indicator of its in-vivo bioavailability, this is not always the case.

The use of citric acid to prolong the in vivo gastro-retention of a floating dosage form in the fasted state

Gastro-retentive dosage forms have the potential to improve local therapy and decrease the variation in bioavailability that is observed with a number of commercially available immediate and modified release preparations. In this study, a dosage form has been developed, utilising freeze-dried calcium alginate beads, designed to float on the surface of the stomach contents thus prolonging the retention time. The aim of the study was to also assess the in vivo behaviour of the radio-labelled calcium alginate beads when they were administered under fasting conditions with either water or an aqueous solution of citric acid, a potential gut transit delaying substance. The study was performed in healthy male volunteers who swallowed the radio-labelled calcium alginate beads after a 10h overnight fast. Gamma scintigraphy was selected as the method to monitor the movement of the calcium alginate beads. The volunteers consumed no further food or drink until gastric emptying of the calcium alginate beads was complete. The results indicated that prolonged gastric retention was achieved when the dosage form was administered with the citric acid solution when compared to retention in the absence of citric acid. Citric acid, therefore, has the potential to delay the gastric emptying of the calcium alginate beads when administered to fasted volunteers.

The role of gamma-scintigraphy in oral drug delivery

The gastrointestinal tract is usually the preferred site of absorption for most therapeutic agents, as seen from the standpoints of convenience of administration, patient compliance and cost. In recent years there has been a tendency to employ sophisticated systems that enable controlled or timed release of a drug, thereby providing a better dosing pattern and greater convenience to the patient. Although much about the performance of a system can be learned from in vitro release studies using conventional and modified dissolution methods, evaluation in vivo is essential in product development. The non-invasive technique of gamma-scintigraphy has been used to follow the gastrointestinal transit and release characteristics of a variety of pharmaceutical dosage forms. Such studies provide an insight into the fate of the delivery system and its integrity and enable the relationship between in vivo performance and resultant pharmacokinetics to be examined (pharmacoscintigraphy).

Gastrointestinal behavior of orally administered radiolabeled erythromycin pellets in man as determined by gamma scintigraphy

The behavior of single 250-mg doses of a multiparticulate form of erythromycin base (ERYC(R)), each including five pellets radiolabeled with neutron-activated samarium-153, was observed by gamma scintigraphy in seven male subjects under fasting and nonfasting conditions. The residence time and locus of radiolabeled pellets within regions of the gastrointestinal tract were determined and were correlated with plasma concentrations of erythromycin at coincident time points. Administration of food 30 minutes postdosing reduced fasting plasma erythromycin Cmax and area under the plasma erythromycin versus time curve (AUC) values by 43% and 54%, respectively. Mean peak plasma concentration of erythromycin (Cmax) in the fasting state was 1.64 micrograms/mL versus 0.94 micrograms/mL in the nonfasting state. Total oral bioavailability, as determined by mean AUC (0-infinity) of the plasma erythromycin concentration versus time curve, was 7.6 hr/micrograms/mL in the fasted state, versus 3.5 hr/micrograms/mL in the nonfasting state. Mean time to peak plasma erythromycin concentration (tmax) in the fasting state was 3.3 hours, versus 2.3 hours in the nonfasting state. Plasma concentrations of erythromycin in both fasting and nonfasting states were within acceptable therapeutic ranges. Evidence provided by this study: 1) indicates that pellet erosion and absorption of active erythromycin base begins when the enteric-coated pellets reach the highly vascular mucosa of the jejunum and proximal ileum, and is essentially completed within the ileum, with a significant portion absorbed in the medial-to-distal ileum; 2) confirms that acceptable therapeutic plasma levels of erythromycin are attained in nonfasting subjects (Cmax = 0.94 microgram/mL) and that superior plasma erythromycin concentrations (Cmax = 1.64 micrograms/mL) are achieved by administration of the dose on an empty stomach 1 to 2 hours before or after meals; 3) corroborates other comparative studies reporting greater fasting bioavailability with this multiparticulate dosage form of erythromycin base than with reference single tablet or particle-in-tablet formulations; and 4) indicates that neutron activation of stable isotopes incorporated as a normal excipient in industrially-produced formulations provides an effective means for in vivo evaluation of dosage forms through gamma scintigraphy.

What happens to tablets and capsules in the stomach: endoscopic comparison of disintegration and dispersion characteristics of two microencapsulated potassium formulations

Previously we investigated gastric emptying and distribution of a capsule formulation of microencapsulated KCl and found the drug was usually present in clumps of KCl crystals held in place by gastric mucus. We therefore investigated whether a tablet formulation of microencapsulated KCl would have improved dispersion. We characterized the intragastric disintegration of capsules and tablets of microencapsulated KCl in 12 subjects. The capsule formulation floated in the gastric pool; one end would adhere to the gastric mucosa and the motion of the tethered capsule would pull the end of the capsule off. The KCl crystals would then be deposited in a mass. In contrast, the tablet formulation sank to the anatomically most dependent portion of the stomach. The tablet rapidly became soft and fragile but, if allowed to remain in one place and minimally disturbed, required a median of 12 min to lose its shape. If allowed to reach the gastric antrum, the tablet was quickly ground by the antro-pyloric pump and widely dispersed. Once liberated in the stomach, the microencapsulated KCl crystals were bound into a more-or-less cohesive mass. The differences between KCl formulations, once the crystals were released, was minimal although the larger crystals from the tablet formulation appeared less adherent and cohesive; they dispersed more in a reticulated pattern when the stomach was distended. We conclude that formulation of a drug in a microencapsulated multiple-unit dosage form does not guarantee wide dispersion nor absence of high local concentration of drug.

Gastroscopic localization of a microencapsulated KCl preparation in the human stomach

A slow release polymer-coated preparation of potassium chloride granules (Micro-K Extencaps) was initially thought not to be associated with gastric mucosal damage. Recent studies have shown that acute gastric ulcers occur with approximately the same frequency as in patients taking wax matrix KCl formulations. The development of acute gastric ulcers was not consistent with the proposed dispersion characteristics of the microencapsulated KCl preparation. The authors therefore endoscopically evaluated the dispersion characteristics of microencapsulated KCl in a double-blind, placebo-controlled study. Subjects received four capsules of Micro-K or matching placebo and endoscopy was performed 30, 60, or 120 min after each drug ingestion. The material was identified with the Olympus HM (high magnification) endoscope and then quantitatively aspirated using the 3.5-mm biopsy channel of the Pentax 34JA endoscope. Microencapsulated KCl particles dispersed poorly and were found adhering to the mucosa and to one another, as a semisolid mass, most frequently in the gastric antrum. In contrast, the placebo (ethyl cellulose) was widely dispersed throughout the stomach. The authors concluded that gastric emptying must be considered in three phases: liquids, solids, and solids which adhere to the mucosa. No unique dispersion characteristics of Micro-K Extencaps were identified, and adherence of the KCl to the gastric mucosa may explain its ability to cause occasional acute gastric ulceration.

Gastric emptying of nondigestible solids in the fasted dog

Gastric emptying of nondigestible solid particles was studied in the fasted dog. Particles of varying sizes (0.5-6.4 mm), density (0.5-2.9 gm/cm3), and surface characteristics were coadministered orally with 50 mL of saline and collected from a permanent duodenal cannula implanted approximately 15 cm from the gastroduodenal junction. The phase of the motility pattern was ascertained by the appearance of bile, which occurs during phase II, as well as by mucus discharge, which stops at the onset of phase I. A lag phase, due to the 'quiet' phase I, was observed in the gastric emptying of coadministered saline. This is in contrast with gastric processing of large volumes (i.e., greater than 200 mL) which can usually be approximated by first-order discharge. Most coadministered saline was discharged before the solid particles. The pH of the duodenal effluent was elevated approximately 1 pH unit during mucus discharge and its pH can be as high as 8.3. In the fasted dog, gastric emptying of nondigestible particles closely followed the gastric motility patterns. The onset of discharge of the particles correlated with the late phase II and the phase III activity. Except for a few cases, which took two migrating motor complexes (MMC), greater than 90% of administered particles was discharged from the stomach after one MMC. The discharged particles were entrapped within mucous plugs. In the fasted state, gastric emptying of nondigestible particles appeared to be independent of size, density, and surface characteristics. Mucus seems to play a significant role in the distribution and discharge of the administered particles.

In vitro and in vivo evaluation of cellacephate microcapsules of sodium salicylate prepared by pan coating

Within various organic solvent based coating systems examined, one containing cellacephate and hydrogenated castor oil as cofilm formers was found to produce microcapsules of sodium salicylate by pan coating with optimum enteric properties, as determined by in vitro evaluation by scanning electron microscopy and dissolution studies. Scintiscans showed that such microcapsules packed in an outer hard gelatin capsule shell lodged temporarily in the oesophagus and tended to form aggregates on liberation in the stomach of the dog. Because of their rapid clearance from the stomach, single dosage with these microcapsules only prolonged appearance of the plasma peak by about 1.5 h in comparison to a conventional form. The microcapsules showed no decrease in bioavailability and only slight faecal blood loss during acute toxicity testing for gastrointestinal bleeding.

The use of gamma scintigraphy to follow the gastrointestinal transit of pharmaceutical formulations

The technique of gamma scintigraphy has been used to follow the transit of a solution and a pellet formulation in the gastrointestinal tract of healthy volunteers. The emptying of the formulations from the stomach and their arrival at the caecum could be quantified, thereby allowing calculation of transit times for the small intestine. Gastric emptying was affected by the nature of the formulation, i.e. liquid or solid. However, transit through the small intestine was independent of the nature of the administered material.

The effect of in-vivo dispersion and gastric emptying on glibenclamide absorption from a novel, rapidly dissolving capsule formulation

The in-vivo dispersion and gastric emptying of a novel glibenclamide dose form have been investigated using gamma-scintigraphy and related to the absorption of glibenclamide determined by measuring glibenclamide plasma concentrations. Its absorption is determined by the rate of emptying of the dose form from the stomach with the lag time between dosing and the start of gastric emptying (and hence absorption of the dose) largely dependent on the in-vivo disintegration time. The presence of food in the stomach has a marked effect on in-vivo disintegration/dispersion of the dose form and hence on the lag time between dosing and the start of absorption.

Effect of stress on the gastric emptying of capsules

During a series of experiments on the gastric emptying of capsules, certain subjects were exposed to stress in the form of high noise levels. In the non-fasting condition, these subjects showed a significantly faster gastric emptying than those who were not exposed to the stress.

Simultaneous measurement of gastric emptying of the soluble and insoluble components of a formulation using a dual isotope, gamma scintigraphic technique

The gastric emptying of a soluble and an insoluble component of a capsule formulation has been monitored by gamma scintigraphy using a dual isotope technique. There was no significant difference between the emptying rates for the two components or between fasting and non-fasting conditions (P greater than 0.01).