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Chiclana-Rodríguez B, Garcia-Montoya E, Rouaz-El Hajoui K, Romero-Obon M, Nardi-Ricart A, Suñé-Pou M, Suñé-Negre JM, Pérez-Lozano P. Development of a Carvedilol Oral Liquid Formulation for Paediatric Use. Pharmaceutics 2023; 15:2283. [PMID: 37765252 PMCID: PMC10537783 DOI: 10.3390/pharmaceutics15092283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Carvedilol (CARV) is an 'off-label' β-blocker drug to treat cardiovascular diseases in children. Since CARV is nearly insoluble in water, only CARV solid forms are commercialized. Usually, CARV tablets are manipulated to prepare an extemporaneous liquid formulation for children in hospitals. We studied CARV to improve its aqueous solubility and develop an oral solution. In this study, we assessed the solubility and preliminary stability of CARV in different pH media. Using malic acid as a solubility enhancer had satisfactory results. We studied the chemical, physical, and microbiological stability of 1 mg/mL CARV-malic acid solution. A design of experiment (DoE) was used to optimize the CARV solution's preparation parameters. A 1 mg/mL CARV solution containing malic acid was stable for up to 12 months at 25 °C and 30 °C and 6 months at 40 °C. An equation associating malic acid with CARV concentrations was obtained using DoE. Microbiological data showed that the use of methylparaben was not necessary for this period of time. We successfully developed an aqueous CARV solution suitable for paediatrics and proven to be stable over a 12-month period.
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Affiliation(s)
- Blanca Chiclana-Rodríguez
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
| | - Encarnacion Garcia-Montoya
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
- Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via de l’Hospitalet, 199-203, 08090 Barcelona, Spain
| | - Khadija Rouaz-El Hajoui
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
- Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via de l’Hospitalet, 199-203, 08090 Barcelona, Spain
| | - Miquel Romero-Obon
- Quality Assurance Pharmaceutical Sites Director—Laboratorios ALMIRALL, Ctra. de Martorell, 41-61, 08740 Sant Andreu de la Barca, Spain
| | - Anna Nardi-Ricart
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
| | - Marc Suñé-Pou
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
- Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via de l’Hospitalet, 199-203, 08090 Barcelona, Spain
| | - Josep M. Suñé-Negre
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
- Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via de l’Hospitalet, 199-203, 08090 Barcelona, Spain
| | - Pilar Pérez-Lozano
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain; (B.C.-R.); (K.R.-E.H.); (A.N.-R.); (M.S.-P.); (J.M.S.-N.); (P.P.-L.)
- Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via de l’Hospitalet, 199-203, 08090 Barcelona, Spain
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Patel AR, Shaddy RE. Role of β-blocker therapy in pediatric heart failure. ACTA ACUST UNITED AC 2010; 4:45-58. [PMID: 21799703 DOI: 10.2217/phe.09.65] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Heart failure is becoming an increasingly common and significant problem in the field of pediatric cardiology. The numerous types of cardiomyopathies, and more recently, long-term survival of patients with congenital heart disease, have added to a growing patient population. Over the last several decades, our knowledge base regarding mechanisms of disease and therapeutic intervention in adult patients with heart failure has drastically changed. The most recent and important breakthrough in the pharmacologic treatment of heart failure has been the particular role of β-blocker therapy. This medication has led to significant improvements in survival and symptoms in adults, with less convincing findings in limited studies in pediatrics. The ability to study the benefits of this therapy in patients has been challenging owing to the heterogeneity of the patient population and lack of large sample sizes. However, as we investigate the mechanisms behind the disease process, the differences that exist between disease conditions and ages, and the significant alterations that may exist at the molecular and genetic level, our understanding of β-blocker therapy in pediatric heart failure will improve, and ultimately may lead to patient-specific therapy.
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Affiliation(s)
- Akash R Patel
- The Children's Hospital of Philadelphia, Department of Cardiology, 34th & Civic Center Boulevard, Philadelphia, PA 19104, USA Tel.: +1 215 590 3548
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