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Effect of Penetration Enhancers on Toenail Delivery of Efinaconazole from Hydroalcoholic Preparations. Molecules 2021; 26:molecules26061650. [PMID: 33809569 PMCID: PMC8000921 DOI: 10.3390/molecules26061650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 12/28/2022] Open
Abstract
The incorporation of permeation enhancers in topical preparations has been recognized as a simple and valuable approach to improve the penetration of antifungal agents into toenails. In this study, to improve the toenail delivery of efinaconazole (EFN), a triazole derivative for onychomycosis treatment, topical solutions containing different penetration enhancers were designed, and the permeation profiles were evaluated using bovine hoof models. In an in vitro permeation study in a Franz diffusion cell, hydroalcoholic solutions (HSs) containing lipophilic enhancers, particularly prepared with propylene glycol dicaprylocaprate (Labrafac PG), had 41% higher penetration than the HS base. Moreover, the combination of hydroxypropyl-β-cyclodextrin with Labrafac PG further facilitated the penetration of EFN across the hoof membrane. In addition, this novel topical solution prepared with both lipophilic and hydrophilic enhancers was physicochemically stable, with no drug degradation under ambient conditions (25 °C, for 10 months). Therefore, this HS system can be a promising tool for enhancing the toenail permeability and therapeutic efficacy of EFN.
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Abobakr FE, Fayez SM, Elwazzan VS, Sakran W. Effect of Different Nail Penetration Enhancers in Solid Lipid Nanoparticles Containing Terbinafine Hydrochloride for Treatment of Onychomycosis. AAPS PharmSciTech 2021; 22:33. [PMID: 33404930 DOI: 10.1208/s12249-020-01893-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022] Open
Abstract
Onychomycosis is considered a stubborn nail fungal infection that does not respond to conventional topical antifungal treatments. This study aimed to develop and characterize novel solid lipid nanoparticles (SLNs) formulae containing terbinafine HCl (TFH) and loaded with different nail penetration enhancers (nPEs). Three (nPEs) N-acetyl-L-cysteine, thioglycolic acid, and thiourea were used. Characterization of the prepared formulae was done regarding particle size, zeta potential, polydispersity index (PDI), entrapment efficiency (EE%), physical stability, in vitro release study, infrared (FT-IR), and their morphological structures. The selected formulae and the marketed cream Lamifen® were compared in terms of their antifungal activity against Trichophyton rubrum as well as their nail hydration and their drug uptake by the nail clippers. Thiourea was the nPE of choice; formulae (N2 and N8), with thiourea, were considered the optimum TFH SLNs containing nPEs. They were selected for their optimum particle size of 426.3 ± 10.18 and 450.8 ± 11.45 nm as well as their highest EE% of 89.76 ± 1.25 and 90.35 ± 1.33, respectively. The in vitro microbiological screening of the antifungal activity of these two formulae showed significantly larger zones of inhibition in comparison with the marketed product. The ex vivo screening of the drug uptake of the two selected formulae was significantly higher than that of the marketed product. The nPE formulae present a very promising option as they showed optimum physicochemical characterization with high antifungal activity and high drug uptake as well as good nail hydration effect.
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Tampucci S, Terreni E, Zucchetti E, Burgalassi S, Chetoni P, Monti D. Formulations Based on Natural Ingredients for the Treatment of Nail Diseases. Curr Pharm Des 2020; 26:556-565. [DOI: 10.2174/1381612826666200122150248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/18/2019] [Indexed: 12/21/2022]
Abstract
Nail is a strong and resistant structure, characterized by a low permeability to foreign molecules. Nails
can be subjected to many diseases, among which fungal infections (e.g. onchomycosis) are the most common and
responsible for nail structure alteration. Many formulations have been produced for the delivery of active ingredients
to treat nail disorders, based on newly synthesized active molecules or containing chemical enhancers or
chemically-modified polymers able to improve the drug transungual penetration. To avoid permanent alterations
of the nail structure due to the use of chemical compounds or organic solvent-based formulation, researchers have
developed novel formulations focusing on the use of new natural-based compounds. The purpose of this review is
to provide information on the outcoming of natural ingredients-based formulations that have been developed in
the last years as potential alternative to chemical-based formulations.
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Affiliation(s)
| | | | | | | | | | - Daniela Monti
- Department of Pharmacy, University of Pisa, Pisa, Italy
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Kushwaha A, Shivakumar HN, Murthy SN. Iontophoresis for drug delivery into the nail apparatus: exploring hyponychium as the site of delivery. Drug Dev Ind Pharm 2016; 42:1678-82. [PMID: 26981643 DOI: 10.3109/03639045.2016.1165690] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In present studies, a hyponychium pathway (from ventral side of the nail plate) was investigated as a potential route of drug delivery into the nail apparatus using iontophoresis as an active physical method. In vitro transport studies were performed across the human nail plate using sodium fluorescein as a marker substrate for 24 h. After transport studies, the amount of sodium fluorescein extracted from an active diffusion area of the nail plate in case of iontophoresis was found to be ∼54-folds more to that of passive. The amount of sodium fluorescein retained in the peripheral area of the nail plate after application of iontophoresis was found to be ∼30-folds more relative to passive. Ex vivo transport studies were performed on excised human cadaver toe using terbinafine hydrochloride as a model drug for three days (8 h/day). The amount of terbinafine retained in the nail plate after application of iontophoresis (3.43 ± 1.34 µg/mg) was ∼20-folds more when compared with passive (0.17 ± 0.10 µg/mg). The amount of drug extracted from the nail bed and nail matrix was 1.73 ± 0.12 µg/mg and 0.55 ± 0.22 µg/mg, respectively. On the other hand, there was no detectable amount of terbinafine found in the nail bed and nail matrix in case of control (passive delivery). These studies show that the iontophoretic drug delivery through hyponychium region to other parts of the nail apparatus could be a potential way of onychomycosis treatment.
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Affiliation(s)
- Avadhesh Kushwaha
- a Department of Pharmaceutics and Drug Delivery , University of Mississippi, University , MS , USA
| | - H N Shivakumar
- b Institute for Drug Delivery and Biomedical Research , Bangalore , India
| | - S Narasimha Murthy
- a Department of Pharmaceutics and Drug Delivery , University of Mississippi, University , MS , USA ;,b Institute for Drug Delivery and Biomedical Research , Bangalore , India
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Kataria P, Sharma G, Thakur K, Bansal V, Dogra S, Katare OP. Emergence of nail lacquers as potential transungual delivery system in the management of onchomycosis. Expert Opin Drug Deliv 2016; 13:937-52. [DOI: 10.1080/17425247.2016.1174691] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Gajanand Sharma
- Division of Pharmaceutics, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Studies, Panjab University, Chandigarh, India
| | - Kanika Thakur
- Division of Pharmaceutics, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Studies, Panjab University, Chandigarh, India
| | - Vikas Bansal
- Chandigarh College of Pharmacy, Mohali, Punjab, India
| | - Sunil Dogra
- Department of Dermatology Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Om Prakash Katare
- Division of Pharmaceutics, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Studies, Panjab University, Chandigarh, India
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Akhtar N, Sharma H, Pathak K. Onychomycosis: Potential of Nail Lacquers in Transungual Delivery of Antifungals. SCIENTIFICA 2016; 2016:1387936. [PMID: 27123362 PMCID: PMC4829734 DOI: 10.1155/2016/1387936] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/01/2016] [Accepted: 03/06/2016] [Indexed: 05/24/2023]
Abstract
Onychomycosis constitutes the most common fungal infection of the nail (skin beneath the nail bed) that affects the finger as well as toe nails. It is an infection that is initiated by yeasts, dermatophytes, and nondermatophyte molds. Nail lacquers are topical solutions intended only for use on fingernails as well as toenails and have been found to be useful in the treatment of onychomycosis. Thus, in the present review an attempt has been made to focus on the treatment aspects of onychomycosis and the ungual delivery of antifungals via nail lacquer. Several patents issued on nail lacquer till date have also been discussed. Penetration efficiency was assessed by several researchers across the human nail plate to investigate the potentiality of nail lacquer based formulations. Various clinical trials have also been conducted in order to evaluate the safety and efficacy of nail lacquers in delivering antifungal agents. Thus, it can be concluded that nail lacquer based preparations are efficacious and stable formulations. These possess tremendous potential for clinical topical application to the nail bed in the treatment of onychomycosis.
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Affiliation(s)
- Nida Akhtar
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, P.O. Chhatikara, Mathura, Uttar Pradesh 281001, India
| | - Hemlata Sharma
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, P.O. Chhatikara, Mathura, Uttar Pradesh 281001, India
| | - Kamla Pathak
- Department of Pharmaceutics, Pharmacy College Saifai, Saifai, Etawah, Uttar Pradesh 206130, India
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Abstract
Nail disorders are beyond cosmetic concern; besides discomfort in the performance of daily chores, they disturb patients psychologically and affect their quality of life. Fungal nail infection (onychomycosis) is the most prevalent nail-related disorder affecting a major population worldwide. Overcoming the impenetrable nail barrier is the toughest challenge for the development of efficacious topical ungual formulation. Sophisticated techniques such as iontophoresis and photodynamic therapy have been proven to improve transungual permeation. This article provides an updated and concise discussion regarding the conventional approach and upcoming novel approaches focused to alter the nail barrier. A comprehensive description regarding preformulation screening techniques for the identification of potential ungual enhancers is also described in this review while highlighting the current pitfalls for the development of ungual delivery.
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Kushwaha A, Murthy RN, Murthy SN, Elkeeb R, Hui X, Maibach HI. Emerging therapies for the treatment of ungual onychomycosis. Drug Dev Ind Pharm 2015; 41:1575-81. [PMID: 25997365 DOI: 10.3109/03639045.2015.1033426] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Onychomycosis, a common fungal infection in the finger and toe nails, affects approximately 2-8% of the worldwide population. Fungal infection is more complicated in those who suffer from conditions, such as diabetes, peripheral vascular diseases and compromised immune diseases. AREA COVERED Onychomycosis treatment has been classified on the basis of location of infection in the toes and fingers and infectious agents (dermatophytes fungi, yeast and non-dermatophyte molds). In this review, the available therapies (traditional and device based) and their limitations for the treatment of onychomycosis have been discussed. EXPERT OPINION The success rate with topical nail products has been minimal. The main reason for this poor success rate could be attributed to the lack of complete understanding of the pathophysiology of the disease and clinical pharmacokinetic data of drugs in the infected nail apparatus.
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Affiliation(s)
- Avadhesh Kushwaha
- a Institute for Drug Delivery and Biomedical Research , Bangalore , India .,b Department of Pharmaceutics , University of Mississippi, University , MS , USA , and
| | - Reena N Murthy
- a Institute for Drug Delivery and Biomedical Research , Bangalore , India
| | - S Narasimha Murthy
- a Institute for Drug Delivery and Biomedical Research , Bangalore , India .,b Department of Pharmaceutics , University of Mississippi, University , MS , USA , and
| | - Rania Elkeeb
- c Department of Dermatology , University of California , San Francisco , CA , USA
| | - X Hui
- c Department of Dermatology , University of California , San Francisco , CA , USA
| | - Howard I Maibach
- c Department of Dermatology , University of California , San Francisco , CA , USA
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