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Racaniello GF, Silvestri T, Pistone M, D'Amico V, Arduino I, Denora N, Lopedota AA. Innovative Pharmaceutical Techniques for Paediatric Dosage Forms: A Systematic Review on 3D Printing, Prilling/Vibration and Microfluidic Platform. J Pharm Sci 2024; 113:1726-1748. [PMID: 38582283 DOI: 10.1016/j.xphs.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/08/2024]
Abstract
The production of paediatric pharmaceutical forms represents a unique challenge within the pharmaceutical industry. The primary goal of these formulations is to ensure therapeutic efficacy, safety, and tolerability in paediatric patients, who have specific physiological needs and characteristics. In recent years, there has been a significant increase in attention towards this area, driven by the need to improve drug administration to children and ensure optimal and specific treatments. Technological innovation has played a crucial role in meeting these requirements, opening new frontiers in the design and production of paediatric pharmaceutical forms. In particular, three emerging technologies have garnered considerable interest and attention within the scientific and industrial community: 3D printing, prilling/vibration, and microfluidics. These technologies offer advanced approaches for the design, production, and customization of paediatric pharmaceutical forms, allowing for more precise dosage modulation, improved solubility, and greater drug acceptability. In this review, we delve into these cutting-edge technologies and their impact on the production of paediatric pharmaceutical forms. We analyse their potential, associated challenges, and recent developments, providing a comprehensive overview of the opportunities that these innovative methodologies offer to the pharmaceutical sector. We examine different pharmaceutical forms generated using these techniques, evaluating their advantages and disadvantages.
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Affiliation(s)
| | - Teresa Silvestri
- Department of Pharmacy, University of Naples Federico II, D. Montesano St. 49, 80131 Naples, Italy
| | - Monica Pistone
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari, Via E. Orabona, 4, 70125, Bari, Italy
| | - Vita D'Amico
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari, Via E. Orabona, 4, 70125, Bari, Italy
| | - Ilaria Arduino
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari, Via E. Orabona, 4, 70125, Bari, Italy
| | - Nunzio Denora
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari, Via E. Orabona, 4, 70125, Bari, Italy.
| | - Angela Assunta Lopedota
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari, Via E. Orabona, 4, 70125, Bari, Italy
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Wang J, Shakleya D, Giacoia G, Rahman Z, Khan MA, Faustino PJ. Bioavailability assessment of a brompheniramine taste-masked pediatric formulation in a juvenile porcine model. Biomed Chromatogr 2024; 38:e5845. [PMID: 38412513 DOI: 10.1002/bmc.5845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/29/2024]
Abstract
A brompheniramine taste-masked pediatric formulation was developed as part of the National Institutes of Health Pediatric Formulation Initiative to help address low patient compliance caused by the bitter taste of many adult formulations. To confirm that the taste-masked formulation can provide a similar pharmacological effect to the previous marketed adult formulations, a juvenile porcine model was used to screen the model pediatric formulation to compare the bioavailability between the marketed brompheniramine maleate and the taste-masked maleate/tannate formulation. Pigs were dosed orally with both formulations and blood samples were obtained from 0 to 48 h. Plasma samples were prepared and extracted using solid-phase extraction. The mass spectrometer was operated under selected ion monitoring mode. The selected ion monitoring channels were set to m/z 319.1 for brompheniramine and m/z 275.2 for the internal standard chlorpheniramine. Calibration curves were linear over the analytical range 0.2-20 ng/ml (r2 > 0.995) for brompheniramine in plasma. The intra- and inter-day accuracies were between 98.0 and 105% with 5.73% RSD precision. The bioanalytical method was successfully applied to a preclinical bioavailability study. The bioavailability profiles were not significantly different between the two formulations, which demonstrates that taste-masking with tannic acid is a promising approach for formulation modification for pediatric patients.
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Affiliation(s)
- Jiang Wang
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Diaa Shakleya
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - George Giacoia
- Obstetric and Pediatric Pharmacology and Therapeutics Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Ziyuar Rahman
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Mansoor A Khan
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Patrick J Faustino
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation, US Food and Drug Administration, Silver Spring, Maryland, USA
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Wargenau M, Baase F, Eckardt K, Spitzhorn LS, Reidemeister S, Klingmann I, Klingmann V. Questionnaire Study to Investigate the Preferences of Children, Parents, and Healthcare Professionals for Different Formulations of Oral Medicinal Products. Pharmaceutics 2024; 16:515. [PMID: 38675176 PMCID: PMC11054268 DOI: 10.3390/pharmaceutics16040515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Since the acceptability of a medicine can significantly impact therapeutic outcomes, this study aimed to determine and compare the preferences of children, parents, and healthcare professionals for the most commonly used pediatric oral medicine formulations (syrup, mini-tablets, oblong tablets, round tablets) addressing all pediatric age groups, 0-<18 years (y). This survey study employed sex-, age-, and participant group-adapted questionnaires for eight cohorts of participants, i.e., children 6-<12 y, adolescents 12-<18 y, parents of children in four age groups (0-<2 y, 2-<6 y, 6-<12 y, and 12-<18 y), nurses, and pediatricians. Descriptive statistics were used for data analysis. In the age groups 0-<2 y and 2-<6 y, mini-tablets were preferred over syrup by all participants. In the age group 6-12 y, solid dosage forms were also preferred over syrup by all participants. In the age group 12-<18 y, healthcare professionals preferred solid dosage forms over syrup. Parents preferred higher amounts of mini-tablets and syrup compared to round and oblong tablets, while adolescents' preferences did not differentiate between these formulations. Based on the study results and in contrast to current practice, it is suggested to consider solid dosage forms for future age-appropriate medicinal products already for younger age groups.
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Affiliation(s)
- Manfred Wargenau
- M.A.R.C.O. GmbH & Co. KG, Institute for Clinical Research and Statistics, Schirmerstrasse 71, 40211 Duesseldorf, Germany; (M.W.); (K.E.); (L.-S.S.)
| | - Felicitas Baase
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Kristin Eckardt
- M.A.R.C.O. GmbH & Co. KG, Institute for Clinical Research and Statistics, Schirmerstrasse 71, 40211 Duesseldorf, Germany; (M.W.); (K.E.); (L.-S.S.)
| | - Lucas-Sebastian Spitzhorn
- M.A.R.C.O. GmbH & Co. KG, Institute for Clinical Research and Statistics, Schirmerstrasse 71, 40211 Duesseldorf, Germany; (M.W.); (K.E.); (L.-S.S.)
| | - Sibylle Reidemeister
- Novartis Pharma AG, Global Drug Development/Technical Research & Development, Novartis Campus, 4056 Basel, Switzerland;
| | - Ingrid Klingmann
- Pharmaplex bv, Avenue Saint-Hubert 51, 1970 Wezembeek-Oppem, Belgium;
| | - Viviane Klingmann
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany;
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Wong SW, Chew SP, Abdul Aziz SA, Mohamed Shah N. Exposure to potentially harmful excipients in medications among neonates at a state hospital in Malaysia. Drug Dev Ind Pharm 2024:1-9. [PMID: 38459761 DOI: 10.1080/03639045.2024.2327462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This study aimed to determine the incidence, types and predictors of Potentially Harmful Excipients (PHE) exposure among hospitalized neonates. METHODS A prospective observational study was conducted from March to April 2022 in neonatal wards at a state hospital in Malaysia. The PHEs of interest were aspartame, benzalkonium chloride, benzyl alcohol, benzoic acid or benzoates, ethanol, parabens, polysorbate 80, propylene glycol, saccharin sodium, sorbitol and sulfites. Product information leaflets (PILs) and summaries of product characteristics (SPCs) were referred to obtain information on active pharmaceutical ingredient, strength, trade name as well as type and amount of the excipients. RESULTS A total of 108 neonates were recruited and 97.2% of them were exposed to at least one PHE. Parabens (47.2%) and sulfites (27.5%) were the two most commonly administered PHEs. Benzyl alcohol is contraindicated in neonates but was administered to 8% of neonates in this study. The median daily dose of ethanol (24.11 mg/kg/day, IQR 19.73, 28.49) exceeded the acceptable daily intake (ADI) by four times. However, the dose was not available for all PHEs as this information is not always available in the PIL or SPC. Administration of cardiovascular drugs was associated with a higher risk of exposure to any PHE (OR 6.38, CI 2.75, 14.79, p-value < 0.001). CONCLUSION The exposure of PHE among neonates in this study is high with certain PHEs exceeding the ADI. It highlights the need for certain strategies to be implemented to reduce such exposure in neonates.
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Affiliation(s)
- Shien Woan Wong
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Pharmacy Department, Hospital Melaka, Melaka, Kementerian Kesihatan Malaysia, Malaysia
| | - Soo Piing Chew
- Pharmacy Department, Hospital Melaka, Melaka, Kementerian Kesihatan Malaysia, Malaysia
| | - Siti Azdiah Abdul Aziz
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noraida Mohamed Shah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Liang E, Wang Z, Li X, Wang S, Han X, Chen D, Zheng A. 3D Printing Technology Based on Versatile Gelatin-Carrageenan Gel System for Drug Formulations. Pharmaceutics 2023; 15:pharmaceutics15041218. [PMID: 37111703 PMCID: PMC10141357 DOI: 10.3390/pharmaceutics15041218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Currently, there is a shortage of pediatric medicines on the market, and 3D printing technology can more flexibly produce personalized medicines to meet individual needs. The study developed a child-friendly composite gel ink (carrageenan-gelatin), created 3D models by computer-aided design technology, then produced personalized medicines using 3D printing to improve the safety and accuracy of medication for pediatric patients. An in-depth understanding of the printability of different formulations was obtained by analyzing the rheological and textural properties of different gel inks and observing the microstructure of different gel inks, which guided the formulation optimization. Through formulation optimization, the printability and thermal stability of gel ink were improved, and F6 formulation (carrageenan: 0.65%; gelatin: 12%) was selected as the 3D printing inks. Additionally, a personalized dose linear model was established with the F6 formulation for the production of 3D printed personalized tablets. Moreover, the dissolution tests showed that the 3D printed tablets were able to dissolve more than 85% within 30 min and had similar dissolution profiles to the commercially available tablets. This study demonstrates that 3D printing is an effective manufacturing technique that allows for flexible, rapid, and automated production of personalized formulations.
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Affiliation(s)
- En Liang
- Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs, School of Pharmacy, Yantai University, Yantai 264005, China
- Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Haidian District, Beijing 100850, China
| | - Zengming Wang
- Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Haidian District, Beijing 100850, China
| | - Xiang Li
- Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Haidian District, Beijing 100850, China
| | - Shanshan Wang
- Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Haidian District, Beijing 100850, China
| | - Xiaolu Han
- Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Haidian District, Beijing 100850, China
| | - Daquan Chen
- Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs, School of Pharmacy, Yantai University, Yantai 264005, China
| | - Aiping Zheng
- Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Haidian District, Beijing 100850, China
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Peng Y, Zhang H, Gao L, Wang X, Peng X. Palatability Assessment of Carbocysteine Oral Solution Strawberry Taste Versus Carbocysteine Oral Solution Mint Taste: A Blinded Randomized Study. Front Pharmacol 2022; 13:822086. [PMID: 35295331 PMCID: PMC8919395 DOI: 10.3389/fphar.2022.822086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/24/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: To compare and evaluate the palatability of two carbocysteine oral solutions (strawberry vs. mint taste) among healthy children aged 2–12 years. Methods: A randomized, triple-blind, crossover, palatability trial in 42 children aged 2–12 years. All subjects received two preparations of carbocysteine oral solutions (strawberry vs. mint) according to randomized administration sequences, and the administration process was recorded by video. The palatability assessed by emotional valences was performed using a facial action coding system by FaceReader™, which reflected the quantification degree of emotion; a positive value represents positive emotion, and a negative value represents negative emotion. At the same time, a face-to-face interview was conducted for 5- to 12-year-old participants. Then, the taste preferential rates were compared to assess the palatability of two carbocysteine oral solutions. Results: Forty-two children were enrolled in this study. Twenty children first tasted the carbocysteine oral solution mint taste and then the strawberry taste preparation (M-S sequence), while 22 children tasted the strawberry preparation first and then the mint one (S-M sequence). The emotional valence of mint preparation (−0.9 in M-S and −1.2 in S-M) was both relatively lower than that of strawberry taste (both −0.7 in M-S and S-M) in two sequences; 69.0% (29/42) of participants’ emotional valences for strawberry preparation were higher than those for mint preparation. Among 27 participants aged ≥5 years, the taste preference rate was 88.5% (23/26) for the strawberry preparation (one missing value for the taste preference), and 77.8% of participants (21/27) chose the strawberry preparation if they had to take the medicine one more time. Conclusion: The carbocysteine oral solution with strawberry taste is an appealing preparation since it was better received by children. The facial action coding system could be an effective alternative for palatability assessment of pediatric pharmaceutical products.
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Affiliation(s)
- Yaguang Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Huan Zhang
- Department of Pharmacy, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Liucun Gao
- Department of Pharmacy, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoling Wang
- Department of Pharmacy, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Katz JS, Chou DK, Christian TR, Das TK, Patel M, Singh SN, Wen Y. Emerging Challenges and Innovations in Surfactant-mediated Stabilization of Biologic Formulations. J Pharm Sci 2021; 111:919-932. [PMID: 34883096 DOI: 10.1016/j.xphs.2021.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 02/08/2023]
Abstract
Biologics may be subjected to various destabilizing conditions during manufacturing, transportation, storage, and use. Therefore, biologics must be appropriately formulated to meet their desired quality target product profiles. In the formulations of protein-based biologics, one critical component is surfactant. Polysorbate 80 and Polysorbate 20 remain the most commonly used surfactants. Surfactants can stabilize proteins through different mechanisms and help the proteins withstand destabilization stresses. However, the challenges associated with surfactants, for instance, impurities, degradation, and potential triggering of adverse immune responses, have been encountered. Therefore, there are continued efforts to develop novel surfactants to overcome these challenges associated with traditional surfactants. Meanwhile, surfactants have also found their use in formulations of newer and novel modalities, namely, antibody-drug conjugates, bispecific antibodies, and adeno-associated viruses (AAV). This review provides an updated in-depth discussion of surfactants in the above-mentioned areas, namely mechanism of action of surfactants, a critical review of challenges with surfactants and current mitigation approaches, and emerging technologies to develop novel surfactants. In addition, gaps, current mitigations, and future directions have been presented to trigger further discussion and research to facilitate the use and development of novel surfactants.
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Affiliation(s)
- Joshua S Katz
- Pharma Solutions R&D, International Flavors and Fragrances, Wilmington, DE 19803, USA.
| | - Danny K Chou
- Compassion BioSolution, LLC, Lomita, CA 90717, USA
| | | | - Tapan K Das
- Bristol Myers Squibb, Biologics Development, New Brunswick, NJ 08903, USA
| | - Mayank Patel
- Dosage Form Design and Development, BioPharmaceuticals Development, R&D, AstraZeneca, Gaithersburg, USA
| | - Shubhadra N Singh
- GlaxoSmithKline R&D, Biopharmaceutical Product Sciences, Collegeville, PA 19426, USA
| | - Yi Wen
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN 46285, USA
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