Solid-state characterization of nevirapine

The purpose of this investigation is to characterize nevirapine from commercial samples and samples crystallized from different solvents under various conditions. The solid-state behavior of nevirapine samples was investigated using a variety of complementary techniques such as microscopy (optical, polarized, hot stage microscopy), differential scanning calorimeter, thermogravimetric analysis, Fourier transform infrared spectroscopy and powder X-ray diffractometry. The commercial samples of nevirapine had the same polymorphic crystalline form with an anhedral crystal habit. Intrinsic dissolution of nevirapine was similar for both the commercial batches. Powder dissolution showed pH dependency, with maximum dissolution in acidic pH and there was no significant effect of particle size. The samples recrystallized from different solvent systems with varying polarity yielded different crystal habits. Stirring and degrees of supersaturation influenced the size and shape of the crystals. The recrystallized samples did not produce any new polymorphic form, but weak solvates with varying crystal habit were produced. Recrystallized samples showed differences in the x-ray diffractograms. However, all the samples had the same internal crystal lattice as revealed from their similar melting points and heat of fusion. The intrinsic dissolution rate of recrystallized samples was lower than the commercial sample. It was found that the compression pressure resulted in desolvation and partial conversion of the crystal form. After compression, the recrystallized samples showed similar x-ray diffractograms to the commercial sample. Amorphous form showed slightly higher aqueous solubility than the commercial crystalline form.

High-Throughput Evaluation of Non-Swellable Controlled Release Matrix Tablets

Drug release from controlled-release (CR) matrix tablets involves the permeation and diffusion of water through the system. In this study, a new methodology is proposed for the measurement of water permeation and simultaneous drug release from the inert, non-swellable CR matrix tablet of diltiazem (DLT) and a correlation is made between these two processes. Cylindrical matrices were readily prepared by direct compression of pellets obtained by extrusion-spheronization. Water transport was studied using tritiated water (HTO) as a permeant in a Franz-diffusion cell and simultaneously drug release was measured. Further, dissolution was performed on USP XXI/XXII dissolution apparatus I using demineralized water. Matrices showed a steady water-uptake up to 6 h and the steady state for HTO permeation lasting from 6-h to 24-h Flux of water permeated and flux of drug released correlated well. Thus, HTO permeation through the matrix tablet and the proposed methodology can be used as a tool and/or surrogate marker for evaluation of controlled release matrix tablets. This methodology can be coined as "high-throughput" in terms of amount of labor and resources required in comparison to that of dissolution.

Thermoreversible liposomal poloxamer gel for the delivery of paclitaxel: dose proportionality and hematological toxicity studies

The currently existing treatment modalities of cancer suffer from a major drawback of systemic toxicity, which results from high systemic drug exposure. Delivery of chemotherapeutic agents by delivery systems that alleviate systemic side effects but at the same time provide therapeutic advantage by controlling tumor growth exists as a viable option. To achieve this objective, a thermo reversible poloxamer gel containing paclitaxel incorporated in liposomes was formulated at three dose loadings. These paclitaxel loaded formations were injected subcutaneously (s.c.) in Sprague Dawley rats. Blood samples collected at various time points were used in the determination of drug concentration as well as white blood cell and neutrophil counts for the estimation of systemic toxicity of the formulation. Absorption of paclitaxel after s.c. injection occurred slowly with prominence of absorption phase in plasma profile, suggesting presence of flip-flop pharmacokinetics. In spite of increase in dose of paclitaxel administered, no statistically significant increase in plasma levels and pharmacokinetic parameters occurred. Further, no significant increase in hematological toxicity was observed with increased drug exposure to animals. These results show that liposomal poloxamer gels reduce systemic toxicity of paclitaxel even at high doses; and thus, can serve as an effective delivery system for alleviating body burden of this toxic chemotherapeutic agent.

Dermal drug delivery: Revisited

The unique histological and molecular organization of skin poses a formidable barrier to drug delivery into and across skin. Due to the severe restrictions on molecular transport, only potent and lipophilic drug candidates have been able to successfully enter the market. New drug discovery programs based on high-throughput screening and combinatorial chemistry have lead to synthesis of potent but highly lipophilic molecules, and yet these molecules are difficult to deliver by conventional routes of administration. (trans)dermal delivery offers an attractive route of administration for these lipophilic molecules. Further, the diverse opportunities offered by genomics and proteomics cannot be effectively utilized without an equally diverse delivery approach. Skin offers a convenient and effective route for those genes and proteins due to the presence of the stem cell compartment in the epidermis.

A decision tree for rapid quality assurance and control of rifampicin-containing oral dosage forms for global distribution for tuberculosis treatment

For centuries tuberculosis remained as a complex socioeconomic problem impeding human development. Directly observed treatment short-course and fixed dose combinations were implemented in tuberculosis therapy for maximum success of treatment. However, drug shortages primarily hindered the expansion of directly observed treatment short-course, which lead to development of the global tuberculosis drug facility. Since large geographical area is covered by the global tuberculosis drug facility for global drug supply for tuberculosis eradication programs, a rapid quality control and assurance has become necessary to ensure the quality and performance of supplied antituberculosis drugs. In this manuscript a decision tree is proposed for facilitating rapid quality control (in vitro and in vivo) of antituberculosis formulations procured by the global tuberculosis drug facility. This decision tree also predicted to be applicable at every stages of anti tuberculosis drug product development, especially in identification of poor quality products and monitoring batch-to-batch variability. Further, it provides opportunity for effective quality control in resource poor settings and the gained knowledge is anticipated to be applicable for development and evaluation of antimalarial and antiAIDS fixed dose combinations.

Studies of the skin permeation of lipophilic drugs: paclitaxel

The objective of this investigation was to develop and validate skin permeation methodology for a highly lipophilic drug with respect to sink conditions and intactness of barrier during the course of experiment, using water permeation and trans epidermal water loss as tools.

Stability of insulin under iontophoretic conditions

The present study focuses on the physical and chemical stability of insulin under iontophoretic conditions using HPLC, SDS-PAGE, RIA and biological assay. Influence of pH, concentration of insulin, current strength and duration of current application on the stability of insulin was studied. Anodal iontophoresis at pH 7.4 caused more than 80% degradation of insulin, while the degradation was minimal at pH 3.6. The degradation was not influenced by insulin concentration, but increase in current strength above 0.75 mA/cm2 or application of current for 12 h (at 0.5 mA/cm2) led to 80 and 20% degradation respectively. All the samples showed biological activity comparable to intact insulin.

Dissolution testing of marketed rifampicin containing fixed dose combination formulations using a new discriminative media: a post marketing retrospective study

Currently recommended compendial dissolution methods for quality control of orally administered solid dosage forms of rifampicin containing formulations are not found to be able to forecast the in vivo performance. A recently proposed dissolution method of 0.01 N HCl at 50 rpm using paddle apparatus for screening was found to be more appropriate and able to predict the in vivo performance of those formulations. The objective of this investigation was to validate the new method of dissolution testing for solid dosage forms of rifampicin containing formulations using a basket apparatus and to compare it with the frequently recommended pharmacopeial method. In the present study the newly proposed dissolution condition (0.01 N HCl) was validated using six formulations of two, three and four drug combinations from two different manufacturers by basket method and compared with the widely recommended compendial medium. In this investigation, the appropriateness of the proposed methodology was confirmed by the dissolution results of the two FDC formulations (a two-drug and a four-drug combinations) that had previously passed the bioequivalence tests. It was found that the recommended dissolution medium of 0.01 N HCl can be used for screening of rifampicin containing formulations using both paddle and basket dissolution apparatus at 50 rpm and 100 rpm, respectively.

Plasma pooling to expedite bioequivalence estimation of rifampicin in fixed dose combinations

Rifampicin has been found to be one of the most important antitubercular drugs; however, variable bioavailability of rifampicin in some fixed dose combinations (FDCs) as well as separate formulations has been reported in the literature. This resulted in proper evaluation of FDCs with standard protocol for bioequivalence trials. Earlier, plasma pooling as a rapid method for bioequivalence assessment of rifampicin in FDCs was proposed from our laboratory. Results obtained after pooled plasma sample analysis were compared with those from the individual plasma sample analysis. Case studies from our laboratories further validate and support the use of plasma pooling method as a faster and cost effective tool for bioequivalence assessment of rifampicin in FDCs, which will be useful in order to speed up the registration and approval of good quality FDCs.

Co-treatment with grapefruit juice inhibits while chronic administration activates intestinal P-glycoprotein-mediated drug efflux

P-Glycoprotein (P-gp) mediated efflux is recognized as a significant biochemical barrier affecting oral absorption for a number of drugs. Various conflicting reports have been published regarding the effects of grapefruit juice (GFJ) on P-gp-mediated drug efflux, in which GFJ has been shown both to inhibit and activate it. Hence, the present study adopted a two-way approach, involving both co-treatment and chronic administration. Bi-directional transport of paclitaxel (PCL) was carried out in the absence and presence of GFJ extract, in rat everted ileum sac. Further, the effect of chronic administration of GFJ to rats was characterized by permeability studies with indinavir (INDI). Co-treatment of GFJ extract at 100% concentration reduced the asymmetric transport of PCL (efflux ratio = 20.8) by increasing absorptive (A --> B) transport by 921% and reducing secretory (B --> A) transport by 41%. Further, GFJ showed a concentration dependent effect on PCL permeability. Imipramine, a passive permeability marker with absorptive permeability of 15.33 +/- 4.26 x 10(-6) cm/s showed no asymmetric transport and also no significant (P < 0.05) change in permeability in the presence of GFJ. Chronic administration of GFJ resulted in a significant decrease in absorptive transport of indinavir, which was even greater than that produced by rifampicin pretreatment. No change in permeability of propranolol, a passive permeability marker, was observed. Further, the decrease in absorptive transport of INDI was reversed by the P-gp inhibitor verapamil. In conclusion, GFJ extract inhibited P-gp-mediated efflux in co-treatment, whereas chronic administration led to increased levels of P-gp expression, thus having a profound effect on intestinal absorption and GFJ-drug interactions in vivo.

Minimum sample size and sampling time requirements for assessment of rifampicin bioequivalence from FDC formulations

SETTING

The WHO- and IUATLD-recommended protocol for rifampicin (RMP) bioequivalence utilises 20-22 volunteers and 8 h, whereas the requirement of other regulatory authorities is 12 volunteers with a 24 h sampling schedule. Differing sampling size and time requirements may change the outcome of RMP bioequivalence.

OBJECTIVE

To determine the minimal sample size and time required to assess RMP bioequivalence from FDC formulations.

DESIGN

Bioequivalence studies were conducted that fulfilled the criteria of the WHO and Indian regulatory protocols. From earlier studies, retrospective pharmacokinetic evaluation, power of the test and bioequivalence limits were also calculated using 8-22 volunteers and sampling points of 8-24 h. Pharmacokinetic and statistical evaluations from three representative studies showing low, moderate and high intra-subject variability are given to determine minimum requirements for RMP bioequivalence.

RESULT

It was found that a sampling schedule up to 8 h was sufficient to compare the absorption process of RMP. There was no influence of reduced sample size on bioequivalence estimates of RMP that showed low or moderate variability. However, in a study showing higher variation, a sample size of 14-16 subjects was found to be optimal.

CONCLUSION

It is possible to reduce the sample size requirement for determination of RMP bioequivalence using the WHO protocol.

Quality control of anti-tuberculosis FDC formulations in the global market: part II-accelerated stability studies

OBJECTIVE

To determine the quality and performance of rifampicin (RMP) containing fixed-dose combination (FDC) formulations of anti-tuberculosis drugs sourced from the international market with respect to physical, chemical and dissolution properties after storage at accelerated stability conditions (40 degrees C/75% relative humidity) and to identify appropriate storage specifications.

METHODS

Formulations across different companies and combinations were subjected to 6-month accelerated stability testing in packaging conditions recommended by the manufacturer. Various pharmacopeial and nonpharmacopeial tests for tablets were performed for 3- and 6-month samples.

RESULTS

All the formulations were found to be stable, where extent of dissolution was within +/- 10% of that of the initial value, and all formulations passed the pharmacopeial limits for assay and content uniformity of 90-110% and +/- 15% of average drug content, respectively.

CONCLUSIONS

Good quality RMP-containing FDCs that remain stable after 6-month accelerated stability testing are available in the marketplace.

Establishment of a reference formulation for bioequivalence assessment of rifampicin-containing FDCs: an essential step towards improving tuberculosis treatment

SETTING

Selection of a reference product for bioequivalence studies of rifampicin (RMP) in prequalifying fixed-dose combinations (FDC) for worldwide distribution through the WHO is critical.

OBJECTIVE

To investigate the feasibility of establishing FDC formulations as reference products for bioequivalence studies of RMP in prequalification programmes.

DESIGN

A biostudy was conducted as an open, two-period randomised cross-over trial. Two three-drug FDCs containing RMP, isoniazid and ethambutol hydrochloride were administered to a group of 22 volunteers with a wash-out period of 1 week. Plasma samples were collected and analysed for the concentration of RMP and desacetyl-RMP, a major active metabolite of RMP, up to 24 h. Pharmacokinetic parameters of RMP were calculated: Cmax, AUC0-24, Tmax, kel and absorption efficiencies.

RESULTS

No significant difference was observed between the administered formulations with respect to the major pharmacokinetic parameters Cmax, Tmax and AUC0-24 when evaluated by parametric (two-way ANOVA) and non-parametric (Hauschke's analysis) statistical analysis. The concentration of RMP falls within the reported acceptable therapeutic range.

CONCLUSION

FDCs can be developed as a reference product for bioequivalence studies.

Plasma pooling: utility in expediting bioequivalence assessment of rifampicin-containing fixed-dose combinations

To improve the rapidity of the registration process of rifampicin (RMP) containing fixed-dose combination (FDC) formulations, a plasma pooling methodology was used to increase the throughput of bioanalysis of plasma samples from bioequivalence trials of FDCs. Plasma samples of a biostudy were analysed for RMP using traditional analysis methods as well as a plasma pooling method (volunteer and time pooling). Both methods produced similar results, with less than 15% variability in both volunteer and time pooling. The plasma pooling method for bioanalysis was validated. Further studies are required to identify and reduce the percentage variability.

Determination of rifampicin bioequivalence in a three-drug FDC by WHO and indian protocols: effect of sampling schedule and size

SETTING

To promote the quality assurance of fixed-dose combination (FDC) formulations, the World Health Organization (WHO) has prepared a convenient simplified protocol for the determination of rifampicin (RMP) bioequivalence. During the development of this protocol, it was proved that sampling time up to 8 h can determine the rate and extent of RMP absorption. However, this protocol utilises 20 volunteers in contrast to other local regulatory requirements of a minimum of 12 volunteers. The different sample sizes utilised in these protocols may affect the sensitivity of the bioequivalence outcome.

OBJECTIVE

To determine the effect of sampling size and schedule on RMP bioequivalence when two different protocols are used.

DESIGN

A bioequivalence trial was conducted with a study design of 20 volunteers and 24 h sampling time, which fulfils the requirements of both the WHO and Indian regulatory protocols. Pharmacokinetic and statistical analysis was done by stepwise reduction in sample size and schedule.

RESULT

Bioequivalence limits of RMP were unaffected by a reduced sample size of 12 volunteers and 8 h sampling time.

CONCLUSION

Minimising sample size after validation for borderline and poor quality FDC formulations can further reduce the cost of conducting bioequivalence trials.

Transdermal Iontophoresis of Insulin

The delivery of large peptides through the skin poses a significant challenge, and various strategies are under active investigation for enhancing the transdermal permeation. For large peptides, it is difficult to achieve significant permeation using iontophoresis alone. Hence a combination of fatty acids with iontophoresis was hypothesized to result in higher enhancement than achieved with either of them alone. Saturated fatty acids and cis unsaturated fatty acids were studied in combination with iontophoresis using excised rat skin. The skin was pretreated for 2 h with an ethanolic (EtOH) solution of 5% w/v or v/v fatty acids, namely lauric acid (LA), oleic acid (OA), linoleic acid (LOA) and linolenic acid (LLA), followed by either passive or iontophoretic permeation (0.5 mA/cm2 for 6 h). Fourier transform infrared spectroscopy (FT-IR) was used to investigate the biophysical changes on treatment with fatty acid/EtOH or neat fatty acid, mainly focusing on the infrared region at 2,920, 1,710 and 1,720 cm(-1). Unsaturated fatty acids showed higher enhancement than LA, and the enhancement increased with the number of double bonds. On the other hand, in the presence of iontophoresis, LA/EtOH showed the highest enhancement. Neat LOA did not show any significant difference (p > 0.05) compared to the LOA/EtOH combination. FT-IR studies revealed that fatty acids act by interacting with the skin lipids. All the fatty acids showed synergistic enhancement when combined with iontophoresis. The flux enhancement was highest with LA, which in the presence of iontophoresis showed 20 times enhancement of insulin flux in comparison to passive flux and 9 times enhancement as compared to iontophoresis alone. Flux enhancement of unsaturated fatty acids was in the following decreasing order LOA > OA > LLA.

In vitro analysis of rifampicin and its effect on quality control tests of rifampicin containing dosage forms

The chemical stability of rifampicin both in solid state and various media has widely been investigated. While rifampicin is appreciably stable in solid-state, its decomposition rate is very high in acidic as well as in alkaline medium and a variety of decomposition products were identified. The literature reports on highly variable rifampicin decomposition in acidic medium. Hence, the objective of this investigation was to study possible reasons responsible for this variability. For this purpose, filter validation and correlation between rifampicin and its degradation products were developed to account for the loss of rifampicin in acidic media. For analysis of rifampicin with or without the presence of isoniazid, a simple and accurate method was developed using high performance chromatography recommended in FDC monographs of the United States Pharmacopoeia. Using the equations developed in this investigation, the amount of rifampicin degraded in the acidic media was calculated from the area under curve of the degradation products. Further, it was proved that in a dissolution study, the colorimetric method of analysis recommended in the United States Pharmacopoeia provides accurate results regarding rifampicin release. Filter type, time of injection as well as interpretation of data are important factors that affect analysis results of rifampicin in in vitro studies and quality control.

In vitro evaluation of fixed dose combination tablets of anti-tuberculosis drugs after real time storage at ambient conditions

Rifampicin exhibits variable bioavailability from solid oral dosage forms and this problem is more apparent when it is formulated as fixed dose combination (FDC) in presence of other first-line anti-tuberculosis drugs. To determine the cause of variable bioavailability, the aging effect on physical and chemical performance of rifampicin from FDC formulations after real time storage at the ambient conditions was investigated. For this purpose, six FDC formulations from different manufacturers were stored at ambient conditions (20-35 degrees C, with no control of humidity) in the final packing for a period of 16-38 months and its in vitro quality control tests for rifampicin were compared with the initial performance of these tablets. None of the formulations have shown significant weight gain/loss and the assay values were within the pharmacopeial limits when evaluated by a stability indicating method. Further storage had no effect on physical performance of FDC tablets as indicated by unaltered dissolution profiles. Formulation reevaluation after real time storage at the ambient conditions for 16-38 months indicated that rifampicin containing FDC formulations are stable throughout its shelf life and instability is not a cause of variable bioavailability.

Quality control of anti-tuberculosis fixed-dose combination formulations in the global market: an in vitro study

OBJECTIVE

To determine the quality, and especially the dissolution properties of rifampicin, of fixed-dose combination (FDC) formulations of anti-tuberculosis agents manufactured by major market holders in the anti-tuberculosis sector and supplied for use in national tuberculosis control programmes.

METHODS

Dissolution studies were performed for four formulations supplied by four different manufacturers in four dissolution media (0.1N and 0.01N HCl, phosphate buffer [PB] and 20% vegetable oil in PB), at four different agitation rates using USP apparatus II. The formulations were subjected to 4-week accelerated stability studies (40 degrees C / 75% RH) and evaluated for physical, chemical and dissolution stability.

RESULTS

The formulations tested complied with pharmacopeial quality control (QC) tests. The extent of rifampicin release was independent of dissolution medium; however, a slight decrease in the dissolution rate was observed in two products. More than 75% of drug was released in 45 min at all agitation intensities except 30 rpm, and 20% oil in the medium reflected fed state. Formulations were stable in the packaging conditions recommended by the manufacturer for at least 4 weeks.

CONCLUSIONS

The formulations tested passed the QC tests and were found to be stable. A decrease in the rate, although not the extent, of dissolution necessitated multiple point dissolution in gastric and intestinal pH conditions to ensure consistency in in vivo bioavailability.

Transdermal iontophoresis of insulin: III. Influence of electronic parameters

Transdermal iontophoresis is a physical enhancement strategy primarily for charged molecules and offers a number of advantages for the delivery of peptides and proteins. The singular advantage of iontophoresis lies in the precise control of dose by manipulating the current protocol. The objective of the present investigation was to understand the role of electronic parameters on iontophoretic transport of large peptides using insulin as a model peptide. Ex vivo permeation experiments were conducted using excised rat skin and the influence of varying current strengths, duration, on/off ratios and switching iontophoresis on insulin permeation were studied. High performance liquid chromatography (HPLC), polyacrylamide gel electrophoresis (SDS-PAGE) and thin layer chromatography (TLC) were used to assess the electrochemical stability of insulin; while Fourier transform infra-red (FT-IR) spectroscopy and thermogravimetric analysis (TGA) were used to understand the biophysical changes in skin during iontophoresis. The permeation of insulin was found to increase as a function of current strength and duration of current application. Skin barrier integrity and electrochemical stability of insulin was dependent on the charge applied during iontophoresis. FT-IR spectroscopy and TGA studies showed that the skin hydration increased with increase in the charge applied and thus facilitated the transport of insulin. Periodic iontophoresis did not show any significant difference in insulin permeation compared with continuous current application; 1:1 on/off ratio resulted in higher amount of insulin permeation, while flux was highest with mixed duty cycle. Switching iontophoresis was useful in reducing the pH shift and in improving the electrochemical stability of insulin at pH 3.6 and 7.4, respectively. The electroosmotic flow was influenced by the pH of the donor medium, as well as by the electrode polarity during switching and non-switching iontophoresis. Overall, the study demonstrates the issues related to the optimization of electronic parameters for the iontophoretic delivery of a large peptide.

Fixed dose combinations for tuberculosis: Lessons learned from clinical, formulation and regulatory perspective

Worldwide, tuberculosis (TB) remains one of the most important communicable diseases in terms of morbidity and mortality. Its control requires multi-drug therapy for at least six months, which could lead to patient non-compliance, failure of therapy and ultimately resulting in the emergence of drug resistance. Fixed dose combinations (FDCs) in TB therapy reduce the number of tablets to be consumed and thereby increase patient compliance with recommended treatment regimens. Thus, FDCs play a significant role in preventing the emergence of drug resistance and successful treatment. However, the quality of FDCs with respect to variable bioavailability and their registration requirements are major hurdles to their implementation in national TB control programs. It is anticipated that a large global market for FDCs will encourage large-scale production and increased competition, which in turn will result in FDCs at affordable prices. The Global Drug Facility (GDF), established by the World Health Organization (WHO), aims to ensure universal uninterrupted access to quality TB drugs for implementation of directly observed treatment short-course (DOTS) in resource-poor countries. In this program, four FDCs were accepted as the drugs of first choice because of their obvious advantages in controlling TB. This demands the necessity of addressing quality and registration requirements of FDCs systematically. In light of this current knowledge on anti-TB FDCs, their dosage, combinations, available clinical studies and the experiences with TB therapy has been discussed in this article, which should serve as lessons for selection of appropriate FDCs for other diseases such as malaria and AIDS.

Combination strategies to enhance transdermal permeation of zidovudine (AZT)

The objective of this study was to evaluate the effect of simultaneous application of two penetration enhancers of different chemical classes or a chemical penetration enhancer and current application on permeation of zidovudine (AZT) across rat skin. Ex vivo permeation of AZT using combinations of cineole or menthol in vehicle with either oleic acid/linolenic acid or 0.5 mA/cm2 anodal current application for 6 h was studied. Penetration enhancers were significantly different in enhancing the permeability of AZT across rat skin and are in the decreasing order of activity: linolenic acid > menthol > oleic acid > cineole > vehicle. The combination of cineole and oleic acid synergistically enhanced transdermal flux of AZT in addition to reducing lag time. However, this was not observed for combinations of menthol with oleic or linolenic acid. On the other hand, the simultaneous application of current with menthol and cineole significantly increased cumulative amounts of AZT permeating during the course of current application and reduced the lag time but failed to further increase steady state flux of AZT. These results suggest that a combination of two penetration enhancers of different classes or the simultaneous use of iontophoresis and a penetration enhancer may be advantageous to achieve permeation enhancement with low risk of skin damage.

Transdermal drug delivery of tricyclic antidepressants: effect of fatty acids

The aim of the present study was to investigate the effects of fatty acids on the permeation of tricyclic antidepressants, e.g., imipramine hydrochloride (IMH) and amitriptyline hydrochloride (AMH). Five percent w/v of saturated (lauric acid) and unsaturated (oleic acid, linoleic acid, linolenic acid, trans-elaidic acid and trans-vaccenic acid) fatty acids in an ethanol (EtOH):water (2:1) system were used in this study. Flux and lag-time of tricyclic antidepressants were significantly increased and reduced, respectively, compared with control (p < 0.05). There were no significant differences between the effects of lauric and unsaturated fatty acids, both cis and trans, on the permeation of IMH and AMH (except vaccenic acid in case of IMH). The formation of 'grain boundaries' by straight chain fatty acids (saturated and trans-unsaturated fatty acids) could not be observed by Fourier-transform infrared spectroscopy (FT-IR). However, perturbation or increased bilayer fluidity of Stratum corneum (SC) induced by cis-unsaturated fatty acid was observed by FT-IR.

Bioequivalence assessment of rifampicin, isoniazid and pyrazinamide in a fixed dose combination of rifampicin, isoniazid, pyrazinamide and ethambutol vs. separate formulations

Depending on the patient category, tuberculosis requires treatment with 3 to 5 drugs which means that patient's compliance to therapy may not be optimal. To increase patient's adherence to treatment schedules, these drugs can be given as single drug preparations or fixed dose combinations (FDCs) of 2 or more drugs in a single formulation. However, an important issue associated with a rifampicin-containing FDC is its quality. Hence, to avoid spurious formulations entering the market, the World Health Organization and the International Union Against Tuberculosis and Lung Disease have recommended FDCs only of proven bioavailability. In this study, the relative bioavailability of rifampicin, isoniazid and pyrazinamide was assessed in a group of 14 healthy male subjects using the FDC tablet containing 4 drugs versus separate formulations at the same dose levels. The study was designed as an open, crossover trial. A total of 9 blood samples were collected over a period of 24 h. The concentration of rifampicin, its main metabolite desacetyl rifampicin, isoniazid and pyrazinamide in plasma were assessed using HPLC analysis. The pharmacokinetic parameters AUC(0-24) and Cmax were subjected to parametric and non-parametric statistical tests at 90% confidence interval. In addition, time to reach peak concentration (tmax), elimination rate constant (Kel) and terminal elimination half-life (t1/2) for each drug were also calculated. It was concluded that the FDC tablet containing 4 drugs is bioequivalent to separate rifampicin, isoniazid and pyrazinamide formulations at the same dose levels.

LC determination of cephalosporins in in vitro rat intestinal sac absorption model

Cefotaxime sodium (CX) and Ceftazidime pentahydrate (CZ) are peptidomimetic cephalosporins (CPS) which exist as zwitterionic compounds at physiological pH and because of this reason they are not absorbed appreciably on peroral administration. The permeability of these compounds can be increased transiently by altering membrane characteristics of absorptive epithelium by use of sorption promoters (SPs). In present work a simple validated HPLC method utilizing isocratic mobile phase and having short retention times for CX and CZ is developed which can be used to monitor their concentrations in Kreb's Ringer Bicarbonate (KRB) solution in in vitro intestinal sac absorption model. The same was utilized to determine apparent permeability coefficients and absorption profiles of CPS by modified Wilson-Wiseman method. The CPS were analysed by the reverse phase HPLC method using Shim-pack C18 column. The mobile phase used was of isocratic composition with phosphate buffer (pH 7.0, 3.5 g/l of KH(2)PO(4) dissolved in 0.03 M Na(2)HPO(4).2H(2)O) and methanol in proportion 85:15 for CZ and 70:30 for CX. The flow rate was 1 ml/min and quantitative determinations were carried out at 254 nm at 25 degrees C. The method was found specific because none of the proposed SPs, components of KRB and intestinal sac artefacts interfered with the drug peaks. The drug concentration versus area under peak relationship was found to be linear in concentration range of 0.25-20.0 microg/ml. The recovery studies, intraday variation, interday variation and interanalyst variation were within statistical limits. The limit of detection (LOD) was 95.0 and 100.0 ng/ml for CZ and CX, respectively. The limit of Quantitation (LOQ) was 240.0 and 250.0 ng/ml for CZ and CX, respectively. The proposed method was found to be rapid and selective and hence applied for continuous monitoring of CPS in in vitro intestinal sac absorption studies.

Insulin therapies - past, present and future

The discovery of insulin is one of the greatest milestones in medical history. This discovery revolutionized the use of peptides and proteins as therapeutic agents. For more than six decades, insulin from different animal sources was used, until the breakthrough in biotechnology made it possible to produce human insulin in sufficient amounts. The evolution of the biotechnological era gave rise to modified insulins to solve some of the bottlenecks in insulin therapy. Efforts are currently focused towards developing non-invasive insulin delivery systems, and there are several competing technologies in different stages of development. The next few years will see several novel approaches to mimic the endogenous release and kinetics of insulin, and also many improved analogues designed to achieve better control and effective treatment of diabetes.

Polymers in drug delivery

Advances in polymer science have led to the development of several novel drug-delivery systems. A proper consideration of surface and bulk properties can aid in the designing of polymers for various drug-delivery applications. Biodegradable polymers find widespread use in drug delivery as they can be degraded to non-toxic monomers inside the body. Novel supramolecular structures based on polyethylene oxide copolymers and dendrimers are being intensively researched for delivery of genes and macromolecules. Hydrogels that can respond to a variety of physical, chemical and biological stimuli hold enormous potential for design of closed-loop drug-delivery systems. Design and synthesis of novel combinations of polymers will expand the scope of new drug-delivery systems in the future.

Bioequivalence of isoniazid in a two drug fixed dose combination and in a single drug dosage form

To increase the patient compliance and reduce the risk of drug resistant strains, WHO and IUATLD recommend the use of Fixed Dose Combination (FDC) tablets as a routine therapeutic regimen in Directly Observed Treatment Shortcourse (DOTS). But the main issue in the use of FDC is the quality of the formulation. At present WHO and IUATLD suggest the bioequivalence assessment of only rifampicin from FDC compared to separate formulations. For the therapeutic effectiveness all the components of the FDCs should be bioavailable at tissue site. Also, the primary and acquired resistance rate of isoniazid is much higher compared to other anti-tubercular drugs. Hence, a comparative bioavailability study of isoniazid from a two drugs FDC compared to a separate formulation was carried out on a group of 12 healthy volunteers. When evaluated by normal or log transformed confidence interval, Two Way ANOVA and Hauschke analysis, the bioequivalence limits for AUC0-8 and AUC0-24 were within 0.8-1.25. For Cmax and Tmax, these limits were within 0.7-1.43. Hence, isoniazid from a FDC formulation was found to be bioequivalent to a separate formulation at same dose levels.

Drug delivery: an odyssey of 100 years

Drug delivery has metamorphosed from the concept of a pill to molecular medicine in the past 100 years. Better appreciation and integration of pharmacokinetic and pharmacodynamic principles in design of drug delivery systems has led to improved therapeutic efficacy. A greater understanding of the molecular transport in relation to physico-chemical properties has led to the evolution of a biopharmaceutics classification system, which should be a future road map, governing drug design, development and delivery. While drugs belonging to class I and II will be delivered by established platform technologies, novel delivery strategies will evolve and mature to realize the potential of 'new generation' biotech and non biotech drugs belonging to class III and IV, respectively.

Transdermal delivery of naloxone: effect of water, propylene glycol, ethanol and their binary combinations on permeation through rat skin

The effect of the solvent systems water, ethanol (EtOH), propylene glycol (PG) and their binary combinations was studied on the ex vivo permeation profile of the opioid receptor antagonist, naloxone, through rat skin. Fourier transform-infrared (FT-IR) spectroscopic studies were done to investigate the effect of enhancers on the biophysical properties of the stratum corneum (SC), in order to understand the mechanism of permeation enhancement of naloxone by the solvent systems used. The flux of naloxone was found to increase with increasing concentrations of EtOH, upto 66% in water, and PG upto 50% in water. The maximum flux of 32.85 microg cm(-2) h(-1) was found with 33% PG in EtOH. The FT-IR spectra of SC treated with EtOH showed peak broadening at 2920 cm(-1) at all concentrations of EtOH studied indicating that EtOH increases the translational freedom (mobility) of lipid acyl chains. Theoretical blood levels well above the therapeutic concentration of naloxone can be achieved with the solvent system comprising 33% PG in EtOH and hence, provides flexibility in choice of patch size depending on the addiction status of the patient to be treated.

Antituberculosis drugs and new drug development

Tuberculosis affects more than 8 million people and has serious repercussions on economic, psychologic, and social status. Since its declaration as a global emergency in 1993 by the World Health Organization, significant development in the treatment and control of tuberculosis has been the implementation of the short-course directly observed treatment along with fixed dose combinations of existing drugs. However, the currently available therapeutic regimens have inherent disadvantages of long treatment duration, patient noncompliance, and risk of drug resistance. Hence, new antituberculosis drugs that are potent, are active against resistant strains and latent forms, and reduce the treatment period are needed to combat this disease. In this review, the authors discuss new chemical entities that in their opinion have a potential to become new antituberculosis drugs. This article emphasizes the role of biopharmaceutics and pharmacokinetics as an indispensable part in the development of new antituberculosis drugs to overcome the common hurdles such as exorbitant cost, time, and attrition rate involved in the process.

Pharmacokinetic study of paclitaxel as a 3-hour infusion in an Indian population: 135 mg/m2 vs. 175 mg/m2

The objective of this clinical study was to determine the pharmacokinetic parameters of paclitaxel at doses of 135 and 175 mg/m2 when given as a 3-hour infusion in an Indian population. Twelve cancer patients of both sexes participated in the study and a parallel experimental design was adopted for the assignment of doses to patients. A solid phase extraction technique was used for sample clean-up followed by a reversed phase HPLC assay for the analysis of paclitaxel in plasma samples. Pharmacokinetic parameters such as Cmax, AUC0-infinity, T1/2 beta, AUMC0-infinity, VSS, VZ and CLT were determined by a compartment model-independent method using a PCNONLIN package. Teff and AUCeff were also calculated and compared at the two doses by considering a plasma concentration of > or = 0.05 microM as threshold. The mean Cmax and AUC0-infinity values were 2.57 microM and 12.06 microM at the 135 mg/m2 dose level while at the 175 mg/m2 dose the values increased to 4.96 microM and 9.52 microM.h/l, respectively. It was found that the 135 mg/m2 dose resulted in greater mean CLT and VSS values than the 175 mg/m2 dose. The disposition of paclitaxel was found to be nonlinear and the pertinent pharmacokinetic parameters were comparable to those from previous clinical studies. It was concluded from the present study that further clinical trials of paclitaxel alone or in combination with other drugs should be undertaken cautiously, taking into consideration its nonlinear pharmacokinetics which necessitate proper adjustment of the infusion schedule and/or dose to avoid any adverse consequences to the patient.

Evaluation of rifampicin bioequivalence in fixed-dose combinations using the WHO/IUATLD recommended protocol

For an accurate assessment of rifampicin bioequivalence from fixed-dose combinations (FDCs), and to reduce the time and cost constraints associated with bioequivalence studies, the World Health Organization and the International Union Against Tuberculosis and Lung Disease have developed a simplified screening protocol. This study was undertaken with the objective of testing the applicability of this protocol for all types of FDCs. Data were obtained for volunteers common to three studies, and pharmacokinetic parameters were evaluated by different statistical tests. From the results, it has been demonstrated that the simplified screening protocol is suitable for evaluating the bioequivalence of rifampicin in all the types of FDCs available on the market.

Bioequivalence of rifampicin when administered as a fixed-dose combined formulation of four drugs versus separate formulations

A bioequivalence study of the antitubercular drug rifampicin in a four-drug combination (rifampicin, isoniazid, pyrazinamide and ethambutol) and separate formulations of the drugs at the same dose levels was carried out in a group of 22 healthy male volunteers. The investigation was designed as an open crossover study. The drugs were administered once in individual formulations and once in a fixed-dose combination. The WHO-approved protocol was followed according to which six blood samples were collected over a period of 8 h for each volunteer and each experimental session. Pooled urine samples were also collected during the study. Rifampicin and desacetyl rifampicin concentrations in both plasma and urine samples were assessed. Various pharmacokinetic parameters such as AUC0-8 h, Cmax and Tmax were calculated for both rifampicin and desacetyl rifampicin. The results indicated that combined (the four-drug combination) and separate formulations are bioequivalent for rifampicin.

Non familial juvenile polyposis presenting as chronic intestinal obstruction

Juvenile polyps are the commonest colonic polyps seen in children and present most often with rectal bleed. Intussusception is an extremely rare presentation in juvenile polyposis (JP) syndrome. This case highlights the rare association of ileo-colic intussusception with non-familial Juvenile Polyposis.

Skeletal drug delivery systems

Selective drug delivery to any organ becomes very important in certain diseases and clinical manifestations, especially when the drug affects other exposed tissues adversely. The importance of selective drug action is still further increased when the affected part is poorly perfused. Although a network of blood vessels is present throughout skeletal tissue (or bone), it is not sufficient for immediate delivery of drugs to the desired site of action in the tissue and in sufficient amounts over appropriate time periods. Hence, selective drug delivery to the skeletal system has remained a great challenge to pharmaceutical scientists over the years. However, in the recent past, attention has been focused on the importance of skeletal drug delivery and the first Skeletal Drug Delivery System (SDDS) was introduced by Bucholz and Engelbrecht in 1970 for the delivery of drugs to skeletal tissues at a high concentration to achieve desirable therapeutic effects. SDDS is used to deliver the drug directly to skeletal tissue through self-setting cement, which also acts as a bone filler, thereby improving the therapeutic effectiveness of drugs in bone diseases. The present review highlights the applicability of various materials as bone fillers for the purpose of skeletal drug delivery.

Transdermal iontophoresis revisited

Iontophoresis evolved as a transdermal enhancement technique in the 20th century, primarily for the delivery of large and charged molecules. Significant achievements have been made in the understanding of underlying mechanisms of iontophoresis and these have contributed to the rational development of iontophoretic delivery systems. The major challenges in this area are the development of portable, cost effective devices and suitable semi-solid formulations that are compatible with the device and the skin. Some of the obstacles in transdermal iontophoresis can be overcome by combining iontophoresis with other physical and chemical enhancement techniques for the delivery of macromolecules. Iontophoresis also offers an avenue for extracting information from the body through the use of reverse iontophoresis, which has potential application in diagnosis and monitoring. The current research is focussed towards resolving the skin toxicity issues and other problems in order to make this technology a commercial reality.

Nicotine transdermal systems: pharmaceutical and clinical aspects

Smoking is creating a burden on the healthcare budgets all over the world. Management of nicotine dependence is difficult due to the so-called pleasurable effects experienced by smokers. Among the various treatment approaches, nicotine replacement therapy, where nicotine from cigarettes is replaced with nicotine from a relatively safer delivery vehicle, has been successful. Transdermal delivery of nicotine is an effective type of nicotine replacement therapy due to inherent pharmacokinetic advantages over other routes of delivery. Several nicotine transdermal delivery systems are available to suit the varying needs of smokers and have been found to be clinically patient friendly and well tolerated. This review focuses on the various clinical and pharmaceutical aspects of nicotine with special emphasis on transdermal delivery systems.

Biopharmaceutics and pharmacokinetics in drug research

With the synergistic and multiplicative interactions of rational drug design, recombinant biotechnology, combinatorial chemistry and high-throughput screening, millions of compounds are being synthesized by chemists. However, development of these drug candidates has often been impeded, if not terminated, due to biopharmaceutic and/or pharmacokinetic constraints. This has resulted in delays in development time and escalation of cost in the drug research programmes. So, the present emphasis is to reduce development time and cost, which is analogous to added patent life besides the enormous reduction in human suffering. In this compilation the important biopharmaceutic and pharmacokinetic approaches are discussed, which will help in the development of safe and more efficacious drugs with reduced development time and cost.