Abstract

The mouth can be affected by important inflammatory processes resulting from localized or systemic diseases such as diabetes, AIDS and leukemia, among others, and are manifested in various types of buccal sores typically presenting pain. This work focuses on the design, formulation, and characterization of four semisolid formulations for oral mucosa in order to symptomatically treat these painful processes. The formulations have two active pharmaceutical ingredients, triamcinolone acetonide (TA) and lidocaine hydrochloride (LIDO). The formula also contains, as an excipient, Orabase®, which is a protective, hydrophobic, and anhydrous adhesive vehicle, used to retain or facilitate the application of active pharmaceutical ingredients to the oral mucosa. After designing the formulations, an analytical method for TA was validated using HPLC so as to achieve reliable analytical results. Franz-type diffusion cells were used to perform drug release studies using synthetic membrane, and permeation studies using buccal mucosa, estimating the amount and rate of TA permeated across the tissue. Additionally, sublingual permeation studies were carried out to evaluate a scenario of a continuous contact of the tongue with the applied formulation. Permeation fluxes and the amount of TA retained within sublingual mucosa were similar to those in buccal mucosa, also implying anti-inflammatory activity in the part of the tongue that is in direct contact with the formulation. In addition, the dynamic conditions of the mouth were recreated in terms of the presence of phosphate buffered saline, constant movement of the tongue, pH, and temperature, using dissolution equipment. The amount of TA released into the phosphate buffered saline in dynamic conditions (subject to being ingested) is well below the normal oral doses of TA, for which the formulation can be considered safe. The formulations applied to buccal or sublingual mucosas under dynamic conditions permit the successful retention of TA within either tissue, where it exerts anti-inflammatory activity. The four formulations studied show a pseudoplastic and thixotropic behavior, ideal for topical application. These results evidence the potential of these topical formulations in the treatment of inflammatory processes in the buccal mucosa.

Highlights

  • The mouth can be affected by important inflammatory processes resulting from localized or systemic diseases such as diabetes, AIDS and leukemia, among others, which can creativecommons.org/licenses/by/

  • A semisolid formulation including triamcinolone acetonide (TA) and lidocaine hydrochloride is marketed in the United States, but there is an overall lack of products containing both active ingredients around the world

  • TA was prepared at 0.05% and 0.1% (w/v), and lidocaine hydrochloride (LIDO) was tested at 2%

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Summary

Introduction

The treatment of oral lesions including inflammation may include lipophilic glucocorticosteroids with immunosuppressive and anti-inflammatory activity [2], such as triamcinolone acetonide (TA), at concentrations ranging from 0.05% to 0.5%, or fluocinolone acetonide at concentrations 0.025–0.05%, either in aqueous solutions or in Orabase®. Antiseptic agents such as chlorhexidine gluconate can be included as a mouthwash, and antibiotics such as doxycycline hyclate for lesions that involve infections, or topical anesthetics such as benzocaine hydrochloride for pain management [3]. A semisolid formulation including TA and lidocaine hydrochloride is marketed in the United States, but there is an overall lack of products containing both active ingredients around the world

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