Abstract
Objective: The objective of the present work was to develop an optimized dosage form for treating comorbidity in combination and evaluate it for its pharmacodynamic performance in male Wistar albino rats.
 Methods: Transdermal proniosomal gel for Combination of Glibenclamide (GLB) and Atenolol (ATN) was developed and optimized by Box Behnken design. This optimized combinational proniosomal gel (OCPG), which was selected by a point prediction method, was evaluated for its ex vivo, skin irritation studies and pharmacodynamic activities of both drugs in rats in comparison with its oral therapy.
 Results: The ex-vivo permeation behavior through different skins was studied and the findings were also confirmed by the values of the steady-state flux (Jss). The OCPG observed an increase of more than twice in the cumulative amount of impregnated drugs compared to pure drug films. The study on skin irritation revealed the non-irritability of the developed OCPG applied. OCPG significantly showed sustained hypoglycemic activity in rats (p<0.001), when compared to orally treat animals up to 24 h. Systolic blood pressure (SBP) lowering effect of OCPG was found to be significant (p<0.02), when compared to orally treat rats up to 24 h. However, the reduction was slow and sustained in the case of OPCG where a significant response was observed in the performed studies.
 Conclusion: Overall, the results show that controlled release GLB and ATN proniosomes offer a useful and promising transdermal delivery system. Henceforth this may be an achievement in treating the diabetic hypertensive patient.
Highlights
Diabetes mellitus (DM) is a complex chronic disease that requires ongoing medical care and multi-factor strategies to reduce risk beyond glycemic control [1,2,3]
Coacervation-phase separation method was followed for the preparation of proniosomes, which was reported by Perrett and Vora [19, 20]
The optimum formulation of Proniosomal gel was chosen dependent on the criteria of achieving the desirable value of vesicles size, entrapment efficiency of GLB and entrapment efficiency of ATN by applying numerical point prediction method
Summary
Diabetes mellitus (DM) is a complex chronic disease that requires ongoing medical care and multi-factor strategies to reduce risk beyond glycemic control [1,2,3]. In DM, a constant increase in glucose levels can lead to chronic micro-and macro-vascular effects [4,5,6,7]. A patient with multiple comorbid conditions requires multiple medications to treat each condition, increasing side effects and treatment costs. Combined pharmacotherapies may provide additive benefits that target multiple disease processes [8]. Fixed-dose combination drugs (FDC’s) were originally developed to target only one disease. CFDCs can target more than one disease/condition [9, 10]. No CDF has been developed for diabetes and its co-morbidities, like hypertension
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