Abstract

In clinical practice, for elderly or pediatric patients who have difficulty swallowing, solid dosage forms such as tablets or capsules are crushed or unsealed, prepared as powder forms, and often administered as suspensions. However, because their dispersibility is poor, aggregation or precipitation occurs readily. Once precipitation and deposition happen, redispersion is difficult, which can limit patient and caretaker drug adherence. In this study, we attempted to prepare nanoparticles as a hospital formulation by a benchtop wet-milling method to obtain a suspension with high dispersibility. This is the first study to apply the wet-milling method to prepare the hospital formulation. We chose cefditoren pivoxil (CDTR-PI) as an experimental active pharmaceutical ingredient. CDTR-PI crystals were physically mixed with various water-soluble polymers such as polyvinylpyrrolidone, polyethylene oxide, hydroxypropyl cellulose, or hypromellose and wet-milled with a surface-active agent (sodium lauryl sulfate) under different conditions. The mean particle diameter of most of the samples was less than 200 nm. In FTIR spectra of ground samples, peak shifts suggesting inter- or intramolecular interactions between CDTR-PI and the other additive agents were not observed. Besides, the nanoparticle suspension had favorable dispersibility, as determined using a dispersion stability analyzer. Providing a suspension with high dispersibility makes dispense with the resuspension, the patient’s medication adherence would improve. These results show that suspended liquid formulations of active pharmaceutical ingredients could be obtained by the simple wet-milling method as hospital formulations.

Highlights

  • The elderly population has been increasing worldwide, and many elderly patients have dysphagia

  • To develop a method for preparing the hospital formulation using such water-insoluble active pharmaceutical ingredients (APIs), we focused on cefditoren pivoxil (CDTR-PI) as a model API in this study

  • As for the simple method for preparing a hospital formulation, we have reported the preparation of nanoparticles (NP) with hydroxypropyl cellulose (HPC; HPC-L, HPC-SL, and HPC-SSL) and sodium lauryl sulfate (SLS) using the wet-milling method to improve solubility and dispersibility, which was used a propeller-type stirrer and zirconia beads

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Summary

Introduction

The elderly population has been increasing worldwide, and many elderly patients have dysphagia. A variety of formulations have been developed for many medicines Dosage forms such as tablets are sometimes crushed by pharmacists to administer for children, because there is no optimal dosage for children in Japan. In a realistic medical setting, such as a hospital, home medical care, or palliative care, various medicines are available to respond to patient needs; there are often cases where the existing medicine cannot treat each patient. To solve these problems, various hospital formulations have been developed and applied in Japan. Hospital formulations are defined as medically required formulations that are not commercially available, but prepared by a pharmacist in the hospital according to a medical doctor’s request and used entirely within that institution

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