Delayed-release Tablets Research Articles

Scintigraphic evaluation of the in vivo performance of dry-coated delayed-release tablets in humans

We characterized the gastrointestinal (GI) transit and drug release characteristics of dry-coated delayed-release tablets under both prandial states in humans using a gamma scintigraphy approach. We also estimated the onset time of drug release from the dry-coated tablets after dissolution of the outer layer in a clinical study, and compared findings with those of in vitro release testing. The dry-coated tablets used in this study were composed of a core containing radiolabeled resin (111-Indium) and a gel forming outer layer made of polyethylene oxide and polyethylene glycol. The dry-coated tablets were administered to human subjects in the fasted and fed state (30 min after ingestion of a standard breakfast radiolabeled with 99m-Technetium). Gastric emptying time, small intestinal transit time, and onset of radioactivity release in the GI tract were estimated from scintigraphic imaging. Release characteristics of the radiolabel from the dry-coated tablets were also assessed in in vitro dissolution testing using a USP apparatus 2 (paddle). Ingestion of food affected the gastric emptying time of the dry-coated tablets but not small intestinal transit. Onset timing of the release of radioactivity from the core of two different formulas of dry-coated tablets was characterized. The onset timing of drug release in the fasted subjects was markedly similar to that in the in vitro dissolution testing at a paddle rate of 200 rpm.

Pharmacokinetics and Pharmacodynamics of Posaconazole.

Posaconazole is typically used for preventing invasive yeast and mold infections such as invasive aspergillosis in high-risk immunocompromised patients. The oral suspension was the first released formulation and many pharmacokinetic and pharmacodynamic studies of this formulation have been published. Erratic absorption profiles associated with this formulation were widely reported. Posaconazole exposure was found to be significantly influenced by food and many gastrointestinal conditions, including pH and motility. As a result, low posaconazole plasma concentrations were obtained in large groups of patients. These issues of erratic absorption urged the development of the subsequently marketed delayed-release tablet, which proved to be associated with higher and more stable exposure profiles. Shortly thereafter, an intravenous formulation was released for patients who are not able to take oral formulations. Both new formulations require a loading dose on day 1 to achieve high posaconazole concentrations more quickly, which was not possible with the oral suspension. So far, there appears to be no evidence of increased toxicity correlated to the higher posaconazole exposure achieved with the regimen for these formulations. The higher systemic availability of posaconazole for the delayed-release tablet and intravenous formulation have resulted in these two formulations being preferable for both prophylaxis and treatment of invasive fungal disease. This review aimed to integrate the current knowledge on posaconazole pharmacokinetics, pharmacodynamics, major toxicity, existing resistance, clinical experience in special populations, and new therapeutic strategies in order to get a clear understanding of the clinical use of this drug.

Posaconazole delayed-release tablets in paediatric haematology-oncology patients.

To date, there are few studies that describe pharmacokinetics, safety and efficacy of posaconazole delayed-release tablet (DRT) formulation in the paediatric population. We evaluated retrospectively posaconazole plasma concentrations and safety of posaconazole DRT in paediatric haematology-oncology patients. Posaconazole DRT was assessed in 28 haematological paediatric patients with a median age 15 of years (range 5-18) and a median body weight of 50kg (range 22-83kg). Twenty-one patients received posaconazole DRT as prophylaxis and 7 patients as therapy. As prophylaxis, the median daily dose was 5.5mg/kg/day (range 2.2-22.2) with posaconazole trough level≥0.7μg/mL in 80% by first week, 62.5% by second week and 87.5% by fourth week. As therapy, the median daily dose was 4mg/kg/day (range 3.3-4.5) with trough level≥1μg/mL 100% by first week, 80% by second week and 33.4% by fourth week. Posaconazole DRT is feasible in paediatric patients capable to swallow tablets. Specific pharmacokinetic studies are needed.

Design and Evaluation of Time Dependent Delayed-Release Diclofenac Sodium Tablets for Chronopharmaceutical Drug Delivery

This research was aimed atformulatingand evaluating time dependent delayed-release diclofenac tablets forchronopharmaceutical drug delivery using press-coating technology. Rapiddisintegrating diclofenac core tablets were initially formulated using the directcompression method. Coats of powdered tragacanth or xanthan gum alone, and incombination in variousmixing ratios of 25:75, 40:60, 50:50 and 75:25 were compressed around the coretablet to form 3- layered tablets. Thepress-coated tablets were evaluated for post compression parameters such asweight variation, crushing strength, friability as well as, swelling index, lagtime and in vitro release studies in three different simulated gastro-intestinalfluids. The result revealed that thecore and compression coated tablet formulations were within the officialspecified limits. The release profile of the press coated tabletsexhibited lag times depending upon the type, amount and polymer combinationratio in the tablet coat. Optimizationwas done using analysis of variance (ANOVA). The optimizedbatch F6 which consisted of 40% xanthan and 60% tragacanth gave a lag time of 6h followed with burst release and complete drug release of 98.51%. Thisresearch shows that press-coated diclofenac tablets with 40:60% xanthan andtragacanth gum coat can be exploited in chronopharmaceutical delivery ofdiclofenac sodium.

Formulation and Evaluation of Rabeprazole Sodium Delayed Release Tablets

Formulation and Evaluation of Rabeprazole Sodium Delayed Release Tablets

A Study to Investigate the Use of Delayed Release Tablets for Colonic Delivery of Brilacidin in Healthy Volunteers

A Study to Investigate the Use of Delayed Release Tablets for Colonic Delivery of Brilacidin in Healthy Volunteers

Comparison of the Efficacy of Posaconazole Delayed Release Tablets and Suspension in Pediatric Hematology/Oncology Patients.

Posaconazole is effective in preventing invasive fungal infections in neutropenic pediatric patients. The oral suspension has challenges in administration and absorption that are theorized to be minimized with delayed release tablets. However, this has not been validated in the pediatric population. This study was conducted to compare the efficacy and safety of posaconazole suspension and delayed release tablets in pediatric hematology/oncology patients. A retrospective chart review in pediatric hematology/oncology patients was conducted from February 2013 to February 2017. Data collected include patient demographic data; posaconazole formulation, dose, and serum concentrations; and adverse events. Sixty-five patients with 353 serum posaconazole concentrations were included; 51.6% of concentrations drawn while patients were receiving posaconazole suspension were therapeutic, whereas 62.5% of concentrations drawn while patients were receiving posaconazole delayed release tablets were therapeutic (p = 0.035). Serum concentrations drawn while taking acid suppression (histamine receptor antagonists or proton pump inhibitors) and posaconazole suspension were less likely to be therapeutic (p < 0.0001) compared with those taken while receiving delayed release tablets. Adverse event profiles were similar between both formulations. Delayed release tablets proved more effective in achieving therapeutic serum posaconazole concentrations than posaconazole suspension, with minimal difference in adverse events, in pediatric hematology/oncology patients.

Synthesis and Purification of Acamprosate Calcium and its Evaluation by RP-HPLC in Pharmaceutical Dosage forms

The purpose of this study is Acamprosate Calcium synthesis of 3-Aminopropane-1-sulfonic acid (Homotaurine) and validation of assay test in the delayed-release tablets by HPLC without organic solvents. The assay method by HPLC was found to be linear in the concentration range of 50 to 200 µg/mL. Successful separation was achieved by isocratic elution on a Phenomenex® C18 column (250 mm × 4.6 mm, 5μm).The mobile phase was triethylammonium phosphate buffer pH: 4.0 (100%) at the flow rate of 1 mL/min using UV detection at 210 nm, column oven temperature 25oC and injection volume 20 𝜇L. The analytical results were validated by recovery studies. The percentage recovery method was found to be 99.36-100.60%. The LOD and LOQ were found to 0.012 μg/mL and 0.042 μg/mL. All the parameters of validation were in the acceptance range. This developed method was successfully applied for estimate the amount of Acamprosate Calcium in the tablets.

The tablet formulation of posaconazole: clinical pharmacology and the use in patients with hematologic malignancies

Posaconazole is a broad-spectrum triazole antifungal agent with potent activity against various fungi, including yeast and molds, including Mucorales, what makes a key difference with itraconazole and voriconazole. Clinical studies have demonstrated his efficacy for prophylaxis against invasive fungal infections in hematological patients at high risk (with acute myeloid leukemia, myelodysplastic syndrome, aplastic anemia, and in patients after hematopoietic stem cell transplantation, especially with graft versus host disease). Posaconazole also use as salvage therapy against invasive aspergillosis, mucormycosis and some other systemic mycoses. For today there are 3 posaconazole formulations – oral suspension, modify release tablet and intravenous solution (not registered in Russia at the time of writing this paper). As far as bioavailability of posaconazole following administration by oral suspension is highly variable with low unstable plasma concentrations and there are number of factors with negatively influence to the pharmacokinetic profile of suspension a delayed-release tablet was developed using hot-melt extrusion technology with a pH-sensitive polymer. The tablet formulation releases the drug in the intestine, and this leads to the enhanced bioavailability and increased posaconazole exposure parameters and, as a result, to a higher efficacy. This was demonstrated in pre-clinical, early phase clinical studies and confirmed with data from real practice. The tablet formulation has well tolerability profile with a low incidence of clinically significant adverse events. For today posaconazole included in all relevant clinical recommendations with high levels of evidence, including prophylaxis of invasive mycoses and therapy of their refractory forms, while the authors agree that for the oral therapy a preference should be given to the tablet formulation of posaconazole.

The Association of Mesalamine With Kidney Disease.

The package inserts for products containing 5-aminosalicylic acid, or mesalamine, include the following language regarding the risk of adverse kidney effects: "renal impairment, including minimal change nephropathy, acute and chronic interstitial nephritis, and rarely renal failure, has been reported in patients given products such as mesalamine delayed-release tablets that contain mesalamine or are converted to mesalamine." In this article, we review the data regarding this nephrotoxicity and the recommendations regarding appropriate monitoring. Chronic interstitial nephritis is a rare occurrence in patients treated with these drugs for Crohn disease and ulcerative colitis. Patients often present with asymptomatic reductions in glomerular filtration rate, without accompanying pyuria, skin lesions, or eosinophilia, unlike cases of acute interstitial nephritis. Drug cessation is usually associated with improved kidney function. However, if left undetected, more prolonged exposure to the drug can lead to irreversible kidney failure and end-stage kidney disease. No convincing studies demonstrate efficacy of treatment with corticosteroids. Frequent monitoring of serum creatinine, especially in the first years after initiation of therapy, is recommended.

Evaluation of posaconazole plasma concentrations achieved with the delayed-release tablets in Korean high-risk patients with haematologic malignancy.

Posaconazole (PCZ) is a triazole approved for prophylaxis of invasive fungal infections. Herein, the impact of clinical variables on PCZ plasma concentrations (PPCs) attained with PCZ delayed-release tablet (DRT) was investigated and compared with a historical cohort treated with PCZ oral suspension (OS). Steady-state PCZ PPCs in 513 patients with haematologic malignancy treated with PCZ-DRT were assessed and impact of variables were analysed. Also, a comparison with matched historical cohort treated with PCZ-OS was made. The median PPC in the PCZ-DRT group was 1,308.9ng/mL (range: 29.8-10455.9). Use of proton pump inhibitor (1181 vs 1344ng/mL, P=.0337) in the AML/myelodysplastic syndrome remission induction group, diarrhoea (867 vs 1543ng/mL, P=.0325) and gastrointestinal graft-versus-host disease (870 vs 1713ng/mL, P=.0178) in the HSCT group were associated with lower PPCs. There was lack of evidence that hepatotoxicity was related with PCZ-DRT. Higher prevalence of UGT1A4*3 allele (33.0%) was noted compared to allele frequency in Koreans in those with PPCs<500mg/mL. The median PPC in the PCZ-DRT group was significantly higher than that in the PCZ-OS group (1308.9 vs 713.0ng/mL, P<.0001). Significantly less patients had PPCs<700ng/mL in the PCZ-DRT group compared to the PCZ-OS group (18.7% vs 48.0%, P<.0001). Our study demonstrates that PCZ-DRT has enhanced absorption and bioavailability than PCZ-OS in real-world clinical settings. In addition, specific factors associated with lower PPCs should prompt consideration of therapeutic drug monitoring in patients treated with PCZ-DRT.

1737. Impact of Therapeutic Drug Monitoring (TDM) of Azole Prophylaxis in Lung Transplant Recipients on the Development of Positive Fungal Events

BackgroundThe utility and clinical impact of therapeutic drug monitoring (TDM) of prophylactic azole antifungals in lung transplant recipients is not well described. The objective of this study was to investigate the impact of TDM of azole prophylaxis in lung transplant recipients on the development of positive fungal events.MethodsA retrospective analysis was performed on 47 lung transplant recipients between 2013 and 2018 at Northwestern Memorial Hospital. A positive fungal event was defined as fungal species on BAL culture and/or positive BAL Aspergillus galactomannan (GM) with an index value ≥1.0. Study groups were defined based on attainment of therapeutic trough levels after initiation of oral therapy (therapeutic if posaconazole level ≥0.7 μg/mL or voriconazole ≥1–5.5 μg/mL, subtherapeutic if ≥2 consecutive levels of posaconazole <0.7 μg/mL or voriconazole <1 μg/mL after initial dose increase).ResultsThere were no differences in baseline characteristics (Figure 1). There were a total of 11 fungal events with 3 (12.0%) occurring in the therapeutic cohort and 8 (36.4%) in those subtherapeutic (P = 0.08). In the 5 patients with a positive GM, the mean index was 2.02 ± 0.95. 7/30 (23.3%) of patients on posaconazole had a fungal event, with 2/7 (28.6%) requiring treatment at the time of event. For patients on voriconazole, 4/17 (23.5%) had a fungal event, with 1/4 (25.0%) requiring treatment. Mean time to fungal event was 164.5 ± 8.9 days vs. 135.9 ± 13.7 days in the therapeutic and subtherapeutic group, respectively (P = 0.05).All patients on posaconazole suspension who experienced a fungal event were subtherapeutic (3/3, 100%) compared with the majority of patients on posaconazole delayed release (DR) tablets who achieved therapeutic levels (17/22, 77.3%). Mean posaconazole trough level observed in the patients receiving DR tablet was 2.15 ± 0.95 μg/mL.ConclusionThere was an association between two consecutive subtherapeutic azole prophylaxis levels and positive fungal events indicating a role for TDM in lung transplant recipients. Time to fungal event post-transplant was shorter in subtherapeutic patients. As anticipated, the use of posaconazole suspension resulted in subtherapeutic levels. This study presents an opportunity for further research of the impact of TDM on clinical outcomes to optimize patient care. Disclosures All authors: No reported disclosures.

Treatment by Posaconazole Tablets, Compared to Posaconazole Suspension, Does Not Reduce Variability of Posaconazole Trough Concentrations.

The delayed-release tablet formulation of posaconazole (POS-tab) results in higher plasma POS trough concentrations (Cmin) than the oral suspension (POS-susp), which raises the question of the utility of therapeutic drug monitoring (TDM). We aimed to compare the variability of the POS Cmin for the two formulations and identify determinants of the POS-tab Cmin and its variability. Demographic, biological, and clinical data from 77 allogeneic hematopoietic stem cell transplant patients (874 Cmin) treated with POS-tab (n = 41), POS-susp (n = 29), or both (n = 7) from January 2015 to December 2016 were collected retrospectively. Interpatient and within-subject coefficients of variation (CVs) of the Cmin adjusted to dose (D) were calculated for each formulation. Between-group comparisons were performed using a linear mixed effects model. The POS Cmin was higher for the tablet than for the suspension (median [25th-75th percentile]: 1.8 [1.2-2.4] mg/liter versus 1.2 [0.7-1.6] mg/liter, P < 0.0001). Interpatient CVs for the tablet and suspension were 60.8 versus 63.5% (P = 0.7), whereas within-subject CVs were 39.7 and 44.9%, respectively (P = 0.3). Univariate analysis showed that age and treatment by POS-tab were significantly and positively associated with the POS Cmin, whereas diarrhea was associated with a diminished POS Cmin Multivariate analysis identified treatment with POS-tab and diarrhea as independent factors of the POS Cmin, with a trend toward a lower impact of diarrhea during treatment with POS-tab (P = 0.07). Despite increased POS exposure with the tablet formulation, the variability of the POS Cmin was not significantly lower than that of the suspension. This suggests that TDM may still be useful to optimize tablet POS therapy.

Metformin hydrochloride delayed release tablets – a comparative dissolution profiles study

Metformin hydrochloride delayed release tablets – a comparative dissolution profiles study

Metformin hydrochloride delayed release tablets – a comparative dissolution profiles study

Multisource or generic drugs represent an important decrease in treatment cost for multiple diseases, which improves patient’s medicine access. However, the therapeutic equivalence between original drugs (innovator) and generic or multisource drugs need to be demonstrated. Bioequivalence represents drug efficacy and higher security for patients, and it is considered as a fundamental factor for product commercialization. This work main objective was to make a comparison between the dissolution profiles of the original and multisource metformin hydrochloride tablets commercialized in Costa Rica. We used a validated analytical method to quantify metformin in dissolution medium, a phosphates buffered solution of pH (6.8 ± 0.05). The obtained results demonstrated products interchangeability using the model-independent similarity factor (f2) and difference factor (f1) criteria.

Plasma exposures following posaconazole delayed-release tablets in immunocompromised children and adolescents.

Posaconazole is a recommended option for antifungal prophylaxis in paediatric patients >12 years of age. However, little is known about plasma exposures and safety following administration of the delayed-release tablets (DRTs) in children and adolescents. In a retrospective observational study, we analysed steady-state trough concentrations of posaconazole in all paediatric patients who had received the DRT formulation between May 2015 and December 2018 for antifungal prophylaxis. Dosing was guided by a published population pharmacokinetic model with weight-based dosing. Drug concentrations in plasma were measured by a validated tandem MS method. Liver function and drug discontinuations due to adverse effects were also assessed. A total of 34 patients (21 male, 13 female; median age 12 years, range 5-17 years; median body weight 43.5 kg, range 16-84 kg) undergoing treatment for haemato-oncological disorders (n=23) or immunosuppression for polyarthritis (n=1) or post-allogeneic HSCT (n=11) received posaconazole DRTs for a median of 70 days (range 9-391 days). The median first steady-state trough plasma concentration following model-derived dosing was 1607 ng/mL (range 501-8485 ng/mL) with trough concentrations being above the dosing target of ≥700 ng/mL in 32/34 patients (94%). Considering all (first and subsequent) trough concentrations, target attainment was 90% (63/70 samples). Posaconazole was well tolerated without adverse event-related discontinuations or breakthrough infections. Administration of posaconazole DRTs to paediatric patients guided by a population pharmacokinetic-derived dosing algorithm resulted in predictable and potentially effective exposures and was well tolerated over prolonged time periods.

FORMULATION AND EVALUATION OF PRESS COATED TABLETS OF LANSOPRAZOLE

Objective: Lansoprazole an proton pump inhibitor, degrades in acidic environment, hence protection of drug is done by coating the drug with enteric coating polymers. The aim and objective of the present study was to prepare enteric coated delayed release tablets of lansoprazole by using press coating technique.&#x0D; Methods: Core tablets were prepared by direct compression and evaluated for their physico-chemical properties. Press coated tablets were formulated by using different combinations of ethyl cellulose, HPMC E15 and HPMC K4M as a coating layer. Core and coated tablets were optimized by dissolution studies. Fourier transform infra-red spectroscopy (FTIR) and differential scanning calorimetry (DSC) studies were performed to know the compatibility of drug with various excipients. Surface morphology and uniformity of coat was evaluated by Scanning electron microscopy (SEM). Stability of optimized formulation was evaluated according to ICH guidelines.&#x0D; Results: Among the various formulations F5 containing ethyl cellulose: HPMC E15 (10:90) and F9 containing ethyl cellulose: HPMC K4M (25:75) were optimized based on the better drug release within 8 h. DSC studies and FTIR studies revealed compatibility of drug with excipients. Obtained SEM photographs of tablets showed that the surface of core tablet is uniformly coated with coat by press coating. Stability studies showed that the formulations were stable.&#x0D; Conclusion: As a result, delayed release press coated tablets developed in this study delivered lansoprazole in the intestine and protected the drug from degradation.

A gas chromatographic analysis method development and validation for determination of common plasticizers in delayed release tablet dosage forms

A simple and efficient Gas Chromatography GC analysis method was developed to identify and quantify plasticizers commonly used with polymers present in delayed release tablets The plasticizers investigated included Dibutyl Sebacate DBS Tributyl Phosphate TBP and Tributyl Acetyl Citrate TBAC The Gas Chromatography GC analysis method employs a common DB GC column mx micro m micro m film The method was shown to be specific and linear r Both accuracy and precision were established across the analytical range mg mL Method applicability was demonstrated by analyzing currently marketed DR tablets from different manufacturers

Comparative bioavailaibilty of two valproic acid delayed-release tablets in healthy volunteers with tighter acceptance criteria to anticipate breakthrough seizures

Comparative bioavailaibilty of two valproic acid delayed-release tablets in healthy volunteers with tighter acceptance criteria to anticipate breakthrough seizures

Therapeutic drug monitoring and adverse events of delayed-release posaconazole tablets in patients with chronic pulmonary aspergillosis.

Posaconazole delayed-release tablets offer better bioavailability than the liquid suspension, but no post-marketing data are available in immunocompetent hosts such as those with chronic pulmonary aspergillosis (CPA). To explore the pharmacokinetics and adverse event (AE) profile of posaconazole tablets in patients with CPA. Patients started on posaconazole tablets at the National Aspergillosis Centre (NAC), Manchester, UK between February 2014 and October 2015 were identified from the NAC database and analysed retrospectively. The medical records were reviewed for factors that could affect posaconazole serum levels and the development of AEs. Seventy-two patients were included; 50 (69%) were male and the mean age was 48.5 ± 12 years. Therapeutic levels (≥1 mg/L) were achieved in 90% of cases on 200 mg versus 90% of cases on 300 mg daily (P = not significant). Based on multivariate analysis, female sex (P = 0.041), a 100 mg daily dose (P < 0.001), asthma (P = 0.01) and bronchiectasis (P = 0.001) were associated with subtherapeutic levels. Forty-nine (68%) patients developed AEs, mainly fatigue (37%), dyspnoea (18%) and nausea (12%). AEs were present on 115/196 (59%) occasions on 300 mg/day and on 45/115 (39%) occasions on 200 mg/day (P < 0.01). The mean level was 1.81 ± 0.96 mg/L for patients reporting no AEs and 1.90 ± 1.11 mg/L for those reporting AEs (P = not significant). Factors associated with AEs of grade ≥2 were a daily dose of 300 versus 200 mg (P = 0.001) and asthma (P = 0.008). A lower-than-recommended posaconazole tablet dose achieved therapeutic levels in most patients and was better tolerated. Males were more likely to achieve a therapeutic level. Underlying conditions affected the degree and frequency of AEs.