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Uy, Alyssa V.

2BPh
CHAPTER 9 - Solid Oral Modified-Release Dosage Form and Drug Delivery  Frequency reduction in dosing
Systems – extended-release products frequently deliver more than less
often than conventional form DepoFoam Drug Delivery System
INTRODUCTION
 Enhanced convenience and compliance
 Describes solid oral dosage forms and drug delivery system that – with less frequency in dosing, a patient is less apt to neglect
virtue of formulation and product design have modified drug taking a dose, also it provides greater convenience with day and
release features night administration

 Modified release products provide either delayed release or  Reduction in adverse side effects
extended release of drug – because of fewer blood level peaks outside therapeutic range
and into toxic range, adverse side effects are less frequent
 Most delayed release products are enteric-coated tablets or
capsules designed to pass through the stomach unaltered, later to
 Reduction in overall health care costs
release their medication within the intestinal tract
– overall cost of treatment may be less because of enhanced
therapeutic benefit, fewer side effects, and reduced time for
 Enteric coatings are used either to protect a substance from
health care personnel to dispense and administer drugs and
destruction by gastric fluids or to irritating drugs
monitor patients

DISADVANTAGE OF ETENDED-RELEASE DOSAGE FORMS OVER


CONVENTIONAL FORMS

 loss of flexibility in adjusting the drug dose and/or dosage


regimen
 risk of sudden and total drug release
 dose dumping due to failure in technology

TERMINOLOGY
1. Sustained Release (SR) – Melatonex
2. Sustained Action (SA) – Drixoral
3. Extended Release (ER) – NOX3
4. Long Acting (LA) – Theraflu
5. Prolong Action (PA) –
6. Controlled Release (CR) – Melatonin
7. Timed Release (TR) – Vit-Min 100
Extended release products are designed to release their medication in a
controlled manner at a predetermined rate, duration, and location to
achieve and maintain optimum therapeutic blood levels of drug

RATIONAL FOR EXTENDED RELEASE PHARMACEUTICALS

 Extended release tablets & capsules = take once or twice daily


Conventional forms = 3 to 4 times daily to achieve same
TE

 For non oral rate-controlled DDSs = 24 hours for most


transdermal patches to months to years
– Ex.: Lovenorgestrel subdermal implants (Norplat
System)
MULTIPLE DAILY DOSING  Products bearing these descriptions differ in design and
performance and must be examined individually to ascertain their
 inconvenient for the patient and can result in missed doses, respective features
made-up doses, and noncompliance with the regimen
 when doses are not administered on schedule, the resulting peaks Rate-Controlled delivery
and valleys reflect the optimum drug therapy  applied to certain types of drug delivery systems in which the rate
 of delivery is controlled by features of service rather than by
ADVANTAGES OF EXTENDED-RELEASE DOSAGE FORMS OVER physiologic or environmental conditions like gastrointestinal pH or
CONVENTIONAL FORMS drug transit time through the gastrointestinal tract

 Reduction in drug blood levels fluctuation Modified release


– controlling the rate of release eliminatedpeaks and valleys of  has come into general use to describe dosage forms having drug
blood levels release features based on time course and/or location that are
designed to accomplish therapeutic or convenience objectives not
offered by conventional or immediate-release forms
Extended-release  BASIS OF DRUG RELEASE modifying drug dissolution by
 dosage forms of this type are the ones that allow a reduction in controlling excess of biologic fluids to the drug through the use of
dosing frequency form that necessitated by a conventional dosage barrier coatings
forms, such as solution or an immediate-release drug dosage form  controlling drug diffusion rate from dosage forms
 chemical reaction or interaction between the drug substance or
Delayed release its pharmaceutical barrier and site-specific biologic fluids
 releases the drug at a time other than promptly after
administration. The delay may be time base or base on the BASIS OF DRUG RELEASE
influence of environmental conditions such as gastrointestinal pH  modifying drug dissolution by controlling excess of biologic fluids
to the drug through the use of barrier coatings
Repeat action  controlling drug diffusion rate from dosage forms
 two single doses of medication; one for immediate release;  chemical reaction or interaction between the drug substance or
another one for modified release its pharmaceutical barrier and site-specific biologic fluids

Targeted release COATED BEADS, GRANULES AND MICROSPHERES


 drug release directed toward isolating or concentrating a drug in a  using conventional pan coating or air suspension coating, a
body region, tissue or site of absorption or for drug action solution of the drug substance is placed on small intact nonparent
seeds or beads made of sugar and stand or on microcrystalline
Extended Release Oral Dosage Forms (Successful ER Product) cellulose sphere
1. Release from dosage forms at a predetermine rate Nonpareil seeds
2. Dissolve in GT  425-850μm
3. Maintain sufficient Gastrointestinal residence time
4. Be absorbed at a rate that will replace the amount of drug being Microcrystalline cellulose
metabolized and excreted  More durable during production than sugar-based cores
 170-600μm
CHARACTERISTICS OF EXTENDED-RELEASE PRODUCTS
1. They exhibit very slow nor very fast rates of absorption and excretion Lipid materials used to coat granules
 drugs with slow rates of absorption and excretion are usually  Beeswax
inherently long-acting, and it is not necessary to prepare them in  Carnauba wax
extended-release forms  Glyceryl monostearate
 drug with very short half-lives, less than 2 hours, are poor  Cetyl alcohol
candidates for extended release  Cellulosic material (ethyl cellulose)
 drugs that act by affecting enzyme systems may be loner acting  Aqueous coating system eliminate the hazards and environmental
than indicated by their quantitative half-lives because of their concerns associated with organic based solvent systems
residual effects and recovery of the diminished biosystem  The thicker the coat, the more resistant to penetration and the
more delayed will be the drug release and dissolution
2. They are uniformly absorbed from the gastrointestinal tract  Spansule
 they must have good aqueous solubility and maintain adequate
residence time in the gastrointestinal tract MULTITABLET SYSTEMS
 small spheroidal compressed tablets 3 to 4 mm in diameter may
 drugs absorbed poorly or at varying and unpredictable rates are be prepared
not good candidates for extended-release products  each capsule contain 8 to 10 minitablets some uncoated for
immediate release and others coated for extended drug release
3. They are administered in relatively small doses
 drugs with large single doses frequently are not suitable for
MICROENCAPSULATED DRUG
extended release because the tablet or capsule needed to
Microencapsulation
maintain a sustained therapeutic blood level of the drug would be
 A process by which solid, liquid or even gases may be enclosed in
too large for the patient to swallow easily
microscopic particles by formation of thin coatings of wall
material around the substance
4. They possess a good margin of safety
 the most widely used measure of the margin of a drug’s safety is
Gelatin
its therapeutic index, that is, the median toxic dose divided by the
 A common wall forming material and synthetic polymers, such as
median affective dose
polyvinyl alcohol, ethyl cellulose, polyvinyl chloride and other
 the larger the therapeutic index, the safer the drug
materials may be used
 drugs that are administered in very small doses or possess very
 dissolving the wall material
narrow therapeutic indices are poor candidates for formulations
 encapsulated material is added to the mixture and the thoroughly
because of technologic limitations of precise control over release
stirred
rates and the risk of dose dumping due to a product defect
 a solution to second material is added, example of acacia
 the final dry microcapsules are free-flowing discrete particles of
5. They are used in the treatment of chronic rather than acute
conditions coated material
 drugs for acute conditions require greater adjustment of the  wall material constitute into 20% of the total particle weigh
dosage by the physician than that provided by extended-release
products
ADVANTAGE OF MICROENCAPSULATION  salts of tannic acid, tannates, provide this quality in a variety of
 administered dose of a drug is subdivided into small units that are proprietary products
spread over a large area of the gastrointestinal tracts, which may
enhance absorption by diminishing local drug concentration (e.g. ION EXCHANGE RESINS
Micro-K ExtenCaps)  solution of a cationic drug may be passed through a column
>Encapsulation. All of the single and combination capsules are containing an ion exchange resin, forming a complex by the
produced here. The empty gelatin capsules are placed in hoppers replacement of hydrogen atoms
and free-flowing to the machine. The bottom portion of the  release of the drug depends on the pH and electrolyte
capsule is filled, which is gravity-fed from a stainless steel bin into concentration in the gastrointestinal tract
the machine’s hopper. An average of 6 million capsules a day can  release is greater in the acidity of the stomach than in the less
be produced. acidic environment of the small intestine
 hydrocodone polistirex (Tussionex) and chlorpheniramine
EMBEDDING DRUG SLOWLY ERODING OR HYDROPHILIC MATRIX SYSTEM polistirex suspension and phentermine resin capsules
 drug substance is combined and made into granules with an
excipient material that slowly erodes in body fluids, progressively Mechanism of ion exchange resins:
releasing the drug for absorption In the stomach
1. drug resinate + HCl ↔ acidic resin + drug hydrochloride
Hydrophilic cellulose polymers 2. resin salt + HCl ↔ resin chloride + acidic drug
 commonly used as the excipient base in tablet matrix systems In the intestine
EFFECTIVENESS OF THE HYDROPHILIC MATRIX IS BASED ON: 1. drug resinate + NaCl ↔ sodium resinate + drug hydrochloride
2. resin salt + NaCl ↔ resin chloride + sodium salt of drug
 successive process of hydration on the polymer’s surface  release is extended over 12 hours by ionic exchange
 gel formation on the polymer’s surface
 tablet erosion
 subsequent and continuous release of drug
Drug suspension or
Hydroxypropyl Methyl Cellulose (HPMC) solution

 a free flowing powder; commonly used to provide the hydrophilic Osmotic drug core Deliver orifices
matrix
 A successful hydrophilic matrix system must contain the
following:
Delivery orifice
 polymer must form a gelatinous layer rapidly enough to protect
the inner core of the tablet from disintegrating too rapidly after Water Water

ingestion
 20% of HPMC results in satisfactory rates of release for an
extended-release tablet formation (e.g Oramorph SR Tablet)
Rate controlling Polymeric osmotic
Semipermeable Osmotic core membrane push compartment
membrane containing drug
Manufacturers may prepare two-layer tablets A. Elementary OROS osmotic B. OROS Push-Pull Osmotic System

 one layer containing the uncombined drug for immediate release pump drug delivery system

 the other layer having the drug encoded in a hydrophilic matrix


for extended release

OSMOTIC PUMP
they may also prepare a three-layer tablets
 the pioneer oral osmotic pump drug delivery system is the Oros
 outer layers containing the drug for immediate release
system developed by Alza
 some commercial tablets are prepared with an inner core
 composed of a core tablet surrounded by a semipermeable
containing the extended-release portion of the drug and an outer
membrane coating having a 0.4mm diameter hole produced by
shell containing drug for immediate release
laser beam. Example: Acutrim
 core tablet has two layers, one containing the drug and the other
containing a polymeric osmotic agent
EMBEDDING DRUG IN INERT PLASTIC MATRIX
 the system is designed such that only a few drops of water are
 Drug is granulated with an inert plastic material such as
drawn into the tablet each hour
polyethylene, polyvinyl acetate, o polymethacrylate and the
 function of the tablet depends on the osmotic gradient between
granulation is compressed into tablets
the contents of the two-layer core and the fluid in the
 released from the inert plastic matrix by diffusion
gastrointestinal tract
 retains its shape during leaching of he drug and during its passage
through the alimentary tract
Drug release rate may be altered by:
 Example: Gradumet
 changing the surface area
 thickness
COMPLEX FORMATION
 composition of the membrane and/or diameter of the drug
 form complexes that may be slowly soluble in body fluids,
release orifice
depending on the pH of the environment

 slow dissolution rate (e.g. Rynatan)


Release rate is not affected by:
 gastrointestinal acidity or alkalinity USP Requirements and FDA Guidelines for Modified Release Dosage Forms
 fed conditions 1. DRUG RELEASE
 gastrointestinal motility  based on drug dissolution from the dosage unit against elapsed
test time (e.g. Aspirin Extended-release Tablets)
Gastrointestinal therapeutic system (GIT systems)  Aspirin dissolution rate:
 is employed in the manufacture of Glucotrol XL Extended release
tablets, and Procardia XL release tablets Time (hours) Amount dissolved
 the initial drug is released 4 to 5 hours after tablet ingestion 1.0 15-40%
2.0 25-60%
REPEAT-ACTION TABLETS 4.0 35-75%
 the initial dose of drug is released immediately and a second dose 8.0 Not less than 70%
follows later
2. UNIFORMITY OF DOSAGE UNITS
 released 4 to 6 hours after administration
 uniformity of dosage units may be demonstrated by either of two
 Example: Repetabs
methods, weight variations or content uniformity
 they are best suited for treatment of chronic conditions requiring
repeated dosing
3. IN VITRO-IN VIVO CORRELATIONS
 low dosage and fairly rapid rates of absorption and excretion
 critical to the development of oral extended-release products
 important throughout product dev’t, clinical evaluation
DELAYED-RELEASE ORAL DOSAGE FORMS submission of an application for FDA approval for marketing, &
 release of a drug that may be intentionally delayed until it reaches during post approval for any proposed formulation or
the intestines for several reasons manufacturing changes
 protect a drug destroyed by gastric fluids  it provides guidance to sponsors of new drug applications and
 reduce gastric distress caused by drugs of particularly irritating to abbreviated new drug applications and abbreviated new drug
the stomach applications for extended release of oral products
 to facilitate gastrointestinal transit for drugs that are absorbed
from the intestines
IVIVC provides methods of:
 Examples: Enteric Coated Enseals – Lilly; Ecotrin SmithKline
 developing an IVIVC and evaluating its predictability
 using an IVIVC to establish dissolution specifications
 applying an IVIVC as a surrogate for in vitro-in vivo bioequivalence
PROPERTIES OF AN ENTERIC COATING TABLETS/CAPSULES
during the approval process or during post approval for certain
 pH dependent
formulation or manufacturing changes
 breaks down in the less acidic environment of the intestine
 time dependent
3 Categories of IVIVCs include in the document
 erodes by moisture over time during gastrointestinal transit
 Level A
 enzyme dependent
 the relationship between the entire in vitro dissolution
 deteriorating as a result of hydrolysis-catalyzing action of
and release time course and the entire in vivo
intestinal enzyme
response time course
 Ex.: the time course of plasma drug concentration or
AGENTS USED FOR ENTERIC COATING OF CAPSULES AND TABLETS
amount of drug absorbed
 fats
 fatty acids
 Level B
 waxes  predictive mathematical model of the relationship
 shellac between summary parameters that characterize in
 cellulose acetate phthalate vitro and in vivo time courses
 Example: models that relate the mean in vivo
EXAMPLES OF MODIFIED-RELEASE TABLETS AND CAPSULES OFFICIAL IN THE dissolution time to the mean in vitro dissolution time
USP

Delayed release  Level C


Aspirin delayed-release tablets  a predictive mathematical model of the relationship
Dirithromycin delayed-release tablets between the amount dissolved in vitro at a particular
Doxycycline hyclate delayed-release capsules time and a summary parameter that characterizes the
Erythromycin delayed-release capsules time in vivo time course or area under the curve
Oxtriphylline delayed-release tablets  the level of IVIVCs may be useful in the early stages of
formulation development when pilot formulations are
being selected

Extended release MOST COMMON PROCESS FOR DEVELOPING IVIVC MODEL (LEVEL A)
Diltiazem extended-release capsules  develop formulations with different release rates or a single
Disopyramide phosphate extended-release capsules release rate if dissolution is independent of condition
Isosorbide dinitrate extended-release tablets and capsules  obtain in vitro dissolution profiles and in vivo plasma
Propanolol hydrochloride extended-release capsules concentration profiles for these formulations
Theophylline extended-release capsules
 estimate the in vivo absorption or dissolution time course for Propriety Modified-Release Oral Dosage Forms
each formulation and subject using appropriate mathematical  Delayed-release
approaches

CRITERIA IN DEVELOPMENT APPLICABLE TO THE DEVELOPMENT OF IVIVCS


ARE THE FOLLOWING
 in determining in vitro dissolution, USP dissolution apparatus;
type I (basket) or type II (paddle) is preferred, although type III
(reciprocating cylinder) or type IV (flow-through cell) may be
applicable in some substances

 aqueous medium with a pH not exceeding 6.8 is preferred as the


medium for dissolution studies. For poorly soluble drugs, a
surfactant may be added

 the dissolution profiles of at least 12 individual dosage units from


each lot should be determined

 for vivo studies, human subjects are used in the fasted state
unless the drug is not well tolerated, in which case the studies
may be conducted in the fed state. Acceptable data sets have
been shown to be generated with use of 6 to 36 human subjects
 Extended-Release Coated Particles and Breads
 crossover studies are preferred, but parallel studies or cross-study
analysis may be acceptable using a common reference treatment
product, such as an intravenous solution, an aqueous oral
solution, or an immediate-release product

LABELING
 they must be specific for the monograph article
 aspirin delayed-release tablets must state that the tablets are
enteric coated
 capsules must indicate whether the product is intended for
dosage every 12 to 24 hours and state which in vitro drug release
test the product complies

CLINICAL CONSIDERATIONS
 not to be used interchangeably
or concomitantly with immediate-release
forms of the same drug
 patients using a modified
release product should not be changed
into immediate release without
consideration to the blood concentration
 patients should not be changed
 Extended-Release Inert Matrix
to another extended-release product unless there is assurance of
equivalent bioavailability
 different product can result in a marketed shift in the patient’s
drug blood level because of differences in drug release
characteristics
 modified release tablets and capsules should not be crushed or
chewed
 patients if fed through the nasogastric tube may receive modified-
release medications
 nonerodible plastic matrix shells and osmotic tablets remain
intact throughout gastrointestinal transit and the empty shells or
ghosts from osmotic tablets may be seen in the stool
 Extended Release Hydrophilic/Eroding Matrix

 Extended-Release Microencapsulated Drug

 Extended-Release Osmotic

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