Current Advances in Drug Delivery Through Fast Dissolving/Disintegrating Dosage Forms E-Book
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- Herausgeber: Bentham Science Publishers
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Fast Dissolving/Disintegrating Dosage Forms (FDDFs) have been commercially available since the late 1990s. FDDFs were initially available as orodispersible tablets, and later, as orodipsersible films for treating specific populations (pediatrics, geriatrics, and psychiatric patients). Granules, pellets and mini tablets are among latest additions to these dosage forms, which are still in the development pipeline. As drug delivery systems, FDDFs enable quicker onset of action, immediate drug delivery, and sometimes offer bioavailability benefits due to buccal/sublingual absorption. With time, FDDF have evolved to deliver drugs in a sustained and controlled manner. Their current market and application is increasing in demands with advances in age adapted dosage forms for different patients and changing regulatory requirements that warrant mandatory assessments of new drugs and drug products before commercial availability.
This book presents detailed information about FDDFs from their inception to recent developments. Readers will learn about the technical details of various FDDF manufacturing methods, formulation aspects, evaluation and methods to conduct clinical studies. The authors also give examples of marketed fast disintegrating/dissolving drug products in US, Europe, Japan, and India. This reference is ideal for pharmacology students at all levels seeking information about this specific form of drug delivery and formulation.
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Current Advances in Drug Delivery Through
Fast Dissolving/Disintegrating Dosage Forms
Edited by:
Vikas Anand Saharan
BENTHAM SCIENCE PUBLISHERS LTD.
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FOREWORD
The major challenge that I have experienced as a pharmaceutical science professional is to keep abreast of the ever-evolving developments in the field and translating the innovations to ensure better quality of life to human and animals. The history of pharmaceuticals is loaded with a concern for the development of new chemical entities. Only in recent years, the importance of dosage form design has been recognized as a vital component of safe and effective clinical outcomes.
Despite tremendous innovations in drug delivery, the oral drug delivery continues to be a step ahead as a preferred route of administration for therapeutic agents. Some obvious advantages include accurate dosage, low cost, self-medication, non-invasive and easy administration. At the same time, an important drawback with oral dosage forms is “dysphagia” or difficulty in swallowing in paediatric and geriatric populations, leading to noncompliance and ineffective therapy.
Recent advances in novel delivery systems aim to enhance the safety of drug molecules while maintaining the therapeutic efficacy with an overall aim of better patient compliance. To achieve this objective, the concept of Fast Dissolving/Disintegrating Dosage Forms (FDDF) was introduced. FDDF is a perfect example of patient-oriented pharmaceutical approach, which has emerged from the need to provide a convenient way to administer medicines. Solid dosage forms that disintegrate, dissolve, or get suspended in the saliva in the mouth rapidly (in seconds) without chewing or use of water, provide an excellent alternative to swallowing the solid dosage form. This technique facilitates easy swallowing providing significant benefits to the relevant patient population.
In addition to patient compliance, extending the pharmaceutical product life cycle is another reason for the increasing popularity of the FDDFs. As a drug entity reaches the end of its patent life, it is common for manufacturers to develop it in a new and improved dosage form that allows extension of market exclusivity, while offering its patient population a more convenient dosage form. It also leads to increased revenue for the company, while targeting underserved and undertreated patient populations. Generally, the additional cost of manufacturing these specialized dosage forms is only marginally higher, which is easily compensated by additional benefits to patients.
The book covers relevant topics in different chapters, e.g. basic introduction with advantages and key concepts, patented technologies, taste masking approaches, general ingredients for developing formulation, quality control parameters, and critical review of clinical trials, which will be useful for a wide range of readers. The book has also included application of FDDFs to achieve controlled and targeted release which is expected to be of considerable interest to experts as well as new researchers. I strongly feel that this addition to literature will be especially useful to undergraduate pharmacy and post-graduate pharmaceutical science students. The book will serve as a sound source of systematic information for FDDFs. Students and researchers who consider dysphagia or pharmaceutical marketing during innovative product development will find it as a welcoming tool. A single textbook that brings together inputs from experts in all of these subjects is certainly an invaluable asset to pharmaceutical industry.
I wish to congratulate the editor, team of authors and Bentham publisher for excellent work and contribution to the pharmaceutical sciences. It is especially pleasing to note that a small Master’s project undertaken by Dr Vikas Anand in his early years motivated him to continue working in the field and led to this wonderful compilation.
Sanjay Garg School of Pharmacy and Medical Sciences University of South Australia, City East Campus Adelaide, SA AustraliaPREFACE
The solid dosage forms that dissolve or disintegrate quickly in the oral cavity, resulting in solution or suspension, eliminating the need of water for swallowing, are known as fast dissolving/disintegrating dosage forms (FDDFs). Over the last 20 years, the field of FDDFs has expanded considerably to address not only concerns of immediate release dosage forms but additionally played an important role in controlled/modified release drug delivery. This is still an exciting and growing area of pharmaceutical research and education. Ironically, to date no single book provides detailed and specific information on FDDFs. Therefore, I decided to write a book comprising of chapters that collectively address this void and provide an insight into the various technologies and methodologies currently adopted to formulate, prepare and evaluate FDDFs. The idea for this book on the topic has been in mind since my first research project during M.S.(Pharm.) at NIPER, Mohali. Since, then it gradually strengthened when I was Assistant Professor at Seth GL Bihani SD College, Sri Ganganagar and Professor/Associate Professor at Sardar Bhagwan Singh Post Graduate Institute (SBSPGI) of Biomedical Sciences & Research, Dehradun. My teaching and research in relevant and related fields continuously helped me in understanding and developing deeper interests towards FDDFs.
The present book is an attempt to provide comprehensive information to the readers interested in FDDFs. The specific emphasis in this book has been given to various technologies of making FDDFs, formulation development, evaluation, clinical studies, and marketed FDDFs products. This book intends to serve as a source of reference work and some chapters may be used for classroom teaching in graduate/postgraduate programmes. The authors do feel that graduate/postgraduate programmes in pharmaceutical sciences often neglect to adequately address FDDFs as novel drug delivery systems. Research fellows and experience scientists also feel paucity to find few resources outside the primary literature for FDDFs.
Due to its organization into different chapters, the book can be read at different levels and a reader can start as per the sequence of chapters or may opt to go directly onto the desired chapter. Thus, this book could be useful for graduate, postgraduate and PhD students belonging to the pharmaceutical sciences. Nevertheless, we do hope that this book is also useful to expert as well as new researchers, who may find information and new ideas for novel advancements in the field of FDDFs.
I hope that all those who consult this book find it useful as an easy-to-understand text for FDDFs. Constructive comments/suggestions are also invited from readers for further refinements in this book.
CONFLICT OF INTEREST
The authors confirm that they have no conflict of interest to declare for this publication.
ACKNOWLEDGEMENTS
I am grateful and highly indebted to my M.S.(Pharm.) supervisor and teacher Prof.(Dr.) Sanjay Garg for teaching the concepts of research in pharmaceutics and extending his support to this book by writing a foreword to this book. I greatly acknowledge continuous motivation and support of my Ph.D. supervisor Prof.(Dr.) P.K. Choudhury for all my efforts to do the best in the field of pharmaceutical sciences.
I am extremely grateful to the management of SBSPGI, especially Sh. S. P. Singh (Chairman, SBSPGI) and Dr. Gauravdeep Singh (Managing Secretary, SBSPGI) for all round support during my entire tenure at SBSPGI. I am highly privileged to have some of my good teachers, like Dr. Luvkush (academic advisor, SBSPGI), Prof. Veerma Ram and Ms. Urmi Chaurasia, as a constant and continuous source of inspiration and motivation.
Without the support of my mother, father and wife, it was really impossible to complete this arduous task. They have sacrificed a lot of my personal time while I was working on this book. I also missed my son, Inesh, when I was working on this book and he was not beside me.
I would like to thank all the chapter authors for their hard work, valuable contributions and their patience in various phases of publication of this book. I am extremely thankful to Bentham for providing a platform from where this book can reach to it’s readers.
Vikas A. Saharan Department of Pharmaceutics School of Pharmaceutical Sciences Sardar Bhagwan Singh Post Graduate Institute of Biomedical Sciences & Research (SBSPGI) Balawala, Dehradun IndiaDEDICATION
List of Contributors
Fast Dissolving/Disintegrating Dosage Forms: Introducing through Development, Market, Pharmacopoeial and Regulatory Status
1. INTRODUCTION
Administering drug by oral route is simple, convenient and a first choice delivery
option among all other routes of delivering drug. Further, in orally administered dosage forms, the solid dosage forms, i.e. tablets and capsules, are mostly liked because of their ease of manufacture, low cost of production, and convenience in packaging and transportation. Conventionally, tablets can be manufactured by either direct compression or granulation methods. Although the basic mechanical compaction approaches for tablet manufacturing remains same. The tablet formulation technology has undergone great improvement and continuous efforts are still ongoing to improve the processes and techniques of tablet manufacturing and physical properties of the tablet vis a vis to the latest developments in science.
Sublingual tablets and buccal tablets are considered as precursors to FDDFs. Sublingual tablets have been developed for antianginal drugs like nitroglycerine, etc., where sublingual and/or buccal absorption can provide faster onset of action in acute attacks and improve bioavailability. Buccal tablets are designed to dissolve on the buccal mucous membrane to improve bioavailability of drugs, which are inconvenient to administer parenterally, like steroids and narcotic analgesics. Absorption through buccal route bypasses the gastrointestinal tract for rapid systemic distribution. Not all FDDFs administered orally can offer buccal absorption and bioavailability/faster onset advantages. Most of the FDDFs have similar absorption, bioavailability, onset and similar pharmacokinetics to conventional solid unit dosage forms. However, a fast disintegration of dosage form, rapid dissolution of the drug in oral cavity, and a small tablet weight can enhance absorption in the oral cavity.
US Food and Drug Administration (FDA), in its guidance document “Size, Shape, and Other Physical Attributes of Generic Tablets and Capsules”, has emphasised on ability of disintegration to influence oesophageal transit time and the performance of the drug product for its intended use, especially in patients suffering from dysphagia [1]. In one estimate, it was reported that over 16 million people in the US are suffering from some sort of swallowing problems (dysphagia). Dysphagia is “subjective awareness of swallowing difficulty during the passage of a bolus from the mouth to the stomach or the perception of obstruction during swallowing” [2]. Depending on the location of this sensation, dysphagia is classified as oropharyngeal or substernal. Dysphagia may arise due to benign or malignant structural lesions, oesophageal motility abnormalities, oropharyngeal dysfunction (including aspiration), neuromuscular disorders, postsurgical changes and gastro-oesophageal reflux disease (GERD). Dysphagia is also a common consequence of many diseases like pneumonia, dehydration, and malnutrition [3]. Neurological disorders (e.g. Parkinson’s disease, brain or spinal cord injury, muscular dystrophy, stroke multiple sclerosis) and gastro-intestinal disorders (GERD, oesophagitis, cancer in oesophagus) are some of the major health problems, which may lead to dysphagia [4]. However, the problem of difficulties in swallowing tablets/capsules is more widespread to 40% of the patient population in US [1]. Paediatric, geriatric and neurologic patients often suffer more from the difficulty of swallowing tablets and capsules [5 - 7]. Tablet swallowing problems have also been observed in adults [3].
In one latest survey, frequent dysphagia was observed in 3% of the US population, uniformly across both gender and all adult ages, and GERD has been indicated as its main underlying cause [8].
FDDFs require less effort to swallow and do not results in increased levels of airway compromise, when swallowing of Orally Disintegrating Tablets (ODTs) is compared to conventional tablets in dysphagic patients [3]. FDDFs are, therefore, considered as an alternate drug delivery option for patients who are either suffering from some sort of dysphagia or patients where compliance is an issue related to size/shape of tablets/capsules or their swallowing ability. FDDFs are comparatively easier dosage form to administer in paediatrics, geriatrics, psychotic, and adult patients who experience dysphagia more often. FDDFs can be administered without water, which makes them more attractive for frequent travellers and situations where access to potable water is an issue. FDDFs improve quality of life in patients by alleviating problems of swallowing, compliance, medication administration without water (nocturea, frequent travellers, nausea) and improving quicker onset of action of medications for immediate action for pain, anxiety, cough-cold, sexual pleasure, anxiety, etc. [9 - 14].
2. PHARMACOPOEIAL AND REGULATORY STATUS
FDDFs were first introduced in late 1990s in the market. In the official pharmacopoeial point of view, these formulations are known as orodispersible tablets in European Pharmacopoeia [15] and Orally Disintegrating Tablets in USP [16] and Japanese Pharmacopoeia (JP 16) [17] uses both of these terms. USP, BP and JP have also included several monographs of ODT tablets (Table 1).
USP 35 NF 30 defines ODTs as “Orally Disintegrating Tablets are intended to disintegrate rapidly within the mouth to provide a fine dispersion before the patient swallow the resulting suspension where the active pharmaceutical ingredient is intended for gastrointestinal delivery and/or absorption. Some of these dosage forms have been formulated to facilitate rapid disintegration and are manufactured by conventional means or by using lyophilisation or molding process” [18].
European Pharmacopoeia 7.4 and British Pharmacopoeia 2010 have defined orodispersible tablets as “uncoated tablets intended to be placed in the mouth where they disperse rapidly before being swallowed” [15, 19]. EP 7.4 and BP 2010 have specified a time limit of 3 minute for disintegration in pharmacopoeial apparatus for orodispersible tablets.
Japanese Pharmacopoeia specifies ODTs as “tablets which are quickly dissolved or disintegrated in the oral cavity. Orally Disintegrating Tablets shows an appropriate disintegration” [17].
US FDA defines ODT as “solid dosage form containing medicinal substances which disintegrates rapidly, usually within a matter of seconds, when placed upon the tongue” [22]. Disintegration time of 30s or less is specified, when disintegration is performed by USP disintegration test method or any other suitable disintegration test. An upper dose limit for ODT is 500 mg is considered appropriate, but a dose greater than 500 mg may be incorporated without affecting the performance, i.e. disintegration time. The idea of 500 mg weight limitation is, therefore, not appreciated by various research groups and pharmaceutical industries. Successful ODTs having more than 500 mg weight and disintegrating time less than a minute have been formulated.
In 2012, films for oral drug delivery became part of the European Pharmacopoeia, edition 7.4 [15]. Films were included in the monograph as 'oromucosal preparations' and described as fast-dissolving 'orodispersible films' or 'mucoadhesive/buccal films', which are intended to be attached to oromucosal sites. Unlike ODTs, pharmacopoeia does not specify any time limit for disintegration/dissolution of FDOFs (Fast Dissolving/Disintegrating Oral Films).
International Conference on Harmonisation (ICH) and drug regulating agencies like European Medicines Agency (EMA), US FDA, Pharmaceuticals and Medical Devices Agency (PMDA), etc. have issued several guidelines on developing age adapted dosage forms with an aim to improve health related quality of life of patients [23 - 27]. FDDFs, like Fast Dissolving/Disintegrating Pellets (FDPs), Orally Dissolving/Disintegrating Mini-Tablets (ODMTs), Fast Dissolving/ Disintegrating Granules (FDGs), provide dosing flexibility for paediatrics and thus their potential as dosage form is rising with the regulatory stringencies and requirements of special dosage forms for special populations. FDPs and ODMTs are currently under development and their entry in pharmacopoeia and market is expected soon.
3. SOME KEY CONCEPTS: RATIONALE, ADVANTAGES AND CHALLENGES
FDTs are also pronounced by various other names, which are presented in Box 1. In this chapter and book, we have uniformly used Fast Disintegrating/Dissolving Tablets (FDTs) for ODTs and for all other similar tablet dosage forms, which disintegrate quickly in oral cavity or in vitro.
Box 1: Various synonyms of FDTs.
Melt in mouth tabletsFast dissolving/disintegrating tabletsRapidly dissolving/disintegrating tabletsRapid melt tabletsFast melt tabletsFast dispersion tabletsMouth dissolving tabletsSaliva soluble tabletsRapid suspension tabletsFDTs have been initially developed as immediate release dosage forms intended for faster and quicker onset and suited best, therefore, to drugs indicated for treatment of acute diseases. Fast acting, compliance critical and paediatric drugs are some good drug candidates for developing FDTs (Box 2). However, FDTs have also been designed and developed for treatment of chronic diseases in patients who are dysphagic. Quick oral disintegration and administration without water have made FDTs popular as an alternative to conventional tablets in patients who are not dysphagic. Advantages of FDTs have significantly impacted the convenience, acceptability and compliance of delivering drugs in special populations. Persons, who often travel, also prefer FDTs over conventional tablets due to difficult access of water, sometimes.
Box 2: Therapeutic categories, which are considered as potential targets for developing FDDFs.
Pain, fever, migraine drugsCardiovascular drugs (angina, stroke, hypertension, etc.)Respiratory drugs (anti-asthmatics, systemic antihistamine, throat, cold and cough problems)Anticancer drugsCentral nervous system drugs (sedatives, antiemetics, antipsychotic drugs, Antimanic drugs, schizophrenia, Parkinson’s disease, Alzheimer’s disease, etc.)Over the counter drugs (multivitamin preparations, antacids, etc.).3.1. Patient Specific Advantages of FDDFs
Easy swallow by patients who have swallowing problems or patients who reject to swallow, e.g. geriatric, paediatric and psychotic patients.Easy swallow in dysphagia due to diseases, e.g. AIDS, parkinsonism, Thyroidectomy , head and neck radiation therapy, neurological disorders, upper gastrointestinal surgery, diseases like injury in food-pipe, persistent nausea, etc.Bed-ridden patients can swallow FDT without water and without the need to rise or sit in the bed for swallowing.Situations when quick access of water is inconvenient, e.g. frequent travellers and busy persons.No water is required for dosing and hence beneficial for patients with renal failure, patients on anti-diuretic treatment and in places where access to water is a problem.Patient compliance due to convenience to carry and administration.Easy and discrete handling.Convenience and accurate dosage, when compared with liquids.Rapid pregastric absorption of drug from, mouth, pharynx and oesophagus. Hence, faster onset of action beneficial in stroke, migraine and pain therapy, and improved bioavailability for buccally absorbed drugs and drugs prone to first pass metabolism.Rapid drug therapy intervention.3.2. Disadvantages/Challenges to FDDFs
Undesirable taste of drug and excipients (bitter, sour, metallic and chalkiness).Friability problems due to Compression-less method of manufacturing or use of low to very low compression forces.Drugs sensitive to humidity and temperature.Need for special packaging and embossing of identification marks.Requirements of special equipments for production and packaging (freeze drying, cotton candy spinning apparatus, 3-D printing, etc.).High cost involved in production and packaging.Drug dose and limitation on the final size of the tablet.4. THE DEVELOPMENT PATH
For the first time, FDDFs were developed and studied in 1970’s by Wyeth Laboratories in the United Kingdom [28]. Patents covering these novel dosage forms were issued to Wyeth around the world [29, 30]. Later this technology was registered and trademarked by the name of Zydis®. Zydis® technology utilise a patented freeze drying process for removing water from an aqueous solution or suspension of active ingredient(s) and excipients kept in blister packs. The cost of making these novel dosage units were significantly higher and thus Wyeth associated with R. P. Scherer (now Catalent), from 1981 onwards, for sharing the costs of development and to bring specific expertise in developing these novel dosage forms. In that joint venture, Wyeth concentrated on the formulation technology and R.P. Scherer on the development of an efficient and economical freeze drying process. Wyeth marketed FDDF sunder ExpidetTM trademark in some of the European countries such as Switzerland, Belgium and Germany [28]. A lorazepam fast dissolving formulation (Tavor ExpidetTM) was launched in 1992. ExpidetTM was a trademark of American Home Products Corp. At that time, in 1990’s, there was only one manufacturing plant at Scherer’s Swindon site. Now, Catalent has four different facilities located at Somerset (New Jersey, US), Swindon (UK), Kakegawa (Japan) and Schorndorf (Germany) for the development and production of Zydis® FDDFs [31].
First generation FDTs were manufactured by freeze drying technologies. The dosage form was formulated with a water soluble carrier material and a unit dose of drug was dissolved in an aqueous solution. The composition was frozen and water was sublimed by freeze drying process to yield FDDFs described as Zydis® FDDFs. Simultaneously or later other companies like Farmalyoc (Lyoc®), Janssen Pharmaceutica (QuickSolv®), and Elan’s (currently Perrigo) (NanoCrystal® Nanomelt™) developed their own freeze drying technologies for manufacturing FDTs. All these freeze drying technologies for manufacturing FDTs are discussed in Chapter 2.
First generation FDTs, prepared by freeze drying technologies, have disadvantages of a low hardness, high friability, costly manufacturing process and special packaging leading to crumble and not so robust tablets. These disadvantages were tried to overcome by developing FDTs by modifying conventional tablet compaction methods to increase disintegration/dissolution time of tablets. Advent of faster and high functionality disintegrants had made this task easy. Tablets get enough hardness when compressed by conventional wet/dry granulation or direction compression, while faster disintegration/dissolution was achieved by adding high amounts of superdisintegrants in the formulation. Direct compression, granulation methods, compaction and subsequent treatments, and effervescent tableting methods evolved for preparing FDTs are described in Chapter 3. New compaction based technologies emerged to produce stronger FDTs. Ziplets®, Flashtab®, Easy Tec®, Advatab®, Frosta®, RACTAB® and other proprietary technologies have also been explored in Chapter 3.
Through three decades, FDT technologies have advanced significantly with their rapid market growth across various countries and numerous therapeutic segments. New and novel methodologies like moulding, extrusion, floss, three dimensional printing have emerged in manufacturing FDTs. These novel methodologies and trademark technologies like EMP® tablet, FlashDose® and others are presented in Chapter 4.
Technologies for manufacturing FDTs are extensively patented across the globe. Patents provide exclusive benefits to recover industry costs on developing a technology. Inventions in the field of FDDFs have led to several patents. Technologies based on the patents have been either registered or trademarked for their commercial exploitation. Chapter 5 explores various inventions related to manufacturing, packaging and other aspects of FDTs through published patents and patent applications.
Formulating an FDT is a difficult challenge due to the expectation of striking a balance between hardness and quicker disintegration/dissolution. Excipients play important roles in striking a balance between mechanical strength and disintegration//dissolution time of tablets. Chapter 6 deals with various excipients used in designing and developing FDTs. Superdisintegrants, diluents and taste masking excipients have been described with their dedicated roles, key properties and their importance in formulation development of FDTs.
Chapter 7 is a comprehensive coverage on various taste masking approaches used in formulating pleasantly flavoured and palatable FDDFs. Taste masking is essential required in FDDFs due to their quick disintegration/dissolution in oral cavity leading to fast access of bitter drug to taste buds. Various proprietary and technological advancements in controlling bitterness and improving taste in FDDF formulations are explained with the help of published research reports and patents.
Evaluation and quality control of novel FDTs require new set of equipments and methodologies for estimation of attributes like disintegration, dissolution, mechanical strength, etc. Various in house disintegration test apparatuses have been reported in literature for estimating quick disintegration/dissolution/water sorption. Some of these disintegration test equipments are available commercially. Special methodologies have been used for estimating drug release from such dosage forms. These evaluation methodologies have been refined and some of these have been accepted by pharmacopoeia/industry/drug regulatory agencies. Chapter 8 provides a comprehensive review on latest quality control tests, quality control equipments and evaluation parameters of FDTs. Disintegration equipments and methodologies for measuring disintegration time are emphasised with due diligence to their development.
Clinical tests on FDDFs have established several pharmacokinetic and compliance/preference benefits of FDDFs over other conventional dosage forms. Chapter 9 is authors’ effort to describe clinical advantages through reported clinical studies on FDDFs.
FDOF or oral drug strip, when placed on the tongue, disintegrates/dissolves within seconds resulting in release of drug, which is swallowed with the saliva. FDOF utilises hydrophilic polymers, which dissolve/disintegrate in oral cavity and thus enable to deliver drug by dissolution followed by quick absorption to the systemic circulation. Absorption of the drug occurs via mouth, buccally or sublingually and/or via small intestine. FDOFs are also considered as advanced alternative to conventional tablets, capsules and liquid dosage forms. Some of these FDOFs are also regarded as good alternatives to FDTs/ODTs. The most popular and straightforward approach to manufacture oral films is the solvent casting method. Other alternative methods include wet and melt extrusion, and drug printing methodologies like flexography and ink-jet printing. Due to small dose incorporation, challenges of bitter taste and other complexities associated with FDOFs, not many products have reached in the market. Chapter 10 describes various formulation factors, manufacturing technologies and evaluation of FDOFs.
FDCs, ODMTs, FDPs and sustained/controlled release FDTs are some latest entry to the family of FDDFs. Chapter 11 gives a latest view on these new FDDF entrants. Perforation and vacuum drying are used to prepare fast disintegrating capsules (FDCs) from conventional hard capsules [32]. Low bloom strength gelatin and various other additives have been used to develop Fastcaps (hard capsules) characterised with rapid disintegration in saliva and adequate mechanical strength [33]. Fast disintegrating capsules are able to overcome disadvantages of other FDDFs especially low pay-load, unsatisfactory taste masking, and time consuming and expensive manufacturing process. Mini-tablet and the FDDF technologies have been combined to develop novel ODMTs with multifunctional excipients. ODMTs, of diameter 3 mm or less, provides easy measuring abilities coupled with rapid disintegration of tablets in small amount of saliva, making them most appropriate dosage form for not only children but also for infants and toddlers [34]. Pectinic acid and MCC Sanaq burst have been used in preparing FDPs by extrusion/spheronisation [35, 36]. These pellets can offer advantages of faster disintegration/dissolution as with other FDDFs and may provide easy measuring abilities in case of paediatric dosing. For reducing dosing frequencies, controlling/sustaining drug release, novel FDDFs utilises FDDF technologies coupled with various other controlled/sustained drug release technologies like ion-exchange resins [37], coating [38], microparticulate beads [39, 40], etc. Chapter 11 also discusses such research reports where technologies have been used in combination to achieve the objectives of modified/controlled release via FDDFs.
5. FDDF MARKET
FDDFs offer various commercial advantages (Box 3) for boosting significant profits to both brand and generic pharmaceutical companies. FDDF products are regarded as novel drug delivery systems by drug regulatory agencies and this viewpoint makes them eligible for patent protection and market exclusivity. The brand value of an established drug increases with patent life extension and market exclusivities by protecting the drug product from generic substitution, which in turn increases revenues. Availability of more oral drug products, based on a single drug, widens the preference/acceptance among special patient populations leading to increase in market demands. FDDFs are considered ideal for drugs that are off patent. Generic manufactures can introduce drug products based on FDDFs for an off patent drug and broaden the range of drug products.
Box 3: Commercial advantages of FDDFs.
New dosage form according to drug regulatory agenciesPatent line extensionExclusivity of productLife cycle extensionProduct differentiationProtect product from generic substitutionFDDF technologies provide simple and safe option to deliver a drug orally, when compared to other delivery technologies based on other routes of drug administration. ODTs, FDOFs and other FDDFs provide the advantage of formulating drugs as either generic versions or bioequivalent extensions of approved drug products offering minimum clinical hurdles in getting regulatory approval.
Zydis® ODT formulation of loratadine (Claritin® Reditabs®) was the first FDDF drug product approved by US FDA in December 1996 [41]. Zydis® ODT formulation of clonazepam (Klonopin®) and a Zydis® ODT formulation of rizatriptan (Maxalt®) entered in market in December 1997 and June 1998, respectively. Lyophilised FDTs were the first FDTs, which were marketed and achieved high success in sales, expanding market size and increasing number of worldwide product launches [42]. Market growth and successful entry of Lyophilised FDTs were possible due to their versatile applications like buccal absorption, stable formulation environment and bioequivalence.
Revenue of above $2 billion was generated by ODT products sales, which was a hike of 20% over revenues of 2003 [43]. ODT market, in regions of US, EU, and Japan, grew more than $8.4 billion in 2011 with an increase of 24 percent from the past two years [44]. Generic competition and approvals in FDT segment were main driving forces to increase the number of FDT products in the market. However, generic competition has eroded the US and EU ODT market faster than the Japan ODT market where minimum impact is observed. FDT market is expected to reach $12 billion globally by 2018 with the popularity and growth of FDTs in various developing countries [44].
In 2004, as an estimate about 92% of the ODT world market share was distributed among three different therapeutic segments, viz. central nervous system, gastrointestinal, and oncology [45]. It has led to conclude that most successful ODTs belong to therapeutic segments like nausea, pain, migraine, insomnia, GERD, Parkinson’s disease and other CNS disorders.
Two commercially successful FDDF products are GlaxoSmithKline’s Zofran® ODT (ondansetron) and Lilly’s Zyprexa® Zydis® (olanzapine) [45]. Zofran® ODT (ondansetron) is used for treatment of nausea and emesis induced by chemotherapy, surgery and radiation. After its approval in Jan 1999 by US FDA, Zofran® ODT reached a worldwide sales of more than $300 million in 2004, which represented about 20% of total Zofran sales with an average annual growth rate of approximately 50% [45]. Motivated by such high growth eight different generic ODT versions for ondansetron appeared in June 2007 to February 2011 [46]. Zyprexa® Zydis® (olanzapine) ODT, for treating schizophrenia and bipolar disorder and approved in April 2000 by US FDA, achieved a worldwide sale greater than $400 million at the end of 2004 [45]. This growth in US market had led to entry of olanzapine ODT by 9 different pharmaceutical companies in Oct 2011 to May 2014 [46]. However, Zyprexa® Zydis® formulation still enjoys marketing exclusivity till 26 July 2016 [46].
FDOF market started with products in mouthwash, OTC and nutraceutical segments. Later the focus of the market was shifted to prescription FDOF. FDOF were first introduced as strips in early 2000 and the first product was Listerine pocket strips, in the mouthwash range [47]. As a pharmaceutical product in OTC section, Zentrip® was launched in US by Sato Pharmaceuticals in August 2009 for prevention of motion sickness. This was followed by approval of Novarits’ Nexcede® (12.5 mg ketoprofen) by the US FDA in November 2009. In July 2010, US FDA approved Zuplenz® (Ondansetron HCl, 4 mg, 8 mg), which was first prescription oral film product. Suboxone® thin film (buprenorphine and naloxone), FDOF product of Reckitt Benckiser’s, was successful commercially with sales of $513 million in 2011 [44]. FDOF products for treatment of CNS disorders, allergies and diabetes are continuously expanding. FDOF market is expected to reach $1 billion in 2015 [44].
Currently, 10 FDOF products are available in the market and 29 FDOF products are in the development pipeline out of which 6 are expected to be launched in 2015/2016 [48]. These FDOF drug products provide rapid onset of action when administered by oromucosal, buccal or sublingual route. PharmFilm® (MonoSol Rx) and RapidFilm® (Applied Pharma Research/teas Labtec) technologies dominate the FDOF market with their use in about 30% of the products. A total of 10 different FDOF technologies have entered in the market. FFT Medical, Cynapsus Therapeutics, IntelGenx are some new entrants in developing FDOF products. Some successful marketed FDOF products are Suboxone®, Breakyl®, Onsolis® and Zuplenz®.
Many FDDF drug products have entered in the market after proving their patient preference/compliance and/or clinical/pharmacokinetic benefits in clinical studies. Market success of these novel FDDF drug products has led to the development and commercial entry of numerous FDDF products. Exhaustive and comprehensive lists of approved and marketed FDDF drug products can be found in Chapter 12.
CONCLUSIONS
Development of FDDFs offers considerable commercial advantages, like patent line extension, product exclusivity, life cycle extension and product differentiation, protect the drug product from generic substitution and market competition. Pharmacopoeial and regulatory acceptance of FDDFs have significantly attracted both big and small scale pharmaceutical manufacturers and specialty drug delivery companies to come up with more and more FDDF products. Market outlook for FDDFs is also potential and promising to both brand pharmaceutical companies and generic pharmaceutical manufacturers. Patient acceptance by all age groups for FDDFs has increased their market potential and outreach. Novel FDDFs, like ODMTs, sustained/controlled release FDTs, FDPs, FDCs, are in development pipeline, which may soon be commercialised.
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1. INTRODUCTION
Freeze drying is widely used in fabricating amorphous, porous and compact structures that dissolve rapidly. Active ingredient can be entrapped in this water soluble compact structure to prepare a unit dosage form, which can dissolve/disintegrate quickly, either in vitro when placed in water or in vivo when placed in the oral cavity. The freeze dried matrix of such tablets comprises a water soluble mixture of saccharides and polymers, the proportions of which are optimised to rapid dispersion characteristics and sufficient mechanical strength
to withstand handling and transportation stresses. The tablet formulations essentially contain excipients like suspending agents or emulsifiers, viscosity modifiers, wetting agents, preservatives, antioxidants, colours, taste masking agents and flavours, which can either enhance the processing capabilities or improve the quality of the resulting tablets.
2. FREEZE DRYING
Freeze drying or lyophilisation may be defined as the process of removing water from solutions/suspensions/emulsions by sublimation under the influence of high vacuum at temperatures below freezing point of water. The resulting final product is dry and extremely porous. Lyophilisation, as a drying process, was developed in 1940s and till then it has advanced as an important manufacturing step in improving stability of pharmaceutical and biological products [1]. The process is helpful in inhibiting chemical, microbiological and physical degradation pathways that has been otherwise evidenced with the presence of water or residual moisture. Drying at a low temperature has made lyophilisation a safe and extensively applied process for thermolabile actives, pharmaceutical ingredients and biological drugs. Since its inception, lyophilisation has been widely applied in formulating long term stable vaccines, preservation of nucleic acid based pharmaceuticals, preserving red blood cells, and development of micro and nanoparticulate delivery of small molecules, proteins and peptides [2
