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      Development and evaluation of a composite dosage form containing desmopressin acetate for buccal administration

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          Abstract

          Desmopressin acetate (DDAVP) is an oligopeptide indicated for the treatment of primary nocturnal enuresis, for example. The poor oral bioavailability of DDAVP accelerated a shift to alternative routes of administration like nasal and oromucosal, whereby nasal administration results in high fluctuations increasing the risk of undesirable side effects. Aim of the study was to use a new composite dosage form (solid matrix attached to a bilayer mucoadhesive film) to make DDAVP available via oromucosal route, reducing the risk of undesirable side effects through precise dosing. DDAVP was incorporated into a solid matrix in the form of a minitablet, and both direct tableting (AV > 30) and granulation followed by tableting (AV = 17.86) were compared. Minitablets with content uniformity could only be obtained by granulation and loss supplementation (AV = 11.27) with immediate drug release (>80% after 7–8 min) and rapid disintegration (<49 s). Permeation studies were performed with a clinically relevant dose (200 μg) in a time interval of up to one hour, resulting in apparent permeation coefficients of 4.90 × 10 −6 cm/s (minitablet) and 2.04 × 10 −6 cm/s (composite). Comparable fluctuations showed no inferiority of composite and minitablet regarding dosing accuracy. Thus, a step towards controlled and dose-accurate transmucosal delivery of systemically active DDAVP could be achieved.

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          Determination of tablet strength by the diametral-compression test.

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            Advances in oral transmucosal drug delivery.

            The successful delivery of drugs across the oral mucosa represents a continuing challenge, as well as a great opportunity. Oral transmucosal delivery, especially buccal and sublingual delivery, has progressed far beyond the use of traditional dosage forms with novel approaches emerging continuously. This review highlights the physiological challenges as well as the advances and opportunities for buccal/sublingual drug delivery. Particular attention is given to new approaches which can extend dosage form retention time or can be engineered to deliver complex molecules such as proteins and peptides. The review will also discuss the physiology and local environment of the oral cavity in vivo and how this relates to the performance of transmucosal delivery systems. Copyright © 2011 Elsevier B.V. All rights reserved.
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              Desmopressin 30 years in clinical use: a safety review.

              Desmopressin acetate is the synthetic analogue of the antidiuretic hormone arginine vasopressin. It has been employed clinically for >30 years in a range of formulations: intranasal solution (since 1972), injectable solution (since 1981), tablets (since 1987), and most recently, an oral lyophilisate (since 2005). The antidiuretic properties of desmopressin have led to its use in polyuric conditions including primary nocturnal enuresis, nocturia, and diabetes insipidus. While a large body of clinical data is available for desmopressin, and despite its widespread use, comprehensive reviews of the safety of desmopressin are lacking (although some case series have attempted to correlate patient and/or dosing characteristics with the occurrence of adverse reactions). The purpose of this paper is to review the safety of desmopressin, based on analyses of both published data (MedLine) and of adverse reactions reported to Ferring Pharmaceuticals, the major manufacturer of desmopressin. Based on the findings, suggested strategies to reduce the risk of adverse reactions are proposed. Treatment with intranasal and oral formulations of desmopressin is generally well tolerated, and side effects are usually minor. The risk of hyponatraemia, although small, can be reduced by adhering to the indications, dosing recommendations and precautions when prescribing desmopressin.
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                Author and article information

                Contributors
                Journal
                Int J Pharm X
                Int J Pharm X
                International Journal of Pharmaceutics: X
                Elsevier
                2590-1567
                09 June 2021
                December 2021
                09 June 2021
                : 3
                : 100082
                Affiliations
                [a ]Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
                [b ]Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
                Author notes
                [* ]Corresponding author. bjoern.fischer@ 123456hhu.de
                Article
                S2590-1567(21)00011-6 100082
                10.1016/j.ijpx.2021.100082
                8220551
                34195604
                e5f67dc8-d064-45a7-a8e9-003ed41ee6a1
                © 2021 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 20 May 2021
                : 24 May 2021
                Categories
                Article

                desmopressin acetate,buccal delivery,minitablet,mucoadhesive film,paediatrics,permeation,confocal raman microscopy

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