Fixed-Dose Combinations for HIV/AIDS, Tuberculosis, and Malaria - Report of a Meeting Held 16-18 December 2003 Geneva
(2003; 199 pages) Ver el documento en el formato PDF
Índice de contenido
Abrir esta carpeta y ver su contenidoSummary: Observations and some ways forward
Abrir esta carpeta y ver su contenidoWelcome
Abrir esta carpeta y ver su contenidoFixed-dose combinations for tuberculosis: lessons learned from a clinical, formulation and regulatory perspective
Abrir esta carpeta y ver su contenidoProduct costs of fixed-dose combination tablets in comparison with separate dispensing and or co-blistering of antituberculosis drugs
Abrir esta carpeta y ver su contenidoFixed-dose combinations: artemisinin-based combination therapies for malaria treatment
Abrir esta carpeta y ver su contenidoDeveloping combinations of drugs for malaria examination of critical issues and lessons learnt
Abrir esta carpeta y ver su contenidoSafety and long-term effectiveness of generic fixed-dose formulations of nevirapine-based HAART amongst antiretroviral-naïve HIV-infected patients in India
Abrir esta carpeta y ver su contenidoEffect of introduction of fixed-dose combinations on the drug supply chain: experiences from the field
Abrir esta carpeta y ver su contenidoEffect of fixed-dose combination (FDC) medications on adherence and treatment outcomes
Abrir esta carpeta y ver su contenidoEffect of fixed-dose combination (FDC) drugs on development of clinical antimicrobial resistance: a review paper
Abrir esta carpeta y ver su contenidoFixed-dose combination (FDC) drugs availability and use as a global public health necessity: intellectual property and other legal issues
Cerrar esta carpetaPharmaceutical development and quality assurance of FDCs
Ver el documentoAbstract
Ver el documentoIntroduction
Ver el documentoPreformulation studies
Ver el documentoSome examples of the relevance of the properties of the API to product formulation!
Ver el documentoGood Manufacturing Practice (GMP)
Ver el documentoIssues that may arise in the formulation of FDCs that do not arise for single entity products include:
Ver el documentoChanges to registered products (variations)
Ver el documentoQuality control of FDCs
Ver el documentoRecommendations
Ver el documentoReferences
Ver el documentoAnnotated agenda
Ver el documentoList of participants
 

Some examples of the relevance of the properties of the API to product formulation!

Solubility

- If water solubility is low, then the formulator will also examine:

- The effect of solubilising agents on solubility. Selection of the optimum dissolution enhancer for a formulation can improve dissolution rate

- The properties of solid dispersions of the drug. For example Abbott Labs have published information on the properties of ritonavir in solid dispersions28.


Formulation as soft gelatin capsules containing a fatty matrix is an alternative for low dose actives.


pka

pKa indicates how solubility will change with pH.

Polymorphic form

If polymorphs of the active exist, it is important to ensure that batches of the API are always of the optimum polymorphic form. See below for more information and a relevant example.

Bulk density

 

Hygroscopicity

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Flow properties

} These properties are important in designing

Wettability/contact angles

} a reliable manufacturing method

Compressibility

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Ability to maintain a static charge

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Taste/palatability Caution - toxicity!

 

Stability

- The effect on the API of heat, light, moisture, oxidative conditions, and altered pH
- Compatibility of the API with potential excipients


Polymorphic form

Polymorphism is the ability of a substance to exist as more than one type of crystal, each crystal having a different internal arrangement of molecules. The different types of crystal can have different physicochemical properties such as melting point and, significantly for pharmaceuticals, the rate at which the substance dissolves in a solvent. Because biological environments are aqueous in nature, polymorphism is generally most relevant for drugs that have low water solubility and for which bioavailability may dissolution-limited.

During chemical synthesis, the conditions of final purification (usually recrystallisation or slurrying) largely dictate the final polymorphic form. The nature of the solvent and the rate and temperature of crystallisation are particularly important. Once the most suitable polymorph has been identified, purification conditions can be adjusted so as to produce it more reliably.

Some polymorphs are physically unstable and can metamorphose into another polymorph, thus providing a mechanism by which the dissolution rate of a finished product can change over time.

It is important to know the polymorphic forms in which a substance can exist, the stability of each, and how they can be distinguished during quality control, in order to ensure that the API (the raw material form of the drug) is always presented for use in manufacture in the most suitable polymorphic form.

In 1998, soft gelatin capsules containing ritonavir were found to have a poor dissolution rate and different to earlier batches 29. Ritonavir has low water solubility and manufacture of capsules involves initial dissolution in ethanol followed by mixing with other excipients. Investigation showed that a hitherto unknown polymorph of even lower solubility than the only one previously known had formed in some batches of the capsule. Insidiously, once detected, polymorph #2 spread to batches of the oral solution, which could no longer be stored in a refrigerator without crystallising. The product was consequently reformulated.

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Última actualización: le 3 mayo 2013