The
opioids buprenorphine hydrochloride (BUP) and naltrexone hydrochloride
(NTX) show promise as a combination treatment for addiction, but no
means of delivering the two compounds in one medicine currently exist.
In this paper, we report sufficient input rates of both these drugs
from one iontophoretic transdermal drug delivery system. Experiments
were performed using dermatomed pig skin mounted in glass side-bi-side
cells. BUP and NTX were iontophoretically delivered together from
the anode using direct constant current from Ag/AgCl electrodes. The
transdermal drug fluxes and the masses of drugs in both the stratum
corneum and the underlying epidermis/dermis were measured. The apparent
electroosmotic flow was quantified using a neutral marker (acetaminophen).
The effects of donor composition (drug concentration/molar fraction
and pH), current density and profile, and the choice of receptor solution
were assessed. Iontophoresis dramatically increased the flux of both
drugs compared to passive control values. Target fluxes (calculated
from literature clearance values and required therapeutic plasma concentrations)
were greatly exceeded for NTX and were met for BUP. The latter accumulated
in the skin and suppressed electroosmotic flow, inhibiting both its
own flux and that of NTX. NTX, in turn, negatively influenced the
flux of BUP via co-ion competition. Lowering current density by increasing
the delivery area resulted in increased electroosmotic flow but did
not significantly affect current-normalized drug fluxes. Delivering
the drugs from both electrodes and reversing the polarity for every
2 h did not increase the flux of either compound. In summary, during
iontophoresis, BUP and NTX inhibited each other’s flux by two
distinct mechanisms. While the more complex behavior of BUP complicates
the optimization of this drug combination, iontophoresis nevertheless
appears to be a feasible approach for the controlled codelivery of
NTX and BUP through the skin.