Pharmaceutical counselling about different types of tablet-splitting methods based on the results of weighing tests and mechanical development of splitting devices

Somogyi, Orsolya; Meskó, Attiláné; Csorba, L.; Szabó, Péter; Zelkó, Romána

doi:10.1016/j.ejps.2017.05.071

Cited by 15 publications

(13 citation statements)

References 16 publications

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“…Such procedure can result in the administration of inaccurate dosing, as well as losing specific benefits of certain dosage forms (e.g., slow release tablets) [57]. To minimize these errors, the design of a proper device on the basis of the shape and size of medicinal products is essential to help caregivers in dosing the medicinal products to assure the reproducibility of dose assumed [58]. Another possible strategy to overcome the unavailability of industrial medicinal product or strength for the paediatric population is the compounding of patient-specific extemporaneous preparation in a pharmacy setting [59].…”

Section: Paediatric Populationmentioning

confidence: 99%

Patient Centric Pharmaceutical Drug Product Design—The Impact on Medication Adherence

et al. 2020

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Medication adherence is a growing concern for public health and poor adherence to therapy has been associated with poor health outcomes and higher costs for patients. Interventions for improving adherence need to consider the characteristics of the individual therapeutic regimens according to the needs of the patients. In particular, geriatric and paediatric populations as well as dermatological patients have special needs/preferences that should be considered when designing drug products. Patient Centric Drug Product Pharmaceutical Design (PCDPD) offers the opportunity to meet the needs and preferences of patients. Packaging, orodispersible formulations, fixed dose combinations products, multiparticulate formulations, topical formulations and 3D printing are of particular relevance in a PCDPD process. These will be addressed in this review as well as their impact on medication adherence.

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Section: Paediatric Populationmentioning

confidence: 99%

Patient Centric Pharmaceutical Drug Product Design—The Impact on Medication Adherence

et al. 2020

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“…[ 14 , 16 – 20 ] Not surprisingly, the accuracy of tablet subdivision is influenced by the size, shape, and hardness of the tablet and by the subdivision method. [ 18 – 20 ] Small and unusually shaped tablets have the greatest deviations in weight and harder tablets are likely to be crushed or fragmented, which might lead to drug loss. Additionally, dividing tablets into quarters results in a greater range of weight differences than dividing tablets into fewer pieces.…”

Section: Introductionmentioning

confidence: 99%

Recent trends in tablet subdivision and factors affecting subdivision in South Korea

Son

2020

Medicine

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Tablet subdivision by physicians or patients frequently occurs in various clinical settings for multiple reasons, including dose adjustment, alleviation of swallowing difficulties, or cost savings. However, not all tablets are suitable for subdivision, and it might cause side effects. It is informative to know which medicines are regularly subdivided, which healthcare institutions prescribe subdivided medicines, and to whom the medicines are prescribed from the perspectives of quality of care and patient safety. In this study, we aimed to examine recent trends in tablet subdivision and to address factors associated with subdivision of tablets both at the patient and healthcare institution levels. The yearly claims data in 2016 retrieved from the National Patients Sample provided by the Health Insurance Review and Assessment (HIRA-NPS). This study used descriptive statistics to examine characteristics of medicines that were frequently prescribed in subdivided forms, and retrieved information regarding the medicines to assess the appropriateness for tablet splitting. Then, we selected five medicines, and performed a multivariate logistic regression analysis to estimate the effect of the variables of interest on tablet subdivision. We presented the top 25 medicines prescribed in subdivided forms in 2016, and confirmed these medicines could be relevantly halved according to their Summary of Product Characteristics. Of the 25 medicines, 14 (56%), 5 (20%), and 3 (12%) medicines belonged to the respiratory system (R), nervous system (N), and systemic hormonal preparations (H), according to the first category of Anatomical Therapeutic Chemical (ATC) classification system, respectively. Being female at the patient level and tertiary healthcare institutions and private owned institutions at the institution level were positively associated with subdivision of medicines. Subdivision of tablets frequently occurred for vulnerable populations with various reasons. Female and geriatric patients are prescribed split medicines for clinical reasons, while low-income patients are prescribed nonsplit medicines for cost savings. It would be better if medicines were not so small, and if they had dividing lines on their surfaces to enable successful splitting of the tablet and to protect the health of vulnerable patients. Furthermore, avoid splitting those pharmacotherapies with a narrow therapeutic range, and provide a pharmacist assistance and a splitting device for unavoidable splitting.

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“…When the required dose is not available, the most common solution, which implies to split a solid dosage form, often occurs in dose inaccurancy (Casiraghi et al, 2014;Somogyi et al, 2017). The possible alternative is to compound a personalized drug product, e.g.…”

Section: Introductionmentioning

confidence: 99%

Personalized orodispersible films by hot melt ram extrusion 3D printing

Musazzi

Selmin

Ortenzi

et al. 2018

International Journal of Pharmaceutics

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This work demonstrates the feasibility of the extemporaneous preparation of maltodextrins orodispersible films (ODF) by hot-melt ram-extrusion 3D printing. This method consists of three simple technological operations which can be also implemented in a pharmacy setting. First, maltodextrins, drug, and other excipients are mixed in a mortar and wetted with the plasticizer (i.e. glycerine). Then, the mixture is fed in the chamber of the ram-extruder and heated. ODF are individually printed on the packaging material foil and sealed without further manipulations. The critical formulation attributes and process variables were investigated to define the processability space. In particular, the optimal conditions to print a mixture of maltodextrins/glycerine in a 80/20 w/w ratio resulted: heating temperature: 85 °C; needle gauge: 18 G; needle-packaging material foil distance: 0.6 mm; maximum print rate: 50 mm/s; filling angle: 120°. The maximum drug loading was about 40%, when paracetamol was used as model drug. The compounded ODF complied with USP and Ph. Eur. specifications for disintegration time (<1 min). The dissolution pattern of paracetamol overlapped with that obtained from ODF with a similar composition prepared by the consolidated solvent casting technique, demonstrating the suitability of the proposed technology.

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Pharmaceutical counselling about different types of tablet-splitting methods based on the results of weighing tests and mechanical development of splitting devices

Cited by 15 publications

References 16 publications

Patient Centric Pharmaceutical Drug Product Design—The Impact on Medication Adherence

Patient Centric Pharmaceutical Drug Product Design—The Impact on Medication Adherence

Recent trends in tablet subdivision and factors affecting subdivision in South Korea

Personalized orodispersible films by hot melt ram extrusion 3D printing

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