Literature DB >> 31157089

Diazepam filled hard capsules intended for detoxification of patients addicted to benzodiazepines and Z-drugs.

Aleš Franc1, Kateřina Kubová1, Jan Elbl1, Jan Muselík1, David Vetchý1, Jan Šaloun2, Radka Opatřilová3.   

Abstract

OBJECTIVES: The abuse of benzodiazepines and Z-drugs reduces the quality of life of millions of addicted people worldwide. They cannot be discontinued abruptly due to harmful withdrawal symptoms. Detoxification is usually based on replacement of short/middle acting benzodiazepines or Z-drugs by diazepam and tapering the dose over time. In order to enhance patient adherence to an individual withdrawal plan, suitable diazepam dosage forms have to be available. Hard capsules containing an exact and uniform dose could be used for the relief of symptoms caused by altering the plasma level and overcoming psychogenic stress from the dose reduction.
METHODS: This work demonstrates that capsules with a content of diazepam ranging from 2.125mg to 0.492 mg (dose decreasing always by 15%) cannot be easily prepared by standard mortar technology in a pharmacy. To meet mass and content uniformity European Pharmacopoeia criteria, capsules were prepared by improved technology based on the preparation of binary blends of calcium phosphate anhydrous and diazepam in descending concentrations in a high-speed mixer (time 30 s) and densification of about 10% during filling of the capsules.
RESULTS: All batches (n=20) prepared by improved technology met the requirement for content uniformity compared with only nine batches prepared by standard mortar blender technology. Based on the process capability index, none of the samples prepared by standard technology fitted pharmacopeia limits at the statistically acceptable level. On the other hand, all batches prepared by improved technology exhibited acceptable process capability index.
CONCLUSIONS: We have shown that at least 99.73% of batches prepared by our improved technology would meet the pharmacopoeia limits for content uniformity and are suitable for treatment of this type of addiction.

Entities:  

Keywords:  Benzodiazepines; Capsules; Content Uniformity; Detoxification; Dose Tapering; Weight Uniformity; Withdrawal

Year:  2017        PMID: 31157089      PMCID: PMC6362874          DOI: 10.1136/ejhpharm-2016-001163

Source DB:  PubMed          Journal:  Eur J Hosp Pharm        ISSN: 2047-9956


  15 in total

1.  The diagnosis and management of benzodiazepine dependence.

Authors:  Heather Ashton
Journal:  Curr Opin Psychiatry       Date:  2005-05       Impact factor: 4.741

2.  Sleep disorders in psychiatric practice.

Authors:  Waldemar Szelenberger; Constantin Soldatos
Journal:  World Psychiatry       Date:  2005-10       Impact factor: 49.548

3.  Benzodiazepine substitution for dependent patients—going with the flow.

Authors:  Peter Tyrer
Journal:  Addiction       Date:  2010-11       Impact factor: 6.526

Review 4.  Oral drug delivery in personalized medicine: unmet needs and novel approaches.

Authors:  Klaus Wening; Jörg Breitkreutz
Journal:  Int J Pharm       Date:  2010-11-09       Impact factor: 5.875

5.  Limitations of compounding diazepam suspensions from tablets.

Authors:  D W Newton; S G Schulman; C H Becker
Journal:  Am J Hosp Pharm       Date:  1976-05

6.  The APA Task Force report on benzodiazepine dependence, toxicity, and abuse.

Authors:  C Salzman
Journal:  Am J Psychiatry       Date:  1991-02       Impact factor: 18.112

Review 7.  Potential role of cortical 5-HT(2A) receptors in the anxiolytic action of cyamemazine in benzodiazepine withdrawal.

Authors:  Amine Benyamina; Mickaël Naassila; Michel Bourin
Journal:  Psychiatry Res       Date:  2012-03-14       Impact factor: 3.222

8.  Effect of drug proportion and mixing time on the content uniformity of a low dose drug in a high shear mixer.

Authors:  W Kornchankul; E Hamed; N H Parikh; A Sakr
Journal:  Pharmazie       Date:  2002-01       Impact factor: 1.267

Review 9.  Benzodiazepine dependence: management of discontinuation.

Authors:  K Rickels; W G Case; E Schweizer; F Garcia-Espana; R Fridman
Journal:  Psychopharmacol Bull       Date:  1990

10.  Chronic benzodiazepine dependence. A comparative study of abrupt withdrawal under propranolol cover versus gradual withdrawal.

Authors:  T Cantopher; S Olivieri; N Cleave; J G Edwards
Journal:  Br J Psychiatry       Date:  1990-03       Impact factor: 9.319

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