Domagoj Segregur1, Talia Flanagan2, James Mann3, Andrea Moir3, Eva M Karlsson4, Matthias Hoch5, David Carlile5, Sakina Sayah-Jeanne6, Jennifer Dressman7. 1. Institute of Pharmaceutical Technology, J. W. Goethe University, 9 Max von Laue Street, 60438 Frankfurt, Germany. 2. Pharmaceutical Technology and Development, AstraZeneca UK Limited, Charter Way, Macclesfield, UK; Now employed at Product Development, UCB Pharma SA, Braine-l'Alleud, Belgium. 3. Pharmaceutical Technology and Development, AstraZeneca UK Limited, Charter Way, Macclesfield, UK. 4. Pharmaceutical Technology and Development, AstraZeneca SE, Pepparedsleden 1, 15185 Gothenburg, Sweden. 5. Quantitative Clinical Pharmacology, AstraZeneca UK Limited, 1 Francis Crick Avenue, Cambridge, UK. 6. Da Volterra, 172 Rue de Charonne, 75011 Paris, France. 7. Institute of Pharmaceutical Technology, J. W. Goethe University, 9 Max von Laue Street, 60438 Frankfurt, Germany. Electronic address: Dressman@em.uni-frankfurt.de.
Abstract
BACKGROUND: Of the various drug therapies that influence gastrointestinal (GI) physiology, one of the most important are the acid-reducing agents (ARAs). Because changes in GI physiology often influence the pharmacokinetics of drugs given orally, there is a need to identify in vitro methods with which such effects can be elucidated. OBJECTIVE: Literature concerning the effects of ARAs (antacids, H2-receptor antagonists, and proton pump inhibitors [PPIs]) on GI physiology are reviewed with the aim of identifying conditions under which drugs are released after oral administration in the fasted state. In vitro dissolution tests to mimic the effects in the stomach were designed for H2-receptor antagonists and PPIs. CONCLUSIONS: The impact of ARAs on GI physiology depends on the type, duration, and amount of ARA administered as well as the location in the GI tract, with greatest impact on gastric physiology. While ARAs have a high impact on the gastric fluid pH and composition, changes in volume, viscosity, surface tension, and gastric emptying appear to be less profound. The proposed dissolution tests enable a ready comparison between dosage form performance in healthy adults and those receiving PPIs or H2-receptor antagonists.
BACKGROUND: Of the various drug therapies that influence gastrointestinal (GI) physiology, one of the most important are the acid-reducing agents (ARAs). Because changes in GI physiology often influence the pharmacokinetics of drugs given orally, there is a need to identify in vitro methods with which such effects can be elucidated. OBJECTIVE: Literature concerning the effects of ARAs (antacids, H2-receptor antagonists, and proton pump inhibitors [PPIs]) on GI physiology are reviewed with the aim of identifying conditions under which drugs are released after oral administration in the fasted state. In vitro dissolution tests to mimic the effects in the stomach were designed for H2-receptor antagonists and PPIs. CONCLUSIONS: The impact of ARAs on GI physiology depends on the type, duration, and amount of ARA administered as well as the location in the GI tract, with greatest impact on gastric physiology. While ARAs have a high impact on the gastric fluid pH and composition, changes in volume, viscosity, surface tension, and gastric emptying appear to be less profound. The proposed dissolution tests enable a ready comparison between dosage form performance in healthy adults and those receiving PPIs or H2-receptor antagonists.
Authors: Mark McAllister; Talia Flanagan; Susan Cole; Andreas Abend; Evangelos Kotzagiorgis; Jobst Limberg; Heather Mead; Victor Mangas-Sanjuan; Paul A Dickinson; Andrea Moir; Xavier Pepin; Diansong Zhou; Christophe Tistaert; Aristides Dokoumetzidis; Om Anand; Maxime Le Merdy; David B Turner; Brendan T Griffin; Adam Darwich; Jennifer Dressman; Claire Mackie Journal: Pharmaceutics Date: 2022-05-07 Impact factor: 6.525