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they’re only fillers, right? Reproduced and distributed by the Medisca group of
companies with the permission of the publisher.
Excipients are not merely inert fillers and, in contrast, AFTER COMPLETING THIS ACTIVITY, THE LEARNER
may affect bioavailability to the extent of causing SHOULD BE ABLE TO:
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Since the API phenytoin (the active) Electrostatic neutralizer Reduce electrical charge; prevents running up metal
is “freely soluble in water”, the lactose
(excipient filler) would serve to increase Adsorbent To reduce or prevent two chemicals from undergoing sorption
the “wetting” of the active, thereby
enhancing the dissolution of the active, Flow agent Reduces powders from sticking to surfaces and/or to itself
which consequently lead to increased
Slow-release agent Retards the bioavailability of active agent
absorption and the systemic toxicity in
patients. This was confirmed when the Chelating agent Binds to and neutralizes trace metals
production of the capsule returned to the
previous formula containing the calcium Antioxidant Prevents oxidation
sulfate instead of lactose, as the patients’
serum levels returned to normal. Tracer Dye Quality assurance measure; visible test
This example demonstrates that
excipients are not merely inert fillers and,
in contrast, may affect bioavailability to the TABLE 2: S
PECIFIC EXCIPIENTS AND THEIR RESPECTIVE FUNCTION IN
extent of causing significant patient harm. POWDER-FILLED CAPSULES
Table 1 identifies types of excipients
and the reasons for their use in capsules. FUNCTION EXCIPIENT
Table 2 lists specific excipients and their
respective function in powder-fill capsules. Adsorbent Bentonite
When selecting only one excipient as
the filler, such as the commonly used Diluent Acidophilus
microcrystalline cellulose, the potential
Diluent Calcium carbonate
beneficial attributes of other excipients
are foregone. Lactose monohydrate, Diluent Lactose, anhydrous
which is also a commonly used filler in
compounding, exhibits poor flowability Diluent Lactose monohydrate
and interacts with various drug actives.3
In contrast, a considered combination of Diluent Mannitol
excipients ameliorates the formulation.
An ideal capsule powder blend for Diluent; Adsorbent Magnesium carbonate
compounded capsules may have the
Diluent Magnesium oxide
following properties:
• lactose-free to accommodate patient- Diluent Microcrystalline cellulose
specific intolerance;
• gluten-free to accommodate patient- Diluent Sorbitol
specific intolerance;
• neutralise electrostatic repulsion of Diluent Starch
highly static APIs;
Diluent; Glidant Talc
• increase chemical stability;
• increase drug dissolution;
Diluent Tapioca powder
• assist with disintegration, if necessary;
• provide bulk; and Flow agent Sodium bicarbonate
• increase compounding efficiency.
Glidant Magnesium stearate
Selecting excipients for
compounded capsules Neutralise electrostatic repulsion Silica gel
using biopharmaceutical
Neutralise electrostatic repulsion Sodium lauryl sulphate
classification system
In 1995, Amidon et al introduced the Slow-release agent Hydroxypropyl methylcellulose
concept of the Biopharmaceutical
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CapsuBlend – H
CapsuBlend – S CapsuBlend – P
*Volume (mL) of water required to dissolve the highest dose strength over pH 1–8 range.
**Biopharmaceutical Classification System.
FIGURE 2: FLOWCHART FOR SELECTION OF PREMIXED EXCIPIENTS FOR ORAL COMPOUNDED CAPSULES10
Melatonin capsule example Naltrexone capsule example LoxOra is a powder blend to improve
in the BCS in the BCS the dissolution of actives and reduce
Melatonin 5mg capsules, 1 nocte. Naltrexone capsules 3mg, 1 daily, static12 developed by PCCA. This one
Melatonin is slightly soluble in water solubility 100mg/mL; hygroscopic active excipient blend is designed to be used in
and not hygroscopic. The BP Solubilities any oral capsule formulation and with
table defines slightly soluble as “from most APIs according to PCCA.
Number of Doses = Usual Dose ÷ 250mL
100 to 1000 parts”. Meaning solubility
ranges from 1000mg/100mL to Solubility of API (mg/mL) Compounding slow-release
1000mg/1000mL. In the worst case capsules
scenario, solubility is 1000mg/1000mL, Do = 3mg ÷ 250mL = 0.00012 Compounding pharmacists are often
which equates to 1mg/mL. asked to compound hard gelatin
100mg/mL
This example emphasises that BCS capsules with a slow-release component
considers more than the aqueous in order to improve patient adherence
solubility of the drug. Although melatonin Irrespective of solubility, since it is a hygroscopic API 6 use the and pharmacotherapy.13,14 This kind
is slightly soluble in the water, the DO excipient blend suitable for hygroscopic actives. of preparation is suitable for APIs that
number is <1, which classifies it as a highly require frequent dosing within a 24-hour
soluble active.* The reason being, that period due to their short half-life.3,6 A
considering a volume of 250 mL of water There are a number of proprietary consequential benefit when compounding
and a very low therapeutic dose, this drug pre-mixed excipient blends on the slow-release oral capsules is the advantage
is highly soluble as per Amidon’s concept. market. The Capsublend range, of minimising a high peak blood level that
developed by Medisca is based on the is sometimes associated with untoward
BCS to meet the specific requirements effects. “The onset is a little slower and
Number of Doses = Usual Dose ÷ 250mL of drugs within BCS classes.11 The the release is a little prolonged, but not
Solubility of API (mg/mL) range contains various combinations of within narrowly defined limits. This aids
glidants, diluents, electrostatic repulsion in patient adherence and is one aspect of
Do = 5mg ÷ 250mL = 0.02 neutralisers and disintegrants in three pharmaceutical care.”15
different excipient blends: There are a number of terms that
1mg/mL
1. C apsublend-H, for hygroscopic drugs should not be used for compounded
2. C apsublend-P, for drugs identified as formulations as the terms have specific
Since Do <1, use excipient powder blend suitable for highly poorly soluble in the BCS by Amidon definitions in the pharmaceutical
soluble actives.* 3. C apsublend-S, for drugs identified as industry and the United States
highly soluble in the BCS by Amidon. Pharmacopoeia, which could imply that
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2 PRACTICE UPDATE
Excipient selection for compounded pharmaceutical capsules: they’re only fillers, right?
CPD CREDITS
This unit attracts up to 2 Group Two CPD credits. Accreditation number: A1708AJP1. Accreditation expires: 01/08/2019.
GROUP TWO
Each question has only one CORRECT answer.
1. Select the TRUE statement regarding B The taste and smell of the API. C Ranges of 10% w/v to 80% w/v
the Biopharmaceutical Classification C The BCS class that the specific dose of have been used.
System (BCS): the API falls into. D NONE of the above statements
A The BSC is used by the pharmaceutical D All of the above are FALSE.
industry and compounding pharmacies in
consultation with the FDA. 3. Which excipients are commonly used 5. Identify the TRUE statement(s)
B The BSC categorises APIs according in pharmaceutical compounding to below in relation to the claims
to their dissolution rate, solubility and slow the release of the active in an oral which can be made in relation to
permeability at its highest dose in compounded capsule dosage form? compounded capsules with impaired
250mL of buffer. A Hydroxypropylmethylcellulose release properties.
C According to the BSC, an API which is B Microcrystalline cellulose A Pharmacists may use the term “control
highly insoluble in water will always C Methocel E4M release” in reference to capsules that
require excipients to improve its D A and C have been compounded with polymers
bioavailability. E All of the above that retard the release of the API.
D E xcipient selection is unimportant B Pharmacists may make a definitive
when considering the electromagnetic 4. Identify the FALSE statement(s) below claim about the duration of action of
properties of an API. in relation to the amount of the excipient the slow-release formulation based on
intended to slow the release of an API in first principles.
2. When determining the choice of excipients compounded capsules. C Pharmacists may use the trade name
for a capsule which of the following factors A The amount varies depending on the of a slow-release drug compounded
need/s to be considered? solubility properties and dose of the API. only during a drug shortage.
A The hygroscopicity of the API is the first B Capsule fill volumes in the order of D None of the above statements
factor to consider. 30-40% are commonly used. are TRUE.
to be cognisant to avoid making claims 1. Jouyban A. Handbook of solubility data for pharmaceuticals. mixtures/pages/solubilities.html.
about the time frame over which an API CRC Press, 2009; 2. 11. www.medisca.com.au/Pages/ProductDetails.
2. Loyd V Allen Jr, Clinical pharmaceutics and compounding, aspx?StockCode=2595&C=B&C2=112.
will be released from a compounded
Part V. Compounding Today. 2014 Oct 10; 11(40). 12. www.pccarx.com.au/products/pcca-exclusives/bases.
slow-release capsule1,3 unless they have 3. Ferreira AO, Guia practico da farmacia magistral, Vol 1, ed 3. 13. Zur E. Compounding slow-release capsules: a comprehensive
conducted appropriate dissolution Sao Paulo, Brazil: Pharmabooks, 2008;106-16. review and an excel spreadsheet for faster calailtaions of
4. Amidon GL, et al. A theoretical basis for a biopharmaceutic drug excipients. Int J Pharm Compd. 2013 Jan/Feb; 17(1):10-22.
studies for their specific formulation. As classification: the correlation of in vitro drug product dissolution 14. Vu N, et al. Compounding slow-release pharmaceuticals. Int
illustrated above, the release rate for a and in vivo bioavailability. Pharm Res. 1995 Mar;12(3):413-20. J Pharm Compd. 2009 Mar/Apr;13(2):144-5.
5. Bock U, et al. Validation of the Caco-2 cell monolayer system 15. Allen L. Prescription. Int J Pharm Compd. 2003 Nov/
specific slow-release formulation cannot for determining the permeability of drug substances according Dec;7(6):418.
be specified with certainty unless studied, to the Biopharmaceutics Classification System (BCS). Across 16. Tiwari S, et al. Controlled release formulation of tramadol
Barriers. 2003 Jul:1-7. hydrochloride using hydrophilic and hydrophobic matrix system.
irrespective of whether the formulation 6. Pinheiro V, et al. In vitro evaluation of extemporaneously AAPS PharmSciTech. 2003;4(3):Article 31.
was compounded or otherwise. As with all compounded immediate-release capsules. Int J Pharm Compd. 17. Li C, et al. The use of hypromellose in oral drug delivery.
quality management systems monitoring 2013 Sept/Oct; 17(5):424-31. J Pharm Pharmacol. 2005;57:533-46.
7. Waiver of in vivo bioavailability and bioequivalence studies 18. Rowe RC, et al. Hypromellose. In: Handbook of pharmaceutical
is required, in this case the response of for immediate-release solid oral dosage forms based on a excipients. 7th edn. London: Pharmaceutical Press, 2012:373-76.
the patient needs to be monitored. biopharmaceutics classification system. Guidance for Industry. 19. https://pubchem.ncbi.nlm.nih.gov/compound/57503849.
FDA, May 2015. 20. Pinheiro V, et al. Development and in vitro evaluation of
In summary, the choice of 8. www.fda.gov/AboutFDA/CentersOffices/ extended-release theophylline matrix capsules. Braz J Pharm
excipients in a compounded capsule OfficeofMedicalProductsandTobacco/CDER/ucm128219.htm. Sci. 2007 Apr/Jun;43(2).
9. Waiver of Bioequivalence Study. FDA, Aug 2000. 21. Radojkovic B, et al. Compounding of slow-release
will directly affect bioavailability 10. Woods DJ. Formulation in pharmacy practice. 2nd edn. niacinamide capsules: feasibility and characterization. Int J
and the pharmacokinetic profile of Available at www.pharminfotech.co.nz/manual/Formulation/ Pharm Compd. 2012;16(5):434-7.
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