Stability of sulfadiazine sugar-free oral suspensions for the treatment of congenital toxoplasmosis
DOI:
https://doi.org/10.1590/Keywords:
Pediatric formulation, Sulfadiazine, Suspension, Congenital toxoplasmosis, Extemporaneous suspensionsAbstract
This study aimed to develop and evaluate the stability of sulfadiazine sugar-free extemporaneous oral suspensions, focusing on treating congenital toxoplasmosis. The excipients were carefully chosen to obtain safe products for the pediatric population. Sulfadiazine suspensions (100 mg/ mL) were prepared from the raw material or tablets, stored in amber glass bottles at 5±3ºC, and evaluated at 0, 14, and 30 days. An ultra-performance liquid chromatographic method was developed and validated to assay the drug. The particle size ranged from 29.3 to 50.6 µm, with some variation over the study; pH values around 7.0 and non-Newtonian behavior were observed without modification in the period. Formulations showed a fast dissolution rate (>80% in 15 minutes) without variation over the study. The drug assay was about 100% of the label claimed throughout the study, demonstrating the chemical stability and the preparations’ dose homogeneity. The microbiological investigation indicated that both preparations met the requirements for the microbial count and absence of pathogens. In conclusion, the developed formulations can be used for 30 days when stored under refrigeration. The oral suspensions produced are easy to prepare and contain safe components, providing an alternative for congenital toxoplasmosis treatment in children.
Downloads
References
Agência Nacional de Vigilância Sanitária. Anvisa. Farmacopeia Brasileira. v. I, 6ª ed. Brasília: Anvisa; 2019a.
Agência Nacional de Vigilância Sanitária. Anvisa. Farmacopeia Brasileira. v. II, 6ª ed. Brasília: Anvisa ; 2019b.
Agência Nacional de Vigilância Sanitária. Anvisa. Resolução de Diretoria Colegiada no. 166, de 24 de julho de 2017. Dispõe sobre a validação de métodos analíticos e dá outras providências. Diário Oficial da União 25 jul 2017.
Allen HC, Garbe MC, Lees J, Aziz N, Chaaban H, Miller JL, et al. Off-Label Medication use in Children, More Common than We Think: A Systematic Review of the Literature. J Okla State Med Assoc. 2018;111(8):776-83.
Alonso AS, Avila-Alvarez A, Eiriz MC, Roca CM, Gómez PY, López AC, et al. Use of off-label drugs in neonatal intensive care. An Pediatr. 2019;91(4):237-43. https://doi. org/10.1016/j.anpede.2018.12.005
» https://doi. org/10.1016/j.anpede.2018.12.005
Attebäck M, Hedin B, Mattsson S. Formulation optimization of extemporaneous oral liquids containing naloxone and propranolol for pediatric use. Sci Pharm. 2022;90(1):1-18. https://doi.org/10.3390/SCIPHARM90010015
» https://doi.org/10.3390/SCIPHARM90010015
Belayneh A, Tadese E, Molla F. Safety and biopharmaceutical challenges of excipients in off-label pediatric formulations. Int J Gen Med. 2020;2020(13):1051-66. https://doi.org/10.2147/ IJGM.S280330
» https://doi.org/10.2147/ IJGM.S280330
Belayneh A, Tessema Z. A Systematic Review of the Stability of Extemporaneous Pediatric Oral Formulations. Sci World J. 2021;2021:8523091. https://doi.org/10.1155/2021/8523091
» https://doi.org/10.1155/2021/8523091
Bonamici D. Sistema de classificação biofarmacêutica e bioisenções. [Dissertação] - São Paulo: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas; 2009.
Brevedan MIV, Varillas MA, Vidal NLG. Dissolution stability of cephalexin extemporaneous suspensions during an accelerated stability study. Dissolution Technol. 2012;19(3):23-7. https://doi.org/10.14227/DT190312P23
» https://doi.org/10.14227/DT190312P23
Castro AEA, Gusmão RS, Souza DAG, Sa HPA, Pereira RMS, Santos ML. Surgimento e Evolução do Cromatógrafo Líquido de Ultra Alta Eficiência (UPLC), sua Aplicabilidade, Vantagens e Desvantagens. Uniciências. 2021;25(2):86-92. https://doi.org/10.17921/1415-5141.2021v25n2p86-92
» https://doi.org/10.17921/1415-5141.2021v25n2p86-92
Costa BSR, Nascimento LP, Amorim MVP, Gomes APB, Veríssimo LA. Stability of extemporaneous sulfadiazine oral suspensions from commercially available tablets for treatment of congenital toxoplasmosis. Trop Med Int Heal. 2020;25(3):364-72. https://doi.org/10.1111/tmi.13354
» https://doi.org/10.1111/tmi.13354
Ferreira AO, Polonini HC, Silva SL, Patrício FB, Brandão MAF, Raposo NRB. Feasibility of amlodipine besylate, chloroquine phosphate, dapsone, phenytoin, pyridoxine hydrochloride, sulfadiazine, sulfasalazine, tetracycline hydrochloride, trimethoprim and zonisamide in SyrSpend® SF PH4 oral suspensions. J Pharm Biomed Anal. 2016;118:105-12. https://doi.org/10.1016/j.jpba.2015.10.032
» https://doi.org/10.1016/j.jpba.2015.10.032
Ferreira LA, Ibiapina CC, Machado MGP, Fagundes EDT. High prevalence of off-label and unlicensed drug prescribing in a Brazilian intensive care unit. Rev Assoc Med Bras. 2012;58(1):82-7. https://doi.org/10.1016/s2255- 4823(12)70159-5
» https://doi.org/10.1016/s2255- 4823(12)70159-5
Food and Drug Administration. FDA. Dissolution testing of immediate release solid oral dosage forms. 1997. Rockville, MD: FDA; 1997. [cited 2023 May 12]. Available from: Available from: https://www.fda.gov/media/70936/download
» https://www.fda.gov/media/70936/download
Gumustas M, Kurbanoglu S, Uslu B, Ozkan SA. UPLC versus HPLC on drug analysis: Advantageous, applications and their validation parameters. Chromatographia. 2013;76:1365-1427. https://doi.org/10.1007/s10337-013-2477-8
» https://doi.org/10.1007/s10337-013-2477-8
Haywood A, Glass BD. Liquid dosage forms extemporaneously prepared from commercially available products - Considering new evidence on stability. J Pharm Pharm Sci. 2013;16(3):441-55. https://doi.org/10.18433/j38887
» https://doi.org/10.18433/j38887
International Conference of Harmonisation. ICH. Q2(R2), Validation of analytical procedures: text and methodology. Geneva: International Conference on Harmonization; 2022.
Khan D, Kirby D, Bryson S, Shah M, Rahman Mohammed A. Paediatric specific dosage forms: Patient and formulation considerations. Int J Pharm. 2022;616:121501. https://doi. org/10.1016/J.IJPHARM.2022.121501
» https://doi. org/10.1016/J.IJPHARM.2022.121501
Khan K, Khan W. Congenital toxoplasmosis: An overview of the neurological and ocular manifestations. Parasitol Int. 2018;67(6):715-21. https://doi.org/10.1016/j.parint.2018.07.004
» https://doi.org/10.1016/j.parint.2018.07.004
Kota AS, Shabbir N. Congenital Toxoplasmosis. [cited 2023 May 12]. Available from: Available from: https://www.ncbi.nlm.nih.gov/ books/NBK545228/
» https://www.ncbi.nlm.nih.gov/ books/NBK545228/
Kulkarni VS, Shaw C. Use of Polymers and Thickeners in Semisolid and Liquid Formulations. Essent Chem Formul Semisolid Liq Dosages. Londres: Academic Press, 2016. 43-69 p. https://doi.org/10.1016/B978-0-12-801024-2.00005-4
» https://doi.org/10.1016/B978-0-12-801024-2.00005-4
Lam JKW, Xu Y, Worsley A, Wong ICK. Oral transmucosal drug delivery for pediatric use. Adv Drug Deliv Rev. 2014;73:50-62. https://doi.org/10.1016/J.ADDR.2013.08.011
» https://doi.org/10.1016/J.ADDR.2013.08.011
Lopez FL, Ernest TB, Orlu M, Tuleu C. The effect of administration media on palatability and ease of swallowing of multiparticulate formulations. Int J Pharm . 2018;551(1-2):67-75. https://doi.org/10.1016/j.ijpharm.2018.08.021
» https://doi.org/10.1016/j.ijpharm.2018.08.021
Mendes C, Costa AP, Oliveira PR, Tagliari MP, Silva MAS. Physicochemical and microbiological stability studies of extemporaneous antihypertensive pediatric suspensions for hospital use. Pharm Dev Technol. 2013;18(4):813-20. https://doi.org/10.3109/10837450.2012.693504
» https://doi.org/10.3109/10837450.2012.693504
Musko M, Sznitowska M. Use of compounded dispersing media for extemporaneous pediatric syrups with candesartan cilexetil and valsartan. Acta Pharm. 2014;64(4):463-74. https://doi.org/10.2478/acph-2014-0037
» https://doi.org/10.2478/acph-2014-0037
Nakama KA, Santos RB, Serpa P, Maciel TR, Haas SE. Organoleptic excipients used in pediatric antibiotics. Arch Pediatr. 2019;26(7):431-6. https://doi.org/10.1016/j.arcped.2019.09.008
» https://doi.org/10.1016/j.arcped.2019.09.008
Nayak AK, Hasnain MS, Aminabhavi TM. Drug delivery using interpenetrating polymeric networks of natural polymers: A recent update. J Drug Deliv Sci Technol. 2021;66:102915. https://doi.org/10.1016/j.jddst.2021.102915
» https://doi.org/10.1016/j.jddst.2021.102915
Niazi SK. Handbook of Pharmaceutical Manufacturing Formulations. Second Edition, New York: Informa Healthcare USA, Inc; 2009. https://doi.org/10.1201/b14437
» https://doi.org/10.1201/b14437
Pathmanathan U, Halgrain D, Chiadmi F, Schlatter J, Vermerie N. Stability of sulfadiazine oral liquids prepared from tablets and powder. J Pharm Pharm Sci . 2004;7(1):84-7.
Provenza N, Calpena AC, Mallandrich M, Halbaut L, Clares B. Design and physicochemical stability studies of paediatric oral formulations of sildenafil. Int J Pharm . 2014;460(1-2):234-9. https://doi.org/10.1016/j.ijpharm.2013.11.006
» https://doi.org/10.1016/j.ijpharm.2013.11.006
Reis F, Pissarra R, Soares H, Soares P, Guimarães H. Off- label and unlicensed drug treatments in Neonatal Intensive Care Units: a systematic review. J Pediatr Neonatal Individ Med. 2021;10(2):e100213. https://doi.org/10.7363/100213
» https://doi.org/10.7363/100213
Rouaz K, Chiclana-Rodríguez B, Nardi-Ricart A, Suñé-Pou M, Mercadé-Frutos D, Suñé-Negre JM, et al. Excipients in the paediatric population: A review. Pharmaceutics. 2021;13(3):1-44. https://doi.org/10.3390/pharmaceutics13030387
» https://doi.org/10.3390/pharmaceutics13030387
Sae Yoon A, Sawatdee S, Woradechakul C, Sae Chee K, Atipairin A. Physicochemical and microbiological stability of the extemporaneous sildenafil citrate oral suspension. Sci Pharm . 2015;83(4):659-70. https://doi.org/10.3797/scipharm.1505-08
» https://doi.org/10.3797/scipharm.1505-08
Shabir GA. Validation of high-performance liquid chromatography methods for pharmaceutical analysis: Understanding the differences and similarities between validation requirements of the US Food and Drug Administration, the US Pharmacopeia and the International Conference on Harmonization. J Chromatogr A. 2003;987(1-2):57-66. https://doi.org/10.1016/S0021-9673(02)01536-4
» https://doi.org/10.1016/S0021-9673(02)01536-4
Silva MRM, Dysars LP, Santos EP, Ricci Júnior E. Preparation of extemporaneous oral liquid in the hospital pharmacy. Braz J Pharm Sci. 2020;56:e18358. https://doi.org/10.1590/S2175-97902019000418358
» https://doi.org/10.1590/S2175-97902019000418358
Sivaneswari S, Karthikeyan E, Veena D, Chandana PJ, Sumana PS, Ramya L, et al. Physiochemical characterization of taste masking levetiracetam ion exchange resinates in the solid state and formulation of stable liquid suspension for pediatric use. Beni-Suef Univ J Basic Appl Sci. 2016;5(2):126-33. https://doi.org/10.1016/j.bjbas.2016.04.004
» https://doi.org/10.1016/j.bjbas.2016.04.004
Souza A, Santos D, Fonseca S, Medeiros M, Batista L, Turner M, et al. Toxic excipients in medications for neonates in Brazil. Eur J Pediatr. 2014;173(7):935-45. https://doi. org/10.1007/s00431-014-2272-z
» https://doi. org/10.1007/s00431-014-2272-z
Strang AGGF, Ferrari RG, Rosário DK, Nishi L, Evangelista FF, Santana PL, et al. The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis. Acta Trop. 2020;211:105608. https://doi.org/10.1016/j.actatropica.2020.105608
» https://doi.org/10.1016/j.actatropica.2020.105608
Storpirtis S, Mori ALPM, Yochiy A, Ribeiro E, Porta V. Farmácia clínica e atenção farmacêutica. Rio de Janeiro: Guanabara Koogan; 2008.
Tonazio L, Vilela MMP, Jesus RR, Pinto MAO, Amaral MPH. Reações Adversas dos Adjuvantes Farmacêuticos Presentes em Medicamentos para Uso Pediátrico. HU Rev. 2011;37(1):63-8.
UNITED STATES PHARMACOPEIA. USP. 39ed. Rockville: United States Pharmacopeial Convention, 2016a, p. 5941.
UNITED STATES PHARMACOPEIA. USP. 39ed. The Dissolution Procedure: Development and Validation. Rockville: United States Pharmacopeial Convention , 2016b, p. 1202-1222.
Zaid AN, Shtayah R, Qadumi A, Ghanem M, Qedan R, Daibes M, et al. Stability of extemporaneously prepared rosuvastatin oral suspension. Am J Heal Pharm. 2017;74(19):1579-83. https://doi.org/10.2146/ajhp160235
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Brazilian Journal of Pharmaceutical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content of the journal, except where identified, is licensed under a Creative Commons attribution-type BY.
The on-line journal has open and free access.