Innovat International Journal Of Medical & Pharmaceutical Sciences, 2016; 1(1) EXCIPIENTS AND ITS VARIATION IN PHARMACEUTICAL AEROSOL FORMULATION: A REVIEW www.innovatpublisher.com Review Article MAHENDRA PRATAP SWAIN1, *MAUNAB PATRA2, DR. MEENAKSHI PATNAIK3 Research Officer1,*Senior Research Officer2, MD & CEO3, Research & Development, ABBESS Healthcare OPC Pvt. Ltd., E-mailresearch@abbess.in,Website- www.abbess.in Received 2016.10.27-Accepted 2016.11.18 Abstract An aerosol can have variations in formulation as per the area of application and intention of use. In short aerosol formulations are the best NDDS for dispensing Active Pharmaceutical Ingredients (API’s) to the systemic circulation as well as faster local action as compared to OSD. As this dosage form is applied topically, it does not affect the major organs of the body. It has been concluded that it does not show or shows minimum hypersensitivity to locally applied area. It shows best bioavailability as compared to the OSD & desired pharmacological effect. Now a days, new excipients are being used to used get the better formulation efficacy and for batter patient’s compliance. According to the formulation to be processed, we should use specific excipients as conformed by the assay procedure in respective furmularary or pharmacopoeia. From various excipients like colorants, disintigrants, antiadherants, lubricants, sweeteners, binders, flavourin agents, glidants, sorbents, preservatives and vehicles, various dosage forms were formulated as per target and bioavailability. The present review is based on the excipients used in topical pharmaceutical aerosols and its variations. Key word: Topical Aerosol, Excipients, Variation, effect on formulation. INTRODUCTION Excipients are defined as inert, safe and nontoxic compound that could be added to the drug formula to enhance the pharmaceutical and pharmacological properties of dosage form.1 Excipients can be classified either according to their function or according to the dosage forms they are being added to. In general excipients such as diluents, fillers, disintegrating agents, lubricants, glidants, sweetening agent, coloring agent, flavoring agent, solubility enhancer, emulsifying agent, suspending agent, surface active agent, plasticizer used in various dosage forms.[3] The fact that excipients are inert substances has been changed with time since now. Some excipients have direct influence in dissolution rate and drug absorption.[3] Furthermore some excipients had been found to encounter some activity regarding the facilitation of penetration inside the tumour cell. On the other hand some studies confirmed presence of some side effects associated with presence of certain types of excipients, e.g. sucrose, lactose, parabens, and menthol are associated with diabetes mellitus, stomach cramps, hypersensitivity reaction, spasms of the larynx in infants, respectively.[3] Since M.. Dou Vsa, P. Gibala, J. Havl'I Vcek, L. Pla Vcek, M. Tkadlecov'a, J. B Vrich'a Vc discovered the phenylephrine in common cold formula is the cause to degradation during pharmaceutical processes having saccharose.[4] The use of excipients in pediatric formulations is one of the most important challenges faced by the formulators. We cannot consider paediatrics pharmacology as that of the adults because they have special and unique needs. On the other hand the different anatomical and physiological features should be considered in formulating pediatric dosage forms which make the formulation difficult as far as compatibility, stability and palatability of the formula is concerned. Cardiovascular, hepatic, respiratory and central nervous system toxicity is found to be associated with the use of a general solvent propylene glycol. Sucrose as sweetening agent, in higher concentration can cause dental caries[6]. Hereby, we can conclude that excipients should not be considered any longer inert, but we should do an extra effort to investigate the possible side or toxic effect of the excipients in order to have safe formulation practice. Before formulate on the aerosol spray, we have to go through the batter choice excipients for a batter formulation. An Aerosol i.e., pressurized packages, pressurized dosage forms is the best NDDS for dispensing the API(s) to the systemic circulation as well as the local action. An Aerosol is defined as "A disperse system, in which most fine solid drug particles and/or liquid droplets get dispersed in to relevant propellant (gas), which behave like continuous phase" or we can say in other word that "An Aerosol is system which expels or actuate the contents from the container depending on the pressure developed by compressed or liquefied gas". An aerosol is also defined pressurized dosage forms containing one or more therapeutic active ingredients which upon actuation emit a fine dispersion of liquid and/or solid materials in a gaseous medium containing smaller than ≤ 45 µm".[7] In this preparation two phases are combined: Dispersed phase and Continuous Phase, Dispersed Phase may be solid and/or liquid and the Continuous phase is Gas or Propellant or blend of propellants. Pharmaceutical aerosol has been playing an important role in the healthcare profession and best wellbeing of millions people throughout the world last many year. These products include pressurized MDIs,[9] DPIs,[10] sublingual,[11] nebulizers,[12] topical sprays (coolants, local anaesthetics) and dental sprays. The technology continual causes advancement, the ease of use, and the more desirable pulmonary effect than IV bolus formulation for systemicdrugs.[8] This has increased the attraction for the pharmaceutical aerosol delivery system in recent years.[7] The term pressurized package is generally used when referring to the aerosol container. Pressure is developed to the aerosol system through the use of one or more liquefied or gaseous propellants. As we need to add many spices to have nice cooked meal with enjoyable taste reflecting the harmonization of different ingredients, it will be the same for as case of in drug formulation as we need to add a many of additive to enhance the performance of our dosage form. Since the mid of 1950s, aerosol dosage forms of pharmaceuticals have played an important role in treating respiratory illnesses such as asthma and COPD, and today this MDIs & DPIs have become an important part of that treatment or medication.[9]Administration of drugs by the pulmonary route is technically challenging because oral deposition can be high, and variations in inhalation technique can affect the quantity of drug delivered to the lungs. Therefore, there have been considerable efforts to provide more efficient and reproducible aerosol systems through improved drug delivery devices and through better formulations that disperse more readily during inhalation.[5,6,8] Advantages over other dosages forms Mahendra Pratap Swain et.al 5 Table 1. Advantages of aerosol over other dosage forms Aerosol Other dosage forms i. Contents can easily be withdrawn from the package without contamination or exposure of the remaining material as it is packed in a tight and high strong materials. i. In case of OSD there are higher chances to contaminate through hand and also in minute brakeage of packaging materials as it is so thin. ii. Convenient to apply and administer without the help of others. ii. Not so much convenient (Exception ODTs) and Help and guide are needed. iii. The onset of action is very faster. iii. Comparably not so much faster in OSD and Other dosage forms. iv. Dispersion of APIs is very good and shows a batter pharmacological action within a shorter period of time. iv. Dispersion takes more time as well as absorption (show low efficacy on ADME process of pharmacokinetic). So it relatively shows less pharmacological action. v. Due to its closed packaging of aerosols, there is no direct contact with the APIs. v. In this case it’s not so as its packaging is thin and blistered. vi. Aerosol formulation and its DDS avoid the decomposition or inactivation of drug, due to the pH or enzymatic action of the stomach or intestine by oral administration. vi. Inactivation is generally seen as it direct contact with enzymes of food particles. vii. Avoids the first pass metabolism (Presystemic metabolism)[17]& Hepatic metabolism leeds to high drug absorption. vii. Hear is shows first pass metabolism so less drug is go through ADME process. viii. A specific amount of calculated dose or drug can be actuated from the container without contamination. viii. No specificity and shows contamination. x. Hydrolysis of APIs and used excipients can be prevented since propellants do not contain any moisture. x. Hear moisture contact is high as it expose to environment leeds to hydrolysis of drug excipients and APIs. xi. It gives sterility to APIs, because microorganism can’t enter even when the valve is opened. xi. Comparatively no such sterile. xii. The fastest volatilization of used propellants provides a cooling sensation and refreshing effect causing the sinus activation that leads to dilation of blood capillaries and muscle relaxation thus best result by APIs obtained. xii. No volatilization in OSDs, so no cooling effect as well as no effective action. xiii. Aerosol formulation, maintaining valve assembly control, the physical form and particle size of the emitted product may increase efficacy of a drug. xiii. Efficacy can be increase in case of Parenteral not in case of OSDs. xiv. Irritation and Inflammation can be reduced by application of topical aerosol APIs in a uniform thin layer to the skin without touching the affected area.[8] xiv. As like aerosol no such irritation seen but in case of parenteral highly irritative if not dispense properly. Disadvantages of Aerosols Aerosol formulations are highly flammable.[10] Usually disposal of empty aerosol containers is difficult. High volatility property of the propellant(s) can cause irritate on open wounds. Some persons may be hyper/ hyposensitive to the propellant(s) and persons who inhalation aerosol(s), the fluorinated hydrocarbons may causes carcinotoxic[11]or carcinogenic and Cyto-toxicity on repeated use. Aerosol packs needs to be kept away from high temp, because the pressure develops inside can cause the container to collapse. If the drug liquid formulation is not soluble in the propellant, then aerosol formulation is difficult and difficult to achieve the proper pharmacological outcomes. Some of the propellant(s) may cause toxic reactions, therapy if continued for a longer period of time. Working Principle of Aerosols In Aerosol DDS, propellant / propellant mixture and product concentrate is sealed and packed within an aerosol container. Equilibrium is quickly established between the portion of propellant that remains liquefied and the other which remains at vaporized state. It occupies the upper portion of the aerosol container. So, the vapour phase develops pressure in sealed container, against the walls. At the end of dip-tube of valve assembly a liquid phase is situated which contains the Innovat International Journal Of Medical & Pharmaceutical Sciences Vol 1 Issue 1 Nov-Dec 2016 liquefied gas and the product concentrate [API(s) + Excipients], liquefied gases have high pressure & this pressure is responsible for actuation of the aerosols due to increase in the valve forces. This forces pushes the liquid phase up to the dip tube and through the orifice of the valve, contents get released into the atmosphere. As Propellant(s) get released in to environment by actuation, it expands and evaporates within a short period of time because of the drop down in pressure, which leaves only the product concentrate as airborne liquid droplets or dry particles depending upon the type of formulation for subjected area So, by even actuation of the product the pressure within the container remains constant and the product may be continuously released at same rate and in same proportion. After activation of the valve assembly in aerosol system, the pressure exerted by the propellant(s), forces the contents of the package to sot-out through the orifice of the aerosol valve assembly. The physical form of the formulation emitted, depends on formulation type (selection of excipients used) and type of valve is used. Generally, aerosol products designed as to expel their contents in the form of a fine mist, a coarse, wet, or dry spray or simply as aero-dispersed form; a steady stream; or stable or fast breaking foam.[13] Important thing is when the liquid reservoir or formulation has just exhausted, the internal pressure decreases. So the gas may be expelled from the container with diminishing pressure until totally empty. Excipients Used in Pharma Aerosols Role of Key Solution/ Suspension Excipients 4-8 Mahendra Pratap Swain et.al Water is the most widely used vehicle; due to: Lack of toxicity, physiological compatibility,[14] and good solubilising power[14] (high dielectric constant), but as it have the property; Likely to cause instability of hydrolytically unstable drugs or polar drugs. Good media for microbial growth 6 utilised in liquid drug formulations to increase the solubility of poor waters soluble substances and/or to enhance the chemical stability of APIs.[16] Polar co-solvents are used for: Enhance solubility, masking taste & smell and anti-microbial effectiveness or stability. It also reduce the dose volume (e.g. oral, injections) Or, conversely. Examples: propylene glycol, glycerol, ethanol, low molecular weight PEGs.[8,9] Non polar co-solvents, e.g. Emulsions / microemulsions using fractionated coconut oils Buffering Agents Figure 1. Excipients used in Pharma aerosols Sorbitol, dextrose etc.are often added as solubiliser, as well as base sweeteners, as like pros and cons to water. Solvents/Co-Solvents Solvents are the chemicals that dissolves a solute (a chemically different liquid, solid or gas), forms a solution. Solvents are usually liquid, but can also be a solid or a gas. E.g.: organic solvents (Acetone, acetic acid, Acetonitrile, Benzene, carbon tetrachloride, methylene chloride etc.) and inorganic solvents(liquid ammonia, liquid sulfur dioxide, sulfuryl chloride and sulfuryl chloride fluoride, phosphoryl chloride, dinitrogen tetroxide, antimony trichloride, bromine pentafluoride, hydrogen fluoride, pure sulfuric acid etc.) Co-solvents are defined as these are the water-miscible organic solvents that are Buffering agents are the weak acids or bases used to maintain the acidity (pH) of a solution near to 1 although after addition of another acid or base. pH of the formulation is necessary in order to: Ensure physiological compatibility and incompatibility, Maintaining or optimising stability of the chemical, antimicrobial effectiveness on formulation, Optimise solubility (or insolubility if taste is an issu). E.g.:( Gifford, Sorensen, The Clark-Lubs etc are solutions and Sodium bicarbonate, magnesium carbonate and sodium citrate etc. are solute)[8,9,19] Preservatives A substance used to preserve the drug formulations, foodstuffs, wood, or other materials against decay is so called as preservatives. Preservatives are used in multi usable cosmetic/pharmaceutical products. It prevents an increased risk of contamination and proliferation by opportunistic microbes, E.g. not required for sterile, single-dose products. Ideal properties of these type excipients mostly targeted for microbial cells and have no toxicity/irritative effect towards mammalian cells. There are a limited number of approved preservatives available for multiuse aerosol as well as OSDs, and options are even more limited for other routes of administration. Should not use in parenteral infusions.[8,9,10,18] Some examples of various topical preservatives are: Table 2. Examples of topical preservatives Chemical class Quaternary ammonium Compounds (QACs) Preservatives Benzalkonium chloride, cetrimonium bromide, benzethoniun chloride, alkyltrimethylammonium bromide QACs/ metal chelator Alkyl/ Aryl Alchol Amino aryl acid ester Alkyl/ aryl amides Organomercurials Bigunides Phenol QACs e.g. : EDTA/ Benzalkonium chloride Benzoic acid, soric acid Methyl, ethyl, propyl, butyl Parabens and combination Chloroactamide, trichlorocarban Thimerosal Chlorhexidine 4-chlorocresol, 4-chloroxylenol, dichlorophene, hexachlorophene Anti-Oxidants A Chemical that decrease damagation of FPPs due to oxygen is called as Antioxidants. Now a day used antioxidants include enzymes and other substances. Vitamin C, vitamin E, and beta carotene are capable of counteracting the damaging effects of oxidation. Antioxidants are also generally used in food products such as vegetable oils and prepared foods to prevent or delay their deterioration from the action of air. These are used to control oxidation of APIs. Preservative, e.g. potassium sorbate and Vehicle, e.g. oils or fats susceptible to βoxidation (rancidification); Colourants (ageing discolouration). [8,9,19] Oxidation monitored by specific assay, Light exposure and metal ion impurities can accelerate oxidative degradation and hence cause depletion of anti-oxidant. Efficacy of this affected by incompatibility with other excipients somehow with APIs, e.g., partitioning into micelles (from surfactants), Adsorption onto surfaces (container, thickening agent and suspended particles), Interaction with metal ions etc. tragacanth, alginates, cellulose derivatives. It is also use as suspending agents and encourages deflocculation if its levels is too low.[8,9,19] Anti-Foaming Agents (Defoamer) A substance used to reduce foam formation in liquid dosage formulation is called anti foaming agents also called as Defoamer. Commonly in process of manufacturing or when reconstituting of liquid dosage have this problem of foam formation forms needs it due to undesirable and disruptive Anti-foaming agents. These are effective to reduce foam by lowering surface tension and cohesive binding of the liquid phase. Generally used antifoaming substances are insoluble oils, polydimethylsiloxanes and other silicones, certain alcohols, stearates and glycols. A typical example is Simethicone (polydimethylsiloxane-silicon dioxide), which is used at levels of 1-50ppm. In addition to the process called wet granulation using a foam rather than aqueous granulation fluid is gaining popularity.[8,9,19] Wetting Agents Humectants A chemical, added to liquid to reduce its surface tension and make it more effective in spreading over and penetrating surfaces. •Oral: polysorbates (Tweens), sorbitan esters (Spans) •Parenteral: polysorbates, poloxamers, lecithin • External: sodium lauryl sulphate Exceptionally, these are cause excessive foaming and can lead to deflocculation also form undesirable physical instability (sedimentation) if levels too high. In other hand hydrophilic colloids that coat hydrophobic particles, e.g bentonite, Innovat International Journal Of Medical & Pharmaceutical Sciences Vol 1 Issue 1 Nov-Dec 2016 These are important pharmaceutical as well as cosmetic ingredients used to prevent loss of moisture thereby retaining the skin's natural moisture. Hygroscopic excipients used about 5% in aqueous suspensions and emulsions for external application. Generally these are used for prevent drying of the product after application to/on the skin and prevent cap-locking caused by condensation onto neck of container closure of a container after first opening. Examples include: propylene glycol, glycerol, PEG.[8,9,10,19] 4-8 Mahendra Pratap Swain et.al Preservatives Propylene Glycol Toxicity Propylene glycol (PG) batter and widely used solvent with anti-microbial properties used in pharmaceutical preparations including oral liquids, topicals and parenteral preparations. • PG is being associated with cardiovascular, hepatic, respiratory and CNS adverse events, especially in neonates where the biological half-life is prolonged (~17h) compared with adults (5h). • If parentral preparation containing PG must be infused slowly. • PG has laxative action at high oral doses through high osmotic pressure effects.[8,9,19,20,21] 7 “flushing out” umbilical catheters with solutions containing benzyl alcohol, because of trace levels of Benzaldehyde that were present; Dilution of nebulisation solutions with benzyl alcohol-preserved saline led to severe respiratory complications and even death in neonates. Attributed to accumulation of BA due to an immature metabolic capability. Only dilute inhaled solutions with non-preserved, sterile diluents.[8, 9, 20, 21, 22] Sodium Benzoate toxicity Widely used as a preservative in cosmetics, foods and pharmaceuticals (including injectable and oral liquids). Injectable combinations of Sodium Benzoate and Caffeine should not be used in neonates, found to elicit non-immunological contact reactions, including urticarial and atopic dermatitis; Limitation on dosing of sodium benzoate to neonates ≤10mg/kg/day due to immature metabolic capability.[8, 9, 20, 21, 22, 23] Ethanol Toxicity Thimerosal toxicity Widely used as a co-solvent to aid solubility; In USA, maximum use in the following measure: • <0.5% for children under 6-years • <5% for children 6-12-years • <10% for children over 12-years Acute (overdose) or chronic (long-term use) toxicity is possible; May cause adverse symptoms of intoxication, lethargy, stupor, coma, respiratory depression and cardiovascular collapse[8,9,20,21] Peanut Oil Toxicity Peanut oil is used as a food additive and as a solvent in intra-muscular injections.[8,9] It has been suggested that the use of peanut oil in childhood (infant formula and topical preparations) can lead to later episodes of hypersensitivity, and therefore should be discontinued.[8,9,20,21] Anti-microbial Preservatives Benzyl Alcohol toxicity in neonates, so widely used as a preservative in cosmetics, foods and pharmaceuticals (including injectable and oral liquids); Toxic syndrome observed in neonates – it was attributed to the practice of Used as a preservative in cosmetics, in soft contact lens solutions and pharmaceuticals (primarily vaccines). Being phased out from most paediatric vaccines as better options emerge, possible links with toxicity in paediatric vaccines, e.g. childhood autism, have been discounted after much debate. [6, 8, 9, 23] Propellants A topical aerosol made up of two components i.e., product concentrate and propellant. A propellant is a chemical with a vapour pressure greater than atmospheric pressure at 40°C (105°F).[12] Propellants commonly used in pharmaceutical aerosols are include chlorofluorocarbons (CFCs), hydrocarbons(HCs), hydro-chlorofluorocarbons(HCFCs) and hydrofluorocarbons(HFCs), and compressed gases. Hydrocarbons are generally widely accepted as it Low Relative Cost, have best Stability and Purity property as well as the fulfilling the following criteria in range for accepting it; they are low odour, range of boiling points, wide range of vapour pressures, low toxicity, versatility and efficiency, natural compounds, flammability, echo friendly.[9, 12, 23, 24, 26, 27, 28] Various propellants used in pharmaceutical aerosol and its properties Table 3. Various propellants used in pharmaceutical aerosol and its properties: Code V.P. (psia) 700F B.P. (°F at 1 atm.) Density (g/ml) 70 0F I. Chloroflurocarbon propellants: Trichloromonofluoromethane CCl3F Dichlorodifluoromethan CCl2F2 11 12 13.4 84.9 74.7 -21.6 1.485 1.325 Dichlorotetrafluoroethane 114 Name of Chemicals Empirical Formula CClF2ClF2 Water solubility 1.1 g/L (at 680F)13 280 mg/L (at 770F)14 130 mg/L (at 770F)14 0.01%15, 16 27.6 39.4 1.468 II. Hydrochlorofluorocarbon and Hydrofluorocarbon Propellants: Chlorodifluoromethane CHClF2 22 -135.7 -41.4 1.21 Trifloromonofluoroethane CF3CH2F 134a 85.8 -15.0 1.21 Chlorodifluoroethane CH3CClF2 142b 43.8 14.4 1.12 Difluoroethane CH3CHF2 152a 43.8 -12.5 0.91 Heptafluoropropane III. Hydrocarbon Propellants: Propane Isobutene Butane Pentane IV. Compressed Gases: CF3CHFCF3 227 27.7 2.3 1.41 2770 mg/L (at 770F)14 1.0 wt.% @ 70°F, autogeneous pressure 1,400 mg/L (at 770F)14 1.7 wt.% @ 70°F, autogeneous pressure 108 mg/L (at 770F)14 C3H8 C4H10 C4H10 C5H12 A-108 A-31 A-17 124.7 45.1 31.2 -6.2 -43.7 10.9 31.1 - 0.50 @ 68 0F (g/ml) 0.56 @ 68 0F (g/ml) 0.58 @ 68 0F (g/ml) 0.63 62.4 ppm (at 770F)14 263 mg/l (at 770F)14 61.2 mg/L (at 770F)14 38 mg/L (at 770F)14 Nitrogen N2 NA 492 -320 0.97 Nitrous oxide Carbon dioxide N2O CO2 NA NA 735 852 Compressed air Mixture of N2 and O2 NA NA -127 -109 -297.4 0F (O2) -384.8 0F (N2) 1.53 1.53 1 (O2) 0 (N2) Linda safety data 0.015 @ 770F or 1.81X10+4 mg/L (at 69.80F)14 0.588 @ 770F 0.759 @ 770F 39 mg/l (O2) 20 mg/l (N2). *NB: Hydrocarbon blends are also used as propellant e.g.: • A-46 =15.2% Propane / 84.8% Isobutane • NP-46 = 25.9% Propane / 74.1% N-butane Innovat International Journal Of Medical & Pharmaceutical Sciences Vol 1 Issue 1 Nov-Dec 2016 4-8 Mahendra Pratap Swain et.al 8 • NIP-46 = 21.9% Propane / 31.3% Isobutane /46.8% N-Butane As like this many blends are also used in aerosol formulation. 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