1. Tailored on demand anti-coagulant dosing: An in vitro and in vivo evaluation of 3D printed purpose-designed oral dosage forms
- Author
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Robert Thomas Forbes, Mohamed Albed Alhnan, Milena Cieszynska, Nidal A. Qinna, and Basel Arafat
- Subjects
Male ,Drug Compounding ,Cmax ,Administration, Oral ,Pharmaceutical Science ,02 engineering and technology ,030226 pharmacology & pharmacy ,Dosage form ,Rats, Sprague-Dawley ,Matrix (chemical analysis) ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,In vivo ,medicine ,Animals ,Dosing ,Dose-Response Relationship, Drug ,Chemistry ,Warfarin Sodium ,B230 ,Warfarin ,Anticoagulants ,General Medicine ,021001 nanoscience & nanotechnology ,Coumarin ,Rats ,Drug Liberation ,Models, Animal ,Printing, Three-Dimensional ,0210 nano-technology ,Tablets ,Biotechnology ,medicine.drug ,Biomedical engineering - Abstract
Coumarin therapy has been associated with high levels of inter- and intra-individual variation in the required dose to reach a therapeutic anticoagulation outcome. Therefore, a dynamic system that is able to achieve accurate delivery of a warfarin dose is of significant importance. Here we assess, the ability of 3D printing to fabricate and deliver tailored individualised precision dosing using an in-vitro model. Sodium warfarin loaded filaments were compounded using hot melt extrusion (HME) and further fabricated via fused deposition modelling (FDM) 3D printing to produce capsular-ovoid-shaped dosage forms loaded at 200 and 400 µg dose. The solid dosage forms and comparator warfarin aqueous solutions were administered by oral gavage to Sprague-Dawley rats. In vitro, warfarin release was faster at pH 1.2 in comparison to pH 2. A novel UV imaging approach indicated that the erosion of the methacrylate matrix was at a rate of 16.4 and 15.2 µm/min for horizontal and vertical planes respectively. In vivo, 3D printed forms were as proportionately effective as their comparative solution form in doubling plasma exposure following a doubling of warfarin dose (184% versus 192% respectively). The 3D printed ovoids showed a lower C of warfarin (1.51 and 3.33 mg/mL versus 2.5 and 6.44 mg/mL) and a longer T (6 and 3.7 versus 4 and 1.5 h) in comparison to liquid formulation. This work demonstrates for the first time in vivo, the potential of FDM 3D printing to produce a tailored specific dosage form and to accurately titrate coumarin dose response to an individual patient. [Abstract copyright: Copyright © 2018. Published by Elsevier B.V.]
- Published
- 2018