Orally disintegrating tablet
An orally disintegrating tablet (ODT) is a drug dosage form available for a limited amount of over-the-counter(OTC) and prescription medications. ODTs differ from traditional tablets in that they are designed to be dissolved in the mouth rather than swallowed whole. The ODT serves as an alternative dosage form that offers an ease of use for patients that experience dysphagia. Dysphagia, or difficulty in swallowing is common among all age groups, and is observed in about 35% of the general population , and has been reported in up to 60% of elderly institutionalized population [1] [2], and 18-22% of all persons in long-term care facilities [3], many of whom are required to consume medications on a regular basis. This may lead to poor or even non-compliance with oral treatments and thus has a negative impact on the efficacy of certain medications. During the last decade ODTs have found their way into a variety of therapeutic markets. ODTs can now be found in over the counter (OTC) products, such as Claritin RediTabs, Alavert, Unisom SleepMelts, as well as prescription products such as Parcopa.
History
Tablets designed to dissolve on the buccal (cheek) mucous membrane were a precursor to the ODT. This dosage form was intended for drugs that yield low bioavailability through the digestive tract but are inconvenient to administer parenterally, such as steroids and narcotic analgesics.[4] Absorption through the cheek allows the drug to bypass the digestive tract for rapid systemic distribution. The first ODTs disintegrated through effervescence rather than dissolution, and were designed to make taking vitamins more pleasant for children.[5] This method was adapted to pharmaceutical use with the invention of microparticles containing a drug, which would be released upon effervescence of the tablet and swallowed by the patient.[6] Dissolution became more effective than effervescence through improved manufacturing processes and ingredients (such as the addition of mannitol to increase binding and decrease dissolution time).[7] Cima Labs in the U.S. and Takeda Pharmaceutical Company in Japan led the development of ODTs.
The first ODT form of a drug to meet FDA approval in the U.S. was Claritin (loratadine) in December 1996.[8] It was followed by Klonopin (clonazepam) in December 1997,[9] and Maxalt (rizatriptan) in June 1998.[10] The regulatory condition for meeting the definition of an orally disintegrating tablet is USP method 701 for Disintegration. This practice is under review by the FDA as the fast disintegration time of ODTs makes the Disintegration test too rigorous.
Manufacturing/Packaging
ODTs don’t necessarily require special manufacturing processes versus traditional tablets. ODTs are compressed at much lower forces (4 – 20 kN) than traditional tablets, but there is no additional challenge in this. However, since ODTs are compressed at very low forces due to the need to them to be soft enough to disintegrate rapidly in the mouth, issues of material sticking to the die walls can be challenging. Typically, as in most tablet blends, lubricants such as magnesium stearate are added to the blend to reduce the amount of material that may stick to the die wall. ODTs are manufactured much in the same way as traditional tablets, but differences in may be the use of disintegrating aids such as crospovidone and binders that aid in mouth feel such as microcrystalline cellulose. Primarily ODTs contain some form of sugar such as mannitol, which typically serves as the major diluent of the ODTs, and is also the primary contributor to the smooth and creamy mouth feel of most ODTs.
ODTs are available in HPDE bottles (Parcopa) or individually sealed in blister packs to protect the tablets from damage, moisture, and oxidation. Because ODTs are soft in nature, the ability to successfully package an ODT in a bottle is difficult. However, CIMA labs markets their Durasolv ODT as being able to be placed into bottle for commercial sale. CIMAs Orasolv is marketed for blisters only. While the differences between these two products are proprietary, the primary difference is expected to be the use of microcrystalline cellulose (MCC), such as Avicel PH101, in the Durasolv product. MCC serves multiple purposes in an ODT but in the case of CIMAs products, it serves primarily as a binder thereby increasing the internal strength of the tablet making it more robust for packaging in bottles.
ODTs currently available
ODTs under development
Product | Manufacturer | Active ingredient | Category | Indication | Intended Age Group |
---|---|---|---|---|---|
Citalopram ODT[27] | Biovail[27] | Citalopram | SSRIs | Major Depressive Disorder[28] | |
Metoclopramide Zydis[29] | Salix Pharmaceuticals[29] | Metoclopramide | Dopamine receptor antagonists | short-term therapy for GERD, acute diabetic gastric stasis[29] | adults[29] |
Reglan ODT[30] | Schwarz Pharma[30] | Metoclopramide | Dopamine receptor antagonists | short-term therapy for GERD, acute diabetic gastric stasis[30] | adults[30] |
Tramadol/Acetaminophen ODT[27] | Biovail[27] | Tramadol/Acetaminophen | Opioid analgesic [Tramadol][31] | Pain[27] | adults[31] |
Zolpidem ODT[27] | Biovail[27] | Zolpidem | Nonbenzodiazepine Hypnotics[32] | Sleep disorders[27] | adults[32] |
See also
- Phagophobia - fear of swallowing
- Pnigophobia - fear of choking
- Sugar alcohol - a family of chemicals common in ODTs to mask the taste of the drug
References
- ^ Sastry, S. et al., Pharm. Sci. & Tech. Today 3: 138-145, 2000.
- ^ Groher ME, Bukatman MS. The prevalence of swallowing disorders in two teaching hospitals. Dysphagia. 1: 3-6, 1986.
- ^ Layne KA, Losinski DS, Zenner PM, Ament JA. Using the Fleming index of dysphagia to establish prevalence. Dysphagia. 4: 39-42, 1989.
- ^ Fast dissolving buccal tablet, 1991
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ignored (help) - ^ FDA Drug Details for Claritin RediTabs
- ^ FDA Drug Details for Klonopin Wafer
- ^ FDA Drug Details for Maxalt-MLT
- ^ a b c Abilify Prescribing Information
- ^ a b Allegra Prescribing Information
- ^ a b c Aricept Prescribing Information
- ^ a b Clonazepam ODT Prescribing Information
- ^ a b FazaClo Prescribing Information
- ^ a b c Klonopin Prescribing Information
- ^ a b Maxalt Prescribing Information
- ^ a b c d Remeron SolTob Prescribing Information
- ^ a b c d Zofran Prescribing Information
- ^ a b Orapred Prescribing Information
- ^ a b Parcopa Prescribing Information
- ^ a b c Prevacid Prescribing Information
- ^ a b Risperdal Prescribing Information
- ^ a b c Zelapar Prescribing Information
- ^ a b Zomig Prescribing Information
- ^ a b Zyprexa Prescribing Information
- ^ a b c d e f g h Biovail Product Pipeline
- ^ Citalopram Prescribing Information
- ^ a b c d Salix Pharmaceuticals Acquires Patent–Protected Metoclopramide–Zydis
- ^ a b c d FDA Drug Approval for Reglan ODT
- ^ a b Ultracet Prescribing Information
- ^ a b Ambien Prescribing Information