Diazepam filled hard capsules intended for detoxification of patients addicted to benzodiazepines and Z-drugs.

Benzodiazepines Capsules Content Uniformity Detoxification Dose Tapering Weight Uniformity Withdrawal

Journal

European journal of hospital pharmacy : science and practice
ISSN: 2047-9964
Titre abrégé: Eur J Hosp Pharm
Pays: England
ID NLM: 101578294

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 15 11 2016
revised: 08 06 2017
accepted: 20 06 2017
entrez: 4 6 2019
pubmed: 4 6 2019
medline: 4 6 2019
Statut: ppublish

Résumé

The abuse of benzodiazepines and Z-drugs reduces the quality of life of millions of addicted people worldwide. They cannot be discontinued abruptly due to harmful withdrawal symptoms. Detoxification is usually based on replacement of short/middle acting benzodiazepines or Z-drugs by diazepam and tapering the dose over time. In order to enhance patient adherence to an individual withdrawal plan, suitable diazepam dosage forms have to be available. Hard capsules containing an exact and uniform dose could be used for the relief of symptoms caused by altering the plasma level and overcoming psychogenic stress from the dose reduction. This work demonstrates that capsules with a content of diazepam ranging from 2.125mg to 0.492 mg (dose decreasing always by 15%) cannot be easily prepared by standard mortar technology in a pharmacy. To meet mass and content uniformity European Pharmacopoeia criteria, capsules were prepared by improved technology based on the preparation of binary blends of calcium phosphate anhydrous and diazepam in descending concentrations in a high-speed mixer (time 30 s) and densification of about 10% during filling of the capsules. All batches (n=20) prepared by improved technology met the requirement for content uniformity compared with only nine batches prepared by standard mortar blender technology. Based on the process capability index, none of the samples prepared by standard technology fitted pharmacopeia limits at the statistically acceptable level. On the other hand, all batches prepared by improved technology exhibited acceptable process capability index. We have shown that at least 99.73% of batches prepared by our improved technology would meet the pharmacopoeia limits for content uniformity and are suitable for treatment of this type of addiction.

Identifiants

pubmed: 31157089
doi: 10.1136/ejhpharm-2016-001163
pii: ejhpharm-2016-001163
pmc: PMC6362874
doi:

Types de publication

Journal Article

Langues

eng

Pagination

10-15

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Pharmazie. 2002 Jan;57(1):49-53
pubmed: 11836931
Am J Hosp Pharm. 1976 May;33(5):450-2
pubmed: 1274959
World Psychiatry. 2005 Oct;4(3):186-90
pubmed: 16633547
Curr Opin Psychiatry. 2005 May;18(3):249-55
pubmed: 16639148
Br J Psychiatry. 1990 Mar;156:406-11
pubmed: 1971767
Psychopharmacol Bull. 1990;26(1):63-8
pubmed: 1973546
Am J Psychiatry. 1991 Feb;148(2):151-2
pubmed: 1987812
Addiction. 2010 Nov;105(11):1875-6
pubmed: 21064246
Int J Pharm. 2011 Feb 14;404(1-2):1-9
pubmed: 21070842
Psychiatry Res. 2012 Jul 30;198(2):307-12
pubmed: 22421069
Br J Clin Pharmacol. 2014 Feb;77(2):295-301
pubmed: 22882333
Drug Alcohol Depend. 2014 Sep 1;142:105-9
pubmed: 25001277
Acta Pharm. 2014 Sep;64(3):355-67
pubmed: 25296681
Aust Prescr. 2015 Oct;38(5):152-5
pubmed: 26648651
J Clin Psychiatry. 1993 May;54(5):189-91
pubmed: 8509349

Auteurs

Aleš Franc (A)

Department of Pharmaceutics, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

Kateřina Kubová (K)

Department of Pharmaceutics, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

Jan Elbl (J)

Department of Pharmaceutics, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

Jan Muselík (J)

Department of Pharmaceutics, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

David Vetchý (D)

Department of Pharmaceutics, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

Jan Šaloun (J)

Department of Applied Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

Radka Opatřilová (R)

Department of Chemical Drugs, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.

Classifications MeSH