A Review On Current Approaches in Gastro Retentive Drug Delivery System
A Review On Current Approaches in Gastro Retentive Drug Delivery System
A Review On Current Approaches in Gastro Retentive Drug Delivery System
Abstract:
Oral controlled release delivery systems are programmed to deliver the drug in predictable time frame that will
increase the efficacy and minimize the adverse effects and increase the bioavailability of drugs. It is most widely
utilized route of administration among all the routes that have been explored for systemic delivery of drugs via
pharmaceutical products of different dosage form. In fact the buoyant dosage unit enhances gastric residence time(
GRT) without affecting the intrinsic rate of emptying. Unfortunately floating devices administered in a single unit
form ( Hydrodynamically balanced system) HBS are unreliable in prolonging the GRT owing to their all- or-
nothing emptying process and, thus they may causes high variability in bioavailibity and local irritation due to large
amount of drug delivered at a particular site of the gastrointestinal tract. One of the most widely gastro retentive
drug delivery system. The present paper highlights the current approaches and another aspect of the GRDS.
Key-words:-Gastro-retentive drug delivery system, physiology of stomach, current approaches in GRDDs,
Evaluation parameters.
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Introduction
Drug Delivery system is becoming increasingly sophisticated as pharmaceutical scientists acquire a better
understanding of the physicochemical and biological parameters pertinent to their performances. Controlled Drug
Delivery System provides drug release at a predetermined, predictable and controlled rate to achieve high therapeutic
efficiency with minimal toxicity. Despite tremendous advancement in drug delivery, oral route remains the preferred
route for the administration of therapeutic agents and oral drug delivery is by far the most preferable route of drug
delivery because of low cost of therapy and ease of administration leads to high levels of patient compliance as well
as the fact that gastrointestinal physiology offers more flexibility in dosage form design than most other routes,
consequently much effort has been put into development of strategies that could improve patient compliance through
oral route[1]. Gastric emptying of dosage forms is an extremely variable process and ability to prolong and control the
emptying time is a valuable asset for dosage forms, which reside in the stomach for a longer period of time than
conventional dosage forms. Several difficulties are faced in designing controlled release systems for better absorption
and enhanced bioavailability. One of such difficulties is the inability to confine the dosage form in the desired area of
the gastrointestinal tract[2].
Conventional oral dosage forms such as tablets, capsules etc provide specific drug concentration in systemic
circulation without offering any control over drug delivery and also great fluctuations in plasma drug levels, by
comparison oral controlled drug delivery systems provide a release profile predominantly controlled by the design of
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the system itself[2,3] . The release of active agents is, therefore, largely independent of external factors. For oral solid
delivery systems, drug absorption is unsatisfactory and highly variable between the individuals. An important
requisite for the successful performance of oral controlled release drug delivery system is that the drug should have
good absorption throughout the gastrointestinal tract (GIT). The major problem is the physiological variability such
as gastrointestinal transit in addition to gastric retention time, as the later plays a dominating role in the over all
transit of the dosage form[4]. Another problem associated with the performance of oral controlled release systems is
that even though the slow release can be achieved, the drug released after passing the absorption site (upper position
of small intestine) is not fully utilized; this is because the GRT of the delivery system is less than 12 hours. Therefore,
it is not possible to deliver the drug for more than 12 hours through the oral route. This has prompted researchers to
retain the drug delivery systems in the stomach for prolonged and predictable time, such a prolonged gastric retention
not only controls the time but also the space in the stomach by maintaining the delivery system positioned at a steady
site and thereby properly delivering the drug. It is evident from the recent scientific and patent literature that an
increased interest in novel dosage forms that are retained in the stomach for a prolonged and predictable period of
time exists today in academic and industrial research groups. One of the most feasible approaches for achieving a
prolonged and predictable drug delivery profile in the GI tract is to control the gastric residence time[4,5].
Dosage forms that can be retained in the stomach are called gastroretentive drug delivery systems (GRDDS). GRDDS
can improve the controlled delivery of drugs that have an absorption window by continuously releasing the drug for a
prolonged period of time before it reaches its absorption site thus ensuring its optimal bioavailability[1,4,6].
Over the past three decades, the pursuit and exploration of devices designed to be retained in the upper part of the
gastrointestinal (GI) tract has advanced consistently in terms of technology and diversity, encompassing a variety of
systems and devices such as floating systems, raft systems, expanding systems, swelling systems, bioadhesive
systems and low-density systems. Gastric retention will provide advantages such as the delivery of drugs with
narrow absorption windows in the small intestinal region. Also, longer residence time in the stomach could be
advantageous for local action in the upper part of the small intestine, for example treatment of peptic ulcer disease.
Furthermore, improved bioavailability is expected for drugs that are absorbed readily upon release in the GI tract.
These drugs can be delivered ideally by slow release from the stomach. Many drugs categorized as once-a-day
delivery have been demonstrated to have suboptimal absorption due to dependence on the transit time of the dosage
form, making traditional extended release development challenging. Therefore, a system designed for longer gastric
retention will extend the time within which drug absorption can occur in the small intestine[7].
Certain types of drugs can benefit from using gastric retentive devices. These include:
Drugs acting locally in the stomach
E.g. Antacids and drugs for H. Pylori viz., Misoprostol
Drugs that are primarily absorbed in the stomach
E.g. Amoxicillin
Drugs that is poorly soluble at alkaline pH
E.g. Furosemide, Diazepam, Verapamil, etc.
Drugs with a narrow window of absorption
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Based on fasted and fed states of stomach, there are two distinct patterns of gastrointestinal motility. The fasted state
is associated with some cyclic contractile events commonly known as Migrating Myoelectric Complex (MMC).
Liquid components easily pass through the partially constricted sphincter. On the contrary, an antral-sieving
process retains the large undigested materials. Usually a series of interdigestive events takes place in stomach. The
Migrating Myoelectric Complex (MMC), which governs the gastrointestinal motility pattern has been described as an
alternating cycles of activity and quiescence. Apparently there are four consecutive phases of activity in MMC[9,10].
Phase II: It consists of intermittent contractions that gradually increase in intensity as the phase progresses and
it lasts about 20 to 40 minutes.
Phase III: This is a short period of intense distal and proximal gastric contractions (4 to 5 contractions per
minute) lasting about 10 to 20 minutes; these contractions, also known as housekeeper wave sweep gastric
contents down to small intestine.
Phase IV: This is a short transitory period of about 0 to 5 minutes, and the contractions dissipate between the
last part of phase III and quiescence of phase I.
The fasted-state emptying pattern is independent of the presence of any indigestible solids in the stomach. Patterns of
contractions in the stomach occur such that solid food is reduced to particles of less than 1mm diameter that are
emptied through the pylorus as a suspension. The duration of the contractions is dependent on the physiochemical
characteristics of the ingested meal[11].
Generally, a meal of ~450kcal will interrupt the fasted state motility for about three to four hours. It is reported that
the antral contractions reduce the size of food particles to 1mm and propel the food through the pylorus. However, it
has been shown that ingestible solids 7mm can empty from the fed stomach in humans.TableNo.1
Gastric secretion: Acid, pepsin, gastrin, mucus and some enzymes about 60 ml with approximately 4 mmol of
hydrogen ions per hour.
Effect of food on Gastric secretion: About 3 liters of secretions are added to the food. Gastro intestinal transit time .
Requirements For Gastric Retention:-
Physiological factors in the stomach, it must be noted that, to achieve gastric retention, the dosage form must satisfy
certain requirements. One of the key issues is that the dosage form must be able to withstand the forces caused by
peristaltic waves in the stomach and the constant contractions and grinding and churning mechanisms. To function as
a gastric retention device, it must resist premature gastric emptying. Furthermore, once its purpose has been served,
the device should be removed from the stomach with ease.
Factors affecting gastric retention time of the dosage form:-[12,13]
1. Density:- GRT is a function of dosage form buoyancy that is dependent on the density. The density of a dosage
form also affects the gastric emptying rate and determines the location of the system in the stomach. Dosage forms
having a density lower than the gastric contents can float to the surface, while high density systems sink to bottom of
the stomach. Both positions may isolate the dosage system from the pylorus. A density of < 1.0 gm/ cm3 is required
to exhibit floating property.
2. Size & Shape of dosage form:- Shape and size of the dosage forms are important in designing indigestible single
unit solid dosage forms. The mean gastric residence times of non floating dosage forms are highly variable and
greatly dependent on their size, which may be large, medium and small units. In most cases, the larger the dosage
form the greater will be the gastric.
3. Single or multiple unit formulation:- Multiple unit formulations show a more Predictable release profile and
insignificant impairing of performance due to failure of units allow co- administration of units with different release
profiles or containing incompatible substances and permit a larger margin of safety against dosage form failure
compared with single unit dosage forms.
4. Fed or unfed state:- under fasting conditions: GI motility is characterized by periods of strong motor activity or
the migrating myoelectric complex (MMC) that occurs every 1.5 to 2 hours. The MMC sweeps undigested material
from the stomach and, if the timing of administration of the formulation coincides with that of the MMC, the GRT of
the unit can be expected to be very short. However, in the fed state, MMC is delayed and GRT is considerably longer.
5. Nature of meal:- feeding of indigestible polymers or fatty acid salts can change the motility pattern of the stomach
to a fed state, thus decreasing the gastric emptying rate and prolonging drug release.
6. Caloric content:- GRT can be increased by 4 to 10 hours with a meal that is high in proteins and fats.
7. Frequency of feed:- the GRT can increase by over 400 minutes, when successive meals are given compared with a
single meal due to the low frequency of MMC.
These systems are osmotically controlled floating systems containing a hollow deformable unit. There are two
chambers in the system first contains the drug and the second chamber contains the volatile liquid.
Matrix Tablets:-
Single layer matrix tablet is prepared by incorporating bicarbonates in matrix forming hydrocolloid gelling agent like
HPMC, chitosan, alginate or other polymers and drug. Bilayer tablet can also be prepared by gas generating matrix in
one layer and second layer with drug for its SR effect. Floating capsules also prepared by incorporating such
mixtures. Triple layer tablet also prepared having first swellable floating layer, second sustained release layer of 2
drugs (Metronidazole and Tetracycline) and third rapid dissolving layer of bismuth salt. This tablet is prepared as
single dosage form for Triple Therapy of H.Pylori.
systems[20,21] . The polymer is mixed with drugs and usually administered in hydrodynamically balanced system
capsule. The capsule shell dissolves in contact with water and mixture swells to form a gelatinous barrier, which
imparts buoyancy to dosage form in gastric juice for a long period. Because, continuous erosion of the surface allows
water penetration to the inner layers maintaining surface hydration and buoyancy to dosage form [21]. Incorporation of
fatty excipients gives low-density formulations reducing the erosion. Madopar LPR, based on the system was
marketed during the 1980s[22] . Effective drug deliveries depend on the balance of drug loading and the effect of
polymer on its release profile several strategies have been tried and investigated to improve efficiencies of the
floating hydrodynamically balanced systems[21,22].
Microballoons / Hollow microspheres:-
Microballoons / hollow microspheres loaded with drugs in their other polymer shelf were prepared by simple solvent
evaporation or solvent diffusion evaporation methods[21] (Figure 1) to prolong the gastric retention time (GRT) of the
dosage form. Commonly used polymers to develop these systems are polycarbonate, cellulose acetate, calcium
alginate, Eudragit S, agar and low methoxylated pectin etc. Buoyancy and drug release from dosage form are
dependent on quantity of polymers, the plasticizer polymer ratio and the solvent used for formulation. The
microballoons floated continuously over the surface of an acidic dissolution media containing surfactant for >12
hours [23]. At present hollow microspheres are considered to be one of the most promising buoyant systems because
they combine the advantages of multiple-unit system and good floating.
pores along its top and bottom walls[26] . The peripheral walls of the device were completely sealed to present any
direct contact of the gastric surface with the undissolved drug. In the stomach the floatation chamber containing
entrapped air causes the delivery system to float in the gastric fluid[27]. Gastric fluid enters through the aperture,
dissolves the drug and causes the dissolved drug for continuous transport across the intestine for drug absorption.
(c) Bioadhessive systems:-
Bio/mucoadhesive systems are those which bind to the gastric epithelial cell surface or mucin and serve as a potential
means of extending the Gastro retention of drug delivery system (DDS). in the stomach by increasing the intimacy
and duration of contact of drug with the biological membrane. A bio/muco-adhesive substance is a natural or
synthetic polymer capable of producingan adhesive interaction based on hydrationmediated, bondingmediated or
receptor mediated adhesion with a biological membrane or mucus lining of GI mucosa[28,29].
(g)Expandable system:-
After being swallowed, these dosage forms swell to a size that prevents their passage through the pylorus[32]. As a
result, the dosage form is retained in the stomach for a long period of time. These systems are sometimes referred to
as plug type systems because they tend to remain lodged at the pyloric sphincter. These polymeric matrices remain in
the gastric cavity for several hours even in the fed state. Sustained and controlled drug release may be achieved by
selecting a polymer with the proper molecular weight and swelling properties. As dosage form coming in contact
with gastric fluid, the polymer imbibes water and swells. The extensive swelling of these polymers is a result of the
presence of physical-chemical crosslinks in the hydrophilic polymer network. These cross-links prevent the
dissolution of the polymer and thus maintain the physical integrity of the dosage form. A balance between the extent
and duration of swelling is maintained by the degree of cross linking between the polymeric chains. A high degree of
crosslinking retards the swelling ability of the system and maintains its physical integrity for a prolonged period. On
the other hand, a low degree of cross-linking results in extensive swelling followed by the rapid dissolution of the
polymer[14]. An optimum amount of cross-linking is required to maintain a balance between swelling and dissolution.
The swollen system eventually will lose its integrity because of a loss of mechanical strength caused by abrasion or
erosion or will burst into small fragments when the membrane ruptures because of continuous expansion[33]. These
systems also may erode in the presence of gastric juices so that after a predetermined time the device no longer can
attain or retain the expanded configuration[14].
The expandable GRDFs are usually based on three configurations:
A small collapsed configuration which enables sufficient oral intake.
Expanded form that is achieved in the stomach and thus prevents passage through the pyloric sphincter.
A smaller form that is achieved in the stomach when the retention is no longer required i.e. after the GRDF has
released its active ingredient, thereby enabling evacuation.
The expansion can be achieved by
i) Swelling system
ii) Unfolding system
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Magnetic systems:-
This system is based on a simple idea that the dosage form contains a small internal magnet and a magnet placed on
the abdomen over the position of the stomach. Ito etal. used this technique in rabbits with bioadhesives granules
containing ultrafine ferrite (g-Fe2O3). They guided them to the esophagus with an external magnet (1700 G) for the
initial 2 min and almost all the granules were retained in the region after 2 h [34]. Although these systems seem to
work, the external magnet must be positioned with a degree of precision that might compromise patient compliance
[35]
.
Where,
F = resultant weight of object
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Df = Density of Fluid
DS = Density of Solid object
g = Gravitational force
M = Mass of dosage form
V = Volume of dosage form
when Ds, density of dosage form is lower, F force is positive gives buoyancy and when it is Ds is higher, F will
negative shows sinking.
ii) Swelling systems:-
a) Swelling Index:-
After immersion of swelling dosage form into SGF at 370C, dosage form is removed out at regular interval and
dimensional changes are measured in terms of increase in tablet thickness / diameter with time.
b) Water Uptake:-
It is an indirect measurement of swelling property of swellable matrix. Here dosage form is removed out at regular
interval and weight changes are determined with respect to time. So it is also termed asWeight Gain.
Water uptake = WU = (Wt Wo) * 100 / Wo
Where, Wt = weight of dosage form at time t.
Wo = initial weight of dosage form.
B) IN-Vitro Evaluation Test:-[39,41]
1. In vitro dissolution test is generally done by using USP apparatus with paddle and GRDDS is placed normally as
for other conventional tablets. But sometimes as the vessel is large and paddles are at bottom, there is much lesser
paddle force acts on floating dosage form which generally floats on surface. As floating dosage form not rotates may
not give proper result and also not reproducible results. Similar problem occur with swellable dosage form, as they
are hydrogel may stick to surface of vessel or paddle and gives irreproducible results. In order to prevent such
problems, various types of modification in dissolution assembly made are as follows.
2. To prevent sticking at vessel or paddle and to improve movement of dosage form, method suggested is to keep
paddle at surface and not too deep inside dissolution medium.
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