Sjams 48D 2976-2985
Sjams 48D 2976-2985
Sjams 48D 2976-2985
Review Article
*Corresponding author
Santosh Thorat
Email: [email protected]
Abstract: The intranasal delivery is preferable route for administration of the drug for local, systemic as well as central
nervous system drug delivery. Advantages of nasal spray dosage form such as it is cost-effective, easy to use/carry and
self-administrable, it has high patient compliance make this dosage form growing opportunity for nasal drug
delivery. This article outlined the relevant aspects of nasal anatomy, physiology and histology, and the biological,
physicochemical and pharmaceutical factors that must be considered during the formulation development of nasal spray.
It is intuitively expected that this review will help to understand nasal formulation and it’s in- vitro characteristics.
Keywords: Nasal Spray, Nasal drug delivery system, formulation and in-vitro characterization.
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Limitations: but, at the same time, the absorption of substances
1. Dose is limited because of relatively small area including drugs becomes very difficult in this region.
available for the absorption of drug.
2. Time available for drug absorption is limited. 2) Atrium
3. Diseased condition of nose impairs drug Atrium is the intermediate area between nasal
absorption. vestibule and respiratory region. Its anterior section is
4. The absorption enhancers used to improve constituted by a stratified squamous epithelium and the
nasal drug delivery system may have posterior area by pseudostratified columnar cells
histological toxicity which is not yet clearly presenting microvilli.
established.
5. Absorption surface area is less when compared 3) Respiratory region
to GIT. It is divided in superior, middle and inferior
6. Nasal irritation turbinate’s which are projected from the lateral wall.
7. Certain surfactants used as chemical enhancers These specialized structures are responsible for
may disrupt and even dissolve Membrane in humidification and temperature regulation of inhaled
high concentration. air. Between them there are spaces, called meatus,
which are passageways where airflow is created to
Nasal Anatomy and Physiology [3, 4]: assure a close contact of the inhaled air with the
Nasal cavity is lined with mucus layer and hairs respiratory mucosal surface. The inferior and middle
which are involved in those functions, trapping inhaled meatus receive nasolacrimal ducts and paranasal sinuses
particles and pathogens. Moreover, resonance of which are air-filled pockets located inside the bones of
produced sounds, mucociliary clearance MMC, the face and around the nasal cavity. The nasal
immunological activities and metabolism of respiratory mucosa, considered the most important
endogenous substances are also essential functions of section for delivering drugs systemically, is constituted
nasal structures. The human nasal cavity has a total by the epithelium, basement membrane and lamina
volume of 15-20 mL and a total surface area of propria. Nasal mucus is indispensable for several
approximately 150 cm2. The nasal halves consist of four physiological functions, such as humidification and
areas (nasal vestibule, atrium, respiratory region and warming of the inhaled air, and also offers physical and
olfactory region) that are distinguished according to enzymatic protection of the nasal epithelium against
their anatomic and histological characteristics (Figure 1; several foreign compounds, including drugs. The
Table 1). presence of mucin in the nasal mucus layer is crucial
because it may trap large molecular weight drugs, such
1) Nasal vestibule as peptides and proteins. Beneath of it, there is the
In this area of nasal cavity, there are nasal hairs, lamina propria which is richly supplied with blood
also called vibrissae, which filter the inhaled particles. vessels, including many very permeable fenestrated
Nasal vestibular characteristics are desirable to afford capillaries, nerves, glands and immune cells. The last
high resistance against toxic environmental substances ones produce immunoglobulin an antibodies that confer
immunological protection against bacteria and virus.
4) Olfactory region
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The olfactory region is located in the roof of the environment. Similarly to the respiratory epithelium,
nasal cavity and extends a short way down the Septum the olfactory one is also pseudostratified but contains
and lateral wall. Its neuroepithelium is the only part of specialized olfactory receptor cells important for smell
the CNS that is directly exposed to the external perception.
Different factors affecting nasal drug absorption [4- increased permeability of a compound is due to
5] parasympathetic stimulation.
Various factors affect bioavailability of nasally
administered drugs as follows; 2) Nasal secretions
Nasal secretions are produced by anterior serous and
A) Biological factors seromucus glands. The permeability of drug through the
1) Structural features: There are five different sections nasal mucosa is affected by:
of nasal cavity: nasal vestibule, atrium, respiratory area, • Viscosity of nasal secretion: The viscous surface layer
olfactory region and the nasopharnyx. These structures will inhibit the ciliary beating if the sol layer of mucus
and the type of cells, density and number of cells is too thin and mucociliary clearance is impaired if sol
present in that region influence the permeability. layer is too thick, because contact with cilia is lost.
Absorption enhancers used in combination with drugs Permeation of the drug is affected due to impairment of
increase the permeation of compounds. mucociliary clearance by altering the time of contact of
drug and mucosa.
2) Biochemical changes: Enzymatic barrier to the • Solubility of drug in nasal secretions: For permeation
delivery of drugs is nasal mucosa because of the of drug solublisation is necessary. A
presence of a large number of enzymes, which include drug needs to have appropriate physicochemical
oxidative and conjugative enzymes, peptidases and characteristics for dissolution in nasal secretions.
proteases. Protease and peptidase were responsible for • pH of nasal cavity variation in pH is observed
the presystemic degradation and subsequent lower between 5.5–6.5 in adults and 5.0–7.0 in infants.
permeation of various peptide drugs, such as calcitonin, Permeation of drug is greater if the nasal pH is lower
insulin, LHRH and desmopressin. To overcome these than pKa of drug because under such conditions the
degradations use of protease and peptidase inhibitors penetrant molecules exist as unionized species.
such as bacitracin, amastatin, boroleucin and puromycin
can be used. 3) Mucociliary clearance (MCC) and ciliary beating
Whenever a substance is nasally administered, it is
B) Physiological factors cleared from the nasal cavity in ~21 min by MCC
1) Blood supply and neuronal regulation because mucociliary clearance is the normal defense
Nasal mucosa is highly permeable site. High mechanism of the nasal cavity which clears substances
blood supply due to parasympathetic stimulation gives adhering to nasal mucosa and cleared in GIT by
congestion and low blood supply due to sympathetic draining into nasopharynx. Drug permeation is
stimulation gives relaxation, regulate the rise and fall in enhanced by increasing contact time between drug and
the amounts of drug permeated, respectively. Based on mucus membrane because reduced MMC.
the above observations, we can conclude that the
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4) Pathological conditions: an increase in lipophilicity or the partition coefficient of
Mucociliary disfunctioning, hypo or hypersecretions, the drugs its concentration in biological tissues
irritation of the nasal mucosa occurs due to diseases increases. The absorption rate of aminopyrine increased
such as the common cold, rhinitis, atrophic rhinitis and with the increase in pH and was found to fit well to the
nasal polyposis, and drug permeation is affected by theoretical profile Major factor governing nasal
this. absorption is partition coefficient.
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dissolved or suspended in solutions or mixtures of
excipients (e.g., preservatives, viscosity modifiers, 2) Excipients used in nasal spray formulations[7]
emulsifiers, buffering agents) in nonpressurized There are various types of excipients used in nasal
dispensers that deliver a spray containing a metered formulations. Commonly used and frequently added
dose of the active ingredient. The dose can be metered excipients are as follows:
by the spray pump. A nasal spray unit can be designed a) Buffers: Nasal secretions may alter the pH of
for unit dosing or can discharge up to several hundred the administrated dose which can affect the
metered sprays of formulation containing the drug concentration of un-ionized drug available for
substance. Nasal sprays are applied to the nasal cavity absorption. Therefore, an adequate formulation
for local and/or systemic effects. Although similar in buffer capacity may be required to maintain
many features to other drug products, some aspects of the pH in-situ. Examples of buffer used in
nasal sprays may be unique (e.g., formulation, container nasal spray sodium phosphate, Sodium citrate,
closure system, manufacturing, stability, and drug citric acid.
product). Metering and spray producing (e.g., orifice, b) Solubilizers: Aqueous solubility of drug is
nozzle, jet) pump mechanisms and components are used always a limitation for nasal drug delivery in
for reproducible delivery of drug formulation, and these solution. Conventional solvents or co-solvents
can be constructed of many parts of different design such as glycols, small quantities of alcohol,
that are precisely controlled in terms of dimensions and Transcutol (diethylene glycol monoethyl
composition. Energy is required for dispersion of the ether), medium chain glycerides and Labrasol
formulation as a spray. This is typically accomplished (saturated polyglycolyzed C8- C10 glyceride)
by forcing the formulation through the nasal actuator can be used to enhance the solubility of drugs.
and its orifice. The formulation and the container Other compounds can be used like, the use of
closure system (container, closure, pump, and any surfactants or cyclodextrins such as HP–s-
protective packaging) collectively constitute the drug Cyclodextrin that serve as a biocompatible
product. The design of the container closure system solubilizer and stabilizer in combination with
affects the dosing performance of the drug product. lipophilic absorption enhancers. In these cases,
Both solution and suspension formulations can be their impact on nasal irritancy should be
formulated into nasal sprays. considered.
c) Preservatives: Most nasal formulations are
aqueous based so needs preservatives to
prevent microbial growth. Parabens, phenyl
ethyl alcohol, benzalkonium chloride, EDTA
and benzoyl alcohol are some of the
commonly used preservatives in nasal
formulations.
d) Antioxidants: A small quantity of
antioxidants may be required to prevent drug
oxidation. Commonly used antioxidants are
sodium bisulfite, butylated hydroxytoluene,
sodium metabisulfite and tocopherol. Usually,
antioxidants do not affect drug absorption or
Fig-2: Nasal spray (Dymista®) cause nasal irritation.
e) Humectants Because of allergic and chronic
1) Active Pharmaceutical Ingredient diseases there can be crusts and drying of
An ideal nasal drug candidate should possess the mucous membrane. Certain preservatives/
following attributes: antioxidants are also likely to cause nasal
• Appropriate aqueous solubility to provide the irritation especially when used in higher
desired dose in a 25–150 ml volume of quantities. Adequate intranasal moisture is
formulation. essential for preventing dehydration.
• Appropriate nasal absorption properties. Therefore, humectants can be added especially
• No nasal irritation from the drug. in gel-based nasal products. Humectants avoid
• A suitable clinical rationale for nasal dosage nasal irritation and do not affect drug
forms, e.g. rapid onset of action. absorption. Common examples include
• Low dose. Generally, below 25 mg per dose. glycerin, sorbitol and mannitol.
• No toxic nasal metabolites. f) Surfactants Surfactant incorporation into
• No offensive odors/aroma associated with the nasal dosage forms can modify the
drug. permeability of nasal membranes, which may
• Suitable stability characteristics. facilitate the nasal absorption of drug. It also
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increase stability of suspension. Common a polymer material is dependent on the nature
examples include Polysorbet. of the polymer, the surrounding medium (pH),
g) Bioadhesive polymers Compound that is swelling and physiological factors (mucin
capable of interacting with biological material turnover, disease state). From a safety (nasal
through interfacial forces and being retained irritancy) point of view use of a combination
on such material for prolonged periods of time of carriers is often recommended.
is called as bioadhesive polymer. They are also h) Penetration enhancer Chemical penetration
called as mucoadhesive if biological material enhancers are widely used in the nasal drug
is mucus membrane. The bioadhesive force of delivery.
3) Metered-dose spray pumps and introduced for delivery of fluticasone furoate for
Metered spray pumps have, since they were the indication of seasonal and perennial allergic rhinitis.
introduced some four decades ago, dominated the nasal The pump was designed with a shorter tip to avoid
drug delivery market. The pumps typically deliver 100 contact with the sensitive mucosal surfaces. New
μl (25– 200 μl) per spray, and they offer high designs to reduce the need for priming and re-priming,
reproducibility of the emitted dose and plume geometry and pumps incorporating pressure point features to
in in vitro tests. The particle size and plume geometry improve the dose reproducibility and dose counters and
can vary within certain limits and depend on the lock-out mechanisms for enhanced dose control and
properties of the pump, the formulation, the orifice of safety are available.
the actuator, and the force applied. Traditional spray
pumps replace the emitted liquid with air, and A simple variant of a single-dose spray device
preservatives are therefore required to prevent (MAD) is offered by LMA (LMA, Salt Lake City, UT,
contamination. However, driven by the studies USA. A nosepiece with a spray tip is fitted to a standard
suggesting possible negative effects of preservatives, syringe. The liquid drug to be delivered is first drawn
pump manufacturers have developed different spray into the syringe and then the spray tip is fitted onto the
systems that avoid the need for preservatives. More syringe.
recently, pumps have been designed with side-actuation
Table 3: Nasal drug products for systemic drug delivery in the market
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Drug Substance Indication Dosage form Status Manufacturer
(Product name)
proteins and peptides for systemic drug delivery
Salmon calcitonin Osteoporosis Solution (spray) Marketed Novartis Pharma
(Karil 200 I.E.)
Desmopressin Antidiuretic hormone Solution (spray) Marketed Ferring Arzneimitted
(Minirin Nasenspray)
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Use for vaccination, especially against respiratory delivery through nasal route into CNS has been reported
infections, has been extensively evaluated. It is able to for Alzheimer’s disease, brain tumors, epilepsy, pain
enhance the systemic levels of specific immunoglobulin and sleep disorders.
G and nasal secretary immunoglobulin A. Examples of
the human efficacy of intranasal vaccines include those CONCLUSION
against influenza A and B virus, proteosoma‐influenza, Considering the potential benefits from nasal
adenovirus‐vectored influenza, group B meningococcal route of administration, we should expect to see a range
native, attenuated respiratory syncytial virus and of novel nasal products reaching the market in the near
parainfluenza 3 virus. future. They will include not only drugs for local
treatment but also for systemic protection against
3) Liposomes infections. The development of drugs for directly target
Liposomal drug delivery systems present various the brain in order to attain a good therapeutic effect in
advantages such as the effective encapsulation of small CNS with reduced systemic side effects. Nasal drug
and large molecules with a wide range of hydrophilicity delivery can be affected by several factors e.g.
and pKa values. In fact, they have been found to Biological Factors, Physiological factors,
enhance nasal absorption of peptides such as insulin and Physicochemical Properties of Drugs, Physicochemical
calcitonin by increasing their membrane penetration. Properties of Formulation. Nasal spray drug products
This has been attributed to the increasing nasal retention contain active ingredients dissolved or suspended in
of peptides, protection of the entrapped peptides from solutions or mixtures of excipients in nonpressurized
enzymatic degradation and mucosal membrane dispensers that deliver a spray containing a metered
disruption. Moreover, liposomal drug delivery systems dose of the active ingredient. Critical characterization
were also reported as useful for influenza vaccine and test for nasal spray includes spray pattern, droplet size
non-peptide drugs such as nifedipine. distribution, Spray Content Uniformity these depend on
formulation as well as device properties.
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