Abstract
Patients who are unable to receive oral medication (p.o.) are a major problem in outpatient settings, especially in home health care systems. Mucosal administration of drugs offers an alternative to the oral route, especially when the parenteral mode cannot be used. There are three main pathways of mucosal administration: sublingual/buccal, intranasal and rectal. We discuss the possibility of mucosal delivery of antihypertensive drugs. Perindopril arginine and Amlodipine besylate are registered in the EU as orodispersible tablets for oromucosal delivery, however, they are not available in all countries. For this reason, we describe other drugs suitable for mucosal delivery: Captopril and Nitrendipine in the sublingual system and Metoprolol tartrate, Propranolol and Furosemide by the transrectal route. Based on the published data and common clinical practice we discuss the use of mucosal delivery systems of all these antihypertensive drugs with special attention to their pharmacokinetics. We illustrate this mini-review with a case report of the prolonged-term use of mucosal delivery of sublingual Captopril and Nitrendipine combined with rectal Metoprolol tartrate and Furosemide in a patient with severe hypertension unable to receive medication p.o. This is also a report on the first human use of Furosemide-containing suppositories as well as prolonged-term transmucosal administration of these four drugs, describing a practical approach leading to successful control of severe hypertension with four antihypertensive drugs delivered via the mucosal route. The treatment was effective and without side effects; however, the long-term safety and efficacy of such therapy must be confirmed by randomized clinical trials.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 71-78 |
| Number of pages | 8 |
| Journal | Biomedical Papers |
| Volume | 162 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jun 1 2018 |
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Keywords
- Antihypertensive drugs
- Furosemide
- Metoprolol
- Mucosal drug delivery
- Suppositories
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
Cite this
Mucosal delivery systems of antihypertensive drugs : A practical approach in general practice. / Bialy, Lukasz P.; Wojcik, Cezary; Mlynarczuk-Bialy, Izabela.
In: Biomedical Papers, Vol. 162, No. 2, 01.06.2018, p. 71-78.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mucosal delivery systems of antihypertensive drugs
T2 - A practical approach in general practice
AU - Bialy, Lukasz P.
AU - Wojcik, Cezary
AU - Mlynarczuk-Bialy, Izabela
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Patients who are unable to receive oral medication (p.o.) are a major problem in outpatient settings, especially in home health care systems. Mucosal administration of drugs offers an alternative to the oral route, especially when the parenteral mode cannot be used. There are three main pathways of mucosal administration: sublingual/buccal, intranasal and rectal. We discuss the possibility of mucosal delivery of antihypertensive drugs. Perindopril arginine and Amlodipine besylate are registered in the EU as orodispersible tablets for oromucosal delivery, however, they are not available in all countries. For this reason, we describe other drugs suitable for mucosal delivery: Captopril and Nitrendipine in the sublingual system and Metoprolol tartrate, Propranolol and Furosemide by the transrectal route. Based on the published data and common clinical practice we discuss the use of mucosal delivery systems of all these antihypertensive drugs with special attention to their pharmacokinetics. We illustrate this mini-review with a case report of the prolonged-term use of mucosal delivery of sublingual Captopril and Nitrendipine combined with rectal Metoprolol tartrate and Furosemide in a patient with severe hypertension unable to receive medication p.o. This is also a report on the first human use of Furosemide-containing suppositories as well as prolonged-term transmucosal administration of these four drugs, describing a practical approach leading to successful control of severe hypertension with four antihypertensive drugs delivered via the mucosal route. The treatment was effective and without side effects; however, the long-term safety and efficacy of such therapy must be confirmed by randomized clinical trials.
AB - Patients who are unable to receive oral medication (p.o.) are a major problem in outpatient settings, especially in home health care systems. Mucosal administration of drugs offers an alternative to the oral route, especially when the parenteral mode cannot be used. There are three main pathways of mucosal administration: sublingual/buccal, intranasal and rectal. We discuss the possibility of mucosal delivery of antihypertensive drugs. Perindopril arginine and Amlodipine besylate are registered in the EU as orodispersible tablets for oromucosal delivery, however, they are not available in all countries. For this reason, we describe other drugs suitable for mucosal delivery: Captopril and Nitrendipine in the sublingual system and Metoprolol tartrate, Propranolol and Furosemide by the transrectal route. Based on the published data and common clinical practice we discuss the use of mucosal delivery systems of all these antihypertensive drugs with special attention to their pharmacokinetics. We illustrate this mini-review with a case report of the prolonged-term use of mucosal delivery of sublingual Captopril and Nitrendipine combined with rectal Metoprolol tartrate and Furosemide in a patient with severe hypertension unable to receive medication p.o. This is also a report on the first human use of Furosemide-containing suppositories as well as prolonged-term transmucosal administration of these four drugs, describing a practical approach leading to successful control of severe hypertension with four antihypertensive drugs delivered via the mucosal route. The treatment was effective and without side effects; however, the long-term safety and efficacy of such therapy must be confirmed by randomized clinical trials.
KW - Antihypertensive drugs
KW - Furosemide
KW - Metoprolol
KW - Mucosal drug delivery
KW - Suppositories
UR - http://www.scopus.com/inward/record.url?scp=85049090359&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049090359&partnerID=8YFLogxK
U2 - 10.5507/bp.2018.022
DO - 10.5507/bp.2018.022
M3 - Article
C2 - 29765168
AN - SCOPUS:85049090359
VL - 162
SP - 71
EP - 78
JO - Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
JF - Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
SN - 1213-8118
IS - 2
ER -