Mucosal delivery systems of antihypertensive drugs: A practical approach in general practice

Lukasz P. Bialy, Cezary Wojcik, Izabela Mlynarczuk-Bialy

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish (US)
Pages (from-to)71-78
Number of pages8
JournalBiomedical Papers
Volume162
Issue number2
DOIs
StatePublished - Jun 1 2018

Fingerprint

Mucosal Administration
Furosemide
General Practice
Antihypertensive Agents
Nitrendipine
Metoprolol
Captopril
Home health care
Pharmaceutical Preparations
Perindopril
Hypertension
Amlodipine
Suppositories
Pharmacokinetics
Cheek
Home Care Services
Propranolol
Tablets
Arginine
Outpatients

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 journalArticle

Bialy, Lukasz P. ; Wojcik, Cezary ; Mlynarczuk-Bialy, Izabela. / Mucosal delivery systems of antihypertensive drugs : A practical approach in general practice. In: Biomedical Papers. 2018 ; Vol. 162, No. 2. pp. 71-78.
@article{0a0f41863ed5425ab293aa4ab9acdd06,
title = "Mucosal delivery systems of antihypertensive drugs: A practical approach in general practice",
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.",
keywords = "Antihypertensive drugs, Furosemide, Metoprolol, Mucosal drug delivery, Suppositories",
author = "Bialy, {Lukasz P.} and Cezary Wojcik and Izabela Mlynarczuk-Bialy",
year = "2018",
month = "6",
day = "1",
doi = "10.5507/bp.2018.022",
language = "English (US)",
volume = "162",
pages = "71--78",
journal = "Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia",
issn = "1213-8118",
publisher = "Palacky University",
number = "2",

}

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 -