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MOUTH DISSOLVING TABLETS: A NOVEL APPROACH TO DRUG DELIVERY
TEJVIR KAUR1, BHAWANDEEP GILL2, SANDEEP KUMAR3, G.D. GUPTA3
1Lecturer, Department of Pharmacy, Government Medical College, Patiala, Rayat & Bahara College of Pharmacy, Kharar, HOD
Pharmaceutics, Department of Pharmaceutics, ASBASJSM College of Pharmacy, Bela, Ropar Punjab 140111 India Email:
tejvironnet@gmail.com, gillbhawan84@gmail.com, Mr.sandeep1970@rediffmail.com, drgdg@rediffmail.com
Received: 17 July 2010, Revised and Accepted: 22 Aug 2010
ABSTRACT
Recent advances in Novel Drug Delivery Systems (NDDS) aim for designing dosage forms, convenient to be manufactured and administered, free of
side effects, offering immediate release and enhanced bioavailability, so as to achieve better patient compliance. Though oral drug delivery systems,
preferably, tablets are the most widely accepted dosage forms, for being compact, offering uniform dose and painless delivery. Yet, dysphagia is the
most common disadvantage of conventional tablets. This is seen to afflict nearly 35% of the general population and associated with a number of
conditions, like parkinsonism, mental disability, motion sickness, unconsciousness, unavailability of water etc. To overcome such problems, certain
innovative drug delivery systems, like ‘Mouth Dissolving Tablets’ (MDT) have been developed. These are novel dosage forms which dissolve in
saliva within a few seconds, when put on tongue. Such MDTs can be administered anywhere and anytime, without the need of water and are thus
quite suitable for children, elderly and mentally disabled patients.
Keywords: Mouth dissolving tablets, MDT.
INTRODUCTION within a few seconds without the need of drinking water or chewing.
A mouth dissolving tablet usually dissolves in the oral cavity within
Drug Delivery Systems (DDS) are a strategic tool for expanding 15 s to 3 min. Most of the MDTs include certain super disintegrants
markets/indications, extending product life cycles and generating and taste masking agents.
opportunities. DDS make a significant contribution to global
pharmaceutical sales through market segmentation, and are moving Ideal properties of MDT
rapidly. Drug delivery systems are becoming increasingly
sophisticated as pharmaceutical scientists acquire a better A Mouth Dissolving Tablet should
understanding of the physicochemical and biochemical parameters a. Not require water or other liquid 5 to swallow.
pertinent to their performance. b. Easily dissolve or disintegrate in saliva within a few seconds.
Despite of tremendous advancements in drug delivery, the oral c. Have a pleasing taste.
route remains the perfect route for the administration of therapeutic d. Leave negligible or no residue in the mouth when
agents because of low cost of therapy, ease of administration, administered.6
accurate dosage, self‐medication, pain avoidance, versatility, leading e. Be portable and easy to transport.
to high levels of patient compliance. Tablets and capsules are the f. Be able to be manufactured in a simple conventional manner
most popular dosage forms.1 But one important drawback of such within low cost.
dosage forms is ‘Dysphagia’ or difficulty in swallowing. This is seen g. Be less sensitive to environmental conditions like
to afflict nearly 35% of the general population. This disorder is also temperature, humidity etc.6, 7
associated with a number of conditions like: Advantages of MDT
1. Parkinsonism a. No need of water to swallow the tablet.8
2. Motion sickness
3. Unconsciousness b. Can be easily administered to pediatric, elderly and mentally
4. Elderly patients disabled patients.
5. Children
c. Accurate dosing9 as compared to liquids.
6. Mentally disabled persons
7. Unavailability of water.2 d. Dissolution and absorption of drug is fast, offering rapid onset
of action.
Improved patient compliance has achieved enormous demand.
Consequently demand for their technologies is also increasing many e. Bioavailability of drugs is increased10as some drugs are
folds. To develop a chemical entity, a lot of money, hard work and absorbed from mouth, pharynx and esophagus through saliva
time are required. So focus is rather being laid on the development passing down into the stomach11
of new drug delivery systems for already existing drugs, with
enhanced efficacy and bioavailability, thus reducing the dose and f. Advantageous over liquid medication in terms of
dosing frequency to minimize the side effects.3 administration as well as
It is always the aim of a scientist or a dosage form designer to g. transportation
enhance the safety of a drug molecule while maintaining its
h. First pass metabolism is reduced, thus offering improved
therapeutic efficacy. Recent advances in Novel Drug Delivery
bioavailability and thus reduced dose and side effects.
Systems (NDDS) aim for the same by formulating a dosage form,
convenient to be administered so as to achieve better patient i. Free of risk of suffocation due to physical obstruction when
compliance. Pharmaceutical technologists have put in their best swallowed, thus
efforts to develop a Fast Dissolving Drug Delivery System 4, i.e Mouth
Dissolving Tablet. j. offering improved safety.
It is a tablet that disintegrates and dissolves rapidly in the saliva, b. Allows high drug loading.13
Kaur et al.
Int J Curr Pharm Res, Vol 3, Issue1, 17
Fig. 1.1: Advantages of MDT Fig. 1.2: Mechanism of Action of Superdisintegrants
[
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Int J Curr Pharm Res, Vol 3, Issue1, 17
Fig.1.3: Disintegration of Tablet by Wicking and Swelling Fig. 1.4: Disintegration by Deformation and Repulsion
c. Because of heat of wetting (air expansion) This increase in size of the deformed particles produces a break up
of the tablet. This may be a mechanism of starch and has only
When disintegrants with exothermic properties gets wetted, recently begun to be studied.
localized stress is generated due to capillary air expansion, which
helps in disintegration of tablet. This explanation, however, is Sugar based excipients: Sugar based excipients are used for taste
limited to only a few types of disintegrants and can not describe the masking and as bulking agents. Most of the dugs are having
action of most modern disintegrating agents. unpleasant or bitter taste. And the basic requirement for designing
MDTs is that the drug should not have disagreeable taste. So taste
d. Due to release of gases masking is necessary in most of the cases. Sorbitol, mannitol, xylitol,
Carbon dioxide released within tablets on wetting due to interaction dextrose, fructose, etc. are mainly used. Aqueous solubility and
between bicarbonate and carbonate with citric acid or tartaric acid. sweetness impart a pleasing mouth feel and good taste masking.19
The tablet disintegrates due to generation of pressure within the But not all sugar‐based materials have fast dissolution rate and good
tablet. This effervescent mixture is used when pharmacist needs to compressibility or compactability. However technologies have been
formulate very rapidly dissolving tablets or fast disintegrating developed to make use of the sugar based excipients in the design of
tablet. As these disintegrants are highly sensitive to small changes in fast dissolving tablets.
humidity level and temperature, strict control of environment is
Other ingredients commonly used are water soluble diluents,
required during manufacturing of the tablets. The effervescent blend
lubricants, antistatic agents, plasticizers, binders, colors and flavors.
is either added immediately prior to compression or can be added in
to two separate fraction of formulation. Approaches for preparation of MDT 20
e. By enzymatic reaction Various technologies used in the manufacture of Mouth Dissolving
Tablets include:
Here, enzymes present in the body act as disintegrants. These
enzymes destroy the binding action of binder and helps in 1. Freeze‐drying or lyophilization
disintegration. 2. Sublimation
3. Spray drying
Actually due to swelling, pressure exerted in the outer direction or
4. Moulding
radial direction, it causes tablet to burst or the accelerated
5. Mass extrusion
absorption of water leading to an enormous increase in the volume
6. Direct compression
of granules to promote disintegration.
Freezedrying21: The tablets prepared by freeze‐drying or
f. Due to disintegrating particle/particle repulsive forces
lyophilization are very porous in nature and disintegrate or dissolve
Another mechanism of disintegration attempts to explain the rapidly when come in contact with saliva. In this process, water is
swelling of tablet made with ‘non‐swellable’ disintegrants. Guyot‐ sublimated from the product after freezing. First of all, the material
Hermann has proposed a particle repulsion theory based on the is frozen to bring it below its eutectic point. Then primary drying is
observation that nonswelling particle also cause disintegration of carried out to reduce the moisture to around 4% w/w of dry
tablets. The electric repulsive forces between particles are the product. Finally, secondary drying is done to reduce the bound
mechanism of disintegration and water is required for it. moisture to the required volume. Due to lyophilization, bulking
Researchers found that repulsion is secondary to wicking. agent and sometimes drug acquire glossy amorphous structure and
thus dissolution is enhanced. A tablet that rapidly disintegrates in
g. Due to deformation
aqueous solution includes a partially collapsed matrix network that
Hess had proved that during tablet compression, disintegranted has been vacuum dried above the collapsed temperature of the
particles get deformed and these deformed particles get into their matrix. The matrix is partially dried below the equilibrium freezing
normal structure when they come in contact with aqueous media or point of the matrix. Vacuum drying the tablet above its collapse
water. Occasionally, the swelling capacity of starch was improved temperature, instead of freeze drying below its collapse temperature
when granules were extensively deformed during compression. provides a process for producing tablets with enhanced structural
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Int J Curr Pharm Res, Vol 3, Issue1, 17
integrity, while rapidly disintegrating in normal amounts of saliva. breakage or erosion during handling and opening of blister packs.30
However the use of freeze‐drying is limited due to high cost of However, adding sucrose, acacia or polyvinyl pyrrolidone can
equipment and processing. Other major disadvantages of the final increase mechanical strength.
dosage forms include lack of physical resistance in standard blister
packs. Mass extrusion31,32: In this technique, a blend of active drug and other
ingredients is softened using solvent mixture of water soluble
Sublimation: This process involves addition of some inert volatile polyethylene glycol, using methanol and then the softened mass is
substances like urea, urethane, naphthalene, camphor, etc to other extruded through the extruder or syringe to get a cylinder of product,
excipients and the compression of blend into tablet. Removal of which is finally cut into even segments with the help of heated blades
volatile material22 by sublimation creates pores in tablet structure, to get tablets. The dried cylinder can be used to coat the granules of
due to which tablet dissolves when comes in contact with saliva. bitter tasting drugs and thereby masking their bitter taste.
Additionally several solvents like cyclohexane, benzene etc can also
be used as pore forming agents. Mouth dissolving tablets with highly Direct compression: The disintegrant addition technology33,34
porous structure and good mechanical strength have been (direct compression) is the most preferred technique to
developed by this method.23, 24 manufacture the tablets due to certain advantages:
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Int J Curr Pharm Res, Vol 3, Issue1, 17
requiring low amounts of active drug. This technology uses drug, the spinning head that flings the floss. The produced floss is
fillers and a lubricant to prepare the tablet. Conventional tabletting amorphous in nature. So by various techniques, it is further chopped
equipment is used to prepare the tablet. Due to higher force of and recrystallised to provide a uniform flow, thus facilitate blending.
compaction used, tablets prepared are rigid. Dosage form can be Then the recrystallised matrix, active drug and other excipients are
packaged into conventional packaging system like blisters.
blended together and finally compressed into tablets. Active drug
and other excipients may be blended with the floss before
Wowtab technology: Yamanauchi pharmaceutical company recrystallising it.
patented this technology. ‘wow’ means ‘without water’. The active
ingredients may constitute upto 50% w/w of the tablet. In this Ceform technology: This technology involves preparation of
technique, saccharides of both low and high mouldability are used to microspheres of the active drug. Drug material alone or in
prepare the granules. Mouldability is the capacity of a compound to combination with other pharmaceutical substances,
be compressed.
and excipients is placed into a precision engineered rapidly spinning
Highly mouldable substance has high compressibility and thus machine. The centrifugal force comes into action, which throws the
shows slow dissolution. The combination of high and low dry drug blend at high speed through small heated openings. Due to
mouldability is used to produce tablets of adequate hardness. Active the heat provided by carefully controlled temperature, drug blend
ingredients are mixed with low mouldability saccharides and then liquefies to form a sphere, without affecting the drug stability.
granulated with high mouldabiity saccharides and then compressed
into tablet. The Wowtab product dissolves quickly in 15 s or less. The microspheres thus formed are compressed into tablets. As the
Wowtab product can be packed in both into conventional bottle and drug and excipients both can be processed simultaneously, it creates
blister packs.37 a unique microenvironment in which the materials can be
incorporated into the microspheres that can alter the characteristics
Flashdose Technology: This technology is patented by Fuisz. This of the drug, such as enhancing solubility and stability.
system uses the combination of both Shearform and Ceform
technologies in order to mask the bitter taste of the drug. A sugar Nanocrystal technology39: For MDT, Elan's proprietary
based matrix, called ‘Floss’ is used, which is made up of a NanoCrystal technology can enable formulation and improve
combination of excipients (crystalline sugars) alone or in compound activity and final product characteristics.
combination with drugs. Nurofen meltlet, a new form of Ibuprofen, Decreasing particle size increases the surface area, which leads to an
as a mouth‐dissolving tablet is the first commercial product increase in dissolution rate. This can be accomplished predictably
prepared by this technology and launched by Biovail Corporation. and efficiently using NanoCrystal technology. NanoCrystal particles
Drawbacks: are small particles of drug substance, typically less than 1000
nanometers (nm) in diameter, which are produced by milling the d
a. The dosage form can accommodate only up to 600 mg of drug. For fast dissolving tablets, Elan's proprietary NanoCrystal
technology can enable formulation and improve compound activity
b. Tablets produced are highly friable, soft and moisture sensitive. and final product characteristics. Decreasing particle size increases
Therefore specialized packing is required. the surface area, which leads to an increase in dissolution rate. This
Flashtab technology 38: Prographarm labs. have a patent over this can be accomplished predictably and efficiently using NanoCrystal
technology. In this technology, microgranules of the taste‐masked technology.
active drug are used. These may be prepared by using conventional NanoCrystal™ Fast dissolving technology provides for:
techniques like coacervation, microencapsulation, and extrusion‐
spheronisation. All these processes utilize conventional tabletting a. Pharmacokinetic benefits of orally administered nanoparticles
technology. These taste‐masked micro crystals of active drug, (<2 microns) in the form of a rapidly disintegrating tablet
disintegrating agent, a swelling agent and other excipients like matrix
soluble diluents etc are compressed to form a multiparticulate tablet b. Exceptional durability, enabling use of conventional packaging
that disintegrates rapidly. equipment and formats (i.e., bottles and/or blisters).
c. Wide range of doses (up to 200mg of API per unit).
Shearform Technology: In this technology, a shearform matrix, d. Employment of non moisture sensitive substances
‘Floss’ is prepared. Feedstock prepared with a sugar carrier is
subjected to flash heat processing. In this process, sugar is NanoCrystal colloidal dispersions of drug substance are combined
simultaneously subjected to centrifugal force and to a temperature with water‐soluble GRAS (Generally Regarded As Safe) ingredients,
gradient, which causes the temperature of the mass to rise and filled into blisters, and lyophilized. The resultant wafers are
hence an internal flow condition is created, permitting part of it to remarkably robust, yet dissolve in very small quantities of water in
move with respect of the mass. The flowing mass comes out through seconds.
Table 1.1: Comparison of fast dissolving techniques
ZYDIS (R.P. SCHERER, INC.)
Novelty Handling/Storage Drug release/bioavailability
First to market Do not push tablet through foil Dissolves in 2 ‐10 s
Freeze Dried Do not use dosage form from damaged package May allow for pre‐gastric absorption
leading to enhanced bioavailability
Sensitive to degradation at humidities > 65%
ORASOLV (CIMA LABS, INC.)
Unique taste masking Packaged in patented oil packs Disintegrates in 5 – 45 s depending upon
the size of the tablet
Lightly compressed No significant change in drug bioavailability
DURASOLV (CIMA LABS, INC.)
Similar to Orasolv, but with better Packaged in foil or bottles Disintegrates in 5 – 45 s depending upon
mechanical strength the size of the tablet
Package in bottles No significant change in drug bioavailability
WOWTAB (YAMANOUCHI PHARMA TECHNOLOGIES, INC.)
Compressed dosage form Avoid exposure to moisture or humidity. Disintegrates in 5 – 45 s depending upon
the size of the tablet
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Int J Curr Pharm Res, Vol 3, Issue1, 17
Table 1.2: Some of Promising Drug Candidates for Mouth Dissolving Tablets40
S. No. Category Examples
1. Antibacterial agents Ciprofloxacin, tetracycline, erythromycin, rifampicin, penicillin, doxycyclin, nalidixic acid,
trimethoprim, sulphacetamide, sulphadiazine etc.
2. Anthelmintics Albendazole, mebendazole, thiabendazole, livermectin, praziquantel, pyrantel embonate,
dichlorophen etc.
3. Antidepressants Trimipramine maleate, nortriptyline HCl, trazodone HCl, amoxapine, mianserin HCl, etc.
4. Antidiabetics Glibenclamide, glipizide, tolbutamide, tolazamide, gliclazide, chlorpropamide etc.
Analgesics/anti‐inflammatory Diclofenac sodium, ibuprofen, ketoprofen, mefenamic acid, naproxen, oxyphenbutazone,
5. agents indomethacin, piroxicam, phenylbutazone, etc.
6. Antihypertensives: Amlodipine, carvedilol, diltiazem, felodipine, minoxidil, nifedipine, prazosin HCl, nimodipine,
terazosin HCl etc.
7. Antiarrhythmics Disopyramide, quinidine sulphate, amiodarone HCl, etc.
8. Antihistamines Acrivastine, cetrizine, cinnarizine, loratadine, fexofenadine, triprolidine, etc.
Anxiolytics, sedatives hypnotics and Alprazolam, diazepam, clozapine, amylobarbitone, lorazepam, haloperidol, nitrazepam ,
9. neuroleptics midazolam phenobarbitone, thioridazine, oxazepam, etc.
10. Diuretics Acetazolamide, clorthiazide, amiloride, furosemide, spironolactone, bumetanide, ethacrynic
acid, etc.
11. Gastro‐intestinal agents Cimetidine, ranitidine HCl, famotidine, domperidone, omeprazole, ondansetron HCl,
granisetron HCl, etc.
12. Corticosteroids Betamethasone, beclomethasone, hydrocortisone, prednisone, prednisolone, methyl
prednisolone, etc.
13. Antiprotozoal agents metronidazole, tinidazole, omidazole, benznidazole, clioquinol, decoquinate etc.
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