PHA619 – LEC
PHARMACEUTICAL DOSAGE FORM, DRUG DELIVERY
SYSTEM, AND MEDICAL DEVICES
Chapter 9: MODIFIEDD-RELEASE DOSAGE FORMS AND DRUG
DELIVERY SYSTEMS
- Definition
- Differentiate the following dosage forms:
o Extended-release
o Delayed-release
o Repeat action
o Targeted release
- Advantages and disadvantages of extended release
dosage forms over conventional forms
- Characteristics of drugs best suited for incorporation
into an extended release product
- Mechanisms by which drug action are achieved
- Explanation of 3 ways by which the rate of drug
release from the solid dosage forms be modified
- Explanation of the different technologies employed
in the modification of drug release rate. Give the
products employing these modifications:
o Coated beads, pellets, granules,
microspheres
o Multi-tablet system
o Microencapsulated drugs
o Embedding drug in slowly
eroding/hydrophilic matrix system
o Embedding drug in inert plastic matrix
o Complex formation
o Ion-exchange resins
o Osmotic pump
- Reasons why drugs must remain intact until it
reaches the intestines? How are these be achieved?
- Development of an IVIVC model
- Clinical considerations in the use of oral modified-
release dosage forms
- How extended drug action is achieved by routes
other than oral administration
- Chapter 20 – Novel and Advanced Dosage Forms,
Delivery Systems and Devices pp 737-750
o In ocular drug products
o Parenteral system
o Vaginal inserts
o Subdermal implants
Modified-release dosage forms
- With drug release features based on time, course,
and/or location to accomplish therapeutic or
convenience objectives
- No offered by conventional or immediate-release
forms
- Differentiated into:
o Extended release
o Delayed release
Extended Release
- Allows a reduction in dosing frequency from the
necessitated by a conventional dosage forms, such
as a solution of an immediate-release dosage form
U.S. Food and Drug Administration (FDA)
- Tablets & capsules
o Taken once or twice daily
- Provides immediate release of drug:
o Provides promptly desired therapeutic
effect
o Followed by gradual and continual release
of additional amounts of drug maintaining
effect over predetermined period of time
Delayed Release
- Release the drug at a time other than promptly after
administration
- Delays is time based or based on the influence of
environmental conditions, like gastrointestinal pH
- Example:
o Enteric coating Aspirin
Examples of Proprietary Modified-Release Oral Dosage Form
Delayed Release – Prilosec (Omeprazole)
- Enteric coated granules of Omeprazole placed in
capsules
- Omeprazole
o Is acid liable and is degraded by gastric acid
o Use: treatment of duodenal ulcer
Modified-Release Dosage Forms
Repeat Action
- Contains two single doses of medication:
o One – for immediate release
o Second – for delayed release
- Example:
o Two layered tablets
 One drug layer for immediate
release
 Second layer for release of drug
later as a second dose/in an
extended release manner
Targeted Release
- Release towards isolating or concentrating a drug in
body
- Region, tissue, or site for absorption or for drug
action
ADVANTAGES OF EXTENDED-RELEASE DOSAGE FORMS OVER
CONVENTIONAL FORMS
- Less fluctuation in drug blood levels
- Frequency reduction in dosing
- Enhanced convenience and compliance
- Reduction in adverse side effects
- Reduction in overall health care costs
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DISADVANTAGES OF EXTENDED-RELEASE DOSAGE FORMS
- Loss of flexibility in adjusting the drug dose and/or
dosage regimen
- Risk of sudden and total drug release/dose dumping
due to failure of technology
Characteristics of drugs best suited for incorporation into an
extended release product
1. They exhibit nether very slow nor very fast rates of
absorption and excretion.
2. They are uniformly absorbed from the
gastrointestinal tract.
3. They are administered in relatively small doses.
4. They possess a good margin of safety.
5. They are used in the treatment of chronic rather
than acute conditions.
How extended drug action is achieved
- By affecting the rate at which the drug is released
from the dosage form
- By slowing the transit time of the dosage form
through the gastrointestinal tract
Rate of drug release of solid dosage forms may be modified
by:
- Modifying drug dissolution by controlling access of
biologic fluids to the drug through the use of barrier
coatings
- Controlling drug diffusion rates from dosage forms
- Chemical reaction or interaction between the drug
substance or its pharmaceutical barrier and site-
specific biologic fluids
EXTENDED-RELEASE TECHNOLOGY FOR ORAL DOSAGE
FORMS
Coated beads, Granules, and Microspheres
- Using conventional pan coating or air suspension
coating, a solution of the drug substance is placed on
small inert nonpareil seeds or beads made of sugar
and starch or on microcrystalline cellulose spheres
- Nonpareil seeds
o Range of 425 to 850 mm
- Microcrystalline cellulose spheres
o Range from 170 to 600 mm
o Considered as more durable during
production than sugar-based cores
- Lipid Materials used to Coat Granules
o Beeswax
o Carnauba wax
o Glyceryl monostearate
o Cetyl alcohol
o Cellulosic material like ethylcellulose
- Aqueous coating systems
o Use ethylcellulose and plasticizer as coating
material
 Ex. Aquacoat and Surelease
o Eliminate hazards and environmental
concerns associated with organic solvent-
based systems
- The variation of thickness of the coats and in the
type of coating material affects the rate at which
body fluids penetrate the coating to dissolve the
drug
- The thicker the coat, the more resistant to
penetration and the more delayed will be drug
release and dissolution
- Coated beads
o 1mm in diameter
o Combined to have three or four release
groups among more than 100 beads
contained in the dosing unit
- Example: Spansule (SmithKline Beecham)
Multitablet System
- Small spheroid compressed tablets 3 to 4mm in
diameter may be prepared to have varying drug-
release characteristics
- They then may be placed in gelatin capsule shells to
provide the desired pattern of drug release
- Each capsule may contain 8 to 10 minitablets, some
uncoated for immediate release and others coated
for extended drug release
Microencapsulated Drug
- Microencapsulation
o A process by which solids, liquids, or even
gases may be enclosed in microscopic
particles by formation of thin coatings of
wall material around the substance
o Cleaner substitute for carbon paper and
carbon ribbons as sought by the business
machine industry
- Gelatin
o Common wall-forming materials;
- and synthetic polymers such as
o polyvinyl alcohol
o ethylcellulose
o polyvinyl chloride
- Encapsulation Process
1. Dissolving the wall material
2. Material to be encapsulated is added and the
two-phase mixture thoroughly stirred
3. With the material to be encapsulated broken up
to the desired particle size, a solution of a
second material, usually acacia, is added
4. This additive material concentrates the gelatin
(polymer) into tiny liquid droplets
5. These droplets (the coacervate) form a film or
coat around the particles of the substance to be
encapsulated
6. The final dry microcapsules are free-flowing
discrete particles of coated material
7. The wall material usually constitutes 2% to 20%
of total particle weight
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 - Different rates of drug release may be obtained by
changing:
o the ratio of core to wall
o the polymer used for the coating
o the method of microencapsulation
- Advantage of Microencapsulation
o the administered dose of a drug is
subdivided into small units that are spread
over a large area of the gastrointestinal
tract, which may enhance absorption by
diminishing local drug concentration
- Example: Potassium chloride (Micro-K Extencaps,
Wyeth)
Embedding Drug in Slowly Eroding or Hydrophilic Matrix
System
- The drug substance is combined and made into
granules with an excipient material that slowly
erodes in body fluids, progressively releasing the
drug for absorption
- When these granules are mixed with granules of
drug prepared without the excipient, the
uncombined granules provide the immediate effect,
and the drug-excipient granules provide extended
action
- The granule mix may be formulated as tablets or
capsules for oral delivery
- Hydrophilic cellulose polymers
o Commonly used as the excipient base in
tablet matrix systems
- The effectiveness of these hydrophilic matrix
systems is based on:
o The successive processes of hydration of
the cellulosic polymer, gel formation on the
polymer’s surface, tablet erosion, and the
subsequent and continuous release of drug
- Hydroxypropyl methylcellulose (HPMC)
o A free-flowing powder
o Commonly used to provide the hydrophilic
matrix
- For a successful hydrophilic matrix system:
o The polymer must form a gelatinous layer
rapidly enough to protect the inner core of
the tablet from disintegrating too rapidly
after ingestion
o 20% of HPMC results In satisfactory rates of
release for an extended-release tablet
formulation
- Example: Oramorph SR Tablets (AllPharma)
 Contains morphine sulfate
- Manufacturers may prepare:
- Two-layer Tablets
o One layer containing the uncombined drug
for immediate release
o Other layer having the drug embedded in a
hydrophilic matrix for ER
- Three-layer Tablets
o Both outer layers containing the drug for
immediate release
o Some commercial tablets are prepared with
an inner core containing the extended-
release portion of drug and an outer shell
enclosing the core and containing drug for
immediate release
Embedding Drug in Inert Plastic Matrix
- The drug is granulated with an inert plastic material
such as polyethylene, polyvinyl acetate, or
polymethacrylate, and the granulation is compressed
into tablets
- The drug is slowly released from the inert plastic
matrix by diffusion
- The compression creates the matrix or plastic form
that retains its shape during leaching of the drug and
during its passage through the alimentary tract
- An immediate-release portion of drug may be
compressed onto the surface of the tablet
- The inert tablet matric, expended of drug, is
excreted with the feces
- Example: Gradumet (Abbott)
Complex Formation
- Form complexes that may be only slowly soluble in
body fluids, depending on the pH of the environment
- This slow dissolution rate provides the ER of the drug
- Example: Rynatan (Wallace)
o Salts of tannic acid, tannates, provide this
quality in a variety of proprietary products
Ion Exchange Resins
- A solution of a cationic drug may be passed through
a column containing an ion-exchange resin, forming
a complex by the replacement of hydrogen atoms
- The resin-drug complex is washed and may be
tableted, encapsulated, or suspended in an aqueous
vehicle.
- The release of the drug depends on the pH and
electrolyte concentration in the gastrointestinal tract
- Release is greater in the acidity of the stomach than
in the less acidic environment of the small intestine
- Example: Hydrocodone polistirex and
chlorpheniramine polistirex suspension (Tussionex
Pennkinetic extended-release suspension – CellTech)
- Phentermine resin capsules (Ionamin capsules
-CellTech)
- The mechanism of action of drug release from ion-
exchange resins may be depicted as follows:
In the Stomach
-
Drug resinate+ HCl ⇌acidic resin+drug hydrochloride
-
Resin salt + HCl ⇌ resin chloride +acidic drug
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In the Intestine
- -
Drug resinate+ NaCl ⇌ sodium resinate+drug hydrochloride
- the second dose in the tablet’s inner core, separated
Resin salt + NaCl ⇌resin chloride + sodium salt of drug
- This system incorporates a polymer barrier coating
and bead technology in addition to the ion-exchange
mechanism
- The initial dose comes from an uncoated portion and
the remainder from the coated beads
- The coating does not dissolve, and release is
extended over 12 hours by ionic exchange
Osmotic Pump
- The pioneer oral osmotic pump delivery system is
the OROS system developed by Alza
- The system is composed of a core tablet surrounded
by a semipermeable membrane coating having a
0.4mm diameter hole produced by laser beam
- The core tablet has two layers
o Containing the drug – active layer
o Containing a polymeric osmotic agent –
push layer
- The system operates on the principle of osmotic
pressure
- As the pressure increases in the osmotic layer, it
pumps the drug solution out of the delivery orifice
on the side of the tablet. Only the drug solution (not
the undissolved drug) is capable of passing through
the hole in the tablet.
- The system is designed such that only a few drops of
water are drawn into the tablet each hour
- The rate of inflow of water and the function of the
tablet depend on the osmotic gradient between the
contents of the two-layer core and the fluid in the
gastrointestinal tract
- The drug-release rate may be altered by:
o changing the surface
o thickness or composition of the membrane
o diameter of the drug-release orifice
- The drug-release rate is not affected by:
o gastrointestinal acidity
o Alkalinity
o fed conditions
o gastrointestinal motility
- Example: AcuTrim
- Gastrointestinal therapeutic system (GITS)
o Glucotrol XL ER tablets
o Procardia XL ER tablets
- Controlled-onset extended release system (COER –
Searle)
o Covera HS tablets
 Initial drug is released 4 to 5 hours
after tablet ingestion
REPEAT ACTION TABLETS
- Prepared so that an initial dose of drug is released
immediately, and a second dose follows later
The tablets may be prepared with the immediate-
release dose in the tablet’s outer shell or coating and
by a slowly permeable barrier coating
- The drug from the inner core is exposed to body
fluids and release 4 to 6 hours after administration
- Example: Repetabs (Schering)
- Best suited for treatment of chronic conditions
requiring repeated dosing
- Low dosage and fairly rapid rates of absorption and
excretion
Delayed-Release Oral Dosage Forms
- Reason why drugs must remain intact until it reaches
the intestines, how are these achieved?
- Release of a drug from an oral dosage dorm may be
intentionally delayed until it reaches the intestines
for several reasons:
o To protect a drug destroyed by gastric fluids
o To reduce gastric distress caused by drugs
particularly irritating to the stomach
o To facilitate gastrointestinal transit for
drugs that are better absorbed from the
intestines
- These can be achieved if the enteric coating is:
o pH dependent
 breaking down in the less acidic
environment of the intestine
o time dependent
 eroding by moisture over time
during gastrointestinal transit
o Enzyme dependent
 Deteriorating as a result of the
hydrolysis-catalyzing action of
intestinal enzymes
- Agents used for enteric coating of tablets and
capsules:
o Fats
o Fatty acids
o Waxes
o Shellac
o Cellulose acetate phthalate
Examples of modifies-release tablets and capsules official in
the USP
- Table 9.2
Examples of propriety modifies-release oral dosage forms
- Table 9.3
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USP REQUIREMENTS AND FDA GUIDANCE FOR MODIFIED-
RELEASE DOSAGE FORMS
Drug Release
- Based on drug dissolution from the dosage unit
against elapsed test time
- Descriptions of the various test apparatus and
procedures may be found in the USP
- The individual monographs contain specific criteria
for compliance with the test and the apparatus and
test procedures to be used
Uniformity of Dosage Units
- Uniformity of dosage units may be demonstrated by
either of two methods, weight variation or content
uniformity
In Vitro-In Vivo Correlations
- Critical to the development of oral extended-release
products
- Assessing IVIVCRs is important throughout product
development, clinical evaluation, submission of an
application for FDA approval for marketing, and
during post-approval for any proposed formulation
or manufacturing changes
Development of an IVIVC model
- a guidance document, Extended Release Oral Dosage
Forms: Development, Evaluation, and Application of
In Vitro/In Vivo Correlations
- Provides guidance to sponsors of new drug
applications and abbreviated new drug applications
for extended-release oral products
- The guidance (IVIVC) provides method of:
o Developing an IVIVC and evaluating its
predictability
o Using an IVIVC to establish dissolution
specifications
o Applying an IVIVC as a surrogate for in vivo
bioequivalence during the approval process
or during post-approval for certain
formulation or manufacturing changes
Three categories of IVIVCs are included in the document
Level A
- A predictive mathematical model for the relationship
between the entire in vitro dissolution and release
time course and the entire in vivo response time
course
- For example, the time course of plasma drug
concentration or amount of drug absorbed
- Most common type of correlation submitted
Level B
- A predictive mathematical model of relationship
between summary parameters that characterize the
in vitro and in vivo time courses
- For example, models that relate the mean in vitro
dissolution time, the mean in vitro dissolution time
to the mean residence time in vivo, or the in vitro
dissolution rate constant to the absorption rate
constant
Level C
- A predictive mathematical model of the relationship
between the amount dissolved in vitro at a particular
time (or the time required for in vitro dissolution of a
fixed percent of the dose) and a summary parameter
that characterizes the in vivo time course (maximum
concentration or area under the curve)
- The level of IVIVCs may be useful in the early stages
for formulation development when pilot
formulations are being selected
Most common process for developing an IVIVC model (Lvl A)
- Develop formulations with different release rates
(e.g. slow, fast, and intermediate) or a single-release
rate if dissolution is independent of condition
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 - Obtain in vitro dissolution profiles and in vivo plasma - Ocular Drug Products / Ophthalmic
concentration profiles for these formulations - Parenteral System
- Estimate the in vivo absorption or dissolution time - Vaginal Inserts
course for each formulation and subject using - Subdermal Implants
appropriate mathematical approaches
Ocular Drug Products
Criteria in Development Applicable to the Development of - Extended periods of therapy may be achieved by
IVIVC are the following: formulations that increase the contact time between
- In determining in vitro dissolution, USP dissolution the medication and the corneal surface
apparatus, type I (basket) or type II (paddle), is - This may be accomplished by:
preferred, although type III (reciprocating cylinder) o Use of agents that increase the viscosity of
or type IV (flow-through cell) may be applicable in solutions
some instances o Ophthalmic suspensions in which the drug
- An aqueous medium with a pH not exceeding 6.8 is particles slowly dissolve
preferred as the medium for dissolution studies. For o Slowly dissipating ophthalmic ointments
poorly soluble drugs, a surfactant (e.g. 1% sodium o Use of ophthalmic inserts
lauryl sulfate) may be added - Gels Extended Release
- The dissolution profiles of at least 12 individual o Use viscosity-increasing agents to increase
dosage units from each lot should be determined corneal contact time
- For in vivo studies, human subjects are used in the o Example:
fasted state unless the drug is not well tolerated, in  Pilocarpine (Pilopine HS gel, Alcon)
which case the studies may be conducted in the fed  Employs Carbopil 940, a
state. Acceptable data sets have been shown to be synthetic high molecular
generated with use if 6 to 36 human subjects weight cross-linked
- Crossover studies are preferred, but parallel studies polymer of acrylic acid
or cross-study analysis may be acceptable using a  Timolol maleate (Timoptic-XE,
common reference treatment product, such as an IV Merck)
solution, an aqueous oral solution, or an immediate-  employs gellan gum
release product (Gelrite), which forms a
gel upon contact with the
Clinical Considerations in the Use of Oral Modified-release precorneal tear film
dosage forms o Ophthalmic Inserts
- Not to used them interchangeably or concomitantly  Lacrisert (Merck)
with immediate-release forms of the same drug  Rod-shaped water-soluble
- Patients stabilized on a modified-release product form of hydroxypropyl
should not be changed to an immediate-release cellulose
product without consideration for any existing blood o Pilocarpine Insert
level concentrations of the drug
 Available in a membrane-
- Patients should not be changed to another
controlled reservoir system
extended-release product unless there is assurance
 Treatment of glaucoma
of equivalent bioavailability
Parenteral Systems
- A different product can result in a marked shift in the
- (Long-acting parenteral systems) extended rates of
patient’s drug blood level because of differences in
drug action following injection may be achieved in a
drug-release characteristics
number of ways:
- Modified-release tablets and capsules should not be
o Use of crystal or amorphous drug forms
crushed or chewed, since such action comprises their
having prolonged dissolution characteristics
drug-release features
o Slowly dissolving chemical complexes of the
- Patients being fed by enteral nutrition through a
drug entity, solutions, or suspensions of
nasogastric tube may receive conventional or
drug in slowly absorbed carriers or vehicles,
modified-release medication
o Large particles of drug in suspension
- Should not generally be used as the source of a drug
o Injection of slowly eroding microspheres of
to prepare other dosage forms
drug
- Non-erodible plastic matrix shells and osmotic
- The rate and duration of drug delivery may be
tablets remain intact throughout gastrointestinal
controlled mechanically using controlled-rate drug
transit and the empty shells or ghosts from osmotic
infusion pumps
tablets may be seen in the stool
- Examples: Table 20.3
EXTENDED DRUG ACTION IS ACHIEVED BY ROUTES OTHER
THAN ORAL ADMINISTRATION

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Vaginal Inserts
- (Vaginal administrations)
- In a polymeric vaginal drug delivery system, such as a
resilient medicated vaginal ring, or a copper-
containing intrauterine contraceptive device, the
drug may be uniformly distributed throughout the
polymeric matrix.
- Upon administration and when in contact with
vaginal fluids, the drug will slowly dissolve and
migrate out of the device.
- Drug inside the device will diffuse toward the surface
along a concentration gradient, resulting in a long-
acting drug delivery system.
- Mirena (levonorgestrel-releasing intrauterine
system)
o consists of a T-shaped polyethylene frame
with a steroid reservoir (hormone
elastomer core) around the vertical stem.
o It is designed to prevent pregnancy for up
to 5 years
- Intrauterine Progesterone Drug Delivery System
o Progestasert System
o slowly releases an average of 60 mg of
progesterone per day for 1 year after
insertion.
o progesterone-induced inhibition of sperm
capacity for survival and alteration of the
uterine milieu to prevent nidation.
o provides contraception without the need
for daily self-medication and has the
advantages of (a) using a natural
- Dinoprostone Vaginal Insert
o Dinoprostone (Cervidil, Forest
Pharmaceuticals)
o is a thick, flat, rectangular polymeric slab
enclosed in a pouch of a knitted polyester
retrieval system.
o It is indicated for initiation and/or
continuation of cervical ripening in patients
at or near term when there is medical or
obstetrical indication for labor induction.
- Estring
o unique method of administering estradiol is
through the use of the estradiol vaginal ring
(Estring, Pharmacia Corp., A Division of
Pfizer)
- Crinone Gel
o bioadhesive vaginal gel Crinone Gel (Wyeth-
Ayerst)
o which contains micronized progesterone
and the polymer polycarbophil in an oil-in-
water emulsion system
o used to assist in reproduction
Subdermal Implants
- long-lasting dosage forms that provide continuous
release of drug, often for periods of months to years
- They can be made by compression, melting, or
sintering.
- Several types are available including pellets,
resorbable microparticles, polymer implants, in situ-
forming gel/solid implants, metal/plastic implants,
and drug-eluting stents.
Pellet Implants
- small, sterile, solid masses of the active drug with or
without excipients
- usually administered using a suitable special injector
(e.g., trocar) or by surgical incision
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 - first-order kinetics - size and rate of erosion will
influence the release rate
Resorbable Microparticles or Microspheres
- 20 to 100 μm in diameter
- composed of the drug dispersed within a
biocompatible, bioresorbable polymeric excipient
(matrix)
- administered as an aqueous suspension
subcutaneously or intramuscularly for systemic
delivery, or they may be injected into a specific
location in the body
Polymer Implants
- formed as a single mass, such as a cylinder
- must be biocompatible and can be either
biodegradable or nonbiodegradable
Shaped Implants
- administered by means of a suitable injector
- release rates are not zero order but can approach
zero-order kinetics
- used to deliver potent small molecules, including
steroids, and large molecules, including peptides
- advantage to the biodegradable implants is that they
do not require removal after release of all the drug.
Liquid-gel / Solid Implants
- initially liquid formulations comprising a polymer,
active drug, and solvent
- a gel or a solid polymeric matrix is formed trapping
the drug and extending the release of the drug for
days or months
Metal/Plastic Implants
- formulated from titanium or other suitable materials
- administered by an injector or surgical installation
- A solution of the drug, located inside the implant, is
released via an osmotically driven pump inside the
implant
- may last as long as 1 year or more
- its release follows zero order
Drug-eluting Stents
- combine the mechanical effect of the stent with a
prolonged pharmacologic effect of the incorporated
drug
- can be coated with a nonbiodegradable or
biodegradable polymer-containing drug
- pellets or implants were sterile, small, usually
cylindrical solid objects about 3.2 mm in diameter
and 8 mm long
- prepared by compression and intended to be
implanted subcutaneously to provide continuous
release of medication over time
Example of Implants
- Levonogestrel Implants
o set of six flexible closed capsules of a
dimethylsiloxane–methyl vinyl siloxane
copolymer, each containing 36 mg of the
progestin
o This system provides long-term (up to 5
years) reversible contraception.
- Gliadel Wafer Implant
o Polifeprosan 20 with carmustine implant
(Gliadel Wafer)
o is a sterile off-white to pale yellow wafer
approximately 1.45 cm in diameter and 1
mm thick
o designed to deliver the carmustine directly
into the surgical cavity created when a brain
tumor is resected, with numerous wafers
being used depending upon the desired
dose.
- Goserelin Implant (Zoladex)
o Goserelin acetate implant (Zoladex,
AstraZeneca)
o sterile, biodegradable product containing
goserelin acetate, equivalent to 3.6 mg of
drug, designed for subcutaneous injection
with continuous release over 28 days
o indicated for a number of disorders,
including the palliative treatment of
advanced carcinoma of the prostate,
offering an alternative to orchiectomy
and/or estrogen administration when the
standard treatments are not indicated or
are unacceptable to the patient
o used in the treatment of endometriosis and
advanced breast cancer.
- Histrelin (Vantas) Implant
o sterile nonbiodegradable, diffusion-
controlled reservoir drug delivery system
designed to deliver histrelin continuously
for 12 months upon subcutaneous
implantation
o It contains 50 mg of histrelin acetate, a
synthetic nonapeptide analog of the
naturally occurring gonadotropin- releasing
hormone (GnRH) or luteinizing hormone–
releasing hormone (LH-RH).
- Viadur Implant
o Viadur (leuprolide acetate)
o A sterile, nonbiodegradable, osmotically
driven miniaturized implant designed to
deliver leuprolide acetate for 12 months at
a controlled rate.
o indicated in the palliative treatment of
advanced prostate cancer
- Vitrasert Implants
o contain 4.5 mg of the antiviral drug
ganciclovir
o used to treat AIDS-related cytomegalovirus
(CMV) retinitis
o surgically implanted into the vitreous cavity
of the eye in an outpatient intraocular
procedure
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