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Azerbaijan Pharmaceutical and Pharmacotherapy Journal

Received July 14, 2023 Accept December 22, 2023 Publish January 25, 2024.
DOI https://doi.org/10.61336/appj/22-3-1

Formulation and Evaluation of Minoxidil Loaded Submicron


Emulsion Based Topical Gel For Treatment of Alopecia
Jasjeet Kaur Narang1, Ramandeep Singh Narang2, Mehak1
1
Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar
2
Department of Oral and Maxillofacial Pathology, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, Punjab, India
Corresponding author: Jasjeet Kaur Narang (e-mail: jasjeet2975@yahoo.com).
©2023 the Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0

Abstract: Introduction: Alopecia is a benign hair condition that causes reduced hair growth on the scalp and has afflicted
population worldwide. Aim: The present study is designed to formulate and characterize submicron emulsion based topical
gel containing an anti-hypertensive drug like minoxidil to overcome the adverse effects of conventional oral dosage forms &
to provide an improved, targetted therapy for treatment of alopecia. Methods: The minoxidil loaded submicron emulsion was
prepared by aqueous titration method using a suitable combination of Clove oil (oil phase), Tween 20 (surfactant) and
Transcutol P (co-surfactant). Results: The maximum submicron emulsion area obtained after constructing pseudo-ternary
phase diagrams was found in S mix ratio 4:1. The optimized submicron emulsion formulation (M5) exhibited a pH of 5.4 ±
0.17, in vitro release of 95.08 ± 0.36 %, ex vivo permeation of 79.36 ± 0.18%, particle size of 181.3nm with an uniform
particle size distribution (<1) and optimum zeta potential (-8.80 mV). The optimized formulation (M5) was then converted
intogel formulation by adding different concentrations (1%, 1.5% and 2% w/v) of gelling agent like Carbopol 934. Among
them, M52%w/v was considered as the optimized gel formulation on the basis of different evaluation studies. The optimized
submicron emulsion based gel formulation also showed an inherited anti-oxidant potential and remain stable for 3 months at
4℃. Conclusion: The minoxidil loaded submicron emulsion based topical gel formulation could be considered as a
beneficial nano-approach in contrast to other traditional topical dosage forms for treating alopecia.

Key Words: Alopecia, Benign, Submicron emulsion, Pseudo-ternary, Antioxidant.

INTRODUCTION with 80% first pass metabolism [10]. Therefore, it


Alopecia is defined as a non-cancerous autoimmune hair necessitates the formulation of nanocarrier which would
disorder in which the extensive loss of hair occurs from overcome the drawbacks associated with oral traditional
various regions of body especially from scalp [1]. It is the formulation and improve the overall efficacy of drug.
most common dermatologial complaint with a varying Further, it would be advantageous if the formulated
prevalence rate throughout the globe [2]. It has an nanocarrier provides controlled release of the drug as it
immense psychosocial influence over the person’s mind would also contribute in reducing the dose and the dose
[3]. The pathophysiological mechanism of alopecia is an related side effects. The controlled drug delivery systems
enigma, but hormones, infections, medications and hair developed and reported in the literature for the treatment
styling practices are the various triggering factors which of alopecia include nanolipid carriers[11-12] solid lipid
are also responsible for the occurrence of alopecia [4]. nanoparticles[13-14], polymeric nanoparticles [15-16],
Nanoemulsions [17-18], liposomes [19-20],
Treatment options of alopecia include masks, wigs and Transferosomes [21-22], Niosomes [23-24], Ethosomes
sunscreen, administration of plasma injection rich in [25-26], cubosomes [27], metallic nanoparticles[28-29],
platelets and corticosteroids, administration of topical Liquid Crystalline nanoparticles [30]. However, since most
prescription drugs like anti-androgens, vasodilators etc of the above mentioned dosage forms are in liquid form,
[5,6,7,8]. Among the different drugs used for alopecia they limit the retention of the drug at the application site.
treatment, minoxidil is the first USFDA approved poorly In order to overcome this drawback in the present study a
water-soluble anti-hypertensive drug which is known to submicron emulsion based gel was formulated for delivery
prolong the growth phase (anagen phase) in hair follicle of minoxidil.
with prominent anti hair loss results [9]. It does not bind to
plasma proteins and exhibits a shorter elimination half-life Submicron emulsions are thermodynamically stable
(4.2 hours). The oral ingestion of this drug however, leads isotropic mixtures of drug with suitable concentrations of
to different adverse effects such as hypotension, oil, surfactants, co-surfactants and water with a mean
palpitations, weight gain, hypertrichosis and itching etc droplet size of 10-500 nm. This nanocarrier has gained
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
attention of many scientists due to its maximum preparation of various oil:S mix ratios. The aqueous phase
solubilization capability, smaller droplet size with was slowly added into these oil:Smix ratios to produce a
maximum stability [31]. However, to overcome the clear, transparent and less viscous submicron emulsion
problem of its low viscosity, formulation of submicron system. The prepared emulsions were vigrously vortexed
emulsion as a topical gel is a better option. The submicron and kept for 24 hours for attaining equilibirium [34]. After
emulsion based gel is defined as the gelling system which this, the combinations for the preparation of placebo
can be obtained after the addition of submicron emulsion submicron emulsions were selected from the constructed
system into gel matrix. The presence of sebum in hair phase diagrams to achieve a formulation with suitable oil
follicles makes it a most promising approach for delivering concentration for better solubilization of drug with
minoxidil [32]. This nanocarrier enhances the permeation minimum Smix and high water content. The same
of active drug moeity into skin and provides sustained procedure was repeated for the preparation of submicron
release which leads to improved patient compliance and emulsion containing minoxidil in a dose of 1%w/v [29].
higher therapeutic effect [33]. This study provides the
concept of preparation and characterization of submicron Physical stability studies
emulsion based topical gel containing minoxidil for
treating alopecia. The gel would not only provide a The minoxidil containing submicron emulsions were
targeted delivery of the drug at the site of application but checked for stability by subjecting them to different
due to its gel state would enhance the retention of the physical stability tests. The first test i.e. heating-cooling
drug at the application site whoich would inturn lead to an cycle was performed by storing the emulsion formulations
overall improvement in the therapeutic efficacy of the drug at 4℃ and 40℃ each for 48 hrs. The second stability test
and inturn patient compliance. which was conducted was centrifugation test in which the
centrifugation of prepared submicron emulsion
MATERIAL AND METHODS wasperformed for 30 minutes at 3000 rpm to examine any
The study was conducted at Khalsa college of Pharmacy, kind of physical instability. The third test i.e. freeze thaw
Amritsar and didnot utilise any living animals or humans cycle or accelerated stability testing was done by storing
and therefore no permission was taken from the the formulations at -21℃ and +25℃ for atleast 2 days [35].
Institutional Ethical Committee. Minoxidil was procured as The stable formulations were further characterized on the
a gift sample from Kwality Pharmaceutical Ltd. (Amritsar, basis of different parameters.
India). Capryol 90 and Transcutol P were procured from
Saint-Priest, France (Gattefosse) as a gift sample. Characterization of submicron emulsion
Polysorbate 20and triethanolamine wereobtained from
S.D. Fine Chem Ltd. (Tamilnadu, India). Carbopol 934 pH
and ferric chloride were obtained from Himedia The pH of submicron emulsions was examined using
laboratories Pvt. Ltd. (Mumbai, India). All other analytical digital pH meter at room temperature as too high or too
reagents& chemicals were purchased from Merck low pH could lead to unwanted side effects [35].
Specialities Pvt. Ltd. (Mumbai, India) and Qualikem Fine
Chemicals Pvt. Ltd. (New Delhi, India). In vitro drug release study& determination of release
kinetics
Formulation of submicron emulsion For the conduct of drug release study, the dialysis
Solubility and Miscibility Studies membrane was firstly treated with 0.3% w/v sodium
sulphide solution and other reagents. It was then mounted
The solubility determination is the prerequisite step to on Franz diffusion cell between two half cell
select the appropriate components for the formulation compartments. The phosphate buffer pH 5.5 was added in
ofsubmicron emulsion. To commence with the solubility receptor compartment as release medium at 37℃ with
studies, an excess amount of drug was added in continuous stirring at 75 rpm. The donor compartment
eppendorf tubes containing different oils (Clove oil, Oleic consisted of one ml of 1% w/v drug loaded submicron
acid, Isopropyl Myristate, Capryol 90, Tea tree oil and emulsions and the alliquots were taken at pre-defined
Olive oil), surfactants (Kolliphor HS 15, Tween 40, Tween time periods upto 6 hours from the receptor compartent.
20, Span 80, Span 20, Tween 60 and Tween 80) and co- The assessment of collected samples was done using
surfactants (Transcutol P, PEG 400 and PEG 600) U.V spectrophotometer at λmax 286 nm and the results
individually. The contents in eppendorf tubes were mixed obtained were compared with those obtained using drug
using vortex mixer and then kept on biological shaker for solution (1%w/v) in ethanol. The experiment was repeated
3 days at 37℃±2℃. After this, the centrifugation of in triplicate [36].
samples was done at 3000 rpm for 15 minutes and the The data produced from in vitro release investigation was
supernatant layer was removed followed by filtration. It plotted in different release models to study the release
was then analysed using U.V spectrophotometer at λ max kinetics of prepared submicron emulsions. The model for
286 nm.The estimations performed in triplicate. which the coefficient correlation (R2) value was found to
For the miscibility studies, one ml of each selected be near unity was considered as release model [37].
surfactants and co-surfactants were taken in 1:1 ratio in Particle size, PDI and droplet charge assessment
eppendorf tubes and mixed using vortex mixer at 25±1℃. The size of particles and polydispersity index of
The obtained mixtures were kept overnight to determine submicron emulsion were examined by dynamic light
the miscibility of Smix [18]. scattering method. For this, the dilution of the samples
was performed 100 times with distilled water and
Pseudo-ternary phase diagram construction and assessed using zeta-sizer. After this, they were directly
formulation development placed into module [38]. The charge on the average
globules was measured by using Malvern zeta-sizer [39].
The method used for construction of pseudo-ternary
phase diagrams was aqueous titration method in which Ex vivo skin permeation study& data analysis
the different Smix (Surfactant: Co-surfactant) ratios (1:0, For the evaluation of drug permeation, the excised rat skin
1:1, 1:2, 2:1, 3:1 and 4:1) were prepared followed by the sample was obtained from pharmacology department,
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
followed by complete removal of hair and underlying fat using U.V spectrophotometer at λmax 286nm [32].
from the body. After this, the excised skin was completely
stabilised and franz diffusion cell was used to conduct this Histopathological investigation
study. Phosphate buffer (pH 7.4) was put into the receptor The skin samples utilized in ex vivo permeation studywere
compartment, while the donor compartment consisted of 1 subjected to histopathological study. For control, skin
mL of the 1% w/v minoxidil-loaded submicron emulsion. samples wereexcised from rat body and placed in saline
The samples were taken at pre-defined time intervals (6- solution. Both the treated and control samples were kept
hrs study) andanalysed by U.V spectrophotometer at λ max for storage in 10% formaldehyde solution. Afterwards, the
286 nm. The experiment was done in triplicate and the samples were chopped vertically and stained with paraffin
comparison was done with 1%w/v minoxidil ethanolic wax. After staining, the treated and untreated samples
solution (Benson et al., 2018).The drug flux (Jss) was were examined using microscope [45].
obtained by plotting the amount of minoxidil submicron-
sized emulsion permeated in steady state conditions v/s Viscosity and in vitro bioadhesion Study
time. The permeability coefficient (kp) was measured by Viscosity of the submicron topical gels was determined by
dividing the flux obtained to the initial drug concentration Anton paar rheometer. The gel was put on the plate and
(Co) present in the donor compartment [40]. kept for equiliberation at 25 ± 0.1℃ for few minutes. The
Formulation of submicron emulsion based topical gel measurement was performed in triplicate [46].
Submicron emulsion based topical gel was prepared by For in vitro bioadhesion study, an agar plate was firstly
dissolving different quantities of selected gelling agent prepared. The gel samples to be studied were placed in
i.e.carbopol 934 into the optimized submicron emulsion the centre of plate and further attached to IP disintegration
(M5) formulation with continuous stirring till the assemby. The plates were coninuously moved up and
equilibirium was attained. The pH adjustment to neutral down in phosphate buffer media (pH 7.4) at room
value was done using triethanolamine. The gel temperature. The residence time of the test samples on
formulations (M51%w/v, M51.5%w/v, M52%w/v) were then kept agar plate was measured visually. The experiment was
overnight and further evaluated [41]. repeated in triplicate [47].
Characterization of submicron emulsion based topical
gels (M51%w/v, M51.5%w/v, M52%w/v) Antioxidant activity of submicron emulsion based
topical gel formulation
Physical appearance, pH, homogeneity & grittiness
The prepared submicron gel formulations were firstly The antioxidant activity of minoxidil loaded submicron
checked under normal sunlight to examine their physical emulsion based topical gel was determined by using two
appearance. The pH was assesed by using digital pH methods:
meter while the homogeneity and grittiness was measured
by rubbing the gel formulations on the back of hand [42]. DPPH method
Drug content Firstly, the stock solution (1mg/ml) of standard (ascorbic
acid) and test formulation was prepared separately in
To determine the drug content,minoxidil-loaded submicron methanol. Following this, the different serial dilutions (1-20
gels weremixed with methanol and shaken for 2 hours. µg/ml) of standard and test formulations were also
The obtained solutions were filtered followed by removal prepared separately. From these dilutions, one ml was
of supernatant layer. The dilution of supernatant layer was taken and dissolved in methanolic solution of DPPH
done using methanol and analysed by U.V (0.004%w/v). After 30 minutes, the prepared solutions
spectrophotometer at wavelength of286 nm [43]. were analyzed at 515 nm against methanol as blank [48].
The formula used for measuring percent inhibition was as
Ex vivo skin permeation studies of topical submicron follows:
gel formulations & data analysis % inhibition = [(ABlank-AFormulation)/ABlank]

The ex vivo skin permeation study of topical submicron Stability studies


emulsion based gels was done usingfranz diffusion cell. The stability studies of optimized gel formulation was
The skin was properly excised, stabilized and placed performed by storing the submicron emulsion based gel
between the half-cell compartments. The different formulations at referigerator temperature (4℃) for the
concentrations (M51%w/v, M51.5%w/v, M52%w/v) of submicron period of 3 months [49].
topical gel were separately placed in donor compartment
while the phosphate buffer pH 7.4 was used as release Statistical analysis
medium. The study was continued for 6 hours with the All the results were represented as mean ± standard
continous withdrawl of sample at predetermined time deviation. The software used for analysis of
intervals followed by replacement with fresh release resultsproduced by various test groups was Graph pad
medium. The comparison of results were done with the Instat 3 (two tailed unpaired t-test). The p-values ≤ 0.05
results obtained from plain minoxidil gel. The experiment were found to be significant.
was performed in triplicate [44]. The flux and permeability
coefficient was also calculated.

Drug retention studies

After the permeation studies, the remaining formulation


was removed from the skin and cleaned with cotton
soaked in 0.05% SLS followed by subsequent washing
using purified water. Further, the skin was weighed and
chopped into small pieces. It was then dissolved in
suitable solvent and kept forsonication. The resulting
solution was centrifuged and filtered.It was then analysed
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
RESULTS
Solubility studies & miscibility assessment
The determination of minoxidil solubility was done in various components and is depicted in Table 1.

Table 1: Drug solubility in various emulsion components


S.No Solubility of Minoxidil
Oil Phase Surfactant Phase Co-surfactant Phase
Oil Solubility Surfactant Solubility Co-surfactant Solubility
(mg/ml) (mg/ml) (mg/ml)
1. Clove oil 51.83 ± 0.52 Kolliphor HS 15 1.8 ± 0.35 Transcutol P 11 ± 0.3
2. Oleic acid 48.6 ± 0.54 Tween 40 1.0 ± 0.25 PEG 400 1.0 ± 0.3
3. Capryol 90 7.0 ± 0.51 Tween 20 5.82 ± 0.4 PEG 600 0.3 ± 0.3
4. Tea-tree oil 0.56 ± 0,058 Span 80 1.3 ± 0.45 - -
5. Olive oil 0.74 ± 0.001 Tween 60 0.9 ± 0.3 - -
6. Isopropyl 0.4 ± 0.041 Tween 80 1.4 ± 0.45 - -
Myristate

Construction of Pseudoternary phase diagrams for formulation selection


Pseudoternary phase diagrams were constructed for each Smix ratios (1:0, 1:1, 1:2, 2:1, 3:1 & 4:1) by aqueous titration method
(Figure 1) to determine the extent of submicron emulsion region.

(A) (B)

(C) (D)
Sub-
micron
sized
Emul-
sion

VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
(E) (F)
Figure 1: Pseudoternary Phase diagrams constructed for different S mix ratios for preparation of submicron emulsion.
(A) represents 1:0 Smix ratio, (B) – 1:1, (C) – 1:2, (D) – 2:1, (E) – 3:1, (F) – 4:1 S mix ratio.

Formulation development and thermodynamic stability studies


The placebo submicron emulsions which were found to be stable after physical stability testing were further chosen for loading
the drug in a suitable dose (1%w/v). The prepared minoxidil loaded submicron emulsion were again checked for stability and
the composition of formulations which passed the stability testing is given in Table 2.

Table 2: Composition of Minoxidil containing submicron emulsions


Formulation Clove oil Tween20: Distilled Drug Volume of
Transcutol P (Smix) water (mg) Submicron
Code (ml) (ml) (ml) emulsion (ml)
M1 0.8 3.2 8 100 10

M5 0.4 3.6 6 100 10

N2 0.597 2.388 7.015 100 10

N6 0.750 1.750 7.5 100 10

H1 0.222 1.778 8 100 10

Characterization and optimization of submicron emulsion

pH
The pH of all submicron emulsion formulations were found to be in the range of 4.5 to 6.6.

In vitro drug release study & determination of release kinetics


The comparision of in vitro release study of different submicron emulsion formulations with minoxidil solution is illustrated in
Figure 2.
Percentage Cmulative drug

M1
released

M5
N6
H1
N2
Drug solution

Time (Hrs)

Figure 2: Comparison of in vitro release profiles of minoxidil loaded submicron emulsion formulations (M1, M5, N2, N6
& H1) with Minoxidil solution (1%w/v) over a period of 6 hours

Ex vivo skin permeation study and data analysis


The submicron emulsion (M5) was further subjected to ex vivo skin permeation study using excised rat skin obtained from the
pharmaclogy department. The results obtained were compared with those obtained by using minoxidil solution (1%w/v) and are
depicted in Figure 3.
Cumulative amount
of drug Permeated
(μg/cm2)

Submicron emulsion (M5)


Drug solution

Time (Hrs.)
Figure 3: Comparison of ex vivo permeation profile of submicron emulsion formulation (M5) and minoxidil solution
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
(1%w/v)
The data obtained from ex vivo skin permeation study is summarized in Table 2.

Table 2: Percent cumulative drug permeated, flux values & Permeability coefficient values of optimized submicron
emulsion and minoxidil solution
Formulation % Cumulative drug permeated [µg Flux Jss ± S.D Permeability
cm-2/ Co *100]± S.D (n=3) coefficient (Kp) ±
(n=3) S.D (n=3)

Submicron 79.36 ± 0.18% 904.96 ± 0.15


9.04 10-3± 1.24
emulsion (M5)
Minoxidil 49.79 ± 0.15% 522.4 ± 0.19
5.22 10-3 ± 1.15
Solution (1%w/v)

Particle size, PDI and Zeta potential


The graphs obtained from particle size, PDI and zeta potential determination are given in Figure 4.

(A) (B)
Figure 4: Fig. 4(A) shows the particle size and PDI value of optimized submicron emulsion formulation (M5) and Fig
4(B) represents the zeta potential of optimized submicron emulsion formulation (M5)

Formulation of Minoxidil loaded submicron emulsion based topical gel


The optimized minoxidil loaded submicron emulsion formulation (M5) was converted into gel formulation by using carbopol 934
as gelling agent.
Characterization and optimization of submicron emulsion based gel formulations(M51%w/v, M51.5%w/v, M52%w/v)
Physical evaluation, pH, Drug content, Homogeneity and grittiness
The gel formulations were visually evaluated to examine their physical appearance. The results are shown in Table 3.

Table 3: Physical appearance, pH, drug content and homogeneity profile of different submicron emulsion based gel
formulations
Property M5(1% w/v) containing 1% M5(1.5% w/v) containing 1.5% M5(2% w/v) containing
carbopol 934 carbopol 934 2% carbopol 934
Colour Slightly yellowish Slightly yellowish Slightly yellowish
Appearance Transparent Transparent Transparent
Odour Characteristic Characteristic Characteristic
Washability Washable Washable Washable
Phase separation No No No
Consistency + ++ +++
pH± S.D 5.6 ± 0.14 6.1 ± 0.23 6.3 ± 0.11
Homogeneity Homogeneous & no grittiness Homogeneous & no grittiness Homogeneous & no
grittiness
Percent drug content 90.74 ± 0.21 88.88 ± 0.15 98.14 ± 0.19
± S.D
+ = low, ++ = medium, +++ = high

Ex vivo skin permeation studyusing excised rat skin & data analysis
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
The cumulative amount of minoxidil permeated from different submicron emulsion-based gel formulations (M5 1%w/v, M51.5%w/v,
M52%w/v) was found to be 64.28±0.15%, 56.29±0.18% and 51.86±0.18% respectively, which was higher in contrast to the plain
gel (33.23 ± 0.18). Figure 5 depicts the outcome of ex vivo permeation study.

Cumulative amount of drug


permeated (μg/cm2)

M5(1%w/v)
M5(1.5%w/v)
M5(2%w/v)
Plain gel

Time (Hrs)

Figure 5: Comparison of ex vivo skin permeation profile of different minoxidil loaded submicron emulsion based gels
and plain minoxidil gel

The flux and permeability coefficient values of different minoxidil loaded submicron emulsion based gels and plain minoxidil gel
were also measured and reported in Table 4.

Table 4: Percent cumulative drug permeated, flux values & Permeability coefficient values of different submicron
emulsion based gelsand minoxidil plain gel
Formulation % Cumulative drug permeated [µg Flux Jss ± S.D Permeability
cm-2/ Co *100]± S.D (n=3) coefficient (Kp) ±
(n=3) S.D (n=3)

M51% w/v 64.28±0.15 759.42 ± 0.29


7.59 10-3± 1.07
M51.5% w/v 56.29±0.18 609.5 ± 0.13
6.09 10-3± 1.15
M52% w/v 51.86±0.18 555.2 ± 0.27
5.55 10-3± 1.02
Plain minoxidil 33.23 ± 0.18 527.92 ± 0.18
Gel 5.27 10-3± 1.24

Drug retention study


The amount of drug retained (mg) and percent drug retained in skin layers were also measured and results are given in Figures
6(a) and Figure 6(b). The drug retention from submicron emulsion based gel formulation M5 2%w/v (16.5 ± 0.28%) was also
significantly higher (p≤ 0.05) as compared to the drug retention from plain gel (5 ± 0.2%).
Percentage of drug retained in
Amount of drug retained in
skin layers (mg)

skin layers

Formulation Formulations

Figure 6(a) Figure 6(b)


VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
Figure 6 (a) & 6(b) represented the comparision of amount of drug retained in skin layers (mg) and percentage of drug
retained in skin layers from differentminoxidil loaded gels.

Histopathological study
The histopathological study of treated and saline treated skin samples to demonstrate the safety of the developed formulation
was done as per the given procedure. The data collected from this study is shown in Figure 7 and 8.

Figure 7: Saline treated excised rat skin Figure 8: Excised rat skin sample treated (magnification 10X)
with submicron emulsion based gel

Viscosity determination & in vitro bioadhesion study


The optimized submicron emulsion based gel formulation M52%w/v exhibited viscosity of 3854 ± 0.027 mpas and bioadhesion of
104 minutes ± 11.24. The bioadhesion time possesed by minoxidil loaded submicron emulsion based gel was significantly
higher (p≤ 0.05) in contrast to plain minoxidil gel (23 minutes ± 6.73).

Antioxidant activity of optimized submicron emulsion based gel


DPPH method
The results of DPPH assay are given in Figure 9.

Ascorbic acid M5
% inhibition

% inhibition

Ascorbic acid
M5

Concentration Log concentration

Fig. 9 (a) Fig. 9(b)


Figure 9(a): Antioxidant activity activity of Ascorbic acid and drug loaded submicron emulsion, Figure 9(b): Log dose
response of Ascorbic acid and drug loaded submicron emulsion based gel

Stability Study
The results of stability study are given in Table 5. The gel formulation (M5 2%w/v) after 3 months storage is given in Figure 11.

Table 5: Stability study of optimized submicron emulsion based gel (M5 2%w/v) stored at 4 ºC
Time (days) Viscosity (mPas) ± S.D pH ± S.D Drug Content
(n=3) (n=3) (mg) ± S.D (n=3)

0 3854 ± 0.023 6.29 ± 0.018 9.814± 0.026

30 3850 ± 0.030 6.33 ± 0.020 9.812± 0.024

60 3847 ± 0.035 6.35 ± 0.037 9.809± 0.021

90 3843 ± 0.016 6.28 ± 0.029 9.807 ± 0.023

VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
Figure 11: Optimized minoxidil loaded gel formulation after storage period of 3 months at 4℃

DISCUSSION checked for stability.


Solubility studies & miscibility assessment
The solubility determination of drug in the oil, surfactant Characterization and optimization of submicron
and cosurfactant is considered as the most important emulsion
criterion in the formulation of submicron emulsion. Among
all the oils, the maximum solubility of minoxidil was found pH
in clove oil (51.83 ± 0.52 mg/ml) (Table 1). Thus, clove oil The pH of all submicron emulsion formulations were found
was chosen for the formulation of submicron emulsion as to be in the range of 4.5 to 6.6, similar to the pH of skin
it would reduce the incidence of alopecia occurred from and hair [52]. This pH value indicated that the prepared
oxidative stress at dermal papillae cells due to its own formulations were safe for topical application.
antioxidant property [50].
In vitro drug release study & determination of release
On screening surfactants and cosurfactants (Table 1), it kinetics
was observed that the drug exhibited maximum solubility This study measured the drug release from prepared
in Tween 20 (5.82 ± 0.4 mg/ml) and Transcutol P (11 ± minoxidil containing submicron emulsions and minoxidil
0.3 mg/ml), which were chosen as surfactant and co- solution (1%w/v) over a priod of 6 hours ( Figure 2). From
surfactant phase repectively. The right blend of the results, it was found that minoxidil solution (1% w/v)
surfactants leads to the formation of a stable submicron showed higher release (98.01±0.19%) as compared to the
emulsion upon dilution with water [51]. prepared submicron emulsion formulations. It was due to
the presence of drug in its free form [53]. However, a
Construction of Pseudoternary phase diagrams for sudden decrease in drug release from minoxidil solution
formulation selection was observed after 2 hours.
Pseudoternary phase diagrams were constructed for each
Smix ratios (1:0, 1:1, 1:2, 2:1, 3:1 & 4:1) by aqueous On the other hand, submicron emulsions showed
titration method to determine the extent of submicron sustained and controlled release of drug. Among the
emulsion region (Figure 1). In Smix ratio 1:0, the submicron submicron emulsion formulations, M5 exhibited an in vitro
emulsion region was found to be very less in contrast to release of 95.08± 0.36%, which was found to be
Smix ratio 1:1 indicating that the surfactant alone was not comparitively higher than M1 (88.08± 0.36%), N2 (79.91±
able to solubilize the oil completely. When co-surfactant 0.26%), N6 (68.83 ±0.29%) and H1 (67.66 ± 0.22)
(Transcutol P) was increased from 1:1 to 1:2, the respectively. Therefore, M5 was considered as optimized
submicron emulsion area was found to be decreased. formulation and selected for further evaluation study.
This is due to the fact that further enhancement in Kinetic analysis of in vitro release profile of optimized
concentration of cosurfactant did not result in lower submicron emulsion (M5) was done by fitting the data
interfacial tension. In case of 2:1 surfactant-cosurfactant obtained in various kinetic models. The correlation
ratio, the area was comparitively higher than previous coefficient values obtained for zero order, first order,
ratios but lower than that found in case of 3:1. The largest higuchi model and Peppas-Korsemeyer were found to be
submicron emulsion area was found in Smix ratio 4:1, 0.8659, 0.9648, 0.683 and 0.6415 respectively.Since the
which might be due to complete solubilization of oil phase, correlation coefficient (R2) for first order model was near to
reduced interfacial tension and formation of flexible film 1, it was concluded that the release of minoxidil from
surrounding the oil droplets of dispersed phase. submicron emulsion formulation (M5) followed first order
Therefore, combinations for development of placebo kinetics.
formulations were selected from S mix ratio 4:1 and
subjected to physical stability testing. The drug was Ex vivo skin permeation study and data analysis
loaded into the stable placebo submicron emulsion The data obtained from this study revealed that minoxidil
formulations. loaded submicron emulsion (M5) exhibited maximum drug
permeation (79.36 ± 0.18%) in comparison with minoxidil
solution (49.79 ± 0.15%). The high drug permeation from
Formulation development and thermodynamic submicron emulsion was due to smaller globule size,
stability studies which resulted in direct and higher drug permeation into
skin. Another reason of higher drug permeation from
The placebo submicron emulsions which were found to be submicron emulsion was due to the presence of
stable after physical stability testing were further chosen Transcutol P as co-surfactant, which is reported to be a
for loading the drug in a suitable dose (1%w/v). The potent permeation enhancer [54].
prepared minoxidil loaded submicron emulsion were again The flux and the permeability coefficient values were
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
found to be remarkably higher for submicron emulsion in Viscosity determination & in vitro bioadhesion study
comparison with drug solution. The bioadhesion time possesed by minoxidil loaded
submicron emulsion based gel was significantly higher (p≤
Particle size, PDI and Zeta potential 0.05) in contrast to plain minoxidil gel, leading to higher
The average droplet size of submicron emulsion (M5) was residence time and better therapeutic activity.
observed to be 181.3 nm with a PDI value of 0.239
(Figure 4), which is less than 1 respectively. The Antioxidant activity of optimized submicron emulsion
polydispersity value less than 1 indicates monodisperse based gel
and homogeneous nature of the formulation. These DPPH method
results confirmed the ability of formulation to achieve the The significant antioxidant activity showed by minoxidil
desired transfollicular and transcellular penetration in skin loaded gel was due to the presence of clove oil, which is a
[49,12]. The formulation M5 exhibited the zeta potential of potent anti-oxidant [57].
-8.80 mV.
Stability Study
Formulation of Minoxidil loaded submicron emulsion The results of stability study revealed that there was no
based topical gel significant change in the value of pH, viscosity and drug
The optimized minoxidil loaded submicron emulsion content of optimized minoxidil loaded submicron emulsion
formulation (M5) was converted into gel formulation by based gel formulation after the storage period of 3
using different concentrations of carbopol 934 as gelling months.
agent.
LIMITATIONS
Characterization and optimization of submicron The efficacy of the dosage form would be dependent on
emulsion based gel formulations(M51%w/v, M51.5%w/v, the storage conditions. In this regards the patients have to
M52%w/v) be counselled.
Physical evaluation, pH, Drug content, Homogeneity
and grittiness CONCLUSION
The gel formulations were visually evaluated to examine The minoxidil loaded submicron emulsion based topical
their physical appearance (Table 3) and found to be gel was formulated and showed a controlled drug release,
stable and homogeneous. optimum particle size with PDI value less than 1,
significantly higher permeation and drug retention with
Ex vivo skin permeation studyusing excised rat skin prolonged stability. It also showed a potent anti-oxidant
& data analysis activity, which would inturn result in decreased incidence
The results of this study revealed that high drug of alopecia. Thus, the stabilized submicron emulsion
permeation was observed in the case of submicron based topical gel of minoxidil would be a beneficial topical
emulsion based gel formulations in contrast to the plain nanostrategy in contrast to other topical dosage
gel , which might be due to the presence of transcutol P, formulations introduced for alopecia therapy.
which is having a permeation enhancing activity [53].
As the quantity of gelling agent enhanced from 1% to 2%, ACKNOWLEDGEMENTS
the drug permeation was found to be reduced. For The authors acknowledge the facilities provided by Khalsa
effective topical delivery, drug permeated from the College of Pharmacy, Amritsar, Punjab.
submicron emulsion-based gel must not come in contact
with blood circulation. Due to this, the formulation with CONFLICT OF INTEREST
least permeation (M52%w/v)was selected as the optimized All the authors of this research declared no conflict of
submicron emulsion-based gel formulation. interest.
The flux and permeability coefficient values of different
minoxidil loaded submicron emulsion gels and plain REFERENCES
minoxidil gel were found to be significantly higher than the [1] Norwood, O.T. Male‒pattern baldness. Classification
plain drug loaded gels due to the presence of suractants. and incidence. South Med J 1975; 68(11) :1359–1370.
[2] Hillmer, A.M et al. Genetic Variation in the human
Drug retention study androgen receptor gene is the major determinant of
The drug retention from submicron emulsion based gel common early onset- Androgenetic alopecia. Am. J. Hum.
formulation M52%w/v was also significantly higher (p≤ 0.05) Gen. 2001;77 : 140-148.
as compared to the drug retention from plain gel which [3] Farrant, P., Messenger, A.G., McKillop, J. British
was due to the submicron size and also due to the Association of Dermatologists-Guidelines for the
presence of transcutol P, which is an efficient penetration management of Alopecia. Br J Dermatolol
enhancer. The presence of sebum in the folliclular 2012;166(916):1-3.
compartment also results in accumulation of drug in lipid [4] Ito, T. Recent advances in the pathogenesis of
environments or skin appendages, thus enhancing the Autoimmune hair loss disease Alopecia areata.Clinical
retention of hydrophobic drugs in the skin appendages and developmental Immunology 2013;1-6.
and follicles [55]. [5] Shapiro, J. Current Treatment of Alopecia Areata. J.
Investig. Dermatology Symp. Proc. 2013; 16 :S42–S44.
Histopathological study [6] Semalty, M., A. Semalty, A., Joshi G.P., Rawat, M.S.M.
From the observations of te histopathological studies Hair growth and rejuvenation: An overview, J.
conducted, it was concluded that both the skin samples Dermatolog. Treat. 2011; 22 : 123–132.
(Treated or untreated) showed no evidence of [7] Alsantali, A. Alopecia areata: a new treatment plan.
inflammation, indicating that the prepared formulation was Clin. Cosmet. Investig. Dermatol. 2011; 107.
not irritating to the rat skin. Thus, the minoxidil loaded [8] Kanti, V., Messenger, A., Dobos, G.,Reygagne, P.,
submicron emulsion based gel was within the limit of skin Finner, A., Blumeyer, A., Trakatelli, M., Tosti, A., Marmol,
tolerance and safe to use for topical applications[56]. V., Piraccini, B.M., Nast, A., Blume-Peytavi, U. Evidence-
based (S3) guideline for the treatment of androgenetic
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
alopecia in women and in men - short version.J Eur Acad Transl. Res 2-013; 3: 587–592.
Dermatol Venereol 2018; 32(1):11-22. [24] Khatereh, Z., Payam, K., Abbas, P., Mehdi, R.
[9] Santos, A.C., Silva, M.P., Guerra, C., Costla, D., Preparation and Physicochemical Characterization of
Peixoto, D., Pereira, I., Pita, I., Ribeiro, A.J., Veiga, F. Topical Niosomal Formulation of Minoxidil and Tretinoin.
Topical Minoxidil-Loaded nanotechnology Strategies for Glob J Pharmaceu Sci 2017; 3(2):555606.
Alopecia. Cosmetics 2020; 7(21) :1-25. [25] Wilson, V., Siram, K., Rajendran, S., Sankar, V.
[10] Silchenko, S., Nessah, N., Li,J., Huang, Y., Hidalgo, Development and evaluation of finasteride loaded
I.J. Ex vivo dissolution absorption system (IDAS2):Use for ethosomes for targeting to the pilosebaceous units. Artif
the prediction of food viscosity effects on drug dissolution Cells Nanomed Biotechnol. 2018; 46(8):1892-1901.
and absorption form oral solid dosage forms. Reference [26] Pravalika, G., Chandhana, P., Chiranjitha, I., Dhurke,
module in Biomedical Sciences. 2019; 1-3. R. Minoxidil ethosomes for treatment of alopecia.
[11] Uprit, S., Sahu, R.K., Roy, A., Pare, A. Preparation International journal of recent scientific research. 2020;
and characterization of minoxidil loaded nanostructured 11(1):37112-37117.
lipid carrier gel for effective treatment of alopecia. Saudi [27] Kwon, T.K., Kim, J.C. In-vitro skin permeation of
Pharmaceutical Journal 2013; 21: 379-385. monoolein nanoparticles containing
[12] Gomes, M.J., Martins, S., Ferreira, D., Segundo, β-cyclodextrins/minoxidil complex. International Journal of
M.A., Reis, S. Lipid nanoparticles for topical and Pharmaceutical Sciences 2010; 392 :268-273.
transdermal application for alopecia treatment: [28] Boca, S., Berce, C., Jurj, A., Petrushev, B., Pop, L.,
development, physicochemical characterization, and in Gafencu, G.A., Selicean, S., Moisoiu, V., Temian, D.,
vitro release and penetration studies. international journal Micu, W.T., Astilean, S., Braicu, C., Tomuleasa, C.,
of nanomadecine. 2014; 9:1231-42. Berindan-Neagoe, I. Ruxolitinib-conjugated gold
[13] Padois, K., Centieni, C., Bertholle, V., Bardel, C., nanoparticles for topical administration: An alternative for
Pirot., F, Falson, F. Solid lipid Nanoparticles versus treating alopecia? Med Hypotheses 2017; 109:42-45.
Commercial solutions for dermal delivery of Minoxidil. [29] Nagai, N., Iwai, Y., Sakamoto, A., Otake, H., Oaku,
International Journal of Pharmaceutics. 2011; 416:300- Y., Abe, A., Nagahama, T. Drug delivery systems based
304. on minoxidil nanoparticle promotes hair growth in
[14] Matos,B.N., Reis, T.A., Gratieri, T., Gelfuso, G.M. C57BL/6 Mice. Drug delivery 2019; 14: 7921-7931.
Chitosan Nanoparticles for targeting and sustaining [30] Madheswaran, T., Baskaran, R., Thapa, R.K., Rhyu,
Minoxidil sulpate delivery into hair follicles. International J.Y., Choi H.Y., Kim, J.O., Yong,C.S., Yoo, B.K. Design
Journal of Biological Macromolecules. 2015; 75: 225-229. and in vitro evaluation of finasteride-loaded liquid
[15] Khalil, R., Hashem, F., Zaki, H., El-Arini, S. Polymeric crystalline nanoparticles for topical delivery. AAPS
Nanoparticles as potential carriers for topical delivery of PharmSciTech. 2013; 14(1):45-52.
Colchicine: Development and in vitro characterization. [31] Mundada, V., Patel, M., Sawant, K. Submicron
International Journal of Pharmaceutical Sciences and emulsions and their applications in oral delivery. Crit. Rev
Research. 2014; 5(5) :1746-1756. Ther Drug Carrier System. 2016; 33(3):265-308.
[32] Benson, A.E., Abd, E., Roberts, M.S., Grice, J.E.
[16] Roque, L.V., Dias, I.S., Cruz, N., Rebelo, A., Roberto, Minoxidil Skin Delivery from Submicron-sized emulsion
A., Rijo, P., Reis, C.P. Design of Finasteride-Loaded Formulations containing Eucalyptol or Oleic Acid:
Nanoparticles for Potential Treatment of Alopecia. Skin Enhanced Diffusivity and follicular Targeting.
Pharmacol Physiol. 2017; 30(4):197-204. Pharmaceutics 2018; 10(19):1-12.
[17] Abd. E., Benson, H.A.E., Roberts, M.S., Grice, J.E. [33] Singh, R.P. Emulgel: A Recent Approach for Topical
Follicular penetration of caffeine from topically applied Drug Delivery System. Asian Journal of Pharmaceutical
nanoemulsion formulations containing penetration Research and Development. 2014; 2(2):13-15.
enhancers in vitro human skin studies. Skin Pharmacol [34] Srivastava, M., Kohli, K., Ali, M. Formulation
Physiol. 2018; 31(5) :252-60. development of novel in situ nanoemulgel of ketoprofen
[18] Cardoso, S.A., Baraddass, T.N. Developing for the treatment of periodontitis. Drug delivery. 2016;
Formulations for Drug Follicular targeting: Submicron- 23(1):154-166.
sized emulsions loaded with Minoxidil and Clove oil. [35] Sunitha, S., Jitendra, W., Sujatha, D., Kumar, M.S.
Journal of Drug Delivery Science and Technology. 2020; Design & Evaluation of Topical gel-Thickened
59:1-10. Microemulsions for Topical Delivery of MXD.Iranian
[19] Kumar, R., Singh, B., Bakshi, G., Katare, O.P. Journal of Pharmaceutical Science. 2013; 9(4): 1-14.
Development of liposomal systems of finasteride for [36] Rai, V.K., Yadav, N.P., Sinha, P., Mishra, N.,
topical applications: design, characterization, and in vitro Luqman, S., Dwivedi, H. Development of cellulosic
evaluation. Pharm Dev Technol. 2007;12(6):591-601. polymer based gel of novel ternary mixture of miconazole
[20] Jain, B., Singh, B., Katare, O.P., Vyas, S.P. nitrate for buccal delivery. Carbohydr Polym. 2014; 103:
Development and characterization of minoxidil-loaded 126–33.
liposomal system for delivery to pilosebaceous units. [37] Dhawan, B., Aggarwal, G., and Harikumar, S.C.
Journal of Liposome Research. 2010; 20(2): 105–114. Enhanced transdermal permeability of piroxican through
[21] Ahmed, O.A.A, Rizg, W.Y. Finasteride nano- novel nanoemulgels formulation. International Journal of
transferosomal gel formula for management of Pharmaceutical Investigation. 2014; 4(2):65-76.
androgenetic alopecia: ex vivo investigational [38] Sood, S., Jain, K., Gowthamarajan, K. Optimization of
approach. Drug Des Devel Ther. 2018;12:2259-2265 curcumin nanoemulsion for intranasal delivery using
[22] Ramezani, V., Honarvar, M., Seyedabadi, M., design of experiment and its toxicity assessment. Colloids
Karimollah, A., Ranjbar, A.M., Hashemi, M. Formulation Surf B Biointerfaces 2014;113:330-7.
and Optimization of transferosomes containing minoxidil [39] Chaudhary, S., Dasgupta, S., Patel, D.K., Ramani,
and caffeine. Journal of Drug Delivery Science and Y.R., Ghosh, S.K., Mazumder, B. Nanoemulsion as a
Technology. 2018;1-26. Carrier for Topical Delivery of Aceclofenac. Advanced
[23] Mali, N., Darandale, S., Vavia, P. Niosomes as a Nanomaterials and Nanotechnology. 2013; 1–19.
vesicular carrier for topical administration of minoxidil: [40] Teichmann, A., Jacobi, U., Ossadnik, M., Richter, H.,
formulation and in vitro assessment. Drug Deliv. and Koch, S., Sterry, W., Lademann, J. Differential stripping:
VOLUME 23, ISSUE Pharmacotherapy and Medical Science Advancements: A Cross-Continental Dialogue with East European and Asian Academics, Pages 92-102
Determination of the amount of topically applied 7(3):11-19.
substances penetrated into the hair follicles. J. Investig. [49] Shakeel, F., Shafiq, S., Haq, N., Alanazi, F.K.,
Dermatol. 2005; 125: 264–269. Alsarra, I.A. Nanoemulsions as potential vehicles for
[41] Sharma, S., Sahni, J.K., Ali, J. Effect of high-pressure transdermal and dermal delivery of hydrophobic
homogenization on formulation of drug loaded compounds: an overview. Expert Opin Drug Delivery.
nanoemulsion of rutin - pharmacodynamic and antioxidant 2012; 9(8): 953-74.
studies. Drug Delivery. 2015; 22(4):541-51. [50] Gulçin, I. Antioxidant activity of eugenol: a structure-
[42] Indora, N., Kaushik, D. Design, development and activity relationship study.J Med Food, 2012;14(9):975-85.
evaluation of ethosomal gel of fluconazole for topical [51] Kommuru, T.R., Gurley, B., Khan, M.A., Reddy, I.K.
fungal infection. International Journal of Engineering Self-emulsifying drug delivery systems (SEDDS) of
Science Invention Research & Development. 2015; coenzyme Q10: formulation development and
1:280-306. bioavailability assessment. Int J Pharm. 2001; 212: 233–
[43] Talele, S., Nikam, P., Ghosh, B., Deore, C., 246.
Jaybhave, A.A. Nanogel as topical promising drug [52] Pichler, J., Adriano, A.R., Cecato, P.M., De Almeida,
delivery for Diclofenac sodium.Indian Journal of A.M., Gavazzoni, M.F. The Shampoo pH can affect the
Pharmaceutical Education and Research. 2017; Hair: Myth or Reality. International Journal of trichology,
51(4):580-87. 2014; 6(3):95-99.
[44] Upadhyay, D.K., Sharma, A., Kaur, N., Narang, R.K., [53] Sarkar, N., Bose, S., Banerjee, D. Effects of PCL,
Gupta, G.D., Rai, V.K. Nanoemulgel for Efficient Topical PEG and PLGA polymers on curcumin release from
Delivery of Finasteride Against Androgenic Alopecia. calcium phosphate matrix for in vitro and in vivo bone
Journal of pharmaceutical innovation. 2020; 1-12. regeneration.Today Chem 2018; 110-120.
[45] Zheng, Y., Ouyang, W., Wei, Y., Shahid, F.S, Chao, [54] Baboota, S., Shakeel, F., Ahuja, A., Ali, J., Shafiq S.
S.H, Yan, H. Effect of Carbopol 934 proportion on Design, development and evaluation of novel submicron
nanoemulsion gel for topical and transdermal drug emulsion formulations for transdermal potential of
delivery: a skin permeation study. International Journal of celecoxib.Acta Pharmaceutical. 2007; 57(3):315–332.
Nanomedicine. 2016; 5971-5987. [55] Lademann J., Knorr F., Richter H., Blume-Peytavi U.,
[46] Biradar, S.V., Dhumal,R.S., Paradkar, A. Rheological Vogt U., Antoniou C., Sterry W., Patzelt A. Hair follicles –
investigation of self emulsification process. Journal of an efficient storage and penetration pathway for topically
Pharmaceuticsl Science. 2009; 12(1):17-31. applied substances. Skin Pharmacol. Physiol. 2008;
[47] Zubairu, Y., Negi, L.M., Talegoankar, S., Iqbal, Z. 21:150–155.
Design and development of novel bioadhesive niosomal [56] Mao L., Yang J., Xu D., Yuan F., Gao Y. Effects of
formulation for the transcorneal delivery of anti-infective homogenization models and emulsifiers on the
agent: in vitro and in vivo investigations. Asian journal of physicochemical properties of b-carotene nanoemulsions.
pharmaceutical sciences. 2015; (10): 322-330. J. Dispers. Sci. Technol. 2019; 31:986-993.
[48] Jufri, M., Dhyaksa, M.L. Formulation and physical [57] Prie, B.E., Iosif, L., Tivig, I., Stoian, I., Giurcaneanu,
stability of nanoemulsion gel (nanoemulgel) containing C. Oxidative stress in androgenetic alopecia. J Med Life
Belimbing Wuluh (Averrhoa Bilimbi L.,) ethanolic extract. 2016; 9(1):79-83.
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