A REVIEW ON THE SOLID ORAL DOSAGE FORM FOR PEDIATRICS, REGULATORY ASPECTS, CHALLENGES INVOLVED DURING THE FORMULATION, AND TOXICITY OF THE EXCIPIENTS USED IN PEDIATRIC FORMULATION

Authors

  • SUSHMITA SANKESHWARI Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015 https://orcid.org/0000-0001-6830-9301
  • GANGADHARAPPA H. V. Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015 https://orcid.org/0000-0002-2961-4108
  • ASHA SPANDANA K. M. Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015 https://orcid.org/0000-0003-2541-1896
  • ANU ELIYAS Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015 https://orcid.org/0009-0005-2075-0751
  • SHAILESH THIRUMALESHWAR Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015
  • PYDA VENKATA HARSHA VARDHAN Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015 https://orcid.org/0009-0005-2080-107X

DOI:

https://doi.org/10.22159/ijap.2023v15i3.47313

Keywords:

Pediatric, Solid oral dosage form, Regulatory aspects, Excipients, Toxicity, Pediatric Drug Delivery

Abstract

Designing an appropriate dosage form in medical treatment for the pediatric population is very challenging. The major challenges faced during designing the oral solid dosage form for pediatrics are also the prerequisites for the development of the dosage form, and they are, administering the drug according to the body weight and taste masking, which is followed by other factors like the safety of excipients, size of dosage form and so on. Oral solid dosage forms like mini-tablets, soluble films, and orally disintegrating tablets are a few promising dosage forms for use in the pediatric population. The obstacles, such as physiological differences between the various age groups, excipient safety, technology requirements, low profitability, clinical trial limitations, and regulatory ambiguity all have an impact on pediatric dosage form development. Recent advancement in the development of pediatrics formulations has been made due to new regulations, more financial opportunities, and novel collaborative research programs. A shift of pattern towards solid oral dosage form and an emphasis on innovative preparations, such as dispersible, flexible, as well as multi-particulate oral solid dose forms, are some of the advanceme nts. Such advancements have allowed for more flexibility of dose, easy administration, and improved medication formulation acceptance in pediatrics. In consideration of dosage forms for pediatrics, issues such as pediatric suitability, excipient selection, prospects for modified drug release formulations or fixed-dose combinations, palatability, and acceptability, as well as challenges were reviewed in the current manuscript.

Downloads

Download data is not yet available.

Author Biographies

SUSHMITA SANKESHWARI, Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015

 

 

GANGADHARAPPA H. V., Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015

 

 

ASHA SPANDANA K. M., Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015

 

 

ANU ELIYAS, Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015

 

 

SHAILESH THIRUMALESHWAR, Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015

 

 

PYDA VENKATA HARSHA VARDHAN, Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Sri-Shivarathreeshwara Nagara, Mysuru, Karnataka, India 570015

 

 

References

Alessandrini E, Brako F, Scarpa M, Lupo M, Bonifazi D, Pignataro V. Children’s preferences for oral dosage forms and their involvement in formulation research via eptri (European paediatric translational research infrastructure). Pharmaceutics. 2021;13(5):730. doi: 10.3390/pharmaceutics13050730, PMID 34063499.

Yellepeddi VK, Vangara KK. Excipients in pediatric formulations: biopharmaceutical and toxicological considerations. Excip Appl Formul Drug Deliv. 2015;2(2):497-519.

Lajoinie A, Henin E, Kassai B, Terry D. Solid oral forms availability in children: A cost saving investigation. Br J Clin Pharmacol. 2014;78(5):1080-9. doi: 10.1111/bcp.12442, PMID 24965935.

Ivanovska V, Rademaker CM, van Dijk L, Mantel Teeuwisse AK. Pediatric drug formulations: a review of challenges and progress. Pediatrics. 2014;134(2):361-72. doi: 10.1542/peds.2013-3225, PMID 25022739.

Galande AD, Khurana NA, Mutalik S. Pediatric dosage forms-challenges and recent developments: A critical review. J Appl Pharm Sci. 2020;10(7):155-66.

Mfoafo KA, Omidian M, Bertol CD, Omidi Y, Omidian H. Neonatal and pediatric oral drug delivery: hopes and hurdles. Int J Pharm. 2021;597:120296. doi: 10.1016/j.ijpharm.2021.120296, PMID 33524524.

Rouaz K, Chiclana Rodriguez B, Nardi Ricart A, Sune-Pou M, Mercade Frutos D, Sune Negre JM. Excipients in the paediatric population: a review. Pharmaceutics. 2021;13(3):387. doi: 10.3390/pharmaceutics13030387, PMID 33805830.

Zisowsky J, Krause A, Dingemanse J. Drug development for pediatric populations: regulatory aspects. Pharmaceutics. 2010;2(4):364-88. doi: 10.3390/pharmaceutics2040364, PMID 27721363.

EMA/Committee for Medicinal Products for human use (CHMP)/Paediatric Committee (PDCO). Guideline on Pharmaceutical Development of Medicines for Paediatric Use. EMA (European Medicines Agency). 2017;44:1-23. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2013/07/WC500147002.pdf. [Last accessed on 02 Dec 02 2022]

Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER). Food and Drug Administration guidance for Industry: the Content and format for pediatric use supplements; 2005. p. 1-18. Available from: https://www.fda.gov/files/drugs/published/Guidance-for-Industry-(Draft)-how-to-comply-with-the-pediatric-research-equity-act-(posted-9-7-2005).pdf. [Last accessed on 02 Dec 2022]

Biotechnology innovation organization: history of pediatric studies, rule, legislation and litigation. Available from: https://archive.bio.org/advocacy/letters/history-pediatric-studies-rule-legislation-and-litigation. [Last accessed on 02 Dec 2022]

Best pharmaceuticals for children act-BPCA. NICHD-eunice kennedy shriver national institute of child health and human development. Available from: https://www.nichd.nih.gov/research/supported/bpca. [Last accessed on 02 Dec 2022]

Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER). Food and Drug Administration Guidance for Industry: recommendations for Complying with the Pediatric Rule (21 CFR 314.55(a) and 601.27(a)); c2000. Available from: https://www.federalregister.gov/documents/2000/12/04/00-30697/draft-guidance-for-industry-on-recommendations-for-complying-with-the-pediatric-rule-availability. [Last accessed on 02 Dec 2022]

Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER). Food and Drug Administration guidance for Industry: how to comply with the pediatric research equity act (draft guidance); c2019. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/how-comply-pediatric-research-equity-act. [Last accessed on 02 Dec 2022]

US Food and Drug Administration. Department of health and human service, food and drug administration memorandum–establishment of the pediatric review committee (PeRC); c2018. Available from: https://www.fda.gov/drugs/development-resources/pediatric-review-committee-perc. [Last accessed on 02 Dec 2022]

European Medicines Agency. ICH topic E11. Note for guidance on Clinical investigation of medicinal products in the paediatric population; c2001. Available from: https://www.ema.europa.eu/en/documents/scientific-guideline/international-conference-harmonisation-technical-requirements-registration-pharmaceuticals-human-use_en-1.pdf. [Last accessed on 02 Dec 2022]

Thomas KB, Joergensen M, Lynch G, Rubison M, Porter BD, Sayers J. Clinical trial disclosure: global overview and implications of new laws and guidelines. Drug Information J. 2010;44(3):213-25. doi: 10.1177/009286151004400303.

European Medicines Agency. The European paediatric initiative: history of the Paediatric Regulation; c2007. Available from: https://www.ema.europa.eu/en/documents/other/European-paediatric-initiative-history-paediatric-regulation_en.pdf. [Last accessed on 02 Dec 2022]

Official Journal of the European Communities. Council Resolution of 14 Dec 2000 on paediatric medicinal products; 2001. Available from. Available from: https://eurlex.europa.eu/lexUriServ/lexUriServ.do?uri=OJ:C:. [Last accessed on 02 Dec 2022]

EUR. Lex. Regulation (EC) No 1901/2006 of the european parliament and of the council of 12 Dec 2006 on medicinal products for paediatric use and amending Regulation (EEC) No 1768/92, Directive. Off J Eur Union; c2006. Available from: https://eur-lex.europa.eu/eli/reg/2006/1901/oj. [Last accessed on 02 Dec 2022]

Cram A, Breitkreutz J, Desset Brethes S, Nunn T, Tuleu C, European paediatric formulation initiative (EuPFI). Challenges of developing palatable oral paediatric formulations. Int J Pharm. 2009;365(1-2):1-3. doi: 10.1016/j.ijpharm.2008.09.015, PMID 18848611.

Preis M. Orally disintegrating films and mini-tablets-innovative dosage forms of choice for pediatric use. AAPS PharmSciTech. 2015;16(2):234-41. doi: 10.1208/s12249-015-0313-1, PMID 25739913.

Zuccari G, Alfei S, Marimpietri D, Iurilli V, Barabino P, Marchitto L. Mini-tablets: A valid strategy to combine efficacy and safety in pediatrics. Pharmaceuticals (Basel). 2022;15(1):108. doi: 10.3390/ph15010108, PMID 35056165.

Aleksovski A, Dreu R, Gasperlin M, Planinsek O. Mini-tablets: A contemporary system for oral drug delivery in targeted patient groups. Expert Opin Drug Deliv. 2015;12(1):65-84. doi: 10.1517/17425247.2014.951633, PMID 25200881.

EMEA European Medicines Agency. Formulations of choice for the paediatric population. Reflection Paper’ 2006;7:1-45. Available from: https://www;europa.eu/en/documents/scientific-guideline/reflection-paper-formulations-choice-paediatric-population_en.pdf. [Last accessed on 02 Dec 2022]

Nunn T, Williams J. Formulation of medicines for children. Br J Clin Pharmacol. 2005;59(6):674-6. doi: 10.1111/j.1365-2125.2005.02410.x, PMID 15948931.

Jacqz Aigrain E, Choonara I. Paediatric clinical pharmacology. Br J Clin Pharmacol. 2006;78(5):1080-9.

Garvie PA, Lensing S, Rai SN. Efficacy of a pill-swallowing training intervention to improve antiretroviral medication adherence in pediatric patients with HIV/AIDS. Pediatrics. 2007;119(4):e893-9. doi: 10.1542/peds.2006-1488, PMID 17353298.

Spomer N, Klingmann V, Stoltenberg I, Lerch C, Meissner T, Breitkreutz J. Acceptance of uncoated mini-tablets in young children: results from a prospective exploratory cross-over study. Arch Dis Child. 2012;97(3):283-6. doi: 10.1136/archdischild-2011-300958, PMID 22253279.

Thomson SA, Tuleu C, Wong IC, Keady S, Pitt KG. SA minitablets: new modality to deliver medicines to preschoolaged children. Pediatrics. 2009:235-8.

Kristensen HG. WHO guideline development of paediatric medicines: points to consider in pharmaceutical development. Int J Pharm. 2012;435(2):134-5. doi: 10.1016/j.ijpharm.2012.05.054, PMID 22883696.

Faisal M, Cawello W, Burckhardt BB, Laer S. Model-dependent pharmacokinetic analysis of enalapril administered to healthy adult volunteers using orodispersible minitablets for use in pediatrics. Drug Des Devel Ther. 2019;13:481-90. doi: 10.2147/DDDT.S188417, PMID 30774312.

Khan D, Kirby D, Bryson S, Shah M, Rahman Mohammed A. Paediatric specific dosage forms: patient and formulation considerations. Int J Pharm. 2022;616:121501. doi: 10.1016/j.ijpharm.2022.121501, PMID 35092832.

Thabet Y, Klingmann V, Breitkreutz J. Drug formulations: standards and novel strategies for drug administration in pediatrics. J Clin Pharmacol. 2018;58;Suppl 10:S26-35. doi: 10.1002/jcph.1138, PMID 30248193.

Lura A, Luhn O, Suarez Gonzales J, Breitkreutz J. New orodispersible mini-tablets for paediatric use–a comparison of isomalt with a mannitol based co-processed excipient. Int J Pharm. 2019;572:118804. doi: 10.1016/j.ijpharm.2019.118804, PMID 31678381.

Ravinder K, Pawan K, Gaurav S, Paramjot K, Gagan S, Appramdeep K. Orally disintegrating tablets-friendly to pediatrics and geriatrics. Pharmacia. 2010;2(2):208-20. Available from: http://scholarsresearchlibrary.com/ABR-vol1-iss2/ABR-2010-1-2-87-90.pdf.

Kole SS, Kuchekar AB, Lİmaye DA. Advancements in formulation approaches to pediatric oral drug delivery systems. Hacettepe Univ J Fac Pharm. 2021;41(4):254-65. doi: 10.52794/hujpharm.941321.

Lopes CM, Lobo JMS, Pinto JF, Costa P. Compressed mini-tablets as a biphasic delivery system. Int J Pharm. 2006;323(1-2):93-100. doi: 10.1016/j.ijpharm.2006.05.063, PMID 16828999.

MD, CP, MS. Taste masking by hot melt extrusion without loss of bioavailability for pediatrics. Int J Pharm Pharm Sci. 2019;11(7):7-13.

Nagaraju T, Gowthami R, Rajashekar M, Sandeep S, Mallesham M, Sathish D. Comprehensive review on oral disintegrating films. Curr Drug Deliv. 2013;10(1):96-108. doi: 10.2174/1567201811310010016, PMID 22920576.

Lopez FL, Ernest TB, Tuleu C, Gul MO. Formulation approaches to pediatric oral drug delivery: benefits and limitations of current platforms. Expert Opin Drug Deliv. 2015;12(11):1727-40. doi: 10.1517/17425247.2015.1060218, PMID 26165848.

Singh Panwar A, Golani P, Verma M. A review of the combination of xanthine and bronchodilator drug in mouth dissolving film for asthma treatment. Lodhi Ds. Asian J Pharm Clin Res. 2021;14(11):24-9.

Shruthi BK, Chandrakala V SS. Formulation and evaluation of mouth-dissolving film of an H1 antihistamine drug. Int J Curr Pharm Res. 2019;14(6):55-66.

Irfan M, Rabel S, Bukhtar Q, Qadir MI, Jabeen F, Khan A. Orally disintegrating films: a modern expansion in drug delivery system. Saudi Pharm J. 2016;24(5):537-46. doi: 10.1016/j.jsps.2015.02.024, PMID 27752225.

Renu J Dahiya, Pawan Jalwal BS. Chewable tablets: a comprehensive review. J Pharm Innov J. 2015;4(5):100-5.

Narang AS, Boddu SH. Excipient applications in formulation design and drug delivery. In: Narang AS, Sai HS, editors. Boddu, editors. Excip Appl Formul Des drug Deliv. Berlin: Springer Cham; 2015. p. 1-10.

Van Riet Nales DA, Kozarewicz P, Aylward B, de Vries R, Egberts TC, Rademaker CM. Paediatric drug development and formulation design-a european perspective. AAPS PharmSciTech. 2017;18(2):241-9. doi: 10.1208/s12249-016-0558-3. PMID 27270905.

Zajicek A, Fossler MJ, Barrett JS, Worthington JH, Ternik R, Charkoftaki G. A report from the pediatric formulations task force: perspectives on the state of child-friendly oral dosage forms. AAPS J. 2013;15(4):1072-81. doi: 10.1208/s12248-013-9511-5, PMID 23907486.

Yochana S, Yu M, Alvi M, Varenya S, Chatterjee P. Pharmaceutical excipients and pediatric formulations. Chim Oggi Chem Today. 2012;30(5):56-61.

Kaguelidou F, Kassai Koupai B, Durrieu G. Pediatric pharmacology. Therapie. 2018;73(2):111-2. doi: 10.1016/j.therap.2018.02.003, PMID 29602602.

Nakamura S, Tanaka C, Yuasa H, Sakamoto T. Utility of microcrystalline cellulose for improving drug content uniformity in tablet manufacturing using direct powder compression. AAPS PharmSciTech. 2019;20(4):151. doi: 10.1208/s12249-019-1365-4, PMID 30903317.

Zhang D, Rumondor ACF, Zhu W, Colace T, Marota M, Mora J. The development of minitablets for a pediatric dosage form for a combination therapy. J Pharm Sci. 2020;109(12):3590-7. doi: 10.1016/j.xphs.2020.08.021, PMID 32882230.

Belayneh A, Tadese E, Molla F. Safety and biopharmaceutical challenges of excipients in off-label pediatric formulations. Int J Gen Med. 2020;13:1051-66. doi: 10.2147/IJGM.S280330, PMID 33204140.

Peire Garcia M. Pediatric pharmacology. Ediciones J. 2019;274. Available from: https://www.edicionesjournal.com/papel/9789874922236/farmacologia+pediatrica.

Warren F. Handbook of pharmaceutical excipients. American Journal of Health System Pharmacy. 1987;44(8):1946-8. doi: 10.1093/ajhp/44.8.1946.

Balbani APS, Stelzer LB, Montovani JC. Pharmaceutical excipients and the information on drug labels. Braz J Otorhinolaryngol. 2006;72(3):400-6. doi: 10.1016/s1808-8694(15)30976-9, PMID 17119779.

Batchelor HK, Marriott JF. Formulations for children: problems and solutions. Br J Clin Pharmacol. 2015;79(3):405-18. doi: 10.1111/bcp.12268, PMID 25855822.

Allam KVI, Kumar GP. Colorants-the cosmetics for the pharmaceutical dosage forms. Int J Pharm Pharm Sci. 2011;3Suppl 3:13-21.

Cheng D, Tan T, Mei Y, Mount S, Galella E, Mitra B, Charlton S, Kuhli M, Ternik R, Walsh J, Rajapakshe A, Thompson K, Mehrotra S, Santangelo M, Liu J, Dixit T, Schaufelberger D, Jamzad S, Klein S, Hoag SW, Wang J, Pfuma E, Khurana M, Alexander J, Radden E, Sood R, Selen A. European journal of pharmaceutics and biopharmaceutics pediatric formulation development–challenges of today and strategies for tomorrow : summary report from M−CERSI workshop 2019. Eur J Pharm Biopharm. 2021;164:54-65.

Ernest TB, Elder DP, Martini LG, Roberts M, Ford JL. Developing paediatric medicines: identifying the needs and recognizing the challenges. J Pharm Pharmacol. 2010;59(8):1043-55. doi: 10.1211/jpp.59.8.0001, PMID 17725846.

Conroy S. Paediatric pharmacy-drug therapy. Hosp Pharm. 2003;10(2):49-57.

Orubu ESF, Tuleu C. Medicines for children: flexible solid oral formulations. Bull World Health Organ. 2017;95(3):238-40. doi: 10.2471/BLT.16.171967, PMID 28250539.

Klingmann V, Linderskamp H, Meissner T, Mayatepek E, Moeltner A, Breitkreutz J, Bosse HM. Acceptability of multiple uncoated minitablets in infants and toddlers: A randomized controlled trial. J Pediatr. 2018;201:202-207202-207.e1. doi: 10.1016/j.jpeds.2018.05.031, PMID 29960767.

Salunke S, Hempenstall J, Kendall R, Roger B, Mroz C, Nunn T. European paediatric formulation initiative’s (EuPFI) 2nd conference commentary–formulating better medicines for children. Int J Pharm 2nd Conference Commentary-Formulating Better Medicines for Children. 2011;419(1-2):235-9. doi: 10.1016/j.ijpharm.2011.06.040, PMID 21784141.

Helin Tanninen M. Extemporaneous preparation of paediatric oral formulations studies conducted in nifedipine powders, capsules and suspensions in a hospital pharmacy; 2008. Available from: https://core.ac.uk/download/pdf/15168083.pdf. [Last accessed on 02 Dec 2022]

Strickley RG, Iwata Q, Wu S, Dahl TC. Pediatric drugs–a review of commercially available oral formulations. J Pharm Sci. 2008;97(5):1731-74. doi: 10.1002/jps.21101, PMID 17823956.

Hoppu K. Editorial: can we get the necessary clinical trials in children and avoid the unnecessary ones? Eur J Clin Pharmacol. 2009;65(8):747-8. doi: 10.1007/s00228-009-0675-y, PMID 19521694.

Viergever RF, Karam G, Reis A, Ghersi D. The quality of registration of clinical trials: still a problem. PLoS One. 2014;9(1):e84727. doi: 10.1371/journal.pone.0084727, PMID 24427293.

De Angelis C, Drazen JM, Frizelle FA, Haug C, Hoey J, Horton R, Kotzin S, Laine C, Marusic A, Overbeke AJPM, Schroeder TV, Sox HC, Van Der Weyden MB. Clinical trial registration: a statement from the international committee of medical journal Editors. Hypertension. 2005;45(4):631-2. doi: 10.1161/01.HYP.0000162403.06848.3e, PMID 15790961.

Thomson D, Hartling L, Cohen E, Vandermeer B, Tjosvold L, Klassen TP. Controlled trials in children: quantity, methodological quality and descriptive characteristics of pediatric controlled trials published 1948-2006. PLoS One. 2010;5(9):1-9. doi: 10.1371/journal.pone.0013106, PMID 20927344.

De Vries TW, Van Roon EN. Low quality of reporting adverse drug reactions in paediatric randomised controlled trials. Arch Dis Child. 2010;95(12):1023-6. doi: 10.1136/adc.2009.175562, PMID 20551194.

Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Obstet Gynecol. 2009;114(6):1341-5. doi: 10.1097/AOG.0b013e3181c3020d, PMID 19935040.

Cramer K, Wiebe N, Moyer V, Hartling L, Williams K, Swingler G. Children in reviews: methodological issues in child-relevant evidence syntheses. BMC Pediatr. 2005;5:38. doi: 10.1186/1471-2431-5-38. PMID 16176579.

Young B, Shilling V, Hickey H, Sowden E, Smyth RL, Williamson PR. What parents think about being approached about children’s trials, how this differs from what practitioners expect, and what this tells us about enhancing recruitment. Trials. 2011;12Suppl 1. doi: 10.1186/1745-6215-12-S1-A116.

Malkawi WA, Alrafayah E, Alhazabreh M, Abulaila S, Al-Ghananeem A, Al-Ghananeem AM. Formulation challenges and strategies to develop pediatric dosage forms. Children. 2022;9(4):488. doi: 10.3390/children9040488.

Salazar JC. Pediatric clinical trial experience: government, child, parent and physician’s perspective. Pediatr Infect Dis J. 2003;22(12):1124-7. doi: 10.1097/01.inf.0000101847.22501.e7, PMID 14688585.

Ackerman TF. The ethics of drug research in children. Paediatr Drugs. 2001;3(1):29-41. doi: 10.2165/00128072-200103010-00003, PMID 11220403.

O’Lonergan TA, Milgrom H. Ethical considerations in research involving children. Curr Allergy Asthma Rep. 2005;5(6):451-8. doi: 10.1007/s11882-005-0025-9, PMID 16216169.

Truog RD, Rockoff MA. Ethical issues in pediatric anesthesia. Semin Anesth. 1991;10(3):187-94. PMID 11651358.

Dixon Woods M, Ashcroft RE, Jackson CJ, Tobin MD, Kivits J, Burton PR, Samani NJ. Beyond “”misunderstanding”: written information and decisions about taking part in a genetic epidemiology study. Soc Sci Med. 2007;65(11):2212-22. doi: 10.1016/j.socscimed.2007.08.010, PMID 17904716.

Altavilla A. Pediatric clinical trials. Leg J Forensic Med. 2013:1127-36.

Klassen TP, Hartling L, Craig JC, Offringa M. Children are not just small adults: Tthe urgent need for high-quality trial evidence in children. PLOS Med. 2008;5(8):1180-2. doi: 10.1371/journal.pmed.0050172.

Hill P. Off licence and off label prescribing in children: litigation fears for physicians. Arch Dis Child. 2005;90Suppl 1:i17-8. doi: 10.1136/adc.2004.058867, PMID 15665151.

Koncert A. Kaletra once daily randomised trial of the pharmacokinetics, safety and efficacy of twice-daily versus once-daily lopinavir/ritonavir tablets dosed by weight as part of combination antiretroviral therapy in human immunodeficiency Virus-1 (HIV-1). United States National Library of Medicine; 2010. Available from: https://clinicaltrials.gov/show/NCT01196195. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Investigating safety, tolerability, efficacy and PK of olaparib in pediatric patients with solid tumours. United States National Library of Medicine; 2020. Available from: https://clinicaltrials.gov/ct2/show/NCT04236414. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Study of entrectinib (RxDx-101) in children and adolescents with loccaly advanced or metastatic solid or primary CNS tumors and/or who have no satisfactory treatment options (STARTRK-NG). United States National Library of Medicine; 2016. Available from: https://clinicaltrials.gov/ct2/show/NCT02650401. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Study of finerenone to investigate a paediatric formulation in healthy male voulnteers. United States National Library of Medicine; 2016. Available from: https://clinicaltrials.gov/ct2/show/NCT02956109. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Ondansetron oral versus orally disintegrating tablets (ODT). United States National Library of Medicine; 2014. Available from: https://clinicaltrials.gov/ ct2/show/NCT02174874. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. A study to evaluate the safety and tolerability of rizatriptan for long term treatment of acute migrane in children and adolescents (MK-0462-086 AM3). United States National Library of Medicine; 2012. Available from: https://clinicaltrials.gov/ct2/show/NCT01004263. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. A study to assess the efficacy and safety of mebendazole for the treatment of helminth infections in pediatric participants. United States National Library of Medicine; 2016. Available from: https://clinicaltrials.gov/ct2/show/NCT02034162. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Study of the Safety and pharmacikinetics of montelukast (MK-0476) in the treatment of Japanese pediatric participants with perennial allergic rhinitis (MK-0476-520). United States National Library of Medicine; 2014. Available from: https://clinicaltrials.gov/ct2/show/NCT01852812. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. The effect of montelukast on difficulty in breathing after exercise in pediatric patients (MK0476-377) (Completed). United States National Library of Medicine; 2011. Available from: https://clinicaltrials.gov/ct2/show/NCT00534976. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Pharmacokinetics, safety and tolerability of fevipiprant delivered via a once daily chewable tablet in children aged 6 to<12 Y with Asthma. United States National Library of Medicine; 2020. Available from: https://clinicaltrials.gov/ct2/show/NCT03650400. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. A study of the safety, tolerability, and antiretroviral activity of raltegravir (MK-0518) in combination with other retroviral therapies in russian children and adolescents infected with human immunodeficiency virus (HV-1) (MK-0518-248). United States National Library of Medicine; 2014. Available from: https://clinicaltrials.gov/ct2/show/NCT01717287. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Safety and pharmacokinetics (PK) of raltegravir in HIV (human immunodeficiency virus)-infected children and adolescents. United States National Library of Medicine; 2007. Available from: https://clinicaltrials.gov/ct2/show/NCT00485264. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Atorvastatin three year pediatric study. United States National Library of Medicine; 2009. Available from: https://clinicaltrials.gov/ct2/show/NCT00827606. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. The role of lactobacillus Reutri in children and adolescents with anorexia nervosa. United States National Library of Medicine; 2013. Available from: https://clinicaltrials.gov/ct2/show/NCT02004288. [Last accessed on 15 Feb 2023]

ClinicalTrials.gov. Phase I study of mebendazzole therapy for recurrent/progressive pediatric brain tumors. United States National Library of Medicine; 2015. Available from: https://clinicaltrials.gov/ct2/show/NCT02644291. [Last accessed on 15 Feb 2023]

Thompson KC, Kaighn KN, Mukherjee IN, Elizabeth C, Hedy D, Mancinelli TWC, Inventor. Merck sharp & Dohme LLC, assignee; taste-masked formulations of raltegravir. Europe Patent EP2699094A1; 2014.

Kojima R, Sakai T, Ryota A, Tanaka M, Inventor. Astellas pharma inc, assignee; pharmaceutical composition for oral administration. United States patent US20210346392. Vol. A1; 2021.

Gupta S, Phaldesai SP, Senthil Kumar NSK, Sathe MV, Inventor. Unichem laboratories ltd, assignee; tofacitinib orally disintegrating tablets. United States Patent US10034882B2; 2018.

Shimizu T, Morimoto S, Tabata T, Inventor. Takeda pharmaceutical co ltd, assignee; orally disintegrable tablets. United States Patent US9901546B2; 2018.

Sato T, Ota M, Kigoshi M, Morita H, Inventor. Kyowa kirin co ltd, assignee; taste-masked formulations of raltegravir. United States Patent US9861577B2; 2018.

Jules Jacob, Guillot KCM, Sultzbaugh KJ, WEST TG, Inventor. Aprecia Pharmaceuticals LLC, assignee; rapidly dispersible dosage form with high drug content. United States Patent US20180296479. Vol. A1; 2018.

Yi Z, Inventor. Jiangsu Huhong Biomedical Co., Ltd, assignee; amlodipine besylate orally disintegrating tablet prepared through 3D printing and preparation method of orally disintegrating tablet. China Patent CN107823153A; 2018.

Yi Z, Inventor. Huhong Ind Shanghai Co Ltd, assignee; preparation method of olanzapine orally disintegrating tablet based on inkjet 3D printing. China Patent CN110269844A; 2019.

Cochran D, dave V, Koll G, Mcnally GP, Ee C, Szymczak SU, Inventor. Johnson & Johnson Consumer Inc, assignee; process for making tablet using radio frequency and lossy coated particles. Australia Patent AU2020201762A1; 2020.

Westrin BA, Inventor. LTS lohmann therapie systeme GmbH and Co KG Acucort AB, assignee; dexamethasone oral film. United States Patent US20190175617. Vol. A1; 2019.

Yang RK, Richard C, Fuisz GL, Myers JM Fuisz, Inventor. Aquestive therapeutics inc, assignee; uniform films for rapid dissolving doasage form incorporating taste-masking compositions. United States Patent US20190380973. Vol. A1; 2019.

Dixit MA, Pawar V, Patel Rushi, Patel M, Inventor. First time US generics LLC, assignee; abuse deterrent soft chewable drug formulations. United States Patent US20190000766. Vol. A1; 2019.

Nguyen Nm, Lim LY, Inventor. University of Western Australia, assignee; Taste masking product. United States Patent US20190350850. Vol. A1; 2019.

Romanoschi O, Oryniak C, Muniz LC, Huatan H, Kanji N, Jones H Inventor. Church and dwight co inc, assignee; multicomponent gummy compositions with hard core. United States Patent US20200000716. Vol. A1; 2020.

Laudon M, Zisapel N, Inventor. Neurim pharmaceuticals. United States patent US20190060277. 1991 Ltd, assignee; Melatonin mini-tablets and method of manufacturing the same A1; 2019.

Liang ACY, Dingari V, Ferring BV, Assignee: oral pharmaceutical compositions of mesalazine. United States Patent US20190105275. Vol. A1; 2019.

Ayalasomayajula SP, Berkhin M, Bush C, Chen F, Trueby B, Winzenburg G, Novartis AG. Assignee: galenic formualtions of organic compounds. Australia patent AU2019280026A1; 2020.

Guittet C, Granier LA, Roussel Maupetit C, Inventor. Advicenne, assignee; pharmaceutical composition comprising citrate and bicarbonate salts, and use thereof for treating cystinuria. United States Patent US9636304B2; 2017.

Dokou E, Jamzad Shahla, Caesar JP, Fawaz M, Das L, Gu CH. Inventor vertex pharmaceuticals inc, assignee; pharmaceutical composition and administrations thereof. United States Patent US20190274959. Vol. A1; 2019.

International conference on h guidance for industry E11 clinical investigation of medicinal products in the pediatric population. Federal Register. 2000;65:19777-81. Available from: https://www;fda.gov/regulatory-information/search-fdaguidance-documents/e11-clinical-investigation-medicinal-products-pediatric-population. [Last accessed on 15 Feb 2023]

Karavasili C, Gkaragkounis A, Fatouros DG. Patent landscape of pediatric-friendly oral dosage forms and administration devices. Expert Opin Ther Pat. 2021;31(7):663-86. doi: 10.1080/13543776.2021.1893691, PMID 33605825.

Emea. Guideline on pharmaceutical development of medicines for paediatric use guideline on pharmaceutical development of medicines for paediatric use. Emea. 2013;44:1-23. Available from: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-pharmaceutical-development-medicines-paediatric-use_en.pdf. [Last accessed on 15 Feb 2023]

Drugs. Tregretol; 2021. Available from: https://www.drugs.com/tegretol. [Last accessed on 02 Dec 2022]

Published

07-05-2023

How to Cite

SANKESHWARI, S., H. V., G., K. M., A. S., ELIYAS, A., THIRUMALESHWAR, S., & HARSHA VARDHAN, P. V. (2023). A REVIEW ON THE SOLID ORAL DOSAGE FORM FOR PEDIATRICS, REGULATORY ASPECTS, CHALLENGES INVOLVED DURING THE FORMULATION, AND TOXICITY OF THE EXCIPIENTS USED IN PEDIATRIC FORMULATION. International Journal of Applied Pharmaceutics, 15(3), 12–27. https://doi.org/10.22159/ijap.2023v15i3.47313

Issue

Section

Review Article(s)