Issue link: https://www.e-digitaleditions.com/i/276262
utility in geriatric formulations. Given the dose loading and the fre- quency of doses, however, be aware that diarrhea is a potential side effect, which could inflict discomfort and lead to dehydration and thus lead to additional therapy to rehydrate and/or replace electrolytes. Isomalt and the careful use of sugars could be used and may indeed be preferred. Diabetes and issues related to glycemia may play a part in how or whether certain binders are used. But in a managed environment these are less of a concern because physicians are aware, as are well managed dia- betic patients, that sugar per se is not an issue, but rather uncontrolled or ignored sugar. Disintegrants and lubricants. These are not considered challenging excipients for many people, and because their use levels are generally so low, they are of limited concern in terms of therapeutic impact. Excipients for suspensions and syrups. Much care is required here. Suspensions are typically aqueous and therefore it is important to know how much liquid the patient is ingesting. The viscosity of the sus- pensions and syrups must also be well managed and formulated to ensure they are easy to self-adminis- ter accurately. Once those factors are addressed, the range of excipients tends to revolve around suspending agents, such as colloidal microcrys- talline cellulose (MCC), including FMC's Avicel RC 591 and CL611, and sodium alginate. Also important are viscosifiers (hydroxyethylcellu- lose) and preservatives (sodium ben- zoate). Syrups are an altogether dif- ferent challenge. Liquid sorbitol and glycerine are popular syrup ingredi- ents, and they, as noted regarding polyols, may cause diarrhea. Overall, suspensions and syrups are considered useful in combination therapies. In the case of geriatric patients residing in care facilities, they can ensure nutritional balance, and suspensions or low-viscosity syrups are especially useful if patients suffer from dry mouth. Conventional dosage forms A great many elderly patients are still able to consume oral medicines in a solid form, but it is vitally impor- tant that they are properly formu- lated. Where possible, formulate modified-release tablets in order to minimize dose frequency and prevent "tablet fatigue." The range of possibil- ities in this realm is nearly endless, and multiparticulate dosage forms (pellets in capsules) are often a good option because they reduce the chances of dose dumping compared to other forms. Therefore, ethylcellu- losic dispersions—with or without pore-formers—would be an appropri- ate excipient technology to use. There is also a potentially very important safeguard available for use in painkilling products, both opioids and non-opioids, which are often pre- scribed alongside other treatments. The technology—FMC's Aquacoat ARC is but one example—ensures that the function of drug products remains robust even when alcohol is present. 44 March 2014 Tablets & Capsules Palm Oil Based (GMO-FREE) Binders, Excipients, Lubricants & Surfactants Glycerine 99.7% USP Calcium Stearate Stearic Acid 50 NF Magnesium Stearate Triple Pressed Stearic Acid Sodium Stearate Fatty Acid Esters Zinc Stearate Medium Chained Triglyceride (MCT) Sodium Lauryl Sulfate We also have a full line of Natural Preservatives & Surfactants Your Partner in Global Sourcing of Green Renewable and Sustainable Products Acme-Hardesty Co. 450 Sentry Parkway East Blue Bell, PA 19422 866.226.3834 www.Acme-Hardesty.com Write an article for Tablets & Capsules Our articles are written by technical professionals for technical professionals. Ask about the types of articles we're looking for, as well as tips on preparing an article for consideration. Contact: Matthew Knopp, Editor Tablets & Capsules Tel. +1 651 287 5618 Fax +1 651 287 5650 E-mail: mknopp@cscpub.com l-EOE_40-45_Masters 3/5/14 10:33 AM Page 44