Dosage forms that are age-adaptable have proven to be a formidable challenge. While the goal is for the patient to consume the active pharmaceutical ingredient (API) to achieve the desired clinical effects, delivery through an appropriate formulation is also an important consideration. While oral solid dosage formulations such as tablets and capsules have been well tolerated by adults, pediatric patients—including newborns and young children/adolescents—have specific needs that may necessitate a change in dosage form.
Depending on the condition of the pediatric patients, various routes of administration (e.g., IV and IM) can be used to deliver medication. Oral, buccal, nasal, transdermal, and rectal routes are all readily available for those who can tolerate a longer term route, with oral the preferred route in most cases. Tablets are typically easier to create and administer than liquid compounds, among oral formulations.
Liquid formulations, on the other hand, are an option for pediatric patients who require special considerations. Pediatric compounding may be required if the patient has difficulty swallowing tablets or capsules, if the commercially available medication does not come in an oral tablet dosage form, or if the patient has an allergy or sensitivity to an inactive ingredient found in the commercial product.
Adherence has emerged as a major barrier to treatment, particularly among pediatric patients. Poor medication adherence leads to inadequate disease management, whether due to a lack of understanding of the disease by caregivers or a fear of medication side effects. Compounding is one method for overcoming specific challenges to increase patient adherence. In particular, providing a liquid formulation in pediatric patients can cater to limitations such as medication taste and side effects.
The two most common types of oral liquid formulations for pediatric patients are solutions and suspensions. The primary distinction is in particle size. Particles in solutions are much smaller than in suspensions. Particles are evenly dispersed to achieve this, resulting in a homogeneous solution. Particles in a suspension are not evenly dispersed, resulting in a heterogeneous mixture. For liquid suspensions, the API remains solid while in the liquid. As a result, one of the most important pieces of advice before administering such a dosage form is to shake it thoroughly before taking a dose.
Liquid dosage forms have several advantages for adherence, including faster absorption rate compared with solids, easier intake route—especially for patients who struggle to swallow other solid dosage forms—and greater dosing flexibility. Furthermore, the flavoring profile can be tailored to the patient’s preferences.
Because of their age, pediatric patients may require a deviation from common oral delivery routes. Medication adherence and age-related factors are addressed by using more patient-specific liquid oral formulations to administer the appropriate medication.
The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.
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Published November 18, 2022