CHANDAN SYNOPSIS
CHANDAN SYNOPSIS
CHANDAN SYNOPSIS
Submitted By:
Chandan Singh
1 INTRODUCTION
3 LITERATURE REVIEW
4 DRUG PROFILE
5 PLAN OF WORK
7 REFERENCES
INTRODUCTION
The prevalence of complex and chronic urological conditions, such as Overactive Bladder
Syndrome (OAB) and Benign Prostatic Hyperplasia (BPH), has been steadily increasing due
to aging populations and lifestyle factors. Both conditions significantly impact the quality of life,
causing symptoms like urinary urgency, frequency, and incomplete bladder emptying. While
OAB and BPH are distinct conditions, they often coexist, necessitating a therapeutic approach
that addresses both disorders simultaneously.
Silodosin, on the other hand, is a selective α1A-adrenoceptor antagonist that alleviates BPH
symptoms by relaxing the smooth muscle in the bladder neck and prostate. This action improves
urine flow and mitigates voiding difficulties. Due to its rapid onset of action, Silodosin is often
formulated as an immediate-release (IR) preparation to provide quick symptomatic relief.
Despite their complementary mechanisms of action, current treatment regimens often require
separate dosing of these medications, which can result in reduced compliance and therapeutic
effectiveness. A bilayer tablet combining Mirabegron (ER) and Silodosin (IR) offers a
promising solution to this challenge. This innovative dosage form ensures the dual benefits of
immediate symptom relief from Silodosin and sustained action from Mirabegron, all in a single
tablet, thus enhancing patient convenience and adherence.
The development of bilayer tablets involves unique challenges, including drug compatibility,
formulation stability, and the need to achieve distinct release profiles for the two layers.
Addressing these challenges requires a systematic formulation approach and rigorous evaluation
to ensure safety, efficacy, and stability.
This thesis aims to formulate and evaluate a bilayer tablet containing Mirabegron and Silodosin,
leveraging advanced formulation techniques and quality-by-design (QbD) principles. The study
will focus on optimizing the formulation for desired release kinetics, ensuring stability under
standard storage conditions, and evaluating the in vitro and in vivo performance of the bilayer
tablet.
The pharmacological management of OAB and BPH typically involves separate therapeutic
agents targeting specific pathophysiological pathways. Mirabegron, a β3-adrenoceptor agonist,
is a cornerstone therapy for OAB, working by relaxing the detrusor muscle of the bladder during
its storage phase. This action increases bladder capacity and reduces episodes of urgency and
frequency. Its extended-release (ER) formulation allows for once-daily dosing, which enhances
patient compliance by reducing the burden of frequent administration.
Despite the clinical efficacy of these agents, the need for separate medications can pose
challenges in patient compliance, especially in populations requiring long-term therapy. Non-
adherence to prescribed regimens is a well-documented issue, often leading to suboptimal
therapeutic outcomes, increased healthcare costs, and reduced quality of life. To address these
challenges, a bilayer tablet formulation that combines Mirabegron (ER) and Silodosin (IR) into
a single dosage form offers a novel and patient-centric solution. This approach not only
simplifies the treatment regimen but also ensures that both immediate and sustained therapeutic
effects are delivered effectively.
BPH, on the other hand, is a common condition in aging males caused by the non-cancerous
enlargement of the prostate gland. This condition leads to lower urinary tract symptoms (LUTS)
such as weak urine flow, straining to void, and a sense of incomplete bladder emptying. The
primary objective of BPH management is to relieve obstruction and improve urinary flow.
Silodosin, a highly selective α1A-adrenoceptor antagonist, is widely prescribed for this purpose.
Its targeted action on α1A receptors in the bladder neck and prostate provides rapid symptomatic
relief while minimizing systemic side effects like postural hypotension. The immediate-release
(IR) formulation of Silodosin ensures quick drug absorption and onset of action, making it ideal
for addressing acute symptoms.
Given the complementary mechanisms of action of Mirabegron and Silodosin, their combination
has the potential to provide a comprehensive therapeutic solution for patients experiencing both
storage and voiding symptoms. However, the need to administer these medications separately
can be cumbersome, particularly for elderly patients managing multiple comorbidities and
complex medication regimens. Poor adherence to such regimens is a well-documented issue,
leading to suboptimal therapeutic outcomes, increased risk of disease progression, and higher
healthcare costs.
Aims:
The primary aim of this research is to develop, optimize, and evaluate a bilayer tablet
formulation combining Mirabegron (Extended Release) and Silodosin (Immediate Release)
for the management of Overactive Bladder (OAB) and Benign Prostatic Hyperplasia (BPH).
The research will focus on enhancing therapeutic efficacy and patient compliance by offering a
combination therapy in a single tablet with controlled drug release.
Objectives:
1. Formulation Development:
o To design a bilayer tablet formulation that combines Mirabegron (Extended Release)
and Silodosin (Immediate Release), utilizing appropriate excipients for each drug to optimize
their release profiles.
o To select suitable polymers for the extended-release (ER) layer of Mirabegron and
disintegrants for the immediate-release (IR) layer of Silodosin.
2. Preformulation Studies:
o To assess the physicochemical properties of Mirabegron and Silodosin, including
solubility, particle size, and compatibility with selected excipients.
o To perform compatibility studies using techniques like FTIR and DSC to ensure no
adverse interactions between the drugs and excipients.
5. Stability Testing:
o To perform stability studies under long-term and accelerated conditions to assess the
physical, chemical, and pharmacological stability of the bilayer tablets.
o To evaluate the impact of packaging materials on the stability of the tablets, particularly
in terms of moisture sensitivity and shelf life.
Rationale:
Hypothesis:
The bilayer tablet formulation combining Mirabegron (Extended Release) and Silodosin
(Immediate Release) will provide an effective, stable, and patient-compliant solution for the
simultaneous treatment of Overactive Bladder (OAB) and Benign Prostatic Hyperplasia
(BPH). The formulation is expected to:
Abrams et al. (2014) conducted a pivotal large-scale randomized clinical trial to evaluate the
efficacy and safety of Mirabegron in patients with Overactive Bladder Syndrome (OAB). The
study demonstrated a significant reduction in urinary urgency and frequency episodes compared
to placebo, confirming its role as a first-line agent for OAB. Furthermore, patients reported a
lower incidence of side effects, such as dry mouth, which are commonly associated with
antimuscarinic agents, making Mirabegron a preferred option in OAB therapy.
Chapple et al. (2013) explored the pharmacokinetics, tolerability, and safety profile of
Mirabegron in its extended-release (ER) formulation. The study highlighted its ability to
maintain therapeutic plasma concentrations for up to 24 hours, supporting its once-daily dosing
regimen. This prolonged action, coupled with a favorable safety profile, underscored its
effectiveness in improving patient adherence and outcomes.
Marks et al. (2009) investigated the pharmacodynamic properties of Silodosin, focusing on its
high selectivity for α1A-adrenoceptors in the bladder neck and prostate. This selectivity was
found to reduce the risk of systemic side effects, such as orthostatic hypotension, often observed
with non-selective α1-blockers like tamsulosin. The study concluded that Silodosin offers
effective symptom relief with enhanced safety, particularly for elderly patients.
Kawabe et al. (2006) compared Silodosin to placebo in a double-blind clinical trial involving
BPH patients. The results showed a rapid onset of symptom relief, including improved urinary
flow rates and reduced residual urine volume. These findings reinforced its utility as a fast-acting
agent for BPH management.
Kaplan et al. (2016) and Gratzke et al. (2018) emphasized the growing need for combination
therapy in patients with coexisting OAB and BPH. Their studies demonstrated that the combined
use of β3-adrenoceptor agonists (e.g., Mirabegron) and α1-adrenoceptor antagonists (e.g.,
Silodosin) addressed both storage and voiding symptoms effectively, leading to significant
improvements in patient satisfaction and quality of life.
Yoo et al. (2020) conducted a meta-analysis of clinical trials involving combination therapies for
OAB and BPH. The analysis showed a marked reduction in symptom severity and improved
patient adherence compared to monotherapy. The study concluded that simplified, integrated
treatment approaches are essential for managing these complex, overlapping conditions.
Goyani et al. (2013) reviewed the design principles of bilayer tablets, emphasizing the
challenges associated with their formulation. The study highlighted the importance of optimizing
layer adhesion to prevent delamination and achieving controlled drug release kinetics to ensure
therapeutic efficacy. The authors also discussed the role of polymers and compression techniques
in stabilizing bilayer formulations.
Pahwa et al. (2012) addressed specific challenges in bilayer tablet development, including drug
incompatibilities and interlayer interactions. They proposed strategies such as using separating
layers, modifying compression forces, and incorporating advanced excipients to overcome these
issues.
Patel et al. (2017) successfully formulated bilayer tablets of Metformin (ER) and Glimepiride
(IR) for the management of type 2 diabetes. Their work demonstrated the feasibility of
combining drugs with different release profiles into a single dosage form, reducing pill burden
and improving patient compliance.
Shirsand et al. (2015) developed bilayer tablets for hypertension by combining Amlodipine (IR)
and Atenolol (ER). The study underscored the importance of conducting drug-excipient
compatibility studies and optimizing manufacturing processes to ensure product stability and
efficacy.
Higuchi (1961) established the foundational mathematical model for drug release from matrix
systems, which remains a cornerstone for developing extended-release formulations.
Siepmann and Peppas (2001) expanded on this framework, introducing models to describe
various mechanisms, including diffusion and polymer relaxation, that control drug release in
complex dosage forms like bilayer tablets.
Singh and Reema (2018) analyzed the stability issues associated with combination
formulations, such as moisture sensitivity and interlayer interactions in bilayer tablets. Their
study emphasized the importance of robust stability testing protocols and the selection of
excipients with low hygroscopicity. The International Council for Harmonisation (ICH)
guidelines (Q1A-R2) provide a standardized approach to stability testing, ensuring that
pharmaceutical products maintain their quality throughout their shelf life.
Yu et al. (2014) advocated for the application of QbD in bilayer tablet development. They
highlighted the use of design of experiments (DOE) to identify critical quality attributes (CQAs)
and optimize formulation parameters, thereby ensuring consistent product performance.
Coyne et al. (2011) studied the effects of combination therapies on patient-reported outcomes in
OAB and BPH management. Their findings demonstrated that simplified regimens, such as
bilayer tablets, significantly improved adherence and overall treatment satisfaction.
Michel et al. (2019) analyzed the economic benefits of combination therapy, noting reduced
healthcare costs and improved long-term outcomes due to better adherence and efficacy.
DRUG PROFILE
Indication:
Pharmacokinetics:
Absorption: Well absorbed after oral administration, with peak plasma concentrations
typically reached within 3–4 hours. The extended-release formulation ensures a prolonged
release, leading to a once-daily dosing regimen.
Bioavailability: Approximately 33%, with food having a minimal effect on the drug’s
absorption.
Metabolism: Mirabegron is primarily metabolized in the liver by the cytochrome P450
enzyme system, particularly CYP3A4 and CYP2D6.
Half-life: Approximately 50 hours, allowing for its extended-release formulation.
Excretion: Mainly excreted in urine as metabolites, with less than 1% of the drug
unchanged.
Side Effects:
Common side effects include increased blood pressure, headache, dry mouth, and urinary
tract infection (UTI).
Serious side effects may include cardiovascular events such as hypertension and QT
interval prolongation.
Contraindications:
Dosing:
Indication:
Benign Prostatic Hyperplasia (BPH): To improve urinary flow and alleviate lower
urinary tract symptoms (LUTS) associated with BPH.
Mechanism of Action: Silodosin selectively targets α1A-adrenergic receptors in the prostate and
bladder neck, leading to the relaxation of smooth muscle, which improves urine flow and reduces
symptoms such as urinary retention, straining, and incomplete voiding.
Pharmacokinetics:
Absorption: Rapidly absorbed after oral administration, with peak plasma concentrations
occurring within 2–4 hours of dosing.
Bioavailability: Approximately 32%, due to significant first-pass metabolism.
Metabolism: Silodosin is extensively metabolized by the liver, primarily via CYP3A4,
producing active metabolites with similar pharmacological activity.
Half-life: Approximately 13 hours, supporting its once-daily dosing.
Excretion: Excreted in the urine, with most of the drug eliminated as metabolites.
Side Effects:
Common side effects include dizziness, retrograde ejaculation, nasal congestion, and
headache.
Serious side effects include hypotension, syncope, and priapism (rare).
Contraindications:
Dosing:
1. Pre-Formulation Studies
2. Formulation Development
3. Evaluation of Tablets
1. Physical Testing:
o Evaluate the physical characteristics of the tablets, including:
Thickness, Hardness, Friability, and Weight Variation: Following USP guidelines.
Interlayer Adhesion: Test the strength of adhesion between the layers to prevent
delamination during storage and handling.
2. Dissolution Testing:
o Perform in vitro dissolution tests using USP apparatus for both layers:
IR Layer (Silodosin): Test in simulated gastric fluid (pH 1.2) to ensure rapid release
within 30 minutes.
ER Layer (Mirabegron): Test in simulated intestinal fluid (pH 6.8) to ensure controlled,
sustained release over 24 hours.
o Apply the Higuchi and Korsmeyer-Peppas models to evaluate the drug release kinetics.
4. Stability Studies
The development and evaluation of a bilayer tablet combining Mirabegron (ER) and Silodosin
(IR) involves systematic formulation design, preformulation studies, optimization of tablet
manufacturing, and comprehensive evaluation of its physical, chemical, and pharmacological
properties. The following methodology will be employed:
1. Preformulation Studies
2. Formulation Development
1. Selection of Excipients:
o For the ER layer (Mirabegron):
Use hydrophilic and hydrophobic polymers (e.g., HPMC, ethylcellulose) to achieve
sustained release.
o For the IR layer (Silodosin):
Select disintegrants (e.g., sodium starch glycolate) and binders for rapid drug release.
o Include appropriate lubricants, glidants, and fillers for both layers.
4. Formulation Trials:
o Apply Design of Experiments (DOE) to evaluate critical formulation variables:
Polymer type and concentration for the ER layer.
Disintegrant type and concentration for the IR layer.
o Optimize the formulation to meet desired release profiles and mechanical strength.
1. Physical Characterization:
o Measure thickness, hardness, friability, and weight variation using standard protocols
(USP guidelines).
o Evaluate interlayer adhesion strength to ensure mechanical stability.
2. Dissolution Studies:
o Conduct in vitro dissolution testing for both layers using a USP dissolution apparatus.
Simulated gastric fluid (pH 1.2) for the IR layer.
Simulated intestinal fluid (pH 6.8) for the ER layer.
o Compare drug release profiles to ensure:
Immediate release of Silodosin within 30 minutes.
Sustained release of Mirabegron over 24 hours.
o Analyze data using release kinetics models (Higuchi, Korsmeyer-Peppas) to understand
the mechanism of drug release.
4. Stability Studies:
o Perform stability testing under ICH-recommended conditions:
Long-term (25°C ± 2°C / 60% RH ± 5% RH).
Accelerated (40°C ± 2°C / 75% RH ± 5% RH).
o Monitor physical appearance, hardness, dissolution profiles, and drug content over time.
1. Establishment of IVIVC:
o Correlate in vitro dissolution data with in vivo pharmacokinetic data using Level A
correlation.
o Conduct pharmacokinetic studies in appropriate animal models to evaluate:
Tmax, Cmax, and AUC for both drugs.
Verify the synchronized release of Silodosin (IR) and Mirabegron (ER).
REFERENCES
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11. Shirsand, S. R., & Deshmukh, R. M. (2015). "Formulation and evaluation of bilayer
tablets of Amlodipine and Atenolol for hypertension." Asian Journal of Pharmaceutics,
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