Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use

<p dir="ltr">Epinephrine is a life-saving treatment in anaphylaxis. In community settings, a first-aid dose of epinephrine is injected from an auto-injector (EAI). Needle phobia highly contributes to EAI underuse, leading to fatalities—especially in children. A novel rapidly-disinteg...

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Main Author: Ousama Rachid (14158917) (author)
Other Authors: Mutasem Rawas-Qalaji (18059995) (author), Keith Simons (18059998) (author)
Published: 2018
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_version_ 1864513526387703808
author Ousama Rachid (14158917)
author2 Mutasem Rawas-Qalaji (18059995)
Keith Simons (18059998)
author2_role author
author
author_facet Ousama Rachid (14158917)
Mutasem Rawas-Qalaji (18059995)
Keith Simons (18059998)
author_role author
dc.creator.none.fl_str_mv Ousama Rachid (14158917)
Mutasem Rawas-Qalaji (18059995)
Keith Simons (18059998)
dc.date.none.fl_str_mv 2018-02-11T03:00:00Z
dc.identifier.none.fl_str_mv 10.3390/pharmaceutics10010024
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Epinephrine_in_Anaphylaxis_Preclinical_Study_of_Pharmacokinetics_after_Sublingual_Administration_of_Taste-Masked_Tablets_for_Potential_Pediatric_Use/25294897
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Pharmacology and pharmaceutical sciences
bioavailability
bioequivalence
intramuscular
auto-injector
sublingual delivery
rapidly-disintegrating
tablets
allergy
anaphylaxis
adrenaline
epinephrine
dc.title.none.fl_str_mv Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">Epinephrine is a life-saving treatment in anaphylaxis. In community settings, a first-aid dose of epinephrine is injected from an auto-injector (EAI). Needle phobia highly contributes to EAI underuse, leading to fatalities—especially in children. A novel rapidly-disintegrating sublingual tablet (RDST) of epinephrine was developed in our laboratory as a potential alternative dosage form. The aim of this study was to evaluate the sublingual bioavailability of epinephrine 30 mg as a potential pediatric dose incorporated in our novel taste-masked RDST in comparison with intramuscular (IM) epinephrine 0.15 mg from EAI, the recommended and only available dosage form for children in community settings. We studied the rate and extent of epinephrine absorption in our validated rabbit model (<i>n</i> = 5) using a cross-over design. The positive control was IM epinephrine 0.15 mg from an EpiPen Jr<sup>®</sup>. The negative control was a placebo RDST. Tablets were placed under the tongue for 2 min. Blood samples were collected at frequent intervals and epinephrine concentrations were measured using HPLC with electrochemical detection. The mean ± SEM maximum plasma concentration (<i>C</i><sub>max</sub>) of 16.7 ± 1.9 ng/mL at peak time (<i>T</i><sub>max</sub>) of 21 min after sublingual epinephrine 30 mg did not differ significantly (<i>p</i> > 0.05) from the <i>C</i><sub>max</sub> of 18.8 ± 1.9 ng/mL at a <i>T</i><sub>max</sub> of 36 min after IM epinephrine 0.15 mg. The <i>C</i><sub>max</sub> of both doses was significantly higher than the <i>C</i><sub>max</sub> of 7.5 ± 1.7 ng/mL of endogenous epinephrine after placebo. These taste-masked RDSTs containing a 30 mg dose of epinephrine have the potential to be used as an easy-to-carry, palatable, non-invasive treatment for anaphylactic episodes for children in community settings.</p><h2>Other Information</h2><p dir="ltr">Published in: Pharmaceutics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3390/pharmaceutics10010024" target="_blank">https://dx.doi.org/10.3390/pharmaceutics10010024</a></p>
eu_rights_str_mv openAccess
id Manara2_25805dbf49392206c7ad6341d97c5ab7
identifier_str_mv 10.3390/pharmaceutics10010024
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/25294897
publishDate 2018
repository.mail.fl_str_mv
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rights_invalid_str_mv CC BY 4.0
spelling Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric UseOusama Rachid (14158917)Mutasem Rawas-Qalaji (18059995)Keith Simons (18059998)Biomedical and clinical sciencesPharmacology and pharmaceutical sciencesbioavailabilitybioequivalenceintramuscularauto-injectorsublingual deliveryrapidly-disintegratingtabletsallergyanaphylaxisadrenalineepinephrine<p dir="ltr">Epinephrine is a life-saving treatment in anaphylaxis. In community settings, a first-aid dose of epinephrine is injected from an auto-injector (EAI). Needle phobia highly contributes to EAI underuse, leading to fatalities—especially in children. A novel rapidly-disintegrating sublingual tablet (RDST) of epinephrine was developed in our laboratory as a potential alternative dosage form. The aim of this study was to evaluate the sublingual bioavailability of epinephrine 30 mg as a potential pediatric dose incorporated in our novel taste-masked RDST in comparison with intramuscular (IM) epinephrine 0.15 mg from EAI, the recommended and only available dosage form for children in community settings. We studied the rate and extent of epinephrine absorption in our validated rabbit model (<i>n</i> = 5) using a cross-over design. The positive control was IM epinephrine 0.15 mg from an EpiPen Jr<sup>®</sup>. The negative control was a placebo RDST. Tablets were placed under the tongue for 2 min. Blood samples were collected at frequent intervals and epinephrine concentrations were measured using HPLC with electrochemical detection. The mean ± SEM maximum plasma concentration (<i>C</i><sub>max</sub>) of 16.7 ± 1.9 ng/mL at peak time (<i>T</i><sub>max</sub>) of 21 min after sublingual epinephrine 30 mg did not differ significantly (<i>p</i> > 0.05) from the <i>C</i><sub>max</sub> of 18.8 ± 1.9 ng/mL at a <i>T</i><sub>max</sub> of 36 min after IM epinephrine 0.15 mg. The <i>C</i><sub>max</sub> of both doses was significantly higher than the <i>C</i><sub>max</sub> of 7.5 ± 1.7 ng/mL of endogenous epinephrine after placebo. These taste-masked RDSTs containing a 30 mg dose of epinephrine have the potential to be used as an easy-to-carry, palatable, non-invasive treatment for anaphylactic episodes for children in community settings.</p><h2>Other Information</h2><p dir="ltr">Published in: Pharmaceutics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3390/pharmaceutics10010024" target="_blank">https://dx.doi.org/10.3390/pharmaceutics10010024</a></p>2018-02-11T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.3390/pharmaceutics10010024https://figshare.com/articles/journal_contribution/Epinephrine_in_Anaphylaxis_Preclinical_Study_of_Pharmacokinetics_after_Sublingual_Administration_of_Taste-Masked_Tablets_for_Potential_Pediatric_Use/25294897CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/252948972018-02-11T03:00:00Z
spellingShingle Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
Ousama Rachid (14158917)
Biomedical and clinical sciences
Pharmacology and pharmaceutical sciences
bioavailability
bioequivalence
intramuscular
auto-injector
sublingual delivery
rapidly-disintegrating
tablets
allergy
anaphylaxis
adrenaline
epinephrine
status_str publishedVersion
title Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
title_full Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
title_fullStr Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
title_full_unstemmed Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
title_short Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
title_sort Epinephrine in Anaphylaxis: Preclinical Study of Pharmacokinetics after Sublingual Administration of Taste-Masked Tablets for Potential Pediatric Use
topic Biomedical and clinical sciences
Pharmacology and pharmaceutical sciences
bioavailability
bioequivalence
intramuscular
auto-injector
sublingual delivery
rapidly-disintegrating
tablets
allergy
anaphylaxis
adrenaline
epinephrine