Enteric coating capsules

Peppermint oil is widely advocated it acts as an antispas-modic agent due to its ability to relax gastrointestinal smooth muscle. However, it also relaxes the lower esophageal sphincter, which could allow reflux of gastric contents into the esophagus. The usual dose is 1 to 2 enteric-coated capsules containing 0.2 mL of peppermint oil two to three times daily. 

By administering both sizes of formulation simultaneously, a better discrimination of relative transit of the two phases can be made. In a cohort of 22 healthy young volunteers, an enteric-coated capsule was administered which contained tablets ("mTc-labeled 5 mm or 8.4 mm diameter) together with pellets (mIn-labeled 0.2 mm ion-exchange resin particles). The unit delivered the radiopharmaceuticals simultaneously to the ileocecal junction [44]. Under control conditions, no difference was observed between the rate of transit through the ascending colon of 0.2-mm particles versus 5-mm tablets, or 0.2-mm particles versus 8.4-mm tablets. The mean period of residence of 50% of the administered 0.2-mm particles in the ascending colon was 11.0 + 4.0 h. 

Enteric-coated capsules In the presence of food, C ax AUC for didanosine capsules were reduced by approximately 46% and 19%, respectively, compared with the fasting state. Take didanosine capsules on an empty stomach. 

Drugs are administrated by intravenous routes or ex-travascular routes including oral, sublingual, subcutaneous, intramuscular, rectal (by enema or suppository), and transdermal. Available dosage forms include suspensions, immediate-release capsules or tablets, sustained-release capsules or tablets, and enteric-coated capsules or tablets that resist dissolution in the acidic pfi of the stomach. 

Developments in the administration of insulin through the skin, the mouth, the nose, and the lung have been reviewed (183). Methods of absorption other than subcutaneous, such as nasal insulin, buccal insulin, rectal insulin, and insulin in enteric-coated capsules, are still experimental. A problem in nasal administration is still how to get a daily reproducible dose (184). The frequency of hypoglycemia is comparable to the frequency with subcutaneous insulin (185). Nasal irritation, sometimes with congestion, and dyspnea (186) can occur. Pulmonary insulin, delivered by aerosol inhalation, is another experimental method. No lung obstruction was reported, but the uptake varied considerably (187). 

Fugono, J., H. Yasui, and H. Sakurai. 2005. Improvement of diabetic states in streptozotocin-induced type 1 diabetic rats by vanadyl sulfate in enteric-coated capsules. Can. J. Physiol. Pharm. 57 665-669. 

DidanosineV idex EC (ddl) 125, 200, 250, orTOOmg enteric-coated capsules Body weight >60kg 400mg once daily <60kg 250mg once dahy Periphei al neuropatliy, pancreatitis, lactic acidosis witli hepatic steatosis 0.11... 

Enteric-coated capsules See Enteric-coated doses. 

Levine, M.M. Ferreccio, C. Cryz, S. Ortiz, E. Comparison of enteric-coated capsules and liquid formulation of TY21a typhoid vaccine in randomized controlled field trial. Lancet 1990, 336, 891-894. 

Structural modifications and formulation are two additional approaches proposed for overcoming the enzymatic barrier (and references therein). Using recombinant or synthetic techniques, selective modifications to the protein or peptide sequence can be introduced effectively reducing proteolytic susceptibility, but these changes must not have significant impact on the pharmacological properties of the molecule (e.g., reduced potency or altered selectivity). Moreover, modifications to address a specific enzymatic action will not eliminate vulnerability to others. The formulation approach essentially involves encapsulation systems to protect the protein or peptide from reactions with enzymes, and selected examples include emulsions, liposomes, or enteric-coated capsules (and references therein). 

Mostly attenuated organisms are being used as live virus vaccines however, in some instances, even virulent organisms could be used, provided they are not administered via the natural route of infection. For example, human adenovirus types 4 and 7 may cause acute respiratory infections in humans when administered via the oronasal route but provide protection when given orally in enteric-coated capsules. ... 

Didanosine one enteric-coated capsule/day (400 mg/day) did not affect the absorption of ciprofloxacin in 16 patients (71). 

Huyghebaert N, Vermeire A, Remon JP. Alternative method for enteric coating of HPMC capsules resulting in ready-to-use enteric-coated capsules. Eur ] Pharm Sci 2004 21(5) 617-623. 

Peppermint oil menthol, the principal constituent of peppermint oil, has been shown to have a relaxant action on smooth muscle. The oil acts directly on the colon and is formulated as enteric-coated capsules to prevent dispersal higher up the gastrointestinal canal. It may nevertheless exacerbate heartburn symptoms. 

Hosny EA, Khan Ghilzai MK, Al-Dhawalie AH. Effective intestinal absorption of insulin in diabetic rats using enteric-coated capsules containing sodium salicylate. Drug Dev Ind Pharm 1995 21 1583-1589. 

Hosny EA, Al-Shora HI, Elmazar MA. Oral delivery of insulin from enteric-coated capsules containing sodium salicylate effect on relative hypoglycemia of diabetic beagle dogs. Int J... 

Zidovudine had no effect on methadone levels in one study, but there is one report of a patient requiring a modest increase in methadone dose after starting zidovudine. Similarly case reports describe patients requiring a modest increase in methadone dose after starting abacavir. Methadone can increase zidovudine serum levels, and reduce levels of abacavir, stavudine, and didano-sine from the tablet formulation, but not the enteric-coated capsule preparation. Tenofovir, and a single dose of zidovu-dine/lamivudine had no effect on methadone pharmacokinetics. 

A study in 17 subjects taking methadone found that the AUC and maximum levels of didanosine tablets were 57% and 66% lower, respectively, when compared with 10 control subjects. Trough levels of methadone did not differ from historical controls, suggesting that didanosine had no effect on methadone pharmacokinetics. A later study found that there was no reduction in the AUC of didanosine given as enteric-coated capsules. ... 

An extremely marked reduction in the serum levels of ciprofloxacin occurs if it is given at the same time as didanosine tablets, because of an interaction with the antacid buffers in the didanosine formulation. Taking the ciprofloxacin 2 hours before or 6 hours after didanosine tablets minimises this interaction. Other quinolones are expected to interact similarly. Didanosine enteric-coated capsules do not interact with ciprofloxacin. 

Other studies have looked at whether separating the administration times affects this interaction. When 16 HIV-positive patients were given ciprofloxacin 1.5 g daily 2 hours before didanosine tablets, the ciprofloxacin AUC was reduced by only 26%. Another study in just one subject found that when ciprofloxacin 500 mg was given 2 hours after taking two didanosine placebo tablets the ciprofloxacin serum levels were reduced below minimal inhibitory concentrations, but giving the ciprofloxacin 2 hours before the didanosine placebo tablets resulted in normal blood levels. The enteric-coated capsule formulation of didanosine (which does not contain antacids) does not interact with ciprofloxacin. ... 

Direct information is limited to these reports but the interaction between buffered didanosine and ciprofloxacin appears to be clinically important. Such drastic reductions in serum ciprofloxacin levels mean that minimal inhibitory concentrations are unlikely to be achieved. Ciprofloxacin should be given at least 2 hours before or 6 hours after didanosine tablets (see Quinolones + Antacids or Calcium compounds , p.328). Other qui-nolone antibacterials that interact with antacids are also expected to interact with didanosine tablets, but so far reports are lacking. Didanosine enteric-coated capsules do not interact. 

The standard dose is 180-350 mg in enteric-coated capsules, three times daily (Grigoleit and Grigoleit 2005 Pittler... 

Enteric-coated peppermint leaf essential oil capsules may produce anal burning in patients with diarrhea, due to excretion of peppermint oil. Use of enteric-coated capsules has been associated with adverse effects such as rashes, headache, bradycardia, muscle tremors, and ataxia (Mills and Bone 2005). Non-enteric-coated preparations of peppermint leaf essential oil have been reported to cause heartburn in sensitive individuals (Nash et al. 1986 Somerville et al. 1984). 

The problem associated to acid lability of the N-glycosidic bond of 109a may eventually be circumvented by some clinical tricks, such as the concomitant administration of antiacids or the use of enteric coated capsules [7]. 

Song, M., Gao, X., Hang, T-J., Wen, A-D. (2009) Pharmacokinetic properties of lansoprazole (30-mg enteric-coated capsules) and its metabolite a single-dose, open-label study in healthy Chinese male subjects. Current Therapeutic Research, 70,228-238. 

Several essential oils have been used in the treatment of functional (nonulcer) dyspepsia. All of the published trials have concerned the commercial preparation known as Enteroplant , an enteric-coated capsule containing 90 mg of M. piperita and 50 mg of Carum carvi essential oils. 

The rst clinical trial of peppermint for the treatment of irritable bowel syndrome was conducted in 1979 by Rees et al. They prescribed 0.2 mL of peppermint oil in enteric-coated capsules (1-2 capsules depending on symptom severity) thrice daily. Patient assessment considered the oil to be superior to the placebo in relieving abdominal symptoms. 

Since then, a further 15 double-blind and two open trials have been conducted examples of these can be seen in Table 13.4. Eight studies used the commercial preparation known as Colpermin and two used Mintoil , the capsules of which contain 187 and 225 mg of peppermint oil, respectively. The other studies used enteric-coated capsules usually containing 0.2 mL of the essential oil. 

Essential oils and their components are incorporated into enterically coated capsules to prevent damage and used for treating irritable bowel syndrome (peppermint in Colpermin), a mixture of monoterpenes for treating gallstones (Rowachol) and ureteric stones (Rowatinex) these are under product licenses as medicines (Somerville et al., 1984,1985 Engelstein et al., 1992). 

---