Extended-release agents

Extended release agent stiffening agent tablet and capsule lubricant. 

Coating agent extended release agent tablet and capsule diluent. 

Applications. These materials are stiU in developmental infancy. Current production is limited to one commercial process in Europe and a demonstration-scale process in North America. The lignins produced in these processes have potential appHcation in wood adhesives, as flame retardants (qv), as slow-release agents for agricultural and pharmaceutical products, as surfactants (qv), as antioxidants (qv), as asphalt extenders, and as a raw material source for lignin-derived chemicals. 

Studies have been extended to determine effect of halogens and halogen-releasing agents. Under similar laboratory conditions as previously described, the effect of these agents on NDPA destruction is shown in the following table. 

More recently copper phosphate cements have been suggested for use as controlled-release agents for supplying trace amounts of copper to cattle and sheep over an extended period (Allen et al., 1984 Mansion et al., 1985 Prosser et al., 1986). The cements were prepared with a Cu/P ratio of 1 1 to ensure that the matrix was an add phosphate and so subject to dissolution in aqueous solutions. They released copper at a constant rate for 90 days. 

The AHA/ASA guidelines recommend that antiplatelet therapy as the cornerstone of antithrombotic therapy for the secondary prevention of ischemic stroke and should be used in noncardioembolic strokes. Aspirin, dopidogrel, and extended-release dipyridamole plus aspirin are all considered first-line antiplatelet agents (see Table 13-1). The combination of aspirin and clopido-grel can only be recommended in patients with ischemic stroke and a recent history of myocardial infarction or coronary stent placement and then only with ultra-low-dose aspirin to minimize bleeding risk. 

Response rates of SSRIs in SAD ranged from 50% to 80% after 8 to 12 weeks of treatment. Paroxetine, sertraline, and venlafaxine extended release are approved for treatment of generalized SAD and are first-line agents. 

Triple reuptake inhibitors (TRIs), which inhibit reuptake at all three transporters, have attracted considerable interest in recent years [77]. The involvement of dopamine reuptake in the etiology of depression and other CNS disorders has been recognized [29,30]. As a result, TRIs have been proposed to offer a faster onset of action and improved efficacy for depression over currently prescribed single or dual action monoamine reuptake inhibitors. Historically, the mesocorticolimbic dopamine pathway is thought to mediate the anhedonia and lack of motivation observed in depressed patients [78,79]. In addition, methylphenidate, both immediate release and extended release formula, has been found to be effective as an augmenting agent in treatment-resistant depression [4]. Furthermore, clinical studies using the combination of bupropion and an SSRI or SNRI have showed improved efficacy for the treatment of MDD in patients refractory to the treatment with SSRIs, SNRIs, or bupropion alone [5,80,81]. 

Patients on other oral antidiabetic agents - No transition period is necessary when transferring patients to the extended-release tablets. Observe patients carefully (1 to 2 weeks) when being transferred from longer half-life sulfonylureas (ie, chlorpropamide) to the extended release tablets due to potential overlapping of drug effect. 

Children Safety and efficacy have not been established for the use of amphetamines as anorectic agents in children under 12 years of age. Extended-release amphetamine mixture capsules are indicated for children 6 years of age and older. Effects in children 3 to 5 years of age have not been studied. 

Pharmacology These agents are used in combination because carbidopa inhibits decarboxylation of levodopa and makes more levodopa available for transport to the brain. There is less variation in plasma levodopa levels than with the conventional formulation. However, the extended-release form is less systemically bioavailable (70% to 75%) and may require increased daily doses to achieve the same level of symptomatic relief. 

Bacterial vaginosis PO 500 mg twice a day for 7 days or 750 mg (extended-release) once daily for 7 days or 2g as a single dose, (pregnant) 250 mg 3 times a day for 7 days. Intravaginal 0.75% apply twice a day for 5 days. Centers for Disease Control and Prevention (CDC) does not recommend the use of topical agents during pregnancy. Rosacea Topical Apply to affected area once daily. (0.75%) Apply to affected area twice a day. 

Use of the extended-release (XL) preparation is recommended because of increased tolerability, decreased seizure risk, and the increased ease of use associated with a once-a-day preparation. Treatment with the sustained-release (SR) or XL preparation is initiated at a dose of 150 mg, preferably taken in the morning. After 4 days, the dosage may be increased to 150 mg twice a day (SR) or 300 mg once daily in the morning (XL). Gradual dose titration helps to minimize initial anxiety and insomnia. Temporary use of anxiolytic or hypnotic agents is reasonable in some patients but generally should be limited to the first few weeks of treatment. 

Other bothersome side effects are related to specific agents. Niacin, for instance, is often associated with cutaneous vasodilation and a sensation of warmth when doses are administered, but administering an extended-release form of this drug can reduce these sensations.71 99 Some fairly serious problems, including liver dysfunction, gallstones, and pancreatitis, can occur with many antihyperlipidemia drugs, but the incidence of these side effects is rare. Cardiovascular problems such as arrhythmias, blood dyscrasias, and angioneurotic syndrome may also occur with fibric acids. 

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