Lozenges manufacture

Beahm, J.S. Dextromethorphan Continuous Lozenge Manufacturing Process. US Patent 5,302,394, April 12, 1994. 

For these and other reasons, lozenges are produced by few pharmaceutical manufacturers, and represent a very small percentage of total pharmaceutical sales. Nosignificant growth can be currently anticipated in these areas. 

Polydextrose acts as a bulking agent in the formulation of sugar-free confectionery-type dosage forms. In conjunction with isomalt, lactitol, or maltitol, polydextrose can be used in the manufacture of sugar-free hard-hoiled candies and acacia lozenges or pastilles. 

As part of his "marketing strategy", Stevens published (or had published) numerous polemics and books of case reports. These books were published by Fraser Co. in London, a publisher who - located conveniently close to Stevens business - never published anything but Umckaloabo literature and thus may well have been ran or at least sponsored by Stevens (41-43). By 1931, Stevens employed 50 people manufacturing and distributing his remedy (lozenges, an extract and capsules) (44). The US authorities, meanwhile, debarred the remedy from the mails (45). 

The manufacturer of amphotericin B notes that its absorption from the gastrointestinal tract is negligible, and that no interactions have been noted with amphotericin B lozenges, or other oral formulations. For a theoretical interaction with sucralfate, see sucralfate , (below). 

The US manufacturer of tranylcypromine notes that the concurrent use of MAOIs and dextromethorphan has resulted in brief episodes of psychosis or bizarre behaviour. Similarly, the US manufacturer of phenelzine mentions one case of drowsiness and bizarre behaviour when dextromethorphan lozenges were used by a patient taking phenelzine. They also note that concurrent use of dextromethorphan may cause a reaction similar to... 

For accurate determination distillation of the formaldehyde from the lozenge base is desirable. A quantity of powdered lozenge, equivalent to about 0 05 g of paraformaldehyde, is steam-distilled in the presence of dilute sulphuric acid into about 100 ml of water until the total volume collected is about 750 ml. The iodine absorption method given above is then used on the distillate. A considerable loss of formaldehyde is liable to occur during manufacture but loss on storage is slow. 

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