Sorbitol oral liquids

Sorbitol is a polyhydric alcohol, with a high caloric content. In a survey of 129 oral liquid dosage forms stocked at a large university teaching hospital, 42% contained sorbitol [66]. The sorbitol concentration in the identified products varied from 3.5 to 72% w/v (0.175-3.6 g/mL). 

D. Lutomski, M. Gora, S. Wright, and J. Martin, Sorbitol content of selected oral liquids, Ann. Pharmacother, 27, 269 (1993). 

Solutions. For oral solutions, elixirs, syrups, tinctures, or other solubilized forms, in vivo BA and/or BE can be waived [21 CFR 320.22(b) (3) (i)]. Generally, in vivo BE studies are waived for solutions on the assumptions that release of the drug substance from the drug product is self-evident and that the solutions do not contain any excipient that significantly affects drug absorption [21 CFR 320.22(b)(3) (iii) ]. However, there are certain excipients, such as sorbitol or mannitol, that can reduce the BA of drugs with low intestinal permeability in amounts sometimes used in oral liquid dosage forms. 

Lutomski DM, Gora ML, Wright SM, Martin JE. Sorbitol content of selected oral liquids. Aim Pharmacother 1993 27(3) 269-74. 

Some patients consider the energetic value of sugars or sorbitol as a problem and demand artificial sweeteners in their medicines. Their effect depends very much on the active substance in the oral liquid and cannot be derived from usual concentrations in soft drinks. 

Besides the use as filling agents and laxatives the hexoles are used as humectants (e.g. sorbitol in creams), for taste correction (e.g. sorbitol in oral liquids), to get iso-osmotic solutions (e.g., mannitol in eyewashes, see Sect. 10.6.2), as diuretics in parenterals and as a cake stabilising agent in freeze drying. 

A wider problem exists with the possible role of liquid medications in dental caries formation [63], The extent of acid production in the oral cavity is closely related to caries formation. In a study of liquid medication, investigators have observed that medications with sucrose concentrations higher than 15% were able to significantly lower pH there was an inverse relation between sucrose content and a decrease in oral cavity pH [64], In a comparison of sorbitol and sucrose-sweetened liquid iron preparations, only sucrose-containing products produced a significant decrease in oral cavity pH [65],... 

Sorbitol, a polyhydric alcohol, is used as a sweetening agent in many oral medicinal liquids. In addition to enhancing the palatability of these liquids, it improves solution stability and reduces crystallization of syrup... 

Pharmaceutical suspensions are dispersions of solid particles of an insoluble or sparingly soluble drug in a liquid vehicle, usually water [33, 34]. Several examples of pharmaceutical suspensions are used Oral Suspensions, antibiotic preparations, antiacid and clay suspensions, radioopaque suspensions, barium sulphate suspensions. The vehicle is syrup, sorbitol solution or gum thickener with added artificial sweetener. Topical suspensions (externally applied shake lotion ) such as calamine lotion USP are also formulated as suspensions. Several dermatological preparations are also used in pharmacy. 

ELIXIRS. Clear, sweetened, hydroalcoholic liquids intended for oral use. They contain flavoring substances and, in the case of medicated elixirs, active medicinal agents. Their primary solvents are alcohol and water, with glycerin, sorbitol, and syrup sometimes used as additional solvents and/or sweetening agents. They are prepared by simple solution or admixture of the several ingredients... 

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