Tablets codeine formulations

An MEKC method for the determination of ibuprofen, codeine phosphate hemihydrate, their nine potential degradation products, and impurities in a commercial tablet formulation was developed, optimized, and fully validated according to ICH guidelines and submitted to the regulatory authorities. The optimized system containing ACN as organic modifier allowed baseline separation of ibuprofen, codeine, and nine related substances within 12 min. 

Many examples of the effects of tablet excipients on dmg decompositions are reported in the pharmaceutical literature. Chemical interaction between components in solid dosage forms may lead to increased decomposition. Replacement of the phenacetin in compound codeine and ARC tablets by paracetamol in NHS formulations in Australia in the 1960s (because of the undesirable side-effects of phenacetin), led to an unexpected decreased stability of the tablets. The cause was later attributed to a transacetylation reaction between aspirin and paracetamol and also a possible direct hydrolysis of the paracetamol (Scheme 4.15). 

Many analgesic effectiveness studies involving combination drug formulations (an opioid combined with a nonopioid) have been reported. For example, in the treatment of moderate to severe postoperative obstetric or gynecologic pain, 2-tablet dose of hydrocodone 7.5 mg with ibuprofen 200 mg was comparable in efficacy to the 2-tablet dose of oxycodone 5 mg and acetaminophen 325 mg. Obviously both of these treatments were superior to the placebo [23]. In contrast, for treatment of chronic pain, the 2-tablet dose of hydrocodone 7.5 mg and ibuprofen 200 mg was more effective than either the 1 -tablet dose of this combination or the 2-tablet dose of codeine 30 mg and acetaminophen 300 mg combination [24]. In a double-blind, randomized controlled trial involving 118 patients with chronic cancer pain, the combination formulation of hydrocodone (25 mg/d) and acetaminophen (2500 mg/d) was effective in relieving pain in 56.5% of the patients [25]. 

Alvi, S.U. Castro, F. A stability-indicating simultaneous analysis of acetaminophen and hydrocodone bitartrate in tablets formulation by HPLC. J.Liq.Chromatogr., 1987, 10, 3413-3426 [stability-indicating simultaneous codeine, hydrocodone hydromorphone tablets column temp 30]... 

While primarily employed as an analgesic, hydromor-phone is an excellent cough suppressant and is associated with less histamine release and pruritus than codeine. Hydrocodone is only available for oral administration, as either a tablet, capsule, or syrup formulation, and is usually combined with acetaminophen or ibuprofen. Standard immediate-release tablets provide 4-6 h of analgesia for patients with... 

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