Chula’s Faculty of Pharmaceutical Sciences Develops Palatable Liquid Vehicle for Extemporaneous Preparation of Pediatric Favipiravir Liquid Dosage Form
Writer Thitirat Somboon
Faculty members from Department of Pharmaceutics and Industrial Pharmacy and Department of Biochemistry and Microbiology at the Faculty of Pharmaceutical Sciences, Chulalongkorn University have developed a liquid vehicle to be used for the preparation of extemporaneous Favipiravir oral suspension for pediatric patients to help lessen the burden of medical practitioners and pharmacists dealing with the process of preparing oral liquid dosage form from tablet medications while also enabling parents to administer the given medications appropriately during the child’s home isolation period.
Not only adults who have suffered from COVID-19 but also a large number of children. In such cases they are also prescribed with Favipiravir in tablet dosage form, which, at present, is the standard regimen for treating the pandemic. Medicines in the form of tablets might be common for treating adults but certainly not suitable for small children and geriatric patients who oftentimes are unable to swallow solid medications. Dr. Wanchai Chongcharoen, a pharmacist and lecturer at the Faculty of Pharmaceutical Sciences, Chulalongkorn University, realizes such problem and developed a formulation of a liquid vehicle to be readily mixed with the acquired Favipiravir tablets. The result is that children no longer need to endure the hard-to-swallow and unacceptable taste of tablets and that the medical practitioner or pharmacists no longer need to individually prepare one dose of liquid preparation thereof for their patients each time of drug administration-.
Original Idea on the Initiation of Liquid Vehicle Development for Extemporaneous Preparation at Chula
When a child contracts COVID-19, the medical practitioner must prepare the adequate amount of medicine for each individual child. This process starts with calculating the required medicine to be taken in the form of tablets which are then finely ground and thoroughly mixed with water or other appropriate liquids such as concentrated flavored syrup before being administered to a child.
“For these processes, one must consider each child patient’s body weight, which means that the number of tablets to be ground and dispersed with typical liquid for each patient will depend on their weight. This is a cumbersome and time-consuming task, which adds more work when the number of patients increases. At times when number of medical practitioners or pharmacists isn’t sufficient, the problem that might arise is that the child may not receive the accurate dose and may subsequently encounter drug resistance issue if the dosage received is incorrect,” Dr. Wanchai explained.
Aside from the insufficient number of medical practitioner and pharmacists, at present and in the future a larger number of COVID-19 patients with mild symptoms will be in home isolation which means that families with children with COVID-19 will need to care for and administer the medication by themselves.
“Our main concern is whether or not parents can follow the entire process of preparation or not, including measuring the dosage accurately in the same way that medical practitioners can. If not, this could lead to children not receiving the correct prescribed dose regimen” he further added.
Such concerns have led Dr. Wanchai and his research team, comprising of Assistant Professor Narueporn Sutanthavibul, Ph.D., Assistant Professor Dusadee Charnvanich, Ph.D., Associate Professor Angkana Tantituvanont, Ph.D., Dr. Phatsawee Junsook and Associate Professor Mali Wirotesangthong, Ph.D., from the Faculty of Pharmaceutical Sciences, Chulalongkorn University to develop an oral liquid vehicle to be used for preparing extemporaneous Faripiravir oral suspension that can be easily taken by children and may be stored and administered over the period of 5–10 days as advised by the medical doctors.
“Health is imperative. Because we have seen how the problem can affect kids and how it is an added inconveniences to medical practitioners, therefore, we developed this vehicle in-hope to subside these problems” Dr. Wanchai pointed out.
Liquid Vehicle for Favipiravir Extemporaneous Preparation– the better solution for kids with COVID-19
Dr. Wanchai described the liquid vehicle to be used with Faviparavir tablets developed by Chula’s Faculty of Pharmaceutical Sciences as having a mild sweet taste with acceptable drug-excipients compatibility that able to retain its efficacies for the duration of the recommended medical period to be taken. When extemporaneously combined with Favipiravir tablets, if stored under controlled room temperature or in the refrigerator, the prepared drug product was proven chemically/physically to last for as long as ten days.
“If you were to imagine a finely ground powder of tablets that has been suspended with other low viscosity liquids, the sediment settles within a short time and may not uniformly redisperse to its original attribute after shaken. The liquid vehicle we have developed can prevent this since the extemporaneous drug preparation can retain its potency and uniform dispersion for long enough period as the prescribed medicine should be administered in children” Dr. Wanchai highlighted on its characteristics.
“We want to make the work of our medical practitioner easier. Also, parents can care for their own kids with uniform liquid medication throughout their treatment and without having the child rejecting the medication they critically needed.”
Liquid vehicle production hastened
Following the success in coming up with this liquid vehicle for Favipiravir, this team of researchers has experimented further in increasing the production scale to meet the needs of high incoming inquiries of many medical hospitals.
“We lack the instrument capable for large scale production. We have therefore prepared this liquid vehicle under the controlled facilities of pilot scale with clean room references at the Faculty of Pharmaceutical Sciences which is about 10 times smaller than the industrial production. We have the capacity to produce 10–20 liters in one hour, or only about 50 liters per day.” Dr. Wanchai enumerated.
Apart from preparing the liquid vehicle, the research team has also put together a direction or standard operating procedures (SOP) for extemporaneous preparation of Favipiravir liquid medication for treatment of pediatric patients.
“We have printed a brochure with a QR Code showing video on how to prepare the oral suspension from Favipiravir tablets for medical hospitals to follow. It also shows how to calculate the number of tablets to be prescribed to child patients based on their weight and age group on a case by case basis.”
In the future once the pandemic has subsided the research team plans to develop liquid vehicle for use with other medicines or even “the ready to use vehicle” in the dry powder form. This is in anticipation for such unexpected situations that could occur in the future. Medical hospitals or facilities or any agencies interested in the liquid vehicle for Favipiravir may contact Assistant Professor Narueporn Sutanthavibul for further information at the Faculty of Pharmaceutical Sciences, Chulalongkorn University, telephone number 083–445–9393 or leave the request at firstname.lastname@example.org.