THEY come in mint, orange and other fruity flavours, and melt in your mouth. No, these aren鈥檛 the latest candy craze. They鈥檙e the next generation of prescription drugs.
A few prescription pills of the new pleasant-tasting, melt-in-your-mouth kind have been quietly introduced in the US and Europe. For instance, CIMA Labs of Minnesota last year introduced fast-melting versions of the migraine drug Zomig and the antidepressant Remeron in the US.
People are responding so well that many pharmaceuticals companies are looking to make their most successful brands more palatable. 鈥淭here have only been about seven prescription products for a couple of years, but now there are about 25 in the pipeline,鈥� says John Hontz, chief operating officer at CIMA Labs. These include Allegra, a popular allergy drug, and tramadol, one of the world鈥檚 most commonly prescribed painkillers.
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To create the melt-in-your-mouth tablets, the active compound is made into a fine powder, then coated with polymers to mask its flavour. 鈥淲e can do mint, chocolate, cherry鈥t really depends on the country,鈥� says Pierre Belichard of the French company Ethypharm. The coated particles are then compressed to form pellets that disintegrate within seconds of being popped in the mouth. 鈥淚n some ways it 鈥榚xplodes鈥� in contact with water,鈥� says Belichard. The medicine can then be swallowed immediately.
The advantages are obvious. Industry studies suggest up to half of people have trouble swallowing pills. For them, a melt-in-your-mouth formulation is a godsend. And there are other benefits, says Belichard. For example, patients under psychiatric or intensive care are more likely to swallow fast-dissolve formulations without nurses having to supervise them.
But other variations of the melt-in-your-mouth approach promise much greater benefits. CIMA is developing pills designed to melt slowly under the tongue, so the drug can be directly absorbed into the bloodstream. This avoids the problem of absorption through the stomach, with the drug going straight to the liver where much of it may be broken down. The approach should also be useful for drugs that irritate the stomach lining, such as aspirin.
The key to CIMA鈥檚 technique is effervescence. The company says its studies have shown that effervescence can help drive drug compounds across mucosal membranes. Its tablet formulation also causes localised changes in pH that can increase the solubility of some drug molecules. 鈥淭his would be specifically targeted to drug products that require a very rapid onset of action, for example relief of pain,鈥� Hontz says. The company is working on pills containing fentanyl to ease cancer pain, for instance. Other companies are working on alternative techniques for getting drugs absorbed through the mouth.
But these pills are raising safety worries too. Because they taste good and dissolve quickly, children could easily think they are sweets. They do come in child-resistant packaging, but Rose Ann Foloway, associate director of the American Association of Poison Control Centers, says parents will have to be more diligent and ensure the pills are kept locked away out of sight.