Iontophoresis enhances voriconazole antifungal potency and corneal penetration

Int J Pharm. 2020 Feb 25:576:118991. doi: 10.1016/j.ijpharm.2019.118991. Epub 2019 Dec 26.

Abstract

Strategies to enhance corneal penetration of voriconazole (VOR) could improve the treatment of fungal keratitis. Here, we evaluated the use of iontophoresis for ocular VOR delivery from either: (i) a cyclodextrin inclusion complex (CD VOR), (ii) a liposome (LP VOR), and (iii) a chitosan-coated liposome (LP VOR CS). LP VOR CS presented mean diameter of 139.2 ± 1.3 nm and zeta potential equal to + 3.3 ± 1.5 mV compared to 134.6 ± 1.7 and -8.2 ± 3.0 mV of LP VOR, which, together with mucin mucoadhesion study, confirmed chitosan-coating. Both drug and liposomal formulations were stable under the influence of an applied electric current. Interestingly, in vitro studies in Candida glabrata culture indicated a decrease in VOR MIC values following iontophoresis (from 0.28 to 0.14 µg/mL). Iontophoresis enhanced drug penetration into the cornea. After 10 min of a 2 mA/cm2 applied current, corneal retained amounts were 45.4 ± 11.2, 30.4 ± 2.1 and 30.6 ± 2.9 µg/cm2 for, respectively, CD VOR, LP VOR, and LP VOR CS. In conclusion, iontophoresis increases drug potency and enhances drug penetration into the cornea, showing potential to be used as "an emergency burst delivery approach".

Keywords: Candida glabrata; Fungal keratitis; Liposome; Ocular iontophoresis.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Ophthalmic
  • Animals
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / chemistry
  • Antifungal Agents / metabolism
  • Candida glabrata / drug effects*
  • Candida glabrata / growth & development
  • Chitosan / chemistry
  • Cornea / metabolism*
  • Cyclodextrins / chemistry
  • Drug Compounding
  • Iontophoresis*
  • Lipids / chemistry
  • Liposomes
  • Microbial Sensitivity Tests
  • Nanoparticles
  • Sus scrofa
  • Tissue Distribution
  • Voriconazole / administration & dosage*
  • Voriconazole / chemistry
  • Voriconazole / metabolism

Substances

  • Antifungal Agents
  • Cyclodextrins
  • Lipids
  • Liposomes
  • Chitosan
  • Voriconazole