Overdose and Alcohol Sensitive Immediate Release System (OASIS) for Deterring Accidental Overdose or Abuse of Drugs

AAPS PharmSciTech. 2020 Nov 25;22(1):9. doi: 10.1208/s12249-020-01879-7.

Abstract

Death from an accidental or intentional overdose of sleeping tablets has increased exponentially in the USA. Furthermore, the simultaneous consumption of sleeping tablets with alcoholic beverages not only intensifies the effect of sleeping tablets but also leads to blackouts, sleepwalking, and death in many cases. In this article, we proposed a unique and innovative technology to prevent multi-tablet and alcohol-associated abuse of sleeping tablet. Agonist- and antagonist-loaded polymeric filaments of appropriate Eudragit® polymers were prepared using hot melt extrusion. Metoprolol tartrate and hydrochlorothiazide were used as model drugs in place of zolpidem tartrate (agonist-BCS class I) and flumazenil (antagonist-BCS class IV), respectively. Crushed filaments were converted into a tablet with a novel rapidly soluble co-processed alkalizing agent. Dissolution studies of single tablet and multiple tablets (5) in fasted state simulated gastric fluid (FaSSGF) confirmed that the release of the agonist was significantly (p < 0.0001) reduced in multi-tablet dissolution. Furthermore, the release of antagonist was significantly higher when tablet was exposed to FaSSGF+20% ethanol and various alcoholic beverages. Thus, appropriate use of Eudragit® polymer's chemistry could help design a tablet to prevent the release of agonist in case of overdose and simultaneous release of antagonist when consumed with alcohol.

Keywords: Eudragit polymer; abuse-deterrent formulation; drug abuse; hot melt extrusion; sleeping tablet; zolpidem.

MeSH terms

  • Drug Overdose*
  • Ethanol / administration & dosage*
  • Humans
  • Polymers / chemistry
  • Polymethacrylic Acids
  • Sleep Aids, Pharmaceutical / administration & dosage
  • Solubility
  • Tablets

Substances

  • Polymers
  • Polymethacrylic Acids
  • Sleep Aids, Pharmaceutical
  • Tablets
  • methylmethacrylate-methacrylic acid copolymer
  • Ethanol