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Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine
Quetiapine is an atypical antipsychotic approved for treating schizophrenia, bipolar depression, and mania but is frequently used in an off-label manner to control the behavioral and psychological symptoms of dementia in elderly patients with dementia. Due to the need to personalize doses for elderl...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469994/ https://www.ncbi.nlm.nih.gov/pubmed/34575599 http://dx.doi.org/10.3390/pharmaceutics13091523 |
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author | Ganzetti, Roberta Logrippo, Serena Sestili, Matteo Caraffa, Alessandro Cespi, Marco Pelliccioni, Giuseppe Blasi, Paolo Bonacucina, Giulia |
author_facet | Ganzetti, Roberta Logrippo, Serena Sestili, Matteo Caraffa, Alessandro Cespi, Marco Pelliccioni, Giuseppe Blasi, Paolo Bonacucina, Giulia |
author_sort | Ganzetti, Roberta |
collection | PubMed |
description | Quetiapine is an atypical antipsychotic approved for treating schizophrenia, bipolar depression, and mania but is frequently used in an off-label manner to control the behavioral and psychological symptoms of dementia in elderly patients with dementia. Due to the need to personalize doses for elderly patients with dementia, quetiapine tablet manipulation is widespread in hospital settings, long-term care facilities, and patient homes. The aim of this study was to assess the impact of the different splitting techniques on quetiapine fumarate tablets by analysing the obtained sub-divided tablets and to discuss compliance with the European Pharmacopoeia limits on whole and split tablets. Quetiapine fumarate tablets of two dose strengths were taken at random (in a number able to assure a power of 0.8 during statistical comparison) and were split with a kitchen knife or tablet cutter. The weight and the drug content were determined for each half tablet. The obtained data were compared to the European Pharmacopoeia limits. The differences between the different splitting techniques were statistically tested. Data showed that split tablets, independently of the dose strength and the technique employed, were not compliant with the European Pharmacopoeia specifications for both entire and subdivided tablets in terms of weight and content uniformity. Thus, such a common practice could have potential effects on treatment efficacy and toxicity, especially when also considering the fragility of the elderly target population in which polypharmacotherapy is very common. These results indicate a compelling need for flexible quetiapine formulations that can assure more accurate dose personalization. |
format | Online Article Text |
id | pubmed-8469994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-84699942021-09-27 Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine Ganzetti, Roberta Logrippo, Serena Sestili, Matteo Caraffa, Alessandro Cespi, Marco Pelliccioni, Giuseppe Blasi, Paolo Bonacucina, Giulia Pharmaceutics Article Quetiapine is an atypical antipsychotic approved for treating schizophrenia, bipolar depression, and mania but is frequently used in an off-label manner to control the behavioral and psychological symptoms of dementia in elderly patients with dementia. Due to the need to personalize doses for elderly patients with dementia, quetiapine tablet manipulation is widespread in hospital settings, long-term care facilities, and patient homes. The aim of this study was to assess the impact of the different splitting techniques on quetiapine fumarate tablets by analysing the obtained sub-divided tablets and to discuss compliance with the European Pharmacopoeia limits on whole and split tablets. Quetiapine fumarate tablets of two dose strengths were taken at random (in a number able to assure a power of 0.8 during statistical comparison) and were split with a kitchen knife or tablet cutter. The weight and the drug content were determined for each half tablet. The obtained data were compared to the European Pharmacopoeia limits. The differences between the different splitting techniques were statistically tested. Data showed that split tablets, independently of the dose strength and the technique employed, were not compliant with the European Pharmacopoeia specifications for both entire and subdivided tablets in terms of weight and content uniformity. Thus, such a common practice could have potential effects on treatment efficacy and toxicity, especially when also considering the fragility of the elderly target population in which polypharmacotherapy is very common. These results indicate a compelling need for flexible quetiapine formulations that can assure more accurate dose personalization. MDPI 2021-09-20 /pmc/articles/PMC8469994/ /pubmed/34575599 http://dx.doi.org/10.3390/pharmaceutics13091523 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ganzetti, Roberta Logrippo, Serena Sestili, Matteo Caraffa, Alessandro Cespi, Marco Pelliccioni, Giuseppe Blasi, Paolo Bonacucina, Giulia Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine |
title | Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine |
title_full | Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine |
title_fullStr | Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine |
title_full_unstemmed | Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine |
title_short | Tablet Splitting in Elderly Patients with Dementia: The Case of Quetiapine |
title_sort | tablet splitting in elderly patients with dementia: the case of quetiapine |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469994/ https://www.ncbi.nlm.nih.gov/pubmed/34575599 http://dx.doi.org/10.3390/pharmaceutics13091523 |
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