Recent Dosage Forms

AAD: Nearly Everyone Needs a Routine Vitamin D Supplement

NEW YORK – The vast majority of children and adults should receive a routine, daily vitamin D supplement, and this recommendation applies from age 1 year all the way up to age 70 years, Dr. Henry W. Lim said at the meeting.

The only exception is a select group of people at high risk for vitamin D inadequacy who warrant initial testing to be sure they don’t need an even higher starting dosage of the vitamin, said Dr. Lim, professor and chairman of dermatology at Henry Ford Hospital in Detroit.

Dr. Lim based his recommendations on the revised dietary reference intakes for vitamin D issued by the Institute of Medicine last November, which set a recommended dietary allowance (RDA) of 600 IU/day for ages 1-70 years.

"In my opinion, testing [of serum vitamin D level] should only be done for people at high risk for vitamin D inadequacy," he said. In the group to consider for testing are breastfed infants, older adults with reduced skin synthesis of vitamin D, or people with limited sun exposure, dark skin, fat malabsorption (because vitamin D is fat soluble), or obesity.

"For the average individual [not in a high-risk group] my suggestion is to take 600 IU per day starting at age 1," Dr. Lim said in an interview. At that level, the supplement is relatively innocuous, inexpensive, and addresses the widespread vitamin D inadequacy. He did not rule out routine vitamin D supplements for children younger than 1 year, but noted that the RDA is lower.

Testing a person’s vitamin D level costs about $100, using ICD-9 code 268.9 for unspecified vitamin D deficiency. Doing that for everyone would incur a "tremendous" cost, he said. He also echoed the recent position taken by the American Academy of Dermatology that most vitamin D should come from diet and supplements, and not from sun exposure. "It is inappropriate to recommend intentional exposure to natural or artificial UV [light] for achieving an adequate vitamin D level," he said.

People at high risk for a low vitamin D level need testing to check whether their level falls as low as 10 ng/mL or even 5 ng/mL. With this degree of deficiency, the person might need a single 10,000-IU or even 20,000-IU dose to raise their level quickly. Daily supplements should not exceed 1,000-3,000 IU in children aged 8 years or younger and should not exceed 4,000 IU daily for those aged 9-70 years, Dr. Lim said.

Experts Pointed Out: New Trends In Pharmaceutical R & D Concern ...

Article by hi joiney

Present, drugs Preparation Facing to improve quality, reduce cost pressures, medical supplies and Preparation The boundaries of the active ingredient in the shrinking profits began to close, the R & D and production of pharmaceutical excipients has become a new growth point in the pharmaceutical industry. In the recently held “The Second China Pharmaceutical Excipients standard use of the” Forum on China Pharmaceutical University, home health, said Professor James, in recent years, research and application of Pharmaceutical Excipients, some new trends have emerged, such as development of multi-purpose accessories, new dosage forms development needs to accelerate development of new pharmaceutical excipients. Recent years, varieties of blockbuster drugs, fewer and fewer profits are significantly reduced; and a large number of patent medicine patent expires, the impact on the market increases; the same time Governments to lower drug prices and improve product quality dual requirements reduced the profit margins of pharmaceutical companies. Some big international system Pharmaceutical companies Industry unwilling to accept high input, low output of reality, seeking cheap, high quality medical accessories become more and more pressing demands. Traditionally, we think that pharmaceutical excipients should be inert (chemical and physical inertia), and now the industry is in the nature of pharmaceutical excipients to form a new consensus that may not inert pharmaceutical excipients. Tu family health, said more and more evidence that there is biological activity accessories, some accessories, such as sodium cholate, HP-CD, propylene glycol, polyethylene glycol 400, etc., can promote the oral absorption of insoluble drugs; many accessories such as CremophorEL, RH40, Tween20, 80, Span20, PluronicP85, TPGS, Brij30, Myrj52andGelucire44/14 can significantly inhibit the efflux of P-GP, and improve drug absorption. In addition, many pharmaceutical excipients on the pharmacokinetics of injections have great influence, such as cyclodextrin can be lipid, such as lipoprotein, cholesterol interaction with the drug combination and the release of water affect the pharmacokinetics of the drug blood larger. Meanwhile, more noteworthy is that some pharmaceutical excipients also has the role of adjuvant therapy, such as oleic acid, – linolenic acid can inhibit the expression of Her-2/neu breast cancer gene, therefore, oleic acid used in the HE tournament Ting (Herceptin) in the formula, linolenic acid for the recombinant anti-HER2 monoclonal antibody (trastuzumab) prescription, xylitol can be used in dentistry. Recent years, the preparation of development has contributed to the development of new accessories. TU Home Health stressed that the new accessories are generally light New Drugs Management, if a simple transformation of existing accessories, making it the series, such as PEG400, 600,800, etc., then the safety data to simplify. But preparations have been accessories to change the channel or increase the amount of the application, you need to provide appropriate security and application based. At present, the development of new accessories focus on three main aspects: First, R & D to improve the compound medicines of new accessories.At present, pharmacological experiments and clinical development as drug dosing has become the bottleneck created, therefore, to solve the solubility of hydrophobic drugs in the development of an attachment order. Second, the R & D to improve the preparation of the production efficiency, performance, quality, new accessories. The third is the R & D to improve the performance of these agents may be the pressure of liquidity, the smoothness of new accessories. In addition, the development of new accessories and a growing trend series of products, for example, cellulose products, products of acrylic resin. Development areas throughout the accessories, natural materials and their derivatives become more and more popular. Starch-based materials to cost-effective than cellulose-based material, some new compressible starch, can provide adhesives, thinners, disintegrant multiple functions; new maltodextrin alternative Povidone (PVP ) as the effective adhesive. At the same time, development of multi-purpose accessory also attracted the attention of many industry, encourage the development of versatile low-cost, efficient excipients have become common, such as the development of starch.In addition, the R & D Pharmaceutical Excipients, the contents of the study further, because the drugs and supplies, accessories and auxiliary materials will produce between interactions, such as the role of the charge generated, so the formula was designed, the general will be considered, such as drug plans can be absorbed accessories (such as cellulose) result in incomplete drug release; drugs can accelerate the degradation, and the formation of eutectic. Excipients in pharmaceutical applications, a growing awareness in the formula should be minimal to add accessories.

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