Table 2 Advantages and disadvantages of different parenteral statin delivery systems
Delivery system | Advantages | Disadvantages | Reference |
|---|---|---|---|
Buccal drug delivery | ■Bypasses the hepatic first-pass ■Bypassing the hepatic first-pass metabolism ■ high bioavailability ■ patient compliance improvement ■facility of availability of absorption site ■Sustainment of drug delivery ■ simple drug administration ■appropriate for drugs irritating mucosa mildly and reversibly ■ pain-free administration ■simplicity of drug withdrawal ■improvement of drug formulation by adding a pH modifier, enzyme inhibitor or permeation enhancer | ■restricted the area of absorption ■postponing the extent and rate of drug absorption via the mucosa by obstacles like mucus, saliva, basement membrane, and membrane covering granules, ■drug dilution by constant saliva secretion (0.5–2 L/day) ■ Choking risk by non-voluntarily swallowing ■elimination of dosage form by non-voluntary swallowing of saliva leading to waste of dissolved drug . | |
Mucoadhesive drug delivery | ■ localized and targeted dosage form at a particular area ■ increasing drug flux at the targeted tissue ■ high bioavailability ■ bypassing first pass metabolism and low enzyme activity ■ sustainment of drug delivery ■ pain-free administration | ■ incidence of local ulcers because of extended contact of the dosage form ■ lack of ability to recognize proper drugs for this delivery system due to absence of suitable model for screening ■poor patient tolerability regarding irritancy and taste ■ forbidden drinking and eating | [40] |
Gastric floating | ■ drug absorption improvment ■controlled drug delivery ■minimizing the mucosal irritation ■ suitable for treatment of gastrointestinal disorders ■simple and typical facilities for producing site-specific dosage forms ■simple drug administration ■ patient compliance improvement | ■ not suitable for drugs with low solubility or stability or in stomach ■ requiring great amount of water (200–250 ml) in the stomach ■ not convenient candidates for drugs injuring gastric mucosa ■ not suitable candidates for drugs absorbing across the whole GIT and undergoing first pass metabolism like nifedipine | [41] |
Pulsatile drug Delivery | prolonged day or night time activity ■reducing side effects by decreasing frequency and size of dosage form ■improvement of patient compliance. ■ suitable for circadian rhythms of disease or body activities ■ targeted drug delivery to a particular area like colon ■ protecting mucosa from irritating drugs ■ bypassing first pass metabolism ■ providing steady drug dosage at the targeted area ■ preventing the peak-valley fluctuations | ■ low capacity of drug loading ■imperfect drug release ■numerous steps for drug production ■ more expensive production | [42] |
Local drug delivery | ■ elevated concentration in subgingival area ■independent of patient compliance ■ not harmful for the significant advantageous microflora of GI tract ■ bypassing systemic intolerance | ■hardness in locating of dosage forms of the antimicrobial agents in deeper areas ■placing should be professionally ■patient compliance is needed for placing manually ■incomplete drug penetration | [43] |
Intravenous drug delivery | ■ possibility of self-administration of drug in controlled/constant manner, undesirable effects of drug administration can be ceased by removing patch. ■ not affecting drug delivery by food and gastrointestinal disorders (diarrhea or vomiting) ■ bypassing first-pass metabolism in the liver, decreasing the level of dosage form, and therefore reducing side effects of drug. ■suitability of administration for patients with facial injuries ■ decreasing frequency of drug dose ■non-invasive administration and improving patient compliance ■simplicity of production and transportation | ■difficulty in Large dose administration ■ not proper for drugs with size 500 Da ■ difficulty in obtaining high plasma level of ■ possibility of allergic or irritating reactions using high drug dosage form ■ variability in skin permeability from one area to another in same person and also in one person to another ■difficulty in contact between device and skin, because of wetting skin during bathing and sweating, leading to device falloff | [44] |
Transdermal drug delivery | ■extended time of drug function ■decreasing the frequency of dosage form ■More steady plasma level of drug ■Improving bioavailability ■Reduction of adverse effects ■Flexibility of withdrawal drug administration by easily taking the patch from the skin | ■probability of local irritation at the area of administration ■ probability of skin irritation or contact dermatitis because of drug or excipients ■limited number of delivered drugs due to low permeability of skin | [45] |
Nasal drug delivery | ■ lack of drug degradation in GI tract ■bypassing hepatic first pass metabolism ■fast drug absorption ■ improving bioavailability of bigger drug molecules using absorption enhancer or other methods ■great nasal bioavailability for smaller drug molecules ■possibility of drug delivery to the systemic circulation via nasal delivery for drugs not absorbing orally ■a suitable alternate to parenteral path, particularly, for peptide and protein drugs. ■appropriate for the patients, particularly for ones on long term therapy, in comparison with parenteral path ■great drug dose absorption due to large nasal mucosal surface site ■quick drug absorption through highly-vascularized mucosa ■quick beginning of function ■simple and non-invasive drug administration ■bypassing the first-pass metabolism ■improvement of bioavailability ■lower required dose therefore, reducing drug side effects ■minimal aftertaste ■ improvement of patient compliance ■self-administration | ■ a smaller absorption surface area compared to gastrointestinal tract ■ more possibility of irritation compared to the oral delivery system. ■ possibility of occurring local side effects and irreversible cilia injury on the nasal mucosa due to added substances to the drug ■ possibility of a mechanical loss of the drug within the other regions of the respiratory tract such as lungs because of the unsuitable administration procedure ■possibility of disruption and even dissolution of membrane due to applied certain surfactants as chemical enhancers | |
Implantable drug delivery systems | ■localized delivery ■ patient compliance improvement ■ lower required dose therefore, reducing drug side effects ■ drug stability improvement ■suitable for direct administration ■ simplicity of drug withdrawal | ■higher intricacy ■more expensive ■lack of accessibility of polymers ■requirement to certain physical characteristic like mechanical strength and adjustable degradation kinetics | [48] |