Lack of adherence can be overcome by combining complex treatments within the same solid dosage form. The annual cost of non-compliance due to medication-related hospital visits may be as high as $100 billion. Although medications for CVDs are effective and can yield very substantial health and economic benefits, these advantages are often not realised, as approximately 50% of patients do not take their medications as prescribed. Four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely, in people under 70 years of age. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions. īased on WHO statistics, cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year, which represents 31% of all deaths worldwide. 3D printing makes feasible the incorporation of multiple active pharmaceutical ingredients (API) into one dosage form that can result in enhanced adherence and better and safer pharmacotherapy in polymedicated patients. Their ability to allow for dose individualisation enables 3D printed dosage forms to ensure efficacy combined with minimal side effects. 3D printing allows for tailoring of dosage forms to patients’ and disease needs such as age, dose, release profile, colour, texture, taste, and size.
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3D printing is an innovative technology that allows the fabrication of personalised medicines to enable a tailored pharmacotherapy instead of a “one size fits all” approach. Since the FDA approval of Spritam ®, there has been a growing interest in the application of 3D printing in pharmaceutical sciences. The small size of the minitablet allows it to fit inside of a 0-size capsule and be combined with other minitablets, of other API, for the treatment of complex diseases requiring polypharmacy within a single dosage form. This release profile of the printed minitablets is more suitable for hypertensive patients than immediate-release tablets that can lead to a marked burst effect, triggering hypotension. The fabricated 3D printed minitablets of small overall weight did not disintegrate during dissolution and allowed for controlled drug release over 24 h, based on erosion. 3D printed nifedipine minitablets containing 20 mg were manufactured by direct powder extrusion combining 15% polyethylene glycol 4000 Da, 40% hydroxypropyl cellulose, 19% hydroxy propyl methyl cellulose acetate succinate, and 1% magnesium stearate. In this study, we demonstrate the manufacturing of small-weight (<100 mg) solid dosage forms with high drug loading (25%) that can be easily undertaken by healthcare professionals to treat hypertension. Direct powder extrusion can overcome the difficulties encountered with fabrication of pharmaceutical-quality filaments for FDM, allowing the manufacturing, in a single step, of 3D printed solid dosage forms.
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However, it is a two-step process requiring the fabrication of filaments using a hot melt extruder with suitable properties prior to printing taking place, which can be a rate-limiting step in its application into clinical practice. Fuse deposition modelling (FDM) has emerged as a novel technology for manufacturing 3D printed medicines.