Intravaginal drug delivery systems: Application in pregnancy and lactation

Abstract

Within recent years the level of interest in both local and systemic vaginal drug delivery systems has increased considerably. The vagina offers advantages as a site for drug delivery, such as convenient access, prolonged retention of formulations, a great permeation area, high vaskularization, relatively low enzymatic activity, and the avoidance of first-pass metabolism. The rate and extent of drug absorption after intravaginal administration may vary depending on formulation factors, vaginal physiology, age of the patient. Peccaries, creams, gels, tablets, inserts and vaginal rings are commonly used dosage forms for vaginal drug delivery. The purpose of this communication is to provide the reader with a summary of advances made in the field of vaginal delivery with respect to preparations used in pregnancy and/or lactation.

Poslednjih godina je u porastu interes za vaginalnu primenu lekova, kako sa lokalnim, tako i sa sistemskim delovanjem. Vagina omogućava niz prednosti kao mesto za primenu terapijskih sistema, kao što su jednostavnost pristupa, duže zadržavanje formulacije na mestu primene, velika površina permeacije, dobra vaskularizacija, relativno niska enzimska aktivnost i izbegavanje efekta metabolizma prvog prolaza. Brzina i obim apsorpcije nakon intravaginalne primene lekova zavisi kako od fizioloških, tako i od farmaceutsko-tehnoloških faktora vezanih za vrstu i sastav lekovitog oblika. U radu su prikazani intravaginalni terapijski sistemi namenjeni za primenu u trudnoći, za indukciju porođaja ili kod dojilja, sa posebnim osvrtom na nove sisteme: vaginalne inserte, vaginalne prstenove, bioadhezivne preparate.