26 Corresponding Author: N. Udupa, Manipal College of Pharmaceuti- cal Sciences, Manipal- 576 104, Karnataka, India. udupa1553@yahoo.com Formulation development, in vitro and in vivo evaluation of membrane controlled transdermal systems of glibenclamide. Srinivas Mutalik, Nayanabhirama Udupa Manipal College of Pharmaceutical Sciences, Manipal, Karnataka State, India Received 5 November 2004, Revised 12 December 2004, Accepted 15 December 2004, Published 21 January 2005 Abstract PURPOSE: The objective of the present study was to develop the membrane controlled trans- dermal systems of glibenclamide and to evaluate with respect o various in vitro and in vivo parameters. METHODS: The membrane moderated transdermal systems were prepared using drug containing carbopol gel as reservoir and ethyl cellulose, Eudragit RS-100, Eudragit RL-100 and Ethylene vinyl acetate (EVA) (2%, 9% and 19% vinyl acetate content) rate control- ling membranes. The possible interaction between drug and polymer was studied by IR spectroscopy, DSC and HPTLC analysis. The formulations were subjected to various physicochemical studies, in vitro drug release studies and permeation studies through mouse skin. The blood glucose reducing hypoglycemic activity of the systems was studied in both normal and diabetic mice. Various biochemical parameters and his- topathological studies were carried out after treating the diabetic mice for 6 weeks. Skin irritation tests, oral glucose tolerance test and pharmacokinetic evaluations were carried out in mice. RESULTS: The results sug- gested no interaction between drug and polymer. Vari- ations in drug release/permeation profiles among the formulations containing different rate controlling membranes were observed. The scanning electron microscopic studies of EVA membranes demonstrated no changes in the surface morphology after in vitro skin permeation studies. The system with EVA rate controlling membrane (with 19% vinyl acetate) was selected for in vivo experiments. The transdermal sys- tem produced better improvement with respect to hypoglycemic activity, glucose tolerance test, all the tested biochemical, histopathological and pharmacoki- netic parameters compared to oral administration, and exhibited negligible skin irritation. CONCLUSION: The present study shows that membrane controlled transdermal systems of glibenclamide exhibited better control of hyperglycemia and more effectively reversed the diabetes mellitus complications than oral glibenclamide administration in mice. INTRODUCTION Diabetes mellitus is a chronic metabolic disorder char- acterized by high blood glucose concentration-hyperg- lycemia-caused by insulin deficiency, often combined with insulin resistance (1). Glibenclamide, an impor- tant drug of sulfonylurea class, is currently available for treating hyperglycemia in (Non-Insulin Dependent Diabetes Mellitus (NIDDM); but has been associated with severe and sometimes fatal hypoglycemia and gas- tric disturbances like nausea, vomiting, heartburn, anorexia and increased appetite after oral therapy (2). Since these drugs are usually intended to be taken for a long period, patient compliance is also very important (3). We already have reported the feasibility of applica- tion of transdermal delivery for glibenclamide. Glib- enclamide (molecular weight: 494 and pK a : 5.3) showed favorable partition coefficients (log octanol/buffer: 0.32 0.0.07; log isopropylmyristate/buffer: 0.50 0.05) and negligible skin degradation (4, 5). In another study, we reported the formulation and evaluation of matrix type transdermal patches of glibenclamide (6). It is highly accepted that membrane controlled trans- dermal systems have the distinct advantage that the drug release rate, which is regulated by permeation through the rate controlling membrane, remains rela- tively constant as long as drug loading in the reservoir is maintained at a high level (7). Hence in the present study, we have formulated the membrane moderated transdermal systems of glibenclamide using carbopol gel as drug reservoir and various polymeric rate con- trolling membranes prepared by ethyl cellulose, Eudragit RL-100, Eudragit RS-100, ethylene vinyl ace- tate (containing 2%, 9% and 19% vinyl acetate) and evaluated with respect to various in vitro parameters (physical characteristics like thickness, drug content, moisture content/uptake, scanning electron micros- J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 27 copy, flatness, in-vitro release/permeation kinetics, etc) and pharmacological, biochemical and histopatho- logical effects in vivo in mouse model. MATERIALS AND METHODS Ethyl cellulose (EC; with an ethoxy content of 47.5- 53.5% by weight and a viscosity of 14 cps in a 5% w/w, 80:20 toluene:ethanol solution at 25 C) was pur- chased from SD Fine Chemicals Ltd., India. Eudragit RL-100 (ERL) and Eudragit RS-100 (ERS) were obtained from Rohm Pharma, Germany. Carbopol 934P NF was purchased from B.F. Goodrich, Ger- many. Di-n-Butylphthalate was procured from Ranb- axy Laboratories, India. Ethylene vinyl acetate (EVA) membranes with 2% vinyl acetate (VA) content (EVA2%; 3M CoTran 9726), 9% VA content (EVA9%; 3M CoTran 9702) and 19% VA content (EVA19%; 3M CoTran 9715), backing layer (a polyester film lami- nate; 3M Scotchpak Backing 1006) and release liner (a fluropolymer coated polyester film; 3M Scotchpak 1022 Release Liner) were gift samples from 3M Phar- maceuticals, USA. Sodium deoxycholate, anthrone, thiourea, streptozotocin, bovine serum albumin were purchased from Sigma Chemical Company, USA. Polyisobutylene was purchased from Aldrich, USA. Glibenclamide was a gift from BAL Pharma, Modi- Mundi Pharma and Wallace Pharmaceuticals, India. All the other chemicals used were of analytical/reagent grade. DEVELOPMENT OF MEMBRANE CONTROLLED TRANSDERMAL SYSTEMS The transdermal systems were fabricated by encapsu- lating the drug reservoir within a shallow compart- ment molded from a drug impermeable backing laminate and a rate controlling membrane. EC, ERL and ERS rate controlling membranes were prepared by dissolving 250, 300 and 300 mg of respective polymers in 5 ml chloroform. Di-n-Butyl phthalate (30% w/w of polymer) was used as plasticizer. The polymeric solu- tion was poured on the mercury surface (25 cm 2 ) and dried at room temperature. After 24 h, the films were cut into 12 cm 2 area. EVA rate controlling membranes were gift samples from 3M Pharmaceuticals, USA. The reservoir (0.5% carbopol gel) of the drug was pre- pared as per the formula given in Table 1. Carbopol was soaked in 5 ml water and neutralized using triethanolamine (q.s.) to form a gel. Drug in 5 ml ethanol was added slowly to carbopol gel with con- stant stirring. Table 1: Reservoir of the glibenclamide membrane controlled transdermal systems. The area of the transdermal system was 12 cm 2. Accurately weighed quantity of the gel (1 g) containing drug (12 mg of glibenclamide) was placed on a sheet of backing layer (3M Scotchpak Backing 1006) covering 3 cm x 4 cm areas. A rate controlling membrane was placed over the gel and the edges of 3 cm x 4 cm area were heat-sealed to obtain a leak proof device. To ensure intimate contact of the patch to the skin, a pres- sure sensitive adhesive, polyisobutylene (PIB), was applied onto rate controlling membrane (3 ml; 10% w/ v in petroleum ether). A release liner (3M Scotchpak 1022 Release Liner) was placed over the adhesive coated rate controlling membrane. DRUG-POLYMER INTERACTION STUDIES Infra-red (IR) spectroscopy (using IR-Spectrophotome- ter; FTIR-8300, Shimadzu, Japan; by KBr pellet method), differential scanning calorimetry (DSC) (Per- kin Elmer, USA; at scanning rate of 10 C/min between 50 and 300 C), and high performance thin layer chromatographic (HPTLC) analysis (using CAMAG-HPTLC system, Switzerland) were carried out on pure substances and their physical mixtures to search the possible interaction between glibenclamide and carbopol (6). IN VITRO EVALUATION OF TRANSDERMAL SYSTEMS For drug content determination, the whole contents of transdermal systems (n=3) were taken into a 100 ml volumetric flask and dissolved in methanol. The solu- tion was filtered through 0.45- membrane (Nulge J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 28 Nunc, UK) prior to drug analysis. The viscosity of drug containing carbopol gel was determined using Brookefield synchro electric viscometer (Brookefield Engineering Ltd., USA). The TD bar spindle of LV-4 at 12 - gear was employed. The in vitro drug release studies and in vitro skin per- meation studies were carried out using USP basket type dissolution apparatus (using 900 ml of phosphate buffer pH 7.4 as dissolution medium) and vertical type diffusion cells (using hairless mouse skin as membrane barrier), respectively (6). The morphology of the EVA rate controlling membranes before and after in vitro skin permeation experiments was analyzed by scan- ning electron microscopy (JEOL-JSM840A, Japan). IN VIVO STUDIES The animals used for in vivo experiments were adult Swiss albino mice (6-8 weeks old) of either sex, weigh- ing 25-30 g, from the Department of Radiobiology, Kasturba Medical College, Manipal. The animals were housed in polypropylene cages, 4 per cage, with free access to standard laboratory diet (Lipton Feed, Mum- bai, India) and water. They were kept at 251C and 45-55% relative humidity with a 12 h light/dark cycle. The in vivo experimental protocol was approved by the Institutional Animal Ethical Committee, Kasturba Medical College, Manipal. HYPOGLYCEMIC ACTIVITY IN NORMAL MICE The hair on the backside of the mice was removed with an electric hair clipper on the previous day of the experiment. Following an overnight fast, mice were divided into 3 groups (n=6). The mice were treated as following: Group I (Control) - 0.2 ml of 0.5% w/v sodium car- boxymethyl cellulose (CMC); p.o. Group II - Glibenclamide (5 mg/kg; p.o.). The oral doses were given using a round tipped stainless steel needle attached to 1 ml syringe and the dose of 5 mg/ kg was selected by conducting a series of experiments with graded doses ranging between 1 to 10 mg/kg. Group III - Applied with 2.5 cm 2 transdermal system prepared with EVA19% rate controlling membrane, containing 2.5 mg of drug in 0.5% carbopol gel. At time intervals between 2-24 h after treatment (acute study), blood was collected from orbital sinuses; blood glucose levels were determined using Accutrend Alpha Glucometer (Roche Diagnostics, Germany). In the long-term study, the above treatments were adminis- tered/applied once daily for 6 weeks. Blood glucose levels were determined once in every 2 weeks in over night fasted mice, 2 h after drug treatment as previ- ously described. INDUCTION OF DIABETES MELLITUS AND HYPOGLYCEMIC ACTIVITY IN DIABETIC MICE The overnight fasted mice were made diabetic by a sin- gle intraperitoneal injection of streptozotocin (150 mg/kg; i.p.) dissolved in citrate buffer (3 mM; pH 4.5) (6). Seven days later, mice with blood glucose levels between 300-400 mg/dL were selected. The acute and long-term hypoglycemic activity of the transdermal patches was evaluated in overnight fasted diabetic mice as described in above. EFFECT ON GLUCOSE TOLERANCE After an overnight fast, mice were divided into 3 groups (n=6). Control group was administered with 0.2 ml of CMC. Other 2 groups were administered with glibenclamide (5 mg/kg; p.o.) or applied with transdermal system as described in earlier experiments. Two hours later, glucose was administered orally (2 g/ kg) to all the 3 groups. Blood samples were collected just prior to and at 0.5, 1.0 and 2.0 h after the glucose feeding and glucose level was determined. The percent- age change in blood glucose was estimated in compari- son with the control group. During the testing period, food was not provided; but water was given ad libitum. BIOCHEMICAL AND HISTOPATHOLOGICAL EVALUATION At the end of the long-term treatment in the diabetic mice, lipid profile (high-density lipoprotein-choles- terol, triglycerides and total cholesterol), alanine tran- saminase (ALT), aspertate transaminase (AST), urea and creatinine levels were estimated in serum using Auto-analyzer (Hitachi 911, Japan). Then the animals were sacrificed and a part of the liver was processed for glycogen estimation and total protein (6). Pieces of liver, pancreas and stomach were subjected to histo- pathological studies using haematoxylene and eosin (H & E) staining. J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 29 SKIN IRRITATION TEST (VISUAL AND HISTOPATHOLOGICAL EVALUATION OF SKIN) The mice were divided into 5 groups (n=6). On the previous day of the experiment, the hair on the back- side area of mice was removed. The animals of group I was served as normal, without any treatment. One group of animals (Group II, control) was applied with marketed adhesive tape (official adhesive tape in USP). Transdermal systems (blank, without drug and drug loaded) were applied onto nude skin of animals of III and IV groups. A 0.8% v/v aqueous solution of forma- lin was applied as a standard irritant (Group V). The animals were applied with new patch/formalin solu- tion each day upto 7 days and finally the application sites were graded according to a visual scoring scale, always by the same investigator. The erythema scale was as follows: 0, none; 1, slight; 2, well defined; 3, moderate; and 4, scar formation. The edema scale was: 0, none; 1, slight; 2, well defined; 3, moderate; and 4, severe. After visual evaluation of skin irritation, the animals were sacrificed and skin samples were pro- cessed for histological examination (6). PHARMACOKINETIC EVALUATION Overnight fasted mice, whose hair was previously removed, were divided into 2 groups (n=6) and treated as follows. Group I - Glibenclamide (5 mg/kg; p.o.). Group II - Applied with 2.5 cm 2 transdermal system prepared with EVA19% rate controlling membrane, containing 2.5 mg of drug in 0.5% carbopol gel. Blood samples were withdrawn at different time inter- vals from orbital sinuses using heparinized capillaries. Plasma was separated by centrifugation using Biofuge- 13 (Heraeus Instruments, Germany) and stored in vials at -70 C until further analysis. ANALYSIS OF GLIBENCLAMIDE Glibenclamide was estimated by an earlier reported reverse phase HPLC method (27). A Shimadzu Class VP series HPLC system with two LC-10AT pumps, a SPD-10A variable wavelength programmable UV/Vis detector, a SCL-10A system controller and a RP C-18 column (Luna, Phenomenex, USA; 250 mm x 4.6 mm; particle size 5 m) was used. The system was equipped with Class VP series version 6.12 software. Chromatographic conditions: The mobile phase con- sisted of 20 mM monobasic potassium dihydrogen orthophosphate in water, which was adjusted to pH 3.5 with phosphoric acid, and acetonitrile in the pro- portion of 60:40 v/v. The mobile phase was filtered through 0.22 m membrane filter (Sartorius, Ger- many). The flow rate was 1 ml/min and the column effluent was monitored at 225 nm. The total run time of the method was set at 20 min. The peaks were well resolved and the retention time for glibenclamide and glipizide (internal standard) was 9.60 and 5.96 min respectively. No interfering peaks were observed at the retention time of glibenclamide and glipizide. Standard Solutions: A standard stock solution of glib- enclamide (100 g/ml) was prepared in acetonitrile. The calibration curve standard solutions were prepared by adding known amount of glibenclamide (concentra- tions: 1-20 g/ml) and glipizide, an internal standard (1 g/ml), to blank plasma. Extraction procedure: A volume of 0.1 ml of blank mouse plasma and 0.1 ml of 0.1 N hydrochloric acid were mixed thoroughly. The plasma was spiked with standard glibenclamide and glipizide solutions to yield concentrations of 1-20 g/ml of glibenclamide and 1 g/ml of glipizide, respectively. Then the mixture was gently shaken for 3 min and then it was added with 5 ml of benzene in a 20 ml glass tube. The tube was gen- tly shaken using cyclomixer (Remi cyclomixer, Mum- bai) for 5 min and centrifuged (Remi Centrifuge, Mumbai, India) for 10 min at 3000 rpm. After centrifu- gation, the organic phase was transferred into a conical tube for evaporation to dryness under nitrogen. The residue was dissolved in 0.1 ml of equilibrated mobile phase by vortexing. An aliquot of 20 l was injected into the chromatograph. Calibration curve: Calibration curve was obtained by plotting peak area ratios of glibenclamide to glipizide (y-axis) against glibenclamide concentration (x-axis). The pharmacokinetic parameters were calculated using noncompartmental pharmacokinetics data analysis software, PK Solutions 2.0. J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 30 STATISTICAL ANALYSIS The results were analyzed by Student's t-test using Graph Pad Instat Software (Version: 1.13). Difference below the probability level 0.05 was considered statisti- cally significant. RESULTS Drug-polymer interaction studies The IR spectral analysis of glibenclamide alone showed that, the principal peaks were observed at wave num- bers of 1527.50, 1157.2, 1618.2, 1714.6 and 819.7 con- firming the purity of the drug as per established standards (8). In the IR spectra of the physical mixture of glibenclamide and carbopol, the major peaks of glib- enclamide were 1527.50, 1157.2, 1618.2, 1716.5 and 819.7 wave numbers. However, some additional peaks were observed with physical mixtures, which could be due to the presence of polymer. The DSC analysis (Figure 1) of pure glibenclamide showed a sharp endotherm peak at 175.16 C corre- sponding to its melting point. Figure 1: DSC Thermograms. a=Carbopol; b=mixture of Carbopol and glibenclamide; c=glibenclamide. The DSC analysis of physical mixture of drug and car- bopol revealed negligible change in the melting point of glibenclamide in the presence carbopol (172.08 C for the mixture of glibenclamide and carbopol). In HPTLC analysis, the R f value of pure glibenclamide was found to be 0.92. In the presence of polymer, the R f value of the drug was unchanged and found to be 0.92. DRUG CONTENT AND VISCOSITY The drug content of the transdermal systems was ranged between 99.950.12 and 99.040.13%. The vis- cosity of reservoir of membrane controlled transder- mal systems (0.5% carbopol gel containing glibenclamide) was uniform among the batches and found to be 17100150 cps. IN VITRO DRUG RELEASE STUDIES The results of in vitro drug release studies from trans- dermal systems are depicted in Figure 2. Figure 2: Cumulative percentage of glibenclamide released in in vitro dissolution studies from reservoir transdermal systems prepared using ethyl cellulose (EC), Eudragit RL-100 (ERL), Eudragit RS-100 (ERS) and ethylene vinyl acetate (EVA) copolymer rate controlling membranes containing 2%, 9% and 19% VA (EVA2%, EVA9% and EVA19% respectively). Each point represents MeanSE, n=3; * significant compared to EVA2%; Control=Suspension of glibenclamide in phosphate buffer. The formulations with ERL rate controlling mem- brane exhibited the greatest cumulative percentage of drug release value (97.459.01%) followed by ERS (89.855.25%), EC (81.555.32 %), EVA19% (80.028.32%), EVA9% (70.255.24%) and EVA2% (55.657.36%) membrane containing systems at the end of 24 h. J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 31 IN VITRO SKIN PERMEATION STUDIES The results of in vitro skin permeation of glibencla- mide from patches are shown in Figure 3. Figure 3: Cumulative amount of glibenclamide permeated (mg/cm 2 ) across mouse skin from reservoir transdermal systems prepared using ethyl cellulose (EC), Eudragit RL-100 (ERL), Eudragit RS-100 (ERS) and ethylene vinyl acetate (EVA) copolymer rate controlling membranes containing 2%, 9% and 19% VA (EVA2%, EVA9% and EVA19% respectively). Each point represents MeanSE, n=3; * significant compared to EVA2%. The formulations (1 cm 2 ) with ERL rate controlling membrane exhibited the greatest (332.5413.36 g) cumulative amounts of drug permeation followed by ERS (291.5712.31 g), EC (270.2312.62 g), EVA19% (267.2510.28 g), EVA9% (224.5812.61g) and EVA2% (165.589.65 g) mem- brane containing devices at the end of 24 h. The trans- dermal systems with EVA2% rate controlling membrane showed significantly low (p<0.05) cumula- tive amount of drug permeation compared to other rate controlling membrane systems. SCANNING ELECTRON MICROSCOPY Figure 4 shows the microstructure of different EVA rate controlling membranes of reservoir systems before and after the in vitro drug permeation experiments. No considerable difference was observed in the micro- structure of EVA films before and after in vitro perme- ation experiments. Figure 4: SEM photographs of EVA rate controlling membranes A and A1= EVA2% rate controlling membranes before and after in vitro skin permeation studies, respectively. B and B1= EVA9% rate controlling membranes before and after in vitro skin permeation studies, respectively. C and C1= EVA19% rate controlling membranes before and after in vitro skin permeation studies, respectively. IN VIVO STUDIES Acute hypoglycemic activity The results of acute hypoglycemic activity of transder- mal system in comparison with glibenclamide (5 mg/ kg; p.o.) in both normal and diabetic mice are shown in Table 2. The blood glucose reducing effect was significant in oral and transdermal patch treated animal groups upto 10 h, compared with control group (p<0.05). Glib- enclamide (oral) produced a decrease of 39.716.81 (normal mice, p<0.05 compared to control) and 38.122.12% (diabetic mice, p<0.05 compared to dia- betic control) in blood glucose levels at 2 h. In case of transdermal system, the blood glucose reducing response was gradual. A maximum blood glucose reducing response was observed after 6 h and thereafter remained stable upto 24 h. J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 32 Table 2: Reduction in blood glucose levels after oral and transdermal administration of glibenclamide in normal and diabetic mice (acute study). All values are expressed as MeanSE, n=6; CMC=Carboxymethyl cellulose; TP- R=Reservoir transdermal system; EVA=Ethylene vinyl acetate; GLB=Glibenclamide; * significant compared to control (p<0.05); # significant compared to GLB (p<0.05); significant compared to DC (Diabetic control) (p<0.05); significant compared to GLB (p<0.05). In orally glibenclamide treated group, the blood glu- cose levels decreased after 6 h. The blood glucose lev- els at the end of 24 h were only 10.585.22% and 13.254.55% in normal and diabetic mice, respec- tively. On the other hand, the transdermal system pro- duced significant reduction in blood glucose levels upto 24 h compared to control (p<0.05). The untreated group did not show any noticeable hypogly- cemia. LONG-TERM HYPOGLYCEMIC ACTIVITY The results of long-term hypoglycemic activity of transdermal system in comparison with oral glibencla- mide in both normal and diabetic mice are shown in Table 3. The transdermal system produced significant (p<0.05) blood glucose reducing effect upto 6 weeks without causing severe hypoglycemia in the initial hours of treatment, which was observed with oral administration. EFFECT ON GLUCOSE TOLERANCE (GTT) The control group showed high-elevated blood glucose levels (p<0.05) after glucose administration (+81.042.81, +62.053.41 and +15.014.01% at 0.5, 1.0 and 2.0 h, respectively) (Figure 5). The hypoglycemia produced after transdermal delivery was significantly (p<0.05) lower than the control group. On the contrary, the orally glibenclamide administered group showed severe hypoglycemia rang- ing from -30.953.52 to -42.202.22% at all intervals of the study period. Table 3: Absolute blood glucose levels after oral and transdermal administration of glibenclamide in long- term study. All values are expressed as MeanSE, n=6; CMC=Carboxymethyl cellulose; TP-R=Reservoir transdermal system; EVA=Ethylene vinyl acetate; GLB=Glibenclamide; * significant compared to control (p<0.05); # significant compared to GLB (p<0.05); significant compared to DC (Diabetic control) (p<0.05); significant compared to GLB (p<0.05). Figure 5: Effect on glucose tolerance after oral and transdermal administration of glibenclamide in mice. Each point represents MeanSE, n=6; * significant compared to control (p<0.05); # significant compared to GLB (p<0.05). BIOCHEMICAL AND HISTOPATHOLOGICAL EVALUATION The results of biochemical studies are shown in Table 4. The glycogen and total protein levels in the liver of diabetic mice were significantly lowered compared to normal mice (p<0.05). The oral as well as transdermal treatment of glibenclamide significantly (p<0.05) increased liver glycogen and total protein levels at the end of 6 weeks. The serum lipid profile (total choles- terol, triglycerides and high-density lipoprotein-choles- J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 33 terol), hepatic enzymes (ALT and AST), urea and creatinine levels were significantly increased in diabetic control mice compared to normal mice (p<0.05). The glibenclamide treatment (both oral and transdermal) significantly (p<0.05) reversed these changes at the end of 6 weeks. Table 4: Liver protein and glycogen levels and serum lipid profile (TC, TG and HDL-C), alanine transaminase, aspertate transaminase, urea and creatinine levels in diabetic mice after oral and transdermal administration of glibenclamide. All values are expressed as MeanSE, n=6; NC=Normal control; DC=Diabetic control; CMC=Carboxymethyl cellulose; TP-R=Reservoir transdermal system; EVA=Ethylene vinyl acetate; GLB=Glibenclamide; TC=Total cholesterol; TG=Triglycerides, HDL-C= High density lipoprotein- cholesterol, ALT=Alanine transaminase, AST=Aspertate transaminse; # significant compared to NC (p<0.05); *significant compared to DC (p<0.05). The histopathological studies of liver, pancreas and stomach from diabetic mice are presented in Table 5. Table 5: Histopathological evaluation of liver, pancreas and stomach from diabetic mice treated with oral and transdermal administration of glibenclamide. CA=Cellular atypia; Deg=Degeneration; Nec=Necrosis; Con=Congestion; Inf=Inflammation; GLB=glibenclamide; TP-R=Reservoir transdermal system; EVA=Ethylene vinyl acetate. Histopathological scale: + = slight; ++ = moderate; +++ = severe. The liver and pancreas from untreated diabetic mouse showed severe/moderate cellular atypia, inflammation, necrosis, degeneration and congestion. The stomach samples from diabetic mice showed moderate ulcer- ation. The severe/moderate toxic manifestations including gastric ulceration were considerably reversed with oral but especially with transdermal administra- tion of glibenclamide by controlling the hyperglyce- mia. SKIN IRRITATION TEST The results (Table 6) showed that the prepared systems (both blank and drug loaded) and USP adhesive tape produced negligible erythema and edema. Table 6: Results of skin irritation test. Visual observation values are expressed as MeanSE, n=6; * significant compared to formalin (p<0.05); GLB=Glibenclamide; TP- R=Reservoir transdermal system; EVA=Ethylene vinyl acetate; Blank=Without drug; Inf= Inflammation. Erythema scale: 0, none; 1, slight; 2, well defined; 3, moderate; and 4, scar formation. Edema scale: 0, none; 1, slight; 2, well defined; 3, moderate; and 4, severe. Histopathological scale: + = slight; ++ = moderate; +++ = severe. On the other hand, standard irritant, formalin pro- duced severe erythema and edema. The histopathologi- cal examination of the skin indicated that adhesive tape and prepared patches produced mild inflammation and edema. Formalin produced high grade of irritation, indicated by severe inflammation and edema besides showing discontinuity in epidermis, thin epidermis, ulceration and hyperplasia. PHARMACOKINETIC STUDIES The plasma concentrations of glibenclamide after transdermal and oral administration against time are shown in Figure 6. J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 34 Figure 6: Plasma concentration-time profile of glibenclamide after oral and transdermal system treatment in mice. * Significant compared to GLB-Oral (p<0.05). Each point represents MeanSE; n=6. Peak plasma concentration, C max , after oral administra- tion was 9.130.45 g/ml and t max was 2.0 h. In the case of transdermal system, the C max and t max were 6.190.14 g/ml and 12.0 h respectively. The pharma- cokinetic parameters were calculated from the plasma concentrations of the drug and recorded in Table 7. DISCUSSION In this study, membrane moderated transdermal sys- tems containing glibenclamide were prepared using dif- ferent rate controlling membranes. It was desired to develop a transdermal system that allows one to pro- vide an optimum drug release via the most appropriate choice of rate controlling membrane and finally to produce the desired overall constant/controlled drug release. Ethanol (50% w/w) was incorporated in the reservoir of the transdermal system as it significantly enhanced the permeation rate of glibenclamide in our earlier study (4, 5). The pharmacokinetic parameters obtained with glib- enclamide transdermal system were significantly differ- ent (p<0.05) from those obtained with respective oral glibenclamide administration, which could be due to the rapid absorption of drugs via oral route; whereas drug in transdermal route were slowly but continu- ously absorbed. With respect to all in vivo experi- ments, similar results were observed with matrix transdermal patches in our earlier study. Table 7: Pharmacokinetic parameters of glibenclamide after oral and transdermal administration All values are expressed as MeanSE, n=6; GLB=Glibenclamide; TP- R=Reservoir transdermal system; EVA=Ethylene vinyl acetate; C max =Maximum concentration; T max =Time of maximum concentration; K e =Elimination rate constant; AUC=Area under plasma concentration-time curve; t 1/ 2 =Elimination half-life; MRT=Mean residential time. * significant compared to oral GLB (p<0.05). In drug-carbopol interaction studies, no distinct differ- ence in the IR peaks and melting point (DSC analysis) of drug in the physical mixture and R f values of drug (HPTLC analysis) in the polymeric solution used in our study indicates that the carbopol do not alter the performance characteristics of the drug from the sys- tems studied. All these results suggest that there is no interaction between glibenclamide and carbopol. Good uniformity with respect to drug content and viscosity among the batches with all formulations was observed. In the membrane controlled transdermal systems, drug reservoir is encapsulated in a shallow compartment molded from a drug impermeable backing membrane while the drug delivery side is covered by rate control- ling polymeric membrane. These systems have the advantage that the drug release rate, which is con- trolled by the rate controlling membrane, remains rela- tively constant as long as drug loading in the reservoir is maintained at a high level and thus provide a zero order drug release (7). But in the in vitro dissolution studies, the systems with ERL, ERS and EC mem- branes did not provide a constant drug release rate and showed high release of drug in the initial hours. This may be due to the loss of integrity of the films by means of solubilization of a part of the polymer by J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 35 ethanol, which was incorporated to the drug reservoir to enhance the drug permeation rate. In addition, direct exposure of Eudragit films to the dissolution medium might also be responsible for the initial burst release as they are permeable to aqueous medium (9). The cumulative amount of drug released at the end of 24 h was depending on the hydrophilicity of the poly- mers (ERL>ERS>EC). ERL films tend to swell more than ERS films in aqueous medium due to the higher concentration of hydrophilic quaternary groups. Also, ERL membranes are more permeable to aqueous medium than other two membranes (10). On the other hand, the systems with EVA membranes exhibited a constant drug release rate upto 24 h as the integrity of these membranes was unaffected by either ethanol con- tent of the drug reservoir or direct contact with aque- ous medium. The release rate studies revealed that, as the vinyl acetate content in copolymer increases, the cumulative percentage of drug release also increases, i.e., the membrane shows a lower resistance to the per- meation of drug molecules. These observations are in accordance with the earlier findings (11). In the in vitro skin permeation studies also, the sys- tems with ERL, ERS and EC membranes did not pro- vide a constant drug release and showed high permeation of drug in the initial hours. This is again because of the ethanol content (50%) of the drug reser- voir, which might have partly dissolved the polymeric membranes and thereby disrupting the integrity of the membrane (9). The ERL, ERS and EC membranes showed loss of uniform structure after fabrication into final system. This was confirmed by examining the films after 24h of fabrication of final systems where the ethanol containing gel is in direct contact with mem- brane or after in vitro skin permeation experiments. It was also supported by the reduced flatness of these rate controlling membranes after preparing the final trans- dermal devices. The films prior to fabrication into final systems exhibited 100% flatness indicating no constric- tion. After 24 h of fabrication, they showed reduced flatness values (80%, 80% and 90% of flatness for ERL, ERS and EC membranes, respectively). These observations suggest that the films prepared by ERL, ERS and EC lose their integral structure after coming into contact with drug reservoir. Hence it was thought to use those membranes, which retain their integrity when they come in contact with the drug reservoir. The membranes prepared by ethyl- ene vinyl acetate copolymer (EVA) are widely used to control the rate of drug release from many transdermal drug delivery systems (11, 12). These membranes did not lose their integral structure when fabricated into final system and also after in vitro skin permeation studies. This could be due to the ability of these films to resist the effect of ethanol in drug reservoir. This is also supported by the SEM studies of the EVA films before fabricating into final system and after in vitro skin permeation experiments, where the films main- tained uniform and smooth surface, 100% flatness and integrity of the structure after permeation experi- ments. Therefore EVA rate controlling membranes are suitable for reservoir transdermal systems in the present study. The cumulative amount of drug permeated at the end of 24 h was increased as the vinyl acetate (VA) content in the EVA rate controlling membranes was increased. This observation is in accordance with the earlier reports where drug permeation was increased as the vinyl acetate content in the EVA copolymer was increased (11,13,14). It is well recognized that it is pos- sible to alter the permeability of EVA copolymer membranes by varying vinyl acetate content. The changes in the permeability have been attributed to the alterations in the glass transition temperature and crys- tallinity of the polymer. As the vinyl acetate content increases, the crystallinity of the polymer decreases rapidly and this could be the reason for high perme- ation rate observed with EVA membrane with 19% VA content in comparison with EVA membranes con- taining 9% and 2% VA in the present study (15). The cumulative amounts of glibenclamide permeated per square centimeter of transdermal devices with ERL, ERS and EC rate controlling membranes through the mouse skin when plotted against time, the permeation profiles of drug seem to follow mixed order/apparent zero order kinetics as observed with matrix systems (Figure 3). High amount of drug was released in the initial hours because of increased perme- ability of the membranes by ethanol. However, later the drug was released depending on the concentration and thus altering the system towards a first order pat- tern. J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 36 The in vitro permeation profiles of formulations with ERL, ERS and EC membranes did not fit into zero order behavior completely and they could be best expressed by Higuchis equation (R 2 = 0.9976 to 0.9990) (16, 17). The data was further treated as per the following equa- tion (18,19). M t /M
=K.t n , where, M t /M
is the fractional release of drug, M
t is the amount released at time t, M
is the total amount
of drug contained in the transdermal patch, t is the release time, K is a kinetic constant and n is the diffu- sional release exponent indicative of the operating release mechanism. The Fickian diffusion dominated drug release from these systems was further confirmed by the n values (0.3897 n 0.4934) obtained by the plots of Korsmeyer's equation. These observations demonstrate that, if the drug release is not properly regulated by the rate controlling membranes, the sys- tem may exhibit diffusion predominated drug release instead of zero order kinetics. The reservoir systems with EVA rate controlling membranes exhibited a zero order pattern throughout 24 h of the permeation studies (R 2 =0.9922 to 0.9995) as the integrity of these membranes was not affected by the drug reservoir (Figure 3). Since the concentration of the drug in equilibrium with the inner surface of the enclosing membrane is constant, zero order perme- ation profile is generally expected with membrane con- trolled systems (20). These results are in agreement with earlier reports where membrane controlled trans- dermal systems with EVA rate controlling membranes showed zero order release (11,20). The systems with ERL, ERS and EC rate controlling membranes exhibited high drug release in the initial hours and on the whole, the drug permeation pattern was diffusion dominated. The membranes lost their integrity after formulating into final systems. Hence, further systems were developed using EVA rate con- trolling membranes having varying VA content (EVA2%, EVA9% and EVA19%). Among these sys- tems, the device with EVA19% membrane exhibited high cumulative amounts of drug permeation at the end of 24 h. The release/permeation rate was in a con- stant manner throughout 24 h. Thus this system was selected for further in vivo studies. The results of short-term blood glucose reducing effect clearly show that the system could sustain the drug release for a period of 24 h when compared with oral administration where the effect declined after 6 h in agreement with short half-life of glibenclamide (21). Also the study clearly shows that severe hypoglycemia associated with oral administration of glibenclamide can be successfully overcome by membrane moderated transdermal system. The results of long-term study indicated that transdermal system provides optimum blood glucose reduction upon chronic application without producing drastic decrease in blood glucose levels in initial time intervals. The results of GTT show that the glucose tolerance curve was completely inhibited in the treated groups. Transdermal route effectively maintained the normoglycemic levels in contrast to the oral group, which produced remarkable hypoglycemia, an indication that a similar incident might be prevented in diabetic patients. In biochemical and histopathological studies, the favourable results from glibenclamide treatment with respect to liver glycogen, liver protein, serum lipid profile, serum urea and serum creatinine levels could be due to increased insulin release and peripheral uptake of glucose after drug treatment, as explained before 6 . The membrane moderated systems of glib- enclamide also produced improved repair of the tissues after diabetes induced tissue injury in comparison with oral administration, which could be due to better con- trol of hyperglycemia. The transdermal systems (both drug loaded and blank) did not produce any cutaneous reaction in skin irritation test indicating they are well tolerated by the subjects. Similar results have been reported by Krishna and Pandit (20)
and Kulkarni et al (22). In the pharmacokinetic study, though the rise in drug concentration was slower than oral administra- tion, the drug concentration in plasma remained high for longer period with transdermal systems. Glibencla- mide binds to plasma proteins to the extent of 99% (6). The prolongation of plasma half life by transdermal systems indicate that the drug when administered by transdermal systems will remain in the body for a longer period and thus will exert a sustained action. The significantly less elimination rate constants (K e ) and high mean residential time (MRT) values of glib- J Pharm Pharmaceut Sci (www.cspscanada.org) 8(1):26-38, 2005 37 enclamide obtained with transdermal systems further support the sustained or slow release of drug from the transdermal systems. Although, the C max was signifi- cantly less with transdermal devices, the AUC values were significantly high compared to oral route, which could be due to maintenance of concentration of drug with in the pharmacologically effective range for longer period of time from the transdermal systems. The significantly high AUC values observed with transdermal devices also indicate increased bioavailabil- ity of drug from these systems compared to oral administration. In the present study, with respect to the in vivo studies conducted, membrane moderated transdermal system of glibenclamide produced better improvement with all the tested parameters compared to oral administra- tion. This could be due to slow and continuous supply of glibenclamide at a desirable rate to systemic circula- tion by transdermal patch, which improved day-to-day glycemic control in diabetic subjects
(23). Further, the slow and sustained release of the drug from the trans- dermal systems might reduce manifestations like sulfo- nylurea receptor down regulation and the risk of chronic hyper-insulinemia, a major risk factor for ath- erosclerosis frequently associated with oral therapy of glibenclamide (2,24,25). The present study shows that membrane moderated transdermal system of glibencla- mide exhibited better control of hyperglycemia besides more effectively reversing the complications associated with diabetes mellitus than oral glibenclamide adminis- tration in mice. In one of our earlier studies, we calculated the target permeation rate for transdermal delivery of glibencla- mide in man (60 kg) as 193.8 g/h based on available pharmacokinetic data (4). In this study, the cumulative amount of drug permeated from the system (1 cm 2 ) at the end of 24 h is 267.2510.28 g. Hence the trans- dermal system with an area of about 18 cm 2 would be sufficient to provide an optimum effect. But, it is well known that human skin is less permeable compared to mouse skin (26). However, in the view of encouraging results obtained in mice, it can be predicted that the required minimum effective concentration could be achieved within an appreciable range of application area in humans in spite of the greater barrier properties of human skin when compared to mouse skin. ACKNOWLEDGEMENTS We are thankful to Council for Scientific and Indus- trial Research (CSIR), India for providing Senior Research Fellowship to one of the authors (Dr. Srini- vas Mutalik). We are thankful to Ms. Chetana, Ms. Sulochana and Mr. Subramanian for help and coopera- tion, Dr. G.C. Jagetia (Head, Department of Radiobi- ology, KMC, Manipal) and Dr. P. Uma Devi (Head, Department of Research, J. N. Cancer Hospital, Bho- pal) for providing some laboratory facilities, and Dr. Sharath Kumar, Pathologist, District Hospital, Udupi for helping in histopathological studies. We are indebted to Bal Pharma, Modi-Mundi Pharma and Wallace Pharmaceuticals, India for providing glibencla- mide as a gift sample. REFERENCES [1] Nolte, M.S., Karam, J.H., Pancreatic hormones and antidiabetic drugs, in Katzung BG (eds), Basic and clinical pharmacology. 8th ed., Lange Medical Books/ McGraw-Hill Publishing Division, New York, pp 711- 734, 2001 [2] Davis, S.N., Granner D.K., Insulin, oral hypoglyce- mic agents, and the pharmacotherapy of the endo- crine pancreas, in Hardman JG: Limbird LE (eds), The pharmacological basis of therapeutics. 9th ed., McGraw-Hill Co., New York, pp 1487-1517, 1996 [3] Takahshi, Y., Furuya, K., Iwata, M., Onishi, H., Machida, Y. and Shirotake, S., Trial for transdermal administration of sulfonylureas. Yakugaku Zassi, 12: 1022-1027, 1997 [4] Mutalik, S and Udupa, N., Transdermal delivery of glibenclamide and glipizide: In vitro permeation stud- ies through mouse skin. 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