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Introduction: Avanafil (AVA) is a very efficient phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction. However, it has limited bioavailability when taken orally and considerable first-pass metabolism. Enhancing its solubility and choosing an alternative delivery route may enhance its effectiveness and duration of action.
Methods: Eight complex formulations were elaborated and analyzed at various ratios using different polyethylene glycols and hydroxypropyl-beta-cyclodextrin (HP-β-CD). Sublingual tablets containing AVA were designed and optimized using the Quality-by-design approach. The tablets' pre-compression and post-compression properties were evaluated. The in-vivo pharmacokinetic behavior of the optimized tablet was assessed and compared with that of the commercial oral tablets in human volunteers.
Results: The HP-β-CD-AVA inclusion complex (1:1 molar ratio) showed an optimum solubilization capacity with an amount suitable for incorporation into sublingual tablets. The total amounts of superdisintegrants and Plasdone XL and the percentage of starch significantly influenced the length of time it took for 80% of the AVA to be released from the sublingual tablets, the tablet hardness, and the length of time for tablet disintegration. The optimized AVA sublingual tablet exhibited a 5.98-fold increase in the AVA mean residence time over the commercial tablet, with greater plasma exposure over 72 hours and 1356.42% relative bioavailability.
Conclusion: The sublingual tablets of the solubility-enhanced HP-β-CD-AVA inclusion complex represent a promising strategy to improve AVA bioavailability and bypass the first-pass effect. Furthermore, their extended activity offers potential clinical benefits, particularly for ED patients, such as ease of administration and reduced side effects.
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http://dx.doi.org/10.2147/DDDT.S504291 | DOI Listing |
Pharmaceutics
August 2025
Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, 881 Madison Ave, Rm 661, Memphis, TN 38018, USA.
In this review, our intention was to shed some light on the history of sublingual and buccal delivery over the past 75 years. By searching the query sublingual and buccal, we noticed four steady growth periods in the number of publications between 1950 and 2025. The early phase of sublingual and buccal drug delivery (1950-1982) saw limited attempts to explore this delivery route.
View Article and Find Full Text PDFCureus
July 2025
Pediatrics, University of Yamanashi, Chuo, JPN.
Precise titration of desmopressin (1-deamino-8-D-arginine vasopressin; DDAVP) is essential for managing neonatal central diabetes insipidus (CDI). Although oral administration is increasingly considered an alternative to the traditional intranasal route, the differences between DDAVP formulations and administration methods are often unclear in clinical practice. This complicates efforts to establish effective sublingual treatment protocols using oral disintegrating tablets (ODTs) in neonates.
View Article and Find Full Text PDFDrugs R D
August 2025
Department of Clinical Research Center, Affiliated Hangzhou First People's Hospital, School of Medicine, West Lake University, Hangzhou, 310006, Zhejiang, People's Republic of China.
Background And Objective: Nitroglycerin, a cornerstone therapy for acute angina pectoris, achieves rapid symptom relief through sublingual administration by bypassing hepatic first-pass metabolism. This study aimed to investigate the pharmacokinetics (PK), bioequivalence, and safety profiles between a test (T) formulation and a reference (R) formulation of nitroglycerin sublingual tablets in healthy volunteers (HVs).
Methods: In this single-center, randomized, open, single-dose, two-part formulations, four-cycle, two-sequence complete repeat crossover design, fasting-dose bioequivalence study, HVs (n = 36) were 1:1 divided into two groups (T-R-T-R and R-T-R-T) and received 0.
Oral Oncol
September 2025
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA; Head and Neck Oncology Center, Dana-Farber Cancer Institute, Boston, MA, USA. Electroni
The most widely utilized formulations of buprenorphine to treat opioid use disorder (OUD) are sublingual tablets or films. In 2022, the FDA issued a safety communication regarding reports of dental diseases associated with orally dissolvable buprenorphine. However, an association of sublingual buprenorphine with oral cavity malignancy has not been previously described.
View Article and Find Full Text PDFAsia Pac Allergy
June 2025
Asthma & Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea.
Allergen immunotherapy (AIT) is an evidence-based therapy for allergic rhinitis and allergic asthma. AIT is largely recognized as the only causal treatment of allergic diseases that targets the underlying pathophysiology and may have a disease-modifying effect in addition to the antisymptomatic effect. Carbamylated monomeric allergoids (CMAs) are chemically modified allergens with reduced IgE-binding activity (reduced allergenicity) but full immunogenicity.
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