Document Type

Book Chapter

Publication Date

2012

Abstract

Patients with a history of abuse/misuse of pain and psychotic medications are at high risk for suicide. Novel drug delivery and formulation approaches have been explored to reduce the potential of drug abuse/misuse and to improve patient compliance. This chapter reviews the design and mechanism of five successful products in the opioid and anti-psychotic categories. Embeda™ is an extended release capsule containing morphine pellets with a sequestered core of naltrexone; naltrexone acts as an aversive agent and is released only when the product is crushed. Remoxy® is an extended release oxycodone capsule with a highly viscous liquid fill content which is resistant to most common methods of tampering. Suboxone® is a sublingual tablet or film strip of buprenorphine with naloxone as an aversive agent; naloxone has poor sublingual/oral bioavailability and does not exert its activity unless the product is abused by the injectable route. Risperidal® Consta®, is a biweekly intramuscular injection of risperidone based on a biodegradable polymer microsphere technology. Invega® Sustenna® is a once-monthly intramuscular injection of paliperidone based on the water insoluble prodrug approach. The review of these five new drug products showcases the novel formulation tools and technologies available to deter drug abuse/misuse in patients who are at high risk of suicide.

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