Regulatory approvals for the marketing of medicinal products authorize medical practitioners to prescribe drugs to a group of patients that are defined within the license of the medicinal product. However, such prescriptions are carried out in a controlled manner. Prior to being approved, the medicinal product will have been evaluated in a population pool containing fewer than 5,000 patients and in a predesigned environment where several factors may be lacking, such as the absence of women of childbearing potential, geriatric patients and paediatric patients. Therefore, it is not surprising that several major adverse drug reactions are detected only when the product has been prescribed to the general population. National and international regulatory bodies have devised systems for monitoring medicinal products after marketing, commonly known as postmarketing surveillance systems. Postmarketing surveillance refers to the process of monitoring the safety of drugs once they reach the market, after the successful completion of clinical trials. The primary purpose for conducting postmarketing surveillance is to identify previously unrecognized adverse effects as well as positive effects. The Yellow Card scheme, practiced in the United Kingdom and the Canada Vigilance Program adopted in the Canadian jurisdiction, are two of the most successful postmarketing surveillance systems implemented across the world. Therefore, this article intends to discuss postmarketing surveillance and its role in the context of the United Kingdom and Canadian jurisdictions with a view on presenting key aspects and measures that are employed for operating an efficient postmarketing surveillance system in regulated markets.

Silymarin, a phyto-constituent derived from the plant Silybum marianum, has been widely acknowledged for its hepatoprotective activities. Nevertheless, its clinical utility is adversely hampered by its poor water-solubility and its limited oral bioavailability. The aim of this study was to investigate the efficacy of phospholipid-based phytosomes for enhancing the oral bioavailability of silymarin. The phytosomes were prepared using the solvent evaporation technique and were optimized using a full factorial design. The optimized silymarin phytosomal formulation was then characterized for particle size, surface morphology, aqueous solubility, and in vitro drug release. Furthermore, in vivo antioxidant activity, hepatoprotective activity and oral bioavailability of the optimized formula were investigated in a rat model. The prepared silymarin phytosomes were discrete particles with a porous, nearly smooth surface and were 218.4 ± 2.54 nm in diameter. In addition, the optimized silymarin phytosomal formulation showed a significant improvement in aqueous solubility (~360 µg/mL) compared to pure silymarin and manifested a higher rate and extent of silymarin release from the optimized formula in dissolution studies. The in vivo assessment studies revealed that the optimized silymarin phytosomal formulation efficiently exerted a hepatoprotective effect in a CCl₄-induced hepatotoxicity rat model via restoring the normal levels of antioxidant enzymes and ameliorating cellular abnormalities caused by CCl₄-intoxication. Most notably, as compared to pure silymarin, the optimized silymarin phytosomal formulation significantly improved silymarin oral bioavailability, as indicated by a 6-fold increase in the systemic bioavailability. Collectively, phytosomes might represent a plausible phospholipid-based nanocarrier for improving the oral bioavailability of phyto-constituents with poor aqueous solubility.

Sulconazole is a broad spectrum antifungal agent of the imidazole class used against dermatophytes and other fungi to treat skin infections. The aim of the present work was to formulate and evaluate a microemulsion-based topical sulconazole gel. Microemulsion formulation of sulconazole nitrate was prepared by using oil, surfactant, cosurfactant and water at different ratios. This was then subjected to clarity and particle size analysis, a centrifugation test, a dilution test, and freeze thawing. The zeta potential of formulation F1 was -41.3 and stable. The pH of the microemulsion formulation was within the range of pH of skin. F1 showed a higher percentage amount of drug as compared with the other formulations. The viscosity showed that F1 was optimum. The freezing and thawing results showed there was no phase separation and the formulation was stable. In vitro drug release showed that the drug release from the microemulsion of F1 was higher when compared to the other formulations. It revealed F1 had the highest drug content of 95.88±0.3% and % cumulative drug release was 88.75% release in 8 h. The in vivo skin irritation study on rats confirmed that formulation was nontoxic and nonirritant. The present study confirmed the safety of the formulated sulconazole loaded microemulsion gel for topical application.

Introduction: Fixed-dose combination (FDC) medicines contain more than one approved active pharmaceutical ingredient (API), are manufactured as a fixed-dose and packed in a single dosage form. FDCs have been drawing attention from the pharmaceutical industries because of the government's ban on 328 irrational FDCs in September 2018. The Drug Technical Advisory Board (DTAB) recommended that 'there is no therapeutic justification' for the active ingredients in the banned FDCs and accordingly these combinations 'may involve a risk to human beings'. Areas covered: The review illustrates the present status of FDCs, its regulatory framework, approvals in India and discusses the substantive cause behind the ban on FDCs in India. Expert opinion: The expert stress to establish a robust regulatory system for the approval of FDCs in India. The pharmaceutical industries should not perceive the ban against irrational FDCs as an impediment; rather, they should view as an opportunity to establish a stronger healthcare system. The current review is an eye-opener for the section of people who consider that the ban on FDCs is irrational. However, the ban on 328 FDCs may prove a landmark decision for the development of stronger healthcare policy in India.

Sathyanarayana SD, et al. Clin Exp Vaccine Res. 2020 Jul;9(2):69-75. https://doi.org/10.7774/cevr.2020.9.2.69

Scopolamine hydrobromide is the hydrobromide salt form of scopolamine and has anticholinergic, antiemetic and antivertigo properties. Its property of reducing the saliva secretion also reported. Orodispersible films are solid dosage forms, which disintegrate or dissolve within a minute when placed in the oral cavity. In order to overcome the drawback of the conventional scopolamine hydrobromide solution as antisialagogue we formulated the scopolamine hydrobromide orodispersible films by solvent casting method using pullulan and HPMC E15 polymer combination. The formulations were statistically optimized by full factorial design (32) using Design Expert® software. The optimized formulations were evaluated in vivo. The optimized formulations exhibited acceptable physical characteristics with good flexibility, folding endurance, tensile strength. As anticipated, the optimized scopolamine hydrobromide orodispersible films exhibited quick disintegration and drug release. From the in vitro disintegration and drug release study it was observed that the formulation F1 disintegrated in 9 ± 1 sec and ~98.37 drug was release at the end of 120 sec. Hence the scopolamine hydrobromide orodispersible films successfully tailored for the use in dentistry as an antisialagogue formulation.