Extemporaneous Preparation of 20 mg/mL Ganciclovir in Artificial Tears in Comparison with Sterile Water for Ophthalmic Administration: Formulation and Stability Study

Ganciclovir is available as a lyophilized powder for reconstitution and is normally used to treat ophthalmic viral infections. The use of ganciclovir in artificial tears containing hydrocolloid polymers may prove beneficial to patients during drug application, by prolonging contact time and providing a moistening effect. Therefore, this study aimed to extemporaneously prepare 20 mg/mL ganciclovir in artificial tears and compare its stability with that of a similar concentration of ganciclovir in sterile water (SWI) for ophthalmic administration. First, a compatibility study of the drug with commercial artificial tears found that it was compatible with artificial tears containing sodium hyaluronate (HYA). Subsequently, ganciclovir/0.1% HYA (HYA0.1) and ganciclovir/SWI eyedrops (EDs) in low-density polyethylene (LDPE) eyedrop bottles packed in light-shielded zipper bags were evaluated for their stability at 5 ± 3 °C and 30 ± 2 °C. The results revealed that ganciclovir/SWI ED had good physicochemical and microbiological stability when stored at 5 ± 3 °C for 12 weeks and at 30 ± 2 °C for 8 weeks. Meanwhile, ganciclovir/HYA0.1 ED was stable for 8 weeks when kept at 5 ± 3 °C and at 30 ± 2 °C, but ganciclovir in 0.3% HYA ED could be stored at 5 ± 3 °C for 8 weeks. Nevertheless, particulate matter may need to be investigated using a suitable method to ensure the absence of invisible particles in these preparations. Of these results, ganciclovir/HYA artificial tears and SWI EDs show potential for use as home medications for the treatment of ophthalmic viral infections.

[1]  Nantana Nuchtavorn,et al.  A Rapid Stability Indicating HPLC Method for Determination of Quetiapine Fumarate in Tablets and Extemporaneous Formulations , 2021, Pharmaceutical Chemistry Journal.

[2]  Ajay Sharma,et al.  Categorization of Marketed Artificial Tear Formulations Based on Their Ingredients: A Rational Approach for Their Use , 2021, Journal of clinical medicine.

[3]  Sarfaraz K. Niazi,et al.  Specifications: Test Procedures and Acceptance Criteria for New Drug Substances and New Drug Products: Chemical Substances , 2016, Handbook of Pharmaceutical Manufacturing Formulations, Second Edition.

[4]  S. Arshinoff,et al.  Role of rheology in tears and artificial tears , 2020, Journal of cataract and refractive surgery.

[5]  N. A. Epshtein System Suitability Requirements for Liquid Chromatography Methods: Controlled Parameters and their Recommended Values (Review) , 2020, Pharmaceutical Chemistry Journal.

[6]  M. R. Hilmi,et al.  Evaluation of 18 artificial tears based on viscosity and pH , 2020 .

[7]  Ganciclovir , 2019, Reactions Weekly.

[8]  P. Aragona,et al.  Physicochemical Properties of Hyaluronic Acid–Based Lubricant Eye Drops , 2019, Translational vision science & technology.

[9]  N. Koizumi,et al.  Stability, safety, and pharmacokinetics of ganciclovir eye drops prepared from ganciclovir for intravenous infusion , 2019, Japanese Journal of Ophthalmology.

[10]  Margaret L. Wells,et al.  Validation of Chromatographic Methods , 2019, Ewing’s Analytical Instrumentation Handbook, Fourth Edition.

[11]  L. Power,et al.  ASHP Guidelines on Handling Hazardous Drugs , 2018, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[12]  S. Sugita,et al.  Diagnostic efficacy of real-time PCR for ocular cytomegalovirus infections , 2018, Graefe's Archive for Clinical and Experimental Ophthalmology.

[13]  Asad F. Durrani,et al.  Cytomegalovirus keratitis , 2018, Current opinion in ophthalmology.

[14]  A. Bron,et al.  Estimating basal tear osmolarity in normal and dry eye subjects. , 2018, Contact lens & anterior eye : the journal of the British Contact Lens Association.

[15]  S. Rudaz,et al.  Long-term stability of ganciclovir in polypropylene containers at room temperature , 2019, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners.

[16]  N. Keorochana,et al.  Efficacy and safety of an extemporaneous preparation of 2% ganciclovir eye drops in CMV anterior uveitis , 2017, BMJ Open Ophthalmology.

[17]  N. Koizumi,et al.  The effect of topical application of 0.15% ganciclovir gel on cytomegalovirus corneal endotheliitis , 2016, British Journal of Ophthalmology.

[18]  C. J. Liu,et al.  Long-Term Topical Ganciclovir and Corticosteroids Preserve Corneal Endothelial Function in Cytomegalovirus Corneal Endotheliitis , 2016, Cornea.

[19]  S. Teoh,et al.  Efficacy and safety of topical ganciclovir in the management of cytomegalovirus (CMV)-related anterior uveitis , 2016, Journal of Ophthalmic Inflammation and Infection.

[20]  Haixia Liu,et al.  Efficacy and safety of two new formulations of artificial tears in subjects with dry eye disease: a 3-month, multicenter, active-controlled, randomized trial , 2015, Clinical ophthalmology.

[21]  L. Suntornsuk,et al.  Stability indicating MEKC method for the determination of gliclazide and its specified impurities. , 2015, Journal of pharmaceutical and biomedical analysis.

[22]  Tsing-Hong Wang,et al.  Clinical outcomes in cytomegalovirus-positive Posner-Schlossman syndrome patients treated with topical ganciclovir therapy. , 2014, American journal of ophthalmology.

[23]  N. Koizumi,et al.  Clinical features and management of cytomegalovirus corneal endotheliitis: analysis of 106 cases from the Japan corneal endotheliitis study , 2014, British Journal of Ophthalmology.

[24]  Chien-Chia Su,et al.  Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty , 2013, Clinical & experimental ophthalmology.

[25]  H. K. Kim,et al.  A Case of CMV Endotheliitis Treated with Intravitreal Ganciclovir Injection , 2013, Korean journal of ophthalmology : KJO.

[26]  K. Basavaiah,et al.  Development and Validation of RP-HPLC Method for the Determination of Ganciclovir in Bulk Drug and in Formulations , 2012 .

[27]  Chi-Chun Lai,et al.  Intravitreal loading injection of ganciclovir with or without adjunctive oral valganciclovir for cytomegalovirus anterior uveitis , 2010, Graefe's Archive for Clinical and Experimental Ophthalmology.

[28]  S. Chee,et al.  Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients. , 2008, American journal of ophthalmology.

[29]  N. Koizumi,et al.  Cytomegalovirus as an etiologic factor in corneal endotheliitis. , 2008, Ophthalmology.

[30]  C. Noppawinyoowong,et al.  Chemical Stability and Sterility of Frozen Ganciclovir Injections , 2008 .

[31]  J. Colin Ganciclovir ophthalmic gel, 0.15%: a valuable tool for treating ocular herpes , 2007, Clinical ophthalmology.

[32]  F. Rozenberg,et al.  Diagnosis and treatment of cytomegalovirus iridocyclitis without retinal necrosis , 2006, British Journal of Ophthalmology.

[33]  Xianshun Chen,et al.  Effect of Ganciclovir on the Hydrolytic Degradation of Poly(lactide-co-glycolide) Microspheres , 2006, Journal of biomaterials applications.

[34]  E. Domingo,et al.  Progress in Drug Research , 2003, Progress in Drug Research.

[35]  E. Villarreal Current and potential therapies for the treatment of herpesvirus infections. , 2001, Progress in drug research. Fortschritte der Arzneimittelforschung. Progres des recherches pharmaceutiques.

[36]  A. Bright,et al.  The composition and interfacial properties of tears, tear substitutes and tear models , 1993 .

[37]  L. Mole,et al.  Extended stability of ganciclovir for outpatient parenteral therapy for cytomegalovirus retinitis. , 1992, Journal of acquired immune deficiency syndromes.

[38]  R M Hill,et al.  Buffering in human tears: pH responses to acid and base challenge. , 1989, Investigative ophthalmology & visual science.

[39]  M. Motolko,et al.  The effect of pH and osmolarity on the ability of tolerate artificial tears. , 1981, American journal of ophthalmology.

[40]  L. Carney,et al.  Human tear buffering capacity. , 1979, Archives of ophthalmology.

[41]  J. E. Terry,et al.  Human tear osmotic pressure: diurnal variations and the closed eye. , 1978, Archives of ophthalmology.

[42]  D. Brossard Methodological guidelines for stability studies of hospital pharmaceutical preparations Part 1 : liquid preparations , 2022 .