Article(id=1198656290647015960, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198656283525087620, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2023-0861, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1689177600000, receivedDateStr=2023-07-13, revisedDate=1695139200000, revisedDateStr=2023-09-20, acceptedDate=null, acceptedDateStr=null, onlineDate=1763711529646, onlineDateStr=2025-11-21, pubDate=1699718400000, pubDateStr=2023-11-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763711529646, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763711529646, creator=13701087609, updateTime=1763711529646, updator=13701087609, issue=Issue{id=1198656283525087620, tenantId=1146029695717560320, journalId=1189982191388893191, year='2023', volume='58', issue='11', pageStart='1', pageEnd='3476', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1763711527949, creator=13701087609, updateTime=1763711688683, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198656957746872553, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198656283525087620, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198656957746872554, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198656283525087620, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3173, endPage=3178, ext={EN=ArticleExt(id=1198656290978365996, articleId=1198656290647015960, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=Discussion on the concerns in paediatric drug taste masking technology and evaluation, columnId=1198656285311861125, journalTitle=Acta Pharmaceutica Sinica, columnName=Special Reports: Pharmaceutical Taste-Masking and Assessment Technologies, runingTitle=null, highlight=null, articleAbstract=

Good palatability of pediatric drugs improves the accuracy of dosing and adherence to dosing regimens. Many active pharmaceutical ingredients have an undesirable taste, so effective taste masking methods need to be developed to improve the palatability of pediatric medicines. This article mainly introduces the commonly taste masking techniques and taste evaluation methods, and puts forward suggestions on the concerns and general principles of the pharmaceutical evaluation of taste masking effects based on cases, in order to provide reference for the development of drug taste masking technology in children.

, correspAuthors=Lian-jie REN, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2023 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Fang SHI, Lian-jie REN), CN=ArticleExt(id=1198656291343270472, articleId=1198656290647015960, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=浅谈儿童药物掩味技术与评价中的关注点, columnId=1198656285597073800, journalTitle=药学学报, columnName=专题报道: 药品口感研究, runingTitle=null, highlight=null, articleAbstract=

儿童药物良好的适口性可提高给药剂量的准确性和给药方案的依从性。许多活性药物成分具有不良的味道, 因此需要开发有效的掩味方法以改善儿童药物的适口性。本文主要介绍了常用的掩味技术和口感评价方法, 并结合案例对掩味效果药学评价的关注点、一般原则等方面提出建议, 以期为儿童药物掩味技术的开发提供参考。

, correspAuthors=任连杰, authorNote=null, correspAuthorsNote=
*任连杰, Tel: 86-10-80996269, E-mail:
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J Drug Deliv Ther, 2022, 12: 255-261., articleTitle=Advances in taste masking of drug: a review study, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1198960230735377172, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656290647015960, xref=null, ext=[AuthorCompanyExt(id=1198960230756348694, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656290647015960, companyId=1198960230735377172, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Center for Drug Evaluation, National Medical Products Administration, Beijing 100076, China), AuthorCompanyExt(id=1198960230764737303, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656290647015960, companyId=1198960230735377172, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=国家药品监督管理局药品审评中心, 北京 100076)])], figs=[ArticleFig(id=1198960233541365800, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656290647015960, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
Taste-masking technology API Dosage form Ingredient Taste evaluation method Reference
Flavoring agent Ibuprofen Oral solution Sucralose Electronic tongue [29]
Diclofenac Fast-dissolving film Mint and licorice flavors and sucralose Electronic tongue [8]
Polymer coating Propranolol hydrochloride Microbeads Eudragit® EPO Electronic tongue [30]
Clindamycin hydrochloride Orally disintegrating tablets Eudragit® EPO In vitro dissolution test [31]
Complexation Donepezil Orodispersible film HP-β-CyD Electronic tongue [32]
Cetirizine hydrochloride Orodispersible tablet β-CyD, cherry flavor and sucralose Human volunteer [33]
Ion exchange resin Sildenafil citrate Chewable tablets Amberlite IRP-88 Human volunteer [34]
Risperidone Capsules Amberlite IRP 64 - [20]
Developed as free base to reduce solubility Propiverine Fine granule / Electronic tongue and human volunteer [35]
Solid dispersion Paracetamol Granule Copovidone Electronic tongue and human volunteer [36]
Microcapsule Azithromycin Powder for oral suspension Ethyl cellulose and Eudragit E100 In vitro taste assessment [37]
Flavoring agents and solid dispersion Arbidol hydrochloride Dry suspension Octadecanol, sucrose, mannitol, aspartame and orange flavor Human volunteer [38]
Flavoring agents and microcapsule Sucrose octaacetate Edible film D-Mannitol, sucralose, peppermint oil, stearic acid, xanthan gum, glycerol Human volunteer [39]
), ArticleFig(id=1198960233671389236, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656290647015960, language=CN, label=Table 1, caption=

Examples of various taste masking techniques

, figureFileSmall=null, figureFileBig=null, tableContent=
Taste-masking technology API Dosage form Ingredient Taste evaluation method Reference
Flavoring agent Ibuprofen Oral solution Sucralose Electronic tongue [29]
Diclofenac Fast-dissolving film Mint and licorice flavors and sucralose Electronic tongue [8]
Polymer coating Propranolol hydrochloride Microbeads Eudragit® EPO Electronic tongue [30]
Clindamycin hydrochloride Orally disintegrating tablets Eudragit® EPO In vitro dissolution test [31]
Complexation Donepezil Orodispersible film HP-β-CyD Electronic tongue [32]
Cetirizine hydrochloride Orodispersible tablet β-CyD, cherry flavor and sucralose Human volunteer [33]
Ion exchange resin Sildenafil citrate Chewable tablets Amberlite IRP-88 Human volunteer [34]
Risperidone Capsules Amberlite IRP 64 - [20]
Developed as free base to reduce solubility Propiverine Fine granule / Electronic tongue and human volunteer [35]
Solid dispersion Paracetamol Granule Copovidone Electronic tongue and human volunteer [36]
Microcapsule Azithromycin Powder for oral suspension Ethyl cellulose and Eudragit E100 In vitro taste assessment [37]
Flavoring agents and solid dispersion Arbidol hydrochloride Dry suspension Octadecanol, sucrose, mannitol, aspartame and orange flavor Human volunteer [38]
Flavoring agents and microcapsule Sucrose octaacetate Edible film D-Mannitol, sucralose, peppermint oil, stearic acid, xanthan gum, glycerol Human volunteer [39]
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浅谈儿童药物掩味技术与评价中的关注点
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史芳 , 任连杰 *
药学学报 | 专题报道: 药品口感研究 2023,58(11): 3173-3178
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药学学报 | 专题报道: 药品口感研究 2023, 58(11): 3173-3178
浅谈儿童药物掩味技术与评价中的关注点
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史芳, 任连杰*
作者信息
  • 国家药品监督管理局药品审评中心, 北京 100076

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*任连杰, Tel: 86-10-80996269, E-mail:
Discussion on the concerns in paediatric drug taste masking technology and evaluation
Fang SHI, Lian-jie REN*
Affiliations
  • Center for Drug Evaluation, National Medical Products Administration, Beijing 100076, China
出版时间: 2023-11-12 doi: 10.16438/j.0513-4870.2023-0861
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儿童药物良好的适口性可提高给药剂量的准确性和给药方案的依从性。许多活性药物成分具有不良的味道, 因此需要开发有效的掩味方法以改善儿童药物的适口性。本文主要介绍了常用的掩味技术和口感评价方法, 并结合案例对掩味效果药学评价的关注点、一般原则等方面提出建议, 以期为儿童药物掩味技术的开发提供参考。

儿童药物  /  掩味  /  掩味技术  /  口感评价

Good palatability of pediatric drugs improves the accuracy of dosing and adherence to dosing regimens. Many active pharmaceutical ingredients have an undesirable taste, so effective taste masking methods need to be developed to improve the palatability of pediatric medicines. This article mainly introduces the commonly taste masking techniques and taste evaluation methods, and puts forward suggestions on the concerns and general principles of the pharmaceutical evaluation of taste masking effects based on cases, in order to provide reference for the development of drug taste masking technology in children.

pediatric drug  /  taste masking  /  taste masking technique  /  taste evaluation
史芳, 任连杰. 浅谈儿童药物掩味技术与评价中的关注点. 药学学报, 2023 , 58 (11) : 3173 -3178 . DOI: 10.16438/j.0513-4870.2023-0861
Fang SHI, Lian-jie REN. Discussion on the concerns in paediatric drug taste masking technology and evaluation[J]. Acta Pharmaceutica Sinica, 2023 , 58 (11) : 3173 -3178 . DOI: 10.16438/j.0513-4870.2023-0861
相比成人, 由于儿童的发育正处在旺盛阶段, 使得儿童对味道的感知尤为敏感, 而相应的耐受性更差。儿童坚持服药率的高低往往归因于处方和适口性。儿童药物良好的适口性可提高给药剂量的准确性和给药方案的依从性, 对于满足儿童临床用药需求至关重要。许多活性药物成分具有不良味道, 因此有必要利用掩味技术来改善儿童药物的适口性[1-3]。通常, 掩味技术和掩味辅料的选择是根据药物的化学结构、剂型以及药物与掩味辅料的相容性来确定[4]。儿童药物开发中, 采用科学、合理的口感评价方法是儿童用药开发和评价的关键。本品介绍了常用的掩味技术及体内外口感评价方法, 结合案例对掩味方法开发和口感评价药学关注点提出建议。
药物的苦味等不良味道是影响儿童用药依从性的重要制约因素。以苦味为例, 苦味的感受依靠舌头上味蕾与苦味物质的接触, 激活苦味受体蛋白, 从而兴奋味觉中枢感受到苦味, 因此掩味的关键在于阻断味蕾与药物的接触或干扰味蕾对药物的感知[5]。掩味方法根据味觉传递机制主要分为两类。第一类涉及阻断味觉传递途径, 包括矫味剂和苦味抑制剂, 其通过与药物竞争刺激味觉受体细胞来避免药物的苦味。第二种类型涉及制剂学手段, 目的是防止药物在唾液中释放而掩盖药物的苦味, 如采用物理屏障、药物性质修饰、制备成固体分散体、微球、微囊等掩味技术来防止口腔中不良药物味道的释放[6]
用来掩盖药物不良味道的最常用方法之一是添加矫味剂, 其原理在于混淆大脑对味觉的感受。矫味剂可按多种方式进行分类, 按照口味通常可分为甜味剂(蔗糖、糖精钠、果糖、纽甜等)、酸味剂(枸橼酸、枸橼酸钠等) 和芳香剂(各种水果口味的香精、天然挥发油)[6, 7]。按照来源分类, 又可分为人工矫味剂和天然矫味剂两种。
使用甜味剂和芳香剂通常是研究的首选方法, 因为有多种可供选择的甜味剂和芳香剂, 且不需要特定的生产技术或设备, 技术难度低, 活性药物成分释放速率及生物利用度一般不受影响。研究表明阿斯巴甜可改善吡格列酮口崩片的口感, 薄荷、甘草香精和三氯蔗糖作为矫味剂可显著抑制双氯芬酸钠口溶膜的苦味[4, 8]。然而, 对于极苦的高溶解性化合物, 仅通过在药物处方中添加矫味剂的方式可以减少但不能消除药物的苦味, 需与其他掩味技术联合使用。Yang等[9]研究发现羟丙基-β-环糊精与0.09%糖精钠组合可有效掩盖盐酸利多卡因苦味。对于甜味剂, 每日可接受摄入量(acceptable daily intake, ADI) 较为重要, 如果超过限量, 可能会产生致癌作用、血糖升高等不良反应, 对于严重肝肾功能不全者、果糖不耐受患者、苯丙酮尿症患者等应限制使用某些特定甜味剂[10]。此外, 还应注意药物不能对儿童有太强的吸引力, 过度适口的药物会增加患者的依从性, 避免药物过量对儿童患者造成身体伤害[1]
苦味抑制剂是通过阻断向大脑发送苦味信号或与药物竞争苦味受体而达到掩盖苦味目的, 是大多数药物的通用抑制剂。常用的苦味抑制剂包括单磷酸腺苷(adenosine monophosphate, AMP) 及其衍生物、阿魏酸和咖啡酸及苯乙烯酸衍生物、磷脂酸等[4]。与传统的矫味剂相比, 苦味抑制剂掩味效果更好, 而且低浓度下即可生效, 因此适用于无法使用大量辅料进行掩味的口腔膜剂[11]。目前苦味抑制剂的种类和适用的药物较少, 其掩味机制复杂, 不良反应研究尚不完全。
掩盖药物不良口味最常用的方法之一是建立物理屏障, 通过有效避免制剂中有苦味的活性药物成分在口腔中溶出, 从而达到掩味目的。聚合物包衣是一种相对简单的掩味手段, 包衣膜通常在唾液中溶解度较差, 药物颗粒包裹在包衣膜中不能在口腔中溶解, 进而达到了味觉掩蔽的目的[12]。环糊精含有疏水性空腔和亲水性外表面, 通过将疏水性药物包合在疏水性空腔内, 避免药物与味蕾接触而掩味。目前应用最广的为β-环糊精及其衍生物, 研究发现环糊精除用于掩味, 还可以通过与药物形成复合物的形式提高难溶性药物在水中的溶解度[13]。例如, 舌下含服咪达唑仑通常用于儿科患者的术前用药, 羟丙基β-环糊精与蔗糖组合使用, 在改善舌下给药药物的味道同时提高了药物的水溶性[14, 15]β-环糊精具有水溶性高、无毒、制备工艺简单等优点, 然而该方法掩味同样存在局限性: 一是环糊精包合物可能会提高难溶性药物的溶解度, 从而改变药物的药代动力学特征和生物利用度, 导致安全性隐患; 二是制剂中的其他辅料可能会与药物竞争进入环糊精的空穴内, 使药物泄漏, 从而降低包合物稳定性和掩味效果。
离子交换树脂是一种不溶于水的大分子聚合物, 结构中含有酸性或碱性基团可以与药物进行离子交换[6]。其掩味机制为药物进入离子交换树脂内腔形成络合物, 络合物在中性的口腔环境中保持结构完整性, 苦味释放极少。树脂与药物形成的络合物必须在pH 6~7的唾液中保持稳定, 在肠pH值条件下(pH < 5), 药物应迅速、几乎完全释放, 以防止生物利用度降低[1]。在选择树脂时, 应注意活性药物成分的离子特性应与离子交换树脂相反, 才能进行阴离子-阳离子相互交换。例如, 盐酸倍他司汀和马来酸氯苯那敏可与阳离子交换树脂络合以达到掩味目的[16-18], 而利培酮适用于阴离子交换树脂[19]。但是, 人口腔内也会存在少量离子, 这些离子也会与树脂材料发生离子交换, 故对于某些水溶性很强的药物, 制备成树脂后可能仍有苦味, 此时还需要联用其他一些掩味方法。
通过降低药物在唾液中的溶解度和/或降低药物对味觉受体的亲和力, 前药被广泛用于掩味目的。研究表明酚类官能团对味觉受体存在相互作用。对乙酰氨基酚的苦味是由于其化学结构中含有酚羟基, 通过对酚羟基进行结构修饰可以抑制对乙酰氨基酚与苦味受体的相互作用, 从而掩盖其苦味。在一项研究中, 通过合成对乙酰氨基酚的脯氨酸前药, 开发出一种可以掩盖苦味的咀嚼剂型[7]。另一种掩味策略是将水溶性药物转化为不易溶解的盐形式或者多晶型, 成盐后或溶解度低的晶型均可以通过降低药物在唾液中的溶解度使得药物无味。氯霉素的极端苦味限制了其在儿童制剂中的使用, 将氯霉素结构修饰为微溶的氯霉素棕榈酸酯, 由于其水溶性低可减少苦味, 在体内经水解反应, 产生发挥药物活性的氯霉素[20]
此外, 还可通过调节酸碱度使药物溶解度降低, 从而达到掩味的目的, 主要适用于溶解度随pH值降低而显著增加的药物。其原理为在制剂中加入碱性物质, 服用时制剂使口腔中pH值升高以减小苦味药物溶解度, 而到达胃肠道时, 制剂中少量的碱性物质很快被酸性环境中和, 药物溶解度得以增加, 从而促进吸收[21]
分散体制备技术是将药物无定形地分散在固体载体材料中, 形成固体分散体的技术。利用载体的包蔽作用可掩盖药物的不良气味和刺激性, 还可延缓药物的水解和氧化进程。固体分散体常用的制备方法有热熔挤出法、溶剂法、熔融制粒、喷雾干燥法等[22]。Pimparade等[23]利用热熔挤出技术制备了柠檬酸咖啡因口崩片, 乙基纤维素与柠檬酸三乙酯一起被用作聚合物载体。体外测试结果显示, 其在人工唾液介质中少量释放, 超过80%药物30 min内在模拟胃液中释放, 与此同时柠檬酸咖啡因的苦味明显地被掩盖。使用固体分散体工艺掩味效果良好, 但同时也存在一些局限性, 例如载药量低、药物高度分散状态下的原料药的稳定性等问题, 需要进一步考察[24]
微球、微囊是利用天然或合成的高分子材料为成球材料, 将药物包裹或分散在成球材料中, 降低或减少味蕾与药物的接触, 以达到掩盖药物苦味和降低药物刺激性的目的。Qin等[25]采用喷雾干燥工艺以十八醇和单硬脂酸甘油酯为材料制备了布洛芬脂质微球, 以掩盖活性药物成分的不良味道。Yi等[26]通过使用喷雾干燥技术用胃溶性聚合物尤特奇E100制备微囊, 以掩盖枸橼酸西地那非的苦味。此外, 还可通过制备成脂质体和纳米乳剂来掩盖口感。磷脂脂质体适合于水溶性差的药物的包封, 同时满足掩味和提高生物利用度的需要[27]。有研究[28]证实了用制备成口服液体系剂的克拉维酸包裹纳米自乳化给药系统, 可以有效地掩盖药物的苦味。
药物常用的掩味手段包括添加矫味剂、增加包衣、形成复合物、制备微球等。据统计, 已有多个儿童及成人用药品开发了不同掩味技术(表 1[8, 20, 29-39]):
在儿童口服制剂的开发过程中, 口感评价是一项重要的研究内容, 主要的评价方法有体外溶出、电子舌、动物偏好实验、人群尝味评价等方法。体外溶出实验一般以模拟唾液为介质(介质体积优选1~3 mL), 检测前5 min内(尤其是前30 s) 的药物释放量, 此方法间接评估掩味技术是否达标。电子舌是一种利用传感器阵列感测样品的特征响应信号, 通过信号识别处理对样品进行定量、定性分析的测定系统, 具有灵敏度高、客观性强等优点, 但目前的传感器尚不能完全模拟人舌的全部味觉受体, 分析结果尚需经人群尝味法进一步验证[40, 41]。动物偏好实验通常采用双瓶偏好实验或单瓶摄取实验来判断受试动物的味觉偏好及动物反应与药物浓度的相关性[42]。人群尝味评价在口服制剂的口感评价中最为常用, 能够直观反映人体真实感受, 是一种简便易行的评价方法。常用的评价方法包括排序评分法、模糊数学综合评价、视觉模拟评分法、单一样品对照评价法、苦度值等级评价法、多因素调查评价法、量度匹配幅度标记评价法等, 但该方法不适用于有毒或有刺激性成分的药物[43], 且涉及医学伦理等问题, 结果主观性强, 个体差异较大。
由于成人和儿童之间以及不同年龄段儿童之间的味觉感知、敏感性和耐受性存在差异, 使得儿童用药的口感评价更加复杂。上述口感评价方法都存在一定的局限性, 单独使用一种方法的实验结果不够全面和准确。因此, 在口感评价过程中建议选择不同方法对结果相互确证, 以便更客观、真实地反映药物的口感情况。
儿童药物开发时, 建议参照《儿童用药(化学药品)药学开发指导原则(试行)》根据药物应用人群的不同年龄选择适宜的给药途径和剂型。在设计开发适合目标儿科人群年龄的剂型时, 除考虑药物的安全性、有效性外, 还需考虑儿童患者用药的依从性, 这一过程需充分考虑掩味的必要性。例如:
药物A原料药味苦, 需要掩味, 制剂目标开发为口崩片, 处方工艺开发中分别对三种掩味技术进行对比研究。方法1原料药与尤特奇E100在溶剂中溶解后, 通过喷雾干燥工艺制得包合物, 添加适当辅料湿法制粒再压片; 方法2将原料药与辅料制备成主药颗粒, 采用尤特奇E100对主药颗粒包衣, 湿法制粒后压片; 方法3采用原料与辅料、矫味剂混合, 湿法制粒后压片。采用人群尝味法对药物口感进行评价, 方法1对苦味无掩味效果; 方法2掩味效果较好, 但由于包衣后颗粒粒径增大, 在口腔中沙砾感明显且崩解时限较长; 方法3制得制剂口感较好, 比方法2略苦, 但易接受, 口腔内崩解时间较短。综合考虑制备工艺的复杂程度及掩味效果, 选择方法3作为拟定工艺。
在进行掩味技术开发时, 首先应通过调研或评估来获得原料药的初始味道, 一般首选添加矫味剂来掩盖味道。如果味道仍然不能接受, 需要考察原料药的理化性质, 这是选择掩味方式的关键因素。本案例中原料药味苦, 且为水溶性药物, 可选择利用甲基丙烯酸氨烷基酯(尤特奇) 的pH值敏感性, 即在pH > 5条件下溶胀和渗透, pH ≤ 5条件下溶解, 口腔pH 6~7条件下不溶解, 使其发挥掩味作用。人群尝味法通常作为药学处方开发阶段进行口感设计的研究方法, 首选成人口尝试验。但考虑到成人与儿童之间味觉的差异, 建议在目标年龄段儿童患者中对药物适口性进行评估。在处方工艺筛选中对掩味效果进行考察的同时, 建议关注掩味方法对生物利用度的影响[44]
药物B原料药略有酸味, 制剂开发目标为混悬颗粒剂, 处方中选择枸橼酸作为矫味剂, 对辅料种类和用量进行筛选。该药物申请成人适应症的同时还扩展了2岁以上儿童使用人群, 申报资料仅简单说明选择枸橼酸作为矫味剂尚不完善。对于儿童人群的适用性, 还应提供制剂处方口感的相关研究资料。在儿童人群中开展适口性研究和评估的基础上, 同时应基于本品剂型特点结合颗粒大小、质地、给药体积等药物特性评估目标年龄儿童对药物的可接受性。
药物C处方中含有多种无机盐成分, 溶液具有咸味, 口感较差。处方筛选时, 对矫味剂安赛蜜、糖精钠、三氯蔗糖从甜度和口味方面进行比较, 并经适口性研究确认三氯蔗糖对制剂的咸味有较好的掩蔽效果, 故选择三氯蔗糖作为矫味剂。由于该药物临床用量较高, 三氯蔗糖每日最大用量已超出该辅料在儿童制剂中使用的安全限度要求, 建议对本品处方进一步优化。申请人在添加矫味剂改善药物口感的同时, 对于儿童使用人群的药物还应格外关注辅料的安全用量, 建议在处方设计时参照国内外法规、指导原则等要求选择适合目标人群的辅料种类和用量。
药物D为改剂型品种, 国内已批准上市剂型为片剂, 其味苦而儿童不易接受, 并且不适合分剂量以满足个体化给药的用药需求。该药物采用专利技术开发为无水吞服颗粒, 由含药包衣微丸和矫味辅料两部分组成, 使用在口腔中不溶解型的包衣材料完全包裹药物, 服药过程中包衣膜将药物与口腔黏膜(味蕾) 分隔开, 掩味效果较好, 且处方中含有促进唾液分泌和顺滑效果的矫味辅料成分, 保证无水吞咽服药, 矫味辅料含有水果口味的香精, 有助于提高儿童对药物的接受性。本品开发为颗粒剂, 便于分剂量服用。处方开发中为研究本品入口后的口感, 考察了药物在人工唾液中的溶出度, 结果显示, 本品在1 min时溶出度不超过3%, 原料药在人体口腔中不会感觉到苦味, 制剂有较好的掩味效果。此外, 还对本品易吞咽性进行考察, 研究包括不同唾液量下的凝胶化时间和状态等。建议在上述体外研究的基础上, 针对本品的使用人群和剂型特点, 在临床研究中增加适口性研究, 并关注低龄幼儿服用时可能存在呛咳风险。
在儿童药物开发时, 由于儿童人群的特殊性, 其相较于成人机体系统, 各器官发育不成熟, 应额外关注辅料潜在的安全性相关问题。即使是已常规用于成人药品或在已获批儿童药品中使用的辅料, 仍然需要评估现有资料是否支持在拟定儿童人群中使用, 尤其甜味剂、溶剂、防腐剂和着色剂等辅料[10]。在降低风险以及确保产品的功效、稳定性、适口性、微生物控制和剂量均匀性的前提下, 应尽可能使用最少种类和最低用量的辅料[3]。欧洲儿童制剂倡议会(EuPFI) 创建了儿童制剂安全和毒性信息数据库(STEP Database), 可作为儿科制剂开发中辅料种类的选择和用量筛选的参考依据。
对于儿童药物的药学审评, 重点关注掩味方法的开发资料和口感评价资料, 申请人应提供足够的数据以支持处方工艺的选择。由于每种口感评价方法都有其优缺点, 建议结合申报品种的基本特点, 应用人群、临床给药途径等选择合理的口感评价方法, 采用多种方法对口感进行综合评价是儿童用药适口性研究的优选方式。儿童药物口味应是产品全生命周期中持续关注的重要问题, 早期开发时口感研究数据可能较少, 在药物获批上市后, 建议继续收集临床患者对于口感数据的反馈, 必要时应继续完善药物处方的口味设计。目前虽然已经开发了多种掩味的方法和技术, 但应用于商业化的案例还比较少, 儿童药物掩味技术开发及口感评价还处于积累阶段, 企业、高校、科研机构及监管部门等各方力量应不断加强先进技术的开发和利用, 促进儿童药物适口性技术的发展。
近年来, 为解决儿童用药研发中的重点、难点问题, 鼓励和促进儿童用药的研发, 国家药品监督管理局药品审评中心发布了一系列儿童用药专项指导原则, 为儿童用药研发和审评提供了重要技术支持与审评依据。尽管目前已经开发了许多掩味的方法和技术, 但目前批准的儿童药物中大多仍采用添加矫味剂、包衣或制粒等传统方式进行掩味, 而能够进行商业化应用的新型掩味技术, 如制备微囊、微球、形成复合物等方法应用较少, 如何对苦味强烈、高剂量的药物进行有效掩味仍是一个难题[24]
建立合适的口感评价方法, 是儿童药物的产品开发和评价的重要环节, 由于每种口感评价方法都存在一定的局限性, 仅采用一种方法可能不能准确的评估, 因此建议选择不同方法对药物口感进行评价。我国儿童药物开发经验尚处于积累阶段, 随着新的掩味机制、掩味材料及制剂工艺的深入研究, 相信掩味技术在不久的将来会有更进一步的发展。
作者贡献: 史芳负责文献查阅、思路整理及文章撰写; 任连杰负责选题及指导。
利益冲突: 本文不存在任何与本稿件相关的利益冲突。
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2023年第58卷第11期
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doi: 10.16438/j.0513-4870.2023-0861
  • 接收时间:2023-07-13
  • 首发时间:2025-11-21
  • 出版时间:2023-11-12
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  • 收稿日期:2023-07-13
  • 修回日期:2023-09-20
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    国家药品监督管理局药品审评中心, 北京 100076

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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