Low Buffer Capacity and Alternating Motility along the Human Gastrointestinal Tract: Implications for in Vivo Dissolution and Absorption of Ionizable Drugs

Mol Pharm. 2017 Dec 4;14(12):4281-4294. doi: 10.1021/acs.molpharmaceut.7b00426. Epub 2017 Aug 4.

Abstract

In this study, we determined the pH and buffer capacity of human gastrointestinal (GI) fluids (aspirated from the stomach, duodenum, proximal jejunum, and mid/distal jejunum) as a function of time, from 37 healthy subjects after oral administration of an 800 mg immediate-release tablet of ibuprofen (reference listed drug; RLD) under typical prescribed bioequivalence (BE) study protocol conditions in both fasted and fed states (simulated by ingestion of a liquid meal). Simultaneously, motility was continuously monitored using water-perfused manometry. The time to appearance of phase III contractions (i.e., housekeeper wave) was monitored following administration of the ibuprofen tablet. Our results clearly demonstrated the dynamic change in pH as a function of time and, most significantly, the extremely low buffer capacity along the GI tract. The buffer capacity on average was 2.26 μmol/mL/ΔpH in fasted state (range: 0.26 and 6.32 μmol/mL/ΔpH) and 2.66 μmol/mL/ΔpH in fed state (range: 0.78 and 5.98 μmol/mL/ΔpH) throughout the entire upper GI tract (stomach, duodenum, and proximal and mid/distal jejunum). The implication of this very low buffer capacity of the human GI tract is profound for the oral delivery of both acidic and basic active pharmaceutical ingredients (APIs). An in vivo predictive dissolution method would require not only a bicarbonate buffer but also, more significantly, a low buffer capacity of dissolution media to reflect in vivo dissolution conditions.

Keywords: bioavailability; bioequivalence; buffer capacity; clinical study; ibuprofen; immediate release; in vivo dissolution; local drug concentration in the GI tract; oral absorption.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Absorption, Physiological
  • Administration, Oral
  • Adult
  • Body Fluids / chemistry*
  • Body Fluids / physiology
  • Buffers
  • Drug Liberation
  • Gastrointestinal Motility / physiology*
  • Gastrointestinal Tract / physiology*
  • Healthy Volunteers
  • Humans
  • Hydrogen-Ion Concentration
  • Ibuprofen / pharmacokinetics*
  • Intestinal Absorption / physiology*
  • Intestinal Mucosa / physiology
  • Manometry
  • Middle Aged
  • Solubility
  • Tablets
  • Therapeutic Equivalency
  • Time Factors
  • Young Adult

Substances

  • Buffers
  • Tablets
  • Ibuprofen