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FLOATING DRUG
DELIVERY SYSTEM
IHTESHAM UR REHMAN
FINAL PROFF.
DEPARTMENT OF PHARMACY
HAZARA UNIVERSITY
DEFINITION
IMPORTANCE
STOMACH PHYSIOLOGY
MECHANISM OF FDDS
FACTORS AFFECTING FDDS
CLASSIFICATION
ADVANTAGES OF FDDS
SUITABLE DRUGS FOR FDDS
EVALUATION TESTS
CONCLUSION
DEFINITION
Floating systems are low-density systems that have sufficient
buoyancy to float over the gastric contents and remain buoyant in
the stomach without affecting the gastric emptying rate for a
prolonged period of time.
OR
Floating drug delivery system or hydrodynamically balance systems
have a bulk density lower than gastric fluid and thus remains
buoyant in the stomach for a prolonged period of time.
This results in an increased gastric retention time and a better
control of the fluctuations in plasma drug concentration.
IMPORTANCE
•Predetermined, predictable, and
controlled Release
•Maintenance of optimum therapeutic
drug concentration in blood
• Enhancement of activity and duration for short
half‐life drugs
•Reducing frequency of dosing and wastage of
drugs;
• Optimized therapy and better patient
compliances
IMPORTANCE CONTD.
•GASTRIC RETENTION
•INCREASED DRUG SOLUBILITY
•INCREASED GASTRIC RESIDENCE
TIME
•IMPROVES BIOAVAILABILITY
•REDUCES DRUG WASTAGE
MECHANISM OF FDDS
BUOYANCY
FDDS has a bulk density less than gastric
fluids and so remain buoyant in the
stomach with out affecting the gastric
emptying rate for a prolonged period of
time.
F = F buoyancy - F gravity = (Df - Ds) gv
Where, F= total vertical force,
Df = fluid density,
Ds = object density,
v = volume and
g = acceleration due to gravity.
FACTORS AFFECTING FLOATING TIME
a)FORMULATION FACTORS
Size of tablets
Density of tablets
Shape of Tablets
Viscosity Grade Polymer
b) IDIOSYNCRATIC FACTORS
Gender
Age
Posture
Concomitant Intake of
Drugs
Feeding Regimen
a) FORMULATION FACTORS
Size of tablets
Retention of floating dosage forms in stomach depends on the size of
tablets. Small tablets are emptied from the stomach during the
digestive phase, but large ones are expelled during the house keeping
waves.
Exp.
FF CONT.
Density of tablets
Density is the main factor affecting the gastric residence time of dosage form. A buoyant
dosage form having a density less than that of the gastric fluids floats, since it is away from
the pyloric sphincter, the dosage unit is retained in the stomach for a prolonged period. A
density of less than 1.0g/ml i.e. less than that of gastric contents has been reported.
Shape of tablets
The shape of dosage form is one of the factors that affect its gastric residence time. Six
shapes (ring tetrahedron, cloverleaf, string,
pellet, and disk) were screened in vivo for their gastric retention
potential. The tetrahedron (each leg 2cm long) rings (3.6 cm in
diameter) exhibited nearly 100% retention at 24 hr12.
FF CONT.
Viscosity grade of polymer
Drug release and floating properties of FDDS are greatly affected by
viscosity of polymers and their interaction. Low viscosity polymers
(e.g., HPMC K100 LV) were found to be more beneficial than high
viscosity polymers (e.g., HPMC K4M) in improving floating
properties. In addition, a decrease in the release rate was observed
with an increase in polymer viscosity.
IDIOSYNCRATIC FACTORS
Gender
Women have slower gastric emptying time than do men. Mean
ambulatory GRT in meals (3.4±0.4 hours) is less compared with
their age and race‐matched female counterparts (4.6±1.2 hours),
regardless of the weight, height and body surface.
Age
Low gastric emptying time is observed in elderly than do in younger subjects.
Intrasubject and intersubject variations also are observed in gastric and
intestinal transit
time. Elderly people, especially those over 70 years have a significantly
longer GRT.
IF CONT.
Posture
i) Upright position
An upright position protects floating forms against postprandial emptying because the
floating form remains above the gastric
contents irrespective of its size.
ii) Supine position
This position offers no reliable protection against early and erratic emptying. In
supine subjects large dosage forms (both conventional and floating) experience
prolonged retention. The gastric retention of floating forms appear to remain
buoyant anywhere between the lesser and greater curvature of the stomach. On
moving distally, these units may be swept away by the peristaltic movements that
propel the gastric contents towards the pylorus, leading to significant reduction in
GRT compared with upright subjects.
IF CONT.
Concomitant intake of drugs
Drugs such as prokinetic agents (e.g., metoclopramide and
cisapride), anti Cholinergics (e.g., atropine or propantheline),
opiates (e.g., codeine) may affect the performance of FDDS. The co
administration of GI‐motility decreasing drugs can increase gastric
emptying time.
Feeding Regimen
CLASSIFICATION
Single unit
floating dosage
systems
NON
EFFERVESCENT
EFFERVECENT
Multiple unit
floating dosage
systems
NON
EFFERVESCENT
EFFERVESCENT
RAFT FORMING
SYSTEMS
HOLLOW
MICROSPHERES
MAGNETIC SYSTEMS
SINGLE UNIT FLOATING DOSAGE SYSTEMS
Single unit dosage forms are easiest to develop but suffers from the
risk of losing their effects too early due to their all‐or‐none emptying
from the stomach and, thus they may cause high variability in
bioavailability and local irritation due to large amount of drug
delivered at a particular site of the gastro intestinal tract.
STEP 1
• Incorporating high level(20-75%w/w) gel-forming
hydrocolloids. E.g.:- HEC, HPC, Sod. CMC
STEP 2
• Mixing Drug Candidate With Hydrocolloids
STEP 3
• Compression To A Tablet Or Capsule
Step 4
• hydrophilic polymer swelling and buoyancy by
Entrapped Air, Bulk density >1
Step 5
•Errosion Of Gel Barrier
Step 6 •Release Of Drug By Diffusion Proceess
NON EFFERVESCENT SYSTEMS PREPARATION
EFFERVESCENT FLOATING DOSAGE FORM
• These are matrix type of systems with the help of swellable polymers
such as methylcellulose and chitosan ad various effervescent eg, sodium
bicarbonate, tartaric acid and citric acid.
• They are formulated in such a way that when in contact with the acidic
gas content ,CO2 is liberated and gets entrapped in swollen
hydrocolloids, which provides buoyancy to the dosage form.
MULTIPLE UNIT FLOATING DOSAGE SYSTEMS
Single unit formulations are associated with problems
such as sticking together or being obstructed in
gastrointestinal tract, which may have a potential
danger of producing irritation. Multiple unit
systems avoid the ‘all‐or‐none’ gastric emptying nature
of single unit systems. It reduces the intersubject
variability in absorption and the probability for dose
dumping is lower.
NON EFFERVESCENT SYSTEMS
LIMITED INFO. ABOUT THESE
LITERATURE reported the possibility of
developing such system containing indomethacin, using chitosan as
the polymeric excipient. A multiple unit HBS containing
indomethacin as a model drug prepared by extrusion process is
reported. A mixture of drug, chitosan and acetic acid is extruded
through a needle, and the extrudate is cut and dried. Chitosan
hydrates float in the acidic media, and the required drug release
could be obtained by modifying the drug‐polymer ratio.
EFFERVESCENT SYSTEMS
Sodium alginate solution is added dropwise to aq.
solution of CaCl2
Instant gelation of Droplet surface by formation of
Calcium alginate
Calcium Alginate beads are obtained and freeze dried
Porous structures are obtained by freeze drying
Porous Structure aid floating
ALGINATE BEADS
• Prepared by dropping sodium alginate solution into aqueous
solution of calcium chloride, causing the precipitation of
calcium alginate
• Freeze dry in liquid nitrogen at -40oc for 24h.
• Beads-spherical and 2.5 mm in diameter.
HOLLOW MICROSPHERES/FLOATING MICROSPHERES
• Hallow microspheres as one of the most promising buoyant systems, as they
possess unique advantages of multiple unit systems as well as better floating
properties, because of central hallow spaces inside the microsphere.
• The general techniques involved in their preparation include simple solvent
evaporation, and solvent diffusion and evaporation.
Techniques involved in their preparation include simple solvent evaporation,
and solvent diffusion and evaporation. The drug release and better
floating properties mainly depend on the type of polymer, plasticizer
and the solvents employed for the preparation. Polymers, such as
polycarbonate, Eudragit® S and cellulose acetate, are used in the
preparation of hollow microspheres, and the drug release can be
modified by optimizing the amount of polymer and the polymerplasticizer
ratio3
RAFT FORMING SYSTEMS
This system is used for delivery of antacids and drug delivery for treatment of
gastrointestinal infections and disorders.
The mechanism involved in this system includes the formation of a viscous
cohesive gel in contact with gastric fluids, forming a continuous layer called
raft.
The raft floats because of the buoyancy created by the
formation of CO2 and act as a barrier to
prevent the reflux of gastric contents like HCl and enzymes into the
esophagus. Usually, the
system contains a gel forming agent and alkaline bicarbonates or
carbonates responsible for the formation of to make the system less
dense and float on the gastric fluids.
Barrier formed by a raft -forming system
ADVANTAGES OF FDDS
•Enhanced bioavailability
•Sustained drug delivery/reduced frequency of dosing
•Targeted therapy for local ailments in the upper GIT
•Reduced fluctuations of drug concentration
•Improved selectivity in receptor activation
•Reduced counter-activity of the body
•Extended effective concentration.
•Minimized adverse activity at the colon
DISADVANTAGES OF FDDS
• The drug substances that are unstable in the acidic environment of
the stomach are not suitable candidates to be incorporated in the
systems.
• These systems require a high level of fluid in the stomach for drug
delivery to float and work efficiently.
• Not suitable for drugs that have solubility or stability problem in
GIT.
SUITABLE DRUGS FOR FDDS
1. Narrow absorption window in GI tract, e.g., riboflavin and
Levodopa
2. Basically absorbed from stomach and upper part of GIT, e.g.,
chlordiazepoxide and cinnarazine.
3. Drugs that disturb normal colonic bacteria, e.g., amoxicillin
trihydrate.
4. Locally active in the stomach, e.g., antacids and misoprostol.
5. Drugs that degrade in the colon, e.g., ranitidine HCl and
metronidazole.
EVALUATION TESTS:
IN-VITRO TEST
Floating lag time
Floating time
Dissolution study
Resultant weight test
IN-VIVO TEST
X ray method
Gamma-scintigraphy
Gastroscopy
Ultra sonography
PRE-COMPRESSION TESTS
• Angle of repose
• Tapped density and
bulk density
• Carr’s compressibility
index and hausner
ratio
• Size and shape
POST COMPRESSION TESTS
• Thickness
• Diameter
• Hardness test
• Weight variation test
• Friability test
• Content uniformity
test
Floating lag time:
•The time between the introduction of the tablet into
the medium and its rise to upper one third of the
dissolution vessel is termed as floating lag time.
Floating time:
•The time for which the dosage form floats is termed
as the floating or flotation time.
Marketed Products of FDDS
Brand name Delivery system Drug (dose) Company
name
Valrelease® Floating capsule Diazepam (15mg) Hoffmann-LaRoche,
USA
Madopar® HBS
(Prolopa® HBS)
Floating, CR capsule Benserazide (25mg) and L-
dopa (100mg)
Roche Products,
USA
Liquid Gaviscon® Effervescent Floating
liquid alginate
preparations
Al hydroxide (95 mg), Mg
Carbonate (358 mg)
GlaxoSmithkline,
India
Topalkan® Floating liquid alginate
Preparation
Al – Mg antacid Pierre Fabre Drug,
France
Conviron® Colloidal gel forming
FDDS
Ferrous sulphate Ranbaxy, India
Cytotech® Bilayer floating capsule Misoprostol
(100μg/200μg)
Pharmacia, USA
Cifran OD® Gas-generating floating Ciprofloxacin (1gm) Ranbaxy, India
Widely used drug and dosage forms
Sr
No.
Dosage
Form
Drugs
1. MICROSPHERE Aspirin, Griseofulvin, p-nitroglycerine, ibuprofen, Terfinadine,
Tranilast.
2. GRANULES Diclofenac sodium, Indomethacin, Prednisolone
3. FILMS Cinnarizine
4. CAPSULE Chlrdiazepoxide, Diazepam, Furosemide, L-Dopa, Benserazide,
Misoprostol, Propanolol
5. TABLET/ PILLS Acetaminophen, ASA, Amoxicilin Trihydrate,Ampicilin, Atenolol,
Chlorphenarimine,Cinnazirine, Diltiazem,Flourouracil, Isosorbide
Mononitrate & dinitrate, p-aminobenzoic acid, Prednisolone,
Quinidine Gluconate,Ribiflavin 5-p, Sotalol,Theophylline, Verapamil
FLOATING DRUG DELIVERY SYSTEM

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FLOATING DRUG DELIVERY SYSTEM

  • 1. FLOATING DRUG DELIVERY SYSTEM IHTESHAM UR REHMAN FINAL PROFF. DEPARTMENT OF PHARMACY HAZARA UNIVERSITY
  • 2. DEFINITION IMPORTANCE STOMACH PHYSIOLOGY MECHANISM OF FDDS FACTORS AFFECTING FDDS CLASSIFICATION ADVANTAGES OF FDDS SUITABLE DRUGS FOR FDDS EVALUATION TESTS CONCLUSION
  • 3. DEFINITION Floating systems are low-density systems that have sufficient buoyancy to float over the gastric contents and remain buoyant in the stomach without affecting the gastric emptying rate for a prolonged period of time. OR Floating drug delivery system or hydrodynamically balance systems have a bulk density lower than gastric fluid and thus remains buoyant in the stomach for a prolonged period of time. This results in an increased gastric retention time and a better control of the fluctuations in plasma drug concentration.
  • 4. IMPORTANCE •Predetermined, predictable, and controlled Release •Maintenance of optimum therapeutic drug concentration in blood • Enhancement of activity and duration for short half‐life drugs •Reducing frequency of dosing and wastage of drugs; • Optimized therapy and better patient compliances
  • 5. IMPORTANCE CONTD. •GASTRIC RETENTION •INCREASED DRUG SOLUBILITY •INCREASED GASTRIC RESIDENCE TIME •IMPROVES BIOAVAILABILITY •REDUCES DRUG WASTAGE
  • 6.
  • 7.
  • 8. MECHANISM OF FDDS BUOYANCY FDDS has a bulk density less than gastric fluids and so remain buoyant in the stomach with out affecting the gastric emptying rate for a prolonged period of time. F = F buoyancy - F gravity = (Df - Ds) gv Where, F= total vertical force, Df = fluid density, Ds = object density, v = volume and g = acceleration due to gravity.
  • 9. FACTORS AFFECTING FLOATING TIME a)FORMULATION FACTORS Size of tablets Density of tablets Shape of Tablets Viscosity Grade Polymer b) IDIOSYNCRATIC FACTORS Gender Age Posture Concomitant Intake of Drugs Feeding Regimen
  • 10. a) FORMULATION FACTORS Size of tablets Retention of floating dosage forms in stomach depends on the size of tablets. Small tablets are emptied from the stomach during the digestive phase, but large ones are expelled during the house keeping waves. Exp.
  • 11. FF CONT. Density of tablets Density is the main factor affecting the gastric residence time of dosage form. A buoyant dosage form having a density less than that of the gastric fluids floats, since it is away from the pyloric sphincter, the dosage unit is retained in the stomach for a prolonged period. A density of less than 1.0g/ml i.e. less than that of gastric contents has been reported. Shape of tablets The shape of dosage form is one of the factors that affect its gastric residence time. Six shapes (ring tetrahedron, cloverleaf, string, pellet, and disk) were screened in vivo for their gastric retention potential. The tetrahedron (each leg 2cm long) rings (3.6 cm in diameter) exhibited nearly 100% retention at 24 hr12.
  • 12. FF CONT. Viscosity grade of polymer Drug release and floating properties of FDDS are greatly affected by viscosity of polymers and their interaction. Low viscosity polymers (e.g., HPMC K100 LV) were found to be more beneficial than high viscosity polymers (e.g., HPMC K4M) in improving floating properties. In addition, a decrease in the release rate was observed with an increase in polymer viscosity.
  • 13. IDIOSYNCRATIC FACTORS Gender Women have slower gastric emptying time than do men. Mean ambulatory GRT in meals (3.4±0.4 hours) is less compared with their age and race‐matched female counterparts (4.6±1.2 hours), regardless of the weight, height and body surface. Age Low gastric emptying time is observed in elderly than do in younger subjects. Intrasubject and intersubject variations also are observed in gastric and intestinal transit time. Elderly people, especially those over 70 years have a significantly longer GRT.
  • 14. IF CONT. Posture i) Upright position An upright position protects floating forms against postprandial emptying because the floating form remains above the gastric contents irrespective of its size. ii) Supine position This position offers no reliable protection against early and erratic emptying. In supine subjects large dosage forms (both conventional and floating) experience prolonged retention. The gastric retention of floating forms appear to remain buoyant anywhere between the lesser and greater curvature of the stomach. On moving distally, these units may be swept away by the peristaltic movements that propel the gastric contents towards the pylorus, leading to significant reduction in GRT compared with upright subjects.
  • 15. IF CONT. Concomitant intake of drugs Drugs such as prokinetic agents (e.g., metoclopramide and cisapride), anti Cholinergics (e.g., atropine or propantheline), opiates (e.g., codeine) may affect the performance of FDDS. The co administration of GI‐motility decreasing drugs can increase gastric emptying time. Feeding Regimen
  • 16. CLASSIFICATION Single unit floating dosage systems NON EFFERVESCENT EFFERVECENT Multiple unit floating dosage systems NON EFFERVESCENT EFFERVESCENT RAFT FORMING SYSTEMS HOLLOW MICROSPHERES MAGNETIC SYSTEMS
  • 17. SINGLE UNIT FLOATING DOSAGE SYSTEMS Single unit dosage forms are easiest to develop but suffers from the risk of losing their effects too early due to their all‐or‐none emptying from the stomach and, thus they may cause high variability in bioavailability and local irritation due to large amount of drug delivered at a particular site of the gastro intestinal tract.
  • 18. STEP 1 • Incorporating high level(20-75%w/w) gel-forming hydrocolloids. E.g.:- HEC, HPC, Sod. CMC STEP 2 • Mixing Drug Candidate With Hydrocolloids STEP 3 • Compression To A Tablet Or Capsule Step 4 • hydrophilic polymer swelling and buoyancy by Entrapped Air, Bulk density >1 Step 5 •Errosion Of Gel Barrier Step 6 •Release Of Drug By Diffusion Proceess NON EFFERVESCENT SYSTEMS PREPARATION
  • 19. EFFERVESCENT FLOATING DOSAGE FORM • These are matrix type of systems with the help of swellable polymers such as methylcellulose and chitosan ad various effervescent eg, sodium bicarbonate, tartaric acid and citric acid. • They are formulated in such a way that when in contact with the acidic gas content ,CO2 is liberated and gets entrapped in swollen hydrocolloids, which provides buoyancy to the dosage form.
  • 20. MULTIPLE UNIT FLOATING DOSAGE SYSTEMS Single unit formulations are associated with problems such as sticking together or being obstructed in gastrointestinal tract, which may have a potential danger of producing irritation. Multiple unit systems avoid the ‘all‐or‐none’ gastric emptying nature of single unit systems. It reduces the intersubject variability in absorption and the probability for dose dumping is lower.
  • 21. NON EFFERVESCENT SYSTEMS LIMITED INFO. ABOUT THESE LITERATURE reported the possibility of developing such system containing indomethacin, using chitosan as the polymeric excipient. A multiple unit HBS containing indomethacin as a model drug prepared by extrusion process is reported. A mixture of drug, chitosan and acetic acid is extruded through a needle, and the extrudate is cut and dried. Chitosan hydrates float in the acidic media, and the required drug release could be obtained by modifying the drug‐polymer ratio.
  • 22. EFFERVESCENT SYSTEMS Sodium alginate solution is added dropwise to aq. solution of CaCl2 Instant gelation of Droplet surface by formation of Calcium alginate Calcium Alginate beads are obtained and freeze dried Porous structures are obtained by freeze drying Porous Structure aid floating
  • 23. ALGINATE BEADS • Prepared by dropping sodium alginate solution into aqueous solution of calcium chloride, causing the precipitation of calcium alginate • Freeze dry in liquid nitrogen at -40oc for 24h. • Beads-spherical and 2.5 mm in diameter.
  • 24. HOLLOW MICROSPHERES/FLOATING MICROSPHERES • Hallow microspheres as one of the most promising buoyant systems, as they possess unique advantages of multiple unit systems as well as better floating properties, because of central hallow spaces inside the microsphere. • The general techniques involved in their preparation include simple solvent evaporation, and solvent diffusion and evaporation.
  • 25. Techniques involved in their preparation include simple solvent evaporation, and solvent diffusion and evaporation. The drug release and better floating properties mainly depend on the type of polymer, plasticizer and the solvents employed for the preparation. Polymers, such as polycarbonate, Eudragit® S and cellulose acetate, are used in the preparation of hollow microspheres, and the drug release can be modified by optimizing the amount of polymer and the polymerplasticizer ratio3
  • 26. RAFT FORMING SYSTEMS This system is used for delivery of antacids and drug delivery for treatment of gastrointestinal infections and disorders. The mechanism involved in this system includes the formation of a viscous cohesive gel in contact with gastric fluids, forming a continuous layer called raft. The raft floats because of the buoyancy created by the formation of CO2 and act as a barrier to prevent the reflux of gastric contents like HCl and enzymes into the esophagus. Usually, the system contains a gel forming agent and alkaline bicarbonates or carbonates responsible for the formation of to make the system less dense and float on the gastric fluids. Barrier formed by a raft -forming system
  • 27. ADVANTAGES OF FDDS •Enhanced bioavailability •Sustained drug delivery/reduced frequency of dosing •Targeted therapy for local ailments in the upper GIT •Reduced fluctuations of drug concentration •Improved selectivity in receptor activation •Reduced counter-activity of the body •Extended effective concentration. •Minimized adverse activity at the colon
  • 28. DISADVANTAGES OF FDDS • The drug substances that are unstable in the acidic environment of the stomach are not suitable candidates to be incorporated in the systems. • These systems require a high level of fluid in the stomach for drug delivery to float and work efficiently. • Not suitable for drugs that have solubility or stability problem in GIT.
  • 29. SUITABLE DRUGS FOR FDDS 1. Narrow absorption window in GI tract, e.g., riboflavin and Levodopa 2. Basically absorbed from stomach and upper part of GIT, e.g., chlordiazepoxide and cinnarazine. 3. Drugs that disturb normal colonic bacteria, e.g., amoxicillin trihydrate. 4. Locally active in the stomach, e.g., antacids and misoprostol. 5. Drugs that degrade in the colon, e.g., ranitidine HCl and metronidazole.
  • 30. EVALUATION TESTS: IN-VITRO TEST Floating lag time Floating time Dissolution study Resultant weight test IN-VIVO TEST X ray method Gamma-scintigraphy Gastroscopy Ultra sonography
  • 31. PRE-COMPRESSION TESTS • Angle of repose • Tapped density and bulk density • Carr’s compressibility index and hausner ratio • Size and shape POST COMPRESSION TESTS • Thickness • Diameter • Hardness test • Weight variation test • Friability test • Content uniformity test
  • 32. Floating lag time: •The time between the introduction of the tablet into the medium and its rise to upper one third of the dissolution vessel is termed as floating lag time. Floating time: •The time for which the dosage form floats is termed as the floating or flotation time.
  • 33. Marketed Products of FDDS Brand name Delivery system Drug (dose) Company name Valrelease® Floating capsule Diazepam (15mg) Hoffmann-LaRoche, USA Madopar® HBS (Prolopa® HBS) Floating, CR capsule Benserazide (25mg) and L- dopa (100mg) Roche Products, USA Liquid Gaviscon® Effervescent Floating liquid alginate preparations Al hydroxide (95 mg), Mg Carbonate (358 mg) GlaxoSmithkline, India Topalkan® Floating liquid alginate Preparation Al – Mg antacid Pierre Fabre Drug, France Conviron® Colloidal gel forming FDDS Ferrous sulphate Ranbaxy, India Cytotech® Bilayer floating capsule Misoprostol (100μg/200μg) Pharmacia, USA Cifran OD® Gas-generating floating Ciprofloxacin (1gm) Ranbaxy, India
  • 34. Widely used drug and dosage forms Sr No. Dosage Form Drugs 1. MICROSPHERE Aspirin, Griseofulvin, p-nitroglycerine, ibuprofen, Terfinadine, Tranilast. 2. GRANULES Diclofenac sodium, Indomethacin, Prednisolone 3. FILMS Cinnarizine 4. CAPSULE Chlrdiazepoxide, Diazepam, Furosemide, L-Dopa, Benserazide, Misoprostol, Propanolol 5. TABLET/ PILLS Acetaminophen, ASA, Amoxicilin Trihydrate,Ampicilin, Atenolol, Chlorphenarimine,Cinnazirine, Diltiazem,Flourouracil, Isosorbide Mononitrate & dinitrate, p-aminobenzoic acid, Prednisolone, Quinidine Gluconate,Ribiflavin 5-p, Sotalol,Theophylline, Verapamil