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Frias JAuthorGuerra PAuthor

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June 26, 2023
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Article

Bioavailability of Cariban® Capsules: A Modified-Release Fixed-Dose Combination of Doxylamine and Pyridoxine to Relieve Nausea and Vomiting During Pregnancy

Publicated to: Drugs in R and D. 23 (2): 185-195 - 2023-06-01 23(2), DOI: 10.1007/s40268-023-00425-7

Authors:

Saz-Leal, P; Zamorano-Domínguez, L; Frías, J; Guerra, P; Saura-Valls, M; Roca-Juanes, R; Nebot-Troyano, J; García-Aguilar, E; Vilchez, T; Urso, K
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Affiliations

Autonomous Univ Madrid, La Paz Univ Hosp, Sch Med, Clin Pharmacol Dept,IdiPAZ, Madrid, Spain - Author
Hospital Universitario La Paz - Author
Inibsa Ginecol SA, Barcelona, Spain - Author
Inibsa Ginecologia S.A - Author
ITF Res Pharm SLU, Med Dept, Alcobendas, Spain - Author
ITF Res Pharm SLU, R&D Dept, Alcobendas, Spain - Author
ITF Research Pharma S.L.U. - Author
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Abstract

Background: Nausea and vomiting is a very prevalent condition during pregnancy. Combination of doxylamine and pyridoxine is placed as first-line pharmacological option for its treatment in most clinical guidelines. Among different release forms available, Cariban® is a fixed-dose combination of doxylamine/pyridoxine 10/10 mg, formulated as modified-release capsules. Objectives: In the present study, we aimed to characterize the bioavailability performance of Cariban® in vitro and in vivo. Methods: An in vitro dissolution test was performed to evaluate the release profile of Cariban®, together with immediate- and delayed-release formulations available on the market. A single-center, single-dose, open-label bioavailability study following Cariban® administration in 12 healthy adult female patients was carried out to explore the drug behavior in vivo (protocol NBR-002-13; EUDRA-CT 2013-005422-35). These data were additionally used to perform a computational pharmacokinetic simulation of the posology approved for this drug. Results: Cariban® capsules demonstrate a prolonged-release performance, with an early, gradual, and progressive release of both actives until reaching a complete dissolution after 4–5 h in solution. The pharmacokinetic features of these capsules show that doxylamine and pyridoxine metabolites are early absorbed, being all detectable in plasma within 1 h following oral administration. Computational pharmacokinetic simulation predicts that different posology provides distinct profiles of metabolites in plasma, with 1–1–2 (morning–midafternoon–night) being the one that concentrates higher plasma levels but lower dose dumping for 24 h. Conclusion: Cariban® behaves as a prolonged-release formulation, which correlates with rapid absorption and arising of the actives in the plasma, but also long-lasting and sustained bioavailability, especially when administered following the complete posology. These results would underlie its demonstrated efficacy to relieve nausea and vomiting of pregnancy (NVP) under clinical settings.
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Keywords

attitudesmanagementstabilityvitamin-b6womenAdultAntiemeticsBiological availabilityCapsulesDelayed-action preparationsDoxylamineDrug combinationsFemaleGastrointestinal transitHumansNauseaPregnancyPregnancy complicationsPyridoxineVomiting

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Drugs in R and D due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Pharmacology. Notably, the journal is positioned en el Cuartil Q3 for the agency WoS (JCR) in the category Pharmacology & Pharmacy.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-01:

  • WoS: 1
  • Scopus: 1
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-01:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 14 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

    It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

    • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
    • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: https://repositorio.uam.es/handle/10486/719590
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