Reduced
Availability of Trimethoprim/Sodium Sulfadiazin and Doxycyclin Hyclate
in Drinking Water Systems
Chris Vervaet, PhD
Jody Voorspoels, PhD
Filip Kiekens, PhD
Jean Paul Remon, PhD
Laboratory of Pharmaceutical Technology, Ghent University,
Gent, Belgium.
KEY
WORDS: Medication administration, dissolution, drinking systems,
trimethoprim, doxycyclin hyctate
ABSTRACT
The availability of drugs in the reservoir and at the
nipples of a drinking water system was documented following the addition
of Trimazin®, a powder formulation containing sodium sulfadiazin (Na-SD)
and trimethoprim (TMP) or doxycyclin hyclate powder (DoxHCl), to the
system using a standard mixing methodology. The theoretical concentration
of Na-SD, a highly water-soluble drug, was obtained immediately after
addition of the Trimazin® powder, whereas the TMP concentrations were
highly variable and did not yield their theoretical concentration
due to the poor dissolution kinetics of TMP at the test conditions.
The availability of DoxHCl was far below its theoretical concentration
(200 mg/L), because the drug concentration in the water system did
not exceed 30 mg/L. Adding 0.1% (w/v) citric acid to the water increased
the DoxHCl concentrations to a maximum of 125 mg/L. This study shows
that drug availability from a drinking water system can be well below
the anticipated drug concentrations, due to solubility or dissolution
rate problems. Therefore, the mixing methodology should be validated
if drugs are administered via drinking water.
INTRODUCTION
From an economic point of view, drug administration
to a group of domesticated animals through medicated feed or drinking
water is preferred over time-consuming and costly individual drug
administration. Although the feed route is usually restricted to prophylactic
treatment, medicated drinking water is often administered to sick
animals for therapeutic purposes because they often lack appetite
but continue to drink.1,2 However, water as a drug medium offers several
challenges and limitations. The main obstacles are the drugs
solubility and stability in water. The solubility issue of powder
formulations intended for use in drinking water systems is often solved
by commercial formulations containing highly soluble salts or by the
addition of suitable excipients. However, rapid and complete dissolution
of the drug when adding the formulation to the water reservoir should
not be taken for granted, because the water quality and design of
the drinking water system (eg, characteristics of the mixing unit)
could affect the drugs dissolution kinetics. Because incomplete
dissolution of the drug could result in a reduced availability, a
suboptimal dosing regimen, and blocking the water system at the drinking
points, drug addition to the drinking system should be validated by
monitoring the drug concentration (not only in the water reservoir,
but also at the drinking nipples). The goal of this study was to document
the availability of drugs from drinking water systems on a pig farm,
using daily used methodology to transfer and mix the drug formulation
into the water reservoir. A commercially available trimethoprim-sulfonamide
formulation was added to the water and the drug distribution throughout
the water system was monitored; a second part of the study deals with
the availability of doxycyclin hyclate at the drinking points.
MATERIALS AND METHODS
Trimethoprim-Sodium Sulfadiazin
Materials: Trimazin® 30%, a water-dispersible
powder for oral administration containing 25% (w/w) sulfadiazin (as
a sodium salt), 5% (w/w) trimethoprim, and a-lactose monohydrate (as a filler), was provided by Kela Laboratoria (Hoogstraten,
Belgium). Sodium sulfadiazin (Na-SD) and trimethoprim (TMP) used for
analytical purposes were purchased from Sigma Aldrich (Bornem, Belgium).
All reagents used during chromatographic analysis were analytical
or HPLC grade.
Field experiment: One
container (±1 kg) of the Trimazin® formulation (Kela) was dispersed
in a bucket of lukewarm (±35˚C) water (±10L). The resulting suspension
was immediately added to a stainless steel tank (maximum volume, 740
L) partially filled with well water (temperature, 8˚C). Both
the bucket and the Trimazin®-container were rinsed with water from
the tank. The drug/water mixture was homogenized for several minutes
using the mixing unit built into the tank. The water reservoir was
connected to a series of nipples (freely accessible for the pigs)
through a set of pressurized tubes. If the pressure inside the tubes
dropped below a threshold value due to water consumption by the pigs,
a pump restored the pressure to a pre-set level. Simultaneously, the
stirrer inside the tank was started to homogenize the drug mixture
inside the tank.
Samples
(10 mL) were taken from the tank just below the water surface and
at 3 drinking points 0, 30 minutes and 1, 2, 3, 4, 7, and 9 hours
after addition (and homogenization) of the drug mixture to the water
system. At the 3 nipples, 2 fractions were collected at each sampling
point. The first sample was taken immediately after opening the valve
of the nipple, and the tubing was purged for 1 minute before the second
sample was taken. Half of each sample volume was immediately transferred
into borosilicate glass tubes (Corning Glass Works, Corning, NY, USA),
the remaining part was filtered through a 0.22 µm cellulose acetate
(CA) filter (Minisart, Sartorius, Vilvoorde Belgium). Awaiting HPLC
analysis of the samples, all solutions were frozen immediately by
transferring the sample tubes into an ethanol bath cooled to -70˚C
with solid CO2. The Na-SD and TMP concentration in the
samples was determined using a validated HPLC method.3
Laboratory experiments:
The field experiment was simulated at lab-scale by dispersing 1g Trimazin®
in 800 mL well water. These dispersions were put in a refrigerator
(8˚C) and continuously mixed. Samples from these media were taken
at the same time intervals as during the field experiment. The pH
of each solution was measured after filtration through a 0.22 µm CA-filter
(Minisart, Sartorius, Vilvoorde, Belgium).
Drug loss during filtration due to adsorption onto the
filter medium was assessed by HPLC analysis of filtered and unfiltered
samples (n = 3) of a Trimazin® solution (addition of 1 g powder to
800 mL well water, followed by 20 minutes of sonication to ensure
complete dissolution of the samples).
Doxycyclin Hyclate
Materials: Doxycyclin hyclate
and citric acid monohydrate were purchased from Ludeco (Brussels,
Belgium). All reagents used during chromatographic analysis were analytical
or HPLC grade.
Field
experiment: During the study, 120 g doxycyclin hyclate (DoxHCl) was
added to a stainless steel tank filled with 600 L tap water, yielding
a theoretical DoxHCl concentration of 200 mg/L. In a second field
experiment, 600 g citric acid was dissolved in the tap water available
in the tank before the addition of 120 g DoxHCl. The water system
was equipped with a pump for continuous circulation of the water through
a closed loop system, providing the required mechanical agitation
for homogeneous distribution of the drug in the water reservoir. The
aqueous drug solution is transported toward the drinking points (the
nipples situated in the boxes of the piglets) using a series of pressurized
tubes. If the pressure inside the tubing decreased due to excessive
water uptake, solution from the loop was pumped (using an automatic
valve) into the tubes to maintain the required pressure at the drinking
points. In the tank and at 3 nipples, samples (10 mL) were taken at
specific time intervals after drug addition to the water system (0,
0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours). These samples were
immediately frozen at -20˚C until HPLC
analysis. The doxycyclin concentration in the samples was determined
using the validated HPLC method described by Santos et al.4
RESULTS and DISCUSSION
Trimethoprim and Sodium Sulfadiazin
As the exact volume of water in
the drinking system, the exact fill weight of the Trimazin® formulation
in the container, and the exact drug dosage in the formulation are
unknown, the theoretical concentration of Na-SD was taken as the average
drug concentration (n = 8) (406.2 ± 5.4 µg/mL) of the samples taken
from the tank over the entire test period. Laboratory experiments
showed that Na-SD (as a highly water soluble drug) dissolved instantaneously
after its addition to water with limited mechanical agitation. The
theoretical concentration of TMP (74.7 µg/mL) was calculated from
the theoretical Na-SD concentration, taking into account the ratio
of both drugs as mentioned on the label.
Figures
1A and B show the average concentration at the drinking points (n
= 3) of sodium sulfadiazin (Na-SD) and trimethoprim (TMP), respectively,
in relation to their theoretical concentration. The theoretical concentration
(Ctheor) of Na-SD was obtained almost immediately at the nipples
and was maintained throughout the entire test period, indicating an
optimal availability of the drug. A similar profile was seen for the
samples taken from the reservoir and at the nipples before purging.
Although the purged samples yielded their Ctheor immediately after drug
addition (t = 0 minutes), the Na-SD concentrations of the samples
taken at t = 0 minutes and t = 30 minutes without purging were considerably
lower, indicating that purging is required before an undiluted drug
solution reaches the drinking points.
Unlike
Na-SD, the concentration of TMP (Fig. 1B) at most sampling points
was below its theoretical value and highly variable. The concentration
profiles measured within the tank and at the nipples without purging
showed the same trend (data not shown). Filtering these samples before
analysis showed that the TMP-concentration decreased and reduced the
variability, indicating that part of the drug remained in suspension
throughout the entire experiment. The reduction in TMP recovery after filtration can partly
be explained by the absorption of dissolved TMP molecules to the cellulose
acetate-membrane during filtration of the samples (the loss ranged
from 3.6% to 6.4%; no loss was detected for Na-SD), but it is mainly
because of retention of the drug fraction in suspension throughout
the entire experiment.
Simulation
of the experimental conditions at laboratory scale using the same
well water at 8˚C showed that Na-SD, as expected, yielded its
Ctheor immediately after addition to the water. However Ctheor of TMP was only reached after about 2 hours of continuous
mixing (Fig. 2; filtered samples). The higher TMP concentration of
the unfiltered samples (Fig. 2) during the initial 2 hours of the
test confirms that part of the drug remains suspended and that the
dissolution kinetics of this drug were poor under these conditions
(the temperature and pH of the well water were 8˚C and 8.62,
respectively).5
The
slightly lower TMP concentration of the filtered samples after 3,
4, and 7 hours are probably due to the limited absorption of TMP to
the filter membrane. Because the close correlation between Ctheor and
the actual concentration at the end of the test indicated that no
chemical degradation occurred, these data confirm that the low TMP
concentrations seen during the field experiment are due to the low
efficiency of the intermittent mixing system used in this study. Even
after 9 hours, about 25% of the drug was not dissolved; the remaining
part was suspended throughout the system or sedimented in the reservoir
and tubes. The data obtained under these specific test conditions
stress the importance of an adequate mixing procedure (optimizing
the duration and intensity of the mixing) to ensure maximum drug availability
from the drinking system.
Doxycyclin Hyclate
Figure
3 shows that the actual concentration of DoxHCl was far below the
theoretical concentration (200 mg/L). The maximum concentration in
the tank and at the nipples did not exceed 30 mg/L. Instability of
DoxHCl in water can not account for the loss in drug concentration
shown by Santos et al.4 After 24 hours, about 85% DoxHCl was recovered
from medicated drinking water stored in metal containers. Although
DoxHCl is described in literature as a good water-soluble drug (1
part drug in 3 parts water; Merck Index), the limited availability
of this compound is probably related to its solubility because laboratory
experiments showed that the solubility of DoxHCl in the tap water
was about 400 mg/L (at room temperature). Dissolving 0.1% (w/v) citric
acid into the water before drug addition yielded higher DoxHCl concentrations.
Its solubility in tap water increased to about 4 g/L. However, the
concentrations obtained in the water system were still far below 200
mg/L (Fig. 3). Possible explanations for this observation are 1) that
despite continuous homogenization of the water through a closed loop
system, the mixing kinetics for such a large volume are insufficient;
or 2) that if the drug dissolved completely, a large portion of the
drug adhered to the inner surface of the water system (reservoir or
tubing). Again, these data show the importance of monitoring the drug
concentrations at various points in the water system and of designing
a proper formulation to ensure complete drug dissolution and optimal
availability of the drug.
Both
field experiments indicated that drug availability from a drinking
water system can be well below the expected drug concentrations, mainly
due to solubility and dissolution rate problems. The mixing methodology
used in combination with the specific water system should be validated
to ensure complete drug dissolution, especially if poorly soluble
drugs are administered. These data also stress the need for a proper
cleaning procedure after administration of medicated drinking water
because any residual drug (suspended in the system or adhered to the
surfaces) will be released over a longer period, exposing the animals
to a subtherapeutic dose. Because many drugs administered through
drinking water systems are antibacterial drugs, resistance of the
microorganisms to the drugs is a major issue under these circumstances.
In addition, residuals in the water system might interact with subsequent
drug therapies, possibly causing intoxication, as recently described
by Croubels et al.6
REFERENCES
1. Larrabee
WL: Formulation of drugs for administration via feed or drinking water,
in Formulation of Veterinary Dosage Forms. New York: Marcel Dekker,
1983:175203.
2. Brooks PH: Water: Forgotten nutrient and novel
drug delivery system. Feed Compounder 7:2427, 1994.
3. Bonazzi
D, Andrisano V, Di Pietra AM, Cavrini V: Analysis of trimethoprimsulfonamide
drug combinations in dosage forms by UV spectroscopy and liquid chromatography.
Il Farmaco 49: 381386, 1994.
4. Santos
MDF, Vermeersch H, Remon JP, et al: Validation of a high-performance
liquid chromatographic method for the determination of doxycycline
in turkey plasma. J Chromatog Biomed Appl 682:301308, 1996.
5. Meshali
MM, El-Sabbagh H, Ramadan I: Simultaneous solubility and dissolution
rate of sulphamethoxyzole and trimethoprim in binary mixtures. Pharmazie
39:407408, 1984.
6. Croubels,
S., Vrielinck, J., Baert, K., et al: A special case of acute tiamulin-salinomycin
intoxication in pigs due to residual tiamulin four months after medication:
Vl. Diergen. Tijdschr 70:5458, 2001.
Figure 1.
Concentration of sodium
sulfadiazin (Na-SD) and trimethoprim (TMP) at the nipples (n = 3)
of the drinking water system (containing well water at 8˚C),
after the addition of ±1 kg Trimazin® formulation. The tubing was
purged for 1 minute before collecting the samples. (A)
Na-SD concentration of an unfiltered ()
sample. The theoretical Na-SD concentration (dashed
line) was 406.2 mg/L. (B) TMP concentration of a filtered sample () and an unfiltered sample (). The theoretical TMP-concentration (dashed line) was
74.7 mg/L.
Figure 2. Dissolution
profile of trimethoprim (TMP) in well water (8˚C, continuous
stirring) as a function of time under laboratory conditions: mean
TMP concentration (n = 3) of a filtered sample () and an unfiltered sample (). The theoretical TMP-concentration (dashed
line) was 64.1 mg/L.
Figure 3. Mean
concentration of doxycyclin hyclate (DoxHCl) at the nipples (n = 3)
()
and in the tank (n) of the drinking water system (600 L) after
the addition of 120 g DoxHCl at 0 minutes. The closed symbols represent
the mean DoxHCl-concentrations (: at the nipples; n:
in the tank) when 0.1% (g/v) citric acid was added to the water reservoir
before drug addition. The theoretical DoxHCl-concentration (dashed
line) was 200 mg/L.