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Table 5 Key advantages and disadvantages of paediatric formulation options for oral solid dosage forms compared to conventional tablets, capsules or oral liquids

From: Drugs for neglected tropical diseases: availability of age-appropriate oral formulations for young children

Chewable tablet

Dispersible tablet

Orodispersible tablet

Multiparticulate formulation

Oral films

Advantages

• Lighter than liquids requiring less space during transportation

• Lighter than liquids requiring less space during transportation

• Lighter than liquids requiring less space during transportation

• Lighter than liquids requiring less space during transportation

• Lighter than liquids requiring less space during transportation

• Superior shelf-life to liquids

• Superior shelf-life to liquids

• Superior shelf-life to liquids

• Superior shelf-life to liquids

• Superior shelf-life to liquids

• Use similar excipients to conventional tablets, i.e. require no special manufacturing expertise

• Use similar excipients to conventional tablets, i.e. require no special manufacturing expertise

• Use similar excipients to conventional tablets, i.e. require no special manufacturing expertise

• Use similar excipients to conventional tablets, i.e. require no special manufacturing expertise

 

• Can be used for large doses as tablet size is not limited by swallowability

• Can be used for large doses as tablet size is not limited by swallowability

   

• Dosing is simpler than for liquid formulations or powders, which require doses to be measured before reconstitution

 

• Dosing is simpler than for liquid formulations or powders, which require doses to be measured before reconstitution

  
 

• Dose adjustment is possible following dispersion by taking a measured portion of the dispersed material

 

• Offer dose flexibility provided that there is a suitable device to accurately count the units required

• Offer dose flexibility provided that there is suitable markings/ scoring to allow accurate division

   

• Coatings can be applied to provide modified release formulations

 
   

• Multiple drugs can easily be combined in a variety of ratios to provide flexible dosing in combination therapy

 

Disadvantages

• Potential palatability issues

• Potential palatability issues

• Potential palatability issues

• Potential palatability issues

• Potential palatability issues

• Often softer and therefore more fragile than conventional tablets and therefore need to be handled with care

• Often softer and therefore more fragile than conventional tablets and therefore need to be handled with care

• Often softer and therefore more fragile than conventional tablets and therefore need to be handled with care

 

• Often softer and therefore more fragile than conventional tablets and therefore need to be handled with care

 

• They are hygroscopic and often need managed storage conditions or desiccants in packaging

• They are hygroscopic and often need managed storage conditions or desiccants in packaging

 

• They are hygroscopic and often need managed storage conditions or desiccants in packaging

• May require a clean water source (or alternative solvent) to facilitate swallowing

• Require a clean water source (or alternative solvent) to facilitate swallowing

• Require a clean water source (a typical tablet needs 5 to 10 ml of water to aid swallowing) and caregivers must spend time waiting for the tablet to dissolve

• Require a clean water source (or alternative solvent) to facilitate swallowing

• Require a clean water source (or alternative solvent) to facilitate swallowing

• Only suitable for children able to chew and cannot be used in the youngest population

  

• Need to be contained in a unit system (usually a capsule or sachet) which involves additional manufacturing steps

• Only suitable for potent drugs as the maximum loading (amount of drug/film) is low

• Insufficient chewing may still lead to a risk of choking or aspiration of large particles

  

• Additional steps in administration (opening the capsule/sachets) to transfer to the patient

• Require specialised manufacturing knowledge and facilities