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An enteric coating is a
polymer A polymer (; Greek '' poly-'', "many" + '' -mer'', "part") is a substance or material consisting of very large molecules called macromolecules, composed of many repeating subunits. Due to their broad spectrum of properties, both synthetic a ...
barrier applied to oral
medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
that prevents its dissolution or disintegration in the gastric environment. This helps by either protecting drugs from the acidity of the stomach, the stomach from the detrimental effects of the drug, or to release the drug after the stomach (usually in the upper tract of the intestine). Some drugs are unstable at the pH of gastric acid and need to be protected from degradation. Enteric coating is also an effective method to obtain drug targeting (such as gastro-resistant drugs). Other drugs such as some anthelmintics may need to reach a high concentration in a specific part of the intestine. Enteric coating may also be used during studies as a research tool to determine drug absorption. Enteric-coated medications pertain to the "delayed action" dosage form category. Tablets, mini-tablets, pellets and granules (usually filled into capsule shells) are the most common enteric-coated dosage forms.


Description

Most enteric coatings work by presenting a surface that is stable at the intensely acidic pH found in the stomach, but breaks down rapidly at a higher pH (alkaline pH). For example, they will not dissolve in the gastric acids of the stomach (pH ~3), but they will in the alkaline (pH 7–9) environment present in the
small intestine The small intestine or small bowel is an organ (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...
. The time required for an enteric-coated dosage form to reach the intestine mostly depends on the presence and type of food in the stomach. It varies from 30 minutes up to 7 hours, with an average time of 6 hours. Although some studies indicated that larger sized dosage forms may require additional time for gastric emptying, others suggested that the size, shape, or volume of the tablet possess no significant effects instead. Enteric coated granules emptying rate is, however, less affected by the presence of food and present the more uniform release and reproducible transit time typical of the multiparticulates
dispersion Dispersion may refer to: Economics and finance *Dispersion (finance), a measure for the statistical distribution of portfolio returns *Price dispersion, a variation in prices across sellers of the same item *Wage dispersion, the amount of variatio ...
. By preventing the drug from dissolving into the stomach, enteric coating may protect
gastric mucosa The gastric mucosa is the mucous membrane layer of the stomach, which contains the glands and the gastric pits. In humans, it is about 1 mm thick, and its surface is smooth, soft, and velvety. It consists of simple columnar epithelium, lamin ...
from the irritating effects of the medication itself. When the drug reaches the neutral or alkaline environment of the intestine, its active ingredients can then dissolve and become available for absorption into the bloodstream. Drugs that have an irritant effect on the stomach, such as
aspirin Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific inflammatory conditions which aspirin is used to treat inc ...
or
potassium chloride Potassium chloride (KCl, or potassium salt) is a metal halide salt composed of potassium and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a salt ...
, can be coated with a substance that will dissolve only in the small intestine. However, it has been shown that enteric coated aspirin may lead to incomplete inhibition of platelets, potentially negating the intended effect for those being treated for vascular disease. Likewise, certain groups of proton pump inhibitors ( esomeprazole, omeprazole,
pantoprazole Pantoprazole, sold under the brand name Protonix, among others, is a proton pump inhibitor used for the treatment of stomach ulcers, short-term treatment of erosive esophagitis due to gastroesophageal reflux disease (GERD), maintenance of heal ...
and all grouped azoles) are acid-activated. For such drugs, enteric coating added to the formulation tends to avoid
activation Activation, in chemistry and biology, is the process whereby something is prepared or excited for a subsequent reaction. Chemistry In chemistry, "activation" refers to the reversible transition of a molecule into a nearly identical chemical o ...
in the
mouth In animal anatomy, the mouth, also known as the oral cavity, or in Latin cavum oris, is the opening through which many animals take in food and issue vocal sounds. It is also the cavity lying at the upper end of the alimentary canal, bounded on ...
and
esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to t ...
. Materials used for enteric coatings include
fatty acid In chemistry, particularly in biochemistry, a fatty acid is a carboxylic acid with an aliphatic chain, which is either saturated or unsaturated. Most naturally occurring fatty acids have an unbranched chain of an even number of carbon atoms, f ...
s, waxes, shellac,
plastic Plastics are a wide range of synthetic or semi-synthetic materials that use polymers as a main ingredient. Their plasticity makes it possible for plastics to be moulded, extruded or pressed into solid objects of various shapes. This adapta ...
s, and plant fibers. Conventional materials used are solutions of film resins. However, as the solvents for such solutions are organic solvents, there is a concern about the toxicity potential of the traces of the residual solvents in the tablet coating. The first form of gastro-resistant coating was introduced by Unna in 1884 in the form of
keratin Keratin () is one of a family of structural fibrous proteins also known as ''scleroproteins''. Alpha-keratin (α-keratin) is a type of keratin found in vertebrates. It is the key structural material making up Scale (anatomy), scales, hair, Nail ...
-coated pills, although it was later discovered that they were not able to withstand gastric
digestion Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...
. Salol was also used by Ceppi as one of the first forms of enteric coating. However, the first material that was extensively used as enteric coating agent was shellac, since its introduction in 1930. Properly treated or hydrolyzed shellac showed different enteric release properties. Recently, some companies have begun to apply enteric coatings to fish oil ( omega-3 fatty acids) supplements. The coating prevents the fish oil capsules from being digested in the stomach, which has been known to cause gastroesophageal reflux. Sometimes the abbreviation "EC" is added beside the name of the drug to indicate that it has an enteric coating.


Composition

* Methyl acrylate-methacrylic acid copolymers * Cellulose acetate phthalate (CAP) * Cellulose acetate succinate * Hydroxypropyl methyl cellulose phthalate * Hydroxypropyl methyl cellulose acetate succinate ( hypromellose acetate succinate) * Polyvinyl acetate phthalate (PVAP) * Methyl methacrylate-methacrylic acid copolymers * Shellac * Cellulose acetate trimellitate * Sodium alginate *
Zein Zein is a class of prolamine protein found in maize (corn). It is usually manufactured as a powder from corn gluten meal. Zein is one of the best understood plant proteins.Momany, Frank A.; Sessa, David J.; Lawton, John C.; Selling, Gordon W.; ...
* enteric coating aqueous solution (ethylcellulose, medium chain triglycerides oconut oleic acid, sodium alginate, stearic acid) (coated softgels)


See also

* Phthalates


References

{{Reflist Pharmacokinetics Pharmacy Coatings Polymers