Effective use of transdermal drug delivery in children
M Begoña Delgado-Charro1, Richard H Guy1
1Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK.
Insights
Transdermal drug delivery offers a convenient, non-invasive route for pediatric patients. However, premature neonates face challenges due to immature skin barriers, limiting approved transdermal formulations.
Area of Science:
- Pharmacology
- Dermatology
- Pediatrics
Background:
- Transdermal drug delivery provides a non-invasive and convenient method for administering medications to children.
- The skin barrier in term infants and older children is competent, regulating water loss and chemical entry, facilitating therapeutic drug concentrations with smaller doses.
- Existing transdermal patches for pediatric use include fentanyl, buprenorphine, clonidine, scopolamine, methylphenidate, estrogens, nicotine, and tulobuterol, with varying levels of clinical trial support and regulatory approval.
Purpose of the Study:
- To review the current state and challenges of transdermal drug delivery in pediatric populations.
- To highlight existing transdermal formulations and novel delivery systems being investigated for pediatric use.
- To address the specific difficulties in formulating transdermal treatments for premature neonates.
Main Methods:
- Literature review of transdermal drug delivery systems in pediatrics.
- Analysis of approved and investigational transdermal patches and devices.
- Examination of skin barrier development and its implications for transdermal absorption in neonates.
Main Results:
- Several transdermal patches are available for pediatric use, some with specific labeling and others used off-label.
- Innovative methods like microneedles, sonophoresis, needleless injectors, and iontophoresis are under investigation.
- Premature neonates present unique challenges due to their immature skin barrier, leading to a lack of approved transdermal formulations and a high risk of excessive drug exposure.
Conclusions:
- Transdermal drug delivery is a valuable modality for pediatric patients, but formulation and safety considerations differ significantly between neonates and older children.
- Further research and development are needed to create safe and effective transdermal formulations for premature infants.
- Addressing the unique physiological characteristics of neonatal skin is crucial for advancing transdermal therapeutics in this vulnerable population.
Abstract:
Transdermal administration offers a non-invasive and convenient method for paediatric drug delivery. The competent skin barrier function in term infants and older children limits both water loss and the percutaneous entry of chemicals including drugs; but the smaller doses required by children eases the attainment of therapeutic concentrations. Transdermal patches used in paediatrics include fentanyl, buprenorphine, clonidine, scopolamine, methylphenidate, oestrogens, nicotine and tulobuterol. Some patches have paediatric labelling supported by clinical trials whereas others are used unlicensed. Innovative drug delivery methods, such as microneedles and sonophoresis are being tested for their safety and efficacy; needleless injectors are primarily used to administer growth hormone; and two iontophoretic devices were approved for paediatrics. In contrast, the immature and rapidly evolving skin barrier function in premature neonates represents a significant formulation challenge. Unfortunately, this population group suffers from an absence of approved transdermal formulations, a shortcoming exacerbated by the significant risk of excessive drug exposure via the incompletely formed skin barrier.
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