Effects of hydrotropic agents on the solubility, precipitation, and protein binding of etoposide

Etoposide, a commonly used anticancer agent, has an aqueous solubility of 0.2 mg/mL. It is formulated for intravenous use as a more concentrated solution (Vepesid; 20 mg/mL) with polysorbate 80 and with cosolvents. In this work, hydrotropic agents such as sodium benzoate, sodium o-hydroxybenzoate (sodium salicylate), sodium 2,5-dihydroxybenzoate (sodium gentisate), and the sodium salts of 2,4-dihydroxy- and 2,6-dihydroxybenzoic acid and of 2,4,6-trihydroxybenzoic acid have been used as alternative solubilizers of etoposide. The weakest and strongest interactants with etoposide were, respectively, sodium benzoate and sodium 2,4,6-trihydroxybenzoate. The effect of mono- and dihydroxybenzoates on etoposide solubility was intermediate. Although sodium 2,4,6-trihydroxybenzoate is the most efficient solubilizer, its use is limited by its own low aqueous solubility. The effect of sodium salicylate and other formulation ingredients on the in vitro protein binding and precipitation of etoposide upon dilution with normal saline and human plasma has been studied. Etoposide binds to the extent of 94% to human serum albumin (HSA) and human plasma, but only 24% to bovine serum albumin (BSA) in vitro. Sodium salicylate significantly decreased the binding of the drug to both HSA and human plasma, whereas the components of Vepesid did not. Dilution of Vepesid (1:2 and 1:3) with plasma in vitro resulted in immediate precipitation, while the corresponding dilutions of etoposide aqueous solution (20 mg/mL in 2 M sodium salicylate) produced no precipitate for the first hour.