Evaluation of Ease of Use for Pediatric Medications Requiring Decapsulation, Dissolution, or Partial Dosing: A...

Solid dosage forms such as fine granules, mini-tablets, and micropellets are gaining popularity worldwide because of their longer shelf lives, lower need for preservatives, and precise dosing compared to liquids. However, international pediatric formulations are often liquids or powders, and it is unclear whether these offer advantages over single-dose packaging, which is used in Japan, for caregiver management, preparation, administration, and cleanup. The acceptability of solid forms that require extra preparation, such as decapsulation, weighing dissolved powders, or taking partial doses, remains uncertain. This study evaluated the acceptability and usability of new dosage forms that involve caregiver preparation.

From April 2024 to November 2025, a survey was conducted among parents and caregivers of pediatric patients aged 0-18 years visiting the National Center for Child Health and Development. The survey focused on formulations involving opening capsules, preparing suspensions, and administering partial doses. Four model formulations were selected and evaluated: tacrolimus capsules (A), mycophenolic acid powder (B), valganciclovir dry syrup (C), and desmopressin oral disintegrating tablets (D). Respondents rated management, preparation, administration, and cleanup on an 11-point scale (- 50 to + 50) compared to conventional powders. Descriptive statistics and 95% confidence intervals were used.

A total of 312 responses were analyzed. The median patient age ranged from 3.6 to 4.6 years. Tacrolimus (A) scored highest for management but lowest for preparation. Mycophenolate mofetil (B) was considered burdensome for management and cleanup, though it was easy to administer. Valganciclovir (C) showed similar trends, with storage challenges. Desmopressin (D) was easy to manage but difficult to prepare and administer. While managing capsules and tablets was seen as convenient, the complexity of decapsulation and dissolving tablets for administration was noted. Dissolution powders indicated potential management difficulties.

Dissolution suspension forms were viewed as more challenging to manage than powders. Preparation and administration were burdensome for all, especially those requiring dissolution and partial dosing. Caregiver-friendly designs are ideal, but establishing the infrastructure for timely delivery and acceptance in clinics is essential.