Forgetfulness is one of the main barriers to medication compliance. Patients who have to take medications at multiple points throughout the day are more likely to forget a dose. While medication reminder systems and patient education play an important role in improving compliance, there’s a third solution: Make the medication last longer so the patient doesn’t need to take it as often.
Extended-release medications are designed to release a drug gradually over an extended period of time. Instead of providing an initial burst of relief that fades within a short time, the drug’s effects may be sustained until it’s time for the next dosage. There are two main ways in which extended-release drugs are formulated. The drug may be coated in a slow-dissolving membrane that controls or slows the rate at which the drug is released. Alternately, the drug may be mixed with a polymer and made into a tablet. When water gets into the tablet, the polymer swells and the drug dissolves and diffuses out of the tablet.
Extended-release drugs may improve patient compliance in several ways. It’s easier to remember to take a pill once a day than it is four times a day. Patients who would normally wake up in the middle of the night to take a traditional immediate-release pill could have uninterrupted sleep with a single-dose pill. Because the effects of an extended-release drug are designed to last longer instead of tapering off, patients may find the medicine to be more effective against symptoms such as pain.
Companies that manufacture controlled-release drugs include Elite Pharmaceuticals, maker of allergy and pain medications; Labopharm (DDSS), which offers once-daily formulations of the pain med tramadol and the antidepressant trazodone; Egalet, which has a pipeline of abuse-deterrent opioid pain medications; and CombinatoRx (CRXX). In March, CombinatoRx received FDA approval for the extended-release opioid painkiller Exalgo, which the company acquired following last year’s merger with biopharmaceutical company Neuromed. Covidien (COV) acquired the rights to Exalgo last year and will handle all marketing activities for the drug.