Bioimpacts. 2018;8(4): 305-320.
doi: 10.15171/bi.2018.33
PMID: 30397585
PMCID: PMC6209825
Scopus ID: 85056076769
WOSID: 000452805700008
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Recent advances in improving oral drug bioavailability by cocrystals  

Shahram Emami 1,2, Mohammadreza Siahi-Shadbad 3, Khosro Adibkia 4 ORCID logo, Mohammad Barzegar-Jalali 5 *

1 Drug Applied Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
2 Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Pharmaceutical and Food Control, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
4 Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
5 Biotechnology Research Center, and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
*Corresponding author: Mohammad Barzegar-Jalali, Email: mahbarja@gmail.com


Introduction: Oral drug delivery is the most favored route of drug administration. However, poor oral bioavailability is one of the leading reasons for insufficient clinical efficacy. Improving oral absorption of drugs with low water solubility and/or low intestinal membrane permeability is an active field of research. Cocrystallization of drugs with appropriate coformers is a promising approach for enhancing oral bioavailability.

Methods: In the present review, we have focused on recent advances that have been made in improving oral absorption through cocrystallization. The covered areas include supersaturation and its importance on oral absorption of cocrystals, permeability of cocrystals through membranes, drug-coformer pharmacokinetic (PK) interactions, conducting in vivo-in vitro correlations for cocrystals. Additionally, a discussion has been made on the integration of nanocrystal technology with supramolecular design. Marketed cocrystal products and PK studies in human subjects are also reported.

Results: Considering supersaturation and consequent precipitation properties is necessary when evaluating dissolution and bioavailability of cocrystals. Appropriate excipients should be included to control precipitation kinetics and to capture solubility advantage of cocrystals. Beside to solubility, cocrystals may modify membrane permeability of drugs. Therefore, cocrystals can find applications in improving oral bioavailability of poorly permeable drugs. It has been shown that cocrystals may interrupt cellular integrity of cellular monolayers which can raise toxicity concerns. Some of coformers may interact with intestinal absorption of drugs through changing intestinal blood flow, metabolism and inhibiting efflux pumps. Therefore, caution should be taken into account when conducting bioavailability studies. Nanosized cocrystals have shown a high potential towards improving absorption of poorly soluble drugs.

Conclusions: Cocrystals have found their way from the proof-of-principle stage to the clinic. Up to now, at least two cocrystal products have gained approval from regulatory bodies. However, there are remaining challenges on safety, predicting in vivo behavior and revealing real potential of cocrystals in the human. 

Keywords: Bioavailability, Cocrystal, Oral absorption, Permeability, Pharmacokinetic, Poorly soluble drug
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Submitted: 03 Jan 2018
Revision: 04 May 2018
Accepted: 05 May 2018
ePublished: 31 May 2018
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