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Biomedical subjects

D R Friend

Publications and source records attributed to D R Friend.

At least 19 recordsLinked to original sources

Guar gum-based sustained release diltiazem.

PURPOSE: This study was performed to examine the use of guar gum to sustain the release of diltiazem under in vitro and in vivo conditions. METHODS: Guar gum tablet formulations were prepared and evaluated under a variety of in vitro dissolution conditions. The formulations, along with Dilacor XR, were administered to a group eight fasted, healthy volunteers in a four period crossover study. RESULTS: Varying the lot of guar gum as well as using guar from different suppliers had little effect on diltiazem dissolution. Also, dissolution of diltiazem from guar gum tablets was essentially independent of stir speed under normal conditions (USP Apparatus II) The stability of guar-based formulations under stressed conditions (40 degrees C/75% relative humidity for 3 months) was also established. All four formulations gave similar plasma concentrations over time in the healthy volunteers pharmacokinetic study. CONCLUSIONS: Guar gum-based matrix tablets represent a simple and economical alternative to existing diltiazem sustained release dosage forms.

Antihypertensive Agents↗

Review article: issues in oral administration of locally acting glucocorticosteroids for treatment of inflammatory bowel disease.

Inflammatory bowel diseases are treated in some cases by local administration of anti-inflammatory drugs. Local delivery of drugs in the colon following oral administration may lead to improved efficacy/side-effect profiles and may improve patient compliance. This review covers a number of issues important in the design of oral delivery systems of glucocorticosteroids for local therapy of colonic inflammation. The choice of specific glucocorticosteroids is based on the drug's physicochemical and pharmacological properties. The conditions under which an orally administered glucocorticosteroid (or other drug) must be delivered to treat ulcerative colitis are also discussed. These conditions include variations in local pH, transit throughout the gastrointestinal tract, the potential role of gut microflora, and drug dissolution in both the healthy and diseased large intestine. The effective delivery of topically-active glucocorticosteroids in ulcerative colitis and Crohn's colitis patients is complex, but if successful could improve their usefulness.

Administration, Oral↗

Optimization of sustained-release diltiazem formulations in man by use of an in-vitro/in-vivo correlation.

In-vitro/in-vivo correlations (IVIVC) are useful for predicting in-vivo results from in-vitro data. An IVIVC has been used to optimize a hydrocolloidal-based matrix tablet designed to be bioequivalent to an existing once-daily diltiazem HC1 product (Dilacor XR 240mg; Rhone-Poulenc Rorer). Data from a preliminary formulation dosed to fasted and fed subjects were used to establish the IVIVC. The correlation was then used during reformulation of the dosage forms to predict changes in the maximum plasma concentration (Cmax) and the area under the plasma-concentration-time curve (AUC) for fasted and fed subjects using in-vitro dissolution data. The IVIVC adequately predicted plasma profiles of two optimized formulations in studies with fasted and fed subjects.

Cardiovascular Agents↗

Purified guar galactomannan as an improved pharmaceutical excipient.

The purpose of this study was to assess certain pharmaceutical attributes of guar galactomannan, a hydrocolloid polysaccharide obtained from the endosperm of the leguminous plant Cyamopsis tetragonolobus (L.), following purification using both literature procedures and new processes. Experiments were performed to measure viscosity, hydration rate, tablet hardness, and dissolution profiles of guar galactomannan both before and after purification. The viscosity of an aqueous 1% purified galactomannan solution is typically 40-50% higher than its unpurified guar galactomannan precursor. The hydration rate of an aqueous 1% purified galactomannan solution increases by 100% after purification. These physicochemical changes resulted in improvements in pharmaceutical properties such as better stir speed independence in both tablet and capsule dissolution profiles and improved tablet hardness. For instance, time to 50% dissolution of ranitidine HCl from capsules containing unpurified guar gum was 0.4 and 1.8 hr at 20 and 40 rpm, respectively, using USP Apparatus II. Using the same amount of purified guar gum and the same conditions (20 and 40 rpm), these values were increased to 2.9 and 3.8 hr, respectively. These data demonstrate a reduced effect of changing agitation conditions and the need for less guar gum to sustain the release of a water-soluble drug. Tablet hardness of purified guar gum (particle size < 75 microns) was about 7 kP and the same unpurified guar gum of equal particle size and hydration gave a hardness of less than 1 kP.

Excipients↗

Steady-state pharmacokinetics of corticosteroid delivery from glucuronide prodrugs in normal and colitic rats.

Ulcerative colitis and Crohn's colitis are chronic intestinal diseases usually treated with various nonsteroidal antiinflammatory agents to maintain remission. Corticosteroids, while useful in acute treatment of these diseases, present side-effects generally too serious to allow maintenance therapy. Colon-specific drug delivery may permit use of corticosteroids for maintenance therapy if doses can be reduced while maintaining efficacy. In this study, two prodrugs (dexamethasone-beta-D-glucuronide (DXglrd) and budesonide-beta-D-glucuronide (BUDglrd)) were administered by intragastric (i.g.) infusion to conventional and colitic rats. In addition, dexamethasone (DX) and budesonide (BUD) were administered either i.g. or subcutaneously (s.c.) to healthy and colitic rats. Colon-specific delivery was assessed using the drug delivery index (DDI). In conventinal rats, DDIs for DXglrd ranged from about five to as high as 11 in the luminal contents relative to DX administered sc or i.g. DDI values were also elevated in the mucosa of both healthy and colitic rats following i.g. administration of DXglrd. BUD was delivered somewhat less effectively from BUDglrd to the rat large intestine than was DX from DXglrd. The data are consistent with efficacy studies and support the conclusion that local delivery of corticosteroids to the large intestine is due, at least in part, to higher levels of drug delivery into the mucosal tissues.

Animals↗

Colonic delivery of dexamethasone: a pharmacoscintigraphic evaluation.

BACKGROUND: Colonic delivery of corticosteroids may reduce the side-effects commonly associated with their use. Therefore, we tested the ability of the naturally occurring polysaccharide guar gum to deliver a corticosteroid, dexamethasone, to the colon using pharmacoscintigraphy. Guar gum is metabolized in the colon by resident bacterial enzymes to trigger drug release. MATERIALS: Each subject (eight per group, parallel study design) was administered one of four dexamethasone (9 mg) tablet formulations, radiolabelled with 153Sm using neutron activation, under fasted conditions. One formulation was designed to release drug rapidly following ingestion while the other three formulations were designed to delay release of dexamethasone to varying degrees. Progression of the formulations down the gastrointestinal tract was followed by gamma scintigraphy. Serum concentrations were measured over time to relate disintegration profiles of the tablets with pharmacokinetic observations. RESULTS: The immediate release formulation disintegrated in the stomach, on average, within 20 min of dosing. One of the three delayed release preparations (CD1) began to disintegrate in the small intestine 1.7 +/- 1.0 h after dosing. The second and third delayed release preparations (CD2 and CD3) did not begin to disintegrate until 5.8 +/- 2.3 and 3.6 +/- 1.6 h after dosing, respectively. All three colonic delivery preparations completely disintegrated in the colon ranging from 7.8 +/- 2.7 h (CD1) to 12.4 +/- 3.2 h (CD2) following oral administration. Pharmacoscintigraphic data indicated that 72-82% of the dexamethasone was delivered into the colon although not all the dexamethasone delivered into the colon was absorbed. CONCLUSIONS: Simple guar gum formulations are capable of delivering the corticosteroid dexamethasone to the colon of normal subjects. Locally delivered corticosteroids may be useful in the treatment of ulcerative colitis and Crohn's disease. Pharmacoscintigraphic evaluation is a useful method to discriminate between the in vivo behaviour of colonic delivery systems.

Adult↗

Increased permeability occurs in rat ileum following induction of pan-colitis.

Acetic acid-induced pan colitis in rats leads not only to colonic injury but also to a bystander ileal injury, characterized by decreased fluid and electrolyte absorption without associated histological injury or infiltration of inflammatory cells. To examine the nature of this decreased ileal fluid and electrolyte absorption, we measured effect of acetic acid-induced pancolitis on ileal transmural sodium and chloride transport, as well as on ileal permeability to mannitol and inulin on mucosal sheets mounted in Ussing chambers. In addition, ileal tight junctional morphology was assessed by electron microscopy. In colitic animals, ileal serosal-to-mucosal sodium and chloride transmural fluxes were increased (P<0.05); compatible with the observed decrease in net fluid absorption. Mannitol and inulin ileal serosal-to-mucosal and mucosal-to-serosal ileal fluxes were similarly increased (P<0.05), suggesting that an increase in ileal permeability occurred during acetic acid-induced pancolitis. This increase in ileal permeability was not accompanied by changes in tight junctional ultrastructure. These results suggest that: (1) the decrease in ileal fluid and electrolyte absorption seen during acetic acid-induced rat pancolitis occurred in parallel with a rise in both transcellular and paracellular permeability, and (2) the ileal permeability changes were not accompanied by structural changes.

Animals↗

Budesonide-beta-D-glucuronide: a potential prodrug for treatment of ulcerative colitis.

Budesonide-beta-D-glucuronide is a potentially useful orally administered prodrug for the treatment of colonic inflammatory bowel disease. Budesonide is a topically active glucocorticosteroid that exhibits low oral bioavailability (15%) in humans and laboratory animals. Oral delivery of budesonide to the inflamed tissues of the large intestine as its glucuronide prodrug should lead to locally high concentrations of active drug. Following liberation and absorption of the active drug, a large portion should be inactivated due to hepatic metabolism. Budesonide-beta-D-glucuronide was chemically stable in solutions at pHs of 1.5, 4.5, 6.5, and 7.4 at 37 degrees C. The enzymatic lability of the prodrug was assessed in luminal contents and mucosa obtained from conventional, germ-free, and colitic rats under in vitro conditions. There was a substantial change in glycosidase activity between the small intestine (proximal and distal portions) and the cecum in both conventional and colitic rat luminal contents. Luminal hydrolytic activity was low along the entire rat gastrointestinal tract of germ-free rats. Mucosal glycosidase activity was relatively low along the entire gastrointestinal tract of all three types of rats. The hydrolysis of prodrugs budesonide-beta-D-glucuronide and dexamethasone-beta-D-glucuronide in human fecal samples from patients with ulcerative colitis and normal volunteers was also measured. There were no statistically significant differences between the normal and colitic fecal samples for hydrolysis of the either prodrug or between the relative rates of hydrolysis of the two prodrugs. Hydrolysis rates of the prodrugs were about two orders of magnitude less in human fecal samples compared with those in cecal and colonic contents from the rat.

Animals↗

In vivo pharmacokinetic study for the assessment of poly(L-aspartic acid) as a drug carrier for colon-specific drug delivery.

Glucocorticoids remain one of the mainstays of therapy for acute attacks of inflammatory bowel disease despite systemic side effects that limit their use. Prodrugs that selectively deliver glucocorticoids to the colon may lower the required dose and side effects. Because enzymes of gut microflora are able to cleave certain peptide and ester bonds, the ability of an ester prodrug consisting of dexamethasone (DX) as model drug and poly(L-aspartic acid) (weight-average mol wt = 30,000) as drug carrier was investigated to selectively release the drug in the large intestine. Prodrug and drug solutions (1.18 mg DX/ml DMSO) were administered to two groups of male Sprague-Dawley rats by intragastric infusion using an ALZET osmotic pump. All rats were infused for sufficient time to achieve steady state in both blood and GI-tract tissues. DX concentrations in blood and tissue samples were measured with HPLC. The steady state DX concentrations at these sites were used to calculate a drug delivery index (DDI). DX blood concentrations were significantly lower (p < 0.05) after intragastric administration of the prodrug. Moreover, prodrug administration resulted in significantly higher DX concentrations in the cecum and colon mucosa and the cecum muscle tissue compared to DX administration (p < 0.05). The prodrug led to an increase of the DX concentration in the large intestinal tissues by factors of 1.3-2.0 and to an 1.3-fold decrease of DX blood concentrations. Thus, this novel conjugate should both increase efficacy and reduce toxicity to some extent.

Animals↗

Colonic delivery of dexamethasone from a prodrug accelerates healing of colitis in rats without adrenal suppression.

BACKGROUND/AIMS: Dexamethasone-beta-D-glucuronide, a colon-specific prodrug of dexamethasone, may be useful in the treatment of ulcerative colitis and Crohn's colitis. The aim of this study was to evaluate colonic delivery and efficacy of this prodrug in the rat. METHODS: Distribution of dexamethasone in luminal contents and tissues of the gastrointestinal tract and in plasma was measured after oral administration of dexamethasone-beta-D-glucuronide or free dexamethasone. Efficacy of the prodrug and free drug was tested in an acetic acid-induced rat colitis model. Healing of induced colitis was assessed by measuring net intestinal fluid absorption, colonic surface area of ulceration, histology, and myeloperoxidase activity. Glucocorticosteroid toxicity was evaluated with serum corticosterone and plasma adrenocorticotropic hormone levels. RESULTS: The drug delivery index (a measure of relative targeting efficiency) was 6.7 and 8.6 in the cecal and colonic mucosa, respectively. The prodrug was significantly more potent than free drug in improving net colonic fluid absorption while significantly reducing surface area of ulceration and histological grade in colitic rats. Treatment with free dexamethasone significantly reduced serum corticosterone levels to subnormal levels, and treatment with the prodrug maintained serum corticosterone and plasma adrenocorticotropic hormone levels near control levels. CONCLUSIONS: The prodrug dexamethasone-beta-D-glucuronide delivers efficacious amounts of dexamethasone to the large intestine from lower doses than free dexamethasone.

Adrenal Cortex↗

A novel colon-specific steroid prodrug enhances sodium chloride absorption in rat colitis.

A recently synthesized novel colon-specific dexamethasone prodrug, dexamethasone-beta-D-glucuronide, delivers efficacious amounts of dexamethasone to the colon with limited adrenal suppressive effects. During experimentally induced colitis in rats, the dexamethasone prodrug is significantly more potent than free dexamethasone in improving colonic fluid and electrolyte absorptive injury. The present studies examined whether the improvement in colonic absorption seen with the prodrug occurred as a consequence of alterations in sodium and chloride epithelial transport. The efficacy of the dexamethasone prodrug and free dexamethasone were tested in an acetic acid-induced rat model of colitis. Healing of the induced colitis was assessed by measuring net colonic fluid absorption and surface area ulceration. Transmural unidirectional fluxes of 22Na and 36Cl across sheets of colonic mucosa were measured in Ussing chambers. Treatment of colitis with the prodrug delivered a sixfold higher concentration of dexamethasone to the colon than did treatment with the free drug. The prodrug accelerated healing of colitis by returning in vivo colonic fluid absorption to normal and virtually eliminated colonic macroscopic ulceration, whereas the free drug did not. In vitro transmural fluxes demonstrated that, in addition to repair of mucosal integrity, the prodrug enhanced electroneutral sodium chloride absorption over and above that seen in control animals or after treatment with the free drug. Both the prodrug and the free drug limited theophylline-mediated net chloride and sodium secretion, an effect that would be consistent with the antidiarrheal effect induced by these drugs in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Glucocorticoid-dextran conjugates as potential prodrugs for colon-specific delivery: hydrolysis in rat gastrointestinal tract contents.

Chronic colitis, e.g., ulcerative colitis and Crohn's disease, is presently treated with glucocorticoids and other antiinflammatory agents. Side effects limit chronic glucocorticoid therapy. The dose, and consequently the side effects, may be reduced by using prodrugs that selectively deliver drug to the colon. We previously synthesized glucocorticoid-dextran conjugates in which dexamethasone and methylprednisolone were attached to dextran (weight-average molecular weight = 72,600) using dicarboxylic acid linkers (succinate and glutarate). In the present study, the hydrolysis kinetics of the hemiesters (hemiester = glucocorticoid+linker) and dextran conjugates were determined after incubation at 37 degrees C in diluted luminal contents of the gastrointestinal (GI) trace of male Sprague-Dawley rats. The hemiesters were rapidly hydrolyzed in the proximal small intestine (e.g., dexamethasone-hemiglutarate t1/2 = 0.5 h). This rate decreased progressively down the GI tract (t1/2 = 4.8, 54, and 68 h in distal small intestine, cecum, and colon, respectively). The enzyme responsible for hemiester hydrolysis, apparently a type-A alkaline carboxylesterase, is probably of host origin because its activity is highest in the small intestine where bacterial count is low. The dextran conjugates resisted hydrolysis in upper GI tract contents but were rapidly degraded in cecal and colonic contents where the bacterial count is high. The dextran conjugate tested, methylprednisolone-succinate-dextran, was easily hydrolyzed by an endodextranase, indicating that substrate specificity is not lost upon the attachment of glucocorticoid. The results of this study indicate that dextran conjugates may be useful in selectively delivering glucocorticoids to the large intestine for the treatment of colitis.

Anaerobiosis↗

A glucocorticoid prodrug facilitates normal mucosal function in rat colitis without adrenal suppression.

BACKGROUND/AIMS: Glucocorticoids remain the foundation of therapy for acute ulcerative colitis despite systemic side effects that limit their use. Prodrugs that selectively deliver glucocorticoids to the colon may lower the required dose and side effects. The aim of this study was to assess the efficacy of a newly synthesized glucocorticoid-dextran prodrug. METHODS: Novel glucocorticoid-dextran prodrug conjugates in which dexamethasone and methylprednisolone were attached to dextran were synthesized using the dicarboxylic acid linkers, succinate and glutarate. The efficacy of the dextran prodrug conjugates and their free glucocorticoids was tested in an acetic acid-induced model of colitis. Repair of the colitis and mucosal function was assessed by measuring net intestinal fluid absorption, macroscopic ulceration, and myeloperoxidase activity. Glucocorticoid toxicity was evaluated by measuring plasma adrenocorticotropic hormone and serum corticosterone levels. RESULTS: The prodrug dexamethasone-succinate-dextran was nine times more potent and dexamethasone-glutarate-dextran three times more potent than free dexamethasone in accelerating mucosal repair. Similarly, methylprednisolone-succinate-dextran was four times more potent than free methylprednisolone. The dextran prodrug conjugates affected adrenocorticotropic hormone and corticosterone levels only at the highest doses in contrast to free dexamethasone and methylprednisolone, which caused marked adrenal suppression at all doses. CONCLUSIONS: The results show that recently synthesized glucocorticoid-dextran prodrug conjugates can be administered orally to facilitate mucosal repair in rat colitis without adrenosuppression.

Adrenal Glands↗

Menthol-beta-D-glucuronide: a potential prodrug for treatment of the irritable bowel syndrome.

Menthol-beta-D-glucuronide is a potential prodrug for colonic delivery of the spasmolytic agent menthol. Menthol is the primary constituent of peppermint oil, which is used to treat the irritable bowel syndrome. The chemical stability of menthol-beta-D-glucuronide was assessed at various pHs (1.5, 4.5, 6.0 and 7.4) over a 4 to 24 h period at 37 degrees C. The prodrug was stable, i.e., there was less than 0.1% hydrolysis of the prodrug, at pHs of 4.5, 6.0 and 7.4. At pH 1.5, the prodrug was about 20% hydrolyzed over a 4 h period suggesting the need for an enteric coating to prevent premature hydrolysis in the stomach. The stability of the prodrug was also assessed in luminal contents of the laboratory rat and in human stool samples. These studies were performed at concentrations designed to assess relative velocities of hydrolysis (i.e., substrate concentrations in excess of the Km). The prodrug was stable in luminal contents of the rat stomach, proximal small intestine, and the distal small intestine. The rate of hydrolysis of menthol-beta-D-glucuronide was 6.26 +/- 2.88 nmol min-1 mg-1 and 2.34 +/- 1.22 nmol min-1 mg-1 in luminal contents of the rat cecum and colon, respectively. The hydrolysis rate of menthol-beta-D-glucuronide was lower in human stool samples (0.52 +/- 0.46 nmol min-1 mg-1). The prodrug had a measured log octanol/buffer partition coefficient of -1.61 suggesting it should be poorly absorbed from the lumen of the gastrointestinal tract. The data support the hypothesis that menthol-beta-D-glucuronide is a candidate for the delivery of menthol to the large intestine under in vivo conditions.

Animals↗

A budesonide prodrug accelerates treatment of colitis in rats.

Although oral glucocorticoids are the treatment of choice for moderate to severe ulcerative pancolitis, their systemic side effects and adrenal suppression account for considerable morbidity. An oral glucocorticoid-conjugate (prodrug), budesonide-beta-D-glucuronide, which is not absorbed in the small intestine but is hydrolysed by colonic bacterial and mucosal beta-glucuronidase to release free budesonide into the colon was synthesised. The objective of this study was to compare treatment with budesonide-beta-D-glucuronide with treatment with free budesonide by examining: (1) the healing of experimental colitis and (2) the extent of adrenal suppression. Pancolitis was induced with 4% acetic acid. Animals were then randomised to receive oral therapy for 72 hours with (1) budesonide-beta-D-glucuronide, (2) free budesonide, or (3) vehicle. Drug efficacy and colitic healing was determined by measuring gross colonic ulceration, myeloperoxidase activity, and in vivo colonic fluid absorption. Adrenal suppression was determined by measuring plasma adrenocorticotrophic hormone and serum corticosterone. Vehicle-treated colitis animals had gross ulceration, increased myeloperoxidase activity, and net colonic fluid secretion. Treatment with oral budesonide-beta-D-glucuronide accelerated all measures of colitis healing at a fourfold lower dose than did free budesonide. Furthermore, treatment with budesonide-beta-D-glucuronide did not result in adrenal suppression whereas free budesonide treatment did. A newly synthesised orally administered glucocorticoid-conjugate accelerates colitis healing with limited adrenal suppression. Development of an orally administered colon-specific steroid delivery system represents a novel approach to inflammatory bowel disease treatment.

Acetates↗

Gastrointestinal parameters that influence oral medications.

The successful functioning of oral medication depends primarily on how the gastrointestinal (Gl) tract processes drugs and drug delivery systems. Parameters such as regional pH, motility (and hence residence time), and brush border and colonic microflora enzymatic activity play an important role in the performance of orally administered dosage forms. In addition, medications are required to treat disease states that alter normal functions of the body. This review (which summarizes the symposium of the same title undertaken in the 2nd Jerusalem Conference on Pharmaceutical Sciences and Clinical Pharmacology, Jerusalem, Israel, May 1992) focuses on two aspects: (1) how some physiological parameters of the intestine can be manipulated to achieve control over drug absorption (P. Bass: alteration of the paracellular space of enterocytes with glucose to modulate the passive movement of drugs; E. Ziv: intestinal absorption of insulin) and spatial placement of drugs (D.R. Friend: use of colonic beta-glucosidases to target glycoside prodrugs of steroids to the large bowel; A. Rubinstein: specific degradation of polysaccharide matrices by colonic bacteria); and (2) how abnormalities of the Gl tract affect drug performance (J.B. Dressman: physiological and pathophysiological changes in upper Gl tract pH may lead to alterations in drug bioavailability; W. A. Ritschel: influence of diseases on the pharmacokinetics of drugs).

Administration, Oral↗

In vitro evaluation of dexamethasone-beta-D-glucuronide for colon-specific drug delivery.

Dexamethasone-beta-D-glucuronide is a potential prodrug for colonic delivery of the antiinflammatory corticosteroid dexamethasone. Previous studies [T. R. Tozer et al., Pharm. Res. 8:445-454 (1991)] indicated that a glucoside prodrug of dexamethasone was susceptible to hydrolysis in the upper gastrointestinal tract. Resistance of dexamethasone-beta-D-glucuronide to hydrolysis in the upper gastrointestinal tract was therefore assessed. Conventional, germfree, and colitic rats were used to examine enzyme levels along the gastrointestinal tract to compare the stability of two model substrates (p-nitrophenyl-beta-D-glucoside and -beta-D-glucuronide) and to evaluate the prodrug dexamethasone-beta-D-glucuronide. Hydrolytic activity was examined in the luminal contents, mucosa, and underlying muscle/connective tissues in all three types of rats. Enzymatic activity (beta-D-glucosidase and beta-D-glucuronidase) was greatest in the lumen of cecum and colon of conventional rats. In contrast, germ-free rats exhibited relatively high levels of beta-D-glucosidase activity (about 80% of total activity in the conventional rats) in the proximal small intestine (PSI) and the distal small intestine (DSI). Rats with induced colitis (acetic acid) showed reduced levels of luminal beta-D-glucuronidase activity in the large intestine; however, beta-D-glucosidase activity was relatively unchanged relative to that of the conventional rat. Mucosal beta-D-glucuronidase activity was significantly lower in the colitic rats compared with that in the conventional animals. Despite reduced luminal levels of beta-D-glucuronidase activity in the colitic rats, there was still a sharp gradient of activity between the small and the large intestines. Permeability of the glucoside and glucuronide prodrugs of dexamethasone through a monolayer of Caco-2 cells was relatively low compared to that of dexamethasone. The results indicate that dexamethasone-beta-D-glucuronide should be relatively stable and poorly absorbed in the upper gastrointestinal tract. Once the compound reaches the large intestine, it should be hydrolyzed to dexamethasone and glucuronic acid. Specificity of colonic delivery in humans should be even greater due to lower levels of beta-D-glucuronidase activity in the small intestine compared with that in the laboratory rat.

Animals↗