Dual-responsive lidocaine in situ gel reduces pain of intrauterine device insertion.

Abstract:

:The most effective and safe contraceptive method, intrauterine devices (IUDs), is still underutilized due to the pain barrier during IUD insertion. Lidocaine, a well-known local anesthetic, can be used to relieve IUD insertion pain. This study aimed at formulation, in vitro, in vivo and clinical evaluation of a novel lidocaine dual-responsive in situ gel. Pluronic and Gelrite® were used as thermosenstive and ion-activated polymers, respectively. In situ gels containing 2% lidocaine, pluronics and/or Gelrite® were prepared. The optimized dual-responsive formula (F5) was clear, with 95% drug content, free flowing at room temperature and gel at vaginal temperature (Tgel of 28 °C). This optimized dual-responsive in situ gel was found to be superior to single-responsive one due to presence of Gelrite®, imparting resistance to dilution effect of simulated vaginal fluids. DSC thermograms revealed no interaction between formulation components. Biocompatibility study showed no degeneration, necrosis or inflammation. Optimized dual-responsive in situ gel was further evaluated for pain reduction efficiency via a pilot randomized, double-blinded, placebo-controlled clinical trial showing ease of self-administeration by patients and significant pain reduction induced at all steps of IUD insertion. In conclusion, lidocaine dual-responsive in situ gel can be effectively used in prevention of pain during IUD insertion.

journal_name

Int J Pharm

authors

Abd Ellah NH,Abouelmagd SA,Abbas AM,Shaaban OM,Hassanein KMA

doi

10.1016/j.ijpharm.2018.01.033

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

279-286

issue

1-2

eissn

0378-5173

issn

1873-3476

pii

S0378-5173(18)30052-8

journal_volume

538

pub_type

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