3D printed bilayer mucoadhesive buccal film of estradiol: Impact of design on film properties, release kinetics and predicted in vivo performance

Despite being an effective therapy for menopausal symptoms, the use of oral estrogen is associated with low bioavailability and serious adverse effects of venous thromboembolism. Individualized therapy has been recommended to maximize benefits and curb the adverse effects, but much has not been done in developing formulations that offer flexibility to personalize therapy. In the present study, we employed an innovative 3D printing technology to design and develop bi-layered estradiol film with different infill patterns with an aim of improving bioavailability and facilitating personalized treatment. Hydroxypropyl cellulose (HPC-H) based formulation exhibited suitable rheological properties and was used as a feedstock to fabricate estradiol films with different infill patterns namely honeycomb, rectangular and plain. The back layer was prepared from a hydroxyethyl cellulose-based formulation. The resulting films were subsequently characterized in terms of their physicochemical, mechanical, environmental impact, and release characteristics among others. Films with a plain infill pattern exhibited significantly higher % elongation break and tensile strength. The in vitro drug release study revealed the fastest drug release profile for rectangular infill (96 % within 4 h) and the slowest drug release was observed for the plain infill pattern (similar to 35 % within 4 h), highlighting the effect of the infill pattern on release kinetics. Films with honeycomb infill patterns were selected for further characterization based on mechanical and in vitro release properties. No interaction between components of the formulation was observed and the absence of crystallinity in the final product was confirmed by Differential Scanning Calorimetry (DSC) and X-Ray Powder Diffraction analyses (XRD). The force of adhesiveness for the film was 0.13 +/- 0.03 N. The predicted AUC 0-4 h, C-max, and T-max were 144.85 ngM/mL, 65.97 ng/mL, and 0.83 h for a film (honeycomb infill pattern) loaded with 1 mg of estradiol. The printing process of films with honeycomb and rectangular infill patterns was evaluated as "green" using the index of Greenness Assessment of Printed Pharmaceuticals (iGAPP) tool. Our finding demonstrates the development of bi-layered estradiol film using Pressure assisted microsyringe (PAM) 3D printing and the influence of infill patterns on release kinetics and mechanical properties. The fabricated film not only facilitates the move towards personalized medicine but could also improve the bioavailability of the drugs by bypassing the hepatic first-pass metabolism and decreasing wash-out by the saliva.