Skip to main content

Considerations for Topical and Transdermal Drug Delivery in Older Adults

  • Chapter
  • First Online:
Book cover Developing Drug Products in an Aging Society

Part of the book series: AAPS Advances in the Pharmaceutical Sciences Series ((AAPS,volume 26))

Abstract

The transdermal delivery of drugs to the systemic circulation is an established route of drug administration for a variety of small molecules. Transdermal drug delivery is characterized by constant plasma profiles through zero-order drug release for up to several days, the circumvention of the first-pass metabolism as well as its noninvasive alternative to oral dosing. Several drugs have been developed for chronic or acute conditions affecting older adults like for example pain, M. Alzheimer and M. Parkinson. Transdermal drug delivery offers some key advantages for the treatment of older adults, but also requires special attention when prescribed to older patients taking into account the individual risk–benefit profile. This chapter is intended to provide a short overview on transdermal drug delivery with the focus on older patients and reviews the major transdermal drug delivery products.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Al-Tawil N, Odar-Cederlöf I, Berggren A-C, Johnson HE, Perrson J. Pharmacokinetics of transdermal buprenorphine patch in the elderly. Eur J Clin Pharmacol. 2013;69:143–9.

    Article  CAS  PubMed  Google Scholar 

  2. Barrios V, Fernandez E, Campuzano R, Pena G et al. Tolerability and efficiency of a new transdermic nitroglycerin patch in outpatients with chronic stable angina. The PATRICH trial. Rev Clin Esp 2002;202(7): 379–84.

    Google Scholar 

  3. Callejo Melgosa AM, Martínez JC, Fuentes MJ, Martín C. Allergic contact dermatitis from buprenorphine. Allergy. 2005;60:1217–78.

    Article  CAS  PubMed  Google Scholar 

  4. Duragesic FDA leaflet. 2003. http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/19813s039lbl.pdf.

  5. Edens C, Collins ML, Goodson JL, Rota PA, Prausnitz MR. A microneedle patch containing measles vaccine is immunogenic in non-human primates. Vaccine. 2015;33(37):4712–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Farage MA, Miller KW, Elsner P, Maibach HI. Structural characteristics of the aging skin: a review. Cutan Ocul Toxicol. 2007;26:343–57.

    Article  PubMed  Google Scholar 

  7. Farage MA, Miller KW, Maibach HI. Degenerative changes in aging skin. In: Farage MA, Miller KW, Maibach HI, editors. Textbook of aging skin. Berlin, Heidelberg: Spinger; 2010. p. 23–35.

    Google Scholar 

  8. Garibyan L, Chiou AS, Elmariah SB. Advanced aging skin and itch: addressing an unmet need. Dermatol Ther. 2013;26:92–103.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gecici O, Gokmen Z, Nebioglu M. Fentanyl dependence caused by the non-medical use: a case report. Bull Clin Psychopharmacol. 2010;20(3):255–7.

    Google Scholar 

  10. Ghadially R, Brown BE, Sequeira-Martin SM, Feingold ER, Elias PM. The aged epidermal permeability barrier. Structural, functional, and lipid biochemical abnormalities in humans and a senescent murine model. J Clin Invest. 1995;95:2281–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Giladi N, Boroojerdi B, Korczyn AD, Burn DJ, Clarke CE, Schapira AHV. Rotigotine transdermal patch in early Parkinson’s disease: a randomized, double-blind, controlled study versus placebo and ropinirole. Mov Disord. 2007;22(16):2398–404.

    Article  PubMed  Google Scholar 

  12. Gratieri T, Aberti I, Lapteva M, Kalia YN. Next generation intra- and transdermal therapeutic systems: using non- and minimally-invasive technologies to increase drug delivery into and across the skin. Eur J Pharm Sci. 2013;50:609–22.

    Article  CAS  PubMed  Google Scholar 

  13. Grove GL. Physiologic changes in older skin. Clin Geriatr Med. 1989;5:115–25.

    CAS  PubMed  Google Scholar 

  14. Grundmann S, Ständer S. Evaluation of chronic pruritus in older patients. Aging Health. 2010;6:53–66.

    Article  Google Scholar 

  15. Hadgraft J, Lane ME. Skin permeation: the years of enlightment. Int J Pharm. 2005;305(1–2):2–12.

    Article  CAS  PubMed  Google Scholar 

  16. Hajek P, McRobbie H, Gillison F. Dependence potential of nicotine replacement treatments: effects of product type, patient characteristics, and cost to user. Prev Med. 2007;44(3):230–4.

    Google Scholar 

  17. Jackson SM, Williams ML, Feingold KR, Elias PM. Pathobiology of the stratum corneum. West J Med. 1993;158:279–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Jia Q, Nash JF. Pathology of aging skin. In: Farage MA, Miller KW, Maibach HI, editors. Textbook of aging skin. Berlin, Heidelberg: Spinger; 2010. p. 275–91.

    Google Scholar 

  19. Kaestli LZ, Wasilewski-Rasca AF, Bonnabry P, Vogt-Ferrier F. Use of transdermal drug formulation in the elderly. Drug Aging. 2008;2594:269–80.

    Article  Google Scholar 

  20. Khavkin J, Ellis DA. Aging skin: histology, physiology, and pathology. Facial Plast Surg Clin North Am. 2011;19:229–34.

    Article  PubMed  Google Scholar 

  21. Kogan A, Garti N. Microemulsions as transdermal drug delivery vehicles. Ad Colloid Interface Sci. 2006;123–126:369–85.

    Article  Google Scholar 

  22. Kuhlman JJ, McCaulley R, Valouch TJ, Behonick GS. Use, misuse, and abuse: a summary of 23 postmortem cases. J Analyt Toxicol. 2003;27:499–504.

    Article  CAS  Google Scholar 

  23. Lampert A, Seiberth J, Haefeli WE, Seidling HM. A systematic review of medication administration errors with transdermal patches. Expert Opin Drug Saf. 2014;12:1–14.

    Google Scholar 

  24. Lasry A, Ben-Neriah Y. Senescence-associated inflammatory responses: aging and cancer perspectives. Trends Immunol. 2015;36(4):217–28.

    Article  CAS  PubMed  Google Scholar 

  25. Lövborg H, Holmlund M, Hägg S. Medication errors related to transdermal opioid patches: lessons from a regional incident reporting system. BMC Pharmacol Toxicol. 2014;15:31.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Makrantonaki E, Zouboulis CC, William J. Characteristics and pathomechanisms of endogeneously aged skin. Dermatology. 2007;214:352–69.

    Article  PubMed  Google Scholar 

  27. Moser K, Kriwet K, Naik A, Kalia YN, Guy RH. Passive skin penetration enhancement and ist quantification in vitro. Eur J Pharm Biopharm. 2001;52:103–12.

    Article  CAS  PubMed  Google Scholar 

  28. Neerken S, Lucassen GW, Bisschop MA, Lenderink E, Nuijs TA. Characteriszation of age related effects in human skin: a comprehensive study that applies confocal laser scanning microscopy and optical coherence tomography. J Biomed Opt. 2004;9:274–81.

    Article  PubMed  Google Scholar 

  29. Pastore MN, Kalia YN, Hosrtmann M, Roberts MS. Transdermal patches: history, development and pharmacology. Br J Pharmacol. 2015;172:2179–209.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Perez-Perez L, Cabanillas M, Loureiro M, et al. Allergic contact dermatitis due to transdermal buprenorphine. Contact Dermatitis. 2008;58:310–2.

    Article  PubMed  Google Scholar 

  31. Prausnitz MR, Mitragotri S, Langer R. Current and future potential of transdermal drug delivery. Nature Rev Drug Del. 2004;3:115–24.

    Article  CAS  Google Scholar 

  32. Quan T, Fisher GJ. Role of age associated alterstions of the dermal extracellular matrix microenvironment in human skin aging: a mini review. Gerontology. 2015;61:427–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Riegelman S. Pharmacokinetics. Pharmacokinetic factors affecting epidermal penetration and percutaneous absorption. Clin Pharmacol Ther. 1974;16:873–83.

    Article  CAS  PubMed  Google Scholar 

  34. Rohr UD, Nauert C, Stehle B. 17Beta-estradiol delivered by three different matrix patches 50 microg/day: a three way cross-over study in 21 postmenopausal women. Maturitas. 1999;33(1):45–58.

    Article  CAS  PubMed  Google Scholar 

  35. Roubenoff R, Harris TB, Abad LW, Wilson PWF, Dallel GE, Dinarello CA. Monocyte cytokine production in an elderly population: effect of age and inflammation. J Gerontol Med Sci. 1998;53A(1):M20–6.

    Article  Google Scholar 

  36. Shiffman S, Hughes J, Pillitteri J, Burton S. Persistent use of nicotine replacement therapy: an analysis of actual purchase patterns in a population based sample. Tob Control. 2003;12(3):310–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Shin J-H, Park J-K, Lee D-H, Song C-S, Kim Y-C. Microneedle vaccination elicits superior protection and antibody response over intranasal vaccination against swine-origin influenza A (H1N1) in mice. PLoS ONE. 2015;10(6):e0130684.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Schmid-Grendelmeier P, Pokorny R, Gasser U, Richarz U. A comparison of the skin irritation potential of transdermal fentanyl versus transdermal buprenorphine in middle-aged to elderly healthy volunteers. Curr Med Res Opin. 2006;22:501–9.

    Article  CAS  PubMed  Google Scholar 

  39. Sanford M, Scott LJ. Rotigotine transdermal patch. CNS Drugs. 2011;25(8):699–719.

    Article  CAS  PubMed  Google Scholar 

  40. Taggart W, Dandekar K, Notelovitz M (2000) The effect of site of application on the transcutaneous absorption of 17-beta-estradiol from a transdermal delivery system (Climara). Menopause 7:364–9.

    Google Scholar 

  41. Tharp AM, Winecker RE, Winston DC. Fatal intravenous fentanyl abuse: four cases involving extraction of fentanyl from transdermal patches. Am J Forensic Med Pathol. 2004;25(2):178–81.

    Article  PubMed  Google Scholar 

  42. US Safety briefs FentaNYL patches fatalities linked to bystander apathy. We all have a role in prevention. J Pharm Pract Res. 2013;43(4): 300–1.

    Google Scholar 

  43. Voigt I. Fatal overdose due to confusion of a transdermal fentanyl delivery system. Case reports in critical care. 2013;2013(154143);3 pp.

    Google Scholar 

  44. Watkoinson AC. Transdermal and topical drug delivery today. In: Benson HA, Watkinson AH, editors. Topical and transdermal drug delivery—principles and practice. Hoboken, NJ: Wiley & Sons Inc; 2012. p. 357–66.

    Google Scholar 

  45. Wiedersberg S, Guy RH. Transdermal drug delivery: 30 + years of war and still fighting! J Contr Rel. 2014;190:150–6.

    Article  CAS  Google Scholar 

  46. Winblad B, Machado JC. Use of rivastigmine transdermal patch in the treatment of Alzheimer’s disease. Exp Opin Drug Del. 2008;5(12):1377–86.

    Article  CAS  Google Scholar 

  47. Wohlrab J, Hilpert K, Wohlrab A. Besonderheiten der Altershaut. Hautarzt. 2014;65:911–21.

    Article  CAS  PubMed  Google Scholar 

  48. Woodall KL, Martin TI, McLellan BA Oral abuse of fentanyl patches (Duragesic): seven case reports. 2008.

    Google Scholar 

Download references

Acknowledgments

I would like to thank Michael Horstmann, Transdermalpharma UG, Neuwied (Germany) for his contributions and support to this chapter.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sven Stegemann .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 American Association of Pharmaceutical Scientists

About this chapter

Cite this chapter

Stegemann, S. (2016). Considerations for Topical and Transdermal Drug Delivery in Older Adults . In: Stegemann, S. (eds) Developing Drug Products in an Aging Society. AAPS Advances in the Pharmaceutical Sciences Series, vol 26. Springer, Cham. https://doi.org/10.1007/978-3-319-43099-7_17

Download citation

Publish with us

Policies and ethics