What is a Clonidine Patch TTS-3. How does it work for hypertension management. What are the potential side effects and precautions to consider. How to properly apply and use the Clonidine Patch TTS-3 for optimal results.

Understanding Clonidine Patch TTS-3: A Powerful Tool for Hypertension Management

Clonidine Patch TTS-3, also known as Catapres-TTS-3, is a transdermal medication system designed for the treatment of hypertension. This innovative drug delivery method offers a convenient and effective way to manage high blood pressure, providing a steady release of medication over an extended period.

What is Clonidine and How Does It Work?

Clonidine belongs to a class of medications called alpha-2 adrenergic agonists. It works by stimulating certain receptors in the brain, which leads to a decrease in heart rate and blood pressure. By utilizing a transdermal patch, the medication is delivered consistently through the skin, maintaining therapeutic levels in the bloodstream.

Proper Application and Usage of Clonidine Patch TTS-3

To ensure optimal effectiveness and minimize potential side effects, it’s crucial to understand the correct application and usage of the Clonidine Patch TTS-3.

How to Apply the Clonidine Patch TTS-3

1. Thoroughly clean and dry the application area.
2. Choose a hairless area on the upper outer arm or upper chest.
3. Remove the backing from the patch.
4. Apply the patch to the chosen area, pressing firmly for about 10 seconds.
5. Wash your hands after handling the patch.

The patch is typically worn for one week before being replaced. It’s essential to rotate the application site to prevent skin irritation and ensure consistent absorption.

Tips for Optimal Use

• Apply the patch to clean, dry skin free from oils, lotions, or other products.
• Avoid areas with broken or irritated skin.
• Do not apply the patch to skin folds where it may easily rub off.
• Use the adhesive cover provided if the patch begins to loosen.
• Replace the patch on the same day each week to maintain a consistent dosing schedule.

Potential Side Effects and Monitoring

While Clonidine Patch TTS-3 is generally well-tolerated, it’s important to be aware of potential side effects and know when to seek medical attention.

Common Side Effects

Some users may experience:

• Dizziness or lightheadedness
• Drowsiness
• Dry mouth
• Unusual tiredness
• Headache
• Mild redness, itching, or irritation at the application site

These side effects are often mild and may diminish as your body adjusts to the medication. However, if they persist or worsen, it’s important to consult your healthcare provider.

Serious Side Effects Requiring Immediate Attention

Seek medical help promptly if you experience:

• Fainting
• Slow or irregular heartbeat
• Significant mental or mood changes (e.g., irritability, depression)
• Signs of an allergic reaction (rash, itching, swelling, severe dizziness, difficulty breathing)

Precautions and Considerations for Clonidine Patch TTS-3 Use

Before starting treatment with Clonidine Patch TTS-3, it’s crucial to discuss your medical history and any current medications with your healthcare provider.

Medical Conditions to Consider

Inform your doctor if you have a history of:

• Kidney disease
• Heart problems
• Blood circulation issues
• Depression or other mental health conditions
• Allergies to adhesives or other medications

Medication Interactions

Clonidine may interact with other medications, potentially affecting their efficacy or increasing the risk of side effects. Be sure to disclose all medications you’re taking, including over-the-counter drugs and supplements.

Dosage and Administration Guidelines

The appropriate dosage of Clonidine Patch TTS-3 varies depending on individual factors such as medical condition and response to treatment.

Typical Dosing Schedule

The patch is usually worn for one week before being replaced. Your doctor will determine the most appropriate dosage based on your specific needs and may adjust it over time to achieve optimal blood pressure control.

Importance of Consistent Use

To maintain effective blood pressure management, it’s crucial to use the Clonidine Patch TTS-3 consistently as prescribed. Abrupt discontinuation can lead to a rapid rise in blood pressure and other potentially serious complications.

Managing Potential Complications and Withdrawal

While Clonidine Patch TTS-3 is an effective treatment for hypertension, it’s important to be aware of potential complications and proper discontinuation procedures.

Withdrawal Symptoms

Abruptly stopping Clonidine can lead to withdrawal symptoms, including:

• Nervousness
• Agitation
• Tremors
• Headache
• Rapid increase in blood pressure

To minimize these risks, your doctor may gradually reduce your dosage when discontinuing treatment.

Long-term Use Considerations

Over time, some patients may develop tolerance to Clonidine, requiring dosage adjustments or additional medications. Regular follow-ups with your healthcare provider are essential to monitor the medication’s effectiveness and make necessary adjustments.

Lifestyle Modifications to Complement Clonidine Patch TTS-3 Treatment

While Clonidine Patch TTS-3 can be highly effective in managing hypertension, combining medication with lifestyle changes can enhance its benefits and improve overall cardiovascular health.

Dietary Recommendations

Adopting a heart-healthy diet can significantly impact blood pressure management. Consider the following dietary modifications:

• Reduce sodium intake to less than 2,300 mg per day
• Increase consumption of fruits, vegetables, and whole grains
• Limit saturated and trans fats
• Incorporate lean proteins and low-fat dairy products
• Consider the DASH (Dietary Approaches to Stop Hypertension) diet

Exercise and Physical Activity

Regular physical activity can help lower blood pressure and improve overall cardiovascular health. Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week. Always consult with your healthcare provider before starting a new exercise regimen, especially if you have existing health conditions.

Stress Management Techniques

Chronic stress can contribute to hypertension. Incorporating stress-reduction techniques into your daily routine can complement your medication regimen:

• Practice mindfulness meditation
• Try deep breathing exercises
• Engage in yoga or tai chi
• Prioritize adequate sleep (7-9 hours per night)
• Consider cognitive-behavioral therapy or other forms of counseling

Special Considerations for Specific Patient Populations

While Clonidine Patch TTS-3 is generally safe and effective for many patients with hypertension, certain populations may require special considerations or additional monitoring.

Elderly Patients

Older adults may be more sensitive to the effects of Clonidine and may require lower initial doses. Additionally, they may be at higher risk for certain side effects, such as dizziness or falls. Close monitoring and gradual dose adjustments are often necessary for this population.

Pregnant and Breastfeeding Women

The safety of Clonidine Patch TTS-3 during pregnancy and breastfeeding has not been fully established. Women who are pregnant, planning to become pregnant, or breastfeeding should discuss the potential risks and benefits with their healthcare provider before using this medication.

Patients with Renal Impairment

Clonidine is primarily eliminated through the kidneys. Patients with kidney disease or reduced renal function may require dosage adjustments and more frequent monitoring to prevent drug accumulation and potential side effects.

Comparing Clonidine Patch TTS-3 to Other Antihypertensive Treatments

Understanding how Clonidine Patch TTS-3 compares to other antihypertensive medications can help patients and healthcare providers make informed treatment decisions.

Advantages of Transdermal Delivery

The transdermal patch delivery system offers several potential benefits over oral medications:

• Provides continuous, steady drug release over an extended period
• Reduces frequency of dosing (weekly vs. daily)
• May minimize gastrointestinal side effects associated with oral medications
• Allows for easy discontinuation if necessary
• May improve medication adherence for some patients

Comparison with Other Antihypertensive Classes

Clonidine belongs to the alpha-2 adrenergic agonist class of medications. Other common classes of antihypertensive drugs include:

• ACE inhibitors
• Angiotensin receptor blockers (ARBs)
• Calcium channel blockers
• Beta-blockers
• Diuretics

Each class has its own mechanism of action, benefits, and potential side effects. The choice of medication depends on individual patient factors, including co-existing medical conditions, potential drug interactions, and patient preferences.

Future Developments and Research in Transdermal Antihypertensive Therapy

As medical technology advances, researchers continue to explore new ways to improve transdermal drug delivery systems for hypertension management.

Emerging Technologies

Several innovative approaches are being investigated to enhance the efficacy and user-friendliness of transdermal antihypertensive treatments:

• Microneedle patches for improved drug absorption
• Smart patches with integrated sensors for real-time monitoring
• Combination patches delivering multiple medications simultaneously
• Nanotechnology-based delivery systems for enhanced drug penetration

Ongoing Clinical Trials

Numerous clinical trials are underway to evaluate new transdermal antihypertensive formulations and delivery methods. These studies aim to address current limitations, expand treatment options, and improve patient outcomes in hypertension management.

As research progresses, patients and healthcare providers can look forward to potentially more effective, convenient, and personalized treatment options for hypertension in the future.

Catapres-TTS-3 Transdermal: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

How to use CATAPRES-TTS 3 Patch, Transdermal Weekly

Read the Patient Information Leaflet if available from your pharmacist before you start taking clonidine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Peel off the backing from the patch and apply the patch to a clean, dry, and hairless area of the skin on the upper outer arm or upper chest. Press the patch firmly in place for about 10 seconds to make sure it stays on. Do not apply the patch on oily, broken, or irritated skin. Avoid applying the patch to areas of the skin where it might be easily rubbed off (such as on skin folds). Use this medication as directed by your doctor. The patch is usually worn for 1 week and then replaced. Follow the dosing schedule carefully. Wash your hands after handling the patch.

The dosage is based on your medical condition and response to treatment.

When replacing your patch, make sure to apply the new patch to a different area. Fold the old patch in half with the sticky side together and throw away in the trash away from children and pets. Do not flush the patch down the toilet.

If the patch starts to loosen from the skin, you may apply the “adhesive cover” over the patch so that it does not fall off during the 1-week period. The “adhesive cover” does not contain any medication. If the patch falls off or if you have mild redness/itching/irritation around the application site, discard the patch as directed and apply a new patch to a different area.

Use this medication regularly to get the most benefit from it. To help you remember, change the patch on the same day each week. It may help to mark your calendar with a reminder. Keep using this medication even if you feel well. Most people with high blood pressure do not feel sick.

Do not stop using this medication without consulting your doctor. You may experience symptoms such as nervousness, agitation, shaking, and headache. A rapid rise in blood pressure may also occur if the drug is suddenly stopped. The risk is greater if you have used this drug for a long time or in high doses, or if you are also taking a beta blocker (such as atenolol). There have also been rare reports of severe, possibly fatal reactions (such as stroke) from stopping this drug too quickly. It is important that you do not run out of clonidine patches or miss any doses. To prevent any reactions while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.

When used for a long time, this medication may not work as well and may require different dosing or an additional medication. Talk with your doctor if this medication stops working well (such as your blood pressure readings remain high or increase).

Side Effects

Dizziness, lightheadedness, drowsiness, dry mouth, unusual tiredness, headache, or mild redness/itching/irritation at the application site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting, slow/irregular heartbeat, mental/mood changes (such as irritability, depression).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using clonidine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, heart rhythm problems (such as slow/irregular heartbeat, second- or third-degree atrioventricular block).

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you are going to have an MRI test or cardioversion, tell health care personnel that you are using this patch. Some patches may contain metals that can cause serious burns during an MRI or cardioversion. Ask your doctor whether you will need to remove your patch before the procedure and apply a new patch afterward, and how to do so properly.

Contact lens wearers may need to use wetting eye drops since this medication can cause dry eyes.

Older adults may be more sensitive to the side effects of this product, especially dizziness, or drowsiness. These side effects may increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Does CATAPRES-TTS 3 Patch, Transdermal Weekly interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

This medication patch may be harmful if chewed or swallowed. If someone has overdosed, remove the patch if possible. For serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness/drowsiness, fainting, slow/irregular heartbeat, slow/shallow breathing, seizures.

Do not share this medication with others.

Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Check your blood pressure and pulse (heart rate) regularly while using this medication. Learn how to monitor your own blood pressure and pulse at home, and share the results with your doctor.

If you forget to replace a patch at the scheduled time, replace it as soon as you remember. Call your doctor right away if you are late replacing a patch by 3 or more days.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed (see also How to Use section).

Images

Catapres-TTS-3 0.3 mg/24 hr transdermal patch

Color: beigeShape: squareImprint: logo BI-33

This medicine is a beige, square, transdermal system imprinted with “logo BI-33”.

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Drug Survey

Are you currently using CATAPRES-TTS 3 Patch, Transdermal Weekly?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Catapres-TTS-3 Advanced Patient Information – Drugs.com

Generic name: clonidine [ KLOE-ni-deen ]
Drug class: Antiadrenergic agents, centrally acting

Medically reviewed by Drugs.com. Last updated on Feb 1, 2023.

Uses for Catapres-TTS-3

Clonidine transdermal is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk for heart attacks. These problems may be less likely to occur if the blood pressure is controlled.

Clonidine belongs to the class of medicines called antihypertensives. It works in the brain to change some of the nerve impulses. As a result, the blood vessels relax and blood passes through them more easily, which lowers blood pressure. When the blood pressure is lowered, the amount of blood and oxygen going to the heart is increased.

This medicine will not cure your high blood pressure, but it does help control it. Therefore, you must continue to use it as directed if you expect to lower your blood pressure and keep it down. You might have to take high blood pressure medicine for the rest of your life.

This medicine is available only with your doctor’s prescription.

Before using Catapres-TTS-3

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of clonidine transdermal in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of clonidine transdermal in geriatric patients. However, elderly patients are more likely to have age-related heart or kidney problems, which may require caution and an adjustment in the dose for patients receiving clonidine transdermal.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acebutolol
• Amitriptyline
• Amoxapine
• Atenolol
• Betaxolol
• Bevantolol
• Bisoprolol
• Carteolol
• Celiprolol
• Ceritinib
• Clomipramine
• Crizotinib
• Desipramine
• Dilevalol
• Diltiazem
• Dothiepin
• Doxepin
• Esmolol
• Imipramine
• Iobenguane I 131
• Levobunolol
• Lofepramine
• Macimorelin
• Metipranolol
• Metoprolol
• Mirtazapine
• Nadolol
• Nebivolol
• Nortriptyline
• Oxprenolol
• Penbutolol
• Pindolol
• Propranolol
• Protriptyline
• Sotalol
• Tertatolol
• Timolol
• Trimipramine
• Verapamil

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Cyclosporine
• Fluphenazine
• Mepivacaine
• Naloxone
• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart attack, recent or
• Heart or blood vessel disease or
• Heart rhythm problems or
• Stroke—Use with caution. May cause side effects to become worse.

• Irritated or scraped skin—Effects may be increased because more medicine is absorbed in the body.

• Kidney disease—Effects may be increased because of slower removal from the body.

Proper use of Catapres-TTS-3

Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many patients feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

To use the skin patch:

• Use this medicine exactly as directed by your doctor. It will work only if applied correctly. This medicine usually comes with patient instructions. Read them carefully before applying the patch.
• Wash your hands with soap and water before and after applying a patch. Do not touch your eyes until after you have washed your hands.
• Do not try to trim or cut the adhesive patch to adjust the dosage. Check with your doctor if you think the medicine is not working as it should.
• Gently wash the area of skin where you will apply the patch with soap and water. Rinse the skin completely and dry with a clean, dry tissue.
• Apply the patch right away after removing it from the pouch. Do not cut it into smaller pieces and do not touch the sticky surface of the patch.
• Apply the patch to a clean, dry, and intact skin area on your upper, outer arm or upper chest. Choose an area with little or no hair that is free of scars, cuts, or irritation. Avoid putting the patch on skin areas where it could be rubbed off by tight clothing.
• Press the patch firmly in place with your fingertips to make sure that the edges stick well.
• The patch should stay in place during showering, bathing, or swimming for a full 7 days. If the patch becomes loose, press the edges against the skin and cover the patch with one of the white adhesive covers that are included in the package. Apply a new patch if the first one becomes too loose or falls off.
• It is best to apply each patch to a different area of the skin to prevent skin irritation.

To help you remember to use your medicine, try to apply the patch at the same time and on the same day of the week.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For transdermal dosage form (patch):
  • For high blood pressure:
    • Adults—One patch applied once every 7 days. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.

If you miss changing the transdermal patch for 2 or more days, check with your doctor right away. If your body goes without this medicine for too long, your blood pressure may go up to a very high level and cause serious side effects.

Storage

Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

After removing a used patch, fold the patch in half with the sticky sides together. Make sure to dispose of it out of the reach of children and pets.

Precautions while using Catapres-TTS-3

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for any unwanted effects.

Do not interrupt or stop using this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. Your blood pressure may become worse when the medicine is stopped suddenly, which can cause serious side effects.

Make sure that you have enough clonidine transdermal on hand to last through weekends, holidays, or vacations. You should not miss any doses. You may want to ask your doctor for a second written prescription for clonidine to carry in your wallet or purse. You can have it filled if you run out of medicine when you are away from home.

You may have some skin redness, a rash, itching, or blistering at the place where you wear the patch. If this irritation is severe or does not go away, call your doctor. Do not remove the patch unless your doctor tells you to.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine.

Before having a magnetic resonance imaging (MRI) scan, tell the doctor in charge that you are using this medicine. Skin burns may occur at the site where the patch is worn during this procedure. Ask your doctor if the patch should be removed before having an MRI scan. You might need to put on a new patch after the procedure.

Clonidine transdermal may cause some people to become drowsy or less alert than they are normally. This is more likely to happen when you begin to use it or when you increase the amount of medicine you are using. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Clonidine transdermal will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause dryness of the eyes. If you wear contact lenses, this may be a problem for you. Talk to your doctor if you wear contact lenses, and discuss how to treat the dryness.

Dizziness, lightheadedness, or fainting may occur after you use this medicine, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help, but if the problem continues or gets worse, check with your doctor.

The dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are using clonidine, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for a long time.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. You should avoid over-the-counter [OTC] medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Side Effects of Catapres-TTS-3

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Itching or redness of the skin

Incidence not known

• Blistering, burning, crusting, dryness, or flaking of the skin
• blurred vision
• chest pain or discomfort
• darkening of the skin
• decreased urine output
• dilated neck veins
• dizziness
• extreme fatigue
• fainting
• fast, slow, pounding, or irregular heartbeat or pulse
• fever
• general feeling of discomfort or illness
• inability to speak
• irregular breathing
• itching, scaling, severe redness, soreness, or swelling of the skin
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• lightheadedness, dizziness, or fainting
• paleness or cold feeling in the fingertips and toes
• seizures
• severe or sudden headache
• shortness of breath
• slurred speech
• swelling of the face, fingers, feet, or lower legs
• temporary blindness
• tightness in the chest
• tingling or pain in the fingers or toes when exposed to cold
• troubled breathing
• unusual tiredness or weakness
• weakness in the arm or leg on one side of the body, sudden and severe
• weight gain
• wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Bluish lips or skin
• change in consciousness
• clumsiness
• confusion
• constricted, pinpoint, or small pupils (black part of the eye)
• depression
• difficult or troubled breathing
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drowsiness
• headache
• irregular, fast or slow, or shallow breathing
• irritability
• lack of coordination
• loss of consciousness
• low body temperature
• muscle aches or weakness
• nervousness
• not breathing
• pale or blue lips, fingernails, or skin
• pounding in the ears
• shivering
• sleepiness
• sweating
• weak or feeble pulse

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Anxiety
• burning or dryness of the eyes
• confusion as to time, place, or person
• decreased interest in sexual intercourse
• dry mouth
• hair loss
• hives or welts
• holding false beliefs that cannot be changed by fact
• hyperventilation
• inability to have or keep an erection
• itching skin
• leg cramps
• loss in sexual ability, desire, drive, or performance
• loss of appetite
• muscle or joint pain
• raised red swellings on the skin, lips, tongue, or in the throat
• redness of the skin
• restlessness
• seeing, hearing, or feeling things that are not there
• shaking
• skin rash
• swelling of the breasts or breast soreness in both females and males
• thinning of the hair
• trouble sleeping
• unusual excitement, nervousness, or restlessness
• vivid dreams or nightmares
• weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Transdermal therapeutic systems | PharmZnanie

Transdermal therapeutic systems (TTS) are a relatively new dosage form being mastered. There are not so many drugs available in the form of TTS. To date, in Russia, 12 items can be attributed to TTC, both prescription and non-prescription from different groups. Part is registered as TTS, part as “transdermal patch” or simply as “patch”. What is the essence, feature and prospects of this dosage form, we will consider in our article.

Transdermal therapeutic system (TTS, transdermal patch) – high-tech external dosage form for controlled transdermal drug transport into the body. TTS have been used for about 20 years in various fields of medicine. The principle of operation of TTS is based on the passive diffusion of drugs through the skin. The advantage of this dosage form lies in the long-term (days, weeks), continuous flow of the active substance into the bloodstream at a constant rate. This ensures the constant presence of the active substance in the blood at a minimum therapeutic level without peaks in concentrations that occur when using classical dosage forms. This avoids possible unwanted side reactions that occur when the concentration approaches the toxic level.

What is TTC?

TTS is a multilayer patch. There are two types of transdermal systems: membrane and matrix.

Membrane TTS (ravioli) contains a reservoir of medicine in liquid or gel form under the outer lining. Next is a membrane, most often made of a polymer film, through which the active substance is gradually released through the adhesive layer. Patch systems of this type are rather bulky and inconvenient to manufacture. Judging by the descriptions of TTS from GRLS, only Fendivia (fentanyl) belongs to the membrane ones. The remaining TTCs are of the matrix type.

Matrix TTS are easier to make and easier to use. Under the protective film there is a polymeric adhesive layer, with the medicine (matrix) distributed in it.

When TTC is used

TTC is a convenient and simple dosage form that has several advantages over oral and parenteral routes of drug administration. They may be used when drugs cannot otherwise be administered or their traditional route of administration is less effective (eg, rapid inactivation in the GI tract, short half-life). With the help of TTS, it is safer to administer substances with a narrow therapeutic corridor (small gap between the therapeutic and toxic dose).

Pain patches Fendivia and Fentanyl for chronic pain (with oncology) clearly outperform injectable and tablet forms at home. Injections are given only in hospitals, fentanyl tablets are not available, and other narcotic analgesics can cause nausea, vomiting and are less effective. Therefore, these patches are unique.

Benefits:

• non-invasive alternative to painful injection therapy
• form of choice when oral medications are difficult to take or the drug adversely affects the gastrointestinal tract
• maintenance of optimal therapeutic concentration at the same level for a long time
• simply cancel the treatment at any time by removing the patch compared to injectable depot formulations
• lack of metabolism in the gastrointestinal tract and the effect of passage through the liver
• faster acting than oral formulations
• no dose will be missed due to forgetting, no need to think about the next dose
• no peak concentrations and associated possible adverse reactions.

Cons

• possible skin reactions, not applicable for skin diseases
• higher cost due to the fact that a large dosage of the active substance must be included in the patch
• TTS can only transport molecules with certain physical and chemical properties through the skin barrier
• Only strong substances requiring small doses can be used in TTS
• longer time to effect compared to injections.

Download the Table of registered TTCs in Russia ( according to GRLS)

Modern prospects for the development of the dosage form

The use of TTCs is considered highly promising in the treatment of various diseases. The main obstacle to the creation of TTS is the barrier properties of the skin, which limit the penetration of most substances into the blood. In order to pass through the skin, an active pharmaceutical ingredient molecule must meet the following requirements:

– be small (less than 500 Daltons). Nitroglycerin, Scopolamine, Testosterone, Clonidine, Ibuprofen have the right weight, so they are used in TTS all over the world. Insulin is much heavier, but TTS with insulin would drastically improve the quality of life of patients, so further research is underway;

– be sufficiently soluble in the hydrophobic surface layer of the skin and the hydrophilic layer of the dermis;

– have a neutral charge.

To circumvent this limitation and expand the range of drugs for TTS, various methods are being developed to improve the penetration of molecules into the skin. These include chemical and physical methods. Most often, the chemical method is effective in relation to low molecular weight compounds.

The chemical method involves the use of chemicals – penetrators, which facilitate the passage of molecules through the skin. Chemical penetrators include ethyl alcohol, dimethyl sulfoxide, pyrrolidones, urea, fatty acids, transcutol, azone, isopropyl myristate.

To improve the permeability of the skin to high molecular weight peptides, proteins, nucleotides, physical methods are used. Most often electrical – iontophoresis, electrophoresis, electroporation. For example, iontophoresis is involved in the Lidosite® lidocaine delivery system; it is not registered in the Russian Federation.

Another promising method is based on mechanical action using microneedles. It was developed by scientists from the Sechenov First Moscow State Medical University and the Australian Griffiths University. Microneedles placed on the patch pierce the outer layer of the skin without causing pain, with minimal risk of infection. Their size is such that it allows to overcome the stratum corneum of the skin, but does not penetrate into the dermis and does not reach the nerve endings.

Using this technology, scientists are already working on a patch with interferon for cancer patients and patients with viral hepatitis. It is predicted that a patch patch with miniature needles will appear on the Russian market in 7 years. Its effectiveness is currently being evaluated.

Meanwhile, scientists from St. Petersburg went even further. They started implementing the smart patch concept. Miniature electronic patch devices will be able to monitor the state of the body and, based on this data, inject drugs through the skin using microneedles. The device is supposed to be placed on the wrist by analogy with a watch.

Research and implementation of ways to improve the transdermal delivery of drugs are actively conducted. Solving this problem will expand the use of TTS in long-term therapy, as well as in the prevention of a large number of diseases.

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Transdermal therapeutic systems | Editorial

Transdermal therapeutic systems provide an alternative way of administering those drugs that cannot be administered otherwise, or their traditional oral route of administration is less effective. The skin has an excellent barrier property, which limits the types of molecules that can be introduced through it. However, for drugs with these properties, the transdermal drug delivery method provides continuous dosing over an extended period of time. The physical and chemical properties of transdermal delivery systems make it possible to administer drugs with large molecular sizes, such as proteins and other biotechnological products, which today can only be administered to the body through painful and uncomfortable injections.

Transdermal drug delivery process

The skin protects the body from adverse external influences. This is ensured by a formidable barrier that keeps foreign molecules from penetrating the body. Also, the skin is a receptacle for tissues and organs, regulates body temperature and primary sensory sensitivity. The outermost layer of the skin (stratum corneum) is the main component of the barrier to penetrating substances. On fig. 1 shows the histological structure of the skin.

The skin protects the body from adverse external influences. This is ensured by a formidable barrier that keeps foreign molecules from penetrating the body. Also, the skin is a receptacle for tissues and organs, regulates body temperature and primary sensory sensitivity. The outermost layer of the skin (stratum corneum) is the main component of the barrier to penetrating substances. On fig. 1 shows the histological structure of the skin.

Figure 1. Skin structure.

A large amount of pharmaceutical products are applied to the skin. Such preparations are called topical, or dermatological, agents. Despite this, molecules with appropriate physicochemical properties can penetrate the stratum corneum in small amounts, causing a systemic effect. These products can be used in transdermal drug delivery systems, or transdermal therapeutic systems.

Transdermal therapeutic systems (TTS) provide an alternative route of administration for drugs that cannot otherwise be administered or their traditional oral route is less effective due to their GI instability, narrow therapeutic corridor, or short half-life. In TTS, the drug molecule diffuses from the drug to the skin surface, then the drug passes through the stratum corneum and reaches the epidermis, and then the dermis, where the vascular network transports its molecules to the organs.

Advantages of TTS

Transdermal drug delivery has several advantages.

• Compared with oral administration, the ability to provide a faster effect of drugs.
• Possibility of avoiding problems associated with oral administration: inactivation or decrease in drug activity as a result of the first passage and gastric metabolism, as well as associated adverse reactions.
• The possibility of immediate discontinuation of treatment with the development of adverse reactions.
• Providing a constant concentration of the drug in the blood, without concentration fluctuations and associated adverse reactions.
• Reducing the frequency of prescribing by delivering the required dose of the drug over a longer period of time.
• Improved patient compliance (easy route of administration).
• Decrease the required dose of the drug, as the losses of the drug associated with metabolism are reduced.

Restrictions on the use of TTS

Transdermal drug delivery has several limitations.

• Possible skin irritation or contact sensitization due to adverse interaction of active or inactive components of the system with the skin.
• Drugs take longer to start working than injectables.
• Only a small percentage of the drug can penetrate the skin from the patch. This means that an excess amount of drug must be manufactured and introduced into the system, which increases the cost of the system.
• The transdermal drug delivery system can only be used for sufficiently potent drugs requiring small doses and for substances with certain physicochemical properties to penetrate the skin in a therapeutically effective amount.

Selection of drug molecules for transdermal delivery

Several factors determine which drug is suitable for TTS. Assuming that the drug is potent enough to meet dosing requirements, researchers study its physicochemical properties to determine whether the drug can penetrate the skin in a therapeutically effective amount, medical necessity, technological implementation, and practical application.

The physical and chemical properties of the drug are in the first place, because the drug molecule must pass through several layers of the skin, each of which has its own distinctive features. Effective transdermal delivery requires a drug molecule that has an affinity for both the hydrophobic stratum corneum and the hydrophilic dermis. The drug molecule must be neutral, since the positive or negative charge of the molecule can slow down its progress through the hydrophobic environment. In addition, it must have sufficient solubility in a hydrophobic and hydrophilic environment. Finally, the drug molecule must be small (molecular weight should not exceed 500 Daltons) in order to provide the necessary speed of its movement.

TTC models

The simplest form of TTC consists of the following components.

• Main membrane to prevent drug release into the environment and moisture from outside.
• Drug reservoir for drug dissolution, storage and release.
• Membrane for optimal drug release rate.
• Pressure-sensitive adhesive used to keep the system in adequate contact with the skin.
• Protective film for system storage.

Fig. 2. Transdermal therapeutic systems.

In the early models of the TTS, each function was provided separately by one of the components (Fig. 2). These systems, known as ‘raviolli systems’, are made by injecting a solution or gel of drug into the space between the base membrane and the drug reservoir, then thermally sealing them to the drug release control membrane and coating the perimeter with adhesive that adheres when pressing, and a protective film. The manufacturing process is inconvenient, and the patch itself is rather bulky.

In the new TTS, the so-called matrix systems, the pressure-sensitive adhesive performs various functions: adhesion, storage, drug release, and drug release rate control (see Figure 2). The manufacturing process of the matrix system is relatively simple and the patch is very thin. However, it is sometimes difficult to find an adhesive that, over the duration of the TTC, can dissolve the drug and release it without crystallization or a separation phase. Moreover, the dissolution and release of the drug can reduce the strength of adhesion and adhesion to the skin.

TTS are popular all over the world. In table. 1 lists transdermal preparations registered in Russia, and in table. 2 and 3 are registered in other countries or are at different stages of development.

Cardiovascular drugs

Therapy for angina and hypertension usually lasts for many years. In the treatment of these diseases, patient compliance is very important, so transdermal forms of drugs are so necessary. Nitroglycerin has been used for over a century, but its short half-life requires frequent administration. Transdermal administration allows maintaining the required systemic concentration in the blood for 12-14 hours.

Another cardiovascular drug in the form of TTC is clonidine (clopheline), which is used to treat mild/moderate hypertension. Oral administration of clonidine requires 2-3 doses, and its transdermal form allows you to prescribe one patch for 7 days. Also, TTS allows you to maintain a uniform dosage in the blood plasma for 7 days, while when taken orally, the concentration changes ‘sawtooth’. In Russia, clonidine in the form of TTC is not yet used.

Table 1. Transdermal therapeutic systems registered in Russia (Register of Medicines, 2001)

90 291

Table 2. Transdermal therapeutic systems registered in other countries

9022 1

Active ingredient	Firm	Name	Duration of prescription	Solvent	Type
17 b-estradiol	Berlex Labs	Climara	7 days	Esterified fatty acid	Matrix
17 b-estradiol	Novartis	Estraderm	3 days	No0223
17 b-estradiol	Novartis, Procter & Gamble, Rhone-Poulenc Rorer, Novo Nordisk	Menorest, Vivelle	3-4 days	Olein ova acid, propylene glycol	Matrix
17 b- estradiol	Parke-Davis	FemPatch	7 days	Esterified fatty acid	Matrix
17 b-estradiol 9 0223	Procter & Gamble	Alora	4 days	Sorbitan monoleate	Matrix
Clonidine	Boehringer Ingelheim	Catapres TTS 9 0223	7 days	No	Matrix
Nicotine	Elan	Prostep	.	No	Matrix
Nicotine	Novartis	Habitrol	24h.	No	Matrix
Nicotine	SmithKline Beecham	Nicoderm CQ	24h	No 21	Nicotine	Warner-Lambert	Nicotrol	16h	No	Matrix
Nitroglycerin	Berlex Labs	Minitran	12-14 hours	Esterified fatty acid	Matrix
Nitroglycerin	Novartis	TransdermNitro	12-2 pm	No 2 Schering-Plough	Nitrodur	12-14 hrs	No	Matrix
Nitroglycerin	Schwarz Pharma	Deponit	12-14 hrs.	No	Matrix le	Nitrodisc	12-14 hrs	No	Matrix
Scopolamine	Novartis	Transderm Scop	3 days	No	Raviolli
Testosterone	Novartis	Testoderm	24 h.	No	Raviolli
Testosterone	SmithKline Beecham	Androderm	24 h. l, glyceryl monoleate, methyl laureate, glycerin	Raviolli
Fentanyl	Janssen Silag	Durogesic	3 days	Ethanol	Raviolli

Hormone replacement therapy

Hormone replacement therapy uses two drugs, estradiol and testosterone. Estradiol is used to treat symptoms associated with menopause. With oral administration of estradiol, most of it is converted in the liver into a low-active metabolite – estrone. Transdermal delivery of estradiol maintains the desired physiological level of estradiol/estrone balance. In addition, when using this form of the drug, its concentration in the blood is 1/6 of the administered dose, in contrast to 1/20 of the concentration when taken orally. TTS with estradiol can release estradiol for up to 7 days.

Another drug, testosterone, is used in hormone replacement therapy for male hypogonadism. In Russia, TTS for hormone replacement therapy is not yet used.

Table 3. T ransdermal therapeutic systems at various stages of development

9 0222 Noven

902 34

Replacement therapy for nicotine addiction

An effective smoking cessation aid, nicotine replacement, requires the use of medications containing nicotine. Nicotine chewing gum has been around for over 20 years. However, chewing gum provides uneven delivery of nicotine and has been associated with tooth staining, bad taste, toothache, dental problems, and gastrointestinal distress. Transdermal delivery of nicotine circumvents these potential problems and provides ease of administration. In addition, one application maintains a constant level of nicotine in the blood for 24 hours.

Analgesics

Transdermal delivery of analgesics for chronic pain management is an important alternative to oral and intravenous administration. For example, a long-term 3-day effect of the transdermal form of fentanyl. This form provides relief of chronic pain in cancer patients, and also avoids the cost of 3-4 injections of morphine, for calling a nurse, an ambulance, prescribing antiemetics, for consumables, as well as other tangible and intangible costs for relatives , and eliminate some of the adverse reactions of morphine.

POTENTIAL TECHNOLOGIES TO IMPROVE TTS

Drug delivery through the skin is subject to significant interactions that limit the overall application of this technology. Today, many approaches are being explored to overcome the barrier properties of the skin and improve the application of TTS. To reach a new level, it is necessary to develop technologies by which the permeability of the drug could be reversible, predictable and controllable. Efforts to improve technology fall into three categories: chemical, biochemical, and physical.

Improvement in the chemical composition of TTS

Chemical improvement in transdermal drug delivery systems leads to the use of external chemical substances to help drugs penetrate the skin barrier by destroying the ordered structure of the intercellular fat layer of the stratum corneum. This modification leads to an improvement in the fluidity of this layer and the solubility of the drug in the stratum corneum. Numerous chemical compounds have been used or evaluated for their ability to enhance the penetration of drug molecules through the skin. They range from polyhydric alcohols to fatty acids and fatty acid esters to terpenes. Despite the promise of chemicals that enhance the penetration of drug molecules through the skin, only a few of them have been used in commercial transdermal delivery systems, mainly due to the costs associated with regulatory registration requirements (evidence of increased penetration; studies of their short and long term safety and toxicity ).

With increasing understanding of how chemical ‘enhancers’ work and their long-term and short-term effects, these tools will be used more widely because they provide the easiest way to improve TTS.

Improvement of the biochemical constituents of TTS

In biochemical improvement, the drug molecule undergoes a short-term physicochemical change that facilitates its movement through the stratum corneum. The altered drug molecule (pro-drug) is not therapeutically active. After penetration into the stratum corneum, it undergoes hydrolytic or enzymatic biotransformation in order to restore the original therapeutically active drug substance. The feasibility of this approach has been proven with various drugs. However, this area of ​​development is still at an early stage of development, and there is no commercial use of such transdermal drug delivery systems yet, but this approach will soon be developed. The developer of a new prodrug will need to gather all the information related to safety, toxicity, and efficacy required for drug registration. The cost and time required to do this are significant.

Another option is to use drug-retaining fat vesicles (like liposomes) that can penetrate the skin and deposit themselves in the stratum corneum. There they can act as controlled release systems. Research efforts to expand the effectiveness of fat vesicles are still in the early stages of being explored. However, many parenteral systems using fat vesicles have been in practice for many years. Such vesicles have been well studied and considerable information regarding their safety, toxicity and biodegradability is already available. If the drug molecule was simply encapsulated, without changing the physical or chemical properties, then registration of such transdermal forms would require less formalities. Therefore, this extension approach is promising.

Physical enhancement

Physical enhancement of transdermal drug delivery systems is an external stimulus or force used to drive a drug through the skin, especially through the outermost layer. External forces produce reversible physical changes within the stratum corneum. Three approaches are used: iontophoresis, sonophoresis and electrophoresis. These approaches may allow transdermal systems to deliver large ionic molecules of peptides or proteins that cannot be delivered by passive diffusion through the skin. In addition, the level of delivery is well controlled by the magnitude and duration of external stimuli. Finally, as with parenterals, the onset of action of the drug is very rapid due to the relatively short time it takes for the drug to enter the bloodstream. The rapid onset of action is very important for the treatment of cancer pain, diabetes and other conditions.

Iontophoresis is the use of an external electrical current to transport a charged molecule through the skin. In this process, which has been known for over a hundred years, an ionic molecule carries a charge across the skin barrier membrane to complete the circuit. There is a lot of research going on now investigating the use of this technique to deliver large molecules of drugs or drugs to relieve cancer pain.

Sonophoresis uses ultrasonic waves to rupture the stratum corneum and cause pores to open, facilitating the transport of drug molecules. Although the feasibility of this approach has been proven, drug delivery systems using sonophoresis are still at an early stage of development and commercial use is not expected in the near future.

Electrophoresis uses a high voltage millisecond pulse to create transit paths through the stratum corneum to facilitate penetration of large drug molecules. The applicability of this approach has been proven. However, drug delivery methods using this technology are still at an early stage of development, and a huge number of safety issues have not yet been resolved. electrophoresis uses a high-voltage external pulse that can cause long-term damage to the skin.

Conclusion

Despite the close physico-chemical interdependence, transdermal drug delivery has great prospects as an alternative to oral and intravenous administration. The ability to administer a certain amount of drug in a controlled manner over an extended period of time will make TTC attractive for patients suffering from chronic conditions, especially for the treatment of chronic pain in incurable cancer patients, as well as for the treatment of asthma. In addition, these systems can be used for hormone replacement therapy and contraception. Because transdermal delivery is easy to administer, this approach will be particularly attractive to older patients, where compliance is an important issue.

In the field of hormone replacement therapy and contraception, drug developers are trying to use new transdermal delivery systems to administer multiple hormones simultaneously, therefore reducing the adverse reactions associated with estrogen alone. Combination patches that deliver both estrogen and progesterone at the same time are in the final stages of development.

Advances in technology will provide an opportunity to increase the variety of drugs that can be delivered transdermally, especially for large and ionized molecules of biotech drugs that can currently only be administered through painful injection procedures.

In addition, the transdermal form of drug delivery gives pharmaceutical companies a competitive advantage in the development of drugs: in terms of costs and the shortest time required for development, in patent protection, protection from dumping generic companies. According to pharmaceutical market analysts, global sales of transdermal drug delivery systems will continue to grow.