Exploring the potential of mucoadhesive buccal films in geriatric medicine

Abstract

As the global demographic shifts toward an aging society, the geriatric patient population is steadily increasing. These patients often suffer from comorbidities and require numerous oral medications, which can be especially challenging for dysphagic geriatric patients. Mucoadhesive buccal films (MBFs) seem promising and could reduce pill burden, simplify administration, and enable individualized drug therapy. This review aims to explore the age-related changes in the oral cavity and their impact on MBF delivery, including potential strategies to overcome these age-related barriers to drug delivery. It was observed that aging impacts the oral mucosa as well the properties of the saliva. There are several studies in the application of buccal films including the use of a wide range of permeation enhancers. The 3D printing of buccal films seems to introduce dosing flexibility to buccal film manufacturing.

Introduction

As healthcare advancements contribute to increased life expectancy, the geriatric population is expanding at a faster rate compared to previous decades. The World Health Organization predicts that the number of geriatric adults (aged 60 years and older) will rise from 1 billion to 2.1 billion by 2050 [Citation1]. The extended lifespan of adults is accompanied by a susceptibility to disease, a consequence of the accumulation of age-related damage at the cellular and molecular level [Citation2,Citation3]. The aging process causes deterioration of body functions, often worsening the function of organ systems at rates dependent on individual environmental and genetic influence [Citation3,Citation4].

Age-related changes to the body often lead to disability and comorbidities in geriatric populations [Citation3]. Currently, the most prevalent method for treating these comorbidities involves the prescription of multiple solid and liquid oral dosage forms. Approximately, 60% of established small-molecule drug products are delivered through the oral route. Oral formulations dominate the global pharmaceutical market, accounting for roughly 90% of all formulations designed for human use [Citation5].

While oral drug delivery is convenient and widely accepted, oral administration poses challenges for geriatric patients, particularly those afflicted with swallowing difficulties (dysphagia) [Citation6,Citation7]. Mucoadhesive buccal films (MBFs) present an alternative dosage form option. These films adhere to the inside of the cheek, facilitating a controlled drug release via the buccal mucosa to achieve systemic or local effects. Buccal films remove the need for swallowing, offering a significant benefit for dysphagic geriatric patients and improving treatment compliance. Furthermore, administering drugs via the buccal mucosa bypasses the hepatic ‘first pass’ metabolism and pre-systemic degradation associated with oral drug delivery, improving bioavailability, and reducing the overall exposure to the active ingredient [Citation8]. An opportunity to tailor and optimize buccal film drug delivery is also made possible with the adoption and adapting of 3D printing in film manufacture. Personalized medicine and dosing are becoming more attractive as the importance of a patient’s individual needs are recognized, rejecting the traditional ‘one-size fits all’ concept, and advancements in technology can now facilitate this [Citation9,Citation10].

The buccal mucosa is a promising site for drug delivery due to the vast number of blood vessels throughout the lamina propria, providing a rich arterial blood supply to the tissue. Combined with the hydrated environment, the buccal mucosa is ideal for the dissolution and permeation of drug molecules into the circulatory system [Citation11]. More details about the oral cavity have been covered extensively [Citation12–14]. However, it is crucial to recognize that age-related changes also influence the physiology and function of the saliva and buccal mucosa, presenting challenges for buccal film drug delivery.

This literature review aims to explore MBFs as an alternative and age-appropriate dosage form for geriatric therapy. To assess their suitability for geriatric patients, this review investigates age-related changes to the buccal mucosa and oral environment, considering how these changes affect buccal drug delivery. Additionally, the review examines methods to minimize and counteract the challenges posed by these age-related changes. Innovative solutions such as permeation enhancers, saliva stimulation and 3D printing are explored to optimize buccal drug delivery for geriatric patients.

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Southward, J., Liu, F., Aspinall, S. R., & Okwuosa, T. C. (2025). Exploring the potential of mucoadhesive buccal films in geriatric medicine. Drug Development and Industrial Pharmacy, 1–21. https://doi.org/10.1080/03639045.2025.2467329