Intestinal drug absorption and the solubility-permeability interplay
The solubility-permeability interplay deals with the question: what is the concomitant effect on the drug‘s apparent permeability when increasing the apparent solubility with a solubility-enabling formulation? The solubility and the permeability are closely related, exhibit certain interplay between them, and ongoing research throughout the past decade shows that treating the one irrespectively of the other may be insufficient. The aim of this article is to provide an overview of the current knowledge on the solubility-permeability interplay when using solubility-enabling formulations for oral lipophilic drugs, highlighting active permeability aspects. Solubility-enabling formulation may affect the permeability in opposite directions; the passive permeability may decrease as a result of the apparent solubility increase, according to the solubility-permeability tradeoff, but at the same time, certain components of the formulation may inhibit/saturate efflux transporters (when relevant), resulting in significant apparent permeability increase. In these cases, excipients with both solubilizing and e.g. P-gp inhibitory properties may lead to concomitant increase of both the solubility and the permeability. Intelligent development of such formulation will account for the simultaneous effects of the excipients‘ nature/concentrations on the two arms composing the overall permeability: the passive and the active arms. Overall, thorough mechanistic understanding of the various factors involved in the solubility-permeability interplay may allow developing better solubility-enabling formulations, thereby exploiting the advantages analyzed in this article, offering oral delivery solution even for BCS class IV drugs.
The use of different solubility-enabling formulations with efflux inhibition properties allowed dramatic increase in oral absorption and bioavailability of class II/IV drugs in animal models, suggesting significant clinical relevancy. Nevertheless, the tradeoff between solubility and permeability still exists in the background, and should be taken into account when striving to design the optimal formulation. Excipient surplus not only may be economically undesirable, but could actually lead to decreased drug permeability.