Table 1.
Comparison of traditional versus drug delivery system/long-acting formulations for the same active pharmaceutical ingredient
| DDS (API) | Type of system | Indication | Duration of effectiveness | Non-DDS alternative(s) | Mechanism(s) by which this system may improve adherence |
|---|---|---|---|---|---|
| Dexedrine Oral (dextroamphetamine), Concerta XL (methylphenidate) | Extended-release oral tablet | ADHD | 8–24 h, 1 day | Oral tablet taken 4–6 times daily (Zenzedi) or oral tablet taken 2–3 times daily (Ritalin) | Reduced dosing frequency, fewer adverse effects |
| Xeloda (capecitabine) | Extended-release oral tablet | Breast, colon and rectal cancer | 12 h | Intravenous bolus 5-fluorouracil and leucovorin administered every 3–4 weeks (Irinotecan) | Less invasive, convenience of at-home administration |
| Catapres-TTS (clonidine) | Transdermal patch | Hypertension | 1 week | Twice-daily oral tablet (Catapres Oral) | Reduced dosing frequency |
| Daytrana (methylphenidate) | Transdermal patch | ADHD | 1 day | Oral tablet taken 2–3 times daily (Ritalin) or daily (Concerta XL) | Reduced dosing frequency |
| Emsam (selegiline) | Transdermal patch | Major depressive disorder | 1 day | Oral tablets taken 2–4 times daily (for example, Marplan, Phenelzine) | Reduced dosing frequency, fewer side effects, appropriate for patients with dysphagia |
| Neupro (rotigotine) | Transdermal patch | Parkinson disease, restless legs syndrome | 1 day | Oral tablets taken 3 times daily (for example, Ropinirole, Pramipexole) | Reduced dosing frequency, fewer side effects, appropriate for patients with dysphagia |
| Exelon Patch (rivastigmine) | Transdermal patch | Alzheimer disease | 1 day | Twice-daily oral tablet (Exelon Oral) | Reduced dosing frequency, fewer adverse effects |
| Ortho Evra (ethinyl oestradiol;norelgestromin) | Transdermal patch | Contraception | 1 week | Daily oral tablet (various) | Reduced dosing frequency |
| Mirena/Kyleena/Liletta/Skyla (levonorgestrel) | IUD | Contraception | 3–7 years | Daily oral tablet (various) | Reduced dosing frequency, fewer side effects |
| Paragard (copper) | IUD | Contraception | ≤10 years | Daily oral tablet (various) | Reduced dosing frequency, fewer side effects |
| NuvaRing (etonogestrel/ethinyl oestradiol) | Intravaginal ring | Contraception | 1 month | Daily oral tablet (various) | Reduced dosing frequency |
| Norplant (levonorgestrel) | Subdermal implant | Contraception | 3 years | Daily oral tablet (various) | Reduced dosing frequency |
| Vitrasert (ganciclovir) | Intraocular, non-degradable polymeric implant | Cytomegalovirus retinitis in patients with AIDS | 5–8 months | Eye drops administered 3–5 times per day, as needed (Zirgan eye drops) | Reduced dosing frequency, reduced barrier to treatment continuation |
| Iluvien, Retisert and Yutiq (fluocinolone acetonide) | Intravitreal, non-degradable polymeric implant | Diabetic macular oedema (Iluvien) or non-infectious uveitis (Retisert and Yutiq) | 2.5 years (Retisert) up to 3 years (Iluvien and Yutiq) | Subcutaneous injection every 2 weeks for non-infectious uveitis (Humira) or intravitreal injection once every 4–8 weeks for diabetic macular oedema (Eylea, Avastin, Vabysmo, Lucentis) | Reduced dosing frequency, reduced barrier to treatment continuation, circumvention of need for monthly or bimonthly intravitreal injections at a provider’s office |
| Ozurdex (dexamethasone) | Intravitreal, extended-release degradable polymeric implant | Macular oedema | Up to 6 months | Eye drops taken 4–6 times a day, as needed (Dexamethasone Ophthalmic) | Reduced dosing frequency, reduced barrier to treatment continuation |
| Apretude (cabotegravir) | Intramuscular, extended-release injectable suspension | HIV PrEP | 2 months | Daily oral tablet (Truvada/Descovy) | Reduced dosing frequency, reduced barrier to treatment continuation, reduced perceived stigmatization |
| Cabenuva (cabotegravir; rilpivirine) | Intramuscular, extended-release injectable suspension | HIV PrEP | 1–2 months | Daily oral tablet (Truvada/Descovy) | Reduced dosing frequency, reduced barrier to treatment continuation, reduced perceived stigmatization |
| Lupron Depot (leuprolide acetate) | Subcutaneous, extended-release degradable microparticle depot | Prostate cancer, anaemia owing to uterine fibroids, endometriosis, central precocious puberty | 1–6 months, depending on formulation | Daily subcutaneous injection (Lupron injection) | Reduced dosing frequency, reduced barrier to treatment continuation, circumvention of need for daily injections |
| Vivitrol (naltrexone) | Intramuscular, extended-release degradable microparticle depot | Substance use disorder | 1 month | Daily oral tablet (Depade) | Reduced dosing frequency, reduced barrier to treatment continuation |
| Risperdal Consta (risperidone) | Intramuscular, extended-release degradable microparticle depot | Schizophrenia | 2 weeks | Daily oral tablet (Risperdal Oral) | Reduced dosing frequency, reduced barrier to treatment continuation |
| Triptodur, Fensolvi (leuprolide acetate) | Intramuscular, extended-release degradable microparticle depot | Central precocious puberty | 6 months | Daily subcutaneous injection (Lupron injection) | Reduced dosing frequency, reduced barrier to treatment continuation, circumvention of need for daily injections |
| Sustol (granisetron) | Subcutaneous, extended-release injectable degradable polymer | Prevention of nausea and vomiting associated with chemotherapy | 1 week | Twice-daily oral tablet (Zofran) | Reduced dosing frequency, alternative to oral tablets for patients with dysphagia |
| Eligard (leuprolide acetate) | Subcutaneous (in situ-forming) extended-release injectable degradable polymer | Prostate cancer | 6 months | Daily subcutaneous injection (Lupron injection) | Reduced dosing frequency, reduced barrier to treatment continuation, circumvention of need for daily injections |
| Lyxumia (lixisenatide)/Victoza (liraglutide) | Subcutaneous injection | T2D | 1 day | Twice-daily subcutaneous injection (exenatide twice daily) | Reduced dosing frequency |
| Bydureon (exenatide QW)/Eperzan and Tanzeum (albiglutide)/Ozempic, Rybelsus and Wegovy (semaglutide)/Trulicity (dulaglutide) | Subcutaneous injection | T2D | 1 week | Twice-daily subcutaneous injection (exenatide twice daily) or daily subcutaneous injection (various) | Reduced dosing frequency, fewer adverse effects owing to extended-release |
ADHD, attention deficit hyperactivity disorder; AIDS, acquired immunodeficiency syndrome; API, active pharmaceutical ingredient; DDS, drug delivery system; HIV, human immunodeficiency virus; IUD, intrauterine device; PrEP, pre-exposure prophylaxis; T2D, type 2 diabetes.