Lisinopril and sertraline

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Stability and Environmental Impact of Lisinopril and Sertraline

Stability of Lisinopril and Sertraline in Oral Suspensions

Stability in SyrSpend SF PH4 Oral Suspensions

Lisinopril and sertraline are commonly used active pharmaceutical ingredients (APIs) that can be compounded into oral suspensions, particularly beneficial for patients with swallowing difficulties, such as the elderly and pediatric populations. A study evaluated the stability of these APIs when compounded in SyrSpend SF PH4, a ready-to-use suspending vehicle. The study found that both lisinopril (1 mg/mL) and sertraline hydrochloride (10 mg/mL) maintained their stability over a 90-day period when stored at both controlled refrigerated temperatures (2°C to 8°C) and room temperature (20°C to 25°C) . The active pharmaceutical ingredient contents remained between 90% and 110% throughout the study period, indicating that SyrSpend SF PH4 is a reliable vehicle for compounding these medications.

Environmental Impact of Lisinopril and Sertraline

Presence in Wastewater Effluents

The environmental impact of pharmaceuticals, including lisinopril and sertraline, has been a growing concern. A comprehensive study measured the concentrations of 56 APIs in effluent samples from 50 large wastewater treatment plants across the United States. Lisinopril was identified as one of the six anti-hypertensive APIs with the highest potential risk estimates for human exposure, although the overall risk was considered very low . On the other hand, sertraline and its metabolite desmethylsertraline were highlighted for their potential ecological impacts, suggesting the need for more detailed studies on their effects on aquatic life .

Conclusion

Both lisinopril and sertraline demonstrate stable profiles when compounded in SyrSpend SF PH4 oral suspensions, making them suitable for patients with dysphagia. However, their presence in wastewater effluents raises concerns about potential environmental impacts, particularly for sertraline. While the risks to human health are low, further research is warranted to understand the ecological consequences of these pharmaceuticals in the environment.

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Most relevant research papers on this topic

Stability of Allopurinol, Amitriptyline Hydrochloride, Carbamazepine, Domperidone, Isoniazid, Ketoconazole, Lisinopril, Naproxen, Paracetamol (Acetaminophen), and Sertraline Hydrochloride in SyrSpend SF PH4 Oral Suspensions.

SyrSpend SF PH4 is a stable suspending vehicle for compounding a wide range of active pharmaceutical ingredients, with beyond-use dates of at least 90 days for both controlled refrigerated and room temperature storage.

2016·

4citations

·H. Polonini et al.

International journal of pharmaceutical compounding

Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation.

The concentrations of 56 active pharmaceutical ingredients in wastewater treatment plants in the US are generally low, with potential risks to human health and aquatic life being minimal.

Highly Cited

2013·

423citations

·Mitchell Kostich et al.

Environmental pollution·

DOI

Clinical Pharmacokinetics of Sertraline

Sertraline is a well-tolerated and relatively safe antidepressant with minimal inhibitory effects on major cytochrome P450 enzymes and few drug-drug interactions.

Highly Cited

2002·

239citations

·C. Devane et al.

Clinical Pharmacokinetics·

DOI

Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety

Combination therapy of cognitive behavioral therapy and sertraline is more effective than either therapy alone in reducing anxiety severity in children with anxiety disorders.

RCTLarge Human TrialHighly Cited

2008·

1314citations

·J. Walkup et al.

The New England journal of medicine·

DOI

Sertraline, an antidepressant, induces apoptosis in hepatic cells through the mitogen-activated protein kinase pathway.

Sertraline induces apoptosis in HepG2 cells partially through activation of the TNF-MAP4K4-JNK cascade signaling pathway.

In Vitro StudyRigorous JournalHighly Cited

2013·

70citations

·Si Chen et al.

Toxicological sciences : an official journal of the Society of Toxicology·

DOI

Safety and Efficacy of Sertraline for Depression in Patients with CHF (SADHART-CHF): A Randomized, Double-Blind, Placebo-Controlled Trial of Sertraline for Major Depression with Congestive Heart Failure

Sertraline may improve depression response and cardiac prognosis in patients with chronic heart failure.

RCTLarge Human TrialHighly Cited

2008·

96citations

·Wei Jiang et al.

American heart journal·

DOI

Sertraline

Sertraline is an effective and well-tolerated treatment for PTSD, particularly in female patients and non-combat-induced cases, with potential for lower drug interactions than other SSRIs.

RCT

2000·

16citations

·A. Comer et al.

CNS Drugs·

DOI

Combined treatment with sertraline and liothyronine in major depression: a randomized, double-blind, placebo-controlled trial.

Liothyronine supplementation enhances the antidepressant effect of sertraline in major depressive disorder patients without significantly increasing adverse effects.

RCTHighly Cited

2007·

107citations

·R. Cooper-Kazaz et al.

Archives of general psychiatry·

DOI

Sertraline: a new antidepressant.

Sertraline is a potent serotonin uptake inhibitor with potential antidepressant effects and prevents depression recurrence at doses of 50 to 200 mg/day, with similar side-effect profiles to drugs of the same class.

Literature ReviewHighly Cited

1988·

120citations

·D. Doogan et al.

The Journal of clinical psychiatry

Effects of sertraline on behavioral indices of crayfish Orconectes virilis.

Sertraline exposure in wastewater treatment plant effluents increases aggression in crayfish, but does not affect predator responses, suggesting potential ecological consequences for urbanized aquatic ecosystems.

Non-RCTAnimal Study

2016·

29citations

·S. Woodman et al.

Ecotoxicology and environmental safety·

DOI

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