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Medicated chewing gum

Pros and cons

Abstract

Chewing gum has been used for centuries to clean the mouth or freshen the breath. The first patent on chewing gum was filed in 1869 and the first medicated chewing gum was commercially introduced in 1928. In 1991, The European Pharmacopoeia defined the intended use of medicated chewing gum as local treatment of mouth diseases or for systemic delivery after absorption through the buccal mucosa or from the gastrointestinal tract.

Medicated chewing gum consists of a masticatory gum core with a coating that can be a film of polymers, waxes, sweeteners, sugar, flavors, or colors. The pharmacologically active ingredient can be present in the core, in the coating, or in both. The degree of the oromucosal absorption depends on the condition of the mucosa, the contact time, and the physicochemical properties of the active ingredient. A small un-ionized lipophilic molecule dissolved in saliva that is enzymatically stable is likely to be absorbed most readily. Regarding local actions, it is possible to achieve beneficial effects with medicated chewing gum that might be superior to those achieved with lozenges.

A saliva-soluble ingredient will be almost completely released within 10–15 minutes of chewing whereas a lipid-soluble ingredient will dissolve in the gum base and thereafter be slowly and incompletely released. As mastication increases the production of saliva, the active ingredient (depending on its characteristics) is dissolved into the saliva and thereafter swallowed with a consequent systemic absorption.

Medicated chewing gum has through the years gained increasing acceptance as a drug delivery system. Several ingredients are now incorporated in medicated chewing gum, e.g. fluoride for prophylaxis of dental caries, chlorhexidine as a local disinfectant, nicotine for smoking cessation, aspirin (acetylsalicylic acid) as an analgesic, dimenhydrinate for motion sickness, and caffeine as a ’stay alert’ preparation. There are many other conditions and diseases where there is a potential for the use of medicated chewing gum. Children in particular may consider chewing gum as a more preferred method of drug administration compared with oral liquids or tablets. The use of medicated chewing gum is feasible as a local treatment of diseases of the oral cavity as well as a treatment of systemic conditions.

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Notes

  1. 1.

    The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgments

Fertin Pharma A/S, Vejle, Denmark is acknowledged for data on the amount of gum consumption.

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Correspondence to Dr Jette Jacobsen.

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Jacobsen, J., Christrup, L.L. & Jensen, N. Medicated chewing gum. Am J Drug Deliv 2, 75–88 (2004). https://doi.org/10.2165/00137696-200402020-00001

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Keywords

  • Nicotine
  • Oral Health
  • Active Ingredient
  • Motion Sickness
  • Salivary Flow Rate