Effect of Food Thickener on Edoxaban Tablet Dissolution

Adherence to medication is essential for effective pharmacotherapy, particularly in elderly patients with cognitive and physical impairments. Thickeners commonly used to assist swallowing in patients with dysphagia may influence drug dissolution and absorption. This study investigated the effect of a xanthan gum-based thickener on the in vitro dissolution of edoxaban tablets. Film-coated (FC) and orally disintegrating (OD) edoxaban tablets with varying viscosities and immersion times were immersed in thickened water. Dissolution tests were performed under different pH conditions simulating the gastric environments of elderly patients or those receiving acid-suppressive therapy. Additional tests evaluated the impact of crushing the tablets. The results showed that thickened water significantly reduced the dissolution rate of OD tablets, particularly at higher viscosities, longer immersion times, and elevated pH levels. FC tablets were largely unaffected unless crushed. These findings indicate that thickeners can markedly affect the dissolution behavior of certain formulations, especially in patients with altered gastric acidity. FC tablets may be more suitable in such cases. Proper formulation selection, minimization of thickener viscosity, and administration of preparations immediately after mixing are recommended. Pharmacists should closely collaborate with healthcare providers to optimize medication administration using thickeners for patients with dysphagia.