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Research Article

Ocular bioanalysis of moxifloxacin and ketorolac tromethamine in rabbit lacrimal matrix using liquid chromatography–tandem mass spectrometry

    Amol Chhatrapati Bisen

    Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, India

    Academy of Scientific & Innovative Research (AcSIR), CSIR-HRDC Campus, Ghaziabad, Uttar Pradesh, 201002, India

    &
    Rabi Sankar Bhatta

    *Author for correspondence: Tel.: +91 522 277 2974; Ext.: 4853;

    E-mail Address: rabi_bhatta@cdri.res.in

    Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, India

    Academy of Scientific & Innovative Research (AcSIR), CSIR-HRDC Campus, Ghaziabad, Uttar Pradesh, 201002, India

    Published Online:https://doi.org/10.4155/bio-2023-0233

    Aim: The fixed-dose combination of moxifloxacin (MOXI) and ketorolac tromethamine (KTR) is widely used for the treatment of bacterial keratitis. Thus, a new LC–MS/MS method was developed to determine MOXI and KTR in lacrimal fluid. Methods: Bioanalysis was performed using a Shimadzu 8050 LC–MS/MS in electrospray ionization-positive mode and the method was validated per US FDA guidelines. Isocratic separation was performed with a Waters Symmetry C18 column using methanol and 0.1% formic acid containing deionized water (85:15, v/v). Results & conclusion: An easy, quick and selective method was established and applied to assess the ocular pharmacokinetic profile of a commercially available formulation containing MOXI and KTR. Based on the pharmacokinetic data, this work describes pharmacokinetics-based dosage regimen calculations and their clinical significance.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Ung L, Bispo PJM, Shanbhag SS, Gilmore MS, Chodosh J. The persistent dilemma of microbial keratitis: global burden, diagnosis, and antimicrobial resistance. Surv. Ophthalmol. 64(3), 255–271 (2019).
    • 2. Egrilmez S, Yildirim-Theveny Ş. Treatment-resistant bacterial keratitis: challenges and solutions. Clin. Ophthalmol. 14, 287–297 (2020).
    • 3. Sanap SN, Bisen AC, Agrawal S, Kedar A, Bhatta RS. Ophthalmic nano-bioconjugates: critical challenges and technological advances. Ther. Deliv. 14(7), 419–441 (2023).
    • 4. Hatami H, Ghaffari Jolfayi A, Ebrahimi A, Golmohammadi S, Zangiabadian M, Nasiri MJ. Contact lens associated bacterial keratitis: common organisms, antibiotic therapy, and global resistance trends: a systematic review. Front.Ophthalmol. 1, 759271 (2021).
    • 5. Kam KW, Yung W, Li GKH, Chen LJ, Young AL. Infectious keratitis and orthokeratology lens use: a systematic review. Infection 45(6), 727–735 (2017).
    • 6. Bisen AC, Agrawal S, Sanap SN et al. COVID-19 retreats and world recovers: a silver lining in the dark cloud. Health Care Sci. 2(4), 264–285 (2023).
    • 7. Balfour JA, Wiseman LR. Moxifloxacin. Drugs 57, 363–373 (1999).
    • 8. Miller D. Review of moxifloxacin hydrochloride ophthalmic solution in the treatment of bacterial eye infections. Clin. Ophthalmol. 2(1), 77–91 (2008).
    • 9. Constantinou M, Daniell M, Snibson GR, Vu HT, Taylor HR. Clinical efficacy of moxifloxacin in the treatment of bacterial keratitis: a randomized clinical trial. Ophthalmology 114(9), 1622–1629 (2007).
    • 10. Vadivelu N, Gowda AM, Urman RD et al. Ketorolac tromethamine–routes and clinical implications. Pain Practice 15(2), 175–193 (2015).
    • 11. Attar M, Schiffman R, Borbridge L, Farnes Q, Welty D. Ocular pharmacokinetics of 0.45% ketorolac tromethamine. Clin. Ophthalmol. 4, 1403–1408 (2010). •• Reports thepreclinical pharmacokinetics of ketorolac in arabbit model.
    • 12. David Waterbury L, Silliman D, Jolas T. Comparison of cyclooxygenase inhibitory activity and ocular anti-inflammatory effects of ketorolac tromethamine and bromfenac sodium. Curr. Med. Res. Opin. 22(6), 1133–1140 (2006).
    • 13. Sandoval HP, Fernández de Castro LE, Vroman DT, Solomon KD. A review of the use of ketorolac tromethamine 0.4% in the treatment of post-surgical inflammation following cataract and refractive surgery. Clin. Ophthalmol. 1(4), 367–371 (2007).
    • 14. Juthani VV, Clearfield E, Chuck RS. Non-steroidal anti-inflammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery. Cochrane Database Syst. Rev. 7(7), Cd010516 (2017).
    • 15. Keenan JD. Steroids in the management of infectious keratitis. Cornea 42(11), 1333–1339 (2023).
    • 16. Biswas A, Choudhury AD, Agrawal S et al. Recent insights into the etiopathogenesis of diabetic retinopathy and its management. J. Ocular Pharmacol. Ther. Doi: 10.1089/jop.2023.0068 (2023) (Epub ahead of print).
    • 17. Sanap SN, Kedar A, Bisen AC, Agrawal S, Bhatta RS. A recent update on therapeutic potential of vesicular system against fungal keratitis. J. Drug Deliv. Sci. Technol. 75, 103721 (2022).
    • 18. Biswas A, Choudhury AD, Bisen AC et al. Trends in formulation approaches for sustained drug delivery to the posterior segment of the eye. AAPS PharmSciTech 24(8), 217 (2023).
    • 19. Heinig K, Bertran E, Potter J, Fraier D. Ocular bioanalysis: challenges and advancements in recent years for these rare matrices. Bioanalysis 9(24), 1997–2014 (2017). • Reported challenges involved in ocular pharmacokinetics useful for the current study.
    • 20. Hubicka U, Żmudzki P, Talik P, Żuromska-Witek B, Krzek J. Photodegradation assessment of ciprofloxacin, moxifloxacin, norfloxacin and ofloxacin in the presence of excipients from tablets by UPLC–MS/MS and DSC. Chem. Cent. J. 7, 1–12 (2013).
    • 21. Bisen AC, Sanap SN, Biswas A et al. A QbD-led simple and sensitive RP-UHPLC method for simultaneous determination of moxifloxacin, voriconazole, and pirfenidone: an application to pharmaceutical analysis. Biomed. Chromatogr. 37(9), e5681 (2023).
    • 22. Radwan M, Alquadeib B, Aloudah N, Enein HA. Pharmacokinetics of ketorolac loaded to polyethylcyanoacrylate nanoparticles using UPLC MS/MS for its determination in rats. Int. J. Pharm. 397(1–2), 173–178 (2010).
    • 23. Mishra A, Chhonker YS, Bisen AC et al. Rapid and simultaneous analysis of multiple classes of antimicrobial drugs by liquid chromatography-tandem mass spectrometry and its application to routine biomedical, food, and soil analyses. ACS Omega 5(49), 31584–31597 (2020).
    • 24. Boddu SHS, Gunda S, Earla R, Mitra AK. Ocular microdialysis: a continuous sampling technique to study pharmacokinetics and pharmacodynamics in the eye. Bioanalysis 2(3), 487–507 (2010). • Discusses the ophthalmic microsampling techniques and its importance in ocular bioanalysis.
    • 25. Schneider MJ. Methods for the analysis of fluoroquinolones in biological fluids. Bioanalysis 1(2), 415–435 (2009).
    • 26. Yıldırım S, Karakoç HN, Yaşar A, Köksal İ. Determination of levofloxacin, ciprofloxacin, moxifloxacin and gemifloxacin in urine and plasma by HPLC–FLD–DAD using pentafluorophenyl core–shell column: application to drug monitoring. Biomed. Chromatogr. 34(10), e4925 (2020).
    • 27. Czyrski A, Sokół A, Szałek E. HPLC method for determination of moxifloxacin in plasma and its application in pharmacokinetic analysis. J. Liq. Chromatogr. Relat. Technol. 40(1), 8–12 (2017).
    • 28. Pranger AD, Alffenaar J-WC, Mireille A, Wessels A, Greijdanus B, Uges DR. Determination of moxifloxacin in human plasma, plasma ultrafiltrate, and cerebrospinal fluid by a rapid and simple liquid chromatography-tandem mass spectrometry method. J. Anal. Toxicol. 34(3), 135–141 (2010).
    • 29. Patri S, Patni AK, Iyer SS et al. A validated high-performance liquid chromatography-tandem mass spectrometric (LC–MS/MS) method for simultaneous determination of R(+)-ketorolac and S(-)-ketorolac in human plasma and its application to a bioequivalence study. Chromatogr. Res. Int. 2011, 214793 (2011).
    • 30. Sanap SN, Bisen AC, Choudhury AD, Verma SK, Kumar M, Bhatta RS. A QBD driven approach for development and validation of an RP-UHPLC method for simultaneous estimation of ofloxacin and fluconazole: an application to pharmaceutical analysis. Analyt. Chem. Lett. 12(3), 310–321 (2022).
    • 31. Hou Z, Wen Q, Zhou W, Yan P, Zhang H, Ding J. Topical delivery of ketorolac tromethamine via cataplasm for inflammatory pain therapy. Pharmaceutics 15(5), 1405 (2023).
    • 32. Zhao X, Yuan Y, Shao Q, Qiao H. Simultaneous determination of moxifloxacin hydrochloride and dexamethasone sodium phosphate in rabbit ocular tissues and plasma by LC–MS/MS: application for pharmacokinetics studies. Molecules 27(22), 7934 (2022). •• Reports simultaneous preclinical pharmacokinetics of moxifloxacin and dexamethasone in a rabbit model and aligns with the objectives of the current paper.
    • 33. Bisen AC, Agrawal S, Sanap SN et al. Simultaneous estimation of voriconazole, moxifloxacin, and pirfenidone in rabbit lacrimal matrix using LC–MS/MS: an application to preclinical ocular pharmacokinetics. Anal. Methods 15(18), 2234–2243 (2023). •• Reports simultaneous method development and validation of analogous drugs with pharmacokinetic studies in a lacrimal matrix.
    • 34. van den Elsen SH, Akkerman OW, Jongedijk EM et al. Therapeutic drug monitoring using saliva as matrix: an opportunity for linezolid, but challenge for moxifloxacin. Eur. Respir. J. 55(5), 1901903 (2020).
    • 35. Mohammed BS, Engelhardt T, Cameron GA, Hawwa AF, Helms PJ, McLay JS. Development of an enantiomer selective microsampling assay for the quantification of ketorolac suitable for paediatric pharmacokinetic studies. Biopharm. Drug Dispos. 34(7), 377–386 (2013).
    • 36. Patel D, Patel M, Patel K. Simultaneous RP-HPLC estimation of moxifloxacin hydrochloride and ketorolac tromethamine in ophthalmic dosage forms. Asian J. Res. Chem. 5(5), 12 (2012). • Attempted to develop a simultaneous analytical method for application to formulation quality control.
    • 37. Nättinen J, Aapola U, Jylhä A, Vaajanen A, Uusitalo H. Comparison of capillary and Schirmer strip tear fluid sampling methods using SWATH-MS proteomics approach. Transl. Vis. Sci. Technol. 9(3), 16 (2020).
    • 38. Sanap SN, Bisen AC, Agrawal S et al. Liquid chromatography-tandem mass spectrometry method for simultaneous assessment of ofloxacin and dexamethasone in ocular biofluids: application to ocular pharmacokinetic studies. Sep. Sci. Plus 5(11), 593–601 (2022).
    • 39. Maksić J, Stajić A, Knežević M, Krnjaja BD, Jančić-Stojanović B, Medenica M. Determination of olopatadine in human tears by hydrophilic interaction liquid chromatography–MS/MS method. Bioanalysis 9(24), 1943–1954 (2017).
    • 40. Sanap SN, Mishra A, Bisen AC et al. Simultaneous determination of fluconazole and ofloxacin in rabbit tear fluid by LC–MS/MS: application to ocular pharmacokinetic studies. J. Pharm. Biomed. Anal. 208, 114463 (2022). •• Reports simultaneous method development and validation of analogous drugs with moxifloxacin and provides a rationale for the use of ofloxacin as an internal standard.
    • 41. Lin J Lu Z Wang Y et al. Pharmacokinetics of sirolimus eye drops following topical ocular administration in rabbits. J. Ocular Pharmacol. Ther. 39 (10), 735–743 (2023).
    • 42. Bisen AC, Sanap SN, Agrawal S, Biswas A, Bhatta RS. Chemical metabolite synthesis and profiling: mimicking in vivo biotransformation reactions. Bioorg. Chem. 139, 106722 (2023).
    • 43. Sanap NS, Bisen CA, Kedar A, Agrawal S, Bhatta SR. Recent update on pharmacokinetics and drug metabolism in CNS-based drug discovery. Curr. Pharm. Design 29(20), 1602–1616 (2023).
    • 44. Vishwanathan K, Bartlett MG, Stewart JT. Determination of moxifloxacin in human plasma by liquid chromatography electrospray ionization tandem mass spectrometry. J. Pharm. Biomed. Anal. 30(4), 961–968 (2002).
    • 45. Shukla RP, Dewangan J, Urandur S et al. Multifunctional hybrid nanoconstructs facilitate intracellular localization of doxorubicin and genistein to enhance apoptotic and anti-angiogenic efficacy in breast adenocarcinoma. Biomater. Sci. 8(5), 1298–1315 (2020).
    • 46. Tiwari P, Shukla RP, Yadav K et al. Dacarbazine-primed carbon quantum dots coated with breast cancer cell-derived exosomes for improved breast cancer therapy. J. Control. Release. 365, 43–59 (2024).
    • 47. Mishra A, Bano M, Bisen AC et al. Topical corneal targeted sustained release amphotericin B liposomal formulation for the treatment of fungal keratitis and its PK-PD evaluation. J. Drug Deliv. Sci. Technol. 60, 101944 (2020).
    • 48. Balla A, Ruponen M, Valtari A et al. Understanding dexamethasone kinetics in the rabbit tear fluid: drug release and clearance from solution, suspension and hydrogel formulations. Eur. J. Pharm. Biopharm. 172, 53–60 (2022).
    • 49. Nilsson LB, Ahnoff M, Jonsson O. Capillary microsampling in the regulatory environment: validation and use of bioanalytical capillary microsampling methods. Bioanalysis 5(6), 731–738 (2013).
    • 50. Bisen AC, Rawat P, Sharma G et al. Hesperidin: enrichment, forced degradation, and structural elucidation of potential degradation products using spectral techniques. Rapid Commun. Mass Spectrom. 37(20), e9615 (2023).
    • 51. Sanap SN, Bisen AC, Kedar A et al. Chitosan/HPMC-based mucoadhesive film co-loaded with fluconazole and ofloxacin for management of polymicrobial keratitis. Int. J. Biol. Macromol. 222, 2785–2795 (2022).
    • 52. Kesarla R, Tank T, Vora PA, Shah T, Parmar S, Omri A. Preparation and evaluation of nanoparticles loaded ophthalmic in situ gel. Drug Deliv. 23(7), 2363–2370 (2016).
    • 53. US FDA. Bioanalytical Method Validation Guidance for Industry. (2023). www.fda.gov/regulatory-information/search-fda-guidance-documents/bioanalytical-method-validation-guidance-industry
    • 54. Agrawal S, Bisen AC, Biswas A et al. Simultaneous pharmacokinetic assessment of phytopharmaceuticals from fenugreek extract by liquid chromatography-tandem mass spectrometry in Sprague Dawley rats. Biomed. Chromatogr. 37(5), e5600 (2023).
    • 55. Agrawal S, Bisen AC, Sanap SN et al. LC–MS/MS based quantification of steroidal biomarkers in polycystic ovary syndrome induced rats. J. Pharm. Biomed. Anal. 234, 115484 (2023).
    • 56. Agrawal S, Sanap SN, Bisen AC et al. Preclinical pharmacokinetics of 4-hydroxy isoleucine using LC–MS/MS: a potential polycystic ovary syndrome phytopharmaceutical therapeutics. Bioanalysis. 15(13), 711–725 (2023).
    • 57. Matuszewski BK, Constanzer ML, Chavez-Eng CM. Strategies for the assessment of matrix effect in quantitative bioanalytical methods based on HPLC–MS/MS. Anal. Chem. 75(13), 3019–3030 (2003).
    • 58. Agrawal S, Bisen AC, Biswas A et al. UHPLC method for quantification of bioactive components in fenugreek herbal preparations. Rev. Bras. Farmacogn. 33, 1031–1040 (2023).
    • 59. Sanap SN, Bisen AC, Mishra A et al. QbD based antifungal drug-loaded ophthalmic liposomal formulation for the management of fungal keratitis: in vitro, ex vivo and in vivo pharmacokinetic studies. J. Drug Deliv. Sci. Technol. 74, 103517 (2022). •• Precorneal residence studies that corroborate the present work to determine pharmacokinetic-pharmacodynamic indices and pharmacokinetic simulation studies.
    • 60. Mishra A, Choudhury AD, Biswas A et al. Concurrent determination of anti-microbial and anti-inflammatory drugs in lachrymal fluid and tissue by LC–MS/MS: A potential treatment for microbial keratitis and its PK-PD evaluation. J. Pharm. Biomed. Anal. 239, 115920 (2024).
    • 61. Mishra A, Biswas A, Choudhury AD et al. Simultaneous determination of amphotericin B, tobramycin and vancomycin in rabbit ocular biofluids and tissues by LC–MS/MS: An antimicrobial therapy for keratitis and its PK-PD application. J. Chromatogr. B. (2023) (Epub ahead of print).