The novel coronavirus disease in 2019 (COVID-19) first identified in Wuhan, China has created a shortage of not only the medical equipment (ventilators, personal protective equipment) and medical devices but also the drug supply chain [1]. Traditional manufacturing of drugs was greatly affected due to lockdown and disruption in the transportation system. This created the need for rapid and decentralized manufacturing technique to prevent the spread of the disease. Therefore, additive manufacturing/3D printing has been utilized which allows rapid and personalized drug production in disease hot spots such as in rural health clinic or in an isolated community, where there are insufficient supply chains and logistical infrastructure. The utilization of various 3D printing technologies depends on the physicochemical properties of the repurposed drugs currently under clinical trials for covid-19.

Many of the repurposed drugs for COVID-19 prevention and treatment can be manufactured as different dosage forms such as 3D printed tablets, polypills, capsules, orodispersible films (ODFs), microneedles using various 3D printing technologies. However, currently available repurposed drugs are known to have low aqueous solubility, and therefore, extrusion-based 3D printing, especially FDM printed amorphous solid dispersions, is known to enhance the bioavailability of such drugs. Extrusion-based 3D printing technology is the most commonly used in drug delivery due to its wide availability of polymers, low cost, ability to fabricate hollow dosage forms of varying porosities, ability to control the drug release by modifying the geometry, and for its ability to print at room temperatures for thermo-labile drugs using semisolid extrusion 3D printing technology [2]. However, major limitations of this technique is the exposure of drugs to higher temperatures causing degradation of heat-labile drugs. Therefore, semisolid extrusion can be utilized to avoid exposure of drugs to higher temperatures. Similarly, another 3D printing technology such as direct powder extrusion 3D printing enables single-step fabrication of dosage forms without the need to pre-fabricate the filaments. Moreover, to avoid the drug resistance and dose dumping due to misuse, multi-layered or multi-drug loaded dosage forms known as polypills can be fabricated to provide a fixed or variable dose combination of two or more anti-viral therapeutics [3]. In addition to polypills, 3D printed ODFs or microneedles can also be explored as alternative drug delivery carriers for various antiviral drugs, herbal extracts, and vaccines [4]. They can be excellent carriers for patients with dysphagia and also for the pediatric and geriatric patients. Therefore, these could be an excellent cost-effective option for delivery of vaccines to subjects across all age groups in the fight against COVID-19.

Keywords: 3D printing, Extrusion-based 3D printing, COVID-19

References

1. Hsiao, Wen-Kai, Barbara Lorber, and Amrit Paudel. "Can 3D printing of oral drugs help fight the current COVID-19 pandemic (and similar crisis in the future)?." (2020): 899-902.
2. Annaji M, Ramesh S, Poudel I, Govindarajulu M, Arnold RD, Dhanasekaran M, Babu RJ. Application of Extrusion-based 3D Printed dosage forms in the treatment of Chronic Diseases. Journal of Pharmaceutical Sciences. 2020 Oct 6.
3. Fernández-García R, Prada M, Bolás-Fernández F, Ballesteros MP, Serrano DR. Oral fixed-dose combination pharmaceutical products: Industrial manufacturing versus personalized 3D printing. Pharmaceutical research. 2020 Jul;37(7):1-22.
4. Maram SG, Tegginamath PK. The potential of ODFs as carriers for drugs/vaccines against COVID-19. Drug development and industrial pharmacy. 2020 Dec 10:1-27.