Table 5

Novel types of oral dosage forms for young children: type of dosage form, age group and main user advantages and disadvantages*

Novel types of oral dosage forms
Dosage form	Formulation characteristics	Likely to be used from	Main (user) advantages	Main (user) disadvantages
Medicated spoon that forms oral pulp	Immediate release†	Probably 4–6 months	Easy to swallow Easy handling	Various strength may be required Need for clean water by patient	20
Multiple scored tablet	IMMEDIATE release†	1 month	As tablet but ▸ Better dosing flexibility	As tablet but ▸ Need for dosing accuracy upon breaking ▸ Acceptability parts depend on size/shape	34
Milk-based oral liquid formulation	Immediate release†	(Term) birth	As liquid formulation	As liquid formulation, but ▸ Solubility and compatibility need attention	35
Nipple-shield drug delivery device	Immediate release†	(Term) birth		For use in breastfed children only	36
Robot system using microencapsulated drug	Immediate† or modified‡ release	6 months, possibly younger	As for granules, but ▸ Swallowed as a pulp ▸ One dosage unit contains all drugs prescribed	Cost only acceptable if adopted on a wide scale	37

*Recommendations on age are based on the reflected literature, considerations of the European Medicines Agency (EMA) guideline on the pharmaceutical development of medicines for paediatric use16 and expert knowledge of marketing authorisations.
†Immediate release administration implies the general disadvantage that dosing frequencies may be high. Although not intended, immediate release formulations may normally be chewed, crumbled or crushed. However, this may affect taste.
‡Modified release administration implies the general advantage that dosing frequencies may be reduced. Depending on the type of modified release, these formulations may sometimes be chewed or crumbled; however, they may never be crushed to powder.