It is not uncommon for peptides and structurally-similar non-peptides
to have poor intestinal permeability and low oral bioavailability. One
possible way to solve a permeability problem is to formulate the comp
ound with membrane permeation-enhancing excipients. Important criteria
for success of this approach are: (1) achieving reproducible intestin
al permeation, (2) doing so without causing toxicity, and (3) understa
nding the mechanisms of permeation enhancement. Some effective and pot
entially safe permeation enhancers are fatty acids, glycerides, surfac
tants, acyl carnitines, and bile salts. The literature on permeation e
nhancement with these agents is briefly reviewed. We evaluated permeat
ion enhancement approaches to increase the oral bioavailability of a n
on-metabolized, cyclic peptide fibrinogen antagonist, DMP 728. Sodium
caprate (15 mM) increased the in vitro intestinal permeation rate 3-fo
ld. Oral absorption in dogs was also increased approximately 3-fold us
ing a formulation containing 150 mg sodium caprate. Inter-animal varia
bility in absorption was considerable, though. A diacidic, non-peptide
angiotensin II antagonist, DuP 532, presented another case of a poorl
y membrane permeable lead compound. Sodium caprate did not affect DuP
532 oral bioavailability in rats. However, oral bioavailability of DuP
532 in rats and dogs was increased approximately 3-fold using glyceri
de vehicles. These excipients have the advantage of already being used
in marketed products. As with DMP 728, there was substantial inter-an
imal variability of DuP 532 oral bioavailability, and optimization of
the formulation would be required to improve reproducibility. These ex
amples demonstrate the possibilities of significantly improving oral b
ioavailability of poorly permeable drugs using seemingly acceptable ex
cipients.