transdermal route

Transdermal route would in principle enable thiamine to be absorbed through the skin and go directly into the blood stream. In general, the use of patches is expected to be associated with increased patient and carer satisfaction, given the lower frequency of doses and the ease of use. Lower doses can be used as the intestine and hepatic first-pass metabolism are bypassed. Ideally, patches would be an optimal option for patients with swallowing difficulties and gastrointestinal problems. Also, theoretically, compliance with treatment should be better, more so in persons with cognitive problems. A difficult aspect to overcome is the development of a formulation which can get through the skin barrier (Grammatikopoulou 2021).

In a review of transdermal patches, the authors conclude: “Presently, the transdermal delivery seems promising with regard to nutritional supplementation, however limited evidence exists for its efficacy in humans.” (Grammatikopoulou 2021).

To note that the existence of differences in human skin, e.g. between genders, ethnic groups and age, may result in different efficacy in different subjects.
Some of the skin patch products available in the market with thiamine (B1) are time-release formulations covering 6 to 24 hours with the application of one patch.

However, skin patches with thiamine have not yet been studied in PD. There is very limited information available and lack of controlled clinical studies in PD.

Issues to be researched in PD include, among others: the absorption rate of thiamine in the transdermal patches, the most suitable form of thiamine for this route – some patches contain thiamine mononitrate -, how to fine-tune dosage according to individual needs and the occurrence of side effects (skin and allergic reactions) especially with long-term, chronic use such as the one needed in PD.

Selected references

Maria G. Grammatikopoulou, Konstantinos Gkiouras, Efthimios Dardiotis, Efterpi Zafiriou, Christina Tsigalou, Dimitrios P. Bogdanos, Peeking into the future: Transdermal patches for the delivery of micronutrient supplements, Metabolism Open, Volume 11,2021,100109, ISSN 2589-9368

Text author: Sergio Pièche
Page updated - 24/04/23