effervescent tablet

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Effervescent or carbon tablets are tablets which are designed to dissolve in water and release carbon dioxide. The carbon dioxide is generated by a reaction of a compound containing bicarbonate, such as sodium bicarbonate or magnesium bicarbonate, with an acid such as citric acid or tartaric acid. Both compounds are present in the tablet in powder form and start reacting as soon as they dissolve in water.{{cite news|last1=Dubogrey|first1=Ilya|title=Putting the Fizz into Formulation|url=http://www.samedanltd.com/magazine/11/issue/204/article/3622|work=European Pharmaceutical Contractor|issue=Autumn|date=2013|access-date=2016-09-02|archive-date=2021-08-28|archive-url=https://web.archive.org/web/20210828151212/http://www.samedanltd.com/magazine/11/issue/204/article/3622|url-status=dead}}{{Cite web

| url=http://www.newdruginfo.com/pharmacopeia/bp2003/British%20Pharmacopoeia%20Volume%20III/Monographs/Formulated%20Preparations%20Genearal%20Monographs/TABLETS.htm

| title=Formulated Preparations Genearal Monographs: Tablets

| work=British Pharmacopoeia Volume III

| publisher=British Pharmacopoeia

| date=2013

| archive-url=https://web.archive.org/web/20170815135102/http://www.newdruginfo.com/pharmacopeia/bp2003/British%20Pharmacopoeia%20Volume%20III/Monographs/Formulated%20Preparations%20Genearal%20Monographs/TABLETS.htm

| archive-date=2017-08-15

| url-status=dead }}{{cite book|title=International Pharmacopoeia 2006|url=https://archive.org/details/bub_gb_s_sBKJNf184C|access-date=2019-08-20|year=2006|publisher=World Health Organization|isbn=978-92-4-156301-7|pages=[https://archive.org/details/bub_gb_s_sBKJNf184C/page/n993 966]}}{{cite journal |last1=Shirsand |first1=S. B. |last2=Suresh |first2=Sarasija |last3=Jodhana |first3=L. S. |last4=Swamy |first4=P. V. |title=Formulation Design and Optimization of Fast Disintegrating Lorazepam Tablets by Effervescent Method |journal=Indian Journal of Pharmaceutical Sciences |date=2010 |volume=72 |issue=4 |pages=431–436 |doi=10.4103/0250-474X.73911 |pmid=21218052 |issn=0250-474X |pmc=3013557 |doi-access=free }}

Effervescent tablets are made by compression of ingredients in the form of powders into a dense mass, which is packaged in blister pack, or with a hermetically sealed package with incorporated desiccant in the cap. To use them, they are dropped into water to make a solution. The powdered ingredients are also packaged and sold as effervescent powders or may be granulated and sold as effervescent granules. Generally powdered ingredients are first granularized before being made into tablets.{{cite web|title=Powders and Granules|url=http://pharmlabs.unc.edu/labs/powders/granulations.htm|website=The Pharmaceutics and Compounding Laboratory|publisher=University of North Carolina|archive-url=https://web.archive.org/web/20170520215340/http://pharmlabs.unc.edu/labs/powders/granulations.htm|archive-date=2017-05-20|url-status=dead|access-date=2019-08-20}}{{cite journal|last1=Stahl|first1=Harald|title=Effervescent Dosage Manufacturing|url=http://www.pharmtech.com/effervescent-dosage-manufacturing|journal=Pharmaceutical Technology Europe|volume=15|issue=4|publisher=PharmTech|date=Apr 1, 2003}}

Effervescent medicinal beverages date back to the late 1800s and originally arose to mask the taste of bitter waters taken as curatives, during the water cure craze of that era.{{cite thesis

| url=http://etheses.dur.ac.uk/9525/

| title=The analytical chemist in nineteenth century English social history

| author=W. A. Campbell

| date=1971

| publisher=Durham University| type=Masters

}}

History

In the 17th and 18th centuries, scientists began uncovering the chemical make-up and physiological benefits of various salts such as Glauber's salt and Epsom salts. These salts were found in mineral springs, which, since the Roman Empire,{{cite web|url=http://www.plumbingworld.com/historyroman.html|title=The History of Plumbing — Roman and English Legacy|work=Plumbing World|archive-url=https://web.archive.org/web/20071111205747/http://plumbingworld.com/historyroman.html|archive-date=11 November 2007|url-status=dead|access-date=1 November 2007}}{{sfnp|EB|1878|p=227}}{{sfnp|EB|2015}}{{sfnp|EB|2015}} had been used as health spas, where people would go to bathe in, and drink, mineral-rich waters for their health. These developments led to attempts to replicate the salt mixtures found in these naturally occurring mineral waters using off-the-shelf ingredients. Mixing these kinds of salts — especially carbonates and tartrates — with flavorings like lemon into an effervescent compound with citric or tartaric acid proved especially popular and set off a craze for the new "fruit salts". Effervescent tablets have been used as products of the pharmaceutical and dietary industries for over two centuries.

Use

= In by-mouth medicine =

Vitamins may be sold as effervescent tablets.

There are several categories of active ingredients that may be best administered in the form of effervescent preparations:

Those that are difficult to digest or disruptive to the stomach or esophagus{{cite web|url=https://secure.medicalletter.org/w1401c|title=In Brief: Effervescent Alendronate|date=October 15, 2012|publisher=The Medical Letter on Drugs and Therapeutics}}
Those that are pH–sensitive, such as amino acids and antibiotics.
Those requiring a large dose.
Those that are susceptible to light, oxygen, or moisture.
It is used as a gastrointestinal agent.

Effervescent preparations may enhance absorption and speed up onset of action by increasing gastric pH, therefore hastening the emptying of medication into the small intestine.{{cite book |last1=Awad |first1=Atheer |last2=Trenfield |first2=Sarah J. |last3=Basit |first3=Abdul W. |chapter=Solid oral dosage forms |title=Remington: The Science and Practice of Pharmacy|edition=23 |date=2021 |pages=333–358 |doi=10.1016/B978-0-12-820007-0.00019-2|isbn=978-0-12-820007-0|s2cid=230548090 }} The carbon dioxide bubbles may also help intestinal absorption by opening up paracellular transport.{{cite journal |last1=Eichman |first1=JD |last2=Robinson |first2=JR |title=Mechanistic studies on effervescent-induced permeability enhancement. |journal=Pharmaceutical Research |date=June 1998 |volume=15 |issue=6 |pages=925–30 |doi=10.1023/a:1011936901638 |pmid=9647360|s2cid=9833100 }} Extreme bioavailability differences of up to 4-fold have been reported comparing effervescent tablets with ordinary tablets, highlighting the need for extra bioequivalence studies when switching dosage forms.{{cite journal |last1=Andersen |first1=MP |title=Lack of bioequivalence between disulfiram formulations. Exemplified by a tablet/effervescent tablet study. |journal=Acta Psychiatrica Scandinavica. Supplementum |date=1992 |volume=369 |pages=31–5 |doi=10.1111/j.1600-0447.1992.tb03312.x |pmid=1471549|s2cid=10127796 }}

= Other =

"Cleaning tablets" are formulations carrying detergents for cleaning. They may be used in laundry, in cleaning of specific machines or containers, in cleaning of dentures and contact lenses,{{cite journal |last1=Begley |first1=CG |last2=Paragina |first2=S |last3=Sporn |first3=A |title=An analysis of contact lens enzyme cleaners. |journal=Journal of the American Optometric Association |date=March 1990 |volume=61 |issue=3 |pages=190–4 |pmid=2186082}} etc.

Some tablets used for dyeing eggs for Easter are effervescent.

There also exist effervescent tablets for making carbonated drinks or soda water.

Capsules

Effervescent tablets mostly come in capsules constructed for these tablets. They may contain an anti-bacterial coating and are water-resistant. The cap contains a little spring-like spiral, which helps keep the tablets in place during transportation and prevents them from breaking. The cap also contains little balls made out of silica gel.{{cite web | url=https://www.webpackaging.com/en/portals/xinfudabottle/assets/11608899/effervescent-tube-with-spiral-desiccant-closure/ | title=Effervescent Tube with Spiral Desiccant Closure - Topic Entry - Xinfuda Bottle }} They sit after a little piece of cardboard and make sure no moisture comes into contact with the tablets.

Contraindications

It is dangerous to swallow an effervescent tablet directly, as the tablet can get stuck in the subglottis and fizzle there. A potentially fatal edema may occur from the irritation.{{cite journal |last1=Yeniocak |first1=Selman |last2=Tatli |first2=Ozgur |last3=Cansu |first3=Aysegul |last4=Erturk |first4=Engin |last5=Erol |first5=Mehmet Muharrem |last6=Turedi |first6=Suleyman |title=Acute severe respiratory distress secondary to misuse of an N-acetylcysteine effervescent tablet |journal=The American Journal of Emergency Medicine |date=September 2010 |volume=28 |issue=7 |pages=842.e5–842.e6 |doi=10.1016/j.ajem.2009.11.013|pmid=20837268 }} In addition, conventional effervescent tablets contain a significant amount of sodium and are associated with increased odds of adverse cardiovascular events according to a 2013 study. Low or no-sodium formulations exist.{{cite journal |last1=George |first1=J |last2=Majeed |first2=W |last3=Mackenzie |first3=IS |last4=Macdonald |first4=TM |last5=Wei |first5=L |title=Association between cardiovascular events and sodium-containing effervescent, dispersible, and soluble drugs: nested case-control study. |journal=BMJ (Clinical Research Ed.) |date=26 November 2013 |volume=347 |pages=f6954 |doi=10.1136/bmj.f6954 |pmid=24284017 |pmc=3898660 |doi-access=free}}

Adverse effects

=Demineralization potential=

The acidic nature of effervescent tablets can lower the pH of the oral environment, promoting acid-induced demineralization.{{cite journal | last=Hellwig | first=Elmar | last2=Lussi | first2=Adrian | title=Oral hygiene products, medications and drugs - hidden aetiological factors for dental erosion | journal=Monographs in Oral Science | volume=25 | date=2014 | issn=0077-0892 | pmid=24993264 | doi=10.1159/000359942 | pages=155–162 | url=https://pubmed.ncbi.nlm.nih.gov/24993264 | access-date=2025-06-11 | type= Review}}{{cite journal | last=Wegehaupt | first=Florian J. | last2=Lunghi | first2=Nancy | last3=Hogger | first3=Vanessa M. G. | last4=Attin | first4=Thomas | title=Erosive potential of vitamin and vitamin+mineral effervescent tablets | journal=Swiss Dental Journal | volume=126 | issue=5 | date=2016 | issn=2296-6498 | pmid=27278776 | doi=10.61872/sdj-2016-05-01 | doi-access=free | pages=457–465 | url=https://www.swissdentaljournal.org/article/download/5815/4392 | access-date=2025-06-11}}{{cite journal | last=Sozen Yanik | first=Irem | last2=Kesim | first2=Betül | last3=Ersu | first3=Bahadır | last4=Koc Vural | first4=Uzay | title=Do effervescent vitamin tablets affect the surface roughness, microhardness, and color of human enamel and contemporary composite resins? | journal=Journal of Prosthodontics | volume=33 | issue=S1 | date=2024 | issn=1059-941X | doi=10.1111/jopr.13878 | doi-access=free | pages=35–46 | url=https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jopr.13878 | access-date=2025-06-11}}{{cite journal | last=Jeong | first=Moon-Jin | last2=Lee | first2=Myoung-Hwa | last3=Jeong | first3=Soon-Jeong | last4=Kim | first4=So-Jeong | last5=Ko | first5=Myeong-Ji | last6=Sim | first6=Hye-Won | last7=Lee | first7=Ju-Young | last8=Im | first8=Ae-Jung | last9=Lim | first9=Do-Seon | title=Effect of Commercial Effervescent Vitamin Tablets on Bovine Enamel | journal=Journal of Dental Hygiene Science | volume=19 | issue=4 | date=2019-12-31 | issn=1598-4478 | doi=10.17135/jdhs.2019.19.4.261 | doi-access=free | pages=261–270 | url=http://www.jkdhs.org/journal/download_pdf.php?doi=10.17135/jdhs.2019.19.4.261 | access-date=2025-06-11}}

References

{{cite EB9 |mode=cs2 |wstitle=Baden (2.) |volume=3 |ref={{harvid|EB|1878}} |pages=226–227 }}
{{cite EB1911 |mode=cs2 |wstitle=Baden (Germany) |volume=3 |ref={{harvid|EB|1911}} |page=184 }}
{{citation |url=https://www.britannica.com/place/Baden-Baden-Germany |title=Baden-Baden, Germany|publisher=Encyclopædia Britannica Online|date=2015 |ref={{harvid|EB|2015}} |access-date=8 October 2015}}.

Category:Dosage forms