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The oral route is the most common choice for drug administration because ofconvenience, low cost, and high patient compliance, but is also a complexroute. The rate of dissolution and gastric emptying of the dissolved activepharmaceutical ingredient (API) into the duodenum is modulated by factors suchas gastric motility, but current in-vitro procedures for assessing drugdissolution are limited in their ability to recapitulate this process. This isparticularly relevant for disease conditions, such as gastroparesis, that alterthe anatomy and/or physiology of the stomach. In this study we employ abiomimetic in-silico simulator based on the realistic anatomy and morphology ofthe stomach, to investigate the effect of body posture and stomach motility ondrug bioavailability. The simulations show that changes in posture can have asignificant (up to 83%) effect on the emptying rate of the API into theduodenum. Similarly, reduction in antral contractility associated withgastroparesis can also significantly reduce the dissolution of the pill as wellas emptying of the API into the duodenum. The simulations show that for anequivalent motility index, reduction in gastric emptying due to neuropathicgastroparesis is larger by a factor of about five compared to myopathicgastroparesis.

Computational model of drug dissolution in the stomach: effects of posture and gastroparesis on drug bioavailability