Using absorbable sugar-based excipients for antidiabetic drugs may not be justifiable. Recently, FDA has warned healthcare professionals of the potential for life-threatening, falsely elevated glucose readings using glucose dehydrogenase pyrroloquinoline guinone-based glucose monitoring systems in patients who have received parenteral products containing maltose or galactose or oral xylose (22). Other excipients such as sodium docusate, polyethylene glycol, guar gum, methyl cellulose, polycarbophil, sodium phosphate, magnesium oxide, and magnesium carbonate, also possess laxative properties and may be used to counter the constipation side effect of some drugs. Furthermore, the magnesium mineral is an obvious powerhouse, which has the beneficial effects on many conditions, including heart attack, angina, arrhythmias, cardiomyopathy, mitral valve prolapse, intermittent claudication, low HDL, high blood pressure, diabetes, muscle cramps, kidney stones, fibromyalgia, and fatigue. In addition, magnesium may be just as important as calcium for the prevention of low bone density and osteoporosis.

Magnesium and calcium work synergistically, and both are needed for bone health, along with other cofactors of bone production, such as vitamin D and K, boron, and zinc. The calcium mineral is critical to bone strength. Calcium carbonate, dicalcium phosphate, calcium sulfate, and tricalcium phosphate can be used with a bisphosphonate drug (e.g., alendronate, risendronate, and ibandronate), a selective estrogen receptor modulator (e.g., raloxifene), or a drug with osteoporosis side effect (e.g., prednisolone) to treat and prevent osteoporosis. Long-term drug therapy for these conditions, in which the mineral can contribute significantly, is the prerequisite to consider using magnesium mineral as an excipient because mineral supplements can take as long as several weeks for results. In addition, these mineral excipients (e.g., calcium carbonate, sodium bicarbonate, and magnesium oxide can impart alkalinity to the drug microenvironment, which is another factor to be considered when using them in formulations. From the alkalinity aspect, these excipients with antacid function can be used with proton-pump inhibitors and H2 blockers to enhance the treatment additively or synergistically.

Amino acids such as glycine, lysine, isoleucine, leucine, arginine, and methionine have been used rarely in formulations as buffering agents, water-soluble lubricants, or for other functionalities. Amino acids may be used to treat certain diseases. For example, lysine is used in the treatment of cold sores and leucine may block the break down of muscle-building proteins at a lower rate. Furthermore, poly-L-lactic acid, a commonly used biodegradable polyester, is approved as an injectable implant for the restoration or correction of the sign of lipoatrophy in individuals with HIV (23). Even for a commonly used enteric polymer, preliminary data in mouse models suggest that properly formulated cellulose acetate phthalate may be an efficacious agent for preventing vaginal transmission of genital herpesvirus infections (24).