Therapeutic Performance of Passive Transdermal Adhesive Patches: A Systematic Review of Bisoprolol, Clonidine, and Nitroglycerin
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Background: Transdermal Drug Delivery Systems (TDDS) offer the potential for stable plasma concentrations and improved patient adherence by bypassing hepatic first-pass metabolism. However, the clinical efficacy of passive adhesive patches varies significantly across pharmacological classes and therapeutic indications. Objective: To systematically review the clinical efficacy, safety, and pharmacokinetic utility of passive transdermal adhesive patches containing Bisoprolol, Nitroglycerin (Glyceryl Trinitrate), and clonidine in adult patient populations. Methods: A systematic literature search was conducted using the PubMed/MEDLINE database for studies published between 2016 and 2024. The eligibility criteria included randomized controlled trials (RCTs), pilot studies, and observational surveys that evaluated passive adhesive matrix systems. Studies that utilized microneedle arrays or active enhancement technologies were excluded. Data were synthesized based on the drug class, hemodynamic outcomes, and safety profiles. Results: Twelve studies met the inclusion criteria. Bisoprolol patches have demonstrated consistent efficacy in maintaining hemodynamic stability, showing a significant dose-dependent reduction in heart rate for acute cardiac symptoms and successful maintenance therapy in chronic heart failure. Clonidine patches have proven effective for neurological control, significantly reducing tic severity in Tourette Syndrome; however, they failed to provide significant analgesic benefits in postoperative pain management. Nitroglycerin patches effectively prevented ischemia-induced microvascular dysfunction but did not improve arteriovenous fistula maturation rates. The safety profiles were favorable across all groups, with bioequivalence established for the various adhesive formulations. Conclusion: Passive transdermal patches are a safe and effective modality for chronic hemodynamic regulation and neuropsychiatric symptom management. Although they offer superior stability over oral dosing for maintenance therapy, their utility in acute postoperative outcomes remains limited. Future developments should focus on integrating active delivery mechanisms to enhance the efficacy of these agents in high-demand clinical settings
Language: English
Subfield: Pharmaceutical Science
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W7166835172