Background: The development of appropriate pharmaceutical formulations for routine neonatal practice
is challenging because of the developmental characteristics and the need for it to be specifically ageappropriate.
This has led to wide use of extemporaneous formulations, which lack standardized procedures that
can result in medication errors in clinical practice resulting in suboptimal efficacy and safety concerns.
Methods: We have reviewed the most recent literature on formulations and pharmaceutical excipients.
Results: We present the issues related with the lack of age-appropriate formulations, discuss the importance and
extent of exposure to pharmaceutical excipients known to be harmful to neonates, indicate ways that can reduce
exposure to excipients of concern, and review challenges of the design of age-appropriate drug formulations and
dosage forms/drug delivery systems for neonates. Finally, we summarize novel approaches regarding drug delivery
Conclusion: Novel approaches in age-appropriate drug delivery should overcome the present obstacles and improve
the quality of medicines, thus avoiding errors in treatment and improving the management of neonates.
Further basic researches on discovering new technologies and modern formulations, using in vitro testing systems
as well as preclinical and clinical trials, are needed to improve the feasibility, practicality and safety of new formulations,
including research on pharmaceutical excipients.