Advantages of the combined use of cyclodextrins and nanocarriers in drug delivery: A review

Complexation with cyclodextrins (CDs) has been widely and successfully used in pharmaceutical field, mainly for enhancing solubility, stability and bioavailability of a variety of drugs. However, some important drawbacks, including rapid removal from the bloodstream after in vivo administration, or possible replacement, in biological media, of the entrapped drug moiteties by other molecules with higher affinity for the CD cavity, can limit the CDs effectiveness as drug carriers. This review is focused on combined strategies simultaneously exploiting CD complexation, and loading of the complexed drug into various colloidal carriers (liposomes, niosomes, polymeric nanoparticles, lipid nanoparticles, nanoemulsions, micelles) which have been investigated as a possible means for circumventing the problems associated with both such carriers, when used separately, and join their relative benefits in a unique delivery system. Several examples of applications have been reported, to illustrate the possible advantages achievable by such a dual strategy, depending on the CD-nanocarrier combination, and mainly resulting in enhanced performance of the delivery system and improved biopharmaceutical properties and therapeutic efficacy of drugs. The major problems and/or drawbacks found in the development of such systems, as well as the (rare) case of failures in achieving the expected improvements have also been highlighted.