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Mathrusri Annapurna et al                Journal of Drug Deli very & Therapeutics; 2012, 2(2)                                  48
                                            Available online at http://jddtonline.info
                                                     RES EARCH ARTICLE
 LIQUID CHROMATOGRAPHIC METHOD FOR THE SIMULTANEOUS QUANTITATIVE
 DETERMINATION OF CANDESARTAN CILEXETIL AND HYDROCHLORTHIAZIDE IN
                   PHARMACEUTICAL DOSAGE FORMS
                                    M. Mathrusri Annapurnaa*, A. Narendra b, K. Ravi Kumar b
a
 * Dept Pharmaceutical Analysis & Quality Assurance, GITAM Institute of Pharmacy, GITAM University, Visakhapatnam-530045, India
      b
       Dept Pharmaceutical Analysis & Quality Assurance, Roland Institute of Pharm Sciences, Berhampur, Orissa-760010, India
                          a
                           * Corresponding author’s E mail: mathru sri2000@yahoo.com Tel: 91-9010476308
                 Received 19 Jan 2012; Revised 21 Feb 2012; Accepted 01 M arch 2012, Available online 15 M arch 2012




          ABS TRACT
          A simple and sensitive RP-HPLC method was developed and validated for the determination of Candesartan
          cilexetil and Hydrochlorthiazide in pharmaceutical dosage forms. The separation of components was achieved on a
          SHIM ADZU Hypersil ODS-C18 column (250 × 4.6 mm, 5 µm) with UV detection at 270 nm. Isocratic elution with
          a mobile phase consisting of 10 mM (pH 3.37) Tetra butyl ammonium hydrogen sulphate: methanol (15:85, V/V), at
          a flow rate 1.0 mL min-1 was employed. Linearity was observed in the concentration range 0.625-62.5 µg/mL for
          Hydrochlorthiazide and 0.8-80 µg/mL for Candesartan cilexetil respectively. The linear regression equation was
          found to be Y=64002X-1412.6 for Hydrochlorthiazide and Y=24649X-6701.8 for Candesartan cilexetil respectively
          with correlation coefficients greater than 0.999. The LOD was found to be 0.1385 and 0.1892 µg/mL for
          Hydrochlorthiazide and Candesartan cilexetil respectively where as the LOQ was found to be 0.4394 and 0.6187
          µg/mL for Hydrochlorthiazide and Candesartan cilexetil respectively. The mean analytical recovery in
          determination of Candesartan cilexetil and Hydrochlorthiazide tablets was 99.31-100.08% Hydrochlorthiazide and
          99.58-100.39% for Candesartan cilexetil respectively. Thus, the proposed method is applicable for routine
          determination of Candesartan cilexetil and Hydrochlorthiazide in pharmaceutical formulations.
          Keywords: Candesartan cilexetil, Hydrochlorthiazide, Liquid Chromatography, LOD, LOQ, Tablets



INTRODUCTION
Candesartan cilexetil 1 (CST), 1-[[(cyclohexy lo xy)                 causes a decrease in extracellu lar volu me, resulting in a
carbonyl]oxy ]ethyl 2-etho xy-1-[[2'-(1H-tetrazo l-5-y l)[1,1'-      decrease in cardiac output and renal blood flow. W ith
biphenyl]-4-yl]methyl]-1H-benzimidazole-7-carbo xylate is            long-term treat ment, plasma volu me approaches a normal
an angiotensin II receptor antagonist, selective for AT1             value, but peripheral resistance decreases.
receptors, with tight binding to and slow dissociation from
the receptor (Figure 1). It has no agonist activity. It is
rapidly converted to the active substance, candesartan, by
ester hydrolysis during absorption from the gastrointestinal
tract.




                                                                          Figure 2: Structure of Hydrochlorothiazide (HCT)
                                                                     Literature survey reveals that s pectrophotometric 3 , LC 4
                                                                     and LC-M S 5 methods were developed for the analysis of
     Figure 1: Structure of Candesartan cilexetil (CST)
                                                                     Candesartan cilexetil alone and three HPLC methods were
Chemically, Hydrochlorothiazide 2 (HCT) is 6-chloro-1, 1-            proposed for the estimat ion of Hydrochlorothiazide 6-8
dio xo-3,    4-dihydro-2H-1,       2,    4-ben zothiadiazine-7       alone in bio logical fluids.
sulfonamide wh ich is a first line diuretic drug of the
                                                                     Very few analytical methods such as spectrophotometric 9 ,
thiazide class (Figure 2). It acts by lowering blood pressure        HPLC 10-12 and HPTLC 13 method have been developed till
initially by increasing sodium and water excretion. Th is
© 2011, JDDT. All Rights Reserved                                                                                 IS SN: 2250-1177
Mathrusri Annapurna et al            Journal of Drug Deli very & Therapeutics; 2012, 2(2)                     49
now for the simu ltaneous determination of Candesartan        Candesartan cilexet il (80 µg/ mL) for brand I
cilexetil and Hydrochlorothiazide in pharmaceutical           (CA NDESAR-H®) and Hydrochlorthiazide (62.5 µg/mL)
formulat ions and biological fluids. The objective of this    and Candesartan cilexetil (40 µg/mL) for brand II
investigation is to develop an efficient, simple, rapid,      (CA NDELONG-H®). Each mixtu re was then filtered
validated and reliable method for the routine quality         separately through a nylon membrane filter.
control analysis for the simu ltaneous determination of
                                                              Method Vali dation
Candesartan     cilexetil and     Hydrochlorthiazide    in
pharmaceutical preparations.                                  Specificity (Selecti vity)
MATERIALS AND METHODS                                        The selectivity of the RP HPLC method was checked by
                                                             comparison of chromatograms obtained fro m samples and
Instrumentation
                                                             the corresponding placebo. Additives in tablets are
A Shimadzu HPLC instrument (LC-10AT Vp) equipped             sparingly soluble in methanol or the mobile phase, whereas
with UV-Vis ible detector, manual in jector with 20 µl       the active constituents are freely soluble.
sample loop and A Hibar 250 x 4.6 mm LiChrospher 100
                                                             Linearity
C18 column (250 mm x 4.6 mm i.d., 5 µm part icle size)
was used. The output signal was monitored and integrated     Calibrat ion curves were constructed by plotting peak areas
using Shimadzu Class-Vp version 6.12 SP1 software was        versus concentrations of Hydrochlorthiazide and
used for separation.                                         Candesartan cilexetil and the regression equations were
                                                             calculated. A calibration curve was plotted over a
Reagents and Materials
                                                             concentration      range     0.625-625       µg/ mL      for
Ranbaxy Laboratories Limited, India, kindly gifted           Hydrochlorthiazide and 0.8-80 µg/ mL for Candesartan
Candesartan cilexetil and Hydrochlorthiazide pure powder     cilexetil respectively. Accurately measured standard
with 99.98% and 99.98% purity respectively. HPLC grade       working solutions of Hydrochlorthiazide (0.625-62.5
methanol was purchased from Merck, India. The water for      µg/mL) and Candesartan cilexetil (0.8-80 µg/mL) were
HPLC was obtained from TKA Gen Pure (Pacific) system         prepared in a series of 10 mL volu metric flasks and diluted
(Germany). Tetra butyl ammon iu m hydrogen sulphate was      to the mark with mobile phase. 20 µL of these solutions
purchased from S.D. Fine Chemicals, Ahmedabad, India         were injected under operating chro matographic conditions
and was of analytical grade. CANDELONG-H®                    at UV detection 270 n m and the peak area was recorded.
(Candesartan cilexetil 8 mg and Hydrochlorthiazide 12.5
                                                             Precision
mg) and CANDESA R-H® (Candesartan cilexet il 16 mg
and Hydrochlorthiazide 12.5 mg) brands are available as      The precision was checked by repeatedly (n = 3) inject ing
tablet.                                                      standard solutions of three different concentrations of
                                                             Hydrochlorthiazide (12.5, 25 and 50 µg/mL) and
Chromatographic Condi tions
                                                             Candesartan cilexet il (16, 32 and 64 µg/mL) respectively.
A Shimad zu C18 column (250 mm x 4.6 mm i.d., 5 µm)
                                                             Intermedi ate Precision (Reproduci bility)
was used at ambient temperature. The mobile p hase
comprised of 0.01 M Tetra butyl ammon iu m hydrogen          The intra-day and inter-day precisions of the proposed
sulphate (pH 3.37) and methanol (15:85 v/v) was prepared,    methods were determined by estimating the corresponding
filtered through nylon 0.45 mm memb rane filter and          responses 3 times on the same day and on 3 different days,
degassed before use. The mobile phase was pumped at a        over a period of 1 week, for 3 different concentrations of
flow rate of 1 mL/ min and the elution was mon itored at     12.5, 25 and 50 µg/ mL Hydrochlorthiazide and 16, 32 and
270 n m. The injection volu me was 20 µL.                    64 µg/mL for Candesartan cilexetil. The results are
                                                             reported in terms of relative standard deviation.
Preparation of Hydrochlorthi azi de and Candesartan
cilexetil Standard Soluti ons                                The stability of standard solutions can also affect the
                                                             robustness of analytical methods. The stability of the
Accurately weighed Hydrochlorthiazide (6.25 mg) and
                                                             standard solutions of the drug substances us ed in these
Candesartan cilexetil (8.0 mg ) were transferred to a 100
                                                             methods was tested over a long period of t ime. One port ion
mL volu metric flask, dissolved in and diluted to the mark
                                                             of a standard solution was kept at room temperature and
with mobile phase to obtain a standard solution having a
                                                             another portion was stored under refrigeration at
concentration of Hydrochlorthiazide (62.5 µg/ mL) and
                                                             approximately 48ºC, and the content of these solutions was
Candesartan cilexetil (80 µg/mL). Th is solution was
                                                             regularly co mpared with that of a freshly prepared
further diluted to obtain working standard solutions with
                                                             solution.
Hydrochlorthiazide (0.625 -62.5 µg/mL) and Candesartan
cilexetil (0.8-80 µg/ mL) for the HPLC method.               Accuracy (% Recovery)
Preparation of Sample Solutions                              The accuracy of the methods was determined by
                                                             calculating recoveries of Hydrochlorthiazide and
Powder of each of 20 tablets (2 brands, CANDESA R-H®
                                                             Candesartan cilexetil by the standard additions method.
and CANDELONG-H®) were weighed and analyzed as
                                                             Known       amounts      of    standard    solution   of
follows. A mass of tablet powder equivalent to the powder
                                                             Hydrochlorthiazide (0.020, 0.025, 0.030 mg mL-1 ) and
of one tablet was weighed from each brand and transferred
                                                             Candesartan cilexetil (0.0256, 0.032, 0.0384 mg/ mL) for
in to a 100 mL volu metric flask separately and methanol
                                                             the HPLC method were added to a pre-quantified sample
(80 mL) was added. It was sonicated for 15 minutes and
                                                             solution of tablet dosage forms (HCT = 0.025 mg/ mL and
final volu me was made up to the mark with methanol to
                                                             CST = 0.032 mg/ mL). The amounts of Hydrochlorthiazide
get a solution with Hydrochlorthiazide (62.5 µg/ mL) and
© 2011, JDDT. All Rights Reserved                                                                       IS SN: 2250-1177
Mathrusri Annapurna et al             Journal of Drug Deli very & Therapeutics; 2012, 2(2)                              50
and Candesartan cilexetil were estimated by applying these     Where σ = the standard deviation of the response, S = the
values to the regression equation of the calibration curve.    standard deviation of y-intercept of regression lines.
Li mit of Detection and Li mit of Quantification                                     Analysis of CST and HCT in Combi ned Tablet Dosage
                                                                                     Form
Experimentally the detection limit is defined as the
concentration of the analyte producing a signal which is at                          Tablets      containing     Candesartan    cilexet il    and
least three times the base line noise measured from peak to                          Hydrochlorthiazide of the two b rands CANDESA R-H®
peak and the quantitation limit is defined as the                                    and CANDELONG-H®) were purchased from the local
concentration of the analyte producing the signal which is                           market and the drugs were extracted using the mobile
at least ten times the base line noise. The limit of detection                       phase. The response of tablet dosage forms was measured
and the limit of quantification of the drug were calcu lated                         at 270 n m for quantificat ion of Candesartan cilexet il and
using the following equations as per ICH 14 guidelines.                              Hydrochlorthiazide respectively as described above. The
                                                                                     amount of Candesartan cilexet il and Hydrochlorthiazide
                         LOD = 3.3 × σ / S
                                                                                     present in sample solutions were determined by fitting the
                         LOQ = 10 × σ / S                                            responses into the regression equation for Candesartan
                                                                                     cilexetil and Hydrochlorthiazide.




    Figure 3: Overlay UV absorption spectrum of Candesartan cilexet il (10 g/ ml) and Hydrochlorthiazide (10 g/ ml)



                                  Detector A - 1 (270nm)
                                  ATA
                                  ATA1159
                   200       Retention Time                                                                                    200
           Volts




                                                                                                                                   Volts
                                                                                                       8.100




                   100                                                                                                         100
                                                           2.750




                    0                                                                                                          0

                         0           1              2              3   4     5            6       7            8   9      10
                                                                           Minutes
     Figure 4: Representative chromatogram of Candesartan cilexet il (32 µg/ mL) and Hydrochlorthiazide (25 µg/ mL)


© 2011, JDDT. All Rights Reserved                                                                                                          IS SN: 2250-1177
Mathrusri Annapurna et al                Journal of Drug Deli very & Therapeutics; 2012, 2(2)                              51
RES ULTS AND DISCUSS ION
To optimize the HPLC parameters, several mob ile phase            based on peak area. The retention times were 8.100 and
compositions were tried. A satisfactory separation and            2.750    mins      for     Candesartan     cilexet il  and
peak symmetry for            Candesartan      cilexetil and       Hydrochlorthiazide respectively. A good resolution of the
Hydrochlorthiazide were obtained with a mob ile phase             peaks with clear base line separation was found (Figure 4).
mixtu re consisting of 0.01 M (pH 3.37) Tetra butyl               The present proposed method has been compared with the
ammon iu m hydrogen Sulphate and methanol (15:85 v/v) to          previously published liquid chromatographic methods in
get better reproducibility and repeatability. Quantificat ion     Table 1
was achieved with UV detection at 270 nm (Figure 3)
 Table 1: Co mparison of the performance characteristics of the present liquid chro matographic method with the previous
                                                       published methods
        S. No.          Mobile phase / Mode           λ (nm)    Linearity ( g/mL)          Remarks              Ref.
          1.
                         (0.02 M) potassium                                           Narro w range and
                       dihydrogen phosphate:                                           more care for pH
                       methanol: triethylamine          271         5-45 (HCT)        adjustment & Less          10
                              (25:75:0.2)                                                  sensitive
                            (pH 6.0 ± 0.1)                          12-56 (CST)

                             (Isocratic mode)
            2       10 mM potassium dihydrogen
                       phosphate : methanol :                                         Very narrow range
                     acetonitrile (2:80:18, v/v/v)                0.02-1.0 (HCT)     (Biological method)
                               (pH 2.5)                 260                                                      11
                                                                   0.03-2.5 (CST)
                            ((Isocratic mode)
            3
                     Acetonitrile : 0.02M sodium                0.0125-1.25 (HCT)
                                acetate                                               Very narrow range          12
                          (Gradient mode)               265       0.016-0.2 (CST)
            4                                                                        Wide linearity range
                    Methanol: (10 mM) TBA HS                     0.625-62.5 (HCT)        and no extra          Present
                            (85:15 v/v)                 270                            reagents for pH          work
                         (Isocratic mode)                           0.8-80 (CST)          adjustment


Vali dati on of the Proposed Method
Specificity (Selecti vity)
The selectivity of the RP-HPLC method was checked by comparison of chro matograms obtained fro m samples and the
corresponding placebo. No interference fro m additives was obtained.
Linearity
Linear correlation was obtained in the concentration range of 0.625-62.5 µg/mL for Hydrochlorthiazide and 0.8-80 µg/ mL
for Candesartan cilexetil (Table 2) respectively. The linear regression equation was found to be Y=64002X-1412.6 for
Hydrochlorthiazide and Y=24649X-6701.8 for Candesartan cilexetil respectively with correlation coefficients greater than
0.999 (Figure 5 & 6).
                                                        Table 2: Linearity
                               CST                                           HCT
                  Conc.        Mean peak area        % RSD Conc. (µg/ ml)      Mean peak area        % RSD
                 (µg/ ml)
                   0.8         19180 ± 44.114      0.23         0.625          44664 ± 169.72          0.38
                   1.6         32214 ±164.29       0.51          1.25          71311± 335.16           0.47
                   3.2         73947 ± 236.63      0.32          2.5          154098±1232.78           0.80
                    4          91489 ± 795.94      0.87         3.125         189825±1366.74           0.72
                    8         186392 ± 1211.55     0.65          6.25         389612±1402.60           0.36
                   16         396720 ± 2935.73     0.74          12.5         813233± 4228.81          0.52
                   32         759988 ± 6763.89     0.89           25        1608031± 11417.02          0.71
                   64        1551197 ± 10237.90    0.66           50        3214327± 22178.86          0.69
                   80        1988198 ± 15110.31    0.76          62.5       3981171± 25877.61          0.65
                                              RSD = Relative standard deviation

© 2011, JDDT. All Rights Reserved                                                                             IS SN: 2250-1177
Mathrusri Annapurna et al             Journal of Drug Deli very & Therapeutics; 2012, 2(2)                                    52




  Figure 5: Calibrat ion curve of Candesartan cilexetil                  Figure 6: Calibrat ion curve of Hydrochlorthiazide

Precision
The low % RSD values of inter-day was found to be 0.73-          Candesartan cilexet il and Hydrochlorthiazide respectively.
1.43 and 0.58-1.39 for Candesartan cilexet il and                The low % RSD values of intra-day and inter-day
Hydrochlorthiazide respectively, while % RSD values of           variations reveal that the proposed methods precise (Table
intra-day was found to be 0.194-0.564and 0.194–1.003 for         3 and 4).
                        Table 3: Intra-day and inter-day precision for Candesartan cilexetil (n = 3)


             Conc.                  Intra-day precision                             Inter-day precision
            (µg/ mL)

                           Mean area ± SD            RSD (% )               Mean area ± SD                RSD (% )
                               (n = 3)                                           (n = 3)
              16           397898 ± 771.92                0.194             397729 ± 5687.52                1.43
              32           760893 ± 4291.43               0.564             770981 ± 6322.04                0.82
              64          1562437 ± 4718.56               0.302            1576879 ± 11511.22               0.73
                              SD = Standard deviation. RSD = Relative standard deviation
                         Table 4: Intra-day and inter-day precision for Hydrochlorthiazide (n = 3)


             Conc.                    Intra-day precision                             Inter-day precision
            (µg/ mL)
                       Mean area ± SD (n = 3)             RSD (% )         Mean area ± SD (n = 3)         RSD (% )

              12.5         814563 ± 1580.25                 0.194              820987 ± 11411.72            1.39
              25         1611251 ± 16160.84                 1.003            1723454 ± 10030.50             0.58
              50          3197687 ± 9657.02                 0.302            3238768 ± 28177.28             0.87
                              SD = Standard deviation. RSD = Relative standard deviation
Because the stability of standard solutions can also affect         sample solutions must, therefore, be freshly prepared in
the robustness of analytical methods, the stability of the          amber colo red flasks to protect from light for both of the
standard solutions of the drug substances used in these             methods.
methods were tested over a long period of t ime. One
                                                                    Accuracy
portion of a standard solution was kept at roo m
temperature and the other portion was stored under                  The recovery experiments were carried out by a standard
refrigeration at appro ximately 48C, and the content of             addition method. The percent recoveries obtained were
these solutions was regularly co mpared with that of a              99.31-100.08 and 99.58-100.39 for Candesartan cilexetil
freshly prepared solution. No changes in drug                       and Hydrochlorthiazide respectively (Table 5). The low
concentrations were observed for solutions stored under             value of % RSD indicates that the method is accurate.
refrigeration. But, it is recommended that the standard and



© 2011, JDDT. All Rights Reserved                                                                             IS SN: 2250-1177
Mathrusri Annapurna et al                 Journal of Drug Deli very & Therapeutics; 2012, 2(2)                                        53
                                             Table 5: Accuracy - Recovery data (n = 3)
               Conc.
              (µg/ mL)                  Total Conc.          Mean Peak Area ± SD               % RSD             Amount recovered
                                         (µg/ mL)                                                                 (% Recovery)
 Pure drug           Formul ation
HCT     CST          HCT     CST       HCT       CST          HCT              CST            HCT      CST       HCT           CST
  20        25.6      25        32       45      57.62869525.67    1403240.67      0.57    0.31                  44.86         57.20
                                                     ± 16295.38     ± 4287.59                                   (99.68)       (99.31)
  25         32       25        32     50      64     3211066 ±     1572033 ±      1.07    0.24                  50.19         64.05
                                                      34452.23       3821.73                                   (100.39)      (100.08)
  30        38.4      25        32     55     70.4 3503930.33      1727601.84      0.98    1.12                  54.77         70.36
                                                     ± 34441.49    ± 19283.27                                   (99.58)       (99.94)
                                   SD = Standard deviation. RSD = Relative standard deviation
Li mit of Detection and Li mit of Quantification                         Candesartan cilexetil and Hydrochlorthiazide and the
                                                                         resolution was >1.5. The tailing factor was found to be
The LOD was found to be 0.1385 and 0.1892 µg/mL for
                                                                         1.04 and 1.12) for Candesartan cilexet il and
Hydrochlorthiazide and Candesartan cilexet il respectively
                                                                         Hydrochlorthiazide respectively and the capacity factor
where as the LOQ was found to be 0.4394 and 0.6187
                                                                         (k’) was found to be >2.0 fo r both.
µg/mL for Hydrochlorthiazide and Candesartan cilexetil
respectively.                                                            Assay of the Tablet Dosage Forms
System suitability                                            The proposed validated methods were successfully applied
                                                              to determine Candesartan cilexet il and Hydrochlorthiazide
As system suitability test is an integral part of
                                                              in their comb ined tablet dosage form and a model
chromatographic methods development and it is used to
                                                              chromatogram obtained from the marketed formulat ion
verify that the system is adequate for the analysis to be
                                                              was shown in Figure 5. The results obtained for
performed, the parameter for Candesartan cilexet il and
                                                              Candesartan cilexetil and Hydrochlorthiazide was
Hydrochlorthiazide was evaluated. The theoretical plates
                                                              comparable with the corresponding labeled amounts
were found to be 4723 and 5435 (N >2000) for
                                                              (Table 6).
                                 Table 6: Analysis of co mmercial formulat ion (Tablets)

                                                    Labeled amount           Amount found
                               Commerci al               (mg)                   (mg)            % Recovery
                               Formul ation
                                                       CST      HCT          CST      HCT      CST       HCT

                            CANDESA R-H®                16       12.5        15.93    12.41    99.56    99.28
                           CANDELONG-H®                  8       12.5         7.96    12.52    99.50    100.16
CONCLUS ION                                                              The advantages of the proposed method involve a simple
                                                                         procedure for sample preparat ion and relatively short time
The results of the analysis of pharmaceutical dosage forms
                                                                         of analysis. Apart from th is, it can be used for assays of
by the proposed methods are highly reproducible, reliab le,
                                                                         Candesartan cilexetil and Hydrochlorthiazide in biological
and are in good agreement with the label claims of the
                                                                         flu ids or in pharmacokinetic investigations.
drug. The additives usually present in the pharmaceutical
formulat ions of the assayed samples did not interfere with              ACKNOWLEDGEMENTS :
Candesartan cilexet il and Hydrochlorthiazide. It may be
                                                                         The authors wish to thank Ranbaxy Laboratories, India for
said that the proposed methods are precise, sensitive, and
                                                                         providing gift samples of Candesartan cilexetil and
accurate, so that these can be used as standard
                                                                         Hydrochlorthiazide and to M/S Roland Institute of
pharmacopoeial      methods      for   the     simultaneous
                                                                         Pharmaceutical Sciences, Berhampur, Orissa for providing
determination      of     Candesartan      cilexetil    and
                                                                         research facilit ies, constant support and encouragement.
Hydrochlorthiazide in tablets using the HPLC systems.

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© 2011, JDDT. All Rights Reserved                                                                                      IS SN: 2250-1177
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     and ratio derivative spectrophotometry for the simultaneous         Requirements for Registration of Pharmaceuticals for Human
     determination      of        candesartan     cilexetil   and        Use (ICH) Guideline on Validation of Analytical Procedure-
     hydrochlorothiazide” Pharmazie, 2003, 58 (11), 796-800.             M ethodology: Geneva, Switzerland, 1996.




© 2011, JDDT. All Rights Reserved                                                                                  IS SN: 2250-1177

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HPLC Method Development

  • 1. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 48 Available online at http://jddtonline.info RES EARCH ARTICLE LIQUID CHROMATOGRAPHIC METHOD FOR THE SIMULTANEOUS QUANTITATIVE DETERMINATION OF CANDESARTAN CILEXETIL AND HYDROCHLORTHIAZIDE IN PHARMACEUTICAL DOSAGE FORMS M. Mathrusri Annapurnaa*, A. Narendra b, K. Ravi Kumar b a * Dept Pharmaceutical Analysis & Quality Assurance, GITAM Institute of Pharmacy, GITAM University, Visakhapatnam-530045, India b Dept Pharmaceutical Analysis & Quality Assurance, Roland Institute of Pharm Sciences, Berhampur, Orissa-760010, India a * Corresponding author’s E mail: mathru sri2000@yahoo.com Tel: 91-9010476308 Received 19 Jan 2012; Revised 21 Feb 2012; Accepted 01 M arch 2012, Available online 15 M arch 2012 ABS TRACT A simple and sensitive RP-HPLC method was developed and validated for the determination of Candesartan cilexetil and Hydrochlorthiazide in pharmaceutical dosage forms. The separation of components was achieved on a SHIM ADZU Hypersil ODS-C18 column (250 × 4.6 mm, 5 µm) with UV detection at 270 nm. Isocratic elution with a mobile phase consisting of 10 mM (pH 3.37) Tetra butyl ammonium hydrogen sulphate: methanol (15:85, V/V), at a flow rate 1.0 mL min-1 was employed. Linearity was observed in the concentration range 0.625-62.5 µg/mL for Hydrochlorthiazide and 0.8-80 µg/mL for Candesartan cilexetil respectively. The linear regression equation was found to be Y=64002X-1412.6 for Hydrochlorthiazide and Y=24649X-6701.8 for Candesartan cilexetil respectively with correlation coefficients greater than 0.999. The LOD was found to be 0.1385 and 0.1892 µg/mL for Hydrochlorthiazide and Candesartan cilexetil respectively where as the LOQ was found to be 0.4394 and 0.6187 µg/mL for Hydrochlorthiazide and Candesartan cilexetil respectively. The mean analytical recovery in determination of Candesartan cilexetil and Hydrochlorthiazide tablets was 99.31-100.08% Hydrochlorthiazide and 99.58-100.39% for Candesartan cilexetil respectively. Thus, the proposed method is applicable for routine determination of Candesartan cilexetil and Hydrochlorthiazide in pharmaceutical formulations. Keywords: Candesartan cilexetil, Hydrochlorthiazide, Liquid Chromatography, LOD, LOQ, Tablets INTRODUCTION Candesartan cilexetil 1 (CST), 1-[[(cyclohexy lo xy) causes a decrease in extracellu lar volu me, resulting in a carbonyl]oxy ]ethyl 2-etho xy-1-[[2'-(1H-tetrazo l-5-y l)[1,1'- decrease in cardiac output and renal blood flow. W ith biphenyl]-4-yl]methyl]-1H-benzimidazole-7-carbo xylate is long-term treat ment, plasma volu me approaches a normal an angiotensin II receptor antagonist, selective for AT1 value, but peripheral resistance decreases. receptors, with tight binding to and slow dissociation from the receptor (Figure 1). It has no agonist activity. It is rapidly converted to the active substance, candesartan, by ester hydrolysis during absorption from the gastrointestinal tract. Figure 2: Structure of Hydrochlorothiazide (HCT) Literature survey reveals that s pectrophotometric 3 , LC 4 and LC-M S 5 methods were developed for the analysis of Figure 1: Structure of Candesartan cilexetil (CST) Candesartan cilexetil alone and three HPLC methods were Chemically, Hydrochlorothiazide 2 (HCT) is 6-chloro-1, 1- proposed for the estimat ion of Hydrochlorothiazide 6-8 dio xo-3, 4-dihydro-2H-1, 2, 4-ben zothiadiazine-7 alone in bio logical fluids. sulfonamide wh ich is a first line diuretic drug of the Very few analytical methods such as spectrophotometric 9 , thiazide class (Figure 2). It acts by lowering blood pressure HPLC 10-12 and HPTLC 13 method have been developed till initially by increasing sodium and water excretion. Th is © 2011, JDDT. All Rights Reserved IS SN: 2250-1177
  • 2. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 49 now for the simu ltaneous determination of Candesartan Candesartan cilexet il (80 µg/ mL) for brand I cilexetil and Hydrochlorothiazide in pharmaceutical (CA NDESAR-H®) and Hydrochlorthiazide (62.5 µg/mL) formulat ions and biological fluids. The objective of this and Candesartan cilexetil (40 µg/mL) for brand II investigation is to develop an efficient, simple, rapid, (CA NDELONG-H®). Each mixtu re was then filtered validated and reliable method for the routine quality separately through a nylon membrane filter. control analysis for the simu ltaneous determination of Method Vali dation Candesartan cilexetil and Hydrochlorthiazide in pharmaceutical preparations. Specificity (Selecti vity) MATERIALS AND METHODS The selectivity of the RP HPLC method was checked by comparison of chromatograms obtained fro m samples and Instrumentation the corresponding placebo. Additives in tablets are A Shimadzu HPLC instrument (LC-10AT Vp) equipped sparingly soluble in methanol or the mobile phase, whereas with UV-Vis ible detector, manual in jector with 20 µl the active constituents are freely soluble. sample loop and A Hibar 250 x 4.6 mm LiChrospher 100 Linearity C18 column (250 mm x 4.6 mm i.d., 5 µm part icle size) was used. The output signal was monitored and integrated Calibrat ion curves were constructed by plotting peak areas using Shimadzu Class-Vp version 6.12 SP1 software was versus concentrations of Hydrochlorthiazide and used for separation. Candesartan cilexetil and the regression equations were calculated. A calibration curve was plotted over a Reagents and Materials concentration range 0.625-625 µg/ mL for Ranbaxy Laboratories Limited, India, kindly gifted Hydrochlorthiazide and 0.8-80 µg/ mL for Candesartan Candesartan cilexetil and Hydrochlorthiazide pure powder cilexetil respectively. Accurately measured standard with 99.98% and 99.98% purity respectively. HPLC grade working solutions of Hydrochlorthiazide (0.625-62.5 methanol was purchased from Merck, India. The water for µg/mL) and Candesartan cilexetil (0.8-80 µg/mL) were HPLC was obtained from TKA Gen Pure (Pacific) system prepared in a series of 10 mL volu metric flasks and diluted (Germany). Tetra butyl ammon iu m hydrogen sulphate was to the mark with mobile phase. 20 µL of these solutions purchased from S.D. Fine Chemicals, Ahmedabad, India were injected under operating chro matographic conditions and was of analytical grade. CANDELONG-H® at UV detection 270 n m and the peak area was recorded. (Candesartan cilexetil 8 mg and Hydrochlorthiazide 12.5 Precision mg) and CANDESA R-H® (Candesartan cilexet il 16 mg and Hydrochlorthiazide 12.5 mg) brands are available as The precision was checked by repeatedly (n = 3) inject ing tablet. standard solutions of three different concentrations of Hydrochlorthiazide (12.5, 25 and 50 µg/mL) and Chromatographic Condi tions Candesartan cilexet il (16, 32 and 64 µg/mL) respectively. A Shimad zu C18 column (250 mm x 4.6 mm i.d., 5 µm) Intermedi ate Precision (Reproduci bility) was used at ambient temperature. The mobile p hase comprised of 0.01 M Tetra butyl ammon iu m hydrogen The intra-day and inter-day precisions of the proposed sulphate (pH 3.37) and methanol (15:85 v/v) was prepared, methods were determined by estimating the corresponding filtered through nylon 0.45 mm memb rane filter and responses 3 times on the same day and on 3 different days, degassed before use. The mobile phase was pumped at a over a period of 1 week, for 3 different concentrations of flow rate of 1 mL/ min and the elution was mon itored at 12.5, 25 and 50 µg/ mL Hydrochlorthiazide and 16, 32 and 270 n m. The injection volu me was 20 µL. 64 µg/mL for Candesartan cilexetil. The results are reported in terms of relative standard deviation. Preparation of Hydrochlorthi azi de and Candesartan cilexetil Standard Soluti ons The stability of standard solutions can also affect the robustness of analytical methods. The stability of the Accurately weighed Hydrochlorthiazide (6.25 mg) and standard solutions of the drug substances us ed in these Candesartan cilexetil (8.0 mg ) were transferred to a 100 methods was tested over a long period of t ime. One port ion mL volu metric flask, dissolved in and diluted to the mark of a standard solution was kept at room temperature and with mobile phase to obtain a standard solution having a another portion was stored under refrigeration at concentration of Hydrochlorthiazide (62.5 µg/ mL) and approximately 48ºC, and the content of these solutions was Candesartan cilexetil (80 µg/mL). Th is solution was regularly co mpared with that of a freshly prepared further diluted to obtain working standard solutions with solution. Hydrochlorthiazide (0.625 -62.5 µg/mL) and Candesartan cilexetil (0.8-80 µg/ mL) for the HPLC method. Accuracy (% Recovery) Preparation of Sample Solutions The accuracy of the methods was determined by calculating recoveries of Hydrochlorthiazide and Powder of each of 20 tablets (2 brands, CANDESA R-H® Candesartan cilexetil by the standard additions method. and CANDELONG-H®) were weighed and analyzed as Known amounts of standard solution of follows. A mass of tablet powder equivalent to the powder Hydrochlorthiazide (0.020, 0.025, 0.030 mg mL-1 ) and of one tablet was weighed from each brand and transferred Candesartan cilexetil (0.0256, 0.032, 0.0384 mg/ mL) for in to a 100 mL volu metric flask separately and methanol the HPLC method were added to a pre-quantified sample (80 mL) was added. It was sonicated for 15 minutes and solution of tablet dosage forms (HCT = 0.025 mg/ mL and final volu me was made up to the mark with methanol to CST = 0.032 mg/ mL). The amounts of Hydrochlorthiazide get a solution with Hydrochlorthiazide (62.5 µg/ mL) and © 2011, JDDT. All Rights Reserved IS SN: 2250-1177
  • 3. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 50 and Candesartan cilexetil were estimated by applying these Where σ = the standard deviation of the response, S = the values to the regression equation of the calibration curve. standard deviation of y-intercept of regression lines. Li mit of Detection and Li mit of Quantification Analysis of CST and HCT in Combi ned Tablet Dosage Form Experimentally the detection limit is defined as the concentration of the analyte producing a signal which is at Tablets containing Candesartan cilexet il and least three times the base line noise measured from peak to Hydrochlorthiazide of the two b rands CANDESA R-H® peak and the quantitation limit is defined as the and CANDELONG-H®) were purchased from the local concentration of the analyte producing the signal which is market and the drugs were extracted using the mobile at least ten times the base line noise. The limit of detection phase. The response of tablet dosage forms was measured and the limit of quantification of the drug were calcu lated at 270 n m for quantificat ion of Candesartan cilexet il and using the following equations as per ICH 14 guidelines. Hydrochlorthiazide respectively as described above. The amount of Candesartan cilexet il and Hydrochlorthiazide LOD = 3.3 × σ / S present in sample solutions were determined by fitting the LOQ = 10 × σ / S responses into the regression equation for Candesartan cilexetil and Hydrochlorthiazide. Figure 3: Overlay UV absorption spectrum of Candesartan cilexet il (10 g/ ml) and Hydrochlorthiazide (10 g/ ml) Detector A - 1 (270nm) ATA ATA1159 200 Retention Time 200 Volts Volts 8.100 100 100 2.750 0 0 0 1 2 3 4 5 6 7 8 9 10 Minutes Figure 4: Representative chromatogram of Candesartan cilexet il (32 µg/ mL) and Hydrochlorthiazide (25 µg/ mL) © 2011, JDDT. All Rights Reserved IS SN: 2250-1177
  • 4. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 51 RES ULTS AND DISCUSS ION To optimize the HPLC parameters, several mob ile phase based on peak area. The retention times were 8.100 and compositions were tried. A satisfactory separation and 2.750 mins for Candesartan cilexet il and peak symmetry for Candesartan cilexetil and Hydrochlorthiazide respectively. A good resolution of the Hydrochlorthiazide were obtained with a mob ile phase peaks with clear base line separation was found (Figure 4). mixtu re consisting of 0.01 M (pH 3.37) Tetra butyl The present proposed method has been compared with the ammon iu m hydrogen Sulphate and methanol (15:85 v/v) to previously published liquid chromatographic methods in get better reproducibility and repeatability. Quantificat ion Table 1 was achieved with UV detection at 270 nm (Figure 3) Table 1: Co mparison of the performance characteristics of the present liquid chro matographic method with the previous published methods S. No. Mobile phase / Mode λ (nm) Linearity ( g/mL) Remarks Ref. 1. (0.02 M) potassium Narro w range and dihydrogen phosphate: more care for pH methanol: triethylamine 271 5-45 (HCT) adjustment & Less 10 (25:75:0.2) sensitive (pH 6.0 ± 0.1) 12-56 (CST) (Isocratic mode) 2 10 mM potassium dihydrogen phosphate : methanol : Very narrow range acetonitrile (2:80:18, v/v/v) 0.02-1.0 (HCT) (Biological method) (pH 2.5) 260 11 0.03-2.5 (CST) ((Isocratic mode) 3 Acetonitrile : 0.02M sodium 0.0125-1.25 (HCT) acetate Very narrow range 12 (Gradient mode) 265 0.016-0.2 (CST) 4 Wide linearity range Methanol: (10 mM) TBA HS 0.625-62.5 (HCT) and no extra Present (85:15 v/v) 270 reagents for pH work (Isocratic mode) 0.8-80 (CST) adjustment Vali dati on of the Proposed Method Specificity (Selecti vity) The selectivity of the RP-HPLC method was checked by comparison of chro matograms obtained fro m samples and the corresponding placebo. No interference fro m additives was obtained. Linearity Linear correlation was obtained in the concentration range of 0.625-62.5 µg/mL for Hydrochlorthiazide and 0.8-80 µg/ mL for Candesartan cilexetil (Table 2) respectively. The linear regression equation was found to be Y=64002X-1412.6 for Hydrochlorthiazide and Y=24649X-6701.8 for Candesartan cilexetil respectively with correlation coefficients greater than 0.999 (Figure 5 & 6). Table 2: Linearity CST HCT Conc. Mean peak area % RSD Conc. (µg/ ml) Mean peak area % RSD (µg/ ml) 0.8 19180 ± 44.114 0.23 0.625 44664 ± 169.72 0.38 1.6 32214 ±164.29 0.51 1.25 71311± 335.16 0.47 3.2 73947 ± 236.63 0.32 2.5 154098±1232.78 0.80 4 91489 ± 795.94 0.87 3.125 189825±1366.74 0.72 8 186392 ± 1211.55 0.65 6.25 389612±1402.60 0.36 16 396720 ± 2935.73 0.74 12.5 813233± 4228.81 0.52 32 759988 ± 6763.89 0.89 25 1608031± 11417.02 0.71 64 1551197 ± 10237.90 0.66 50 3214327± 22178.86 0.69 80 1988198 ± 15110.31 0.76 62.5 3981171± 25877.61 0.65 RSD = Relative standard deviation © 2011, JDDT. All Rights Reserved IS SN: 2250-1177
  • 5. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 52 Figure 5: Calibrat ion curve of Candesartan cilexetil Figure 6: Calibrat ion curve of Hydrochlorthiazide Precision The low % RSD values of inter-day was found to be 0.73- Candesartan cilexet il and Hydrochlorthiazide respectively. 1.43 and 0.58-1.39 for Candesartan cilexet il and The low % RSD values of intra-day and inter-day Hydrochlorthiazide respectively, while % RSD values of variations reveal that the proposed methods precise (Table intra-day was found to be 0.194-0.564and 0.194–1.003 for 3 and 4). Table 3: Intra-day and inter-day precision for Candesartan cilexetil (n = 3) Conc. Intra-day precision Inter-day precision (µg/ mL) Mean area ± SD RSD (% ) Mean area ± SD RSD (% ) (n = 3) (n = 3) 16 397898 ± 771.92 0.194 397729 ± 5687.52 1.43 32 760893 ± 4291.43 0.564 770981 ± 6322.04 0.82 64 1562437 ± 4718.56 0.302 1576879 ± 11511.22 0.73 SD = Standard deviation. RSD = Relative standard deviation Table 4: Intra-day and inter-day precision for Hydrochlorthiazide (n = 3) Conc. Intra-day precision Inter-day precision (µg/ mL) Mean area ± SD (n = 3) RSD (% ) Mean area ± SD (n = 3) RSD (% ) 12.5 814563 ± 1580.25 0.194 820987 ± 11411.72 1.39 25 1611251 ± 16160.84 1.003 1723454 ± 10030.50 0.58 50 3197687 ± 9657.02 0.302 3238768 ± 28177.28 0.87 SD = Standard deviation. RSD = Relative standard deviation Because the stability of standard solutions can also affect sample solutions must, therefore, be freshly prepared in the robustness of analytical methods, the stability of the amber colo red flasks to protect from light for both of the standard solutions of the drug substances used in these methods. methods were tested over a long period of t ime. One Accuracy portion of a standard solution was kept at roo m temperature and the other portion was stored under The recovery experiments were carried out by a standard refrigeration at appro ximately 48C, and the content of addition method. The percent recoveries obtained were these solutions was regularly co mpared with that of a 99.31-100.08 and 99.58-100.39 for Candesartan cilexetil freshly prepared solution. No changes in drug and Hydrochlorthiazide respectively (Table 5). The low concentrations were observed for solutions stored under value of % RSD indicates that the method is accurate. refrigeration. But, it is recommended that the standard and © 2011, JDDT. All Rights Reserved IS SN: 2250-1177
  • 6. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 53 Table 5: Accuracy - Recovery data (n = 3) Conc. (µg/ mL) Total Conc. Mean Peak Area ± SD % RSD Amount recovered (µg/ mL) (% Recovery) Pure drug Formul ation HCT CST HCT CST HCT CST HCT CST HCT CST HCT CST 20 25.6 25 32 45 57.62869525.67 1403240.67 0.57 0.31 44.86 57.20 ± 16295.38 ± 4287.59 (99.68) (99.31) 25 32 25 32 50 64 3211066 ± 1572033 ± 1.07 0.24 50.19 64.05 34452.23 3821.73 (100.39) (100.08) 30 38.4 25 32 55 70.4 3503930.33 1727601.84 0.98 1.12 54.77 70.36 ± 34441.49 ± 19283.27 (99.58) (99.94) SD = Standard deviation. RSD = Relative standard deviation Li mit of Detection and Li mit of Quantification Candesartan cilexetil and Hydrochlorthiazide and the resolution was >1.5. The tailing factor was found to be The LOD was found to be 0.1385 and 0.1892 µg/mL for 1.04 and 1.12) for Candesartan cilexet il and Hydrochlorthiazide and Candesartan cilexet il respectively Hydrochlorthiazide respectively and the capacity factor where as the LOQ was found to be 0.4394 and 0.6187 (k’) was found to be >2.0 fo r both. µg/mL for Hydrochlorthiazide and Candesartan cilexetil respectively. Assay of the Tablet Dosage Forms System suitability The proposed validated methods were successfully applied to determine Candesartan cilexet il and Hydrochlorthiazide As system suitability test is an integral part of in their comb ined tablet dosage form and a model chromatographic methods development and it is used to chromatogram obtained from the marketed formulat ion verify that the system is adequate for the analysis to be was shown in Figure 5. The results obtained for performed, the parameter for Candesartan cilexet il and Candesartan cilexetil and Hydrochlorthiazide was Hydrochlorthiazide was evaluated. The theoretical plates comparable with the corresponding labeled amounts were found to be 4723 and 5435 (N >2000) for (Table 6). Table 6: Analysis of co mmercial formulat ion (Tablets) Labeled amount Amount found Commerci al (mg) (mg) % Recovery Formul ation CST HCT CST HCT CST HCT CANDESA R-H® 16 12.5 15.93 12.41 99.56 99.28 CANDELONG-H® 8 12.5 7.96 12.52 99.50 100.16 CONCLUS ION The advantages of the proposed method involve a simple procedure for sample preparat ion and relatively short time The results of the analysis of pharmaceutical dosage forms of analysis. Apart from th is, it can be used for assays of by the proposed methods are highly reproducible, reliab le, Candesartan cilexetil and Hydrochlorthiazide in biological and are in good agreement with the label claims of the flu ids or in pharmacokinetic investigations. drug. The additives usually present in the pharmaceutical formulat ions of the assayed samples did not interfere with ACKNOWLEDGEMENTS : Candesartan cilexet il and Hydrochlorthiazide. It may be The authors wish to thank Ranbaxy Laboratories, India for said that the proposed methods are precise, sensitive, and providing gift samples of Candesartan cilexetil and accurate, so that these can be used as standard Hydrochlorthiazide and to M/S Roland Institute of pharmacopoeial methods for the simultaneous Pharmaceutical Sciences, Berhampur, Orissa for providing determination of Candesartan cilexetil and research facilit ies, constant support and encouragement. Hydrochlorthiazide in tablets using the HPLC systems. REFERENCES 1. The M erck Index, 14 th ed., Whitehouse Station, NJ: M erck spectrophotometric method” Analytical Letters, 2009, Research Laboratories Division of M erck and Co., Inc.; 2006, 42(14), 2232 – 2243. p. 1742. 4. Subba Rao D V, Radhakrishnanand P, Suryanarayana 2. The M erck Index, 14 th ed., Whitehouse Station, NJ: M erck M V, Himabindu V,”A stability-indicating LC method for Research Laboratories Division of M erck and Co., Inc.; 2006, Candesartan cilexetil” Chromatographia, 2007, 66 (7/8), 499- p. 4785. 507. 3. Naseem AC, M ohammad B, Enas A and Khalid Ibrahim HA, 5. Surbhi M ehta, Ravi PS, Rajkamal P and Saranjit S, “LC and “Determination of Candesartan cilexetil in tablet dosage LC-M S/TOF studies on stress degradation behaviour of forms and dissolution testing samples by first derivative UV © 2011, JDDT. All Rights Reserved IS SN: 2250-1177
  • 7. Mathrusri Annapurna et al Journal of Drug Deli very & Therapeutics; 2012, 2(2) 54 candesartan cilexetil” J. Pharm. Biomed. Anal., 2010, 52 (3), 10. Qutab SS, Razzaq SN, Ashfaq M , Shuja ZA and Khan IU 345-354. “Simple and sensitive LC–UV method for simultaneous 6. Be-Sheng K, Arun M , David RO and Kin-Kai H, “Column- analysis of hydrochlorothiazide and candesartan cilexetil in switching High Performance Liquid Chromatographic pharmaceutical formulations” Acta Chromatographica, 2007, (HPLC) determination of Hydrochlorothiazide in rat, dog and 19, 119-129. human plasma” Pharmaceutical Research, 1990, 7 (12), 1257- 11. Erk N, “Simultaneous Analysis of Candesartan Cilexetil and 1261. Hydrochlorothiazide in Human Plasma and Dosage Forms 7. Richter K, Oertel R and Kir W, “New sensitive method for Using HPLC with a Photodiode Array Detector” J. Liq. the determination of hydrochlorothiazide in human serum by Chromatogra. & Rel. Tech.” 2003, 26 (15), 2581 – 2591. high-performance liquid chromatography with 12. Alaa Khedr, “Simultaneous Determination of Candesartan electrochemical detection” J. Chromatogra. A, 1996, 729 (1- Cilexetil and Hydrochlorothiazide by High-Performance 2), 293-296. Liquid Chromatography ” The J. King Abdulaziz University- 8. Dragica Z, Traj e S, Petar M , “Development of solid-phase M edical Sciences, 2008, 15 (2), 3-13. extraction method and its application for determination of 13. Bipin HM and Sachin BM “HPTLC–Densitometric Analysis hydrochlorothiazide in human plasma using HPLC” of Candesartan Cilexetil and Hydrochlorothiazide in Tablets” Biomedical Chromatography , 2004, 18 (2), 71-76. J. Planar Chromatogra., 2008, 21 (3), 173–176. 9. Erk N, “Application of first derivative UV-spectrophotometry 14. International Conference on Harmonization of Technical and ratio derivative spectrophotometry for the simultaneous Requirements for Registration of Pharmaceuticals for Human determination of candesartan cilexetil and Use (ICH) Guideline on Validation of Analytical Procedure- hydrochlorothiazide” Pharmazie, 2003, 58 (11), 796-800. M ethodology: Geneva, Switzerland, 1996. © 2011, JDDT. All Rights Reserved IS SN: 2250-1177