02 October 2017

Chocolate for trial to help medicine go down

The best medicine will not work if a child refuses to take it but a team of WA researchers believes it may have a solution to the dearth of strong pain relief options available for children – chocolate-flavoured medicine. 

The team will use a Telethon Perth Children’s Hospital Research Fund grant to produce – and trial – a child-friendly formulation of the pain-relief drug, tramadol.

University of Western Australia professor Lee-Yong Lim (Pharmacy), who along with PMH paediatric anaesthetist Professor Britta Regli-Von Ungern-Sternberg is leading the study, described Tramadol as a safe medication that was very effective in managing severe pain.

“Unfortunately it is not available commercially in dosages low enough for children and has an extremely bitter taste,” she said.

“Our method does not coat the pills in chocolate but rather uses a chocolate flavour to help mask the extreme bitterness that can make medications like this unpalatable for children.”

The researchers will use a proprietary chocolate-based delivery system, developed by researchers from the University of Western Australia, to produce a modified Tramadol mini-tablet that will be more palatable then standard Tramadol and at a dosage safe for children.

Children will be able to chew it, swallow it whole with water or add hot water to take it as hot chocolate.

If successful the trial could lead to a safe, effective and more palatable form of pain relief for children experiencing severe pain.

Professor Lim revealed that there was a method for producing paediatric doses of Tramadol from commercially available capsules but said it was a long and involved process that came with a high risk of dosing error.

“We are very limited in what we can do for young patients who are in severe pain, particularly young cancer patients,” Professor Lim said.

At PMH oral tramadol is not routinely available for young children.

As well as assessing children’s willingness to take the modified tablets, the new study will investigate how quickly the chocolate pills are absorbed by – and eliminated from – the body and how effective they are at relieving patients’ pain.

Professor Lim said that because medication dosage was based on bodyweight, the modified tablet also had potential for managing pain in frail elderly patients or other patients of low bodyweight.

The Telethon Perth Children’s Hospital Research Fund is a collaboration of the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Department of Health and Channel 7 Telethon Trust that provides funding for WA research activities that focus on the health and wellbeing of children and/or adolescents.

In this fifth round of the program, 15 research projects will share in $3,526,970 of funding.

Western Australia’s Chief Medical Officer, Professor Gary Geelhoed said the Tramadol study was an example of the important research underway in Western Australia that could be of real benefit to young patients, especially those experiencing severe or chronic pain.

The full list of recipients:

Stream 1: Short-term research projects

Establishing a centre of research excellence in juvenile macular disease

Coordinating Principal Investigator (CPI)

Dr Fred Chen

Lions Eye Institute

Zoledronic Acid to improve the outcome of children with high-risk leukaemias


Dr Laurence Cheung

Telethon Kids Institute (TKI)

Methotrexate in Seriously Sick Kids (MiSSK); personalised Cancer Treatment using pharmacogenomics to improve patient outcomes and reduce the cost of cancer care when treating seriously sick children


Professor Rhonda Clifford

University of Western Australia (UWA)

Precision medicine for relapse leukaemia


Dr Mark Cruickshank


Plasma Secretory Type II Phospholipase A2: A Novel Diagnostic Marker for Neonatal Late-Onset Sepsis


Dr Andrew Currie

Murdoch University

Improving cellular immunotherapies for the treatment of leukaemia


Dr Bree Foley


Defining the early life window for immune tolerance and food allergy


Dr Cristina Gamez


Prompt and Spatially Accurate Allocation of Health Service for Children under Unexpected Extreme Weather Condition and Air Quality


Dr Le Jian

Public Health Division

Department of Health, WA

Ex-vivo uterine environment (EVE) therapy for extreme preterm birth


Dr Matthew Kemp


Palatable and chewable tramadol chocolate-based tablets for effective pain management in young paediatric patients


Professor Lee Yong Lim


Improve immuNologiCal assessment to improve PaediaTric kidney transplantION outcomes (INCEPTION)


Clinical A/Professor  Wai Lim


Breastfeeding and Eating Nuts and Eggs For Infant Tolerance (BENEFIT) Trial


Dr Debra Palmer


Developing metabolomic profiles to differentiate between healthy, preschool wheeze and asthma.


Dr André Schultz


Understanding the neuroimmune axis and its role in the development of autism to develop better prognostic tools


A/Professor Deborah Strickland



Stream 2: Strategic Research Initiatives

CRIPTIC: Collaboration for Research and Innovation in Platform Trials in Children


Dr Thomas Snelling




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