“Tastes Like Raspberry Candy”

The medication should be sparing children from the nausea that often accompanies chemotherapy, but sometimes these bitter pills containing the ingredient dexamethasone only make the problem for young cancer patients worse. “Some kids find the taste so terrible that they can’t get them down. For others, they’re just too big to swallow,” explains Dr. Beate Winkler, a specialist in pediatric oncology at the University Medical Center Hamburg-Eppendorf (UKE).

Most drugs simply aren’t designed for children. The same is true of dosages, which mostly only apply to adults. Because many medications do not exist in liquid or drop form, the pharmacists at the clinic have to adjust them to the patient’s weight – which means halving, quartering or crushing the pills for children. But mistakes can occur easily, such as when ingredients end up unevenly distributed within the pills.

Because sometimes the divided and crushed pills do not taste good, the young patients occasionally refuse to swallow them. Clinical pharmacist Adrin Dadkhah cuts to the chase: “If a medication isn’t taken, it can’t work.”

Printing, not crushing

Necessity is famously the mother of invention, which is how the pharmacy at the clinic, together with the pediatric oncology unit, developed a tasty alternative to make treatment more bearable for the kids: chewable tablets shaped like hearts, tasting of raspberries, produced in-house with a 3D printer. The tablets, which the UKE is testing in a study ending in late 2026, open up completely new possibilities for the pharmacists, as dosage, taste and consistency can all be adjusted to children’s individual needs.

Innovations in 3D printing are on the rise, particularly in the medical field. The process involves applying material layer by layer to produce three-dimensional objects – which include medical implants, prostheses and surgical instruments, which are coming directly out of the 3D printer more and more often. The trend of personalized medicine is directing the attention of pharmaceutical companies increasingly to this futuristic technology, as 3D printing can produce single preparations and limited series with individually adjusted doses. The first 3D-printed medication to receive approval was the epilepsy drug Spritam in the United States in 2015.

Tailor-made mix

The research got a powerful push during the Covid-19 pandemic. As supply chain issues made work difficult for pharmacies and clinics, pharmacists and doctors gave their imaginations free reign. Some, for example, printed replacement parts for lab equipment on commercial 3D printers, which is how the idea eventually came to use the method to produce medications as well. The process at the UKE, according to pharmacist Dadkhah, works like this: “We process the excipients and medicinal ingredients into a homogeneous mixture in advance. Then, the 3D printer heats the mixture and prints tablets from it in the size and amount that we determine.”

There are good reasons for the technology’s favorable reception from clinics and pharmacies, such as, above all, individual dosing. Bitter-tasting ingredients can also be covered up in 3D-printed medications. For example, the cortisone that young cancer patients at the UKE receive is disguised with bitter-taste blockers, sweeteners and raspberry flavor. The chewable tablets, which appear as hearts, stars or bears, are not just visually appealing to children’s tastes: they also dissolve quickly in the mouth and are easier to swallow.

Multiple active ingredients, one pill

Chronically ill patients who often have to take different pills multiple times a day can also benefit from 3D printing. The University of Nottingham has developed the “single pill concept” , in which multiple drugs are printed into one tablet with precise individualized dosing. “We know that up to 50% of people in the UK alone don’t take their medicines correctly and this has an impact on poorer health outcomes with conditions not being controlled or properly treated. A single pill approach would simplify taking multiple medications at different times,” explains Felicity Rose from the School of Pharmacy. Even the speed of the medications’ release would be determined by the tablet’s internal structure, which would make it ideal for treating conditions where precise dosing and intake timing are crucial.

Flexibly on call

Last, but not least, 3D printing also offers distinct practical advantages, such as shortening the development time of a drug. As well, in cases of ingredient unavailability on the market or supply chain shortages, pills may be printed by pharmacies on demand, in small amounts and in a decentralized fashion. The same is true for medicines with a short shelf life or temperature-sensitive ingredients.

3D printing probably will not replace the mechanical press in the foreseeable future, however, as the cost of producing pills individually is significantly higher than mass-producing them. Even so, 3D-printed medications are a milestone on the way to personalized medicine thanks to their range of possibilities. At the UKE, at least, 3D printing could help “solve very practical problems in a clinic’s day to day operations,” states pharmacist Dadkhah; problems like those of young leukemia patient Aliya, who still remembers with a shudder the nauseating medicine she had to take before her chemo at the UKE. “I couldn’t swallow any pills. I had to chew them, and they got stuck in my teeth. That was so disgusting!” she says. Rather the raspberry, then!

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