This study aims to design and characterize berberine-loaded wafers for the treatment of chemotherapy-induced oral mucositis. Wafers were prepared by lyophilization of hydrogels of various ratios of chitosan (CS)/sodium alginate (SA) as well as CS/hydroxypropyl methylcellulose (HPMC). In vitro release, in vitro mucoadhesion, porosity, and swelling studies were conducted to select the optimized formulations. Moreover, scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and mechanical properties studies were also performed for further characterization. The efficacy of optimized berberine-loaded wafers in the treatment of oral mucositis was investigated in a 5FU-induced oral mucositis rat model. F2-CS-SA and F6-CS-HPMC wafers exhibited sustained release profile and excellent mucoadhesion strength. Therefore, these wafers were selected as the optimized formulations. SEM confirmed the porous structure of these wafers and is in agreement with the results of porosity and swelling studies. XRD and FTIR studies indicated that berberine was incorporated into the wafer matrix in the amorphous form. In vivo studies demonstrated that topical application of berberine-loaded optimized wafers reduced significantly the severity of 5FU-induced oral mucositis and decreased the expression of inflammatory markers (TNF-α and IL-1β). The results of in vitro and in vivo studies revealed that berberine-loaded F2-CS-SA and F6-CS-HPMC wafers can be effective in the treatment of chemotherapy-related oral mucositis.

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