PHARMACEUTICAL SERVICES DIVISION Ministry of Health Malaysia Extemporaneous FORMULATION Pharmaceutical Services Division Ministry of Health Malaysia Lot 36, Jalan Universiti, 46350 Petaling Jaya, Selangor. Tel: 03-78413200 Fax: 03-79682222/79682268 Extemporaneous Formulation, MOH 2015 Pharmaceutical Services Division, Ministry of Health Malaysia Lot 36, Jalan Universiti, 46350 Petaling Jaya, Selangor. Previous edition was Extemporaneous Formulary MOH 2012. ALL RIGHTS RESERVED No part of this publication may be reproduced, stored or transmitted in any form or by any means whether electronic, mechanical, photocopying, tape, recording or other without permission from the Senior Director of Pharmaceutical Services, Ministry of Health Malaysia. Perpustakaan Negara Malaysia Extemporaneous Formulation, Ministry of Health Malaysia. PHARMACEUTICAL SERVICES DIVISION Ministry of Health Malaysia Extemporaneous FORMULATION . Haq Director of Pharmacy Practice & Development.Hospital Sibu Cynthia Hee Xiao Ying . MOH Advisor Rosminah binti Mohd Din Pharmaceutical Services Division.Institut Kanser Negara Chan May Yee .Hospital Wanita & Kanak-Kanak Sabah Khoo Sze Ni .Hospital Sungai Buloh Nabilah Mohamad Shohaime .Hospital Pulau Pinang Azhani Kamarudin . Pharmaceutical Services Division.Hospital Raja Permaisuri Bainun Ng See Yee .Hospital Tengku Ampuan Rahimah.Hospital Kuala Lumpur Chuo Sing Hong .Hospital Sultanah Bahiyah Zaitun binti Mohd Saman .Hospital Pakar Sultanah Fatimah Asmahani Ramelan .Hospital Raja Prempuan Zainab II Nik Nuradlina binti Nik Adnan . MOH Editors Nurul Adha binti Othman Pharmaceutical Services Division.EDITORIAL BOARD Patron Abida Haq binti Syed M. MOH Contributors Noor Haslina binti Othman . Klang Teoh Ai Luan .Hospital Kuala Lumpur . MOH Rabi’ah binti Mamat Hospital Selayang Noor Liyana Yusup Pharmaceutical Services Division.Hospital Pulau Pinang Darshini Siwanandan .Hospital Sungai Buloh Janice Lee Siaw Vun .Hospital Putrajaya Gurvinderjit Kaur . ................ ALPRAZOLAM SUSPENSION 1MG/ML................. BACLOFEN SUSPENSION 5MG/ML............................ CAPTOPRIL SOLUTION 1MG/ML.................................................................................................................................................................................................. 17 9.. CARBIDOPA/LEVODOPA (SINEMET®) SUSPENSION 1........ CLONAZEPAM SUSPENSION 0...................... BACLOFEN SUSPENSION 10MG/ML........................................................................................................................................................................................................................................5MG/ML............................................................1MG/ML...........CONTENTS INTRODUCTION...................................... 26 18.......................... CHLOROQUINE SUSPENSION 15MG/ML... ATENOLOL SUSPENSION 2MG/ML.... 20 12........................................................................................................... AMLODIPINE SUSPENSION 1MG/ML............. 2 CONSIDERATIONS FOR PREPARING EXTEMPORANEOUS COMPOUNDS..................................................... 25 17..................................... CARVEDILOL SUSPENSION 1MG/ML.. 14 6... 5 CHECKLIST 1: SOURCING THE COMPOUNDING FORMULARY LIST OF EXTEMPORANEOUS PREPARATION MEDICINES........................................................................................... 12 4................................. 19 11........................................... 21 13.............................................................................................. 33 ......... FERRIC AMMONIUM CITRATE 400MG/5ML MIXTURE.................... ENALAPRIL SUSPENSION 1MG/ML................................... AMIODARONE SUSPENSION 40MG/ML................................... 31 23....................................... 1 POLICY....................................................... 29 21. 11 3........................................ 8 CHECKLIST 2: HANDLING OF PRESCRIPTIONS WITH EXTEMPORANEOUS PREPARATION MEDICINES IN THE PHARMACY...... CAPTOPRIL SYRUP 1MG/ML..................................................................... 3 WORK FLOW CHART 1: SOURCING THE COMPOUNDING FORMULARY LIST OF EXTEMPORANEOUS PREPARATION MEDICINES.....................................1MG/ML......... 27 19...................................................................................................................................................................................... ACETAZOLAMIDE SUSPENSION 25MG/ML................................ 9 1.......................... DIPYRIDAMOLE SUSPENSION 10MG/ML....................................................................................................................... CAFFEINE CITRATE SOLUTION 10MG/ML....................................................25MG CARBIDOPA/5MG LEVODOPA/ML. ALLOPURINOL SUSPENSION 20MG/ML..................................................................................................... 10 2..... DEXAMETHASONE SUSPENSION 0................................................................................... 28 20....................................................................... 18 10..... 13 5............................................................................................. ENALAPRIL SUSPENSION 0.......................... CLOPIDOGREL SUSPENSION 5MG/ML................................ 32 24................................................................... 24 16......................... 15 7......................... 23 15. 16 8........ 7 STANDARD LABEL DESIGN & WORKSHEET REQUIREMENTS FOR EXTEMPORANEOUS PREPARATIONS................................................................. 1 OBJECTIVE.............................................. 6 WORK FLOW CHART 2: HANDLING OF PRESCRIPTIONS WITH EXTEMPORANEOUS PREPARATION MEDICINES IN THE PHARMACY.............5MG/ML............. 22 14........................................................................ CARVEDILOL SUSPENSION 0............................................................. DAPSONE SUSPENSION 2MG/ML................................. CITRIC ACID 25%....................................................................................................................... 30 22............................... .............................. 38 30... 56 48......................5MG/ML................... 52 44............................................................................... PROPRANOLOL SUSPENSION 1MG/ML....................................................................................................................... MIDAZOLAM SYRUP 2MG/ML..................................... PYRAZINAMIDE SYRUP 100MG/ML................. 39 31.......... 63 55.............. PHENOBARBITONE SUSPENSION 10MG/ML................................. GABAPENTIN SUSPENSION 100MG/ML........... TRIMETHOPRIM SYRUP 10MG/ML......................... VERAPAMIL SUSPENSION 50MG/ML.........................................................4MG/ML..................................................... 48 40................................................. 57 49............ HYDROCHOLOROTHIAZIDE SUSPENSION 5MG/ML........ PANTOPRAZOLE 2MG/ML...................................................................... TRIMETHOPRIM SUSPENSION 10MG/ML......................... OMEPRAZOLE SUSPENSION 2MG/ML.................. SPIRONOLACTONE SYRUP 1.................... 51 43............ 50 42.. URSODEOXYCHOLIC ACID SUSPENSION 50MG/ML..................... LABETALOL SYRUP 40MG/ML.................................................. RIFAMPICIN SYRUP 10MG/ML............................ INDOMETHACIN SYRUP 5MG/ML.................................. 41 33............................5MG/ML...................................... 62 54............ NITROFURANTOIN SUSPENSION 10MG/ML... 34 26....................... 58 50.......... 68 ABBREVIATIONS..... 55 47.... 47 39......................................................................................................... PROPRANOLOL SUSPENSION 0................ NIFEDIPINE SUSPENSION 1MG/ML....................................................................................................................................... 53 45.............. ISONIAZID SYRUP 10MG/ML................................... GLYCOPYRROLATE SYRUP 0............................................ PYRAZINAMIDE SUSPENSION 10MG/ML.............................1MG/ML..................... 59 51.................................................................... 66 58................................................ 64 56............. NIFEDIPINE SUSPENSION 4MG/ML.........................25MG/ML.................................................. METHYLCELLULOSE SUSPENDING AGENT 1% (0.. SPIRONOLACTONE SYRUP 2................ 37 29............................................................... 49 41....... 36 28.. FOLIC ACID SUSPENSION 1MG/ML........................................ 35 27............................................................ 46 38................ 40 32................................................................................................................ 54 46. PHYTOMENADIONE (VITAMIN K1) LIQUID 1MG/ML............................. 60 52................................. LORAZEPAM SYRUP 0.............................................. SILDENAFIL SUSPENSION 2...................... 67 59..........................................5MG/ML....................................................................................................... 42 34..............................................................................................................................01G/ML)................ 45 37................... LANSOPRAZOLE SUSPENSION 3MG/ML................................................................... 44 36............................................. PENTOXIFYLLINE SOLUTION 20MG/ML.............................. LABETALOL SYRUP 10MG/ML...................................................................... 43 35............................... 69 ............................................25.... 65 57.......... VERAPAMIL SUSPENSION 8MG/ML........................................................................................................................... METOPROLOL SUSPENSION 10MG/ML.................................................................................. RIFAMPICIN SUSPENSION 25MG/ML..... 61 53................. the lists of compounded items in this manual are not exhaustive. use readily available ingredients. The use of this manual requires knowledge based interpretation by healthcare professionals and is intended solely for use by pharmacists in healthcare facilities. OBJECTIVE To standardise formulations of extemporaneous preparations and practice in healthcare facilities. Formulations are only included where there is existence of published formulations and associated stability data. Preparations included in the manual are for ingredients available commercially but not in the required dosage form for therapy and thus. However. necessitate extemporaneous preparations. Efforts have been made to search for substantiated references in producing this manual of extemporaneous preparations.INTRODUCTION Compounding of pharmaceutical formulations remain as the core skill of pharmacists and this manual is produced to include well referenced recipes that are easy to prepare. All information contained in the manual has been provided with the sole intention that it be readily accessible for pharmacist’s information and as a guide for preparing extemporaneous preparations that may be prescribed. 1 . The committee has made all reasonable efforts to confirm the accuracy of the information contained in the manual and to present the best practices as identified at the time of its completion. have the longest expiry date possible and when necessary. provide more than one strength of formulation to accommodate the unique needs of different groups of patients. Documentation after each preparation should include details on the materials used. 6. 3. 2 . Techniques in compounding preparations and manipulations should always be in line with the standard Good Preparation Practice as delivering an accurate dose is paramount. Always consider the use of commercially available products as far as possible. 2. This must be discussed with the physician. 4. the stability of the preparation should be no longer than 30 days.POLICY 1. consider a therapeutic alternative that is available in a suitable dosage form. Once opened. Always check for the suitability of the product/brand for extemporaneous preparations. If no suitable commercial product exists. compound an oral medication by dispensing a tablet and/or capsule and directing the caregiver to mix just prior to administration. Refrain assumptions on the therapeutic equivalence in the case of suggesting alternative agents as the possibilities and supporting data may be limited. Stability stated in this manual is applicable for shelf storage in the pharmacy without opening. When no information is available. Staff and facilities are challenged to undertake intermittent competency assessments in order to achieve the standards requirement. Preparations listed in this manual should be done according to what is stated as far as possible unless stated otherwise in the product leaflet. Maximum quantity of the extemporaneous preparations to be dispensed should not exceed one month. 7. 5. 9. 10. 8. Extemporaneous preparations should be done based on evidence-based references. processes involved and the responsible personnel in charge. 11. Ensure that all utensils are clean. Product should be labelled clearly and stored as recommended within the formula. including mortar and pestle. Solutions will have a clearer appearance versus a compounded suspension. Pharmacy personnel are reminded not to empirically change flavourings or suspending agents because they can affect the pH and stability of the product and result in an unstable product. pill cutters and stirring rods. 3 . to soften the coating prior to grinding the tablets. Ensure that all ingredients used are within the expiry date. 6.CONSIDERATIONS FOR PREPARING EXTEMPORANEOUS COMPOUNDS 1. it may be necessary to add a small amount of diluents such as water. 5. For solution or suspension products. If you are using capsules. graduates. Place tablet(s) within mortar and pestle to grind tablets to a fine powder. remember to withdraw the solution (medication) from the ampoule using a filter needle to ensure no glass particles are incorporated into the compound. For film-coated tablets. 3. Please consider ingredients in the formulations that require special precautions in neonates. If compounding a preparation using contents from an ampoule. Mixing of a compounded formulation should always be in line with the following principles: a. 2. b. c. emphasise on the importance of thorough shaking before administration. This will ensure that the compound will not have an eggshell appearance from the film coating floating throughout the suspension. 4. d. open the capsule and empty the powder into the mortar and discard the capsule shell. 7. and vice versa. 9. compatibility and stability profile. 8. Understand the roles of excipients in certain formulations and consider their risks over benefits limitation. If distilled water is not available. 4 . water for injection can be used as a substitution. Manipulations of the available dosage forms in order to fulfil the unusual practitioner’s request may impose risks such as preparation and administration errors as well as unpredictable bioavailability. WORK FLOW CHART 1: SOURCING THE COMPOUNDING FORMULARY LIST OF EXTEMPORANEOUS PREPARATION MEDICINES Identify list of extemporaneous medicines currently being used Do not proceed NO Check appropriateness of medicine YES Get company/ manufacturer to register/produce NO Check registration status YES Apply to get in into the FUKKM list if used extensively NO Determine FUKKM status YES Prepare and dispense extemporaneous medicine NO Check commercial availability YES Prepare and dispense extemporaneous medicine Check cost of commercial product versus cost of preparing medicine NO YES Propose hospital to purchase 5 . Determine FUKKM status 5. Propose hospital to purchase TICK (√) NOTE .CHECKLIST 1: SOURCING THE COMPOUNDING FORMULARY LIST OF EXTEMPORANEOUS PREPARATION MEDICINES NO 6 ACTION 1. Check cost of commercial product versus cost of preparing medicine 7. Check appropriateness of medicine 3. Check commercial availability 6. Identify list of extemporaneous medicines currently being used 2. Check registration status 4. if need to prepare stat each time Dispense tablet / capsule and counsel patient accordingly 7 .WORK FLOW CHART 2: HANDLING OF PRESCRIPTIONS WITH EXTEMPORANEOUS PREPARATION MEDICINES IN THE PHARMACY Receive prescription Dispense YES Check availability of medicine in pharmacy NO Dispense alternative medicine YES Discuss with medical practitioner on alternative medicine NO Obtain and dispense within 24 hours YES Check commercially available status at pharmacy retail outlet NO Prepare and dispense extemporaneous medicine Search for evidence-based reference / product leaflet to prepare extemporaneous medicine YES NO Instruct patient on how to prepare prior to administration. STANDARD LABEL DESIGN & WORKSHEET REQUIREMENTS FOR EXTEMPORANEOUS PREPARATIONS The proposed label for extemporaneous preparations must have the information as shown below: Details of Hospital/Klinik Kesihatan HOSPITAL/KLINIK KESIHATAN Jalan Alamat 1. Negeri Tel: 03-9876 5432 Nama: Minum: Pagi Expiry Date R/N: Tarikh: Details of Patient mL setiap hari Tengahari Petang Sebelum makan Bersama/selepas makan Malam Apabila perlu Setiap ____ jam Administration Instructions ARAHAN: Goncang botol sebelum guna Simpan di peti sejuk (2-8ºC) Simpan pada suhu bilik GUNA SEBELUM: NAMA UBAT: Drug’s Name with Strength UBAT TERKAWAL JAUHI DARIPADA KANAK-KANAK The worksheet of the product should contain the following details: • Patient’s name • ID number • Prescription number • Date of preparation • Name of drug • Dose • Volume of diluent/vehicle • Batch number of preparations & starting materials • Name and signature of preparing personnel • Name and signature of checking personnel 8 . Poskod 12345 Daerah. Receive prescription 2. Search for evidence-based reference to prepare extemporaneous medicine 6. Dispense medicine and counsel patient/caregiver accordingly TICK (√) NOTE 9 . Check availability of medicine 3. Check commercially available status at retail pharmacy outlet 5.CHECKLIST 2: HANDLING OF PRESCRIPTIONS WITH EXTEMPORANEOUS PREPARATION MEDICINES IN THE PHARMACY NO ACTION 1. Instruct patient/caregiver on how to prepare prior to administration of medicine. Discuss with medical practitioner on alternative medicine 4. if needed to prepare stat each time 7. azathioprine. Crush tablets in a mortar to fine powder.(1996) Stability of acetazolamide allopurinol. Am J Health Sys Pharm. 3. Allen LV. Make up to final volume with vehicle. Erickson MA.1. NOTES: REFERENCES: 1. secondary glaucoma and peri-operatively in angle-closure glaucoma : Suspension : 25mg/mL : 60 days : Refrigerate (preferable) or at room temperature STRENGTH QUANTITY 250mg 12 tablets qs 120mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Sweet SF® : Ora-Plus®(1:1) or • Ora-Blend SF® or • Cherry syrup or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Shake well and label. 6. Levigate the powder with small amount of vehicle until smooth paste is formed. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. clonazepam. and flucytosine in extemporaneously compounded oral liquids. 5. 10 . 53:1944. 2. 4. ACETAZOLAMIDE SUSPENSION 25MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Acetazolamide Vehicle : Acetazolamide : Reduction of intra-ocular pressure in open-angle glaucoma. Azathioprine. and Flucytosine in Extemporaneously Compounded Oral Liquids.2. 3. Levigate the powder with small amount of vehicle until smooth paste is formed. 11 . Shake well and label. Make up to final volume with vehicle. Allopurinol. Clonazepam. Allen LV and Erickson MA. ALLOPURINOL SUSPENSION 20MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Allopurinol Vehicle : : : : : : Allopurinol Gout or uric acid and calcium oxalate renal stones Suspension 20mg/mL 60 days Refrigerate (preferable) or at room temperature STRENGTH QUANTITY 300mg 8 tablets qs 120mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Sweet SF® : Ora-Plus®(1:1) or • Ora-Blend® or • Ora-Blend SF® or • Cherry syrup or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) • Methylcellulose 1% : Simple Syrup (1:1) PROCEDURE: 1. 2. 40 (4): 616-8. Stability of Acetazolamide. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. NOTES: REFERENCES: 1. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Crush tablets in a mortar to fine powder. Dressman JB and Poust RI. Am J Hosp Pharm 1983. 2. 5. Stability of Allopurinol and five antineoplastics in suspension. 4. Am J Health Sys Pharm 1996.53:1944-9. 6. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. 2. Shake well and label. 6. 4. ALPRAZOLAM SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS : : : : : : Alprazolam Anxiety disorders Suspension 1mg/mL 60 days Room temperature and protect from light STRENGTH QUANTITY 1mg 60 tablets qs 60mL Alprazolam Vehicle VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. Pharmacy Compounding Manual 2008. 3. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 5. Levigate the powder with small amount of vehicle until smooth paste is formed. Crush tablets in a mortar to fine powder. 2. NOTES: REFERENCES: 1. 12 .3. X-Temp® Oral Suspension System. Make up to final volume with vehicle. Master Formulation Sheets 2013. Calgary Health Region Pharmacy. REFERENCES: 1.4. Make up the final volume using more vehicle (pH adjusted) and stir well. Shake well and label. 13 . Grind the tablets to fine powder in a mortar and levigate the powder using a small amount of vehicle (pH adjusted) to form smooth paste. 3. 5. NOTES: 1. X-Temp® Oral Suspension System. Use additional vehicle to rinse the remaining drug from the mortar and add to the container. 2. 4. Gradually add the vehicle (pH adjusted) in small amounts to the paste. Measure out the vehicle and adjust the pH to pH 6-7 using Sodium Bicarbonate 5% solution. AMIODARONE SUSPENSION 40MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Amiodarone Amiodarone Arrhythmias Suspension 40mg/mL 28 days Room temperature and protect from light STRENGTH QUANTITY 200mg 20 tablets - ~10mL qs 100mL Sodium Bicarbonate Vehicle VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. Shake the bottle before consume. mix well until liquid is formed and transfer into a container. 6. Master Formulation Sheets 2013. 4. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Pharmacy Compounding Manual 2008.5. Add 3-4mL of distilled water to disintegrate the tablets. Master Formulation Sheets 2013. 2. 6. NOTES: REFERENCES: 1. Shake well and label. 7. Make up to final volume with vehicle. 14 . 3. Calgary Health Region Pharmacy. X-Temp® Oral Suspension System. 5. 2. Levigate the powder with small amount of vehicle until smooth paste is formed. AMLODIPINE SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Amlodipine Hypertension Suspension 1mg/mL 30 days Refrigerate INGREDIENTS Amlodipine Distilled water Vehicle STRENGTH QUANTITY 10mg 6 tablets - 3-4mL qs 60mL VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Crush tablets in a mortar to fine powder. ATENOLOL SUSPENSION 2MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS : Atenolol : Hypertension. Add vehicle to the paste until liquid is formed and transfer the liquid into a container. Ora-Sweet SF® should not be used in neonates ≤28 days corrected age. 6. Make up to final volume with vehicle. Shake well and label. 3. Desia A. 5. Crush tablets in a mortar to fine powder. 2. myocardial infarction and arrhythmias : Suspension : 2mg/mL : 14 days or 90 days : Refrigerate STRENGTH QUANTITY Atenolol 100mg 1 tablet Glycerin - 2mL Vehicle qs 50mL VEHICLE OF CHOICE: • Simple Syrup (stability 14 days) or • Ora-Sweet® (stability 14 days) or • Ora-Sweet SF® (stability 90 days) PROCEDURE: 1. 2. angina pectoris. Short term stability of Atenolol in oral liquid formulations. REFERENCES: 1. Calgary Health Region Pharmacy. Patel D. 15 . Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. International Journal of Pharmaceutical Compounding 1997. Levigate the powder with glycerin until smooth paste is formed.6. 4. NOTES: 1. 437-439. Pharmacy Compounding Manual 2008. Doshi DH. 50(11):2353-5. Grind tablets in a mortar to fine powder. REFERENCES: 1. Repeat the last step as necessary to bring the final volume to 60ml. Add about 15ml of simple syrup to the paste. Rinse the mortar with about 15ml of simple syrup and transfer the contents into the graduated cylinder.7. 5. 16 . 4. Calgary Health Region Pharmacy. Keep in an amber glass bottle. 2. 2. triturate well and transfer the contents into a graduated cylinder. BACLOFEN SUSPENSION 5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Baclofen Spasticity of the skeletal muscle Suspension 5mg/mL 35 days Refrigerate and protect from light INGREDIENTS STRENGTH QUANTITY Baclofen 10mg 30 tablets Glycerine - 3mL qs 60mL Simple Syrup PROCEDURE: 1. Johnson CE and Hart SM. Add glycerin to make fine paste. Stability of an Extemporaneously Compounded Baclofen Oral Liquid. Pharmacy Compounding Manual 2008. NOTES: 1. 3. Am J Hosp Pharm 1993. Crush tablets in a mortar to fine powder. 17 . X-Temp® Oral Suspension System. Allopurinol. Am J Health Sys Pharm 1996. 4. Allen LV and Erickson MA.53:1944-9. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Shake well and label. BACLOFEN SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Baclofen Vehicle : : : : : : Baclofen Spasticity of the skeletal muscle Suspension 10mg/mL 60 days Refrigerate (preferable) or at room temperature and protect from light STRENGTH QUANTITY 10mg 120 tablets qs 120mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) • X-Temp® Oral Suspension System PROCEDURE: 1. Stability of Acetazolamide. 6. 3. 2. Azathioprine. NOTES: REFERENCES: 1. 5. Make up to final volume with vehicle. Clonazepam. 2. Levigate the powder with vehicle until smooth paste is formed. Master Formulation Sheets 2013. and Flucytosine in Extemporaneously Compounded Oral Liquids.8. 2. Weigh the powders and mix with a small amount of vehicle in a measuring cylinder. Nahata MC. 3. 2. CAFFEINE CITRATE SOLUTION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Caffeine Citrate Apnoea of prematurity Solution 10mg/mL 30 days Refrigerate and protect from light INGREDIENTS STRENGTH QUANTITY Caffeine Citrate Anhydrous BP - 1g Citric acid anhydrous BP - 1g qs 100mL Vehicle VEHICLE OF CHOICE: • Distilled water or water for injection PROCEDURE: 1.html [Accessed:15th Oct 2015].4: 133. PharmInfoTech: Database of Oral Liquid Formulations-eMixt.(1990) Stability study of caffeine citrate. [Online] Available from: http://www. NOTES: 1. 3. REFERENCES: 1. Hopkin C.pharminfotech. Add more vehicle to the mixture and make up to final volume with the vehicle.nz/manual/Formulation/mixtures/caffeine_citrate.9. Hanson S. Chemically stable for at least 90 days but the potential for microbial growth was not assessed. 4. (2011) Pediatric Drug Formulation. Hipple TF. 2. Pai VB. Shake well before consume. 4. Make up to final volume with vehicle and transfer into a suitable container. Taylor A.6th Edition. 18 . Observe for precipitation. Shake well and label.Br J Pharm Pract.co. Harvey Whitney Books. Refrigeration recommended to reduce potential for micobial growth. 3. Equivalent to 5mg per mL anhydrous caffeine base. 10. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Lye MY. Keep in an amber glass bottle. Make up to final volume with vehicle. Shake well and label. Levigate the powder with simple syrup until smooth paste is formed. 4. Pharmacy Compounding Manual 2008. 2.(1997) Effects of Ingredients on Stability of Captopril in Extemporaneously Prepared Oral Liquids. 6. NOTES: 1. Am J Health Syst Pharm . 2. Lim LY.54(21):2483-7. Crush tablets in a mortar to fine powder. Add more simple syrup to the paste until liquid is formed and transfer the liquid into a container. Calgary Health Region Pharmacy. CAPTOPRIL SYRUP 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Captopril : i) Hypertension ii) Congestive heart failure iii) Post-myocardial infarction iv) Diabetic nephropathy : Syrup : 1mg/mL : 30 days : Refrigerate and protect from light INGREDIENTS Captopril Simple Syrup STRENGTH QUANTITY 25mg 4 tablets qs 100mL PROCEDURE: 1. REFERENCES: 1. 5. 19 . et al. 3. Yow KL. 11. 3. Shake well and label. 51(13):1707-8. Allow the captopril tablets to dissolve in 50mL of distilled water in a graduated cylinder. Am J Hosp Pharm. CAPTOPRIL SOLUTION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS : Captopril : i) Hypertension iii) Post-myocardial infarction : Solution : 1mg/mL : 56 days : Refrigerate ii) Congestive heart failure iv) Diabetic nephropathy STRENGTH QUANTITY Captopril 25mg 4 tablets Ascorbic Acid 500mg 1 tablet Distilled Water qs 100mL PROCEDURE: 1. Need for Extemporaneous Formulations in Pediatric Patients. Morosco RS. and Hipple TF. 20 . Nahata MC. NOTES: 1. A sulfur like odour is not indicative of captopril degradation. Add 500mg of ascorbic acid tablet to the mixture and make to final volume with distilled water. (1994) Stability of Captopril in Liquid Containing Ascorbic Acid or Sodium Ascorbate. Secundum Artem (Vol 8) No 3. 2. REFERENCES: 1. Paddock Laboratories. 2. 6. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. REFERENCES: 1. Make up to final volume with vehicle. CARBIDOPA/LEVODOPA (SINEMET®) SUSPENSION 1.25mg Carbidopa/5mg Levodopa/mL 42 days if refrigerated or 28 days at room temperature Refrigerate (preferred) or at room temperature and protect from light STRENGTH QUANTITY 25mg/100mg 5 tablets qs 100 mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Blend ® or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container.25MG CARBIDOPA/5MG LEVODOPA/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Sinemet ® Vehicle : : : : : : Carbidopa/Levodopa (Sinemet®) Parkinson’s disease Suspension 1. 5. 2. Levigate the powder with small amount of vehicle until smooth paste is formed.12. 21 . Shake well and label. NOTES: 1. Crush tablets in a mortar to fine powder. Suspension stored at room temperature may change colour to darker yellow. 3. 4. Pharmacy Compounding Manual 2008. Calgary Health Region Pharmacy. 4. Compounding Formulas. Nationwide Children’s.5mg 4 tablets qs 100mL VEHICLE OF CHOICE: • Ora-Sweet®: Ora-Plus® (1:1) or • Ora-Blend ® or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. CARVEDILOL SUSPENSION 0. nationwidechildrens. [Accessed: 9th Oct 2015]. 5. 6.5 mg/mL : 30 days : Room temperature and protect from light INGREDIENTS Carvedilol Vehicle STRENGTH QUANTITY 12. Crush tablets in a mortar to fine powder.[Online] Available from: http://www. 22 . 3. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. NOTES: 1. REFERENCES: 1. Make up to final volume with vehicle.13. Shake well and label. Levigate the powder with small amount of vehicle until smooth paste is formed. 2.org/outpatient-pharmacy-compounding-formulas. Keep in an amber glass bottle.5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Carvedilol : Treatment of stable moderate to severe congestive cardiac failure in addition to ACE inhibitors and diuretics : Suspension : 0. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. 41:254–9. Pharmacy Compounding Manual 2008. Hosp Pharm. CARVEDILOL SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Carvedilol : Treatment of stable moderate to severe congestive cardiac failure in addition to ACE inhibitors and diuretics : Suspension : 1mg/mL : 84 days : Room temperature and protect from light INGREDIENTS Carvedilol Sterile water for injection Vehicle STRENGTH QUANTITY 12. Levigate the powder with 10mL of sterile water for injection until smooth paste is formed. 2. Yamreudeewong W.5mg 8 tablets - 10mL qs 100mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus®(1:1) or • Ora-Blend ® or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. REFERENCES: 1. Make up to final volume with vehicle. Calgary Health Region Pharmacy. 23 . 3. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 2. Shake well and label.(2006) Stability of two extemporaneously prepared oral metoprolol and carvedilol liquids. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Dolence EK. 5. NOTES: 1.14. Crush tablets in a mortar to fine powder. 6. 4. Pahl D. Keep in an amber glass bottle. 2. Alberta Health Services. 5. 4. Pai VB. Levigate the powder with small amount of vehicle until smooth paste is formed. REFERENCES: 1. NOTES: 1. 6th Edition. Hipple TF. 6. Make up to final volume with vehicle. Shake well and label. Provides 9mg/mL of chloroquine base. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. 2. (2011) Pediatric Drug Formulation.15. Keep in an amber plastic bottle. Crush tablets in a mortar to fine powder. Ora-Sweet SF® and Ora-Blend SF® should not be used in neonates ≤28 days corrected age. Pharmacy Compounding Manual 2011. Nahata MC. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 3. 2. Harvey Whitney Books. CHLOROQUINE SUSPENSION 15MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Chloroquine Vehicle : : : : : : Chloroquine Treatment of malaria .acute attack Suspension 15mg/mL 60 days Refrigerate (preferable) or at room temperature and protect from light STRENGTH QUANTITY 250mg qs 6 tablets 100mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Sweet SF® : Ora-Plus® (1:1) or • Ora-Blend ® or • Ora-Blend SF® or • Cherry syrup or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. 24 . 3. 2.16. Make up to final volume of 50mL. NOTES: 1. CITRIC ACID 25% Generic Name Dosage Form Strength Stability Storage : : : : : Citric Acid Solution 25% (0.5g qs 50mL Distilled water PROCEDURE: 1. Bottle or container must not have rubber cap liners. 25 . REFERENCES: 1. Add approximately 30mL of distilled water and stir well. monohydrate - 12. 3. Weigh the citric acid.25g/mL) 60 days Refrigerate INGREDIENTS STRENGTH QUANTITY Citric acid powder. Alberta Health Services. Pharmacy Compounding Manual 2011. Ora-Sweet SF® and Ora-Blend SF® should not be used in neonates ≤28 days corrected age. REFERENCES: 1. NOTES: 1.1mg/mL 60 days Refrigerate or at room temperature and protect from light STRENGTH QUANTITY 2mg 6 tablets qs 120mL VEHICLE OF CHOICE: • Ora-Blend® or Ora-Blend SF® or • Ora-Plus®: Ora-Sweet® (1:1) or • Ora-Plus®: Ora-Sweet SF (1:1) Cherry Syrup or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Make up to the final volume using vehicle. Keep in an amber glass bottle. Pharmacy Compounding Manual 2011. CLONAZEPAM SUSPENSION 0. 26 .17. Alberta Health Services. Clonazepam solutions should not be stored in polyvinyl chloride (plastic) bottle or polypropylene (oral syringes) for longer than 24 hours. 3. Grind up tablets in mortar. Levigate powders with small amount of vehicle until homogenous. 2. 2.1MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Clonazepam Vehicle : : : : : : Clonazepam i) Epilepsy ii) Non-epileptic myoclonus Suspension 0. Shake well before consume. NOTES: 1.18. Shake well and label. 2. Levigate the powder with small amount of vehicle until smooth paste is formed. stroke or established peripheral arterial disease : Suspension : 5mg/mL : 60 days : Refrigerate or at room temperature and protect from light INGREDIENTS STRENGTH QUANTITY 75mg 8 tablets qs 120mL Clopidogrel Vehicle VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. 2. CLOPIDOGREL SUSPENSION 5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Clopidogrel : Prevention of myocardial infarction. 5. X-Temp® Oral Suspension System. 3. Crush tablets in a mortar to fine powder. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Master Formulation Sheets 2013. 6. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 27 . REFERENCES: 1. 4. Make up to final volume with vehicle. Keep in an amber plastic bottle. 6. X-Temp® Oral Suspension System. 2. Master Formulation Sheets 2013. Pharmacy Compounding Manual 2008. Shake well and label. 3. 28 . NOTES: 1. Crush tablets in a mortar to fine powder. 2. 5. 4. Dermatitis herpetiformis Suspension 2mg/mL 91 days Refrigerate or at room temperature and protect from light STRENGTH QUANTITY 100mg 2 tablets qs 100mL VEHICLE OF CHOICE: • Ora-Blend® or Ora-Blend SF® or • Ora-Plus® : Ora-Sweet® (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. DAPSONE SUSPENSION 2MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Dapsone Vehicle : : : : : : Dapsone Leprosy. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container.19. Ora-Blend SF® should not be used in neonates ≤28 days corrected age. Levigate the powder with small amount of vehicle until smooth paste is formed. Preparation may slightly darken at room temperature. 2. Calgary Health Region Pharmacy. Make up to final volume with vehicle. REFERENCES: 1. 5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Dexamethasone : Croup.5mL qs 100mL Vehicle VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. Add the sufficient quantity of vehicle and stir well. REFERENCES: 1. Shake well and label. X-Temp® Oral Suspension System. Keep in an amber bottle. 4. Draw up the required amount of injection using a 5µm filter needle or filter straw and transfer to a measuring cylinder. cerebral oedema and respiratory distress syndrome : Suspension : 0. Septic shock. 3. DEXAMETHASONE SUSPENSION 0.5mg/mL : 91 days : Room temperature and protect from light INGREDIENTS STRENGTH QUANTITY Dexamethasone (Sodium Phosphate Injection) 4mg/mL 12. 29 . 2.20. NOTES: 1. Make up to final volume with vehicle. Master Formulation Sheets 2013. 21. Make up to final volume with vehicle. 30 . 6. Levigate the powder with small amount of vehicle until smooth paste is formed. DIPYRIDAMOLE SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Dipyridamole As an adjunct to oral anticoagulation/antiplatelet therapy Suspension 10mg/mL 60 days Room temperature and protect from light INGREDIENTS Dypiridamole Vehicle STRENGTH QUANTITY 25mg 40 tablets qs 100mL VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. Crush tablets in a mortar to fine powder. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 5. Shake well and label. 3. 4. X-Temp® Oral Suspension System. 2. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Master Formulation Sheets 2013. NOTES: REFERENCES: 1. 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Enalapril Distilled water : : : : : : Enalapril i) Hypertension ii) Congestive heart failure Suspension 0.1mg/mL 14 days Room temperature STRENGTH QUANTITY 10 mg 5 tablets qs 500mL PROCEDURE: 1. 6. 2.22. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Saulnier JL. Australian Journal of Hospital Pharmacy. Add more distilled water to the paste until liquid is formed and transfer the liquid into a container. 31 . 5. Levigate powders with small amount of distilled water until homogenous. Shake well and label. (1997) Stability of enalapril solutions from tablets in sterile water. 3. ENALAPRIL SUSPENSION 0. 4. Crush tablets in a mortar to make fine powders. NOTES: REFERENCES: 1. Make up to final volume with vehicle. Schlatter J. 27(5). 7. Use additional vehicle to rinse the remaining drug from the mortar and add it into the graduate. NOTES: 1. Stir well. REFERENCES: 1. X-Temp® Oral Suspension System. 6. ENALAPRIL SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Enalapril i) Hypertension ii) Congestive heart failure Suspension 1mg/ mL 60 days Room temperature and protect from light INGREDIENTS Enalapril Vehicle STRENGTH QUANTITY 20mg 5 tablets qs 100mL VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. 5. 3. 32 .23. Add more vehicle to the paste until liquid is formed. Keep in an amber bottle. Master Formulation Sheets 2013. Crush tablets in mortar to make fine powders. Transfer suspension to final container and label. soak tablets in small amount of vehicle. If needed. Make up to final volume with vehicle. 4. Add vehicle in small quantities until smooth paste is formed. 2. Transfer the contents into a graduated cylinder. NOTES: REFERENCES: 1. FERRIC AMMONIUM CITRATE 400MG/5ML MIXTURE Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Ferric Ammonium Citrate Prevention and treatment of iron deficiency anaemia Mixture 400mg/5ml 3 months Room temperature and protect from light STRENGTH QUANTITY Ferric Ammonium Citrate - 80g Chloroform Water Double-Strength BP - 500ml Lemon Spirit - 2ml Syrup BP/Syrup Simplex - 100ml Distilled water qs 1000ml PROCEDURE: 1. 3. 33 . Pharmaceutical Society of Great Britain (1973) British pharmaceutical codex 1973. Add simplex syrup and lemon lime essence. Prepare chloroform water double strength BP by mixing chloroform water BP with sterile water for (1:200) ratio. Stir well. 38th Edition. 4. (2014) Martindale: The complete drug reference. Sweetman SC. England: Pharmaceutical Press. 2. Add sufficient water to make up the final volume required. Add Ferric Ammonium Citrate powder and stir.24. 2. Pharmaceutical Press. Crush tablets in mortar to make fine powders. Transfer suspension to final container and label. Add more vehicle to the paste until liquid is formed. 34 . NOTES: REFERENCES: 1. Add vehicle in small quantities until smooth paste is formed. Make up to final volume with vehicle. 3. 4.25. FOLIC ACID SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Folic Acid Folate deficiency Suspension 1mg/mL 60 days Room temperature and protect from light INGREDIENTS Folic Acid Vehicle STRENGTH QUANTITY 5mg 20 tablets qs 100mL VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. 6. Transfer the contents into a graduated cylinder. Use additional vehicle to rinse the remaining drug from the mortar and add it into the graduate. Stir well. 5. Master Formulation Sheets 2013. X-Temp® Oral Suspension System. 2. Transfer the contents into a graduated cylinder. X-Temp® Oral Suspension System. Carefully empty the capsules content into a mortar. Neuropathic pain Suspension 100mg/mL 28 days Room temperature INGREDIENTS Gabapentin Vehicle STRENGTH QUANTITY 300mg 20 capsules qs 60mL VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. 4. Use additional vehicle to rinse the remaining drug from the mortar and add it into the graduate. Add more vehicle to the paste until liquid is formed. Make up to final volume with vehicle.26. 6. 3. Add vehicle in small quantities until smooth paste is formed. 5. Master Formulation Sheets 2013. Transfer suspension to final container and label. 35 . 2. GABAPENTIN SUSPENSION 100MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Gabapentin Epilepsy. Stir well. NOTES: REFERENCES: 1. Keep in an amber plastic bottle. 4. 36 . 2. Kraus DM. Int J of Pharmaceutical Compounding. Jean-Marc F & Patrice H. REFERENCES: 1. Shake well and label. 9(5):396. NOTES: 1. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container.1mg/mL 14 days Refrigerate (preferable) or at room temperature and protect from light.(2005) Stability and subjective taste acceptability of four glycopyrrolate solutions for oral administration. Christine L. 5. Add the sufficient quantity of simple syrup and stir well. United State:Lexi-Comp. Taketomo CK. STRENGTH QUANTITY Glycopyrrolate injection 200mcg/mL 5mL Simple Syrup qs 10mL PROCEDURE: 1. Hodding JH. Break the ampoule and syringe out the content of glycopyrrolate from the ampoule with 5 µm filter into a mortar. 3.27. Make up to final volume with simple syrup. GLYCOPYRROLATE SYRUP 0. 2.1MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS : : : : : : Glycopyrrolate To reduce excessive drooling Syrup 0. Pediatric Dosage Handbook 1996-1997. 3. Make up to final volume with vehicle. Add vehicle in small quantities until smooth paste is formed.28. Crush tablets in mortar to make fine powders. Use additional vehicle to rinse the remaining drug from the mortar and add it into the graduate. HYDROCHOLOROTHIAZIDE SUSPENSION 5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Hydrochlorothiazide Diuretic. 4. Master Formulation Sheets 2013. 7. 37 . Transfer suspension to a container and label. X-Temp® Oral Suspension System. NOTES: REFERENCES: 1. Stir well. 2. Transfer the contents into a graduated cylinder. Add more vehicle to the paste until liquid is formed. 5. soak tablets in a small amount of vehicle. 6. If needed. hypertension Suspension 5mg/mL 60 days Refrigerate or at room temperature and protect from light INGREDIENTS Hydrochlorothiazide Vehicle STRENGTH QUANTITY 25mg 20 tablets qs 100 mL VEHICLE OF CHOICE: • X-Temp® Oral Suspension System PROCEDURE: 1. 29. Keep in an amber bottle. 2. REFERENCES: 1. 38 . 14(2). Levigate the powder with small amount of simple syrup until smooth paste is formed. 3. Pharmacy Compounding Manual 2008. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container. Canadian Society of Hospital Pharmacy (1988) Extemporaneous Oral Liquid Dosage Form Preparations. Make up to final volume with simple syrup. 6. 2. 5. NOTES: 1. Calgary Health Region Pharmacy. Open capsules and empty the contents into a mortar.63.p. Pharmacy Practice. Shake well and label. 4. Add more simple syrup to the paste until liquid is formed and transfer the liquid into a container. INDOMETHACIN SYRUP 5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Indomethacin Pain and inflammation in rheumatic disease Syrup 5mg/mL 60 days Refrigerate and protect from light INGREDIENTS STRENGTH QUANTITY Indomethacin 25mg 20 capsules Simple syrup qs 100mL PROCEDURE: 1. 39 . 2. REFERENCES: 1. Do not use sugar based syrups. 3. 6. 4. NOTES: 1. 5. Pharmacy Compounding Manual 2008. Shake well and label. Calgary Health Region Pharmacy. ISONIAZID SYRUP 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Isoniazid i) Tuberculosis ii) Tuberculous meningitis Syrup 10mg/mL 21 days Refrigerate INGREDIENTS Isoniazid Distilled water Sorbitol 70% Solution STRENGTH QUANTITY 100mg 10 tablets - 10mL qs 100mL PROCEDURE: 1. Make up to final volume with Sorbitol 70%. Add Sorbitol 70% to the paste until a liquid is formed and transfer the liquid into the container. Crush tablets in a mortar to a fine powder. Use additional Sorbitol 70% to rinse the remaining drug from the mortar and pour into the container.30. Levigate the powder with 10mL of distilled water until a smooth paste is formed. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 5. 2. 4. 3. Shake well and label. Pharmacy Compounding Manual 2008. Levigate the powder with small amount of Simple syrup until smooth paste is formed. 6. NOTES: REFERENCES: 1. Crush tablets in a mortar to fine powder.31. 40 . Calgary Health Region Pharmacy. Add more Simple syrup to the paste until liquid is formed and transfer the liquid into a container. Make up to final volume with vehicle. LABETALOL SYRUP 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Labetalol Simple syrup Labetalol Hypertension Syrup 10mg/mL 28 days Refrigerate (preferable) or at room temperature STRENGTH QUANTITY 100mg 12 tablets qs 120mL PROCEDURE: 1. Keep in an amber plastic (polyethylene terephthalate) bottle. Erickson MA (1996) Stability of labetalol hydrochloride. Levigate the powder with small amount of vehicle until a smooth paste is formed. 41 .32. 5. Pharmacy Compounding Manual 2008. Calgary Health Region Pharmacy. 2. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. REFERENCES: 1. 53(2). NOTES: 1. LABETALOL SYRUP 40MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Labetalol Vehicle Labetalol Hypertension Syrup 40mg/mL 60 days Refrigerate (preferable) or at room temperature and protect from light. Allen LV. 2. verapamil hydrochloride and spironolactone with hydrochlorothiazide in extemporaneously compounded oral liquids. 3. STRENGTH QUANTITY 100mg 48 tablets qs 120mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus®(1:1) or • Ora-Blend ® or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Am J Health Sys Pharm. Shake well and label. Crush tablets in a mortar to a fine powder. Make up to final volume with vehicle. metoprolol tartrate. Add more vehicle to the paste until a liquid is formed and transfer the liquid into the container. 6.2304-8. 4. Open capsules and empty the contents into a mortar. Pharmacy Compounding Manual 2011. Keep in an amber plastic bottle or oral syringes. Levigate the powder with small amount of sodium bicarbonate solution until smooth paste is formed. 5. Use additional sodium bicarbonate solution to rinse the remaining drug from the mortar and pour into the container.33. Alberta Health Services. 4. Shake well and label.4% injection STRENGTH QUANTITY 30mg 10 capsules qs 100mL PROCEDURE: 1. 2. REFERENCES: 1. 8 hours (room temperature) : Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Lansoprazole Sodium bicarbonate 8. LANSOPRAZOLE SUSPENSION 3MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Lansoprazole : i) Peptic ulcer disease iv) For eradication of ii) Reflux oesophagitis Helicobacter pylori in iii) Zollinger-Ellison Syndrome combination with antibiotic : Suspension : 3mg/mL : 14 days (refrigerated). NOTES: 1.4% injection solution from ampoule using 5µ filter. 7. Syringe out sodium bicarbonate 8. 3. 6. 42 . Add more sodium bicarbonate solution to the paste until liquid is formed and transfer the liquid into a graduated container. Make up to final volume with sodium bicarbonate solution. 5. Calgary Health Region Pharmacy. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container.34. 6. LORAZEPAM SYRUP 0. NOTES: REFERENCES: 1. Add more simple syrup to the paste until liquid is formed and transfer the liquid into a graduated container. Levigate the powder with small amount of simple syrup until smooth paste is formed. Shake well and label. 3. 2. Pharmacy Compounding Manual 2008. Crush tablets in a mortar to fine powder. 43 .4mg/mL 30 days Refrigerate STRENGTH QUANTITY 2mg 15 tablets qs 75mL PROCEDURE: 1. Make up to final volume with simple syrup. 4.4MG/ML Generic Name Indication Dosage Form Strength Stability Storage INGREDIENTS Lorazepam Simple syrup : : : : : : Lorazepam i) Severe anxiety ii) Insomnia Syrup 0. 35. METHYLCELLULOSE SUSPENDING AGENT 1% (0.01G/ML) Generic Name Dosage Form Strength Stability Storage : : : : : Methylcellulose Suspending Agent 1% (0.01g/mL) 6 months Room temperature INGREDIENTS Methylcellulose Powder Sodium Benzoate Powder Simple syrup STRENGTH QUANTITY CPS 1500 10g - 2g qs 1,000mL PROCEDURE: 1. Dissolve Sodium Benzoate in 200mL of boiling distilled water. 2. Add Methylcellulose powder and stir well for 2-3 minutes (use blender if available). Make sure mixture is sufficiently heated so powders are completely dissolved. 3. Add 800mL ice cold water (carefully but quickly) and stir or blend well for 10 minutes. 4. Transfer to a 1 litre bottle. 5. Place on side and refrigerate overnight (minimum 4 hours) until liquid converts to gel. NOTES: 1. Mixture is initially cloudy, becoming crystal clear with adequate cooling/ refrigeration and time. 2. Discard 30 days after opening. REFERENCES: 1. Canadian Society of Hospital Pharmacy (1988) Extemporaneous Oral Liquid Dosage Form Preparations. Pharmacy Practice.14(2).p.63. 2. Pharmacy Compounding Manual 2011, Alberta Health Services. 44 36. METOPROLOL SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Metoprolol Hypertension, angina, myocardial infarction, arrhythmias Suspension 10mg/mL 60 days Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Metoprolol Vehicle STRENGTH QUANTITY 100mg 12 tablets qs 120mL VEHICLE OF CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Sweet SF® : Ora-Plus® (1:1) or • Ora-Blend ® or • Ora-Blend SF® or • Cherry syrup or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Crush tablets in a mortar to fine powder. 2. Levigate the powder with small amount of vehicle until smooth paste is formed. 3. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. 4. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 5. Make up to final volume with vehicle. 6. Shake well and label. NOTES: 1. Keep in an amber plastic bottle. 2. Ora-Sweet® SF and Ora-Blend SF® should not be used in neonates ≤28 days corrected age. REFERENCES: 1. Nahata MC, Pai VB, Hipple TF. (2011) Pediatric Drug Formulation. 6th Edition. Harvey Whitney Books. 2. Pharmacy Compounding Manual 2011, Alberta Health Services. 3. American Journal of Health-Systems Pharmacy, 1996, 53(19): p 2304-9. 45 37. MIDAZOLAM SYRUP 2MG/ML Generic Name : Midazolam Indication : Pre-operative sedation, induction of general anaesthesia, premedication and sedation in ICU and sedation for minor procedures Dosage Form : Syrup Strength : 2mg/mL Stability : 56 days Storage : Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Midazolam injection Simple Syrup STRENGTH QUANTITY 5mg/mL 48mL qs 120mL PROCEDURE: 1. Break the ampoule and syringe out the content of Midazolam from the ampoule with 5 µm filter into a mortar. 2. Add the sufficient quantity of simple syrup and stir well. 3. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container. 4. Make up to final volume with simple syrup. 5. Shake well and label. NOTES: 1. Undiluted injection can be administered orally. 2. Injection may contain benzyl alcohol. 3. Keep in an amber glass bottle. REFERENCES: 1. Pharmacy Compounding Manual 2011, Alberta Health Services. 2. Nahata MC, Pai VB, Hipple TF. (2011) Pediatric Drug Formulation.6th Edition. Harvey Whitney Books. 46 38. NIFEDIPINE SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Nifedipine Methylcellulose 1% Nifedipine Hypertension Suspension 1mg/mL 28 days Refrigerate (preferable) or at room temperature STRENGTH QUANTITY 10mg 5 tablets qs 50mL PROCEDURE: 1. Crush tablets in a mortar to fine powder. 2. Levigate the powder with small amount of Methylcellulose 1% until smooth paste is formed. 3. Add more Methylcellulose 1% to the paste until liquid is formed and transfer the liquid into a container. 4. Use additional Methylcellulose 1% to rinse the remaining drug from the mortar and pour into the container. 5. Make up to final volume with Methylcellulose 1%. 6. Shake well and label. NOTES: REFERENCES: 1. Nahata MC, Pai VB, Hipple TF. (2011) Pediatric Drug Formulation. 6th Edition. Harvey Whitney Books. 2. Minna HT. (2013) Compounding of paediatric oral formulations: Extemporaneous nifedifine capsules, powders and suspensions in the hospital pharmacy. University of Eastern Finland. 47 J Am Pharm Assoc. 5. Morosco R. Make up to final volume with vehicle. (42):865-867. NOTES: 1. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Crush tablets in a mortar to fine powder. NIFEDIPINE SUSPENSION 4MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Nifedipine Hypertension Suspension 4mg/mL 90 days Refrigerate (preferable) or at room temperature INGREDIENTS Nifedipine Vehicle STRENGTH QUANTITY 10mg 12 tablets qs 30mL VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Blend ® or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Shake well and label. 48 . 2. REFERENCES: 1. Willhite E. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. (2002) Stability of nifedipine in two oral suspensions stored at two temperatures. 4. 2.nationwidechildrens. X-Temp® Oral Suspension System. Levigate the powder with small amount of vehicle until smooth paste is formed. Compounding Formulas.org/outpatient-pharmacy-compounding-formulas. Nahata MC. 3. [Accessed:9th Oct 2015] 3. Keep in an amber bottle. Master Formulation Sheets 2013. Nationwide Children’s. [Online] Available from: http://www. 6.39. 2. 6. Shake well and label. If use X-Temp® Oral Suspension System. Make up to final volume with vehicle. Keep in an amber bottle. REFERENCES: 1. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 2.p. NOTES: 1. Can J Hosp Pharm (59). 2.(2006) Stability of nitrofurantoin in extemporaneously compounded suspensions. Add more vehicle to the paste until a liquid is formed and transfer the liquid into a container. 49 . Levigate the powder with small amount of vehicle until a smooth paste is formed. 4.40. Do not freeze. X-Temp® Oral Suspension System. 3. 5. Master Formulation Sheets 2013. Alberta Health Services. Pharmacy Compounding Manual 2011. Decarie D. the stability of the product is 60 days. 29-33. NITROFURANTOIN SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Nitrofurantoin Vehicle Nitrofurantoin Uncomplicated lower urinary tract infections Suspension 10mg/mL 91 days Refrigerate or at room temperature and protect from light STRENGTH QUANTITY 100mg 10 tablets qs 100mL VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Blend ® or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. 3. Crush tablets in a mortar to a fine powder. Ensom MHH. Nahata MC. Crush tablets to form slurry and stir the mixture well. Place tablets in mortar and soak in sodium bicarbonate for 20 minutes. Chengde F. (2011) Pediatric Drug Formulation. NOTES: 1. et al. 3. Pai VB. Am J Health-Syst Pharm. Pylori infection. Pharmacy Compounding Manual 2011. 3. Keep in an amber glass bottle. Alberta Health Services. (1997) Stability of omeprazole in an extemporaneously prepared oral liquid. Empty contents of capsules in a mortar and cover with sodium bicarbonate and stir the mixture. Rinse mortar with additional sodium bicarbonate and make up to the final volume required. (54): 1833-6. 2. 4. 2. ZollingerEllison Syndrome ii) Endoscopically confirmed peptic ulcer Dosage Form : Suspension Strength : 2mg/mL Stability : 14 days (room temperature) or 30 days (refrigerate) Storage : Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS STRENGTH QUANTITY Omeprazole (capsules or tablets) 20mg 10 capsules Sodium Bicarbonate Injection 8. 3. Add more sodium bicarbonate to form liquid and then transfer to a graduated container. Quercia RA. 2. Tablets 1. Colour changes of the preparation might occur. Add more sodium bicarbonate to form liquid and then transfer to a graduated container. eradication of H. Harvey Whitney Books. benign peptic ulcer not responding to conventional therapy. Xinchun Liu. Rinse the mortar with additional sodium bicarbonate and make up to the final volume required. Hipple TF.41.4% 10 amp x 10mL PROCEDURE: Capsules 1. 2. 6th Edition. 50 . OMEPRAZOLE SUSPENSION 2MG/ML Generic Name : Omeprazole Indication : i) Reflux oesophagitis. REFERENCES: 1. 3. Make up to final volume with distilled water. Levigate the powder with small amount of distilled water until smooth paste is formed. Pylori infection.42. eradication of H. Zollinger-Ellison Syndrome ii) Endoscopically confirmed peptic ulcer : Solution : 2mg/mL : 62 days : Refrigerate INGREDIENTS STRENGTH QUANTITY Pantoprazole sodium 20mg 10 tablets Sodium bicarbonate Powder 8. add sodium bicarbonate powder. Alberta Health Services. Stir until tablets disintegrate. PANTOPRAZOLE 2MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Pantoprazole : i) Reflux oesophagitis. Pharmacy Compounding Manual 2011. Use additional distilled water to rinse the remaining drug from the mortar and pour into the container. While stirring. 5. Crush tablets in a mortar to fine powder. 4. 51 . 2. benign peptic ulcer not responding to conventional therapy. Add more distilled water to the paste until liquid is formed and transfer the liquid into a container. NOTES: REFERENCES: 1.4g qs 100mL Distilled water PROCEDURE: 1. NOTES: 1. 2. 4. Nahata MC. PENTOXIFYLLINE SOLUTION 20MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Pentoxifylline Peripheral vascular disease Solution 20mg/mL 91 days Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Pentoxifylline Tablets Distilled Water STRENGTH QUANTITY 400mg 12 tablets qs 240mL PROCEDURE: 1. 6th Edition. Harvey Whitney Books. Shake well and label. Alberta Health Services. 5. 52 . 3. (2011) Pediatric Drug Formulation. Pai VB. Hipple TF. Abdel-Rahman S. 2. 6. Levigate the powder with small amount of distilled water until smooth paste is formed. (1997) Stability of pentoxifylline in an extemporaneously prepared oral suspension. 3. Am J Health Syst Pharm. REFERENCES: 1. 54(11):1301-3. Keep in an amber glass bottle. Nahata MC. Make up to final volume with distilled water. Add more distilled water to the paste until liquid is formed and transfer the liquid into a container.43. Use additional distilled water to rinse the remaining drug from the mortar and pour into the container. Pharmacy Compounding Manual 2011. Crush tablets in a mortar to fine powder. 2. 64(6):644-646. 5. Keep in an amber plastic bottle. Cober MP. Am J Health Syst Pharm. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. REFERENCES: 1. Johnson CE. 53 . 3. Crush tablets in a mortar to fine powder. PHENOBARBITONE SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Phenobarbitone Epilepsy Suspension 10mg/mL 115 days Room temperature and protect from light INGREDIENTS Phenobarbitone Vehicle STRENGTH QUANTITY 30mg 20 tablets qs 60mL VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. (2007) Stability of an extemporaneously prepared alcohol-free phenobarbital suspension. Make up to final volume with vehicle. NOTES: 1. 3. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Stability of extemporaneously prepared oral liquid formulations – part vi. X-Temp® Oral Suspension System. Secundum Artem (Vol 15)No 1. 4. Levigate the powder with small amount of vehicle until smooth paste is formed. Shake well and label. 6. 2.44. Master Formulation Sheets 2013. Paddock Laboratories. 45. special precaution for children less than 2 years old. Sterile water formulation is preferred in neonates due to absence of dyes and lower osmolarity. This preparation contains benzyl alcohol. 2. REFERENCES: 1. withdraw the required amount of Vitamin K1 and transfer into an amber glass bottle. 54 . 2. Keep in an amber glass bottle. 3. PHYTOMENADIONE (VITAMIN K1) LIQUID 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : Phytomenadione (Vitamin K1) Vitamin K deficiency due to liver failure Liquid 1mg/mL Sterile water (preferred): 104 days Simple Syrup: 111 days : Refrigerate or at room temperature and protect from light INGREDIENTS STRENGTH QUANTITY Phytomenadione Injection 10mg 1mL Sterile Water or Simple Syrup qs 10mL PROCEDURE: 1. Alberta Health Services. Pharmacy Compounding Manual 2011. Add vehicle and mix well. Using a 5µm filter. NOTES: 1. To make up final volume with simple syrup.5mg/mL : 30 days : Room temperature INGREDIENTS STRENGTH QUANTITY Propranolol 40mg 3 tablets Simple Syrup qs 240mL PROCEDURE: 1. PROPRANOLOL SUSPENSION 0. a maximum expiry date of 30 days is recommended for these formulations. [Online] Available from: http://www. tachycardia. Levigate the powder with distilled water until smooth. Use additional simple syrup to rinse the remaining drug from the mortar. Transfer the suspension into the amber bottle.html [Accessed:15th Oct 2015]. 6. hypertrophic obstructive cardiomyopathy (For cardiologist only) : Suspension : 0. Due to the lack of microbial testing and evaluation of stabilty under in use conditions. Add more syrup until a liquid is formed and transfer the contents into a graduate cylinder.co. PharmInfoTech: Database of Oral Liquid Formulations-eMixt. 5.5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Propranolol : Dysrhythmias. 3. NOTES: 1. Add a small amount of simple syrup to form a smooth paste.46.pharminfotech. Shake well and label. 2.nz/manual/Formulation/mixtures/propranolol. REFERENCES: 1. Crush tablets in a mortar to a fine powder. 55 . 4. 4. Add a small amount of simple syrup to form smooth paste. (2007) Compounding Service. Use additional simple syrup to rinse the remaining drug from the mortar. REFERENCES: 1. Citric acid is used only for pH adjustment. tachycardia. Pai VB. Add more syrup until liquid is formed and transfer the contents into a graduated cylinder. Add citric acid to the suspension in the graduate. Hipple TF. Mix well. Levigate the powder with distilled water until smooth. 5. 3.ca/Pharmacy/Compounding-Service/index. Shake well and label.html [Accessed:15th Oct 2015]. Crush tablets in a mortar to fine powder. No need to decrease expiry to citric acid’s expiry. hypertrophic obstructive cardiomyopathy (For cardiologist only) : Suspension : 1mg/mL : 45 days : Refrigerate and protect from light INGREDIENTS Propranolol Distilled Water (wetting agent) Citric Acid Solution Simple Syrup STRENGTH QUANTITY 40mg 6 tablets - 4. NOTE: 1. (2011) Pediatric Drug Formulation. Nahata MC. 6. Pharmacy Compounding Manual 2011. 3. Sick Kids® Pharmacy. Keep in an amber glass bottle. 6th Edition. 2. Alberta Health Services. Harvey Whitney Books.47. 2. sickkids. Transfer the suspension into an amber bottle. Make up to final volume with simple syrup. 7. 2. 56 .[Online] Available from: http://www.8mL 25% 1mL qs 240mL PROCEDURE: 1. PROPRANOLOL SUSPENSION 1MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Propranolol : Dysrhythmias. 2. REFERENCES: 1. PYRAZINAMIDE SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Pyrazinamide Vehicle Pyrazinamide Tuberculosis Suspension 10mg/mL 60 days Refrigerate (preferable) or at room temperature and protect from light STRENGTH QUANTITY 500mg 3 tablets qs 150mL VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Sweet SF®: Ora-Plus® (1:1) or • Ora-Blend SF® or • Cherry syrup or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. 6. 5. 2. 3. pyrazinamide.48. 55(17):1804-1809. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Crush tablets in a mortar to fine powder. Shake well and label. quinidine sulfate. rifampin. Am J Health Syst Pharm. 4. Keep in an amber bottle. and tetracycline hydrochloride in extemporaneously compounded oral liquids. Erickson M A. Ora-Sweet SF® and Ora-Blend SF® should not be used in neonates ≤28 days corrected age. NOTES: 1. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. Levigate the powder with small amount of vehicle until smooth paste is formed. Allen LV Jr. Make up to final volume with vehicle.(1998) Stability of bethanechol chloride. 57 . nationwidechildrens. Morosco RS. Nahata MC. NOTES: 1. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container. Compounding Formulas.org/outpatient-pharmacy-compounding-formulas. Alberta Health Services. (1995) Stability of pyrazinamide in two suspensions. 3. Make up to final volume with simple syrup. Shake well and label. Peritore SP. 4. 5. 52(14): 1558-1560. Am J Health Syst Pharm. Pharmacy Compounding Manual 2011.000mL PROCEDURE: 1. Add more simple syrup to the paste until a liquid is formed and transfer the liquid into the container. 2. PYRAZINAMIDE SYRUP 100MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Pyrazinamide Tuberculosis Syrup 100mg/mL 60 days Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS STRENGTH QUANTITY Pyrazinamide 500mg 200 tablets Simple Syrup qs 1. Crush tablets in a mortar to form a fine paste. Keep in an amber bottle. Levigate the powder with small amount of simple syrup until a smooth paste is formed. [Online] Available from: http://www. [Accessed:9th Oct 2015] 58 . 2. 3. REFERENCES: 1. 6.49. Nationwide Children’s. 6. Alberta Health Services. Levigate the powder with small amount of simple syrup until smooth paste is formed. 2.50. Make up to final volume with simple syrup. Keep in an amber bottle. NOTES: 1. Pharmacy Compounding Manual 2011. Open capsules and empty the contents into a mortar. RIFAMPICIN SYRUP 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Rifampicin Tuberculosis Syrup 10mg/mL 28 days Refrigerate and protect from light INGREDIENTS Rifampicin Simple Syrup STRENGTH QUANTITY 300mg 4 capsules qs 120mL PROCEDURE: 1. Add more simple syrup to the paste until liquid is formed and transfer the liquid into a container. REFERENCES: 1. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container. Shake well and label. 3. 5. 59 . 4. Pharmacy Compounding Manual 2011. 5. 3. Open capsules and empty the contents into a mortar. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. 60 . RIFAMPICIN SUSPENSION 25MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : INGREDIENTS Rifampicin Vehicle Rifampicin Tuberculosis Suspension 25mg/mL 28 days Room temperature and protect from light STRENGTH QUANTITY 300mg 10 capsules qs 120mL VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. 6. 4. 2. Alberta Health Services. Make up to final volume with vehicle.51. NOTES: REFERENCES: 1. Add more vehicle to the paste until a liquid is formed and transfer the liquid into the container. Levigate the powder with small amount of vehicle until a smooth paste is formed. Shake well and label. 4. (2006) extemporaneous sildenafil citrate oral suspensions for the treatment of pulmonary hypertension in children. Levigate the powder with small amount of vehicle until a smooth paste is formed.. 6. 61 . Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Pharmacy Compounding Manual 2011.5mg/mL 91 days Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Sildenafil Vehicle STRENGTH QUANTITY 20mg 5 tablets qs 40mL VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Methylcellulose 1%: Simple Syrup (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. REFERENCES: 1. Alberta Health Services. 2. Crush tablets in a mortar to form a fine paste. 3. 63(3): 254-257. Shake well and label. 5. Am J Health Syst Pharm. Morosco RS. NOTES: 1. SILDENAFIL SUSPENSION 2. Keep in an amber bottle. Make up to final volume with vehicle. Brady MT. Nahata MC.52.5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : : : : : : Sildenafil Pulmonary hypertension Suspension 2. 2. Add more vehicle to the paste until a liquid is formed and transfer the liquid into the container. Crush tablets in a mortar to form fine paste. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container.53. 5. congestive heart failure : Syrup : 1.25MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Spironolactone : Oedema and ascites in cirrhosis of the liver.25mg/mL : 60 days : Room temperature and protect from light INGREDIENTS Spironolactone Vehicle STRENGTH QUANTITY 25mg 5 tablets qs 100mL VEHICLE CHOICE: • X-Temp® Oral Suspension System. 4. Make up to final volume with vehicle. 3. PROCEDURE: 1. Levigate the powder with sterile water for injection until smooth paste is formed. Add simple syrup to the paste until liquid is formed and transfer the liquid into a container. SPIRONOLACTONE SYRUP 1. Master Formulation Sheets 2013. X-Temp® Oral Suspension System. Keep in an amber bottle. 2. NOTES: 1. 62 . 6. Shake well and label. REFERENCES: 1. SPIRONOLACTONE SYRUP 2. REFERENCES: 1. Duarte MA et al. 5. Levigate the powder with sterile water for injection until smooth paste is formed. Crush tablets in a mortar to form fine paste. Add simple syrup to the paste until liquid is formed and transfer the liquid into a container. (2005) Stability of Spironolactone in an extemporaneously prepared aqueous suspension: the importance of microbiological quality of compounded paediatric formulations. : Syrup : 2. 3. Make up to final volume with simple syrup. 6. Salgado AC. Keep in an amber bottle. Shake well and label.5mg/mL : 60 days : Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Spironolactone Sterile water for injection Simple Syrup STRENGTH QUANTITY 25mg 4 tablets - 5mL qs 40mL PROCEDURE: 1. Rosa ML. 2. Use additional simple syrup to rinse the remaining drug from the mortar and pour into the container.5MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Spironolactone : Oedema and ascites in cirrhosis of the liver.54. Eur J Hosp Pharm Science. congestive heart failure. 11(3):68-73. NOTES: 1. 4. 63 . REFERENCES: 1.pharminfotech.co. 2. 5. Keep in an amber plastic bottle. [Accessed: 15th Oct 2015]. Prepare 100mL of a mixture of equal parts methylcellulose 1% and syrup.55. Crush the trimethoprim tablets and then slowly add the base whilst mixing. NOTES: 1. Make up to final volume with vehicle. Shake well and label. TRIMETHOPRIM SUSPENSION 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Trimethoprim : Treatment of urinary tract infections due to susceptible pathogens : Suspension : 10mg/mL : 6 weeks at 25°C. 2. 4. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container.nz/manual/Formulation/mixtures/trimethoprim. PharmInfoTech: Database of Oral Liquid Formulations-eMixt. Nahata MC. 3 months at 4°C : Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS Trimethoprim Methylcellulose 1%: Simple Syrup (1:1) STRENGTH QUANTITY 100mg 10 tablets qs 100mL PROCEDURE: 1. 2(2):82-4. 3. 64 . J Ped Pharm Pract. [Online] Available from: http://www.(1997)Stability of trimethoprim in an extemporaneous liquid dosage form. 6. 2. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container.html. A suspending base of methylcellulose 1-2% without syrup can be used if preferred. [Online] Available from: http://www. sickkids. Add more vehicle to the paste until liquid is formed and transfer the liquid into a graduated container.56. 4.ca/Pharmacy/Compounding-Service/index. 3.html [Accessed: 15th Oct 2015]. Levigate with small amount of vehicle until smooth paste is formed. 5. TRIMETHOPRIM SYRUP 10MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Trimethoprim : Treatment of urinary tract infections due to susceptible pathogens : Syrup : 10mg/mL : 30 days : Room temperature and protect from light INGREDIENTS STRENGTH QUANTITY Trimethoprim 100mg 10 tablets Simple Syrup qs 100mL PROCEDURE: 1. 2. Soak the tablets in mortar with some simple syrup for about 10 minutes. Alberta Health Services. Make up to final volume with vehicle. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. REFERENCES: 1. Keep in an amber bottle. 6. 65 . Pharmacy Compounding Manual 2011. (2007) Compounding Service. Sick Kids® Pharmacy. NOTES: 1. 2. Shake well and label. Sick Kids® Pharmacy. NOTES: 1. Shake well and label.pdf [Accessed: 15th Oct 2015].[Online] Available from: http://www. PharmInfoTech: Database of Oral Liquid Formulations-eMixt. 6. primary biliary cirrhosis. pre-mix the Ora-Plus and Ora-Sweet. Add vehicle to the paste until liquid is formed and transfer the liquid into a container. If Ora-Blend or X-Temp® is unavailable.57.html [Accessed:15th Oct 2015]. 5. REFERENCES: 1.ca/Pharmacy/Compounding-Service/index.pharminfotech.co. Levigate the powder until smooth paste is formed. to form the diluent. 2. Make up to final volume with vehicle. Open capsules and empty the contents into a mortar and add the diluent. 3. 7. 66 . (2007) Compounding Service. primary cholangitis etc) : Suspension : 50mg/mL : 30 days : Refrigerate or at room temperature INGREDIENTS Ursodeoxycholic Acid Vehicle STRENGTH QUANTITY 300mg 20 capsules qs 120mL VEHICLE OF CHOICE: • Ora-Blend® or Ora-Blend SF® or • Ora-Plus® : Ora-Sweet® (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) • X-Temp® Oral Suspension System (stability is for 90 days) PROCEDURE: 1. 3. 4. URSODEOXYCHOLIC ACID SUSPENSION 50MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Ursodeoxycholic Acid : Cholestatic liver diseases (eg. Master Formulation Sheets 2013. sickkids. X-Temp® Oral Suspension System. [Online] Available from: http:// www. 2.nz/manual/Formulation/bsheets/ursodeoxycholicNZS_1. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Ora-Blend SF® should not be used in neonates ≤28 days corrected age. 5. Shake well and label. Crush tablets in a mortar to a fine powder. 2. Ora-Sweet SF® should not be used in neonates ≤28 days corrected age. 67 . Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. NOTES: 1. Calgary Health Region Pharmacy. 3.58. 4. Make up to final volume with vehicle. VERAPAMIL SUSPENSION 50MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Verapamil : i) Supraventricular tachyarrhythmia (SVT) prophylaxis ii) Angina : Suspension : 50mg/mL : 60 days : Refrigerate (preferable) or at room temperature and protect from light INGREDIENTS STRENGTH QUANTITY Verapamil hydrochloride 40mg 150 tablets qs 120mL Vehicle VEHICLE CHOICE: • Ora-Sweet® : Ora-Plus® (1:1) or • Ora-Sweet SF® : Ora-Plus® (1:1) or • Equivalent vehicle to Ora-Sweet® : Ora-Plus® (1:1) PROCEDURE: 1. Levigate the powder with small amount of vehicle until smooth paste is formed. Pharmacy Compounding Manual 2008. 2. Keep in an amber bottle. Add more vehicle to the paste until liquid is formed and transfer the liquid into a container. 6. REFERENCES: 1. Make up to final volume with vehicle. VERAPAMIL SUSPENSION 8MG/ML Generic Name Indication Dosage Form Strength Stability Storage : Verapamil : i) Supraventricular tachyarrhythmia (SVT) prophylaxis ii) angina : Suspension : 8mg/mL : 30 days : Room temperature INGREDIENTS STRENGTH QUANTITY Verapamil hydrochloride 40mg 10 tablets Distilled water - 1mL Simple syrup qs 50mL PROCEDURE: 1. Flavouring may be added. Shake well and label. 68 . 2. Use additional vehicle to rinse the remaining drug from the mortar and pour into the container. Calgary Health Region Pharmacy. 3. 5.59. 6. REFERENCES: 1. Levigate the powder with vehicle until smooth paste is formed. Pharmacy Compounding Manual 2008. NOTES: 1. Soak tablets in a small amount of distilled water and then crush tablets in a mortar to fine powder. Add more vehicle to the paste until liquid is formed and transfer the liquid into a graduated container. 4. millilitre .up to 69 .ABBREVIATIONS: mg mL qs .milligram . NOTES: 70 .