Emergency Extemporaneous Preparation of Oral Suspension from Tamiflu Capsules
This article responds to your request for information on the emergency extemporaneous preparation of oral suspension from Tamiflu® (oseltamivir) capsules.
Last updated August 11, 2023
Tamiflu formulation recommendation
Tamiflu powder for oral suspension (6 mg/mL) is indicated for use in
- pediatric patients
- adult patients who have difficulty swallowing capsules, or
- patients in need of lower doses.
Compounding oral suspension
Oral suspension may be compounded from Tamiflu capsules in emergency situations if directed by the healthcare provider. The instructions below provide guidance on how to prepare a 6 mg/mL oral suspension for a 5-day course based on
- the patient weight
- various Tamflu capsule strengths, and
- the amount of water containing 0.05% w/v sodium benzoate.[1]
Purpose of sodium benzoate
Sodium benzoate acts as a preservative for the oral suspension.
Instructions for preparing the oral suspension:
1. Transfer the contents of the appropriate number of Tamiflu capsules into the bottle (Table 1).
2. Add the appropriate volume of water with sodium benzoate solution (Table 1).
3. Close the bottle with the cap and shake for 2 minutes.
4. Pull an ancillary label on the bottle indicating "Shake gently before use".
5. Place an appropriate expiration date label according to the storage conditions.
6. Instruct the parent or caregiver to discard any remaining solutino after the patient has completed the full course of therapy.
Table 1. Number of capsules and amount of vehicle needed to prepare the total volume of 6 mg/mL suspension
*We have no data on mixing capsule at this strength to obtain the target concentration since whole numbers of capsules cannot be used to achieve the target concentration. Please use an alternate capsule strength.
Storage of compounded oral suspension
Room temperature storage conditions
The compounded oral suspension is stable for 3 weeks, or 21 days, when stored at room temperature.[1] Do not store above 25ºC.
Refrigerated storage conditions
The compounded oral suspension is stable for 6 weeks when stored at 2ºC to 8ºC.[1]
Other external stability studies
Other external studies have evaluated the preparation and stability of Tamiflu in various extemporaneous liquid preparations.[2,3]
References
1. Roche Internal Regulatory Document. (Accessed on 11Jul2023).
2. Ford SPBB, Kloesel LRBF, Grabenstein JRP. Stability of oseltamivir in various extemporaneous liquid preparations. Int J Pharm Compd 11:162-74. https://www.ncbi.nlm.nih.gov/pubmed/23974623
3. Winiarski A, Infeld M, Tscherne R, et al. Preparation and stability of extemporaneous oral liquid formulations of oseltamivir using commercially available capsules. J Am Pharm Assoc (2007) 47:747-55. https://www.ncbi.nlm.nih.gov/pubmed/18032138
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