compounding HOTLINE

JANUARY 01, 2008
Martin A. Erickson III, RPh

Mr. Erickson is director of professional affairs at Gallipot Inc.

Loxapine suspension is not available. How can I compound the suspension for a patient?

Loxapine is an anxiolytic. Loxapine 1 mg is provided by Loxapine succinate 1.36 mg or loxapine HCl 1.12 mg. The latter is no longer available in the United States. The starting adult dose is 10 mg twice daily in psychoses and may be increased in the first 7 to 10 days of therapy; usual maintenance doses are 60 to 100 mg daily, divided into 2 to 4 doses. Absorption, distribution, and effects are nearly identical regardless of route, and first-order degradation of loxapine succinate should approximate that of loxapine HCl; therefore, it is reasonable to suggest compounding loxapine succinate suspension for oral administration.

Loxapine Succinate Oral Suspension/Solution

Loxapine succinate

capsules qs

SyrSpend SF

qs ad 100%

  1. Calculate the number of capsules required to provide loxapine equivalent for the preparation. Note: Capsules contain excipients; consider the equivalences above. [Source: American Hospital Formulary Service Drug Information 2007].
  2. Accurately weigh/measure ingredien ts—empty capsules into a weigh boat.
  3. Reduce powder to fine, uniform consistency with ceramic or Wedgwood mortar and pestle (not glass).
  4. Add a small amount of SyrSpend SF to (3) and triturate to a smooth paste.
  5. Continue adding aliquots of SyrSpend SF to the paste (4), triturating until approximately half of the total for the preparation is incorporated.
  6. Transfer the smooth, homogeneous suspension (5) to a graduated cylinder, using small amounts of SyrSpend SF to ?wash? the mortar and pestle contents into the graduate.
  7. Add sufficient SyrSpend SF to the graduated cylinder in (6) to reach total final volume.
  8. Transfer to light-resistant dispensing bottle. Label: Shake well and Refrigerate.

Beyond-Use Date: 14 days, per USP <795>

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