compounding HOTLINE

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

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

Loxapine is an anxiolytic. Loxapine 1 mg is providedby Loxapine succinate 1.36 mg or loxapine HCl1.12 mg. The latter is no longer available in the UnitedStates. The starting adult dose is 10 mg twice daily in psychosesand may be increased in the first 7 to 10 days of therapy;usual maintenance doses are 60 to 100 mg daily, dividedinto 2 to 4 doses. Absorption, distribution, and effects arenearly identical regardless of route, and first-order degradationof loxapine succinate should approximate that of loxapineHCl; therefore, it is reasonable to suggest compounding loxapinesuccinate suspension for oral administration.

Loxapine Succinate Oral Suspension/Solution

Loxapine succinate

capsules qs

SyrSpend SF

qs ad 100%

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

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

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