FDA Issues Guidelines for Compounding Liquid Tamiflu

As flu season continues into 2010, vaccine availability remains an issue of concern for patients and pharmacists. For pediatric patients, a pharmacy-compounded oral suspension may help reduce the impact of predicted shortages.

In response to a shortage of Tamiflu for Oral Suspension, the FDA has published guidelines for preparing the suspension using Tamiflu capsules (75 mg) and either Cherry Syrup or Ora-Sweet SF. Released last November, the guidelines offer a solution for pharmacies experiencing a demand that far exceeds available supply of the commercially manufactured product.

Pharmacies may use the approved procedure to compound the suspension prior to receiving prescriptions, using as many as 100 capsules at a time. The process yields enough medicine for 5 days of treatment and 10 days of preventive treatment and can be stored for up to 5 weeks if properly refrigerated.

In the event that compounding cannot be completed in advance by pharmacies, the Centers for Disease Control and Prevention advises that patients with difficulty swallowing pills be prescribed Tamiflu capsules, which can, if necessary, be opened and mixed with sweetened liquids to enable treatment.

The CDC’s predictions for the coming months indicate that this information may be of increasing interest to pharmacists as the shortage persists and stockpiled supply remains somewhat limited. For detailed instructions on how to execute the procedure, visit the FDA Web site.

Pharmacists seeking further information about the 2009-2010 flu season may also consult the CDC, which has published a specific Web page dedicated to pharmacy-related concerns.