Prescription analysis for extemporaneous preparations in hospital pharmacies of Southern Nigeria

Abstract

Today community and hospital pharmacies worldwide (including Nigeria) experience an increased demand for extemporaneous preparations. Due to “per body weight” dosing system, difficulty in swallowing, frailty in organs of metabolism and unavailability of required dosage forms, the reconstitution/tailoring of medications to individual patients needs has become necessary. In Nigeria most (>95 %) of the extemporaneously prepared medications are oral dosage forms. It is a common practice for these medications to be prepared from a commercially available oral solid dosage form by crushing tablets or mixing contents with a dispersion medium (base/vehicle). The aim of the work was to analyse frequently compounded prescriptions in south-south geopolitical region of Nigeria, bases/vehicles used in compounding and stability study concerns of compounded preparations. For this purpose a survey of prescriptions in hospital pharmacies in the south-south geopolitical region of Nigeria was conducted. The prescriptions that required extemporaneous preparation were selected and sorted into active pharmaceutical ingredients (APIs), doses, regime and duration of treatment. Most prescribed preparations that required compounding include antibiotics (24.9 %) and drugs indicated for cardiovascular diseases (60.0 %). While the treatment duration prescribed for extemporaneous preparations ranged from two days to a month, the most recurring duration was one week. Syrups of ascorbic acid and Vitamin B Complex were occasionally used as bases for compounding, but stability study of extemporaneous preparations made from these medicated syrups is yet to be conducted in Nigeria. APIs as part of commercial drugs were mostly (92.9%) used in compounding. Stability study of extemporaneous preparations in Nigeria is an urgent problem that needs to be resolved.