Updating formulations for compounded oral liquid medications in a university health system.

Abstract

The development of a compounded oral liquid medication formulary and subsequent implementation of revised standard formulations in a university health system are described. A standard assessment form was developed to direct evaluation of published literature and current compounding resources for all oral liquid formulations prepared by health-system pharmacies. Specific variables reviewed included concentration, components, beyond-use dating, and storage recommendations. After their review and approval, revised formulations were typed into distinct templates that incorporated additional safety features. An online departmental repository was developed to house the revised formulations. Modifications were made to 136 (78%) of the 175 compounded formulations reviewed. Changes in storage conditions and extension of beyond-use dating were the most common revisions in 77 (44%) and 42 (24%) of compounds, respectively. In addition, strawberry syrup was removed as a component of 38 (22%) formulations, reducing exposure of pediatric patients to red dye. Presentations were given at several forums to inform pharmacy staff of the goals of the project and details regarding implementation. In addition, e-mail communications were sent to share the online location of the updated formulations and compounding sheets. Nursing, medical, and pharmacy staff were notified of concentration changes through the pharmacy newsletter and e-mail. A comprehensive review resulted in updates to over 75% of oral liquid medications prepared by pharmacies in a university health system. Revised formulations were made available through an online repository, ensuring consistency of compounding procedures with respect to concentrations, components, and storage requirements.