Directions for the Emergency Compounding of an Oral Suspension from Tamiflu 75-mg Capsules (Final Concentration 6 mg/mL)
The following directions are provided for use only during emergency situations. These directions are not intended to be used if the FDA-approved, commercially manufactured Tamiflu for Oral Suspension is readily available from wholesalers or the manufacturer. Find the same instructions in the Prescribing Information.
Compounding an oral suspension with this procedure will provide 1 patient with enough medication for a 5-day course of treatment or a 10-day course of prophylaxis.
Commercially manufactured Tamiflu for oral suspension (6 mg/mL) is the preferred product for pediatric and adult patients who have difficulty swallowing capsules or where lower doses are needed. In the event that Tamiflu for oral suspension is not available, the pharmacist may compound a suspension (6 mg/mL) from Tamiflu capsules 75 mg using one of these vehicles: Cherry Syrup (Humco®), Ora-Sweet® SF (sugar-free) (Paddock Laboratories), or simple syrup. Other vehicles have not been studied.
This compounded suspension should not be used for convenience or when the FDA-approved Tamiflu for oral suspension is commercially available.
First, determine the dose of Tamiflu for the patients, then determine total volume of an oral suspension needed to be compounded based on the table below.
Volume of an Oral Suspension (6 mg/mL)
Needed to be
Compounded Based Upon the Patient's Tamiflu Dose
Second, determine the number of capsules and the amount of water and vehicle (Cherry Syrup, Ora-Sweet SF, or simple syrup) that are needed to prepare the total volume of compounded oral suspension (6 mg/mL) by using the table below.
Number of Tamiflu 75 mg Capsules and Amount of Vehicle
(Cherry Syrup, Ora Sweet® SF, or Simple Syrup) Needed to Prepare the Total Volume of a Compounded Oral Suspension (6 mg/mL)
Third, follow the procedure below for compounding the oral suspension (6 mg/mL) from 75-mg Tamiflu capsules:
Storage of the emergency compounded suspension
- Refrigeration: stable for 5 weeks (35 days) when stored in a refrigerator at 2° to 8°C (36° to 46°F).
- Room temperature: stable for 5 days when stored at room temperature, 25°C (77°F).
Note: The storage conditions are based on stability studies of compounded oral suspensions, using the aforementioned vehicles, which were placed in glass and polyethylene terephthalate (PET) bottles. Stability studies have not been conducted with other vehicles or bottle types.
Please see the Tamiflu full Prescribing Information for complete safety information.