Pharmacies Turn to Compounding to Handle Shortage of Liquid Tamiflu for Kids

Relying on "Old-School" Mortar and Pestle Pharmaceutical Preparation

TORONTO, Nov. 4 /CNW/ - Some pharmacies across Ontario are turning to the art of compounding, to deal with the increasing number of children prescribed Tamiflu, an anti-viral medicine approved to treat H1N1 influenza. There is currently a shortage of Tamiflu in one pediatric dosage form, a liquid or "oral suspension" that makes the medication easier for small children to take. In response, pharmacists are manually mixing precise measures of the adult-dose medicine with suspension ingredients and sweeteners, to ensure that kids with the flu receive their treatment.

"This is one of the basic skills we all learn in pharmacy school and still use regularly," said Donnie Edwards, former Chair of the Ontario Pharmacists' Association, and a community pharmacist in Port Colborne, Ontario. "It's old-school pharmacy, using the mortar and pestle to make up the patient's medicine. It's much more time-consuming than filling an ordinary prescription, but it's what we need to help fight the flu."

Edwards' pharmacy, which has a special certification in compounding, is fielding a large number of requests for the pediatric compound, and is seeing rising demand for the dosage form. "We're preparing up to a dozen Tamiflu compounds a day," said Edwards. "A few nights ago after we had closed the pharmacy, I got a call from the emergency room at Port Colborne General Hospital. They had young patients needing Tamiflu, so I went back, re-opened the store, and we filled those prescriptions until 10:30 that night. Waiting until the next business day isn't an option, because treatment with Tamiflu has to begin within 48 hours of the onset of symptoms."

Pharmacist Billy Cheung, Region Director for Pharmasave Ontario, had so many reports of Tamiflu compounding from his pharmacists that he conducted a fast online survey. "We found that the number of overall Tamiflu prescriptions is rising quickly, and about a quarter of them are for the pediatric dose form. It's meticulous work, and can take up to 20 minutes to prepare each patient's course of therapy, but we're ready for it," Cheung said.

The compounding process involves opening the adult Tamiflu capsules, grinding the medicine into a fine powder, calculating and measuring the proper dose (by weight) for each child, then adding a suspension vehicle and a sweetening agent to transform it into a liquid medicine that tastes palatable to kids.

There has been a shortage of appropriate suspension vehicles, making it difficult for all pharmacies to do the compounding, but this shortage is expected to be resolved shortly.

About Ontario's Community Pharmacies

Ontario's Community Pharmacies are dedicated to providing trusted one-on-one personal health care to our patients. Community pharmacies play an important and growing role as vital health care infrastructure province-wide - promoting public health objectives and ensuring reliable emergency preparedness in the case of an acute need, such as an infectious disease pandemic.


For further information: For further information: or to arrange an interview, please contact: Billy Cheung, Pharmasave Ontario, Tel: (416) 419-8218,; Deborah McNorgan, Ontario Pharmacists' Association, Tel: (416) 441-0788 ext. 4266, Cell: (416) 523-3446,

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