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U.S. Department of Health and Human Services

Drugs

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Emergency Compounding of an Oral Suspension from Tamiflu 75 mg Capsules (Final Concentration 15 mg/mL)

Commercially manufactured Tamiflu for Oral Suspension (12 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, pharmacists may compound a suspension (15 mg/mL) from Tamiflu (oseltamivir phosphate) Capsules 75 mg using Cherry Syrup (Humco) or Ora-Sweet Sugar-Free (SF; Paddock Laboratories). 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 available.

The approved compounding procedure is included in the professional prescribing information and results in a 15 mg/mL suspension. Healthcare providers should note that the compounded suspension is a different concentration compared to commercially available Tamiflu for Oral Suspension, which has a concentration of 12 mg/mL. Pharmacists and health care providers should ensure that an appropriate dispensing device (i.e., one that measures volume in mL) is provided with the compounded suspension of Tamiflu.

The following tables provide the volume of compounded suspension (15 mg/mL) made from Tamiflu Capsules needed for a full treatment course based on the patient’s weight, and the dosing chart for pharmacy-compounded Tamiflu suspension.

Total Volume of Suspension Needed for Correct Dosing

Body Weight (kg)Body Weight (lbs)Total Volume to Compound per patient (mL)
< 15 kg

< 33 lbs

30 mL

16 to 23 kg

34 to 51 lbs

40 mL

24 to 40 kg

52 to 88 lbs

50 mL

> 41 kg

& > 89 lbs

60 mL

Dosing Chart for Pharmacy-compounded Tamilfu

Body Weight (kg)Body Weight (lbs)Dose (mg)Volume per Dose
(15 mg/mL)
Treatment Dose Required (for 5 days)Prophylaxis Dose Required
(for 10 days)

< 15 kg

< 33 lbs

30 mg

2 mL

2 mL twice daily

2 mL once daily

16 to 23 kg

34 to 51 lbs

45 mg

3 mL

3 mL twice daily

3 mL once daily

24 to 40 kg

52 to 88 lbs

60 mg

4 mL

4 mL twice daily

4 mL once daily

> 41 kg

> 89 lbs

75 mg

5 mL

5 mL twice daily

5 mL once daily

Healthcare professionals and consumers can access complete compounding directions and other information on emergency compounding of an oral suspension from Tamiflu Capsules in the Tamiflu package insert at: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=11065