Availability of oral liquid formulations: Dilemmas in managing children with nephrotic syndrome

Abstract

Conditions such as nephrotic syndrome (NS), which require administration of drugs for a protracted period, present a difficult situation for pediatricians to treat due to lack of appropriate formulations. In the present study, we explored the issue of availability of pediatric oral formulations and suggested solutions with NS as an example. We searched PubMed, Embase and Ovid, Google, Google Scholar, Current Index of Medical Specialties-Monthly Index of Medical Specialties, and standard textbooks for data acquisition. We found that many drugs used in NS are either not available in suitable pediatric formulation or are not specifically approved for use in pediatric population. Most of these drugs have high pharmacokinetic variability, which further necessitates the availability of proper formulation. Standardized compounding vehicles are also not available in our country. Manipulation of existing adult dosage forms for administering to pediatric patients is often arbitrary and may be associated with either underdosing or overdosing. There is an urgent need for development and standardization of compounding vehicles so that required dose delivery can be ensured in children with NS.

Keywords

• extemporaneous preparations
• nephrotic syndrome
• oral liquid formulations
• pediatric