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Compounded Apixaban Suspensions for Enteral Feeding Tubes.

Maria L Caraballo1, Seda Donmez1, Kobi Nathan1

  • 1St. John Fisher College, Rochester, NY, USA.

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Summary

A new apixaban suspension formulation using Ora-Plus and water was developed for enteral feeding tubes. This stable, easy-to-prepare compounded medication maintains over 98% drug recovery and is suitable for 7-day use.

Keywords:
NG tubesanticoagulantcompatibilitycompoundingstability

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Area of Science:

  • Pharmaceutical Compounding
  • Drug Delivery Systems

Background:

  • Limited data exists on compounded apixaban formulations for enteral feeding tubes.
  • Ensuring medication accuracy and compatibility is crucial for patient safety.

Purpose of the Study:

  • To identify a stable apixaban suspension for enteral feeding tubes.
  • To establish preparation ease, dosage accuracy, and tube compatibility.
  • To determine a 7-day beyond-use date for the formulation.

Main Methods:

  • Apixaban suspensions were prepared from commercial tablets using various vehicles and compounding methods.
  • Compatibility was tested with polyurethane and polyvinyl chloride feeding tubes.
  • A 7-day stability study was conducted at room temperature.

Main Results:

  • Ora-Plus/water mixtures (40-60%) showed satisfactory flowability.
  • Mortar/pestle method yielded more accurate suspensions than other methods.
  • The 0.25 mg/mL apixaban in 50:50 Ora-Plus:water formulation was compatible with tubes (>98% recovery) and stable for 7 days.

Conclusions:

  • A suitable apixaban suspension formulation (0.25 mg/mL in 50:50 Ora-Plus:water) was identified for enteral feeding tube administration.
  • The formulation demonstrated stability and compatibility, supporting a 7-day beyond-use date at room temperature.