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Case study: Miquel has high blood pressure
Miquel's case
The challenge
The Case
Miguel (age three) has a genuine sweet tooth and healthy appetite. He happily eats any treat his mother gives him, but she is a little concerned. Last time they visited their family doctor, Miguel’s blood pressure was up in the 95th percentile for boys of his age. Today, the doctor checks his blood pressure again and diagnoses hypertension. He also tests for diabetes and wants to start Miguel on a dose of atenolol at 0.5 mg/kg/day, once-daily, to treat his hypertension [1].

[1] The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health and National Heart, Lung, and Blood Institute; 2005. NIH Publication No. 05-5267.
The challenge
The solution
The Challenge
Miguel weighs 17 kg, so his doctor wants to prescribe him 8.5 mg atenolol per day. As this dosage is commercially unavailable, he calls the pharmacist to discuss compounding an oral suspension. Although he is concerned about giving young Miguel a suspension with preservatives and a high sugar content, he is not sure whether Miguel will accept his medication without taste masking.
The solution
The Cure
The Solution
The pharmacist has the perfect solution for Miguel’s situation. He suggests compounding a 1 mg/ml atenolol suspension with the Atenolol & SyrSpend® SF PH4 kit. SyrSpend® SF PH4 is sugar and preservative-free and has excellent taste-masking properties as well as a sweet, neutral taste. Beginning with a 1 mg/ml suspension, the dose can be adjusted over time as Miguel develops.
The cure
Cases overview
The Cure
Six months later, Miguel’s blood pressure has improved and his doctor wants to try to start lowering the dose of atenolol. The pre-diabetes signs that were initially present have diminished and almost gone. His mother has also cut back on the treats, and Miguel has become a lively young fellow. The doctor hopes to eventually have Miguel come off the medication completely.
Case study: Josh has problems swallowing
Josh's case
The challenge
The Case
Josh (51 years old) is recovering from a Laryngeal cancer treatment. He’s doing well but he’s having problems swallowing solid food and medication. His wife is currently suffering a bad flue. Since Josh’s immune system is considered to be acquired after his cancer treatment his oncologist wants to prescribe Josh an oseltamivir treatment to prevent him from developing influenza as well.
The challenge
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The Challenge
Patient accessibility: Because Josh is having problems swallowing he needs a liquid dosage form, which is not available as a licensed product in the right dosage strength for Josh.
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The Challenge
Patient acceptance: Josh is experiencing retching when feeling an unpleasant bitter taste in his mouth. Oseltamivir has a bitter taste.
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The Challenge
Unpleasant side effects: Josh is suffering diarrhea and other gastrointestinal discomfort due to his cancer medication. Stomach distress and diarrhoea are seen with sorbitol containing suspending vehicles.
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The Challenge
Proven stability: The stability of oseltamivir in a fluid form needs special attention.
The solution
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The Solution
With the focus on patient, prescriber and pharmacist, Fagron offers unique solutions that add significant value in the individualized treatment of patients with specific needs. Also for Josh.

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The Solution
Patient accessibility: With SyrSpend® SF PH4 it is possible for a pharmacist to easily compound a 15 mg/ml oseltamivir suspension for Josh, based on oseltamivir capsules. SyrSpend® SF PH4 can be used with a broad variety of active pharmaceutical ingredients (APIs) so the pharmacist can keep SyrSpend® SF PH4 on stock for similar cases similar cases.
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The Solution
Patient acceptance: SyrSpend® SF PH4 is available in cherry flavour and unflavored, both with taste-masking capacities to cover the bitter taste of oseltamivir. Flavoring concentrates from the SyrSpend® SF Flavoring Kit may be added to the neutral versions to customize to Josh’s individual preference.
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The Solution
Unpleasant side effects: Low osmolality of SyrSpend® SF PH4 minimizes the risk of stomach distress and diarrhoea seen with traditional sorbitol containing suspending vehicles. The suspension prepared with SyrSpend® SF PH4 is free from alcohol, parabens, sorbitol, sugars, gluten and colorants. SyrSpend® SF PH4 is also available as a preservative-free powder for reconstitution.
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The Solution
Proven stability: Stability tests have proven a 30 days stability of a suspension of SyrSpend® SF PH4 with oseltamivir*.
The cure
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The Cure
A simple process of mixing the oseltamivir capsule contents with SyrSpend® SF PH4 enables the pharmacist to prepare a stable suspension in just minutes for Josh.
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The Cure
Josh is doing really well. He did not get caught by the influenza virus, his energy level is improving and he’s eating more and more solid food again. Last week he and his wife booked a holiday out of their dreams to Hawaii and he’s looking forward to it. Josh is enjoying life. * Voudrie MA, Allen DB. Stability of oseltamivir phosphate in SyrSpend® SF, cherry syrup, and SyrSpend® SF (for reconstitution). Int J Pharm Compd. 2010;14(1):82-85.
Case study: Laura has been struggling with the symptoms of mild psoriasis
Laura's case
The challenge
The case
Laura has been struggling with the symptoms of mild psoriasis for the past few years. She recently had an interview for a position as a flight attendant - her dream job. She visits her dermatologist to inquire about treating her symptoms with a more comfortable preparation than the one she already uses.
The challenge
The solution
The challenge
Psoriasis is often treated with traditional ointments, which can be very greasy and highly uncomfortable. Especially considering the fact that Laura will have to wear a uniform for stretches of time.
The solution
The Cure
The solution
Laura’s dermatologist has positive experiences with combinations of topical corticosteroids and emollients. Considering the dryness of the affected skin, he suggests an innovative ointment-based preparation. To guarantee Laura maximum comfort and results during therapy, he proposes Occluvan™, a Fagron Advanced Derma vehicle.
The cure
Cases overview
The cure
The dermatologist asks Laura’s pharmacist to compound clobetasol proprionate 0.05% and dexpanthenol 3% in Occluvan™, an innovative ointment base with minimal tackiness. Laura is very satisfied with the preparation’s elegance and comfortable skin feel. She now has her symptoms under control and recently received the news that she has been hired as a flight attendant.
Case study: Isabella has alopecia areata
Isabella's case
The challenge
The case
Isabella, a 35 year old female volleyball player, suffers from alopecia areata; an autoimmune disease that targets the hair follicle which causes hair loss. As a result she recently started loosing her eyelashes and eyebrows. The eyelashes and eyebrows have a protective as well as an aesthetic function. Additionally, they also establish personal identity. During her competitive volleyball matches the sweat drips into her eyes which has a stinging effect. Moreover, Isabella suffers from social embarrassment due to the hair loss and consults her physician.
The challenge
The solution
The challenge
Her physician likes to prescribe Isabella latanoprost to regrow the eyelashes and eyebrows and to help regain her self-esteem [1]. In order to do so, a skin-friendly and compatible vehicle is needed with a viscosity that allows easy application, but prevents the preparation from running into the eyes. Moreover, application on this delicate specific skin area can be challenging and needs to be done with the right tools.
[1] Coronel-Perez, IM. Latanoprost in the treatment of eyelash alopecia in alopecia areata universalis. J Eur Acad Dermatol Venereol. 2010 Apr;24(4):481-5
The solution
The Cure
The solution
Seraqua™ is an ultra-light and readily vanishing serum. It is an ideal compounding vehicle for a broad range of APIs, including latanoprost. Seraqua™ is highly suitable for application on the eyebrows and eyelids. It can be used in combination with Fagron’s pharmaceutical eyelid applicator to maximize ease of application and patient comfort.
The cure
Cases overview
The cure
Isabella received a prescription for latanoprost 0.005% in Seraqua™ from her physician. With Fagron’s latanoprost, pre-weighed packaging, compounding instructions and pharmaceutical eyelid applicator, the pharmacist efficiently compounded the latanoprost 0.005% in 10 ml Seraqua™. After two months treatment the first results are very promising and Isabella’s physician expects full regrowth of the eyelashes and eyebrows in the near future.
Case study: Hugo has androgenetic alopecia
Hugo's case
The challenge
The case
Hugo, a 40 year old male, suffers from the most common form of hair loss in men: androgenetic alopecia. As a result of the gradual but progressive miniaturization of the hair follicles, Hugo experienced a substantial amount of hair loss in the past years. Due to the hair loss, Hugo is experiencing emotional distress.
The challenge
The solution
The challenge
Last year, he started a topical treatment with 5% minoxidil in an alcoholic solution. The effects of the alcoholic minoxidil treatment are moderate and Hugo is not fond of the alcoholic solution. After applying the minoxidil solution, the preparation drips of Hugo’s scalp and it leaves him with a unpleasant alcoholic smell. As Hugo’s hair loss is progressing, he consults his physician about alternative treatment options.
The solution
The Cure
The solution
A dysregulation in the prostaglandin pathway can lead to alopecia [1]. Latanoprost, minoxidil and Prostaquinon™ each act on a different prostaglandin and synergize to restore the prostaglandin balance. Espumil™ is a creamy, drip-free, foam formulation with a light skin feel that is highly suitable for application on hairy skin, such as the scalp. This easy-to-apply, skin-friendly vehicle maximizes patient comfort for optimal compliance and treatment results. Espumil™ is compatible with minoxidil, latanoprost and Prostaquinon™.
[1] Valente Duarte de Sousa, IC and Tosti, A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs 2013 May;22(5):573-89.
The cure
Cases overview
The cure
Hugo’s physician decides to prescribe a triple therapy of latanoprost 0.005% and minoxidil 5% in Espumil™ and Prostaquinon™ 3% in Espumil™ to increase the efficacy Hugo’s therapy. His pharmacy uses the convenient pre-weighed packaging of latanoprost and Prostaquinon™ to efficiently compound the prescription. The formulation is dispensed in Fagron’s foam dispenser that transforms Espumil™ into a foam which improves the ease of use of Hugo’s therapy. After 3 months Hugo notices an increase in hair (re)growth and thickness and he is very happy with the easy-to-apply foam. He is regaining his confidence.

Josh has problems swallowing

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