Josh's Case

Josh's 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
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.

Patient acceptance: Josh is experiencing retching when feeling an unpleasant bitter taste in his mouth. Oseltamivir has a bitter taste.

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.

Proven stability: The stability of oseltamivir in a fluid form needs special attention.

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.

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.

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.

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.

Proven stability: Stability tests have proven a 30 days stability of a suspension of SyrSpend® SF PH4 with oseltamivir*.

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.

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.