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By Fabiana Banov, RPh, MS, PCCA Senior Formulation Pharmacist
It is important to have a range of flavors as part of the inventory for your pharmacy’s compounding lab, but it is also crucial to stock all the other components needed to help mask the taste of the bitter active ingredients when preparing a high-quality formulation. To help you with this, I have provided lists below containing ingredients that a pharmacy should have on the shelf to start flavoring custom oral medications. There are three main categories: flavors, sweeteners and oral bases. I have also included a brief explanation of the need for each type of ingredient to improve the flavor of any compounded oral formulation.
Below are some of the most popular flavors for oral compounded medications. Every active pharmaceutical ingredient (API) has a specific taste characteristic, such as bitter, sour, sweet or salty, so it is important to have the correct flavors in stock to enhance the taste of compounded oral formulations.
FLAVOR
PCCA #
SUGGESTED CONCENTRATION RANGE (%)
SUGGESTED FOR MASKING API TASTE
Chocolate (aldehyde base)
30-2275
1-4
Salty, bitter
Banana Creme
30-2169
Creme DeMenthe
30-2327
0.5-1.5
Bitter
Marshmallow
30-2699
Sour, salty, bitter
Raspberry
30-2323
1-3
Sour, sweet, bitter
Tangerine Oil
30-2155
0.1-1
Peppermint Oil NF
30-3462
Tutti Frutti
30-2152
Sour
Bubble Gum Concentrate (colorless)
30-2233
Grape
30-2243
PCCA Sweetened Flavor Powder, Tangerine
30-3715
1-10
Sour, sweet, salty, bitter
The flavors listed above can also be used for veterinary patients. However, the list below shows the most common flavors used in veterinary medicine and will give more options for flavoring the prescriptions of different species.
Apple
30-2171
Bacon
30-3676
0.5-1
Beef (water miscible)
30-3866
Beef (oil miscible)
30-4786
Caramel
30-2163
Chicken Broth (spray dried)
30-3646
1-6
Chicken (oil miscible)
30-4757
Fish
30-3839
Liver (water miscible)
30-2905
1-5
Liver (oil miscible)
30-3840
Peanut Butter
30-2226
Vanilla Butternut
30-2151
Also on The PCCA Blog: Flavoring Options for Veterinary Compounding
Emulsifiers help to incorporate an insoluble flavor into your vehicle of choice. For example, when adding an oil flavor to an aqueous vehicle, you can mix polysorbate with the flavor in a 1:1 ratio to emulsify it. Polysorbate 20 is the best choice for this since it is less bitter than the other polysorbates. When adding an aqueous flavor to an oil vehicle, you can mix sorbitan monooleate with the flavor in a 1:1 ratio to emulsify it.
EMULSIFIER
Polysorbate 20 NF
30-1054
Sorbitan Monooleate NF (Span® 80)
30-5095
The use of sweeteners in a formulation will help to create a foundation, masking any undesirable taste of the API or other substance in the formulation and enhancing the taste of the flavor in the medicine. Sweetness enhancers may especially help mask the bitterness of active ingredients. Salt can help further if needed (see below). Acesulfame potassium is a synergistic sweetener and may be added up to 0.5% in combination with Steviol Glycosides 95% up to 0.5%. Magnasweet® may also be added as an additional sweetener at 0.1% for the powder form and 0.2% for the liquid form. These sweeteners can be used for both human and veterinary patients.
SWEETENER
Acesulfame Potassium FCC
30-4398
0.1-0.6
Steviol Glycoside 95%
30-4539
Magnasweet 110® (liquid)
30-2628
0.2-1
Magnasweet 135® (powdered)
30-2629
In some cases, the taste of the API is very bitter, and the sweetener in combination with the flavor of choice can’t cover it all. In this situation, adding 0.5-1% of Sodium Chloride USP Granular (PCCA #30-1087) to the composition can help improve the final taste of the medication.
Also on The PCCA Blog: 6 Tips to Help You Flavor Compounded Medications
The bases listed below provide the best choices for delivering APIs in preparations that will be acceptable to different types of patients.
ORAL BASE
NOTES
SuspendIt®
30-4825
All-in-one sugar-free oral suspension vehicle.
Acacia Syrup™
30-3321
Has emulsifying characteristics.
Fixed Oil Suspension Vehicle
30-4316
Anhydrous, allowing for longer default beyond-use dates. Ideal for veterinary medicine.
Syrup Vehicle™
30-3521
Combine with equal parts PCCA Plus to create a suspension.
PCCA-Plus™ Oral Suspending Vehicle
30-3227
Combine with equal parts Syrup Vehicle or Sweet-SF Sugar Free Syrup Vehicle to create a suspension.
Sweet-SF™ Sugar Free Syrup Vehicle
30-3228
Combine with equal parts PCCA-Plus to create a suspension.
These are the primary products that you can use to start building the flavoring inventory for your lab. PCCA carries a variety of other flavors, sweeteners and oral bases that can be added beyond these to help improve your ability to serve your community and doctors better. In addition, we have a digital PCCA Flavor Guide, which lists the most recent findings in how to flavor a compounded preparation. PCCA members with Clinical Services support can access it by going to “Resources” > “Formula Tools” > “Flavor Guide” after logging in to our website. They can also call us any time for flavoring questions at 800.331.2498.
Also on The PCCA Blog: The Art of Flavoring: How to Mask the Taste of Different Medicines
Fabiana Banov, RPh, MS, PCCA Senior Formulation Pharmacist, earned her pharmacy degree from the College of Pharmaceutical Science of the University of Mogi das Cruzes in Brazil. She also obtained specialization in cosmetic science from São Paulo State University and completed post-graduate work at Osvaldo Cruz College. Prior to joining the PCCA team, Fabiana was the owner of Fórmula Médica Compounding Pharmacy in São Paulo. She is also the author of the Pharmaceutical Veterinary Formulary.
A version of this article originally appeared in PCCA’s members-only magazine, the Apothagram.