by Fabiana Banov, RPh, MS, PCCA Senior Formulation Pharmacist

We often look to sweet flavors to improve the taste of oral medications, but in some cases, combing sour tastes into a formula can help improve the medicine. Some formulations may benefit from intensely sour ingredients, such as ascorbic, malic, tartaric and citric acids.

As compounders, a part of our daily routine is to evaluate all aspects of a formula, including the flavor profile. Exploring flavor combinations can help improve medication taste and adherence. For example, if a medication includes an acidic API, the taste is already sour. If you don’t choose the correct flavor, you will not be able to highlight the final taste that you need. In cases like this, fruity flavors are the best choice.

PCCA carries many fruity flavors. Below are some popular choices that compliment sour flavor profiles

PCCA Citric Acid USP (PCCA #30-1199) and Malic Acid (DL) FCC (PCCA #30-1991) are two ingredients that, when combined with fruity flavors, create a more appealing taste.

Another flavoring option uses a powdered fruity base, PCCA Sweetened Flavor Powder. Our ready to use powder contains two sweeteners, potassium acesulfame and steviol glycoside, that synergistically promote sweetness, so no additional sweetener is needed. The bases are water soluble and contain bright colors that children find appealing. We offer two flavors, PCCA Sweetened Flavor Powder, Mango (PCCA #30-3717) and PCCA Sweetened Flavor Powder, Tangerine (PCCA #30-3715). We recommend dosage of up to 5%.

A great way to incorporate these powder bases into your practice is by using effervescent formulas. Effervescent formulas contain PCCA Citric Acid USP to develop a carbonic acid reaction. The citric acid increases sourness, which helps block taste sensitivity and aids in masking bitter APIs. Our effervescent formulas are anhydrous, which increases the stability of the formulation to achieve USP beyond-use date (BUD) of 180 days. There are many effervescent formulas available in the PCCA formulation database, but a good starting point is following the Oral Effervescent - General Formula (PCCA Formula #13389).

PCCA Sorbitol Lollipops™ (PCCA #30-3363) are another dosage form that can be used for sour-tasting medications. The sweetness of the base works great with fruity flavors. A suggestion to increase the sourness experience when working with lollipop formulas is to add a sour flavor to lollipops, mix the Mango or Tangerine PCCA Sweetened Flavor powder with 1% of Citric Acid USP and place in a separate container. When it’s time to take the medicine, a patient can dip the lollipop into the powder for a sour/sweet flavor. This may make taking medicine more fun for children.

For those new to compounding lollipops, we recommend Sorbitol Lollipop Base, General Formula (PCCA Formula #5542), which explains the procedures step-by-step. Lollipops may be dispensed in a Light Inhibiting Zip Lock Bag (PCCA #35-1674) or the Vapor-Flex Flat Barrier Bag (PCCA #35-3751) that can be sealed and cut to size.

Exploring all possible flavor combinations, formula ingredients and bases can help reduce the daily challenges many compounding pharmacies face. Keep sour in your mind. Sour can be the new sweet in your patient’s eyes.

A version of this article originally appeared in PCCA’s members-only magazine, the Apothagram.