Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Imipramine Oral Suspension    5 mg/mL
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    imipramine  25 mg  TAB   
    Cherry syrup      qs to 
Recipe Total Quantity:
Final Quantity Desired: mL

Directions: 1. In a mortar, crush tablets and triturate to a fine powder.
2. Gradually levigate powder with cherry syrup until a liquid is formed.
3. Pour into a graduated cylinder.
4. Rinse mortar and qs to final volume with cherry syrup.
5. Transfer to final container and label.

Notes Cherry Syrup selected to make recipe, however original reference used Wild Cherry Syrup (prepared by adding 0.2 mL of wild cherry flavoring to simple syrup qs to 100 mL).

Please note recipe requires the ready-to-use cherry syrup and NOT the cherry syrup concentrate. If your site uses the concentrate, it MUST be diluted before using in the recipe.

THIS FORMULATION IS NOT BASED ON LITERATURE, but is from unpublished data, historical use, or physician/pharmacy experience.

Packaging:  Amber Plastic Bottle

Auxiliary Labels: Refrigerate
  Shake Well

Storage/Expiry:Refrigerator: 60 days

Last Date Revised: 7-Dec-11

References:
  Based on information on file at the Hospital for Sick Children pharmacy.
McCrea J, Rappaport P, Stansfield S, Baker D, Dupuis LL. James G., Extemporaneous oral liquid dosage preparations. 1st ed. Toronto, ON: Canadian Society of Hospital Pharmacists; 1988.

Completed Compound Check
Lot NoDate Prepared Expiry DateTechnicianPharmacist
   6-Dec-2021         


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