Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Sucralfate in Eucerin (Aquaphor®)   4%
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    sucralfate  1 g  TAB   
    Water, sterile        
    Eucerin    CRM   
Recipe Total Quantity:
Final Quantity Desired: g

Directions: 1. Dissolve sucralfate tablets in water.
2. Once tablets are dissolved, add the eucerin. Mix until creamy and homogenous - may use electric mixer at slow speed.
3. Transfer to ointment jar and label.

Notes May use sucralfate powder instead of tablets.

Since no stability data available, assign beyond use date using NAPRA Guidance Document For Pharmacy Compounding Of Non-Sterile Preparations:
Water-containing topical/dermal, mucosal liquid and semi-solid formulations – The BUD is not later than 30 days.

THIS FORMULATION IS NOT BASED ON LITERATURE, but is from unpublished data, historical use or physician/pharmacy experience.

Packaging:  Ointment Jar

Auxiliary Labels: For External Use Only
  Store at Room Temperature

Storage/Expiry:Room Temperature: 30 days

Last Date Revised: 20-Aug-21

References:Hayashi AH, Lau HYC and Gillias DA. Topical sucralfate: effective therapy for the management of resistant peristomal and perineal excoriation. Journal of Pediatric Surgery 1991 (Nov); 26(11): 1279-1281.
  Water-containing topical/dermal, mucosal liquid and semi-solid formulations – The BUD is not later than 30 days.
National Association of Pharmacy Regulatory Authorities (NAPRA). Guidance Document For Pharmacy Compounding Of Non-Sterile Preparations. Ottawa, ON: National Association of Pharmacy Regulatory Authorities (NAPRA); 2018.
Available at: https://napra.ca/sites/default/files/documents/Mdl_Stnds_Pharmacy_Compounding_Nonsterile_Preparations_Guidance_June2018_FINAL.pdf

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


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