Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Lisinopril Oral Suspension - Sugar Free    1 mg/mL
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    lisinopril  20 mg  TAB   
    Water, sterile        
    Modified Shohl's Solution        
    Ora-Sweet® Sugar Free    SYRUP   
Recipe Total Quantity:
Final Quantity Desired: mL

Directions: 1. Combine tablets and water in a bottle, cap and shake for one minute.
2. Add Modified Shohl's solution and shake bottle again.
3. Add Ora-Sweet® SF and shake to thoroughly mix contents.

Notes See recipe for Sodium Citrate/ Citric Acid (Modified Shohl's Solution).

Ora-Sweet SF® should not be used in neonates less than or equal to 28 days corrected age.

Packaging:  Amber Plastic Bottle

Auxiliary Labels: Can be stored at room temperature or refrigerated
  Shake Well

Storage/Expiry:Refrigerator or Room Temperature: 4 weeks

Last Date Revised: 2-Jun-14

References:Thompson KC et al. Characterization of an extemporaneous liquid formulation of lisinopril. Am J Health-Syst Pharm 2003 (Jan); 60:69-74.

Completed Compound Check
Lot NoDate Prepared Expiry DateTechnicianPharmacist

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