Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Cocaine Topical Solution    4% (LOW STRENGTH)
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    Cocaine, USP    PWD   
    Water, sterile        
Recipe Total Quantity:
Final Quantity Desired: mL

Directions: To be prepared ONLY in the event that the commercial product is NOT available or unsuitable.

1. Weigh out cocaine powder and dissolve in sterile water.
2. Transfer solution into a vial and label.

Notes For TOPICAL USE only.

NOT for intravenous or ophthalmic use.

If desired, 1 to 2 drops of methylene blue can be added to tint the solution blue.

Packaging:  Vial, Amber

Auxiliary Labels: Note Strength
  Single USE only
  Store at Room Temperature

Storage/Expiry:Room Temperature: 45 days (intact vials)

Last Date Revised: 30-Jul-14

References:Gupta VD. Stability of cocaine hydrochloride solutions at various pH values as determined by high-pressure liquid chromatography. International Journal of Pharmaceutics 1982 (1) 249-257. - Modified to make 4% solution

Completed Compound Check
Lot NoDate Prepared Expiry DateTechnicianPharmacist

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