Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Water with Sodium Benzoate    0.05%
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    sodium benzoate    PWD   
    Water, sterile        
Recipe Total Quantity:
Final Quantity Desired: mL

Directions: 1. Weigh out sodium benzoate powder.
2. QS to final volume with sterile water.
3. Stir well until dissolved.
4. Transfer to final container and label.

Notes Wear mask and gloves when handling sodium benzoate.

Packaging:  Amber Glass Bottle

Auxiliary Labels: Note Strength
  Store at Room Temperature

Storage/Expiry:Room Temperature: 2 months (sealed). 30 days (once opened)

Last Date Revised: 3-Oct-12

References:Recipe extrapolated from Preserved Water (Water with Sodium Benzoate) 0.1% recipe from SickKids Compounding Service [online recipes]. Toronto, ON: The Hospital for Sick Children. c1999 [current date]. Available from:

Completed Compound Check
Lot NoDate Prepared Expiry DateTechnicianPharmacist

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