Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Hydroxychloroquine Sulfate Oral Suspension (in Medisca Oral Mix or Medisca Oral Mix-SF)   25 mg/mL
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    hydroxychloroquine sulfate  200 mg  TAB   
    Medisca Oral Mix (Flavored Suspending Vehicle)    LIQ  qs to 
Recipe Total Quantity:
Final Quantity Desired: mL

Directions: If tablet brand being used has imprint, it can be removed by rubbing with a towel dampened with water. If the imprint is not removed, there may be dark flecks in the suspension.

1. In a mortar, crush the hydroxychloroquine sulfate tablets and triturate into a fine homogenous powder.
2. Levigate the hydroxychloroquine sulfate tablet powder with Medisca Oral Mix vehicle.
3. Continue adding vehicle, approximately half the total volume, geometrically, mixing well after each addition.
4. Transfer the contents of the mortar to the graduated measure. Use additional vehicle to rinse remaining drug from the mortar.
5. Make up the final volume using more vehicle.
6. Transfer the final product into the specified dispensing container.
7. Label.

Notes Medisca Oral Mix-SF can be substituted for Medisca Oral Mix.

HSC Suspending Vehicle can be substituted for Medisca Oral Mix or Medisca Oral Mix-SF. See recipe for HSC Suspending Vehicle.

If HSC Suspending Vehicle is used store in amber glass bottle with an expiry (beyond use date) of 30 days, under refrigeration.

Packaging:  Amber Plastic Bottle

Auxiliary Labels: Protect From Light
  Shake Well

Storage/Expiry:Refrigerator: 90 days

Last Date Revised: 8-Sep-20

References:McHenry AR, Wempe MF & Rice PJ. Stability of Extemporaneously prepared hydroxychloroquine sulfate 25-mg/mL suspensions in plastic bottles and syringes. International Journal of Pharmaceutical Compounding 2017; 21(3): 251-254.

Hydroxychloroquine Sulfate 25 mg/mL Oral Liquid (Suspension, 160 mL). FIN: F 006 870v2. Medisca® Nework Inc. [updated 2017 Feb 27]. Available from:

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. Recommended a stability of 30 days refrigerated with HSC vehicle.

Trissel LA. Trissel’s™ Stability of compounded formulations. 4th ed. Washington, DC: American Pharmacists Association; 2009.

Completed Compound Check
Lot NoDate Prepared Expiry DateTechnicianPharmacist

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