Recipe - Compounding Worksheet
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These recipes are intended for use by the pharmacy manufacturing departments only.
Levothyroxine Oral Suspension   25 mcg/mL
Lot No Expiry(mm/yyyy) Ingredients Master Formula
    levothyroxine  100 mcg  TAB   
    glycerin  100%  PO SOLN   
    Water, sterile       qs to 
Recipe Total Quantity:
Final Quantity Desired: mL

Directions: 1. In a mortar, crush tablets and triturate to a fine powder.
2. Gradually levigate powder with glycerin.
3. Add water until a liquid is formed.
4. Pour into a graduated cylinder.
5. Rinse mortar and qs to final volume with water.
6. Transfer to final container and label.

Notes Refrigerated storage is recommended in reference even though formulation is stable for 8 days at room temperature and refrigerated.

Packaging:  Amber Plastic Bottle

Auxiliary Labels: Refrigerate
  Shake Well

Storage/Expiry:Refrigerator or Room Temperature: 8 days

Last Date Revised: 30-May-13

References:Boulton DW, Fawcett JP, Woods DJ. Stability of an extemporaneously compounded levothyroxine sodium oral liquid. Am J Health-Syst Pharm 1996; 53(10):1157-1161.

Completed Compound Check
Lot NoDate Prepared Expiry DateTechnicianPharmacist

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