Analysis on present status and countermeasures of small dosage splitting in children oral formulations

Objective To investigate the frequencies of different dosages splitting of tablets and capsules for children, to understand the existing problems and put forward targeted countermeasures so as to arise drug administration warnings in splitting of high-alert medications and drugs with narrow therapeutic window. Methods From January 1 to December 31, 2019, the frequencies of prescriptions of splitting dosage of oral tablets and capsules were obtained, among which the frequencies of splitting prescriptions with dosage of ≤0.2 tablet/capsule and ≤0.1 tablet/capsule were selected, and their clinical applications were analyzed. In this paper, methods of extemporaneous preparations recommended by foreign literature were collected for these typical small dosage splitting medicines, and countermeasures and suggestions were put forward to present situations of these typical drugs with splitting dosage. Results The daily differential small dosage splitting work was frequent in the inpatient pharmacy department of children's hospital, Furosemide tablets, Nitazepam tablets and Propranololol hydrochloride tablets ranked the top three in terms of ratio of dosage splitting frequency, two of them were high-alert drugs for children. The highest frequency of splitting prescriptions with dosage of ≤0.2 tablet/capsule and ≤0.1 tablet/capsule were Sildenafil citrate tablets, Bosentan tablets and Fluconazole capsules. Conclusion Accuracy and stability of individualized accurate dosage splitting are directly related to drug quality. In order to ensure the safe, effective and accurate use of drugs for children, the improvement and development of splitting adult-dosage formulations need jointed efforts of different parts.