Mixtures and dilutions of commercial solutions for oral drops: What happens in these cocktails? - 03/12/25

Doi : 10.1016/j.therap.2025.11.002

Caroline Castera-Ducros ^a,^b,⁎ , Romain Paoli-Lombardo ^a,^b, Ikram Zaddam ^a, Cyril Fersing ^c,^d, Charleric Bornet ^e, Patrice Vanelle ^a,^b, Pascal Rathelot ^a,^b, Christophe Curti ^a,^b

^a Pharmacy Department, Service Central de la Qualité et de l’Information Pharmaceutiques (SCQIP), AP–HM, 13005 Marseille, France

^b UMR 7273, Équipe de Pharmaco-Chimie Radicalaire, CNRS, Institut de Chimie Radicalaire (ICR), Aix-Marseille University, 13385 Marseille, France

^c Department of Nuclear Medicine, Institut du Cancer de Montpellier (ICM), 34298 Montpellier, France

^d CNRS, ENSCM, IBMM, University of Montpellier, 34293 Montpellier, France

^e Pharmacy Department, Pharmacie Usage Intérieur, Hôpital Conception, AP–HM, 13005, Marseille, France

^⁎ Corresponding author. Pharmacy Department, Service Central de la Qualité et de l’Information Pharmaceutiques (SCQIP), AP–HM, 147, boulevard Baille, 13005 Marseille, France. Pharmacy Department, Service Central de la Qualité et de l’Information Pharmaceutiques (SCQIP), AP–HM 147, boulevard Baille Marseille 13005 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 03 December 2025

Summary

Background

Physicochemical incompatibilities of parenteral drugs are frequently studied and reported, but are rarely documented for liquid oral drugs. However, in clinical practices, nurses may perform mixtures of several liquid oral formulations. Although such practices are not recommended, there is a lack of scientific evidence to support this statement.

Objective

We aimed to study potential incompatibilities of the most dispensed commercial liquid oral formulations in a psychiatric ward.

Methods

First, a bibliographic analysis was performed. Then, 1:1 mixtures of one commercial liquid specialty and tap water and 1:1:1 mixtures of two commercial formulations and water were realized and controlled both visually and analytically. When a precipitate was formed, the mixture was considered incompatible.