Re: Rx Flavori Question!!! Any Compounders out there?

[Guest guest]

Hi J,

If you are referring to the company Flavor Rx, this company supplies the

flavorings, droppers, syringes and the recipe book needed to flavor anything the

pharmacy sells. If its not in the book, the company has and 800 number. The

technicians can easily give the amounts and types of flavors needed for what you

need.

But a better example to your question would be this. If you wanted to flavor

Amoxicillin 250/5 80 ml, first decide on the flavor. Look up Amoxicillin 250/5

in the book. The amount 50-, 80-, 100-, 150- mls does not factor in just yet.

Under the Amoxicillin heading are listed the flavors which should and should not

be used. Once you find the flavor, it tells you to use X drops/5 mls. Also,

almost every time a flavor is used Bitterness Suppressor and Sweetening Enhancer

need to be added. One more thing, sometimes you need to remove a few mls of

water when adding flavor to keep the reconstitution correct.

Is this what you're looking for? Unless your pharmacy has some sort of recipe

book, it seems like you'd be working hit or miss.

--

To love what you do and feel that

it matters - how could anything

be more fun? -- Graham

.. . . for my heart rejoiced in

all my labour . . . Ecclesiastes

2:10

-------------- Original message --------------

From: Jeanetta Mastron <rxjm2002@...>

Dear All,

This just in at my personal email. Can ANYONE help?

Feel free to post the answer or email me privately.

" Hi

I need to know a simple way to use rx flavor

I can't understand how you figure how many drops of flavor like in

cx500 250/5.

I have to learn this soon thanks "

Respectfully,

Jeanetta CPhT

[Guest guest]

Try Donna Mackey---she's a member on this site with compounding experience.

Contacting a local compounding pharmacy might be a good learning experience as

well.

Dora

Jeanetta Mastron <rxjm2002@...> wrote:

Dear All,

This just in at my personal email. Can ANYONE help?

Feel free to post the answer or email me privately.

" Hi

I need to know a simple way to use rx flavor

I can't understand how you figure how many drops of flavor like in

cx500 250/5.

I have to learn this soon thanks "

Respectfully,

Jeanetta CPhT

[Guest guest]

Dear ,

There are many reasons why you are one of the TEXPERTS to my site!

This is just ONE of them.

This will be read by the person who sent ti to me who is a member of

the site. For some reason he/she felt the need to be anonymous or

emailme privately. I will also sendfhim/her a copy of this response just in

case she/he does not read from the net of get emails.( I have not

checked the email addy ).

Yes I am aware of this company. It seems that " 'Donna' from Texas had

mentoned it on Dora's site before. I recallher posting about specific

flavorings to 'mask' specific tastes such as bitter or sour or ???

I am still learning even though I know so much about other things in

pharmacy. We never stop learning and the minute we think we are or do,

we do not belong in it!

Thanks again!

Jeanetta.

cphtgenius@... wrote: Hi J,

If you are referring to the company Flavor Rx, this company supplies the

flavorings, droppers, syringes and the recipe book needed to flavor anything the

pharmacy sells. If its not in the book, the company has and 800 number. The

technicians can easily give the amounts and types of flavors needed for what you

need.

But a better example to your question would be this. If you wanted to flavor

Amoxicillin 250/5 80 ml, first decide on the flavor. Look up Amoxicillin 250/5

in the book. The amount 50-, 80-, 100-, 150- mls does not factor in just yet.

Under the Amoxicillin heading are listed the flavors which should and should not

be used. Once you find the flavor, it tells you to use X drops/5 mls. Also,

almost every time a flavor is used Bitterness Suppressor and Sweetening Enhancer

need to be added. One more thing, sometimes you need to remove a few mls of

water when adding flavor to keep the reconstitution correct.

Is this what you're looking for? Unless your pharmacy has some sort of recipe

book, it seems like you'd be working hit or miss.

--

To love what you do and feel that

it matters - how could anything

be more fun? -- Graham

.. . . for my heart rejoiced in

all my labour . . . Ecclesiastes

2:10

-------------- Original message --------------

From: Jeanetta Mastron <rxjm2002@...>

Dear All,

This just in at my personal email. Can ANYONE help?

Feel free to post the answer or email me privately.

" Hi

I need to know a simple way to use rx flavor

I can't understand how you figure how many drops of flavor like in

cx500 250/5.

I have to learn this soon thanks "

Respectfully,

Jeanetta CPhT

[Guest guest]

Thanks Dora!

I should have read your note sooner! Yes Donna Mackey. Sorry Donna, at that

moment in time I just couldnot recall your last name. It was on the tip of my

tongu... (er ....fingertips) as they say!

Yes Donna is very knowledgeable in this area.

Thanks

Jeanetta CPhT

Dora <doracpht@...> wrote:

Try Donna Mackey---she's a member on this site with compounding experience.

Contacting a local compounding pharmacy might be a good learning experience as

well.

Dora

Jeanetta Mastron <rxjm2002@...> wrote:

Dear All,

This just in at my personal email. Can ANYONE help?

Feel free to post the answer or email me privately.

" Hi

I need to know a simple way to use rx flavor

I can't understand how you figure how many drops of flavor like in

cx500 250/5.

I have to learn this soon thanks "

Respectfully,

Jeanetta CPhT

[Guest guest]

Hi Everyone

I hope all on this forum are doing well. This caught my attention as

I have seen pharmacies that are " flavoring " liquid medications for a

fee and was wondering what you felt about this activity?

Personally, I feel that if it tastes too good, children may be more

inclined to take what they should not be taking. I can see the pros

in the respect that most medication simply tastes awful...and if not

for the potential poisoning of a child due to this action, I would

also jump on the bandwagon in the flavoring of medications.

What are your thoughts?

Joe Medina, CPhT

[Guest guest]

Dear Joe,

You will always have good quality issues to discuss. We are happy to

see you post your thoughts to get 'us' technicians to think about the

ethical questions that various issues that you post raise. I invite

you to continue on this positive path. Your input is greatly appreciated.

In my opinion, most compounding pharmacies are privately owned not

chain. So the mom/pop have to make a dime. Therefore they must charge

for the flavorings. The question is should it be part of the total

compounding charge/disp charge or 'extra'.

I think that when a child is ill, we must ensure that the patient gets

his meds. That includes ensuring that it is 'palitable' or tasty

enough to take. Here is a personal experience you be the judge:

I was 7 or 8 yrs old when our family of four went to the high school

auditorium for several visits to take our 'flu sugar cubes'. It was

thought that Jeanetta who loves candy would have no problem with that

'sugar'. What my family/parents knew is that I spit out the terrible

red syrup soakedd sugar cube when they were not looking as we walked

back to our family car. I remember this to day as CLEAR as it were

happening NOW!. That year I got the HONG KNOG flu with my family. They

say I almost died. Everyone else got a mild case by comparison. They

thought that it was my immune system they thought that it was 'just'

me. But I NEVER to this day told them that I did not take that

immunization!!! I SPIT it out! on the parking lot black top as I

lagged behind my family.

I say we MUST make the drug palitable to ensure better patient

compliance.

NOW regarding the possibility of a child taking a 'good as candy'

tasting drug when they are not sick and getting sick or overdose:

We saw this with vitamins, cough syrup, cough drops etc. It is the

responsibility fo the parent to get the medication or bug spray or

detergent or any other potential poison OUT of the REACH of a

child---their child. It is the responsibility of all to lock up old

and not in use refrigerators. ETC ETC WE do not stop selling bug

killer, or detergent or refrigerators. We take RESPONSIBILITY. This

does not mean that there will not be inquisitvie and curious children!

Of course there will be. And some will become injured. But it is the

chance that we take as society that we also take the RESPONSIBILITY to

avoid this mishap.

My nephew died in a near drowing in the next door neighbors pool. In

California pools are every where. A child drowing is not common, bu

tno unheard of. It is the inherent risk that society has decided it

can take.

I believe that flavoring a childs med is as important as making sure

that they take it on time.

I believe that if we have extra flavored childrens meds or other meds

or other poisons that we must take full responsibility for storage out

of the reach or dispose of them properly.

By the way this does not negate the fact that children do die from

accidental poisonings daily. I am aware of this....But there are

more sick children than deaths from poisonings.

Regarding charging? I think it should be part of the disp fee. But if

a patient is allergic to the flavoring or does not want it or like the

flavor then perhaps they can get a discount for not putting it in. But

I do not see the benefit in the charge/flavor or no charge/no flavor.

In this case I would worry that many parents would opt for no flavor

no charge due to personal finances, and believing that their child

would take the med and they would be there to ensure it (Just like my

parents thought I took my sugar cube!) And then the child would suffer

the consequences of NOT taking the med.

Just my two cents...

Thank you for allowing me to respond,

Jeanetta Mastron CPhT BS

Founder/Owner of this site

>

> Hi Everyone

>

> I hope all on this forum are doing well. This caught my attention as

> I have seen pharmacies that are " flavoring " liquid medications for a

> fee and was wondering what you felt about this activity?

>

> Personally, I feel that if it tastes too good, children may be more

> inclined to take what they should not be taking. I can see the pros

> in the respect that most medication simply tastes awful...and if not

> for the potential poisoning of a child due to this action, I would

> also jump on the bandwagon in the flavoring of medications.

>

> What are your thoughts?

>

> Joe Medina, CPhT

>

[Guest guest]

Dear Group,

As far as the flavor of liquid medications is concerned:

1. There is a member of this group who had horrible chronic ear

infections when he was a child.

2. He eventually had 'ear tube surgery' when he was seven.

3. His tympanic membranes are good and well in 2006.

4. That pink Amox. that mommy kept in the fridge tasted pretty good.

5. Tylenol/Codeine Elixor (Which was a measure of last reort for

this poor child's pain as his mother really did not want to 'drug'

the poor child) had this really 'good' cherry flavor.

6. The child liked it because it was one of the myriad teaspoons of

liquid medication that did not taste 'yukky'.

7. Mom and Dad liked it because it was one of the myriad of

teaspoonfulls of liquid medications that they had to give to their

child that he (or... um... she...) did not object to taking.

8. This child prefered cherry over bubble gum so he did not go to

the fridge.

9. Since this kid had the chronic ear infections, there was a half

filled bottle of what Mom termed as 'cherry juice' in the medicine

cabinet that Mom thought would be out of reach physically for a

person of this child's height to be able to reach, and the bottle

had a 'child proof cap'.

10. In theory, an intelligent 5 year old could easily put a chair

(or was it some sort of stool, I... um... the kid can't remember...)

in front of Mom's sink in her bathroom, climb himself up onto the

counter, and open the medicine cabinet.

11. Now, at this point, the child had to do a little bit

of 'snooping', as there were many brown bottles from which he knew

had come many spoons full of many liquids that he did not EVER want

to taste again.

12. So he opened several of them (so much for the child proof caps)

and smelled inside until he found the one that had the cherry smell.

13. The child drank about half of a pint of Tylenol/Codeine Elixor.

I grew up in a large house, and both Mom and Dad were there when I

did this. I was a bright young kid whose Papa worked for a

pharmaceutical company, so I know that I had been told not to get

into the medicine cabinet. This particular bottle (the only one out

of all of them, I'm not quite sure why) had one of those split pea

green 'Mr. Yuck Mouth' stickers on it that were supposed to keep

kids away from liquid meds. I guess the stickers and the 'child

proof bottles', and the 'Mr. Yuck Mouth' stickers did not work too

well in 1977! I was in the hospital for two days.

2006-1977= 29....

Almost 30 years ago, pretty much the only two liquid meds. for kids

that tasted good were Tylenol/Codeine and Amox. Coming in a close

third was Dimetapp which back then was a prescription, not OTC med.

So to ask/answer a question about flavoring liquid meds., especially

for children, if it wasn't the best idea 30 years ago, why should we

do it now?

Christian B. Oliver RCPhT (TX)

>

> Hi Everyone

>

> I hope all on this forum are doing well. This caught my attention

as

> I have seen pharmacies that are " flavoring " liquid medications for

a

> fee and was wondering what you felt about this activity?

>

> Personally, I feel that if it tastes too good, children may be more

> inclined to take what they should not be taking. I can see the

pros

> in the respect that most medication simply tastes awful...and if

not

> for the potential poisoning of a child due to this action, I would

> also jump on the bandwagon in the flavoring of medications.

>

> What are your thoughts?

>

> Joe Medina, CPhT

>

[Guest guest]

With all the stuff kids can get in to, I don't think taking the

flavoring from meds is a solution. Perhaps locked cabinets in houses

should be more common, so we can lock up the meds, and the cleaning

supplies. When you think of all the 'common' things that kids would

love to get their hands on (birth control pills look like candy,

Tums come in chocolate flavoring)When my daugter was 3, she managed

to decorate my living room with bleach in a spray bottle. THis took

only the time I was in the restroom, and yes, she had been told not

to. I think that better control is the solution.

Just my " as a mom " 2 cents

Lori

> > Hi Everyone

> >

> > I hope all on this forum are doing well. This caught my

attention

> as

> > I have seen pharmacies that are " flavoring " liquid medications

for

> a

> > fee and was wondering what you felt about this activity?

> >

> > Personally, I feel that if it tastes too good, children may be

more

> > inclined to take what they should not be taking. I can see the

> pros

> > in the respect that most medication simply tastes awful...and if

> not

> > for the potential poisoning of a child due to this action, I

would

> > also jump on the bandwagon in the flavoring of medications.

> >

> > What are your thoughts?

> >

> > Joe Medina, CPhT

> >

>

[Guest guest]

Dear Joe and All,

First of all I want to thank you, Joe, for this posting of a very

interesting topic. I do hope that you will make more similar

contributions to this site. Your positive input is very much

appreciated and welcomed here. I appreciate your actions and desire to

stimulate provocative thought and discussion on pertinent topics.

Please continue in this positive educational venture more often.

I can still recall the lie, that to date, I have NEVER revealed to my

parents or my sister! Our family of four had three visits scheduled

for flu `sugar' cubes. The cubes were soaked in a magenta/burgundy

syrup that was supposed to be `yummy' and the sugar `helped the

medicine go down'. I have never told my parents that upon receiving

the immunization cube in my mouth, on three separate consecutive

occasions, that I spit it out because it tasted so bad. They all

thought that the `candy lover: little Jeanetta' would surely `love and

take' her medicine. No one noticed that I lagged behind in the high

school gym, as we returned to our parked car each time, and that I

spit it out on the black top, EACH time! They say that year everyone

got the Hong Kong Flu or was it the Swine Flu ( I forgot) and that I

was no exception. However they also say I nearly died and was

hospitalized for 7 days due to complications. In this case I was the

exception! Every one else in the family got the same flu with no

complication. I was about 7 or 8 yrs old back then. I have no memory

of the pneumonia. I may have been in a coma. They say every time they

visited I did not respond. I get a flu shot every year, since I

turned 45, which prevents me from death. I also get a pneumonia shot

q5yrs. I am due this year.

I think that flavored medicines do help children to be more compliant

(to take their medicine correctly). I am aware of accidental

poisonings by bug spray, detergents, medicines etc. But I am also a

believer in `taking responsibility'. My nephew died two years after

the `near drown' accident. He never actually woke up after he was

'rescued', stayed in a coma in an institution for 2.5 yrs, died at 5

yrs old. Pools are still legal in California! Children die each year

from suffocation in abandoned refrigerators, but we are still allowed

to have them empty IF we lock them up. But what about the ones still

running in homes? And dryers and washers? We as a society must take

responsibility (NOT blame) for the location and position that we keep

our medications, car oils, antifreeze, bug spray, room freshener,

detergents, refrigerators etc. We must also take responsibility for

watching our children, controlling the medications, their actions as

much as possible. We all know children are curious. We cannot blame

parents for things out of their control, especially when/if they have

taken every precaution.

Vitamins are flavored today. When I was small they tasted nasty and

would come up in my throat and cause me to burp and it would 'burn'

and I stopped taking them. I needed them as I had malnutrition for the

first five years of my life. Mom claimed it was because I was her

" change of life baby " . Dad said cause I needed the vitamins because I

would not eat my vegetables, because I did not like the taste of peas,

spinach or cabbage etc. Back to taste again aren't we! I think that

takes us full circle.

I believe that the flavoring of medication has increased and helped

compliance far more than it has been a detriment to society. There are

far more children taking medications compliantly than there are

mishaps due to flavorings. The benefits outweigh the risks. There are

more people enjoying fresh refrigerated foods and the coolness of

swimming pools than dying in them or because of them. We still use

them. They are still legal. My nephew died because he fell in a pool

and no one noticed his disappearance for at least 10 minutes. They all

though he was with someone else in the house! I do not think that

pools should be destroyed.

The same person who hated the yucky magenta syrup, also hates

peppermint. That seemed to be the ONLY flavor of toothpaste when I was

a child. My parents saw me go to the bathroom to brush my teeth every

night as instructed. But I seldom did. I primped instead. I hated

brushing. As I aged and newer flavors came to become the norm, I did

not brush with them because I was out of the habit of brushing for so

many years and because my gums had become very sensitive. Today I

face tooth loss. If only bubble gum flavored toothpaste was available

back then, or cinnamon was not more expensive than peppermint, my

parents may have opted for that flavor to encourage my brushing; I

might NOW have the same great teeth that my 91 yr old mother still

has! Genetically I should have no problem with my teeth or gums. In

this case the habit of good oral hygiene was abandoned by me due to

the yucky taste factor. I still don't do peppermint or menthol

Altoids! YUCK! Okay so my breath is not so sweet and I may not get all

the kisses I want, but at least I don't have that yucky stuff in my

mouth! I will eat my words soon when I get false teeth.

Regarding the cost factor. I believe that the cost of the flavoring

should be included in the dispensing fee. Far more compounding

pharmacies are independently owned than chain. The mom/pop must absorb

the cost otherwise, but cannot afford to. Therefore it should be

included in the disp fee. I question and have concerns over no

flavorings and charging only IF the patient or parent wants it. This

may result in people opting not to have the flavoring due to the cost

factor, which may lead to less compliance too often. This may lead to

sicker children or more resistant strains of bacteria etc. However I

am not opposed to a parent who does not want the child to have

flavorings for whatever reason: allergy, safety, taste or dislike of

the flavor and getting a discount because they did not get it in their

product. However, I prefer the method used by restaurants: the cost of

butter should be built into the cost of toast, cream or milk in the

cost of coffee; whether the customer uses it or not.

I offer my experience as reason to continue to use flavorings to

increase compliance with kids who are the worse offenders when it

comes to yucky medicine.

I do respect the experience of others.

We need to

1. Have better or increased counseling regarding storage of meds, by

pharmacists, or pamphlets for techs to hand out

2. Take responsibility to follow the counsel or advice

3. Accept the fact that we are not perfect and that children's

behavior is unpredictable no matter how hard one tries to follow the

counsel and that accidents will happen.

4.We need to provide immediate and follow-up psychological counseling

to parents, pharmacists and techs who dispense/administer/store such

meds that may lead to accidental poisonings and deaths.

With great respect to all

Just my two cents….

Jeanetta Mastron CPhT BS Chemistry

Founder/Owner of this site.

>

> Hi Everyone

>

> I hope all on this forum are doing well. This caught my attention as

> I have seen pharmacies that are " flavoring " liquid medications for a

> fee and was wondering what you felt about this activity?

>

> Personally, I feel that if it tastes too good, children may be more

> inclined to take what they should not be taking. I can see the pros

> in the respect that most medication simply tastes awful...and if not

> for the potential poisoning of a child due to this action, I would

> also jump on the bandwagon in the flavoring of medications.

>

> What are your thoughts?

>

> Joe Medina, CPhT

>

[Guest guest]

Dear All,

I Did some research on this and found that I may be thinking of the

polio sugar cube. Either way I did not get my drug and I was/am at

risk for that disease state for which the immunization was for. My

parents always told me that the immunization did not work for me and

that is why I got sick ( the doctors told my parent's this). As a

child I felt very guilty for being sick, their hospital bills and

causing them worry. I just knew my not taking that sugar cube, as I

was supposed to, resulted in their financial problems due to my dad

out of work, no medical insurance and the hospital bills. Little

children can sense things that we expect them to be oblivious to. At

any rate, flavoring or better flavoring would have increased my

chances of compliance.

Thanks for letting me spout off,

Jeanetta

[Guest guest]

Hi Jeanetta,

Sorry I have been busy with a new project I am working on that

actually may be beneficial to our profession. More of that later.

I still believe that as long as we make " medications " flavorful, we

will find poisonings occurring that would not normally occur. This is

simply common sense and does not take a rocket scientist to see the

potential ramifications of tooty fruity Acetaminophen Suspension or

Banana Flavor Phenothiazines, etc.

I recall once a statement that if we prevent the harm of one

individual then we have done our job. In this case, we simply open

the door to a child getting into the medication bottle. Why? Because

it tastes good. Of which Mom paid extra for.

Yes the argument applies that good parents would keep medications away

from the child...but reality does not always dictate this happening.

Now where is my bubble gum flavored Prozac? That's right I left it by

the remote control in the family room.

Just my two cents

Joe Medina, CPhT

----------

Dear Joe,

You will always have good quality issues to discuss. We are happy to

see you post your thoughts to get 'us' technicians to think about the

ethical questions that various issues that you post raise. I invite

you to continue on this positive path. Your input is greatly appreciated.

In my opinion, most compounding pharmacies are privately owned not

chain. So the mom/pop have to make a dime. Therefore they must charge

for the flavorings. The question is should it be part of the total

compounding charge/disp charge or 'extra'.

I think that when a child is ill, we must ensure that the patient gets

his meds. That includes ensuring that it is 'palitable' or tasty

enough to take. Here is a personal experience you be the judge:

I was 7 or 8 yrs old when our family of four went to the high school

auditorium for several visits to take our 'flu sugar cubes'. It was

thought that Jeanetta who loves candy would have no problem with that

'sugar'. What my family/parents knew is that I spit out the terrible

red syrup soakedd sugar cube when they were not looking as we walked

back to our family car. I remember this to day as CLEAR as it were

happening NOW!. That year I got the HONG KNOG flu with my family. They

say I almost died. Everyone else got a mild case by comparison. They

thought that it was my immune system they thought that it was 'just'

me. But I NEVER to this day told them that I did not take that

immunization!!! I SPIT it out! on the parking lot black top as I

lagged behind my family.

I say we MUST make the drug palitable to ensure better patient

compliance.

NOW regarding the possibility of a child taking a 'good as candy'

tasting drug when they are not sick and getting sick or overdose:

We saw this with vitamins, cough syrup, cough drops etc. It is the

responsibility fo the parent to get the medication or bug spray or

detergent or any other potential poison OUT of the REACH of a

child---their child. It is the responsibility of all to lock up old

and not in use refrigerators. ETC ETC WE do not stop selling bug

killer, or detergent or refrigerators. We take RESPONSIBILITY. This

does not mean that there will not be inquisitvie and curious children!

Of course there will be. And some will become injured. But it is the

chance that we take as society that we also take the RESPONSIBILITY to

avoid this mishap.

My nephew died in a near drowing in the next door neighbors pool. In

California pools are every where. A child drowing is not common, bu

tno unheard of. It is the inherent risk that society has decided it

can take.

I believe that flavoring a childs med is as important as making sure

that they take it on time.

I believe that if we have extra flavored childrens meds or other meds

or other poisons that we must take full responsibility for storage out

of the reach or dispose of them properly.

By the way this does not negate the fact that children do die from

accidental poisonings daily. I am aware of this....But there are

more sick children than deaths from poisonings.

Regarding charging? I think it should be part of the disp fee. But if

a patient is allergic to the flavoring or does not want it or like the

flavor then perhaps they can get a discount for not putting it in. But

I do not see the benefit in the charge/flavor or no charge/no flavor.

In this case I would worry that many parents would opt for no flavor

no charge due to personal finances, and believing that their child

would take the med and they would be there to ensure it (Just like my

parents thought I took my sugar cube!) And then the child would suffer

the consequences of NOT taking the med.

Just my two cents...

Thank you for allowing me to respond,

Jeanetta Mastron CPhT BS

Founder/Owner of this site