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Different formulations and dosages are available on the market. Division of the suppository form is a widely-used technique and it allows for optimization of the dosage based on the weight of the child. Yet, few data are available in the literature about the effectiveness of this practice. The aim of this study was to evaluate the uniformity of distribution of acetaminophen inside the suppository and to verify the homogeneity of distribution after the division.

In each of the groups (whole and fractional), the suppositories were evaluated by weight, acetaminophen content and the uniformity of the acetaminophen distribution. In no case did the partition of the suppositories led to significant differences (t-test) between weight of the head and tail portion. No significant differences in weight, acetaminophen content or acetaminophen distribution of the active component were present in any of the two halves of the total suppositories analyzed after the partition.

Splitting acetaminophen suppositories is a common practice and it is a convenient medical procedure, with low chance of error, and it should not raise concerns of accurate dosage. Acetaminophen is the active metabolite of phenacetin, a weak inhibitor of COX-1 and COX-2 in peripheral tissues, and does not have significant anti-inflammatory effects.

Paracetamol has been used in clinical practice for over 100 years. Acetanilid, the parent compound of paracetamol, was introduced in 1886. However, toxicity-related problems with acetanilid lead to the introduction of paracetamol (acetaminophen, N- relationship between serum concentration and acetyl-p-amino-phenol) by von Mering in 1893. Acetaminophen is well tolerated, lacks many of the side effects of aspirin, is available without prescription and is already widely used in the management of children with pain or fever.

There is evidence, however, that combination of these two products is more effective than their use as single agents. Yet, there are concerns that combined treatment may be more complicated and contribute to Ditropan XL (Oxybutynin Chloride Extended Release Tablets)- FDA unsafe use of these drugs. Pediatricians should promote patient safety by advocating for simplified formulations, dosing pfizer meaning, and dosing devices.

The division of a rectal suppository is a widely-used technique and it allows for optimization of dosage that is administered according to the weight of the child, but few data are present in the literature regarding the efficacy of such a practice.

In fact, positioning the suppositories in a steady position for long time during the production or the storage period might provoke an attraction toward the base of their components, due to gravity, which might differ for several reasons, such as viscosity Ditropan XL (Oxybutynin Chloride Extended Release Tablets)- FDA hydrosolubility.

All solvents and reagents were from BHD (Poole, England). Standard acetaminophen came from Sigma-Aldrich Srl (Milan, Italy). All commercial brand suppositories containing acetaminophen sold in Italy (125, 150, 250, 300 and 500 mg) were purchased in local drugstores. Acetaminophen content was measured by UV-Vis spectroscopy.

All samples were diluted with the same solvent mixture to have an UV absorption at 248 Ditropan XL (Oxybutynin Chloride Extended Release Tablets)- FDA in the range 0.

The partition of the suppositories was realized with the same technique that would be used in practice to yield one half the value of the dose. The accuracy in partition was evaluated Ditropan XL (Oxybutynin Chloride Extended Release Tablets)- FDA comparison of the weight of the two portions of the suppositories (head and tail), its acetaminophen content and the uniformity of its distribution.

The partition of the suppositories was simple to obtain, and the two portions (head and tail) retained their integrity so that they could be administered to a patient. The results obtained for uniformity of Ditropan XL (Oxybutynin Chloride Extended Release Tablets)- FDA of the various suppositories (entire, head and tail) are summarized in Figure 1.

In no instance did the partition of the suppositories led to significant differences (t-test) between weights of the head and tail portions. The results obtained for acetaminophen content in the various suppositories (entire suppository, head and tail) are summarized in Figure 2. In no Ditropan XL (Oxybutynin Chloride Extended Release Tablets)- FDA did the partition led to significant differences (t-test) between acetaminophen content of the head and tail portions.

The distribution of acetaminophen in the suppositories was determined with consideration to the weight of the sample (entire, head or tail portion), and the results are summarized in Figure 3. All the suppositories analyzed, of each brand investigated, showed a good homogeneity. In no case did the partition led to significant differences (t-test) between acetaminophen distribution of the head and tail portions.

Partitioning acetaminophen suppositories is a common practice, but there are few data in the literature regarding the correctness and appropriateness of this kind of procedure. Our results are coherent with those of other studies which concluded that the analyzed commercial suppositories containing acetaminophen are of good quality in regard to homogeneity of content of the active ingredient.

However, those authors concluded that the accuracy of partitions is unsatisfactory for achieving the target dose, and that only the whole suppositories were certain to contain the target dose. This study was limited, however, in its ability to establish if this deviation is due to human error during the suppository portioning or if it is a product deviation. Splitting suppositories is a viable medical procedure, since chance of error is journal of the taiwan institute of chemical engineers low and very much operator-related.

Considering the homogeneous distribution of the drug inside the suppositories, each portion contains proportionally the right amount of active ingredient.

The problem of dividing a tablet or a suppository accurately is not limited to acetaminophen, but involves other drugs, in particular in pediatrics. A tight collaboration between pharmacologists and pediatricians is required, because when using drugs for infants or children that are otherwise formulated for adults it may become necessary to divide them, and it is indispensable to be aware of doing the right thing.

A manual split of a paracetamol suppository can be accurate and safe enough to be performed routinarely. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.

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