Variations in captopril formulations used to treat children with heart failure: a survey in the United kingdom.
OBJECTIVE
Different liquid formulations of a drug prepared for use in children cannot be assumed to have therapeutic equivalence. The objective of this study was to ascertain the interhospital constancy of unlicensed liquid captopril formulations used to treat children with heart failure in the UK.


METHODS
A questionnaire-based telephone survey.


METHODS
13 tertiary paediatric cardiac centres in the UK and 13 large hospitals referring patients to these centres.


METHODS
The study included pharmacists responsible for providing the pharmaceutical input to children with congenital heart disease or a pharmacist designated to cover paediatric services. Technical staff employed by "specials" manufacturers also participated.


RESULTS
Four hospitals dispensed captopril tablets for crushing and dissolving in water before administration; the remaining 22 used nine different liquid formulations of captopril. Only three cardiac centres and their referring hospitals were found to be using the same liquid captopril formulations; 10 centres and their referring hospitals were using completely different captopril formulations.


CONCLUSIONS
This survey shows that paediatric cardiac centres and their referring hospitals use a variety of unlicensed liquid captopril formulations interchangeably. This degree of inconsistency raises issues about optimal captopril dosing and potential toxicity, such that its use may influence paediatric cardiac surgical and interventional outcomes.
Mulla
Hussain
H
Centre for Pharmacy Practice Research, Glenfield Hospital, Leicester, UK.
Tofeig
Magdi
M
Bu'Lock
Frances
F
Samani
Nilesh
N
Pandya
Hitesh C
HC
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000737:chemistry* / Q000627:therapeutic use; D002216:Captopril / Q000737:chemistry* / Q000627:therapeutic use; D002626:Chemistry, Pharmaceutical; D002648:Child; D017277:Drug Approval; D004355:Drug Stability; D004363:Drug Utilization; D019538:Health Care Surveys; D006330:Heart Defects, Congenital / Q000150:complications; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D019999:Pharmaceutical Solutions; D010607:Pharmacy Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D011364:Professional Practice / Q000592:standards; D013607:Tablets; D006113:United Kingdom
D000806:Angiotensin-Converting Enzyme Inhibitors; D019999:Pharmaceutical Solutions; D013607:Tablets; D002216:Captopril