title: Compounding of vitamin A, D3, E and K3 supplements for cystic fibrosis patients: formulation and stability study.
abstract: OBJECTIVE
  Cystic fibrosis (CF) patients suffer from malabsorption of fat-soluble vitamins (A, D, E and K). These vitamins are available as water-dispersible (A, D(3) and E) or water-soluble grades (K(3)), which is favoured in CF patients as they fail to absorb oil-based products. The objective of this study was to determine stability of these raw materials after opening the original package and to develop a compounded formulation of acceptable quality, stability and taste, allowing flexible dose adaptation and being appropriate for administration to children and elderly people.
  
  
  METHODS
  The raw materials were stored after opening their original package for 8 months at 8 degrees C and room temperature (RT). Stability was assessed using a validated HPLC method after extraction of the vitamin from the cold water-soluble matrix (vitamin A acetate, D(3) and E) or using a spectrophotometrical method (vitamin K(3)). These materials were mixed with an appropriate lactose grade (lactose 80 m for vitamins A and D(3); lactose 90 m for vitamin E, lactose very fine powder for vitamin K(3)) and filled in hard gelatin capsules. Mass and content uniformity were determined and stability of the vitamins in the capsules was assessed after 2 months storage at 8 degrees C and RT.
  
  
  RESULTS
  All raw materials showed good stability during storage in the opened original package for 8 months storage at 8 degrees C as well as RT (>95% of the initial content). The compounded formulations complied with the requirements of the European Pharmacopoeia for mass and content uniformity and can be stored for 2 months at 8 degrees C or RT while maintaining the vitamin content between 90% and 110%.
  
  
  CONCLUSIONS
  As these fat-soluble vitamins are not commercially available on the Belgian market, compounded formulations are a valuable alternative for prophylactic administration of these vitamins to CF patients, i.e. a stable formulation, having an acceptable taste, allowing flexible dose adaptation and being appropriate for administration to children and elderly people.
authors.affiliation: Laboratory of Pharmaceutical Technology, Ghent University, Gent, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Huyghebaert
authors.forename: J
authors.initials: J
authors.lastname: De Beer
authors.forename: C
authors.initials: C
authors.lastname: Vervaet
authors.forename: J P
authors.initials: JP
authors.lastname: Remon
mesh_terms: D002214:Capsules; D002762:Cholecalciferol / Q000008:administration & dosage / Q000737:chemistry* / Q000627:therapeutic use; D002851:Chromatography, High Pressure Liquid; D003550:Cystic Fibrosis / Q000188:drug therapy*; D004338:Drug Combinations; D004339:Drug Compounding; D004355:Drug Stability; D004356:Drug Storage; D006801:Humans; D013053:Spectrophotometry; D013649:Taste; D014801:Vitamin A / Q000008:administration & dosage / Q000737:chemistry* / Q000627:therapeutic use; D014810:Vitamin E / Q000008:administration & dosage / Q000737:chemistry* / Q000627:therapeutic use; D024483:Vitamin K 3 / Q000008:administration & dosage / Q000737:chemistry* / Q000627:therapeutic use; D014815:Vitamins / Q000008:administration & dosage / Q000737:chemistry* / Q000627:therapeutic use
chemical_list: D002214:Capsules; D004338:Drug Combinations; D014815:Vitamins; D014801:Vitamin A; D014810:Vitamin E; D002762:Cholecalciferol; D024483:Vitamin K 3