COMPOUNDING SPIRONOLACTONE
​BULK ORAL SUSPENSION

INSTRUCTIONS FOR FLOAT 1 PHARMACIST
1) Obtain 5 tablets of Spironolactone 25 mg tablets, bottle of Simple Sugar, 60 ml Rx Bottle, RX crusher, EnFit Pouch, 10 ml Enfit Syringe, 2 HD Clean Wipes, non-sterile chemotherapy prep mat, and 3 zip lock bags
2) Make MILT labels for bulk Spironolactone Suspension Bottle
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3) Don PPE:
  • 2 pairs nitrile gloves
  • Chemo gown
4) Place a non-sterile chemotherapy prep mat on pharmacy counter
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5) Draw up 10 ml of Simple Sugar in and EnFit syringe
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6) Place 5 tablets of Spironlactone 25 mg in the EnFit Pouch then attach the EnFit syringe of Simple Sugar to the Enfit Pouch. Place empty tablet packaging in a zip lock bag for checking.
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7) Using the RX Crushers, crack the tablets with the platform, then crush the tablets with the roller moving the EnFit Pouch with the syringe attached until desired consistency is reached.
8) Inject 10 ml of Simple Sugar into the Enfit Pouch to dissolve the tablet. When the tablets are dissolved draw the solution out of the pouch and place in RX bottle. QS Rx bottle with the rest of Simple Sugar (15 ml) for a total volume of 25 ml to make a final concentration of 5 mg/ml. Place cap on the RX bottle and shake the bottle
9) Wipe RX bottle with HD Clean Wipe 1 and wait 30 seconds, then wipe the bottle with HD Clean Wipe 2 and allow surface to dry. Place used wipes in a zip lock bag for disposal

10) Remove outer gloves and place in a zip lock bag, then label the stock bottle with MILT label and place in empty bag for checking.

11) Clean pharmacy counter with HD clean wipes and RX crusher with soap and water, then dispose all used PPE and chemotherapy prep mat in the chemo trash by the hazardous medication cart
12) Wash hands with soap and water.
13) Have a 2nd Pharmacist check stock bottle in MILT computer and place bottle on the designated NIOSH shelf by the MILT computer
14) Place empty Spironolactone tablet packaging in Black Hazardous Container
15) Follow repackaging instructions for Reproductive Risk oral syringes