Abstract

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 inter-hospital constancy of unlicensed liquid captopril formulations used to treat children with heart failure in the UK.

Design: A questionnaire-based telephone survey.

Setting: 13 tertiary paediatric cardiac centres in the United Kingdom and 13 large hospitals referring patients to these centres.

Participants: Pharmacists responsible for providing the pharmaceutical input to children with congenital heart disease or a pharmacist designated to cover paediatric services. Also technical staff employed by “specials” manufacturers.

Results: 4 hospitals dispensed captopril tablets for crushing and dissolving in water prior to administration; the remaining 22 used 9 different liquid formulations of captopril. Only 3 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 inter-changeably. This degree of inconsistency raises issues about optimal captopril dosing and potential toxicity to a level where its use may influence paediatric cardiac -surgical and -interventional outcomes.