Variation in captopril formulations in pharmacies across Canada

Captopril, an angiotensin-converting enzyme inhibitor used to manage congestive heart failure in the paediatric population, has limited data on efficacy and safety. Its variety of liquid formulations dispensed by different pharmacies poses a challenge in optimizing captopril dosing in patients. Fourteen tertiary paediatric centre pharmacies across Canada were contacted to decipher the type of captopril formulation they dispense, their recipe and the stability of each formulation. Of the 14 centres surveyed, four dispensed solid tablets, two dispensed either solid tablets or liquid formulations, and eight dispensed extemporaneously prepared liquid formulations. There was also great variety in the solutions used to prepare the liquid formulations. The bioequivalence of these preparations has not been studied. As a result, physicians cannot be certain about the effective dose of captopril. Uniformity is recommended among paediatric pharmacies in Canada when preparing medications such as captopril. Proper testing of the stability and bioequivalence of medications is recommended.