Long‐term Stability of a Compounded Suspension of Torsemide (5 mg/mL) for Oral Administration

Background Torsemide use for congestive heart failure ( CHF ) has been reported, but prescription frequency is unknown. Commercially available tablet sizes in North America limit dosing precision, indicating a need to evaluate its strength and stability in suspension. Objectives To determine the frequency of torsemide prescriptions and to determine a beyond use date ( BUD ) of a compounded suspension of torsemide for oral administration stored under 2 temperature conditions for 90 days. Animals No animals used. Methods Pharmacy records were retrospectively reviewed for torsemide and furosemide prescriptions from 2008 to 2015 at 2 veterinary referral centers. After preliminary strength testing, compounded torsemide suspension (5 mg/mL) for oral administration was prepared using torsemide tablets suspended in OraPlus:OraSweet 1:1, buffered to a pH of 8.3 and stored at refrigeration (2–8°C) and room temperature (20–25°C) in 2 oz amber plastic bottles. Samples were analyzed by reverse phase high‐performance liquid chromatography ( RP ‐ HPLC ) on days 0, 14, 30, 60, and 90. Results Prescriptions for torsemide increased from 2008 to 2015. Analysis of the torsemide 5 mg/mL suspension for oral administration at each time point met United States Pharmacopeia ( USP ) requirements for torsemide content of 90–110% of label claim. The average strength at 90 days decreased to 92 ± 3% at 2–8°C and 95 ± 2% at 20–25°C. Stability testing did not detect unknown impurities. Conclusions Increasing torsemide use warrants availability of a validated and stable compounded formulation. Our results support the assignment of a 90‐day BUD for torsemide 5 mg/mL suspension for oral administration compounded in OraPlus:Sweet 1:1 buffered to a pH of 8.3.