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Dispersible calcium carbonate preparation

For more information obtaining calcium carbonate dispersible tablets in the community, please click here

Discontinuation of Ditropan® (oxybutynin) 2.5mg/5mL elixir

Ditropan® (oxybutynin) 2.5 mg/5 mL elixir manufactured by Sanofi has been discontinued; therefore when stocks have run out it will no longer be available. We do not know of any other child suitable oxybutynin liquid at present.

Children who are currently taking oxybutynin in liquid form will have their prescriptions changed to tablets. The standard release oxybutynin 2.5 mg and 5 mg tablets can be crushed and dispersed in water for administration.  For smaller doses of 1.25 mg a 2.5 mg tablet can be dispersed in 10 ml of water and a 5 ml aliquot given.

If you require further information please contact This email address is being protected from spambots. You need JavaScript enabled to view it., Paediatric Renal Pharmacist at Nottingham Children's Hospital.

Discontinuation of Calcium Sandoz

Calcium Sandoz is being discontinued. This is the main liquid calcium supplement that has been used in children.  Suitable alternatives would be Cacit or Sandocal tablets (which requires dispersal in a known volume of water and taking the required proportion).  There is also another liquid formulation available: Alliance calcium syrup.  It contains a very similar amount of calcium per 5 ml (102 mg vs 108.3 mg).

More information about alternative preparations is available from Peter Foxon, Paediatric Renal Pharmacist at Nottingham Children's Hospital on This email address is being protected from spambots. You need JavaScript enabled to view it.

Discontinuation of Paediatric Renal Dialyvit®

The vitamin supplement used in our dialysis patients has unfortunately been discontinued by the manufacturer.   We will be converting patients to two different formulations depending on age.

Less than 5 years:  Ketovite®, 1 tablet ONCE a day

5 to 16 years:  Ketovite®, 1 tablet TWICE a day

16 years and over:  Renavit®, 1 tablet ONCE a day

If you require further information please contact Peter Foxon, Paediatric Renal Pharmacist at Nottingham Children's Hospital on This email address is being protected from spambots. You need JavaScript enabled to view it.

Changes to Sodium bicarbonate liquid

From 12th September 2016 the Nottingham University Hospitals Pharmacy non-sterile manufacturing unit will cease to manufacture sodium bicarbonate 1 mmol/mL oral solution.

Patients who currently obtain sodium bicarbonate liquid through Nottingham University Hospitals will change to one of two options:

a)      Opening the 500 mg capsules (containing 6mmol bicarbonate and 6 mmol of sodium) and dispersing the contents in water

b)      A 1 mmol/ml oral solution from an alternative manufacturer. Mandeville medicines

The new sodium bicarbonate 1 mmol/ml oral solution differs from the current product in the following ways:

a)      Different storage conditions and expiry (once opened store in the fridge, 7 day expiry once opened)

b)      Does not come with a children resistant closure

c)       Contains a preservative (Disodium Edetate 0.01%)

The disadvantages of this liquid mean that for the majority of our patients we will recommend switching to the opening capsules method including those who are tube fed. This may mean some doses need to change to a multiple of 6 mmol.

The capsules should not be chewed. The capsules should be opened and contents mixed with water (milk or juice are acceptable if appropriate) or a small amount of soft food. More information can be found on the Medicines for Children website

If you require further information please contact Peter Foxon, Paediatric Renal Pharmacist at Nottingham Children's Hospital on This email address is being protected from spambots. You need JavaScript enabled to view it.

oral drugsHere are a range of resources that local pharmacists, paediatricians and nurses may find of use.  

The best resource for dosing in children with impaired renal function is to base doses on a combination of the proportional dose reduction from the Renal Drug Handbook on children's doses found in BNFc.  The Renal Drug Handbook should be available in most hospital pharmacies.  

Practical information on specific renal drugs

  1. Aranesp (information on dosing and conversion from erythropoietin)
  2. Calcium carbonate dispersible tablets. 
  3. Calcium carbonate suspension How to obtain this if local supply difficult.
  4. Citrate conversion chart
  5. Cyclophosphamide Dosing/preparation/supply for use in nephrotic syndrome.  
  6. Renvela (how to make up sevelamer sachets)

 

High risk drug monographs for patients with renal impairment from Nottingham Children's Hospital

  1. Morphine
  2. Gentamicin
  3. Vancomycin
  4. Sodium bicarbonate
  5. Intravenous potassium
  6. Intraperitoneal potassium
  7. Urokinase for treating blocked central venous lines
  8. Rituximab
  9. Intravenous methylprednisolone
  10. Intravenous immunoglobulin
  11. Tazocin 
  12. Alteplase line lock dialysis lines
  13. Cyclophosphamide
  14. ATG renal
  15. Eculizumab
  16. Enoxaparin
  17. Ketamine for renal biopsies

 If you have other suggestions for high risk drug monographs that you would like to see here please email This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it. 

Useful links

  • Medicines for children.  Information leaflets for patients on a wide range of drugs
  • MHRA.  Information on the regulation of children's medicines.
  • British National Formulary.  Via Medicines Complete (available only from NHS computers and registration required)