18 de junho de 2020

Oral anticancer drugs: To crush or not to crush

Tine Van Nieuwenhuyse, Birgit Tans, David Devolder, Isabel Spriet.

Hospital Pharmacy Department, UZ Leuven, Leuven, Belgium. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium 

Objective/purpose: Healthcare professionals, involved in the daily care of cancer patients, are faced with the growing issue using oral anticancer drugs in patients experiencing swallowing difficulties. The lack of commercially available oral liquid dosing forms might compromise initiating or prolonging necessary therapies in this patient population. Pharmacists are often challenged to provide liquid alternatives for oral drugs that have solely been made commercially as a solid formulation; therefore, it is common practice to crush tablets or to prepare oral liquids from solid forms. When preparing liquids ex tempore, a number of requirements need to be fulfilled. In addition to chemical, physical and microbiological stability of the active ingredients, therapeutic and toxicological aspects should be the subject of review. The goal was to develop a guide for healthcare providers in order to assist them in providing scientific and up-to-date information for patients who are in need of special dosing forms.

Study design/methods: A literature search in PubMed/Medline was conducted. Also, the registration documents and relevant phase I and II data from the pharmaceutical industry, U.S. Food and Drug Administration and European Medicines Agency were used as a source of information. 

Results/key findings: An overview for healthcare providers was drafted. Sixty-two oral anticancer drugs that were available on the Belgian market at the moment of the development were included. 

Conclusion/recommendations: The development of a pocket guideline has increased the awareness and will be added to the standard of care as to improve safe medication use in patients with swallowing difficulties.

Selected abstracts presented at the XVI Symposium of the International Society of Oncology Pharmacy Practitioners April 26-29, 2017, Budapest, Hungary

J Oncol Pharm Practice 2017, Vol. 23 4(Supplement) 1–21.