Good morning all!  We have recently switched from in-house compounded sildenafil suspension to a commercial preparation for batched oral syringe doses.  We have found significant foaming with the commercial product, leading to lower than expected volumes in the final syringe once the product has settled.  In discussions with the manufacturer, we have been told via one source to ensure vigorous shaking and by another to avoid vigorous shaking.   We have trialed preps at room temp and refrigerated, immediately after reconstitution and hours after, vigorous and non vigorous shaking, and still see significant foaming.  

If your institution is currently using the commercial product, what strategies have you employed to achieve best results?

Regards,

Tommy

Tommy Lupton, PharmD, MBA, BCPS (he, him, his)
Pharmacy Manager
Children's Hospital Los Angeles