ABSTRACT:
Drug compounding is still carried out throughout the world, especially in developing countries like Indonesia. Drug compounding from the solid dosage formed by splitting or crushing the tablet might change the stability, pharmacokinetic profile, and drug irritation. Most of the pharmacist in Indonesia had a limited time to do a risk assessment for potential incompatibility and instability of drug combination in compounding preparation. This article was aimed to provide an overview of compounding practice in divided powder preparation in Indonesia and as a case study of potential incompatibility and instability of an extemporaneous preparation. This study is an observational study using a case study. The consideration in selecting the case is the prescription that is most frequently prescribed in five months of the study period will be chosen. Risk assessment of technical risk in compounding was conducted using a matrix based on the Handbook on Extemporaneous Preparation. Analysis of instability and incompatibility potency was conducted based on the literature review (descriptive analysis). There were 666 prescriptions that needed compounding preparation. The most frequently prescribed formula was the combination of cetirizine tablets, ketotifen tablets, and cyproheptadine tablets that must be crushed to be divided powder. The combination has instability potency. The instability might be prevented by proper packaging and storing. A pharmacist must be able to understand the physical and chemical properties of each drug that is prescribed to determine the potential instability and incompatibility that may occur in the compounding order. Furthermore, the pharmacist must decide the most appropriate solution to overcome the incompatibility or instability that occur. This is the part of quality assurance of compounding preparations, so that patients will get safe and effective drugs, and can prevent medication errors.