How to prepare following eye drops: Nystatin 100 mg after chloride 90 mg chlorhexidine Acetate 1 mg Aqua ad 10 ml

Based on the composition, I suspect that a precipitation occurs. This is due to the combination of chlorhexidine with NaCl. Consequently, there are 2 solutions logically. I suggest replacing the NaCl with another isotonising compound, preferably a non-ionogen product like e.g. Mannitol. You can therefore safely use the isotonic concentration and it is: 5% In addition, we still have the problem of low solubility in water of Nystatin 4 mg/ml!

so there will be a suspension to be prepared and this is not evident in an officina. I do not know how you are equipped otherwise you can follow the example of other colleague & #039; s, who invoke the services of a hospital pharmacy to dispose of a LAF cabinet.

According to the literature, Nystatin is not sterilizable by heat and of course also not by filtration. There remains only the possibility of an aseptic preparation whereby all material, suspension medium and vial are sterilized by heat. Thereafter, in the LAF cabinet, the Nystatin, which was weighed by reweighting, in a sterilized mortar, is gradually rubbed with the reinforced suspension medium with a sterilized pestle and spatula. Eventually, the suspension is poured into the sterilized Zentrop vial. All this under aseptic conditions.

a not impossible task but still not easy.