You Can Make Your Own Liquid Tamiflu At Home

G.’s young son was recently ill with H1N1, but no pharmacy in the city where he lives had liquid Tamiflu in stock. (Even the federal government released its stockpile not long ago.) He writes that nearly every pharmacy he called turned him down. Then he learned that the liquid can be made from Tamiflu capsules by pharmacists, or even by parents at home. Why didn’t the pharmacy staff, or his doctor, tell him this?

He writes:

When his H1N1-induced fever spiked at 104, I brought my 16-month-old son to the pediatrician, who promptly prescribed Tamiflu.

When I arrived at CVS, I was told that they were out of stock of the liquid form and none would be available until late the next day. Further, I was told that none of the other CVS branches had any liquid Tamiflu. I called around and, sure enough, no pharmacy in the area had any liquid Tamiflu.

Knowing that Tamiflu needs to be taken promptly, I panicked and called my sister-in-law, who is a doctor in another city. She told me that although the liquid can be out of stock, pharmacists can make liquid Tamiflu from Tamiflu capsules.

I returned to CVS, asked the pharmacist if this could be done. I was told that it would take a half-hour. I am furious that he did not volunteer this information the first time around.

Parents, do not take “no” for an answer. Especially for at-risk children like mine, insist that the liquid be made promptly.

If you’re not able to find a pharmacy equipped to make the liquid for you, the CDC has posted instructions for parents on how to make their own liquid Tamiflu out of the adult capsules.

What liquids can I use?

A thick and sweet liquid, such as regular or sugar-free chocolate syrup, that masks the flavor of the medicine can be mixed with the contents of the Tamiflu® capsule. Sugar-free sweet liquids are available. The child should consume the liquid mixture entirely.

If my child can’t swallow capsules, how do I open Tamiflu capsules and mix the medicine?

Pour a small amount (about a spoonful) of sweet, thick liquid into a cup or bowl. Carefully open the Tamiflu® capsule prescribed by your doctor and pour out all of the powder inside the capsule and mix it into the liquid. The exact amount of liquid used doesn’t matter, as long as the powder inside the capsule is mixed in well. (All of the medicine may not dissolve. Just be sure it is all well mixed.) Use only the prescribed dose.

What will I need to do this?

You will need

* The prescribed Tamiflu® capsule
* A small bowl or cup and a spoon
* 1-2 Teaspoons of sweetened liquid

How do I mix the ingredients?

* Pour a small amount (about a spoonful) of a sweet thick liquid into a cup or bowl.
* Holding one capsule over a small bowl, carefully pull the capsule open and pour the complete contents of the capsule into the bowl.
* Stir the mixture and give the entire dose to the child with a spoon.

Should my child take all of the mixture?

Yes, make sure your child takes all of the medicine mixture.

Opening and Mixing Tamiflu® Capsules with Liquids if Child Cannot Swallow Capsules [CDC]
D.I.Y. Tamiflu for Kids: Pharmacists Cope With Shortage [ABC News]

(Photo: timsnell)

Comments

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  1. jakesprincess says:

    This is exactly what happened to me a few weeks ago. Very ill child, could not find Tamiflu to save my life. I was told to do mail order. Huh? Walgreens said they had not been able to get it for three weeks. Now I am wondering if what was really the case was all the pharmacies were out of the liquid form (my daughter is too young for capsules. No one I spoke to volunteered any kind of information or guidance.

    We rode out the flu without the medicine. I gave up after two days of calling and driving to places to try and find it.

    This scares me. If we have a shortage like this now, what will happen when flu season really picks up?

    • coffeeculture says:

      @jakesprincess: I’ve worked in a pharmacy before…a lot of the chain/corporate pharmacies were either a) forbidden from creating the liquid formulation or b) face some sort of red tape in terms of dispensing.

      The correct term for this is “compounding” and if you have bad luck with chain stores, try smaller independent pharmacies…some specifically exist for compounding only, we used to send patients needing this service there.

      Another issue is billing…our hands were tied with insurance such that we could not dispense one item and bill for another. Technically, we would be giving you (the patient) a liquid formulation but bill for the capsules. Further, compounded items are billed differently and many chain stores lack the ability to bill for it, so chains often forbid their pharmacists from compounding since they get paid the same as simple tablets…chains are all about efficiency, and the time involved in traditional compounding doesn’t warrant the payment.

      Another issue is the way the prescription was written. If a physician writes for Tamiflu oral suspension, by law the pharmacists hands are tied in that they cannot simply interchange into the capsule format.

      But you are right, they should have at least told you about other options; sometimes, it just doesn’t pop into our heads, especially if it’s a brief encounter on a busy day.

      Best tip from me: When you go to your physician, ask for two prescriptions: one for the capsules, one for the liquid formulation. That way, if you go to the pharmacy at 7pm and they don’t have the liquid formulation but they do have the capsules, you can just hand in the capsule script and not wait until the pharmacy gets a hold of your physician the next morning.

      Be prepared to shop around with different chains…ask when they get their primary order in (usually once a week) and come in on that day (if you can). If it arrives at, say 10am…a well staffed pharmacy should have it on the shelf by mid-afternoon.

      Sorry for the long response, hope this helps for the next time!

      • catastrophegirl chooses not to fly says:

        @coffeeculture: because i can’t take pills, if i have to take antibiotics my doctor always writes the prescription with the order “convert to liquid” on it so that the pharmacy doesn’t argue.
        never had a problem with CVS doing this for me.
        i don’t know if they get antibiotics in a form that makes it easy though

        • coffeeculture says:

          @catastrophegirl: Depends on the antibiotic…a lot are preformed in a bottle and we just added water (usually for kids) with the machine in the back.

          Can’t remember off the top of my head if some antibiotics came in liquid form already.

          It’d be highly unusual if your CVS straight up compounded it, but I have seen other chains (Walgreens specifically) have pharmacies that do it.

          • NancyCpants says:

            @coffeeculture: I work for a large chain pharmacy which I won’t name, but we are a compounding pharmacy. I have personally made a gallon or two of compounded Tamiflu suspension this year.

            There are laws that prevent the compounding of a manufactured product, but there are also laws that allow you to compound that product when it is not available from the manufacturer.

            Billing and making compounds is not hard, but it’s time consuming. Pharmacies are staffed with people who are not mathematically or medically minded. I don’t mean to denigrate technicians, because I am one and I have no plans to become a pharmacist, but a lot of people working the job simply don’t have the aptitude for it.

            Honestly, even if we didn’t have our billing software set up to allow for proper billing of compounded medications, it would still be quite possible to file paper claims rather than the online claims pharmacies today use. It’s just an extra step and takes a little more work. Combine slashed personnel hours, high volume, and people without the desire to even do it, and you run into a problem.

            And I still laugh at adults who can’t swallow pills. A medical condition is one thing, but if you can swallow food you can swallow a pill.

  2. SDreamer says:

    During the flu season, pharmacies obviously get swamped, and the busier they are, the more they work, the more grumpy they get. Not an excuse for bad customer service, but it is almost pretty much fact. I think it would be good to know any local indepedent pharmacies, as they deal with a smaller amount of patients, and just generally have better customer service. Time is the pressure when it comes to dealing with children, parents want things done asap, and don’t generally care what the excuse is till after. So its best just get the medicine instead of getting fed up with poor customer service that really has no excuse.

    • pittpanther says:

      @SDreamer: So let me get this right… Pharmacists get grumpy when they have MORE business? So they must be downright giddy when their store is completely empty?

      Tell you what… How about I take my prescriptions to a pharmacist that understands basic concepts of business: customers == profit.

  3. JohnDeere says:

    my doctor specifically sent me to a pharmacy that could do this. the pharmacy said it wasnt necessary and wouldnt do it. i had to pay my little girl the first time to take it (broke pill open and sprinkled on hersheys syrup). after that she didnt want the money or the medicine. its evidently so bad that they hersheys syrup couldnt cover it up.

    • pecan 3.14159265 says:

      @JohnDeere: When I was a kid, if I was sick, there were only two ways of taking medicine: I either took it willingly or I took it against my will. Either way, I took my medicine. Mom didn’t care that I sulked for an hour afterward, or that it tasted bad. If it’s between sulking because I taste medicine for an hour in my mouth afterward and getting sicker, there was no room for sympathy for my mom. I had to do what was needed for my own health.

    • SagarikaLumos says:

      @JohnDeere: Info I didn’t know. I would willingly eat a spoon of Hershey’s Syrup most any time. If it couldn’t make Tamiflu edible, I don’t think that the drug store has anything that could.

      • Rachacha says:

        @SagarikaLumos: My son had some medicine some time ago when he had a very, very mild case of Pneumonia. The first day was an absolute chore to get him to take the med. We dried diluting it in a large glass of milk with extra chocolate syrup, milkshakes, everything. We eventually just settled on 1/2 teaspoon at a time, administered via medicine dropper way at the back of the mouth, followed by a 6oz milk chaser.

        Just to see if he was over reacting, I tried about 1/8 teaspoon of the medecine, and I can say without a doubt that it was the nastiest medicine that I have ever had. White liquid that had the consistency of Pepto, with a granular substance about the size of a grain of sand, with the consistency of chalk.

        I wish I could remember the medicine so I could be sure to NEVER get it again.

    • Oranges w/ Cheese says:

      @JohnDeere: Try honey – try holding her nose (that should help).

      Also tell her she won’t get better if it doesn’t taste bad because she’d want to stay sick so she can have more yummy medicine!

    • shepd says:

      @JohnDeere:

      That’s when you start calling their competence into question.

      “If you’re not a compounding pharmacy, then please tell me where the closest one is.”

    • outlulz says:

      @JohnDeere: If you’re paying your kid to do something like that you’re setting yourself up for behavior problems in the future.

      • liquidnumb says:

        @outlulz: For gods sake if their kids are sick and it works, let them do it. It wouldn’t be worth the time, effort and stress to develop a working relationship with your young child while he or she has the flu or pneumonia or what else.

        • emmaforce says:

          @liquidnumb: I was also forced to take any medicine I didn’t eat willingly as a child. Mouth pried open, medicine shoveled in, mouth forced closed.

          My daughter surprised me by fighting it off and then gagging it back out when I forced it upon her. You can get in in their mouth, sure, but you can’t make them swallow it. And if they do swallow it, you can’t stop them from heaving it back up.

          If I could have those hours of my life back that were spend wrangling with her and watching her puke medicine back up onto the floor?? I’d have paid her ten bucks and been grateful.

  4. theblackdog says:

    $10 says this is happening because of all the panicky folks who get their doctors to write prescriptions for Tamiflu so they can stockpile the stuff before they get sick.

    Thanks for taking it away from the folks who actually need it, jackasses.

    • katstermonster says:

      @theblackdog_FeelingRandom: You’re probably right: [en.wikipedia.org]

    • Wombatish says:

      @theblackdog_FeelingRandom: It wasn’t that they refused him Tamiflu, they (and everyone else) were out of the liquid, and they aren’t a compounding pharmacy (probably a grocery store pharmacy or a CVS, they’ve refused to compound on me several times, even when it’s on the scrip).

      The issue is that Doctors are writing scrips, or patients are requesting services that are perfectly reasonable, but because of various constraints (mainly money, time, and insurance/liability), pharmacies are refusing.

      It’s 75% bull-poop, especially when they advertise “Ask me about liquid medicine for your kids!” and most parents don’t realize there’s a difference between a compound and a liquid, and the pharmacist (unless they’re one of the few saints who actually care ((a good pharmacist is a lovely thing to have, and worth holding on to))), won’t take five minutes to explain, or refuse to put up the dumb sign and just offer the service on a case by case basis.

  5. skeksis says:

    I work at a grocery-store pharmacy (not as a pharmacist, just a clerk), and we had to do this for a while because there was a big run on the liquid Tamiflu. If we were running low, we never turned anybody away, but we did let them know it would take longer than usual.

    I could understand this kind of treatment if the pharmacy were short-handed and overrun with customers. Sometimes it’s faster to get it somewhere else than to wait for it. But the customer definitely needs to be informed so that they can make the right decision.

    And they definitely need to know that sometimes, they just have to wait for it. Rushing prescriptions is never a good idea.

  6. unpolloloco says:

    I think making the liquid adds extra liability for the pharmacy – therefore, they don’t do it unless asked.

  7. hi says:

    The shortage of tamiflu reminds me of the vaccine shortage which is an artificial shortage created to get people to take the vaccine.

    Here the CFR memeber talks about it and proves there is no shortage at all.


    + Watch video

    Could the tamiflu shortage be the same artificially created shortage to either jack up the price or maybe another way to get people to take the vaccine?

    • bhr says:

      @hi: Ample Supples /= no shortage

      There was a significant shortage in parts of the country, as the supply model from years past did not meet the needs of significant population centers who were doing more clinics and massive distributions then usual. I know my company gave out nearly 100 shots just at my office.

    • HappyPig says:

      @hi: Having watched the video a few times, I don’t think they’re actually saying what you think they say. Here’s the transcript of the part you’re referring to:

      Jon Cohen (writer for Science Magazine): Well there is a shortage.
      Lone Simonsen (researcher at George Washington University): No, actually, because we thought we were going to need two doses for every adult and since we are – only one dose, so, actually, we have twice as many doses and enough for the whole population at this point…
      Jon Cohen: But it’s not there today, so…
      Lone Simonsen: Right, right. But I mean, that’s … (tapers off)

      Basically what’s being said is that the H1N1 vaccine efficacy was recently shown to good enough to require only one shot, meaning that twice the number of people will now be able to get the vaccine. Jon Cohen realizes that she’s misspoken, and clarifies what Dr. Simonsen has just said. His point is that even though the vaccine is twice as “good” as was initially thought, there still isn’t enough for the population AT THIS POINT. To that, Dr. Simonsen says “Right, right.”

      Where in that full statement, in context, do you decide that she’s proved (your verb) that there’s no shortage? She said one thing, got corrected, and revised her statement.

    • mobiuschic42 says:

      @hi: She says they created an artificial shortage *in the past,* not in this case.

      I work for a hospital and we’re out of both H1N1 and seasonal flu vaccines to give to providers and personnel (I’m IS, so I’m down the line of needing it, but they just don’t have it). There was a recent government mandate requiring all hospital personnel (myself included) to report a) if we’ve received the seasonal vaccine, b) if we want to receive it and haven’t been able to get it, or c) decline to receive it. The “can’t get it” option is real.

      • hi says:

        @mobiuschic42: No she says the best way to get people to take the vaccine is to create an artificial shortage. The she refers to a year when people lined up for it at night to take it. She is saying they “should” artificially create the shortage to get people to take the vaccine. And now that is what you are seeing. The reason you can’t get it is because they are either 1) Not experienced enough to handle such a task (and you want to hand over all health care to these people) or 2) They created the shortage as stated by the CFR. I’m going to say since they proposed to create a shortage and now there is a shortage… wait for it… wait for it… they created the shortage.

        Now another link for those who think the vaccine is safe: This is the the second case (I posted the first yesterday) of someone being harmed by the vaccine.

        1) [www.msnbc.msn.com]

        2)
        [www.monstersandcritics.com]

  8. xoxor says:

    I hit this too, but with a catch:

    The pharmacy was not on my health insurance list of “compounding” pharmacies. Insurance would only pay their portion of the cost if I received the capsules in their original form.

    Otherwise I was told it would be about $100 out of pocket.

    What did I do? Took the capsules as packaged, did a little research and verified the dose in the liquid form vs the capsule form, and simply poured the capsules onto a spoon full of yogurt or ice cream.

    My son ate it with no real issues. BTW: I tasted a tiny bit of the medicine – it isn’t pleasant but isn’t that bad either. A reasonably strong flavored yogurt should suffice.

    • pecan 3.14159265 says:

      @xoxor: The worst medication I have ever taken was liquid cherry robitussin. There is nothing that can possibly taste worse than cherry robitussin, I’m convinced of this.

      • JulesNoctambule says:

        @pecan 3.14159265: Nasty stuff; I think it’s a tie with fake-grape-flavoured anything.

      • yevarechecha says:

        @pecan 3.14159265: Yellow Triaminic. Absolutely horrific stuff. Tastes like the concentrated remains of several aspirin tablets mixed in Mountain Dew syrup. It’s vomit-inducing. I don’t know what it’s meant to taste like, but it doesn’t.

        Suprax (cefixime), on the other hand, is awesome. I am allergic to both amoxicillin and sulfonamides, so my doctors usually have to go straight to the second and third-line stuff when I need antibiotics. Suprax always tasted like a vanilla milkshake. It actually made getting ear infections sort of pleasant. I was disappointed when I got my last ear infection at age 12 and they gave me erythromycin tablets instead.

        • grumpymo says:

          @yevarechecha: Yellow Triaminic, Absolutely. Though nothing was worse then the cough medicine my grandmother gave me, smelled like mentholated turpentine and burned like a thousand suns.

          The smell of the pink amoxicillin still makes me gag every time I have to administer a dose to one of my children. Though they’re pretty good about just taking it. When they were small we used a medicine dropper and would do it a few drops at a time into the fold of the check where the molars are. They can’t seem to help swallowing it, and you seem to get _less_ spit-back. You still get some but they can’t seem to help swallowing at least part of each load.

      • floraposte says:

        @pecan 3.14159265: I would suggest generic cherry cough syrup as being worse. That’s definitely a case where it pays to spend for the fancy stuff.

        • samurailynn says:

          @floraposte: I don’t know, sometimes the brand name doesn’t do it right either. I’ve tried cherry Nyquil and it is really nasty. I’ll take their liquid green death flavor over cherry Nyquil any day.

          • floraposte says:

            @samurailynn: Oh, I’m not saying the brand name is tasty; just that one of the reasons the generic is cheaper is those special things that slightly more effectively cover up the taste of the medicine.

      • jessedybka says:

        @pecan 3.14159265: I chewed a non-chewable Gravol accidentally, one upon a time. It couldn’t have been less than 12 or 13 years ago, but just typing this puts that taste back in my mouth.

      • snidelywhiplash says:

        @pecan 3.14159265: Oh, there are worse things. Thinking of liquid iron supplement in particular. It tastes just like you might think it would – reminiscent of a rusty nail (and not the kind you get at the bar).

      • LadyTL says:

        @pecan 3.14159265: Trust me, any medicine syrup that has no food dye and thus no flavoring is the most god awful tasting stuff in the universe. I had a red food dye allergy as a kid and nearly threw up each time my mother made me take the stuff. Even the smell of it today still makes me sick to my stomach.

    • xoxor says:

      Green Nyquil was the thing I hated most.

      Also, when I grew up (a bit off topic) whenever you got a cut the fluorescent orange merthiolate antiseptic got put on it and burned like the fires of hell. I hated that stuff….

      I quit mentioning cuts and the like….and quickly learned to treat them myself…

  9. ScooterOslo says:

    Great to live in Canada! I’m a pharmacist in Vancouver. Not only is Tamiflu available up north, its free if you have H1N1. Just walk in with a script and its yours.

    There is a shortage of the pediatric suspension up here too, so the goverment kicked in and covered the compounding fee for kiddies too! Everyone wins. Whoo hoo!

  10. bohemian says:

    I quit using Walgreens when they became too busy and visibly pissed off about being asked questions about a new prescription.

    CVS is much the same type of set up. Maybe an in clinic pharmacy or a compounding pharmacy would be more willing to help.

  11. Applekid ┬──┬ ノ( ゜-゜ノ) says:

    Wow… yesterday I would have regarded anyone who would have claimed “I make my own Tamiflu at home” as being sarcastic.

    Life imitates humor?

  12. coren says:

    Yeah, so what if you make your own liquid Tamiflu at home. I make my own capsules at home. Booya, Consumerist. Booya.

  13. Corporate_guy says:

    Just so you know by the time the child had a 104 fever it’s too late for tamiflu to do anything. Your doctor basically gave you an expensive placebo and you ended getting all stressed out over nothing.

    Find a new doctor.

    • Naame says:

      @Corporate_guy: That is not true. You are correct that Tamiflu is not as effective once the virus has completely proliferated though.

      Tamiflu is an Antiviral which means it’s purpose is two fold:

      “First, they can lessen your symptoms and give your body a better chance of fighting the virus. Second, they can actually slow down the rate of an epidemic or pandemic spreading. They do this by slowing down the speed with which viruses proliferate in the body: in people who already have symptoms this means that fewer viruses get coughed and spluttered over other people; and in people who do not yet have symptoms it stops the virus reproducing as soon as it gets into their bodies, so that they may never develop symptoms.”

      So basically, your body is trying to kill it off and you will see positive results faster if you are on Tamiflu because while on it the virus is not able to proliferate as quickly which gives your body a keen advantage.

      In addition, even if the Tamiflu fails to do what it is intended to do for you it will help reduce the chances of it spreading to others.

      In the end, it is worth taking even after you get the symptoms. It is hardly a placebo.

    • marsneedsrabbits says:

      @Corporate_guy:

      Not true. It seems to take much less for fevers to spike in young children than in adults. One of my kids gets a fever of 101-103 30 minutes after vaccinations, just like clockwork. Their fevers seem to drop faster, too.

  14. AnxiousDemographic says:

    The instructions to make liquid Tamiflu from Tamiflu capsules are inside the Tamiflu box, printed on the drug information sheet.

  15. idip says:

    I thought Tamiflu was only to prevent the flu. Once you have the flu the drug doesn’t help.

    Lots of rest, liquids (Just like the reg. flu) was all you can do.

  16. StanTheManDean says:

    Off the books, non-PDR etc medications are not normally volunteered.

    I suspect there are some Pharmacist regs that prohibit the Pharmacist from prescribing meds or alternatives.

    That said, most good Pharmacists will help the customers.

    I watched the late night Pharmacist at Walgreens help a lady having a mild asthma attack find OTC treatments that might help her. I am willing to bet he would have found her an inhaler of prescribed meds if he wasn’t being observed by Big Brother.

  17. greeneyedguru says:

    Thank all the people who ran out and got Tamiflu prescriptions when the swine flu scare first started (and only a few hundred people were sick).

  18. J_Sensei says:

    I am an intern at a CVS, and I can give you some of the reasons that we don’t offer this without being asked. For one, if we make the liquid, it is considered a compounded product. Most insurances will not, under any circumstances, pay for Tamiflu. So instead of paying your 20 dollar copay, you’re now on the hook for the whole 107 dollars. A lot of people aren’t going to pay it.
    Also, it takes time. I’ve compounded it several times, and it takes about twenty minutes to make. Plus there is extra paperwork. Add in the fact that it’s winter, so we’re pretty swamped anyway, it’s not a service we really advertise. We do it when asked, but that’s just the nature of it.

    • MadCatMU says:

      @J_Sensei: Also an intern at CVS, and we are one of the only stores around that makes the compound. It’s my understanding that pharmacies either do it or they don’t. Having to come back and ask them for the compound seems odd.

      Kept refrigerated, the compound lasts 30 days, so we usually make a few days at a time (FDA/state board limits how much you can make without being labeled a manufacturer.) This cuts down on the work quite a bit.

      Unlike the intern above, I have seen very few problems getting insurances to cover the compound, but the copay does vary widely.

  19. MrEvil says:

    Any Compounding Pharmacy should be able to make liquid medications from capsules or tablets. It’s possible that none of the locations G visited were compounding pharmacies. Not every pharmacy is a compounding pharmacy.

  20. Sbrools says:

    While pharmacists might be ABLE to make a liquid suspension from the pills, doesn’t mean they SHOULD. I’m willing to be that the commercial liquid form is substantially different from the solid turned liquid. For one, it throws off the dosage. A lot of work goes into finding the correct way of manufacturing the pills so that they release into the body at the right time… if you make it a liquid, it’s likely that the body will absorb it faster, causing dosage issues: even though it’s the same amount of medicine, you’re getting it into your system at a different time. I know people like to think of Pharma as just tossing a bunch of chemicals into a pill and voila, but there’s actually a lot of research that goes into stabilizing the chemicals, altering bioavailability, etc. I can completely understand pharmacists not wanting to screw that up, simply for liability issues.

  21. Panamapeter says:

    Here in Panama nurses go door to door giving flu vaccine free. Of course we are a very rich country, unlike the US

  22. jayphat says:

    My pharmacist got tired of having to mix one bottle after another after another, so she came in almost an hour early one day, and made a GALLON of the liquid. It took her forever to break open all the capsules.

    • sukichloe says:

      @jayphat: I do this all the time for the RPh that never have enough time to do it themselves. Takes around 90 minutes to break open 48 pills. And people wonder why pharmacies never want to make Tamiflu suspension..

  23. bomble says:

    why couldn’t the kid just take a capsule like a normal person? Is there something special about liquid tamifu I am missing?

  24. LeChiffre says:

    I thought this would be a better alternative:

    What will I need to do this?

    You will need

    * The prescribed Tamiflu® capsule
    * A spoon
    * 1-2 Teaspoons of sweetened liquid
    * A local junkie

    How do I mix the ingredients?

    * Pour a small amount (about a spoonful) of a sweet thick liquid into a spoon.
    * Heat spoon.
    * Stir the mixture and insert needle into spoon.
    * Insert needle into arm.
    * Enjoy.

  25. notlupus says:

    you can also put the powder from the capsule into anything and eat/drink it. I have a problem taking pills and when my wisdom teeth came out they gave me some horse pills to take for infections and the pain, since I couldn’t swallow them I used applesauce.

  26. NE-Phil says:

    Doesn’t surprise me that CVS would not volunteer using the capsule method to make the liquid.
    I only recently became aware that many generic meds can be purchased cheaper by buying a 90 day supply. I’ve been buying my meds from CVS for years and they never volunteered that bit of information. I now get my meds directly from my health care provider – for cheaper.
    I no longer shop at CVS.

  27. wezelboy says:

    I would like to point out that if you follow these instructions, you might be giving your child an adult dose of tamiflu, which is probably not a good thing considering some of the potential adverse side effects.

    When my 3 year old came down with H1N1, I mixed one 75mg capsule in 40 ml of syrup and gave 10 ml doses 3 times daily.

  28. Hua Kul says:

    When I was a kid and we had to take a sulfa drug my mom would crush the tablet between two spoons and mix it with a little water and sugar and we’d swallow it down. It seems strange to see the list of instructions above for such a simple technique; how dumb have we become?

  29. Compounding Doctor says:

    As a healthcare professional and a compounding pharmacist for a large medical complex, I urge parents and caregivers to find a compounding or independent pharmacy to prepare Tamiflu for you so that your child or patient will receive the correct dose. Compounding pharmacists do undergo special training and there is more to compounding than just crushing a tablet or opening a capsule and mixing it in a liquid. You are taking a risk of overdosing or underdosing your child or patient by mixing it yourself and trying to measure an accurate dose.

    Unfortunately, insurance companies do not pay for compounding services and you may need to pay cash. People will spend hundreds of dollars for pet care, concerts, lottery tickets…. Isn’t your sick child worth spending $50-$100 out-of-pocket to get them the medicine that they need. You can file a claim for the money with your insurance company and will probably recoup most or all of the cost and the compounding pharmacy will help you will that claim. Most compounding pharmacies don’t accept insurances because insurance companies will not pay fair reimbursement for the services.

  30. solareclipse2 says:

    @nstonep: It’s not that he concocted anything. He questioned the pharmacy about their ability to make the liquid version from the pills. My understanding is that the pharmacy did the concocting, and it was a perfectly viable option.

  31. Areia says:

    @nstonep: I’d agree if you were ‘concocting’ medicine from other ingredients, but what the CDC suggests in that link is just to mix the contents of the adult capsules into chocolate syrup. That sounds more like me putting my cat’s pills into some liverwurst than playing amateur pharmacist.

  32. treimel says:

    @nstonep:

    Well, I’ll go with the CDC’s advice that this is perfectly safe and easy to do at home. rtfa.

  33. The Porkchop Express says:

    @nstonep: so the ER would do the same thing the pharm did?

  34. kateblack says:

    @The Porkchop Express: No, their hands would be tied in the same way chainstore pharmacists’ hands may be tied. See @coffeeculture’s post above.

    But then mom & dad could’ve been distracted by the $2000 hospital bill!

  35. Kuchen says:

    @pecan 3.14159265: My husband’s doctor did not give him a prescription for Tamiflu when he had H1N1 in July. This was even before there were shortage issues, and they were already pretty strict about who would get it. I wasn’t sick, but I “got to” take Tamiflu preventively because I was pregnant. Not a fun drug. I kind of felt like I was drunk for 2 days.

  36. GrandizerGo says:

    @pecan 3.14159265: Yeah, just ask the doctors in Hwood that supply celebrities EVERYTHING without ever seeing them…

    (I am not picking on you Pieman, really)

    Just ask Anna Nicole Smith and Michael Jackson to name a few…
    Ooops, can’t now can we???

  37. theblackdog says:

    @pecan 3.14159265: I hope you’re right, but at the same time I’ve become aware of doctors that see no problem prescribing certain medications for off label uses that could cause problems in the future, so that may be coloring my view.

  38. pecan 3.14159265 says:

    @GrandizerGo: That’s PieWoman to you. And both Michael Jackson and Anna Nicole Smith had personal doctors who handled their health nearly full time. Most celebrities don’t have doctors on call, but like most of us, they have primary care physicians who operate practices and take on various clients.

  39. The Porkchop Express says:

    @pecan 3.14159265: you got a cheap hospital there. or really good insurance.

    I heard pudding cups cost more than Cosby made off the pudding pops.

    @kateblack: indeed they would be.

  40. failurate says:

    @idip: And it goes from being a product they are just distributing to being an ingredient in a product they are producing.

  41. treimel says:

    @The Porkchop Express:

    Not buying dosage: the dosage is neither more nor less than was contained in the original capsules. Of course, there is the risk that the wrong measures will be used in preparing the new compound, but that is the same risk as putting the wrong strength capsules in a bottle–nothing new there. Certainly I see the *theoretical* avenue for a new theory of liability for a compounding pharmacy rather than a simple dispensing pharmacy insofar as they are introducing new ingredients, but I’d like to see a cite to a successful action–I don’t think it exists.

  42. XTC46 says:

    @treimel: Dosage does change. If you combine a powder and a liquid, and the poder does not properly breakdown into the liquid it would very possible to have too high of a dosage in a single teaspoon,and nearly none in the next.

    Im not sure what the effects of a double dose of tamiflu are, ive never had to take it, but im gussing when breaking down an adult size pill, for a child to take, there needs to be some caution taken.

  43. treimel says:

    @xtc46 – thinksmarter on twitter:

    Your response assumes that the contents of tamiflu capsules are not easily soluble in liquids or are otherwise difficult to mix in evenly. Given that the CDC says this is a DIY project for completely un-trained people, I simply don’t believe that is the case here.

  44. thisistobehelpful says:

    @nstonep: And a terrifying surplus of urea cream.

  45. thisistobehelpful says:

    @catastrophegirl: I had strep a lot as a kid so I always had to take that horrific “bubblegum” flavor pink liquid amoxicillin. There was absolutely nothing that could hide the flavor. The doctor would give my mom a double script since I gagged and puked it up often enough to empty a bottle on missed doses. I bet it was a huge relief when I finally a) developed an allergy to the stuff and b) was finally old enough to take pills.

  46. catastrophegirl chooses not to fly says:

    @thisistobehelpful: could be worse. it also comes in banana. we had to order the banana flavored one for a sick turtle once

  47. scoosdad says:

    @pecan 3.14159265: Cake frosting in a can. My dog in the avatar is fussy about taking his pills from time to time, and I use a pill crusher and mix the powder into a teaspoon of white frosting. He happily licks the mix off the tip of my finger.

    The only medication that I’ve found so far that he won’t take that way is a really nasty canine pain med called Tramadol. I tasted some of the powder once to see why my dog was refusing to take it, and my mouth was reeling for about an hour. Tamiflu must be similar to Tramadol.

    I chuckle whenever I’m sitting in my vet’s office and I hear them handing out Tramadol at the counter on the way out to some of their clients, and not warning them about the nasty taste.

  48. Mythandros says:

    @NancyCpants: Neither can I.

    You aren’t a customer, you’re their parent. “Take it or you get punished.” The choice was very simple. That’s how my parents gave me my medicine.. and Nancy is right.. it was that FEAR that made me comply. I’m grateful that they did it that way now.