P27 The accuracy of tablet splitting to provide appropriate paediatric enalapril doses

Aim The angiotensin-converting enzyme inhibitor, enalapril, is considered a first-line treatment for chronic heart failure in children. However, there lack of an age-appropriate formulation and tablet splitting, although not recommended, common, attempt, to provide suitable doses paediatric use. An analysis currently available UK brands explored the accuracy splitting low-dose tablets enalapril. Method Four different commercially enalapril were evaluated: Innovace® 2.5 mg 5 mg, (both Organon Pharma UK), generic (Ria Generics Ltd) (Dexcel Ltd). Five from each brand/dose split manually where possible. For unscored tablets, sharp knife or metal spatula was used replicate home environment. Tablet fragments weighed. Using high-performance liquid chromatography, percentage theoretical 1.25 dose contained within half-tablet analysed (percentage label claim [%LC]) uniformity dosage units calculated (acceptance value [AV]), AV ≤15 meet acceptance criteria. Results Manual proved relatively easy only with deep-scoring Innovace tablets; 0.007 0.483 material lost across five replicates, mean%LC (SD) 97.5% (4.3) 11.3. less easily; 0.113 0.627 lost, 99.9% (10.7) 25.7. soft Ria high variability: 0.609 13.488 96.0% (17.9) 45.5. Dose variation also Dexcel 1.097 13.801 95.9% (11.7) 30.7. Conclusion In general, use results inaccurate dosing. Acceptable dosing achieved scored tablets. Accurate below achieved. needed.