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mixtures as potential vehicles for apixaban suspension. All 3
Ora-Plus and water mixtures exhibited satisfactory flowability through the 10 French and 18 French tubes. For simplicity, the 50:50 mixture was recommended as the vehicle.
When prepared by the traditional mortar/pestle method, the
0.25 mg/mL apixaban suspension in the 50:50 mixture vehicle exhibited satisfactory flowability and compatibility with
the 2 commonly used types of enteral feeding tubes. The stability study also confirmed that this suspension formulation
was stable physically and chemically for up to 7 days at room
temperature.
The authors would like to point out 2 limitations of this
study. First, the pill crusher and crushing syringe are convenient options for suspension preparations at patient bedside.
This study confirmed that these methods can be used to prepare apixaban suspensions of acceptable dosage accuracy.
However, the tube flowability was not evaluated due to limited
time and resource. It is possible that these 2 methods may produce larger powder particles than the mortar/pestle method,
which may cause blockage in narrow tubes. Second, this study
only evaluated polyurethane and PVC enteral feeding tube
materials. Silicone represents another commonly used tube
material. However, the authors were unsuccessful at sourcing
the silicone enteral feeding tubes during this study.

Hospital Pharmacy 52(7)
tubes with minimal sorption to the polyurethane and PVC
tube materials. The BUD of this apixaban suspension was
established for up to 7 days at room temperature.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

References
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3.
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5.

Conclusions
A suitable apixaban suspension for enteral feeding tube
administration was identified as 0.25 mg/mL apixaban in
50:50 Ora-Plus:water. This suspension was prepared from
the 5-mg-strength oral tablets using the traditional mortar/
pestle. The apixaban suspension formulation exhibited satisfactory flowability via 10 and 18 French enteral feeding

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http://packageinserts.bms.com/pi/pi_eliquis.pdf

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