Page 28 - A Guide to Dosage Form 1

PAGE 1

COMPOUNDING WORKSHEET

Dose/Amount/Concentration
Ingredient Quantity used Physical State Solubility Use in the prescription
Given Accepted range

The physical state and These columns are used This is to specify the

Each ingredient and the function of each

quantity (poison/non- solubility of each to compare between the ingredient in the
poison/excipients) have ingredient have to be given dose and the

to be detailed out here. written. This accepted range (can be formulation
information can be found in the reference

obtained from reference book)
books
(BPC/BP/Martindale)

INCOMPATIBILITY/OVERDOSE (if any): LABELLING (Please include auxillary labels, if any):

_Note here if there is any incompatibility or overdose_____________

CONTAINER: You are required to paste a label here. The same
label as the one you pasted on your product that
_Specify a suitable container________________________________ you dispensed. Make sure that the label is
complete.
EXPIRY DATE:

_Specify the expiry date for your product______________________