1. Which excipient consideration applies to a medicine given to a neonate?
- Excipient content is irrelevant at any age
- Benzyl alcohol, propylene glycol and ethanol can accumulate to toxic levels because of immature metabolism
- Excipients are metabolised faster in neonates
- Neonates tolerate all excipients better than adults
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B. Benzyl alcohol, propylene glycol and ethanol can accumulate to toxic levels because of immature metabolism
Benzyl alcohol caused fatal gasping syndrome in neonates, and propylene glycol accumulates because of limited alcohol dehydrogenase activity and immature renal clearance, causing hyperosmolality, acidosis and central depression. Neonatal formulations are therefore chosen with the excipient profile in mind, not only the active ingredient.