Table 1

Liquid formulations for young children: type of dosage form, age group and main user advantages and disadvantages*

Formulations manufactured and administered and swallowed as a liquid
Dosage form	Formulation characteristics	Likely to be used from	Main (user) advantages	Main (user) disadvantages	Specific reference
Solution	Immediate release†	(Term) birth	Easy to swallow Flexible dosing	Potential need for harmful solvents Potential short product/in-use shelf-life Potential need for storage in refrigerator Common need for preservation Common need for taste optimisation Dosing volume may be high Need for suitable dosing device Risk for errors when measuring the dose Risk of spillage upon administration Portability may be a problem	9 13 14
Emulsion (including microemulsion)	Immediate release†	(Term) birth	As solution Reduced need of harmful solvents	As solution, but Risk for incorrect shaking/emulsion break up resulting in incorrect doses	9 14
Suspension	Immediate† or modified‡ release	(Term) birth	As solution, but Reduced need of harmful solvents Possibility of particle coating for taste masking	As solution, but Mouth feel may be an issue Risk for incorrect shaking/segmentation resulting in incorrect doses	9 13 14
Concentrate for oral liquid (solution, emulsion, suspension)	As solution/emulsion/suspension	(Term) birth	As solution/emulsion/suspension, but Reduced volume for storage and transport Fewer stability problems	As solution/emulsion/suspension, but Need for reconstitution Need for clean water by patient/pharmacist	14
Drops (solution, emulsion, suspension)	Immediate release†	(Term) birth	As concentrate for oral liquid, but Low dosing volume	As solution/emulsion/suspension, but Variable drop size Counting errors	14 15

*Recommendations on age are based on the reflected literature, considerations of the European Medicines Agency (EMA) guideline on the pharmaceutical development of medicines for paediatric use16 and expert knowledge of marketing authorisations.
†Immediate release administration implies the general disadvantage that dosing frequencies may be high. Although not intended, immediate release formulations may normally be chewed, crumbled or crushed. However, this may affect taste.
‡Modified release administration implies the general advantage that dosing frequencies may be reduced. Depending on the type of modified release, these formulations may sometimes be chewed or crumbled; however, they may never be crushed to powder.