Shake Before Use

Background

Numerous drugs exist that must be shaken well immediately before administration. These include, for example, certain eye drops, nasal sprays, injectables, and antibiotic suspensions for children (see below). The reason is usually that the active ingredient in the drug is in suspension. Suspensions are heterogeneous mixtures of substances consisting of a liquid in which a powdered solid is finely dispersed. In the case of suspensions, the solid active substance can settle at the bottom of the vessel over time (sedimentation). Shaking causes it to be stirred up and evenly distributed in the liquid. If shaking is not performed, there is a risk that too little or too much active substance is applied. Also, some syrups and thick preparations must be shaken before ingestion because they thicken on standing. Juices and herbal remedies sometimes contain ingredients that settle. Some preparations only need to be shaken gently or swayed back and forth (swish). Instructions can be found in the professional information and package insert.

Examples

The following list shows a selection of medicines that need to be shaken before administration: