Elixirs are clear, sweetened hydroalcoholic solutions intended for oral use and are usually flavored to enhance their palatability. Nonmedicated elixirs are employed as vehicles, and medicated elixirs are used for the therapeutic effect of the medicinal substances they contain.

Compared with syrups, elixirs are usually less sweet and less viscous because they contain a lower proportion of sugar and consequently are less effective than syrups in masking the taste of medicinal substances. However, because of their hydroalcoholic character, elixirs are better able than aqueous syrups to maintain both water-soluble and alcohol-soluble components in solution. Also, because of their stable characteristics and the ease with which they are prepared (by simple solution), from a manufacturing standpoint, elixirs are preferred to syrups.

Alcohol Proportion and Solvent Use in Elixirs

The proportion of alcohol in elixirs varies widely because the individual components of the elixirs have different water and alcohol solubility characteristics. Each elixir requires a specific blend of alcohol and water to maintain all of the components in solution. Naturally, for elixirs containing agents with poor water solubility, the proportion of alcohol required is greater than for elixirs prepared from components having good water solubility. In addition to alcohol and water, other solvents, such as glycerin and propylene glycol, are frequently employed in elixirs as adjunctive solvents.

Although many elixirs are sweetened with sucrose or with a sucrose syrup, some use sorbitol, glycerin, and/or artificial sweeteners. Elixirs having a high alcoholic content usually use an artificial sweetener, such as saccharin, which is required only in small amounts, rather than sucrose, which is only slightly soluble in alcohol and requires greater quantities for equivalent sweetness.

All elixirs contain flavorings to increase their palatability, and most elixirs have coloring agents to enhance their appearance. Elixirs containing more than 10% to 12% of alcohol are usually self-preserving and do not require the addition of an antimicrobial agent.

Advantages and Disadvantages of Medicated Elixirs

Medicated elixirs are formulated so that a patient receives the usual adult dose of the drug in a convenient measure of elixir. For most elixirs, one or two teaspoonfuls (5 or 10 mL) provides the usual adult dose of the drug. One advantage of elixirs over their counterpart drugs in solid dosage forms is the flexibility and ease of dosage administration to patients who have difficulty swallowing solid forms.

A disadvantage of elixirs for children and for adults who choose to avoid alcohol is their alcoholic content. The reader may wish to refer to the discussion of alcohol as a solvent earlier in this chapter for FDA recommended limits on alcohol content for OTC oral products. Because of their usual content of volatile oils and alcohol, elixirs should be stored in tight, light-resistant containers and protected from excessive heat.