THE SWEETENERS
MARTINDALE�S 24^th 1958 (Br.)
Compiled by Ivor Hughes

 

DEXTROSE and other SWEETENING AGENTS
Dextrose (B.P.). Dextros.; Anhydrous Dextrose; Anhydrous Medicinal Glucose; D-Glucose; Anhydrous Grape Sugar; Glucosum; Glycosum; Saccharum Amylaceum; Glucose Officinal (Fr. P.); Traubenzucker. a-D-Glucopyranose. C₆H₁₂O₆ = 180-2.

  Foreign Pharmacopoeias: In Belg., Chil., Cz., Egyp., Fr., Ger., Hung., Ind., Jap., Jug., Nor., Span., Swed., and Swiss. U.S. specifies anhydrous or monohydrate. A white odourless crystalline or granular powder with a sweet taste.

  Soluble 1 in 1 of water, 1 in 140 of alcohol at 25�, and 1 in 6.5 of boiling alcohol; soluble in glycerin. Solutions are sterilised, immediately after preparation, by autoclaving or by filtration. Protect from moisture.

  Uses. Dextrose is given orally as a readily absorbed carbohydrate in all conditions associated with insufficiency of carbohydrates. It also assists the metabolism of fats and prevents acidosis by raising the glycogen content of the liver. This latter action is utilised in the prevention and treatment of poisoning by cinchophen, carbon tetrachloride, chloroform, and other drugs which have a toxic action on the liver.

  Before operations dextrose may be given for the prevention of post-anaesthetic acidosis, and of delayed chloroform poisoning. Dextrose is widely used in the severe nutritional disturbances of infants, especially when accompanied by diarrhoea and vomiting. Hypertonic solutions (25%) are injected intravenously to relieve intracranial pressure by osmosis in meningitis and hydrocephalus. Isotonic dextrose (5%) is given intravenously to increase the volume of circulating blood in the treatment of severe dehydration and can be used following shock and haemorrhage when no blood or plasma is available. After abdominal operations it may be necessary to give large amounts of saline intravenously until the patient can take fluids by mouth, but as large doses of normal saline predispose to oedema, dextrose-saline is often preferred. A suitable solution contains 4-3% of dextrose and 0-18% of sodium chloride. Concentrated (50% or more) solutions have been used for the injection treatment of varicose veins but recanalisation and pulmonary embolism are likely to occur. Hypertonic solutions have been used as wound dressings to promote increased flow of lyrnph to the tissue.

  Bull's Mixture. 'Hammersmith Cocktail". Dextrose 400 g., arachis oil 100 g., acacia sufficient to emulsify (25 g.), water to 1000 ml. In the treatment of anuria, this quantity is given daily by stomach tube. G. M. Bull et al., Lancet, ii/1949, 229. Suggested that the final volume should be reduced to 600 ml .� G. M. Bull, Lancet, i/1955, 777. For a suggested modification of this formula, see High Calorie Emulsion for Oral Use, p. 665.

  Dextrose and Sodium Chloride Injection (U.S.P.). A sterile solution of dextrose and sodium chloride in Water for Injection. pH 3-5 to 6. Usual strengths: dextrose 2-5 and 5% with sodium chloride

0-45%; dextrose 2-5, 5, 10, and 25%, with sodium chloride 0-9%.

  Injection of Dextrose (B.P., Egyp. P., Ind. P.). Inj. Dextros. (B.N.F.). A sterile solution in Water for Injection. Unless otherwise specified, a solution containing 5% w/v is supplied. U.S.P. usual strengths: 5, 10, 20, 25 and 50%. Similar injections of various strengths are included in many foreign pharmacopoeias. Store in a cool place.

  Intravenous Solution C (Leeds Gen. Infirm.). Dextrose 33 g., sodium citrate 3 g., potassium citrate 1 g., hydrated calcium chloride 400 mg., magnesium chloride 100 mg., water to 1000 ml.

Narist. Dextros. (Liverpool Ear, Nose & Throat Infirm.). Dextrose 25%, glycerin 25 % in water.

Oral Solution of Dextrose and Electrolytes. The following solution used in the treatment of acute dehydration in infants, has a reaction about pH 6-6. Calcium chloride 2, magnesium chloride 2, potassium citrate 7, sodium chloride 9, sodium dihydrogen phosphate 5, sodium citrate 31/3 (all quantities in millimoles), dextrose 50 g., water to 1000 ml. This formula, based on readily available materials, provides a solution of pH 6'6, equivalent in composition to that recommended in M.R.C. Memorandum No. 26.�G. Bryan, Pharm. J., ii/1952, 418.

Strong Injection of Dextrose (B.P.C.). Inj. Dextros. Fort. A sterile 50% w/v solution of dextrose in Water for Injection, in single-dose containers of neutral glass. Unless otherwise specified, ampoules each containing 50 ml. are supplied. Store in a cool place.

PROPRIETARY PREPARATION CONTAINING DEXTROSE

Nutri-Sal (Ortho). A powder containing dextrose 71*19%, potassium chloride 0-66%, sodium chloride 25-63%, and calcium gluconate 2-52%, in vials of 19*9 g. For the preparation of a vaginal douche in the treatment of subfertility. The contents of one vial should be dissolved in 1 pint of warm water.

Dextrose Monohydrate (B.P.). Dextros. Hyd.; Medicinal Glucose; Purified Glucose; Grape Sugar. C6H₁₂O₆,H_2O = 198-2.

Glucosum (I.P.) is the monohydrate, but the use of anhydrous is permitted.
Foreign Pharmacopoeias: In Chin., Dan., Egyp., bid.. Jap., Mex., Pol., and Swed.
Several pharmacopoeias use the title Glucosum or Glycosum for this material (sec Dextrose).

Dextrose (U.S.P.) is the monohydrate or the anhydrous material. Odourless colourless crystals or a white or cream-coloured crystalline or granular powder with a sweetish taste. Soluble 1 in 1 of water, 1 in 115 of alcohol at 25�, and 1 in 6-5 of boiling alcohol.
Uses. Dextrose monohydrate is chiefly used in infant feeding when ready assimilation of carbohydrate is required.

Infundibile Glucosi Isotonicum (Dan. P.). Isotonic Dextrose Solution. Dextrose monohydrate 5-5% w/v, O.1N hydrochloric acid 1% w/v in Water for Injection. Sterilised by autoclaving. Nor. P. is similar; Swed. P. omits the hydrochloric acid.

Pig. Glucos. (Roy. Nat. T.N. and E. Hosp.). Dextrose monohydrate 110 gr., glycerin to 1 fl. oz.

PROPRIETARY PREPARATIONS CONTAINING DEXTROSE MONOHYDRATE

Glucodin (Glaxo). A powder containing dextrose monohydrate 98-6%, with vitamin D 250 units per oz., calcium phosphate and calcium glycerophosphate.

Glucose B-D (Crookes). Dextrose monohydrate with aneurine hydrochloride 1 nig., calciferol 300 units, and calcium hydrogen phosphate 425 mg. per oz.

Liquid Glucose (B.P.). Glucos. Liq.; Corn Syrup.
Foreign Pharmacopoeias: In Chin., Egyp., Ind., Nor., Swed., and U.S.
A colourless, or almost colourless, odourless, very viscous syrup with a sweet taste. It consists of a mixture of glucose, maltose, dextrin, and water. Wtperml. about 1-6 g. Miscible with water; partly soluble in alcohol.
Uses. Liquid glucose is sometimes used instead of dextrose for oral administration and it is also used as a pill excipient, either alone or as syrup of liquid glucose. It is not administered by injection.

Pig. Glucos. (St. Bart.'s Hosp.). Liquid glucose 25, glycerin to 100. Syrup of Liquid Glucose (B.P.C.).  Syr.  Glucos.  Liq.;   Syrup of Glucose. Liquid glucose 33-3% w/w in syrup.

Dextrin. British Gum; Starch Gum. An intermediate product in the ultimate hydrolysis of starch, made by heating starch, which has been moistened with a small quantity of dilute nitric acid, at 110� to 115�.
Foreign Pharmacopeias: In Cz., Dan., Ger., Jap., Jug., Pol., Span., and Swiss.
A white or yellowish amorphous powder or granules with a slight characteristic odour and a sweet taste. It does not reduce Fehling's solution. Slowly soluble in cold water and readily soluble in boiling water, forming a mucilaginous solution; insoluble in alcohol and ether. Protect from moisture.
Uses. It is an ingredient of some infant foods and is used as an adhesive and stiffening agent for surgical dressings. It has many industrial uses as * binding and thickening agent.

Lactose (B.P.). Lactos.; Milk Sugar; Saccharum Lactis. C₁₂H₂₂O₁₁, H_2O = 360-3.
Foreign Pharmacopeias: In all pharmacopoeias examined.
A disaccharide obtained from the whey of milk. It is a white odourless crystalline powder with a slightly sweet taste. Lactose exists in two modifications corresponding to the a and β isomerides. Milk sugar of commerce is chiefly a-lactose (4-O-β-D-galactopyranosyl-a-d-glucopyranose). β-Lactose is also obtainable; it is anhydrous, more soluble than a-lactose, and passes into the a form in solution. Soluble 1 in 6 of water and 1 in 1 of boiling water; almost insoluble in alcohol, chloroform, and ether. It may be sterilised by drying at 105� and then heating at 150� for one hour.

Uses. Lactose is used in infant feeding to adjust the carbohydrate content of diluted cows' milk to that of human milk, but it should not be used excessively since it is laxative and makes the stools too acid. Lactose is widely used as a diluent to give bulk to powders and as a diluent in compressed tablets which are required to dissolve completely. Sterilised lactose is used as a diluent for antibiotic powders.

The use of sterile gauze dressings dipped in a sterile 12% solution of lactose instead of the usual vaselined gauze packs, in the closed-cast treatment of osteomyelitis and compound fractures, prevents the odour of putrefaction.� A. D. Wallis and M. J. Dilworth, Brit. med. J., i/1941, 750.

Karilac No. 1 (Mothercraft Training Society, Hove, Sussex). A powder containing lactose 60%, dextrin-dextrose 35% and gelatin 5%. Karilac No. 3. A powder containing lactose 80%, dextrin-dextrose 15% and gelatin 5%.

Laevulose (B.P. 1948). Laevulos.; Diabetin; Fructose; Fruit Sugar. D-Fructopyranose. C₆H₁₂O₆ =180-2.
Foreign Pharmacopoeias: In Egyp., Ind., and Swiss.
A monosaccharide, containing small quantities of glucose and water, prepared from invert sugar or from honey. It is a white or cream-coloured, odourless, Iaevorotatory, hygroscopic, crystalline powder with a sweet taste. Very soluble in water; less soluble in alcohol (90%); almost insoluble in dehydrated alcohol and ether. Protect from moisture.
Uses. Laevulose is a stronger sweetening agent than sugar and is more easily assimilated. It is especially suitable for diabetics. Since laevulose does not raise the concentration of sugar in the blood, except where there is hepatic derangement, it is employed as a test for liver efficiency.

DIABETES MELLITUS. To 32 patients with well-controlled diabetes 16 to 160 g. of laevulose was given daily for 4 to 50 days. No decline in fructose tolerance was observed.� P. Plancherel and S. Moeschlin, per Abstr. World Med., 1954, 16, 57. Studies on the utilisation of laevulose by patients with diabetes mellitus led to the following conclusions. (1) Although laevulose is rapidly utilised even after prolonged administration, the rate is much slower than in a healthy person; (2) it results in weight gain, decrease in the need for insulin and improvement in the patient's general metabolic condition; and (3) it is devoid of dangers. For acidosis, and renal and myocardial impairment secondary to diabetes, laevulose may be given intravenously provided that the rate of administration is checked to avoid reaching the renal threshold too quickly. R. Klinger and P. D. Coste, Minerva med., Tor., 1955, 46, 1389, per /. Amer. med. Ass., 1955, 159, 401.
There appears to be no reason for including the early administration of laevulose in the routine treatment of severe diabetic ketosis. � J. D. N. Nabarro et al., Lancet, ii/1955, 1271.

ALCOHOLISM. Laevulose, which promotes the metabolism of alcohol, may be given as a supplement to pyridoxine treatment (see p. 157). For this purpose 2 doses of about 125 g. of honey may be given at an interval of half an hour. The combined effect of pyridoxine and laevulose persists somewhat longer than the effect of pyridoxine alone and is often followed by a desire for sleep which, when satisfied, tends to leave the patient free from any desire for more alcohol. Larger doses of laevulose produce phenomena similar to that of the disulfiram-alcohol reaction.� O. Marten-sen-Larsen, Brit. med. J., ii/1954, 464.

 
Purified Honey (B.P.C.). Mel Depuratum; Clarified Honey; Strained Honey; Mel Despumatum; Miel Blanc; Gereinigter Honig.
Foreign Pharmacopoeias: In all pharmacopoeias examined, except Mex.
Purified honey is obtained from the honey in the comb of the hive bee, Apis mellifera and other species of Apis (Apidas). It is prepared by melting the honey, allowing to stand, straining off the scum rising to the surface, and adjusting the wt per ml. to 1'355 to 1'356 g. by adding water. Contains from 70 to 80% of glucose and fructose, together with water, sucrose, dextrin, wax, proteins, volatile oil, and formic acid.
Uses. It is used as a demulcent and sweetening agent, and as a vehicle for the application of borax to the mouth in aphthous conditions. It is also a useful addition to the diet of infants suffering from ceeliac disease.

Oxymel (B.P.C.). Acetic acid 15 ml., water 15 ml., purified honey to 100 ml. Dose: 2 to 8 ml. (30 to 120 minims).

Manna (B.P.C. 1934).
Dose: 2 to 16 g. (30 to 240 grains); Jug. P. usual single dose 30 g.
The dried saccharine juice exuded from the stems of the European flowering ash, Fraxinus ornus (Oleaceae), usually containing from 40 to 60% of mannitol.
Foreign Pharmacopeias: In Belg., Dan., Fr., Ger., Hung,, Jug., Nor., Span., Swed., and Swiss. Jug. specifies not less than 72-5% of mannitol, Hung, and Nor. not less than 75%.
Flake manna, which is the best variety, occurs as yellowish-white, brittle, stalactitic masses about 10 to 15 cm. long and about 2 to 2-5 cm. wide, with a slight agreeable odour and a sweet taste. Inferior qualities (small or broken manna) consist of agglutinated fragments and are usually darker in colour and more glutinous. Soluble 1 in 5 of water and 1 in 150 of alcohol (90%).
Uses. Manna has mild laxative properties but it sometimes causes flatulence and griping. It has been employed as a laxative for infants and children. A syrup (1 in 10) has been used.

Mannitol (.U.S.N.F., Span. P.). Manna Sugar; Mannite; D-Mannitol; Mannita. C₆H₁₄O₆ = 182-2.
A hexahydric alcohol closely related to the hexose sugars; it is isomeric with sorbitol. It occurs as a white odourless crystalline powder with a sweetish taste. Soluble 1 in 6 of water, 1 in 85 of alcohol, 1 in 18 of glycerin, and 1 in 3 of pyridine; insoluble in ether; soluble in aniline and in solutions of alkali carbonates and hydroxides. Solutions are sterilised by autoclaving or by filtration.
Uses. Mannitol has diuretic properties. It has also been used in the same way as inulin, in a test for renal function (see Vol. II) but as about 10% is reabsorbed by the tubules, the validity of the results is doubtful. The daily diuretic dose is 50 to 100 g. administered intravenously as a 25% solution. It is also used as a diluent and excipient in pharmaceutical preparations.

Mannitol Injection (U.S.N.F.). A sterile supersaturated solution in Water for Injection; it may require slight warming before use if crystallisation has occurred. pH 6-5 to 7-3. Usual strength: 12-5 g. in 50 ml.

Sorbitol. Sorbite; Sorbol; D-Glucitol; D-Sorbitol. C₆H₁₄O₆ (+ � to 1H₂O) = 182-2.
A hexahydric alcohol closely related to the hexose sugars. It occurs naturally, in small quantities, in apples, cherries, pears, plums, mountain-ash berries, and other fruits, and it is prepared commercially by the catalytic hydrogenation of glucose. It is isomeric with mannitol.
A white odourless crystalline powder with a sweet taste. Very soluble in water and hot alcohol; sparingly soluble in cold alcohol.
Uses. Since it does not produce a rise in blood sugar when taken by mouth, it may be used by diabetics, in a daily dose of 30 to 80 g., in place of sucrose. Soibitol may be used as a substitute for glycerin in pharmaceutical preparations.

DIABETES MELLITUS. A daily intake of 36 to 54 g. as a sweetening agent had no significant effect on blood sugar level and insulin requirement in patients with controlled diabetes, except in a case with advanced hepatic cirrhosis. In patients with uncontrolled diabetes it may aggravate the hyperglycaemia.� C. R. Shuman et al, Amer. J. dm. Nutr., 1956, 4, 61, per Abstr. World Med., 1956, 20, 213.

Glycerin Substitute. A mixture of equal volumes of sorbitol solution (70%) and propylene glycol **  may be used in place of glycerin in a large number of elixirs, mixtures, solutions, syrups, and tinctures.�S. W. Goldstein and U. Biermacher, Drug Standards, 1952,~20, 14.
Editors Note. propylene glycol **   is extremely toxic and destroys brain cells.

Sorbitol Solution (U.S.N.F.). A clear colourless syrupy liquid with a sweet taste, containing 70% w/v of total solids consisting essentially of D-sorbitol, together with a small amount of mannitol and other isomeric polyhydric alcohols. It contains not less than 64% w/v of D-sorbitol. Wt per ml. about 1 -28 g. It is neutral to litmus. Miscible with water, glycerin, and propylene glycol; slightly soluble in alcohol; almost insoluble in most other organic solvents.

Sucrose (B.P.). Sucros.; Refined Sugar; Saccharose; Saccharum; Sucre; Zucker; Sacarosa. a-D-Glucopyranosyl  β-D-fructofuranoside. C₁₂H₂₂O₁₁ = 342-3.
Foreign Pharmacopoeias: In all pharmacopoeias examined.
Colourless odourless crystals, crystalline masses, or white powder, with a sweet taste, obtained from the juice of the sugar cane or of the sugar beet. Soluble 2 in 1 of water and 1 in 370 of alcohol; insoluble in chloroform and ether. Solutions are sterilised by autoclaving or by filtration.
Uses. Sucrose is used as a sweetening agent and demulcent. If the sweetness of sucrose is taken as 100,  Laevulose has a value of 173, dextrose 74, maltose 32, galactose 32, and lactose 16. Syrups prepared from concentrated solutions of sucrose form the basis of many linctuses. Sucrose is also used as a lozenge basis. An injection of 100 ml. of a 50% solution of sucrose is used by slow intravenous drip in the treatment of cerebral oedema or to decrease intra-ocular tension in glaucoma; there is some danger of kidney damage, especially if the injection is repeated.

CEREBRAL HYPOXIA (Dehydration therapy). 40 ml. of a 50% sucrose solution, is given intravenously and the result assessed after 15 minutes. Some lightening of coma and other evidence of recovery occurs in most patients and occasionally there is an immediate return of consciousness. A further 40 ml. of the solution is given 15 minutes after the first, then 30 minutes later another 20 to 40 ml. according to the response of the patient. If necessary an intravenous drip of dextran (10%) is then administered at a rate of about 50 ml. per hour.� D. E. Argent and D. H. P. Cope, Brit. med. J., i/1956, 593.

Simple Basis for Lozenges (B.P.C.). For 100 lozenges: sucrose 100 g., acacia in fine powder 7 g., water q.s.

Syrup (B.P.). Syr.; Simple Syrup; Sirop Simple; Zuckersirup; Jarabe simple. Sucrose 66-7% w/w in water. Wt per ml. 1-315 to 1-327 g.;  9 oz. of syrup contains approx. 8 oz. of sucrose. Syrup, when diluted with even a relatively small proportion of aqueous liquid, is liable to ferment. Potassium carbonate 1 gr. in 12 oz. of syrup prevents" crystallisation. The best temperature for producing syrup free from invert sugar is thought to be 90�. A similar syrup is included in most foreign pharmacopoeias. Chin. P., Jap. P., Mex. P., and U.S.P. specify 85% w/v. Sirop Simple (Fr. P.) is either 'heat-prepared' (165 g. to 100 g. of water) or 'cold-prepared' (180 g. to 100 g. of water).

PRESERVATIVES FOR SYRUP. The following are reported to be satisfactory: benzoic acid 0-1%, cinnamaldehyde 0-01%, p -hydroxybenzoate mixture (methyl, ethyl, propyl and butyl 15% each, benzyl 40%) 1 in 7500, hydroxyquinoline sulphate 0-001%, or o-phenylphenol 1 in 15,000. Many volatile oils inhibit the growth of moulds in syrup. � C. T. Lord Jr and W. J. Husa, J. Amer. pharm. Ass., Sci. Edn, 1954. 43, 438; J. Schimmel and W. J. Husa, ibid., 1956, 45, 204.

Simple Linctus (B.P.C.). Linct. Simp. (B.N.F.). Citric acid 2 gr., emulsion of anise 1 m., emulsion of chloroform 5 m., solution of amaranth 1 m., syrup to 60 m. Dose: 2 to 4 ml. (30 to 60 minims).

Simple Linctus for Infants (B.P.C.). Linct. Simp, pro Inf. (B.N.F.). Simple linctus 15 m., syrup to 60 m. Dose: 2 to 4 ml. (30 to 60 minims).

Invert Sugar. An equimolecular mixture of glucose and fructose, prepared by the action of dilute mineral acid on sucrose. Invert sugar forms in simple syrup on keeping. Very soluble in water forming solutions with a pH of 3-5 to 6.
Uses. Solutions of invert sugar have been used in the injection treatment of varicose veins, and are stated to have the advantage of not causing cramp or sloughing if accidentally injected outside the vein. 5 to 20 ml. of a 60 to 75 % w/v solution of invert sugar has been given.

GASTRO-ENTERITIS. Groups of infants received invert sugar solution (10%) or dextrose (5%); the solution was given orally in mild cases and intravenously in the more severe ones. Results were equally satisfactory in both groups, no venous thrombosis resulted from the high concentration of invert sugar in the infusion solution, and no sugar was excreted in the urine. Invert sugar is of value when a high-calorie intake is required in a minimum volume of fluid.� R. M. Todd, Proc. R. 6'oc. Med.t 1953, 46, 1066.

Infundibile Invertosi 10% (Dan. P.). Sucrose 95 g., 0.1N hydrochloric acid 4 g., Water for Injection to 1000 nil. Sterilised by autoclaving.

Injectabile Invertosi (Dan. P.). Sucrose 760 g., 0-1N hydrochloric acid 10 g., Water for Injection to 1000 ml. Dissolve the sucrose with the aid of heat in 500 g. of Water for Injection, cool, add the hydrochloric acid, adjust to 1000 ml., and sterilise by autoclaving.

Injection of Invert Sugar (for use as a sclerosing solution). Sodium chloride 100 g., laevulose 150 g., dextrose monohydrate 150 g., benzyl alcohol 10 ml., Water for Injection to 1000 ml. (pH about 12). Filter and sterilise by autoclaving at 121� for 5 minutes. The final pH is 4 to 5.� J. Murphy, Amur. prof. Pharm., 1955, 21, 258.

Treacle. Theriaca. The uncrystallisable residue from sugar refining. It is an ingredient of Tincture of Chloroform and Morphine. A 50% solution of treacle in hot milk in doses of 5 to 20 n. oz. has been used as an enema.

Burnt Sugar (B.P.C.). Saccharum Ustum; Caramel (U.S.N.F.).
A thick, but free-flowing, dark brown liquid, prepared by heating sucrose at 180� to 200�, and diluting to the required standard with water. Wt per ml. 1-37 to 1-41 g. Miscible with water, dilute alcohol up to about 55%, dilute mineral acids, and sodium hydroxide solution, but precipitated by strong alcohol; immiscible with chloroform and ether.
Uses. Burnt sugar is used as a colouring agent, usually as Solution of Burnt Sugar, 10 m. of which will give a suitable colour to 1 fl. oz. of most liquid preparations.

Solution of Burnt Sugar (B.P.C.). Liq. Sacch. Ust. Burnt sugar 1 and chloroform water 1, by vol. Wt per ml. about 1 -20 g.  
Caramel of commerce is made from many raw materials, including sucrose, glucose, liquid glucose, molasses, and invert sugar. It is supplied in various qualities and strengths, with different colour intensities, to suit the various commodities in which it is used.

Maltodextrin (B.P.C. 1949). A mixture of dextrins and maltose prepared by the limited hydrolysis of starch. A slightly hygroscopic white powder with a slight odour and sweet taste. Soluble 2 in 1 of water; partly soluble in alcohol. Protect from moisture.
Uses. As maltodextrin is more readily digested than starch, it is used in infants' foods, and in place of foods containing starch when carbohydrate digestion is impaired. It is used in infant feeding in place of lactose for adjusting the carbohydrate content of diluted cows' milk to that of human milk.

PROPRIETARY PREPARATION CONTAINING MALTODEXTRIN

Dextrin-Maltose (Alien & Hanburys). A starch-free mixture of carbohydrates for the modification of cows' milk in infant and invalid feeding. Available in two forms: plain, and with sodium chloride 2%.

Maltose (B.P.C. 1949). Maltos. 4-a-D-Glucopyranosyl-D-glucopyranose monohydrate. C₁₂H₂₂O11,H_2O = 360-3. A white crystalline powder with a slight odour and sweet taste; it is obtained from starch by hydrolysis with diastase. Very soluble in water; soluble in alcohol; insoluble in ether. Protect from moisture. It is used in bacteriological culture media.

Saccharin (B.P.). Benzosulphimide; Gluside. o-Benzoicsulphimide. C₇H₅0₃NS = 183-2.
Foreign Pharmacopoeias: In Belg., Egyp., Fr., Pol., Span., Swiss, and U.S.
White odourless or almost odourless crystals or crystalline powder with an intensely sweet taste. Solutions in water are acid to litmus.
Soluble 1 in 290 of water, 1 in 25 of boiling water, 1 in 12 of acetone, 1 in 30 of alcohol, and 1 in 50 of glycerin; slightly soluble in chloroform and ether; very soluble in dilute solution of ammonia and in solutions of alkali hydroxides and, with the evolution of carbon dioxide, bicarbonates.
Uses. Saccharin is used as a sweetening agent, and as a substitute for sucrose in diabetes, obesity, and generally where the use of sucrose is undesirable. It has no food value. It is commonly employed in the form of saccharin sodium; the average amount required is about 1/20 gr. in each fl. oz. or about 1 in 10,000.

Saccharin is usually considered to have about 550 times the sweetening power of sucrose, but this depends to some extent on the strength of solution used, the relative sweetening power being greatest in dilute solution. Pharmacological, toxicological and clinical investigations have confirmed the fact that saccharin is a completely harmless substitute*** for sugar even when used continuously.  1� to 3 gr. of saccharin is sufficient to replace the whole of the sugar required by an adult for daily sweetening of food and drink, i.e. 50 to 57 g .� H. Staub and R. Staehelin, Med. Pr., 1936, 193,419.
Experiments in vitro snowed saccharin to have an antiprothrombin effect, but ingestion of saccharin in amounts above those obtaining in ordinary dietary use was found to be without effect on the prothrombin time. There is stated to be no synergism or antagonism between saccharin and dicoumarol.� R. D. Barnard, J. Amer. pharm. Ass., Sci. Edn, 1947, 36, 225.
Editors Note: *** This has been proven to be incorrect.

 
Saccharin Sodium (B.P.). Saccharin. Sod.; Sodium Benzosulphimide; Soluble Gluside; Soluble Saccharin. C₇H₄O₃NSNa,₂H₂O = 241-2.
Foreign Pharmacopoeias: In Chil., Chin., Cz., Dan., Egyp., Ger., Hung., Ind., Jap., Jug., Mex., Nor., Span., Swed., Swiss, and U.S.
A white odourless or almost odourless crystalline powder with an intensely sweet taste. Soluble 1 in 1-5 of water and 1 in 50 of alcohol. Solutions are sterilised by autoclaving.

ARTIFICIAL SYRUP. Methylcellulose (4000 cp.) 5 g., saccharin sodium 2 g., glycerin 10 ml., imitation strawberry flavour 2 ml., amaranth solution (U.S.P.) 0-8 ml., water to 1000 ml. Incompatible with ascorbic acid, quinine hydrochloride, acetylsalicylic acid, sulphanilamide and sodium acid phosphate; discoloration occurs with ephedrine sulphate and phenobarbitone sodium; compatible with aneurine hydrochloride and potassium iodide.� E. Bechara T. and C. L. Huyck, Amer. prof. Pharm., 1957, 23, 53.
Uses. Saccharin sodium is used for the same purposes as saccharin, usually as tablets or solution. It is also used to determine the arm-to-tongue circulation time in patients with cardiac disease. A solution of 2-5 g. in 4 ml. of warm water is rapidly injected into the median basilic vein of the arm held level with the heart, and the time-lapse between the injection and the first perception of a sweet taste in the mouth is noted. In normal persons this circulation time is 9 to 16 seconds, but in the presence of severe cardiac failure it may exceed 45 seconds. Administration of saccharin sodium to human subjects in a dose of 50 mg. in 80 ml. of water causes a decrease of 12 to 16% in the blood sugar level of normal persons. Administration of the saccharin in 4 portions during a 40-minute period increased the duration of hypoglycaemia.� H. Kun and I. Horwath, Proc. Soc. exp. Biol, N. Y., 1947, 66, 288, per J. Amer. med. Ass., 1948,136, 502.

Saccharin Sodium Tablets (U.S.P.). Soluble Saccharin Tablets. Usual strengths: 15, 30, and 60 mg. of saccharin sodium.

Solution of Saccharin (B.P.C.). Liq. Saccharin.; Elixir of Saccharin; Elixir Glusidi. Saccharin sodium 7-31 g., alcohol 12-5 ml., water to 100 ml. 1% added to mixtures for flavouring.

Tablets of Saccharin (B.P.C.). Tab. Saccharin. Prepared from a mixture of saccharin and sodium bicarbonate or from saccharin sodium. Unless otherwise specified, tablets each containing the equivalent of  1/5 grain of saccharin are supplied.

PROPRIETARY PREPARATION OF SACCHARIN SODIUM

Saxin (Burroughs Wellcome). Saccharin sodium, available as tablets each equivalent in sweetening power to about 1 teaspoonful of granulated sugar.

Calcium Cyclamate. Cyclamate Calcium (N.N.R.). Calcium eyclohexyl-sulphamate dihydrate. C₁₂H₂₄O₆N₂S₂Ca,₂H₂O = 432-6.
A white, almost odourless, crystalline powder with a very sweet taste. Readily soluble in water; almost insoluble in alcohol, benzene, chloroform, and ether. A 10% solution in water has a pH of 5 '5 to 7-5.
Uses. It is used in place of sodium cyclamate when sodium intake must be restricted.

Sucaryl Calcium (Abbott). A brand of calcium cyclamate.

Sodium Cyclamate. Cyclamate Sodium (N.N.R.). C₆H₁₂O₃NSNa = 201-2. A white, almost odourless, crystalline powder "with a very sweet taste. Readily soluble in water; almost insoluble in alcohol, benzene, chloroform, and ether. A 10% solution in water has a pH of 5 -5 to 7-5.

ARTIFICIAL SYRUP. Methylcellulose (4000 cp.) 5 g., sodium cyclamate 27 g., glycerin 2 ml., imitation strawberry flavour 9'8 ml., amaranth solution (U.S.P.) 10 ml., water to 1000 ml. Incompatible with quinine hydrochloride and sulphanil-amide; compatible with ascorbic acid, ephedrine sulphate, aneurine hydrochloride, acetylsalicylic acid, phenobarbitone sodium, potassium iodide and sodium acid phosphate.� E. Bechara T. and C. L. Huyck, Amer. prof. Pharm., 1957, 23, 53.
Uses, Sodium cyclamate is a sweetening agent used as a substitute for sucrose by diabetics and patients on a restricted carbohydrate diet. It should not be given to patients with renal damage, or those on a low salt diet. It is about 30 times as sweet as sucrose. It is stable in hot solutions, and is free from bitter after-taste in concentrations below 0-8%. An excessive intake may produce a laxative effect and this should be controlled by regulating the amount used in the diet.

Sucaryl Sodium (Abbott). A brand of sodium cyclamate.

Dulcin. Phenetolurea (Span. P.). p-Ethoxyphenylurea. C₉H₁₂SO₂N₂ = 180-2.
Foreign Pharmacopeias: In Ger., Jap,, and Span.
Lustrous colourless crystals or a white crystalline powder with a very sweet taste. Soluble 1 in 800 of water, 1 in 50 of boiling water, and 1 in 25 of alcohol.
Uses. It is used as a substitute for sucrose, being about 250 times as sweet.
Dulcin in quantities likely to be consumed is harmless. No ill-effect has been observed in people consuming 25 dulcin tablets (each 60 mg.) daily over a period of some months.� J. M. Dyson, Lancet, ii/1942, 141.
The use of dulcin is being discouraged by the U.S. Food and Drug Administration since it has been found to cause injury to rats when fed at relatively low levels during 2-year tests.� Mfg Chem., 1950, 21, 182.

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