World Health Organization (WHO)
Polyoxyethylated castor oil is a non-ionic emulsifying agent
produced by reacting ethylene oxide with castor oil. It has been used for over 20
years to prepare stable injectable liquid preparations of drugs with low aqueous
solubility. By the mid-1970s, its use had been associated with cases of severe
anaphylactoid reactions and haematological changes including hyperlipidaemia,
altered blood viscosity and erythrocyte aggregation. For the formulation of certain
lipophilic substances such as ciclosporin there is currently no viable alternative to
this pharmaceutical aid. It continues to be approved in some countries whereas its
use is restricted or banned in others. One manufacturer has withdrawn worldwide
all products containing polyoxyethylated castor oil.
