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Information for prescribers -
Compounding
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PRESCRIBED COMPOUNDED MEDICATIONS
 In
every field of medicine, there are some patients who don’t
respond to traditional methods of treatment. Sometimes they need
medicine at strengths that are not manufactured by drug
companies, or perhaps they simply need a different method of
ingesting a medication.
Pharmacy compounding meets these needs. It provides a way for
physicians and compounding pharmacists to customize an
individualized prescription for the specific need of their
patient. Compounding provides solutions which are not met by
commercial products.
Q: What is compounding and what are its benefits?
A: Pharmacy compounding is the art and
science of preparing customized medications for patients. Its
practice dates back to the origins of pharmacy; yet,
compounding’s presence in the pharmacy profession has changed
over the years. In the 1930s and 1940s, approximately 60 percent
of all medications were compounded. With the advent of drug
manufacturing in the 1950s and ‘60s, compounding rapidly
declined. The pharmacist’s role as a preparer of medications
quickly changed to that of a dispenser of manufactured dosage
forms.
Within the last two decades, though,
compounding has experienced a resurgence as modern technology
and innovative techniques and research have allowed more
pharmacists to customize medications to meet specific patient
needs.
 There
are several reasons why pharmacists compound prescription
medications. The most important one is what the medical
community calls “patient non-compliance.” Many patients are
allergic to preservatives or dyes, or are sensitive to standard
drug strengths. With a physician’s consent, a compounding
pharmacist can change the strength of a medication, alter its
form to make it easier for the patient to ingest, or add flavor
to make it more palatable. The pharmacist also can prepare the
medication using several unique delivery systems, such as a
sublingual troche or lozenge, a lollipop, or a transdermal gel
or cream that can be absorbed through the skin. For those
patients who are having a hard time swallowing a capsule, a
compounding pharmacist can make a liquid suspension instead.
Compounding pharmacists have the
opportunity to work with a variety of practice specialties, such
as hospice, pediatrics, pain management, and OB/GYN, which in
turn broadens the scope of their practices and creates other
opportunities to provide other pharmacist care services. Your
pharmacy can become a compounding pharmacy – one that is
committed to providing high-quality compounded medications in
the dosage form and strength prescribed by the physician. This
triad relationship between the patient, the physician, and the
pharmacist is vital to the process of compounding so all three
can work together to solve unique medical problems.
Q: Can children or the elderly use compounded medication?
A: Yes. Children and the elderly
are often the types of patients who benefit most from
compounding. Often, parents have a tough time getting their
children to take medicine because of the taste. A compounding
pharmacist can work directly with the physician and the patient
to select a flavoring agent, such as vanilla butternut or tutti
frutti, which provides both an appropriate match for the
medication’s properties and the patient’s taste preferences.
Compounding pharmacists also have
helped patients who are experiencing chronic pain. For example,
some arthritic patients cannot take certain medications due to
gastrointestinal side effects. Working with their physician’s
prescription, a compounding pharmacist can provide them with a
topical preparation with the anti-inflammatory or analgesic
their doctor has prescribed for them. Compounded prescriptions
often are used for pain management in hospice care.
Q: What kinds of prescriptions can be compounded?
A: Almost any kind. Compounded
prescriptions are ideal for any patient requiring unique dosages
and/or delivery devices, which can take the form of solutions,
suppositories, sprays, oral rinses, lollipops and even as
transdermal sticks. Compounding applications can include:
Bio-identical Hormone Replacement Therapy, Veterinary, Hospice,
Pediatric, Ophthalmic, Dental, Otic (for the ear), Dermatology,
Medication Flavoring, Chronic Pain Management, Neuropathies,
Sports Medicine, Infertility, Wound Therapy, Podiatry and
Gastroenterology.
Q: Is compounding legal? Is it safe?
A: Compounding has been part of
healthcare since the origins of pharmacy, and is widely used
today in all areas of the industry, from hospitals to nuclear
medicine. Over the last decade, compounding’s resurgence has
largely benefited from advances in technology, quality control
and research methodology. The Food and Drug Administration has
stated that compounded prescriptions are both ethical and legal
as long as they are prescribed by a licensed practitioner for a
specific patient and compounded by a licensed pharmacy. In
addition, compounding is regulated by state boards of pharmacy.
Prescription compounding is a rapidly growing component of many
physicians’ practices, providing expanded treatment options and
solving challenging medication needs. Western Iowa Compounding
Solutions is committed to providing high-quality compounded
medications in the dosage form and strength prescribed by the
physician. This triad relationship between the patient, the
physician, and the pharmacist is vital to the process of
compounding so all three can work together to solve unique
medical problems.
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PRESCRIBED COMPOUNDED MEDICATIONS |
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