6 Medical Situations That Call for Compounded Medications

Compounded medications can be incredibly useful to some patients who require individualized care. These are 6 common medical situations where customized medication can be beneficial.

Every patient has their own individual health story and biochemical makeup. Even though the world of medicine relies on research, studies, and proven treatment methods to alleviate sickness, illness, and disease, the approach to treatment should address the needs of the individual patient, always.

This can make prescribing medication incredibly complex and is just one of the reasons pharmacists and physicians have such in-depth training on everything from contraindications to potential drug interactions.

For some patients, the need for an individualized approach can be a matter of life or death. Certain complicated medical situations and conditions may make commercially-available medications unsuitable or downright dangerous for these patients. Instead of prescribing a brand-name pill, many physicians and specialists will prescribe compounded medications that are custom-made at the pharmacy to eliminate concerns like filler allergies, unique dose requirements, or delivery format concerns.

When Should You Consider Compounded Medications?

To spread awareness about the benefits of compounded medications, we’ve outlined a few of the complex conditions that benefit from custom medications. If you have questions about whether a compounding pharmacy is right for you or your unique health situation, consult with your pharmacist today.

1. Allergies and/or Sensitivities

One of the most common complex conditions that necessitate compounded medications is allergies and sensitivities. Although most commercially-available drugs are tested to spur on reactions in as few people as possible, the potential for allergic reactions and sensitivities does still exist.

Drug allergies and sensitivities occur on a spectrum. A reaction could be as simple as mild itching or as complicated as full-blown anaphylaxis. Either way, treatment can become dangerous and ill-advised.

Through compounding, pharmacists can remove the offending filler or addition and break the medication down to its base compounds, recreating it into something that’s safer, more reliable, and less likely to cause a reaction. In some cases, allergy sufferers may also benefit from combining certain medications with anti-allergens instead. Pharmacists can often compound an antihistamine with the offending product if treatment is critical.

Even treating allergies and sensitivities directly may be easier with compounded medications. If a single medication isn’t enough, pharmacies can often combine medications for a better result. This includes pairing traditional antihistamines with H2 receptor blockers like Zantac.

2. Infants/Children

Infants and very young children are exceptionally sensitive, and that’s reflected in their specialized medical needs. Before the age of five or six, dosages must be weight-adjusted and tailored to the child’s needs. In the case of neonatal and preemie care, the need for customized medication is often even greater because infants have yet to develop a liver and kidneys that can efficiently clear medication.

Compounding gives the pharmacist the power to add only the exact dosage needed in the best dosage format for the child. In some cases, this is remarkably simple; adding flavoring to an antibiotic is an excellent example. In other cases, such as developing parenteral medications for preemies who can’t yet swallow, it can be much more complex. Pediatric compounding is quite popular as children and infants are two of the most common patient populations that utilize compounding in the pharmacy.

3. Patients Over 65

Like infants and children, geriatric patients also have special medical needs. They are frequently more sensitive to side effects and complications and may react to commercial medications. This is simply because the aging body needs to work harder to clear medication in the first place.

Geriatric patients who struggle with dementia and cognitive disorders may also benefit from a dosage format change, especially if they’re unable or unwilling to swallow. Depending on the medication, the pharmacy may be able to re-compound the ingredients into the following:

• patches
• creams
• injectable medication
• liquids
• capsules

Each of these can make it easier for caregivers to give medications and secure patient compliance.

4. Nursing Mothers

Treating a nursing mother for health conditions isn’t always easy. Often, doctors attempt to find a treatment that prevents or limits how much of the medication reaches the bloodstream, and thus, the mother’s milk. Sometimes, all that’s needed is to change the dosage format rather than the medicine. For example, a topical cream may still impart benefits without the risk of systemic circulation. The same is true for patches.

Not every medication compounded at the pharmacy is by prescription; the pharmacist can also compound soothing nipple creams, antifungal topicals, and anti-inflammatory topicals that reduce swelling and pain in mastitis.

5. Complex Genetic Conditions

Certain complex genetic conditions may predispose patients to a greater or lesser response to medication. This includes genetic conditions like a duplicated CYP2D6 gene that produces the enzyme directly responsible for processing codeine into morphine within the body.

Pain patients who have this duplicated gene process codeine faster than the average individual. Therefore, they may experience less relief for a shorter period. They’re also more prone to overdose because of the rapid metabolism.

Some genetic conditions demand compounding, not because of a specific gene, but because the genetic condition causes dangerous side effects from otherwise harmless compounds. This includes:

• Mast Cell Activation Syndrome
• Mastocytosis
• Multiple Chemical Sensitivity Syndrome

Though these disorders effectively cause an allergic reaction, they aren’t the same as everyday allergies and can be much more severe.

Often, patients with these complex conditions spend years identifying the exact brands and substances they can take safely. Since commercial medications can change fillers or formulations, it’s safer to have compounded medications every time.

6. Hospice and End-of-Life Care

Both hospice and end-of-life care demand a different approach to medication than in everyday patient care. Whereas concerns about addiction or sedation may be realistic for a patient who will survive their illness, this is less of an issue for a patient who is dying. Thus, doses are often escalated to whatever dose keeps the patient comfortable without causing additional illness along the way.

What makes end-of-life care especially puzzling is that doses are often much higher for compassionate medications like painkillers and sedatives. They may increase far beyond what commercial drugs can provide depending on how long end-of-life care lasts.

The patient’s level of consciousness can also dictate dosage format. These dosages may change back and forth over the course of care. If the patient loses consciousness and becomes unable to swallow or take their medication, caregivers need to give compassionate care prescriptions in a format that doesn’t require effort.

Compounded medications for end-of-life care addresses both of these issues by providing whatever dose the patient needs in whatever format he or she needs. The pharmacist can make up powders, liquids, patches, creams, or even IV medications as needed by the patient, rather than as provided commercially by drug companies. This allows for greater comfort care and less stress over medications as families say their goodbyes.

Compounded Medications and Your Health

Compounding was once the only way medication was created; centuries ago, a physician would prescribe your medication and the local apothecary would create it from scratch using only herbs and base compounds. Though it isn’t as widely used as it was in the 17th or 18th Century, compounded medications still have a significant role to play in medicine even today.

The combination of time-tested strategies and newer methods makes it easier than ever to create a medication that’s just right for the needs of every patient.