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Compounding

5 Benefits of Compounded Pain Medication

We understand the human body and its functions far more now than compared to a hundred years ago. This knowledge, combined with advancements in biology and chemistry, has dramatically increased the power of curative treatment. As humans, we’ve created treatments for diseases which were previously fatal and have outright cured a few along the way, too. But there’s still a long way to go.

Treating pain is an excellent example of exactly how much and how little science knows about medicine. No single pain treatment works for everyone, and science still doesn’t fully understand the subtle neurological differences in pain perception — but they’re making progress.

Treating chronic pain is especially complicated. Medical conditions may interact with each other, often in unexpected ways, and that makes diagnosing and addressing the pain a real challenge. Certain conditions may also contraindicate or disallow the use of specific medicines, either together or individually, significantly reducing available options.

Fortunately, there is an option: compounded pain medication.

 

Compounded Pain Medication Facts

Compounding refers to the process of stripping a medication down to its base elements and then reformulating it, either to better suit the patient or to reduce associated risks (like allergies). Through compounding, pharmacists can target treatments much more effectively with fewer side effects and easier medication use, and that results in improved patient compliance.

When treating chronic pain, your medical care team may suggest compounded pain medication as a reasonable solution. Here are five of the many benefits that compounded pain medication has to offer.

 

1. Combination Medications

For every form of pain — neuropathic pain, muscle pain, fascial pain, visceral or organ pain, and cancer pain, for example — there’s a particular drug that bests targets the pain. Some medications may work only on one type of pain, while others address many. If you experience more than one type of pain, combination medications can help you resolve it with fewer doses and fewer side effects.

Often, combination drugs offer pure and simple convenience. Rather than having to keep track of every pill, you only need to keep track of one or two doses instead.

Sometimes, doctors prescribe combination medications because they know the drugs work together efficiently to produce a better outcome. This is the case with certain nausea drugs, topicals to treat skin conditions, and many allergy formulas.

 

2. Better Dosage Level Control

Managing dosage is one of your pharmacist’s most important jobs. That’s especially true for pain relievers due to the high risk of side effects and tolerance. Some drugs, like NSAIDs, can cause severe and devastating stomach issues if taken excessively by mouth. Compounding these drugs into a non-oral form or topical solution reduces strain on your stomach and other sensitive organs.

Some patients may need more pain relief, yet the doctor may be hesitant to increase narcotics dosage due to the risk of addiction or sedation. Compounded topical numbing agents, usually applied by patch, cream, or gel, may enhance the patient’s narcotic by relieving surface and subdermal pain. It isn’t an actual fix, but it acts like a slight boost on the worst days. This approach is especially useful for patients with musculoskeletal issues.

Other patients, including children and pets (yes, compounding works for pets, too!) may be especially susceptible to dosage adjustments. Commercially-available pills may not come in doses low enough or specific enough for treatment. In the case of children, creating liquid solutions containing just enough painkiller is the best way to achieve effective pain control without side effects or sedation.

 

3. Easier Dosing Formats

Very sick patients often take multiple medications and may struggle with bitter drugs, large pills, or painful injections. Changing the intake method noticeably improves quality of life for these patients. In some cases, it may even be necessary — any parent who’s had to convince a child to take a bitter antibiotic liquid knows this first-hand.

Through compounding, the pharmacist can do the following:

  • add flavoring
  • change a pill to an injectable
  • change an injectable to a topical
  • create dissolvable lozenges that require less effort to swallow

Compounded pain medication is ideal for the following types of people:

  • little ones who balk at medicine
  • patients who are very weak
  • patients with oral cancers
  • anyone else who struggles with their current dosing format

 

4. Wider Range of Treatment Options

As mentioned further up, sometimes medical conditions can seriously limit a patient’s medication options. Moreover, there are situations where plain oral pills aren’t even the best choice due to efficacy.

For example, topical creams and gels work far better for treating pain within the surface of the skin, such as at the site of nerve trauma, than narcotics. They work by turning nerve signals from the area off (if only temporary). Products containing a topical NSAID also show serious improvement for patients undergoing a Rheumatoid Arthritis (RA) flare, with an onset time of around 30 to 60 minutes — pills often take much longer to “kick in.”

Patients with weakness, such as those who are recovering from stroke, may benefit from a dosage format change because they lack the ability to swallow pills at all. Others, including patients who have neurodegenerative conditions like Alzheimer’s Disease, may present a swallowing risk. Thus, topical or injectable works far better.

Overall, because compounding is so precise, it can be used in place of or beside other treatment modalities. The patient has more options for treatment regardless of case complexity.

 

5. Necessary for Hospice Patients

Hospice presents specialized pain control needs and very specific difficulties in achieving pain treatment goals. End-of-life care is inordinately complicated; medical professionals much achieve pain control without over-sedating the patient or causing secondary illness via overdose, all while determining how to dose a half-conscious or fully unconscious patient. Further complicating the issue is the fact that hospice patients often demand very high doses of medicine — higher even than what may be available commercially.

Determining how to achieve pain control goals in hospice is, for these reasons and many more, almost always difficult. Most hospice patients cannot, or will not, take medication orally. Injectable solutions, topical creams, and patches help caregivers and family members to ensure that the patient’s needs are met with as much dignity, respect, and safety as possible.

 

In Conclusion

For patients who need individualized pain management tools, compounding really can shine a bright light on brand new treatment options. Whether it’s the freedom to live comfortably, the ability to reduce the total number of doses per day, better dosage control, or easier dosage formats, compounded pain medication can enable you to better treat your pain. If you have questions about your pain treatment, speak with your physician or pharmacist to see if compounding is right for you.

 

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Compounding Skin Care

7 Types of Anti-Aging Compounding Remedies

Everyone wants to preserve their youth for as long as possible, be it in body, mind, or spirit. A healthy lifestyle and positive attitude go a long way in achieving this goal, but sometimes, aging skin needs an extra helping hand. Anti-aging compounding remedies relieve the side effects of aging and empower you to look your best youthful self as you grow older, wiser, and sharper every single day of your life. Whether you’re just reaching 40 or headed for 90, these pharmacy-created products can brighten, even, smooth, and restore your skin to its natural youthful glow.

 

1. Hand Creams, Lotions, and Moisturizers

Compounded creams, lotions, and moisturizers all achieve one main goal: they impart vital moisture to aging or thinning skin. As our skin ages, it loses elasticity and the ability retain moisture equally; that plays a role in the development of sagging and wrinkles. Moisturizing regularly can effectively offset those effects for some patients. Nutrient-rich blends containing ingredients like hydrating oils, humectants, and vitamins impart moisture where it’s needed most — skin-deep.

Unlike commercial products, anti-aging compounding remedies can be adjusted to suit your needs. Adding or removing ingredients one-by-one makes it easier to limit over-moisturizing and prevent undesired side effects while still achieving your skin care goals.

 

2. Scalp and Hair Growth Treatments

Compounded scalp and hair growth treatments get to the root of the problem to alleviate the following issues:

  • hair loss
  • dry and itchy scalp
  • seborrheic dermatitis
  • psoriasis
  • other scalp conditions related to aging

These remedies often cleanse the scalp and rejuvenate pores along the hair shaft, creating conditions that inspire hair to grow and thicken over time. Medicated products also reduce symptoms of skin and scalp conditions for greater patient comfort.

Some scalp and hair growth treatments may also contain hormones that encourage hair growth long into later life. These products may be especially useful for patients suffering from Male Pattern Baldness (MPB) or certain thyroid conditions.

 

3. Wrinkle and Fine Line Reducers

Compounded products that treat wrinkles and fine lines do so from a number of different approaches. They may plump the skin by injecting moisture to a localized area, or they may utilize antioxidants to reduce toxins that slow the development of wrinkles in the first place. Still others may simply mask wrinkles and fine lines under your daily makeup. Many of these products contain a substance known as retinoic acid (Retinol) that plumps the skin and encourages the production of collagen, encouraging the growth of new connective tissue and skin.

Retinol-containing skin treatments also have the added side effect of greatly smoothing and softening the skin, aiding patients in restoring youthfulness after sun, wind, and weather damage.

 

4. Dark Spot and Uneven Tone Removers

Dark spot removers and tone-evening formulas use a combination of substances like caffeine, vitamins, minerals, skin lighteners, and/or moisturizers to first re-balance your skin to a healthy state. Then, gentle lighteners work to remove age spots, scars, and other undesired blemishes.

Advanced products containing hydroquinone, a prescription-strength lightening cream, and tretinoin, an anti-blemish product often applied to acne breakouts, may work best for patients with particularly sticky spots or hard-to-lighten skin. These products should be used with care under the guidance of a pharmacist.

 

5. Remedies for Specific Skin Conditions

Anti-aging compounding remedies may also address skin problems aggravated by aging, such as:

  • psoriasis
  • rosacea
  • eczema
  • dermatitis

Because aging skin loses elasticity and moisture, many patients find these conditions worsen over time as they age. By creating a patient-tailored formula with prescription ingredients to relieve skin disorder symptoms as well as moisturizers, vitamins, and healthy skin ingredients, patients can fight everyday signs of aging without worsening skin issues.

For patients with psoriasis, compounded Vitamins A, B12 and B6 products work best. Coal tar, alpha-hydroxy-acid, and salicylic acid soften and reduce the appearance of scales and refresh skin.

For patients with eczema, avoiding allergens and sensitivities is especially important as these can trigger eczema in the first place. Compounded cosmeceuticals not only address the issue directly but also allow pharmacists to remove potentially offending substances.

Overall, patients with chronic skin conditions benefit more from compounded solutions than commercially-available products. Every patient is unique — your skin care solution should be unique, too.

 

6. Medicated Ointment Sticks and Applicators

Anti-aging compounding remedies don’t just address the signs of aging directly; they may make it easier to address these issues through delivery format changes. This is especially helpful for patients who may struggle with lids or creams due to mobility challenges or weakness in the wrists. Medicated ointment sticks and applicators make it easier to apply treatments to specifically targeted areas of the face or body, especially in hard-to-reach areas like the armpits.

Other specialized applicators may include:

  • tubes
  • specialized dosing dispensers
  • rollerball applicators
  • transdermal gel delivery systems

All of these make it easier to achieve your anti-aging goals with less hassle, muss, and fuss.

 

7. Antioxidant-Based Skin Treatments

Oxidization stress and skin glycation are two of the primary contributing factors in aging-related skin damage. Over time, free radicals increase dermal protein damage within the first few layers of skin. This leads directly to skin glycation, a condition where skin proteins bind with sugars in the body to encourage the growth of certain damaging bacteria, like Propionibacterium acnes.

There’s a great deal of research that shows eating and applying antioxidants may reduce both oxidation and glycation, especially if patients start early and are consistent with treatment all throughout life.

Compounded antioxidant skin care treatments typically include very specific antioxidants — many of which are the same as those found in the foods we eat. Effective formulas may contain Vitamins A, B, C, D, and E as well as other substances, like essential fatty acids, amino acids, glycolic acid, beta-carotene, or CoQ10. There is at least some evidence that Vitamin C itself may actually encourage the cross-linking of collagen, making it one of the most common ingredients for antioxidant-based skin treatments.

 

In Conclusion

Aging doesn’t have to mean dull, dry, or uneven skin. Through anti-aging compounding, your local pharmacy can create custom-tailored skin care solutions that alleviate your toughest aging-related issues. Find your perfect solution today — schedule a consultation with your pharmacist.

 

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Compounding

How Your Child Can Benefit From Pediatric Compounding

No child looks forward to being sick, much less taking medicine to feel better when they do. If it were up to children, the main treatment for most minor illnesses would be plenty of candies, unlimited video games, or maybe even the freedom to stay home from school just once.

Unfortunately, this is a situation where parents truly know best; sometimes, taking medication is the solution. It’s at these times when finding ways to make it easier and safer for your child to take his or her medication comes into play. This article will discuss how pediatric compounding can make parents feel at ease when it comes to giving children medication.

 

Complex Medication Needs

Medicating children is complicated and often difficult. Their smaller bodies and faster metabolisms often demand dose changes and depending on how small they are, may even necessitate delivery format changes, too.

Even when the dosage is correct, children are more prone to adverse side-effects and interactions. Risks seem to be the highest for infants and newborns, gradually stabilizing by the time most children reach around 12 years of age.

The fantastic news is that pediatric compounding really can help to make medicating your child a less stressful experience. Through pediatric compounding, your pharmacist creates the ideal custom medication to match your child’s treatment plan.  He or she follows the doctor’s prescription and then seeks to make the medicine easier to take, less likely to cause side-effects, and safer for your child.

 

Dosage Adjustments for Size

Commercial medications come in exact doses, and those doses aren’t always suitable for children, much less newborns and infants. Giving a dose that’s even a few milligrams or micrograms off can be the difference between success and severe side effects, so getting it just right matters.

Unfortunately, even age isn’t a perfect predictor of required dose; two little ones can be the same age but may be completely different weights or heights.

Because commercial drugs come in predetermined doses, that can leave your little one’s dosage well outside of the spectrum of what’s available. Giving a slightly higher or lower dose or changing the delivery format on your own (e.g. crushing pills) seems like a viable solution, but it’s neither reliable nor accurate.

Instead, pediatric compounding allows the pharmacist to calculate the exact dose-per-weight ratio for your child. He can then work out exactly how much medication is safe and suitable for your child’s condition. Each prescription is tailor-made for your child!

 

Removing Allergy-Inducing Fillers

Parenting an allergy-prone child can be incredibly stressful and downright frightening, especially if your child experiences anaphylaxis. Though it’s rare, some children do seem to react to certain fillers, binders, and dyes in medications. Unfortunately, it’s not always obvious to identify potential allergy triggers in a pill, liquid, patch, or aerosol medication.

For kids with allergies, compounding can quite literally be a lifesaver. Because pediatric compounding strips the drug down to base ingredients, pharmacists can remove as many potential risks as possible while maintaining treatment efficacy.

If you know what substance is triggering the allergic reaction, the pharmacist can leave it out. If you’re not sure which filler is the problem, the pharmacist can re-compound the medication with fillers or binders with a lower likelihood to trigger allergies in the first place.

Depending on the drug, it may be possible to compound the base drug into flavoring or delivery systems alone instead of with binders, fillers, or preservatives. That’s particularly useful when trying to identify unknown allergy triggers.

 

Combining Multiple Medications

You know your child can’t stand taking medicine. They kick up a fuss, run, hide under the couch, and spit the pill out. It’s no fun for anyone when taking medication is a struggle. Whether you’re treating something like an ear infection or long-term, chronic childhood conditions, the prospect of mediation time can become something to dread. Add multiple medications into the mix, and that struggle begins to telescope into a potential nightmare.

Here’s the thing: if your child doesn’t ingest the drug, it’s not helping. Combining multiple drugs shown to be safe when taken at the same time into a single delivery format reduces the amount of time you spend struggling with your child, and most importantly, probably results in more medicine reaching your son or daughter’s system. It gets all of you through medication time with less muss, less fuss, and happier family members all around.

Though it isn’t possible to combine drugs in every case (contraindications and negative interactions may exclude combination medications as an option) your pharmacist can mix many medications into a single capsule, patch, cream, aerosol, or liquid.

The potential for combinations is extensive, including:

  • certain antibiotics
  • specific seizure drugs
  • combination medications for conditions like ADHD

Instead of three or four doses, you only need to worry about convincing them to swallow one, making it much easier on the entire family.

 

Dye-Free Pediatric Compounding Solutions

There’s good evidence that food dyes may trigger sensitivities in little ones. By far, the most common trigger seems to be red lake dyes (specifically Red 40), but it’s difficult to predict how children will respond to dyes of any color. Some little ones experience allergic reactions, while others experience hyperactivity. Some experience migraines, stomach upset, and other more subtle undesired responses.

Current evidence shows that children with ADHD may react to food dyes at a higher rate than children in other patient populations. The same research tells us there is a link, but it doesn’t say exactly how far that link extends and whether it’s just correlation or causation.

Truthfully, we just haven’t reached a point where we know exactly how, what, why, or when medication dyes affect children. What we know so far is that there is a potential risk.

Researchers continue to probe the issue for conclusive evidence one way or another, but in the meantime, many pediatricians recommend parents avoid dyes altogether whenever possible.

Dye-free compounding produces medications that don’t contain dyes, drug preservatives, and other potential triggers, ameliorating the risk of triggering these sensitivities in the first place. It’s not a sure-fire way to reduce side effects, but it is a proactive way to protect your child until researchers are sure.

 

Delivery Format Changes

Delivery format (how your child takes his or her medication) can be just as important as the medication dose itself. The wrong delivery format will make it difficult or even downright impossible for a little one to take their medication with ease. In the case of infants and newborns, it may even pose an additional choking hazard.

The most obvious example of this concept is pills and infants three months of age or less. These little ones aren’t yet old enough to know how to swallow properly, and thus, a pill isn’t a suitable delivery format for them. Even older children can struggle with unusually large tablets. Sometimes it’s just as easy to have the pharmacist reformulate your prescription.

Your child’s particular health condition may also indicate a need for a delivery format change. A child with pneumonia often benefits more from liquid inhalation via aerosol delivery rather than a pill or liquid antibiotic. Likewise, children treated with CBD derivatives for seizures certainly can’t smoke marijuana (though not every pharmacy offers CBD processing just yet).

In cases like these, your pharmacist can re-compound the base drug into the best delivery format for your child. As treatment goes on, he or she can utilize pediatric compounding to continuously adapt the treatment to better suit your child’s waxing or waning needs.

 

In Conclusion

Pediatric compounding strategies aren’t always about improving treatment; sometimes, it’s just a way to make the experience easier for your child. As a whole, it may include:

  • adding flavors to bitter or bad-tasting medications
  • creating aerosol inhalation mixtures to treat pediatric asthma and other lung conditions
  • creating liquids from pills or capsules from powders
  • reformulating everyday medications into painless patches or creams for easier application

Either way, the primary goal is that your child spends less time struggling with the medication and more time being his or her happy, healing self.

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Compounding

What is Gluten Free Compounding?

Do you suffer from Celiac’s Disease or gluten reactivity? If you do, you should know that it isn’t only food you need to restrict to avoid reactions. Even the medication you take on a daily basis can contain trace amounts of gluten–enough to cause a reaction for many patients. But the options for gluten-free medications ate rare on the commercial market. That’s why many pharmacies are turning to gluten free compounding instead.

In this short guide, we’ll help you break down the nuances to gluten sensitivities (including misconceptions). Then, we’ll outline how gluten free compounding may help you avoid trace sources of gluten.

 

What is Gluten Sensitivity or a Gluten Allergy?

Approximately 3 million people throughout the United States have a legitimate gluten sensitivity issue. This usually presents as either Celiac’s Disease or Non-Celiac Gluten Intolerance. Both are legitimate and extremely serious medical conditions that cause pain, bloating, and digestive upset.

For patients with true allergies, even a molecular amount of gluten can spur on cramping, diarrhea, constipation, gas, and general discomfort for days. Responses can start as little as 15 minutes after eating the offending product or taking the gluten-containing pill, while others may not react for as much as four days.

 

Gluten: Trend or Tragedy?

There’s so much misconception around gluten. Although a small number of people really do experience gluten sensitivity and gluten allergies, the rate is quite small. Surprisingly, nearly 30 percent of Americans admit to shopping for gluten-free products. They seem to tolerate gluten fine, yet still avoid it.

What exactly is happening here? Why would people shop for gluten-free products if they don’t have an allergy?

The answer lies in the fact that bread (and more specifically, breads that contain gluten) have erroneously been connected to weight gain and poor health.

Though it’s true that eating too many carbs and not exercising enough certainly can cause weight gain, this is less of an issue with gluten and more of an issue with calories in, calories out. Of course, weight loss and weight gain is also influenced by everything from genetics to lifestyle, too.

To further confuse the matter, some people do react to other substances in gluten-containing foods. Short-chain triglycerides called FODMAPS are known irritants for patients with:

  • Irritable Bowel Syndrome (IBS)
  • Irritable Bowel Disease (IBD)
  • Crohn’s Disease (CD)
  • and other gastrointestinal upsets

For these patients, avoiding anything sourced from wheat may be beneficial–including gluten-containing medications.

The most important step to take is to have your doctor work to find the source of your issues rather than self-diagnosing a gluten issue.

When Gluten Strikes: How Gluten Free Compounding Helps

You’ve determined that you have a legitimate gluten sensitivity. Or, your doctor recommends that you cut out all sources of gluten to lessen symptoms from a condition like IBD or IBS. You’ve changed your diet, now it’s time to check and alter your medications, too.

Your pharmacist can run your medications through the system and bring up their MSDS or pharmacology sheets. These information sheets contain extremely in-depth technical information about what exactly is inside your medication. If gluten or gluten-containing fillers are present, they will be able to identify them from the sheet alone.

If your pharmacist identifies that your medication contains gluten, he or she will evaluate it for gluten free compounding.

Gluten free compounding allows the pharmacist to re-create commercial medications without the offending gluten (or perhaps without any fillers at all). Compounding can also reformulate medications to make them easier to take or use, or to combine multiple medications.

When compounding your medications, your pharmacist takes all of the base substances in your medication and then removes anything that may be harmful. Then, he or she can combine the substances back together into a liquid, a pill, a patch, a cream, or some other delivery method altogether.

 

What Medications Contain Gluten?

Surprisingly, the list of medications that contain either gluten or trace amounts of gluten is quite extensive. That’s because gluten is an excellent filler; it’s a protein that becomes stretchy like a web when manipulated.

This is why bread is kneaded to make it softer and denser.

In a medication, gluten holds all of the other substances together into one cohesive pill, patch, or substance. Unlike other potential allergens, the FDA has no required law to label whether pills contain gluten or gluten-sourced substances. It’s up to your pharmacist to investigate your medication on an individual level to see if they contain gluten.

Certain medications may be more likely to contain gluten or gluten-sourced substances if they contain specific ingredients. These will be listed on the MSDS or pharmacology data sheet, and are usually listed as:

  • Wheat
  • Pregelatinized starch
  • Dextrates/Dextrin
  • Dextrimaltose
  • Caramel coloring
  • Barley malt

Essentially, anything with a filler or coloring sourced from a gluten-containing plant is a problem. Furthermore, the above list is far from exhaustive. If you’re not sure whether your medication contains gluten, ask your pharmacist to pull the data sheet for it.

 

What About Non-Prescription Medications and Supplements?

If you rely upon non-prescription medications and supplements, your pharmacist may be able to use gluten free compounding to better suit you, too. Surprisingly, gluten is extremely common in vitamins and health supplements. This is because those who do not have a gluten sensitivity or allergy really can benefit from the nutrition found in gluten-containing plants, like wheat protein or wheat germ oil.

Unlike prescription medications, the FDA does require that all over-the-counter products be marked clearly if they are gluten-free. This labeling makes it significantly easier to identify which commercial products are safe and unsafe.

That said, those with a gluten allergy should never rely upon labeling alone. Some patients find that even substances grown or sourced near gluten are enough to trigger an attack. Your pharmacist can pull the ingredient lists and MSDS for many over-the-counter products, too, and will help you to make an informed decision about OTC products.

Need information about your medications? Your pharmacist is standing by to take your call. Informative patients make better choices about their health in nearly all cases, so you should never be afraid to ask for clarification or investigation. Reach out to your pharmacy today for more information on your medications and gluten free compounding.

 

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Compounding

What are Compounding Pharmacies?

If you’re hearing the term “compounding pharmacy” tossed around lately, it’s no surprise. Compounding pharmacies are rapidly growing in popularity thanks to their ability to custom-tailor medications that better suit individual patient needs. As a facet of the healthcare industry, they provide an invaluable service to patients who may not necessarily fit the standard treatment guidelines for medications.

Any facility who makes medications either from scratch or by combining substances to make a drug that isn’t commercially available is classified as a compounding pharmacy. This includes medications that need to be adjusted for dose, delivery method, or even flavor.

Curious if compounding pharmacies can help you to achieve your healthcare goals? Let’s dive in and take a look at how and why it works.

When is Compounding Used?

Your pharmacist turns to compounding whenever a standard medication doesn’t make sense. It is a science of adjustments that focuses on customizing patient medications to be as easy to take and effective as possible.

Exactly how he or she utilizes compounding depends entirely on the patient for whom the compounded drug is intended. Drug compounding is all about customizing treatments to better suit patient needs.

 

Compounding for Children

Compounding for children is exceptionally common. A young child or infant might need a smaller dose of a certain medication, or may be unable to swallow pills. The pharmacist can transmute the correct dose into liquid form to make the drug in question accessible. One of the most recognizable forms of compounding for children includes flavoring antibiotics and other medications to make them easier to take.

 

Drug Allergies

Compounding can also resolve issues of drug or filler allergies, too.

Example 1: Patients who are gluten-intolerant may need their drugs compounded by hand to prevent gluten-based fillers from causing severe allergic reactions.

Example 2: A patient might have an allergy to one of the components in a drug that is commercially available. The pharmacist can access the base drug in question without the additives, and then create a solution that’s free of the allergen instead.

In both instances, the compounding pharmacy would be responsible for making the form and correct dosage of the drug while ensuring that it did not contain any of the offending ingredients.

 

Discontinued Medication

A medication that has been discontinued for lack of profit or for increased risk of side effects may also remain available via compounding in special situations. This is most common for life-saving medications that either lose approval or lack the approval to be sold on the public market.

The compounding pharmacist orders the necessary ingredients from a wholesale supplier and then compounds it to a specified dosage based on the patient’s needs. He or she works directly with the doctor to adjust or modify the dose as needed. This prevents patients from falling through the cracks due to a one-size-fits-all approach.

 

Side Effects

Sometimes, patients might need a specific medication because the commercially-available form causes intense side effects for them. This is most common in combination medications, but can also include solitary substances. Commonly experienced side effects include:

  • drowsiness
  • irritation
  • stomach pain
  • diarrhea
  • constipation

Though a medication change is often needed, in some cases, all that’s required is a change in the formula itself. Compounding pharmacies prepare the specified medication in a way that eliminates side effects.

For example, the pharmacist may create a transdermal numbing cream that patients apply directly to the source of pain. This eliminates the need to take harsh pills that may harm the stomach.

This is a common application for many non-steroidal anti-inflammatory medications (NSAIDs) like ketoprofen and diclofenac. NSAIDs are notoriously harsh on the gastrointestinal tract, but don’t cause the same damage when applied topically.

Medications for neuropathic pain (including gabapentin and Lyrica) are also good candidates for transdermal patches and creams. Applied topically, they don’t cause drowsiness or come with the risk of behavioral changes in elderly or liver-compromised patients.

 

Availability of Compounding Pharmacies

According to the IACP (International Academy of Compounding Pharmacists), there are 56,000 compounding pharmacies based in American communities all across the country. Nearly half of those serve local doctors and patients, while others serve medical facilities and healthcare organizations directly. Around 7,500 American pharmacies fall under what the IACP refers to as advanced compounding services. These facilities have special licenses and more technology, allowing them to handle high-tech compounding projects. Of these pharmacies, 3,000 specialize in making products that are sterile.

 

Compounding Pharmacies and the FDA

When it comes to drug manufacturers, the FDA is responsible for overseeing all regulations. But when it comes to pharmacies, regulations are handled by the state. Compounding pharmacies fall under a totally separate governing body, though they are still guided by FDA requirements.

There are a total of three government level agencies that regulate compounding pharmacies. Each state has a pharmaceutical board who ensures that pharmacies follow all state regulations. These boards also dictate the regulations for pharmacy practices.

The FDA is responsible for regulating the actual integrity of the drugs that are made by a compounding pharmacy as well as any active pharmaceutical ingredients that go into them.

Finally, the DEA (Drug Enforcement Administration) is responsible for regulating the way that compounding pharmacies handle controlled substances.

The independent PCAB (Pharmacy Compounding Accreditation Board) makes its official seal of approval available to those pharmacies that can pass very strict inspections. Requirements are lengthy and include a host of rigid but voluntary standards designed to keep pharmacies effective and accountable.

 

Is My Medication Compounded?

In nearly all cases, your physician or pharmacist will advise you if a drug requires compounding. If you’re not sure, ask your local pharmacist directly. In some cases, a compounded version of a medication may be more effective for you, so don’t be afraid to ask your pharmacist whether compounding can improve your treatment outcomes.

Your health matters, and if you take medication on a regular basis, compounding may be able to help you achieve better health. Whether your pharmacist removes an offending filler or allergen or compounds a topical cream for you from scratch, the goal is always the same: to make taking your medication easier and more effective with less hassle and struggle. If you have any further questions about compounding, speak with your pharmacist.

 

Categories
Compounding

Different Types of Compounded Medications for Pets

You’re an animal lover–you want what’s best for your bet, especially when they are sick. A trip to the vet can cause stress for both you and your pet. With payments, medications, and lists of do’s and don’ts, it’s easy to feel overwhelmed. While most vets have a pharmacy right on site, there are some medical problems that require specific or targeted treatments. That’s where your local compounding pharmacy comes in. Compounding pharmacies can mix ingredients to the very specific doses that your pet requires, alter the flavor of a medication, or create pet-specific combination medications that improve your ability to treat your pet. Here is a list of some of the different types of compounded medications for pets that your local compounding pharmacy can provide.

 

Transdermal Gels

These compounded medications for pets are made into a gel that is put inside the animal’s ear flap. Vets prescribe transdermal gels most commonly to deliver antiparasitics, anti-inflammatories, and sometimes, hormones. Transdermal gels work in the same way as transdermal patches–by transferring the medication through the derma (skin) and into the bloodstream.

 

Methimazole

Vets use Methimazole to treat canine or feline hyperthyroidism, also known as an overactive thyroid. It’s used in both dogs and cats, but is a much more common and effective treatment for felines. The medicine used in the transdermal gel is the exact same as the tablets, and often comes in ready to use syringes for easy dosing of your pet.

This is a fast-acting medication, though full results can take some time. Compounding pharmacies can also create oral methimazole suspensions and pills. Wet versions of the drug have a three-month lifespan, whereas pills generally last approximately one year..

 

Amitriptyline

Amitriptyline is a tricyclic antidepressant. It balances certain receptors and chemicals in the brain. It treats a variety of behavioral issues in pets, and is often prescribed for anxiety, separation anxiety, excessive grooming, spraying in cats, and overgrooming. Some pets may benefit from using this drug for chronic nerve pain and severe itching.

Amitriptyline pills are small and easy to dose, so it isn’t really common for a vet to prescribe it in a transdermal gel. Vets typically prescribe it when other dosing methods have failed or when the pet has pre-existing liver considerations.

 

Prednisolone

This medication is a steroid that decreases inflammation and alters the immune system’s response. Vets prescribe it to treat itching, swelling, and redness associated with allergies, breathing and skin problems, and a wide range of auto-immune conditions. Veterinary oncologists also prescribe it alongside chemotherapy treatments for particularly aggressive or difficult-to-treat growths and cancers.

Prednisolone is available in a long list of delivery methods, but the transdermal gel is particularly appropriate for pets with autoimmune skin conditions as it can be applied directly to the affected area.

 

Capsules

Another type of compounded medications for pets is capsules. Capsules mimic the style and shape of a pill, but rather than being sold, are pre-filled and then snapped together by your compounding pharmacist. Dosing a capsule is identical to dosing a pill; the only difference is that your pharmacist can alter what’s inside the pill before you begin.

 

Diethylstilbestrol

Commonly known as DES, this medication is used to treat estrogen responsive urinary incontinence. This condition occurs in spayed female dogs and may be related to incomplete spay or other hormone conditions. Estrogen responsive urinary incontinence can be a serious challenge for pet owners; to some, it may seem like the dog has regressed. But no amount of potty training will change this condition. Only medications like DES can help.

DES is also used to treat male dogs with an enlarged prostate, whether due to a condition like cancer or even just old age. The medication reduces the swelling and relieves pressure.

DES has a short shelf life of just 20 weeks. You should closely monitor your usage of the drug and request a refill at least one week in advance of the end of your current prescription.

 

Potassium Bromide Capsules

Potassium bromide treats seizures and neurological disorders. This drug is one of the oldest anti-seizure drugs available on the market to date, and was first created to treat people in the late 1800s. Today we have better medications for humans, but in pets, potassium bromide remains a go-to medication for hard-to-treat or resistant epilepsy.

This medication contains the original medication potassium bromide, but comes in an easier-to-dose capsule form. Compounding pharmacies sometimes combine it with other medications, like phenobarbital or benzodiazepines, to increase the efficacy of the other drug.

During treatment, your vet will monitor your pet’s blood work closely. He or she may make adjustments to the amount of potassium bromide that your pet receives daily along the way.

 

Cisapride Capsules

The medical and veterinary industries both rely upon Cisapride as a medication that reduces gastrointestinal complaints. It is remarkably effective at treating acid reflux, G.E.R.D., and diarrhea or constipation in Irritable Bowel Syndrome.

Cisapride capsules increase motility in the upper gut, preventing food and substances from sitting too long in the stomach. This improves digestion and reduces irritation along the bowel for most pets.

Like potassium bromide, Cisapride has a short shelf life. Seek refills at a maximum of every 90 days.
 

Mixed Form Medications

Mixed form medications come in such a broad range of options that it would be functionally impossible to list them all here in a single blog post. Essentially, anytime your pharmacist mixes two medications together, they are creating a new mixed form medication. This is useful for pets with filler allergies, pets who are particularly small or very large, and any animal who has a special health consideration or pre-existing condition.

For example, Trilostane commonly treats pets who suffer from Cushing’s Disease, also known as hyperadrenocorticism. This is a disorder where the body produces too much cortisol.

Because the exact dose can vary based on your pet’s hormone levels, compounding is almost always necessary for adrenal issues. But there’s another good reason to give Trilostane as a compounded substance; vets often add other medications into it, like steroids, when treating conditions like cancer or adrenal tumors.

Some medications, depending on the pharmacy, may also come in flavored chewables, micro tablets, eye drops or gels, otic ear packs, and sterile injectables. All of these give you the option and ability to meet your pet’s needs however suits you both best.

 

How to Access Compounded Medications for Pets and their Prices

Do you have a prescription for a compounded medication? If so, understand that ordering compounded medications for pets doesn’t need to be any more difficult than ordering any other medication. Speak with your pharmacy to get started; most human pharmacies also provide this service by request.

Sometimes, compounded medications for pets do come at a premium. But for the most part, you’ll find that compounded medications are just about on par with standard commercial medicines. The peace of mind and healing achieved through a tailor-made medication is well-worth any slight increase in price. To your companion, be it dog or cat, the interactions you have with them mean everything. When those interactions are negative due to medications, it affects your pets bond with you and may even hamper their ability to heal.

 

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