What is Compounding?

 

Compounding is the Art and Science of Creating Personalized Medications

Pharmacy compounding is the art and science of preparing personalized medications for patients. Compounded medications are “made from scratch” – individual ingredients are mixed together in the exact strength and dosage form required by the patient. This method allows the compounding pharmacist to work with the patient and the prescriber to customize a medication to meet the patient’s specific needs.

 

A Brief History of Compounding

At one time, nearly all prescriptions were compounded. With the advent of mass 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, and most pharmacists no longer were trained to compound medications. However, the “one-size-fits-all” nature of many mass-produced medications meant that some patients’ needs were not being met.

 

Innovative Compounding Technology & Techniques Meet Patient Needs

Fortunately, 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.

 

Our trained, PCCA member pharmacists can now personalize medicine for patients who need specific:

  • Strengths
  • Dosage forms
  • Flavours
  • Ingredients excluded from medications due to allergies or other sensitivities

 


Benefits of Compounding

 

We can make medication that is difficult to find or discontinued

Sometimes a large pharmaceutical manufacturer discontinues a medication. Often this happens because not enough patients are taking the drug, so it is unprofitable to keep mass-producing it. But what about the patients who still need that drug? Hundreds or even thousands of patients still may need that medication. A compounding pharmacist can re-create that medication by compounding it, so even if only one person in the world still needs that medication, they can have it thanks to compounding!

 

We Can Make Medication Allergy-Friendly

A patient may be allergic to or intolerant of an ingredient commonly found in the commercially manufactured form of a medication. Ingredients that may be allergy-inducing include:

  • Lactose
  • Preservatives
  • Dyes
  • Gluten
  • Sugar

A compounding pharmacist can create a personalized medication, formulated to give the patient the treatment they need while leaving out the problematic ingredient.

 

We Can Make Medication Easier to Use

Some medications have a very unpleasant flavor, which makes the patient less likely to take it as directed. A compounding pharmacist can flavor many medications to make it more palatable without compromising the medication’s effectiveness. This is especially handy when dealing with medications for patients who may refuse medication, such as young children, elderly patients, or even pets! A patient may need their medication in a different dosage form. For instance, patients who have difficulty swallowing a pill may find it easier to take their medication in a pleasantly flavored liquid form. Some medications can be compounded in a topical form such as a cream or a gel that allows the medicine to be absorbed into the bloodstream through the skin.

 


Alternative Medication Forms

 

Unique medication delivery for your unique needs

Compounding enables prescribers and pharmacists to meet the special needs of patients. One of its most important benefits is to those patients who have difficulties with commercially available medication. With the prescriber’s consent, pharmacists can custom-prepare medications in a variety of unique dosage forms, including:

  • Capsules
  • Oral liquids
  • Troches or lollipops
  • Topical preparations
  • Suppositories
  • Eye and ear drops
  • Nasal sprays
  • Sterile injections

The result? A way to take medicine that helps increase patient compliance.

 

Custom Flavouring

Custom flavouring is available for most oral medication forms, and unique delivery systems may be employed to help give medication to finicky patients. Many medications can be taken through a flavoured lollipop. Infants especially benefit from alternate delivery devices such as pacifiers or baby bottles. These devices, which are provided in child-proof packaging, allow parents to dispense prescription medicine easily and accurately.

 

 

Capsules

Medication can be compounded into customized capsules, especially in cases where an alternate strength is required or to omit potential allergens or irritants, such as dyes, preservatives, or gluten. To lessen the number of doses to be taken, multiple medications often can be combined into a single dosage or made into sustained-release capsules. Vegetarian capsules made from cellulose are available for patients who do not want to take a gelatin capsule.

 

 

 

Oral Liquids

Many medications can be compounded as oral liquids for those patients who have difficulty swallowing tablets and capsules. Some patients may have problems tolerating the taste of a commercially available liquid, but a compounding pharmacist can make a pleasant-tasting, custom-flavored oral solution or suspension which can be administered easily and accurately. Some medications may be available as effervescent powders, which are mixed with water to make a fizzy drink.

 

 

Troches/Lollipops

Troches and lollipops are used to keep drugs in the mouth when local action is needed there. Troches also may be placed under the tongue and allowed to dissolve, which allows the medication to enter the bloodstream quickly and easily. Some troches can be chewed and swallowed by a patient who cannot or will not take a capsule or tablet. These dosage forms can be enhanced with natural sweeteners and pleasant-tasting flavors, making them ideal for geriatric and pediatric patients.

 

 

 

Topical Preparations

Topical methods of delivery also are widely used because they allow the absorption of medicine directly through the skin, and may help avoid potential side effects such as stomach upset or drowsiness. Topical medications often are prescribed for pain management, inflammation and nausea/vomiting. They are easy to use and are effective delivering the medication as needed. Topical medication forms include:

  • Gels
  • Creams and lotions
  • Sprays
  • Foams
  • Stick applicators, such as lip balms

 

Suppositories

Patients who cannot take medications orally are ideal candidates for compounded suppositories. Available in various shapes depending on the route of administration, suppositories can be given rectally, vaginally or urethrally. By melting or dissolving into the body cavity, they allow the medication to pass quickly into the bloodstream. They can be used for bio-identical hormone replacement therapy (BHRT), to fight nausea, or to treat local conditions such as hemorrhoids, infections, or inflammation.

 

A compounding pharmacist working closely with you and your physician can prepare medication in a dosage form that has been customized to your particular needs.

 


Compounding FAQs

 

Pharmacy compounding is a long-established tradition that offers customized care to meet the specific needs of individual patients.

Have you ever wished your child’s medicine tasted better, so they would accept it without a fuss? Or struggled to cut a prescription tablet in half because the pill wasn’t manufactured in the strength you required? Perhaps an ill loved one could have benefited from having multiple medications combined into a single dose. Compounding pharmacists provide solutions to all these problems, and more.

 

What is compounding?

Pharmacy compounding is the art and science of preparing customized medications for patients. Its practice dates back to the origins of pharmacy, although compounding’s presence in the pharmacy profession has changed over the years. In the 1930s and 1940s, the majority of prescriptions were compounded. With the advent of mass drug manufacturing in the 1950s and ‘60s, compounding declined as the pharmacist’s role as a preparer of medications quickly changed to that of a dispenser of manufactured dosage forms. However, this “one-size-fits-all” approach to medication meant that some patients’ needs were not being met. Within the last few decades, however, compounding has experienced a renaissance as modern technology and innovative techniques and research have allowed more pharmacists to customize medications to meet a patient’s unique needs.

 

How does compounding benefit me?

There are several reasons why prescribers and pharmacists provide compounded medications for patients. The primary reason for compounding is to avoid patient non-compliance, which means the patient is either unable or unwilling to use the medication as directed. Many patients are allergic to preservatives or dyes, or require a dosage that is different from the standard drug strengths.

With a physician’s consent, a compounding pharmacist can:
  • Adjust the strength of a medication
  • Avoid unwanted ingredients, such as dyes, preservative, lactose, gluten, or sugar.
  • Add flavor to make the medication more palatable
  • Prepare medications using unique delivery systems. For patients who find it difficult to swallow a capsule, a compounding pharmacist may prepare the drug as a flavored liquid suspension instead. Other medication forms include topical gels or creams that can be absorbed through the skin, suppositories, sublingual troches, or even lollipops.

 

Can my child – or my elderly parent – take compounded medication?

Yes! Children and the elderly are often the types of patients who benefit most from compounding. It is common for parents to 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 bubblegum, grape, tutti frutti, or vanilla butternut, which provides both an appropriate match for the medication’s properties and the patient’s taste preferences. Just think – no more wasting medicine when a cranky patient spits it out! Compounding pharmacists also can help patients who experience chronic pain. For example, some arthritic patients cannot take certain medications due to gastrointestinal side effects. With a healthcare practitioner’s prescription, a compounding pharmacist may be able to provide these patients’ anti-inflammatory or pain-relieving medications with topical preparations that can be absorbed through the skin. Compounded prescriptions frequently are used to ease pain, nausea, and other symptoms for hospice patients as well.

 

Is compounding legal? Is it safe?

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 few decades, compounding’s resurgence has benefited largely 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.

 

Is compounding expensive?

Compounding may or may not cost more than conventional medication. Its cost depends on factors such as the type of ingredients and equipment required, plus the time the pharmacist spends researching and preparing the medication. Fortunately, compounding pharmacists have access to pure-grade quality chemicals which dramatically lower overall costs and allow them to be very competitive with commercially manufactured products.

 

What kinds of prescriptions can be compounded?

Almost any kind! Compounded prescriptions are ideal for any patient requiring unique dosages and/or delivery devices.

Compounding applications can include:
  • Bio-identical hormone replacement therapy (BHRT)
  • Hospice
  • Paediatrics
  • Pain management
  • Ophthalmology
  • Dentistry
  • Otic (for the ear)
  • Dermatology
  • Medication flavoring
  • Neuropathy
  • Veterinary
  • Sports medicine
  • Infertility
  • Wound therapy
  • Podiatry
  • Gastroenterology
  • And many more!

 

Is custom compounding right for you? Ask us today about the benefits of personalized prescription compounding!