Compounding

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 ’40s, 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.

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’ antiinflammatory 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 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.

Will my insurance cover compounded medications?

Some insurance plans allow the patient to be reimbursed by sending in claim forms. While you may be paying a pharmacy directly for a compounded prescription, many insurance plans may cover the final cost.

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 at Breakwater can include:

  • Hospice
  • Pediatrics
  • Pain management
  • Dentistry
  • Dermatology
  • Medication flavoring
  • Neuropathy
  • Veterinary
  • Sports medicine
  • Infertility
  • Wound therapy
  • Podiatry
  • Gastroenterology
  • And many more!

Does my prescriber know about compounding?

Prescription compounding is a rapidly growing component of many physicians’ practices, but some may not realize the extent of compounding’s resurgence in recent years due to today’s climate of aggressive marketing by drug manufacturers. Ask your healthcare practitioner about compounding, or get in touch with our staff – one that is committed to providing high-quality compounded medications in the dosage form and strength prescribed by the practitioner. Through the triad relationship of patient, prescriber, and pharmacist, all three can work together to solve unique medical problems.

Is custom compounding right for you? Ask your healthcare practitioner or pharmacist today about the benefits of personalized prescription compounding.

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 authorization, pharmacists can custom-prepare medications in a variety of unique dosage forms, including:

  • Capsules
  • Oral liquids
  • Troches or lollipops
  • Topical preparations
  • Suppositories
  • Nasal sprays
  • Sterile injections

THE RESULT? A WAY TO TAKE MEDICINE THAT HELPS INCREASE PATIENT COMPLIANCE.

Custom Flavoring

Custom flavoring 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 flavored 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. 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 hormone replacement therapy (HRT), 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.

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