What is Compounding?
Pharmaceutical compounding is the science responsible for the creation of customised medication. Compounded medications are created by combining individual ingredients in the exact strength and dosage form required by the patient and their own unique needs. Compounded medications are ordered by a licensed physician, veterinarian or other prescribers, and prepared in a safe and carefully controlled laboratory environment by a registered compounding pharmacist.
Types of Compounding
Living with chronic pain is a reality for countless people, both young and old. Many of the available pain relief options come in the form of narcotics or drugs with substantial side effects. While these options may help reduce the pain, the numerous side effects can be cause for great concern. With the advancements in pharmaceutical compounding, these people can now receive medication that is customised for their own unique needs to provide pain relief. Utilizing a number of different compounding solution options such as creams, gels, ointments, sprays, capsules and others, painful conditions can be managed in a fashion tailored to the individual needs of each patient.
It can be difficult to find the right solution for skin concerns such as acne, rosacea, eczema, psoriasis or even cosmetic concerns such as fine lines and deep wrinkles. Many skin care products can leave unwanted side effects such as dry, thinning, red, peeling and irritated skin. Compounding allows for the right medications to be customised to the patient’s needs by carefully selecting the right moisturizing agents, non-irritating bases and hypoallergenic products to treat your concerns based on your skin type. Compounding solutions for dermatological concerns come most often in the form of creams, ointments, gels, sprays, topical powders and shampoos.
Nobody wants to have their child’s health depend on whether their son or daughter refuses to take the medication due to it tasting “yucky” or because it is not available in a kid-friendly dosage form such as chewable tablets or liquid, or because the child cannot swallow a large tablet or capsule. Often times the medication is difficult to measure and find the appropriate dosage for a child. Pediatric compounding gives the ability to completely customise the medication for your child’s unique taste preference and condition in mind, whether that includes being preservative free, dye-free, sugar-free or any other customization that may be required. The medication can be delivered in a more child-friendly compounding solution such as gummies, troches, lozenges, lollipops, oral liquids and more.
The concerns we have for dosing medication in children are often shared for medication dosage for the elderly. The older we get, conditions such as dry mouth make it very hard to swallow tablets and capsules. Also, many elderly patients need to take several medications in dosages that are lower than what is normally required for the average-age adult. Compounding offers a solution to address some of these issues by combining multiple drugs into one preparation, which may not only make it easier to administer but also more convenient for the patient. Geriatric compounding solutions come in many different vehicles such as oral liquids, creams, ointments, gels, rapid dissolving tables, injections, suppositories and more.
Hormone Replacement Therapy (HRT)
Hormones play a huge role in our overall state of health. Unfortunately, as we get older our hormone levels can increase, decrease or fluctuate. These changes in hormone levels cause symptoms ranging from weight gain/loss, mood changes, hair loss and everything in-between for both men and women. Compounding allows for the appropriately prescribed treatment to be completely customised based on the patient’s hormone levels, symptoms and health concerns where medication that is commercially available may not be able to address or be suitable to their needs. The most prevalent HRT compounding solutions are creams, gels, troches, lozenges, drops, injections, capsules, vaginal suppositories and rapid dissolving tablets.
Most medications are manufactured with intended use in humans rather than animals. While the drug itself might still treat your furry friend, it is the other ingredients, the inactive ingredients, which can sometimes be toxic to your pet. Compounding allows for the most appropriate medication therapy by considering the unique habits and taste preferences of your pet. When dealing with veterinary compounding, the most popular compounding solutions are oral pastes, creams, ointments, gels, oral liquids, chewable treats, capsules and powders.
Benefits of Compounding Medicines
There are benefits associated with compounding, many of which focus on providing patients with pharmaceutical products that have been customised to fit their own unique needs when standard marketed drugs fail to do so. Examples include:
1. Modifying a formulation to prevent allergies:
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:
A compounding pharmacist can create a personalized medication, formulated to give the patient the treatment they need while leaving out the problematic ingredient.
2. Patients with difficulty taking their medication:
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 flavoured 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.
A compounding pharmacist may be able to provide solutions for challenges such as these. Working closely with the patient and the prescriber, compounding gives the pharmacist the means to customize medication to meet the individual needs of each patient.
3. Improving flavouring and making medicines more palatable
Some medications have a very unpleasant flavour, which makes the patient less likely to take it as directed. A compounding pharmacist can flavour 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! Some of our long list of flavours include:
- English toffee
- Tutti fruiti
4. Discontinued and Out of Stock Medicines:
There has been a growing number of drug shortages and discontinuations in recent years, causing concern for both patients and physicians alike. 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.
Other times, the manufacturer faces difficulties manufacturing a medication for a variety of reasons, leaving the patients with no medication for an extended period.
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!
5. Requiring a strength of medication that is not available from the manufacturer:
A compounding pharmacist may be able to provide tailored doses for individual patients.
Does Private Insurance Cover Compounding Prescriptions?
Depending on your insurance plan, patients may be reimbursed by sending their insurance provider an official pharmacy receipt of their medication. This receipt will accompany your medication when you receive your medication in the mail. Many insurance companies will reimburse compounded prescriptions; however, we suggest that you consult with your insurance provider for eligible benefits.
Which Types of Prescriptions Can Be Compounded?
We can compound almost any non-sterile medication. Delivery vehicles that are often used for compounding include:
- Creams, gels & ointments
- Oral solutions & suspensions
- Tablets & capsules
- Lollipops & lozenges
- Medicated Foams
- Animal treats
- Medicated Soaps