What is Compounding?
Compounding is the method of preparing customized medications to help meet unique physician and patient needs. Most drugs are mass produced and prescribed therapies tend to be the same – “take one every four hours.” Intuitively, we are skeptical about the “one-size-fits all” concept. The fact is that no two people are exactly alike, and mass produced drugs may not be a fit for everyone.
Compounding pharmacists focus on providing compounded medications for the following reasons:
- Limited dosage strengths – One size does not fit all and it is often necessary to change the strength of a drug for patients through compounding.
- Limited dosage forms – Compounding addresses the needs of children, premature infants, the elderly and special needs patients. Some patients may not be able to swallow pills or capsules; compounding allows for different dosage forms such as liquids, fast-dissolving troches, and lollipops. Other methods include compounded medications for oral inhalation, nasal administration, topical/transdermal and rectal use. Some patients may be allergic or sensitive to red dyes or preservatives commonly found in most mass-produced preparations; compounding allows for medications to be compounded without dyes or preservatives.
- Discontinued Drugs – The pharmaceutical industry has discontinued thousands of drug products due to economic considerations. These were very effective and important medications and the only way they are now available is through pharmacy compounding.
- Drug Shortages – Commercially manufactured drugs become unavailable and these can be compounded to help “bridge the gap” until the commercial product comes back on the market.
- Special Patient Populations – These include pain management patients, Hormone Replacement Therapy (HRT) patients, sports injury patients, dental patients, dermatological patients, environmentally and cosmetic sensitive patients and other patients who are being treated successfully with compounded medications prescribed by their physicians. Many cancer treatments involve compounded “cocktails” or mixtures of cancer drugs that would be unavailable if they could not be compounded.
- New Therapeutic Approaches – If a physician desires to use a medication that is successfully used in other countries but is not commercially available here, that physician can prescribe a compounded formulation of the medication for patients.
- Veterinary Compounding – There are relatively few medications available for animals and those medications that are available are for specific species and diseases. For an animal to be satisfactorily treated, a compounded medication is needed.
- Clinical Studies – Pharmacists compound drugs that are not commercially available that are used in various clinical studies.
- Nuclear Compounding – A radioactive source is “tagged” to a compound that circulates throughout the body and eventually concentrates in the organ under exploration.
References: Excerpts from International Journal of Pharmaceutical Compound, www.IJPC.com, April 2005. Lloyd V. Allen, Jr, PhD, Editor-in-Chief