The practice of compounding medications is as old as the knowledge that combinations of animal, vegetable and mineral elements can be administered to cure various ailments. Modern day compounding came with the advent of the pharmacy in the early nineteenth century, as a science separate from medicine, although many physicians continued to compound medications themselves well into the later years of the century.
However, by the beginning of the twentieth century there was a clear distinction between doctor and pharmacist. The doctor prescribed the medicine and the pharmacist “created it” by compounding or mixing certain ingredients. Dispensing medicine continued in this personalized way until the rise of the pharmaceutical industry in the 1950s. After this, the pharmacist primarily became a dispenser of manufactured medications.
It is only until recently that the need for compounding ingredients to meet specific requirements has become valued again, and many pharmacists are once again compounding customized medications.
Compounding medications allows the physician to prescribe customized medications, and the pharmacist to compound the ingredients in the exact dosage that the patient requires. Creating medications this way is thought to be more effective than a one-size-fits-all commercial preparation.
The most common types of compounding that pharmacists are creating today include:
*Topical medication – Stomach upset and other side effects can be avoided by compounding the required medication as a cream, lotion, foam or gel and allowing the medication to be absorbed by the skin rather than the stomach. This is especially applicable to pain management and inflammation.
Oral Liquids – Medications can be customized as oral liquids for patients who have difficulties swallowing pills or commercial liquids, or as effervescent powders to mix with water.
*Suppositories – When patients are unable to take medication orally, various suppositories can be compounded for rectal, urethral or vaginal delivery to create a fast means of dissolving them quickly to be absorbed into the bloodstream. This is useful for hormone replacement, bowel and bladder conditions, and hemorrhoid treatment.
*Nasal sprays, ear or eye drops and injectable medications – Compounding required ingredients to enable them to be delivered in liquid form to specific locations is necessary in cases where delivery systems are not met by commercial pharmaceutical manufacturers.
*Flavored Dosages – Lollipops and pacifiers can be used to administer oral medications to infants and young children when they have a more desirable flavor.
Troches/lozenges – Medicines compounded for pediatric or geriatric patients as a flavored troche that can be dissolved under the tongue or as a flavored chewable lozenge meets needs where swallowing is an issue.
Other Ways the Compounding Pharmacy Adds Flavor
Compounding to meet the challenge of situations from small children who refuse medication and pets who spit out capsules is perhaps the most widely adopted solution to administering medications.
*Children – Flavoring children’s medications to taste like chocolate or bubblegum is the simplest way to customize them. Natural flavors are mostly used to avoid adding sugar to the child’s diet and the pharmacist can work with the doctor to avoid allergens and other sensitivities that may be a problem with manufactured drugs.
*Adults with Chronic Conditions/Geriatrics – Sometimes specific flavors become undesirable and may even cause nausea and vomiting. Compounding medication that is not palatable to mask the taste is the answer.
*Pets and Livestock – Medication for animals often needs to be flavored with something that they are familiar with – meat, liver, or cheese for dogs, fish for cats, apples or carrots for horses. The compounding pharmacy can work with the owner and veterinarian to customize the flavor.
There are numerous ways in which the compounding pharmacy works directly with health and wellness professionals to customize consumer products.
*Cosmeceutical creams can be custom-made to solve skin problems that mass-produced preparations just don’t – or further irritate.
*Compounded hormone replacement therapy can restore balance and ease menstrual and menopausal symptoms.
*Men’s health problems from hair loss to erectile dysfunction may all benefit from working with a compounding pharmacist.
*Customized pain management medications will prevent the side effects associated with commercial headache, arthritis, backache pills, capsules and topical gels and creams. Acute pain due to sports or accident injuries is also better controlled with a compounded medication, especially in terms of customizing it for the size and body type of the patient.
*Topical anesthetic for patients with needle anxiety can be compounded, as can pain relievers, dental rinses and gum disease formulations.
*Children, older adults, athletes, whether injured, diagnosed with a chronic condition of being proactive in terms of achieving wellness can all benefit from consultation with a compounding pharmacist.
*End-of-life care can be improved with compounded pain relief and symptom management.
As you can see, the benefits of compounding pharmacies are numerous. At Ray’s Pharmacy, we create custom medications for our patients. To learn more about compounding and how it can benefit you, talk your doctor and your pharmacist.