Pharmacy compounding is the art and science of preparing customized medications for patients. Within the last two decades, 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. Many patients are allergic to preservatives or dyes, or are sensitive to standard drug strengths. With a physician’s consent, a compounding pharmacist can change the strength of a medication, alter its form to make it easier for the patient to ingest, or add flavor to make it more palatable. The pharmacist also can prepare the medication using several unique delivery systems, such as a sublingual troche or lozenge, a lollipop, or a transdermal gel or cream that can be absorbed through the skin. For those patients who are having a hard time swallowing a capsule, a compounding pharmacist can make a liquid suspension instead.
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.
Who Uses Compounding?
- Patients requiring an allergen-free medication, such as one without gluten or colored dyes
- Children who want flavoured additives in liquid drugs, so that the medication tastes like fruit or candy
- Patients requiring limited dosage strengths, such as a very small dose for infants
- Patients requiring a different formulation, such as turning a pill into a liquid or transdermal gel for people who can’t swallow pills due to a medical condition
- Patients who absorb or excrete medications abnormally
- Patients facing a supply shortage of their normal drug
- Many types of hormone replacement therapy
- Veterinary medicine, for a change in dose, change to a more easily-administered form, or to add a flavour more palatable to the animal
Please contact us for further information.
Compounding – Frequently Asked Questions
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, or sublingual troches.
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, tuttifrutti, 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! (This applies to veterinary patients too!)
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 provincial boards of pharmacy.
Will my insurance cover compounded medications?
Most third party insurance companies will pay for compounded medications. However, we are unable to bill them electronically. As such, we recommend that all patients who have their medication specially compounded submit their claims manually. Official receipts are provided at the pharmacy at the time of pick up.
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)
- Pain management
- Otic (for the ear)
- Medication flavoring
- Sports medicine
- Wound therapy
- 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 us.