Compounding
What Custom Compounding is...
Professional compounding is not just diluting existing medications, or mixing powders with bases. We must consider physical and chemical properties of each active and inactive ingredient in order to prepare an effective and safe customized medication with the desired taste, color, fragrance, viscosity, uniformity, texture, and stability. The quality and effectiveness of any compounded medication is influenced by many factors including technique and equipment and the purity and quality of all the ingredients.
A growing number of people and pets have unique health needs that commercially available medicines cannot always meet. For them, compounded medications prescribed physicians or veterinarians and prepared safely by the staff at qualified compounding pharmacies are their only way to better health. Compounding is in even greater demand for treating animals because of the relatively narrow selection of medicines that are manufactured by pharmaceutical companies.
Pharmacists are the only health care professionals that have studied chemical compatibilities and can prepare alternate dosage forms. In fact, each state requires that pharmacy schools must, as part of their core curriculum, instruct students on the compounding of pharmaceutical ingredients.
Because every patient has different needs, compounded medications are a vital part of quality medical care. Some of the circumstances that require compounded medications:
- When needed medications are discontinued by pharmaceutical companies.
- When the patient is allergic to certain preservatives, dyes or binders in available manufactured medications.
- When treatment requires tailored dosage strengths for patients with unique needs (for example, an infant).
- When a pharmacist can combine several medications the patient is taking to increase compliance.
- When the patient cannot ingest the medication in its commercially available form and a pharmacist can prepare the medication in cream, liquid or other form that the patient can easily take.
- When medications require flavor additives to make them more palatable for some patients, most often children.
Examples of compounded products we can provide:
- Bio-identical hormone replacement therapy
- Hospice medications
- Vaginal and rectal suppositories
- Transdermal preparations
- Injectables
- Eye and ear drops
- Nasal sprays
- Lozenges
- Dye free
- Sugar free
- Gluten free
- Sensitivities to inactive ingredients
- Flavored solutions and suspensions
Children
Children may pose many challenges when it comes to medication. They may resist having to take a medication, dislike the taste or texture or have difficulty swallowing solid dosage forms. Children usually need smaller amounts of medication than adults, and many medications are only available in strengths that are appropriate for adults. Fortunately, our compounding pharmacy is able to help. We can compound oral medications into pleasantly flavored liquids. A better tasting prescription is more likely to improve compliance and minimize spillage or waste during administration. Some drugs can be compounded into transdermal gels that can easily be applied to a child's skin and absorbed into the body. Some children can be allergic to dyes or other inactive ingredients in commercially available products. We can formulate products to eliminate ingredients like dyes, sugars, and glutens.
Veterinary
Our compounding service should not be viewed as competition with local veterinarians; rather, compounding allows veterinarians to broaden their prescribing abilities and to offer dosage forms that are patient-specific in strength and formulation. Therefore, the goal of compounding for the veterinary patient is to enhance the veterinarian's ability to treat patients in a more effective and efficient manner. One of our most frequent requests is to flavor a medication. We have special flavorings for cats, dogs, birds, rodents, and other domesticated animals. We can increase or decrease the strength of medications as well as change the dosage form from a solid to liquid. Some drugs can be compounded into transdermal gels that can easily be applied and absorbed into the body.
Compounding is actually a means to an end. We work together with veterinarians and their clients and patients to solve medication problems by compounding specialized medications that meet the unique needs of each animal.
Sterile
The US Pharmacopeia outlines specific guidelines for the preparation of sterile compounded products and are found in Chapter 797. These guidelines cover topics relating to equipment, environmental testing, documentation, personnel training, specific techniques, packaging, expiration dates, and overall safety of sterile compounds. At Bedford Pharmacy we strictly adhere to these guidelines in order to provide the best quality and safest products possible. All of our sterile compounding staff have been specially trained and are routinely tested and validated for proper technique, accuracy, and sterility of their compounds.
Examples of sterile compounds:
- Subcutaneous/Intramuscular/Penile injectables
- Ophthalmic Drops/Ointments
- Otic Drops
- Nasal Sprays/Drops
- Inhalation Therapy
- Bladder irrigations
All sterile products are routinely and randomly tested for potency and sterility. Information on specific products can be provided upon request.