The Art and Science of Compounding

HOW ARE COMPOUNDS MADE?

Making a compound incorporates the pharmaceutical sciences with the art of making a preparation, which is in a form most effective for the patient. Our pharmacists and technicians have undergone extensive training and use special equipment to prepare these medications.

Professional compounding is not just diluting existing medications, or mixing powders with bases. Here at Perrone Pharmacy, we must consider the physical and chemical properties of each active and inactive ingredient in order to prepare a safe, customized medication with the desired taste, color, fragrance, viscosity, uniformity, texture and stability. This is why it is important to have compounds made at a pharmacy you know and trust.

WHEN ARE COMPOUNDS USED?

Compounds are used for a number of reasons. One instance in which a compound is used is when no commercially manufactured medication is available. For example, the drug Epidrin (which is the generic of Midrin) recently became temporarily unavailable. When this happened, our director of compounding researched its ingredients, located reliable sources for those ingredients and then created a therapeutic equivalent.

Another reason pharmacies compound a prescription is when a patient cannot tolerate the commercially available medication. For example, if a person has trouble swallowing, and the commercially manufactured drug prescribed to the person is available only in a hard-to-swallow pill, then the physician can write a prescription for a compounded liquid version of that medication.

WHAT TYPES OF MEDICATIONS ARE USUALLY COMPOUNDED?

There are many types of medications that can be compounded. Some must be prepared utilizing a sterile lab while most of the compounds we prepare are made in our regular compound lab.

Though most patients rarely need to have a sterile medication prepared, we feel that it is important to offer this service since we are a full-service pharmacy. Sterile products include injections, intravenous fluids, ophthalmic (eye) drops and ointments and otic (ear) preparations as well as respiratory solutions.

As part of our sterile products program, we perform both “in-house” and third party sterility testing. Quality assurance and process validation are an important part of our overall program.

Non-sterile compounded products are used in virtually every patient population from babies to adolescents to older men and women. Even pets take compounded medications. Some examples of the kinds of compounds we make are listed below.

Bio-identical Hormone Replacement Compounds for Men and Women

Our pharmacists work together with patients and prescribers to provide customized bio-identical hormone replacement therapy that provides the needed hormones in the most appropriate strength and dosage form to meet each person’s specific needs. Close monitoring and medication adjustments are essential.

Goals of Hormone Replacement Therapy in older adults may include:

  • Improvement in psychological well-being and mood
  • Increased libido
  • Increased muscle mass
  • Increased strength and stature
  • Preservation of bone mass
  • Possible decrease in cardiovascular risk

Dental Compounds

Commonly used dental compounds include lip balms for viral lesions, transdermal (topically applied) muscle relaxants/analgesics, topical anesthetics, antibacterial rinses, oral sedation in lollipops and freezer pops, lollipops for oral thrush, mouth rinses for ulcers, lozenges that help to prevent gagging and many more unique preparations.

Pediatrics

Children pose many challenges when it comes to medication: they may resist having to take a medication, dislike the taste or texture, have difficulty swallowing solid dosage forms, and are fearful of injections. Sometimes, a medication is not available in a suitable pediatric dosage form. Fortunately, our compounding pharmacy is able to help. We can compound oral medications into pleasantly flavored suspensions, solutions, concentrates, freezer pops, “gummy bears” or lozenges, in colors that entice the child to take the medication.

Veterinary Compounding

Anyone who is a pet owner knows how difficult it can be to administer a pill or unpleasant flavored liquid. Cats and dogs have an acute sense of smell, which plays a major role in their sense of taste. We carry a wide range of veterinary flavors including beef, liver, grilled chicken, and triple fish (a favorite with cats). When oral dosing isn’t possible, a number of drugs can be formulated into a cream or gel, which can be applied to the ear or abdomen.