The practice of preparing medications dates back to the origins of pharmacy. Pharmacy compounding is the art and science of preparing customized medications for patients. Approximately 60 percent of all medications were compounded in the 1930s and 1940s.
With advent of manufacturing in the 1950s and 1960s, the pharmacist's role as a preparer of medications was quickly changed to that of a dispenser of manufactured dosage forms. Then, decades later, physicians and patients again began to realize the benefits of customizing medications.
Modern technology, research, and innovative techniques now allow pharmacists specializing in compounding to customize medications to meet specific patient needs. Today, pharmacists, working closely with physicians and their patients, are compounding an estimated 1% of all prescriptions.
Because every patient has different needs, customized medications are a vital part of quality medical care. The ultimate goal in preparing any customized medication is to help the physician and patient achieve a more positive therapeutic outcome.
Compounding allows a practitioner to prescribe specific medications that are:
Almost any type of medication can be created through compounding. A compound drug, in some cases, is no different chemically than the commercially manufactured drug, though it may be delivered in a different dosage or form. In other cases, such as in bio-identical hormone replacement therapy (BHRT), a compound is formulated to be molecularly identical to the hormones found in the patient's own body, allowing a patient-specific medication; thus, being different from many commercially available medications.
In some cases, a compound medication can be prepared using various "delivery" systems, such as a lozenge, sublingual troche, or a transdermal gel. A suspension possibly could be compounded for those patients who have difficulty swallowing a capsule.
Compounding pharmacists focus on meeting special needs, as well. This may involve compounding an eye drop, assisting physicians in treating hospice patients, preparing an injection for impotency, preparing medications in a variety of dosage forms and flavors, providing natural alternatives in hormone replacement therapy, and, even providing compounded medications for veterinarian use.
The Food and Drug Administration states 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 pharmacist. The State Boards of Pharmacy also regulates compounding drugs.
Compounding is widely utilized in all areas of the industry, from hospitals to nuclear medicine. Since the origins of pharmacy, it has been a part of our healthcare. The resurgence of compounding over the last decade has largely been due to advances in technology, research methodology, and quality control.
Many times it's difficult coaxing a child to take their medicine, mainly due to taste. A compounding pharmacist can work directly with the patient and physician to select a flavoring agent that provides an appropriate match for both the medication's properties and the patient's taste preferences.
Patients who experience chronic pain have also benefited from compounded medications. For example, some arthritic patients cannot take certain medications due to gastrointestinal side effects. A compounded topical preparation with the anti-inflammatory or analgesic their doctor prescribed could possibly be an alternative to the oral medication. Compounded prescriptions often are used for pain management in hospice care.
Almost any kind of prescription can be compounded.
Compounded prescriptions are ideal for any patient requiring unique dosages and/or delivery devices, which can take the form of solutions, suppositories, sprays, oral rinses, lollipops, or even transdermal sticks. Compounding applications can include medication flavoring, chronic pain management, neuropathies, sports medicine, infertility, wound therapy, podiatry, gastroenterology, bio-identical hormone replacement therapy, hospice, pediatric, ophthalmic, dental, otic, dermatology, and veterinary.
The cost of a compounding depends on the type of dosage form and what is required to prepare a particular medication. It may or may not cost more than a conventional medication. Fortunately, compounding pharmacists have access to pure-grade quality chemicals which dramatically lower overall costs and allow them to be competitive with commercially manufactured products.
