Mixing Things Up

Compounding pharmacists concoct medications formulated specifically for you

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“To successfully compound, you have to get to know the patient, which establishes a good relationship between you and the pharmacist.” -Rick Chester, Medicap Pharmacy, Talent

Have you ever hit a roadblock with your medication? Maybe your child needs a smaller dose of a medication which is not commercially available, or you would have an easier time taking your daily pill if it came in liquid form. If you do not want to settle when it comes to your family’s prescriptions, you may benefit from a compounded medication. Prepared by a compounding pharmacist, these medicines are mixed and prepared specifically for you, explain local pharmaceutical experts.

The roots of pharmacy

Compounding is the creation of a medicine by a licensed pharmacist that meets the unique requirements of an individual when a commercially available drug does not, says Rick Chester, a pharmacist at Medicap Pharmacy in Talent. “Compounding is twofold: first, you combine one or more drugs into a new product. Second, you create a new product in a different strength or formulation,” he says.

Compounding medicine is useful for people who cannot use standard manufactured products, according to Angie Meeker, a compounding pharmacist at Wellness Compounding Pharmacy in Medford. “The drug manufacturers are great, but there are limits for what they can mass produce. It doesn’t make sense for them to make every strength of every drug, because a lot of people can successfully use the commercially available dosage. But that doesn’t take care of everybody,” she explains, adding that compounding is a good option for people who cannot tolerate a commercial product. “After discussing your needs with your doctor and compounding pharmacist, the latter goes to the compounding bench and makes a product specifically for you.”

Compounding targets individual needs says Chester. “Compounding medicine is an art form that began with the origins of pharmacy. To successfully compound, you have to get to know the patient, which establishes a good relationship between you and the pharmacist.”

Many uses for compounded medicine

People usually think of compounding when they’re at a crossroads, says Meeker. “We see many people who have already been to the doctor and were prescribed something — or many things — that didn’t work,” she explains.

Additionally, she says there are many reasons why a medication may not work, such as an intolerance to the fillers, dyes or preservatives. “In the day-to-day of medical practice, patients and doctors get stuck. Usually at that moment, they think ‘What do we do? What’s left?’ Then either the patient or provider suggests compounding medicine.”

However, a successful compounded medicine relies on feedback from the customer, explains Chester. If you receive a compounded medicine, he says it’s important to be honest with your pharmacist. “We may need to add or subtract something, or use a different filler, to create a product which achieves your desired goal. Sometimes we need to make adjustments to produce a compounded medicine which fits your requirements,” he says.

While every person and situation are different, Meeker says compound pharmacists often encounter certain scenarios many times, such as creating a smaller dose of medicine for a pediatric patient, when it’s only available in adult dosages. Additionally, she explains people may need to take ibuprofen to treat pain, but it hurts their stomach. “In that instance, we can make it into a cream they rub on their skin, so it never goes through their stomach.”

Another use for compounded medicine is to help post-menopausal women, Chester says. He explains that after reviewing bloodwork or a saliva test, they find the deficient hormone and replace it with a compounded medication. “We then follow up with that person in a couple of months to see if they’re still deficient in that hormone. If necessary, we adjust the compound. The goal is to find the safest hormone regimen that results in your desired outcome,” he says.

A personalized experience

If you are considering receiving a compounded medicine, Meeker and Chester suggest speaking with your doctor. “Compounding medicine allows people to form a strong relationship with their pharmacist and doctor, resulting in a product that is tailored to your specific needs and goals,” says Meeker.

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More to Explore

Bioidentical hormone replacement

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Bioidentical hormones have become more popular because they match the molecular structure of hormones made by the body in ways that synthetic hormones cannot. The majority of bioidentical hormones are only available through a compounding pharmacy. Compounding offers patients the chance to get customized dosages of these hormones. For example, if one patient needs less estrogen, and another needs more testosterone, compound pharmacists can create the right amount to keep hormones in balance. Through compounding, pharmacists can provide the hormones in a variety of dosage forms, including capsules and creams.

Prescriptions for pets

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Compounding medicine isn’t limited to people, notes pharmacist Angie Meeker of Wellness Compounding Pharmacy in Medford. “If you’ve ever tried to give a cat a pill, you know how difficult it is. We can turn those pills into a liquid or a tasty treat, so the animal has an easier time ingesting it,” she says.

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