Compounding has been performed for thousands of years. The first compounders used mixtures of botanicals and organic substances to prepare salves, powders and other treatments for a number of maladies. Today, most of the equipment has changed dramatically. We still make salves, lotions and creams the traditional way, with mortars and pestles. In addition, we use ointment mills, homogenizers, capsule makers and precision balances. By employing computers and bar-code technology, we can ensure that each item being prepared is the exact item and quantity needed for a particular formula.
We are fortunate to live where people have access to the best medical care in the world; however, despite advances in medicine, there are still some who don’t respond to traditional methods of treatment. Sometimes they need medicine at strengths that are not manufactured by drug companies, or perhaps they simply need a different method of ingesting a medication.
Pharmacy compounding meets these needs. It provides a way for physicians and compounding pharmacists to customize an individualized prescription for the specific needs of their patient. Compounding provides solutions that are not met by commercial products.
Compounded Medicines are a Vital Part of Quality Medical Care
A growing number of people have unique health needs that over-the-counter prescription medicines cannot meet. Customized, compounded medications prescribed or ordered by licensed physicians or veterinarians and mixed safely by trained, licensed compounding pharmacists are the 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 healthcare 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.
Compounding pharmacies are licensed and regulated in the 50 states and the District of Columbia by their respective state boards of pharmacy.
The basis of the profession of pharmacy has always been the “triad,” the patient-physician-pharmacist relationship. Patient needs are determined by a physician, who then chooses a treatment regimen that may include a compounded medication. Physicians often prescribe compounded medications for reasons that include (but are not limited to) the following situations:
- Medications are discontinued by, or generally unavailable from, pharmaceutical companies, often because the medications are no longer profitable to manufacture;
- Patient is allergic to certain preservatives, dyes or binders in available off-the shelf medications;
- Treatment requires tailored dosage strengths for patients with unique needs (for example, an infant or woman looking for alternative relief from menopausal symptoms);
- Pharmacist can combine several medications the patient is taking to increase compliance;
- 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;
- Medications require flavor additives to make them more palatable for some patients, most often children.
Also, compounding is extremely important to the veterinary community, which often requires more flavors, dosages and potency levels than commercially available medications supply.