What is compounding?
Compounding is the art and science of customizing medication for a particular patient’s needs under the direction of that patient’s physician. We can make a medication taste better, make an oral medication into a gel or cream for topical application, or customize a medication for an animal at the direction of a vet to name a few examples.
Large pharmaceutical manufacturers do a lot of good for society, and most new medications discovered for diseases come from them. But, an off-the-shelf solution isn’t the best for everyone. At the direction of a patient’s physician, often we can better meet a patient’s needs through compounding a medication specifically for that patient.
- Preservative-free or colour-free medications.
- Compounded medications that replace medications that aren’t being made commercially anymore.
- Changing the dosage of a medication made for a horse to make it appropriate for a rabbit.
Why is there a need for pharmacists to compound?
The basis of the profession of pharmacy has always been the “Triad”, the patient-physician-pharmacist relationship.Through this relationship, patient needs are determined and decisions are made about treatment regimens that may include a compounded medication, including but not limited to:
Medications that are not commercially available:
Manufacturers must be assured that there will be a return on their investment when entering the market place with a drug product. Therefore, there are limited chemical forms, dosage forms, strengths, flavors and packaging that are available for the physician to prescribe and the pharmacist to dispense. Compounding allows the physician to prescribe a custom-tailored medication that is not available commercially.
Medications that are not stable:
Pharmacists prepare small quantities of a prescription more frequently to ensure stability of the product for its intended use.
altered commercially available medications:
Physicians prescribe a commercially available medication in a different dosage form to meet a specific patient need and ensure patient compliance. For example, a patient may be allergic to a preservative or dye in a manufactured product that compounding pharmacists can prepare in a dye-free or preservative-free dosage form. Some patients have difficulty swallowing a capsule and require a troche or lozenge. Many pediatric patients are non-compliant because their medications are bitter, but become compliant when the medication is flavored to their liking.