What is compounding? History of Compounding In the 1930's and 1940's, about 60% of all medications were compounded. During the 1950's and 60's, manufacturing in mass quantities, the business of compounding declined. A pharmacist's role as a preparer of medications quickly changed to that of merley a dispenser of manufactured mass produced drugs. In the 1980s, and especially in the 90s, physicians and patients again realized the benefits of preparing customized medications to meet specific patient needs. Today, an approximately 43,000 prescriptions are compounded daily. That's one percent of all the prescriptions being dispensed. Today's compounding pharmacists are using modern technology and innovative compounding techniques to prepare prescriptions for the specific need of patients. The Triad Relationship Compounding is achieved through an essential triad relationship — patient, physician and pharmacist. The physician first prescribes the medication, then the pharmacist takes the necessary ingredients, compounds them, and dispenses the medicine to the patient after a thorough consultation. This enables patients to receive the type of personalized care they deserve and allows independent community pharmacists the opportunity to provide superior, patient-oriented services. Reasons for Compounding There are several reasons why pharmacists compound prescription medications; yet, the most important one is patient noncompliance. Many patients are allergic to preservatives or dyes, or are sensitive to standard drug strengths. With a physician's consent, a compounding pharmacist can change the strength of a medication, alter its form to make it easier for the patient to ingest, and add flavor to it to make it more palatable. The pharmacist also can prepare the medication using several unique delivery systems, such as a sublingual troche or lozenge, a lollipop, or a transdermal gel. Or, for those patients who are having a difficult time swallowing a capsule, a compounding pharmacist can make a suspension instead. Often parents have a tough time getting their children to take their medicine because of the taste. A compounding pharmacist can work directly with the physician and the patient to select a flavoring agent, such as vanilla butternut or tutti frutti, that provides both an appropriate match for the medication's properties and the patient's taste preferences. Compounding pharmacists also have helped patients who are experiencing chronic pain. For example, arthritic patients who cannot take certain medications due to gastro intestinal side effects. Working with their physician, a compounding pharmacist can provide them with a topical preparation with the anti-inflammatory or analgesic their doctor prescribed for them. Meeting Patient and Practitioner Needs Compounders focus on meeting special needs. This may involve compounding height/weight- appropriate pediatric medications, injections for impotency, medications for veterinarians in a variety of dosage forms and flavors, alternatives in hormone replacement therapy, or dosage options, such as transdermal gels, when treating hospice patients. The ultimate goal in preparing any of these customized medications is to help the physician and patient achieve a more positive therapeutic outcome and patient compliance. What are compounded medications? Compounds are customized medications designed to meet specific patient needs. We work closely with your physician to design the medication which is right for you. Why use compounded medications? We can provide medicines which are simply not available commercially. Sometimes a medicine cannot be patented by a pharmaceutical company, and therefore it is not to their economic advantage to produce the medicine. Another reason a medicine may not be commercially available is that it may not be used widely enough to make commercial production practical. We make one special medicine for one special patient. We can provide alternate dosage forms. Frequently medicines are only available in one form. This often presents a problem for patients who find that they are unable to swallow a large pill, don't like the taste of their medicine, or who simply don't wish to use a suppository. However, through compounding we can make a form of the medication that almost anyone can use. Examples of alternate dosage forms include: Liquids- Some patients cannot swallow tablets, and their medicine is unavailable in a liquid dosage form. However, we can transform almost any pill into a tasty liquid. Many individuals find compounded liquids to be beneficial. Transdermal Gels- This is a specially formulated gel which is able to pull medicine through the patient's skin. They are most frequently used on a painful area to relieve pain and inflammation, but they can also be used as a substitute for oral medications or suppositories. Each situation is considered individually as to the appropriateness of using the medicine transdermally. Suppositories- Another route available when oral medicines can't be used is rectal (or in some cases vaginal) administration of medicines. These are just a few of the more popular choices for alternate dosage forms. We are able to create many other dosage forms such as troches, sprays, and even lollipops.