What is compounding?
Compounding is the art and science of preparing personalized medications for patients. Think of medications like shoes. Most of the time, you can walk into a shoe store and get a shoe off the rack. Sometimes, none of the shoes off the rack will do. Wouldn’t it be nice if a shoe store could make a pair of shoes for you from scratch for those special times? That’s what compounding is. When an off the shelf medication won’t work for you, we can create a compounded medication. Working with your doctor, we make a medication from scratch to meet your specific needs.
Why would I want my medication compounded?
Not everyone will want or need a compounded medication. For most people, the off the shelf, commercially available medications work fine for them. However, sometimes the one size fits all solutions that are commercially available are not appropriate for a specific patient. Compounding offers solutions to those people who:
- Need a specific strength of a medication that isn’t commercially available
- Have difficulty taking their medications. Maybe they need it in liquid form, or chewable form or in a form that can be absorbed through the skin. Compounding can change the form of the medication to one that the patient is able to use.
- Have allergies to preservatives, perfumes, flavours and dyes. When a medication is compounded we can control exactly which additives go into each compound.
- Need a medication that isn’t available anymore. Some medications go off the market. This can be very distressing for people who have successfully used those medications for years. In some cases, a compounding pharmacy can re-create a discontinued medication.
What different types of compounding services can the Dauphin Clinic Pharmacy provide?
- Hormone treatments for both men and women. Under the direction of a physician, the Dauphin Clinic Pharmacy can compound hormone creams, troches, capsules, suppositories and other dosage forms to help balance the hormones.
- Pediatric preparations. The Dauphin Clinic Pharmacy can make small doses forms, low dose dosage forms, flavoured dosage forms and other modifications to help your child.
- Pain medications. Being in pain sucks. We can work with your doctor to help treat your pain. We can take oral pain medications and make them into one that can be rubbed on the skin and go directly to the sore joint. We can take medications that are usually reserved for injections and use them topically to treat painful nerve pain or neuropathic pain conditions like shingles and diabetic nerve pain. We can put morphine like medications into wound treatments to treat painful wounds. Ask us if we can help your pain.
- Your dog, cat or ferret. Ever tried to get medication past the sharp pointy teeth of your cat? Wouldn’t it be easier if you could rub it into their ear? Doesn’t your dog want medications shaped like little dog bones? Ferrets are too small to take commercially available dog medications. We can get the right dose for them. We will work with your vet to help out the furry, scaly or feathered members of your family.
What different types of compounds are there?
- Compounds are only limited by your imagination and our imagination. There was once a compounding pharmacist working for a zoo (no it wasn’t us). The zoo had a gorilla with an eye infection. Usually to treat an eye infection a gorilla has to be tranquilized and kept sedated for days. That is very expensive and hard on the gorilla. One day a pharmacist who worked with the zoo was walking home his kids squirted him with a super soaker. This gave the pharmacist an idea. The pharmacist lined up Dixie cups on a picnic table the same distance away as the gorilla would be in the back of his cage. Then the pharmacist figured out how many shots it took him to fill the Dixie cup. A little math and a little compounding later the zoo had a super soaker eye drop delivery device. Working with the zoo’s Vet, the pharmacist enabled the gorilla to be treated without sedation and the expense and danger that went with it.
- Common compounded dosage forms include:
- Topical medication that go through the skin (creams, ointments, gels, lotions)
- Oral liquids like suspensions and solutions
- Troches that dissolve under the tongue and lozenges
- Gummy bears
- Eye/ear drops
- Powder papers
- Nasal sprays
- And many more
- While not as spectacular as the gorilla story, at the Dauphin Clinic Pharmacy we helped some nursing home patients. Sometimes in nursing home patients with dementia go into delirium. They can scream and kick and be a real hazard to themselves and others. There are medications that can be given to calm the patients. One of these medications comes in pill form. The problem is when a nurse tries to give a pill to an agitated patient, the nurse can get bitten. So the other option is an injection. Not surprisingly seeing a nurse with a needle didn’t calm the agitated patient either. So with the nursing home’s doctor we put the calming medication into a topical cream. Then the nurse could sit with the agitated patient and rub the cream into their wrist. The act of sitting with a patient and rubbing their wrist was an inherently calming action and the patient got the medication they needed.
- Let our imagination help you. Bring us your most difficult medication problems and let us work with you and your physician, vet or dentist to come up with a solution.
How do I get my prescription for a compound prepared?
- First you have to see your doctor and get the prescription. Depending on the situation, sometimes you can see us first for ideas, and we can send suggestions to your doctor, dentist or vet. But the doctor, dentist or vet has to write us a prescription.
- Once you bring us your prescription we can start working on it.
How do I get my prescription for a compound prepared?
- The easiest and least satisfying answer to that is “It depends.” Different compounds take more or less effort on our part to prepare. Sometimes we have to order in unusual ingredients.
- The standard rule of thumb is it takes about 24 hours to prepare a custom compound. That could increase to 2-3 days to a week if we have to order in unusual ingredients.
How do I pick up or have my compound delivered?
- Just tell us what you want. After it is made it is just like any other prescription. You can pick it up in store or at the drive-thru. We deliver in Dauphin 7 days a week and we courier to many nearby communities Tuesday through Saturday. Or if all those won’t reach you, we can pop the compound in the mail.