Custom Compounding

Jan 29, 2013

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy


Did you know that there are over 550 miles of roads in the RM of Dauphin? If you are clearing snow with a grader, that means you have over a thousand miles to cover since you have to clear both sides of the road. That huge number surprised me when I was talking to Mick after Monday Night Hockey. Mick actually does clear the RMs roads. I was happily surprised to I learned something new about my own backyard.


Other people seem happily surprised by our pharmacy. A couple years ago a customer came into the store and told me she didnt know the Dauphin Clinic Pharmacy was so special. The customer had just got back from Toronto where her child was seeing a specialist. Her child was on a medication that is only commercially available as liquid. We had compounded it into a capsule. The child was happier taking the capsule and the Toronto specialists were impressed that we could help her child in little old Dauphin. The customer said she didnt know that the custom compounding we did here for her child was so unusual. There was another local child who was in hospital in Alberta. The Alberta specialists didnt believe the parents that a Dauphin pharmacy had made a liquid form of aspirin for their child. You see if aspirin is just crushed and mixed with water it will break down. So we mixed it in an oil base. I had Alberta hospital pharmacists phoning us to get our formula for the liquid aspirin so the child could continue to receive the medication in the Alberta hospital.


We probably dont blow our own horn enough about the custom compounding we do at the Dauphin Clinic Pharmacy. Custom compounding is when a pharmacist mixes together a preparation that isnt commercially available for a patient at the direction of a physician, vet or dentist. To explain compounding, I often have to show people what we do in our compounding lab for it to make sense to them. That used to be difficult as our compounding lab was hidden where the public couldnt see it. In our new building, the compounding lab is right out front, with nice big windows so you can see what we are doing.


At the Dauphin Clinic Pharmacy, we use the art and science of compounding to tailor medications to an individual patients needs. Our most popular compound is called diclofenac cream. It can be rubbed directly on a sore knee or shoulder to reduce the pain without bothering the stomach. We get to compound some more unusual things too. For example, we made a topical version of haloperidol for a nursing home patient. Haloperidol can be used to calm someone who has dementia and is very agitated. Sometimes if the patient is very agitated, the nurse has to give the haloperidol by injection. But, as you can imagine, trying to give an injection to someone who is very agitated and has dementia can be difficult. There is a pill version of haloperidol, but with some agitated patients it is not possible for the pill to be given and sometimes the nurse even gets bitten. But, holding an agitated patients hand and rubbing a medication on their wrist is a very natural and calming thing for a nurse to do. So, we made a topical version of haloperidol so the nurse could rub into onto the wrist. It worked well for both nurse and patient.


For animals, under a vets direction, we have made a variety of products. In the spring we compound a liquid to prevent scours in calves. We have compounded liquid antidotes for dogs who ate rat poison. One interesting thing we compounded was an antibiotic for a cat. We started with a human medication, ground it up an put it into a special fish paste that the cats love. However, we found one cat didnt like fish, so that cat got its medication in a chicken paste. When the patient is a cat, it is still important to listen to the patients likes and dislikes.


Any one who has had hemorrhoids will tell you how annoying, painful and itchy they can be. The problem is most suppositories slide right by the hemorrhoid and so they dont release much of their medication onto the hemorrhoid. At the Dauphin Clinic Pharmacy we have a suppository mold called a Rectal Rocket. It flares at both ends so the suppository stays where it can do the most good. And, of course we can customize which medications we put in the suppository.


When you are next in the pharmacy, press your nose up against the glass and have a look in the compounding lab. Check out what we do first hand. When you are watching us mix something together you might get an idea of how we could help you, your family or your animals. Then knock on the glass and ask me your questions. We want you to be happily surprised about how we can make your life better.


The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at


As always if you have any questions or concerns about these or other products, ask your pharmacist.


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