Compounding Dosage Forms

Compounding allows doctors and pharmacists to meet the special needs of patients. The most important benefit compounding offers is for those patients who may have difficulty taking or responding to commercially available medication. Some people are allergic or sensitive to preservatives and dyes, or are non-compliant to standard drug strengths. Others may have a hard time swallowing a pill, or react adversely to a medicine's taste. Working with the patient's physician, pharmacists can prepare medications in one of several unique delivery systems that are not generally available from pharmaceutical companies. The result? A way to take medicine that helps increase patient compliance.

Medication can be compounded into individually customized capsule form, especially in cases where an alternate strength is required or to omit potential allergens or irritants. To lessen the number of doses to be taken, multiple medications can often be combined into a single dosage or made into delayed-release capsules.

Lozenges or troches are a popular dosage form used to keep drugs in the mouth when local action is needed there. They also can be placed under the tongue and allowed to dissolve for sublingual delivery, which allows the medication to enter the bloodstream quickly and easily. Lozenges and troches can be enhanced with natural sweeteners and pleasant-tasting flavors, making them ideal for geriatric patients.

Transdermal methods of delivery also are widely used because they allow the absorption of medicine directly through the skin. Gels, emulsion creams, sprays and lip balm stick applicators are easy to use and are effective in getting medicine into the bloodstream quickly. Frequently, transdermal medications are prescribed for pain management, inflammation and nausea / vomiting. In many cases, transdermals are used to help avoid potential side effects such as stomach upset or drowsiness.

As many patients often have a difficult time taking medicine, a number of dosage forms can be custom-prepared for easier ingestion. Many medications can be taken through a flavored lollipop or a frozen popsicle. Others can be taken as chewable "gummy" treats. Infants especially benefit from alternate delivery devices such as pacifiers or baby bottles, which are wonderful for dispensing medicine easily and accurately.

Many medications are not available in liquid forms for those patients who have difficulty swallowing tablets and capsules. Other patients may have problems tolerating the taste of a commercially available liquid. Through compounding, a pharmacist can make a naturally sweetened, pleasant-tasting oral solution or suspension that can be administered easily and accurately. Oral solutions and suspensions are also used in compounding eye drops, ear drops, sterile injections or nasal sprays.

Insufflators are used to apply an extremely fine dry powder to the nose, throat, ears or other body cavities, or topically for wounds. By squeezing a bulb, a patient can direct a powdered medication through a nozzle for direct application. Dry powder insufflators offer rapid onset of treatment, and can minimize adverse reactions by releasing small, accurate dosages. They are often used in the treatment of earaches.

Patients who cannot take medications orally are prime candidates for compounded suppositories. Available in various shapes depending on administration, suppositories can be given rectally. vaginally or urethally. By melting or dissolving into the body cavity, they pass quickly into the bloodstream. They can be used for delayed-release medications, hormone replacement therapy, or to treat local conditions such as nausea, hemorrhoids, infections or inflammation.