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Prescription Compounding

at Valley Integrative Pharmacy

The term “compounded prescription” is both becoming more commonplace in today’s community retail pharmacy, yet is still an unknown therapeutic alternative to the majority of patients in our health care system. Although it appears to be a recent phenomenon in pharmacy, compounding has existed for centuries and actually was exclusively the practice of pharmacy in the early days of our country. As the pharmaceutical industry was born in the late 1800’s and came of age in the mid 20th century, branded commercially prepared drug products gradually replaced the extemporaneously prepared compounded drugs. However, a need arose for specific drug therapies, custom dosages, and novel drug delivery forms which were neither in high enough demand for commercial production nor eligible to be patented for commercial profit. Thus, the “compounded prescription” began to see a resurgence in the late 1980’s and reclaimed its rightful place in the practice of pharmacy.

                The word “custom” best defines what a compounded prescription is—an exact drug combination or dosage formulated for an individual patient to treat a specific clinical symptom or condition. Note the key words: exact dosage, individual patient, and specific clinical condition. This combination is often difficult to achieve from a predetermined fixed dosage commercial drug product. Although most patients can be and are treated successfully with the present commercial drug products available in the marketplace, there exists a substantial subset of patients whose pharmaceutical therapy is more suited to the compounded, or “custom” prescription approach. Categories in which custom compounding plays a significant role include bioidentical hormone replacement therapy, pediatrics, veterinary, pain management, and wound and scar treatments.

                Compounding pharmacies, such as Valley Integrative Pharmacy, use sophisticated equipment and techniques to accurately prepare high quality pharmaceuticals. Formulations used in prescription compounding are scrupulously reviewed and evaluated before being approved for use in the compounding lab. Once tested a formulation is logged into a database available for future compounding purposes. These formulas can be modified when necessary to meet the need of the individual patients, such as a flavor change, an alteration in the viscosity, or thickness, of a liquid preparation, or the use of an alternate device to deliver the dose, such as a pump in place of
a syringe.

                An important concept of prescription compounding is flexibility. Changing the dosage form, flavor, or route of administration are a few examples. If your child is unable to swallow a tablet or capsule, the drug may be formulated into an oral liquid or lozenge to facilitate dosing. A pet who may be difficult to dose orally can be treated with a transdermal cream with equivalent therapeutic results. The patient who is resistant or reluctant to utilize oral pain management therapy may respond to topical pain ointments. Topical therapy is often advantageous due to the compounded formulation’s ability to deliver an effective dose to the affected area of the body while minimizing the systemic, or whole body exposure to the drug. Thus, side effects are kept to a minimum while optimal therapeutic results are obtained.

Valley Integrative Pharmacy (VIP) compounding services specialize in bioidentical hormone replacement therapy and veterinary care, other patient concerns are frequently addressed with a compounding solution such as oral mucosal trauma due to chemotherapy, neurological based pain in the extremities, and rectal tissue damage or swelling. For unique medication challenges not addressed by traditionally available commercial drug products, contact the staff at Valley Integrative Pharmacy for the solution to your medication problem. 75 Washington Valley Road, Somerset Hills Shopping Center, Bedminster Township. 908-658-4900.


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