Compounded drug uses
In 2012, when I was diagnosed with hypothyroidism, my endocrinologist prescribed a compounded thyroid medication. He preferred it because it allowed him to tweak the ingredients to my individual needs. I like it better than getting too much or too little from a commercially available drug. I also like that there are no fillers, like dyes, sugars, corn starch, lactose or gluten, and that I have not had a negative response from its use.
Compounding of pharmaceutical products is also used to add flavor to avoid nausea, to change a formulation to liquid for ease of swallowing and for customizing to a cream, gel, lotion or ointment. Compounding pharmacists are able to provide discontinued medications to patients by recreating pharmaceutical-based ingredients from scratch. They can make a formula without offensive fillers or preservatives. This benefits allergy-sensitive individuals, avoiding certain substances found in mass-produced pharmaceuticals. Most hospitals use compounded medications to create patient-specific dosages. Allowing them to accommodate an in-between dose matching a particular patient’s weight and size. Also to combine some multiple medications into a single dose. According to the International Academy of Compounding Pharmacists, the compounding industry is an estimated 1-3 percent of the U.S. prescription market or $300 billion overall. A national survey of independent pharmacists revealed that 76 percent compound medication for patients.
Pharmaceutical companies and compounding facilities follow strict regulations
Sadly, compounded medications that do not use approved FDA ingredients, like natural dietary supplements, are not covered by insurance plans. In addition, a compounded medication may not be covered if there is a commercially available product. This does not mean they are not safe. Compounding pharmacies have access to the highest quality pharmaceutical ingredients. They use the latest research, quality control processes, and techniques for filling prescriptions. Compounding pharmacies and pharmacists are licensed. Like drug manufacturers, they have to follow the same regulations as those pertaining to a manufacturing process in a controlled environment. Compounding is strictly regulated by State Boards of Pharmacy, the Drug Enforcement Agency (DEA) and the standards of the United States Pharmacopeia (USP) Convention. In addition, accreditation from non-profit agencies establishes guidelines and quality improvement in compounding processes.
Both compounding facilities and large pharmaceutical companies have had problems resulting in tighter regulations. In 1971, Abbott Laboratories, one of the nation’s largest commercial suppliers, had an incident where 400 hospital cases, including 40 deaths, were attributed to contaminated bottles of dextrose intravenous solution. The FDA and CDC enforced additional precautionary procedures for packaging and labeling. In 2012, several patients developed fungal meningitis, resulting in 64 deaths, after receiving contaminated steroid injections prepared by a New England compounding center that is no longer in business. The compounding facility did not have proper storage. It also held quantities that were not permitted under state and federal law. Since then the Compounding Quality Act of 2012 has placed more federal and state regulations on general and sterile compounding.
The advantages of compounded medications
Interestingly, all medications were compounded before mass drug manufacturing. As compounding declined pharmacists became pill counting drug dispensers. Recent technology advancements have allowed pharmacists to once again customize medications. The benefits of natural compounded supplementation are that the ingredients are less toxic and can be less expensive. The cost of compounds depends on both labor and ingredients. Because compounds are custom made, unlike commercial products produced by large manufacturers, the process steps and time determines the labor costs. Many compounds have fairly low-cost ingredients if they are commonly used by the pharmacy. Bulk buying helps lower the costs but expiration dates minimize large quantity storage.
My personal experience with commercially available antidepressants became an eight-year nightmare. During that time of trial and error with different reuptake inhibitors, I had awful side effects of insomnia, weight gain, restless leg syndrome, fatigue, the flatness of emotions and increased anxiety. When I finally switched to prescription compounded natural supplements I no longer endured side effects and my symptoms improved to near non-existence. Prescription mass-produced psychiatric drugs were not suited to my biochemistry. I needed the option of something more natural that corrected my imbalance rather than band-aiding. The option of compounded nutrients prescribed at targeted therapeutic levels helped to normalize my brain chemistry and increase my energy. Unfortunately, I pay out of pocket for this relief because my insurance carrier does not cover non-FDA approved medications.
Individualized treatment as an option
The slogan “Have It Your Way” was created by Burger King to accommodate individual consumer needs. A lactose intolerant person can order a burger without cheese. Along the same line, compounding pharmacists with their extensive drug knowledge are able to provide a unique treatment plan with targeting solutions. Allowing for patients who do not tolerate commercially available drugs to have an option of specific natural ingredients for their individual chemistry needs. Having gone through a health crisis when my brain and body struggled on commercially available psychiatric drugs I now choose to “Have It My Way” for optimal health. My hope is that more patients choosing and improving on natural compounded medications will demonstrate the clinical benefits. Until that time, I continue to budget for medical expenses not covered by my insurance carrier.
Some doctors, like my endocrinologist, prescribe both commercially available and compounded drugs to provide what is best for the patients’ medical needs. It’s our patient responsibility to ask about the ingredients in prescribed medications. If you are experiencing side effects from mass-produced pharmaceuticals, or just not feeling like they are helping, talk to your doctor about a compounding option. Alternative or integrative doctors are more likely to prescribe a natural product and use a compounding option. It is important to choose the right compounding pharmacy for the effectiveness of any formulation that is directly correlated to its preparation. Below are a couple of resources to help find a quality compounding pharmacy near you. The International Academy of Compounding Pharmacists (IACP) https://www.bullseyelocations.com/pages/, The PCCA https://www.pccarx.com/Resources/FindACompounder.