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There are few topics more personal than talking to someone about their health, especially when it comes to medication. And just like that unique conversation, medications should be tailored to each patient - that’s why we compound prescription medication in necessary cases. 

 

Compounding medications is a process of creating customized prescriptions tailored to the specific needs of each patient. This practice is performed by pharmacists or registered pharmacy technicians. 

 

Compounded prescriptions meet the patients unique need by:  

• Delivering specific strength not commercially available 

• Offering various routes of administration such as liquid, dissolvable/chewable tablets, suppositories 

• Adding flavours to improve adherence 

 

However, approaching a patient to make these suggestions can seem daunting, as addressing someone’s unique health position is a very personal conversation; even if it’s a necessary one. Fortunately, the professionals at Cook’s Pharmacy are here to help. 

 

In this blog, we’ll explain to you how to talk to your patients about compounding prescription medication, the benefits of said medication, and how to maintain patient wellbeing during these conversations. 

 

As a medical or pharmacy professional, it’s essential for you to always speak with your patients about their medication options - especially when it comes to compounding. This process is designed to be very customizable because these prescriptions are tailored to meet the unique needs of each patient. 

 

When it comes to considering compounded medication for your patient, it's essential that you reassure them that they're receiving the best possible care. 
 

Here’s what you need to know about communicating to your patient about compounded medication.  

 

Understanding Compounded Medication 

Research on the benefits and risks of compounding prescription medication can raise a lot of questions; as a professional, you should be prepared to answer a list of questions and concerns ahead of time.  

 

Regardless of the situation, whether it’s imperative or simply a recommendation, you must ensure patient safety is at the forefront. 

 

Here’s a list of examples, including their purpose/applications.  

 

1. Pediatric Medications: Creating flavoured liquid formulations from pills or capsules for children who find commercially available formulation not palatable. 

2. Hormone Replacement Therapy (HRT): Customizing hormones like estrogen or testosterone to match a patient’s specific hormonal needs. 

3. Pain Management Creams: Combining multiple pain-relieving ingredients into a single topical cream or gel for localized treatment. 

4. Allergy-Free Medications: Formulating drugs without common allergens like dyes, gluten, or preservatives for sensitive patients. 

5. Medication for Dysphagia Patients: Converting oral tablets into liquid suspensions or dissolvable forms for those with swallowing difficulties. 

6. Dermatological Preparations: Creating custom creams or ointments for specific skin conditions. 

A healthcare provider may prescribe a compounded medication when a specific combination of drugs is not available commercially. For further example, a compounded topical cream for treatment-resistant neuropathic pain might include a mixture of: 

 

• Amitriptyline: A tricyclic antidepressant often used in lower doses to manage chronic pain, including neuropathic pain. 

• Baclofen: A muscle relaxant that helps reduce muscle spasms and stiffness associated with nerve pain. 

• Bupivacaine: A local anesthetic that provides long-lasting pain relief by blocking nerve signals. 

• Clonidine: An alpha-agonist that can help reduce pain by lowering nerve signal transmission and blood pressure. 

• Gabapentin: An anticonvulsant that is commonly used to treat nerve pain by stabilizing electrical activity in the brain. 

• Ketamine: An NMDA receptor antagonist that can help manage severe pain by blocking pain receptors in the brain and spinal cord. 

 

A combination of these medications in a compounded topical cream can provide targeted relief for treatment-resistant neuropathic pain, addressing different aspects of the pain pathway. 

 

However, there are some additional considerations when it comes to approaching your patient with compounding medication:  

 

 

Querying About Allergies and Potential Sensitivities 

 

It’s imperative to avoid including any substances that could trigger your patient based on allergy or possible adverse effect.  

 

Conduct Thorough Research into Current Medications, Including Over-The-Counter-Drugs, Supplements, and Herbal Medicines 

 

Pharmacists are medication interaction experts. Providing the pharmacist with medication history (including supplements and over the counter medications) can help them further refine the compound recipe to avoid any unwanted interactions. 

 

What to Recommend to Your Patient When Considering Compounding Prescriptions 

 

A crucial part of patient success is having open dialogue for your patient in terms of what is required to develop a care plan. Having clear and concise expectations can help not only determine the best care for your patient, but it can also ease the patient’s mind by clarifying what is required of them. Here are some examples of questions/requirements you can present your patient with:  

 

• Is the prescribed medication strength not commercially available? 

• Could difficulty or aversion to swallowing be alleviated by compounding the medication into dissolvable/chewable tablets, liquid/suspension, or suppositories? 

• Can allergies or intolerances to commercially available products, such as those containing allergens, lactose, gluten, bovine, fish, or pork derivatives, be mitigated with compounded medication? 

• How can patient care be maintained during medication backorders or shortages? 

• Has the cost of compounded medications been discussed, considering they are often more expensive than comparable commercial products due to material costs, professional mixing fees, and overhead? 

• What is the coverage for compounded medications under the patient’s private plan? Will it require prior authorization, partial coverage, upfront payment with manual claim submission, or is it not covered at all? 

 

Make Sure to Ask Questions

 

As the professional, the more questions you ask - the better you get to know your patient’s unique circumstance. This helps you and your patient to make informed decisions about the care plan and ensure that you provide the best possible treatment.  

 

Emphasize the Importance of Following Instructions 

 

You need to emphasize that your patient needs to follow their care plan carefully, including instructions and dosages for use. Make sure your patient knows that if your patient has concerns or questions, that they can come to you freely and without concern.  

 

Be Open to Hearing Feedback 

 

As a professional, you can dispel and ease the anxieties and concerns of your patient with your knowledge and experience.  

 

This ensures a healthy and communicative relationship between you and your patient. This also helps your patient take a more active role in their care plan, including being involved in any medication adjustments that may be required as they continue in your care. Empowering your patient ensures they take their health seriously.  

 

For more information, contact Cook’s Pharmacy today. Cook’s Pharmacy is a compounding pharmacy capable of providing personalized medicine for patients.  

 

At Cook’s Pharmacy, we focus on patient-centric care. The health and safety of our patients is what comes first, so we hope that you found this guide helpful. For more information about us and what we do, see our website for more details.