Compounding combines an ageless art with the latest medical knowledge and state-of-the-art technology, enabling specially trained professionals to prepare customized medications that are just what the doctor ordered.

Customized Medications Offer Alternatives & Advantages for Children

• Change in Dosage Form — If a child is unable to take, has not responded to, or experienced adverse effects from commercially available medications, numerous options exist. We can compound the needed drug(s) into different dosage forms, such as cosmetically appealing creams, ointments, transdermal gels, topical sprays and powders, lozenges, lollipops, or freezer pops.

• Elimination of Problem-Causing Excipients — Medications can be formulated to eliminate unnecessary dyes, sugar, lactose, alcohol, and preservatives.

• Change in Route of Administration — Some drugs are commercially available only as injections or oral dosage forms that must be swallowed. A child may be unable to take medications orally or may not be permitted to consume liquids or food required to administer the medication. The child’s family may wish to avoid frequent injections or intravenous administration. Our compounding professionals can provide additional therapeutic options by compounding alternate dosage forms such as lollipops, suppositories, or transdermal gels.

• Combination Preparations — We can combine compatible drugs into a single dosage form to simplify a medication administration schedule, and improve compliance. Also, a synergistic effect can be achieved when certain medications are used in combination.

• “Unavailable” Medications —When a medication is temporarily unavailable or has been discontinued due to manufacturing concerns, we can usually obtain the needed drug as a bulk pharmaceutical grade chemical and compound a similar preparation.

• Individualized Dosing—We can compound a dosage form that contains the optimal dose of medication (based on age, weight, and disease state) to provide needed benefits but minimize the risk of adverse effects. Also, single doses of medication can be prepared for school or travel.

• Prescriber-Specific Formulations — Physicians often develop specific formulations to meet the unique needs of their patient population, or acquire “tried and true” formulas during medical training. We commonly prepare these customized medications.

Pediatric Problem Solvers

Children pose many challenges when it comes to medication. In general, they may resist having to take a medication, dislike the taste or texture, have difficulty swallowing solid dosage forms, and are fearful of injections.

The limited pediatric market for most drugs may be the leading reason for the lack of investment in drug development for this population by the pharmaceutical industry. Most medications are not labelled for pediatric populations, and when a medication is not approved for use in infants and children, it usually is not available in a suitable pediatric dosage form. Many drugs are not commercially available as liquids, and fewer are available in dosage forms that children like.

Fortunately, our compounding pharmacy is able to help with all of these problems. Extemporaneous formulations have an important role, especially in infants and young children who are unable to swallow tablets or capsules. We can compound oral medications into pleasantly flavoured suspensions, solutions, concentrates, freezer pops, “gummy bears” or lozenges, in colors that entice the child to take the medication. A palatable formulation is more likely to improve compliance and minimize spillage or waste during administration. Lollipops are an ideal alternative to “swish and swallow” medications that need to be retained in the mouth for a pro longed period of time. Most drugs can be compounded into transdermal gels that can easily be applied to an appropriate site, such as the child’s wrist, for absorption through the skin.

The efficacy of any compounded medication is influenced by the technique and equipment used in preparing the formulation, the purity and quality of the ingredients, choice of vehicle (base), and proper use of additives such as penetration enhancers.

Professional compounding is not just diluting existing medications, or mixing powders with bases. We must consider physical and chemical properties of each active and inactive ingredient in order to prepare an effective and safe customized medication with the desired taste, color, fragrance, viscosity, uniformity, texture, and stability.

We are dedicated to meeting the unique needs of pediatric patients.

Attention Deficit Hyperactivity Disorder

The use of medications to treat ADHD has greatly increased, yet the dosage requirements for many children differ from strengths that are commercially available. This often necessitates a midday dose at school, which can be embarrassing to a child. Slow-release dosage forms can be compounded to contain the precise dose of medication needed by each child.’

Nausea & Vomiting

Orally administered anti-emetics can be difficult for a nauseated child to “keep down”, and rectal suppositories may not be well accepted by children. ‘transdermal anti-emetics, such as promethazine, can offer an alternative.

Laxatives

Constipation is a common problem for children with certain disease states and gastrointestinal defects. Commercially available products offer limited flavour choices which are often not appealing to children, and these products are difficult to re-flavour. However, compounding pharmacists can concentrate preparations such as milk of magnesia, and flavour each prescription differently to please each patient.

Diaper Rash

Customized formulations containing protectants, absorbents, and bile acid sequestrant can provide relief for irritated skin. We can also compound medications, such as cholestyramine ointment, to prevent site irritation in ostomy patients.

Acne

Emergence of resistant pathogens emphasizes the need for alternatives to antimicrobial agents for acne therapy. We can compound cosmetically-appealing customized formulations.

Topical Anesthesia

Topical anesthesia is needed for common pediatric procedures such as suturing, wound cleaning, and injection administration. The ideal topical anesthetic would provide complete anesthesia following a simple pain-free application, not contain narcotics or controlled substances, and have an excellent safety profile. The combination of topical anesthetics lidocaine and tetracaine and the vasoconstrictor epinephrine has been used successfully for anesthesia prior to suturing linear scalp and facial lacerations in children. A triple-anesthetic gel containing benzocaine, lidocaine, and tetracaine (“ BLT”) has also been reported to be effective when applied prior to laser and cosmetic procedures. Convenience of application without need for occlusion is an advantage of these topical anesthetics.

Autism

Chelation, amino acid, nutritional, and supplemental therapies can be customized for each child. Tthnsdermal options exist.

Traumatized or Diseased Nails

Although surgical excision is the most popular method for removing nails, the use of concentrated urea plasters applied under occlusion may be superior. The use of urea plasters has inherent advantages — they are inexpensive, several nails can be treated in one session, and the procedure is essentially painless. Various synergistic combinations and topical medications with penetrant enhancers can be compounded for antifungal therapy! Topical medications usually have a lower adverse drug-reaction profile than systemic medications.

Warts and Motluscum

Resistant warts and molluscum contagiosum have been treated successfully with compounded topical medications, avoiding discomfort associated with freezing, scraping, electrocautery and laser therapy.

Head Lice/Scabies

Concerns about emerging resistance and the potential harm of using permethrins have prompted a search for effective pediculicidal therapies that are not harmful to children with repeated use. An herbal formulation has been shown to be effective for head lice. Ivermectin can also be compounded for topical application or as an oral dose titrated for each patient for the treatment of head lice and scabies.

Children with Special Needs

Children with cancer, burn patients, and those who are developmentally challenged can all benefit from customized medications.

We welcome your questions and medication problems.

Our compounding professionals are problem-solving specialists!