Compounding

Oakdell Pharmacy - Medical Center is San Antonio’s first and only fully PCAB accredited compounding pharmacy.

Compounding is the ancient art of pharmacy. Prior to the 1850’s, all prescriptions in the United States had to be made from scratch or compounded by the apothecary (or now known as the pharmacist). Once manufactured medications became widely available, pharmacists stopped compounding until recently. Why, you might ask?

Manufactured Medicine & and “the Void”

Many wonderful medicines are available, but because of the fierce competition in our market and the standardization of mass produced medications, there is a void… Most mass produced medicines have limited strengths and dosage forms, which do not quite fit the needs of many patients. Other good medications are discontinued simply because of lack of profit to the manufacturer. Many physicians seek customized and unique formulations for their patients in vain.

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Pharmaceutical medications can treat most of the people. However, some patients, including children, may require custom tailored medication for various reasons such as medication strength & allergies. Until now, the physician who wanted to customize therapy for a particular patient ended up frustrated because it was too difficult and often impossible to find support from the manufacturer or pharmacist. Now physicians have the opportunity to initiate customized therapy for their patients when desired....The solution is compounding!

What is Compounding

Compounding is the art and science of preparing customized medications for patients to improve care. Compounding allows a practitioner to prescribe, and a pharmacist to prepare, a customized medication that is not available commercially, or to place an available medication in a different dosage form to meet a specific patient need (such as allergies or sensitivities) and improve compliance.

Who can use Compounding

Compounding can be used for the entire family! Children benefit from having flavors added to make their medications easier to swallow. Adults can use compounding to help alleviate unwanted side affects. Even the family pet can benefit from compounding to make their medications and vitamins easier to take.

What is a Common Reason to Compound

One of the most important reasons to use a compounded medication is patient non-tolerance of a manufactured product. Many patients are allergic to preservatives or dyes, or are sensitive to standard drug therapies. Physicians also prescribe compounded medications to change the strength, alter its form to make it easier for the patient to ingest, and/or change the route of administration based on an individual patient's needs.

Customized Medications Offer Therapeutic Alternatives and Improve Compliance

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Route of Administration
A medication may only be commercially available as an oral or injectable product but we can simplify home administration by compounding using an alternate form such as a gummy drops, transdermal gel, suspensions, or lollipop.
Combining Medications
Yes, often it is possible to combine several medications into a single oral dosage form such as a capsule, troche, transdermal gel, or suppository.
Flavors
We can flavor each medication to suit the individual’s palate, and eliminate aftertastes. Physicians can prescribe compounded medications to change the flavor to make it more palatable. Some of the best selling flavors available are: Apple, Tutti Frutti, Marshmallow, Raspberry, Tangerine, Grape, even Crème de Menthe.

Dosage Modification

We can compound a medication that contains the most appropriate strength of medication to proved therapeutic benefit but avoid adverse effects. The pharmacist can also prepare the medication using several unique delivery systems, such as a sublingual lozenge, a lollipop, or transdermal gel. Thus, compounding can substantially improve patient compliance by allowing the physician to prescribe a custom- tailored medication to meet the patient’s need.

As mentioned, dosage forms, also called delivery systems, can be altered to meet the patient’s need. Suppose it is most desirable to continue oral administration but the patient has difficulty swallowing. With consideration give to particle size, solubility, and stability, we can properly compound a solution or suspension. How about a freeze-pop or lollipop?

These are particularly useful when it is desirable to prolong medication contact with the oral cavity.

Full Service Sterile Compounding Facility
Several of our locations are equipped with USP<797> compliant sterile labs. This enables us to custom compound items such as preservative free eye drops, injectables, and many others as well. Many area hospitals and clinics rely on us and our expertise in taking care of patient needs.
Here are some other delivery systems…
Capsules, Suspensions, Transdermal Patches, Pediatric dosing bottle, Creams, Ointments, Oral Syringes, Troches (lozenges that dissolve in the mouth), Gummy Animals, Popsicles, Lollipops, Rapid dissolve tabs, Inhalation devices, Drops, Lip Balms, Suppositories and Sinus Rinses

Ways to administer medications to the body

There are several ways to get the medication to the body and to improve patient

compliance.

By Mouth – flavoring, suspensions, gelative lozenges, capsules, gummy drops/shapes, candy, lollipop, freezer-pops.

Eyes, Ears, Nose – drops & sprays in virtually any strength and concentration.

Skin – the drug can be delivered to the local problem area without incurring systemic side effects and without involving the liver or kidneys. Some medicines that may be irritating to the stomach are excellently tolerated through the skin. We make creams, ointments, transdermal gels & sprays.

Rectal, vaginal and urethral suppositories may be the best method of drug administration in some patients. We use various shapes and sizes of suppository casts and molds to produce medications that are delivered in this manner.

Injectable medications usually a last alternative for most patients, are highly effective in directly and instantaneously administering drugs into the body. Sterility is paramount. Our compounding laboratory is equipped with a laminar flow hood that enables us to maintain the highest standards of quality in producing sterile injectable drugs.

Oakdell Pharmacy Commonly Prescribed Compounds

Injectables

Hyaluronidase, Glutathione, Chelation, Corticotropin, Clonidine, Baclofen, Bupivacaine, Progestrone in Sesame Oil (instead of Corn Oil).

Pain Medication Tolerance

Low-Dose Naltrexone 0.05mg to 0.1mg Capsules

Iontophoresis Solutions

Dexamthasone, Acetic Acid, etc.

Phonophoresis l

Hydrocortisone 10% in Aquasonic Ge

Erectile Dysfunction

  • Triple “P” Penile Injection
  • Papaverine/Phentolamine/Prostaglandin E1
  • Double “P” Penile Injection
  • Papaverine/Phentolamine
  • Single “P” Penile Injection
  • Prostaglandin E1 (up to 100mcg/ml)

Anal Fissures

Nitroglycerin 0.2% in Lidamantle HC Diltiazem 2%/Hydrocortisone 1%/Lidocaine 2% Cream

Hemorrhoids

Cohen’s Rectal OintmentHydrocortisone, Benzocaine, Ichthamal, Phenol, Menthol, Lassar’s Paste, Petrolatum, Peruvium Balsum, Hydroxychloroquine, Benzocaine, Nifedipine, Hydrocortisone

Shingles

  • Ibuprofen
  • 2%/Gabapentin 6%/Clonidine 0.1%
  • Ketoprofen 10%/Lidocaine 2%/DDG 0.2%

Neuropathy

Baclofen, Amitriptyline, Ketoprofen, Capsaicin, Ketamine, Gabapentin, Clonidine, Guaifenesin, Piroxiacam, Ibuprofen, etc.. in Transdermal PLO gel. Lipoderm Cream

Nausea

  • Promethazine Topical Gel (PLO) 50mg/ml
  • Bendec Capsules (Doxylamine 10mg, Pyridoxine 10mg)

Topical Anesthetics

LAT Gel, Tetracaine Lollipops, Lidocaine Popsicles, Tattoo Gel

Aphthous Ulcers

  • Negatol (PhenolSulfonic Acid)
  • Betamethasone 0.025% rinse

Radiation Burns

  • TLC Cream
  • Phenytoin 2%/Misoprostol 0.0024%/Lidocaine 2%
  • Aloe 0.2% in an emollient cream base

Radiation Dermatitis

  • Hydrocortisone 1%/Lidocaine 10%/Tetracaine 10%
  • Benzocaine 5%/Misoprostol 0.002%
  • Pentioxifylline 10%

Dermatisis

Clobetasol 0.5%/Zinc Pyrithione 2% Topical Spray

Warts

  • Triple Acid
  • Salicylic Acid 10%/Lactic
  • Acid 10%/Acetic Acid 10%
  • 2-Deoxy-D-Glucose 0.2%/Cimetidine 4%/Ibuprofen 2%

Decubitus Wound Care

  • Ketoprofen
  • Misoprostol
  • Lidocaine
  • Phenytoin

Migraines

  • Lidocaine 4% Nasal Spray
  • Ketoprofen 5%/Gabapentin 4%PLO

Motion Sickness and/or Vertigo

  • Diphenidol
  • Scopolamine Nasal Spray 2mg/ml

Diaper Rash Combinationss

  • Cholestyramine
  • Resinol
  • Nystatin
  • Stomahesive Paste

Smoking Cessation

Nicotine Lollipops

Ophthalmics (Some Preservative Free)

  • Antibiotics (Vancomycin, Cefazolin, Ceftriaxone, etc.)
  • Antifungals (Fluconazole, Itraconazole, etc.)
  • Antivirals (Vidarabine) Ointment
  • Others (Mitomycin, Neomycin, PHMB, Chlorhexadine, Acetylcysteine,
  • Glutathione, Timolol, Pilocarpine, etc.)

Natural Compounded Hormone Replacement

  • Tri-Est (80% Estriol, 10% Estradiol, 10%Estrone)
  • Progesterone
  • Testosterone
  • DHEA

Embryo Implantation

Sildenafil Vaginal Suppositories

Pregnancy Support

  • Progesterone Suppositories
  • Progesterone Chocolate
  • Troches
  • Progesterone in Sesame Oil (up to 100mg/ml)
  • Hydroxyprogesterone
  • Caproate

Proton Pump Inhibitor Suspensions

  • Omeprazole
  • Suspension
  • Lansoprazole Suspension