Back to the Future
Compounding pharmacies are springing up all over the place. But what are they and how can they help you and your family? Amin Jagani, a practising compounding pharmacist, explains.
In recent years, the role of the independent community pharmacist has evolved significantly, with many pharmacists returning to the early roots when medications were tailored to specific requirements. These pharmacists practise pharmaceutical compounding – the preparation of medications to meet each physician’s and patient’s unique needs.
History of compounding
Medication preparation dates back to the ninth century and Moslem scientists such as Jabir Bin Hayyan, reputed to be the ‘Father of Alchemy’. Over the years, compounding has changed. In the 1930s and ‘40s, approximately 60% of all medications were compounded, as many of the large scale pharmaceutical companies did not yet exist.
During the 1950s and ‘60s, with the advent of manufacturing, compounding declined. Pharmaceutical companies began producing off-shelf medications and the pharmacist’s role quickly changed to that of a dispenser of pre-manufactured dosage forms.
However, in the 1980s, and especially in the ‘90s, physicians and patients again began realizing the benefits of customized medications to meet specific patient needs. This resulted from issues such as allergies, availability and supply issues, patient medication compliance issues, and last but not least, the media focus on the importance of customized medication therapy.
Setting the standards
Today, compounding is the result of co-operation between patient, physician and pharmacist, and is regulated by the Health Professions Act. First, the physician prescribes the medication, then the pharmacist compounds the necessary ingredients and dispenses the medicine to the patient after a thorough consultation. The result? Patients get the personalized care they deserve and community pharmacists are allowed to provide patient-oriented services.
How does compounding help?
There are several reasons why pharmacists compound prescription medications. The most important is patient non-compliance. Many patients are allergic to preservatives or dyes, or sensitive to standard drug strengths. With a physician’s prescription, a compounding pharmacist can change the strength of a medication, alter its form to make it easier to ingest, or add flavour to make it more palatable. The pharmacist can also prepare the medication as a lozenge, lollipop or transdermal gel. For patients who have difficulty swallowing capsules, a compounding pharmacist can make a suspension instead.
Great for kids, too!
For example, at Hayyan Healthcare, a compounding pharmacy in Richmond Hill, dentists work with Hayyan’s compounding pharmacists to prepare tetracaine lollipops for their patients. Children can suck on these lollipops in the waiting room, and by the time they are called to the dentist’s chair, they are ready for the dental procedure.
“Kids love these lollipops instead of having a cotton gauze with anesthetic placed in their mouths,” says Amin Jagani, compounding pharmacist and owner of Hayyan Healthcare.
Parents often have a tough time getting children to take medicine because of the bitter taste. A compounding pharmacist can work with the physician and the patient to select a flavouring agent, such as cotton candy, banana, vanilla, butternut, bubble gum or tutti frutti, providing an appropriate match for the medication’s properties and the patient’s preferences.
And there’s more . . .
Compounding pharmacists can also help patients with chronic pain - for example, arthritic patients who cannot take certain medications due to gastro intestinal side effects. Working with the physician, a compounding pharmacist can provide these patients with a topical preparation with the anti-inflammatory or analgesic the doctor prescribed. For patients living in nursing or retirement homes, compounding pharmacies can supply intravenous medications which a nurse can administer in the home setting.
Getting the special treatment
Essentially, compounding pharmacists focus on special needs – from compounding eye drops in a sterile lab or preparing an injection for impotency, to providing natural alternatives in hormone replacement therapy or assisting physicians in the treatment of hospice patients.
“The ultimate goal in preparing customized medications,” Jagani concludes, “is to help physicians and patients achieve a more positive therapeutic outcome.”
Amin Jagani, BPharm, RPh, Compounding Pharmacist, Hayyan Healthcare (a Clinetica Company). Tel: 905.237.7472; email: info@hayyan.ca; www.hayyan.ca.
2600 John Street, Unit 207, Markham, ON L3R 3W3 T: 905.475.5222 F: 905.475.6369
