9 Common Pharmacy Compounding Formulations Used Today

For many patients, allergic reactions, harmful side effects, or barriers to administration make it very difficult to receive necessary treatment. Fortunately compounding pharmacies have a solution. Whether for pain relief, hormone replacement therapy, or other medication needs, pharmacy compounding formulations can offer solutions to any number of challenges faced by individuals seeking medication treatment.

In this article, we will discuss the types of pharmacy compounding formulations, their benefits, and some of the most common formulations created by compounding pharmacies today. 

What is a compounding pharmacy?

Often working closely with healthcare providers, a compounding pharmacy creates personalized medications that are formulated to meet the specific needs of a patient, making alterations such as custom strength, dosage, form, and flavor.

compounding creams for pain, a girl is shopping the medicine

What are pharmacy compounding formulations?

Pharmacy compounding formulations, also called medication compounds or compound medications, are custom-made medications that involve the combination or alteration of commercially available drugs. These alterations are typically prescribed for patients who cannot tolerate commercially available drugs or who require adjustments for more sustainable medication administration.

Often, medications are compounded into different forms—for example, a drug that is commercially available as a tablet might be compounded as a cream, gel, solution, or suspension. Particularly useful for patients with allergies or other sensitivities, pharmacy compounding formulations can also eliminate or replace certain medication ingredients.

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What types of medications can be compounded?

Compounding is available for a wide variety of medications, but the most common families of compounded drugs include those for pain, hormone replacement, hemorrhoids or anal fissures, and pets.

Pharmacy compounding formulations for pain

Compounding creams for pain are often used to provide localized relief for patients through a combination of medications. Compounding creams for pain allow for a customized approach to pain management that can be tailored to each patient’s unique needs.

What is in compound medication for pain?

The ingredients in pharmacy compounding formulations for pain can vary, but the most common active ingredients include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and anesthetics. Additionally, antidepressants and anticonvulsants are sometimes added.

Pharmacy compounding formulations for hormone replacement

Bioidentical hormone replacement therapy (BHRT) involves the use of bioidentical hormones—man-made hormones that are nearly identical to those found in the human body—to treat hormone imbalances, as well as:

  • Female and male menopause
  • Osteoporosis
  • Insulin resistance
  • Adrenal and thyroid disorders
  • Fibromyalgia

What is in compound medication for hormone replacement?

Estrogen, progesterone, and testosterone are the most commonly replicated hormones used in BHRT treatment. They can be created in the form of pills, patches, creams and gels for a variety of health conditions. 

Pharmacy compounding formulations for pets

Pharmacy compounding formulations can be used to treat a variety of medical conditions in pets, including anxiety, pain, and seizure disorders. Formulations with added flavorings are particularly common for pets who refuse to otherwise take medications. 

compounding pharmacy, two dongs are seeing above

What is compound medication for pets?

The ingredients in pharmacy compounding formulations for pets can vary depending on the condition being treated. Common ingredients include anti-inflammatories, antihistamines, antibiotics, and pain relievers. 

Pharmacy compounding formulations for hemorrhoids & anal fissures

Pharmacy compounding formulations can be used to relieve the symptoms of hemorrhoids and anal fissures, commonly in the form of creams or ointments.

What is in compound medication for hemorrhoids & anal fissures?

Common active ingredients in these types of compounding formulations include local anesthetics, anti-inflammatory drugs, and topical steroids.

Pros and cons of compounding

Pharmacy compounding formulations offer a variety of solutions for patients with custom medication needs, by providing alternative forms of medication, removing allergens, and combining medications.

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What are some reasons why a person might prefer a compounded medication over a manufactured medication?

Pharmacy compounding formulations can make medications more palatable and easier to take.

This can be especially helpful for children who cannot swallow pills or who reject unsavory flavors. A compounding pharmacist can create medications in different forms, such as gummies, to make it easier for children to take their medication.

Pharmacy compounding formulations can provide alternative forms of medication.

Pharmacy compounding formulations can provide alternative forms of medication, such as creams, ointments, or suppositories. For example, a person with arthritis may prefer a cream or ointment over a pill, as it can be applied directly to the affected area, providing localized relief.

Pharmacy compounding formulations can remove allergens from your medications.

Common allergens that can be removed include casein, gluten, fragrances, alcohol, sugar, allergens, or dyes. Removing these allergens can mitigate many of the unpleasant side effects that some people experience with commercially available drugs.

Pharmacy compounding formulations can provide custom strengths or dosages.

In this way, pharmacy compounding formulations can make it easier to accurately administer medication. For example, a compounding pharmacist can prepare a medication in a lower dose, so that patients do not have to rely on pill cutting to get the dosage they need. 

Pharmacy compounding formulations can combine medications.

By combining multiple prescriptions into a single medication, pharmacy compounding formulations can eliminate the need for multiple doses. This is especially helpful for medications that are taken one or more times daily. 

What are the risks?

Because pharmacy compounding formulations are tailored alterations of commercial drugs, they are not FDA-approved. However, the FDA has established guidelines for compounding pharmacies to ensure that these formulations are safe and effective. Compounding pharmacies must adhere to strict standards and regulations, including using high-quality ingredients, following established formulas, and ensuring proper sterilization and packaging.

In addition to these FDA guidelines, the Professional Compounding Centers of America (PCCA) provides accreditation and compounding training, as well as high-quality chemicals and formulas, for its members. Thomas Seashore Drugs is proud to be a PCCA member; we have undergone rigorous training and follow strict quality standards. By choosing PCCA-accredited pharmacies, patients can be confident that the medications they receive are safe, effective, and properly formulated for their individual needs.

What are examples of compounded medications?

Pharmacy compounding formulations are used to tailor countless medications in a wide variety of ways. Nine of the most common compound medication examples include:

1. Oral Ketamine 

Commercially available in injection and nasal spray forms, ketamine is commonly used as an anesthetic and pain reliever. Compounding pharmacies provide an oral form which allows patients to receive the benefits of the medication without the need for injections or hospital visits.

2. Low-dose naltrexone (LDN)

Low-dose naltrexone (LDN) is a medication compound that consists of a low dose of the FDA-approved drug naltrexone which is used to treat opioid overdoses. In much lower doses, naltrexone has immune-modulating effects that have been shown to promote healing and alleviate pain caused by a number of conditions, such as rheumatoid arthritis, fibromyalgia, multiple sclerosis, and Crohn’s disease. The LDN compound is particularly beneficial for patients who do not respond well to other conventional treatments for their conditions. It comes with very few, if any, side effects and is cost-effective compared to other traditional therapies.

3. Magic mouthwash 

Magic mouthwash is a pharmacy compounding formulation that combines several commercial ingredients to treat or alleviate pain caused by oral conditions such as thrush or oral mucositis resulting from chemotherapy. The ingredients in magic mouthwash vary depending on the specific prescription, but it typically contains a combination of:

  • An anesthetic, such as lidocaine
  • An antifungal medication, such as nystatin 
  • An antihistamine or anti-inflammatory medication, such as diphenhydramine or hydrocortisone
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4. Progesterone cream

Progesterone is one the most commonly replicated hormones used in BHRT therapy to supplement the body’s natural progesterone production and treat a variety of hormone-related issues such as irritability, trouble staying asleep, and symptoms of menopause. Commercially available in capsule form, it is commonly compounded as a cream to allow for convenient and easy application to the skin. Additionally, pharmacy compounding formulations may include other hormones or supplements such as estrogen, testosterone, depending on the individual’s specific goals.

compounding formulas for pharmacists, Testosterone cream

5. Testosterone cream

Similarly to progesterone, testosterone is commonly replicated in BHRT therapy to treat a deficiency in the body’s testosterone levels. Treating a deficiency can alleviate symptoms such as fatigue, muscle decline,, and low libido. Testosterone cream compounds are popular, especially among those who prefer not to use injections, as they are easier to apply and allow for direct absorption through the skin.

6. Bi-Est cream

Bi-Est cream is a pharmacy compounding formulation that combines two natural estrogens, estradiol and estriol, to optimize symptom relief. A bioidentical hormone replacement therapy, Bi-Est cream is often prescribed to treat the symptoms of menopause, such as hot flashes, night sweats, vaginal dryness, and mood swings.

7. Scream cream 

Typically prescribed to enhance sexual satisfaction for women experiencing sexual dysfunction, scream cream is a pharmacy compounding formulation that combines several commercial ingredients to help increase blood flow to the application area. The most common are:

  • Sildenafil, a PDE5 medication
  • Pentoxifylline, a vasodilator
  • Arginine, a naturally occuring amino acid 
  • Ergoloid Mesylate, a nootropic 

8. Anal fissure & hemorrhoid suppositories & ointments

Anal fissures and hemorrhoids are common conditions that affect the rectum and anus. Medications for these conditions are often compounded into suppositories and ointments because they can provide targeted relief to the affected area. Suppositories are designed to be inserted into the rectum, where they can deliver medication directly to the site of the problem. Ointments are applied externally to the anal area and can help reduce pain, itching, and inflammation. Compounding allows for customized dosing and delivery methods to meet the specific needs of each patient. Suppositories and ointments for anal fissures and hemorrhoids can contain a variety of commercial ingredients, depending on the specific formulation. Some common ingredients include: 

  • Lidocaine
  • Hydrocortisone
  • Phenylephrine
  • Witch hazel

9. Gabapentin compounds for dogs

Gabapentin is a medication used in both human and veterinary medicine to treat chronic pain and seizures.  Commercially available gabapentin is sometimes too strong for small dogs, in which case veterinary compounding formulations can provide lower dosage compounds. Additionally, because many dogs are resistant to oral medications, gabapentin can be compounded into a variety of forms that are easier to administer, such as suspensions or transdermal gels, or formulated with flavoring to make it more palatable. 

How to get pharmacy compounding formulations

How do you get a prescription for pharmacy compounding formulations? 

To get pharmacy compounding formulations, you will need a compounding prescription from your doctor. Compounding formulas for pharmacists are only prepared upon receiving a valid prescription, as all pharmaceutical activity is regulated by state pharmaceutical boards. At Thomas Seashore Drugs, our pharmacists can help you and your doctor determine if a pharmacy compounding formulation is the right option for your needs.

If you’re interested in exploring the benefits of pharmacy compounding formulations, start by talking to your doctor about a compounding prescription. Then, reach out to our pharmacy to discuss your options with our knowledgeable pharmacists. They can work with you and your doctor to develop a customized medication solution that’s safe, effective, and tailored to your unique needs.

How does the cost of pharmacy compounded medications compare to commercially available drugs, and are they covered by insurance?

Pharmacy compounding formulations are custom-made medications that are altered to meet individual patient needs. Therefore, a direct comparison cannot be made between pharmacy compounding formulations and commercially available drugs. 

In most cases, pharmacy compounding formulations are not covered by insurance. If you have questions about a specific compounding formulation, our pharmacists at Thomas Seashore Drugs can help answer questions about coverage options under your specific insurance plan.

Compounding can be beneficial for patients who require customized doses, unique delivery methods, or specialized medications that are not commercially available. However, it’s important to ensure that the compounding process is done professionally and with great care. At Thomas Seashore Drugs, our pharmacists are trained and experienced in compounding medications and follow strict quality control measures to ensure that every medication we prepare is safe, effective, and of the highest quality.

If you’re interested in learning more about how compounding could benefit you or a loved one, contact the pharmacists at Thomas Seashore Drugs or visit one of our locations near you. We can help you understand what options are available to you and work with your doctor to create a safe and effective medication solution just for you.

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