Ask the Compounding Expert – Andrew Gilbertson

Ask the Compounding Expert – Andrew Gilbertson

Hill Ave Drugs has been your local neighborhood pharmacy for 63 years, and has been specializing in compounding for over 15 of those years. Specializing in compounding means that the staff at Hill Ave Drugs can tailor prescriptions specific to each individual patients’ needs. What does this actually mean? What is the process that goes into preparing a unique compound for a patient? In the next few paragraphs the general process will be discussed.

Compounding can be utilized in a variety of patient populations. Anyone with a valid prescription from a doctor could have their medication compounded at Hill Ave Drugs. Pediatric patients are a population that often requires special compounds. Say your child cannot swallow a pill, or needs a dose that is much smaller than what is available commercially—we can compound a liquid with an exact dose to make it easier. Another special population that may require compounding are pets. Pets become part of the family and when they get sick, you want to be sure that they are receiving accurate doses of medications that will not be harmful to them. We can make medications for a variety animals—birds, reptiles, dogs, cats, and many more. Having dental surgery? Have an intolerance or allergy to ingredients in commercial products? We can compound medications to meet your specific needs! All types of dosage forms can be made via compounding. Some examples that we compound at Hill Ave Drugs are hormone creams, sterile eye drops, specialized capsules, suspensions, and solutions. We can also compound for a variety of medical conditions including anything from pain to diaper rash to epilepsy.

So, once the doctor has sent us the prescription, how do we get started? It starts with creating a formulation record which has a list of all the ingredients that will be needed for that specific compound. Then based on the required strength of the prescription, the quantities need to be calculated for each individual ingredient. For example, a 2mg/mL suspension will require much different quantities than a 5mg/mL suspension. When creating a formulation record it is also important to look up properties of each ingredient. This may include things such as solubility (to help determine what kind of base is required), appearance, and purpose. Another important factor to consider is expiry dates. The expiry of each ingredient is checked and then based on mixing compatibilities and stability, a best before date is created for the final product. Along with the active ingredient there are often “fillers” added to a compound. These fillers may include flavoring agents. We have a variety of flavors that can be added to your medication to improve palatability and make it easier to take. We also have special flavors for pets—beef, chicken, liver, and fish are among some of the choices!

The next step after calculating quantities and gathering the ingredients is to prepare the compound. At Hill Ave Drugs we have a special area for all our compounding to ensure proper preparation of the final products. In addition to this, our compounding staff wear proper attire which includes gowns, gloves, and masks. This is done as a safety measure to ensure the compounder is not unintentionally ingesting a product that is not intended for them, as well as to ensure the compound is not contaminated with foreign objects. In order to make a compound there may be a wide range of activities the compounder must perform. Just a few examples are crushing tablets, opening capsules, and measuring exact millilitres or grams. Accurate measurements are very important so we have many ways of ensuring quality products. We also have excellent devices that allow for exact measurements to ensure proper strength. Our scale is accurate up to one thousandth of a gram, and we have different sizes of graduated cylinders and syringes that are accurate up to one hundredth of a millilitre.

The final step in the preparation of a compound is ensuring proper appearance. The pharmacist always double checks the final product to be sure that the highest standard of patient care is met. If compounding sounds like something you or someone you know could benefit from, be sure to talk to your doctor or stop by Hill Ave Drugs and speak with one of the amazing pharmacists—Andrew, Gavin, Michaeline, or Janice.