Every drug we use that is approved by the Food and Drug Administration (FDA) goes through a lengthy and arduous testing process. Used appropriately, these drugs help us sleep, ease pain and fight infection.
Our pets benefit from this testing as well. However, there aren't as many drugs specifically designed to treat diseases and conditions in animals. This means human drugs (those not tested for use in animals) are used if there is no species-specific alternative.
This is where the compounding pharmacist comes in. Compounding is the method used to prepare a tailor-made drug for a specific patient, done only by a qualified compound pharmacist.
Any time a drug is changed, it is no longer approved for use. For instance, simply taking a tablet and crushing it to make syrup means that drug is no longer approved for safety and effectiveness by the FDA. Every time a medication is changed from its original form, essentially a new medication is created. A few reasons for compounding medications include:
Before the advent of all-night pharmacies and medicines available in so many different formulations, compounding was a popular technique. Pharmacists are trained to make medications from raw ingredients. For hundreds of years, all drugs were compounded since there was no way to make large quantities of the same medication, test it for safety and store it. The pharmacist would take the order and custom make the medication for the individual. Half a century ago, 60 percent of all medications were compounded. Today, only about one percent of all drugs given are compounded. The majority of these are within the animal field.
Compounding is an art form. The methods used to get the final product vary depending on final desired drug. If your pet needs Propulsid®, compounding is the only way your pet can stay on this drug since it has been found to be unsafe in people and has been removed from the market. The pharmacist, with a prescription from your veterinarian, will take the raw ingredients necessary to make Propulsid and make the medicine just for your pet. If your cat readily takes his medicine if it tastes like salmon, compounding is the way to go. Very few human medications are made with a salmon flavor. The pharmacist can take the original medication and add a special flavoring. This changes the original form of the drug and therefore falls under the rules and guidelines of compounding.
Not everyone can compound a drug. It takes special talent and specific training. Though most licensed pharmacists are trained to compound medications, make sure your pharmacist has experience. One minor slip can cause problems.
Compounding is regulated under a pharmacy compounding law that explains what the licensed pharmacist can and cannot do. Even though the pharmacist has followed the rules and made the best compounded drug he can, there are still some negative aspects to compounding. The safety and effectiveness of the drug can no longer be guaranteed. The exact amounts of the drug may not be guaranteed and the additives may not be tolerated well by your pet. If a professionally manufactured product is available in the form and strength that works for your pet, choose this option before compounding. Compounding should be reserved for those cases in which there is no other alternative.