Carr Drugs, which has three locations on the West Bank, offers a special compounding service to help make prescription medications easier for patients to take. Kandace Power Graves discusses the process with pharmacist Randy Carr.
Q: What exactly is compounding?
A: It's simply the combining of different ingredients.
Q: Basically, for your customers you make tailor-made pharmaceuticals that take into account whether a medication is easy to take and palatable or to leave out things a patient might be sensitive or allergic to. How do you determine what needs to be done?
A: We rely on the doctor and the patient. In order for us to do anything at all, the three of us have to be involved. The doctor is the diagnostician and prescriber and tells us what they want and ask us how they can get to that spot.
Q: What is the most common reason a patient needs special compounding?
A: The main reason is usually that something (medication) is not available in the form they need. It may only be available in a tablet form and this patient can't swallow a tablet. Or it may be that the strength they need isn't available and the patient would have to use pieces of a tablet, and that's very inaccurate. We can do it very accurately.
Q: Do most pharmacies offer compounding?
A: No. All pharmacists can do it. In most cases it's not convenient or if (the pharmacy) is not set up for it, it's not cost effective. Where it may take 15 minutes to a half hour to fill a regular prescription, if we have to compound something, it could take from a half hour to six hours, depending on what we had to do to the medication. If we take a medication usually taken by mouth and make it so the patient can rub it on in a topical cream, that takes longer. Some things have to sit for two-to-three days so the chemical reactions we need to have happen can take place. Most compounds, however, can be done pretty readily.
Q: So it's the time factor that limits the number of pharmacies doing compounding?
A: Most of the pharmacies out there are trying to get out as many medications as they can safely, and this would slow them down.
Q: Is this how all prescriptions used to be filled?
A: Yes. Prior to the 1930s, this is how most prescriptions were made. There would be a list of ingredients and a pharmacist would have to put it into a capsule, suppository or whatever.
Q: Why do you do it?
A: We specialize in problems, whether it's a human patient or an animal, whether they have trouble taking the medication or need a medication that isn't on the market anymore.
Q: You deal with non-human patients?
A: We do a lot of veterinary prescriptions. One animal may like chicken flavor, one might like tuna, and another might like tutti-frutti. We try to make it so the animal will take the medicine readily. We even had a pair of monkeys come in the store and do a taste test. They needed the same medication, but one liked banana flavor and the other liked raspberry.
Q: Do all doctors know this is available?
A: Not all. We try to visit them and let them know it's available. We also tell the patients that it's an option if they have a problem (with their medication) or a family member who has a problem.