Posts Tagged 'compounded medications'

Why Compounded Medications Take Longer Than Regular Prescriptions

Making capsules with an individualized prescription is a time-consuming process.

Making capsules with an individualized prescription is a time-consuming process.

Patients sometimes ask us at our compounding pharmacy: “Why does my medication typically take a day to be ready and sometimes longer?”

There are several factors that can affect how quickly each medication is made at a compounding pharmacy. These factors include:

  1. The number of orders ahead of a patient’s prescription
    The number of prescriptions a compounding pharmacy receives on any given day is one factor we can’t always predict.. At Koshland Pharm, we do our best to catch up when we are especially busy by taking measures such as bringing our staff in on weekends to make medications.
  2. The dosage form of the medication ordered
    Capsules, for example, are one of the most time-consuming medications to make. Each capsule is hand-packed, and a random capsule weight check is performed on each finished batch to ensure each capsule holds the proper amount.
  3. The availability of specific ingredients
    At a compounding-only pharmacy like Koshland Pharm, we stock the active ingredients of the medications we most often make; sometimes, however, a customized medication is prescribed with an active ingredient that we need to order before making.
  4. Communication needed between the doctor, pharmacist, and patient
    Because each medication is formulated specifically for an individual patient, sometimes the prescribing doctor and pharmacist need to talk to clarify or adjust an order. This can make the process take a little bit longer. Also, because each prescription is made from scratch and by hand, we only begin the process after both receiving the prescription (or refill authorization) from the doctor and also verifying with the patient that we should go ahead with the order.

It always helps compounding pharmacies like ours to have as much advance notice as possible when filling a customized prescription. We greatly appreciate any advance planning that is possible, especially for refills. We also encourage patients to choose our expedited, trackable shipping option if they are going out of town and needing the medication on an exact date.

Much like the slow food movement, the “slow medicine” movement prioritizes processes that sometimes take longer but lead to successful health outcomes. Compounding pharmacies that make individualized prescriptions for specific patients with only the highest quality standards are a part of this “slow medicine” philosophy. While we want to make medications in a timely fashion, especially when it is an antibiotic or another medication that is immediately needed, we know we must always follow the best procedures that have been developed and tested within the industry to ensure quality.

Krista Shaffer, Outreach Director at Koshland Pharm

Ensuring Quality and Safety in Compounded Medications

As a compounding pharmacist, I have been saddened by recent unfolding news about a meningitis outbreak in southern and eastern states tied to injectable medications made at a compounding pharmacy in Massachusetts. As this news is shining a national spotlight on compounding, I would like to highlight two key issues this situation raises:

1) Accreditation by the Pharmacy Compounding Accreditation Board (PCAB) is essential in the compounding profession. Although new facts continue to be uncovered in the investigation of the pharmacy in question in Massachusetts, it has been established that it was not PCAB accredited. There are currently 165 compounding pharmacies nation-wide (and  21 in the state of California) that are PCAB accredited.

Although every compounding pharmacy is regulated by its state board of pharmacy, variation does exist state to state in practice requirements. Being PCAB accredited ensures that a pharmacy has passed the highest standards for safety and quality in the profession. The Pharmacy Compounding Accreditation Board was founded and is governed by eight leading national pharmacy organizations, including the United States Pharmacopeia (USP), and it requires pharmacies to adhere to strict policies and procedures that include rigorous and consistent testing of their finished products.

2) Sterile and non-sterile compounding are two different kinds of compounding a pharmacy can specialize in. Of the approximate 7,500 pharmacies nation-wide that specialize in compounding, 3,000 provide sterile compounding.  Sterile compounding requires additional equipment and procedures to ensure the sterility of the finished products that are injected directly into the body.  The medications that are under current investigation from the Massachusetts compounding pharmacy were sterile injections.

I, along with thousands of my compounding pharmacist colleagues, am dedicated to providing patients with the valuable option of using high-quality, customized medications when standard treatments are not working for their particular situation.  To read six key questions for a patient to keep in mind when evaluating a compounding pharmacy (particularly one that makes non-sterile products), see  Koshland Pharm’s “Understanding Compounding” webpage.  To read extensive questions a doctor can ask of a compounding pharmacy (particularly one that makes sterile products), see this questionairre created by the International Academy of Compounding Pharmacists. To read another recent blog about how the Massachusetts compounding pharmacy in question appears to differ from traditional pharmacy compounding, see the National Community Pharmacists Association blog.

Your comments and questions on this important topic are welcome.

~Peter

www.koshlandpharm.com


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