Commonly Used Compounded Medications

Compounding can be a bit elusive. You don’t know what you don’t know. If you are seeing a doctor that does not commonly prescribe compounds, chances are they aren’t even really considering this treatment modality for you. However, most physicians are more than happy to consider this treatment option if you believe you would benefit from a compounded product. So…. What are the most common reasons someone might have a compounded prescription? I will be listing a few of the most common reasons we at Remedy see someone on a compound.

 

Bioidentical Hormone Replacement Therapy

At Remedy, by and large, our most popular compounds are bioidentical hormones; estradiol, estriol, progesterone, and DHEA. These hormones are prescribed based on symptoms commonly associated with imbalances as well as based on lab values testing serum levels to further adjust dosing. Advantages of compounded hormone products over commercial products include the following- First, we can adjust precise concentrations to match your needs (hence, the blood work). Second, the type of estrogen and progesterone can be the exact compound that your body is naturally producing versus a synthetic version. Third, we can also adjust the dosage form to reduce side effects and increase efficacy. For example, topical estrogen is associated with a reduced rate of cardiovascular risk than an oral dosage form. Commercially available progesterone is not time-released so it offers less help with insomnia related to menopause or perimenopause. If you would like to learn more about our BHRT, I invite you to register for our FREE event on 2/26/20 with Dr. Winter.

 

Pain

The way that we are treating pain is changing rapidly. Unless you have been living under a rock, you may have heard of the Opioid Epidemic. Among other things, we have learned that the long-term benefits for people on opioid medications suffering from chronic pain are not good. As the rate of opioid use declines, sadly the rate of people suffering from chronic pain is not likely to follow. A major philosophy for successfully treating pain is to use multiple agents, that combat pain signals in different ways in combination. For example, there is a compounded pain cream that has a combination of ketamine (an anesthetic agent), gabapentin (a medication known for its ability to fight nerve pain), ketoprofen (a non-steroidal anti-inflammatory agent, cousin to ibuprofen or Voltaren) and lidocaine (another anesthetic or topical agent). As patients are weaning off of powerful narcotics, topical agents that have a combination of pain-fighting medications offer a promising alternative.

 

Low Dose Naltrexone

This is one that we get excited about! Autoimmune conditions are on the rise and present as a constellation of various symptoms. We are learning more and more about the immune-modulating effects of low dose naltrexone, or LDN for short. LDN works differently at receptors compared to traditional higher doses that are used as opioid antagonists. Benefits of oral LDN have been seen in autoimmune driven conditions such as Lupus, Idiopathic Pruritis, Psoriasis and Eczema, IBS and Ulcerative Colitis. Benefits are also seen for pain syndromes such as fibromyalgia. The most common side effect of LDN is strange dreams and can typically be avoided or lessened if doses are slowly tapered.

 

Avoiding Preservatives or Additives

If you have sensitivities to preservatives such as parabens or dietary sensitivities to dairy products like lactose, you may want to check the ingredient in your medications as well. Typical medications are manufactured with long shelf lives, which is beneficial for reducing waste and for supply channels, however, the downside is that to achieve longer shelf lives preservatives must be added. If you have a known chemical sensitivity to preservatives, please ask your pharmacist to check the inactive ingredients on the medication you are being given. Inactive ingredients vary depending on the manufacturer and can change from refill to refill. If you need to avoid these additives, compounding is a great option. Compounds are made to order, have shorter shelf lives and way fewer additives. In regards to lactose, this is a common filler in tablets and is added to help aid in manufacturing.  Those with more extensive dairy allergies may react to the amount in tablets.

 

At Remedy, we are passionate about personalized medicine and that’s why we get so excited about compounding. The compounds mentioned above are only a small percentage of the possibilities. If you have questions on anything that you have read here or want to talk to a pharmacist more please email us or stop in and ask! If you are currently on a compound and are curious about using Remedy as your compounding pharmacy please let us know and we can give you a price quote!