When you go into your local pharmacy and look past the Rx counter you will see rows and rows of oral dosage forms (tablets and capsules), a small section of oral liquids (solutions and suspensions), and an even smaller section of topical preparations (ointments and creams), and a smattering of others (eye drops, nasal sprays, etc.). It is this way because oral dosage forms generally are easy to produce, are less costly, provide ease of use, and are more acceptable to the general public than say a rectal suppository or a sublingual (under the tongue) product which may be bitter to the taste. Pharmaceutical manufacturers know this and tend to produce and promote oral preparations over other dosage forms they don’t manufacture.
There is nothing inherently wrong with this approach except that for some medication and for some patients there may be better ways of delivering a drug. For instance: oral dosage forms go through the stomach and into the small intestine where they are absorbed into the blood stream, then go through the liver where they are partially metabolized, then into the systemic blood supply, and finally to the site of their action. Some of the problems a particular patient might encounter are: stomach upset, vomiting, diarrhea, inconsistent absorption, and liver toxicity.
Alternatives to an oral drug might be:
- sublingual drops or troches (semi-solid dissolvable disks) – medication is absorbed directly into the blood stream via the mucus membrane in the mouth. This route bypasses the stomach and the first pass through the liver. Taste can be a drawback.
- topical transdermal creams – many drugs will penetrate the skin, be absorbed into the capillary system and then into the main blood stream. This route also bypasses the stomach and the first pass through the liver. It can be used to treat pain (muscle aches, joint inflammation, back pain) right at the site of the pain. Since it is slowly absorbed into the system it has few side effects compared to oral administration.
- suppositories – the drug is absorbed through the sigmoid colon, bypassing the stomach, but still goes through the liver before it gets into the systemic circulation. Main drawback is patient acceptance.
- injections – in many ways the best route of administration from a therapeutic point of view but not practical outside the doctor’s office or hospital.
The use of alternative dosage forms is not well-known or understood by many medical providers. Compounding pharmacists are the experts. If you are having difficulty with your medication an alternative dosage form might be of value.
Contact the experts at Key Compounding Pharmacy. They can advise you and your medical provider on what possibilities exist.
We at Key are here “Just For You”!
About 15 years ago, Big Pharma and the FDA pushed legislation through Congress designed to control and restrict what a compounding pharmacy could do. In addition, the legislation contained a clause restricting the ability of a compounding pharmacy to advertise its products. Essentially the legislation said that it could advertise that it compounds but could not advertise what it compounds. Imagine Congress telling General Motors it can advertise that it is a manufacturer but not advertise that it makes cars and trucks.
After multiple lawsuits the matter of advertising went to the Supreme Court and the Court found that the restriction of advertising violated the first amendment and was therefore unconstitutional. That should have ended it, but Congress chose to do nothing. The “advertising ban” remained in the legislation leaving compounding pharmacies in limbo.
As a result of the tragic events surrounding the New England Compounding Center debacle, Congress amended the law to create a special category of manufacturer / compounder, designed to increase oversight by the FDA and hopefully stop such tragic events from occurring again. In addition, Congress finally got around to striking the advertising ban from the bill.
President Obama recently signed the legislation. So now a compounding pharmacy can advertise not only that it compounds medicines but exactly what medicines it compounds. This is a great step forward for compounding and for patients and medical practitioners.
You must also understand that manufacturers (Big Pharma) and compounding pharmacies function at two different levels of patient care. Manufacturers make large volumes of medication intended for the general population and thus are required by the FDA to demonstrate that their products are safe and effective all across the general population. Whereas compounding pharmacies make a specific medication for one specific patient at a time, working closely with that patient and the patient’s medical practitioner to create a medication designed to help only that patient. Thus, a compounder can make no claims of safety and efficacy because of the very nature of the product. But rest assured it is the compounder’s responsibility as well as the medical practitioner’s to do no harm. Both do everything possible to assure that the medication is safe. Both also use their years of experience to come up with a compound that is effective in each specific patient. It is also the case that virtually 100% of the chemicals used to create a particular medication and dosage form are approved for pharmaceutical use in humans by the FDA.
You will begin to see compounders advertise what they compound as well as what treatment category the active ingredient(s) fall under. For example you might see that a compounder makes “ibuprofen topical cream” and that this compound’s active ingredient, ibuprofen, is an antiinflammatory and pain reliever. What you should not see is that this topical medication is used to treat tennis elbow or other joint pain. That would be making an unsubstantiated claim of efficacy.
We at Key Compounding Pharmacy are here Just for You! Hopefully you will never need our services but if you do you can rest assured that we will compound the safest and most efficacious medication possible for you!
The frequency of nut consumption was associated with a lower mortality in a study of two large groups of men and women reported in the November 21 issue of the New England Journal of Medicine. For individuals eating nuts less than once per week there was a 7% decrease in mortality risk compared to those who did not eat nuts. For those who ate nuts seven or more times per week there was a 20% decrease in mortality. There were significant associations between nut consumption and deaths resulting from cancer, heart disease, and respiratory disease. Results were similar for peanuts and tree nuts.
Nuts are rich in nutrients, such as unsaturated fatty acids, fiber, vitamins, and minerals, which may confer cardioprotective, anticarcinogenic, antiinflammatory, and antioxidant properties.
This data is consistent with a wealth of existing studies supporting the health benefits of nuts. In addition to the nutrients listed above, nuts provide a number of phytochemicals including carotenoids, flavonoids, and phytosterols.
The authors of the study indicated that there might be a concern that frequent nut consumption can result in weight gain. However, in this and other clinical trials, nut intake was associated with reduced waist circumference, less weight gain, and a decreased risk of obesity.
Much is yet to be learned about these associations but it seems reasonable to add nuts to your daily diet.
A prospective study, published in the November 6th issue of Nature, which followed 110 children from birth to age 3 years, showed that those who had a subsequent diagnosis of ASD started life with relatively normal attention to others’ eyes. However, their eye fixation began to decline between the ages of 2 and 6 months and continued declining to the study’s end at 3 years of age. This pattern was not observed in typically developing children.
Deficits in eye contact have been a hallmark of autism but the onset of these has not been studied before. Dr Warren Jones, PhD, director of research at the Marcus Autism Center With Children’s Healthcare Center of Atlanta, and Emory University School of Medicine, indicated that this study “…has helped us to identify the earliest signs of autism that we’ve ever observed. And it gives us some proof that it’s possible to identify these signs within the first few months of life”.
Scientists have long wondered why sleep is restorative and why lack of sleep impairs brain function. Now, new animal research published in the October 18th edition of Science suggests that the sleep state helps clear the body of potentially toxic central nervous system metabolites. It seems that the sleep-wake cycle regulates an internal “flushing” system which is responsible for clearing waste from the brain and spinal cord. This research has not yet been duplicated in humans. But if it is it might lend credence to the old saying “a good night’s sleep can clear the brain”.
If you are diagnosed with cancer a first priority for you and your doctor will be to remove the cancer, if possible, and/or treat it with radiation, chemotherapy, or both. But equally important is avoiding malnutrition, minimizing toxic side effects from radiation and chemotherapy, and boosting the immune system to fight the cancerous cells. This is where proper nutrition and nutritional supplementation is essential. It is also the area of treatment that is entirely in your hands.
To take control of your nutrition and nutritional supplementation you will need to have good information on what to do and what nutrients are of value. The pharmacists at Key Compounding Pharmacy can help. They can recommend what to do to strengthen your immune system and what nutrients you can take to make chemotherapy more toxic to cancer cells and less toxic to good cells. There are also measures you can take to minimize nausea, neuropathies, and damage to mucous membranes.
Talk with one of our pharmacists. They are there….Just for You!
Happy news for men. The estimated degree to which genes contribute to the risk of prostate cancer is between 50%-63%. This is the highest for any malignancy studied. Breast cancer in women is estimated at about 28%.
The familial connection for prostate cancer is very low. But apparently there are multiple other genes which, of themselves, may only be of moderate risk, but in combination with other “risky” genes contribute to the 50-63% overall risk. Much work needs to be done to identify risky genes and determine how environmental factors might be involved.
But in the meantime about the only reasonable course is to do everything you can too stay healthy and watch for signs and symptoms of prostrate issues. Do not hesitate to contact your physician if your body is telling you something might be wrong.
Contact Key Compounding Pharmacy if you have any questions about what signs and symptoms to watch for. Remember, we are here….Just For You!
As a person transitions through life, it is a good idea to stop occasionally to take stock of who they are and where they are going. This is also true of businesses such as Key Compounding Pharmacy (KCP). What is it that identifies why it exists and at the same time forms the basis for future direction? For KCP it is its mission statement.
KCP exists and constantly strives: to empower patients and healthcare providers to make informed, alternative choices for improved health and wellness.
What does this mean in actual practice? KCP….
- focuses on its patients and healthcare providers and their needs
- provides the best healthcare information possible – guidance that can be trusted
- focuses on the art of compounding and how it can help improve health and wellness
- encourages its patients to be proactive and take control and responsibility for their own health
- provides the safest, most effective compounded medication possible
The owners, pharmacists, technicians, and assistants strive to live this mission everyday, in every encounter with patients and healthcare providers.
You can trust Key Compounding Pharmacy. It is here “Just For You”.
You will be hearing more about Choosing Wisely, an initiative of the ABIM Foundation that aims to promote conversations between patients and physicians and help patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary. Visit and explore their website www.choosingwisely.org and you we get some great information that will stimulate questions to ask of your medical provider. Consumer Reports’ Advice on a number of topics is also part of the site. Well worth the read.
We at Key Compounding Pharmacy have always advocated for the patient to take charge of his/her medical care. Choosing Wisely will help do that. What you read is not intended to be medical advice but to give you the information you need to ask the right questions of your medical provider and then mutually make decisions about that care.
You will be hearing more about the hormone melatonin and its use for the prevention of migrane. Melatonin is secreted by the pineal gland and helps regulate the sleep/wake cycle. Evidence is emerging that exogenous doses may be helpful in reducing the incidence of migrane while having fewer side effects than some of the drugs currently in use. A multicenter controlled trial showed that 3mg of melatonin was significantly better than placebo with respect to migrane prevention. The primary outcome seen was a reduction in the number of headache days per month. Secondary endpoints included reduced migrane intensity, duration, and analgesic use. The dose studied was 3mg by mouth at bedtime.
There have not been many studies done so far but these results will prompt additional ones which are needed to validate the results seen. In the meantime melatonin is relatively safe and is available OTC without a prescription. But if you are planning on trying it be sure to check with your pharmacist about drug interactions. Most significantly, melatonin may potentiate the effect of warfarin (Coumadin) which could cause bleeding problems.