Compounding Pharmacy vs. Regular Pharmacy: What’s the Difference?
In Canada, most prescriptions are filled at a regular pharmacy. Pharmaceutical companies manufacture tablets, capsules, liquids and other medications, which are then supplied to pharmacies. The pharmacist fills your prescription, checks the dose and provides instructions on how to take it. This works well for most patients.
However, not every patient is a good fit for a standard medication. A young child may not be able to swallow tablets. Someone may be sensitive to certain dyes or fillers. In other cases, a doctor may prescribe a strength or form that isn’t commercially available. That’s where compounding pharmacy services come in.
What a Regular Pharmacy Does
A retail pharmacy dispenses medications that have already been manufactured. Your pharmacist checks the prescription, looks for drug interactions, verifies the dosage and provides instructions on how to take the medication safely. Pharmacists can also identify prescribing errors and potentially harmful drug interactions.
However, the medication itself is pre-made. If a drug is only available in 10 mg or 20 mg tablets, those may be the only commercially available strengths. Most pharmacies do not prepare medications from raw ingredients, although some may prepare simple formulations when needed.
What a Compounding Pharmacy Does Differently
A compounding pharmacy prepares customized prescriptions for patients when a commercially available product does not meet their needs. The pharmacist uses the prescribed ingredients and specialized equipment to prepare the required dose and formulation.
The medication can be prepared in a form that is more suitable for the patient, such as a cream, liquid suspension (shake before use), capsule, lozenge or topical treatment.
In Canada, compounding pharmacy standards are established by the National Association of Pharmacy Regulatory Authorities (NAPRA) and enforced provincially by bodies such as the Ontario College of Pharmacists. These standards cover areas such as preparation stations, cleanliness, training and labelling.
Patients can ask the pharmacy about its compounding facilities and how compounded medications are prepared.
Why a Medication Might Need to Be Compounded
Compounded medications may be used when a commercially available product does not match a patient’s prescribed dose, dosage form, or other specific requirements.
Many medications are only available in tablet form, while some children may need a liquid dose. A compounding pharmacist may be able to prepare the medication in a flavoured liquid that is easier to swallow and measure.
Medication shortages can also create a need for compounding in some situations. When appropriate ingredients are available, a pharmacist may be able to prepare an alternative formulation so treatment can continue.
Some medications may also be discontinued even though a patient still needs them. A compounding pharmacy may be able to prepare the medication if the required ingredient is available.
Difficulty swallowing is another reason compounding may be considered. Patients with dysphagia or certain medical conditions may require liquid, topical or alternative dosage forms instead of tablets.
Customized Strengths and Dosage Forms
Compounding can also be used when the prescribed strength is not commercially available.
For instance, if a patient requires 1.25 mg but the smallest available tablet is 5 mg, splitting the tablet may not always provide the most consistent dose. A compounded capsule can be prepared in the prescribed strength.
Medication forms may also be changed. For some patients, topical pain creams may be considered as an alternative to oral medications. Flavoured gels or lozenges may also be prepared for children or after dental procedures. Other compounded products can include mouth rinses, dermatology products, suppositories and troches.
Removing Ingredients You React To
Inactive ingredients such as fillers, dyes, preservatives and coatings are common in commercial medications. Some patients may need to avoid certain ingredients because of allergies, sensitivities, dietary requirements or other concerns.
These may include lactose, certain food dyes such as tartrazine, sugar, alcohol, wheat starch or gelatin capsules.
With compounding pharmacy services, the pharmacist may be able to prepare the medication using an alternative base, filler or capsule type that avoids certain ingredients, as long as the required drug ingredient is available.
Patients should clearly describe any reactions or sensitivities they have experienced so the pharmacist can determine whether the formulation can be adjusted safely.
When to Ask About Compounding
Consider asking about a compounded medication if you regularly need to split tablets, have difficulty swallowing tablets or capsules, or react to inactive ingredients in a medication.
You may also want to ask about compounding if a medication is back-ordered, discontinued or only available in a dosage form that does not work well for you. An alternative dosage form may be appropriate in some cases.
A compounded prescription must be prescribed by a doctor or dentist and include the required drug, strength and formulation. Pharmacists may work directly with the prescriber to confirm or finalize the details.
It is also a good idea to check with your insurance company before starting, because compounded prescriptions may be covered differently than regular prescriptions.
Getting Compounded Prescriptions in Kitchener
Fairway Lackner Pharmacy (Pharmasave) is located on Fairway Crescent, past Chicopee Ski Hill. Our pharmacist, Gurinder Brar, prepares pain management, dermatology, dental, wound, wart, bio-identical hormone replacement therapy and hard-to-find medications in-house.
To get started, have your doctor or dentist fax your prescription to us, or call us at (519) 954-8794 to discuss your options. Already taking medications elsewhere? You can transfer them using the online transfer form on rxrefill.ca and ask us about prescription delivery in Kitchener, Waterloo and Cambridge.
We’re open Monday to Friday from 9:30am to 7pm and Saturday from 10am to 3pm. We’re closed on Sundays.