Compounding can fill a need when commercial products have been discontinued by the manufacturer for economic reasons as opposed to clinical reasons. In situations where we can still access the pharmaceutical grade ingredient, we can compound the medication for the patient. The same situation arises during temporary shortages from manufacturers where we are still able to access the pure powder to make a version of the commercial product.
Discontinued Products (Examples)
Pyridium©/Phenazo© (phenazopyridine 200mg): A urinary analgesic that treats pain from bladder infections. Sig Oral: 200 mg 3 times/day after meals for 2-3 days when used concomitantly with an antibacterial agent (typically dispensed in multiples of 10).
Antabuse© (disulfiram 250mg): Initial Sig: 500 mg once daily for 1-2 weeks (maximum daily dose: 500 mg). Average maintenance dose: 250 mg once daily (range: 125-500 mg; maximum daily dose: 500 mg).
Septra/Teva-Trimel (SMZ/TMP) Suspension – Has been discontinued after years of being on back-order.
Stievamycin® gel (Tretinoin & Erythromycin) Mild, Regular or Forte– The three formulations have 4% erythromycin & three strengths of tretinoin (0.01%, 0.025% & 0.05%).
Uremol© HC Cream & Lotion (Urea 10% & HC 1%) – We can also make a more moisturizing formula using our Fallowfield Eucerin Emollient as the base to which we add Urea & HC.
Products Not Previously Commercially Marketed (Examples)
Riboflavin 400mg Capsules: Sig: 400mg orally daily for migraine prevention (www.tinyurl.com/q2cm949)
Boric Acid 600mg Vaginal Capsules: For treatment of vulvovaginal candidiasis, boric acid 600 mg vaginally once or twice daily for 2 weeks has been used. For prevention of recurring vulvovaginal candidiasis, boric acid 600 mg vaginally twice weekly has been used. References on our website at www.tinyurl.com/n98m859
Ibuprofen Suppositories: Ibuprofen is commercially available only in oral forms in North America whereas oral & rectal versions are available in Europe. We can make this in strengths tailored to the child’s weight. The oral dose is 5-10 mg/kg/dose. Rectal absorption is less than oral absorption so it should be dosed rectally at the top of the range (10 mg/kg/dose). These suppositories are prescription-only since non-oral forms of Ibuprofen require a prescription in Canada.
Low-Dose Naltrexone (LDN): We compound Naltrexone capsules in several strengths ranging from 0.5mg to 4.5mg for chronic once daily dosing. We also compound a Naltrexone 1% transdermal cream for short-term adaptation of neuroreceptors. https://ldnresearchtrust.org/
Updated March 2022
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