A new article in the latest issue of Australian Prescriber explains that the art and science of compounding medicines is alive and well in Australia.
Compounding is the preparation of a medicine for an individual patient—a practical way to have medicines supplied when there is no other way, for example for people who need a dose or form of medicine that isn’t commercially available, or who have difficulty swallowing medicines whole.
Dr James Falconer and Associate Professor Kathryn Steadman of the University of Queensland explain that some people might have very specific needs when it comes to medicines, such as needing an individualised dose that can’t be purchased ready-made, or a medicine that can be delivered via a feeding tube.
“All pharmacists have training to prepare simple compounded products that might include different types of creams, liquids, tablets or powders, and these can be made in any community pharmacy or hospital,” says Dr Falconer.
“However there are other more complicated types of compounded medicines such as injectable preparations, products with a safety hazard, modified-release dosage forms, and some eye medicines. To prepare these, pharmacists require further postgraduate training, as well as specialised facilities and equipment.
“There are specialist compounding pharmacies in most major towns and cities around Australia.”
Importantly, anyone taking a compounded medicine should know that while all the components of the medicine including the active and non-active ingredients are subject to quality standards, the final medicine itself is exempt from assessment by the Therapeutic Goods Administration (TGA), and there is no assessment of the final product.
“What this means is that while compounded medicines are a good option when commercially made medicines are not available, the stability of the product isn’t known,” says Dr Falconer.
“To minimise the risk of a compounded medicine degrading before use, it will usually have a short-term expiry date compared to a mass-produced medicine.
“For example, the expiry date on most oral or topical products will be 28 days, while injectable medicines are likely to have a 24-hour expiry.
Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice.
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