Compounding: Dosage Forms

Capsules

Undoubtedly the most popular compounded dosage form is the capsule.  With access to pure powdered forms of thousands of drug entities, compounding pharmacists can prepare a multitude of both single- and multiple-ingredient capsules, in a variety of dosages, colors, and sizes to suit the needs of the individual patient.  For those with allergies to certain fillers or colors, the pharmacist can compound capsules without the offending agents.  Special ingredients can also be used to make extended-release capsules when required.

Oral Liquids (Suspensions, Syrups)

This is a popular dosage form in pediatrics, geriatrics, and for those who have difficulty swallowing solid dosage forms, such as patients undergoing chemotherapy or radiation.  Due to the fact that many drug products are not commercially available as oral liquids, the compounding pharmacist is often asked to compound oral liquid dosage forms.  A variety of dosages and flavors can often be compounded.

Suppositories (Rectal, Vaginal)

Suppositories are solid dosage forms that melt, soften, or dissolve in a body cavity.  Though not often the patient's first choice as a dosage form, there is no disputing that suppositories are very useful for administering drugs to infants and children, severely debilitated patients, and those for whom an avoidance of oral or injectable products is desired.  Their benefits can be local in nature (e.g. hemorrhoid treatment) or systemic (e.g. analgesics, antibiotics, hormones, anti-nauseants) and can be formulated into either single- or multiple-ingredient suppositories.

Topical Dosage Forms (Creams, Ointments and Gels)

Topical dosage forms have been around for thousands of years, primarily to deliver a drug into the skin for various disorders.  In more recent years, compounding pharmacists have compounded transdermal formulations as well.  Whether to use a cream, ointment, gel, or lotion depends upon both the degree of skin penetration of the medication that is desired as well as the characteristics of the skin to which the product is being applied.

Troches / Sublingual Tablets

Troches and Sublingual Tablets are used primarily for patients receiving Bio-Identical Hormone Replacement Therapy (BHRT). This delivery method is optimal for achieving therapeutic goals, as the drug is absorbed into the oral mucosa rather than through the gastrointestinal tract.  This avoids the 'second-pass effect', in which the drug is broken down into other forms (referred as metabolites), thereby possibly rendering treatment less than desirable.  Both single- and multiple-ingredient troches can be compounded, depending on the particular patient's needs.  Sublingual Tablets are much smaller than Troches and, for this reason, are better-suited to use with testosterone, estrogens and dehydroepiandrosterone (DHEA); progesterone is best delivered by the Troche.  See this page for flavoring options!