Compounded medications are regularly created for pediatric patients, and they have a wide range of uses in pediatric medicine. Many pediatric patients are not able to ingest commercial medications, and compounding pharmacies can create customized medications with different methods of delivery such as dissolving lozenges, smaller pills, liquids and more. Also, commercial medications often have ingredients that pediatric patients may be allergic to. Many parents would prefer to have a compounding pharmacy create medications so that they their pediatrician can control the ingredients used in the preparation. In other cases commercial medications may not have labels or indications for children, and as a result their dosages are not suitable for children. Compounded medications have proven to be very useful for the treating of several pediatric conditions, and continue to be used regularly as substitutes for other medications.
There are a wide range of different applications of compounding medications, and pediatric patients can greatly benefit from customized medications. At a compounding pharmacy, medications that are flavored can be created including flavored syrups, lollipops, and lozenges and compounding pharmacists have access to several different flavors. Pediatric patients are often times more likely to take medicines that are flavored, and flavoring medications may improve treatment outcomes. Gels, suspensions and creams can be created for easier administration for pediatric patients. Several different types of medication forms can be created including gummies, freezer pops, gelatins, gums, pacifier dosages, and syrups can each type of medication form can be flavored to be appealing to the child.
Commercial medications may be used for pediatric compounding
In many cases commercial medications can be used as the basis for pediatric compounded medications, however there are several important considerations for physicians and pharmacists to take into account. Commercial medications have been used for decades to safely create compounded medications for pediatric patients, and the most common example of this is the creation of oral liquids from oral tablets or capsules. In other cases injections or other dosage forms that are easier for the patient to ingest are created.
Some of the concerns and considerations to take into account include the following:
- Inactive ingredients must be thoroughly considered and evaluated for their potential effects on the patient. In many cases commercial medications have a wide range of inactive ingredients that can cause allergic reactions or other harmful effects on a pediatric patient. The medical provider should be able to anticipate any adverse effects from using a commercial medication and avoid the use of the medication if there are any.
- If a solution is to be created, the pH of the solution must be taken into account, and if there is a major difference in pH between the compounded medication and the original commercial medication, there may be significant effects on the stability of the drug. Physicians and pharmacists should anticipate with the effects of varying pH levels are for each medication in solution, and if necessary a different dosage form should be created. Also many commercial medications have pH buffers that will affect the pH of a compounded medication, and if there are any buffers they must be taken into account while preparing the compounded medication.
- There are several types of commercial medications that should be used to create compounded medications for pediatric or adult patients. For example, extended release medications, targeted release, delayed release and other medications with controlled release formats are not suitable for compounded medications in the majority of cases because it is more difficult to anticipate and control their potency and absorption rate.
- When commercial medications are used to create large batches of compounded medications, they should be assayed for their potency. Potency level can vary quite dramatically from one commercial medication to another. The allowable potency range for compounded medication is only 90% to 110% potency, and if the commercial medication used to create the compounded medication has a higher potency range, an assay is even more necessary. Most commercial drugs are between 90% to 110% potency, however some of them may have a greater range of 80% to 120%. Physicians and pharmacists must be aware of these potency ranges and take them into account when creating compounded medications for pediatric patients, as they are more sensitive than adult patients to potency issues.
Dosages are particularly important for pediatric patients
One important consideration with pediatric patients is the fact that dosages must be carefully monitored. Many commercial medications are not suitable for children because the dosages are intended for adults. Also, they are often only available in pill format, and many pediatric patients cannot safely swallow pills. As a result, compounding pharmacies fill the important need of creating medications in an easy to administer form for children, particularly in the cases where the medication is only available for adult patients. At a compounding pharmacy, the dosage of each medication is carefully controlled by the pediatrician and pharmacist, and dosages can be split up for multiple doses throughout the day if necessary. The side effects of each medication can therefore be reduced, as each dosage can be monitored and controlled.
Every child has is unique and has a different dosage requirement, and the child’s age, weight and size must be taken into account when preparing medications. Commercial medications do not take this into account, and even when commercial medications are created for children they often are not accurate with their dosages based on the patient’s size and weight. Pediatricians can work with compounding pharmacies to create the exact dosage needed for each patient, which is particularly important when the medications being used are more potent or have stronger side effects. It allows the child’s doctor the utmost control over their treatment, which is particularly important for many pediatric patients as children are much more sensitive to medication ingredients and dosages.
Compounding pharmacies serve an important purpose in pediatric medicine by creating compounded medications that are in a suitable format and dosage level for pediatric patients, with carefully controlled ingredients. If you are a pediatrician or pharmacists interested in how Absolute Pharmacy can create compounded medications for use in your practice, please visit our physician enrollment page for more information.