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Compounding Prescriptions

What Is Compounding Puppy Medicines?

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Compounding Prescriptions

Puppies require much smaller doses than standard prescriptions for adult dogs, so compounding can be a great benefit for puppies.

Image © Amy Shojai, CABC

Puppies often need pet medication, but it can be hard to give puppy prescriptions unless pharmacy compounding makes it tastes good to the puppy. Even if you know how to medicate your puppy, you can make it easier on both yourself and the baby dog. After all, would you rather argue with him and have to restrain him in order to get him to take a pill, or have him lap it up like a treat? Compounding can be the answer.

In the beginning the doctor wrote the prescription and the pharmacist prepared (compounded prescriptions) as medicine on an individual basis for the patient. Pharmacists kept all the necessary ingredients and mixed up the proper combinations on an as-needed basis. “Compounding is the foundation of pharmacy,” says Alton Kanak, a Houston pharmacist, “but over the years, modernization has resulted in most medicines being manufactured.”

Mass production of pills, liquids, injections, salves, and ointments in a wide range of strengths has been driven by a demand for convenience, and this has changed the face of pharmacy. Today, the giant pharmaceutical companies provide the lion’s share of prescription medications.

“A resurgence in compounding started about 10 to 15 years ago when they found there was a void in specialized items that you couldn’t get in manufactured products,” says Kanak. “Veterinarians especially have a limited formulary of drugs made for animals in the dosage form and strength that they need,” he says. That means veterinarians often must scale down dosages from manufactured strengths, especially for the off-label use of human medicines.

For instance, a puppy dosage of a standard-size form might be an eighth of the pill, while a horse or giraffe dose could be several bottles of tablets. Also, pets that are already sick rarely benefit from the added stress of being force-fed pills or liquids they dislike. “Owners wonder if it’s worth it to risk getting bitten, or putting the pet through so much. And you don’t always know if she really swallowed the pill,” says Kanak.

The compounding pharmacist takes the veterinarian’s prescription and creates the proper dose for the individual pet, often in a flavor or form—such as fish-flavored paste—that the pet takes like a treat. “You make the dosage fit the patient, as opposed to the patient having to fit into the dosage that’s already made,” says Kanak.

Today pharmacists compound medicine for puppies in tasty flavors and unique delivery systems that make treating the dog painless and easy for both the puppy and the pet parent. This is more than simply hiding a capsule in a hunk of cheese. For instance, medicated "pup-cicles" and "loli-pups" can contain antibiotic or pain relief for a pup with mouth burns from chewing through an electric cord.

Specialized equipment and access to the drug chemicals are required. “None of the chain pharmacy stores do compounding,” says Kanak. “The specialty remains a very limited practice within the independent pharmacists.” However, some individual veterinary practices do formulate special medications for their clients on a limited basis.

Few pharmacists are equipped to compound prescriptions. Compounding is no longer taught in pharmacy school, and there are only a few major training centers in the U.S. One of the largest is Professional Compounding Centers of America (PCCA), located in Houston. Another, National Association of Compounding Pharmacists, offers a three-day training period, access to all their formulas, and opportunity to consult with their Ph.D. researchers and pharmacists.

Today, you don’t need to have a compounding pharmacy in your city to benefit from the expertise. Most prescriptions can be filled with a phone call from the veterinarian and shipped directly to the pet owner.

Standing orders for ongoing medication can be filled on a monthly basis, for convenience. “Controlled drugs require the pharmacist to have the original prescription in hand,” says Kanak, “but we can fill the prescription on the basis of a faxed signed prescription as long as we receive the original in the mail.”

Compounding pharmacies also fill prescriptions via the Internet, he says. Shipping takes one to two days, as requested.

Depending on the particular prescription, compounding may be more or less expensive than manufactured medicine, and offers options that otherwise are not available to veterinarians and their clients. “If an animal will be on the medicine for the rest of his life, compounding a large quantity cuts the price down drastically,” says Kanak.

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