FAQ's (Frequently Asked Questions)
Does compounding require a prescription?
How do I go about obtaining a compounded prescription?
I know I need it but my doctor won't let me try it.
Can I talk to a pharmacist when I want to?
How are my compounded medications shipped?
Definition of Compounding:
Prescription "COMPOUNDING" is the pharmacists' art of preparing custom
medication for the unique needs of a specific patient. It has to be on
the orders of a health care professional with a license to prescribe.
Its preparation has to be overseen by a licensed pharmacist in a
licensed pharmacy. Unfortunately, this definition suggests that when a
pharmacist prepares a custom formulation for a hospital or physicians'
office it is not legally considered a compound because it is not for a
specific patient. It might even be considered "manufacturing" if done in
large quantity. The term "unfortunately" is used here because there is
great need for what a compounding pharmacist can provide to a clinic. In
a clinic situation, certain products can be very useful but not
available on a specific patient basis because the need is not realized
until the patient is in the clinic. For example, Acology has prepared an
LAT solution containing Lidocaine, Adrenalin, and Tetracaine. This
product can be used in an office for anesthetizing skin after an injury
and during suture procedures. No pharmaceutical manufacturer makes it
and since a patient does not know he/she needs it BEFORE an injury, how
can it be ordered and available when the clinic needs it. There are
hundreds of other such examples but we will not go beyond this one. It
is a problem for the medical community and regulators to solve. If you
are a patient, you should not have any trouble obtaining a compounded
prescription specifically for your needs.
Return to index
Prescription requirement for compounds
Compounding is done on an order from a health care practitioner that is
licensed to prescribe. Even if the chemicals used do not require a
prescription, compounding by definition requires an order from a
licensed prescriber. Otherwise, it is manufacturing. Most compounding
pharmacies do not have a license to manufacture- only to compound.
There are some gray areas here however. If the ingredients are available
by prescription only, the usual prescription order for a compound is
required. If the ingredients are available without a prescription but
are classified as drugs, then again a prescription is required. Any
chemical that "modifies body function or structure" is considered by the
FDA to be a drug. They may be OTC (over the counter) and not require a
prescription, but are still a drug. Therefore, they can either be
prepared as a compound by prescription or by manufacturing which
requires FDA manufacturing permits and licensure.
However, if the ingredients are considered "natural" and are not
considered drugs, you could make up the mixture in your own kitchen sink
and sell it. (Many companies take advantage of this unregulated area of
manufacturing so be careful). The gray areas regard natural drugs.
Progesterone for example is a drug. It carries a federal legend and is
USP (United States Pharmacopoeia). It modifies body function (can
regulate menses, pregnancy etc etc.). However, many companies are
selling it without a prescription because it is "natural". The product
strength is usually very low so as to not affect a body function that
they might later be held liable for if something goes wrong. But if the
strength is low enough to not affect body function is it of any value?
If it does not affect body function does it actually have any
progesterone in it at all???? Our advice is to go through the added
effort to obtain medications from a licensed compounding pharmacy with
the approval of your other health care providers.
Return to index
Obtaining a compounded prescription:
We are here to provide you with your next prescription that requires
compounding. It is quick and easy to become one of our patients.
We need the following: (all of which can be faxed or called in by
telephone via our toll free #)
Patient Name
Date of Birth
Address (complete)
Phone Number (home and daytime if different)
Allergies
Credit Card #
And of coarse we need the order from your practitioner. This can be
called in, faxed, e-mailed or mailed. In most cases, we will have to
call to verify the Rx but that is just a regulatory formality that we
can take care of.
Hopefully, this web site will offer a lot of the information that your
practitioner needs to create an order for you. However, we are always
available to help consult with your prescriber (via e-mail or toll free
telephone) to help him/her to write the correct order for you. You might
be able to help him or her by printing some of the pages from this site
that pertains to your needs. Our information regarding Bio-identical
Natural Hormone Replacement Therapy could be of great help if that is
what you need.
Resistance and turning the tides of
conventional wisdom
Some physicians are a little slow to come around. They like the
"evidence" presented by the sales reps of the big drug manufacturers. We
respect that. However, considering how many pharmaceutically
manufactured drugs have been withdrawn from the market due to safety
issues, one must wonder about all that great evidence that was paid for
by the manufacturers. Not to mention retracted claims. No drug therapy
is perfect and safe for everyone. Physicians need to feel comfortable
with what they are ordering. If you have a different practitioner order
a compounded prescription for you, let your regular one know what you
are doing. In all but a few rare cases, they will want to watch and
monitor your results. Given time and good results, your practitioner may
come around and want to start ordering for you and their other patients.
It's another way to spread the good word.
Return to index
Cost issues
Prescription compounding typically costs a little more than manufactured prescriptions. Sometimes a lot more- depending on complexity, availability, equipment required to prepare and time spent on research and development.
Fortunatly, most health insurance companies recognize the value of compounded prescriptions and the expected long term outcome they can offer. If a compounded prescription is better tolerated there will be better patient compliance and therefore more effective treatment. Compounding allows a practitioner to offer dosage form and strength that is best for an individual patient. The concept of one-dose-fits-all is for the convenience of large pharmaceutical companies, not for the patient. Think about it- is it reasonable to think that a 100 pound 50 year old should have to take the same dose as a 135 pound 35 year old? Should a patient be forced to take a product that is potentially harmful in some respects but helpful in others? Not if there is a better solution to be had through compounding. Compounding can save health care dollars in the long run by helping patients be healthier.
Back to pricing. Pharmaceutical manufacturers have the ability to mass produce large quantities of the same product. Economy of volume plays into this. Compounded medications are tailored to each individual. In our practice, we have prepared hundreds of different strengths and combinations of estrogen, progesterone and testosterone. The most frequently prescribed pharmaceutically manufactured estrogen (Premarin) comes in 4 strengths with 2 variations in combination. There is no way a compounded estrogen in its many forms and combinations can be produced for the same amount of money. How much more? A monthly course of combination estrogen + progesterone + testosterone costs between $45 and $100 or more depending on strength, dosage form, ingredient choice and ratio and delivery device. If price is an issue, talk to us. We can suggest ways to trim expense. For example (again with natural hormones) a sublingual drop can be much less expensive than an absorption enhanced cream because of inactive ingredient cost, time to prepare, and lower necessary strength of active ingredients. If price is not an issue, lets try for convenience, accuracy, therapeutic results and least amount of side effects. IT IS DIFFICULT TO PUT A PRICE ON HEALTH AND WELL BEING.
We offer a toll free number that you can use to call in refills, ask questions, and even talk to a pharmacist. The toll free number is available 24 hours a day for your convenience to leave messages and refill requests. If you would like to talk to a pharmacist, you will need to call between 8AM and 5PM Monday thru Friday. Although we pharmacists love to talk to our patients, we do need to work on our compounds so please be patient with us if we need to call you back to councel with you. Our toll free number is 800-240-8958.
Shipping
We pay the shipping. We usually ship within 24 hours of receipt of order request.
How long does it take?
Refill orders are usually shipped same day order is received. New orders may take a little longer especially if we need to confer with physician. We try to maintain a 2 to 3 day delivery time.
Re-orders
Call us a few days to a week before you need your next refill and we will ship it off to you. We also offer a free auto-ship program if you request it. This simply means that we will automatically refill your prescription, bill your credit card and then ship your order when it is due for refill. We only do this if you ask us to.