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10 Answers To Common Questions About Veterinary Compounding

Published on 4/9/21

 

The popularity of compounding medications on the human side has risen and fallen over the years. However, the popularity of compounding on the veterinary side is here to stay due to all the variation of species and animal sizes within each species. This creates the need for a wide range of medication dosages as well as dosage forms that simply aren't available in manufactured products.

There are many things to keep in mind regarding veterinary compounding. Information isn't always black and white and can vary by state. To help give some clarity to the topic, we've compiled 10 important things you need to know!


Q: What is compounding?

A: Compounding is preparing a unique product for a specific patient based on a prescription. Compounded medications are not FDA approved products. They are also not generic versions of approved products. All compounded medications fall under off-label or extra-label drug use (ELDU).

 
 

Q: Who can compound?

A: Legally, both veterinarians and pharmacists are allowed to compound. However, most veterinarians choose to have their compounds prepared at compounding pharmacies.


Q: Can I choose to compound a commercially available medication? For example, I want to compound a medication that is commercially available because it will be cheaper for the pet parent.

A: No, compounded medications can't mimic commercially available products. Price alone is not an approved reason to compound a medication.


 

Q: Does it matter which compounding pharmacy I choose?

A: YES! Not all compounding pharmacies are created equally. Some compounding pharmacies utilize stricter quality control measures. It’s very important to evaluate them before sending prescriptions. Here are some questions you can consider when choosing a compounding pharmacy:

  • What credentials does the pharmacy have for preparing veterinary compounds? Does the pharmacy use high quality components for compounding? What kind of quality, stability, and efficacy assurances can they provide? Do they use USP quality control? How do they determine the beyond-use-date on the compounded product? It should be based on the USP beyond-use-dating guidelines in chapters <795> and <797>.
 

Q: Can I expect the same potency, purity, and stability from compounded medications as I can with commercially approved products?

A: Not necessarily. Manufacturers of commercially available medications spend millions of dollars to develop medications. The extensive development allows for formulations that offer uniform potency, purity, stability, etc.

Compounded medications cannot offer the same guarantees as commercially available products. That makes it even more important to critically evaluate each compound before prescribing it.


Q: What about compounding medication for office use?

A: Obviously veterinarians can't always anticipate which patients will need which medications. Not every patient who is prescribed a compounded medication will be able to wait until the medication is shipped from the compounding pharmacy.

In these cases, a veterinarian may prefer to have the compounded medication on hand to dispense to their patients at their appointment or other times when necessary. Unfortunately, compounding medication for office use isn't legal in all states. You should consult your individual state's laws.

 
 

Q: I'm prescribing an oral compounded medication. Is flavoring an option?

A: Yes! Depending on the instance, flavoring can be added to compounded medications. Flavoring can help increase compliance for pets. When considering options for flavoring, taste is not the only thing you should consider.

Color and smell can impact the flavor experience as well. Pets can be more sensitive to smells than taste. Plus, different medications will have different inherent flavors and odors. It is recommended to correlate flavoring with the medication's natural characteristics. For example, sour tasting medications would go well with a bitter flavor such as citrus.

It's a good idea to consult with the pet owner who will most likely know if their pet fits the flavor stereotypes. For example, a cat may prefer a marshmallow flavor instead of fish.


 

Q: Who's in charge of the compounded medication patient instructions?

A: Ultimately - the veterinarian. On the human side, doctors can depend on the pharmacist to counsel patients when they pick up their medications. However, veterinarians won't be able to rely on the pharmacists to counsel the pet parent.

Most pharmacists aren't sufficiently trained to teach pet parents how to administer medications to resistant patients, explain potential side effects, or address any other issues. Be sure to cover all pertinent prescription information with the pet parent. Let them know who to contact with questions or prescription refills.

 

Q: Why are some compounded medications so popular right now?

A: Continued backorders on certain commercially available medications have caused a spike in sales of compounded medications. Sometimes, when these medications go on backorder, veterinarians have other acceptable substitutions. However with some medications, like pimobendan and carprofen Injection, veterinarians prefer to look at compounded options.


Q: What is Beyond-Use Dating?

A: Compounded medications don't have the same "expiration dates" as manufactured products. Instead, compounded medications have Beyond-Use Dating (BUD). BUDs indicate the date which the product should not be used after.


Q: How can I order compounded medications?

A: You can purchase compounded medications directly on pennvet.com! This service is available in approved states only. To see the list of approved states click here.

 

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