What speciality in Pharmacy does the most compounding?

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Snoopy92

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Recently I've been thinking about what I like the most about both medicine and pharmacy as a start to finding the right career. While researching about pharmacy I stumbled upon compounding and it really caught my interest. What specialty does the most compounding, and is it anything like I imagine where you're mixing/removing chemicals to suit the patient's preference?

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Well... compounding pharmacy is a specialty. Compounding pharmacies do nothing but compound medications (veterinary services are also commonly a big component of many compounding pharmacies).
 
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So is compounding the specialty that creates the drugs? Such as if a certain IV or pain medication is needed, I would make it? Or is it like you already have the drug from a company and have to modify it, which is then sold to stores/pharmacies/hospitals? Is it like lab work where you have to grow cultures or do PCR for hours and prepare mixes of the same thing everyday?
 
I doubt it's like doing pcr. You typically compound drugs and drug formulations that are not commercially available.
 
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So is compounding the specialty that creates the drugs? Such as if a certain IV or pain medication is needed, I would make it? Or is it like you already have the drug from a company and have to modify it, which is then sold to stores/pharmacies/hospitals? Is it like lab work where you have to grow cultures or do PCR for hours and prepare mixes of the same thing everyday?

Here's an example of a successful compounding pharmacy "chain" in Iowa/Illinois areas:

http://www.nucara.com/

The president is a really nice, down-to-earth guy and can answer questions too if you want to email him. I don't work for NuCara or anything, but I had an interview with the president when he came to our campus for job fairs.

[email protected]
[FONT=Arial,Helvetica,sans-serif]TJ Johnsrud
NuCara Management Group, Inc.

126 N. Main St., PO Box 640

Conrad, IA 50621

office phone: 641.366.3440 Ext 31

cell: 515.290.1050

.
 
So is compounding the specialty that creates the drugs? Such as if a certain IV or pain medication is needed, I would make it? Or is it like you already have the drug from a company and have to modify it, which is then sold to stores/pharmacies/hospitals? Is it like lab work where you have to grow cultures or do PCR for hours and prepare mixes of the same thing everyday?
Create as in create the active ingredient? No, that is not compounding.

Compounding as a specialty usually deals with changing dosage forms or medications that are no longer available. Compounding pharmacies "make" drugs only after receiving a prescription and sell the product directly to the patient.

(Compounding medications without a prescription in anticipation of a prescription based on historical trends is allowed depending on state law, but no large-scale compounding is permitted or you cross into manufacturing)
 
So is compounding the specialty that creates the drugs? Such as if a certain IV or pain medication is needed, I would make it? Or is it like you already have the drug from a company and have to modify it, which is then sold to stores/pharmacies/hospitals? Is it like lab work where you have to grow cultures or do PCR for hours and prepare mixes of the same thing everyday?

Would that be like compounding an Anthrax infusion?

Compounding is actually pretty similar to baking, if you ask me. You're asked to make a product (cream/brownie) and mix a bunch of ingredients (petrolatum, acyclovir, lidocaine/eggs, sugar, chocolate), then you get your end result. Only difference is that one is for herpes and the other is delicious.
 
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Create as in create the active ingredient? No, that is not compounding.

Compounding as a specialty usually deals with changing dosage forms or medications that are no longer available. Compounding pharmacies "make" drugs only after receiving a prescription and sell the product directly to the patient.

(Compounding medications without a prescription in anticipation of a prescription based on historical trends is allowed depending on state law, but no large-scale compounding is permitted or you cross into manufacturing)

Well I guess what I'm asking is whether or not compounding is more like "Alright this person needs XXXXXX medication, let me go get the ingredients mix them together and create that." vs something like going into your job and thinking "Alright I'm going to create the same part of the medication that I do everyday, like an assembly line." I figure that it's possible that you're going to be creating the same medications for some part of your job but there would still be some differences in everyday work right?
 
Well I guess what I'm asking is whether or not compounding is more like "Alright this person needs XXXXXX medication, let me go get the ingredients mix them together and create that." vs something like going into your job and thinking "Alright I'm going to create the same part of the medication that I do everyday, like an assembly line." I figure that it's possible that you're going to be creating the same medications for some part of your job but there would still be some differences in everyday work right?

It's not the same thing every day. Let's say a physician wants a patient to get a drug in a strength that is not made commercially. You would take ingredients that are prepared commercially and prepare the final product.
 
Well I guess what I'm asking is whether or not compounding is more like "Alright this person needs XXXXXX medication, let me go get the ingredients mix them together and create that." vs something like going into your job and thinking "Alright I'm going to create the same part of the medication that I do everyday, like an assembly line." I figure that it's possible that you're going to be creating the same medications for some part of your job but there would still be some differences in everyday work right?

Most have certain compounds they prepare all the time and are known in the community to supply. Then, you would do those special ones that are patient specific that require a certain dose that has to be made.
 
Pharmaceutical chemistry....... synthesis of active ingredients.
Pharmaceutics.......................Compounding of active ingredient into patient ready formulation.
Pharmaceutical engineering........ All the various process machinery and equipment required.
Microbiology..........use of living organisms.
Pharmacology...........Study of action of active molecules etc.
Pharmacognosy...........study of botanicals.

For my final year I took Pharm Chem and Pharm Eng.
johnep
 
It's not the same thing every day. Let's say a physician wants a patient to get a drug in a strength that is not made commercially. You would take ingredients that are prepared commercially and prepare the final product.

I have no clue what sparda is talking about...

I spent 6 weeks making estrogen cream. Sometimes it was estradiol. Sometimes it was a gel... But it is the same approximate 35 drugs over and over again.

Levothyroxine, estrogens/progesterone lozenge/cream/gel/whatever, methimazole, tamiflu (when we are back in season), Triple P injections... that's about 90% right there.

It's interesting work, but I wouldn't say it has a lot of variety. Certainly less than a typical retail store.
 
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I have no clue what sparda is talking about...

I spent 6 weeks making estrogen cream. Sometimes it was estradiol. Sometimes it was a gel... But it is the same approximate 35 drugs over and over again.

Levothyroxine, estrogens/progesterone lozenge/cream/gel/whatever, methimazole, tamiflu (when we are back in season), Triple P injections... that's about 90% right there.

It's interesting work, but I wouldn't say it has a lot of variety. Certainly less than a typical retail store.

How does working in retail provide for more variety? I've always read that retail was probably the most boring part of pharmacy. I have a few more questions about a compounding specialty in pharmacy. Is getting a specialty anything like in medicine where you have to go through residency after 4 years of medical school? How much do compounding pharmacists usually make? Are there any other specialties within pharmacy that have compounding but might have more variety and is rarely boring?
 
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I have no clue what sparda is talking about...

I spent 6 weeks making estrogen cream. Sometimes it was estradiol. Sometimes it was a gel... But it is the same approximate 35 drugs over and over again.

Levothyroxine, estrogens/progesterone lozenge/cream/gel/whatever, methimazole, tamiflu (when we are back in season), Triple P injections... that's about 90% right there.

It's interesting work, but I wouldn't say it has a lot of variety. Certainly less than a typical retail store.

Sounds like nuclear where you essentially compound ~30 or so drugs.
 
I was essentially an errand boy for a compounding pharmacy... they had quite a bit of variety. They do compound a lot of hormone creams/gels, but they also get a lot of veterinary prescriptions and pain medication. They'll make gummies containing gradually decreasing amounts of a narcotic to ween someone off, for example. They also did a fair amount of a medicine for nail fungus, but the name escapes me. The pharmacist also did a lot of work under a hood. There were two patients in particular who had an optical solution compounded for an infection they got by sharing contact solution. It's definitely something I would consider after graduation.
 
I was essentially an errand boy for a compounding pharmacy... they had quite a bit of variety. They do compound a lot of hormone creams/gels, but they also get a lot of veterinary prescriptions and pain medication. They'll make gummies containing gradually decreasing amounts of a narcotic to ween someone off, for example. They also did a fair amount of a medicine for nail fungus, but the name escapes me. The pharmacist also did a lot of work under a hood. There were two patients in particular who had an optical solution compounded for an infection they got by sharing contact solution. It's definitely something I would consider after graduation.

Sounds really interesting haha. What were the hours that the pharmacists worked like?
 
Sounds really interesting haha. What were the hours that the pharmacists worked like?

Fairly standard: 9-5 M-F and 10-2 on Saturdays. They had an older pharmacist (one of the co-founders of the pharmacy, the business is ~40 years old) take one shift a week. It was a pretty chill place to work and I got to be good friends with the pharmacist. If you have a compounding specialty pharmacy nearby (I'd guess that most mid-sized cities will have them), they'd probably love to have you shadow.

I got weird looks from cashiers at the grocery stores they sent me to because I'd be buying 5 and 6 bags of dog treats at a time for them to mix with medication. Also, compounding pharmacies typically don't take insurance since there aren't many around. Most large hospitals have a dedicated compounding pharmacist too- my friend's dad is one and absolutely loves his job.

Edit: Actually, I just Googled them. They registered with the Better Business Bureau since 1960, so they're at least 51 years old. Cool.
 
I have no clue what sparda is talking about...

I spent 6 weeks making estrogen cream. Sometimes it was estradiol. Sometimes it was a gel... But it is the same approximate 35 drugs over and over again.

Levothyroxine, estrogens/progesterone lozenge/cream/gel/whatever, methimazole, tamiflu (when we are back in season), Triple P injections... that's about 90% right there.

It's interesting work, but I wouldn't say it has a lot of variety. Certainly less than a typical retail store.
Have you come across a recipe that has a > 8 day stability for levothyroxine susp?
 
They'll make gummies containing gradually decreasing amounts of a narcotic
As if narcotics weren't addicting before, now you go and make them delicious.
 
Sounds like nuclear where you essentially compound ~30 or so drugs.

Less risk :xf: As long as you wear gloves while making the estrogen whatever.

Have you come across a recipe that has a > 8 day stability for levothyroxine susp?

Hmmm... I honestly don't remember. In hindsight, we did plenty of dessicated thyroid caps. Not sure about the levo susp.
 
Compounding is great! I volunteered at a vet school pharmacy and it was great. I made hundreds of tylosin tablets- darn dogs will never learn to not eat everything!:eek:
Watching them formulate chemo was cool, but when they told me what some of the drugs could do to me just from contact, I decided to never touch the fridge where they kept the poison.
I love the earlier example that its like baking: there's a perfect combination of ingredients for everyone.
 
I really appreciate the responses from everyone. Its rare that I actually read something positive about either pharmacy or medicine on these boards. Do I have to be a pharmacy technician to be able to shadow or volunteer at a compounding pharmacy?
 
I really appreciate the responses from everyone. Its rare that I actually read something positive about either pharmacy or medicine on these boards. Do I have to be a pharmacy technician to be able to shadow or volunteer at a compounding pharmacy?

To shadow, no. If you want to get your hands a little dirty, you'll have to be hired on. Certification isnt necessary initially.
 
look into PCCA for resources. THey are headquartered in Houston.
 
What is the average salary of a compounding pharmacist?
 
Compounding Pharmacies prepare medicines under the guidance of physicians according to the needs of patients.Yes, they prepare medicines or drugs by compounding different medicines and you can also get desired dose of medicine here that is not available at regular pharmacy.
 
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What specialty does the most compounding...?

Compounding...

What is the average salary of a compounding pharmacist?

Depends on if you own your store or just work at it. We have a compounder around our area of the state that has multiple stores and has a niche that they work to fill (hormone replacement products). They actually do patient consults and physician referrals, suggest the formulation to the physician, then compound it specifically for the patient. They seem to be doing quite well.
 
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