Compounded Medications: 5 Tips to Maximize Their Benefits
Sponsored by Covetrus
Veterinarians regularly use compounded medications to treat a variety of conditions in dogs and cats. Compounded medications can offer significant benefits, especially when there is not a commercially available alternative for patients; however, obtaining the maximum benefits of compounded medication requires careful attention to numerous factors.
To maximize success with compounded medications, follow these 5 tips.
Tip #1: Identify Situations When Compounded Medications Can Be Beneficial
Compounded medications should be considered when there is not an appropriate FDA-approved drug available for a given patient. In many cases, an FDA-approved drug is not available in the appropriate dosage, and in other cases, the FDA-labeled drug may contain an ingredient that would be toxic to the pet (eg, xylitol) or a certain FDA-approved drug may present problems with client compliance. For example, a client who cannot administer pills to their pet may need to have their pet’s medication compounded into an oral suspension. All 3 of these scenarios can be addressed using compounded medications, providing a means to safely and effectively deliver a specific dose of medication to a patient.
It is important to note that cost savings alone is not a valid reason to prescribe a compounded medication. Compounded medications should only be used when medically justified.
Tip #2: Set Appropriate Client Expectations for the Purchase of Compounded Medications
Clients may be accustomed to refilling prescriptions through their veterinarian in a matter of hours or even minutes, as this can typically be done very easily when dispensing FDA-approved medications that come in convenient packaging (eg, parasite prevention). Compounded medications, however, are created on request for an individual patient. Preparing these medications and shipping them to the client may take several days. This process should be explained to clients when discussing compounded medications, as this can help set reasonable expectations and potentially increase client satisfaction with compounded medications.
Tip #3: Maintain Active Follow-Up
Like any other prescription medication, compounded medications require veterinary monitoring. Veterinary teams should work proactively with clients to schedule regular follow-up visits for patients receiving chronic medications, especially those receiving compounded medications, as this allows the veterinary team to assess the pet’s response to therapy and make dosage changes as needed. Regular rechecks also offer an opportunity to discuss treatment concerns and determine whether a change in formulation, flavor, or other factors may be needed to improve compliance.
Tip #4: Understand Federal & State Guidelines Surrounding Compounded Medications
Understanding both federal and state guidelines for the veterinary use of compounded medications is an important step in their successful use. In 2023, the United States Food and Drug Administration’s Guidance for Industry (GFI) #256, titled “Compounding Animal Drugs from Bulk Drug Substances,” took effect, providing additional guidance for veterinarians in the use of compounded medications.1
One important guideline in GFI #256 discusses office stock medications, which are those kept in-clinic for use rather than compounded for a specific patient. Many veterinary practices have historically kept compounded medications in stock to dispense to patients for client convenience, and GFI #256 offers more detailed guidance around these limitations, including which bulk drug substances can be used to create compounded office stock medications.2 More frequently asked questions surrounding these updated guidelines can be found here.
In addition to the requirements outlined in GFI #256, veterinarians should take time to familiarize themselves with the regulations of their specific state board of pharmacy.
Tip #5: Use a Trusted Compounding Pharmacy
When selecting a compounding pharmacy, it is important to carefully research that pharmacy’s policies and reputation. Although human pharmacies may offer compounding services, using a veterinary compounding pharmacy can limit risks to patients.
When selecting a compounding pharmacy, consider the following questions:
Is the pharmacy involved with and dedicated to the veterinary community?
Is the pharmacy licensed in your state?
Is the pharmacy accredited by the Pharmacy Compounding Accreditation Board (PCAB)?
Does the pharmacy comply with United States Pharmacopeial (USP) Convention standards?
Covetrus® Compounding Pharmacies meet all of these standards. Covetrus is actively involved in the veterinary community, licensed in all 50 states, accredited by the PCAB, and complies with all USP Convention standards. In addition, Covetrus has a pharmacy team of >800 members. With the help of these team members, Covetrus actively monitors their compounding facilities closely for quality assurance for the benefit of all patients.
Conclusion
Compounded medications play a crucial role in providing optimal care to veterinary patients. Knowing when and how to utilize these medications is key for meeting the unique needs of the animal population without sacrificing the quality of care. Partnering with a knowledgeable compounding pharmacy can provide valuable guidance on the compounding process, benefitting both the veterinary team and pet owners.
